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HomeMy WebLinkAbout01-1036 ~_7.-~r)_~7 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of: Marguerite Bowers No. ~J- 01- JOa<o Also known as: To: Register of Wills for the Deceased County of Cumberland in the Social Security Number: 1214-24-8795 Commonwealth of Pennsylvania The Petition of the undersigned respectfully represent that: 1. Your Petitioner(s), who is/are 18 years or older app.lies for Letters of Administration I-d-. b:n:- (d.b.n.: pendente lite; durante absentia; durante minoriate) on the Estate of the above decedent. 2. Decedent at death was domiciled in Cumberland County, Pennsylvania, with her last family or principal address at: Street address City Municipality State Zip code 120 Ewe Road Mechanicsburg Lower Allen Township PA 17055 3. Decedent, then 72 years of age, died on October 27, 2001 4. Decedent at death owned property with estimated values as follows: (If domiciled in P A) All personal property $34,000.00 (If not domiciled in P A) Personal Property in Pennsylvania (lfnot domiciled in PA) Personal property in County Value of real estate in Pennsylvania $0.00 situated as follows: 5. Petitioner after a proper search has ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name Relationship Residence Patricia G. Marshall Daughter 120 Ewe Road, Mechanicsburg, P A 17055 Louis G. Bowers, Jr. Son 3704 N.Charles Street, Baltimore, MD 21218 Robert J. Bowers Son 5318 E Street, Sacramento,CA 95819 WHEREFORE, Petitioner(s) respectfully request(s) the grant of Letters of Administration in the appropriate form to the undersigned. signatures and residences of petitioner(s) 120 Ewe Road, Mechanicsburg, P A 17055 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYL VANIA : SS COUNTY OF CUMBERLAND : ~S 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 the petitioner (s) and that as personal representative(s) of the above decedent, petitioner(s) will well and truly administer the estate according to law. 'OM/LV. no. <t.:1 ~ CAr.. r-D. - 0 Q No. 21-20u1-1036 Estate of MARGUEFlTE BONERS , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW, November 13th ,2001, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that II is entitled to Letters of Administration, and in accord with such fmding, Letters of Administration are hereby granted to Patricia G. Marshall in the Estate of Marguerite Bowers. Mary c. ~'~~) ~, FEES Probate, Letters, etc. $ 70.00 Short Certificate( s) 4 $ 12.00 Renunciation( s) 2 $ 10.00 Miscellaneous JCP $ 5.00 TOTAL $ 97.00 DIANE G. RADCLIFF, ESQUIRE Supreme Court LD. # 32112 3448 Trindle Road, Camp Hill, PA 17011 Phone: (717) 737-0100 Fax: (717) 975-0697 Filed ~RY~~};.. .l.~.th. .20U 1............................ RENUNCIATION 21-2001-1036 In Re Estate of Marguerite Bowers deceased. To the Register of Wills of Cumberland:ounty, Pennsylvania. The undersigned Louis Garfield Bowers, Son of the above decedent, hereby renounce(s) ~e right to administer the estate and respectfully ask(s) that dIn... \\ /., Letters of A lnlstratl~4 f -- be issued to Patricia G-..e Marshall WITNESS ~..f. '( , hand this 2~ day of ~ 0 l}.Q.. rv-.. ~ t ti 2001 ~~?J~ 3 ?6'f N.CHAR/e5 ~-f. . 6a 11e>. fJD. 'Z./GI8 (Addrnsl (Sian.lurel (AddrnSI Subscribed and sworn to before me this ~/1.c;( day of ~ AJ 2001. (Siana.urel (Addrnsl (Si,nalurel ~P"':1 ~~ (Addressl (Slanl, urel NotJr;",! (~""'~:': Debor~h L. D~nl~y,0Notary Public ,i Camp HIli Bora. Cumberland County I My Commission Expires Sept. 23, 2~ Member, PennsliivanlA ,I\',',c,;;,," ,'I' ,',: ;\;ctaiies (Addrnsl RENUNCIATION 21-2001-1036 In Re Estate of Marquerite Bowers deceased. To the Register of Wills of Cumberland County, Pennsylvania. The undersigned Robert John Bowers, son of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that "'" ./"" I t I b Letters of Amni ni ~rr~i-iou:g/'A..