HomeMy WebLinkAbout01-0656
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of
also known as
Tay K. Tambolas
'"JAy If'fNlViTI.f
~<7C~
mJ1U1 ocA ~
No.
~'-OJ - 0 (P5lo
, Deceased
Social Security No. 176 - 30 - 6558
Ellen D. Tambolas
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
[.KJ A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut r ix named in the last Will of
the Decedent, dated 07/10/1979 and codicil(s) dated None
none
State relevant circumstances, e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
none
D B. Grant of Letters of Administration
(c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
I
Name
Relationship
Residence
I
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland
County, Pennsylvania with his/her last family
or principal residence at 104 Orchard Street, Mechanicsburg Borough
(list street, number, and municipality)
Decedemt, then ~years of age, died 06/16/2001 at Mechanicsburg, PA
(Location)
DecedEmt at death owned property with estimated values as follows:
(If domiciled in PAl All personal property
(If not domiciled in PAl Personal property in Pennsylvania
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
$
$
$
$
2,500.00
situated as follows:
none
Harrisbur , PA 17109
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-'" . Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
ThEl 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 re sentative(s) of
the Decedent, Petitioner(s) will well and truly administer the estate 0 ding to law.
Sworn to or affirmed and subscribed
-r.:T~
before me this ~ day of
I/~II
.::r l-L L '-
aj-Ol-DIo5tP
No.
Estate of Tay K. Tambalas
Deceased
Social Security No: 176 - 30 - 6558 Date of Death: 06/16/2001
AND NOW,
0U L \.../
II
2001
, in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters [RJ Testamentary 0 Of Administration
(c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
are hereby granted to
Ellen D. Tambalas
in the above estate and that the instrument(s) dated
07/10/1979
FEES
letters. . . . . . .
$
25.00
Short Certificate(s).
$
6.00
Renunciation.
$
Attorney:
Donna M. Mullin
Affidavits (
$
\.0. No:
30392
JAMES, SMITH, DURKIN & CONNELLY
134 Sipe Avenue
Extra PagE!S (5 ).
$
/5 cJV
Address:
Codicil. .
$
Hummelstawn, PA 17036
JCP Fee.
$
5.00
Telephone: 717/533 - 3280
Inventory.
$
Other
$
-$ 51. Or)
. 36. ot+-
TOTAl.
$
Form RW-1 (1991)
Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only cPSystems, Inc.
HI05.805 REV 9/86
This is to l~ertifY that the information here given is correctly copied from an original certificate of death d~ly filed with me as
Local R~gistrar. 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.
Fee for rhis certificare, $2.00
p
7387037
No.
~f:.~
Local egistrar
9~' /1; d<t7t1(
Date
Hl0S 144 RSII_ 1/91
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
TYPE/PRINT
IN
PERMANENT
BLACK INK
SEX
zMale
K
Tambolas
DATE Of BIRtH
(Monlh, Day. YeaT}
BIRTHPlACE (City and
Stale or ForStgo COIJntry)
PlACE OF DEATH (Check only one see lOSttuctions. on other SIde)
HOSPITAL:
Ma r 15, 1939 F ayelte County, lopalionl D
~ ~ _.
P OF DERH FACilITY NAME (II no! ins! utioo. give street and number)
=,lyIO
RACE. Amdrican tmt..n, 8Mclt, Whir., 4th;
tSpoc,~) White
UNDER 1 DAY
Hour. t..tinutft
c
eo
Cl.\mberland
Ie. Mechanicsburg
...
KIND OF BUSINfSSJINOUSTAY
OECEDENT'S USUAl OCCUPATION
{~~~oIa:.~donedur~(~
Ind"ustnar~nglneer
11 , llb.
DECEDENt'S MAJl1HG ADDRESS (Street, Cityllown. Stale, Zip Codel
104 Orchard Street
Mechanicsburg, Pennsylvania 1705
Engineering
DECEDENT'S
ACTUAL
RESIDENCE
(See Instructions
ooottl6fsidaJ
8WE FILE NUMBER
SOCIAL SECURITY NUMBEl'
.. 176 3U
2001
1..
MARITAl STATUS. Married
~ Mallled, Widoftd,
'~~rre8
SURVIVING SPOUSE
(II wile, g.vemaiden name)
Ellen C. Dillon
17b. Coun
Did
decedent
live In a
Cumberland township? 17d.r3 ~:t.=~=ol
MOTHER'S NAME tF,,~. Middle. Maiden Su<name) Leah Knolton
cilylbOfo
Medar Tambolas
Ellen C, Tambolas
",p
Mechanicsburg
1..
INFORMANrs mtNb^fc'll~fd'mt'll'e'ttill~"i~rc'~burg, Pa. 17055
LOCATION. CitylTown, Slale. Zip coo.
Schaefferstown, Pa. 17088
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on
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on
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21c.
PLAce OF DISPOSITION. Nam. of Cemetery, Crematory
'" ""'"' Pfaca
Conolite Crematory
ld.
OR PERSON ACTING AS SUCH
LICENSE NUMBER
FD-014318-L
22b.
, death occurred al the lime, dale and place staled
(Signature and Me)
DATE PRONOUNCED DEAD ~Moolh, Day, Year)
H ertensive Cardiovascular Disease
QUE 10 (OR AS A CONSEQUENCE OF):
DUE 10 (OR AS A CONSEQUENCE OF):
DUE 10 (OR AS A CONSEQUENCE Of):
d
WERE AUTOPSY FINDINGS
A\lAA.A8lE PflIOR 10
COMPLETION OF CAUSE
OFOEATH?
MANNER Of DEATH
DATE OF INJURY
(Month, Day, Ye,u)
~
D
D
NAME AND ADORESS OF fACILITY
Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, Pa 17055
UCENSE NUMBER one SIGNED
(Month. Day, Veil,)
2:zc.
23b. 23C.
~ CASE REFERRED 10 ME~ EXAtotlNERlCOAONER1
...~ NoD
21.
!::~~~:8fln
i onset and death
i
PART II:
Ottl8rsiQniCicanlconditionsconlribulinglOdeaItl,buI.
not ruulting In In. undet1ring UUH given in PART I
NoD
Accident
Pending Inve6tigation
o
[] 3Oa. 3
[] :~~~~'i"~~;t'1 nome, farm, 8UM!, factory, office
....
Natunll
Homicide
v.. 0 NO~ Yea 0
2". a..
CERTIFIER (Check only one)
"CERTIFYING PHYSICIAN (PhysiclC:ln carlllYIIlQ cau5tl ol dealh when another physician has pronouoced dealtl and completed ltel n 23)
To &he be.t of my know.... dHth occwrad dw 10 _ c~.).nd m.n....... .~ted. . , . . , . . . . .
Could oot be determined
Suicide
21.
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irl
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"POONOUHQHG AND CERTIFYING PHVSJeJAH (PhYSICian both pronouncing death and cerlilying 10 cause 01 ooath)
To &he tMst 0' my knowledge, cItIrath OCC"rrM.' the Unle, pt., and piece. and due to tfM caUM(a. and menlM'r.. aa,,'ed.. .
"MEDICAL EXAMINERlCORONE:R
On the bPI. of examination and/or Inynttg.tlon. In my opinion, d..th occurred at the Ume, date, and place, .nd due to the cau..t.. and
mann.........ed...,.,.............."........""......,............,... ..,.."..,..,..................
31..
AEGlS
[;t ,/I.~-ritl
INJURY At WORK?
""
StGNAl'URE AND T
Coroner
D ,'b.
UCE SE NUMBER DATE StONED (Month. Day, Yea!!
