HomeMy WebLinkAbout04-0766 REGISTER OF V(II,LS OF ...~~ ............ COUNTY
No. 21 - O4 -
PETITION FOR PROBATE OF WILL AND LETTERS OF ADMINISTRATION CUM TESTAMENTO ANNEXO ~
C7'
in the Estate of ROBERT E. DOWD deceased. ~-~
SgNi......T5 9.z2.4.:zffg i.9 .............................
Petitioner {:~) ......07~]~.~..~.,... ~W~&~ ~ ......................................................................................
allege(s) that:
o
1. PctitionerCq ~ twenty-one years of age or older and applies for ~etters of ~ministration
............... .G....¢..,./~..? ........................................................... in the above capRoned estate.
2. Decedent died on ....... ~L. Li.~...~J:.~....~.Q.(~ ................................ at .................. M. in the County of
· .Q~J~.,gEt~ ................. State of ......~3.Y.~.~ .......... at the age of ............ 7.~ .......... years, having
made ....... ~1,~. Last xA ~ and Testament dated thc ..~.3.~}!.. day of ....~.13 ...................... A.D.' 19.?.~..
\Vherein 2- ............... appointed ................................................................................................................ Exec ..............
Which Exec ................ has since ......................................................................................................................................
OR
On ................ day of ...~qgJ~.[ .......................... ¥0.~Q.Q4Letters of Administration were granted to ..................
..... 4~.~...~.,....~q~ ~...~...!~,....~f~...~..~...2/.~.[ ~.~). ...................................
d4om.
3. Letters of Administration e.t.a, are needed bec t se ~.]:5~..Z.%...~ ~...~.]...~.G~...~&..~zld
..... 8QiJ~..:~.t..~c~.!'....ff..~.?....~....D..~7.~?...~.t..~:q~a ~petitioner(,~ ~;~;i~es in ....... ]3.e.17. ....... capacity
heirs, renounced
...................................................................... .~.~..~ole heir of Decedent.
Pennsylvania .~
4. Decedent died domiciled in .................a. ...................................... w~m his last family or principal
(state or country)
residence at ..~...N.~t3~'~S.-..C.?.@~.~q-~h...~qg.~,~...P45......?/9.8~ .....................................................................
5. (Where decedent died testate) Decedent was not married and a child was not born to or
adopted by decedent after execution of the will '"-" ._.t_ ...... ~ ........ .L__~ ....... , __ · ·
d; ..... d f ...... l~t, lk,..; ,,ft~ ....... tit,.'~rf Mil ,.d ~,t death.
6. The said decedent was possessed of Goods, Chattels, Rights and Credits to the estimated
valne of $...~.O.O.t..C).O.O..,.Q.O.. and of Real Estate, to the estimated value of $ .............. 77.Q~ .......... as near as
can be ascertained. That the said Real Estate in so far ;is known is located in .I~./.~ ..............................
7. (Where decedent died intestate as to any portion of this estate). Petitioner after a proper
search has ascertained that decedent was survived by the following-named persons entitled to distribution
under the Intestate Act of 1947:
Name Relationship Residence
i..~.~Kg..j~.`..J2~..~.~*...~...2:...~QD`..27".~.7~...~:~L~.~p....R...Q.9~.t...~~.L~. 26104
~ .13.Q.4=..~ 2.~r3.~.fi.~ ......................................................................................................................................................
~ .....(.22 Z)....fi 92=7782 ...................................................................................................................................................
~ .IZ~21....22fir7~.Q ......................................................................................................................................................
Therefore, petitioner(s) respectfully applies for (probate of the will presented herewith and
for) citers of tdministration .~.¢.~.~.~ ............. ~7;x
ated: ........ 23' ?jS'i i ...................
· ....................
Address:
1'5·''N~'§ ' ' C~ g'~'i~';' ' ' l~l~ I'a'}'" PA
17025
· ~ . .~ , ' PENNSYLVANIA
(,OMMON~~. EALq H OF ~,~,,,T.~v.~ SS
................................................................................................ the petitioner(s)
~e~kE~.[..P.~....~.~9.~4~ ................................................................................................
in the above application, being duly .....~ ........ according to law say(s) that the statements set forth
and belief .
in this petition are true to thc ,)est of he~ knowh'd~e / [ . ~ ;~.~_d
c .,.Z:.~ .............. t ............... :.-
..... ~Q.~ ............... and subscribed betore ~e~ife~ D. S~weztzer
mc&U~ ................................................ ~..20.0A ........................................................................................
GXen~ Famer Stras~uqh ........................................................................................
~ C'~' ~t.~ L¢~~ ........ ~'~'"~"g~Over Street
~' ~ ~ ~ ~ ~ff~'~ ..................................
~ ~ ......... ~-k~t'e';'"~a ...........
OATH OF PERSONAL REPRESENTATIVE
coMMONWEALTH OF PENNSYLVANIA ss:
cOUNTY OF cUMBERLAND
· r ..................................... petitioner(s)
Jennifer D. Schweztze ........................
being du~y swo~n ......... according to law doq-s. ......... depose and say that as the
administra LX~.~4 ........ of the estate of ....~Q..b~...~;....~.,..D~ ..........................................
deceased . .~b.e.. ............ will well and truly administer the goods and chattels, rights and credits of said
deceased, according to law. And also will diligently comply with the provisions of the law relating
to Transfer Inheritances.
