HomeMy WebLinkAbout01-0831
Estate of
Register of Wills of County, Pennsylvania
PETITION FOR GRANT OF LETTERS
kY],l:)ro~P V. rYlanon
No. 21-01-831
also known as
, Deceased
Social Security No.
,,;zJ O-L2 -::2. 77b
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
[]] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut~ named in the last Will of
the Decedent, dated .....'3JA'f/oO and codicil(s) dated 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:
~
B. Grant of Letters of Administration
(c.I.a.; d.b.n.c.l.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:
rU:.>n
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in t..-lA.h1 ber{&i.y/r'
County, Pennsylvania with his/her last family
or principal residence at rl2fseerYlor-,-j.
!1VTSIYj 4 ~b,/.kh(Jy1 &der ,37~rt'11Nzj l>R {br;;J~ 4/7cJ/J
/. ./. . (list street, number, and municipality)
~?iO/ at PA 37S~Mre'n()~f ~ ,Clfyl.J4 ~
(Location)
Decedent, then ~years of age, died
Decedent at death owned property with estimated values as follows:
(It domiciled in PAl All personal property
(If not domiciled in PAl Personal property in Pennsylvania
(If not domiciled in PAl Personal property in County
Value of real estate in Pennsylvania
$
$
$
$
7500
3)-(-:=>
situated as follows:
N(4
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of
letters in the a ro riate form to the undersi ned:
Si nature
~enr,\~ V. rYlttnUlo) --107 t.J, s.ou~ sf-. CPif'LI.p i? 170/3
/7-S--/~
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
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 representative(s) of
the Decedent, Petitioner(s) will well and truly administer t.~. . ta"te , a"ccoo",rd;iong t~ ~aw/' v:
Sworn to or affirmed and subscribed "~ ~ V. ~~
before me this~day of tf), M )
,yr tV.tJ IS V. !.lIt v<--' (;
SEPTEMBER 2001
?/r-!:f//<<i:'n~'&'e/~y. .
For e Reglstar (
No.
21-01-831
A VY'\ b roSe: V. V"l\C\ V-l 011"\
.::2Jo- ~~ -.<77?Date of Death: fr- D7 - 0 I
Deceased
Estate of
Social Security No:
AND NOW,
SEPTEMBER 7
2001 ,in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters [R] Testamentary 0 Of Administration
(c,t.a.; d,b,n,c.t.a,; pendente lite; durante absentia; durante minoritate)
are hereby granted to
"--
~ r-............~ ~ \J,
('(\C\. Y' ~ D VI
in the above estate and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
3/~'f 100
FEES
25.00
~(J ~~p~ d//A) h7 MJ,M7r-
Resfster of Wills
Letters,
$
Short Certificate(s),
$
18.00
Renunciation.
Attorney:
S~e-veY\ J. h S~VYlq V)
$
Form RW-1 (1991)
Affidavits (
$
5.00
I.D. No: } b ~ 0 cr
Address: 9 S A-€.tK?iJl\~ Sg''' J 41
fu l ("'\) Le fh I / 0 I "3
Telephone: (71 7) ::L '-{. q -" 3 3 ~
Extra Pages ( ) .
$
6.00
Codicil. .
. . . . . . . . .
$
JCP Fee.
$
Inventory.
. . . . . . . . .
$
~~~/
Other. .
$
TOTAL.
. . . . . . . .
$
Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc.
54.00
:--:1 is IS to certi(v that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
~
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this cerrificate, $2.00
No.
:Y;J (,~~
Local Registrar
P 7619800
AUG 0 8 2001
Date
21-01-831
5.14JRev.2I87
COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
NAME OF DECEDENT I"".""". L..,
.. AmblLo-<\e V. Ma!L.ion
AGE (l.. -Yl UNDER 1 YEAR
- Doyo
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CalLl~le, PA 17013 ~~
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21-01-831
LAST WILL AND TESTAMENT
OF
AMBROSE V. MARION
I, AMBROSE V. MARION of 529 N. Pitt Street, Carlisle,
Cumberland County, Pennsylvania, being of sound mind, memory and
understanding, do hereby make, publish and declare this as and
for my Last Will and Testament, revoking all other wills and
codicils heretofore made by me.
FIRST
I direct the payment of my debts and the expenses of my
last illness and funeral from my estate as soon after my death as
conveniently may be done.
SECOND
I give, devise and bequeath all of my estate of
whatever nature or wherever situate in equal shares to such of my
nieces and nephews as shall survive me.
THIRD
I hereby appoint DENNIS V. MARION of 407 W. South St.,
Carlisle, PA as Executor of this my Last Will and Testament. I
direct that my said Executor not be required to post any bond in
regard to his duties as Executor, any laws of the Commonwealth of
Pennsylvania or any other jurisdiction notwithstanding.
"
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this, my Last Will and Testament, consisting of two (2)
typewritten pages, the first of which bears my signature in the
margin for the purpose of identification, this day of
2000.
~--?~ - -7 ~__, ~~___~r
AMBROSE V. MARION
(seal)
Signed, sealed, published and declared by the above
named testator, AMBROSE V. MARION, as and for his Last Will and
Testament, in the presence of us, who, at his request, in his
sight and presence, and in the sight and presence of each other,
have hereunto subscribed our names as witnesses.
