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HomeMy WebLinkAbout10-07-05 (2) REV. 16IIG EX.. (e~) . COMMONWEAlTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 1712e-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I(lF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL) I I Andrews, Margery 0 i-~ 1. Original Return 0 2 Suppiemental Return o 4. limited Estate 0 4a. ~ 6. Decedent Died Testate (Attach COpy 0 7. of Will) o 9 litrgation Proceeds Received 0 10. Spousal Poverty Credit (date of death between 0 11. Election to lax under Sec. 9113(A) (Anach Sch 0) 1?:31:91 a_ndJ~_'_~95) ITHIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME---- -----___n__ -------- -----rcoMPLETEMAILlNGAOORESS ____ _____ Stephen L. Bloom I .... z w o w o w o DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) Andrews, Bruce R 21 05 COUNTY COOE YEAR SOCIAL SECURITY NUMBER 00076 NUMBER DATE OF DEATH (MM-DD-YEAR) DA TE OF BIRTH (MM-DD-YEAR) 145-20-0267 THIS RETURN MUST BE FilED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D o 3. Remainder Retum (date of death prior to 12-13-82) w .... ~:$U) 0"''' wo.O %09 u~m 0. .. Future Interest Compromise (date 01 death after 12-12-82) Decedent Maintained a Living Trust (Attach copy of Trusl) 8. Total Number of Safe Deposit Boxes 5 Federal Estate Tax Return Required ! 01108/2005 08/27/1926 2100 Longs Gap Road Carlisle, PA 17013 r----~'->-~~- (1) None (2) 140,607.60 -j (3) None (4) None - .J (5) 500.00 (6) None L (7) None c.) --_.._-,_.~-_.._.- - ~ -_..._CC21_. (8) (9) 12,698.03 (10) 507.35 -0 -;! : C-) C) '~':J ':) i"n '.J (---, --j _- -.n - j~~ -) i i i _.___________J .... UlZ Ww "'0 "'z 00 00. FIRM NAME (It applicable) Stephen L. Bloom, Esquire TELEPHONE NUMBER 717/249-7717 141,107.60 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole. Proprietorship 4. Mortgages & Notes Receivable (Schedule D) z o >= :3 ::> .... 0: .. o w '" 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9_ Funeral Expenses & Administrative Costs (Schedule H) (11) 13,205.38 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) (12) 127.902.22 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) (13) 500.00 (14) J27,40222 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15.Amount of Line 14 taxable at the spousal tax rate, 127,402.22 x .00 (15) or transfers under Sec. 9116(a)(12) 16.Amount of Line 14 taxable at lineal rate x .045 (16) ::> 0. 17. Amount of Line 14 taxable at sibling rate x .12 (17) '" 0 0 " 18. Amount of Line 14 taxable at collateral rate .. x .15 (18) .... 19. Tax Due (19) 20. 0 0.00 0.00 Copyright 2000 form software only The Lackner Group, Inc. . - >> BE SURE to ANSWER ALL QUEStiONS ON REVERSE SIDEANDRECHECK MATH << --~,-- .-.- - -. ___'_"_h.._ _ _ _ ____ ...._.._.. Form REV-1500 EX (Rev. 6-00) ~ ...........IYIU1'fYVl:.PoL1M VI" t"I::N"'~TLVANIA "'U"'''''''A'''''''''''^'''''~'D''' Decedent's Complete Address: STREET ADDRESS 252 South College Street CITY Carlisle STATE PA ZIP 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount 3. InteresVPenalty if applicable D. Interest E. Penalty Total Credits (A + 8 + C) TotallnteresVPenalty (D + E) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPA YMENT. Check box on Page 1 line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. 8. Enter the total of Line 5 + SA. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (1) 0.00 (2) 0.00 (3) 0.00 (4) (5) 0.00 (SA) (58) 0.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred;........ .................. .................... ................... b. retain the right to designate who shali 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? ..... .............. ................... ................ ....... . ....... ..... ......... Yes No ~ I o ~ o ~ o ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, ADDRESS ADDRESS 2100 Lonj!,S Gap Road Carlisle, PA 17013 DATE 9/"30~<:r~ DATE 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. 99116 (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. 99116 (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. 99116 (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 PS 99116 1.2) [72 PS 99116 (a) (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. 99116 (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. ESTATE OF . SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Andrews, Bruce R i , FILE NUMBER 21 - 05 - 00076 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION UNIT VALUE Fidelity Investments Account #2AR-691429 10 1.99 TOTAL (Also enter on line 2, Recapitulation) VALUE AT DATE OF DEATH 140,607.60 140,607.60 . SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIOENT DECEDENT ESTATE OF Andrews, Bruce R , FILE NUMBER I 21 - 05 - 00076 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 I DESCRIPTION VALUE AT DATE OF DEATH 500.00 Miscellaneous Books and Papers - Nominal Market Valuc - Useful for Research/ Academic/Historical/Reference Purposes only TOTAL (Also enter on Line 5, Recapitulation) 500.00 ESTATE OF ITEM NUMBER A. B. 2. 3. 4. *' SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Andrews. Bruce R ! FILE NUMBER 21 - 05 - 00076 Debts of decedent must be reported on Schedule I. DESCRIPTION AMOUNT FUNERAL EXPENSES: Hoffman-Roth Funeral Home, Inc. - Funeral Service 2 Georges' Flowers - Floral Arrangement for Service 3 Dickinson College - Memorial Service Refreshments 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City Year(s) Commission paid State Zip Attorney's Fees Stephen L. Bloom, Attorney and Counsellor at Law Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Margery D. Andrews Street Address 252 South College Street City Carlisle Relationship of Claimant to Decedent State PA Spouse Zip 17013 Probate Fees Cumberland County - Register of Wills 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. I Other Administrative Costs RestoreCore Central PA - Biohazard Remediation TOTAL (Also enter on line 9, Recapitulation) 2,919.29 68.98 1,753.12 2,764.61 3,500.00 302.00 1,390.03 12,698.03 . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEAlTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Andrews, Bruce R FILE NUMBER 2] - 05 - 00076 Include unreimbursed medical expenses. ITEM NUMBER 1 DESCRIPTION AMOUNT 507.35 Citicorp Credit Services, Inc. - Credit Card Balance (#5424180055960626) TOTAL (Also enter on Line 10. Recapitulation) 507.35 REV.1513 EX+ (9-00) . SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Andrews, Bruce R FILE NUMBER 21 - 05 - 00076 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT Do_Nol.Ust_Trustee(a) AMOUNT OR SHARE OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) Margery D. Andrews 252 South College Street Carlisle, P A 17013 Spouse Residue 127.402.22 Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet i II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTiON 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE lB. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Dickinson College 500.00 I TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET' 500.00 STEPHEN L. BLOOM ATTORNEY ,\ND COI'1\:Sr':I.LOR AT LA\\' 2 I () Ii L () :\ (; s G ,\ I' R () ,\ I) C \ It I. 1 S I. 1':, PI'"'' S Y I, \' \ "1\ 17 ()] 3 7]7.249.77]7 LAST WILL AND TESTAMENT I, BRUCE R. ANDREWS, of the Borough of Carlisle, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. 