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21-01-78
LAST WILL AND TESTAMENT OF LOUISA F. BOES
I, LOUISA F. BOES, of North Middleton Township, Cumberland
County, Pennsylvania, declare this instrument to be my Last Will
and Testament, in manner and form following:
1. I hereby expressly revoke all wills and Codicils
heretofore made by me.
2. I hereby direct my Executrices to pay all my just debts,
funeral and administrative expenses out of my estate, as soon as
practicable after my death.
3. I direct that all taxes that may be assessed in
consequence of my death of whatever nature and by whatever juris-
diction imposed shall be paid out of my estate as a part of the
administration of my estate.
4. I give and bequeath such of my tangible personal property
as is set forth in a separate unsigned memorandum, which I shall
place with my Will, to the persons therein designated.
5. I give, devise and bequeath the remainder of my estate,
of whatever nature and wherever situate, to my daughters,
Petronella Johanna Heyman and Margaretha Corbellini, also known
as Margo Corbellini, in equal shares, to share and share alike.
In the event that either of my said daughters should predecease
me, I direct that her share be distributed to her children, in
equal shares.
6. I nominate and appoint Dauphin Deposit Bank and Trust
Company, Harrisburg, Pennsylvania, Trustee of the share of any
beneficiary who may be under the age of twenty-five years. The
income and/or principal of said trust may be accumulated or
expended for the maintenance, education and support of such bene-
ficiary as my Trustee in its sole discretion may determine; and
my Trustee, in the expenditure of income and/or principal for such
purposes, may, at its discretion, apply the same directly without
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the intervention of a guardian or pay the same to any person
having the care or control of said beneficiary or with whom the
beneficiary resides, without duty on the part of the Trustee to
supervise or inquire into the application of the funds by any
person to whom any payment is so made. The balance of such
income and/or principal shall be paid to such beneficiary upon
reachinq the age of twenty-five years, or to such beneficiary's
estate in the event of death prior thereto.
7. I nominate and appoint my daughters, Petronella
Johanna Heyman and Margaretha Corbellini, also known as Margo
Corbellini, or the survivor of them, as Executrices of this my
Last Will and Testament. In the event that both of my said
Executrices predecease me, or for any reason are unwilling or
unable to serve in that capacity, I hereby nominate and appoint
Dauphin Deposit Bank and Trust Company, Harrisburg, Pennsylvania,
as substitute Executor.
8. I direct that my personal representative and Trustee, as
well as their successors, shall not be required to file bond or
security in any jurisdiction.
9. To the extent that it provides services under the
provisions of this Will, Dauphin Deposit Bank and Trust Company,
Harrisburg, Pennsylvania, or its lawful successors, shall be
entitled to compensation based on its regular schedule of fees
for such services in effect at the time of the services rendered.
10. I give each of my said personal representatives
respectively, the fullest power and authority in all matters and
questions and to do all acts which I might or could do if living,
including, without limitation, complete power and authority to
sell at public or private sale, for cash or credit, with or
without security, and to mortgage, lease and dispose of all my
property, real and personal, at such time and upon such terms and
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conditions as they may determine, all without court order; in
this connection my personal representatives shall have the power
to execute and deliver all deeds, instruments of transfer and
other writings necessary to pass proper title thereto.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
I this 2 Y -IL day of July, 1985.
f ~
~alJ: ~
Louisa F. Boes
(SEAL)
WITNESS:
COMMONWEALTH OF PENNSYLVANIA
SSe
COUNTY OF CUMBERLAND
I, Louisa F. Boes, 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 ~~ill; that I signed it will-
ingly; and that I signed it as my free and voluntary act for the
purposes therein expressed.
Sworn or affirmed to and acknowledged before me, by Louisa
F. Boes, Testatrix, this LL(~ day of July, 1985.
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Testatrix
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CO~10NWEALTH OF PENNSYLVANIA
SSe
COUNTY OF CUMBERLAND
We, Roger M. Morgenthal and James D. Flower, Jr., the
witnesses, whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, do depose and
say that we were present and saw Testatrix, Louisa F. Boes, sign
and execute the instrument as her Last Will; that she signed
willingly and that she 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.
I Sworn or affirmed to and subscribed to before me by Roger M.
Morgenthal and James D. Flower, Jr., wi tnesses, this 2- y'~ day
of July, 1985.
