HomeMy WebLinkAbout95-0216~~_q~~c~a~~
This is to certify that the certificate hereunto attached is a true and accurate copy of the original
death record on file with the Division of Vital Records, and that Frank Yeropoli, whose name is
subscribed thereto, was at the time of subscribing the same and now is Director, Division of Vital
Records of the Department of Health, for the Commonwealth of Pennsylvania, duly appointed
and commissioned as directed by Act 66 of the General Assembly, approved 29 June 1953, P.L.
304.
AUG 16 200 ? .
Date Fran eropoli, ' ect
Division of Vital Records
P.O. Box 1528
New Castle, PA 16103
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INHERITANCE AX RETURN
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RESIDENT DECEDENT
COMMONWEALTH OF PENNSYLVANIA (TO BE FILED IN DUPLICATE
DEPARTMENT OF REVENUE
DEPT. zeobol WITH REGISTER OF WILLS)
HARRISBURG, PA 17128-0601
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tZU SOCIAL SECURITY MBER
162-12-5957
W
O QF ArPLICARLEI SURVIVING s-OU,
~] 1. Original Return
^ 4. Limited Estate
FOR DATES Of DEATH AFTER 14!31!91 CHECK HER'.
IF A sPOUSaL
POVERTY CREDIT IS CLAIMED. ^
FILE NUMBER
21 95 0216
YEAR NUMBEI
1127 Rana Villa Avenue
DATE OF DEATH DATE OF BIRTH '(,aj[Q Hill, PA 17011
8/20/ 1/25/05 co~~
(LAST, FIRST AND MIDDLE INIiIAI) SOCIAL SECURITY NUMBER AMOUNT RECEIVED (SEE- INSTRUCTIONS)
Decedent Died Testate
(Attach copy of Will)
^ 2. Supplemental Return
^ 4a. Future Interest Compromise
(for dates of death after 12-12-82)
^ 7. Decedent Maintained a Living Trust
(AHach copy of Trust)
~TIAL T~uc~rrFaRMAT10N s~ouLa BE
Ralph H. Wright, Jr. , Eyq,
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages and Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
b. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G) (Schedule L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses, Administrative Costs, Miscellaneous
Expenses (schedule H)
10. Debts, Mortgage Liabilities, Liens (Schedule I)
1 1. Total Deductions (total Lines 9 8, 10)
12. Net Value of Estate (line 8 minus Line 11)
13. Charitable and Governmental Bequests (Schedule J)
14. Net Value Subject to Tax (Line 12 minus line 13)
15. Spousal Transfers (for dates of death after b-30-94)
See Instructions for Applicable Percentage on Reverse
Side. (Include values from Schedule K or Schedule M.)
16. Amount of Line 14 taxable at b% rate
(Include values from Schedule K or Schedule M.)
17. Amount of Line 14 taxable at 15% rote
(Include values from Schedule K or Schedule M.)
18. Principal tax due (Add tax from Lines 15, lb and 17.)
19. Credits Spousal Poverty Credit Prior Payments
C/O Johnsen Duffie, Stewart & Weidner
301 Macke St.,~ O. Box 109
Lemoyne, PA 170 -109 ..; _._. ?7
64,784.00 /~' ' - '` --
(1) -
12) ~ _ -,
(3) ~ --
(5) 6,229.03 J
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(b) 2,263.65 - ~,
(7) r.- C~
(9) __ 8.088 20 /, (B )
73,276.68
(lo) 1,025.52
l t) 9,113.72
(lz) 64 162.96
(13) -0-
(14) 64,162.96
(16) _ 64,162 96 .ob 3,8 9.78
(18) __ 3,849 78
Discount Interest
!0. If Line 19 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT. (20)
'1. If Line 18 is greater than Line 19, enter the difference online 21. This is the TAX DUE. (Y1) 3,849.78
A. Enter the interest on the balance due on Line 21A. _ _
B. Enter tha total of line 21 and 21A on Line 218. This is the BALANCE DUE. (41 g) _ 3, 849.78
Make Check Payable to: Register of Wills, Agent
~ ~ BE SURE TO ANSWER ALL Ct'UEST10N5 ON REVERSE SIDE AND TO RECHECK MATH ~ ~
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. I declare that all real estate has been reported at true market value. Declaration of preparer other than the personal representative is
based on all information of which preparer has any knowledge.
