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HomeMy WebLinkAbout02-0700 Estate of JoAnn Bosler also known as PETITION FOR PROBATE and GRANT OF LETTERS No. 2..'-02.-'00 To: Register of WilIs for th~ Deceased. County of Cumber iand in the Social Security No. 162 - 2 2 - 4 8 8 6 Commonwealth of Pennsylvania The petition of the undersigned respectfuUy represents that: Your petitioner(s), who is/are 18 years of age or older an the execut rix in the last wilI of the above decedent, dated J u n e 22 and codicil(s) dated n / " named ,~O (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Cumberland h er last family Ofllrincil1al residence at 30 Wes t Ridge Carlisle, FA 1701J County, Pennsylvania, with Street, (list street, number, Twp. or Boro.) Decedent, then 72 years of age, died Jul y 30 ,19x 2002, . ~RrliAlp RpeionAl Mediclal Center Except as foUows, 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: Decedent at death owned property with estimated values as foUows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: -?u w';Ss. /~'0GC:. ;;i. rrtt...T, CAZf....JSl<.:...j '::>.L\ I-}Ol-:r WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant ofletters te stamen tary theron. (testamentary; administration c.La.; administration d.b.n.c.t.a.) ~ u C ~ ~3 ~- "'~ ,,0 c'';:: ",.;:: 3~ ~~ ~o ;; c ., in Beverly A. Kelchner 34 Liberty Court Carlisle FA 17013 ~ C/. ~/~~J OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } 88 The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will wel and truly adminis~t~e es;a, ac,c~r~ng to ~a~. Sworn to or affirmed and subscribed { L...-[ /L.-e..L~ before me this 6th day of ~. JULY 2002 ~ .. ~~~~"{1~I.~.J ~ LE ~~ister ~ \'l-\q- \C) No. 21-02- ,00 Estate of JOANN BOSLER , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW Augus t 6 l<9Ll.Q.Q.j1in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, lT IS DECREED that the instrument(s) dated June 22. 2000 described therein be admitted to probate and filed of record as the last will of JoAnn Bosler and Letters res tamen tary are hereby granted to Bever ly A. Ke lchner "1'Y)l.'tg (I, qt'''~'''fHA~ MARY Lffi"..I~egister of Wi . FEES Probate, Letters, Etc. ......... $ Short Certificates( 4l . . . . . . . . .. $ ~. ~tra .pag~. $ jcp $ TOTAL _ $ FI'led 8-6-2002 .. :Caiied . b.tty' 8:_-'5":20'0';2" . . .. . . 200.00 12.00 Patricia R. Brown #27474 AITORNEY (Sup. Ct. J.D. No.) 10 West Pomfret Street Carlisle PA 17013 ADDRESS 9.00 5.00 226.00 (71 n 249-3024 PHONE S<-i .. '" ?fl LAST WILL AND TESTAMENT OF JOANN BOSLER 21-o~-IOO I, JO ANN BOSLER, a resident of and domiciled at 30 West Ridge Street, Carlisle, Cumberland County, Pennsylvania, being of sound mind and disposing Intent, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking all Wills and Codicils at anytime heretofore made by me. FIRST I order and direct my Executrix, hereinafter named, to pay all of my debts, funeral expenses and expenses Involved or connected with the administration of my estate as soon after my death as is reasonably possible. However, my Executrix need not accelerate and pay those unmatured obligations which, In her opinion, might be proper and more advantageous to retain or renew and pay as they become due and payable. SECOND I direct that my body shall be cremated and the ashes disposed of as discussed with my Executrix, following a memorial service to be held at the discretion of my Executrix. TmRD I give, devise and bequeath all my estate, real or personal, and my property of every kind and description (Including lapsed legacies and devises and any property over which I may have a power of appointment) and whether acquired before or after the Page 1 of 4 I~ execution of this Will. to my niece. KATHY BOSLER of 4225 North Stevens Street. Tacoma. Washington, provided she survives me by thirty (30) days. FOURTH Should the gift in paragraph THIRD fail, for whatever reason. I give. devise and bequeath all the rest, residue and remainder of my estate to BEVERLY A. KELCHNER, 34 Liberty Court, Carlisle. Pennsylvania. FIFTH I also have a daughter. DIANE M. CORNMAN of Carlisle. Pennsylvania. who was otherwise amply provided for during my lifetime and is not a beneficiary of my estate. SIXTH I hereby nominate. constitute and appoint as Executrix of this. my last Will and Testament. BEVERLY A. KELCHNER. 