Loading...
HomeMy WebLinkAbout96-00665 No. 21 96 f>f>5 Estute 01' flFt.,t5lJ K StAJ/r,(! T2- . I>eceuscd I>ECREE 01' PRonATE ANI> GRANT 01' LETTERS AND NOW AUGUST 27 1~9E.._. in consilleralil1n of the pelitionon Ihe re\'erse side hereof, s;lIisractory proof ha\'ing been presented hefore me, IT IS DECREED thai Ihe inslrUmel1l(s) dated SEPTEMBER 18. 1989 described Iherein he admilled 10 probate and filed or record as Ihe Ia,t will of HELEN K. SWARTZ and Lellers TESTAHENTARY are hereby gran led In ~.Jj:JLA-,-SWARTZ ~U~.p {I{j..J1I:,-k." ~ Reith-fer of Wilh I FEES Probale, Lellers, Etc, " , , , , , " $ 235.00 Short Certiricales(5} ",.'.,.., $ 15.00 KlW'ilWOOlK ,EXTRA, PAGE, " $-3...00_ JCP $ 5,00 TOTAL _ $ 258.00 Filed N!9!J,~~, 7.7,., ,! 9,9.1\ , , , , , , , , , , , , , , , , ~E_~-:or AnnRNH (SlIP,l'I, I.ll, NlI'I(Jl~SI3) .;) t.J. l11al,., .st. .....Jlkck",csl.u"UJ hi I7DSS' AnllRESS 7/7- 761r0209 !'1I0NE tin :v c ,-., \'""1 ~ \,., LJ '" '" " '. , ~ ..' -.J 21-96-665 lbi, ,.. llllt'llil~ Ih.lt tilt' inltll IIl.H hIll hl'll gl\Tlll. \IIIllllh \"1'11.111"111 .111 'lI11'lll.d tt"IIIlJI,IU' ,I! dt'.lth dlll~' flkd willi IIII.' .1' 11.\.11 Hq~,..lr.ll Tilt "II.~~llI,dtl'll1lh,lll' \~dl ht Il"\\,II,!I,II..1111 ,......,11 \lId Hlt.oI.hllllltl Io,II"'llIl.tIltll1Ilhllg WARNING: Ills Illegal to duplicate this copy by photostat or photograph, I'll' h'l dll' \tllllh.llt. LIt/II t' :(.....U"',d/....:. /!..,C/.</,//. ,,9~,,"-r;.j. 1,11\ ,i1 Hq,~I'II.1I U U 3757274 ,(i.."'t' h.~ J.. J 17 II'''/{ ". ll.lIe ~IJ "1~1~1lh"11 CO......ONWEALTHQF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH II......' . "JIII.u.lMI ........ ...,...-- MI lol.C1.I4SlUlflltl'--'1l . Female 210- 26 9784 ~Qf'Ot:aDl" ...._~_ lIelen K. Swartz ~(1I'r-.HICNr..""_-_"""".."'__ ......~ ~(J I~O ~O IWIt-..ca.u._ "--..fOO.."c.u... AQ.IJ"~ \,NlfIllIYUl' - - UI'Cl(IlIIW -,- I ::::"'0 ,L 86 <C",.... .. . DO> Perry New 8loomfield White --...... iII_.,...__ DfDlII"'UIUAl~ ....10l'_.5/IOO1."" -:-.=:.:.~.:::&:r Homemaker I Own !lome exaoun-.........aIlPDN..$..u.;......-r.C<alIOl C(Ol"'-S 8 Rockaway Drive ~~~ .. Camp Iii 11. Pa 17011 :.:::::' '.~'I:'dwTJ'kmrer "...... 0oOI wp, - -.. _CumberJa!ld --.,' n.O~=CIII lolO'toU\,t....-~.....\Io ~-""- . tlorence tetro ..,(JNWoII-S......-aAOON..ISnol~- ,,0d0I 204 Cockleys Dr., Mechanicsbur . pa 17055 '''.'UClItI U.._oII~o--. I ."""""'"....Ie .~.... .. .~ .-OMWI .S.......ll~ltI Peter A. Swartz ...'I<<XIOf I 3 .. Ouncannon Pa Myers Funera 110m D-St MP~h~n1r.~~ uaHK....-" ~o .....000_1 '''rlOlNH., __tMlN'iMlOIO...llOCAll....c ,.,- JJ"A~ .. tI:....Jl,. fft. __0..cJ 1'1lYIl1; 1_..._........__..---..._0.--...-..""'" ....._./..!,.-............................I...- ""'II: ,....--.-- II, A I :=-= .__ (!ll~JiJ~d~l!Pl~!.',L_mlt..l)i", _.______l~ tMro~ASIU,.G~(,IJ(oo(ltfl I ! I :-:::=;::::::'.~:=- ,--- - ~~,~~~::~==l-- . _.__.no _. on _.~ __ I ft'lfll'"'l1CPfY'IHDIffOS tIA.IlIC"OfDlNIt tWiOf~' ,_rlH.A.II"f .....-..1 It9lO'I II) / ,.......[;0,_* ~n~OI~ OfOllRHl _oil - -..- . ./ ..,_ { I .._.--.-'" ...)l'1 .... n _0 . , OIW......._......._ .. ...--.......-"I"'I_....1lYIl1 fJdJA-'IJfd 4~7rp.J- I ;kJib"~'-A(1/1J . iii lfUlIII'oOMlfOI\' U1IC1*.IO'l'M.UI'IX.CU'NO _ LJ _fJ .. s I ~ J ~=::::t"ul.JtuFB.r __._~. ~d .lL\dJ .. :"l~ -, 17Ul/7 . ~ LAST WILL AND 'I'I>S'I'AMEN'I' OF Imum K. SWAR'I'Z I, HELEN K. SWARTZ, widow, of the Township of Lower Allen, County of Cumberland, and State of Pennsylvania, being of sound and disposing mind, memory and undorstanding, do make, publish and declare this to be my Last Will and Testament, hereby revoking and making void all former Wills by me at any time heretofore made. 1- I direct the payment of all my just debts and funeral expenses as soon as conveniently may be after my decease. 2. All the rest, residue and remainder of my Estate, real, personal and mixed, whatsoever and wheresoever situate, I give, devise and bequeath in equal shares unto my three (3) children as follows: A. One-third (1/3) to my son, Edwin K. Swartz, of Olathe, Kansas. B. One-third (1/3) to my son, Peter A. Swartz, of Mechanicsburg, Pennsylvania. C. One-third (1/3) to my daughter, Carolyn L. Linn, of Newport, Pennsylvania. 3. I nominate, constitute and appoint my son, Peter A. Swartz, to be the Executor of this, my Last Will and Testament. If he should predecease me, or for any other reason be unable to act as Executor, I appoint my daughter, Carolyn L. Linn, to be the Executrix in his place and stead. If she should predecease me, or for any other reason be unable to act, or to continue to act, as such Executrix, I appoint Dauphin Deposit Bank and Trust Company to be the Executor in her place and stead. I further direct that they shall not be required to file bond or other security in the Office of the Register of Wills for the purpose of administering my Estate. I .. . 4. I authorize and empower my personal representative, 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 he 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 in undivided fractional shares in property different in kind from any other share; and to execute and deliver such instruments as may be necessary to carry out any of these powers. IN WITNESS WHEREOF, I have hereunto set my hand and seal this /5/1, day of / .iR.p0.,JJ(/U , A. D. 1989. .7J uV.- /r' A......,-(\.,d~ '.,.) (SEAL) signed, sealed, published and declared by the above-named HELEN K. SWARTZ, as and for her Last Will and Testament, in the presence of us, who at her request and in her presence, and in the presence of each other, have hereunto subscribed our names as witnesses. J 4' / . (!!ltl~d:a p. \/f1u~ltt./-f:ZIJ /) 'l~,' .;:t,--". <-<<..~"''-- /,...