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HomeMy WebLinkAbout04-0144PETITION FOR PROBATE & GRANT OF LETTERS Estate of Jeannette R. Shuqhart also known as Social Security No. 196-14-4453 , deceased. No. 21-04- ! ~/~'/ To: Register of Wills for the County of Cumberland Commonwealth of Pennsylvania The Petition of the undersigned respectfully represents that: Your Petitioners, who are 18 years of age or older and the Executors named in the Last Will of the above decedent dated Mamh 2, 1982 , and codicils dated none . The Executor named Raymond L. Shuqhart died Auqust 24, 2003 Renunciation for Joan K. Shu.qhart is attached hereto. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 801 North Hanover Street, North Middleton Township Decedent, then 83 years of age, died January 13 ,2004, at Chumh of God Home, North Middleton Township, Carlisle, Pennsylvania 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: Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in PA) Personal property in PA (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania, situated as follows: $46,O00.0O $ WHEREFORE, Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented herewith and the grant of letters testamentary thereon· Signature(s) and Residence(s) of Petitioner(s): Donna k. Thumma 943 Forest Court Carlisle, PA 17013 717-249-4188 Mack W. Shu.qhart 16 Raylen Drive Boiling Springs, PA 17007 717-258-6516 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ' · SS COUNTY OF CUMBERLAND ' 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 representative of the above decedent, petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed ~~ ~' x-~/v/~ · ~/-/ Donna L. Thumma before me th~s//~,~ day of February ,2004. -' ' ..~"~ ../.~egister Mack W. Shu.qhart No. 21-04- Estate of JEANNETTE R. SHUGHART , deceased. DECREE OF PROBATE & GRANT OF LETTERS AND NOW, February ?~7,,',' ,2004, in consideration of the Petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated March 2, 1982 described therein be admitted to probate and filed of record as the Last Will of Jeannette R. Shuqhart ; and Letters Testamentary are hereby granted to Donna L. Thumma and Mack W. Shu.qhart FEES Probate, Letters, Etc ........ $ 80.00 Short Certificates(-3- ) .... $ 9.00 Renunciation(s) ........... $ 5.00 JCP .................... $10.00 Other Will Paqes (-2-) .... $ 6.00 TOTAL: .... $110.00 Filed. ~ 7 ./.'.,~.-~--0.~. .............. IRWIN & McKNIGHT Hoqer I~1'rtWin, Esquire (06282) ATTO~ (Sup. Ct. I.D. No.) 60 West Pomfret St., Carlisle, PA 17013 ADDRESS 717-249-2353 PHONE RENUNCIATION In regard to the Estate of To the Register of Wills of JEANNETTE R. SHUGHART Cumberland , deceased. County, Pennsylvania. The undersigned daughter the right to administer the estate and respectfully ask(s) that Letters Donna L. Thumma and Mack W. Shughart WITNESS my hand this i -~ day of January, 2004. of the above decedent hereby renounce(s) Testamentary be issued to I, JEANNETTE R. SHUGHART, of South Middleton Township, Cumberland County, Pennsylvania, declare this instrument to be my last will and testament, hereby expressly revoking all wills and codicils heretofore made by me. 1. I direct my executor to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. 2. I authorize and empower my executor to sell any realty owned by me at my death, and not specifically devised or bequeathed herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 3. I devise and bequeath all of my estate of every nature and wherever situate to my husband, Raymond Lester Shughart, providing he shall survive me by sixty days. 4. Should the gift in Paragraph No. 3 not take effect, I devise and bequeath all of my estate of every nature and wherever situate to my three children, share and share alike, the child or children of any deceased child taking the share their parent would have taken if living. 