HomeMy WebLinkAbout06-18-07
--.J
15056041147
REV-1500 EX (06-05)
PA Department of Revenue
Bureau of Individual Taxes
PO BOX.280601
Harrisburg, PA 17128-0601
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
OFFICIAL USE ONLY
*'
County Code Year
INHERITANCE TAX RETURN
RESIDENT DECEDENT 2 1 0 6
File Number
1031
Date of Birth
204035675
10022006
07231921
Decedent's Last Name
Suffix
Decedent's First Name
LEAPHART
BETTY
MI
J
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
Suffix
Spouse's First Name
MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
[!J 1. Original Return D 2. Supplemental Return D 3. Remainder Return (date of death
prior to 12-13-82)
D 4. Limited Estate D 4a. Future Interest Compromise D 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
[K] 6. Decedent Died Testate D 7. Decedent Maintained a Living Trust 1 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
D 9. Litigation Proceeds Received D 10 Spousal Poverty Credij ~date of death D 11. Election to tax under Sec. 9113(A)
. between 12-31-91 and -1-95) (Attach Sch. 0)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRaCTED TO:
Name Daytime Telephone Number .
JERRY A. WEIGLE ESQUIRE 7175327388
f'. ,
Firm Name (If Applicable)
WEIGLE & ASSOCIATES, P.C.
REGISTER Ot= WILLS UsE9NL V;
"",
First line of address
C .J
126 EAST KING STREET
-~'-~
Second line of address
City or Post Office
SHIPPENSBURG
State
PA
ZIP Code
17257
r. "
DATE FILEDr<;
Correspondent's e-mail address:
Susan Leaphart
Jerry A. Weigle Esquire
DATE
(;-/
126 East King Street, Shippensb
L
15056041147
15056041147
--.J~
Side 1
--.J
15056042148
REV-1500 EX
Decedent'. Name: Betty J. Leaphart
RECAPITULATION
1. Real Estate (Schedule A).......................................................................................... 1.
2. Stocks and Bonds (Schedule B)............................................................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3.
4. Mortgages & Notes Receivable (Schedule D).......................................................... 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E)................ 5.
6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) 0 Separate Billing Requested............. 7.
8. Total Gross Assets (total Lines 1-7)....................................................................... 8.
Decedent's Social Security Number
204035675
126,811.89
52,388.79
1, 822 47
181, 023 15
22, 267 25
3 , 415 99
25,683 24
155,339 91
9. Funeral Expenses & Administrative Costs (Schedule H)......................................... 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)................................ 10.
11. Total Deductions (total Lines 9 & 1 0)...................................................................... 11.
12. Net Value of Estate (Line 8 minus Line 11)............................................................. 12.
13. Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J)................................................. 13.
14. Net Value Subject to Tax (Line 12 minus Line 13)................................................. 14.
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, of
transfers under Sec. 9116
(a)(1.2)X ~ 0 00
16. Amount of Line 14 taxable
at lineal rate X .045 1 5 5 , 3 3 9 9 1
17. Amount of Line 14 taxable
at sibling rate X .12 0 0 0
18. Amount of Line 14 taxable
at collateral rate X .15 0 0 0
15.
16.
17.
19. Tax Due..................................................................................................................... 19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
L
15056042148
155,339.91
o 00
6,990 30
o 00
18.
o 00
6,990 30
[!]
15056042148
--.J
REV-1500 EX Page 3
Decedent's Complete Address:
DECEDENT'S NAME
Betty J. Leaphart
--
STREET ADDRESS
620 Charles Street
File Number 21-06-1031
nn_ _un
. _____~n-.--.--
CITY
I STATE
PA
IZIP
17257
Shippensburg
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
7,000.00
349.52
Total Credits (A + B + C)
(2)
3. InterestlPenalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(3)
(4)
(5)
(5A)
(5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
6,9$0.30
7,349.52
359.22
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLocKs
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?................................... .................................................................................. ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE ~ETURN.
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;..................................................................................
b. retain the right to designate who shall use the property transferred or its income;....................................
c. retain a reversionary interest; or.......... ........................................................................................................
d. receive the promise for life of either payments, benefits or care?..............................................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?...................................................................... ................................................
Yes
D
D
D
D
D
D
No
~
~
~
[!]
[!]
~
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of th~
surviving spouse is three (3) percent [72 P.S. ~9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zerro
(0) percent [72 P.S. ~9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements'
for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a
natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. ~9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent,
except as noted in 72 P.S. ~9116 1.2) [72 P.S. ~9116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. ~9116 (a) (1.3)]. A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Rev-1503 EX+ (6-98)
*'
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Leaphart, Betty J.
FILE NUMBER
21-06-1031
ESTATE OF
All property Jolntly-owned with right of survivorship must be disclosed on Schedule F.
ITEM CUSIP VALUE AT 'DATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 1,623 shares of Allied Irish Stock 26.43 42.895.89
2 2,268 shares of Orrstown Bank Stock 37.00 83.916.00
TOTAL (Also enter on Line 2, Recapitulation) 126.811.89
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule B (Rev. 6-98)
, Rev-1508 EX + (6-98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Leaphart, Betty J.
