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HomeMy WebLinkAbout95-00652 , ',I' , ~.. < I"~ PETITION FOR GRANT OF LETTlmS OF AI>MINISTnATION Eslale of fl..... r '" .\ (1. L oZ " n G. ., ..oJ also known as No, To: ll-q5-lD52- Dt'C('I.lSNJ. Social SrclIrll)l No, ,;J. 0 3 - G; 8 - q 0 '::L~ Reglsler of Wills for Ihe ..J Coullly of C...... h ,,:-(... in Ihe C0Il1I1111nIVenll h of Pennsylvnnln The petlllon of Ihe undersigned respeclfnlly represents thnl: Your pethloner(s), who Is/nre 18 yenrs of nge or older, nppLI~,L- for lellers of ndmlnlslrntlon on Ihe estnle of (d.b.n.; pendente Ihej durnnte ubst'nliu: duuullc mlnorluuc) Ihe above decedent. Decendent wns domiciled III delllh in C ..... __ 6 Q. ,.1 *'-....1. County, Pennsylvania, will! ~~'&. j, b I ~ lastfamllyorprinelpalresldencelll ,(OS c,'_~,,,~ Dr,'"... (''''''''"''1., eA "t; I (1i\1 lIlrCl'I, 1I11111bcr nnd mun(dpnlll)') /7"13 _ 'I~' 0 Decendelll, then .~' q years of al\e, died :J". u. .... to ''i ,19 q 5- , at U"''''''CNlt~ H"I"JI't~l kYlo","-\u lie. TN " I Deeendentat death owned propcrly wllh eSllmnted vnlues ns folllows: (If domiciled In I'n,) All personal properly (If not domicil cd In I'n,) Personnl properlY in Pennsylvnnln (If not domiciled in I'a.) Personnl properlY In CoulllY Vnlue of real eslate In Pennsylvanln shoalcd os follows: N A $ ;1-, OOOr - $ $ $ Petllloner_after 0 proper scorch hoh aseerlnined Ihnl deeedenlleflno will and wns survived by Ihe following spouse (If any) ond heirs: Name A, G",~ ..... ..... A "1<.10;. .,T. G-" LU "GLe..~ Resld(nee -'.1.0:;' c;.....J ~,. Dr; II C....r I,/Ie I {'II " - THEREFORE, pelhloner(s) respeclfully requesl(s) Ihe grunt of lellers of admlnlslratlon In Ihe appropriate form to Ihe undersigned. .J~ ~~ t '0_ '6~ "'c III _'il ~o.. ~'S ~ .. Vi 110. S'.....t /., r Dr; v 0<. C_r/,;t<.,/ 1>11 /7ol:3-~.:l/;o " " .' ',- '" " ~ " ,:'-- '. :. . -,':;' '- - '. . .,'. . ,.;,1 ',' "jl;;E2:~_--_' ._.;' .':.'~}:::'_:, '. " ,.:_ _',' , . . ',' L'.::;', C ',~:l.::__, ".!,:.,::,;"; ;-,". 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(';;~2:t,;: ~_.;,,::> .~:>'~' /;~ ::'iil~~~ ,i'" ~~~.,:,: ':c. .":,, '-'X: :_--'- ::.,,:..:.-:, ,:; 'T(';J.~~ --, ,..:'" . .. - "-':":..-;" ....., ," '", -; :',. ,';',:'-- ',_i;.,,,::,, :>~'.' .,.:'" ',-c. .;' _,::<' >' '::.. .._:,.\,:;;.~,>,";', '. .. :' ,~;;;:::\ _":,'.;'" ,_, '.'.,>.'....:;. ", -, '. d...../; .- ,,", "'-",:', - <.:... ..... : __ . . , ,: <.....~ " .... ..',,;" __ :::,....,\:, :-;,:' :,,;:~ ':< ~,; ,:' .:, . i . . :",..;,.. ...... ~ ..' .>< '"r, .~.. ..,,~:: - 'v';' , ,-,- , .:'-~".',\.' :,: ,;~.... '. -., " v' ::.:, t. _.~ , }^^ , :} . ",') '::,..-. -..... .rE':' .', .' "'.' -,' ..-.:)i :;', ".~.:.::'-: ' ~l ,- ....: ....... ~ ..... ~:::. ':'<: ':,,"'" "." -~:~.. '...)f " -." ,,; ;:::'_.' .,.,;.,,: " ',:,'" .....,:'..: "".' ,:",:.. " ". ....." .......:...\:~~~;;j: ' ~;.:....'.)'....':...~:<....".:~. ......... ,,' ,;,<,:,5:1: ,:.,~,~s~~(~: ", - :t.,; ;~;<.... ' ..'. " ;,' .. ' - '..- '. - '..;_ ,--.....'. '.'_ - "-.:'.f'" ".. __ .... ::::<:.' ',:' .' ;;,,, ',',.' :.. ._c.';,;..'~.:" ,;,"""Y-,.'," ,-,,_:,.':,.. " ' ' ';~:' '" '::"i.,' "C ' , " " ,," ;;;;:;;(;~':, , .-.", . , ., RENUNCIATION In Re Estatc of Ao- roo'\ GLeV\r\ Qo...... deccased. To thc Register of Wills of C l.).WI h e. ,./_.-..J County, Pennsylvania. The undcrslgned /( 0-1' eo"" S. Go...u ) M o+-h~r, of thc abovc decedent, hereby rcnounee(s) thc right to administer the estate and respectfully ask(s) that Letters . I . a.....J.. ~I ""': ~1-r__T" a.... ~I_~ (Jo;;):::E~ . WITNES4 /"" d this .). q day of A "-.J .... d, 19 9.5. ~J~.1hJ / (Slanatur. if 0 t,- S c>-J Ie.r 0 r' 've C.....rnJl~,PA l'70I3-J./,}..~() , (Addres.) (Slanatur.) \C ,~ ,:-( I';' .-: : .~C<4 ~~ " (L ; , (Addres.) tr\ N I.=> => .= " (J ~.'" .~_l OJ ('1 ,.. E (Slanatnr.) IDa.; P' Q a: -=> UU (Add,...) -'" -- ~ CERTIFICATION OF NOTICE UNDER RULE 5.61al Name of Decedent: Aaron Glenn Gow Date of Death: June 14, 1995 Will No: 21-95-0652 To the Register: I certify that notice of beneficial interest 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 Nov. 28, 1995: Glenn A. Gow, 1105 Sadler Drive, Carlisle, PA 17013 Karen J. Gow, 1105 Sadler Drive, Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: No exceptions. Date: November 29, 1995 /~~~ tephen B. L pson, Esq. 169 W. High st., Ste. 4 Carlisle, PA 17013 Phone: 717-249-3929 capacity: Counsel for personal representative 1M" . "'JnO j):1' '110 liS: (, II at W'! <::1. , , -'8 .' NOTICE OF BENEFICIAL INTEREST IN ESTATE J I , BEFORE THE REGISTER OF \~II,I,S, COUNTY OF CUMI3ERLAND, PENNSYLVANIA IN RE: Estate of Aaron Glonn GoW, doceased, No. 21-95-0652 TO: Karen A. GoW 1105 Sadler Drive carlisle, PA 17013 Please take notico of the death of decedent and the grant of letters to the personal representative named below. You may have a beneficial interest in the estate as follows: one-half of estate. (However, note that it ilppears that the Estate is insolvent) . Name of decedent: Last Known Address: /laron Glenn GOI" 1105 Sadler Drive Carlisle, P/I 17013 Date of Death: place of Death: June 14, 1995 Knoxville, Tennessee county of Grant of original Letters: Decedent died intestate. cumberland Glenn A. Gow 1105 Sadler Drive carlisle, PA 17013 . (717) 249-1297 Names, addresses I and telephone numbers of all personal representatives appointed: Names, addresses I and telephone numbers of all counsel: Stephen B. Lipson, Esq. 169 w. High st" Ste. 4 (717)249-3929 Carlisle I PA 17013 Additional information may be obtained from the undersigned: Date: ,A.'::vi /r. I 1995 / 0, ,/ C . . "t_ ..' ,~C~>'.::> ' / '"I '/. ,__ ~ _......t---- 'Stephen B. Lipson, Esq. 169 w. High st., ste. 4 Carlisle I PA 17013 Phone: 717-249-3929 capacity: counsel for personal representative / ~) REY.I500U+ 1'.9'" J ~~t} COMMONWfAlTH Of PfNNSYlVANIA DfPAIITM(NT Of R[YUWf D!PT. lIDOO I ttAII.RISlURO. PA 11 21.0601._ _ DEClOINI" NAM( (lA' . mu. M~D MIODll INITIAII Gow, Aaron Glenn SOCIAl UCUIUIY NUMllIl ~ ",,:$.. ...."''''' w...... ",oS ....~.. ~ "2 _l INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) fOR DATES Of DEATH AnlR 12/31/91 CHICK HIRI If A SPOUSAL __ POVERTY CREDIT IS CLAIMED [] flU NUMBER ffi fil ld .. DAtE Of Of AT" 203-68-9046 6/14/95 IIf '''''II(AtLII 11J1"''tING "00'1'1 No""'f lioUl, Illst ""0 "'.ODII '!lIII''l1 95 YEAR 12/25/75 21 COUNTY CODE o CIOWI'S COM'U f ADOII 5 1105 Sadler Drive Carlisle, PA 17013 '00 1. Original Return o .t. limited ellot. 