HomeMy WebLinkAbout04-10-14 1505610105
REV-1500 Ex Oc-in(F0 rj`
PA Department of Revenue permsytvarda OFFICIAL USE ONLY
Bureau of individual Taxes 1-1 County Cede year File Number
PO BOX 28oi INHERITANCE TAX RETURN -n l-
Harrisburg PA 17128-o6o1 RESIDENT DECEDENT G
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
08/02/2013 01/14/1912
Decedent's Last Name Suffix Decedent's First Name MI
Downs Marguerite M
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name Ml
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
CID 1.Original Return C= 2.Supplemental Return p 3. Remainder Return(Date of Death
Prior to 12-13-82)
O 4.Limited Estate O 4a.Future Interest Compromise(date of C:D 5. Federal Estate Tax Return Required
death after 12-12-82)
1 8.Decedent Died Testate O 7.Decedent Maintained a Laving Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of will) (Attach Copy of Trust.)
O 9.Litigation Proceeds Received 11-11 10.Spousal Poverty Credit(Date of Deal],. C=) 11, Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule 0)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Artell Law Group, LLC (717) 238-4060 0
s M rn
REGISTER OSIM USE Ol M n
First Line of Address O '
;0
z, Tn z t
4098 Derry Street _ �y l
CD
Second Line of Address O n
Prt
City or Post Office State ZIP Code D FTID 1" O -
'v CO �
Harrisburg PA 17111 '
Correspondent's e-mail address:colleen @artell-law.com
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 co ete cl atp f preparer other than the personal representative is based on all information of which preparer has any knowfedge-
SiGNA'i'U PE52 N E FOR F,(yING RETURN D TE
A Cv76ve
ADDRESS
5 H Iwood Path, Mee anicsburg, PA 17050
SIl PRE N REPR SEMATIVE ATE
ADDRESS
4098 Derry Street, Harrisburg, PA 1 111
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610105 1505610105 J
r�A�1
J 1505610205
REV-1500 EX(Fl)
Decedent's Social Security Number
Decedent's Name: Marguerite M Downs
RECAPITULATION
1. Real Estate(Schedule A). . .............. .. . ........ ............... .. 1.
2. Stocks and Bonds(Schedule B) .. .... .. ... .... ........... ............. 2. 457,345.60r
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . ... . 3. j
4. Mortgages and Notes Receivable(Schedule D)......... .. ........... ..... 4.
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. ;
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6.
........."_.._.____..__.....___`.____. . ..._._-
.. .._"._."....... .
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested.. ...... 7.
B. Total Gross Assets(total Lines 1 through 7).... ......... .............. .. S. 457,345.60? ,
9. Funeral Expenses and Administrative Costs(Schedule H)..... ......... .... . 9. . 20,001.61
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1).. .. ....... .... 10. 10,124.76
11. Total Deductions(total Lines 9 and 10).. .. ... .... ......... ..... .... ... . 11. j 30,126.36
12. Net Value of Estate(Line 8 minus Line 11) . ......... .. .. ..... ........... 12. 427,219.24
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) ... ..... ......... ._.... 13. 64,082.89 t,
14. Net Value Subject to Tax(Line 12 minus Line 13) ..... .... ......... ..... . 14. 363,136.35
,i
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 . ... ., ........ . . ...._. ..... _. ...... _... _ c
(a)(1.2)X.0- 15.
16. Amount of Line 14 taxable at lineal rate X.0_ - 16,
17. Amount of Line 14 taxable _
at sibling rate X.12 17.
18. Amount of Line 14 taxable
at collateral rate X.15 363,136.35 8 54,470.45
19. TAX DUE . ... .. .... ....... .. .......... ....... .. .. ..... .... ....... 19. 54,470.45 '..
y
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Of 4
y
Side 2
4;
L 1505610205 1505610205 J
A
REVw1500 Ex(FI) Page 3 File Number
Decedent's Complete Address:
DECEDENTS NAME
Marguerite M Downs
STREETADDRESS
100 Mount Allen Road
CffY � STATE ZiP
Mechanicsburg PA 17055
Tax Payments and Credits:
L Tax Due(Page 2,Line 19) (1) 54,470.45
2. CreditslPayments i
A.Prior Payments --_ 54,59198
B.Discount
Total Credits(A+B) (2) 54,593.98
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) 123,53
5. if Line 1+Line 3's greater than Line 2,enter the difference.This is the TAX DUE. (5)
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.............................._..........__..............................................................................
