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HomeMy WebLinkAbout01-0920 p.N PETITION FOR GRANT OF LETTERS Estate of John~Veres No. t5J1-Dl-q;l.() also known as , Deceased Social Security No. 177206883 Petitioner(s), who is/are 18 years of age or older, apply)ies) for: (COMPLETE "A" OR "B" BELOW:) GJ A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut or Decedent, dated 5/9/1980 and codicil(s) dated named in the Last Will of the 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 incapacitated: o 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 the 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 1071 Pebble Court, Mechanicsburg, PA 17055 (list street, number and municipality) Decedent, then 71 years of age, died September 22 ,2001 ,at Granby Medical Ctr., Granby, CO (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property......................................... $ (if not domiciled in PA Personal property in Pennsylvania .................... $ (if not domiciled in PA Personal property in County.............................. $ Value of real estate in Pennsylvania ........................................................................................ $ Total ..................................................................................................................... $ Real Estate situated as follows: 607 Comly St., Philadelphia, PA 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 appropriate form to the undersigned: 200.00 30,000.00 30,200.00 Signature Typed or printed name and residence Q-... John A. Veres, 2152 Canterbur Dr., Mechanicsbur l'l- ,~- L.\ Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and 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 the estate according to law. Sworn to and affirmed and subscribed before me this 5th day of OCTO~ 3t1 2b- '-1lf:/dv C' LEWIS~~J f" - Cf:t;. ~ CLl) O~ DECREE OF REGISTER F. Estate of John t~Veres also known as Deceased 21 - 01 - 920 No. Social Security No: 177206883 Date of Death: 9/22/2001 AND NOW, OCTOBER 5, 2001 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary 0 of Administration are hereby granted to John A. Veres ((c.I.a., d.b.n.c.t.; pendente lite; durante absentia; durante minoriate) in the above estate and that the instrument(s), if any, dated MA y 9 J 1980 described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Letters .................................... $ 70.00 Short Certificates(s) ..J?L.... Renunciation .......................... Extra Pages ( 2 ) ............... I.T.R....................................... JCP Fee ................................. Inventory................................ Other ...................................... TOTAL .............................$ $ $ $ $ $ $ $ $ 24.00 6.00 5.00 105.00 Mailed to attorney on 10-5-01 Signature. Attorney: R. Mark Thomas, Esq. I.D. No: 41301 Address: 101 S. Market St. Mechanicsburg Telephone: 717-796-2100 DATE FILED: OCTOBER 5, 2001 PA 17055 PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. If RESIDENT DECEDENT make check or money order payable to: REGISTER OF WILLS. AGENT. If NON-RESIDENT DECEDENT make check or 1I0ney order payable to: COMMONWEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices or from the Department's 24-hour answering service for forms ordering: 1-800-362-2050, services for taxpayers with special hearing and I or speaking needs: 1-800-447-3020 (TT only). REPLY TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar 1I0nths after the decedent's death, a five percent (57.) discount of the tax paid is allowed. PENALTY: The 157. tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax allnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (67.) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19B2 through 2002 are: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor 1982 207. .000548 1992 97. .000247 1983 167. .000438 1993-1994 77- .000192 1984 117. .000301 1995-1998 97. .000247 1985 137. .000356 1999 77- .000192 1986 107. .000274 2000 87. .000219 1987 97. .000247 2001 97. .000247 1988-1991 117. .000301 2002 67. .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest lIuSt be calculated. -II -- -- .. LAST WILL AND TESTAMENT OF JOHN F. VERES I, JOHN F. VERES, of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and revoke any and all wills and codicils previously made by me. ITEM I: I direct that all my just debts and funeral expenses shall be paid from the assets of my estate as soon as practicable after my decease. ITEM II: All federal, estate and other death taxes imposed because of my death with respect to the property forming my gross estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such tax, shall be considered as a part ot the expense of the administration of my estate, and shall be paid out of the principal of my estate, without apportionment or right of reim- bursement. ITEM III: I give, devise and bequeath all of my estate of every name and nature and wheresoever situate unto my wife, Helen Veres, provided she shall survive me by thirty days. 'I II> - ITEM IV: Should my wife, Helen Veres, predecease me, or die on or before the thirtieth day following my death, I give, devise and bequeath all of my estate of every name and nature and and wheresoever situate, in equal shares, to my children, John A. Veres, Karen J. Logan, and Thomas J. Veres, or their issue, per stirpes. ITEM V: I appoint my son, John A. Veres, Executor of this my Last Will and Testament. Should my son, John A. Veres, fail to qualify or cease to act, I appoint my son, Thomas J. Veres, as Executor of this my Last Will and Testament. ITEM VI: I direct that my personal representative shall not be required to give bond for the faithful performance of his duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this l day of t'1t.Jy ,1980. / I~' '} ! -:It~L-l>l1-1.. 