HomeMy WebLinkAbout01-0248
Social Security No.
PETITION FOR PROBATE & GRANT OF LETTERS
No. 21-01-.:L. 't ~
To: Register of Wills for the
County of Cumberland
Commonwealth of Pennsylvania
Estate of MYCHAILO KOMESZ
also known as
, deceased.
176-26-0678
The Petition of the undersigned respectfully represents that:
Your Petitioners, who are 18 years of age or older and the Executors named in the Last Will of the
above decedent dated October 18 . 1994, and codicils dated none, 19----2. The
Executor named Maria Komesz died November 24. 1999. Renunciations for
none attached hereto.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal
residence at One Chestnut Street. Mt. Holly Sprinas Borouah
Decedent, then ~ years of age, died January 24 ,2001, at
Carlisle Hospital
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the Will offered for probate; was not the victim of a killing and was never adjudicated
i ncom petent:
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(If not domiciled in PA) Personal property in PA
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania, situated as follows:
One Chestnut Street. Mt. Holly Sprinos Borouoh, Cumberland County
$138,000.00
$
$
$89,000.00
WHEREFORE, Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented
herewith and the grant of letters testamentary thereon.
~ature(s) and Residence(s) of etitione~s):
Om ro
1408 r Road
ReadinQ. PA 19611
610-372-4806
/j1~7~~
;O/~ 7<"~
Mvchael Komesz a/kJa
Mvchael Komesz Jr.
3315 Biolerville Road
Biolerville, PA 17307
OATH OF PERSONAL REPRESENT A TIVE
COMMONWEALTH OF PENNSYLVANIA
ss
COUNTY OF CUMBERLAND
The Petitioner(s) above named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of Petitioner(s) and that as personal representative of
the above decedent, petitioner(s) will well and truly administer the estate according 0 law.
Sworn to or affirmed !;['d subscribed ~ lJ"-.
b.ef~re me thi~ ~ . day of Dm ro Ko e z
t.n~ljdUJ . 2001. ~
<rt;Q;y~ JG<,';'" ctli... t?O.~,dUJ ~.
. / Registef ~ r
/(;, _ ~ I)": .L
No. 21-01- 248
Estate of
Mychailo Komesz
, deceased.
DECREE OF PROBATE & GRANT OF LETTERS
AND NOW, March 6, , 2001, in consideration of the Petition on the reverse side
hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated
October 18, 1994 described therein be admitted to probate and filed of record as
the Last Will of Mvchailo Komesz ; and Letters Testame~ are
hereby granted to Dmvtro Komesz and Mvchael Komesz a/kJa Mvchael Komesz Jr.
'TY}O,;/': ,;(;nd. ~. ~a ~~'9 J4-J/4-
Re ister of Wills
IRWIN McKNIGHT & HUGHES
FEES
Probate, Letters, Etc. . . . . . . . $ 270.00
Short Certificates(-3- ) . . . . $ 9.00
Renunciation(s) ..... . . . . . . $
JCP . . . . . . . . . . . . . . . . . . . . $ 5.00
Other Will Paqes (-3-) .... $ 9.00
TOTAL: .... $ 293.00
Filed. .MAE-ClI. P". .2.QQ~............
James D. HUQhes, Esquire (58884)
ATTORNEY (Sup. Ct. I.D. No.)
60 West Pomfret St., Carlisle. PA 17013
ADDRESS
717 -249-2353
PHONE
CALLED ATTORNEY MARCH 7, 2001
'lw is to certify that the information here given is correctly copied from an original certitlcate of death duly filed with me as
IX;I] Registrar.' The original certificate will betorwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
~~:a~~~~
Fee f(H this certifIcate, $2.00
p
6948076
JAN 2 6 2001
Dale
05. ~ 4J R"" 2187
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
AGE ILa.. 8"""'.y)
88
UNDER 1 YEAR
Montna Days
SEX
2. Mate.
STATE FILE NUMBER
SOCIAL SECURITV NUMBER
3.176 -26
OAT E OF DEATH ,M"""'. D.~.""'''
a. 1/24/2001
NAME OF DECEDENT jF<", M_o. C....I
1. Myc.n.a.<.to KomeJ.>z
v".
UNDER 1 DAY
_ ! Minut...
81RTHPLACt IC..., and
R Os;;,a."h~lf Ceu>hVI
::".,.,0
" '
-<.\
$.
COUNTV OF OEJITH
Cumbvrtand
PlACE OF oe,qH fC~k oNy f)f"Ie ~- iee ,nstrUC;11()OS on ott"et ,..,.)
HOSPITAL:
Inpolienl ~ E~i.... 0
7. ...
FACIUTV NAME 111 nol """,'''''''''. QMl..... and numb."
Cakt.<.J.>te HOJ.>p.<.tat
RACE - Amencan Indi.". 8lat;k, 'Nh~.. etc.
1Sl>ec*t' Wh..i.te
lit.
Ie.
10.
DECEDENT'S USUAL OCCUPATION KIND Of' BUSINESS/lNDUSTRY
((;;j':",,~ Mf':!'~ ':: ::~:'f
. IlL LabMVr 1111. Manu 6 ac.tuk..i.ng
DECEDENT'S MAILING ADDRESS (SIrNl. CIlyIlOwn. _. Z'f) COde) DECEDENT'S
1 CheJ.>tnut St. ~~~~NCE
Mt. Hotty Spk..i.ngJ.>, PA 17065 ~;~
WAS DECEDENT EVER IN
U.S. ARMED FORCES?
.....0 No~
17b.Cou CumbC'Jrland
[);d
--
Mini
-..ship? l1d.!]' :;"'~:'::o'
MOTHER'S NAME (F"I. ModdIe. M_ Surn.tme,
11. MaIt.<.a Ha.<.d k.
INFORMANT'S MAIlING ADDRESS ISh.... Cilyfl'own. Slala. Lop c.-,
~,1 CheJ.>nut St. Mt. Hotty Spk..i.n J.>, PA 17065
PlACE Of' DISPOSITION. Name Of C_ery, Cr.matooy lOCATION. CilyITown, Slat., Lip Cocle
Of 01"., Place
la.
l1e.0 Vaa.__in
MARITAL STATUS._
Ne_ Married. WicIowed.
w.ldo~e.r
SURvIVING SPOuSE
(If ..... 9'Y8 ma.oen name)
rwp
Cllyll>om.