652 NUMBER Cowtll AMOUNT UCllV(D ISf! INSTAUClIOHS) o 2. Supplemental R.lurn R.malnder Relurn (for dol.. of death prior to 12.13.82) Federal Eslol. Toll. R,turn Required o .to. Future Inlar.11 Compromhe liar dalol of death afllr 12.12.82) 06. Oecedenl Died r.,tole 0 7. Dec.dent Malntaln.d 0 lI...lng Truu ~--~~ ~--~~ ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO. H"MI COMPUTf MAIUNG "ODlUS Ste hen B. Li son, Esq. 169 W. High Street mUHONE NUMIUI SU i te 4 249-3929 Carlisle, I'A 17013 03. OS. _ 8. Talal Number of Safe Depalit Ba..el . ~:'.'Jt:,.';., " , ,';" .. :ilffi "''' "'z fl~ '" o 5 => ~ '" 1. Real EUal. (Schedule A) 2. Sloch and Bondi (Sch.dule B) 3. Clollly H.ld StockJParln.,.h1p Int.ralt (Schedule CJ 4. Mortgag81 and Nole. R.cel...obl. ISch.dule D) 5. Co 01111 & Mhcellaneaul Penonal Properly Sch.dul. E) 6. Jalnlly Owned Property (Schedul. F) 7. TrDn.f... ISch.dul. G)ISch.dul. L) 8. Tolal Grall Allell (lolalUnes 1.7) 9. funeral ~."'I.I Aj)ni11rali.... COlli, Mhcellan,oul Expenll chedul. H 10. Debll, Marlgog. lIabilill81, lI.nl (Sch.dule I) 11. Tolal Deducllonl (10101 line I 9 & 10) 12. Nel Value of Ellale Illne 8 minus LIne 11) 13. Charitable and Go....rnm.nlal Bequelts (Schedule J) 14. N.I Valu. Sub eclla Tax (line 12 m1nuIllno 13) 15. Spoulal Tranlf.n Ifor dat81 of d.alh oft.r 6.30.94) S.. Inl!ruCllons for Ar,pllcabl. Percenlage on R....en. SIde. (Includ. 'Ialu81 rom Schedul. K or Sch.dul. M.) 16. Amounl of lIn. 14 laxabl. 01 6% rat. (Includ. '1011.181 from Schedule K or Sch.dule M.) 17. Amount of lIn. 14 laxabl. at 15% ral. (Include '1011.1.1 from Schedule K or Sch.dule M.) 18. Principal lax due (Add lax from Un81 15, 16 and 17.) 19. Cr. dill Spoulal Po....rty Cr.dit Prior Payments 111 (2) (3) 14) (5)_$3173.80 16) $ 212.06 (7) (91$8816.04 (10)$20365.75 (8) $3385.86 z o S => .. .. o u g (151 (161 (17) (111 $29181.79 (121 $0.00 113) (14) $0.00 $0.00 )(._11 )( .06 II $0.00 $0.00 )( .15 II (18) $0.00 Dlscounl Inl.r.u (19) (20) $0.00 1211 $0.00 (21AI (2IB) + + 20. If lIn. 1911 gr,ol.r Ihan lln. 18, .nl.r rhe difference an Une 20. Thll Is the OVERPAYMENT. aD 21. If lIn. 1811 gr.ol.r than line 19, .nl.r the dlFf.rence on lIn. 21. This Illh. TAX DUE. A. Enter rh. 1nl.r.I' on th. balance due on Un. 21A. 8. En'orth. 'DtDI of L1n. 21 Dnd 21A on lIn. 218. Thl. I, ,h. BALANCE DUE. Make Check Payabl. to, R.gllt., of Will., Agen' \l!i7.I.~ ;,;!;', >' BE SURE TO ANSWER ALL QUESTIONS:'ON REVERSE SIDE ANDTOiRECHECI(,MATHm: " ~ Und.r p.naltl.. of perjury, I d.c1ar. that I ha.... examln.d this r.rurn, Including accompanying Ich,dul'l and Ilolemenl., and 10 lh. bill of my knowl.dg. and b.lI.f, bltlllrue, corr.ct and campl.I., I d.c1ar. Ihdl all r.ol"lol. hal b..n r.parl.a at true maikt. ...011.1.. Declarollon of pr.par.r oth.r Ihon Ih. p'lIonol r.pr.llntall.... II aled on alllnformollan of which pr'par.r halon knowl.dg.. S N II O"El AU'ONsrILI: fOil; flLlNO l:ElU.N ADO. En I DATI <'''''''-', /lcI.--.,....;I,.j" II oS- S'....dl,,( {' ~ noli PI! 170/J '3 -:;; 0 - '10 SIONATUlI'!"p' '.l'A~.U OlHU I.~~ "['USl~~"TlV~_ .tOOllEU _ _ _ . __ ' _ ' . . '._ . OA11:. I I . /I:--'l'f-::-- /> /'r"- - It' 5" 11/, J//.;~- 5'/. I Cd ,.;,.Jc .3/:!.'c'/f'E-' ,.- ,./ ,Y/f /'?C/j' . Check' hero if you OfC requcstlng.o'fofund of your overpayment. Act #48 of 1994 provIde. for the reduction of the talC rate. Impo..d on th. n.t valu. of tranden to or for the u.e of the .pou.e. The rate. a. premlbed bV the .tatute will ber e 3% (.03) will be applicable for e.tat.. of decedenll dV'ng on or after 711/94 and before 1/1196 e 2% (.02) will be applicable for e.tate. of d.eedent. dVlng on or alt.r 1/1/96 and before 1/1197 e 1% (.01) will be applicable for ellate. of decedent. dvlng on or after 1/1197 and before 111/98 e Spou.allranden oceurrlng on or after 111/98 will be elCempt from Inheritance talC. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (....) IN THE APPROPRIATE BLOCKS. YES NO 1. Old decedent make a transfer and: c. retain the use or Income of the properly tranlferred, ....................................................... x b. retain the right to deslgnale who shall u.e Ihe properly Iransferred or lis Income, ............... x c. retatn a reversionary Interos.; or ........................,.......................................................... d. receive the promise far life of ellher paymenls, ben.flls or care9....................................... 2. If dealh occurred on or before Decemb.r 12, 1992, did decedent wllhln two years preceding dealh transfer property wllhaul receiving od.quote consideration' If dealh occurred after December 12, 1982, did decedentllanl'er property wllhln one year of death wllhaut receiving adequate conslderallon' ... II f.......... """'"'' "'......,....". 11".'1.... .................. It....... ................. x x X 3. Old decedent awn an 'In trust for' bank account 01 hi, or her deathi...................................... X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. It\l.lJoe... 1)"71 . COMMONWEALTH OF PENNSYLVANIA IN,UIITANCI TAX IfTUIN IIIIDENT DECIDINT SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Ploaso Prinl or l' 0 FilE NUMBER 21-95-652 ESTATE OF Gow, Aaron Glenn IAII prop.rty Jolntlv..own.d with th. Right of Survlvor.hlp mu.' b. dlulo..d on Sch.dul. F) ITEM DESCRIPTION NUMBER VALUE AT DATE OF DEATH 1 1987 Dodge 150 Ram Van $2160.00* f' I I 2 Erie Insurance Company - refund of automobile Ins. $786.00 3 Erie Insurance Company - refund of automobile Ins. $114.00 4 Federal tax refund calendar year 1995 $113.80 * Value = Sale price of $3300.00 less $1140.00 costs of towing, storage, inspection, battery, wiring repairs, return of vehicle to Pennsylvania from Georgia, etc. ~ a f TOTAL Also ontor on IIno 5, Roea IAnoch additional llAI- )II 11- .h..t. If mON Ipoce " "..dad.) 11\l.IJOtIl.IIUII , *' COMMONWUlrH 0' 'INN,nYAWA INHllnANCI fAX urUIH UllDIHr DICIOINt SCHEDULE F JOINTLY.OWNED PROPERTY ESTATE OF Gow, Aaron Glenn FILE NUMBER 21-95-652 Jolntt.nantl')' NAME A. Karen J. Gow ADDRESS 1105 Sadler Drive Carlisle, P^ 17013 RELATIONSHIP TO DECEDENT Mother B. C. Jalntly.own.d properly. ITEM LEnER DATI FOR TOTAL VALUE DECD'S DOLLAR VALUE OF NUMBE JOINT MAD' DUCRIPTION OF PROPERTY OF ASSET '" INT. DECEDENT'S INTEREST TlNANT JOINT 1. A. unknow U.S. Savings Bonds $424.12 50% $212.06 , , TOTAL l"ha .nlor on IIn. 6. Rocapltulallan) , S 212.06 (II more 'POct I. n..d.dlns.rl additionol sh..I. 0' .om. tin) ..