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HomeMy WebLinkAbout01-0323 PETITION FOR PROBATE and GRANT OF LETTERS ,;L 1- 6 (- 3;1,,3 Estate of MARY 'T', M~G~BO also known as No. To: Register of Wills for the , Deceased. County of Cumberland in the Social Security No. I q J - 'f 2 - ., S- 8. q Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execu1Qr in the last will of the above decedent, dated March 7, and codicil(s) dated Po IJ.r.If I'v.. C f2.() Ci-f'l ft t- & I ~ t::/J-C' P P named , 19--9.5.- (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in ~l1mhprl;:ln(l County, Pennsylvania, with last family or principal residence at 72 3 Shaffer Street, Enol a l PA ~ (list street, number and muncipality) Decendent, then q 3 years of age, died March 12 ,21.~ 2001, at 'iTi 1 ] a Teresa Nursing Hom@ . 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 incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: 7' '..9- $ ~ 10 Ot<. 0_ :----- $ ,/ $ $ 5 s;, 6o~ po- WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary theron. (testamentary; administration c.La.; administration d.b.n.c.t.a.) ~ on 'tr u C 0) ~3 0).... lX:~ ",,0 C';:: ~'':: ~O) ~o... 0) '- a 0 ~ C bll rii ~~~Tfl 389 Quail Hollow Road Harrisburq, PA 17112 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I ss COUNTY OF l!;/m~r'r/tZ Ild J 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 represen- tative(s) of the above decedent petitioner(s) will we nd truly administer the estate according to law. /6-:JJ.6-J affirm. ed ~ncl subscribed ,.,..,.~ d f 0'''' ~1 ay 0 j w;;col 7 ~ ~ ~. ::s t:l .... l:: ~ ~ No. 21-01-323 Estate of MARY T. MAGARO , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW MARCH 26, 2001 2HZ 7- 0 0 ~ 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 Ma r c h 7. 1 9 95 described therein be admitted to probate and filed of record as the last will of Mary T. Mag-aro and Letters Testamentary are hereby granted to . Andrew S. Merlina, Jr. 7J)a~ L~ :;<;~ ~1(, . t! a. ~.L;.-u; 11,.:I~ Register of Wills FEES Probate, Letters, Etc. ......... $ 115.00 Short Certificates(6 ) . .. . . . . . .. $ 18.00 ~ .F;~rM.:r9.S..).. $ 9.00 JCP $ 5.00 TOTAL _ $ 147.00 Filed M!RCE .26... .400.1.... ......... ..... WilliRm J. PAtArs, Esql1irA ATTORNEY (Sup. Ct. I.D. No.) 09983 2931 North Front Street ADDRESS Harrisburg, PA 17110 (717) 238-7555 PHONE MAILED LETTERS TO ATTORNEY MARCH 26, 2001 f"~,,1 . , ; .,~ C~ H1f)C;.:::l0C; R..FV ql.Q,(.. This is to certify that the information here given is correctly copied fro~ an original certificate of death dul): filed with Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filmg. me as WARNING: It is illegal to duplicate this copy by photostat or photograph. HEM # Si-IOULD READ AS FQLLOWS: ,4. ( 91..1~' ~ .61.1./1') ,4~ k? . No. a-,~~ Local eglstrar . Fee for this certificate, $2.00 p 7294930 \~iM'\ 2 3 200\ Date a-v~~ "- ~ov. 2/87 COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECOROS CERTIFICATE OF DEATH NAME OF DECEDENT (F'" ..idtte, lOll) ..Mary T. Magaro AGE (l.. BWlhday! UNOEA . YEAR _ o.p UNDER. OIl\' -llotlnul. SEX Ifemale STAfE FILE NUM8EA SOCIAL seCURITY NUMBER ..191 42 9583 IlIRTHPLACE (City _ Pl.<CE OF OER'H IChecl< only """ _ _uct..,.,. on _ ~ SloJe or Foreogn Counuy) HOSPITAl.; OTHER: 7.owellspX~lle 1,:,...0 ::::;:OCQI FACIUTV NAME (II no! .nstiIuIion. QlVtI.1eI and nomber) Dauphin DECEDENT'8 USUAl.. OCCUIWlON ~..=:~~.:::~.,. "..Houseduties 11b. DECEDENT'S MMJNG _ss (SIr"', c....li>wn, _, lIpC_1 Villa Teresa Nursing Ho. 105 I Avilla Rd. ...Lowe r Pax t on KINO OF IUSlNESS/lNDUSTAY DECEDENT'S ACTUAl RESIDENCE (See II\Ib'UCbClfW on om8f SlOe) '1. 17.._ Pa. 1Wp. 'lb. Ccu 'TO.o :... ""::"::: of MOTHER.S NAME IF.., MNldlo, M8KlonSurI1llme) ...Josephine Magnelli INFORMANT"S MAlUNO ADDRESS (Soreet, CjtyI!Own, _, 2'", C_I .1389 Quayle Hollow Rd. Harrisburg, Pa. PlACE OF DISPOSITION. N....of Como'Oty, c,_ lOCAnON. C~. Stol.. Zip ~ Of Other PIac. Holy Cross Cemetery Lower Paxton Twp. ate. Ztcl, cilylboro. 171 12 ] 5, 2001 Pa. PART II: 0Ih0r",-, _COlOrlbulfngIO_.... not NIUIting in tM undIrtying C8UH g;.. in PART I. lb. c. . DUE TO (OR AS A CONSEOUENCE Of): DUE TO (OR AS A CONSEQUENCE Of): WERE AUTOPSY fINDINGS MANNER OF DEATH _LAlllE PAIOR TO ~ COMPlETION CE CAUSE D OF DEATH? ........ Homicide -- D Pending __Ion D ...0 NoD - D Could not be determined D DATE OF INJURY (Month, Qey, 'lItar) TIME OF INJURY INJURY II.f WORK? DESCRIBE HOW INJURY OCCURRED. ..... D NoD ..... ~ER ICheck only one) -C8I1'IFYINQ PHYSICIAN (PhytlClan C8f1lfy~ cause 01 death wheo anoth8f phVSlCian has prOf1OlJnced death and ccmpleted Item 23) To.......o..ny knowIedge.....OCCurred due 10 Ihe QUH(.).nd manner a 1ItMed. .... .......,.. ...."...",.................... D. . .... PlACE Of INJURV . At home. farm, II"", factory. otftce bWldlng. .... ISpecoIy) _. 'MEIIlCAI. EXAMINER/CORONER On.... buIa ot..aminatton anellOI' lnv.ltlgatton, In my opinion, d.ath occurred It the time. da'" and place, and due to the cau"(I) and mann.,....ltecI..........,.",.....,............,..,.........................,....,.....,.,............... _...... 31.. REGISTRAR'S SIGNATURE AND NUMBER I~/I~//I (!t I'll tJ '1 -ttfIONOUNClNG N40 CERTIFYING PHYSICIAN (PhVSlClan boIh prooouoclI"Ig death ana clK1if'y!nQ 10 cause 01 dealhl To the........, knowledge, .... occurred II the........ ate. and pIKe. and.,. 10 the CMIM(I) and manner _ alated., . . . . . . . . . . . . . . . . . . . . , . . . ... \ 21-01-323 LAST WILL AND TESTAMENT OF MARY T. MAGARO I, MARY T. MAGARO, of East Pennsboro Township, Cumberland COlmty, Pennsylvania, declare this to be my last will and revoke any will previously made by me. ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my resid11ary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II. I devise and bequeath all of my estate, of every nature and wherever situate to my daughter, Norma M. Crognale, providing she shall survive me by thirty (30) days. ITEM II. Should my daughter, Norma M. Crognale, predecease me or die on or before the thirtieth day following my death, I devise and beq11eath all of my estate of every nature and wherever siblate to my issue per stirpes living on the thirty-first day following my death. ITEM III. I appoint Andrew S. Merlina, Jr., gllardian of any property which passes either under this will or otherwise to a minor and with respect to which I am authorized to appoint a gnardian and have not otherwise specifically done so, provided that this appointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to llse principal as well as income from time to time for the minor's support and education (including college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. Should Andrew S. Merlina, Jr., predecease me or cease to act as guardian, I appoint Joseph F. Merlina, guardian of this my Last Will and Testament. ITEM V. I direct that all taxes that may be assessed in consequence of my death, of whateve nature and by whatever j11risdiction imposed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. -2- ITEM VI. I appoint my daughter, Norma M. Crognale, executrix of this my last will. Should my da1lghter, Norma M. Crognale, fail to qualify or cease to act as executrix, I appoint Andrew S. Merlina, Jr., executor of this my last will. ITEM VII. I direct that my executrix or gllardian or their Sllccessors shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand this I ~ day of .~ , 1995. ~4jjfl!a~~~vU ~ ary_ agaro The preceding instrument, consisting of this and two other typewritten pages, identified by the signat1lre of the testatrix, was on the day and date thereof signed, published and declared by Mary T. Magaro, the testatrix therein named, as and for her last will, in the presence of us, who, at her request, in her presence and in the presence of each other, have subscribed our names as wit~ hereto. U~ _ -~ ~ 1:~: -3- . . " '. . COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF DAUPHIN ) We, Mary T. Magaro, (j); Ihw(h ,1. Mic- v:::' and LQ::\'" T (:A:f..(>J~ 'f respectively, whose names are signed to the , the testatrix 3MY1~ A. Lu"'J and the witnesses, attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her last will: that she had signed willingly: that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as witness and that to the best of their knowledge the testatrix was at that time eighteen (18) years of age or older, . /<. Testatr1x, of sound mind and under no constraint or undue influence. . residing at 7-:( 3 J~/1/JJ~/ ~ I ~~~I p:r-fj 7/JdS-- residing at residing at ~ /A residing at ~'l~ g Witness, Witness, Witness, Subscribed, sworn to and acknowledged before me by Mary T. Magaro, the testatrix, and subscribed and sworn to before me by (2). II id.J{Y) J: -U--k:.v "') {AMnO.:"3 ~4. lo..JII\q and J 1\ ncL. .T (<)(V(Y\ b{/t witnesses, this -;IT;;" day of 7JlA )},/,JLI i 1995. !). L' , . . 1 ,: t ti-J 11. A ,y ~ ' U3-J{; Notary Pub ic , NOTARIAL SEAL P. KATHRYN SWARTZ, Notary Public Harrisburg, Dauphin County M Commission Ex ires March 30 1995 ! ~.. E. -- CERTIFICATE OF MOTICE UMDER RULE 5.6(a) NAMe Oil DECEDENT: Mary T. Magaro ESTATE I 21-01-0323 DATE OF DEATH: March 12, 2001 WILL or ADMINISTRATION will To the Register: I certify that notice of benefici~l interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or .ailed to the following beneficiaries of the above captioned estate. on April 3, 2001 Na.e Address Robin Sheriff 10 Vir.tnr Drive. Mechanicsburq, PA 17055-2914 Robert Croanale Rqht:\ 'R"";~'JOf'"'''''f"'\C'c nr;'t7~r lTRr!k~(')n't;"p, FT. 32244 Notice has been given to all persons entitled thereto under Rule 5.6(a} except N/A Date: It - Lr -' 61 ( . \.A 1. I - 'dJ. e. ) Slgnrlure." ~ Na..William J. Peters, Esquire Address 2931 North Front Street Harrisburg, PA 17110-1280 Telephone (717 )238-7555 . Capacity: Personal Representative Counsel for Personal Representati - -' ". ;.' x PETERS & WASILEFSKI ATTORNEYS AND COUNSELORS AT LAw 2931 NORTH FRONT STREET HARRISBURG, PENNSYLVANIA 17110-1280 WilLIAM J. PETERS CHARLES E. WASllEFSKI DENNIS J. BONETTI JOSEPH C. PHilliPS MICHAEL R. BONSHOCK THOMAS A. lANG STEPHEN F. MOORE SCOTT M. SCHWARTZ TELEPHONE (717) 238-7555 FAX (717) 238-7750 E-Mail Addresses: pwlaw@pwlegal.com WEB SITE: www.pwlegal.com January 18, 2002 Mary C. Lewis, Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, Pennsylvania 17013-3387 Re: Estate of Mary Mae:aro Our File No: 31-34 Dear Ms. Lewis: Please find enclosed a check in the amount of $25.00 for ftling of the Inventory and Inheritance Tax Return in the above-captioned matter. I am enclosing an extra copy of the Inventory and Inheritance Tax Return. Please time stamp each document and return them to me in the self-addressed, stamped envelope provided. Thank you for your time and attention to this matter. If any additional information. is needed, please do not hesitate to contact me. f ~:~~~~~ ...~.v ~ William J. Peters " WJP/mmk Enclosure 0'1 i.f:! " :~, D- N N Z <:::t: -, <.I .::.g (j)= Go -",.,..1 .