~~4J~ '-9 4~r-k4vJ
(/
/7VL lM~
I
ADDRESS 95 It) Of-c.t4'I~ ~:;q Ro((Q(\ /; ~/~/ PA
ADDRESS '1rAl~~ JJyt...,,') /lJ/
C #tY{}J/t tJ A 170/.7
/
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS.
We, AMBROSE V. MARION,
RT 11l. yYj O~+hJ
1S-e~-eo-\\f 1. DurharYl
and
the testator and the witnesses,
respectively, whose names are signed to the attached or foregoing
instrument, being first duly sworn, do hereby declare to the
. ...- "'.'to.
undersigned authority that the testator signed and executed the
instrument of his Last Will and Testament, and that he signed
willingly and that he executed as his free and voluntary act for
the purposes therein expressed, and that each of the witnesses,
in the presence and hearing of the testator, signed the Will as
witnesses, and that to the best of their knowledge, the testator
was at the time eighteen (18) years of age or older, of sound
mind and under no constraint or undue influence.
Sworn to and subscribed before
me this J ~~ay of 1Yl&lC~ , 2000.
{~ dYYffYl1~-
NOTARIAL SEAL
KATHY L. MUMMERT, NOTARY PUBLIC
CITY OF CARLISLE, CUMBERLAND CO., PA
MY COMMISSION EXPIRES AUGUST 11 2003
-
t:-
.-
.. '
CERTIFCATION OF NOTICE UNDER RULE 5.6(A)
Name of Decedent: Llrnbrose..V. /L1an'on
Date of Death:
Will No.:
Admin No.: fro I -0083/
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules
was served on or mailed to the following beneficiaries of the above-captioned estate on
Name
Address
])e,nY'l10 V. mQrioY\
407 V'Je.s+ ~6LA\-h ~+reefl CarL~/e } PA 17013
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: ~
xft-~9.,17G~tih
Signature
~~~ eD en J. h's h f'N1f)
Name
r",
CL
qs A-lexaV1d~r ~ri~ Rd~,&J-e 3} Car/.JstJ..{/!4 /?(jJ3
Address
C'l11}xV-Q-1tJ333
Telephone
\0
N
N
:z
c:t:
J
~
,.6 Capacity: D Personal Representative
.a5 ~ [RJ Counsel for personal representative
rjc
m
U")
m
ru
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-D
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IT"
C\ stage $
Certifk d Fee
CJ Heturn Recei)t Fee "
r-=I (Endc'rsement ReqUI,red) r--
CJ Restncted Delivery Fee
CJ (Endorsement Reqwed)
'---
Postmark
Here
Total Postage 1>. Fees Lt
CJ
I"-
-D
.-=t _~5I~____.~____:t\~~rL_____----------------------_.
g _~:~~~-=\\('______~~__~_Q.t=_~__~_L_________________
I"- City, State, ZIP+4
"
See Revprse for Instructions
Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
. Print your name and address on the reverse
so that we can return the card to you.
. Attach this card to the back of the mail piece,
or on the front if space permits.
1. Article Addressed to:
0TE\Jen .J -F\ ~N\OX\
q:5 'A \-e'tu.,'(\(.\€.-r SpA ~ ~~
S~-\\(. 3
c.o...r\,~ \-(..?'A \'1()\3
D. Is delivery dd d' t from item 1?
If YES, enter delivery address below:
o Agent
o Addressee
Dyes
B"'No
3. Service Type
[g"" Certified Mail 0 Express Mail
o Registered 0 Retum Receipt for Merchandise
o Insured Mail 0 C.O.D.
4. Restrict~ Delivery? (Extra Fee) 0 Yes
2. Article Number
(Transfer from service label) '1 0bD
PS Form 3811, March 2001
l~lO
~O\O Qllo3 .2~53
Domestic Return Receipt
102S95-01-M-1424
"
"
. "
JRD/June 30, ] 992/17858
-
JAN 0 3 IUUi yl
In Re: Estate of Ambrose V Marion
Late of Middlesex Township
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
Estate No.: 21-01-831
NO.
NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE S.6(e), SUPREME COURT
ORPHANS' COURT RULE
Personal Representative: Dennis V. Marion
Counsel for Personal Representative: Steven J Fishman
Date of Grant of Original Letters: September 7, 2001
Date of Delinquency Notice: December 17, 2001
The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6,
Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of
Common Pleas of Cumberland County, that neither the above named personal representative nor
the above named counsel for the personal representative have filed with the Register of Wills or
Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court
Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court
Orphans' Court Rules, was given by the Register of Wills on December 7, 2001, and that the ten
(10) day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6(e)
the Court is hereby notified of such delinquency and the undersigned requests that a Court
conduct a hearing to determine whether sanctions should be imposed upon the delinquent
personal representative or counsel for the delinquent personal representative.
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
Date: January 2,2002
A hearing is scheduled for ,J; ~ // ,M;;b at f?.- 3 J In Courtroom No.3. If the
Certification of Notice is filed prior to the hearing date, the hearing will automatically be
cancelled.