{t.'v 2 21-96-665 REGISTER 01' WILLS 0... CUltJB/iRWfIU)) COUNTY OATil OF sunSCIUIlING WITNESS (!.IfARteJ /?", t5111EU>s ~__~ ..ooidl (each) a subscribing witness III lhe will pre'enled herewilh, (clIch) being dUly qualified according to law. depose(s) and say(s) thaI ---.1/..E /SHE present and saw , HB/::?J K. SWtfllZ7Z the Icslat~X , sign the ~all1e and Ihal HE"/ .sNE signed as a wilness at thc request of leslal~ inl1.M_ prescnce lInd (in Ihe presence of each olher) (inlhe presence of Ihe other subscribing witness(cs)). lPN/lA/Nt: ,.i:/STt.€{!, &u/w 8/~d.J-;a- Sworn to or affirmed and mbscribed bcfore .) l.:If me this ~ , day of (!I(A,q(/6S t!'. .s;.y~ame)7ZZ'" (!{<Ju.Jt )9 lit... , __W,l1/lfh,SC, Iledttll,'t!sblAj' PII/7osr;; L/J.'tJl,,('. v.,,,,,, ,,'.( ('<'1' :Jf",:I"'--"W!tLt'J (Address) r.I I . '7 ' ReRisler . I(tJl1toflAJR KI5~ame) ~ ~...I9Y 1>1(, , (!,fIN!' Hltt., ,oil (Addrcss) 17"11 REGISTER OF WILLS OF COUNTY OATH OF NON-SUBSCRIBING WITNESS (cach) a subscriber hcrclo, (each) being duly qualilied according 10 Jaw, depose(s) and say(s) thai familiar wilh Ihe signalure of codicil will testa' of (one of the subscribing witnesses to) Ihe Ihal prcscnled herewith and codicil believes the signature on the will is in thc handwriting of to the best of knowledge and belief. Sworn to or affirmed and subscribed before me Ihis day of 19_ (Name) (Address) ReRisler (Name) (Address) CERTIFICATION OF NOTICE UNDER RULE 5.6(0\ Name of Decedent: HELEN K. SWARTZ Date of Death: August 16, 1996 Will No. Admin. No. :z 1- 9(, - t) U, S TO TIlE REGISTER: I cenify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Coun Rules was served on or mailed to the following beneficianes of the above-captioned estate on ~ Address Carolyn S. Linn Edwin K. Swartz RR #5, Box 100, Newpon, PA 17074 2631 W. 131st Street, Olathe, KS 66061 204 Cockley's Drive, Mechanicsburg, PA 17055 Peter A. Swartz Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Da:!;: September 10, 1996 0\ ,- " ~ (',' ~ c- U.) '. L '- .." , " ...."\ ~~ 0.:- UU ~~/~:LL CHARLES E. SHIELDS, III Mellon Bank Building 2 W. Main Street Mechanicsburg, PA 17055 Telephone: (717) 766.0209 Counsel for Personal Representative S.pltmb" 10, 1996 ~, ::' If) ~; :. I') ( 1<) ,-1 ,- l'.' "~J f:-" . 0.: It,. I-.~ ,-', ....: .J 00 ..: T) C w - . c. ;1.i (J '(0 ~ ~ :3 E r.: "".....~ g ~ '~ ~ 5 ~ '" 0 '" <'''''GJ~lJC 1IlC>"'wu,8 .s.8~~: - _=... .co o ,- > 0 ... ... ~ .. ~ .- g>.,'Oc:l:nl ::Etii~cu l;: ".!2 ,- !: III Q)U>> CDom -5~.sc",~!! -~ .. oco~Ctii Q) GJ 0 QJ u.c'tJ\f)~QJ '~~:6~8.5 cue.... c c CD 0'" QJ.- Q) _ ,- c s::. ... =a.1O:J...~ ._'Oe80- ~~.~:J~! Q''C '40 Q) C n;eo'O~'c . -S.-=:U'- ca.s ~ . -IX 0 e'" IDO .... - . _ - O"D 'iQ 0 i~t:...c:u)( U Q) :3 I/) ~ ... OJ >.c 0 C ... 0 c: .0 ... U ,2 C d) ~ GJOCDtj(Q>O ... .c \1,: E It! ~ Q) "C ... .-,'- .:: ,- .cCO.n~OlIi _tt...0 o.....l:. ~ i~ \1 ~ I ~ I ~ I .;.~p.)by cer f~lat "1!~~TI n:".tw{. 01 the tiling of this f::.r.; , ;")rt,posod 01 nhl , j; -\d l)~ Hie Jate, tinlt~ 3nti pl('C" ' ~ ~ame w II ~ pr '<.:.1":: !1 U.. 'ihe Cnurt for COnflfll1;Hicl1 l~ thO last' BY to Ii J WI ;Hdl ohlfctlon~ to said Statena;n\ r. . .oposed Distribution. hilS been gl\:en tn ~verv unpaid clnimll: , .-.d 10 every Olher person known to I"" accountant 10 l1a',' ,,' claim an interest in Il1e eSlatB as creditor, beneficiary, I,,,;, (Jr ne~1 of kin. A copy of said Statement was included wilh the nolica. 1. ",'" G) "0 .c .,"- ~r. ,_ u 0,.. ], G) ctJ en 0'0-0 . _coJ:. c:. 0 "'- U- 0 'i _0.., :l 0 ~ D-" -:: o..c ~ .!!-E,c: ",-0 1I-: "OG)g c: u- lOe::' .... >",- mo .;u-- _ u 0 tA:c: o as ::>08 .. ., Q..c- as- :l cz: J~ . .; ~ . ~. ... '. '. . . - ~ III t:: a~~~ Xlii !c ee eel!! >- ... III ., ::l ...~~al ~~~~ ~<"'~ X 0 U U) :::E :j. BECEwrs OF PRI NCI PA L Re.,1 Eslnte: NONE Stocks und Bonds: NONE Ca~h Bunk Dcposil~ and Miscellaneous Personal Prnpcrt\': 1. HARRIS SA VINGS BANK a. 13 mo. Certif. #30-15-155821 b. accr. int. on a. c. 13 mo, Certif. #30-15-155823 d. accr. int. on c. e. II mo. Certif. #30-55-295158 f. accr. int. on e. (scc copy of leller attached). $ 20,000.00 $ 45,62 $ 20.000.00 $ 45.62 $ 10.000,00 $ 10.09 2. MELLON BANK a. Inc. Certif. #00134669 b. accr. into on a. c. Inc. Certif. #00284683 d. accr. int. on c. e. Inc. Certif. #O-B19365-C f. accr. into on e. g. Inc. Certif. #14-A29670-C h. accr. int. on g. i. Inc. Certif. #14-A49160-C j. accr. into on i. k. Inc. Certif. #145-09696I-C I. accr. int. on k. m. Inc. Certif. #21O-001146-C n. accr. into on m. o. Ine. Certif. #210-001205-C p. accr. into on O. (scc copy of leller attached). $ 10,000.00 $ 18.51 $ 10,000.00 $ 20.99 $ 20.000.00 $ 34.83 $ 10,000.00 $ 17.42 $ 10,000,00 $ 17.83 $ 10,000.00 $ 16.78 $ 10,000.00 $ 60.00 $ 10,000.00 $ 129.77 3. DAUPHIN DEPOSIT BANK & TRUST CO. a. C.D. #8000095572 b. acer. int. on a. c. C.D. #8000095661 d. accr. int. on c. e. C.D. #8000405741 f. accr. int. on e. g. C.D. #8000409828 h. accr. int. on g. i. Checking Accl #0083108378 $ 20.000.00 $ 33.37 $ 25,000.00 $ 24.38 $ 10,000.00 $ 15.85 $ 25,000.00 $ 68.32 $ 18,833.04 3 j. accr. in\. on i. $ II).OX 4. Grocery & Misc. l';L~h in wallet, etc. $ 120,00 5, Rcfund due froml.RS. on 1040 close-out $ I)II.lXI 6. Rcfund due from PA Dep\. of RCl'enue on PA 40 $ 132.00 c1ose,out 7. 1984 Chen. Celebrity es\. 5O,(XXI miles $ 1,000,00 8. *There were no pcr.;onal items of any consequencc or asscssable I'aluc. Whcn dccedcnt's husband died sel'er.tl YC<lr.; ago shc auctioncd hcr pcr.;onal items off and movcd in with hcr sister. * TOTAL RECEIPTS OF PRINCIPAL $24/,574.50 DISBURSEMENT OF PRINCIPAL Funcml E.xllCnsc I. Mycr.; Funcral Home of Mechanicsburg $ 6,578.00 2. Gingrich Memorials (initial payment) $ 437.50 3. Gingrich Memorials (final payment) $ 437,50 $ 7.453.00 Fces and Commissions: 1. Executor fee: Peter A. Swartz $ 1,500.00 2. Charles E. Shields, III, Allorney Fces $ 5.122,50 $ 6.622.50 Family E.xemption: NONE Miscellancous Probate and Administmtive E.xllCnses: 1. Probate Fees and Short Certificates $ 258,00 2. Additional Short Certificates $ 15.00 3. Advcrtising in Cumberland Law Journal $ 60.00 4, Advertising in Pamot Metro-West $ 59.50 t 5. Additional Probate Fee $ 35.00 6. Janet Brackbill, H&R Block. closeout 1040 $ 320.00 & fiduc. I 7. Filing Account (estim.) $ 105.00 8. Filing Inheritance Tax Return $ 15.00 $ 867,50 I Inheritance Taxcs: I. Initial cstimated advance paymcnt $ 10,830.00 i 2. Final balance payment $ 2.167,38 $ 12.997.38 4 .