D "c. " . June 18, 2uOl
=2r,~~~~:tf~~:ei(>t~~~~~~ ~~~~oner
6375 Basehore Road, Suite 81
Mechanicsburg, Pa. 17050
~
'4.
LAST WILL AND TESTAMENT
I, Tay Kenneth Tambolas, of the Borough Of Mechanicsburg,
County of Cumberland and Commonwealth of Pennsylvania, being of
sound and disposing mind and understanding and considering the
uncertainty of life, do hereby make, publish and declare this to I
;
be my Last Will and Testament, hereby revoking any will, wills or\
codicils heretofore made by me, in the manner and form following; !
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that is to say:
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First: I order and direct that all my just debts and funera~
~
expenses be fully paid and satisfied as soon as conveniently may
be after my decease.
Sec9nd: All the rest, residue and remainder of my estate,
whether real, personal or mixed, of whatever nature or kind, of
wheresoever situate at the time of my decease, I give, devise and
bequeath unto my wife Ellen Catherine Dillon Tambolas, absolutely
and in fee.
Third: In the event that my wife, Ellen, should predecease
me, or in the event that we shall die simultaneously, or in the
event that she should die within thirty (30) days of the date of
my death, or in the event that she and I are no longer husband
and wife according to the laws of the jurisdiction under which
this Will is first probated, then I give, devise and bequeath the
remainder of my estate to my trustee hereinafter named in trust
for the benefit of my surviving children.
My trustee shall hold the property so given in trust until
all.my children have either received a bachelors degree from an
accredited college or university or, in the alternative, attained\,~
the age of twenty-five (25) years as hereinafter provided for.
After all of my children have either received a bachelors degree
or attained the age of twenty-five (25) years, then the remaining
property so given in trust, whether it be principal or income,
shall be divided a~ong my then living children, absolutely and in
fee, share and share alike. If, at the time of my decease, each
of my surviving children taking under this Will is at least
twenty-five (25) years of age, or in the alternative, in posses-
sion of a bachelors degree from an accredited college or univer-
sity, then I give, devise, and bequeath the remainder of my es-
tate to my surviving children, absolutely, and in fee, share and
. share alik:e.
I. Trust
In conformance ...vi th the Third paragraph herein, my trustee
shall use so much of the income and principal for my children's
reasonable support, comfort and education as the Trustee, in his
discretion, determines to be required for these purposes, with
special emphasis upon education as set forth above. The Trustee
need not use the income and principal equally for each of the
children nor only for those children without a bachelors degree o~
those under the age of twenty-five (25), but may distribute prin-
cipal and income as the needs of each of my children require, re-
gardless of their education or ages, providing at least one of my
children does not have the bachelors degree or is not twenty-five
(25) years of age. As aforementioned, after all of my children
taking under this Will have either received a bachelors degree or
attained the age of twenty-five years, then the remaining propert~
so given in trust whether it be principal or income, shall be
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:Idivided among my then living children, absolutely and in fee,
11 share and share al ike.
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:1 A. Nei ther the principal
II be liable for the debts of any
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lithe same be subject to seizure or attachment by any creditor of
il any beneficiary under any writ or proceeding at law
Jand
II.
Terms and Conditions
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nor the income of this Trust shall I
beneficiary hereunder, nor shall I
no beneficiary hereunder shall have any power to sell, as-
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or in equity, I
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"principal which he is authorized in this instrument
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: sign, encumber, or in any manner to anticipate or dispose of his I
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or her interest in this trust or in the income produced thereby. I
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to use for thEt
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benefit of any person, or may pay it over to them or for their us~,
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to their guardian, or to any person with whom they are residing, I
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The Trustee shall i
;
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B.
The Trustee may either expend directly any income or
without responsibility for their expenditure.
!l withhold any such income
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iltate, without any duty of diversification, any and
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!Ior other property, real or personal, received from
limy Trustee shall not be responsible for any loss by reason of
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!I such retention.
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not so used, and at his discretion add
III:
My Trustee Shall Have the Followinq Powers:
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all securities~
my estate, and I
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To take and to retain as an investment for the trust
B.
To invest and reinvest the trust estate in such stocks,
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II bonds,
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mortgages, securities or other property, real or personal,
rof,
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as he may believe advisable, without being limited to the classes
Of securities or investments in which trustees are authorized by
law to invest trust funds.
c. To sell any and all real estate received hereunder, at
such times, at public or private sale, for such prices and upon
such terms as he shall believe advisable, and to make, execute
and deliver any deed or deeds therefor, conveying title thereto
in fee simple absolute, or for any less estate, freed and dis-
charged of any and all trusts hereunder, and without necessity
on the part of any purchaser or purchasers, to see to the appli-
cation of the purchase money.
D. To sell, exchange, lease, encumber, option or otherwise
dispose of all or any portion of the trust estate in such manner
and upon such terms and conditions as he shall believe adviSable,
and to make, execute and deliver deeds, mortgages, leases, as-
signments and other documents necessary to effect any of these
powers.
E. To make distribution of the trust estate to any person
entitled thereto in kind, in cash, or partly in kind and partly
in caSh, as he shall believe advisable.
F. To register or carry without referring to the trust es-
,tate, any securities, investments or other property, held by him
]hereunder in hi s own name or in the name of a nominee or nominees.,
G. To vote any and all stock held in the trust estate and
;00 participate in any reorganization or merger of companies or
~orporations whose stock is held in the trust estate.
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Fourth: In the eyent that my wife, Ellen, should predecease I
me, and that I further die without leaving a surviving child, I I
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Fifth: In the event that my wife, Ellen, should predecease I
me, and that I further die without leaving any surviving issue, ii'
I then give, devise and bequeath the remainder of my estate to my
!
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devise
and bequeath the remainder of my estate to my
!then give,
!IChildren' s
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issue, absolutely and in fee, share and share alike.
surviving nieces and nephews, absolutely and in fee, share and
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! In the event that both named individuals are unable to
:1 serve, then I request the court to appoint a responsible
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Pittsburgh, Pennsylvania, who shall serve as CO-j
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able to serve, then I hereby nominate, constitute and appoint the I
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truste~. I
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Prancis Tambolas and Joyce Ann Meade Tambolas, his wife, as guar-l
dians of the person of any of my minor children taking under this 1
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,I Will. I
,I In the event that one of the above named guardians is unable,
,\ to serve, then I hereby nominate, cons ti tute and <:lppoin t the othet'
'I named indiv;i,dual to serve as sole guardian.
:1 In the event that both named individuals are unable to servel
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ilthen I request the court to appoint a responsible guardian(s). I
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share alike.
Sixth:
I hereby nominate, constitute and appoint as trus-
tee, under this my Last Will and Testament, my brother Stephen
Francis Tambalas and Joyce Ann Meade Tambolas, his wife, of 633
~mrshall Avenue,
i
I trustees.
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In the event that one of the above named co-trustees is
other named individual to serve as sole trustee.
Seventh:
,
In the event that my wife, Ellen, should pre de-
cease me, then I hereby nominate and appoint my brother Stephen
Eiqhth: I hereby nominate, constitute and appoint my wife,
Ellen, as executrix of this t ffi)" Last Will and Testament.
In the event that Ellen predeceases me or we are no longer
husband and wife according to the laws of the jurisdiction under
which this Will is first probated, I hereby nominate, constitute
and appoint my daughter, Teresa, so long as she is twenty-five
years of age. In the event that Teresa is unable to serve, then
I hereby nominate, constitute and appoint my brother Stephen
Fr~1cis Tambolas as executor of this my Last Will and Testament.