FILE NUMBER
21-06-1031
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jolntly-owned with the right of survlvonshlp must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 Check on hand at date of death - Allied Irish stock dividend payable 09/26/2006
VALUE AT IDATE
OF DEArrH
1.042.97
2 Commonwealth of Pennsylvlania - pension check, October
1.002.32
3 U. S. Treasury - 2006 federal income tax refund
186.13
4 Citizens Bank Checking Account #6100800334
41.257.37
5 1955 Studebaker Commander
8.150.00
6 1979 Motobecane Moped
350.00
7 1995 Buick Park Avenue Sedan
400.00
TOTAL (Also enter on Line 5, Recapitulation)
52J388.79
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
Rev-1510 EX+ (6-98)
*'
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Leaphart, Betty J.
FILE NUMBER
21-06-1031
This schedule must be completed and filed ~ the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM OESeRI ,,~..~, t'l'\uPERTY OA TE OF OEA TH % OF DECO'S EXCLUSION TAXABLE
NUMBER INCLUDE NAME OF TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
THE DATE OF TRANSFER. ATTACH A COPY OF THE DEED FOR REAL ESTATE.
1 Orrstown Bank Certificate of Deposit IRA - 1,818.05 1,$18.05
Account # 30041593, beneficiary Susan Leaphart,
daughter
Accrued income on Item 1 through date of death 4.42 4.42
TOTAL (Also enter on Line 7, Recapitulation) 1 J822.47
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule G (Rev. 6-98)
REV.1151 EX+ (12-99)
*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Leaphart, Betty J.
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-06-1031
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
See continuation schedule(s) attached
9, t69.00
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
B.
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City
Year(s) Commission paid
State Zip
2.
Attorney's Fees
Weigle & Associates, P.C.
8,991.00
3.
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant Susan Leaphart
Street Address 620 Charles Street
City Shippensburg
3,$00.00
Relationship of Claimant to Decedent
State
Daughter
PA
Zip
17257
4.
Probate Fees
Register of Wills, Cumberland County
299.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
Other Administrative Costs
See continuation schedule(s) attached
308.25
TOTAL (Also enter on line 9, Recapitulation)
22,a67.25
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (5-98)
.
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Leaphart, Betty J.
FILE NUMBER
21-06-1031
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Fogelsanger-Bricker Funeral Home
9.169.00
Subtotal
9J169.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1502 EX+ (6-98)
*'
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Leaphart, Betty J.
FILE NUMBER
21-06-1031
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Cumberland Law Journal - advertising Letters Testamentary
75.00
2
Linda K. Klein - notary fees
12.00
3
News Chronicle - advertising Letters Testamentary
92.75
4
Register of Wills, Cumberland County - 2 Short Certificates
8.00
5
Register of Wills, Cumberland County - 2 Short Certificates
8.00
6
Register of Wills, Cumberland County - filing PA Inheritance Tax Return
15.00
7
Register of Wills, Cumberland County - filing Family Settlement Agreement
75.00
8
Weigle & Associates, P.C. - reimbursement for postage, xerox copies, and long
distance telephone calls
22.50
Subtotal
308.25
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-1512 EX+ (6-98)
*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Leaphart, Betty J.
FILE NUMBER
21-06-1031
Include unrelmbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Citizens Bank Checking Account #6100800334 - checks clearing after date of death
VALUE AT DATE
OF DEATH
2.254.45
2 R. T. Henry Pharmacy
191.26
3 State Employees' Retirement System - refund of overpayment
970.28
TOTAL (Also enter on Line 10, Recapitulation)
3,415.99
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
REV-1513 EX+ (9-00)
*'
SCHEDULE ..
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
NUMBER
Leaphart, Betty J.
NAME AND ADDRESS OF
PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal
aistributions.z. and transfers
under Sec. l:I116(a)(1.2)]
RELATIONSHIP TO
DECEDENT
Do Not List Trusteels)
FILE NUMBER
21-06-1031
SHARE OF ESTATE AMOUNT OF ESTATE
(Words) ($$$)
ESTATE OF
I.
1
Susan Leaphart
620 Charles Street
Shippensburg, PA 17257
Daughter
100%
155,339.91
Total 155,339.91
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
-
MARK AND WEIGLE
AttorneYI at Law
Shlppenlburg, ....
-
LAST WILL AND TESTAMENT
I, BETTY J. LEAPHART, of 620 Charles Street, Shippensburg, Cumberland
County, Pennsylvania, being of sound mind, memory and disposition, do hereby
I
I
,
! make, publish and declare this my Last Will and Testament, hereby revoking
I
i
\
I
i
I
I
I
I
I
i
I
I
and making void all wills by me at any time heretofore made.
FIRST.
expenses as soon as may be convenient after my decease.
