HomeMy WebLinkAbout08-15-08 (2)15056D41147
RSV-1500 Ex (06-05) OFFICIAL USE ONLY
PA Department of Revenue county coda Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
Po Box.zsoso~ 21 0 8 0 3 7 6
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
03 25 2008 09 11 1910
Decedent's Last Name Suffix Decedent's First Name MI
MCDOWELL DOROTHY F
(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
XD 1. Original Retum ~ 2. Supplemental Retum ~ 3. Remainder Retum (date of death
prior to 12-13-82)
4. Limited Estate ~ qa. Future Interest Compromise ~ 5. Federal Estate Tax Retum Required
(date or death aver 12-12-82)
g, Decedent Died Testate ~ ~, Decedent Maintained a Living Trust Q 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9. Litigation Proceeds Received ~ 1 p. Spousal Poverty Credd (data of death 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach SCh. O)
CORRESPONDENT -THIS SECTION MUST BE GOMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
JENNIFER B. HIPP 717 737 8761
r~:;
Firm Name (If Applicable)
BOGAR AND HIPP LAW OFFICES
First tine of address
1 WEST MAIN STREET
Second line of address
City or Post Office
SHIREMANSTOWN
State ZIP Code
PA 17011
REGISTER O~~C,LS USE QRLY
~~ ~~`-,
;,y-y
- T. ~
,: ~ ~
DATL~FILED
Correspondent's e-mail address:
Under penalties of perjury, I declare that I have examined this return, inGuding 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.
c'~z~/S~'`-..vVV ~~~/ Stephen B. Wagoner `~~~D~D~'
600 1fith Street, New Cumberland, PA 17070
IGNAIURE OF PREPARER OTHER T TATIVE
Jennifer B. Hipp
DATE
1 West Main Street, Shiremanstown, PA 17011
1505604114?
Side 1
15056041147 J
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15056042148
REV-1500 EX
Decedent's Social Security Number
oeceaeot'sName: DOCOthy F. McDowell
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. 2 2 8 , 3 3 3 . 4 5
6. Jointly Owned Property (Schedule F) ~ Separate Billing Requested ............. 6.
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested ............. 7. 5 , 8 5 1 . 6 6
8. Total Gross Assets (total Lines 1-7) ....................................................................... 8. 2 3 4 , 18 5.11
9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9. 2 6 , 915.0 7
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10. 5 6 5 . 0 0
11. Total Deductions (total Lines 9 & 10) ...................................................................... 11. 2 7 , 4 8 0 . 0 7
12. Net Value of Estate (Line 8 minus Line 11) ............................................................. 12. 2 0 6 , 7 0 5 . 0 4
13. Charitable and Governmental Bequests/Sec 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. 2 0 6 , 7 0 5 . 0 4
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 .00 0 . 0 0 15.
16. Amount of Line 14 taxable
at lineal rate X .045 2 0 0, 8 5 3. 3 8 1 s.
17. Amount of Line 14 taxable
at sibling rate X .12 0 . 0 0 17.
18. Amount of Line 14 taxable
at collateral rate X .15 5, 8 5 1. 6 6 18.
19. Tax Due .................................................. .................................................................. . 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
L, 15056042148
Side 2
0.00
9,038.40
0.00
877.75
9,916.15
a
],5056042148
REV-1500 EX Page 3
Decedent's Complete Address:
File Number 21-08-0376
DECEDENTS NAME
Dorothy F. McDowell
STREET ADDRESS
5225 Wilson Lane
CITY .. STATE ZIP
Mechanicsburg PA 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. CreditslPayments
q. Spousal Poverty Credit
B. Prior Payments
C. Discount
3. Interest/Penalry if applicable
p, Interest
E. Penaity
9,391.68
494.30
Total Credits (A + B + C)
(1) 9,916.15
(2) 9,885.98
Total InterestlPenalty (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.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3)
(4)
(5) 30.17
(5A)
(5B> 30.17
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 :.................................................................................. x
b. retain the right to designate who shall use the property transferred or its income :.................................... x
c. retain a reversionary interest; or .................................................................................................................. x
d. receive the promise for life of either payments, benefits or care? .............................................................. x
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?......... ^ ^x
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, 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. §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 i72 P.S. §9116 (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. §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.
Rev-1508 D(+ (6-98}
SCHEDULE E
CASH, BANK DEPOSITS, ~ MISC.