.......... .S..w..O....~Z.. ......................... and subscribed
oeiore me. .. o004 ' , ~4,~ ~,"-tc r '. . ................... ~ ................................
.............................. '"
~ ~..CZ.'..:?..k~.::~'.~t..w'~'':'~' ...................... :'"' ~-~-cflJ. ,q ~ da F e Stria ~ ,,
~ . ....... day ............. :. '~' ....................... ,
Be it remei~bered that on the ........................ --. :
Letters of Administration in the estate of .......................................................... ~"i ..............................
....................................... . ........................ late of ....................................................................................
rland County, Pennsylvania,';' ~deceased, were granted to .................... ~~ .........................
Cumbe '-- ........... ~ ...................
Witness my hand and official seal the davY'-and year aforesaid.
..................................................................... ........
,Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NO~lvr
the reverse side hereof, satisfactory proof having been presented before me,
iT iS DECREED that the instrament(s) dated_ ~d ~i~ ~
described th.-rein be admitted to probate aad filed of record as the last will
and Letters _ ~/11 ~' ' -' ' '
are hereby granted to ~4[ F~ 0 ~kk'~ T Z~_
~, in consideration of the petition on
FEES
Short Certificates(W) .......... $__l{) .('Ci
$ lC,
Renunciation ........ 7' ' ~ .... 77
TOTAL S~ C C'
Filed ...................................
AFfORNEY(Sup, Ct, I.D No.)
ADDRESS
PHONE
UL 2.
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS ~
CERTIFICATE OF DEATH
Robert E. Dowd {~ale13.159 -- 24 --8819
Earl Dowd I~g. Jennie Sutton
Jennifer D. Schweitzer I~. 15 Natures Crossinqf Enola~ PA 17025
OATH OF SUBSC?.!B!NG WITNESS
, Deceased
(each) a subscribing wimess to the will/codicil presented herewith, (each) being duly qualified
that ._.~,/,~2__ sic, ned as a x~ imess at the request of the testate'( _ in h /5.,~presence
and (in the presence of each other) (in the presence of the other subscribing wimess(es).
(Name)
(Address/Y: .
Swom to or affirmed ~a.?d subscribed
Before me this i l~ da.y pf
/~II:~,~_~T ,20 0t
(Name)
(Address)
OATH OF NON-SUBSCRIBING WITNESS
No.
~Deceased
(each) a subscriber hereto (each) being duly qualified ac, oording to law, depose(s) and say(s) that
_ ~c4/b~familiar with the signature of_ L) ~'- ~/~-"%~f~ ,testat of
(one of the subscribing witnesses to) the codicil/will presented herewith and that believes
the signature on the codicil/will is in the handwriting of :~'q~A~~-'' ~bv=F/
ro the bes .~f. ~. knowledge and belie£
Address)
Sworn to or affirmed .apd subscribed
Before me this ~ day of
For the Register ' '4. jf~n/'j (_./, '
(Name)
-- (Address)
RENUNCIATION
In Re Estate of
Robert E. Dowd
deceased.
To the Register of Wills of
Cumberland
County, Pennsylvania.
The undersigned Robe_re_ R. Black~ Esqu_ ire of
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
of Administrationt c.t.a.
be issued to Jennifer D. Schweitzer
WITNESS his
hand this 28th day of July ,xlgr 2004.
(Signature)
Robert R. Black, Esquire
60 Conway Street
Carlisle, PA 17013
(717) 243-9829
(Address)
(Signature)
(Address)
(Signature)
(Address)
RENUNCIATION
In Re Estate of Robert E. Dowd
deceased.
To the Register of Wills of Curab~rl&nd
County, Pennsyh'ania.
The undersigned Robert E. Dowd, Jr. and Diane D. Beidel of
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
of Administration, c.t.a.
be issued to Jennifer D. Schweitzer
WITNESS their hand this 28th day of July ,:~) 2004
/ '' t~gnature) Rob~t E. Dowd, Jr.
(Signature)
(Address)
b (Signature)
Diane D; B~ldel
60 Parsonag~ Street
Newvii le, PA 17241
(717) 776-70~ddress)
LAST WILL AND TEST&\~NT
OF
ROBERT E. DO~q3
I, ROBERT E. DOWD, of the Borough of Carlisle, Ctm~berland County,
Permsylva~lia, declare this to be my Last Will and revoke any Will previously
made by me.
ITEM I: I direct that all just debts and funeral expenses, includ-
ing my grave marker, shall be paid from the assets of my estate as soon as prac-
ticable after my decease.
ITEM II: I devise and bequeath the residue of my estate, of every
nature an~ wherever situate, to my wife, b~IRGERY B. DOI~q), providing she shall
survive me by thirty (30) days.
ITEM III: Should my wife, }4argery B. 9owd, predecease me or die on
or before the l~rtieth day following my death, I devise and bequeath the resi-
due of my estate, of eve~7 nature and wherever situate? to my children provided
that the share of any child who predeceases me or dies on or before the thirtie~
day following my death shall be distributed to his or her issue, per stirpes,
living on the thirty-first day following my death and in default of any such
then living issue, such share shall be added to the share or shares for my other
children.
ITEM IV: I direct that all taxes that may be assessed in conse-
quence o~th, of whatever nature and by whatever jurisdiction imposed,
shall be paid from my residuary estate as a part of the expense of the a~ninis
tration of my estate.
