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HomeMy WebLinkAbout03-0540 PETITION FOR PROBATE and GRANT OF LETTERS also known as To: Register of Wills for the Deceased. County of in the Social Security No. 195- 32- 4 ~ 40 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut r±× named in the last will of the above decedent, dated ©¢ t obe r 24, ,19 96 and codicil(s) dated None (state relevant circttmstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland County, Pennsylvania, with h i.~ last family or principal residence at 206 Beaver Drive, Hampden Wc~wn~hip, Cumberland County, Mechanicsburg: PA 17055 (list street, number and muncipality) Decendent. thcn ~0~earso a~' June 13, at Holy SpiritHOspital'f~e'died X~9 2003, · Pennsboro Twp., Cumberland County,. PA Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: No ne .. Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ Unestimated (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ Unestimated situated as follows: Spring Township: Perry County: PA WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. 206 Beaver Drive ' ~'= . PA ] 7055 ~ Mechani CSbl~ ~o OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA 3 COUNTY OF Cumberland y ss The petitioner(s) abOve-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well ang~ruly administer the estate according to law. Sworn to or affirmed and subscribed ~ /f/-ff.~o'~-- f)J~~-~t ~ //'-~fore me this . 2nd ~ day of [ / ' Sahc~a~t L[-~-lAfi. ey ~' Donna M Otto,lst De ut / & 17- NO. 21-2003-540 Estate Of TERRY W. SHEIBLEY , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW July 2nd ~cgX 2 00,~n consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated October 2 4, 1 996 described therein be admitted to probate and filed of record as the last will of Terry W. Sheibley ; and Letters Testamantary are hereby granted to Sandra L. sheibley FEES Probate, Letters, Etc .......... $18.00 By Short CertificatesP ) .......... $ 9.00 ~'h~A~iT~R~T~¥~n~ (~u~-a~t-~-D. No':)b~ b200 ~R~gg~XK. (.3) ........ $ 9 00' 44 West Main Street · ' Mechanicsburq, PA 17055 JC.P $10.00 ADDRESS TOTAL $46.00 (717) 697-8528 Filed . J.u Ly. 2ncl, 200 ~t ............... PHONE MAILED LETTERS TO ATTORNEY SNELBAKER ON JULY 2nd, 2003. O0:6V g-qrt? E0. This isto certify that the information here given is correctly copied fi'om an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to thc State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 ~~ ¢a¢-~/~--,¢',~' ~'d>'~ '"~"'" ~~ ~Y~[ Local Registrar P 9 2 ~ 7 0 9 0 ~av~ =,~;v dUN ~ 0 2003 No. Date ~v 2/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH .... TerryE OF DECEOENT( ............. W. Sheibley sex S'J~-QC,^L SECU.,T¥ NU,.aER]'O^.E~)[ $~0^.~ ~ ~T. .... o?~,~ '. ,.male 60 ~", ! ~'" ~' :~ .... ~ ~'~" ,Harr~ p~ urg, Cumberland E. Pennsboro Co~ercSal s ~E EN EVERINI DECE~NT'SEDUCATION M~ITALSTATUS-Mam~ SURVIVI~S~USE 206 Beave~ D~ ~ctu~ ~z..sta~, H. Dean She~ble~ ,~ Sandra L. Sheibley ,~06 Beaver Dr. Mechanicsburg,Pa. L a n ~ ~'--~ ~,~ ~ ne 19,2003 Con-O-Lite Crematory . . 24. ' DUE ~ (~ ~ A CONSEQUENCE ~: i~,. ~/~ TO t~ ~t Of my k~wledge, death ~curr~ il i~ lime, ~le, and pllce, a~ due to Ihe cau~(i) .nd manner ...lar~ ......................... L3 31c. O~Ot ' MESCAL EXAMIN ER/CO~ONEa 21-2003-540 LAST WILL AND TESTAMENT TERRY W. SHEIBLEY I, Terry W. Sheibley, of Cumberland County, Pennsylvania, being of sound mind,, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. I direct the payment of my legally enforceable debts and the expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. If there be no cemetery lot available for my interment, owned by me at the time of my death, -I authorize my personal representative to purchase such cemetery lot with a contract for perpetual care, using therefor funds from my estate, and I authorize my personal representative to cause title to or ownership of such lot so purchased to be vested in such person as my personal representative shall designate. Further, in this connection, I authorize my personal representative to expend funds from my estate, in such amount as my personal representative shall consider necessary and desirable, for the purchase, erection and inscription of a suitable marker for my grave. Should my Wife predecease me, I bequeath five thousand ($5,000.00) dollars to the person who cares for my dogs until the death of my dogs. T~IRD I give, devise and bequeath the rest, residue and remainder of my estate of whatever nature and wherever situate to my wife, Sandra L. Sheibley, if she shall survive me by thirty (30) days. In the event my Wife predeceases me or fails to survive me by thirty (30) days, then I give, devise and bequeath the rest, residue and remainder of my estate to my sons, Michael Sheibley and Gregg Sheibley, in equal shares. I d~rect that no trustee, executor, guardian or other fiduciary named, n~minated, or appointed by this my Last Will and Testament shall be required to post any bond or give any security of any type for any purpose whatsoever, any law or rule of the court of the Commonwealth of Pennsylvania or any other jurisdiction to the contrary notwithstanding. I direct that the law of the Commonwealth of Pennsylvania shall apply to any interpretation or application of the validity of this instrument. Any and all payment or payments of any