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REV-1500 EX + (6-00) OFFICIAL USE ONLY
COMMONWEALTH OF PENNSYLVANIA REV-1500
DEPARTMENT OF REVENUE
DEPT. 280601 INHERITANCE TAX RETURN FILE NUMBER
HARRISBURG. PA 17128-0601 RESIDENT DECEDENT 21 2001 00078
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURIT'Y NUMBER
BOES, LOUISA F. 114-40-5392
DECE- DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RET'URN MUST BE FILED IN DUPLICATE
DENT 01/06/01 06/28/1911 WIT'H T'HE REGISTER OF WILLS
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURIT'Y NUMBER
3. Remainder Return
CHECK ;' Original Return ~' Supplemental Return 8 (date of death prior to 12-13-82)
APPRO- 4. Limited Estate 4a. Future Interest Compromise 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
PR lATE 6. Decedent Died Testate 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach copy of Will) (Attach acopyofTrust)
BLOCKS 9. Litigation Proceeds Received 10. Spousal Poverty Credit (date of death between D 11. Election to tax under Sec. 9113(A)
12-31-91 and 1-1-95) (Attach Sch 0)
tin$'$~"Ml)jfili!li:QPMl'iU'ij!iiitAt'Qpijijli:$PQaf#$~eQ"i1iqgi'niAl;;!Allljlj!@!lMi!fjdii$l!9ijUi~jjiR~~ptQi
NAME COMPLETE MAILING ADDRESS
COR- ROGER M. MORGENTHAL, ESQUIRE 95 ALEXANDER SPRING ROAD
RE- FIRM NAME (If Applicable) SUITE 3
SPON
DENT FISHMAN & MORGENTHAL CARLISLE, PA 17013
TELEPHONE NUMBER
717-249-6333
OFFICIAL USE ONLY
1. Real Estate (Schedule A) (1) None
2. Stocks and Bonds (Schedule B) (2) None,".
None "
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4 Mortgages & Notes Receivable (Schedule D) (4) None
5. Cash, Bank Deposits & Miscellaneous Personal
Property (Schedule E) (5) 15,451. 05 -.-'
6. Jointly Owned Property (Schedule F) ,.,
D Separate Billing Requested (6) 98.962.10
RECA-
PITULA- 7. Inter-Vivos Transfers & Miscellaneous
TION Non-Probate Property (Schedule G or L) (7) 12,047.59
8. Total Gross Assets (total Lines 1-7) (8) 126,460.74
9. Funeral Expenses & Administrative Costs (Schedule H)(9) 5,602.31
10. Debts of Decedl!lnt, Mortgage Liabilities, & Liens(Schedule I} (10) 6,864.37
11. Total Deductions (total Lines 9 & 10) (11) 12,466.68
12. Net Value of Estate (Line 8 minus Line 11) (12) 113,994.06
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax (13) None
has not been made (Schedule J)
14. Net Value SubJectto Tax (Line 12 minus Line 13) (14) 113,994.06
SEE INSTRUCTIONS ON PAGE 2 FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2) X.O (15)
TAX 16. Amount of Line 14 taxable at lineal rate 113,994.06 X .0 45 (16) 5,129.73
-
COMPU- 17. Amountof Line 14taxable atsibling rate 0.00 x.12 (17) 0.00
TATION 18. Amountof Line 14taxable at collateral rate 0.00 x.15 (18) 0.00
19. Tax Due .. ~ ... ~~ 0~ 5,129.73
20. D 14ij!iCKHiSR"ijjli&ilAR"RiiQlIEm!l$AR,,*ilijp!:lit>>!pVi!iii~i!VM"i'n(1
/6'~c:1o.3- 7
C-
.. .....~~.aE$l)RSTOAN$W!iRA!4qUe$TION$.o!l"'AGe~AN!:!!\~!;!l!!11KMiM!'BiUII.................
o PA15001
NTF 29755
Copyright 2000 Greatland/Nelco LP - Forms Software Only
PA REV-1500 EX (6-00)
Page 2
Decedent's ComDlete Address:
STREET ADDRESS
CUMBERLAND CROSSINGS
1 LONGSDORF WAY
CITY I STATE I ZIP
CARLISLE FA 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
5,129.73
4,850.00
242.50
Total Credits (A + B + C)
(2)
5,092.50
3. InteresVPenalty if applicable
D. Interest
E. Penalty
(3) 0.00
(4)
(5) 37.23
(5A) 0.00
(5B) 37.23
TOlallnterest/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax dUe.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable 10: REGISTER OF WILLS, AGENT
ptg~~~~~~!~~~~g~8~~8!i~~~tl~~~I~~~~~~~21~~~~!~~!!I~~~~~~~~8~~i~~~~[82R~f
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 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, correct and complete. Declaration of preparer other than the personal representative is based on information of
which preparer has any knowledae.
RE OF PERSON RESPff,I'/,SIBLE FOR FliNG !ijETURN DA E
~ \V\ .QX1.~' If It 6
A RE S
See Schedule attached
SIGNATU F PREPARER OTHER THAN REPRESENTATIVE
Yes No
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DATE
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co
CARLISLE, FA 17013
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[72 P,S. 8 9116{a)(1.1)(i)].
For dates of death on or after January 1, 1995, the tax rate is imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. Ii 9116 (a) (1.1) (ii)].
The statute rln",,, t1nt Axpmnt 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 isthe only beneficiary.
For dates at death on orafterJuly1, :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 patent, an adoptive parent,
orastepparentofthechildisO% [72 P.S.li9116(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.li 9118(1.2) {72 P.S.li9118(a)(1)J.
