HomeMy WebLinkAbout04-0005 PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Irma E. Shelby No.
also known as N/A To
Regtster of Wtlls for the
Deceased. County of Cumberland tn the
Soctal Securtty No 192-34-50'16 Commonwealth of Pennsylvama
The pet~tton of the understgned respectfully represents that
Your pettttoner(s), who ts/are 18 years of age or older an the execut or named
tn the last wdt of the above decedent, dated Auqust 6, " ,19 81
and cod~ctl(s)dated N/A. Dw:l. qht W. Shelby died February 14. 1999.
Ppflflnnpr ~ fha ~l~rn~f~ l~.~n~fnr nnmo~ in fho l~f ~/1l].
(state relevant c)rcumstances, e g renuncmt:on, death of executor, etc )
Decendent was domtctled at death m Cumberland County, Penn~sylvalata, w~th
h er last famtly or prtnc~pal restdence at 17 Pine Hill Avenue, MecnanlcsDurg,
Silver Sprlnq Township, Cumberland County, Pennsylvania
(list street, number and munclpabty)
Decendent, thffn 91 years of age, d~ed December 17, 2003 , ;/ge
at Carlisle,. P6finsylvanxa
Except as follows, de-ce"dent dtd not marry, was not d~vorced and d~d not have a chdd born or adopted
after execuuon of tti~wtlf ofire'red for probate, was not the v~cum of a ktlhng and was never ad3udtcated
~ncompetent -- -
Decendent at death owned property wtth esUmated values as follows
(If dom~cded tn, Pa.,) ~.., ? All personal property , $ unknown
(If not d6mtctI$~ t~ P.a-)~ .C Personal property tn Pennsylvama $
(If not domt~:led tn Pa )',.c' Personal property ~n County $
Value of real estate tn Pennsylvama $
sttuated as follows' N/A
WHEREFORE, peunoner(s) respectfully request(s) the probate of the last wtll and codtcd(s)
presented herewith and the grant of letters T~.~tamnntary
(testamentary, admm~strauon c t a, admm~strauon d b n c t a )
theron
540 Appalachian Avenue
Mechanicsburg, PA 17055
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF CUMBERLAND
The peuUoner(~ above-named swear(s) or affirm(s) that the statements tn the foregotng petmon are
true and correct~to'thYbest ~6~ the knowledge and behef of pet~uoner(s) and that as personal represen-
. ~ petmoner(s) will and truly adm~mster the estate accor&ng to law
taUve(s) of th.,e'~l~ov~ dec~dent '" well
Sworn to-or ~affir~n~sdtand subscribed ~' ~
' Herbert Zink ~
before me th~s ~ day of |
~ December 2003
No. O.A
Estate of Irma E. Shelby
, Dece~ed
DECREE OF PROBATE AND GR~NT OF LETTERS
AND NO~'---~' / ~ , 200~ ~ ,lo consideration of the petltlo~ on
the reverse m~hereof, sa~facto~ proof having been presented before me,
IT IS DEC~ED that the ~nst~ment(s) dated
descmbed thereto be admitted to probate and filed of record as the last will of Irma g. Shelby
~d Letters Test~entary
are hereby granted to Herbert Z2_nk
FEES
Probate Letters, Etc. 5 /~,~
Sh~t '2~Ificates( ) $
Renunciation . . $
~/~ ~R.~g~$tcr ° f ~t~-
A~ORNE~{Sup Ct ID'No)
Kexth O. Brenfieman #47077
44 W. Maxn St.. Mechan~csburg,
~DD~SS
PA
17055
717-697-8528
PHONE
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
codicil
(each) a subscribing witness to the will presented herewith, (each) being duly qualified according to
law, depose(s) and say(s) that present and saw
the testat , sign the same and that signed as a witness at the
request of testat in h__ presence and 0n the presence of each other) (In the presence of the
other subscribing witness(es)).
Sworn to or affirmed and subscribed before
me this day of
19
Register
(Name)
(Address)
(Name)
(Address)
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF NON-SUBSCRIBING WITNESS
Herbert Zlnk
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
he is familiar with the signature of Irma E. Shelby
testat._r.i~ of ~Y~x~oSx~a~g-~i~i~:~:~ the will presented herewith and
that hE believes the signature on the will is in the handwriting of
Irma E. Shelby
to the best of, '~ __his_; £/~'
~- .knowledge and belief
Sworn to qr affirmed and subscribed before
m~-4hls- -~/x2,FC - day of
/Name}
Herbert ~ink
~ddress)
540 Appalchlan Avenue
(Nam~A
Mechan~csburg, ~ 17055
(Address)
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
codtctl
(each) a subscnbtng w~tness to the wdl presented herewtth, (each) betng duly quahfied accordtng to
law, depose(s) and say(s) that present and saw
the testat ., sign the same and that stgned as a wttness at the
request of testat tn h presence and On the presence of each other) On the presence of the
other subscnbmg'wttness(es)).
Sworn to or affirmed and subscribed before
me thts day of
19.__
Regtster
(Name)
(Address)
(Name)
(Address)
REGISTER OF WILLS OF CUMBERLAND
OATH OF NON-SUBSCRIBING WITNESS
Phxlxp H. Spare
COUNTY
(each) a subscriber hereto, (each) being duly quahfied accordtng to law, depose(s) and say(s) that
he is famfltar wtth the stgnature of Irma E. Shelby
testatrix of (dffi~x~lX~xg~fl~xx~l~6~x~ the ~dl presented herewith and
that he beheves the stgnature on the will ts tn the handwriting of
Irma E. Shelby
to the best of , ,- - ,<-~ 3~J~ ,kno~wledge and behef.
bworo to or alilrmefl &~o s~oscrloefl,eetore
meshes ~/~-~ ~ d~y of
Phil1? H_ .q.nnr~
(Address)
44 W. Maxn Street
(Name)
(Address)
t105 805 RFV 9186
This ts to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar The original certificate will be forwarded to the State Vital Records Office for permanent filing
WARNING: It ~s illegal to duplicate th~s copy by photostat or photograph.
Fee for this cemficate, $2 O0
P 98~~994
No
Local Registrar~'q~~
DFC 18 ZOO3
Date
4an~ z'67 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH ,
Irma E. Shelby[, Female[: 192- 34 --5016 . December 17,2003
., ~rl~d ~ ~rllsle ., ~rllsle Reglo~l ~d. Ctr. ~ ~ ~ ,. ~te
17 Pine Hill Ave.
MechanlcsbLLr9, PA 17050
Alfred Schackls
Herbert Zlnk
:,¢ P, olllng Green Mem. Park ,,~Camp Hill, PA 17011
[2
~0 ~ *#0 ~0
lAST Wll.I. AND 'II¥['AMI'NT
OF
IPJ~A E, SHELBY
{ I, IRMA I. SHELBY, of 138 North 33cd Street, tamp Hill, (umberland
County, Pennsylvania, betng of' sound m~.nd, memory and understandzng, do
hereby make, puhllsh and declare this to be my l,ast W~I1 and Testament,
hereby revoking any and all wills by me heretolore made. '
ding with my ustate and sltuat*on zn life aud that all my just deht~ and
Yuneral expenses be fully satisfzed as soon as may be after my decease
ITEM II. I give, devise, and bequeat~ all the rest, residue and rematnd-
er of my estate, wheresoever situate, and whatsoever kind, whether it be real,
personal, or mixed, unto my loving husband, ])WIGHT W. SHFLBY. [n thu ew.nt
that my loving husband, DWIGHT W. SHELBY, should pre-decease me, then and only
then, do I g~ve, devx~e and bequeath all the rest, residue, and rema~ncier
my estate unto mv surviving children: HERBERT ZINK; OTTO ZINK: HEL(:A WAI.KI
ELVIRA RESH AND MANERED ZINK, ~n equal share%, share and share alike
ITEM Ill, I nominate, constitute , and appoint my loving husband, DWtCIIT
W, %II['IBY, lEI hi' IIId ,Icl ,I~, eX(,~lltiJT (il Ih]~ IJIV I,,l',l ~llJJ .Jlld I~",l III1~111 .