IT~X{ V: I appoint Ctnnberland County National Bank of Carlisle,
Pennsylvania, .guardian of any property which passes to a rnis~or and with respect
to which I am authorized to appoint a guardian and have not otherwise specifi-
cally done so. Said guardian shall have the power to use principal as well as
income from time to time for the minor's education, support and welfare without
regard to his or her parent's ability to provide for such education, support
and welfare, or to make payment for these purposes without further responsibilit~
to the minor or to the minor's parent, or to any person taking care of such mino~.
ITEM VI: I appoint my wife, Margery B. Dowd, Executrix of this my
Last Will. S~-t]ld my wife, b2rgery B. nowd, fail to qualify or cease to act as
Executor, then I appoint my brother-in-law, Robert R. Black, Executor of this
my Last Will and Testament.
ITEM VII: I direct that my personal representative or guardian shall
not be req~re~o give bond for faithful performance of their duties in any
jurisdiction.
IN WITNESS ~,~blEKEOF, I have hereunto set my hand this ay of
/{/,~7iZ~Ii , 1975.
Robert E. Do~d
The preceding instrument, consisting of this one typewritten page,
identified by the signature of the Testator, was on the day and date thereof
signed, published and declared by Robert E. Dowd, the Testator herein nmned, as
and for his Last Will and Testament, in the presence of us, ~4~o, at his request,
in his presence rmd in the presence of each other, have subscribed our hanes as
witnesses thereto.
CERTIFICATION OF NOTICE UNDER RULE 5.6 (cl
Name of Decedent:
Date of Death:
Will No.:
To the Register:
Robert E. Dowd
July 21, 2004
21-04-0766
I certify that notice of 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
on2
Nam~ Address
Robert E. Dowd, Jr.
Jennifer D. Schweitzer
Diane D. Beidel
978 Winding Heights Road, Parkersburg, WV
15 Natures Crossing, Enola, PA 17025
60 Parsonage Street, Newville, PA 17241
26104
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None.
Date:
Roben~K ~lack, Esquire
36 South Hanover Street
Carlisle, Pennsylvania 17013
Telephone (717) 243-3727
Capacity: Personal Representative
X Counsel for Personal Representative
G~': Oili £2 d3S ~0.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENTOFREVENUE
BUREAU OSINDIVlDUAL TAXES
OEPT 280801
RARRISBURG, PA 17128 0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11 96)
NO. CD 004488
BLACK ROBERT R
36 S HANOVER STREET
CARLISLE, PA 17013
ESTATE INFORMATION: SSN: 159-24-8819
FILE NUMBER: 2104-0766
DECEDENT NAME: DOWD ROBERT E
DATE OF PAYMENT: 1 O/13/2004
POSTMARK DATE: 09/13/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 07/21/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $9,700.00
REMARKS:
SEAL
CHECK# 101
TOTAL AMOUNT PAID:
$9,700.00
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
Glenda Farner Strasbaugh
Register of Wills
and
Clerk of Orphans' Court
Marjorie A. Wevodau
First Deputy
Kirk S. Sohonage, Esq
Solicitor
Register of Wills and Clerk of the Orphans' Court
County of Cumberland
One Courthouse Square
Carlisle, PA 17013
(717) 240-6345
FAX (717)240-7797
INVOICE
Bill To:
ROBERT R BLACK
36 SOUTH HANOVER ST
InvoiceNo:
Invoice Date:
Estate of:
Estate No:
221
2/15/2005
ROBERT E DOWD
21-2004-0766
vz
CARLISLE, PA 17013
Qty
1
Fee Description
Additional Probate
Fee Total
35.00 $35.00
Total:
$35.00
Checks should be made payable to the Register of Wills. Terms: Net 30.
Please return one copy of this invoice with your payment. Thank you.
~.
REV-1500EX+~
*' CQMMONWEALTHOF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0001
DECEDENT'S NAME (lAST, ARST, AND MIDDLE INmAl)
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DOWD ROBERT E.
DATE OF DEATH (MtMlO-Yea-)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAl.. USE ONlY
FIlE NUMBER
2 1 -0 4 0 7 6 6
""COiiilvCOiiE -YEAR- - - NUMiiER- -
~SECURITYNUMBER
DATE OF BIRTH (MM-DD-Yea-)
1 59- 2 4 - 8 8 1 9
THIS RETURN MUST BE FLED IN DUPlICATE WITH THE
REGISTER OF WILLS
07/21/2004 05/19/1925
(IF APPliCABLE) SURVMNG SPOUSE'S NAME (LAST, ARST, AND MIDDLE INITiAl)
....