.
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ N v.
2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death '
without receiving adequate consideration?....._....._.__................._............,,.....................-........._....................._. ❑ x
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? .._...................._..............,........................_._.........._......_-_.......................... 0 0 -
s
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. r
For dates of death an or after July 1,1994,and before Jan.1,1995,the tax 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 exempts 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 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 172 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, s'
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
L
ii
n
REV-1503 EX+(8-e2)
pennsylvania SCHEDULE B
DEPARTMENT OF REVENUE
RESIDENT DECEDENT STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Marguerite M Downs 2013-00988
All property jointly owned with right of survivorship must be disclosed on Schedule F.
REM
NUMBrPNCCD31400313205 DESCRIPTION VALUE E DATE
OF DEATH
I' 048702
99,900.73
2 388309886 28,720.08
3
29,882.80
4 PNC CD 31000334129
36,584.72
5 Ameriprise 02014790376002 COM CUSIP 197651-850 262,257.27
t
TOTAL(Also enter on Line 2, Recapitulation) $ 457,345.60
If more space is needed,insert additional sheets of the same size
t
REV-7509 EX+(ot-Io)
pennsytvania SCHEDULE F
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN JOINTLY-OWNED PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Marguerite M Downs 2013-00988
If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A' Brian McCarthy 5 Hazelwood Path, Nephew
Mechanicsburg, PA 17050
8.
C.
JOINTLY OWNED PROPERTY:
LETTER 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 DECEDENT'S VALUE OF
NUMBER TENANT iolm' IDENTIMNC NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 11123109 PNC Checking Account-5005060558(TAX PAID) 21,958.85 50%
I
5
TOTAL(Also enter on Line 6, Recapitulation} $ 0.00
If more space is needed,use additional sheets of paper of the same size.
RLV-1510 EX+ (08-09)
i� pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
RESIDENT DECEDENT MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
Marguerite M. Downs 2213-00988
This schedule must he completed and filed if the answer to any of questions I through 4 on page three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY n
ITEM INCLUDE NAME Or THE TRANSFEREE,THEIR RELA ONSHTP TO DeCEDENT AND DATE OF DEATH % DECD'S EXCLUSION TAXABLE
NUMBER ME DATE Or TRANSFER. ATTACH A COPY Or THE DEED FOR REZ ESTATE. VALUE OF ASSET INTEREST (IEAPPUCaem) VALUE
ING USA Annuity&Life Insurance Company Contract#F000025579
30,022.02 100 30,022.02 0.00
J
t
4
TOTAL(Also enter on Line 7,Recapitulation) $ 0.00 a
If more space is needed,use additional sheets of paper of the same size.
r
y
REV-1511 EX+ (08-13)
. pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN
RESIDENT DECEDENT ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Marguerite M Downs 2013-00988
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Neil Funeral Home
324.16
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s) Brian P McCarthy
Street Address 5 Hazelwood Path
City Mechanicsburg State PA Zip 17050
Year(s)Commission Paid:
2. Attorney Fees: 18,750.00 vi
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: 623.45
0
S Accountant Fees:
6. Tax Return Preparer Fees: 79.00
7 Estate Advertising 225.00
4
1'
h
4
1
Q.
�S
TOTAL(Also enter on Line 9, Recapitulation) $ 20,001.61
If more space is needed,use additional sheets of paper of the same size.
