HomeMy WebLinkAbout02-09-07
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15056041125
REV-1500 EX (06-05)
PA Department of Revenue.
Bureau of Individual Taxes INHERITANCE TAX RETURN
PO BOX 280601
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
County Code Year
2 1 0 6
File Number
093 5
Date of Birth
193246511
1 0 1 0 2 0 0 6
11271931
Decedent's Last Name
Suffix
Decedent's First Name
S HAM B A UGH
ROBERT
MI
L
(If Applicable) Enter Surviving Spouse's Infonnatlon Below
Spouse's Last Name Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
lXI 1. Original Retum
o 4. Limited Estate
~
o
o 2. Supplemental Return
o 4a. Future Interest Compromise (date of
death after 12-12-82)
o 7. Decedent Maintained a Living Trust
(Attach Copy of Trust)
o 10. Spousal Poverty Credit (date of death 0 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. 0)
CORRESPONDENT - THIS seCTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
o
o
3. Remainder Retum (date of death
prior to 12-13-82)
5. Federal Estate Tax Return Required
6. Decedent Died Testate
(Attach Copy of Will)
9. Litigation Proceeds Received
8. Total Number of Safe Deposit Boxes
S U S A N J . H A R T MAN
Firm Name (If Applicable)
D U N C A N & H A R T MAN , P . C .
First line of address
1 I R V I N E R 0 W
Second line of address
REGISTER OF WILLS USE ONLY
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:--) - -'
I
W
DA~ FILE~
11
City or Post Office
State
ZIP Code
.....j,
,
._~.)
I
CAR LIS L E
P A
17013
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(n
(Ii
Correspondent's e-mail address:SUSANHARTMAN@PLANETCABLE.NET
Under penallies of pe~ury, I declare that I have examined this retum, including accompanying schedules and statemenls, 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 DATE
_KOON1~. P. p~ ;l-Q-..1DOI
ADDRESS
5 TOPVIEW DRIVE
CARLISLE
PA 17013
pATE.
1,!9/01
. I
PA 17065
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
A!~~7' z~y:>u
411 A. MOUNTAIN VIEW ROAD MT. HOLLY SPRINGS
PLEASE USE ORIGINAL FORM ONLY
Side 1
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15056041125
15056041125
.....I .
qs\
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15056042126
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: ROBERT L. SHAMBAUGH
RECAPITULATION
193246511
1. Real estate (Schedule A)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1.
74300.00
2. Stocks and Bonds (Schedule B)
.................................. 2
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3.
4. Mortgages & Notes Receivable (Schedule D)
........................ 4.
O. 0 0
16415.08
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5.
6. Jointly Owned Property (Schedule F) D Separate Billing Requested . . . . . .. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) D Separate Billing Requested. . . . . .. 7.
9. Funeral Expenses & Administrative Costs (Schedule H)
9.
90715.08
2 2 1 2 3.9 5
8. 3 1
22132.26
68582.82
8. Total Gross Assets (total Lines 1-7)
........................... 8.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
. . . . . .. .. . . . 10.
11. Total Deductions (total Lines 9 & 10)
. . . . . . . . . . . . . . . . . . . . . . . . . . . 11.
12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . 12.
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . 13.
14. Net Value Subject to Tax (Line 12 minus Line 13)
. . . . . . . . . .... . . . . . 14.
68582.82
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X.O _ o . 0 0 15. o . 0 0
16. Amount of Line 14 taxable 6 8 5 8 2 . 8 2
at lineal rate X .04..E-. 16. 3 0 8 6. 2 3
17. Amount of Line 14 taxable o . 0 0 o .
at sibling rate X .12 17. 0 0
18. Amount of Line 14 taxable o . 0 0 O.
at collateral rate X .15 18. 0 0
19. Tax Due 19. 3 0 8 6. 2 3
............................................... .
