HomeMy WebLinkAbout06-30-14 (2) � 1505610143
REV-1500 Ex(o2-ii) �' OFFICIAL USE ONLY
PA Oepartment of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes �EPARTMENTOFREVENUE
PO BOX.280601 INHERITANCE TAX RETURN 2], 13 0819
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
241 07 08 2013 12 28 1946
DecedenYs Last Name Suffix DecedenYs First Name M�
BOWEN JOSEPH C
(If Applicable)Enter S�rviving Spouse's Information Below
Spouse's Last Name Su�x 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 ❑
1. Ori inal Return 2. Supplemental Return 3, Remainder Return(Date of Death
� g� ❑ Priorto 12-13-82)
4. Limited Estate � qa.Future interest Compromise � 5. Federal Estate Tax Return Required
� (date of death aker 12-12-82)
� 6 Decedent Died 7estate � 7. De�a dh�oPy�o�Trust)a Living Trust 1 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will)
� 9. Liti ation Proceeds Received � �Q.Spousal PoveA Credit�(Date ot oeath � 11.Election to tax under Sec.9113(A)
9 between 1231�1 and -1-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
ROGER B IRWIN ESQ 717 24� 6333 � �
c; �,.,� --� �;, r,.�
_ . _;:� c__. :. c-�
REGISTER,O�VWILLS USE�NLY. ...' �
' c'7 ;�� ;��
t..._ W r�,�
:�; �,..,I I'�1
First Line of Address r� � � �
354 ALEXANDER SPRING RO �'> c:, Z' , `�'
,' .�
�� -.�3 =� ....� �-�
Second Line of Address „y t�� -•= '�
��"{ C.J ,.._ _1
`J C"'
$ATE FILED N �
City or Post Office State ZIP Code
CARLISLE PA 17015
CorrespondenYs e-mail address: ro erbirwin saizmannhu hes.com
Under penalties of pery'u eclare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct an laration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF N E FOR FILING RETURN DATE
James D. Hughes
ADDRE
3 4 Alexander rin Road Suite 1 Carlisle PA 17013
DATE
SIGNA UREOF EP EROTHERT�REPRE TATIVE Roger B. Irwin, Esq.
ADDRESS
354 Alexander Spring Road, Suite 1, Carlisle, PA
� Side 1 �
1505610143 1505610143
J 1505610243
REV-1500 EX
Decedent's Social Security Number
Decedent'sName: BOWen� JOS@ph C. 241 74 3544
RECAPITULATION
1. Real Estate(Schedule A)...........................................................................
............ 1. 220 , 000 . 00
2. Stocks and Bonds(Schedule B)............. .... 2. 17 , 627 . 90
............................................................
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages&Notes Receivable(Schedule D)........................................................ 4.
5. Cash.Bank Deposits&Miscellaneous Personal Property(Schedule E)............... 5. 7 8 , 8 7 7 . 65
6. Jointly Owned Property(Scheduie F) ❑ Separate Billinq Requested............ 6.
7. Inter-Vivos Transfers&Misceilaneous�nq Probate Property
(Schedule G) U Separate Billing Requested............ 7.
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 316,505 . 55
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 116, 310 . 92
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 2 68 � 18� . 54
11. Total Deductions(total Lines 9 and 10)................................................................ ��. 3 8 4 , 4 91 . 4 6
12. Net Value of Estate(Line 8 minus Line 11).......................................................... �2. -67 , 985 . 91
�3, 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. -67 , 985 . 91.
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 i5 O . 00
(a)(1.2)X.00
16. Amount of Line 14 taxable � . 0 0 16. O . O O
at lineal rate X .045
17. Amount of Line 14 taxable � . �� 17. 0 . 0 0
at sibling rate X.12
18. Amount of Line 14 taxable 0 . 0 0 18. 0 . 0 0
at collateral rate X.15
19. TAX DUE................................................................................................................
19 O . ��
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. �
Side 2
� 1505610243 1505610243 J
REV-1500 EX Page 3 File Number 21-13-0819
Decedent's Complete Address:
DECEDENT'S NAME
Bowen,Joseph C.
STREET ADDRESS
7 Circle Drive
C�.� STATE ZIP
Carlisle PA 17015
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits(A +B) (2) 0.00
3. Interest �3�
q, If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
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. (5) �.�0
Make Check Pa able 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
• • ... . ... . .. .
x
a. retam the use or income of the property transferred:...................... . . . . . .........................................
b. retain the right to designate who shall use the property transferred or its income:.................................. � �
c. retain a reversionary interest;or............................................................................................................... x
d. receive the promise for life of either payments,benefits or care?............................................................ � �
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without ❑ ❑
receiving adequate consideration?.................... . .. . . ....................................................................................
. . . . . .
3. Did decedent own an"in trust for' or payable upon death bank account or security at his or her death?....... ❑ �
4. Did decedent own an individual retirement account,annuity,or other non-probate property which ❑ ❑
contains a beneficiary designation?.................................................................................................................. x
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 Jan.1,L1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after January 1, 1995,th�tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 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 appiicable 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 21 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 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 decedenYs lineal berteficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)).
. The tax rate imposed on the net value of transfers to or for the use of the decedenYs siblings is 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.
Rev1502 EX+(01-10)
SCHEDULE A
pennsylvania REAL ESTATE
�EPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bowen, Jose h C. 21-13-0819
All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller,neither being compelled to buy or sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with nght of survivorship must be disclosad on schedule F.
Attach a copy of the sett�ement sheet if the property has been sold
Include a copy of the deed showing decedent's interest if owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real estate situate at 7 Circle Drive, Carlisle, Middlesex Township, Cumberland Co., PA-See 220,000.00
HUD-1 attached
TOTAL(Also enter on Line 1,Recapitulation) 220,000.00
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule A(Rev.01-10)
Rev7503 EX+(6-98)
SCHEDULE B
, STOCKS 8� BONDS
COMMONWEALTH OF PENNSVLVANIA
INHERITANCE TAX RETURN
RESI�ENTDECEDENT
ESTATE OF FILE NUMBER
Bowen, Jose h C. 21-13-0819
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
VALUE AT DATE
ITEM CUSIP DESCRIPTION UNIT VALUE OF DEATH
NUMBER NUMBER
� 058498106 8 Bail Corp-Com 42.785 342.28
2 3.99 shares of Fidelity Destiny Plans I-O; No. 507 22.4110276 89.42
g 172.77 shares of Harleysville Group Inc. 60 10,366.20
4 696429307 100 shares of Pall Corp-Com 68.3 6,830.00
TOTAL(Also enter on Line 2,Recapitulation) 17,627.90
(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 B(Rev.6-98)
Rev-1508EX+(��.�D) gCHEDULE E
pennsylvania CASH, BANK DEPOSITS, � MISC.
DEPAR7MENT OF REVENUE
INHERITANCETAXRETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bowen, Jose h C. 21-13-0819
Include the proceeds o�litigation and the date the proceeds were received by the estate.
All propeRy jointly-owned with the right of survivorship must be disdosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 25-$2 bills uncirculated-Found in safe deposit box 50.00
2 Airy View Storage-refund of security deposit for two storage units 110.00
3 Ball Corporation -payment for uncashed dividend checks 12.32
4 Bank of America-Cassese v.Washington Mutual, Inc., Class Action distribution 11.32
5 Cash found in house 613.91
6 Cash in safe deposit box 1,198.00
7 Commonwealth of Pennsylvania-unclaimed property 3,192.09
8 Georgeson-replacement check for uncashed PALL checks 228.00
9 Pall Corporation -payment for uncashed dividend checks for February and May of 2013 50.00
10 AlaskaUSA Federal Credit Union, Relationship Checking Account 163795-70 4,943.85
11 AlaskaUSA Federal Credit Union, Share Savings Account 163795-10 45.05
12 First National Bank of Mifflintown,Common Sense 50+Account No.3884 3,328.62
Accrued interest on Item 12 through date of death 0.09
13 PSECU,Share Account No. 8438 54.57
14 The Bank of Landisburg, Passbook Savings Account No.068495390 113.34
Accrued interest on Item 14 through date of death 0.02
Total of Continuation Schedules See attached
a es
TOTAL(Also enter on Line 5, Recapitulation) 78,877.65
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev.11-10)
Rev1508EX+(��_�0) gCHEDULE E
pennsylvania CASH, BANK DEPOSITS, 8� MISC.
DEPARTMENT OF REVENUE
INHERITANCETAXRETURN PERSONAL PROPERTY
RESIDENT DECEDENT
continued
ESTATE OF FILE NUMBER
Bowen, Joseph C 21-13-0819
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
15 The Bank of Landisburg, Regular DDA Account No.714534 82•25
16 USAA,Subscriber Account No.001068522 6,036.69
17 1973 Convertible Voikswagen -VIN 1832944149,at proceeds of sale 1,000.00
18 2006 Carry On Trailer-VIN 4YMUL12196V028103,at proceeds of sale 500.00
19 2012 Volkswagen Passat-VIN 1 VWCN7A36CCO23153,at proceeds of sale 20,000.00
20 Colt 32 pistol-at proceeds of sale 250.00
21 Flint lock reptica-at proceeds of sale 30.00
22 Household goods at proceeds of sale 12,895.00
23 Household goods at proceeds of sale 1,225.00
24 Household goods at proceeds of sale 17,393.50
25 Househoid goods at proceeds of sale 2,963.00
26 Sleigh-at proceeds of sale 750.00
27 Special Construction Trailer-VIN SW101240PA 50.00
28 Victor 32 pistol -at proceeds of sale 70.00
29 Bank of America, Nome Loan Account No.227326740-refund balance left in real estate 169.70
escrow account
30 Carlisle Propane-refund 32.85
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10)
Rav1508 EX+(71.70) gC H E D U LE E
pennsylvania CASH, BANK DEPOSITS, 8� MISC.
