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HomeMy WebLinkAbout01-0999 Estate of Michael E. Matsko also known as PETITION FOR PROBATE and GRANT OF LETTERS ~/-OI-CJ9'1 No. To: Register of Wills for th~ , Deceased. County of Cumber land in the Social Security No. _'20 6 - 1 0 - 7 9 2 9 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), whO}j~are 18 years of age or older an the execut ors in the last will of the above decedent, dated June 1 0 . ~~~A9~ g~med , 19_ (state relevant circumstances. e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 41 3 South Broad S tree t, Mechanicsburg, PA (list street, number and muncipality) Decendent, then 84 years of age, died October 17 , ~ 200,1 at Holy Spirit Hospital, Camp Hill, Cumberland County, PA Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: No exceptions Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 85, 000. 00 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled inPa.) Personal property in County $ Value of real estate in Pennsylvania $ 1 2 8 . 000 . 00 situated as follows: 413 South Broad Street, Mechanicsburg, PA WHEREFORE, petitioner(s) respectfully re~uestf~ the €robate of the last will }QKdC~0i~ presented herewith and the grant of letters es men ary theron. (testamentary; administration c. La.; administration d. b. n.c. La.) t ~,uOl1r(q-/cJ" ~~ E~ G. Ma~~ ~o 1268 W. Trindle Road c::"Z ~~ Mechanicsburg, PA 17055 3~ 0)"-0 ;';0 ~ c: "" U3 d(b:~1t 0 Nlka~ 903 Norway Street Mechanlcsburg, FA I IU~~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 1- ss COUNTY OF CUMBERLAND J ~ oQ' :::s ~ .... s:: ~ ~ ~o. 21-2001-0999 Estate of , Deceased AND NOW October 31~ ~fl. 200)" in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated June 10th, 1992 described therein be admitted to probate and filed of record as the last will of , MICHAEL E. MATSKO and Letters TESTAMENTARY EDWARD G MATSKO AND ROBERTA M. NICO'I'ERA are hereby granted to . MICHAEL E.MATSKO DECREE OF PROBATE AND GRA~T OF LETTERS Probate, Letters, Etc. ......... Short Certificates(3 ) . . . . . . . . . . Renunciatio(n )' . . . . . .. . . . . . . . . . x-Pages 4 JCP Filed FEES $ 270.00 $ 9 .00 $ $ 12.00 TOTAL _ $ 5.00 . Dctober. 3.1st.2001...$ .29.6.00. Richard L. Placey 07232 ATIORNEY (Sup. Ct. I.D. No.) 3631 North Front Street ADDRESS Harrisburg, PA 17110-1533 (717) 236-9577 PHONE MAILED LETI'ERS 'ill AT'illRNEY ~i~ .. ~j11c' ./ . JUt. L -::i'- LE,'WISk/.(~ ,/ H !i1';:,Kl',", '\F\ This is to certif\' that the information here given is correctly copied from an original certitlcate of dt'ath duly filed with me as Local Re,;gistrar. The original certifIcate will be forwarded to the State Vital Records Oftlce for pernHllenr flling. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee t(H this certificate. $2.00 ~~7iiii;;;;;;;. 4;.iii~~\,1\\ OF P(~__ /#/ ~ ~~..\~ I~\~~I . !I'~\~\ i~ ~I-~:-~ - \7 ~ I'~oo:::' . .... ,~~ ~c::.j f ';-::: ~ c,..)\ ..-j:.r~~,:J::. ~I ~ .. \~ ,~'._~ '::.r ~/ * I' ''- a..~ . ''"~ I' \C1-P~ /~\,\' ..,.~- '11/~~ENT-(\~ ~\;,\')'" ~;,:rJ t N \ \) \,;f!l/' ~ P 7691528 "lo. 21-2001-999 (!)cU/J _ /~,) Cd I [{ltC' I Hl05 143 Rev Ve7 COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH l>d .......... Cumberland ::':::"1 11..~ ::"....""::'..':::'.. Mechanicsburg ""THER'SN...E "..,..".... ..""""....""'t:'Iizabelh Csevenyock ... 1Nf00MANTS~~lsWfndlem:cr~e:CIi~nicsburg, Pa 17055 2Gb. PlACE OF DISPOSITION - N..... of CerMlery, C,emalOfy LOCRION . CilyllOwn, SLile. Zip Code ,""",",ptGale of Heaven Cemetery Mechanicsburg, Pennsylvania 21c. l1d. iYPE/PRINT IN PER.....NENT "dL"'CK INK N.....ME Of DECEDENT (fllsr Middle, lalill SEX Male .. 1. AGE (laSl BorttlQay) UHOER 1 DAY Hot,n Mlnut.. B~THPl.ACE (Coty 4f'.d Stale 01 fCleK)Il CouncrYI UNDER 1 yeAR MontN Oeya 84 Y.. s. COUNTY OF DEATH Cumberland lb. Ie. DECEDENT'S uSUAl OCCUPATION iGlVe!unci of WQ'k done dufll'ltJ mo51 of WOfkmg Ide; do f\OC use reflled ) La Dorer 11b. DECEDENT'S .......IUNG AOOAESS ~r". C~fbwn. S1aee. ZlpCOdeI 413 South Broad Street Mechanicsburg, Pennsylvania 1705 DECEDENT'S .....CTUAl RESIDENCE ,See""""""",, OIloUlefSldel t7b.County it. FATHER'S N.....ME {FiliI. Middle. lasrl George Matsko Edward Matsko ... INFORMANT'S N.....ME (T ypelPflnI) .... METHOD OF DISPOSITION Bunel ~ C,emanon 0 QI ltvf CJ .~ ..n 1'"'-;- ..,J bl~~ 7~lM:ENS~/ 24. 25. 27. PART I: Enlel the diS41ases. injUlieS Of complic.allOl'lS which cause4lhe death. Do nolen181lhe mode 01 dying, such ilS cardiac 01 lespltalOt't allest. shoctl 01 heal1lallule llSl only one cause 00 eacJ\ lOne . r'rJd..()/lla 2.:iSt2fIV7.f!//!t DUE 10 lOR AS .....CONSEOUENCE Of) b /! (' ()T6-. 11\ iO (j r1 d./)/ /1 <... l ?,:Jl'''Y'1SAC''!jSEOUE EOf);1 cC 0 r. u/vtl L1Y- n Ii rtZ d ~( . DUE 10(00 AS .....CONSEQueNCE Of) . I AJ F 1/ZC. r OI5G-/-; > --- \_\..J WERE AUTOPSY FlNOtNGS MANNER Of DE.....TH A\lJ\1l.ABLE PRIOR to COMPLETION OF CAUSE 0 0 Of OERH1 Nalut. Homocide Ace...... 0 PendIng 1oY851K;illlon rJ Y.. 0 No 0 """'... 0 Could noI be deltlfm,,,ed 0 O.....TE OF INJURY IMonlh Day. ~fl '___J .~ ., STATE fILE NUMBER SOCiAl SECURITY NUMBER s. 206 10 White MARITAL STATUS - Mamed N....... Married, Widowed, "'WicIgwe'6 SURVIVING SPOUSE IIINlle.~""m;;roOetlnafl'\tll - coOy-" NAME AND AOORESS OF FACILITY Myers Funeral Harne, Inc. 37 East Main Street Mechanicsburg, Pa 17055 .... lK:ENSE NUMBER DATE S.GNED AAO 7". - '2. L (MOIlItl.Oay.....iIIl 2310. IVI . U' l.- ')') /. .2< C'c t (,\)l"V Wl.S CASE REFERRED TO MEotCAl EXAhotINERlCORONER? ....0 Nol1!:l 17) LUl'1 :It. I AppIOlumale I inIatva8 befween : onMI and death I i PARTN: OtherSigrnflCaIM~C:OC'llrlbulingto(jealh.bul not ,.suIling in !he under1yIng CauM given in PART I E S /2 f) TI..e Of IN.JUAY INJURY AT WORK? DESCFuBe HOW INJURY OCCURRED Y.. 0 NoD 30. M. JOe. PLACEOFINJURY. Al home. lalm. stt"', lactOly. office buikirog:. alc cSpecII"'1 1... lib. It. JeM. URTIFIER (C~eck OOy onel .CERTIFYING PHYSJ.CIAH IPhySlC'"'' CO!fllfylng cause 01 death whef' .lllOlhtlf Oh",!ioIl:.aro hdS PfQ(lOVroced d~dln .l(1..J ComjJIl:led Htltn .!31 To !.he belli 01 my IU'lOw'-dge. d.alhoc:curred due 10 taM cause(s) and me"n.' a. ..aled. . ~ 8 ~ o ~ z .PRONOUNCING AND CERTIFYING PHYSICIAN 1pt,~1aI1 boI~ ;.lrO'>Ouoc,"g <.Ie.un dnd <.;t.'fhly'ng to ":dUse 01 ae.Jlfl\ To tha ~I ot my .roowledge, lHIIlh <Kcyn" at the time, dale, a"d plIlC., .."d due 10 Ihe causa(.' arod mennef ol' sUllecd "MEDICAL EXAMINER/CORONER On the b..is of ..ami"eUon and/or inves1lgalion, in my opinion, death occuHed allhe lime, dale, ~"d place, and due to the cause(l) and manner as stated , ". ~~G.