HomeMy WebLinkAbout10-25-06
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17128-0601
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I DECEDENTS NAME (LAST. FIRST. AND MIDDLE INITIAL)
MOCK, JANE S.
11_- -- ------
I FILE NUMBER
21 06
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
223-66-9257
00328
NUMBER
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
SOCIAL SECURITY NUMBER
REGISTER OF WILLS
I
D 3. Remainder Return (date of death prior to 12-13-82)
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5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
Ten East High Street
Carlisle, P A 17013
(1 ) None
(2) 1,318,526.67
(3) None
(4) None
(5) 148,030.00
(6) None
(7) 1,100,786.48
(9) 59,622.99
(10) 5,969.35
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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(8)
(11 )
(12)
13_ Charitable and Governmental Bequests/Sec 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)
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 1-1-95)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
AME COMPLETE MAILING ADDRESS
Ivo V. Otto III, Esquire
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
(13)
(14)
15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15)
or transfers under Sec. 9116(a)( 1.2)
z 2,501,750.81 .045 (16)
0 16.Amount of Line 14 taxable at lineal rate x
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Q. 17.Amount of Line 14 taxable at sibling rate x .12
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....
19_ Tax Due (19)
DATE OF DEATH (MM-DD-YEAR) I' DATE OF BIRTH (MM-DD-YEAR)
102/04/2006 , 08/14/1918
I (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST. FIRST AND MIDDLE INITIAL)
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1. Original Return
D 2. Supplemental Return
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4. limited Estate
6. Decedent Died Testate (Attach copy
ofWIIi)
9. litigation Proceeds Received
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Q.
IRM NAME (If applicable)
Martson Deardorff Williams & Otto
ELEPHONE NUMBER
717/243-3341
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
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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)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
>>BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH<<
Copyright 2000 form software only The Lackner Group, Inc.
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65,592.34
2,50 1,750.81
2,501,750.81
112,578.79
112,578.79
Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
One Longsdorf Way
CITY
Carlisle
STATE PA
ZIP 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
112,578.79
100,000.00
5,263.16
Total Credits (A + B + C)
(2)
105,263.16
3. Interest/Penalty if applicable
D. Interest
E. Penalty
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3) 0.00
(4)
(5) 7,315.63
(5A)
(5B) 7,315.63
Total Interest/Penalty (0 + 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.
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:
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?............................................................................................................... .......
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? .......................... .......... ....... ..... ............... ... ......................................... ..........
Yes No
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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 retum, 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 PERSON RESPONSIBLE FOR FILING RETURN AODRESS
Phil~ ck J
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SIGNATURE OF PER
3 Creek Bank Drive
Mechanicsburg, PA 17055
DATE
JO/]i.f-/o~.
RESPONSIBLE FOR FILING RETURN
ADDRESS
DATE
SIGNATURE OF PREPARER OTHER T
Ivo V. Otto III, ES~
ADDRESS
Ten East High Street
Carlisle, P A 17013
DATE
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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. ~9116 (a) (1.1) (i)l.
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. ~9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. ~9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116
1.2) [72 P.S. ~9116 (a) (1 )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. ~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.
ESTATE OF
'.
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
MOCK, JANE S.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1
2
3
4
DESCRIPTION
Securities listed on Estate Valuation, File 10 1 0832.l.ml, attached hereto
Securities listed on Estate Valuation, File 10 I 0832.l.ml.bonds, attached hereto
500 shares American Medical Election Bonus, of no value
94267 shares Merrill Lynch CMA Tax-exempt money market fund
! FILE NUMBER
I 21 - 06 - 00328
UNIT VALUE
1.00
TOTAL (Also enter on line 2, Recapitulation)
I! VALUE AT DATE OF
DEATH
1,088,046.70
136,212.97
0.00
94,267.00
I
1-
1,318,526.67
'.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MOCK, JANE S.
FILE NUMBER
21 - 06 - 00328
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM
NUMBER
1
DESCRIPTION
VALUE AT DATE OF
DEATH
148,028.00
Interest in cottage at Cumberland Crossings
2
Visa, refund
2.00
TOTAL (Also enter on Line 5, Recapitulation)
148,030.00
.
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MOCK, JANE S.
