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Home My WebLink About10-05-07 (2) ...:.J 15056051047 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 Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT ~l (), {yo if :z I Date of Birth Decedent's Last Name Suffix Decedent's First Name MI (If Applicable) Enter Surviving Spouse's Information Below Last Name Suffix MI THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW .- 1. Original Return C) 2. Supplemental Return c::> c:::::> 4. Limited Estate c:::::> 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required C) c:::::> 4a. Future Interest Compromise (date of death after 12-12-82) C) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) C) 10. Spousal Poverty Credit (date of death C) 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received o 8. Total Number of Safe Deposit Boxes C) -~ - ---.., First line of address Correspondent's e-mail address: be amercs @ ~ix. J1~t Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. p/l- /70 So ADDRESS (! II -#/21. ES iF. Sill EZ-OS 71I. " CL.Ptl:S~ #//A-t>. /J1E(!.H"IfN/t!S.l9t:(~6~ ~A 170SS:- . PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056051047 15056051047 ....J cf' --.-J 15056052048 REV-1500 EX Decedent's Name 5E AM ,IN- Lf AI IJ,4 L. . RECAPITULATION 1. Real estate (Schedule A). . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B) . . 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 4. Mortgages & Notes Receivable (Schedule D) . . . ... ... .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) <=> Separate Billing Requested . 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) <=> Separate Billing Requested.. 7. 8. Total Gross Assets (total Lines 1-7). . 8. 9. Funeral Expenses & Administrative Costs (Schedule H). . 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . 10. 11. Total Deductions (total Lines 9 & 10).......... .. .. ..' 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . 12. . . . . . 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, or transfers under Sec. 9116 (a)(1.2) X .0lL . () tJ 15. 16. Amount of Line 14 taxable at lineal rate X.O!:lf 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 . 0 0 16. . I:) 0 17. 3 &f. 6" B ~ 18. 19. TAX DUE. . 19. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056052048 Decedent's Social Security Number ~I 0 'I 0 ~..~:zo 2. 00 .00 .{)O 00 3. 5. .,. 0 () J Olj.././l I ~ 7 s> I . ", I 7 , L{ 7. 8'D 3 0 Lj' 2. , ... ~. 9 o ie' 00 ,.0.0 if Sa!. Soy1. t"fS 01/. (/0 .00 . 00 1t s.. r if s.. 9 ~ c::> 15056052048 -.J . . REV-1500 EX Page 3 File Number :2/-~6 - 8';1./ Decedent's Complete Address: DECEDENT'S NAME STREET ADDRESS LltllJ,f ------------------ - fo 5KfR :5EA-IHIfN __. __________n__ CAIlLISLE ..a/KG" L. CITY STATE ,iJA ~- ------..-------------------- ZIP IJt €CI(I'r/IJ(CS~U IJ. cr- /705"0 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) ., s: 9lf o ~__'_____ _n_____________ ~ o --- [':) Total Credits ( A + 8 + C ) (2) o 3. InteresUPenalty if applicable D. Interest E. Penalty () ------ --------- ---- () 8. Enter the total of Line 5 + SA. This is the BALANCE DUE. (3) 0 (4) 0 (5) " 5.9'1 (SA) c " (58) 5.9'1 - ____n. --- - --- TotallnteresUPenalty ( D + E ) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. 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. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... 0 ~ b. retain the right to designate who shall use the property transferred or its income; ........................................... 0 lZJ c. retain a reversionary interest; or.......................................................................................................................... 0 [Z] d. receive the promise for life of either payments, benefits or care? .................................................................... 0 IX] 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .................................................................................................... 0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ............. 0 ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............................................................................................................... ~ 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 PS. 99116 (a) (1.1) (ii)]. The statute does not exempt 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. 