HomeMy WebLinkAbout01-03-07
REV-1500 EX + (6-00)
i OFFICIAL USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN IFILENUM;E; 06
RESIDENT DECEDENT___L COUN~ODE YEAR
SOCIAL SECURITY NUMBER
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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NUMBER
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Mowery, Charles C.
DATE OF DEATH (MM-DD-YEAR)I DATE OF BIRTH (MM-DD-YEAR)
.08-12-2006 . I 02-11-1927 ________
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
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 '-'-~5)
[!] 1. Original Return
D 4. Limited Estate
[!] 6. Decedent Died Testate (Attach
copy of Will)
D 9. Litigation Proceeds Received
D
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2. Supplemental Return
202-20-1508
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
I
o 3. Remainder Return (date of death prior to 12.13-82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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I COMPLETE MAILING ADDRESS
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15.Amount of Line 14 taxable at the spousal tax rate,
or transfers under Sec. 9116(a)(1.2)
NAME
Jan M. Wiley
._~---~--._--_. ---"~I
FIRM NAME (if applicable)
_WiI_!~,-.!:enox,_<::o.!.~an, !~arzzac~o--,-P.~. _. .!
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TELEPHONE NUMBER
717-432-9666
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)
130 W. Church St
Dillsburg, PA 17019
(1 )
(2)
(3)
(4)
(5)
(6)
(7)
140,742.23
OFFICIAL USE ONLY
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
None
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None
None
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18,202.34
13,729.57
- ---"-~---..._-------~-.'--'-~"---
1 0,692.50
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(8)
1 &5>,366.64
(9)
(10)
25,032.23
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1,536.57
(11) 26,568.80
(12) 156,797.84
! 12. Net Value of Estate (Line 8 minus Line 11)
nl3. Charitable and Governmental Bequests/See 9113 Trusts for which an election to ta. x has
not been made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
16. Amount of Line 14 taxable at lineal rate
17.Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.0
(13) 0.00
(14) 156,797.84
0.00
x .00 (15)
0.00
156,797.84
x .045 (16)
7,055.90
0.00
0.00
x .12 (17)
x .15 (18)
(19)
0.00
0.00
7,055.90
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
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Copyright 2002 form software only The Lackner Group, Inc.
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Form REV-1500 EX (Rev. 6-00:
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Decedent's Complete Address:
STREET ADDRESS
4700 Delbrook Road
-----------m---r;.:-.,----m--r.-....-..------.---
I STATE PA ZIP 17055
C/TY
Mechanicsburg
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1 )
7,055.90
5,343.75
_____~___.._m.___ ____.______
281.25
Total Credits (A + 8 + C)
(2)
5,625.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Tota/lnterest/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.
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3)
(4)
(5) 1,430.90
(5A)
(58) 1,430.90
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? .......... ................................................. ............ .......... ....... .................. ...... ......
Yes
o
No
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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 peljury, I declare that I have examined this retum, including accompanying schedules and statements. and to the best of my knowledge end 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 ADDRESS
P icia Ann Mowery
~
SIG ATURE OF PERSON RESPONSIB E FOR FILING RET N
Pamela Sue Bower
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fIGNATUR~F PREPARER OTHER THAN REPRESE AliVE
\ Jan . Wiley ., J.-..
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DATE
ADDRESS
617 Cedar Ridge Lane
Mechanicsburg, PA 17055 ---.---.-.--....L...i:E I +c::! (,
126 W. Portland St., Apt. 3
Mechanicsburg, PA 17055 ~ J~, I () l.
__.__.__m_._____.___~_._._____ ~_
130 W. Church St I Z. <1/ 0 <-
Dil/sburg, PA 17019
ADDRESS
or 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
urvj{.ing spouse is 3% [72 P.S. 99116 (a) (1.1) (i)].