34 Liberty Court, Carlisle. Pennsylvania. If BEVERLY A. KELCHNER is unable or unwilling to qualify as Executrix or having qualified is unable or unwilling to continue to act, I appoint my niece. KATHY BOSLER, as Altemate Executrix. In addition to the powers conferred by law I authorize my Executrix: A. To retain in the form received, or to sell at either a public or private sale any real or personal property; B. To exercise any options to subscribe for stocks. bonds, or other investments. C. To sell, transfer, convey. mortgage. pledge. lease or exchange any property. real or personal, which at any time may form part of my estate. for the payment of debts or taxes, or for any purpose of administration or distribution. for such prices and upon Page 2 of 4 ~ such terms as my Executrix, in her discretion, may deem wise, and to execute and deliver deeds of conveyance or transfer thereof; D. To make settlements and compromises on such terms as my Executrix in her discretion may deem wise without the necessity of obtaining any court approval thereof; E. To make distribution hereunder either in cash or kind, as my Executrix, in her discretion, deems wise. SEVENTH I direct that no executrix, trustee or any fiduciary under this instrument shall be required to give bond or surety for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my seal this ~;o,~ day of June, 2000. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS We, JO ANN BOSLER, Vickie J. Group and Patricia R. Brown, Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament, and she had signed willingly and that she executed it as her free and Page 3 of 4 voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness and that to the best of his/her knowledge, the Testatrix was at that time eighteen years of age or older, of sound mind, and under no constra' , . ,- ~ t ,~ \J \ 0 (19"') ~\.R)J-i).esiding at (\ \'\nf{\Lk\..~\~F1' '\~ Witness , residing at c.------<...-<.Ju VC!.. . / '-4- '- /7 :kL~'_<J 7<{ Witness ~~ Subscribed, swom to and acknowledged before me by JO ANN BOSLER, the Testatrix, and subscribed and swom to before me by Vickie J, Group and Patricia R. Brown, witnesses, this ,~ d.yofJ""",,2000.. Ida ~ ~' ff(~ I~ C Notary u He NOTARIAL SEAL DENISE I'INAMONTI, Notary Public Carlisle Borough, Cumberland County M Co~sion Expires Nov. 20, _ Page 4 of 4 E-< Z "" :E: < E-< Ul "" E-< o Z < ....l ....l H ~ E-< Ul < ....l ".'i"'" '.,.-,',',,.;.,'r" "" o pe: ~ ....l Ul o "" z z < o >-J c: 6 ==~ o 0 ... 0- m 0 "u c:m e CIl.Q ... Vl Ql :B >>- CIl e ~Cl. <( (j) ::J CC') (j)~ ~f2 >-~ -emN cD -- C\J .De", :..J~r-;- w~~ ","eN e _ . (j) "- Cl.~ - -"- 'Om- -'Vi >-= -e Cii 1;U ::J jl CERTIFICATION OF NOTICE UNDER RULE 5.6(3) Name of. Decedent: JOANN BOSLER Date of Death: Will No. 21-02-0700 Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rulcs was 'served on or mailed to the following beneficiaries of the above-captioned estate on Name Address Kathy Bosler 4225 N. Stevens Street, Tacoma W~ 98407 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: s~~ 3, .,;Io'-'~ ~'7P.~, Signature Name Patricia R. Brown Address 10 West Pomfret Street Carlisle PA 17013 Telephone (717 249-3024 Capacity: ~ Personal Representative ~Collnsel for personal represent[ltive COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARR1SBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT PATRICIA R BROWN ESQUIRE lOWEST POMFRET STREET CARLISLE, PA 17013 -- fold ESTATE INFORMATION: SSN: 162-22-4886 FILE NUMBER: 2102-0700 DECEDENT NAME: BOSLER JOANN DATE OF PAYMENT: 10/30/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 07/30/2002 NO. CD 001783 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $5,000.00 I I I I I I I I TOTAL AMOUNT PAID: $5,000.00 REMARKS: BEVERLY A KELCHNER C/O PATRICIA R BROWN ESQUIRE CHECK# 121 SEAL INITIALS: SK RECEIVED BY: REGISTER OF WILLS MARY C. LEWIS REGISTER OF WILLS IP- ;/9-/0 \, COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPARTMENT 280601 HARRISBURG, PA 17128-0601 January 3, 2003 Telephone (717) 787-3930 FAX (717) 772-0412 Patricia R. Brown, Esq. 10 West Pomfret St. Carlisle, Pa.17013 Re: Estate of JoAnn Bosler File Number 2102-0700 Dear Ms Brown: This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before October 30,2003. Because Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. Sincerely,. ._ Jeftrey Hollenbush, Supervisor Document Processing Unit Inheritance Tax Division COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 2aoeol HARRISBURG, PA 17128-0601 OFFICIAL USE ONLY REV-1500 INHERITANCE FILE NUMBER TAX RETURN RESIDENT DECEDENT 21-02-0700 UJ <( ~t:.U) u"'''' UJO-u :rOO u"''''' o-lQ 0- <( , :~:W::~:.};::i.:: COUNTY cooe YEAR NUMBER .... Z W C W () W C DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) Bosler, Joann NMI DATE OF DEATH (MM-DD-YY) 7/30/2003 (IF APPLICABLE) SURVIVING SPOUSE'S NAME SOCIAL SECURITY NUMBER 162-22-4886 THIS MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER DATE OF BIRTH (MM-DD-YY) 4/14/1930 I- Z UJ o z o 0- W UJ '" '" o u 1. Original Return 0 2. Supplemental Return 4. Limited Estate 0 4a. Future interest Compromise 6. Decedent Died Testate 0 7. Decedent had Living Trust o 3. Remainder Return o 5. Fed. Est. Tax Return Req'd 6. Total number of SOB's COMPLETE MAILING ADDRESS: NAME: Patricia R. Brown, Esquire FIRM NAME: Patricia R. Brown, Esquire TELEPHONE NUMBER (717 249-3024 10 W. Pomfret St. Carlisle, PA 17013 z o 5 :l .... ii: <I: () W a:: (1) (2) (3) (4) (5) (6) $78,350.0a $0.00 OFFICIA~ USE ONLY 1. Real Estate (Schedule A) 2. Slocks and Bonds (Schedule B) 3.Closely Held Corporation, Partnership or Sole-Prop. 4. Mortgages & Notes Receivable (Schedule 0) 5. Cash, Bank Deposits & Misc. Personal Prop.(Sch.E) 6. Jointly OWned Property (Schedule F) o Separate BiRing Requested 7. Inter-Vivos Transfers & Misc. Non-Propate Prop. 6. Total Gross Assets (Iota I lines 1-7) 9. Funeral Expenses & Administration Costs (Sch H) 10. Debts of Decedent, Mortgage liabil~ies, & Liens 11. Total Deduc<<ons (total lines 9&10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (13) 14. Net Vaiue Subject to Tax (Line 12 minus Line 13) 14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RAT1:S 15. Amnt of Line 14laxable at the spousal rate, or transfers under Sec.9116(a)(1.2) 16. Am.ount of Line 14 ta>cabfe at lineal rate 17. Amount of Line 14 taxable at sibfing rate 18. Amount of tine 14 taxable at collateral rate $0.00 $15.324.05 $0.00 (7) (9) (10) (8) $93,674.05 $64,728.46 $21,198.38 (11) $85,926.84 (12) $7,747.21 $7,747.21 ~ ~ i :IE 8 :l I- (15) (16) (17) (16) (19) $0.00 $0.00 $929.67 $0.00 $929.67 $0 $7,747.21 $0 X.O_ x.045 x.12 x.15 19. Tax Due 2Q CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Dec!!dent's Complete Address: STREET ADDRESS 30 West Ridae Street STATE ZIP CITf Carlisle PA 17013 Tax Payments and CredIts: 1 Tax Due 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C Discounts (1) $5,000.00 Total Credits (A+8+C) (2) 3. lnteresUPenalty if applicable D. Interest E. Penalty 4. Totar InterestlPentalty (D+E) If Line 2 IS greater than Une 1 ... Line 3, enter the difference thIS is the OVERPAYMENT Check box on Page 1 line 20 to request a refund (3) (4) 5. (5) (SA) (5B) If Line 1 + Line 3 is greater than line 2, enter the difference. This is the TAX DUE. A Enter the interest on the tax due. B. Enter the total of Une 5 + SA. This is the BALANCE DUE. Make Check to: REGISTER OF $929.67 $5,000.00 $0.00 $4,070 $000 AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN .X"IN THE APPROPRIATE BLOCKS Did decedent make a transfer and: yes no a retain the use or income or the property transferred b, retain the right to designate who shall use the property transerred or its income c retain a reversionary interest or d retain the promise for life of either payments or care? 2 If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? 3 Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 4 Did decedent own an Individual Retirement Account, annuity, or other non-prObate property wllich contains a beneficiary disignation? CJ CJ D CJ CJ CJ CJ [CJ [CJ [CJ [CJ [CJ [CJ [CJ IF THe ANSWER TO ANY OF THE ABove QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this retorn, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, CDrrect and complete Declaration of preparer other than the personal representativE! is basl!ld on all informatiDn of which preparer has any knowled~e SIGNAT)JRE OF PERSO~ RESPONS$lE FOR.f1L1Nq ~ETl.Jf-N .A,/ , j --0t.l-L' C. /~0 AOD S 34 Liberty Court, Carlisle, PA 17013 SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE '-P~ Y( ~- ADDRESS DATE I (J DATE 10/30120 (0 3 , For dates of death on or after Juiy 1, 199<1 and before January 1, 1995, the tax rate imposed on the net value 01 transfer; to or fQrthe use of the surviving spouse is 3% [72P.S Sec_ 9"116(8)(1.1)(111 For dates oIdeatJ'l on or after January 1, 1995, the tax rate imposed Qn the net value of tral'\Sfers to or for tile use of the surviving spouse is 0% 172 P,S Sec_ 9116(a)(1.1)(ii)] The statute ~s not exempt a transfer to a sl.lrviving spo\Jse from tax, and the statutory requirements fOf disclosure or assets and filing a lax return are still applicable even if the survivin9 spouse IS tt,e only beneficiary For dates of death on or after July " 2000 The tal! rate imposed on the net value oflransfers from a dese8sed child twenty-one years of age or younger at death to or lor the use Qf a natural parent. an adoptive parent, or I stepparenrof the child is 0% {72 PS Sec 9116(01)(12)) The tax rate Imposed on the net '<'alue of transfers 10 or for the use of the decedenfs lineal beneficiaries is 4_5%, except as noted in 72 PS, Se<;. 9116/12) 172 P.S. Sec_9116(a)(1l The tax rate imposed <)fl the net value of transfers to Qr for the use of 1M decedenfs siblings is 12% [72 P,5. 5ec,9116(<I)(13)1 A sibling is defined, under Section 9102, as all individuai who has at least one parent 10 common with the decedent, whether by blood or adoption . ,_! 4Jl1h.l-..........;'.~...",.:;..j\Oiw,u.,.,.., .,.,...........,.,,,..,"....,,.-..... ""711t4 ................""'.......'" ',' - ", ..::..... .... ..... execution ";;r !his Will, to my niece, ._....JO..,_~....'.l,.~'~.;.:..'.:...,: . .,~, ., ' " ;" oj,', "., ER r 4225 North Stevens Street, KATHY BOSL' 0 .' Tacoma, Washington, provided she survives me by thirty (30) days. FOURTH Should the gift in paragraph THIRD fail. for whatever reason, I give, devise and bequeath all the rest. residue and remainder of my estate to BEVERLY A. KELCHNER. 34 Liberty Court. Carlif'lJe, Pennf'lylvfln!a FIFTH I also have a daughter, DIANE M. CORNMAN of Carlisle, Pennsylvania, who was otherwise amply provided for durtng my lifetime and is not a beneficiary of my estate. SIXTH I hereby nominate, constitute and appoint as Executrix of this, my last Will and Testament. BEVERLY A. KELCHNER, 34 Liberty Court, Carlisle, Pennsylvania. If BEVERLY A. KELCHNER is unable or unWilling to qualify as Executrix or having . .. qualified is unable or unWilling to continue to act. I appoint my niece, KATHY BOSLER. as Alternate Executrix. In addition to the powers conferred by law I authorize my Executrix: A. To retain in the form received. or to sell at either a public or private sale any real or personal property; B. To exercise any options to subs~ribe for stocks, bonds. or other investments. I C. To sell, transfer, convey, mortgage. pledge, lease or exchange any property, 'real or personal, which at any time may form part of my estate, for the payment of debts or taxes, or for any purpose of administration or distribution, for such prices and upon Page 2 of 4 ~ I . .\ '~~K"'r,ro:tmfNII ~_'~~.iI.f:::r:r..~~'.:Z:~~;::':"'.I~.:u.t!;..".. .,..... "....;. "; "', "~.'~'~' , ,"'.", ,,_ ~............._....'l,.~,,~.,;'. '~.: "'~.," .. ". ... . ,.., ", execution .of this Will. to my niece, KATHY BOSLER of 4225 North Stevens Street, '1" Tacoma, Washington, provided she survives me by thirty (30) days. FOURTH Should the gift in paragraph THIRD fail, for whatever reason, I give, devise and bequeath all the rest, residue and remainder of my estate to BEVERLY A. KELCHNER. 34 Liberty Court, Carlisle, Pennsylvfln!a FIFTH I also have a daughter, DIANE M. CORNMAN of Carlisle, Pennsylvania, who was otheIWise amply provided for durtng my lifetime and is not a beneficiary of my estate. SIXTH I hereby nominate, constitute and appoint as Executrix of this, my last Will and Testament, BEVERLY A. KELCHNER. 34 Liberty Court, Carlisle, Pennsylvania. If BEVERLY A. KELCHNER is unable or unwilling to qualify as Executrix or having qualified is unable or unwilling to continue to act, I appoint my niece, KATHY BOSLER. as Alternate Executrix. In addition to the powers conferred by law I authorize my Executrix: A. To retain in the form received, or to sell at either a public or private sale any real or personal property; B. To exercise any options to subs~ribe for stocks, bonds, or other investments. I C. To sell, transfer, convey, mortgage, pledge, lease or exchange any property, real or personal, which at any time may form part of my estate, for the payment of debts or taxes, or for any purpose of administration or distribution. for such prices and upon Page 2 of 4 9r- .:~..it.i/::', < . A.."1:l'li~'I~''':'',:1 " such terms as my Executrix, in her discretion. may deem wise, and to execute and deliver deeds of conveyance or transfer thereof; D. To make settlements and compromises on such terms as my Executrix in her discretion may deem wise without the necessity of obtaining any court approval thereof; E. To make distribution hereunder either in cash or kind, as my Executrix, in her discretion, deems wise. SEVENTH i direct that no executrix, trustee or any fiduciary under this instrument shall be required to give bond or surety for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and affixed my seal this p,d day of June, 2000. COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND j :1 We. JO ANN BOSLER, Vickie J. Group and Patricia R. Brown. Testatrix and the witnesses, respectively, whose nanles are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and .' < Testament, and she had signed willingly and that she executed it as her free and .;~ Page 3 of 4 , .~.. ..... ~ , . I ~""'.~ ',- ", " - - , .........-.......,......,.-,.- . .-.-...--......,...--.,--------- voluntary act for the purposes therein expressed. and that each of the wltnesses, in the presence and hearing of the Testatrix. signed the Will as witness and that to the best of his/her knowledge, the Testatrix was at that time eighteen years of age or older. of sound mind. and under no constr t \j Ie' 'l; N~'ldlng atC'Y'(\ffil:'\l.vhn~, ~ . Witness \-4~:z.v'...:.._-<./7f ~ residing at ~, ~....... Witness Subscribed, sworn to and acknowledged before me by JO ANN BOSLER. the Testatrix. and subscribed and sworn to before me by Vickie J. Group and Patricia R. Brown. witnesses, this c!J::l... day of J?fl " Page 4 of 4 NOTARIAL SEAL DENISE PINAMONTI. Notary Public Carlisle Borough. CUmbertand County M Commission Ex Ires No SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER JOANN BOSLER 21-02-0700 (Property jointly--owned with Right of Survivorship must be disclosed on Schedule F) AIl real estate should be reported at fair market value with is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to sell. both having reasonable knowledliW of the relevant facts. ITEM DESCRIPTION NUMBER VALUE AT DATE OFDEA1H I 30 West Ridge Street, Carlisle, Cumberland County, P A (see attached settlement statement) $78,350.00 TOTAL (also on line 1, Recapitulation) $78,350.00 SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES ESTATE OF FILE NUMBER JOANN BOSLER 21-02-0700 A. (All .ointly-owned with Right ofSurvivorsmp must be disclosed on Schedule F) ITEM DESCRIPTION AMOUNT NUMBER Funeral Expenses: I Hoflinan-Roth-cremation service, cemetery, death certs, newspaper notice $1,783.60 2 Elks luncheon (following memorial service) $1,290.97 3 Rev. E.J. Shefer (condncted memorial service) $150.00 Administrative Costs: I Personal Representive Commissions Social Security Number of Personal Representative: 2 Attorney fees to Patricia R. Brown $4,700.00 3 Family Exemption Claimant Beverly A. Kelchner $7,825.40 Address of Claimant at decedent's death: Street: 34 Liberty Court City: Carlisle State & Zip PA 17013 4 Probate Fees to Register of Wills $226.00 Miscellaneous Expenses: I H&R Block - preparation of tax return $226.00 2 Filing fee - tax.dosing papers $50.00 3 Purchase of heating unit $3,207.00 4 Real Estate commission (6% - $78,350) $4,701.00 5 Electrical work at 30 West Ridge Street $145.00 6 Payment of school taxes $684.35 7 Attorney and notary fees $210.00 8 Title fees $732.75 9 Recording fees $109.00 10 2% realty transfer taxes $1,567.00 II Settlement fee $75.00 12 Misc. Fees $31.58 13 Payoff Mortgage - Valley National Bank $37,013.81 TOTAL (al,o on line 9, Recannulation) $64,728.46 B. C. ....... >,~. OMB NO> 2502-0265 ,or A// B. TYPE OF LOAN: U>S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT l.QFHA 2.QFmHA 3> DCONV. UNINS. 4.DVA 5. ~CONV. INS. 6. FILE NUMBER: 17. LOAN NUMBER: SETTLEMENT STATEMENT GLEN19H3 217fJ15/Q012673653 B. MORTGAGE INS CASE NUMBER: 19405359 C. NOTE: This form is furnished to give you a slatement of actual sell/ement costs. Amounts paid to alld by the selt/omen! agenl are sfJowtI. Items marlced "{POC/" were paid outside the closing; [hey are shown here for informDtional purposes and are no! included in the 'olals. '.0 3/98 {GlENI91.03PFOIGlEN191-0J/10) D. NAME ANO ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER: BRADLEY L. GLENN and JO ANN BOSLER ESTATE Citizens Mortgage Corporal ion KIRSTEN J. GLENN 30 W. RIDGE ST 875 Elm Street 1671 GRACE AVE CARLISLE. PA 17013 Manchester. NH 03101 LEBANON. PA 17046 G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 25-1619811 I. SETTLEMENT DATE: 30 W. RIDGE ST TRI-COUNTY ABSTRACT SERVICE CARLISLE. PA 17013 June 12.2003 CUMBERLAND Counly, Pennsylvania PLACE OF SETTLEMENT I C/O PATRICIA R. BROWN. ESa 10 W. POMFRET STREET I CARLISLE. PA 17013 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract Sales Price 78,350.00 401. Contract Sales Price I 78.350.00 102. Personal Prooertv 402. Personal Prooertv , , 103. Settlemenl Charnes to Borrower (Line 1400) 1,756.17 403. I 104. 