Ninth: I direct that the Trustee, Guardian, Executor and
their alternatives herein named shall not be required to give any
bond or security for the faithful performance of their duties.
IN vUTNESS WHEREOF, I, Tay Kenneth Tambolas, Testator above
named, have hereunto subscribed my name and affixed my seal this
10
day of
jv \~
\
. 19 79 .
~ ' -r::~~
Tay ~neth Tambolas
Signed, Sealed, Published and Declared by Tay Kenneth Tambolas,
Testator above named, as and for his Last Will and Testament, in
the presence of us, who, at his request, in his presence and in
the presence of each other, have hereunto subscribed our names as
\1i tn€lsses.
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aJ-OI-LP5l.P
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
codicil
(each) a subscribi witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s present and saw
i / signed as a witness at the
d (in the presence o'f each other) (in the presence of the
the testat , sign the same an
request of testat_ in h
other subscribing witness(es)).
Register
/i
Sworn to or affirmed and subscribed before
me this day of
19_
/
/
(Name)
(Address)
/'\
REGISTER OF WILLS OF LLlVYl B E::'l<-LJ\1.JD COUNTY
OATH OF NON-SUBSCRIBING WITNESS
Q",~u Namf'T~rV
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
~~ 't. I" ,) familiar with the signature of ~ Y l." ~ 13 ()( A ~ ,
eodieil -
test at '\) "'- of (one of the subscribing witnesses to) the @ presented herewith and
redi€il
that believes the signature on the~is in the handwriting of
to the best of
77\'1
m'-l
~lM4C T/~
~(J vc.~
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&: - - lt3G
(Name)
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Sworn to or affirmed and subscribed before
me this 10 T I\- day of ':..-
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knowledge and belief._
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(Address)
(Name)
(Address)
a 1-01- (g 5l.J;
REGISTER OF WILLS OF COUNT
OATH OF SUBSCRIBING WITNESS
ach) being duly qualified according to
present and saw
codicil
(each) a subscribing witness to the will presented herewith,
law, depose(s) and say(s) that
the testat , sign the same and that
request of testat_ in h
other subscribing witness(es)).
signed as a witness at the
d (in the presence of each other) (in the presence of the
Sworn to or affirmed and subscri
me this
(Name)
(Address)
Register
(Name)
(Address)
REGISTER OF WILLS OF CLlmStRLAND COUNTY
OATH OF NON-SUBSCRIBING WITNESS
P //c- /I _ j 7drn~~S
'Y
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
r AtY'\ familiar with the signature of TA '-J KE::N N E.. Tit- TArn BOLA::)
c~
testat~ of (OB@ af tA~ €YeBerH~iRg witnesses tel the @ presented herewith and
cadieil
that r believe~ the signature on the (fTIDis in the handwriting of
TA \.} l(ENNET1+ ~ fAfY\BC)lA,~
to the best of ~ knowledge and belief. ,. tf; ~ ~4
/oy/l:n."!,:/ &f J1IJd;; ) 70'52:;
(Address)
(Name)
(Address)
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
T A Y KENNETH T AMBOLAS
Date of Death:
June 16,2001
Will No.
Adm. No. 2001-00656
To the Register:
I certify that notice of estate administration required by Rule 5.6(a) of the Orphan's Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on July
1l3,2001.
Name
Ellen Catherine Dillon Tambolas
Address
467 Radcliff Drive
Harrisburg, P A 17109
Notice has now been given to all personal entitled thereto under Rule 5.6(a) except
Date:
(7)0/) 'O'V (
. ,
Signature~.,.. -:>>!. ~
Name Donna M. Mullin
Address 134 Sipe Avenue
Hummelstown, P A 17036
Telephone (717) 533-3280
Capacity:
Personal Representative
x
Counsel for Personal
Representative
j\\II.<..\IIIIIDlRhl..-N((l..-.III\111. I 111011111\ J.S.).(
September 5,2001
Mary C. Lewis, Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013-3387
ESTATE
SECURITY
RE: ESTATE OF TAY KENNETH TAMBOLAS, DECEASED
NO. 2001-00656
Stephanie L. Gaffey
Paralegal
slg@jsdlega1.com
Dear Ms. Lewis:
I am enclosing herewith the Pennsylvania Inheritance Tax return for the above-referenced
decedent, which is in triplicate. I am also enclosing the Inventory which is in duplicate.
Enclosed is a check made payable to the Register of Wills in the amount of $28.00
representing the filing fees owing.
Please file the inheritance tax return and Inventory and return a stamped copy of each to
me in the enclosed, self-addressed, stamped envelope.
Thank you for your attention in this matter.
Sincerely,
~~G~Jv
Stephanie L. Gaffe~ ' (
Paralegal
:slg
Enclosures
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134 SIPE AVENUE
HUMMELSTOWN, PA 17036
MAILING ADDRESS
PO BOX 650
HERSHEY, PA 17033
TOLL FREE 1800.942.3660
TEL 717.533.3280
FAX 717.533.7771
www.jamesestateplan.com
Register of Wills of
CUMBERLAND
County, Pennsylvania
INVENTORY
Estate of Tay K. Tambalas
No. 2001- 00656
Date of Death 06/16/2001
also known as
,Deceased Social Security No. 176 - 30- 6558
Ellen Catherine Tambalas,
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned
no I~eal estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
lnvlmtory. I /We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Name of Donna M. Mullin Esq. Signature:
Attorney:
E
I.D. No.: 30392 Signature:
Address: 134 Sipe Avenue Address: 104 Orchard Street
Hummelstown, PA 17036 Mechanicsburg, PA 17055
Telephone: 717/533-3280 Telephone: 717/697-5348
Dated: ((-(- pO 01
Description
Value
(See continuation page(s) attached)
(Attach additional sheets if necessary)
Total:
2,778.46
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the Pennsylvania Bar Association
Copyri9lht (c) 1996 form software only CPSystems, Inc.
Form ##RW-7 (1992)
INVENTORY
Estate of:
Date of Death:
County:
Tay K. Tambalas
06/16/2001
Cumberland
STOCKS/LISTED:
34.00 shares TRW Inc - traded on the
NYSE, common
1,405.56
33.21 shares TRW Inc - Dividend
Reinvestment Shares
1 ,372 . 90
2 , 77 8 . 46
TOTAL RECEIPTS OF PRINCIPAL...............
2,778.46
-1-
REV-1S00 EX + (6-00)
CAPB
HpRL
EplO
CRAC
KOTK
ES
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
o
E
C
E
o
E
N
T
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG,PA 17128-0601
DECEDENT'S NAME(lAST, FIRST, AND MIDDLE !NITIAl)
Tambalas Ta
DATE OF DEATH (MM-DD-YEAR)
FILE NUMBER
/
-.
,
-)/\.
C
OFFICIAL USE ONLY
21-01-0656
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
176-30-6558
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
COMPLETE MAlUNG ADDRESS
NUMBER
REGISTER OF WILLS
S CIAl ECURITY NUMBER
o
o
None
2,778.46
None
None
126,366.72
None
87,954.40
2,350.49
15,292.12
x
X
X
X
.0 0
.045
.12
.15
DATE OF BIRTH(MM-DD-YEAR)
Tambalas, Ellen
X 1. Original Return
4. Limited Estate
Catherine
2.
40.
7.