\"'- I be issued to Patricia G-.e Marshall handthis 2"~dayof_~~ ~.i' WITNESS "es , 3 2001 - 96e,q (5ilnllur~) (Addrn~) Subscribed and sworn to before me this d2l1d-dayof~ Xi 2001 (5i,nltUff) (Addrns) (51,nllure) ~,,~ L1~./.Ly (Address) (SI,n.turd N013iial Sea; Deborah L. Donley, Notary PUbl~.C Camp Hill Bora, Cumberland County My Commission Expires Sept. 23, 2003 Member, Pennsylvania Associati,J, ct Notaries (Addrnst ThIS is to certify that the information here given is correctly copied fro~ an o~iginal certificate of death dul~ filed with me as Loca I Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filmg, WARNING: It is illegal to duplicate this copy by photostat or photograph, 7744933 /1 ~ #-:-,i (.~k-""./ /-? </4 t: ;'..4: 'lfi!=- Local Registrar /' L Fee for this certificate, $2.00 p OCT 2 9 Z001 No. Date 21-2001-1036 .143 R.... 2117 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH IJNDER , Y!AR MonItIa Deya SWI 'lI.E NUMBER SOCIAl SECURITY NUMBER NAME Of' DECEDENT IFni. MIdclIe. Las) ,. AGE (lall YI - 24 8795 72 Y... . COUNTY Of' OEArH UNOEA , DAY Hours ~ ......... IIIRTHPLACE (Cly """ SlaM 01 Fcr"9' Counlry, Mary land ::"v10 RACE - A__1nclien. 1IlKk. WIIiIe. ell:. (SpeclIy) .. Clmt>er land DECEDENT'S USUAl OCC\JPllQ'JON (~"=:~~'::::2=r 11.. Hanernaker 11.. DECEDENTS IoWUNG ADOAESS (SIr...~. SlMe. ZopCodeI 120 Ewe Road Mechanicsburg, Pa 17085 ,.. White SUAVMNG SPOuSE In..... "..--1 CoIIoe (1-4 or!l+ 1 lotAAITAl. STAtUS - ........ Never ......... WiIIINlM. OiooocedtsPecllYl 'c. Widowed 17c.o _.........iIt ,o. RlfHEA'S NAaolE (F... ModdIe. LasI) 11, John Dimartino IIiIFOAMAHT'SNAME (T~ lDuis G. Bowers METHOD OF Dl$POSlTlON .....1X1 CteIMIion 0 "--.... Slat. IX! DDMliaftD 0.. (SpeclIy\ , DECEDENT'S ACTUAl RESIDENCE -- on CllIlef Sldel '7a. SIMe Old dIcedenI .... in a Ctnlberland -.? 17ltJ ~-:::':::of MOTHER'S NAME IF... MoclaIe. ~Sur"""", ,I. Grace Lanza INFOAUAHT'S MAIUNG ADOAESS (SIr.... ~ s... Zip Cod., 3704 North Charles Street Baltimore Md 21218 PLACE Of' DISPOSITION. ~ of CemeleIy. Cr..-y LOCRION. CiIy/boft. sr-. Zip Code or OIlIer "'- Mechanicsburg c:il)o':~ '711. . Uc. Wi'$ CASE REFERRED TO MEDICAl ElCAMlNEAICORONER'1 ..!"if' ...0 "9l"I :II. !==- PART I: ~.:'==::m~ ._..... dMIII · · L. l ~Ul\~{ _....2...21_ beawnpleled by --...-......---. 3 OF): DUE 10 (OR AS A CONSEQUENCE Of): MANNER Of' DEATH ......... AccidenI ~ o o DATE Of' INJURY (Monln. Day. _I TIME OF INJURY INJURY AT WORK? DESCAI8E HOW IH.JUAY OCCUAIlED. _0 NoD &licide tforn;c:;de Pending ~ion CouId_ beclet_ o o o PlACE Of' INJURY _ AI_. ....... _.laclacy, 0Illce M. buiIdIne. e1C. 1Spec.lv1 He. ... 0 NoD ~ ~ 'I'RONOIINCING AND CERTIFYING PttYSICIAN (Ph\lllC*' bolh P'C>nOuIlCong <lea1ll _ """lIyong 10 cause 01 <lealhl 3 To......... ot.-y knowtedo.. .......oceurrM.. ........... dat.. -plec., _clue to ....C.UM(.)."".........r .....ted............ . .. '" ........ .= .MEDlCAL EXAMlNERlCOAONEA ~ On tile baeIa oI..amlnatlon andIOI in...s'lgatlon.ln my opinion, deatll oc:curreela' llIeltrne. dala. and plac.. Md du.lo III. csu..Cs)..... :Ua. --.. ....eel.. . . . . . .";;'.' ..... - - . . . . . . . . - . . . . . . . . . .;. :;.;,. . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . _ . . . . . . . . . _ . . . _ . . . .. ... _ . . . . ~l REGISTRAA.SSIGN~ne:ra~ 1?,/~ i/ / I 33. o :u. d~~9J .;;l~~/ ... 2.... CERT..... Iet.:k only one) 'CERTIf'YIiIG I'HYStClAN (Ph~ c8IlIIyIng cause d Cll!alh wh.... anoIIIer IJhvsoc.... Res prOt>ClUf1Ced Cll!alll &nO completed "em 231 ...........O,...,knowIetIge. ....._.....Io...catIM(.'