SIG ATURE OF PERS' RE;PONSI LE FOR FILI~R URN ADDRESS
;- 1127 Rana Villa Ave . DATE
~' s//~/ss
A R E DDRESS
301 Miirket St. , P. O. Box 109 DATE
Ral H. Wrigh , Jr. - ,
^ 3. Remainder Return
(for dates of death prior to 12-13-82
^ 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes.
Act #48 of 1994 provides for the reduction of the tax rates imposed on the net value of transfers to or for
the use of the spouse. The rates as prescribed by the statute will be:
• 3% (.03) will be applicable for estates of decedents dying on or after 7/1/94 and before 1/1/96
• 2% (.02) will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97
• 1% (.O1) will be applicable for estates of decedents dying on or after 1/1/97 and before 1/1/98
• Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (r) IN THE APPROPRIATE BLOCKS.
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred, ..... ..................................................
b. retain the right to designate who shall use the property transferred or its income, ...............
c. retain a reversionary interest; or ...................................................................................
d. receive the promise for life of either payments, benefits or care?
2. If death occurred on or before December 12, 1982, did decedent within two years preceding
death transfer property without receiving adequate consideration? If death occurred after
December 12, 1982, did decedent transfer property within one year of death without receiving
adequate consideration? ...................................................................................................
3. Did decedent own an 'in trust for' bank account at his or her death?.........._ ...........................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
LAST WILL AND TESTAMENT
I, RHODA ALMEDA BOSTWICK, of Lower Allen Township, Cumberland
County, Pennsylvania, being of sound and disposing mind and memory,.
do hereby make, publish and declare this to be my Last Will and
Testament, hereby revoking any and all former Wills or Codicils by
me made .
1. I direct that all my just debts, funeral expenses,
testamentary expenses and all inheritance taxes (whether such taxes
may be payable by my estate or by any recipient of any property)
shall be paid from my residuary estate as soon as practicable after
my decease and as part of the administration of my estate. My
Executor shall have no duty or obligation to obtain reimbursement
for any. such tax so paid, even though on proceeds of insurance or
other property not passing under this Will.
2. I give, devise and bequeath all of my estate, both real
and personal property, unto my daughter, JACQUELINE FAYE EBERLY,
absolutely, and I hereby appoint my said daughter, JACQUELINE FAYE
EBERLY, as Executrix of my estate.
3. I direct that my Executrix shall not be required to
file a bond to secure the faithful performance of her duties in any
jurisdiction.
4. I authorize and empower my personal representative, in
her sole and absolute discretion, to purchase or otherwise acquire
and retain any investments of which I die seized or any real or
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Page 1 of 3 Pages
personal property of any nature; to sell, lease, pledge, mortgage,
transfer, exchange, dispose of or grant options in regard to any or
all property of any kind forming a part of my estate for such terms
and such prices as they may deem advisable; to borrow money for any
purposes connected with the protection and preservation of my
estate; to mortgage or pledge any real or personal property forming
a part of my estate or to join in or secure the partition of same;
to compromise any claims or demands of my estate against others or
of others against my estate; to make distribution in kind and to
ca u s e any share to be composed of cash, property or undivided
fractional shares in property different in kind from any other
share; and to execute and deliver such instruments as may be
necessary to carry out any of these powers .
IN WITNESS WHEREOF I have hereunto set my hand and seal this
~3 i G~ day of ~`--~~,--,' ~ , 19 91 .
~i ~,~
~,-- ~;
Rhoda lmeda' ostwick l /~SEAL~
SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named
Testatrix, as and for her Last Will and Testament, in the presence
of us, who at her request, have hereunto subscribed our names as
witnesses thereto, in the presence of the said Testatrix and of
each other.
~/
Page 2 of 3 Pages
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
I, Rhoda Almeda Bostwick, Testatrix, whose name is signed to
the attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and executed
the instrument as my Last Will; that I signed it willingly; and
that I signed it as my free and voluntary act for the purposes
therein expressed.
