HomeMy WebLinkAbout80-00051
No. 21.80
-
PETITION FOR PROBATE' OF WILL AND LETTERS TESTAMENTARY
in the Estate of
ANNlLM. SHEAF.EER-____
, deceased.
Harold B. McLane, Deputy ~
To rlicharEl E. Anderson, Register of Wills for the County of Cumberland,
in the Commonwealth of Pennsylvania-
IS
Petitioner(s) j(kfj'{ the execuL.QL.~.--- named In the Lost Will and
Testament of ANNA M. SHEAFF'ER . dated .;Januarv 16. 1967
Decedent was a citizen of the United States and a resident of
Xfuw':lll!llipc
Lemoyne Borough, Cumberland County, Commonwealth
of Pennsylyania.
Decedent died on
Saturday
the
29th day of December
A. D. 19.-!2., in the County of
Cumberland
State of
Pennsylvania at the age of
:has PUllS her
Decedent has not been married and hos not hod children born to Jbimc
since the execution of the above described Will.
Decedent was possessed of personal property to the value of
$12 , 000.00 and of real estate to the value of
98
years.
-0-
. as near os can be ascertained; said reol
estate situated os follows
JOPP;IlIx
Therefore, your petitioner(s) respectfully applies for the probate
of the said Last Will and Testament and for Letters Testamentary thereon.
Da"d J~:::::~d ::::", -jlfjlw:'i:~~
of Petitioner(s)
307 Market Street
Lemoyne, Pennsylvania 17043
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
~ ss
WILLIAM S. SHEAFFER
named in above applicotion, being duly sworn according to law
say(s) thot the statements set forth in this petition are true to the
best of
knowledge ond beJ.ie:f: "j . /.:) _ ,,oj
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and subscribed before ~Jl 'f( (tJ)(..4/LtI, .-.
WILLIAM S. SHEAFFE
me, . January 24 19 80_
~~. ~ ~Q\ ~,..
., .1,' T~-'~ .~_
rin I:l. ne, !p1!,ty
nichard E. Ander3err, Register
his
Sworn to
US-.J .5:}
(-fo
At torney: MYERS'jMYERS, F'La\'ER & JCllNSrn
.'1;1-11 ' "11,, .~.J
Filed; January 25, 19BO
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OATH OF SUBSCRIBING WITNESS
COMMONWEALTH OF PENNSYLVANIA I ""
COUNTY OF CUMBERLAND \
ThiS............................~~.~~................................... day of .................,q.'!!1.~I;y................ ",'....,....... A.I)., I \J......~,O
Harold B. McLane, Deputy
before me Ri~hl'l'!l E. .'.F1BS}'[JSft. Register for the Probate of Will" and /.(I'an\.ing \"U."r" of Adlllinistl'lItion
in and for said County of Cumberland, in the Commonw"alt.h of 1','nn"ylvIlIlia. P"I'S'"lally elln'" ..............
....... ..........GUBNEY...E\... ..RlJJ).'i~ ...JR......!.. ....~~.~... ~.~................"......."."....,....,.............,.....................................
the subscribing witnesses to the foregoing instrutn"nt of wl'iting pIII'IMn'!in/.( t.o Ill' th" last Will and
Testament of .........)\N.!':l..?\...I:1......~.l;j~..(\f..f;'.l;;!L........... .... ...... ,.....,... ,.., ,.', ,..,., ,." I ),llPd ,..;!.'?:~.\l.'?:!;Y...~.9.1....l:.~.~.?
late of .....................~.O'RQ.U(i~...9.r....~Ft.I:lQm.1';............ ........................ ........' \. :lIlllb"r1and County I'a., deceased
who being duly ..............~W!?nl.................. at'Ctmling t.o law. d"I""" 1I11d "ny, t.hnl .......1!!'!...':'!~.?...................
present, and saw and heard the testa.......tr.ix................, ..... ,J\NNJ\, JI....SJ.lll^lcf.E.R.................................
sign, seal, publish, pronounce and declare the ,aid inslrunll'nt of writ.ing ns and '''I' h.....R.r....... Testament
and Last Will, and at the time of so doin/.( ...........Hl1f.\..............................wlI" of Hound and disposing mind
memory and understanding, to thc bcst of .............his...........................I\Ilowl"dgl., ob"ervation and belief.
......swor;n...to....................... and subscribed belllre
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.,......'MiiN.i.i~.:...iiuii.y.;..'jRr... .................
~.~.. ,((lrJL.1~?,.~:J4<;..'?/)~,~"-~,...P.~.p.~.~y
!{~~~~~~n, Register '.
....."...........................,,,.............................................
....,.............................................................................
AFFIDAVIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA ( s,:
COUNTY OF CUMBERLAND \
......... .............~!;11);.IN1..!'?,.. .!,?!~.J;.;!}.f:'.f.!::,1.\.........,...........,. ...."...""......,....,.....,.................................... .being duly
..............!?>>:QIJ.\....................... Hays t.hat. as n<'lIdy as "1111 \,,' aSI"'l'tllin",\ t.Iw ""id deccdcnt ..........................
......................1\N.!':l.11...1:1......$.I.\r;.!\!:.f;'.I:~ !1..."......... .
,...",........,.......,....................... ............ .....died on
..........Satul:d<l:f.................... t.Ill' .........).'),1;11....,.... .dll,v 01' ........I.l,o.!':r-!.~)!:?9.r........................... A.D., 19......~9
at or about .............................
0'1'1'11'1" ' . 1\1.
.............s.'I!()l:.o...tQ................. ..lIl1d MIII>..I'I'II".d 11>1.,
................?~~~...................., dll,\' "I' .. ,JI\I1UIII'Y
19,~~...... hefon'
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nUl'uly
OATH OF PERSONAL REPRESENTATIVE
COMMONW!<:AL1'H OF PENNSYLVANIA} "
COUNTY OF CUMBERLAND 55:
Before me, the Register 1'0" the Probate of Wills and granting o!' Lelte,'s of Administration in and for
the County of Cumberland, personally came ............RU..);,.;I;i\.kU:;.,...::?lJ.J;;/IJ.'.r:l't.J.L.........................................
who, being duly .........?W!;>.J::ll........, do ....~.$.. depose and say that. as........l't.l!;?Q.\1tR.+......................................
of the last Will and Testament of ................M'Ir...f\..!:k..:;;.~);:Af.););:.!L..................................................deceased
.....p..':'................ will wen and truly administer the goods and chattels, rights and credits of said deceased
according to law. And also will diligent.ly comply with the provisions of the law relating to Transfer
Inheritances. ......swcJ:;n...tO... and subscribed
before me.
