HomeMy WebLinkAbout01-0545
PETITION FOR GRANT OF LETTERS
OF ADMINISTRATION
Estate ofRETHA M. KINGSBOROUGH,
Deceased.
Social Security No. 182-22-6528
No.
To:
2/-L)f- 5'15
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner is 18 years of age or older, applies for letters administration on the estate of the
above decedent.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or
principal residence at 7765 Wertzville Road, Carlisle (Middlesex Township), PA 17013.
Decedent, then 83 years of age, died May 26, 2001, at Carlisle Hospital, 246 Parker Street
(Carlisle Borough), Cumberland County, Pennsylvania.
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) 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
situated as follows: N/A
$ 55,000.00
$
$
$
Petitioner, Carolyn J. Vaughn, after a proper search, has ascertained that decedent left no will and
was survived by the following spouse (if any) and heirs:
Carolyn J. Vaughn
Daughter
7765 Wertzville Road, Carlisle, PA 17013
THEREFORE, petitioner respectfully
appropriate form to the undersigned.
requests the grant of letters administration
~ Q (/Q'~/..~
arolyn . Va<<'ghn
in the
OA TH OF PERSONAL REPRESENT A TIVE
COMMONWEAL TH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
The petitioner above-named swears or affirms that the statements in the foregoing petition are true
and correct to the best of the knowledge and belief of petitioner and that as personal representative of the
above del.:edent, petitioner will well and truly administer the estate according to law.
c~~L/k/
Sworn to or affirmed and subscribed
before me this 7 th day of
June 01.
/6-d3~~-7
No. 21-2001-545
Estate of RETHA M. KINGS BOROUGH, Deceased
DECREE OF GRANT OF LETTERS
JUNE
AND NOW, ~ 8th, 2001, in consideration of the petition on the reverse side hereof,
satisfactory proof having been presented before me,
IT IS DECREED that Letters Administration are hereby granted to Carolyn J. Vaughn.
Will Book #
Page
TOTAL
$ 115.00
$ 15.00
$
$ 5 . 00
$ 135.00
Stephen L. Bloom, Esquire
Sup. Ct. I.D. No. 49811
2100 Longs Gap Road
Carlisle, PA 17013
(717) 249-7717
FEES
Probate, Letters, Etc.
Short Certificates( 5 )
Renunciation
JCP
Filed June 8th, 2001
CALL STEPHEN L BI..Ca1 WHEN LE'ITERS ARE FINISHED
CILASIEST A TES\ 1 0248-pet 1
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: RETHA M. KINGS BOROUGH
Date of Death: May 26,2001
File No. 21-01-0545
To the Register:
I certify that Notice of Beneficial Interest required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above estate on June 15,2001:
Name
Address
Carolyn 1. Vaughn
7765 Wertzville Road, Carlisle, PA 17013
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: N/A
Date: Junej8' ,2001
_--KJ~
Stephen L. Bloom, Esquire
2100 Longs Gap Road
Carlisle, PAl 7013
(717) 249-7717
Capacity: Counsel for Personal Representative
C :\LAS\Estates\ I 0248-1 cert. not
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2B0601
HARRISBURG, PA 171 2B-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BLOOM STEPHEN L
2100 LONGS GAP ROAD
CARLISLE, PA 17013
______u fold
ESTATE INFORMATION: SSN: 182-22-6528
FILE NUMBER: 21-2001- 0545
DECEDENT NAME: KINGSBOROUGH RETHA M
DATE OF PAYMENT: 08/24/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: OS/26/2001
NO. CD 000199
ACN
ASSESSM ENT
CONTROL
NUMBER
AMOUNT
101 I $3,060.98
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: CAROLYN J VAUGHN
CHECK# 320
SEAL
INITIALS: DO
RECEIVED BY:
REGISTER OF WILLS
$3,060.98
MARY C. LEWIS
REGISTER OF WILLS
Estate Recoveries, Inc.
Over 15 Years o(SelTice 10 Ihe Final/cialllli/lIIllT
February IS, 2002
Register of Wills for Cumberland County
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013-3387
RE: Estate of Retha M.
Kingsborough, deceased.
Our File#: KCI-02308
Estate#: 21-01-545
Dear Sir:
Enclosed please find our claim regarding the above captioned decedent which
is being filed on behalf of CitifinanciaL a creditor. Supporting documents have been
requested and will be forwarded to you upon receipt.
A copy of this claim is being forwarded to Carolyn J. Vaughn, Personal
Representative for the estate. ? ,C":
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N
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If you have any questions concerning the attached claim, please do netj hesitate
to contact this office. t8
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Sincerely,
'J
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i. :C~~-ln, ~~ t;~
Kathleen M. Spinella
Ext. 133
KMS
Enclosure
See Reverse Side For Special State Disclosures.
This communication is from a debt collector.
This is an attempt to collect a debt and any information obtained will be used for that purpose.
P.O. Box 24566, Baltimore, Maryland 21214 · 5543 Harford Road, Baltimore, Maryland 21214
Monday - Friday 8:00 am - 6:00 pm Eastern Time · Telephone: 410-444-8022 . 800-229-8472 . Fax: 410-426-4051
Special State Disclosures
Colorado
You may request Estate Recoveries, Inc. to cease calling you at your' place of r'esidence 01' place of employment.
This request must be in writing and once received no further contact by telephone shall be made.
lfyou refuse to pay the debt or you wish Estate Recoveries, Inc. to cease fur'ther communication with you, then
this agency will not communicate further with you with respect to such debt except for a written
communication which:
a. Advises you that this agency's further efforts arc being terminated;
b. Notifies you that this agency may invoke specifit.'d renll'dies which arc ordinarily' invoked by this
agency; or
c. Notifies you that the agency intends to invoke a specified n'medy pennitted by law.
Estate Recoveries, Inc. is licensed by tht., Colorado Collection Agency Boar'd, 1525 Sht.'rman Street, Fifth Floor,
Denver, Colorado, 80203. Do not send payments to this Board.
