HomeMy WebLinkAbout09-08-06
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OFFICIAL USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV.1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ALE NUMBER
II
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
06
0533
NUMBER
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Brown, Gertrude L.
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-OD-YEAR)
179-36-1226
THIS RETURN MUST BE ALED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
4a. Future Interest Compromise (date of death after
12-12-82)
7. Decedent Maintained a Living Trust (Attach
copy of Trust)
10 Spousal PovertY Credit.(date of death between
. 12-31-91 and 1-1-S5)
o 3. Remainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
o 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
o 1. Original Retum
o 4. Limited Estate
[!] 6. Decedent Died Testate (Attach
copy of Will)
o 9. Litigation Proceeds Received
o
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o
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2. Supplemental Return
One West Main Street
Shiremanstown, PA 17011
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06-11-2006
01-14-1906
COMPLETE MAILING ADDRESS
(1 ) None
(2) None
(3) None
(4) None
(5) 117,291.91
(6) None "
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(7) None
(8)
(9) 4,204.80
(10) 7,166.34
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has
not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
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NAME
James D. Bogar
FIRM NAME (If applicable)
Bogar & Hipp Law Offices
TELEPHONE NUMBER
717-737-8761
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
117,291.91
(11 )
11,371.14
105,920.77
0.00
105,920.77
15.Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15)
or transfers under Sec. 9116(a)(1.2)
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0 (16)
i= 16.Amount of Line 14 taxable at lineal rate 105,920.77 x .045
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l1. 17.Amount of Line 14 taxable at sibling rate 0.00 x .12 (17)
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0
() 18. Amount of Line 14 taxable at collateral rate 0.00 .15 (18)
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i5 19. Tax Due
(19)
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
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4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L) 0 Separate Billing Requested
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
(12)
(13)
(14)
0.00
4,766.43
0.00
0.00
4,766.43
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
Copyright 2002 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00:
Decedent's Complete Address:
STREET ADDRESS
1771 North Meadow Drive
CITY Mechanicsburg
I STATE PA
I ZIP 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
4,766.43
238.32
Total Credits (A + B + C)
(2)
238.32
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (0 + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 1 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)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58)
4,528.11
4,528.11
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;.................................................................................. D ~
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d. receive the promise for life of either payments, benefits or care?............................................................. 0 ~
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?................... .......................................... ................................. ........................
D ~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ D ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?......... ........... .............. ......... ................ .................. ..... ................................... D ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penatties of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, tt is true, correct and
complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
Wi~~JOW "Brow~. ~ / _ /
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SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
Lois B.
DATE
1771 North Meadow Drive
Mechanicsburg, PA 17055
40 Teaberry Drive
Carlisle, PA 17013
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DATE
ADDRESS
One West Main Street
Shiremanstown, PA 17011
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For dates of death on after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a
natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S.
99116 1.2) [72 P.S. 99116 (a) (1 )].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116 (a) (1.3)]. A sibling is
defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Rev-1508 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONVIotOALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Brown, Gertrude L.
FILE NUMBER
21-06-0533
ESTATE OF
Include the proceeds of litigation and the date the procaeds were received by the estate.
All property Jolntly-owned with the right of survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 Commonwealth of Pennsylvania - Rent Rebate
VALUE AT DATE
OF DEATH
500.00
2 Embarq - Sprint Refund
20.02
3 Highmark - Refund of Health Insurance Premium
291.51
4 M& T Bank - Checking Account No. 42697204; date of death balance $19,403.77;
accrued interest $0.39
19.404.16
5 M& T Bank - Savings Account No. 015004213662461; date of death balance
$58,921.72; accrued interest $65.50
58.987.22
6 M&T Bank - Certificate of Deposit No. 031003913498183; date of death balance
$17,992.87; accrued interest $41.25
18.034.12
7 Sovereign Bank - Certificate of Deposit No. 1685471557; date of death balance
$20,037.95, accrued interest $16.93. (The attached June 22, 2006 letter from
Sovereign Bank also makes reference to Certificate of Deposit No. 1685500447,
titled "Gertrude L Brown ITF Winslow R. Brown II & Lois B Lee". This account was
closed out on March 16, 2006 for a closeout amount of $73,756.70. A majority of
these closeout funds were placed into the savings account of Gertrude L. Brown
with M&T Bank being Account No. 015004213662461. The balance of the closeout
was used to pay the expenses being incurred for the maintenance of the Decedent
at the Manor Care Center, Carlisle, Pennsylvania.)