1. I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and all inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any property) shall be paid from my residuary estate as soon as practicable after my decease and as part of the administration of my estate. My personal representative shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. 2. I give, devise and bequeath my professional library to DICKINSON COLLEGE and the BOSLER LIBRAR Y, both of Carlisle, Pennsylvania, with DICKINSON COLLEGE having the first right of selection of any portion or all of my said library. 3. Ifmy spouse shall survive me by thirty (30) days, then I give, devise and bequeath all the rest, residue and remainder of my estate, whether real, personal or mixed property, whether tangible or intangible, and wherever situated, unto my spouse, MARGERY D. ANDREWS, absolutely. 4. In the event my said spouse shall predecease or fail to survive me by thirty (30) days, then I give, devise and bequeath all the rest, residue and remainder of my estate, whether real, personal or mixed property, whether tangible or intangible, and wherever situated, in equal shares, unto my children, STEPHEN B. ANDREWS, MARY-MARGARET ANDREWS and CAROLYN ELIZABETH ANDREWS, absolutely, with substitution of issue per stirpes. Page 1 of 4 Pages ~ B.R.A. 5. I nominate, constitute and appoint my spouse, MARGERY D. ANDREWS, as Executrix of my estate. In the event she shall be unable or unwilling to serve in such capacity, then I appoint my son, STEPHEN B. ANDREWS, as Executor of my estate. In the further event he shall be unable or unwilling to serve in such capacity, then I appoint my daughter, MARY-MARGARET ANDREWS, as Executrix of my estate. 6. I direct that my personal representative shall not be required to file a bond to secure the faithful performance of his or her duties in any jurisdiction. 7. I authorize and empower my personal representative, in his or her sole and absolute discretion, to purchase or otherwise acquire and retain any investments or any property of any nature which I own at my death; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind forming a part of my estate for such terms and such prices as he or she may deem advisable; to borrow money for any purposes connected with the protection and preservation of my estate; to mortgage or pledge any real or personal property forming a-part of my estate or to join in or secure the partition of same; to compromise any claims or demands of my estate against others or of others against my estate; to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; to employ agents, attorneys and proxies and to delegate to them such power as my personal representative considers desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys arid proxies; and to execute and deliver such instruments as may be necessary to carry out any of these powers. In addition, I direct that my personal representative shall have the power to conduct an inventory of any safe deposit box necessary to the administration of my estate. Page 2 of 4 Pages :bf?P1 B.R.A. 2003. IN WITNESS WHEREOF I have hereunto set my hand and seal this 2151 day of August, ~C"- f: fl;;L ",.r,; (SEAL) Bruce R. Andrews . SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, have hereunto subscribed our names as witnesses thereto, in the presence of the said estator and of each other. __~c~ / Page 3 of 4 Pages COMMONWEALTH OF PENNSYL VANIA ) : SS. COUNTY OF CUMBERLAND ) I, BRUCE R. ANDREWS, 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 Will; that I signed it willingly; and that I signed it as my free and voluntary act [0, the pmpose' thereio expre~ J6 .D~_~, ~-/p~ Broce R. Andrews Sworn or affirmed to and acknowledged before me by BRUCE R. ANDREWS, the Testator, this 21st day of August, 2003. q;,!hi tl ~~ N ary Public Notarial Seal lori A. Sullivan, Notary Public Carlisle Boro, Cumberland County My Commission Expires Feb. 16.2004 Memb', Pennsvlvania'lS$odaliono/Notarles ) : SS. ) COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND We, ()h()mn r;;. 