RamonI_ StoIa 0
21e.St. FJraYlc..<.J.> Xav..i.ek
17325
-6 PA 1706
LICENSE NUMBER
2211.071589L
~Ol
24. , M.
27. PART I; Enter tNt diMases, infUrieS 01 comphUihons which caused lhe dealh. 00 not enter 1M mode of t1ying, sue" as cardiac 01 ,espn-alory .".st. shod&: or heal1 fa.....'.
List onPf one cause on ..en fine
PART II: 01"., signille.... _ con<riI>uling to doOlh, bul
nol resu"in9 in Iha UfIdattying ...... given in PART I
l ~t',-\~~ ~ i h.-
DUE TO (OR AS A CONSEOUENCE OF):
~\\:)~l:.~
v...Jt ~~~~q
\ :
DUE TO (OR AS A CONSEOUENCE OF):
DUE TO (OR AS A CONSEOUE NCE OF):
WERE AUTOPSY FINDINGS MANNER OF DEATH
-'l.AIIU PRIQA TO
COMPlETION OF CAUSE ~ 0
OF OEnH? _urlll Homcide
_nt POndlnq I"""Sliglllion 0
No '9:: v... 0 No 0 Suicida 0 Could not be dele""lned 0
DATE Of' INJURY
(Month. Day. ~ar)
TIME OF INJURY
INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED.
Vaa 0 NoD
288. 211I.
CERTIFIER IC"eck oniy onel
-CERTIFYING PHVStClAN IF*I~aan CP.t1~ cause d dealh 'Nher" anotf'\er phVSIC.an has pronounce<' oealh ana completed Item 23\
To the t>>at O. my II:nGwledoe. death accurn<l due to 1Pl. cause(.) and manner a. st..ted. . . . . . . . . . . . . . .. ...............
at.
308. 30ll.
PLACE OF INJURY. AI home. larm, str.... 'actory, orne.
buildln9. "c. lSpec.tv)
300.
t:\. ~~~~
~~I~\lal
03111.
. PRONOUNCING AND CERTIFYING PHYSICIAN (PhVSCl.3n 00tt'. ~::>nOunc::,ng death and cerlllYlng 10 cause of deattl\
To the b+I1 ot my knowl.dOl'!, d.alh occurred at the ,tine, date, .and pl.ce, and due to the UUH(S) and manner u staled
'MEDICAl EXAMINER/CORONER
On the basil of 1.lminlUon and/or investigation, in my opinion. death occurred at the lime, date, and place. and due to the CIUSe(l) and
manne' .s stated.. . . . . . . _ . .. . _ . . . . . . . . . , . , . , . . . . . . , . , , . . , . . . . . , . , . . . . . . , . . . . . . . . . . . . . . . , . . . , . . . . . . . . . . . , . . . . . . . . ,
310.
REGISTRAR'S SIGNATURE AN
o
all
ft
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,
21-01-248
LAST WILL AND TESTAMENT
I, MYCHAILO KOMESZ, of 1 Chestnut Street, Mt. Holly Springs, Cumberland
County, Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby make,
publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils
heretofore made by me.
ONE. I direct my Executor or Executrix, as the case may be, to pay all of my debts,
funeral and administrative expenses as soon as convenient after my decease. Furthermore, I direct
that all state, inheritance, succession and other death taxes imposed or payable by reason of my
death and interest and penalties thereon with respect to all property composing of my gross estate
for death tax purposes, whether or not such property passes under this will, shall be paid by the
Executor or Executrix of my estate.
TWO. My Executor or Executrix may, at his or her discretion, compromise claims,
borrow money, retain property for such length of time as he or she may deem proper; lease and
sell property for such prices, on such terms, at public or private sales, as he or she may deem
proper; and invest estate property and income without restriction to legal investments unless
otherwise provided hereunder. I authorize and empower my Executor or Executrix to sell any
realty and/or personalty owned by me at my death and not specifically devised or bequeathed
herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale
therefor, in fee simple, as I could do if living. My Executor or Executrix is authorized and
Ji. j{',
empowered to engage in any business in which I may be engaged at my death, for such period of
time after my death as seems expedient to said Executor or Executrix.
THREE. I give, devise and bequeath all of my estate of whatever nature and wherever
situate to my spouse, Maria Komesz.
FOUR. If my spouse, Maria Komesz, does not survive me by a period of at least sixty
(60) days, then my estate of whatever nature and wherever situate I give, devise and bequeath as
follows:
a) $15,000.00 to my granddaughter, Natalie Patricia Komesz; and
b) All the rest, remainder and residue thereof to my two sons, Mychael Komesz,
Jr. and Dmytro Komesz, share and share alike, and if either of them is deceased, their share shall
go to my granddaughter, Natalie Patricia Komesz; and
c) Notwithstanding the provisions of subparagraph 4(b) above, either Mychael
Komesz or Dmytro Komesz, as they shall agree, shall have a right of first refusal upon my death
to purchase the aforementioned residence at 1 Chestnut Street, Mount Holly Springs,
Pennsylvania, for a purchase price which shall be calculated using the fair market value of the
property at the time of my death or using such other amount as they shall both agree in writing.
The fair market value shall be determined by a certified appraisal of the property as of the date of
my death. In the event that neither of my sons are desirous of exercising this right of first refusal
to so purchase, then the property shall be sold and the proceeds therefrom distributed in
accordance with this my Last Will and Testament.
FIVE. I nominate and appoint my spouse, Maria Komesz, to be the Executrix of this my
Last Will and Testament. If my spouse has predeceased me, failed to qualify or is not able or
2
cJi. )C
does not serve for whatever reason, then I appoint Mychael Komesz, Jr. and Dmytro Komesz to
serve as Co-Executors of my estate having the same powers as the original Executrix hereunder.
SIX. No person(s) shall benefit hereunder unless such beneficiary shall survive me by
sixty (60) days.
SEVEN. No Executrix or Executor acting hereunder shall be required to post bond or
enter security in this or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day of
October, 1994.
1YUj ~ !(fJ /j1'LI/l V(SEAL)
MYCHAILO KOMESZ
Signed, sealed, published and declared by the above-named person as and for a Last Will
and Testament, in our presence, who at said person's request, in said person's presence and in the
presence of each other have hereunto set our names as subscribing witnesses.
