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HomeMy WebLinkAbout01-0366 Estate of ANNA L. YONAS also known as ANNA L. YONASH PETITION FOR PROBATE and GRANT OF LETTERS OLf- 01- ~l, No. To: Register of Wills for the Deceased. County of CUMBERLAND in the Social Security No. 166-14-7734 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that:c 0- Your petitioner(s), who is/are 18 years of age or older an thelexecut ors in the last will of the above decedent, dated Novembe r 20, and codicil(s) dated February 1. 2001 named ,19~ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in her last family or principal residence at Cumberland County, Pennsylvania, with 1555 Simpson Ferry Road Borough of New Cumhp-rl~nn (list street, number and muncipality) Decendent, then 80 years of age, died Fe bruary 1 7 . 2001, at Carolyn Croxton Slane Hospice 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: 50,500.00 $ $ $ $ 80,000.00 1555 Simpson Ferry Road, Borough of New Cumberland. Cumberland County, PA WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters Testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. t~~~ ~ ti /; eors.fe e ch "2.g 125 Green Valley Drive ;:'~ Palmerton, PA 18071 Vlo.. ar~ ~ f- ~o ~~~~acff1~J~ M ~ 125 Green Valley Dr. Palmerton, PA 18071 / OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I '" COUNTY OF CUMBERLAND J s~ 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. llo - ~;2 3 - \ affirmed and 6TH ~ ()Q' ;::s l:::l ..... :0:::: ~ ~ No. 21 - 01 - 366 Estate of ANNA L. YONAS a/k/a ANNA L. YONASH , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW APR I L 9 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 Novembe r 20, 1997 and Fe bruarv 1, 2001 described therein be admitted to probate and filed of record as the last will and Cod i c i 1 of Anna L. Yonas a/k/a Anna L. Yonash and Letters rrpst~mpnt~ ry are hereby granted to John Lesniak, George Seach and Rhea Seach Register of Wills MARY CLEWIS Edmund G. Myers (20558) Johnson, Duffie, Stewart & Weidner ~ tf FEES Probate, Letters, Etc. ......... $ 235.00 Short Certificates(4 ) . . . . . . . . .. $ 12 .00 Renunciation ................ $ CODICIL 10.50 $ X-PAGES 21.00 JCP TOTAL - $ 5.00 Filed.... !-\.P.BJ~. .Q,. ~.o.Ql....... .283...5.0 ATTORNEY (Sup. Ct. I.D. No.) 301 Market St., P. O. Box 109 Lemoyne, PA 1704~-OlOg ADDRESS (717) 761-4540 PHONE Mailed letters to attorney on 4-9-01. ilO'i.HO'i RF\' 'J/Hf, This is to certi~' that (he information here given is correctly copied from an original cerrificate of death duly flied with me as Local Registrar. The original certificate will be forwarded to the State Vita] Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. No, ~Jj/f7fi7/;-///,:-- ~ ~ / l'~~~\\\ OF fi;--,,~_ it. ?~ "':ftF --~ ~ ~ ~ i€~7 \!f' '~\. ' ~ ~ocal Reg;",,! ---- I~ ~ ~ \~~ "'"' " l~c:::>>, /r# -":: L ~~c..>\ '/d I:b.~ . _ ~ * , ~~<,~ \ * ~ 1:" ~ ....A -~ _..... ~ , C', \~ ~\,~~\\ \-:.~"':.~''',. /'<"~/\\ ---_ '.?"'I---"--~ ~'\,. ,I\... -'-""/,,ENl \), IIII~!/ ";'//~"-!!.!!!.!1.1.!.~ lee for this certificate. $2.00 P 7202631 Date ~.J-J / '7 e f~~J fi)..5 ' Hl05.143 Raw. 2187 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH TYPElPRlHT IN PEflllAHENT BLACK INK NAME Of DECEDENT (f.", MI<jde, La~) ANNA I. AGE (last """'day) YONAS SEX afema1e STIJE FILE NUMBER SOCIAL SECURITY NUMBER 3. 1 6 6 - 1 4 17, 2001 80 UNPER 1 YEAR Yr6. Mom,," 1 Days BIRTHPLACE (City and Slale'" f0l611ln Coumry) OIhe,HospicE (Speedy) IKJ 5. COUNTY Of DEJlfH RACE. American Indian. Black, White, efe (SfJ"I'.y) 8b. Ie. 10. White Dauphin DECEDENT'S USUAL OCCUPATION (~;~~~:,~~:~e:::~~or . 111. Accountant lIb. Savings and Loan DECEDENT'S MAILING ADDRESS (Stroet, CdylTown, Stale. lip Code) DECEDENT'S ...CTUAl RESIDENCE (Soo Instrudions on Olhar side) 1555 Simpson Ferry Road 18. New Cumberland, PA. 17070 FATHER'S NAME (f.'I. ",.''''..last) _ Harry Lesniak INFORMANT'S NAME (T ypefPnnl) John Lesniak 17b. Count Dauphin Did decedem a.... in . lownship? 17d.O ~~=;~=ol MOTHER'S NAME (Fi,st Middle. ",..dan Surname) ~ Kathryn (Unknown) INFORMANT'S MAILING ADDRESS (Slr...l, CitylTown Stale. lip Code) 2Gb. 2203 Bernvil1e Road, Reading, PA. 19601-11l~_~.~_ PlACE OF DISPOSITION - Name 01 Camelery. Cremalory LOCATION - CitylTown. Stala. Zip Code 01 01"'" Pleca MARITAL STATUS. Married Newar Married, Widowed. OJ\lO(ced (Specify) 14. Widowed 17c.[XJ v.... <l8CedenHved In SURVIVING SPOUSE (11 WIle, Ql'....e maiden naJnd) 171. Stat. None Dauphin CI~~ tz U1 @ U U1 o (S w ::I 0( Z PATE Of DISPOSITION Removallrom Slale 0 (Monlh Day. Year) D lIb. February 20, 2001 E OR PERSON ACTING AS SUCH LICENSE NUMBER Ste hen A. Chowka 22b. FD 012419-L To th. best 01 my knowledge. dealh occurred II the liml. dale Ind place stated. (Sillnalure and Tille) 2~Transfiguration Cemetery ~&Coa1 Twp., PA. 17866 NAME ANP ADDRESS Of FACILITY 2~.Chowka F.H. 114 N. Shamokin St., Shamokin, PA. LICENSE NUMBER PATE SIGNED (Monlh, Day, Year) a UJ CIl :;) VI 0( ::; 0( PATE PRONOUNCED neAP (Moo1h. Day Year) "2-/7- Of 23b. 230. WAS CASE REFERREP TO MEDICAL EXAMINER/CORONER? YHO NO~ ~ (JIrr',I'K;.//t'IJ ('- A-o~/D~/t1t.CIl;r/()frl/f O,':::T;tJE DUE 10 (OR AS A CONSCUU(N~; OF): l8. , ApproXImate : "lieNal belwaen t onset and dtiath 2/l~! PAflT II: Other 8tgnfhc:ant conditions contributing 10 death, but nol '...sutting in the uncleffying CtlU>>8 gj\lsn in PART I l : DUE TO (OR AS A CONSEQUENCE Of): WERE AUTOPSV FINDINGS AVAILABLE PRIOR TO COMPLETION Of CAUSE OF DEIJH? MANNER OF DEATH D,uE OF INJURY (MOl:~I, 0.0,. Yep!) I I I 1 ! .-.i--.--. TIME OF INJURY INJURY JIf WORK? DESCRIBE HOW INJURY OCCURRED DUE TO (OR AS A CONSEQUENCE Of) Natural ~ o o HomICide [J Ll [J PLACE OF INJURY - AI home. rarm~;"I, factory, oIfic. building. .,e (Sp"".y) 30.. Yea 0 NoD Accident Pending Investigation NO~ VB' 0 NoD Su\clde Could nol ~ determined M. 30<:. IJ.f 1'1' lr.hSlbl fYJO 2". 28b. CEflTlFlER (Chec.. ,onl, 0n<' I -CERTifYING PHYSICIAN (PtI)l5ICiCiIl canlt-jUlg caufoe of death when another phY$K:lant'a~ pfOnouncad dealh and comptelt'd lIem 23) To the bell 01 my knowledge. delth OCCUI'red _to Ihl clUM(e) Ind ....nner _ I..tld. . . . . . . . . . . . . . . .. . . . . . . . . . . . .. .. . .. . 29. .PRONOUHClNG AND CERTIFYING PtfYSIClAN (PhYSlCI3Il boIh p<OIlOUnc'''IJ dea~, ."d c",I"""I1IO ca"". ot OBB"') To the bell 01 my knowlldllll. dlllh occurred lithe time. dale, Ind plece, Ind due to the caUH(l) Ind ....n...'.. I.al.d.. . . . . . . . . . . . . . 'IIEDlCAL EXAIIlNERICORONER On lhe b..,. ol..amlnlllon and/or In"..tlllallon, In my opinion, d..th occurred Illhe 11m., dl18, and placa, end due to the CIUI"'.) Ind 311~ann8t - atalad.. . . . , . . . . . . . ,. . . .. . . . . . . . . . . . . , . . ,. . ,. . . . . , . . . . .. . ,.. ,. . . . , . , . . . . . .. . , . .. , . . ,. . . ... . . . . . . . . . . . . . . 34. 