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(XJ 1. ~inal Return
o 4. Limited Estate
(XJ 6. Decedent Died Testate (Allach Cll\lY of WI)
o 9. Litigation Proceeds Received
THIS SECTION MUST BE
NAME
Robert R. Black E uire
FIRM NAME (If Applicable)
Landis & Black
TELEPHONE NUMBER
717-243-3727
o 2. Supplemental Return
o 4a. Future Interest Compromise (daEofdealll aIler 12-12-82)
o 7. Decedent Maintained a Living Trust (AllachCll\lYofTrusl)
o 10. Spousal Poverty Credit (daEofdealll beIween 12-31-91 and 1-1-95)
SOCIAl SECURITY NUMBER
o 3. Remainder Return (daEofdealllpriorlD12-13-82)
o 5. Federal Estate Tax Return Required
Q.. 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (AlIach Scb 0)
. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
COMPLETE MAILING ADDRESS
Landis & Black
36 South Hanover Street
Carlisle
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or SoIe-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposils & MisoeIIaneous Personal Property (5)
(Schedule E)
6. JoinUy Owned Property (Schedule F) (6)
o Separate Billing Requested
7. Inter-VIVOS Transfers & MISCellaneous Non-Probale Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debls 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 Bequeslst'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)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPlICABlE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at Hneal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable atcoUatelal rate
19. Tax Due
X _(15)
269,709.58 X _045 (16)
""
X .12
X .15 (18)
119\
PA 17013
OFFICIAL USE ONLY
245,878.02,
33,000.00
(8)
8,487.31
681.13
(11)
(12)
(13)
(14)
(17)
l.....}
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278,878.02
9.168.44
269,709.58
269,709.58
12,136.93
12,136.93
Decedent's Complete Ad ress:
STREET ADDRESS 15 Natures Crossing
CITY I STATE I ZIP
Enola PA 17025
d
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
12,136.93
9.700.00
510.52
Total Credits (A +B +C)
(2)
10,210.52
3. Interest/Penalty if applicable
D. Interest
E. Penalty
T otallnterest/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. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
0.00
1,926.41
1,926.41
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; ........................................................................... 0 00
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 00
c. retain a reversionary interest; or ...................................................................................................... 0 00
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 00
2. If death occurred after December 12,1982. did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................. 00 0
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... 0 00
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
ADDRESS
PA
2:
Robert R. Black, Esquire
36 South Hanover Street. Carlisle
PA 17013
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 exemQt 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)].
REV;'508 EX '*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DOWD ROBERT E.
FILE NUMBER
21 04
Include the proceeds of litigation and the date the proceeds were received by the estate.
AU pIOperty jolntly~ with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
Orrstown Bank, checking account 106001849. See attached letter
Principle - $42,098.52
Interest - $1.15
Orrstown Bank, sole investment account 50 00 0769 070. See attached letter.
Principle - $191,123.58
Interest - $122.47
1999 Ford stationwagon, VIN ZFMZA5143XBA28608. See
attached title and Kelley Blue Book value.
2.
3.
4.
Personal property. See attached appraisal report.
5.
American Legion, death benefits.
6.
Failor-Wagner Post 421, death benefits.
7.
BP Corp., retirement benefits.
8.
State Farm, insurance refund.
9.
PEB Trust Fund, retirement benefits.
10.
New York Life Insurance Co., policy No. 41 899 056, whole life insurance - $21,562.33.
See attached letter.
0766
VALUE AT DATE
OF DEATH
42,099.67
191,246.05
5,540.00
5,567.00
100.00
100.00
130.68
40.86
1,053.76
0.00
TOTAL (Also enter on line 5, Recapitulation) $
245878.02
""'(-1510 EX_.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DOWD. ROBERT E.
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER
21 04
0766
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV -1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY
ITEM INClUDE THE NAME OF THE TRANSFEREE. THEIR R8.Al1ONSHIPTO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER. ATTACH A CC1i'Y OF THE DEED FOR REAl ESTATE. VALUE OF ASSET INTEREST (IF Al'l'UCASlE) VALUE
1. Robert E. Dowd, Jr. 11,000.00 100. 11,000.00
Son, July 12, 2004
2. Jennifer D. Schweitzer 11,000.00 100. 11,000.00
Daughter, July 12, 2004
3. Diane D. Seidel 11,000.00 100. 11,000.00
Daughter, July 12, 2004
TOTM,/AlSoentermilne7 Recaoltulation\ S
3~ 000.00
REV;"" EX '('.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DOWD. ROBERT E.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule L
FILE NUMBER
21 04
0766
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Jennifer Schweitzer, reimbursement for food. 105.19
2. Jennifer Schweitzer, reimbursement for food. 180.61
3. Wayne Noss, flowers. 80.56
4. Hoffman-Roth Funeral Home, expenses 315.00
B. ADMINISTRATIVE COSTS:
1. ~ffiOO~~~~s~m~ioos
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of PeIsonaI Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. AlIomey Fees Landis & Black 2,500.00
3. Family Exemption: (If decedenfs address is not the same as claimants, allach explanation) 3,500.00
Claimant Jennifer Schweitzer
SlreetAddress 15 Natures CrossinQ
City Enola State P A Zip 17025
Relationship of Claimant to Decedent DauQhter
4. Probate Fees Landis & Black, advanced to date 456.95
5. Accountanfs Fees
6. Tax Return Preparel's Fees
7. Ibis Appraisal Services, real estate appraisal. 210.00
8. Social Security Administration, return unearned benefits. 823.00
9. Orrstown Bank, charge. 16.00
10. Reserve for closing and filing Releases. 300.00
TOTAL (Also enter on line 9, Recapitulation) $ 8.487.31
,..t_~.___ ~..__.!. ____.1....1 ~.___...... _...I..l1!.!._._' .L._". .....i.. ___u_ _~__\
RE\'1512 EX +"(6-98)
*'
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
DOWD. ROBERT E.
FILE NUMBER
21 04
0766
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. West Shore EMS, ambulance services.