5. I nominate and appoint Raymond Lester Shughart to be the executor of this my last will and testament; he is to serve as such without bond. Should he die before my death, renounce or refuse to serve for any reason, or die leaving any of my estate unadministered, I nominate and appoint Donna L. Thumma, Mack W. Shughart and Joan K. Shughart, as substitute executors, also to serve as such without bond, with the same powers as are given herein to my executor. 6. I hereby suggest that my personal representative retain the services of Irwin, Irwin & Irwin, as attorneys in the settlement of my estate. this IN WITNESS WHEREOF, I have hereunto set my hand and seal day of March, 1982. JEANNETTE R. S.HUGHART (SEAL) Signed, sealed, published and declared by Jeannette R. Shughart, the above named testatrix, as and for her last will and testament, in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names as witnesses hereto. -2- ACKNOWlEDGEmENT AND AFFIDAVIT We, JEANNETTE R. SHUGHART , BETZI A. MORRISON , and SHARON L. SCHWALM , the testatrix and the witnesses, respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will and that she had signed willingly· and that she ex~cuted it as her free and ~oluntary act for the purposes therein expressed· and that each of the witnesses, in the presence and hearing of the testatrix , signed the Will as a witness and that to the best of their knowledge the testatrix was at that time eighteen years of age or older, of sound mind and under ~o constr~i~t or undue influence. JEANNETTE R. a~HUGHART SHARON L. SCHWALM COMMONWEALTH OF PENNSYLVANIA : : SS: COUNTY OF CUMBERLAND : Subscribed, sworn to and acknowledged before me by JEANNETTE R. SHUGHART and sworn to before me by SHARON L. SCHWALM March BETZI A. MORRISON , witnesses, this , 19 82. , the testat rix, and subscribed · and ~ day of CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Estate No.: JEANNETTE R. SHUGHART JANUARY 13, 2004 21-04-0144 To the Register: I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on March 2, 2004 . Name Address Donna L. Thumma Mack W. Shughart Joan K. Shughart 943 Forest Court, Carlisle, PA 17013 16 Raylen Drive, Boiling Springs, PA 17007 211 Kennington Drive, Goose Creek, SC 29445 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except __ Date: 03/02/04 Signature~iR~~Mc~i~ Name Roger B. Irwin, Esquire Address 60 West Pomfret Street Carlisle, PA 17013 Telephone (717) 249-2353 none . gO:Zd Z-~I~I 170. X __ Personal Representative __ Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDiViDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003812 IRWIN ROGER B ESQ 60 W POMFRET ST CARLISLE, PA 17013 ........ fold ESTATE INFORMATION: SSN: 196-14-4453 'ILE NUMBER: 2104-01 44 DECEDENT NAME: SHUGHART JEANNETTE R DATE OF PAYMENT: 04/1 3/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/1 3/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 91,911.31 TOTAL AMOUNT PAID: 91,911.31 REMARKS' SEAL CHECK# 021 087 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV- 1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. ;>80601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN DECEDENT RESIDENT ED i DECEDENT'SNAME(LAST'FIRST'ANiMIDDLEINITIAL)shughart Jeannette R. C DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) E D 01/13/2004 02/16/1920 E (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) N T cAPB HpRL EpIO c=AC ~TK 1. Original Return 2. Supplemental Return 4. Limited Estate 4a. Future Interest Compromise (date of death after 1Z- 1Z-8:>) 6. Decedent Died Testate 7. Decedent Maintained a Living Trust (Attach copy of Will) (Attach copy of Trust) r-~ 9. Litigation Proceeds Received ['~ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) NAME iRoger B. Irwin Esq. FI RM NAM E (If Applicable) IRWIN & McKNICHT TELEPHONE NUMBER 717/249-2353 cg OFFICIAL USE ONLY FILE NUMBER 21-04-0144 COUNTY CODE YEAR NUMBER 2. 3. 4; R 5. E C A 6. P I T U 7, L A T 8. I O 9. N 10. 11. 