HomeMy WebLinkAbout94-00144
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No. 21 - 94 - 144
Estate of
"AUT" P MflIJPUV
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW Febrllnry 16.. 199.1....-. in consideration of the petition on
the reverse side hereof. satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated Mol' 11, 1 Q6Q
described therein be admitted to probate and tiled of record as the last will of "o"i ~ R Mn"'o~l'
and Letters 'T'~Clt-~m~n"~"~,
are hereby granted to Robert S. Mowpry
FEES
-mo (0.;;2 ~ :>(2U. (rm. OJn /la;;
RegislcrofWiIIs .TJ-.a
MARY C. LEWIS
115.00
Probate. Letters. Etc. ......... $
Short Certilicates( ~'.......... $ 6 . 00
Renunciation ................ $
X-pages J.UO
JCP -- $ 5.60
TOTAL _ $ 1?Q.OO
Filed.... f~.~~Y~~.X. J?... !~~.~..........
Sally J. Winder SilO. Ct. No ?4705
ATTORNEY (Sup. Ct. 1.0. No.)
701 East King Street
Shiooensburg. PA 17257
ADDRESS
(717) ,1?-q47~
PHONE
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, Letters and order put in attorneys file in Prothy. on 2-16-94.
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MCCREA I MeCRtA
Amlln. A' LAw
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LAST lHLL AND TESTMmNT
I, DavidE. Mowery, a resident of the TOlmship of Hopewell"
County of Cumberland and Commom,ealth of Pennsylvania, being of
sound mind and memory, do make, publish and declare this to be
my Last Will and Testament, hereby revoking any and all Wills
by me heretofore made.
FIRST: I hereby direct my Executrix, hereinafter named, to
pay .111 my just debts and funeral expenses as may conveniently
be done after ny decease.
SECOND: I give, devise and bequeath all my estate, be it
real, personal or mixed, to my beloved IVife, V. Pauline Mowery,
for her o\Vn proper use and behoof forever.
In the event my wife, V. Pauline 1.Iowe ry, predeceases me or
\~e should perish in a common disaster, then I give, devise and
bequeath all my estate, be it real, personal or mixed, to my
children, Robert S. MOI,ery and .Judy P. 1.lm,ery, equally, share
and share alike. I hereby authorize my Executor, hereinafter
named, to offer my farm to my son, Robert S. 1.:o\Very, for the sum
of $12,000.00. If my son, Robert S. Hm~ery, does not desire to
purchase the farm, then my Execlltor is to offer the farm to my
daughter, Judy P. 11m,ery, for the sum of $12,000.00. If neither
my son nor my daughter \Vish to purchase the farn, then my
Executor hereinafter named, is to expose the same at public sale,
the proceeds therefrom to becone part of the residue of my
estate.
In the event Judy P. !-Im,ery is a minor at the date of my
death, then I Rive, devise and bequeath her equal distributive
share to Robert S. ~fO\,ery, IN TRUST :,EVERTHELESS, to pay the
inCOMe and so lT'uch of the princi pal which he in his discretion
deems necessary for the care, I"aintenancc, support and education
of .Judy P. /lowery until she attains the arc of tIVenty-one years
21 - 94 - 144
REGISTER O}' WILLS OF CUMBERLAND COUNTY
OATH OF SUBSCRIBING WITNESS
Milr1rprl r.. nl1\1i~nn (nP-l\ RlHHull1)
oodioik
(~ a subscribing witness to the will presenled herewith, icallb;l being duly qualified according to
law, depose(s) and say(s) that she was present and saw
O:1\1i rI R. f\fnwery
the testat or , sign the same and Ihat she signed as a witness at the
request of testa~ in h....ts.- presence and (in the presence of each other) (in the presence of the
other subscribing witness(es)).
jJjJjx. ~l (!.Ir!,,,,,l J h/J-if(~"j
MILDRED C. DAVf~~efnee Russell)
~~ Middle Soring Rd., Shipoensburg, PA 17257
(Address)
. LEWIS
(Name)
(Address)
REGISTER OF WILLS OF rtlMRRRI nln COUNTY
OATH OF NON-SUBSCRIBING WITNESS
John McCrea III
(OlIC!Ula subscriber hereto, ~a.obl being duly qualified according to law, depose(s) and sa7(s) that
he is familiar with the signature of David E. Mowery
mdidl
testa~ of (onoclOCxllllDcX5Ubsllll:ibiqx~xlO/ the will presented herewilh and
~
that he believes the signature on the will is in the handwriting of
testa~bt~~~M!~~~~"~~~~~~KKl~H~~xxxxxxxxxxxxxxxxxxxx
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~~~~~~~i~~~~BkYYYYYYYYYVYYYYYYYYYYYYYYYYYYYYYx
to the best of ...Jlls._ knowledge and belief.