nly beloved ~on, HI.I~BJ;Rq ZTNK, ,]~ nlV aJtt,rlhlte gXLttlL()r. Aild lily
shall flor be required Lo post any security Joy the per}ormance of his dtltle%
a% my executor, In ca~e of their death, I appoint Otto Zlnk~ or Helga Walker,
1N WITNESS ~EREOF. I have hereunto %et my hand and seal th]~ 6th d~v of
August, 1981
[ rrna lq.
%lin ] hy ~
The preceding instrument, consisting of th~s and one other typewritten
page, each identified by s~gnature of the Testatrix, was on the date there-
of s~gned, sealed, and published and declared by IRMA E, SHELBY, the Testatrix
there~n named, as and for her Last Will and Testament, in the presence of us,
who at her request, ~n her presence and ~n the presence of each other, have
subscribed our names as witnesses thereto.
Witnesses:
Irma E. Shelby ~ '
~L.AST 'WIIJL A'~N~ TES'T~VLE~NT
,~ ' 6~ I%RMA .E. SHELBY'
1-22 No'~h. Enola Drive
Enola, Pe~nsy]vanm 17025
_oD
Name of Decedent
Date of Death
No 21-04-0005
To the Register
CERTIFICATION OF NOTICE UNDER RULE 5 6(a)
Irma E. Shelby
December 17, 2003
I certify that notice of estate administration required by Rule 5 6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned Estate on
January 8, 2004
Name Address
Herbert Zlnk
540 Appalachian Avenue
Mechanlcsburg, PA 17055
Helga T Walker
17 Pine H,ll Avenue
Mechamcsburg, PA 17050-1642
Otto Zlnk
8171 Somerset Street
Hummelstown, PA 17036-9316
Notice has now been given to all persons entitled thereto under Rule 5 6(a) except None
LAW OFFICES
SNELBAKER
BRENNEMAN
& SPARE
Date January 8, 2004
Ke~th O Brenneman, Esquire
Snelbaker, Brenneman & Spare, P C
44 W Main Street
Mechamcsburg, PA 17055
(717) 697-8528
Counsel for Personal Representative
REV 1509 EX', (6-98)~.~
'~.,.~'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Irma E. Shelby
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
21-04-0005
if an asset was made joint wdhln one year of the decedent's date of death, ~ must be reported on Schedule G
SURVIVING JO[Nm TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
aerbert Zink
Son
C
540 Appalachian Avenue
Mechanicsburg, PA 17055
JOINTLY-OWNED PROPERTY
t A 12/94 Waypoint Bank, checking account $5,152.44 50% $2,576.
No. 1000009604
2. A 2/92 Waypoint Bank, savings account $6,797.46! 50% $3,398.
No. 1002123057
3. A 8/00 Waypoint Bank, certificate of 93,372.91 50% $46,686.
deposit No. 710000 1929
TOTAL (Also enter on hne 6, Recap~ulat~on) I $ 5 2,6 61.41
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
FiLE NUMBER
Ima R. Shelby 21-04-0005
This schedule d~ust be'completed aed filed ~f ~he answer to any of quesbons 1 ~hmugh 4 on L~e reverse mdc of/he REV-1500 C
ITEM DESCRIPTION OF PROPERTY
1 Waypoint Hank, certifmcate of deposit 41,551.;10 100~ N/A $41,55]
No. 71000012073, Beneficiary or "in
trust for" designee: Herbert Zink,
son. Date of transfer: December 17,
2003 (date of death).
TOTAL (Also enter On fine 7 Rec~oltuJabon) S 41; 551.80
REV-1511 EX+ (12 99)~
.~,
COMMONWEALTN OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT (DECEDENT
ESTATE OF
Irma E. Shelby
SCHEDULE H
FUNEEAL EXPENSGS &
ADMINISTRATIVE COSTS
FILE NUMBER
21-04-0005
iTEM
NUMBER
A
5
6
7
Debts of decedent must be reported on ScheduJe i
DESCRIPTION
FUNER~ EXPENSES
Myers Funeral Home - funeral expense
ADMINISTRATIVE COSTS
Name of Persona~ Represema~lve(s)
Social Secunty Number(s)/E[N Number of Pemonal Representabve(s)
Sheet Address
C~ State -- Zip
Year(s) Commission Paid
At~3meyFees to Snelbaker, Brenneman & Spare, P.
Exempban (If decedent's address ~s not the same as cla~msnt s, aP, ach explanabon)
Sb-ee[Ad(~ress
C~ State
Re[abonshlp of Claimant ~ Decedent
P~ba~e~es to Register of Wills
A~0untanrsFe, and reserve for miscellaneous expenses
T~~~ Cumberland Law Journal - advertise
grant of letters testamentary
The Patriot News - advertise grant of letters
testamentary
AMOUNT
$4,913.00
1,750.00
40.00
350.00
75.00
103.15
TOTAL (Also enter on llne g, Recap~tuJat~on)t $ 7,231.15
ESTATE OF
Irma E. Shelby
Sec 9116 (a) (I 2)]
Herbert Zink
540 Appalachian Avenue
Mechanlcsburg, PA 17055
Helga T. Walker
17 Pine Hill Avenue
Mechanicsburg, PA 17050-1642
Otto Zink
8171 Somerset Street
H-mmelstown, PA 17036-9316
FiLE NUMBER
21-04-0005
RELATIONSHIP TO DECEDENT AMOUNT OR SHA~E
Do Not L~st Trustee(s) OF ESTATE
Son
Daughter
Son
1/3 of residue
1/3 of residue
1/3 of residue
SCHEDULE
BENEFICIARIES
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE ON REV-1500 COVER SHE6T
NON-TAXABLE DISTRIBUTIONS
A SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B CHARITABLEAND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SFEET !$
Of
IRMA E, SHELBY
'r / I,, IRbtA E. qiIFLBY, of [38 North 33rd htreeU, k,tmp Illll, tumberkand
County, Pennsylvania. being of bound mind, memory and understanding, do
hereby make, pub]iMI and declare th~s to be my labr Will and lestament,
hereby revoking any and ail wills by me heretol.~u mddc
ding uttb my estate and s~-tuation 2n life and ill,it .ill my JUbL debtu and
funeral expenses be fully satisfied as soon as may be after mv decease
ITEM II. I give, devise, and bequeath all the rest, residue ,md remalml-
er of my estate, wheresoever situate, and whatsoever kind, whether it be real,
perqonal, or mixed, unto my loving buqband. IIWIIIIIT W MIEI,ID In thc event
that my loving husband, DWIGHT W. qHELBY, should pre-decease me, then and only
then, do I give, devl~e and bequeath ali tile re~t, residue, and remainder ~*t
my estate unto mv surviving children HERBEBF 7lMk, OFTO 7INK HII(.A WMKIB.
gLVI~ RESH AND ~NFRFD ZINK, ~n equal shares, shdre and share alike
e
,~consisting of this and one other typewritt~' -
· -Irma E. Shelby C/' '
"
~<.".15lX1ex.~\
*'" COMMONWEALTH OF
PENNSYlVANIA
DEPARTMENT OF REVENUE
DEFT. 280601
~ HARRISBURG, PA 17128.0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
2 1 _ 0 4
000 5
-WER---
--
COUNTY CODE YEAR
.....