.""_....._..................................................... a. CERTIFICATE OF SERVICE OF NOTICE OF ESTATE ADMINISTRATION UNDER RULE 5.6(a} NAME OF DECEDENT: MARGUERITE BOWERS DATE OF DEATH: October 27, 2001 WILL/ADMIN NO. : 2001-01036 TO THE REGISTER: I certify that Notice of Estate Administration 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: December 13, 2001 NAME AND ADDRESS STATUS 1. patricia G. Marshall Daughter 2 . Louis G. Bowers, Jr. Son 3 . Robert J. Bowers Son Notice 5.6(a) I None has now been given to all persons entitled thereto under Rule except: NAME I N/A ADDRESS Date: ]... /'l.~()7..--- Signature: Name: Address: D' dcliff, Esquire 3 Road Camp Hill, PA 17011 (717) 737-0100 32112 Counsel for Personal Representative cO ~ .- 2. Telephone: I . D. No.: Capacity: 1...0 (--...1 ffi \..J- ....,f" (..., (..~ 'J) ct. n: ~ .;.) 'Xi ~ (jC .j t '. ..... .... 0/ Register of Wills of CUMBERLAND County, Pennsylvania INVENTORY Estate of Marguerite Bowers No. 2001-01036 Date of Death 10/27/2001 also known as ,Deceased Social Security No. 214 - 24 - 8795 Patricia G Marshall, 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. I/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 Signature: 'P~~ ~ I yy?~dQ Patricia G Marshall Name of DIANE G. RADCLIFF Attorney: 1.0. No.: 32112 Address: 3448 Trindle Road Camp Hill, PA 17011 Telephone: 717/737-0100 Signature: Address: 120 Ewe Road Mechanicsburg, PA 17055 Telephone: 7/22/2002 C I' "~' Dated: Description Value l_N :.. (See continuation page(s) attached) (Attach additional sheets if necessary) Total: 12,250.27 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 'RW-7 (1992) .. '. , .. . . .. V' 4. INVENTORY Estate of: Date of Death: County: Marguerite Bowers 10/27/2001 Cumberland CASH: AT&T - Residence service refund 4.73 M&T Bank - Checking Account No. 1088963 522.03 M&T Bank - Savings Account No. 150042000927620 2,522.95 PNC BANK - No. 5002173063 569.56 Senior Blue - Premium refund 51.00 3,670.27 PERSONAL PROPERTY: 2001 Chevrolet Malibu 8,580.00 8,580.00 TOTAL RECEIPTS OF PRINCIPAL............... 12,250.27 ===-----===== -1- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT RADCLIFF DIANE GILBERT 3446-3448 TRINDLE ROAD CAMP HILL, PA 17011 -------- fold EST A TE INFORMATION: SSN: 214-24-8795 FILE NUMBER: 2101-1036 DECEDENT NAME: BOWERS MARGUERITE DA TE OF PAYMENT: 01/29/2002 POSTMARK DATE: 01/28/2002 COUNTY: CUMBERLAND DATE OF DEATH: 10/27/2001 NO. CD 000813 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $845.24 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: PATRICIA G MARSHALL C/O DIANE G RADCLIFF ESQ. CHECK# ? SEAL INITIALS: DO RECEIVED BY: REGISTER OF WILLS $845.24 MARY C. LEWIS REGISTER OF WILLS ~ /?-dC-7 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG1 PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN DIANE G RADCLIFF 3448 TRINDLE RD CAMP HILL ""7 f RA 17011 . ,\ \ ' 09-02-2002 BOWERS 10-27-2001 21 01-1036 CUMBERLAND 101 . REY-1547 EX AFP (81-02) MARGUERIT Allount Rellitted 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 ~ REY=is4-j-ix--AFP--fol-':o2i--Noy-ici-oF-'rtiliiifiTAifcE-Y-A)rAPPRAisiiiENT~--AL1-owAifcE-oR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BOWERS MARGUERIT FILE NO. 21 01-1036 ACN 101 DATE 09-02-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED ) 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) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 121250.27 41419.13 191807.17 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax NOTE: If an assessment was issued previously, lines reflect figures