REV-1.517 EX+ (1247)
Tpennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE ED RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Marguerite M Downs 2013-00988
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM
NUMBER VALUE AT DATE
DESCRIPTION OF DEATH
1 rAlert iah Lifeways
9,935.40
al Area Health Associates 69.13
Pharmacy S ervices, Inc 120.23
s
TOTAL(Also enter on Line 10, Recapitulation) $ 10,124.76
If more space is needed,insert additional sheets of the same size. ,
REV-1513 EX+ (01-10)
pennsytvania SCHEDULE ]
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER: -
Marguerite M Downs 2013-00988
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER rDorothy ME AND ADDRESS OF PERSONS)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I IBUTIONS[Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
I arthy,6310 Pine Street Harri sburg,PA 17112 Sister-in-law 5%
2 on, 127 Buss Street Pen Argyl,PA 18072 Sister-in-law 10%
3 Patricia Johnson,703 Napoleon Avenue New Orleans,LA 70115 Niece 10%
4 Leo McCarthy,221 E.Washington Street Charles Town,WV 25414 Nephew 10%
5 Janet Wilhelm,7149 Starting Road Harrisburg, PA 17112 Niece 10%
6 Kevin McCarthy, 1392 Shuman Drive Carlisle,PA 17015 Nephew 10%
7 John McCarthy,13 Driftwood Drive Plains, PA 18705 Nephew 10%
8 James McCarthy, 16 Savoy Drive Dallas,PA 18612 Nephew 10%
9 Brian McCarthy,5 Hazelwood Path Mechanicsburg, PA 17050 Nephew 10%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
St.Joseph's Roman Catholic Church,Mechanicsburg,PA 10%0
2 Cumberland-Perry Association of Retarded Citizens,Carlisle,PA 5%
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $ 64082.89
If more space is needed,use additional sheets of paper of the same size.
f
LAST WILL AND TESTAMENT 1,
OF 'l FA
MARGUERITE M. DOWNS
I, MARGUERITE M. DOWNS, now domiciled in Cumberland County, Pennsylvania,
declare this to be my Last Will and Testament. I revoke all other wills and codicils that I may
have previously made.
Article I
My just debts and expenses of my last illness, funeral, and administration of my estate
shall be paid by my Executor from the principal of my residuary estate as soon as practicable
after my death.
Article II
All inheritance, estate, and succession taxes (including interest and penalties thereon, but
not including any generation skipping tax) payable by reason of my death shall be paid out of
and be charged generally against the principal of my residuary estate without reimbursement
from any person. This provision is not a waiver of any right which my Executor has to claim
reimbursement for any such taxes which become payable as the result of any property over
which I have the power of appointment.
Article III
I give, devise and bequeath my tangible personal property in accordance with any
memorandum I have handwritten or signed, located with my will or with my valuable papers and
found within 30 days of the probate of my will. Gigs may only be to persons who survive me or
to organizations which exist at my death, and if there is a conflict, the memorandum having the
latest date shall govern. To the extent no such memorandum is found, or all of my tangible
personal property is not disposed of pursuant thereto, my tangible personal property shall be
added to my residuary estate and pass under Article V hereof.
Article IV
I give,devise and bequeath any refund due to my estate pursuant to the terms of my
contract with Messiah Village, or its successor(s), for my apartment located at 809 Oak Oval,
Mechanicsburg,Pennsylvania.
Article V
All the rest,residue and remainder of my estate,of whatsoever nature and wheresoever
situate, I give,devise and bequeath as follows:
A. TEN PERCENT (10%) to ST. JOSEPH'S ROMAN CATHOLIC CHURCH,
or its successor(s), of Mechanicsburg, Pennsylvania, for the purpose of maintaining the church
and school;
B. FIVE PERCENT (5%) to CUMBERLAND-PERRY ASSOCIATION OF
RETARDED CITIZENS, or its successor(s), of 71 Ashland Avenue, Carlisle, Pennsylvania,
17013,to be used as it determines best;
2
C. FIVE PERCENT (5%) to my sister-in-law, DOROTHY McCARTHY, of
Harrisburg, Pennsylvania, if she survives my death by thirty days. If she fails to so survive my
death,her share shall be distributed to her issue,Per Stirpes.
D. TEN PERCENT (10%) to my sister-in-law, ELEANOR WHARTON, of
Lewistown, Pennsylvania, if she survives my death by thirty days. If she fails to so survive my
death, her share shall be distributed to her issue,Per Stirpes.
E. TEN PERCENT (10%) to my niece, PATRICIA JOHNSON, of Nola,
Louisiana, if she survives my death by thirty days. If she fails to so survive my death, her share
shall be distributed to her issue,Per Stirpes.
F. TEN PERCENT(10%) to my nephew, LEO McCARTHY, of Charleston, West
Virginia,if he survives my death by thirty days. If he fails to so survive my death,his share shall
be distributed to his issue,Per Stirpes.