DEPARTMENT OF REVENUE
INHERITANCETAXRETURN PERSONAL PROPERTY
RESIDENT DECEDENT continued
ESTATE OF FILE NUMBER
Bowen, Joseph C 21-13-0819
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
37 Chase Bank-refund of credit balance 192.73
32 FTC v.Central Coast Nutraceuticals Settlement-settlement proceeds 12.26
33 Pennsylvania Turnpike Commission -refund 2$'92
34 Republic Services, Inc.-refund cancellation of York Waste service 28.00
35 Shipley Energy-refund of credit 56.06
36 Sirus XM Satellite Radio-refund 477.21
37 The First National Bank of Mifflintown-refund from closed safe deposit box 0.57
38 USAA-refund of unused automobile insurance premium 86.55
39 USAA-refund of unused homeowners insurance premium 596.18
TOTAL(Also enter on Line 5, Recapitulation) 78,877.65
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule E(Rev. 11-10)
_ __ _
REV-1511 EX+(�0-09)
pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bowen, Joseph C. 21-13-0819
DecedenYs debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
q, FUNERAL EXPENSES:
See continuation schedule(s) attached 12,715.55
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
James D. Hughes
Street Address 354 Alexander Spring Road, Suite 1
Cicy Carlisle state PA zio 17013
Year(s)Commission Paid 12,495.00
2, Attorney's Fees Salzmann Hughes, P.C. 42,770.00
3, Family Exemption: (If decedenYs address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State Zi�
Relationshio of Claimant to Decedent
4. Probate Fees 423.50
5. AccountanYs Fees
6. Tax Retum Preparer's Fees
7. Other Administrative Costs 47,906.87
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 116,310.92
Copyright(c)2009 form software only The Lackner Group,inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Bowen, Joseph C 21-13-0819
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Exoenses
1 Erin Wheeler-payment to Davidson Funeral Home, 1/2 funeral services 6,245.70
2 Erin Wheeler-payment to Lisa Hinkle for funeral flowers 224.16
3 Jennifer Greanias-payment to Davidson Funeral Home, 1/2 funeral services 6,245.69
H-A 12,715.55
Other Administrative Costs
4 Baye Auto Sales, LLC -complete interior and exterior detail to sell the 2012 VW Passat in 185.50
order to administer the estate
5 Computershare-processing fee and Bond premium for replacement of lost Ball Corp. 70.00
certificates required to sell the stock in order to administer the estate
6 Computershare-trading fees to sell Ball Corp in order to administer the estate 15.96
7 Erin Wheeler-reimbursement for payment to Airy View Storage for storage unit rental after 316.00
death in order to administer the estate
8 Erin Wheeler-cleaning services to prepare for the household goods sale in order to 500.00
administer the estate
9 George D. Reilly,Jr. -seller assistance to sell real estate in order to administer the estate 8,425.00
10 George D. Reilly,Jr.-termite inspection reimbursement to sell real estate in order to 75.00
administer the estate
11 Harleysville Group Inc.-processing fee to sell Harleysville Group Inc.stock in order to 1,036.62
administer the estate
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Bowen, Joseph C. 21-13-0819
ITEM
NUMBER DESCRIPTION AMOUNT
12 Hilton's Lock&Security-change locks on house in order to administer the estate 211.99
13 Jennifer Greanias-reimbursement for express mailing Donna Bowen's death certificates 22.74
required in order to administer Joseph Bowen's estate
14 Jeremiah Negley-partial payment for moving the storage unit items to the house,trash 1,500.00
removal and mowing
15 Jeremiah Negley-payment for August lawn mowing, hauling refuse and refuse disposal to 692.50
sell real estate in order to administer the estate
16 Jeremiah Negley-balance due for payment for moving the storage unit items to the house, 325.84
trash removal and mowing
17 Jeremiah Negley-lawn care, refuse removal and labor to sell real estate in order to 912.50
administer the estate
18 Middlesex Township Municipal Authority-water and sewer service 85.09
19 Middlesex Township Municipal Authority-water and sewer service 7$•75
20 Middlesex Township Municipal Authority-final water and sewer service 32•8$
21 Patricia A. Rosendale CPA-preparation of the final 2013 life period income tax returns 100.00
22 PPL Electric Utilities Corp. -electric service 243.11
23 PPL Electric Utilities Corp.-electric service 197.94
24 Prudential Homesale-commission paid to sell real estate in order to administer the estate 13,495.00
25 Recorder of Deeds-1%realty transfer tax paid to sell real estate in order to administer the 2,200.00
estate
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Bowen, Joseph C. 21-13-0819
ITEM
NUMBER DESCRIPTION AMOUNT
26 Redding Auction Service-commission paid to sell personal property in order to administer 5,244.00
the estate
27 Redding Auction Service -reimbursement for shrink wrap of pictures to sell personal 166.00
property in order to administer the estate
28 Redding Auction Service-commission paid to sell personal property in order to administer 3,865.00
the estate
29 Redding Auction Service -commission paid to sell personal property in order to administer 883.00
the estate
30 Register of Wills -three short certificates 15.00
31 Register of Wills-three short certificates 15.00
32 Register of Wills-short certificates 5.00
33 Salzmann Hughes, P.C.-reimbursement for FedEx to Pall Corporation to sell the security in 20.50
order to administer the estate
34 Salzmann Hughes, P.C.-reimbursement for payment to Cumberland Law Journal for legal 75.00
advertising
35 Salzmann Hughes, P.C. -reimbursement for payment to Carlisle Bakery Enterprises for 70.00
storage unit rental in order to administer the estate
36 Salzmann Hughes, P.C.-reimbursement for FedEx to Ball Corporation to sell the security in 20.50
order to administer the estate
37 Salzmann Hughes, P.C.-reimbursement for FedEx 20.50
38 Salzmann Hughes, P.C.-reimbursement for FedEx 20.50
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Bowen, Joseph C 21-13-0819
ITEM AMOUNT
NUMBER DESCRIPTION
39 Salzmann Hughes,P.C. -document preparation to sell reai estate in order to administer the 267.12
estate
40 Salzmann Hughes, P.C.-Tax Certification to sell real estate in order to administer the estate 30.00
41 Salzmann Hughes, P.C.-closing costs and final fees for income tax preparation,postage 3,500.00
and miscellaneous contingencies in order to administer the estate
42 The Sentinel-Legal -Legal advertising 200.16
43 USAA-automobile insurance paid to sell automobile in order to administer the estate 97.95
44 USAA-automobile insurance paid to sell automobile in order to administer the estate 31.72
45 Wesley Woltz Construction-repairs to home to sell real estate in order to administer the 2,540.00
estate
46 York Waste Disposal#611 -refuse service 7/1/13 to 9/30113 48.75
47 York Waste Disposal#611 -refuse service 1011/13 to 12/31/13 48.75
H-67 47,906.87
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev-7572 EX+(�p-08)
SCHEDULE I
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCETAXRETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bowen, Joseph C. 21-13-0819
RepoR debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Alaska USA Federal Credit Union Credit Card Account No.4110-balance due on account 8,392.75
2 AlaskaUSA Federal Credit Union, Credit Line Loan Account 163795-11 2,747.20
3 AlaskaUSA Federal Credit Union, Credit Line Loan Account 163795-11 -Notice of Claim, 1,144.45
balance due on account
4 AlaskaUSA Federal Credit Union,Credit Line Loan Account 163795-11 119.37
5 Bank of America, Home Loan Account No.227326740 1,238,04
6 Bank of America, Home Loan Account No. 227326740-payoff of first mortgage loan upon 185,970.57
sale of real estate
7 Barclays Bank of Delaware Credit Card Account No.5406-8100-0022-8008-balance due on 1,111.57
account
8 Bio Sorb Inc. -Check written prior to death cleared after death 119.85
9 Carlisle HMA Physician Managem -balance due on account 315.00
10 Century Link-phone service 212.02
11 Century Link-phone service 12.14
12 Dish-balance due on account 36.04
13 Guthy-Renker Account No.46-963-462229279 -balance due on account 147.18
14 Internal Revenue Service-payoff of second mortgage upon sale of real estate 8,218.35
15 Internal Revenue Service-balance due for past income taxes 39,484.87
16 Kohl's Credit Card Account No. 068-4397-201 -balance due on account 103.80
Total of Continuation Schedule See attached page
TOTAL(Also enter on Line 10, Recapitulation) 268,180.54
(If more space is needed,additional pages of the same size)
Copyright(c)2008 form software only The Lackner Group,Inc. Form PA-1500 Schedule I(Rev. 12-08)
Rev-1572 EX+(12-OS)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OF REVENUE
INHERITANCETAXRETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
continued
ESTATE OF FILE NUMBER
Bowen, Joseph C. 21-13-0819
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
17 PPL Electric Utilities Corp. -electric service 327.56
18 PSECU Credit Card Account No.8438-balance due on account 247.05
19 Score Sense-credit score membership ID#28921292 29.95
20 Verizon Wireless Account No.819715666-00001 -balance due on account 101.21
21 VW Credit, Inc. -2 car payments 933.62
22 VW Credit, Inc. -loan payoff for 2012 VW Passat 16,705.76
23 VW Credit, Inc.,Loan Account No.870911419 462.19
TOTAL(Also enter on Line 10,Recapitulation) 268,180.54
Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08)
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN B E N E F I C IARI E S
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Bowen, Jose h C. 21-13-0819
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S)RECEIVING PROPERTY DECEDENT (Words) ($$$)
�5 te
I� TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116 a 1.2
1 Erin L. Bowen now by marriage Erin Wheeler Daughter 1/2 Residue
8005 Tanjier Bay Court
Raleigh, NC 27613
2 Jennifer C. Bowen now by marriage Jennifer Daughter 1/2 Residue
Greanias
402 Brookwood Place
Lansing, KS 66043
Total
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro riate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group,Inc. Form PA-1500 Schedule J(Rev.01-10)
' :
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c�.: _� _ ;,:i �:
�.� - ` -_ __ �
LAST yVILL AND TESTAMENT �-� � �. � <- :�
� - ,
I, JOSEPH C. BOWEN, of South Middleton Township, Cumberland +County,
Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby make,
publish and declare this to be my Last Will and Testament, hereby revoking all Wills and
Codicils heretofore made by me.