VALUE AT DATE
OF DEATH
558.93
2. George Shahiman, M.D., invoice.
100.00
3. Burick Associates, invoice.
15.24
4, EKG Association, invoice.
6.96
TOTAL (Also enter on line 10, Recapitulation) $
(If Il10Ie space is needed, insert additional shee1s of 1he same size)
681.13
LAST WILL AND 'lESTAMBNT
OF
ROBERI' E. lXJ'lD
I, ROBERI' E. OOWD, of the Borough of Carlisle, a.unberland County,
Pennsylvania, declare this to be my Last Will and revoke any Will previously
made by me..
r:rnM I: I direct that all just debts and ftmera1 expenses, inchxl-
ing my grave marker, shall be paid from the assets of my estate as soon as prac-
ticable after my decease.
r:rnM II: I devise and bequeath the residue of my estate, of every
nature and wherever situate, to my wife, MARGERY B. OOWD, providing she shall
survive me by thirty (30) days. .
r:rnM III: Should my wife, Margery B. Doltd, predecease me or die on
or before the thirtieth day following my death, I devise and bequeath the resi-
due of my estate, of every nature and wherever situate, to my children provided
that the share of any child who predeceases me or dies on or before the thirti
day following my death shall be distributed to his or her issue, per stirpes,
living on the thirty-first day following my death and in default of any such
then living issue, such share shall be added to the share or shares for my other
children.
r:rnM.IV: I direct that all taxes that may be assessed in conse-
quence of my death, of whatever nature and by whatever jurisdiction imposed,
shall be paid from my residuary estate as a part of the expense of the adminis-
tration of my estate.
r:rnM V: I appoint Cumberland County National Bank of Carlisle,
Pennsylvania, guardian of any property which passes to a minor and with respect
to which I am authorized to appoint a guardian and have not otherwise specifi-
cally done so. Said guardian shall have the power to use principal as well as
income from time to time for the minor's education, support and welfare without
regard to his or her parent's ability to provide for such education, support
and welfare, or to make payment for these purposes without further responsibilit
to the minor or to the minor's parent, or to any person taking care of such mino .
ITEM VI: I appoint my wife, Margery B. Doltd, Executrix of this my
Last Will. Should my wife, Margery B. Dmd, fail to qualify or cease to act as
Executor, then I appoint my brother-in-law, Robert R. Black, Executor of this
my Last Will and Testament.
ITEM VII: I direct that my personal representative or guardian shall
not be reqlured to give bond for faithful performance of their duties in any
jurisdiction.
I ~ P,
IN WI1Nf.SS l\flERIDF, I have hereunto set my band this j' day of
(111)1'2(/1 ,1975.
fl>cl1!f JJ~t1.UzJ (SEAL)
Ro rt E. Do
The preCeding instn.unent. consisting of this one typewritten page,
LAW OFFlCES identified by the signature of the Testator, was on the day and date thereof
LANI)IUBLACK signed, published and declared by Robert E. Doltd, the Testator herein named, as
CARLtSLa. ",,",""'LYANIA and for his Last Will and Testament, in the presence of us, Wlo, at his request,
in his presence and in the presence of each other, have subscribed OUT names as
witnesses thereto.
(2.~'t,J (l f3it~F~
~~~
~
ORRSTOWN BANK
TO: Law Offices
Landis & Black
36 South Hanover Street
Carlisle, PA 17013
FROM: ORRSTOWN BANK
P.O. BOX 250
SHIPPENSBURG PA 17257-0250
RE: ESTATE OF Robert E Dowd DECEASED
DATE OF DEATH: July 21,2004
IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE
FOLLOWING ACCOUNTS WITH ORRSTOWN BANK:
(1) CHECKING ACCOUNTS
DATE OF DEATH
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST
106001849 RobertEDowd 12/18/00 42,098.52 1.15
SAVINGS ACCOUNT
DATE OF DEATH
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST
(3) CERTIFICATES OF DEPOSIT
DATE OF DEATH
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPLE & ACCRUED INTEREST
9/23/04 By Timothea Customer Service Operator
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PennsylvaQia · July 26, 2804
1998 Ford Windstar LX Minivan
~.~ ~_;-:-l - ',~ l' 'I
~Ft' .
~....:i
~......'J__;:~ '
"'~lJ
engine: V6 3.8 Uter
Tmns: Automatic
DrIve: Front Wheel Drive
.......= 20,000
Equipment
Second Sliding Door Power Windows
7 Passenger Power Door Locks
Air ConditIoning Tilt Wheel
Power Steering Cruise Control
AM/FM Stereo
Cassette
Dual Front Air Bags
ABS (4-Wheel)
Conslll1*' Rat8d Condition: Good
-Good" condition means that the vehicle is free of any major defects.
The paint, body and interior have only minor (if any) blemishes. and
there are no major mechanical problems. In states where rust Is a
problem, this should be very minimal, and a deduction should be
made to correct it. The tires match and have substantial tread wear
left:. A dean Is assumed. A "good" vehicle will need some
reconditioning to be sold at retail; however major reconditioning
should be deducted from the value. Most recent model cars owned by
consumers fall Into this category.
Tracle__ Value $6.640
Trade-in value represents what you might expect to receive from a
dealer for this consumer owned vehide. Keep in mind that the
dealer must then absorb the cost of making the vehlde ready for
sale, advertising, sales commissions, arranging financing and
insurance and standing behind the vehicle for any mechanical or
safety problems.
