Loading...
HomeMy WebLinkAbout03-0993 Estate of also known as Social Security No. 181-32-3502 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older and the executors in the last will of the above decedent, dated April 1, 2002 and codicil(s) dated N/A PETITION FOR PROBATE and GRANT OF LETTERS Geraldine E. Bolze No 21-03 - To: Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania named (Note:Arthur W. Bolze died May 14, 2002) (state relevenat circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in Cumberland with her last family or principal residence at 208 Todd Circle, Borough of Carlisle, Cumberland County, (list street, number and municipality) Decedent, then 94 years of age, died Nov. 11, 2003 at Borough of Carlisle, Cumberland County 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: No Exceptions County, Pennsylvania, 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: $ unestimated Total: unestimated WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary thereon. 4 White Oak Drive Carlisle PA 17013 (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) 1299 Asper Drive Boiling Springs PA 17007 OATH OF PERSONAL REPRSENTATIVE COMMONWEATLH OF PENNSYLVANIA COUNTY OF CUMBERLAND The petitioner(s) above-named swear(s) or affirm(s) that the statement in the foregoing peition 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 well and truly administer the estate according to law. ,/ Sworn to or affirme~and subscribed before me this ~c day of November, 2003 · 0 ' ' Estate of Geraldine E. Bolze , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW"~t_0.txn ~ ~_ 20 t53 , 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__ April 1, 2002 described therein be admitted to probate and filed of record as the last will of Geraldine E. Bolze and Letters Testamentary are hereby granted to Kenneth W. Bolze and Kathleen M. Donkus FEES Probate, Letters, Etc.$ o~3 Short Certificates(1 )$ $ Total $ Filed.. i~ :.~...-.,0~..O.~ ........... ~Register of X~r, li~ -O '~~-~ Robert M. Frey #06274 ATTORNEY (Sup. Ct. I.D. No.) 5 South Hanover Street Carlisle, Pennsylvania 17013 ADDRESS (717) 243-5838 PHONE REGISTER OF WILLS OF CUMBERLAND COUNTY OATH OF SUBSCRIBING WITNESS Robert 'M. Frey and Mary C. Wert (each) a subscribing witness to the will presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that they were present and saw Geraldine E. Bolz, the testatrix, sign the same and that they signed as a witness at the request of testatrix in her presence and (in the presence of each other)' (in the presence of the other subscribing witness(es)). Sworn to or affirmed and subscribed before me this. ~..~.~X.~ day of November, 2003 ~ C~ .~lRegi;tOer Robert M. Frey .5 S.Hanover St., Carlisle PA 17013 Mary C} W'ert 5 S.Hanover St., Carlisle PA 17013 REGISTER OF WILLS OF CUMB j AND COUNTY OATH O__F__N_?_N__S__U____~_C__R_I__B_I__N__G____~NESS (each) a subscriber hereto, y(s) that they are fa ' ' with the signature of ~,.. , (one o~' e subscribin itnesses to) the will ~. "'-~ , (one o?'14~,.subscribin~.~tn · presented herewith ~rrd_,~that each believes't~ signature o'~'~e w'fll is in~e handwritin ~., ~ g of to the be4.t~f our knowledge a~lief. Sworn to or af~ae~d and subscribed b-Xef, ore me this .... ~",~,,.~. day o'~ , Register of Wills 105.805 REV 9/R6 This is to 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 to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 97,50330 No. Local Registrar NOV 1 3 2003 Date H10$.~(al%.. Z'~7 COMMONWEALTH OF PENNSYLVANIA * OEPARTMENT OF HEALTH * VITAL RECORDS ~ CERTIFICATE OF DEATH "[,.~"~"."P" I ~.,~rg~.,...~~~ I' " _~]81 -- 32 --3502 J,. 11/11/2003 c~. ~nO, ,~rl~ste Reo~onal Med ,,. ~rlisle, P~ 17013 ,,. Sauel J. Butts M. ~n~s ~ I~ {OR ~S A CONSEQU~'~CE O1~: r em~ m oeec) LJ~T ~ TO (~'A$ A CON,SEOUE N~E ~ 11/15/2003 Viola Fern Mundy 1299 Asper Drive; Boilinc Springs, PA 17007 I ,,;W~?.~,?