ONE. I direct my Executor or Executrix, as the case may be, to pay all of my debts,
funeral and administrative expenses as soon as convenient after my decease. Furthermore, I
direct that all state, inheritance, succession and other death ta�es irnposed or payable by reason of
my death and interest and penalties thereon with respect to all property composing of my gross
estate for death tax purposes, whether or not such property passes under this `Vill, shall be paid
by the Executor or Executrix of my estate.
TWO. My Executor or Executrix may, at his or her discretion, compromise
claims, borro�v money, retain property for such length of time as he or she may deern proper;
lease and sell property for such prices, on such terrns, at public or private sales, as he or she may
deem proper; and invest estate property and income without restriction to legal investments
unless otherwise provided hereunder. I authorize and empower my Executor or Executrix to sell
any realty and�'or personalty owned by me at my death and not specifically devised or bequeathed
herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale
therefor, in fee simple, as I could do if living. N1y Executor or Executrix is authorized and
empowered to engage in any business in w�hich I may be en�aged at my death, for such period of
time after my death as seems expedient to said Executor or Executrix.
( /� /
1�,(
/
THREE. I give, devise and bequeath all of my estate of whatever nature and
wherever situate to my dauahters, ERI�i L. BOWEN and JE��IFER C. BOWEN, per stirpes,
which provides that the child or children of any deceased child shall take the share their parent
would have taken if living. Noriy�ithstanding the above, in the event my daughters are under the
age of twenty-eight (28) years at the time of my death, then in that event my estate shall be held
in trust and administered and distributed in accordance with the provisions of Paragraph Four
hereof.
FOUR. In the event that my dau�hters, or any other beneficiary shall be under the
age of twenty-eight (28) years at the date of my death, then his or her inherited share under this
my Last Will and Testament shall be held in trust by the hereinafter mentioned Trustee according
to the following terms and conditions:
The Trustee, as well as my Executor or Executrix, as the case may be, is hereby
authorized to retain, unconverted, any property, real or personal, that I may own at my
death and shall be under no duty to convert it into legal investments. The Trustee shall
have the power and authority to sell, transfer, convey, invest and reinvest and to pay over
the net income of the trust property, to or for the use of my children, or to accumulate it
in the sole discretion of the Trustee. The Trustee is also authorized and empowered to
pay over to, or for the use and benefit of my children such portion of or all of the
principal of the trust estate as in the Trustee's sole discretion seems proper for their
continued support, maintenance, education, medical care or general welfare. My primary
object is to ensure the continued support, maintenance, education and medical care of my
children until they reach the age of twenty-eight (28) years. Notwithstanding the above
purpose of this trust, the Trustee, in the Trustee's sole discretion, may distribute any
portion of the income or principal of the trust estate over to any of my children who have
� �
C-�
z
attained the age of twenty-eight (?8) years prior to the ultimate distribution hereof as the
Trustee deems proper for the health, maintenance, education or settin; up of a child in
business or in a profession, or the purchase of real property or for similar purposes or for
any other purpose which ��ould in the Trustee's sole discretion advance the best interest
of said child. The Trustee shall be under no duty to distribute or use the principal equally
for each of my children, but may distribute or use principal unequally in his or her
discretion. When the youn�est child reaches the age of twenty-one (21) years, then one-
third (1/3) of whatever remains of income or principal of this trust estate shall be
distributed in equal shares to my children, share and share alike, per stirpes, which
provides that the child or children of any deceased child shall take the share their parent
would have taken if living. When the youngest child reaches the age of twenty-five (25)
years, then one-third (1/3) of whatever remains of income or principal of this trust estate
shall be distributed in equal shares to my children, share and share alike, per stirpes.
When the youngest child reaches the a�e of t�venty-eight (28) years, then whatever
remains of income or principal of this trust estate shall be distributed in equal shares to
my children, share and share alike, per stirpes. In the event that any of my children of
this Paragraph Four predecease me or become deceased prior to the distribution of this
Trust without leaving surviving issue, then in that event, the deceased child's share shall
be divided equally, per stirpes, between my surviving children of this Paragraph Four.
For whatever reason, if all of my children of this Paragraph Four predecease me or
become deceased prior to the distribution of this Trust without leaving surviving issue,
then this share as stated in this Paragraph Four shall be distributed in accordance
Paragraph Five hereo£
� �. /
�t
3
FIVE. In the event of a common disaster causing the death of myself and my
daughters, without surviving issue, all within a period of si�cty (60) days, then I give, devise and
bequeath the rest, residue and remainder of my estate as follo��'s:
A. Twenty-five percent (25%) to JANE STOKES, per capita;
B. T��enty-five percent (25%) to CINDY COLDREN, per capita;
C. Twenty-five percent (2�%) to RICHARD NORRI5, per capita; and
D. Twenty-five percent (25%) to TRICIA NEGLEY, per capita.
SIX. I hereby nominate and appoint JAMES D. HUGHES, ESQUIRE to be the
Executrix of this my Last Will and Testament. If he has predeceased me, failed to qualify or is
not able or does not serve for whatever reason, I then appoint REBECCA R. HUGHES,
ESQUIRE to be the Executrix of my estate. If she has predeceased me, failed to qualify or is not
able or does not sene for whatever reason, I then appoint the senior partner of Irwin McKnight
& Hughes or its successor, whereby the substitute personal representative shall have the same
powers as the original Executor hereunder.
SEVEN. I nominate and appoint JAMES D. HUGHES, ESQUIRE, or if he is not
able or does not serve for whatever reason, REBECCA R HUGHES, ESQUIRE, or if she is not
able or does not serve for ���hatever reason, the then senior partner of Irwin McKnight and
Hughes or its successor to serve as Trustee of the trust created in Paragraph Four hereof.
EIGHT. I�To person(s) shall benefit hereunder unless such beneficiary shall survive
me by sixty (60) days.
�
NINE. No Erecutrix, Exeeutor, or Trustee acting hereunder shall be required to
post bond or enter security in this or any other jurisdiction.
TEN. I�`o beneficiary may assign or anticipate his or her interest in any income
or principal held or distributable hereunder; and no beneficiary's creditors may attach or
otherwise reach any such interest.
ELEVEN. The validity and administration of any trust established hereunder and any
question or disputes relating to the construction or interpretation of any said trusts shall be
governed and construed in accordance with the laws of the Commonwealth of Pennsylvania.
sr
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 3� day of
October, 200 L �
L� / ( EAL)
J S H C. BO�VEN
Signed, sealed, published and declared by the above-named person as and for a Last`Vill
and Testarnent, in our presence, who at said person's request, in said person's presence and in the
presence of each other have hereunto set our names as bscr' in witnesses.
-, �
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,
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!
�
5
ACKNO`�'LEDGMENT AND AFFIDAVIT
�`'E, JOSEPH C. BO`VEN, Ja�IES D. HUGHES and CHERYL L. CLELAND, the
testator and �vitnesses respectively, whose names are signed to the foregoin� instrument, being
first duly sworn, do h�reby declare to the undersi�ned authority that the testator signed and
executed the instrument as his Last Will, and that he had signed willingly, and that he executed it
as his free and voluntary act for the purpose herein expressed, and that each of the witnesses, in
the presence and hearing of the testator, signed the `Vill as a witness and that to the best of their
knowledge the testator was, at that time, eighteen years of age or older of sound rnind and under
no constraint or undue influence. �
,
, j
BOWEN
S D. HUGHES,;�
_r .J /,�;� . J ,�' ��" 1
CH��2YL L. CLELAND
COMMON�i'EALTH OF PENNSYLVANIA .
. SS:
COUNTI' OF CUNIBERLAND •
Subscribed, sworn to and ackno�lbefo e mef b eJAN1ES DOHUG S ad CHE� the
testator herein, and s�zbscribed and sworn Y „
L. CLELAND,�vitnesses, this ,�l-S� day of October, 2001. � � �
� � �� ��,���r;�
; � � �
tar ublic �
Notarial Seal
Jacqueline L. Drawbaugh,Notary Public
Cariisie Boro, Cumberland County
My Commission Expires Aug.14,2003
Mem�Ger.?er,ns��l�arna Asscciation ot Notaries
,., OM8 Approval No.2502-0265
�iiuli� A. Settlement Statement (HUD-1) FINAL
3�
1,Q FHA 2.Q RHS 3.❑Conv.Unins. 6.File Number: 7.Loan Number: 8.Mortgage Insurance Case Number:
2013-193 27011859 10-10-6-0652324
q.Q VA 5.Q Conv.Ins.