13. C O M SOCIAL SECURITY NUMBER 196-11-4445 Real Estate (Schedule A) (1) Stocks and Bonds (Schedule B) (2) Closely Held Corporation, Partnership or (3) Sole-Proprietorship Mortgages & Notes Receivable (Schedule D) (4) Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) Jointly Owned Property (Schedule F) (6) E~] Separate Billing Requested Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) Total Gross Assets (total Lines 1-7) Funeral Expenses & Administrative Costs (Schedule H) (9) Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) Total Deductions (total Lines 9 & 10) Net Value of Estate (Line 8 minus Line 11 ) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER (date of death 3. Remainder Return prior to 12-13-82) 6. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes Etection to tax under Sec. 9113(A) (Attach Sch O) COMPLETE MAILING ADDRESS '60 West Pomfret Street West Pomfret Professional Bldg. Carlisle, PA 17013 OFFICIAL.~JSE ONLY :~;~. ~cj, Ue . 2,7~.:~:8 !:-~one None 45,282.42 ~O (a) 48,048.60 (11) 3,339.60 (12) 44,709.00 (13) (14) 44,709.00 (15) 0.00 (16) 2,011.91 ~None None 2,945.95 393.65 Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 0.00 X .0 0 16. Amount of Line 14 taxable at lineal rate 44,709.00 X .0 45 17. Amount of Line 14 taxable at sibling rate 0.00 X .12 18. Amount of Line 14 taxable at collateral rate 0.00 X .15 19. Tax Due (17) O. O0 (18). O. 00 (19) 2,011.91 T I O N :opyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 801 North Hanover Street CITY Carlisle Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit El. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty STATE ZIP PA 17013 (1) 2,011.91 100.60 Total Credits ( A + B + C ) (2) 100.60 0.00 0.00 1,911.31 0.00 1,911.31 Total Interest/Penalty ( D + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page I 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) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retaintheuseorincomeofthepropertytransferred; ......................... ~ ~ b. retain the right to designate who shall use the property transferred or its income; ........... c. retain a reversionary interest; or .................................... d. receive the prom se for fe of ether 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? ................................ ~ ~ 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? ................................ [~ r-~ 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 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 RESPONSIBLE FOR FILING RETURN Donna L. Thumma 943 Forest Court i¥[- -i} i § ........................... DATE SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE IRWIN & McE_NIG[-TT DATE ./////'.,,r~ /;, ~j~. . 60 West Pomfret Street ~/,~,, ' ' - i;;;- --iY i§ ........................... ;;;' ;;' ];;i;;"i i' ;;;;' ;,;;';,;;";;i;,'" ;f i;';; ........ surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (i)]. For dates of death on or after Janua~ 1, 1995, the tax rate imposed 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 tra.sfer to a surviving spouse from tax, and the statuto~ requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficial. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twe.~-one years o[ a~e or ~oun~er 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 rote imposed on t~e net value of transfers to or for the use of the decede.t's lineal be~ficiaries is 4.5%, except as noted in 72 ~.S. 9116(1.~) [~Z P.S. 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. Copyrig ht (c) ~000 form software o~1~ The Lackner Group, Inc. Form ~V- 1500 ~X (Rev. ADDITIONAL Personal Representatives Estate of Jeannette R. Shughart SS# 196-11-4445 01/13/2004 Under penalties of perjury, the undersigned declare that they have examined this return, including accompanying schedules and statements, and to the best of their knowledge and belief, it is true, correct and complete. Signature Marne Address Line 1 Address Line 2 City, State, Zip Mack W. Shughart 16 Raylen Drive Boiling Springs, PA 17007 Date REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE B STOCKS & BONDS FILE NUMBER Jeannette R. Shu8hart SS# 196-11-4445 01/13/2004 21-04-0144 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION UNIT VALUE OF DEATH 1 40 shares Metlife Inc. 32.86 1,314.40 2 251. 