HomeMy WebLinkAbout04-0997 PET TION FOR PROBATE and GRANT OF LETTERS
Estateqf AMOS BOSTOCK No. -~ I- ('~'c~- '~( ~'*- (~q(/ ~
also known as A~ lOS STEPHEN BOSTOCK To:
Register of Wills for the
, Deceased. Coun~ of ~D~8~R~ . in the
Social Securi~ No 2~ ~ 076788 Co~onwealth of Pennsylvania
The petition of t ~e undersigned respect~lly represents that:
Your petitioner( 0, who is/are 18 years of age or older and the execut ors named
in the last will of ti e above decedent, dated MARCH 26~ 2001
and codicil(s) date. NONE
(state relevant circumstances, e.g. renunciatiom death of executor, etc.)
Decedent was & miciled at death in COMDERLAND County, Pennsylvania, with
h is last fan fly or pnncipal residence at 4837 E. TRINDLE ROAD~ MECHANICSBURG~ HAMPDEN
TOWNSHIP~ MEI IANICSBURGI PA 17050
(list street, number and municipality)
Decedent, then )1 years of age, died 10/21/2004
at WEST SHORE 4EALTH & REHAB CENTER~ 770 POPLAR CHURCH RD.I CAMP HILL~ PA 17011
Except as follo,z s, decedent did not marry, was not divorced and did not have a child bom or adopted
after execution of ~e will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decedent at death ~ ,wned property with estimated values as follows:
(If domiciled in Pa ) All personal property $ 3651000.00
(If not domiciled irPa.) Personal property in Pennsylvania $ 0.00
(If not domiciled ir Pa.) Personal property in County $ 0.00
Value of real estate in Pennsylvania $ 0.00
situated as fbllows:
NONE
WHEREFORE, >etitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters TES'rAMENTAR¥
thereon. (testamentmy; administration c.t.a.; administration d.b.n.c.t.a.)
~' ¢ Z~, - F_~/~ylJ2~/ CAMP HILL PA 17011
~ RUTH A. I IARNES
~: §~ ~-*~*~-~/ ,~ /~ ,~.~.~ 601 MANOR ROAD
· CAMP HILL PA 17011
STEVE B. HELBERT
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF c UMBERLANO~ SS
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to ~ ae best of the knowledge and belief'of petitioner(s) and that as personal represen-
tative(s) of the abc~ e decedent petitioner(s) will well and truly)administer the estate according to law.
Sworn to or affinn~ J..s~d, subscribed
bef~o, re me this _':/T~4 dayof
rOi Register
No. ~l-(~- ~ QQ~/
Estat, of AMOS S. BOSTOCK , Deceased
D ',CREE OF PROBATE AND GRANT OF LETTERS
, in consideration of the petition on
the reverse sid hereof, satisfactory proof having been presented before me,
iT IS DECRE ) that the instrument(s) dated ,.312SI2001
d~scribed ther~ ~ be admitted to probate and filed of record as the last will of AMOS S. SOSTOCK A/K~A
AMOS STEVEN 8OSTOCK
and Letters TEa 'AMENTARY
are hereby gr~t, ,d to
RU~H A. BARNI ',S and STEVE B, HELBERT
FEES , -, MURREL a. WALTERS III
Probate, Letters Etc ......... $ ~ 24849
Short Certificat, ;( ~). ...... $ 2-~ ~')(.~ AI'TORNEY(Sup Ct ID. No)
P. sa'aaciatio=~ .~-.~(~.> .... $7 ~TC 54 EAST MAIN STREET
,T( r ' '
$ ,. PA 17055
TOTAL __ $ ;~ ADDRESS
717-697~650
Filed ...... ,~ .................
PHONE
OMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
~-.~ /~.~.- ~ ~.~pH./F ~/7~'~1~
~',~- ~ 2s. IO-~.~Oo,J 2s v~bl~i
I
i[1 anh e tament
AMOS S. BOSTOCK
I, AMO S. BOSTOCK, of Mechanicsburg, Cumberland County, Pennsylvania,
sound and disp( sing mind, memory and understanding, do hereby make, publish and declare
as and for my _asr Will and Testament, hereby revoking and making void any and all Will
Codicils at any me heretofore made by me.