~.ryAA'S.S'GNAfURE'N~NU"~ . ' ,,_~f\./..iU.4.1A. L< 'U.O j 1l!J.l.~____~ ....., ~ A...--- [J ,. c. To b021€... /8 ,;? (){') ( / 21-2001-0999 LAST WILL AND TESTAMENT OF MICHAEL E. MATSKO I, MICHAEL E. MATSKO, now of Mechanicsburg, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and hereby revoke all prior Wills and Codicils made by me. ITEM I. I direct that all of my debts and funeral expenses including the cost of my gravemarker, if any, shall be paid from my estate as soon as practicable after my decease as a part of the administrative expenses of my estate. ITEM II. If I am survived by my brother-in-law, DAVID J. NOLAN, then I give and devise of all my estate, of every nature and wherever situate, unto my daughter, ROBERTA M. NICOTERA, and my son, EDWARD G. MATSKO, as Trustees, or the survivor of them as Trustee, for the following uses and purposes: A. To payor apply so much of the income and principal as, in Trustee(s) discretion, is necessary to provide for the care, maintenance and support of my brother-in-law, DAVID J. NOLAN, so as to permit him to continue to reside in my residence at 413 S. Broad Street, Mechanicsburg, Pennsylvania as long as he is able and desires to reside there or in some other place where he can live independently. B. At DAVID J. NOLAN's death or should he become institutionalized in a nursing home or similar facility, this trust shall terminate and the principal thereof and any undistributed income shall be paid, in equal shares, to my son, EDWARD G. MATSKO, and my daughter, ROBERTA M. NICOTERA, or their respective issue, per stirpes. ITEM III. If my brother-in-law, DAVID J. NOLAN, does not survive me, then I give and devise all of my estate in equal shares to my son, EDWARD G. MATSKO, and my daughter, ROBERTA M. NICOTERA or their respective issue, per stirpes. ITEM IV. I direct that all estate, transfer, inheritance and succession taxes upon or ln respect to the estate of which ~' ,/. J IJ f:.. 7 ) /1' "I /Jt (/r'/uL~{ . / IL d;[1i/olU Michael . Matsko I shall die seized and possessed, and upon all other property upon which or in respect to which any such taxes may be due and owing shall be paid out of my estate as if they were my debts, without any apportionment or right of reimbursement, and all legacies, devises and other gifts made by this Will or by any Codicil hereto shall be free and clear thereof. ITEM V. I appoint my son, EDWARD G. MATSKO, and my daughter, ROBERTA M. NICOTERA, as Co-Executor/Executrix of this my Last Will and Testament. No bond shall be required by my Personal Representative in any jurisdiction. ITEM VI. In addition to the powers given by law to my personal representative(s) and trustee(s) [hereinafter fiduciaries] in the administration of my estate and of the trust(s) created herein, they shall have the following discretionary powers applicable to all real and personal property held by them, including property held for minors, effective without court order until actual distri- bution. (Words used in the singular may be read to include the plural or the plural may be read as the singular. Similarly, the masculine form may be read to include the feminine and neuter; the feminine may be read to include the masculine and neuter; and the neuter may be read to include the masculine and feminine.) A. To retain any property owned by me at my death and to invest any funds held by them in any stocks, bonds, notes or other securities or property, real or personal, including common trust funds, mutual funds and money market deposit accounts operated or offered by my corporate trustee, if any, or any affiliate of it. B. To sell or otherwise dispose of any property, real or personal, at any time forming a part of my estate or the Trust estate, for cash or upon credit, in such manner and on such terms as they see fit, and no one dealing with the fiduciaries shall be bound to see to the application of any monies paid. C. To manage, operate, repair, improve, mortgage or lease for any term any real estate at any time held or owned by them as fiduciaries. )/i IlcAuf ~ 7 k~I~Jq) Michae E. Matsko D. To hold investments in the name of a nominee and exercise and dispose of warrants. E. To engage in litigation and compromise, arbitrate or abandon claims and property. F. To conduct any business in which I am engaged or in which I have an interest at the time of my death, for such period as the fiduciaries deem advisable, with the power to borrow money and to pledge the assets of the business and do all other acts, which I, in my lifetime, could have done, or to delegate such powers to a partner, manager or employee, without liability for any loss occurring therein. G. To allocate items of receipt or disbursement between principal and income as the fiduciaries deem equitable regardless of the character given such items by law: to distribute in cash or kind or partly in each at valuations fixed by the fiduciaries. H. To borrow money, including the right to borrow from any corporate trustee, if any, and to mortgage or pledge as security or to hold its own stock if a corporate trustee. I. To join in any merger, reorganization, voting-trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto. J. Should the principal of any trust herein provided for be or become too small in trustee's opinion so as to make establishment or continuance of the trust inadvisable, my trustee(s) may make immediate distribution of the then remaining principal and any accumulated or undistributed income outright to the person or persons and in the proportion they are then entitled to income. Upon such termination, the rights of all beneficiary(ies) who might otherwise have an interest as succeeding income beneficiary(ies) or in remainder shall cease. K. In general, to exercise all powers in the management of the assets of my estate or the Trust estate which any individual could exercise in the management of similar property owned in his own right, upon such terms and conditions as the fiduciaries may deem best, and to execute and deliver all instruments and ")1' . ~ 1 d .,! i L:{ l'" :{1 (.