rt.~" !lfe CzI?A-
I McCREA 1HJme)
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Sworn 10 or affirmed and subscribed before
me this 4 TH day of
17257
(Address)
(Name)
(Address)
Name(s), /Iddress(es) and telephone numbeds) of all counsel
Name
Address
Telephone
Sally J. Winder
701 East Kinl! Street
(717 )532-94 76
Shippensburi! PA 1725"
Additional information may be
Date: February 17, 1994
Address: 701 East King Street
Shippensburg PA 17257
Telephone: (717) 532-9476
Capacity: ______ personal Representative
~ Counsel for personal
representative
MCCREA' McCREA
An'lIn. n lAw
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LAST \'JILL ANIl TESTAHliN'f
I, IJDvid E. /lowery, a resident of the Tmvnship of 1I0peIVell,
Count)' of Cumherland and ComTnon\,ealth of Pennsylvania, heing of
sowld mind and memory, do make, puhlish and declare this to be
my Last Will and Testament, herehy revokinn any and all Wills
by me he re to fore made.
PIIlST: ,r hereby uirect lilY Executrix, hereinafter named, to
pay all my just debts and funeral expenses as may conveniently
be uone after my decease.
SECOND: J nive, devise and bequeath all my estate, be it
real, personal or mixed, to my heloved lVife, V. Pauline 1l0IVery,
for her mVJl proper use and behoof forever.
In the event my lvife, V. Pauline HOlVery, predeceases me or
IVe should perish in a common dis:lster, then I give, devise and
,bequeath all my estate, he it renl, personal or mixed, to my
children, Hobert S. ~Im,ery and .Juuy 1'. I,!mvory, equally, share
and share alike. I hereby authorizc my Executor, hereinafter
named, to offcr my farl!! to 1\1)' son, Hohert S. HOIVery, for the SUI"
of $12,000.00. If my son, Hohert S. r-IOl,el'Y, uoes !lot desire to
purchase the fllrm, then my lixecutor is to offer the fann to my
daughter, Judy P. /lolVery, for the sum of $12,000.00. If neither
my son nor my dauj!hter IVish to purchasc the f:lfl'1, then, my
Executor hcreinafter named, is to expose the same at puhlic sale,
the proceeus therefrom to hecome part of the residue of my
estate.
In the event Judy 1'. '.l01,ery is a minor at the date of Iny
death, then I give, devise and hequeath her equal distributive
share to Hobe rt S. Howe ry, Hl TRUST NEVERTIIELESS, to pay the
income and 50 much of the principal which he in his ,Iiscretion
deems necessary for the care, maintenance, support and education
of .Judy P. 1f00,ery until she attains the ape of tIVenty-one yellrs
at Nhich tilllc I direct my saill Trustee to pay any amount
remainiag in said trust fllnd to Judy P. }lclIVery.
TIIIIW: I hereby nOI'linnte, constituto I\nd appoint my \Vife,
V. 1':llIlinc flcmery to be the l!xeclltdx of this my Last IHll aad
Testament. In the event 1!1)' NiCe, V. Pauline IloNery, should be
unahle to serve as l!xecutrix for any reason whatsoever, then I
name, constitute and appoint my son, Rohert S. ~Iowery, to he
the suhsti tute l!xecutor.
IN lnTNESS \'IIIEnEOr, I have hereunto set m)' hand and seal
to this my Las t l'/ill and Tcs tament, Nri tten on tIVO sheets of
paper, dated this J1tf}!: day of nay, 1968.
a~l', ?o/~
(SEAL)
This instrument I~as hy the Testator, David E. Howery, on the
date hereof, signed, published and declared by him to be his
Last Will and Testament, in onr presence, who at his request and
in his presence and in the presence of each other, we believini
him to be of sound and disJlosing mind and memory, have hereunto
subscribed our names as IVitnesses.