The tax rate imposed an the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. Ii 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 oradoption.
o PA15002
NTF 29756
Copyright 2000 Greatiand/Nelco lP- Forms Software Only
Estate of: LOUISA F. BOES
21-2001-00078
TIle following person (s) are signing the return as representative (s) of the estate:
PETRONElJA JOHANNA HEYMAN
619 LEREW ROAD
BOILING SPRINGS, PA 17007
MARGAREI'HA CORBELLINI
17 EAST HIGH STREET
APARTMENT 403
CARLISLE, PA 17013
'.':(
LAST lULL AND TESTAMENT OF LOUISA F. BOES
I, LOUISA F. BOES, of North Middleton Township, Cumberland
County, Pennsylvania, declare this instrument to be my Last will
and Testament, in manner and form following:
1. I hereby expressly revoke all wills and COdicils
heretofore made by me.
2. I hereby direct my Executrices to pay all my just debts,
funeral and administrative expenses out of my estate, as soon as
practicable after my death.
3. I direct that all taxes that may be assessed in
consequence of my death of whatever nature and by whatever juris-
diction imposed shall be paid out of my estate as a part of the
administration of my estate.
4. I give and bequeath such of my tangible personal property
as is set forth in a separate unsigned memorandum, which I shall
place with my Will, to the persons therein designated.
5. I give, devise and bequeath the remainder of my estate,
of whatever nature and wherever situate, to my daughters,
Petronella Johanna Heyman and Margaretha Corbellini, also known
as Margo Corbellini, in equal shares, to share and share alike.
In the event that either of my said daughters should predecease
me, I direct that her share be distributed to her children, in
equal shares.
6. I nominate and appoint Dauphin Deposit Bank and Trust
Company, HarriSburg, Pennsylvania, Trustee of the share of any
beneficiary who may be under the age of twenty-five years. The
income and/or principal of said trust may be accumulated or
expended for the maintenance, education and support of such bene-
ficiary as my Trustee in its sole discretion may determine; and
my Trustee, in the expenditure of income and/or principal for such
purposes, may, at its discretion, apply the same directly without
- 1 -
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the intervention of a guardian or pay the same to any person
having the care or control of said beneficiary or with whom the
beneficiary resides, without duty on the part of the Trustee to
supervise or inquire into the application of the funds by any
person to whom any payment is so made. The balance of such
income and/or principal shall be paid to such beneficiary upon
reaching the age of twenty-five years, or to such beneficiary's
estate in the event of death prior thereto.
7. I nominate and appoint my daughters, Petronella
Johanna Heyman and Margaretha Corbellini, also known as Margo
Corbellini, or the survivor of them, as Executrices of this my
Last Will and Testament. In the event that both of my said
Executrices predecease me, or for any reason are unwilling or
unable to serve in that capacity, I hereby nominate and appoint
Dauphin Deposit Bank and Trust Company, Harrisburg, Pennsylvania,
as substitute Executor.
8. I direct that my personal representative and Trustee, as
well as their successors, shall not be required to file bond or
security in any jurisdiction.
9. To the extent that it provides services under the
provisions of this Will, Dauphin Deposit Bank and Trust Company,
Harrisburg, Pennsylvania, or its lawful successors, shall be
entitled to compensation based on its regular schedule of fees
for such services in effect at the time of the services rendered.
10. I give each of my said personal representatives
respectively, the fullest power and authority in all matters and
questions and to do all acts which I might or could do if living,
including, without limitation, complete power and authority to
sell at public or private sale, for cash or credit, with or
without security, and to mortgage, lease and dispose of all my
property, real and personal, at such time and upon such terms and
- 2 -
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conditions as they may determine, all without court order 1 in
this connection my personal representatives shall have the power
to execute and deliver all deeds, instruments of transfer and
other writings necessary to pass proper title thereto.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this 2 y..u. day of July, 1985.
.~(lI1 ~
LOU1sa F. Boes
(SEAL)
WITNESS:
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
I
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I, Louisa F. Boes, 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 Willl that I signed it will-
inglYl and that I signed it as my free and voluntary act for the
purposes therein expressed.
Sworn or affirmed to and acknowledged before me, by Louisa
F. Boes, Testatrix, this 'Ll(.Jl, day of July, 1985.
~~7~
Testatr1x
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JANICE E. 1~-'::1.T;;;LEJ.. NCTA'1Y PUBLIC
O::J~~'~;-L"T,~ ('Cl~;1ty Cml:;l~. PA
My Co:r.n:ission E:~;;ir ~ Janu~ry 27. 19&1
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,;V"_', . ~. . 'I
REV-15GB EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LOUISA F. BOES
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21-2001-00078
Include proceeds of litigation & date proceeds were received by the estate. All DrOD. lolntlv-owned with rlaht of survlvorshlD must be disclosed on Soh. F.