°''''°" ...... ~'~"~ ,,.. ~,.. ~. .... ~. ,,Zlliottsburg Cemetery (East Zlliottsburg, PA Brothers Funeral Hcme, Carlisle, PA 17013 ,:,9.. I o -qq. LAST WILL AND TESTAMENT OF GERALDINE E. BOLZE I, GERALDINE E. BOLZE, of 208 Todd Circle, in the Borough of Carlisle, Cumberland County, Pennsylvania 17013, 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 void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter named Executors to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. 3. All of the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath in equal shares to such of my six children as shall survive me by a period of ninety (90) days, their heirs and assigns, but should any of them fail to so survive me them the share such deceased child of mine would have received shall pass to such of his or her issue, their heirs and assigns, per stirpes, as shall survive me by a period of ninety (90) days, and if there be no such issue, the same shall lapse and be added to the shares of my other children, per stirpes. · 3. I have made no provision herein for my husband ARTHUR W. BOLZE, not because of any want of affection for him but because I am confident that he is already adequately provided for. 4. I hereby nominate, constitute and appoint my son, KENNETH W. BOLZE and my daughter, KATHLEEN M. DONKUS, and the survivor of them, as Executors of this my Last Will and Testament. and I fu."ther direct that neither of them shall be required to post any bond to secure ihe faithful performance of his or her duties in the Commonwealth of Pennsylvania or in any other: jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on one (1) page, this 1st day of April 2002. GERALDINI~ E. BOLZE ~ (SEAL) Signed, sealed, published, and declared by GERALDINE E. BOLZE, the Testatrix above named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. LAST WILL AND TESTAMENT OF GERALDINE E. BOLZE FREY & TILEY ATTORNEYS-AT-LAW 5 South Hanover Street Carlisle, PA 17013 Telephone (717) 243-5838 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Will No. To the Register: Geraldine E. Bolze November 11, 2003 Admin.No. 21-03-0993 I certify that notice of (beneficial Interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on: February 9, 2004 Name Address Kenneth W. Bolze Kathleen M. Donkus Ray S. Bolze Deanna E. Seibert Esther L. Gibbs Norma B. Emersor~ 4 White Oak Drive, Carlisle PA 17013 1299 Asper Drive, Boiling Springs PA 17007 5010 Westpath Terrace, Bethesda MD 20816 R.D. 1, Box #112, Landisburg PA 17040 117 N. Williams Street, York PA 17404 46 Richard Avenue, Shrewsbury MA 01545 Notice has now been given to all persons entitled thereto under Rule 5.6)a) except NO EXCEPTIONS Date: February 9, 2004 Signature Name: Robert M. Frey Address: 5 South Hanover Street Carlisle, Pennsylvania 17013 Capacity: Personal Representative X Counsel for Personal Representative REV 1500 EX (64~0) COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER_ OFFICIAL21_03_0993USE ONLY DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) BOCIAL SECURITY NUMBER Geraldine E Bolze t81-32-3502 ~u~ I Original Return [] 2 Supplemental Return NAME Robed M. Frey FIRM NAME (If Applicable) Frey and Tiley TELEPHONE NUMBER COMPLETE MAILING ADDRESS 5 South Hanover Street Carlisle PA 17013 i(717)243-5838 Z 1 Real Estate (Schedule A) (1) NONE 2 Stocks and Bonds (Schedule B) (2) 3 Closely Held Corporation, Partnership or Sole-Proprietorship (3) NONE 4 Morigages & Notes Receivable (Schedule D) (4) 5 Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 6 Jointly Owned Properly (Schedule F) (6) NONE [~Separate Billing Requested 7 Inter Vivos Transfer & Miscellaneous Non-Probate PropeNy (Schedule G or L) (7) NONE 8 TOTAL GROSS ASSETS (total Lines 1-7) 9 Funeral Expenses & Administrative Costs (Schedule H) (9) 10 Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ',10). 