HomeMy WebLinkAbout09-17-15 (2) � 1505610105
REV-1500 EX(oz-xi)(FI) �:
PA Department of Revenue pennsyl�ania oFFIC1AL uSE oNLY
�F�^A,MF•� F^E�t��F County Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 280601
Harrisburg,PA 1�i28-o6oi RESIDENT DECEDENT :�� 1�� �����J
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
04/09/2015 ' 03/23/1933
DecedenYs Last Name Suffix Decedent's First Name MI
Brown ' ' ' ' Mary E
(If Appiicable)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
(� 1. Original Return p 2.5upplemental Return p 3. Remainder Return(Date of Death
Prior to 12-13-82)
p 4. Limited Estate p 4a. Future Interest Compromise(date of p 5. Federal Estate Tax Return Required
death after 12-12-82)
� 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust _ 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credii(Date of Death O 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
Andrew C. Sheely, Esquire ',717-697-7050
REGISTER OF WILLS USE ONLY
First Line of Address
127 South Market Street '
J
�.. ... . .... .. .. . . . ..... .. ......... ......... ......... . ....... .... ..... .... ..... ...... ... ... ... �""� C.-:,:)
Second Line of Address � O v-� r` 3'�
P.O. Box 95 `� ,-�, � ' �:�?
...
City or Post Office State ZIP Code i3A7�fIL`Eb � , '`a
, .
Mechanicsburg PA ' 17055 _ , , ..� .._,
_ _ ._ J,
� ' ;;�
CorrespondenYs e-maii address:andrewc.sheely@verizon.net ;`=,
►--_
Under penalties of perjury,I dedare that I have examined this return,inciuding accom nying schedules a d state ents,and to the best of my knowiedge and'belie,T
it is true,correct and complete.Declaration of preparer other than the personal repr ent ti is based II i ation of which prepar r has an wledg�. ����
S NATU E O�PER�N RESPONSIBLE FOR FILING RETURN ATE � ' � /
/l;l�.�
�it✓,-- �L.�
A DR SS
oseph D. Brown, Ex., P.O. Box 322, Enola, PA 17025/William L. Brown, Ex., 401 W. Main St. Shiremar�{�jw,r� �/-3/7U/l
SIGN RE OF,PREPAR AN REPRESENTATIVE {�TE
�G
RESS
Andrew C. Sheely, Esqui , 27 South Market Street, P.O. Box 95, Mechanicsburg, PA 17055
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 1505610105 15056],07,OS J �
���
li f
J 1505610205
REV-1500 EX(FI)
DecedenYs Sociai Security Number
DecedenYs Name: BrOWfI, Mary E. ',
RECAPITULATION
1. Real Estate(Schedule A). .. . . . .. . .. . .. . . . . . . . . . .. . .. . .. .. .. . . .. .. . .. . ?. 125,000.00 `
2. Stocks and Bonds(Schedule B) 2, 1,638.72
. .. .. . . . . . .. .. .. .. . . .. . .. .. . .. .. . . .. . . .
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. ' '
4. Mortgages and Notes Receivable(Schedule D).. . .. .. .. . . ... .. . .. .. .. . . .. 4.
5. Cash, Bank Deposits and Miscellaneous Personai Property(Schedule E). .. . .. . 5. ', 665,042.64 '
6. Jointiy Owned Property(Schedule F) O Separate Billing Requested .. . .. .. 6.
7. lnter-Vivos Transfers&Miscellaneous Non-Probate Property
{Schedule G) O Separate Billing Requested.. . . . . . . 7. : 13,319.17
8. Total Gross Assets(total Lines 1 through 7}. . . . . . . . .. . .. .. . .. .. .. .. ... .. 8. ', 805,000.53
9. Funeral Expenses and Administrative Costs(Schedule H). . . .. . .. .. . . . .. .. .. 9. ' 12,319.35
10. Debts of Decedent, Mortgage Liabilities and Liens(Schedule I}.. . .. .. .. . .. . . . 10. ', 4,242.26
11. Totai Deductions(total Lines 9 and 10).. . .. .. . . .. . .. . .. . .. .. . . . . . . . .. .. 11. ' 16,561.61
12. Net Value of Estate(Line 8 minus Line 11) .. . . . . .. . . .. . . ... . . . .. .. . . . . .. 12. ', 788,438.92
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. ' 788,438.92
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousai tax rate,or
transfers under Sec. 9116 _ _
ta)�1.2)X.0�• ' 15.
16. Amount of Line 14 taxable _ __ _ ;
at Iineai rate X .0 45 788,438.92 ' 16. 35,479.75 '
17. Amount of Line 14 taxable _ __
at sibling rate X.12 �7, ,
18. Amount of Line 14 taxable
at collateral rate X.15 ' �g. '
19. TAX DUE . . . . . . . .. .. . . . .. . . .. .. . . . .. . . .. . . . .. .. . . .. .. . .. . . . .. .. .. . 19. ' 35,479.75
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
Side 2
� 1505610205 150561�205 J
REV-1500 EX(FI) Page 3 File Number �
Decedent's Complete Address: �� � � `� " �� � �'''S
DECEDENT'S NAME
Mary E. Brown
_ __ _ _ _ _ ___ __ _ _ _ __
STREETADDRESS
401 West Main Street
_ _ _ - __.