'J.Y\Lk.~A.L ' JotriJ F. VERES The preceding instrum~it, consisting of this and one othe typewritten page, was on the date thereof signed, published and declared by JOHN F. VERES, the test~ortherein named, as and for his last will, in the presence of us, who, at his request, in his presence, and in the presence of each other, have subscribed our/names as witnesses hereto. '{ j /X<M.--lttlJ j It, ~ Residing at ---t 1/ (SEAL) e~/~ '~6.~ Residing at I ' -J/~ LJUAJ-, /ilu /J EtA-. t?u~ , G?-,. . -2- " - , " .. COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF DAUPHIN WE, JOHN F. VERES , /-!Cl.::tlk)J tfl/Lk:i~L and C) j -IJ.U~1..~ L7~~- ~ , the testator and the witnesses, respectively, whose names are signed to the attached or fore- going instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his last will, and that he had signed willingly and that he executed it 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 that time eighteen years of age or older, of sound mind and under no constraint or undue influence. 7/ . -~ J ~ .'lrJ~.v- 1- O~/Li/:L Testa-t.pr ')1 . ' "'A1t;7t,-.uJlIUo.j~ Witness ~v~- ~~~ Witness Subscribed, sworn to and acknowledged before me by JOHN F. VERES, the testator, and subscribed and sworn to before me by ;Jcu~~j 8~ and (~,~~ 7/cr~~.>eA. k wi tnesses, this ql1J- day of 7'7LlA-l , 19~. ;f /) ~:~/~ {l &klAuk - Notary Public My Commissions~~~A~ H . M~l, Notary pubrrc' arnsburg D I . Mv rn...~::_'~l'p" ~n. Co., Pa. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Veres, John Frank Date of Death: 9/22/2001 Estate No. 21-()1-0~20 SSN: 177-20-6883 File No. 2001-920 Date Letters Granted: Will or Administration No. To the Register: I certify that Notice of 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 10/1 0/gQQ1 Name Thomas J. Veres Address 15 Forry Court Rd. Lewisberry 840 Longview Ave. Berthoud 2152 Canterbury Dr. Mechanicsburg Karen J. Adams John A. Veres Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: / ~;:A-/ ) A~ '0 .," // ~.. . .~>~- Signature f""'... ... n____. ----- Capacity: Personal Representative Name (Please type or print) R. MCirk ThomCis, E$q. Address 101 S. Market StreE3t x Counsel for Personal Representative ME3chanicsburg Telephone No. Z17.-796-21.QQ____ E --- PA .17:339 CO _8..l_5j~ PA 1705fS_ PA 17Q!29 . W t- lo:: SlII (.) ex: lo:: Wc.(.) :1:00 " ex:..J .., c. al C. ct z o 5 :J l- ii: <t U w a: z o i= <t I- :J a. ::E o U ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST. AND MIDDLE INITIAL) I- Z W C w U w c VERES, JOHN F. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) 09/22/2001 09/19/1930 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) IKJ 1. Original Return o 4. Limited Estate o 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (AltachcopyofTrust) o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) OFFICIAL USE ONLY 1.1 <!../ )1 I c1 FILE NUMBER 2J- Oi q~O COUNTY'COiiE ---vEA~ - - _R - SOCIAL SECURITY NUMBER 1 77- 2 0 - 6 883 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return (date of death pnorto 12-13-82) o 5. Federal Estate Tax Return Required _ 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A)(Altach Sch OJ THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAXINF0RMATION SHOULD eEOIRECTED TO: NAME COMPLETE MAILING ADDRESS R. MARK THOMAS, ESO. 101 S.MARKETSTREET FIRM NAME (If Applicable) t- Z W C Z o C. III W ex: ex: o (.) TELEPHONE NUMBER 717 -796-2100 MECHANICSBURG 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 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 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 Govemmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subjectto Tax (Line 12 minus Line 13) 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) X _(15) 15,655.70 X .045 (16) X .12 (17) X .15 (18) (19) 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 PA 17055 19,975.00 ' OFFICIAL USE ONLY - ..' ~ 0.00 " ff-? I r 9,502.30'-k y L" l (8) 29,477.30 3,595.65 10,225.95 (11) (12) (13) 13,821.60 15,655.70 (14) 15,655.70 704.51 704.51 20. 0 Decedent's omplete A ress: STREET ADDRESS 1 P bbl C 107 e e ourt CITY . I STATE PA I ZIP 17055 Mechanlcsburg 'C dd Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2 Credits/Payments A Spousal Poverty Credit B Prior Payments C Discount (1) 704.51 Total Credits (A + B + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty T otallnterestlPenalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference This is the OVERPAYMENT. Check box on Page 1 line 20 to request a refund (4) 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. (58) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and'. Yes No a. retain the use or income of the property transferred; ........................................................................... 0 [Z] b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 [Z] c. retain a reversionary interest; or ...................................................................................................... 0 [Z] d. receive the promise for life of either payments, benefits or care? ............................................................. 0 [Z] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?............................................................................................... 0 [Z] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 [Z] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ....................................................................................................... 