C.Note:This form is fumished to give you a statement of actual setUement costs.Amounts paid to and by lhe settlement agents are shown Items marked
"(p.o.c)"were paid outside the closing;they are shown here for informational purposes and are not included in the totats.
D. Name&Address of Borrower: E.Name&Address of Seller: F.Name&Address of Lender:
George D.Reilly,Jr. The Estate o(Joseph C.Bowen GMH Mortgage Services,LLC
911 Gobin Drive,Carlisle,PA 17013 7 Circle Drive,Carlisie,PA 17015 10 Campus Bivd.,Newtown SGuare,PA 19073
G. Property Location: H.Settiement Agent: I.Settlement Date:1 V08/2013
7 Circle Drive PA Real Estate Settlement Services,LLC Disbursement Date: 11/08/2013
Carlisle,PA 17015 354 Alexander Spring Road,Carlisie,PA 17015
Middlesex Township
Telephone:717-249-6333 Fax:717-249-7334
Place of Settlement: TitleExpress
354 Alexander Spring Road,Carlisle,PA 17015 Printed 1 V07/2013 at 1:08 pm
by KSC
100. Gross Amount Due from Borrower 400. Gross Amount Due to Seiler
101. Contract sales price 220,000.00 401. Conlract sales price 220,000.00
102. Personal ro ert 402. Personal ro ert
103. Settlement charges lo borrower(line 1400) 16,803.11 403.
104. 404.
105. 405.
Ad'ustments for items aid b seller in advance Ad'ustments for items aid b seller in advance
106. Cityltown taxes to 406. Citylfown taxes to
107. Countytaxes 11108/2013to 1213112013 105.77 407. Countytaxes 1110812013to 12/31/2013 105.77
108. Assessments 11108/2013 to 0613012014 1,148.15 408. Assessmenis 11108/2013 to 06/30/2014 1,148.15
109. 409.
110. 410.
111. 411.
112. 412.
120• Gross Amount Due from Borrower 238,057.03 420. Gross Amount Due to Seller 221,253.92
200. Amounts Paid b or in Behalf of 8orrower 500. Reductions In Amount Due to Seller
201. Deposil or earnest money 2,000.00 501. Excess deposit(see instruclions)
202. Principai amouni of new loan(s) 227,260.00 502. Setllemenl charges to seller(line 1400) 18,565.00
203. Exislin loa s taken sub'ect ro 503. Existin loa s taken sub'ect to
204. Borrower Paid Fee 495.00 504. payoff of first mortgage loan to Bank of America, 185,970.57
N.A.
205. Lender Credit 1,564.94 505. Payoff o(second mortgage loan
2� 506. Payment to the IRS 8,218.35
207. 507.
208. Seller Assislance 8,425.00 508. Seller Assistance 8,425.00
209. Termile Reimbursement 75.00 509. Termite Reimbursement 75.00
Ad'ustments for items un aid 6 seller Ad'ustments for items un aid b seller
210. Cityltow�taxes to 510. Cityltown tanes to
211. County laxes to 511. County taxes �o
212. Assessments to 512. Assessments to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
2�8 51A.
2�9 519.
�20 239,819.94 520. Total Reduction Amount Due Seller 221,253.92
Total Paid b lfor Borrower
300. Cash at Settlement iromlto Borrower 600. Cash at Settlement tolfrom Selier
3p�, Gross amount due(rom borrower(line 120) 238,057.03 gpt, Gross amount due lo seiler(line 420) 221,253.92
3p2, Less amounis paid bylfor borrower(line 220) 239,819.94 602. �ess reductions in amount due seller(line 520) 221,253.92
303. Cash ❑ From XQ To Borravrer �.�62•9� 603. Cash XQ To ❑ From Seller 0.00
eW����8 es per iesponse or w ec inY,revie.wiq.an re{w ing e a a. is aqmcy niaY'�o� � yuu are nu ieQu�re o c e
IMf fOlm!YnlesS�I E�splay3 e[��renlly vilM OMB„COn1�W numEe�s Na COnfMenl'iality ii assurtC:Ih�s Uiulosure is marWalory.Th�S is OesgneU lo proviCe I�e parlies to a RESPA wve�eG�ansaci�on wM iniarmalian dunnq i�e o
Seltlemenl protess.
uun_i
700. Total Real Estate Broker Fees $13,495.00 Pdid F�Om Pd id F�om
Divisionofcommission Iine700 asfoltows� Bort'Owef'S Selle�'s
701. $13,495.00 to P�udential Homesale FundS dt Funds at
7�2. 50.00 to Settlement Settiement
703. Commission paid al settlement 13,495.00
704. to
800. Items Pa able in Connection with Loan
801. Our origination charge (Includes Originalion Point 0.000°/a or S0.00) 5995.00 ((rom GFE#1)
802. Your credit or charge(points)for lhe specific interest rate chosen 5881.77 �from GFE�2)
803. Your adjusted origination charges ((rom GFE A) 1,87677
804. Appraisal(ee to GRU A raisals Associales,LLC (�rom GFE�3) 375.00
805. Credit report to Credit Plus (from GFE#3) 30.94
806. Tax service to lrom GFE#3)
807. Flood certificalion to from GFE x31
808. to
900. Items Re uired b Lender to be Paid in Advance
901. Daily interest charges from trom 1 110 8/2 01 3 to 12101l2013 @ 526.46181day (from GFE#10) 608.62
902. Mort a e insurance remium months to from GFE#3
903. Homeowner's insurance for 1 ears to Done al Mutal Insurance (from GFE#11) 819.00
904. VA Funding Fee for months to HUD (from GFE#3) 7,260.00 .
1000. Reserves De osited with Lender
1001. Initial deposit for your escrow account (from GFE#9) 839.58
1002.Homeowners insurance 3 months $ 68.25/monlh $204.75 �
1003. Mort a einsurance monihs $ Imonth
1004. Pro rt taxes monlhs $ /month
1005.County taxes 10 months $ 59.59/month �595.90
1D06.SchoolTaxes 6 months $ 148.61lmonth $89�.66 (
1007.Aggregate Adjustment $-852.73
1100.Title Char es
1101. TiUe services and lender's title insurance (rom GFE#4 1,891.50
1102. Settlement or closing fee lo �
1103. Owner's title insurance from GFE#5 150.00
1104. Lender's title insurance �1,765.00
1105. Lender's tiUe policy limit$227,260.00 Lender's Policy
1106. Owner's title policy limit�220,000.00 Owner's Policy
1107. AgenPs portion of the total title insurance premium $1,586.50
1108. Underwriter's porlion of the total tille insurance premium $328.50
1109. to �
1110. Doc Prep Fee to Salzmann Hu hes,P.C. 26�'�2
1200. Government Recordin and Transfer Char es
1201. Government recording charges $ �from GFE#7) 164.00
�2�2. Deed 367.00 Mort a e$97.00 Release$
1203. Transfer taxes $ (Irom GFE#8) 2,200.00
1204. CitylCounty lax/stamps Deed$2,200.00 Mort a e$
1205. State Tax/stamps Deed$2,200.00 Mort a e$ 2,200.00
1206. Deed$ Mort a e S
1300. Additional Settlement Char es
1301.Required services that you can shop for (irom GFE#6)
1302. Tax Certi(icalion to Salzmann Hu hes,P.C. 30.00
1303. WalerlSewer Bill to Middlesex Townshi 32.88
1304. Home Warranty toAHS 587.70
1305. Repairs to Wesle Woltz Construction 2,540.00
1306. Home Inspection to AI ha Home Ins ection $ $400.00 P.O.C.8'
,�� � , � 16,803.11 18,565.00
'Paid outside o(closing by(B)orrower,(S)eller,(L)ender,(I)nvestor,Bro(K)er."Credii by lender shown on page 1."'Credit by selier shown on page t.
_ , ., , uiin_�
Com arison oiGood Faith Estimate GFE and HUD-1 Char es Good Faith Estimate HUD-1
Char es That Cannot increase HUD•1 Line Number
Our origination charge ' # 801 995.00 995.00
Your credit or Charge(points)for lhe specific interest rate chosen # 802 881.77 881.77
Your adjusled origination cherges # 803 1,876.77 1,876.77
Trans�er taxes # 1203 2,200.00 2,200.00
Char es That in Tatal Cannot increase More Than 10°/ Good Faith Estimate HUD-1
Govemmeni recording charges p 1201 150.00 164.00
Appraisal(ee # 804 475.00 375.00
Credit report # 805 50.00 30.94
VA Funding Fee # 904 7,260.00 7,260.00
#
#
#
�
7,935.00 7,829.94
, �y -105.06 or -1.3240°/
Char es That Can Chan e Good Faith Estimate` HUD•1
inilial deposit for your escrow account q 1001 2,600.04 839.58
Daily interest charges from # 901 $26.4618/da 608.62 608.62
Homeowners insurance # 903 540.00 819.00
Title services and lender's tiUe insurance # 1101 1,870.00 1,891.50
q 1103 0.00 150.00
Owners title insurance p pp 400.00
Home Inspection p 1306
#
Loan Terms
Your initialloan amounl is _ 5227,260.00
Your loan term is 30.years
Yourinitial interest rate is 4.2500%
Your initial monthly amount owed for principal,interest,and any mortgage $1,117.98 includes
insurance is QX Principal
_ XQ Interesl
❑Mortgagelnsurance
Can your interest rate rise? XQ No. ❑Yes,it can rise to a maximum of %. The first change
will be on I I and can change again every years after I I . Every
change date,your interest rate can increase or decrease by %. Over the life of
the loan,your interest rate is guaranteed to never be lower lhan %or higher
_ _ than %.