-.--......-.-.... ,~- Debts of Decedent I. Care Apothecary 2. Pert)' Village for July & August Bill #120 3. Mcdiq. Mobile X-my. $ $ $ 3K.56 445.{X) 24,R3 $ 5OR,39 TOTAL DISBURSEMENT OF PRINCIPAL $28,448.n RECEIJ7fS OF INCOME Income from Certificates of Deposit 10-11-96 11-13-96 12-02-96 12-11-96 01-03-97 01-10-97 01-10-97 01-10-97 02-04-97 02-04-97 03-14-97 04-18-97 05-06-97 05-16-97 05-22-97 $ \,160.34 $ 834.10 $ 93.04 $ 536,94 $ 305.10 $ 66.75 $ 263.59 $ 406.25 $ 13a.27 $ 303.48 $ 609.17 $ 507.55 $ 638.58 $ 92.36 $ 8.94 TOTAL INCOME RECElJ7fS $ 5.964.46 DISBURSEMENT OF INCOME Direct withdmwals from Estate Checking Account 11-06-96 Social Security withdmwal Assorted Service Charges on Monthly basis $ $ 546.71 42,{)(} $ 588,7] ~. .. 5 -'1 I _..~ . . 1 auUloL.i:.o <lOll cr::PO',IOl" r..,/ pcr::onal roproticntativo, 1n hi:.; 0010 am! aboolutu Ji~c..:rcliun, to t;urcha::;o or othorwiuo acquire ilnu rotain any invlwtr.a.mtu or 'Jhich I dio ~oi;:cd, or any roal or parnenal propurty of uOY nature: to Gall, leace, pledgo, mortgi1CJO, trancecr, oxchamJo, c.1iopooo of, or (Jrant eptlona in regard to any or all property of any kind forming n part of my EOlato for ouch torr..n ilnd ouch priceD 0.0 ho may doom advisable: , "j , 1 i :\ ) i '\ i'l '1 ,4 -' t'l~i "I : 'I ., i\ " I I i to borrow ~oncy for any purponco connected with tho protoction and praoorvat~on of ~y E~tatc: to ~ortgago or pledgo any roal or parnooal proporty !or~ing il part of my E~tQto: or to join in or oocuro tho partition of narno: to cornprornico any claims or domando o! my Estato againot othcrc or of othora against ~y E~totQ: to mnke di~tribution in kind and to cnu~e any ~hare to be composed of cn~h. property in undivided fractionnl shnres in property different in kind fro~ any other ahara; and to execute and doliver ouch instrurnQnt~ aD may be neceGoary to carry out any of thODO Fowcro. IN WITnESS WIlEREOf. I have hereunto ~et "y hand and seal this IS/I, day of / ..1tJG.,/;.'^, . A.D. 1989. /(j ,..(\-..--("......J-:- .:) (SEAL) 7-1, i" Signed, Gealed, publiohed and declared by tho above-naiwed HELEN K. SWARTZ, an and (or hor Li10t \-li11 and Testament, in tho presence of us, who at her request and in hor presence, and in the presence of each other, have hereunto subscribed our names as witnesses. . I I , ~ . '1 " /, .. .' 8t:M rJ,.l 2.. /Jt.<-~{'lI:E1 , . , , ,:;\ ['11 ~ ~ : I 11 I I ': ,\_-----, -,-... ,:::1._""-<,, .,.~ J(,..tti,/ 2 -'.-"'----'--' - ._-~-~ -~- .._--- ---- ...-. ---..- - --. -- _..__.-':"":--~.. " AI\! '~tKJD I"HJ w ... )(:!'" U",,,, w"u ",,,,,, U",-, ..", ~ .... :315 "'c> "'Z 8~ I '.:)- I l2-1 'rOR DMI5 or DIAnt AFIIR 17/31191 C1l1CK III II A srOU5AL rOVIR" CRIDII15 CLAIMID I I IILI NUMBIR '4 9'1:':t,,;l Il,',<<:n. ~(\ ..... ~ (ti"" INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) ,'"S I I I Ullliijrjj"'\iiii.if"iIA...niii,j" Ai,i. ;..iii"", ",,'lId 1 .5 WII-~ TZ, IIGLEN 1<'. "'~;'~':' ;~': 91tf'l I"^?:;~': 'I" \,,^S~ 3~'-IO "'-m;'"~'i''"~;~''''''' ,...., ,,," '''' ..., .""..,,,, \""'" '"'''N/;''''' ) Jo rvlurf' IlIl",,!,l CUl11prorlll\l'! (10/ dut,., 01 (!1m!" uh.., 11,11.021 D~tedenl Died T rnlflle I I 7 D'Hf!dt!nl Moilllfllll"d II hl/iny T IUS' (AlIath tOpy 01 Willi IAlIoth tOpy 01 Tru,11 ALL CORRESPONDENCE AND CONFiDENTIAL TAX INForfMATIOt.fiHCn;io-OEDIRECTED TO: HAM! lo;",iiIiMAliljiOijji'iil~~ (!/(IIIUeS.E.. SHIeL os 1JJ: HUPtlON( UUMIlI 76," - tJZ.o9 (UMMOIlW[AIIII 01 r"jfj~,nv^,~IA OlrAAIMflllol A(vltllJl fllrl 1110f,(JI IIAIUII!:iIHJllli rA In}" OW! ... Z w C> w u w C> ~ I. Originnl Return I-j 4. limited hlalr plJ6 I 7 ~I tOWHY (OIJ( 9' z C> S => ... ~ u w '" 1, R.al Esta" (Sch.dul. Al 2, Slack. and Bond. ISch.dul. BI 3. Closely Held StocUParlne,.hip Intere" (5thedule C) ... Mortgage, and Noles Reteivable (5thedule 0) S. Cash, Bank Oepasill & Miscellaneous Penonal Properly (Sch.dul. EI 6. Joinlly Owned Property 15thedule F) 7, Trand", {5ch.dul. GI(Sch.dul. LI e. Talol Gron An." (lolalUnll 1.71 9. funeral E..penulI, Admini,tralive Co,IS, Miscellaneous bp.n... ISch.dul. HI 10. nebll, Morlgage liabililill, lien, (5thlldule I) 11. Tolal Oedutlion, (lolaIU"", Q & 101 12. Nel Volue of hlole (lin" 8 minu' lin~ 11) 13. Choritable and Governmental Beque," ISthedul" JI vlMl IUJMA 1.lllo.rll'., 11""'1111 AIJl!III.... !JuPI"f!!II1'Il!ul ~1'lu'" S' ROCKRW~I' :J.W. CIMfP HILL. (I.DI.JCI(' HU,lilV r...,/,?) ('."', CWJ/O/illiA,vJ> I'"'"'''''I~/A''' """'" """" . H"mflind~f R"lurn Ilor duhn 01 deOlh pliur 10 12.1 J.l fodoral htole fru Return Required 113 I I ~ Lu 10lul Number of Sole Oepo,il Bou ..2 W. IllAtA) ,Sr. /YlE(]jf/I,1J Ie s ,8ttR6-- f7II IV (7/1/../:' -<0- /70S!; (I) (21 (31 - 0 - (41 - 0- (51 -, ~,.5.i4.50 ,-.,- " 161 (71 -0 -0 fl{l $7'1- -.'--. .$0 (91 l' I~ 1'13. p. ~ SM. 39 (B I (101 " (111 J~,._l(s.'".~'1-_.- (171 '! .:l~G>, 1~3dL_____ - CJ - (131 . ~ ,.- ______.__I.~I__ .:!~~,_~.;j3:~_ 15, 16, 17, Z C> ;:: IB, "" ... tq, => .. :E C> u S 70, 21. 14. Nel Value Subjed 10 TUll Jline 1.~_~irl~.,"tine ~~L__. 5pou,01 lron"e" Ifor dolo, 01 death aher 6.JO.Q.t1 See In"fUtlion, for Allplicablo P"'((!nloge on ReI/one Side. (Indude volu", ,om Sthedule K Of Sdledulc M_I Amounl of line 1d la..obln 01 b% rnl,. (In dude value, horn Sthedule K or Sthedule M I Amounl ollino 1.t la.l.Clble at 15% rolo (Indude value, Irani 5thodulo K or Sthodulo M_I Printipal fait due (Add 10... from lilll" 15. 