ITEM
NO. DESCRIPTION
VALUE AT
DATE OF DEATH
1 REFUND. CAPITAL AREA BLUE CROSS SUPPLEl'IIENT
401. 90
2 HOLLAND PENSION PAYMENT
553.49
3 F&M TRUST CO. CHECKING ACCOUNT #33-08464
3,028.97
4 WAYFOINT BANK, CERTIFICATE OF DEPOSIT #1766234567
10,466.69
5 1986 BUICK CENTURY AI.JTOrIK)BILE, VALUE APPROXIMATED FROM KELLEY
BLUE BOOK REPORTS ATTAOlED, VEHICLE IN IN FAIR TO POOR CONDITION
1. 000.00
7 CPA81 NTF 10908
Copyright Forms Software Only, 1997 Nelco, Inc.
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
15,451. 05
February 16, 2001
Fishman & Morgenthal
Law Offices
95 Alexander Spring Rd Suite 3
Carlisle, PA 17013-913'1
RE: LOUISA F. BOES
Gentlemen:
In reference to the above customer, our records show the
attached information to be correct. Our total researching fee for
the information we have provided is $15 00. Please send your
remittance to the following address:
Farmers and Merchants Trust Company
ATTN Stacey Stenger
20 South Main Street
Chambersburg, PA 17201-0819
If I may be of any further assistance, please con~act me.
Sincerely,
AL A ^ t /\ 1
~Ij ,L /:.JC /__
stacei?~. Stenger
Operations Clerk
FARMERS & MERCHANTS TRUST COMPANY
P.O. Box "T", CHAMBERSBURG, PA 17201-0819. FAX 717-264-3415 $\ '2.0 ')jjl\
Chambersburg.264-6116 Marion. 375-2200 Waynesboro. 762-2188
RE:
LOUISA F. BOES
DATE OF DEATH
1-6-2Q01
ACCOUNT INFORMATION
X--CHECKING
SAFE DEPOSIT
SAVINGS
CERTIFICATE OF DEPOSIT
SHARES OF STOCK
DATE OPENED
9-25-1996
DATE CLOSED
1-25-2001
ACCOUNT NUMBER
33-08464
ACCOUNT BALANCE AT DATE OF DEATH
ACCRUED INTEREST 52.02
TOTAL ACCOUNT BALANCE $3.028.97
NAME(S) ON ACCOUNT LOUISA F. BOES
53.026.95
---------------------------------------------------------------
ACCOUNT INFORMATION
x CHECKING
SAFE DEPOSIT
SAVINGS
CERTIFICATE OF DEPOSIT
SHARES OF STOCK
DATE OPENED
9-13-1999
DATE CLOSED
1-25-2001
ACCOUNT NUMBER
70-32374
ACCOUNT BALANCE AT DATE OF DEATH
5134.716.80
ACCRUED INTEREST
TOTAL ACCOUNT BALANCE
NAME(S) ON ACCOUNT
5164.42
5134.881.22
LOUISA F. BOES & PETRONELLA ~ HEYMAN
------------------------------------------------------------------
'VI Way~qi!lt
LOOK FOR US. WE'LL GET YOU THERE.
FEBRUARY 8. 2001
FISHMAN & MORGENTHAL
95 ALEXANDER SPRING RD SUITE 3
CARLISLE PA 17013
The information which you requested on the LOUISA BOES DECEASED
(Social Security Number 114-40-5392) is as follows.
Date Ownership Was Established
1765307419 1766234567 1725515815
CERTIFICATE CERTIFICATE IRA
021297 022693 073189
62990.26 10458.91 12037.84
52.72 7.78 9.75
63042.98 10466.69 12047.59
no SOLE SOLE
PETRONELLA HtYlvIA'"
021297 022693 073189
PLEASE COMPLETE W-9
Account Number(s)
Class of Account
Date Opened
Principal Balancc
Accrued Intcrest
Balance at Datc 0 [' Death
Account Ownership
Name of Joint Own cr. i r any
Additionallnl(lJ"tl1ation Rcquested
Sl?:/I lfr'111(
Kathy l. Ya.rJ:j ()
~<X Servires Rep.
P.O. Box 1711. HARRISBURG. PENNSYLVANIA 17105-1711
-011 FrEE I-B66-WAYPOINT (I-B66-929-7646) . www.waypointbank.com
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Engine: V6 2.8 Liter
Trans: Automatic
Drive: Front Wheel Drive
Mileage: 50,000
Equipment
Air Conditioning
Power Steering
AM/FM Stereo
Retail Value
$2,075
Suggested retail represents the price a dealership might ask for this make and
model vehicle. This represents a fully reconditioned vehicle in excellent
condition with a clean ti11e history. This retail price is not a trade-in or private-
party value, but rather assumes that a dealer has absorbed the cost of making
the vehicle ready for sale, reconditioning, advertising, sales commissions,
arranging for financing and insurance and standing behind the vehicle for any
mechanical or safety problems. Many late model vehicles at this price have
passed an inspection program or carry a warranty. Actual dealer selling price
may vary from this price.