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%
2 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.
fuast lIill nnn QIestCtm.ent
OF
CHARLES c. MOWERY
BE IT REMEMBERED, that I, CHARLES c. MOWERY, of 4700
Delbrook
Road,
Mechanicsburg,
Cumberland
County,
Pennsylvania, being of sound mind, memory and understanding,
do make, publish and declare this as and for my Last Will and
Testament, hereby revoking and making null and void any and
all wills and Testaments and writings in the nature thereof
by me at any time heretofore made.
ITEM 1:
I direct that all my just debts and funeral
expenses be paid as soon after my demise as may be
convenient.
ITEM 2:
I give my 1989 Pontiac 600 LE, to my friend,
MARY A. MOWERY.
ITEM 3:1 give my real estate situate at 4700 Delbrook
Road, Mechanicsburg, Cumberland county, Pennsylvania, and all
my personal property situate therein to my daughter, PATRICIA
ANN MOWERY.
ITEM 4:
I give the sum of One Thousand Dollars
($1,000.00) to my granddaughter, MICHELE L. MOWERY.
ITEM 5 :
All the rest, residue and remainder of my
estate, of whatsoever nature and wheresoever situate, whether
it be real, personal or mixed, including property over which
I have a power of appointment, I give, devise and bequeath as
follows to wit:
(a) Forty-five percent (45%) thereof to my daughter,
PATRICIA ANN MOWERY.
(b) Forty-five percent (45%) thereof to my daughter,
PAMELA SUE BOWER.
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~e ~(SEAL)
CHARLES C. MOWERY
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(c) Five percent (5%) thereof to my son, RICHARD C.
MOWERY.
(d) The remaining five percent (5%) thereof to my son,
ROBERT W. MOWERY. L~eC\5ecL "8/0 I 0 &)
ITEM 6: I direct my hereinafter named Co-Executrices to
pay all inheritance, estate, succession and legacy taxes of
whatsoever nature and kind, to which my estate or the
transfer of any property passing hereunder or otherwise
passing by reason of my demise, may be subject and to charge
such taxes against my residuary estate, it being my intention
that none of the aforesaid taxes, either federal or state, on
any property required to be included in my gross estate,
under the provisions of any state or federal law now in force
or hereafter enacted, shall be prorated among the persons
interested in my estate to whom such property is or may be
transferred or to whom any benefit accrues.
ITEM 7: I appoint my daughter, PATRICIA ANN MOWERY, and
my daughter, PAMELA SUE BOWER, as Co-Executrices of this my
Last will and Testament.
ITEM 8:
I direct that my CO-Executrices shall not be
required to give bond for the faithful performance of their
duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this 3:)dl. day of ----<'r~tJ/n1...../d-<-..' , 1998.
an/l~C '~(SEAL)
CHARLES C. MOWERY
-2-
COMMONWEALTH OF PE~~SYLVANIA
SS
COUNTY OF YORK
We, CHARLES C. MOWERY, JAN M. WILEY, ESQUIRE and
JANICE E. YOCUM, the Testator and the witnesses
respectively, whose names are signed to the attached or
foregoing instrument, being first duly sworn, do hereby
declare to the undersigned authority that the Testator
signed and executed the instrument as his Last will and
Testament and that he had signed willingly (or willingly
directed another to sign for him), and that he executed
it as his free and voluntary act for the purposes therein
expressed, and that each of the witnesses, in the
presence and hearing of the Testator, signed this Last
Will and Testament as witness and that to the best of
their knowledge the Testator was at the time eighteen
(18) years of age or older, of sound mind and under no
constraint or undue influence.
before
day of
, 1998.
NOTARY PUBLIC
MY COMMISSION EXPIRES:
Notarial Seal
S. Dawn Gladfelter. Notary Public
OiIlsburg Bora. York COUrTly
My Commission Expires May 17.2001
Member. Pennsylvania Association 01 Notaries
FIRST CODICIL TO THE LAST WILL AND TESTAMENT
OF
CHARLES C. MOWERY
I, Charles C. Mowery, of 4700 Delbrook Road, Mechanicsburg, Pennsylvania, declare this
to be the first codicil to my will dated the 30th day of September, 1998.