16 and 17_) Credi" Spousal po;tl'f Credit .Jfifj g.30,n~'o ~ DiHOUlll 11llere\1 + ".1-/-__. +-5.10.00___ -___0____, If line 19 i. grealer .han line 18, enler the diffefence on Une 20. Thi, i, the OVERPAYMENT. U D.II:Tr:I~ .1 .u ,.I"'~.I'.'U ..',1.1'1.1 ,IIoI~.'.' 1m:Tl~ ......III..l.'J-U:l:J.~ ..I ,hi If line 18 is greater Ihan line 19. enler the differente on line 21. Thi. i.,he TAX DUE. A, Enler the interesl on Ihe balante due on line 21 A. 8. Enler the 10101 of line 21 and 21A on line 219. This i, Ihe BALANCE DUE. Mah Ch.eI, Payabl. to: R.~!~!!!...~ WUlI~~@~.!!~__ _______".____~____ (I~I NIl? f. ~':l.I" 1~3. II ,vIA . JIlII1_. ~ /3,5"7.36_ , MIlt' . = (161 . ,06 = (Ill )( .15 = 13, S"7.~B.. (l9) !JJ, 'loo..~.__ - " - 1201 ._..____ -----. (21) _ .._~.'J.,IIo.?,-~fL_ (71AI n ...-_0 ~_... 121B) ,.,.., _:l"lw_1-_3El (IBI ~ ~ BE SURE TO AN'SWERALL OUESTlONS-oN'iiEVERSESIDE'A-Nii-TO-RECHECK- MATH ~ ~ ~nder penalties of perjury, I deda,,, Ihat I hove "...nminlld lhiS;-~lurn, induding ac(omp[)nyi;g~-h~d~I", and"';"t~mll~~J~h~-h~~f;Y~~;:i~dge and b.li " is true, corred and complele. I dedDfethatall reale,lail!l has been reporled 01 Irue ma'~el value. O~doraljon 01 prepa,,,, other than Ihe personal r~re'enlotive based on all informalion of whith preparer hat any knowledge. _ _ _ _ _ _ _ _ s-;Z 3 -'17 ~U" a',..~a" "~a""""a""" G'~::" _~tQVii"~~HA~~~~i~~~~ 11 D$S PAIl ' ,[.~ . a'" Q:)h$, ..." ",f: ,"'0"" :l. W. 1'1111'''' "-T-. v." S--:1,3-97 c. . _:;1!![_ mC:CH.!l.H.IC;SIO..II.!t~,_I'A 11DS~ Act #48 011994 provides lor the reduction 01 the taK rates imposed on Ihe net value 01 transfers to or for the use of the spouse. The rates as prescribed by the statute will be: e 3% (.03) will be applicable for estates of decedents dying on or after 7/1194 and before 1/1196 e 2% (.02) will be applicable for estates of decedents dying on or alter 1/1196 and before 1/1197 e 1% (.01) will be applicable for estates of decedents dying on or after 1/1197 and before 1/1/98 e Spousal transfers occurring an or alter 1/1198 will be eKempt from Inheritance taK. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (1"') IN THE APPROPRIATE BLOCKS. 1. Did decedent make a transfer and: a. retain Ihe use or income 01 the property Iranslerred, ....................................................... b. retain the right to designate who shall use the property tronslerred or ils income, ............... c. retain a reversionary interest; or .................,.............,........,.............,............................ d, receive the promise lor life of either poyments, benefits or care' .........,............................. 2. 11 dealh occurred on or before December 12, 1982, did decedent within two years preceding dealh transler properly without receiving adequate consideration' If dealh occurred alter December 12, 1982, did decedent transler property within one year 01 dealh without receiving adequate consideration'"......"..".,.,....,.......,',.,.".,' ...........,..,.........,......, .....,.................... 3. Did decedent own on 'in trust for' bonk accounl 01 his or her dealh"'.................................... YES NO x X X ^ )<. >< )I. IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. , ... ". I \,.~ ,. . II 8'j SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Ple",u Print or Tyl'" -,-- ---- --H---"H'------rilE'NuMIiEP,' , 'sL.J/f /I T Z ;2./- "it, _ 6105 "~.i~~" _.IYji,uro. (UMMU'''''' At III UI rUHI""',MII'\ nmUIlAUCI 'AX IUIUA,. RnIOWIOIClO.", ESTATE OF HE!LEN 1(. (AU propt'll; 10'"lly.0.....,\I.1I "",rl, ,I". RIlll'l 01 ~"'., ..,,\1"1' ",,,.,' IH' d'\llo\1'I1 nil ~H ,...dul.. I) .".--.. I ITEM NUMBER DE9CRIPTlON VALUE AT DATE OF DEATlI I. HA(({UJ ~//lIJI"6S 8I1NK. a. /.3 1116. a.er/,'1. """ 3o~/5-15se:Z1 6. tl.Ccr. /nt. 0'1 a. - .20,000. "D II 'YS.'2 a. /8 h1(). ce,.t,'1. # ~()~/S-15~B:l:J J. Acer. in&, M c:. e. 1/ hip, auf,'1. ~ .3O~$S'-29SIS8 f: ace,.. int, ();r~. (set: t!o/1f P/ k#er aI/ached J. ~. mELt./),v 8.fNK 4, II/c. eerf,"{, '" t!JPI31/''''' b. a au. il/t. on a. " .:2"IOOOdX, ~ 'Is. il>.z. '/0000,011 , II), O? - /~ t:XJD. 6" '/30$1 "10, Oo(). OQ " ~.99 ~ .:(0, Ot:>0. liD III 3~. 8.3 ,. I~ ODO. tJD ,. 17. <tz ~ /0 {)()().OD , Jl 17.83 '-/~ ()()O. /1t) '1'.78 11 /0,000. otl 'i'ho.'o S ~ ~57#. g . ' C. Inc. Ce.rf.'{. W:- ()o:;, 6lfbeJ d. (Jaar. lnf. M c. e. J:,.c. {!.e,.t,'f, .J: f)-13/rt.3bS-C t. ac~r. ,'Ilt OIl e. f- 'Xnc. (!.erl;1. IF /If -,{- Z.9 670 - c. h. <</Jar. i'1t. en f' . I. Inc. (!erf;f, :iJ:' l'f-I/l-l'i/bo~c t' acer. illt. . Of! I I. f ( ~ S . 1(, :rna. eert;f. .tf: IJlS- P9(,'1~/- C. I. aOl!r, illt, Dnl<. /II. :rile. aertil. ~ :J./D ~ ()/)/II./&. - C- /I. a/!(!.". i"t, 0>1 /II. (!()l}l-ill/fecJ TOTAL (AI,o enler on line 5. Recopilulotion) (AIIOth additional BY," )( II" ,hIli, if more 'pan it nelld.d.J "', - cST/lTi: of /le-L.EN ~ c5N/lRrz. ~'2/~9~ -~S .3. I 'c!J.Jn -h'n. d. Inc. Cern'J. #- :tIO- 610/~ DS-C fl. (leer, int, on (). (5e~ ebpy cI leller ql/ilc/wl) ])/IoU{//(IN /)EPa.slr ..;JAW/( ~ 7A!!USr t!IJ. ~. t!. 1:>. <# !?oooo 9'SS 72 b. aee/", int. on ii, . 10 DCO, ID "/~1. 77 4. s. b. ~. c.Z>. #- !'''o()o..f!5~''1 d. "eer. jilt 0" a. e. c. l>. JIl- f'Doo'fPS7'f/ f. a~. lnt. 011 ~. !', 0...1>. #- tf()()o"lo'l e~ B h. aCU", ;"t. DI1 J. I;C1Iteck,,,! /lcci:. #- Pt)93/ofJ:nB I' tU.lr. Il1f, Dn /. (See &;JjI t:J( h&,. (dl/J.dt~) c.~oce.fJ ~ ll\'lse, CIl5\.. 'In yJ~\\a.t lei-c... RefUnd dtA~ (;.Ml :r.~, s. /)7/ IPf() cliNe.....t IIth-wJ due h-'"'' fJ~ ~t #1 ,feYaiH( PIt JJP/p ~1IlSe~u t 19M (Jhev'r. feltbr;,y i'jt, .5V1()tJt) IK;/(~ (Juldlir tilhaeJ.e.I) 1. * 7iiet'( Nerr 110 fl2r.s 011111 ,hip eI f<ny C()nSe!lAc.lce 0'" assc5.s461e Yake. /Vliet! c1teet/eFJ/'; /W.5/;lllltl c:/,'etj se~trll Yetlf'S 'if: :;k Kllcl1'pnul ht!r ~e....u"l1/ I'Kdlf' p~4n~ , /11N&/' In 1II;Ih her .:5(:S/~r. ~- 707/1/; /I ~ DOO,<<J 'of -3 3' 3. ' fl 25; t)0(). .., J& :1'(, ~8 ,c 101000, .0 ~ l:s-.iS 11 :is: DCO, U "It 6e.~; If I;; S3:!S. C 7' /9. ()~ 7, ~1U>11ff) "9 /I, IJf1 )II 1.)2.0' Jl I (J()t). <lD I t;J'f11 S7'/. . -.. -.. .