HomeMy WebLinkAbout11-18-13 (2) J �� 1505610105
l;
REV-1500 EX(02-11)(Fq'l�
PA Department of Revenue Pennsylvania OFFICIAL USE ONLY
Bureau of Individual Taxes INHERITANCE County Code Year File Number
PD BOX rg,2806oi 1 i - I O
Harrisburg,PA t7tz8-0601 RESIDENT DECEDENT ` o_/)
ENTER DECEDENT INFORMATION BELOW
07/1212013 12/2411925
Decedent's Last Name Suffix Decedent's First Name
MI
Bowers Dorothy
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
C1111D 1.Original Return O 2.Supplemental Return O 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4.Limited Estate O 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
(31D 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9. Litigation Proceeds Received O 10.Spousal Poverty Credit(Date of Death O 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED,ALL CORRESPONDENCE AND CONFIDENTIAL TA%INFORMATION SHOUL4$E DIRECTEMO:
Name Dayl�a Telephone 6iumberm M
R. Scott Cramer (71A 824-5700c 62 o
7E� Y R OF IWItLS 116H r�p'Ly
M 00
First Line of Address 7C O rl
Tj
P.O. Box 159 ° 3 Zz -^I = a
Second Line of Address H� M
t-
'9 � CIT � O
City or Post Office Stale ZIP Code DATE FILED
Duncannon PA 17020
Correspondent's e-mail address:
Under penaities 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.Declaration of preparer other than the personal representative is based on It information Of which preparer has any knowledge.
SIG , E OF PER ON R PONSIBL F R FILING RETURN
ATE
ADDRESS /�
it
AP l7rIP. C Rrn /�/// �Nf zo`
SIGNATU REP R�TFi R A REPRESENTATIVE
f(7 DATE
ADORE _
PLEASE USE ORIGINAL FORM ONLY
Side 1
L 1505610105 1
1505610105
J 1505610205
REV-1500 EX(Fl)
Decedent's Name: Dorothy Bowers
RECAPITULATION - -
1. Real Estate(Schedule A). . _.... ....... ..... . ............. ... .... .... 1.
2. Stocks and Bonds(Schedule B) .................. ....... ..... .. . ..... . 2.
20,869.34
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) .... . 3.
4. Mortgages and Notes Receivable(Schedule D). ...... ............ . .... . .. 4.
5. Cash,Bank Deposits and Miscellaneous Personal Properly(Schedule E)... ... . 5.
5,294.80
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) C7 Separate Billing Requested..... ... 7.
8. Total Gross Assets(total Lines 1 through 7)..... . . .... .....
6. 26,164.14
9. Funeral Expenses and Administrative Costs(Schedule H). .....
9. 15,127.57
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1).. . 10.
11. Total Deductions(total Lines 9 and 10)..- -- .
11 15,127.57
12. Net Value of Estate(Line 8 minus Line 11) ......... ... ..... . .. ..... .....
12 11,036.57
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) ............. ........ ... 13.
14. Net Value Subject to Tax(Line 12 minus Line 13) ....... ....
14. 11,036.57
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 15
(a)(1.2)X.0_
16. Amount of Line 14 taxable 11,036.57 16. 496.65
at lineal rate X.0 45
17. Amount of Line 14 taxable
at sibling rate X.12 17. .
18. Amount of Line 14 taxable
of collateral rate X.15
18.
19. TAX DUE ... . . . .......... ....... . .. ..... . ........ ... . . .. ..... ... .. 19.
496.65
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT C�
Side 2
1505610205 1505610205 J
REV-1500 EX(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Dorothy Bowers
STREET ADDRESS
4502 Hampden Ave.
N STATE ZIP
GI
PA 17011
Camp Hill
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 496.65
2. Credits/Payments
A.Pnor Payments
B.Discount
Total Credits(A+B) (2)
3. Interest (3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2,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)
496.65
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 or the property transferred.......................................................................................... ❑ E
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ N
c. retain a reversionary interest .............................................................................................................................. ❑ 0
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ a
2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................................. El
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.
For dates of death on or after July 1,1994,and before Jan.1,1995,the lax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[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 far 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 21 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 percent[72 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[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 percent[72 P.S.§9116(a)(1.3)].A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
SCHEDULE B
STOCKS AND BONDS
Estate of Dorothy Bowers No. 2013-00824
1. Annuity
Jackson National Life Insurance Company
I Corporate Way
Lansing,MI 48909
Policy No.0058966450 $ 20,869.34
TOTAL(Also enter on line 2 Recapitulation)__$ 20,869.34
(if more space is needed insert additional sheers of same size.)
SCHEDULE E
CASH,BANK DEPOSITS AND MISCELLANEOUS
PERSONAL PROPERTY
Estate of Dorothy Bowers No. 2013-00824
All property jointly-owned with Right of Survivorshi must be disclosed on Schedule F.
