HomeMy WebLinkAbout01-0329
Estate of. in IT f( 'f T
also known as
PETITION FOR PROBATE and GRANT OF LETTERS
6U-DI- 3:2..'1
LOf)/};-W
No.
To:
Register of Wills for the
, Deceased. County of CUMBERLAND in the
Social Security No. -20 1'- j/:;- ...25o'f 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 execute> R..
in the last will of the above decedent, dated IJ?lty .;;2/
and codicil(s) dated
named
,19 ~7
(state relevant circnmstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in eu m8e1{l..ftN 6
hE;~ last family or principal residence at $ S0 I-J I t.l C(:BSf
CouQty, Pennsylvania, with
IJ/J' ue:- 50ttrfJ 1'Yl) dJ(~TG,<J
/
(list street, number and muncipality)
Decendent, then 86
at
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:
years of age, died
mftlKft.
G'
..:2.00 {
,19
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:
$ ..:S~~
$
$
$
WHEREFORE, petitioner(s) respectfully r~u~..p~J.~rA.RT9bate of the last will and codicil(s)
presented herewith and the grant of letters Ie=> '''flc-'v ~
(testamentary; administration c. La.; administration d. b.n.c. La.)
theron.
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OATH OFPERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 1..ss
COUNTY OF CUMBERLAND J
MAR'U C
l(q - ;J.;XO - 7
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 well and truly administer the estate according to law.
S:b~~~~~ ~~~~
Register
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No (1 - 01 - 3(9
.
Estate of
MARY T LOBATO
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW MARCH 27, xt~ 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 MARCH 21. 1989
described therein be admitted to probate and filed of record as the last will of
MARY T LOBATO
and Letters TESTAMENTARY
are hereby granted to ANTHONY E LOBATO
~t(}/Ifi~FMmBi:D91.
MARY CLEWIS
FEES
80.00
18.00
Probate, Letters, Etc. ......... $
Short Certificates( r, . . . . . . . . .. $
':~~gcj~tion ................ $
JCP $
TOTAL _ $
MARCH 27, 2001
ATIORNEY (Sup. Ct. J.D. No.)
6.00
5.00
109.00
ADDRESS
Filed
.................................. .
PHONE
Mailed letters to Executrix on 3-27-01
'-t \' \e..~ .3 - ;>lD- D \
H 105.R05 REV 9/Ro
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 filIng.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
..
me as
Fee for this certificate, $2.00
No.
~~. ~eu..~Q~
Local Registrar
p
7247723
MAR 1 5 2001
Date
Hl05.144 Rev. 1191
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
IPRINT
IN
ANENT
;KINK
T
Lobato
&WE Fll.E NUMISER
SOCIAL SECURITY NUMBER
UNOER 1 OM
Hours Mlnulft
DATE OF BIRTH
(Month. Qey, Year)
BIRTHPLACE 'City and
SI.t. Of FOfeign Country)
209-16-2504
DATE OF DEATH (Month. Day, "Nr)
.. March 13, 2001
CITY. BOA
~o
DECEDENT'S
ACTUAL
RESIDENCE
(Seeinslructions
on other side)
17..Stet8
PA
MAArt\l. STATUS - Married
~MII'rIed. Wkbwed,
-ISpoc<y)
Widowed
RACE. Amertclln Indian, Blick, WhIte, etc.
-
1.. White
SURVIVING SPOUSE
(If wife. give maiden name)
~ DECEDENT EVER IN
U.S. ARMEO FORCES?
Yo.O No~
lTb. Coun
Old
-,
!We In a
CUIlt>erland 'OW"""Ip? l?d.o =-:'':::::0'
MOTHER'S NAME IFIl'Sl. Middle. Maiden Surname)
Elizabeth Shoffler
17c.1XI Vel. dececlentllved ItI
S. Middleton Two.
twp.
""""
21c.
A P rx . DATE PRONOUNCEO DEAD (Month, Day, Year)
... 2: 00 P. M. .S. March 13; 2001
27. PART f: Ene., the dIMun, injuries or comptlcatlons whk:h caused the dult". Do not em., I"e mode 01 dying. sue" a. cardi8c or respiratory arrest, ahock or""rt tailure.