I order and direct the payment of all my just debts and funeral
SECOND.
absolutely.
whatsoever and wheresoever situate, to my beloved husband, PAUL B. LEAPHART,
I give, devise and bequeath all my estate, real, personal and mixed,
THIRD. In the event my said husband precedeases me or is not living On the
60th day following my death, I then give, devise and bequeath my said estate
to my daughter, SOSAN LEAPHART, on a per stirpes distribution basis.
i
ii
Ii FOURTH.
\1
Ii
Ii
II
,I
I'
I:
1\
II
,.
H
Ii
II
Ii
I
is under the age of twenty-five (25) years, I then give and bequeath said
In the event that any beneficiary of this my Last Will and T~stament
beneficiaryts share to and appoint as Guardian of any property which passes
under this will or otherwise, DORIS JEAN CORREL, of 175 West King Street,
to invest and re-invest I
twenty-five (2$) years,
Chambersburg, Pennsylvania, AS GUARDIAN, NEVERTHELESS,
the same until the said beneficiary reaches the age of
with the following powers in addition to those presently given by law:
I
I
I
I
I
,\
I,
II
Ii
'I
A. The power to expend the income towards the health, support and
maintenance, and education, including a college, trade, business
or technical school education, of the said beneficiary;
B. The power to expend the principal, within the discretion of the
said Guardian, if the income is insufficient, towards the ~ealth,
support and maintenance, and education,. including a college,
trade, business or technical school education, of the said
beneficiary;
C. The power to sell any and all real estate, within the discretion
of the said Guardian;
D. The power to distribute the balance of principal and interest,
if any remaining, when the said beneficiary reaches the ag~ of
;~~.1~~
twenty-five (25) years, without the necessity of a formal adjudication
of the Guardian's account in the Court of Common Pleas of Cumberland
County, upon the receipt of a good and valid release;
E. The principal of the Guardianship and the income therefrom shall
be free from the debts, liabilities, and engagements of those
beneficially interested therein, and shall not be subject to
assignment by him or her, nor to attachment or execution und~r
any legal, equitable or other process for the enforcement of,
judgments or claims of any sort against them, either individually
or collectively.
FIFTH. I nominate, constitute and appoint my husband, PAUL B. LEAPHART, to be
the Executor of this my Last Will and Testament; if he be unable to fulfill
the duties of Executor of this my Last Will and Testament, I then nominate,
constitute and appoint SUSAN LEAPHART and DORIS JEAN COPJREL to be the Co-
Executors of this my Last Will and Testament.
SIXTH. I direct that neither my personal representatives nor Guardians shall
I be required to give bond for the faithful performance of their duties in any
II jurisdiction.
II
"
II
\ seal to this my Last Will and Testament, written on two pages, the first page
I signed for identification purposes only, this
II
1:
I
II
II This instrument was by the Testatrix, BETTY J. LEAPHART, on the date
,I
I hereof, signed, published and declared by her to be her Last Will and Testameni
'IN WITNESS WHEREOF, I, BETTY J. LEAPHART, have hereunto set my hand and
day of March, 198~.
~~.&-f~
~ 1/
(SEAL)
in our presence, who at her request and in her presence and in the presence of
each other, we believing her to be of sound and disposing mind and mE!mory,
have hereunto subscribed our names as witnesses.
I
I
I
II
I
,
I
MARKANDWEIGLE I
I
I
II
II
II
Ii
I:
#ihJ. C. /lfid<urv
~. Yrj, )U.I j;,/J.<J )
-2-
Attorneys It LlW
Shlppensburg, PI.
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
.
.
Sworn or affirmed to and acknowledged
before me by Betty J. Leaphart, the
Testatrix, this ?2tt day of March , 1981.
~C'.~
Miry . Seavers, Notary PubGc
Shlppensburv. PA Cumberland Countt
My Commission Expires July 27, 1982
I, BETTY J. LEAPHART, the Testatrix whose name is signed to the forego-l
I
I
ing instrument, having been duly qualified according to law, do herehy acknow-l
I
I
I
I
~.~.~
l
I
!
;
I
;
i
,
;
~
,
i
j
!
I
I
ledge that I signed and executed the instrument as my Last Will;
thait I
signed it willingly;
and that I signed it as my free and voluntary aict for
the purposes therein expressed.
COMMONWEALTH OF PENNSYLVANIA
~ ss
COUNTY OF CUMBERLAND
We, ,4i~ ~7 Ynt</uar and ~ vn ~
the witnesses whose names are signed to the foregoing instrument, being duly
, I
,
!
!
I
,
qualified according to law, do depose and say that we were present and saw
Testatrix sign and execute the instrument as her Last Will; that she signed
j;
j willingly and that she executed it as her free and voluntary act for the
~ j
t
,
I: purposes therein expressed; that each of us in the hearing and sight of the
l
!!
Testatrix signed the will as witnesses; and that to the best of our knowledge
the Testatrix was at that time eighteen (18) or more years of age and of sound
mind and under no constraint or undue influence.
Ii
Ii
H
I!
Ii
Ii
H
jl
r
I,
I;
\\
H
l!