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COMMOHWIAUH 0' PfNNSYlVANIA
(lI"IIMlNI Of "YEN"E
INMIIt'ANCI 'AIl DlYISfOH
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""1I1U"'O,'A 1712I.cl601 Plea.. Print or Type
MUST BE COMPLnED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE OEPOSIT BOX IS lOCATED AND RETURNED TO ABOVE AODRESS
COUNTY CODE fiLE NUMIER SOCIAL nCURITY OR 0 RTlFICAU NUMIER:o
&.\ .1<1 i20 -.30.. .:5' ~ ;l?~
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SAFE DEPOSIT BOX
INVENTORY
I. ~ Ne I V"
EQUEsTING THE OPENING OF THE SAFE DEP
(CITYI
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NAME, ADDRESS AND RELATIONSHIP
a. [NAMEI
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(STREE.f ADDRESSI
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ISTUET ADDRESS)
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NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT lOX I
INAMII, I
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(STREET ADDRESSI
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. NAME OF PERSON MAKING LAST ENTRY
.. ...t $>
DATI OF CONTRACT TO RENT lOX
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NAME AND ADDRESS OF PER50N1SI HAVING ACCESS TO lOX
.. tNAMEI
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(STlUET AOORUSI "
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(CITYI / l"A"1
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AKING THE INVENTORY
ICIIY1
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IF ANYI TO DECEOENT, OF PERSONlsl PRESENT T HE lOX OPENING
(RElATIONSHIPI
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ICIIY1
New b" \"q ,IJ /9
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NAMI AND nnE OF EMPLO
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INSTRUCTIONS
(1) Ca.h: Report total only. ,
121 Stock.. List In detail ev.ry common or prelerred certilicat., worrant or ather rights lound in box. Stocks are , ,
to be deslgnoted by nome 01 company, certilicote number, date 01 certificate, nome in which stock is registered,
and number 01 shores and closs 01 stock.
(3) Obligation. of U. S. Govemment: Number 01 Items, dote of illue, lace value, nomes in which registered
and type 01 awn.rshlp, i.e., jointly held, payable an death, etc.
141 Bond.. Designate by nome, amount, serial number, or other designation. (Bearer Bondsl
IS) Bonk and Saving. and Loan POllbook.. Stat. name of deposit"r, number 01 book, last date appearing in
book, name 01 bank and branch, and balance.
(6) Jewelry, CoIn., Stamp., Monu.crlp,", etc: List and de..,ibe as lully as pallible.
(7) Deed., Mortgagtl, Current In.urance Pollcle. or oth.r IVldence. of Indebtedne..: List and describe as
lully as pOllible.
181 All ather content.. , , ,
IIEM , ITEM DESCRIPTION
NO.
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~ t'A7l. (,fie. /1 )g rJ /d5/i1cbtl ~ 9;$ ?>13 i> 9 u &' lu / 09'3,f r;,
I, +1 ,€o::II 2'( 'S ~ 81 ~'8'/() 7.- "h~t~ .llc.t;.~e. ::1.-1-90 ,
TIt/I! In') 'DA oJ i)) f; JV11l"'''~V I AJa /.., e'tJ S ')
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I certlly under penalty 01 perjury that the above record I. correct and complete to the be.t 01 my knowledge
and belief.
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SAFE DEPOSIT BOX INVENTORY
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~Ill"ach addItIonal Iv.. - x 11- .heetl') If n.....ary or u.. duplicate. of thl. pall. of form.
Witt J L,ui1..l.'.-- ~J(.,7S. fHp-.'/'''YJ ,
Il:EY.1500 EXt 112.881
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMD'r.r.!~VMI.'lrv~wrANIA (TO BE FILED IN DUPLICATE 21
HAORlsfJl& ~~nb9"OOI WITH REGISTER OF WILLS) COUN1Y CODE
- mEDEI'IT'S NAME (lAST, rIJIst, At,jO MIIJllili'f'III-iAll- D[C(OENT'S COMf'lE1E: ADDR[S~
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FILl NUMBIR
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94
144
YEAR
NUMBER
46 Howery Lane
Newburg, PA 17240
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MOWERY, DAVID E.
SOCIAL SECURIIY NIJMBiii-.-_._.--'li:j,.ff'u"'ffjlA!"Hw.,--- ~loA1TOF BIRTH
204-30 - ~0_~...__Jul~??(~~ I 5/29/12
!Xl I, Originol Return 1._] 2, Supplementol Rolurn
o ,4, llrtllled Eslote I IAa, Futuro Inleresl Compromise
(for delo. of doolh oftor 12.12.82)
o 6, Deledent Died Toslolo I.] 7, Oer.odoOl Maintoined a living Trust
(Allach copy 01 Will) IAllech copy 0/ Tro,')
ALL CORRESPONDENCE A-NO-CONFIDENTIAl. TAX INFORMATION SIIOJjLD BE DIRECTED TO. ,
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1E~E~O~; N~.mWINDEIlI__.!lSQUI.BlL ________ - _____... 701 E. King St.