UIt onty one CIluM on eacl'lline
23b. 23c.
WAS CASE REFERRED TO MEDICAL EXAMINER/CORONER?
,..~ NoD
b.
,ApproximBte
: int.......1 between
iO-.""".'"
PART II: Ol:hef signiflcanl condIIiont; contributing 10 C1eath, but
not resulling in Ihe undertylng cauM given In PART I.
CHF, H ertension
DUE TO (OA AS A CONSEQUENCE OF):
DUE 10 lOR AS A CONSEauENCE OF),
d
WERE AUTOPSY ANrnNQS
JMtJLA8LE PRtOR TO
COMPLETION OF CAUSE
OF OEJJH?
MANNER OF DEATH
Natural
~
o
o
DATE OF ~URY
{Month, Day. \'\ItIrl
TIME OF INJURY
Coroner
INJURY AT WORK?
-
o
o M
o =O~~~~tl home, farm, street, factory, office
....
,..0
No 0
-
Pending lnvtiltigellon
Could not be determined
2Ia. lib.
CEIlTIFIEA (Cfl8ck ....., ....)
.CERTIFYtHO PHVSJCIAN (Physician certifying cause of deeth when aneth. physician hils pronounced death and completed l1em 23)
To Ihe belt of my knowledge, dellthoccurredduetathe~')'ndmennerHstatl'd..,..""....,.".....".....,..,.,...".........,...
-
D.
o
.PRONOuNcING AND CERTIFYING PHYSICIAN (Physician both pronouncing dearh and certifying 10 cause d death)
To the but of my knowtedge. death OCCUf'NCf at the..... det., end pteq. and'" to the ceuu(s) end menner.. etell'd.. '. . . . . , , , . . . . , , . . . . . . . . .
.MEDlCAl. EXAMINERlCORONER
On the butt: of .xamlnetton and/or Investigation. In my opinion, d.ath occurred lit the time, d.te, and place. and due to the C8UH{a} and
m.nner......Id......... ....,.,...,.......,...,....,.................................................... .........
3t..
REGISTRAR'S SIGNRURE AND
~. ~tu...~
/8.,\ ~ \,01
DATE StONED (Month. Day, ""'r)
o 31. "d. March 14, 2001
NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH
(lIem 27) Type or Pnnt Michael L. Norris. Coroner
~ 6375 Basehore Road, Suite #1
1\n. Mechanicsburg, Pa. 17050
CATE FILED (Month. OIlY. 'IlIar)
...
LAST WILL AND TESTAMENT OF
MARY T. LOBATO
I, Mary T. Lobato, of South Middleton Township, Cumberland
County, Pennsylvania, declare this to be my Last Will and
Testament and revoke all Wills and Codicils previously made by me.
ITEM I: I direct that all my legally enforceable debts and
funeral expenses, including all expenses of my last illness, shall
be paid from my residuary 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 the residue of my estate of
every nature and wherever situate in equal shares to my son,
Anthony E. Lobato, my daughter-in-law, Mary Jane Lobato and my
grandson, David E. Lobato. Should any of the above named persons
predecease me, his or her share of my estate shall be added to
the shares for the other named persons.
ITEM III: I appoint my son, Anthony E. Lobato, of South
Middleton Township, guardian 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 guardian 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
use principal, as well as income, from time to time for the
minor's support, health and medical care, and education (including
college education, both undergraduate and graduate), or to make
payment for these purposes, without further responsibility, to the
minor or to any person taking care of the minor.
ITEM IV: All Federal, State and other death taxes payable
because of my death, with respect to the property forming my gross
estate for tax purposes, whether passing under this Will or
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otherwise, including any interest or penalty imposed in connection
with such taxes, shall be considered a part of the expense of the
administration of my estate and shall be paid out of the principal
of my residuary estate without apportionment or right of
reimbursement.
ITEM V: I appoint my said son, Anthony E. Lobato, Executor
of this my last Will. Should my said son fail to qualify or cease
to act as Executor, I appoint my said daughter-in-law, Mary Jane
Lobato, Executrix of this my last Will.
ITEM VI: I direct that all fiduciaries acting under this
Will, whether or not named herein, 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 and seal,
this a/at day of PlaNJv , 1989.
