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HomeMy WebLinkAbout03-10-10 (2)--.~ REV-1500 15056~712~ EX (06-05) OFFICIAL USE ONLY PA Department of Revenue counryCode near File Number Bureau of Individual Taxes INHERITANCE TAX RETURN 2 1 0 9 116 9 PO 60X.280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 177526453 12122009 06231958 Decedent's Last Name BOWER (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Decedent's First Name MI GWEN Suffix Spouse's First Name Ml Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ® 1. Original Return ^ 2. Supplemental Return ^ 3, Remainder Return (date of death prior to 12-13-82) ^ 4. Limited Estate ^ 4a. Future Interest Compromise ^ 5. Federal Estate Tax Return Required (date of death after 12-12-82) 1 ® g, Decedent Died Testate ^ ~ Decedent Maintained a Living Trust 8. Total Number of Safe De sit Boxes (Attach Copy of Will) (Attach Copy of Trust) po ^ 9. Litigation Proceeds Received ^ 1 p, Spousal Poverty Credit (date ;f death 11, Election to tax under Sec. 9113 A between.l2-31- 1 and 1-1-95 ^ ( ) (Attach Sch. O) _C,ORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: name Daytime Telephone Number WILLIAM R. BUNT, ESQ. 7175828195 Firm Name (If Applicable) LAW OFFICE OF WILLIAM R. BUNT First line of address 109 SOUTH CARLISLE STREET Second line of address P.O. BOX 336 City or Post Office NEW BLOOMFIELD State ZIP Code PA 17068 P~J REGISTER OILS USELY :~' . 11. l -L C-> i.7 ~ ~ ,_, ~ r- -- . ~ _ i,1`) ~r~ .:': ~. ~ .... ,~ } ~ ~., 7 r ~ C~'-~ '~ = --+ DAT~ILED TV _ n _.; y ....a ~`> r~ 4_. j ~~ ~:~.~ Correspondent's e-mail address: W r b@ p a. n e t Under penalties of pery'ury, I declare that i have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it ism, cPrrect~td complete. Declaration of preparer other than the personal representative Is based on all information of which preparer has any knowledge. Beth B. 12 Stingray DY'ive, Sinking Spring, PA 19608 --' y,~D1v SIGNATURE O . PREP RER OTHER THAN R N ' T / DATE ~~ Iliam R. Bunt, Esq. ~ ~ 7r~~lp ADDRESS - `~ - ~ - 109 South Carlisle Street, New Bloomfield, PA 17068 Side 1 15D5607120 1505607120 J REV-1500 EX 1505607220 Decedents Name: BOWER, G W E N RECAPITULATION 1. Real Estate (Schedule A) .......................................................................................... 1. 2. Stocks and Bonds (Schedule B) ............................................................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3. Decedent's Social Security Number 177526453 192,812.00 2,307.09 4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4. 5• Cash, Bank Deposits & Miscellaneous Personal Pro a P rty (Schedule E) ................ 5. 2 9, 8 5 6 5 0 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) ^ Separate Billing Requested ............. 7, 1 3, 9 0 7 0 5 8, Total Gross Assets (total Lines 1-7) ..................................................................... 8. 2 3 8, 8 8 2 6 4 9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 47,975.89 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 123,637.37 11. Total Deductions (total Lines 9& 10) ................................................................ 1 7 1, 6 1 3. 2 6 12. Net Value of Estate Line 8 minus Line 11 ( ) ............................................................. 12. 6 7 , 2 6 9 3 8 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ................................................. 13, 6 , 0 0 0 . 0 0 14. Net Value SubJect to Tax (Line 12 minus Line 13) ................................................. 14, 6 1 , 2 6 9 3 8 TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .00 15. 16. Amount of Line 14 taxable at lineal rate X .045 3 0, 6 3 4. 6 9 1 g, 1, 3 7 8. 5 6 17. Amount of Line 14 taxable at sibling rate X ,12 3 0, 6 3 4 6 9 17, 3, 6 7 6.16 18. Amount of Line 14 taxable at collateral rate X .15 18. 19. Tax Due ..................................................................................................................... 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. 