~ I) } Z (Ire .rn:l,[) Mlchael E. Matsko _ '1 _ to do all acts which the fiduciaries may deem necessary or proper to carry out the purposes of this Will or the Trust(s) created herein. L. To apply income or principal to which any beneficiary is entitled, directly for his or her comfort, maintenance and support, should the fiduciaries deem such beneficiary incapable of receiving the same by reason of age, illness, infirmity or incapacity, or to pay the same to such person or persons as the fiduciaries select to disburse it, whose receipt shall be a complete acquittance therefore without the intervention of any guardian. M. To assume continuance of the status of any beneficiary with reference to death, marriage, divorce, illness, incapacity or other change in the absence of information deemed reliable without liability for disbursements made on such assumptions. N. All principal and income shall, until actual distribution to any beneficiary, be free of the debts, contracts, alienations and anticipations of any beneficiary, and the same may not be liable for any levy, attachment, execution or sequestration while in the hands of any fiduciaries. seal this IN WITNE~S WHEREOF, I have hereunto set my hand and / (J ~~ay of '---TJ 0 Q , 1992. , )11, .' 1e )' I . '..... \' . . .. i . / QC{'//1 t4!j " ! (( ~ *",IJ-f) Michael E. Mats 0 The preceding instrument, consisting of this and three (3) other typewritten pages, identified by the signature of the Testator, was on the day and date thereof signed, published and declared by MICHAEL E. MATSKO, the Testator therein named, as and for his last Will, in the presence of us, who, at his request, in his pr sence ~nd' the presence of each other, subscribed our names s(bf's~e. ,hereto. (' 1 r v -cL'a . ';1-2 c:>J ::J,P J ,1;{~/,',,,/~i;/d7,'J( I ( II / j<~ -z::::-~ ~~/?}O( - 4 - ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF DAUPHIN I, MICHAEL E. MATSKO , testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last Will, that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. )! c j L f/J~(l if l' ~ J! C{Jjtp~ Michael E. Matsko MiC7el E. Matsko 1'/ "- J. J11. 'L Sworn or affirmed to and acknowledged before me, by , testator, this J 0 t.Jh day of , 19 92 . LlFN.:W.-l. ~J{) Notary P lic My Commission Expires: NOT ARl/\L SEAl UNDA,L. GUSTIN. Notary Public I Harrisburg, Dauphin County ! My Commission Expires May 20. 1995 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF DAUPHIN We, --'K U2 haJl W-diL~~JYY) K , , witnesses whose names are signed to ached or foregoing instrument, being duly qualified accordin to law, do depose and say that we were present and saw testator sign and execute the instrument as his last Will~ that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed~ that each of us in the hearing and sight of the testator signed the Will as witnesses~ and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. . .-e - ._.._~ ~~ ~-=9- ~ of C1 Sworn to and subscribed before me this ~J- , 19 92 . } () f:Ji day My Commission E NOT ARIAL SEAl LINDA L. GUSTIN, Notary Public Harrisburg, Dauphin County I My Commission Expires May 20 1995 f --- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Michael E. Matsko Date of Death: October 31,2001 Administration No.: 21-01-0999 To the Register: I certify that notice of estate administration required by Rule 5.6(a) of the Orphans' Court Rules was given to the following beneficiaries set forth on the attached list. Notice has now been given to all persons entitled thereto under Rule 5.6(a). 2"". ~ \ . ;/ / / ,/ ,. (( a L. Pia ' , s '- omey for the Estate 3631 North Front Street Harrisburg, P A 17110 (717)236-9577 Date: November 8, 2001 NOTICE GIVEN TO: ESTATE OF MICHAEL E. MATSKO Edward G. Matsko 1268 W. Trindle Road Mechanicsburg, P A 17055 Roberta M. Nicotera 903 Norway Street Mechanicsburg, P A 17055 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 PLACEY RICHARD L ESQ 3631 NORTH FRONT STREET HARRISBURG, PA 17110-1533 _nn___ fold ESTATE INFORMATION: SSN: 206-10-7929 FILE NUMBER: 21 - 200 1 - 0999 DECEDENT NAME: MA TSKO MICHAEL E DATE OF PAYMENT: 01/15/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 10/17/2001 NO. CD 000749 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $11,291.13 I I I I I I I I TOTAL AMOUNT PAID: $11,291.13 REMARKS: ROBERTA M NICOTERA C/O RICHARD PLACEY ESQUIRE CHECK# 1004 SEAL INITIALS: VZ RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER' OF WILT.s RE\l.1Sl1OEX(6-OO) . COMMONWEAlTH OF PENNSYlVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 t- Z W o W o W o ~ :ll::5l/) ulI::ll: wILg x~..J UILID IL 4( REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INiTIAl) MATSKO, Michael E. DATE OF DEATH (MM-OD-YEAR) DATE OF BIRTH (MM-OD-YEAR) October 17, 2001 November 17, 1916 (IF APPliCABLE) SURVIVING SPOUSE'S NAME (lAST, FIRST, AND MIDDLE INITIAL) n/a [XJ 1. Original Return o 4. Limited Estate [i/ 6. Decedent Died Testate (AIIach copy of WI) o 9. Litigation Proceeds Received o 2. Supplemental Return o 43. Future Interesi Compromise (~of ~ atIor 12.12-82) o 7. Decedent Maintained a Living Trust (AIlachcopyofTrusl) o 10. Spousal Poverty Credit (daIa of dealh ~ 12-31-91 aOO 1-1-95) r' '- FILE NUMBER 21_01 o 999 COUN1Y COOE YEAR ------ NUMBER SOCIAl SECURITY NUMBER 206 10 - 7929 THIS RETURN MUST BE FILED IN DUPUCATE WITH THE REGISTER OF WILLS SOCIAl SECURITY NUMBER o 3. Remainder Refum (daIa of dealh prilr m 12.13:32) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. EIecIion to lax under Sec. 9113(A) (AIlach Sdl 0) z o 5 :::>> t- o: c( o w a:: COMPLETE MAILING ADDRESS NAMjichard L. Placey, Esquire FIRM NAME (If AppIicabIo) Place & Wri ht ffiEPHONE NUMBER (717)236-9577 14. Net Value Subject to Tax (Une 12 minus Une 13) 3631 North Front street Harrisburg, PA 17110-1533 (1) (2) (3) (4) (5) 128,810.00 .00 .00 .00 84,742.42 