'a/be, IY) and 51-ep hR 1/ L . f3lco ;" the witnesses whose names are signed to the attached or forego~ng instrument, being duly qualified according to law, do depose and say that we were present and saw BRUCE R. ANDREWS, the Testator, sign and execute the instrument as his Last Will; that the Testator signed willingly and that the Testator 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 witnesses; 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. ~CY--- Address ,;l100 LoAre; ?'c...,.? l2oc-..d /.c..rl, 5 {~ ~?A !'7n;-S , Notarial Seal lori A. SuIIlYan. NotaIy Public Carlisle BolO. CumberlaOd County My Commission Expires Feb. 16, 2ilO4 Page 4 of 4 Page~emt PennsylvoniaAssoctaUonolNotarles C;\SLBIOffice - Estate P/anningI87/4.lh-will.doc n ,~ltl'1fff:J! February 11, 2005 STEPHEN L BLOOM ATTORNEY AND COUNSELLOR AT LAW 2100 LONGS GAP ROAD CARLISLE PA 17013 Dear Stephen L. Bloom: We are responding to your request for information about Bruce Andrews's account with Fidelity. The table below lists the account holdings and values as of 0 1/08/2005. Fidelity account 2AR-691429: BRUCE R ANDREWS - INDIVIDUAL Established: 07109/1991 Security Description CUSIP Quantity Unit Value Market Value 01107/2005 Fidelity Magellan 316184100 1378.641 $10 1.99 $140,607.60 Total Value $140,607.60 We hope this information is helpful. For questions concerning account holdings or instructions on how to transfer the ownership of the accounts, please call our Inheritor Services Group at 800-544-0003 between 9:00 A.M. and 5:30 P.M. Eastern time Monday through Friday or visit our website at www.fidelitv.com. Sincerely, Fidelity Investments Our fi Ie: W006063-06FEB05 Hrl)~('r"'I\: C""'VI(l", :)f(J,;tdf'cl t,.,., Fidelity BrOkerage Services LLC, M"'rnh~lr Nyf:,l ',If'( '-I, ,,-;: l,<.,,.-,,J\ ,,-,,-j \,'ttk'rTIC"lt ';"!Vll"l th' National Financial Services LLC, M.>nlh," {\jve;! (;II'( f', Hi-" "'\(\(1'1 r .J.. nH ,11:1.) 1.'i\1)~,1 DICKINSON COLLEGE LIBRARY April 11,2005 Margery Andrews 252 S. College St. Carlisle, PAl 70 13 Dear Margery, On behalf of Dickinson College, I would like to acknowledge receipt of the bequest of Bruce Andrews consisting of 602 books and 87 individual journal issues. I would also like to thank you for the gift of six boxes of his papers, reflecting not only his personal research, but also his teaching and his administrative responsibilities to the college throughout his long and distinguished tenure. These papers are a valuable record showing the impact that Professor Andrews had on this college community, and I appreciate your thoughtfulness in sending them along to us. Thank you again very much for these donations, and I wish you all the best. Si~CerelY' ~ ~ (' Julie ePh~ Director, Library Services Department JG:nls Dickinson College PHONE 717-245-1396 1'.0, Box 1773 FAX 717-245-1439 Carlisle, Pennsylvania 17013-2X96 WEB www,dickinson.edu/library The firH college chartered ill tilL' newly recogllized ,/(HIOll S('Ptemllt~r y. 17XJ Hoffman-Roth Funeral Home, Inc. 219 North Hanover Street Carlisle, PAl 7013 (717)243-4511 January 31, 2005 Margery D. Andrews 252 South College St. Carlisle, P A 17013- The Funeral Service for Bruce R. Andrews I 101M ~A ~ 14443-3 We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. (A) OUR SERVICE: CREMATION PACKAGE #5. . . . . . . . EMBALMING. . . . . . . . . . . . . FUNERAL HOME SERVICE CHARGES SELECTED MERCHANDISE: Visitor Register . . . . . . . . . . . . . . . . . . . . . . Memorial