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HomeMy WebLinkAbout01-0949 OCT. 15.2001 1:16PM 717 7638293 CRRIG R DIEHL ESQ NO.733 P.l/2 Law Offices of Craig A. Diehl 3464 Trindle Road Camp HilI, Pennsylvania 17011-4436 Telephone (717) 763-7613 Telecopier (717) 763-8293 FACSIMILE COVER SHEET In Spring Grove, Pennsylvania 119 West Hanover Street Spring Grove, PA 17362 Telephone: (717) 225-1929 Craig A. Diebl, Esquire. C.P.A. Linda A. Clotfelter, Esquire DATE: TO: October 15, 2001 Sue COMPANY: Register of Wills FAX NUMBER: FROM: 240-7797 Craig A. Diehl, Esquire We are sending a total of 2 pages, including this cover sheet. If you do not receive the indicated pages, please call 717-763-7613. For your information, ourfax number is 717-763-8293. Thank you. RE: ESTATE OF LAZENA O. COLE Additional Comments: Original Documents will not follow by U.S. Mail. OCT. 15.2001 1:16PM CRAIG A DIEHL ESQ NO.733 P.2/2 Law Offices of Craig A. Diehl 3464 Trindle Road Camp Hill. Pennsylvania 17011-4436 Telephone (717) 763-7613 Telec:opier (717) 763-8293 Craig A. Diehl, Esquire, C.P.A. Linda A. Clotfelter. Esquire In Spring Grove. Pennsylvania 119 West Hanover Street Spring Grove, PA 17362 Telephone: (717) 225--1929 October 15. 2001 Attn: Sue Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Attn: Estate of LaZena D. Cole Dear Sue: This letter serves to confirm our telephone conversation authorizing modification of the Petition from Letters of Administration c.t.a. to Letters of Administration. Further, modification of the Estate Information Sheet to make it consistent with the contents of this letter is authorized. Sincerely, CMtJ A.fd,~/~ Craig A. Diehl, Esquire CAD:her Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS ~ AIMINISTRATION C.T.A. Estate of LaZena D. Cole No. ;;. J..O J - qt.{ q also known as Lozena D. Cole Lazena D. Cole L":ll.IIA t- Celt e.~ ~tacey C. Tormollan CtlOne'1I), who i1/aJa 18 yaa.ra of ~ Of O~,IWIy(_) b: (COMPLETE 'A' OR 'S' BELOW:) o A. Probate and Grant of letters Testamentary and ayer ht PetiDonertl) Ware the eno.rt _name-d WI the Il.It Wil of . Deceased Social Security No. 201- 28 - 5 91 0 lhe Deoeden I. da led and codici~l) da>>d ~....... dtc..wra~.~~. clecII GlueaAaf, eIC. Except as fonowl, Decedent dd not malT'(, WIll not divoro&d, and cid not haw a child born or adopted attar eXea.Jtion of the documents oHered for probata; was not the victim of a kJlling and was never adjvdc:ated incompetent: !ill B. Grant of letters of Administration e. t. It. (d.J>.1\.L.I..&.; __ he; dural'll. -.n:1a: du<anle rnt'oClttAOe Petitionertl) after a proper search halhlaye ascertained that Decedent leh no Will and waa Il.I'\Iived by the following lpouse (If any) &"\d heirs: I Name ReIa tionship Residence 1 Jacqueline H. Eleuteri Daughter 653 Spring Lane n7\ 17(\(\ Ip'nilinrr c..........~~- po ~G)l. .-:: .~_ --::T Bradley D. Cole Son l~t\{C; N /';"II~,_; 04 q~ Stacey C. Tormollan Daughter 31 Messalonskee Avenue Waterville, ME 04901 7 ~/r (COMPlETE IN I>J..l CASES:) An.adl addDa'l&I aheetl it n.ceuary. DecOOent was domiciled at death in Cumbe rland County, Pennsylvania. with hilhl8l' lut family or principal ruidenoe at 30 Circle Drive, Camp Hill, FA 17011 (East pennsboro Twp.) (41 IUHI" numb<< and tnU'liopaJity) Decedenl.then 82 yellTSolage,ded October 9 .~20011lf her residence ( l.o<:aIion) Decedent at death owned property with ntimated value. u tollowt: (II domiciled WI PAl AD ~nal property (II not domiciled in PA) Personal property in Penn.ytvanla (11 not domiClled n PAl Personal property In County Value 01 real eslB18 WI Penn.ytvania 400,000.00 s S $ $ 100,000.00 sitlJa led u tonowa: 30 Circle Drive, Camp Hill, PA 17011 Wherefore, Petitioner(l) respectfuny requell(l) !he probata 01 the last Will and CodiCll(l) presented with this Petition and the grant of Iel18rs in the appropria18 form to the undersigl'led: Onted name and residence "- Stace C. Tormollan 31 Messalonskee Avenue Waterville, ME 04901 FOt1TI.RW., Paoe' of 2 Pr~ed by \tie ParvuytvanLa Bar Auocialion 1W1 /7 -/~ -..." Oath of Personal Representative Commonwealth of PennsylvBnLa County of Cumberland The Petitioner(s) above-named sv....ear(s) or affirm(s) that the statements In the foregoing Petition are true and correct to the best of the knowledge and be~e! of Petitioner(s) and that. as personal representative(s) of the Decedent, Petitioner(s) v/ill well and truly admnister the ~ale according to law. Swom to or affirmed and subscribed ffiUX.'1 ( (;~~ stacey C. Tormollan before me this 15th day 01 October No. 21-2001-0949 Estate of IaZena D. Cole, a/k/a Lozena D. Cole, a/Kia Iazena D. Deceased a/k/a . Cole Lozena F. Cole Social Security No: 201- 28 - 5 91 0 Date of Death: Octobe r 9, 2001 AND NOW. Octn~r 1 t)th ,2Ul 2001 , In consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, rT lS DECREED that letters 0 Testamentary ~ Of Administration C. T .A. ~;~ lIa;durame ~ d...",. ~ are hereby granted to stacey C. Tormollan in the above estate and that the Instrument(s) dated N/A described in the Petition be admitted to probate and filed of record as the last Will of Decedent. Letters ..................... $ 340.00 Short Certificate(s) .10 $, 30.00 BOND 15.00 Renunciation ....h...... $ 10.00 Nfidavits ( ) ......--... S Extra Pages ( ) ......... $ Codicil...................... $ JCP Fee ................... $ 5.00 Inventory .................. $ Other ....c.opies........ S.J...oo r.F1Rh At1orney: Esauire FEES LD.No: Addre..: 3464 Trindle Road Camp Hill, PA 17011 Tolephone: ( 717) 763-7613 TOTAL ._........... $ 401.00 Fom\.RW.1 Paoe 2 of 2 Prepar~ by 1M PennsylvaniA 8M ,..tooO"lIon 1001 LETTERS WILL BE PICKED UP BY EXECUTRIX 10/15/01 OFFICE OF THE CORONER MICHAEL L. NORRIS CORONER 6375 BASEHORE RD, SUITE I MECHANICSBURG, PA 17055 PHONE 717-766-6418 FAX 717-766-6419 CUMBERLAND COUNTY 12 October 2001 21-2001-0949 TO WHOM IT MAY CONCERN: The original death certificate for Lozena F. Cole also showed an alias for the same person of Lazena D. Cole. This alias does not show on the certified copies of the death certificate but is on the original signed by me showing these both to be the same person. ~-::r Michael L. Norris RENUNCIATION 21-2001-0949 InReEstateof LaZena D. Cole, a/k/a Lozena D. Cole, a/k/a Lazena D. Cole a/k/a Lozena F. Cole deceased. To the Register of Wills of Cumberland County, Pennsylvania. The undersigned Bradley D. Cole, son of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters of Administration be issued to Stacey C. Tormollan WITNESS my hand this day of October ,1f~ 200.1 S1vom to .n~ SubsC3~ before me "'~dayOf Wlfbo\ c~ tv<3T4-tL'( P vB U L PI by I r~c;q ;1/ !lu/~W()4 j C4 I (Address) '7 ( C, IS- ~ ---.