i FILE NUMBER
21 - 06 - 00328
This schedule must be com leted and filed if the answer to an of
ITEM DESCRIPTION OF PROPERTY ! E EATH % OF
Include the name of the transferee, their relationship to decedent and the date of transfer. I DAT OF D . , EXCLUSION TAXABLE VALUE
NUMBER Attach a copy of the deed for real estate. ,vALUE OF ASSET! DECD S I (IF APPLICABLE)
INTEREST I
, ML Retirement Plus Annuity Contract #991526603; 188,575.64 100% 188,575.64
beneficiary: Jane S. Mock Trust as amended and restated
3/20/03
2 ML Retirement Plus Annuity Contract #991526939; 261,272.97 100% 261,272.97
beneficiary: Jane S. Mock Trust as amended and restated
3/20/03
3 PHCM Plus 2003 Variable Annuity Contract #711539354 4; 144,322.13 100% 144,322.13
beneficiary: Jane S. Mock Trust as amended and restated
3/20/03
4 PHCM Plus 2003 Variable Annuity Contract #7115393555; 127,140.00 100% 127,140.00
beneficiary: Jane S. Mock Trust as amended and restated
3/20/03
5 PHCM Plus 2003 Variable Annuity Contract #7115393566; 200,116.70 100% 200,116.70
beneficiary: Jane S. Mock Trust as amended and restated
3/20/03
6 ML Retirement Plus Annuity Contract #991526524; 161,359.04 100% 161,359.04
beneficiary: Bradley Mock and Mai Lara Mock,
grandchildren
7 Cash gift on 1/1/06 to Phillip W. Mock, son 12,000.00 100% 3,000.00 9,000.00
8 Cash gift on 1/1/06 to Christopher A. Mock, daughter 12,000.00 100% 3,000.00 9,000.00
TOTAL (Also enter on line 7, Recapitulation)
1,100,786.48
.. SCHEDULE H
FUNERAL EXPENSES &
COMMONWEALTH OF PENNSYLVANIA ADMINISTRATIVE COSTS
INHERITANCE TAX RETURN I I
RESIDENT DECEDENT
ESTATE OF MOCK, JANE S. I FILE NUMBER
. 21 - 06 - 00328
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION I AMOUNT
NUMBER I
A. FUNERAL EXPENSES: !
I Hoffman-Roth Funeral Home I 2,184.14
2 Christopher Mock, burial expense 63.00
3 Kathy Petty, music for memorial service 50.00
4 Reverend James Link, gratuity for memorial service 100.00
5 Fort Myers Restaurant, reception 154.50
6 Wayne Noss Flowers, memorial service 77.38
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees Martson Deardorff Williams & Otto (estimated) 55,000.00
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 I
I
5. Accountant's Fees
6. Tax Return Preparer's Fees Boyer & Ritter, 2005/2006 income tax returns I 800.00
I
I
7. Other Administrative Costs i
I Register of Wills: Filing fee, inheritance tax return i 15.00
i
2 I Office Max, supplies 58.97
I
Total of Continuation Schedule(s)
1,120.00
59,622.99
TOTAL (Also enter on line 9, Recapitulation)
'.
Schedule H
Funeral Expenses &
Adminis1rative Cos1s continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MOCK, JANE S.
3
Stock valuation reports
4
Certified mail
5
Reserved for filing fees, accounting, postage, brokerage fees
i FILE NUMBER
I 21 - 06 - 00328
I
i
I
I
I
I
Page 2 of Schedule H
115.00
5.00
1,000.00
'.
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MOCK, JANE S.
FILE NUMBER
21 - 06 - 00328
Include unreimbursed medical expenses.
ITEM
NUMBER
1
DESCRIPTION
AMOUNT
Diakon Lutheran, account payable, nursing home
1,538.35
2
Lead Forward, account payable for pledge
4,260.00
3
P A Dept. of Revenue, 2005 income tax
171.00
TOTAL (Also enter on Line 10, Recapitulation)
5,969.35
REV.151:S EX+ (9.00)
~
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SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MOCK, JANE S.
FILE NUMBER
21 - 06 - 00328
NUMBER I
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
i
RELATIONSHIP TO
DECEDENT
nn "'nt I
AMOUNT OR SHARE
OF ESTATE
I. I TAXABLE DISTRIBUTIONS (include outright spousal distributions)
I Bradley Mock
1381 Pitty Pat Road, Clarksville, TN 37042
I
'Grandson
I
!
$80,679.52 (Sch. G,
Item 6)
2
Mai Lara Mock Clark
Catterick Barracks, Petawawa
Ontario, Canada
Granddaughter
$80,679.52 (Sch. G,
Item 6)
3
Phillip W. Mock
3 Creek Bank Drive, Mechanicsburg, P A 17055
Son
$9,000.00 (Sch. G,
Item 7); 1/2 estate
residue
4
Christopher A. Mock
4713 Mt. Zion Road, Frederick, MD 21703
Daughter
$9,000.00 (Sch. G,
Item 8)
5
Phillip W. Mock, Trustee
Jane S. Mock Trust dtd 3/20/03
tho Christopher A. Mock
Daughter
1/2 estate residue
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
I