January 24 80
........................................................ A. D., 19............
\:~~~B.~':::~.-l~,~~.........~.~!?~~y
~~~.:tliglster
211lc.,{ul~;/..Il~Jt.~............
WILLIAM s. SHEAFFiy(jI..........
..................................................................................
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DECREE
Be it remembered that on the ........?~.~~....... day of ...................~.a.~~.a.~.y............., A. D.. 19 .~~..., there
was probated and recorded the last. Will and Testament of ......A.~Il.~..!'I.~...~~~.a.g~.r..................................,
late of ...............~~.~~X.~~............................................., Cumberland County, Pennsylvania, Deceased. Letters
..........................'~~.~.~~~~.~a.~.y.. were grant.ed to ....................~.~~.1.~~~..~.:...~~~~.;~~.r............................
Witness my hand and official seal t.he clay and year aforesaid..
,._~)j lill'p \ ,)
T {~nU....~....Y\1~..jl~_"'~~~.::~.P.~!?~.~?:'..
~~, Register.
I~. ". ~1"J <<j_} ~J
APPLlCA liON rOil AHlJ CUN'.I./J I
TO ',IAIlSI'U, \I:(.IIIIITII \
REGISIEIIEIJ Ilj IIIL IIM,I
OF A I,ESIIJFlI ~ IiI:UIJI r/I
~
~d"~~
; ... .\!'!;).c t\
~,;:"Iil,'l;~,t
COMMOtlWEAL TH OF PENN~YLVANrA.
DEPARTM(NT Of REVr:NUE
BUREAU OF fiELD OPERATIONS
APPLICATION (MUST BE FILED IN TIIIPLlC A TEl
TO THE PENNSYLVANIA DEPARfMEflT OF lil,VElilIL.
Application is hcrcLy Illude fUI L UI~.C.'1I1 10 lilt. IIIlH~ft" 1)1 1111'
Corporation or 0 Notionol Bunking ^~.~oLr\llillll lO(1I1l'd 1/1 jJPI1I1'.tl"'tllllll
11.\ I I" M,1rch 26, 198.0
h;llOI'\IIIIj ',I:\,IJlIIIC~ of {\ Pennsylvania
(a)__30~n_ .__ jb) DMJl'lI TN 1J1':I'()i: I 'I' '1'1<11::'1' ('mlI'ANY (<) COllllTlOn
(NOTE: In describing securities L'lllel ill (n), ub ""I', l.'rlll('1 tlllt 1ll/lllla'! uf .,IHI1l1\ III \ltJl:k fH the fllCc Ulllount of
registered bonds, in (b), ,he I1UIlIC 0' llit' 1~~IH/lI' CIII/lplll/( II III , III (,.) ,JIL' d(/,.~; vi :,',I(j.. or Ill<.' 5tutc>d interest rate
and maturity date 01 registered bOlllb.)
ISSUED ON ~':l_:~()lls da teo;. nlld huvilllJ II TOTAL MAf~1\ L I V ALlI[ OF ~ 9,824.00
(OUle)
as 01 the date of death 01 the decedelll,. ^NN^ N. :;lIl':M'jo'l'~1{
(t~lllll\' 'jl I)., l "tlt'nll
,uu Dcce~lbeJ:' ~~L 1979_
(DOlu 01 dt!uth)
who was late of.__}O 7_ Narke t lit ,-"" l
l,t.'IIlUYlllJ
Cumberland
Pa.
(Strout and Nurulllll)
(fJrj'IOUll-II)
(("1I111y)
(Stute)
The securities ore registered us follows:
^"Ii1 N. :il1l!affcr & William N. Sheaffer Tenants by
l[1n[) 1l/7/6R\ ----EntTr-etles
It~tJllllf ur IIUI1Il!\ in whlcll f~rfiliclllo' o(t: rGCJIS""d'r~d)
IdilMU41S:"IaiUd1&R) William S. lilwilff\!1'
EXECUTOR )- - (No"...)
307 Narket St. ,r,em()Xlle! _P~:.J-_?.~~
(Addll'Si)
NAME OF APPLICANT Nye rs, Nyers,. F:l_QW~J;"u~_ Johnson
COUNTY FILE NUMBER 21.,.BO-~1 ADDRESS OF APPLICANT 1'.0
BUREAU FILE NUMBER_.. SIGNATURE OF APPLlCANTA
NOTICE: IF YOU FAIL TO PROPERLY FILL IN ANY PORTION OF THI~ API' IC
CON~IDERED COMPLETE AND WILL BE RETURNED TO YOU FOR C
. Lemoyme.._.Ea_~__
17043
N. IT WILL NOT BE
LETlON.
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
CONSENT TO TRANSFER SECUR)TIE_S -,'J D-- 1Qori
DA TEu n<+t._~::ill,..:J.:j_
I hereby consent 10 Ihe Ironsfel ollhe uhove securities now registered in the nome of Ihe o{oresaid
Decedent and waive the filing 01 n certificnle ccrlifying 10 the payment of the lronsler inheritance to. to which
the property 01 said Decedent is made subject pursunnl to Ihe provisions of Ihe Act of June 20, 1919, P.L. 521,
os amended and the Act 01 June 15, 1961, P.L. 373, us omended. This is ulso In occordonce will, the provisions
01 the Act 01 April 9, 1929, P.L. 3013.
This Consent 10 Trnnsler Ihe Iwrelll descrihed property opernte' nnly in referellce to the estate 01 the
obave.nomed Deceden I.
~ilJlI.(".lhUI the S.eere.tary 01 Revenue
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I~. ~~.~\ B; . ,Gvlol~ '-B~\.()<:-rjN~"---
r;'\~}!iJ .' 1\;'''0''''.)' C \.