Z
W
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W
U
W
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DECEDEWS NAME (lAST, FIRST. AND MIDDLE INITIAL)
She1b Irma E
DATE OF DEATH (MM-DD-YEAR)
12-17-2003
DATE OF BIRTH IMM.Do- YEAR)
06-01-1912
(IF APPLICABLE) SURVlVlNG sPOUsE's NAME (LAST. FIRST. AND MIDDLE INITIAL)
N/A
I SOCIAL SECU~TY NUMBER
I THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
I SOClAL SECURITY NUMBER
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[!I 1. Original Return
o 4. limited Estate
[Xl 6. Decedent Died Testate (A::.i:l;/l C!lP'!' of Wlllj
o 9. Utigation Proceeds Received
o 2. Supplemental Return
o 4a Future Interest Compromise (Dale afaeath after 12-1HZ)
o 7. Decedent. Maintained a living Trust CAr..achtopyo!7ruSt)
o 10. Spousal Poverty Credit (lIal8 oI11lllllh betWeen 12.31.91 aM 1.1.95\
o 3. Remainder Return (d.a~ of lleath!l~a: 'l:I '1.~Z~7.1
o 5. Federal Estate Tax Retum Required
o 8. Total Number of Safe DepOSit Boxes
o 11. Ejection ta tax under Sec. 911J(A) (A:achSch0)
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THIS.'SECTlON'MUST:BE:COMI'LE1"ED:.A\..L-:CORRESP.ONDENCE'AND::.cONFJDENTfACTAX INFORMATION SHOULD BE.DlRECTED,O:
NAM.E COMPLETE MAJLlNG ADDRESS
Keith O. Brenneman Es ire
ARM NAME (r.~le)
Sne1baker, Brenneman & S are, P.C.
TELEPHONE NUMBER
717 ';Q7-R'i?R
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44 W. Main Street
Mechanicsburg, PA
(1)
(2)
(3)
(4)
(5)
17055
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14. Net Value Subject to Tax (line 12 minus Une 13J
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES
(6)
E:
'i?, fifi1 41
(7)
41,551. 80
(6)
94,213.21
(9)
7,231.15
(10)
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'.0_ (i5)
x.O~(16)
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held COrporation, Partnership or Sole-Propl'ietcrship
4. Mortgages.\ Notes Receivable (Schedule 0)
5. Cash. Bank Deposits &. Miscellaneous Perscr.al Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Bimng Requested
7. Inter-VIVos Transfers & Misceltaneous Nc".Probate Property
(Schedule GorL)
8. Total Gross Assets (fotal Lines 1-7)
9. Funeral Expenses & Administratilfe Costs (Schedule H)
10. Debts of Decedent. Mortgage UabiJi!ies, & Liens (Schedule I)
11. Total Deductions (total Lines g & 10)
12. Net Value of Estate (l.ine 8 minus Une 11)
13. Charitable and GOIIemmental BequestslSec 9113 Trusts for which an ejection to tax has not been
made (5che<1ule J)
(11) 7,231.15
(12) 86,982.06
(13)
(14) 86,982.06
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15. Amount of l.ine 14 :nable at the spousal tax
rale, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable allineal rate
17. Amount of line 14 taxable at Sibling rate
18. Amount of Line 14 taxable at collateral rale
19. Tax Due
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
86,982.06
. .12 (17)
3,914.19
(19J
3,914.19
x .15 (13)
20.0
".,~,.,::"0;"';""'_":SI$SURE".:rO'ANSWER:AtL".QlIEsnONS'ON.REVERSE'SIDE'AND RECHECK MATH < <
Decedent's Complete Address:
S REET ADDRESS
17 Pine Hill Avenue
Mechanicsburg
Tax Payments and Credits:
1. Tax Due (Page 1 line 19)
2. CredilslPaymenls
A. Spousal Poverty Credit
B. Pnor Payments
C. Discount
CITY
(1)
3,914.19
3,725.00
186.25
Total Credlts(A+ B + C)
(2)
3,911.25
3. Interest/Penalty it applicable
O. Interest
E. Penalty
TotallnleresUPenalty ( 0 + E ) (3)
". If Litva 2. is greater than line 1 .,. Line 3, enter the difference. Tnis is the OVERPAYMENT.
Cheo. box on Page 1 Line 20 to request a refund (d)
Ii Line 1 + Une 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
2.94
A. Enter the mterest on the tax due.
15AI
2.94
S. Enler tne total of line 5 + 5A. This is the BALANCE DUE.
1551
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
a. retain the use or income of the property transferred;.......................................................................................... 0
b. retain the nghtto designate who shall use tne property lransferred or its income;............................................ 0
c. retain a reversionary interest; or..............................................................................................,............................ 0
d. receive the promise for life of either payments, benefits or care? .....,................................................................ 0
2. If deatn occurred aflerDecamber 12.1982. did decedent transfer property within one year of dealh
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? ..m......... 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a benefiCiary designation? ........................................................................................................................ 0
No
:&l
U
U
U
XX
XX
XX
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalliu of perjuy, I dedart tl1at I have examined lt1il retum, including acalITlPMyin9 sd1edulss and statements. and to the bast of my Kno'HlBdge :anti belief. it is true, correa
and complete.
Declaration ofp1lparerCllhet'lhan 1f\e p&f5m1l ~ is based on.-t irJIomlalil1I af\'otlich preparer has any I<now!edge.
SIGNATU~9f PERSON RESPONSIBLE FOR FILING RETURN
~M- ~ , Executor
~DRESS '
540 Appalachian Avenue, Mechanicsburq, FA 17055
SIGNATURE OF pr1A~ESENTATIVE
~DRESS
DATE
03/P"3/~<(
44 W. Main Street, Mechanicsburg. PA ]7055
.'~.'. :<;'::~::;;:1..r~-:^'!.;:;:.:~:I~,}"~",~!..';::ti:.~;.-r~i~~~etf::.s::?:~~;::'L' .;:--::,.~:~~;i~~.:.~~;:~:::!2.::tGi2::::~..;.~-c':c-' -'
DATE
~/3 7",<1
I
For dales of death on or after July 1. 1994 and before January 1, 1995. the tax rate imposed on the net value of transfers 10 or for the use of Ihe surviving spouse is 3%
172 P.S. ~9'16(a) (1.1) (i)).
For dales of death on or efter Janua'Y 1, 1995, the lax rale imposed on the nel value of lransfers to or for tne use of tne survlvin9 spouse is 0% 172 P.S. !j9116 (a} 11.1) (Ii)}.
The stabJte does nol exemot a transfer 10 a surviving spouse from tax, and: the statutory requirements for disclosure of assets and filing a tax return are stiU applicaole ellen If
the surviving spouse is the only beneficiary,
For dates of deatn on or ailer July 1. 2000:
The tax rate imposed on the net value of transfers from a deceased chiid twenty.one years of age or younger at death to or far the use of a natural parent, an aoooiive parem.
or a slepparent afthe chrId ;sO% \12 P.S. !j9116(a)11.2)].