99116(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. 99116(1.2) [72 P.S. 99116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedents siblings is twelve (12) percent [72 P.S. 99116(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. EV-l508 ~X + (1-97) :STATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT S~AA1I1-AI, FILE NUMBER d2 / - ~4. - 8'2/ L/N'./JII- L. Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. 2. 3. VALUE AT DATE OF DEATH 1. DESCRIPTION t2GIM6unSGIlfEtJT ~1t1 }{16HMIf/2/( 13/,uE SIIIElD FoR.. CcSr IJF ,4/J/ ~Ut.AIlI(!'t: 71l/l-#G;;Jt)~-rA 7iPA' t!.1IEl>ff ~,4L.ANCE I A 7 ~ T PJ#P#li" .5E1f!.!/lcE "90 7oYo7'A (!,ELI(!,,/ .:< DK. c."[ COU.PE (S~E J/lI-tttA-7iNv' Pre/lJlr -i/1t1T /I- TT;f(!J./E;A) REFUND IRs ?'j/IfJ.I)O 'f.; IS: PO fl! ';.3. 31 " 5?~. /) 0 TOTAL (Also enter on line 5, Recapitulation) $ J J 9'11./, 3/ (If more space is needed, insert additional sheets of the same size) Edmunds used Toyota Celica car appraisal. Used Toyota car pricing. vVelcome.. Guest ISIQt-lINJ luoll'li1l Edmunds.com I Inside Line I YOUI" Account HelD I Directorv ~ HRRKETPLROE Financino As Low As 7.29% APR Free Insurance Ouote HOME NEW CARS CERTIFIED CARS . 08/17/200601:30 PM USED CARS CAR REVIEWS TIPS &. ADVICE FORUMS .. Get a free CARFAX record check. Buy your next used car with confidence. Great Rates. No Lender Fees. . Search for Used Cars in your area . Sell your car online . 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Condition Adiustment Average Total Certified Used Vehicle Price Another Vehicle Print Private Party Window Sticker I Print Dealer Window Sticker lttp: / /www.edmunds.com!used/1990/toyota/celica/11821!options.html?tmvaction =vd presult Dealer ~ $2,089 $299 $25 $24 $31 $97 $122 $0 $-1 05 $596 $-703 $2,176 NIA Page 1 of 3 III " Your AT&T Statement July 5 - September 4,2006 #BWNCJFM 110919124725601711 1228.8.314.708061 AT 0.308 11111111111111111111,11,111111111,11.11111111111111,1,1111,111 LINDA SEAMAN 6584 CARLISLE PIKE MECHANICSBURG PA 17050-1767 11IIII1111111111111111111111111111111111111111111111111.1.11111111111111 Summary of charges Previous balance.............................. ..................... .....-11.50 Payment received Jul6 - Thank you............................. -24.00 Credit balance as of September 4 ............................-$35.50 Other charges and credits .............................p 3...........10.93 Taxes and surcharges...................................p 3.............1.26 Current charges .......... ..... ........... ..... ......... .... ......... ..$12.19 Credit Balance -$23.31 This statement includes charges from the last two months. Your savings and benefits Never Mail Another Check to Pay Your AT&T Bill. For the ultimate convenience, enroll in AT&T Automatic Bill Payment (ASP) and have your future payments automatically deducted from your enclosed check. To enroll, check the box and sign on the line on the back of the remittance coupon, and return with your payment. Or sign up for online billing to review and pay your bill each month by logging onto your AT&T Online Billing account at http://www.att.com/remitdoc ~ Detach and return with payment Please write your customer 10 on your check or money order made payable to AT&T. Do not send cash. Do not staple this portion to your payment. Thank you. Credit Balance -$23.31 Amount enclosed: $ I Do Not Pay 1.1111111"11,1.1,"1111111,1111,11111,11111,1111111,111111111 AT&T PO BOX 8212 AURORA IL 60572-8212 11.11111111111111111111111111111111111111111111111111111111.1111111111" ~ W." ~ euatv~~ ~ ~ at&t Customer 10: 717 691-4761 1247256 Page 1 of 4 Customer Service: 1 800222-0300 Text Phone (TTY): 1 800 833-3232 Internet Address: www.att.com Extra! Extra! For collect calls just dial down the center 1 800 C-A-L-L-A-T-T. Continued q Benefit news Sign up for AT&T Online Billing and you won't get another paper bill! To sign up just visit http://www.aU.com/online Continued q Continues on back ~ ~ at&t LINDA SEAMAN Jul 5 - Sep 4, 2006 Customer 10: 717 691-4761 D Moving? It's hassle free with AT&T. Check the box, print your