Maine
The business hours for' Estate Recoverit..s, Inc. arc l\londay - Friday 8:00 a.m. - 6:00 p.m. Eastern Time. This
agency may be contacted using the following numbel's: 800-229-8472 or 410-444-8022, Fax: 410-426-4051
1\1 assac h usetts
Notice of Important Rights: You have the right to make a written 01' oral request that telephone calls regarding
your debt not be made to you at your place of employment. Any such oral request will be valid for only ten
days unless you provide written confirmation of tht.' request postmarked or delivered within seven days of such
request. You may terminate this request by writing to Estate Recoveries, Inc.
Minnesota
Estate Recoveries, Inc. is licensed by the Minnesota Department of Commerce.
New York
The license number for Estate Recoveries, Inc. in New York City is as follows: 0976707
North Carolina
The permit number for Estate Recoveries, Inc. in North Carolina is as follows: 3523
Tennessec :=J
This collection agency is licen.sed by the Collectio~ Ser:iet., Board, Statt.' Department of Commerce and
Insurance, 500 James Robertson Parkway. Nashnlle, lennessee 37243.
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
* * *
File No. 21-01-545
Estate of Retha M Kinl!sboroul!h
, Deceased
***
NOTICE OF CLAIM by KATHLEEN M. SPINELLA. AGENT FOR CITIFINANCIAL
Filed Pursuant to Section 3532 (b) (2) of the Probate, Estate,
and Fiduciary Code, 20 Pa. C. S. A ~ 3 5 3 2 (b) (2)
To the Clerk of the Orphans' Court Division:
Enter the claim of KATHLEEN M. SPINELLA. AGENT FOR CITIFINANCIAL
(Claimant)
in the amount of $4.522.69
, against the above entitled
estate. The Decedent, who resided at
50 Bonnvbrook Road Lot 39
(Street Address)
, Cumberland County ,
Carlisle. PA 03547
(City)
Pennsylvania, died on May 26. 2001
Written notice
of said claim was given to Carolyn J. Vau2:hon
(Personal RepresentatIve, or
. Ifknown to claimant, at 7765 WertzvilleRoad
his Counsel)
Carlisle, P A 17013
( Address)
.on February 15. 2002
(Date)
~l!;Cilu0.~~.
KATHLEEN M. SPINELLA, AGENT
Post Office Box 24566, Baltimore, Maryland 21214
( Address)
, Claimant
Claimant's Counsel:
( Address)
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STATE OF PENNSYLVANIA
IN THE MA TIER OF
ESTATE OF:
RETHA M KINGSBOROUGH
IN THE ORPHANS' COURT
OF CUMBERLAND COUNTY
ESTATE#: 21-01-545
STATEMENT OF CLAIM
1. The creditor, Citifinancial, certifies that there is due and owing by RETHA M KINGSBOROUGH, deceased,
the sum of FOUR THOUSAND FIVE HUNDRED TWENTY TWO DOLLARS AND SIXTY NINE CENTS ($
4,522.69).
2. The nature of the claim is a LOAN account 09090349276.
3. The name and address of the claimant is: Citifinancial, Investment Recovery, 11436 Cranhill Dr., Suite H,
Owings Mills, MD 2117.
4. The name and address of the claimant's agent is: Kathleen M. Spinella, Estate Recoveries, Inc., P. O. Box
24566, Baltimore, Maryland 21214.
5. This claim is not contingent and is not secured by any liens or judgments. The last payment on the account
was made on 5/11/01 in the amount of$160.00 .
6. This claim is not based on anyone instrument. Said balance has accrued since the account was established.
On behalf of Citifinancial, creditor, I do solemnly declare and affirm under the pen~~s of p~ury that, tJte
information in the foregoing claim is true and correct to the best of my knowledge, infol:Uftition a'i\a be1ie~i ~l)'
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THLEEN M. SrJNELLA .,'i:
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Estate Recoveries, Inc.
P.O. Box 24566
Baltimore, Maryland 21214
(410) 444-8022
County of Baltimore, Maryland:
IN WITNESS WHEREOF, I hereunto set my hand and Notarial Seal this February 15,2002.
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My Commission Expires: August 8, 2004.
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OFFICIAL USE ONLY
REV-1500 EX + (6-0Q)
P NAME
C
0 0 Ste hen L. Bloom, Es uire
R N FIRM NAME (If Applicable)
R D
E E Ste hen L. Bloom, Es uire
S N
T TELEPHONE NUMBER
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
D
E
C
E
D
E
N
T
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
21-01-0545
DATE OF BIRTH (MM-DO-YEAR)
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
182-22-6528
THIS RETURN MUST BE FilED IN DUPLlCATEW1TH THE
NUMBER
X 1. Original Return
4. Limited Estate
6. Decedent Died Testate
(Attach copy of Will)
o 9. Litigation Proceeds Received
2. Supplemental Return
4a. Future Interest Compromise (date of death after 12-12-82)
7. Decedent Maintained a Living Trust 0
(Attach copy of Trust)
3. date of death
. Remamder Return prior to 12-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
010.
D 11. Election to tax under Sec. 9113(A)
(Attach Sch 0)
II! , ~ INI OH..-''tIGNSHGIl~b\lllUl ASlTm'tO!
COMPLETE MAILING ADDRESS
2100 Longs Gap Road
Carlisle, PA 17013
R
E
C
A
P
I
T
U
L
A
T
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1
Real Estate (Schedule A)
Stocks and Bonds (Schedule B)
Closely Held Corporation, Partnership or
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Tolal Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
60,509.26
(1)
(2)
(3)
None
55,22UU
~n;j,
c:i
N
OFFICIAL USE ONLY
:JJ
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(4)
(5)
None
29,669.62
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III
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~
(6)
None
:i2
",)
Nbne
.Ji
(B)
84,892.34
16,152.49
8,230.59
(11)
(12)
(13)
24.383.08
60,509.26
(14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of line 14 taxable at sibling rate
18. Amount of line 14 taxable at collateral rate
19. Tax Due
20. X
o 0
o 45
.12
.15
(15)
(16)
(17)
(1B)
(19)
x
X
X
X
0.00
2,722.92
0.00
0.00
2,722.92
60,509.26
Copyright (c) 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
7765 Wertzville Road
CITY I STATE I ZIP
Carlisle PA 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)
2,722.92
3,060.98
136.15
Total Credits ( A + B + C) (2)
3,197.13
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line S + SA. This is the BALANCE DUE. (5B)
Make Check Payable 10: REGISTER OF WILLS, AGENT
0.00
474.21
0.00
0.00
0.00
"""W''':::::::::~'t'~~~~''i~~~!~~::~:~~::~:~tt~!~~~i'!~~~~~~~i~!~III~~:i~t~~li!~~!I~~:~~'!l
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.
i~~iil~~I~:i~~~!~:~~i~ii~~~:i~~~~i~~mir'r"
Yes No
~;
o
o
o
[RJ
[RJ
[RJ
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 all Information of which preparer has any knowledge.
