HomeMy WebLinkAbout07-29-05
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
INVENTORY
Estate of Loraine C. MaQarQle
No.
11 -05-0liJ'75
, Deceased
Date of Death 6/19/2004
Social Security No. 202-09-8050
also known as
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 Teal 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 the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. IM/e
verify that the statements made in this inventory are true and correct. IM/e understand that false statements herein made Bre subject to the
penalties of 18 Pa. e.s. Section 4904 relating to unsworn falsification to authorities.
Personal Representative:
Name of
Attorney: David H. Radcliff, ESQ.
1.0. No.: 25483
Address: 20 Erford Road, Ste 200
Lemoyne
Telephone: 717236-9318
J~~ YY\~Je/
Dated 71111()~
PA 17043
Description
Wachovia Bank, N.A. - acct #1 014222850476
Value
6,617.39
Conseco Long Term Care Insurance (claim payment)
2,300.00
Social Security (June 3 payment)
843.00
Total
(Attach Additional Sheets jf necessary)
9,760.39
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may I 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.
RW-4
REV-1500EX + (6-00)
'* COMMONWEALTH OF
, PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENTS NAME (LAST, FIRST. AND MIDDLE INITIAl)
MAGARGLE LORAINE C.
DATE OF DEATH (MM-DD-Y",,)
DATE OF BIRTH (MM-DD-Year)
OFFICIAl USE ONLY
FILE NUMBER
.L ..L-~.L -=- _QiQ 1 fL
COUNT'/' CODE YEAA NUMBER
SOCIAL SECURITY NUMBER
2 02- 0 9 - 8 0 5 0
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCiAl SECURITY NUMBER
2 0 6 - 3 0 - 8 2 7 1
o 3. Remainder Return (date ofdealh priorto 12.13--82)
o 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) IA""'''hO)
THIS SEcnOlil MUST BE COMPLETE:D. ALL CORRE:SPONDE:NCE: AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRE:CTED TO:
NAME COMPLETE MAILING ADDRESS
David H. Radcliff Es . 20 Erford Road
FIRM NAME (If Ap~icab.)
Radcliff Law Office P.C. Suite 200
TELEPHONE NUMBER
717 236-9318 Lemo ne PA 17043
06/19/2004 05/08/1908
(IF APPlICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
MAGARGLE EVELYN C.
00 1. Orilinal Return
D 4. Limited Esfate
00 6. Decedent Died Tesfate ~ ",",<>tWIll
D 9. Litigation Proceeds Received
D 2. Supplemenlal Return
o 4a. Future Interest Compromise (datil ofdealh after 12-12-1521
o 7. Decedent Maintained a living Trust (AltachctlJlyofTrust)
o 10. Spousal Poverty Credit (datil ofdealh between 12-31-91 and 1.1.95)
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1. Real Esfafe (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Close~ Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposils & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (tolal Lines 1-7)
9. Funeral Expenses & Admin~trative Costs (Schedule H) (9)
10. Debls of Decedent Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (tolal Lines 9 & 10)
12. Ne! Value of Estate (Line 8 minus Line 11)
13. Charilable and Govemmenlal Beques1slSec 9113 Trusls for which an election to tax has not been
made (Schedule J)
9,760.39
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0.00 X _(15) 0.00
0.00 X .045 (16) 0.00
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 0.00
14. Ne!Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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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. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS.ON REVERSE SIDE AND RECHECK MATH < <
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(8)
9,760.39
1,805.00
15,196.44
(11)
(12)
(13)
17,001.44
-7,241.05
(14)
-7,241.05
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Add
ece Il~nt s omDlete ress:
STREET ADDRESS
Messiah Villaae
100 Mount Allen Drive
CITY I STATE I ZlP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
0.00
Total Credits (A + 8 +C)
(2)
0.00
3. InteresUPenalty ~ applicable
D. Interest
E. Penalty
T otallnteresUPenalty ( 0 + E ) (3)
4. II Une 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. II Line 1 + Line 3 is greater than Une 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
8. Enter the total of Une 5 +5A. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Old decedent make atranslerand: Yes No
a. retain the use or income 01 the propertytranslerred; ........................................................................... 0 1RI
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 1RI
C. retain a reversionary interest; or ...................................................................................................... 0 1RI
d. receive the promise lor life of either payments, benefits or care? ............................................................. 0 1RI
2. If death occurred affer December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?.................... ......................................... ................. ................ 0 1RI
3. Did decedent own an 'in trustfo~ or payable upon death bank acoount or security at his or her death? ................. 0 1RI
4. Did decedent own an Individual Retirement Acoount. annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... 0 1RI
0.00
0.00
0.00
0.00
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under pen~ of perjury, I declare that I have examined this return, includi~ accompCllYing schedules a'ld statements, and to lhe best of my knoMedge and belief, it is true, COlT8Ct and complete.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF IIE\'lS RESPONSI LE FOR Fill G RETURN DATE
:fL:::. 7 (111 0 r
ADDRESS 4920 oodbox L
Mechanicsbur!l
SIGNATUREOF~:::/~~TIVE 0"
ADDRESS 20 Erford Road, Ste 200
Lemo ne
PA
:>
PA 17043
For dates of death on or affer July 1, 1994 and before January " 1995, the tax rate imposed on the net value of transfers to or lor the use of the surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (i)].