~..,.. UQ Q)a: a: p Register of Wills of Cumberland County, Pennsylvania ~' INVENTORY Estate of Mary T. Maqaro No. 2001- 00323 , Deceased Date of Death March 12, 2001 Social Security No. 191-42-9583 also known as Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. INVe verify that the statements made in this inventory are true and correct. INVe understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. Personal Representative: Name of Attorney: William J. Peters, Esquire 1.0. No.: 09983 Address: 2931 North Front Street Harrisburq Telephone: 717-238-7555 Andrew S. Merlina, Jr. Dated .I ~ l I PA 17110 Description Real Estate located at Lot 13, Plan of No. 1 Gatesway Townhouses, Plan Book 38, Page 144, Cumberland Cty. known and numbered as 723 Shaffer Street, Enola, Cumberland, County, Pennsylvania AIIFirst Bank, Harrisburg, Pennsylvania Checking Account No. 5966-5475-99 Value 60,433.70 6,895.90 Metlife - Life Insurance Policy No. 806509421472 1,283.08 Metlife - Life Insurance Policy No. 611263837MS 5,058.40 Reimbursement of Utility Bill 19.64 Total (Attach Additional Sheets if necessary) 73,690.72 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 r ~.. , -::'~ i Ii~-': ; ill iI'o~ -.-. i rljl:~", '~!. i !~~!' >>,~<.~~ ~ ' .' J '.:.:.. . :1 ~ 0() r~,,:,;/ ," '\ I !.;~.,,>.~ <::(\ 1 ...._, 00 i l(~i L1j -. ~; I !,,::~ . -) I ~J j J' :.~:_._/ ,~ !~ ~ """.,... o i.? {~.i E: .;, -~ ., C) '".' ..,:......... () ".,~ 1- 'Co Q (:\:I go:: 0: ~ o ~ c"., 0- N N ~ ~ - - < Ie .. U U -a.' - c.; l- t/,. a _. u. ~ i r~"~ (E~ ." P,' .i; .~ (1)~ 00 - ~6 j - ~I-I-r-- (f)c(l:l- LLl/Ilt<( IJJ It I- Z -' 9 (/) !l: (/)-::l~~ z 0 CIl ;$:Jltz ::>OlLz .xu:r~ "U C I- (J)z~o c( a: D::l/Iz:> IJJ >- - III ti III C'l CIl Z en _ It N IE Il.~ ~ <( -'fl!:"- o (l) N r--- co II)Q) ~ ~ ~ M :> 0 ~ _..c: 0 ot r--- ....~~,.... .su ~.!!! II) -- C .- ~ C" ro ~c(J)~ O::~m~ II).U ;:, C 'j "C ~ ~ Q)cta.. ..J~;:, _ 0.88-* ~EQ):e ro;:'cro :EUQU \/ 16-~~ ~ / BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z8D6Dl HARRISBURG, PA 171Z8-D6Dl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN .02 liAY -3 ",11 :20 WILLIAM J PETERS ESQ PETERS S WASILEFSKI 2931 N FRONT ST HBG Cc; PA 1~~i1'ij:"0300 04-29-2002 MAGARO 03-12-2001 21 01-0323 CUMBERLAND 101 Allount Rellitted '* REV-1547 EX iFP 101-021 MARY T 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 ~ REV=is'4i-EX--AFP-foY':oZY-NcfficE--OF-YNHEifiTANCE-TAsrjrpPRAisEMiNT~--Ar:rOWANCE-oi----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX I ESTATE OF MAGARO MARY T FILE NO. 21 01-0323 ACN 101 DATE 04-29-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED 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) ~. 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 ( ) CHANGED U) (2) (3) (~) (5) (6) (7) 60.433.70 .00 .00 .00 13.257.02 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) l~. Net Value of Estate Subject to Tax (9) UO) 13,234.63 100.738.20 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 73,690.72 (11) (12) (13) (1~) 113.972 83 40,282.11- .00 40,282.11- NOTE: I~ an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Allount of Line l~ at Spousal rate 16. Allount of Line l~ taxable at Lineal/Class A rate 17. Allount of Line l~ at Sibling rate 18. Allount of Line l~ taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: (5) .00 X 00 = .00 (6) .00 X 045 = .00 (7) .00 X 12 = .00 (18) .00 X 15 = .00 (19)= .00 AMOUNT PAID DATE n.......... NUMBER (+) INTEREST/PEN PAID (-) TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 .00 .00 .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 THIS FORM FOR INSTRUCTIONS.) FIRST AND FINAL ACCOUNT OF Andrew S. Merlina, Jr., Executor For ESTATE OF Mary T. Ma2aro. Deceased Estate File Number Date of Death Place of Death Date of Advertisement of Estate Letters Cumberland Law Journal The Evening Sentinel Date of Executors Appointment Principal of Personal Estate Principal of Converted Real Estate Total Principal Receipts 2001-00323 March 12,2001 East Pennsboro Township, Cumberland County April 13,20,27,2001 April 7, 14,21,2001 March 26,2001 $13,257.02 $60,433.70 $73,690.72 Purpose of Account, Andrew S. Merlina, Jr., Executor, offers this account to acquaint interested parties with the transactions that have occurred during his administration. The account also indicates the proposed distribution of the estate. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: Andrew S. Merlina, Jr., Executor 1389 Quail Hollow Road Harrisburg, Pennsylvania 17112 OR William J. Peters, Esquire 2931 North Front Street Harrisburg, Pennsylvania 17110 717-238-7555 STATEMENT OF ACCOUNT ANDREW S. MERUNA, JR. .EXECUTOR OF THE ESTATE OF MARY T. MAGARO Personal ProDertv Allfirst Checking Account Met-Life Life Insurance Met-Life Life Insurance Reimbursement of Utility Bill Total Income Real ProDertv Real Estate located at 723 Shaffer Street Encla, Cumberland County, Pennsylvania Total PrinciDal ReceiDts Disbursements Richardson Funeral Home Our Lady of Lourdes Administrative Costs (Andrew S. Merlina, Jr.) Attorney's Fees (Peters & Wasilefski) Reimbursement to Andrew Merlina Cumberland County Law Journal The Sentinal Pennsylvania Water Company PPL -Electric Villa Theresa - Hospital Bill Pennsylvania American Water Company PPL -Electric Jane Biddle - County Tax 2001 East Pennsboro Township Sewer Remax Realty - Realtor Commission Notary for Sale of Real Estate 1 % Transfer Tax for sale of Real Estate Total Disbursements ProDosed Distribution to Beneficiaries 02/28/95 04/09/01 04/06/01 04/06/01 04/06/01 04/16/01 05/03/01 05/09/01 04/06/01 04/16/01 6,895.90 $1,283.08 $5,058.40 $19.64 $13,257.02 $60,433.70 $73,690.72 $3,384.00 $257.00 $4,401.00 $4,893.00 $147.00 $75.00 $77.63 $9.86 $60.32 $906.31 $15.60 $35.54 $197.55 $87.75 $1,800.00 $5.00 $600.00 $16,952.56 $0.00 ProDosed Distribution for Administrative EXDenses Executor's Commission - Andrew S. Merlina, Jr. Attorney's Fees (Peters & Waslefski) $4,401.00 $4,893.00 $60,122.60 ProDosed Distribution to the DeDartment of Public Welfare (See Department of Welfare Notice of Claim attached as Exhibit nAn and acceptance of proposed sum by the Department of Public Welfare attached as Exhibit B Insolvent Estate: All monies in excess of funeral expenses and Administrative Costs to be paid to the Pennsylvania Department of Public Welfare for Restitution for Medical Assistance granted on behalf of Decedent. EXHIBIT A . . * ,11". n I"'" "(\n' !.1,~~, I COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG. PA 17105-8486 April 23, 2001 PETERS & WASILEFSKI WILLIAM J PETERS ESQUIRE 2931 NORTH FRONT ST HARRISBURG PA 17110-1280 Re: MARY MAGARO CIS #: 680141633 Co/Rec: 22/0219066 Date of Birth: 09/03/1907 SSN: 191-42-9583 Dear Attorney Peters: Please be advised that the Department of Public Welfare maintains a claim in the amount of $97.020.27 against the above-mentioned estate. This claim is for restitution of medical assistance granted on behalf of the decedent for which the Probate Estate is now responsible to reimburse the Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as amended by Act 20-95, effective June 30, 1995. Enclosed is the Department's itemized statement of claim. A portion of this medical expense, namely $19.240.96 was incurred during the last six months of the decedent's life; therefore, it is a Class 3 claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $77.779.31 is to be entered as a priority Class 6 claim against the estate. Please acknowledge receipt of this letter and advise whether the Commonwealth's claim is admitted and when payment may be expected. If the estate accounting is complete, please provide a copy. If the estate contains real estate, please provide copies of the deed and the latest tax assessment. Sincerely, '-A~ ~.L Linda C. Price Claims Investigation Agent 717-772-6741 717-705-8150 FAX Enclosure EXHIBIT B .. *' . : 1f1t:.~ ~.} t.c_tt1~;t<. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS TPL SECTION CASUAL TV UNIT PO BOX 8486 HARRISBURG, PA 17105-8486 October 10, 2001 PETERS & WASILEFSKI WILLIAM J PETERS ESQUIRE 2931 NORTH FRONT ST HARRISBURG PA 17110-1280 Re: MARY MAGARO CIS #: 680141633 Incident Date: 03/12/2001 Dear Attorney Peters: Thank you for your correspondence dated October 5, 2001. I have reviewed the information and everything appears to be in order. The Department of Public Welfare will accept $60,122.60 as payment in full for its medical assistance lien as long as no other assets are found in the future. Sincerely, ~~~.L Linda C. Price Claims Investigation Agent 717-772-6741 717-705-8150 FAX ~ FIRST AND PiNAL ACCOUNT AND SCHEDULE OF PROPOSED DISTRIBUTION OF ANDREW S. MERLINA, JR., EXECUTOR IN THE ESTATE OF MARY T. MAGARO, DECEASED C -.1 _::l 0"' . .. ' .0 00- -oc: 0- a."" ;. ~-< , ~:1 -.n ., C"1IIl::lCh c: Q...,- ::.: g-a. ;; - :T ~ .~ - ~..a .Or: ~, -1= ;l~ -til --.11 LATE OF EAST PENNSBORO TOWNSHIP, CUMBERLAND COUNTY, PENNSYLANIA --, ,. J ESTATE FILE NO: 2001-00323 d r,) F ,-' .J. en ce,: .u~~ William J. Peters, Esquire Attorney of Record I hereby certify that written notico of the filing of I n~ieby cortify tMl wrlt10n not!'Xl of the flUng of this this Aocount. and of the date, time and place " Swerr~ of Proposed OIsttIbution. and ~ the data, Nnen the same wiU be preeentecl to ~ Court time and place when the same will be ",see. IMd kl 'or oonikmatton and of ~ last day to file written the Court for cou.fmelion en:! of Ile I8It ~ to tie vOjectlonS to said Aocount. has been given \0 written objecticlI'lI to IlIid Sill t Ml~ ~ Propoeed t1very unpaid cI8knent and \0 evefy ot~ perlOO DiWI:lulIor" h8I been gNen to ..., unpeId cteimant l<nown to the aooountant to have Of cI8tm an and to 8Y8fY 0Iher pnon known to the acoouneent to ---Altoi' ....~ heYI!t or eIalm an inlil!Jr8St In the estaI8 as c:MlItor interest In ~ estate as \;ItnJ ,L1<"I"""~1' f kin ~. h9lr Of' (Y.l.)it of Idn. . heir or next 0 . A COfjy of ~aid Statement was lnduded with the notlce (/~ STATUS REPORT UNDER RULE 6.12 BEFORE THE REGISTER OF WillS, COUNTY OF Cumberland , PENNSYLVANIA Name of Decedent: Mary T. Magaro Date of Death: 3/12/01 2001-00323\ File No. Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to the completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: YES X NO_ 2. If the answer 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~ NO_ b. The separate Orphan's 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? YES_ NO_ d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: 2 - J'i-O} W-o: ~ Signature William J. Peters. Esquire Name (Please type or print) 2931 North Front Street Address Harrisburg - PA 17110 717-238-7555 Tel. No. Capacity: _ Personal Representative --L Counsel for personal representative .. Cumberland County - Register Of wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 2/07/2003 ANDREW S MERLINA JR 1389 QUAIL HOLLOW ROAD HARRISBURG, PA 17112 RE: Estate of MAGARO MARY T File Number: 2001-00323 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS I COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 3/12/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, DONNA M. OTTO DEPUTY REGISTER OF WILLS cc: j File Counsel Judge REV-1500 EX+ (S-OO) '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 260601 HARRISBURG. PA 17126-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W C W o w c w ~ ",-II> 0"'''' w~o J:a::9 u~co .. DECEDENTS NAME (LAST, FIRST, AND MIDDlE INITIAL) DATE DF BIRTH \MM-oo.Vear) [R) 1. Original Retum o 4. Limited Estate [R) 6. DecedentDied Testate 1_'"'''''''') o 9. Litigation Proceeds Received o 2. Supplemental Retum o 4a. Future Interest Compromise {daleddealh after 12-12-&2) o 7. Decedent Maintained a Living Trust (Attacll copy of Trust) o 10, Spousal Poverty Credn (dale ofdeatll between 12-31-91 and1-1..gs) OFFICIAL USE ONLY c 03 12 2001 09 03 1917 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST. AND MIDDLE INiTIAl) NA I~ - ..J:;l.,o -1____ FIlE NUMBER .el' -...a.L _~~l6...