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
D
Side 2
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15056042126
15056042126
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REV-1500 EX Page 3
Decedent"s Complete Address:
File Number
21 06 0935
DECEDENTS NAME
ROBERT L. SHAMBAUGH
STREET ADDRESS
45 WATER STREET
CITY I STATE I ZIP
WALNUT BOTTOM PA 17266
Tax Payments and Credits:
1. Tax Due (Page 2 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
3,086.23
Total Credits ( A + B + C) (2)
0.00
3. InterestlPenalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3. enter the difference. This is the OVERPAYMENT.
Fill in oval on Page 2, Line 20 to request a refund. (4)
0.00
0.00
3,086.23
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5A)
(5B)
A. Enter the interest on the tax due.
3,086.23
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ...................................................................... 00 0
b. retain the right to designate who shall use the property transferred or its income; ...................... ......... 0 00
c. retain a reversionary interest; or ................................................................................................ 0 00
d. receive the promise for lite of either payments. benefits or care? ....................................................... 0 00
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .......................................................................... ........... .. 0 00
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ... ...... 0 00
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .................................................................................................. 0 00
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is three (3) percent [72 P .S. ~9116 (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 zero (0) percent
[72 P.S. ~9116 (a) (1.1) (ii)l. 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 retum are still applicable even it 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 zero (0) percent [72 P.S. ~9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent. except as noted in
72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedenfs siblings is twelve (12) percent [72 P.S. ~9116(a)(1.3)1. 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-1502 EX + (6-98)
*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
ROBERT L. SHAMBAUGH 21 06 0935
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 wiHing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real DI'ODlrtv which is iointlv-owned with riaht of survivorshiD must be disclosed on Schedule F.
SCHEDULE A
REAL ESTATE
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
74,300.00
420 Ponderosa Road. Carlisle, PA
Amount due at date of death on Installment Agreement of Sale dated 10-1-2003
(see attachment)
TOTAL (Also enter on line 1, Recapitulation) $
{If mom !UlIIr.P. i!l nAAtlAd. inAArt ::ltltlition::ll !lhAAfl; of !hI! !l::lmP. !li71! \
74300.00
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AGREEMENT FOR INSTALLMENT
"
.
,~;~kf= G L E R
~, ':~ Or'rlrr:r~('
I-J ,_ ....~ .../ ~ I
>.i;L/\ND COUNTY'-:
SALE OF REAL ESTATE
!J3 OCT 15 Arll1 21
MADE THIS I~J/ day of (R://:tJe/~.< ~(x'S by and between, Robert L.
Shambaugh, of 420 Ponderosa Road, Carlisle, Cumberland County, Pennsylvania, hereinafter
called SELLER,
AND
Tracy Planken, a single woman, and Jesse Beichler,a single man, of 3512 Enola Rd.
Newville, Cumberland County, Pennsylvania, hereinafter called BUYERS.
WITNESSETH:
1. For and in consideration of the terms and conditions hereof, Seller agrees to convey
and to sell and Buyers agree to purchase and accept the real estate known and numbered as 420
Ponderosa Road, Carlisle P A 17013; more fully described in Schedule "A" attached hereto and
incorporated herein by reference thereto.
~~ R.i,S
2. Buyers agree to pay the sum of Ninety-fiveThousand and 00/100 ($1",00<2;..00) Dollars
as total consideration, payable as follows: -rL.~U
Four Thousand ($4,000.00) Dollars payable upon the execution of this Agreement with
the remaining Ninety-oneThousand and 00/100 ($91,000.00) Dollars is to be paid in monthly
payments of Five Hundred Seventy-five and 00/100 ( 575.00) Dollars each, with the first such
payment being due thirty days from the execution hereof and continuing monthly thereafter for
five years at which time the entire remaining balance shall be due and payable.
3. Final settlement shall occur on or before 0,,-1-0 lo'C.r I ,2008, at which time
Buyers shall pay to Seller all sums of money due and owing by virtue ofthis Agreement. At
final settlement Seller shall tender a duly executed special warranty deed conveying to the
Buyers a good and marketable title in fee simple, free and clear ofliens and encumbrances
excepting presently existing easements or restrictions, visible or of record.