11 TOTAL DEDUCTIONS (total Lines 9 & 10) 12 NET VALUE OF ESTATE (Line 8 minus Line 11 ) 13 Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14 Net Value Subject to Tax (Line 12 minus Line 13) OFFICIAL USE ONLY 918 8,896 116,762 (8) 13,234 7,580 (11) (12) (13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15 Amount of Line 14 taxable at the spousal tax rate ,or transfers under Sec9116 (a)(1 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 x .0 (15) 105,762 x .045 (16) x .12 (17) x .15 (18) t9 Tax Due (19) 126,576 20,814 105,762 105,762 4,759 4,759 2~ z Geraldine E Baize 181-32-3502 Decedent's Complete Address: STREET ADDRESS ?n~ mr~,~d Circle 'aT,,is,e STATE ZIP PA 17013 Tax Payments and Credits: 1 Tax Due (Page 1 Line 19) (1) 4,759 2 Credits/Payments A Spousal Povedy Credit B Prior Payments 4,496 C Discount 237 Total Credits ( A + B + C ) (2) 4,733 3 Into rest/Penalty if applica ble 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 I Line 20 to request a refund (4) 5 If line I + line 3 is greater than line 2, enter the difference This is the TAX DUE (5) 26 A Enter the interest on the tax due (SA) 8 Enter the total of Line 5 + 5A This is the BALANCE DUE (SD) 26 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Did decedent make a transfer and: a retain the use or income of the proper[y 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'~ If death occurred after December 12,1982,did decedent transfer property within one year of death Yes No 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 properly which contains a beneficiary designation? [] [] 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 perlurY, I declare that I have examined this return, including accompany,no schedules and statements, and to the best of my knowledge and belief, i~ is true and complete Declaration of preparer other than the pa_ rsonal representative is based on all information of which preparer has any kn ewled,ge AD~ ES~" --' ,/ (1)4 White Oak Drive, Carlisle PA 17013 (2)1299 Asper Drive, Boilin§ Springs PA 17007 SIGNATURE OF P P~PARER~/,~¢1~ OTHER THAN~ ~EPRESENTATIVE '~'~ /<..¢~ DATE ADDRESS / 5 South Hanover Street, Carlisle PA 17013 7/19/2004 7/19/2004 For dates of death on or after July t. 1994 and before January 1, 1995 the lax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P S Section 9116 (a){1 1 )(i)] For dates of death on or after January l 1995 hetaxraeimposedon hone vaueo anses oo 0 heuseo hesuvvngspouse SO%[72PS Section 9116 (a)(1 1)(,)] The statute does not exempt a transfer to a su~iving spouse from tax and the statutory requirements for disclosure of assets and filing a tax re[urn are still applicable even if ~he surviving spouse is the only beneficiary For dates of death on or after July 1,2000: The tax rate imposed on [he net value of transfers from a deceased child twenty-one years of age or younger at death Io or for the use of a natural parent an adoptive parent, or a stepparent of Ihe child is 0%[72 P S Section 9116(a}(1 2)j The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 45%, except as holed in 72 P S Section 9116(1 2} [72 PS SecllOn 9116(a)(1 )] The tax rate imposed on Ihe net value of transfers to or for the use of the decedent's siblings is 12% [72 P S Section 9116(a)(1 3)] A sibling is defined under Sechon 9102 as an individual who has at least one parent Ln common with the decedent, whether by blood or adoption 217 REV-1503 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEE)ENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Geraldine E Bolze 21-03-0993 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. MetLife(30shares @30.60) 918 TOTAL (Also enter on line 2, Recapitulation) $ 918 (If more space is needed, inset[ additional sheets of the same size) WSJ corn Stock Charting for MET 5/6/04 2:23 PM Inc (MET) (NYSE) U.S. Dollar Date Price High Low Volume 11/11/03 30.6 30.78 30.49 1,822,600 No Splits Get another quote any day after 1/2/1970 1/2/1970 Symbol: [ Date: [11/11/2003 ~ Copyright © lg98-2004 BiqChar s corn Inc. Historical