ARTICLE I
I direct ~e payment of all my legal debts, and the expenses of my last illness and fur
from my Estate as soon after my death as conveniently may be done.
ARTICLE II
I direct ~ny Executor to pay all inheritance, transfer, estate and similar taxes (inclu
interest and per alties) assessed or payable by reason of my death on any property or intere ~t in i
property which i ~ included in my estate for the purpose of computing taxes. My Executor shal not
require any ben ~ficiary to reimburse my estate for taxes paid on properly passing under the rms
of this Will or ot ~erwise.
ARTICLE III
I give, levise and bequeath all the rest, residue, and remainder of my Estate of
whatsoever nat re and wheresoever situate in equal shares to the following persons and entit
Jeanette A. Weaver
William Snyder
Amos R.G. Bostock
Rowland J. Bostock
Charlotte Ann Huston
Alice Ann Winegardner
Cora M. Stock
Ruth A. Barnes
Steve B. Helbert and Patricia L. Helbert, or the survivor
Camp Hill Congregation of Jehovah Witnesses,
2 Willow Mill Road, Mechanicsburg, Pennsylvania
Should ~ny person named above not be living at the time of my death, their share
estate shall lap., e, and my residuary estate shall be divided equally among the entity and
named above Ii/lng at the time of my death.
ARTICLE IV
I name constitute and appoint RUTH A. BARNES and STEVE B. HELBERT,
Co-Executors this my Last Will and Testament. Should either one of them fail to quail'
cease to so a~ I name, constitute and appoint the other as the sole Executor to com
administration ( my estate, I direct that no fiduciary appointed herein shall be required to
bond for the fait ,ful administration of the duties required in any jurisdiction.
IN WITI~ ESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will
Testament, this ~e dayof.,.j~-~.~/L_ ,2001.
AMOS S. BOSTOCK
Signed, sealed, published and declared by the above-named Testator, as and for his Last
Will and Testam< ~nt, in the presence of us, who at his request, in his presence and in the prese ice
of each other, hs Ye hereunto subscribed our names as witnesses.
AFFIDAVIT AND ACKNOWLEDGMENT
COMMONWEA_TH OF PENNSYLVANIA
: SS:
COUNTY OF C JMBERLAND
We, AM3SS. BOSTOCK, ~ ~,udt,! ~ I !,_-h~.'~e~-- . and
"~j'c~. ,/, '-~--L.Ji.A~Q..Q~ .... the Testator and the witnes:;es,
respectively, wi' ose names are signed to the attached or foregoing instrument, being first :fuly
sworn, do heret declare to the undersigned authority that the Testator signed and execute¢ the
instrument as h Last Will and that he had signed willingly and that he executed it as his free and
voluntary act fo~ he purposes therein expressed, and that each of the witnesses, in the pres~,nce
and hearing of · he Testator, signed the Will as witness and that to the best of his/her knowl( dge
the Testator w;~s at that time eighteen years of age or older, of sound mind and unde' nc
constraint or un, lue influence.
Subscrib ed, sworn to and acknowledged before me by AMOS S. BOSTOCK, Test~ tor,
ad~d subscribed and sworn to before me by /t(/-/~ ~tL~i ~L. '~,C/-~L: ,~ and
..~;[~.F, ~'I [t'i~I~L~I l{C~ ,witnesses, this /~?~Oayof }~(~Lit(.[( ,2(01.
