HomeMy WebLinkAbout02-0168PETITION FOR PROBATE and GRANT OF LETTERS
Estate of ANNA M. BOYER
also known as
Deceased
Social Security No. 184-12-2733
No.
To:
,Z/-02-I ,Z
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner is 18 years of age or older and the Executrix named in the last will of the above
decedent, dated October 15, 1962 and codicil(s) dated [none].
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or
principal residence at 216 Wolf's Bridge Road, Middlesex Township, Carlisle, Pennsylvania.
Decedent, then 84 years of age, died February 3, 2002, at Carlisle Regional Medical Center,
Cumberland County, Pennsylvania.
Except as follows, decedent did not marry, was not divorced and did not have a child born or
adopted after execution of the will offered for probate; was not the victim of a killing and was never
adjudicated incompetent: [none]
Decedent at death owned property with estimated values as follows:
(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: 216 Wolf's Bridge Road
Carlisle, PA 17013
$ 20,000.00
$
$
$100,000.00
WHEREFORE, petitioner respectfully requests the probate of the last will and codicil(s) presented
herewith and the grant of letters testamentary thereon.
Anna M.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
The petitioner above-named swears or affirms that the statements in the foregoing petition are true
and correct to the best of the knowledge and belief of petitioner and that as personal representative of the
above decedent, petitioner will well and truly administer~e according to law.
Sworn to er affirmed 'and subscribed ~-/~o-~,~,~,.t-a_ .~~~
before me this 1 2 ~h day of An~ ~ R~dd~ugh' -
UARY , v002
Y ~ L~g / Registe~ Z
No. Y_/- 1
Estate of ANNA M~. BOYER, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW, FEBRUARY 13 , 2002, in consideration of the petition on the
reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated October 15, 1962, and described therein be admitted to
probate and filed of record as the last will of Anna M~. ~oyer and Letters Testamentary are hereby granted
to Anna M':. Raudabaugh.
Will Book # ] 7
Page 4 2
MA~Y C/LE~[S R~'gister of~ilis 7 '~f//
FEES
Probate, Letters, Etc. $ 2 3 5.0 0
Short Certificates(4) $ 1 2.0 0
Renunciation $
JCP $ 5.00
TOTAL $ 252.00
Filed F~BRUARY 13, 2002
Stephen L. Bloom, Esquire
Sup. Ct. I.D. No. 49811
2100 Longs Gap Road
Carlisle, PA 17013
(717) 249-7717
call lori on 2-]3-02
CALAS~ESTATES\ 10303-I pet. I
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF NON-SUBSCRIBING WITNESS
Anna M. Raudabaugh and Mildred Ellerman, (each) a subscriber hereto, (each) being duly
qualified according to law, depose(s) and say(s) that they are familiar with the signature of Anna M.
Boyer, testatrix of the Will presented herewith and that they believe the signature on the Will is in
the handwriting of Anna M. Boyer to the best of their knowledge and belief.
Sworn to or affirmed and subscribed
before me this 1 2th day of
FEBRUARY ,2002.
Anna M. Raudabaugh
16 Green Hill Road
Mechanicsburg, PA 17050-1510
Mildred Ellerman
20 Meeting House Spring Road
Carlisle, PA 17013
C:~LAS~ESTATES\ 10303-1 oath. 1
105.805REV 9/86
This is ro certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded ro the State Vital Records Office for permanent filing.
WAFINING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 7914093
No.
!i ~.~ !:i!' ,_. Lo---cai Registra~
~/**..'7
FEe, 2002
Date
mos..~ n.,,. z~? COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH * VITAL RECORDS
' CERTIFICATE OF DEATH
K " klna M. Borer ~x soc,~ s~cu.,r~j;~"
,~ ~ F. ~i~n
~ ~lla ~e ~rri~n
2/7/2002
FD 012633 L
16 Green PA 17050
Middleton Church of C~a. Carlisle, PA 17013
Brothers Puneral Hcme, Carlisle, PA 17013
,>'77-
21-02-168
O0:~Ld ~!. B3~ ZO.
LAST WILL AND TEST;J~ENT OF ANNA MAE BOYER
I, ANNA MAE BOYER, of the Township of Middlesex, Cumberland
County, Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby make, publish and declare this as and for
my Last Will and Testament, hereby revoking and making null and void
any and all prior wills, or i~truments in the nature thereof, by me
at any time heretofore made.
ITEM 1 - I give, devise and bequeath one-half of my es-
tate to my daughter, ANNA MAE RAUDABAUGH.
ITEM 2 - The remaining one-half of my estate I give, de-
vise and bequeath in equal shares to such of my grandchildren as
may be living at my death.
ITEM 3 - Should a~y of my said grandchildren be a minor
at the date of my death, I give, devise and bequeath his or their
share,to the HARRISBURG NATIONAL BANK, CARLISLE OFFICE, in trust,
nevertheless, to invest and reinvest the same, ~d to accmumlate
the income thereon until such grandchild or grandchildren attain
the age of twenty-one years, at which time it shall pay over to
such grandchild or grandchildren the entire share or shares of the
trust, together with income accumulated thereon, absolutely. I
authorize and empower my said Trustee in its sole discretion to
apply .any part or all of the corpus and income accumulated on the
share of any grandchild hereunder for the education of such grand-
child.