G-k. ~ I-~-o~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1162 EX! 11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 002054
FISHMAN STEVEN J ESQUIRE
95 ALEXANDER SPRING ROAD
SUITE 3
CARLISLE, PA 17013
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
__u_u_ fold
101
$664.06
ESTATE INFORMATION: SSN: 210-22-2776
FILE NUMBER: 2101-0831
DECEDENT NAME: MARION AMBROSE V
DA TE OF PAYMENT: 01/17/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 08/07/2001
TOTAL AMOUNT PAID:
$664.06
REMARKS: DENNIS MARION
C/O STEVEN J FISHMAN ESQUIRE
CHECK#104
SEAL
INITIALS: VZ
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
I/-O:/~
'v BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
03-17-2003
MARION
08-07-2001
21 01-0831
CUMBERLAND
101
STEVEN J FISHMAN
SALZMANN ETAL
95 ALEXANDER SPG
CARLISLE
ESQ
RD 3
PA 116-13
Allount Rellitted
*'
REY-1547 EX AFP 101-D5l
AMBROSE
V
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REY=is4j-i3f-AFP--roY=03Y-No'Tici--oF-YNHiifiTANcE-7fA'x-APPRA-isii'-ENT~--Ail-oWANCE-OR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MARION AMBROSE V FILE NO. 21 01-0831 ACN 101 DATE 03-17-2003
TAX RETURN WAS: (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
( ) CHANGED
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
11,392.71
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
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
AX CREDITS:
DATE
01-17-2003
.--.
NUMBER
CD002054
l+J
INTEREST/PEN PAID (-)
.00
1,137.23
5.828.44
(11)
(12)
(13)
(14)
(9)
(10)
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
11,392.71
6.965 67
4,427.04
.00
4,427.04
14, IS and/or 16, 17, 18 and 19 will
returns assessed to date.
.00 X 00 =
.00 X 045 =
.00 X 12 =
4,427.04 X 15 =
(19)=
AMOUNT PAID
664.06
BALANCE OF UNPAID INTEREST/PENALTY AS OF 01-18-2003 TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
.00
.00
664.06
664.06
664.06
.00
27.47
27.47
. 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.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 002353
FISHMAN STEVEN V ESQUIRE
95 ALEXANDER ROAD
SUITE 3
CARLISLE, PA 17013
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
-------- fold
101
$27.47
ESTATE INFORMATION: SSN: 210-22-2776
FILE NUMBER: 2101-0831
DECEDENT NAME: MARION AMBROSE V
DA TE OF PAYMENT: 03/28/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 08/07/2001
TOTAL AMOUNT PAID:
$27.4 7
REMARKS: STEVEN J FISHMAN ESQUIRE
CHECK# 2334
SEAL
INITIALS: JA
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
/'7-~-- I~
'\, BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REV-1U7 EX AFP (Ol-OS)
.03 APR 28
m DATE
v'tills ESTATE OF
DATE OF DEATH
FILE NUMBER
P 3 :OOCOUNTY
ACN
04-14-2003
MARION
08-07-2001
21 01-0831
CUMBERLAND
101
AMBROSE
v
Recordej
Register
STEVEN J FISHMAN
SALZMANN ETAL
95 ALEXANDER SPG
CARLISLE
ESQ
RD 3 CIeri"
PAl 7 o~mberland Go., PA
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
Allount Rellitted
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REv=i&'ifj-ix-AFP--("oY:03y------...--iNHERITANCE-TAX-ST'A-fEMENT-OF'-AC-COLitif--.i.---------------------
ESTATE OF MARION AMBROSE V FILE NO. 21 01-0831 ACN 101 DATE 04-14-2003
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-17-2003
P R I NCI PAL TAX DUE: ...........................................................................................................................................................................................................................
664.06
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-17-2003 CD002054 .00 664.06
03-28-2003 CD002353 27.47- 27.47
TOTAL TAX CREDIT 664.06
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
iii IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
RECEIVED FROM:
FISHMAN STEVEN J ESQUIRE
95 ALEXANDER SPRING ROAD
SUITE 3
CARLISLE, PA 17013
ACN
ASSESSMENT
CONTROL
NUMBER
______n fold
101
ESTATE INFORMATION: SSN: 210-22-2776
FILE NUMBER: 2101-0831
DECEDENT NAME: MARION AMBROSE V
DATE OF PAYMENT: OS/20/2003
POSTMARK DATE: 0010010000
COUNTY: CUMBERLAND
DATE OF DEATH: 08/07/2001
TOTAL AMOUNT PAID:
REMARKS: STEVEN J FISHMAN ESQUIRE
CHECK# 740
SEAL
INITIALS: JA
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
REV-1162 EX( 11-96)
NO. CD 002587
AMOUNT
I
I
I
I
I
I
I
I
I
$159.19
$159.19
r
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D 0
,
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D ....
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
FISHMAN STEVEN J ESQUIRE
1225 HILLSIDE DRIVE
CARLISLE, PA 17013
-------- fold
ESTATE INFORMATION: SSN: 210-22-2776
FILE NUMBER: 2101-0831
DECEDENT NAME: MARION AMBROSE V
DA TE OF PAYMENT: 06/19/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 08/07/2001
NO. CD 002702
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $9.07
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: STEVEN J FISHMAN ESQUIRE
CHECK# 745
SEAL
INITIALS: AC
RECEIVED BY:
REGISTER OF WILLS
$9.07
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
/
,
Name of Decedent:
STATUS REPORT UNDER RULE 6.12
AYYlbro&: \1.. MariolJ
.8 17/0/
Date of Death:
Will No.:
~06, -OD831
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~ No 0
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No ~
b. The separate 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? Y es ~ No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
Date: J):zl03 and may be attacbed ~:~ --=:~
Signature
r'-,
4~"'.
s~, J. ~sll-l'~
c:--\
Name
c
_J
=:J
--:)
CJ5 Afex~Yld~v ~r~ ~ ~/(;)~4
Address I ') 0; :s
~.
p
~
. r .