~,,/ ~ /
/
:140807
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: AMOS S. BOS FOCK
Date of Death: October 21, 2004
Will No. 2004-00997 Admin. No. 21 04-0997
To the Register:
I certify that notice of (beneficial intercs0 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
Name Address
Jeanette A. Weaver 135 Algonquin Street, Johnstown, PA 15904
William Snyder 429 W. Market Street, York, PA 17404
Amos R. G. Bostock 181 Hickory Drive, Salix, PA 15952
Roland G. Bostock 405 Bedford Street, Windber, PA 15963
Charlotte Ann Huston Aummnwood Personal Center, 1400 Somerset Avenue
Windber, PA 15963
Alice Ann Winegardner 1552 Corley Road, Manns Choice, PA 15550
Cora M. Stock R. 100 Hemlock Street, Windber, PA 15963
Ruth A. Barnes 3520 September Drive, Apt. 1, Camp Hill, PA 170I 1
Steve B. Helbert 601 Manor Road, Camp Hill, PA 17011
(;amp Hill Congregation
of Jehovah's Witnesses ' ~ anicsbmg,~
2 Willow Mill Park Road, Mechanicsburg, A 17050
Notice has now been given to ' ~
ail persons enutled t e o un e e 5 ) except: NONE
Date: November 8, 2004
Murrel R. Walters, III, Esquire
~ 54 East Main Street
Mechanicsburg, PA 17055
(717) 697 4650
CapaciU': __ Personal Representative
X Counsel for personal representative
REV-1162 EX(11-96)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF iNDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601 PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT NO, CD 004824
BARNES RUTH A
3520 SEPTEMBER DR. APT 1
CAMP HILL, PA 17011
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
........ fold
101 $39,410.83
ESTATE INFORMATION: SSN: 211-07-6788
:ILL NUMBER: 2104-0997
DECEDENT NAME: BOSTOCK AMOS S
)ATE OF PAYMENT: 01/11/2005
POSTMARK DATE: 01/1 1/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 10/21/2004
TOTAL AMOUNT PAID' $39,410.83
REMARKS: R A BARNES
CHECK# 1 001
INITIALS: VZ
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
REV-1500 EX + (6-00)
REV-1500
PENNSYLVANIA
DEPA.TMENTOFREVE.UE INHERITANCE TAX RETURN
DEPT. 280601
HARR.BBURG. PA17126 601 RESIDENT DECEDENT 2 t -0 4 0 ' 0 7
COUN~f CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Z BOSTOCK ,&_MOS $. 2 I I - 0 7 - 6 7 8 8
I.U DATE OF DEATH (MM-DD-Year) I DATE OF BIRTH (MM-DD-Year) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
U.I I REGISTER OF WILLS
t,~ 10/2112004 03/05/1913
III (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
~_"' [] 1. Original Return I~1 2. Supplemental Return O 3. Remainder Retum elate ofdeah pdor= 12-13-1~2)
~~-Oa::'~~LI 4. Limited Estate D 45. Future Interest Compromise (d~ of dea~ after 12-12-82) D 5. Federal Estate Tax Return Required
oo
o~,, [] 6. Decedent Died Testate (Attachcopyofwm) D 7. DecedentMaintainedaLivingTrust(AttachcopyofTrust) I 8. Total Number of Safe Deposit Boxes
< D 9. Litigation Proceeds Received D 10. Spousal Poverty Credit (da~ of de~ between 12-31-91 and 1-1-95) O 11. Election to tax under Sec. 9113(A)(^t~ach Sch O)
Z NAME COMPLETE MAILING ADDRESS
I,U
z MURREL R. INALTER$ II1~ ESQUIRE
o
FIRM NAME (If Applicable)
,,, 54 EAST M~IN STREET
0 TELEPHONE NUMBER
7t 7-697-4550 MECH~,NICSBUR~ PA t 7055
~ OFFICIAL USE ONLY
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mo~ages & Notes Revivable (Schedule D) {4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 282~54t
--0 6. Jointly Owned Property (Schedule F) (6) 41 ~283.7~:~
I- D Separate Billing Requested
7.Inter-Vivos Transfem & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
~ 8. Total Gross Assets (total Lines 1-7) (8)
I,U 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 24,t 21.43
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 5t 5.2t
11. Total Deductions (total Lines 9 & 10) (11) 24,645.64
12. Net Value of Estate (Line 8 minus Line 11) (12) 299,t 80,12
13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) 22~6t 2,93
made (Schedule J)
14. Net Value Subjeot to Tax (Line 12 minus Line 13) (14) 276,567.t9
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
,~ rate, or transfers under Sec. 9116 (a)(1.2) X (15)
B 16. Amount of Line14 taxable at lineal rate X ~ (16)
17. Amount of Line 14 taxable at sibling rate X .12 (17)
18. Amount of Line 14 taxable at collateral 276~567.19 4t
rate
X
(18)
,45S.05
19. Tax Due 4t
(19)