Folders. . . . . . . . . . . . . . . . . . . . . . THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED . . . . . . . . . . . . . Cash Advances Newpaper Obituary Notice-Patriot News. Newspaper Obituary Notice-Sentinel . Certified Copies of Death Certificates. . Coroner Authorization Cremation Fee. . TOTAL CASH ADVANCES AND SPECIAL CHARGES . Total Total Cost . . . . . . . . . . . . . . . . . . . . . . . . . . History 01/24/2005 Cumberland County V A TOTAL AMOUNT DUE rhis statement Is net and payable In full within 30 days of receipt. - . . - - - - - - . - - $1450.00 $645.00 $2095.00 $25.00 $25.00 $2145.00 $468.00 $321.29 $60.00 $25.00 $874.29 $3019.29 $-100.00 $2919.29 -- - .. - . - . - - - - - - / ~~7 7V\ ~~ ACCT. It DATE FLOWERS 101-199 G STREET, CARLISLE, PA 17013 PHONE 717-243-2626 FAX: 717-243-5601 www.georgesflowershop.com BRUCE ANDREWS 252 SOUTH COLLEGE STREET CARLISLE, PA 17013 ~ "" .-' STATEMENT DATE ACCOUNT NO : , 01/31/05 007903 PLEASE INDICATE AMOUNT PAID: $ PLEASE DETACH AND REMIT WITH PAYMi" AMOUNT DUE: 139.92 REMEMBER YOUR VALENTINE ON FEBRUARY 14TH. PLEASE ORD~R EARLY' !' I I INV0IC1!!'NOIOESCRIPTION' LOOSE Taken 01/25/05 CHARGE / 170085 BLOOMING PLANT Pat MlIlg'rew 1. CURRENT 3.00 BALANCE CREDITS 3.90 G8.90 0.50 1.44 10.60 79.50 CONTINUED ON NEXT PAGE 25.44 104.9': ........''''~ ~ , 1000'I'lJ:PA8T:'ll!l!,': IO'DAYSI'A8T,DllE DICKINSON COLLEGE POBOX 1773 CARLISLE, PA 17013-2896 (717) 245-1900 INVOICE Mary Margaret Andrews 22 Beaver Meadow Road Norwich VT 05055 Invoice Date 1/25/05 :.'Pay.abte~.p>>~~(e,~pf GL NUMBER DESCRIPTION AMOUNT Charges incurred for the use of facilities and/or services on January 13,2005: 00-9140 10-4630 Memorial Service Refreshments Credit for unused Wine $ 1,806.40 ($ 152.5l)A $ 1,653.89 00-020300-2301 6% PA State Sales Tax $ 99.23 1A:M:0UNT:DU]J) .$;l,,!75a;1~ Tenns: Net 30 Days. 1.5 % finance charge for all past due invoices will be assessed monthly. This invoice covers charges incurred during use of our facilities and/or services. Please be in touch with me if you have any questions regarding this invoice. Thank you for using our facilities and/or services. Perhaps there will be opportunities in the future when we can work together again. f~riginal Invoice Dorothy M. Warner (])irector of tE vent rpfanni1l!J and'11ie :J{oo:and Vnion (]Juifdi1l!J o Remittance Copy o Office Copy o Ledger Copy STEPHEN L. BLOOM A T T () R N E Y 1\ N D C () l' N S ELL 0 RAT L A \XI \1,1 W W J' R :\ C T I I.." 1\ l. C () I : N S I: l. l' () M 2 1 0 C L,)"" S C; .\ I' J( , , .\ I , C ..\ I{ II S IF, [> I. , " S Y I \..\ " 1.\ I 7 0 I .\ S B 1 ( ) l ) \<f fib I' g 1\ ( T I ( A [ ( (1 l "s Fl. ( () 1\1 Invoice submitted to Estate of Bruce R Andrews 252 South College Street Carlisle, PA 17013 Margery D Andrews, Executrix September 27,2005 In Reference To Estate Administration - Initial Interim Billing Statement Invoice #1643 Professional Services 2/8/2005 Appearance at Register of Wills Office to present Certification of Notice to Beneficiaries; Telephone conference with Ms. Rice of The Bosler Library re status of bequest Review and file correspondence re Fidelity 2/18/2005 Telephone conferences with Dickinson College 3/8/2005 Review correspondence and information from Fidelity Investments; Review correspondence from Executrix; Correspondence with same 3/18/2005 Telephone consultation with client; Review file; Correspondence re Insurance Policy 3/30/2005 Telephone consultation with client/file documentation and review 6/8/2005 Review written claim of Cltlcorp Credit ServIces; Review status of administration; Correspondence with Executrix 6/10/2005 Telephone consultation with client 7/26/2005 Review documents and information TFI.FI'II(),F 