For dates of death on or affer 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 exernot a transfer to a surviving spouse lrom tax, and the statutory requirements lor disclosure of assets and filing a tax return are still applicable even If
the surviving spouse is the only beneficiary.
For dates 01 death on or affer July 1, 2000:
The tax rate imposed on the net value of transfers Irom a deceased child twenty-one years of age or younger at death to or lor 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 lor 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(a)(I11.
The tax rate imposed on the net value of transfers to or lor the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Seclion 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1508 EX + (8-98)
*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MAGARGLE LORAINE C
FILE NUMBER
21 05
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property joinlly..,wned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
OESCRIPTION
Wachovia Bank, NA - acct #1 014222850476
VALUE AT DATE
OF DEATH
6,617.39
2.
Conseco Long Term Care Insurance ( claim payment)
2,300.00
3.
Social Security (June 3 payment)
843.00
TOTAL (Also enteron line 5, Recapitulation) $
(If more space is needed, insert additional sheels of the same size)
9 760.39
REV.1511 EX + (12.99)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
MAGARGLE LORAINE C
FILE NUMBER
21
05
Dobis of decodent must be reported on Schedule t.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) R. Lvnn MaQarQle 750.00
Social Security Numbo~s)JEIN Number of Personal Representative(s)
Street Address 4920 Wood box Lane
City MechanicsburQ State PA Zip 17055
Yea~s) Commission Paid: 2005
2. Attomey Fees Radcliff Law Office, P.C. 1,000.00
3. Fami~ Exemption: (If decedenfs address ~ not the same as c1aimanfs. attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountants Fees
6. Tax Return Prepare~s Fees
7. Filing fees - Petition, Inventory and Inheritance Return 45.00
8. Wachovia Bank, N.A. - bank acet charge 10.00
TOTAL (Also enter on line 9, Recapitulation) $ 1 805.00
(If more space is needed, insert additional sheets of the same size)
REV.1512 EX ... (6-98)
*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MAGARGLE LORAINE C
FILE NUMBER
21 05
Include unrelmbullled medical expens....
ITEM
NUMBER DESCRIPTION
1. Messiah Village
VALUE AT DATE
OF DEATH
4,562.41
2. Department of Public Welfare
5,060.38
3. West Shore EMS
462.81
4. PharMenca
495.23
5. Stoken Ophthalmology
48.81
6. Cumberland Crossings
4,566.80
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
15 196.44
REV_1513EX+IW
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
'" r. ?1 05
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS pndude OU~ht s~usal d~lIibutions. and transfers under
Sec. 9116 (a (1. )]
1. R. Lynn Magargle Lineal 0.00
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
"
(If more space IS needed, insert additional sheets of the same Size)
IN THE MATTER OF THE
ESTATE OF LORAINE C.
MAGARGLE, Deceased
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
: NO. 21-2005- li15
PETITION FOR SETTLEMENT OF SMALL ESTATE UNDER
SECTION 3102 OF PROBATE, ESTATES AND FIDUCIARIES CODE
The Petition ofR. LYNN MAGARGLE, Petitioner, only surviving child of LORAINE C.