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Date of Death: 02/04/2006
Valuation Date: 02/04/2006
Processing Date: 02/27/2006
Shares
or Par
Security
Description
" ,
400 AMEREN CORP (023608102; AEE:
COM
New York Stock Exchange
02/03/2006
02/06/2006
2 )
50 AVAYA INC (053499109; AV)
COM
New York Stock Exchange
02/03/2006
02/06/2006
3 )
304 BURLINGTON RES INC (122014103; BR)
COM
New York Stock Exchange
02/03/2006
02/06/2006
4)
1200 CATERPILLAR INC DEL (149123101; CAT)
COM
New York Stock Exchange
02/03/2006
02/06/2006
Estate Valuation
High/Ask
50.46000
50.37000
10.44000
10.40000
90.80000
90.62000
68.97000
68.82000
Low/Bid
49.89000 H/L
50.12000 H/L
10.23000 H/L
10.22000 H/L
89.60000 H/L
89.63000 H/L
5)
Div: 0.25 Ex: 01/18/2006 Rec: 01/20/2006 Pay: 02/18/2006
67.75000 H/L
68.00000 H/L
1930 CISCO SYS INC (17275R102; CSCO)
COM
NASDAQ - Industrial
02/03/2006
02/06/2006
6)
235 COCA COLA CO (191216100; KO)
COM
New York Stock Exchange
02/03/2006
02/06/2006
7)
1400 DELL INC (24702R101; DELL)
COM
NASDAQ - Industrial
02/03/2006
02/06/2006
8 )
400 EXXON MOBIL CORP (30231G102; XOM)
COM
New York Stock Exchange
02/03/2006
02/06/2006
9:
1200 GENERAL ELECTRIC CO (369604103; GE:
COM
New York Stock Exchange
02/03,'2006
02/06/2006
18.33000
18.10000
41.23000
41.00000
29.32000
29.58000
61.82000
62.61000
33.14000
32.89000
Page 1
17.95000 H/L
17.83000 H/L
40.52000 H/L
40.63000 H/L
28.69000 H/L
29.10000 H/L
61. 03000 H/L
61.65000 H/L
32.77000 H/L
32.65000 H/L
Estate of: Jane S. Mock
Account: 10832.1, Merrill ~ynch Rev TUA
Report Type: Date of Death
Number of Securities: 29
File ID: 1J832.1.ml
Mean and/or Div and Int
Adjustments Accruals
Security
'lal ue
50.210000
20,084.00
10.322500
516.13
90.162500
27,409.40
68.385000
82,062.00
300.00
18.052500
34,841. 33
40.845000
9,598.58
29.172500
40,841.50
61.777500
24,711. DO
32.862500
:39,435.CO
This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4)
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Date of Death: 02/04/2006
Valuation Date: 02/04/2006
Processlng Date: 02/27/2006
Shares
cr Par
Security
Description
10 ;.
800 INTEL CORP (458140100; INTC)
COM
NASDAQ - Industrial
02/03/2006
02/06/2006
High/Ask
21.17000
20.85000
Low/Bid
11)
Div: 0.100000 Ex: 02/03/2006 Rec: 02/07/2006 Pay: 03/01/2006
20.73000 H/L
20.50000 H/L
900 JOHNSON & JOHNSON (478160104; JNJ)
COM
New York Stock Exchange
02/03/2006
02/06/2006
12)
57.50000
57.56000
60 MEDCO HEALTH SOLUTIONS INC (58405U102; MHS)
COM
New York Stock Exchange
02/03/2006 54.70000
02/06/2006 54.51000
13)
130 MEDTRONIC INC (585055106; MDT)
COM
New York Stock Exchange
02/03/2006
02/06/2006
14)
500 MERCK & CO INC (589331107; MRK)
COM
New York Stock Exchange
02/03/2006
02/06/2006
15)
1200 MICROSOFT CORP (594918104; MSFT)
COM
NASDAQ - Industrial
02/03/2006
02/06/2006
16)
2 ORTHOFIX INTL N V (N6748L102; OFIX)
COM
NASDAQ - Industrial
02/03/2006
02/06/2006
17)
320 PEPSICO INC (713448108; PEP)
COM
New Ycrk Stock Exchange
02/03/2006
02/06/2006
18)
1000 PFIZER INC (717081103; PFE)
COM
New York Stock Exchange
02/03/2006
C2/C6/:::CC6
19\
:~cc PITXEY BCWES INC :7244791CCj PEl;
COM
New York S~ock Exchange
02/03/2006
02/06/2006
56.07000
55.30000
34.64000
34.29000
27.70000
27.54000
43.32000
43.99000
57.59000
57.57600
25.78000
25.32000
42.61000
43.00000
Page 2
57.02000 H/L
56.65000 H/L
52.90000 H/L
53.44000 H/L
55.07000 H/L
54.55000 H/L
33.82000 H/L
33.74000 H/L
27.34000 H/L
27.09000 H/L
42.33000 H/L
42.50000 H/L
57.10000 H/L
56.77000 H/L
25.27000 H/L
24.95000 H/L
42.01000 H/L
42.21000 H/L
Estate of: Jane S. Mock
Account: 10832.1, Merrill Lynch Rev TUA
Report Type: Date of Death
Number of Securities: 29
File ID: 10832.1.ml
Mean and/or Div and :nt
Adjustments Accruals
security
Value
20.812500
+ 0.100000
20.912500
16,730.00
57.182500
51,464.25
53.887500
3,233.25
55.247500
7,182.18
34.122500
17,061.25
27.417500
32,901.00
43.035000
86.07
57.259000
18,322.88
25.330CO'c
:S,33C ,:C)
42.457500
50,949.00
/)
f) -I
This report was produced with EstateVa1, a product of Estate Valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revislon 7.0.4)
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Date of Death: 02/04/2006
Val~ation Date: 02/04/2006
Processing Date: 02/27/2006
Shares
or Par
Security
Description