I hereby DELETE Item #2 of said Last Will & Testament, which reads as follows: I give
my 1989 Pontiac 600 LE, to my friend, Mary A. Mowery.
It is my desire to entirely eliminate Mary A. 1\I10wery from my Last Will & Testament.
In all other respects, 1 do hereby ratify and confirm my will dated the 30th day of
September 1998.
Signed, this 7+.!J day of k6raa.rLt, 2001 by Charles C. Mowery, the testator, as and for
a codicil to his will dated the =30-+21 day of S~plember, 1998, in the presence of us who, at his
request, in his presence, and the presence of each other have signed our names as witnesses.
0CnA~ c: '\n-.~
CHARLES C. MOWERY, TEST TOR
~~./~~
. I\N M. WILEY, ESQ
One South Baltimore Street
Dillsburg, P A 17019
~v~
'""SHAWNAL. ARNER
One South Baltimore Street
Dillsburg, P A 17019
Commonwealth of Pennsylvania
County of York
SS.
)
)
)
We, CHARLES C. MOWERY, JAN M. WILEY, ESQUIRE and SHAWNA L. VARNER, the
testator in and the undersigned witnesses to the codicil, the attached or foregoing instrument, who
have signed the instrument, having been qualified according to law do depose and say:
(a) that 1, the testator, do hereby acknowledge that I signed and executed the instrument as a
codicil to my will, that 1 signed it willingly and as my free and voluntary act for the purposes
therein expressed: and
(b) that we, the witnesses, were present and saw the testator execute the instrument as his codicil,
that he signed it willingly and executed it as his free and voluntary act for the purposes therein
expressed: that each of us in the hearing and sight of the testator signed the codicil as a witness
and that to the best of our knowledge the testator was at that time 18 or more years of age, of
sound mind and under no constraint or undue influence.
i2.J41~ C' 'J-vl, th.~
estator
VV\.....
Sworn to and subscribed before me
this 7.t!J day of -kb r t.h:1.-rt.J... , 2001
I
-5;D~ ),iu~
NOTARYP LIC ,
MY COMMISSION EXPIRES:
Notarial Seal
S Dawn Gladfelter, Notary Publie
, Dillsburg Bora. York County
M Commission ExpIres May 17,2001
Y .
emoer, Pennsylvania Association of Notanes
Rev.1502 EX+ (6.98)
.
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mowery, Charles C.
FILE NUMBER
21-06-00731
All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at which property would be
exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which Is Jolntly-owned with rtght of survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 Sale of real estate situate at 4700 Oelbrook Road, Mechanicsburg, PA:
VALUE AT DATE
OF DEATH
140,000.00
2 Tax proration due estate from sale of real estate:
742.23
TOTAL (Also enter on Line 1, Recapitulation)
140,742.23
(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 A (Rev, 6-98)
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A. B. TYPE OF LOAN:
U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1.DFHA 2.0FmHA 3.!RlCONV. UNINS. 4.0VA 5.0CONV.INS.
6. FILE NUMBER: 17. LOAN NUMBER:
SETTLEMENT STATEMENT ASA-060337 11929973
8. MORTGAGE INS CASE NUMBER:
C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settiement agent are shown.
Items marked "[POC]" were paid outside the closing; they are shown here for informational purposes and are not included in the totals.