ITEM h - I name, constitute and appoint as the Executrix
of this my Last Will and Testament my said daughter, ANNA MAE
RAUDABAUGH.
this
IN WITNE~E~ WHEREOF I have h~re!~my hand and seal
day of , 1962.
(StoL)
Signed, sealed, published, pronounced
and declared by the said Testatrix as
and for her Last Will and Testament,
in our presence, who, at her request,
and in her presence, and iH the pre-
-.I --
.~ Z
·
STEPHEN L. BLOOM
ATTORNEY AND CO~UNSELLOR AT LAW
2100 LONGS GAP ROAD
CARLISLE, PENNSYLVANIA 17013
717-249 7717
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: ANNA MAE BOYER
Date of Death: February 3, 2002
File No. 21-02-0168
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 estate on March 19, 2002:
marne
Address
Anna M. Raudabaugh
Jeffrey L. Raudabaugh
William L. Raudabaugh
Michael L. Raudabaugh
Suzanne Keller
16 Green Hill Road, Mechanicsburg, PA 17050-1510
1600 Pebble Brook Lane, Harrisburg, PA 17110
R. D. #1, Box 471, Landisburg, PA 17040
486 N. Locust Point Rd., Mechanicsburg, PA 17050
370 Charlyne Way, Dacula, GA 30019
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: N/A
Date: March 20, 2002
"'~tephe'n L. Bloom, Esquire
2100 Longs Gap Road
Carlisle, PA 17013
(717) 249-7717
Capacity: Counsel for Personal Representative
C :XLASXEstates\ 10 3 0 3 - l cert. not
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 001135
DUPLICATE
BLOOM STEPHEN L
2100 LONGS GAP ROAD
CARLISLE, PA 17013
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
........ fold
101 $4,000.00
ESTATE INFORMATION: SSN: 184-12-2733
FILE NUMBER: 2102-01 68
DECEDENT NAME: BOYER ANNA MAE
DATE OF PAYMENT: 05/01/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 02/03/2002
TOTAL AMOUNT PAID'
$4,000.00
REMARKS: ANNA MAE RADUBAUGH
C/O STEPHEN L BLOOM ESQUIRE
SEAL
CHECK# 13
INITIALS' SK
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 001286
STEPHEN L BLOOM ESQUIRE
2100 LONGS GAP ROAD
CARLISLE, PA 17013
........ fold
ESTATE INFORMATION: SSN. 184-12-2733
FILE NUMBER: 2102-01 68
DECEDENT NAME: BOYER ANNA MAE
DATE OF PAYMENT: 06/12/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 02/03/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $395.80
TOTAL AMOUNT PAID:
$395.80
REMARKS: ANNA MAE RAUDABAUGH
C/O STEPHEN L BLOOM ESQUIRE
SEAL
CHECK//19
INITIALS: CW
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGISTER OF WILLS
REV-1500 EX + (6-00)
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Boyer Anna M.
DATE OF DEATH (MM-DO-YEAR) I DATE OF BIRTH (MM-DO-YEAR)
02/03/2002 I 02/14/1917
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
OFFICIAL USE ONLY
1'7.- ¥ -
FILE NUMBER
21-02-0168
COUNTYCODE YEAR NUMBER
SOCIAL SECURITY NUMBER
184-12-2733
THIS RETURN MUST BE FILED IN DUPLICATE W1TH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
1. Original Return ~ 24i Supplemental Return
4. Limited Estate . Future lnterest Compromise (date of death after 12-1Z-82)
6. Decedent Died Testate Decedent Maintained a Living Trust
(Attach copy of Will) (Attach copy of Trust)
--]9. Litigation Proceeds Received U Spousal Poverty
10.
Credit
(date of death between 12-31-91 and 1 - 1-95)
. (date of .cLe a,t ~h
3. Remainder Return prior to ]/-],~-82)
5. Federal Estate Tax Return Required
0 6. Total Number of Safe Deposit Boxes
F----] Election to tax under Sec. 9113(A)
1
1.
(Attach Sch O)
NAME
Stephen L. Bloom,
FI RM NAM E (If Applicable)
Stephen L. Bloom,
TELEPHONE NUMBER
717/249-7717
Esquire
Esquire
1. Real Estate (Schedule A) (1)
COMPLETE MAILING ADDRESS
2100 Longs GaR~P~oad
Carlisle, PA
94,000. O0
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or (3)
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
E~] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
Total Gross Assets (total Lines 1-7)
Funeral Expenses & Administrative Costs (Schedule H) (9)
9.
10.
11.
12.
13.
14.