that include the total of Abb ASSESSMENT OF TAX: 15. Allount of Line 14 at Spousal rate (15) 16. Allount of Line 14 taxable at Lineal/Class A rate (16) 17. Allount of Line 14 at Sibling rate (17) 18. Allount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due 11,371.28 7.893.58 (11) (12) (13) (14) (9) (10) NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 36,476.57 ]9.264 86 17,211.71 .00 17,211.71 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = 17,211.71 X 045= .00 X 12 = .00 X 15 = (19)= .00 774.53 .00 .00 774.53 TAX CREDITS: . n. ,-...... . n____. . II (+ J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-28-2002 CDOO0813 .00 845.24 08-26-2002 REFUND .00 70.71- TOTAL TAX CREDIT 774.53 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . 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.) /7-020-7 ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG~ PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE lNHERITANCE TAX STATEMENT OF ACCOUNT * REY-1U7 EX AFP [01-02) DIANE G RADCLIFF 3448 TRINDLE RD CAMP HILL "II~ 1 (J DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-09-2002 BOWERS 10-27-2001 21 01-1036 CUMBERLAND 101 MARGUERIT /1 ~I' Allount Rellitted PA 1,7011 f ~, 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 ~ RE-y-:i6rfj-ix--AFP--fol-:02i-------...-iNifERii'-ANc'E-;:AX--STA-fEME-N';:-ifF'-AC-cou'Nf--.-..------------------ --- ESTATE OF BOWERS MARGUERIT FILE NO.21 01-1036 ACN 101 DATE 09-09-2002 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PRO~ECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-02-2002 P R I NCI PAL TAX DU E : ........................................................................................................................................................................................................................... 774.53 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-28-2002 CDOO0813 .00 845.24 08-26-2002 REFUND .00 70.71- TOTAL TAX CREDIT 774.53 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 PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "'CREDIT"' (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) C:I ~ STATUS REPORT UNDER RULE 6.12 NAME OF DECEDENT: Marguerite Bowers DATE OF DEATH: October 27, 2001 WILL NO.: ADMIN. NO. 2001-01036 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: I. State whether administration of the estate is complete: Yes No X 2. If the Answer is No, state when the personal representative reasonably believes that the administration will be complete: October 2002 3. If the Answer to No.1 is Yes, state the following: a. Did the personal representative file a fmal account with the court? Yes 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? 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. Date: 7 !2.-.,.!OL--- I I ~0i 3448 Trindle Road. Camp Hill. P A 17011 Address .~ (717) 737-0100 Telephone number --' ? '. Capacity: _ Personal Representative ~ Counsel for personal representative I (} (j~ STATUS REPORT UNDER RULE 6.12 NAME OF DECEDENT: Marguerite Bowers DATE OF DEATH: October 27, 2001 WILL NO.: ADMIN. NO. 2001-01036 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: 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 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? Yes x No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. G. RADCLIFF. ESQUIRE Name (please type or print) Date: 4/15/2003 3448 Trindle Road. Camp Hill. P A 17011 Address (717) 737-0100 Telephone number Capacity: _ Personal Representative ~ Counsel for personal representative REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT < REV -15riO EX . (6-00) FILE NUMBER 7-;lo~ 7 ~ o E