1.0 3I9B (ASMlB0337.PFO/ASMlB0337121 )
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
Cory M. Gumby Estate of Charles C. Mowery M& T Mortgage Corporation
4700 Delbrook Road One Fountain Plaza. Attn: Post Closing/6th FI
Mechanlcsburg. PA 17050 Buffalo. NY 14240
G. PROPERTY LOCATION: H. SETTLEMENT AGENT: 02-0640071 I. SETTLEMENT DATE:
4700 Delbrook Road Appalachian Settlement Agency. LLC.
Mechanicsburg, PA 17050 November 27, 2006
Cumberland County, Pennsylvania PLACE OF SETTLEMENT
M&T Bank
Mechanicsburg, P A
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER:
101. Contract Sales Price 140 000.00 401. Contract Sales Price 140.000.00
102. Personal Prooertv 402. Personal Property
103. Settlement Charoes to Borrower (Line 14001 4,667.34 403.
104. 404.
105. 405.
Ad'ustments For Items Paid Bv Seller in advance Ad'uslments For Items Paid Bv Seller in advance
106. Citvrrown Taxes to 406. Citvrrown Taxes to
107. County Taxes 11/27/06 to 01/01/07 28.89 407. County Taxes 11/27/06 to 01/01/07 213.89
108. School Taxes 11/27/06 to 07/01/07 666.17 408. School Taxes 11/27/06 to 07/01/07 666.17
109. Sewer Proration 11/27/06 to 01/01/07 47.17 409. Sewer Proration 11/27/06 to 01/01/07 4'7.17
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 145,409.57 420. GROSS AMOUNT DUE TO SELLER 140,742.23
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
201. Deoosit or earnest money 15,000.00 501. Excess Deposit (See Instructions)
202. Plincioal Amount of New Loan(s\ 135,800.00 502. Settlement CharQes to Seller (Line 1400\ 1,400.00
203. ExistinQ loan(s) taken subject to 503. Existina loan(s) taken subiect to
204. 504. Payoff of first Mortgage
205. 505. Payoff of second MortgaQe
206. 506.
207. 507. (Deposit disb. as oroceeds\
208. 508.
209. 509.
Adiustments For Items Unoaid Bv Seller Adiustments For Items Unoaid Bv Seller
210, Citvrrown Taxes to 510. Citvrrown Taxes to
211, CountvTaxes to 511. Countv Taxes to
212. School Taxes to 512. School Taxes to
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. TOTAL PAID BY/FOR BORROWER 150,800.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 1,400.00
300. CASH AT SETTLEMENT FROMrrO BORROWER: 600. CASH AT SETTLEMENT TO/FROM SELLER:
301. Gross Amount Due From Borrower (Line 120 145,409.51 601. Gross Amount Due To Seller (Une 4201 140,742.23
302, Less Amount Paid By/For Borrower (Line 220) ( 150.800.00) 602. Less Reductions Due Seller (Line 520) ( 1,400.00
303. CASH ( FROM) ( X TO) BORROWER 5,390.43 603. CASH ( X TO) ( FROM) SELLER 139,342.23
OMB NO 2502 0265 A-.
The undersigned hereby acknowledge receipt of a completed copy of pages 1&2 of this statement & any attachments referred to herein/'J
'10... pc~~ -6.. b'~..:"""c.~
a, ~1 pIA-" a m
Borrower ill! / /. Seller >- GUtW~\ . / I ?dLU
-~. .,mo, '/' ! ' "..o'C""~C_" d
L. SETTLEMENT CHARGES
700. TOTAL COMMISSION Based on Price $ lID % PAID FROM PAlO FROM
Division of Commission (fjne 700 as Follows: BORROWERS SELLER'S
701. $ to FUNDS AT FUNDS AT
702. $ to SETTLEMENT SETTLEMEIIIT
703. Commission Paid at Settlement
704. to
BOO. ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Orioination Fee % to
802. Loan Discount % to
803. Appraisal Fee to Appraisal.com 320.00
804. Credit Report to M& T Mortgage Corporation LPOC $7.00
805. Lender's Inspection Fee to
806. Mortoaoe Ins. App. Fee to
807. Assumption Fee to
808. Tax Service Fee to First American RETS 72.00
809. Flood Cert Fee to First American FDS 8.00
810. Application Fee to M& T Mortgage Corporation 100.00
811. Processing Fee to M& T Mortgage Corporation 195.00
812. Doc/Prep Fee to M&T Mortgage Corporation 400.00
813.