- -- ,,' ..... - . N~~~~\~? IlillIl" Sjl\III'~"" ('I"'lillloll', C"IIIt'1 lirl :\111111 1:1111 ~I"','l 1."11111\111', 1"'II11~\h,lIl1,1 \','O!.: ','1'/'/:11 1110 ','1",' ';:11 ~U";' r,l\ NOvember 8, 1996 Charles E. Shields III 2 ~t M3.In street ~, PA 17055 The Estate infor~ation which you requected on the (Socinl Sl~euri ty Humber nccount(D) of 210-26-9784 llelen K. 9nnrtz ) is as !0110\1I1. Account !lumber(s) 30-15-155821 30-15-155823 30-55-295158 13 Hths. cmt. 13 Hths, cmt, 11 foIths. cmt. 7-26-95 7-28-95 8-9-96 $20,000.00 $20,000.00 $10,000.00 45.62 45.62 10.09 20,045.62 20,045.62 10,010.09 Illtlivitltkl1 JrdivitlLJoll Irdivitltkll Class o! Account Date Openee! Principal Dalnnce '\ccrJed !ntereot Dalance n t Date of Death Account Ownerohip !lsme of Joint Owner, if any NJ =nl oC a saCe tlqxlsit box. Dnte Ownership ....~s Eslnblil1hed 7-26-95 7-28-95 7-5-95 Additional Infor- I:llllion Rel]lInl1ted Plrosc I~IIO the EKecutor oC this Estate sign the enclos<Xl W-9 Corm ard return it to rc in the providOO envclq:e. '!hank yw. ~rclY' , tC--/ (1~~ L. Oile Sr. Retail Mninistratioo Servias Rep. - , I I oJ " ~ Mellon Bank November 13, 1996 "I I_ no, j,\I~1 1'1111;111."11111;1.1',\ 1!I1l11-iS!IH Charles E. Shields III Attorney At Law MOllon Bank BUilding :l liest MOln Street Hechanlcsburg,PA 17055 Re: Estate oE Helen K. Swartz Dear Mr. Shields: In accordance with your request, the attached lnEormatlon sheet has been provided as oE August 16, 1996. Please see attached lnEormatlon sheet. IE you require Eurther assistance, please contact the under signed at (215) 553-1585. ;r;;;!kuiWA-- Shell a liarner Hellon 8ank, N.A. Deposit SUpport Services (199-5355) P.O. Box 7899 Philadelphia, PA 19101-7899 482 la Iii ~o -'~ klj' ~ ~ . ~ lJll:! oo M oo '" N ~ M '" ~... E~l:! ... ., III 0 ... ~ ~ ... . . . . , . ... ~ oo M ... III N oo III 0 0 III oo ... ... ~ N N III N N N N M tl~~ C> II ... ... ~~~~ U ~ '" M N M ., 0 ... QI III '" ., ~ ., ... 0 ... a . . . . . . . . ., 0 ~ ... ... oo 0 '" .. ~ N M ~ ~ ~ oo N C> >J 0 0 0 0 0 0 0 ~ II QI QI . . . . . . . . .ri ~.iIC 0 0 0 0 0 0 0 0 > 10 " ~ ~ N ~ ~ ~ ~ ~ IOU;;! lJl... ~~ ... tn .&J ..-4 >t tJ\QI>JQI II'" "II ..-4 ... lU 0 h!l~ ~;;!UX Ul f" >t QI >J QI QI Cl2~ ~ '" M N M ., 0 ... QI II 0 >J III '" ., ~ ., ... 0 ... ... 0 " ~ . . . . . . . "XCI ., 0 ~ ... ... oo 0 '" 10 " ~ N M ~ ~ ~ oo N X~~~ ~ >'MMC) QI II ~ . lJl ~tl '" xuu . x~x ... ",0 Ul . ~~~ ~~~~; X 0 0 0 0 0 0 0 0 . 0 0 0 0 0 0 0 0 X ......CI . . . . . . 0 0 0, 0 0 0 0 0 0 0 O' 0 0 0 0 0 0 0 0 0 0 0 0 0 . . . . . . . . ., 0 0 0 0 0 0 0 0 .. ~ ~ N ~ ... ~ ~ ~ QI ~~ QI QI " >J >J QI 10 tJ\lO >J . . . . . . . . U II U II ~~ U U U U U U U U .....ri."" M . . . . . . . . ...>... ... ... ... ... ... ... ... ... .... to OM . >JUl>J:- " " QI >J QI 8 UIIU QI ... il Il QI Il ~ ~ QI Il QI III oo M N ~ '" N '" :- >J 0 " ~i '" '" '" '" '" ..... '" ..... 0 lOUIl< ..... ..... ..... ..... .... '" ..... N " >J II ~ M ... N ., 0 ... N CI Ul'" I M ~ ~ ~ ..... ..... N ..... ..... ..... ..... ..... ~ 0 ..... 0 I l:!0 M M oo '" ... ~ oo ~ ... , . . . U Ul U ~ . . . . CI Ul ... Il< " >J >J .. ~ " QI ~ " QI Ul >J C> tJ\ II II .. II . ...... c>'.. I lo: ... "'" il U ... U II lU .&J > III QI QI QI QI QI QI QI QI ... .Q ... 10 .Q ... ~ ~ ~ ~ ~ ~ ~ ~U"UlU ~ QI 0 121 lJl Ul Ul Ul Ul lJl Ul t:Tt rot Clf oW tn = co lU 0 VI .... r:I Q 0 GJ U U U ... 0 ,Q II U U I I I U tn tI UJ.... U I I ~ oo III cu ....... VI VI .. I 0 0 oo ~ 0 .Q QI 10 10 :l '" M III ... oo '" ~ N .. UIl<UlIl<IIl ~ oo ., oo oo ... oo ~ ~ i oo oo M '" '" '" 0 0 I I I I ... ~ '" N ~ 0 0 0 M ., ~ .c I I I . . . . ... N III I I III 0 0 CI "'u l:! UlU 0 0 I ~ ... ~ ~ ~ ~ ~~ . . . 0 0 0 ~ ... ... N N III Il<IIl .. Account No. Type Date Opened or Issued Date Closed or Matured D Dauphin Deposit Bank and Trust Company MAIN OrrrCE: 213 MAnKEr STnEET, IlAnfllSOuna. PENNSYLVANIA 17101 717255,2121 Decedent Call' i rrnill ion Nome: lie 1 en K. SIVa rt z Social Security No.: 210-26-9784 Date of Death (DOD): 08/16/96 8000095572 8000095661 8000405741 ------------------------ ------------------------ ------------------------ Certificate of Deposit Certificate of Deposit Certificate of Deposit ------------------------ ------------------------ ------------------------ 08/17/84 OS/22/84 02/03/87 ------------------------ ------------------------ ------------------------ 01/31/97 (Maturity) 05/07/97 (Maturity) 02/03/97 (Maturity) ------------------------ ------------------------ ------------------------ Date of Death Balance $20,000.00 PlUS $25,000.00 $10,000.00 ------------------------ ------------------------ ------------------------ Date of Death Accrued Int. $33.37 $24.38 $15.85 ------------------------ ------------------------ ------------------------ Joint C>.Yners (if any) None Date of Joint C>.Ynership None None ------------------------ ------------------------ ------------------------ -- . - _h _. ..h_. _.. __..__..__.._______________ ------------- ------------------------ ------------------------ ------------------------ Special Conrnents: NIA AddiUonal tnrormation avanable at $20.00 per hour. On. hour lIIinilllum. Date Prepared: November 12, 1996 Prepared by: Cheryl A, Bowers Customer Management Information Dept. (041) For. 00-020-218 (REV 7/93) Telephone No. (717) 255-2054 Page 1 of 3 . ... ~. .- - .~ l'^" I)MJI'IIIN 1)11" '''11 I"'N'" _"Nil IIH'''' CIIMI',\N.... lIMU{I"lItIlH.. 