_. _ _.. _....._ ___... _ __ _ _
_ _... - - __ _ _ __. _
CITY STATE ZIP
Shiremanstown � PA '; 17011
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 35,479.75
2. Credits/Payments
A. Prior Payments _ 33,000.00
--___._.
B.Discount 1,736.79
--------_...__- --- ----
Total Credits(A+g) (2) 34,736.79
3. Interest —"—�
(3)
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. --
Fiil in ovai on Page 2,Line 20 to request a refund. (4}
5. if Line 1 +Line 3 is greater than Line 2;enter the difference.This is the TAX DI:E. (5) 742.96
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.......................................................................................... ❑ �
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ �
c. retain a reversionary interest .............................................................................................................................. ❑ �
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 d�ath
without receiving adequate consideration?.............................................................................................................. ❑ �
3. Did decedent own an"in trust for"or payabie-upon-death bank account or security at his or her death?.............. ❑ �
4. Did decedent own an individual retirement account,annuity or other non-probate propeRy,which
contains a beneficiary designation? ........................................................................................................................ ❑ �
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, 1995,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 Jan. 1, 1995, the 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 tlisclosure of assets and
filing a tax return are still applicable even if the suroiving 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 beneficiaries 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 decedent's 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 camrr�on wi#h the decedent,whether by blood or adoption.
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX�11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
N0. CD 020790
BROWN JOSEPH D
229 PENNSYLVANIA AVENUE
PO BOX 322
ENOLA, PA 17025
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- fold
101 � 533,000.00
ESTATE INFORMATION: SSrv: �
FILE NUMBER: 21 1 5-0405 I
DECEDENT NAME: BROWN MARY E (
DATE OF PAYMENT: 06/05/201 5 �
POSTMARK DATE: 06/05/201 5 �
CoutvTY: CUMBERLAND �
DATE OF DEATH: 04/09/2015 I
�
TOTAL AMOUNT PAID: $33,000.00
REMARKS: RCPT TO ATTY
CHECK# 1013
INITIALS: DB1
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
TAXPAYER
42EV-SSJ2 EX+ '11-031
� ,`�i ' pennsylvania SCHEDULE A
�� DEPARTMENT OFREVENUE
INHERITRNCE TAX RETURN REA L ESTATE
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary E. Brown 21-15-0405
Ali 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 wiiling buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property that is jointiy-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1� DecedenYs real estate located at 401 West Main Street, Shiremanstown, Borough of $125,000.00
Shiremanstown, PA 17011,Tax Parcel No.37-23-0557-006.Value per attached appraisal of
Brett Lechthaler,Appraisal Solutions.
TOTAL(Also enter on Line 1, Recapitulation.) $ $125,000.00
If more space is needed, insert additional sheets of the same size.
Main We No.1SBrown #
SUMMARY OF SALIENT FEATURES
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jp� 17011
Cen9t5 T2Ct 0112.00
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S�e Price S NA
Dale Of S2k �
Bamw�Ciau �
� Estate of MarY E Brown
S'v8(Squse FeeQ �.�4
piee per$quae Faot S
� 8usy Road
pce 76 Years
� Above Average
Tatal Rooms s
geMpoms 4
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p�� Brett Lectd�ler,PA Sq1e Cert Gan ApQr
�he d P4P2i�d V�e 04/09Y2(115
Fi�EsGmale af YaYie S 125.000
Fum SSD—WnTOTAL'apprasal sa�ware M a la mo�,inC.—t-800-AWADDE
REV-i,o3 EX+(�-ii)
�i`� ' pennsylvania SCHEDVLE B
� DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN STOCKS & BONDS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary E. Brown 21-15-0405
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1� MetLife common stock,Account#C0006378714-32 shares @$51.21/share at date of death
1,638.72
TOTAL (Also enter on Line 2, Recapitulation) $ 1,638.72
If more space is needed, insert additional sheets of the same size
Page 1 of 1
• �,omputershare
et ' e Computershare
PO Box 30170
� College Station,TX 77842-3170
� Within USA,US territories b Canada 800 649 3593
= Outside USA,US territories&Canada 201 680 6578
� 0 0 0 0 9 7 Hearing Impaired(TDD) 201 680 6611
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MeiLife,Inc.is incorporated under the laws of lhe
� MARY E BROWN State of DE.
— 401 W MAIN ST
= SHIREMANSTOWN PA 17011-6335 Holder Account Number
=
= C0006378714
Ticker Symbol MET
CUSIP 59156R108
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YOUR ACCOUNT HAS BEEN CLOSED AND YOU ARE NO LONGER ELIGIBLE TO PARTICIPATE IN THE PURCHASE AND SALE PROGRAM.
Transaction(s)
Date Transaction Description Trust Interests CUSIP I Class
I (Shares) I Description
04 May 2015 Trust Transfer -32.000000 59156R108 Trust Interesls
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001CS0003.dcusA51828 5423/000097/000097/i 01JV1A
I
REV-i5o8 EX+{1i-1o}
��� ' pennsylvania SCHEDULE E
� DEPARTMENTOfREVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEUENT
ESTATE OF: FILE NUMBER:
Mary E. Brown 21-15-0405
Include the proceeds of litigation and the date the proceeds were received by the estate.
