HomeMy WebLinkAbout09-13-06
Register of Wills, Cumberland County, Pennsylvania
INVENTORY
Estate of
Chris W Mummert
No.
21-06-00143
also known as
, Deceased
Date of Death 12/26/2005
Social Security No. 171-42-8800
Michael L. Mummert
The Personal Representative(s)olftle-a-boveEstate, deceased, verify thaftheltems 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:
Sharon E Myers
Signature:
. ~~~
Michael L. Mummert
I.D. No.:
32111
Signature:
Signature:
Firm:
CGA Law Firm____ __ __
106 Harrisburg Street
PO Box 606
East Berlin, PA 17316
-~----'-'-'-"-'.'--~-'-----"-------------'--
717259-9592
Telephone:
Address: 6 Pemberton Drive
East Berlin, PA 17:l16
Telephone: 717-259-0077
Address:
~ llJ.91
Dated:
Personal Property
Cash...............................................................................................
Personal Property ................................................ .........................
Stocks/Listed............................................................................... ..
Stocks/Closely Held ............................ ..........................................
Bonds.............................................................................................
Partnerships and Sole Proprietorships .....................................
Mortgages and Notes Receivable...............................................
All Other Property................................ ..... ....................................
2,~.29
1,3sl1:-ijo
(,'-.'l
Total Personal Property.........................................
3,892.29
Total Real Property................................................
Total Personal and Real Property.........................
Total Out-of-State Real Property..........................
Register of Wills, Cumberland County, Pennsylvania
INVENTORY
Estate of
Chris W Mummert
No.
21-06-00143
also known as
: Deceased
Date of Death 12/26/2005
Social Security No. 171-42-8800
Cash
M & T Bank Checking Account 1349953
2.094.69
McCoy Bros. - pay check 12/21/05
319.38
McCoy Bros. - pay check 12/28/05
128.22
Total Cash
2.542.29
Personal Property
1989 Toyota Truck
1.350.00
Total Personal Property
1.350.00
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
3.892.29
! OFFICIAL USE ONLY
I
I ALE NUMBER
I II 06
! COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
REV-1500 EX + (6-00)
REV.1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
.
00143
NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Mummert, Chris W
DATE OF DEATH (MM-DD-YEAR)
1 j'1-42-8800
I-
Z
111
o
111
o
111
o
DATE OF BIRTH (MM-DD-YEAR)
THI~i RETURN MUST BE ALED IN DUPUCATE WITH THE
k REGISTER OF WILLS
I SOCIAL SECURITY NUMBER
o 3, R:emainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
01-19-1955
12-26-2005
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
~ 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (Attach
copy of Will)
o 9. Litigation Proceeds Received
Supplemental Return
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4a. Future Interest Compromise (date of death after
12-12-82)
7. Decedent Maintained a Living Trust (Attach
copy of Trust)
10 Spousal Povertv Credit (date of death between
. 12-31-91 and 1-1-M)
to-
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COMPLETE MAILING ADDRESS
NAME
Sharon E Myers
FIRM NAME (II applicable)
CGA Law Firm
1 06 Harrisbur!~ Street
PO Box 606
East Berlin, P,f\ 17316
TELEPHONE NUMBER
717 259-9592
(1) None OFFICIAL USE ONL Y
(2) None
(3) r--.,'
None )
(4) None
-)
(5) 3,892.29
( ., "',
(6) j
None
.J
(7) 1,247.10 'j
~8) 5, 13:g:.1~
.- . ,
(9) 5,660.23 ~-
(10) 5,761.04
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
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)
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111
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(11)
11,421.27
11. Total Deductions (total Lines 9 & 10)
(12)
insolvent
12. Net Value of Estate (Line 8 minus Line 11)
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)
(13)
0.00
(14)
0.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15.Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15)
or transfers under Sec. 9116(a)(1.2)
z
0 .045 (16)
i= 16. Amount of Line 14 taxable at lineal rate 0.00 x
c(
I-
:)
Il. 17. Amount of Line 14 taxable at sibling rate 0.00 x .12 (17)
~
0
0 18. Amount of Line 14 taxable at collateral rate 0.00 x .15 (18)
)(
c(
I- 19. Tax Due (19)
0.00
0.00
0.00
0.00
0.00
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
20.0
Form REV-1500 EX (Rev. 6-00:
Copyright 2002 form software only The Lackner Group, Inc.