PERSONAL PROPERTY
coti>MONwt=a~TH of aENNSnvnNw
WHERRANCETAX RETURN
RESIDENT DECEDENT
ESTATE OF (FILE NUMBER
McDowell, Dorothy F. 21-08-0376
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointlyoxmed wNh tl» right of wrvivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Edward Jones Investment Account -Date of death balance $188,578.35; accrued
interest $20.24
2 Pennsylvania State Employees' Retirement System -Final Prorated Pension
Payment of $1,011.60 + $100.00 Premium Assistance Payment (payment received
3/31/08 of $987.40 + second payment of $124.20)
3 I PNC Bank -Checking Account No. 5140040162; date of death balance $37,930.96;
accrued interest $4.97
4 Susquehanna Valley Federal Credit Union -Regular Share Account; date of death
balance $26.43; accrued interest $0.00
5 1 U.S. Treasury -Economic stimulus payment (minus payment of penalty for late
I filing)
6 ~ Personal Properly -sold at private sale
188.598.59
1,111.60
37.935.93
26.43
585.90
75.00
7 Kern County California Mineral Rights -1/6 interest in Township 29 South, Range 23 0.00
East, M.D.B.M., Section 30: S1/2S1/2SW1/4 -After diligent search, it was determined
that mineral right interest is of no value. Unable to transfer mineral rights due to
lack of interest and right being of no value.
TOTAL (Also enter on Line 5, Recapitulation) I 228,333.45
(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)
Edward Jones Mark D. Bioty
1433 Bridge Street Financial Advisor
New Cumberland, PA 17070
(? 17) 774-5475
EdwardJones
April 16, 2008
James D. Bogar, Esquire
One West Main Street
Shiremanstown, PA 17011
Re: Estate of Dorothy F. McDowell
Date of Death: March 25, 2008
Dear Mr. Bogar:
In response to your letter of April 3, 2008, following is the information you
requested regarding accounts held at Edward Jones by the above-referenced
decedent, Dorothy F. McDowell.
On November 29, 2007, Stephen B. Wagoner (Agent under Dorothy F. McDowell's
Power of Attorney dated September 17, 2003) opened a single account titled
"Dorothy F. McDowell, c/o Stephen B. Wagoner" which was owned solely by the.
decedent. The date-of-death balance in this account was $188,598.59, which
includes $20.24 in accrued interest.
If you need additional information, please do not hesitate to telephone me at
774-5475.
Very truly you s,
°-z
Mark D. Bioty
Financial Advisor
/se
Copy to: Stephen B. Wagoner, Executor
COMMONWEALTH OF PENNSYLVANIA
PUBLIC SCHOOL EMPLOYEES' RETIREMENT SYSTEM
Mailing Address
PO Box 125
Harrisburg, PA 17108-0125
July 14, 2008
JENNIFER B HIPP
ATTORNEY AT LAW
1 W MAIN ST
SHIREMANSTOWN PA 17011
Toll-Free - 1-888-773-7748
(1-888-PSERS4U)
Local - 717-787-8540
Web Address: wwwpsers.state.pa.us
RE: Dorothy McDowell
S.S.# XXX-XX-7121
Dear Ms. Hipp:
Thank you for your correspondence.
Building Location
5 North 5th Stteet
Harrisburg, PA
A gross prorated payment of $1,011.60 for the period of March 1, through March 25,
2008, was due Dorothy McDowell, and is now payable to the estate or next of kin of
Dorothy McDowell.
An additional amount of $100.00 is also due the estate or next of kin. This payment is
for the premium assistance that was scheduled to be paid to Dorothy McDowell for the
month in which death occurred.
The March 31, 2008 payment of $987.40 has already been electronically transferred to
Northern Trust Co., account #9999571229211.
Since the prorated payment due is $1,011.60, and the premium assistance due is
$100.00 and net payment of $987.40 was issued, we will forward a check for $124.20
after receiving all information and forms requested.
If Dorothy McDowell left an estate, please submit a Short Certificate showing the
appointment of the executor or administrator of the estate. A photocopy of the Short
Certificate will be accepted. A copy of the. deceased member's will is not sufficient proof
of appointment.
If Dorothy McDowell did not leave an estate, the enclosed "Next-of-Kin Affidavit"
(PSRS-85) must be completed before a Notary Public and returned to this office.
Please read the instructions carefully, specifically the order of preference. Election of
this form indicates that no formal estate is in existence.
Enclosed is PSERS Health Options Program information sheet which applies to any
surviving spouse or dependent(s) of the deceased member.