Supplemental Return
Future Interest Compromise (date of death after 12-12-82)
Decedent MaIntained a LIving Trust
(Attach copy of Trust)
Spousal Poverty Credit
(date of death between 12-31-91 and 1-1.95)
3 date of death
. Remainder Return prior to 12.13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
11. Election to tax under Sec. 91 13(A)
(Attach Sch 0)
C P
o 0
R N
R D
E E
S N
T
C
o
M
P
T U
A T
X A
T
I
o
N
X 6. Decedent DIed Testate
(Attach copy of Will)
D 9. Litigation Proceeds Received
010.
NAME
Donna M. Mullin Es .
FIRM NAME (If Applicable)
JAMES, SMITH, DURKIN & CONNELLY, LLP
TELEPHONE NUMBER
134 Sipe Avenu.e
Humme1stown, PA 17036
33 - 280
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
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)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Ex nistrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 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)
Copyright (c) 2000 form software only The Lackner Group, Inc.
(1)
(Z)
(3)
R
E
C
A
P
I
T
U
L
A
T
I
o
N
(4)
(5)
OFFICIAL USE ONLY
(a) 217,099.58
(11) 17.642.61
(12) 199,456.97
(13)
(14) 199,456.97
(15)
(16)
(17)
(1a)
(19)
(6)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of LIne 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.
199,456.97
0.00
Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
104 Orchard Street
CITY I STATE I ZIP
Mechanicsburg FA 17055
Tax Payments and Credits:
1. Tax Due (Page I Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
Total Credits ( A + 8 + C) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Totallnterest/Penaity ( D + E) (3)
4. If Une 2 is greater than Line 1 + Une 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
S. If Une 1 + Une 3 is greater than Une 2, enter the difference. This is the TAX DUE. (S)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line S + SA. This is the BALANCE DUE. (5B)
Make Check Payable 10: REGISTER OF WillS, AGENT
""~::::~'~:::::.".".,_,.".,.".""_,.""_:,,,,,.."".,_".",.""..,.".",.""_"",..".",,:,,.,....,.":,:,,.,.,:.,:,.:,:,;.,:,:,;::';;:;;,!I!!:;::::::::'::::,;.::::!!::!!!!!!i!!!!!!!!I!!i!!!!ii!!iii:.,::::,:::
~:::::::::!:::::::!!!!!:!!!!!!!!!!!!!!!!i!!!!ii!ii!!!!!!!!~;:::i::::::::::::':':"::,."".,:,::,:,:::::::;:;;:;::;::::::::::::::::::!i!!!i
PLEASE ANSWER THE FollOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
8. retain the use or income of the property transferred; ~ ~Xi
b. retain the right to designate who shall use the property transferred or its income; .
c. retain a reversionary interest; or.
d. receive the promise for life of either payments, benefits or care?
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death?
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation?
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN.
o
o
o
rn
rn
rn
Under penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of my knowledge and belle1, It Is true,
correct and complete. Declaratron of preparer other than the personal representative Is based on all Information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FlU f1fETURN Ellen Cather ine Tambalas DATE
1 !r. -~~~h~~l~~~~/;'~11:-ii655--------h------h-- 9-1-0/
EPARER OTHER THAN REPRESENTATIVE JAMES, SMITH, DURKIN & CONNELLY, LLF DATE
~ S Avenue ______________h__h___,?- -"'_ 0)
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. 9116 (a) (1.1) (;l].
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) (ii)), The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and firing a tax return are still applicable even if the survlving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 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% [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.
Copyright (c) 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
REV~ 1503 EX t (1-97)
COMMONWEALTH of PENNSYLVANIA
INHERITANCETIV< RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Tay K. Tambalas
SSff 176-30-6558
06/16/2001
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
FILE NUMBER
21-01-0656
ITEM DESCRIPTION VALUE AT DATE
NUMBER UNIT VALUE
OF DEATH
1 34 shares TRW lnc, CUSIP #872649108 - traded an the 41. 34 1,405.56
NYSE, common
2 33.21 shares TRW Inc, CUSIP #872649108 - Dividend 41. 34 1 , 372 . 90
Reinvestment Shares
TOTAL (Also enter on line 2, Recapitulation) 2,778.46
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc,
Form REV-1503 EX (Rev. 1-97)
REV -1508 EX t (1 -97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Tay K. Tambalas SS# 176-30-6558 06/16/2001 21-01-0656
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
Putnam Investments - TRW Employee Stock Ownership and Savings
Plan
VALUE AT DATE
OF DEATH
126,366.72
TOTAL (Also enter on line 5, Recapitulation) $ 126,366.72
(If more space is needed, insert additional sheets of the same size)
copyright (c) 1996 form software only CPSystems, Inc. Form REV-15G8 EX (Rev. 1-97)
REV-1S1CEX +(1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Tay K. Tambalas
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
SSll 176-30-655B
06/16/2001
FILE NUMBER
21-01-0656
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2. is yes.
DESCRIPTION OF PROPERTY % OF
ITEM INC~UOE THE NAME OF THE TRANSFEREE THEIR DATE OF DEATH DECD.S EXCLUSION TAXABLE VALUE
RELATIO SHIPTO DECEDENT AND THE DATE ot TRANSFER.
NUMBER ATTACH ACOPYOFTHE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE)
1 Dayton Walther Pension Plan 9,438.58 9,43B.58
- Beneficiary is spouse,
Ellen D. Tambalas
2 JPE, Inc. 401 (k) Savings 78,515.82 78,515.82
Plan - Beneficiary is
spouse
TOTAL (Also enter on line 7, Recapitulation) $ 87,954.40
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
Form REV-1510 EX (Rev. 1-97)
REV-1511 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Tay K. Tambalas
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
B.
5511 176-30-6558
FILE NUMBER
21-01-0656
06/16/2001
DESCRIPTION
AMOUNT
FUNERAL EXPENSES'
1.
ADMINISTRATIVE COSTS,
Personal Representative's Commissions
Name of Personal Representatlve(s)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City
State
Zip
Year(s) Commission Paid:
2.
3.
Attorney's Fees JAMES, SMITH, DURKIN & CONNELLY, LLP
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State ZIp
Relationship of Claimant to Decedent
2,000.00
4.
Register of Wills
51. 00
Probate Fees
S. Accountant's Fees
6. Tax Return Preparer's Fees
7.
1
Other Administrative Costs
Cumberland Law Journal ~ estate notice
75.00
2
Paralegal expense to travel to Cumberland County to meet client
and probate Will
25.25
3
Reserve for additional administration expenses
100.00
4
The Patriot News - estate ad
99.24
TOTAL (Also enter on line 9, Recapitulation) $ 2,350.49
(If more space is needed, insert additional sheets of the same si2e)
copyright(c) 1996 form software onty CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
Estate of: Tay K. Tambolas
Soc Sec #: 176-30-6558
Date of Death: 06/16/2001
Item
#
Description
Continuation of Schedule H-B2
(Attorney's Fees)
Amount
1
James, Smith, Durkin & Connelly, LLP - attorney fees
2,000.00
2,000.00
Estate of: Tay K. Tambalas
Sac Sec #: 176-30-6558
Date of Death: 06/16/2001
Item
#
Description
Continuation of Schedule H-B4
(Probate Fees)
Amount
1
Register of Wills - probate fee
51.00
51.00
REV-1512. EX.., {1-97)
COMMONWEALTH OF PENNSYLVANIA
\NHERITANCETJ>Y.. RETURN
RESIDENT DECEDENT
ESTATE OF
Tay K. Tambalas
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
SSff 176-30-6558
06/16/2001
FILE NUMBER
21-01-0656
Include un reimbursed medical expenses.
ITEM
NUMBER
1
DESCRIPTION
Outstanding loan against Putnam Investments, JPE, Inc.