~ COUN~ YEAR NUMBER SOCIAL SECURJTY NUMBER 191-42-9583 TIllS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURJTY NUMBER o 3. Remainder Retum (daleofcleathpriorkl12-13-82J o 5. Federal Estate Tax Retum Required _ 8. Total Number of Safe Depos~ Boxes o 11.ElectiontotaxunderSee.9113{A)_',",0) z o ~ 0:( ..J :J l- ii: 0:( o w D:: COMPLETE MAILING ADDRESS 2931 North Front 5treet NAME William J. Peters E uire FIRM NAME (If Applicable) Peters & Wasilefski TELEPHONE NUMBER 717-238-7555 Harrisbur X .0_(15) X .0_(16) X .12 (17) X .15 (16) (19) z o I- ~ :J a. :E o o >< 0:( I- 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 60.433.70 ~ ,n.; ;..I -. ;:('1) :;;) ." t:r ' ,. PA 17110 OFFICIAL USE ONLY (1) (2) (3) (4) (5) 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortyages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Scheduie E) 6. Joint~ Owned Properly (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 6. Total Gro.. As.... (total Lines1-?) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Deceden~ Mortyage Liabilities, & Uens (Schedu~ I) 11. Total Deduction. (lotalUnes 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Govemmental Bequests/See 9113 Trusts forwhk:h an eleclion to lax has not been made (Schedule J) (6) (7) (9) (10) 14. Net Value Subject \0 Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal lax rate, ortransiers under See. 9116 (a}(1.2) 16. Amount ot Line 14 taxab~ at lineal rate 17. Amount of Une 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due F:3 :0 ro ,:,^" ~~2 '- "" Z :, IN 13,257.02 N U ,N 1M l~_____ (6) 73.690.72 13.234.63 100.738.20 (11) (12) (13) 113.972.83 -40.282.11 (14) -40.282.11 Decedent's omplete Address: STREET ADDRESS 723 Shaffer Street CITY I STA1E I ZIP Enola PA 17025 C Tax Payments and Credits: 1. TaxDue(PagelUneI9) (I) 2. Credils/Payments A. Spousal Poverty Credit 6. Pnor Payments C. Discount Tolal Credits (A +6+C) (2) 3. InteresVPenalty W applicable D.lnteresl E. Penally T otallnleresVPenally ( 0 + E ) (3) 4. If Line 2 is greater than Une 1 + Une 3, enlerthe difference. This is Ihe OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is grealer than Une 2, enler Ihe diffOfOnce. This Is the TAX DUE. (5) A. Enter the interesl on the tax due. (5A) 6. Enler the total of Line 5 + 5A This is the BALANCE DUE. (56) Make Check Payable to: REGISTER OF WILLS, AGENT illlillliM.I_iMI_. liilllillll.iII-~lIillllllllrlllFiHr'l.illlllll illl'~" i ..111111111..111. PlEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or Income of the property lransferred; ........................................................................... 0 ~ b. retain the nghl to deslgnalewho shall use the property transferred or its income; ........................................ 0 ~ c. retain a reversionary interest; or ...................................................................................................... 0 1Zl d. receive the promise for life of eilher payments, benefits or care? ............................................................. 0 ~ 2. If death occurred after December 12, 1962, did deceda11t transfer property within one year of death without receiving adequale consideralion?............. ....................................... .......... .... .................. .......... 0 IE] 3. Did decedenl own an 'in trustfo~ or payable upon death bank account or secunly at his or herdealh? ................. 0 ~ 4. Did decedent own an Individual Retiremenl Accounl, annuily, or other non-probate property which conlains a beneficiary designation? ....................................................................................................... 0 IE] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjU'Y, I declare thai I have examined this return, includi~ ~ying schedules and statements, and to the best of my knowledge and belief, it is !rue, correct and complete. Declorcmn of prepanl!r other thal the personal representative is based on all Information of which preparer has any knowledge. SIGNATURE OF R N RESPONSIBLE FOR FILING RE RN DATE ADDRESS ndrew S. Merlina 1389 Ouail Hollow Road. HarrisburQ. SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE PA 17112 DATE ADDRESS William J. Peters, Esquire 2931 North Front Street. Harrisburq PA 17110 _~_~__~_,__"IfJ.L.J". .,.,."'...d,~.,'__,,_~~,a;;Jlc .___1 ill ..LI-'" llil:l. For dates of death on or after July 1, 1964 and before January 1, 1995, Ihe lax rale imposed on the net value of transfers 10 or for the use of Ihe surviving spouse is 3% (72 P.S. ~9116 <a) (1.1) (i)]. For dales of death on or after January 1, 1995, the tax rate imposed on the nel value of transfers to or for the use oflhe surviving spouse is 0% (72 P.S. ~9116 (a) (1.1) (iill. The statule does nol exemot a transfer 10 a surviving spouse from lax, and the slatulory requiremenls for disclosure of assets and filing a tax retum are still applicable even if Ihe surviving spouse is the only beneficiary. For dates of dealh on Dr after July 1, 2000: The lax rale imposed on the net value of Iransfers from a deceased child twenty-<lne years of age or younger at death to Of for the use of a natural parent, an adoptive parent, or a slepparent 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 beneficianes is 4.5%, excepl as noled in 72 P.S. ~9116(1.2) (72 P.S. ~9116(a)(1)]. The lax rale imposed on the net value of Iransfers 10 or for the use of the decedenl's siblings is 12% (72 P.S. ~9116{a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has alleasl one parenl in common with Ihe decedent, whether by blood or adoption. ~'~~'I"" '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETlRN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Maaaro MaN T Indude the proceeds 01 litigation and the date the proceeds were received by the eslate. All property jolntly-owned with the right.' survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Allfirst Bank, Harrisburg, Pennsylvania 6,895.90 Checking Account No. 031300834-5966-5475-99 2 Metlife - Life Insurance 1,283.08 Policy No. 806509421472 3 Metlife - Life Insurance 5,058.40 Policy No. 611263837MS 4 Reimbursement of Utility Bill 19.64 TOTAL (Also enter on line 5, Recapitulation) $ (if more space is needed, insert additional sheets of the same size) 13 257.02 ~""EX..I'~I. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER Manaro MaN T Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Richardson Funeral Home, Inc. 3,384.00 2 Our Lady of Lourdes - Luncheon and Service 257.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Andrew 5. Merlina. Jr. 4,401.00 Sodal Security Numbeljs) I EIN Number of Personal Represenlative(s) Street Address 1389 Quail Hollow Road City Harrisburq Slate PA Zip 17112 Year(s) Commission Paid: 4,401.00 2. Attorney Fees 4,893.00 3. Family Exemption: (If decedents address is not the same as daimanfs. attach explanation) Claimant Streel Address City Slate Zip Relationship of Claimant to Decedenl 4. Probate Fees 5. Accountants Fees Reimbursement to Andrew 5. Merlina for advancement of Probate fees 147.00 6. Tax Return Prepare~s Fees 7. Cumberland County Law Journal 75.00 The Sentinel - Legal 77.63 TOTAL (Also enler on line 9, Recapitulation) $ 13 234.63 (If more space IS needed, Insert additional sheets of the same size) . ~l"m~I:$1 . COMMONWEALTH OF PENNSYLVANIA INHERITANCE 1AX RE1URN RESIOENT DECEDENT ESTATE OF Maaaro Marv T Include unrelmbursed medica' expenses. ITEM NUMBER SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS FILE NUMBER DESCRIPTION AMOUNT 1. Pennsylvania Water Company 9.86 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. PPL - Electric 60.32 Villa Theresa - Hospital Bill 906.31 Pennsylvania American Water Company 15.60 PPL Electric 35.54 Jane Biddle, Treasurer County Tax 2001 197.55 East Pennsboro Township Sewer 87.75 Remax Realty Professionals, Inc. Realtor Commission Sale of 723 Shaffer Street, Enola, Pennsylvania 17025 Notary for Sale of Real Estate 1,800.00 5.00 1% Transfer Tax Sale of Real Estate 600.00 Department of Public Welfare Medical Assistance Class 3 19,240.96 Department of Public Welfare Medical Assistance Class 6 77,779.31 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 100 738.20 '~'''''':''.n . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER "~n,T RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS (Include outright spousal distributions) 1. Insolvent Estate 60,122.60 Balance of Funds to be paid to the Commonwealth of Pennsylvania Department of Public Welfare ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL OISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE 1. S. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART n - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) , . ~ ~ \ . LAST WILL AND TESTAMENT OF MARY T. MAGARO I, MARY T. MAGARO, of East pennsboro Township, Cnmberland COlmty, Pennsylvania, declare this to be my last will and revoke any will previo1lsly made by me. ITEM I. I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my resid11ary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. ITEM II. I devise and bequeath all of my estate, of every nature and wherever situate to my daughter, Norma M. Crognale, providing she shall sllrvive me by thirty (30) days. ITEM II. Should my daughter, Norma M. Crognale, predecease me or die on or before the thirtieth day following my death, I devise and beq1leath all of my estate of every nature and wherever situate to my issue per stirpes living on the thirty-first day following my death. t ~ ITEM III. I appoint Andrew S. Merlina, Jr., gnardian of any property which passes either ,mder this will or otherwise to a minor and with respect to which I am a11thorized to appoint a gnardian and have not otherwise specifically done so, provided that this appointment of a guardian shall not supersede the right of any fidnciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to l1se principal as well as income from time to time for the minor's s11pport and edncation (incl11ding college education, both gradnate and undergradnate) withont regard to his or her parent's ability to provide for such support and eduoation, or to make payment for these pnrposes, without fnrther responsibility, to the minor or to the minor's parent or to any person taking care of the minor. Should Andrew S. Merlina, Jr., predecease me or cease to act as guardian, I appoint Joseph F. Merlina, guardian of this my Last Will and Testament. ITEM V. I direct that all taxes that may be assessed in consequence of my death, of whateve natnre and by whatever j11risdiction imposed, shall be paid from my residnary estate as a part of the expense of the administration of my estate. -2- ITEM VI. I appoint my daughter, Norma M. Crognale, executrix of this my last will. Shollld my dallghter, Norma M. Crognale, fail to qualify or cease to act as executrix, I appoint Andrew S. Merlina, Jr., execlltor of this my last will. ITEM VII. I direct that my executrix or ~Iardian or their successors shall not be reqllired to give bond for the faithful performance of their d'lties in any jurisdiction. hand this IN WITNESS ----, Lr I day WHEREOF, I have hereunto set my of .