HomeMy WebLinkAbout11-08-05
REV .'1500 EX + (6.00)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
2005
I
I FILE NUMBER
I 21
COUNTY CODE YEAR
II SOCIAL SECURITY NUMBER
I 161-32-4649
0794
NUMBER
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT,280601
HARRISBURG, PA 17128-0601
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fDECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
, SABLOSKY, HELEN M.
~ATE OF DEATH (MM-DD.YEAR)
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108/18/2005 105/26/1916
rlF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
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5. Federal Estate Tax Return Required
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
DATE OF BIRTH (MM-DD-YEAR)
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
3. Remainder Return (date of death prior to 12-13-82)
o 2 Supplemental Return
o 4a. Future Interest Compromise (date of death after
12.12-82)
I ~ 6. Decedent Died Testate (Attach copy 0 7. Decedent Maintained a Living Trust (Attach
I of Will) copy 01 Trust)
: 0 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death between 0 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
-----1- 12.3'.91 and 1-'-95
_.___ ITHIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
~AME COMPLETE MAILING ADDRESS
I LEONARD TINTNER
rlRM NAME (If applicable)
. Boswell, Tintner, Piccola & Alford
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[ELEPHONE NUMBER
_ 717/236-9377
I 1, Real Estate (Schedule A)
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8. Total Number of Safe Deposit Boxes
Original Return
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315 N. Front Street/PO Box 741
Harrisburg, P A 17108-0741
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2. Stocks and Bonds (Schedule B) (2) None
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) None
4. Mortgages & Notes Receivable (Schedule D) (4) None
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 67,452.34
(Schedule E)
6. Jointly Owned Property (Schedule F) (6) 6,330.29
z o Separate Billing Requested
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~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 22,572.51
...J (Schedule G or L)
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c: 8. Total Gross Assets (total Lines 1-7)
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1 O. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 332.10
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
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(8)
96,355.14
(11 )
17,648.69
(12)
78,706.45
49,803.65
13. Charitable and Governmental Bequests/Sec 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)
(14)
28,902.80
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15)
or transfers under Sec. 9116(a)(1.2)
z .045 (16)
0 16. Amount of Line 14 taxable at lineal rate x
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c( 28,902.80 x .15 (18) 4,335.42
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19. Tax Due (19) 4,335.42
20. 0
>> BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH <<
Form REV-1500 EX (Rev. 6-00)
Copyright 2000 form software only The Lackner Group, Inc.
Decedent's Complete Address:
STREET ADDRESS
Claremont Nursing Home
CITY
I STATE PA
I ZIP 17013
-~
Carlisle
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
4,335.42
2,800.00
147.37
Total Credits (A + B + C)
(2)
2,947.37
3. InteresVPenalty if applicable
D. Interest
E. Penalty
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3) 0.00
(4)
(5) 1,388.05
(5A)
(5B) 1,388.05
TotallnteresVPenalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Make Check Payable to: REGISTER OF WILLS, AGENT
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;..................................................................................
b. retain the right to designate who shall use the property transferred or its income;....................................
c. retain a reversionary interest; or................................................................................. ...................... ...........
d. receive the promise for life of either payments, benefits or care?..............................................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?...................... ..................................... ................................................. ...........
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.........
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a ben eficiary designation?................................................................................................................. ....
Yes No
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of pe~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
preparer other than the personal representative is based on all information of which pre parer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
~fargaretC;.~agaro
DATE
3621 N. 4th Street
Harrisburg, P A 17110
// ~ for
DATE
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ADDRESS
ADDRESS
DATE
315 N. Front Street/PO Box 741
Harrisburg, P A 17108-0741
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 P.S. 99116
1.2) [72 P.S. 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.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SABLOSKY, HELEN M.
I FILE NUMBER
21 - 2005 - 0794
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 DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
---~
1 M&T Bank - Savings Account #015004206015718 1,792.54
2 Sovereign Bank - Checking Account #0351080988 4,392.10
3 Sovereign Bank - Certificate of Deposit #0465113009 15,000.00
4 Sovereign Bank - Certificate of Deposit #0465113272 16,200.00
5 Sovereign Bank - Certificate of Deposit #0465113728 21,500.00
6 Highmark - Refunds 379.12
7 Homesteaders Life Company - Pre-paid funeral 6,629.00
8 County of Cumberland - refund from County nursing home 1,559.58
TOTAL (Also enter on Line 5, Recapitulation)
67,452.34
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SABLOSKY, HELEN M.