S{~:~:/=I?;;~R FILING RETURN __ _~Q~i~~y_~~~~~~~~~, _ !-:~t: _ tl_~? _ __ ___ ___ _ __ ___ __ _ ;A~~ 3 _ 0:2
---" Carlisle, PA 17013
Stephen L. Bloom, Esquire
_ _ ?~99_ }:,~!'J\~ _ ~_aJ) _ ~_",,~_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Carlisle, PA 17013
~GNATU~~PRESENT:'VE
DATE
? - .:10- 0;2
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 9116 (a)(1.1) (il].
For dates of death on or after January 1, 1995. the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.$. 9116 (a) (1.1) (ii)]. The statute does not exemct a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1. 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 P.S. 9116(aX1J].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyright (c) 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
REV-1503 EX +(1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
Retha M. Kin~sborou~h
5511 182-22-6528
OS/26/2001
All property jOintly-owned with right of survivorship must be disclosed on Schedule F.
FILE NUMBER
21-01-0545
ITEM DESCRIPTION VALUE AT DATE
UNIT VALUE
NUMBER OF DEATH
1 9,008.601 shares Mainstay High Yield Corporate Bond B 6.13 55,222.72
TOTAL (Also enter on line 2, Recapitulation) 55,222.72
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc.
Form REV-1503 EX (Rev. 1-97)
REV-150a EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Retha M. Kingsborough SS# 182-22-6528 OS/26/2001 21-01-0545
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1
DESCRIPTION
M&T Bank, Checking Account #3741366169
VALUE AT DATE
OF DEATH
1,505.62
2
Ray W. Kingsborough Estate, Residuary Interest
26,800.00
3
Personal Property
1,364.00
TOTAL (Also enter on line 5, Recapitulation) $ 29,669.62
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-15G8 EX (Rev. 1-97)
REV-1511 EX+(1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCETIV< RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Retha M. Kingsborough
Debts of decedent must be reported on Schedule I,
ITEM
NUMBER
A.
B.
SSfj 182-22-6528
FILE NUMBER
21-01-0545
OS/26/2001
DESCRIPTION
AMOUNT
1
FUNERAL EXPENSES,
Fogelsanger-Bricker Funeral Home, Inc., Funeral expenses
5,044.00
1.
ADMINISTRATIVE COSTS,
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City
State
Zip
Year(s) Commission Paid:
2.
3.
Attorney's Fees Stephen L. Bloom, Esquire
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Carolyn J. Vaughn
Street Address 7765 Wertzville Road
City Carlisle State PA Zip 17013
Relationship of Claimant to Decedent Daughter
7,244.62
3,500.00
4.
Register of Wills
Probate Fees
135.00
s. Accountant's Fees
6, Tax Return Preparer's Fees
7.
1
Other Administrative Costs
Register of Wills, Cumberland County, Filing fees for PA
Inheritance Tax Return ($15.00) and Inventory ($13.00)
28.00
2
Roy D. Gottshall, Appraisal of personal property
45.00
3
The Cumberland Law Journal - Publication of Legal Notice
75.00
4
The Sentinel - Publication of Legal Notice
80.87
TOTAL (Also enter on line 9, Recapitulation) $ 16,152.49
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
REV-1512 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Retha M. Kingsborough
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
SSfl 182 - 22 - 6528
FILE NUMBER
21-01-0545
OS/26/2001
Include unreimbursed medical expenses.
ITEM
NUMBER
1
10
11
12
13
14
15
16
17
DESCRIPTION
1999 and 2000 County and Township per capita tax
AMOUNT
57.00
2
Belvedere Medical Corporation, Final medical expenses
1,014.58
3
Blue Mountain Anesthesia, Final medical expenses
25.99
4
Calaman's Lawn Service
132.50
5
Carlisle A.L.S., Ambulance Service
74.58
6
Carlisle Pathology Assoc., Final medical expenses
107.08
7
Carlisle Digestive Disease Associates, Ltd., Final medical
expenses
171. 04
8
Carlisle Imaging Assoc., Final medical expenses
120.04
9
Carlisle Hospital, Final medical expenses
792.00
Citifinancial
4,522.69
Commercial Acceptance Co., Collection Account
68.04
C.H. Harris Associates, Inc. - 1999/2000 School Per Capita Taxes
(Delinquent)
69.80
Household Bank, Mastercard Acct. #5407 9106 0060 4530 (Joint
obligation)
451. 73
O'Brien, Baric & Scherer, Legal services
420.00
Philip D. Carey, M.D., Final medical expenses
144.24
RWC Corporation, Final medical expenses
52.35
Walnut Bottom Radiology, Final medical expenses
6.93
I
TOTAL (Also enter on line 10, Recapitulation) $ 8,230.59
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software onlyCPSystems, Inc. Form REV-1512 EX (Rev. 1-97)
REV-1513 EX + (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Retha M. Kingsborough
NUMBER
I.
SSII 182-22-6528
OS/26/2001
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
FILE NUMBER
21-01-0545
AMOUNT OR SHARE
OF ESTATE
1
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outrIght spousal distributions, and
transfers under Sec. 9116{a)(1.2)]
Carolyn J. Vaughn
7765 Wertzvi11e Road
Carlisle, PA 17013
Daughter
100% of Estate
Residue
ENTER DOLLAR AMTS. FOR DiSTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON TAXABLE DISTRIBUTIONS,
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX is NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTiONS ON LINE 13 OF REV 1500 COVER SHEET S
(It more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lackner Group,lnc.
0.00
Form REV-1513 EX (Rev. 9-00)
MainStay
. :Jment
Management LLC
MainStav Shareholder Services
P.O. Box 8401
8oston, MA 022/56-8401
800 MainStay 800 624~6782
July 16, 2001
JAMES D DAY
NYLIFE SECURITIES INC.