717.249.7717 FA(:SIMII.F 717.249.7707 T () I I F In I' H 7 7 S 4 H <J (, C 2 Hrs/Rate Amount 0.43 86.94 200.00/hr 0.08 16.67 200.00/hr 0.17 34.33 200.00/hr 055 109.56 200.00/hr 0.43 8672 20000/hr 0.11 2128 20000/hr 0.69 13894 20000/hr 0.08 16.67 20000/hr 0.17 33.33 20000/hr PRACTICAL COUNSEL + CHRISTIAN PERSPECTIVE Estate of Bruce R Andrews 7/28/2005 Review correspondence 9/27/2005 Preparation of Inheritance Tax Return, Schedules and Exhibits; Calculation re same and final assembly; Administrative matters Reserve for final administrative and estate matters, including; Execution and filing of PA Inheritance Tax Return; Preparation, execution and filing of Inventory; Correspondence with Department of Revenue and client; Appearance at Register of Wills for filing of Inheritance Tax Return and Inventory; Preparation of Final Notice of Administration; Appearance at Register of Wils for filing of same For professional services rendered Previous balance 2/15/2005 Payment - thank you Total payments and adjustments Balance due PAYABLE UPON RECEIPT - THANK YOU PRACTICAl. COUNSEL <10 CHRISTIAN PERSPECTIVE Page 2 Hrs/Rate Amount 0.08 16.67 20000/hr 1.41 28100 20000/hr 250 500.00 200.00/hr 670 $1,342.11 $1,42250 ($1,422.50) ($1,422.50) $1,342.11 S 'I' E P HEN L. B L 0 0 M .\[ '<>1(:-:1\' 1:-:1) C<>""\FI.I.()I\ .IT 1..1\\ \\'ww l'I{/\CTIC,\I.C{)IINSI':1. COM ~ I II II I (I..... (, -.; (: \ I' l{ ( I \ I) (. \){ I 1.., 1 I PI"'; '\. "y I \ \ "\ 1,\ I -:' () I J ." 1\] (l( \1\1 Ill' 111{ \ I j Ii \ ! I) I ~:' I I. ( t 1 \1 Invoice submitted to. Estate of Bruce R. Andrews 252 South College Street Carlisle, PA 17013 Margery D. Andrews. Executrix February 04. 2005 In Reference To Estate Administration - Initial Interim Billing Statement Invoice #1531 Professional Services 1/18/2005 Telephone consultation with Executrix; Administrative matters and preliminary preparations for probate 1/19/2005 Telephone conference with Mr. Stephen Andrews; File memorandum 1/25/2005 Telephone consultation with Executrix; Preparation of Petition for Probate and Grant of Letters Testamentary, Oath of Personal Representative, proposed Decree of Probate and Grant of Letters, and Department of Revenue Estate Information Document; Administrative matters; Appearance at Register of Wills for presentation of Petition and exhibits; Review Letters Testamentary and Short Certificates issued by Register of Wills 1/26/2005 Telephone consultation with Executrix; Memorandum to file 2/4/2005 Administrative matters; Preparation of required 'Notice to Beneficiaries of Estate Administration' and 'Certification of Notice Under Rule 5.6(A)' to Register of Wills; Review and Evaluation of projected Estate Administration, tax obligations and related matters; Correspondence and telephone conferences with Fidelity Investments; Preparation of Fidelity Funds Account Change of Ownership Form and related correspondence; Preparation of Letter of Instruction re Fidelity Investment Account Date of Death Valuation Documentation; Preparation of correspondence and advice to Executrix For professional services rendered I' R ,\ C T 1 <. .\ I. C () I . '" S I.: I. + C II R 1ST i r\ N PER S PEe T J Y E 'j'I': r. J.: P II (1 ~ I - I - 2.1 C) - - I FAC S I MI/.l - , - 2 ,~ ') - - 'i - T ClI. [ 1'1(1':1'. 8-- ) -I H ()(lll..':: Hrs/Rate Amount 0.50 100.00 20000/hr 0.10 20.00 20000/hr 257 51322 20000/hr 0.08 20000/hr 16.67 3.86 20000/hr 77261 7.11 $1,422.50 Estate of Bruce R Andrews Balance due PAYABLE UPON RECEIPT - THANK YOU I' IL\ c: T I ( ,\ I. C () I ~ S F I. + ell R 1ST i A N PER S PEe T J Y F Page 2 Amount $1,42250 RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17IT13 Rece~pt Date: ReceJ.pt Time: Receipt No. : 1/25/2005 14:15:05 1039259 ANDREWS BRUCE R Estate File No. : Paid By Remarks: 2005-00076 M D ANDREWS VZ ------------------------ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST WILL SHORT CERTIFICATE JCP FEE AUTOMATION FEE Check# 9258 Total Received.... . . . . . 