I FILE NUMBER
21 - 2005 - 0794
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
3621 N. 4th Street, Harrisburg, PA 17110
Friend
A Margaret G. Magaro
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF
ITEM Include name of financial institution and bank account number DATE OF DEATH DATE OF DEATH
FOR JOINT MADE DECD'S VALUE OF
NUMBER TENANT JOINT or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET INTEREST DECEDENT'S INTEREST
estate.
1 A I 10/28/1986 M&T Checking Account # 1 0029192 12,660.571 50% 6,330.29
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TOTAL (Also enter on line 6, Recapitulation) 6,330.29
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SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SABLOSKY, HELEN M.
FILE NUMBER
21 - 2005 - 0794
ESTATE OF
, This schedule must be completed and filed if the answer to any of Questions 1 through 4 on page 2 is yes.
ITEM I DESCRIPTION OF PROPERTY DATE OF DEATH %OF
I Include the name of the transferee, their relationship to decedent and the date of transfer. DECD'S EXCLUSION TAXABLE VALUE
NUMBER VALUE OF ASSET (IF APPLICABLE)
Allach a copy of the deed for real estate. INTEREST
1 II Sove"ign B'nk - CD #0465293348 - In Tw" fo, Robe" J 8,500.00 100% 8,500.00
Burchfield
I
2 I Sovereign Bank - CD 0465357812 - In Trust for Jeanette F. 4,500.00 100% 4,500.00
, Kelly
I
3 Sovereign Bank - CD#0465364370 - In Trust for Tamara 1. 5,072.51 100% 5,072.51
Gramley
4 Sovereign Bank - CD#0465423788 - In Trust for Margaret 4,500.00 100% I 4,500.00
G, Magaro
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TOTAL (Also enter on line 7, Recapitulation) 22,572.51
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SCHEDULE H
FUNERAL EXPENSES &
ADMlf\lSTRAllVE COSTS
I
I FILE NUMBER
21 - 2005 - 0794
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SABLOSKY, HELEN M.
Debts of decedent must be reported on Schedule I.
ITEM I DESCRIPTION
NUMBER I
A : FUNERAL EXPENSES:
. I
Gilbert L. Dailey Funeral Home - funeral
AMOUNT
6,629.00
B.
ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Margaret G. Magaw
Social Security Number(s) / EIN Number of Personal Representative(s):
201-16-4961
4,800.00
Street Address
City Harrisburg
Year(s) Commission paid
3621 N. 4th Street
State P A
1/2 2005; 1/2 2006
Zip 17110
2.
Attorney's Fees
Boswell, Tintner, Piccola & Alford
4,800.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
Cumberland County Register of Wills
272.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
1
Other Administrative Costs
The Sentinel - advertise estate
180.59
2
Cumberland Law Journal - advertise estate
75.00
Total of Continuation Schedule(s)
560.00
TOTAL (Also enter on line 9, Recapitulation)
17,316.59
.
Schedule H
FlI1E!I'aI Expenses &
Ach1inistrative Costs cootinued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SABLOSKY, HELEN M.
I FILE NUMBER
21 - 2005 - 0794
3
Boswell, Tintner, Piccola & Alford - reimbursement postage, photocopies, etc.
60.00
4
Boswell, Tintner, Piccola & Alford - reserve to close estate
500.00
Page 2 of Schedule H
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SABLOSKY, HELEN M.
I FILE NUMBER
21 - 2005 - 0794
Include unreimbursed medical expenses.
ITEM
NUMBER
1
DESCRIPTION
AMOUNT
Highmark Blue Cross - monthly healthcare payment
332.10
TOTAL (Also enter on Line 10, Recapitulation)
332.10
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RE\l-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I
NUMBER I
----------r
I. I
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
\ FILE NUMBER
I 21 - 2005 - 0794
RELATIONSHIP TO I AMOUNT OR SHARE
DECEDENT 1 OF ESTATE
Do Not List Trustee(s) 'I
I
ESTATE OF
SABLOSKY, HELEN M.