ITEM DESCRIPTION VALUE AT DATE
NUMBER OF DEATH
1. Bank Accounts
Sovereign Bank
P.O.Box 841005
Boston,MA 02284
Money Market #0571138349 $ 8,863.87 g 4,439.89
DOD accrued interest $ 15.90
6oinl account with son,Harold Bowers)
M&T Bank
499 Mitchell Road
Millsboro,DE 19966
Checking Account# 16802519 $ 1,709.77 $ 854.91
DOD accrued interest $ 0.04
(joint account with son,Harold Bowers)
TOTAL S 5,294.80
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATNE COSTS
Estate of Dorothy Bowers No. 2013-00824
Debts of decedent must be reported on Schedule I
ITUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
Trefz&Bower Funeral Home $ 9,382.57
B. ADM[NISTRATIVE COSTS:
I. Personal Representative's Commission -
2.
Name of Personal Representative(s) -
Social Security Number(s)/EIN Number of Personal Representative(s)
Address:
2. ATTORNEY FEES - R. Scott Cramer $ 2,245.00
3. FAMILY EXEMPTION:(If decedent's address is not the same as claimam's,attach explanation)
Claimant -Harold D. Bower
Street Address - 4502 Hampden Ave.
City - Camp Hill State PA zip- 17011
Relationship of Claimant to Decedent -Son $ 3,500.00
TOTAL(Also entcr on line 9 Recapitulation) _ $ 15.127.57
JACKS � N`
NATIONAL LIFE INSURANCE COMPANY
October 30, 2013
R SCOTT CRAMER
5 SOUTH MARKER ST
PO BOX 17020
DUNCANNON PA 17020
Policy. Number(s): 0058966450_.
Insured Name: Dorothy Bowers
Dear R Scott Cramer:
Please accept our condolences on the loss of Dorothy Bowers. We want you to know that we are
available for any questions you may have.
Per your request, the value as of 7/12/13 was $20,869.34.
Your service needs are very important to us. If you have additional questions or concerns, please
contact our Service Center at (888) 565-4995, Monday through Thursday, 8:00 a.m. to 7:00 p.m. and
Friday 8:00 a.m. to 6:00 p.m. (ET). You may also contact Jackson via email through "Contact Us" on
our website at www.jackson.com.
Sincerely,
Toni Klus,
AVP, Claims Administration
Jackson Service Center
I Corporate Way, Lansing MI 48951
Toll Free Number: 800-777-7779
Email at CustomerCare @jackson.com; Our W'ehsite is www jackson.com
LOPEZML/CLBLK
80/13 M&T Bank/Dorothy Bothers-Inbox-Yahoo! Mail
n;:rci e'.atl �naah:keb josephwcr.-. Profile � Go Sign Out Home
Contacts Switch to the newest Yahoo!Mail _ -
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Car Rental
Inbox(4) M&T Bank I Dorothy Bowers
Drafts prom: "Nicrone Jennifer'<jnicmne @mtb.com>
Sent To: 'Josephwcramer @yahoo.com-<josephwcmmer @yahoo.com> t
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Hi Joseph, -.
My Folders [Edit] Here is the information you hate requested...
Joint checking account 16802519
reports(193)
Date of death balance:$1709.77 there wasn't any accrued interest ! -
Date Harold D Bowers was added to the account:5.13.2004 S t
$.04 was accrued interest from January 2013 through date of death }
Please let me know if there is any other information you need.
Thank you,
Jan t
Jennifer Nicrone
Relationship Banker III I M&T Bank iiii _ p
Harrisburg Main Branch
717 255 2070(P)1 717 237 6853(F)
JNicroneO.mtb.com
This;email*may*contain"privilegedt and/or confidential information that
is intended solely for the use of the addressee. If you are not the i .S-1' ---
intended recipient or entity, you are strictly prohibited from ti n
disclosing, copying, distributing or using any of the information
contained in the transmission. If you received this communication in
error, please contact the sender immediately and destroy the material ° '.
in its entirety, whether electronic or hard copy. This communication
may contain, nonpublic personal information about consumers subject to
the restrictions of the Gramm-Leach-Bliley Acz and the Sarbanes-Oxley
Act. You may not directly or indirectly reuse or disclose such
information for any purpose other than to provide the services for
which you are receiving the information.
There are risks associated with the use of electronic transmission.
The sender of this information does not control the method of
transmittal or service providers and assumes no duty or obligation for
the security, receipt, or third party interception of this
transmission.
F,�..c i Actions J A ply j cUS rler,:
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Sovereign Bank
ESTATE OF Dorothy Bowers
SOCIAL SECURITY #: 188-12-3642
DATE OF DEATH: July 12, 2013
Account#: 0571138349 Type: Money Market Open date: 11/18/1996
In the name of: Dorothy Bowers or Harold Bowers
Date of Death Balance: $8,863.87
Int.(YTD) from 1/1/2013 to 7/12/2013 $15.90
Accrued interest to date of death: $0.70
Otherinfo:
Page 1 of 1
7refz & Bowser FuneraCHome, Inc.