004250-00002/11.13.97/EGM/PBD/103025 Ilast mill aub Wtstamtnt OF ANNA L. YONAS, also known as ANNA L.YONASH I, ANNA L. YONAS, also known as ANNA L. YONASH, of the Borough of New Cumberland, Cumberland County, Pennsylvania, beine of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills or Codicils at any time heretofore made by me. ARTICLE I I direct the payment of all my legal debts, and the expenses of my last illness and funeral from my Estate as soon after my death as conveniently may be done. ARTICLE II I give, devise and bequeath all the rest, residue and remainder of my Estate, of whatsoever nature and wheresoever situate, as follows: (a) one-seventh (1/7) thereof unto my brother, JOHN LESNIAK, Reading, Pennsylvania; (b) one-seventh (1/7) thereof unto my brother, RUDOLPH LESNIAK, Shamokin, Pennsylvania; (c) one-seventh (1/7) thereof unto my brother, JOSEPH LESNIAK, Carlisle, Pennsylvania; (d) one-seventh (117) thereof unto my sister, HELEN SmCORA, New Cumberland, Pennsylvania; (e) one-seventh (1/7) thereof unto the then-living issue, per stirpes, of my deceased brother, NICHOLAS LESNIAK; (f) one-seventh (1/7) thereof unto the then-living issue, per stirpes, of my deceased sister, ROSE SEACH; and (g) one-seventh (1/7) thereof unto the then-living issue, per stirpes, of my deceased sister, MARIA REEDER. Should any brother or sister predecease me, I direct that such brother's or sister's share shall be distributed unto his or her then-living issue, per stirpes, and if there be a failure of same, I direct that such 004250-00002/11.13.97/EGM/PBD/103025 share shall be divided among the remaining beneficiaries named herein or their issue, per stirpes, as the case may be. ARTICLE III In the event that any beneficiary of my Will shall not have reached the age of twenty-one (21) years at the time for distribution of his or her share, distribution of said share may be made in the discretion of my Personal Representative after considering the age and needs of the beneficiary, either directly to the beneficiary or to a Custodian under the Pennsylvania Uniform Transfers to Minors Act, 20 Pa. C.S.A ~ 5301 et seq., or the applicable Uniform Gifts to Minors Act or Uniform Transfers to Minors Act in the state of residence of such beneficiary as the case may be. My Personal Representative may, designate as such Custodian any institution or person, including my Personal Representative, qualified to act as a Custodian for such beneficiary under such Act in effect at the time such distribution is made. A receipt for any payment or distribution so made shall be a full discharge therefor to my Personal Representative, who shall not be responsible to see to, or be liable for, the application of such proceeds thereafter. ARTICLE IV I name, constitute and appoint my brother, JOHN LESNIAK, Executor of this my Last Will and Testament. If my brother, JOHN LESNIAK, fails to qualify or ceases to so act, I name, constitute and appoint my brother, RUDOLPH LESNIAK, alternate Executor to complete the administration of my Estate. I direct that no fiduciary appointed herein shall be required to post bond for the faithful administration of the duties required in any jurisdiction. 004250-00002/11.13. 97/E GM/PBD/1 03025 IN WITNESS WHEREOF, I have hereunto set my hand this Zo ~ day of /J;~ i , 1997. /I ;f~ ( Z14-IUJ / - UJ/1LW/ ANNA L. YONAS I (SEAL) th1LLL ?t ZI~ ANNA L. YONASHy (SEAL) SIGNED, SEALED, PUBLISHED AND DECLARED, by ANNA L. YONAS, also known as ANNA L. YONASH, the Testatrix above named, as and for her Last Will and Testament and 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. /0) Ail 27tJJ~. ~;MI/fA Address Lt) I ~ tJ. FMkf(j ;)'}. t1to/J HI/! J!4 Address / 004250-00002/11.13.97/EGM/PBD/103025 ACKNOWLEDGMENT COMMONWEALTH OF PENN8YL VANIA :88: COUNTY OF CUMBERLAND I, ANNA L. YONA8, also known as ANNA L. YONA8H, Testatrix, whose name is signed to the foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. tbtrlttV ;f' fYJuu/ ANNA L. YONA8 (?uta- ~ f01r1J ANNA L. YONASH Sworn to or affirmed and acknowledged before me, by ANNA L. YONA8, also known as ANNA L. YONA8H, the Testatrix, this)~ of "f"'\~ , , 1997. ~'d~ Notary Public ~~~ My commission expires: (~EA.L)....._",._....._~." ., NOiAHLJ\L SEAL I DIANNE lENIG, Notary Pubiic ; Lemoyne Borough Cumberland Co. ; My Commission Exrmes Dec. 21, 1997 004250-00002l11.13.97/EGM/PBD/103025 AFFIDA VIT COMMONWEAL TH OF PENNSYLVANIA :SS: COUNTY OF CUMBERLAND -i~ ~ !0~~ .~k~_ We, . ~ ~.~~ ,~he wi~ess~s ~~~mes are signed to the foregoing instrument, b~g duly qualIfied accordmg to law, do depose and say that we were present and saw the Testatrix sign and execute the foregoing instrument as her Last Will and Testament; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge, the Testatrix was at that time at least 18 years of age, of sound mind and under no constraint or undue influence. ~Gt'J-- .~ J~. ~ __,*-,--' Sworn t'hor ~ed and subscribed to before me by 0 and (!~>--.- ,~ .~~'" ~ . . . ., Witnesses, th~~ '-J- day of 'f\ ~ , .1997. ~~~~ Notary Public ~~ My commission expires: (SEAL) {~ ! NOTAHIAL SEAL I DIANNE LENIG, Notary Public I Lemoyne Borough . Cumberland Co. I My Commi~lsjon Expires Dec, 21, 1997 ~...--~,..,.....,~;..,V'"'J':"",,W>~ 004250-00002/2.1.01/EGM/KL T/142992.2 OJobicil to 1JJast _ill nub Wtstnmtut of ANNA L. YONAS, also known as ANNA L. YONASH I, ANNA L. YONAS, also known as ANNA L. YONASH, of the Borough of New Cumberland, Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this to be the sole Codicil to my Last Will and Testament dated November 20, 1997. Item I. I hereby revoke Article IV of my Will and in lieu thereof provide as follows: ARTICLE IV I name, constitute and appoint my brother, JOHN LESNIAK, my nephew and his wife, GEORGE SEACH and RHEA SEACH, Co-Executors of this my Last Will and Testament. If anyone Co-Executor fails to qualify or ceases to so act, I direct that the other Co-Executors shall complete the administration of my estate. I direct that no fiduciary appointed herein shall be required to post bond for the faithful administration of the duties required in any jurisdiction. Item II. In all other respects, I hereby ratify, confirm and republish my Last Will and Testament dated November 20, 1997. 004250-00002/2.1.01/EGM/KL T/142992.2 IN WITNESS WHEREOF, I have hereunto set my hand and seal on this the /fV day of [ebWCi-"1 ' 2001. ~ d. ~on'" 4-/ ANNA L. YONAS (SEAL) v~~ .x r~L ANNA L. YONASH (SEAL) Signed, sealed, published and declared by the above-named Testatrix, as and for her sole Codicil to her Will dated November 20, 1997, in the presence of us, who, at her request, in her presence and in the presence of each other have hereunto subscribed our names as witnesses. cA~4 d~ c!