5,054.72 Side 2 1505607220 1505607220 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 - 09 - 1169 D E Bower, Gwen STREET ADDRESS 4131 Darious Drive CITE' Enola STATE PA ZIP 17025 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. InterestlPenalty if applicable p. Interest E. Penalty Total Credits (A + B + C) (1) 5,054.72 (2) 5,054.72 Total Interest/Penalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4) Check box on Page 2 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) q. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF W/LLS, AGENT 0.00 0.00 ~.~~ 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 :.................................................................................. x b. retain the right to designate who shall use the property transferred or its income :.................................... x c. retain a reversionary interest; or .................................................................................................................. x d. receive the promise for life of either payments, benefits or care? .............................................................. x 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................................................... ^ 0 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ^ ^x 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ...................................................................................................................... 0 ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 three (3) percent (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 zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemot 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 an 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 zero (0) percent [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 four and one-half (4.5) percent, 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 twelve (12) percent [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. 4,801.98 252.74 COMMONWEALTH OF PENN3YLVANIA WHERiTANCE TA% RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE FILE NUMBER ESTATE OF Bower, Gwen 21 - 09 - 1169 Aft 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 wilting 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. Attach a copy of the settlement sheet if the property has been sold. Include a copy of the deed showing decedent's interest if owned as tenant in common. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 All that certain piece, parcel or tract of land situate in Hampden Township, Cumberland County, 192,812.00 Pennsylvania, conveyed unto Gwen Bower by deed of Robert M. Levitas dated December 21, 2004 and recorded in the Office of the Recorder of Deeds of Cumberland County, Pennsylvania in Record Book 266 at Page 4404. Soid by private sale. See attached settlement sheet. TOTAL (Also enter on Line 1, Recapitulation) ~ 192,812.00 SCHEDULE C CLOSELY-HELD CORPORATION, COMMONWEALTH OF FENNSriVANw PARTNERSHIP or INNERRANCE TAX RETURN RESIDENT DECEDENT SOLE-P ROP RI ETORS H I P FILE NUMBER ESTATE OF Bower, Gwen 21 - 09 - 1169 Schedule C-1 or C-2 (Including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than asole-proprietorship. See instructions for the supporting information to be submitted for sole-propnetorships. ITEM DESCRIPTION VALUE AT DATE OF NUMBER DEATH 1 Decedent was the owner of a sole proprietorship known as Keystone Connections. No assets 0.00 were owned by the said business other than bank accounts listed below and one account receivable. The business consisted of the Decedent leading tours of the Capitol complex in Harrisburg and had no employees. No market exists for said business as the same was wholly dependent upon the Decedent's knowledge and expertise related to the Legislative process in Pennsylvania. 