Tne tax rate imposed on the net vaiue of transfers to or for the use of the decedent's lineai benefiCIaries is 4.5%, exceot as noted In 72 P,S. $9116(1.2) [72 F.S. 99116{a)(1j]
The tax rate imposed on the net value of transfers to or ier the use 01 the decedent's siblings is 12% [72 P.S. 99116(a)(1.3)). A slbiing is defined. under Section 9i02, as an
indIvidual who has alleast one parent in common with the decedent whether by blood or adopiion.
REV.1509 EX. 16.98*
COMMQNWEAl-TH OF FENNSYLVAN1A
INHERITANce TAX RETURN
RESIDENT OECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
Irma E. Shelby
FILE NUMBER
21-04-0005
ESTATE OF
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
A . Hemert Z:Lnk
ADDRESS
RELATIONSHIP TO DECEDENT
540 Appalachian Avenue
Mechanicsburg, PA 17055
Son
8.
c.
JOINTLY-OWNED PROPERTY:
LEiTER OAT~ DESCRJPTIQN OF PROPERTY I %0; DA,::OfOEA1'l-t
no" FOR JOINT O.lAQ' INQ.UOE NAME OF F!NAfIlC\,ll,L lNSm\1TJON AND BANK ACCOUNT NUMBER OR SIMIl.AR DATE OF DEATH C;':O.S VAJ..UEOF
NUMBER TENANT JOINT IDENTIFYING NUMBER-ATTACH DEED FOR J01N1lY.HE.'~D REAL EST,l,TE \!AlVE OF ASSET INTEREST OECEDENrSlNTE~T
1. A. 12/94 Waypoint Bank, checking account $5,152.44 50% $2,576.
No. 1000009604
2. A 2/92 Waypoint Bank, savings account $6,797.46 50% $3,398.7
No. 1002123057
3. A 8/00 Waypoint Bank, certificate of 93,372.91 50% $46,686.4
deposit No. 710000 1929
22
3
6
TOTAL (Also enter on line 6, Recap"ulotion) I $ 52, 661 . 41
(If more space is needed. insert additional sheets of the same size)
REV-151 0 EX. (6-98*
COMMONWEALTH OF F'ENNSYLVANlA
INHERITANce TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
Irma E. Shelby 21-04-0005
This schedule must be cOmpleted and filed if the answer"to any of Questions 1 tl\rougr. 4 01'\ the reverse side of lhe REV.1500 COVER SHE::T is yes.
ITEM
NUMBER
,.
DESCRIPTION OF PROPERTY
INCl.LIOE THEE NAME OF THE TRANSFEREE. THEiR RE\.N1QNSlo;lP TO OECEOefi IIND
THE DATE OF "TRANSFER A7TACli A COPY OF n.e DEED FOR REAL ESTATE
DATE OF DEATH % OF DECO'S
VALUE OF ASSET INTEREST
EXCLUSION
(IFAPPLICASlEl
TAXABLE
VALUE
Waypoint Bank, certificate of deposit
No. 71000012073, Beneficiary or nin
trust forn designee: Herbert Zink,
son. Date of transfer: December 17,
2003 (date of deathl.
41,551. 0 100%
N/A
$41,551.80
TOTAL (Also enteron line 7 Recaollulauon) S 141,551.80
(If more space is needed. insert additional sheets of the same size)
REV-IS11 EX- 112.99.
COMMONWEALTH OF PENNSYLVANIA
INHERIT ANCE TAX RETURN
RESIDENT OECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Irma E. Shelby
FILE NUMBER
21-04-0005
Debts of decedent must be reported on Schedule L
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. funeral $4,913.00
Myers Funeral Home - expense
6. ADMINISTRATIVE COSTS: I
,. Personal Recresentative's CommiSSions
Name of Personal Represenrative(s)
Social Security Nurnber{s)/EIN Number of Personal Representative(s) ...
Street Address
City Stale _Zip
Year{s) Commission Paid;
2. AttomeyFees to Snelbaker, Brenneman & Spare, P. C. 1,750.00
3. Family Exemption: (If decedel\rs add,gss \s not the same as claimant's, attach explanation)
Claimant
Street Address
City State _Zip
Relationship of Claimant to Decedent
4. Probate Fees to Register of wills 40.00
5. Accountanrs Fees and reserve for miscellaneous expenses 350.00
6. T<<Ile~!l(S{ Cumberland Law Journal - advertise
grant of letters testamentary 75.00
7. The Patriot News - advertise grant of letters
testamentary 103.15
TOTAL (Also enter on line 9, Recapitulation) I S 7,231.15
(If more space ls nela'Jed. insert additional sheets of the same size)
REV.l513EX'\S.C) ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RES10E.I.,IT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Irma E. Shel~
FILE NUMBER
21-04-0005
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers unoer
Sec. 9116 1'1 (1.211
Herbert Zink
540 Appalachian Avenue
Mechanicsburg, PA 17055
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
Son
1/3 of residue
2. Helga T. Walker
17 pine Hill Avenue
Mechanicsburg, PA 17050-1642
Daughter
1/3 of residue
3. otto Zink
8171 Somerset Street
Hummelstown, PA 17036-9316
Son
1/3 of residue
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE. ON REV.l500 COVER SHEET
/I 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 Is
(If more space is needed. insert additional sheets of the same size)
:~~ ~~<'; :f';;" ': . i . ~ - ~ .' l';~ ~ :' . I _ . '
'1....}J . . ri ~' t. ' .' ~ j~. --'
'ft". "" ' .
. .. ...." " ,,I" ',' , ....... ~ I ..... .
~ '. ~ " ..-
. ,
LAST WIl.1. ANn '['FS'!'MlI':NT
OF
!RM~~~
! I,:':f~HA E.~Hf.LBY. 'of 138 North J3nl StrL>L't, Camp lIill, Cllmh~rland
cou~ty. Pennsylvania. being of sound mind, nlL'mory and understanding, do
hereby make, Pllh] ish <:Iod dC!clare this to he my L<lst \.Ji It and 'I'L'stament.
hereby revoking any and all wills by me ht'rt.'ll)rilrl' nladl'.
ITEM J.
,os'
dir~cr tho'lt my funernl b,~ condl1cted in <I manner cnrrespon-
ding with my estate and situation in 11 ff:' and llwl a 11. my jm;t dehl!; and
funeral expenses be fully satisfied as soon as may be after mv decease.
ITE~ II. I give, devise, and bequeath all the rest, residue illld remainu-
er of my -estate, wheresoever situate, and whatsoever kind, whether it be reol,
personal, or mixed. llnto my loving husband, IlHICJlT H. SHELBY.
[n till' t'vvnt
that my loving husband, pWIGHT W, SHELBY, should pre-decease me, then and unly
then, do I give, devise and bequeath all the rCBt, residue, and rL'mainder I,j"
my'estate unto my surviving children: HERnERT ZINK; OTTO ZINK: HELCA WALKEn;
ELVIRA RESH: AND MANFRED ZINK, in equal shares, share and share alike.