20,054.88
TOTAL (Also enter on Line 5, Recapitulation)
117,291.91
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA.1500 Schedule E (Rev. 6-98)
rl:1 M&I'Bank
499 Mitchell Road, Millsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
June 23, 2006
James D Bogar
Attorney At Law
One West Main Street
Shiremanstown, Pennsylvania 17011
Re: Estate of' Gertrude L Brown
Social Securitv: 179-36-1226
Date of Death: June 11,2006
Dear Sir or Madam:
Per your inquiry dated June 16, 2006, please be advised that at the time of death, the above-named decedent had on deposit
with this bank the following:
1.
Type of Account
Checking Account
Account Number
42697204
Ownership (Names oj)
Gertrude L Brown '"
Opening Date
12/28/85 Closed 06/16/06
Balance on Date of Death
$19,403.77
Accrued Interest
$
0.39
Total
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$19,404.16
2.
Type of Account
Savings Account
Account Number
015004213662461
Ownership (Names oj)
Gertrude L Brown '"
Opening Date
03/16/06 Closed 06/16/06
Balance on Date of Death
$58,921.72
Accrued Interest
$ 65.50
Total
$58,987.22
3.
Type of Account
Certificate of Deposit
Account Number
031003913498183
Ownership (Names oj)
Gertrude L Brown *
Opening Date
03/24/05 Closed 06/16/06
Balance on Date of Death
$17,992.87
Accrued Interest
$ 41.25
Total
$18,034.12
Please be advised, there was no safe deposit box found for the above decedent.
* For further account information, regarding ownership, closures and/or reimbursement of funds, etc., please call
the Mechanicsburg Office # 717-255-2031.
Sincerely,
F~~
Nancy Clagett
Records Management
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Court Ordered Processing / MAl MB3 02-10
P.O. Box 841005
Boston, MA 02284
June 22, 2006
James D. Bogar
Attorney at Law
One W. Main St.
Shiremanstown, PA 17011
RE: Estate of: Gertrude L. Brown
Date of Death: June 11,2006
Dear Mr. Bogar:
Per your request, enclosed please find the account information as of date of death for the
above-named decedent. Please note the balances do not include accrued interest.
If you should have any further questions, please do not hesitate to call.
Very truly yours,
lt7 p ~.
(;y:J~
Linda Spavento
GAG Team Leader
(617) 533-1789
(617) 533-1931-fax
Sovereign Bank
Gertrude L Brown
179-36-1226
June 11, 2006
ESTATE OF
SOCIAL SECURITY #:
DATE OF DEATH:
Account #: 1685471557 Type:
In the name of: Gertrude L Brown
Date of Death Balance:
Int.(YTD) from 1/1/2006 to
Accrued interest to date of death:
Other Info:
CD
Open date: 2/25/2004
$20,037.95
5/31/2006
$16.93
$211.69
Account #: 1685500447 Type: CD Open date: 7/16/2004
In the name of: Gertrude L Brown ITF Winslow R Brown II & Lois B Lee
Date of Death Balance: $0.00
Int.(YTD) from 1/1/2006 to 3/16/2006 $446.77
Accrued interest to date of death: $0.00
Other Info: closed 3/16/06 for $73,756.70
Page 1 of 1
REV-1151 EX+ (12-99)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Brown, Gertrude L.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-06-0533
ESTATE OF
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 344.80
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees Bogar & Hipp Law Offices 2,700.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 310.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 850.00
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 4,204.80
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (6-98)
.
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMON\l\lEAL TH OF PENNSYLVANIA
INHERrT ANCE TAX RETURN
RESIDENT DECEDENT
Brown, Gertrude L.
FILE NUMBER
21-06-0533
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Parthemore Funeral Home - Balance due for funeral
344.80
Subtotal
344.80
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1502 EX+ (6-98)
*
SCHEDULE H-87
OTHER
ADMINISTRATIVE COSTS
continued
COMMON'M;ALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Brown, Gertrude L.
FILE NUMBER
21-06-0533
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
RESERVES: - Cost to conclude administration of Estate including filing fee for PA
Inheritance Tax Return, Inventory and First and Final Account; preparation of
Personal and Fiduciary Income Tax Returns
850.00
Subtotal
850.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-1512 EX+ (6-98)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Brown, Gertrude L.