G. TEN PERCENT (10%) to my niece, JANET WILHELM, of Harrisburg,
Pennsylvania, if she survives my death by thirty days. If she fails to so survive my death, her
share shall be distributed to her issue,Per Stirpes.
H. TEN PERCENT (10%) to my nephew, KEVIN McCARTHY, of Carlisle,
Pennsylvania, if he survives my death by thirty days. If he fails to so survive my death,his share
shall be distributed to his issue, Per Stirpes.
I. TEN PERCENT (10%) to my nephew, JOHN McCARTHY, of Plains,
Pennsylvania, if he survives my death by thirty days. If he fails to so survive my death,his share
shall be distributed to his issue,Per Stirpes.
3
J. TEN PERCENT (10%) to my nephew. JAMES McCARTHV, of Dallas,
Pennsylvania, if he survives my death by thirty days. If he fails to so survive my death, his share
shall be distributed to his issue, Per Stirpes.
K. TEN PERCENT (10%) to my nephew. BRIAN McCARTHY, of
Mechanicsburg, Pennsylvania, if he survives my death by thirty days. If he fails to so survive
my death, his share shall be distributed to his issue, Per Stirpes.
Article y
I nominate, constitute and appoint my-ntpii _, of Cumberland
County, Pennsylvania as Executor of my Last Will and Testament. I direct that my Executor be
permitted to serve without bond. In addition to those powers granted by law, I grant him power
to distribute in cash or in kind, in like or in unlike shares, and to file any qualified disclaimer I
could have filed if living. My Executor shall receive reasonable compensation for services
rendered to my estate.
Article VII
In addition to the powers conferred by law, I authorize my Executor, in his absolute
discretion:
(a) to retain in the form received and to sell either at public or private sale, any real
estate or personal property except that which I specifically bequeath herein,
(b) to manage real estate,
(c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
(d) to exercise any option or right arising from the ownership of investments,
4
(e) to compromise claims without court approval and without consent of any
beneficiary,
(f) to file any federal income tax return for any year for which I have not filed such
return prior to my death,
(g) to make distributions in cash or in kind, or in both, and to determine the value of
any such property,
(h) to employ any attorney, investment advisor, or other agent deemed necessary by
my Executor;and to pay from my estate reasonable compensation for all their services,
(i) to conduct alone or with others, any business in which I am engaged in, or have
an interest in at time of my death, and
6) to receive reasonable compensation in accordance with their standard schedule of
fees in effect while their services are performed.
IN WITNESS WHEREOF, 1, MARGUERITE M. DOWNS,hereby set my hand to this
my Last Will and Testament, on 7 �'"6 , 2006, at Harrisburg, Pennsylvania.
MARL RITE M. DOWNS
In our presence, the above-named MARGUERITE M. DOWNS signed this and
declared this to be her Last Will and Testament and now at her request, in her presence, and in
the presence of each other,we sign as witnesses.
Name Address
VV). 2000 Linglestown Rd., Suite 202, Harrisburg, PA 17110
%'/• /"J 2000 Linglestown Rd., Suite 202, Harrisburg PA 17110
5
I, MARGUERITE M. DOWNS, Testatrix, who signed the foregoing instrument, having
been duly qualified according to law, acknowledge that I signed and executed this instrument as
my Will, and that I signed it willingly as my free and voluntary act for the purposes therein
expressed.
Sworn to or affirmed and
Acknowledged before me by
MARGUERITE M. DOWNS,the Testatrix
on 2006.
Notary Public MARGUPITE M. DOWNS
MONWEALTHF PENNSYLVA IA
Notarial Seed
Merielic F. Haan, Notary Public
Susgwhmm Twp.., m Cg0y
W Commission Expires Sept.23,2006
We, the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the Testatrix sign and execute
this instrument as her Will; that she signed and executed it willingly as her free and voluntary act
for the purposes therein expressed; that each of us in her sight and hearing signed the Will as
witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) years or
more of age,of sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
Subscribed to before me
by M _ F PC kmA
and l E s5R (1,7.X4. ' Witn s
witnesses,on 7 2006.
Nbta6 Public
ONWEA TH OF PENNSYLVANIA
Notmial Metift F. Haan,N�otory Public
smiIiteJtenna'nsp., in Cmft
W Ckmabeton Expires SepL 23. 2W6 6
PSECU
03/27/2014
Estate of Marguerite Downs
Brian P.McCarthy,Executor
5 Hazelwood Path
Mechanicsburg,PA 17050-9155
Re:MARGUERITE M DOWNS,Deceased.