Even i(you make payments on time,can your loanbalance rise? ❑X No. ❑Yes,it can rise ro a maximum oi$ •
Even if you make payments on time,can your monthly amounl owed for X❑No. ❑Yes,the first increase can be on / / and the monthly
pnncipal,inlerest,and mortgage insurance rise? amount owed can rise to$ •
The maximum it can ever rise to is$
Dces your loan havea prepayment penalty? �No. ❑Yes,your maximum prepayment penalty is$ •
Does your loan have a balloon payment? Q No. ❑Yes,you have a balloon payment of S due in
years on / !
Total monthly amount owed including escrow accounl paymenls ❑You do not have a monlhly escrow payment for ilems,such as property taxes
and homeowner's insurance. You must pay these items direcUy yourself.
❑X You have an additional monthly escrow payment o($276.45
lhat results in a total initial monlhly amount owed of$1,394.43. This includes principal,inlerest,ai
mortgage insurance and any ilems checked below:
QX Property taxes 0 Homeowner s insurance
�Flood insurance ❑
Q School Tax ❑
Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender.
uiin_i
_ _ _ __ . _ _
HUD CERTIFICATION OF BUYER AND SELLER
I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,it is a true and accurate statement of all receipts and
disbursements made on my account or by me in lhis transaction.I fuRher certify that I have received a copy of the HUDt Settlement Stalement.
�' D�/� `
t�_�
George D. eilty,J�
THE ESTAT 0 PH C.BOW N
The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this lransaclion.I have caused or will cause the funds to be
disbursed in accordance with this statement.
,��.s_ ` �' f1 � � �� �
- ' . � �1-^�
SETTLEMENTAGENT DATE
WARNING:IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM.PENALTIES UPON
CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT.FOR DETAILS SEE TITLE 18:U.S.CODE SECTION 1001 AND SECTION 1010.
1 1 1�
Name o(Borrower: Name of Seller: File Number
George D.Reiliy,Jr. The Estate of Joseph C.Bowen 2013-193
TiUeExpress
Prepared 11/07/2013 at 1:08 pm
Nocc: This page is fUrnishcd to givc you an itemization oF thc amo�tnts shown on Lincs 1i01, 1103 �nd P81C� F�Ofll P21C� Ff0171
1104 of thc Sctticment Statcmcn[ (HUD-I�. 'T'his pagc accvmpanics but is no[ a par[ of thc BOffOWBf�S S@��Bf�S
se[dement sta[ement.If a discrepancy exists,the information shown on the Setdemen[Statement FUf1dS 8t FUfIC�S at
(Fiu�-i),PP�;�S. Settlemenf Settlement
1100. Title Char es . Amounts included
9 in Line 1101
1101. Title services and lender's title insurance ��891•50
a. Overnight Mail 5 20.50
b.Wire Fee 12.00
c. Processing Fee 49.00
d. Notary Fee 45.00
$ 126.50
1102. Settlement or closing fee
1103. Owner's title insurance (policy) $ 150.00 150.00
1104. Lenderstilleinsurance (policy) 1,540.00 $ 1,765.00
a. Endorsement 900 EPL-Residential 50.00
b. Endorsement 100(No Violation) 50.00
c. Endorsement 300 Survey 50.00
d. Closing Service letter 75.00
(Tota11103+1104) g g���QQ
1105.'Lenders title policy limit Sz27,260.00
1106.;Owners title policy limit 5220,000.00
1107.!Agent's portion oi the total title insurance premium :$ 1,586.50
1108: Underwriter's portion of the total title insurance prem. 328.50-
; �Tocari�o�+>>oa) �Q
��os.
i�io.
>>>�.
��iz.
�
Total : = 6orrower �Borrower Seller
1100.�Title Char es with Pa ee �-Char�e ' ��POC or Credit Line 1101 ��'� ���Paid
1101. Title services and lender's litle insurance g
a. Overnight Mail to Salzmann Hughes,P.C. 20.50 20.50
b. Wire Fee to PA Real Estate 12.00 12.00
c. Processing Fee lo Salzmann Hughes,P.C. 49.00 49.00
d. Notary Fee to Kamela Cornman 45.00 45.00
1104. Lenders title insurance to Stewart Title GuarantylPA RE SS 1,765.00 1,765.00
- $` 1,89L50 ;1,891.50
THE ES PH C.BOWEN
y � ° � Date 11/8/13 �! ' Date 11/8/13
Geor e .Reilly,Jr.
t3a11 (:orp., IiLL Historical Quote - (NYSE) BLL, Ball Corp. Stock Price - BigCharts.com Page 1 of 1
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r' ' CLAIM FORM FOR UNEXCHANGED HARLEYSVILLE GROUP INC. ± r� `'�
�ND TO: ALLIANCE SHAREHOLDER COMMUNICATIONS,P.O.BOX 1942 SOUTH HACKENSACK,NJ 076d6-9986
{�
TE: � MULTIPLE Signatures are required. Failure to sign ail necessary boxes may result in rejection of account.
p?� A—Name and Address of Registered Holder(s) I30\ t3 —Complete ONLY if you need to change the
*Please make address changes in Box B address on the account
Address:
AccountlD:'0101000316 Total Shares: 172.77
DONNA BOWEN& C1Y�':
JOSEPH C BOWEN JTTEN Certificated:0
847 LINDSEY RD Electronic: 172.77 State:
CARLISLE,PA 17015-9223
3400552129 �ip:
BOh C: Signature of Registered Shareholders
This Claim Form must be signed by all registered owners exactly as it appears in the registration. Failure to do so will delay the
processing of your exchange. If one or more owners is deceased, the other(s) must sign and provide an inheritance tax waiver(s) if
required by the decedent's state of residence. If a tax waiver is not required, please provide a copy of the death certificate. If you
are signing for someone else OR for a change in registration, a Signature Medallion Guarantee is required. *Please note, a
Notary Public stamp is unacceptable.
I,the undersigned,agree to the terms and conditions described in the Letter and Questions and Answers from Nationwide Mutual
Insurance Co.dated October 7`�',2013. I acknowledge that a$6.00 processing fee per share of HGI common stock will be paid to
Alliance Shareholder Communications("Alliance")(by means of a deduction from my cash proceeds)as compensation for
Alliance assisting me with this special exchange effort.
If you are not in possession of some or all of the HGI stock certificates listed in Box A, the missing certificates will be declared
lost. Your signed authorization below (i) acknowledges your agreement to place stops on those certificates and (ii) evidences your
agreement with the terms and conditions for the replacement of lost certificates. Depending on the value of the lost certificates,
additional documentation may be required.
Affidavit for the Replacement of Lost Stock Certificate(s): By signing this authorization form, I certify tha± I am the lawful
owner of the above/below described certificate(s). The certificate(s) has not been endorsed, transferred, assigned, pledged or
otherwise disposed of. I have made a diligent search for the certificate(s)and have been unable to find it,and make this affidavit for
the purpose of inducing the exchange of the certificates(s) without sunender of the certificates(s). I hereby agree (for myself, my
heirs, assigns and personal representatives)to indemnify, protect, and hold harmless Wells Fargo Bank N.A.(and its successors and
assignees), and Harleysville Mutual Insurance Co. (and its successors and assignees), from all liabilities, ]osses, damages and
expenses, including court costs and attorneys fees, which it may incur by reason or account of assuming liability under the
indemnity bond account number 7132722 with Travelers Casualty and Surety Company of America. I hereby agree to surrender the
certificate(s)for cancellation should I, at any time, find the certificate(s).
Q RECEIVE CASH DUE ME (SUBTRACT THE PROCESSING FEE AND ANY LOST FEE
FROM THE CASH D ME)
E ate ph C. Bowen
� X Executor X
gnature Co-Signature
ames D. ghes, Executor 717-249-6333
(TURN �'ER T U�IPLETE FOR'tl) Daytime Phone Number:
_
• • �
Nat �on
WIC��
� Insurance
IMPOItTANT NOTIC� FOR HOLD�RS OF UN�XCHANGI:ll SHAR�S OF
HARL�YSVILL� GROUP INC.
f
October 7`�', 2013
Dear Sharel�older:
In May 2012, Harleysville Group Inc. (HGI) was acquired by Nationwide Mutual Insurance
Co. (Nationwide). As a result of the acquisition, your shares of HGI common stock have been
converted into the right to receive $60.00 cash for eacl� share of I�GI common stock you held at the
time of the acquisition. The number of shares of HGI common stock you held is indicated in Box
A on the attached Claim Form.
At various times since May 2012, we have delivered to you a letter of transmittal with instructions
on how to send in your HGI stock certificate(s) in exchange for the cash proceeds due you. Since
our records indicate that you have not yet exchanged your shares of HGI common stock, we have
asked Alliance Shareholder Communications LLC (Alliance), a third party shareholder solicitation
firm, to contact you and offer to assist you with the exchange process and claiming your cash
proceeds. To claim your cash, you may complete the Claim Form and return it along with your
certificate(s) in the envelope provided. Even if you liave /ost your certificcrte(s), you may stil!
participate in tliis volctntary program.