3401 NORTH FRONT ST 1ST FLOOR
HARRISBURG PA 17110-1462
REFERENCE: 01006831
MAINSTAY HIGH YIELD CORPORATE BOND B
ACCOUNT NUMBER 54509700-2 (CLOSED)
RETHA KINGS BOROUGH
Dear Mr. Day:
I am contacting you concerning your request for account value
information about the above referenced MainStay account
registered to Retha Kingsborough.
The account value information you requested as of the date of
death, May 26, 2001, is listed in the table below:
Account Number
43-54509700
Net Asset V.~u.
$6.13
Tota~ Shares
9 008.601
Account B.~ance
$55 222.72
The value of the account was determined by multiplying the total
number of shares by the Net Asset Value. Fluctuations in the
value of the account occurred based on the fluctuation in the
Net Asset Value of the fund. Carolyn Vaughn redeemed the assets
held in this account on June 26, 2001.
Mr. Day, if you have any questions, please contact MainStay
Shareholder Services by calling I-800-MAINSTAY. A representative
will be happy to assist you.
Sincerely,
~atW
Richard Gallitelli
Correspondent
CC : CAROLYN J VAUGHN
MuonS!"" Sharellold.![ S<!fVI~<lS 'S d division of NYLlM SllfV1Ul COrn!),,,,,, ,I Meqtst'H,~<I
T',l,,<;tm '-1"'1111 '111\1 _,Hi!>"!,, "I Ntlw YOlk Lif" IrlVestmlll1t M,ll\,l'jHrn')r1t LlC
v
~M&rBank
July 27, 2001
RE:
Estate Search
The Estate of:
Date of Death (0.0.0.)
RETHA M. KINGSBOROUGH
5-26-2001
To Whom It May Concern:
Identified below is the account information requested.
I. M&T Bank accounts in which the decedent's name appears:
Account
Type
Account Number
Account Title
Opening Branch
0.0.0. Accrued Interest
Balances
(Includes Acer.
Int.)
$1,505.62 $.00
CHK
3741366169
RETHA M.
KINGSBOROUGH
4335
2. Loans, Mortgages, or other obligations titled in the decedent's name
Account Number
Amount Owed
Account Description
No Safe Deposit Box titled in the Decedent's name existed at our office.
If you have any questions about the information provided, please contact our Records Department at (716) 635-4010 or 1-800-724-
2440 outside of the Buffalo, NY calling area. Thank you.
Sincerely,
M&T BANK CORPORATION
BY:
~ ^^ ~^^^-^~
Authorized Signature
~ c-rrl J^ 'c k1
DATE:
I J.tLiIOl
I I
Manufacturers and Traders Trust Company. 1100 Wehrle Drive. PO. Box 767, Buffalo. NY 14240-0767
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STEPHEN L. BLOOM
ATTORNEY AND COUNSELLOR 1\1' LAW
2100 Longs Gap Road
Carlisle, Pennsylvania 17013,Tel 717-249-7717
Federal EIN 25-1851818
Invoice submitted to:
Kingsborough, Retha M. Estate
c/o Carolyn J. Vaughn, Administratrix
7765 Wertzville Road
Carlisle, PA 17013
February 13, 2002
in Reference To. Estate Administration
Invoice #832
Professional Services
Hrs/Rate Amount
8/28/01 SLB Telephone conference with Attorney Rebert's office 0.17 29.17
175001hr
8/24/01 PL Conference with Administratrix re Inheritance Tax payment and 2.58 245.42
outstanding medicai bills; Remit Inheritance Tax payment to Register of 9500/hr
Wills
8/27/01 PL Review additional invoice received from RWC 0.17 1583
95.00/hr
9/6/01 PL Review matters with Mr. Bloom; Draft correspondence to Attorney 200 190.00
Rebert 9500lhr
915101 PL Conference with Administratrix re additional medical expenses 0.58 55.42
9500/hr
9/7/01 PL Telephone conferences with Administratrix re additional medical 0.83 79.17
expenses; Review Medicare statement re recent payments received; 95.00/hr
Correspondence to Attorney Rebert
9/17/01 SLB Review correspondence from Attorney Hazen; Preparation of 012 2124
responsive communication re same 17500/hr
9/10/01 PL Telephone conference with Administrator re additional medical bills and 0.42 39.58
proration of 2001 real estate taxes; Correspondence with Attorney 9500/hr
Rebert
PRAC'fICAL COUNSEL 01< CHRISTIAN PERSPECTIVE
Kingsborough, Retha M. Estate
9/11/01 PL Review additional medical records; Telephone conference with Carlisle
Hospital re status of payment of account
9/17/01 PL Review correspondence from Attorney Hazen; Responsive
correspondence re same
1/29/02 PL Review proposed Quitclaim Deed
1/30/02 PL Telephone conference with Attorney Rebert's office re Quit Claim Deed
1/31/02 PL Telephone conference with Estate Recoveries Inc. re status if
CitiFlnancial claim
9/20/01 PL Telephone conference with client re electric bill for Ray's estate;
Telephone conference with Attorney Rebert's office; Revise
correspondence with Attorney Hazen re revocation of Decedent's Will
9/21/01 PL Telephone conference with client re additional bill received from
Carlisle Hospital; Finalize correspondence to Attorney Hazen;