new address on back. Save your check' Visit www.att.comlremitdoc ... J, Customer Service: 1 800 222-0300 Text Phone (TTY): 1 800833-3232 Internet Address: www.att.com Jul 5 - Sep 4, 2006 Customer 10: 717 691-4761 Page 3 of 4 Why more customers are choosing online billing! Simply visit http://www.customerservice.att.com to manage or set up your online account. An online account puts you in charge 7 x 24! Just log in to check your order status, view, print and pay your bill online, look up a number you don't recognize, sort your calls and more. And if you sign up for Automatic Bill Payment, you can forget about late payments and the cost of stamps! Products and services Changes since your last statement Products AT&T One Rate@ Plus Plan Activity status removed on Dale Aug 16, 2006 Other charges and credits Date Description Amount Charge for service removed 2.38 Aug 4 thru Aug 15, 2006 AT&T One Rate@Plus Plan ($5.95/mo) 2 Sep 4 Universal connectivity charge .67 For an explanation of this charge, please call 1 800 532-2021 or visit hllp:/lwww .consumer.all.comlconnectivity charge 3 Sep 4 In-state connection fee 3.90 For an explanation of this charge, please call 1 800 333-5256 or visit hltp:/lwww .consumer .all.comlinstate-connectionfee 4 Sep 4 Carrier cost recovery fee 3.98 This fee helps recover costs for providing long distance I service including expenses for regulatory fees, programs & compliance, connection & account servicing. This fee is not a tax or charge required by the government. For more information, call 1 800854-9940. $10.93 Taxes and surcharges Description Interstate Gross Receipts + applicable UCC PA Gross Receipts Surcharge Intrastate State tax Amount .14 .42 .70 $1.26 ,'-"" ~ at&t ~ REV.1509 EX. (1.97) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNS, LVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 's' ./ ,~/ /'l A t.. EAIJIHIV / L//VVIT . FILE NUMBER ;l/-~tf:, -F~ I If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. At-ICE IJ/. SE',f-IIfIl-N ~3S~ (!A/2t.IStt: /Jlkli' ME=CNANIe.5LJtlIf'6.. I/A 17"~O 1UoT#6e B. fAut,A H~G'FN~ (.f",.l1Iu'y 140uh1 as PAIALA S"'-/I. SL.EY) /:'0 FAmILY CII!.e,L& I3EI2.KJ:LEY SP~/N6S" f1jJ/ ;{S"'1// FI€IGN.D c. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY '10 OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECO'S VALUE OF JMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 1/')7' PIJC f)NNK (JJ.lEOkIAl6 Ate r: ~ F f!. Sol 008 .tf'* 79 fA 1 Ill!. 'It{ S-04, '3,D57.22- (SEF V Attt l17/pA' Lt: 7Te;e H rrAC#ED) ). ~. NOli. 85 5E,efE5 a;:- II.S. S/f1//N6S ;30ND rr S-o~ ;139. Sf 79.1' #L "/.3 S(, I 5"'11 EE" (SE~ rA-tt1A-7}dU SI-It:E T A-77';f-~/lEt>) I I I I I TOTAL (Also enter on line 6, Recapitulation) $ 3, P f ~, R() RUG-22-200S 23:35 F'tICEHH 412 7e,:::: 345.:::: A~.NJ/J o PNCBAN< August 23,2006 Mr. JetTWineka and Mr. Charlie Shlelds 6 Closer Rd. Mechanclsburg, PA liOSS RE: Estate ofLmda L Seaman (Deceased) SSN: 210-40-2220 DaD: 08-12-2006 Dear Gentlemen: In response to your request for Date of Death balances for the customer noted above, our records show the following: Checking Account Account #5070084679 Established 01-01-1979 ALICE M SEAMAN LfNDA L $EAMAl'l" DOD balance: $6,114.44 Non interest beanng account Please note that this office only provides date of death balances for deposit accOlUlts (IRAs, CDs, Checking and Savings aCcOlrnts). We do not process any financial transactions or provide statements. If you need assistance with any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office:. Sincerely, ~:; L.,,~~~A' '--~-~'- Enca L Schlegel 1-800-762-1775 P7-PFSC-04-F 500 first Ave. P11tsburgb P A 15219 Member FDIC F.Ol/0l lleulateo the Value .of Vour Paper Savings Bond(s) t'~ J/~- 08/17/200601:35 PM T reasuryDirect. . Mv Accounts . TreasLlrv Secur;tlp.s & Proorams . Research Cente! . Plan nino & Givino . llliilii .