0 [Z] 704.51 704.51 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 all information of which preparer has any knowledge. SIGNA TURE OF PERSON. R~SPONSI8LE FOR FILING RETURN ~C.U~ ADORE. 2152 Canterbury, Dr. Mechanicsbur P ER THAN REPRES DATE 5:)2- 3>) oZ PA SIGNAT 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 PS. 99116 (a) (1.1) (i)). For dates of death on or after January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exemDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 PS. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S 99116(1.2) (72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(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. ec"_,.",, * COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE A REAL ESTATE ESTATE OF VERES JOHN F All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorshiD must be disclosed on Schedule F. ITEM NUMBER 1. FILE NUMBER DESCRIPTION VALUE AT DATE OF DEATH 19,975.00 607 Comly Street Philadelphia, PA Row home in the Cityt of Philadelphia which was sold pursuant to a written sales agreement, an unsigned copy of which is attached hereto. The decedent had received the $4000.00 down payment prior to his death and had comingled this money with his other assets. The estate actually received the amount shown on line 603 of the HUD settlement sheet. TOTAL (Also enter on line 1, Recapitulation) $ 19,975.00 REV.15Q8 EX. (1.97) . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF VERES JOHN F FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly.owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH 223.84 First Union Bank Checking Account #1014133471546 2. First Union Bank Savings Account #3000402747971 6.46 3. The Mountainside at Silver Creek (Time Share) Silver Creek, CO 3,995.00 4. The Blue Tree Resort (Time Share) Orlando, FL 4,995.00 5. Chair 15.00 6. Various inexpensive jewelry 100.00 7. Sporting goods 50.00 8. Refund - Car Insurance 117.00 *Decedent lived with his friend, Constance Cooper, at her residence. the above items of personal property were his sole possessions as of his date of death. TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 9,502.30 c"",,,',,,,,, . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF VERES JOHN F FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A FUNERAL EXPENSES: 1. Schoenfeld Mortuary 2,175.78 2. Food and miscellaneous expenses (Post service dinner) 242.22 3. Flowers 138.81 4. Priest 50.00 S. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2 Attorney Fees R. Mark Thomas 703.00 3. 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 4. Probate Fees Cumberland County 114.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Patriot News (Publication of Estate Notice) 96.84 8. Cumberland Law Journal (Publication of Estate Notice) 75.00 TOTAL (Also enter on line 9, Recapitulation) $ 3,595.65 (If more space is needed, insert additional sheets of the same size) . .~- ~''''',.,,'" ~ SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER ESTATE OF VERES. JOHN F. Include unreimbursed medical expenses. ITEM NUMBER 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. AMOUNT 5,837.93 DESCRIPTION First Union National Bank Consumer Loan Erie Insurance (Car insurance) 351.00 Chase Credit Card Accl. #4029-3700-11753023 320.34 Blue Tree Resort Fee 488.49 Mountainside Resort Fees 145.00 Chase Visa 309.89 Water/Sewer - Philadelphia 76.96 Water/Sewer 13.82 First Union National Bank 57.52 Constance Cooper Decedent's live-in companion claimed that $2625.00 was owed to her by decedent for shared living expenses. Decedent's children did not question this amount as they had known Constance Cooper for several years. This amount was paid to Constance Cooper out of the estate account. 2,625.00 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 10,225.95 ,,,,,,,,,, lOW COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FilE NUMBER .~~~~ Inl-lN ~ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not list Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. John A. Veres Son 1/3 2152 Canterbury Drive Mechanicsburg, PA 17055 2. Thomas J. Veres Son 1/3 15 Forry Court Road Lewisberry, PA 17339 3. Karen J. Adams Daughter 1/3 840 Longview Avenue Berthoud, CO 87513 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) ,~ - "....-- ..~ LAST WILL AND TESTAMENT OF JOHN F. VERES I, JOHN F. VERES, of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and revoke any and all wills and codicils previously made by me. ITEM I: I direct that all my just debts and funeral expenses shall be paid from the assets of my estate as soon as practicable after my decease. ITEM II: All federal, estate and other death taxes imposed because of my death with respect to the property forming my gross estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such tax, shall be considered as a part of, the expense o~ the administration of my estate, and shall be paid out of the principal of my estate, without apportionment or right o~ reim- bursement. ITEM III: I give, devise and bequeath all of my estate of every name and nature and wheresoever situate unto my wife, Helen Veres, provided she shall survive me by thirty days. ITE~1 IV: Should my wife, Helen Veres, predecease me, or die on or before the thirtieth day following my death, I give, devise and bequeath all of my estate of every name and nature and and wheresoever situate, in equal shares, to my children, John A. Veres, Karen J. Logan, and Thomas J. Veres, or their issue, per stirpes. ITEM V: I appoint my son, John A. Veres, Executor of this my Last Will and Testament. Should my son, John A. Veres, fail to qualify or cease to act, I appoint my son, Thomas J. Veres, as Executor of this my Last Will and Testament. ITEM VI: I direct that my personal 'representative shall not be required to give bond for the faithful performance of his duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this l day of tAl-) Y , 1980. /' -)" , L:'-J-ti~ 7' /~, Jt, N F. VERES The preceding instrume t, consisting of this and one othe typewritten page, was on the date thereof signed, published and declared by JOHN F. VERES, the testocortherein named, as and for his last will, in the presence of us, who, at his request, in his presence, and in the presence of each other, have subscribed o~vl name~, a~l J' tnesses hereto. 1 ~~ lu~ ~ Residing at - Jl:c~~tfl fL /! 1i1lc jJ~ , <8::, . ( SEAL) ~~/~ 'Mvvu 6~ Residing at . . SS: COUNTY OF DAUPHIN WE, JOHN F. VERES , lIb L'~r1i{d ,ji ILkf)L and fY~ Jk~lj~ , the testator and the witnesses, respectively, whose names are signed to the attached or fore- going instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his last will, and that he had signed willingly and that he executed it 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 that time eighteen years of age or older, of sound mind and und~r no constraint or undue influence. ?1(/?..c/~ Testat r / I I ~)k1c1f,<Ji Witness 1/ ," J0t.-1(.t/"--' H;~Jc~ ~~J.CAb-~ witness Subscribed, sworn to and acknowledged before me by JOHN F. VERES, the testator, and subscribed and sworn to before me by l~~-to( 8~ and Gct-~f'tl- ;4,~~ 6~ witnesses, this 0;11J- day of jJ7a.t_t ' 19 ~. ,J /)n f7 ~(A4.ClrJ'1 (A _ KK/1I.1AdilLt/ - Notary Public . My commissions~ifm,r,;, Hi! . b' AII'MH. Nofary Publle rr/s urg. Dal'rliin Co AMENDED AGREEMENT OF SALE THIS AGREEMENT, made this day of 2002, between JOHN A. VERES, Executor of the Estate of JOHN F. VERES, hereinafter called "SELLER"; and JAMES CLACK, single man, of 609 Comly Street, Philadelphia, P A, hereinafter called "BUYER". W 1 TN E SSE T H: IT IS MUTUALLY AGREED AS FOLLOWS: 1. That the Seller hereby agrees to sell and convey to Buyer, who hereby agrees to purchase certain real property situate at 607 Comly Street, Philadelphia, Pennsylvania. 2. PURCHASE PRICE - The purchase price for said real estate is the sum of TWENTY -FOUR THOUSAND ($24,000.00) DOLLARS, plus Buyer to pay any outstanding and unpaid real property taxes as of the date of settlement. The purchase price is payable from the Buyer to the Seller as follows: Deposit --------------------$ 4000.00 (Seller acknowledges receipt thereof) Balance at settlement ----$20,000.00 plus Buyer to pay all unpaid and due real property taxes as of the date of settlement. TOTAL ------------------ $24,000.00 plus the unpaid taxes. 3, TITLE - Title is to be good and marketable. The premises are to be conveyed from Seller to Buyers by special warranty deed, free and clear of all liens and encumbrances, except unpaid taxes and except restrictions and easements of record, and/or physically noticeable street improvements, if any, and to provisions of zoning ordinances affecting the use of said premises. 4. CONDITION OF PREMISES - Buyers accept the property in its "as is condition", There are no representations or guarantees as to the condition of the dwelling or any systems contained therein. 5. SETTLEMENT - Settlement shall be held on or before February 28, 2002. 6. T AXES AND ADJUSTMENTS - Buyer agrees to pay all real estate transfer taxes, and all county, municipal and school real estate taxes due and owing as of the date of settlement and all sewer and refuse due and owing as of the date of settlement. Cost of preparation of the Deed shall be borne by Seller. 7. TIME OF THE ESSENCE - Time is of the essence. This contract has been negotiated and renegotiated with the decedent and at this time it is imperative that this sale take place and the Estate of John F. Veres be settled. Therefore it is understood that settlement must occur on or before February 28, 2002 with Seller receiving proceeds in the amount of twenty thousand ($20,000.00) dollars on or before that date. In the event that settlement does not take place on or before February 28, 2002 then this contract is void and the parties will rely upon their rights as set forth in previous Agreements of Sale concerning this property. 8. BINDING EFFECT - For the true performance of all and everyone of the covenants and agreements aforesaid, each of the said parties binds himself, heirs, executors and administrators and assigns, firmly by these presents. WHEREFORE, the parties hereto have carefully read and considered this Agreement and, intending to be legally bound thereby, acknowledge receipt of a copy of this Agreement, having hereunto set heir hands and seals the day and date first above written. Witness John A. Veres, Executor Estate of John F. Veres Witness James Clack U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT File Number: 1245 PAGE 2 FINAL L. SETTLEMENT CHARGES PAID FROM PAID FROM 700. TOTAL SALESfBROKER'S COMMISSION based on price $24,000.00 = BORROWER'S SELLER'S Division of commission (line 700\ as follows: FUNDS AT FUNDS AT 701. $ to SETTLEMENT SETTLEMENT 702. $ to 703. Commission paid at Settlement 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee % 802. Loan Discount % 803. Appraisal Fee 804. Credit Report 805. Lender's Inspection Fee 806. Mortgage Application Fee 807. Tax Service Fee 808. Document Prep Fee 809. Flood Cert Fee 810. 811. I 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest From to @$ /day 902. Mortgage Insurance Premium for to 903. Hazard Insurance Premium for to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance mo.