Decedent's Complete Address:
STREET ADDRESS
324 N. Baltimore Street
CITY Mt. Holly Springs
I STATE PA
IZIP
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
0.00
0.00
Total Credits (I>. + B + C)
(2)
0.00
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
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.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(3)
(4)
(5) 0.00
(SA)
(5B) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN nlE APPROPRIATE BLOCKS
1. Did decedent make a transfer and:
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; or... ..... .... .............. ....... ............ ..... ........ .... ...... .................. ......... ......... ..........
d. receive the promise for life of either payments, benefits or care?.............................................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?.................................................................................................................... ..
Yes
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?..... ............................ ....... ......... ..... ........ ...................................... ........... ....... ~ 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties 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, it is true, correct and
complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSO RESPONSIBL~E FOR FILING RETURN ADDRESS
'C. ael. nm~ _ 6 Pemberton Drive
l\v~ . East Berlin, PA 17316
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
o
o
o
o
o
o
No
~
~
~
~
~
~
DATE
t1-' l do 6
DATE
N REPRESEN
ADDRESS
t1 \ rtl (fL
DATE
106 Harrisburg Street
East Berlin, PA 17316
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 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 exemot 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 ,So 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
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Mummert, Chris W
JFILE NUMBER
21-06-00143
ESTATE OF
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property JolnUy-owned with the right of survivorship must be disclosed on sched.,le F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 M & T Bank Checking Account 1349953 2.094.69
2 McCoy Bros. - pay check 12/21/05 319.38
3 McCoy Bros. - pay check 12/28/05 128.22
4 1989 Toyota Truck 1.350.00
TOTAL (Also enter on Line 5, RecaJl,itulation)
3.892.29
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
Rey.1510 EX+ (6-98)
*'
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Mummert, Chris W
JFILE NUMBER
21-06-00143
ESTATE OF
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECD'S TAXABLE
EXCLUSION
NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE.
1 M & T Bank IRA 035004200166997 $645.86 + 650.55 650.55
DOD into $4.69
2 M & T Bank IRA 035004200297362 $594.10 + 596.55 596.55
DOD int $2.45
TOTAL (Also enter on Line 7, Recapitulation) 1.247.10
(If more space is needed, additional pages Dfthe same size)
Copyright (c) 2002 form software only The Lackner Group. Inc.
Form PA-1500 Schedule G (Rev. 6-98)
REV-1151 EX+ (12-99)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
J
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Mummert, Chris W
Debts of decedent must be reported on Schedule I.
] FILE NUMBER
21-06-00143
ESTATE OF
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 2,343.20
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 3,000.00
See continuation schedule(s) attached
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 91.00
See continuation schedule(s) attached
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 226.03
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 5,660.23
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (6-98)
*'
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Mummert, Chris W
lFILE NUMBER
21-06-00143
ESTATE OF
ITEM
NUMBER DESCRIPTION
1 Feiser Funeral Home - funeral bill
AMOUNT
2.343.20
Subtotal
2.343.20
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-B2
ATTORNEY'S FEES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAA RETURN
RESIDENT DECEDENT
Mummert, Chris W
-/FILE NUMBER
21..Q6..Q0143
ESTATE OF
ITEM
NUMBER DESCRIPTION
1 CGA Law Firm - Attorney Fees
AMOUNT
3.000.00
Subtotal
3.000.00
Copyright (c) 2002 form software only The Lackner Group. Inc.
Form PA-1500 Schedule H-82 (Rev. 6-98)
Rev-1502 EX+ (6-98)
*'
SCHEDULE H-B4
PROBATE FEES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Mummert, Chris W
-I FILE NUMBER
21-06-00143
ESTATE OF
ITEM
NUMBER DESCRIPTION
1 Register of wills of Cumberland County - Probate fee
AMOUNT
91.00
Subtotal
91.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B4 (Rev. 6-98)
Rev-1502 EX+ (6-98)
SCHEDULE H-87
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Mummert, Chris W
lFILE NUMBER
21..06..00143
ESTATE OF
ITEM
NUMBER DESCRIPTION
1 CGA Law Firm - Notary Fees
AMOUNT
10.00
2 Cumberland Law Journal - Advertise Estate
75.00
3 Register of Wills of Cumberland Co - Short Certificate
4.00
4 The Sentinel - Advertise Estate
137.03
Subtotal
226.03
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
Mummert, Chris W
JFILE NUMBER
21-06-00143
ESTATE OF
Include unrelmbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Chase Credit Card bill
VALUE AT DATE
OF DEATH
1.609.41
2 Met-ED - final electric bill
422.84
3 Providian Credit Card bill
3.728.79
TOTAL (Also enter on Line 10, Recapitulation)
5,761.04
(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 ..