~ lil)mp , ~ ' ~ ' C"lcul"te the V"lue of Your Paper S"vings Bond(s) 'OOLS . SavinCls Bond Calculator . SavlnCls Bond Wizard . SavII)Qs Bond Vallie Fries . SavlnQs Bond FRB Locator . Treasurv Bills Notes Bonds, 1:\ Tlpe, FRB locator . Treasurv Hunt . Estimation Calculators . SavintlS Bond Earninqs Reports . RedenlDtion Tables :alculate the Value of Your Paper Savings Bond(s) iAVINGS BOND CALCULATOR value as of: 08/2006 (~) Q) Help ieries: EE'8on~-' k~J Denomination: Bond Serial Number: Issue Date: r 50 /,;;'-'1 ~CALCUtATE4 I HOW TO SAVE YOUR INVENTORY I :alculator' Results for Redemption Date 08/2006 'VIEW/PRINT/SAVE LIST 'otal Price: $25.00 Total Value: $79.16 Total Interest: $54.16 YTD Interest: $1.56 lands: 1-1 of 1 ;erial # L213561541EE ;eries EE )enom $50 Issue Date Next Accrual Final Maturity 11/1985 Issue Price 11/2006 Interest 11/2015 Interest Rate $25.00 Value $79.16 $54.16 Note 4.00% ("REMOVE"1 ALCULATE ANOTHER BOND nstructlons low \'0 Use thp SavillC/" Bonel Calculator ,ate Descr! ption 'III Not Issued 'liE Not eligible for payment '5 Includes 3 month interest penalty Y1A Matured and not earnlllg interest ;urvey low would you rate this tool? -, Excellent \ Good Fair p://www,lreasurydirecl.gov/BC/SBCPrice Page 1 of 2 01/-1510 E~ '11-97) SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBA TE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT STATEOF SE/lIJIIIAI.I t/AlAA L. FILE NUMBER ;z /-0' - 7z 1 This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes_ EM 1BER I. DESCRIPTION OF PROPERTY INCLUDE THE NAME OF THE TRANSFEREE. THEIR RElATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAl ESTATE _ DATE OF DEATH VALUE OF ASSET 7NAyg IJI:NTAL I./l-BtJ,e/l72?,e;: /AlC. ,eE 7i~EIUJ:;A/T S/I-f//A/u.f P~AI 1/tI~~/l/llIf7UAlAt. /fIt/TtF/ tJEt!GlJBl/T tIJ/h$ 1v~7 pr S#FfitJ/EN'/ ~ 7P /RAKE A7t1y ttllr#/lMW/fiS tp/T#t:'tlr (JE/YAt.. "-Y. IJECIiftJ/:"Nr AlA-mED flE~ m~ mb~ kL/eE" SE'A-/J(A-~ ,$ .6/:/VEI9C!/A/'G)/. , :1./21./. 73 (JEE /A1HLVJ1AlIlJlY/Ii ...:w~c rs ~7r.I/tW~ %OF DECO'S INTEREST IDol;, EXCLUSION IF APPLICABLE \ /1Ior St( eJ: 70 IAiN~ T /1-;( 8~l:fi) oAJ A-6€ SI. TOTAL (Also enter on line 7, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) ZtS'eO TAXABLE VALUE )Jet 2BUJ . THAYER DENTAL LABOR I c- _ ATORY,INC. f..-- c: I of / - /D - ( 0 - (;J b J) 77 7, 3! '!. rI L/ 1./ 1./. J~ 2?<2 j ,7:3 &~ '.?!J'j! '. i i') f} . r' . j-I.L ~OV~ ~~,. ^ " I. I {a.J.L;~. ." /7 ., -0 ~~ e:~~~.d ~ . .~~) .' J.-u...~~j ~~:3g ~ ~~~lr:VJ- ~ ~r~L~ ~'4{!-3s:~fr :; ~~):;4;. J ~.(';E'~.~ fJ-4.., /1Jh;~~ j) ~ ~. jb- / f-()~ 100 N Walnut St ;;-1 It. . leel PO Box 1 ?O~ . . Mechan,csburg P (J.AJWJ ~ ~' ,r- " A 1705' ~ J . (717) 697-632 . 80C~382-1240 R(:V-1511 EX,+ (12-99) .. ~' ~~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF ,.2;/- o~ - €fill .5EA-IJIA~ L/i1/j),f FILE NUMBER L. Debts of decedent must be reported on Schedule L ITEM NUMBER A. DESCRIPTION AMOUNT {T"t-tJ ?J. by A/.'u JallY/~ f7. r~r.. SO B. 4. 5. 6. 7. 8. 1- IP. fl. 1.2. 1. FUNERAL EXPENSES: roy~ F1..tne-ntl Home of m ed'ulJ\icshu.rj (See ~/es pf "qJrodl.(c.t.d cht:.cks Q;H-A-du.J) G;n~r;c..h lYlexnoriCLLs .f'.,r tvla.rl<er W Etlft"o..v;~ CSe.e t!.f;" 41 tJMe:r ~Nn fi/ftUJlUI) ~ J J 't DO . 00 <<, ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) 11-1IC.c ~EAAI~H 4JA/lI~.D Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 65'81./ C'#K.t.ISL.€ ,4'J/KG City /JI/FC.NAAlIC.S/JUIi Go State PI/- Zip /7oS0 2. Year(s) Commission Paid: Attorney Feet Clt~,.l~~ ,E, Slt/eta'.s- 'ilL '* inc./udes tt,/tI,'/"Mal to,rk ;/1 d~pl/r', kI,i'J e1?e:I/fz)l'~ I4U/ ;nSlllvellCY Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) tf!J ~J qt:JO. o() 3. Claimant KPjII/F AI{)NG" cL.16/Al.E Street Address City State _ Zip Relationship of Claimant to Decedent Probate Fees 4M.II eri,;lIaJ i .sSue. t# sk,,.t ct.rf//''c4.reS ". Lf 3. t:)O Accountant's Fees j , ~. .1a.ne+ H. 'Erac:.kb,ll) l-Iti< Sloe.J<. OT l11ecl1a.n,cs- Tax Return Preparer's Fees b u. ~9 I P A Adn.rf/",'1 ;/1 Cu.m ~trfanJ lAw II-dt'erf,s/"J ill Carl/sit. Sud/lle/ AtleI/ "'()IIi1 slwl't ce.rfi n'ca.re.r !/e/mbll.,r6{Ulltnt {.,. eiU'-f,'/,t.rI Ihtt;/,'IVjSj {Josfl.lJ€ ",flhdof!IJpJa. (~H-" H'/,''';! n-e, ~r A(!"CoulI h'n, Ifdel/h'Mal Pre?bcde Fee $ltrJI4/ /Yt1V.>fJa,tltr 'i 30.00 f7s. at) ~ /t/7. 99 1f ?, bO t 4 t, (){) "" l.3o.()o ((!bnhiuc.uI ) -()- TOTAL (Also enter on line 9, Recapitulation) $ 1'2. I 71'1. 1./9 (If more space is needed, insert additional sheets of the same size) sell~j)1 H., t!MhAlletl /f"s7: /),c SEAIJ14-Al" t./Alt)~ L. _ntJ., .;:::/["/_ E~e_k__~/stf/: _~tl(!/l!s._ Gr .&,~r. m____lf-Ln_ /tAtI.