,45S.08
20. O ...........
I~ecede,nt's Complete Address:
STREET ADDRESS
4837 E. TRINDLE ROAD
CITY I STATE
MECHANICSBURG PA 17050
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) 41,485.08
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount 27074.25
Total Credits ( A + B + C ) (2) 2,074.25
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page I 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) 39,410.83
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) .39,4t 0.83
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a, retain the use or income of the property transferred; ........................................................................... [] []
b. retain the right to designate who shall use the property transferred or its income; ........................................ [] []
c. retain a reversionary interest; or ...................................................................................................... [] []
d. receive the promise for life of either payments, benefits or care? ............................................................. [] []
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ............................................................................................... [] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property 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 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, conect and complete.
Declar~on of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATV
ADDRESS
RI,~TH
A. BARNES 3520 SEPT~I~IB/ER DR., CAMP HILL, PA 17011
STEVE B..I'IEI.~ERT,,,.,6J~ .MA~OAD CAMP HILL PA 17011
SIGNATURE OF PREPARE~~.,R~ /~/ / D,~E
ADDRESS MURRI~L R: I~I~LTER" III ESQ t,,..
54 EAST MAIN STREET, MECHANICSBURG PA 17055
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. {}9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P,S, {}9116 (a) (1,1) (ii)].
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary,
For dates of death on or after July 1,2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. {}9116(a)(1.2)],
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P,S. {}9116(1.2) [72 P.S. {}9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P,S, {}9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption,
REV-1508 EX + (6-98)
~ SCHEDULE E
BANK
&
MISC.
COMMONWEALTH OF PENNSYLVANIA [,~JI~M! UI::I"U~I/~,
,..~.,~A.CE ~X.E?U.. PERSONAL PROPERTY
.ES,OE.T DECEDENT
ESTATE OF FILE NUMBER
BOSTOCK AMOS $, 21 04 0997
Include the proceeds of litiga~on and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. PHC BANK 93,454.83
SAVINGS ACCOUNT
2. FULTON BANK 64,t 67.98
CHECKING ACCOUNT
3. WAYPOINT BANK 54,227.83
CHECKING ACCOUNT
4. WAYPOINT BANK 69,022.94
CHECKING ACCOUNT
5 VERIZON 10.74
REFUND TELEPHONE
6 COMCAST 54.24
REFUND CABLE TELEVISION
7 COUNTRY MEADOWS 1,578.41
REFUND RESIDENTIAL CARE
8 CAPITAL SAFE STORAGE 25.00
REFUND
TOTAL (Also enter on line 5, Recapitulation) $ 282,54t.97
(If more space is needed, insert additional sheets of the same size)
NOU-22-2~)84 23: ~ PNCBRNK 4~2 768 ~458 P.01×0~
PNCBAAK
November 23, 2004
Murrel R. Walters, III
54 E, Main Street
Mechanicsburg, PA 17055-3851
RE: Estate of Amos S. Bostoek, deceased
SSN: 211-07~6788
DOD: 10/21/2004
Dear Mr. Walters:
In response to your request for Date of Death balances for the customer noted above, our
records show the following:
Savings Account
Account #5001097978
Established 04/27/1998
AMOS S BOSTOCK
DOD balance: $93,454.83 + $0.00 accrued interest
Interest Paid 1/1/2004 - 10/21/2004 - $428.16
Safe Deposit Box
#285
Established 0910312003
AMOS S BOSTOCK
Located:
EAST PENNSBORO BRANCH
29 HUNTER LANE
CAMP HrtL PA 17011
717-763-8265
Please note that this office only provides date of death balances for deposit accounts
(IRA, s, CDs, Checking and Savings accounts). We do not process any financial
transactions or provide statements. If you need assistance with any of these items,
please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
Sincerely,
Rachelle Wells
1-800-762-I 775
P7-PFSC-04-F
500 first Ave.