None
None
None
12,509,28
10,210.22
None
13,542.49
814.08
;~:~= OFFICIAL USE ONLY
(8) 116,719.50
Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
Total Deductions (total Lines 9 & 10) (11)
Net Value of Estate (Line 8 minus Line 11) (12)
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13) (14)
14,356.57
102,362.93
102,362.93
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(aX1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
O. O0 X .0 0 (15)
102,362.93 x .0'45 (16)
0.00 X .12 (17)
0.00 X .15 (18).
(19)
0.00
4,606.33
0.00
0.00
4,606.33
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
216 Wolfs Brid~e Road
CITY
Carlisle
STATE
PA
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
4,000.00
210.53
(1)
Total Credits ( A + B + C ) (2)
ZIP
17013
4,606.33
3. Interest/Penalty if applicable D. Interest
E. Penalty
Total Interest/Penalty { D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ......................... [] ~'~
b. retain the right to designate who shall use the property transferred or its income; ...........
c. retain a reversionary interest; or ....................................
d. receive the promise for life of either payments, benefits 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
a beneficiary designation? ................................ [~ ~
which
contains
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
4,210.53
0.00
0.00
395.80
0.00
395.80
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
........................... '/o
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) {1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 P.S. 9116(a)(1 )].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
REV-1507 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Anna M. Boyer SS~/ 184-12-2733
SCHEDULE A
REAL ESTATE
02/03/2002
FILENUMBER
21-02-0168
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price
at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable
knowledge of the relevant facts, Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
DESCRIPTION
ITEM
NUMBER
Single-family dwelling located at 216 Wolf's
Carlisle, Pennsylvania (Appraisal attached)
Bridge Road,
TOTAL (Also enter on line 1, Recapitulation)
VALUE AT DATE
OF DEATH
94,000.00
$ 94,000.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1502 EX (Rev. 1-97)
REV-1508 EX + (1-97)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Anna M. Boyer SS~/ 184-12-2733 02/03/2002 21-02-0168
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
Citizens Bank, Checking Acct. #182-111-8005
Cemetery Lot, Letort Cemetery (2 spaces)
Personal Property
9,702.28
350.00
2,457.00
TOTAL (Also enter on line 5, Recapitulation) $ 12,509.28
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form RI~V- 1508 EX (Rev. 1-97)
REV-1509 EX* (1-97) SCHEDULE F
COMMONWEA'TH Or.ENNS¥'VAN~A JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Anna M. Boyer SS~/ 184-12-2733 02/03/2002
FILE NUMBER
21-02-0168
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A.Anna M. Raudabaugh Daughter
B0
16 Green Hill Road
Mechanicsburg, PA, 1705
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
Include name of financial institution and bank
ITEM --OR JOINT MADE account number or similar identifying number. DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT Attach deed for jointly-held realestate. VALUE OF ASSET INTEREST DECEDENT'S INTERE.c
1 A 01/01/71 Waypoint Bank, Savings 20,420.43 50.007~ 10,210.22
Acct. ~/1700001840
TOTAL (Also enter on line 6, Recapitulation) $ 10,210.22
(If more space is needed insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1509 EX (Rev. 1-97)
REV-1511 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Anna M. Boyer SS~/ 184-12-2733
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
02/03/2002
FILENUMBER
21-02-0168
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
1
2
3
1
2
3
4
5
6
FUNERALEXPENSES:
Bonanza Family Grill, Meal after funeral
Ewing Brothers Funeral Home
Wayne Noss, Flowers
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / ElM Number of Personal Representative(s)
Street Address
City State
Zip
Year(s) Commission Paid:
Attorney's Fees Stephen L. Bloom, Esquire
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
Probate Fees Register of Wills
Accountamt's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Diversified Appraisal Services - Real Estate Appraisal
Inheritance Tax Return and Inventory filing fee
PPL, Electric bills
Roy D. Gottshall - Personal Property Appraisal
SICO, Heating oil bills
Sprint, Telephone bills
Total of Continuation Schedule(s)
TOTAL (Also enter on line 9, Recapitulation)
137.27
7,545.00
121.90
4,500.00
252.00
250.00
28.00
37.25
60.00
352.02
96.70
162.35
$ 13,542.49
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV- 1511 EX (Rev. 1-97)
Estate of: Anna M. Boyer
Soc Sec #: 184-12-2733
Date of Death: 02/03/2002
Item Description
Continuation of Schedule H-B7
(Other Administrative Costs)
Amount
The Cumberland Law Journal Publication of Legal Notice
The Sentinel - Publication of Legal Notice
75.00
87.35
162.35
REV-1512 EX, (1-97)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Anna M. Boyer SS# 184-12-2733 02/03/2002
FILE NUMBER
21-02-0168
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1
2
3
4
5
2002 Real Estate Taxes
Carlisle Imaging Associates
PPL, Final electric bill
Sprint, Final telephone bill
West Shore EMS, Ambulance
TOTAL (Also enter on line 10, Recapitulation)
AMOUNT
273.58
59.12
15.76
32.22
433.40
$ 814.08
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97)
REV- 1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Anna M. Boyer SS# 184-12-2733
SCHEDULE J
BENEFICIARIES
02/03/2002
FILENUMBER
21-02-0168
NUMBER
2
4
II.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 9116(a)(1.Z)]
Suzanne Keller
370 Charlyne Way
Dacula, GA 30019
Anna M. Raudabaugh
16 Green Hill Road
Mechanicsburg, PA
17050
Jeffrey L. Raudabaugh
1600 Pebble Brook Lane
Harrisburg, PA 17110
Michael L. Raudabaugh
480 N. Locust Point Road
Mechanicsburg, PA 17050
William L. Raudabaugh
41 Henry Road
Landisburg, PA 17040
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Granddaughter
Daughter
Grandson
Grandson
Grandson
AMOUNT OR SHARE
OF ESTATE
12.5% of
Estate Residue
50% of Estate
Residue
12.5% of
Estate Residue
12.5% of
Estate Residue
12.5% of
Estate Residue
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) Z000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00)
LAST.WILL AND TESTAMENT OF ANNA MAE BOYER
I, ANNA MAE BOYER, of the Township of Middlesex, Cumberland
County, Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby make, publish and declare this as and for
my Last Will and Testament, hereby revoking and making null and void
any and all prior wills, or i~struments in the nature thereof, by me
at any time heretofore made.