-T 004250-00002/2.1.01/EGM/KL T/142992.2 ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEAL TH OF PENNSYLVANIA SSe COUNTY OF CUMBERLAND We, ANNA L. YONAS, Sfepl-teVl Coe-f~ also known as ANNA L. YONASH, and TrJJ~ t<\J",~c the Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as the Codicil to 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 sole Codicil to her Will as witness and that to the best of his/her knowledge the Testatrix was at that time was eighteen years of age or older, of sound mind and under no constraint or undue influence. ~~NA1' ifcr71'C1d ~Nt:H fJ,rna4) (' ~ .~ ~~- ~~:J Subscribed, sworn to and acknowledged before me by ANNA L. YONAS, also known as ANNA L. YONASH, Testatrix, and &'(J ~it\ Coe..t:e-e'e- and ~ '('tJ (,l~ k U iI\ ~ witnesses, this ( $1- day of ~\''Vr ' 2001. ~!t' Edmund G. Myer~ Pennsylvania Attorney ID No. 20558 004250-00002/2.1.01/EGM/KL T/142992.2 ATTORNEY CERTIFICATION COMMONWEAL TH OF PENNSYLVANIA : SSe COUNTY OF CUMBERLAND On this, the \,..j::: day of \- ...0..."I\.k.J. ~~ ' 2001 before me, the undersigned officer, personally appeared Edmund G. Myers, Attorney I.D. #20558, known to me (or satisfactorily proven) to be a member of the bar of the highest court of Pennsylvania and certified that he was personally present when the foregoing acknowledgment and affidavit were signed by the Testatrix and witnesses. IN WITNESS WHEREOF, I hereunto set my and official seal. _~N'-'~ ~~ Notary Public . " NOTARIAL SEAL DIANNE LENIG. Notary Public I Lemoyne Borough Cumberland Co. I My Commission Expires Dec. 21, 2001 / r.:.- ---- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Anna l. Yonas alkla Anna l. Yonash Date of Death: February 17, 2001 Will No.: 2001-00366 To the Register: I certify that notice of beneficial interest 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 QLt{(bj Name Address 2203 Bernville Rd., Reading, PA 19601 Manor Health Care - 1700 Market St. Camp Hill, PA 17011 529 Bear Valley Ave., Shamokin, PA 17872 400 Woodland Ave., New Cumberland, PA 17070 John Lesniak Joseph Lesniak Rudolph Lesniak Helen Shicora Please see attached. Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None. Date: 51'Mlo; ~>M1fJ ~ Signature Name Edmund G. Myers, Esq. Johnson, Duffie, Stewart & Weidner Address 301 Market St. P. O. Box 109 Lemoyne, PA 17043-0109 Telephone (717) 761-4540 Capacity: Personal Representative X Counsel for personal representative .- . Estate of Anna L. Yonas a/k1a Anna L. Yonash 2001-00366 Beneficiaries - continued: Name Children of Rose Seach. Deceased: George Seach Joan Wiegand Michael Seach Rosemarie Vicinanza Beatrice Wallace Harriet Gati Gregory Seach Children of Marie Reeder. Deceased: Alvin Reeder Belle Reeder Elrica Swank Child of Nicholas Lesniak. Deceased: Lu Ann Schleig Address 125 Green Valley Drive, Palmerton, PA 18071 6540 Rain Dores Dr., Las Vegas, NV 89108 242 So. 750 E, Clearfield, UT 84015 802 Park St., Apt. B3, Grinnell, IA 50112 8070 W. Russell Road #1087 Las Vegas, NV 89113 16 Swan Lane, Holidaysburg, PA 16648 2982 Hylan Blvd., Staten Island, NY 10306 1105 W. Independence St. Coal Township, PA 17866 20 W. Sunbury St., General Delivery Snydertown, PA 17877 355 Clark Road, General Delivery Snydertown, PA 17877-9999 1001 Montgomery St., Shamokin, PA 17872 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96l RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT MYERS EDMUND G 301 MARKET STREET POBOX 109 LEMOYNE, PA 17043 -------- lold ESTATE INFORMATION: SSN: 166-14-7734 FILE NUMBER: 21 - 2001 - 0366 DECEDENT NAME: YONAS ANNA L DA TE OF PAYMENT: 10/01/2001 POSTMARK DATE: 09/28/2001 COUNTY: CUMBERLAND DATE OF DEATH: 02/17/2001 NO. CD 000335 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $17,452.87 I I I I I I I I TOTAL AMOUNT PAID: $17,452.87 REMARKS: JOHN LESNIAK C/O EDMUND G MYERS ESQUIRE CHECK# 91 SEAL INITIALS: PB RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 1. J ss: [;' Georqe Seach, Rhea Seach and John Lesniak being duly sworn according to law. deposes and says that thN are Co-Executors of the Estate of Anna L. Yonas a/k/ a Anna L. Yonash New Cumberland Borough . I Cumberland County. Pa., deceased and that the h h h Lesniak within is an inventory made by George .?eac , R ea Se~ & John , the said C.o- R~p(""l1t-()rc:: of the e~tire estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania. and that the figures opposit~ each item of the Inventory represent it's fair value as of the date of decedent's death. Ati:.1 7~.~":li ~:;. ." /C.-L.e--et./ / d~--<" -/i/ ......R --0'{:..c/, Sworn to and subscribed before me, ?J, -'. ...~ '. ..;;7 ". / / ~v C U4/2-eC4'!-//C. l2~c . I ~. i 2001 u..r- ExecutorS ~MiKi>>~ George Seach, Rhea Seach, John Lesniak 125 Green Valley Dr. 2203 Bernville Rd. rate of A4---- Notarial Seal Krlstee K. Myers. Notary Public Lemoyne Bore. Cumberland County My Commission Expires Dec. 2, 2002 Member, PennsvlvaniaAssociation ot Notaries Palmerton, PA 18071 Reading, PA 19601 Address Date of Death 17th February Month 2001 Day Year INSTRUCTIONS J. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of dis~overy of additional assets. 3. Additional sheets may be. aHached as to personalty or realty 4. See Article IV. Fiduciaries Act of 1949. 0'1 0 ..c:: .-i 0 I ::J M 0 ~ ~ 0 0 l""'-- III .-i >- -c ~ \.0 I- W to '0 al \.0 ... ~ ex: I- ........... C I'D M W ~ ~ to QJ .. 0 a.. u Q) 0 Vl ........... r-l Q). CD ~~ 0 0 w w to ~ C ~ I J: ex: ..c:: Q) 1IO Q) ~ ~ .-i l- e.. u.. ,.j a.. Z I- ...J en en ..0 0 u.. ...J < 0 to to E a.. I UJ 0 < w C C ::J .;.. ~H .-i > Z ~ o 0 u - ::E <. .. N 'z 0 ~~ r:: 0'1 C ::s V1 Z ~ 0 . 0 0 ~ Q) U l? .-i Z W < HH Z ~ X c.. -0 '0' r:: &3 lU to I'D C eel .... I: ::J 0 eel Q) E . ..c 0 .:::t:.:::t: QJ E -c ...IiC '0 I - CD 0 j:Ll . I'D ::l 0 I ~ U u: t:Q P.. Inventory of the real and personal estate of YONAS, ANNA L. a/k/a YONASH, ANNA L. deceased 1. Real Estate - No. 1555 Simpson Ferry Road, Borough of New Cumberland, Cumberland County, PA (Deed Book K, Volume 15, Page 187) Sale Price 2. Household Goods - appraised value 3. 1983 Chevrolet Sedan - date of death value 4. Cash in decedent's possession 5. PNC Bank - Checking Account No. 51-4007-1049 Date of death balance 6. Waypoint Bank - Account No. 500072701 - Savings Date of death balance, plus accrued interest 7. Waypoint Bank - Account No. 500007040 Date of death balance, plus accrued interest 8. Waypoint Bank - Account No. 500007099 Date of death balance, plus accrued interest 9. Waypoint Bank - Account No. 500007133 Date of death balance, plus accrued interest 10. Waypoint Bank - Account No. 555302846 Date of death balance, plus accrued interest 11. Waypoint Bank - Account No. 555302847 Date of death balance, plus accrued interest 12. Waypoint Bank - Account No. 561279903 Date of death balance, plus accrued interest 13. Lincoln Financial Group - Life Insurance Policy No. 1848023 - Beneficiary: Estate 14. Waypoint Bank - Individual Retirement Account Certificate No. 596528349 - Beneficiary: Estate 15. The Patriot-News - subscription refund 16. Hospice of Central PA - refund of February charges overpaid 17. Refund - automobile insurance policy TOT AJ~ . 