HomeMy WebLinkAbout10-02-07
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15056041147
REV-1500 EX (06-05)
PA Department of Revenue
Bureau of Individual Taxes ~.
PO BOX.280601 ~
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
INHERITANCE TAX RETURN
RESIDENT DECEDENT 2 1 0 5
File Number
0232
Decedent's Last Name
Suffix
Date of Birth
02241928
Decedent's First Name MI
R:tCBARD S
Spouse's First Name MI
CAROL J
202201164
03032005
NOWBRY
(If Applicable) Enter Surviving Spouse'. Infonnatlon Below
Spouse's Last Name Suffix
NOWBRY
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WillS
FILL IN APPROPRIATE OVALS BELOW
D 1. Original Retum [!J 2. Supplemental Retum D 3. Remainder Retum (date of death
prior to 12-13-82)
D 4. Limited Estate D 4a. Future Interest Compromise D 5. Federal Estate Tax Retum Required
(date of deeth after 12-12-82)
[K] 6. Decedent Died Testate 00 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
D 9. Litigation Proceeds Received D 10 Spousal Pover\)' Cred~ ~date of death D 11. Election to tax under Sec. 9113(A)
. between 12-31-91 and -1-95) (Attach Sch. 0)
aORRESPONDENT . THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
ame Daytime Telephone Number
BDWARD P. SBBBBR BSQ. 7175333280
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Finn Name (If Applicable)
JANBS, SN:tTB, D:tBTTBR:tCK &
First line of address
SO:tTB 204, 5020 R:tTTBR ROAD
REGISTER Q!~LLS US~NL Y
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C)
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Second line of address
-)
DAtE FILED 0
City or Post OffIce
NBCBAN:tCSBORG
State
PA
ZIP Code
17055
COlTMpondenf. e-mail address:eP.@J.dc.com
Under penalties of pe~ury, I declare that I have examined this retum, 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 ",SON RESrYNSIB,LE ILING RETURN DATE
~ . Carol J. Mowery - ;21( -0
ADDRESS
Edward P. Seeber Esq.
VI:
Su 204, 5020 RItter Road, Mechanlcsburg, PA 17055
Side 1
L
15056041147
15056041147
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15056042148
REV-1500 EX
Decedenl'sNarne: Richard S. Mowery
RECAPITULATION
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.
6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested............. 7.
8. Total Gross Assets (total Lines 1-7)....................................................................... 8.
9. Funeral Expenses & Administrative Costs (Schedule H)......................................... 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)................................ 10.
11. Total Deductions (total Lines 9 & 10)...................................................................... 11.
12. Net Value of Estate (Line 8 minus Line 11)............................................................. 12.
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.
TAX COMPUTATION. SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, of
transfers under Sec. 9116
(a)(1.2) X ~
16. Amount of Line 14 taxable
at lineal rate X .045
17. Amount of Line 14 taxable
at sibling rate X .12
18. Amount of Line 14 taxable
at collateral rate X .15
9,795.06
0.00
0.00
0.00
19. Tax Due............ ........................................................ .......................... ....... ................ 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
L
15056042148
Decedent's Social Security Number
202201164
9,825.06
9,825.06
30.00
30.00
9,795.06
9,795.06
15.
0.00
0.00
0.00
0.00
0.00
16.
17.
18.
D
15056042148
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REV-1500 EX Page 3
Decedent's Complete Add.....:
File Number 21-05-0232
DECEDENT'S NAME
Richard S. Mowery
STREET ADDRESS
168 Kerrs Road
CITY I STATE \ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
0.00
Total Credits (A + 8 + C)
(2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
TotallnterestlPenalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 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 + 5A. This is the BALANCE DUE.
(3)
(4)
(5) 0.00
(5A)
(58) 0.00
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: Ves
a. retain the use or income of the property transferred;.................................................................................. [!]x
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?................................................ ........................... ........................................... 0
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?..................................................................... ................................................ 0 [!]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, VOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
.d~
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. ~9116 (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 P.S. ~9116 (a) (1.1) (Ii)]. The statute does not exemDt 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. ~9116 (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 P.S. ~9116 1.2) [72 P.S. ~9116 (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. ~9116 (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.
No
o
o
o
o
[!]
[!]
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Rev-1107 EX. (....)
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SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mowery. Richard S.
FILE NUMBER
21-05-0232
All property jointly--*, with rtght of aurvlvcnhlp must be d1ac:10Hd on Schedule F.
ITEM
NUMBER DESCRIPTION
1 Rodney & Debra Little Note Receivable - payment from Chapter 13 bankruptcy
trustee on 7/10/07
VALUE AT DATE
OF DEATH
8.148.73
2 Rodney & Debra Little Note Receivable - payment from Chapter 13 bankruptcy
trustee on 818107
838.16
3 Rodney & Debra Little Note Receivable - payment from Chapter 13 bankruptcy
trustee on 9/5107
838.17
TOTAL (Also enter on LIne 4. Recapitulation)
9.825.06
(If more space Is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule D (Rev. 6-98)
': :
REV.1111 EX+ (12-11)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Mowery, Richard S.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-05-0232
ESTATE OF
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
G
G
(
(
c
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
B.