0Ya4hcd'!~~
e~7~~ d~
3
, ,
ACKNOWLEDGMENT AND AFFIDA VIT
WE, MYCHAILO KOMESZ, SHARON L. SCHWALM and CHERYL L.
CLELAND, the testator and witnesses respectively, whose names are signed to the foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator
signed and executed the instrument as his Last Will and that he had signed willingly, and that he
executed it as his free and voluntary act for the purpose herein expressed, and that each of the
witnesses, in the presence and hearing of the testator, signed the Will as a witness and that to the
best of their knowledge the testator was, at that time, eighteen years of age or older, of sound
mind and under no constraint or undue influence.
2i!t ~ j( O./J11M-z-.--
MYCHAILO KOMESZ
I!M,U/)-L d'?y~
" SHARONL;SCHWALM
e~~.1&6I
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by MYCHAILO KOMESZ, the
testator herein, and subscribed and sworn to before me by SHARON L. SCHW ALM and
CHERYL L. CLELAND, witnesses, this 18TH day of October, 1994.
13kf ~}(h~lJ
Nota Public
Notarial Seal
Betzi A Mooison. Notary PurJic
Carlisle Bore, Cumberland County
My Commission Expires Dec. 15. 1596
Member, Pennsylvania Assooiation of Notaries
E
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
MYCHAILO KOMESZ
Date of Death:
JANAUARY 24, 2001
Estate No.:
21-01-0248
To the Register:
I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's
Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate
on March 22, 2001
Name
Address
Dmytro Komesz
Mychael Komesz
Natalie P. Komesz
1408 F arr Road, Reading, P A 19611
3315 Biglerville Road, Biglerville, P A 17307
1212 Village Crossing Drive. Chapel Hill. NC 27514
Date:
03/22/01
Notice has now been given to all persons entitled thereto unde
Carlisle. P A 17013
Telephone (717) 249-2353
Capacity:
Personal Representative
x
Counsel for Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
l
j
55:
Mychael Komesz, Jr. and Dmytro Komesz
according to law. deposes and says that they are the Co-Executors
of the Estate of Mychailo Komesz
late of _ Mt_~_J!~~!:Y_~J~_Fj-_n.~s__B_orou~!:_______ I Cumberland County, Pa., deceased and that the
within is an inventory made by Mychael Komesz, Jr. & Dm~tro Komesz _, the said Co-Executors
of the entire estate of said decedent, consisting of all the personal prop~rty and real estate, except real estate outside
the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedent's death.
being duly
sworn
Sworn
and subscribed before me,
Mychael Kanesz,
Co-Executor
3315 Biglerville Road
Biglerville, PA 17307
1408 Farr Road
Reading, PA 19611
Address
Notarial Seal
Jacque.line L. Drawbaugh, Notary Public
Carlisle .B~ro, Cumberland COunty
My CommissIon Expires Aug. 14,2003
DeatlMemhpr Pennsyl',ania ^33ocial'o IN t
" IIIV oanes
Day
01
2001
Date of
Month
Year
INSTRUCTIONS
I. An inventory must be filed within three months after appointment of personal representative.
2. A supplement inventory must be filed within thirty days of discovery of additional assets.
3. Additional sheets may be attached as to personalty or realty
4. See Article IV. Fiduciaries Act of 1949.
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Inventory of the real and personal estate of
MYCHAILO KOMESZ
deceased
1. One Chestnut Street, Mt. Holly Springs Borough, Cumberland County, PA. . 110,000 00
2. Adams County National Bank - Savings Account . . . . 7,487 18
3. Adams County National Bank - Checking Account. . . . . 5,435 97
4. Adams County National Bank - Certificate . . . . 8,505 62
5. Adams County National Bank - Certificate . . . . . . . . il 9,948 24
Ii
I,
6. Adams County National Bank - Certificate . . . . 20,868 88
7 . Adams County National Bank - Certificate 15,230 70
8. Adams County National Bank - Certificate . . . . . . . . 10,477 34
9. Adams County National Bank - Certificate . . 7,376 04
10. Adams County National Bank - Certificate . . . . . . 5,281 17
11. PNC Bank, N.A. - Certificate . . . 8,069 52
12. PNC Bank, N.A. - Certificate . . . . . . . . . 35,950 41
13. PNC Bank, N.A. - Checking. . . . . . . . . 566 33
14. Personal Property Sold . . . . . . . 17,686 00
TOTAL . . . . . . . . . . . . . . . . . 262,88J 40
\' / 6"-(~ /6--.:l
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG. PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
JAMES D HUGHES ESQ
IRWIN ETAL
60 W POMFRET ST
CARLISLE PA 17013
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
08-27-2001
KOMESZ
01-24-2001
21 01-0248
CUMBERLAND
101
*
REV-l!;47 EX AFP (12-00>
MVCHAILO
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ifE-Y-=is4j-EX--AFP--ci'2=ol.-r-NO'TicE--OF-'rNHEifiTANCE-'TAX-APPRAisEMEN:r,--ALi-oWANCE-oi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF KOMESZ MVCHAILO FILE NO. 21 01-0248 ACN 101 DATE 08-27-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
U)
(2)
(3)
(4)
(5)
(6)
(7)
110.000.00
.00
.00
.00
152.883.40
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
UO)
19,313.59
3.294.50
Ul)
(2)
(3)
(4)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
262,883.40
??608 09
240,275.31
.00
240,275.31
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
(5) .00 X 00 = .00
(6) 240,275.31 X 045 = 10,812.39
un .00 X 12 = .00
(8) .00 X 15 = .00
(9)= 10,812.39
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
04-23-2001 AA478300 513.16 9,750.00
07-17-2001 CDOOO058 .00 549.23
TOTAL TAX CREDIT 10,812.39
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO'PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THI~ FORM FOR INSTRUCTIONS.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
p' 'qEAU OF INDIVIDUAL TAXES
..... DEPT~ 280601
HARRISBURG, PA 17128-0601
REV-1162 EX! 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HUGHES JAMES D
60 WEST POMFRET STREET
CARLISLE, PA 17013
______u fold
ESTATE INFORMATION: SSN: 176-26-0678
FILE NUMBER: 21-2001- 0248
DECEDENT NAME: KOMESZ MYCHAILO
DATE OF PAYMENT: 07/17/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 01/24/2001
NO. CD 000058
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $549.23
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$ 549.23
REMARKS: JAMES D.HUGHES, ESQ.