A 1099-R will be sent which will report the deceased member's income. This form will
be necessary for the preparation of the final income tax return. 1099-R's are generated
and issued at the end of the calendar year.
JENNIFER B. HIPP
RE: Dorothy McDowell
S.S.# XXX-XX-7121
Page 2
July 14, 2008
There will be no further benefits payable fram this account.
Please include the decedent's name and social security number with all
correspondence.
If you have any questions, please contact the Member Service Center by calling toll-free
1-888-773-7748 (local calls 787-8540). If you prefer, you may reach PSERS by FAX at
717-772-3764. For your convenience, the Member Service Center is staffed each
business day from 7:30 a.m. to 5:00 p.m.
~~'~ s~ ~e ~~~~~ ~ ~~~~ s~.~
Enclosure(s)
AP r, 14. 2008 ?.45PM PNC BANK 412-705-2147 No. 2651 P, 1/1
~ PN~BA]~K
The Thinking Hthind The Money
April 14, 2008 '
James D Boger
Attorney at Law
One W Main St
Shiremeustown, PA 170] 1
IZE: Dorothy F McDowell (Deceased) .
SSN: 186-34.7121
DOD: 03-25-2008
Dear NIr. Boger:
In response to your request for Date of Death balances for the customer noted abovq our
records show the following:
Checking Aecoant
Account # St40040162 Established 08-01-1960
DOROTHY F MCDOWELL
DOD balance: $37,930.96 + 4.97 accrued interest
Please note ttaat this office only provides date of depth balances for deposit accounts
(IRAs, CDs, Checking and Savings accounts). We do not process any financial
transactfona or provfde statements. If you need assistance with any of these items,
please call 1-888-PNC-BANK (1-888-762.2265} or stop by your local PNC Bank branch
office. .
Sine !~~
1,~~~~ l~
Colleen Crowder
1-800-762-1775
P7-PFSC-04-F
500 First Ave
Pittsburgh, PA 15219
Member FDIC
Page 1 of 1
JUN-I7-OS TUE 10,07 AM SUSQUEHANNA UALLEY FCU
SUSQUEHANNA VALLEY F. C. U.
3850 HARTZDALE DRIVE
CAMP HILL, PA 17011-7809
{717)-737-4152
Dorothy F McDowell
5225 Wilson Lane
Mechanicsburg, PA 17055
FAX N0. 7177370589
Member#:
Statement Date:
Page#:
Mail Code:
Web Code:
91
03/33./2008
1
YTD Taxable Dividends: $89.40
YTD Taxable Interest: $.00
YTD Finance Charges: $.00
Overdraft Fees This Period: $.00
Overdraft Fees YTD: $.00
Returned Item Fees This Period: $.00
Returned Item Fees YTD: $.00
Trap Post Transaction Trap Fee FINANCE Joan
Date Date Description Amount Amount CHARGE Principal Balance
01/01 Type: 00 - REGULAR SHARES - 00 PREVIOUS BALI~.NCE 26.43
03/31 NEW BALANCE 26.43
01/01 Type: 50 - 4271 - 6 MONTH CERTIFICATE - 50 PREVIOUS BALANCE 11613.91
01/31 01/31 Dividend Posting 44.36 11658.27
02/01 02/O1 CD Renewal 11658.27 11658.27
02/29 02/29 Dividend Posting 31.63 11690.10
03/13 03/13 Dividend Credit 13.21 11703.31
03/13 03/13 Moved CD to 8273 per jt owner 11703.31- .00
03/31 NEW BALANCE .00
Maturity Date; 08/01/2008
Dividend Rate: 3.4A6
• APY: 3.50 ~
Cr1e~ uo~ I°r~~~r ~~
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UW N GYM- a N CD '~ n~~ ` ,Std ~ U ` {
Rsv-1510 teJ(+ (8-98)
SCHEDULE G
INTER-VIVOS TRANSFERS ~
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERRANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF (FILE NUMBER
McDowell, Dorothy F. 21-0$-0376
This schedule must be completed and fled if the answer to any of questions 1 through 4 an the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBER I I
INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE. DATE OF DEATH
VALUE OF ASSET %OF DECD'S
INTEREST EXCLUSION
(IF APPLICABLE) TAXABLE
VALUE
1 Susquehanna Palley Federal Credit Union - 5.851.66 5.851.66
Certificate of Deposit; made joint with Stephen
6. Wagoner on August 1, 2001; transferred to
Stephen B. Wagoner March 13, 2008, prior to
Decedent's date of death, March 25, 2008.. Total
value of CD at time of transfer X17,703.31.