\lUll I" (7.111 ~'b COMMONWEALTH Of PfNN$Y1VANIA INHUITANCE TAX InUIN AUIDfNf DlCfDfNf SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES fA E OF Gow, Aaron Glenn 2. B. 4. C. 1. 2. 3. 4. S. 6. 7. 8. DESCRIPTION AMOUNT ITEM NUMBER A. Fun.ral EKp.nIOl' 1. Ewing Brothers $5694.50 $2395.00 cumberland Valley Memorial Gardens - marker & grave 1. Admlnlltratlv. COlli I Personal Reprelentative Comml..lanl N. A . Sadal Security Number of Personal Representative: Yea, Camml..lans paid 2. Allarney Feel Stephen B. Lipson, Esq., 169 W. High st., carlisle, PA 17013 Family E.emplian Claimant $500.00 3. Relalianshlp Address of Claimant al decedent's death Street Add,e.. City Slate Zip Code Probate Fees Register of Wills - letters Register of wills - Agent - of administration inheritance tax return $34.00 $10.00 $40.00 $48.19 $94.35 Mlle.llan.oul bp.nlell Cumberland Law Journel - advertising of estate Patriot - News Co. - advertising of estate Knoxville News Sentinel Co. - advertising of estate TOTAL (Also enter an line 9, Recapltulalian) (If mar. Ipae. I. n..d.d, In..rt addlllonallheol. of lam. .In.) $ 8816.04 .' . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS Ploa.o Print or Tv 0 FILE NUMBER 21-95-652 IlIY-U11 lit lUll COMMONWIAUH 0' 'INN''fI'"''NI''' INHUlIAHClt.. .flUIN 1I1'IDIHf DICIOINI ESTATE OF Gow, Aaron Glenn ITEM NUMBER DESCRIPTION AMOUNT 1, University of Tennessee Memorial Hospital $12797.15 2. Monroe County EMS 3. Assoc. of University Radiologists, P.C. 4. Sweetwater Hospital $301. 00 $6733.00 $534.60 TOTAL IAllo onltr Gn lino 10, RocapllulallGn) (If more .pac. I. n..d.d, ins," additional ,h..,. ol.am. sill.) $ 20365.75 IN RE: ESTATE OF AARON GLENN GOW, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA FILE NO. 21-95-652 NO. ORPHANS I ORDER OP COURT AND NOW, this 'Z ,~- day of /J-u ~ t~96, upon consideration of the within Petition under Section 3102 of the PEF Code For Distribution of a Small Estate, a Rule/citation is hereby issued upon creditors Tennessee Memorial Hospital, Monroe County EMS, University Radiologists and Sweetwater Hospital to show cause, if any they have, why the remaining funds on hand should not be paid to them in the amounts set forth in said Petition. Rule returnable~c) days after service thereof. j:2i 7~T~ U- ( /f ,J. IN RE: ESTATE OF AARON GLENN GOW, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA FILE NO. 21-95-652 DECEASED NO. ORPHANS' PETITZON UNDER SECTION 3102 OP THE P.E.F. CODE FOR DISTRIBUTION OF A SMALL ESTATE 1. petitioner is Glenn A. GoW, an adult individual who currently resides at 1105 Sadler Drive, carlisle, cumberland county, pennsylvania. Petitioner is the Father of decedent Aaron Glenn Gow. 2. Decedent Aaron Glenn GoW died on June 14, 1995. His last domicile was 1105 Sadler Drive, Carlisle, Cumberland county, Pennsylvania, although he died at University Hospital, Knoxville, Tennessee. 3. Decedent died intestate, and Letters of Administration were granted to Petitioner on August 29, 1995. No bond was required. 4. Decedent was not married, and thus under intestate law, any estate would have been divided between Petitioner, as decedent's father, and Petitioner's wife, Karen J. GoW, as decedent's mother. However, this estate is insolvent, and thus Petitioner and his wife have not received, and will not receive, any bequests. Moreover, Petitioner is not requesting any commission for his services as Administrator. 5. No family exemption has been claimed by any individual. 6. Decedent owned no real estate at the time of death, and the value of his personal property at time of death was $3385.86. A breakdown of Decedent's personal estate can be found in Schedule E and F to the filed Inheritance Tax Return, with a copy of the entire Return attached hereto and incorporated herein as Petitioner's Exhibit "A". 7. Schedule I to Exhibit "A" sets forth four unpaid creditors known to Petitioner, namely, University of Tennessee Memorial Hospital, Monroe County EMS, Association of University Radiologists and Sweetwater Hospital. 8. Schedule H to Exhibit "A" breaks down the $8816.04 in funeral and administrative expenses paid by Petitioner as of the date of filing of said Return. $8089.50 of this total was paid by Petitioner from his own funds for funeral and burial expenses, while $726.54 has been expended out of estate monies on administration costs. 9. Petitioner also will pay $12.00 to Register of wills Office for the filing of this Petition and an additional $200.00 to Stephen B. Lipson for preparation, filing and certified mail costs for this Accounting. Thus, total administrative costs will be $938.54, which, when subtracted from the personal estate of $3385.86, leaves $2447.32 available for distribution among the unpaid creditors And for reimbursement of funeral expenses paid out of Petitioner's own funds. See 20 Pa. C.S.A. S 3392 (1) and (3) which gives priority to administration expenses but places the funeral and medical expenses (provided in last 6 months of decedent's life) in equal priority thereafter. 10. The balance of $2447.32 is not sufficient to pay these creditors in full, in that the funeral expenses total $5694.50 and the claims for unpaid medical expenses total $20365.75. Therefore, each creditor is entitled to a pro-rata share based upon total assets ($2447.32) divided by total debt ($26060.25) or 9.391% of each claim. 