1'1 NN.....' V^NI^ .. III Charles E. Shields III !'""CII Nll 2 of 3 Nome: lIelen K. swartz SSN: 210-20-9704 000: 00/10/90 0000409020 0003100370 4301720730109197 Account No. ------------------------ ------------------------ ------------------------ Type Certificate of Deposit Checking Charge Card ------------------------ ------------------------ ------------------------ Date Opened or Issued 06/07/83 03/26/90 OS/28/15 ------------------------ ------------------------ ------------------------ Date Closed or Matured 09/09/96 (Closed) 09/05/96 (Closed) 03/26/97 (Maturity) ------------------------ ------------------------ ------------------------ Date of Death Balance $25,000.00 -0- $18,833.04 ------------------------ ------------------------ ------------------------ PLUS Date of Death Accrued Int. $68.32 $19.08 -0- ------------------------ ------------------------ ------------------------ Joint Oimers (if any) None None None ------------------------ ------------------------ ------------------------ Date of Joint Oimership ------------------------ ------------------------ ------------------------ ----------- ------------- ------------------------ ------------------------ ------------------------ Special eomments: tllA Additional information availabl. at $20.00 per hour. One hour mtntmum. Date Prepared: November 12, 1996 Prepared by: Cheryl A. Bowers CUstomer Management Information Dept. (CHI) Telephone No. (717) 255-2054 ... i ,..,1 , .1. 1 .IUlhul'j,:c ,I lid l'i'lIUj''''I'I" 1:'1 IH'I'~.IJIl;tl repn.niont,IllVfJ, in hiti :;IJl,~ .IIUJ ,IlJ,adllll.' di::cn!lilJII, tu IHarclhl:;!! ur olhol'Wltill oICIJuit'u ,llId I'l!l.lin iHI}' inve:.ll:lt~lIl:.. 01 \';hH.:h 1 tHo uoll.oll, ur nny 1'0.11 or pun;oJl.ll pru}Jo1"ly vI ;:1I1Y IhlLUl'{Jj to uoll, lcnuo, JlltH.hJo, l:1o:"lrJiHJU, tnuwCC1', f.!X{:h'IIHJ(', di~;puuu (Jf, ur fJr.lllt optlum. In n.'IJtU'tl to ;IIlY 01' .Ill l'rup(~I-ti' ()f .II1Y }:ind formilH) i1 lJ.lrt or illY , I, I EULaLt! Cur Guch lUl'mG l1nLl tiuch priceG lIU hu may deom nt.lvlsuu!oj to LOl'row nonoy (or any pUt'poGon connecteu with tho protection , , ii~:J I' j !." j" j; .,~ dud !>t'C:.HH"VOItion 01 tly I;Ul':JlOi to mOL'leJ.HJe or 1'1cc..lrJO nny real or perGonal property Corming a part oC my EGtate; or to join in or securo tho partition DC camo: to compromise any claims or domantlo DC my Estate against othors ur DC othora aCjQinot my Estate: to molKe t.I1utriuution in kinll and to caUtio any share to uo compoocll .'. oC caGh, property in undivided Cractional GhareG in property dlCCerent in kind from any other share; and to executo and deliver such Instrumenta on may be necessary to carry out any of .' t.~ thoso powers. I'" , ,'{ " I,' ~,: , ! thiG III WITIIESS WlIEREOf, I have hereunto Get my hand and Goal IS/I, day oC ,././JI,;'7.,/;.-,,, . A.D. 1989. }/, (, '-<--1," ..<\~, - ('~ ,-1-;-, ".J (SJ;A',) tiiyncu, Gcalcll, pUlJl1:.;hcu null lIcclllrcu by the o1bovo-n,]mcll IIt-:Llm K. ~~U.HTZ, .1:; o1lld fur her I..JGt Hill .,l1u 'l'o:;tnmcnt, In tho p,-oL>cncc of mi, who o1t )H:1' n..'lJuo5l null in her prc!;cncc, itull in tile JJt'C:';CIH.:C of c<.1ch at.:lCr, Jhlve hereunto :;uuacr iuct.l OUr har.1CD no \1 i lnu:;ouc. 1 j, , . I , ,. l/ .' '_, _ f'litN ({'.J f:, ./-: -/~' (', f;-t..,j..1.:. . k: f" 'if .' 'r.. " ~ ,\ ,I (, ~ ., t, r:;l /~ ' t I /L,....'..n.......r oJ. l.t../ ~ " " . l .:"" ,- -----..--..-"--.--..---.""":"'!c.~ .." .-......... " , I I 1 , I I I 1 I 1-.- I I . t , I I I I I I I , I I I I I I I ., COMMONW(ALlU or !>fUUSYlVANlA UEPAAIMENT OF nEVEUUE BUREAU OF INDIVIDUAL TAXES OEPT 280601 tlARfUSOURG, PA 1712H.Ofi01 *' ~. ... :-> ,", ' PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. AI\211359 J1lV,IHi2 LX l1HHij RECEIVED FROM: 1- ACN ASSESSMENT CONTROL NUMBER AMOUNT SHIELDS CHARLES E III 2 W MAIN STREET 101 $2,167.30 MECHANICSDURG, PA 17055 FOlOH[RE ~ HXDIIlfll ESTATE INFORMATION: FilE NUMBER 21-'99b~l>c5 NAME OF DECEDENT lLASTI SSN...a1.~~':;>04 IFIRSTI !MII ---SWA~~HE~EN-K OATE or PAVMENT 5.'21U97 POSTMARK DATE __01-001.00- COUNT V $2,lc7.3B TOTAL AMOUNT PAID _-CUMBE:Rl.AND DATE or DEATlt REMARK PETER A SWARTZ C/O CHARLES E SHIELDS 111 ESO SEAiCHECKII 091 . '_' .. ~; h (' t ",' i~:1 - .. - .---...-., -.-. ---..-- ..--------------- -------------.--...---- .'-'-- ---.. I \' I, ' if:' ~ " ..... 'f -~ ~_._~--:-----....:II. ---~,.""..,,- --.~ ~ _ II. -F:_~ " J .'. .. COMMor'WI All" or f1l:tmSYlVArllA OlPArHM[NT or fl[VEUUI: BUREAU OF INDIVIDUAL TAXES OlPT 280601 HAru~ISUUJm. PA 17128.0601 .9.'J~"~_ ~ NO. AA 242291 R'Y ".m t"".' PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT RECEIVED FROM: r ACN ASSESSMENT CONTROL NUMBER AMOUNT CHARLES E SHIELDS III ESQ. lCd "'I-. .." 6 CUlJSER RQ'\I) MECHANICS~URG. PA 17055 rOlOtlER[ rOlDHERE ESTATE INFORMATION: FILE NUMBER 21-1996-0665 NAME OF OECEDENT ILAST) SWARTZ HELEN K OATE OF PAYMENT 10/01/1997 POSTMARK D.f>T~ 9/30/1997 COUNTY CUMBERLAND DATE OF OEATH SSN 210-26-9784 IFIRSH IMI) TOTAL AMOUNT PAID $6.42 REMARKS PETER SWARTZ C/O CHARLES E SHIELDS III ESQ. SEA~HECKII 098 RECEIVED BY MARY C. LE IS REGISTER :rJF WILL -r------ -.-------.- .---.-... ..----. - ------.- --- ----.--- .---.-___.__._._______.__~~~~- i'~:: I Ii ') If; { OF \ l/i:_L~; , t,!w r, , j ,,~ .. . ' __f "..--- ~ __ r-:'" , --.-_.'--'-~-"""""""'.A.I ,- D , "..} /. (1 - / r~~ c/ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU Of INDIVIDUAL INtlLRlfANC[ lAIC DIVISION D[PI. :806Dl HARRISBURC, PA IIlts-ObOt TAXES NOrlCE or INItERIfANCE TAX APPRAISEHENr. ALLOWANCE OR DISALLOWANCE or OEoucrIONS AND ASSESSHENr Of rAX ""lhl Ill" III.'" 09-22-97 SWARTZ 08-16'96 21 96-0665 CUMBERLAND 101 F~~o,-"~~!'t R.!'!'tttod ==j MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV:is'4i-Ex--AFP-ioj":ij;rNorlcE--oF-YNHEiiITAifcn'-A'x-jippiiA'IsEi.fENT-;-ALDiwANcE-oli--mm--------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX HELEN K FILE NO. 21 96-0665 ACN 101 CHARLES E SHIELDS III 2 W MAIN ST MECHANICS BURG DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN IlELEN PA 17055 ESTATE OF SWARTZ DATE 09-22-97 TAX RETURN WAS: I X I ACCEPTED AS fiLED CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..I Est.t. (Schedule AJ n) 2. stocks and Bonds (Schedule OJ (2) 3. Closely Held Stock/P.