-'--."
7 I 7 ~ 'fq-~.3>~
Telephone No.
Capacity: 0 Personal Representative
lae'ounsel for personal representative
I /} -...5~ I:J~
~'" ..
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
REV~1547 EX AFP (01.03>
mATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
:il8UNTY
ACN
06-23-2003
MARION
08-07-2001
21 01-0831
CUMBERLAND
101
AMBROSE
V
'03 JUN 20
'\11
STEVEN J FISHMAN
SALZMANN ETAL
95 ALEXANDER SPG
CARLISLE
ESQ
R 3 C;Si
D CUlnb,:.
PA 17013 .
Amount Remitted
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-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MARION AMBROSE V FILE NO. 21 01-0831 ACN 101 DATE 06-23-2003
TAX RETURN WAS: ( ) ACCEPTED AS FILED
( X) CHANGED
SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
4. Mortgages/Notes Receivable (Schedule D) (4)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
NO. 01
.00 NOTE: To insure proper
. DO credit to your account,
. DO submit the upper portion
. DO of this form with your
1,061.27 tax payment.
.00
.00
(8) 1,061. 27
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate SUbject to Tax
(9)
CIO)
.00
.00
CI1>
CI2)
CI3)
CI4)
on
1,061.27
.00
5,488.31
NOTE:
If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of !hh returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS'
CIS)
CI6)
CI7)
CI8)
.00 X
.00 X
.00 X
5,488.31 X
DO
045 =
12
15
CI9)=
.00
.00
.00
823.25
823.25
.
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-17-2003 CD002054 .00 664.06
03-28-2003 CD002353 .00 27.47
05-20-2003 CD002587 27.47- 159.19
BALANCE OF UNPAID INTEREST/PENALTY AS OF 05-21-2003 TOTAL TAX CREDIT 823.25
BALANCE OF TAX DUE .00
INTEREST AND PEN. 9.07
TOTAL DUE 9.07
* 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.)
~ "" '...
REV-1470 EX (6-88)
'* INHERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENrS NAME FILE NUMBER
Marion, Ambrose V. 2101-0831
REVIEWED BY ACN
Daniel Heck 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
E 1 Accepted additional assets.
ROW
Page 1
REV-1500 EX + (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECE-
DENT
CHECK
APPRO-
PRIATE
BLOCKS
COR-
RE-
SPON
DENT
RECA-
PITULA-
TION
TAX
COMPU-
TATION
'-
OFFICIAL USE ONLY
REV-1500
I 7 - j-- / ~
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 2001
0831
YEAR
NUMBER
COUNTY CODE
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
MARION, AMBROSE V.
DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR)
08/07/01 11/21/1929
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
210-22-2776
THIS RETURN MUST BE FILED IN DUPLICATE
WITH THE REGISTER OF WILLS
SOCIAL SECURITY NUMBER
~ 1. Original Return
4. Limited Estate
6. Decedent Died Testate
(Attach copy of Will)
9. Litigation Proceeds Received
~ 2. Supplemental Return
4a. Future Interest Compromise
(date of death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach a copy of Trust)
10. Spousal Poverty Credit (date of death between
12-31-91 and 1-1-95)
3. Remainder Return
8 (date of death prior to 12-13-82)
5. Federal Estate Tax Return Required
o 8. Total Number of Safe Deposit Boxes
011. Election to taxunderSec. 9113(A)
(Attach Sch 0)
tW$$E;QtJQNMQ$tj3E;QQM#j$tijp.A4'Q.Qijijg$#Q~E;~.~iQ9NFIP$tftIAtt:~~ijFQRMAtjQN$HQQ'P/ij$il.ijR~(:;jtipT9#
NAME COMPLETE MAILING ADDRESS
STEVEN J. FISHIVIAN, ESQUIRE 95 ALEXANDER SPRING ROAD, SUITE 3
FIRM NAME (If Applicable) CARLISLE, PA 17013
SALZMANN, DePAULIS & FISHMAN, P.C.
TELEPHONE NUMBER
(717) 249-6333
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
None
None
None
None
OFFICIAL USE ONLY
3. Closely Held CorporatIOn, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal
Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested (6)
11,392.71
None
7. Inter-Vivos Transfers & Miscellaneous
Non-Probate Property (Schedule G or L)
None
(7)
--;-'.