814.
815.
816.
817.
818.
819.
820.
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest From 11/27/06 to 12/01/06 @ $ 21.318740/day ( 4 days %) 85.27
902. Mortaaoe Insurance Premium for months to
903. Hazard Insurance Premium for 1.0 years to
904.
905.
1000. RESERVES DEPOSITED WITH LENDER
1001. Hazard Insurance 3.000 months $ 42.08 oer month 126.24
1002. Mortaaae Insurance months $ 56.58 oer month
1003. CitylTown Taxes months $ oer month
1004." County Taxes 10.000 months $ 25.62 per month 256.20
1005. School Taxes 5.000 months @ $ 95.72 per month 478.60
1006. months lID $ oer month
1007. months lID $ ner month
1008. Aooreoate Adiustment months lID $ oer month -370.72
1100. TITLE CHARGES
1101. Settlement or Closind Fee to Appalachian Settlement Aoencv, LLC. 150.00
1102. Abstract or Tille Search to
1103. Tax Certification Fee to Appalachian Settlement ADencv, LLC. 10.00
1104. Tille Insurance Binder to
1105. Document Preparation to Aooalachian Settlement Aaencv, LLC. 25.00
1106. Notarv Fees to Appalachian Settlement ADencv, LLC. 10.00
1107. Attorney's Fees to
!includes above item numbers: I
1108. Title Insurance to Annalachian Settlement Anencv. LLC. 1058.7
linc/udes above item numbers: J
1109. Lender's Coverage $ 135,800.00
1110. Owner's Coverage $ 140,000.00 1,058.75
1111. Endorsements to Appalachian Settlement Agency, LLC. 100/300/8.1 150.00
1112. Closing Protection Letter to Stewart Title Guaranty Company 35.00
1113.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recording Fees: Deed $ 38.50; Mortgage $ 64.50; Releases $ Deed/Mtg 103.00
1202. City/County Tax/Stamps: Deed 1 400.00' Mortoaoe 1,400.00
1203. State Tax/Stamos: Deed 1,400.00; Mortnaoe 1,400.00
1204. ,
1205. I
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Survey to
1302. Pesllnspection to
1303. Courier Fee to APpalachian Settlement ADencV, LLC. 40.00
1304. Wire Fee to APoalachian Settlement Aoencv, LLC. 15.00
1305.
1400. TOTAL SETTLEMENT CHARGES (Enter on Lines 103, Section J and 502, SeetlOn Kh. 4,667.34 1,400.00
By signing page 1 of thIS statemenL the signatories acknowledge receipt of a completed copy of page 2 of this two ~age '] ~ ~
A~~' ent Agency, LLC.
Se ent Agent
P'age2
Certified to be a true copy.
( ASA-Qa0337 / ASA-oa0337 /21 )
Rev-1508 EX+ (6-98)
*'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
21-06-00731
Mowery, Charles C.
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jolntly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Ambulance (refund): 50.37
2 Cash found in decedent's possessions: 579.00
3 Comcast (refund): 21.64
4 Hardy's Auction (sale of personal property): 7,000.50
5 J.J. Skelton (refund on oil): 318.68
6 M&T Bank Checking Account 28849116: 3.263.34
7 Messiah Village (refund): 270.99
8 Monumental Life Insurance (refund): 27.40
9 Mutual of Omaha (reimbursement): 33.22
10 PNC Bank Checking Account 5140044921: 6.327.52
11 Refunds from Verizon, Liberty Mutual, State Farm: 309.68
TOTAL (Also enter on Line 5, Recapitulation)
18,202.34
<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 E (Rev. 6-98)
"~
.~.
m1 M&I'Bank
499 Mitchell Street, Millsboro, DE 19966
September 20, 2006
The Wiley Group
Attomeys at Law
Wiley, Lenox, Colgan & Marzacco, P.C.