Shippensburg, PA 17257
L __5~_k~_4J~===,_o~:"'___ -- -- -
1. Rool E,'olo (Schodulo A) ( 11 _!4~1 100.00
2. Slock. ond Bond. (Schodule B) ( 2) _u --,-,--
,3. C1o.ely Hold Slock/Perlno"hip Inlere.' (Schedulo q (3) --_..__.__'
4. Morlgoge. ond Nolu. Roceivoblo ISchodulo DI ( 41 __._____
5. Co.h, Bon\ Depo.ih & Mi"ellonoou. Penonal Property I 51.. 68,585.22
ISchedule E)
6. Joinlly Owned Properly (Schodulo F) ( 6) __u_
7. Trons'e" (Schedule G) (Schodule LI ( 71 ---------
B. Total Gran Assels(lotallinos 1.71
9. Funeral Expenses, Administrative Cosls, MilCellaneous
EXpon... (Schedul. 1;)
10, Debts_ Mor,lgag8 liabilities, liens (Schedule II
11. Tolo1 Deducllon. (10101 line. 9 & 10)
12. Nel Volue 01 E,'ole (line 8 minus line 11)
13. Charitable and Governmental Bequests (Schedule JI
lA. Net Valve S\lbjecl to Ta~ (line 12 minus line I~l
15. Amount of line 14 taxable at 6% rale
(Indude volue. from Schedule K or Schedule M,I
16. Amount of line 1.4 taxable at 15% fple
(Include values from Schedule K or Schedule M,l
17. Principalla.lt due (Add lox from line 15 and from line 16.)
18, Credits Prior Paymenls Discount
......9~,(illO~OO__ + __480.00_
19. If line 181s gfealer than line 17, anler the difference on line 19, This is tho OVERPAYMENT.
aD
20, If line 171':'greater thon line 19, enlf'r Ihe djfference on line 20, This is the TAX DUE.
A, Enter the !nleunl on the balance due cm line 20A,
~O\lnly
~t1mh~rl Anrl
o 3. Remainder Return
(lor dale. 01 ~eolh prior 1012. t 3.B21
o 5, Feoderal eslate Tak
Relurn Raquired
_ 8. Talal Number of Safe Deposit Bakes
( 8) ~14,685.22
(10)
(15) 207....!lJ]~2Q
(11) -1..2.41L1l?
(121 ...1QZ., 437 . 20
(131
(14) ~4J7.20
x .06" ---12...!l..4.6..,2J
(16)______,_________" .15"
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(17) -11.44(;..L23
Interes'
(181 10,080.00
(191 _...
Cfll'[~ here if .you oro luquesting CI ,e-hmd of your overpaymen-t.
2.366.23
(201
(20/>0)
(20B) _516~23~_____
B, Enter the lotal of line 20 Ilnd 20A on line 20B, "his is the BALANCE DUE.
Moh ChICk Poyebl. to: R.gl.ter of Will.. ABent
, ", .. ..BE SURE TO ANSWER ALL QUESnONS ON REVERSE SIDI AND TO RECHICK MATH.. " ' _. _
U~dH p.-nalliel of f'leriury, I declotethol I h-;;.. ",..aminttd thi, f~tuln. i~~iuding ;7~;p~;ying ,chedules and ,tal.menlS. and to the b"t of my knowledg_ and b:elie!,
it is true. ton.ct onrt complete, I dedolP thaI all feol "'tlnl(' no' bprn rt"rolied 01 true mOfkf'1 \'alue, Oeclaration of pr"pof.' other Ihon lh, fMuonoltep,,,.nlaliv.. u
bat.d on 011 information 01 which plf'paff'l h_o, any lc.nowle~g(l, _ .. . .., ,,_ _ ,..
'tGNAIUKE Of t(II{ONifiiiOmiilnoHii1i~G UTUR~--';..j)DR(~S ... ..... 9CJ '.M6w-ri-r~}'-Ciine-"'- ror
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LLL~__..____._..__S~lil'~Cn9b~~g. PA 17257 '~/)'1/q1
, .