173 shares Waddell & Reed Inc. 5.78 1,451.78 TOTAL (Also enter on line 2, Recapitulation) 2,766.18 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1503 EX (Rev. 1-97) REV- 1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jeannette R. Shughart SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER SS~/ 196-11-4445 01/13/2004 21-04-0144 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH Members First Federal Credit Union - regular savings account Members First Federal Credit Union - checking account Members First Federal Credit Union - investment savings account TOTAL (Also enter on line 5, Recapitulation) 1,748.57 3,758.71 39,775.14 $ 45,282.42 (If more space is needed, insert additional sheets of the same size) Copyright(c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97) REV-1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA iNHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jeannette R. Shughart SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER SS~/ 196-11-4445 01/13/2004 21-04-0144 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. 1 2 3 4 FUNERAL EXPENSES: Westminster Cemetery - grave opening ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address' City State Zip Year(s) Commission Paid: Attorney's Fees IRWIN & McKNIGHT Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Register of Wills Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Cumberland Law Journal estate notice publication Patricia A. Rosendale CPA - 2003 income tax preparation Register of Wills filing fee The Sentinel - Legal - estate notice publication TOTAL (Also enter on line 9, Recapitulation) 185.00 2,400.00 110.00 75.00 42.00 25.00 108.95 $ 2,945.95 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. REV- 1515 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jeannette R. Shughart SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS FILE NUMBER SS~ 196-11-4445 01/13/2004 21-04-0144 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 2 3 4 5 6 7 8 9 Bronstein Jeffries Carlisle Regional Medical Center Central Penn Medical Group Lanc. HMA Phsycians Management Moffitt Heart & Vascular Spring Road Family Practice Spring Road Family practice Stocken 0pthalmology West Shore EMS TOTAL (Also enter on line 10, Recapitulation) 26.67 90.70 40.07 15.00 15.22 27.94 93.55 6.94 77.56 $ 393.65 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV- 1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Jeannette R. Shughart SS~/ NUMBER I1. SCHEDULE J BENEFICIARIES 196 - 11- 4445 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY 01/13/2004 TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a~1.Z)] Joan K. Shughart 211 Kennington Drive Goose Creek, SC 29445 PA 17007 Mack W. Shughart 16 Raylen Drive Boiling Springs, RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Daughter Son FILE NUMBER 21 - 04- 0144 AMOUNT OR SHARE Of ESTATE 1/3 remainder Donna L. Thumma 943 Forest Court Carlisle, PA 17013 1/3 remainder Daughter 1/3 remainder ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0 o 00 (If more space is needed, insert additional sheets of the same size) Copyright (c) ZOO0 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-OO) i, JEANNETTE R. SHUGHART, of South Middleton Township, Cumberland County, Pennsylvania, declare this instrument to be my last will and testament, hereby expressly revoking all wills and codicils heretofore made by me. 1. I direct my executor to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. 2. I authorize and empower my executor to sell any realty owned by me at my death, and not specifically devised o~ bequeathed herein, at either public or private sale, and to give good and sufficient deeds therefor, in fee simple, as I could do if living. 