11. Based upon the percentage determined above, petitioner purposes to pay the following amount to the creditors: Glenn A. Gow (funeral) - $5694.50 X 9.391% = $534.77 Tenn. Memorial Hospital - $12797.15 X 9.391% = $1201.78 Monroe County EMS - $301.00 X 9.391% = $28.27 University Radiologists - $6733.00 X 9.391% = $632.30 Sweetwater Hospital - $534.60 X 9.391% = $50.20 12. The Inheritance Tax Return filed by Petitioner has been accepted by the Department of Revenue. A copy of said notice of acceptance is attached hereto and incorporated herein as Petitioner's Exhibit "B" WHEREFORE, Petitioner requests that this Honorable Court, pursuant to local Orphan's Court Rule 3.2-1, incorporating local Rules of civil Procedure 206.1, et seq, issue a Rule upon creditors Tennessee Memorial Hospital, Monroe county EMS, University Radiologists and Sweetwater Hospital to show cause, if any they have, why payment should not be made in the amounts shown and why Petitioner should not be discharged from future liability. Respectfully submitted, , ___-.~.,1 ~' ,,.e ,/----- ~~, ,_ /L_ _---~~~_ . '" _ / ,- ,/.-' .....-- '-- Stephen B. Lipson, Esq. Counsel for Petitioner 169 W. High Street suite 4 Carlisle, PA 17013 (717) 249-3929 "V "00 IX. 1'9'1 II~-:~:?I' INHERITANCE TAX RETURN ',~.'<r,;.v.. RESIDENT DECEDENT COMMOIIWIA111l0""""YIV^,IlA (TO BE FILED IN DUPLICATE O!PA"M[N' 0' "VENU! W LS) 21 95 IlARO"fJl'; ~~o\iI"o601 '" WITH REGISTER OF IL , COUtHY CODe .,. .,_... .vfA~ Dfet i-;;I '$ -,t;'~["l'j,. t, fII "~l.tIO-;"'~O-D~1 ;1~.II;A.il--:~~":':':=:"';":':--~:'-;-':~~:":':';"--~ - Di(f'olt~T', (o~.;rli rf ;i~~tS ,. Gow, Aaron Ulenn 1105 Sadler Drivu SOCIAL UCU.IIY UUMau ]OA" OTOIAlii.'--U--r"Ti"fi"~T.-, .n_ Car 11 s I u I PAL 70 1 3 203-60-9046 6/14/95 12/2 ~/75 C"., II.....""'W~;".. ..o,,~~:'.=::" .~~" .''''':~~:.]',::~'~~~~:=M~~:=~~J~:~~i~ ~~:I~~.:.::"'UC1IQIlII .---. ._-.- 1Xl I. Orluinol Roturn [] 2. Supplemonlul Rolurn [J 3. R.malnd., Relurn IIof doles of death prior 10 12.13.82) [J .tn. rUIUfC Inlor8,1 CQmpromhe [] S, Federal ellal. Tux Return Requited Ifor dUhu of doOlh oft." 12.12.01) [J 6. Decodenl Died rullale I] 7. Oacedent Mainlained u liYing Ttu.' (AlIech copy 0' Willi (Allud, copy 0' T,ultl ALL, CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD DE DIRECTED TO. NAM[ COMf'tl1( MA'lHm AOO.tU Stephen 13. [.ipson, Bsq-'-_,._.._._.__ 16'J N. lIigh Street ttUfliOtn fWMI-U Sui l:. 0 tl _J..1H V..19 -..iJl19 ===:~,===~= ~:,===.==~~,"~; 11 ~2:e , = I' ~_:l? ~~ 1. Real Ellole (Schedule A) (II _'..._..._,_._..._____ 2, Sloch and Bond. (Schedule B) (2) ,..,_,__.______,__ 3. Clolely Hald Sloc~/Po'lne,.hlp Inlerlll (Schedulo CI (3 ) ~... _~. ~_..__.___ 4. Mo"gage. and Nata. Recelyoble (Schedule 0) ( oS ) .___....._q__.. S. Co o.ill & MiI"l/o",o", Po"onol P'OpOlty (S) _,$,31.7.3."Q,CL...__ Schedul. E) 6. Jointly Own.d P,.pOIly ISch.dule f) (61 ...L.~J_2...'.0_6.,___.__ 7. T,o",',,, (Schodur. 01 (Sch.dul. II (7) ___ 8. Tolol G.OII Auel. (total line. 1.7) 9. Fune.al fit on1U-~lnhlrall.... Call', Mhcellon.ou. expenle chedur~9J 10. Oebu, Mortoage lIabilille., lien. (Schedule I) 11. lolnl Oeducllon. (Iololllna. 9 to 101 12. N.l Valua of E,'ole (line 8 mlnu. lIna 11) 13. Chorilable and Governmentol Sequelh (Schedule J) U, Nel Value Sublllclto Tax line 12 mlnu. line 13) 15. Spoulal T,anl'en (for dolal 01 d.oth afler 6.30.941 Sill Inllrucllonl for Applicoblo Pe,cenlage on Reve,.o (1.5) Side, (Indude \10 lUll from Schedul. K or Sch.dule M.) 16. Amount of LIne 141 10Aoble 01 6% rol. (Indude \lalue. from Schedule K or Sch.dulo M.J 17. Amounl of LIne 141 taxable at 1.5% tale (Indude \lolulI from Schedule K or Schedule M,) 18. Ptlnclpoltox due (Add lox 'rom line I IS, 16 and 17,) 19. Crediu Spoulol POVllrlt C,edit Prior Poymanll + + 20. If line 191. g,eoler Ihan line 18, enler the diff.rence on lIna 20. Thh h Ihe OVERPAYMENT. (;!o 21. If line 181. greoler Ihon line 19, enler Ihe difference on line 21. This Illhe TAX DUE. A. Enler the Inle,." on the balan" due on lIn. 21A. B, Enl" ,halalal of line 21 and 21A on line 218. This i.lh. BALANCE DUE. Make Check Payable 101 R.ahl.r of Willi, Agenl ::; l,';;''.\)J; ~~.!,li ,,', BE SURETO'ANsWER'ALI:QUEsTIONS ON REVERSE SIDE AND,TORECHECK~MATH'" .. ','~ , Under penahl.. of p.,fury, I declare that I have e~amln.d Ihl. relu,n, Including accompanying ICh.dule. and Ilalemenh, and to the b.I' of my knowl.dge and b.llef, 'b't l. I,ue, correcl ana complele. I dedo.. lhol 011 ,eal .lIat. hat been report.a allrue ma,llet volu.. Oeclarallon of prtpor" olh" than Ihe p,"onal rtprllenlallv, I. a.ed On olllnfo,mollon of whtch re arer hat an knowledge. Sl N'9Y"1 O. .u~. ,ONSIIII 10. "~IN? 1f1UlN ADDIUS _ '/J'II 00411: ,e... " ,..!9~'\..J lid....,.. IJ I,..~ /u " o~ S' ,.dIe,.. ,('"., I... Ie r. 170 I ] '- :hJ - 90 'O'4Al~' ~~I'AJlU 01 U UIA~"UIN'A'IVI __ DOlUS . . " DAn ..I. '7/ ~uC- ,6. ~"~ /15;7 /.u, /&-<- 0.1 , c::...,.../......~ ~c@ F,,", (/1 /. .; ~/J 170/3 .~~-'..._,~ ~'-._....",,< .., _,..__-_"'-C w ... ~~t2 w~u :c~9 u~'" ~ lOR DAIIS 01 DEATIf AnrR 11/31191 CIfICK lURE " A SPOUSAL _. POVERTY CREDtTIS ClA'MED I, ] fILi-NU;.,iiIR-.--. ,.. ...--...-,--.---- 652 ...NY,~~r,~ ffi fil u "' o o .t, lImilatl EllotQ _ 8, Tolal Number of Safe Dopolll Bouu ,,-.' . .".\. ;-,-. .... ...'" Ww "'co "'''' COo u~ '" o 5 E ~ u w '" ( 9)$.0J3J.,D_..D4 (B I $..uD5. 86 (101$.20365,,,,]5 III) $29181. 79 (121 $0.00 (13) (14) $0.00 $0.00 ><,_a (161 __,____,_,____,_,__X .06 a $.0_,-0_0 $0.00 (17) )( ,1S I:lI '" '" S :0 ~ .. o u (IBI iQ..,J)0 011 COlin I Jnlero~l (19) 120) $0.00 (211 $0.00 (21AI (21B) ~ ... Ch~clc' horo If you orc rcquDstlnO'Q',o'und of your ovorpaymont. u'_' -... 'I~UO'U. 11111 9"J~9_ ~ COMMOUWfA\1H 0' rU4USnVANIA. IUHIllItAUC. 'AX .uu.H .1'IDI~IU' SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY ___ ,__ Ploa!o Prlnt_ ar T~ - FilE NUMOER 21-95-652 ESTATE OF Gow, Aaron Glenn (All prap,rty folntly.own,1i wllh th; RIght of Survlvo"t.lp mUll b. cllullu,1i on Schedule f) ITEM DESCRIPTION VALUE AT NUMBER DATE OF DEATH 1 19B7 Dodgo 150 Ram Van $2160.00. 2 Erie Insurance Company - refund of automobile Ins. $7B6.00 3 Erie Insurance Company - refund of automobile Ins. $114.00 4 Federal tax refund calendar year 1995 $113.00 . Value = Sale price of $3300.00 loss $1140.00 costs of towing, storage, inspection, battery, wiring repairs, return of vehicle to pennsylvania from Georgia, etc. TOTAL Aha onlor an IIn. 5. R.ea !A!lach addlllonal8Ya" M U" Ihuh If more Ipan 11 n..ded,l IIV'JOt"tl""" J ,,~~ SCHEDULE F COIo\Io\O"W'A;:C~f"N"mv"nA JOINTLY.OWNED PROPERTY UlliU.lTAHCE lAX aEIUAN AE'IDIHT DlClDtHT _.__ _____.__________.___~~.__.__._ -------='-- - -'- FILE NUMBER 21-l)5-Q.~__, ESTATE OF Gow, Aaron Glenn Joint lonanl(')1 ------. ------------......--.--.-.