MAGARGLE, respectfully represents:
1. Your Petitioner is an adult individual now residing at 4920 Woodbox Lane,
Mechanicsburg, Cumberland County, Pennsylvania, 17050, and is named as alternate executor in
the Will of Decedent.
2. The decedent, LORAINE C. MAGARGLE, died June 19, 2004, with his
residence at Messiah Village, Mechanicsburg, Cumberland County, Pennsylvania. Death
certificate for decedent is attached hereto and marked Exhibit A.
3. A copy of the Last Will and Testament of LORAINE C. MAGARGLE dated
January 11, 1990, is attached hereto as Exhibit B. Neither your Petitioner nor any other person
has previously probated this Will or given a bond in this matter.
4. The decedent was survived by Evelyn C. Magargle of Apartment # 92, Messiah
Village, Mechanicsburg, Pennsylvania, his spouse, with whom he resided at the time of his
death. Although named as the Executor in the Will she is unable to serve.
5. The total value of the decedent's personal estate is less than $25,000. (See copy
ofInventory attached as Exhibit C. n ~'~
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6. The assets were insufficient to pay the debts of the decedent. Petitioner attaches
an informal accounting of the estate administration as Exhibit D.
7. The decedent is survived by the individual beneficiaries named in his will:
A. Surviving Spouse: EVELYN C. MAGARGLE
Apartment # 92
Messiah Village
Mechanicsburg, P A 17055
B. Surviving Son:
R. LYNN MAGARGLE
4920 Woodbox Lane
Mechanicsburg, P A 17055
C. Surviving Granddaughter:
KAREN J. MAGARGLE TAMBORELLO
249 Dubois Avenue
Woodbury, NJ 08096
D. Surviving Granddaughter
ROBIN LYNNE MAGARGLE SMITH
213 Cherokee Circle
Royersford, P A 19468
E. Surviving Granddaughter
SUSAN J. MAGARGLE JOHNSON
1632 North Hills Avenue
Willow Grove, P A 19090
Written notice of intent to file this Petition was given to EVELYN C. MAGARGLE, KAREN J.
MAGARGLE TAMBORELLO, ROBIN LYNNE MAGARGLE SMITH, and SUSAN J.
MAGARGLE JOHNSON, by mail as set forth on the affidavit of David H. Radcliff, Esquire,
attached hereto as Exhibit E-l.
8. Expenses of the administration of the Estate, reimbursements to Pennsylvania
Department of Welfare and Messiah Village and other priority items to be paid under Pa. C.S.
~3392 totaling $10,318.63 are set forth on the Estate Accounting attached as Exhibit D.
9. The additional creditors of LORAINE C. MAGARGLE and the amounts claimed
are listed on Exhibit F. The Estate is insolvent and no amount is available for payment to these
creditors. Written notice of intent to file this Petition was given to all creditors by mail as set
forth on the affidavit of David H. Radcliff, Esquire, attached hereto as Exhibit E-2.
2
10. Petitioner attaches a copy of the inheritance tax return as filed with the Register of
Wills as Exhibit G. No inheritance tax is due on this insolvent estate.
11. Five monthly pension checks, each in the amount of$105.85, from Wachovia
Bank, N.A., forwarded to decedent after June 19,2004, and to which he was not entitled were
inadvertently deposited to the decedent's bank account and must be returned to Wachovia Bank,
NA
12. Petitioner advanced the $45.00 filing fee for this Petition but has not paid any of
the items listed on Exhibit D because he does not have access to the estate assets.
Wherefore your Petitioner respectfully requests your Honorable Court to issue a decree
authorizing R. LYNN MAGARGLE to withdraw the funds in the account of the Decedent for the
purpose of making distribution to the priority creditors as shown on Exhibit D.
Respectfully submitted,
vid H. Radcliff, Esquire
Radcliff Law Office, P.C.
20 Erford Road, Suite 200
Lemoyne, PA 17043
(717) 236-9318
Supreme Court ID No. 25483
3
COMMONWEALTH OF PENNSYLVANIA:
SS.