70,202.46 (6) (7) .00 (9) (10) 19,039.06 595.85 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES 15. Amount of Line 14 taxable at the spousal lax rate, or transfers under Sec. 9116 (a)(12) 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Close/y Held Corporation, Partnership or Sole-Proprielolship 4. Mortgages & NOtes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. JoinUy Owned Property (Schedule F) o Separate Billing Requested 7. Inter-VIVOS Transfers & Miscellaneous Non-Probale 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 Unes 9 & 10) 12. Net Value of Estate (Une 8 minus Line 11) 13. Charitable and Governmental BequeslslSec 9113 Trusts for which an election to lax has not been made (Schedule J) z o ~ ~ :::>> Q. :::E o o ~ 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 264,119.97 OFFICIAL USE ONLY pc. :::(to ::1:::: cr . ,C", ~ ::IJ ::U (') n) c~ .',....,. ....." C- ::l::> ::z:: -.. U1 J::.~ OJ 'J; (8) 283,754.88 (11) (12) (13) 19,634.91 264,119.97 .00 (14) 264,119.97 x.O_ (15) .00 X.o 45 (16) 11,885.40 x .12 (17) .00 x .15 (18) .00 (19) 11,885.40 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 20.0 -~.~ *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE MICHAEL E. MATSKO FILE NUMBER 21-01-0999 ESTATE OF AD 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 wiI\ing buyer and a wll\ing seller, neither being compeIIecI to buy or sell, bolh having reasonable knowledge of the relevant fads. Real property which Is jolntly-owned with right of survlvorshiD must be dlsc:losed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH Real estate situate in the Borough of Mechanicsburg, Cumberland County, Pennsylvania, more particularly described in Cumberland County Recorder of Deeds Office in Deed Book "X", Volume 24, Page 98, known and numbered as 413 Broad Street, Mechanicsburg, PA. (Assessed value. See notice- attached.) 128,810.00 TOTAL (Also enter on line 1, Recapitulation) $ 1 28 , 8 1 0 . 0 0 (If more space is needed, insert additional sheets of the same size) THIS IS NOT A TAX BILL MAILING OATH: July 1, 2000 Parcel Identifier: District. 20 - IIBOWUCSBQRG 5T1l'1fRJ) 20 - 24 - 0185-250.:,4:". School. .: IIBCHAHICSBt1RG SD Location: 413 S BROAD STRBBT GLBNIfOOD TBRRACB LOT 53 fo 54 Land Buildings TOTAL 200CH".>".. Mai1c:et Vatue' '.i'ii<~~'OOO 109;810 . 128",83:0 Old Assessed Value (1974 Market x 25%) 1,880 7,940 9,820 Land Siz...... .50 acres Land Buildings TOTAL Assessed Value (2000 Market x100%) "";;';"'';'''].9,000 -,.,' 109',810 128,810 TAXABLB 2000 Clean and Green Values UNIT/LOT ID..: L-0053 + NOT APPLICABLE ;>',-~- c-~:_:::'~c~'-\:'j, Property Type. R Residential With Buildings Clean and Green values apply to some fann and forest land.' Such values become effective onl1uponappHcation and approval. All applications must be received by the AssessmentOffice by 4:30 p.m. on October 15, 2000. Those previously approved for Clean and Green do not need to re-apply. Control No: 20000382 CUTQPIVP Pennsylvania law requires that all real estate be valued as of the most recent county-wide reassessment. The last reassessment, or tax base year, was 1974. Since the last reassessment in 1974, properties have been assessed at 25% ofthl 1974 value (the "Pre-Determined Ratio'. The new tax base year will be the Year 2000, with the new assessed values becoming effective for the 2001 tax year. The Pre-Determined Ratio has been changed to 100%. Your new assessed value equals your Year 2000 market value. It is very important for you to know that when the new 2000 tax base is determined after this reassessment, all taxing dIstricts are requIred by law to lower the millage rate by the same proportion that the tax base went up. The law provides that in the first year after reassessment (2001), the county and all townships and bOroughs may not increase overall revenue by more than five percent (5%) and school districts may not increase overall revenue by more than ten percent (10%). The county and the other taxing bodies will make these decisions next year,. and may choose not to increase overall revenue. Of course, some individual's taxes will go up or down by more than those percentages. The essential point Is that an Increase In market values does not necessarily mean a corresponding Increase In taxes. Individual changes In taxes will depend upon a specific property's change as compared to the overall change for the taxing district. The ESTIMATED impact statement printed below is our best estimate of change, based on 2000 COUNTY tax figures. This estimate does not include any borough, township, or school district impact. ESTIMATED COUNTY TAX IMPACT: Current 2000 County mills.. 27.500 Adjusted 2000 County mills.. 1.858 $ 270 : 2000 County Tax BEPORE Reassessment. $ 239 2000 County Tax APTER Reassessment. __R.,,, .- COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER 21-01-0999 MICHAEL E. MATSKO Include the proceeds of litigation and the date the proceeds were received by the estate. All property joIntIy~ed with the right of survivorship must be dlsc:losed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Citizens Bank Checking Account 140-070-7673 Principal - $84,076.27 Interest - $ 10.87 84,087.14 (See bank letter attached) 2. 3. 4. Quantum Imaging - refund Household Goods Kitchen table and chairs Refrigerator Microwave Miscellaneous pots/pans/dishes/glasses Dining room table and chairs Hutch Book Shelves Sofa Recliner Coffee table and end tables Rocker TV Chair Lamps (3) Beds (2) Dressers (2) Bureaus (2) Table TV Recliner Mower Air Conditioner Washer and dryer Small TV Miscellaneous Personal Effects 19.28 20.00 25.00 10.00 45.00 75.00 50.00 20.00 20.00 25.00 15.00 25.00 25.00 10.00 6.00 65.00 40.00 40.00 5.00 15.00 15.00 25.00 35.00 20.00 5.00 636.00 NO VALUE TOT At (Also enter on line 5, Recapitulation) $ 84, 7 4 2 . 