4. Buyers have the right to prepay at any time.
5. Transfer taxes at final settlement shall be paid by Buyers and Seller, 1 % each with the
provision that Seller's maximum liability for transfer taxes shall not exceed one (1 %) percent of
the sale price or Nine Hundred Fifty and 00/100 ($950.00) Dollars.
6. Buyers shall be responsible for repairs, maintenance and upkeep of the premises and
agree, in the event of a default under this Agreement, to deliver up possession of the premises to
Seller in as good condition as the premises are now, reasonable wear and tear, fire or other
casualty excepted.
7. Buyers shall pay for and maintain fire and extended coverage insurance in the amount
of at least $95,000.00 on the premises, naming Seller and Buyers as insureds, as their respective
interests may appear. ~OOK 702 PAGE 4:)20
8. Proration of property taxes and shall be as of the date of the execution of this
Agreement.
9. Payment of property taxes shall be the responsibility of Buyers after the date of
possession. Buyers agree to pay all property taxes at face value and furnish Seller with receipts
of same.
10. Any municipal improvements, liens or assessments shall be the responsibility of
Buyers after the date of possession.
11. Buyers assumes all risk and responsibility for any accident, injury or damage to
persons or property as to themselves or others on said premises and agree to hold Seller harmless
from all liability therefrom.
12. This Agreement is not assignable by Buyers without the written consent of Seller.
Which shall not be unreasonably withheld.
13. Buyer shall not carry on any unlawful business on the property or any business
whereby the hazard would be increased or the fire insurance invalidated. The use of the property
must be in accordance with the zoning laws ofthe municipality and Buyers will not file an
application for a variance without the approval of Sellers which shall not be unreasonably
withheld.
14. The Buyesr shall not make any major structural changes without the prior written
approval of Seller which shall not be unreasonably withheld.
15. In the event Buyer shall fail to make a monthly paYment for the space of thirty (30)
days after the same shall have become due by the terms hereof, or if a breach of any of the other
covenants or conditions be made by Buyer, then such failure or breach shall constitute a default
of this Agreement. Buyer shall be given written notice of a breach ofthe Agreement and shall
have twenty (20) days from the mailing ofthe notice to correct the default. If not corrected, then
Sellers shall have the right to terminate this Agreement and to demand immediate possession of
said premises upon thirty (30) days written notice and thereupon all rights and obligations under
this Agreement shall cease and terminate. Buyers agree to a five (5%) percent late charge which
shall be added to each monthly payment more then'S.days late.. IJ
I 0 I~ P It -./ ef",
16. Upon default of Buyer, the entire principd~um remaining unpaid shall become due
and payable at once and may be collected by suit or otherwise, and if authorized by law, the
Prothonotary or any attorney of any Court of record in Pennsylvania is hereby authorized and
empowered to appear for and confess judgment against the Buyer and in favor of Sellers for the
whole amount of said principal remaining unpaid, together with interest, costs of suit, release of
errors, attorney's commission of five (5%) percent and waiving inquisitions and exemptions.
17. Upon default and if authorized by law, the Prothonotary or any attorney of any court
of record is hereby authorized and empowered to appear for and confess judgment against Buyer
in an amicable action of ejectment and in favor of Seller for the said premises and to direct an
immediate issuance of a writ of possession, with clause for costs, waiving all irregularities
without notice and without leave of court.
18. In the event Seller are unable to give a good and marketable title such as will be
insured by a licensed title insurance company, Buyers shall have the option of taking such title as
Sellers can give, without abatement ofm:ice or ofb.ei~g repaid all monies paid by Buyers to
BOOK ",02 PALE .1~1~1
Sellers on account ofthe purchase price, less reasonable rental value for use of said premises. In
the latter event, there shall be no further liability or obligations as to either party concerning this
Agreement which thereafter shall be null and void.