!i
I'
f\
ii
i!
MARKANDWEIGLE
Attorneys at Law
Shlppensburg,. Pa.
.4L7 f2 2'LJ1,~'f'U
~AL\ ) YJ? ~
to and subscribed
-: - a.d..uiAJ and
Yn. , witne
tliis 1.:?t1 day of March, 1981.
/r)(Uu C. ~11f1AA./
/
Mary E. Seavers. Notary Public
~sburv, PA Cumberland County
My Commission Expires July 27. 1982
I
j':
-3-
~ ~ REV-485 EX (05-04) ~-
SAFE DEPOSIT ~
BOX INVENTORY
PA Department of Revenue
Social Security or Death Certificate Number Date of Death
48500041046
PLEASE USE ORIGINAL FORM ONL1f
County Code Year File Number
2 0.4.
ADDRESS OF DECEDENT STREET:
620 Charles Street Shi ensbur
NAME AND ADDRESS OF PERSON REQUESTING THE OPENING OF THE SAFE DEPOSIT BOX
NAME: Jerry A. Weigle, Esquire
STREET ADDRESS: CITY: STATE: ZIP CODE: .
WEIGLE & ASSOCIATES, P.C., 126 East King Street, Shippensburg, PA 17257
, NAME, ADDRESS AND RELATIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING
a. NAME: RELATIONSHIP:
Jerry A. Weigle, Esquire Attorney for the Estate
STREET ADDRESS: CITY: STATE: ZIP CODE:
WEIGLE & ASSOCIATES, P.C., 126 East King Street, Shippensburg, PA 17257
b. NAME: RELATIONSHIP:
STREET ADDRESS:
CITY:
STATE:
ZIP CODE:
c. NAME:
RELATIONSHIP:
STREET ADDRESS:
CITY:
STATE:
ZIP CODE:.
NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED
NAME:
Citizens Bank
STREET ADDRESS:
153 West Orange Street, Shippensburg, PA
. NAME OF PERSON MAKING LAST ENTRY
Susan Leaphart
DATE OF CONTRACT TO RENT BOX . NUMBER OF BOX
04/05/1990 29902413280
NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX
a. NAME:
CITY:
17257
STATE:
ZIP CODE;
DATE AND TIME OF LAST ENTRY
July 29, 2003
, TITLE UNDER WHICH BOX IS REQUESTED
Betty J. Leaphart
STREET ADDRESS:
620 Charles Street
CITY: STATE: ZIP CODE:
Shippensburg, PA 17257
NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY
b. NAME:
Susan Leaphart, Power of Attorney
STREET ADDRESS:
620 Charles Street
C1TYS. b 172 .sIATE: ZIP COD~:
hippens urg, PA ':>/
WAS A WILL IN THE BOX? 0 YES gg NO
If yes, a. Date of will:
b. Name and address of personal representative, if named In the will
NAME:
STREET ADDRESS:
CITY:
STATE:
ZIP CODe:
c. Name and address of attorney, if any
NAME:
Jerry A.Weigle, Esquire
STREET ADDRESS: CITY: STATE: ZIP CODE:
WEIGLE & ASSOCIATES, P.C., 126 East King Street, Shippensburg, PA 17257 .
L
48500041046
48500041046
.....J
. -485 EX
SAFE DEPOSIT BOX INVENTORY
Page
of
INSTRUCTIONS
(1) Cash: Report total only.
(2) Stocks: List in detail every common or preferred certificate, wa~rant or other rights found in box. Stocks are to be designated by
name of company, certificate number, date of certificate, name in which stock is registered, and number of shares and class of stock.
(3) Obligations of U.S. Government: Number of items, date of issue, face value, names in which registered and type of ownership,
Le., jointly held, payable on death, etc.
(4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds)
(5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank
and branch, and balance.
(6) Jewelry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible.
(7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible.
(8) All other contents.
(9) Return completed form to: DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
ITEM ITEM DESCRIPTION
NO.
No contents. Box was empty.
.
I CERTIFY UNDER PENALTY OF PERJURY THAT THE ABOVE RECORD IS PERSON RECEIVING COpy OF
CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SAFE DEPOSIT BOX INVENTORY:
SIGNATURE SIGNATURE
PRINT NAME PRINT NAME AND CHECK APPROPRIATE BOX BELOW:
Jerry A. Weigle, Esquire Jerry A. Weigle, Attorney for the Estate
PRINT TITLE DATE CHECK APPROPRIATE BOX:
Attorney for the Estate o Executor(trix) o Administrator(trix)
of Betty J. Leaphart 12/20/2006 I[] Estate Representative o Joint owner of safe deposit box
NOTE: Attach additional 8'/2" x 11" sheet(s) if necessary or use duplicates of this page of form.
The Department is authorized by law, 42 U.S.C. ~05 (c)(2)(C)(i), to require disclosure of Social Security numbers in connection with administering state tax laws. The Department uses the
Social Security number to identify the decedent and personal representatives of the estate. The Commonwealth may also use the information in exchange of tax information agreements
with Federal and local taxing authorities. The state law prohibits the Commonwealth's personnel from disclosing confidential tax information except for official purposes.