401 (K) Savings Plan in decedent's name alone
AMOUNT
15,292.12
TOTAL (Also enter on line 10, Recapitulation) $ 15,292.12
(If more space is needed, insert additional sheets of the same size)
Copyright(c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97)
REV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Tay K. Tambolas
55{1 176-30-6558
06/16/2001
FILE NUMBER
21-01-0656
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
1
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [Include outright spousal dIstributions, and
transfers under Sec. 9116(a)(1.2)]
Ellen D. Tambolas
467 Radcliff Drive
Harrisburg, PA 17109
Spouse 100% of
residue
NUMBER
I.
ENTER DOLLAR AMTS. FOR OISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON- TAXABLE DISTRIBUTIONS,
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lackner Group, Inc,
Form REV-1513 EX (Rev. 9-00)
b.::@:'" VI.LL J\'jJ~~
..,
'l,'n:,'
~~_e):m'3tL '1'2.mbal2.s, 0:': tile fl.orOtl'Jh OF Ilech2nicsbt1_r9,
CO'..lnL\" o:=~ Cumh8J:-l<.!xt~-' ,.,:",~1 ::::(")T;-~,',,()n_1:JoC~d.1t,L. t::f PennsyJ."=lan5.a, }'Y?::1..nq of
SalEH:;! uncI ,~2:L:spo.sinq mind D.nd lEl<:1erst_iJ.n'Jin~? anrJ. eons:L'jel':'ilY" t,he
uncertaint.y o:~: lL;:':.:~, ~lo
Jni;tJ::C, lJt.:bllsh nnc2 (l<~(:l~,n:'f: th_~\1l "1'.0
be m:,/ T,ast 1:l:Ll]. anet "r'~,~D-tarae:n.:,: l h0.l:"{::~by re-v'olctn9 a!T}! t-.;ill. ~ vI:U.ls or
coclicLi."J bt;;r(,,-tD:!~'Or(~' ;.lar3>2 b::,-' rJC'? in t:he maJlrlel~ <:tnd t'O.!:"'),":1 f'ollot';'ing;
tJlt:,!t J",~~ to Si:c.\':
:;'::'1'5": ~
: o:cdr~!:' <:lnd (1"il~CC-t_ thnt all rTf"; :just debt.s and
CT.:pr.,'llses be
and :.;nt:1.sf:~i..ed as soon. us cOEven:1.cnt:L~/ .\110\'
be 02:' tel:' m:{ deC'eu;~1e ~
,:hcond:
--
..'\Ll the: r.e,s-t, re,s;LcluE;: ulH; .r.-el:12.in(i.(:3:.!::' of Et} (~stat.e,
~;!hether reQ.~~, pex:'[;~)n2.1 0.1,:' :l1:i.;~e':..~, 0,: 1:J;1a'tev-e,1::" natu:r-e o.!~ j.~~Lnd, 0:1:
h']VZ,17C3!':')CVCJ.7 s:1..tua.tG lit; tI-l,~ t1;',I(.' of my' deC::E:cJ.f:ie, :c ~J.i."V(~, oJc:\.ri~)e and
!)c:qlJ~~a'.:h tm-t.o m:'{ \"r.:L::e ,GllE,;l Cati'lerinf" Dillon 'I'e.m:bolas, absoJ.uteJ."{
an.d ).1"1 fe8~
'1'ld1.~IJ ~
:J:~.'1 'l:h(" E,7"~:!nt thQ'::' h'..Y 'id.fc ~ lDl)"en, 31101.:1';'_ predeCE:'ase
\fi9, Ol~' :1.n tl1'?:- ovent i:hat we sh(-:lll 'J.:l~~ ,simultaneously, 0[' it!, t.1-1e_
c.~yent that ~:;he should (U..e i.-Jithirl -l:hir-L:y (JO) da:,r.s of the r.lale 0:1::
mv death 9 O.!:' in the:: (,vent that t)hc ~Ul(1 I iJ!'e !1-0 longeJ".' I1LH-:;band
o.nc1 \",ri:C("~ accordinq .to the-:> lat>J~i 0,': t.hE' jurist1iction unde.t~ ~...liicll
.t.h:'L:c', l'!~L1J is f':Lrsl: P.!::'Oho.t:f:~(l" Ule!"2
giVG 1 cl.l:;'!~,ri8e nncI bequo~t:h t~lO
reme.inder 0::: my estate t.o IllY trust-2I~~ h<:"r(::i.na:f"cer named in, t,}::,ust
for the beneXi t D:,'
sur'l~.v:Lnc; chiJ..d.t'(,,!t~
i'1"' t.t'ust~.ee she.ll hel':! C.l1f:! p.,-~opert:y so qi"\!CE 1.i), b:UBt un.lcil
21.1 nv ch:U_d.r.en l'li:;p,":~ e:Ll.:1J8T 1:"2C1:":1.7E:'d a bactJelo!:,E', Cl(~q.1:ee 2ro\i1 Ct~"J
c:1CC.:.l:E~(li i:e~ collfJqe OJ.--: "Jl:L'" v,~r.'::n t-." :,,:',1,'(.' :U; 1:hc.~ 0..1 ter~'la t~b~e, atbl:L-lf>('
tl-1E-; r7.::y" e~_: '1;\'I]",'n't:t--::},-:re {;:~1.J) 'r0.':cL!:.~,s uS JH::'re.:!.n2:fte.J::' 1Jl~'oY:Ld~'!tJ. :,,:'el:'4
l,fJc.r:)):' oj,} (yC,' D:J ch:_lr11:'en )-10).',"'2- E~:llbe.~:' J:'r:::l'~,.,!:i."V(~:} iJ. ba(~helo!;,.'C~ c}(:CJ_'::'ee
02::' i':.'.t:t'.n.ined ~~:h_~'! O.f~H::; fy0 t,lo]el~t.,:"-:rj'-;JC' (25) iea.l..~S 1 i:hen 'I;ht':'! rem~dn:Lnq'
p!.'operi:~." SO qiven :1.n t.1:"ust, ~"he'the!:' :1J:: b(,Ol principcd o.1:'J,.rlcome ~
':;~'12lJ l,"! '1';",rij,e:i ~~.,,:l>;'.lq my l.:hE'~!:1 1:1.vin(,J childrra:n, absol1.1'b:'!.1.:.i:' QIH:1 "1,
:', ~ , :'".'..
2_'
.> ,;)~'e cl)<lJ:c..
T:::', e t t,he timf.':' of m~ decea.sf~ ~ eac.h
of my m__U:'YJ..
c::b:ildren taJ:inq under this ('J:U.} :U., at least
-l:;t'l/"<2!1"C....-f":L'\t2 (2:)) '.'l'CcU:~c of: Wire, OJ::' in th"" .::Jterpa1::1.v'21 :Ln PODS8S-
slot!. of o. bechelors d29ref1'~o;:' W'" nc~;re"_1j. t,_",! r~('Jllf"'qe 0.'1:' un5.ve.l::'-
sitYr then :r 9ive, de~,,'J..se, an':l bequeath t.he remaincler of !:1.y Em-
'i:e.-r.e to my fHU:'v:.i., :l.ng chil'..iren, ab::H)ll1tel~/ ~ 2.nd i_n r:E?c:, ~lli)t'e and
s)-:.nx".~, 2,J .'L
1'l:~
In (~c\'.:Cr:l.1:m~'.n:.