High/ASk
20)
1000 PROCTER & GAMBLE CO (742718109; PG)
COM
New York Stock Exchange
02/03/2006
02/06/2006
60.05000
59.90000
Div: 0.28 Ex: 01/18/2006 Rec: 01/20/2006 Pay: 02/15/2006
59.32000 H/L
59.10000 H/L
21 ;
244 VERIZON COMMUNICATIONS (92343Vl04; VZ:
COM
New York Stock Exchange
02/03/2006 31.72000
02/06/2006 31.80000
22;
400 WAL MART STORES INC (931142103; WMT)
COM
New York Stock Exchange
02/03/2006
02/06/2006
46.21000
45.51000
23'
13560.87 EATON VANCE INVT TR (EZPNX)
PA LTD MAT C
Mutual Fund (as quoted by NASDAQ)
02/03/2006
24)
869.0578 EATON VANCE TAX ADVT DIV INCM (27828G107; EVT)
COM
New York Stock Exchange
02/03/2006 23.13000
02/06/2006 23.08000
25)
22909 EVERGREEN PA TAX FREE FD (EKVCX)
CL C
Mutual Fund (as quoted by NASDAQ)
02/03/2006
26)
727.65 ING EQUITY TR (44978A541; PBTAX)
CL A
Mutual Fund (as quoted by NASDAQ)
02/03/2006
27:
1178.677 MERRILL LYNCH GLOBAL ALLOCATN (589939404; MDLOX)
CL A
Mutual Fund (as quoted by NASDAQ)
02/03/2006
28)
3366 MLWIYIELD INSD FD INC (62630E107; MYI)
COM
New York Stock Exchange
02/03/2006 14.79000
02/06/2006 14.77000
29:
71.315 NUVEEN FLAGSHIP MULTISTATE I . FVACX;
VA M\.,W BD C
Mutual Fund (as quoted by NASDAQ:
02/03/2006
Total Va:t:.e:
,otal Accrual:
Total: $:,088,046.70
Page 3
Low/Bid
31.25000 H/L
31.50000 H/L
45.44000 H/L
45.05000 H/L
9.76000 Mkt
22.94000 H/L
22.91000 H/L
11.32000 Mkt
22.80000 Mkt
17.48000 Mkt
14.64000 H/L
14.67000 H/L
lC.850CO Mkt
Estate of: Jane S. Mock
Account: 10832.1, Merril~ Lynch Rev TUA
Report Type: Date of Jeath
Number of Securities: 29
File ID: 10832.1.ml
Mean and/or Div and Int
Adjustments Accrua:s
Security
Va:'-le
59.592500
59,592.50
280.0C
31.567500
7,702.47
45.552500
18,221.00
9.760000
132,354.09
23.015000
20,001.37
11.320000
259,329.88
22.800000
16,590.42
17.480000
20,603.27
14.717500
49,539.11
~0.85GOOO
773.77
$l,C87,-t66.7G
$58C.CO
This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If ycu have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4)
/J- I (:; ) ~ )
"
Estate Valuation
Date of Death: 02/04/2006
Valuation Date: 02/04/2006
Processing Date: 03/07/2006
Shares
or Par
Security
:::escripticn
High/Ask
Lcw/Bid
l'
118000 U S TREAS SEC STRIPPED INT PMT (912833KD1)
Flnancial Times Interactive Data
Mat: 11/15/2014 0%
02/03/2006
02/06/2006
66.74950 Mkt
66.70080 Mkt
2) 10000 ALEXANDRIA VA INDL DEV AUTH PO POLLUTN C (015309AE7)
Financial Times Interactive Data
DTD: 02/15/1994 Mat: 02/15/2024 5.375%
02/03/2006 100.11100 Mkt
02/06/2006 100.11100 Mkt
Int: 08/15/2005 to 02/04/2006
3 )
15000 BEDFORD CNTY VA INDL DEV AUTH REV BDS (07609PAP9)
Flnancial Times Interactive Data
DTD: 05/15/1999 Mat: 10/01/2020 5.1%
02/03/2006 105.41400 Mkt
02/06/2006 105.40900 Mkt
Int: 10/01/2005 to 02/04/2006
15000 NORFOLK VA G.O. REF (655867CM9)
Financial Times Interactive Data
DTD: 06/15/1998 Mat: 07/01/2014 5%
02/03/2006 104.78500 Mkt
02/06/2006 104.78100 Mkt
Int: 01/01/2006 to 02/04/2006
15000 STAFFORD CNTY VA CTFS PARTN REF COPS (85243 OBM)
Financial Times Interactive Data
DTD: 02/01/1994 Mat: 11/01/2009 5%
02/03/2006 101.07400 Mkt
02/06/2006 101.07000 Mkt
Int: 11/01/2005 to 02/04/2006
4)
5)
Total Value:
Total Accrual:
Total: $136,212.97
Page 1
Estate of: Jane S. Mock
Account: 10832.1-bonds
Report Type: Date of Death
Nu~~er of Securities: 5
Flle 10: 10832.1.ml.bcnds
Mean and/or Div and Int
AdJustments Accruals
66.725150
100.111000
105.411500
104.783000
101.072000
252.33
261.38
68.75
193.75
$776.21
Security
Va:ue
78,735.68
10,011.10
15,811.73
15,717.45
15,160.80
$135,436.76
7hlS report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If ycu have questlons,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.0.4)
SC.H
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JANE S. MOCK
ACCOUNT VALUATIONS
AS OF 2/4/2006
ML Retirement Plus Annuity Contract #991526603
Owner: Jane S. Mock
Beneficiary: Jane S. Mock Fiore Trust
Contract Value as of 2/3/06: $188,575.64
*
ML Retirement Plus Annuity Contract #991526939
Owner: Jane S. Mock
Beneficiary: Jane S. Mock Fiore Trust
Contract Value as of 2/3/06: $261,272.97
*
ML Retirement Plus Annuity Contract #991526524
Owner: Jane S. Mock
Beneficiaries: Bradley Mock and Mai Lara Mock - 50/50
Contract Value as of 2/3/06: $161,359.04