and current end-of-day data provided by FT Interactive Data. 2 ]b~nth (D~ily) ©SigChar~.co m Copyright © 2004 Dow Jones & Company, Inc. All Rights Reserved ~ttp://w~vw bigcharts.com/custom/wsjie/wsjbb_historical.asp?symb=mct&sid=8630&close date=l 1/11/2003 Page i o£ 1 Please Note: Your Sale Proceed~ Check is Attached BROKER'S Name. Addt ess, ZIP Code. Fede~aI COPY B FOR RECIPIENT Exchange Transactions 85 Challenge~ ~oacl This is important ~ax information and is being furnisl~ed to ~TU~ FOR 2004 OMB NO. determh~es that il has no~ been reported 05Y20/2004 59156R 10 TO WHOM PAID a. Stocks. Bonds. etc B. Bartering ~1.006.5 1 Kenneth W. Bolze & KathleeR M. 4. FEDE~L INCOME T~ WITHHELD Donkus Ex Uw Geraldine E, Bolze C/O Robe~ M Frey $0.00 5 S. Hauover Street Carlisle, PA 17013 REPORTED } Me.ire, Inc. 8065 1874 4277 54-6587945 · IMPORTANT TAX RETURN DOCUMENT ATTACHED · Balance 30.0000 05/25/2004 Shares Sold 30.0000 1,006.51 0.00 1,006.5I 00000 FULL (07 03) YOUR ACCOUNT HAS BEEN CLOSED. THE ATTACHED CHECK REPRESENTS THE FULL VALUE OF YOUR ACCOUNT. Retain this number for future reference: Investor ID: 8065 1874 4277 For information concerning this statement, call MetLife, Inc.'s Transfer Agent, Mellon IDvestor Services toll free at 1-800-649-3593 PLEASE DETACH ALONG [HE PERFORATION 17 (1524 OO00034 THE:ACEOF]HSDOCUMEN~ HASA BLUE BACKGROUND ON WHfTE PAPER THE BACK OF TH S DOCUMENT CONTAiNS AN ARTrF CiAL WATERMARK HOLD AT ANGLE TO VIEW efkife' Desc- plion: Sale Proceeds Check No, 00595532 511-937 213 Check Date Imcstor ID Pay 05125/114 8065 1874 4277 ****S1,006.51 Pay to The Order of: Kenneth W Bolze & Kalhleen M. Donkus Ex. Uw Gcraldine E. Bolze C/O Robert M Frev 5 S. Hanover Stre~t Carlisle, PA 17013 Payable at Chase Manhattan Bank S',racuse, NY or The Chase Nhmhattan Bank. New York Authorized Oflicer Signature COMMON~NEALTH Of PENNSYLVANIA iNHER/TANCE TAX RETURN RESIDENT DECEDEN~ ESTATE OF Geraldine E. Bolze SCHEDULE D MORTGAGES & NOTES RECEIVABLE FILE NUMBER 21-03-0993 All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION Mortgage for Real Estate, 44 Wilson Street, Borough of Carlisle, Cumberland County PA %ccrued interest to Date of Death VALUE AT DATE OF DEATH 8,880 Z6 8896 TOTAL (Also enter on line 4, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) Analysis Amount financed $45,000.00 Annual interest (e.g., 8.25) 6.00 Duration of loan (in years) Start date of loan 06/01/2000 Monthly payments $1,000.00 Total number of payments 0 Yearly principal + interest 12,000.00 Prindpal amount $45,000.00 Finance charges ($45,000.00) Total cost Payment Schedule for Mark & Rebekah's load at 44 Wilson St to Grandma Bolze Ref: Documents signed when we settled on the house in Spring of 2000 Pmt No. Payment Beginning Interest Principal Balance Accumulative Accumulative Date ~!=_~ce ~nterest Principal I 06/01/2000 45,000.00 225.00 775.00 44,225.00 225.00 775.00 2 07/01/2000 44,225.00 221.13 778.88 43,446.13 446.13 1,553.88 3 08/01/2000 43,446.13 217.23 782.77 42~663.36 663.36 2,336.64 4 09/01/2000 42,663.36 213.32 786.68 41,876.67 876.67 3,123.33 5 10/01/2000 41,876.67 209.38 790.62 41,086.06 lr086.06 3,913.94 6 11/01/2000 41,086.06 205.43 794.57 40,291.49 1,291.49 4,708.51 7 12/01/2000 40,291.49 201.46 798.54 39,492.94 1,492.94- .~ 5,507.06 - 8 01/01/2001 39,492.94 197.46 802.54 38,690.41 ~" 1,690.4! /) 6,309.59 ~" 9 02/01/2001 38,690.41 193.45 806.55 37,883.86 1,883.86 7,116.14 10 03/01/2001 37,883.86 189.42 810.58 37,073.28 2,073.28 7,926.72 11 04/01/2001 37,073.28 185.37 814.63 36,258.65 2,258.65 8,741.35 12 05/01/2001 36,258.85 181.29 818.71 35,439. 2,43g.94 g,560.06 13 06/01/2001 35,439.94 177.20 822.80 34,617.14 2,617.14 10,382.86 14 07/01/2001 34,617.14 173.09 826.91 33,790.22 21790.22 11,209.78 15 08/01/2001 33,790.22 168.95 831.05 32,959.18 2,959.18 12,040.82 16 09/01/2001 32,959.18 164.80 835.20 32,123.97 3,123.97 12,876.03 17 10/01/2001 32,123.97 160.62 839.38 31,284.59 3,284.59 13,715.4! 