(8)
1,137.23
5,828.44
(11 )
(12)
(13)
11,392.71
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative 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)
SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES
15. Amountof Line 14 taxable atthe spousal tax
rate, or transfers under Sec. 9116 (a)(1.2) X .0 _ (15)
16. Amount of Line 14 taxable at lineal rate O. 00 X.O ~ (16)
17. Amountof Line 14 taxable atslbling rate 0.00 X .12 (17)
18. Amount of Line 14 taxable at collateral rate 4, 427 . 04 x .15 (18)
19. Tax Due (19)
20. 0 I&Heck..HeREiFvoU.ARE.ij~dUI;$fjij$ARiI;FUNPOFANQvef.l;eAYM~ijt>I
6,965.67
4,427.04
None
(14)
4,427.04
0.00
0.00
664.06
664.06
. .. .......................;;,"sgSWRETOANSWSBAl.tOlX!;STfON$QN..PAGl;.i:lANo:Bl;CHEGKMAtHi@>................................. .
o PA15001
NTF 29755
COPYright 2000 GreatlandfNelco LP - Forms Software Only
PA REV-1500 EX (6-00)
d C I
Page 2
Dece ent s ompl ete ress:
STREET ADDRESS
CLAREMONT NURSING & REHAB
CITY I STATE I ZIP
CARLISLE PA 17013
Add
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
664.06
0.00
0.00
Total Credits (A + B + C)
(2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
0.00
0.00
(3) 0.00
(4)
(5) 664.06
(5A) 0.00
(5B) 664.06
Total Interest/Penalty (D + E)
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
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
1. Did decedent make a transfer and:
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; 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0
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 perjury, 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 information of
which preparer has any knowledqe.
SIGNAf~ OF PERSON RESf,ONSIBLE FOR FILING RETURN DATE
I. //:/ . /~;.~.v'- ..
A~ ~/1/"/;~-. "V ,v;:::>~~~~.: ~
AIO 7 (,.oJ. 60 V\..-1 \--, S t
SIGNATU EPA ER 0
Yes No
~ I
8 ~
[g
/ //'r
..J..]
fer
17D/J
1- 1
DATE
- t>
.~
ADDR
95 ALEXANDER SPRING ROAD, SUITE 3, CARLISLE, PA 17013
an on or use spouse
[72 P.S. !i 9116 (a)(1.1) (i)].
For dates of death on or after January 1,1995, the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. !i 9116 (a) (1.1)(';)].
The statute dnes not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure 01 assets and 'filing a tax return are still applicable even jf
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.s9116(aX1.2)].
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. Ii 9116(1.2) [72 P.S.!i 9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings,s 12% [72 P.S.!i 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.
o PA15002
NTF 29756
COPYright 2000 GreatlandiNelco LP- Forms Software Only
I .
Estate of: AMBROSE V. MARION
Sl.M/fARY OF ALLOCATIONS TO BENEFICIARIES
Taxable at collateral rate
LAWRENCE Di VITTORIO
MARK Di VITTORIO
THOMAS Di VITTORIO
VINCENT DiVITTORIO
KATHY HARRISON
PAT HARRISON
PAUL HARRISON
KATHLEEN KOBYLAK
BRIAN MARION
DENNIS MARION
JOSEPH MARION
KAREN MARION
MICHAEL MARION
PAUL MARION
ROSALEEN MARION
MARY POTTS
ANN SCERBO
MAUREEN STROKA
KATHLEEN VALLI
233.01
233.01
233.01
233.01
233.00
233.00
233.00
233.00
233.00
233.00
233.00
233.00
233.00
233.00
233.00
233.00
233.00
233.00
233.00
4,427.04
21-2001-0831
REV-1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
AMBROSE V. MARION
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21-2001-0831
Include proceeds of l,tigatJon & date proceeds were received by the estate. All prop. Jointly-owned with right of survivorship must be disclosed on Sch. F.
ITEM
NO. DESCRIPTION
VALUE AT
DATE OF DEATH
1 1988 SUBARU AUTOMOBILE - VIN JF1AN43BXJC449668
200.00
2 PERSONAL FURNISHINGS
50.00
3 MEMBERS FIRST FEDERAL CREDIT UNION ACCOUNT - NUMBER 145967
11,142.71
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
11,392.71
7 CPA81 NTF 10908
Copyright Forms Software Only, 1997 Nelco, Inc.
REV-1511 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
AMBROSE V. MARION
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-2001-0831
Debts of decedent must be reported on Schedule I.
ITEM
NO.
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
1 FATHER ANDRE MELUSKY
125.00
8. ADMINISTRATIVE COSTS:
1.
Personal Representative's Commissions
Name of Personal Representative(s} DENNIS R. MARION
Social Security Number(s)/EIN No. of Personal Representative(s}
Street Address 407 WEST SOUTH STREET
City CARLISLE State
552.00
PA Zip 17013
Year(s) Commission Paid: 2003
2.
3.
Attorney Fees Name: SALZJVJANN', DePAULIS & FISHMAN
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
150.00
0.00
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7 REGISTER OF WILLS - FILE RETURN
8 REGISTER OF WILLS - SHORT CERTIFICATE
9 U-HAUL TRUCK
10 THE SENTINEL - ESTATE ADVERTISElVIENT
54.00
0.00
0.00
15.00
3.00
31. 19
132.04
11 CUMBERLAND LAW JOURNAL - ESTATE ADVERTISElVIENT
75.00
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1,137.23
7 CPA11 NTF 10911
Copyright Farms Software Only, 1997 Nelco, Inc.