*
PHCM Plus 2003 Variable Annuity Contract #711539354 4*
Owner: Jane S. Mock
Beneficiary: Jane S. Mock Fiore Trust
Contract Value as of 2/3/06: $144,322.13
PHCM Plus 2003 Variable Annuity Contract #711539355 5*
Owner: Jane S. Mock
Beneficiary Jane S. Mock Fiore Trust
Contract Value as of 2/3/06: $127,140.00
PHCM Plus 2003 Variable Annuity Contract #711539356 6*
Owner: Jane S. Mock
Beneficiary: Jane S. Mock Fiore Trust
Contract Value as of 2/3/06: $200,116.70
* Death Claim Packets Forthcoming
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Global Private Client Group
P.O. Box 841
30 West Patrick Street
Frederick, Maryland 21705
301 694 7300
8007533113
FAX 301 694 7102
F TILES\DATAFILE'Est3te Planning.l0832_1 w,lI
LAST WILL AND TESTAMENT
I, JANE S. MOCK, of South Middleton Township, Cumberland County, Pennsylvania,
being of sound and disposing mind and memory, do hereby make, publish and declare this to be my
Last Will and Testament, hereby revoking any and all former Wills or Codicils made by me.
ITEM I: I have two (2) children whose names are PHILLIP W. MOCK and
CHRISTOPHER A. MOCK (herein referred to as "my children"). I have two grandchildren (the
children of my son, Phillip W. Mock), whose names are BRADLEY F. MOCK and MAl LARA
MOCK.
ITEM II: I direct that all my legally enforceable debts, funeral expenses, and
administrative expenses be paid from my estate, as soon as practicable after my death.
ITEM III: Notwithstanding the provisions of the foregoing ITEM II hereof, in the event
that my Executor shall determine that there is insufficient cash, or equivalent in marketable
securities, in my probate estate to satisfy the administrative and other expenses, debts and taxes
chargeable against my said probate estate, my Executor is directed to certify the amount of any such
deficiency to the then acting Trustee serving under the provisions of the AMENDED AND
REST A TED TRUST OF JANE S. MOCK created by me this date, for the purpose of securing
funding of such deficiency from the assets of the Trust Fund existing under the said AMENDED
AND RESTATED TRUST OF JANE S. MOCK.
ITEM IV: I bequeath any automobiles or motor vehicles I may own at my death, my
personal effects, such household goods if any as may be my individual property, and other tangible
personal property of like nature (not including cash or securities), together with any existing
insurance thereon, to my children as are living on the thirty-first day after my death, to be divided
between them with due regard for their personal preferences in as nearly eq ual shares as practical and
as they shall mutually agree. I direct that any of the foregoing articles not selected by my children
or about which there is no agreement shall be sold at public or private sale by my Executor, and I
further direct that the net proceeds thereof shall be administered and distributed as a part of the
/
residue of my estate.
Page I of 4 Pages
./.. /- :lL.
i [Initials]
ITEM V: I give, devise and bequeath all the rest, residue and remainder of my estate to
my Trustee under a certain inter vivos Trust Agreement heretofore created this date naming myself
and my son, PHILLIP W. MOCK, as Trustees, and my grandson, BRADLEY F. MOCK, as alternate
Trustee, to have and to hold, in trust, for the uses and purposes and subject to the terms and
provisions thereof.
ITEM VI: I hereby direct that all estate, inheritance, succession and other taxes imposed
or payable by reason of my death, together with interest and penalties thereon, if any, with respect
to all property comprising my gross estate for death tax purposes, shall be paid as provided in the
inter vivos Trust referred to above.
ITEM VII: I nominate, constitute and appoint my son, PHILLIP W. MOCK, as Executor
of my estate. In the event he shall be unable or unwilling to serve in such capacity, then I appoint
my grandson, BRADLEY F. MOCK, to act in such capacity.
ITEM VIII: I direct that my Executor shall not be required to file any bond in any
jurisdiction to secure the faithful performance of his duties, nor shall he be required to obtain any
order or approval of any court for the exercise of any power or discretion set forth in this Will.
