HomeMy WebLinkAbout05-22-08 (2)
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHAN'S COURT DIVISION
NO. 2007-00271
FIRST AND FINAL ACCOUNT OF
LAWRENCE J. NEARY, ADMINISTRATOR C.T.A.
ESTATE OF CARL R. BURRELL
LATE OF HAMPDEN TOWNSHIP, CUMBERLAND COUNTY
Date of Death:
Letters Granted:
First Complete Advertisement of Letters:
Account Stated To:
August 17, 2006
March 22,2007
None
April 15, 2008
SUMMARY & INDEX
Estate Probate Assets: (Schedule A)
$27,749.74
Estate Expenses: (Schedule B)
$11,956.69
Net Estate for Distribution:
$15,793.05
Distribution: (Schedule C)
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SCHEDULE A
ESTATE PROBATE ASSETS:
1.
2.
3.
4.
5.
6.
7.
M& T Bank - checking account
M&T Bank - IRA account
Met Life dividend
Mutual of Omaha - premium refund
Holy Spirit Hospital - refund
Met Life stock sale
Income Tax Refund
Total Estate Assets
2
$8,173.93
$9,135.12
$48.38
$24.41
$57.53
$5,260.36
$5,050.00
$27,749.73
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
SCHEDULE B
ESTATE EXPENSES:
Register of Wills - Probate fee
Mobile Imaging - x-ray
Lehigh Valley P.T.
West Shore EMS
Hamilton & Musser CPA - Income Tax Return
Register of Wills - Inheritance Tax Return
PA Inheritance Tax
PA Inheritance Tax
Hamilton & Musser CPA - Fiduciary Return
Lawrence J. Neary, Esq. - Adm./attorney's fees
Register of Wills - Supplemental Inheritance
Tax Return
PA Inheritance Tax
Hamilton & Musser, CPA - Tax Return
U.S. Treasury (Income tax on Estate funds)
Pa. Dept. of Revenue (Income tax on Estate funds)
Lawrence J. Neary, Esq. - Adm./attorney's fees
Total Estate Expenses
3
$112.00
$14.32
$1.57
$114.84
$255.00
$15.00
$6,500.00
$904.52
$250.00
$750.00
$15.00
$170.44
$50.00
$753.00
$306.00
$1.745.00
$11,956.69
SCHEDULE C
DISTRIBUTION:
Locust Lane Dental Practice - Benjamin C. Burrell
(Dental expense)
$1,769.00
Annuity Purchase 1
Total
$14,000.00
$24.05
$15,793.05
Miscellaneous Reserve
Pursuant to Item VII of the Decedent's Last Will and Testament, it has been
determined that what would be the trust principal, i.e. $14,024.05 is too small to make the
establishment of a trust advisable or feasible and yet not wanting to make an immediate
distribution of the balance to the beneficiary, Benjamin C. Burrell, it was agreed with the
beneficiary that an annuity would be purchased that would supplement on a quarterly basis the
beneficiary's living and medical expenses over a period of 15 years with any balance payable to
his Estate for burial or other final expenses. A copy of said annuity contract is attached hereto
and marked as Exhibit A.
4
VERIFICA TION
verify that the statements made in the attached First and Final Account and
Schedules of Distribution are true and correct. I understand that false statements herein
are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn
falsification to authorities.
Date:
L.I//sIIJP
I I
Hartford Life Insurance Companies
Annuity Benefit Summary
Owner
Annuitant
Designated
Name
Benjamin C. Burrell
Benjamin C. Burrel:
Estate Of Benjamin C Burrell
Date of Birth
Percentage
10/05/1957
10/05/1957
100%
Annuity Number SPIA / 712652425
Plan Type Non Qualified
Product SPIA
Gross Premium Amount $14,000
Annuity Option Payments for a Designated Period of 15 Years
Annuity Option Definition Annuity Payments will be made for 15 years.
Frequency Quarterly
Annuity Commencement Date June 1,2008
Annuity Amount Fixed: $321.38
Tax Cost Basis $14,000.00
Period Certain Expires March 1,2023
Annuity Option Note If the Annuitant dies prior to March 1,2023, we will pay the person(s)
entitled to receive the Death Benefit, as specified in your contract, the
present value of the remaining payments in a lump sum payment or
continue the payments until March 1, 2023.
Upon the Owner's death and the Annuitant is living then the surviving
owner becomes the sole owner. If no surviving owner then the
beneficiary(ies) become the owner(s). If no beneficiary is listed on the
contract, the owner's estate will continue the contract as owner.
Page 3
THE
HARTFORD
EXHIBIT
r:
j)
~ A
THE CONTRACT
Entire Contract
The entire contract consists of this contract and the application, a copy of
which is attached at issue This contract is made in consideration of the
application and the payment of the single premium. We will not use any
statement to void this contractor to defend against a claim under It, unless
that statement is contained In the attached written application All statements
in the application will, in the absence of fraud, be deemed representations
and not warranties.
Modifications
The only way this contract may be modified is by a written agreement slg'led
by our President, or one of our Vice Presidents, Secretaries or Assistant
Secretaries.
Non-Participation
This contract is non-participating It does not share In our surplus earnint;;S
so you will receive no dividends under it
Incontestability
We cannot contest thiS contract after it has been in force for one year fro:" ItS
Date of Issue
Required Distributions in the Event of the Owner's Death
In the event the Owner of this contract dies prior to the entire Interest In trls
contract having been distributed, the remaining portion of such Interest m .1st
be distributed at least as rapidly under the method of distributions being used
as of the date of the Owner's death
HL.9421.1
Page 5
DEFINITIONS
The definitions in this section apply to the following words and phrases
whenever and wherever they appear in this contract
We means Hartford Life Insurance Company Similarly, Us and Our refer
specifically to Hartford Life Insurance Company
You means the Owner of this contract. Similarly, Your refers specifically to
the Owner of this contract.
Income Payment means an annuity payment under this contract The
amount and frequency of payments are shown on Page 3
Certain Period means the period so shown on Page 3 It begins on the Date
of the First Payment.
In Writing means In a Written form satisfactory to us and filed at our office In
Hartford, Connecticut. All correspondence concerning this contract should be
sent to our mailing address at PO Box 5085, Hai1ford, CT 06102-5085
CONTRACT CONTROL
Change of Owner or Beneficiary
The Owner and Beneficiary will be those named in the application until you
change them To change the Owner or BenefiCiary, notify us in writing After
we receive written notice, the change will be effective as of the date you
signed such notice.
However, the change Will be subject to any pay"',ent "'Ie made or action we
may have taken before we received such notice
Assignment
You may assign this contract Until you notify us In writing no assignment Will
be effective against us We are not responSible for the validity of any
assignment
No Named Beneficiary
If no named Beneficiary survives the Annuitant then, unless this contract
provides otherwise
a) you will be the Beneficiary; or
b) if you are the Annuitant, your estate will be the BenefiCiary
HL9421-1
Page 2