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HomeMy WebLinkAbout07-28-08 (3) n REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes ~ INHERITANCE TAX RETURN PO BOX 280601 Harrisburg, PA 17128-0601 RESIDENT DECEDENT ~ ' ~ ~ ~ ~ r ~'-3 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth boy D3 ~7y~ ~o~$~007 0~~,""~ yak. Decedent's Last Name Suffix Decedent's First Name MI s~~~~~ti ~- ~~~ ~- A M (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI 15056051047 Spouse's Social Security Number THIS RETURN MUST SE FILE D IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death prior to 12-13-82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required death after 12-12-82) ~ 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust Q 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach 5ch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Te{ephone Number l~Ar3tZ-Cr M co~~I~D 7i7 ~s~~~~.~ Firm Name (If Applicable) First line of address y98 S1-~Cnw~©D U~ Second line of address City or Post Office State ZIP Code rv REGI , _ }j.QF WILLS E~E ONLY `.~ ~.. ~ -- r __: 1~- ' _ ' _~7 }`_ C~ ~. - - J ; ._.. ,~ - DATE FILER- `~ ~~ i 5 Correspondent's a-mail address: f~ ~ ~ I-! C(~~ ~~/~ ~ ~ ~~ / -/ ~G 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. SIGNATURE OF PERSON RE PONSI E FOR FILING RETURN DATE ~. ADDRESS SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLX 15056051047 Side 1 15056051047 ~~~ 15056052048 REV-1500 EX / ~ / /~/~ j /~ /~ /~ Decedent~',sJ Social Security Number Decedent's Name: ~ V ~ L. ~ ~ / 1 S /~ ~ / ~ 1T /~~ ~ RECAPITULATION i. Real estate (Schedule A) . ............................................ 1. 2. Stocks and Bonds (Schedule B) ....................................... 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) ............................. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ........ 5 6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6. 7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) O 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) .............................. 12. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 13 3~f 3;~ 7•~ 9 • d ~~ ~. y y 1 ~ i ~• 3 `~ ~7 '~• ~~ 14. Net Value Subject to Tax (Line 12 minus Line 13) ..................... ... 14. 3 ~ ,,~, ;~ y ~ ~; y ~, TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 16. Amount of Line 14 taxable at lineal rate X .0 ~_ r ~~ ~ ~ ,3 . ~ ~ 16. , ~ ~ !j ~ ,' 17. Amount of Line 14 taxable at sibling rate X .12 • 17. s 18. Amount of Line 14 taxable at collateral rate X .15 • 18. 19. TAX DUE ....................................................... .. 19. ~ ~ +;7 rJ •~ •, ~ ~+ 20. FILL tN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ~} 1\\ J l ' ~ ~ ~- ~, ~~~ Side 2 15056052048 15056052048 J REV-1500 EX Page 3 File Number ueceaenrs Lompiece p-aaress: ~ ~- U -~ .- ~ ~ - DECEDENT'S NAME STREET ADDRESS CITY STATE ZIP Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) ~S~ ~.~"3 , /,~ 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 3. InterestlPenalty if applicable D. Interest E. Penalty Total InteresUPenalty (D + E) (3) 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. (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) r .