95,900 00 2,440 00 425 00 1,989 15 3,587 14 7,625 71 2,275 78 2,502 33 13 , 61"'1 30 1,218 62 2,719 15 9,868 31. 5,204 16 18,378 88 40 50 1,460 00 2811 00 $ 169,527 03 ~~ ~.'-~,-, \ , _ ~.l (J.... \~~~ ~~ - - ~~:~.-~_. ~~~II......--;.:I . ~:; ,~;1(:, ,~t, ", \~1/~, . '-.I .....--r _'" ,:' ~-. / ,..).., /" i)'___'- ...) .S ("\) \ v " i '- ~ ~ Z o \ii ~ ~ r ~ \--'~~ ~ ~J(t.~?, r r ~ ~ 30 <(. \f) )(. ~ U1 \f) ti 0 -z. ~~~6~ ra4. .Go ~o~Goui \J.. r"- -z.. \J.. '4. ~ 'b ? o Q r J ~ o (0 ~ ~ o ~ ~ /6-0:k?0 -/ 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 Recore-; .01 DATE ESTATE OF DATE OF DEATH FILE NUMBER NOV 16 All :51 COUNTY ACN EDMUND G MYERS ESQ JOHNSON ETAL PO BOX 109 LEMOYNE 11-12-2001 YONAS 02-17-2001 21 01-0366 CUMBERLAND 101 *' REV-1547 EX AFP 02-00) ANNA L \. -, lcJ"! ~_,,;; L Cierk- . PA 170'JY,nboll8.nCJ Amount Rellitted , PA 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: iS4j-EX-AFP--fi2":ofjr-NoYicE--OF-'rtiHEifiTANci-YAX-A-PPRA-isEi.fENT-,--AL"LOWANCi-oi------------ - - --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF YONAS ANNA L FILE NO. 21 01-0366 ACN 101 DATE 11-12-2001 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. 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 (1) (2) (3) (4) (5) (6) (7) 95,900.00 .00 .00 .00 68.422.67 .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 (9) (10) 29,975.45 2.981.55 (11) (12) (13) (14) NOTE: To insure proper credit to your account, subllit the upper portion of this form with your tax payment. 164,322.67 ~? 957 on 131,365.67 .00 131,365.67 14, IS and/or 16, 17, 18 and 19 will returns assessed to date. NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total of ALL ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 = .00 X 045 = 75,066.10 X 12 = 56,299.57 X 15 = (19)= .00 .00 9,007.93 8,444.94 17,452.87 PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 09-28-2001 CDOO0335 .00 17,452.87 TOTAL TAX CREDIT 17,452.87 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 to . 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.) , COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-01-00366 ESTATE OF ANNA L. YONAS a/kJa ANNA L. YONASH, DECEASED Late of New Cumberland Borough FIRST AND FINAL ACCOUNT AND PROPOSED SCHEDULE OF DISTRIBUTION OF George Seach, Rhea Seach and John Lesniak, Executors Date of Death: Date of Executors Appointment: Advertisement of Letters: February 17, 2001 April 9, 2001 Cumberland Law Journal: April 27, May 4, 11, 2001 The Patriot-News: April 24, May 1, 8, 2001 April 9, 2001 to January 15, 2002 Accounting for the Period: Purpose of Account: George Seach, Rhea Seach and John Lesniak, Executors offer this Account to acquaint interested parties with the transactions that have occurred during their administration. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: George Seach, Rhea Seach and John Lesniak, Executors 125 Green Valley Drive Palmerton, PA 18071 (610) 681-4721 or Edmund G. Myers, Esquire Johnson, Duffie, Stewart & Weidner 301 Market Street P.O. Box 109 Lemoyne, PA 17043-0109 (717) 761-4540 SUMMARY OF ACCOUNT Fiduciary Acquisition Page Value Principal Receipts 3 $170,297.52 Less Disbursements: 4&5 Debts of Decedent 2,981.55 Funeral Expenses 5,607.87 Administration Expenses 692.85 Inheritance Tax 17,452.87 Fees and Commissions 14,270.00 Costs: Maintenance/Sale of Real Estate 9,423.30 Reserve 175.00 50.603.44 Principal Balance Remaining $119,694.08 Income Receipts Less Disbursements 6 7 $ 2,922.11 100.00 Income Balance Remaining 2.822.11 COMBINED BALANCE REMAINING* $122,516.19 Proposed Schedule of Distribution 8&9 *Combined Balance Remaining consists of Cash $122,516.19 -2- RECEIPTS OF PRINCIPAL Cash: PNC Bank - checking account No. 51-4007-1049 Waypoint Bank - savings account No. 500072701 Waypoint Bank - Certificate No. 500007040 Waypoint Bank - Certificate No. 500007099 Waypoint Bank - Certificate No. 500007133 Waypoint Bank - Certificate No. 555302846 Waypoint Bank - Certificate No. 555302847 Waypoint Bank - Certificate No. 561279903 Cash in possession of decedent The Patriot-News - subscription refund Hospice of Central P A - refund - overpaid charges Automobile and Homeowner's insurance refunds Stephen A. Chowka Funeral Home - refund American Red Cross - refund Verizon - refund Cash in decedent's possession Tangible Personal Property: 1983 Chevrolet Sedan - date of death value Household Goods - sold at auction Realty: Residence - No. 1555 Simpson Ferry Road Borough of New Cumberland, Cumberland County, PA Sale Price Retirement Account: Waypoint Bank -Individual Retirement Account No. 596528349 Life Insurance: Lincoln Financial Group - Life Insurance Policy No. 1848023 - Beneficiary: Estate TOTAL RECEIPTS OF PRINCIPAL -3- Fiduciary Acquisition Value 3,587.14 7,625.71 2,275.78 2,502.33 13,611.30 1,218.62 2,719.15 9,868.31 1,989.15 40.50 1,460.00 323.00 82.87 5.00 12.37 387.00 47,708.23 425.00 2.681.25 3,106.25 95.900.00 95,900.00 18.378.88 18,378.88 5204.16 5.204.16 $170.297.52 DISBURSEMENTS OF PRINCIPAL Debts of Decedent 5/18/01 Pinacle Health - decedent's account balance 151.00 5/31/01 West Shore EMS - decedent's account balance 76.95 5/31/01 Johnson, Duffie, Stewart & Weidner - attorney fee for services rendered prior to death 125.00 8/18/01 Susquehanna Internal Medicine - decedent's account balance 34.29 8/18/01 Barbara Louise Huff - services provided for Mrs. Y on as prior to death as her attorney-in-fact. 250.00 8/18/01 Joy Losh - providing transportation to doctors & errands for Mrs. Yonas. 250.00 8/29/01 Robin Gasperetti - County/Borough personal taxes 11.00 Checks that cleared after death - PNC Account No. 51-4007-1049: Check No. 3863 - Borough of New Cumberland sewer & refuse 57.43 Check No. 3867 - AT&T 25.88 Check No. 3868 - Hospice of Central PA 2.000.00 2,981.55 Funeral Expenses 5/17/01 Stephen A. Chowka Funeral Home - funeral expenses; cemetery charges & monument engraving 5607.87 5,607.87 Administration Expenses 4/9/01 Register of Wills - charges - Will probated 283.50 4/16/01 Cumberland Law Journal - advertise Letters 75.00 5/11/01 Register of Wills - short certificates 6.00 5/17/01 The Patriot-News - advertise Letters 99.24 5/22/01 First Union - charge for Estate checks 45.05 6/23/01 Chuck Bricker - household goods appraisal 75.00 6/23/01 George Seach - reimbursement for AT&T charges advanced; postage and charge paid for lost safe deposit box key. 63.06 9/27/01 Register of Wills - file Inventory and Inheritance Tax Return 25.00 First Union - service charges - Estate accounts 21.00 692.85 Inheritance Tax 9/27/01 Register of Wills, Agent - Inheritance Tax 17.452.87 17,452.87 -4- Fees and Commissions Reserve: Johnson, Duffie, Stewart & Weidner - attorney's fee 6,500.00 