- (Signature) NOTARIAL SEAL HELEN ,E. RASMUSSEN, Notary Public Camp HIli Borough. Cumberland County I My Commission Expires Aug. 2, 2003 (Address) (Signature) (Address) RENUNCIATION 21-2001-0949 In Re Estate of LaZena D. Cole, a/k/a Lozena D. Cole, a/k/a Lazena D. Cole, a1kta Lozena F. Cole deceased. To the Register of Wills of Cumberland County, Pennsylvania. The undersigned Jacqueline H. Eleuteri (daughter) of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters of Administration be issued to Stacey C. Tormollan WITNESS my hand this I:l-'I-L day of October , ~ 2001 Yh~~:~ Sworn to and Subscribed before me tnIlS~ciaYOf ,OcllJher lJI.J.QDt Jacqueline H. Eleuteri 653 Spring Lane Boiling Springs, PA 17007 (Address) /---~ ~~ (Signature) -- N6f4jl.Y pv 3/-fC - [NOTARIAL SEAL HELEN E. RASMUSSEN, Notary Public Camp Hill Borough, Cumberland County My Commission Expires AUQ. 2, 2003 (Address) (Signature) (Address) " 21-2001-0949 BOND Bond #B159491 . REGISTER OF WILLS OF ClImnprl Ano COUNTY BOND AND SURETY FOR PERSONAL REPRESENTATIVE KNOW ALL BY THESE PRESENTS, That Stacey C Tormollan 31 Messalonskee Ave, Waterville, ME 04901 as principa1(s) and Selective Insurance Company, 40 Wantage Ave., Branchville, NJ 07890 as surety (sureties) are held and firmly bound unto the Commonwealth of Pennsylvania in the sum of Eight hundred thousand dollars ($800 ,000) to be paid to the Commonwealth, for which payment we do bind ourselves, jointly and severally, our heirs, executors, administrators and successors, the condition of this obligation being that if Stacey C Tormollan as (state fiduciary capacity) Adm in is t rat 0 r of the estate of Lazena D Cole / Lozena F Cole , deceased, or any of them, shall well and truly administer the estate according to law, then this obligation shall be void as to the personal representative or representatives who shall so administer the estate and his or their surety or sureties; but otherwise it shall remain in full force. Signed and sealed this t w elf t h day of Oc tober {CP9 2001 , each intending to be legally bound hereby. I~ (1~ Stacey C Tormo t\.lM",,~trJv/" (Seal) dmil1istrator J . (Seal) A t ~r:: r~ey- In-1".e.c t ~(Scal) (Seal) (Seal) SdNSURANCE eCtIVe Selective Insurance Company of America 40 Wantage Avenue Branchville, New Jersey 07890 973-948-3000 f POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the Selective Insurance Company of America, a New Jersey cor- poration having its principal office in Branchville, State of New Jersey, pursuant to Article VII, Section 13 of the By- Laws of said Company, to wit: "The Chairman of the Board, President, any Vice Presidents or the Secretary may, from time to time, appoint attor- neys in fact, and agents to act for and on behalf of the Company and they may give such appointee such authority, as his/her certificate of authority may prescribe, to sign with the Company's name and seal with the Company's seal, bonds, recognizances, contracts of indemnity and other writings obligatory in the nature of a bond, recognizance or conditional undertaking, and any of said Officers may, at any time, remove any such appointee and revoke the power and authority given him/her. does hereby make, constitute and appoint PATRICIA K ARBEGAST, DAVID W. HOPCRAFT, JEFFREY L SCOTT its true and lawful Attorney-in-fact, to make, execute, seal and deliver for and on its behalf, and as its act and deed, bonds, undertakings, recognizances, contracts of indemnity, or other writings obligatory in the nature of a bond sub- ject to the following limitations: NO ONE BOND TO EXCEED ONE MILliON DOLLARS (51,000,000.00) and to bind the Selective Insurance Company of America thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of the Selective Insurance Company of America, and all the acts of said Attorney are hereby ratified and confirmed. IN WITNESS WHEREOF, the Selective Insurance Company of America has caused these presents to be signed >- by its Vice President and its corporate seal to the hereto affixed this 13TH day of c.... o ~EC~ ~ m ,~, ~ ----~ C.tJ : '5c.r ~~\~ ". u:: BY:. ,....;:, "7" "" 5 St fN J EE Gr~M:';'Jr., esidert" ~ ate 0 . ew ersey 1'1 ...... I,' 926 ,1/ ~ 11 (3 County of Sussex ":\'tJ,\'\.~ ~//I:!i/ On this 13TH day of DECEMBER 1999 befote the subsctibei',iI" No~JZ<<.I,li~te 0 ~ew Jetsey in and fot the County of Sussex duly commissioned and qualified. came F.F. Greaver, Jr, of the Selective Insutance C' an~rTle . on ally known to be the officet desctibed hetein, and who executed the pteceding instrument, and he acknowledged the execution 0 e sam~d bei me duly sworn, deposed and said that he is an officet of said Company aforesaid; that the seal affixed to the pteceding instrument is the COt aid Company, and the said corporate seal and his signature as officer were duly afftxed and subscribed to the said instrument by the authority and direction of the Company; that Article VII. Section 13 of the By-Laws of said Company is now in force, DECEMBER 1999 Selective Insuran e "RESOLVED, the Board of Directors of Selective Insurance Company of America authorizes and approves the use of a facsimile corporate seal, facsimile signatures of corporate officers and notarial acknowledgements thereof on powers of attorney for rhe exec~tion of bonas, recognizances, contracts of indemnity and other writings obligatory in the nature of a bOliO, (t;'cogi'Jizance or conditional undertaking......." I, Parricia A, F'ulkrGtl, 'Assi;l~n' Se~ru.ty of the Selecrive Insurance Company of America, do hereby certify that the above and foregoing is a true and correct copy of a Power 0r At'"mey ~"~c~lted by said Company which is still in full