HomeMy WebLinkAbout01-30-07
--.J
15056041125
REV -1500 EX (06-05)
PA Department of Revenue '*
~~~~~~~~~~~uaITaxes INHERITANCE TAX RETURN
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
2 1 0 6
File Number
o 998
Date of Birth
182166317
110 4 2 0 0 6
122 3 1 9 2 1
Decedent's Last Name
Suffix
Decedent's First Name
B ROW N
E V A
MI
I
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
[XI 1. Original Return
o 4. Limited Estate
[XI
o
4a. Future Interest Compromise (date of
death after 12-12-82)
7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
10. Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
o
o
o
o
8. Total Number of Safe Deposit Boxes
2. Supplemental Return
o
o
3. Remainder Return (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
J A C QUE L I N E A K ELL YES Q
Firm Name (If Applicable)
71754 1 555 0
REGISTER OF WILLS USE ONLY
J A N L B ROW N ASS 0 C I ATE S
First line of address
"
845 SIR THO MAS C 0 U R T
Second line of address
...-....
SUI TEl 2
City or Post Office
State
ZIP Code
DAlE FILED,
H A R R I S BUR G
P A
17109
( "'t
Correspondent's e-mail address:JACKIEJLB@VERIZON.NET
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
~ [(5"A~ ) ~/f-L<- /-27-07
ADDRESS
55 BURD DRIVE CAMP HILL PA 17011
REPRESENTATIVE
THOMAS
SUITE 12 HARRISBURG
PLEASE USE ORIGINAL FORM ONLY
PA 17109
Side 1
L
15056041125
15056041125
--.J
\
ce
....J
15056042126
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: EVA I. BROWN
RECAPITULATION
182166317
1. Real estate (Schedule A)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.
2. Stocks and Bonds (Schedule B)
.................................. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3.
4. Mortgages & Notes Receivable (Schedule D) ....................... . 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 5. 7 9 5 8 6 2 8
...... .
6. Jointly Owned Property (Schedule F) o Separate Billing Requested . . . . . . . 6. 6 5 3 5 0 0 0
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested. . . . . . . 7.
8. Total Gross Assets (total Lines 1-7) 8. 1 4 4 9 3 6 2 8
.......................... .
9. Funeral Expenses & Administrative Costs (Schedule H) 9. 1 7 9 0 1 0 2
............... .
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . . 10. 2 2 5 7 2 3
11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 2 0 1 5 8 2 5
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12. 1 2 4 7 7 8 0 3
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . 14. 1 2 4 7 7 8 0 3
TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116 0
(a)(1.2) X.O _ 0 0 15. 0 0 0
16. Amount of Line 14 taxable 1 2 4 7 7 8 0 3 5 6 1 5 0 1
at lineal rate X .042- 16.
17. Amount of Line 14 taxable 0 0 0 0 0 0
at sibling rate X .12 17.
18. Amount of Line 14 taxable 0 0 0 0 0 0
at collateral rate X .15 18.
19. Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 5 6 1 5 0 1
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
o
Side 2
L
15056042126
15056042126
....J
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
EVA I. BROWN
-----~ -~.._-
. STREET ADDRESS
55 Burd Drive
File Number
0998
CITY
Camp Hill
, STATE
PA
ZIP
17011
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
5,615.01
280.74
Total Credits (A + B + C) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
280.74
4.
Total Interest/Penalty ( 0 + E)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund.
(3)
(4)
(5)
(5A)
(5B)
0.00
0.00
5,334.27
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.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
5,334.27
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ...................................................................... D IKI
b. retain the right to designate who shall use the property transferred or its income; ............................... D IKI
c. retain a reversionary interest; or ................................................................................................ D IKI
d. receive the promise for life of either payments, benefits or care? ....................................................... D IKI
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... D IKI
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ......... D IKI
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. D IKI
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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 three (3) percent [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 zero (0) percent
[72 PS. 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 zero (0) percent [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 four and one-half (4.5) percent, except as noted in
72 PS. 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 twelve (12) percent [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.