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
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
3
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
Friars of the Atonment
PO Box 301
Missionary Oblates of Mary Immaculate
9480 North De Mazenod Drive
The Missionary Servants of the Most Holy Spirit
9001 New Hampshire Avenue
Sisters of Saind Casimir
2601 W. Marquette Road
12,450.92
12,450.91
2
12,450.91
12,450.91
4
TOTAL OF PART 11_ ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
49,803.65
LAST WILL AND TESTAMENT
OF
HELEN M; "SABLOSKY
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I, HELEN M. SABLOSKY, of Susquehanna Township, Dauphin CountY~
Pennsylvania, being of sound and disposingmiIldand memory, do hereby revoke aUprior Wi1!s
and Codicils made by me, and do make, publish and declare this to be my Last Will and
Testament:
ITEM I: I direct that I be buried beside my beloved husband, Charles A.
Sablosky, in Resurrection Cemetery, R.D. 3, Harrisburg, Pennsylvania, and I further direct my
Executor to place a grave marker similar to the one placed for my said husband over my grave.
In addition, I direct that, in the administration of my estate, my Executor conduct no public sale
or auction of any asset of my estate, but, rather, that it dispose of all of my said assets by private
sale" or otherwise.
ITEM II: All inheritance, estate and similar taxes becoming due by reason of my
death (hereinafter collectively referred to as "Death Taxes"), whether such Death Taxes shall be
payable by my estate or by any recipient of any property, shall be paid by my Executor out of the
property passing under Item Iv' of this iflill as an expense ai1d cost of administration of my
estate. My Executor shall have no duty or obligation to obtain reimbursement for any Death
Taxes paid by my Executor, even though paid with respect to proceeds of insurance or other
property not passing under this Will.
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ITEM III: I hereby exercise all powers of appointment which I may have at the
time of my death in favor of my Executor, and all property subject to all such powers of
appointment shall be included in my estate and shall be governed by the provisions of this Will.
ITEM IV: I give, devise and bequeath all of my property, real, personal and
mixed, to the following four (4) charitable organizations, in each instance for the perpetual
enrollment of my beloved father and mother, Peter and Mary Y ousavage, my beloved husband,
Charles A. Sablosky, and myself in the respective spiritual alliance, spiritual union, mass
association or similar concept of each of the said organizations, in the following shares and for
the following purposes:
A. Twenty-five percent (25%) thereof to FRIARS OF THE ATONEMENT,
INC., presently having offices at Graymoor, Garrison, New York, to.be used as th~ said
organization sees fit.
B. Twenty-five percent (25%) thereof to THE MISSIONARY ASSOCIATION
OF MARY IMMACULATE of MISSIONARY OBLATES OF MARY IMMACULATE,
EASTERN AMERICAN PROVINCE, presently having offices at 350 Jamaicaway, Boston,
Massachusetts, to be used as the said organization sees fit.
C. Twenty-five percent (25%) thereof to THE MISSIONARY SERVANTS OF
THE MOST HOLY TRINITY, presently having offices at 9001 New Hampshire Avenue, Silver
Spring, Maryland, to be used as the said organization sees fit.
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D. Twenty-five percent (25%) thereofw SISTERS OF SAINT CASIMIR,
presently having offices at 260 I West Marquette Road, Chicago, Illinois, to be used as the said
organization sees fit.
ITEM V: No interest in the income or principal of my estate shall be assignable
by, or available to anyone having a claim against, any beneficiary of my estate before actual
payment to the beneficiary, and no part of the income or principal of my estate shall be subject to
attachment, levy or seizure by any creditor, assignee or trustee or receiver in bankruptcy of any
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beneficiary of my estate prior to the beneficiary's actual receipt thereof. My Executor shall pay
over the net income and the principal to the beneficia..;es herein designated, as their interests
may appear, without regard to any attempted anticipation, pledging or assignment by any
beneficiary of my estate and without regard to any claim thereto or attempted levy, attachment,
seizure or other process against the said beneficiary.
ITEM VI: In the settlement of my estate, my Executor shall possess, among
others, the following powers, to be exercised for the best interests of the beneficiaries:
A. To retain any investments, whether real or personal
property, including any shares of stock or other securities of my Executor
or of a holding company controlling my Executor, which I may have at my
death, for so long as my Executor may deem it advisable for my estate to
do so.
B. To vary investments, when deemed desirable by my Executor,
and to invest in all forms of real and personal property, including such
stocks, bonds, notes, real estate mortgages or other securities, including
common trust or investment funds operated by my Executor, and stocks,
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bonds, time deposits and other funds of my Executor or of a hording
company controlling my Executor, as my Executor shall deem advisable,
all regardless of any limitations imposed by law on investments by
executors, any principle oflaw concerning delegation of investment
responsibility by executors, or any principle of law concerning investment
diversification. '
C. In order to effect a division of the principal of my
estate, or for any other purpose, including any final distribution of iny
estate, my Executor is authorized to make said divisions or distributions of
personalty and realty partly or wholly in kind, said assets being divided or
distributed at their respective values on the date or dates of their division
or distribution. In making any division or distribution in kind, my
Executor shall divide or distribute said assets in a manner which will fairly
allocate any unrealized appreciation among the beneficiaries.