PSECU Reference# 1335388309886
Dear Mr.McCarthy:
The above referenced person has an account with PSECU which was opened on
September 3, 1993. The Share account was individually held by MARGUERITE M
DOWNS.
The following is the Date of Death Balance for MARGUERITE M DOWNS'S account with
PSECU:
Account Date of Death Balances hrterest—August 1-2
(Sl) Savings $28,719.84 $0.24
The account has been closed.
If you have any questions,please contact our department toll-free at(800)237-7328,press 6,
extension 3120 or email accountservices(a,psecu.com.
Sincerely,
Sandy F gley
Member Service Representative
PSECU
P. O. BOX 67013 HARRISBURG, PA 17106-7013 800.237.7328 >>psecu.com
0
THIS CREDIT UNION IS FEDERALLY INSURED BY THE NATIONAL CREDIT UNION ADMINISTRATION.EQUAL OPPORTUNITY LENDER.
LEAD O THE WAY
April 2,2014
Brian McCarthy
5 Hazelwood Path
Mechanicsburg,PA 17050
RE: Marguerite M Downs
SSN: 174-20-3681...
DOD: 08-02-2013
Dear Mr. McCarthy:
In response to your request for Date of Death(DOD)balances for the customer noted above, our
records show the following:
Certificate of Deposit
Account#31400313205 Established: 05-10-2007
MARGUERITE M DOWNS
DOD balance: $29,878.70+4.10 accrued interest
Account# 31000334129 Established: 12-18-2008
MARGUERITE M DOWNS
DOD balance: $ 36,583.00+ 1.72 accrued interest
Checking Account
Account#5005060558 Established: 11-23-2009
MARGUERITE M DOWNS
BRIAN MCCARTHY
DOD balance: $21,985.77+0.08 accrued interest
i
Please note that this office provides date of death balances for deposit accounts(IRAs,CDs,Checking and
Savings). 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,
National Financial Services Center e
PNC Bank,N.A. R
Member FDIC
Page 1 of 2
Ameriprise Q
Financial
Account Summary for'the Estate Settlement of Marguerite Mc Carthy Downs, Client ID 11268568
1)Type of investment: Mutual Fund
Product Name: Mutual Fund
Total Account Value(as of Date of Death):$262,257.27
Account Number:02014790376 002
Account Registration: Marguerite Mc Carthy Downs
Beneficiary Designation:
How the account(s)proceeds will be settled: _
We will transfer assets in this account according to direction received from the estate representative. If the estate is not being
probated, please contact us for alternatives.
Important Details about this account:
N/A
z
s
XFINITY Connect Page I of 2
XFINITY Connect bpmccarthy @comcast.ne
+Font Size-
Fwd:prod-Date of Death Request
From :Brian P McCarthy <bpmccarthy @comcast.net> Tue,Apr 08,2014 10:29 AN
Subject:Fwd: prod - Date of Death Request
To :Colleen Artell <colleen @artell-law.com>
Colleen, I sent this to you last week. This is the statement that isn't very of cal.
From: "Torrin Cavanaugh" <tavanaugh @mtb.com>
To: "bpmccarthy @comcast.net" <bpmccarthy @comcast.net>
Sent: Wednesday, April 2, 2014 9:06:38 AM
Subject: FW: prod - Date of Death Request
Here you go!
-----Original Message-----
From: Mercer, Valarie On Behalf Of DATE OF DEATH REQUESTS
Sent: Tuesday, April 01, 2014 11:46 AM
To: Cavanaugh, Torrin
Subject: RE: prod - Date of Death Request
Account# Balance Interest Total
1.29048702 99900.73 .00 99900.73
Valarie Mercer
M&T Bank
Adjustment Services / Operations Specialist
MB-50 Adjustment Services
499 Mitchell Road, Millsboro, DE 19966
(P) 302-934-2205 (F) 302-934-2610
Email: vmercer @mtb.com /www.mtb.com '
-----Original Message-----
From: Cavanaugh, Torrin
Sent: Wednesday, March 26, 2014 11:01 AM
To: DATE OF DEATH REQUESTS
Cc: Cavanaugh, Torrin
Subject: prod - Date of Death Request
Account Information
4
Date of death: 08/02/2013
A
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XFINITY Connect Page 2 of 2
Account Number: 29048702
Product Type: Deposit Account
Request Details
' Deliver to: Requestor
Delivery Options: E-mail
Delivery Details: ebrnl3i
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ING MSPO (C—time) GMT 4/8/2014 5:31 : 17 PM PAGE 2/003 Fax Server
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January 19,2012
MARGUERITE M DOWNS
_ MESSIAH VILLAGE
ON OAK OVAL
MECHANICSBURG PA 170554"
Dear Pollcyowner.