4 2 (If more space is needed, insert additional sheets of the same size) t: CITIZENS BANK Thursday, December 06,2001 Account Number Account Title 00051932 Michael E Matsko ITF Date Opened: 11/28/1994 Account Type: TO Edward G Matsko Principal Sal Int from Last Account Sal YTD Int to as of DOD Posting to DOD . as of DOD DOD $11,519.23 $199.48 $11,718.71 $390.59 00051941 Michael E Matsko ITF Date Opened: 11/28/1994 Account Type: TO Edward G Matsko Principal Sal Int from I.,ast Account Sal YTD Int to as of DOD Posting to DOD as of DOD DOD $11,519.23 $199.48 $11,718.71 $390.59 00051947 Michael E Matsko ITF Date Opened: 11/28/1994 Account Type: TO Edward G Matsko Principal Sal Int from Last Account Sal YTD Int to as of DOD Posting to DOD as of DOD DOD $11,519.23 $199.48 $11,718.71 $390.59 00051954 Michael E Matsko ITF Date Opened: 11/28/1994 Account Type: TO Roberta E Nicotera Principal Sal Int from Last Account Sal YTD Int to as of DOD Posting to DOD as of DOD DOD $11,658.31 $23.80 $11 ,682. 11 $394.24 00052715 Michael E Matsko ITF Date Opened: 11/28/1994 Account Type: TO Roberta E Nicotera Principal Sal Int from Last Account Sal YTD Int to as of DOD Posting to DOD as of DOD DOD $11,658.31 $23.80 $11,682.11 $394.24 00053232 Michael E Matsko ITF Date Opened: 11/28/1994 Account Type: TO Roberta E Nicotera Principal Sal Int from Last Account Sal YTD Int to as of DOD Posting to DOD as of DOD DOD $11,658.31 $23.80 $11,682.11 $394.24 140-070-7673 Michael E Matsko Date Opened: 01/07/1986 Account Type: DO Principal Sal Int from Last Account Sal YTD Int to as of DOD Posting to DOD as of DOD DOD $84,076.27 $10.87 $84,087.14 $203.75 Page 2 of 2 __n.",. . COMMONWEAI..lH OF PENNSYlVANIA taiERlTANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON.PROBA TE PROPERTY ESTATE OF MICHAEL E. MATSKO FILE NUMBER 21-01-0999 This schedule must be completed and filed iflhe answer to any of questions 1 through 4 OIIlhe reverse side oflhe REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY % OF DECDS ITEM N:WIlElHE _OFlHE~ 1IEIl1BA11ONSI.-1ODEalIENT _lHE DAlE OF_ DATE OF DEATH INTEREST EXCLUSION TAXABLE VALUE NIIUR~R AnAClf A COPY OF lHE DEED FIlR RE.<L ESTAlE. 1. Citizens Bank C.D. 00051932. Beneficiary Edward G. Matsko, Son. Transferred 10/17/2001. 11,718.71 100% n/a 11,718.7 2. Citizens Bank C.D. 00051941. Beneficiary Edward G. Matsko, Son. Transferred 10/17/2001. 11,718.71 100% n/a 11,718.7 3. Citizens Bank C.D. 00051947. Beneficiary Edward G. Matsko, Son. Transferred 10/17/2001. 11,718.71 100% n/a 11,718.7 4. Citizens Bank C.D. 00051954. Beneficiary Roberta M. Nicotera, Daughter. Transferred 10/17/2001. 11,682.11 100% n/a 11,682.1 5. Citizens Bank C.D. 00052715. Beneficiary Roberta M. Nicotera, Daughter. Transferred 10/17/2001. 11,682.11 100% n/a 11,682.1 6. Citizens Bank C.D. 00053232. Beneficiary Roberta M. Nicotera, Daughter. Transferred 10/17/2001. 11,682.11 100% N/a 11,682.1 (See bank letter attached) TOTAL (Also enter on Une 7, Recapitulation) $ 70,202.46 1 1 1 1 1 1 (If more space is needed, insert additional sheets of the same size) +: CITIZENS BANK Thursday, December 06,2001 Account Number Account Title 00051932 Michael E Matsko ITF Date Opened: 11/28/1994 Account Type: TO Edward G Matsko Principal Bal Int from Last Account Bal YTD Int to as of DOD Posting to DOD . as of DOD DOD $11,519.23 $199.48 $11,718.71 $390.59 00051941 Michael E Matsko ITF Date Opened: 11/28/1994 Account Type: TO Edward G Matsko Principal Bal Int from L,ast Account Bal YrD Int to as of DOD Posting to DOD as of DOD DOD $11,519.23 $199.48 $11,718.71 $390.59 00051947 Michael E Matsko ITF Date Opened: 11/28/1994 Account Type: TO Edward G Matsko Principal Bal Int from Last Account Bal YTD Int to as of DOD PostIOg to DOD as of DOD DOD $11,519.23 $199.48 $11,718.71 $390.59 00051954 Michael E Matsko ITF Date Opened: 11/28/1994 Account Type: TO Roberta E Nicotera PrincIpal Bal Int from Last Account Bal YTD Int to as of DOD Posting to DOD as of DOD DOD $11,658.31 $23.80 $11,682.11 $394.24 00052715 Michael E Matsko ITF Date Opened: 11/28/1994 Account Type: TO Roberta E Nicotera PrincIpal Bal Int from Last Account Bal YTD Int to as of DOD Posting to DOD as of DOD DOD $11,658.31 $23.80 $11,682.11 $394.24 00053232 Michael E Matsko ITF Date Opened: 11/28/1994 Account Type: TO Roberta E Nicotera Principal Bal Int from Last Account Bal YTD Int to as of DOD Posting to DOD as of DOD DOD $11,658.31 $23.80 $11,682.11 $394.24 140-070-7673 Michael E Matsko Date Opened: 01/07/1986 Account Type: 00 PrincIpal Bal Int from Last Account Bal YTD Int to as of DOD Posting to DOD as of DOD DOD $84,076.27 $10.87 $84,087.14 $203.75 Page 2 of 2 -_.~. '* COMMONWEALTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-01-0999 ESTATE OF . MICHAEL E. MATSKO Debts of decedent must be reported on Schedule L ITEM NUMBER A. DESCRIPTION 1. FUNERAL EXPENSES: Myers Funeral Home, Inc. B. ADMINISTRATIVE COSTS: 1. Personal Representative's eoodnisslollS Name aI Personal Representative (s) Social SecurlIy NumbeI(s) I EIN Number of Personal RepleS8fllative(s) Street AddreSs CIty Stale Zip 2. 3. Yearts) CommIssion Paid: AIklmeyFees Placey & Wright Family Exemption: (If decedenfs address is not the same as cIalmant's. attach explanation) Claimant Street Address Clty Relationship aI Claimanlto Oec::edent Stale Zip 4. Probate Fees Gumberland County Register of Wills 5. Accountant's Fees 6. Tax RelUm Preparer's Fees 7. 8. 9.. 10. Cumberland Law Journal - estate advertising The Patriot-News Company - estate advertising Fulton Bank - check order Reserve for future costs, income taxes and expenses AMOUNT 9,054.00 7,500.00 nla 296.00 75.00 96.81 17.25 2,000.00 TOTAL (Also enter on line 9, Recapitulation) $ 1 9, 039 . 06 (If more space is needed, insert adcfmonal sheets of the same size) ~.,,~.""'. '*' COMMONWEAlTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF MICHAEL E. MATSKO FILE NUMBER 21-01-0999 Include unreimbursed medical expenses. ITEM NUMBER 1. 2. 3. 4. 5. 6. DESCRIPTION United Water Pennsylvania - various billings PP&L - various billings UGI Utilities - various billings Verizon - various billings Comcast - various billings Sewer Authority - debt of decedent AMOUNT 97.77 103.20 157.04 48.02 99.02 90.80 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert addtional sheets of the same size) 595.85 RE\!.,S13 EX + (,-91) '* SCHEDULE J BENEFICIARIES COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT MICHAEL E. MATSKO FILE NUMBER 21-01-0999 RELATIONSHIP TO DECEDENT Do NotUstTrustee(s) AMOUNT OR SHARE OF ESTATE ESTATE OF NUMBER I. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (indude outright spousal distributions) 1. Roberta M. Nicotera 903 Norway Street Mechanicsburg, PA 17055 Daughter One-Half Estate 2. Edward G. Matsko 1268 W. Trindle Road Mechanicsburg, PA 17055 Son One-Half Estate ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART n. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ - 0- (If more space is needed. insert additional sheets of the same size) , LAST WILL AND TESTAMENT OF MICHAEL E. MATSKO I, MICHAEL E. MATSKO, now of Mechanicsburg, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament and hereby revoke all prior Wills and Codicils made by me. ITEM I. I direct that all of my debts and funeral expenses including the cost of my gravemarker, if any, shall be paid from my estate as soon as practicable after my decease as a part of the administrative expenses of my estate. ITEM II. If I am survived by my brother-in-law, DAVID J. NOLAN, then I give and devise of all my estate, of every nature and wherever situate, unto my daughter, ROBERTA M. NICOTERA, and my son, EDWARD G. MATSKO, as Trustees, or the survivor of them as Trustee, for the following uses and purposes: A. To payor apply so much of the income and principal as, in Trustee(s) discretion, is necessary to provide for the care, maintenance and support of my brother-in-law, DAVID J. NOLAN, so as to permit him to continue to reside in my residence at 413 S. Broad Street, Mechanicsburg, Pennsylvania as long as he is able and desires to reside there or in some other place where he can live independently. B. At DAVID J. NOLAN's death or should he become institutionalized in a nursing home or similar facility, this trust shall terminate and the principal thereof and any undistributed income shall be paid, in equal shares, to my son, EDWARD G. MATSKO, and my daughter, ROBERTA M. NICOTERA, or their respective issue, per stirpes. ITEM III. If my brother-in-law, DAVID J. NOLAN, does not survive me, then I give and devise all of my estate in equal shares to my son, EDWARD G. MATSKO, and my daughter, ROBERTA M. NICOTERA or their respective issue, per stirpes. ITEM IV. I direct that all estate, transfer, inheritance and succession taxes upon or in respect to the estate of which !M(:J\f)~1 t, lJf/JdalJ Mic ael . Matsko I shall die seized and possessed, and upon all other property upon which or in respect to which any such taxes may be due and owing shall be paid out of my estate as if they were my debts, without any apportionment or right of reimbursement, and all legacies, devises and other gifts made by this will or by any Codicil hereto shall be free and clear thereof. ITEM V. I appoint my son, EDWARD G. MATSKO, and my daughter, ROBERTA M. NICOTERA, as Co-Executor/Executrix of this my Last Will and Testament. No bond shall be required by my Personal Representative in any jurisdiction. ITEM VI. In addition to the powers given by law to my personal representative(s) and trustee(s) [hereinafter fiduciaries] in the administration of my estate and of the trust(s) created herein, they shall have the following discretionary powers applicable to all real and personal property held by them, including property held for minors, effective without court order until actual distri- bution. (Words used in the singular may be read to include the plural or the plural may be read as the singular. Similarly, the masculine form may be read to include the feminine and neuter~ the feminine may be read to. include the masculine and neuter~ and the neuter may be read to include the masculine and feminine.) A. To retain any property owned by me at my death and to invest any funds held by them in any stocks, bonds, notes or other securities or property, real or personal, including common trust funds, mutual funds and money market deposit accounts operated or offered by my corporate trustee, if any, or any affiliate of it. B. To sell or otherwise dispose of any property, real or personal, at any time forming a part of my estate or the Trust estate, for cash or upon credit, in such manner and on such terms as they see fit, and no one dealing with the fiduciaries shall be bound to see to the application of any monies paid. C. To manage, operate, repair, improve, mortgage or lease for any term any real estate at any time held or owned by them as fiduciaries. JJi'({tJvu/ t rJlvr;;j~ ichae . Matsko - ., - D. To hold investments in the name of a nominee and exercise and dispose of warrants. E. To engage in litigation and compromise, arbitrate or abandon claims and property. F. To conduct any business in which I am engaged or in which I have an interest at the time of my death, for such period as the fiduciaries deem advisable, with the power to borrow money and to pledge the assets of the business and do all other acts, which I, in my lifetime, could have done, or to delegate such powers to a partner, manager or employee, without liability for any loss occurring therein. G. To allocate items of receipt or disbursement between principal and income as the fiduciaries deem equitable regardless of the character given such items by law: to distribute in cash or kind or partly in each at valuations fixed by the fiduciaries. H. To borrow money, including the right to borrow from any corporate trustee, if any, and to mortgage or pledge as security or to hold its own stock if a corporate trustee. I. To join in any merger, reorganization, voting-trust plan or other concerted action of security holders, and to delegate discretionary duties with respect thereto. J. Should the principal of any trust herein provided for be or become too small in trustee's opinion so as to make establishment or continuance of the trust inadvisable, my trustee(s) may make immediate distribution of the then remaining principal and any accumulated or undistributed income outright to the person or persons and in the proportion they are then entitled to income. Upon such termination, the rights of all beneficiary(ies) who might otherwise have an interest as succeeding income beneficiary(ies) or in remainder shall