Copyright (9 2001 by Kelley Blue Book Co., All Rights Reserved. Mar-Apr 2001 Edition. The information
in this report was printed from the Kelley Blue Book Web site (www.kbb.com) and Is intended for the
personal use of the customer only and may not be sold or transmitted to another party. We assume no
responsibility for errors or omissions.
http://www.kelleybluebook.com/kb/ki.dll/kw.kc. ur?kbb;677295&:r&277 & 16;BU;E 1
04/03/200 I
REV-1509 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LOUISA F. BOES
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
21-2001-00078
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 TENANHS) NAME
A PETRONEIJA JOHANNA HEYMAN
ADDRESS
619 LEREW ROAD
BOILING SPRINGS, PA 17007
RELATIONSHIP TO DECEDENT
DAUGH'IER
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR MADE Include name of financial institution and bank
JOINT account number or similar identifying number. DATE OF DEATH DECD'S VALUE OF
NO. TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1 A 2/12/97 WAYFOINT BANK CERTIFICATE OF 63,042.98 31521. 49 31,521. 49
DEPOSIT #1765307419
2 A 9/13/99 F&M TRUST CO. CHECKING ACCOUNT 134,881. 22 67440.61 67,440.61
#70-32374
TOTAL (Also enter on line 6, Recapitulation) $ 98,962.10
7 CPA91 NTF 10909
(If more space is needed, insert additional sheets of the same size)
Copyright Forms Software Only, 1997 Nelco, Inc.
REV-1510 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LOUISA F. BOES
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FILE NUMBER
21-2001-00078
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY %OF EXCLUSION
ITEM INCLUDE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECD'S (IF TAXABLE VALUE
RELATIONSHIP TO DECD & DATE OF TRANSFER.
NO. ATTACH COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST APPLICABLE)
1 Gift taxes on gifts within 3 years 0.00
of death
2 WAYPOINT BANK IRA#1725515815 12,047.59
TOTAL (Also enter on line 7, Recapitulation) $ 12,047.59
7 CPAOl
NTF 10910
(If more space is needed, insert additional sheets of the same size)
Copyright Forms Software Only, 1997 Nelco, Inc.
REV-1511EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LOUISA F. BOES
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-2001-00078
Debts ot decedent must be reported on Schedule I.
ITEM
NO.
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
1 RONAN FUNERAL HOME, CARLISLE, PA
1,515.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/E1N No. of Personal Representative(s)
Street Address
City St.te
0.00
Zip
Year(s) Commission Paid:
2.
3.
Attorney Fees Name: FISHMAN & MORGENTHAL
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City St.le Zip
Relationship of Claimant to Decedent
3,500.00
0.00
4.
Probate Fees
0.00
5.
Accountant's Fees
0.00
6.
Tax Return Preparer's Fees
0.00
See Schedule attached
Total fran continuation page (s)
587.31
TOTAL (Also enter on line 9, Rec.oil"l.tion) $
(If more space is needed, insert additional sheets of the same size)
5,602.31
7 CPA11 NTF 10911
Copyright Forms SoHware Only, 1997 Nelco, Inc.
Page 2
Estate of: WUISA F. BOES
21-2001-00078
SCHEDULE H, PART B n Administrative Costs
Item
No. Description Amount
7 REGISTER OF WILLS, PROBATE CHARGES 267.00
8 CUMBERLAND LAW JOURNAL, ADVERTISE LEITERS 75.00
9 THE SENTINEL, ADVERTISE LEITERS 100.31
10 F&M TRUST, RESEARCHING OF ACCOUNT INFORMATION 15.00
11 REGISTER OF WILLS, FILING INHERITANCE TAX RETURN 15.00
12 EXECUTORS' RESERVE FOR MISCELLANEOUS CWSING EXPENSES 100.00
13 WIRE TRANSFER FEE 15.00
TOTAL. (Carry forward to main schedule) . . . . . .
587.31
REV-1512 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
LOUISA F. BOES
Include unreimbursed medical exnenses.
ITEM
NO.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
FILE NUMBER
21-2001-00078
DESCRIPTION
AMOUNT
1 APPAlACHIAN REHAB, STATEMENT
180.00
2 GPU ENERGY, FINAL BILL
20.73
3 CARLISLE HOSPITAL, CO-PAY
15.00
4 DON BRACKBILL, CAR REPAIRS FOR DECEDENT'S VEHICLE.
432.09
5 CUMBERLAND CROSSINGS, BILL FOR DECEMBER 2000
4,432.93
6 ALERT PHARMACY, MEDICINE BILL
42.30
7 CUMBERLAND CROSSINGS, FINAL PAYMENT
697.50
8 POSTMASTER, BILL FOR POST OFFICE BOX RENTAL
10.00
9 STATE FARM CAR INSURANCE, 6 MONTH BILL OWED BY DECEDENT
265.82
10 INTERNAL REVENUE SERVICE, 2000 INCOME TAX OWED BY DECEDENT
567.00
11 PA DEPT OF REVENUE, 2000 INCOME TAX OWED BY DECEDENT
201.00
7 CPA12 NTF 10912
TOTAL (Also enter on line 10, Recapi1Ula~on) $
(If more space is needed, insert additional sheets of the same size)
6,864.37
Copyright Forms Software Only, 1997 Neice, Inc.