REV-1512 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
AMBROSE V. MARION
Include unreimbursed medical expenses,
ITEM
NO,
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21-2001-0831
DESCRIPTION
AMOUNT
1 ROOM & BOARD - CLAREMONT NURSING & REHABILITATION
5,795.44
2 PER CAPITA TAX - CUMBERLAND COUN'IY TAX COLLECTION BUREAU - 2001
23.00
3 BOROUGH OF CARLISLE - PER CAPITA TAX
10.00
7 CPA12 NTF 10912
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
5,828.44
Copyright Forms Software Only, 1997 Nelco, Inc.
REV-1513 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
AMBROSE V. MARION
21-2001-0831
RELATIONSHIP TO DECEDENT AMOUNT OR
No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) SHARE OF ESTATE
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
See Schedule attached
ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17 AS APPROPRIATE ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
None
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
None
TOTAL OF PART II -- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00
7 CPA13 NTF 10913
(If more space is needed, insert additional sheets of the same size)
Copyright Forms Software Only, 1997 Nelco, Inc.
, .
Estate of: AMBROSE V. MARION
SCHEDULE J, Part 1 - - Taxable Distributions
Item
No.
Name and Address of Beneficiary
Relationship
1 LAWRENCE Di VITTORIO
27-58 27TH ST. 3RR
ASTORIA LONG ISLAND, NY
NEPHEW
2 MARK Di VITTORIO
36-08 CRESCENT STREET
LONG ISLAND CITY, NY 11106
NEPHEW
3 THOMAS DiVITTORIO
30-25 37TH STREET
ASTORIA, NY 11102
NEPHEW
4 VINCENT DiVI'ITORIO
43-44 171ST ST.
AUBURNDALE, NY 11358
NEPHEW
5 KATHY HARRISON
99 MYRTLE AVENUE
NUTLEY, NJ 07110
NIECE
6 PAT HARRISON
29 OAK DRIVE
CEDAR GROVE, NJ 07009
NEPHEW
7 PAUL HARRISON
412 ELLIS STREET
GLASSBORO, NJ 08028
NEPHEW
8 KATHLEEN KOBYLAK
23 DUBLIN DRIVE
BALSTON SPA, NY 12020
NIECE
9 BRIAN MARION
3 GENESE ROAD
WINDSOR, NY 13865
NEPHEW
10 DENNIS MARION
407 W. SOUTH STREET
CARLISLE, PA 17013
NEPHEW
11 JOSEPH MARION
26 PLEASANT VIEJ.t.l DRIVE
EXETER, NH 03833
NEPHEW
12 KAREN MARION
4 WIWWOOD LANE
N'lHERST, NH 03031
NIECE
Page 2
21-2001-0831
Amount
233.01
233.01
233.01
233.01
233.00
233.00
233.00
233.00
233.00
233.00
233.00
233.00
. .
.
Page 3
Estate of: AMBROSE V. MARION
21-2001-0831
SCHEDULE J, Part 1 - - Taxable Distributions
Item
No.
Name and Address of Beneficiary
Relationship
Amount
13 MICHAEL J.VJARION
59 MIDDLE DUNSTABLE ROAD
NASHUA, NH 03062
NEPHEW
233.00
14 PAUL MARION
314 ST. CLARE AVENUE
SPRING LAKE, NJ 07762
NEPHEW
233.00
15 ROSALEEN MARION
93 SHOSHONE STREET
BUFFALO, NY 14214
NIECE
233.00
16 J.VJARY POTTS
40 BROOKSIDE TERRACE
VERONA, NJ 07044
NIECE
233.00
17 ANN SCERBO
261-H SIGNS ROAD
STATEl'J ISLAND, NY 10314
NIECE
233.00
18 MAUREEN STROKA
356 SANITARIA SPRINGS ROAD
SANATARIA SPRINGS, NY 13833
NIECE
233.00
19 KATHLEEN VN..LI
58-10 69TH STREET
MASPETH, NY 11378
NIECE
233.00
- -
REV-1500 EX + (6-00) OFFICIAL USE ONLY
COMMONWEALTH OF PENNSYLVANIA REV-1500
DEPARTMENT OF REVENUE
DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER
HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 21 2001 0831
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
MARION, AMBROSE V. 210-22-2776
DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE
DENT
08/07/01 11/21/1929 WITH THE REGISTER OF WILLS
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
8 3. Remainder Return
CHECK ~' Original Return ~2 Supplemental Return (date of death prior to 12-13-82)
APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
PRIATE 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach copy of Will) (Attach a copy of Trust)
BLOCKS 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death between 0 11. Election to tax un der Sec. 9113(A)
12-31-91 and 1-1-95) (Attach Sch 0)
m.$~ijMV$tijiQQMijU$timAUijQqijij~mI~.e.QijMiiMtjitt.~tBRMAn~$ijQijUiW$pmjmbtQ~
NAME COMPLETE MAILING ADDRESS
COR- STEVEN J. FISHMAN, ESQUIRE 95 ALEXANDER SPRING ROAD, SUITE 3
RE- FIRM NAME (If Applicable) CARLISLE, PA 17013
SPON
DENT SALZMANN , DePAULIS & FISHMAN, P.C.
TELEPHONE NUMBER
(717) 249-6333 -,..., ,.,..