.~ J.'
tih'." 1':'':;'.1'<.,1 j:JdJ:"dql:'aph JJere.Lr\, JTl\T ;:.~:'lH_;'L~pe
f5l1al.l.. llse SO :'~1.Udl 0::: the income 2.nd principal :frJl:" nv chi.l 1.;,~"~rl'~;
rca;;;on,Gt?:Jl~:: "in} ';',"0.'::-.':;'; \.,,,,;;, ~--,)l:':~ ;;:m,J (";(1:.1,'_:[-1. t:i.r.Jn f_'D tl ~':" ',1::'.'1 U.;;t;:0(."-~ ~ his
di:'.~('.:]::,::'LLoI\.l '...:l'c-L.(;::.'D.]_n.e~,i.:o ,)~: ~_~(~qui.!..~ed ~fOL these l~!~l!'pose.s, h1j, L.h
spE-,ci,a:~, erilDh,=!..3J.3 up'-:nl c:::i'L,CaL1.0il as sE~-L 1:'orth above..
'J.'hr~ 'l'rus'i::eo
rJ,(::ed not use the .I,Beam,,'; and p.~:::-:Lncici:'~l oqua:'U.y for ea:::,h o~f -I::he
chi.1Jrel1 no.'c anIj fo_:c those childr-en "dthout ,:). I)ac1)clors deq~::~"'!r:l CH:'
those tmder t:.i'Je aqe of [:vJ('mt:.y-:1:-:Lv'c (;2.C:), b1.It 1~18.y cUstr:Lbute px'in-
cipaI and :Lnco1ilc a~l th.e DA:!ods of each of mV chil(h.'(:lrl l_E.;qlUJ':'(",; .!:'F'-
ga.'-;-c?h~;3S O~':' 'thei;:, edllccd::Lon 01::' age,;:::, pro1ri.d:Lng G.t L?2.5l: on,E, or m;,~
children doer:.: not ha',.re 1.:h-r:.~ bachc;lors de9ree OJ: .is not: twenty...fi_v-e
(25) yenrs of age.
As aforer:lent:Lo!'lec1, after.' all of nlY (:~hiJ.(t~~~en
t.akinq uxtde.t' t:.h:Ls ~:JiLL ha:v-e either.' J::-eceiv~,6 8 bachelor's degn,~c:~ or
a.tta::.ned the c1qcc Q;C: b'J8Yl."t:y-f'iv(~ ye.a.rr,;, t.l1(:":!'. the .l-:,emaininSJ property
so :JlilC:B :Ln trus-l", l,fJhc~"t:he.Y.' it be p,1:'1nc:Lp21.1 or :tnccme, ~,;h<dl ~'~e
-;2-
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Ae l.jei {:l!e,t" t:h.e prJ.!:,cJ.r}al )1O!.~ the :i.n::;omJ.:~ of t:hi::! 'J.',1::'1JSt: srw..l1
ibe Ltal)lc' ~:'o.t' '[:;1'::8 ":~e})-J:::8 of' a1'!:"l l.)en~:.=;F:lciars' hereunde'!:, nOl::' sl"la1J.
the Game Ix; sub:)(,;;ct to sei..zu.!..~s O.1.~ o.t:t:achmer1t by any (':recUtor QF
any })erl~.:C!:~:1c__;,u.r.Jt Un.dFJ.t~ o..lJJ VJJ:':~_L 01.- proceecu.nq ai: lal'J or in cquii:::.t,
a.nd no lY;~n0:::j.eii'\y.:~." ~l,p,eeu~lde;:' shalJ have a.':1Y POl'fe.': to s9111 i::.~.s-
s,:Lgn,2:nc'J.::nbe:c~ or :1..0 any manner to antic:il'Jate or d.ispos(:~ 0 his
Q!.' hor: int~~r.est. :L~:'. 'i::,~,-<Lr, b:-ust, or :1.n t..he income pj.:'odu:~ed t11erel)/ ~
B.. Th.e '.L'ru,:::.t:ee rJ.2\J' r~ithQr m~Dend di.!:'eet1.v alT'.! in{.:o,!!e 0)::'
prin<:: .:l,p;'"':;.1 t)l:::l".'_~h h0. :L~; ,::l.l.1.thox':Lz,ed in 'l:his :Lnstrument to us('~ "fo.;::- .th(1
'ii bor~'2~5, +:. 0:::' c,ny );181::'S01"1, 0-'..:' Fla~l pe,:,' :L'c o,]"e~'" 't:o them 0.1:' 20r their U!;H~,
,
to ~::hC!i..r ~:,~)_;::..,::,dian 'I 01.:' to Hny p0.J:I",Ol:. Ir,d, th it/hom .th(~y a!7C r'e~::;icEnq,
Wi.1.:.1101.1'1; reS{lons:tblJt t::." :':"OJ~' tl!(~:1.l:~ E'!:::tP(.;j!1{"Ji tUJ:'C ~
'NH:} T.r'L:st(~e shaLl
lJ2. tl)l~old ;lTI>c c,ucl'J 2.:,lcom02 not. 80 used ~ and \?t 1':~:L.'S dir,c!."~~t..iQ.\::r. add
it to 'tho ::,~ p:,::,:;.!"~c,:L)~)a:i...
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A.. TCi .[:i":l.]~:'2- an-::: to .'::'et.:n.tl:' as a.n invest.:ment.f:Q.l.,:, tlw tr.ust, es-
,.. , . t., I 1 ~ 0' l' . , J..' ) !, - -. ,., t: ~ -!!
(':'i:;l ,.:e, Cl'J..':lOU',' P.1")\-" ccu ,,:'Y o:c r.J.verS2.7.::l.ca t;1..0n, a.n:i ant. a:":. ~e'.",tL.J. .:.L'c~::'; ~
O!~ other !,,':I.!::'ope.?::"t.:~{~ J:,ea} O.L~ personal, rec:(~ived fl_~()m my '2-state, 8.:;-1(1';
my 'l'r:usb?:,E' ,s),iul1 rlOt~ br.,> respolisibl'"" fo!..~ any loss by reasor: o:i:
r,u':.:h 1'~r.'~tent.ion_
.'''j" 'Eo invest lJT.l.c1. ~:e.in'\re!3t t:i')I~: t.!.~us'l':: C!Si:i'),t.e .~~.t, ,?11..:(~h .c..~tocI::::;.,
bo~')!"hJ ~ !!\O~:::,i,::90.(,7r~~~'3, .sec'Jl,,:,~L!:,:Les or other prnI)er'i:y ~ :real or r.lc!l:'sonal,
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as he T'ia:' ;:)~~J.j,(~';e C1,::~,~:L;::<JJ)J c'~: h'.LtllfJ?-"l~ })0'.:C !Y' Ji.;Cl:1. te'"_: to thE:.~ classeD
0:';" B~cur:L~~.ie~.~ o.t~ .,-~T ':~.:.~tm(~;J{:S J.rl t,;L::..c' t.'c~unh~~es a,',:-e 2.uthor.ize':J. by
J.avJ t:o ::Lr:.~,-"~"'!;:"~: -'c.,~:'-'-;:;l.: ":y-~~~
C.. '1'0 ~,;~~ll any a.nt' nl1 real (o'l S tab::, J~.'ece~:'."ed 1t~:;!'E~\.n,,(jQ~', t,:d~_
.guch tines, f-:d~, p,ublic 01." prl',,!'at.e SE1.I.C; ['-03:' GU:::i7 rl2:'iceG a1<I,:l l-1!]or~
Su::!il i:o]:,mi? as he shall J)c:llev".~ ad'"cisabJ.(?~ an'..: 1:0 !:l,d:.:e, CXfc-'CEt.E;'!
and c1(~J.:Lve.i:' any (teed 0::' deeds 'l::l1en::f:o,t~ 1 cOl'Jve:,d.Ilq ti tIE,; th("~rfd;o
in feE' .simp10 absolute, or :for a.mi Jc;,ss e8t,a'(~e-, :Fr(~e':2 ,;,lnd di~1-
chargoe;, of any and <:1.1::0 trusts hG1.'eunde.t":' 1 ='l.w::,: wi t:!:lO'~;.+: neccssi tv
:on -1:.11.'2 p:ari: o:C: any j?l.\.1,:,chn.ser OJ_~ pUI:'chu.ser.s ~ to Bee -cr.1 the clPPJ.:,_-
cation of 1:118 p1.u:,cha,se money ~
D..