One-half of this amount is taxable to the Estate
as the CD was jointly owned for a period in
excess of one year.
TOTAL (Also enter on Line 7, Recapitulation) 5,851.66
(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 G (Rev. 6-98)
JUN-17-08 TUE 10,07 Ali SUSQUEHANNA VALLEY FCU
FAX N0. 7177370589
SUSQUEHANNA VALLEY F. C. U.
3850 HARTZDALE DRIVE
CAMP HZLL, PA 17011-7809
{717)-737-4152
Member#: 91
Statement Date: 03/31/2008
Page#: 1
Mail Code:
web Code:
Dorothy F McDowell
5225 Wilson Lane
Mechanicsburg, PA 17055
YTD Taxable Dividends: $89.40
YTD Tastable Interest: $.00
YTD Finance Charges: $.00
Overdraft Fees This Period: $.00
Overdraft Fees YTD: $.00
Returned Item Fees This Period: $.00
Returned Item Feea YTD: $.00
Trap Post Transaction Tran Fee FINANCE Joan
Date
----- Date
----- Description
-------------------------- Amount Amount CHARGE Principal Balance
01/01
Type: ----
00 - REGULAR SHARES - 00 ----------- -------- - -------- --
PREVIOUS -------- -
BALANCE ----------
26
43
03/31 NEW BALANCE .
26.43
O1/O1 Type: 50 - 4271 - 6 MONTH CERTIFICATE - 50 PREVIOUS BALANCE 11613
91
01/31 01/31 Dividend Posting 44.36 .
;11658
27
02/01 02/01 CD Renewal 11658.27 .
11658
27
02/29 02/29 Dividend Posting 31.83 .
:11690
10
03/13 03/13 Dividend Credit 13.21 .
:L1703
31
03/13 03/13 Moved CD to 6273 per jt owner 11703.31- .
00
03/31 NEW BALANCE .
.00
Maturity Date: 08/01/2008
Dividend Rate: 3.446
APY: 3.50 ~ .
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CC711-~~~~cAT~ c7aael+JV.f+a..-( bPL•aJ dN Cg`l ~~.n01 A`~U ~2fit,Lt'~U (yJ~yL ~UCw~( S1Y.
N~cyNC' lYs
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES 8~
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
McDowell, Dorothy F. 21-08-0376
Debts of decedent must be reported on Schedule 1.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Stephen B. Wagoner
Social Security Number(s) / EIN Number of Personal Representative(s}:
Street Address 60016th Street
city New Cumberland State PA zip 17070
Year(s) Commission paid 2008
2. Attorney's Fees Bogar and Hipp Law Offices
3. Family F~cemption: (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. I Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. I Other Administrative Costs
1,006.00
9,840.00
8,200.00
310.00
100.00
7,459.07
TOTAL (Also enter on tine 9, Recapitulation? I 26,915.07
Copyright (c) 2002 form software only The Lackner Group, Inc. Forrn PA-1500 Schedule H (Rev. 6-98)
Rev-1602 EX+ t~Y
cor~nnoNw>=n~ni of aENNmvnNw
- - iNHERRANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H-A
FUNERAL EXPENSES
continued
ESTATE OF FILE NUMBER
McDowell, Dorothy F. 21-08-0376
ITEM
NUMBER
DESCRIPTION
AMOUNT
1 Gerry Seiler -Soloist for funeral 25.00
2 Gingrich Memorials -Headstone engraving 130.00
3 Musselman's Funeral Home -balance of funeral bill 612.00
4 Trinity Lutheran Church -food for funeral luncheon 179.00
5 Trinity Lutheran Church -custodian for funeral luncheon 35.00
6 Trinity Lutheran Church -service of funeral luncheon 25.00
Subtotal
1,006.00
Copyright (c) 2002 form sofhvare only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 5-98)
Rev-1602 EX~ (8-98)
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
COAS.fONWEALTH OF PENNSYLVANIA
MHERRANCE TAX RETURN continued
RESmENT DECEDENT
ESTATE OF FILE NUMBER
McDowell, Dorothy F. 21-08-0376
ITEM
NUMBER
DESCRIPTION
AMOUNT
1 Bethany Village Skilled Nursing -bill for skilled care 5,461.78
2 Continuing Care RX -pharmacy bill 279.35
3 East Pennsboro Amublance -medical transportation 159.00
4 Frederick Lorenzo, M.D. -medical bill 10.00
5 Hampden Physicians -medical bill 17.34
6 Heritage Medical Group -final bill 8.19
7 Heritage Medical Group -medical bill 8.19
8 PA Dept. of Revenue -Penalty for late filing 15.22
9 RESERVES -Costs to conclude administration of Estate, including filing of PA 1,500.00
Inheritance Tax Return and Inventory, and Fiduciary Income Tax Returns
Subtotal I 7,459.07
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-67 (Rev. 6-98)
Rev-1b12 pt+ (b.®b)
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
CONNAONWEALTM OF PENNSYLVANIA
WHERRANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF (FILE NUMBER
McDowell, Dorothy F. 21-08-0376
Mduds unrolmbunred mabcsl expenses.
