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No, 21.80 :31(;
PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY
in the Estate of HELEN L. SHOEMAKER
, deceased,
To Mary C. Lewis
of Cumberland, in the Commonwealth
is
Petitioner(ti cue the executoR
, Register of Wills for the County
of Pennsylvania.
named in the Last Will and
Testament of IIRT,"tJ T, ~lIn"Ml\K"R
dated Alia",,!: ll, 1 q7q ,
Decedent was a citizen of the United States and a resident of
SILVER SPRING Township
~~, Cumberland County, Commonwealth
of Pennsylvania.
Decedent died on Fridav
the 25!:h
day of 1\pTI 1
A. D, 19 Rn , in the County of cumberland
State of
Pennsylvania at the age of 87 years.
illsD6 ,&1i!Z her
Decedent has not been married and has not had children born to lIIJIiIH
since the execution of the above described Will.
Decedent was possessed of personal property to the value of
'1'WP.tJ'I'Y_FTUP. 'l'1I0n~l\l.m rYlT,UR~ and of real estate to the value of
-NONE- as near as can be ascertained; said real
estate situated as follows -NOtJ"-
~
Therefore, your petitioner:ki* respectfully applies for the probate
of the said Last Will and Testament and for Letters Testamentary thereon.
Dated May 8, 1980
N~~;e~~~o~~~~:s . ~!:;tp(. F~:E::~;~-/ ~:ea?(/,j -
1122 West Trindle Road
[!6...1.alkicaLu~'::i' FA 1705S
COMMONWEALTH OF PENNSYLVANIA ~
ss
COUNTY OF CUMBERLAND
r.F.O'Rt':F. 'P 1i'F.ll~~a.nr.J.t
named in above application, being duly IIWO~R according to law
say(s) that the statements set forth in this petition are true to the
best of
his
knowledge and belief.
.swn""
and subscribed before
,.-'~' ('1 '/1..
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Register
):5O[U
me,
~}J(rI-1 ~,
Filed:
,00/-f,IJ -8/6
May 12, 1980
MURREL R. WALTERS III ~
Attorney:22 East Main Street J -- >'&' (,2/
Hl!lchanicsbur9. PA l7055~
..
.
VI.
I give and bequeath to Daniel Billman, my automobile.
VII.
I give and bequeath to Jean Billman Brenneman, my chest of
drawers.
VIII,
I give and bequeath the sum of Two Thousand ($2,000.00) Dollars
to Mrs. Treva Billman for the kind services she rendered to me during my
lifetime.
IX.
I give and bequeath the sum of Five Hundred ($500.00) Dollars
to Mr, and Mrs, Clarence Shearer, of R. D. #1, Boiling Springs,
Pennsylvania, and in this respect also, I give all of my pictures to Mrs.
Shearer.
X,
I give and bequeath the sum of Two Hundred Fifty ($250.00) Dollars
to Mrs, Larry Vogelsong, of 179 Konhaus Road, Mechanicsburg, pennsylvania.
XI.
I give and bequeath the sum of Two Hundred Fifty ($250.00) Dollars
to Mrs, Jack Finkey of Carlisle, Pennsylvania.
XII.
I give and bequeath the sum of Two Hundred Fifty ($250.00) Dollars
to Mary Jane Brenizer Lowry, of Carlisle, Pennsylvania.
XIII.
I give and bequeath the sum of Two Hundred Fifty ($250.00) Dollars
to Master William McGuire, son of William M. McGuire, of R. D. #1, Mechanicsburg,
Pennsylvania.
lXV.
I give and bequeath the sum of Two Hundred Fifty ($250.00) Dollars
to Pamela Shearer Sentz,
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RCC-J 14-131
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act of May 28. 1956, P.L. 1757, and Act of June 15, 1961,
P.L. 373, os omended)
.'.
'1;'._rl.. '
-,' . "
COMMONWEAL TH OF PENNSYLVA"'A
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
Application is hereby filed far the approval
of on exemption from Pennsylvania Transfer
Inheritance Tax on the transfer of the property
described below:
1. Bureau File 11.___~(:.f'O:.3.16
2, Dote of Death ._ AP~H 25. ,.l980_H .--.-'"
3. Dote of Approvol _.~2!C;1{Jt...J.<cJ;f.L
4, Nome of Decedent 1I1llen L. Sh~er
S. The Commonwealth's appraised value of the property for which on exemption is claimed is $ Is: of residult
(Note: Where the property is other than 0 specified amount of cash, the exemption cannot be approvod until the value of
the property has been estoblished by appraisal by the Commonwealth, except in those cases where the amount of the gift
or bequest represents a stated fractional or percentage portion of the entire estate or the entire residue. In those cases
enter such fractional or percentage amount above).
6. Checkthe manner in which the transfer was effected and submit a copy of the document authorizing the transfer, unless
such material has been previously Filed.