Telephone conferences with Carlisle Hospital re status of payments,
Telephone conference with Attorney Rebert; Correspondence with
Attorney Rebert re Quit Claim Deed
9/25/01 PL Telephone conference with client re PP&L bill and outstanding Carlisle
Hospital bill
9/24/01 PL Review additional bill from Carlisle Hospital and PP&L Electric bill
10/29/01 PL Telephone conference with Carlisle Regional Medical Center re stop
payment; Telephone conference with client re same
9/26/01 PL Telephone conferences with client re PP&L bill and status of invoice
from Carlisle Hospital; Telephone conferences with Carlisle Regional
Medical Center re account
9/27/01 PL Telephone conference with Carlisle Regional Medical Center re
outstanding invoice; Telephone conference with client re same
10/2/01 PL Telephone conference with client re stop payment on check for Carlisle
Hospital invoice; Telephone conference with Carlisle Hospital re
confirmation of stop payment; Draft correspondence to Attorney Rebert
forwarding expenses for Ray Kingsborough Estate
10/5/01 PL Telephone conference with Attorney Rebert re utility Information;
Telephone conference with Shipley Oil re Kingsborough account;
Correspondence to G.H. Harris Associates re delinquent 1999/2000
school per capita taxes
PRACTICAL COUNSEl. ~ CHRISTIAN PERSPECTIVE
Page 2
Hrs/Rate Amount
0.17 15.83
95.00/hr
0.83 79.17
95.00/hr
0.25 26.25
105.00/hr
0.17 17.50
10500lhr
0.17 17.50
10500/hr
108 102.92
95.00/hr
2.00 190.00
9500/hr
0.25
95 OO/hr
23.75
0.25
95.00/hr
2375
0.08
95.00/hr
0.42
9500/hr
7.92
39.58
0.33
9500/hr
31.67
0.42
9500/hr
3958
083
95.00/hr
79.17
Kingsborough, Retha M. Estate
10/9/01 PL Finalize correspondence to G.H. Harris Associates re delinquent taxes
10125/01 PL Telephone conference with Carlisle Regional Medical Center re
outstanding medical invoices; Telephone conference with client
11/5/01 PL Telephone conferences with client re outstanding invoice at Carlisle
Regional Medical Center; Te/ephone conferences with Carlisle
Regional Medical Center re same
11/8/01 PL Telephone conference with client
11/16/01 PL Telephone conference with Shipley Oil re hold status for oil delivery
11/29/01 PL Telephone conference with Mr. Day re status of estate administration
12/4/01 PL Correspondence to Attorney for Ray Kingsborough Estate re status;
Correspondence to client
12/13/01 PL Review DPW status
1/11/02 PL Telephone conference with Mr. Day; Telephone conference with client;
Administrative matters
1/23/02 PL File and estate status conference with Mrs. Chronister and formulate
strategy for finalizing administration and related matters for Ms. Vaughn
1/24/02 PL Review correspondence received from Estate Recoveries re
CitiFinancial claim for balance due; Telephone conference with client;
Telephone conference with Attorney Rebert's office re status of Quit
Claim Deed and Account for Ray Kingsborough Estate;
Correspondence to Estate Recoveries requesting documentation of
claim; Review additional information pertaining to Inheritance Tax
Return
2/5/02 PL Review correspondence received from Attorney Rebert re Quitclaim
Deed; Review 1099-INT received from client re Mainstay account
2113102 SLB Administrative Matters
SLB Reserve for final administrative matters, including special issues arising
in connection with Estate's interest in pending distribution of residuary
interest from Estate of Ray W. Kingsborough, certain creditor issues,
and necessary tax filings
For professional services rendered
P RAe T r c: ALe 0 L N S E L + ell R I S '1' J A N PER S PEe T! V E
Page 3
Hrs/Rate Amount
017 15.83
9500/hr
0.17 1583
9500lhr
0.83 79.17
95.00/hr
0.08 792
95.00/hr
0.17 15.83
9500lhr
0.33 31.67
9500/hr
0.42 3958
9500/hr
0.17 15.83
95.00/hr
1.00 105.00
10500/hr
067 7000
105 OO/hr
2.50 262.50
105.00/hr
0.50 52.53
10500/hr
025 4625
185.00/hr
4.71 871.66
18500/hr
26.09
$3,000.02
Kingsborough, Retha M. Estate
Previous balance
8/27/01 Payment - thank you
Total payments and adjustments
Balance due
PAYABLE UPON RECEIPT - THANK YOU
PRACTlCAL COCNSEL '" CHRISTIAN PERSPECTIVE
Page
4
Amount
$4,580.49
($4,58049)
($4,58049)
$3,000.02
STEPHEN L. BLOOM
ArrOHNI.:Y AND COUNSI':LLO\\ AT LAW
W\\'\\' .pl{ 1\ (:TI C,\ Let) L" NSFI.. CO M
2100 LON(iS C; AI' ROAD
CARLlSI.E, PENNSYI.VANIA 17013
TELEPHONE 717-249.7717
,; ^ C s r M r 1.1,: 7 1 7 - 249 - 7 7 5 7
T () J. J. Fit 1-:1,: 87 7 . S 4 8 . 9 6 0 2
() 1:1.ICI'. ;\ \)1\11 N ISTR :\TOI{
S 11.\ R () N F. B J.I)(),\1
J. 1'. (; :\ 1. ;\ S S 1ST :\""1
LORI r\. SI'I.I.I\:\r-.