......, ,'- ,\~,C~. 1 01.1 f~~dJc '~,/ L0....Lh. 'V'(\l~J. \
'.\ (T1I1'1'i, l (Coullty) ~
".',. \ \':.:.
C(.',\M(IMWEAL1HOf l'lNt.:'ll.VAf'lI/'
OEPAIHMtN r OF 1<E.....lt~uf
BUREAU OF F1ELO OPH.\ lIONS
APPlIC/, TION FOil A~;r, CGt,~l:N I
fa [J"(ANSFER SE:CURIrlf:S
REGISTERED It~ 'IIIE HI,,!"
OF A r,ESIDEN; DECEDCN 1
~~~~
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UA1E March 26,1980
APPLICATION (MUST BE FILED IN TRIPLICATE)
TO THE PENNSYLVANIA DEPARTMENT OF I~EVENUE
Applicution i, he ruby nlUde fur C<.<1..,enlla the Itn"..I"1 ,,\ '''.: 1011"......'.1 ..".(...i1t..", "f u f'(.nn,ylvonia
Corporation or (1 Notional Bonking Associntion located rn Pcnl1~.flv(l11 ll'
(aL5_._.,. .(b) DAUPHlN IJr-:POS 1'1' 'l'HUS'I' COMPANY (c I Corrunon
(NOTE: In describing securities enl," in (n), lib Ole, eilher Ih" nlJlllher 01 '\11""" ..I "ock ur the Inca ulllaunt of
regisfered bonds, in (b), the nOllle allhe "suing co."pnIJY ond In (e) th,' cIlJ';,. ,.,1 "ll,CK III ,he stulcd interest rofe
and maturity dote of regislered bunds.)
ISSUED ON _v~r.~()us..da ~esd' and having 0 TOTAL MARKET VALUE m' 5 160.00
-,. ,- .-.----'.- -
(Dulc)
os of the dole of death 01 the decedent, _. ~~Ni\ M. Sllr-:AFI'EH
(Nlllllt: "I UtJcellcnl\
o December 29, 1979
I 1\ _. -- .. ,,,.~..,-----,,_..__.-.-.---.
(Dute 01 dcuth)
who was late oL_~?7t4arket Street
(Slrcllt and NUlllbtJr)
Lemoyne
cumberland
Pa.
.------
(Po!>! Office)
(County)
(51011:)
The securities are registered as follows:
l\nna
M. Sheaffer & William M. Sheaffe~
(000 11/7/68) .
(NOllie or llonH!~ in wInch cl:lnliclllc:!l \Iff! Ill~lstcH'd)
Tenants by
Entireties
M>.fMbl\Siftiif~ WILLIAM S. SHEAFFE R
EXECUTOR r---'- (Nome)
307 Market St., L.emo~ne, l?_<l._~7.~'!.~
(Addrc!os)
NAME OF APPLICANT Myers, Myers, Flower o..gl?~'2I1--
COUNTY FILE NUMBER_~1~8Q::~1_-.-_- ADDRESS OF APPLICANT P.O. Box 125,. Lem..ClYE..~.L~a-,
17043
BUREAU FILE NUMBER.--- .- SIGNA TURE OF APPLICANT
I'IOTICE: IF YOU FAIL TO PROPERLY FILL 11'1 AI'IY PORTlOI'I OF THIS AP L1CA
COI'ISIDERED COMPLETE AI'ID WILL BE RETURI'IED TD YOU FOR COM L
. ----..----
.__,.__,..____ ._n _
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF REVENUE
~911~~N_I:r() TRANSFER SE~~~I_I'-E.? DA T~I'lJ~y. ~&)9. ~
I hereby consent to the transler of the above securities now registered in the name of the aforesaid
- .------ -' --.
-----.-..- _.------ --..-,---.----.' ..-'-_. -.
Decedent and waive the filing of a certificate certifying to the payment of ti,e transfer ,nherlt"nce tax to which
the property of said Decedent is made subject pursuant 10 the proviSions of the Act of June 20, 1919, P.L. 521,
os amended and the Act of June 15, 1961, P.L. 373, as amended. This is olsa In occaldonce with the prayisions
01 the Act of April 9, 1929, P.L. 343.
This Consent to Transfer the herein described ploperty operules only in reference to the estote of the
aboye-nomed Decedent.
t1~"~
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.J,",.'. tlI.,.,.,',J.;
Signed..rr the Secretory of Revenue
\.[~,_ \.' I(] -/~'\rv-. c.- ;;.J.
By.J.. )<tL\ TS.ll/ d)t~--
,., . --I. .. . (5~"'U'C.) . M .r !s
~.J...\; 1-\~. At\-' I lv ~ Iv\kr..."
~ ~(T;'I~ ~ (Cou,"") L'i~
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss:
WILLIAM S. SIIEAl'l'ER
being duly. sworn .1Ccording to I.,W. dopolo' .,nd ,,'y' th"t h. is Ex.acutor
of tho blot. of ANNA M. SHEAFFER
lal. of BorOUg!1 of Lamo.YJ}SL..._--.......- ..., Cumborland County. P,1.. dece.,ed .nd th.t tha
within is an inventory mado by him .._' tho s.id....ExeC1.ltO.L--
of the entire eshte of s.id decedent. consi.ting of all Ihe perlon.,1 properly and ro.1 est.te. except ro.1 estate outside
the Commonwealth of Pennsylv.nia, and that the ligures opposite each itom of the Inventory represent it's fair valuo
as of tho dato of decedent's death.
sworn to
_ "d ,.b",,,,d b.f"" m', \
..,
19._UL
~LA~. -.. .......--........
Ellocutor .
William S. Sheaffer, xecutor
307 Market Street
- --" .-----. -.----.----,.---'.'-----.-. . -------
~ '. O"~
NOTARY PUBLl l0
My Comml,,;on Esplte, Doc. 21, 1981
Lem::>yne, Pa.. CumberlaDd CouAt1
.'--,,--- ---,. ---- .-~,----_.__._-----------
Lemoyne, pennsylvania 17043
Adorou
Date of Death .- ...