2 PSECU-savings account (S1) See attached letter 3 ~ PSECU-checking account (S4) See attached letter 4 ~ Account receivable 581.13 1,625.96 100.00 I TOTAL (Also enter on Line 3, Recapitulation) ` 2,307.09 COMMONWEALTH OF PENNSriVANIA MHERRANCE TAX RETURN RESEIENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER ESTATE OF Bower, Gwen 21 - 09 - 1169 Include the proceeds of litigation and the date the proceeds were received by the estate. Ali property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM DESCRIPTION NUMBER 1 Personal property appraisal of Kling's Auctions, Inc. See attached appraisal. 2 PSECU-savings account (S1) See attached letter 3 PSECU-checking account (S4) See attached letter 4 I PSECU-money market account (S7) See attached letter 5 ~ PSECU-Certificate (S52) See attached letter 6 {PSECU-Certificate (S53) I See attached letter 7 ~ AIA-paycheck and expense reimbursement 8 ~ PA Treasury Department-retirement proceeds 9 Reimbursement for School taxes (see attached HUD-1 Settlement Sheet) 10 Reimbursement for Homeowners Association fee (see attached HUD-1 Settlement Sheet) 11 Reimbursement for Sewer/Refuse (see attached HUD-1 Settlement Sheet) VALUE AT DATE OF DEATH 7,675.00 138.49 1,686.51 13,823.23 3,139.32 1,049.71 971.32 766.82 538.96 7.14 60.00 TOTAL (Also enter on Line 5, Recapitulation) I 29,856.50 SCHEDULE G COMMNHERITAANCETAXRETUYL~VANIA I+N/+TER-VIVOS TRANSFERS & RESIDENT DECEDENT M~JV. NON-PROBATE PROPERTY ESTATE OF Bower, Gwen FILE NUMBER 21 - 09 - 1169 This schedule must be completed and tfiea it the answer to any or questions •t mrougn 4 on page ~ i s yes. ITEM NUMBER DESCRIPTION OF PROPERTY Include the name of the transferee, their relatanship to decedent DATE OF DEATH VALUE OF ASSET % OF I D EREST EXCLUSION liF APPLICABLE) TAXABLE VALUE and the date of transfer. Attach a copy of the deed for real estate. 1 Decedent was the owner of a Roth IRA invested 0.00 100% 0.00 through Waddell & Reed. Due to Decedent's age at the time of her death (age 51), the asset is being reported but no tax is due thereon. Said asset was valued as of the date of death at $21,112.62. See attached letter. 2 Decedent was the owner on an IRA invested through 0.00 100% 0.00 Edward Jones. Due to Decedent's age at the time of her death (age 51 ), the asset is being reported but no tax is due thereon. Said asset was valued as of the date of death at $53,500.75. See attached letter. 3 Ameriprise Annuity No. 93007394566 7 004 13,907.05 100% 13,907.05 TOTAL (Also enter on line 7, Recapitulation) I ~s,yvi,va COMMDNINEALTH ~ PENNSYlYAN1A INHERRANCE TAX RETURN RE3DENT DECEDENT SCHEDULE H /F lry 1 ~ N~ qE ~ ~R~A ~ Lp E~ X~PE ~N / S- ~E S~ ~& ~ /'YJIY111~11~71I~F\I IYG VW 1~7 FILE NUMBER ESTATE OF Bower, Gwen 21 - 09 - 1169 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER FUNERAL EXPENSES: A. 1 Nickel Funeral Home-funeral 8,164.87 2 Rev. Yankovitz-funeral ($100) and Pastor Thornton ($50.00) 150.00 3 Rice Memorial Works -reserved for gravemarker 1,500.00 4 Zion Lutheran Church-funeral luncheon 550.00 5 Assistance with funeral -Pamela Amende($50.00) and Rebecca Brown ($125) and 235.00 organist ($60) B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representatives} Beth B. Grayson 11,200.00 Street Address 12 Stingray Drive city Sinking Spring state PA zip 19608 Year(s) Commission paid 2. Attorneys Fees William R. Bunt 9,000.00 3, 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 4. Probate Fees William R. Bunt-reimbursement of expenses 669.29 5. ~ Accountant's Fees Robert W. Morris, II-reserved for preparation of income tax returns ~ 500.00 6. Tax Return Preparer's Fees 7, Other Administrative Costs 1 Kling's Auctions, Inc.-appraisal 175.00 TOTAL (Also enter on line 9, Recapitulation) 47,975.89 SCHEDULEI DEBTS OF DECEDENT, MORTGAGE COMMONWEALTN OF PENNSYLVANIA LIABILITIES & LIENS INHERITANCE TAX RETURN f RESIDENT DECEDENT ESTATE OF gOWer, Gwen FILE NUMBER 21-09-1169 Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses. ITEM DESCRIPTION AMOUNT NUMBER 1 Citi Mortgage, Inc. (January mortgage payment of $763.11) and (payoff of mortgage 122,349.77 $121,586.66-see attached settlement sheet) 2 American Express 837.78 3 PSECU-Visa 443.82 4 Best Buy 6.00 ~ TOTAL (Also enter on Line 10, Recapitulation) ~ 123,637.37 REV-1513 EX+(11-05) ~ SCHEDULE) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN BENEFICIARIES RESIDENT DECEDENT ESTATE OF Bower, Gwen FILE NUMBER 21 - 09 - 1169 NUMBER NAME AND ADDRESS OF PERSON(S) RELAT{ONSHIP TO DECEDENT SHARE OF ESTATE (Words) AMOUNT OF ESTATE ($$$) RECEIVING PROPERTY Do Not Llet Trustee(s) I~ TAXABLE DISTRIBUTIONS[include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)) 1 Jack B. Grayson Nephew 5,000.00 12 Stingray Drive Sinking Spring, PA 19608 2 Megan K. Grayson Niece 5,000.00 12 Stingray Drive Sinking Spring, PA 19608 3 Beth B. Grayson Sister 10,000.00 12 Stingray Drive Sinking Spring, PA 19608 Enter dollar amounts for distributions shown above on lines 1 5 through 18 on Rev 1500 cover sheet, as appropriate. II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT TAKEN B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1 The Church Without Walls 5,000.00 2 Compassion International 1,000.00 TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 6,000.00 REV-1513 EX+=(9.00) ,~ ~ SCHEDULE .1 COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES continued INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Bower, Gwen I FILE NUMBER 21-09-1169 NUMBER NAME AND ADDRESS OF PERSON(S) RELATIONSHIP TO DECEDENT SHARE OF ESTATE (Words) AMOUNT OF ESTATE ($$$} RECEIVING PROPERTY Do Not List Trustee(s) ~~ TAXABLE DISTRIBUTIONS [nclude outright spousal di ib i d str ons, an transfers ut under Sec. 9116 (a) (1.2)] 4 Donna B. Bawer Mother one-half (1/2) of 3155 Seagertown Road residuary estate Blain, PA 17006 5 Logan M. Bower Brother one-half (1/2) of 2675 Conococheague Road residuary estate Blain, PA 17006 Page 2 of Schedule J s LAST WILL AND TESTAMENT OF GWEN BOWER I, GWEN BOWER, of Enola, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do hereby declare this to be my Last Will and Testament, revoking all former wills or writings in the nature thereof and any codicils ~ thereto made. FIRST: t direct my hereinafter named Executrix, or alternate Executor, as the case may be, to pay all of my Just debts, funeral expenses, costs of administration and inheritance taxes out of the corpus of my estate as soon after my decease as is practicable Ito do so. SECOND; A. I give and bequeath the sum of five thousand ($5,000.00) dollars ~ unto the Church Without Walis of 229 Lewis Street, Harrisburg, Pennsylvania. B. !give and bequeath the sum of one thousand ($1,000.00) dollars unto Compassion International of 12290 Voyager Parkway, Colorado Springs, Colorado, ($0921. C. I give and bequeath the sum of five thousand ($5,000.00) dollars unto my niece, Megan K. Grayson. D. I give and bequeath the sum of five thousand ($5,000.00) dollars WILLIAM R. 9UNT CHRYSTAL L. PROSSER ATTORNEYS AT LAW 109 S. Cargale Street New Bioomneld Pa. 17068 ~ unto my nephew, Jack B. Grayson. E. I give and bequeath the sum of ten thousand ($10,000.00} dollars unto my sister, Beth B. Grayson. Tel. (71 T) 582-8195 FAX (717) 582-7521 SIXTH: I name, constitute and appoint my sister, Beth B. Grayson, as the Executrix of this my Last Will and Testament. !n the event of the renunciation, death, resignation or inability of my sister, Beth B. Grayson, to act for any reason whatsoever, as the Executrix of my estate, then and in that event, I name, constitute and appoint my brother, Logan M. Bower, as the attemate Executor of this my Last Will and Testament. My Executrix or alternate Executar, as the case maybe, is hereby excused from the posting of any bond or security notwithstanding any provisions of the law to the contrary. IN WITNESS WHEREOF, !have hereunto set my hand and seal to this my Last Will and Testament this 21 ~ day of February, 2005. ~.~N % ' °1~ (SEAL) Signed, sealed, published and declared by the above named Testatrix, as and for WlLLtAM R. BUNT CHRYSTAL L PROSSER ATTORNEYS AT LAW 109 S. Carlisle Street New Btoomtleld Pa. T ~oea her Last Witl and Testament, in our presence, who, in her presence, at her request and in the presence or each other, have hereunto set our names as attesting witnesses. Page 3 of 4 pages rei. (7 T n sae-8195 FAx cn n sa2as2T A. SaNbnMM ~bN~l Y.t. De-atbmnt O(Hatfini Otd9 Appro~el Fb. 2502-0265 ., •, I • a.d ue6an D.wlopmnt I e. Type d t. ( ] FFN L ~. ( ] VA !. C. ) RHS >. ( ] Cenv Uldtb. 