ITEM 1 - I give, devise and bequeath one-half of ~y es-
tate to my d~ughter, ANNA MAE RAUDABAUGH.
ITEM 2 - The remaining one-half of my estate I give, de-
vise and bequeath in equal shares to such of my grandchildren as
may be living at my death.
ITEM 3 - Should~y of my said grandchildren be a minor
at the date of my death, I give, devise and bequeath his or their
share.to the HARRISBURG NATIONAL BANK, CARLISLE OFFICE, in trust,
nevertheless, to invest and reinvest the same, ~d to accmumlate
the income thereon until such grandchild or grandchildren attain
the age of twenty-one years, at which time it shall pay over to
such grandchild or grandchildren the entire share or shares of the
trust, together with income accumulated thereon, absolutely. I
authorize and empower my said Trustee in its sole discretion to
apply .any part or all of the corpus and income accumulated on the
share of'any grandchild:.hereunder for the education of such grand-
child.
ITEM4 - I name, constitute and appoint as the Executrix
of this my Last Will and Testament my said daughter, ANNA MAE
RAUDABAUGH.
th is
INWITNE~WH~REOF I have h~e~y hand and seal
/~'~day of , 1962.
Signed, sealed, published, pronounced
and declared by the said Testatrix as
and for her Last Will and Testament,
in our presence, who, at her request,
and in her presence, and in the pre-
sence of each other, have hereunto
names ~s su~bs~/ing witnes~es.~
APPRAISAL REPORT
OF
A SINGLE-FAMILY DWELLING
LOCATED AT
216 WOLF'S BRIDGE ROAD
CARLISLE, PENNSYLVANIA
PREPARED FOR
THE ESTATE OF ANNA M. BOYER
AS OF
FEBRUARY 3, 2002
BY
LARRY E. FOOTE
DIVERSIFIED APPRAISAL SERVICES
EAST I-UGH STREET, SUITE 101
CARLISLE, PENNSYLVANIA
17013-3052
(717) 249-2758
SUMMARY OF IMPORTANT FACTS AND CONCLUSIONS
LOCATION:
216 Wolfs Bridge Road
Carlisle, Pennsylvania
TAX PARCEL NUMBER:
21-07-0467-002
IMPROVEMENTS:
A single-family dwelling.
PROPERTY RIGHTS:
Fee simple interest.
OWNERSHIP HISTORY:
The subject property is owned by Anna M. Boyer. The
property was purchased on October 9, 1962 for a reported
consideration of $1.00 and ownership transferred on deed
reference 20-R- 1.
SCOPE OF THE ASSIGNMENT:
The scope of the assignment included an analysis of the
subject's area, an inspection of the subject property, an
estimation of the property's highest and best use,
consideration of all three approaches to value, and the
application of those relevant to the valuation of the
subject.
OBJECTIVE:
To estimate the market value of the subject property as
unencumbered.
EFFECTIVE DATE:
As ofFebruary3, 2002.
HIGHEST AND BEST USE: Use as a single-family residence.
COST APPROACH:
$113,000
SALES APPROACH:
$94,000
INCOME APPROACH:
N.A.
FINAL VALUE CONCLUSION: $94,000
2
APPRAISAL CERTIFICATION
I hereby certify that upon application for valuation by:
THE ESTATE OF ANNA M. BOYER
the undersigned personally inspected the following described property:
All those two certain parcels of land, with the improvements thereon erected, situate in
Middlesex Township, Cumberland County, Pennsylvania, bounded and described as follows:
.TRACT NO. 1: Beginning at a stone in a public road; thence by lands now or formerly
of John Durnin, North 87 degrees West, 10 perches to a stone; thence by the same, North 32
degrees 45 minutes West, 33 perches to a stone; thence by lands now or formerly of Hays
Miller, North 86 degrees 20 minutes East, 26.6 perches to a stone in said public road; thence by
said public road, along lands now or formerly of Hays Miller, South 2 degrees 30 minutes East,
30 perches to a stone, the place of beginning. Containing 3 acres, 54 perches, more or less.