REV-1513 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
LOUISA F. BOES
No. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1 PETRONELLA JOHANNA HEYl'WJ
619 LEREW ROAD
BOILING SPRINGS, PA 17007
2 MARGARETHA CORBELLINI
17 EAST HIGH STREET
APARTMENT 403
CARLISLE, PA 17013
FILE NUMBER
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
DAUGHTER
DAUGHTER
21-2001-00078
AMOUNT OR
SHARE OF ESTATE
56,997.03
56,997.03
ENTER DOLLAR AMTS. FOR DISTRIBS. SHOWN ABOVE ON LINES 15 THROUGH 17 AS APPROPRIATE ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
None
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
None
7 CPA13 NTF 10913
TOTAL OF PART II -- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
Copyright Forms Software Only, 1997 Nelco, Inc.
(If more space is needed, insert additional sheets of the same size)
0.00
Register of Wills of CUMBERLAND County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of LOUISA F BOES
also known as
No. 21-01-78
Social Security No. 114 - 40 - 5392
MIt~G~ Co!!. BELL/NI
, Deceased
PETRONELLA JOHANNA HEYMAN and MARGARETHA CORBELLINI n/~/A
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW:)
[K] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut~ named in the last Will of
the Decedent, dated 07/24/1985 and codicil(s) dated None
NONE
State relevant circumstances, e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
D B. Grant of Letters of Administration
(c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
I
Name
Relationship
Residence
I
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in CUMBERLAND
County, Pennsylvania with his/her last family
or principal residence at 1 LONGSDORF WAY, SOUTH MIDDLETON TOWNSHI P
(list street, number, and municipality)
Decedent, then ~years of age, died 01/06/2001 at CUMBERLAND CROSSINGS, PA
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in P A) All personal property
(If not domiciled in PA) Personal property in Pennsylvania
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
194,495.00
$
$
$
$
situated as follows: N/ A
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of
letters in the a riate form to the undersi ned:
S' nature
PETRONELLA JOHANNA HEYMAN
619 LEREW ROAD, BOILING SPRINGS, PA 17007
MARGARETHA CORBELLINI
17 EAST HIGH STREET, CARLISLE, PA 17013
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc.
/6 -e2cJ3 - 7
Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of CUMBERLAND
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of
the Decedent, Petitioner(s) will well and truly administer the e according to aw.
JANUARY
. 2001
~
MARGAR HA CORBELLINI
tM'l~ ~~
/v'I ARC 0 ~ BeLL J }\/ "I
Sworn to or affirmed and subscribed
before me this _~ day of
, .
7?20/.( i' (J,::'1f;/I/;~1/ //ifj~,
(/ Fo . the Register
/
No. 21-01- 78
Estate of LOU I SA F BOES
Deceased
Social Security No: 114 -40 - 5392 Date of Death: 01/06/2001
AND NOW, JANUARY 18 2001 ,in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters ~ Testamentary D Of Administration
(c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
are hereby granted to
PETRONELLA JOHANNA HEYMAN and MARGARETHA CORBELLINI A/~/A
11 /l ~ Go
Cd (l. 8EL'- / N I
07/24/1985
in the above estate and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters. . . . . . .
$
235.00
~ V>J1 'j A2 f,
- !bY- / < .{/~>'~Ak~_~'Lj AY~/tf
'Register of Wills
Short Certificate(s).
$
9.00
Renunciation.
$
Attorney:
ROGER M. MORGENTHAL, ESQUIRE
Affidavits (
$
1.0. No:
17143
FISHMAN & MORGENTHAL
95 ALEXANDER SPRING ROAD
SUITE 3
CARLISLE, PA 17013
Extra Pages (
) .
$
18.00
Address:
Codicil. .
$
JCP Fee.
$
5.00
Telephone: 717/249- 6333
~.L~ L.0G) ~y;;fLu
Inventory.
$
Other . .
$
TOTAL.
$
267.00
Form RW-1 (1991)
Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc.
;1-:~' -c ccrti{y tj1at the information here given is correctly copied fro~ an original certificate of death dul~ filed with me as
Lo:al Rl~gistrar. The ocginal certificate will be forwarded to the State Vital Records Office for permanent fihng.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
, "tI"ffl"//~'''Ji''"""
l,'ll~\\\\\\ OF PE,f-,--___
;"'~~J;.,\
f~~' ..!I'. " ~'\
~ :E'.J' . \~l
~ c:::l -- -: \_~
~ c,..).rr:-h' .i~~
\ *' ...'," ". ',' .~I * ~
';. a '. ~e_ '....- ~~
'\. ~ ,'. ~~ l
~ ~ ~.:t-"'" ,\
-~~-_~!IMEN1 \\~ ~'IIII'"
""""',,, ~,,"/11 / /,1 I
21'~ ~. ~eu..&.~~
Local Registrar
P 6947709
JAN 1 0 2001
No.
Date
21-01-78
HtOS. t~ A.... 2/87
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
'PRINT
If
'NENT
I( INI(
89
UNOER 1 YEAR
MonIM Days
Louisa F. Boes
UNDER 1 DAY
HourI i Mlnut_
SEX
2.