3. I d~vise and bequeath all of my estate of every nature and wherever situate to my husband, Raymond Lester Shughart, providing he shall survive me by sixty days. 4. Should the gift in Paragraph No. 3 not take effect, I devise and bequeath all of my estate of every nature and wherever situate to my three children, share and share alike, the child or children of any deceased child taking the share their parent would have taken if living. 5. I nominate and appoint Raymond Lester Shughart to be the executor of this my last will and testament; he is to serve as such without bond. Should he die before my death, renounce or refuse to serve for a~y reason, or die iea~i~g a~y of my estate unadministered, I nominate and appoint Donna L. Thumma, Mack W. Shughart and Joan K. Shughart, as substitute executors, also to serve as such without bond, with the same powers as are given herein to my executor. 6. I hereby suggest that my personal representative retain the services of Irwin, Irwin & Irwin, as attorneys in the settlement of my estate. IN WITNESS WHEREOF, I have hereunto set my hand and seal this t~? day of March, 1982. JEANNETTE R. SHUGHART Signed, sealed, published and declared by Jeannette R. Shughart, the above named testatrix, as and for her last wilI and testament, in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names as witnesses hereto. _O_ and SHARON L. SCHWALH ~ the test%tPLx and rt}{;~e2tJivels~ whose r~alo:~ a'_o ~igned to the foregoing instrument, bein~ fir'st duly sworn, do h~:r'eby declare to the n'..~[hor~ty {iha~ the testatrix sL6ned ~nd ~2xecuted the instrument as her Last }llil and that: she h.~d signod willingly, and that she exoc'lted i~ as hep free and voluntary act for the pu[rpeses therein expPessel, and that each of the witnesses, in the presence and heerinS of the testatrix , sJ_~ned the ~'li]_l as e witness artd that to the best of their knowledge the tesba~mix was at that time- eighteen yea~s of age or oider~ of sound mind and under con.-:hrn, in~. OF undue infinence. JEANNETTE R. :SHUGHART SHARON L. SCHWALM COi'?!},'[ONiJEALTH OF PENNSYLVANIA : : SS: JEANNETTE R. SHUGHART a:.qd sw:t~t~.~.t ~o before me by SHARON L. SCHWALM March , 1_9 82. , tthet, estat rix , and subscribed BETZI A. HORRISON , and ., witnesses, this ~.'~ day of Mellon Mellon lnvesl'or Services Mellon Investor Services P.O. Box 4444 South Hackensack, NJ 07606 February 4, 2004 ESTATE OF JEANNETTE SH ATTN ROGER B IRWIN WEST POMFRET PROFESSIONAL BUfl~DING 60 WEST POMFRET STREET CARLISI.F. PA 17013-3222 Dear Mr. Irwin: Company Name ][METLIFE, INC. Account Key J[SH ....... JEAN-0000 Investor ID # ][806527125259 Control Number t200402030006459 Thank you for your inquiry requesting information for this account. Our records show this account has 40.0000 shares of Metlife Inc stock. The closing price on Jan 13, 2004 was $ 32.8600 per share. ~ ~ If you have any additional questions or concerns, please call our Customer Service Center at 1-800-649-3593. You may also access your MetLife, Inc. common 'stock account on the Intemet at https://vault, melIoninvestor, com/isd. Sincerely, Mellon Investor Services Ovcrpeck Centre * 85 Challenger Road * Ridgefield Park, NJ 07660 www.melloninvestor, com A ,:¥1e!l( tt Fin~a,:'io./Compa~zy. '"' MEMBERS 1" FEDERAL CREDIT UNION IRWIN & h,!o.[<iN[OHT February 4, 2004 Roger B. Irwin Irwin & McKnight West Pomfret Professional Building 60 W. Pomfret Street Carlisle, PA 17013-3222 Estate of Jeannette R. Shughart SSIN 196-14-4453 Dear Mr. Iriwn, Enclosed is the information requested in your letter of January 30, 2004 regarding the accounts held with Members 1st by Jeannette Shughart. Please provide a short certificate evidencing court appointment of an Executor along with an address for future statement mailings. You may contact me at 795-5131 or by email at wolfed~membersl st.org should you have any questions or require additional information. Ve/5~truly yours~ Dk-'fii§eA. Wolfe ~' Insurance Services Supervisor Enclosure 5000 Louise Drive · RO. Box40 · Mechanicsburg, Pennsylvania 17055 · (717)697-1161 ° ww-w. memberslst.org st REGULAR SAVINGS ACCOUNT: MEMBERS 1" FEDERAL CREDIT UNION Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/1/04 