COUNTY OF CUMBERLAND
Personally appeared before me, a notary public in and for said Commonwealth and
County, R. LYNN MAGARGLE, who, being duly sworn according to law, deposes and says that
he is the Petitioner in the foregoing "Petition for Settlement of Small Estate Under Section 3102
of Probate, Estates and Fiduciaries Code" and that the facts set forth therein are true and correct
to the best of his knowledge, information and belief.
~-L~}1J~
Sworn to and subscribed before me this It
~
day of J \.\.l;
,2005.
NOTARIAL SEAL
DAVID H RAOCUff
Notary Public
LEMOmE BOROUGH. CUMBERlAND cOUNlY
My commlsSfOn Expll'es Jun 29. 2008
4
H \05805 REV 'jfg6
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. 1'he onglnal certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
No.
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
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Mechanicsburg. PA 17055 :"0:.'::""
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Dr. R, Lynn Magargle
Me'ntODOFOlSPOSlTION
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SIGNIiI1lRe OFF\JNE.RAlSEl'lVlCE UCENSEE~RSONACTING~CH UCENSENUIllBER
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1JIast lll1Iill aub illtstauuut
OF
LORAINE C. MAGARGLE
BE IT REMEMBERED, that I, LORAINE C. MAGARGLE, of 30 North
Broad Street, Hughesville, Lycoming County, Pennsylvania, being
of sound and disposing mind, memory and understanding, do make,
publish and declare the following as and for my Last Will and
Testament, hereby revoking and making null and void any and all
Wills and Testaments or writings in the nature thereof by me at
any time heretofore made:
It is my wish that my legal debts and funeral
FIRST:
expenses and transfer, inheritance or estate taxes, if any, be
paid by my Executrix or Executor herein named as soon as
practicable after my decease.
SECOND: All the rest, residue and remainder of my
estate, whether real, personal or a combination thereof, and
wheresoever the same may be situate at the time of my death, I
give, devise and bequeath to my wife, EVELYN C. MAGARGLE,
provided she survives me by at least thirty (30) days.
THIRD: In the event that my wife predeceases me or
fails to survive me by at least thirty (30) days, I then give
EXHIBIT B
and bequeath the sum of FIVE HUNDRED ($500.00) DOLLARS to such
charities as my Executor, in his sole discretion shall
designate.
FOURTH:
In the event my said wife predeceases me or
fails to survive me by at least thirty (30) days, I then give,
devise and bequeath my entire residuary estate into two (2)
equal shares to be distributed as follows:
ONE (1) SHARE to my son, R. LYNN MAGARGLE or to his issue
per stirpes;
ONE (1) SHARE to be divided equally among my three (3)
granddaughters, KAREN J. MAGARGLE, ROBIN LYNNE MAGARGLE and
SUSAN J. MAGARGLE, children of my late son, DR. RONALD K.
MAGARGLE.
In the event that an outstanding balance remains on a loan
made by my wife and I to my granddaughter, Karen J. Magargle,
at the time of distribution of my estate under this Paragraph, I
direct that the balance due on said loan be considered a debt
payable to my estate which may then be deducted from the
inheritance of Karen J. Magargle.
FIFTH:
In the event my said wife and I are killed in
what is known as a common disaster so that it is not readily
discernible which of us died first, it shall be presumed for the
purpose of settling our estates that my wife predeceased me and
I survived her.
2 .
SIXTH: I hereby authorize and empower my Executrix or
Executor herein named to sell any or all of the real or personal
property of my estate at public or private sale for such price
or prices and upon such term or terms as she/he shall deem best.
SEVENTH: I hereby authorize and empower my Executrix or
Executor herein named to distribute my estate in cash or in
kind, or partly in cash and partly in kind, as she/he shall deem
best.
EIGHTH:
I hereby authorize and empower my Executrix or
Executor herein named to settle any and all claims for or
against my estate on such terms as she/he shall deem best.
NINTH: I hereby authorize my Executrix or Executor
herein named to manage, control, operate, maintain and improve
any real or personal property of my estate, including any
operating business concerns, during the period of administration
of my estate.
TENTH:
I hereby excuse any fiduciary from filing a
bond in this or any other jurisdiction.