WILL t!c
DEED 0;
TRUST IHDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(If other, explain)
7. Correct Business Nome and Address of Charitable Organization receiving property:
NAME
ChriA~iAn HArAld r.hildrAn's Home
ADDRESS__40 O~rloq~ Qrive, ChaEPaqqa, NY 10S14
o See listing on reverse side for additional charitable organizations covered,
8. I certify that the information contained herein jJi; to th"e best of my kn~~ and belief, true and correct.
h(~ ~-;~
Signature of Applicant ~/..'i A ... --
Murre R. Walters III, Esquire
Address 01 Applicant 22 East Main Street. Mechllnicsburg. PA 17055
Attorney for the Estate of
Official Title Helen L. Shoemaker
Dote
(i) ~Q 3 I 'i rf-O
I
This form must be completed in triplicate ond all three copies delivered ro the Register of Wills for the County In which tho decedent
resided, or In which letters were Issued for (I non_resldont decedent's estato. If tho decodent was a non_resident of Pennsylvania and
letters were not Issued by 0 Pennsylvania Roglster of Wills, deliver all three copies to the Director, Bureau of County Collections,
Penna. Deportment of Revenue, 26 S. 4th Street, Harrisburg, Po.
00 not write below this line. For Official Use Onl
REFERRED to Bureau Headquarters
Approved 0
For Secretory of Revenue
~
Denied" 0
a (Sig ture of Regis r of Wills)
4' 4?1 / rt1 L"/JVZ':-
~ (County)
/W,mIUA/ cJ ~ /1 f1
(Date of Approval) , ,
(Initials ef Register of Wills)
(Authorized Signature)
(County)
(Title)
(Date 01 Referral)
(Dote of Action)
* See reverse side for roasons
MUST BE FILED IN TRIPLIC~,T~
~CC.3 (4.131
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act of May 28,1956, P.L, 1757, and Act of June 15, 1961,
P,L, 373, as amendtld)
i+-
~
COMMONWEALTH OF PENNSYLVAtllA
OEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
Application i, haraby filed lor the approval
of an exemption from Pennsylvania Transfer
Inharltanca To. an the tran,fer of the praparty
da..rlbed below:
1. Bureau File 1/~~r:_S).~_:_~_L".__ __w__
2. Date of Dealh. APr;~ 25, 19BO __.. u" ,..,.-----
3, Date 01 Approval J:;I;!J."::t~k.h-~,;2~f',tJ
4, Name of Daceden t Helen L. Shoemaker
5. The Commonwealth'. appral.ed value of tho praparty for which an a.emptian I. c1almad isJS ... of residue
(Note: Where tho proporty /s other than a spocified amount of cosh, the exemption cannot be approved until tho value of
the property ltas boen established by appraisal by thO' Commonwealth, except in those cases where the amount of the gift
or bequest represents a statod fractional or percentage portion of the entire estate or the entire residue. In those cases
enter such fractional or percentage amount above).
6. Check the mannor in which tho transfer was effected and submit a copy of the document authorizing the transfer, unless
such motorial ha, bean praviausly Hlad,
WILLXX;
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(If ather, a.plaln)
7. Correct Business Nome and Address of Charitable Organization receiving property:
NAME ~fVen of "."t
ADDRESS ~410 Hyperion _Av~tle, Los Angeles, CA 900U
o See listing on reverse side for additional charitable organizations covered,
8. I certify that the information contained herein i.....,.yo tho bes~o~m.Y. kn wlad 1> and balief, true and corract,
4~Y~..~:';
Signature 01 Applicant //..1?"~/ /~ -
Murrol R. Walters III, Esquire
1
1
i
I
I
I
I
1
I
i
Addre.. of Applicant 22 EllA!:. Mllin Suset:. MechlU\icAbura. PA 17055
(f) vV- Q. 3 (YJ-il
At:l:orney for the Estate of
Helen L. Sh~er
Date
I
Olliclal Title
This form must be completed In triplicate and all three caples delivered to the Register of Wills for the County In which the decedent
resided, or In which letters wore Issued for \,1 non_residant decedent's estate. If the decedent was a no~resldont of Pennsylvanl(l and
letters were not Issued by a Pennsylvania Register of Wills, deliver all three copies to the Director, Bureau of County Collections,
Penna. Deportment of Revenue, 26 S. 4th Street, Harrisburg, Po.
Do not write balaw this Ilna, For Olllclol Use Onl
APPROVED: For tho Sacretary of Ravenua REFERRED to Bureou Haadquartars
Approved 0
For Secretary of Revenue
Denied' 0
~J
(Authorized Signature)
!! (Slg ure 01 Regl er of Wills)
~(41:1 k(!:r4~.k-
-$.' // (CaJnty)
~ , ~fl1.ff.eJ ~ ~ If yZ)
(Date of Approval)
(Initial. 01 Registor of Wills)
(County)
(Title)
(Date of Referral)
(Date 01 Action)
'" See reverse side for reasons
MUST BE FILED IN TRIPLlr.~T~
RCC.J (4_131
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Ac:t of Moy 28,1956, P.L. 1757, and Ac:1 of June 15,1961,
P.L. 373, as amended)
COMMONWEALTH OF PENNSYLVAtI\A
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
Application is hereby filed for the opprovol
of an oxemption from Pcnn1ylvania Transfer
Inheritance Tax on the transfer of the property
described below:
1, Bureau Fi Ie "__;\ /-,g!l~ :SJ~:_____._
2, Date of Deoth . _ Apri~ 25, 19BO .." .., ,..-.------
3. Dote 01 Approvol _&Id".dt~..b.jeS!~-.L;!,ft7
4, Nome of Oeceden t /I..1..n L. S!Io.IIIlak..r
5. The Commonweahh's appraised value of the property for which an exemption is claimed is" ,. oft r..irht.
(No to: Where the property ;5 other than D spocifjed amount of cash, the exemption cannot be approved until the value of
the property has been established by appraisal by the Commonwealth, except in those cases where the amount of the gift
or bequest represents a stated fractional or percentage portion of the entire estate or the entire residue. In those cases
enter such fractional or percentage amount above).