To I.;;E!ll ~
, lease, 0IF,:::uL?ber, o;.)t:l.on or othe.t'viise
disposC':' of all Dr. any pOl':tion of" ~::he t.l,:,usl: es-t:ate 5.n sw;h rnann€.-~r
:ancl. upor~ suc:}, t~e.r.ms and GODcEtioIlE; ,2,13 he ,'eihall believe ad'l,risabl;:'~t
'G.,-'lCi to I,,-al:e 1 execEt:e en(\ "lel:1vel;' rJeedf.~, m01..~t';.ra ]'2S, 10.ase.s r as-
'sign11len'1:s and othe.': dOc::tHlIEm-[:.s W~(;e8sary to ef:foct any of these
l--)(",JDl':'S..
;;,~ lJ!o make disb:-:U)tttion ()f t,h-\? trust es'tute1:o dn~/ r)(~.t"s()n
8111:1 tIed there.to i.n lU..nc1, in cash, Ol~ pC'.rtJ..y in l~:Ln(( and part,ly
<in cash, as h,e .shall be'lieyp aClvisable..
f". To register or C'cl.1.:."ry Nithout x'(-~:feJ:',~l-nq to th(-o' t~lJr:lt es~'
:tEL'te~ any se(",'uri.~.::LeE.;~ ~,.J,'l''i!"estrrmn.ts or other p.t:'ol'1el:,t::/~ hel,3 b.'/ h.:i.IT'.
:hereun,c1er. in hi,s 01l;'T1 name O.L~ J_D ~d1,e name, o:~~ a nomip.ee O!,;' nomInees.
G. 'I'o vote arl':'/ al1d all st.od: h,:,ld in the t.l.~ll.st f~.'Jt:8.'L,,~ o.u-d
,:t;o p::t.t:'ticipate :Ln any ~::-eorgani:zab.on 01.': nv-?rger' oJ~ (.:omrJ8J."L1J'!F.\ or
corporations \"lhose s-tocl:" is hc:Jd in the t,t:,ust':";stat:r::.
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f.!nd thE! t
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stU;".ci"lTinc{ n:L~3ce~~ aDO nel:;heMS
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shaJ::'e al:l"':,:::"
ili~:
I hr;::r:el)~,- non'1.in\}..-t.E\;. c.-:::mst.;!,.tut.~ i;~'nc"i. u})pD:J.nt. as .trus-
tee, l.md.er this :ny 1 !:l[~t. ~~r5.,JJ.. and TestaIlJent, my brat.he):" ;:;t'.~:::pl1en
T~~1T!bol~u, nnJ. ,.To, 'CC! 1'l.1:.1"l ne~g3,0 ~;.\n.':T~:bo:!.i'lG J his V5.',:':0, 0;: C3~,
'il"~cl.l:-Glw.ll A.ve~.~1.-le ~ LL t;'(;:3)]<).1:":;)1 ~ E"ennr';IJ.vnni 1::1. ~ '.'JhC 5lwl:L SC;2'~V,,:? 2.S r:o-
1:.;T.'ur::;i:{c:es"
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c.tble to E"€-',::--J"e. t;.len I J1erc~1)":.r !VJm:Lnate, '~onsti tut(~ ClJ.1d c~pp')int the
ot'.her nC:~J.ned ind:i.v~1.d'_lc:-tl t.o ;:";e.l:'ve ;:~.E, solG trustee..
11', 'U1(.o e.-,.; (,n'l: ';} ~:~\:~ l,:c '\::.\\ i';";},1\'te~,~ llL'..I:i:' i.('}u;~I :'; c\..'::'~" :":,;.:~'.bJ.. '::= ~CC'
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~:':cur,;1:,r.' ',;:~
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In .t~hc C:'Iel~1':; tl',10:t: my j;.:i f.' e ~ Bl.l.en i' shoulr] nr-ede-
cease l'ile ~ t.:jH~n
}:0.':'C:::3)",' llDI,,-3.nac:c' and ~~ppoir~,I. I~l'./ !~:orothe.1:' 3~>8ph:;:~n
i ~:',t'a.nc).s 'J:i~mt,'olas G,n:1 ,TO: 'C'" J'tnL' (,j2B.;5(~ 'I'a:r.l}10}as r h~~.G \/'15 :~'e 3 as ~TJ.c:1..::'-
J:l.(-~.i.113 0:[ i:-:.!le P2..!:'SI"JU 02 Qfry 0
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-l:o r;v~!:,v(.~., F~E:;:.1 I l!~"-~::'Bl'"
;:l'~)nLnat:0., c:.oDt,'l'.:l.t.,yt,r;;, ~;mL1 :::ppo;'..:'.1l'. tht:; ai:hef,'
i.lamed :i.nrl:i..v:L. Ju;:.d_ b:.J s(~r'v'ro, ,;r,c; SOJ.2 qUiJ"r.-d:i_;:m..
II': tll(~ r.:':~lcnt '::liL"(' ':::')i:;h l~(1med individuals are unable 'co S~J~V"~*
then T ,--:-',:,ql.'.es"t: [-.he, 'cO',E-:-'l.: b';1 ::q:)po:Ln.t a responsibJ.(~) ~!uc.rdial)( s) ~
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Eiohth:
:c ll(::!.1:'r~h,,:" 1:,O!-i!:U'l2::':'_~ cO.l:"Jr;'::::i.b~-l:.~,; e-~n(} appoint, my tlJ.~.'e,
::'::L1 E::H ~ i,:.,~~; p:;~:r,'cv-',~1.:
(::' 1:.] ~ ::;,_ f; "
',33~- ',.; -j' ;:In(l, '.2'2S-te..Fl0n+'_~
:1 ';~,'n:' p~:o-"c' '!',i-~.~" EJ.J~-~'.' "':c",:',:lcc'2as,-::-;s l(I~.:~ {)~:' :'..'12 il~-::'C no lonqE;'j,:'
hUS'-Y;1Z"
2'_'1 _, k,~,:U 0; fie ~:nr ",j,~, :'\',j \,;..:-, -tlH,~ 10.1,1"0" ofl:,!_lc jur2.sdic'\:ion under
wJ'dcI'l t::h5.n i}~1.~_
is 11"S~ r'~ohated,
l1erd-:'~: llOD.l~;.il8,tB, cons.titu-b:;:;
Gnd appoin_t ?i't:'i da)..l~\l1ter, 'l'el~e~:a? ,gO Jonq e.~ .91'H.~ is t,'i,'Jenty-:C:'i"JCl
\,'(:'!ars 0:[' QC(r;"
1'::':', the (Y;i'(~~-d', ~Jlat 'r(,:0,SD. :~G 'L\!.IabJ.c~ to S'.::,C'ire~ 'L:.hen
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t\ra,2,,--::Ls '.I:'n_':lL')o~::~8 ;28 m:eGU~::o.!:' coJ 'chis my I.,ag-~- WiLL cHlC;, 'J:'est1=.lln(:!!lL.
li.i.ntll ~
_ "Jil1'(,?Ct: ';;hat the: l'r1..LSteE:t Gut:u-.'diaH, E;":ecutor and
t.hei!,:, al;te,::,:,---,~\.:.i~,,::c:'J 1-),;"21"c:it:, namGci 511,:111 no~;; 1)0 requir'.'H.I "b;) qi~,.f(-;! en:';.-'
])CE'"H} 02:'
:.i:'Cl.l':" '''11(', X:Q,J,;t.h.ftll peY:'fo!.~mance of t:J.le~:.j,:' duties.