Sll!(){I,\l([I}I'It-\CTIL:\ I.C(l['r-.;sl-:I..cn,\l
C 1.11-..'"1"/ e(),\1 \11" I ry:-; I-,J( \ I(I~
"1.\ III f,;.,\ "I' <: 111,(1\'1 \,\'11'1\
August 24, 200 I
Invoice submitted to:
Kingsborough, Retha M. Estate
c/o Carolyn 1. Vaughn, Administratrix
50 Bonnybrook Road, Lot #39
Carlisle, PA 17013
In Reference To: Estate Administration
For professional services rendered to date for administration of the
Estate of Retha M. Kingsborough
$4.244.62
Additional Charges for Costs Advanced:
Probate Fee - Register of Wills of Cumberland County
135.00
Publishing Fee - Legal Notice - Cumberland Law Journal
75.00
Publishing Fee - Legal Notice - The Sentinel
80.87
Personal Property Appraisal Fee - Roy D. Gottshall, Auctioneer
45.00
Total costs
$335.87
~
@
(
Total amount of this bill
$4.580.49
Balance due
$4.580.49
(fi
"
PRACTICAL COUNSEL oJ< CIIRlSTIAN Pr:.RSPECTIVE
STEPHEN L. BLOOM
ATTORNEY AND COUNSELLOR AT LAW
2100 Longs Gap Road
Carl i s Ie, Pen n s y I van i a 17013, Tel 717-249-7717
Federal ErN 25-1851818
Invoice submitted to:
Kingsborough, Retha M. Estate
c/o Carolyn J. Vaughn, Administratrix
7765 Wertzville Road
Carlisle, PA 17013
August 27, 2001
In Reference To: Estate Administration
Invoice #689
Professional Services
6/5/01 SLB Prepare for and attend conference with client (Ms. Vaughn) and
financial advisor (Mr. Day); Preliminary administrative matters;
Examine Ray Kingsborough Estate records at Register of Wills Office
PL Administrative Matters; Research unclaimed property records; Draft
Petition and Decedent Information Sheet; Prepare Draft SS-4 and
correspondence to IRS
6/7/01 SLB Appearance at Register of Wills Office
PL Conference with client and Mr. Bloom at Register of Wills; Draft
correspondence to Department of Public Welfare; Administrative
matters; Correspondence with client
6/8/01 SLB Finalize correspondence; Administrative matters
PL Administrative Matters; Obtain Obituary for file; Correspondence
6/11/01 SLB Review and evaluate Ray Kingsborough Estate documents; Certificate
of Grant of Letters and Short Certificates for Retha Kingsborough
Estate; Correspondence with Attorney Rebert (counsei to Ray
Kingsborough Estate)
6/12/01 SLB Conference with paralegal; Online research re property information
Hrs/Rate
2.00
175.00/hr
0.92
95.00/hr
0.33
175.00/hr
1.50
95.00/hr
0.17
175.00/hr
1.83
95.00/hr
0.46
175.00/hr
0.31
175.00/hr
Kingsborough, Retha M. Estate Page 2
HrsJRate
6/11/01 PL Administrative Matters; Correspondence with Attorney Rebert re Ray 0.92
Kingsborough Estate 95,00/hr
6/12/01 PL Review documents, notices and Wiil of Ray Kingsborough 0,25
95.00/hr
6/13/01 PL Research at Recorder of Deeds Office re property at 7765 Wertzville 0.33
Road and nature of decedent's interest therein 95,00/hr
6/15/01 SLB Teiephone conference with Attorney Rebert; Draft memorandum to file 0.20
175,00/hr
6/18/01 SLB Review correspondence from Department of Public Welfare re Estate 0,08
Recovery Program 175,00/hr
6/14/01 PL Telephone conference with client (Ms, Vaughn) re file status, personal 3,92
property appraisal and distribution of home; Telephone conference with 95,00/hr
Roy Gottshail (Auctioneer) re vaiuation of personai property;
Correspondence with bank; Prepare required Legal Notices for
publication; Correspondence with IRS re Form SS-4; Correspondence
with Mainstay; Correspondence with Household Finance re joint credit
card account; Draft required Notice to Beneficiary and Certification re
same; Administrative matters
6/15/01 PL Telephone conference with Mr, Sanders at Mainstay re date of death 0.25
vaiuation of account 95,00/hr
6/20/01 SLB Review personal property Appraisal 0.08
175.00/hr
6/22/01 SLB Telephone conference with Attorney Denlinger re proceeds to 0.17
beneficiary (Ms, Vaughn); Telephone conference with Administrator 175,00/hr
(Ms. Vaughn) and advice
6/19/01 PL Telephone conference with Household Finance re joint credit card 1.17
account; Correspondence re same; T eJephone conference with 95,00/hr
Administrator re PP&L statement, property valuation and removal of
plants from real estate; Correspondence with Social Security
Administration
6/18/01 PL Telephone conference with Administratrix; Review correspondence; 0.92
Telephone conference with Household Finance; Office conference with 95.00/hr
Attorney Bloom
6/20/01 PL File Certification of Notice with Register of Wills 0,17
95,OO/hr
6/21/01 PL Telephone conference with Department of Army re Commissary 0,75
Identification Card; Correspondence with Department of Army and 95.00/hr
Attorney Rebert
Kingsborough, Retha M. Estate Page 3
Hrs/Rate
6/25/01 SLB Review information from Military Personnel Division and Agreement of 0.21
Sale; Office conference with paralegal 175.00/hr
6/22/01 P L Telephone conference with Administratrix; Teiephone conference with 0.33
Mr. Day re asset transfer and liquidation 95.00/hr
6/25/01 PL Review correspondence received from Carlisle Barracks re termination 0.58
of identification card for both Retha and Ray Kingsborough; Review 95.00/hr
personal property appraisal and pay invoice; Telephone conference
with Administratrix
6/26/01 PL Review correspondence from IRS re estate FEIN 0.08
95.00/hr
7/2/01 SLB Review claim of creditor (O'Brien, Baric & Scherer); Review 0.11
correspondence from SSA 175.00/hr
6/29/01 PL Review correspondence from Carlisle Barracks re Uniformed Services 0.17
Identification Card 95.00/hr
7/6/01 PL Review correspondence received from Social Security Administration 0.25
and Attorney O'Brien re outstanding invoice for services rendered; 95.00/hr
Telephone conference with Mr. Day's office re Mainstay account
valuation matters
7/9/01 PL Telephone conference with Administrator 0.17
95.00/hr
7/10/01 PL Telephone conference with Mr. Day; Telephone conference with 1.08
Administrator; Correspondence 95.00/hr
7/17101 PL Review confirmation of iegal notice; Administrative matters; Review 1.25
bills from collection agency re county taxes and Belvedere Medical 95.00/hr
Corporation to determine liability of estate for same; Review Carlisle
Hospital statement submitted to insurance
7/20/01 PL Administrative Matters; Telephone conference with Mr. Day re Mainstay 2.50
date of death account information; Conference with same; Review and 95.00/hr
evaluate same; Accounting and preparation of Inheritance Tax return
and schedules
7/23/01 PL Correspondence; Preparation of asset information and Inheritance Tax 2.67
Return and schedules 95.00/hr
7/24/01 PL Review and file Proof of Publication of Notice from Cumberland Law 0.08
Journal 95.00/hr
8/15/01 SLB Review correspondence from Attorney Rebert; Office conference with 1.00
Paralegal re same and responsive correspondence, etc. 175.00/hr