BENEFICIARIES
J
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
Mummert, Chris W
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
RELATIONSHIP TO
DECEDENT
Do Not Ust Trustee(s)
FILE NUMBER
21-06-00143
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
I.
Colby Frantz
4 Photinia Drive
Newark, DE
Son
Total
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-15Q1[) COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
~M&rBank
~R 1 ~ '2.000
499 Mitchell Road, MiIlsboro, DE 19966 Mail Code DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
March 10, 2006
CGA Law Firm
Attorneys At Law
106 Harrisburg Street
POBox 606
East Berlin, Pennsylvania 17316
Re: Estate of Chris W Mummert
Social Securitv: 171-42-8800
Date of Death: December 26. 2005
Dear Sir or Madam:
Per your inquiry dated February 22, 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
1349953
Ownership (Names of)
Chris W Mummert *
Opening Date
04/28/97
Balance on Date of Death
$2,094.69
Accrued Interest
$ 0.00
Total
$2,094.69
2.
Type of Account
IRA
Account Number
035004200166997
Ownership (Names of)
Chris W Mummert *
Michael Mummert, Beneficiary *
Opening Date
05/06/99
Balance on Date of Death
$645.86
Accrued Interest
$ 4.69
Total
$650.55
3.
Type of Account
IRA
Account Number
035004200297362
Ownership (Names oj)
Chris W Mummert *
Michael Mummert, Beneficiary *
Opening Date
11/12/99
Balance on Date of Death
$594.10
Accmed Interest
$ 2.45
Total
$596.55
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 Mt Holly Springs Office # 717-486-3038.
Sincerely,
~u;~
Nancy Clagett
Records Management
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1989 Toyota Pickup Short Bed
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.. Private Party Value
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BLUE BOOK~ PRIVATE PARTY VALUE
Estimated Pay.
$27 /mo @ 7.15% A
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Condition
Value
http://www.kbb.comlkb/ki.dll/kw.kc.ucp?kbb.PA;;P AOOI ;&17316&;873541&:;;ucp;&18;TT;AI 03/16/2006
Excellent
$1,975
Good
$1,675
Fair
$1,350
(Selected)
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Vehicle Details
Change Equipment
Engine:
Transmission:
Drivetrain:
Mileage:
4-Cyl. 2.4 Liter
4 Speed Manual
2WD
90,000
Selected Standard Equipment
AM/FM Stereo
Blue Book Private Party Value
Private Party Value is what a buyer can expect to pay when buying a used car from a private
party. The Private Party Value assumes the vehicle is sold "As Is" and carri"s no warranty
(other than the continuing factory warranty). The final sale price may vary depending on the
vehicle's actual condition and local market conditions. This value may also be used to derive
Fair Market Value for insurance and vehicle donation purposes.
Vehicle Condition Ratings
Check Vehicle Title History
Excellent
r.."fOO"tD $1,975
"Excellent" condition means that the vehicle looks new, is in excellent mechanical condition
and needs no reconditioning. This vehicle has never had any paint or body work and is free
of rust. The vehicle has a clean tit~e history and will pass a smog and safety inspection. The
engine compartment is clean, with no fluid leaks and is free of any wear Ol~ visible defects.
The vehicle also has complete and verifiable service records. Less than 5Gf:) of all used
vehicles fall >oto this category.
LAW
i~
..
R M
F
COllntess Gilbert j\ndrcws roc
Sharon E. Myers, Attorney
smyers@cgalaw.com
September 8, 2006
Register of Wills of Cumberland County
One Courthouse Square
CarlislePA 17013-3387
Re: Chris W. Mummert Estate File No. 21-06-00143
Dear Register of Wills:
Enclosed please two copies of a P A Inheritance tax return and one Inventory for the above
referenced Estate. Also included is a check for $30.00, the filing fee.
Please send a receipt to this office.
Sincerely,
Sharon E. Myers
Enclosures
SEM/nh
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{00175564/l}
CGA L.aw Firrn, 106
St, PO BCJX 606, East Berllll, PA17316, 7172599592, Fax 717;)59 c, 48. Wlt/'/',
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