BLUE OVAL ~
CERTIFIED 'IIi
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..
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t Run A CARE
~ Record Check- No'
j.
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http://www.kbb.comIkblki.dllIk:w.kc.ur?kbb.P A;078018;P A041 &1702S;+t&39;Ford; 19990/'02... 7 fl6/04
-~ -.,."---,,,"-
APPRAISAL REPORT
OF
PERSONAL PROPERTY
OF
Robert E. Dowd.. deceased
date of death (d.o.d.) July 21,2004
15 Nature's Crossing
Mechanicsburg, P A 17050
for:
Jenni Schweitzer.. executrix
15 Nature's Crossing
Mechanicsburg, P A 17050
AS OF:
d.o.d. July 21,2004
Reported on August 11, 2004
BY:
ffiIS APPRAISAL
SERVICES
145 N lfanover Sf.
P'Q Box ~4
Carlisle,PAI70V
(717) ~4j-:J474
lax ~{}5(9
!hisas@eartlJmk.nei
APPRAISAL SUMMARY
It is in my opinion, that as of d.o.d. July 21, 2004, the Fair Market Value of the personal
property of Robert E. Dowd, deceased:
(Five Thousand Five Hundred Sixty Seven Dollars and Zero Cents)
($5,567.00)
IBIS APPRAISAL
SERVICES
d
The report must be read in its entiretv. The Appraisal Summa", ONLY is
not the appraisal report
4
$1,120.00
$1,935.00
$250.00
$256.00
$175.00
$145.00
$186.00
$1,500.00
TOTAL
$5,567.00
13
APPRAISAL CERTIFICATE
I hereby certify that, upon the request for the estate appraisal of the personal property of
Robert E. Dowd, deceased, 15 Nature's Crossing Mechanicsburg, PA 17050, I have
personally and physically inspected the listed personal property. The personal property
was appraised to determine the FAIR MARKET VALUE, AS OF d.o.d. July 21,2004 &
reported on August 11,2004. The date of inspection was August 3, 2004.
The information and values contained in this report are based upon my experience as an
appraiser and other reliable sources. The personal property was found to be in GOOD to
EXCELLENT condition, unless otherwise noted. Values are reported piece-by-piece,
and/or as a whole. All values reported have been determined with consideration to the
condition of the item, market conditions, and salability factors.
IBIS APPRAISAL
"SERVICES
3
'III
UUlD1TTIU
NEW YORK LFE
PO Box 6916
Cleveland, OH 44101-191&
www.newyorklfe.com
New York Life Insurance Company
Annual Policy Summary
7JIe ~ YGvICetlpl!l
......
Policyowner
AgentlRepresentative
1...111...111.....1.1.1.1....1111....1..1..11....11.1.1....111
ROBERT E DOWD
15 NATURES XING
ENOLA, PA 17025-1043
JAMES D DAY
(717) 232-2555
DATE PREPARED: MAY 13, 2004
00lI
This annual summary highlights the financial activity for your policy during the period from May 14, 2003
to May 13, 2004. If you have questions, please contact your New York Ufe Agent listed above or one
of our Cu;rtomer Service Representatives at 1-800-695-9873.'
Coverage
life Insurance
Death Benefit
Policy
Cash Value It
DivIdend
SUmmary -
Insured:
PolIcy Number:
Policy Plan:
Base Plan Death Benefit:
Policy Date:
Premiums are Paid To:
Annual Premium:
Total Death Benefit on May 13, 2004:
(See Page 2 for details.)
Net Cash Value on May 13, 2004:
(See Page 2 for details.)
2004 DIVIDEND on May 13, 2004:
(See Page 2 for details.)
ROBERT E DOWD
41899056
Whole life Insurance
$15,913
May 13, 1985
May 13, 2005
$85&.00
$21,562.33
$12,742.93
$529.08
During the past policy year, your base plan's cash value increased $397.83 from $7,701.89
to $8,099.72. In addition to this increase, your _nual dividend was $529.08.
The NUMBER ONE cause of problems in processing daims is inaccurate or invalid beneficiary
designations - Call your Agent TODAY to review yours.
Important infonnalon for policies with loans: If you have a pofley loan and your policy lapses
or you surrender it and the amount of the loan plus the cash surrender value is more than the
sum of premiums paid, you will generally be Hable for taxes on the excess. Such amount will be
taxed as ordinary income.
For poI"lCJ Information -.d online service, please visit us at --> www.l18WJOI.Idife.colnlvsc
Please refer to the Definition of Terms and other Infonnatton on the reverse side of page 2-
. Any gain In the poley may be 8UbjeaI II) taxaIon If It ill aunencIer8d or Iapeea prior II) the death at the lnaured.
- DivIdenda are not guaranteed. Therefore, the dividend Oftldited to your policy mar be diIfer8nt than the divIdenda originally 1Iuatra18d.
IMPORTANT POLICYOWNER NonCE: To ablain an updafllld policy .U8Irdon baaed on ourcummt dividend ecaIe contaet your
agenf(.). Ramen", plIUr policy ill a valuable ...... If IIOINICIn8 ...... that you cancel or NpIace it, yau ahouId Immediately contaet
- aaRIII(a\..... .m- or _ at aur CUIdamer SeMoe Rearee&ntaIvea at 1-8000695-9873.