cease. K. In general, to exercise all powers in the management of the assets of my estate or the Trust estate which any individual could exercise in the management of similar property owned in his own right, upon such terms and conditions as the fiduciaries may deem best, and to execute and deliver all instruments and JJi1 Lr' 'iCJ1 j d. }Wd J;dw M1chael E. Matsko - 3 - to do all acts which the fiduciaries may deem necessary or proper to carry out the purposes of this Will or the Trust(s) created herein. L. To apply income or principal to which any beneficiary is entitled, directly for his or her comfort, maintenance and support, should the fiduciaries deem such beneficiary incapable of receiving the same by reason of age, illness, infirmity or incapacity, or to pay the same to such person or persons as the fiduciaries select to disburse it, whose receipt shall be a complete acquittance therefore without the intervention of any guardian. M. To assume continuance of the status of any beneficiary with reference to death, marriage, divorce, illness, incapacity or other change in the absence of information deemed reliable without liability for disbursements made on such assumptions. N. All principal and income shall, until actual distribution to any beneficiary, be free of the debts, contracts, alienations and anticipations of any beneficiary, and the same may not be liable for any levy, attachment, execution or sequestration while in the hands of any fiduciaries. INWI~S WHERE~ have hereunto set my hand and seal this / () day of . / J 0 Q , 1992. , !fLV')Vlf!. e. Jl;U~~ M1chael E. Mats 0 The preceding instrument, consisting of this and three (3) other typewritten pages, identified by the signature of the Testator, was on the day and date thereof signed, published and declared by MICHAEL E. MATSKO, the Testator therein named, as and for his last Will, in the presence of us, who, at his request, in his p sence an the presence of each other, subscribed our names s~sse hereto. ';]:2 tAl ;).,tJ J~ lit /~<cl/, (d;7rJ ( ~/7/0( ...........7'''' "'-/"~'''--'-~_ .~~~ ~-:> - 4 - ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF DAUPHIN I, MICHAEL E. MATSKO , testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last Will, that I signed it willingly, and that I signed it as my free and voluntary act for the purposes therein expressed. )J{)(flcJi/ ~. ?ZL{~dJl-{J Michael E. Matsko M(h{el E.. Mi>UkQ 1. /)1.. 'L Sworn or affirmed to and acknowledged before me, by , testator, this lOW day of , 19 92 . L~l.~ Notary P lic My Commission Expires: AFFIDAVIT NOTARIAL SEAl LINDA l. GUSTIN. Notary Public Harrisburg, Dauphin County My Commission Expires May 20, 1995 COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF DAUPHIN . w~mK, , witnesses whose names are signed ached or foregoing instrument, being duly qualified accordin to law, do depose and say that we were present and saw testator sign and execute the instrument as his last Wil11 that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed1 that each of us in the hearing and sight of the testator signed the Will as witnesses1 and that to the best of our knowledge the testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. .~/ - .~ ~-~~ of c=r.~ to and,s~~~~r~bed before me this 16th day L~l~) Notary Pu ic My Commission E NOTARIAL SEAL LINDA L. GUSTIN, Notary Public Harrisburg, Dauphin County My Commission Expires May 20, 1995 /1-/7 -If BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 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 COUNTY ACN 02-26-2002 MATSKO 10-17-2001 21 01-0999 CUMBERLAND 101 RICHARD L PLACEY PLACEY & WRIGHT 3631 N FRONT ST HBG '02 l'lA~1-1 r\jl :22 ESQ v* REY-1547 EX AFP (01-02) MICHAEl E Amount Remitted PA 1 ita:mt, 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-E3CAFP--COY:02Y-NOYicE-OF-YNHEiiifANCe-TAX-;'-PPRA-isEi.fENT-,--AL.rOWANCi-oi----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MATSKO MICHAEL E FILE NO. 21 01-0999 ACN 101 DATE 02-26-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED CHANGED NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: .00 X 00 = .00 264,119.97 X 045 = 11,885.40 .00 X 12 = .00 .00 X 15 = .00 ll9)= 11,885.40 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 ll) (2) (3) (4) (5) (6) (7) 128,810.00 .00 .00 .00 84,742.42 70,202.46 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) llO) 19,039.06 595.85 lllJ ll2) ll3) ll4) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 283,754.88 19.634.91 264,119.97 .00 264,119.97 .. ".......... . (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) PAYMENT MUST BE MADE BY 07-17-2002*. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE 11,885.40 INTEREST AND PEN. .00 TOTAL DUE 11,885.40 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A D~~IINn ~FF REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) v /~~ /-;J. /y 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-1607 EX lFP CDl-OZI '02 ["lAr-: -8 F' 1 DATE ESTATE OF DATE OF DEATH FILE NUMBER : 1 BOUNTY ACN 03-04-2002 MATSKO 10-17-2001 21 01-0999 CUMBERLAND 101 MICHAEL E RICHARD L PLACEY PLACEY & WRIGHT 3631 N FRONT ST HBG ESQ Allount Rellitted (,;,.., PA 1711cal:mi. 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 =i"i;ifj-Ex-AFP-foY:o'2Y------...--iNHERiYANcE-fAx--sTATEMENf-cfF'-AccoliN"T--.-i.------------------ --- ESTATE OF MATSKO MICHAEL E FILE NO. 21 01-0999 ACN 101 DATE 03-04-2002 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-19-2002 PR I NC I PAL TAX DU E : ........................................................................................................................................................................................................................ 11,885.40 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-15-2002 CDOO0749 594.27 11,291.13 '-. TOTAL TAX CREDIT 11,885 . 