FILE NUMBER
21-06-0533
ESTATE OF
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Embarq - Final bill
VALUE AT DATE
OF DEATH
52.37
2 HCR Manor Care - Final bill - nursing home care
7.041.07
3 Holy Spirit Hospital - Final bill
35.00
4 NeighborCare Pharmacy Services, Inc. - Final bill
37.90
TOTAL (Also enter on Line 10, Recapitulation)
7,166.34
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
REV 1513 EX+ (9-00)
.
SCHEDULE .J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
Brown, Gertrude L.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
aistributions, and transfers
under Sec. 9116(a)(1.2)]
FILE NUMBER
21-06-0533
ESTATE OF
RELATIONSHIP TO
DECEDENT
Do Not Ust Trustee(s)
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
See attached schedule
Total 3,000.00
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
SCHEDULE J
BENEFICIARIES
(Part I, Taxable Distributions)
ESTATE OF:
Gertrude L. Brown 179-36-1226 06/11/2006
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) ($$$)
1 Thomas K. Brown Grandson 1,000.00
15 Victoria Place
West Windsor, NJ 08550
2 Winslow R. Brown II Son One-half of rest, 0.00
1771 North Meadow Drive residue and
Mechanicsburg, PA 17055 remainder
3 Teresa J. Lawrence Granddaug hter 1,000.00
51 Honeysuckle Road
Mechanicsburg, PA 17050
4 Lois B. Lee Daughter One-half of rest, 0.00
40 Teaberry Drive residue and
Carlisle, PA 17013 remainder
5 Tammie J. Mauck Granddaughter 1,000.00
1441 Crums Mill Road
Harrisburg, PA 17110
Total
3,000.00
1
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LAST WILL AND TESTAMENT
OF
GERTRUDE L. BROWN
I, GERTRUDE L. BROWN, of New Cumberland, 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 give and bequeath the sum of One Thousand and
NO/100 ($1,000.00) Dollars to each of my specifically named
grandchildren as follows: TAMMIE J. MAUCK, TERESA J. LAWRENCE and
THOMAS K. BROWN. Should any of these grandchildren predecease
me, I direct that their share under this, my Last Will and
Testament, shall pass to their issue per stirpes by representa-
tion.
SECOND: I devise and bequeath all the rest, residue
and remainder of my estate of whatever nature and wherever
situate, including any property over which I hold power of
appointment and together with any insurance policies thereon, in
equal shares, to my children, WINSLOW R. BROWN, II and LOIS B.
LEE.
THIRD: Should my son, WINSLOW R. BROWN, II, predecease
me, then I direct that his share under this, my Last Will and
Testament, shall pass to his wife, CAROLINE J. BROWN. Further-
more, in the event that both WINSLOW R. BROWN, II and CAROLINE J.
BROWN predecease me, then I direct that the share of WINSLOW R.
BROWN, II and CAROLINE J. BROWN under this, my Last will and
Testament, shall pass to their issue per stirpes by representa-
tion.
FOURTH: Should my daughter, LOIS B. LEE, predecease
me, then I direct that her share under this, my Last will and
Testament, shall pass to my son, WINSLOW R. BROWN, II, to be
disposed of as set forth in Clause THIRD hereinabove.
FIFTH: In addition to all powers granted to them by
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law and by other provisions of this Will, I give the fiduciaries
acting hereunder the following powers, applicable to all proper-
ty, exercisable without court approval and effective until actual
distribution of all property:
(A) To sell at public or private sale, or to lease,
for any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or
conditions as are deemed proper. This includes the power to give
legally sufficient instruments for transfer of the property and
to receive the proceeds of any disposition of it.
(B) To partition, subdivide, or improve real estate
and to enter into agreements concerning the partition, subdivi-
sion, improvement, zoning or management of real estate and to
impose or extinguish restrictions on real estate.
(C) To compromise any claim or controversy and to
abandon any property which is of little or no value.
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for pennsylvania fiduci-
aries, as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted
in insurance policies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws.
(G) To make distributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes.
2
(I) To select a mode of payment under any qualified
retirement plan (pension plan, profit sharing plan, employee
stock ownership plan, or any other type of qualified plan) to the
extent the plan or the law permits them to do so, and to exercise
any other rights which they may have under the plan, in whatever
manner they consider advisable.
SIXTH: I direct that all inheritance, estate, trans-
fer, succession and death taxes, of any kind whatsoever, which
may be payable by reason of my death, whether or not with respect
to property passing under this Will, shall be paid out of the
principal of my residuary estate.