.!..TEM_IIT, I nominate, constitute, and ilPptlint illY luving husband, IMIC]!T
H. SllI,:t.BY, In Ill' ;l11d ,11'1 :tS l'XI'l'lllot" 01 !hi~; IllY 1.;1~;t I.lill ;lI1d Tl'~;I,'IlIll'llt. III".
if my be tUVt'd hllsh.anu slla II prl'dl'cl'iISL' OJ". I 11UlU i 11,11 t', t'Ollst i lull" <llld ,Ippt' i III
my Iw loved son,
HEIUJERT ZINK, ;IS my ;tlll'I'll;l! (' t.'xl,t'ul 01". ^IHI lilY I'XI'l'lIlor
shall not be required to post any security for the performance of his dutics
us my executor, In case of their death, I appoint Otto Zink, or Helga Walker,
or E l.vira Hl'.sh u1 tcrn,ttl! executors.
. .
IN .HITNESS WHEREOF~ I have hereunto .set my 1I,1lld and seal this nth day uf
, .t,;.!~~ :~b~':'r:'
~ugust~')9Bl ;
--~~~Jij/g-<L_____
Intn E, Slll'llly U'
~.
"
~,
'!!lfi
","";~;'it',!~'I'; :'';J'','~r'~'':rl:l;';.; . "',,",:1~,C, N*:iI%V' '"
. . ;'::;~.*.J:~,':.;!t . " -Yi,/;;t". ?~:~ iii,,' ~f'>::'!~'}"'" ~,t h<1iF
"\)'h;:"J."~r :i'~ :1: .i!.;~",!t:r,'j!; ~~'$::;f"l;l';:;;:~,..:~~; '.
"f'"~:~"j~The!:preC~'ding~:T1ii~strun;ent'~'~:COnSisting of this and one other
:. --:ill:> ':;1,!.,c_;/':""'lJ "",.:{!;j'!i~,,':" \;""
.i "J:;'f;;.', ~'!l,:I: ;,~:! ,~<., '~t:,:;-,l:J~,,~.lt .::>'> ;";,~,;:~:",
page~ eac!f'"1dent:J.(,ied."qy_:.signature of the Testatrix, was on the date there-
':',:;:-~):- ,;~f:i:'!'l' j. ~ ),tl~,';-.':r~!r~iNi :'~~:::, '. r~";~~
::0,' ,( ~l, 'lf1 "'j\ ,.;,l~; ,f~ ,~;'t,'j'.:\l"~'*:i' "1',_' ,. 1':;"
:'()f.l,'signed'I'~!'sealed":'-and:published and declared by IRMA E. SHELBY, the Testatrix
,- i"-~~llb :~"1J!'1. .it~i~ . '; lt~" ",l;-<
': ~1:i1i~ ~\~~'lil~:t' :,fJ", ,~c oS '..;~,"
./ Fherein.c~amed, '~a or:iher: Last Will and Testament, in the presence of us.'
i_I:' b, I"'~', ,,<i.. " ~, " .',
"tt~ :t.,},,~ :nfJ~,.,;~nu ~~ 'Il'! _-'1.
~who at he~~lreques, n~her presence. and in the presence of each other. have
j"':'. .,' ~.fl~ 11)-.'!";.1L~1;V l,~~t';i !t:'; ,
" ".f 'lt~~.-; ,111' 1;,~:r,j[rf' ~~i'~ ...' L " "',
:Subscr1bed'fOur'/ witnesses thereto.
;;..!..~ ~ . . ,,~ ;';!fI~~
:1'...", ,;"''U$~' <f~::,'
"":,j'j',
..~. ,
-
'~'i~:
)T-:::"
typewri tte~"
':<:~;l~iH!i~;f
, :~":i "<:.. :t~l
~:::ir-i~:,
",';.:;;f:..t\.~,,~
'~":,,,,,,
'~Y~'~,~lt .
....1
.: :i'~.:!~fi~~~'lf~t~{la~JifJ
"'" . ",':.'l
'.
,i;t'0nD' 3: r:I..{u{f,,<
Irma E. Shelby ~
"",;
"",,,,
..'.,
~~i:[~Jr
'" :~~l1;
:~':f';'i:
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
Herbert Zink
being duly sworn according to law, deposes and says that he is the
RW~,,~T of the Estate of Irma E. Shelby
late of ............ S__i_l..v_er. Sp_r_i_n__q__Township , Cumberland County, Pa., deceased and that the
within is an inventory made by Herbert Zink , the said Executor
of the entire estate of said decedent, cons;sling of ali %he personal property and real estate, except real estate outs;de
fha Commonwealth of Penn,sylvan;a, end that the figures opposite each item of the Inventory represent it's fair value
as of the date of decedent s death.
Sworn to
COMMONWEAL3 H OF PENNSYLVANIA
Notana~ Sea~
Susan L Matraz~, Nota~J Pub~tc
Mechan~s, burg Bo~o, Cumberland County
My Comn~sson Expires Nov 24, 2007
Member Pennsylvania Assocmbon Of Notaries
Da{'e of Death
end subscribed before me,
2004
Herbert ZinE~
540 Appalachian Avenue
hechanicsburg,
Addr.,s
December 2003
Day Month Year
~ ~ ~ INSTRUCTIONS
I.~ A~ i~ven~ry ~6st be filed within three months after appolntment of personal representative
2.',~A~ypRlemen.~.~,nvenf~ory must be fded w~fh~n th~Hy days of d~scovery of additional assets.
3. ~;'o ~$;t%~ ~ may be aHached as fo personally or realty -= ~-
4. See Arhcle IV, F~duc~ar~es Act of 1949. ~ ~'
z
Inventory of the real and personal estate of
Trma R_ ~h~]hy
deceased
I. PERSON~L~Y
NONE
II. REAL ESTATE
NONE ,
........... ~6~At X~m~SED- VALUE:
ALL PROPERTY
NONE
NONE
NONE
COivtMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128 0601
RECEIVED FROM
BRENNEMAN KEITH O
44 W MAIN STREET
MECHANICSBURG, PA
17055
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 0O3639
~:'STATE INFORMATION SSN 192-34-5016
FILE NUMBER 2104-0005
DECEDENT NAME SHELBY IRMA E
DATE OF PAYMENT 03/04/2004
POSTMARK DATE 00/00/0000
COUNTY CUMBERLAND
DATE OF DEATH 12/17/2003
I~EMARKS
TOTAL AMOUNT PAID:
KEITH O BRENNEMAN, ESQ
INITIALS: AC
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $2.94
CHECK#2178
$2.94
SEAL
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
LAW OFFICES
SNELBAKER
BRENNEMAN
& SPARE
Name of Decedent
Date of Death
No 21-04-0005
To the Register
CERTIFICATION OF NOTICE UNDER RULE 5 6(a)
Irma E Shelby
December 17, 2003
I certify that notice of estate administration reqmred by Rule 5 6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned Estate on
January 8, 2004
Name Address
Herbert Zink
540 AppalacNan Avenue
Mechamcsburg, PA 17055
Helga T Walker
17 Pine Hill Avenue
Mechanicsburg, PA 17050-1642
Otto Zlnk
8171 Somerset Street
Hummelstown, PA 17036-9316
Notice has now been given to all persons entitled thereto under Rule 5 6(a) except None
Date January 8, 2004
Kelth 0 Brenneman, Esquire
Snelbaker, Brenneman & Spare, P C
44 W Main Street
Mechanlcsburg, PA 17055
(717) 697-8528
Counsel for Personal Representative
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVTSZON
DEPT. 280601
HARRISBURG, PA 17128-0601
KEITH 0 BRENNEHAN ESQ
SNELBAKER ETAL
44 W MAIN ST
NECHANICSBURG
CONNONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
iDATE 04-19-2004
ESTATE OF SHELBY
DATE OF DEATH 12-17-2005
FILE NUMBER 21 04-0005
:73~)~ UNTY CUMBERLAND
ACN 101
Amount: RemL~ced
PA 1705~
CUT ALONG THIS LINE ~
RE¥-1547 EX AFP
IRMA E
HAKE CHECK PAYABLE AND REMIT PAYMENT TO=
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
RETAIN LOWER PORTION FOR YOUR RECORDS ~
DZSALLO#ANCE OF DEDUCTIONS AND ASSESSNENT OF TAX
ESTATE OF SHELBY IRMA E FILE NO. 21 04-0005 ACN 101 DATE 04-19-2004
TAX RETURN #AS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE ZNTEREST- SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON:
1. Real Es~a~e (Schedule A)
2.