If you elect to have Alliance assist you, a processing fee of$6.00 per share of HGI common stock
will be deducted fi•om your proceeds and paid to Alliance. If you cannot locate your stock
certificate(s), a lost certificate fee of$1.20 per sllare of HGI common stock will also be deducted
from your proceeds. Nationwide will receive no portion of these fees.
Please note that the proceeds to which you are entitled cannot be sent to you Luitil you surrender
. your old certificate(s) or a lost certificate affidavit has been properly executed. It is i»zportant tl:at
you exchange your stock certificates as soon as possible. Failici•e to do so ivitliin a tin:ely
manner niay result in you�• procee�ls being tau�ned over to state nartlrorities u��der applicable
aba�t�ioned pr•operty laivs.
Please read the enclosed materials cai•efull�y. Alliance is being permitted to administer this
notification program through November 18t', 2013. If you have questions after reading these
materials, call Alliance toll-free, at 1-877-777-2101, 9am to Spm EST for assistance.
Sincerely,
Name
Nationwide Mutual Insurance Co.
Pall Corp., PLL Historical Quote - (NYSE) PLL, Pall Corp. Stock Price - BigCharts.com Page 1 of 1
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USA
Federal Credit Union°
August 16, 2013
James Hughes, Esq. - Salzmann Hughes, P.C.
354 Alexander Spring Road, Suite 1
Carlisle, PA 17015
,�ear Jamc-s r�ughes, �sq.:
RE: Account# 163795 Joseph C Bo�ven
In response to your rccent inc�uiry rcgardin� accounts held by Joseph C Bowen;
1. Date account was established: February 15, 1980.
2. No change of ownership ar registration of the account within one year prior to the date
of death.
3. No accounts closed within one ycar prior to the date of death.
4. Interest accrued to date of death for the calendar year is $0.02.
5. On the date of death thc total balance was $ (7,394.16). Following is a balance by cach
account: 000016379�-S10: $45.05; 0000163795-L11: $ (3,903.84); 0000163795-570:
$4,943.85; 0000163795-Visa: $ (8,479.22).
If you have any questions, please contact me at 1-800-525-9094 or in Anchorage at
907-563-4567, extension 2714. My office hours are 9:00 a.m. - 5:30 p.m., Monday through
Fridav.
Sincerely,
�
Christin Garncr
Account Support Coordinator I1
P.O.Box 196613 • Anchorage,Alaska 99519-6613
Phone(907)563-4567 • (800)525-9094 outside Anchorage • (800)742-7084 TTY/Hearing Impaired • www.alaskausa.org
� , I
, 1 � I
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OJ:tili(flin t o wn
PO BOX 96
NIIFFLINTO`�'N PA 170�9
RESPONSE TO ACCOUNT INQUIRY
TO: James D Hughes, Esquire
DECEDENT: Joseph C Bowen DATE OF DEATH: 07/08/2013
SOCIAL SECURITY#: 241-74-3544
We held account s) in which this decedent had an interest at the time of his/her death as follows:
ACCOUNT OWNER (S): Joseph C Bowen
Type of Account : Individual Checking Account#: 1123884
Principal Balance at D.O.D: $ 3328,62 Interest Rate: 0.1000%
Original Opening Date: 09/O1/2000 Interest to DOD: $ 0.09
ACCOUNT OWNER(S):
Type of Account: Account#:
Principal Balance at D.O.D: $ Interest Rate: %
Original Opening Date: Interest to D.O.D: $
ACCOUNT OWNER(S):
Type of Account: Account #:
Principal Balance at D.O.D: $ Interest Rate: %
Original Opening Date: Interest to D.O.D: $
Penalty is waived on ' wal of decedent's fund before maturity. Yes No
Safe Deposit Box: Yes No [ @ Loy�ville Office, paid through e 013]
' Financia Co . stock or other securities: Yes No
First Communrty �
Trust Dept. Accounts: Yes No
� 't�/ ,� � ��,��,.x� � t'[���� �'� �� � ��� —
,t� • ' . . .
Authorized 'gnature/Title Date ,
���z�x�co-�
� R
08;'30i?013
Salzmann I-lu��he,, P.C.
Jam�s D. ��Iu�.;h�s. Lsq.
3�=� Al�xand�r Sprin�, Ri���ii, Suite 1
Carli�le. P_�� 1701�
Re: JO�i.r`ri �Ai�cOLi. FsOvJEi�, Deceasecl.
PSECU Reference# 1835204113378
Dear Attorney Hughes:
The above referenced person has an account with PSECU which was opened on
November 16, 2009. The Share accounts were individually held by JOSEPH CARROLL
BOWEN. The Visa loan was individu��lly held.
The following are the Date of Death Balances for JOSEPH CARROLL IiOWEN's account
with PSECU:
Account Date of Death Balances Interest—July 1-8
Shares:
(Sl) Savings $54.55 $0.00
Loans:
(L9) Visa Loan �?��•��
The account has been closed per your request and a check totalin�the share balance will be
sent to your oftice.
If the Estate has sufficient funds to payoff the decedent's Visa loan,please remit a check,
made payabie to PSECU. If there are not sufficient funds to pay off this loan,please submit
a letter of insolvency alonb with supporting documentation such as a final inheritance tax
return and tinancial accounting.
If you have any questions, please contact our departinent toll-free at(800)237-7328,press 6,
extension 3120 or email accountservices[upsecu.com.
Sincerely,
, � ,,1 "�
? �fI LL�/���t�/`'�`/
.✓-i l,.
andy Fa�ley � �
Member Service Representative
PSECU
Pennsylvania State Employees Credit Union
1 Credit Union Place, P.O. Box 67013, Harrisburg, PA 17106-7013 • 800.237.7328 • »psetu.COm
.
he �� oFL�, r�c�� s]�ur ESTABLISHED 1903
� �
�
P.O. BOX 179 • LANDISDUI�G, P,q 17040
Bank records indicate the following account
balances on �/a/2013 for
Bowen, Joseph C. SS # 241-74-3544
7 Circle Drive
Carlisle PA 17013
Balance
Acct Sole Jt Acct Account Prior to Interest Accrued
Opened Ownership With Number Tvqe Interest Bearin Interest
12/6/2000 Yes 0714534 DDA 82.25 No
068495390 Passbook
12/6/2000 Yes Savin s 113.34 Yes .02
BY
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REDDING AUCTION SERVICE 34280
C. DAVID REDDING, AUCTtONEER
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Attorneys at Lc�iv
354 Alexander Spring Road, Suite 1 6/30/2014 27400
Carlisle, PA 17015
Joseph C. Bowen Estate
Hrs/Rate Amount
7/9/2013 TSS Return PC for JDH to Jen Greanias/father's passing/set Meeting 1.80 270.00
w/client/discuss estate matters w/JDH 150.00/hr
JDH Confer w/TS/Initial Meeting w/Client/Estate Matters 2.25 787.50
350.00/hr
7/10/2013 TSS Meeting w/Jen & Erin obtain information for the estate 2.00 150.00
7/11/2013 TSS Email JDH/discuss meeting with clients/PC to Jen/Erin discuss estate matters 0.90 135.00
w/a foltowup email 150.00/hr
JDH Review/TS/emaiUEstate Matters 0.60 210.00
350.00/hr
7/12/2013 TSS PC from JDH dicuss estate matters/email to Jen and Erin update estate 1.10 165.00
matters 150.00/hr
JDH PC/TS/discuss Estate Matters 0.80 280.00
350.00/hr
7/15/2013 TSS Meeting with Jen and Erin follow up on estate matters/prepare beginning 5.70 855.00
estate memo with assets, debts, all other pertinent info/prepare probate 150.00/hr
docs/date of death Itrs
7/16/2013 TSS prep for meeting w/JDH/complete informational estate memo/discuss 7.50 1,125.00
w/JDH/email estate questions to Jen and Erin/travel w/JDH to house to view 150.00/hr
household goods/discuss w/JDH procedure for sale
JDH Confer w/TS/RF/ House Visit/ Rev of assets/Liabilities/RF 350.00/hr 1,785.00
7/17/2013 TSS Discuss Real Estate/value with Trish Negley/PC to Dave Redding 2.30 345.00
appraisal,sale of household goods/to storage facilities/to Hilton's Lock Service 150.00/hr .
