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HomeMy WebLinkAbout11-30-07 (2) .-J 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 ONL V County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT 2 1 0 7 0919 Date of Birth 204012016 09012007 07051915 Decedent's Last Name Suffix Decedent's First Name BROWN MILDRED MI E (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 D 1. Original Return [K] o 6. Decedent Died Testate (Attach Copy of WIll) o o o o 4a. Future Interest Compromise (date of death after 12-12-82) 2. Supplemental Return o o 3. Remainder Return (date of death prior to 12-13.82) 5. Federal Estate Tax Return Required 4. Limited Estate 7 Decedent Maintained a Living Trust . (Atlach Copy of Trust) o 8. Total Number of Safe Deposit Boxes 9. Litigation Proceeds Received 10 Spousal Poverty Credit (date of death . between 12-31-91 and 1-1-95) o 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) ijORRESPONDENT - THIS SECTION MUST BE COMPl.ETED. Al.l. CORRESPONDENCE AND CONFIDENTIAl. TAX INFORMATION SHOUl.D BE DIRECTED TO: ame Daytime Telephone Number EDMUND G. MYERS 7177614540 301 MARKET STREET "TJ REGISTER .~_ LLS US~NL vri ;:3 ,....:: ~ 0 c.: ''-.) :j'~g ~ ~:,1~ ." U) 5:: -, (-)S s:? -~ll l'J <::::) Firm Name (If Applicable) JOHNSON DUFFIE First line of address Second line of address -0 :x '.... )C') ;, "'n ." +1 "0 rn )r~ City or Post Office LEMOYNE ~ ~r-' ~u ::::i DAt~ FILED o State PA ZIP Code 17043 Correspondent's e-mail address: 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 pre parer has any knowledge. SIGNATUR OF PERSON RESPONSI L OR FILING RETURN DATE Mary Marjorie Nielson 17055 EDMUND G. MYERS DATE lJ-2 '-0'1 301 MARKET STREET, LEMOYNE, PA 17043 Side 1 L 15056041147 15056041147 .-J (J ---1 15056042148 REV-1500 EX Decedent's Name: Mildred E BROWN Decedent's Social Security Number 204012016 RECAPITULA TION 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) D Separate Billing Requested............. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) D 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 0.00 15. 0.00 16. 0.00 17. 18. 11,594.79 19. Tax Due.................................................................................................................. J9. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Side 2 L 15056042148 14,756.19 14,756.19 -----~--- 1,464.11 1,697.29 3,161.40 11,594.79 11,594.79 0.00 0.00 0.00 1,739.22 1,739.22 D 15056042148 ---1 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21-07-0919 DECEDENT'S NAME Mildred E BROWN STREET ADDRESS Church of God Nursing Home -- -- 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) 1,739.22 86.96 3. InteresVPenalty if applicable D. Interest E. Penalty Total Credits (A + 8 + C) (2) 86.96 TotallnteresVPenalty (D + 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) (5A) (58) 1,652.26 1,652.26 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;.................................................................................0 [!J b. retain the right to designate who shall use the property transferred or its income;....................................D [~ c. retain a reversionary interest; or............................................................................................................... 0 [!J d. receive the promise for life of either payments, benefits or care?.............................................................D [!J 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?....................................................................................................................O [!J 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... 0 [!J 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation?........... ..... .................................................................................................. 0 [!J 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 P.S. 99116 (a) (1.1) (ii)]. The statute does not exempt! 