sum or sums, whether in cash or in kind and whether for principal or income, payable to an heir, or any of them, sb~ll be made upon the sole receipt of the respective individual to whom the payment is made, and free from anticipation, alienation, assignment, attachment, and pledge, and free from control by the creditors of any such beneficiary. I appoint my wife, Sandra L. Sheibley, Executrix of this my Last Will and Testament. Should my said Executrix fail to survive me or for any reason fail to qualify as Executrix, then I a~point my sons, Michael Sheibley and Gregg Sheibley, Co-executors of this my Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of four (4) typewritten pages, the first two (2) of which bear my signature in the margin for the purpose of identification, this ~5/X~ day of October, 1996. (SEAL) .~' . Sh~ibley.~ Signed, sealed, published and declared by the above named testator, Terry W. Sheibley, as and for his Last Will and Testament, in the presence of us, who, at his request, in his sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as witnesses. fXi~RqWEALTH OF PENNSYLVANIA : : SS. ODUNTY OF CUMBERLAND : We, Terry W. Sheibley, ~J~ ~' ~/~ and ~J~ ~. j~.~~ ' , the tes~tor and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument of his Last Will and Testament, and that he signed willingly and that he executed as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as witnesses, and that to the best of their knowledge, the testator was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. Sworn to and subscribed before me this ~-~ day of October, 1996. Notarial Seal Jennifer S. Calaman, Notary Public Carlisle Boro, Cumberland County My Commission Expires Nov. 29, 1999 Member. Pennsylvania Association of Notaries TERRY W. SHEIBLEY LA9,/OFFICES O'BRIEN BARIG & SGHERER 17 W.Fr, ST SOUTH STREET CAP, dL_ISLE. PENNSYLVANIA 17OI3 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Terry W. Sheibley Date of Death: June 13, 2003 No. 2003-00540 PA No. 21-03-0540 To the Register: I certify that notice of beneficial imerest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiary of the above-captioned estate on or about July 3, 2003: Name Address Sandra L. Sheibley 206 Beaver Drive Mechanicsburg, PA 17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: NONE. Date: July 3, 2003 ~--~/~~P,--~ Philip ~ Spar~, Esquire 44 West Main Street Mechanicsburg, PA 17055-0318 (717) 697-8528 --'3 REV-1500 EX (6-00) OFFIOAL USE ONLY · , COMMONWEALTH Of DEPARTMENT OF REVENUE DEPT. 280604 INHERITANCE TAX RETURN F,LENUMBER HARRISBURG, PA 17120-0601 RESIDENT DECEDENT 21 -- 2003 0540 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FI RST, AN D MIDDLE IN ITIAL) SOCIAL SECURITY NU MBE R ~ Sheibley, Terry W 195-32-4740 LLI CATE OF DEATH (MM-DD-YEAR) I CATE OF BIRTH (MM-DD-YEAR TI-IS RETURN MUST BE FILED IN DUPLICATE WITH THE U.l 06/13/2003 I03/10/1943 REGISTER OFWILLS LLI (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Sheibley, Sanclra L 1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death pdor to 12-13-82) I-- [~1 4. Limited Estate II 4a, Future Interest Compromise (date of death after 12-12-82) I 15. Federal Estate Tax Return Required ~oo n,'.~ L_43,_J 6. Decedent Died Testate (Attach copy of Will) I I 7, Decedent Maintained a Living Trust (Attach copy of Trust) -- 8. Total Nu m bar of Safe Deposit Boxes ~ 9. Litigation Proceeds Received ~1 I 10. Spousal Poverty Credit (date of death between 12-31-91 ,n~ 1-1-~5)--II 11. Election to tax under Sec. 9113(A)(Attach Sch O) Z NAME COMPLETE MAILING ADDRESS tu o Philip H. Spare z o 44 West Main Street a. FIRM NAME (If Applicable) _~ Snelbaker, Brenneman & Spare, P.C. P.O. Box 318 8 TELEPHONE NUMBER Mechanicsburg, PA r.~-]'~'~ 5 717-697-8528 ~ .... - Z= ,::- 8 8, 3 7 0 1. Real Estate (Schedule A) (1) · ~ OFFICIAL USr~'-ONLY 2. Stocks and Bonds (Schedule B) (2) 110.04 3~ Closely Held Corporation, Partnership or Sole-Proprietorship (3) 0.00 ~.~ 4. Mortgages & Notes Receivable (Schedule D) (4) 0. ~ . . · 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (5) 5 ¢ 350.00 ~' 6. Jointly Owned Property (Schedule F) 0.0 0 o [--I (6) I-- Separate Billing Requested 7. Inter-Vivos Transfers& Miscellaneous Non-Probate Property (7) · 0 O0 ~) (Schedule G or L) ~:Ct' 8. Total Gross Assets (total Lines 1-7) (8) 9 3,8 30 . 0 4 O 1,748.61 I.LI 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens(Schedule I) (10) 0. 00 11. Total Deductions(total Linea9 & 10) (11) 1,748. 61 12. Net Value of Estate (Line 8 minus Line 11) (12) 92,081.43 13. Charitable and Governmental Beq uests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) (13) 0.00 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 92,081.43 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax 92,081.43 0 00 ~ rate, or transfers under Sec. 9116 (a)(1.2) x ,00__ (15) ' _o ~- 16. Amount of Line 14 taxable at lineal rate 0.00 x .045 (16) 0 00 < · ~ 0 O0 0 O0 O. 17. Amount of Line 14 taxable at sibling rate ' x.12 (17) ' o 0 00 0 00 O 18. Amount of Line 14 taxable at collateral rate ' x .15 (18) x < 0 00 ~ 19. Tax Due (19) ' 2W4645 1.000 Decedent's Complete Address: [ S ~-REET ADDRESS 206 Beaver Drive Hampden Twp., Cumberland Cty CITY STATE ZIP / Mechanicsburg PA 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 0.00 2. Credits/Payments A. Spousal Poverty Credit 0.00 B. Prior Payments 0.00 C. Discount 0. O0 Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest 0.00 E. Penalty 0.00 Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 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) 0.00 A. Enter the interest on the tax due. (5A) 0.00 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0.00 Make Check Paj(able to: REGISTER OF I/I/ILLS, 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; ....................... [~ r~ b. retain the right to designate who shall use the property transferred or its income; ......... F~ ~-~ c. retain a reversionary interest; or ................................ F---] d. receive the promise for life of either payments, benefits or care? ................. 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? ............................ E~] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? E~ [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................................ E~] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE (3 AND FILE IT AS PART OF THE RETURN. 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 ell information of which preparer has any knowledge, SIGNATUP~ OF PERSON RESPOI~SIBLE FOR FILING RETURN DATE A~DRESS 206 Beaver D~±ve Hampden ~p., Cumberland Cty Mechanicsburg, PA 1705e ~ SIG NAT,,,,.U~O~.%RE/I~ARxE~A N REP R ES E N TATIV E DATF7 / A~ORES~4 W~st ~H' Street P.O. Box 318 Mechanicsburg, PA 17055 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate im posed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. § 9916 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate im posed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. § 9116 (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 alter 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 0% [72 P.S. § 9116(a)(1.2)]. The tax rate im posed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. § 9116(1.2) [72 P.S § 9116(a)(1 )]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. § 9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 2w4646 1.000 ,~v-~o~x + ~-~ SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Sheibley, Terry W 21-2003-0540 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts, Real property which is jointly-owned with right of survivorship must be disclosed on Schedule F, ITEM DESCRIPTION VALUE AT DATE NUMBER OF DEATH 1. Property located in Spring Township, Perry County, PA 88,370.00 containing 3 acres 148 perches and having a two and one-half story house. Value determined using assessed value (copy of assessment attached) TOTAL (Also enter on line 1, Recapitulation) $ 88,370.00 2w4695 2.000 (If more space is needed, insert additional sheets of the same size) .~ON- TILL DEEDED 3.93 Market Land Value: 25430 AGRIuu,.TURAL USE T.mND VALUE PRODUCTI VI TY $/ACRE VALUE 3ASEACRE 1.00 15246 15246 ~I LIJtBLE 2.93 ~OODED ~ON-TILL ]EEDED 3.93 Ag Use Land Value: ~lean & Green? NO A9 Sec Area: N Av9 Slope: % 240,180.03-002.000 SHEIBLEY >> PERR~ COUNTY -- PROPERTY R~CORD CARD ¢< R TERRY W ~PBC ID: CTL:00518384 Fair Market Clean & Green: NO Land - 25430 L - ?IEBACK: 206 BEAVER DRIVE Bldg - 62940 School: 5 h[bhd: 240 - Total - 88370 T - Part Interest of MECHANICSBURG PA 17050 Assessed - 88370 A - RESID~'i'~&b INP0~%TION: ~uildin~ Descript. - ............................. l .................. ~torles Grou9 ..... 2 PROPERTY TYPE ..... R ( 101 ) ~elling Type ..... DETAC~ Year Built.. (est), 1900 :xterior Walls .... Wood Remodeled ......... ~i~hborhood Type. RUR Effective Age ..... 1900 ~taI/Bed Rooms.. 6 / 4 Cond (Iht & Ext).. S .................................................. Finished Bsmnt: I Living Area .... : 1736 ~ll/Half Baths... 1 / 0 FINAL ~RADE ....... C+10 Basement Garage I Enclosed Porch.: fearing Type ...... Forced Air '/replace Count... I [ ~ 0 cars, a_~rx: I Attached ~arage:' RE9-1§03 EX + (1-97) SCHEDULE B [ COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN / RESIDENT DECEDENT '-~TAT~ ~ ~ __ ~ Sheibley, Terry W FILE NUMBER 21-2003-0540 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUM DESCRIPTION VALUE AT DATE 1. Series EE savings bonds, $50.00 face value, with zssue 110.04 date of 5/23/89 __OfDEATH TOTAL (Also enter on line 2, Recapitulation) $ 110.04 2W46963~000 (If more space is needed, insert additional sheets of the same size) REV- ~1508' EX'+ (1-97) COMMONWEALTH OF PENNSYLVANIA / CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN ~~ ~ RESIDENT DE~CEDENT_ ESTATE OF Sheibley, Terry W FILE NUMBER 21-2003-0540 Include the proceeds of litigation and the date the proceeds Were rece/ved by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBEF DESCRIPTION VALUE AT DATE 1966 Chevy Corvair ~ OF DEATH 2 1977 Peugeot Moped 300.00 3 1984 Sachs Moped 25.00 25.00 4 2000 Suzuki Grand Vitara 5,000.00 2W46AD 2.000 $ 5,350. O0 (if more space is needed, insert additional sheets of the same size) -- RE~/-1511 EX+ (1-97) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA / FUNERAL EXPENSES & / INHERITANCE TAX RETURN AD MINISTRATIV ~T I_ E COSTS Sheibley, Te=ry W FILE NUMBER 21-2003-0540 ITEM ~edule I. NUMBER DESCRIPTION A. FUNERAL EXPENSES: AMOUNT 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) 0.0 0 Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State __ ~ Zip Year(s) Commission Paid: 2. Attorney Fees Name: Snelbaker, Brenneman & Spare 1,500.