ELEVENTH:
I nominate, constitute and appoint my wife,
EVELYN C. MAGARGLE, Executrix of this, my Last Will and
Testament, and my son, R. LYNN MAGARGLE, as First Alternate
3.
Executor and COMMONWEALTH BANK AND TRUST COMPANY, N.A., as
Second Alternate Executor.
IN WITNESS WHEREOF, I hereby sign, seal, publish and
declare this as my Last Will and Testament, consisting of six
(6) typewritten pages, in the presence of the persons witneSSing
it at my request this 11th day of January, 1990.
~~"-- e. )J/I.7--017Jt;, (SEAL)
~/LOraine C. Magargl!'e ~'
SIGNED, SEALED, PUBLISHED and DECLARED by LORAINE C.
MAGARGLE, the Testator above named, to be his Last Will and
Testament, in our presence, and we, at his request and in his
presence, and in the presence of each other, have hereunto
subscribed our names as witnesses this 11th day of January,
1990.
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4.
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF LYCOMING
I, LORAINE C. MAGARGLE, Testator, whose name is signed to
the attached or foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Wil11 that I signed it
willinglY1 and that I signed it as my free and voluntary act for
the purposes therein expressed.
Sworn or affirmed to and acknowledged before me by LORAINE
C. MAGARGLE, the Testator, this 11th
NO, ^.?JIl.l SEAL
~TrvEN D. I;:: ~~: ~Jctary Pllblic
Hus:hc~'.:: (;_;:~'/, Pa.
My Ccn:;'l\j$~:{.,; :':;;,. i,G:; r':J. 24, 1990
day of January, 1990.
c- ~
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Notary Public
-
5.
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA :
SS.
COUNTY OF LYCOMING
We, the witnesses whose names are signed to the attached or
foregoing instrument, being dUly qualified according to law, do
depose and say that we were present and saw Testator sign and
execute the instrument as his Last Wil11 that he signed
willingly and that he executed it as his free and voluntary act
for the purposes therein expressed; that each of us in the
hearing and sight of the Testator signed the will as witnesses1
and that to the best of our knowledge the Testator was at that
time 18 or more years of age, of sound mind and under no
constraint or undue influence.
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Sworn or affirmed to and subscribed to before me by the
witnesses, this 11th day of January, 1990.
:t::J ,
Notary Publ ic
\ NOTARIAL SEA!: \
STEVEN D. HEZS, Notary Public
Hughes,,:!:;::, :.:i-::;' ,; -:9 C,'t.:;'1ty, Pa.
My Commissic;'l E;{j:.ires Feb. 24, 1990 .
6.
REGISTER OF WILLS
CUMBERLAND COUNTY, PENNSYLVANIA
INVENTORY
Estate of Loraine C. MaQarQle
, Deceased
No.
Date of Death 6/19/2004
Social Security No. 202-09-8050
also known as
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 the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. IM/e
verify that the statements made in this inventory are true and correct. lNIIe understand that false statements herein made are subject to the
penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Personal Representative:
Name of
Attorney: David H. Radcliff, ESQ.
1.0. No.: 25483
Address: 20 Erford Road, Ste 200
Lemoyne
Telephone: 717 236-9318
P-dr Yt1 ~ je/
Dated 71111()1;'
PA 17043
Description
Wachovia Bank, NA - acet #1014222850476
Value
6,617.39
Conseco Long Term Care Insurance (claim payment)
2,300.00
Social Security (June 3 payment)
843.00
Total
9,760.39
(Attach Additional Sheets W necessary)
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.
RW-4
EXHIBIT C
ESTATE OF LORAINE C. MAGARGLE
NO. 21-2005-
ESTATE ACCOUNTING
Principal Received
Listing of assets per inventory
Post death pension payments in error
Administrative Expenses Paid
Bank charge on checking account
Balance Available
$ 9,760.39
529.25
$ 10,289.64
(
10.00)
$ 10,279.64
Prioritv Claims for Administrative Expenses. Medical Expense and Gravemarker
Messiah Village for care of Decedent
(portion within 6 months before death)
Wachovia Bank, N.A. (Pension - July-Nov)
Fee to file Petition and Tax Return
Department of Public Welfare
PharMerica (portion within 6 months)
West Shore EMS
R. Lynn Magargle, Estate Administrator
David H. Radcliff, Esq.