~tn.rshlp Int.re.t (Schedule CJ (3) 4. Horta.ges/Notes Receivable (Schedule OJ (4) 5. Cash/Bank Oeposlts/Hlsc. Personal Property (Schedule EJ IS) 6. Jointly Owned Property (Schedule fJ (6) 7. Trensfers (Schedule GJ (7) 8. Total Ass.ts ,00 ,00 ,00 ,00 241.574.50 .00 ,00 181 NOTE: To insure proper credit to your account, subnlt the upper portion of this forn with your tal( paYIII.nt. 241, 574.50 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Fun.ral El(P.ns.s/Adn. Costs/Hisc. Expanu. (Schedule H) (9) 10. Dabts/Hortgag. Li.blli U../Liens ISchedul. I) no) 11. Total Deductions 12. N.t Value of Tax R.turn 13. Charitable/Governn.nt.1 a.qu.sts (Schedule J) 14. N.t V.lu. of Estat. Subject to Tex 14,943.00 508,39 Ill) 1121 1131 1141 1~,4~1 3q 226,123.11 .00 226.123.11 If an assessment was issued previously, lines reflect figures that include the total of ALL ASSESSHENT OF TAX: 15. Anount of Line 14 at Spousal rat. (15) 16. Anount of Lin. 14 texeble .t Lin.el/Class A rete C16) 17. Anount of Lin. 14 taxable at Coll.terel/CI..1 8 rat. C17) 18. Principel T.x Du. 14, 15 and/or 16, 17 and 18 will returns assessed to date. NOTE: .00 X .00: 226,123.11 X.06: .00 X .15: 1181 .00 13.567.38 .00 13,567.3B TAX CREDITS: PAYHENT DATE 11-08-96 05-28-97 DISCOUNT 1+1 INTEREST/PEN PAlO I-I 570.00 .00 RECEIPT NUHBER AA146923 AA211359 AHOUNT PAID 10.830,00 2,167.3B BALANCE OF UNPAID INTEREST/PENALTY AS OF 05-29-97 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 13.567.3B .00 6.42 6.42 . If PAID AfTER DATE INDICATED, SEE REVERSE fOR CALCULATION Of ADDITIONAL INTEREST. If TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. If TOTAL DUE IS REfLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE A REfUND. SEE REVERSE SIDE Of THIS fORH fOR INSTRUCTIONS. I K " RESERVATIONI E,tat.. of dlCldent. dying on or blfor. Dlc..ber 11, 1982 .- If any future Int.r..t In thl ..t.t. I. transf,rred In Po.....lon or ."Joy..nt to Cl... I Ceollnt,r.l) bln,flcl.,i.. of thl dlCldlnt .ft" thl ..pltallon of any ..tat. for 11f. or for y..r., thl Co..anw'llth het.by ..pre'lly r...rv.. thl right to apprals. and ...... tran,f.r Inh.rltance ,.... at the lawful cta.. I (collat,r.l) rat. on any such future Inter..t. PURPOSE OF NOllCEI To fulfill thl requlr...nt. of Slctlon ll~O of thl Inh.rltancl and E,tat, 'a. Act, Act 21 of 1995. e12 P.S. Slctlon 9UOJ, PAYttEHT: Oetach thl top portion of thl, Hotlee and IUblit with your pay..nt to thl Rlgl'ter of Will, printed on thl r.ver.. .Ida. "Hak. chick or 10n'Y ordu payftbl. tot REGISTER OF MILLS, AGENT REFUND fCR)t A r.fund of a tex cr.dIt. which we. not r.qu..ted on th. Te. R.turn, nay b. r.qu..ted by cD.pl.tIng en "Appllcetlon for Refund of P.nnsYlvenIe Inherltenc. and Eslat. 'e." tREY-Ill]). Appllcetlon. are aveIlabl. et Ih. Offlc. of the Regl.ter of WIll., eny of the 2] R.v.nu. DI.trlct Dfflc... or by ceiling th. .p.clel Z4-hour ensw.rlng servlc. nu.b.r. for for.. ordering: In P.nnSYlvenla 1-800.J6Z.Z050. out.Id. PennSYlvanle and within local Hl!lrrlsburg area (117) 181'8094. '001 (117) 112-ZZSZ Wearing r.palred Only). OIJEC'IONS: Any party In Int.r..t not ..tl.fl.d wIth th. ftpprftls.eent. allowanc. or dlsallowanc. of d.ductIon., or ass..s..nt 0' ta. (Including dl.count or Int.r..t) a. shown on this Notlc. .u.t obj.ct within .I.ty (60) days of r.c.lpt of this Notice by: ..wrltt.n prot.st to the PA D.part..nt of R.v.nu.. Board of App.als, Dept. Z8IDZ1. Harrl.burg, PA 111Z8.10Z1, OR ...I.ctlon to hev. the .ett.r d.ter.ln.d et audit of tho account of the p.r.onel r.pr...nt.tIv.. OR ...pp.al to the Orphan." Court. ADMIN ISTRATIVE CORRECTIONS: Fectual .rror. dl.cov.r.d on this ft.......nt should be addr....d In writing to: PA D.part.,nt of R.v.nu.. Bur.au 0' Individual 'ax.., A"Nt Po.t A....s..nt R.vl.w Unit. O.pt. Z80601, Harrl.burg, PA 171Z8-0601 Phon. (717) 787-6505. S.. page 5 of the bookl.t "In.tructlonl for Inh.rltanc. 'ex R.turn for a R.sident D.c.d.nt" (REY.15Dl) 'or an .xplanatlon of ad.lnistratIv.lv corr.ctabl. .rrorl. DISCOUNT: If any taM due I. paid within thr.. Il) cal.ndar .onth. aft.r the dec.d.nt"s d.ath. a flv. p.rc.nt eS~) dl.count of the taM paid i. allowed. PENALTY: The 15~ t.x a.ne.ty non.pertlclpatlon p.nalty I. coeput.d on the total 0' the taM and Int.r,.t a......d. and not paid b,'or. Jenuary 18, 1996, the flr.t day .ft.r the end of the ta. a.n..ty p.riod. Thl. non'partlcipatlon p.nalty I. appealabl. In the .ae. .anner end In Ih. the .... tl.. p.rlOd as you would app.al the teM and Intere.t th.t h.. b.en as.....d a. Indlcet.d on thl. notlc.. INlERESTt Int.r..t I. charg.d b.glnnlng with flr.t day of d.llnqu.ncy. Dr nln. (9) .onth. .nd on. el) dey fro. the det. of d.eth. to the date of pey..nt. T.x.. which b.ce.. d.llnquent be for. Jenuery I. 198Z b.ar Int.r..t at Ih. rat. of .IM e6~) perc.nt per annu. calculat.d at e delly rat. of .000164. All tax.. whiCh b.ca.. d.llnqu.nt on and aft.r January 1. 198Z will b.ar Int.r..t et a rat. which wlll vary fro. cal.ndar y.ar to cal.ndar y.ar with that rat. announc.d by the PA D.part..nt of R.v.nu.. 'h. appllcabl. Int.r..t rat.. for 198Z through 1997 .r.: '!!!! Inter..t Rllt. Dally Inter..t Factor !!!!! Inhr..t Rat. Dally Inter.st Factor 1982 ZO~ .OOOSU 1987 'X .000l47 1983 16~ .000438 1988.1991 11:< .0DDlDI 1984 1IX .000301 199Z 'X .ODOZ47 1985 BX .00OSS6 199].1994 lX .000192 1986 lOX .000274 1995-1997 'X .000Z47 uInt.r..t It celcul.t.d .. fol10...: INTEREST = BALANCE OF TAX UNPAID X NUnBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR ..,"y Hotlc. I..u.d a,t.r tho taM b.co.., d.llnquent will r.fl.ct an Int.r..t calculation to flft.en (IS) day. b.yond the date of the a.......nt. If pay..nt I. ead. .ft.r the Int.r..t co.putatlon date .hown on the Hotlc.. additional Int.r..t eu.t b. celculat.d. /5'-/:<J" / COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT t/ ~-'~~'~~ '~ irr:ll~ ,t-~ ~j.l. .r; BUREAU or INOIVIDUAl TAXES IHIl(AIUNCI laIC UI\l15111N DUll. tUbOI 1"""15811110. I" 111:11'01,01 '1'-1'''1111'111.111 CHARLES E SHIELDS III Z W MAIN ST MECHANICSBURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 10-Z7'97 SWARTZ OB'16-96 ZI 96-0665 CUMBERLAND 101 HEL EN K f=,~=_~.ounl R..lII.d MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 HOTE: To in sur. proper credit to your account, subnlt the upper portion of thil forn with your tax paynent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ RE.V:i60-j-EX--AFP-.ioi-:97i----.