18 11/01/2001 31,284.59 156.42 843.58 30,441.01 3,441.01 14,558.99 19 12/01/2001 30,44.1.01 152.21 847.79 29,593.22 3,593.22 15,406.78 20 01/01/2002 29,593.22 147.97 852.03 28,741.19 3.741.19 16,258.81 21 02/01/2002 28,741.19 143.71 856.29 27,884.89 3,884.89 17,115.11 22 03/01/2002 27,884.89 139.42 860.58 27,024.32 4,024.32 17,975.68 23 04/01/2002 27,024.32 135.12 864.88 26,159.44 4,159.44 18,840.56 24 05/01/2002 26,159.44 130.80 869.20 25,290.23 4,290.23 19,709.77 25 06/01/2002 25,290.23 126.41 873.55 24,416.69 4,416.69 20,583.31 26 07/01/2002 24,416.69 122.08 877.92 23,538.77 4,538.77 21,461.23 27 08/01/2002 23,538.77 117.69 882.31 22,656.46 4,656.46 22,343.54 28 09/01/2002 22,656.46 113.28 886.72 21r769.75 4,769.75 23,230.25 29 10/01/2002 21,769.75 108.85 891.15 20~878.59 4,878.59 24~121.41 30 11/01/2002 20,878.59 104.39 895.61 19,982.99 4,982.99 25,017.01 31 12/01/2002 19,982.99 99.91 900.09 19,082.90 5,082.90 25,917.10 --. 32 01/01/2003 19,082.90 95.41 904.59 18,178.32 :~_},178.32 26,821.68 33 02/01/2003 18,178.32 90.89 909.11 17,269.21 5,269.21 27,730.79 34 03/01/2003 17,269.21 86.35 913.65 16,355.55 5,355.55 28,644.45 i 35 04/01/2003 16,355.55 81.78 918.22 15,437.33 5,437.33 29,562.67 ?~ 36 05/01/2003 15,437.33 77.19 922.81 14,514.52 5,514.52 30,485.48 %' 3~ 06/01/2003 14,514.52 72.57 927.43 ! 13,587.09 5,587.09 31,412.91 38 07/01/2003 13,587.09 67.94 932.06 12,655.03 5,655.03 32,344.97 39 08/01/2003 12,655.03 63.28 936.72 11,718.30 5,718.30 33,281.70 AT REV-1508 EX + (1-97) (I) COMMONWEALTH OF PENNSYLVANIA RESIDENT DECEDENT SCHEDULEE CASH~BANK DEPOSlTS~& MISC. PERSONALPROPERTY ESTATE OF FILE NUMBER Geraldine E. Bolze 21-03-0993 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 4. 5. 6. 7. M&T, Checking Acct #16420268 M&T, Checking Acct #950224067 Accrued interest to date of death :~efund, Ewing Brothers Funeral Home ,Cash from Home Miscellaneous Household Goods PSERS pension prorated for November 2003 Refund, Kemper Homeowners Insurance 3,195 1 t 1,844 65 926 180 2OO 237 115 TOTAL (Also enter on line 5, Recapitulation) $ 116,762 (if more space is needed, insert additional sheets of the same size) January 13, 2004 Frey & Tiley Attorneys At Law 5 South Hanover Street Carlisle, PA 17013 499 Mitchell Street, Millsboro, DE 19966 RE: Estate of Geraldine E. Bolze Date of Death: November 11, 2003 Social Secm-ity Number: 181-32-3502 Dear Mr. Frey: In response to your request, please be adv/sed that at the time of death, the above- named decedent had on deposit with this bank the following accounts. Account Type ........................... CD (escrow account for E~ving Bros. Funeral Home) Account Number. ...................... 31003910844165 Ownership (Names o~) .............. Geraldine E. Bolze (trustee) Opemng Date ........................... 05/17/00 (account closed 11 / 20/03) Balance on Date of Deatlz ......... $6,616.94 Accrued Interest $ 27.18 Total. ...................................... $6,644.12 Account Type ........................... Checking Account Account Number. ...................... 16420268 Ownership (Names ofl .............. Geraldine E. Bolze Opening Date ........................... 08/28/64 (account closed 12/08/03} Balance on Date of Death_ ......... $3,194.51 Accrued £nterest $ O. 11 Total. ...................................... $3, I94.62 · Page 2 Janua~ 13,2004 Account Type ........................... Checking Account Account Number. ...................... 950224067 Ownership {Names ofl ..............Geraldine E. Bolze Opening Date ........................... 