Markets: Quote Historical
Page 1 of2
The Internet home of: .~ -..,UUSINDI2.8
Mone,com'"
HOME NEWS
MARKETS
TECHNOLOGY
TRADING
CENTER
lSt:DtIrBdIlJ
$7 Online Stock Trades
FORTUNE
!Jt,lW.,.L DUIlNeu
1l~~~~11:'r.1~~~,1 t6~~~~
JOBS & ECONOMY
PERSONAL FINANCE
Join TO AMERITRADE
FXCM: Currency
Historical Quote ~tiJT!qtE:ll)
Allied Irish Bks P L C (OTHER OTC:AIBSF) 26.97
+0.15 I +0.550/0
Oct 16
Price information going back to 1972
Enter Date 10/02/2006 LOOK UP
Closing Price 26.43
Open 0.00 ADJUST
CHART:
High 26.43 Time Frame:
2 months
Low 26.43
REFRESH
Volume nfa
Split Adjusted Price No Splits
Adjustment Factor No Splits
The Hot List
Wh"'!t..m"'!lse$W"'!HeO...l:3uffett"'!ndTigerWQQcJ$ gre"'!t
7 money problerrI~J easy solutions
Wt!Y9"'!$priCe$drQPpecJ
N D 06 F M A t1 ,J J A S 0
Markets
Powe"'!$e$"'!ftef..pre"'!kio9..1.4,QQQ
Second wind for the bull market
Qil$ink$"'!fterri$e io crude $upply
L++_.II~~_~" ~__ ~~,"",/"'''r\t",/h;"tn..;"",l/h;ctn..;"",l html?na=hiRrrlnl::p rlMp=1001n?FO?OIn?F?
10/1 RnOOil
L1F8STYL
I '
I
I
i
!.
! J
\
J
l
ALLIED IRISH BANKS FLC
SIPNDMBER
C 0*24:3 7 50-235
. ." ........ . ...... CKi0045798 U-~19-~
$ $ $ $ $1, O.4\20:0L LAR$ANIfI~i7*c~~TS
OA~~~2T~~~~~R'C'-~!~~'~;~~~-: .........................................................~... $.-$- $-'-$' ~$" '.A.lm,ouOn._.14. .2' ..'-9.'.~.7'. 1
.__~~64~_~!_~_ ._Q~~'i~Z~_~__...... .
RATE RECORD DATE
'-',.-. ...
.......1..,..~..2:3
. AbR'S
TO THE
ORDER
OF
PAUL.,~. LEAPHA~T
LEAPH'~~J.JT .... TEN
6?O."QH AJ~l,. ft~ST
SHIPPENSBU~G PA
& BETTYJ
<f:"
: ~ .':.": ::
.P.l..E..A.S .E. 'INDICATE ..~...........ST...REET...
CHANGEDF . '. ." . '. '. . .'
ADDRESS.. ...... ........'... ..... ......... ........'....\....
. .' GllY....... .., '. . ". . ......... ." ..' STATE ~~~- ZIP -----'----'-
'''--_'''~____ AND PUSH OUT CIRCLE ONLY IF CHANGE IS MADE.
II (,Q) 0 L. 5 7 11 a II- I: 0 '2 ~ 11 0 2 j 5 2 I: 5 bill 0 j a 2 a 0 II-
. ~'~(':'1...:-
~
ORRSTOWN
BANK
OCT 1 9 2006
October 17,2006
To Whom It May Concern:
This is to verify that Paul and Betty Leaphart are the owners of 2268 shares of Orrstown
Financial Services, Inc. common stock and the market price of the stock on October 2,
2006 was $37.00 per share.
If you should have any questions, please contact me at (717)530-2607.
'.
'PO Box 250. Shippensburg, PA 17257 · (717) 532-6114 · (717) 532-4143 Fax · www.orrstown.com
II CittzensBank"
525 William Penn Place
Suite 153-261$
Pittsburgh, PA 15219
DEe 1 !. '2nn~
December 11, 2006
JERRY A WEIGLE, ATIORNEY
126 EAST KING STREET
SHIPPENSBURG PA 17257-1397
Estate of BETIY J LEAPHART
Date of Death: Oct 02, 2006
SSN: 204-03-5675
Dear Sir/Madam:
In accordance with your request, the attached information sheet has been provided in the above decedent's
name as of his/her date of death.
For IL or LC accounts, contact our Loan Department at 1-800-708-6680. For all other inquiries, please
call 1-888-999-6884
sm~
Ann~deS
Operations Services
a Citizens Bank'"
Account Number 6100800334
Account Title PAUL B LEAPHART OR BETTY J LEAPHART
Date Opened 3/29/1980
Account Type Checking
Principal Balance as of DOD $41257.37
Interest from Last Posting to DOD $.00
Account Balance as of DOD $41257.37
YTD Interest to DOD $175.84
II Citizens Bank"
Account Number 600029902413280
Account Title PAUL B LEAPHART OR BETTY J LEAPHART
Date Opened 4/5/1990
Account Type Bank Deposit Box
For questions regarding safe box please call the branch.
