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HomeMy WebLinkAbout02-1153ALLEN E. HENGH LAVY OFFICES 224 MARKET STREET NEWPORT, PENNSYLVANIA 17074 (71 ~ v67~3 i 39 FAX NUMBER (717) 567-3130 Email: attorney@pa.net Cumberland County Courthouse Register of'JVills Hanover and High Street Carlisle, Pa. 17013 November 15, 2002 Re: Estate of Hattie M. Sheaffer Social Security #177-24-5286 Date of Death: 10/15/02 Dear Register: I enclose the paperwork necessary for probate in the above-mentioned estate. The Executrix of the Estate, Kathy A. Reighter, has already been sworn-in in the Perry County Courthouse. We would also like three short certificates. I enclose a check in the amount of $257.00. If you naed anything further, please do not hesitate to contact this office. Thank vou. AEH; sdh Enclosures Sincerely, ~~ Aheti E. Hench v 0 ~pG~~ cc: Kathy A. Reighter R.R.#2, 8 Creekview Drive Newport, Pa. 17074 PETITION FOR GRANT OF LETTERS Estate of Hattie M. Sheaffer No. also known as ,Deceased Social Security No.177245286 Kathy A. Reighter Petitioner(s), who is/are 18 years of age or older, apply)ies) for . (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut rix named in the Last Will of the Decedent, dated 1/26/96 and codicil(s) dated State relevant circumstances, e.g., renunciation, death of executor, etc Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Perry County, Pennsylvania, with his/her last family or principal residence at care of Kathy A. Reighter, R.R.#2 8 Creekview Drive Newport Perry County, Pennsylvania (list street, number and municipality) Decedent, then 74 years of age, died October 15 , 2002 , at Thornwald Nursing Home Cumberland Co. PA (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property ......................................... $ 130,000.00 (if not domiciled in PA Personal property in Pennsylvania .................... $ (if not domiciled in PA Personal property in County .............................. $ Value of real estate in Pennsylvania ........................................................................................ $ Total ..................................................................................................................... $ 130,000.00 Real Estate situated as follows: Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Signature Typed or printed name and residence !,t, ~.r~-~1~_/~11 Kathy A Reighter R R #2 8 Creekview Dr., Newport,PA17074 RW-1 I ~ //b -~ B. Grant of Letters of Administration (c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Oath of Personal Representative Commonwealth of Pennsylvania COUnty Of Perry The Petitioner(s) above-named swear(s) and 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(s) of the Decedent, Petitioner(s) will well and truly administer tJ~e estate accordipq to law. Kathy A. f~'eighter DECREE OF REGISTER of Perry County, Pennsylvania Estate of Hattie M. Sheaffer Deceased No. also known as Social Security No: 177245286 Date of Death: 10/15/02 AND NOW, ~~~~-m~E-2- ! G ~~b..Z , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary ^ of Administration ((c.t.a., d.b.n.c.t.; pendente liter durante absentia; durante minoriate) are hereby granted to Kathy A. Reighter in the above estate and that the instrument(s), if any, dated January 26, 1996 described in the Petition be admitted to probate and filed of record as the Last Will of Decedent. FEES Letters .................................... $ ~~~~JOO /~7 C»zv / ~ ~ ,.~ ~ Register of Wills „~~~ J /~~e~~ l Short Certificates(s) ............... $ '~1. DO ~' ,Sf~ Renunciation .......................... $ Extra Pages ( ) ............... $ _ ~ ~ O .T.R ....................................... $ Signature JCP Fee ................................. $ ~~• d ~ Attorney: Allen E. Hench, Esq. Inventory ................................ $ I.D. No: 23315 Other ...................................... $ Address: 224 Market Street Newport PA 17074 TOTAL .............................