~ ~ .~j ~ . / A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) ~ jA ~' •5 ~ , / - --T Make Check Payable to: REGISTER OF W-LLS, 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 : ..................................... ...... ^ c. retain a reversionary interest; or .................................................................................................................... ...... ^ d. receive the promise for life of either payments, benefits or care? ................................................................ ...... 0 ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................................................................................................ ...... ^ 3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death? ........ ...... ^ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................................................................................................ ....... ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHE[)ULE 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. §9116 (a) (1.1) (i)}. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and 1'.he statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is zero (0) percent [72 P.S. §9116(x)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(x)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. §9116(x)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. . ,- _ v, , ,, _ .. cc--=~ 1'.' !. HANOVBI~ ITRtRT „-,,:- _.... - .. ,.... - CARLISL.B, PA. 17013 ^~w i~ J '~ 7 I T 1 ~1. Ti1.1~~'i_£2)`~,~ Q r C, .-c~1E'.. °_': ~10:?21 ~+~1 i +? ~ t~'-L~a!..~-.i'~! ir, ')L1T1C,~~ _ ~~..i't `~T1.".'~r1..=3~ +'-'_.1' j C)~. ~~iOL~T?:~ +i'-~..~ -!~ +T1E~rO't'~' ;IT.iC'. _1ilr-,nYSt:,'1T'.'-~:LTt'i~ '?.Q _:r~. l<<~• ~-1l ~?~-_~i'? ~a 1Cl '~iPC 121:'(_' t~i1 :'__ aS ~3 T'.ry j"C L' i7J _~~a S'i_ 'l l.L ~_31~.+-. ..~£'::i tcl ,1='I1ty ~.°i°Fjy ~-t~~7fJl- i.ia'~T 2f1.~_1 (~?''~ lid;, V~~-l` Gi-~ ~ f:l~i?i:~',± .'111.,'3 ~`~ r1 E? c C U •~ `i1 SJ. ?"t lii~ L~. a. f~(, l_~7 .r. ~ 1_ ~ ii~.~ -t.~ s -.~n}'~,, "t l~_r~ct x,11 mi.> >,l~r ~~bts ,t1.~ flnet'al e.<,t;~i~~~~ ~? -tt i ~ `I i"': a-i r1 ~~.~-~ `..:2i_ .S ~'_C)~:~ G'_l~' (:1.1. Ry ~~~C2~2 ~y "lti fi•~Z':iCl'1ci~. ~"r~'i7Z"n_ / / t y~ yy y.~ _ry ~ry T i ~ • l,_~)~ ~~-. ~_.. ..t. L, .l cl t~.l. ~.. :7 .~1~1) t. ..~ i12 ~!.1~ t~1t1 S...~ ~ t'.l `_'}i"7 ~>r ~Ai. ll t). _ ..._ J G: J~ ~i~ "'~'7 '-(-~(7"t 1'Jn c~r't'~ ~;~1~11 L?c`~ j.'. E.? ~ 1_J_ U ~ ~I !~. ~~ .r"a. S l„%~ 1.. ~'~ .°!'U^ 1 _ , ul~~': ~ ' i. C'T` ~ J ~ ~-!': "~ T __l'_ e't.`at? • ~ ~ t'_e~?"1^ V , •, . >'.11.2.'?a:l ~ .~ ~ ,G .11< ~,T~?~, 1.r,-' ~ >~;>>rt`= t~+.a+~ ;nv 9a ~ -i '..:;wl~;r;~tn;i ~,_,~_1~c~~a~ ~ c'~, t11,°n T ,;'i_ c. 211Ci ~'~:1C!11~'.ct 1~t7 +~L`!~ 31.1 ti. G_~ t~dC% i1!!?"+.i"Y';t'.C~ r" y ' ~ _ i~ ~. Ti'.!.'_t (~ ~. i:i~ ,'.~ t~l i.=£'. ~ ;i!,c3 i r 11t). ;>F'%'`.'Si?1i~ .~ ~ :i? .,j C''Cl-~ .~7'c':1 ._'l. ~_C~t12~ ;:,i12:~cS OY_' %?~F'1s .S I~%~~~i.~J'D~ I~C~LClc"3 ~O ~8C~1 ;~ %I'.E? 'L'~' ~ ~ 1'1..5 ~. X5171. c+T'ti~! C~ " ~j_ r,` ~ .1.,.,y~j Sty 2f1~:~ i"iC~<:~Lif 1 =1: 1. S .. r~ i.l ° . { ~ 'L~-,• ~" !"iC~'l?1*?~3~ i:t)T'`i1~ii-lif~;_ ~:~.~~ lt''1?()il?~.. '1'J 58'_~i 111..151")i"1C1 1y t,., ~ _ _ ~' it I .z. ._ +.-. :'S ~:1;;'l~+ .. - - __. _ _, . . ~. _ . , _. , . . ,.. .- .~. -. ,,. Y _ ,. _ 1 ~- - 1 ~ F~i ~ _ _ ~, % '~ ' REV-15Q8 EX+ (6-98} COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, 8 MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER LUELLA M SHUMAN 21-07-1153 Include the proc~ds of litigation and the date the proceeds were received by the estate. Ali property jointlyowned with right of survivorship must be disclosed on Schedule F. (it more space is needed, insert additional sheets of the same size) _._..__. ,__ _ _._._..,_.. .. ,. , q. _ ~ ~ r ~~a~a / Wi''`t' ~ ~. ~ ~ _ ' ~ , ~ . ' ~' .. ,.._. t .•, . .. ~.. , .. ~ - =- _. .. ~ ~ -, . .. , ., ~r . - -_ _~ ; _ ~. _ /~ ~ ! _ ~ ` .... _ u ~.~ ~ /~ ~~ ,~- a'... .~ -' ~ ,_. -' . ,, I -~ ,i~i ,._. ,! r /~ ~ , ~ ~ v_ ~' i :~ ,. ..,, _: i ~, -_ •- _ -- r L°- i . / E ~~ :~. _ ~ .. _ .o- ~ -' ~' _ ~, ~ . ' .. '`i ~ „ , /~r~".r _ ..~= -- t,..~- h. ~ ,.. ,. ~'' .- 7`?~... 1~ ~r`~". ~ ~ ..~ ...~ hy'~„/~_r re.. ~. L~".,,,~_~ ~ ~ l ~ ._~` ~- r .. l~ / ' / ~~• y f f , ~ t, ~: ' ~ % ..rte _. ... ... ~ «, _ ~ I~ ~ `T '~ . '` ~ ~ ~ ' ~`. ~~ ~ ' ' ~ ~ ' !° • i . ~ _. ~ fi .~.fL:.l ~, , -- -+" C... ~., : , e:~ 4 ----~ "s'r .: t ., ~ ...r '. c„~ # r ~ .,/ ',. 6 4~ ~, ~/' ---~ ~= --C `~ ~$f. c ~~c., , L., ' ~ x.~v " "~ ,. v ~ , ~~ r,. ~~ L BRUNSWICK PRINTING (215) 322-1115 Te15a6 Retail Installment Contract and Security Agreement (umtxrland Valley Memorial Gardens fa Riverview Memorial Gardens [7 Tri-County Memorial Gardens [_1 Westminster Cemetery ~ 7 . Gl ' 1921 Ritner Highway 3776 Peters Mountain Rd. 740 Wyndamere Road 1159 Newville Road - ~ Y ~J ' Carlisle, PA 17013 Halifax, PA 17032 Lewistxrry, PA 17339 Carlisle, PA 17013 Contract N 717-243-3541 717-896-3272 7I7-938-3435 717-249-2029 THIS AGREEMENT, made by and between Seller and Lie=Li./-~ ~SN~~/ljg~ (Pleax PrinQ- (hereinafter called the "Purchasel") W ITNESSETH THAT Purchaser agrees to buy and Seller agrees to sell to Purchaser, or his designated beneficiary in accordance with the terms hereof, the following items to be provided or used at the above checked location (hereinafter called "Cemetery'"). In consideration for Seller binding itself to provide the items with- out regard to the actual cost and price of said items prevailing at the time of performance hereunder, Purchaser agrces that this Agreement shat{ be irrevocable. 1. DESCRIPTION OF BURIAL RIGHTS. The Burial Rights covered by the Agreement are shown by the map of such garden/building on file in the office of the CEMETERY, and are more particularly described below. The purchase price o[ Burial Rights does not include IntermentlEntombment/Inurnment Fees (opening and closing costs}. _ Burial Rights in _ Grave Spacels) ~ *Mausoleum: C] Chapel C 1 Garden I_] Tandem (l Side-by-Side I 1 Single ___~ Lawn Crypt: f 1 Douhlc Depth I l Side-by-Side L l Developed (I Preconstruction ^ Single C1 Developed U Preconswction ~ Niche: ^ Chapel l_I Garden I { Single t i Companion I. I Developed I I Preconswcuon •Mnrimum tnske! dimensions are: (engrh 85", width 29", height 26" 1st Choice 2nd Choice 1st Choice 2nd Choice Gazden Building ----------- ___-__---__-_- Section ~---- Section __ __. _ `.~_.. __.___. __ ___- ------ ---- --- No.