19. Seller agrees that he will not knowingly or voluntarily cause any encumbrance to be
placed on the premises without prior written approval of Buyers.
Notice ofthe entry of any mortgage, judgment, lien or other encumbrance affecting title
to said premises received by the Seller after the date of the execution of this Agreement shall be
given by the Sellers to the Buyers within thirty (30) days ofthe recording thereof in the
Cumberland County Courthouse.
In the event any mortgage, judgment, lien or other encumbrance affecting title to the said
premises existing at the date of the execution of this Agreement or hereafter entered of record
and default in the payment is made by the Seller, then Buyers shall have the right to make the
delinquent payments and to receive credit for the full amount thereof from the required monthly
payments under this Agreement. Prior to exercising the rights stated in this paragraph, Buyer
shall give Seller three (3) days notice by certified mail of their intent to do so, but this provision
shall not limit Buyers' right to make the delinquent payments and to claim credit therefor.
20. This Agreement may be filed of record in any public office, as appropriate.
21. No modifications ofthis Agreement shall be binding unless same shall be in writing
and duly approved by Seller.
22. The failure by Seller to insist on strict performance by Buyers of the terms of this
Agreement shall not be construed as a waiver, release or relinquishment thereof.
23. This Agreement shall inure to and be binding upon the heirs, executors,
administrators and assigns ofthe parties hereto.
IN WITNESS WHEREOF the parties hereto have hereunto set their hands and seals
the day and year first above written.
WITNESS:
1W~;J-:lJLJJ7~AV
Robert L. Shambaugh, Sel r
(~~ ctXQ
~uv~ ,p~Yl
Tracy lanken, Buyer
~~OI>< t j(~-
Jesse Beichler, Buyer
BOOK 702 PAGE 4322
BOOK Pi 17 PAGE 26
ViECORDEO.OHlCE OF 1HE
W2RK OF COIJRi$ &
~tCOR~tR OF O"tOS
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This
2Jlltab-e t4e 4th day of Sept~Ilber ". ,in the year of our
Lord one thousand nine hundred and fifty-four,
~ Frankford
11lIdfueett CHARLES L. MYERS and IDA M. MYERS, of Lower," ~'" Township,
Cumberland County, Pennsylvania, parties of the first part, Grantors,
AND
ROBERT L. SHAMBAUGH and EMMA R. SHAMBAUGH, his wife, of the said
'Township, County and State, parties of the second part, Grantees,
follows:
BEGINNING at an iron pipe in the center of a Public Lane leading
from the Enola Road to the North Mountain; thence by the center of
the same, North 220 West, a distance of 150 feet to an iron pin;
thence along lands of William N. Davis, South 750 45 minutes West,
a distance of 376 feet to a stake; thence along lands of the Grantors,
South 220 East, a distance of 150 feet to an iron post; thence by
same North 750 45 minutes East, a distance of .376 feet to an iron
pipe in the center of the Public Lane above described and place of
Beginning; and
CONTAINING 1.27 Acres, more or less; and
BEING the srone property which David E. Gensler, Widower, conveyed
to Charles L. Myers and Ida M. Myers, his wife, the above Grantors,
by deed dated November 30,1935, and recorded in 11 11011 498;
BOOr- 702 PAGE 4:)23
COMMONWEALTH OF PENNSYLVANIA:
:55.
COUNTY OF CUMBERLAND
On this the 15th day of October, 2003, before me, the undersigned officer, personally
appeared Robert L. Shambaugh known to me (or satisfactorily proven) to be the person
whose name is subscribed to the within Agreement, and acknowledged that he
executed the same for the purposes therein contained.
WITNESS my hand and official seal the day and year first above written.
NOTARIAL SEAL
Cynthia L Darr, Notary Public
South Middleton Twp., County of Cumberland
My Commission Expires Aug. 14, 2004
COMMONWEALTH OF PENNSYLVANIA:
:55.