05/08/00 (account closed 12/08/03) Balance on Date of Deat& ......... $111,843.64 Accrued Interest $ 64.63 Total. ...................................... $I 11,908.27 Sincerely, Chark n~e ~Warrin gton, Ass~ (302) 934-2722 November 15, 2003 KatNeen M. Dookus I299 Asper Road 13oiling Springs, PA 17007 Ewing Brothers Funeral Home 630 South Hanover Street Carlisle, PA 17013- (717)243-2421 The Funeral Service for Geraldine E. Bolze We sincerely appreciate the confidence you have placed in as and will continae to assist you in eve~w wav xve can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLO\V[NG IS AN ITEMIZED STATEMENT OF TF{E SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT. AND MERCHANDISE THAT YOU SELECTED \VHEN lvlfiO,:l~NG THE r U~RA~ ARRA~,*GEMr:N FS. 1. PROFESSIONAL SERVICES Services of Funeral Director/Staff ................... $3375.00 FUNERAL HOME SERVICE CHARGES ............ $3375.00 SELECTED MERCHANDISE: 20G NG Silver Casket ...................... $795.00 #5 American Vault ....................... $1095.00 THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED ............... $5265.00 Cash Advances Opening Grave ......................... $300.00 Certified Copies of the Death Certificate S20.00 Vault Saturday Charge 550.00 Grave opening Sat. ChaLoe $50.00 Hairdresser .......................... $35.00 TOTAL CASH ,ADVANCES AND SPECIAL CHARGES ........ $455.00 Total Total Cost .......................... $5720,00 SUB-TOTAL $5720.00 INITIAL PAYMENT/DISCOUNT / CREDITS 0.00 TOTAL AMOUNT DUE $5720.00 TheLmpaidbalanceover45da?sissubjected oalOO%servicechargepermomh_[2OOOO%perannum __ ~/ ~ 5/~ ~'~2 Member of National Funeral Directors Association 2t7 REV 1511 EX+ (12-99) SCHEDULE H FUNERAL EXPENSES A ABMINISTRATIVE COSTS ESTATE OF FILE NUMBER Geraldine E Bolze 21-03-0993 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 5. 6. 7. 8. :UNERAL EXPENSES: Messiah Lutheran Church Rice Memorial Works, Inscription on Grave Marker ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) SEE AqFIACHED SHEET Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: 2004 Zip Attorney Fees Family Exemption (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Prepareds Fees Checks cleared after the date of death Filing Fee for PA Inheritance Tax Return State __ Zip. 100 95 6,062 6,062 251 649 15 TOTAL (Aisc enter on line 9, Recapitulation) $ 13,234 (If more space is needed, inser~ additional sheets of the same size) REV-1512 EX+ (12-03) 217 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI MORTGAGE LIABILITIES,& LIENS ESTATE OF FILE NUMBER Geraldine E Bolze 21-03-0993 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 2. 3. 4. 5. 6. 7. 8. 9. 10. Mary Fluss, Caretaker Beulah Bender, Caretaker Patricia Cook, Caretaker Bosler Free Library, Contribution Messiah Lutheran Church,Contribution Carlisle Regional Medical Center, Medical Sprint, Telephone Sarah Todd Nursing Home,Medical Otterbien United Methodist Church, Contribution 5OO 5O0 5OO 1,000 1,000 38 50 2,992 1,000 TOTAL (Also enter on line 10, Recapitulation) $ 7,580 (If more space is needed, insed additional sheets of the same size) 217 REV-1513 EX + (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Geraldine E Bolze NUMBER 1. 2. 3. 4. 5. 6. II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Son Daughter Son Daughter Daughter Daughter AMOUNTORSHARE OF ESTATE TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Kenneth W. Bolze 4 White Oak Drive Carlisle PA 17013 Kathleen M. Donkus 1299 Asper Drive Boiling Springs PA 17007 Ray S. Bolze 5010 Westpath Terrace Bethesda MD 20816 Deanna E. Seibert 384 Walnut .3arlisle PA 17013 Esther L. Gibbs 117 N. Williams Street fork PA 17404 ~lorma B. Emerson ~.6 Richard Avenue Shrewsbury MA 01545 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) 1/6 residue of estate 1/6 residue of estate 1/6 residue of estate 1/6 residue of estate 1/6 residue of estate TOTAL OF PART It - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, inset[ additional sheets of the same size) B CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS NON-TAXABLE DISTRIBUTIONS: ~, SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET 1/6 residue of estate LAST WILL AND TESTAMENT OF GERALDINE E. BOLZE I, GERALDINE E. BOLZE, of 208 Todd Circle, in the Borough of Carlisle, Cumberland