$ ~?'oo Telephone: 717-567-3139 DATE FILED: Sworn to and affirmed and subscribed OATH OF SUBSCRIBING WITNESS Estate of Hattie M. Sheaffer No. also known as ,Deceased Allen E. Hench (each) a subscribing witness to the ^ codicil(s) ^ will(s) presented herewith, (each) my qualified according to law depose(s) and say(s) that she/he/they was/were present and saw the above T ator(rix) sign the same and that she/he/they signed as a witness at the request of the Te o~~ her/his/ eir presence and] in the presence of each other ^ in the presence of the other su cr bi wi ess(es . (Signature) 224 rket Street ~ PA 17074 (Signature) (Address) Sworn to or affirmed and subscribed before me this 1 ~ day of . Z o~~v~Z o~L ary Public My Commission Expires: LINDA J. HALL,NOT~p(~ NEWPORT BOROUGH, PERRII CQ. PA ~- Commission Expires Nov. 29, ZOOQ (Signature and seal of Notary or other NOTE: To be taken by officer authorized to administer oaths. Please have official qualities to administer oaths. Show present the original or copy of instrument(s) at time of notarization. date of expiration of Notary's commission.) RW-2 OATH OF SUBSCRIBING WITNESS Estate of Hattie M. Sheaffer No. also known as ,Deceased Linda J. Hall (each) a subscribing witness to the ^ codicil(s) ^ will(s) presented herewith, (each) duly qualified according to law depose(s) and say(s) that she/he/they was/were present and saw the above Testator(rix) sign the same and that she/he/they signed as a witness at the request of the Testator(rix) in her/his/their presence and] in the presence of each other ^ in the presence of the other subscribing witness(es). Sworn to or affirme~i~~ubscribed bed me this~_`"='day of iGotary Public My Commiss (Signature and seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's commission.) v ~ (Signature) P.O. Box 387 New Bloomfield PA 17068 (Address) (Signature) (Address) NOTE: To be taken by officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. RW-2 -~ `7 ~~ c ~~ .~ . ^ ~. ALLEN E. HENCH ATTORNEY AT LAW 221 MARKET 3T. NEWPORT, PA 17074 TEL. p~7~ se7-S~3o FAX (717) 587-3130 LOYSVLLE OFFICE: WEST MAIN ST. (RT. 274) LOYSVILLE. PA 17047 TEL. (717) 789.3847 I, HATTIE M. SHEAFFER, of Newport Borough, Perry County, Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all Wills by me heretofore made. FIRST: I direct payment of the expenses of my last illness, funeral and burial costs from my residuary Estate, as an expense of my Estate, as soon after my death as conveniently may be done. All Federal, State and other death taxes payable because of my death, with respect to the property forming my gross Estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such tax, shall be considered a part of the administration of my Estate and shall be paid from my residuary Estate without apportionment or right to reimbursement. SECOND: I give and bequeath: A. my automobile to my son, Neil A. Sheaffer in Urbana, Ohio; and B. all my tangible personal property, such as furniture, household goods, and personal effects, if any, and other tangible personalty of like nature, not including cash or securities, together with any existing insurance thereon, in equal shares, to my three children, Kathy A. Reighter, Neil A. Sheaffer, and Beverly K. Sheaffer. THIRD: I give and bequeath to each of my grandchildren the sum of One Thousand ($1,000) Dollars each. FOURTH: All.. the rest, residue and remainder of my estate, whether real, personal or mixed, of which I shall die seized and possessed; and to which I may be entitled at the time of my decease, .and wheresoever the same may be situate, I give, devise and bequeath, in equal shares, unto my three children, Kathy A. Reighter, Neil A. Sheaffer, and Beverly K. Sheaffer. In the event a child fails to survive me, I give and bequeath that deceased child's share to his or her issue, per stirpes, or in default thereof, to my other children. I! ~ II / FIFTH: In addition to all powers granted by law, I give my Executrix(tor), hereunder, the following powers, which may be exercised without leave of court: to retain and to invest in all forms of real and personal property; to compromise claims and to abandon any property which is of little or no value, if deemed appropriate to my Executrix(tor); to sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property, or interest therein, and to give option for sales or leases, and to give a good deed of conveyance or bill of sale for the transfer thereof; to allocate any property received or charge incurred to principal or income or partly to each, without being obliged to apply the usual rules of Trust accounting; to distribute in cash or in kind (according to the fair market value prevailing at the time of .distribution) or partly in each. SIXTH: I nominate, constitute and appoint my daughter, KATHY A. REIGHTER as the Executrix of this my Last Will and Testament and my Estate. In the event KATHY A. REIGHTER is unable or unwilling to serve, I nominate, constitute, and appoint my son NEIL A. SHEAFFER as Executor of this my Last Will and Testament and my Estate. SEVENTH: I direct that no Executrix(tor) acting under this Will shall be required to enter bond for the faithful performance of duties, in any jurisdiction. IN WITNESS WHEREOF, I, the said HATTIE M. SHEAFFER, have hereunto set my hand and seal, to this my Last Will. and Testament, this~~~ day of January, 1996. ,~~~~,~.. :~' ~ ( SEAL ) HATTIE M. SHEAFFE ALLEN E. HENCH ATTORNEY AT LAW 224 MARKET ST. NEWPORT, PA 17074 TEL (717) 687-3139 FAX (717)687.3130 LOYSVLLE OFFICE: WEST MAIN ST. (RT. 274) LOYSVILLE, PA 17047 TEL. (717) 789-3847 The writing contained in this and the preceding sheet was signed and sealed by the above named, HATTIE M. SHEAFFER, and by her published and declared as and for her the Last Will and Testament, in the presence f us, who have hereunto subscribed our names::°as 'fines es at her request, in her presence. ,~ , _~ o .. , ~, A dress : y% ' /' ,~ a ,n H-S EAFF.WIL ~ `~ s ~ ,~ 1 l"~ C, .,.k,.o--d ~_.. , -:t ~`~ ~4, I~ J `~~ .. ~. y.. _~ `° a ----~--------------`____ r` ---~.. ~ ------------ Q- ~~ 1 M1 7 !__ 1 ~ L 1 ~ O 1, 1 -' ~ ...~] •' 0 ~ 0 ~ -~~~ 0 ~~~ x zaWo w~.~~ x~ ~~ rzi w ~ 0 a ~ ~w ~~'Nz U c ~ t ~- ~ N •~n ~ ~ ~ ~ ~ O ~ ~ ~~~a _ ~ ~ > inn ~ '~ ~ •` U~=U 1 y .:•.~ ~n ,••:~ •M 1 ~} •N ALLEN E. HENCH LAVY OFFICES 224 MARKET STREET NEWPORT, PENNSYLVANIA 17074 (7 i 7) 567.3 i 39 FAx rvuMBER (717) 567-3130 Email: attorney@pa.net January 6, 2003 Cumberland County Courthouse Register of Wills Hanover and High Streets Carlisle, Pa. 17013 Re: Estate of Hattie M. Sheaffer Social Security No. 177-24-5286 File No ~' Via Certified Mail Dear Register: I enclose a check in the amount of $7,000 to be applied toward inheritance tax in the above-referenced estate. Thank you. Sincerely, ~' ~ Allen E. Hench AEH/sdh Enclosures cc: Kathy A. Reighter COMMONWEALTH OF PENNSV LVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: HENCH ALLEN E ESQUIRE 224 MARKET STREET NEWPORT, PA 17074 fold ACN ASSESSMENT CONTROL NUMBER PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT N0. CD 002021 ESTATE INFORMATION: ssly: ~~~-24-52E6 FILE NUMBER: 2102-1 153 DECEDENT NAME: SHEAFFER HATTIE M DATE OF PAYMENT: 01 /07/2003 POSTMARK DATE: 01 /06/2003 COUNTY: CUMBERLAND DATE OF DEATH: 1 0/ 1 5/2002 REV-1162 EX111-96) AMOUNT 101 ~ 57,000.00 TOTAL AMOUNT PAID: REMARKS: ALLEN E HENCH ESQUIRE SEAL CHECK# 2639 INITIALS: JA RECEIVED BY: DONNA M. OTTO 57,000.00 DEPUTY REGISTER OF WILLS REGISTER OF WILLS CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent:l~a~tie M. Sheaffer Date of Death: 10/15/02 } Will No. 2002-01153 Admin. No. To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules wa: served on or mailed to the following beneficiaries of the above-captioned estate on 1/8/03 Name Address Kathy A. Reighter R.D.#2, 8 Creekview Drive Newport PA 17074 Neil A. Sheaffer 4809A Thomas Paine Circle Scott AFB IL 62225 Beverly K. Sheaffer 626 North Pitt Street Carlisle PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: The grandchildren, whose share of the estate was distributed prior to the death of Hattie M. Sheaffer. Date: 118/03 Capacity: ~ ~ e~ L~. Signature Name: Allen E. Hench. Esquire Address: 224 Market Street Newport PA 17074 Telephone (7r7) -~'~ ~'~ 3 Personal Representative ~_ Counsel for Personal Representative BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 KATHY A REIGHTER CREEKVIEH RD RR 28 NEHPORT PA 1707q CONHONgEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLONANCE OR DXSALLONANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 02-02-200q ESTATE OF SHEAFFER DATE OF DEATH 10-15-2002 FILE NUMBER 21 02-1155 COUNTY CUMBERLAND SSN/DC 177-2~,5286 ACN ~ 03106253 ~ I Amoun~ Rem J.