~~.,Z:-~~AL]
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t
The preceding instrument, consisting of this and one other
typewritten page each identified by the signature of the
Testatrix, was on the date thereof, signed, published and declared
by Mary T. Lobato, 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 witnesses hereto.
- -- .."
"
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
We, Mary T. Lobato, Michael R. Rundle and Mary M. Price, the
Testatrix and the witnesses, respectively, whose names are signed
to the 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 and that she had signed
willingly, and 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 his/her knowledge the
Testatrix was at that time eighteen years of age or older, of
sound mind and under no constraint or undue influence.
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Witness -
ifo/ fI!. O~
Witness
Subscribed, sworn to and acknowledged before me by Mary T.
Lobato, the Testatrix, and subscribed and sworn to before me
Michael R. Rundle and Mary M. Price, witnesses, this ~/~~
of ma,'1J\ , 1989.
by
day
NOTARIAL SEA.L
BONNIE L. COYLE. NOTAP,Y PUBLIC
MT HOLLY spes. BORG. CUME:EflLf,:i;; COUNTY
MY COMMISSiON EXP;RES OCin3t." Ri990
.~~
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CERTIFICATION OF NOTICE UNDER RULE 5.6(al
Name of Decedent:
Mary T. Lobato
Date of Death:
March 13, 2001
Will No.
2001-00329
Admin. No.
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans. Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on March 25, 2001
Name
Address
David Lobato
556 Hillcrest Drive Carlisle, PA 17013
Mary Jane Lobato
556 Hillcrest Drive Carlisle, PA 17013
Anthony E. Lobato
79 Fairway Drive Camp hill, PA 17011
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except N/ A
Date:
July 6, 2001
~2$U
Signature
Name
Anthony E. Lobato
Address
79 Fairway Drive
Camp Hill, PA 17011
Telephone (711 763-7862
Capacity: ~ Personal Representative Executor
_Counsel for personal representative
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRIS8URG, PA 17128-0601
RECEIVED FROM:
ANTHONY E LOBATO
79 FAIRWAY DRIVE
CAMP HILL, PA 17011
___u___ fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ESTATE INFORMATION: SSN: 209-16-2504
FILE NUMBER: 21-2001- 0329
DECEDENT NAME: LOBA TO MARY T
DATE OF PAYMENT: 11/30/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 03/13/2001
REMARKS: ANTHONY LABA TO
CHECK# 100
SEAL
ACN
ASSESSMENT
CONTROL
NUMBER
101
TOTAL AMOUNT PAID:
INITIALS: AC
RECEIVED BY:
REGISTER OF WILLS
REV-1162 EX(11-96)
NO. CD 000576
MARY C. LEWIS
REGISTER OF WILLS
AMOUNT
$ 1 31 .00
$131.00
/ t -~d.CJ.- 7
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
DAfS
'ESt1vtTE OF
DATE OF DEATH
FILE NUMBER
eobfffi
ACN
Recor(>~
ReCliET
.02 JAN 25
ANTHONY E LOBATO
79 FAIRWAY DR
CAMP HILL
Clen:.
C',umb€rlar," .
PA 17011
,./ c
uq I)A
01-21-2002
LOBATO
03-13-2001
21 01-0329
CUMBERLAND
101
Allount Rellitted
*'5":
REV-1547 EX iFP liZ-DOl
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 ~
REY=is4j-EX-AFP--n'2=OOY-NOTicE--OF-YNHEifiTANCE-TAX-APPRAisEMENT-,--AL1-owANCE-cfi------------ -----
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF LOBATO MARY T FILE NO. 21 01-0329 ACN 101 DATE 01-21-2002
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)
4. Hortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
( ) CHANGED
(I)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
93.649.45
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
I~ an assessment was issued previoUSly, lines 14, 15 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 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
PAYHENT
DATE
06-08-2001
11-30-2001
NOTE:
RECEIPT
NUHBER
AA496700
CD000576
DISCOUNT (+)
INTEREST/PEN PAID (-)
338.16
.00
7,451.96
34.29
(11)
(12)
(13)
(14)
(9)
(10)
.00 X
57,442.00 X
.00 X
28,721.00 X
AHOUNT PAID
6,425.00
131.00
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
00 =
045 =
12 =
15 =
(19)=
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
93,649.45
7.486 25
86,163.20
.00
86,163.20
.00
2,585.00
.00
4,308.00
6,893.00
6,894.16
1.16CR
.00
1.16CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
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C i;
Of)
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Mary T. Lobato
Date of Death: 3-13-2001
Will No.
2001-00329
Admin. No.
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 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 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? Yes X No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date: 2/24/2003
sf!~ CC~
Anthony E. Lobato
Name (Please type or print)
79 Fairway Drive
Address
Camp Hill, PA17011
( 717) 763-7862
Tel. No.
Capacity:
X
Personal Representative
Counsel for personal
representative
(MAH:rmf/AM3)
, ..
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 2/07/2003
ANTHONY E LOBATO
79 FAIRWAY DRIVE
CAMP HILL, PA 17011
RE: Estate of LOBATO MARY T
File Number: 2001-00329
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' 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: 3/13/2003
Your prompt attention to this matter will be appreciated.
Thank You.
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
cc: ./ File
Counsel
Judge
REIJ.15{l()EX \t.oo\
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
R~-~~1500
L/
OFFICIAL USE ONLY
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FILE NUMBER
cJ/_-L2L
COUNTY CODE YEAR
INHERITANCE TAX RETURN
RESIDENT DECEDENT
__~.:2...0
NUMBER r-
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Lobato, Mary T.
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
03-13-2001 12-07-1914
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
None
SOCIAL SECURITY NUMBER
209 - 16 - 2504
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
GJ 1. Original Return
o 4. Limited Estate
06. Decedent Died Testate (Attach copy 01 Willi
o 9. Litigation Proceeds Received
03. Remainder Return {dale ofdealh priOfto.12-13-82)
o 5. Federal Estate Tax Return Required
8, Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (AttachSch 0)
D 2. Supplemental Return
o 4a. Future Interest Compromise (dale of death alter 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy 01 Trust)
o 10. Spousal Poverty Credit (date ofdealh between 12.31.91 and 1-1-95)
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THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCEi
NAME
o IDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: .
COMPLETE MAILING ADDRESS
Anthony E. Lobato
79 Fairway Drive
Camp Hill, PA 17011
Anthon E. Lobato
FIRM NAME (If Applicable)
TELEPHONE NUMBER
717-763-7862
1, Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held CmpcratiQn, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule OJ
(1) 0.00 I
I
,
(2) 0.00 I
(3) 0.00 on
~i
(4) 0.00 C1'~
(1.)
(5) 93. fi49.45 "',
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~:)
(6) 0.00 ('~ ,
(';
(7) 0.00 "tIe
).....-.
(8) 93,
(9) 7451. 96
(10) 34.29
::>.
649.45
OFFICIAL USE ONLY
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5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10-. Debts of Decedent. Mortgage Uabililies, & Liens (Schedule 1)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (line 8 minus line 11)
".',
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(',
-0
N
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(11) 7486.25
(12) 0.00
(13) 0.00
(14) 86, 163.20
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election 10 tax has not been
made (Schedule J)
14. Net Value Subject to Tax (line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x.O_ (15) 0.00
x .0 45 (18) 2585
x .12 (17) 0.00
x .15 (18) 4308
(19) 6893
16, Amount of line 14 taxable at lineal rate
57 , 442
17. Amount of line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
28, 721
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUES
ESIDE AND RECHECK MATH < <
~";'~~ ,', ','
Decedent's Complete Address:
STREET ADDRESS 556 Hillcrest Drive
.