-.....-iNH-ERiifANCE..TAX--sriiiEHE-NT"O-F.AC-Couiii--.-..--......---".-------- ESTATE OF SWARTZ HELEN K FILE NO. ZI 96'0665 ACN 101 DATE 10-Z7-97 THIS STATEMENT IS PROVIDED TO ADVISE or THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS. THE CURRENT BALANCE, AND. IF APPLICABLE. A PROJECTED INTEREST FIGURE, DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09'15-97 PRINCIPAL TAX DUE: 13.567.38 PAYMENTS (TAX CREDITS), PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (- ) 11-08-96 AA1469Z3 570,00 10,830.00 05'Z8-97 AAZ11359 .00 Z,167.38 09-30-97 AAZ4ZZ91 6.4Z- 6.4Z TOTAL TAX CREDIT . IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS lESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR I, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I TOTAL DUE 13,567.38 .00 .00 .00 BALANCE OF TAX DUE INTEREST AND PEN. PAYH[HT I D.tach tha top portion of thl. Notlc. and .ubalt with your Plty..nt aad. payabl. to tha nu. and IIddr... prlntad on the r.v.r.. lid.. If RESJDENT DECEDENT eah ch.ck or aon.y ord.r payable to: REGISTER OF WILLS, AGENT. If HOH-RESIDENT DECEDENT aak. ch.ck or aonay ordtlr payabl. to: COHHONWEAL TH OF PENNSYLVANIA. REFUND (CAI: A r.fund of . taM cr.dlt, which wa. not raque.tad on the Ta. R.turn, aay b. raquastad by ~oapletlng an "Application for R.fund of P.nnsYlvanla InharItanc. and Estate r.... IREY-l.U31. APPlications are available at the Office of the R.gl.ter of Wills, any of the Zl R.vanue DistrIct Offlc.. or froe the D.partaent's Z4-hour an.w.rlng ..rvlc. nu.b.rs for for.. ordering I In P.nn'Ylvanla 1-800-36Z-Z0S0, out.ld. P.nn'Ylvanla .nd within 10c.1 HarriSburg ar.. (717) 787-8094, 1001 (7171 77Z-ZZSZ (Hearing lapalr.d only). REPLY TO: Qu..tlon. r.gardIng .rror. contaln.d on thl. not Ie. should be address.d tal PA Depart.ant of Ravanu.. Bur.au of IndIvidual Tax.., ATTNI Po.t A.......nt Revl.w Unit. Dapt. Z80601, Harrl.burg, PA 1712800601, phon. (717) 787-6S0S. DISCOUNh If .ny t.. due I. paid within thra. (3) calandar eonth. aft.r tha d.c.d.nt's daath, a flv. parc.nt IS~) dl.count of tha ta. paid 1. .llowad. PENALTY: Th. 15~ ta. a~a.ty non-partlclp.tlon p.nalty I. coeput.d on tha total of the tax and Int.r..t .......d. and not paid bafor. January 18, 1996, the flr.t day .ft.r the .nd of the t.. aan..ty parlod. INTERESTr Intar..t I. charg.d bag Inning with flr.t day of dalJnquancy. or nlna (9) .onth. and ana II) day fro. the data of d.ath, to the data of pay.ent. Ta.a. which bac... d.llnquent b.for. January 1, 1982 bear Inter..t at the rata of .1. 16~1 parc.nt p.r annua calCulated at a dally rat. of .000164. All ta.e. which b.ca.. d.llnqu.nt on and after January 1, 1982 will b.ar Int.r..t at a rate which will Vary froa c.l.ndar yaar to C.l.ndar yaar with that r.t. .nnouncad by the PA Depart.ent of Rev.nu.. Th. appllcabl. Inter.st rat.. for 1982 through 1997 ar.: v.., Int.r..t Rat. Dally Int.r..t factor V.ar Jntar..t Rat. D.lly Int.r... factor 1982 ZOX .000S48 1987 9X .0002U 19n lU .000U8 198801991 11:< .00D10l 1984 ll~ .0003Dl 1992 9X .000247 1985 13X .OoolS6 199501994 7X .000192 1986 lax .000274 1995-1997 9X .000247 -"Int.r..t Is c.lculat.d .. followlI INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTDR -"Any Notlc. 1..u.d aft.r the taM b.co... dallnqu.nt will r.'I.ct an Int.r..t c.lculatlon to ,1,t..n (IS) day. b.yond the data of the ........nt. If P.y..nt I, aad. .ft.r the Int.r..t co.putatlon data .hown on the Hotlc., additional Int.r..t au.t b. calculatad. . '. - ~. , COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU Dr INDIVIDUAL TAXES IHtIERJrANCE fAX DIVISION D[pr. za0601 HARRISBURC, PI. 11114-0601 NOTICE Dr INHERITANCE TAX APPRAISEHENT, ALLOWANCE DR DISALLOWANCE Dr DEDUCTIONS AND ASSESSHENT Dr TAX CHARLES E SHIELDS III 2 W MAIN ST MECHANICS BURG PA 17055 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN '("Ih/fl AI, 111'11, 09-22-97 SWARTZ 08-16-96 21 96-0665 CUM8ERLAND 101 HELEN AMount R.nitt.d CUT ALONG THIS LINE &, ,,/Jv MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 R~TAIN LOWER PORTION FOR YOUR RECORDS ~ II- ----.-------------------------- :v ~ '. t' I , " ;.:-. ). '. t, f ~ -1 \ _ ',', ; , f ." . . .,. " 'J, . " . ----- - --------..~. --- ~~ _ _ l----.~ 1!"-:...-- ) /( ,c . ,\ r I . . J 'f( . , ... . .. ~. .' .~ . .......,......... .. ........ '"4. "I J.......ul '1.111111' A.... II .- ~.Ul "..... -j " " (" '. ., r. j;. , ' " { " tl . " "'.} ~" ,f , L' ), -. . '" ,I . Ii .\. ;>' " . . " -; ~. :," . , t, .f ._-, -r~ r. r-~_ , ,- . --_-.---:-'"~.M. r'-~ \ . \ ~ ~ , . J ~' . . .' .,..:.... ~ , '. STATUS IlEI'OIlT UNOEIl RULE 6.12 Name of Decedent: H~~JI k Jlvuli: Date of Death: /- It. . 9" ..- Will No. Admin. No. ~J-96- f4'~ Pursuant to Ilule 6,12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of th& above-captioned estate: 1. State whether administration of the estate is complete: Yes X No , 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No ',( r ~ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes~ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of 'he Orph,"" Co"r' ,"d .'y be ""ched '0 'hi~~~~: Oate: cr. :2?~ ~ ~~ 5i)> Signature ~rk.s E: ~/d4-~ Name (Please type or print) b e~~( Ser Rei. 4tt'(!/a;/ICS'J(!~ Address )/;( / l~a- (7/7) 7t,t,-IJJ,Of Tel. No. ;--J I : , , .Ii" L!: -- "~-I ~, ~:; ''')l; Capacity: Personal Ilepresentative ~Counsel for personal repreSentative (MAH:rmf/AM3) ~ ;7