~h~!1aL__ ~~rt_9~~_tLB._~t~~ ___.. _._,__.____....__.____._.__ ..~_~__.___.._ __. ____._~___._..~.___ ___.____ _.___~_.___M__ ;u - 1>6 - R;i.1 /~_n~~!"'~_n ___~!~ ()t:) 'I 4. bD ~ *D31DDO[!40- D<J.'\J?/EOOb b \. 1 b I, 5 0 '1'1 .s ~ ~-- AUO~ ~'SEAM~N ..., r"l' U'HDA.1.. S!~..UlJ\N ..!l ~: 115~~ '.AIlL.sL ~ PlrJ:: C ru "1~t....A,rUc.."tS;J;.'G, F-.A. 11OS" "- 0 t'""O 00 ru In Fl ~ run! rJl CD .00 ~D ,.., 0 m ::r o .... fI).1~".'Jl:: 3091 . ., f.-...... ..'~ Dau ,1zM~~--j~ ~ , "t. q~S-a~ Th.I' 1.8 Il L~(;AL CDPY "r y~ur cne.: k 'y(>U C<111 us~ i I \ "" ,;.H(.;' WB). you wo" J d u!'e lh" 0" 9'"i! I ct1~Cr. I $ $'.3 5'. fi ~ f >-__ -0"'" DoCI.3H ~ ::r:- Pll'JIOlh~' Or.!rr ~r '.." ..1dt; _ _:' L PNC ~J:: "'A 04~ 3Civnltrr~R.N.. ~'" :..."tt-., #I#~ .bL'~i - ,/ 50700BL.b?g.. 30'1. . fetl~- I:CH. ~ 1. 21 J81~ .~ 1.... .....~ .-....., ....... ac.... 4tA _"'1 uo. ~c-c.a~"""f""~ ..,.,..I,T'Z I..!I:lI'JIQ,;,I\l -............-.. "~I 0000 S 3 S b 50." 50 7 00 B l, b 7 q II' :I 0 g .. l.,1:0:1 ~ 3 .. 2? 381: O~) /07/2006 $... C)....6 I"'() t> 'L')~ .0. 3091 e 6O-12?J,':ll3 3086 Al..'CE M.SEAMAN LINDA L. SEAMAN 658.4 CARLISLE PIKE .MECHANICSBURG, f'A "\7050 .. Date 3" - /4- 0 c; I $ Z SS-O .0::..-:'; ili0(1J((Jj-<e ~/~~ ~~~.. I ' 3-, ~fI'::o(j rS tD ~.;2' "",...;.' 1f , ~~. for.__ ---- &~~; m ~<<.~~r ~) --~. 30B b llOOOO 255000.,1 1:0313.2738': 50? 0 0 a It E, ? q 11' '..;t:.,..'C)(~'-...:.\.11" 'V~ i-''tI., ...," , K-: :I~.]~: ,.,.-.. :,'",,\...o..~O-'1 ~-_. ~J~CI. :." (:..c,.....:. ",,' t;"'u JI"'-'ltl:l "I" ."L":-...."l po."\ll "", ,""Q "',Ve'I;ll;.1O t.,.O "11:1 3086 $2,550.00 08/15/2006 r\ (\. , bVe" ;;.. t ~>:r1 I Lettered ORDER FORM ingrict Foundation By o Carved o o o Drawing Required Drafter Since 1921 5243 Simpson Ferry Road, Mechanicsburg, PA 17050 (717) 766-5622 · Fax (717) 766-8007 www.gingrichmemorials.com Sandblast By Manufacturer LDTO: CS~L{ ~ (let ~\b.: rot!. f \ ~ \'C' r, \Iv, <" VI Date of Order Cemetery Location Center Over C(jct/VI L I (' fl v\ t: ( ,-1. r't"(~ ) . 0 M \ rill D v\t~ <; blq"'-~ , .-' "-/\ r f. \ V '"'! . , I...... \. \ '__. '~-). r \ t', ~ "'1 \ .. \ t ,to- ("_\,,,o\\1\~\.'~ ~\.,,( ""~ t I IlfJ'5( 1"r -'o9{) me (H) bin - :\ (, :,,~ (W) Approx. Date of Completion t'-' tering CD 1. IV l!l>v\Nt: t-1 t M oR Y L!..~1)~ L. SEF\t-'IAN 'DE C. IS \ II1Sl.{ t Rue-. 1i..1 M":.G I ~ -- ....25 .. ',a~ t""~- '. l!:-.~ ' -# r ...f,"t" ., o. 2 .....~. .../l. ..... Supplier Ack. # Date Rec'd Found. Ordered Position Verified Graves Lot # \ 'D \J..,!1",\: k \ x ~ Spelling and dates have been approved. <, \'/I\.L~ J Material c'" \ 4- trtN,'" {: ~ 0 \ trY\C\(L,~ 0\0' (). '\r(A",'\l'~ J f) (e' e of Memorial hv 11\1', 2:..t ~I" ~11" ~ X ., X Finish l2LX I;\?" X~Finish G'''',:'A\..F I 1YOII:Jr- M O() \1',\ \-(~\\t I ;ign ation lase o Corner Posts ement: A 50% deposit is required to commencement of work. e to pay stated balance upon erection regardless of labor troubles or shipments or any other good reasons. This order or contact ot be cancelled by customer unless agreed by both parties. The article herein mentioned shall remain the property of James R. rich Memorials until paid in full and they reserve the right to remove the same is not paid as stated. 3e to carefully proofread all names and dates for accuracy and accept full responsibility for any errors or omissions. THERE . BE AN ADDITIONAL CHARGE FOR ANY LETTERING ADDED TO THIS MEMORIAL AFTER ERECTED ON THE ETERY. ler agree to pay the balance stated for the work pertormed under this contract within thirty (30) days of receipt ot the final invoice urther agree that interest shall accrue at the rate of one and one-half percent (1 Y2%) per month on the unpaid balance owed to ,s R. Gingrich Memorials not paid within thirty (30) days of the invoice date. In addition thereto, I agree if it becomes necessary lmes R. Gingrich to institute iegal proceeding to collect any funds due from me for my account being past due thirty (30) days, y all court costs and attorneys fees incurred by James R. Gingrich Memorials to collect the same. Jer -- r_ . I to., r. h "-: Customer I' (I further agree that the above names, spelling, and dates are correct) \^'UI"T"C flU;.....,... vel I r')\^, D.......rI. ,.........i.......n 01f\11,.