3.
5.
6.
7.
8.
ORIGINAL RETURN
(1)
S~ocks end Bonds (Schedule B) (2)
Closely Held S~ock/Par~nership In~eres~ (Schedule C) ($)
Hor~gages/No~es Receivable (Schedule D) (~)
Cash/Bank Deposi~s/Hisc. Personal Proper~y (Schedule E) (5)
Jointly Owned Proper~y (Schedule F) (6)
Transfers (Schedule G) (7)
To~el Asse~s
APPROVED DEDUCTIONS AND EXEHPTZONS:
9. Funeral Expenses/Adm. Cos:~s/Hisc. Expenses (Schedule H)
10. Deb~s/Nor~gage Liebili~ies/Liens (Schedule Z)
11. To,al Deductions
12. Nm'l: Value of Tax Re~urn
15.
1~.
(9)
(10)
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J)
Ne~ Value of Es~a~e Subjec~ ~o Tax
O0 NOTE: To insure proper
O0 credi~ ~o your account,
O0 submi~ ~he upper portion
O0 of ~h~s form wi~h your
O0 ~ax payment.
521661
411551.80
(8)
7,251.15
.O0
NOTE:
94,215.21
ZF PA/D AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
ASSESSHENT OF TAX:
15. Amoun'l: of L~.ne lq a~ Spousal ra~e
16. Amoun~ of L/ne lq ~axable a~ Lineal~Class A ra~e
17. Amoun~ of Line 1~ a~ Sibling ra~e
18. Amoun~ of Line lq ~exable a~ Colla:~erel/Class B ra~e
19. Principal Tax Due
TAX CREDITS:
PAYHENT RECEIPT DTSCOUNT (+)
DATE NUHBER ]:NTEREST/PEN PA:]:D (-)
02-27-2004 CD005615 195.71
05-04-2004 CD005659 . O0
(15) .00 x O0 = .00
(16) 86,982.06 x 045= 5,914.19
(17) . O0 X 12 = . O0
(18) .00 x 15 = .00
(19)= 5,914.19
ANOUNT PAID
5,725.00
2.94
reflect figures that /nclude the total of ALL returns assessed to date.
TOTAL TAX CREDIT J 3,923.65
BALANCE OF TAX DUEJ 9.46CR
INTEREST AND PEN. .00
TOTAL DUE 9.46CR
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT 1S RE~UZRED.
IF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR ZNSTRUCTZONS.)~
Zf an assessment was Lssued previously: lines 14, 15 and/or 16, 17, 18 and 19
(11) 7.2~1. IS
(12) 86,982.06
(15) . O0
(1~) 86,982.06
RESERVATION:
Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such futura interest.
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
To fulfill the requirements of Section 21~0 of the Inheritance and Estate Tax Act, Act 13 of ZOO0. (72 P.S.
Section 91~0).
Detach the top portion of this Notice and submit mith your payment to the Register of Hills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NILES, AGENT
A refund of a tax credit, which mas not requested on tho Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office
of the Register of Nills, any of the 25 Revenue District Offices, or by calling the special 2q-hour
answering service far forms ordering: 1-BO0-361-ZO50; services for taxpayers eith special hearing and / or
speaking needs: 1-soo-qqT-3Ogo (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 181021, Harrisburg, PA 17118-1011, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17118-0601
Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the dacedent's death, a five percent (51) discount of
the tax paid is allomed.
The 15Z tax amnesty non-participation penalty is computed on the total of the tax ~nd interest assessed, and not
paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (93 months and one (1) day from the date of
death, to the data of payment. Taxes which became delinquent before January 1, 1981 bear interest at the rate of
six (61) percent per annum calculated at a daily rate of .O0016q. AIl taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which et11 vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 200q are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ ~ .0OOSq8 1988-1991 11Z .000301 ZOOX 9Z .OOOZq7
1983 16Z .000~38 199Z 9Z .0002~7 2002 6Z .O0016q
198~ 11Z .000301 1993-199~ 7Z .000192 ZOO3 5Z .000137
1985 lSX .000~56 1995-1998 9Z .O00Zq7 200q ~Z .000110
1986 lOX .000Z74 '1999 7Z .000192
1987 102 .00027q 2000 7Z .000192
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shomn on the
Notice, additional interest must be calculated.
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Irma E. Shelby
Date of Death:
December 17, 2003
Will No.: 21-04-0005 Admin. No.'
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes ~ No [-]
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No. 1 is Yes, state the following:
Did the personal representative file a final account with the Court?
Yes _ No F'-I
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes ~1 No [--]
Date,~? June 7,
Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this repo~.
,_0o
Signature
Keith O. Brenneman
Nanle
44 W. Main Street
Mechanicsburg, PA 17055
Address
(717)697-8528
Telephone No.
Capacity: I--] Personal Representative
[] Counsel for personal representative
LAW OFFICES
SnElBakEr,
BrEnNEMAN
& SPare
ESTATE OF IRMA E. SHELBY
NO. 21-04-0005
RECEIPT AND RELEASE
WHEREAS, IRMA E. SHELBY, late of Silver Spring Township, County of Cumberland
and Commonwealth of Pennsylvania, died on the 17th day of DeCember, 2003, having first made
her Last Will and Testament in writing dated August 6, 1981, which since her decease was duly
probated before the Register of Wills of Cumberland County and Letters Testamentary were
issued to HERBERT Z1NK, the Executor named in the Last Will and Testament of said decedent.
NOW KNOW ALL MEN BY THESE PRESENTS, that we, HERBERT ZINK, OTTO
ZINK and HELGA T. WALKER, being the only surviving beneficiaries named in the Will of
said decedent and the persons entitled to share in the residuary distribution of the Estate of said
decedent, do hereby declare and say that we have examined the attached Account and Schedule
of Proposed Distribution attached hereto as "Exhibit A" and "Exhibit B", respectively, and find
the same to be true and correct, and in strict accordance with the terms and provisions of said
Will, and we do hereby acknowledge that we this day have, had and received of and from
HERBERT ZINK, Executor of the Estate of IRMA E. SHELBY, the cash and/or personalty, if
any, set opposite our names in the above stated Schedule of Proposed Distribution, in full
satisfaction, payment and discharge of all such sum or sums of money, legacies and bequests,
share or shares, purparts and dividends which were due, owing and payable and belonging to us
by any means whatsoever, for or on account of our full share, part orXli~Tidend of the Estate of
IRMA E. SHELBY, Deceased, and all interests accrued thereon.