404. I 105. 405. Ad;ustments For Items Paid Bv Seifer in advance Adiustments For Items Paid Bv Seller in advance 106. CitvITown Taxes to 406. CitvITown Taxes to 107. Counlv Taxes 06/12/03 to 01101104 256.33 407. Counlv Taxes 06/12/03 10 01/01104 I 256.33 108. SCHOOL TAX 06/12/03 to 07/01103 51.10 408. SCHOOL TAX 06/12/03 to 07/01103 51.10 109. 409. 110. 410. ",. 411. 112. 412. 120. GROSS AMOUNT DUE FROM BORROWER I 80,413.60 420. GROSS AMOUNT DUE TO SELLER I 78.657,43 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deoosit or eamest money 1.000.00 501. Excess Deoosit (See lnstruclions) 202. Princioal Amount of New Loan s) 75.950.00 502. Selllement Charoes to Seller rline 1400 11,462.68 203. Existino loan(s) taken subiect to-' 503. Existino loan(s) taken subiect to 204. 504. Payoll 01 firsl Mortgage 10 VALLEY NATIONAL BANK/l 37.013.81 205. 505. Pavoff of second Mortnaae I 206. 506. I 207. 507. (Deoosit disb. as oroceeds) 208. 508. 209. 509. Ad'ustments For Items Unoaid By Seifer Adjustments For Items Un aid By Seller 210. CitvITown Taxes 10 I 510, CilvfTnwn T::Ixpt:; In I SCHEDULE I DEBTS OF DECEDENT MORTGAGE LIABILITIES AND LIENS ESTATE OF FILE NUMBER JOANN BOSLER 21-02-0700 ITEM NUMBER I 2 3 4 5 6 7 8 9 10 II 12 13 14 15 16 17 18 19 20 21 22 DESCRIPTION Sprint telephone Cumberland-Goodwill Ambulance (9 trips @ $664 each) PP&L - electric bill Carlisle Borough - water sewer bil UGI - gas bill AAA (title to car) Comcast Cable - TV bill VNB Mortgage SClVices ($406/month for 7 months) VNB Mortgage Services ($413/month for 4 months) LANCHMAPHYSMGMT West Shore Path American Red Cross (lifeline charges) Medicines Monogram credit card Discover credit card Hilton's lock service (changed all house locks) Carlisle personal lax Cumberland County Office of Aging James Devor (heat cable and photo inventory) Carlisle Regional Medical Center (account no: 7177025) (12/11/02) Grass cutting and snow shoveling Carlisle Relrional Medical Center (account no: 7178780) 1711212002) TOTAL (also on line 10, Recapitulation) AMOUNT $186.72 $4,648.00 $147.86 $70.20 $436.07 $42.00 $76.47 $2,842.00 $1,652.00 $47.89 $7.84 $70.00 $22.08 $10.45 $278.21 $133.00 $9.90 $72.25 $160.00 $66.89 $220.00 $9,998.55 $21,198.38 SCHEDULE] BENEFICIARIES ESTATE OF FILE NUMBER ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHARE NUMBER OF ESTATE I Kathy Bosler niece 100% 16106 VashonHwy SW Vashon, W A 98070 JOANN BOSLER 2 I -02-0700 ITEM NAME AND ADDRESS OF BENEFICIARY NUMBER AMOUNT OR SHARE OF ESTATE B. Charitable and Governmental Bequests: TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (also ent<r on line 13, Recapitulation) $0 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. ~80601 HARRI~'BURG. PA 17128-0601 PATRICIA R BROWN ESQ 10 W POMFRET ST CARLISLE PA 17013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE -~J~' '~ J'? ESTATE OF 03-29-2004 BOSLER REV-tE4? EX (t2-91) PC JOANN '04 t PR -5 P..3:04 DATE OF DEATH 07-30-2002 FILE NO. 21 02-0700 COUNTY Cumberland ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: Register of Wills Cumberland County Courthouse Carlisle, PA 17013 CUT ALONG THIS LINE =~ RETAIN LOWER PORTION FOR YOUR RECORDS C= REV-1547 EX (06-97) PC NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BOSLER JOANN FILE NO. 21 02-0700 ACN 101 DATE 03-29-2004 TAX RETURN WAS: ( [] ) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE ([])CHANGED SEE ATTACHED NOTICE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 78,350.00 NOTE: To Insure proper 0.00 credit to your account, 0.00 submit the upper portion 0.00 of this form with your 15,324.05 tax payment. 