R~ ~ u l! r.,,a.~~rr~~ .~ ~ ~,i t~~ ,~ ;
dda Almeda Bostwick '
Sworn or affirmed to and acknowledged before me~by Rhoda
Almeda Bostwick, the Testatrix, this ~T3:-~Lday of Hf~i/i 1991.
l
Notary Public
Ncta•~:.s~ jai
COMMONWEALTH OF PENNSYLVANIA ) Casino L. ~.t~ers, ~!otar~ P•iblic
S S Car!as~a 3c7o, C~:.^s'yesfac?d Co~rr?ty
COUNTY OF CUr'iBERLAND t": Cam?+nmis~s~~s~ Exr:+zc~ t:tzy 27, l:i~t
We , S~ ~~~/) ~i~ ~ . /J~G~C%I"7'j Cc,~ ~G( S' i< r ~~.h ~~ , C/~ e~ e f'~
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and
say that we :vere present and saw Rhoda Almeda Bostwick, the
Testatrix, sign and execute the instrument as her Last Will; that
the Testatrix signed willingly and that the Testatrix executed it
as her free and voluntary act for the purposes therein expressed;
that each of us, in the hearing and sight of the Testatrix, signed
the Will as witnesses; and that to the best of our knowledge the
Testatrix was at that time 18 or more years of age, of sound mind
and under no constraint or undue influence.
Sworn or affirmed to and subscribed before me this a~.3'''~day of
~j~>r-% / 19 91 .
~~7iS~- • -; ,~ i
r.~~ .
Notary Public
Page 3 of 3 Pages hc;2r;~; ~"~---
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' REV•~,~02 a+ (12.85)
SCHEDULE A
CDMMONWEAIiH Of PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF BOSTWICK, RHODA A. a/k/a FILE NUMBER
BOS'Iin1ICK, RHODA ALNiF.DA 21-95-0216
(Property jointly-owned with Right of Survivorship must be disclosed on Schedule F) All real estate should be reported at fair market value
which is defined as the price at which property would be exchanged between o willing buyer and a willing seller, neither being compelled
to buy or sell,- both having reasonable knowledge of the relevant facts.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
OF DEATH
1.
Real Estate - No. 1127 Rana Villa Avenue, Township
of Lower Allen, Cumberland County,
Pennsylvania.
(Rana Villa Spring Terrace -Lot 66)
(Deed Book "F", Volume 35, Page 670)
Cumberland County Assessed Value - 4,860.00
Cumberland County Common Level
Ratio Factor X 13.33
I
Date of Death Value I $ 64,784.00
TOTAL (Also enter on line 1, Recapitulation) ~_-
(If more space is needed, insert additional sheets of same size_1 S 64,784.00
REV-9508 EXi IZ.e71~
4. ` ~°~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
-----.... w, ~~,
BOS'IWICK, RHODA ALMEDA
(All property jointly-owned with the Right of Survivorship must be disclosed on Schedule F)
ITEM
NUMBER DESCRIPTION
1• Household Goods -old and worn
2. PNC Bank, N.A. -Checking Account No. 51-4000-5842
Date of death balance
Please Print or Type
ILE NUMBER
21-95-0216
VALUE AT
DATE OF DEATH
$ 350.00
5,879.03
TOTAL (Also enter on line 5, Recapitulation) $ 6 29.03
(Attoch additional BIRi" x 11" sheets if more spoce is needed.)
COMMONWEALTH OF PENNSYLVANIA
I~FiERITANCE TAX RETURN
RESIDENT DECEDENT
STATE ~F
Joint tersnf(s):
BOSZia7ICK, RHODA A. a/k/a
BOSTWICK, RHODA ALMEDA
FILE NUMBER
21-95-n~iti
NAME
A• Jacqueline F. Eberly
B
e.
Jointly-orvnrsd property:
ITEM LFORR DATE
NUMBE JOINT MADE
TENANT JOINT
1 • ~ A ~ 5/81
ADDRESS
1127 Rana Villa Avenue
Camp Hill, PA 17011
DESCRIPTION OF PROPERTY
Harris Savings Bank
Savings Account No.