CHECK# 17656
SEAL
INITIALS: VZ
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
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STATUS REPORT UNDER RULE 6.12
Name of Decedent:
MYCHAILO KOMESZ
Date of Death:
November 1. 2001
No. 21-01-0248
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete: ~ Yes _ No
2. If the an,swer is No, state when the personal representative reasonably believes that the
administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes -X-. No
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? ---X...--. Yes No
Date:
d. Copies of receipts, releases, joinders and
accounts may be filed with the rk of
attached to this report.
,/
//
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l
11/28/01
~.'.'.." .~~:;c
, I........
vals of formal or informal
rphan's Court and may be
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James D. Hughes. Esquire
Name (please type or print)
60 West Pomfret Street
Address
Carlisle. P A 17013
City, State, lip
(717) 249-2353
Telephone Number
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Personal Representative
Counsel for Personal Representative
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
'*
No.AA 4 7 8 300 REV-1162 EX (11-96)
RECEIVED FROM:
I
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
'"U(:;ilE:; ) (-lIvrE::;; D
1 r,l 1
'b:';' t 7(')0 . 00
()(i IdEE, T ('C'!"lF f::F T ;3 -f F'EC';
:~_' ~', ~-, ~_ I r:_~: l.~ J=.. r~-' i~
1. ~}' (j .i, :J
FOLD HERE
FOLD HERE -
ESTATE INFORMATION:
FILE NUMBER
,~-) 1 ~. ~..IC:.I,} \ (~,,~) t.f. ~:-;
.'?r';
NAME OF DECEDENT (LAST)
,,"', 'J:
DATE OF PAYMENT
(FIRST)
(MI)
~ / "} .:_~/ ',( ";
POSTMARK DATE
,_ I ... l -H, -~ "~"; '.-'j (" r)
COUNTY
TOTAL AMOUNT PAID
':tl ,750.00
DATE OF DEATH
V7'
,-
~- ,.....l " :~j .,,). ,.
REMARKS .J I fY\ D i"~UGHF:.; [~;CHJ r HE:"
RECEIVED BY
f"lAF~Y C. L.EW I El
SEAL C, ;~,.r~ ;~ l ' ....'t
~CGrSrE? OF W:~LS
REGISTER OF WillS
-"'-
C
OFFICIAL USE ONLY
REV-1500 EX +-{6-00) REV-1500 ilo ;l/5 -L
-
INHERITANCE TAX RETURN FILE NUMBER
COMMONWEALTH OF PENNSYLVANIA 21-01-0248
DEPARTMENT OF REVENUe: RESIDENT DECEDENT
DEPT. 280601 COUNTY CODE
HARRIS8URG,PA 171l8-0601 YEAR HUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
0 Komesz Mvchailo 176-26-0678
E
C DATE OF DEATH (MM-DD- YEAR) DATEOF BIRTH (MM~DD-YEA.R) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
E
0 01/24/2001 08/23/1912 REGISTER OF WILLS
E
N (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. HAST. AND MIDDLE INITlAl) SOCIAL SECURITY NUMBER
T
.is 1. Origin;;!l Return _ 2. S,pploment,' Re"," B 3. . 1 lEa~ 01 death
Remamder Return prior to 12- 13-82)
APB X 4. limited Estate _ 4a. Future Interest Compromise (date of death after 12~ 12-82.) 5. Federal Estate Tax Return Required
HpRL Decedent Maintained. a Living Trust ~
EplO 6. Decedent Died Testate _ 7. 8. Total Number of Safe Deposit Boxes
...;.:
CRAC (Attach copy of Will) (Attach copy of Trust)
KOTK 0 9. 010. 0 11. Election to tax under Sec. 9113(A)
ES Litigation Proceeds Received Spousal Poverty Credit
(date of death between 12-31 ~91 and 1-1~95) (AttaCh Sch 0)
THI$$ECT@(:M\.I$'l'!le:C:<>MI>tml'l;:Ajl.:C:QBBE;S/ION"!;NC$l!.~I'IPeNT'At'l'AX:!NI'QAM"'I'Il:i!,!$fI<)\!I.l)Ill;l)IBl;q(El):'l'(l;
P NAME COMPLETE MAILING ADDRESS
C
0 0 James D. Hughes Esq. 60 West Pomfret Street
R N FlAM NAME (If Applicable) West Pomfret Professional Bldg.
R 0
E E IRWIN McKNIGHT & HUGHES Carlisle, PA 17013
S N
T TELEPHONE NUMBER
717I?NI-2353
1. Real Estate (Schedule A) (1) 110,000.00 OFFICIAL USE ONLY
2. Stocks and Bonds (Schedule B) (2) Niine.
3. Closely Held Corporation, Partnership or (3) None
Safe-Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4) None
R 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 152,883.40 ~.".
E (Schedule E)
C
A 6. Jointly Owned Property (Schedule F) (6) None
P
I 0 Separate Billing Requested
T 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) None
U
L (Schedule G or Ll ..
A
T 8. Total Gross Assets (total Lines 1-7) (8) 262,883.40
I 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 19,313.59
0
N 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 3,294.50
11. Tolal Deductions (total Lines 9 & 10) (11) 22.608.09
12. Net Value of Estate (Line 8 minus Line 11) (12) 240,275.31
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 240,275.31
C SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
0
M
T P 15. Amount of Line 14 taxable at the spousal tax
U
A T rate, or transfers under Sec. 9116(aX1.2) X .0 0 (15) 0.00
X A 16. Amount of Line 14 taxable at lineal rate 240,275.31 45 (16) 10,812.39
T X .0
I 17. Amount of Line 14 taxable at sibling rate X .12 (17) 0.00
0
N 18. Amount of Une 14 taxable at collateral rate X .15 (18) 0.00
19. Tax Due (19) 10,812.39
20. n hc::l'iI;c::K:HE;l!I;:II':YIi!IiIA!lI;::l!lEIliQl!$t'Nlil:AREl'\lil~~~nli!\ll;!!I!A't''''~Tnl
> > BE SURE TO ANSWER All. QUESTIONS ON REVERS!; SIDE AND TO RECHECK MATH < <
COPYfight (c) 2000 form software only The Lackner Group, Inc.