0• F9a Nwnbor: 7. Loon, t4ttntb4r. 0. NorlOapo insurotteo Ca.o Npntboe: ) Coety, Im. /01000106.6K I ' NOTE: Thlt /Oten k 6an14fted b give you • alelaettaen d aLiuaf aatlkmwtt eroab. ARqunb pak b aml by the smlhm4nt agem va ,tom. mawed'mA.e.l' wee PaN Ou1N4a d1M ekoln0: fxry w ahom bsre for kdbrrttaboeal Dt.p04w and oro eat ktrJttdad M Ste blsts~ 0. Narita and NELSON SEARS 1026ENTLEY LANCASTER. of Cafrewer a Name asd Adee.w a Ssnar F. Nama nnf Addnsa et Landes ~ AND SARA ALICE OF ESTATE OF QWEN I40YVER ,PA ~ 17601 ~ I o. Pe.PanP 4131011RIU6 ENOLA, PA 7T COUNTY: PARCEL ID: 10 TOIAMEiHIP: .. H. s.tnwt.ttt AOont BPER CHAN RG Waw stSed6amant 1. SatOamaM Date 6t4 ,r BLAND 13 NARKIET STREET Dlabursamaetl Only 02lZW2010 4-0637.160 CAMP HILL, PA 17011 ~ DEN TONMSHIP ~ J.SUPAMAM' BORROWiRYTRANSADTIOttS KSUMR7AR'ID-SELLEti'STRANSACTIONS ttN. Droso M Des Prent Senawr 4t10.4rosa AmeoM lhea Te 3aNar t tol.eoetk.et Pew 5192,et2J10 40t,Con1ea41SakoPriw 'st92,e12.ao 102. Per4ate! 402. Personal Propoy 103. se Itttyoa b senew.r s3.stttao ~. AOJeatmwb F Ilenes MN 0b Sa6ar In Adttlnw AeOuatmeeKo Perlbma -dd s1129aMe In Adroetw t t13.1.k1lTOrm awa 41aCM1Mtttw6T4uets ~ 114. Ceuny T 414. Count Totten t ts. seho417 t54t.t4+00yr 0221/10 b D7ro1H0 1630.96 416. Seltool Tstte91646.9900lyr 02/2A/tO b 07p1I10 t 5536.96 1, 6. 416. Aawwmrtts t t9. HOA 10 0224/10 b 03b1M0 ST.t4 419. HOA 40.000OAtb 02t21M0 b 03roV10 i 67.14 121. i60.000Wph far 6921110 b OIro1/10 160.00 421. SarradR44Uas 160JXIOOph for 02!24/10 b 04l01H0 600,00 120.Oress I Dun Fran Be/teerot itS7,W6.00 420.4irwo AmeOtR Dw Te S.IM (3193.410. f 0 200. AmaMb Sy Or b BeMN Of YerrerreR 900. RNretlans M AmenM Ona To caller 201. DepooR ar maN manoy 8s,00t1.00 501. Eteaeaa Depoalls 20LPentlpaf s~.6atlbtttaMChatpstsSalAr ~ ~ 541.930.64 203. EaiaNn6 n(a1 T4kon BubJset to 503. Laan(o) Token &tb]eel b ]04. 504• PoyON Fest NW~aOB b C16MOIIQoOe. inC, 5121,666,66 Adjustmaetb RamaUtt-sN9ySNker Adjtrs6nenbFerNamaunyoNgya.u.r 210. s1o. I 2t1. s1t. l . 212. 572. xta eay76wet ..ea s+a C1gNroten Tote4o ztl.countyT. 446.e1oohrolptnobozrJVlo 566.06 s7s.cwMFTs.«us.e4ooyrotrotnabmrzuto I se6.oe 216. Aaae ste. Asaustnsms 279. 519. 220. Boye-'aT 1 Credit ~ 56,06SJI6 e2D.6aNear's TeW Cbaeras i 5/63,seas6 300. Ca4A At wl FrotNPo l6eerevear 000. Dasb AI Sel6etetant TalFrom Saeter 301.Otttw aD2. Laa4 303. Cash [ X Duo Nets ttsrroeea Qkta 120) Pak OtlFar Conerwr (nits no) From [ j To 9errolwr HS7,t1S6J10 601, Oroaa Amount Dw to SeOer (W4 420) I :,93.4t s.t o is.086.00 002. taw Dodueaans M AmL Des To SetAr 0>M 920) t s163,S69.s6 5197 570.52 603. Cash (X J To ( J from SNkf t29.826J2 t Z00 'a 9056 165 L I d 'btt zra arnn a3~ro~s na 50 ~ EO a3~1/0 f OZ/~Z/fl3 a ~~ i M1100otM.- ~_ s.«~..~.w. 700. TaW Oaiairbe U2619.00 A 6 %~ 116N.72 i ()n6iian d pine 700) Ai FaYOiia: ~ Paid Flom BOrtDrrara PMd Flom 701. j116j6. b ERMNR'T, LLC - Fulldi At aalNaelMnt Fungi A4 b'a6Nment 702. Sa91g , 703. Fak N aeoamaw ~ ~ jt 1.369.)2 706. AadtbnN Pee b 6RMNRT, L1.C 6195.00 709. Mdibnal oherapa FN b ERA-NRT. LLC f79S.00 600. lame Ne M pnniabn Wltb Loen 601.Laan Fea 602.Laae ant ~ 602. ApprelMl ~ , ea. cne6 1 e9s.landat Fee 900. Rene M By Lander Te b Piid M Adrana ' 901.3Ntleat 902 . hbntape Pramilln 9W . Msaa-d I F7emlun I 1a9a Daraa6!adM11n1 L~Rear i 1001. Na2aM Reaerw loot M.Raaarw 1oo6.cx)Pro Taaea t00a, County Tap{ 101 D. Appnpi A0 Ad-uiNxnt ' 1100. TMIa Ch~ ryn 1101.8N tlClialn j Fee b Seouna LanO Tnrrbra - ataehenieebur0 , St 00,00 i 1102. AtgY6C1 Tate Sard~ 1103, Ti6e ~ 11a.Troa eider 116s. penr.ree ~ S t0i. No1My b taeund LeM Trrr/an - Madm9tximq 12.00 ~ 63.00 110). Atlomey t 106. TiY ir, oW b aecvnd Land Trindan - NaehaNabur6 11,191.30 11,09: Landa/3 rqe i (i) ~ 1110.OwMr's a 3192612.OD (j1191,8i)RI 1136. ei CeR. b Qa+wd Lena Teendan- Wchenlei0up j1b.00 1200. Gowen M RICarO'Ie' Md Tnnafar Cheryis t201. Feai 9K Dead 62.00: RaopdMp Faaa ler x,00 I 1202. TawOlMmPi 1926.12 ji,926.12 1203, ibb Tei 1926.12 - 11,926,12 1100. MdMN lN6amant Cheryas - 1806. In6is6on b Whelan Cfewinp NOrnaOwMn Asaada6en 1100.00 1306. Duaa 3M b Whahn CrasNj HOnlaownsrs AgodNlOn ja0.00 1807. Ft~36k b WheMn CYOiaii9 tlomeownep Aaeedahon ~ j2S00 1300. Eicnw EttaN ana Mh. hps b Sewied Lend Tnnden - ikehanieitnrp S23,SIM.00 1310. ENab OiY^Mnt b Rpdw d V1M4, ApMt j~,700.00 UOO.TOW la antOMr9es 66,610.30 ! 