( _r'. lC"t,....,rno,.. ~nl nhf\It:::'fln_~Y"=ln,...h Price Foundation $ $ $ $ $ $ o Set. ;;~ Sf; 4 Clon I . "".- f; TOTAL DEPOSIT ,.. \:. .:f:i, "" :J \1 :2, "...: ,.. C"j -~, Balance Due Upon Completion $ ,.....~ r~. Ii"'" REV-is12 EX+ (12-'03) SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF S€AMJ9.N ~ L./#/J,f L. FILE NUMBER .:z/-O~ -t?2! ITEM NUMBER 1. d- J. Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. VALUE AT DATE DESCRIPTION OF DEATH HAlJ/fJlJt:1I 7'~A/SN/,a A-/JIi!JtllHA/CE ~S$oc./'" n~N (SEE tJ/JI'JI tip. ~SI6";/1IeAlr/'::'A/t)~R~I!:=A1EA1r or 17'tS".wI / t:>N SMlEP. .e:. ~Tr""'CHI:.b /{€~7i:J). ~ ~ IS", 190 eJ.lI1-S~ ~MK ~/)rr (!.A-teJ) #: L/dOS i1-o3 6'01-' fr,7..95"" ./I-SSIGAla) Hi tPHlA/Itl'J1 tUoJe./../J tV/At!;', /All!. (s~e eopy t}F CLAIA/ ST47E"AlE"II/T A-rrA-t!#€I>) , /0) 1 2 S. ()(o 'I. 1J10N-'/- MEJ)rT C!A-fl.I) #53~9 OS~3 3'2.1 7'i3S' {SEE (!L)!1V OJ=" ~A-/A1 S77f'~A(GA/'T A- TTACflE"D) CIlIrSE ~.lfAl/( CR.El)/T CIHW#5/t,B'o 3001 Ol"~ 350'/- (SEE' (!.(;PY Or A-t!CollA.JT 57A T€Mt:NT A TTA-eHEl>) (SE"E ~py 01= CAIYCELt..I17ipA/ t)~ ~'i,5hO. 70 'DEBT) HNGGteHUT CR.€J>J7 ,4-0VANTA-G€ C/1-12-D .#' 9312. tJ()/ r ?I? 1- 2. /bt:>/ (SEE" ~I'Y Or A-e~t(lfIr .5rA-72:/HE7V T A-T77tMNen) ~ "" JL/9.08' JC NET ZBfo .... :J. J2S~~6 " ". .,,_ .....;;;-J.~ I ~.,' ,. . TOTAL (Also enter on line 10, Recapitulation) $ I 7" (,,, 7. 30 (If more space is needed, insert additional sheets of the same size) .000780606 <f~d....IG....HMAR. ..:.:.......:K,... ~. BL.UESHIELD ~ All 1IIiJfi'''lldtfIUI 'Lk~ul'..:6( 1}".:lIlj'''' (",1,>; .4Ilflt.IJlIt' Sh/f:III,hunj,d",,, 'PAY :[O.THE OIWEIFOF .'... " . '. L INDASEAMAN 6584 CARLISLE P1KE MECHANICSBURG, PA 17050"'"1767 FOUR HUNDREIJF1FTEENDOLLAR~tAND.()O CENTS VP000512 III b 2 bOB .. b '-t III I : 0 l, :1 :1 0 .. b 2 7 I : . l, 0 :1 9 l. 5111 541796 PNC: BanK, "Natlonal.Associatlon JEANNETTE,.PA 60;162 433 CHECKNo6Z60.8 l6 4- M lJSTf:lECASHED WITH IN'12 MONTtI DATE OF CHECK ..MD DAY YR. . J b .. AUTHORIZED SIGNATURE HIGHMARI<BLUESHIELD r.!~i [ ~. ~ ~ ~~. 5' ~ ~ . ~ _\ ~ ~ S- ~ ~ \)1'< 0 CD::l ~ ~ ~ f. j. ~. ~ m ,,-'nco. CDS- Z ~ _ - (f)-. O ....::T0_(f) ... CD ca 0 ~ ~~()S;g. ClJm It.~~~ ~~ ~-()^ I ~I:l _. (f) ::T < m I ~ (f) <0' "D CD :0 , "D::l ~:::!. m ." S~ 3~ ~~ en t:; g; (f) I~~ ~~~ ~ i ~ I "l;;:~S 5. g S- I 0..0 CD CD 1 ~CD in ::l I, ~~CD 312 lit ~~ ~ * ~ ~ ~ HAMPDEN TOWNSHIP AMBULANCE 23U SOUTH SPORTING HILL ROAD INVOICE #: 0601378 MECHANICSBURG, PA 17055 (717) 761-5343 TAX # 23-6050136 DATE: 09/08/2006 PATIENT: LINDA SEAMAN BILL TO: LINDA SEAMAN 6584 CARLISLE PIKE MECHANICSBURG, PA 17050 ACCOUNT #: ZAR105373951CONTROL #: 0601378 DATE OF SERVICE: 08/08/2006 PATIENT PICKED UP: 6584 CARLISLE PIKE MECHANICSBURG, PA 17 PATIENT TAKEN TO: HOLY SPIRIT HOSPITAL SH DESCRIPTION 2006 BLS BASE RATE 2006 MILAGE CHARGE UNIT COST A0429 350.00 A0425 5.00 QTY. 1.0 13.0 AMOUNT DUE- 350.00 65.00 \ Comments: THIS INVOICE WAS SENT TO YOUR INSURANCE CARRIER. WE ARE NON-PARTICIPATING IN THIS PLAN SO THE INSURANCE COMPANY WILL SEND YOU A CHECK. YOU ARE RESPONSIBLE FOR THIS AMOUNT. PLEASE PUT INVOICE NUMBER ON CHECK- THANK YOU THANK YOU. SUBTOTAL AMOUNT PAID 415.00 0.00 TOTAL 415.00 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA (-"\ \,~ ,/~~ ~~( //.h ~/I I J Ilh '-, 1/ FORM 93 - O. C, DIVISION ORPHANS' COURT DIVISION IN RE: ESTATE OF } } } } } } No. 210"'06-0821 of 2006 LINDA L SEAMAN (Deceased) CLAIM To the Clerk of Orphans court Division: Index and make proper entry in your official records of the claim of OMNIUM WORLDWIDE, INC. for BANK ONE (Claimant), account # 4305870380766295, in the amount of $10,125.06 against the estate of the above named decedent. This claim is filed under Section 732 (b) (2) of the Fiduciaries Act of 1949 as amended. The said decedent, who resided at 6586 CARLISLE PIKE APT 2, MECHANICSBURG, PA 17050-1767, died on August 12, 2006. Written notice of this claIm was given to CHARLES SHIELDS, 6 CLOUSER RD, MECHANICS BURG, P A 17055 (Personal representative, if any, or counsel). September 28 , 2006 CJ/y ~-L/ . (Claimant) OMNIUM WORLDWIDE, INC. 7]71 MERCY RD, SUITE 400 PO BOX 66]8 OMAHA NE 68106 800-999-3778 (Claimant's Address) /U::L---~ fG'( /.., IV f? .. I 15 IN RE:ESTATE OF LINDA L. SEAMAN STATE OF PENNSYLVANIA IN THE REGISTER OF WILLS COURT: CUMBERLAND COUNTY ESTATE NO.