Kingsborough, Retha M. Estate
8/6/01 PL Review correspondence received from Sandra Jordan (step-daughter
of decedent); Review date of death account information received from
M&T Bank
8/7/01 PL Review correspondence and enclosures received from Attorney Rebert
re Ray Kingsborough Estate and real estate; Telephone conference
with Administrator re revoked Will and content of letter from Attorney
Rebert
8/8/01 PL Correspondence to Administrator re delinquent CountyfTownship tax
bill; Draft correspondence to Sandra Jordan re revoked will
8/10/01 PL Review final medical statement from Belvedere Medical Corp.; Draft
correspondence to Executrix; Preparation of Account and Inheritance
Tax Return
8/13/01 PL Administrative Matters; Accounting; Preparation of Inheritance Tax
Return and Schedules; Preparation of Inventory for filing at Register of
Wills
8/14/01 PL Review requests of Attorney Rebert re Ray Kingsborough Estate;
Preparation of Inheritance Tax Return and Schedules
8/16/01 SLB Conference with paralegal re status of revoked Will
PL Telephone conference with Attorney Irwin's office re documentation of
Decedent's appointment scheduled through Office of Aging; Telephone
conference with Office of Aging re same; Telephone conference with
Administratrix re copy of Will, status of file re Inheritance Tax discount
and change of address form for Post Office; Telephone conference
with Post Office; Conference with Administratrix; Review documents
received from Administratrix; Telephone conferences with various
medical providers re invoice balances; Administrative matters;
Preparation of Inheritance Tax Return and Schedules
8/20/01 PL Telephone conference with Carlisle Hospital re outstanding invoices
8/21/01 PL Review invoice from RWC Corporation; Telephone conferences with
Carlisle Hospital re outstanding invoices; Telephone conferences with
Commercial Acceptance Co. (collection agency) re outstanding
balance for medical bills; Telephone conference with Dr. Carey's office
re outstanding medical bill; Review additional bills received from
Administratrix
8/22/01 PL Telephone conference with Carlisle Pathology Assoc. re final invoices;
Telephone conference with Carlisle Regional Medical Center re final
invoice; Telephone conference with RWC Corporation re outstanding
invoices; Telephone conference with Dr. Carey's office re outstanding
Page
4
Hrs/Rate
0.33
95.00/hr
0.75
95 OO/hr
0.92
95.00/hr
2.50
95.00/hr
3.25
95.00/hr
3.00
95.00/hr
0.17
17500/hr
7.50
95.00/hr
0.25
95.00/hr
2.83
95.00/hr
7.25
95.00/hr
Kingsborough, Retha M. Estate
invoice; Update Accounting information; Prepare Inheritance Tax
Return and Schedules; Prepare Inventory
8/23/01 PL Telephone conference with Administrator re Inheritance Tax Matters;
Review Inheritance Tax Return and Inventory for Ray Kingsborough
Estate; Research residuary interest of decedent in same; Prepare
Inheritance Tax Return and Schedules; Prepare Inventory;
Administrative matters
SLB Preparation of Inheritance Tax Return and Schedules
For professional services rendered
Additional Charges:
6/7/01 Filing Fee - Probate Fee - Cumberland County Register of Wills
6/25/01 Appraisal Fee (Personal Property of Estate) - Roy D. Gottshall, Auctioneer
7/17/01 Publishing Fee - Legal Notice - The Sentinel
Publishing Fee - Legal Notice - Cumberland Law Journal
Total costs
Total amount of this bill
Fees for professional services reduced to 5% of tentative gross estate
Balance due
PAYABLE UPON RECEIPT - THANK YOU
Hrs/Rate
6.67
95.00/hr
0.50
175.00/hr
63.13
Page
5
Amount
$4,244.62
135.00
45.00
80.87
75.00
$335.87
$4,580.49
$4,580.49
fI
Register of Wills of
CUMBERLAND
County, Pennsylvania
INVENTORY
Estate of Retha M. Kingsborough
No. 21- 01- 0545
also known as
Date of Death OS/26/2001
,Deceased Social Security No. 182 - 22 - 6528
Carolyn J. Vaughn, Administrator,
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the
personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. I !We verify that the statements made in this Inventory are true and correct. l!We understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Personal Representative
Name of
Attorney:
Stephen L. Bloom, Esquire
Signature:
1.0. No.:
49811
Signature:
Address:
2100 Longs Gap Road
Address:
7765 Wertzville Rd.
Carlisle, PA 17013
Carlisle, PA 17013
Telephone: 717/249-7717
Telephone: 717/249 - 0142
Dated:
D? /3-() d.-
Description
Value
r.
rI ~ "
- (l"'l
c:::i
N
:n
;,'.".,
(See continuation page(s) attached)
rTl
co
N
i~':~
.C::>
(Attach additional sheets if necessary)
Total:
84,892.34
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc.
Form tlRW-7 (1992)
..
INVENTORY
Estate of:
Date of Death:
County:
Retha M. Kingsborough
OS/26/2001
Cumberland
CASH:
M&T Bank, Checking Account
/13 741366169
1,505.62
Ray W. Kingsborough Estate,
Residuary Interest
26,800.00
28,305.62
PERSONAL PROPERTY:
Personal Property
1,364.00
1,364.00
STOCKS/LISTED:
9,008.601 shares Mainstay High Yield
Corporate Bond B
55,222.72
55,222.72
TOTAL RECEIPTS OF PRINCIPAL...............
84,892.34
----------------
----------------
-1-
,/
INRE:
ESTATE OF:
RETHA M. KINGSBOROUGH
ESTATE NO. 21-01-545
DECEASED.
SATISFACTION AND RELEASE OF CLAIM
The undersigned, Jaime L. Bengies, Agent for CITIFINANCIAL, has received a payment
of $4522.69 which satisfies the claim as filed for the date of death liability. This Satisfaction and
Release of Claim is executed to acknowledge discharge of the claim and to release the estate and
personal representative from all further liability with respect to the date of death liability on
account number 09090349276.
Executed this March 18, 2002.
CITIFINANCIAL
Claimant
By: iI t
JAI L. BENGIES, Agent
Estate Recoveries, Inc.
P.O. Box 24566
Baltimore, MD 21214
410-444-8022 Ext. 765
/6-~$Cw 7
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRIS8URG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'*
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-1547 EX AFP (01-02)
'LiZ
I.,"", 12
If' 1\ _
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
r"'" .r-...,
, i cd'lJt.I TY
ACN
04-08-2002
KINGSBOROUGH
05-26-2001
21 01-0545
CUMBERLAND
101
RETHA
M
STEPHEN L BLOOM ESQ
2100 LONGS GAP RD
CARLISLE PA
~.I; ~
1 7 0 1 3 - P;V~~
Amount Remitted
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-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF KINGSBOROUGH RETHA M FILE NO. 21 01-0545 ACN 101 DATE 04-08-2002
T AX RETURN WAS: (X) ACCEPTED AS F I LED
CHANGED
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)
.00 NOTE: To insure proper
55,222.72 credit to you r account,
.00 submit the upper portion
.00 of this form with your
29,669.62 tax payment.