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City
Year(s) Commission paid
State _ Zip
2.
Attorney's Fees
Jam.., Smith, Dletterlck & Connelly
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Carol J. Mowery
Street Address 168 Kens Road
City Carlisle State PA Zip 17013
Relationship of Claimant to Decedent Spouse
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Other Administrative Costs
30.00
TOTAL (Also enter on line 9, Recapitulation)
30.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule H (Rev. 6-98)
.
., ... I. .
REV 1113 EX+ (I-GO)
*'
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
Mowery, Richard S.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
Clistributions, and transfers
under Sec. 9116(a)(1.2)]
RELATIONSHIP TO
DECEDENT
Do NoI Wet TruetHlsl
FILE NUMBER
21..05..0232
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
ESTATE OF
I.
1
Carol J. Mowery
168 Kerrs Road
Carlisle, PA 17013
Spouse
9,795.06
Total 9,795.06
Enter dollar amounts for distributions shown above on lines 5 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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule J (Rev. 6-98)
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INVENTORY
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REGISTER OF WILLS OF
CUMBERLAND
COUNTY,PENNSYLVA~
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberl.nd
C.rol J. Mow.ry
Personal Representative(s) of the Estate of
} SS
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File Number
2005-00232
Richard S. MOw.ry
deceased1 depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate
and all of the real estate in tlie Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said
inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the
Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory.
I verify that the statements made in this Inven- } ~ ~ f1Y1 ~ [,
tory are true and correct. I understand that false state- . I ,~(.. .
ments herein are made subject to the penalties of C.rol J. Mow.
18 Pa.C.S. ~ 4904 relating to unswom falsification to )
authorities.
Attorney - (Name)
(Firm)
(Address)
(Telephone)
Edward P. Seeber Esq. (Supreme Court I.D. No.)
James, Smith, Dletterlck & Conn.11y
Suite 204, 5020 Ritter Road, Mechanlcsburg, PA 17055
7171533-3280
76084
DATE OF DEATH
0310312005
LAST RESIDENCE 168 K.ns Road
Carlisi., PA 17013
FIGURES MUST BE TOTALED
DECEDENT'S SOC, SEC. NO.
202-20-1164
P.rsonal prouertv
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Stocks/Closely Held ......... ..... ................................. ........ ..... ..........
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Personal Property' ............ ............... ..... ........ ..... ........ ......... .... .......
StocksILlsted.................................................................................
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Bond..............................................................................................
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partn.rshlps and Sol. Proprietorships .....................................
Mortgages .nd Notes Recelv.bl................................................
9,825.06
All Other Property' ............ ....... ....... ........... ............... ......... .... ........
Total Personal Property' .........................................
9,825.06
Total Real Property' ... .... ..... ............... ..... .... ............
Total Personal and Real Property'.........................
..825~.1
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each
item. but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S, ~ 3301 (b))
Form Rw-DSI Rev. 10-13-2006
~
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October 1, 2007
Glenda Farner Strasbaugh, Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013
THE
ESTATE
SECURITY
FORMULA",>
Re: Estate of Richard S. Mowery, deceased
File No. 2005-00232
Cheryl 1. Baker, CP
Certified Paralegal
clb@jsdc.com
Dear Ms. Farner Strasbaugh:
Enclosed are the following documents to be filed in the above-referenced Estate:
1. An original and two (2) copies of supplemental Pennsylvania Inheritance
Tax Return.
2. An original and two (2) copies of the supplemental Inventory.
3. Check number 8376 in the amount of Thirty Dollars ($30.00) representing
the filing fee for the supplemental Return and Inventory.
Please time-stamp the extra copies and return them to in the enclosed self-addressed,
stamped envelope.
Additionally, please update the file with Attorney Ted Seeber's new contact information
as reflected on the Return and Inventory.
If you have any questions, please feel free to give me or Ted a call at either 717-620-2316
or 717-533-3280.
Sincerely,
JAMES, SMITH, DIETI'ERlCK & CONNELLY, LLP
elL. Baker, CP
ified Paralegal
Enclosures
cc: Carol J. Mowery
Reply to:
Suite 204
5020 Ritter Road
Meehanicsburg, P A 17055
134 SIPE AVENUE
HUMMELSTOWN, PA 17036
MAILING ADDRESS
PO. BOX 650
HERSHEY, PA 17033
TOLL FREE 1.600.942.3660
TEL. 717.533.3280
FAX 717.533.7771
www.jsdc.com
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