- ADDRESS 1105 Sadler Drive Carlisle, 1'1\ 17013 --RELAiiONS.i1PiODECEDENT -= Hother A. NAME Karen J. Gow B. C. Jotntly~ownDd proportYI ITEM LETTER DATE FOR TOTAL VALUE DECO'S DOLLAR V ALU E OF NUMB'EF JOINT MADE DESCRIPTION OF PROPERTY OF ASSET '10 INT. DECEDENT'S INTEREST TENANT JOINT 1. A. unknow U.S. Savings Donds $424.12 50% $212.06 TOTAL (Also en'" on line 6, Recopllule'lon) S 212.06 (II mot. 'pac. i. nuJ.cl in,.,' aJdjlionol ,h.." of 'om. ,ill) ....tllll,,',"1 ~~ij. COMMONWEAmt 0' PlNtUVlVA.U1A lUHERIT.AUCf ,.AX RllURU aUIDEHf OEC[DEUl SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Plaa.a Prlnl or Typo _~~._~~~.~___~_-__--J~I~El~~B~~;2 _ .._..__.,___.,.._. DESCRIPTION AMOUNT ESTATE OF GOW, Aaron Glenn ITEM NUMBER A. Funaral Expan.... 1. 2. -.---------.----.------ ----~---~-_.~.- Ewing Brothers $5694.50 $2395.00 cumberland Valley Memorial Gardens - marker & grave I. B. Admlnlllrallva COlts: 2. 3. 4. C. 1. 2. 3. 4. S. 6. 7. 8. Personal Ropro~ontotlyo CommissIons N. ^. Social Sacurily Numbor 01 Panonol Ropro.onlullyo, - Yoo, Comml..lonl pold ___ Attoinoy foal stephen Il. Lipson, Esq., 169 ,.,. lIigh St" Carlisle, PA 17013 family exampllon Clolmanl $500.00 RololloRlhlp _ Add,o.. of Clalmanl 01 docodonl'l doalh Slrool Add,o.. City 51010 __ Zip Coda Probala fOOl Register of IoIills - letters Register of IoIills - Agent - of administration inheritance tax return $34.00 $10.00 $40.00 $46.19 $94.35 Mlscollan,oul expon.... Cumberland Law Journel - advertising of estate Patriot _ News Co. - advertising of estate Knoxville News Sentinel Co. - advertising of estate TOTAL (AI.o anlar on lina 9, Racapltulollon) (II mare Ipaca II n..d.d, Inl.rt addlllonal Ihoots 0' lama II...) S6816.04 I.M.T.~--j' .....",':.,,,,,. COIolMONWIAUH 0' PlNtdtlvAWA Itf..Ul'...N(lt.....ItU.lj 1(lIOW' OlelDINI SCHEDULEf l DEBTS OF DECEDENT, M~RTG~GE LIA~fLITIES_~~~_~~E~S__ _ , PloD,. PrInt _Dr !ypD r'LE NUMBER 21-95-652 --------'---,--,-,----,---,-----.._- ---- ESTATE OF GOIol, Aaron Glenn ITEM NUMBER DESCRIPTION AMOUNT I. University of 1'ennesseo Memorial Ilospit:nl $12797.15 2. Monroo County EMS $301.00 $6733.00 $534.60 3. Assoc. of University Radiologists, P.C. 4. Sweotwater Ilospital TOTAL (Aho .nl.r on IIn. 10, RocGpllulollon) (II moro .poce i, no.c/eJ, .inl'" oele/iUana' .h..r. of lame sin.) $ 20365.75 ,..."1'" f\\"J~'~_ ~ COMMOt4wIAIlH 0' rfNtllUVAI41A IHIII_nAHCI fAX "IUIN "1'DIHIDIClDINI SCHEDULE J BENEFICIARIES l ESTATE OF Gow, Aaron Glenn FILE NUMBER 21-95-652 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SliARE OF ESTATE A. fallabl. Bequ.IIIl 1. Glenn A. Gow 1105 Sadler Drive, Carlisle, PA 17013 Father 50% 2. Karen A. Gow 1105 Sadler Drive, Carlisle, PA 17013 Hother 50% * There will be no distributions to these beneficiaries in that this is an insolvent estate. ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE 8. Charltablo and Governmantal Baquallll 1. TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Aha onler Gn IIno 13. RocGpltulatlanl S (If mar. .pac. I. n..ded, In.ert additIonal ,h..tl of lam. Itul REV-1547 EX AFP 112-951*, :G COHHOHWEAL 111 OF PENNSVLVANIA ' ACN 101 OEPARlHUH Of R[VF.HIJE NOTICE OF INIlERITANCE TAX BUREAU Of INDIVIDUAl fUES ; ", APPRAlSEMENT I ALLOWANCE OR DISALLUWANCE .'.1. """ Of O,\OUCTIONS ANO ASSESSMENT Of TAM DATE 07-22-96 IIAARlSBUAC, PA l1ua.Q601 ESTATE OF GOW -~^"AROll=~=~G-==- "il:E -N.D. ~r'i!r-06S'2~=~~~ DATE OF DEATH 06-14-95 COUNTY CUMBERLAND NOTE. TO INSURE PROPER CREOIT TO YOUR ACCOUNT. SUBM.l.T TIlE UPPER PORTION Of TillS fORM WIlli VOUR TAM PAYMENT TO TilE REGISTER OF WILLS. MAKE CIIECK PAYABLE TO "REGI5TER Of WILLS. /.GENT" REMIT PAYMENT TO: STEPHEN B LIPSON ESQ STE " 169 W HIGH ST CARLlSLF PA 17013 REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE. PA 17013 r "nount Relllit tad - ..=-- i CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ it if v : is-;fi- ilif"AFP- -( i'F 9sT - NoYf(;~--liF -YNH ERTi' ;.i;"!;e -r Ai; -X? F ~A"i iiEi-fim'r-; -A r:i.-,j ;ii.1fcir b-li- -- _m -- -- - - - - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GOW AARON G FILE NO. 21 95-0652 ACN 101 DATE 07-22-96 TAM RETURN WAS, (X) ACCEPTEO AS FILEO I CIIAtlGEO RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGItIAL RETURN 1. R..1 eat.t. (Schedule Al n) 2. stock. and Bonds (Schedule OJ 12J 3. Closely Hald stock/Partnorship InterDst CSchedule C) (3) 4. Hartg.ge./Not.. Recaiyable ISchedule DJ 14J S. C..h/B.n~ Oepo.it./Hlsc. Parsonal Property ISchodulo E) IS) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers tSchedule G) (7) 8. Total Auets .00 .00 .00 .00 3.173.80 212.06 .00 CB) 3.385.86 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Hisc. ExpensBs CSchadule H) (9) 10. Debts/Hortgage L1DbiliUe../Llens (Schedule 1) (10) 11. Tot.l Deductions 12. Net V.lue of Tnx Return IS. Cherit.ble/Covernmontal Bequest. (Schedule J) 14. Net Valu. of e.t.t. SUbjeot to Tex 8,816.04 20.365.75 IllI lI21 lI31 lI4) ?q,IRI ?q 25.795.93- .00 25.795.93- I~ an assessment was issued previously, lines 14. 15 and/or 1b, 17 and 1H will reflect figures that include the total of abh returns assessed to date. ASSESSI1ENT OF TAX: 15. A"ount of Line 14 16. A"ount of Line 14 17. Amount of Line 14 18. Prinoipal TaM Du. TAX CREDITS: PAYMENT OATE NOTE: at Spous.l te)lable at taxabl. at rat. Line.l/Class A r.te Coll.t.raI/CI.ss Brat. lI51 lI61 Cl71 .00 .00 .00 M .00: M .06: M .15: lIBI .00 .00 .00 .00 RECEIPT NUMBER DISCOUNT (+1 INTEREST C-) AMOUNT PAID j' I,. 7:> / ,-.'