ITEM IX: I authorize and empower my Executor, in his sole and absolute discretion, to
purchase or otherwise acquire and retain any investments of which I die seized or any real or
personal property of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or
grant options in regard to any or all property of any kind forming a part of my estate for such terms
and such prices as they may deem advisable; to borrow money for any purposes connected with the
protection and preservation of my estate; to mortgage or pledge any real or personal property forming
a part of my estate or to join in or secure the partition of same; to compromise any claims or
demands of my estate against others or of others against my estate; to make distribution in kind and
to cause any share to be composed of cash, property or undivided fractional shares in property
differcnt in kind from any other share; to employ agents, attorneys and proxics and to delegate to
them such power as my Executor considers desirable and to pay reasonable compensation for such
services as may be rendered by such agents, attorneys and proxies; and to execute and deliver such
instruments as may be necessary to carry out any of these powers. In addition, I direct that my
Page 2 of 4 Pages
/</~.
/ [Initials]
Executor shall have the power to conduct an inventory of any safe deposit box necessary to the
administration of my estate.
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IN WITNESS WHEREOF I have hereunto set my hand and seal this
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day of
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SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testatrix, as and
for her Last Will and Testament, in the presence of us, who at her request, have hereunto subscribed
o\t{" na~, es a~itn esses thereto, in the presence of the said (Tes~atr:ix, a, r Q, f eaCh,' ',\other.
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Page 3 of 4 Pages
COMMONWEAL TH OF PENNSYL VANIA )
: SS.
COu~TYOFCUMBERLAND )
We, Jane S. Mock, Ivo V. Otto III, and
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, the
Testatrix and the witnesses, respectively, whose names are signed to the foregoing instrument, being
first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and
executed the instrument as her last Will and that the Testatrix has signed willingly, and that the
Testatrix executed it as her free and voluntary act for the purposes therein expressed, and that each
of the witnesses, in the presence and hearing of the Testatrix, signed the Will as a witness and that
to the best of his/her knowledge the Testatrix was at that time eighteen years of age or older, of
sound mind and under no constraint or undue influence.
IK~~
subscribed and sworn to before me by Ivo V. Otto III and
1, --"'\ ,I'!
the witnesses, this ,At " " day of /}(,0. ,~{'f/.._ , .)t' { ~
Subscribed, sworn to and acknowledged before me by Jane S. Mock, the Testatrix, and
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( "[1,' ( I , /'\' I ':) ': "/ )
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Notary Public /
i NOTARIAL SEAL
J CORAlNE l. MYERS NotMv Public
I , Carlisle Born, CumberiandCouiity J
~~~!l..I.Pires May 27, 2003
Page 4 of 4 Pages
f FlL[S' D.-\TAFlLE' b(at~ pl;lnl~:l~g\ i CS32- i Ir.;Sf
AME\'DED AND RESTATED TRuST OF JANE S. ~fOCK
MADE and entered into this'" '.\ day of ) i \ . , "', , 2003, by and between JA0JE
S. ~fOCK (fonnerly known as Jane S. Mock Fiore) of 75 Magaw Avenue, Carlisle, Cumberland
County, Pennsylvania (hereinafter referred to as "Settlor"), and JANE S. .\10CK and PHILLIP W.
MOCK of34 East Pomfret Street, Carlisle, Cumberland County, Pennsylvania (hereinafter referred
to as "Tmstee(s)").
WHEREAS, Settlor has previously established a certain tmst by Jane S. Mock Fiore Tmst
dated the 15th day of July, 1996; and
WHEREAS, Settlor wishes to amend and restate such Tmst.
NOW, THEREFORE, intending to be legally bound hereby, Settlor and Tmstee(s) agree that
such Tmst is hereby amended and restated and Tmstee( s) shall hold and manage such property held
in such Tmst, as well as any other property that is a part of the Tmst or that may be added to the
Tmst for the following uses and purposes:
ARTICLE I
Settlor has two (2) children whose names are PHILLIP W. MOCK (referred to herein as
"Settlor's son") and CHRISTOPHER A. MOCK (referred to herein as "Settlor's daughter") Settlor's
son and daughter are referred to herein collectively as "Settlor's children", Settlor has two
grandchildren (the children of Settlor's son, Phillip W. Mock), whose names are BRADLEY F.
MOCK and MAl LARA MOCK.
ARTICLE II
The Tmstee(s) shall collect the income from the Tmst Estate and shall pay all proper charges
and expenses. The net income of the Tmst Estate after pay111ent of all such charges and expenses
shall be held, administered and invested by the Tmstee(s), to be distributed, together with the net
income and such accumulated income and corpus, as hereafter provided. All dividends payable in
shares of stock on the corporations declaring the dividend shall be treated as principal without regard
to the number of shares payable.
/\RTICLE III
During the lifetime of Settlor, this trust may be revoked by Settlor by giving five {5) days
written notice to the Trustee(s) hereunder, and in the case of such revocation, all the propeliy then
held in the trust shall be distributed to Settlor.