6. Check the manner in which the transfer was effected and submit a copy of the document authorizing the transfer, unless
such moterial has been previously filed,
WILL &;
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(II other, explain)
7. Correct Business Name and Address of Charitable Organization receiving property:
NAME Wn.,.lrl: T.ot ....,....,ft"'. (',..,'a,~.
ADDRESS 20232 Sunburst Street, Chatsworth, CA 91311
- - -- ,--- - - .'
o See listing on reverse side for odditionol charitable organizations covered,
8. I certify that the information contained herein is,....to the best of my kl!owle~ge and belief, true and correct.
~~~~~-
Signature of Applicant /~_ ~ ~M<Y <-' .>
Murrel R. Walters III, Esquir..
Address 01 Applicont 22 East Main StrHt',"Mechanicsburc:r, PA 17055
Attorney for the Estate of
Official Title "9'.n T ~l1~"''''.r
Date
(!) c3{';Z. J 19H
I
This form must be c:omploted In trlpllc:ate and all throe c:oples delivered to the Register of Wills for the County in whlc:h the dec:edent
resided, or in whlc:h lettors were issued for 0 non.rosident decedont's estato. If the dec:edent was 0 non.resldent of Pennsylvania and
lotters were not Issued by 0 Pennsylvania Register of Wills, deliver all three c:opies to the Direc:tor, Bureou of County Collec:tions,
Penna. Deportment of Revenue, 26 S. 4th Street, Harrisburg, Po.
Do not write below this line. For Official Use Only
For the Secretary 01 Revenue REFERREDta Bureau Heodquarters
Approved 0
For Secretary of Revenue
xd
Denied' 0
a;;;ig ture 01 Re. 'ster 01 Wills)
Y/)K4.-!Mt--d -
~ (Counly)
~V&JJ~J~~ ,FJf21
(Oat. of Approval)
(Initials 01 Register of Wills)
(Authorized Signature)
(County)
(Title)
(Date 01 Relerral)
(Date 01 Action)
.. See reverse side for reasons
MUST BE FILED IN TRIPLICHF
RCC.3 \4.131
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act of May 28, 1956. P.L. 1757, and Acl of June 15,1961.
P.L. 373, as emended)
".,""
;J. ).
~.' ' ')
COMMONWEALTH OF PENNSYLVAtIlA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
Application is horoby filed far the approval
of an exemption from Pennsylvania Transfer
Inhoritanco Tax on tho transfer of the property
described below:
1. Bureau File ::
,. ,'3./:., SL:,3LL______________
2, Dote of Deoth April 25. 1980.....,..____. ----..-..-....'-_
3, Dote of Approvol 3ltfJ@1J!,<LJ ..R ~_lilcJ
4, Nome of Decedent ~Jl!!!l\kl.L.-
5. The Commonwealth's appraised value of the property for which an exemption is claimed is S 'r of residUA
(Note: Where the property is other than a specified amount of cash, the exemption cannot be approved until the valuo of
the property has been established by appraisal by the Commonwealth, exct'pt in those cases where the amount of the gift
or bequest represents a stated fractional or percentage portion of the entire estate or the entire residue. In those cases
enter such fractional or percentage amount above).
6. Check the manner in which the transfer was effected and submit a copy of the document authorizing the transfer, unless
such material has been previously filed.
WILL !I;
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(If other, exploin)
7. Correct Business Name and Address of Charitable Organization receiving property:
NAME Holy rand ChriR~ian Mission
ADDRESS~UUO East R~ct Brid~Roact,__Kansas Ci~V, MO 64131
o See listing on reverse side for odditionol choritoble organizotions covered,
8. I certify that the information contained herei " o~e ~- wle ~ and belief, true and correct.
~~"',-',-
..~
Signature 01 Applicant
Walters III. Esquire
Addre.. 01 Applicant 22 East Main Street. Mechanicsburg, PA 17055
Official Title
Mal_", T. ~hlVtm.1r.,..
Dote
() C./f
:23
/
19'.0
Attomey for the Estate of
This form must be completed I,.., triplicate and all three copies delivered to tho Register of Wills for the County In which the decedent
re51ded, or In which letters were Issued for 0 non_resldenl decedent's cstate. If tho decedent was 0 non.resident of Pennsylvania and
letten were not Issued by 0 Pennsylvania Register of Wills, deliver all three caples 10 the Director, Bureau of County Collections,
Penna. Department of Revenue, 26 S. 4th Streel, Harrlsburg, Po.