CITY Carlisle I STATE PA I ZIP 17103
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
6893
0.00
6425.00
337.00
Total Credits ( A + B + C ) (2)
6762.00
3. InteresUPenaity if applicable
D. Interest
E. Penalty
TotallnteresUPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
0.00
0.00
5. If Line 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 5 + SA. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
111.00
0.00
131. 00
-'.;7,f:.4f~"''''.''''' ~ 0 .~, '4-<<~ ","". 'l""'/-" ' ~.,~"""~'~ ,_"" )-<.t _ ..j-''C'~~~~'''''~'''':.4k-''''j..~\~-~-~''',;:..,K.,:t, %;tJj't.:'_",.;,'i'",~'1", , ,
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Ves
a. retain the use or income of the property transferred;.......................................................................................... D
b. retain the right to designate who shall use the property transferred or os income; ............................................ D
c. retain a reversionary interest; or.......................................................................................................................... D
d. receive the promise for life of either payments, benefits or care? ...................................................................... D
2. If death occurred after December 12, 1982, did decedent transfer property wohin one year of death
without receiving adequate consideration? .............................................................................................................. D
3. Did decedent own an 'in trust fo~ or payable upon death bank account or security at his or her death? .............. D
4. Did decedent own an Individual RetirementAccount, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ D
No
ua
ua
ex
ua
[j
ua
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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 pe~ury, I declare thai I have examined this return, including accompanying schedules and statements, and 10 the besl of my knowledge and belief, it is true, correct
and complete.
Declaration of preparer other than the personal representative is based on all lnfonnation of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONS BLE FOR FILING RETURN DATE
~ II 0
ADDRESS
~ PIi
SIGNATURE OF PREPAR DATE
ADDRESS
For dates of 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 survivln9 spouse is 3%
[72 P.S. ~9116 (a) (1.1) (ill.
For dates 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% [72 P.S. ~9116 (a) (1.1) (i1)].
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 retum are still 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 vaiue of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a naturai 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 decedenfs lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(111.
The tax rate imposed on the net vaiue of transfers to or for the use of the decedenfs siblingS is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined. under Section 9102, as an
individual who has a1least one peront in common with the decedent, whether by blood or adoption.
~~'~M~' '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
Mary T. Lobato
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
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
M & T Bank, Carlisle, FA
Certificate of Deposit
Acct. # 31003910646016
38, 252.84
M & T Bank, Carlisle, FA
Certificate of Deposit
Acct. # 31003911022520
15, 511.32
M & T Bank, Carlisle, FA
Certificate of Deposit
Acct. # 31003911022546
10, 340.88
Orrstown Bank, Carlisle, PA
Hometown Investment Account
Acct. # 106210222
27, 487.77
Orrstown Bank, Carlisle, PA
Carriage Club Opportunity
Acct. # 106000434
2, 056.64
TOTAL (Also enter on line 5, Recapitulation) $
(if more space IS needed, Insert additional sheets of the same size)
93, 649.45
~M&rBank
July 18,2001
RE:
Estate Search
The Esta te of:
Date of Death (D.O.D.)
MARY T. LOBATO
3/13/2001
To Whom It May Concern:
Identified below is the account information requested.
I. M&T Bank accounts in which the decedent's name appears:
Account
Type
Account Number
Account Title
Opening Branch
0.0.0.
Balances
(Includes Accr.
Int.)
$38252.84
$15511.32
$10340.88
Accrued Interest
CD
CD
CD
31003910646016
31003911022520
31003911 022546
MARY T. LOBATO
MARY T. LOBATO
MARY T. LOBATO
4334
4334
4334
$300.53
$511.32
$340.88
2. Loans, Mortgages. or other obligations titled in the decedent's name
Account Number
Amount Owed
Account Description
No Safe Deposit Box titled in the Decedent's name existed at our office.
If you have any questions about the information provided, please contact our Records Department at (716) 635-40 I 0 or 1-800-724-
2440 outside of the Buffalo, NY calling area. Thank you.