29th
D.y
--------_.'-
December 1979
--.-.--,.,------------ ---------------.----
Month Yur
I. An inventory must be filed within three months after appointment of personal represent.tive.
2. A supplement inventory must be filed within thirty days of discovery of additional assets.
3. Additional sheets may be attached as to personalty or realty
4. See Article IV, Fiduciaries Act of t949.
INSTRUCTIONS
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COMMO~""'EALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF EXAMINATION
OFFICIAL NOTICE OF
INHERITANCE TAX
ASSESSMENT
*'
COUNTY FILE NO:
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DATE
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ESTATE
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Appraised ~,ilue of Estate:
Real Estate
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FILE NO,
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COUNTY '/1.' /~{, 1/'" A'
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DATE OF OE~~H ,if (I' .' '.'/1 / // 1
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$
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Personal Property
+
Jointly Held PropertylTransfers
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10/'/ ~ ".,
$
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Total Gross Estate
Total Approved Deductions
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1/ .~
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Clear Value of Estate
$ '( ~/ .) /,. 1
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Less: Approved Charitable Exemptions
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Clear Value of Estate Subject to Tax
$ L/I/ "I ~
- .: (-, / '
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Amount Tax.ble @ 6% Rate
$ LI ,.1. ;\ t:3 / :>
/
tax due
$ j / </;:' '/1
" ",r , ) '. ~
Amount Tax.ble @ 15% Rate
tax due
TOTAL PENNSYLVANIA INHERtTANCE TAX DUE
, .!;> /, '~I
- I
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,
.. .. ~ .. .. .. A five percent discount totaling $
wHl be granted if the Inheritance Tax is paid by
Less Credits:
DATE OF PAYMENT
AMOUNT PAID
~
'OISCOUNT INTEREST TAX CREDIT
I ,,)-y
+ $ - '. ;, " - $ = $ ;./ /
,
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~
$ _~ ./) /1:
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+ =
Interest accrues at the rate of six (6) percent per annum
on the unpaid balance of Inheritance Tax from
to date of payment. Interest due if paid by
is
/
1/"/ "
/1{;1<-
1
.!
j
BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE $
As....ed by: /' l,i,
See Informotion on Revorse Side Ag.nlforth.Co~, n~ilth V)
;,' "
~" J "A/' ~;."CLj
(.' ,
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"
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To insure proper credit to your account, lhn name of tho cstiltll ilnd fild numbor should be clcnrly print.
ed on tho check or money ordor.
This assossment is made in nccordilnc(j with SectIOn 708 01 the lnhoriwncc and Estate Tnx Act of
1961172 P.S. 92465.7061.
To the extent that inheritance tax is paid within three (3) months ofter the death of tile decedent, a
discount 01 live (5) percent is ellowed (72 P.S. 9 2465.7161
Inheritance Tax, other than lax on a future interest is due at the dale of the decedent's death and becomes
delinquent at the expiration of nino (9) months alter the decedent's death (72 P.S, 9 2485.711). Inheritance
Tax on a future interest is payable within three (3) monthS after the tri.lnsfer tak.es effect in possession and
enjoyment and is delinquent thereafter (72 P.S. fi 2485-712). Calculate interest from the delinquent date shown
on the face of this form to the date of actual payment using the follOWing interest table:
---------~--------------------- --- ---------- --- - - ---- --- -------- -- ---- - ----
1 month .005 4 months .020 7 months .035 10 months .050
2 months .010 5 months .025 8 months .040 11 months .055
3 months .015 6 months .030 9 months .045 12 months .060
1 days .00017 11 days .00166 21 days .00352
2 days .00034 12 days .00203 22 days .00369
3 days .00051 13 days .00220 23 days .00386
4 days .00066 14 days .00237 24 days .00403
5 days .OOOB5 15 days .00250 25 deys .00420
6 days .00101 16 days .00267 26 days .00437
7 days .00118 17 days .00284 27 days .00454
8 days .00135 16 days .00301 28 days .00471
9 days .00152 19 days .00316 29 days .00466
1 0 days .00169 20 days .00335 30 days .00500
- - --- ------ ---------- -- - - --- -- --- -- - - - --- -- ----,-- -- - - - - --------- ------
Any party in interest. including the Commonwealth and the personal representative, not satisfied with
the assessment may object thereto Within sixty (60) days after receipt of this Notice as provided by Section
1001 of the Inheritance and Estate Tax Act of 1961 172 PS. S 2485.1001).
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed below:
OF CUMBERI,AND COUNTY
AND AGENT OF THE COMMONWEALTH
)
J!, l .. \ ,d. 'Ii I'IJ "I
DEOUCTIONS ALLOWED IN
TIlE SUM OF I ;tJIJt/. ,3tJ
om AP ROVED t(~~t . (~ jtJ!f~
/~ ,j ~J '
v (6 ./' ;i~
F WILl.!;" .GENT
OFFICE OF THE
REGISTER OF WILLS
,;.' / hi -,,-/
STATEMENT OF DEBTS
AND DEDUCTIONS
REV-"" (8-781
i
1
\
,
J
I j
I
\
I
\
-
ESTATe OF ANNA M. SHEAFFER LATE OF BOrough of Lemoync
DATE OF FILING APPRAISEMENT (}i!:t. /t.) /15'~ DATE OF DEATH December 29
1979
, . , ..:
NO.OF I AMOUNT
DATE VOUCHER NAME OF PAYEE REMARKS
Jan. Reaister of Wills Probate, Letters &
1 Short Certificates 28 00
FQh ? pr{)fpssi{)nal ph"rmac" Decedent's Accoun t 35 84
3 Family Physician AssocS. Decedent's Account 30 00
Mar. 4 cumberland Law Journal Advertise Letters 18 00
5 Patriot-Evening News Advertise Letters 23 43
Apr. 6 Register of Wills Short certificates - Stock 2 00
-
7 Pa. Dept. of Revenue Decedent's 1979 income tax 16 63
8 Lester G. Connor Real Estate Appraisal 200 00
9 Bache, Halsey, Inc. Commission - sale of stock 201 49
10 Musselman Funeral Home Funeral Expenses 2,409 11
11 Ohio Casualty Bond - lost stocks 20 00
-
May 12 Holy spirit Hospital Decedent's Account 3,019 30
-
13 William A. Sullivan, M.D. Decedent's Account 400 00
14 Holy Spirit Radiology Decedent's Account 94 00
-
15 Chuck E. Bricker Household Goods Appraisal 25 00
Reqister File Inventory, RCC &
16 of wills Debts & Deductions 9 00
17 Notary Fees all documents 4 50
18 Mvers, MyerS, Flower & JO lnson Attorney Fee 568 00
19 Reserve for close-out cos s & marker lettering 150 00
20 William S. Sheaffer Family Exemption 2,000 00
TOTAL 9,254 30
-
COMMONWEALTH OP PENNSYLVANIA \
COUNTY OF CUMBERLAND 55,
I WILLIAM S. SHEAFFER HEREBY CERTIFY THAT TO THE BEH OF
, '
MY KtlOWLEDGE AND BELI~F. 'rHE FOREGOING IS A JUST AND TRUE STATeMENT OF DEBTS, FUNERAL EXPENSES AND
EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF ~NNA M. SHEAFFER
DECEASED. AS DEDUCTIONS FOR INHERITANCE TAX PURPOSES.