,. "
-~ <m=ICIAL ~b:pNL Y
1. Real Estate (Schedule A) (1) Nong 7'
2. Stocks and Bonds (Schedule B) (2) Nona: :3:
3. Closely Held Corporation, Partnership or Soie-Proprietorship (3) None ~
4. Mortgages & Notes Receivable (Schedule D) (4) None: N
0
5. Cash, Bank Deposits & Miscellaneous Personal
Property (Schedule E) (5) 12,453.98' p
;:;....>
" 0
6. Jointly Owned Property (Schedule F) ;'1""~ .c;.
0 Separate Billing Requested (6) Noner: :": N
RECA-
PITULA- 7. Inter-Vivos Transfers & Miscellaneous
TION Non-Probate Property (Schedule G or L) (7) None
8. Total Gross Assets (total Lines 1-7) (8) 12,453.98
9. Funeral Expenses & Administrative Costs (Schedule H)(9) 1,137.23
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule i) (10) 5,828.44
11. Total Deductions (total Lines 9 & 10) (11) 6,965.67
12. Net Value of Estate (Line 8 minus Line 11) (12) 5,488.31
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax (13) None
has not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 5,488.31
SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2) X .0 (15)
TAX 16. Amount of Line 14 taxable at lineal rate 0.00 X .0 45 (16) 0.00
0.00 - 0.00
COMPU- 17. Amount of Line 14 taxable at sibling rate X .12 (17)
TATION 18. Amount of Line 14 taxable at collateral rate 5,488.31 x.15 (18) 823.25
19. Tax Due (19) 823.25
20. 0 ICBI;Pk.ij$ij~IJkyQijAij~ij~&ij~$TIN$Aaaw.ipQfANQveRijivM~"Tl
II :) \2-
~
......................................................<............................>........;:;;:i;iaaStlBlitTOANSWEiBAWQVt;E$'1JON$ONPA&t;E~ANPRt;EOlilEGKMATH*i:i<...................................
...
o PA15001
NTF 29755
Copyright 2000 Greatland/Nelco LP - Forms Software Only
PA REV-1500 EX (6-00)
D d C I
Page 2
ece ent s omplete ress:
STREET ADDRESS
CLAREMONT NURSING & REHAB
CITY 1 STATE I ZIP
CARLISLE PA 17013
Add
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
823.25
664.06
0.00
Total Credits (A + B + C)
(2)
664.06
3. Interest/Penalty if applicable
D. Interest
E. Penalty
0.00
0.00
Total Interest/Penalty (0 + E) (3)
4. If Une 2 is greater than Une 1 + Une 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 DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
}}.. ..... .~~~~9~~~~~~v.a~let(): .RE:~Il:)~Fl. 9~ .~I.L~~!. ~~.EN.!....
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; ....................................... ~ I
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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. B ~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? eg
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 0 eg
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 perjury, 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 information of
which preparer has any knowledqe.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
0.00
159.19
0.00
159.19
SIGNATURE OF
ADDRESS
95 ALEXANDER SPRING ROAD,
, f'~O
SUITE 3, CARLISLE, PA
17013
t~;J~;~~~~J1~~~~~~;r~~~;iJI~;,i;~~i~ggg;f~;rJ~~U;;~,1~~~:~~l~g;~~;ll~~~;g~~~~;~~~aCr~fM~~;r;~t~~r~:~;~~;~~~tnHs~;~I~'~~~~~~~;i~~i2><
[72 P.S. g 9116 (a)(1.1)(i)].
For dates of death on or after January 1, 1995, the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. g 9116 (a) (1.1) (ii)].
The statute dop,<::; not AXF!mpt a transfer to a surviving spouse from tax, and the statutory requirements far disclosure aT 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 th e child is 0% [72 P.S. gg116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for th e use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72.P.S. g 9116(1.2) [72 P.S. g 9116(a)(1)].
The tax rate imposed on the net value of transfers to or forthe use of the decedent's siblings is 12% [72 P.S. g 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.
o PA15002
NTF 29756
Copyright 2000 Greatland/Nelco LP- Forms Software Only
Estate of: AMBROSE V. MARION
SUMMARY OF ALLOCATIONS TO BENEFICIARIES
Taxable at collateral rate
LAWRENCE Di VITTORIO
MARK Di VITTORIO
THOMAS Di VITTORIO
VINCENT Di VITTORIO
KATHY HARRISON
PAT HARRISON
PAUL HARRISON
KATHLEEN KOBYLAK
BRIAN MARION
DENNIS MARION
JOSEPH MARION
KAREN MARION
MICHAEL MARION
PAUL MARION
ROSALEEN MARION
MARY POTTS
ANN SCERBO
MAUREEN STROKA
KATHLEEN VALLI
288.85
288.85
288.85
288.86
288.86
288.86
288.86
288.86
288.86
288.86
288.86
288.86
288.86
288.86
288.86
288.86
288.86
288.86
288.86
5,488.31
21-2001-0831
REV-1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
AMBROSE V. MARION
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21-2001-0831
Include proceeds of litigation & date proceeds were received by the estate. All prOD. Jointly-owned with right of survivorship must be disclosed on Sch. F.
ITEM
NO. DESCRIPTION
VALUE AT
DATE OF DEATH
1 MEMBERS FIRST FEDERAL CREDIT UNION SAVINGS ACCOUNT NUMBER
145967-00
1,061. 27
2 1988 SUBARU AUTOMOBILE - VIN JF1AN43BXJC449668
200.00
3 PERSONAL FURNISHINGS
50.00
4 MEMBERS FIRST FEDERAL CREDIT UNION ACCOUNT - NUMBER 145967
11,142.71
7 CPA81 NTF 10908
Copyright Forms Software Only, 1997 Nelco, Inc.