STArE FILE NUM8ER
SOCIAL SECURITY NUMBER
NAME OF DECEDENT If".. Moddle, L_)
t.
3.
1 14 - 40
5392
DATE OF OEATH ;MCNh. Dav. '<'1!08.,
L January 6, 2001
y,..
81ATHPlAC( (C~ and ~ OF OER'H (CMlck 0f'Iy one - _ ontlrUCbOnll on 0II'lel Sode)
Am~t ~ fciTr:iountrvl HOSPITAL; OTHER:
Inpallent D ~ Xl
7. Netherlands ...
FACILrTY NAME (II no! on&ItM1On. lloYlJ SlTeel ilnd number.1
=rtv} 0
AGE (Lase Birtt>davl
1 Tb. Coon
Old
decedent
..... in a
Cumberland toWnShip? 17d.D ~~~'"
MOTHER'S NAME (FifsI. Middle. Maiden Surname)
1.. Pietie P. Van der Linde
INFORMANT'S IAAILIHG AOOAESS (StrMt. C4tyIlOwn, Slate. ZIp Code)
2Gb. 619 Lerew Rd. Boiling Springs, Pa 17007
PlACE OF DISPOSITION. Name Of c.m.tery, C'~atory LOCATION. CifyfTown, Slat., Zlp Code
or Other Place
MARITAL STATUS. Mamecs
Newr Married, Widowed.
Oi\oofced (Specify)
Widowed 15.
South Middleton
RACE . Amenc:an Indian. 8Iaek. ~.. Me
(SpeclIy)
10. White
SURVIVING SPOUSE
(n WII.. qrve matCl8n name)
COUNTY OF OE.Q'H
.~i
lb. Cumberland
DECEDENT'S USUAL OCCUPATION
(Give kind 01 work done durong ITlOII
of workin9l1fe; do not use refired,)
. 11.. Homemaker 11b. Homemaking
DECEDENT'S MAIUHG ADOAESS (SIree!. CilyrTown, StaI8. Zop Code) DECEDENT'S
1 Longsdorf Way ~~~~E
Carlisle, Pa 17013 ~~~
11.
FlJ'HEA'S NAME (1"..11. ModdIe. Lase)
11. Jean U tdebroeck
INFORMANT'S NAME (T ypelPrint)
, P J He man
METHOD OF DiSPOSITION
BurIal 0 C~ at R__ffOmStat.O
17a. Stat.
IWPI
citylboro
Jan 8, 2001
RSOH ACTING AS SUCH LICENSE NUMBER
22tI.FD-0 12909-L
10 me bIM 01 my knowledge. death occurred at I~ lime, dill. and ~ Slaled.
(SionBlure and rille)
2311.
TIME OF OUifH DATE PRONOUNCED OEAO (Monlh. Day. 'I9af)
2.. 2 :40 A M. 25. January 6, 2001
27. MAT I: Ent., me diH_, injuries or complicalions wllich caUMd the dealll. 00 not .nt...tlle mode of dying. aucl\.. cardlac Of reapifalory a,rest, shoc:ll or heart 'aHure.
Liat 0I'IIy one ~ on .ad\ line.
21c.
Yorktowne Crematory 21d, York Pa
NAME AND ADDRESS OF FAClUTY
22c.Ronan Funeral Hare 255 York Rd. Carlisle, Pa 17013
LICENSE NUMBER DATE SIGNED
{MonlII. 0Iry. 'lWl
2311. 23c.
WIoS CASE REFERRED TO MEDICAL EXAMINERlCORONER?
'lllakt
NoD
I :.
d.
Myocardial infarction
DUE TO (OR AS A CONSEOUENCE Of):
coronar artery disease
DUE TO (OR AS A CONSEOUENCE Of);
21.
I "WOximat.
l=-=
I
: 24 hrs
PART n:
OIllee' signifk:anI c:ondIliclN ClDI'ArlbuIIng to dutII. buI
not 1ftUIIin9 in me unde<ty\nQ ca... g;...n in f'It.FIT I.
Dementia-Altzheimer's type
DUE TO (OR AS A CONSEOUENCE Of):
WERE AUTOPSY FINDINGS MANNER OF DEATH
JllWLASlE PAlOA TO
COMP\.ETtON OF CAUSE ~ 0
OF DEATH? NatUral Homicide
Acc:idanI 0 Pending Investigallon 0
'iliaD NoD Sulc:ida 0 Could not be det.rmined 0
DATE OF INJURY
(Monlll. Day. ....ar)
TIME OF INJURY
INJURY AT WORI(? DESCRIBE t<IN INJURY OCCURRED.
__ 0 NoD
. 011. M.
PLACE OF INJURY. AI home. farm, It,.... factory, ollie.
building. etc. (Specify)
a.. 2aIa.~. :so..