<', b TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 .00 .00 .00 . If PAID AFTER DATE INDICATED. SEE REVERSE FOR e1.LCULATION OF ADOITIONAL INTEREST. If TOTAL DUE IS LESS TIIAN .1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (eR), YOU HAY BE DUE A REfUND. SEE REVERSE SIDE Of TillS FORH fOR INSTRUCTIONS.) / REV-1547 EX AFP 02.95)_ COMMONWEALTH OF PE~SYLVANIA DEPAAIK[H' OF REVENU( BUREAU OF INDIVIDUAL lAKES DEPl. lID6Dl HARRISBURG, PA 11121.0601 . ;.rJ <> :' -' / ACN 101 NOTICE OF INHERITANCE TAM APPRAISEHENT, ALLOWANCE DR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAM DATE 07-22-96 FILE NO. OF DEATH 06.14-95 COUNTY CUMBERLAND NOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT. SUBHIT THE UPPER PORTION OF THIS FDRH WITH YOUR TAM PAYHENT TO THE REGISTER OF WILLS. HAKE CHECK PAYABLE TG "REGISTER OF WILLS. AGENT" REMIT PAVMENT TO: STEPHEN B LIPSON ESQ STE 4 169 W HIGH ST CARLISLE PA 17013 REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE. PA 17013 Allount R..i ttad C'-- CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS .. iiEv=iiI4j"iiC-"j:p.nZ:95Y"iioTici""OF-YNHEiiii'ANCE.TA'x.APpiiA'isEHiiir.;.ALi."owANci.oli-...._..._...._-- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GOW AARON G FILE NO. 21 95-0652ACN 101 DATE 07-22-96 TAK RETURN WAS. (X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..l Elt.t. (Schedule A) (1) 2. stock. and BondI (Schedule 8) (2) S. Clo..ly Held stock/Partn.rship Int.r..t (Schedule C) (S) 4. Hortaag'I/Hot.. Rlcelvable (Schedule DJ (4) S. c..h/Bank a.politl/Hllc. ,.rlon.1 Property (Schedule E) IS) 6. Jointly Owned Property (Schedule F) (6) 7. Tranafer. (Schedule OJ (7) a. Total A...t. CHANGED .00 .00 .00 .00 3,173.80 212.06 .00 tBI APPROVED DEDUCTIONS AND EXEMPTIONS I t 8,816.04 9. Fun.ral E~p.n.../Ad.. COI a/Hllc. Expan... (Schadule HI (9) 10. D.bb/H.du'.' L1.blUU../LI.na ISch.dul. II UOI 20.365.75 11. Tobl Daductiona 111>> 12. H.t V.lue of Tax R.turn ( 12) 15. Charitable/Govern.antal Bequa.t, (Schedule J) (13) 14. H.t Value of Est.t. Subject to TaM (14) NOTEI I~ Bn assussmunt was iusuud pruviouslY, linus 14, 15 and/or 16, 17 and 18 re~luct figurus that include thu total o~ ALL returns assussud to data. ASSESSMENT OF TAXI 15. Anount of Lin. 14 at Spou..l rat. 16. AMount of Lin' 14 taMable .t Lin..l/Cl... A rat. 11. AMount of Lin. 14 taxable .t Collateral/Cl... 8 rat. 1a. Principal Tax Due USI U61 1171 .00 .00 .00 M'OO. M .06. M .15. UBI TAX CREDITS: PAY"ENT DATE DISCOUNT 1 + I INTEREST 1-) AHOUNT PAID RECEIPT NUHBER TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUll , 3.385.86 ?Q.1Rl 7Q 25.795.93- .00 25.795.93- - will .00 .00 .00 .00 .GO .00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN fl. NG PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI. YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FGR INSTRUCTIONS. I C7\ 1:: ," - r:-, () .t!.:. .-~~ <.:J , ..<::- Et L :J ,', ~.':: . C7\ .' U , ) - ,I .. ~ ~ , ~J ,> d \~i . ".lJ >..> " iP. ." t= wc: :ii - c: _::I UU RESERVATION I E,t.t.. of dac~.nt. dying on Dr blfar. D.c.~.r II, 19.Z .~ If any future Int.r..t In thl ..,.t. I. tran.flrrad In pa.....Jon Dr InJD~~t to el.,' . (co11".r,1) b~flcl.rl.. Df t~ dlcld.nt .,t.t tha Ixplr.tlon of any ..,.t. for 11'. or 'or y..r., t~ Co..onw..tth hlteby '.Pt..,IV r...tv., thl right to appr.i.. ~ ...... tran.,.r Inh.rl~anc. ,.X.. .t ttM l.w'ul el... . (coll,tln1) nt. on BnY luch future lnt.r.,t. PU.".$! Ill' NOllCEI To fulfIll thl requlr...ntl of Section ZlU 0' thl Inh.rltMCI ....d [,tat, 'I. Act, Act ZZ of 1991. 1Z P.S. Section 2140. . PAY~TI O,tlch ttM top portlon 0' thl, Hotlel and ,ubelt with your P.~t to thl Rlalst't of Willi printed on thl r.v.r.. ,Ida. uHlh check or .on.y order PIVab.. tal REGISTER OF HILLS, AGENT All p.v-ent. r.c.ly.d .h.ll flr.t b. .ppll.d to anv Int.r..t which .''1 b. due with anv r...lnd.r .ppll.d to the t... REFUND (CA), A r.fund of . tl. cr.dlt, which w.. not r.qu..t.d on the T.. R.turn, ..y b. r.qu..t.d by co.pl.tlng en "Application for RI'und of P~.wlv...la InhlrH.ne. and Esht. TlIIl" IREY-lSU). Appllcatlon. .r. Iv.ll.bl. .t thl OffiCI 0' the R.gllhr of "1111, any of the 25 Rn.nu. [llItrlct Offlcn,' or by c.lllng th. .p.el.l 24-hour ....w.rlnD ..rvlc. nueb.r. for for.. ord.rlngl In P.nnlvlvnnla 1-100-362-2050, out.ld. Plnn,Ylvanla and within local H.rrl.burg .r.a (117) 717-1094, TDOI (711) 772-2252 (H..rlna lapalr.d only). OBJECTIONS, Any party In Int.r..t not .atl.fl.d with th. .ppr.I....nt, .llowanc. or dl..llowlnc. 0' d.ductlon., cr .......ent of t'lIl I Including dl.count or Int.r..tl .. .hown on thl. Hotlc. .u.t obJ.et within .IKtv (60) d.y. 0' r.c.lpt of this Notice byl "written prot..t to the PA D.p.rt..nt of ".v.nu., loard of App..l., D.pt. 211021, H.rrll~rg, PA 17121-1021, OR --.Iactlon to h.v. thl ..tt.r d.t.rlln.d .t .udlt of thl .ccount C' thl p.r.onal r.pr...nt.tlv., OR --.pp.al to thl arph....' Court. ADHIH lSTRATtVE COAAtCTt DHS I DISCOUNT. factual .rror. dl.cov.r.d on thl. .......ant .hould bl .ddr....d In wrltln, tOI PA a.p.rt.ant of R'v,nu., Bur.au of Individual T.IIl.I, ATTMl po.t A....I..nt R.vl.w unit, D.pt. 210601, H.rrl.bur., PA 11121-0601 Phon. (1111 117-6505. Saa p.g. 5 a. thl bookl.t "Inltruetlon. 'or Inhlrltlnc' TIIIl R.turn far a R..ldent Olc.dent" IREV-IS01) for an llIlPlln.tlon of Id.lnlltr.tlv.ly corr.otabl. .rror.. If any t'lIl ~ I. p.ld within three IS) cal.ndar .onthl .ft.r thl dlc.d.nt'l d.ath, I flYI p.rc.n~ IS~I dl.count of the tllll p.ld I. allow.d. The In tllll untidY non-p.rtlclpltlon plnllty II co.puhd on the tot.l 0' the tl.ll 1M Int.r..t .......d, Iind not p.ld b,'or. Janu.ry 16, 1996, the flr.t d.y .,t.r t~ .nd of the t..11 ..n..ty p.rlod. Thll non-p.rtlolpatlon pan.tty II app..I.bl. In the .... .annar and In the the .... u.. p.rlod .. vou would app.Il thl tax and Inter..t th.t h.. baan .......d .. Indlcat.d on thl. notlc.. PENALTY. IHTERESTI Int.r..t II ch.rgad blglnnlng with flr.t day of d.llnqulncy, or nln. (,) .onth. and on. II' d.y fro. thl data of delth, to thl d.t. of pay..nt. Talll" which b.ea.. delinquent b.fur. January 1, 1'82 bl.r Inter..t at thl rata of .Ix 16X) p.rcant p.r ~ c.lculat.d .t a dally t.t. 0' .00016~. All taM" which b.c", dlllnquent on and .,t.r January 1, 1912 will ba.r Int.r..t at 8 r.t. which will v.ry 'raa cltlndar y..r to calend.r y.ar with that rata ennounc.d by the PA D.p.rt..nt of R.venua. The .ppllcabl. Int.r..t r.te. for 1'8Z through 199~ .r'l '!!!! Int.r..t nat. Dallv lnt.r..t Factor :!!!r lnt.r..t R.t. 0.1ll/ Int.rnt F.ctor 1912 'OX .GDOS41 1917 .X .000247 1915 16X .000451 1981-19" llX .aanOl .914 llX .000501 1992 'X .000247 19.5 UX .0005S6 1995-1"4 'X .000192 ,.., lOX .000274 1995-1'''' .X .000241 --lntlr..t II celcul.tld "" 'ollowu INTEREST . SALANCE OF TAX UNPAID X HUHIER OF DAYS DELINQUEHT X DAILY INTEREBT FACTOR --Any Hotlc. I..ued .,t.r th. talll b.cc... dlllnquent will r.'18ct ~ Int.ra.t c.lculatlon to ,I,t.an (151 day, b.vond th. data of thl ........nt. If p.y.....t II .lda Ift.r tha Inter..t coaput.t1on data lhoWn on the Hotlc., .ddltlon.l Int.r..t ault