REV-15G8 EX + (6-98)
'*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
EVA I. BROWN
FILE NUMBER
0998
Include the proceeds of litigation and the date the proceeds were received by the estate,
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Fulton Bank 5,291,14
Checking account #1068-52937
2, Fulton Bank 10,072,95
Certificate of Deposit #022-0245748
3. P8ECU 10,530.27
Checking account #0182166317-801
4. P8ECU 16,835.87
Certificate of Deposit #0182166317-850
5. Transamerica Life Insurance Company 574.16
interest check dated October 24, 2006
6. Transamerica Life Insurance Company 35,556.41
Annuity contract #26155415
estate is beneficiary
7, Verizon; refund check 2.39
8, 8ER8; November 2006 pension check 149.27
9, UGI; refund check 73.82
10, Household items and furniture 500.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
79,586.28
REV-1509 EX + (6-98)
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
EVA I. BROWN
FILE NUMBER
0998
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
A. Byron E. Brown
55 Burd Drive
Camp Hill, PA 17011
son
B
c
JOINTLY.OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY '!oOF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 6/2006 Real property located at 55 Burd Drive, Camp Hill, PA 130,700.00 50. 65,350.00
see attached tax assessed value and Deed
TOTAL (Also enter on line 6, Recapitulation) $ 65 350.00
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX + (12-99)
'*
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
EVA I. BROWN
FILE NUMBER
0998
ITEM
NUMBER
A.
1.
2.
3.
B.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11 .
Debts of decedent must be reported on Schedule I.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
Zimmerman funeral home
Funeral clothes
Funeral luncheon
7,379.20
89.77
287.17
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City
State
Zip
Year(s) Commission Paid:
Attorney Fees Jan L. Brown & Associates
5,797.00
3,500.00
Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant Byron E. Brown and Sharon Price
Street Address 55 Burd Drive
City Camp Hill State PA
Relationship of Claimant to Decedent son and daughter
Zip 17011
Probate Fees Register of Wills, Cumberland County
310.00
Accountant's Fees
Tax Return Prepare~s Fees Parks & Company
250.00
Register of Wills, Cumberland County; Inheritance Tax Return and Inventory filing fees
Register of Wills, Cumberland County; Family Settlement Agreement filing fee
Cumberland Law Journal; legal advertising
The Sentinel; legal advertising
Fulton Bank; estate check fee
30.00
20.00
75.00
137.03
25.85
TOTAL (Also enter on line 9, Recapitulation) $
17 901.02
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX + (12-03)
'*'
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
EVA I. BROWN
FILE NUMBER
0998
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. PPL Electric; outstanding debt
VALUE AT DATE
OF DEATH
91.02
2. AT&T; outstanding debt
49.13
3. Comcast Cable; outstanding debt
47.82
4. Lowe's; outstanding debt
17.63
5. Crystal Springs; outstanding debt
27.56
6. Choice VISA; outstanding debt
1,035.22
7. Pennsylvania American Water; outstanding debt
58.65
8. East Pennsboro township; sewer/sanitation debt
115.00
9. United States Treasury; estimated individual taxes 2006
150.00
10. Citicard; check cleared after death
200.00
11. Check #7315 cleared after death
141.00
12. Check #7316 cleared after death
12.13
13. Check #7317 cleared after death
156.00
14. Check #7318 cleared after death
7.00
15. Check #7320 cleared after death
149.07
TOTAL (Also enter on line 10, Recapitulation) $
2,257.23
(If more space is needed, insert additional sheets of the same size)
'~"n"'("*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
EVA I. BROWN
SCHEDULE J
BENEFICIARIES
FILE NUMBER
0998
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 [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Byron E. Brown Lineal 80,207.00
55 Burd Drive
Camp Hill, PA 17011
2. Kathleen L. Klawitter Lineal 14,857.01
1765 Rosedale Avenue
Middletown, PA 17057
3. Karen B. Holtzman Lineal 14,857.01
125 Peach Street
Harrisburg, PA 17112
4. Sharon A. Price Lineal 14,857.01
55 Burd Drive
Camp Hill, PA 17011
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 II - 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)
31Beeb
[~ COpy
fifil 1:-
no, 0
THIS INDENTURE, r;l;lC~:::: Ll;C '1, I ciao, .~ILi,.~__~_
Six (2006).
r::C:' ;<,arTwo Thousand
BETWEEN EVA I. BROvVN, of East Pennsboro Tm,vIlship, Cumberland County,
Pennsylvania, KAREN HOLTZl\IAN, of Lower Paxton Township, Dauphin County,
Pennsylvania, SHARON PRICE, of East Pennsboro Township, Cumberland County,
Pennsylyania, KATHLEEN BRO\VN, a.k.a. KATHLEEN KLAWITTER, of Lower Swatara
Township, Dauphin County, Pennsylvania, and BYRON BRO\V:\') of East Pennsboro
Township, Cumberland County, Pennsylvania, GRANTORS
A
~
D
EVA 1. BROWN, of East Pennsboro Township, Cumberland County, Pennsylvania,
and BYRON E. BROWN, orEast Pennsboro Township, Cumberland County, Pennsylvania, as
joint tenants with right of survivorship and not as tenants in common, GRANTEES.