CERTlf'lEA (Chec:I< only one)
'='::::=::=:~C:':::"Cft""':s=:==:~~~~~~.c~~~~~~.~~)..............,. ~
'MEDICAL EXAMINER/CORONER
On the baal. of examination and/or Investigation, In my opinion, d.a1h occurred at 1he time, date, and place, and due to the cauae(a) and
manner a. atated.. . . . . . . . . . . . , . . . , . . . . . . . . . . , . . . . . . . . . . . . , . . . . . . . . . . . . , . , . . . . . . . , , . . . . . . . . . . . . . . . . . . . . . . . , . . . . , . . .
31..
REGISTRAR'S SIGNATURE AND
~. ~~~
J
k~ t Id-I llO I
34.
'PAOftOUNCING AND CERTIFYING PHYSICIAN (PIIysoC18n bolt> P<QnOUrlC1nq death and CerlIfylnQlo cause of aealh)
To _ ~ of my knowledQ., c1ealt\ occurred at lhe time, dat., and pi..,., and due 10 lhe cause{a) and manner.a alalad.. , . . . . . . . . . . . . . . . . . . . . . . .
""/b-,Q.cJ$- 7
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
7/(
(\
L/,
V
'*
REY-l'07 EX lFP (12-00>
ROGER M MORGENTHAL ES~
FISHMAN & MORGENTHAL
95 ALEXANDER SPRG Rn
CARLISLE P~'17DI3
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-25-2001
BOES
01-06-2001
21 01-0078
CUMBERLAND
101
LOUISA
F
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax pay.ent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REY=i6cfj-ix-AFP-fi'2-:oiir------...-iNifERITANc"E-TAx-sTAfEMENY-OF-ACCouiff--...---------------------
ESTATE OF BOES LOUISA F FILE NO. 21 01-0078 ACN 101 DATE 06-25-2001
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-14-2001
P R I NC I PAL TAX DU E : ...........................................................................................................................................................................................................................
5,129.73
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
04-04-2001 AA478239 255.26 4,850.00
04-12-2001 AA478268 .00 37.23
06-11-2001 REFUND .00 12.76-
TOTAL TAX CREDIT 5,129.73
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
:IE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRl,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l
<6-~8-7
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-21-2001
BOES
01-06-2001
21 01-0078
CUMBERLAND
101
ROGER M MORGENTHAL ESQ
FISHMAN & MORGENTHAL
95 ALEXANDER SPRG RD
CARLISLE PA 17013
~
V
REY-1S47 EX AFP (12-00)
LOUISA
F
Amount Remitted
CHANGED
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
15,451.05
98,962.10
12,047.59
(8)
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 ~
REV=iscij-E3f-AFP-("i'2=ool--NcfficE--OF-i-NHEiiiTANCE-YAX-A-PPRAisEMENT~--Ai:.i-oWANCE-OR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BOES LOUISA F FILE NO. 21 01-0078 ACN 101 DATE 05-21-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
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
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
If an assessment was issued preViously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (IS)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
NOTE:
5,602.31
6.864.37
(11)
(12)
(13)
(14)
(9)
(10)
.00 X 00 =
113,994.06 X 045 =
.00 X 12 =
.00 X 15 =
(19)=
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
126,460.74
]2.466 68
113,994.06
.00
113,994.06
.00
5,129.73
.00
.00
5,129.73
PAYHENT RECEIPT DISCOUNT (+) AHOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
04-04-2001 AA478239 255.26 4,850.00
04-12-2001 AA478268 .00 37.23
TOTAL TAX CREDIT 5,142.49
BALANCE OF TAX DUE 12.76CR
INTEREST AND PEN. .00
TOTAL DUE 12.76CR
. 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 MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
~
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: LOUISA F. BOES
Date of Death: JANUARY 6.2001
Estate No.: 21-01-0078
To the Register:
I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's
Court Rules was served on or mailed to the following beneficiaries of the above-captioned
estate on JANUARY 22.2001
Name
Address
Petronella Johanna Heyman
Maraaretha Corbellini
619 Lerew Road. Boilina Sprinas. PA 17007
17 East Hiah Street. Carlisle. PA 17013
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
NONE
Date: February 2. 2001
FISHMAN & MORGENTHAL
Name Roger M. Moroenthal . Esouire . #17143
Address 95 Alexander Sorino Road. Suite 3
Carlisle. PA 17013
Telephone (717) 249-6333
,..-:.:\
, 9~pacity:
_ Personal Representative
....L Counsel for Personal Representative
'J~
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
LOUISA F. BOES
Date of Death:
1/6/01
No. 2001-00078
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: xx Yes _No
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to NO.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes xx No
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. Did the personal representative state an account informally to the
parties in interest? xx Yes _ No
d. Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of Orphan's Court and
may be attached to this report.
Date:
2/11/02
'~In. 7Y)mgaJl~/m
Signa re
i,..c
-:~r
c'<
SALZMANN, DePAULlS, FISHMAN & MORGENTHAL, P.C.
N~,me (please type or print) ROQer M. Morgenthal. Esquire. #17143
95 Alexander SprinQ Road. Suite 3.
Address
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carlisle! PA 17013
City, Sta e, Zip
(717~ 249-6333
Telep one Number
Capacity: _ Personal Representative
..lL Counsel for Personal Representative
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