b. calcul.t.d. JRD/June 30, 1992/17858 REGISTER OF WILLS Cumberland Counly Courthouse One Courlhouse Square Cnrllsle, PA 17013 NOTICE PURSUANT TO RULE 6.12 PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULES To: Personal Representative Counsel: S'l'EPHEN B. LI PSON, j:;5Q., RE: &l8le of AARON ,G{,ENN GOW , Deceased, Lale of CARI.ISLE BOROUGH &l8le No.: 21-1995-652 Dale of Decedenl's Dealh: JUNE 14, 1995 Pursuanl to Rule 6.12, the above named personal representative or the above nal"ed attorney. If applicable, within two (2) years of the decedent's death, and annually thereafter until administration Is completed, Is required to file with the Register of Wills a Status Report as required by Rule 6.12, In substantially the prescribed form, showing the date by which the personal representative, or attorney, as applicable, reasonably believes administration will be completed. The purpose of this Notice is to advise you that unless the requisite Status Report Is filed with the Register of WlIls or Clerk of the Orphans' Court, as appropriate, within ten (10) calendar days after the date of this Notice that the Register of Wills Is required to notify the Orphans' Court Division, Court of Common Pleas of such delinquency and to request that said Court conduct a hearing to detennlne whether sanctions should be Imposed upon the delinquent personal representative and the delinquent personal representative's counsel, if any. Accordingly, if the requisite StalUS Report is not filed by AUG. 6 , 1997, you are hereby advised that a request will be submitted to the Court In accordance with Rule 6.12. ['~ Date: JUI.Y 24, 1997 \~n 11'..1. ,1 ~ ~ L..!- l',a1 t<, Deputy R gister of Wills t Distribution to Estate File , . . STATUS REPORT UNDER RULE 6,12 Name of Decedent: A.... I~t ~h C;:J"',, .. G~c~ I{/ Date of Death: ;-7":'1-_'-: /p/ /(/'/5 " ./ Will No. Admin. No. I:J-j- 9:5-- '(. >.-2- 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 wAether administration of the estate is complete: Yes V No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. I f the answer to No, 1 is Yes, state the following: a. Did the perso9al representative file a final account with the Court? Yes v No, . ..::-- C<,(/,"/' 0">:<';'.- < ,,-- , S ,..--'.: ( D/ r'.....:-{C...j1."7./0'...... b. The separa te Orphans' Court No. (i f any) for ' the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts I releases,' joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. '.., .~ ." N V.' 0\ 1,..::( 'n_ J, , //'/ {'- Signat.ure 5--. / . (':.r-;:J/L~"'. Nam (Please //' , ...r.' 07- "" Date: 7/;5/11 tl.rr, C:;'- "- ~7\ 14) c:; .ae c::>. type /69 /~~ //;'//~ oS!: . Address /' ..- 17/1) .A $I 9 - J P,,2 '7 Tel. No. "::: co 1'1 ~ "' (MAH:rmf/AM3) Capacity: Personal Representative c--'----Counse], for personal representative , .. ,':'1'; '~:f,:;;(.~~;~t~~;~} 9Cll1601t'10'" " ..' ': ,,,,,;''.' ''.I'''I,,~ Wi' . V,:: .,'~";<" , ,'""'{;;:"-?i:l',';'X',:::- ~,;5,;ii,~'i<~'{iM~i,~~!~~;'l\r ,i .i,:LW "i,;,f,_t';:;..~!h,.t;!..:(nt::r<l",,'~~".\'t1J:i.:':Jifi, i';.....,~..?';,.,Jt~~~. ~~~~_ .'- .. r ;~,/ ,-a.r~.~:,:-~!~~",:".2'.~._~.._\___ __ IN RE: ESTATE OF AARON GLENN GOW, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA FILE NO. 21-95-652 NO. ORPHANS' PETrTrON TO MAKE RULE ABSOLUTE 1. By Order of the Court dated August 2, 1996, the Honorable Harold E. Sheely, President Judge, issued a Rule/citation upon creditors Monroe County EMS, Glenn A. Gow, Tenn. Memorial Hospital, University Radiologists and Sweetwater Hospital to show cause why distribution of the above-captioned small estate shall not be distributed in the amounts set forth in the Petition of Administrator Glenn A. Gow. A copy of said Order and Petition (without the Exhibits) is attached hereto and incorporated herein as Petitioner's Exhibit "0". 2. Stephen B. Lipson, counsel for the Estate, served certified copies of the Citation, Order and Petition upon four of these creditors, namely, Tennessee Memorial Hospital, Monroe County EMS, University Radiologists and Sweetwater Hospital, by certified mail, return receipt requested. No service was necessary upon creditor/petitioner Glenn A. Gow, who obviously does not object to his own Petition. 3. The letters containing the certified copies were mailed to the four creditors on August 6, 1996. On August 15, 1996 stephen B. Lipson received return receipts for three of the creditors I namely, Tennessee Memorial Hospital, Monroe County EMS and University Radiologists. The latter two were served on August 12, 1996, but no date of service is shown on the return receipt for Tennessee Memorial Hospital (obviously, service occurred prior to August 15, 1996). The actual Receipts and Return Receipts for these three creditors are attached hereto and incorporated herein as Petitioner's Exhibit "E". 4. Counsel for Petitioner never received a Return Receipt for Sweetwater Hospital (nor was the letter returned). Accordingly, on September 11, 1996 Stephen B. Lipson mailed a second certified copy of the Petition to Sweetwater Hospital, and on September 20, 1996 Stephen B. Lipson received a return receipt proving service on Sweetwater Hospital on September 17, 1996. 5. These Citations made the Rule Returnable 20 days after service thereof. Accordingly I the creditors had until Monday, October 7, 1996 to object to Petitioner's proposed distribution. 6. The October 7, 1996 deadline has passed and no objections have been filed or communicated to Petitioner or his counsel. 'JUL 30 1~8tK . IN RE: ESTA'l'E OF AARON GLENN GON, DECEASED IN 'rHE COUR'r OF COHI'IOH PLEAS OF CUMBERLAND COlJN'l'Y, PENNSYLVANIA FILE NO. 7.1-95-(,57. NO. ORPHANS' QRl.llm OF COU~ ANI) NON, thJ.o ,;),1)1), day oCCt.l.lt\.I..\"O:C 1996, upon considel:ation oJ~ the \'Iithin 1'etil:1.o'h undel' Sectt,)n 3101. oJ: th~) PEL' Code. ['or. DJ.stl:ibutir)n of a Slnll,U Estatl', a Hulo/Cu:"ttoll 1s hereby issucd upon creditors Tennossce Hemor.ial HDspitnl, Honroo county F.I1U, UniV'3rsity HlItl.i.ologisto ami SI-Ieetl-I"tnl: Hospital. to shol-l cause I 1f a ny they hn 'Ie, I-Ihy tho l:p.ma in inq funds on hand should not be paid Co them in th,~ amount:) tiel: COI:Ch in I,il.i.tl 1'ot11:ion, Hule rutul'nabl,Q ,;lO days llfC'n' sm:v.i.cl~ tIHll:COJ:, DY 'rim CQUR'l', / sf f./CLl,,,Q,,\ ~"':'~~''4--~ ,,) J. /' IV..... .'