SUBJECT: Policy F000025M ING USA Annuity and Life Insurance Company
` Marguerite M Downs,.Annuftant
As of January 14,2012,the above policy has an annuiNzation value of$36,912.18. This will
provide a monthly payment to you of$362.64 beginning January 14,2012 and continuing for
your lifetime. C
If the annuitant should die prior to us distributing 120 payments,the beneficiary will receive
the remaining payments.The current beneficiary designation Is William Downs.You may
change the beneficiary in the future;however,you cannot surrender or change any other
aspect of this payment plan.
Each year,'d applicable,you will receive a tax document Indicating your tax liability under the 91 Z $
settlement plan you have elected.
The first payment of$362.64 less federal and state taxes,d applicable,Is enclosed.
Sincerely,
�a4,OZZ.o2
Todd Nevenh000n J>}0 202
Head of Operations and Des Moines Site Leader 'J�OJtdt
Iq YV105• b/FS�ID.IIo�
ING MSPO (C-time) GMT 4/8/2014 5:31 : 17 PM PAGE 1/003 Fax Server
ING
Fax Cover Sheet
To: Brian Mccarthy
Fag Number: 1717-614-1711
Telephone:
Cc:
From:
Fax Number:
Telephone:
Date and time of transmission: Tuesday, April 08, 2014 12:31:02 PM (CST)
Number of pages (including cover sheet): 03
Fax Notes:
l
i
NOTICE: The information contained in this facsimile transmission is confidential and intended only for the use
of the intended particular recipient(s). It may also contain attorney work product and/or be protected by the
attomey-client privilege or other privileges. Delivery to someone other than the intended recipient(s)shall not
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disclosure,reproduction,distribution or other use of this communication,in whole or in part,is strictly
prohibited. If you have received this transmission in error,please notify the sender by reply facsimile and delete
this communication without copying or disclosing it.
BENEFICIARY.DIRECTION This form may be used for more than
one pulley only if all AND REQUEST FOR QUITABLE LIFE INSURANCE COMPANY OF11 ,y samelife,thesamepneficialeonthe
same life,the same beneficial designs-
AMENDMENT OF POLICY lion is desired, and all policies have
•the same owner.
Policy No. F000025579 and/or Application No.
Insured Marguerite M Downs
1. All prior revocable beneficiary directions under the above policy(s)are.revoked.Any proceeds payable on death of the Insured shall be
paid In one sum lo:
A. (Do not complete this Section to name a Trust as beneficiary)
PRIMARY BENEFICIARY(S)
NAME RELATIONSHIP DATE OF BIRTH
Masonie,Homes..pit'ton Schoo3' Alumni •Ass 'n: Scholarship -Fund ..50'8"of' invest-
ddress: , Eliz•abethtown;.Pa.:............ .....................ment
.................I......I.................. ....:................... .......................
Masonic-•Homesr Elizabethtown, Pa............ .•. ••.. -501i"of"inves ment
and, if no primary beneficiaries survive the insured, to:
FIRST CONTINGENT BENEFICIARY(S)
NAME -. Estate o�'=Marguetite-M.Downs RELATIONSHIP DATE OF BIRTH
e
u
c
and, It no primary or first contingent beneficiaries survive the insured, to:
° SECOND CONTINGENT BENEFICIARY(S)
u
n
NAME RELATIONSHIP DATE OF BIRTH
u
e ........................................... ........................ .......................
e
'u
c SU
j If a(check appropriate box Primary Beneficiary;❑ First Contingent Beneficiary: !: Second Contingent Beneficiary dies before
e or at the same lime as the insur eLQr before receiving the entire proceeds due that beneficiary,any proceeds that would have been
paid to him shall be paid In one surtTtohis surviving issue pet stlrpes and.not per capita.If there are no surviving Issue,such pro-
_ ceeds shalt be paid to the surviving beneficiaries,if any, of his same beneficiary class. "Issue" shall include adopted children.