00 not write below this line, Far Official Use Onl
Far the Secretory 01 Revenue REFERRED to Bureau Headquurters
Approved 0
For Secretary of Revenue
) ~(..'<.'.P'
Denied' 0
(Initials 01 Register 01 Wills)
(Authari zed Si gnature)
(County)
(Title)
(Dote of Raferroll
(Date 01 Action)
.. See reverse side far reasons
MUST BE FILED IN TRIPLIr.HF
RCC-J \4-7Jl
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act 01 Moy 28, 19S6, P,L, 1157, and Aa' 01 June 15, 1961,
p, L. 373, as amended)
r.~-
~
COMMONWEAL Tfl OF PENNSYLVMlIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
Application is horoby filod for tho approval
of an oKomptlon from Pennsylvania Transfer
Inhorltonco Tax on tho tronsfor of tho proporty
doscribod bolow:
1. Buroou Fila ff
:j,)-J>o - 31 t.
2, Data of Dooth APri~~,.19BQ j'._________...
3. Doto of Approval _1!!d2~-?nj::...~.-J d? /" /.p' 5cj
4. Name of Decedent 'U_'an To. ~h,wn"''It...,..
5. The Commonwealth's appraised value of the property for which an exemption is claimed is $ 2,nnn nn
(Note: Where the property is oiher than a specified amount of cash, the exemption cannot be approved until the value of
tho proporty has boon ostablishod by nppraisol by tho Commonwoalth, oxcopt in thoso casos whoro tho amount of tho gilt
or bequest represents a stated fractional or percentage portion of the entire estate or the entire residue. In thoso casus
enter such fractional or percentage amount above).
6. Check the manner in which the transfer was effected and submit a copy of the document authorizing the transfer, unless
such motorial has boon proviously filod,
WILL XX;
DEED 0;
TRUST INDENTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(If othor, oxploin)
7. Correct Business Name and Address of Charitable Organization receiving property:
NAME ~t ~tllpb.II' Ll~.h..."n l'1mr..h
ADDRESS >>~~fngston, pa 1101'
o See listing on reverse side for additional charitable organizations covered,
8. I certify that the information containe~her~i 5 t. e)~~~:n_af k -ledge and belief, true and correct.
" ~/~~
/ ~ ~~
Signature of Applicont-/?:' ,.J ;-
Murrel R:-'Walters, III, Esquire
Address of Applicant 22 FASt:. MAin Stt_f:, ~.."hllni"sburq. PA 17055
Official Titlo Attornev for the Estate of
Helen L. Shoemaker
Thla farm must be completed In triplicate and all three copies delivered to the Register of Wills for the County In which the decedent
rellded, or In which letters wore luued for a non_resident decodent's ostate. If the decodent was a non~resldent of Pennsylvania and
letter. were not luuEld by a Pennsylvania Register of Wills, deliver all three caples to tho Director, Bureau of County Collections,
Penna. Department of Revenue, 26 S. 4th Street, Harrisburg, Po.
Dote
(!!) c'/.f- :;Z.. J
I
/rtF-v
Do not writo below this line. For Official Usa Onl
APPROVED: For the Secrotary of Rovonue REFERRED to Bureau Headquarters
Approvod 0
For Secretary of Revenue
.)
Doniod' 0
i) (Si ature of Ro istor of Wills)
t.ll-1?1/W ._d~./J c..-,( ---
.M1 , _ (County)
~<{:-'ml!<-e-J,;( ~ )~11/
(Dato of Approval)
(Initials of Rogistor of Wills)
(Authorlzod Signoturo)
(County)
(Title)
(Doto of Reforrol)
(Doto of Action)
ll; See reverse side for reasons
MUST BE FILED IN TRIPI,Ir.AT\"
...:'
INFORMATION
To insure proper credit to your account, tho nnme of the oststo and file number should be clemly print-
ed on the check or money order.