.." .. I. ' , ' ,..' /".}... F.;:)~'l ~<r.'C'Jnl) :~ ~":1..>'. _', . .... ., , -. - t I' ., _. ..".. ,\ '." ' '. ~ . -,'., . =: "l' 0;' ~.t~'1 . :"::;r '~~Il~'r,'J aiz, t tl'~f f"'l\"n" I. -.; - i" ". "1'1 ' . 't "~1 l1 '.'... ." -, ..,,~ '0- ro/t",!, '~. ,.~ III .', III' 1 ., \ ,,, _. ;::- tJ.. ' ~.~ .... ...; t'll W, 1,- 1"...:_ ,_--J:l/IJl' U! _.~.._ 1~OI ":'I..b._ C/61k of thCl Or hUl3 Cot;r! CumllerlewJ OWl! i:,r f~-L.. A ' <:-'/ ') 71 ?1"{':.~7 ;5~", '2) J.- ,,- {-... , _n_ ~~-.-".... . . i ~. ,"'--~.--- .~-..,.....: ~. 'i \. ." IN RE; ESTATE OF AARON GLENN GOW, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA FILE NO. 21-95-652 DECEASED NO. ORPHAllS' PETrTION UNDER SECTION 31~ pF THE P.E.F. CODE FOR DISTRIBUTION OF A SMALL ESTATE 1. petitioner is Glenn A. Gow, an adult individual who currently resides at 1105 Sadler Drive, carlisle, cumberland county I pennsylvania. Petitioner is the Father of decedent Aaron Glenn Gol1. 2. Decedent Aaron Glenn GoW died on June 14, 1995. His last domicile was 1105 sadler Drive, carlisle, Cumberland county, Pennsylvania, although he died at University Hospital, Knoxville, Tennessee. 3. Decedent died intestate I and Letters of Administration were granted to Petitioner on August 29, 1995. No bond was required. 4. Decedent was not married, and thus under intestate law, any estate would have been divided betl1een petitioner, as decedent's father, and Petitioner'S wife, Karen J. Gow, as decedent's mother. However, this estate is insolvent, and thus petitioner and his wife have not received, and will not receive I any bequests. Moreover, Petitioner is not requesting any commission for his services as Administrator. 5. No family exemption has been claimed by any individual. 6. Decedent olmed no real estate at the time of death, and the value of his personal property at time of death 11as $3385.86. A breakdown of Decedent'S personal estate can be found in schedule E and F to the filed Inheritance Tax Return, with a copy of the entire Return attached hereto and incorporated herein as petitioner'S Exhibit "A". 7. Schedule I to Exhibit "A" sets forth four unpaid creditors known to petitioner, namely, University of Tennessee Memorial Hospital, Monroe county EMS, Association of University Radiologists and sweetwater Hospital. 8. Schedule H to Exhibit "A" breaks down the $8816.04 in funeral and administrative'expenses paid by petitioner as of the date of filing of said Return. $8089.50 of this total was paid by Petit~oner from his own funds for funeral and burial expenses" while $726.54 has been expended out of estate monies on administration costs. 9. Petitioner also will pay $12.00 to Register of Wills Office for the filing of this Petition and an additional $200.00 .-- _.'....".,.~ !'-~i"j,.,,,,,,~. to Stephen B. Lipson for preparation, filing and certified mail costs for this Accounting. Thus, total administrative costs will be $938.54, which, when subtracted from the personal estate of $3385.86, leaves $2447.32 available for distribution among the unpaid creditors anY for reimbursement of funeral expenses paid out of Petitioner's own funds. See 20 Pa. C.S.A. S 3392 (1) and (3) which gives priority to administration expenses but places the funeral and medical expenses (provided in last 6 months of decedent's life) in equal priority thereafter. 10. The balance of $2447.32 is not sufficient to pay these creditors in f.ull, in that the funeral expenses total $5694.50 and the claims for unpaid medical expenses total $20365.75. Therefore, each creditor is entitled to a pro-rata I:hare based upon total assets ($2447.32) divided by total debt ($26060.25) or 9.391% of each claim. 11. Based upon the percentage determined above I petitioner purposes to pay the following'amount to the creditors: Glenn A. Gow (f.uneral) - $5694.50 X 9.391% = $534.77 Tenn. Memorial Hospital - $12797.15 X 9.391% = $1201.78 Monroe County EMS - $301.00 X 9.391% = $28.27 University Radiologists - $6733.00 X 9.391% = $632.30 Sweetwater Hospital - $534.60 X 9.391% = $50.20 12. The Inheritance Tax Return filed by Petitioner has been accepted by the Department of Revenue. A copy of said notice of acceptance is attached hereto and incorporated herein as Petitioner's Exhibit "B" WHEREFORE, Petitioner requests that this Honorable Court, pursuant to local Orphan's Court Rule 3.2-1, incorporating local RUles of Civil Procedure 206.1, et seq, issue a RUle upon creditors Tennessee Memorial Hospital, Monroe County EMS, University Radiologists and Sweetwater Hospital to show cause, if any they have, why payment should not be made in the amounts shown and why Petitioner should not be discharged from future liability. Respectfully submitted, /~vg ~. Ste en B. Lipson, Esq. Counsel for Petitioner 169 W. High Street . suite 4 CarliSle, PA 17013 (717) 249-3929 I verify that the statements made in the foregoing petition are true and correct. I understand that false statements herein are made subject to the penalties of Pa. C.S. S 4904, relating to unsworn falsification to authorities. DATE: 7-,;{ r - 9~ ~~ A~~ Glenn A. GOW, Administrator - ".,'.,.<..,:- i;i~": c........ i,.... 1 and"" 2 10' 'dd/IIon.; .........' , "I .1,0 w/lh 10" I.c.lvethe, , , 'j"~' e........ h.... 3, and 4. · b. ,. i ' 'Ollowlng.e, V/C, e.. 110 ,...n ,. ef'. e 1',:.:.::' ~.-.'.i 7..--'.::. :"':':'::::,:~Odd......nl"'''.''''''''''''O'''!IOI''''.....n ,..): . ',:" , r }' ~n:.:.~~~.."" ',onl."... ........., ..on.'" bo,~ lI.pu. 1. 0 Addr..~.,... Addle ,'.. 1;11:". Wrll"'R'iurnR~R......tod"on''''_bol''''''..n''Io_, 2. 0 Re.ltlcl.d D.llvery '" j.~f.{.~~5:~~;~:::::-:-3:.g1? -:"""'1",' ~r~1'1:;~~~t~~llo. "" 37940 ~ ::':::::' g :::.,"'" 'H jii i;c~;':;;';: ':.,' " 0 e.p,e.. 1,1.11 0 Ratu," R.c./pUo, 'J i " ~;Y'ii/ :: ;;:.:.. ..,,, ~r't'd i~: lti oj!!! <:> i!: ~lr;~"(':~, ' I 'D~~~~~~'~~URNRECEIPT'f^,1 ~",iC"v"'.',,, ""! IV,-..",., , '-----_,H_',_"'_,:,~__"'~~ ~"? 12'1 108 867 Receipt for Certified Mail --. No InluI8nco CO\l'Ot"uo Providod ':''%:L''~~1 00 not Uso fat Intornotional Mail (SOD RO\l'or501 ~f'f\1 'n U.T. Memorial Has ita s"..., ill'''' Nil t:1"I"~'J'rl' TN 37940 $ 'il.t-U.ti lJW".., I..~. .'._"'.. . .... ; ~ ~ a 0 Q) ... ! C;-' .~'" III 0..