D. To sell, by private sale only, upon such terms and
conditions as my Executor may deem advantageous to my estate, any or
all real or personal property or interest therein owned by my estate
severally or in conjunction with other persons or acquired after my death
by my Executor, and to conswnmate said sale or sales by sufficient deeds
or other instruments to the purchaser or purchasers, conveying a fee
simple title, free and clear of all trust, and without obligation or liability of
the purchase or purchasers to see to the application of the purchase money
or to make inquiry into the validity of said sale or sales; and also to make,
execute, acknowledge and deliver any and all deeds, assignments, options
or other writings which may be necessary or desirable in carrying out any
of the powers conferred upon my Executor in this paragraph or elsewhere
in this Will.
E. To mortgage real property, and to make leases of real property
for any term.
F. To borrow money from any party, including my Executor, to
pay indebtedness of mine or of my estate, expenses of administration,
Death Taxes or other taxes.
G. From the same source as from which Death Taxes are to be
paid in accordance with Item II of this Will, to pay all Death Taxes or
other taxes, a.l1d expenses, costs and charges in connection with tL1e
administration of my estate, and my Executor shall pay the expenses'or
my last illness, funeral and burial.
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.t1. To vote any shares of stock which form a part of my estate,
including any shares of stock or other securities of my Executor or of a
holding company controlling my Executor, and to otherwise exercise all
the powers incident to the ownership of such stock, and to actively
manage and operate any unincorporated business, including any joint
ventures and partnerships, with all the rights and powers of any owner
thereof, including the power to incorporate the same.
;
I. In the discretion of my Executor, to unite with other owners of
similar property in carrying out any plans for the merger or reorganization
of any corporation or company whose securities form a part of my estate,
. ,. including my Executor or a holding company controlling my Executor.
asset.
J. To assign to and hold in my estate an undivided portion of any
K. To hold investments in the name of a nominee.
L. To compromise claims and controversies, and to abandon any
property which, in my Executor's opinion, is oflittle or no value.
M. To partition, subdivide or improve any real property in which
my estate may have an interest, and to enter into agreements concerning
the partition, subdivision, improvement, zoning or management of any
such real property, and to impose or extinguish restrictions on any such
real prol?erty.
ITEM VII. I hereby appoint my two dear friends, MARGARET G. MAGARO
and JEANETTE F. KELLY, as Executors of this Will. If for any reason either of my said dear
friends should fail or cease to so act, no successor shall be appointed in her place, and the other
of my said dear friends shall act or continue to act with all of the powers granted to the two of
them. If for any reason both of my said dear friends should fail or cease to so act, I appoint
DAUPHIN DEPOSIT BANK AND TRUST COMPANY, with primary offiGes in Harrisburg,
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Dauphm County, eWlsYlval'1ia, as xecULor 01 L IS vv il . 11 relerences m IDS vv 111 0 my
"Executor" shall refer to my aforesaid Executors, individually or collectively.
ITEM VIII: Any Executor shall qualify and serve without the duty or obligation
of filing any bond or other security, and shall be entitled to full and adequate compensation for
her or its services as Executor of this Will.
IN WITNESS WHEREOF, I, HELEN M. SABLOSKY, herewith set my hand and
seal to this my Last Will and Testament, type\Vritten on seven (7) sheets of paper, including the
self-proving attestation clause and signatures of witnesses, upon each sheet of which I have also
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written my name, this J I'~day of July, 1997.
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I Helen M. Sabldsky ( ,
On this "] 7 ~ day of July, 1997, in our presence, HELEN M. SABLOSKY
declared to us, the undersigned, that the foregoing instrument was her Last Will and Testament,
requested us to act as witnesses to it and to her signature thereon, and thereupon signed said Last
Will and Testament. We now, at her request, in her presence, and in the presence of each other,
believing the said HELEN M. SABLOSKY to be of sound mind, hereby sign our names as
witnesses.