114 West Main Street
Hummelstown, PA 17036
717-566-0451
Date of Death 7/12/2013
Invoice
Description Amount
FUNERAL EXPENSES FOR DOROTHY BOWERS
Services of Funeral Director&Staff
Embalming 725.00
g, 900.00
Other preparation of an embalmed the body 440.00
Use of facilities and services for viewing,daytime before service 190.00
Use of facilities and services for Funeral ceremony 830.00
Use of services for Graveside service 425.00
Vehicle to transfer remains to Funeral Home
Hearse(local) 350.00
Limousine(local) 300.00
Flower car or floral disposition(local) 200.00
Acknowledgement cards 130.00
Register Book 30.00
Memorial folders/Prayer cards 40.00
Standard Package discount 60.00
-562.00
CASKET 1,030.00
OTHER RECEPTACLE
Burial.Clothing 1,140.00
Grave opening paid to cemetery 120.00
Cemetery Equipment charge 900.00
Obituaries The Patriot 350.00
Certified copies(10 at$6.00 each) 306.57
Clergy/Mass Offering 60.00
Flowers 100.00
318.00
Total $9,382.57
Payment Due Upon Receipt Payments $0.00
Balance Due $9,382.57
LAST WILL
7
1, DOROTHY-BOWERS, of Camp Hill, Cumberland County,
Pennsylvania; declare this to be my Last Will, hereby revoking
all prior:-Wills' and Codicils.
FIRST: I direct that the expenses of my last illness and
funeral be paid out of my estate as soon after my death as is
convenient and expeditious in the judgment of my Executor,
hereinafter named.
SECOND: I give, devise and bequeath all of my property
to my beloved husband, Jack H. Bowers, provided he survive me
by a period of thirty days.
THIRD: Should my husband, Jack H. Bowers, predecease me
or die on or before the thirtieth day following my death, then
and in that event, I give, devise and bequeath all 'my property
to my son, Harold D. Bowers.
FOURTH: All estate, inheritance and other death taxes,
together with any interest and penalties payable with respect
to property or interests therein subject to taxation by reason
of -my death and whether passing under my will or any codicil
thereto, or otherwise, including jointly held and other non-
testamentary property shall be paid out of the principal of my
residuary estate without apportionment.
FIFTH: I hereby nominate, constitute and appoint my
husband, Jack H. Bowers, Executor of this my Last Will.
Should my husband, Jack H. Bowers, be unable to so serve for
any reason whatsoever, then and in that event, I nominate,
constitute and appoint my son, Harold D. Bowers, Executor of
this My Last Will. I further direct that they shall not be
required to post any bond to secure the faithful performance
of their 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, which consists of one (1) sheet of
paper, dated this S""Iday of October, 1993.
R.SCOTT CRAMER C-Cr�x
Attorney at Law Z/ 7 (SEAL)
P.O.Drawer 159 Dorothy Bowers
luncamon,PA 17020
1,
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I, 1
The writing contained on the one ^receding page was
signed and sealed by Dorothy Bowers and by her published and
declared as her Last Will, in the presence of us, who have
hereunto subscribed our names as witnesses at her request, in
her presence, and in the presence of each other.
i y7
i
1 r
1
COMMONWEALTH OF PENNSYLVANIA )
)SS
COUNTY OF PERRY )
s
I, Dorothy Bowers, testatrix, whose name is signed to the
attached or foregoing instrument, having been duly qualified j
according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will; that I signed it j
willingly; and that I signed it as my free and voluntary act
for the purposes therein expressed. s
3
f
I
i
SWORN or affirmed to and acknowledged
before me by Dorothy Bowers, testatrix,
this S fhday of October, 1993 . 1
f� ^ t
R.SCOTT CRAMER A_
Attamey at Law `-/
P.O.Drawer 159
Duncannon,PA 17020
7ELEAWR NT )M-M
AUTPSTRU&E,gotary PuDkkg.ParTy-C*"ty PA
is &Dims May I&IW7
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COMMONWEALTH OF PENNSYLVANIA )
l+ )SS
COUNTY OF PERRY )
r
1 We, ` tG�� �i1 1 eke and
the witnesses whose names are s_.
foregoing instrunar._,
do depose- a
I1 3v:;ers =_=" +w___ _�1y+ a.,',. '.Z z she executed`i:_ as her free
an ,o: . =a-- a-- for the purposes therein expressed; that
t.e hearing and sight of the testatrix signed
Witnesses; and that to the best of our knowledge
the testatrix was at the time 18 or more years of age, of i
sound mind and under no constraint or undue influen
7'
1
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11a
f!
I� SWORN or aff_r-,..eo = -_. -= subscribed
to before me by
and
I! this 574, day „_
n. SCOTT C:J.Y:3
Attcmey& Law !
P.O. Drawer 159
mncannon, PA 17020
! to