COUNTY OF CUMBERLAND
On this the 1 st day of October, 2003, before me, the undersigned officer,
personally appeared Tracy Planken and Jesse Beichler, known to me (or satisfactorily
proven) to be the persons whose names are subscribed to the within Agreement, and
acknowledged that they executed the same for the purposes therein contained.
WITNESS my hand and official seal the day and year first above wr" ten.
NOTARIAL SEAL
Cynthia L Darr, Notary Public
South Middleton Twp., County of Cumberland
My Commission Expires Aug. 14, 2004
BOOf, 702 PACt ,t~24
REV-1508 EX + (6-98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ROBERTL.SHAMBAUGH
FILE NUMBER
21 06 0935
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
ORRSTOWN BANK CHECKING ACCOUNT # 102800043
VALUE AT DATE
OF DEATH
3,953.07
2.
ORRSTOWN BANK CERTIFICATE OF DEPOSIT # 400001185
5,047.68
3.
ORRSTOWN BANK CERTIFICATE OF DEPOSIT # 4000011951
5,289.44
4.
PROCEEDS OF SALE OF JOHN DEERE 212 TRACTOR
300.00
5.
PROCEEDS FROM SALE OF 1992 CHREVROLET GEO
500.00
6.
PROCEEDS FROM SALE OF 1991 GMC SONOMA TRUCK
500.00
7.
STATE FARM AUTOMOBILE INSURANCE REFUND
62.31
8.
WACHOVIA BANK ACCOUNT # 1000293605457
762.58
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
16415.08
REV-1511 EX + (12-99)
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ROBERTL.SHAMBAUGH
FILE NUMBER
21 06 0935
ITEM
NUMBER
A.
1.
2.
B.
1.
2.
2.
3.
4.
5.
6.
7.
8.
Debts of decedent must be reported on Schedule I.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
HOFFMAN-ROTH FUNERAL HOME - FUNERAL
CARLISLE MEMORIAL SERVICE, INC. - HEADSTONE FOR GRAVE
6,916.70
1,052.00
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of PelSOnal Representative(s) GLENDA PLANKEN I PENNY JUMPER
Social Security Number(s)/EIN Number of PelSOnal Representative(s)
Street Address 5 TOPVIEW DRIVE 1411A MT VIEW ROAD
City CARLlSLElMT HOLLY SPGS (17065) State PA Zip 17013
Year(s) Commission Paid: 2007
AttomeyFees DUNCAN & HARTMAN, P.C.
Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation)
Claimant
Street Address
4,500.00
4,500.00
City
State
Zip
Relationship of Claimant to Decedent
ProbateFees REGISTER OF WILLS PROBATE FEE (248.00) &
REGISTER OF WILLS SHORT CERTIFICATE FEE (4.00)
252.00
Accountanfs Fees
Tax Return Prepare(s Fees
THE NEWS CHRONICLE LEGAL AD
CUMBERLAND LAW JOURNAL LEGAL AD
76.25
75.00
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed. insert additional sheets of the same size)
22 123.95
REV-1512 EX + (12-03)
'*
SCHEDULE.