SAlOIS
SHUFF, FLOWER
& LINDSAY
A'JTORNEYStAT-LAW
26 W. High SIr..t
Carlisle. PA
IN RE:ESTATE OF ROBERT
E. DOWD.
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHANS' COURT DIVISION
: NO. 21-2004-0766
NOTICE OF CLAIM
TO THE CLERK OF THE ORPHANS' COURT:
Notice of claim by creditor, Pursuant to the Probate, Estates and
Fiduciaries Code, 20 Pa.C.SA S3532(b)(2).
1.
Claimant's Name:
Gerald L. and Barbara L. Fowler
2.
Claimant's Address:
245 Conway Street, Carlisle, PA 17013
3. Creditor listed below is the owner and holder of a claim in the amount 0
$11,299.50.
4. The facts upon which this claim is based: By Deed dated March 31, 2003,
Robert E. Dowd conveyed 245 Conway Street, Carlisle, Pennsylvania, t
Gerald L. Fowler and Barbara L. Fowler. As part of the negotiation for said
transaction, Robert E. Dowd completed a Seller's Property Disclosur
Statement concerning 245 Conway Street, Carlisle, Pennsylvania, in which h
asserted at paragraph 8(d) that the property was connected to the public sewer,
as required by law. The Fowlers learned in the process of making modification
to the property that they were not connected to the public sewer, and in order t
come into compliance with the Borough Ordinances, have made such
connection.
5.
Decedent's address:
Jennifer D. Schweitzer, Executrix
c/o Robert E. Black, Esquire
36 South Hanover Street, Carlisle, PA
("')
. :::J
-',')
,
o
;.'-~
-,
1rW13
C",
c:;
o;;,.n
6.
Date of Death:
July 21,2004
7.
The claim arose in early 2005.
on
'j -0
8.
That the claim is unsecured.
_,;,'c.
r;~)
o
'>~
SAIDlS
SHUFF. FLOWER
& LINDSAY
A'I1'ORNEYS-AT-UW
26 W. High Street
Carlisi., PA
We do solemnly declare and affirm under the penalties of perjury that th
information and representations made herein are true and correct to the best of ou
knowledge, information and belief.
Dated: May /1t::1- ,2005
JiJJg.~
Gerald L Fowler
~~~ D.....
Barbara L. Fowler
Written notice of claim was given to the Personal Representative and/or her counsel
as stated below:
Jennifer D. Schweitzer, Executrix, c/o Robert R. Black, Esquire
36 South Hanover Street, Carlisle, PA 17013
Date notice mailed: May
11
,2005
JOHN E. SLIKE
ROBERT C SAlDIS
GEOFFREY S. SHUFF
JAMES D. FLOWER, JR.
CAROL). LINDSAY
BRIAN C. CAFFREY
GEORGE F. DOUGLAS, III
MATTHEW j. ESHELMANt
THOMAS E. FWWER
LINDSAY GINGRICH MACLAY
JACLYN M. SMI11-I
LAW OFFICES
SAIDIS, SHUFF, FLOWER & LINDSAY
A PROFESSIONAL CORPORATION
26 WEST HIGH STREET
CARLISLE, PENNSYLVANIA 17013
TELEPHONE: (717) 243-6222 - FACSIMILE: (717) 243-6486
EMAIL: attorney@ssfl-law.com
www.ssfl-Iaw.com
CAMP HILL OFFICE:
2109 MARKEr STREET
CAMP HILL, P A 11701
TELEPHONE, (717) 737-3405
FACSIMILE: (717) 737-:3407
tBoard Certified Creditors'
Rights Representation
REPLY TO CARLISLE
May 19, 2005
Jennifer D. Schweitzer, Executrix
of the Estate of Robert E. Dowd
clo Robert R. Black, Esquire
36 South Hanover Street
Carlisle, PA 17013
IN RE: ESTATE OF ROBERT D. DOWD
PROBATE NO. 21-2004-0766
CLAIMANT: GERALD L. & BARBARA L. FOWLER
AMOUNT OF DEBT: $11,299.50
Dear Bob:
Enclosed please find a copy of the Creditor's Claim for the above referenced Estate. The
original has been filed in the office of the Clerk of the Orphans' Court, of the Cumberland
County Court House, One Courthouse Square, Carlisle, PA 17013
If you have any questions please call to discuss them with me.
Very truly yours,
SAJDI~l~WER & LINDSAY
Ja~D. Flower, Jr.
JDFJr:mjm
Enclosure
cc: Clerk of the Orphans' Court, Cumberland County Court House___
Gerald L. Fowler and Barbara L. Fowler
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EXI11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SCHWEITZER JENNIFER 0
15 NATURES CROSSING
ENOLA, PA 17025
__hn__ fold
ESTATE INFORMATION: SSN: 159-24-8819
FilE NUMBER: 2104-0766
DECEDENT NAME: DOWD ROBERT E
DATE OF PAYMENT: 05/18/2005
POSTMARK DATE: 05/18/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 07/21/2004
NO. CD 005340
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,935.11
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK#106
SEAL
INITIALS: CCP
RECEIVED BY:
REGISTER OF WILLS
$1,935.11
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
BUREAU OF INDIVlDU~"I';.)l\\~=:i
INHERITANCE TAX DIVISIOH--'-"--~'- -,-'---~-.-'
PO BDX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERIT ANeE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
2D:J5MAYIG PI; :44
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-09-2005
DOWD
07-21-2004
21 04-0766
CUMBERLAND
101
AllOUl1t R..Utad
CLEEK OF
~~:~~~ ~,f~~~i?:~Tp!\
36 S HANOVER ST
CARLISLE PA 7013
*'
REV-lS47 EX AFP (03-05)
ROBERT
E
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS ...