George Seach - one-third Executor's commission 2,590.00 Rhea Seach - one-third Executor's Commission 2,590.00 John Lesniak - one-third Executor's Commission 2 590.00 14,270.00 Costs: Maintenance/Sale of Real Estate 5/18/01 Shipley Oil - delivery 199.67 5/18/01 Comeast Cable - final charges 3.68 5/18/01 AT&T - telephone charges 16.48 6/4/01 AT&T - final telephone charges 3.52 6/23/01 Verizon - final telephone charges 39.70 Borough of New Cumberland - sewer/trash charges March/July 91.26 P A Water Company - water service charges - March/July 63.09 PP&L - electric service charges - March/July 124.67 6/27/01- 6/28/01 Mary K. Haring - removal of six loads of trash 330.00 4/9/01 - 7/28/01 Tim Losh - lawn maintenance 395.00 7/30/01 ReMax Realty/Brokers Realty - commission - sale of real estate 5,754.00 7/30/01 ReMax Realty - transaction fee 125.00 7/30/01 Liberty Land Transfer - notary fees 6.00 7/30/01 Recorder of Deeds - 1 % transfer tax 959.00 7/30/01 Sudden Death Pest - termite treatment 720.80 7/30/01 Robin Gasperetti - portion of school district real estate taxes due at settlement - 7/1 - 7/30/01 66.08 7/30/01 Portion of sewer charges due at settlement - 7/1-7/30 7.11 7/30/01 Robin Gasperetti - portion of County/Borough real estate taxes due at settlement 188.24 7/30/01 Orpha M. Douden - reimbursement for earpet cleaning and door pins replacement 80.00 8/18/01 Jack & Rose Kolsar - maintaining & checking house prior to settlement - helping with removal of clothing 250.00 9,423.30 Reserve: Register of Wills - filing First and Final Account and Proposed Schedule of Distribution 175.00 175.00 TOTAL DISBURSEMENTS OF PRINCIPAL $50.603.44 -5- RECEIPTS OF INCOME Interest: Waypoint Bank - Savings Account No. 500072701 2/17/01 - 5/15/01, date closed Waypoint Bank - Certificate No. 500007040 2/17/01 - 9/28/01, date closed Waypoint Bank - Certificate No. 500007099 2/17/01 - 6/25/01, date closed Waypoint Bank - Certificate No. 500007133 2/17/01 - 5/14/01, date closed Waypoint Bank - Certificate No. 555302846 2/17/01 - 9/28/01, date closed Waypoint Bank - Certificate No. 555302847 2/17/01 - 9/28/01, date closed Waypoint Bank - Certificate No. 561279903 2/17/01 - 9/28/01, date closed Waypoint Bank - Individual Retirement Account No. 596528349 - 2/17/01 - 9/28/01 First Union - Estate High Performance Money Market Account No. 2000003138032 5/16/01 - 12/31/01 TOTAL RECEIPTS OF INCOME -6- 42.66 56.60 39.28 156.22 34.63 76.80 275.17 803.38 1.437.37 $ 2~922.11 DISBURSEMENTS OF INCOME Estate Income Tax: Internal Revenue Service - Form 1041 - Estate Income Tax Return for fiscal year beginning February 17, 2001 and ending January 31 ,2002. Estate income will be offset by the attorney's fee and Executors commissions paid. PA Department of Revenue - PA 41 Estate Income tax Return for fiscal year beginning February 17, 2001 and ending January 31, 2002. Tax rate 2.8% Reserve TOTAL DISBURSEMENTS OF INCOME -7- -0- $100.00 S 100.00 PROPOSED DISTRIBUTIONS TO BENEFICIARIES Balance for Distribution as per First and Final Account Distributions per Article II of Will To: John Lesniak Cash One-seventh $17,502.31 One-seventh 17,502.31 One-seventh 17,502.31 One-seventh 17,502.31 To: Rudolph Lesniak Cash To: Joseph Lesniak Cash To: Helen Shicora Cash Child of Nicholas Lesniak. deceased: To: Lu Ann Schleig One-seventh Cash 17,502.31 Children of Maria Reeder. deceased: To: Alvin Reeder One-third of One-seventh Cash 5,834.11 To: Belle Reeder One-third of One-seventh Cash 5,834.11 To: Elrica Swank One-third of One-seventh Cash 5,834.11 -8- $122,516.19 Proposed Distributions to Beneficiaries. Continued: Children of Rose Seach, deceased: To: George Seach One-seventh of One-seventh Cash $1,985.33 Car 425.00 Household Goods 90.00 2,500.33 To: Joan Wiegand One-seventh of One-seventh Cash 2,500.33 To: Michael Seach One-seventh of One-seventh Cash 2,500.33 To: Rosemarie Vicinanza One-seventh of One-seventh Cash 2,500.33 To: Beatrice Wallace One-seventh of One-seventh Cash 2,500.33 To: Harriet Gati One-seventh of One-seventh Cash 2,500.33 To: Gregory Seach One-seventh of One-seventh Cash 2.500.33 Total Distributions to Beneficiaries $122.516.19 -9- . COMMONWEALTH OF PENNSYLVANIA COUNTY OF ~~.\ \ \J.. SS. George Seach, Rhea Seach and John Lesniak, Executors under the Last Will and Testament of Anna L. Yonas alkla Anna L. Yonash, deceased, hereby declare under oath that they have fully and faithfully discharged the duties of their office; that the foregoing First and Final Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the Estate have been paid in full; that, to their knowledge, there are no claims now outstanding against the Estate; that all taxes presently due from the Estate have been paid; and that the Grant of Letters and the first complete advertisement thereof occurred more than four (4) months before the filing of the Account. Subscribed and sworn to before me this ,::2.3 .k day of January, 2002. ~" ~ ' /C~ ,//' ~A/" Rhea Seach, Executor ~~~~ Notary Public . . NOTARIAL SEAL DIANNE LENIG, Notary Public Lemoyne Borough Cumberland Co. My Commission Expires Dec. 21. 2005 -10- ~ H ~~ Z ~O Cf) ~ H ~ Cf) Cf) ~ ~ H \0 H W > \0 p... p... H M aO Z -. 0 O~E-t I ~~Ct;,......., :2: 80 o 01 Uu U,......., ~~m~ :5zo E-t 0:; ~ z 8~ ~ uS 0 ':D ~ C,j ~""'1 N - ~~ p ~ o ~ E-t ~ E-t Cf) ~ a ~ Cf) ~ ~ rou "'""'w ~a "'"'" ro -. ::r: Cf)Cf) ~~ zz 00 >;>; ....:!.....:1 ~~ zz zz ~~ ;.......; - I- :) :5 ,..;.,,,, ',JI- ~ o ~ E-t ~ H :r: ~ 8 o Ct; o o:.l a z ~ H Ct; ~ o:l ::E :::> u 8= ~ Z z ::r: ~ 0 E-t0 ~ Z W :::>~~'O O.....:1~C u:::>oro ua~ Cf) 4;W~::r::o::; ::r:: UO .....:1U~4;E-t ~Cf)OW:=> z Cf)U Haz ~ ~lilO4;:X: Cf)Hlil~ aOE-t::r: z p... :=> ~ -. ~Oo::l ~ O:;H -.~ E-tp...~:r:H Cf) E-tUZ o::;aCf)~Cf) HZH~W ~~aCf)H , he.~'Y ct;?iiiy '[?><iJ writton (K:h;.H {:i the iiihYd of ~ smtement of Propc..'3ild DisuicooC,fl. aOO of the datd. ane and p!ace whe.~ b'1e sarna d be P'~ted to the Court tor ooc~ SId of \he ie8t dI:\l ~. wdt8n~ to said mr' 2 ~' ~ Propoeed DIIrtUlon. has been glt.1en to wety ~ d8Imen and to fNety other person known to the ~ K; hfMt CI de.fm en mt~ In the aatat& as Ct'OCIIrJr I ~f. ~l!' (;f !i~ of /fm. A cop; of %,K% S..areffi6rn Wf>...f, iiidiJdad wtth the notIo'~ ~', i ~ t,'.' ~~j 52 ~i - '",::!8~ ill! .] '0 ii:! '5 . =,',~R.91 ~? ~S >- f~ L,. C l~ 1- J:..f5 5 ~~~ IJjia1 i:;: Q).... II ~ ..s ..8 0 .- - "C Cii "., "= e .~~:'.' :i: cu d '~,:' fi ~ St, ~ i i ~ }.;,,~ II Sl~~ j 2~ gl~ilio ~!I~t~~ljg .*- ~ ~ ~ ~ f-4 0::: 0- <C 0 ~ Ul ~ ~ hi ~ ~ "" 6i .( if)~f-<o-"'" Ul ~Ul8z B p:.f Z f-< .( ffi~0S'26~ o~~~~G; ~~~~o~ :3 VJ p.; p.. Zr.?J~ o 53 if) f-< Z ~ o ....... uS Z >- o :2: ~ ...l tY v PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION. STATUS REPORT UNDER RULE 6.12 Name of Decedent: ANNA L. YONAS a/k/a ANNA L. YONASH Date of Death: February 17. 