SWORN AND SUBSCRIBED BEFORE ME THIS q t/l DAY OF william
'~'Y:"'. 19~
~'8 ~--.:-.
N~ PU~Ll~ (S
My l.;ot..,ro:s..icn E.p\r~'1 Uo:. 21,1981
1..rJJ)'1lC, Po. C.l:...1.>Olbud Cau.nl)
(L.S.)
fer, Executor
v
. ,
REV-449 (8.76)
COMMONWEM,T!-! OF PENNSYLVJ\Nll\
DEPM~TMFNT OF REVENUE
liU I\bl',U OF FIELD OPER1\'l'lUNS
.
"//-ft:-'J/
ReSIDENT UECE6EtH
COUI~TY OF .CUMBEJ~Ll\ll!).--------.
'=,,- ._--.===~_....._-_._--_._,.----..._------' -- --------_._----~ . .' - ...----.
IMPORTANT, 'Ih;,; ,<""" ,,"'" h" ,."""k"'" '" d,'I"d ,,,,,,,d,'d '" 01",,'"'''''' ""h ai' ,"Ia,-la'd. ""h ,'," "".,st,', "I Wdh ,,[ "I'
(''''''''1' wh,"" ,,,,,,co""" ".,,,1, a, ",,,,,,,;, ",,,. ""h", ""'" "'''''''1' ..."., "a'" ", "".lIh. ""Ie" a" exte",,,,,,,, granled
hI' ,h.' S,.",,'a'y "I 1l,"H'''''''' "" ,,,,,,, 711\ ", II", 1"1,,..n"".... a'''' ,.stal" \,u' ,I", ", 1""1.1
-..;...:...;....;~
. ' ' " ,,-' --
~'-'- - ---,-----..-..----.-
~
IN TilE MATTI'.1l (IF TilE F,S'\,.ITI' Ill'
1
-. -. f
CoJun1'l
Al':FIIJAVIT OF
ANNA M. SHEAFFER
____---.----ir.T-i,-iEF-liLl~NA;A.i:"..Q T.i-I~-,~i "i :I:: ~ :I~)
EXI~C\lTtHl
,)Q>> WJllliliOOX I{lK
~a'" of _______~U~ERLAl'lD
Sta,a 0/ _-..!'.J;;.Nl'!~.L..Y~NI~----_- \
County .I_~E~~~Y-_--.--J '"
WILLIAM S. SHEAFFER
~ ----~i-~,;::'o~;-;{~;;:l;O;'-O,:,,,,j-d~;:d.'O~-b;;;;;;;;;~-;;-;.::d.;:;'-i
Executur
-----
and ~oy
S,
Decedent died
December
_~. 1'1 79 1 ...".. ',o,io," ,,,' will. ,"py 01 whi,h i. h,,",o ott"h,d. I.
,u/.yl ~X!l{~ J
(MONTH)
l'lome and nddrllls of aHorney or }
"1her outhodud rl)pro...ontotlve 10 whom
all eort..~ondt"nee should be mulled.
That as such_EXe.9_uto.J;_-_dellonenl is familiar wilh Ihe affairs nf said o"ralC and the I"operty constituting
{ E)". r::.CU TO r,. ADMIN 1ST H A TO R:
the assets thercof and their fail market valuc.
That at Iho time..f dealh thero waS no safe d01'osit box reglSte,od in dee"Jent's indi"idualname, or joinlly with...r
as agent or deputy of annther. or in decedent's individoalname, with lighlnf access by anolher as agenl or deputy. with the
c:"CC1Jtiol1 of the ftJl\o\\'in~: -
__l-lY":!S, Mye~F19~ & Johnson
___~~~~x 125, Lemoyne, Fa. 17043
NAME AND ADORES!:> OF flANK; OR OTHER lN~TITUTION
IN W"1ICH DECEDENT RENTED A aAFE DEPO~I'r BOX
~. ~=..r.
___,~=---,-",~,,-,,=.=c,'''-''='-~~~-'---::O-=.o....=-.,.==----=:-o-;o''~
THl5 SAFE DEPOSIT BOX RENTED
IN NA!~ O~_]'JAMES 0':._
RELATIOf'.iSH1P OF JOINT
HOLDf.HS TO DECEDENT
--
NONF.
--
1
=-~.='.=--- -_.__.,,'----,:..:;.-=~-----------...,,=----_..- -
That the eontents of suid safe deposil box or boxes aro itemil.ed under Schedules
with the e>:ccptiofl of tbe fullowiI1!;, for the reasons hereinafter set forth:
of this return,
That S::hedde A attached herelo and made part hereof sets forth fully and in d"tail all the real property
in tne Commonwe"lth of Pennsylvania of which dceedent died having an iaterest therein. It also setS forth the
mortgage encumbrance" opon each p"fccI of real I"opcrly al the d"te of death, giving the amount s\ill dac .t
death, n.me of morl&aEee. date. rate of inlefest, and book and pa~e of record thereof. II .Iso sets forth io the
eolumns provided Iheret'orc thc assessed valuation of each of said parcels, the estimated market vaiue thereof
as of dr\te of death of decedent.