Branch Address: Shippensburg West Branch
153 West Orange Street
Shippensburg, Pa 17257
Phone number: 717-532-2151
Shoemaker's Insurance Agency Inc.
P.O.Box 148
Newville,Pa 17241
May 22,2007
To whom it may concern,
This is to confirm Mr Leaphart had his 1955
Studemaker insured through our agency at a agreed
value of $6000.; till 6/20/2007.
June's issue 2007 of "01d Cars Price Guide" lists
the value at $8150. This is for a #3 car which means it
is completely operable original or old restoration; all
presentable and servicable inside and out.
Robert L.Shoemaker, Agent
12~~ ~~1L-
'tU bbU l,fUU 2,850 6,440 10,000 14,300
600 1,800 2,950 6,660 10,400 14,800
Commander Skyway Series
Cpa 750 2,200 3,700 8,330 13,000 18,500
ed 650 1,900 3,150 7,110 11,100 15,800
650 2,000 3,350 7,560 11,800 16,800
President Custom Series
Cpe 750 2,200 3,700 8,330 13,000 18,500
ed 650 1,900 3,150 7,110 11,100 15,800
650 2,000 3,350 7,560 11,800 16,800
President Deluxstyle Series
cpa 800 2,350 3,900 8,780 13,700 19,500
ed 650 2,000 3,350 7,560 11,800 16,800
700 2,150 3,550 8,010 12,500 17,800
President Skyway Series
Cpe 800 2,450 4,100 9,230 14,300 20,500
ed 700 2,150 3,550 8,010 12,500 17,800
750 2,250 3,750 8,460 13,200 18,800
Skyway Champion, 6-cyl., 109.5" wb
pe 680 2,040 3,400 7,650
pe 700 2,100 3,SOO 7,880
608 1,824 3,040 6,840
616 1,848 3,080 6,930
~9 Champion, 6-cyl., 112" wb
pe 640 1,920 3,200 7,200 11,200 16,000
pe Starlight 700 2,100 3,500 7,880 12,250 17,500
588 1,764 2,940 6,620 10,290 14,700
592 1,776 2,960 6,660 10,360 14,800
I 1,040 3,120 5,200 11,700 18,200 26,000
19 Commander, 6-cyl., 119" wb
pe 660 1,980 3,300 7,430 11,550 16,500
pe Starlight 680 2,040 3,400 7,650 1.1,900 17,000
604 1,812 3,020 6,800 10,570 15,100
612 1,836 3;060 6,890 10,710 15,300
1,040 3,120 5,200 11,700 18,200 26,000
19 land Cruiser, 6-cyl., 123" wb
"$ Sed 668 2,004 3,340 7,520 11,690 16,700
:hampion, 6-cyl., 113" wb
)e 700 2,100 3,500 7,880 12,250 17,500
JeStarlight 720 2,160 3,600 8,100 12,600 18,000
720 2,160 3,600 8,100 12,600 18,000
720 2,160 3,600 8,100 12,600 18,000
1,040 3,120 5,200 11,700 18,200 26,000
:ommander, 6-cyl., 120" - 124" wb
le 840 2,520 4,200 9,450 14,700 21,000
Je Starlight 880 2,640 4,400 9,900 15,400 22,000
740 2,220 3,700 8,330 12,950 18,500
740 2,220 3,700 8,330 12,950 18,500
1,120 3,360 5,600 12,600 19,600 28,000
and Cruiser, 6-cyl., 124" wb
; Sed 760 2,280 3,800 8,550 13,300 19,000
hampion Custom, 6-cyl., 115" wb
760 2,280 3,800 8,550
760 2,280 3,800 8,550
e Starlight 840 2,520 4,200 9,450
e 780 2,340 3,900 8,780
~ampion Deluxe, 6-cyl., 115" wb
680 2,040 3,400 7,650
680 2,040 3,400 7,650
J Starlight 840 2,520 4,200 9,450
J 760 2,280 3,800 8,550
lampion Regal, 6-cyl., 115" wb
720 2,160 3,600 8,100 12,600 18,000
720 2,160 3,600 8,100 12,600 18,000.
800 2,400 4,000 9,000 14,000 20,000
760 2,280 3,800 8,550 13,300 19,000
1,080 3,240 5,400 12,150 18,900 27,000
Immander Regal, V-8, 115" wb
720 2,160 3,600 8,100 12,600 18,000
720 2,160 3,600 8,100 12,600 18,000
! Starlight 840 2,520 4,200 9,450 14,700 21,000
Immander State, V-8, 115" wb
740 2,220 3,700 8,330
740 2,220 3,700 8,330
880 2,640 4,400 9,900
1,200 3,600 6,000 13,500
nd Cruiser, V-8, 119" wb
760 2,280 3,800 8,550 13,300 19,000
l Starlight
!