~.c , 1995. t;::, <1j}1:o ~-Ekl~vU - ary L agaro The preceding instr1lment, consisting of this and two other typewritten pages, identified by the signa~lre of the testatrix, was on the day and date thereof signed, published and declared by Mary T. Magaro, the testatrix therein named, as and for her last will, in the presence of lIS, who, at her req1lest, in her presence and in the presence of each other, have subscribed our names as witness hereto. u 1:/~: .' "kh',~ ,- -3- COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF DAUPHIN We, Mary --IT-Anlru~> II" [-ijf../kCl J and the witnesses, r, /11- i" I ,':,i r T. Magaro, VJ' ......ufY) ,-. ti:..-fc~/~ and ,1((,,,[,,,, T ["'(frY] hi) . j. respect~vely, whose names are s~gned to the , , the testatrix attached or foregoing instr1lment, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her last will; that she had signed willingly; that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as witness and that to the best of their knowledge the testatrix was at that time eighteen (18) years of age or older, Testatrix, '/7u ~ residing at residing at residing at residing at influence. ' # It- "'/'2.3 Jlt, e1,~' c>'n~"#.-f p= I TPdS - ~/,/A 5:::kf: h. ~ LA,L)fd'.-'-~ cL before me by of sound mind and under no constraint or undue Witness, Witness, Witness, Subscribed, sworn to and acknowledged Mary T. Magaro, the testatrix, me by UX 1111.1/01 IR)-k~\( ::, ! '",,1,,- ,T (")e""rnt"l, witnesses, this I and subscribed and sworn to before tI:/ffYJOfJ A, -~) !'.-.t' Lcfi_N\q J day of and IJ: 1 .1,1 j)/>,f!..-; 1995. NOTARIAL SEAL p, KATHRYN SWARTZ. Notary Public Hanlsburg. DauphIn County Mv Commission Exoires March 30 1995 *' ~J"I.; ,;" '7(,1)1 ~~' ',' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG, PA 17105-8486 April 23, 2001 PETERS & WASILEFSKI WILLIAM J PETERS ESQUIRE 2931 NORTH FRONT ST HARRISBURG PA 17110-1280 Re: MARY MAGARO CIS #: 680141633 Co/Rec: 22/0219066 Date of Birth: 09/03/1907 SSN: 191-42-9583 Dear Attorney Peters: Please be advised that the Department of Public Welfare maintains a claim in the amount of $97,020.27 against the above~mentioned estate. This claim is for restitution of medical assistance granted on behalf of the decedent for which the Probate Estate is now responsible to reimburse the Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as amended by Act 20-95, effective June 30, 1995. Enclosed is the Department IS itemized statement of claim. A portion of this medical expense, namely $19,240~96 was incurred during the last six months of the decedent's life; therefore, it is a Class 3 claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $77.779.31 is to be entered as a priority Class 6 claim against the estate. Please acknowledge receipt of this letter and advise whether the Commonwealth's claim is admitted and when payment may be expected. If the estate accounting is complete, please provide a copy. Xf the estate contains real estate, please provide copies of the deed and the latest tax assessment. Sincerely, ~~Q..L Linda C. Price Claims Investigation Agent 717-772-6741 717-705-8150 FAX Enclosure *' '" lMlt (, "U\t~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS TPL SECTION CASUAL TV UNIT PO BOX 8486 HARRISBURG, PA 17105-8486 October 10, 2001 PETERS & WASILEFSKI WILLIAM J PETERS ESQUIRE 2931 NORTH FRONT ST HARRISBURG PA 17110-1280 Re: MARY MAGARO CIS #: 680141633 Incident Date: 03/12/2001 Dear Attorney Peters: Thank you for your correspondence dated October 5, 2001. I have reviewed the information and everything appears to be in order. The Department of Public Welfare will accept $60,122.60 as payment in full for its medical assistance lien as long as no other assets are found in the future. Sincerely, ~l-'v'<.a....l!...L Linda C. Price Claims Investigation Agent 717-772 -6741 717-705-8150 FAX A. ::.eUjemenl.Slalemenl U.S. Department of Housing .nd UrlNin Development OMB No. 2502-0265 ~ 1r B. Type 01 Loan 6. File Number 7. loan NumbeJ 8. Mortgage Insul1Ince Case Number 1.0 FHA 4.0 VA C. NOTE: 2. 0 FmHA 3. D COny. Unins. 5. 0 COny. Ins. This form is furnished 10 give you a sl",,,,,,,, I of aclual settlemenl costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. D. NAME AND ADDRESS OF BORROWER: RONALD G. GATES and DONNA L. GATES E. NAME AND ADDRESS OF SELLER: ANDREW S. MERLINA, JR. EXECUTOR OF THE ESTATE OF MARY T. MAGARO G. PROPERTY LOCATION: 723 SHAFFER STREET ENOLA EAST PENNSBORO TOWNSHIP CUMBERLAND COUNTY H. SETTLEMENT AGENT: A-1 ABSTRACT .ASSOCIATES INC. PLACE OF SETTLEMENT: 1aOO Ling1estown Road, Suite COYNE & COYNE, PC, Attorneys 102 Harrieburg, PA at Law 17HO (717) 257-5400 I. SETTLEMENT DATE: J. SUMMARY OF BORROW R'S RANSACTlON ::jddi:LG.a.osl,fAMQijijt;b.us::f'aoM:,a6,AAOWeatW:::t>:J::::'::: :::':'::::::'",::::;::,;,::;;,:::;,;;:.::::',:::::::;::::::::;:;:::~ 101. Contract sales price 102. Personal property :103; Settlement charges, t6J)()rrowar: (Iromline14oo) 1,219.25 K. SUMMARY OF SELLER'S TRANSACTION AOO;GRQSs AMDUNT.DuEtoselLER:.:..... ." ." 