@$ /010 , 1002. Mortgage Insurance mo.@$ /010 1003. City Property Taxes mo.@$ 89.70 /010 1004. County Properly Taxes mo.@$ /010 1005. School Taxes mo.@$ /010 1009. Aggregate Analysis Adjustment 0.00 0.00 1100. TITLE CHARGES 1101. Settlement or closing fee 1102. Abstract or title search to CLTIC (P.O.C. ) 150.00 Buver 1103. Title examination 1104. Title insurance binder 1105. Document Preparation 1106. Notary Fees and Services to Clerk 25.00 25.00 1107. Attorney's fees (includes above items No: ) 1108. Title Insurance to Savinas Abstract Company (includes above items No: ) 1109. Lender's Coverage $ 1110. Owner's Coverage $ 24 000.00 - 1111. 1112. 1113. to Underwriter 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees Deed $ 60.00 ; Mortgage $ ; Release $ 60.00 1202. City/County tax/stamps Deed $ 720.00 ; Mortgage $ 720.00 1203. State Tax/stamps Deed $240.00 ; Mortaaae $ 240.00 1204. Registration Fee 1205. Record Assignment 1300. ADDITIONAL SETTLEMENT CHARGES 1301. 1302. Pest Inspection 1303. 1304. BRT #3521493000 2002 & 2002 to City of Phila real estate 2 438.14 1305. 2002-5th cycle water bill to Water Revenue Bureau 38.00 1306. Judgement to City of Phila 1 030.00 1307. 1308. 1400. TOTAL SETTLEMENT CHARGES (enter on lines 103, Section J and 502, Section Kl 4 551.14 25.00 HUD CERTIFICATION OF BUYER AND SELLER ~ Jam~a I have carefully reviewed the HUD-1 Settlemenl Slatement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify that I have received a copy of the HUD-l Settlement Statement. a;!~ Estate of John Frank Veres ",~Q.\) -'-<- WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY StMlLAR FORM. PENALTIES UPON CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT FOR DETAilS SEE TITLE 18: U.S. CODE SECTION 1001 AND SECTION 1010. The HUD-l Settlement Statemenl which t have prepared is a true and accurate account of Ihis transaction. I have caused or will cause the funds to be disbursed in accordance with this statement. ByJ~ 6Ju' S-3-{) 7- DATE TitleExpress Settlement System Printed OSf03f2002 at II: 16 REV. HUD-I (3/86) A. Settlement Statement U.S. Department of Housing FINAL OM N 5 65 B. Type of Loan and Urban Develooment B o. 2 02-02 1. DFHA 2. DFmHA 3. DConv. Unins. I 6. File Number I 7. Loan Number \ 8. Mortgage Insurance Case Number 4. OVA 5. DConv. Ins. 1245 C. Note: IS torm IS turn.s eo to give you asia emem 0 ac ua selllemenl coslS. Amoun s palo 0 ana oy me selllemenl agem are snown. Items marked "(p.o. c.)" were paid outside the ctosing: they are shown here for informalion purposes and are not included in the lotals. WARNING: 1\ is a crime to knowingly make false statements to the Uniled Slales on Ihis or any olher similar form. Penalties upon conviction can include a fine and imprisonment. For details see: Title 18 U. S. Code Section 1001 and Section 1010. D. NAME OF BORROWER: James H. Clack ADDRESS: E. NAME OF SELLER: Estate of John Frank Veres ADDRESS: F. NAME OF LENDER: ADDRESS: G. PROPERTY ADDRESS: 607 Comly Street, Philadelphia P A 19120 Philadelphia City H. SETTLEMENT AGENT: :Savmgs Abstract Company, lelephone: LD-)/o-::;'l54 Fax: L.15-Y/o-)~j4 PLACE OF SETTLEMENT: 501 Washington Lane Suite 201, Jenkintown, PA 19046 I. SETTLEMENT DATE: 05/03/2002 J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION: 100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER: 101. Contract sales orice 24 000.00 401. Contract sales price 24 000.00 102. Personal PropertY 402. Personal PropertY 103. Settlement charoes to borrower (line 1400) 4 551.14 403. 104. 404. 105. 405. Adiustments for items paid by seller in advance Adjustments for items paid by seller in advance 106. Cjtv/town taxes 406. Citvllown taxes 107. Countv taxes 407. County taxes 108. School Taxes 408. School Taxes 109. Water Sewer Adiustment 409. Water Sewer Adjustment 110. 410. 111. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER 28 551.14 420. GROSS AMOUNT DUE TO SELLER: 24 000.00 200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER 201. Deposit or earnest money 4 000.00 501. Excess De DOS it (see instructions) 4 000.00 202. Principal amount of new loans 502. Settlement charges to seller (line 1400) 25.00 203. Existinllloan(s) taken subiect to 503. Existinllloan(s) taken subiect to 204. Funds brought to closino 504. Payoff of First Mortgage Loan 205. 505. Payoff of Second Mortoaoe Loan 206. 506. 207. 507. 208. 508. 209. 509. Adiustments for items unpaid by seller Adjustments for items unpaid by seller 210. Cjtv/town taxes 510. Citvltown taxes 211. Countv taxes 511. County taxes 212. School Taxes 512. School Taxes 213. Water Sewer Adi. NONE 513. Water Sewer Adj. NONE 214. Buyer Davs 2002-6th water bill 514. 215. Water Readina 186 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY/FOR BORROWER 4 000.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 4 025.00 300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER 301. Gross amount due from borrower (\jne 120) 28 551.14 601. Gross amount due to seller (line 420) 24 000.00 302. Less amounts oaid bY/for borrower (tine 220) 4 000.00 602. Less reduction amount due seller (line 5201 4 025.00 303. CASH FROM BORROWER 24 551.14 603. CASH TO SELLER 19.975.00 SUBSTITUTE FORM 1099 SELLER STATEMENT: The infonnationcontained herein is important tax infonnation and '.S being furnished to the Internal Revenue Service. If you are required to file a return, a negligence penalty or other sanctIOn will be Iffiposed on you W thIS .tem .s reqUired to be reported and the IRS determines that It has not been reported. The Contract Sales Price descnbed on line 401 above constitutes the Gross Proceeds of this transaction. SELlER INSTRUCTIONS: If this real estate was your principal residence. file Form 2119. Sale or Exchange of Principal Residence. for any gain, with your Income tax relurn; for other transactions. complete the applicable parts of Fonn 4797. Fonn 6252 andlor Schedule 0 (Form 1040). You are required by law to provide the seltlemenl agent (Fed. Tax ID No: 233056520) with your correct taxpayer identification number. If you do not provide your correct taxpayer identification number. you may be subject to civil or criminal penalties imposed by taw. Under penalties of perjury, I certify that Ihe number shown on this statement is my correcl taxpayer identWication number. TIN: SE~LER(S) SIGNATURE(S) 8 0.. \).o.r" ~ , I SELLER(S)NEWMAILtNGADORESS -z.)~"2- C a \,\e..... ~ 'C)I 'be. }VJe r ),.~.):::6 , ") I () r-Y- TjtJeExpress Settlement System Printed 05/0312002 at II: 16 REV. HUD-I (3/86) F~N. Reference ID: 205004 First Union National Bank Attn: Account Verifications POBox 40028 Roanoke VA 24022-7313 October 17,2001 R MARK THOMAS AITORNEY AT LAW 101 SOUTH MARKET STREET MECHANICSBURG, P A 17055-3851 SUBJECT: Verification / Confirmation of Account and Balance Information provided for: JOHN F VERES (SSN# 177-20-6883) Date of Death: September 22, 2001 Deoosit Account Information Account Account Date of Death Average Date Maturity Interest Accrued YTD Date Type Number Ba]ance Ba]ance. Opened Date Rate Interest Interest Paid Closed CHECKING 101413347]546 $223.84 7/30/1996 NA LEGAL TITLE: JOHN F. VERES SAVINGS 3000402747971 $6.46 4/1/1981 $0.00 $0.05 LEGAL TITLE: JOHN F. VERES · Due to system limitations, we can only provide a twelve month average balance on depository accounts. Loan Account Information Account Type CONSUMER LOAN LEGAL TITLE: JOHN F. VERES Account Number Date of Death Ba]ance Original Amount Date Opened Monthly Interest Times Payments Rate Late Terms Due Date 08900266632 $6,238.] I 4/10/] 998 Other Account Information Account Type Account Number Date of Death Balance Date Opened Date Closed Title(s) SAFE DEPOSIT BOX 0758510900]01 2/111988 SOPHIE VERES JOHN F. VERES LOCA TED AT: 595] RISING SUN A VENUE PHILADELPHIA PA ]9120 PHONE 2] 5-725-6226 001032 F~N' Reference ID: 205004 .. Date of death balance does not include accrued interest. .. If date of death occurrs on a weekend or a holiday, date of death balance does not include any transactions that were made during that time period. October I 7, 200 I Date Julia Sorrells Depository Representative Servicenter Associate Title (540)563-7323 Phone Number sss; ses 001032 -~1 11:45 PAX 717 975 4138 PAM & EMP SRVCS Sep. 28 2001 1~: 3~AM P2 FROM : S01[:J;;NFELD MORTUARY FAX NO. :970 725-3314 ~02 Sche.n-r.14 Mort"...,. 204 Byet& Av_n",.. P.O. lox 215 Hot SUlphur spn"p. Colorado so.M1 (970) 72&.3313 DATE Septem~..72, %OOJ _ ..___. SERVIce NO CI-I032 DECEAS~o NlWt; .John "Fntok Vel"ell DATE OF OEAT~ Sept~mber 2:1, Z001 _ PLACE OF DUTH Cranby Mrdi~l Centn. Gran,by~ CO . GIIerun ste Oll/y Ibl' ltI~e ~ ffwlr you~" tN r/lfII""'~, 11_.... __ toy,....*' ~ My JlfJntII. we-"'" flxprairr m ~ tIeIDw. rryou ~1OeI&1l a ~I """1C!'1 requinld embB/miIl9, $lICIt iJ$ Ii frlr1f!(a/ with w.e~_ ytN FIfiifY"ave 10 pay lOt ~rmmg_ YOIJ ~ "~ /1<1..... ... p.., ror ttmtHt/TtWIr; 1f'U (/ftJ II/lr ~ve if)'OO _'A~1Id' "".ngeroef1$ "1IlOh .... air~ cret1liJI/tJfIClr irrrmediIIle /)",(/tI( " tor _ wr1f Pi If! ~.......... &.9v, STATtEM~ OF FUNeRAL GOODS AND SlERVlCES SaECTED ",'u"..un- C;W CJMRCI'-C;:: A. O'AIlr.T.!I> fl'nR lI;l':llV1~"-'.. .. .. . .. .. _ ... , .. . . ,. S B. (~f_" !ttoES ';OJ( ~"..Rr:...v.'D''''F. . . . .' . . . - ,.. .. . . .. $ C ~1:Cf.""L C"tl,~RC".jl... --.. -. ,...... .. --... --... $ D. C.A.OllII ADV.\NO.!l. - . . . - . . . . . . . . . . - . .., . .. . . . , . . ~ 1'. !l:",I_~~'" 'rAI(, IF A\"t'I.JC:A.I..~. -..... .. . , . . . . , . . .. ,. TOT"" \, l'UNE'RA1. nOME CHARGES LJ l~~ C;"F.DfT1'> AND PIlf':P. "MF-NTS", P,\ril AT TI~.: 01' ARJL\l\OG".A1ICNTIli. .. . . . '" ." .. .. $. . . .. . . -- -.. . - . -- --. . - . -- . -' -- . . .. . , - , , . . - .. --. . ... $ . --,."...........- --... --.. -- --. --......,...... -- $ '1"Ql'.\I.C1lf.DlT APPLlr.~.U: $ TOT ~L 8" ~/lICf.: !)lIE. .. . . .. . . . . . .. . --.. . .. S If My /iW, ~ ," ~~ rt'quinmlOIll$ /l;JwtJ mquif'Od fiN J1U~;J:;U pf II"" or _ iIltms 1isl~ ltl1o>'e {'IO """ rN' ,.,,,UI""""'" ~ lKp{>>iMII /1Q(fNtI. Thp,' Qfl~ wamlllly an rhe ~I ~o'J$r 00ria1 ctmftJinw 1iDlf1." CDMrt:1/Ofl wittl /lI,$ Se<WCs 41 me erpren __It owmonIy. if allY. oran/ed by tile mad<lQ~ ~ funtlr8r 1101110 mtlkes (10 W8fl'eIIIY. ~ptrR1; or implied. with ~/ 10 1M tiiiilSkt# iIIldAJr otJIp, lIurllll CI01'falmlr. BMIlngTO . John A. "EI~e 21.5:2 Canterpuzy D~;i.v. uMechani.eebur.". i>A. j,,"f055 ) 1lOr-el'W ~ree lhIIt I nINe 1!1IIl~",", tlv! sbove-51BIed .m~ aftd found....m 10 'Do! """""" _ ~ tv III-cl a..anoon1etlls 1"Illqu_. ant! I hQfQlrr :acknawlBIIJ;lO ,,,,,"",,I "I a rop; or ltlls mt/l'lorBnd:;lm Bl1d agreemer<t I ~fI!Ilresenllhatl ha.... stJ!llel..-.t funds.nc1 u~s logally:waUIIllIO ror ~~monl.of~1'I pri<:ttaM "".,,~ lICI_.ftd cowenlImJol"tIY alld !leYel8\1Jl tel lNIIle peymomt af$2. H!d!1I WII!1Irt 30""". A brv ""~ DI 1 SO'" ~r..._ .",....l'Ifino ~ 1i.llO% per ye....l:s .."lIfJIIoIl<lll'\4l u"lHIicl b..'1\'MCe ~nlng $0 d'W!l from ,he dele ct lhi5 aCrrllllmf!nl. Arrt addiOOlOal ~ Qr "",1d1.,diso ood<InIO eo- ..,.,..e"OlI ~Ror 11'10 cIa1IQ gf 11'IiS ~"t """I be ......Ml..-G pert o. lh1!18gr_nt and the eo&t thenlOf will boI ...."BClOd an ~!INII s_~ I a,,*-n~~ tl>.at I 1\;0"., .....,.,1VOd Ill. 1l_:Illll'iGO list :wid havo boon 0_11 fOr rOVl_ 'i. QI!