FormREV-1500 EX (Rev. 6~OO)
Decedent's Complete Address:
STREET ADDRESS
One Chestnut Street
CITY I STATE I ZIP
Mount Ho11v Springs PA 17065
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Paymenrs
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
10,812.39
0.00
9,750.00
513 .16
Total Cred"s ( A + B + C) (2)
10,263.16
3. Interest/Penalty if applicable
D. Interest
E. Penalty
TotallnterestlPenalty ( D + E) (3)
4. If line 2 is greater than Line 1 of line 3. enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 10 requesl a refund (4)
5. If Une 1 ... Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line S + SA. This is the BALANCE DUE. (5B)
. Make Check Payable 10: REGISTER OF WILLS, AGENT
..pLEASffANSWERTHEFOLLOWiNG(m~~~;:ONSBYPLACJNGAN "X,,~~iiif~~~~~~8~~il~fi~ii~t~~i~f~i.
1.
0.00
0.00
549.23
0.00
549.23
Did decedent make a transfer and:
a. retain the use or income of the property transferred;
b. retain the right to designate who shall use the property transferred or its income; .
c. retain a reversionary interest; or.
d. receive the promise for life of either payments, benefits or care?
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .
3. Did decedent own an ~in trust for" or payable upon death bank account or security at his
or her death?
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation?
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Yes No
~~
o
o
o
[]J
[]J
[]J
Under penalties of perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct and complete. Declaration of preparer other than the petsonal representatlve is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
t!,
5 NTATIVE
Dmytro Komesz
1408 Farr Road
- - R~adin - -,- -PA- - - i 96-1i - - - - - - - - - - - - - - - - - - - - - - - - - - --
IRWIN McKNIGHT & HUGHES
60 West Pomfret Street
-- Car'i'i~i"": - P/;- -i'i6h----- -- - - - -- - ---- - ---
death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
spouse is 3% [72 P.S. 9116 (a)( 1. 1) W].
es of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
.S. 9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and filing a tax return are stiff applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0'% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the uSe of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 Ps. 9116IaXll).
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(aX1.3)]. A sibling is defined, under
Section 9102, as an individual who has at feast one parent in common with the decedent, whether by blood or adoption.
Copyright (cl 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
ADDITIONAL Personal Representatives
Estate of Mychailo Komesz SS# 176-26-0678 01/24/2001
****************************************************
Under penalties of perjury, the undersigned declare that they
have examined this return, including accompanying schedules and
statements, and to the best of their knowledge and belief, it is
true, correct and complete.
Signature
~/("~
Name
Address Line 1
Address Line 2
City, State, Zip
Mychael Komesz
3315 Biglerville Rd
Date
Biglerville, PA 17307
4" . '2 ,., . 2.d d /
REV-l502. Ej( to-97)
COMMONWEALTH OF PENNSYLVANIA
INHERIT ANeE T M RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mychailo Komesz SS# 176-26-0678 01/24/2001 21-01-0248
AU real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price
at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable
knowledge of the relevant facts. Real property which is iOintly-owned with riaht of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
DESCRIPTION
NUMBER OF DEATH
lOne Chestnut Street, Mt. Holly Springs Borough, Gumb. Co. - 110,000.00
settlement sheet attached
SCHEDULE A
REAL ESTATE
TOTAL (Also ontor on lino 1, Rocap."I..;on) SlID, 000.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-tS02 EX (Rev. 1~97)
REV-1508EX + (1-971
COMMONWEALTH OF PENNSYLVANIA
INHERIT ANCe. Tf(X RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Mychai10 Komesz SS# 176-26-0678 01/24/2001 21-01-0248
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Adams County National Bank, savings account 7,487.18
2 Adams County National Bank, checking account 5,435.97
3 Adams County National Bank, certificate 8,505.62
4 Adams County National Bank, certificate 9,948.24
5 Adams County National Bank, certificate 20,868.88
6 Adams County National Bank, certificate 15,230.70
7 Adams County National Bank, certificate 10,477.34
8 Adams County National Bank, certificate 7,376.04
9 Adams County National Bank, certificate 5,281.17
10 PNC Bank NA, certificate 8,069.52
11 PNC Bank NA, certificate 35,950.41
12 PNC Bank NA, checking 566.33
13 Personal property sold 17,686.00
TOTAL (Also enter on line 5. Recapitulation) S 152,883.40
(If more space is needed, insert additional sheets of the same size)
Copyright (el 1996 form software only CPSystems,lne. Form REV-1508 EX (Rev. t-97)
REV-'S'" E~ ~('4'97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Mychailo Komesz
SSiI 176-26-0678
01/24/2001
FILE NUMBER
21-01-0248
Debts of decedent must be reported on Schedule I-
ITEM
NUMBER
A. FUNERAL EXPENSES,
B.
1.
2.
3.
DESCRIPTION
AMOUNT
ADMINISTRATIVE COSTS,
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number{s) I EIN Number of Personal Representative(s)
Street Address
City
State
Zip
Year{s) Commission Paid:
Allorney's Fees IRWIN McKNIGHT & HUGHES
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City SIOle Zip
Relationship oi Claimant to Decedent
12,500.00
4.
Register of Wills
293.00
Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
1
Other Administrative Costs
Cumberland Law Journal - estate notice publication
75.00
2
Dehart's Auction, commission
4,520.91
3
Patricia A. Rosendale CPA - 2000 income tax prep.
95.00
4
Register of Wills - filing fee
25.00
5
Scott Ramsey, lawn care
60.00
6
Settlement charges on sale of real estate
1,650.85
Total of Continuation Schedule(s)
93.83
TOTAL (Also enler on line 9. Recopoulotion) S 19,313 .59
(If more space is needed, insert additional sheets of the same size)
Copyright (el 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
Escace of: Mychailo Komesz
Soc Sec #: 176-26-0678
Dace of Deach: 01/24/2001
Icem
If
Descripcion
Concinuacion of Schedule H-B7
(Ocher Adminiscracive Coscs)
Amounc
93.83
7
The Sencinel, Legal - estate notice publicacion
93.83
, RE'f-151'z'EX+(V37)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERIT.AlNCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mychailo Komesz
FILE NUMBER
21-01-0248
SSII 176-26-0678
01/24/2001
Include unreimbursed medical expenses.
ITEM
NUMBER
1 Aero Oil Company
DESCRIPTION
AMOUNT
447. 11
2
79.33
Barrick's Plumbing & Heating
3
Belvedere Medical Corp.
24.42
4
Bronstein Jeffries PA
55.09
5
Carlisle Imaging Associates
14.67
6
193.72
GPU Energy
7
PA Department of Revenue, 2000 income tax
159.00
8
RWC Emergency Physicians
30.30
9
S&W Petroleum Service - tank removal
2,009.50
10
Sprint Telephone
135.99
11
United States Treasury, 2000 income tax due
129.00
12
Walnut Bottom Radiology
16.37
TOTAL (Also enter on line 10, Recapitulation) S 3,294.50
{Ii more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97)
REV -15 13 E~ + (9-00}
COMMONWEALTH OF PENNSYl.VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Mvchailo Komesz
SSj/ 176-26-0678
01/24/2001
FILE NUMBER
21-01-0248
RELATIONSHIP TO DECIil!ENT AMOUNT OR SHAHE
Do Not List Trustee(s) OF EST ATE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS [Include outright spoLJSaI distributions, and
transft!rs under Sec. 9116{a)(1.2)]
1
Dmytro Komesz
1408 Farr Road
Reading, PA 19611
Son
1/2 remainder
2
Mychae1 Komesz
3315 Biglerville
Biglerville, PA
Son
1/2 remainder
Road
17307
3
Natalie P. Komesz
1212 Village Crossing Drive
Chapel Hill, NC 27514
Gr anddaughter
15,000.00
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS,
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET S
{If more space is needed, insert additional sheets of the same size}
Copyright (e) ZOOO form software only The lacknerGroup, Inc.
0.00
Form REV-1513 EX (Rev. 9-00)
LAST WILL AND TESTAMENT
I, MYCHAILO KOMESZ, of 1 Chestnut Street, Mt. Holly Springs, Cumberland
County, Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby make,
publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils
heretofore made by me.
ONE. I direct my Executor or Executrix, as the case may be, to pay all of my debts,
funeral and administrative expenses as soon as convenient after my decease. Furthermore, I direct
that all state, inheritance, succession and other death taxes imposed or payable by reason of my
death and interest and penalties thereon with respect to all property composing of my gross estate
for death tax purposes, whether or not such property passes under this will, shall be paid by the
Executor or Executrix of my estate.
TWO. My Executor or Executrix may, at his or her discretion, compromise claims,
borrow money, retain property for such length of time as he or she may deem proper; lease and
sell property for such prices, on such terms, at public or private sales, as he or she may deem
proper; and invest estate property and income without restriction to legal investments unless
otherwise provided hereunder. I authorize and empower my Executor or Executrix to sell any
realty and/or personalty owned by me at my death and not specifically devised or bequeathed
herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale
therefor, in fee simple, as I could do if living. My Executor or Executrix is authorized and
Ji. /(
empowered to engage in any business in which I may be engaged at my death, for such period of
time after my death as seems expedient to said Executor or Executrix.
THREE. I give, devise and bequeath all of my estate of whatever nature and wherever
situate to my spouse, Maria Komesz.
FOUR. If my spouse, Maria Komesz, does not survive me by a period of at least sixty
(60) days, then my estate of whatever nature and wherever situate I give, devise and bequeath as
follows:
a) $15,000.00 to my granddaughter, Natalie Patricia Komesz; and
b) All the rest, remainder and residue thereof to my two sons, Mychael Komesz,
Jr. and Dmytro Komesz, share and share alike, and if either of them is deceased, their share shall
go to my granddaughter, Natalie Patricia Komesz; and
c) Notwithstanding the provisions of subparagraph 4(b) above, either Mychae1
Komesz or Dmytro Komesz, as they shall agree, shall have a right of first refusal upon my death
to purchase the aforementioned residence at 1 Chestnut Street, Mount Holly Springs,
Pennsylvania, for a purchase price which shall be calculated using the fair market value of the
property at the time of my death or using such other amount as they shall both agree in writing.
The fair market value shall be determined by a certified appraisal of the property as of the date of
my death. In the event that neither of my sons are desirous of exercising this right of first refusal
to so purchase, then the property shall be sold and the proceeds therefrom distributed in
accordance with this my Last Will and Testament.
.E!Y.t. I nominate and appoint my spouse, Maria Komesz, to be the Executrix of this my
Last Will and Testament. If my spouse has predeceased me, failed to qualifY or is not able or
2
vU. JC.
does not serve for whatever reason, then I appoint Mychael Komesz, Jr. and Dmytro Komesz to
serve as Co-Executors of my estate having the same powers as the original Executrix hereunder.
SIX. .No person(s) shall benefit hereunder unless such beneficiary shall survive me by
sixty (60) days.
SEVEN. No Executrix or Executor acting hereunder shall be required to post bond or
enter security in this or any other jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this .!.i'-.- day of
October, 1994.
1fUJ~/{fJ~V(SEAL)
MYCHAfi,O KOMESZ
Signed, sealed, published and declared by the above-named person as and for a Last Will
and Testament, in our presence, who at said person's request, in said person's presence and in the
presence of each other have hereunto set our names as subscribing witnesses.
0Ya4hL~vJ.I,./~~
~ rC/7.f ;t' c?/-'~
3
, ,
ACKNOWLEDGMENT AND AFFIDA VIT
WE, MYCHAILO KOMESZ, SHARON L. SCHWALM and CHERYL L.
CLELAND, the testator and witnesses respectively, whose names are signed to the foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator
signed and executed the instrument as his Last Will and that he had signed willingly, and that he
executed it as his free and voluntary act for the purpose herein expressed, and that each of the
witnesses, in the presence and hearing of the testator, signed the Will as a witness and that to the
best of their knowledge the testator was, at that time, eighteen years of age or older, of sound
mind and under no constraint or undue influence.
Ji!tt ~ f{ () /J1-tM-z---
MYCHAILO KOMESZ
0YtU/)-L- Y;~ku
I SHARONL.SCHWALM
f'~f.(1f.61
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by MYCHAILO KOMESZ, the
testator herein, and subscribed and sworn to before me by SHARON L. SCHWALM and
CHERYL L. CLELAND, witnesses, this 18TH day of October, 1994.
.&, ~11(J111
Nota Pubhc
Notarial Seal
I3e1zII>. Mooison. NotaJy Pubr"
Carnsle Boro, Currl:>e<Iar<l County
My ComrrUssioo Expires Dec. 15. 159G
Member, Penos~tvactia.Assoc:ia\lon 01 NCl\afics
A.
OMB NO. 2502-0265 "r::
SETTLEMENT STATEMENT
U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT
B. TYPE OF LOAN:
3. ~CONV. UNINS. 4. OVA
17. LOAN NUMBER:
615021863
5.0CONV.INS.
l.oFHA 2.oFmHA
6. FILE NUMBER:
2171.1
8. MORTGAGE INS CASE NUMBER:
C. NOTE: This (ann is furnished to give you a statement of Bctual settlement costs. Amounts paid to and by the settlement agent are shown.
Items marked '1pOCr were paid outside the closing; they are shown here for informational purposes and are not includod ;n the totals.
1.0 3198 (2171,1DONlEVPFDf21711/1O)
D. NAME AND ADDRESS OF BO~ROWER:
Eric J. Donley
P. O. Box 93
Ml. Holly Springs, PA 17065
G. PROPERTY LOCATION:
1 Chestnut Street
Mt. HoUy Springs. PA 17065
Cumberland County, Pennsylvania
Adiustments For Items Unnaid Bv Seller
210. CountvfTwn Taxes to
211. School Taxes to
212. Assessments to
213.
214.
215.
216.
217.
218.
219.
E. NAME AND ADDRESS OF SELLER:
F. NAME AND ADDRESS OF LENDER:
The Estate of Mychaito Komesz
1 Chestnut Street
Ml. Holly Springs, PA 17065
ABN AMRO Mortgage Group, Inc.
2600 West Big Beaver Road
Troy, MI 48084
H. SETTLEMENT AGENT: 25-1736654
Law Omce of Michael J. Hanft
June 6, 2001
I. SETTLEMENT DATE:
PLACE OF SETTLEMENT
19 Brookwood Avenue, Suite 106
Carlisle, PA 17013-9142
110,000.00
K. SUMMARY OF SELLER'S TRANSACTION
400. GROSS AMOUNT DUE TO SELLER:
401. Contract Sales Price
402. Personal ProDertv
403.
404,
405.
J. SUMMARY OF BORROWER'S TRANSACTION
100, GROSS AMOUNT DUE FROM BORROWER:
101. Contract Sales Price
102. Personal Prooerty
103. Settlement Charaes to Borrower (Une 1400l
104.
105.
Adjustments For Items Paid By Seifer in advance
106. CountvlTwo Taxes 06106/01 to 12/31/01
107. School Taxes 06/06/01 10 06130101
108. Assessments to
109.
110.
Ill.
112.
120. GROSS AMOUNT DUE FROM BORROWER
200, AMOUNTS PAID BY OR IN BEHALF OF BORROWER:
201. Deposit or earnest monev
202. Princioal Amount of New Loan(s
203. Existina loanis) taken subiect to
204.
205.
206,
207.
208.
209.
6,320.30
256.50
86.81
Adiustments For Items Paid Bv Seifer in advance
406. CountvlTwD Taxes 06/06/01 to 12/31101
407, School Taxes 06106101 10 06130/01
408. Assessments 10
409.
410.
411.
412,
420. GROSS AMOUNT DUE TO SELLER
500. REDUCTIONS IN AMOUNT DUE TO SELLER:
501. Excess Denosit-'See Instructions\.
502. Settlement Charries to SellerfLine 14001
503. Existino loants\ taken subiect to
504. Payoff of first Mortgage
505. Pavoff of second Mortaaoe
506.
507. (Qeoosit disb. as nroceedsl
508.
509.
116,663.61
22,000.00
88,000.00
Adjustments For Items Unnaid Bv Seifer
510. CountvlTwo Taxes to
511. School Taxes 10
512. Assessments 10
513.
514,
515,
516,
517.
518.
519.
220. TOTAL PAID BY/FOR BORROWER 110,000.00 520, TOTAL REDUCTION AMOUNT DUE SELLER
300, CASH AT SETTLEMENT FROMITO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER:
301. Gross Amount Due From BorrowerlUne 1201 116,663.61 601. Gross Amount Due To Sellerlline 420\
302. Less Amount Paid By/For Borrower (Une 220) (110,000.00) 602. Less Reductions Due Seller (Line 520)
303. CASH ( X FROM) ( TO) BORROWER 6,663.61 603. CASH ( X TO)( FROM) SELLER
The underSIgned hereby aCkno;:.recei~~a compleled copy of pages 1&2 01 Ihls Slale~e:::~ferr:~r:;.
Borrower ~ _____ y.,:; Seller // ~ , P:
Eric J, Donley / ~e of Mychallo Komesz
/
110,000.00
256.50
86.81
110,343.31
1,650.85
1,650.85
110,343.31
1,650.85
108,692.46
-..- -..--..- -,.~,. -~-.-._. ~._..-
L. SETTLEMENT CHARGES
700. TOTAL COMMISSION Based on Price $ Ii1l % PAID FROM PAID FROM
.
Division of Commission (/ino 700) as Follows: BORROWER'S SEL.LER'S
701. ~ to FUNDS AT FUNDS AT
702.$ to SETTLEMENT SETTLEMENT
703, Commission Paid at Settlement
704. to
BOO. ITEMS PAYABLE tN CONNECTION WITH LOAN
801. loan Oriaination Fee % to
802, loan Discount 1.5000 % to Cody Financial Mortgage Services, Inc. 1.320.00
803. Appraisal Fee to Cody Financial Mortgage Services, Inc. 275.00
804. Credit Report to Cody Financial Mortgage Services, Inc. 50.00
805. Processing Fee to Cody Financial Mortgage Services. Inc. 250.00
806. lender Administration Fee to ABN AMRO Mortna e Grourl, Inc. 375.00
807. Flood Cert Fee to Cody Financial Mortgage Services. Inc. 21.50
BOB.
B09.
Bl0.
Bll.
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest From 06/06/01 to 06/30/01 @ $ 15.890000/day ( 25 days %) 397.25
902. Mortaaae Insurance Premium for months to
903. Hazard Insurance Premium for 1.0 vears to Nationwide $448.00 POC
904.
905.