force and effect, IN WITNESS ~.E~~~(I hav~ hereunto set IT)l[ haAd and affixed the seal of said Company at Br~ctivil~N~Jersey this 12 t h dayof OctobeL _ Luu1 , ~ Q_~~ Assistant Secretaty B-91 (10/98) The RED border on the tace of this document has a security VOID background pallern. If it is not RED and the word VOID is visible, this is not a certified copy, Telephone us at Area Gode 973-948-3000. IN WITNESS WHEREOF. I have hereunto set my hand and affixed my official seal at Branchville. New Jersey this day of DECEMBER 1999 , , JUDITH E. CHAMBfRLAIN ~ ' CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: LaZena D. Cole, aJk/a Lozena D. Cole, aJk/a Lazena D. Cole Date of Death: October 9, 2001 Will No. 21-01-00949 Admin. No. To the Register: 1 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 October 24, 2001 Name Address Bradley D. Cole 6924 Teesdale Avenue, North Hollywood, CA 91605 Jacqueline K. Eleuteri 653 Spring Lane, Boiling Springs, PA 17007 Stacey C. Tormollan 31 Messalonskee Avenue, Waterville, ME 04901 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except N/A Date: October 24, 2001 C~,ZJ:vf.f~ Signature Name Craig A. DiehL Esquire Address 3464 Trindle Road Camp HilL PA 17011-4436 Telephone (717) 763-7613 Capacity: Personal Representative x Counsel for Personal Representative * ::10 -l 3' ~ )> ~ 1"'1 ;:: -I . 0 l.JJ "0 ;:: ...... m m l.JJ 3 3 'C 'C is" is" i i C- oo 00 -'= <ii' <ii' " " ~ III ~ C iil iil [):I C- -'= !'b 0 ~ -! c: 0 ~~ 0 ...... 0 ~ ~ U VJ ~~ * Addressee Copy Label 11-8 August 2000 r z o o ~ <' ~ - <fl ~[l 10' )> 3:;:: , -;; ~ m .. " Z .:l o N !" ':J "0 ;:: to-' , .. % o Z m ~u )> '" 'p, III 0 . Cl"< o c: " ~ LJ Cl w o ' Q, 0. m 0 ~ Cl o o "Tl ~ ~ L .J J r , I :ll ~ {"' r "OJ ~ ..,. I"\"-" m + (' .'::':JH .,;)0098 ~o S" ~ -< z o g iP~ ~ 3 JJ l'l ~ -g: "Tl ~ ~ ::1 3 ;:: ~ P 5' -- r ! ~J ~ ii1q . ~ ~ ~ \., ~ - "'tI :;; r- ~ ~ ~ ~ ~ .~ '" o III -< m [] ~ ! a o ~ ~. -< ~ en ..... o jI ...... ~ o ~ t:J t:J ~ ~ m l8J '" .. ~ o (Jl ~ g 0. l' 0 "Tl a ! , III cc ~ JJ III c; m " < ~ is" -g 0;:: ~ 0 <" . ~ -< )> ;0 3 III ~'< o. !2. ~. -< )> ::I . ~ 3 'C ~ . . , I , --_____J o -E:A- 0_ ~I"'U N. 5l-b ~ t..Tl w :E ~ OS ;:- :DZ nl (I) 3: C>:;J;J-U. Oo...t.<:D c....J(!)I-!I--I-o z. c)rOQ --< ....r (,1 C) rn --< N :D 3: c:J rn rn ~l , : I I- .... ,Ii .. ~ ~ -- -- -- ...- -ci " 0 ~ ::J " q ~ s' III ~ (bl~d'~~ Cii:~""CilC/j is'o-iil'3;::t ::JiilCi.;;:;z: R '. .... ~ :b /b"iiri! ~ar~ fl!~ 0 l5 & o ::J o 1 @ (") 0: :::l S- i ai' <it g :::l ~ ~ ~ ~ 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 TORMOLLAN STACEY C 31 MESSALONSKEE AVENUE WATERVILLE, ME 04901 n___n_ fold ESTATE INFORMATION: SSN: 201-28-5910 FILE NUMBER: 21-2001- 0949 DECEDENT NAME: COLE LAZENA 0 DATE OF PAYMENT: 01/08/2002 POSTMARK DATE: 01/07/2002 COUNTY: CUMBERLAND DATE OF DEATH: 10/09/2001 NO. CD 000730 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $20,000.00 I I I I I I I I TOTAL AMOUNT PAID: $20,000.00 REMARKS: STACEY C TORMOLLAN CHECK# 2009 INITIALS: AC RECEIVED BY: SEAL MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS R?V.'I500 EX (6.001'" COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 <...... (1-/4-5 I- Z W C W (.) W C UJ I- :.:::$(1) ua:::':: UJll.U :z::oo ua::...l ll.al ll. '" FILE NUMBER 2 1 _ 0 1 INHERITANCE TAX RETURN RESIDENT DECEDENT COUNTY CODE YEAR NUMBER o 0 9 4 9 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) COLE, LAZENA D. DATE OF DEATH (MM-DD-YEAR) 10-09-2001 SOCIAL SECURITY NUMBER 201 - 28 5910 DATE OF BIRTH (MM-DD-YEAR) 04-18-1919 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST. AND MIDDLE INITIAL) [K] 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 D 4a. Future Interest Compromise (date of death after 12-12-82) o 7. Decedent Maintained a Living Trust (AtlachtopyofTruSI) o 10. Spousal Poverty Credit (date of death between 12.31.91 and 1-1-95) D 3. Remainder Return (date of death prior \012.13.82) o 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Atlaci1 Sch 0) I- Z UJ C Z o Il. In UJ a:: a:: o u THIS..SECTION..MUST.BE..COMP!..EtEO;.ACC..CQRRESPOI\IDE:l\lel.:~I\IQCONFIQENT~C:r~II\IFQRI'JIA.TION.SHQU(;O$E:OIR.EeTEO to: NAME COMPLETE MAILING ADDRESS CRAIG A. DIEHL ES DIRE C.P.A. FIRM NAME (If Applicable) LAW OFFICES OF CRAIG A. DIEHL TELEPHONE NUMBER (717) 763-7613 3464 TRINDLE ROAD CAMP HILL, PA 17011-4436 (1) $ (2) (3) (4) (5) $ 92,000.00 -0- -0- -0- 413,427.09 -0- z o ~ ...J :J !:: c.. <( (.) w 0:: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 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) (11) $ 31,929.90 (12) $ 473,497.19 (13) -0- (14) $ 473,497.19 X.O_ (15) '-O- x .04~ (16) $ 21,307.37 x .12 (17) -O- x .15 (18) -0- (19) $ 21,307.37 (6) (7) -0- (8) $ 505,427.09 (9) $ (10) $ 28,861.12 3,068.78 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o i= ~ :J c.. ~ o (.) X ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) -0- $ 473,497.19 -0- -0- 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND..RECHECK MATH < < "'. Decedent's Complete Address: LAZENA D. COLE 21-01-00949 STREET ADDRESS 30 CIRCLE DRIVE CITY CAMP HILL 1 STATE PA I ZIP 1 7011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments $ C. Discount $ (1) $ 20,000.00 1,052.63 Total Credits ( A + B + C ) (2) $ 21,052.63 3. InteresUPenally if applicable D. Interest E. Penalty Total Interest/Penalty ( 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. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58) $ Make Check Payable to: REGISTER OF WILLS, AGENT 21,307.37 -0- -0- 254.74 -0- 254.74 PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;.......................................................................................... 0 b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 c. retain a reversionary interest; or.......................................................................................................................... 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 No ~ ~ IX] IX] IX) IX] IX] ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ME 04901 DATE 07 2002 DATE 07/ /2002 ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)}. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. S9116(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. s9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. , . , REV-1502 EX+ (6-9*, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE LAZENA D. COLE FILE NUMBER 21-01-00949 ESTATE OF 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 survivorship must be disclosed on Schedule F. . ITEM NUMBER 1. DESCRIPTION REAL PROPERTY SITUATE AT: 30 CIRCLE DRIVE, CAMP HILL, PA 17011 EAST PENNSBORO TOWNSHIP, CUMBERLAND COUNTY (SEE HUD-1 SETTLEMENT STATEMENT ATTACHED) VALUE AT DATE OF DEATH $ 92,000.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 92,000.00 REV-1508 EX+ (6-98) . * COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY LAZENA D. COLE FILE NUMBER 21-01-00949 ESTATE OF Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. 1.. REFUND OF SCHOOL TAXES UPON SALE OF REAL PROPERTY 2. PERSONAL PROPERTY/HOUSEHOLD GOODS (SEE APPRAISAL ATTACHED) 3. PNC BANK - CHECKING ACCOUNT NO. 5140175147 DATE ESTABLISHED: 09/25/1990 DATE OF DEATH BALANCE: $78,179.63 ACCRUED INTEREST: $33.36 PNC BANK - SAVINGS ACCOUNT NO. 5000939571 DATE ESTABLISHED: 03/21/1997 DATE OF DEATH BALANCE: $202,945.35 ACCRUED INTEREST: $419.67 VALUE AT DATE OF DEATH $ 392.70 $ 1,641.00 $ 78,212.99 ITEM NUMBER DESCRIPTION 4. $ 203,365.02 5. MELLON BANK, N.A. - CHECKING ACCOUNT NO. 252-110-3115 $ 12,834.88 DATE ESTABLISHED: 03/31/1983 DATE OF DEATH BALANCE: $12,834.88 ACCRUED INTEREST: $0.00 6. MELLON BANK, N.A. - CHECKING ACCOUNT NO. 100-015-3781 $ 109,778.36 DATE ESTABLISHED: 07/14/2000 DATE OF DEATH BALANCE: $109,563.63 ACCRUED INTEREST: $214.73 7. UNITED STATES TREASURY - FEDERAL TAX REFUND $ 1,346.00 (2001 FORM 1040) 8 . REFUNDS: AAA INSURANCE & VERIZON $ 366.46 9. UNCASHED CHECKS AT DATE OF DEATH $ 5,489.68 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 413,427.09 ", REV-1511 EX+ (12-99)_ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT (PAGE 1 OF 3) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF LAZENA D. COLE FILE NUMBER 21-01-00949 ITEM NUMBER A. Debts of decedent must be reported on Schedule L DESCRIPTION AMOUNT 1 FUNERAL EXPENSES: MYERS-HARNER FUNERAL HOME - FUNERAL EXPENSE $ 1,830.00 B. ADMINISTRATIVE COSTS: 1 . Personal Representative's Commissions 8 . 9. 10. 11. Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State _ Zip Year(s) Commission Paid: 2. Attorney Fees - LAW OFFICES OF CRAIG A. DIEHL $ 10,108.54 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 - REGISTER OF WILLS, CUMBERLAND COUNTY $ 400.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. CUMBERLAND LAW JOURNAL - ESTATE ADVERTISEMENT THE SENTINEL - ESTATE ADVERTISEMENT LAW OFFICES OF CRAIG A. DIEHL - CERTIFIED MAIL REGISTER OF WILLS, CUMBERLAND COUNTY - FILING FEE FOR PENNSYLVANIA INHERITANCE TAX RETURN ORPHANS' COURT, CUMBERLAND COUNTY - FILING FEE FOR FAMILY SETTLEMENT AGREEMENT $ $ $ $ 75.00 97.07 3.94 15.00 $ 17.00 TOTAL (Also enter on line 9, Recapitulation) $ CONTINUED (If more space is needed, insert additional sheets of the same size) " , , SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS (PAGE 2 OF 3) ESTATE OF LAZENA D. COLE FILE NO. 21-01-00949 I ITEM I I I NO. DESCRIPTION AMOUNT 12. LAW OFFICES OF CRAIG A. DIEHL - $ 72.17 OVERNIGHT DELIVERY FEES 13. COUNTY/TOWNSHIP TAXES OWED AT SALE $ 10.37 OF REAL PROPERTY 14. SEWER/TRASH OWED AT SALE OF REAL $ 16.58 PROPERTY 15. FORlNA'S ANNVILLE AUCTION COMPANY - $ 5,520.00 COMMISSION ON SALE OF REAL PROPERTY 16. PENNSYLVANIA REALTY TRANSFER TAX DUE $ 920.00 UPON SALE OF REAL PROPERTY 17. FORTNA'S ANNVILLE AUCTION COMPANY - $ 195.00 APPRAISAL OF PERSONAL PROPERTY 18. DOUBLE GOLD PUROFIRST INC. - CLEANING $ 964.52 OF REAL PROPERTY PRIOR TO SALE 19. FORlNA'S ANNVILLE AUCTION COMPANY - $ 2,298.50 ADVERTISING EXPENSE FOR AUCTION OF REAL PROPERTY 20. STACEY C. TORMOLLAN, ADMINISTRATRIX- $ 2,090.71 REIMBURSEMENT OF TRA VEL EXPENSES - AIRFARE = $1,182.00 - RENTAL CAR/GAS = $597.73 - HOTEL = $310.98 I TOTAL SCHEDULE H I CONTINUED I SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS (PAGE 3 OF 3) ESTATE OF LAZENA D. COLE FILE NO. 21-01-00949 I ITEM I I I NO. DESCRIPTION AMOUNT 21. STACEY C. TORMOLLAN, ADMINISTRATRIX- $ 158.52 REIMBURSEMENT OF MISC. SUPPLIES, BOOKS, POSTAGE 22. ABC FUEL - HEATING OIL $ 189.81 23. PAWC - WATER BILLS $ 273.16 24. PPL ELECTRIC - ELECTRIC BILLS $ 111.39 25. VERIZON - TELEPHONE BILLS $ 90.76 26. AT&T - TELEPHONE BILL $ 35.08 27. HOPCRAFT HOCKLEY & O'DONNELL - BOND $ 1,910.00 FOR ADMINISTRATRIX 28. AAA INSURANCE AGENCY - HOMEOWNERS $ 460.00 INSURANCE 29. KREAMER BROS. GLASS - HOME REPAIR $ 95.00 30. KEYSTONE FLOORING - HOME REPAIR $ 900.00 31. JANE E. BIDDLE, TAX COLLECTOR - TAX $ 3.00 CERTIFICATION FEE I TOTALSCHEDULEH I $ 28,861.12 I " " REV-1512 EX+ (6-98) '* SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF LAZENA D. COLE Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1. PENNSYLVANIA DEPARTMENT OF REVENUE - PAYMENT OF TAX DUE ON 2001 PA40 2. UNITED STATES TREASURY - ESTIMATED TAX PAYMENT (2001 FORM 1040ES) 3. PPL ELECTRIC - FINAL ELECTRIC BILL 4. PAWC - FINAL WATER BILL 5. VERIZON - FINAL TELEPHONE BILL 6. EAST PENNSBORO TOWNSHIP - FINAL SEWER/REFUSE BILL 7. COMCAST - FINAL CABLE BILL 8. DR. HARHIGH - MEDICAL BILL FILE NUMBER 21-01-00949 VALUE AT DATE OF DEATH $ 273.00 $ 2,400.00 $ 120.40 $ 25.13 $ 43.48 $ 87.75 $ 105.62 $ 13.40 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3,068.78 '. REV.1513 EX+ (9-00) ~o Wn SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT LAZENA D. COLE ESTATE OF NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. JACQUELINE H. ELEUTERI 653 SPRING LANE BOILING SPRINGS, PA 17007 2. BRADLEY D. COLE 6924 TEES DALE AVENUE NORTH HOLLYWOOD, CA 91605 3. STACEY C. TORMOLLAN 31 MESSALONSKEE AVENUE WATERVILLE, Mn 04901 fo1G, ,&U ' FILE NUMBER 21-01-00949 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT OR SHARE OF ESTATE DAUGHTER 1/3 OF ESTATE SON 1/3 OF ESTATE DAUGHTER 1/3 OF ESTATE 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART" - 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) A. Settlement Statement '. OMB No. 2502-0265 U.S. Department of Housing and Urban Development ~ ,r B. Type of Loan 1. 0 FHA 4. OVA 2. 