260.00 15.00 12.00 10.00 5.00 ---------------- $302.00 $302.00 CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN BUREAU OF RECEIPTS & CNTR M.D CUMBERLAND COUNTY GENERAL FUN 1/31/05 RestoreCore Central PA Michael Goldberg Contractor 2322 North 7th Street Harrisburg, PA 17110 Voice: Fax: 717-232-1500 717-232-9936 Account Of: Andrews, Bruce & Margery 252 S. College St. Carlisle, PA 17013 USA Date Date Due Reference 2/10/05 5053 0-30 0.00 Paid Description {I (oC; r1J1 V ~"lQrtJ 31 - 60 61 - 90 1,390.03 0.00 You may haw forgotten this bill. Thanks for your attention. Statement Statement Date: Mar 3, 2005 Customer Account 10: andbru-CA50112 Amount Enclosed $ Amount Balance 1,390.03 1,390.03 Total 1,390.03 Over 90 days 0.00 RestoreCore 2322 North Seventh Street Harrisburg, Pennsylvania 17110 717-232-1500 fax717-232-9936 EIN 25-1767775 Room: CA50112 Emergency service call- after bus iness hours Bio-hazard Remediation Technician - per hour - after hours Note: 2 techn icians for for 2.5 hours and 3.75 hours respectively to respond to claim, remove contaminated items, and take to diposal facility. Bio - hazard disposal Add for personal protective equipment (hazardous cleanup) I.00EA 6.25 HR I.00EA 2.00 FA Grand Total 1,390.03 Michael Brown Grand Total Areas: 0.00 SF Walls 0.00 SF Ceiling 0.00 SF Walls & Ceiling 0.00 SF Floor 0.00 SY Flooring 0.00 LF Floor Perimeter 0.00 SF Long Wall 0.00 SF Short Wall 0.00 LF Ceil. Perimeter 0.00 Floor Area 0.00 Total Area 0.00 Interior Wall Area 0.00 Exterior Wall Area 0.00 E\'terior Perimeter of Walls 0.00 Surface Area 0.00 0.00 Total Perimeter Length 0.00 Total Ridge Length 0.00 0.00 Area of Face I CA50112 02102/2005 Page: 2 MINNESOTA OFFICE: JAMES A. BALOGH - MN GARY W. BECKER - DC. FL. IL. MN. WI' .CREDITOR'S RIGHTS SPECIALIST AMERICAN BOARD OF CERTIFICATION CHELSEA A. WHITLEY - MN, WI ANGELA M. HORN - MN MICHAEL D. JOHNSON - MN MARY EllEN WEEMAN - KS. MN. MO THERSIA O. LEE - MN CHAD J. BotINSKE - MN JASON R. FOSTER - MN MEAGAN M. PROBST - MN MICHAEL J. DOUGHERTY - MN MICHAEL D. BOllNSKE - MN. OR Jill M. GEMlO - MN EMILY L. FINGER - MN ANDREW S. MILLER - MN KAMlllE R. DEAN - CA MATTHEW R. EICHENLAUB - MN BALOGH BECKER, LTD. ATTORNEYS AT LAW SEND ALL WRITTEN REPLIES TO: ARIZONA OFFICE: 64 E. BROADWAY ROAD SUITE 17 5 TEMPE. AZ 85282 DIANA THEaS - AZ. CO 4150 OLSON MEMORIAL HIGHWAY, SUITE 200 MINNEAPOLIS, MINNESOTA 55422-4811 TELEPHONE 763-852-8440 FAX 763-852-8499 TOLL-FREE 866.234.0513 FLORIDA OFFICE: 120 SOUTH OLIVE AVENUE SUITE 501 WEST PALM BEACH, FL 33401 ANTHONY J. MANISCALCO - FL 05/12/05 OF COUNSEL: LiTOW LAW OFFICES, P.C. (IOWA) LUSTIG, GLASER & WILSON, P.C. (MASSACHUSETTS) STEVEN BLOOM 2100LONGSGAPRD CARLISLE, P A 17013 Re: In the Estate of BRUCE R ANDREWS Probate Case No. Social Security No: Last known residence: Our Client: Account Number: Amount of Debt: 21200576 145200267 252 S COLLEGE ST CARLISLE, P A 17013 CITICORP CREDIT SERVICES 1Ne. 5424180055960626 $507.35 Dear STEVEN BLOOM Enclosed herewith is a copy of the Creditor=s Claim for the above-referenced Estate. The original was mailed to CUMBERLAND COUNTY COURTHOUSE If you have any questions or if this is a duplicate claim, please call our firm toll free at 1- 866-234-0513 Cordially, Balogh Becker, Ltd. Attorneys at Law Enclosures cc: Court Personal Representative This letter is an attempt to collect a debt and any information obtained will be used for that purpose. This letter is from a debt collector. 6187 Sllon~ 1320511