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK ('" )IN THE,
, APPROPRIATE B!.OCKS. . '
YES NO
1. Did decedent make a transfer and:
a. retain the use or income of the property tronsferred, .......................................
b. retain the right to designate who shall use the property transferred or its income,
t. a . . t t
c. re oln reversionary In eres or ....................................................................
d. receive the promise for life of either poyments, benefits or care' .......................
2. If death occurred on or before December 12, 1982, did decedent within two years
preceding death tronsfer property without receiving adequate tonsideration' If death
occurred after December 12, 1982, did decedent transfer property within one year of
death without ,receiving adequate considerationi ..........................."....................
3. Did decedent own an 'in trust for' bank account at his or her death'--....................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
I".
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, . pase 2
Stool 10.00
Blanket chest 50.00
Parlor chalr 15.00
Oha-lr .'., , 10.00
Slelsh bell (lneomplete) 25.00
Mlsc. back room 10.'00
'rrunk 50.00
Pressed-back chalr 15.00
Oot 10.00
, oha1rs ln attle 15.00
Nlsc. ln attic 20.00
1951 Case pull-type Combine
w/Wisoons1n motor (5 ft) 10.00
Int. No. 46 Baler 200.00
Oase 2-row corn planter 20.00
Oaso pull-type 2 bm. plow 20.00
N.I. one hole corn sheller 25.00
1 kettle butoher furnace 15.00
1 kettle 50.00
M1lk oan 15.00
Wooden tub 15.00
2 Plank bottom etoole 20.00
Miso. 50.00
Oross-out saw 40.00
Post vlse 15.00
Miso 1n ohlcken houee 20.00
Mlso.1n hoS pen 30.00
,40 ft. alumlnum Dbl. ladder 90.00
, m1lk oans 12.00
Total
2.543.00
,~~
Arthur W. Rlfe Auot1oneer
Lle. No 76BL
, .
IEY.15I1U.I'."1
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COMMONWEALTH Of PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
L SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
, MISCELLANEOUS EXPENSES
ESTATE OF
E
Ploa.o Prl~I or TVPQ
B R
DAVID E. NOWliRY
ITEM
NUMBER
A.
21-94-144
DESCRIPTION
AMOUNT
1.
FunoralExponll"
Fogelsanger-Br1cker Funeral lIome-Funera1
Robert S. Howery-Reimbursement for grave opening
IHlling Workers S.S. Class - funeral reception
$4,738.90
$ 275.00
$ 250.00
2.
3.
B. Admlnl,'rallvo Co.I"
I. Personal Representative Commissions
Social Securily Number of Personol Representotive:
Year Commissions paid
2. Allorney F.es Sally J. Winder $ 825.00
3. Fnmily Exemption
Claimant Relationship
Address of Claimant ut decedent's deolh
Stre.t Addre..
Cily Stote Zip Code
4. Probot. Fe.s Cumberland Couo ty Register of Wills $ 144.00
C. MI.collanoou. Expon.e"
1. News-Chronicle - advertise letters testamentary $ 33.50
Cumberland Law Journal-advertise letters testamentary $ 40.00
2.
3. Arthur Rife-appraisal uf personal property $ 50.00
4. Reserve for filIng account $ 50.00
5.
6.
7.
8.
TOTAL (Also enter on lino 9, Rocopitulationl
(II more .paco I. n..dod, Inll" oddlllonol .h..,. of .amo .1...1
S
6,406.40
I(V,UUUt\I,1I1
1
FILE NUMBER
. . .
~j~
CO/lWONWfAUll Of "lllli'UVAllIA
INHlIlIANtI lAI IIrVIN
I..IOINI DICID~~t::.:~.~~"~,::~'
." .::';.~::':'.\=~=::'::'=.:'"'-
SCHEDULE J
BENEFICIARIES
lUATE OF
DAVID E, MOWERY
21-94-144
ITEM
NUMBER
NAME ANIJ AIJIJRESS Of nENEflCIARY
RUATlONSHIP
I.
A. To"ablo Beques":
Robert S. Mowery
99 Mowery Lane
Newburg, PA 17240
child
2.
Judy P. Fogelranger
499 Royal Road
Annvil1e, PA 17003
, child
nEM
NUMBER
NAME AND ADDRESS OF BENEFICIARY
B. Chorilabt. alld Gov811lmC'OIoI Bequ81ll:
1.