0 FmHA 3. 0 Conv. Unins File Number breen Loan Number Mortgage Insurance Case Number 5. 0 Conv. Ins. C. NOTE:This form is fur2ishe~ to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked p.oc were paid outside of clOSing: they are shown here for informational purposes and are not included in the totals. D NAME AND ADDRESS OF BORROWER: Robert M. Breen 1041 Dogwood Lane, Enola, PA 17025 E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER Estate of Lazena D. Cole 30 Circle Drive, Enola, PA 17025 Commerce Bank/Harrisburg, N.A. 100 Senate Avenue, Camp Hill, PA 17011 G. PROPERTY LOCATION: 30 Circle Drive Enola, PA 17025 H. SETTLEMENT AGENT: PLACE OF SETTLEMENT: TIN: Turner and O'Connell 4415 North Front Street, Harrisburg, PA 17110 23-2272907 I. SETTLEMENT DATE: 01/17/2002 RESCISSION DATE: 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 Price 92 000.00 401. Contract Sales Price 92 000.00 102. Personal Property 402. Personal property 103. Settlements charges to borrower 403. (from line 1400) 3,461.49 104. 404 105 405. ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: ADJUSTMENTS FOR ITEMS PAID BY SELLER IN ADVANCE: 106. City/town taxes to 406. City/town Taxes to 107. County Taxes to 407. County Taxes to 108. Assessments 01/17/2002 \0 06/30/2002 392.70 408. Assessments 01/17/2002 to 06/30/2002 392. 70 109 409. 110 410 111 411 112 412 120. GROSS AMOUNT DUE FROM BORROWER 95,854.19 420. GROSS AMOUNT DUE TO SELLER: 92,392.70 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest money 9,200.00 501, Excess deposit (see instructions) 202. Pflncipal amount of new 10an(s) 50,000.00 502. Settlement charges to seller (lIne 1400) 4,993.01 - 203. EXIsting loan(s) taken subjecl to 503. Existing loan(s) taken subject \0 204 504. Payoff of first mortgage loan 205. 505. Payoff of second mortgage loan 206. 506 207. 507. 208. 508 209 509. ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: ADJUSTMENTS FOR ITEMS UNPAID BY SELLER: 210_ City/town taxes to 510. City/town taxes to 211. County taxes 01/01/2002 10 01/17/2002 10.37 511 County taxes 01/01/2002 to 01/17/2002 10.37 212. Assessments to 512. Assessments to 213 Sewer/trash 1/1 to 1/17 16.58 513 Sewer/trash 1/1 to 1/17 16.58 214. 514 215 515 216 516 217 517. 218 518 219. 519. 220. TOTAL PAID BY/FOR 59,226.95 520. TOTAL REDUCTIONS 5,019.96 BORROWER: IN AMOUNT DUE TO SELLER 300. CASH AT SETTLEMENT FROMfTO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER 301. Gross amount due from borrower (line 120) 95,854.19 601. Gross amount due to seller (line 420) 92,392. 70 302. Less amount paid by/for borrower (line 220) 59,226.95 602. Less reductions in amI. due seller (line 520) 5,019. 96 303. CASH ( ~ FROM) ( OTO) BORROWER: 36,627.24 603 CASH ( 0 FROM) ( ~TO) SELLER 87,372. 74 HUD-1 (3-86) - RESPA, HB 4305.2 PAGE 1 " OMS No 2502-0265 (Rev 3186) L SETTLEMENT CHARGES 700. TOTAL SALESIBROKER'S COMMISSION PAID FROM PAID FROM BASED ON PRICE 92,000.00 @ 6 %= 5,520.00 BORROWER'S SELLER'S FUNDS FUNDS DIVISION OF COMMISSION (LINE 700) AS FOLLOWS: AT AT 701 5,520.00 10 Fortna's Auction SETTLEMENT SETTLEMENT 702 /' 10 703. Commission paid at settlement ( 2,760.00 paC) 2, 760.00 704 801. Loan origination fee % 10 Commerce BankIHarrisburg,N.A. B02 Loan discount 1. 0000 % 10 Commerce Bank/Harrisburg,M.A. 500.00 803. Appraisal fee to: The Appraisal Finn 250.00 804. Credit report 10 Commerce Bank/Harrisburg,N,A. 805. lender's inspection fee C~erce BankIHarrisburg,N.A. 606. Mortgage insurance application fee to Cozmnerce Bank/Harrisburg IN. A. 807. Assumption fee Commerce Bank/Harrisburg,N,A. aoa PLocessing Fee to Ccumnerce Bank 15.00 a09 Flood Certification to Geotrac 15.00 810 Courier Fee to Airborne Express 25.00 a11 Underwriting Fee to Commerce Bank 245.00 9UU. UI:lI= 901. Interest from 01/17/2002 10 02/01/2002 @ B.73lday 130.99 902. Morlgage insurance premium for mos. to 903. Hazard insurance premium for yrs to 904 Flood insurance premium for yrs 10 905 lUUU. 800 I I I=MS PAY AI:lLI= IN CUNNI=I,; I IUN WI I H LUAN 1002. Mortgage insurance 1003 City property taxes 100.4. County property taxes 1005. Annoal assessments months @ months @ months @ months @ months @ months @ months @ months @ Aggregate Accounting Escrow Adjustment per month per month per month per month per month per month per month pel' mooth 1001. Hazard insurance 1006. Flood insurance 1007 1008. 1009. 1101, Settlement or closing fee 10 TUrner and O'Connell 1102. Abstract or litle search 10 1103. Titre Bllarnina!ion to 110.4, Tille insurance binder to 1105. Documen\ preparation 10 Commerce Bank/Harrisburg,N.A. 150.00 , 106 Notary fees 10 Cash 10.00 1107. Allorney's lees to (includes above items Numbers ) 1106 Tille insurance to TUrner and O'Connell 810.751 (includes above \\ems Numbers ) 1109. lender's coverage ( 50,000.00 I , 110. Owner's coverage ( 92,000.00 ) 1111. Ends. 100, 300, 8.1 150.001 1112 Closing Services Letter to Old Republic Ti tle 35.00 I 1\13 120U GUV~HNMI=NI KECORDINGAND IKAN:;r~H(';HARGE:S. 1201. Recording fees Deed 25.50 ; Mortgage 31.50 Releases 57.00 1202. Cily/county tax/stamps Deed 920.00 , MOf\gage 920.00 1203 Slate laxfstamps Deed 920.00 : Mortgage 920.00 1204 1205 13UlJ. .::iIoIILIoMI=NI 1301. Swvey to 1302. Pest inspection 10 1303 East pennsob.ro Township 1st qtr sewer/traSh 81.75 1304 2001 county/township tax 269.01 1305 2001 school tax 1, 044 . 00 1306 1307 1400. TOTAI...SETTLEMENT CHARGES 3,461.49 4,993.01 t have carefully reviewed the HUD-1 Settlement Statement 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-1 sett:!:..: Statae'L:r"'~ ~ f -i.G- fJ J I f2 " Seller or A ~L 0" fl r t' tr Borrower ~~'v\..." L~~__ Date Agent {;tqt'",~" -1-.,,.. I:~ . -l~ Robert M. Breen Stacey c. formal/an, Administratrix Dale # Borrower' Oa\e Sellerar Agenl: Dale The HUD-1 Settlement Statement which I have prepared IS a true and accurate account of thiS transaction I have caused or Will cause the funds to be disbursed In accordance With thiS statement 'l ___ ,~~/ / --~~.