2001 Will No.: 2001-00366 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 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: 4-g/o'v {i Signatur~,b JlY'-' _'j'l Edmund G. Myers. Esq. Johnson, Duffie, Stewart & Weidner 301 Market Street, P.O. Box 109 Lemoyne. PA 17043-0109 Address -.,. j p (717) 761-4540 Telephone No. Capacity: Personal Representative X Counsel for Personal Representative RF,V.:.:.;i"txI6.QO) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 (0 -;);2,3 _ I REV-1500 w ..., :ll:~1J) v"'''' wo.v ",00 v"'''' 0.10 0. '" INHERITANCE TAX RETURN RESIDENT DECEDENT I- Z W C W o w c DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) YONAS, ANNA L. a/k/a YONASH, ANNA L. G OFFICIAL USE ONLY FILE NUMBER 21-01 o 0 3 6 6 DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) February 17, 2001 October 15, 1920 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) [] 1. Original Return D 4. Limited Estate ~ 6. Decedent Died Testate (Attach copy of Will) D 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date oldealh after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copy 01 Trust) D 10. Spousal Poverty Credit (dale otdeath between 12-31-91 and 1-1-95) COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 166 14 7734 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Return (date of death prior to 12-13--82) D 5. Federal Estate Tax Return Required 1 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Seh 0) NAME ..., Z W o Z o 0. ., W '" '" o v Edmund G. Myers, Esq. FIRM NAME (It Applicable) Johnson, Duffie, stewart & Weidner TELEPHONE NUMBER (717) 761-4540 COMPLETE MAILING ADDRESS 301 Market St. P. O. Box 109 Lemoyne, PA 17043-0109 OFFICIAL USE ONLY (B) 164,322.67 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 95,900.00 (11) (12) (13) 32,957.00 131,365.67 -0- (1) (2) (3) (4) (5) z o !( ...I ::l l- ii: <l: o w a:: 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4 Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) (7) (14) 131,365.67 68,422.67 -0- (19) -0- 9,007.93 8,444.94 17,452.87 (6) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) (9) (10) 29,975.45 2,981.55 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o !;( I-' ::l C. :ii: o o g 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x,0_(15) 16. Amount of Line 14 taxable at lineal rate x,0_(16) x ,12 (17) x ,15 (18) 17. Amount of Line 14 taxable at sibling rate 75,066.10 56,299.57 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUNO OF AN OVERPAYMENT Decedent's Complete Address: ~ STREET ADDRESS 1555 Simpson Ferry Road CITY New Cumberland I STATE PA -1 ZIP 17070 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 17,452.87 Total Credits (A. B. C) (2) -0- 3. InteresVPenal1y if applicable D. Interest E. Penaily TotallnteresVPenalty ( D . E ) (3) - 0 - 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) 5. If Line 1 . Line 3 is greater than Line 2, enter the difference. This is the TAX OUE. (5) 17 , 452 . 87 A. Enter the interest on the tax due. (5A) -0- B. Enter the total of Line 5 . 5A. This is the BALANCE OUE. (5B) 17 , 452 . 87 Make Check Payable to: REGISTER OF WILLS, AGENT 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 transferred; ....................... ..................................... ........... D IKI b. retain the right to designate who shall use the property transferred or its income; .. ............... 0 [KI c. retain a reversionary interest; or ..................... ........................................... .................................... 0 0 d. receive the promise for life of either payments, benefits or care? .............. .................m.. ................ D IX] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................ ............................. ...................... D IX] 3. Did decedent own an "in trust fo( or payable upon death bank account or security at his or her death? ............. D IKJ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................... ...................... .........m.... D lKJ 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 that I have examined this return, 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 personal representative is based on all information of which preparer has any knowledge DATE 'tln/O( RE OF P SON RESPONSIBLE FOR FILING RETU .~ eorg ea h; R ea Seac John Le 125 Green Valley Drive, Palmerton, SIGNATURE OF P~ THAN REPRESENTATIVE ADDRESS t:amun . Myers, t:sq. 301 Market St., P. O. Box 109, Lemoyne, PA 17043-0109 I r I" ]~Il 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 surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)]. 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. 99116 (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 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 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. 99116(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. 99116(1.2) [72 P.S. 99116(a)(1)]. 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{a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Rc'J-l50~r ""',. SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF YONAS, ANNA L. a/k/a FILE NUMBER YONASH, ANNA L. 21-01-00366 All 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 jointly-owned with right of survivorshiD must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1, Real Estate - No. 1555 Simpson Ferry Road, Borough of New Cumberland, Cumberland County, PA. (Deed Book K, Volume 15, Page 187) Sale Price 95,900.00 (Copy of Settlement Sheet attached) TOTAL (Also enter on line 1, Recapitulation) $ 95,900.00 (If more space is needed, insert additional sheets of the same size) A US DEPARTMENT OF HOUSJNG and URBAN DEVELOPMENT SETTLEMENT STATEMENT OMt!No.2502.0265 L.~e'p",,1 , LIBERTY LAND j TRANSFER, INC. B. TYPE OF LOAN ! 4660 Trindle Road, Suite 101 1. ( I FHA 2.[ ] FMHA J.! ] CONY. UNINS ! Camp Hill, PA 17011 4, l)VA 5. ( 1 CONV,INS. 6 FilE NUMBER j 7, LOAN NUMBER I Phone (717) 975-9915 Fax (717) 763-7460 90478 8 MORT. INS. CASE NO.' I C NOTE This IOrm is lurnished 10 give you a statement of actual settlement costs_ Amounts paid to and by the seltlemenl agent are shown Items marked I '(p 0 c r were paid au/side Ihe closing, they are shown here for informational purposes and are not included in the totals. o NAME AND ADDRESS OF BORROWER E NAME AND ADDRESS OF SELLER F. NAME AND ADDRESS OF LENDER ORPHA M. DOUDEN ESTATE OF ANNA L. YONAS , : G PROPERTY LOCATION H. SETILE:MENT AGENT I. SEITlEMENT DATE: I TRANSFER, INC. 07/30/01 , 1555 SIMPSON FERRY ROAD LIBERTY LAND I NEW CUMBERLAND BOROUGH, PLACE Of: SETTLEMENT PA I CUMBERLAND COUNTY, PA. 4660 TRINDLE ROAD, ST 101, CAMP HILL, J, SUMMARY OF BORROWER'S TRANSACTION: K, SUMMARY OF SE.LLER'S TRANSACTION: I 100 GROSS AMOUNT DUE FROM BORROWER ~OO, GROS$ AMOUNT DUE TO SELLER 101 Contract sales price 95900.00 ~01.Contracl sales price I 95900.00 10,0 Personal property , ~Ol' Persona[ pro~erjv ; 10:1 Seltlemenl charges to borrower (line 1400) 2578.54 '" i , , '" I ~o~. i IQ~ 405 1 : Ad~slmenls lor items paid ~eller in advance Adi~stmen!s for items paid bv seller in advance 'on City/Town \<'l~ " ~06 CilvlTown lax " I IIJl Cou01Vlax 07/36101<0 12/31Toir 11 7.12 ~07,COl.lnty tax 07 30 011012/31/011 11 7.12 , IOH ASSCSSI1lcnIS " ',08 Assessments 10 I \O~ Sella"l " -, '" Sr;:hool '0 I , 110 TRASH 7/30 - 9/,a 0 23.60 '" TRASH 7/30 - 9/tBO I 23.60 , '" , ll~ '" j 1:'0 GROSS AMOUNT DUE FROM BORROWER 98619.26 ~20, GROSS AMOUNT DUE TO SELLER 96040.72 '00 AMOUNTS PAID BY OR IN BEHALF OF BORROWER ~OO REDUCTIONS IN AMOUNT DUE TO SELLER JClJosit 01 earnest money I 3500.00 50lExcess deposit (see instructions) i ~o:' Principal amount oj new loan(s) s02,Settlemenl charoes to seller (line 1400) I 7927.59 "0:1 Ex!SlinnIOanfs) taken subjecl 10 503_Exislinn loan(s) taken subject to I ';(l~ s04.Payoff of First Morlgage Loan I 1 ; '0" 505Payol1 01 Second Morlgage Loan I . , , "" CARPET CLEAN CREDIT 70.00 506. CARPET CLEAN CREDIT I 70.00 :'07 DOOR PINS CREDIT 10.00 '" DOOR PINS CREDIT I 10.001 :'on , ". I , :'09 I 509 Adiustments lor items unpaid ~ seller Adjustmenls jor items unpaid bv seller ~'o C"ylTown lax " I 510,CllyIToWn\ax " ! '11 Cu"nly l.~x " , 511 County tax I " "'. t'~~~'",m(,'rlto " !l1?,AssDssmDr:ls " I '.:\ """'1 07/01 01" 07/301011 66.08 513 schaal 07/01/0110 01130/01 66.08 . ., I ~ SEWER 7/1-7/30 I 7.11 '" SEWER 7/1 7/30 7.11 1 ~", 515 , ?1r, 1 516 I :'17 I 51' i "11! , 51' i I 219 ! 519. , i P2(J TOTAL PAID B\'IFOR BORROWER : 3653.19 S2D_ TOTAL REDUCTION AMOUNT DUE SELLER 8080.78 I \00 CASH AT SETTLEMENT FADM OR TO BORROWER 600 CASH AT SETTLEMENT TO OR FADM SELLER . '\01 Gross amount due from borrower (line 120) I 98619.26 601.Gross amount due to seller (line 420) I 96040.72 ' 30~. Less amount paid bv/lor borrower (line 220) 3653.19 602_Less reduction amount due seller (line 520) I 8080.78 , JjJ:.\ CASH (j)!FROM) (f ) TO) BORROWER 94966.07 603 CASH ([XTO) ([ ) FROM) SELLER , 87959.94 , TlTI(,1'110 Seller's$lgnature HUD.1 Rev, 5186 US DEPARTMENT OF HOUSING AND U!=lBAN DEVELOPMENT SETTLEMENT STATEMENT OMB No 2502.0265 RE/MAX REALTY ASSOC. L. SETTLEMENT CHARGES 90478 700 TOTAL SALESlBROKER'S COMMISSION based on price S Division of Commission (line 700) as 101l0ws 701$ 2902.00 10 702:& 2852.00 to 7QJ C9~.mission paid at Settlement 70~ 'TRANS. FEE 800 ITEMS PAYABLE IN CONNECTION WITH LOAN aOt Loan Origination Fee % 80:< i...oanD,scounl % 2n, Appraisal Feeto 804 Credit Reporllo 805. Lenders Inspection Fee 806 Mortgage InsL;rance Application Fee 10 '807 Assumption Fee ,,, 809 'W '" 900 ITEMS REOUIRED BY LENDER TO BE PAID IN ADVANCE 901lntereslJrom 07 30 01 to07 31 01 @$ 902. Marl age Insurance Premium for mo, to \103 Hazard Insurance Premium for yrs to ~04 y~.to 95900.00 6.0 Total, 5,754.00 RE/MAX REALTY ASSOC. BROKERS REALTY.COM Iday CliJ5 1000 RESERVES DEPOSITED WITH LENDER FOR 100\ Hazard Insurance mo @$ 1002 Mortgage Insurance mo @$ 1003 CilyfTown tax mo. @$ 1004 Coumylax mo @$ 1005 Assessments mO.@$ t006 mo.@$ 1007 mo @$ 1U0U mo @$ 1100 TlTLECHARGES 1101 Settlemenl or closing lee to I IU<: il,ustr3t.:1 01 Iltle sea~ct~ to 1103 rltleexamlnalion to 1104 TiUe insurance binder to ,,"~ nocur1enl preparation 10 1 :06 r'llolary lees 10 ,~, Altorney's fees 10 (Iflcludesabove ilems No,:) . ',m T,tlCo'lilsuranC& (0 (11'ciudes above Items No IIU9 l2nder's coverage $ 1'10 Owner's coverage $ ,mo 'mo 'mo 23.13/mo 'mo 67.00 Imo. ,mo ,mo CASH 6.00 LIBERTY LAND TRANSFER INO 95 900 ~ 1 1 3 ;:!LC' GOVERNMENT RECOROING ANO TRANSFER CHARGES t201 Recording lees: Deed$ 26.50 MortgageS 1:<02 City/county tax/stamps. Deed $ 959. OOMortgage $ ':!C:\ St3Ielax/s!amps Deed$ 959. o o Morlgage $ Misc. $ 26.50' 959.00 959.00 , .",~ 1205 '300 ADDITIONAL SETTLEMENT CHARGES 1301 Survey 10 1302 Pest InspeClion to lJLlS '01 SCHOOL 1304 '01 CO TWP IjU~ SEW TRASH SUDDEN DEATH PEST ROBIN GAS PERETTI ROBIN GASPERETTI NEW CUMBERUL~D BOROUGH 720.80 788.29 1400 TOTAL SETTLEMENT CHARGES (onter on lines 103 IInd 502. Sections J and KJ 2578.54 305.36 57.43 7927.59 I',,,',,,, ow"',, It,al "'" l;nt.i'.I~'5 'l""men tJY Selll"mcnl Agcnllo, "'" ~ccwac~ ullillorm~liD" lurlllsh"d by OlhNS as shown Dn Ihe HUD.l Sctllemenl Slalem",,1. SI!llIemellt Agent hereby e.pros~ly """'VN. L"" '"yhl to dopO",1 ""~ amou"" cOlleCled 10. disburseln",,1 i" an i"lerest bea.ing account in a Federally i""utcd instlluhen and Ie c.edjl any inle."SI so "~rned Ie its OWn accounl asaddilio"al ,H"P""~;"'"'''''' ,,. ~"""c"'~ '" II,,~ Ira"~acllon Hue CERTIFICATION OF BUYERS AND SELLERS I hewD cClrofully "~Iliewcd the HUD. T Seltlemenl Stalemcnl and 10 Ihe best 0' my knowladga and beliel, il is IIlrue and.<\cCLJrale statement of all receipts and disbursemenlS rnndc on mv account by me! in lhis Iransacliort. I further certify that I have reccj~ed a copy oll~e~u elH~m;nl~e~ertL ,_ (- . ~ II ."'r.~0:p?t7c-</:' (1' \ \' \l (>- \\..\. \\ ,)~J).L.'- <. '''';Z'JA'- 'f_L_ ' .. ~ "r:7 v , ~ A -~"'> , 11""" ."H",,,>,",,,-,S'!J"4Lu,"' Scll~r'.S'!lMturC 11"\'ur'. ^ddr"~$& I'hone Seller's N~w Addr~.s& Phene I iLl) IIUll., Sctll~",c'" Slal..f'r"~.~hiCh ,l hav" pr"pat<ld is a Iruc and 8CCur8llt account olll,is transaclicn_ I havD caused or will causa lhe lund~ 10 b~ disbu.scd in accarda"c~ wilh l~'s slat~mer,t -O-u .\lL 7 - )(;?-p / s....lI~'"'~''' ^y",,1 D~ie WAllNIN~)I:"~ ~ ~:'~"'c'~';~'~~~~'nr. T'~;~ ~~}~es:~,\~~~~\SQIO Ihc Uniled Sial"" 0" Ihis ", ""Y s"nlla. 101m. PellalliCs upon cOl1viClio" can ,,,elude u fjne and imprisonment For del~ils s~e HI!f1.'llf'v.'iIAr, ..,.,...",.,..n* COMMONWEALTH OF PENNSYLVAN<A INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF YONAS, ANNA L. a/k/a YONASH, ANNA L. FILE NUMBER 21-01-00366 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolnUy<>wned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE A T DATE NUMBER DESCRIPTION OF DEATH 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Household Goods - appraised value 2,440.00 1983 Chevrolet Sedan - date of death value 425.00 1,989.15 Cash in decedent's possession PNC Bank - Checking Account No. 51-4007-1049 Date of death balance Waypoint Bank - Account No. 500072701 - Savings. Date of death balance, plus accrued interest Waypoint Bank - Certificate No. 500007040 Date of death balance, plus accrued interest Waypoint Bank - Certificate No. 500007099 Date of death balance, plus accrued interest Waypoint Bank - Certificate No. 500007133 pate of death balance, plus accrued interest Waypoint Bank - Certificate No. 555302846 Date of death balance, plus accrued interest 3,587.14 7,625.51 2,275.78 2,502.33 13,611.30 1,218.62 Waypoint Bank - Certificate No. 555302847 Date of death balance, plus accrued interest 2,719.15 Waypoint Bank - Certificate No. 561279903 Date of death balance, plus accrued interest 9,868.31 Patriot-News - subscription refund Waypoint Bank - Individual Retirement Account Certificate No. 596528349 - Beneficiary: Estate 40.50 18,378.88 Hospice of Central PA - refund of February charges overpaid Refund - automobile insurance policy 1,460.00 281. 