SEVENTH: All interests hereunder, whether principal or
income, which are undistributed and in the possession of the
fiduciaries acting hereunder, even though vested or distribut-
able, shall not be subject to attachment, execution or sequestra-
tion for any debt, contract, obligation or liability of any
beneficiary, and furthermore, shall not be subject to pledge,
assignment, conveyance or anticipation.
EIGHTH: I nominate and appoint WINSLOW R. BROWN, II
and LOIS B. LEE, Co-Executors of this, my Last will and Testa-
ment. I direct that my Co-Executors, and their successors, shall
not be required to post security or a bond for the performance of
their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and
seal to this, my Last will and Testament, this l...:IJl-.. day of
~'-'.
, 1998.
._~,~ -fl. WsG~s-.-'
GERTRUDE L. BROWN
(SEAL)
3
Signed, sealed, published and declared by the above-
named Testatrix as and for her Last Will and Testament in our
presence, who, at her request, in her presence and in the
presence of each other, have hereunto subscribed our names as
attesting witnesses.
Address
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Register of Wills, Cumberland County, Pennsylvania
INVENTORY
Estate of Gertrude L. Brown
No. 21-06-0533
Date of Death 06/11/2006
Social Security No. 179-36-1226
also known as
. Deceased
Winslow R. Brown" Lois B. Lee
The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory
Include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania
of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of
the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except
that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory
are true and correct I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S.
Section 4904 relating to unsworn falsification to authorities.
Attorney:
James D. Bogar
19475
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Signature: ~ '-
~w R. jJroV!)t "
Signature: ~ It5 .~
Lois B. Lee
J.D. No.:
Signature:
~
Firm: Bogar & Hlpp Law Offices
Address: One West Main Street
Shlremanstown, PA 17011
Telephone: 717-737-8761
Address: 1771 North Meadow Drive
Mechanlcsburg, PA 17055
Telephone: (717) 766-1648
Dated: Of.u,)'l~
Personal Prooerty
Cash.............................................................................................. .
Personal Property......................................................... ................
Stocks/Listed.................................................................................
Stocks/Closely Held......................................................................
Bo n ds................................................................................ .............
Partnerships and Sole Proprietorships .....................................
Mortgages and Notes Receivable...............................................
All Oth er P rope rty .........................................................................
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Total Personal Property........................... ......... .....
117,291.91
Total Real Property.................................... ............
Total Personal and Real Property.........................
Total Out-of-State Real Property..........................
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Register of Wills, Cumberland County, Pennsylvania
INVENTORY
. Deceased
No. 21-06-0533
Date of Death 06/11/2006
Social Security No. 179-36-1226
Estate of Gertrude L. Brown
also known as
Cash
Commonwealth of Pennsylvania - Rent Rebate
500.00
Embarq - Sprint Refund
20.02
Highmark - Refund of Health Insurance Premium
291.51
M&T Bank - Checking Account No. 42697204; date of death balance $19,403.77;
accrued interest $0.39
19,404.16
M& T Bank - Savings Account No. 015004213662461; date of death balance
$58,921.72; accrued interest $65.50
58,987.22
M&T Bank - Certificate of Deposit No. 031003913498183; date of death balance
$17,992.87; accrued interest $41.25
18,034.12
Sovereign Bank - Certificate of Deposit No. 1685471557; date of death balance
$20,037.95, accrued interest $16.93. (The attached June 22, 2006 letter from
Sovereign Bank also makes reference to Certificate of Deposit No. 1685500447,
titled "Gertrude L Brown ITF Winslow R. Brown II & Lois B Lee". This account
was closed out on March 16,2006 for a closeout amount of $73,756.70. A
majority of these closeout funds were placed into the savings account of
Gertrude L. Brown with M&T Bank being Account No. 015004213662461. The
balance of the closeout was used to pay the expenses being incurred for the
maintenance of the Decedent at the Manor Care Center, Carlisle,
Pennsylvania.)
20,054.88
117,291.91
Total Cash
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
117,291.91
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BOGAR JAMES 0
1 W MAIN STREET
SHIREMANSTOWN, PA 17011
n_____. fold
ESTATE INFORMATION: SSN: 179-36-1226
FILE NUMBER: 2106-0533
DECEDENT NAME: BROWN GERTRUDE L
DATE OF PAYMENT: 09/08/2006
POSTMARK DATE: 09/08/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 06/11/2006
NO. CD 007181
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $4,528.11
I
I
I
I
I
I
I
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TOTAL AMOUNT PAID:
REMARKS:
CHECK# 1001
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$4,528.11
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS