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09-08-15
pennsytvania 1505614105 DEPApTMEM Of REVBlUE EX(03-14)(FI) REV-1500 OFFICIAL USE ONLY Bureau of Individual Taxes .. Year File Number PO BOX 280601 INHERITANCE TAX RETURN ........................... Harrisburg, PA 17128-0601 RESIDENT DECEDENT a 1 ; 13 Sd ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY _ 08 D Z Zdl3 09 vs 93 i v Decedent's Last Name Suffix Decedent's First Name MI _...-.__ ._..................... ..._._......... __. ........... MOtI-ich G6-NV,*neo (If Applicable)Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI ^)1,4 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW M 1.Original Return p 2. Supplemental Return p 3. Remainder Return(date of death prior to 12-13-82) C=:) 4.Agriculture Exemption(date of O 5. Future Interest Compromise(date of C=) 6. Federal Estate Tax Return Required death on or after 7-1-2012) death after 12-12-82) M 7. Decedent Died Testate p 8. Decedent Maintained a Living Trust 9. Total Number of Safe Deposit Boxes (Attach copy of will.) (Attach copy of trust.) C=:) 10. Litigation Proceeds Received p 11. Non-Probate Transferee Return O 12. Deferral/Election of Spousal Trusts (Schedule F and G Assets Only) O 13. Business Assets O 14.Spouse is Sole Beneficiary (No trust involved) CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number CHH R LES J. Sf/l FL-DS 7_1T' '� 766. -o 2 First Line of Address ...... ...... //............._._... _.._..m....,.,..._.......,.... __......__._._._.,....,..._........_.._........ . _..,_................ _ __.. (Q C[ou. SFR Oe 00 j L.........___.__.__ ___.�.... __.. _.._ _,.__.._, _....m..._..,...-...........--_a...._-.—..___.__.-........................................._.....-._...... m....... a Second Line of Address I N, )/A i...............__......................._.....................................:................................___.................................._......_................................_.................................................................................. City or Post Office State ZIP Code .... h1 �CHAA11 BW2G �A� 170 S - f73s Correspondent's email address: G'e Sh%e I d s 3Q co/y1cost. n G I REGISTER OF WILLS USE ONLY REGISTER OF WILLS USE ONLY .... DATE FILED MMDDYYYY' ' j © DATE;FIUQSTAMF0 •� CD Q:7 PLEASE USE ORIGINAL FORM ONLY Side 1 I11I11 1I'1I 1I11I 111III ILII III)I111)1111I11III1') CIOo5lilt �14105 1505614105 r 1505614205 REV-1500 EX(FI) Decedent's,Social Security Number ....................... Decedent's Name: GAW1149 M01-LiC4 RECAPITULATION 1. Real Estate(Schedule A). ............... ................_....... 100 2. Stocks and Bonds(Schedule B) ....................................... 2. • &90 3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) .... . 3. 001 4. Mortgages and Notes Receivable(Schedule D).. ...... ........... . ... . .. . 4. . 0(9 5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 1 - 41 6. Jointly Owned Property(Schedule F) C-% Separate Billing Requested ....... 6. 7. Inter-Vivol Transfers&Miscellaneous Non-Probate Property (Schedule G) C-1 Separate Billing Requested........ 7. QQ 8. Total Gross Assets(total Lines 1 through 7)... .. ... ........... ... ... .... 8. o 9. Funeral Expenses and Administrative Costs(Schedule H). ... ........ ... .. . . 9. 3 53S, 9 f 10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)......... 10. 11. Total Deductions(total Lines 9 and 10)................................. 11. 12. Net Value of Estate(Line 8 minus Line 11) ........ ... ..... ....... .. ..... 12. 1 13. Charitable and Governmental Bequests/Sec.9113 Trusts for which an election to tax has not been made(Schedule J) ... ..... ........... . .... 13. . 00 14. Net Value Subject to Tax(Line 12 minus Line 13) ..... .... ..... .... .. .... 14. TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or tra)(1.2ansfersXunderj0_Sec.9116 ( ) .0 00 15. 16. Amount of Line 14 taxable at lineal rate X.0 16. 17. Amount of Line 14 taxable at sibling rate X.12 Soo 17. . . 00 1 18. Amount of Line 14 taxable at collateral rate X.15 000 18. 19. TAX DUE .... ... .... . . ... .... ... .. . ... ..... ........... ........ ... . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C=D Under penalties of perjury,I declare I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief, it is true,c;Ip and com late. Declaration of preparer other than the person responsible for filing the return is based on all information of which preparer has any knowle , v, O SIGNA7r7R7ff !BLE FOR FILING RETURN ITE X ADDRffSCJ146&S J. MOL-LIC'+ 30.3 AF ft)&;Yl St, ID eaha n;c:4 t4 r '3, PA )70-SS SIGNATURE 0 PAR R 0;: RESPONSIBLE FOR FILING THE RETURN DATE E2, gkh:r ADDRESS EHtARZ'cs E, '511,1EIGS 6 Clomser ed., 1U-echan;dsht4r,5j PW /70:59- 11111111111111111 1JQ111[1l�illJ1t1P11llJll 11111 Jill 1111 Side 2 4 1505614205 REV-1500 EX (FI) Page 3 File Number Decedent's Complete Address: DECEDENT'S NAME ----G CA)1U,4i20 .. oi.t-� STREET ADDRESS 05 IF. A- dJ 5-r TAT, !�s ---..--...—..... CITY STATE ZIP �'1FGN�N/CSB�12G �A � joss Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) (1) 0. 2. Credits/Payments 0 A.Prior Payments B.Discount (See instructions.) Total Credits(A+B) (2) 0 3. Interest (3) 4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. D Fill in oval on Page 2,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 DUE. (5) Make check payable to: REGISTER OF WILLS, AGENT. .W.�.��...2,x .. , x,51,1„1& ,,,,, ....,. 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.......................................................................................... ❑ b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ c. retain a reversionary interest ..............................................................................................................I............... Eld. receive the promise for life of either payments,benefits or care?...................................................................... ❑ Ill 2. If death occurred after Dec. 12, 1982,did decedent transfer property within one year of death without receiving adequate consideration?........................................................................ 3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?............... ❑ 4. Did decedent own an individual retirement account,annuity or other non-probate property,which contains a beneficiary designation? ........................................................................................................................ ❑ Q= IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ,.., ;»� .a'�.v. ,.._ ....�.'..'..�'.. c3...., ,S '. + .i'„ -e......_..._._.. aP.a .. For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt 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 21 years of age or younger at death to or for the use of a natural parent, an adoptive parent or a step-parent of the child is 0 percent[72 P.S.§9116(a)(1.2)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[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. REV-15o8 EX+(ii-io) Zii SCHEDULE E i pennsylvania CASH, BANK DEPOSITS & MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEpENT ESTATE OF: FILE NUMBER: �ennaro n'loll,Ca /3 _ 11ro Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH �. lntk» AmAl NCO Aut /Yo• S/3 a 3, ?7.2. ,3. Znf �CCrutu� r� c%o.a! 6" .1.-�,m no•/ (aYG l%P�lf�l�iOA IG�C�" a�R'G��J dee � ,306•SO (see �fem��l d��ka.Son � 9� �dJ �. -?00h ft rur y Grand Ma.r l5 , 310 q-50 199 6 /0,m � 7P,4 TOTAL(Also enter on Line 5, Recapitulation) $ If more space is needed,use additional sheets of paper of the same size. 112-411, METRO BANK 3801 Paxton Street 888.937.0004 Harrisburg, PA 17111 mymetrobank.com 1/12/14 Charles E. Shields III Attorney at Law 6 Clouser Rd. Mechanicsburg, PA 17055 RE: Estate of: Gennaro Mollica Tax Identification Number: Date of Death: August 2, 2013 To Whom It May Concern: This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Type:CK Account Number: 513189852 Date Opened: 10/05/2000 Primary Owner: Helen Mollica Secondary Owner: Gennaro Mollica Accrued Interest: **$0.27 Date of Death Balance: $3,272.14 ** Please note: The accrued interest will not be paid if the account is closed prior to the date the interest is scheduled to post. Please feel free to contact us at 1-888-937-0004 if we may be of further assistance. Sincerely, JJ ni Jacobs Research Associate Metro Bank Gennaro Mollica Estate Schedule E Accessories/Personalty Two watches $ 10.00 3 Rings-men's costume $ 15.00 Miscellaneous trinkets in jewelry case (small items) $ 3.00 2 Jewelry cases-women's $ 6.00 Miscellaneous pins-women's costume jewelry $ 3.00 Ladies earrings- 10 pairs-costume @ 50¢per pair $ 5.00 Indian sculpture $ 2.50 Indian doll $ 5.00 Indian tortoise shell $ 5.00 Indian statue $ 7.50 Indian lamp with shade $ 5.00 Walker $ 2.00 3 Small lamps-decorative $ 7.50 9 Women's necklaces-costume-silver- $1.50 each $ 13.50 1 Women's faux pearl necklace- $1.00 $ 1.00 10 Women's necklaces-costume-gold - $1.50 each $ 15.00 Large women's case $ 6.00 Hospital bed-motorized (with blow up mattress) $ 25.00 Wood file cabinet(small) $ 3.00 2 boxes of miscellaneous wall plaques-$8.00 each box $ 16.00 2 Small end tables - $1.50 each $ 3.00 Box of small knick knacks $ 7.50 3 Elvis Presley whiskey decanters-2 @ $40.00, 1 @ $50.00 $130.00 White dresser-small-particle board $ 10.00 TOTAL $306.50 ato NAc'a ol k b , eo { i e a AU = 103 4 S-o _._... __- ._. __..-_._...._._......_..__w. _ __._____._._.__........__..____....... _.. ...-_-........... ..____--...r i i i i i i �j -Home/Used Cars/Mercury!Grand Marquis!2007 Grand Marquis!Prices with Options/Prices with Options Results i I Share This Page ADVERTSEMENT ,.-.-_........ -.,.,....-..�..._._.,..____.... 9 k Tips and Advice See your Q5 offers ►I+T, 10 Steps to Buying a New Car 10 Steps to Selling Your Car 2007 Mercury Grand Marauis - What Your Car is Worth New Car Buying Guides Price Prornises" ! 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REV-1511 EX+(10-06) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OFFILE NUMBER Gcnnaro kollf'Ca •�/- / 3 /�s'b Debts of decedent must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: t. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) C/J d r/GS �/• d//1(A J d Street Address X03 1G• city IMe('h An e 5,&ti req State-1p ...zip ho S_�' Year(s)Commission Paid: CharG5 F. cSh;akl5 '71' �pstrna�cd desp%k �14irwa� gaS�Av 2. Attorney Fees 1 � 1)t¢ lye assefis. 1� /ws . cwt Con en,fio/�lrllOn� �'u r%aNs k4 e&:u r;_9 aid 3. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation) G&-food Qe&p,nR! hYKsk 46f 4• Claimant AAV 1-0&4F— Street NF Street Address City State Zip Relationship of Claimant to Decedent / 1 4. Probate Fees Gvrit[ or'j;nal %SSLte a� S�'1Drfi' CETf)T��7'GS U II 5. Accountant's Fees Wh)hw10b rpt se.-Y.cGs, o� 11CCAAnlC. e) -�»r c.)ealisWDM pasf 6. Tax RetuReturnPreparer's Fees D rte}ttr z. 14ddi koaal PiV bafie -Pee Oi 00 f i4 ea--A's lc �nh��/ f/.3� 4eq lb. CDS o, �/�� tn;' / al4vnq /l, Rei aburse►nent t Mtr4es i11,e. Shields A .-�vr. p,Sfuge_, phc cap;e,5, ema;I;r,ys, ems. TOTAL(Also enter on line 9,Recapitulation) $ �� 53✓• 4 .(If more space is needed,insert additional sheets of the same size) REV-1512,EX+(12-08) i' pennsylvania . SCHE®ULE I DEPARTMENT OF REVENUE DEBTS OF DECEDENT,r . INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS RESIDENT DECEDENT ESTATE OFFILE NUMBER. . Gennaro h�ollta � Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. 13ltreask Of 4Wount. McmajerneAf -for p►nnaclle Kft4lfJ $1.2� /76. 99 (see C;a;m 40a eil ed �. -1>C rr) 54erviees on behaIf of C hase 34k kSA n.,� #38, Dy/. q7 SGB da,m it 744G4ed> TOTAL(Also enter on Line 10,Recapitulation) $ qb If more space is needed,insert additional sheets of the same size. �r�P 7 xlis/ni f NOTICE OF CLAIM (Filed Pursuant to 20 Pa.C.S. § 3532) COtJRCOMMON PLEAS OF �lh�� COUNTY,PENNSYLVANIA ORPHANS' COURT DIVISION ��r ESTATE OF 68�1,74a-,-D �r� Il/e-a- ,DECEASED No. o?l To the Clerk of the Orphans' Court Division: Enter the claim of t?4,1? ey �X�E �►`ll in the (Claimant) �} amount of$ ,P te, ."Iq ,against 69 above entitled Estate. nay q The Decedent,who resided at �O T t I� � ► I l� PA` I ® — 6 eet Address) died on I . Written notice of (Date of Death) said claim was given to r l ia— 9 �iJ CAS (Per oval Representative or his/her counse at !1 �`� • y �=A 1 ,� (Address) on (Date) r i& — . (Claimant) P9 (StreetAddress)flalw JA (City,Stat,Zip) / (Claimant's Counsel) (Supreme Court LD.No.) (Address) (Telephone) Form OC-07 rev.10.13.06 Oki7601 PENN AVE S,SUITE A600 MINNEAPOLIS, MINNESOTA 55423-5004 y�y/iy C � 9 April 10, 2014 Re: the Estate of Dear Sir or Madam: GENNARO MOLLICA On behalf of our client Chase Bank USA N.A., we offer condolences for the loss of GENNARO Our Client: MOLLICA, who was a valued customer. Chase Bank USA N.A. We are contacting you only in your capacity as Personal Representative or attorney for the Estate of GENNARO MOLLICA. We are attempting to collect a debt and any information Account #: obtained will be used for that purpose. We are not holding you personally responsible for the ************3235 balance. We are seeking payment from the assets of the decedent's estate. Reference #: Please contact us. On behalf of the estate, you may: 9980291 1. Complete the payment slip below and mail it and a check made payable to DCM Services LLC in the envelope provided. DO NOT SEND CASH. 2. Call us toll-free at 1-855-234-1135. We have a number of payment options available. Unpaid Balance: 3. Call us with a probate case number and/or trust information, if applicable. $3091.47 Calls may be monitored or recorded for quality assurance purposes. You have the right to dispute the validity of this debt or any portion of it. We will assume this debt to be valid unless you do so within 30 days after receipt of this letter. If you do so in writing within that time frame, we will obtain verification and mail it to you. If you send a written request within'the same time frame, we will provide you with the name and address of the original creditor, if different from the current creditor. If you are not the one handling decisions about the outstanding bills of the estate, fill in the form at the bottom of the reverse side of this letter and return it to us in the envelope provided.. Respectfully, DCM Services, LLC lam - 7 pm CTM-TH lam - 5pmCTF Telephone: 612-243-8620 Toll-Free: 855-234-1135 Fax: 877-326-8784 ""Detach Lower Portion and Return with Payment— DCM SERVICES, LLC 7601 PENN AVE S, SUITE A600 Reference #: 9980291 Client ID: IPMC12 s MINNEAPOLIS, MN 55423-5004 Unpaid Balance: $3091.47 ADDRESS SERVICE REQUESTED Checks Payable to: DCM Services LLC Amount Enclosed: $ April 10, 2014 I1. 1(I(Il.11(11(I11 .11111111('I('lll(I'I(I,II1.(I11. ((I.. sass-iss The Estate of GENNARO MOLLICA DCM Services/Chase g Attn:CHARLES EDWARD SHIELDS PO Box 1473 6 CLOUSER RD Minneapolis MN 55440-1473 MECHANICSBURG PA 17055-9751 11111111 11411 Ill 11 11111 Sligo 11111411 1 Ill A IS Ill 9980291 3235 96855-7505-156 REV-1513'EX+(01-10) syy pennsylvania SCHEDULE J r DEPARTMENT OF REVENUE , INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF: FILE NUMBER: .Crennaro doll, Ca RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under Sec.9116(a)(1.2).) 1. Wobard Lee, Powe 0 -/,a,) W d Ponilac Ca►►ns� y3 Cambr;dam C;rcla �nsOl✓ent 1.;�erpaol, P� i�o�s• 01. Charles 4i; Mercury also canno f be�,fftd as 30,6 'C. Ir�a;n ° 6gf1IE is in�mJre,�t (?echun;c6byrj, Pfd 17es� Rcs:d-c pea,- 3. ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON-TAXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS: 1. TOTAL OF PART 11— ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ONLINE 13 OF REV-1500 COVER SHEET. $ If more space is needed,use additional sheets of paper of the same size. LAST WILL AND TESTAMENT OF GENNARO MOLLICA 1,CENNARO MOLLICA,an unremanied widower,currently of 105 East Allen Street, Apt. 1 l 5,Mechanicsburg,Cumberland County,Pennsylvania,being of sound and disposing mind,memory and understanding,do make,publish and declare this my Last Will and Testament, hereby revoking and making void any and all prior Wills by me at any time heretofore made. 1. I direct the payment of all my just debts and funeral expenses as soon after my decease as the same can conveniently be done. 2. 1 give and bequeath my motor vehicles,as follows:to wit: A) 1998 Pontiac SW— VIN No.: I GMDX03E7WD33 to my son-in-law, RICHARD LEE POWELL,111. In the event he predeceases me,this gift shall lapse and shall become part of the residue of my Estate. B) 2007 Mercury Sedan—VIN No.:2MEFM75V47X639 to my son,CHARLES JAMES MOLLICA. In the event he predeceases me,this gift shall lapse and shall become part of the residue of my Estate. I understand that by making these specific bequests that any fees,commissions,death taxes and the like typically assessed against the value hereof will be paid from the residue of my Estate and not by the recipient hereof. 3. All the rest,residue and remainder of my Estate,real,personal and mixed,whatsoever and wheresoever situate,I give,devise,and bequeath to my son,CHARLES JAMES MOLLICA,outright and absolutely. In the event he predeceases me,then to his son,my grandson,NASH J.MOLLICA. In the event my said grandson also predeceases me,then to my son-in-law,RICHARD LEE POWELL,III. . 4. In the event any recipient of a share herein s under the age of twenty-one(21)at the time of my passing,then his or her share,as the case may be,shall be invested in good and safe investments,such as U.S.Government Bonds,Certificates of Deposits of highly rated banks, Page 1 c � "` money market accounts,and the Iike. The income and dividends thereon shall be accumulated and when the recipient has attained age twenty-one(2 1)his or her share,as the case may be, shall be paid over to him or her. In the event any of my said grandchildren shall survive me but shall not live to attain the age of twenty-one(21),then his or her share,as the case may be,shall be proportionally divided and distributed among my grandchildren who do survive me in Trust,or outright,as their ages shall determine. As an exception to the necessity of accumulation of income and dividends,I authorize my Co-Trustees named herein,to expend principal in their sole and absolute discretion for educational purposes such as college,community college,vocational-technical school,clerkship, internship,apprenticeship or the like. In making such decisions they shall consider grants, subsidies,scholarships and the like that may be available. I nominate,constitute and appoint my trusted friend,LARRY ORT,to be Trustee,in Trust,of any share to be held in Trust,as set forth hereinabove. S. 1 nominate,constitute and appoint my son,CHARLES JAMES MOLLICA,to be Executor of this my Last Will and Testament. In the event that he is unable or unwilling to act as Executor,I appoint my trusted friend,LARRY ORT,to be Executor in his place and stead. In the event he is unable or unwilling to act as Executrix,I appoint my son-in-law, RICHARD LEE POWELL,111,to be Executor in his place and stead. I further direct that they shall not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. IN WITNESS WHEREOF,I have hereunto set my hand and seal this 2� day of ,A.D.2011. 'J' W "i. (SEAL) GENNARO MOLLLICA Signed,sealed,published and declared by the above-named GENNARO MOLLICA, as and for his Last Will and Testament,in the presence of us,who at his request and in his presence,and in the presence of each other,have hereunto subscribed our names as witnesses. Page 2 CHARLES E. SHIELDS,III ATTORNEY-AT-LAW 6 CLOUSER ROAD Corner of Trindle and Clouser Roads MECHANICSBURG,PA 17055 GEORGE M.HOUCK TELEPHONE (717) 766-0209 (1912-1991) FAX (717) 795-7473 September 3, 2015 Register of Wills Cumberland County Court House 1 Courthouse Square Carlisle, PA 17013 Re: Estate of Gennaro Mollica Admin. No. 21-13-1150 Dear Register of Wills: Please find enclosed for filing 2 copies of the Inheritance Tax Return for the Gennaro Mollica Estate as well as Check No. 4316 in the amount of$40.00 for additional Probate. Thank you for your kind attention to this matter. Very truly yours, Charles E. Shields, III Attorney-At-Law CES/mjj Enclosures r-0 c� u ern' r,r� rn co C- - ty? •U F ' rn C-n C> a 00 71 US POSTAGE AND FEES PAID SEP 03 2015 Mailed from ZI P 17055 7oz Fust-Gass Rats Rate girl, �', III endicia.com/mac 071M00625744 USPS FIRST-CLASS CHARLES SHIELDS C001 6 CLOUSER RD MECHANICSBURG PA 17055-9751 Ship To: REGISTER OF WILLS CUMBERLAND COUNTY COURTHOUSE 1 COURT HOUSE SQ RM 102 CARLISLE PA 17013-3322 II���III��II��'1111"I'I'II��III��II�I���IIII���II�III���II�III�� k, j S'f'd u o 8S iI Wj 8 d3� Stai; 3�1��0 .0342�0�3� 3� lr���l����jl��lll►�i��l�{�iil�t��lrlr�llx�:�����i����ll�t!