2,197.10
529.25
45.00
5,060.38
244.09
462.81
750.00
1.000.00
Insolvent Estate - Amount of deficiency
Balance to be distributed
EXHIBIT D
8
( 10.288.63)
$( 8.99)
$ 0.00
COMMONWEALTH OF PENNSYLVANIA:
ss.
COUNTY OF CUMBERLAND
Personally appeared before me, a notary public, in and for the said Commonwealth and
County, David H. Radcliff, who being duly sworn according to law deposes and says that he
mailed copies of the Petition in the Estate of LORAINE C. MAGARGLE to the beneficiaries
named in the Will at the addresses as set forth.
A. Surviving Spouse:
EVELYN C. MAGARGLE
Apartment # 92
Messiah Village
Mechanicsburg, PA 17055
B. Surviving Son:
R. LYNN MAGARGLE
4920 Woodbox Lane
Mechanicsburg, P A 17055
C. Surviving Granddaughter:
KAREN J. MAGARGLE TAMBORELLO
249 Dubois Avenue
Woodbury, NJ 08096
D. Surviving Granddaughter
ROBIN LYNNE MAGARGLE SMITH
213 Cherokee Circle
Royersford, P A 19468
Dated:
E. Surviving Granddaughter SUSAN J. MAGARGLE JOHNSON
1632 North Hills Avenue
Willow Grove, P A 19090
:-r.:-, IZ ,2005 (Ub_u/i#~~
David H. Radcliff ../
Sworn and subscribed before me this I Z
'"
COMMONWEALTH OF PENNSYLVANIA
NaIaItII ,... .
Imi WIiamICn. Nafary PublIc
Camp HIIl101o. c...,~1Ind Counly
My Coo......... , ExplrlI8 Apt. 7, 2lIlI9
Member. Pennsytvanla Asaodation of Notaries
,2005.
Exhibit E-l
9
COMMONWEALTH OF PENNSYLVANIA:
ss.
COUNTY OF CUMBERLAND
Personally appeared before me, a notary public, in and for the said Commonwealth and
County, David H. Radcliff, who being duly sworn according to law deposes and says that he
mailed copies of the Petition in the Estate of LORAINE C. MAGARGLE to the creditors at the
addresses as set forth.
Messiah Village
100 Mount Allen Drive
Mechanicsburg, P A 17055
Department of Public Welfare
P.O. Box 8486
Harrisburg, P A 17105-8486
PharMerica
940 Messiah Village Commons
POBox 2015
Mechanicsburg,PA 17055
Stoken Ophthalmology
338 Alexander Spring Road
Carlisle, PA 17013
West Shore EMS
clo Specialized Recovery Services
261 Chapman Road, Ste 101
New Castle, DE 19702
Cumberland Crossings
1 LongsdorfWay
Carlisle, P A 17013
Dated:
:::A, ., /2-, 2005
~~,,,/,
David H. Radcliff
Sworn and subscribed before me this J 2.. day of . \,. ) u. L Lj' , 2005.
n. I/'\A , A '^ 11li (U')\O'-
COMMONWEALTHOFPENNSYLVAMA NO~
NoInISeeI
c::;.~~ Exhibit E-2
My ec...I.....' E>cpkea 1>fA. 7, 2009
_or, ....noyIvanla ....socIaIion 01 Nolarlel
10
SCHEDULE OF NON-PRIORITY CREDITORS
Non-orioritv claims more than six months before the date of death:
Messiah Village for care of Decedent 2,365.31
Stoken Ophthalmology 48.81
PharMerica (Over 6 months before death) 251.14
Cumberland Crossings 4,566.80
EXHIBIT F
11
R~.1500~+(6-00l
. COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-1)601
DECEDENTS NAME (LAST, FIRST, AND MlOOLE INITIAL)
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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MAGARGLE LORAINE C.