to Date of Death Name of Joint Owner Previous Joint Owner Date Joint Owner Removed CHECKING ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/1/04 to Date of Death Name of Joint Owner Previous Joint Owner Date Joint Owner Removed INVESTMENT SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Interest Earned from 1/1/04 to Date of Death Name of Joint Owner Previous Joint Owner Date Joint Owner Removed 105232 -00 11/18/1988 $1,748.03 $.54 $1,748.57 $.54 None Raymond L. Shughart (deceased) 09/02/2003 105232 -11 11/18/1988 $3,758.4O $31 $3,758.71 $.31 None Raymond L. Shughart (deceased) 09/02/2003 105232 -05 O4/15/2OO2 $39,760.89 $14.25 $39,775.14 $14.25 None Raymond L. Shughart (deceased) 09/02/2003 ;, BERS 1.~,~CEDERAL CREDIT UNION Denise A. Wolfe Insurance Supervis~or February 4, 2004 Estate of: JEANNETTE W. SHUGHART Date of Death: 01/13/2004 Social Security Number: 196-14-4453 5000 Louise Drive · P.O. Box 40 · Mechanicsburg, Pennsylvania 17055 · (717) 697-1161 · www. memberslst.org Inventory of the real and personal estate of JEANNETTE R. SHUGHART deceased 1. 40 shares Metlife, Inc ........................... 2. 251.173 shares Waddell & Reed, Inc ..................... 3. Members 1st Federal Credit Union - Regular Savings Account ......... 4. Members 1st Federal Credit Union - Checking Account ............ 5. Members 1st Federal Credit Union - Investment Savings Account ....... TOTAL .................. 1,314 1,451 1,748 3,758 39,775 48,048 40 78 57 71 14 6O COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003855 ........ fold ORRSTOWN BANK PO BOX 250 SHIPPENSBURG, PA 17324 ESTATE INFORMATION: SSN: 255-07-8552 FILE NUMBER: 2104-01 66 DECEDENT NAME: SHEARER ANNA VIVIAN DATE OF PAYMENT: 04/22/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 01/25/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $5,000.00 REMARKS: TOTAL AMOUNT PAID: $5,000.00 SEAL CHECK# 016398 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 ROGER B IRNIN ESQ IRWIN & MCKNIGHT 60 N POHFRET ST CARLISLE CONNONNEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAZSENENT, ALLO#ANCE OR DZSALLO#ANCE OF DEDUCTIONS AND ASSESSNENT OF TAX REV-1547 EX &FP (01-05) DATE 05-$1-2004 '' ESTATE OF SHUGHART JEANNETTE R DATE OF DEATH 01-13-2004 F/LE NUNBER 21 04-0144 COUNTY CUHBERLAND ACN 101 RAKE CHECK PAYABLE AND RENZT FAYHENT REGISTER OF NILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~,~ RETAIN LONER PORTION FOR YOUR RECORDS REV-154? EX AFP [01-03) NOTICE OF ZNHER/TANCE TAX APPRAZSENENT, ALLONANCE OR DZSALLONANCE OF DEDUCT/ONS AND ASSESSNENT OF TAX ESTATE OF SHUGHART JEANNETTE R FILE NO. 21 04-0144 ACN 101 DATE TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRA/SED VALUE OF RETURN BASED ON: ORIGINAL RETURN - 1. Reel Es'ca'ce (Schedule A) (1) . O0 NOTE: To ~nsure proper credi'c 'co your 2. S'cocks end Bonds (Schedule B) (2) subei'c 'che upper $. Closely Held S'cock/Par'cnership In'ceres'c (Schedule C) ($) ~. Hor'cgages/No'ces Receivable (Schedule D) (q) . O0 of 'chis fore wi'ch your E. Cash/Bank Deposi'cs/Nisc. Personal Proper'cy (Schedule E) (5) 451 Z82.4Z 'cax 6. Join'cly Owned Proper'cy (Schedule F) (6) , O0 7. Transfers (Schedule G} (7) .00 (8) 8. To'Ce1 APPROVED DEDUCTIONS AND EXEMPTIONS: 2,945.95 9. Funeral Expenses/Ado. Cos'cs/Misc. Expenses (Schedule H) (9) 10. Deb'cs/Nor'cgege Liebili'cies/Liens (Schedule Z) (10) 393.65, (11) 11. To'cai Deduc'cions (12) Z~766.18 .00 NOTE: 12. Ne'C Value of Tax Re'cum 15. Chari'ceble/Governeen'cal Beques'cs; Non-elec'ced 9115 Trus'cs (Schedule J) (13) lq. No'C Value of Es'ce'ce Subjec'c 'co Tax (lq) ~f an assessment ~as issued previously, lines 14, 15 and/or 16, 17, reflect flgures that include the total of ALL_ returns assessed to date. ASSESSNENT OF TAX: O0 x O0 15. Amoun'c of Line 1~ a'c Spousal re'ce (15) ' = 16. Aeoun'c of Line lq 'caxeble e'C Lineal/Class A re'ce (16) 44,709.00 x 045 = .00 x 12 : 17. Aeoun'c of Line 1~ e'C Sibling re'ce (17) .00 x 15 = 18. Amoun'c of Line 1~ 'cexeble e'C Colla'ceral/Cless B re'ce (18) (19)= 19. Principal Tax Due RFCFTp1 NUHBER CD003812 TAX CREDITS: pAYtI~NT DATE 04-13-Z004 INTEREST/PEN PAID (-) 100.60 ANOUNT PAID 1,911.31 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADD/T/ONAL /NTEREST. 