1000. RESERVES DEPOSITED WITH LENDER
1001. Hazard Insurance 4.000 months $ 37.34 ner month 149.33
1002. Mortgage Insurance months $ ner month
1003. CountvfTwn Taxes 6.000 months $ 36.59 ner month 219.54
1004. School Taxes 13.000 months $ 103.51 ner month 1.345.51
1005. Assessments months @ $ per month
1006. months (ij) $ ner month
1007. months (ij) ~ ner month
1008. Aaareaate Adiustment months /1l) $ oer month -294.83
1100. TITLE CHARGES
1101. Abstract or Title Search to
1102. Settlement or Closin Fee to
1103. Document Prenaration to Irwin McKniaht & Huahes POC
1104. Attomev's Fee to
1105. Notary Fee to Notarv Public 4.00
1106. DRS Lien Searches to Law Office of Michael J. Hanft 20.00
1107. Title Binder Fee to
(includes above item numbers: )
1108. Title Insurance to CT1C/Law Office of Michael J. Hanft B37.00
(includes above item numbers:
1109. lender's Coverage $ 88.000.00
1110. Owner's Coverage $ 110.000.00
1111. Endorsements 100/300/8.1 to CTICllaw Office of Michael J, Hanft 150.00
1112.
1113.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recording Fees: Deed $ 25.50; Mort9age $ 49.50; Releases $ 75.00
1202. City/County Tax/Stamos: Deed 1.100.00' Mort a e 1.100.00
1203. State Tax/Stamos: Revenue Stamos 1.100.00; Mortoaae 1.100.00
1204.
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Survey to
1302. Pest Inspection to
1303. Ovemioht Mail Fee to law Office of Michael J. Hanft Pko 26.00
1304. 2001 Countv/Boro Taxes to Mable Sattison, Tax Collector 447.95
1305. Final Water/SewerfTrash to Mt. Holly Springs Borough Acct # 3054 102.90
1400. TOTAL SETTLEMENT CHARGES fEnter an Lines 103, Section J and 502, Section Kl 6.320.30 1 ,650.85
By Signing page 1 of this statement. the signatories acknowledge receipt of a completed copy of page 2 of this \'M) page statemen JA-j /I )1+19-
;j
La~tn:~cl!'of MichaeilJ. Hanft 1/ I /
Selt ment A ent
9
Certified to be a true copy.
(2171.112111,1110)
MAR-?7-~1 ng:1~
0PNCBAN<
_en. Reporting
Firstside Center
P7-PFSC-4-F
SOO First A venue
Pittsburgh,PA 15219-3128
March 21, 2001
James D. Hughes
60 West Pomfret Street
Carti.lo, FA 17013-3222
RE: Estate ofMycbailo KomCllZ, D<c<ased
SSN: 176.26-0678
DOD: 1/2412001
Dear M, H~ghes:
Please: find the date of death balances you have requested listed belOw"
CERTIFICATES OF DEPOSIT
1131800162242
MYCHAlLO KOMESZ
DOD Ba1=: $8,056.82 + S 12. 70 accrued in'e=!
lnt=st Paid 1/112001-1/24/2001 - 530.11
#31900204138
MYCHAlLO KOMESZ
DMYTRO KOMESZ
DOD Balance: $35,810.05 + S140.36 occtUed in....est
Inl..est Paid 111/200-1/2412001- S193.70
Page 1 of2
A member of The PNC Financial SE,rvic::~ On')U'
PNC Bank N,A" Pimol.l<'9h Ptl'll'l~~I..atl,.. 15~6S
03/22/01 07:38
p.m...\'\?
ISCP
Established 08/1111999
Established 1210112000
TX/RX NO.5402
P,001
.
I'm-.7;:,-;:n;::U nq: 111
P.ro/~-:"
~PNCBAN<
CHECKING ACCOUNT
#SOl10515359
Established 0212711997
MYCHAILO KOMESZ
DOD B_: S56633 + SO.OO """roed int=st
Interest Paid 1/]/2001 -1/24i2001 - SO.OO
For Brokerage information, please call 1-800..762-6111.
/NV# 20740147
Our office only provides date of death bI.bulces tor IRA's, CD'" Chedda.g aDd
Savmgs. Keounts. We do NQ. Fhwu::bl TnmPCtioIU or StatemeAt Orden. For
Further Infor_tiOD pi.... caU 1-800-4-BANKER or your local PNC Br...ch ...d
ask to speak with a Financlal Servka Representative..,
g--~~~
RacheUe Sciullo
1-800-762-1775
Page 2 of2
A _to.". <1fT""" PNf; R~ow;:l,,1 St....oees G-.
!'Nt: Bank N_A- P",tt~urgh ~nm.ylwnia 15265.
TOTR P.02
03/22/01 07:38
TX/RX NO.5402
P.002
.
.~ ADAMS COUNlY
NATIONAL BANK
","; ,-:'," .---',
",#
,.,,-,
~;.; J "
. i l"~ 1;; I ...... .;;; .~,J
February 21, 2001
Irwin, McKnight & Hughes
60 West Pomfret Street
Carlisle, P A 17013
Re: Estate ofMychailo Komesz
Dear Mr Hughes:
The following information is being provided as per your request:
Acct. Type Acct. Acct. Acc. Int. Ownership Date
Number Balance to 0.0.0. Joint
On 0.0.0.
Savings 96-0553-3 $7,449.84 $37.34 Individual N/A
Checking 060-587-5 $5,429.94 $6.03 Individual N/A
C.O. 147567 $8,339.63 $165.99 Individual N/A
C.O. 131279 $9,916.68 $31.56 Individual N/A
CD. 6-4-006668 $20,788.34 $80.54 Individual N/A
C.O. 6-4-104585 $15,000.00 $230.70 Individual N/A
C.O. 152377 $10,274.38 $202.96 Individual N/A
C.D. 152356 $7.000.00 $376.Q4 Individual N/A
C.D. 152321 $5,257.14 $24.03 Individual N/A
Inquiries concerning ACNB Corporation stock information should be directed to the
Registrar and Transfer Company at 1-800-368-5948. If you need any additional
information, please feel free to contact me.
.
.~ ADAMS COUNIY
NATIONAL BANK
Sincerely,
'IJ&1/lJ (l. ~ ~
Lois A. Kime
Certificate of Deposit Coordinator
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*09IL9*