County, Pennsylvania 17013, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will aad Testament, hereby revoking and making void any and all Wills by me at any time heretofore made. 1. I direct my hereinafter named Executors to pay all of my just debts and funeral expenses as soon after my death as may be found convenient to do so. 3. All of the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath in equal shares to such of my six children as shall survive me by a period of ninety (90) days, their heirs and assigns, but should any of them fail to so survive me them the share such deceased child of mine would have received shall pass to such of his or her issue, their heirs and assigns, per stirpes, as shall survive me by a period of ninety (90) days, and if there be no such issue, the same shall lapse and be added to the shares of my other children, per stirpes. 3. I have made no provision herein for my husband ARTHUR W. BOLZE, not because of any want of affection for him but because I am confident that he is already adequately provided for. 4. I hereby nominate, constitute and appoint my son, KENNETH W. BOLZE and my daughter, KATHLEEN M. DONKUS, and the survivor of them, as Executors of this my Last Will and Testament, and I further direct that neither of them shall be required to post any bond to secure the faithful performance of his or her duties in the Commonwealth of Pennsylvania or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on one (1) page, this 1st day of April 2002. GERALDINE E. BOLZE ~J (SEAL) Signed, sealed, published, and declared by GERALDINE E. BOLZE, the Testatrix above named, as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRLSBURG, PA 1 ? 128 0601 RECEIVED FROM; PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004174 DONKUS KATHLEEN M 1299 ASPERS DRIVE BOILING SPRINGS, PA 170O7 ESTATE INFORMATION: SSN: 181 32-3502 FILE NUMBER: 2103-0993 DECEDENT NAME: BOLZE GERALDINE E DATE OF PAYMENT: 07/19/2004 POSTMARK DATE: 07/19/2004 COUNTY: CUMBERLAND DATE OF DEATH: 11/11/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $26.00 TOTAL AMOUNT PAID: $26.00 REMARKS: K M DONKUS SEAL CHECK# 110 INITIALS: VZ RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF TNDZVZDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRTSBURG, PA 17128-0601 COHHONgEALTH OF PENNSYLVANIA DEPARTHENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-164? EX AFP (01-05) ROBERT H FREY FREY & TILEY 5 $ HANOVER ST CARLISLE CUT ALONG THIS LINE ~ PA 17013 DATE 09-Z0-200q ESTATE OF BOLZE DATE OF DEATH 11-11-2005 FILE NUMBER 21 05-0993 COUNTY CUHBERLAND ACN 101 Amount GERALDINE E HAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 RETAIN LOWER PORTION FOR YOUR RECORDS ~ 7,580.00 (11) 20.8]4.00 (12) 105,762.00 ASSESSMENT OF TAX: 15. Amount of Line lq at Spousal rata 16. Amount of Line lq taxable at Lineal/Class A rata 17. Amount of Line lq at Sibling rata 18. Amount of Line lq taxable at CollateraZ/C1ass B ratm 19. Principal Tax Duo TAX CREDITS: PAYMENT RECEZPT DTSCOUNT (+J DATE NUHBER :]:NTEREST/PEN PA]:D (-) 02-10-200q CO0035q5 236.63 07-19-200q CD00q17q .00 ZF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDIT/ONAL INTEREST. NOTE: reflect flgures that include the total of ALL returns assessed to date. (15) .00 X O0 = .00 (16) 105,762.00 X OtiS = q,759.00 (17) .00 x 12 = .00 (18) .00 x 15 = .00 (lO)= q,759.00 AMOUNT PAID q,q96.00 26.00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REgUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE ~'/~ A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) Charitable/Governmental Bequests; Non-elected 911:5 Trusts (Schedule J) (1:5) Nat Value of Estate Sub,~oct to Tax (1~) ]:f an assess;ent ~as lssued previously, lines 1~, 15 and/or 16, 17, .00 105,762.00 18 and 19 will q,758.63 .37 .00 APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Hmld Stock/Partnership Interest (Schedule C) (:5) fi. Mortgages/Notes Receivable (Schedule D) (~) 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 DEDUCTZONS AND EXEMPTZONS: 9. Funeral Expensos/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10) 11. Total Deductions 12. Nat Value of Tax Return TAX RETURN WAS: (X) ACCEPTED AS FZLED ( RESERVATZON CONCERNZNG FUTURE ZNTEREST- SEE REVERSE 13,ZSr+. O0 ) CHANGED ~ :: ': ' .00 -~ ' i'~ )NOTE: ::To xnsure proper ~18 O0 ~credit t~your account, · O0 ~C:::~submit the upper portion 8,r896.00 of *his form wi~h your 116~762.00 ~ax paymen~. .00 .00 (8) 126,576.00 REV-I$4? EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSENENT, ~'~3~k~,~---~-~ .... :~ ........... DZSALLONANCE OF DEDUCTZONS AND ASSESSMENT ~F:TAX~ i~.~; ESTATE OF BOLZE GERALDINE E FILE NO. 21 03-0993 AC~:r* 101 DATEi~Og-z0-Z00q RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND [CR]: OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on ar before December II, 198Z -- if any futura interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Comaonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. To fulfill the requirements of Section ZI~O of the Inheritance and Estate Tax Act, Act Z3 of ZOO0. (TI P.S. Section 91qO). Detach the top portion of this Notice and submit aith your payment to the Register of Hills printed on the reverse side. --Make check or money order payable to: REGISTER OF NILLS, AGENT A refund of a tax credit, which ams not requested on the Tax Return, say be requested by completing an "Application ~or Refund of Pennsylvania Inheritance and Estate Tax" (REV-iSIS). Applications are available at the Office of the Register of Nills, any of the 25 Revenue District Offices, or by calling the special Zq-hour answering service for forms ordering: 1-800-56Z-ZOSO; services for taxpayers with special hearing and / or speaking needs: 1-800-qqT-~OZO iTT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice oust object within sixty i60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBlOgl, Harrisburg, PA 17lZS-lOZl, OR --election to have the matter determined at audit of the account of the persona[ representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should bm addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 17liB-0601 Phone i717) 787-6505. See page 5 of the booklet "Instructions far Inheritance Tax Return for a Resident Decedent" iREV-1501) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the dmcedent's death, a five percent (SI) discount of the tax paid is allowed. The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January l, 198Z bear interest at the rata of six (6Z) percent per annum calculated at a daily rate of .O0016q. All taxes which became delinquent on and a~ter January 1, 198Z will bear interest at a rate which will vary free calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19aZ through ZOOq arm: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ 2DZ .O005qB ~)"&""8-1991 llX .000301 ~ 9Z .O00gq7 198~ 162 .O00qS8 199Z 9Z .O00Zq7 ZOOZ 6Z ,00016q 198~ llg .000301 199S-199~ 72 .00019Z 2003 5Z .0001S7 1985 l~Z .000~56 1995-1998 9Z .0002q7 ZO0~ ~Z .000110 1986 lOX .00027¢ 1999 72 .000192 1987 102 .O00Z7q ZOO0 7Z .O0019Z --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINIIUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen ilS) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculatad. STATUS REPORT UNDER RULE 6.12 Name of Decedent: GERALDINE E. BOLZE Date of Death: November 11, 2003 Will No. Admin. No. 21-03-0993 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. lf 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 () No (x ). (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 Clerk of the Orphans' Court and may be attached to this report. Date: April 5, 2005 5 South Hanover Street Carlisle. Pa 17013 Address (717) 243-5838 Telephone No. ~~pac~ty: ( ) Personal Representative , ,., c. __ . . '- ( X ) Counsel for personal representative O"'i ;' J