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
12,453.98
REV-1511EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
AMBROSE V. MARION
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-2001-0831
Debts of decedent must be reported on Schedule I.
ITEM
NO. DESCRIPTION
A. FUNERAL EXPENSES:
AMOUNT
1 FATHER ANDRE MELUSKY
125.00
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) DENNIS R. MARION
Social Security Number(s)/EIN No. of Personal Representative(s)
Street Address 407 WEST SOUIB STREET
City CARLISLE State
552.00
PA Zip 17013
Year(s) Commission Paid: 2003
2.
3.
Attorney Fees Name: SALZMANN, DePAULIS & FISHMAN
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
150.00
0.00
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7 REGISTER OF WILLS - FILE RETURN
8 REGISTER OF WILLS - SHORT CERTIFICATE
9 U-HAUL TRUCK
10 THE SENTINEL - ESTATE ADVERTISEMENT
54.00
0.00
0.00
15.00
3.00
31.19
132. 04
11 ClJlVIBERLAND LAW JOURNAL - ESTATE ADVERTISEMENT
75.00
7 CPA11 NTF10911
Copyright Forms Software Only, 1997 Nelco, Inc.
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
1, 137.23
REV-1512 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
AMBROSE V. MARION
Include unreimbursed medical expenses.
ITEM
NO.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21-2001-0831
DESCRIPTION
AMOUNT
1 ROOM & BOARD - CLAREMONT NURSING & REHABILITATION
5,795.44
2 PER CAPITA TAX - CUMBERLAND COUNTY TAX COLLECTION BUREAU - 2001
23.00
3 BOROUGH OF CARLISLE - PER CAPITA TAX
10.00
7 CPA12 NTF 10912
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
5,828.44
Copyright Forms Software Only, 1997 Nelco, Inc.
REV-1513 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
AMBROSE V. MARION
21-2001-0831
RELATIONSHIP TO DECEDENT AMOUNT OR
No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) SHARE OF ESTATE
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
See Schedule attached
ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17 AS APPROPRIATE ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
None
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
None
TOTAL OF PART 11-- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00
7 CPA13 NTF 10913
(If more space is needed, insert additional sheets of the same size)
Copyright Forms Software Only, 1997 Nelco, Inc.
Page 2
Estate of: AMBROSE V. MARION
21-2001-0831
SCHEDULE J, Part 1 - - Taxable Distriliutions
Item
No.
Name and Address of Beneficiary
Relationship
!\mount
1 LAWRENCE Di VITTORIO
27-58 27TH ST. 3RR
ASTORIA LONG ISLAND, NY
NEPHEW
288.85
2 MARK DiVITTORIO
36-08 CRESCENT STREET
LONG ISLAND CITY, NY 11106
NEPHEW
288.85
3 THOMAS Di VITTORIO
30-25 37TH STREET
ASTORIA, NY 11102
NEPHEW
288.85
4 VINCENT Di VITTORIO
43-44 171ST ST.
AUBURNDALE, NY 11358
NEPHEW
288.86
5 KATHY HARRISON
99 MYRTLE AVENUE
NUTLEY, NJ 07110
NIECE
288.86
6 PAT HARRISON
29 OAK DRIVE
CEDAR GROVE, NJ 07009
NEPHEW
288.86
7 PAUL HARRISON
412 ELLIS STREET
GLASSBORO, NJ 08028
NEPHEW
288.86
8 KATHLEEN KOBYlAK
23 DUBLIN DRIVE
BALSTON SPA, NY 12020
NIECE
288.86
9 BRIAN JVJARION
3 GENESE ROAD
WINDSOR, NY 13865
NEPHEW
288.86
10 DENNIS JVJARION
407 W. SOUTH STREET
CARLISLE, PA 17013
NEPHEW
288.86
11 JOSEPH MARION
26 PLEASANT VIEW DRIVE
EXETER, NH 03833
NEPHEW
288.86
12 KAREN MARION
4 WILDWOOD lANE
AMHERST, NH 03031
NIECE
288.86
Estate of: AMBROSE V. MARION
SCHEDULE J, Part 1 - - Taxable Distributions
Item
No.
Name and Address of Beneficiary
13 MICHAEL MARION
59 MIDDLE DlJNSTABLE ROAD
NASHUA, NH 03062
14 PAUL MARION
314 ST. CLARE AVENUE
SPRING LAKE, NJ 07762
15 ROSALEEN MARION
93 SHOSHONE STREET
BUFFAW, NY 14214
16 MARY POTTS
40 BROOKSIDE TERRACE
VERONA, NJ 07044
17 ANN SCERBO
261-H SIGNS ROAD
STATEN ISlAND, NY 10314
18 MAUREEN STROKA
356 SANITARIA SPRINGS ROAD
SANATARIA SPRINGS, NY 13833
19 KATHLEEN VALLI
58-10 69TH STREET
MASPETH, NY 11378
Relationship
NEPHEW
NEPHEW
NIECE
NIECE
NIECE
NIECE
NIECE
Page 3
21-2001-0831
Amount
288.86
288.86
288.86
288.86
288.86
288.86
288.86