This assessment is made in accordance with Section 708 of the Inheritance and Estate Tax Act of
1961 (72 P.S, 9 24B5.708),
To the extent that Inheritonce tax is paid within three (3) months after the death of the decedent, a
discount of five (5) percent is ellowed (72 P,S, I 2485.715),
Inheritance Tax, other than t8x on a future interest, is due at the dato of tho decedent's death and becomes
delinquent at the expiration of nine (9) months after the docedent's death (72 P.S. '3 2485.711). Inheritance
T8x on a future interest Is payable within three (31 months after the transfer takes effect in possession and
enjoyment and is delinquent thereafter (72 P,S. 9 2485.712), Calculate interest from the delinquent date shown
on the face of this form to tho date of actual payment using tho following interest table:
--------------------- ------ ---- --- ---- --------- - - - -- - --- -------- -- -- -- - -- --
1 month .005 4 months ,020 7 months ,035 '0 months .050
2 months .010 5 months ,025 8 months .040 " months .055
3 months .015 6 months .030 9 months .045 '2 months .060
1 days .00017 I I days .00186 21 deys ,00352
2 deys ,00034 12 days ,00203 22 days .00369
3 deys .00051 '3 days ,00220 23 days ,00386
4 deys ,0006B 14 days ,00237 24 days ,00403
5 days .00085 15 deys ,00250 25 days .00420
6 days ,00101 16 days ,00267 26 days ,00437
7 deys .0011B 17 days ,002B4 27 days .00454
8 deys .00135 18 days .00301 28 days .00471
9 deys .00152 19 deys ,00318 29 days .00488
10 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 Inheritence end Estate Tax Act of 1961(72 P,S, 9 2485.1001),
Make check or money order payable to:
"Register of Wills, Agent"
Mail to the address listed below:
GENERAL INHERITANCE TAX INFORMATION
Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her taxable estate,
In addition to debts incurred by the decedent or estate, other items are claimable including the cost of administration,
attorney fees, fiduciary fees, funeral and burial expenses including the cost of a buriallnt, tombstone or grave marker,
Ail debts being claimed against an estate are subject to the approval of the Register of Wiils with whom the
Inheritance Tax Return is filed, Evidence to SllPPOrt the decedent'S or the estate's liability for the debts being claimed
should be attached to this schedlde,
A family exemption of $2,000 may be claimed by a spouse of a decedent who died domiciled in Pennsylvania,
If there is no spouse, or if the spollse has forfeited his/her rights, then any child of the decedent who is a member of
the same household can claim the exemption, In the event there is no such spouse or child, the exemption can be
claimed by a parent or parents who are members of the same household as tile decedent. The family exemption is
ailowable only against assets which pass by a will or by the Pennsylvania intestate Laws,
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INSTRUCTIONS FOR COMPLETING SCHEDULE "F"
1, If the family exemption is being claimed, indicate the claimant's name, address and his/her relationship to the
decedent, Enter "family exemption" in the remarks column and the amount claimed in the amount column,
2, Assign consecutive numbers to each item listed,
3, Enter the date on which each debt was incurred and/or paid,
4, Enter the names of each payee,
5, Provide a brief explanation in the remarks column for each debt claimed,
6, Enter the amount of each debt being claimed,
7, The form must be signed by the person who has assumed the responsibility for paying the debts,
. Rel/.449 EXt (3.80)
COMMONWEAL TH OF PENNIV L VANIA
OEPARTMEIlT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT OECEOENT
AFFIDAVIT OF
FIDUCIARY
(Instructions on Reverse Side)
-*
-~ .-
Estate of
Ii:":, Lr::1 I,. r..:iOr;.~;\:'-::~:
Date of Dea ih
;:"o:,x:il 2:;, l~l~~')
_.______.___.___.__n___._____..___.
Last Address__ 171 ;:~nh"us .'~"d _______.__
Social Security No.
1 ;..~:,-- .1/1. -. (;C :J/
i1f:Chanicsbur<j f rl~
17'):JS
Bureau File No.
11.:11"'0
(S1" A TV-I
(ZIP)
County File No.
\,
~/'eI:" - ,9/t.
1. Decedent died:
( ) Intestate (without 0 will)
( :, ) Testate (leaving 0 last will--copy attached)
2, Is the filing of 0 Federal Estate Tax Return required for this estate?
3. (X) Executor/Executrix ) Administrator! Administratrix
Yes_ No ,.
,r'-
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ex! ",'"
0 ,.,,~
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Li):;o
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Name GEORGE I? F2R'1'E;iBAUGH
, ~.-:;
, : ~:~
, :: ~
Address 1122 TrillGllL.!\o.-,,,j
-WaG1-ta-l~~\U;.gr-~ J '/'"lS'::
(CITY) (STATF.:I (ZIP)
4. All correspondence should be moiled to (:: ) Attorney
) Fiduciary.
5. If an a!!orney is representing the estate, indicate:
Name
r.mRr~EL R. 1SI.L'::~~R.3 III
Address
22 Eci.si:. :.:ain SLr~,ei;
;.l(:',chdnicsburg I PI, 17 OJ 5
(CITY) (STATE) (ZIP)
List 011 safe deposit boxes registered in the decedent's individual namel or jointly with, or as an agent or deputy
of another, or in decedent's individual name with right of access by anotner as agent or deputy. Include the name
and address of the bank or ather instituti~n where the safe deposit box i~ located, the nome (s) in which the box
is registered and the relationship of the joint holders to the decedent.
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH OECEDENT MAINT^,NEO A SAFE OEPOIIT BOX
NAME OR NAMES IN WHICH
SAFE DEPOSIT BOX 15 REGISTERED
RELATIONSHIP OF JOINT
HOLOERS TO OECEOENT
7'C'~:--
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and
statements, and to the bost of my knowledge and belief it is true, correct and complete.
't---P I
t. ,-, _ ,. ."
, d.c.!'u "'1.6a~(.f0.
IGNATURE OF FIOUCIARY "/
(K'f:; -< ~ /7lfCi
OATE
PENNSYLVANJA INHERITANCE TAX GENEHAL INI'OHMPTlON
------_._------~----
1. PERSONS RESPONSIBLE FOR RETURN
Section 701 of the Inheritance and Estate Tax Act 011961 provide:; th;illhe fnl:ow;rlf: p,:rsuns "hall prepare and file
a return:
a, The personal representative of lhe estate of the decedent ,15 \0 \Irop"lfy ul Ihe dt:cellcnt :Jrllllinisteled by him
and such additional property which is or may be sobfeclfo Inhetit,lI1ce 'Iax 01 which he/she ~,hall have or
acquire knowledge;
b, The ttansferee of properly upon lhe lwnsfer of which Inheritance T;IX i'i orll1ay he imposed by the 1961 Statute,
including a tfllstee of property ttanslerred in tfllst, provided ih<1lno :.I:p,\lale retnlil need be I1wde by tbe transferee
of property included in tbe relurn of a personal representative.