0.00 NOTE: 0.00 (8) 93,674.05 Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 64,728.46 Debts/Mortgage Liabilities/Liens (Schedule I) (10) 21,198.38 Total Deductions (11 ) Net Value of Tax Return (12 ) Charitable/Governmental Bequests; Non-elected 9113 Trusts (schedule J) (13) Net Value of Estate Subject to Tax (14) If an assessment was Issued previously, lines 14, 15 and/or 16, 17 and 18 will reflect figures that include the total of ALL returns assessed to date. 85,926.84 7,747.21 0.00 7,747.21 ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 0.00 X .00 0.00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 0.00 X .045 0.00 17. Amount of Line 14 taxable at Sibling rate (17) 0.00 X .12 0.00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 7,747.21 X .15 1,162.08 19. Principal Tax Due (19) 1,162.08 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 10-30-2002 CD001783 58.10 5,000.00 TOTAL TAX CREDIT 5,058.10 BALANCE OF TAX DUE 3,896.02CR INTEREST 0.00 TOTAL DUE 3,896.02 CR IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQOIRED. IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FO~M FOR INSTRUCTIONS. ) ;EV-1470 EX (6-88) EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDEN3~S NAME FILE NUMBER JOANN BOSLER 21 02-0700 REVIEWED BY ACN CHARLES WRIGHT t 01 ITEM SCHEDULE NO. EXPLANATION OF CHANGES J Nieces are taxed at the collateral rate of 15%. ROW Page 1 FAMILY SETTLEMENT AGREEMENT AND FINAL RELEASE IN_ ESTATE OF JOANN BOSLER~ DECEASED (File No: 21-02-0700) KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, JOANN BOSLER, late of Carlisle, Cumberland County, Pennsylvania, deceased, died testate on July 30, 2002, having first made her Last Will and Testament, which was duly executed on June 22, 2000, and is duly recorded at the Register of Wills in Cumberland County, Pennsylvania. WHEREAS, the said JoAnn Bosler, by the aforesaid Last Will and Testament, named Beverly A. Kelchner, as Executrix of said Last Will and Testament; WHEREAS, letters testamentary on the estate of the said decedent were duly issued by the Register of Wills of Cumberland County, Pennsylvania, to the said Executrix hereinafter called personal representative; WHEREAS, the said personal representative has gathered the assets of the estate of the said decedent and the assets consists of real and personal property to a total value of $93,674.05 as set forth in Exhibit A, which is a statement of account of the said personal representative, and which is attached hereto and made a part hereof and marked Exhibit A; WHEREAS, the debts and deductions amount to $85,926.84, leaving the sum of $1,162.08 for distribution, also as set forth in the statement of the said personal representative, which is attached hereto and marked Exhibit A; NOW, THEREFORE, KNOW YE, that I, KATHY BOSLER, the heir under the Last Will and Testament of the said decedem, and being that person entitled to inherit under said Last Will and Testament, and in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, agree that no account is necessary and do hereby agree that and consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if they had been filed and confirmed by the Orphans' Court Division of the Court of Common Pleas, Cumberland County. THEREFORE, I, do hereby remise, release, quitclaim and forever discharge the said personal representative, BEVERLY A. KELCHNER, her heirs, executors, administrators, and assigns, of and from the said estate and from all actions, suits, payments, accounts, reckonings, claims, and demand whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever, touching upon the estate of the said decedent, and I do further hereby covenant and agree that should any liability come due to the estate of the said decedent after the signing of this agreement, do hereby covenant and agree that I will contribute my share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal representative after the signing, sealing and delivery of this family settlement agreement and final release. IN WITNESS WHEREOF, I have hereunto set my hand and seal this oQ~t~ay of WITNESS: ,2004. Beneficiary of the Estate of Joann Bosler STATE OF WASHINGTON ) COUNTY OF ~ ) ON THIS, the 7~,~q~L day of ~ ,2004, before me, the undersigned officer, personally appeared Kathy Bosl~r, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have set my hand and official seal. Notary Public 3 EXHIBIT "A' STATEMENT OF ACCOUNT OF BEVERLY A. KELCHNER Assets: (A) Stocks and Bonds (B) Miscellaneous Personal Property Debts: l) 2) Funeral Expenses and Administration Expenses Miscellaneous Expenses Balance for Distribution to Heir: Kathy Bosler TOTAL TOTAL $78,350.00 $15,324.05 $93,674.05 $64,728.446 $21,198.38 ..$85,926.84 $1,162.08 BI-~REAU..OF INDIVIDUAL TAXES II~II'II~;~',*ANCE TAX DIVISION D~P¥. 