Starlight
11,900 17,000
12,250 17,500
10,640 15,200
10,780 15,400
13,300 19,000
13,300 19,000
14,700 21,000
13,650 19,500
11,900 17,000
11,900 17,000
14,700 21,000
13,300 19,000
12,950 18,500
12,950 18,500
15,400 22,000
21,000 30,000
LU ot' \"pe tltlU L,ti4U 4,400 9,900 15,400 22,000 ~u 0l::U -'00
2d HT 920 2,760 4,600 10,350 16100 23000 1958 Silv~r Hawk, 6-cyl
2d Sta Wag (1954 only) 760 2,280 3,800 8,550 13:300 19:000 2d Cpe. 800
1953-54 Commander Deluxe, V-8, 116.5" -120.5" wb 1958 Commander, V-8,
4d Sed 720 2,160 3,600 8,100 12600 18000 4d Sed 520
2d Sed 724 2,172 3,620 8,150 12:670 18;100 2d HT 580
2d Cpe 920 2,760 4,600 10,350 16,100 23000 4d Sta Wag 540
Sta Wag (1954 only) 800 2,400 4,000 9,000 14,000 20:000 1958 President, V -8, 12
1953-54 Commander Regal, V-8, 116.5" -120.5" wb 4d Sed 528
4d Sed 740 2,220 3,700 8,330 12,950 18500 2d HT 588
2d Cpe 940 2,820 4,700 10,580 16,450 23;500 1958 Silver Hawk, V-8,
2d HT 1,040 3,120 5,200 11,700 18,200 26 000 2d Cpe 840
2d Sta Wag (1954 only) 820 2,460 4,100 9,230 14,350 20:500 1955 Golden Hawk, V-8,
1953-54 land Cruiser, V-8, 120.5" wb 2d Spt HT ' 1,080
4d Sed 760 2,280 3,800 8,550 13,300 19,000
4d Reg Sed (1954 only) 780 2,340 3,900 8,780 13,650 19,500 1959-60 ~ark DeLuxe, V
1955ChampionCustom,6-cyl.,116.5"wb ,~~~e~ joO~
4dSed 640 1,920 3,200 7,200 11,200 16000 4dSe W ~
2dSed 644 1,932 3,220 7,250 11,270 16:100 2dS~W:~\19600nIY) j~~
1955 Champion Deluxe, 6-cyl., 116.5"-120.5" wb 1959-60 lark Regal, V-t
4d Sed 680 2,040 3,400 7,650 11,900 17,000 4d Sed 420
2dSed 684 2,052 3,420 7,700 11,970 17,100 2d HT, 580
2d Cpe 960 2,880 4,800 10,800 16,800 24,000 2d C (19t:l
1955 Champion Regal, 6-cyl., 116.5" -120.5" wb 4d SPanWag 10 only) ~~~
4d Sed 700 2,100 3,500 7,880 12,250 17,500 NOTE: Dedu~t 5 percent for 6
2d Cpe 1,000 3,000 5,000 11,250 17,500 25,000 1959-60 J.lawk, V-8, 120
2d HT 1,080 3,240 5,400 12,150 18,900 27,000 "I
Wa 800 2,400 4,000 9,000 14,000 20,000 2d Spt Cpe i 840
1955 Commander Custom, V-8, 116.5" wb 1961lark!Deluxe, V-8,
4d Sed 720 2,160 3,600~ 12,600 18,000 4d Sed' 392
2d Sed 724 2,172 3,620 8 5 12,670 18,100 2d Sed 396
1955 Commander Deluxe, V-8, 116.5" - 20.5" wb 1961lark!Regal, V-8, 11
4d Sed 740 2,220 3,700 8,330 12,950 18,500 ~~ ~fd 400
2d Sed 744 2,232 3,720 8,370 13,020 18,600 2d Conv ~88
2d Cpe 1,120 3,360 5,600 12,600 19,600 28,000 1961 lark ',',Crul'ser, v-s,
Sta Wag 840 2,520 4,200 9,450 14,700 21,000 .
1955 Commander Regal, V-8, 116.5" - 120.5" wb 4d Sed 408
4d Sed 760 2,280 3,800 8,550 13,300 19,000 1961 Stati~n Wagons, V
2dCpe 1,140 3,420 5,700 12,830 19,950 28,500 4dDeL' 392
2d HT 1,180 3,540 5,900 13,280 20,650 29,500 2d 392
2d Sta Wag 880 2,640 4,400 9,900 15,400 22,000 4d Reg 396
President Deluxe, V-8, 120.5" wb 1961 Haw~, 8-cy!., 120.,
4d Sed 780 2,340 3,900 8,780 13,650 19,500 2d Spt Cpe , 840
1955 President State, V-8, 120.5" wb NOTE: Dedudt 5 percent for 6
4d Sed 800 2,400 4,000 9,000 14,000 20,000 Haw~s.