That Schedule /J a\lached herelll and made part hereof sets forth folly and in detail all personal properlY
wheresover situat"d owned hy the decedellt at the time of dealh; all muneys left by the decedent at the time of
dealh. whcth,:r in decedent's immediale i)ossessiun, standing tu decedelll'S credit in banks of deposit, savings
baab, trllst e"nlpanies, ur other in:;tiluti,,"s, whethcr individually, or in trost for any other I,ersnn or persons
giving also :;eparatc\y the aecroed illlGrcst thereon, if any, down to the I"st interest day priar to decedent's
death in the case of s.viogs b'lIlb, ar,d 10 lho dCle III deeedenl'S death in all nther cases; all bonds. postal
savings. treasury certificatcs or lIule' and other evidence uf indebtedness of the United States to the de-
cedent; all "bligatiuns, whetber hI' statule ur a~reemenl they arc desip,'led as tax free, of the United States.
ur any staIC, or p"litica' subdivision there"f, or of "ny fo"ign cOllntry, which :>re uwaed at the time of death;
011\ wearin~ :>nl1:lIel. .i"",dry, ,ilverwcre. piclures, buoks. work> of an. hUllsehold furni.ure, horses, carriages.
antomobiks. boalS, and ao)' and all IIthct personal ,'hauds of whatsoe"er kind or natore. left by decedent,
together wilh the fairly eSlimaled 1",.r~c1 \'clue ,Iwre"f; all Inmds :1tl<1 ,""ngages held by decedenl and nf all
claillls due and owillg de,'edelll al Ihe lilllO "I' de:>.h, and all promisso\)' n"ICS ur other illstrumellts ill writing
fur the payment uf money uf which decedent died possessed. "f wlll,tso,,'er nalllre, with interest thereon. if
any. giving the fac" value and estiff,ated fair market "allle thereof. and if such es'imated fair market vatue he
less than the fare ",.Iue. it selS forth brid'ly the re",ons fur such d<p<ceiation as to cadI item; a\l moneys
payable (<> the estate from life in""an<o polidos carried by decedent; a\l annuity and endowment c""traets
the proeoeds of winch were payable U!,'Hl the death uf the decerlenl; a\l ..nrl thc <orporale stock. and dividends
rille thereon ano! unpaio! as uf the oale "r death. honds and a<Clu,'d intncst thero,," to the date of deeedenl's
death alld other in\e,une." '"""llti" ,""1cd hI' the d,.cedent at the lime uf dcath. with the market value there-
of at such timc.
, .
In the ellfit' or :-;"I'llrlt\p:-; ,II' ('IllS" 01' 1'I11111ly l,'ol'llt.rHtlt,l\s, till' Vltlll'.'S rl!pflrl.lHl tlr;l 11B f'ar 118
)loss!hlo sllbslllllt.lut.erl by l'IIl'l!\~I.'\1 ~~L'\'.r'nll~llt:-; or !,hl' 1:1)/';Hlrlli.l;lfJ-;, "illnwlllt!, l.h.~ 'IS<;..'t'" Ilml 1l'lhllJt,les
tlL"rt'l1t' 'IS (11' the IlIlU. rll' '1'''I'.~I. 'fhr. >;t'h,'d\lt.. 1l.1~t1"I!I'-; for/II f.Ill! Illl.fll'I':H (If' Ih!cOfltmt rIt, tn.: time of
df'lllh In Ill\~' l'n-pllrtn(t-l.shll' or Inl~;lr1f's':';, dill! III ;;l\l'p'll'l 01' (II'. V!I\lll' 0(' -;n.:11 \1\l.I'rHst t.hln'l! Is Il.nn~x.)d to
sultl St'!I,'dll!/', f'ITHlIII~I.tl :-,tlll'lt'.'nl.; ...11<)'11111'.'; I ill! 'I""!!!" 'It,d ll'll,llltlt's "t' :>Hld l:n-jl!\rl.llI>I'shlp or illl:-ilnr''iS.
..\ l'np~'!lf' ttl" Cll-pllrtTU'rshill ,"!,r"I'mt'lll.. (If' ornl, It ,.:.;llll"111"n: s,'lllrll!, 1'01'111 tlH-' 1I11tllrf-' ot' Ul" 'H;r""mf~rll.)
to~t.tllnr \'11th 1\ slnt.pmPILt. sl!t.llrl~ l'II,.I!1 tiLl! /~llilr'llelpr ,.1' 11u' !ltl"IIlI'SS. Its IIl(,Hl.tlln, IHHI stH~h ot.her j':1CtS
iH~rIHII1I11~ to tlw huslllf'SS liS mny Ill' w'rlI1lt'nl Ill!1 l'~lll' dlHI .I11SI. Iqlpral'iul Ill' l.be tll!ef!llent's Inl..~rl!sL
IILl~rl'llllllllSI bl'SlIhmttt.l'd. It slLoultl 111...0 Sl.t j'uI'l.h In Il.t'rnl...-pd rurrn, to'~t'tllt'r wlt.h t.h,' !'fllr r.\Ilrk.~t. v/llll'~
lllt!rt'ol', /IllY ot.llt'r prop/~rl~' ownpt! or iJeqlH!nlll.>d II.\' lit.' dl'e..i!t'l\! III. 1.111' t tm.. of tll'ltlil.