B. TESTAMENTARY TRUSTEE
c
° The duly appointed,qualified and acting Trustee of the Testamentary Trust created in the Last Will and Testament of:
...................................................1........................... or the successor in Trust is named as
(Name of Person Who Made Will)
C .,
11(check appropriate box) 0 Primary Beneficiary; ❑First Contingent Beneficiary; Second Contingent Beneficiary of the policy(s).
L If Equitable Life Insurance Company of Iowa Is not furnished evidence of the appointment and qualification of such a Trustee within
one year after the death of the insured, the proceeds of the policy(s)shall be paid to the beneficiary(s)named in this form as con-
tingent tingent beneficiary(s)to the Testamentary Trustee in the order shown.If no such continggant beneficiaries are named or none of them
u survive the insured,the proceeds of the policy(s)shall be paid to the owner of the policy(s),If living,otherwise to the executors or
A administrators of the owner's estate.
C. TRUSTEE OF AN EXISTING TRUST -
Nameof Acting Trustee: ...................................................... .....................................
Address of the Acting Trustee: .................................. ......................,Trustee,
or the successor in Trust under Trust Agreement dated .................. ...............................................
entered into by ........................................................................... ........ antl the Trustee is
r' Primary Beneficiary;
(Name First Contingent Beneficiary;to be(check appropriate box) . , y y; �- g F! Second Contingent Beneficiary:
D. CHARITABLE DESIGNATION (Optional) ,
Before payment of proceeds as herein directed, it Is requested that .......% of said proceeds be paid to ..................
....... ........................................... .................... as a charitable donation. It being understood and
(show charity's full name&address)
agreed that said charily shall, in no event, be entitled to receive more than the percentage of proceeds herein stated.
II. This Beneficiary Direction Is subject to any indebtedness which may be due EQUITABLE LIFE INSURANCE COMPANY OF IOWA under
the Pollcy(s) and to the rights of any collateral assignee.
Each Copy Must Be Dated And Signed On Reverse Side
Ill. It is requested that as of today's date,any ownership and beneficiary provisions now included in the policy(s)be revoked,and that the
policy(s)be amended to Include the following ownership and beneficiary provisions.This request does not change any ownership designs.
lion now in force, nor does it revoke any beneficiary provision In any Supplemental Agreement or Additional Provision attached to the
policy(s),nor any beneficiary or ownership provision in a Disability Insurance policy:
A. Ownership—During the lifetime of the insured,the owner has all the rights and may receive all the benefits under the policy(s)subject
to:
(1) The Payment Options Provision of the policy(s);
(2) The rights of any assignee of record at the Home Office of Equitable Life Insurance Company of Iowa;and
(3) The consent of all joint owners.
The rights of all owners cease on death of the insured. Unless Equitable Life Insurance Company of Iowa is given other directions:
(1) If a joint owner dies before the insured, that owner's rights will vest in the surviving joint owners.
(2) If all owners the before the insured, the owner of the policy(s)will be the estate of the Iasi surviving owner.
B. Beneficiary—Unless Equitable Life Insurance Company of Iowa is given other directions:
(1) The interests of all beneficiaries named jointly shall be equal.
(2) The interest of a beneficiary who dies before the insured will cease.The proceeds due that beneficiary will be paid in equal shares
to the surviving beneficiaries having a right to payment.
(3) H the interests of all beneficiaries have ceased,the proceeds will be paid to the owner, if living,otherwise to the owner's estate.
The interest of a beneficiary will cease as if he had died before the insured it the beneficiary dies:f1)at the same time as the insured
dies or within 60 days(30 days for policies of the 1981 and later series)after the insured dies,and(2)before the payment of any pro.
seeds.
Equitable Life Insurance Company of Iowa may rely on a swom statement to identify any beneficiary whose name has not been given.
To the extent allowed by law,payment of proceeds will not be subject to the claims at a beneficiary's creditors or to legal process
against a beneficiary.If the owner or beneficiary is a trustee,Equitable Life Insurance Company of Iowa is not liable for the use of any
payment made to the trustee.