(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 1(Rev. 6-98)
SCHEDULE J
BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF:
Dorothy F. McDowell 03/25/2008 186-30-7121
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) {$$$)
7 Eleanor A. Bogert Granddaughter One-sixth of rest,
22 Linda Drive residue and
Kingston, PA 18704 remainder
2 John P. McDowell Son One half of rest,
31231 Stoney Brook Drive residue and
Brooksville, FL 34602 remainder
3 Pauline S. Shatswell Granddaughter One-sixth of rest,
218 Mt. Pleasant Bivd. residue and
Fredericksburg, VA 22405 remainder
4 Margaret Watkins Granddaughter One~sixth of rest,
218 Mt. Pleasant Blvd. residue and
West Paim Beach, FL 33405 remainder
1
LAST WILL AND TESTAMENT
OF
DOROTHY F. McDOWELL
,1
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I, DOROTHY F. McDOWELL, of Mechanicsburg, Cumberland
County, Pennsylvania, make, publish and declare this as and for-
my Last Will and Testament, hereby revoking all other Wi11s anti
Codicils heretofore made by me.
FIRST: I devise and bequeath all the rest, residue and
remainder of my estate of whatever nature and wherever situate,
including any property over which I hold power of appointment and
together with any insurance policies thereon, as .follows:
(A) Fifty (500) percent. thereof, to my son, JOHN P.
McDOWELL, provided that should JOHN P. McDOTnTELL predecease me, I:
give and bequeath his share unto his issue per stirpes by repre-
sentation.
(B} Fifty (50%) percent thereof, in equal shares, to
my grandchildren, ELEANOR A. BOGERT, PAULINE S. SHATSWELL, and
MARGARET WATKINS.
SECOND: In addition to all powers granted to them by law
and by other provisions of this Will, I give the fiduciaries
acting hereunder the following powers, applicable to all proper-
ty, exercisable without court approval and effective until actual
distribution of all property:
(A) To sell at public or private sale, or to lease,
for any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or
conditions as are deemed proper. This includes the power to give
legally sufficient instruments for transfer of the property and
to receive the proceeds of any disposition of it.
(B) To partition, subdivide, or improve real estate
and to enter into agreements concerning the partition, subdiv:i-
', lion, improvement, zoning or management of real estate and to
impose or extinguish restrictions on real estate.
(C) To compromise any claim or controversy and to
abandon any property which is of little or no value.
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries, as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted
in insurance policies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws.
. a
(G) To make distributions to my herein named benefic_L-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes.
(I) To select a mode of payment under any qualified
retirement plan (pension plan, profit sharing plan, employee
stock ownership plan, or any other type of qualified plan) to the
extent the plan or the law permits them to do so, and to exercise
any other rights which they may have under the plan, in whatever
manner they consider advisable.
THIRD: I direct that all inheritance, estate, trans-
fer, succession and death taxes, of any kind whatsoever, which
may be payable by reason of my death, whether or not with respect
2
to property passing under this Will, shall be paid out of the
principal of my residuary estate.
FOURTH: All interests hereunder, whether principal or
income, which are undistributed and in the possession of the
fiduciaries acting hereunder, even though vested or distribut-
able, shall not be subject to attachment, execution or sequestra-
tion for any debt, contract, obligation or liability of any
beneficiary, and furthermore, shall not be subject to pledge,
assignment, conveyance or anticipation.
FIFTH: I nominate and appoint my nephew, STEPHEN B.
WAGONER, Executor of .this, my Last Will and Testament. In the
event of the death, resignation or inability to serve for any
reason whatsoever of the said STEPHEN B. WAGONER, I nominate and
appoint my son, JOHN P. McDOWELL, Executor of this, my Last Will
and Testament. I direct that my Executor, and their successors,
shall not be required to post security or a bond far the
performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this, my Last Will and Testament, this ~~-~~ day of
~~- r1~ • ',~ G ~i-''~^~~'- ~ `~ ( SEAL )
DOROTHY F ~ McDOWELL
3
Signed, sealed, published and declared by the above-
named Testatrix as and for her Last Will and Testament in our
presence, who, at her request, in her presence and in the
presence of each other, have hereunto subscribed our names as
attesting witnesses.
Address
Address
~. (,.QJ ~ ~/L~
~t
4
I r
REGISTER OF WILLS OF
COMMONWEALTH OF PENNSYLVANIA } SS
couNrr of Cumberland }
Stephen B. Wagoner
INVENTORY
CUMBERLAND COUNTY, PENNSYLVANIA
File Number 21-08-0376
Personal Representative(s) of the Estate of Dorothy F. McDowell "°'
i `:~~
C'' Q '-'- _ . _
deceased, depose(s) and say(s),that the items appearing in the following inventory include ali of the personal asset here~ r
situate and all of the real estate In the Commonwealth of Pennsylvania of said Decedent, that the valuation plaosit~-e+ach '~
item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent owned rte rree~~I estate -
outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. v'I
I verify that the statements made in this Inven- ' ~ ~ ' ?"w;°~ `~ '
-;;
tory are true and correct. I understand that false state- } =--------_~
menu herein are made subject to the penalties of Step en B. Wagone =~ w'
18 Pa.C.S. § 4904 relating to unsworn falsification to } '-' ~--
authorities. c+.a
Attorney- (Name) Jennifer B. Hipp
(Supreme Courtl.D. No.) $6556
(F/m,) Bogar and Hipp Law Offices _
(address) 1 West Main Street, Shiremanstown, PA 17011
(telephone) 717-737-8761
DATE OF DEATH LAST RESIDENCE 52 2 5 W llson Lane DECEDENTS SOC. SEC. ND.
03/25/2008 Mechanicsburg, PA 17055 186-30-7121
FIGURES MUST BE TOTALED
Personal Proaerty
Cash ...............................................................................................
Personal Property .........................................................................
Stocks/Listed .................................................................................
Stocks/Closely Held ......................................................................
Bonds .............................................................................................
Partnerships and Sole Proprietorships .....................................
Mortgages and Notes Receivable ...............................................
All Other Property .........................................................................
Total Personal Property .........................................
Total Real Property ................................................
Total Personal and Real Property .........................
22.8,333.
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))
Fwm Rw-t79 Rev. 10.13-2006
228,258.45
75.00
228,333.45
~~
I ~ ~-
REGISTER OF WILLS OF
INVENTORY
CUMBERLAND COUNTY, PENNSYLVANIA
COMMONWEALTH OF PENNSYLVANIA } SS
COUNTY OF Cumberland
File Number 21-08-0376
DATE OF DEATH - I LAST RESIDENCE 325 Wesley Drive, Apt. 3216 DECEDENTS SOC. SEC. N0.
03/25/2008 Mechanicsburg, PA 17055 186-30-7121
Cash
Edward Jones Investment Account -Date of death balance $188,578.35;
accrued interest $20.24
Pennsylvania State Employees' Retirement System -Final Prorated Pension
Payment of $1,011.60 + $100.00 Premium Assistance Payment (payment
received 3/31/08 of $987.40 + second payment of $124.20)
PNC Bank -Checking Account No. 5140040162; date of death balance
$37,930.96; accrued interest $4.97
Susquehanna Valley Federal Credit Union -Regular Share Account; date of
death balance $26.43; accrued interest $0.00
U.S. Treasury -Economic stimulus payment (minus payment of penalty for late
filing)
Total Cash
Personal Property
Kern County California Mineral Rights -1/6 interest in Township 29 South,
Range 23 East, M.D.B.M., Section 30: S1/2S1/2SW1/4 -After diligent search, it
was determined that mineral right interest is of no value. Unable to transfer
mineral rights due to lack of interest and right being of no value.
Personal Properly -sold at private sale
Total Personal Property
188,598.59
1,111.60
37,935.93
26.43
585.90
228,258.45
0.00
75.00
75.00
(Attach additional sheets if necessary) Total Personal Property and Real Estate 228,333.45