2. PLACE FOR FILING
The return is to be filed in duplicate witb lIle Register 01 Wills of the county whereiu the decedent resided,
3. TIME FOR FILING
~he return is due nine months aflerthe decedent's death, unless an extensioillol titing has been applied for and
granted by the Secretary of Revenue within lI\e nine-month period.
4. FAILURE TO FILE RETURN
Section 791 of the 1961 Statute provides that" , ' ,any person who willfully f<1ils to file a return or other report
required of him, , ,sball be personally liable, . ,to a penalty of 25% of lI)e tax ultimately found to be due or $1,000
whichever is lhe lesser to be recovered by the Department of Revenue as debts of like amount are recoverable by
law."
5, TAX RATES
Inheritance Tax is payable atlbe rate of 6% on transfers to lineal descendants, such as father, mother, husband, wife,
son, daughter, grandchildren, grandparent, son-in-law and daughter-in-law and at the rate of 15% as to all others,
6, PAYMENT OF TAX
The tax assessed on the transfer of property reported in the return is due 9 months after the decedent's death. Interest
at the rate of 6% per annum accrues thereafter until payment is made, All payments received are first applied to any
interest which may be due with any remainder applied to the tax, IF TAX IS PAID WITHIN 3 MONTHS AFTER THE
DECEDENT'S OEATH, A DISCOUNT OF 5% OF THE TAX PAYMENT IS ALLOWED,
All checks should be made payable to the Register of Wills of the county wherein the decedent resided and are
received subject to the final determination of the Department of Revenue.
7, FAILURE TO PAY
The taxes imposed, together with any interest thereon, are a lien upon real property, which lien remains in effect until
the taxes and interest have been paid in full. TI18 taxes may be sued for against any real property in the decedent's
estate or against any property belonging to a transferee liable for the tax,
8, FILING OF FALSE RETURN
Any person who willfully makes a false return or report required of hilll sh,ll1, in accoldance with Section 793 of the
1961 Statute, be guilty of a misdemeanor and, on conviction thereof, shall be sentenced to pay a fine not exceeding
$1,000 or undergo imprisonmenl not exceeding one year or both,
QUESTIONS CONCERNING PROPERTY TRMSFERS
1. Did decedent, within Iwo yeiHs 01 deilth, milv,e any trilllsfer Ilf ilny IlIilterial \lilrt of his esU,[L; without receiving
valuable and adequate consideration? (Answer "Yes" or "No" ,) 410-
2, Did decedent, wilhin two years of death, trilnsfer properly from himself' helsell to hllllself!herself ilnd ilnotnor party
or parties (including a spouse) in joint ownership? (Allswer "Yes" or "No",1 -WI:>-
3, If the answer 10 one or two :Ibove is "Yes" and the tri1nslers ,1re t:lillilWrlto be nontaxablo, provide the following
information:
a, Age of decedent al time of transler. "fftlt-
b, Copy of death certificate,
c, Affidavit by the attending physiCian indicating Ihe stale of decedent's Iwalth 'llliw: of lmnsfer,
d, All other information supporting nontmbility 01 Irilnsler,
4, Did decedent, in hi s/her lifetime, Inilke ilny {r;,ns(er of property wi I/Ioul receiving a valllahle or adequate cOllsi deration
therefor which was to take effect in possessionllr enjoyment at or ilflCll1is/her death? (Answer "Yes" or "No",)
110
a, Was there any pOSSibility t1li1t the property transfmred mig!!t relurn to Irilnsferor olhis/llCr estate or he subject
to his/her power of disposition? (Answer "Yes" or "No",) Ill.
b, What was the transferee's ilge ilt time of decedent's deilth? 110I ilIA
5, Did decedent in his/her lifetime make ilny transler without receiving iI valuable and ildeQllate consideration therefor
under which transferor expressly or impliedly reserves for his/her life or any period which docs in fact end before his/her
death:
a, The possession or enjoyment of or the right to income from the property tmnsferred'! (Answer "Yes" or "No" ,) ~
b, The right to designate the persons who shall possess or enjoy Ihe property transferred or income therefrom? 0
(Answer "Yes" or "No",) llo
6, If the answer to live b. above is "Yes," stilte whether the right was reserved in decedent alone or others, 11/"
7, Did decedent in his/her liletilllC make a transfer, the consideration for which WilS transferee's promise to pay income
to or for the benefit or care of transferol? (Answer "Yes" or "N8".) 4<10-
8, Did decedent, at any time, trilnsler property, the brneficial enjoyment of which WilS subject to change, because of
a reserved power to alter, amend, or revollO, or which conld revert to decedenlunder terms of transfer or by opemtion of
law? (Answer "Yes" or "No",) lIo
9, If the answer to eight above is "Yes," was the power to aller, amend or revoke the interest of the beneficiary reserved
in the decedent alone or the decedent and others'! (Answer "Yes" or "No" ,) ~IA--
R~V.4~4 EX+ (3.801
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIOENT DECEOENT
SCHEDULE "E"
JOIi'lTl.Y OWNED PROPERTY
(Instructions on Reverse Side)
'*
Estate of
Helen T../o Shoomak(jr
ITEM
NO.