\~_ enrl1M \j'"lK.Irii!ll """"i!liner price 1Il!1. SIA"" (f r-yr~ Q \. ~ ~."_"'IO ~ed ~~~~-- '- ~~---~ i\. ('"H^RGE FOll "i:Il"I(:t;.~ 1. 'RO'mzO~^L PAO'.ITIF:S,IIIMI A.trTOMOTI\"!: Oil'e9t C~on... - ....... ...., , .' S _~"711S.00 SI'lI~ingofCremalf\&.. . .,.. -.., _. S ~O,.OO S ~ S .. ..._ S S S __ s $ $ S S S $ '.f. ~ C. 5PJ;(';IA.. {:1t'AflGf'.5; lor df!IJili"",,[ ..""r~s) Qwmigftt "!&ilinJl c;t-Iarges . . , . . . . ) $ lc~rt~~~ed CCpieA $ $ S $ J i S $ TO't.d. 01' !i1F:("r~~. IInnAr. CHAICMr.'; p, (;';\$" ,\D'....NC..._~: Cert. CopieIi; 1@S1S.00. 190$6.00 s I,au.cO ! ,; 31 $ $ $ $ $ .$ !i t. ~ TOTAL OF W..cnON n. c ~~1 ^DV ANCr.~ TOT.". n.' 1lt'.lTJON "'. "ravu:'"... R. (:HAKljr; ,"Uft MJ;KCIl,~NJJtSl-: C'lk.t . -..."...........".- " $ e uri",1 Vault: ............... . . . - . . . 5 U"'t1 Ooclge St01'\8Wllfll IIrOlM'l Hammel't8Jrt . - S $ I" S S S S S S I Hi..QO TOT"'.()"'SL':(~TI(l'" u. M~:llCfL'NDI5>f: l.?!I.flo s Rea!Ol\ for tmllIImiolu ~o J~mba1aina Requ8sted ~..."'ip ~ ~ Hu SEP.28'2001 12:~7 RECEIVED FROM: 7179754138 12.45 l 12.4.5 l??!I!l. $ 12!l.OO ~,1l46_00 1.15.00 12..5 . i29'.00 l:i.'3 Z;~7~:~11 0.00 2,].'75.28 Inltlel.. #0788-002 RECEIPT FOR PAYMENT ------------------- ------------------- Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Receipt Date 10/05/2001 Receipt Time 14:38:11 Receipt No. 1027073 VERES JOHN F File Number 2001-00920 Remarks JOHN A VERES DO ------------------------ Distribution Of Receipt ------------------------ Transaction Description Payment Amount Payee Name PETITION FOR PROBA SHORT CERTIFICATE EXTRA PAGES JCP FEE 70.00 24.00 6.00 5.00 CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN BUREAU OF RECEIPTS & CNTR M.D Check# 4784 Total Received......... $105.00 $105.00 RECEIPT FOR PAYMENT ------------------- ------------------- Cumberland County - Register Of wills Hanover and Hiqh Street Carlisle, PA 17013 Receipt Date Recetpt Time Recelpt No. 5/02/2002 11:45:26 1029213 VERES JOHN F File Number 2001-00920 Remarks R MARK THOMAS, ESQ AC ------------------------ Distribution Of Receipt ------------------------ Transaction Description Payment Amount Payee Name SHORT CERTIFICATE 9.00 CUMBERLAND COUNTY GENERAL FUN Check# 4264 Total Received......... $9.00 $9.00 "- ~ ). .s~\~ '\' "'-I . ~\ ~.~~ ~ :\ <~~~\ aL~ .- o(J I \'-- \ "'-.. 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'.! ~\ ~ ~ ~j .J' <-'.J ~ ! ~ ': i ,. \ ,iii \.....v\ ~ "'-l Ii '~I ",'Y, -J ~ ~ i ! l'Y _I , I \ y oj -:> ~ , \ ::J\ i ':..:; I ~ ~ --.. 1 -~\ 0>1 ~" i ''j.. ~l ,"~I -.....:: '''4 " ~ .- ."", ...; '-.:; ~ "" ..... ~ r~ (~ ~ '::::J ~<o "'" '0 ~ ,~ ~ \\, ~ ~'" '~ '}.... .J ~) ,. ~ ; \,,\" ",j1 u\ .), \ ~\ ,~\ . \ (~\ .~ ~.. '-' '(,s- \ 1'(',\ .~ ~ 1,,,,-1 l...'\ ""'-' 'VI J '~:. "\' !'f-" ...........i . I \'~ IIC\ r 1'("-..1 i J \ ~ \ I .{- i~')~~ '. I IX! \./ I \ I I I \ ~ J i i I \ I q : I , I : ' ! 'I:-. I I I ~ \\ \ ~~\ i - ~! : K i ,~\ ,~ I ~ I -...-N-. I I ' ".......1 ~I~ ! ~ \ ~I : Li d \ . I 'U ! ~l'~ I ~ ,- ~I~L ' L-:::,--i--_L~ __.--=-~---t---~~' } '--=. 0. J. -1-- "." I --sr---i. j~1 .r i '~\'::l I ~~\ !~' I i ~ c~ . '~ 'I' <i" : "'<'" \ i" ~,..r0.> \::-. '::, '" ,I \ ~ i i.. ~i- "'\ i;-j , , ';",'''' ('1\) ~~ j\ \ .)\ l~\ \ ~~1~' . ='1 >'::>1 \~~ \ ~ \ ~ i 1 ) I ! i j I . ' -H "'\ . [~. i i I i I ! I I i . 1 I I \ I ! ; \ \~ , "" \~ I ,'-.; l~ \. '~. i ~ \~ i ~\ i '1'. t . ~~ ''1 \ ~ ~ k I I ~\ '\;;\ \ i , I A....\ ~\ \ i ~ ''J ! !~\ , " i .~!\ d(i ~i \ I I I I ! i I i I I \ i i " .J i'" j---~ ~ \7J ,~\ \ i." ~I''-.l ........ - ! .~.\ ~ l-. !,,'" ' ~ .~ ~\ ''*- ,.",~ "J 1 ~" i' .:.r~ .-(:! V ~,'oJ I ~I \ -..J '\\ V I t'~ '1 """'" "'-...! ~I..\ , . I, i, I \ I ,,-~ \ "'-'l i _\'\'\ \ ~ ..\ N" ~ l~ .~ i~. ~ ....., ~\ ,I \." . ~~\ ~,' ~\ "<.1 'i i ^'-...-I ~---'\. t '-..J I ~\ 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 THOMAS R MARK 101 SOUTH MARKET STREET MECHANICSBURG, PA 17055 -------- fold ESTATE INFORMATION: SSN: 177-20-6883 FILE NUMBER: 2101-0920 DECEDENT NAME: VERES JOHN F DA TE OF PAYMENT: OS/28/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 09/22/2001 NO. CD 001220 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $704.51 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: R MARK THOMAS ESQUIRE CHECK#1629 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $704.51 MARY C. LEWIS REGISTER OF WILLS 11-/c:::.. - -'/ '''v BURE"~ OF INDIVIDUAL TAXES INHERl NeE TA~ DIVISION OEPT. '80601 HARRISBURG, PA 17128-0601 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 7COUNTY ACN R MARK THOMAS ESQ 101 S MARKET ST MECHANICSBURG PA 17~5 . ,t 07-08-2002 VERES 09-22-2001 21 01-0920 CUMBERLAND 101 '* REV-1547 EX AFP (01-02) JOHN F Allount Rellitted U) (2) (3) (4) (5) (6) (7) 19,975.00 .00 .00 .00 9,502.30 .00 .00 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'; i5'4-j-E3f-AFP-foY:02Y-NOTicE--OF-YNHEififAifcrTAx-jrpPRAysEirENT:--ALi-owAi.fcE-cfi-------------- - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF VERES JOHN F FILE NO. 21 01-0920 ACN 101 DATE 07-08-2002 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE 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 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: If an assessment was issued previously, lines reflect figures that include the total of 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 TAX CREDITS: (9) UO) 3,595.65 7.600.95 (8) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 29,477 .30 11.196 60 18,280.70 .00 18,280.70 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = 18,280.70 X 045= .00 X 12 = .00xI5= (9)= .00 822.64 .00 .00 822.64 ......... l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-28-2002 CDOO1220 .00 704.51 INTEREST IS CHARGED THROUGH 07-23-2002 TOTAL TAX CREDIT 704.51 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 118.13 REVERSE SIDE OF THIS FORM INTEREST AND PEN. .60 TOTAL DUE 118.73 (11) (2) (3) (14) · 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) I YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December lZ, 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z3 of ZOOO. (7Z P.S. Section 9140). Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the Z3 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and I or speaking needs: 1-800-447-30Z0 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 171Z8-10Z1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administrativelY correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOZ are: Year Interest Rate Daily Interest Factor Year Interest Rate Da ily Interest Factor 198Z ZO% .000548 199Z 9% .000Z47 1983 16% .000438 1993-1994 n .00019Z 1984 11% .000301 1995-1998 9% .000Z47 1985 13% .000356 1999 n .00019Z 1986 10% .000Z74 ZOOO 8% .000Z19 1987 9% .000Z47 ZOOl 9% .000Z47 1988-1991 11% .000301 ZOOZ 6% .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. REV-1470 EX (6-set . I '*' INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME John F Veres FILE NUMBER Deborah Washington ACN 2101-0920 101 REVIEWED BY ITEM SCHEDULE NO. EXPLANATION OF CHANGES I 10 The deduction claimed for reimbursement has been disallowed. No evidence of a written contract of indebtedness between decedent and claimant was submitted. ROW Page 1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 2B0601 HARRISBURG, PA 1712B-0601 REV-1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT THOMAS R MARK 101 SOUTH MARKET STREET MECHANICSBURG, PA 17055 ______n fold ESTATE INFORMATION: SSN: 177-20-6883 FILE NUMBER: 2101-0920 DECEDENT NAME: VERES JOHN F DA TE OF PAYMENT: 07/26/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 09/22/2001 NO. CD 001448 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $118.73 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 5215 SEAL INITIALS: AC RECEIVED BY: REGISTER OF WILLS $118.73 MARY C. LEWIS REGISTER OF WILLS 1~ STATUS REPORT UNDER RULE 6.12 BEFORE THE REGISTER OF WillS, COUNTY OF CUMBERLAND , PENNSYLVANIA Name of Decedent: JOHN F. VERES Date of Death: 9/22/2001 File No. 2001 -920 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to the 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: t~, i l. 3 If the answer to NO.1 is "Yes", state the following: a. Did the personal representative file a final account with the Court? t.>,'; 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: ~ . /~ .;!{)o.3 ~J~ Signature R. MARK THOMAS Name (Please type or print) 101 S. MARKET STREET Address MECHANICSBURG PA 17055 717-796-2100 Tel. No. Capacity: Personal Representative X Counsel for personal representative \.-1-')-/.:; - ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-IU7 EX AFP lDI-D2l R MARK THOMAS ESQ 101 S MARKET ST MECHANICSBURG PA 170S5 ( DATE ESTATE OF DATE OF DEATH FILE NUMBER I ,COUNTY -" ACN 08-26-2002 VERES 09-22-2001 21 01-0920 CUMBERLAND 101 JOHN F Allount Rellitted ~' '. MAKE CHECK PAYABLE AND REMIT PAYMENT TO: 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 =i6cfj-Ex--AFP--("oY:02Y------...--iNifiRITANCE--;:AX--Si'7rfEMEN;:-O-F-AC-COLitff--.-..---------------- -- --- ESTATE OF VERES JOHN F FILE NO.21 01-0920 ACN 101 DATE 08-26-2002 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: 07-08-2002 P R I NC I PAL TAX DU E : ........................................................................................................................................................................................................................... 822.64 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-28-2002 CD001220 .00 704.51 07-26-2002 CDOO1448 .60- 118.73 TOTAL TAX CREDIT 822.64 BALANCE OF TAX DUE .00 INTEREST AND PEN. .06 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .06 IE 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 PAVMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. If RESIDENT DECEDENT make check or money order payable to: REGISTER OF WILLS, AGENT. I f NON-RESIDENT DECEDENT make check or 1I0ney order payable to: COMMONWEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13l3). Applications are available at the Office of the Register of Wills, any of the Z3 Revenue District Offices or from the Department's Z4-hour answering service for forms ordering: l-800-36Z-Z050; services for taxpayers with special hearing and I or speaking needs: l-800-447-30Z0 (TT only). REPLV TO: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessllent Review Unit, Dept. Z8060l, Harrisburg, PA l7lZ8-060l, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (57-) discount of the tax paid is allowed. PENALTY: The 157- tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of paYllent. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (67-) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Departllent of Revenue. The applicable interest rates for 198Z through Z002 are: Vear Interest Rate DailY Interest Factor Vear Interest Rate Daily Interest Factor 198Z Z07- .000548 199Z 97- .000247 1983 167- .000438 1993-1994 n .000192 1984 117- .000301 1995-1998 97- .000Z47 1985 137- .000356 1999 n .000192 1986 107- .000Z74 ZOOO 87- .000219 1987 97- .000Z47 ZOOl 97- .000Z47 1988-1991 117- .000301 ZOOZ 67- .000164 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If paYllent is made after the interest computation date shown on the Notice, additional interest must be calculated.