(s) -- --- - --- ---- Lot -- --- - -_------ -------_------- Level _ __ -- - - - _ _--- Space(s) - - _----- - - -- ---- - - _ _ _ -- _ _- _ _ - 3, ITEMI7,ATION OF CHARGES 2. MERCHANDISE (A) Burial Rights (aa described in Para. 1 above) ___. $ _. ___'_~? _-'__--. _ _ (7 Check here i(merchandise is being purchased for use at another cemetery. iB) Perpetual Care $ - ~'" Cemetery's Name: (C) Less Certificate Discount $ - ~" _ -v -- A. YAULT(S} #1. Description ___-._--__-_ #2. Description_-- -_.___ _ B. URN(S): #l. Description _ _ #2. Description -- C. MEMORIAL INFORMATION: Memorial Design: Bronze Size X Granite Size Location (Section, etc.) D. MONUMENT INFORMATION: type: Color: Size: x x _ Die: x x _ Base: x ~ x _ E. CASKET(S): i T t ~ 1. Model: ~1~~ ~ Type: _-, (11)~coad Ri~hl of Interment $ _._ _..--- _--^ _ - c y f .. _._ _ (G) Magsol~utt>aLettering(Crypt Plate $_'__' -_-- ~ f (H~ Meri)orip nument $ _~°~_ . ~~ ,i (J) Instal(ayem C azge .~ -_- $ __ `, 4 ~ 5 oN~-f~;~,M`~ _-~_-$ X530 _ o_ S s Vase: Y J N ---" 7~ ,O l -" ( Interrrren nt bment/ln~ ment Fees __~^ $ D _...-- - (M)P ecords & Processing Fee ! S _ 95.00 _. -'' (N) Other .~-._.__ _ __ _~ .. (O) Sales Tax $ -- G- -- 4. TOTAL CASH PRICE (A THRU O) $ _ .~~.~~?~ - P P P Model # R"~~ - ~ /! FINANCED (1) Total Cash Price (2} A. Cash Down Payment B. Trade In: Old Agreement No. C. Total Down Payment (2A + 2B) (3) Unpaid Balance of Cash Price (1 2C) $ ,~35J $ -~~-pO- $ _~ ,- - -- -- _ $ oZ'~.Y7,OD /~meriChoice '~ FEDERAL CREDIT UNION Building Relationships. For Life Jufy 25, 2008 RE: Account number:23919 To Whom It May Concern: This is to inform you of all owners associated with account 23919. The following names are all owners on the account: Luella Shuman Harriet Conrad Paul Shuman The following balance information was the balance in the accounts as of 10/28/2007: 23919-01 $54,361.35 23919-13 $2,449.25 23919-60 $28,217.31 23919-61 $5,221.97 Sincerely, 7~~ Jarod Buck Head Teller 2175 Bumble Bee Hollow Rd Mechanicsburg, Pa 17055 717-697-3474 jbuck@americhoice.org E N D E R ___ _.__.~ ~t.~in f)ffice: % I ~ I~~.n~ , ~, .~ t i„II~:~,~ I~u~~~l ti'.~ ~ hh,u~i, ~,l~~u~_;, I';l lei>> Phone: ~ ~1 , ~,'3:~ ;-t '-I f~x• ~ _ i ,)_. ;-~ , ,~. i REV-151(1 EX+ (6-98) COMMONVdEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER LUELLA M SHUMAN 21-07-1153 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. ITEM NUMBER DESCRIPTION OF PROPERTY iVC._UDE THE Vk;~E OF THE TRAYSFEREE. THEtli RE1sTNV5HIV TO DECEDEViAVD rHE DnrE of rRavsFER. nTmcHacovr of rr~E DEED FDR REAESTATE. DATE OF DEATH VALUE OF ASSET °~6 OF DECD'S INTEREST EXCLUSION nF nvP~~cas~E~ TAXABLE VALUE ~~ PROPERTY: 498 SHERWOOD DR. CARLISLE PA. JANUARY 31 1996 , 328 OUQ 00 MAP CODE 21-45-0431-014 PAUL ESHUMAN -SON HARRIET M. CONRAD -0AUGHTER $268,840.04 ASSESSED VALUE X 1.22 CUMBERLAND COUNTY COMMON LEVEL RATIO $327,984.84 ROUNDED TO 328,404.00 TOTAL (Also enter on line 7 Recapitulation) ; ~ 328,000.00 SCHEpULE G INTER-VIVOS TRANSFERS & M15C. NON-PROBATE PROPERTY (If more space is needed, insert additional sheets of the same size) •. MAKE CHECKS PAYABLE TO: .i'enny G. Davis 158 Fieldstone Dr Cartisle~PA 1701.5 THIS TAX IS DUE AND PAYABLE, YOU ARE HEREBY REQUESTED TO MAKE PAYMENT THEREOF. SHUMAN, PAUL E & HARRIET M