-1-
During the lifetime of Settlor, this trust may be altered or amended by agreement between
Settlor and the Trustee(s) hereunder.
ARTICLE IV
During the lifetime of Settlor, the net income of the trust, if any, shall be paid to or for the
benefit of Settlor in quarterly installments, and the principal of the trust, if any, or any portion of the
principal, shall be paid as Settlor, or someone acting legally on Settlor's behalf, may demand. Even
though Settlor is not adjudicated incompetent, if Settlor is under a legal disability or because of
mental or physical disability Settlor is, in the opinion of the Trustee(s) hereunder, unable to make
reasoned demands for amounts from the principal, the Trustee(s) hereunder shall pay for Settlor's
benefit such amount from the principal as may be necessary to maintain for Settlor a standard of
living approximately equal to that maintained by Settlor during Settlor's lifetime, and to meet
Settlor's expenses arising from ill health, or invalidism.
ARTICLE V
Upon the death of the Settlor, the Trustee shall consult Settlor's Executor following the death
of the Settlor with respect to the adequacy of assets in the probate estate of the Settlor to meet Settlor's
debts, expenses of last illness, funeral expenses, administration expenses and estate, inheritance,
transfer or other succession or death taxes assessable upon Settlor's estate. Should there be insufficient
cash or its equivalent in marketable securities in the probate estate of Settlor to satisfy such charges and
costs, then upon written certification of Settlor's Executor as to the amount of such deficiency, the
Trustee shall meet the deficiency from the assets of the Trust, either by distribution of the appropriate
amount to the said Executor, or by direct payment of such charges and costs to the respective claimants.
ARTICLE VI
Upon the death of Settlor, the principal and undistributed income, ifany, shall be distributed
in the follo\ving manner:
A. Fifty percent (50%) thereof shall be further held in trust for Settlor's daughter,
CHRISTOPHER A.~10CK, as provided under ARTICLE VII hereof.
B. Fiftypercent (50%) thereofshaIl be distributed to Settlor's son, PHILLIP \V. MOCK.
In the event he shall predecease or fail to survive Settlor, thcn his sharc shall be distributed or held
in trust as provided under ARTICLE VIII hereof.
-2-
ARTICLE VII
The Trustee for the purposes of this ARTICLE VII shall be PHILLIP W. yIOCK. In the
event that he shall be unable or unwilling to serve, then the Trustee shall be BRADLEY F. :MOCK.
The Trustee shall hold the property designated for the benefit of Settlor' s daughter, CHRISTOPHER
A. yIOCK, as follows:
A. The Trustee shall hold, invest and reinvest the same, collect the income arising
therefrom, and after paying expenses incident to the management of the Trust, shall use and apply
as much of the income as may be necessary in the sole discretion of the Trustee for the health,
maintenance and support of Settlor's daughter. The Trustee shall have the further discretion to
invade the principal of such share for such purposes, however, the Trustee is cautioned with regard
to the distribution of any income or principal, it being the intention that the trust established herein
for the benefit of Settlor's daughter benefit only Settlor's daughter and no other person or entity.
B. Upon the death of Settlor's daughter, the principal balance hereunder, and
accumulated income, if any, shall be distributed to Settlor's son, PHILLIP W. MOCK. In the event
he shall predecease or fail to survive the said CHRISTOPHER A. MOCK, then such principal
balance and accumulated income shall be distributed or held in trust as provided under ARTICLE
VIII hereof.
ARTICLE VIII
The Trustee for the purposes of this ARTICLE VIII shall be BRADLEY F. MOCK. The
Trustee shall hold the property designated for the benefit of the issue of Settlor's son, PHILLIP
W.MOCK, in equal shares, as follows:
A. The Trustee shall forthwith divide the trust estate into equal shares to create one share
for each of the issue of Settlor's son, each of whom is herein referred to as a "beneficiary." Each
share shall be held as a separate trust and disposed of as follows: The Trustee shall hold, invest and
reinvest the same, collect the income arising therefrom, and after paying all expenses incident to the
management of the trust, shall use and apply so much of the income and principal as may be
necessary in the sole discretion of the Trustee tor the support, well-being and education of the
beneficiary thereof
B. At such time as a beneficiary shall attain the age of thirty (30) years, the Trustee shall
distribute such beneficiary's share to such beneficiary, absolutely. In the event any beneficiary shall
-3-
fail to attain the age for distribution of his or her share hereunder and shall be survived by issue, then
his or her share shall continue to be held by the Trustees for such issue and distributed to them per
stirpes as each shall attain the age of thirty (30) years. In the event any beneficiary shall fail to attain
the age for distribution of his or her share hereunder and shall not be survived by issue, then his or
her share shall continue to be held or distributed, as appropriate, by the Trustees to the surviving
beneficiary.
ARTICLE IX
No part of the income or principal of the property held under this trust or trusts subsequently
created hereunder shall be subject to attachment, levy or seizure by any creditor, spouse, assignee
or trustee or receiver in bankruptcy of any beneficiary prior to his or her actual receipt thereof. The
Trustee shall pay over the net income and the principal to the parties herein designated, as their
interests may appear, without regard to any attempted anticipation, pledging or assignment by any
beneficiary of these trusts, and without regard to any claim thereto or attempted levy, attachment,
seizure or other process against said beneficiary.