---:---/ Date Setttement Ageilt-- ~ j' ~--- . ---- Date James H. Turner WARNING: It is a crime to knowingly make fCllse statements to the United States on this or any other similar form Penalties upon conviction can include a fine and imprison- ment. For details see: lme 18 U.S. Code Section 1001 and Section 1010. '. . m Aonvill~ AUlIino Cn. {j Gallery 18 E. Main Slreet, Annville, PA 1700.1 . Phone: 7178674451 Michael R. Forlna CAt. Auclioneer I.ie. No. 001711-L APPRAISAL OF PERSONAL PROPERTY DATE october 31 ?001 TO: ,......", ~ tii ",1-11 ll.t-t-nrn",y 3464 Trindle Rd. Camp Hill, PA 17011 RE Estate of LaVena D. Cole .:10 ClrC.le or. Camp Mlll, pd 17011 Pursuant to your request, I have inspected certain personal property located at 30 Circle Dr. Cafup nill, ~a 17011 for the purpose of appraising Its fair market value as ofthe~day of octobor .~ Based upon the Information contained in this report in the attachments and sChedules attached hereto and hereby made a part hereof and upon my general experience as an appraiser and auctioneer, it is my opinion that said personal property had an estimated fair market value on the above date of' ono thoYQang Qix nYRgrOg ang forty OR9 dgl15r~ 1.6~1 00 The term "Fair Market Value" as used In this report Is defined as follows: the highest price estimated in terms of money which the property will bring if exposed for saleln the open market by a seller who is will- Ing but not obligated to sell, allowing a reasonable time to find a buyer who is willing but not obligated to buy, both parties having full knowledge of all the uses to which it is adapted and for which it is capable of being used. This appraisal is based upon the following assumptions, limitations and conditions' 1. That title to the property appraised Is good and merchantable or that it will be prior to the time 01 sale. 2. That all liens and encumbrances. If any. have been satisfied and the property has been appraised as though free and clear under responsible ownership and competent management. 3. That matters of a legal nature have not been considered in this appraisal. 4. That this appraisal report is made for the use of the named recipient only and that no part of it may be used or relied upon by any other person without the previous written consent of client and/or the appraiser. 5. That the fee for this appraisal does not provide for or Include compensation for conference or testimony and/or attendance at any court proceeding. ;J'he undersigned appraiser hereby certifies: 1. That he has no interest now, heretofore or contemplated In the future in the personal property covered by this appraisal. 2. That he has personally Inspected the personal property to the extent that it was reasonably necessary and possible to do so. 3. That, to the best of his knowledge and bellet, all statements and ih10rmallon included in this appraisal are true and are based upon his objective findings and trlOt no pertinent information has been knowingly withheld or deleted In this report. 4. That neither his employment to make this appraisal nor his compensation for so doing is contin- gent upon the value of the property. E"en tllOUgh it is the iirm Deliel 01 the appraiser that the information furnished in this appraisal report and the conclusions drawn from this information are true and correct. they are nol guaranteed. Respectfully sub.;.p.it1~9~" ~ /" . r.~'~:-::' ,,h/;/. ....Appralssr 'and Au lIoneb( ,/#~~~ ~ Slreel Addre.. / ~ ,;:::?' ~~~La-:_ /~a.3 Clly Slale Zip Code ., .. FORTNA'S ANNVILLE AUCTION COMPANY 18 E. MAIN ST. ANNVILLE, PA 17003 APPRAISAL OF PERSONAL PROPER'n' for ESTATE OF LaVeoa D. Cole 30 Cirde Dr.. Camp Bill, PeDD.ylvuia 17011 QUANUn' ITEM DESCRlYllON waluut ohest of drawers (4 drawers) lamp pink upholstered clWr(queeii aone style. WlnS back) 1 walnut blanket chest zenith color tele\'ision walDut stained tv !1bmd(with 2 doors. VCR slot) Panasonic VCR Seth 'I'homu mantle clock misc. nick. nacks from lUIlIlth: 2 light wood end tables 2 brass lamps ~ cushioa sofa with pillowi misc. ~ 00. waD ooffee table cureb swecpet .1. October ZS, 1001 APPRAISAL V~UE S 45.00 $ S.OO S 3'.00 S 65.00 S 30,00 $ 45.00 S 20.00 $ 30.00 S 10.00 $ 20.00 $ 20.00 $ 95.00 $ 50.00 $ 1.5.00 $ 20.00 ~ 'lr QUANIlTY ITEM DESCRIPTION APPRAISAL VALUE boobbelf $ 3~.00 dining room tabJe with 4 chairs (2 boards. qucaa IDDC style) S 150.00 misQ. glass in corner cupboard $ 40.00 refrigerator/freezer $ 95.00 3 piece breakfast set $ 110.00 blender $ ~.OO :m.p microwave S 30.00 pfaltzgratf diunerwue set $ 25.00 misc. pots and plUlS $ 35.00 3 piece mapJc bedroom suite(bed. bureau, mittor aad nisht s1aud) $ 125.00 upholst.ercd oobaW style wingback chair(tlowon:d print) S 95.00 sofabed $ 110.00 2 maple 2 door c.-biDets S 60.00 hoover vacuum $ 10.00 drop leaf table $ 1.5.00 Kemnore washing machine $ 25.00 dryer S 0.00 2 telephones $ 15.00 Chris1mas decoratioos $ 5.00 1 step ladder $ 8.00 misc. had tools S 20.00 electric edger S 8.00 I'M pacer treadmill $ 45.00 T oro electric kat blower $ 15.00 Black &: decker mower with bag (eloc1ric) S 55.00 APPRAISAL TOTAL $ 1.641.00 -2- 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 DIEHL CRAIG A 3464 TRINDLE ROAD CAMP HILL, PA 17011 _n_n__ fold ESTATE INFORMATION: SSN: 201-28-5910 FILE NUMBER: 2101-0949 DECEDENT NAME: COLE LAZENA D DATE OF PAYMENT: 07/08/2002 POSTMARK DATE: 0010010000 COUNTY: CUMBERLAND DATE OF DEATH: 10/09/2001 NO. CD 001382 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $254.74 I I I I I I I I TOTAL AMOUNT PAID: $254.74 REMARKS: STACEY C TORMOLLAN CIO CRAIG DIEHL ESQUIRE CHECK# 2017 INITIALS: VZ RECEIVED BY: SEAL REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS ~//} /-r'~' BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX CRAIG A DIEHL ESQ C A DIEHL LAW OFFICES 3464 TRINDLE RD CAMP HILL PA HUll DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-19-2002 COLE 10-09-2001 21 01-0949 CUMBERLAND 101 '* REV-1547 EX AFP (01-021 LAZENA D Allount Rellitted 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=i5'4j-EX-AFP-foY=02Y-NOTicE--OF-YNHERiTANCE-TAirA"PPRA"iSEHENT-,--AL.i-OWANCE-oR'----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF COLE LAZENA D FILE NO. 21 01-0949 ACN 101 DATE 08-19-2002 TAX RETURN WAS: (X] ACCEPTED AS FILED ] CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A] 2. Stocks and Bonds (Schedule B] 3. Closely Held Stock/Partnership Interest (Schedule C] 4. Hortgages/Notes Receivable (Schedule D] S. Cash/Bank Deposits/Hisc. Personal Property (Schedule E] 6. Jointly Owned Property (Schedule F] 7. Transfers (Schedule G] 8. Total Assets (1] (2] (3] (4] (S] (6] (7] 92,000.00 .00 .00 .00 413,427.09 .00 .00 (8] APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H] 10. Debts/Hortgage Liabilities/Liens (Schedule I] 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J] 14. Net Value of Estate Subject to Tax 28,861.12 3.068.78 (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. 