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant 0.00 Street Address City State ~ Zip Relationship of Claimant to Decedent 4. Probate Fees 0.00 5. Accountant's Fees 0.00 6. Tax Return Preparer's Fees 0.00 7. Cumberland County Law Journal, advertising Executrix notice 75.00 8 The Patriot-News, advertising Executrix notice 117.61 9 Register of Wills, Cumberland County, probate fees 46.00 10 Register of Wills, filing fee for Inheritance Tax Re turn 10.00 TOTAL (Also enter on line 9, Reca__ $ 1,748.61 2W46AG 2000 (If more space is needed, insert additional sheets of same size) REV-1513 EX+ (9-00) ~ [ SCHEDULE j COMMONWEALTH OF PENNSYLVANIA / BENEFICI INHERITANCE TAX RETURN ARIES ESTATE OF W FILE ~UMBE~'~'~-~~-----'~---- 1540 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUME NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY ~ Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] 1. Sheibley, Sandra L 206 Beaver Drive Spouse 92,081.43 Hampden Twp., Cumberland Cty Mechanicsburg, PA 1705~ ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: ~ A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.0 0 2W46A[ 1000 (If more space is needed, insert additional sheets of the same size) TERRY W. SHEIBLEY I, Terry W. Sheibley, of Cumberland County, Pennsylvania, being of ~'~ sound mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other wills and codicils heretofore made by me. FIRST I direct the payment of my legally enforceable debts and the expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. If there be no cemetery lot available for my ~ interment, owned by me at the time of my death, I authorize my personal representative to purchase such cemetery lot with a contract for perpetual care, using therefor funds from my estate, and I authorize my personal representative to cause title to or ownership of such lot so purchased to be vested in such person as my personal representative shall designate. Further, in this connection, I authorize my personal representative to expend funds from my estate, in such amount as my personal representative shall consider necessary and desirable, for the purchase, erection and inscription of a suitable marker for my grave. Should my Wife predecease me, I bequeath five thousand ($5,000.00) dollars to the person who cares for my dogs until the death of my dogs. I give, devise and bequeath the rest, residue and remainder of my il estate of whatever nature and wherever situate to my wife, Sandra L. Sheibley, ~i if she shall survive me by thirty (30) days. In the event my Wife predeceases me or fails to survive me by thirty (30) days, then I give, devise and ~ ~x~f~ bequeath the rest, residue and remainder of my. estate to my sons, Michael Sheibley and Gregg Sheibley, in equal shares. I direct that no trustee, executor, guardian or other fiduciary named, nominated, or appointed by this my Last Will and Testament shall be required to post any bond or give any security of any type for any purpose whatsoever, any law or rule of the court of the Con~nonwealth of Pennsylvania or any other jurisdiction to the contrary notwithstanding. I direct that the law of the Cc~monwealth of Pennsylvania shall apply to any interpretation or application of the validity of this instrument. Any and all. payment or Payments of any sum or sums, whether in cash or in kind and whether for principal or income, payable to an heir, or any of tham, shall be made upon the sole receipt of the respective individual to whom the payment is made, and free from anticipation, alienation, assignment, attachment, and pledge, and free from control by the creditors of any such beneficiary. SIX~ I appoint my wife, Sandra L. Sheibley, Executrix of this my Last Will and Testament. Should my said Executrix fail to survive me or for any reason fail to qualify as Executrix, then I appoint my sons, Michael Sheibley and Gregg Sheibley, Co-executors of this my Last Will and Testament. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, consisting of four (4) typewritten pages, the first two (2) of which bear my signature in the margin for the purpose of identification, this ~-/~ day of October, 1996. Signed, sealed, published and declared by the above named testator, Terry W. Sheibley, as and for his~Last Will and Testament, in the presence of us, who, at his request, in his sight and presence, and in the sight and presence of each other, have hereunto subscribed our names as witnesses. ~TH OF PENNSYLVANIA : COUNTY OF CUMBER/AND : SS We, Terry W. Sheibley, L~ ~)..z(~/{7 .i , the testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instrument of his Last Will and Testament, and that he signed willingly and that he executed as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as witnesses, and that to the best of their knowledge, the testator was at the time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. Sworn to and subscribed before me this SA,. day of October, 1996 - Notadal Seal Jennifer S. Calaman Notary Pub c Carlisle Boro, Cumberland County My Commission Expires Nov. 29, 1999 r.:;am~er. Penqs~,lvania Assp. ciation of l~otaries STATUS REPORT UNDER RULE 6.12 Name of Decedent: Elizabeth S. Freet Date of Death: June 6, 2000 Register File No. 21-00-054~ 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 x No 