I
LAW OFFICES
SNELBAKER,
BrENNEMAN
& SPARE
NOW, THEREFORE, we, the said HERBERT ZINK, OTTO ZINK and HELGA T.
WALKER, do by these presents, remise, release, quit-claim and forever discharge the said
HERBERT ZINK, his heirs, executors and administrators, of and from our said share or dividend
of the Estate aforesaid, and of and from all actions, suits, payments, accounts, reckonings, claims
and demands whatsoever, for or by reason thereof, or of any act, matter, cause or thing
whatsoever, from the beginning of the world to the day and date of these presents.
AND, desiring to avoid the delay and expense of the settlement of said Estate by filing a
formal Account of said administration in the Office of the Register of Wills of Cumberland
County and by having any balance in the hands of the Executor, as shown by said Account,
distributed by the Court of Common Pleas of Cumberland County - Orphans' Court Division, we
do hereby agree that the foregoing schedule concerning the matter of settlement may be recorded
with the same effect upon us as if the same had been reported upon by said Court, in a Decree of
Distribution made on such report by the said Court of Common Pleas - Orphans' Court Division.
AND in consideration of the aforesaid settlement being made without the aid of such
Court of Common Pleas - Orphans' Court Division, that we, the undersigned, do hereby agree
that if any debts or demands other than those included in the First and Final Account of the said
HERBERT ZINK, Executor of the Estate of IRMA E. SHELBY, Deceased, as hereinbefore set
forth, shall be hereafter recovered against the Estate of said decedent and be legally payable out
of the same, that we will return to the said Executor such amounts thereof as may be necessary to
pay such debts or demands.
-2-
LAW OFFICES
SNELBakEr,
BRENNEMAN
& SPARE
IN WITNESSWHEREOF, we have hereunto set our handsand seals the respective dates
as set forth below.
WITNESSED BY:
Herbert 3i2r~k_ ~
Date:
(SEAL)
(SEAL)
Hefgh)'<~a. iker .
Date:
-3-
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND )
SS.
On this the O2"7'~'~ day of /0"],~r.// ,2004, before me, a Notary Public in and
for said Commonwealth and County, the undersigned officer, personally appeared HERBERT
ZINK, known to me (or satisfactorily proven) to be the person whose name is subscribed to the
within instrument and acknowledged that he executed the same for the purposes therein
contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
Notary Public
My Commission Expires:
LAW OFFICES
SNELBAKEr,
BreNNEmaN
& SpAre
~COMMONWEALTH OF PENNSYLVANIA
J Notadal Seal
| Susan L Malmzi Notary Public
~ Mechanicsburg Bom ~n~ ~'~,-~,,
ti, MY ~ ~ Nov. 24", 2'"'~"
Member, Pennsylvania Association Of Notaries
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND )
SS.
On this the c9 ?-e,~ day of ,~,q t~ ,2004, before me, a Notary Public in and
for said Commonwealth and County, the undersigned officer, personally appeared HELGA T.
WALKER, known to me (or satisfactorily proven) to be the person whose name is subscribed to
the within instrument and acknowledged that she executed the same for the purposes therein
contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
Notary
My Commission Expires:
LAW OFFICES
SNELbAkEr,
BrENNEMan
& SPAre
COMMONWEALTH OF PENNSYLVANIA
j- Notarial Seal
~ Susan L. Matmzi, Notary Public
I , ~IVI~. ~n_icsl~. ~ Bo~o_, Cumberland County J
J. w~ybomn'~s~on~Nov. 24,2007 J
Member, Pennsylvania Association Of Notaries
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND )
SS.
On this the 3rd day of June, 2004, before me, a Notary Public in and for said
Commonwealth and County, the undersigned officer, personally appeared OTTO ZINK, known
to me (or satisfactorily proven) to be the person whose name is subscribed to the within
instrument and acknowledged that he executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
' -~'"- Notary~
My Commission Expires:
LAW OFFICES
SNELBAkER.
BrENneMAN
& Spare
FIRST AND FINAL ACCOUNT OF HERBERT ZINK,
EXECUTOR OF THE ESTATE OF IRMA E. SHELBY,
DECEASED, LATE OF SILVER SPRING TOWNSHIP,
CUMBERLAND COUNTY, PENNSYLVANIA
HERBERT ZINK, EXECUTOR and Accountant herein
avers as follows:
DATE OF DECEDENT'S DEATH:
DATE LETTERS TESTAMENTARY ISSUED:
December 17, 2003
January 5, 2004
DATES EXECUTOR'S NOTICE ADVERTISED:
The Patriot-News Co.:
Cumberland Law Journal:
January 27, February 3 and 10, 2004
January 16, 23 and 30, 2004
Date of Rule 5.6(A) Certification:
January 8, 2004
PERSONALTY - PRINCIPAL ACCOUNT
DEBITS
The Accountant charges himself with receipt of the Decedent's personal
property as follows:
TOTAL, PERSONALTY PRINCIPAL ACCOUNT, DEBITS:
NONE
NONE
LAW OFFICES
SNElbAKEr,
BRENNEMAN
& SPARE
EXHIBIT A
PERSONALTY - PRINCIPAL ACCOUNT
CREDITS
Accountant claims credit for payment of the following items from
personalty principal:
Funeral Home - Funeral expense:
Brenneman & Spare, P. C., reimbursement for
costs advanced:
Register of Wills - probate fee
Cumberland County Law Journal - advertise
Executor's Notice
Patriot News - advertise Executor's Notice
Federal Express fee
Total:
Brenneman & Spare, P. C. - attorneys fees:
for filing final account, miscellaneous expenses
TOTAL, PERSONALTY PRINCIPAL ACCOUNT, CREDITS:
$ 40.00
75.00
103.15
4.42
$4,913.00
$ 222.57
1,750.00
$ 35O.OO
LAW OFFICES
SNELBAKER,
BRENNEMAN
& SPARE
-2-
PERSONALTY - INCOME ACCOUNT
DEBITS
Accountant charges himself with receipt of the following items of
income from personalty:
PERSONALTY INCOME ACCOUNT, DEBITS:
NONE
NON_. E
_PERSONALTY - INCOME ACCOUNT
CREDITS
Accountant claims credit for payment of the following items from
personalty income:
PERSONALTY INCOME ACCOUNT, CREDITS:
NONE
NON_____E_E
REAL ESTATE - PRINCIPAL ACCOUNT
_DEBITS
Accountant charges himself with receipt of the Decedent's Real
Estate as follows:
REAL ESTATE PRINCIPAL ACCOUNT, DEBITS:
_NONE
NON.. E
LAW OFFICES
SnELBAKEr,
BrENNeMAN
& SPARE
-3-
REAL ESTATE - PRINCIPAL ACCOUNT
CREDITS
l'he Accountant claims credit for payment of the following items
from real estate principal:
TOTAL, REAL ESTATE PRINCIPAL ACCOUNT, CREDITS:
.NONE
_NONE
REAL ESTATE - INCOME ACCOUNT
DEBITS
Accountant charges himself with receipt of the following income
from real estate:
TOTAL, REAL ESTATE, INCOME ACCOUNT, DEBITS:
NONE
NON_ E
REAL ESTATE - INCOME ACCOUNT
CREDITS
Accountant claims credit for payment of the following items from
real estate income:
REAL ESTATE INCOME ACCOUNT, CREDITS:
NONE
NON~
LAW OFFICES
SNEIBakEr,
BrEnNEMAn
& SParE
-4-
LAW OFFICES
SNElBakEr,
BRENNEMaN
& SPare
RECAPITULATION
I. PERSONALTY
A. PRINCIPAL ACCOUNT
Debits NONE
Credits $7,235.57
Balance
B. INCOME ACCOUNT
Debits NONE
Credits NONE
Balance
C. NET BALANCE OF PERSONALTY:
[I. REAL ESTATE
A. PRINCIPAL ACCOUNT
Debits NONE
Credits NONE
Balance
B. INCOME ACCOUNT
Debits NONE
Credits NONE
Balance
C. NET BALANCE OF REAL ESTATE:
II. NET BALANCE OF ESTATE FOR DISTRIBUTION:
-5-
($7,235.57)
NONE
NONE
NONE
($7,235.57)
NONE
NONE
1AW OFFICES
SneLBakEr.