05-00090227 -Date of
death balance, plus accrued
interest.
~~
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SCHEDULE F
JOINTLY-OWNED PROPERTY
RELATIONSHIP TO DECEDENT
Daughter
TOTAL VALUE I DFCD'S I DOLLAR VALUE OF
OF ASSET % INT. DECEDENT'S INTEREST
4, 527.30 50$
2,263.65
TOTAL (Also enter on line 6 Recapitulation) $ r 263 65
(If more space rs needed insert oddrfronal sheets of same size)
,:
REV-1511 E7~ + 1881 ~~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
tCTATr /h
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Please Print or
BOS'IWICK, RHODA A. a/k/a
BOSTWICK, RHODA ALMEDA
ITEM
NUM Bit DESCRIPTION
A• Funeral Expenses:
~- George P. Garman Funeral Home, Inc. -funeral expense;
2 • Gingrich Memorials -Marker & Installation
B.
2.
3.
4.
C.
1
2
3
4.
5.
6.
7.
8.
21-95-0216
AMOUNT
3,028.75
1,248.00
Administrative Costs:
Personal Representative Commissions
Social Security Number of Personal Representative: _
Year Commissions paid
Attorney Fees -Johnson, Duffle, Stewart & Weidner
Family Exemption
Claimant Jaco'ueline Faye E_berlyRelotionship _ Daughter
Address of Claimant at decedent's death
Street Address 1127 Rana Villa Avenue
City Camp Hill ,
State PA Zip Code 17011
Probate Fees -Register of Wills -Cumberland County
Miscellaneous Expenses:
Cumberland law Journal -advertise letters
The Patriot-News Co. -advertise letters
Register of Wills -file Inventory-and Inheritance Tax Return
Reserve for close-out costs
1,500.00
2,000.00
141.00
40.00
55.45
25.00
50.00
TOTAL (Also enter on line 9, Recapitulation) $ 8,088.20
(If more space is needed, insert additional sheets of same size.)
. .
COM,I~N~,yEAITM OF VENN$YLVANIA
NHER ITANCE TAX RETURN
RESIDENT DECEDENT
BOSTWICK, RHODA A. a/k/a
z1F~i~~P[57Tnu DLTl1ilT TT l.mr~
ITEM
NUMBE
1.
2.
3.
4.
5.
6.
7.
8.
9.
'R DESCRIPTION
The A. Z. Ritzman Associates, Inc. - decedent's account
balance not covered by insurance
Susquehanna. Surgeons, Ltd. - decedent's account balance
not covered by insurance
John M. Sullivan, M.D. - decedent's account balance
not covered by insurance
Connor-Rich-Kearney-Torchia Associates - decedent's account
balance not covered by insurance
Bell Atlantic - decedent's account
Pennsylvania American Water Co. - decedent's account
UGI Gas Service - decedent's account
Pennsylvania Power & Light Co. - decedent's account
Mary Ann Prior, Treasurer - 1994 School District Real
Estate Taxes billed 7/1/94.
634.00
TOTAL (Also enter on line 10, Recapitulation) S i n~c ~•,
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
Please Print or Type
NUMBER
21-95-0216
AMOUNT
18.51
137.66
31.86
36.28
67.41
24.34
15.96
59.50
(ff more space is needed, insert additional sheets of some size.) -, v`! • ~`
REY.15"~'%. ii~61~ ~
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COhnONwEA1TF Jf RENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE C7F BOSZWICK, RHODA A. a/k/a
BOS~IICK, RHODA AI~iEDA
fTEM
NUMBER NAME AND ADDRESS OF BENEFICIARY
A. Taxable Bequests:
~' Jacqueline Faye Eberly
1127 Rana Villa Ave.
Camp Hill, PA 17011
ITEM
NUMBER NAME AND ADDRESS OF BENEFICIARY
B. Charitable and Governmental Bequests:
1.
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21-95-0216
RELATIONSHIP AMOUNT OR
SHARE OF ESTATE
Daughter
Entire Estate,
both real and
personal
property,
AMOUNT OR
SHARE OF ESTATE
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13 Recapitulation) I $
(If more space Ls needed, insert additional sheets of same size)