/ttV-"MI:,.'ft.m.m~~1am .!Ir.!MMA'r1"~M!r.m.lWllTftMMf~."ttt'll\l'~M!r.llTr.............. ...
DIS LLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF DOWD ROBERT E FILE NO. 21 04-0766 ACN 101 DATE 05-09-2005
I~ an assessmen~ was issued previouslY, lines 14, 15 and/or 1&, 17, 18 and
r~lect ~igures h~ include ~he ~otal ~ ALL r~urns assessed to d~e.
ASSESSMENT OF TAX:
l~. Aaount of Line l~ .t
16. AIIount of Li.... 1'1 t.
17. Aaount of Li.... 1'1 at
lB. ,,",ount of Li.... 1'1 tax
19. Principal Tax Due
T .
TAX RETURN WAS: I X) ACCEPTED AS FILED
I ) CHANGED
RESERVATION CONCERNING FU E INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN ASED ON: ORIGINAL RETURN
1. R..l Esteta ISchodula A
Z. Stocks and Bonds I , la B)
3. Closely Held Stock/Pert ...ship Interest (Schedule C)
4. Mortgages/Notes Race!" 1. (Schedule D)
S. Cash/B.nk Oeposiis/Hisc P.rsonal Property (Schedule E)
6. Jointly Owned Property Schedula F)
7. Transfers (Schedule G)
8. Total Assets
(1)
IZ)
13>
1'1>
(5)
16>
17>
.00
.00
.00
.00
245.878.02
.00
33,000.00
IB>
APPROVED DEDUCTIONS AND E EMPTIONS:
9. Funeral ExP8nses/Ada. sts/Hisc. Expenses (Schedule Hl
10. Oabts/Kortgaga Llabl1l ias/Liens ISchedula I>
11. Total OBductions
12. Net Value of Tax Re urn
13. Charitabl./Gov.r~ tal Bequests; Non-.l.ct~ 9113 Trusts
1ft. Net Value of Estate Subject to Tax
(9)
(10)
8,487.31
681.13
Ill>
I1Z>
(13)
11'1>
ISchedula J>
NOTE:
pousal rat.
Ie .t Lineal/Class A rat.
Ibling rat.
Ie at Collateral/Class Brat.
115>
116>
117J
(IB>
.00 X
269,709.58 X
.00 X
.00 X
00 =
045 =
12 =
IS =
NUllBER
CD0044 8
INTEREST/PEN PAlO 1-)
510.53
AMOUNT PAID
9,700.00
DATE
09-13-2004
~
INTEREST IS CHARGED THR
AT THE RATES APPLICABL
REVERSE SIDE OF THIS F
UGH 05-24-2005
AS OUTLINED ON THE
M
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTE: To insure proper
credit to your 8cCOuntl
su~lt the upper portion
of this for. with your
tax pay...,t.
278,878.02
9 . 1 68 46
269,709.58
.00
269,709.58
19 w:i.ll
119>=
.00
12,136.93
.00
.00
12,136.93
10,210.53
1,926.40
8.71
1,935.11
. IF PAID AFTER OATE lHOICA EO, SEE REVERSE
FOR CALCULATION OF ADOITI L INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTEO AS A "CREDIT" (CR>, YDU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORK FOR INSTRUCTIONS.)
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
REV-1607 EX AFP (03-05)
00
~o
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-13-2005
DOWD
07-21-2004
21 04-0766
CUMBERLAND
101
AIIount H..1 tted
ROBERT
E
ROBERT RO BLACK
LANDIS & BLACK
36 S HANOVER ST
CARLISLE
ESQ
PA 17013
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your 8ccount, sub.it the upper portion of this form with your tax pay.ent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
................................................................................................................
REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT KKK
ESTATE OF DOWD
ROBERT
E FILE NO.21 04-0766
ACN 101
DATE 06-13-2005
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-09-2005
PRINCIPAL TAX DUE: 12,136.93
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-13-2004 CD004488 510.53 9,700.00
05-18-2005 CD005340 7.13- 1,935.11
TOTAL TAX CREDIT 12,138.51
BALANCE OF TAX DUE 1. 58CR
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE 1.58CR
.
~
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
-
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
NameOfDeC~entJ.60t.e-( ~ Qol/JO
Date OfDeath:~! Z-J/.zootf
Estate No.: 'Z/-tJ'-f ,-01 (p,b
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 D?1. No 0
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes 0 No m
b. The separate Orphans' Court No. (ifany) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties in
interest? Yes rs No 0
Date:
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report. f7 .a /J ^ & A.
3111-z0~ U '-1J1'VU j1~
Signature
r0i7tR-r f<. /?urU::::
Name
. l .
3~ ~ #,ftJIl ~ (( $7
Adc1ressCI1(lL{SLf: I fit. (11113
"/~~ ~- ,,1,'1
Telephone No.
. .. C(apacity~ WersonaI Representative
" " lA Counsel for personal representative
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