P'ltt=buugh p~. t$219
M ~n,nla~a- FDIC
TOTRL P.01
CAPITAL DIVISION · LANCASTERJCHESTER DIVISION
DROVERS BANK DIVISION ° GREAT VALLEY DIVISION
(717) 291-2437
November 19, 2004
Murrel R. Walters, III
54 East Main Street
Mechanicsburg, Pennsylvania 17055
Dear Mr. Walters:
RE: Amos S. Bostock, deceased October 21, 2004
In response to your recent inquiry concerning the accounts maintained in the name of
the decedent, please be advised that the following accounts were open at the date of death:
Checking # 3622-45587, open 7/7/2003, balance $64,167.98.
Ruth A. Barnes as Power of Attorney.
If you should have any further questions, please do not hesitate to contact me.
Very truly yours,
Karen D. Hilleg~~l'lb~
Credit Inquiry Processor
P O Box 4887 Lancaster, PA 17604
fultonbank.com 1-800-FULTON-4
DEC-2B-2004 14:S~ FROM:WAYPOINT 717g~g7481 T0:96979~95 p.2~2
· - WaBp inl:.
12/28/2004
MI.~LL R WALTERS Ill
54 E MA.IN ST
MECHANC1SBURG PA 17055-3851
The information which you requested on the account(s) of AMOS S BOSTOCK
(Social Security Number 211-07-67 88) idare as follows:
Aceotmt Number 1003017703 20072272
Class of Account CI-[ECKING CH~ECK1NG
Date Opened I 1.0199 071498
Principal Balance 54198.37 68985.45
Accrued Interest 29.46 37.49
Bal.cmce at Date of. 54227.83 69022.94
Death
Account Ownership SOLE SOLE
Name of Joint
Owner, if any
Date Own,r~hip 110199 071498
Was Established
Account Number
Class of Account
Date Opened
Principal Balance
Accrued Inter~t
Balance at Date of
Death
Account Ownership
Name
Owner, if,my
Date Ownersb_ip
Was Estahli~hefl
Additional
Information .
Requested
SE-DqlOR SERVICES REP.
RO. Box 171 I, HARRISBURG. PENI ISYI~aJA 17105-1711
Toll Fr~ 1-866-WAYPOINT (I-866-9E[9-7646) · IN YORK AIREA 717/B1~-4500 - www. wa~ll~ointbanlccom
REV-1509 EX + (6-98)
SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
BOSTOCK AMOS S, ~1 Q4 Q~)~)7
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A. KAY M.BOSTOCK WIFE ~;;;0 PREDECEASED ON AUGUST 9, t999 WIFE
B STEVE B. HELBERT 601 MANOR ROAD, CAMP HILL, PA 17011 NONE
JOINTLY-OWNED PROPERTY:
L~- ~ I I:R DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER, ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTERES
1. B 4/4/97 M&T BANK 79,566.30 50. 39,783.15
CHECKING ACCT
2. A 8/28/64 M&T BANK 1,500.64 100. t,500.64
CHECKING ACCT.