#21-06-0821 STATEMENT OF CLAIM 1. MBNA America hereby presents for filing against the above estate this statement of claim in the amount of $6.849.08. 2. The basis for the claim is MBNA account number 5329056336217935_which was opened on 03/19/96. 3. The tax identiticationnumber of the claimant is 510331454. 4. The name and address of the claimant is FIA CARD SERVICES (BANK OF AMERICA). PO BOX 15409. Wilminl!ton. DE 19885-5409. 5. This claim IS NOT contingent. 6. This claim IS NOT secured. 7. The last payment made on the account was $250.00 on 07/31/06. 8. Please send payments to FIA CARD SERVICES DE5-014-02-03, 1000 Samoset Drive Wilmington, DE 19884. Please write the above account number on your check. Under penalties of perjury, I declare at I have read the foregoing, and the facts alleged are true, to the best of my knowledge and bel' f. Executed this ,2006 Claimant State Of Delaware, Coun IN~TSS WHERE ~ day of of NEW CASTLE , have set my hand and notarial seal this ,2006 My Commission Expires: tf1) J:1)U) . !'~;~~~ L N!\LlY '-11,_ l:.~?\/ PU~UC ,., .~. 'c'~ SLU.",:;,;:~E ]' 2UtJ1~ X165-1 CUSTOMER INFORMATION SYSTEM MD 11/07/06 * 5329056336217935 * USA 14:12:09 LINDA L*SEAMAN CURBAL: 7016.95 CYCLE: 08 N 0000000000000000 CR LIN: 8400.00 STATUS: 5 CHANGED: 09/08/06 ***************************** SEPTEMBER STATEMENT ***************************** POST -------REFERENCE------- TRAN --------DESCRIPTION------- BC ---AMOUNT--- MBNA PERKS .00 o MONTHLY .00 ***************************** SEPTEMBER STATEMENT *CLOSE DT: 09/08/06 ********* PREV BAL - 6674.07 PAY + 0.00 SALE + 0.00 CASH + F/C ,0.00 175.01 = NEW BAL 6849.08 STATEMENT TO DISPLAY (MM/YY): / PF10=P/FWD PF03=10/07/06 PF06=09l08/06 PF09=08/08/06 PF11=T/SUM PF15=07/10/06 PF18=06/08/06 PF21=05/08/06 4-@ 1 MBNAIS 171.197.32.80 PA1=BEGIN AGAIN 1 PA2=SYSTEM MENU AAQP TNOH2633 2/31 4 Payment Due Date 08/19/06 aLl,.;uuall lIUIIIUt::I. '-JUOU JUU I U 14.f"" ~..,u'"t Past Due Amount Minimum Payment $000 $19600 CHASE 0 VA J 3 so'f . L ,UI I Make your check payable \0 Chase Card Services. New address or e-mail? Print 011 back. . Enclosed 1$ 568030010145350400019600008233640000003 25749 SEX Z 20606 0 LINDA L SEAMAN 6586 CARLISLE PIKE MECHANICSBURG PA 17050-1767 111,111.1111.,1.11,1,,1111,1.1'11.11,1 JI,"II,.I.I'III1IIII..1 CARDIVIEMBER SERVICE PO 80X 15153 WILMINGTON DE 19886-5153 1.,.111",111'"11.1,11'11...111...1,11..1...11.,1.,11....1.11 I: 5 0 0 0 . b 0 2 B I: 0.... 0 . 0 .... 5 :l 5 0 ... 0 II- CHASE 0 Statement Date: Payment Due Date: Minimum Payment Due: 06/27/06 - 07/25/06 08/19/06 $196.00 CUSTOIlAER SERVICE In LIS. 1.800-945.2000 Espanol 1-888-446.3308 TOO 1-800-955-8060 Pay by phon<; 1-800-436-7958 Outside U.S. cail collect 1-302-594-8200 ACCOUNT SUMMARY Account Number: 5680300101453504 Cash Access Line Available for Cash ACCOUNT INQUIRIES $9,600 PO Box 15298 $1,366 Wilmington. DE 19850-5298 PAYMENT ADDRESS P.O. Box 15153 Wilmington. DE 19886-5153 Previous Balance Payment, Credits Purchases, Cash, Debits Finance Charges New Balance $8,175.81 -$210.00 +$7264 +$195.19 $8,23364 VISIT US AT: wwwchase.Gom/creditcards TRANSACTIONS Trans Date Reference Number Merchant Name or Transaction Description Amount Credit Debit 07/15 07125 . 11961960233564176380890 PaymenlThank You Electronic Chk . -.------ ..-- PA VMENt PROTECrOR1:Ss-il:3T4:4371--------.--- $21000 72.64 FINANCE CHARGES Daily Periodic Rate Corresponding Category 29 days In cycle APR Purchases V .08217% 29.99% Cash advances V .08217% 29.99% Average Daily Balance $2,127.69 $6,06289 Finance Charge Due To Periodic Rate $50.71 $144.48 T ransaetion Fee $0.00 $0.00 FINANCE CHARGES $50.71 $144.48 $195.19 Total finance charges Effective Annual Percentage Rate (APR): 29.99% Please see Information About Your Account section for balance computation method, grace period, and other important information. The Corresponding APR is the rate of interest you pay when you carry a balance on any transaction category. The Effective APR represents your total finance charges - including transaction fees such as cash advance and balance transfer fees - expressed as a percentage. IMPORTANT NEWS URGENT: As a valued cardmember, claim your Thank You of a full year of 3 magazines, worth up to $100.00. Limited lime 09i 10/06 to claim your Thank You of up to $100.00 processed by NewSub Services and for details. 