C. Change of Owner or Beneficiary—On request, the owner or the beneficiary of the policy(s) may be changed during the insured's
lifetime.The request,when recorded at the Home Office of Equitable Life Insurance Company of Iowa,will take effect on the date it is
signed,subject to any payment made or action taken by Equitable Life Insurance Company of Iowa before the recording.Equitable Lite
Insurance Companv of Iowa reserves the right to require the policy(s)for endorsement of any change of owner or beneficiary.A change
of beneficiary will revoke any prior election of a payment option.
IV. If any policy on which these changes are requested is an annuity policy,then all references to the insured are amended to refer to the an-
nuitant.
Sign: Marguerite M. Downs
Date
Owner(Owner of Policy) ......._._.
Equitable Life Insurance Company of Iowa has completed the changes herein requested.
Date ........
• Prertftlertl
Counterslgned_� !�'!.. ............_.._._.._.__.............
aeparrer,
INSTRUCTIONS
I. individual beneficiaries—Use Section "A" on reverse side.
A. Beneficiaries other than children of insured.
1. indicate given first name, middle initial and present last name, relationship and date of birth.
S. Children of Insured. (Unnamed children must be limited to those bom and adopted to a specific marriage.)
1. Children of present marriage bom and unborn
"Any children bom of Insured's marriage to(Name of wife)wife"
2. ChlUbian Of prior mamaga and present marriage
"(Names, relationship and blrthdates of children born 01 prior marriage) and any children bom of insured's marriage to (Name
of wlfs)wife"
3. If adopted children also to be included, add following to B.1. or B.2.: "and any children legally adopted by the insured"
8. Testamentary Trustee beneficiary—Use Section "B" on reverse side.
A. Do not Include the name of the Testamentary Trustee on the form. The name of this Trustee may be changed several times before
the insured dies.
B. If a contingent beneficiary to the Testamentary Trustee is to be named, use proper space under A on reverse side.
Ill. Trustee beneficiary under an eaiaBng Trust Agreement—Use Section "C" on reverse side.
A. Give name of Trustee and date of Trust Agreement
B. Do not name a beneficiary In a subsequent class unless Trust is revocable.
IV. Signature Requirements:
A. All owners must sign. Examples:
B. if owner Is a partnership,sign as follows: 1. "The ABC Company, a Partnership
"(insert name of partnership),a Partnership E By (Signature of a Partner)
BY A Partner"
A Partner" 2 "Jones, Black,and Green, a Partnership
C. If owner Is a corporation,sigh ass follows: By (Signature of a Partner)
"(insert name of corporalI - - A Partner"
B..
(insen title of Officer signing)" 3. ll partners each rt ter must sign.
as
I.6n-611 �.o� g g) owners,each partner must sign.
statement
)t4 ' MESSIAH Fo Pn l
w
Lfewa s"
at MESSIAH VILLAGE
100 MT.ALLEN DRIVE,MECHANICSBURG, PA 17055 RESIDENT# UNIT STMT. DATE
30001 053 W 12/31/2013
RESIDENT(S)
BRIAN MCCARTHY Mrs. MARGUERITE DOWNS
5 HAZELWOOD PATH
MECHANICSBURG, PA 17055 TOTAL AMOUNT DUE $0.00
DATE DUE 01/31/2014
DATE DESCRIPTION RATE Days`
Units CHARGES CREDITS BALANCE
Balance Forward 9,935.40
. 12/31/2013 PAYMENT RECEIVED - THANK YOU!!! 9,935.40 0.00
***HAPPY 2014! PLEASE MAKE SURE THAT YOU HAVE UPDATED ANY INSURANCE
CHANGES WITH THE BUSINESS OFFICE. THANK YOU!***
RESIDENT# CURRENT OVER 30 OVER 60 OVER 90 OVER 120 TOTAL AMOUNT DUE
30001 0.00 0.00 0.00 0.00 0.00 $0.00
RESIDENT NAME Mrs. MARGUERITE DOWNS Form P9
Please make check payable to Messiah Lifeways at Messiah Village.
A 1% finance charge may be assessed on accounts for which payment has not been received by the due date. Thank you!
If you have any questions or concerns about your bill,please address them directly to Fiscal Services at 790-8220. Thank You!