130 W. Church Street, Suite 100
Dillsburg, PA 17019
RE: Estate of Charles C. Mowery
Date of Death: August 12, 2006
Social Security No.: 202-20-1508
Dear Ms. Gladfelter:
In response to your request, please be advised that at the time of death, the above-
named decedent had on deposit with this bank the following accounts.
1. Account Type............ ...... ..... ....Checking Account
Account Number........ ............ ...28849116
~
Ownership (Names oj)...............Charles Mowery
Opening Date..... ........... .......... .04/28/89 (account closed 08/18/06)
Balance on Date oj Death....... ..$3,263.28
Accrued Interest
$
0.06
TotaL..................................... .$3,263.34
2. Account Type...........................Individual Retirement Account
Account Number.......,.............. .3500420 1819040
Ownership (Names oj)...............Charles C. Mowery
',",- \, \
Opening Date........... ................04/07/05 (account closed 08/23/06)
Balance on Date ojDeath.........$10,661.27
'A"
~
Accrued Interest
$
31.23
"')
\
,.)
,
TotaL..... ............................ ....$10,692.50
. Page 2
September 20, 2006
The above nmned decedent did not have a safe deposit box.
For any additional information on the above accounts, including ownership,
statements and closures please contact our Mechanicsburg branch at 717-255-2031.
Sinc~l~, ) I, vit
C/)/AvUJ1L WY/;,;, u "IJ
Charlene Warrington, Recortls Management
1-888-502-4349
SElLER NAME. CJ?ur les- (~; I'll 0 ~v <: //
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ADDRESS '/700 DeilJ'7JDk l~J
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LOCATION. OF SALE 5'Ci /t~i c.--
FINAL
SETTLEMENT
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DATE' OF SAtE
PHONE
ZIP
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AUCTlONEER'
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PHONE L13J-1715
PROFESSIONAL FEES _ "-~j (II//"
AUCTIONEER --I I() $ I /;-5 () ()")
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CLERK $ I 4 UO . t)).
CASHIER
OTHER EXPENSES
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OTHER RECEIPTS
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TOTAL RECEIPTS
LESS TOTAL EXPENSES
I (or we), the seller, acceptthis settlementandiacknowledge receipt of the above .spedfied net proceeds
from the auction of my goods and property sold on the above date. t accept all responsibility for providing-
merchantable title to all goods, and property sold, and for deliveryoftitle to the purchaser. .
/~~. , .F": j /.(. . (?.-f/ .' /'j f7'~J I ..,. '-P n. j J i. I-J (iji r . /
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"'. / ~ ~u<;ti~neer or Cashier's Signature ,0/ _ (Seller's ~~gna.ture) /
/'0; j i/(}lO Date I (:J-I~c:....' ..6. 11 C:5(,<(.A. Date) 0 J,) :? / u 10
, (Seller's Signature) .
OCT-09-2006 23:55
PNCBANK
412 768 3458
P.01/01
$ PNCBAN<
October 10, 2006
S. Dawn Gladfelter
130 w. Church Street, Suite 100
Dillsburg, PA 17019
RE: Estate of Charles C. Mowery, (deceased)
SSN: 207-04-9880
DOD: 08/12/2006
Dear: Ms. Gladfelter
In response to your request for Date of Death balances for the customer noted above, our
records show the following:
Checking Account
Account # 5140044921
Established 12/14/1990
CHARLES C MOWERY
DOD balance: $6,327.52 + $0.00 accrued interest
The decedent maintained line of credit (RCA# 4003049000017513). For further
information, please call 1-888-762-2265. Select option 1, then option 3, and then O(zero).
This will connect you to a loan service representative.
Please note that this office only provides date of death balances for deposit accounts
(IRAs, CDs, Checking and Savings accounts). We do not process any financial
transactions or provide statements. If you need assistance with any of these items,
please call1-888.PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch
office.
essica Scheller
1-800~762-1775
P7-PFSC-04-F
500 first Ave.