C E o E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Bowers Mar uerite ATE OF DEATH (MM-DD-YEAR) COUNTY CODE YEAR SOCIAL SECURITY NUMBER 214-24-8795 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE OFFICIAL USE ONLY 2001-01036 NUMBER REGISTER OF WILLS SOCIAL SECURITY NUMBER Supplemental Return Future Interest Compromise (date of death after 12-12-82) Decedent Maintained a Living Trust (Attach copy of Trust) Spousal Poverty Credit 0 (date of death between 12-31-91 and 1-1-95) 3. date of death . Remainder Return prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch 0) 1. Original Return 2. CAPB 4. Limited Estate 4a. HpRL 6. Decedent Died Testate 7. EplO CRAC (Attach copy of Will) KOTK o 9. Litigation Proceeds Received 010. ES P NAME C 0 0 DIANE G. RADCLIFF R N FIRM NAME (If Applicable) R 0 E E S N T TELEPHONE NUMBER C o M P T U A T X A T I o N COMPLETE MAILING ADDRESS 3448 Trind1e Road Camp Hill, PA 17011 3 -0100 Real Estate (Schedule A) (1) None Stocks and Bonds (Schedule B) (2) None Closely Held Corporation, Partnership or (3) None Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) (4) None 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 12,250.27 (Schedule E) 6. Jointly Owned Property (Schedule F) (6) 4,419.13 o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 19,807.17 (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) (8) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 11,371.28 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 7,893.58 11. Total Deductions (total Lines 9 & 10) (11) 12. Net Value of Estate (Line 8 minus Line 11) (12) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) R E C A P I T U L A T I o N SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(aX1.2) 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 17,211.71 x X X X .0 0 .0 45 .12 .15 ::-: OFFICIAL USE ONLY 36,476.57 19,264.86 17,211.71 17,211.71 (15) (16) (17) (18) (19) 0.00 774.53 0.00 0.00 774.53 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 120 Ewe Road CITY I STATE I ZIP Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount ( 1) 774.53 845.24 38.73 Total Credits ( A + B + C) (2) 883.97 3. InterestlPenalty if applicable D. Interest E. Penalty TotallnterestlPenalty ( 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 5 + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 109.44 0.00 0.00 0.00 Wflllllil . . ..........:.:.:::::: :::::::::nn:nnn~nn~n~H~~@: i i i ijnj~j~jjjj~j~n[[: [[ [jU~): [: Uy~U:: iH ". ".":.; :;:;~:;:: :;~;~~~~~j~~~;: ~~~~~~~m~~~~:::: :::~:;::::;: jjmmi!i ',....pLEASe'ANS'WER'YHE"F'ottOWING.QUESfioNS..BYPLici"N'G'AN "X" 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ...... D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. . .'.' .";. :.::: :::;:;:;;;; ;:~:j:Hnn~Hinu i iH~:nn;;: D D D Under penalties of perj ury, 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 pre parer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSiBLE FOR FILING RETURN ~iC ia G Marshall --------~-~-~~~~~---------------- DIANE G RADCLIFF 3448 Trind1e Road ------------------------------------- Carn Hill PA 17011 DATE f)-/Cc,-()~ ( DATE -\- I Iq / '2-- i.':":::'Wii:mmm~ SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net va ue of transfers to or for the use of the surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 9116 (a) (1.1) (ii)). The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116( 1.2) [72 P.S. 9116(aX1)]. 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(aX1.3)]. 