� � All property jointly owned with right of survivorship must be disciosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
� ; Long-term health Insurance refunds 4,354.56
2 TJX credit card refund 20.00
3 Nationwide Auto Insurance refund 44.40
4 Discover card refund 22.33
5 Quantum Imaging refund 3 78
6 ' Susquehanna Valley Federal Credit Union-Savings Acct.#15410-00 13.64
� Susquehanna Valley Federal Credit Union-Money Market Acct.#15410-35 40,169.29
8 Belco Community Credit Union-Savings Acct.#538290,$100,142.18 principal,$40.76 accrued dividends 100,182.94
9 Members 1st Federal Credit Union-Savings Acct.#7773-00,$11,053.30 principal,$0.24 accrued interest 11,053.54
10. Members 1st Federal Credit Union-Life Savings Acct.#7773-04,$4,000.00 principal,$.09 accrued interest 4,000.09
11. Members 1 st Federal Credit Union-Investment Savings Acct.#7773-05,$60,344.32 principal,$1.98 60,346.30
accrued interest
�2 Metro Bank-Savings Acct.#626113039 100,262.54
13. M&T Bank-Savings Acct.#15004206210475 100,022.44
14. � Santander-Checking Acct.#231372691 3570193780 100.00
15. � Santander-Money Market Acct.#231372691 9992291915 gg,g2g.61
16. Santander-Savings Acct.#231372691 2334023260 1.40
�� PNC Bank-Checking Acct.#5140007821,$47,149.92 principal,$Q.02 accrued interest 47,149.94
�8 PNC Bank-Savings Acct.#5000627754,$95,705.57 principal,$0.79 accrued interest 95,706.36
�9 � Decedent's personal property 1,200.00
20 Nationwide Homeowners Insurance refund 454.00
21 Member's 1st-misc.refund �48
TOTAL(Also enter on Line 5, Recapitulation) $ 665,042.64
If more space is needed, use addikional sheets of paper of the same size.
3850 Hartzdale Dr.Camp Hill,PA 17011-7809
USQUEHANNA 339 East Park Dr.Harrisburg,PA 17111-2730
ALLEY Lo��:717-737-4152
Toll Free:800-948-1454
FEDERAL CREDIT U N ION Fax:717-737-0589
April 24, 2015
Andrew C.Sheely
127 S Market Street
PO Box 95
Mechanicsburg, PA 17055
Re: Estate of Mary E. Brown
Estate#: 21-15-0405
Dear Mr.Sheely:
The date of death balances that you requested regarding the Estate of Mary E. Brown are as follows:
• 15410-00(savings): $13.64
• 15410-35 (money market): $40,169.29
Please let me know if you need any additional information.
Kind regards,
,��������c_"'"`--
Kathy Jo McCabe
Member Services Supervisor
www . S VFCU . org
1
ELCO
' COMMUNITY CREDIT UNION
,�.:�:.� ,�a��_.:��:: e _„ - �����.�v��� ,�, �,��:u , ,
Decedent Account Inforaiation(On Date of Death)
Belco Community Credit Union '
1. Name(s)in which the account was held: Mary E. Brown
2. Account Number: 538290
3. Total Account Balance as of Date of Death: $100,142.18
Balance Accrued Dividends Date Opened
Regular Savings $100,142.18 $40.76(O1/O1/2015-04/09/2015) 09/26/1994
Holiday Club $
IRA $
Money Market $
Checking $
Money Market $
Certificates:
Certificate Number Balance Accrued Dividends Date Opened
$
$
$
$
$
$
4. Name(s)in which Safe Deposit Box was held: None
5. Date the box was initially rented:
6. Branch address at which the box is located:
. . . . . :�� .�
St
�
MEMBERS 1St
FEDERALCREDIT TJNION
REGULAR SAVINGS ACCOUNT:
Account Number/Suffix 7773-00
Date Account Established 03/10/1965
Principal Balance at Date of Death $11,053.30
Accrued Interest to Date of Death $024
Total Principal and Accrued Interest $11,053.54
Name of Joint Owner None
LIFE SAVINGS ACCOUNT:
Account Number/Suffix 7773-04
Date Account Established 03/10/1965
Principal Balance at Date of Death $4,000.00
Accrued Interest to Date of Death $0.09
Total Principal and Accrued Interest $4,000.09
Name of Joint Owner None
INVESTMENT SAVINGS ACCOUNT:
Account Number/Suffix 7773-05
Date Account Established 08/25/1989
Principal Balance at Date of Death $60,344.32
Accrued interest to Date of Death $1.98
Total Principal and Accrued Interest $60,346.30
Name of Joint Owner None
MEMBERS 1ST FEDERAL CREDIT UNION
V
Tessa L Klugh c��
Lending Insurance Support Specialist