00 TOTAL (Also enteron line 5, Recapitulation) $ 68,422.67 (If more space is needed, insert additional sheets of the same size) ~t:"'!-1511 EX+ (12-99) . ~. ..^.:-'~ . .:.10.1;;' COMMONWEALTH OF PENNSYLVANiA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF YONAS, ANNA L. a/k/a YONASH, ANNA L. FILE NUMBER 21-01-00366 ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Chowka Funeral Home funeral Stephen A. - expenses and cemetery charges 5,450.00 2. Stephen A. Chowka Funeral Home - engraving of cemetery monument 75.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions George Seach - SSN: 2,590.00 Name of Personal Representative(s) Rhea Seach - SSN: 2,590.00 Julul L~ll.ic:::t:k. - 6~1": 2,590.00 Social Security Number(s)/EIN Number of Personal Representative(s) 125 Valley Green Drive Street Address 2203 Bernville Road City Palmerton State PA Z' 18071 Readluy Ip ---pj\ 19601 Year(s) Commission Paid: 2. Attorney Fees - Johnson, Duffie, Stewart & Weidner 6,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City SIal. _ Zip Relationship of Claimant to Decedent 4. Probate Fees - Register of wills - Cumberland County 283.50 5. Accountarrt's Fees 6. Tax Return Preparer's Fees 7 . Cumberland Law Journal - advertise letters 75.00 8. The Patriot-News - advertise letters 99.24 9. Register of Wills - short certificates 6.00 10. Register of Wills - file Inv. & Inh. Tax Return 25.00 1I. Chuck Bricker - household goods appraisal 75.00 12. First Union - Estate checks 45.05 13. Reserve for close-out costs 125.00 Total from additional sheet 9,446.66 TOTAL (Also enter on line 9, Recapitulation) $ 29,975.45 Debts of decedent must be reported on Schedule I. (It more space is needed, insert addilionalsheets of the same size) SCHEDULE H - CONTINUED Estate of: YONAS, ANNA L. alkJa YONASH, ANNA L. 21-01-00366 14. Shipley - oil delivery 15. Comeast Cable - final charges 16. AT&T - final charges 17. George Seach - reimbursement for AT&T charges advanced; Stamps and charge to replace lost safe deposit box key. 18. Borough of New Cumberland - sewer/trash 19. PA Water Company - water service 20. PP&L - electric service 21. Mary K. Haring - removal of trash from residence 22. Tim Losh -lawn maintenance - 4/9 - 7/28 23. Jack & Rose Kolsar - watching, maintaining & checking house prior to settlement. 24. Costs - sale of real estate - 1555 Simpson Ferry Road: Re/Max - real estate commission Re/Max - transfer fee Notary Fees - cash Recorder of Deeds - 1 % transfer tax Sudden Death Pest - pest inspection & treatment Robin Gasperetti - County/Borough real estate taxes due at settlement Borough of New Cumberland - trash charges due at settlement Orpha M. Douden, purchaser - carpet cleaning charges Orpha M. Douden, purchaser - credit for door pins missing Borough of New Cumberland - sewer charges due at settlement Robin Gasperetti - school real estate taxes due at settlement Total 199.67 3.68 20.00 63.06 57.43 63.09 124.67 330.00 395.00 250.00 5,754.00 125.00 6.00 959.00 720.80 188.24 33.83 70.00 10.00 7.11 66.08 $9,446.66 REV-15IlEX.(l-91). ~ .,)..l't , > ~ . ',,- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FILE NUMBER 21-01-00366 YONAS, ANNA L. a/k/a YONASH, ANNA L. Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1. 2. 3. 4. 5. 6. 7. 8. West Shore EMS - decedent's account balance not covered by insurance Pinac1e Health - decedent's account balance not covered by insurance Johnson, Duffie, Stewart & Weidner - services rendered prior to death 76.95 151.00 125.00 Checks that cleared after death - PNC Account No. 51-4007-1049 Check No. 3863 - Borough of New Cumberland sewer & refuse Check No. 3867 - AT&T - Check No. 3868 - Hospice of Central PA 57.43 25.88 2,000.00 Susquehanna Internal Medicine - decedent's account balance not covered by insurance Robin Gasperetti - County/Borough personal taxes 34.29 11. 00 Barbara Louise Huff - services provided for Mrs. Yonas prior to her death as her attorney-in-fact. 250.00 Joy Losh - providing transportation to and from doctor visits and running errands. 250.00 TOTAL (Also enter on line 10, Recapitulation) $ 2, 981 . 55 (If more space is needed, insert additional sheets of the same size) '~""","":. COMMONWEALTH OF PENNSYLVANIA INHERITANCE. TAX RETURN RESIDENT DECEDENT ESTATE OF NUMBER L II. SCHEDULE J BENEFICIARIES YONAS, ANNA L. a/k/a V"M~C:1-1 """ r. FILE NUMBER 21-01-00366 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. John Lesniak - 2203 Bernvil1e Rd. Reading. PA 19601 2. Joseph Lesniak - Manor Health Care 1700 Market st., Camp Hill, PA 17011 3. Rudolph Lesniak - 529 Bear Valley Ave. Shamokin, PA 17872 4. Helen Shicora - 400 Woodland Ave. New CUmberland, PA 17070 5. Child of Nicholas Lesniak, deceased: Lu Ann sch1eig - 1001 Montgonnery St. Shamokin, PA 17872 Broth~r One-seventh Residue Brother One-seventh Residue Brother One-seventh Residue Sister One-seventh Residue Niece One-seventh Residue 6. Children of Maria Reeder, Deceased: Alvin Reeder - 1105 Independence St. Coal Township, PA 17866 Belle Reeder - 20 W. Sunbw:y St. General Delivery, Snydertown, PA 17877 Elrica Swank - 355 Clark Road, General Delivery, Snydertown, PA 17877-9999 (See additional beneficiaries on sheet atta hed). ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET NON.T AXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELlECTION TO TAX IS NOT BEING MADE Nephew One-third of One- seventh of residue One-third of One- seventh of residue One-third of One- seventh of residue Niece Niece 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II. 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) SCHEDULE J - CONTINUED BENEFICIARIES ...----.......------.....-...-----...-----................----.-----..........--.....---.....-...-------..-----..--....-......----..-.........-----..-----........------.......-----...---.... Estate of: YONAS, ANNA L. a1k1a YONASH, ANNA L. 21-01-00366 7. Children of Rose Seach, Deceased: George Seach -125 Green Valley Drive, Nephew One-seventh of One Palmerton, PA 18071 seventh of residue Joan Wiegand - 6540 Rai Dores Dr., Niece One-seventh of One Las Vegas, NV 89108 seventh of residue Michael Seach - 242 So. 750 E., Nephew One-seventh of One Clearfield, UT 84015 seventh of residue Rosemarie Vicinanza - 802 Park St., Niece One-seventh of One Apt. B3, Grinnell, IA 50112 seventh of residue Beatrice Wallace - 8070 W. Russell Rd. Niece One-seventh of One #1087, Las Vegas, NV 89113 seventh of residue Harriet Gati - 16 Swan Lane, Niece One-seventh of One Holidaysburg, PA 16648 seventh of residue Gregory Seach - 2982 Hylan Blvd. Nephew One-seventh of One Staten Island, NY 10306 seventh of residue