.00
.00
(8) 84,892.34
Jointly Owned Property (Schedule F)
Transfers (Schedule G)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6.
7.
8.
Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
(9)
(10)
16,152.49
11.
12.
13.
14.
Total Deductions
Net Value of Tax Return
8,230.59
( 11)
(12)
(13)
(14)
/4.383 08
60,509.26
.00
60,509.26
Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
Net Value of Estate Subject to Tax
NOTE:
If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of !hh returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate
(15)
(16)
(17)
(18)
.00 X
60,509.26 X
.00 X
.00 X
00
045 =
12
15
(19)=
.00
2,722.92
.00
.00
2,722.92
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
08-24-2001 CDOOO199 136.15 3,060.98
TOTAL TAX CREDIT 3,197.13
BALANCE OF TAX DUE 474.21CR
INTEREST AND PEN. .00
TOTAL DUE 474.21CR
* IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT 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.)
RESERVATION: Estates of decedents dying on or before December 12. 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth herebY expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTI ONS :
DI SCOUNT :
PENALTY:
INTEREST:
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act. Act 23 of 2000. (72 P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side.
--Make check or money order payable to: REGISTER OF MILLS, AGENT
A refund of a tax credit, which was not requested on the Tax Return, may be requested by cOlllpleting an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office
of the Register of Wills. any of the 23 Revenue District Offices. or by calling the special 24-hour
answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or
speaking needs: I-BOO-447-3020 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue. Board of Appeals. Dept. 281021. Harrisburg. PA 17128-1021. DR
--election to have the matter determined at audit of the account of the personal representative. OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes. ATTN: Post Assessment Review Unit. Dept. 280601. Harrisburg. PA 17128-0601
Phone (717) 787-6S0S. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-lS0l) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death. a five percent (S%) discount of
the tax paid is allowed.
The lS% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed. and not
paid before January 18. 1996. the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency. or nine (9) months and one (1) day from the date of
death. to the date of payment. Taxes which became delinquent before January 1. 1982 bear interest at the rate of
six (6%> percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1. 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are:
Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor
1982 20% .000S48 1992 9% .000247
1983 16% .00043B 1993-1994 7% .000192
1984 11% .000301 1995-1998 9% .000247
1985 13% .0003S6 1999 7% .000192
1986 10% .000274 2000 8% .000219
1987 9% .000247 2001 9% .000247
1988-1991 11% .000301 2002 6% .000164
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax beCOMes delinquent will reflect an interest calculation to fifteen (IS) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice. additional interest must be calculated.
REGISTER OF WILLS OF CUMBERLAND COUNTY
STATUS REPORT UNDER RULE 6.12
(For Resident Decedents Dying After July 1, 1992)
Name of Decedent:
RETHA M. KINGSBOROUGH
Date of Death:
May 26, 2001
File No.:
21-01-0545
Social Security No.:
182-22-6528
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to
completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X
No
2. If the answer is No, state when the personal representative reasonably believes that the
administration will be complete: N/A.
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes_
No X
b. The separate Orphans' Court No. (if any) for the personal
representative's account is: N/A.
c. Did the personal representative state an account informally to the parties in interest?
Yes
No~
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts
may be filed with the Clerk of the Orphans' Court and may be attached to this report.
1. L l:J
. "1
-
Date:
May 21, 2002
Signature:
, N.~1J,1e:
, A 6 I!I/'
, uress."
Stephen L. Bloom, Esquire
Zo. 2100 Longs Gap Road
Carlisle, PA 17013
(717) 249-7717
Counsel for Personal Representative
C:\LAS\Estates\10248-statrpt.\
~
/6- a ,f3.s- - 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
'*
REV-1U7 EX AFP (01-02)
'02
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
., 6COUNTY
ACN
05-06-2002
KINGSBOROUGH
05-26-2001
21 01-0545
CUMBERLAND
101
RETHA
M
STEPHEN L BLOOM ESQ
2100 LONGS GAP RD
CARLISLE PA 17~~~
2.4
Allount Rellitted
r~vn
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, subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
ifiv =i6Cfj-EX-AFP--foY:02y------...--iNHERiYANC'E--fAX-STA-TEHENf-oF'-ACCo[iiiT--.-i.---------------- - - ---
ESTATE OF KINGSBOROUGH RETHA M FILE NO.21 01-0545 ACN 101 DATE 05-06-2002
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: 04-01-2002
PR I NC I PAL TAX DU E : .......................................................................................................................................................................................................................
2,722.92
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
08-24-2001 CDOOO199 136.15 3,060.98
04-17-2002 REFUND .00 474.21-
TOTAL TAX CREDIT 2,722.92
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
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" (CRJ,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J
PAYMENT:
Detach the top portion of this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
If RESIDENT DECEDENT make check or money order payable to: REGISTER OF WILLS, AGENT.
If NON-RESIDENT DECEDENT make check or money order payable to: C0l1110NWEAL TH OF PENNSYLVANIA.
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13l3). Applications are available at
the Office of the Register of Wills, any of the 23 Revenue District Offices or from the Department's 24-hour
answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and I or
speaking needs: 1-800-447-3020 (TT only).
REPLY TO:
Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, phone
(717) 787-6505.
DISCOUNT:
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount
of the tax paid is allowed.
PENALTY:
The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period.
INTEREST:
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (6%) percent per annum calculated at a daily rata of .000164. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are:
Year
Interest Rate
Daily Interest Factor
Year
Interest Rate
Daily Interest Factor
1982 20% .000548 1992 9% .000247
1983 16% .000438 1993-1994 7% .00Dl92
1984 11% .000301 1995-1998 9% .000247
1985 13% .000356 1999 7% .000192
1986 10% .000274 2000 8% .000219
1987 9% .000247 2001 9% .000247
1988-1991 11% .000301 2002 6% .000164
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.