TIl!' SCf1('dulf> ( Ilt.tllel1t~d 1l.~r('lo 111111 Hl/IlIt' lillI'\. 111'1'1'(11' s"t,s I'nrl.li /I trlll~ IltlS'l\'t~r 1.0 IHt~h InlJlltry
t~Olluli!wtl tllt'rt~tn nllt! tn l.lw l'1I.5P, of'fTllns!'"rs lIt'Pf.oflt'r.ty, r'('nl III' jIf~rs{JnfJ'. Ivlt.llln two 'ye/lr,o; nf dl.'~f'df!'ntl s
death, In cont.nmpll.ltloll 01' d(ll~(.dent.'s dl~lit.il, or 11l1.f'lldl'd j,lJ t.f\kt~ ef'fp('l ill J1ossl~sslon or en.1oymt'nt fit or
nf't.er deat.h, stlld sch('dulH Sf!t.S fort.h t,lw Illtturt! Hnrl vlllllt~ 01' such prnpf'rt.y, t.o whom t.rll1lsfl~rl.lHt, the
rl' 10 l.lonslll p of t.he t.rIUlS I'ernes t.o t.he rleel'lll'n!., !lIt' propol' t, t tlllllle ~llltr(! rflen I V{~t1 hy ellch trnnsfpree and
1111 ottwr filets of II IH!rl.lnellt 1I(ll.lIrl" l.cg,nrrUIlJ!; !'iutrl I.rllllsl'('rs. ln 111f! ells/> of t.rllll"il'crs Intender! t.o
tllke t!f'f't?el. In possession 01' en.loynwnL nt 01. Id'(y!' dt!Hth. t.hert! Is lllsn IIttlil~h(~tl to tile schedule (I conY
of the deed, trust IIp;rl'cment. or ot.tler instrument. cl'clltlnp; lhe trust. 'l'llt'rt~ Js IIlso set forth in said
schedule 11 Ust of nIl property, r~ll] Ilnct pel'sollul, wtt.h 1U_'> vlLllll~, wll1r:1l1Jll!-;Sl.'S lit th'!cellent's !tent.h by
virtue or the exercise b~' decedent, eithf!'r Inrltvldllully, or.lnint.l~' wlt,h IIfl'IU1I.'1', or 'lilY }lower of u'ppolllt-
mtmt vest.erltndec~edt?nt, (!Ither hvttvitlllU.lly ot' ,lolntl'.J'. by the wj]1, (lepd, or oth(~r lll~trllment of' 11IIothcr,
wit.h II. copy 01' t.he instrument. crenting such power IIttlleheri t.o t1JI~ Sf:!l(ldllle.
That Schedule 0 /lUnched hereto IUlll mude pftrt. hereof sets forth t.lw nlllnes /lllli uddresses or nIl
per'sons hC!lIef'iclally interl!stp.d in lhis estnte ut. tbe tlme of' decedl't1I.' s dtHlt.h, the no.l,lIl'e of their res-
pel~tive interests, their relationship, if llllY, t.o tILe (Iecc/lent, tog;ether with the uges I\t the time of
rlececlent's clenth of' nIl minors, f\nnuitunts lUld Ileneflclflrles for ]lf~ Ilnnor decedent,'s Will. It 0.150
cont.nlns /1 stat.ement showing which of t,he IJ{'Jlcl'tclilr.ies nlUlled III the decntlpnt.' s wU 1, if any, dicel prior
to decedent, the dates of t.heir del1tll, UH~lr iSSIWI lUll! thf~ relutlonship ot' such issue to the ben~ficiury.
Thllt S,;/1edule E HUnched heret.o unci mllde (l }lIlrt. ht~r'~of sp.ls forth 1111 property, renl nnd IJer-
SOllll1 t owned by the decedent Jointly wi th IUIOl.lwl' 01. (JtlH~rs, induillng lntllll):!;ihle, 5tllndlng in the nlime
of tILl"? decedent /lnd others, plus the d8U~ /lnrl plncti of recorrl of' instruments effecting the \estlture of
r(!lil I~stlit(' unit the <lute of' /lc'lulsition 01' p~rsonlllt.y, plus the nl1me, fulrlress tm(l relationship, if any,
of co-oWners to the decedent.
Thnt Sc/1~dul(! F Ilttnched hereto fmd mude Il purt her~of sets forth fully and in detail all debts
and deduc ti ons claimed for lHlrl on behal f' oj' thI s deccden tis es tat.e, i He 1 urllng j'unernl expenses paid;
family exempUon, where nppl tcnhlej costs of Ilflminlstrlltion of thts estnte; counsel fMS nnd. rudieiary's
conunlsstons [laid or LO be paidj cost cxpendetl ror hlll.Jnl t.rust,S, tombstolles 01' gl'll\'l'mnrkers, and reli-
gious services, in consequence of the dent.h 01' t.he tiecerlent.; debts nnri cluims o.....lng Ilml unpnlrl at time of
df-nth; tn.xes Ilccrued chnrgcl\hlt! for llt~riotll'rior to decedent' 5 tlelil.h (except. t.IlOse 1l11o\\'ed under Section
fi51 of tile InheritlulCH flnrl Estllte Tux Act); top;nther wit.h n statement ot' cnllnterul plerlgcn for obliga-
tions, if any. [t is lIgreed thllt, tile f'tduc1nry will preSl'nt proof' 01' sllld c1ntmetl oblIgations upon re-
'lIWSt., thnt if the Ilmollnt Ilf~tuldly pllid In settlement or Imy fec, commission or (tellt Is Less than the
esUmllted !lmollnt cl/1imlng Illld 1111 owed, Uwt t.hl~ sump w111 I)(! rllJlOI.tt!d to the lh'gistlll' of Wills, and that.
1,11;:> IUnount of' Un;: nss('ssed CUll he reltssf"SSf'tl In IIccordlm("(> tJ)erewi t.h.
1'1l/lt. the lnl.1l1s of t.hl'! IlJlpl'npl'lltl...., (;Il)umlls tn S{'.hl~(lu)es "Aft, "B", "(:", "E", Imd "F" IlS dtr~cted therein,
hll\'l" tW('!l clll'ril~d ror'wlIrr! I\nd properly t.tYgistl~red in till.' SlIlIInlllrr.
Subscribed and sworn to before me tbis
.. . CI.iJl
....~V\~
day of
..~.
'GC'~...
19...TQ
~.1;/fA ~ .~..~_~._..
. fExeCILtJ1T~~~~'"''
W~l ~am :;. HSheaffe-t
3 0.7... .Mark.e.t...Stree.L..............................._..._._.