2. If the answer to #1 is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to #1 is Yes, state the following: a. Did the personal representative file a final ...... account with the Court? Yes No X 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 __ No X d. Copies of receipts, releases, joinders and approvals of formal or information accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: April 13, 2004 ~ _ _ DONN L. SNYDER, ESQUIRE SAUL EWlNG LLP POST OFFICE BOX 1291 Harrisburg, PA 17108-1291 717.257.7552 54463 1 4/13/04 IN RE: THE ESTATE OF : IN THE COURT OF COMMON PLEAS ELIZABETH S. FREET : DAUPHIN COUNTY, PENNSYLVANIA : ORPHANS' COURT DIVISION : DECEASED : NO. 21-00-0540 ACKNOWLEDGMENT AND RELEASE KNOW ALL MEN BY THESE PRESENTS, that we, David E. Freet, James A. Strite, Jr., and Katharine S. Caldwell, Co-Trustees of the Elizabeth S. Freet Trust, do hereby acknowledge the receipt of and from David E. Freet, Executor of the Estate of the said Elizabeth S. Freet, Deceased, cash and securities valued at Seven Hundred Twenty Thousand Two Hundred Seventy-Eight and 76/100 ($720,278.76) Dollars, in full and final satisfaction and payment of all sums of money, share or shares, purparts, and dividends which are or were due, owing, payable and belonging to me, by any means whatsoever, for my share, part, or dividend of the Estate of said Elizabeth S. Freet, Deceased, made pursuant to the Last Will and Testament of Elizabeth S. Freet. AND THEREFORE, the undersigned, do by these presents, remise, release, quitclaim, and forever discharge the said David E. Freet, Executor and his attorney and agent of and fi.om the said share or dividend 'of the estate aforesaid, to the extent of the sum of Seven Hundred Twenty Thousand Two Hundred Seventy-Eight and 76/100 ($720,278.76) Dollars, of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or of any other act, matter, cause, or thing whatsoever, from the beginning of the world to the day of the date of these presents. 56112.1 12/4/02 As the condition for receipt of this full and final distribution made this date by the said Executor I hereby agree to pay or refund any amount, to pay any tax (including interest and penalties), liability, or any proper debt of the estate as determined by the said Executor or a court of competent jurisdiction to the extent of proportional liability, which proportional amount represents the proportion that would be paid to me after the payment of all taxes, debts, and administrative expenses. I agree to accept this stated amount as a full distribution pursuant to said Last Will and Testament of Elizabeth S. Freet, under the conditions as stated in that agreement and in this Acknowledgment and Release. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day of (A.o,,il ,20Q~..~ ELIZABETH S. FREET TRUST By: ~ ~ DAVID ~. FREET KATHARINE S. CALDWELL EIN: Sworn to and subscribed before me this ~ day of /~,~ , NOTARY PUBLIC My Commission Expires: [ Notarial Sea~ I Lorl A. B. Zer'oe, Notary Public / ~Of Harrisburg, Dauphin County 56l 12.1 12/4/02 IN RE: THE ESTATE OF : IN THE COURT OF COMMON PLEAS : ELIZABETH S. FREET : DAUPHIN COUNTY, PENNSYLVANIA : : ORPHANS' COURT DIVISION : DECEASED : NO. 21-00-0540 ACKNOWLEDGMENT AND RELEASE KNOW ALL MEN BY THESE PRESENTS, that I, David E. Freet, of Mechanicsburg, Pennsylvania, do hereby acknowledge the receipt of and fi.om David E. Freer, Executor of the Estate of the said Elizabeth S. Freer, Deceased, two vehicles valued at Nine Thousand Seven Hundred ($9,700) Dollars, in cash and securities, including income, dividends and growth, in full and final satisfaction and payment of all sums of money, share or shares, purparts, and dividends which are or were due, owing, payable and belonging to me, by any means whatsoever, for my share, part, or dividend of the Estate of said Elizabeth S. Freet, Deceased, made pursuant to the Last Will and Testament of Elizabeth S. Freet. AND THEREFORE, I, David E. Freer, do by these presents, remise, release, quitclaim, and forever discharge the said David E. Freer, Executor and his attorney and agent of and from the said share or dividend of the estate aforesaid, to the extent of the sum of, Nine Thousand Seven Hundred ($9,700) Dollars of and from all actions, suits, payments, accounts, reckonings, claims, and demands whatsoever, for or by reason thereof, or of any other act, matter, cause, or thing whatsoever, from the beginning of the world to the day of the date of these presents. 56112.1 12/4/02 As the condition for receipt of this full and final distribution made this date by the said Executor I hereby agree to pay or refund any amount, to pay any tax (including interest and penalties), liability, or any proper debt of the estate as determined by the said Executor or a court of competent jurisdiction to the extent of proportional liability, which proportional amount represents the proportion that would be paid to me after the payment of all taxes, debts, and administrative expenses. I agree to accept this stated amount as a full distribution pursuant to said Last Will and Testament of Elizabeth S. Freet, under the conditions as stated in that agreement and in this Acknowledgment and Release. IN WITNESS WHEREOF, I have hereunto set my hand and seal this ~ day of /kpc, ~ ,200~. Social Security No. //q~-~.z/-~,7~.