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-1508 EX +(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Marguerite Bowers SS# 214-24-8795 10/27/2001 2001-01036 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 AT&T - Residence service refund 4.73 2 M&T Bank - Checking Account No. 1088963 522.03 3 M&T Bank - Savings Account No. 150042000927620 2,522.95 4 PNC BANK - No. 5002173063 569.56 5 Senior Blue - Premium refund 51.00 6 2001 Chevrolet Malibu 8,580.00 TOTAL (Also enter on line 5, Recapitulation) S 12,250.27 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97) REV-1509 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Marguerite Bowers SCHEDULE F JOINTLY-OWNED PROPERTY SSff 214-24-8795 10/27/2001 FILE NUMBER 2001-01036 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. A. SURVIVING JOINT TENANT(S) NAME Patricia G Marshall ADDRESS 120 Ewe Road Mechanicsburg, PA 17055 RELATIONSHIP TO DECEDENT Daughter B. c. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank DATE OF DEATH DECD'S VALUE OF account number or similar identifying number. NUMBER TENANT JOINT Attach deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES 1 A 08/04/00 PNC Bank Certificate of 1,163.40 50.00% 581.70 Deposit - No. 21000193620 A 11/20/00 PNC Bank Certificate of 1,053.32 50.00% 526.66 Deposit - No. 31500202948 2 A 01/11/01 PNC Bank Certificate of 1,039.90 50.00% 519.95 Deposit - No. 31500205584 3 A 08/21/00 PNC Bank Certificate of 5 ,581. 64 50.00% 2,790.82 Deposit - 31500211516 TOTAL (Also enter on line 6, Recapitulation) $ 4,419.13 T (If more space is needed insert additional sheets of the same size) CoPyrl9ht (c) 1996 form software only CPSystems, Inc. Form REV-1509 EX (Rev. 1-97) REV-1510EX +(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Marguerite Bowers SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY SSfF 214-24-8795 10/27/2001 FILE NUMBER 2001-01036 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. DESCRIPTION OF PROPERTY %OF ITEM RELAWg~Mr:lI~ t~b~~~5~Ml'riJ~~~1fIl~:EJF t~~~RSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER ATTACH ACOPYOF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) 1 M&T Bank - Western-Southern 19,807.17 19,807.17 Life Single Premium Deferred Annuity TOTAL (Also enter on line 7, Recapitulation) $ 19,807.17 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1510 EX (Rev. 1-97) REV-1511 EX +(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Marguerite Bowers Debts of decedent must be reported on Schedule I. ITEM NUMBER A. B. SS# 214-24-8795 10/27/2001 FILE NUMBER 2001-01036 DESCRIPTION AMOUNT 1 FUNERAL EXPENSES: Johnson Funeral Home, PIA. - Funeral Bill 3,987.28 2 Moreland Memorial Park Cemetery, Inc. - Bronze Memorial 1,387.00 3 Moreland Memorial Park Cemetery, Inc. - Grave opening and liner 1,250.00 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. 3. Attorney's Fees DIANE G. RADCLIFF Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address 1,625.00 3,000.00 City Relationship of Claimant to Decedent State Zip 4. Register of Wills 97.00 Probate Fees 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Register of Wills - Filing Fee - Inventory and Inheritance Tax Return 25.00 TOTAL (Also enter on line 9, Recapitulation) S 11,371.28 (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) Estate of: Marguerite Bowers Soc Sec #: 214-24-8795 Date of Death: 10/27/2001 Continuation of Schedule H-B2 (Attorney's Fees) Item # Description Amount 1 Diane G. Radcliff, Esquire - Attorneys Fees 1,125.00 2 Diane G. Radcliff, Esquire - Reserve for additional atty's fees and costs 500.00 1,625.00 REV -1512 EX . (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Marguerite Bowers SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SS1! 