2d Cpe 1,160 3,480 5,800 13,050 20,300 29,000 1962 lark peluxe, V-8,
2d HT 1,200 3,600 6,000 13,500 21,000 30,000 4d Sed' 392
2d Spds HT 1,240 3,720 6,200 13,950 21,700 31,000 2d Sed 392
NOTE: Deduct $200 for Champion models in all series. 4d Sta Wag 412
1956 Champion, 6-cyl., 116.5" wb 1962 lark Regal, V-S, 1[
4d Sed 600 1,800 3,000 6,750 10,500 15,000 4d Sed' 392
2dSed 604 1,812 3,020 6,800 10,570 15,100 2dHT 580
1956 Flight Hawk, 6-cyl., 120.5" wb ~~ ~PanWag . ~~~
2d Cpe 840 2,520 4,200 9,450 14,700 21,000 ..
1956 Champion Pelham, 6-cyl., 116.5" wb 1962 lark vaytona, V-8,
2d HT 580
Sta Wag 860 2,580 4,300 9,680 15,050 21,500 2d Conv 680
1956 Commander, V-8, 116.5" wb 1962 lark Cruiser, V-8, 1
4dSed 620 1,860 3,100 6,980 10,850 15,500 4dSed' 560
2dSed 624 1,872 3,120 7,020 10,920 15,600 tr
1956 Power Hawk, V-8, 120.5" wb 1962 Gran '. urismo Hawk
2rJ Cpe 900 2,700 4,500 10,130 15,750 22,500 2d HT' 880 .
1956 Commander Parkview, V-8, 116.5" wb NOTE: Deduct 5 ;)ercent for 6-
2d Sta Wag 880 2,640 4,400 9,900 15,400 22,000 1963 lark Standard, V-8,
1956 President, V-8, 116.5" wb ~~ ~~~ ~~~
4d Sed' 860 2,580 4,300 9,680 15,050 21,500 4d Sta Wag , 420
4d Classic 880 2,640 4,400 9,900 15,400 22,000. 1963 lark Illegal, V-8, 10
t'J Sed 864 2,592 4,320 9,720 15,120 21,600
',956 Sky Hawk, V-8, 120.5" wb ~~ ~~~ ~~~
2d HT 920 2,760 4,600 10,350 16,100 23,000 4d Sta Wag 428
1956 President Pinehurst, V-8, 116.5" wb 1963 lark Custom, V-8, 1
4d Sta Wag 900 2,700 4,500 10,130 15,750 22,500 4d Sed' 392
1956 Golden Hawk, V-8, 120.5" wb 2d Sed 396
2d HT 1,160 3,480 5,800 13,050 20,300 29,000 1963 Lark Uaytona, v-s,
1957 Champion Scotsman, 6-cyl., 116.5" wb 2d HT 560
4d Sed 560 1,680 2,800 6,300 9,800 14,000 2d Conv 660
2d Sed 564 1,692 2,820 6,350 9,870 14,100 4d Sta Wag 560
2d Sta Wag 720 2,160 3,600 8,100 12,600 18,000
www.olclcarspriceg;
Performance Cycle
5 N. Fayette Street
Shippensburg, PA 17257
-'/7 - "r 3rl. i17 $-0
1979 Moped valued at $350
~&~ Chevrolet, Oldsmobile
Pontiac & Cadillac
730 East King Street
Shippensburg, PA 17257
(717) 532-2121
Fax (717) 532-3658
www.hhchev.com
To: Estate of Paul B. & Betty 1. Leaphart
620 Charles St.
Shippensburg, P A 17257
April 07, 2007
The trade-in value for one 1995 Buick Park Avenue Sedan, VIN: IG4CW52K5SH619799, with 111,019 miles, in poor con<llition,
is $ 400. The car has damage to the left rear quarter panel, the trunk lid is held down with bungie cords and the car needs.
completely repainted. The appraisal value was detennined by using the Kelly Blue Book Used Car Guide.
If you have any questions concerning this price please call me toll free at 888-532-2121.
Sincerely yours,
~/1t~
Timothy M. Nye
General Sales Manager
H & H Chevrolet, Pontiac, Cadillac Inc.
ORRSTOWNBANK
A Tradition of Excellence
October 23,2006
77 East King Street
P.O. Box 2$0
Shippensbwg, PA 17257
To: Weigle & Associates, P.C.
126 East King Street
Shippensburg Pa 17257
From: Traci Shaffer
Orrstown Bank
Customer Service Center
PO BOX 250
Shippensburg, Pa 17257
Re: Betty J. Leaphart
IT IS HERERBY CERTIFIED THAT THE ABOVE NAMED DECEDENT, ON THE
ABOVE DATE, HAD THE FOLLOWING ACCOUNTS WITH ORRSTOWN BANK.
CHECKING ACCOUNT Not applicable
Account # Title of Account Date opened Principle Accrued Interest
SA VINGS ACCOUNT Not applicable
Account # Title of Account Date opened Principle
Accrued Interest
CERTIFICATE OF DEPOSIT
Account #
30041593
Title of Account
IRA 12-17 MIR
Date Opened Principle
05/06/91 $1818.05
Accrued Interest
$4.42