48,048.60 3.339.60 44,709.00 .00 44,709.00 18 and 19 Nill .0O 2,011.91 .00 .00' Z,Oll.91 TOTAL TAX CREDIT / 2,011.91 BALANCE OF TAX DUE .00 ZNTEREST AND PEN. .00 TOTAL DUE .00 ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REgUZRED. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTZONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z) 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 Coamonmealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes et the lamful Class 8 (collateral) rata on any such future interest. To fulfill the requirements of Section Z160 of the Inheritance and Estate Tax Act, Act Z5 of ZOO0. (TZ P.S. Section 9160). 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 A refund of a tax credit, which was not requested on the Tax Return, may ba requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-ISIS). Applications are available at the Office of the Register of Hills, any of the 23 Revenue District Offices) or by calling the special 26-hour ansmering service for fores ordering: 1-800-36Z-ZOSO; services for taxpayers with special hearing and / or speaking needs: 1-800-q6?-30ZO (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. Z810Z1, Harrisburg) PA 171ZB-10Z1, OR --election to have the matter determined at audit oft he account af the personal representative, OR --appeal to the Orphans' Court. Interest Daily Interest Daily Year Rate Factor Year Rate Factor ~ ZOZ .000568 1988-1991 117. .000301 1983 167. .000638 1992 97. .000267 1986 117. .000301 1993-1996 77. . OO019Z 1985 137. .000356 1995-1998 97. .000167 1986 107. .000276 1999 77. .000192 1987 107. .000276 ZOO0 71 .000192 --Interest is calculated as fellows: I'NTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINItUENT 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. Z80601, Harrisburg, PA 171lB-0601 Phone (717) 787-6S05. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-IS01) far 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 allowed. The 157. tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the end 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 (9) months and Dna (1) 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 (67.3 percent per annum calculated at a daily rate of .000166. All taxes ehich became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOOq are: Interest Daily Year Rate Factor ~ 97. .000Z67 ZOOZ 6Z .00016q ZOOS 57. .000137 zoo6 67. .000110 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. STATUS REPORT UNDER RULE 6.12 Name of Decedent: JEANNETTE R. SHUGHART Date of Death: JANUARY 13. 2004 No. 21-04-0144 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 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? X Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphan's Court and may be attached to this report. Date: 03/15/2005 ///?~r /?).~, Signature I,..,') IRWIN & IGHT Roger B. Irwin. Esquire Name (please type or print) 60 West Pomfret Street Address Carlisle. PA 17013 City, State, Zip (717) 249-2353 Telephone Number Capacity: X Personal Representative Counsel for Personal Representative ; CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Paul S. Shugart Date of Death: Ng"wmbQr Ui, 10Q" Will No. 21-04-1144 Admin. No. 2004-0ill44 To the Register: I certify that notice of (beneficial interest) estate adminlstration 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 onMarch 11. 2005 Name Address Caroline L. Bowes 10 Har-John Drive, Carlisle PA 17013 PAlll T ~h.l'g~Y"T '}"Q '\".Hlcnn <::'rTAAt- . rAr1 i C!1 A pA 17011 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except ~/ Date: March 11, 2005 Signature Name Hubert X. Gilroy, Esquire Address 4 Nortn HAnover Street Carlisle, PA 17013 Telephone (117) 243-4574 Capacity: _ Personal Representative ~Counsel for personal representative , . v"'"