611,66.84 1 hiw owehl7 made en rty etrreta 6r NUO. 3a91n11aM and b 6N bast d my baaled0'a and itM end eaoureb ebtenfent d aN n~egla and Oisla er b7 me ti Wa tranieo6on. L Ra6nr aealy Iha f Inva neaiwd • aOa! d 1M FtUD•18etllenKnl 8tatamenl. ~ se s ~ r ^ i Nation SNn .~_ I r~. / 211. 1~ The HUD-1 aecordance SeMlameM SECURED ~= d,,,p~i o7: 1 . n! Shbnwd ~whigl I hew pnipared b a 1nN end eeeurala aceotlnt dMh trenaeeaen. l h or YrAI uuaa Oro Nndi b i» ditneled In ehtarnenl I Oab 02124/20'10 X00 'd 90SB 165 L 1 L 'aN X9d QIJK1 Q38f1~35 -9d S0 ~ EO 43M/O l Ol/tZ!H3d Pipe 2 ' 8dbfi PSE(~ January 26, 201.0 William R Bunt Attorney at Law 109 South Carlisle Street PO Box 336 New Bloomfield, PA 17068-0336 ke: Gwen Bower, Deceased. Account # 0177526453 Dear Mr. Bunt: ' The account was opened on October 11, 1983. The Share accounts were held solely by Gwen Bower. The Visa loan was held solely by Gwen Bower. The following are the Date of Death Balances for Ms. Bower's account with PSECU: Account Date of Death Balances Interest -December 1-12 Savings (S 1) $ 13 8.47 $ 0.02 Checking (S4) $ 1,686.44 $ 0.07 Money Market (S7) $ 13,820.52 - $ 2.71 Certificate (S52) $ 3,138.03 $ 1.29 Certificate (S53) $ 1,049.08 $ 0.63 Loans: Visa Loan (L9) $ 443.82 The Visa was paid and the remaining funds released to The Estate. Pennsylvania State Employees Credit Union Main Address: 1 Credit Union Place, Harrisburg, PA 1 71 1 0-2990 • 717.234.8484 • 800.237.7328 Mailing Address: P.O. Box 67013, Harrisburg, PA 171 Ob-7013 • 717.777.2100 (TDD) • 800.472.1967 (TDD) psecu.com This credit union is federally insured by the National Credit Union Administration. Equal Opportunity lender ~° PSEC~k Re: Gwen Bower, Deceased. Account # 8219626432 Keystone Connections Business Account The account was opened on October 19, 2007. The Share accounts were held solely by Gwen Bower. The following are the Date of Death Balances for Ms. Bower's account with PSECU: Account Date of Death Balances Interest -December 1-12 Savings (S1) $ 581.11 $ 0.02 Checking (S4) $ 1,625.89 $ 0.07 If you have any questions, please contact me at (717) 234-8484 or toll-free at (800) 237- 7328, then press 6, extension 3120. Sir;,cerely, ~~~ Roxann Myers Service Advisor P~ECU ..~ ,. _ Pennsylvania Sfate Employees Credit Union Main Address: 1 credit Union Place, Harrisburg, PA 1 71 1 0-2990 • 717.234.8484 • 800.237.7328 Mailing Address: P.O. Box 67013, Harrisburg, PA 1 71 06-701 3 • 71 7.777.2100 (TDD) • 800.472.1967 (TDD) psecu.com This credit union is federolly insured by the National Credit Union Administration. Equal Opportunity Lender ~Ct1Z~'S ~..ItCttOn.S~ I?tC. Auctioneer and Certified appraiser 6334 `Waggoner's Gap ?Z,oad Phone # 717-789-3883 Landisd urp, Pa. 17040 ~"ax # 789-4226 APPRAISAL REPORT, PREPARED JANUARY 21st, 2010 FOR: THE ESTATE OF GWEN BOWER BY V. ART KUNG Summary: On January 11 ih, 2010, I personally inspected the personal property of Gwen Bower, Enola, Pa.- at the request of the- Estate Executrix, Beth Grayson Purpose of Appraisal: To determine valuation of assets for Estate Purposes Method of Valuation: Fair Market Value Definition: The most probable price which the items mentioned in this appraisal should bring in an open and competitive market under all conditions requisite to a fair sale, with the price not affected by undue stimulus, implicit in this definition is the consummation of a sale as of a specifies date, and passing from seller to buyer. Allowing a reasonable exposure time in an open market, public auctions being one such forum, payment is arranged and made, with no creative financing or concessions granted by anyone associated with the sale, be it public or private. Conditions