~,,~4"- Sworn to and subscribed before me this (s'{k day of t~G.J , NOTARY PUBLIC My Commission Expires: Notarial Seal Lori A. B. Zerbe. Notary Public City Of Harrisburg. Dauphin County My Commission Expires Jan 7. 2005; Member, Penns?:..:,,~ A:,::,~.z'uat~on Of Not,pcs 56112.1 12/4/02 COHHONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTNENT OF REVENUE INHERITANCE TAX DIVZS/ON DEPT. 280601 HARRISBURG, PA 17118-0601 NOTZCE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR DZSALLONANCE OF DEDUCT/ONS AND ASSESSMENT OF TAX RE¥-lSq?EXAFPCOI-OS) DATE 05-Zq-ZO0q ESTATE OF SHEIBLEY TERRY DATE OF DEATH 06-15-2005 FILE NUNBER 21 05-05q0 PHILIP H SPARE '04 ~J/i¥ ~ ~',~ ~OUNTY CUHBERLAND '~ ACN 101 SNELBAKER ETAL Amoun~ Remi~ed PO BOX 518 ~. - I MECHANICSBURG PA HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~- RETAIN LOWER PORTION FOR YOUR RECORDS REV-154? EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEMENT~ ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SHEIBLEY TERRY WFZLE NO. 21 05-05q0 ACN 101 DATE 05-2q-200q TAX RETURN #AS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 88;~70.00 NOTE: To insure proper 2. S~ocks and Bonds (Schedule B) (2) ~O.Oq credit ~o your account, $. Closely Held S~ock/Per~nership Interes~ (Schedule C) (5) .00 submi~ ~he upper portion q. Mor~geges/No~es Receivable (Schedule D) (q) .00 of ~his form wi~h your $. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) (S) 51~50.00 ~ax payment. 6. Jointly Owned Proper~y (Schedule F) (6) .gO 7. Transfers (Schedule G) (7) .00 8. Total Assets (a) 95,850.0q APPROVED DEDUCTIONS AND EXEMPTIONS: 1,7q8.61 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00 11. To,al Deductions (11} 1.748.61 12. Net Value of Tax Re~urn (12) 92,081.q$ 15. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) .00 lq. Ne~ Value of Es~a~e Sub5ec~ ~o Tax (lq) 92,081.q$ NOTE: If an assesseent ,as issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amoun~ of Line lq e~ Spousal ra~e (1S). 92,081.q$ x O0 = .00 16. Amoun~ of Line lq ~axeble e~ Lineal/Class A re~e (16). .00 X OR5 = .00 17. Aeoun~ of Line lq a~ Sibling rata (17). .00 X 12 = .00 18. Amount of Line lq taxable at Collateral/Class B rate (18) .00 X 15 = .00 19. Principal Tax Due (19}= .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT [ .00 BALANCE OF TAX DUEl .00 INTEREST AND PEN. .00 TOTAL DUE . O0 IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REgiUTRED. FOR CALCULATION OF ADDZTIONAL INTEREST. ZF TOTAL DUE ~S REFLECTED AS A 'CRED[T" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THTS FORM FOR ZNSTRUCT[ONS.) RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any futura interest in the estate is transferred in possession or enjoyment to Class B (collatmral) beneficiaries of the decedent after the expiration of any astmtm for 1ifa or for years, the Commonwealth hereby axpressZy reserves the right to appraise end assess transfer Inheritance Taxes at the laaful Class 8 (collateral) rate on any such futura interest. PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000o (7Z P.S. Section 9140)o PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "AppIication for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). AppLications ara available at the Office of the Register of Nills, any of the Z3 Revenue District Offices, or by calling the specie! Z4-hour anseering service for forms ordering: 1-800-36Z-Z050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-30Z0 (TT only). OBJECTIONS: Any party in interest not satisfied with the appraisement, allowance, or disaIIoeanca 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. ZBLOZ1, Harrisburg, PA 171ZB-lOZ1, OR --election to have the matter determined at audit of the account of the persona! representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individua! Taxes, ATTN: Post Assessment Review Unit, Depto ZB0601, Harrisburg, PA 171Z8-060! Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the decadant's death, a five percent (5X) discount of the tax paid is allowed. PENALTY: The 15Z tax amnesty non-participation penalty is computed on the totm! of tho tax and interest assessed, and not paid before January 18, 1996, the first day after the end of the tmx 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: Interest is charged beginning with first day of delinquency, or nine (9) months and one (L) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of six (6Z) percent per annum calculated at a daily rata of .000164. AIl taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which mil! vary from calendar year to calendar year eith that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through Z004 ara: Interest Daily Interest DaiIy Intarest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ ZOZ .000548 ~'~'~8-1991 11Z .000301 ~ 9~ .000Z47 1983 16~ .000438 1992 9~ .000Z47 ZOOZ 6~ .000164 1984 11~ .000301 1993-1994 7~ .00019Z ZOO3 S~ .000137 1985 13~ .000~56 1995-1998 9~ .OOOZ47 2004 4~ .O00XLO 1986 102 .000274 1999 72 .00019Z 1987 102 .000274 Z000 72 .00019Z --Interest is calculated as falloas: XNTEREST = BALANCE OF TAX UNPAXD X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (1S) days beyond the date of the assessment. Xf payment is made after the interest computation date shown on the Notice, additional interest must be calculated. COMMONWEALTH OF PENNSYLVANIA ~. ss: COUNTY OF CUMBERLAND Sandra L. Sheibley being duly sworn eccording to ~aw, deposes end says that ~e is the Executrix of the F~tate of Terrv W. Sheibley ~ate of Hampden Township · , Cumberland County, Pa., deceased and that the within is an inventory mede by Sandra L. Sheible¥ __ , the said_ Executrix of the enHre estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. Sworn and subscribed before me, ~---L~L_~.