40 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 If SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. J PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION o V STATUS REPORT UNDER RULE 6.12 Name of Decedent: Michael E. Matsko Date of Death: Will No.: October 17, 2001 2001-00999 Admin. No.: 21-01-0999 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes x No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: / 3. If the answer to No. 1 is yes, state the following: A. Did the personal representative file a final account with the court? Y~ ~ X B. The separate Orphans' Court No. (if any) for the personal representative's account IS: C. Did the personal representative state an account informally to the parties in interest? 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. ) ~"- Signature //' ! /" : RicMfd L. phcey--/ i " ) Date: April 17, 2002 ,/ .,/F '- -l. Name (Please type or print) 3631 N. Front street Harrisburg, PA 17110-1533 Address (MAH:rmtlAM3) (717)236-9577 Telephone No. Capacity: Personal Representative X Counsel for Personal Representative RW. - 27 INRE: ESTATE OF MICHAEL E. MATSKO, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION APPROVAL OF ACCOUNT. RELEASE AND INDEMNIFICATION EST A TE OF MICHAEL E. MATSKO. DECEASED The undersigned is one of the residuary beneficiaries of the Estate of Michael E. Matsko, Deceased. Edward G. Matsko and Roberta M. Nicotera, Co-Executors ofthe Estate of Michael E. Matsko (hereinafter "Personal Representatives"), are willing to make distribution ofthe assets of the estate without the formality of a court accounting upon the receipt of a proper release, receipt and indemnification, which it is the purpose of this document to provide. In consideration of the willingness of the Personal Representatives to make distribution without the formality of a court accounting and agreeing to be legally bound hereby, the undersigned does hereby: 1. Waive the filing of an account of the administration of the estate in any court; 2. Declare that the undersigned has examined the attached informal Statement of Account of the Personal Representatives; accepts and approves it with the same force and effect as if it had been prepared and filed with, audited, adjudicated and confirmed absolutely by a court of competent jurisdiction; and as if the balance of principal and income had been awarded by the court in accordance with the Statement; 3. Warrant that the undersigned is one of the residuary beneficiaries named in the informal Statement of Account and is entitled to receive the distribution therein set forth; 4. Absolutely and irrevocably releases and discharges the estate, the Personal Representatives and P1acey & Wright, attorneys for the estate, their respective heirs, personal representatives, successors and assigns, of and from any and all actions, liabilities, claims and demands relating in any way to the administration of the estate and distribution in accordance with the informal Statement of Account. 5. Agree to indemnifY and hold harmless the Personal Representatives and their personal representatives, successors and assigns, from and against any claims, liabilities, loss or expenses (including costs and counsel fees) arising from any cause whatsoever which the Personal Representatives may incur as a result of the administration of the estate and distribution in accordance with this document and to refimd to the Personal Representatives any portion of the distribution of the undersigned which exceeds the amount of the undersigned's share as the Personal Representatives finally determine. IN WTINESS WHEREOF, intending to be legally bound, the beneficiary has executed this document this /&-/1 day of ap,,/ , 2002. ~ ,!)~vi WItness t1JI~{/dy~v (SEAL) Edward G. Matsko INRE: ESTATEOF MICHAEL E. MATSKO, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION APPROVAL OF ACCOUNT. RELEASE AND INDEMNIFICATION ESTATE OF MICHAEL E. MATSKO. DECEASED The undersigned is one of the residuary beneficiaries of the Estate of Michael E. Matsko, Deceased. Edward G. Matsko and Roberta M. Nicotera, Co-Executors of the Estate of Michael E. Matsko (hereinafter "Personal Representatives"), are willing to make distribution of the assets of the estate without the formality of a court accounting upon the receipt of a proper release, receipt and indemnification, which it is the purpose of this document to provide. In consideration of the willingness of the Personal Representatives to make distribution without the formality of a court accounting and agreeing to be legally bound hereby, the undersigned does hereby: 1. Waive the filing of an account of the administration of the estate in any court; 2. Declare that the undersigned has examined the attached informal Statement of Account of the Personal Representatives; accepts and approves it with the same force and effect as if it had been prepared and filed with, audited, adjudicated and confirmed absolutely by a court of competent jurisdiction; and as if the balance of principal and income had been awarded by the court in accordance with the Statement; 3 . Warrant that the undersigned is one of the residuary beneficiaries named in the informal Statement of Account and is entitled to receive the distribution therein set forth; 4. Absolutely and irrevocably releases and discharges the estate, the Personal Representatives and Placey & Wright, attorneys for the estate, their respective heirs, personal representatives, successors and assigns, of and from any and all actions, liabilities, claims and demands relating in any way to the administration of the estate and distribution in accordance with the informal Statement of Account. 5. Agree to indemnifY and hold harmless the Personal Representatives and their personal representatives, successors and assigns, from and against any claims, liabilities, loss or expenses (including costs and counsel fees) arising from any cause whatsoever which the Personal Representatives may incur as a result of the administration of the estate and distribution in accordance with this document and to refund to the Personal Representatives any portion of the distribution of the undersigned which exceeds the amount of the undersigned's share as the Personal Representatives finally determine. IN WIlNESS WHEREOF, intending to be legally bound, the beneficiary has executed this document this / & 11l day of OJ n / ,2002. ~ 1.id~ ;z ~ l1:2k~ i4i- Roberta M. Nicotera (SEAL)