BrEnNEmAN
& SPARE
1. To:
2. To:
3. To:
SCHEDULE OF PROPOSED DISTRIBUTION
Herbert Zink per Item II of Decedent's Will:
Otto Zink per Item II of Decedent's Will:
Helga T. Walker per Item II of Decedent's Will:
TOTAL DISTRIBUTION TO BENEFICIARIES.
EXHIBIT B
-6-
NONE
NONE
NONE
NON_ E
LAW OFFICES
SNeLbakEr,
BrENNEMAN
& SParE
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND )
SS.
HERBERT ZINK, being duly sworn according to law deposes and says: that he is the
Executor of the Estate of IRMA E. SHELBY, Deceased; that he is the Accountant herein; that the
foregoing Accounting is true and complete; that the attached list or schedule [*] contains the
names and addresses of all persons who have given notice of their claims, and whose claims
remain unpaid; that the attached list or schedule [**] contains the names of all persons interested
in the distribution of said Estate; and that the facts set forth in the within Account are true and
correct to the best of his knowledge, information and belief.
Sworn to and subscribed before me this
,.~c~,tday of /~;/9 ?~' ,2004.
Notary Public j
* Persons having claims against Estate:
None
Herbert Zink
(Executor and Accountant)
_COMMONWEALTH OF PENNSYLVANIA
· Susan L Matrazi, Notary Public
nay t.,ornrnissi(~ Expires Nov. 24, 2007
Member, Pennsylvania Association Of Notaries
** Persons interested in distribution of Estate:
Herbert Zink
540 Appalachian Avenue
Mechanicsburg, PA 17055
Helga T. Walker
17 Pine Hill Avenue
Mechanicsburg, PA 17055-1642
Otto Zink
8171 Somerset Street
Hummelstown, PA 17036-9316
-7-
BUREAU OF 'rNDZVZDUAL TAXES
THHERZTANCE TAX DTVTSTON
DEPT. Z80601
HARRI'SBURG,, PA '171Z&-0601
COMMONNEALTH OF PENNSYLVANZA
DEPARTMENT OF REVENUE
ZNHERZTANCE TAX
STATEMENT OF ACCOUNT
REV-i&07 EX AFP C01-05)
KEITH 0 BRENNEMAN ESQ
SNELBAKER ETAL
qq N MAIN ST
MECHANICSBURG PA 170S5
DATE 05-17-200q
ESTATE OF SHELBY
DATE OF DEATH 12-17-200:5
FZLE NUMBER 21 0q-0005
COUNTY CUMBERLAND
ACN 101
Amoun'lc Rem i'l:'l:ed
IRMA E
MAKE CHECK PAYABLE AND REMZT PAYMENT TO:
REGTSTER OF NTLLS
CUMBERLAND CO COURT HOUSE
CARLTSLE, PA 1701:5
NOTE: To insure proper crmdi~ ~o your account, subei~ ~che upper por/(:ion of ~his form wi~h your ~ex payment:.
CUT ALONG TH'rS LZNE ~* RETAZN LONER PORT'rON FOR YOUR RECORDS ~
REV-1607 EX AFP (01-03) ### 'rNHER'rTANCE TAX STATEMENT OF ACCOUNT NJ(#
ESTATE OF SHELBY TRMA E FZLE N0.21 0q-0005 ACH 101 DATE 05-17-200q
THZS STATEMENT ZS PROVZDED TO ADVZSE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAMED ESTATE. SHO#N BELO#
ZS A SUMMARY OF THE PRZNCZPAL TAX DUE, APPLZCATZON OF ALL PAYMENTS, THE CURRENT BALANCE, AND., ZF APPLZCABLE,
A PROJECTED ZNTEREST FZGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 0q-lZ-Z00q
PRINCIPAL TAX DUE: ..........................................................................................................................................................................................................................
PAYMENTS (TAX CREDITS):
:5,91q.19
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID ¢-) AMOUNT PAID
OZ-Z7-200~
0:5-Oq-200q
05-0:5-200q
CD00:5615
REFUND
ZF PAZD AFTER THZS DATE, SEE REVERSE
SZDE FOR CALCULATZON OF ADDZTZONAL ZNTEREST.
( ZF TOTAL DUE ZS LESS THAN $1,
NO PAYMENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A 'CREDZT'
195.71
.00
.00
:5,725.00
Z.9q
9 .q6-
TOTAL TAX CREDTT
:5,91q.19
.00
BALANCE OF TAX DUE
ZNTEREST AND PEN. .00
TOTAL DUE .00
YOU MAY BE DUE A REFUND. SEE REVERSE STDE OF TH'rS FORM FOR TNSTRUCT*rONS. )
PAYNENT:
Detach the top portion of this Notice and submit with your payment made payable to the name and address
printed on the reverse side.
-- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF NZLLS, AGENT.
-- If NON-RESIDENT DECEDENT make check or money order payable to: COHHON#EALTN OF PENNSYLVANIA.
REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications are available at
the Office of the Register of gills, any of the 15 Revenue District Offices or from the Department's Z~-hour
answering service for fores ordering: 1-800-561-ZOSO; services for taxpayers with special hearing and / ar
speaking needs: 1-800-~7-5010 (TT only).
REPLY TO:
Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau
of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 180601, Harrisburg, PA 17128-0601, phone
(717) 787-6505.
DISCOUNT:
If any tax due is paid within three (5) calendar months after the decedent's death, a five percent (51) discount
of the tax paid is allowed.
PENALTY:
The 151 tax amnesty nan-participation penalty is computed on the total of the tax and interest assessed, and nat
paid before January 18, 1996, the first day after the end of the tax amnesty period.
INTEREST:
Interest is charged beginning with first day of delinquency, or nine (9) months and one ([) day from the date of
death, to the date of payment. Taxes which became delinquent before January l, 1981 bear interest at the rate of
six (61) percent per annum calculated at a daily rate of .000i6~. Ali taxes which became delinquent on and after
January l, 1981 will bear interest at a rate which wil! vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for [gBz through ZOOq are:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year__ Rate Factor
1981 201 .0005~8 1988-1991 11Z .00050! 20Ol 91 .0002~7
1985 162 .O00~SB 1992 92 .O00Z~7 ZOOZ 62 .00016~
198~ 11Z .000501 1995-199~ 7Z .O0019Z ZOO5 5Z .000157
1985 152 .000556 1995-1998 92 .O00Z~7 200~ ~Z .O00110
1986 IOZ .O00Z7~ 1999 7Z .O0019Z
1987 9Z .OOOZ~7 ZOO0 8Z .000219
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.