280601 H'ARRISPbI~G, PA 17128-0801 PATRICIA R BROWN ESQ 10 W POMFRET ST CARLISLE PA 17013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 03-29-2004 ESTATE OF BOSLER DATE OF DEATH 07-30-2002 FILE NO. 21 024)700 COUNTY CumbeHand ACN 101 REV-t~4/EX (t2-%?) PC JOANN Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: Register of Wills Cumberland County Courthouse Carlisle, PA 17013 CUTALONG THIS LINE c~ RETAIN LOWER PORTION FOR YOUR RECORDS C= "~-~Y:i ~¥' ~'(bk'-b¥)'~,~ ............. ~ b'fi~'~ '6'~ -~i h'~ k'iYA'~ ~:',~- ~-X~(- X~,~'Xi~'~ki,~-; 'Ai~,' ~,A'~i=- ~- ................................ DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BOSLER JOANN FILE NO. 21 02-0700 ACN 101 ~E_'rURN WAS: [] ) ACCEPTED AS FILED [] DATE 03-29-2004 EVERSE CHANGED SEE ATTACHED NOTICE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 10. 11. 12. 13. 14. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) Debts/Mortgage Liabilities/Liens (Schedule I) Total Deductions Net Value of Tax Return Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) Net Value of Estate Subject to Tax (1) 78,350.00 NOTE: To Insure proper (2) 0.00 credit to your account, (3) 0.00 submit the upper portion (4) 0.00 of this form with your (5) ... 15,324.05 tax payment. (5) 0.00 (7) 0.00 (8) .. 93,674.05 (9) 64,728.46 (10) 21,198.38 (11) . 85,926.84 (12) 7,747.21 (13) 0.00 NOTE: ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 taxable at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: (14) 7,747.21 If an assessment was issued previously, lines 14, 15 and/or 16, 17 and 18 will reflect figures that Include the total of AL._._.~L returns assessed to date. * IF PAID AFTER DATE INDICATED, SSS REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. AMOUNT PAID 5,000.00~ TOTAL TAX CREDIT 5,058.10 BALANCE OF TAX DUE 3,896.02 CR INTEREST 0.00 TOTAL DUE 3,896.02 CR Db'- IS LESS THA~ -~3.. ~n u~v.,._. .......... (IT TO IF TOTAL DUE IS REFLECTED AS A CREDIT (CP.), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF TEIS FORM FOR INSTRUCTIONS.) (15) 0.00 X .00 0.00 (16),_ 0.00 X.045 0.00 (17) 0.00 X.12 0.00 (18) 7,747.21 .X.15 1,162.08 (19)'_' 1,162.08 /~/VEALTH OF PENNSYLVANIA - 2PARTMENT OF REVENUE ~REAU OF INDIVIDUAL TAXES DEPT. 280601 'HARRISBURG PA 17128-0601 .'N'PS NAME JOANN BOSLER ~EWED BY INHERITANCE TAX EXPLANATION OF CHANGES CHARLES WRIGHT .i 101 $CHEDULE~ EXPLANATION OF CHANGES Nieces are taxed at the collateral rate of 15%. ORIGINAL Page 1 BUREAU OF INDIVIDUAL TAXES TNHERZTAHCE TAX DTVZSTON DEPT. 280601 HARRTSBURG,, PA 17128-0601 COMMONNEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ZNHERZTANCE TAX STATEHENT OF ACCOUNT REV-160? EX AFP CDi-OS) *04 PATRICIA R BRONN ESQ 10 N POMFRET ST CARLISLE PA 170~$-~ DATE 04-19-2004 ESTATE OF BOSLER BATE OF BEATH 07-$0-2002 .~FZLE7 NUMBER 21 02-0700 ~COUNTY CUMBERLAND ACN 101 I Amoun~ Remi~ed dOANN MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 NOTE: To insure proper credi4: ~:o your accoun4:, submi4: ~he upper por~ion of ~his for. wi~h your ~ax payment. CUT ALONG TH'rS LINE ~* RETA'rN LONER PORT'rON FOR YOUR RECORBS ~ ESTATE OF BOSLER JOANN FILE NO. 21 02-0700 ACN 101 DATE 04-19-2004 THIS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACM TN THE NAHED ESTATE. SHO#N BELO# ZSA SUHHARY OF THE PRINCIPAL TAX DUE., APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, ZF APPLZCABLEz A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTMENT: 05-29-2004 PRINCIPAL TAX DUE: ........................................................................................................................................................................................................................... PAYMENTS (TAX CREDITS): 1,162.08 PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-$0-200Z 05-29-2004 CD001785 REFUND IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYHENT ZS REQUIRED. ZF TOTAL DUE IS REFLECTED AS A "CREDIT" {CR), 58.10 .00 5,000.00 3,896.02- TOTAL TAX CREDIT 1,162.08 BALANCE OF TAX DUE .00 ZNTEREST AND PEN. .00 TOTAL DUE .00 YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) S~~TUS REPORT UNDER RULE 6.12 Name of Decedent: JoAnn Bosler Date of Death: July 30, 2002 Will No. 21-02-0700 Admin. No. 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? Yes X No . By Family Agreement 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 Cerk of the Orphans' Court and may be attached to this report. Date: 5/~I/O'f / ~ '-fr~ '7C ~~ Signature Patricia R, Brown Name (Please type or print) 10 West Pomfret Street, Carlisle, PA 17013 Address ~) 249-3024 Tel. No. Capacity: Personal Representative X Counsel for personal representative (MAII:rmf/AM3)