(Street Number)
Lemoyne, Pa. 17043
(City or Town and StIlte)
HOT hRY PlIEL1C
My Comml.:aioD t.J:pirc5 Doc. 21, 1981
!..oQl:;Jyua, PQ. Cl.lmhorland CoUJJi,
SOTE: BI'forl' S t~tllllg hl'l'ld/lvt t 1111lh:t' f;url' Ill1 hlUllh. ~I'HC"S ill t.11\' affitlll\'t 1 ILnli sell,'dlllf"" IUllH-Xf'tt urf!'
fi11pI1 In ....,tl.h c!et/lils or tllt~ ....'nrct "!\Ollt~", Hull III C:IlSt' tilt' ItSSt't~ tllt'l.ltlt~ "lIrt-' /lull U111ist.ed securities,
sl~('urIUI~s 0(' close or fllndly cot"}lOrntlo11S or /Ill llltt'rllst In BUY CO-plll'UJPrshtp or huslness, tlint the
dll1,ll /lnd <;thtl~JTJf'llts rf~fJulrt'tl IItltler till" plll'op,I'ltJ1h IIbo\'.' I'f']htillg to ~('llt'rllllt' "B" ILr(! iLt.t.IIChcl'. Also mnke
c~l~rlllll1 thllt ("t)lumn #1 In tile "SUl1cnlll'Y" hilS heen prop,'rly eOl1lpJ..tt'lt :Il'j Ilbll\'t'-lllrt'ctetl.
. ,
RCC..34 14-731
COMMONWI!ALTH OF PENt;SYLYANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "A"
REAL PROPERTY
*'
Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at death of dece-
dent. Property held by the decedent as tenant in common with another or other, should be identified
as to quantum of interest and the estimated value should be that of the decedent's interest only. (Property
held as iaint tenants with right of surviorship or tenancy hy ,,,,tireties should be reported an Schedule "E.")
-
The real property located In the Cornmol'lwnolth of Pennsylvonla should bo (1) (2) m
dCl&crlbed by lot and black numbo" ".reef and strntl' numbor, togethor with or:.PARTMr:NT
a ganeral dfllcrlpllon oltha property, with 0 rofctonco to the record of tho ASSESSED VALUE VALUA TlaN
canvayoncn by which the decadant took title; If 0 farm lita.e numher of a. FOR YEAR OF ESTIMATED CAUTION
eros; olso statement of mortgage ancumbranclU upon cach [loreel at decth
of decedent. Toxos, alsessnlent., accrued lntflrcst on mortgog1u, etc.,are aECEDENT'S MARKET YALUE (Do nol write
to be listed on Schedula "Fit and must not be deducled fronl thl" schedule. DEATH In this spoco)
NONE
(See Schedule "EII)
NONE
N orn.u
.,u..gte
Insert this lotol opposite "reol property". Schedute "A" in Ihe X X X X X
"As Reported" co1ul1," on the lost page of this return.
"
" ~
:; "'''':
g::: 11
-r," C
'C ~ e
,_ (oJ ::l
e- "0
JE"U
~ 8 :
c "C
...... 1.1
::l :r. ~
~ g g
;.0: :J
~ "
SII~l~I,\I{ \'
Renl Property _______
Personal Property
Transfcrs_------.
(Seh. "A")
(Sdl. liB")
(Seh, "C")
(I)
(A s Reported)
-0-
11. 361. 00
540.00
~
.~
~
~
~
~ 11 ,9QL,.Q.2--__
c
0
~ 00
"C .E
" z "
'" lJJ ,
" . 0
.-l?- ::;; 0 <1l '"
In lJJ 0 C
rJJ 0 ..I
I - Q <l: ""
0 ...: '"
<Xl " U. .~ :;;: H
I 0. 'Cl <1l M
.-l 0. 0 ~ c a '" ~ ....
ll.
N " ...: ~UJ &l <ll > ll. 0
.c lJJ .c~ M >. <l: .-l ...
0 I- ~..: ~ H '" ~ .-l
:I: ~I- .0: <1l e " In
Z c l- e %
ol/l r4 ~ " _N .
U. UJ :Ii 0- <l: OO.-l <ll
'" 0 Ul '"s l- H P.
.S U '" <1l X
" . -5 0 ~g -
~ lJJ :;: ll. <1l
" "
::: I- " w C
'" I- .0: ~ ;, '" - . ><
c
.~ ...: z ~ e 000 ~
0 2:'
- .s ::;; ~ E H
" 5 E <1l . <1l
;:='"'0 ;;
:::~ 0 c ~P.H
-' '-- u
I'
.1
..---------.-.
--------
Gross TLlxablc Estutc___ _.-.-..
-".,-.----.---
(2)
(As Ilele,mined)
$
~
$
$
~-
~
R( V.47J (1I"7f\)
1l^l,K IIU.
60-8>
COMMONWEALTH OF PENNSYLVANIA
OEPARTME NT OF REVENUE
IJI, fl. nl.lD
1 ~: 80
NOTICE OF DECEDENT ACCOUNT STATUS
Submit III truplicate within 1
the death.
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SOCIAL 'iFr.UHI TV NUMOER{SJ
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RETURN COMPL ETED
FORMS TO LOCAL COUNTY
INHERITANCE TAX OFFICE
(Inn!" M Shopffl3r or
wi11lrm B. Sh~r,ffr.r
NAME
SURVIVING DEPOSITOR (Benellclory) INFORMATION
rH~L.tTlON5HIP
WilliI'm 5. 5hEl~frElr TO l:iBO'DENT.
DECEDENT IN FORMA TlON
NA1{'nnp M. Shonffel'
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ADORE';';
ADDRE5S
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J07 M!"rket utrol'Jt
CITY
Lr.moyna
BANKIINSTITU1'ION ADDRESS
Dfluphin Onpoe1t thmk & Trust ,;13.
213 Market street
th.rr1sburg, PennBy1vpn1P 17101
INTEf<EST ACCRUED ANO COLLECTlOLE AT 000 $
ToTAL S
I3ALANCE OF ACCOUNT AT ODD
$
BANK AUTHORIZATION
I HEREBY CERTIFY THAT THE INI"ORMATION CONTAINED HEREIN IS A
CORRECT REPRES'=N1ATION of INFor~MATlON IN OUR FILESIN ACCORD
WITH SECTION 742 PI fI E TAX ACT OF t9lit.
~IGNATur,lI:. or FINANCI"L INVESTIGATOR
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