~ ~ ~X 2004 / Sh e'ib ~, Executrix ~.~_ ~~~/~ 206 Beaver Drive i6~J . - _ ' ~lechanicsDurg, FA ±7UbU COMMONWEALTH OF PENNSYLVANIA Saridra lC Showels, Nota~/Public Address Date o{ Death ~e~ ~'ennsylvenieAss°cieti°nOfN°tades~une 2003 Day k4onfh Year INSTRUCTIONS I. An ~nvenfory must be f~led within three months after appointment of personal representative. 2. A supplement inventory must be filed wlfh;n thirty days of discovery of additional assets. 3. Additional sheets may be aHached as to personalty or realty 4. See AHicle IV, Fiduciaries Act of 1949. inventory of the real and personal estate of TERRY W. SHEIBLEY, Deceased PERSONALTY: 1. Two Series EE Savings Bonds, $50.00 face value, with issue date of 5/23/89 110.04 2. 1966 Chevy Corvair 300.00 25.00 3. 1977 Peugeot Moped 25.00 4. 1984 Sachs Moped 5,000.00 5. 2000 Suzuki Grand Vitara TOTAL PERSONALTY: 5,460.04 REAL ESTATE: 1. Property located in Spring Township, Perry County, PA containing 3 acres 88,370.00 148 perches aned having a two and one-half story house. TOTAL PERSONALTY AND REAL ESTATE: 93,830.04 Page 1 ESTATE NO.21-03-0540 FIRST AND FINAL ACCOUNT AND STATEMENT OF PROPOSED DISTRIBUTION OF AND BY SANDRA L. SHEIBLEY, EXECUTRIX OF THE ESTATE AND UNDER THE LAST WiLL AND TESTAMENT OF TERRY W. SHEIBLEY, DECEASED, LATE OF HAMPDEN TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA Sandra L. Sheibley, Executrix as aforesaid and Accountant herein, avers as follows: DATE OF DECEDENT'S DEATH: June 13, 2003 DATE LETTERS TESTAMENTARY ISSUED: July 2, 2003 DATES EXECUTOR'S NOTICE ADVERTISED: Cumberland Law Journal July 11, 18, 25, 2003 Patriot-News Co. July 15, 22, 29, 2003 FIRST AND FINAL ACCOUNT PERSONALTY - PRINCIPAL ACCOUNT r-he Accountant charges herself with the receipt of the Decedent's personaltv, ~ ~ (~~' ~1.,= goods and chattels as set forth in her inventory heretofore filed in the ~m ~f: t~ "~, 5,460.04 TOTAL, PERSONALTY, PRINCIPAL ACCOUNT, DEBITS; ~ ~-~ ~:i-'5,460.04 PERSONALTY - PRINCIPAL ACCOUNT C~ -{3 CREDITS ~.~ The Accountant claims credit for the payment of the following items from Decedent's Personalty Account: 1. Register of Wills, filing fee for Final Accounting and Inventory $ 123.00 Items to be paid subsequent to confirmation of Final Accounting: 2. Snelbaker, Brenneman & Spare, P.C,, attorney services 1,500.00 3. Snelbaker, Brenneman & Spare, P.C., costs advanced: 248.61 a. Register of Wills, probate fee 46.00 b, The Patriot-News, advertising Executrix notice 117.61 c. Cumberland Law Journal, advertising Executrix notice 75.00 d. Register of Wills, filing fee for Inheritance Tax Return 10.00 TOTAL, PERSONALTY, PRINCIPAL ACCOUNT, CREDITS: 8 1,871.61 PERSONALTY - INCOME ACCOUNT DEBITS The Accountant charges herself with the receipt of the following Income from the investment of Personalty Principal: $ NONE LAW OfFiCES TOTAL, PERSONALTY, INCOME ACCOUNT, DEBITS: $ NONE SNELBAKER BRENNEMAN Page 1 PERSONALTY- INCOME ACCOUNT CREDITS Fhe Accountant claims credit for the payment of the following items from the Personalty Principal Account: $ NONE TOTAL, PERSONALTY, INCOME ACCOUNT, CREDITS: $ NONE REAL ESTATE - PRINCIPAL ACCOUNT DEBITS rhe Accountant charges herself with the receipt of Decedent's Real Estate as set forth in her Inventory heretofore filed in the amount of: $ 88,370.00 TOTAL, REAL ESTATE, PRINCIPAL ACCOUNT, DEBITS: $ 88,370.00 REAL ESTATE - PRINCIPAL ACCOUNT CREDITS the Accountant claims credit for the payment of the following items from Real Estate Principal Account: $ NONE TOTAL, REAL ESTATE, PRINCIPAL ACCOUNT, CREDITS: $ NONE REAL ESTATE - INCOME ACCOUNT DEBITS The Accountant charges herself with the receipt of the income from the investment of Real Estate Principal Account: $ NONE TOTAL, REAL ESTATE, INCOME ACCOUNT, DEBITS; $ NONE REAL ESTATE - INCOME ACCOUNT CREDITS The Accountant claims credit for the payment of the following items From the Real Estate Income Account: $ NONE TOTAL, REAL ESTATE, INCOME ACCOUNT, CREDITS: $ NONE Page 2 RECAPITULATION PERSONALTY: PRINCIPAL ACCOUNT: Debits $ 5,460.04 Credits $ 1,871.61 Balance $ 3,588.43 INCOME ACCOUNT: Debits $ NONE Credits $ NONE Balance $ NONE TOTAL PERSONALTY $ 3,588.43 REAL ESTATE: PRINCIPAL ACCOUNT: Debits $ 88,370.00 Credits $ NONE Balance $88,370.00 INCOME ACCOUNT: Debits $ NONE Credits $ NONE Balance $ NONE TOTAL REAL ESTATE: $ 88,370.00 TOTAL FOR DISTRIBUTION: $ 91,958.43 Page 3 COMMONWEALTH OF PENNSYLVANIA ) SS, COUNTY OF CUMBERLAND ) Sandra L. Sheible¥, Executor, being duly sworn according to law deposes and says: that she is the Executrix of the Estate and under the Last Will and Testament of Terry W. Sheibley, Deceased; that she is the Accountant herein; that the foregoing is a true and cornplete accounting of her administration of said Estate; that the attached list or schedule [~] contains the names, addresses and amounts due unpaid creditors who have given proper notice of their claims; that the attached list or schedule [~] contains the names and addresses of all persons interested in the distribution of said Estate; and that the facts set forth herein are true and correct to the best of her knowledge, information and belief, ~ ~',~ Sandra L, Sheib'l~y, Sworn to and subscribed before me this~l.