CONRAD 7647 WERTZVILLE ROAD CARLISLE, PA 17015 TAX PAYER'S COPY • I~Fp THIS PORTION FOR YOUR RECORDS MUNICIPAL CODE: Middlesex Twp. BILL DATE: 7/01108 PROPERTY: 498 SHERWOOD DRIVE BILL NO: 2489 MAP CODE: 21-05-0431-010 TAXES PAYABLE TO: TAX MILLS: 9.721 Penny G. Davis gSSESSED VALl1E~ Q26R.R40 ssessed Land Values 515,650 Ho ste d Exclusion Improvement 8253,790 Mineral go Total $268.840.00 $0.00 F rm t lusio 0.00 Cumberland Valley SD Discount Face Penal Rates .009721 SCHOOL. R!E $152.13 .009721 $2,461.26 2 % $2,613.39 10 Homestead Credit 0.00 Farmstead CredR $0.00 TAX AMOUNT DUE-~ 52,561.12 52,613.38 52,874.73 ff Pald On or Before 8/15/2008 9/15/2008 10!15/2008 ND CHECKS ACCEPTED 15 FIRST PAYMENT SECOND PAYMENT FINAL PAYMENT N/A N/A N/A NO DISCOUNT 9115108 nor Before I~f/PS D8 n or Before ~0/75/08n or Before I _I_t _ $ Return Bill with Payment. For a Receipt, ~ •' ~ • • Tax Collector Signature Date Paid Amount Paid Enclose aself-addressed stamped envelope ~~a r~ ~ ~~ • Tax Parcel No. DEED MADE THE 3~'~ day of ~~~~'~`'~~ , in the year of Our Lord one thousand nine hundred ninety-six (1996) BETWEEN LUELLA M. BHUMAN, widow, of 498 Sherwood Drive, Carlisle, Cumberland County, Pennsylvania 17013-9026, GRANTOR, and PAUL 8. BHIIMAN, of 254-A Govdhart Road, Shippensburg, Pennsylvania 17257, and HARRIET M. C~J1tRAD, of ?647 Wert2ville Road, Carlisle, Pennsylvania 1?013-9057, GRANTEES WITNESSETH, that in consideration of Clne and no/100 ($1.00) Dollar in hand paid, the receipt whereof is hereby acknowledged, the said Grantor does hereby grant and convey unto the said Grantees, their heirs and assigns, as tenants in common, ALL THAT CERTAIN improved tract of land situate in Middlesex Township, Cumberland County, Pennsylvania, bounded and described as follows: BEGINNING at a stone in the public road leading to Hoover's Mill; thence along said road, South 40 degrees 38 minutes East 448.6 feet to a paint; thence North 0 degrees 58 minutes East 390.2 feet to a post; thence North 78 degrees 8 minutes East 1,320.5 feet to a post; thence North 5 degrees 59 minutes East 709 feet to a past; thence South 79 degrees 23 minutes West 2,071.7 feet to a past; thence South 3 degrees 47 minutes West 747.2 feet to a point in a public road leading to Carlisle Springs; thence along said road, North 76 degrees 48 minutes East 4tT~":~feet fo a stone; thence North 73 degrees 28 minutes East 28.5 feet to a stone in the public road leading to Hoover's Mi11, the place of BEGINNING. CONTAINING 34.35 acres. THERE 1S EXCEPTED from the above described premises the following tracts of land: A. ALL THAT CERTAIN premises consisting of approximately 1.21 acres which Harry A. Shuman and Luella M. Shuman, husband and wife, by their deed dated February 20, 1965, and recorded in the Office of the Recorder of Deeds in and for Cumberland County in Deed Book "M", Volume 21, Page .