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 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 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 COMMONYVEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF BROWN, Mildred E FILE NUMBER 21-07 -0919 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER DESCRIPTION 1 Cash Received VALUE AT DATE OF DEATH 25.00 2 Commerce Bank Checking Account 3.842.58 3 Ecumenical Community Home - Resident Refund 735.75 4 Masland & Barrick Daily Income Money Market Account 10.152.86 TOTAL (Also enter on Line 5, Recapitulation) 14.756.19 (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 E (Rev. 6-98) REV-1151 EX+ (12-99) . SCHEDULE H FUNERAL EXPENSES & ADMINISTRA TIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF BROWN, Mildred E FILE NUMBER 21-07-0919 Debts of decedent must be reported on Schedule I. ITEM DESCRIPTION AMOUNT NUMBER A. FUNERAL EXPENSES: See continuation schedule(s) attached 198.11 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Social Security Number(s) / EIN Number of Personal Representative(s): Street Address City State Zip - Year(s) Commission paid 2. Attorney's Fees Johnson Duffie 750.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent 4. Probate Fees 111.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 150.00 7. Other Administrative Costs 255.00 See continuation schedule(s) attached TOTAL (Also enter on line 9, Recapitulation) 1,464.11 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98) Rev-1502 EX+ (6-98) *' SCHEDULE H-A FUNERAL EXPENSES continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT BROWN, Mildred E FILE NUMBER 21-07-0919 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Auer Memorial Home & Cremation Services, Inc. 198.11 Subtotal 198.11 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98) Rev-1502 EX+ (6-98) *' SCHEDULE H-B7 OTHER ADMINISTRATIVE COSTS continued COMMON~LTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT BROWN, Mildred E FILE NUMBER 21-07-0919 ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1 Cumberland County Register of Wills Office - Filing fees for Inheritance Tax Return ($15.00) and Inventory ($15.00) 30.00 2 Cumberland Law Journal - Notice of Estate Administration 75.00 3 The Patriot News - Notice of Estate Administration 150.00 Subtotal 255.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98) Rev-1512 EX+ (6-98) *' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIOENT DECEDENT BROWN, Mildred E FILE NUMBER 21-07-0919 ESTATE OF Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION 1 Allegheny Recovery Services 2 Church of God 3 Comcast Cable 4 Metro Med Services 5 Pinnacle Health 6 PSERS - Refund on Final Payment 7 South Central EMS 8 Susquehanna Township EMS VALUE AT DATE OF DEATH 320.72 26.06 94.00 95.90 55.72 949.89 75.00 80.00 TOTAL (Also enter on Line 10, Recapitulation) 1,697.29 (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 I (Rev. 6-98) REV-1513 EX+ (9-00) ESTATE OF NUMBER I. *' SCHEDULE ,J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT BROWN, Mildred E NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] FILE NUMBER 21-07 -0919 SHARE OF ESTATE AMOUNT OF ESTATE (Words) ($$$) RELATIONSHIP TO DECEDENT Do Not List Trustee/s) 1 Charles Brown 87 West Shore Drive Coventry, CT 06238 Friend 1/10th of Estate 2 Connie Griggs 2229 Sheperd Avenue Harnden, CT 06518 Friend 1/10th of Estate 3 Robert C Hammaker 521 Wilnding Hill Road Mechanicsburg, PA 17055 Pearl Kent 5225 Wilson Drive, Apt. 1144 Mechanicsburg, PA 17055 Friend 1/10th of Estate 4 Friend 1/10th of Estate 5 Mary Marjorie Neilson 447 Delancey Court Mechanicsburg, PA 17055 Friend 1/2 of Estate See continuation schedule attached Continuation Total Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE 0.00 Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98) SCHEDULE" BENEFICIARIES (Part I, Taxable Distributions) ESTATE OF: Mildred E BROWN 204-01-2016 09/01/2007 Item Name and Address of Person(s) Share of Estate Amount of Estate Number Receiving Property Relationship (Words) ($$$) 6 Winifred & Ralph Paulus Sr. 1000 Houck Road Mechanicsburg, PA 17055 Friend 1/10th of Estate Total 1 EXHIBIT A EXHIBIT B EXHIBIT C :317168 ESTATE OF MILDRED E. BROWN SCHEDULE OF EXHIBITS Last Will and Testament signed and dated June rd, 1998 Commerce Bank Checking Account Date of Death Letter. Commerce Bank Checking Account Date of Death Letter. EXHIBIT A \.. - <- -- mast Bill an~ westament OF MILDRED E. BROWN I, MILDRED E. BROWN, OF THE Township of Susquehanna, Dauphin County, , Pennsylvania, declare this to be my last will and revoke