Sincerely,
M&T BANK CORPORATION
~zii
Authorized Signature
BY:
j~'
DATE:
7 -If -'JOJ /
Manufacturers and Traders Trust Company. 1100 Wehrle Drive. PO. Box 7OT. Buffalo, NY 14240-0767
~
ORRSTOWN BANK
ORRSTO\VeJ. PENNSYLVANIA 17244
Date 5/10/01
PRIMARY ACCOUNT
TAX ID
ENCLOSURES
Page 1
106210222
209-16-2504
MARY T LOBATO
556 HILLCREST DR
CARLISLE PA 17013-4332
C H E C KIN G A C C 0 U N T S
HOMETOWN INVESTMENT ACCOUNT
ACCOUNT NUMBER
PREVIOUS BALANCE
DEPOSITS/CREDITS
1 CHECKS/DEBITS
SERVICE FEE
INTEREST PAID
CURRENT BALANCE
106210222
27,450.88
.00
27,487.77
.00
36.89
.00
CHECK SAFEKEEPING
Statement Dates 4/11/01 thru
DAYS IN THE STATEMENT PERIOD
AVERAGE LEDGER
AVERAGE COLLECTED
Interest Earned
Annual Percentage Yield Earned
2001 Interest Paid
5/10/01
30
10,980.35
10,980.35
36.89
4.17%
419.17
ACTIVITY IN DATE ORDER
DATE DESCRIPTION
4/23 INTEREST CREDIT TO CLOSE ACCT
4/23 CLOSE INTEREST BEARING ACCOUNT
TRACE NO
009000004
060244170
AMOUNT
36.89
27,487.77-
BALANCE
27,487.77
.00
~
ORRSTO\vN BANK
ORRSTOWN. PENNSYLV./lNIA 17244
Date 5/15/01
PRIMARY ACCOUNT
TAX In
ENCLOSURES
Page 1
106000434
209-16-2504
MARY T LOBATO
556 HILLCREST DR
CARLISLE PA 17013-4332
CHECKING ACCOUNTS
CARRIAGE CLUB OPPORTUNITY
ACCOUNT NUMBER
PREVIOUS BALANCE
DEPOSITS/CREDITS
1 CHECKS/DEBITS
SERVICE FEE
INTEREST PAID
CURRENT BALANCE
106000434
2,056.38
.00
2.056.64
.00
.26
.00
CHECK SAFEKEEPING
Statement Dates 4/16/01 thru
DAYS IN THE STATEMENT PERIOD
AVERAGE LEDGER
AVERAGE COLLECTED
Interest Earned
Annual Percentage Yield Earned
2001 Interest Paid
5/15/01
30
479.82
479.82
.26
0.66>0
6.10
ACTIVITY IN DATE ORDER
DATE DESCRIPTION
4/23 INTEREST CREDIT TO CLOSE ACCT
4/23 CLOSE INTEREST BEARING ACCOUNT
TRACE NO
009000003
060244160
AMOUNT
.26
2.056.64-
BALANCE
2,056.64
.00
REV-1511 EX+ (12-99) "
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
Mary T. Lobato
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
Hoffman Roth Funeral
Funeral Mass Luncheon-Carlisle
Funeral Burial Luncheon-Mt. Carmel
Tombstone Lettering
6808.50
63.31
381.15
90.00
1.
B. ADMINISTRATIVE COSTS:
Personal Represenlative"s Commissions
0.00
2.
3.
4.
5.
6.
7.
Name of Personal Representative(s)
Social Security Number~sllEIN Number 01 Personal Representative{s)
Street Address
City
State _ Zip
Year(s) Commission Paid
Attorney Fees
0.00
Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation)
0.00
Claimant
Street Address
City
State _ Zip
Relationship of Claimant to Decedent
Probate Fees
80.00
Accountant's Fees
0.00
Tax Return Preparer's Fees
0.00
Misc Expenses
Register of Wills-Short Certificate
Extra. Pages
JCP Fee
18.00
6.00
5.00
7451. 96
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
REV:1512EX'(l_9T)C..'~1'...
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF
FILE NUMBER
Mary T. Lobato
Indude unreimbursed medical expenses.
ITEM
NUMBER
1.
DESCRIPTION
AMOUNT
Giesswein Plastic Surgery
Carlisle, PA
34.29
TOTAL (Also enter on line 10, Recapitulation) $ 34.29
(If more space is needed, insert additional sheets of the same size)
~"'m'''97I.