of Appraisal The value stated in this appraisal is based on the best judgement of the appraiser given the facts and conditions available and presented at the date and place of evaluation. These values are based upon the experience of Art Kling as a licensed auctioneer, whose services were recommended to and/or requested by the client, recognizing data used from 40 plus years of selling and marketing all types of merchandise, real estate, equipment, vehicles. etc. as updated and realistic sources of information. The statements and values given in this report are true and correct to the best knowledge and belief of the appraiser -and prepared in accordance with the standards and practices Of the Certified Appraiser's Guild of America, C.A.G.A. Our business has been incorporated since 1988, and operated as a private entity from 1966 until then, conducting hundred of successful auctions up to and including the present. We appreciate being considered to conduct this appraisal and your trust to evaluate ite c d' a of importance to you, your fannily, or your business. V. Art Kling APPRAISAL FOR THE ESTATE OF GWEN BOWER APPRAISAL SITE: RESIDENCE OF GWEN BOWER 4131 DARNS ST., WHELAN CROSSING WERTZVILLE, RD. ENOLA, PA. JANUARY 11, 2010 AUTOMOBILE 2003 FORD ESCAPE XLT, 72,000 MILES, AVERAGE CONDITION PERSONAL PROPERTY ELECTRONICS: _ GATEWAY LAPTOP, APPROXIMATELY 5 YEARS OLD 200. DELL PRINTER, NEWER 200. TELEVISION, FLAT SCREEN, 32", NEWER, LG 300. 5,000. APPLIANCES ALL APPLIANCES STAY WITH THE RESIDENCE, ON CONTRACT WITH REALTY COMPANY FURNITURE AND HOUSEHOLD ITEMS OFFICE DESK, PRINTER STAND, SMALL SHELF 200. KITCHEN: 4 CHAIRS, RATTAN, NEWER 200. SMALL APPLIANCES, MICROWAVE 250. DINNERWARE, POTS & PANS, UTENSILS, KITCHEN LINENS 250. LNING ROOM: SOFA, LOVE SEAT, END TABLES, LAMP, AREA RUG 300. DINING ROOM: WOODEN TABLE W/4 CHAIRS, NOT NEW, SERVER, COMPOSITE WOOD 300. BEDROOM: FULL SIZE BED, FRAME ONLY, NIGHT STAND, LAMP 250. MIRRORS, DECORATIVE ITEMS, WALL HANGINGS 225• TOTAL APPRAISED VALUE OF AUTOMOBILE 5,000. TOTAL APPRAISED VALUE OF PERSONAL ITEMS 2,675. TOTAL OF APPRAISED ITEMS: 7S •675•UO JAN.26.2f310 9:36AM ~TADDE~. Strvices Company CSR FAX2 N0.011 P.Zi2 6300 Loma Avenue Post Offica Box 29217 Shawneo Miss;on, KS 66201-9217 www.waddell.com January 25, 2010 William R Bunt Attorney At Law 109 South Carlisle ST New Bloomfield, PA 17068-0336 RE. Account 3225214f1 To Whom It May Cons;ern: Listed below is the valae of Gwen Bower's Roth IRA as of Fund Shares Price WR Advisors Science & Tech {622) 1,379.449 $ 9.11,1 WR Advisors New Copcepts {630) 992.548 $ 8.61 If you have any questions regarding the above iafozmation, 1888-WADDELL (9~3-3355. Thank you, ~~~ csRlResource cenu~r Client Service Division Waddell & Recd Servsces Company 12, 2009: Balance $ I2,56b,78 $ 8, 545.84 free to call us at Account number: 896-95403-1-2 p'Pro~'~~11°~' ~~.l~~l.l~,~npis W ryun0 FrNdxs. MO 63D43.3ot2 Statement type: Preferred uww.edw,rdpnsa,eom October 31-December 31, 2009 """~Ns~ A Unique Understanding of Your Financial Needs At Edward Jones, we beisve the beat Mvesbnent rocommer-dafions aro lhoae taUored to your apacMc needs. Theta why we work so hard to ttaroughy understand your flnandal aitrmtlon and your goals. The following is ~ overview of your investment and borrowing acUviy with Edwaro Jones. Working wfih your ilnandai advlaor, use it to determine how we can help you mast other Important finendal goals. Call SEAN FERGUSON at 717-731-5432. Altlaugh account information is provkled on ills page, U does rat guarantee an actual statement was produced. Please refer to your account statement for the exact registratlon and moro spedfic details regarding each accamt. Edward Jones statements are issued for each account hokfirrg securttlea In firm name wUh Edward Jorrea M March. June, September and December. Monttry statements (fir months other than those previously referred to) will rat be sent to you in months for which there was no acfiviy or your ony account actlvUy is the payment of Income an your Edward Jones rrrorrey market account