1-800-641-3426. 4UQ v....." ,..,j...._,~ ~_....I_ l.__ 1_ ,'rNGERHUT ,;J.. Crcdn Advantage'? SEP 09, 2006 $258.66 $13.00 Is I II Paymem Due Date New Balance Minimum Payment Amount Enclosed --- I.." III"" "1.1""1" "" ...,' III II ..1" "" I...' '".,,. ,., PAYMENT PROCESSING PO BOX 23064 COLUMBUS GA 31902 - - - = - - = 7425 1 MB D.32b D8-15-5321-5321-T~D17 1,"'" III II' .111' .,.,' ,"","'".'.'1..'..." ""," """" LINDA L SERMAN UPDDD7425 6586 CARLISLE PIKE APT 2 MECHANICSBURG PA 17050-1767 -... <> II f- - - Chan.ge in address? Please complete r'3Verse side. 9312001796721601 000013003 000258665 --------.---.----------------------------------------------------.---------------------- Please detach and return with your payment ~fL~&~3_HUT ~ For Customer Service Information, see the Cardholder Services 'nformation section below. /' For billing e'ro,.s~ and other information about your card. see r.averse side. Account Summary Account Number Closing Date Total Credit Line Available Credit Payment Due Date Minimum Payment 9312 0017 9672 1601 AUGUST 15, 2006 $0.00 $0.00 SEPTEMBER 09, 2006 $13.00 Previous Balance Payments & Credits Purchases & Debits Cash Advances Periodic FINANCE CHARGE New Balance $253.41 $0.00 $0.00 $0.00 $5.25 $258.66 Finance CharQe Summary AVERAGE DAILY BALANCE" MONTHLY PERIODIC RATE CORRESPONDING ANNUAL PERCENTAGE RATE (APR) PERIODIC FINANCE CHARGE Purchases $ 253.41 Cash Advances $ 0.00 ANNUAL PERCENTAGE RATE 24.86% "" 2.0750% .0000% Periodic Rates may vary 24.90% $ 5.25 0.00% $ 0.00 Number of days in billing cycle: 29 days Grace Period: To avoid an additional Finance Charge on Purchases, pay the entire New Balance by the Payment Due Date. Finance Charges accrue daily on Cash Advances until paid and will be billed on your next statement. . For the Average Daily Balance calculation, see reverse side. He Fixed Fee Finance Charges will cause ~he APR to appear overstated. Cardholder Services Information Payment Processing P.O. Box 23064 Columbus, GA 31902 Correspondence 16 McLeland Road St Cloud, MN 56303 Dispute Resolution P.O. Box 105374 Atlanta, GA 30348-5374 Account Inquiry 1 (800) 755-9333 Fax Number 1 (320) 229-8581 REV-1~13 EX+ (~-OO) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF 3E/lm/}d~ LIA/./J/f L. FILE NUMBER NUMBER I RELATIONSHIP TO DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not ListTrustee(s) TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1ft-Ice St:/I/IIM /Jib TH~ (,S it{ (!,tfIU-ISLe /lIKE /JtEc!'#,f-NleSt$U/lu/ /'# /7oSO 1. 2/- t:J f&, - If :ll AMOUNT OR SHARE OF ESTATE /tJCJ~ ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 1 S, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) CHARLES E. SHIELDS, III ATTORNEY-AT-LAW 6 CWUSER ROAD Corner ofTrindle and Clouser Roads MECHANICSBURG, PA 17055 GEORGE M. HOUCK (1912-1991) TELEPHONE (717) 766-0209 FAX (717) 795-7473 September 26, 2007 Register of Wills Cumberland County Court House 1 Court Square Carlisle, P A 17013 Re: Estate of Linda L. Seaman No. 21-06-0821 Dear Register of Wills: Please find enclosed for filing 2 copies of the Inheritance Tax Return for the Raymond E. Wall Estate as well as Check No. 1017, in the amount of $15.00 for the filing fee and Check No. 1018, in the amount of$5.94 for the Inheritance Tax due. Thank you for your kind attention to this matter. Very truly yours, ~t~~?2 l,~{) Charles E. Shields, III':'.~ c~ Attorney-At-Law ,::":-.' CES/mjj Enclosures e--". .r::- \.C )') ...:J' , " r:--.CF ~ '-.-j , ' 85:;: c::: j 'S:OlO mOI or)> IO::IJ )>cr zoom om 00 oo::IJOO OJ::IJI co- ::IJ m G) 5 -0 00 )> (J) ::r '6' c} . . cq s: c: en -C en ." - :D en -:-I o .. )> en en :s: )> - .. @ ":T) ..:1" 0-"0 >ocJJ ~O~~ _cro- cnJJmen I-lJJ-l m rm "1Jr)>JJ >zzO ..... o"Tl c: o~ ..... Or ~ "C r ..... zen Co) -l ~ -< o o C JJ -l I o C en m L. L ---J o CJ1 CJ1 <b ---J W CJ1 I, ! . ,:-......... - :::::: - - =- - - :::::: - -:,.- (J) :J 9: 'S:O"Tl-El) Q. ~" 0 - I\) O)~CD-l:C. (; c.oenUl o~=t.j>.";-IO 3 L 01\)(") 3~ - 3 g r- 0) ~N---J> ()~=o en ...... -' en ~~ ~ o~ CJ1 ~ ~~~ g~ Ol ... ~~ .j>. .j>. '; L-~ ~- C'J -. - ~ ..:::::: .2.: -'