]:1,] ",;:C'_':I'JESS ~'mE:r:'EO:F', It 'l'ay I\0-x1tle-l::11 T'ambolo:;.s, r;>:~~lt<::1.t.OJ::' above
nc,mc-,i5, ;')1;.1'
1_1e;,:'e1.:~d;c-' ~'~~.11J:';cr:i.1;!e(! n;' :l:.l!rl€":) ~:"'O'l';), a~'::::::l.:;'c~~d fir/' ser~l tl1;iE;
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Sj_qX1l:::,d~ Deal(~d, I:>utL_siJed un..;,) ;:-;'ecJm:ed %J,I' '~:::a:'.' l~e.l.mc.-l,;]l ':'ilin1':c1.ns,/
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tha I:.:c'esence 0:'" til::;~ h;l:1(J~ 8'[:: lds rc~qu8.S'.t;- in his presence L"J.nd in
the r)res(:~nc(: of ee.cl.-, () t~1'.."~~:", 1:12>VO hC~1:;,eU1<to mJ1J;3::,:J:,:1.1:,i:";'::: 0'1...1.1.:- ::>,E'!'rr,.::s e.!~
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More Info: Qt10ltll rhart I News I Profile I gesearcl1l ~EC I Msgs I Insider
Historical Quotes
NYSE:TRW
Month Day Year
StartDate:IJun _115101 .
End Date: IJun II 115 .101 .
@ Daily
r Weekly
r Monthly
r Dividends
Ticker Symbol: Itrl'J.
Date Open High Low Close Volume Adj. Close*
15-Jun-Ol 40.45 41.37 40.31 40.90 740,600 40.90
Do",nlolld Spreadsheet Format
· adjusted for dividends and splits, pleaseseefAQ.
Questions or Comments?
Copyright@2001 Yahoollnc. All rights reserVed. Privacy p~ - Term~ of Service
Historical chart data and daily updates provided by C91'fl.rD-QJmY..$Y.$.JemJ'.L11l.G_.__-'C,$J)'
Data and information is provided for informational purposes only, and is not intended for trading purposes. Neither Yahoo nor any of its data or
content providers (such as CSI) shall be liable for any errors or delays in the content, or for any actions taken in reliance thereon.
http://chart.yahoo.com/t?a=06&b=15&c=01&d=06&e=15&f=0 1 &g=d&s=trw&y=O&z=
6/26/01
Historical Quotes
Page I of I
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FinancElJ:lome - Yahoo! - Hel[l
More Info: Quote I Chart I News Il'rofile I Research I SEC I Msgs I Insider
Historical Quotes
NYSE:TRW
Month Day Year
Start Date: IJun _118 .101 .
End Date: IJun _118 .101 .
@ Daily
C Weekly
C Monthly
C Dividends
Ticker Symbol: ltry;
Date Open High Low Close Volume Adj. Close*
18-Jun-0 1 41.20 42.55 41.10 41.64 332,500 41.64
Download Spreadsheet Format
* adjusted for dividends and splits, pleliseseeFAQ.
Questions or Comments?
Copyright@2001 Yahoo! Inc-:PJI rightsresel1ied. erfvacv p~ . Terms of Service
Historical chart data and daily updates provided by G9J[lf!l.QgjtY.$Y$.tE!!rIl_SL1nl;:,JG.$J}.
Data and information is provided for infonnational purposes only, and is nat intended for trading purposes. Neither Yahoo nor any of its data or
content providers (such as CSt) shall be liable for any errors or delays in the content, or for any actions taken in reliance thereon.
http://chart.yahoo.com/t?a=06&b=18&c=01&d=06&e=18&i='0 1 &g=d&s=trw&y=O&z=trw
6/26/01
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Putnam Defined (;ontributioD. PllUIS
PO eo> 9740
Prow)",,,. R1wd, [.Iand 02940.9740
c
PUT NAM INVESTMENTS
August 9, 2001
Ellen D. Tambolas
467 Radcliff Dr
Harrisburg, PA 17109
Dear Mrs. Tambolas:
,
Please be advised that the balance in MI. Tambolas' accouilt as of June 17,2001 was
S 126,366.72.
Please call the Participant Service Center at (800) 859-4567 with any questions regarding
this matter.
Sincereh"
Putnam Investments Plan Administration
o
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Number of pages including cover sheet: ~
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OVERNIGHT MAIL: PUTNAMINVE5Thi1ENTS
(Your Plan Name)
1'.0 &ox 9740
Providence. RI 02940-9740
(Your PI.n N.mo)
InvllStors Way
Norwood, IJA 02062-9'05
PUT NAM INVESTMENTS
CD
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PUTNAM INVESTMENTS
7 Shattuck Road
Andover. MA 01 B 10
Egx Coversheer
Number of Pages Including Cover Sheet: ,;::L
Date: ~Ja3JOl
To: ;)kphflv-.;~ GCl+..fx,\/
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Phone:
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Message:
-'NO. 2724-P ~
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18 GAIN !LOSS
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78,515.82
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DONNA M MULLIN
JAMES ETAL
134 SIPE AVE
HUMMELSTOWN
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
10-22-2001
TAMBOLAS
06-16-2001
21 01-0656
CUMBERLAND
101
ESQ
'*
REV-1547 EX IFP liZ-DOl
TAY
K
Allount Rellitted
PA 11,036
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV=is'4-i-E3f-AFP-fi'2-':oOY-NO"ficE--OF-YNHEifiTAN-Ci-YAX-XpPRXiSEiiENT~--ALUiwAiicE-OR-------------- ---
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF TAMBOLAS TAY K FILE NO. 21 01-0656 ACN 101 DATE 10-22-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
U)
(2)
(3)
(4)
(5)
(6)
(7)
.00
2,778.46
.00
.00
126,366.72
.00
87,954.40
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
UO)
2,350.49
15.292.12
(11)
(2)
(3)
(4)
NOTE: I~ an assessment was issued previously, lines
re~lect ~igures that include the total o~ ALL
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
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
217,099.58
17 .64:7 61
199,456.97
.00
199,456.97
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
199,456.97 X 00 =
.00 X 045=
.00 X 12 =
.00x 15 =
(19)=
.00
.00
.00
.00
.00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (ot) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A RFFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
c..
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
TA Y KENNETH TAMBOLAS
Date of Death:
June 16,2001
Will No.
Admin. No.
2001-00656
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. Ifthe answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account
with the Court? Yes No _X_
b. The separate Orphan's Court No. (if any) for the
personal representative's account is:
c. Did the personal representative state an account
informally to the parties in interest? Yes _X_ 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: .-LIJL, -0 I
~7Jt.~-
Signature
Donna M. Mullin, Esquire
JAMES. SMITH. DURKIN & CONNELLY
134 Sipe Avenue
Hurnmelstown, PA 17036
(717) 533-3280
Capacity:
_ Personal representative
_X_Counsel for personal representative