~ 69b, granted and conveyed unto Richard J. Conrad and Harriet M. Conrad, husband and wife. B. ALL THAT CERTAIN premises consisting of approximately .69 acre which Harry A. Shuman and Luella M. Shuman, husband and wife, by their deed dated July 6, 196?, and recorded in the Office of the Recorder of Deeds in and for Cumberland County in Deed Book "R", Volume 22, Page 398, granted and conveyed unto James F. McGarry and Gaii S. McGarry, husband and wife. BEING the same premises which Luella M. Shuman, Executrix of Harry A. Shuman, deceased, by her deed dated March I4, 1991, and recorded in the Office of the Recorder of Deeds in and for Cumberland County, in Deed Boak "Z", Volume 34, Page 1030, granted and conveyed unto Luella M. Shuman, the Grantor herein. This conveyance is a transfer from parent to children and is exempt from Pennsylvania realty transfer taxes. AND the said Grantor hereby covenants and agrees that she will warrant SPECIALLY the property hereby conveyed. IN WITNESS WHEREOF, said Grantor has hereunto set her hand and seal the day and year first above written. Signed, sealed and delivered in the presence of .:, ~'~,~~~,- '7~ ~ ~'-~-K .e-ti.~ ( SEAL) Luella K. Shuman COMMONWEALTH OF PENNSYLVANIA _ ~.._ . __ CQUNTY 4F CUMBERLAND ) SS. On this, the •~ ~ ~ day o ~.~..~t-+--"~-~-~ , 1996, before me the undersi ned officer ers~ orYAll a e`~red Luella M. 4 P Y PP Shuman, 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. -~ ~~>~''~ C f~,;S f~.~ c~'~, ._ .~+~..e...,. .• . ~' >w Fi>. r c ..rt ~~?.~xtr , ~v~'``~"~ a ~~ may"[ y ~(i -kP yir„ r~ f - s J:': '%a~•:;....;,'~'1 tit'{ i~•„ `.:; ~ r ~~~~y ~ ~Ll_~ (SEAL] Notary Public Notarial Seal Susan K. Guyyer, Notary Public Carlisle Boro, Cumberland Courriy ~__M__y_ C__o_rn~_mission Expires Sept. 4, 1999 Member, Pelulsvl'~ania AAAAnlgtlglj ¢t ..at,?tt98 ~oo~c f 3~ ~,tVc ~~~~ I do hereby certify that the precise residence and complete post office address of the within named Grantees are cjo Paul E. Shuman, 254-A Goodhart Road, Shippensburg, Pennsylvania 17257. ~}~ld~Y ~~ 199 ~ ~ ---- Attorney for Grantee COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) Recorded on this ~ da of ~ A. D. 1996 in th Recorder's Office of the said County, in Deed Book, Page 7 Given under my hand and seal of the said office, the date above written. /~' Recorder ^ti W rn ~OOX ~,~~ ~'1,G~ ~~.~. t-+ '~ }.~i' ~_~ . -:1 ~~J •-!7 _I7 ;, <> ~ i- .~ r~ ~_ ~ ~-~ - ~ --~ ~.~~•~ -T1 tom, c, ~-~ c *~ I'r7 G ~ ~~ ~ (_ ~: C'7 t r~ ~ ~ .:I) ~~ -, _ _ry ,~+.,. ?~":, x ..# as.r He, ~ ~ ~Y``€ - lea .. ~ r , v t r•~, <~,~ , - ,~cniwxR ~ , .'. + _ 1 ..r flEV-1511 EX+ (12-99) ' ~ SCHEDI~LE N COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES & INHERITANCE TAX RETURN ADMINISTRATIVE COST5 RESIDENT DECEDENT ESTATE OF FILE NUMBER LUELLA M SHUMAN 21-07-1153 Debts of decedent must be reported on Sdbduk L NUMBER DESCRIPTION A. FUNERAL EXPENSES: t~ HOFFMAN-ROTH FUNERAL HOME (SEE ATTACHED) 2 CUMBERLAND VALLEY MEMORIAL GARDENS, CASKET, AND GRAVE OPENINGJCLOSING Zip Zip AMOUNT 4,965.49 3.350.00 107.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Numberts)IEIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: {Ii decedents address is not the same as claimant's, attach exptanation) Claimant Street Address City State Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 6. Tax Return Preparers Fees 7. TOTAL (Also enter on line 9, Recapitulation} I $ (If more space is needed, insert additional sheets of the same size) 8,422.49 Hoffman-Roth Funeral Home & Crematory, Inc. 219 North Hanover Street Carlisle, PA 17013 (717)243-4511 July 