DATE OF DEATH (MM-OO-YeaIj
DATE OF BIRTH (MM-Do.Y'N)
OFFICIAl USE ONLY
FILE NUMBER
2 1 -0 5
Ci5i:iNiYCOOE' -YEAA- -- N'UMiER--
SOOAL SECURJTY NUMBER
2 02- 0 9 - 8 0 5 0
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURJTY NUMBER
2 06- 3 0 - 8 2 7 1
o 3. Remainder Return IdaleofdealhpficrlD12.1J.82)
o 5. Federal Eslate Tax Retum Required
_ 8. Tolal Number of Safe Deposo Boxes
o 11.E\ec\ion\OlaxunderSec.9113{A)(!Ulad>&ho)
06/19/2004 05/08/1908
(IF APPLICABlE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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THISSEC'T10NMUSTBECOMPLETED, ALL'CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOUlO SE OIREctEDtO~
NAME COMPLETE MAILING ADDRESS
David H. Radcliff Es . 20 Erford Road
FIRM NAME pI Applicable)
Radcliff Law Office P.C. Suite 200
TELEPHONE NUMBER
717 236-9318 Lemo ne PA 17043
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1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule BI (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. MoJ1gages & Noles Reoeivable (Schedule D) (4)
5. Cash, Bank Depos", & Misoellaneous Personal Property (5)
(Schedule E)
6. JoinUy Owned Property (Schedule F) (6)
o Separate Billing Requealed
7.lnler.VlVos Transfers & Misoellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Grossllssets (total Lines 1-7)
9. Funeral Expenses & Admin~trative Cosls (Sohedule H) (9)
10. Debls 01 DeoedenL MoJ1gage Liabilities, & Liens (Schedule I) (10)
11. Total Deducllons (total Lines 9 & 10)
12. NelVslueolEstate (Line 8 minus Line 11)
13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been
made (Schedule J)
MAGARGLE EVELYN C.
00 1. Original Return
o 4. LimKed Estate
00 6. Deoeden\ Died Teslate I-'''PY'''WII)
o 9. Liligation Proceeds Reoeived
o 2. Supplemental Retum
o 4a. Future Interest Compromise (daI801dea\t1aller12.12.82)
D7.DecedentMalntainedaLivingTrust(Alla::hcOPYolTrvsl)
o 10. Spousel Poverty Credo (...."'..... _".M' "" '.'.951
OFFICIAL USE ONLY
9,760.39
0.00 X _(15) 0.00
0.00 X .045 (16) 0.00
0.00 X .12 (17) 0.00
0.00 X .15 (18) 0.00
(19) 0.00
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR IlPPLICABLE RIlTES
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15.llmouol of Line 14 taxable at1l1e spousal tax
rale, orlranslers under Sec. 9116 (a)(1.2)
(8)
9,760.39
16.llmounl of Line 14 taxable allineal rate
1,805.00
15,196.44
(11)
(12)
(13)
17,001.44
-7,~41.05
17. Amount of line 14 taxable at sibling rate
(14)
-7,241.05
18. Amount 01 Line 14 taxable at oollateral rate
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE: SORE TO ANSWER ALLQUESTIONSOlfREVEi'{SE SlOE AND RECHECK MATH", <
19. Tax Due
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ece en s omPle e ress:
STREET ADDRESS
Messiah Village
100 Mount Allen Drive
CITY Mechanicsburg I STATE I ZIP
PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
0.00
Totai Credits (A + 8 +C)
(2)
0.00
3. InteresUPenalty ~ applicable
D. Inleresl
E. Penaity
TotallnleresUPenalty ( 0 + E ) (3)
4. If Line 2 is greater than Une 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Une 1 + line 3 is greater than Une 2, enler the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58)
Make Check to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedenl make a transfer and: Yes No
a. retain the use 01 income of the propertytransfened; ........................................................................... 0 lZl
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 lZl
c. relain a reversional)' interest; 01 ...................................................................................................... 0 00
d. receive the promise for life of either payments, benefits Oleare? ............................................................. 0 lZl
2. If death occurred after December 12, 1982, did decedent Iransfer property within one year of death
wilhoul receiving edequale consideration?............................................................................................... 0 00
3. Did decedent own an 'in trustfor' or payable upon death bank account or security at his or her death? ................. 0 lZl
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a benellciary designation? ....................................................................................................... 0 00
0.00
0.00
0.00
0.00
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under pen~ of perjury, I declare thai I have examined this return, incIud~ ~yiog schedules and statements, and., the besl of my knowledge and belief. it is true. correct and complete.