any will previously made by me. I. I direct that all of my legal debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. II. I devise and bequeath the residue of my estate of every nature and wherever situate as follows: A. One-half (1/2) thereof to my friend, MARY MARJORIE NEILSON. B. One-tenth (1/10) thereof to my mother's niece, PEARL HEIGES KENT. C. One-tenth (1/10) thereof to my father's brother's grandchild, CONSTANCE WRIGHT BROWN GRIGGS. D. One-tenth (1/10) thereof to my father's brother's grandchild, CHARLES DANIEL BROWN, JR. E. One-tenth (1/10) thereof to my mother's cousin's child, GERALDINE COCKLIN HAMMAKER. F. One-tenth (1/10) thereof to my mother's cousin's child, WINIFRED COCKLIN PAULUS, and her husband RALPH PAULUS, or the survivor of them. In the event that any of the above-named individuals does not survive me, I devise and bequeath his or her share to his or her then living issue, per stirpes, and in default of any such issue his or her share shall be added to the other shares of my residuary estate in the same proportion that they now bear to each other. III. I appoint DAUPHIN DEPOSIT BANK AND TRUST COMPANY, of Harrisburg, Pennsylvania, guardian of any property which passes either under this Will or otherwise to a minor and with respect to which I am authorized to appoint a guardian and have otherwise specifically done so, provided that this appointment of a guardian shall not supersede the right of any fiduciary in its discretion to distribute a share where possible to the minor or to another for the minor's benefit. Such guardian shall have the power to use principal as well as income from time to time for the minor's support and education (including trade school and college education, both graduate and undergraduate) without regard to his or her parent's ability to provide for such support and education, or to make payment for these purposes, without further responsibility, to the minor or to the minor's parent or to any person taking care of the minor. IV. I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as part of the expense of the administration of my estate. v. I appoint DAUPHIN DEPOSIT BANK AND TRUST COMPANY of Harrisburg, Pennsylvania, Executor of this, my last Will. Should DAUPHIN DEPOSIT BANK AND TRUST COMPANY fail to qualify or cease to act as Executor, I appoint my friend, MARY MARJORIE NEILSON, Executrix to this, my last Will. 2 VI. I direct that my Executor and Guardian, or their successors, shall not be required to give bond for the faithful performance of their duties in any jurisdiction. IN~HEREOF' I have hereunto set my hand and seal this I ' 1998. . ~ day of ;lJW/hd ~ ~-wI,,^- MILDRED E. BRO (SEAL) Signed, sealed, published and declared by the above-named Testatrix, as and for her Last Will and Testament, in the presence of us, who, at her request, in her presence and in the presence of each other have hereunto subscribed our names as witnesses. 7J~ j rf~ <2~Cg ~ 3 I f' ---..------JI ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA : COUNTY OF n"'II".'1I1~ ~ : 55. I, MILDRED E. BROWN, 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 instrument as my Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes therein expressed. aJ~~ &~ M LDRED E. BROWN Sworn or affirmed to and acknowledged before me, by MILDRED E. BROWN, the Testatrix, this ~ day of ~ ' 1998. ~O~~~ Notary blic -~ NOTARIAL SEAL ' JEANNE A. SHEARER. Notary Pi!;) , Wormleysburg BOrD. Cum'.,:dand Cu. : My Commission Expires D~l;. 29~:~~~ 4 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF DAUPHIN I We, 7J.J.d;; l;f~;z and c..A~ '$_ ~_"" , the witnesses whose names are signed to the foregoing 'nstrument, being duly qualified according to law, do depose and say that we were present and saw the Testatrix sign and execute the foregoing instrument as her Last Will and Testament; that she signed willingly and that she executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as witnesses; and that to the best of our knowledge, the Testatrix was at that time at least 18 years of age, of sound mind and under no constraint or undue influence. , V~ jJf~ L'~Cd ~~ and s,,:,orn or affirmed to and subscribed to before rn~ ~ ,,,A ~ Cvo~ -S . \JJ~, witnesses, this . day of , 1998. ~ :':;.;~ ~ Nota Public I NOTARIAL SEAL . JEA.NNE A. SHEARER, Notafy Pubhc Worm!eysburg Boro. Cumberland Co. My Commission Expires Dec. 29, 2001 5 -~~'~-~'---'--'-"-"~---~-'-'-~---" -'-----".--'-' --"~-"-"-'---".~--'-'--~----'-'-"- --,..".'-"---" ,-"'--- ..._..-.. ,- "-~''''. ---_.---._-'"',.:-:-----~--.....,..._,.'----'--+ I- ~ 0:: ~ ~ " ~ ~ ~ w z , I- oC( .. (f) 0:: ~ > <( .J . - W .J >- f:) ~ ~ Z I- Ul <( Z ~ !l... 0 (f1 Z !l... - >- w :J W lJJ a.. o ~ z a: W ~ 0 z i~ I- I- >- 0 <( 0 (f) ::E Z W .J :r 0 .., ~ ~ ~ ~ - -.? October 24, 2007 COl1JI1Jerce eBank Johnson Duffie 301 Market Street PO Box 109 Lemoyne PA 17043-0109 RE: Estate of: Mildred E Brown Tax Identification Number: 204-01-2016 Date of Death: September 1, 2007 Dear Sirs: This letter is in reference to decedent account information you requested for the individual listed above. We are able to provide the following: Account Type: Checking Account Number: 513301754 Date Opened: May 9, 2001 Primary Owner: Mildred E Brown Date of Death Balance: $3,842.58 Accrued Interest: $0.14 Principal Balance: $3,842.44 Please feel free to contact me at (717) 412-6129 if I may be of further assistance. ~.nn:c~reIY, .. .1 t\. I I \IN. 'I , yWJld \lYvl'1' l\Uvf'- .. Marcy Kauf~an Overdrawn Accounts Associate/Deposit Services Commerce Bank Commerce Bank / Harrisburg, NA PO Box 4999 3801 Paxton Street Harrisburg, PA 17111-0999 commercepc.com MASLAND & BARRICK - ADVISORY, INe.- INDEPENDENT F1NANOAL ADVISORS October 25, 2007 ReCEIVED OCT 2 6 2007 JOHNSON, DUFFIE STEWART AND WEIDNER Johnson Duffie Stewart & Weidner PC Attn: Dana L. Wieseman PO Box 109 Lemoyne, PA 17043-0109 Re: Estate of Mildred E. Brown 5W8-156031-H09 Dear Dana, As per your request dated October 24,2007, please find below the date of death valuation as of September 1,2007. The registration was indeed an individually owned account held with Walnut Street Securities, Inc. Name of Investment Number of Shares Price per Share Valuation Daily Income Money Market 10,152.860 $1.00 $10,152.86 If you have any further questions, please let me know. d.' "'.'./." rely, ..~... f I {)J7J[]JJO Danette M. Howarth Office Manager Assistant to Stacey G. Barrick, CFP@ 3461 Market St., Suite 102, Camp Hill, PA 17011 Tel. 717-761-6606 Fax 717-761-7524 www.maslandandbarrick.com Securities offered through Walnut Street Securities, Inc. Member NASD, SIPC Masland & Barrick Advisory, Inc. and Walnut Street Securities are unaffiliated entities. JERRY R. DUFFIE RICHARD W. STEWART C. FlOY WEIDNER, JR. EDMUND G. MYERS DAVID W. DELUCE JOHN A STATLER JEFFERSON J. SHIPMAN JEFFREY B. RETTIG KEVIN E. OSBORNE RALPH H. WRIGHT, JR. MARK C. DUFFIE JOH'i R. NINOSKY MICHAEL J. CASSIDY LAW OFFICES JOHNSON DUFFIE MELISSA PEEL GREEVY ROBERT M. WALKER WADE D. MANLEY ELIZABETH D. SNOVER KELLY L. BONANNO OF COUNSEL HORACE A. JOHNSON F. LEE SHIPMAN (1965-2006) November 28, 2007 (") C;O . .~::O !-O ;~ . i! (./:-i~~ z o -< w o ':'1 1'-,"-: ~-:~ rl c:-=J f~"'1 CJ Register of Wills Office Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 5~~~ J~-'1 -0 3 :_-:~) ""';,.. ~ - --r-i c:.::s __ r-r-l o .. RE: Estate of Mildred E, Brown Date of Death: September 1, 2007 Your File No.. 21-2007-0919 Our File No. 2820-3 Dear Register: Enclosed for filing please find the following documents for the above referenced decedent: 1. 2 Original PA Inheritance Tax Returns with tax due in the amount of $1 ,652.26. This payment also reflects the 3 month early prepayment of inheritance tax. Estate Check No. 108 is attached to this Return 2. Inventory 3. Two copies of Pages 1 of the Pa Inheritance tax return, which we ask that you time- stamp and return to us in the enclosed envelope. 4. One copy of the of the Inventory to be time-stamped and returned to us in the enclosed self addressed envelope. 5. Check No. 109 attached to this correspondence in the amount of $30.00 representing the filing fee for the Inheritance Tax Return and Inventory. Should you have any questions, please do not hesitate to contact our office. Thank you for you Very truly yours, ~HNIS~Nn ~\Ut)~ART & WEIDNER ~~mW C4G Estate Administration Paralegal c: Mary Ma~orie Neilson. Executrix :317171 301 MARKET STREET PO. BOX 109 LEMOYNE, PENNSYLVANIA 17043-0109 WWWJDSWCOM 717.761.4540 FAX: 717.761.3015 MAIL@JDSWCOM JOHNSON, DUFFIE, STEWART & WEIDNER, P.C.