~ day of~L~ 2004 COMMONWEALTH OF PENNSYLVANIA ~K ~m, ~ P~I~ .._ ~,~n~ ~ ~ ~ ~. 22, ~7 LAW OFFICES SNELBAKER BRENNEMAN & SPARE Page 4 * UNPAID CREDITORS: NONE ** PERSONS INTERESTED IN DISTRIBUTION OF ESTATE: Sandra L. Sheibley 206 Beaver Drive Mechanicsburg, PA 17050 LAW OFFICES SNELBAKER BRENNEMAN & SPARE Page 5 STATEMENT OF PROPOSED DISTRIBUTION Sandra L. Sheibley, Executrix and Accountant herein, proposes to distribute the balance of the Estate of Terry W. Sheibley, Deceased, to wit: $91,955.43 in accordance with the Last Will and Testament of said Decedent as follows: Sandra g Sheibley 100% of residue, per Item Third of Will $ 3,588.43 a. Property located in Spring Township, Perry County, PA, in kind 88,370.00 TOTAL DISTRIBUTION: $ 91,958.43 Page 6 COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) Sandra L. Sheibley, Executrix, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Statement of Proposed Distribution are true and correct to the best of her knowledge, information and belief. a L, Sheibley, Executrix Sworn to and subscribed before me th,s k day of COMMONWEALTH OF PENNSYLVANIA 8andm K. Sho~. I~:~ Publi~ Member, Pennsy{vanJa Associefien Of Notarfe$ LAW OFFICES SNELBAkER BrENNEMAN & SPAre Page 7 STATUS REPORT UNDER RULE 6.12 Name of Decedent: Terry W. Sheibley Date of Death: June 13~ 2003 Will No.: 21-03-0540 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: a. Did the personal representative file a final account with the Court? Yes x_xx No ['-] 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 ['-] No [] c. 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 report. Date: 9/23/04 ~ Si~natur[ ~' Philip H. Spare Snelbaker, Brenneman & Spare, P.C. N~q4est Main Street mr Mechanicsburg, PA 17055 " Xddres~ m_ ~ (717) 697-8528 ' z..;~ Telephone No. ' 22',3 Capacity: [-] Personal Representative ['~rCounsel for personal representative SEP Z 2004 IN RE: ESTATE OF IN THE COURT OF COMMON PLEAS OF TERRY W. SHEIBLEY, LATE CUMBERLAND COUNTY, PENNSYLVANIA OF HAMPDEN TOWNSHIP, ORPHANS' COURT DIVISION CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED : ESTATE NO 21-03-0540 DECREE AWARDING REAL ESTATE AND NOW, this da.,,' of .2004. it appearing that thc First and Final Account and Statement of Proposed Distribution of Sandra L. Shcibley, Executrix of the Estate and under the Last Will and Testament of Terry W. Sheibley. Dcceascd, havc been dui)' filed and advertised according to law and roles of court, and that said Account was dui) confirmed and Statcmcnt of Proposed Distribution dui3' approved b) this Court on Augnst 24. 2004: and it fiwther appearing that said Executrix has proposed in said Statement of Proposed Distribution to distribute the Decedent's real estate in kind to herself in her individual capacity, as beneficiar)- under the above mentioned Last Will and Testament. and said Court having dccreed distribution in accordm~cc with said Statemcnt of Proposed Distribution on August 24. 2004. IT IS ORDERED, ADJUDGED and DECREED that all right, title and interest of the said TERRY W SHEIBLEY. Dcceascd. in and to the following described real estate is hcrcb)ax~ardcd m fee simple to SANDRA L SHEIBLEY: ALL that certain tract of land situate in Spring Toxxnship. Perry Count), Pennsyl,,ania. bounded and described as follows, to wit: BEGINNING at a point at thc intersection ora lane and the public road leading from Carlisle to Landisburg: thencc South 11 dcg. East 15.3 Pcrches to a point in said public road: thence by lands now or formerly of WcntzeI Bros. South 70½ deg. West 26.6 Perchcs to a stone at a comer: fl~encc by lands of samc North 29½ dcg. Wcst 26.1 Perchcs to a lane and lands now or L~ oF~,c~s formerl) of CH. Stambaugh: thencc by lands of same last named premises South 79 deg East 165 SN~L[B'~K~R Perches to a stone; thcnce North 81½ deg. East 20.2 Perches to a stone the placc of BEGINNING. BRENNEMAN containing 3 acres 148 Perches. morc or less. and having thereon erected a tx~o and one-half stor~ framc dwelling house, small barn and other outbuildings. BEING the same property conveyed to H. Dean Sheiblev and Fax K Shciblcv. his wife. by deed of Annie Rachacl Sherman, Widow, dated Max: 9. 1963 anal recorded in Pcrr¥ C-ountv Deed Book 176 at Pagc 419. The said Fa5' K Sheibley died On May i0, 2002, and property vcsied in said H. Dean Sheibley as surviving spouse. Thc said H. Dean Shcibley, Widower conveved to Tcrry W. Sheibley, by decd dated June 14, 2002 and recorded in PerD, County Deed Boo~ 1519 at Page 296 IT IS FURTHER ORDERED AND DIRECTED that a certified cop.x of this Decree shall be recorded in the Office of the Recorder of Deeds in and for PerD~ County. Pennsylvania~ among thc dccds recorded in satd ()ffice, said Decree ,~o be indcxe't in the Gra)~tor Index .%r Dced~ against thc Estate of TERRY W. SHEIBLEY, Deccased, and in thc Grantee Index for Decds to SANDRA L SHEIBLEY. pursuant to the Scction 3536 of thc Decedents, Estates and Fiduciarics Code (20 Pa. CS 3536). LAW OFFICES SNELBAKER BRENNEMAN