ARTICLE X
In addition to the powers conferred by case law, by statute, and by other provisions hereof,
the Trustee(s) and their successors, shall have the following discretionary powers applicable to all
property held by it which powers shall be effective without order of any court and shall exist until
final distribution:
A. To retain any property of any nature received for whatever period it shall deem
advisable;
B. To invest and reinvest all or any part of said property in such stocks, bonds, common
trust funds, securities, accounts, certificates of deposit (including, but not limited to, stocks, bonds,
common trust funds, securities, accounts or certificates of deposit of any trustee) or other property,
real or personal, as the Trustee(s) shall deem proper, without regard to statutes limiting the property
which a fiduciary may purchase;
C. To sell, transfer, exchange or othenvise dispose of, any part of said propcr1y, tor cash
or on tC1l11S, publicly or privately, or to lease, even for a tCll11 exceeding five (5) years or the duration
of any trust herein, without liability on the purchasers or lessees to see to the application of the
-4-
proceeds, and to give options for these purchases without the obligation to repudiate them in favor
of a higher offer;
D. To execute and deliver any deeds, leases, assignments or other instruments as may
be necessary to carry out the provisions of any tmst hereunder;
E. To borrow money, including the right to borrow money from any bank and to
mortgage or pledge any asset of the estate as security;
F. To assume continuance of the status of any beneficiary with regard to death, marriage,
divorce, illness, incapacity and the like in the absence of information deemed reliable without
liability for disbursements made on such assumption;
G. To pay from the corpus of the Tmst, or the income therefrom, all debts, claims, taxes
or similar charges;
H. To make any distribution hereunder either in kind or in money, or partially in kind
and partially in money. Distribution in kind shall be made at the market value of the property
distributed, and the Trustee(s), in their absolute discretion, may cause the share distributed to any
distributee to be composed of property similar to or different from that distributed to any other
distributee;
1. To exercise any subscription right in connection with any security held hereunder, to
consent to or participate in any recapitalization, reorganization, consolidation or merger of any
corporation, company or association, the securities of which may be held hereunder, to delegate
authority with respect thereto, to deposit investments under agreements, to pay assessments, and
generally to exercise all rights of investors;
1. To invest in endowment, insurance or annuity policies on the lives of beneficiaries
of any trust hereunder;
K. To continue in any partnership, joint venture, joint ownership or other business
enterprise of which Settlor is a part at thc time of her death;
L. To compromise claims;
,\1. To continue for whatC\'lT period of time as the Trustee(s) shall deem necessary any
ownership as a tenant in common or as a partner, in real estate or other property and to act as Settlor
could have acted while living;
N. To employ agents, attomeys and proxies and to delegate to them such pO\ver as my
-5-
personal representative and Trustee(s) consider desirable and to pay reasonable compensation for
such services as may be rendered by such agents, attorneys and proxies;
O. To do all other acts in the judgment of the Trustee(s) necessary or desirable for the
proper management, investment and distribution of Settlor's trust.
ARTICLE XI
In the event the Trustee, PHILLIP W. MOCK, shall be unable or unwilling to continue to
serve as Trustee, then and in that event BRADLEY F. MOCK shall serve as successor Trustee for
the remaining life of Settlor.
ARTICLE XII
This trust shall be administered and interpreted 111 accordance with the laws of the
Commonwealth of Pennsylvania.
IN WITNESS WHEREOF, Settlor and Trustees have hereunto set their hands and seals the
day and year first aforesaid.
Witness:.",':.-\,
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SETTLOR:
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Jane S. Mock
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(SEAL)
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TRUSTEES:
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Jane S. Mock
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Phillip W., ock
-6-
COMMO~WEAL TH OF PENNSYL VA~IA )
:SS.
COG0iTY OF CUMBERLA~ )
On this, the <' day of / I:,;, (l t , ~)( (, , before me, the undersigned officer,
personally appeared Jane S. Mock, known to me to be the person whose name is subscribed to the
within instmment as Settlor and Tmstee, and acknowledged that she executed the same for the
purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and notarial seal.
/
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Notary Public
'~.-'.-. ..-_""".....,...... .~<.J"___ ._..... ...............""'. '''"''''<_,..-.. '_"""'.'.__ ____...,
':OT.\RIAl :-,tAl :
'~Ci=iAINE L. MYEPS.'Jotary MJbIicI
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.~~!Y,Q9~:~j~~:~~: ,::~~:~~_y.ay 27, 200~
COMMONWEALTH OF PENNSYLVANIA )
:SS.
COUNTYOFC~fBERLAND )
On this, the' if .. t'day of ) / ,; " /'.
,. .','.. , , before me, the undersigned officer,
personally appeared Phillip W. Mock, known to me to be the person whose name is subscribed to
the within instmment as Tmstee, and acknowledged that he executed the same for the purposes
therein contained.
IN WIT;\,ESS \VHEREOF, I hereunto set my hand and notarial seal.
~otary Public
I
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