TOTAL CI!ARIlABlE AND GOVERNMf,NTM BEQUESTS (Aho onlo' on lino 13, Ro.opllulollon) S
_.~_.--_._.,--- (I; ;~;;~p~~;-i~-;;d~d:i;..rl-;ddillonol ,".e...1 IDm~ II.e)
AMOUNT OR
SIlARE o. mATI
%50
%50
AMOUNT OR
SHARE O' EST"T.
REV-1547 EX AFP (08.94*
COI'lHONWEAl TH OF PENNSYlVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAkES
Df:PT. 2110601
HARRISBURG, Pi 1712.~06D1
14-/90 - /1
v
NOTICE OF INHERITANCE TAK
APPRAISEMENT. ALLOWANCE DR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAK
ACN 101
DATE 01-30-95
FILE NO.
DATE OF DEATH 01-27-94 COUNTY CUMBERLAND
NOTE I TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FoRN WITH YOUR TAK
PAYMENT TO THE REGISTER OF WILLS. NAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT"
REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
00
I ~ ;.A.O~ R.OUrf
CUT ALONG THIS LINE .... RETAIN LOWER PORTION FOR YOUR RECORD$ ..... 5: .~ h
iiEV:is4'j-Ex--iiFP-iiiii:94T"iioiicE-.oF-YNHEifii'AifcE-i:Ax-APpiiAisEifEil:r,--Ar.rOWAiic~Ii----'~:7~-----.---
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT 0;,' TAX -" .',..
ESTATE OF HOWERY DAVID E FILE NO. 21 94-0144 ACN;' 101 "'0 DAiI ;",; 01-30-95
r.:- (t)
I CHANGE~!:i w a
",
SALLY J WINDER ESQ
701 EKING ST
SHIPPENSBURG
PA 17257
TAK RETURN WAS I (X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL
1. Roal Eatot. (Schodub AI 111
2. Stock. and Bond. (Schodul. BI 121
J. Clo..ly Held stock/Partnership Inter.lt (Schedule Cl (3)
4. "ortgag..IHot.. Receivable (Schedule OJ (4)
5. Cash/Bank Dlpollts'Hisc. Perlonel Property (Schedule E) eS)
6. JoJntly Owned Property (Schedule F) (6)
7. Tr"'afara ISchlidule G) (7)
B. Tot.l A...t.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expans../Ad.. COlta/Hi.c. Expen... (Sch.dul. H) (9)
10. Dobt.lHortgoo. Llabllltlo./Llon. (Sch.dulo II (101
11. Totol Deduction.
12. Net Value of Tax Return
15. Charitable/Govern.ental a.que.t. (Sch.dul. J)
14. Not Volu. of E.tot. Subj.ct to T.x
NOTE:
146.100.00
.00
.00
.00
68.585.22
.00
.00
(II
214,685.22
6,406.40 '
841.62
1111
112'
1151
1141
'."R n?
207,437.20
.00
207,437.20
If an ass...m.nt waB i..ued pr.viou.1Y, line. 14, 15 and,or 16, 17 and 11 will
r.flect figure. that include the totel of Abb r.turn. a......d to data.
ASSESSMENT OF TAX:
15. Aaount of Llno 14 .t Spou..l rot. 1151
16. AlIOUI'It of Line 14 taxabl. .t Llnool/Clo.. A roto 11,61
17. Aaount of line 14 taxabl. et Co11.ter.1/Cl... 8 rate (17)
lB. Prlnclp.l T.. Duo
TAX CREDITS:
PAYNENT
DATE
04-27-94
10-27-94
RECEIPT
NUHBER
XABB6006
HM913122
DISCOUNT (+1
INTEREST (-I
505.26
.00
.00 K' 00.
207.437.20 K.06.
.00K.15.
IlBI
.00
12,446.23
.00
12,446.23
AItDUNT PAID
9,600.00
2,366.23
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
o IF 'AID AFTER DATE INDICATED. SEE REVERSE
Foe CALCULATION OF ~TIDHAL INTEREST.
.~- (.,5"-1 ~
12.471.49
25.26CR
.00
25.26CR
I IF TOTAL DIIE lS LESS TIWI n. NO PAYIlENT IS RElII/lllED.
IF TOTAL DIIE IS REFLECTED AS A "CREDIT" leal, YOU /lAY IE DUE
A REFUND. SEE REVERSE SIDE OF THIS FOIR FOR IHSTlUCT10NS.1