Pittsburgh P A 15219
Member FDIC
TOTRL P.01
Rev-1509 EX+ (6.98) .-
COMMONWEAl-TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
Mowery, Charles C.
FILE NUMBER
21-06-00731
ESTATE OF
If an asset was made joint within one year of the decedent's date of death, It must be reported on schedule G.
SURVIVING JOINT TENANT(S) NAME
A. Patricia A. Mowery
ADDRESS
RELATIONSHIP TO DECEDENT
Daughter
617 Cedar Ridge Lane
Mechanicsburg, PA 17055
B. Pamela Sue Bower
126 W. Portland St. #3
Mechanicsburg, PA 17055
Daughter
C.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT NUMBER OR SIMILAR IDENTIFYING NUMBER ATTACH DEED FOR VALUE OF ASSET INTEREST DECEDENT'S INTEREST
JOINTLY-HELD REAL ESTATE
1 A&B 01/17/2002 Utilities Employees Credit Union: 20.593.32 33.333% 13.729.57
&05/12/20
06
TOTAL (Also enter on Line 6, Recapitulation) 13.729.57
(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 F (Rev. 6-98)
Uti I ities
Employees
Credit Union
P.O. Box 14864
Reading, Pa 19612-4864
(610) 927-4000 · (800) 288-6423
Fax (610) 927-4009
Advantages@uecu.org · www.uecu.org
September 13, 2006
S. Dawn Gladfelter
The Wiley Group
130 W. Church St., Suite 100
Dillsburg, P A 17019
Dear Ms. Gladfelter:
The account of Charles Mowery was opened May 16, 1972. The account became jointly
owned with Patricia Mowery on January 17,2002 and with Pamela Bower on May 12,
2006. The balance at date of death was $20,593.32. The accrued interest at that date is
$20.30. The date of death value including the interest is $20,613.62. He has no other
accounts or safe deposit boxes.
If you have any questions or need further information, please call me at 1-800-288-6423,
extension 4020.
Sincerely,
~~
Mena Feltenberger
Deposit Services Specialist
Rev-1510 EX+ (6-98)
.
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mowery, Charles C.
FILE NUMBER
21-06-00731
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 DECO'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 Account Number 35004201819040 10.692.50 10.692.50
(Patricia A. Mowery, beneficiary):
TOTAL (Also enter on Line 7, Recapitulation) 10.692.50
(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 G (Rev. 6-98)
.~
rm M&rBank
499 Mitchell Street, Millsboro, DE 19966
September 20, 2006
The Wiley Group
Attomeys at Law
Wiley, Lenox, Colgan & Marzacco, P.C.
130 W. Church Street, Suite 100
Dillsburg, PA 17019
RE: Estate of Charles C. Mowery
Date of Death: August 12,2006
Social Security No.: 202-20-1508
Dear Ms. Gladfelter:
In response to your request, please be advised that at the time of death, the above-
named decedent had on deposit with this bank the following accounts.
1. Account Type...........................Checking Account
Account Number.......... ...... .... ...28849116
Ownership (Names oj)...............Charles Mowery
Opening Date........ ........ .......... .04/28/89 (account closed 08/18/06)
Balance on Date of Death....... ..$3,263.28
Accrued Interest
$
0.06
Total................................... ....$3,263.34
2. Account Type...........................Individual Retirement Account
Account Number.......,.. .......... ...3500420 1819040
Accrued Interest
$
31.23
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Ownership (Names oJ).......,.......Charles C. Mowery
Opening Date....................... ....04/07/05 (account closed 08/23/06)
Balance on Date of Death. ........$10,661.27
TotaL................................ .....$10,692.50
. Page 2
September 20, 2006
The above named decedent did not have a safe deposit box.