505,427.09 31 .929 90 473,497.19 .00 473,497.19 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. NOTE: If an assessment was issued previously, lines reflect figures that include the total of Abb ASSESSMENT OF TAX: lS. Allount of Line 14 at Spousal rate (lS] 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: .00 X 00 = 473,497.19 X 045 = .00 X 12 = .00 X 15 = (19]= .00 21,307.37 .00 .00 21,307.37 "....~. . (+] AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-] 01-07-2002 CDOOO730 1,052.63 20,000.00 07-08-2002 CDOO1382 .00 254.74 TOTAL TAX CREDIT 21,307.37 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR], YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH 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: To fulfill the requirements of Section Zl40 of the Inheritance and Estate Tax Act, Act Z3 of ZOOO. (7Z P.S. Section 9140). PAYMENT: 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 KILLS. AGENT 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 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). 08JECTIONS: 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: ADMIN- ISTRATIVE CORRECTIONS: 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. --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. DISCOUNT: 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. PENALTY: 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: 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 Daily Interest Factor 198Z ZO% .000548 199Z 9% .000Z47 1983 16% .000438 1993-1994 7% .00019Z 1984 11% .000301 1995-1998 9% .000Z47 1985 13% .000356 1999 7% .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 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 must be calculated. .. F AMIL Y SETTLEMENT AND FINAL RELEASE IN THE ESTATE OF LAZENA D. COLE KNOW ALL MEN BY THESE PRESENTS, THAT WHEREAS, LaZena D. Cole, late of East Pennsboro Township, Cumberland County, Pennsylvania, deceased, died on October 9, 2001, intestate. WHEREAS, Stacey C. Tormollan was named Administratrix of the estate which was recorded in Cumberland County, Pennsylvania, Estate No. 21-01-00949; WHEREAS, the said personal representative has gathered the assets ofthe estate of the said decedent and the assets consist of real and personal property to a total value of $508,946.86, as set forth in Exhibit" A", which is a statement of account of the said personal representative, and which is attached hereto and made a part hereof, and marked Exhibit "A"; WHEREAS, the debts and deductions, including the payment of inheritance tax in the said estate, amount to $52,184.64, leaving a balance for distribution of $456,762.22, also as set forth in the statement of the said personal representative, which is attached hereto and made a part hereof, and marked Exhibit "B"; NOW THEREFORE, KNOW YE, that we, Jacqueline H. Eleuteri, Bradley D. Cole, and Stacey C. Tormollan, being the heirs of the said decedent under the intestate statutes and being the persons entitled to inherit under said intestate statutes, do hereby acknowledge that we have this day had and received from the aforesaid personal representative, in full satisfaction and payment of all sum or sums of money that we are entitled to by law, and which is the amount set opposite our names in the table and schedule of distribution in said statement attached hereto and marked Exhibit "e"; AND, we do hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, we agree that no account is necessary and we hereby agree and consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if it had been filed and confirmed by the Orphans' Court Division of the Court of Common Pleas of Cumberland County. THEREFORE, we do hereby remise, release, quitclaim and forever discharge the said personal representative, her heirs, executors, administrators and assigns, of and from the said estate and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, touching upon the estate of said decedent, and we do further hereby covenant and agree that we will contribute our share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal z:epresentative after the signing, sealing and delivery of this family settlement agreement and final release. 1 .' IN WITNESS WHEREOF, we have hereunto set our hands and seals this of July, 2002. rJ -S day WITNESS: C-~~~- J~~ ~~~ J '~~ ~ l[[0il.VM1 Brad 4/;tu," , t'lJt-- I Stacey C. Torrnollan COMMONWEALTH OF PENNSYL VANIA SS. COUNTY OF CUMBERLAND On this d I ,~ day of &C~ , 2002, before me, the undersigned officer, personally appeared Jacqueline H. Eleuteri, known to me (or satisfactorily proven) to be the individual whose name is subscribed to the foregoing instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ~ J i Gifotary ... lie -. - NOTARIAL SEAL HELEN E. RASMUSSEN, Notary Public Camp Hill Borough, Cumberland County My Commission Expires Aug. 2, 2003 2 STATE OF ~ ~("yvt ~ ckr:. ~~e~~ SSe COUNTY OF On this 2-10;:: day of ~r- , 2002, before me, the undersigned officer, personally appeared Bradley D. Cole, l\ te me (or satIsfactonly proven) to be the individual whose name is subscribed to the foregoing instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. - RAVINDER SHALLA NOTARY PUBUC . CALIFORNIA COMMISSION II 1318265 ~ LOS ANGELES COUNTY My Comm. Exp. Aug. 25, 200S J/2I})~ r- ..