TRACT NO. 2: Beginning at a point in the center of the public road leading from the
Carlisle-Harrisburg Turnpike to Wolf s Bridge; thence along lands now or formerly of William
E. Boyer, South 86 degrees 30 minutes West, a distance of 455.5 feet to a stone; thence by
lands now or formerly of Frances Dernan, North 32 degrees 30 minutes West, a distance of
96.5 feet to a stake; thence along lands now or formerly of John A. Owens and wife, North 86
degrees 30 minutes East, a distance of 516.2 feet to a point in the center of the public road
above described; thence by the center of the public road, South 7 degrees 30 minutes West, a
distance of 91.0 feet to the place of beginning Containing one acre, more or less.
To the best of my knowledge and belief the statements contained in this report are true
and correct, and that neither the employment to make this appraisal nor the compensation is
contingent upon the value reported, and that in my opinion the Market Value as of February 3,
2002 is:
NINETY-FOUR THOUSAND DOLLARS
$94,00O
The property was appraised as a whole, subject to the contingent and limiting conditions
outlined herein.
Certified General Appraiser
GA-000014-L
3
CITIZENS BANK
Account
Number Account Title
Thursday, March 14, 2002
182-111-8005
Anna M Boyer
Date Opened: 09/04/1984
Principal Bal Iht from Last
as of DOD Posting to DOD
$9,701.20 $1.08
Account Type: DD
Account Bel YTD Int to
as of DOD DOD
$9,702.28 $1.69
Page 2 of 2
This a raisal COdOTTSHALL
/.3-
BOLLING SPP, I~GS. PA
LOOK FOR US. WE'LL GET YOU THERE.
02/21/2002
STEPHEN BLOOM
2100 LONGS GAP RD
CARLISLE PA 17013
Account Number
Class of Account
Date Opened
Principal Balance
Accrued Interest
Balance at Date of
Death
The information which you requested on the account(s) of ANNA BOYER DECEASED
(Social Security Number 184-12-2733 ) is/are as follows:
1700001840
SAVINGS
01/01/71
20419.04
1.39
20420.43
Account Ownership JTO
Name of Joint ANNA
Owner, if any RADABAUGH
Date Ownership 01/01/71
Was Established
Account Number
Class of Account
Date Opened
Principal Balance
Accrued Interest
Balance at Date of
Death
Account Ownership
Name of Joint
Owner, if any
Date Ownership
Was Established
Additional
Information
Requested
PLEASE COMPLETE W-9
Sgerely, .
SENIOR SERVICES REP~/¢'~
P.O. Box 171 I, HARRISBURG. PENNSYLVANIA 17105-1711
Toll FPEE 1-86~;-WAYPnINT II.RR~_C~CL'7C:,~C~ ....................
February 8, 2002
Anna M. Raudabaugh
16 Green Hill Rd.
Mechanicsburg, PA 17050-
Ewing Brothers Funeral Home
630 South Hanover Street
Carlisle, PA 17013-
(717)243-242 !
The Funeral Service for Anna M. Boyer
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please
fee! free to contact us if you have any questions in regard to this statement.
THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT,
AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
1. PROFESSIONAL SERVICES
Services of Funeral Director/Staff
FUNERAL HOME SERVICE CHARGES
SELECTED MERCHANDISE:
18G Three Roses Sealer
American Chief
THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED
AT THE TIME FUNERAL ARRANGEMENTS WERE MADE, WE ADVANCED CERTAIN PAYMENTS TO OTHERS AS AN
ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES.
CASH ADVANCES
Opening Grave $400.00
Clergy/Mass Offering $75.00
Certified Copies of the Death Certificate $20.00
Hairdresser $35.00
TOTAL CASH ADVANCES AND SPECIAL CHARGES $530.00
$3195.0O
$3195.00
$2525.00
$1295.(!0
$7015.00
The statement is net and payable in full on or before March i~;2002.
SUB-TOTAL
INITIALPAYMENT/DISCOUNT/CREDITS
TOTAL AMOUNT DUE
$7545.00
$751:'.;.00
STEPHEN L. BLOOM
ATTORNEY AND COUNSELLOR AT LAW
2100 Longs Gap Road
Carlisle, Pennsylvania 1 7013, Tel 717-249-7717
Federal EIN 25-1851818
Invoice submitted to:
Boyer, Anna M. Estate
c/o Anna M. Raudabaugh
16 Green Hill Road
Mechanicsburg, PA 17050-1510
March 07, 2002
In Reference To: Estate Administration
Invoice #855
Professional Services
2/4/02 SLB
2/6/02 SLB
2/5/02 PL
2/6/02 PL
2/7/02 PL
2/8/02 PL
2/12/02 SLB
Preliminary preparations for probate; Review Decedent's real property
information in Cumberland County Assessment Database
Preparation for preliminary conference and conduct same;
Preparations for probate
Preparation and opening estate administration file; Telephone with
Executrix re information needed for Petition for Grant of Letters;
Prepare Estate Information Sheet and Petition for execution and filing;
Prepare IRS Form SS-4 and correspondence to IRS re same
Initial conference with client regarding administration of estate;
Administrative matters re same
Correspondence to Executrix; Correspondence to Blue Cross/Blue
Shield re cancellation of policy and refund; Assessment of
administration process required for estate; Documentation and
commence implementation of same
Telephone conference with Executrix re death certificates and probate
procedures; Revise Petition for Probate; Prepare Oath of
Non-Subscribing Witnesses
Review and finalize probate documents
PL
Conference with Executrix for probate of Will; Correspondence to IRS
re Form SS-4
PRACTICAl. COLINSEI. ,!, CHRISTIAN PERSPECTIVE
Hrs/Rate
0.33
185.00/hr
1.38
185.00/hr
2.00
105.00/hr
1.25
105.00/h r
3.50
105.00/hr
0.67
105.00/h r
0.17
185.00/hr
0.42
105.00/hr
Amount
61.67
255.92
210.00
131,25
367.50
70.00
30.83
43.75
Boyer, Anna M. Estate
2/14/02 PL
2/19/02 PL
2/20/02 PL
Obtain Certificate of Grant of Letters from Register of Wills;
Administrative Matters
Correspondence to Social Security Administration, Department of
Public Welfare, Citizens Bank, Waypoint Bank and Executrix;
Administrative matters
Conference with Mr. Bloom regarding distribution of Cemetery Plots
2/21/02 PL
2/22/02 SLB
Telephone conference with LeTort Cemetery Association re transfer of
cemetery plots and valuation of same; Telephone conference with Mr.