214 - 24 - 8795 10/27/2001 FILE NUMBER 2001-01036 Include un reimbursed medical expenses. ITEM NUMBER 1 AT&T - Final Bill DESCRIPTION AMOUNT 15.54 2 Boscov's - Final Bill 3 GMAC - Automobile Loan Payoff 4 GMAC - Loan payment 5 Holy Spirit Hospital - Final Bill 6 J.C. Penneys - Final Bill 7 Sears - Final Bill 8 State Farm - Car Insurance 9 The Bon Ton - Final Bill 10 Verizon - Final Bill 11 Visa - Final Bill 16.88 7,416.91 154.21 25.00 12.99 12.59 142.05 25.49 8.90 63.02 TOTAL (Also enter on line 10, Recapitulation) S 7,893.58 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Marguerite Bowers SCHEDULE J BENEFICIAR IES SS1f 214-24-8795 10/27/2001 FILE NUMBER 2001-01036 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] 1 Louis G. Bowers, Jr. 3704 N. Charles Street Baltimore, MD 21218 Son 1/3 of residue 2 Robert J Bowers 5318 E Street Sacramento, CA 95819 Son 1/3 of residue 3 Patricia G. Marshall 120 Ewe Road Mechanicsburg, PA 17055 Daughter 1/3 of 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 (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. 0.00 Form REV-1513 EX (Rev. 9-00) JAN-07-2002 13:49 412 705 0057 P~~CBA~iK elF DEPARTMEt~T 412 705 0057 P.01/02 o PNCBAl\K January 7, 2002 /SGP Diane G Radcliff, Esquire Attorneys At Law 3448 Trindle Road Camp Hill P A 17011 RE: Estate of Marguierite Bowers, Deceased SSN: 214-24-8795 DaD: 10/27/2001 Dear: Ms. Radcliff: In response to your request for Date of Death balances for the customer noted above, OUT records show the following. CERTIFICATES OF DEPOSIT #31000193620 Established 08/04/2000 MARGUERITE BOWERS PATRICIA MARSHALL DaD Balance $1,161.66 + $1.74 accrued interest #31500202948 Established 11/20/2000 MARGUERlTE BOWERS PATRICIA MARSHALL DaD Balance: $1,052.81 + $0.51 accrued interest #31500205584 Established 01/11/2001 PATRICIA G MARSHALL MARGUERITE BOWERS DaD Balance: $1,037.54 + $2.36 accrued interest #31500211516 Established 08/2112000 PATRICIA G MARSHALL MARGUERITE BOWERS DOD Balance: $5,500.00 + $81.G4 .:.....,~~ued intere'it Page 1 of2 A member of The PNC Financial Services Group Om' PNC Pla,a 249 Fifth Avenue Pittsburgh Pennsylvania 15222 2707 rl:1. M&rBank December 17,2001 RE: Estate Search The Estate of: Date of Death (D.a.D.) Marguerite Bowers 10-27-01 To Whom It May Concern: Identified below is the account information requested. 1. M&T Bank accounts in which the decedent's name appears: Account Type Account Number Account Title Opening Branch D.O.D. Accrued Interest Balances (Includes Accf. Int. ) $19807.17 IRA 35004200225488 Int. Rate 4.55% 1088963 lnt. Rate 0% 15004200927620 Int. Rate .06% Marguerite Bowers 4350 chk Louis G Bowers SR Marguerite Bowers Louis G Bowers Sf. Marguerite Bowers 4350 $522.03 sav 4350 2522.12 .83 2. Loans, MOligages, 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. If you have any questions about the information provided, please contact our Records Department at (716) 635-40 10 or 1-800-724- 2440 outside of the Buffalo, NY calling area. Thank you. Sincerely, M&T BANK CORPORATION c-' ') '-~? ' BY: ~c-l Vcz C)c<?-?-, 6...?-??<" Authorized Signature / DATE: I ~ - / 7 -cJ L Manufacturers and Traders Trust Company · 1100 Wehrle Drive, PO. Box 767, Buffalo, NY 14240-0767 JAN-07-2002 13:50 PNCBANK CIF DEPARTMENT 412 705 0057 P.02/02 0. PNCBAN< SA VINGS ACCOUNT #5002173063 Established 12/27/1999 MARGUERlTE BOWERS DOD Balance: $569.06 + $0.21 accrued interest Please note that this office only provides date of death balances for deposit accounts (lRAs, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, fr\~1 .~ Manan Donne Iy . 