~ .... I Notary Public STATE OF MAINE COUNTY OF Somerset SSe Skowhegan, Maine On this 3rd day of July, 2002, before me, the undersigned officer, personally appeared Stacey C. Tormollan, known to me (or satisfactorily proven) to be the individual whose name is subscribed to the foregoing instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ( /h;fth(/~~M Notary Public 3 My Commission Expires April 4, 2008 FIRST AND FINAL ACCOUNT OF THE ESTATE OF LAZENA D. COLE LATE OF EAST PENNSBORO TOWNSHIP, CUMBERLAND COUNTY, PENNSYL VANIA DATE OF DEATH: OCTOBER 9, 2001 PRINCIPAL ACCOUNT DEBITS: Your Accountant charges herself with the following: Real Property Value 1. Personal Residence situate at 30 Circle Drive, Camp Hill, P A $92,000.00 Personal Property 2. Refund of School Taxes upon Sale of Real Property $392.70 3. Personal Property/Household Goods $1,641.00 4. PNC Bank - Checking Account No. 5140175147 $78,212.99 5. PNC Bank - Savings Account No. 5000939571 $203,365.02 6. Mellon Bank, N.A. - Checking Account No. 252-110-3115 $12,834.88 7. Mellon Bank, N.A. - Checking Account No. 100-015-3781 $109,778.36 8. United States Treasury - Federal Tax Refund (2001 Form 1040) $1,346.00 9. Refunds - AAA Insurance and Verizon $366.46 10. Uncashed Checks at Date of Death $5,489.68 EXHIBIT "A" 4 DEBITS (continued) Personal Property (continued) Interest Earned on Estate Account Value $3,519.77 11. TOTAL PRINCIPAL DEBITS $508.946.86 EXHIBIT "A" 5 CREDITS Your Accountant asks credit for payments made from Principal Account as follows: Description Myers-Hamer Funeral Home - Funeral Expense Law Offices of Craig A. Diehl- Attorney Fee (Retainer) Register of Wills, Cumberland County - Probate Fee Cumberland Law Journal- Estate Advertisement The Sentinel - Estate Advertisement Register of Wills, Agent - Pennsylvania Inheritance Tax County/Township Taxes owed at Sale of Real Property Sewer/Trash owed at Sale of Real Property Fortna's Annville Auction Company - Commission on Sale of Real Property Pennsylvania Realty Transfer Tax due upon Sale of Real Estate Fortna's Annville Auction Company - Appraisal of Personal Property Double Gold Purofirst Inc. - Cleaning of Real Property Prior to Sale Fortna's Annville Auction Company - Advertising Expense for Auction of Real Property Stacey C. Tormollan, Administratrix - Reimbursement of Travel Expenses - Airfare = $1,182.00 - Rental Car/Gas = $597.73 - Hotel = $310.98 E X H I BIT "B" 6 Amount $1,830.00 $2,500.00 $400.00 $75.00 $97.07 $20,000.00 $10.37 $16.58 $5,520.00 $920.00 $195.00 $964.52 $2,298.50 $2,090.71 CREDITS (continued) Description Amount Stacey C. Tormollan, Administratrix - Reimbursement of Misc. Supplies, Books, Postage $158.52 ABC Fuel - Heating Oil $189.81 P A WC - Water Bills $298.29 PPL Electric - Electric Bills $231. 79 Verizon - Telephone Bills $134.24 AT&T - Telephone Bill $35.08 Hopcraft Hockley & Q'Donnell- Bond for Administratrix $1,910.00 AAA Insurance Agency - Homeowner's Insurance $460.00 Kreamer Bros. Glass - Home Repair $95.00 Keystone Flooring - Home Repair $900.00 Pennsylvania Department of Revenue - Payment of Tax Due on 2001 PA40 $273.00 United States Treasury - Estimated Tax Payment (2001 Form 1040ES) $2,400.00 East Pennsboro Township - Sewer/Refuse Bill $87.75 Comcast - Cable Bill $105.62 Dr. Harhigh - Medical Bill $13.40 Jane E. Biddle, Tax Collector - Tax Certification Fee $3.00 Law Offices of Craig A. Diehl- Attorney Fee (Balance Due) $7,608.54 E X H I BIT "B" 7 .' CREDITS (continued) Description Law Offices of Craig A. Diehl - Reimbursement of Certified Mail Costs for Department of Public Welfare Letter Law Offices of Craig A. Diehl- Reimbursement of Overnight Delivery Fees Register of Wills, Cumberland County - Filing Fee for Pennsylvania Inheritance Tax Return Orphans' Court, Cumberland County - Filing Fee for Family Settlement Agreement Register of Wills, Agent - Additional Pennsylvania Inheritance Tax Liability TOTAL PRINCIPAL CREDITS EX H I BIT "B" 8 Amount $3.94 $72.17 $15.00 $17.00 $254.74 $52.184.64 . . .. RECAPITULATION Less: Previous Distributions to Beneficiaries Less: Personal Property Retained $508,946.86 - $52.1 84.64 $456,762.22 - $300,000.00 - $1.641.00 Principal Debits Principal Credits Subtotal TOT AL AMOUNT TO BE DISTRIBUTED $155.121.22 EX HI BIT "B" 9 .. : PROPOSED DISTRIBUTION The Personal Representative proposes distribution of the Total Balance for Distribution to the following heirs as described: N ame/ Address Inheritance V alue/ Amount Jacqueline H. Eleuteri 653 Spring Lane Boiling Springs, P A 17007 33.3% of Rest, Residue and Remainder of Estate Less: Previous Distributions Subtotal $151,707.07 - $100.000.00 $51.707.07 Bradley D. Cole 6924 Teesdale Avenue North Hollywood, CA 91605 33.3% of Rest, Residue and Remainder of Estate Less: Previous Distributions Subtotal $151,707.07 - $100.000.00 $51.707.07 Stacey C. Tormollan 31 Messalonskee Avenue Waterville, ME 04901 33.3% of Rest, Residue and Remainder of Estate Less: Previous Distributions Subtotal $151,707.08 - $100.000.00 $51.707.08 TOTAL DISTRIBUTED $155.121.22 EX H I BIT "e" 10 r-------- () ~ )> j s: ~ r trl trl "U -I ~ (J) (J) .:::! ::c JJ t-3 t-rj t-rj t-3 -.J r= Z :;l> Ol r 0 0 :;l> H 3: :;l> w ;- t-3 Z t-3 ~ ~ m "r1 trl :;l> H Z trl ~ ::j JJ "r1 L' L' 0 w ~ (1 t-<: . ~ ~ 0 0 ~ 0 m t-rj :;:0 t-rj j CJ) trl (J) N 0 L' t'""" trl I-' t'""" .:::! "r1 :;l> trl t-3 I :;l> -.J (J) ~ 0 N :;l> t-3 0 N Ol "U ~ L' I-' w JJ co :0 trl C/l trl a, trl I '" Z ~ )> Z tr1 3: 0 Z co ':::J G) :;l> :;l> w ::c C5 trl 0 .:::! G) )> H Z \.0 JJ Z )> CJ Z CJ '" 0 ~ t-3 .j::-- '" . . Cf < 52 \.0 .m m t-3 ~ JJ (') ::r:: :;l> (') co ~ m z '" (J) ::I: 0 trl 0 co -I CJ ::j JJ r L' t'""" w m trl trl Ol m '" -I - C// oK STATUS REPORT UNDER RULE 6.12 Name of Decedent: LaZena D. Co le Date of Death: October 9, 2001 Will No.: Admin. No.: 2001-00949 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 0 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 00 b. The separate Orphans' Court No. (if any) for the personal representative's accountis:~ c. Did the personal representative state an account informally to the parties in interest? Yes IDi 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 and may be attached to this report. Date: Q2.L11/2003 ~~.~11 Signature Craig A. Diehl, Esqllirp Name 3464 Trindle Road Camp Hill, PA 17011-4436 Address (717) 763-7613 Telephone No. Capacity: 0 Personal Representative !Kl Counsel for personal representative