Gottshall re personal property appraisal; Telephone conference with
Mr. Foote re real estate appraisal
Review Waypoint Bank account valuation information
PL
2/25/02 SLB
Telephone conference with LeTort Cemetery Association re value and
transfer of cemetery plots
Telephone conference with real estate appraiser
2/28/02 SLB Review personal property Appraisal; Administrative matters
2/26/02 PL Review correspondence from Waypoint Bank
3/6/02 SLB Review Department of Public Welfare Estate Recovery Clearance
Letter
For professional services rendered
Additional Charges:
2/12/02 Probate Fee - Register of Wills of Cumberland County
3/6/02 Publishing Fee - Legal Notice - The Cumberland Law Journal
Total costs
Total amount of this bill
Balance due
Hrs/Rate
0.67
105.00/hr
4.33
105.00Ih r
0.08
105.00/hr
0.25
105.00/hr
0.09
185.00/hr
0.25
105.00/hr
0.08
185.00/hr
0.11
185.00/hr
0.08
105.00/hr
0.08
185.00/hr
15.74
Page 2
Amount
70.00
455.00
8.75
26.25
16.75
26.25
15.42
20.04
8.75
15.42
$1,833.55
252.00
75.00
$327.00
$2,160.55
$2,160.55
PRACTICAL COUNSI£1. · CHRISTIAN PERSPISCTIVE
Boyer, Anna M. Estate
Page 3
PAYABLE UPON RECEIPT - THANK YOU
PRACTICAI. CO[INSEL · CHRISTIAN PERSPEC'FIVF,
STEPHEN L. BLOOM
ATTORNEY AND COUNSELLOR AT LAW
2100 I. ongs Gap Road
Carlisle, Pennsylvania 1 701 3, Tel 717-249-7717
Federal EIN 25-1851818
Invoice submitted to:
Boyer, Anna M. Estate
cio Anna M. Raudabaugh
16 Green Hill Road
Mechanicsburg, PA 17050-1510
June 10, 2002
In Reference To: Estate Administration
Invoice #937
Professional Services
3/7/02 PL
3/15/02 PL
3/18/02 SLB
Telephone conference with Waypoint Bank re Form W-9;
Correspondence to Executrix
Preparation of Legal Notices for publication; Preparation of required
Notices to Beneficiary
Review correspondence and documentation from Citizens Bank
3/21/02 SLB Review correspondence from Mr. Foote and real property appraisal
3/19/02 PL
3/20/02 PL
Review account information from Citizens Bank/Mellon; Prepare
Certification of Notice and correspondence to beneficiaries re same;
Prepare Forms W-9
Telephone consultations with client and Mr. Foote
3/21/02 PL
4/9/02 PL
Administrative and estate accounting matters; Telephone conference
with Executrix re appraisal of real estate; Correspondence with
Executrix
Review Proof of Publication; Disburse funds for Sentinel invoice
4/15/02 SLB Telephone conference with Auctioneer re real estate sale; File
memorandum
Hrs/Rate
1.00
105.00/hr
0.25
105.00/hr
0.07
185.00/h r
0.06
18500/hr
1.17
105.00/hr
0.08
105.00/hr
0.42
105.00/hr
0.17
105.00/hr
0.11
185.00/hr
Amount
105.00
26.25
13.41
11.56
122.50
8.75
43.75
17.50
20.20
PRACTICAL C()LiNSEI. · CHRISTIAN PERSPECTIVE
Boyer, Anna M. Estate
4/16/02 SLB
4/18/02 SLB
Review Proof of Publication of Legal Notice (The Cumberland Law
Journal)
Preparation of Inheritance Tax Return
4/19/02 SLB Administrative, estate accounting and inheritance tax matters
4/18/02 PL
4/25/02 SLB
Administrative and estate accounting matters; Preparation of draft
Inventory and Inheritance Tax Return
Preparations for Public Sale of Real Estate
4/23/02 PL
4/29/02 SLB
4/30/02 SLB
Administrative and estate accounting matters (Letort Cemetery Rules
and Regulations, bank statements, receipts and 2001 tax information);
Confirm no income tax return required for 2001
Telephone conference with potential real estate purchaser (Ms. Linda
Rumple); Draft memorandum to file; Telephone conference with
Executrix re same; Terms of Sale/Agreement of Sale matters
Administrative matters
4/29/02 PL
4/30/02 PL
Telephone conference with Executrix regarding Inheritance tax matters
and status of medical bills
Preparation of draft Terms of Sale/Agreement of Sale re real property
5/3/02 SLB
5/7/02 SLB
Telephone conference with Ms. Lehr (wife of Michael Raudabaugh) re
notices received; Memorandum documenting file
Preparations for real estate sale; Review notices
4/25/02 PL
4/29/02 PL
4/30/02 PL
Telephone conference with Mr. Gottshall; Draft Terms of Sale;
Inheritance Tax Return and Accounting matters; Telephone conference
with West Shore EMS, Carlisle Regional Medical Center and Carlisle
Imaging Associates re final medical bills; Preparation of Inventory and
Appraisement
Telephone conference with Executrix re Inheritance Tax matters and