0- 1-800-762-1775 P7-PFSC-04-F 500 First Avenue Pittsburgh, P A 15219 Page2of2 A member of The PNC Finan<:ial Sel'llil'eS Group One PNC PiaL" 249 Fifth Avenue Pittsburgh Pt:nnsvlv"n;" , 5222 2707 TOTAL P.02 ~C1vlng.s account ~tatenlent PNC nallk o PNCBAN< Primary account number: 50-0217 -3063 Page 1 of 1 For the period 10/01/2001 to 12/31/2001 Number of enclosures: 0 MARGUERITE BOWERS DECD 120 EWE RD MECHANICS BURG PA 17055-4881 tr For 24-l1our customer service or current rales: Call1-888-PNC-BANK [8J Write 10: Customer Service PO Box 609 Pittsburgh PA 15230-9738 Ie Visit liS at www.pncbank.colTl ~ I ~DD terminal: 1-800-531-1648 "01 hf'~-Irlll~ IInp~ut"11 dlcnl,,<; only :iavings Account Summary ,uGulinl nwuuer: 50-0217-3063 Acculllll link 0 1l11llluer: 02 i4248795 Marguerite Bowers Deed Jalance Summary 50.50 Checks and other deductions 569.56 Endi ng balance Beginning balance 519.06 Deposits and other addition s .00 As of 12/31, a total of $4.60 in interest was earned this year. nterest Summary Annual Percent3ge Yield Earned (APYE) rE,]% Number of days in interest period Average collected balance for APYE I nterest Earned this period G!:. 555.35 .50 Jeposits and Other Additions ate 0/]9 :l/31 1/30 .!/'O!'. Amount Description ;,0.00 Dcposil Refcl'cncc No. .23 Interest P:1)'lllcnl .2.1 Intercsl Payment JXl Interest Payment There were 4 Deposits and Other Additions totaling $50.50. 0250t",979 ,Ie Amount Description U05 .on OtHst:1nding llem Close ~/05 5G~I.5G WitlKh;1wal Tel 0.1000112 J.l 0056 Ither Deductions 'aily Balance Detail .te Balance Date Balance Date Balance )/01 519.0G 10/31 ~lG9.2D J2/05 .00 >/1 ~. 5G9.()(i 11/30 569.53 FOR M953R Keystone Health Plan Central, Inc. P.O. Box 898812 Camp Hill, PA 17089-8812 MARGUERITE BOWERS ESTATE 120 EWE ROAD Mechanicsburg PA 17055 1I~1!2~ lepcndenf Licensee ollhe Blue Crors and Blue ShieJd Aisociation egi$lered MIUb of \he Bl~e Cross Ittld Blue Shield ~ociatian. Associ.lion of Independent Blue Cmu and Blue Shield P1lU1S CHECK NO. 013271 'LEASE CASH OR DEPOSIT CHECK PROMPTLY DATE OF CHECK 12/05/01 VENDOR NO. 03-0657338 IOUCHER DATE DESCRIPTION VOUCHER NO. INVOICE AMOUNT DISCOUNT PAYMENT AMOUNT 11/29/01 SENOIRBLUE PREMIUM REFUND 113001 51. 00 .00 51.00 C HK TOTAL: 51. 00 -=---.. ~ . ms-r{'" carpolnt Your complete source for car buying information Kelley Blue Book Trade-In* Report Saturday, January 05, 2002 2001 Chevrolet Malibu Sedan 40 V6 3.1 Liter Engine Automatic Transmission 29,000 Miles Pennsylvania Selected Equipment Front Wheel Drive Cruise Control AM/FM Stereo Air Conditioning Power Door Locks Compact Disc Power Steering Power Windows Steel Wheels ASS (4-Wheel) Tilt Wheel Vehicle in "Excellent" condition An excellent vehicle rating means that the vehicle looks great. is in excellent mechanical condition and needs no reconditioning. It should pass a smog inspection. The engine compartment should be clean. with no fluid leaks. The paint is glossy and the paint, body and interior are free of any wear or visible defects. There is no rust. Tires are the proper size and match and are new or nearly new. A clean title history is assumed. *Trade-In Value Trade-in Value represents what you might expect to receive from a dealer for a consumer-owned vehicle. Keep in mind that the dealer must then absorb the cost of making the vehicle ready for sale, advertising, sales commissions, arranging financing and insurance and standing behind the vehicle for any mechanical or safety problems. 11$8,580*11 Back to Kelley Blue Book Go to CarPoint Used Car I\!iarketplace Copyright @ 2002 by Kelley Blue Book Co., All Rights Reserved. Jan.Feb 2002 Edition. The information in this report 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://carpoint.msn.com/kbb/printpage.asp?type=tradein&ti?7'18577&c=id18577c2extxm2 9C.. 1/5/2002