WIT N E SSE T H, That in consideration of the sum of One (1.00) Dollar, in hand paid,
the receipt whereof is hereby acknowledged, the said Grantors do hereby grant and convey to the said
Grantees, their heirs and assigns,
ALL THAT CERTAIN lot or parcel of ground situate in the TO\vnship of East Pennsboro,
County of Cumberland and State of Pennsylvania, bounded and described in accordance with a
survey and plan thereofmade by Ernest 1. Walker, Professional Engineer, dated September 14,1964,
as follows:
BEG INN I N G at a point on the northeast side ofBurd Drive 295.10 feet southeast of the
southeast corner ofBurd Drive and Brentv/ood Road; thence North 42 degrees 31 minutes East along
the division line between Lots Nos. 13 and 12 a distance of 130.07 feet to a point; thence South 40
degrees 14 minutes East, a distance of 40.19 feet; thence South 47 degrees 29 minutes East a
distance of 35.13 feet to a point; thence South 42 degrees 31 minutes West along the division line
between Lots Nos. 12 and 11 a distance of 125 feet to a point on the line ofBurd Drive; thence North
47 degrees 29 minutes West a distance of75 feet to a point, the Place of BEGINNING.
BEING Lot No. 12, Block "D" on the Plan of North wood Hills as recorded in Plan Book 9,
Page 29, Cumberland County records.
HA VING thereon erected a one story brick and frame dwel~ing kno-.vn as No. 55 Burd Drive.
COMMONWEALTH O~~' ?E>E'iSYLV;\1';lA.
':- C'
_J'........' .
COUNTY OF DAUP:
~~
On this, the day of '. j lene __________,_,_____, }GD6, before me the
undersigned officer, persop;::;ly appeared Eva 1. BrowlI aud Byron Brown known to me (or
satisfactorily proven) to i:;'.c persons whose names c1fC subscric::/ :0 the 'N:thin instrument, and
acknowledged that they:;:cc~_,ted the same for tl'e pGpCi~:C t1\e:e;(1 ,;,)ntaineJ.
IN WITNESS \\-IIEREOF, I have herelwto set ;1:;; h:;;:c :l(\Ll ;;(ll:c,:'al seaL
" , I, , ,IJ
'" i".' "] ,I, (" ! {
j_'_(>~_::-_+~_ \~~:-~.>-{:.. :::~-'!<-=f~.___, t___
';.'v [;(:
. taft)
COUNTY OF DAUPHI:'i
COMMONWEALTH OF mUtSYlYANIA
NOTARIAl SEAL
JACOUELlNE A. KELl'( NOTARf PUBlIC
LOWER PAXTON TWP., DAUPHIN coum
,-_MY COMMISSION EXPIRES DEe.n. 2007
COMMONWEALTH :)ENNSYLVANIA
,-.,',
~).~, .
On this, the ...!:~{?,____ day of J Un 0' _____.._, 2006, before me the
undersigned officer, P(;;-:;()n:,.ily appeared Sharon Price known to me (or satisfactorily proven) to be
the person whose naIT:C :;; ;mbscribed to the withi:l instrument, and acknowledged that she executed
the same for the purpoc:c1lh:=rein contained.
IN WITNESS
;EREOF, I have hereunto set my hand Z'.!iG notarial seal.
_~IiJL1_U:L~ ~
=<o-~a:.;,.. _P-Llblic
NOTARIAl SEAl.
~ It WHITE, NOTARf PU8UC
toWER PAXTON TWP., DAUPHIN coum
MY COMMISSION EXPIRES APRIL 5 2001
COMMONWEALTH C:X"' I)ENNSYL VANIA
C' ('
'-...-I~.J .
COUNTY OF DAUPEIN
On this, the ~l:i_ day of j Un e---- 2006, before me the
undersigned officer, pcrson2Jly appeared Karen Holtzman known to me (or satisfactorily proven) to
be the person whose m:rr:e is subscribed to the within instrum~nt, and acknowledged that she
executed the same for the purpose therein contained.
IN WITNESS \7.;1-1EREOF, I have hereunto set my hand and notarial seal.