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COMMONWEALTH OF PEl\TNSYL V Ac1\JIA
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COUNTY OF DAUPHIN
I, HELEN M. SABLOSKY, the testatrix whose name is signed to the foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I signed
and executed the said instrument as my Last Will and Testanient; and that I signed it willingly
and as my free and voluntary act for the purposes therein expressed.
't\ . "'. <-."- }^[ \: t;, L'
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s! I ~4z.LP.n \ \ \, _. )" 11 (50, IL.L.J\
Helen M. Sablosky I
Sworn to or affirmed and acknowledged before me by HELEN M. SABLOSKY,
the testatrix, this :.11 ~ day of July, 1997.
:if
Frank L. Wright, Attorney
PA Supreme Court LD. No. 07133
COMMONWEALTH OF PENNSYLVANIA
)
)
)
SS:
COUNTY OF DAUPHIN
WE, (hr~ i-b T./1.t..) lev. 0:, and 7J:.,r..1II.~ 0,1.1:.. / I"..n~ , the
witnesses whose names are signed to the foregoing instrument, being duly qualified-(ccording to
law, do depose and say that we were present and saw the testatrix sign and execute the said
instrument as her Last Will and Testament; that the testatrix signed it willingly and executed it as
her free and voluntary act for the purposes therein expressed; that each of us, the subscribing
witnesses, in the hearing and sight of the testatrix signed the said Last Will and Testament as a
witness; and that to the best of our knowledge the testatrix was at that time eighteen (18) or more
years of age, of sound mind and under no constraint or undue influence.
sJ
,
Witness
5}
I
Witness
.- Sworr;..to ~raffirmed and s~bscribed b~fore:r::~by 02,:. 'f-~!::j T..1t.1 }",'1'31
and I h.; 1'1\ ,...~. -t. / ~1i1./ ,I'M.. '1J ' the WItnesses, thIS "J, day of July, 1997.
sj
Frank L. Wright, Attorney
PA Supreme Court LD. No. 07133
7
. .
COMMONWEALTH OF PENNSYLVANIA:
: SS.
COUNTY OF DAUPHIN
~~ ~
.. On this, the oJ 1:::- day of July, 1997, before me, the undersigned officer,
personally appeared Frank 1. Wright, Supreme Court J.D. No. 07133, known to me (or
satisfactorily proven) to be a member of the bar of the highest court of said state, and certified
that he was personally present when the foregoing acknowledgment and affidavit were signed by
the testatrix and witnesses.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
51
I Notary Public
My Commission Expires:
8
-
Sovereign Bank
ESTATE OF
SOCIAL SECURITY #:
DATE OF DEATH:
Helen M Sablosky
161-32-4649
August 18, 2005
Account #: 0351080988 Type: Checking
In the name of: Helen M Sablosky, Margaret G Magaro Arty Iff
Date of Death Balance: $4,392.10
Int.(YTD) from 1/1/2005 to 7/21/2005
Accrued interest to date of death: $1.16
Other Info:
Open date: 5/11/1992
$42.29
Account #: 0465113009 Type: CD
In the name of: Helen M Sablosky, Margaret G Magaro Atty Iff
Date of Death Balance: $15,000.00
Int.(YTD) from 1/1/2005 to 7/31/2005
Accrued interest to date of death: $13.92
Other Info:
Open date: 11/20/1995
$134.18
Account #: 0465113272 Type: CD
In the name of: Helen M Sablosky, Margaret G Magaro Arty Iff
Date of Death Balance: $16,200.00
Int.(YTD) from 1/1/2005 to 7/31/2005
Accrued interest to date of death: $21. 77
Other Info:
Open date: 9/16/1996
$209.82
Account #: 04651'13728 Type: CD
In the name of: Helen M Sablosky, Margaret G Magaro Arty Iff
Date of Death Balance: $21,500.00
Int.(YTD) from 1/1/2005 to 7/31/2005
Accrued interest to date of death: $23.71
Other Info:
Open date: 5120/1997
$228.51
Account #: 0465293348 Type: CD
In the name of: Helen M Sablosky ITF Robert J Burchfield
Date of Death Balance: $8,500.00
Int.(YTD) from 1/1/2005 to 7/31/2005
Accrued interest to date of death: $7.88
Other Info:
Open date: 9/24/2001
$76.04
Page 1 of 2
Sovereign Bank
ESTATE OF
SOCIAL SECURITY #:
DATE OF DEATH:
Helen M Sablosky
161-32-4649
August 18, 2005
Account #: 0465357812 Type: CD
In the name of: Helen M Sablosky ITF Jeanette F Kelly
Date of Death Balance: $4,500.00
Int.(YTD) from 1/1/2005 to 7/31/2005