JDH Confer w/TS/Estate issues/PCs re: same 9.10 385.00
350.00/hr
7/18/2013 TSS Discuss storage units w/Jeremiah NegleylPC from Jen and Erin discuss 3.00 450.00
estate matters/PCs to storage facilities/emails to Jen and Erin update's/PC 150.00lhr
from Dave Redding discuss pers. prop. appraisal/sale/PC to USAA home&
auto insurance/prepare Itr to USAA
Joseph C. Bowen Estate Page 2
Hrs/Rate Amount
7/19/2013 TSS PC to Computershare discuss security redemption/to house to prepare for 3.00 450.00
real estate listing 150.00/hr
7/23/2013 TSS PC to Life ins. Co. report death/Email Erin/Jen RE: death certs & Life Ins 4.30 645.00
infoNiew paperwork found at house 150.00/hr
7/24/2013 TSS PC from Harleysville Pension/emails to Jen, Erin and JDH estate matters/Talk 1.70 255.00
with Tricia Negiey RE real estate value 150.00/hr
JDH Review/TS/Email/Real Estate matters/PC to T. Negley 1.10 385.00
350.00/hr
7/29/2013 TSS Preparation for Meeting with JDH/review estate matters with JDH 1.50 225.00
150.00/hr
JDH Meetings w/TS/Site Visit/Reviewing issues/ RF e: same/Meeting w/ 3.90 1,365.00
Realtor 350.00/hr
7/30/2013 TSS Prepare estate docs for JDH/emails to Erin, Jen, JDH/update PA Inheritance 2.50 375.00
tax return 150.00/hr
JDH Meeting w/TS/Estate issues/PC w/J. Negley/Meeting w/T. Negley/ RF 2.85 997.50
re: same 350.00/hr
7/31/2013 JDH Meeting with TS/house/conf call with daughters/estate matters/IRS/rf 2.75 962.50
350.00/h r
TSS prepare for Conf call with JDH/Jen/Erin; Conf cali review estate matters; PC's 425 637.50
to Utility companies cancel services; PC's to various loan companies report 150.00/hr
death/deposit
8/1/2013 TSS Continue work on estate matters 4.00 600.00
150.00/hr
JDH Meeting w/TS! RF re same 1.30 455.00
350.00/hr
JMN Email to/from JDH &TS re: Judge/Confer w/T. Negley/ RF 0.40 60.00
150.00/hr
8/7/2013 TSS PC's to Landisburg Bank, AlaskaUSA, PennState Hershey RE: estate 5.60 840.00
information; Meeting with JDH discuss estate matters/Prepare estate 150.00/hr
Itrs/email to Erin with response/update estate asset information
JDH Confer w/TS/Estate Matters 1.90 665.OQ
350.00/hr
8/14/2013 TSS PC from JDH update estate matters/PC to Mifflinton Bank RE: safe deposit 5.00 750.00
box, ckg acct/update estate acctg entries/continue going through paperwork 150.00/hr
for important documentation
JDH PCS/TS/Estate Matters 0.75 262.50
350.00/hr
8/19/2013 TSS Phone calls to Utility Companies address change/AlaskaUSA bank info/First 3.00 450.00
Nat Bk of Mifflintown set safe dep box appt/process maiVwrite checks 150.00/hr
Joseph C. Bowen Estate Page 3
Hrs/Rate Amount
8J20/2013 TSS Phone calls to Dish/Computershare (Ball Corp)/Dave Redding Auctioneer/Fay 3.50 525.00
Hain(VWPassat potential sale)/Dave George (VWTHING potential 150.00/hr
sale)IUSAA Insurance/prepare Itr to Dish/discuss estate matters with
JDH/process mail/filing
JDH Confer w/TS/Estate Matters 1.20 420.00
350.00/hr
8/21/2013 TSS Meeting w/Dave Retting, Auctioneer discuss HHG's sale/discuss estate 150.00/hr 525.00
matters with JDH
JDH Confer w/TS/Personal Sale/Estate Matters 1.10 385.00
350.00/hr
8/23/2013 TSS respond to emaii from Jen/research unclaimed property 0.60 90.00
150.00/hr
JDH Meeting w/TS/ Est. Issues/house/ Research !Taxes 1.90 665.00
350.00/hr
8/26/2013 TSS Travel with JDH safe deposit box inventory/review real estate agreement and 150.00/hr 435.00
other estate matters with JDH/phone call to realtor
KAR Confer w/TSS/ RF re send Itrs. to 9 credit card companies. 0.70 105.00
150.00/hr
JDH PCs w/T. Negley/Contract/ Rev of Same/ Lock Box inventory/Loysville/ 4.35 1,522.50
Meeting w/T. Negley/ Estate issues/RF/Personal Items/Taxes 350.00/hr
8/27/2013 JMN Confer w/JDH/Review contract/ Counter Offer/ RF 0.80 120.00
150.00/hr
JDH Meeting w/TS/ PCs to IRS/RF re: same 1.10 385.00
350.00/hr
8/28/2013 TSS Phone call's to Dave Redding, Auctioneer/Jennifer at AAFMAA/prepare Ball 3.60 540.00
Corp stock docs for redemption/write cks/update memo/research internet for 150.00/hr
other potential securities/prepare FedEx mailing
JDH Confer w/TS/ IRS/ Land Issues/RF 1.70 595.00
350.00/hr
8/29/2013 TSS foCms o Erinn&Jen/PC t pComputersha e/pr cesste ate clhe ks/filing update 150.00/hr 360.00
estate info list
9/1/2013 TSS Meeting w/JDH/IRS issues/Land Deal 1.30 - 195.00
150.00lhr
1.90 665.00
JDH Meeting w/TS/ IRS Issues/Land deal/Meeting at Orrstown Bank 350.00lhr
0.60 210.00
9/4/2013 JDH Confer w/JMN/Real Estate inspection/RF 350.00/hr
Joseph C. Bowen Estate Page 4
Hrs/Rate Amount
9/6/2013 JMN PCs to/from T. Negley Re: Reply to Inspection/Confer w/JDH re: same/RF 0.50 75.00
150.00/hr
9/9/2013 TSS Phone call from David Redding Auctioneer discuss HHG's sale 0.25 37.50
150.00/hr
9/10/2013 JDH Meeting w/TS/ PCs to IRS/Claims/Lien/ RF 1.80 630.00
350.00/h r
TSS Prepare for Meeting w/JDH/PCs to IRS/Claims/Lien 2.10 315.00
150.00/h r
9/11/2013 JMN Confer w/JDH /Emails to/from T. Negley re: Reply to Inspection / PC to T. 0.60 90.00
Negley re: repairs 150.00/hr
JDH Confer w/JMN /Agr of Sale/RF/IRS issues 0.60 210.00
350.00/hr
9/16/2013 JDH Confer w/TS/IRS/ House/ RF 0.50 175.00
350.00/hr
TSS Prepare for Meeting w/JDH/PCs to IRS/House 1.20 180.00
150.00lhr
9/26/2013 TSS phone call to Dave Redding discuss HHG auction/phone call to VW 1.40 210.00
Credit/discuss estate matters with JDH/write checks 150.00/hr
JDH Meeting w/TS/ House/Car/ Estate matters/ IRS/Auction Agr/RF 1.75 612.50
350.00/hr
9/27/2013 JDH PCs w/IRS/Confer w/TS/ RF 1.65 577.50
350.00/hr
TSS Confer w/JDH/IRS 1.70 255.00
150.00/h r
9/30/2013 TSS Discuss IRS tax lien with JDH and KC/prepare IRS discharge lien docs/phone 1.80 270.00
call to VW CrediUdeposiUfiling 150.00/hr
10/2/2013 J DH Confer w/TS! RF re; same 0.85 297.50
350.00/hr
10/3/2013 TSS phone call VW Credit/write checks/ltr to VW Creditlprepare FedEx/discuss 1.50 225.00
estate matters with JDH 150.00/hr
JDH Confer w/TS/ IRS/Escrow Agr/DHM / RF 0.90 315.00
350.00/hr
10/4/2013 JDH Rev of IRS filing/Confer w/TS/ Household goods/RF re: same 1.10 385.00
350.00/hr
TSS Discuss household goods w/JDH/IRS 1.10 165.00
150.00/hr
10/16/2013 JDH Meeting w/TS/T. Negley/ Est issues/house/IRS 1.35 472.50
350.00/hr
Joseph C. Bowen Estate Page 5
Hrs/Rate Amount
10/16/2013 TSS Prepare for Meeting w/JDH/estate issues/house/IRS 1.70 255.00
150.00/h r
10/18l2013 JDH Confer w/TS/IRS/ RF 1.40 490.00
350.00/hr
TSS Discuss w/JDH/IRS 1.40 210.00
150.00/hr
10/23/2013 JDH PC to IRS/T. Negiey/RF re: same 0.90 315.00
350.00/hr
10/24/2013 TSS phone call to Computershare for sale of Balt Corp. 0.30 45.00
150.00/hr
TSS Gather information for IRS lien 1.25 187.50
150.00/hr
JDH Draft corr to IRS/Meeting w/TS/ RF re; same 1.10 385.00
350.00/hr
10/29/2013 JDH Confer w/TS/ PC to IRS/T. Negley/ House/ Lien/ RF 1.00 350.00
350.00/hr
TSS Prepare for Meeting w/JDH/House/Lien/Estate matters 1.30 195.00
150.00/hr
10/30/2013 JDH Confer w/TS/ IRS lien / RF/ Estate matters 0.75 262.50
350.00/hr
11/5/2013 JOH Confer w/TS/Meeting at Orrstown/Confer w/KC 1.00 350.00
350.00/hr
11/7/2013 TSS email Erin and Jen to set conference call time 0.40 60.00
150.00/hr
11/8/2013 JDH Confer w/T. Negley/Settlement of property/Ltr to IRS/ RF 1.50 525.00
350.00/hr
11/12/2013 TSS Phone call to USAA cancel homeowners insurance 0.25 37.50
150.00/hr
JDH Confer w/TS/Insurance claim/PCs w/Green Tree/J. Negley/ RF 1.10 385.00
350.00/hr
11/13/2013 JDH Confer w/TS/PCs/w Beneficiaries/RF 0.90 315.00
- 350.00/hr
TSS Confer w/JDH/Pcs w/beneficiaries 0.90 135.00
150.00/hr
12/12/2013 JDH Confer with TS/IRS issues/rf re same 0.50 175.00
350.00/hr
12/13/2013 TSS Discuss Estate matters with JDHIPrepare Itr to George Coldren/prepare Itr to 0.70 105.00