or yore' cash account balance. Investment acoounb Account lalder Account number Current value Value one kWlvidrral rssrarrrsrrt account - GWEN BOWER 89ti-95403-1-2 =53 500 75 ~ 30121 Totallnvesfinentaccounts - - - 553.500.75 542.30121 The 11'tS deadHns for maUing 1099s is now Feb. 15. The 1f2S has dranged its deadUne for mailkrg Consolidated 1099 Tax Statements from Jan. 31 to Feb. 15. While we expel to Issue most 1099s by Jan. 31, the Issuers of some irwestrr-enta may not provide final tax data to us until after that data. This means you may rat receive your 1099 untU mid- to late February. You may wish to consuU your tax professional regardng when to schedule your tax preparation appointment. For more details, please corned your flnandal advisor. (Yourfinanclal needs) December 2009 page 1 ,~ ~, ~ ,•y EdwardJones Estates - Htstortcal Date of Death Valuation Worksheet Account Registration: GWEN BOWER A~~ N~nber. 896.95403.1-2 pate; Jan 12, 2010 4131 DARIUS DR ENOIA, PA 17025 Date of Death: Dec 12, 2009 Date of Death Valuation: Jan 12, 2010 Alternate Date d Valuatton: ^ C.Fiedc here If date of death was a dosed market day (i.e., holiday. weekend). use the additiartal wodaFieets (papas 2 - 8) to detemdne the total value and dividertdsflrrterest due for stocks, ods, bonds and mutual iurxis held in the deceased persons axarn. Then use those totals to complete section B and C to determine the overal total aoaount value. A. Total Cash Held: 1. Cash s o.oo -- - - 2 Money Market 3 -- B. Total Valus of Assets Held: 3. Stocks S 4. Bands /CDs S 5. Mutual Funds S 53,500.75 6. Mlacepansous Securitlea S C. Total Dlvidsnds / Mterost Dua: 7. Stocks dividends $ 8. Bonds / t~s interest S 9. Mutual Funds divdends S 0•~ 10. Miscellaneous distributlons = D. Total Aooount Value S 53,500.75 eter~are not gu eed. Gbrrsult xMh a competent t~aoc~apadaAst or ~mey for prafesaional advice your apecs7ic eidration. ~~ ~ Revised 30 Juy 2008 Pepe 1 d 9 ~~ .,, Ameriprise ~~ ~ r<; Flnanciai January 27, 2010 BETH B GRAYSON 12 STINGRAY DR SINKING SPRIIJG, PA 19608 RiverSour rY i.ifa Insurance Company RiverSouroa Funds Ameriprise Certtflcate Company Ameriprise Brokerage 70100 Ameriprlae Financial Canter Mtnneapotis. MN SSd74 Ikar BETH B GRAYSON: Thank you for your recent inquiry regarding GWEN BOWER's accounts, Client ID 14965516 _ ~ -~ ' ` ' ~' 9001. These arc the values of the accounts as of IZIl?12009. Account Information Annuities -Post 1985 Account Number ~~D 93007394566 7004 Individual Annnities -Post 1985 ` ~~- :. • Account Number Total Value # of shares Asst Value Per Share 93007394566 7004 r ~ .513907.05 The date of death vahies provided sre for estate tax purposes and are not a value to be paid. Acrouats maybe subject to market fhicwatioa as governed by each product. Please note that the values indicated for any Life Insurance product(s) with the insured deceased reflect the gross death benefit at date of death and not the.cash vahue. Values indicated for Life Insurance Products with only the owner deceased reflect the cash value as of the date of death. Valnes for any proptietary mutual fiords include acenied dividends as applicable. Vahus provided for brokerage products ate maanally catcalated, and should be used as estimates only. The prices used to provide vshus are estimates obtained from outside sources believed to be reliable. Ameriprise Financial provides these values as a service to its clients. Actual values used in preparation of tax returns or for planning purposes should be verified by your legal and accounting advisors. We appt+eciate the opportunity to be of servict to you. Please comact us if you have any questions. Sincerely, Judy Wiens Death Settlements Processing Team '. .. _ . 70100 Aipcriprise Financial Centel ~~ ~~ Minneapolis, MN 55474 1-800-862-7914,.Optioa 2; ask for Estate Settlements Insurance and annulUes are issued by RfverSource Life Insurance Company, an Ameriprise Flnancial company. Ameriprise Brokerage is provided by Ameriprise Flnanclal Services, inc. Ameriprise Flnancisl Services, Inc. Member FlNRA and SiPC