7".1 .. n-1P:
iLL1-l-LlfL if llltU}{ u ,
Notary Public
w
I" NOTARIAL SEAL
PAULA It WHITE, NOTARY PUBLIC
lOWER PAXTON TWP., DAUPHIN COUNTY
,,",-,=_ MY COMMISSION EXPIRES APRIL 5. 2008
Ll\ST \VILL AND TESTA;\lF>T
r;~:~
~~.~. E~
li ~ 'l~.. ~;~ JF"J;:3
OF
EV A 1. BRO\VN
I, EVA I. BROWS, EO\'/ domiciled in Cumberlaild COL:rlfY,
,':;l v;:mia, declare this to be
my Last Will and Testament. I l':voke all other wills and codicils th2',t I:':::ry lU\,:; previously made,
Article I
My just debts and t:xpen::;cs of my last illness, funerai, and :l:',r,~ni:;t;Jtic'n of my estate shall
be paid by my Executor frG,n the principal of my residuary estate itS soon as practicable after my
death,
Article II
All inheritance, est(~te, 2T,([ succession taxes (including interest aDd penJlties thereon, but not
including any generation sklpping tax) payable by reason of my dc;ath St1alJ be paid out of and be
charged generally against th,~ principal of my residuary estate v.'Jhout reimbursement from any
person, This provision is :1.0t'1. ';vaiver of any right which my Executor has to claim reimbursement
for any such taxes which become payable as the result of any property over which I have the power
of appointment
r-\Tt.i C 1 r;,\/I
-.-.----.-.
I nominate, COTP',tute, and <lppoint my son, BYRON E. BRO\NS as Executor of my Last
Will and Testament. In tllC event of the rem':llc:,,-~:c;n, death, or i:"lbi::ty to act, for any reason
whatsoever of my Execnt)".~ nomill"tc, constitulc :!nd appoint my d:ljlgH.:~r, SH,\RON A. PRICE
as successor Executrix of rcy L,cst V/ill and Tcstmnent. I direct tbat In> Executor or successor
Executlix be permitted :OC,i~I'/C \'.'ithout bor,i~ ::liV~ i:) "ddition to Glase po"vcrs granted by law, I grant
them pO\\el (0 distribute in cash or in kir,d in 11 kc or in unlike shares :me! to file any qualified
disclaimer I could have filed ifliv:ng. LvIy E;<:CCi!tcr ,)r successor Executrix shall ;-cceive reasonable
compensation for services remiered to rny estate.
Article:\'IJ
In addition to ti'e powers conferred by 1m.';, I authorize my Execc;tor amI successor Executrix,
in his/her absolute discretion;
(a) to retain in the D.)ml recei ved and to seH either at public or private sale, any real estate or
personal property except that which T specifically bequeath herein,
(b) to manage real estate,
(c) to invest and rein vest In all fonT,S of property wi thout belr'..g confined to legal
investments, and without re::iard to the principal of diversification,
(d) to exercise any option or right arising from the ownership of investments,
(e) to compromise claims without court 3pproval and \vithout consent of any beneficiary,
(f) to file any federal income tax return for any year for which I have not filed such return
prior to my death,
- 3 -
I, EVA I. BROWN, Testatrix, who signed the foregoing instrument, having been duly
qualified according to law, acknowledge that I signed and executed this instrument as my Will, and
that I signed it willingly as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and
acknowledged before me by
EVA I. B~OWN, the Testatrix
on G a-O 2006.
~iMJ t,.~
! ot Public '
E~/'-tZj-Qd/)~-1~
EV A I. BROWN
COMMONWEALTH OF PENNSYlVANIA
NOTARIAL SEAL
JACQUElINE A. KELLY, NOTARY PUBLIC
LOWER PAXTON TWP., DAUPHIN COUNlY
MY COMMISSION EXPIRES DEC. 17,2007
We, the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the Testatrix sign and execute this
instrument as her Will; that she signed and executed it willingly as her free and voluntary act for the
purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and
that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of
sound mind, and under no constraint or undue influence.
Sworn to or affirmed and
subscribed to before me
by FI7/i/uK J; 5"coT<:../lLfJ5
and keNNEf-H L, Woomt;f2
witnesses, on lL>/~o ,2006.
~~~~~~
Witness ~
~AJQ~ a. -f1-
. N ary ~blic
7it"MWl1 / .2J,{~
Vl'tness
COMMONWEALTH OF PENNSYlVANIA
NOTARIAL SEAL
JACQUEliNE A. KELLY, NOTARY PUBLIC
LOWER PAXTON TWP., DAUPHIN COUNlY
MY COMMISSION EXPIRES DEC.n, 2007
- 5 -
~
V\
~
-v;
?
VI
U
-\
"?
X
)
.s::>
V\
~~
,. .~
\.J\, "3
\j\0:l
cP~
~~
\
d~
"I ~
- _.
~ (\J
~\/)
'- ~
~~
~
V ~
:::c. <:
=:::. ,~
'-
-~
~
~
,_-.11____
- \ -
~ f,
~-
-
....j
\::)
-
-
JAN L. BROWN, ESQUIRE"
JACQUELINE A. KELLY, ESQUIRE
. ADMITTED IN PA AND DISTRICT OF COLUMBIA
JAN L. BROWN & ASSOCIATES
ATTORNEYS AND COUNSELORS AT LAW
OLOE ENGLISH GAP
845 SIR THOMAS COURT
SUITE 12
HARRISBURG, PA 17109
EMAIL jlbassoc@verizon.net
TELEPHONE (717) 541-5550
FACSIMILE (717) 541-9223
BRENDA F. KEPHART, LEGAL ASSISTANT
PAULA K. WHITE, LEGAL ASSISTANT
JUDITH A. EBERSOLE, ADMINISTRATIVE ASSISTANT
January 29,2007
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P A 17013
Re: Estate of Eva I. Brown
Estate No. 21-06-0998
Executor: Byron E. Brown
To Whom It May Concern:
Enclosed for filing are an original and two copies each of the Inventory and Inheritance
Tax Return for the Estate of Eva 1. Brown. A check in the amount of $5,334.27 made payable to
the Register of Wills, Agent, for payment of Pennsylvania Inheritance Tax due, and a check in
the amount of $30.00 made payable to the Register of Wills for the filing fees have also been
enclosed.
Please return a time-stamped copy of each document in the envelope provided. Also,
Please forward the receipt of payment to my office.
Sincerely,
,'::CUtlrUdt~ (). }J.:f;4
Jacc/beline A. Kelly, Esq. .a
Enclosures
COMMONWEALTH OF PEhlNSYl VANIA
DEPARTMENT OF REVENUE
c,UREAU OF INDIVIDUAL TAXES
DEPT 250601
HARRISBURG, PA 17: 28,0601
REV,1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BROWN BYRON E
55 BURD DRIVE
CAMP HILL, PA 17011
-------- fold
ESTATE INFORMATION: SSN: 182-16-6317
FILE NUMBER: 2106-0998
DECEDENT NAME: BROWN EVA I
DATE OF PAYMENT: 01/30/2007
POSTMARK DATE: 01/29/2007
COUNTY: CUMBERLAND
DATE OF DEATH: 11/04/2006
NO. CD 007754
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $5,334.27
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$5,334.27
REMARI<S: ESTATE OF EVA I BROWN
BRYON E BROWN EXECUTOR
CHECI<# 111
SEAL
INITIALS: AJW
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
:CORDE[
~--'I""'--'
7 I~JJ ')'
,",' ,"'I i' \-J
! "'): :~J J
CLE
O.RP!-~ .,~J
: i I. ',I
1.1',
""""3
o
-,
_.
-
-
-
-.
-
-
_.
_.
-
-
-
-
-
~
=
~ =
non:;o ~~
III :J ~ (D
t1(DS\.Q ~~.
f-' 0" 1-'- I:/) l.IJ~=
==
1-" n (D en ~ I:/)t>i
en 0 t1rt ::tI ... t;j ..,
f-' ~ f-' (D ~ ::tI~=
(D t1 III t1 ~~~t:;~
.. rr:J
:::ro..o z=308 =
'tl 0 H1 zt'j~~
;J:::l~n ~... ~~
en 0:8 NI:/)/>l
(D ~ 1-'- ~ ("}t-o>
-> :J f-' ;Ii> o~
--.JUlrrf-' z ~VJtI)
0..0 "< en s: ::l:I~tI)
->~ ""l"'=
will n ... r;~
t1 0 --I ::e _.
...
(D ~ = =
t1 'C l"'f'
rt tD
~ tI)
0
~
en
(D
I::h::1 1,,',,1,.,," *
LIJ,j !,,'PI,:J
I"",J/::::::I"'"I *
,I::'" C:::I
1:.1:1 *
:;: ij""'"
~ "",,,) UN/~
r--m""~IJ~~.s
C9m "
:H (::0 m;l
~ (~:~'~J i ~~. .
g~ ~1;'~~J:lii ~I. 1-
m ::2::: 1,,'iJ.~
.I>,m~.