OEseR I PTION
TOTAL
MARKET
VALUE
PE
\
N
T
VALUE OF
DECEDENT'S
INTEREST
DEPARTMENT
VALUATION
(Offici.' Use Only)
.._-
-NONE-
TOTAL THIS PAGE
Nt"'LL
INSTRUCTIONS FOR COMPLETING SCHEDULE "E"
Schedule "E" must include all property, real and personal, owned by the decedent jointly with another
party or parties as joint tenants with right of survivorship, Both tangible and inliln'iible property are to be
included, List real estate first,
1. Describe all real property as indicated in the instructions for Schedule "A". Describe all personal property
as indicated in the instructions for Schedule "B", Include the nal11e, address and relationship to the
decedent of the co' owner (sl and the date the joint ownership was establisi1ed,
2. Indicate the total market value of the jointly owned property,
3, Indicate the percentage of the decedent's interest.
4, Indicate the market value of the decedent's interest.
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File Number
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
21-80-0316
REV.484 EX" (3.801
Estate Name ____________..lI<1.1."ll.L.,--m}g-e.r."li"x
Date of Death
4-25-80
Social Security Number
186-34-0654
REPORT OF INHERITANCE TAX APPRAISER
I, the undersigned duly appointed Inheritance Tax Appraiser in and for the County of _ Cumberland
Pennsylvania, do respectfully report that I have appraised the real and personal property as reported In the foregoing
retum at the values set forth opposite eoch Item In the lost column to tho right in Schedules IlAlt, flB", ICC", and liE"
Dated: November 20. 1980
,~/",.,... ,'" ) '/fF, p_. .' }
INHERITANCE TAX APPRAISER
INVENTORY
VALUE AS APPRAISED
ADJUSTMENTS
CODE (HARRISBURG USE ONLY) REMAINDER APPRAISEMENT CODE
Real Property (Schedule A)
Personal Proporty (Schedul. 8)
Jolnt.Held ~roperty (Schedule E)
Transf.rs (Schedule C)
$
-0-
00+
92+
TOTAL GROSS ASSETS
23.576 85 '0+
-0- 31+
-0- 30+
$2.3_.51.L _13_?_____ ________
Leu D.bts and Deduction.
(SCHEOULE F)
CLEAR VALUE OF ESTATE
40-
93.
Valuation of life utot.s or
annultl.s. . . . . . , . . . . . . .
RATE
FACTOR
PRINCIPLE
VALUE
CODE
FOR USE OF REGISTER ONLY
Tax on $
CODE
COM PUT A liON OF TAX
$
$
$
$
6"
"
Tax on $
\5%
T ox on $
Tax on $
Tax on $
$
Exemptions
Total Estate_
TOTAL TAX
INTEREST FROM
BALAN CE
TO
$-
$
$
Lus Credits
OATE OF PAYMENT AMOUNT PAlO OISCOUNT INTEREST
S + S S =
+ =
BALANCE $
INTEREST FROM TO __ S
BALANCE OUE S
TAX CREOIT
$
III
III
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IN 'l'HE COURT OF CO~ON PLEAS OF CUMBERLAND COUNTY, PENNSYLVM1Il\
ORPHAN'S COURT DIVISION
IN RE: ESTATE OF HELEN L. SHOE!'AY-ER, LATE OF SILVER SPPItIG ~'OI'lNSIlI",
COUNTY OF CUMBERLAND, AND CC11l1OmlEALTIl OF PENNSYI,VI\NI7\
SCHB!ll1LE OF PROPOSED IlISTRI~!~~I~~,I.
suggestion is mace, thdt tl)(~ baldncf:) in lHlwln o( i'\r.c:ouubm1" rot"
Distribution, to ""it: t:-w. sum of $17,OlO.lB in f?~lrsollalt:y Hurl clHill pllrtHlltnt.
to the provisions of t.he LZ\ST \Hi,L of Gl'.Ct'rJpnt, dS follo'I!~;:
I
I
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TREVA C. BILI~All, (Paragraph III)
Hiscbllamwus rurnitur~, per dpprdisul
EILEEN BILLHi\)l ",OUDERS, (Paragrap:l IV)
piano, per appraisal
KAY BILLHAl1 RYDER, (Paragraph V)
Furniture., per appraisal
DAHIEL BILL',""", (Paragraph vI)
Automobilb, 1948 Chevrolt':t'., per dPprctisul
JEA'il BIT.lL:-il'''I'i BR::I:n'jfj'Iiu.1, (Paragraph VII)
Furnitur~", per apprdisal
'::'l\1NA C. ;;Uli1A;I, (paragrapL VIII)
Cash
MR. and lmS. CLARENCE Sl1EIU'<ER, (Paragr"p!l T:':)
C"sh
L,i\RF.Y VOGELSO~G, (Fc.traqrctph ::)
Cash
JilCK FI:;I:EY, (Paragrapn XI)
Cash
r.1}\RY Jl'..tlE PP.E:ilZ,1':P. LO,\'::1Y, (Pardgraph :.:IT.)