status of medical bills
Preparation and revision of draft Terms of Sale; Preparation of draft
Agreement of Sale
Hrs/Rate
0.02
185.00/hr
0.25
185.00/hr
0.38
185.00/hr
2.00
105.00/hr
0.15
185.00/hr
0.75
105. O0/h r
0.43
185.00/hr
0.08
185.00/hr
0.17
105.00/hr
0.50
105.00/hr
0.16
185.00/h r
0.17
185.00/hr
2.08
105.00/hr
0.17
105.00/hr
0.50
105.00/hr
Page 2
Amount
4.16
46.25
70.92
210.00
27.96
78.75
79.70
15.42
17.50
52.50
30.32
30.83
218.75
17.50
52.50
PRACTICAl, (~'()t;NSEL · CHRISTIAN PERSPECTIVI,~
Boyer, Anna M. Estate
5/7/02 SLB
PL
Telephone conference with Executrix (message); Preparations for sale
of real estate
Administrative and estate accounting matters
5/10/02 SLB
5/11/02 SLB
5/13/02 SLB
Finalize Terms of Sale and Legal Description of Premises; Prepare for
Estate Auction; Telephone conference with Auctioneer
Travel to and attend public sale of real estate; Announcement of Terms
of Sale at same; Execution of Terms of Sale; Preliminary preparations
for real estate settlement
Administrative and estate accounting matters
PL
5/14/02 SLB
Preparation of escrow deposit and preliminary closing documentation;
Prepare escrow account ledger
Finalize proposed Fiduciary Deed
PL
5/15/02 PL
5/17/02 PL
PL
Preparation of fiduciary Deed; Correspondence with buyer's attorney
(Mr. Orr) re same; Telephone conference with Mr. Gottshall re public
sale expenses and commissions
Finalize proposed Deed and correspondence with Mr. Orr re real estate
settlement matters
Telephone conference with Attorney Orr's Office; Settlement
Preparations
Review public sale receipts, bank statement and utility receipts
6/3/02 PL
6/4/02 PL
Telephone conference with Ms. Hill at Pennsylvania State Bank;
Telephone conference with Attorney Orr's office
Telephone conference with Attorney Orr's office
6/6~02 SLB Prepare for Real Estate Closing
6/7/02 SLB
6/10/02 SLB
Finalize Pennsylvania Inheritance Tax Return; Preparations for Real
Estate Settlement
Telephone conference with Mr. Peffer; Settlement Preparations;
Inheritance Tax Matters; Finalize Inventory; Attend Real Estate
Settlement
Hrs/Rate
0.10
185.00/hr
0.08
105.00/hr
1.11
185.00/hr
1.56
185.00/hr
0.12
185.00/hr
0.83
105.00/hr
0.53
185.00/hr
0.83
105.00/hr
0.42
105.00/hr
0.07
105.00/hr
0.08
105.00/hr
0.08
105.00/hr
0.08
105.00/h r
0.18
185.00/hr
0.47
185.00/hr
1.21
185.00/hr
Page 3
Amount
18.50
8.75
205.35
289.47
22.20
87.50
97.48
87.50
43.75
7.00
8.75
8.75
8.75
33.87
86.95
224.16
PRACTICAI. COUNSEl. · CHRISTIAN PERSPECTIVE
Boyer, Anna M. Estate
6/7/02 PL Inheritance Tax Return and Schedules/Inventory; Tax Calculations
For professional services rendered
Additional Charges:
3/15/02 Publishing Fee - Legal Notice - The Cumberland Law Journal
4/9/02 Publishing Fee - Legal Notice - The Sentinel
Total costs
Total amount of this bill
Previous balance
3/13/02 Payment - thank you
Total payments and adjustments
Balance due
Hrs/Rate
1.01
105.00/hr
19.90
Page 4
Amount
105.73
$2,666.44
75.00
87.36
$162.36
$2,828.8O
$2,160.55
($2,160.55)
($2,160.55)
$2,828.8O
PAYABLE UPON RECEIPT - THANK YOU
PRACTICAl. (7()UNSEI~ ,I~ CHRISTIAN PERSPECTIVE
r ~ '~
r
Register of Wills of CUMBERLAND
INVENTORY
Estate of Anna M . B
also known as
,Deceased Social Security No. 184-12-2733
Anna M. Raudabaugh,
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I /We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Personal Representative
Attorney: Stephen L. Bloom, Esquire Signature: ~
An M. audabaugh
I.D. No.: 49811
Address: 2100 Longs Gap Road
Carlisle, PA 17013
Telephone: 717/249 - 7 717
Signature:
Address: 16 Green Hill Road
County, Pennsylvania
No. 21-02-0168
Date of Death 02/03/2002
Mechanicsburg, PA 17050
Telephone: 717/76b - 4874
Dated:
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form #RVU-7 (1992)
y Y ~
INVENTORY
Estate of: Anna M. Boyer
Date of Death: 02/03/2002
County: Cumberland
CASH:
Citizens Bank, Checking Acct. 9,702.28
~k182-111-8005
9,702.28
PERSONAL PROPERTY:
------------------
Cemetery Lot, Letort Cemetery 350.00
(2 spaces)
Personal Property 2,457.00
2,807.00
REAL ESTATE/PA:
Single-family dwelling located 94,000.00
at 216 Wolf's Bridge Road,
Carlisle, Pennsylvania
(Appraisal attached)
94,000.00
TOTAL RECEIPTS OF PRINCIPAL ..............