401. Contract sales price 402. Personel property 403. 60,000.00 ~ 404. 405. ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: 406. Clty/town taxes 10 143.43 407. County taxes 04/11/01to 12/31/01 408. Assessments 10 409. School tax 04/11/01-06/30/01 410. SEWER/TRAS 04/11/01-06/30/01 411. 412. 420. GROSS AMOUNT 61,652.95 DUE TO SELLER: .,: :/t".<.Aioo; ..AEDOeTIONSIN AM6uNT.OUETO SELLEii: ....... 5, 000 . 00 501. Excess deposit (see/nstructions) 502. Settlement charges 10 seller (lIne 1400) 503. Existing loan(s) taken subject to 504. Payoff of first mortgaga loan 505. Payotl of second mortgage loan 506. 2001 CO/'t'WP TAX 507. SEWER/TR 2ND QTR 508. 509. ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: 143.43 104. 105. ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: 106. Clty/town taxes to .107. County taxes 04/11/0110 12/31/01 108", Assessments to 109. School tax 04/11/01-06/30/01 110. SEWER/TRAS 04/11/01-06/30/01 111. 112. 120. GROSS AMOUNT DUE FROM BORROWER: ,2oo.iiMOUNTSpilw.IlYORII!iBEHALF.OF.BOIlROWElli', 212.38 77.89 212.38 77.89 ~ 60,433.70 201 \. Oepos,it or ~arnest money 202. Principal amount of new loan(.) 203., Existing ,lq_lln{s) taken, subject to 204. 205. 206. 207. 208. 209. ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: 210. Cltyltown taxes to 21 f county taxes to 212. Assessments to 213. School Taxes 214. 215. 216. 217. 218. 219. 220. TOTAL PAID BY/FOR BORROWER: ;l00.. C:/lSH At SE'rt"EI.1EN:r~1'I9M/T(j .!lDIl!i9W.ER~ . 301. Gross amount due from ~rrower (line, 1_20) 30~, _ Less, amo\Jnt paid byJlor_bortowet (Iihe 220) ; 2,405.00 197.55 87.75 510. ,Clty/town taxes 511. County taxe. 512. Assessments 513. 514. 515. 516. 517. 518. 519. 520. TOTAL REDUCTIONS 5,000.00 IN AMOUNT DUE SELLER: .. ..,\ ...i.',' ,,<.lIll11, .eMIl. 4l Sm~EMEI'Ir'r9~IlDMSE~~I!!i(' .'. . 61, 652 . 95 601. Gross amount due to seller (Iin,s 420) 5,,' O.o,:O.-:~- q 0) 602, Lesa total reductions in amount due sellet. to to . . to ~ 2,690.30 (fine 520) 60,433.70 2,690.30 303. CASH ~ FROM 0 TO BORROWER: ~ 56,652.95 603. CASH ~ TO 0 FROM SELLER: ~ 57,743.40 ~~501 (8811).01 '" VMP MORTGAGE FORMS. (313)293-8100. (800)521-7291 HUD-l (3-66) RESPA, HB 4305.2 HU()... 'Rev~3186 rUWJ@b'.W~.?1t'4~~ll:t~>~~~:;:~f:ffl '~t; ~it.t*P*~*i~U!~f~~it~!t.8:~~W~~:~t1:~::::f*-~W:i:'."" 700. TO~AL S!,Le.s / "ROKER'S COMMISSION: .. BASED ON PRICE to $ 60,000.00@ %- 1,800.00 PAID FROM BORROWER'S FUNDS AT SETTLEMENT PAID FROM SELLER'S FUNDS AT SETTLEMENT 1,800.00 ~M:':.'~i : i\1!lilliiiC IF'" $ 1,800.00 $ .:u. "jf4MWMV@@M 701, 702. 703. 704. ....... ....~ ". REALTY PROFESSIONALS INC to 601. 802. 603. 804. 805. Loan- 6flginatiOn ,fee Loan ,(:tiscount Apprtilsa\..fee:.(o, Credit ,report ,to: Lender's inspection fee Mortgage Insurance application le;e 10 ASsumptiOn fee 606. 607. 606. 809. 610. 811. IJlllllii1WIfi1M$Ml!l!)iJIM~'lf;;j;mllr ..' 901. Inleres,lrom 04/11/01'0 902. Mortgage insurance premium for 903. Hazard insurance prem,ium lor >l1ll!l'litAlb.'INt. .6.\!J\Ne~P\%YW 04/30/01 @ $ Iday 904. Flood Insurance Premium for mas. 10 ynt to yrs.lo 1001. monlhs,@ S 1002. Mortgage insurance months @$ 1003, City. property taxes monthS @ $ 1004. Co:unly property _t,~.xes months @ $ 100s. Annuai assessments monthS '@,$ 1006, Road insuranc9 montt:'s_ @ $ 1007. School property taxes monlh. @$ 100B. Aggregate Adjustment months@ rar: "\Wfr;"::,'. 'r.]!jiJiJr.":-:~~m 'A:~~P*lr~%~~:~F~*!}~~Hlt.M~~t~;~':l\#@~:M~:~W@w.. pet monlh per month pel' month per ,month petli1Cirlth per ,~onth pel' mOnth er month 1101. Se:ttlementorclos,ing,feeto 11b2. Abstract ot title search to 1103. Title examinatlon to 1104. Title in~uriit1te binder to ~ 1 05. Dqcurnent prep,afation to, t1OO. Notary,fees t6 1107. Attorneys' lees to A-1 Al3STRACT ASSOCIATES tNC 75,00 1108. A-1 ABSTRACT ASSOCIATES INC 5.00 A-1 ABSTRACT ASSOCIATES, INC (lffclUdeS above irimls Numbers: 1109. Lender's coverage $ 1110. OWner's coVerage $ 1111. PA End. 300, 100, 1112. APPROVED ATTOlWEY 1113. M~%l!~!iiiji'lM~ilfj1' ............. ." 60,000,00 8.1 FEE COYNE & COYNE, PC 291.25 1301. SurVey to 1302. Pest inspection to 1303. FED-EX 1304. 1305. 1306. 13 7. ;' Releases $ '201; ReCOrding fees: beed ,$ 1202. City/county ,tax 'stamps: . 1203. Stale tax / stamps 1204. 1205. '\1@ll' M;llfjfftlil~All\f Deed $ Deed $ : Mortgage $ ; Mortgage $ 1400. TOTAL SETTLEMENT CHARGES (Enter on line 103, Section J-and./ine 502, Section K) 1,219.25 2,405.00 I have carefully reviewed Ihe HUO.1 Seltlement Slatement and to the besl 01 my knowledge and belief, it Is a lrue and accurate statement of all receipts and disbursemants made on m, .~~o.;'a'by me In ~I':'"'!i' lI.rt.: .rt;r, ."hovo "",~,,<lo "'o,art"o HUO.' SOlllom,"~ ~. eana_, . /"7; 0010' 04/11 /01 Sollo. j_.s~. /... fx'i.... --D.4/11/01 RONALD G. GATES . REW S. LINA R or ecutor Borrower: '11{>~ .J. LJUNNA L. (jAl~~ ~ Date: 04/11/01 Seller: Dale: The HUD.1 Settlement Statement which I have prepared is a true and accurate in accordance with this statement. account 01 this transacllon. I have caused or will cause the lunds to be A-1 ABST~T ASSOC INC. Dale: 04 / 11 / 0 1 Selllemen! Agent ' WARNING: II Is It crime to knowingly make fBlse statements to the United States on this or any other similar fonn. Penallles upon convl Ford9lails see: Title 18 U.S. Code Secllon 1001 and Section 1010. G>m-502 (8811).02 disbursed 04 11 01 VMP MORTGAGE FORMS (313)293.8100 - (800)521-7291 PAGE 2