TOTAL (Also enter on line 6, Recapitulation) $
41,283.73
(If more space is needed, insert additional sheets of the same size)
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4349
Fax (302) 934-2955
Murrel R. Walters, III November22, 2004
Attorney At Law
54 East Main Street
Meehaniesburg, PA 17055-3851
Re: Estate of: Amos B. Bostock
Social Securi~: 211-07-6788
Date of Death: October 21, 2004
Dear Sir or Madam:
Per your inquiry dated November 4, 2004, please be advised flint at the time of death, the above-named decedent had on
deposit with this bank the following:
1. Type of Account Checking Account
Account Number 16659635
Ownership (Names o.19 Amos S Bostock, Kay M Bostoc~ Joint Owners
Ruth A Barnes, Stephen B Helbert, POA 's
Opening Date 8/28/64 Closed 11/8/04
Balance on Date of Death $1,500.60
Accrued Interest $ O. 04
Total '--~-]~3-0-~-87t .....................................................................................
2. Type of Account Checking Account
Account Number 98120204
Ownership (Names oo0 Amos S Bostock, Kay M Bostock, Joint Owners
Stephen B Helbert, Joint Owners
Ruth A Barnes, POA
Opening Date 4/4/97 Closed 11/8/04
Balance on Date of Death $79,528.92
Accruedlnterest $ 3Z38
Total '-'-$~-9-~-8-~-3-0- ............................................................
Please be advised, there was no safe deposit box found for the above decedent. For further account information,
regarding ownership, closures and/or reimbursement of funds, etc., please call the West Shore Plaza Office # 717-
255-2271.
Sincerely,
Nancy Clagett
Records Maaagement
REV-1511 EX + (12-99)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN
RESIDENT DECEDENT ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
BOSTOCK AMO,~ $. 21 Q4 Q997
Debts of decedent must be reported on Schedule !.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. W. ORVILLE KIMMEL FUNERAL HOME, INC. 1,028.63
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) RUTH A. BARNES 5,760.00
Social Security Number(s)/EIN Number of Personal Representative(s) 184-20-7968
Street Address 3520 SEPTEMBER DRIVE~ APT, 1
City CAMP HILL State PA Zip 17011
Year(s) Commission Paid: 2005
2. Attorney Fees MURREL R. WALTERS III, ESQ. 10,650.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees REGISTER OF WILLS
CUMBERLAND COUNTY 385.00
5. Accountant's Fees AL WHITCOMB P.A. 495.00
6. Tax Return Preparer's Fees
7. PNC BANK CHECK PRINTING 48.80
TOTAL (Also enter on line 9, Recapitulation) $
24,127.43
(If more space is needed, insert additional sheets of the same size)
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
BOSTOCK AMOS S. 21 04 0997
Decedent's Name Page 1 File Number
Schedule H - Funeral Expenses & Administrative Costs - B1
ITEM
NUMBER DESCRIPTION AMOUNT
B. ADMINISTRATIVE COSTS:
Personal Representative's Commissions
2. Name of Personal Representative (s) STEVE B. HELBERT 5,760.00
Social Secudty Number(s)/EIN Number of Personal Representative(s) 192-30-1857
Street Address 601 MANOR ROAD
City CAMP HILL State PA Zip 17011
Year(s) Commission Paid: 2005
SUBTOTAL SCHEDULE H-BI 5,750.00
REV-1512 EX + (6-98)
SCHEDULE I
COMMONWEALTH OF PENNSYLVANIA DEBTS OFDECEDENT,
INHERITANCE TAX RETURN
RES,DE.TOECEDENT MORTGAGE LIABILITIES~ & LIENS
ESTATE OF FILE NUMBER
BOSTOCK AMOS $. 21 04 0997
Include unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. WEST SHORE EMS-BLS 80.24
2. WEST SHORE HEALTH & REHAB 54.97
3. PENNSYLVANIA STATE EMPLOYEES 383.00
RETIREMENT
TOTAL (Also enter on line 10, Recapitulation) $
518.21
(If more space is needed, insert additional sheets of the same size)
REV-1513 EX + (9-nm
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
BOSTO( K AMQ,~ $. 21 04 0~7
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
TAXABLE DISTRIBUTIONS [includeoutdghtspousaldistJ'ibutions, and tmnsfers under
Sec. 9116 (a) (1.2)]
1. JEANNE'IrE A. WEAVER NIECE 10%