Dec_of_otherlllan\llepelSOl\lll_latWe~based""illinfonnation"which_hasany_ge.
SIGNATURE OF I/fllSl RESPONSI LE FOR Fill G RETURN DATE
h 7 (Illof
ADDRESS 4920 oodbox L
Mechanicsburg PA 17050
SIGNATUREOFP~:~E~~~~ATIVE
C U F ~~/ "'t ->
ADDRESS 20 Erford Road, Ste 200
Lemo ne PA 17043
For dales of death on 01 after July 1, 1994 and befOle January 1,1995, the tax rate imposed on the net value oflransfers to or for the use of the surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (i)J.
For dates of death on or after Janual)' I, 1995,the tax rate imposed on the net value oflransfers to or for the use ofthe surviving spouse is 0% [72 P.S. ~9116 (aJ (1.1) (Ii)J.
The statute does not exemot a Iransfer to a surviving spouse from tax, and the statutory reQuirements for disclosure of assets and filing a tax return are sti! applicable even if
the surviving spouse is the only beneficiary.
For dates of death on 01 after July 1, 2000:
The tax rate imposed on the net vaiue of transfers from a deceased child twenty-one years of age or younger at death to 01 for !he 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 vaiue oflransfers to or for the use of the decedents lineai beneficianes is 4.5%, except as noted in 72 P.S, ~9116(1.2) [72 P.S. ~9116(aX1)1.
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)J. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood 01 adoplion.
REV-1508 EX + (6-98)
'*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX REl1JRN
RESIDENT DECEDENT
ESTATE OF
MAGARGLE LORAINE C.
FILE NUMBER
21 05
Indude the proceeds of litigation and the dale the proceeds were received by the estale.
All property Jolntly-owned with right of survivo..hlp must bo disclosed on Schedule F.
ITEM
NUMBER
1.
OESCRlPTlON
Wachovia Bank. N.A. - acet #1014222850476
VALUE AT DATE
OF DEATH
6,617.39
2.
Conseco Long Term Care Insurance ( claim payment)
2,300.00
3.
Social Security (June 3 payment)
843.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space ~ needed. insert additional sheels of the same size)
9 760.39
REV-1511 EX + (12-99)
'*
COMMONWEAL 1M OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MAGARGLE LORAINE C.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of de<:eclent must be reported on Schedule I.
FILE NUMBER
21
05
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
8. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name 01 Personal Representalive (s) R. Lynn MaQarQle 750.00
Sodal Security Number(sVElN Number of Personal Representative(s)
SueelAddress 4920 Woodbox Lane
City MechanicsburQ State PA Zip 17055
Year(s} Commission Paid: 2005
2. Attorney Fees Radcliff Law Office, P.C. 1,000.00
3. Fami~ Exemption: (If decedents address ~ not Ihe same as claimants. attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountanfs Fees
6. Tax Return Preparefs Fees
7. Filing fees - Petition, Inventory and Inheritance Return 45.00
8. Wachovia Bank, N.A. - bank acct charge 10.00
TOTAL (Also enter on line 9, Recapitulation) $ 1 805.00
(If more space is needed, insert additional sheets of the same size)
REV.1512 EX '" (6-98)
*
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MAGARGLE. LORAINE C
FILE NUMBER
21 05
Include unrelmbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. Messiah Village
VALUE AT DATE
OF DEATH
4,562.41
2. Department of Public Welfare
5,060.38
3. West Shore EMS
462.81
4. PharMerica
495.23
5. Stoken Ophthalmology
48.81
6. Cumberland Crossings
4,566.80
TOTAL (Also enteron line 10. Recapitulation) $
(If more space ~ needed. insert additional sheets of lI1e same size)
15196.44
REV.,513EX+(W
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
- I, or: ?1 no;
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS Vndude outright s~usal distributions. and transfers under
Se~ 9116 (a)(1. )]
1. R Lynn Magargle lineal 0.00
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18. AS APPROPRIATE. ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed. Insert addltionai sheets of the same size)