COMMONWEALTH DF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Mary T. Lobato
FILE NUMBER
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 outfight spousal dlstfibutions)
1. Anthony Lobato Son 33%
79 Fairway Drive
Camp Hill, PA 17011
2. David Lobato Grandson 33%
556 Hillcrest.cDrive
Carlisle, PA 17013
3. Mary Jane Lobato Caregiver 33%
556 Hillcrest Drive
Carlisle, Pal7013
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 DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1. None
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1. None
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets of the same size)
WHEREAS, on the 27th
dated March 21st 1989
was admitted to probate as the last will of LOBATO MARY T
C LA::;'1', .t 11(::;'1', M1UUL.t;)
late of SOUTH MIDDLETON TOWNSHIP
13th day of March 2001 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, MARY C. LEWIS , Register of Wills in and -
the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certif',/
that I have this day granted Letters TESTAMENTARY
to ANTHONY E LOBATO
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Register of Wills of CUMBERLAND County, Pen. syl \".
Certificate of Grant of Letters
No. 2001-00329 PA No. 21-01-0329
ESTATE OF LOBATO MARY T
(~~L, r!X~L, M!UU~~J
Late of
SOUTH MIDDLETON TOWNSHIP
f..;U1VJ..tu:~a'(J...A.NU l,:UU.N'l'X I
Deceased
Social Security No. 209-16-2504
day of March
20Ql an
, "_imerl'-:'
,
CUMBERLAND County, who died on the
who has duly qualified as ExecutorCrix)
and has agreed to administer the estate according to law, all of whic~ fu)
appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my Office the 27th day of March 2001.
l!r'd@.!4~~l;4f.
**NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE)
LAST WILL AND TESTAMENT OF
MARY T. LOBATO
I, Mary T. Lobato, of South Middleton Township, Cumberland
County, Pennsylvania, declare this to be my Last will and
Testament and revoke all Wills and Codicils previously made by me.
ITEM I: I direct that all my legally enforceable debts and
funeral expenses, including all expenses of my last illness, shall
be paid from my residuary 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 the residue of my estate of
every nature and wherever situate in equal shares to my son,
Anthony E. Lobato, my daughter-in-law, Mary Jane Lobato and my
grandson, David E. Lobato. Should any of the above named persons
predecease me, his or her share of my estate shall be added to
the shares for the other named persons.
ITEM III: I appoint my son, Anthony E. Lobato, of South
Middleton Township, guardian 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 guardian 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
use principal, as well as income, from time to time for the
minor's support, health and medical care, and education (including
college education, both undergraduate and graduate), or to make
payment for these purposes, without further responsibility, to the
minor or to any person taking care of the minor.
ITEM IV: All Federal, State and other death taxes payable
because of my death, with respect to the property forming my gross
estate for tax purposes, whether passing under this Will or
AL~7Z:~~
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otherwise, including any interest or penalty imposed in connection' ..
with such taxes, shall be considered a part of the expense of the
administration of my estate and shall be paid out of the principal
of my residuary estate without apportionment or right of
reimbursement.
ITEM V: I appoint my said son, Anthony E. Lobato, Executor
of this my last will. Should my said son fail to qualify or cease
to act as Executor, I appoint my said daughter-in-law, Mary Jane
Lobato, Executrix of this my last Will.
ITEM VI: I direct that all fiduciaries acting under this
will, whether or not named herein, 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 and seal,
this f1 /",.t day of fY/a.Jv , 1989.
~?' ~of~AL'
/
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The preceding instrument, consisting of this and one other
typewritten page each identified by the signature of the
Testatrix, was on the date thereof, signed, published and declared
by Mary T. Lobato, 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 witnesses hereto.
~~~LL
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1/;]i t10~~<
-------------- -~~"
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS
We, Mary T. Lobato, Michael R. Rundle and Mary M. Price, the
Testatrix and the witnesses, respectively, whose names are signed
to the 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 and that she had signed
willingly, and 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 his/her knowledge the
Testatrix was at that time eighteen years of age or older, of
sound mind and under no constraint or undue influence.
/
Witness
1t(( fit. O~
Witness
Subscribed, sworn
Lobato, the Testatrix,
Michael R. Rundle and
of ma."d, , 1989.
to and acknowledged before me by Mary T.
and subscribed and sworn to before me
2/51-
by
day
Mary M. Price, witnesses, this
NOTARIAL SEAL
BONNIE l. COYLE. NO,AP'y pueuc
MT HOLLY SPGS, BORO. CUM2EiiLt.;';i) CamHY
MY COMMISSlON EXPiRES 0CTi'':~z:fJ R 1990
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No ry Public