23, 208 . ~.rt ' .Conrad 'LLB'- ~ zY' r~ ` ~C `-~ ~,} _~-64-7 W~rt~+illeR©8d- ~.:~~ ~T• / Carlisle, PA 17015 The Funeral Service for Luella M. Shuman 15165-232 We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. OUR SERVICE: Traditional Funeral Service Package $4150.00 FUNERAL HOME SERVICE CHARGES $4150.00 SELECTED MERCHANDISE: Wearing Apparel , $120.00 THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED $4270.00 Cash Advances Newspaper Obituary Notice- Sentinel , , Organist Clergy Offering Certified Copies of Death Certificates , , Flowers 159+31.80+37.10 , Hairdresser, , TOTAL CASH ADVANCES AND SPECIAL CHARGES . Total Total Cost , , History 11!23!2007 Harriet Conrad , , TOTAL AMOUNT DUE . this statement is net and payable in full within 30 days of receipt, $190.59 $75.00 $100.00 $72.00 $227.90 $30.00 $695.49 $4965.49 $-4965.49 $0.00 Please return this portion with your Remittance $ Amount Enclosed Service ID # 15165-232 Luella M. Shuman REV-1512 EX+ i12-D3) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN SCHEDULE 1 DEBTS OF DECEDENT, MORTGAGE LIABILITIES, 8~ LIENS ESTATE OF FILE NUMBER LUELLA M SHUMAN 21-07-1153 Report debts Incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE r NUMBER DESCRIPTION OF DEATH t~ ALEXANDER SPRINGS MEDICAL 23.54 2 CARLISLE HMA 32.17 3 MOFFITT HEART 48.41 4 CARDIOLOGY DIAGNOSTIC LLC 1.53 5 WEST SHORE EMS 102-87 6 CARLISLE HMA 32.17 7 HOLY SPIRIT HOSPITAL 892.80 8 KINETIC IMMAGING 6.61 9 CARLISLE HMA 16.20 1 D NEPHROLOGY ASSC 12.39 11 BELVEDERE MEDICAL 23.10 12 CARLISLE CARDIOLOGY 12.85 13 QUANTUM IMMAGING 36.00 14 KINETIC IMMAGING 1.68 15 CUMBERLAND GOODWILL FIRE CO. 86.61 16 PHILIP D CARY MD 26.56 17 SPRING ROAD FAM{LY PRACTICE 199.82 18 CAMP HILL EMG PHY 32.17 19 CUMBERLAND PATHOLOGY ASSC 18.62 20 KINETIC IMMAGING 6.24 TOTAL (Also enter on line 10, Recapitulation) ! I 1,612.34 (if more space is needed, insert additional sheets of the same size) REV-1513 EX+ 19-00) SCHEDI~LE J COMMONWEALTH Of PENNSYLVANIA BENEFICtARtES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER LLI~LL/~ NJ Sh/VM r,21 "D7'-1 /33 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON{S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE r TAXABLE D15TR16UTfONS Jinclude outright spousal distributions, and transiers under Sec. 9116 (aJ {1.2)J 1 EDWARD P CONRAD, 200 S HUMER ST. ENOLA, PA. 17025 GRANDSON $200.00 2 LINDA M WOODS, 186 Buffalo Hollow Rd.Glen Gardner,NJ 08826 GRANDDAUGHTER $200.00 S STEVEN P CONRAD 7647 WERTZVILLE RD CARLISLE PA 17015 GRANDSON $200.00 4 MICHAEL D CONRAD 144 Chestnut grove Rd Dillsburg, Pa 17019 GRANDSON $200.00 5 Gregory A Shuman, 2546 Goodhart Rd. Shippensburg, Pa. 17257 GRANDSON $200.00 B David P Shuman 101 Bluerock Rd. Newville, Pa 17241 GRANDSON $200.00 7 Kristen M Gordon 208 Woodlawn Ln. Carlisle, Pa. 17015 GRANDDAUGHTER $200.00 8 Harriet M Conrad 498 Sherwood Dr. Carlisle, Pa. 17015 DAUGHTER 50 % of Balance 9 Paul E Shuman 212 Lynco Ln. Surfside Beach, NC 29575 SON 50 % of Balance [I ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, A:> APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOl' BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I S (B more space is needed, insert additional sheets of the same size)