t 35 ALGONQUIN STREET
JOHNSTOWN, PA 15904
2. WILLIAM SNYDER NEPHEW 10%
429 W. MARKET STREET
YORK, PA 17404
3. AMOS R.G. BOSTOCK NEPHEW 10%
181 HICKORY DRIVE
SALIX, PA 15952
4. ROWLAND J. BOSTOCK NEPHEW 10%
405 BEDFORD STREET
WINDBER, PA 15963
5. CHARLOTTE ANN HUSTON NIECE 10%
C/O CHARLENE KISER, 5500 DARK SHADE DRIVE
CAIRNBROOK, PA t 5924
6. ALICE ANN WINEGARDNER NIECE 10%
1552 CORLEY ROAD
MANNS CHOICE, PA 15550-7245
7. CORA M. STOCK SISTER-IN-LAW 10%
R. 100 HEMLOCK STREET
WINDBER, PA t5963-2514
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
[[. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1. CAMP HILL CONGREGATION OF JEHOVAH'S WITNESSES 22,612.93
2 WILLOW MILL PARK ROAD
MECHANICSBURG. PA 17050
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 22,612.93
(If more space is needed, insert additional sheets of the same size)
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
BOSTOCK AMOS S. 21 04 0997
Decedent's Name Page 3 File Number
Schedule J - Beneficiaries I
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
! TAXABLE DISTRIBUTIONS (include outdght spousal distributions)
8. RUTH A. BARNES NONE t0%
3520 SEPTEMBER DRIVE, APT..1
CAMP HILL, PA 1701'1
9. STEVE B. HELBERT and PATRICIA L. HELBERT NONE '10%
60'1 MANOR ROAD
CAMP HILL, PA '170'1'1
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX Z806Dl
HARRISBURG PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
MURREL R WALTERS III ESQ
54 E MAIN ST
MECHANICSBURG PA 17055
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
03-28-2005
BOSTOCK
10-21-2004
21 04-0997
CUMBERLAND
101
Allount Relli tted
'*
REV-1547 EX AFP (03-05)
AMOS
S
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 ~
IIIV-"Ml;"Yf.m.m~'U!,.wtm.W.UIIMAW~M.m.lWltlmflWt'~.-r.:tw~AtY.a'rl'.............. ...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BOSTOCK AMOS S FILE NO. 21 04-0997 ACN 101 DATE 03-28-2005
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ~ returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. A.ount of Line 14 taxable at Lineal/Class A rate (16)
17. AIlount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CR T:
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Hortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
282.541.97
41, 283.79
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequestsj Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
24,127.43
518.21
(11)
(12)
(13)
(14)
NOTE:
.00
.00
.00
276,567.19
X ,09 -
xO~=
X 12_'~'t-~
X 15?l~T:
119l):F.,;
NOTE: To insure proper
credit to your account,
sublli t the upper portion
of this forll with your
tax paYllent.
323,825.76
24.645 64
299,180.12
22,612.93
276,567.19
f~"',J'
{.~,:::~} .0,0
j:~~,\"~
_ ~ 0'0',
:-:: . (UI'
-41 , 485. 08:
~i, 485; O:S,'
DATE
01-11-2005
NUHBER
CD004824
+
INTEREST/PEN PAID (-)
2,074.25
AHOUNT PAID
39,410.83
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
\>"[--!
41,485.08
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
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.) ,
q..~
PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY
UNTIL COMPLETION
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
AMOS S. BOSTOCK
10/21/2004
Estate No.:
21-04-0997
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court rules, I report the following with
respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes_X_ No
2. If the answer is No, state when the personal representative reasonably believes that the
administration will be complete
(date)
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: (Not Applicable in Dauphin County)
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' Cour 'l1d may be
attached to this report.
Date: September 2, 2005
co. t~d (~- ~~
'j MURREL. W ALTERS, III, ESQUIRE
54 East Main Street
Mechanicsburg, P A 17055
717-697-4650
Capacity:
Personal Representative
_X_ Counsel for Personal Representative
&