Accrued interest to date of death: $8.02
Other Info:
Open date: 5/8/2002
$77.37
Account #: 0465364370 Type: CD
In the name of: Helen M Sablosky ITF Tamara I Gramley
Date of Death Balance: $5,072.51
Int.(YTD) from 1/1/2005 to 7/31/2005
Accrued interest to date of death: $6.51
Other Info:
Open date: 7/11/2002
$62.76
Account #: 0465423788 Type: CD
In the name of: Helen M Sablosky ITF Margaret G Magaro
Date of Death Balance: $4,500.00
Int.(YTD) from 1/1/2005 to 7/31/2005
Accrued interest to date of death: $6.56
Other Info:
Open date: 1/2/2003
$70.49
Page 2 of 2
.&
- Sovereign :aank
Success is C(mfidet~e. Wi can help you gpllhere.DI
Court Ordered Processing I MA 1 MB3 02-10
P.O. Box 841005
Boston, MA 02284
September 16 2005
Boswell, Tintner, Piccola & Alford
Counselors at Law
P.O. Box 741
Harrisburg, PA 17108-0741
RE: Estate of: Helen M. Sablosky
Date of Death: August 19,2005
Dear Ms. Foster:
Per your request, enclosed please find the account information as of date of death for the
above-named decedent. Please note the balances do not include accrued interest. It is the
policy of Sovereign Bank that certificates held in the name of a decedent will incur no
penalty for withdrawals prior to maturity.
If you should have any further questions, please do not hesitate to call.
Very truly yours,
~r
'- c:::::---- ,
. \ ,{_L-Lc~
, I
Linda Spavento
OAG Team Leader
( 617) 533-1789
rlIM&fBank
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
September 19,2005
Boswell, Tintner, Piccola & Alford
Counselors At Law
315 North Front Street - POBox 741
Harrisburg, PA 17108-0741 '
Re: Estate of' Helen M Sabloskv
Social Security: 161-32-4649
Date of Death: Auzust 18, 2005
Dear Sir or Madam:
Per your inquiry dated September 06, 2005, please be advised that at the time of death, the above-named decedent had on
deposit with this bank the following:
I.
Type of Account
Checking Account
Account Number
10029192
Ownership (Names oj)
Margaret Magaro, Helen M Sablosky *
Opening Date
10/28/86 Closed 09/06/05
Balance on Date of Death
$12,659.46
Accrued Interest
$
1.11
Total
$12,660.57
2.
Type of Account
Savings Account
Account Number
015004206015718
Ownership (Names oj)
Helen M Sablosky *
Margaret Magaro, POA
Opening Date
12/28/82 Closed 09/06/05
Balance on Date of Death
$1,792.28
Accrued Interest
$ 0,26
Total
$1,792.54
Please be advised, there was no safe deposit box found for the above decedent. *For further account information,
regarding ownership and any changes, closures and/or reimbursement of funds, etc., please call the Harrisburg
Main Office # 717-255-2070.
Sincerely,
~~
Nancy Clagett
Records Management
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
, Deceased
No. 21 - 2005 - 0794
Date of Death 8/18/2005
Social Security No. 161-32-4649
SABLOSKY, HELEN M.
Estate of
also known as
Margaret G. Magaro
The 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 located 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 the 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.
/
Atlomey .a
/
06859
I.D. No.:
Personal Representative
S;gnaMe '2Z~.2/. ~~
Signature:
Signature:
Address:
315 N. Front Street/PO Box 741
Harrisburg, P A 17108-0741
Address: 3621 N. 4th Street
Harrisburg, P A 17110
Telephone: 717/236-9377
Telephone:
j 1- 1-0j/
Dated:
Personal Property
M&T Bank - Savings Account #015004206015718
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f,J92.54
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Sovereign Bank - Checking Account #0351080988
4,392.10
Sovereign Bank - Certificate of Deposit #0465113009
, ,-,
15",600.00
Sovereign Bank - Certificate of Deposit #0465113272
16,,290.00
Sovereign Bank - Certificate of Deposit #0465113728
t:"-~)
21~0.00
Highmark - Refunds
379.12
Homesteaders Life Company - Pre-paid funeral
6,629.00
County of Cumberland - refund from County nursing home
1,559.58
Total Personal Property
$67,452.34
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
$67,452.34