106,509.28
.~
.~
-1-
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 71 2 8-0601
RECEIVED FROM:
STEPHEN L BLOOM ESQUIRE
2100 LONGS GAP ROAD
CARLISLE, PA 17013
fold
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX111-961
NO. CD 001286
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
ESTATE INFORMATION: ssN: ~ s4-i 2-2733
FILE NUMBER: 2102-0168
DECEDENT NAME: BOYER ANNA MAE
DATE OF PAYMENT: 06/ 1 2/2002
POSTMARK DATE: 00/00/0000
couNTY: CUMBERLAND
DATE OF DEATH: 02/03/2002
101 ~ 5395.80
TOTAL AMOUNT PAID:
REMARKS: ANNA MAE RAUDABAUGH
C/O STEPHEN L BLOOM ESQUIRE
CHECK# 19
SEAL
INITIALS: CW
RECEIVED BY
MARY C. LEWIS
REGISTER OF WILLS
5395.80
REGISTER OF WILLS
l ?- ya - ~~ COMMONWEALTH OF PENNSYLVANIA
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 288601
HARRISBURG, PA 171za-oboe NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 ER ~FP (01-027
DATE 07-29-2002
ESTATE OF BOYER ANNA M
DATE OF DEATH 02-03-2002
FILE NUMBER 21 02-0168
STEPHEN L BLOOM ESQ ~'~- ~~•' ~ i' COUNTY CUMBERLAND
ACN 101
2100 LONGS GAP RD Amount Remitted
CARLISLE PA 170.13
,.
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~
----------------------------------------------------------------------------------------------------------------
REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BOYER ANNA M FILE NO. 21 02-0168 ACN 101 DATE 07-29-2002
TAX RETURN WAS: (X) ACCEPTED AS FILED ( l CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. 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
(1) 94, 000.00
(2) .00
[3) .00
(4) .00
(5) 12,509.28
(6) 10,210.22
(7) .00
(8)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this fora with your
tax payment.
116,719.50
APPROVED DEDUCTIONS AND EXEMPTIONS: 13,542.49
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 814.08
11. Total Deductions (11) 1 4 .3~6 _ ~7
12. Net Value of Tax Return (12) 102,362.93
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 102, 362.93
NOTE: If an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15) •00 X 00 __ .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 102,362.93 X 045. 4,606.33
17. Amount of Line 14 at Sibling rate (17) .00 X 12 - .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 - .00
19. Principal Tax Due (lq)= 4,606.33
TOY CRFIITTC•
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
05-01-2002 CD001135 210.53 4,000.00
06-12-2002 CD001286 .00 395.80
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
TOTAL TAX CREDIT 4,606.33
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00 ~,
TOTAL DUE . 00., „
( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
REGISTER OF WILLS OF CUMBERLAND COUNTY
STATUS REPORT UNDER RULE 6.12
(For Resident Decedents Dying After July 1, 1992)
Name of Decedent: ANNA MAE BOYER
Date of Death: February 3, 2002
File No.: 21-02-0168
Social Security IVo.: 184-12-2733 ~ -
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: N/A.
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No X
b. The separate Orphans' Court No. (if any) for the personal
representative's account is: N/A.
c. Did the personal representative state an account informally to the parties in interest?
Yes X No
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts
may be filed with the Clerk of the Orphans' Court and maybe attached to this report.
Date: ~ j~~/~ 3 Signature:
Name: Stephen L. Bloom, Esquire
Address: 2100 Longs Gap Road
Carlisle, PA 17013
(717) 249-7717
Counsel for Personal Representative
C:ALAS\Estates\10303-1 statrpt. l