For any additional information on the above accounts, induding ownership,
statements and closures please contact our Mechanicsburg branch at 717-255-2031.
Sinc~l~, t'
e}VCrvU lU-- W1'lti U; L'
Charlene Warrington, Recor s Management
1-888-502-4349
REV-1151 EX+ (12-99)
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mowery, Charles C.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-06-00731
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
See continuation schedule(s) attached
698.00
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
B.
Patricia Ann Mowery Pamela Sue Bower
Security Number(s) I EIN Number of Personal Representative(s):
Street Address 617 Cedar Ridge Lane
City Mechanicsburg State PA
Year(s) Commission paid 2006
Zip 17055
9,500.00
2.
Attorney's Fees
Wiley, Lenox, Colgan, & Marzzacco, P.C.
9,500.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
321.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Other Administrative Costs
See continuation schedule(s) attached
5,013.23
TOTAL (Also enter on line 9, Recapitulation)
25,032.23
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
Mowery, Charles C.
FILE NUMBER
21-06-00731
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Myers-Harner Funeral Home:
698.00
Subtotal
698.00
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-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Mowery, Charles C.
FILE NUMBER
21-06-00731
ITEM
NUMBER DESCRIPTION AMOUNT
1 Cumberland Law Journal ( advertise estate): 75.00
2 Hardy's Auction (expenses): 3,033.05
3 Real estate closing costs: 1.400.00
4 Register of Wills (additional short certificates): 16.00
5 Register of Wills (filing fee): 30.00
6 Roto-Rooter: 256.81
7 The Sentinel (advertise estate): 202.37
Subtotal
5.013.23
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
ESTATE OF
Mowery, Charles C.
FILE NUMBER
21-06-00731
Include unrelmbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 J.J. Skelton (oil):
VALUE AT DATE
OF DEATH
143.00
2 PA American Water Co. (total):
42.05
3 Pinnacle Health:
1.223.23
4 PP&L:
50.19
5 Verizon (total):
78.10
TOTAL (Also enter on Line 10, Recapitulation)
1,536.57
(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 d
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Mowery, Charles C. 21-06-00731
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$)
Do Not List Trustee(s)
I. TAXABLE DISTRIBUTIONS [include outright sr,ousal
aistributions, and ransfers
under Sec. 9116(a)(1.2)]
Pamela Sue Bower Daughter 14,076.19
126 W. Portland St., Apt 3
Mechanicsburg, PA 17055
Michele L. Mowery Granddaughter 1,000.00
5929 Srevs Oak Road
Burke, VA 22015
Patricia Ann Mowery Daughter 165,510.92
617 Cedar Ridge Lane
Mechanicsburg, PA 17055
Richard C. Mowery Son 3,779.53
1481 Sugarloaf Blvd.
Sugarloaf Key, FL 33042
Total 184,366.64
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)
Jan M. Wiley
David J. Lenox
Timothy J. Colgan
Christopher J. Marzzacco
David E. Hershey
Bradley A. Winnick
Thomas M. Clark
December 28, 2006
THE WILEY GROUP
Attorneys at LaW"
Wiley, Lenox, Colgan & Marzzacco, P.c.
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, P A 17013
In Re: Estate of Charles C. Mowery, deceased
File Number 21-06-00731
Dear Register:
Enclosed for filing please find an Inventory, the inheritance tax return in duplicate, and the status
report with regard to the above captioned estate. Also enclosed is a check in the amount of
$1,430.90 representing the tax due, and a check in the amount of $30.00 representing the filing
fee.
Please return the recording receipts to my attention in the enclosed envelope.
Thank you for your cooperation.
Sincerely,
~~
Dawn Gladfelter/Assistant
/dg
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130 W. Church Street, Suite 100 · Dillsburg, PA 17019.:lj 5'!)~ CBetJ{R)3~666 · (800) 682-4250 · Fax: (717) 432-0426
Offices in Harrisburg · York · Carbondale
www.wileygrouplaw.com
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