April 20, 2015
Estate of: MARY E BROWN
Date of Death: 04/09/2015
Social Security Number: 023-26-2515
5000 Louise Drive • P.O.Box 40 • Mechanicsburg,Pennsylvania 17055 • (800) 283-2328 • �vwwmemberslst.org
Signature - Servicing -BNKPRDA550 Page 1 of 1
Savings Account Inquiry -Basic Account Data 4-21-2015
02-Stop/hold information
Account NamelAddress
Account number 62611303 IBA A MARY E BROWN
Short name BROWN MARY E€ M �01 W MAIN ST
TIN IXXX-XX-2515 ; TIN Crt BR �& HIREMANSTOWN PA 17�11 i:
Baiance Data �
Current balance '' .00' j
Avail balance .00 f
Avail romorrow .00; -�—;
�_—..�----...-----__� (....._.._......_.._._
Memo balance .00; Customer Activity
Hold amount .00 f Stops/holds active
�--...__._._....--
Check CR balance .00� Date tast contact 4-14-15
Interest due .00 f Date last active �r 41415�
Int pd this year 8625 j Date last dortnant � 0-00-00
Int po last year 373.31! Date last deposit j 1-12-OT
Acct current rate .20000i Amount last deposit � 4,445.00'
Account Data Previous Statement Data
Stat �; Prod type 505 Last stmt date T 3-31-15
Statemen;code/cycle ( 5 Last stmt balance 100,262.54 j
Date opened 3-11-03 Checks/deposits since ' � 1;/ �
Date last closed 4-141� Service charge rype/plan � �I� 505
Date last reopened 0-00-0q Combined stmUnbr copies ;�
Processed thru 4-20-1 ,
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499 Mitchell Road,Millsboro,DE 19966 Records Management
Phone 888-502-4349
F ax (302)934-2955
April 30,2015
Andrew C Sheely
127 S Market Street
P. O. Box 95
Mechanicsburg,PA 17055
Re: Estate of: _Ma_ry E Brown
Social Security: 023-26-2515
Date of Death: April 19, 2015
Dear Sir or Madam:
Per your inquiry on Apri122, 2015, please be advised that at the time of death,the above-named
decedent had on deposit this bank the following:
1. Type of Account Savings
Account Number 15004206210475
Ownership(Names o fl William L Brown(POA)
Joseph D Brown(POA)
Mary E Brown
Opening Date O1/14/2002
Balance on Date of Death $0.00
Accrued Interest $0.00
_. _ __ _
Total $0.00
For any additional information on the above accounts, including ownership and any changes,
closures and/or reimbursement of funds,please call Brewster Branch at 845-279-8018.
We were unable to locate any safe deposit box for the above-mentioned decedent.
This letter does not include any accounts in which the deceased may have been listed as Power of
Attorney, Custodian of Uniform Transfers, Representative Payee, or Tnistee under a Written
Agreement.
Sincerely,
Tomara Williams
Records Management
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Krolczyk, Nichotas A
Subject: MARY E. BROWN -Account Hoidings Screen -Snap Shot as of 04/14/2015 @ Ol/45 PM
Date Of Death:04/09/2015
.
_ -
. F. . ,. ... _.,.: .: - - �
-��.� '�" `-'�`�.��'��'��,�`�'t;�.���'. �` " �. . :.�. _ , . _ _ �.�.�,x ��;
"� �.
'., Name:; Mary E Brown Main Phone Number: 17177376615
; QocumienE: XQ�. Q232625i5 Date of Birth: Q3J23/i933 �:
j Address: 402 w main st shiremanstawn pa 17U11-6335 i
. _....,. _
PersactaE Acca�cnts-�Ifck on a raw#+a sefecE art acca��
,�ccaur�t Number Q�scription Particapatitzn T}rPe Gurrer�t B�lar�e Av�iiabl�Ealance
232372691 3�70193�8t� CHECKI[��{IP[... OWNElt(fNE?IVF--- �t}Q.dO ft�E} 140.OD USD
232372fs91 359229Z925 MOIdEY MARKET OUVIVEIt(IN�M... , 44,929.61 USD 44,429.61 USD
2313725�� 2334Q23260 Sf1VING5 OWNER(II�t�M... 1.4Q tJSE} i.40 USD
__
TOTAL: IQ0,031.01 USD_ 20Q,031.01 U3D
_ _ _ _ _ _. __- .__ __ _ ._ _.__ _._.. __ _ __ __..... . _ _ ___ .._. _._ __ _
Nicholas A Krolcryk
Branch Manager-NMLS ID:1062873
Summerdale Branch#0092
401 North Enola Rd.
Enola,PA 17025
TeL-717-732-3637
Fax:717-732-2361
Mail Code:PAi-CBO-0092
NKrotczvC�santander.us
i
Ap r. 17, 2015 1 ;36PM No, 0054 P, 1/2
' : �.���.
April 17,2015
Andrew Sheely
.A.ttozne�At Law
127 S Mazl�et St
Mechanicsburg PA 17055
RE= Mary��rown
SSN: 023-26-2515
DOD: 04-49-2415
Dear Mr. Sheely: .
In response to your request for Date of l7eath(D0�7)balances for the customer noted abo�ve,our
records sho'c�the follovring_
Checlring Accou�nt
Accoumt#�140007821 Established: 48-2�-1989
MARY E BRO'WN
DOD balaz�ce: $47,149_92+0_02 accrued interest
Interest paid 01-01-20�5 thru Q4-09-2015 $ 1.f3 YTD
Sa'�ings Aceount
Account#SQ006277�4 �stablished: Q7-30-1996
MAItY E BROWN
DOD balance: $ 95,705_57+�.79 accn1ed interest
rnterest paid Ol-01-2015 thru 04-09-ZO1S $ 15.86 YTD
IRA A,CG011k�t
.A,ccount#7510Q02310$ �S�blis��a=a4-z��2aoz
MARY E BROWN
DOD balance: � 12,813.41 +5.76 accrued i.nterest
Ynterest�aid 01-01-2015 thru 04-49�2415 �47.02 YTD
�'or beneficiary informatian,�lease call 1-888-762-4727.
Please note that this office provi.des date of deatJa bala�aces:fox deposxt accqunts(�RA,s,CDs,C�ecking and
Savirzgs). We do not process any financial transactions or�rovide statements. Tf you need assistance wit�a
any of these items,please call 1-888-PNC�BANK�1-888-762-2265)or stop by your local pNC�ank branch
office.
Sincerely,
National�'inancial Services Center
: PNC Bank,N.A.Member�DTC
Page 1 of 2
12E4�-IS1D[�X+ ;0�-U9)
����`� pennsylvania SCHEDULE G
�� DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
1NHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary E. Brown 21-15-0405
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY
ITEM INCIUDE THE NAME OF THE TRANSFEREE,THEIR RElAT70NSHIP TO DECEDENT AND DATE OF DEATH °/a OF DECD�S EY.CLUSION TAXABLE
NUMBER THE DATE OF TR4NSFER. A�ACH A COPY OF THE DEED FOR REAL ESTA?E. VALUE OF ASSET INTEREST QF APPL',C.4RLE1 VALUE
1 PNC Bank IRA-Acct.#75100023108,$12,813.41 principal,$5.76 accrued
interest. Beneficiaries:son,Joseph D.Brown, 229 Pennsylvania Avenue, 12,819.17 100 12,819.17
Enola, PA 17025,daughter Linda M.Sharretts, 1511 Letchworth Road,Camp
Hill,PA 17011,daughter Brenda A.Troutman,538 Arlington Avenue, Folsom,
PA 19033,son William L. Brown,401 West Main Street, Shiremanstown, PA
17011,daughter, Donna G. Rossi,510 Midland Pass, Grovetown, GA 30813
2003 Toyota RAV4.VIN JTEHH2OV436092519.Jointly titled with daughter,
Z' Donna G. Rossi.Transfer completed on December 12,2014. 3,500.00 100 3,000.00 500.00
TOTAL(Also enter on Line 7, Recapitulation) $ 13,319.17
If more space is needed,use adtlitional sheets of paper of the same size.
�s' Y'J�
__,i , � \Ii�.Vbt': ,;jt. � � 1 ' � 1 1 s:�..�:C z'',.�rl��� - f
: .._ 'ra;.. .
� „ _ ., + . , . . . . .. . ,...�.�.�.............. ... .-.,.. .... ....� ;_ � ,. `�
�' CERTIFICATE OF TITLE FOR A VEHICLE
��yl h� �Mr��
I� (� �
i.--� N� �U� . . �������-
.�IIe4%�: . .. . . � �
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'��:�': .. .. . - � . � . � . .
ti�: � . . . . . . . . . ��i
f�;� J�'�NH2fJ'd4�6t]9�SL9 2GICl3 1'OYOTA 51�95955"�5[72' BR ��
j�;::... VEHICLE IDEN"fIFICATION NUMBER YEAR MAICE OF VEHICLE TITLF NUMBER
�. ��W Cl I I 121L2f�,41 C]232C1C11 ❑
E.: .,� BObY TYPE DUP SEAT CAP PRIOR TITLE SiATE OUOM.PROCD.DATE ODOM.MILES ODOM.STATUS
�� 6JC13/"L7� 1.��112I],4 II
OATE PA TITLED DATE OF ISSUE I UNLADEN WEIGHT GVWR GCWR TITLE BPAN�S ' =pea,`!y;
."%.
OOOMFTER STATUS J,.��
0=ACTUAL MILEAG[ i
1=MILEAGE EXCEEDS THF MEriiANICAL ����:a�-�
LIMITS
� _=fJOT'INC-ACTUAI P+IILEAGE �1�,��
� � 3=NOT ThIE ACTU�L MILEAGF-ODOMETCR _
. TFlMPERING VCRIFIEfI �
4=EX[MPT FROM ODOM[TER GISCLOSUR[
� REGISTERED OWNER(S) � 7ITLE 6RANDS i �
. . . . Fl=ANTIOUE VEHICLE �'
� �I�IA�i E��LJiLTL�fI UI\`VWI'. ���-�� t ` , €<<.= C=GLASSIGVEHICLE "
D=COLLECTIOLE VEMCLE
��. �tif1YlYH 1.?f�I.LL i\V��d . . . ..'� _.._.. . , .. F -OUTOFCOUNTRY ' '.
G=UFIGIfIALL/MFGfi.fGR NON-U.�. �' �
. DISTFlIBUTIUN �i
��� � �A�� �r]� � � H=AGFlICULNFlAL VEFIICL[ :�i
R 1 L =LOGGING VEHICLE •
:�NIREMAIVSTOWN �H 1`7C111 P=ISNJASAPOLICEVEHICLE •;Y:•;
R=RECONSTRUCTED
S=STRF_E�POD -
y� T=RECOVF_RED TIIEFT VEHICLE ����
V=VEHICLE CONTAINS HEISSUE�VIN ��yt:;�
W=FLOOD V[HICLC _�
��� FIRST UEN FAVOR OF: % =IS/WAS 4 TAxI � ; �
SECOPID LIEN FAVOR OF: �'�`
=r:�.{;
��4i'.
i.�J
i
� i� a second lienholder is listed upon satisfaction of the tirsi Ilon, the first � ����„�,'
lienholder must forward ihls Title to the Bureau of Motor Vehicles with the �.
�. FIRST LIEN RELEASED ' appropriate form and fee. � ��«4:,
DATE �''=-`;i�
t }.�.. v
F'�'25_
BY SECOND LI[N RELEASED �`�'
AUTHORIZED REPRESENTATIVE DATE �"'��='
•�.::;'
��� MAILING ADDRESS ,=��`'.� .
BY 'z:z=
•:,� AUThIORl7_ED REPRF_SENTATIVE l�:.'i{
MA�Y ELT�ABETH BROWN & � '%��%
UONNA wATL Rd.�5I � a�`'�}
4�]► W MA:�N ST �
: . SM�REMAN:iTOWN PA ],70�,�, pennsylvania -�::`
�::�
DEPARTMENT OFTRANSPORTATION �� -
�',�{i
Lf �t C� :�•:`t,�t
• I I cedity as of fhe date of issue, the official records of ihe Pennsylvania Depatlment ����Y � • ��H��1 t� r • �^ • •;�,�=,`;'t
of Tranc�ortation re(lect thaf tha person(s)or company narned herein is the lawful owner �
� of ihe said vehicle. SecrcL•uy uf'franspm•tatinr. __ _ �
�� wr�" �i �� ."-'�a:� '�1Si6� '� !11 i)I�til, m��.�y ��. � Y :
�:.}l` � �'� „E�.;V'�.�°� � . . \ .d� 0 ���i. l I I i. J�,J Ic �+!!,�^��.V � .
`:�� � - ,n o ir s ouse is hsted and ou want the tifle to �'
-' .SUBSCRI6ED AND SWORN , I f a c o p u r c h a s e r o t h e r t h a y i p y
;;.�� i be listed as"Joint Tenants With Right of Survivorship" (On death of one �. s,`"::
'��� ��.TOBEFORFME � :*T•
�'C�; nno. onr vena � owner,title goes to surviving owner)CHECK HERE O.Otherwise,the title � �1;,?
� � will be issued as"Tenants in Common"(On death of one owner,interest of
t�„ i }
; j deceased owner yoes to his/her heirs or estate). ��'�
f�•..� :::ay'
SIGNATURC-Of PC�SON AOMINISTCfiING O�TFI � �����' �
,,'�y,� . ` IF NO LIEN,CHECKI_] IS 1h115 AN ELT9(IF VES,FIN REQUIRED) YES[J NO[.] ;�q;;
J �
..".0 \�r,_:.
y=' W j 1ST LIENHOLDEP.FMANCIAL INSTITUTION NUMBER: --_
a:,�y-�+''_' �� � '
��� 1ST LIENHOLDER NAME ' ��
O � �
:�.
d � STREET "'.��j:=
� '=«'
� .� , CIIY STATE ZIP �%'.,'
� '>:�i
'^ j i IF NO 2ND LIEN,CHECK❑IS THIS AN ELT?QF YcS,FIN REOUIRFD)YES❑NO❑ :::�'
�� Tlie untle�signeU heroby inekes appllcalion loi Cerlllica�e ol Tllle �o iha ��cl�kle tlesciiUetl I
O a�ova,si�b�eol Io Ihe enciimbrpnces and oiher leyal clrims se�loilli licre- { �
� 2ND I_IENHOLDER FINANCIAI_INSTITUTION NUM�ER:
� �2N0 IIENHOLDER NAME ,�' '
SIGNATURE OF APPLICANT OR AUtHORIZEU SIGNER .
_ 1 � STREET �-�-
�1
� SIGNATUFE OF CO�FPPLICANTRITLE UF AUTHOfiIZED SIGNEfi i CITY STATE ZIP
� .�.., . �.... . .. .. ._:..�ex�X i�rtiitrvr.H»e.rs��w.. .. � y�
``t,.� ..... , ...... - •.. ..•._ . . .•. ,...,... . . •. �_' ��{�SSjSW
� � . . ,. ..... . .. ........ .. ....... ... ..I..
..,.,. ...,.,..... �. ............ ..... ....
. . f_�f}
..1,;.......z... . . . .s.. . .......... . .......s. . ... .... . .. .... .......... . . . . . . �i
�tev-�sl� rx+ tlf�-a�;
��..��� pennsylvania SCHEDULE H
� OEPARTMENTOFREVENUE FUNERAL EXPENSES AND
����������������� 1NHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary E. Brown 21-15-0405
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
i� Myers-Buhig Funeral Home 5,926.73
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions: $0.00
Name(s}of Personal Representative(s) Joseph D. Bfow�t/ William L. Brown
Street address 229 Pennsylvania Avenue, P.O. Box 322 / 401 W. Mam Street
_.. ___ ___.__ _____.. _.___. __
c�ty Enola / Shiremanstown _ state PA ZIP 17025/1701�
_
Year(s)Commission Paid.
_ ____.. _ _ _ __ _
2. attorney Fees: {-�-vi��l��c.) C'. �l7��l�� �lv�`� S,OOO.dO
,
3. Family Exemption: (If decedent's address is not the=ame as claimant's,attach explanation.)
Claimant
Street Address
City __ __. _. . —_ _ State ZIP .____
Relationship of Claimant to Decedent ___
4. Probate Fees; 720.50
5. Accountant Fees:
6. Tax Return Preparer Fees:
�. Postage,overnight mailing costs 72.12
8. Reserves to conclude Estate administration,final accountings 600.00
TOTAL(Also enter on Line 9, Recapitulation) $ 12,319.35
If more space is needed, use additional sheets of paper of the same size.
RECEIPT FOR PAYMENT
LISA M. GRAYSON, ESQ. Receipt Date: 4/14/2015
Cumberland County - Register Of Wills Receipt Time: 09 : 12 :51
One Courthouse Square Receipt No. : 1081065
Carlisle, PA 17613
BROWN MARY E
Estate File No. : 2015-00405
Paid By Remarks: JOSEPH D BROWN
HMW
------------------------ Receipt Distribution ------------------------
Fee/Tax Description Payment Amount Payee Name
PETITION LTRS TEST 510 . 00 CUMBERLAND COUNTY GENERAL FUN
WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN
SHORT CERTIFICATE 75 . 00 CUMBERLAND COUNTY GENERAL FUN
JCS FEE 35 .50 BUREAU OF RECEIPTS & CNTR M.D
AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN
INVENTURY 15 . 00 CUMBERLAND COUNTY GENERA.L FUN
INH TAX RETUR.N 15 . 00 CUMBERLAND COUNTY GENERAL FUN
----------------
Cash $670 .50
Total Received. . $670 .50
�tEL•'-I512 [�x,+ (12-0�)
�� pennsylvania SCHEDULE I
� �EPAiiTMENT OF REVENUE DEBTS OF DECEDENT,
INNERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mary E. Brown 21-15-0405
Report 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 OFDEATH
1• PPL-final bill 277.63
2. PAAmerican Water-final bill 177.61
3. Comcast-final bill 313.91
4. Verizon-final bill 99.10
5. Ativanced Disposal 42.21
6. AT&T-final bill 52.65
7. Misc.reimbursements to Joseph Brown-gas,turnpike tolls 151.12
8. Holy Spirit EMS-final bill 123.17
9. Misc.costs for yard maintenance 44.51
10. UHaul rental-removal of decedent's personal property from residence 239.11
11. Evine-final bill 3.28
12. Quantum Imaging 3.78
13. Misc.reimbursements to William Brown-unhaul rental,gas,tolis 351.97
14. Settlement costs-title search,real estate transfer tax 1,902.00
15. Appraisal of decedenYs residence.See attached appraisal by Appraisal Solutions 350.00
16. PNC Bank check printing fee 18.45
17. Misc.supplies 76.30
18. Publishing Clearing House-final bill 15.46
TOTAL(Also enter on Line 10, Recapitulation) $ 4,242.26
If more space is needed, insert additional sheets of the same size.
REV-1513 EX+ (01-10)
�� pennsylvania SCHEDULE �
DEPARTMENT OFREVENUE
INHERITANCE TAX REiURN BENEFICIARIES
� RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Mary E. Brown 21-15-0405
RELATIONSHIPTO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS[Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
1. Joseph D. Brown,229 Pennsylvania Ave.,P.O. Box 322, Enola, PA 17025 Son 20%
2. `Llnda M.Sharretts, 1511 Letchworth Road,Camp Hill, PA 17011 Daughter 20%
3. Brenda A.Troutman,538 Arlington Avenue,Folsom, PA 19033 Daughter 20%
4. William L. Brown,401 West Main Street,Shiremanstown, PA 17011 Son 20%
5. Donna G. Rossi,510 Midland Pass,Grovetown,GA 30813 Daughter 20%
ENTER DOLLAR AMOUNTS fOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
L
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size.
� f
LAST WILL AND TESTAMENT
OF
MARY E. BROWN
I, MARY E. BROWN, of 401 West Main Street, Shiremanstown,
(Borough of Shiremanstown), Cumberland County, Pennsylvania, make, publish
and declare this as and for my Last Will and Testament, hereby revoking all other
Wills and Codicils heretofore made by me.
FIRST: I direct that any and all just debts and f'uneral expenses, of
any kind whatsoever, which may be payable by reason of my death, shall be paid
out of the principal of my estate as the same can conveniently be done.
SECOND: I specifically give and bequeath my John Deere zero turn
mower, Toro snow blower and other lawn and garden tools located in my shed
,
unio my son, WILLIAM L. BROWN, of Shiremanstown, Pennsylvania.
THIRD: I hereby grant an option to purchase my real property
locate� at 401 West Main Street, Shiremanstown, (Borough of Shiremanstown),
Cumb�;r�land County, Pennsylvania, unto WILLIAIVI L. BROWN, for an amount
�
of�ighty thousand dollars ($80,000.00), said option to purchase my real property
to ��e ex:�rcised within sixty (60} days after my death.
,
1'i+f��IJRTi�: i give, Qevisc dn�i L�yueai�i a�� t�he rest, p8S1'u�ue an�
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) Twenty percent (20%) thereof unto my son, JOSEPH D. BROWN, of
Enc�la, Pennsylvania, provided thaT should JOSEPH D. BROWN predecease me, I �;ive
anc� bequeath his share unto my surviving children narned herein, share and share alike;
�� anci
(b) Twenty percent (20%) thereof unto my daughter, LINDA M.
S�-IARRETTS, of Camp Hi11, Pennsylvania, provided that should LINDA M.
S�iARRETTS predecease me, I give and bequeath her share unto her issue, share and
share alike; and
(c) Twenty percent (20%) thereof unto my daughter, BRENDA A.
T1xOUTMAN, of Folsom, Pennsylvania, provided that should BRENDA A.
TROUTMAN predecease me, I give and bequeath her share unto my surviving
children named herein, share and share alike; and
(d) Twenty percent (2U�'io) thereof unto `wii.�..iAT�'i �,. �Rf3�iio1, proviueu
that should WILLIAM L. BROWN predecease me, I give and bequeath his share unto
his issue, share and share alike; and
(e) Twenty percent (20%) thereof unto my daughter, DONNA G. ROSSI,
of Grovetown, Georgia, provided that should DONNA G. ROSSI predecease me, I
give and bequeath her share unto her issue, share and share alike.
FIFTH: I acknowledge that I am the mother of ROY A. BROWN, of
Albany, Georgia and further state that ROY A. BROWN is not a named beneficiary of
this, my Last Will and Testament, as appropriat� distributions and gifts have been made
to �iim dczring my lifetime. .
SIXTH: In addition to all powers granted to them by law and by other
pre�visi��s of this �1Vi�1, I gi��� �he f�>>v:��-��� �.yr_�n� �.ere�.�nder the following powers,
applicable to all property, exercisable without court approvai and effective until actual
di;stribution 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
pric�es 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
trarisfer of the property and to receive the pro�eeds of any disposition.
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(B) To partition, subdivide, or impr�ove r.eal estate and to enter into
agreements concerning the partition, sutidivision, improvement, zoning or management
of real estate and to impose or extinguish restrictions c�n real estate.
(C) To compromise any claim or con�roversy and to abandon any properiy
which is of little or no value.
(D) To invest in all forms af property, including stocks, common trust
funds and mortgage investment funds, w�+hout restriction to investments authorized for
Pennsylvania fiduciaries, as are deeme� nroper, �vithout r�gard to any principle of
� diversification, risk or prociuctivity.
(E) To exercise any option, right or privilege granted in insurance poli�ies
or in other investments.
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(F) To exercise any election or pri�.�ilege given by the Federal and other
tax'laws, including, but not necessarily being limited to, personal income, gift and estate
or inheritance tax laws.
(G) To make distributions to my herein named beneficiaries in cash or in
kind or partly in each.
(H) To borrow money from themselves or others in order to pay debts,
tax�s, or estate or trust administratic,n expenses, to protect or improve any property held
under my vuill, and for investment purposes.
(�) �'U s�?�ct a �r_�d� �f��yrn�nt �nder. any o,ualified retirement plan
(per�sion plan, profit sharing plan, employee stock ownership plan, or any other type of
qualified plan) to the extent provided for by the plan �r the law.
SEVENTH: I direct that any and a11 inheritance, estate, transfer,
succession and similar death taxes shail be paid oui of the principal of my residual
estate.
EIGHTH: I nominate and appoi.nt JOSEPH D. BROWN and
WILLIAM L. BROWN, Co-�xecut�rs.; �af thisa my I:ast VVill �nd Testament. I direct
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that my Co-Executors or the�r success�� slzal! nat �i� .requ:red te post security or a
bond for the performance of their duties ;n ariy�urisdiction.
IN WITNESS WHEREOF, 1 have hereunto set my hand and seal to this, my Last
Will and Testament, this �Z '�^� da.y� af'D�cember, 2014.
' �'J`-���,-►�. (SEAL)
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Signed, sealed, published an� declared ay t.�� above-named Testatrix as and for
her Last Will and Testament in our pres�n�e, wh�, ar her request, in her presence and in
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� the presence of each other, have hereunrc► saz�scribed our nam�s as attesting witnesses.
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Address � t�.� :� N�mu
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Address t�c?=�S ��v�,�,� � �'^�
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