Cdsh
HILLINl c. I.!cGUIRr:, (Paragrdr-h :n.II)
Cash
PA!'.lr..I.u~. SIn:i~.ER SE:~'l':';, (Pardgrdph :ZlV)
Cash
TAr.1J~Ri\ SHEAR::n. ST:..~mC:RG, (rdrdqrdj.)l~ :-:\,)
Cash
ST. STEPHEllS LUT;-:r,:1)\': CEUPCli, (Pdl~dlJr..\n:1 ~:vr)
Cash
DAVID ;], BO\''ERS, (Pardgraph :':\'II)
Cash
GEORGE D. rr:RTF;lj\Al.~r.H, (r'ciraqrctpl\ :-::::.:)
Cash
GEOJ.GI' P. FEHr:l'r:::'J'.t"GI', (Purr..1?f,\;lll >":.:)
Cash
CI!RIST!".~! 1:EY'AI}J C!'IV;~;~':' ~~ "r}:',., (hU-'lPli.l1,11 :,'\')), Ct1.:1h
HOLY LT\~!D Ct:nISTIl','j !:If:-:IC':, (J"""t',j{;rll!111 :-::.:1) I CclH'l
,- (1'15.0{)
(,0.00
115.00
lO.OO
70,:111
2,nOO.Oo
!)On.00
~jO.~O
250.ilO
~SO.OO
~50.0()
2)0.00
2)0.00
2,000.00
1,000.00
loOCO.OO
1,000.00
1,112.55
1,112,55
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:lIS~\lIP:1p'~Erlt!'S
Accountant asl:s cr(:di t. for l:'l('~ following dmonnts prli.d out,:
_ Register of Nills - filin" r....e"
_ 14yers FUlwral Home - funeral cxponsr>s
_ Cumberland publishers - Estate notice pUblication
_ Chuck Bricker - ~ppraisa1
_ Howard Roy cohen - Medical
_ Howard Zlotoff, D.P.M. - Medical
_ John W. Snoke, D.D. - Medical
_ Credit Bureau of York - Fire Insurance past due premium
_ ~~.bOr1and Law Journal - Estate Notice publication
_ Seidle Memorla1 Hospital - Medical
_ Waltz and 81xler, P.~. - Medical
_ Mrs. ~larence Shearer - !AIXlr, orgaJU.ze household goodS
_ Mrs. Treva Billman - Labor. organize household goodS
_ Cash _ Notary, postage. reproduction of documents
_ George P. Fertenbaugh. Executor's commission
_ Murrel R. Walters III. Esquire - Attorney's fees
_ Register of Wills. Pennsylvania Inheritance Tax
$ 74.00
2.094.70
21. 50
25.00
233.04
87.24
12,00
124.2'/
l8.UU
203.00
lU.UU
JU.UO
30.00
37.00
1,175.00
1,175.00
1,224.00
$6,573.75
TOTAL D ISBURSE~Ifl'ITS
REC1\PITUL~TI011
GROSS EST~TE ~SS~TS
LESS: OISBURSF.:,IENTS
$23,583.93
6,573.75
BALANCE ON HA'IDS OF ~CC0U11TN'lT FOR DISTRI!1UTIml
$17,010.10
COt',!MON\'1r.AL'J:':~ Of? PEi'iNSYLVA:lIA
S5.
Personally appearc.d bR:ore mp., the. undf':rsiqnH1 office.r, a :'lotary Public,
in and for said COPJ)";'lonwealth and county, GeorgI:' P. Fertenbaugh, Executor of
the Estate of i.:elen T.... Shoe,T:1a]:er, late of Silver Spring 'l'owns'hip, cumberland
County, l'ennsylvdnici., dt-:CedSH:, \.,hu being (July sworn a.ccording to la\o,', d~poseS
ar:.d says t:r.at. he. is U....,e i~ccountdl1i.: in thH ann\~:.:p(1 l\ccount and t!1at th(~ said
.,<....\1 """" ~ccoullt is true anc1 correct to t"" bf,St. of hiG l:no>llec1ge, information and heliof,
,.' ,..",:?i!.:,'Il,nd thdt there an. no unpaid credit:ors to b" notified of th,., filing of thi.s ~ccount
.".,;;"" '.' ,I.r:: ;; "-'II,l that. ~Tittcn not.icn of the filino of this [,ccount dn,l thf'. day of p"oprosed
::,,:";;r-"'~': -::_, ~(j,r"e of confirmat,ion has hr!<'n 'liven to all person" ,,1'0 hav<'l any int.erest in the
:....1 ".,:.;': ./,', ,', ......" b f" '
.'~"'. .~: ~....~'t.f? as ~ni.:"" '~Cl.arl.f-s.
,~, ";~; .:~.<~~ '.. :~.\,..n::.:
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