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ROBERTL.SHAMBAUGH
FILE NUMBER
21 06 0935
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. CARLISLE REGIONAL MEDICAL CENTER BILLING
VALUE AT DATE
OF DEATH
8.31
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
8.31
""-"" "'. ",*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
ROBERTL.SHAMBAUGH
SCHEDULE J
BENEFICIARIES
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS pndude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. GLENDA P. PLANKEN Lineal
5 TOPVIEW DRIVE 33.34
CARLISLE, PA 17013
2. PENNY E. JUMPER Lineal
411 A MOUNTAIN VIEW ROAD 33.34
MOUNT HOLLY SPRINGS, PA 17065
3. DONALD ABLES Lineal
249 ABLES ROAD 16.66
SOUTH PITTSBURG, TN 37380
4. CHARLES ABLES Lineal
249 ABLES ROAD 16.66
SOUTH PITTSBURG, TN 37380
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
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
FILE NUMBER
21 06 0935
(If more space is needed, insert additional sheets of the same size)
3!111
3
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1{1
LAST WILL AND TESTAMENT OF
r
I
, ~
ROBERT LEE SHAMBAUGH
I, ROBERT LEE SHAMBAUGH, of Lower Frankford Township, (R. D. #
:1
3, Carlisle), Cumberland County, Pennsylvania, being of sound and disposin~
"
mind, memory and understanding, do hereby make, publish and declare this
'I
as and for my last Will and Testament, hereby revoking and making void any
and all Wills by me at any time heretofore made.
1. I direct my hereinafter named Executrix to pay all of my just debts
II
"
I
~
and funeral expenses as soon after my death as may be found convenient to
do so.
2. The Skyliner Mobile Home located on lot of ground of my daughter,
Glenda P. Shambaugh, belongs to her even though the title to the mobile
home is registered in my name as an accommodation for her.
1
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I
3. All the rest, residue and remainder of my estate, real, personal and
mixed, and wheresoever the same may be situate, I give, devise and
bequeath to mY' wife, Emma R. Shambaugh, her heirs and assigns, to the
exclusion of my children, born and unborn, provided my said wife, Emma R.
Shambaugh, shall survive me by a period of Ninety (90) days.
4. Should my said wife, Emma R. Shambaugh, pre-decease me or fail to
survive me by the aforesaid period of Ninety (90) days, then in such event
all the rest, residue and remainder of my estate, real, personal and mixed,
and wheresoever the Same may be situate, I give, devise and bequeath in
equal shares to my Three (3) daughters, their heirs and assigns, the share
Of any deceased daughter to pass to her issue per stirpes and if there be no
issue then such share shall lapse. My Three (3) daughters are Glenda P.
Sha.mbaugh, Panda L. Shambaugh, and Penny E. Shambaugh.
5. Should any person less than 18 years of age be entitled to distribution:
from my estate, then in such event I nominate, constitute and appoint Dauphin
Deposit Trust Company and its successors, 2 West High Street, Carlisle,
Pennsylvania, as Guardian of the estate of such person, and I authorize and
directsafdFGuardian to invest the same and to pay the income arising there-
from together with so much of the principal thereof as in the opinion of said
Guardian is necessary or desirable to be expended for the proper maintenanc:
support and education of such person, to the person having custody of such
person, and upon such person attaining 18 years of age to pay to him or her
the then remaining principal together with any undistributed income.
6. I hereby.nomiriate, constitute and appoint my said wife, Emma R.
,';>',i~
_;......,.'.., "">',::'<'1'
Shambaugh.. .a.s Executrix of this my lasfWill and Testament, but should she
pre-decease me or fail to qualify,thert in such event I nominate.. constitute
and appoint my Three (3) daughters, Glenda P. Shambaugh, Panda L.
Shambaugh, and Penny E. Shambaugh, or any of them, as Co-Executrices of
this my last Will and Testament, and I further direct that neither my wife
nor any of my said daughters shall be required to post any bond to secure the
faithful performance of her duties in the Commonwealth of Pennsylvania or
in any other jurisdiction.
'i'i.~~ii:~~~ESS'Wli~REQF, I have hereunto .set my hand and seal to this my
las~ ;~~~ and Testament written on two (2) pages this 3 tt) ~ay of ~
1973.
fi/-4 k .~ . . L__
Robert Lee Shambaugh ~
( SEA]
Signed, sealed, published and declared by Robert Lee Shambaugh, the
Testator above named, as and for his last Will and Testament, in our preseJ
al his request, and in the presence of each other, hav
our names as attestiIlgwitnesses.
~4.~ . ". ,
~Xn.jQr ~~