IRS 150.00/hr
Joseph C. Bowen Estate Page 6
Hrs/Rate Amount
12/17/2013 JDH Confer with TS/pc to G. Coidren/prep affidaviUrf re same 1.10 385.00
350.00/h r
TSS Confer w/JDH/Pcs to G. Coldren/Affidavit 0.80 120.00
150.00/hr
12/23/2013 TSS Phone call to Fidelity Destiny Plan discuss share account/filing 0.25 37.50
150.00/hr
12/31/2013 JDH Meeting with J. Negley/travel to Shuman/transfer of guns/rf re same 1.65 577.50
350.00/hr
TSS Call from Dave Redding discuss estate personal property sales 0.40 60.00
150.00/hr
1/2/2014 TSS Call from Faye Hain discuss pers. prop. sale/send Dave Redding advertising 1.00 150.00
info/process mail/update estate bank ledger 150.00/hr
1/9/2014 JDH Meeting w/Orrstown/guarantee/Confer w/TS 0.90 315.00
350.00/hr
TSS Confer w/JDH/signed documetns/expedite 0.60 90.00
150.00/hr
2/5/2014 JDH Confer w/TS/ Estate sale I estate issues/ RF 0.90 315.00
350.00/hr
TSS Prepare for Meeting w/JDH/Estate salelEstate Issues 1.30 195.00
150.00/hr
2/7/2014 JDH Confer w/TS/ RF re: same 0.65 227.50
350.00/hr
TSS Confer w/JDH/Estate Issues 0.65 97.50
150.00/hr
2/17/2014 TSS Confer with JDH and Dave Redding, Auctioneer RE: househoid goods sale 0.50 75.00
150.00/hr
TSS Confer w/JDH/Household goods sale 0.50 75.00
150.00/hr
2/18/2014 TSS Conf call with JDH/Steve Kovesek with IRS 0.25 37.50
150.00lhr
JDH PC w/Steve K/Confer w/TS/ PCs to D. Redding /RF re: same 1.10 385.00
350.00/h�
2/19/2014 TSS Process first household goods sale/Bali Corp sale/deposit check/update 0.50 75.00
accounting 150.00/hr
JDH Confer w/TS/Estate issues/RF 0.90 315.00
350.00/hr
2/20/2014 TSS Phone call to AAFMAA and ReMax Ist Realty/RE: tax information received 0.25 37.50
150.00/hr
Joseph C. Bowen Estate Page 7
Hrs/Rate Amount
3/18/2014 TSS Call to Dave Redding Auctioneer discuss auction results 0.20 30.00
150.00/h r
3/19/2014 TSS Gather 2013 tax information for Pat Rosendale CPA to prepare 0.70 105.00
returns/copies/memo 150.00/hr
3/20/2014 TSS Discuss income tax return preparation with Pat Rosendale CPA 0.25 37.50
150.00/hr
4/8/2014 JDH Meeting w/TS/Property Sale/Rev of corr/IRS/lien/RF re;same/Refund 0.70 245.00
350.00/hr
4/9/2014 TSS Prepare for Meeting w/JDH/Property Sale/Rev. Corr/IRS/lien 1.20 180.00
150.00/hr
4/14/2014 JDH Confer w/TS/Estate sale/RF 0.35 122.50
350.00/hr
4/25/2014 JDH Confer w/TS/Property sale/IRS/PA 1500 0.80 280.00
350.00/hr
TSS Conferw/JDH/Property Sale/IRS/PA1500 0.80 120.00
150.00/hr
5/22/2014 JDH Confer w/TS/Property sale//RF 0.40 140.00
350.00/hr
5/28/2014 TSS Call from Dave Redding Auctioneer/Property Sale 0.25 37.50
150.00/hr
5l29/2014 TSS Review estate matters w/JDH/Call to IRS Steven Kovscek/update estate 1.30 195.00
filing/calls to medical entities 150.00/hr
JDH Confer w/TS/personal property/PA Inher Return 0.35 122.50
350.00/hr
5/30/2014 TSS Deposit proceeds fromsale of personal property/update check registeNPA 0.80 120.00
Inheritance tax 150.00/hr
6/16/2014 JDH Conferw/TS/return/rf 0.40 140.00
350.00/hr
6/20/2014 TSS Work on finalization of PA Inh. tx return 3.80 570.00
150.00/hr
6/26/2014 TSS Meeting with client to review status w/JDH/rev revised returnlestate 1.50 225.00
issues/Continue work on finalizing return 150.00/hr -
JDH Meeting w/TS/rev of revised return/estate issues/rf re 1.10 385.00
350.00/hr
6/27/2014 TSS Update corrections to PA REV 1500/Draft Acctg 2.30 345.00
150.00/h�
JDH Confer w/TS/Initial Meeting with client/estate matters 1.30 455.00
350.00/hr
Joseph C. Bowen Estate Page 8
For professional services rendered 190.80 $42,770.00
Balance due $42,770.00
Please include invoice number and remit payment to address listed above. Thank you for your prompt payment. if you have
any questions concerning your invoice please contact Kandy Coyle at 717-249-6333
,..------.'
T�AL �t�'
�,�'�� � DEPARTMENT OF THE TREASURY
z c INTERNAL REVENUE SERVICE
. r--� ;' Washington, D.C. 20224
s�1�v IG`v
SMALL BUSINESS/SELF-EMPLOYED DIVISION 1000 LibertyAve, Room 704
Pittsburgh, PA 15222
Fax No. (412)395-5291
James D. Hughes, Esquire Date: 12-9-2013
Administrator, Estate of Joseph C. Bowen, Dec'd
Salzmann Hughes, P.C. Person to Contact: Steven Kovscek
354 Alexander Spring Road Badge: 0212570
Carlisle, PA 17015 Telephone No: (412) 395-4667
Re: 7 Circle Drive, Carlisle, PA 17015
Lien Nos. 12-2754 FTL
Dear Mr. Hughes:
This is to acknowledge receipt of a check in the amount of$8,218.35 for an Application for
Dischazge of Notice of Federal Tax Lien in the above referenced matter.
Enclosed is/are the Certificate(s) you requested.
In order to reflect the relief requested, the discharge certificates must be filed in the Prothonotary
Office where the original liens are recorded.
If there are any further questions regarding this matter, please feel free to contact the person
whose name and telephone number is noted above.
Sincerely,
Steven Kovscek
Advisor
Enclosure
F669-(B)
Form 10492 Department of the Treasury-Internal Revenue Service Escrow or pocket Number
(Rev. November 2007) Notice of Federal Taxes Due
21-13-0819
To (Name of Escrow Holder,Agent of Taxpayer or Fiduciary)
Amount due
SALZMANN HUGHES, P.C. ATTN: JAMES HUGHES, EXECUTOR �39,484.87
Address (Numbe� Street,P.O. Box, City, State, Zip code)
354 ALEXANDER SPRING RD, SUITE 1
CARLISLE, PA 17015
You are hereby notified that there is now due, owing,and unpaid from --(Name and Address of Taxpayer)
JOSEPH C BOWEN, DEC'D
7 CIRCLE DRIVE, CARLISLE, PA 17015
to the United States of America,the sum of Thirtv-nine thousand, four hundred eiQhtv-four and eiqhty seven hundredths
for Internal Revenue taxes secured by a lien pursuant to Internal Revenue Code(IRCJ Sections 6321 and 6322,or the Estate Tax Lien
arisin under IRC Section 6324, from the date of each assessment.
Kind of Tax Taxpayer EIN or Assessment Unpaid Accrued Late
and Period SSN Date Assessed Balance Accrued Interest Payment Penalty TOTAL
1040 12/31/2007 xxx-xx-3544 06/O6/2011 $30,551.09
$1,920.24 $0.00 $32,471.33
1040 i2/31/2009 xxx-xx-3544 02/20/2012 $6,485.47
$96.12 $0.00 $6,581.59
1040 12/31/2012 xxx-xx-3544 08/12/2013 $413.99
$5.90 $12.06 $431.95
Date after which additional interest will
be char ed 01/31/2014 Dated at Pittsburqh, PA this 10th day
Date after which applicable late payment
penalty will be charged 01/31/2014 of December, 2013
If a Notice of Federal Tax Lien(s) has been recorded,a Certificafe of Re/ease of Federal Tax Lien will be filed immediately only if
payment is made in cash or by either a certified, cashier's, o�treasurers check. The check must be drawn on any bank or
trust company incorporated under the laws of the United States, or of any state orpossession of the United States.
Payment a/so can be made by a Unifed States postal,bank, express,or te/egraph money order. If you pay by personal
check, issuance of the certificate of release will be delayed until the bank honors the check.
Caution to Fiduciaries: A representative of a person or an estate(except a trustee acting under Title 11)paying any part of a debt of
the person or estate before paying a claim of the Government is liable to the extent of the payment for unpaid claims of the
Government. (31 U.S.C. §3713)
Please make payment payabie to United States Treasury and send it to the Internal Revenue Service at the address below.
By(Name) 4 � _ Title ID Number Telephone number
STEVEN J KOVSCEK �� ADVISOR 0212570 (412)395-4667
Address(Number, Street P.O.Box,City,State,Zip code) Signature
Internal Revenue Service
1000 LIBERTY AVENUE
PITTSBURGH, PA 15222-4004000
ATTN: STEVEN J KOVSCEK 2297-6931 STEVEN J KOVSCEK
Catalog Number 65710D Form-10492(Rev. 11-2007)