~'~ed REV-lgq8 EX AFP HATTIE M MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF gILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~ RETAXN LONER PORTXON FOR YOUR RECORDS ~ REV-1548 EX AFP (01-033 NOTICE OF XNHERXTANCE TAX APPRATSEMENT, ALLOgANCE OR DXSALLOgANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX ON dOZNTLY HELD OR TRUST ASSETS DATE 02-02-200q ESTATE OF SHEAFFER HATTIE M DATE OF DEATH 10-15-2002 COUNTY CUMBERLAND FILE NO. 21 02-1155 S.S/D.C. NO. 177-Zq-5286 ACN TAX RETURN gAS: (X) ACCEPTED AS FILED ( ) CHANGED 05106255 JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PHC BANK ACCOUNT NO. 21001057826 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING C ) TRUST (~ TIME CERTIFICATE DATE ESTABLISHED 10-28-199q Account Balance 5,179.15 Percent Taxable X 0.500 Amount Subject to Tax 1,589.57 Debts and Deductions - .00 Taxable Amount 1,589.57 Tax Rate X .q5 Tax Due 71.55 TAX CREDITS= NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE gITH YOUR TAX PAYMENT TO THE REGISTER OF gILLS AT THE ABOVE ADDRESS. HAKE CHECK OR MONEY ORDER PAYABLE TO: "REGISTER OF gILLS, AGENT." PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROUGH OZ-lO-200q AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM TOTAL TAX CREDIT BALANCE OF TAX DUEI INTEREST AND PEN. TOTAL DUE XF PAID AFTER TH/S DATE, SEE REVERSE FOR CALCULATION OF ADD/TXONAL /NTEREST. ( XF TOTAL DUE 1S LESS THAN $1, NO PAYMENT XS RE~U/RED. ZF TOTAL DUE 1S REFLECTED AS A 'CREDIT' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR /NSTRUCTXONS. ) .00 71.55 1.98 75.51 BUREAU OF INDIVIDUAL TAXES ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION ,« DEPT. 280601 INHERITANCE TAX HARRISBURG, PA 17128-0601 RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS KATHY A REIGHTER CREEKVIEW RD RR 28 NEWPORT PA 17074 REV-1604 EX ~FP (O1-OSl DATE 03-02-2004 ESTATE OF SHEAFFER HATTIE M DATE OF DEATH 10-15-2002 FILE NUMBER 21 02-1153 COUNTY CUMBERLAND SSN/DC 177-24-5286 ACN 03106254 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1604 EX AFP (01-03) ~~ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ~~ DATE 03-02-2004 ESTATE OF SHEAFFER HATTIE M DATE OF DEATH 10-15-2002 COUNTY CUMBERLAND FILE N0. 21 02-1153 S.S/D.C. N0. 177-24-5286 ACN 03106254 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT N0. 21001037801 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 10-28-1994 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: .00 X 0.500 .00 _ .00 00 X .45 .DO NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN A80VE. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. [ IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), ,i5 YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~~ PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- Make check or money order payable to: REGISTER OF WILLS, AGENT. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices or from the Department's 24-hour answering service for forms ordering: 1-SOD-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (T7 only). REPLY 70: Questions regarding errors contained an this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, Phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% 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. INTEREST: Interest is charged beginning with first day of delinquency or nine C9) months and one (1) day from the date of death to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which 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 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20% .000548 1987 9% .000247 1999 7% .000192 1983 16% .000438 1988-1991 11% .000301 2000 8% .000219 1984 11% .000301 1992 9% .000247 2001 9% .000247 1985 13% .000356 1993-1994 7% .OOD192 2002 6% .000164 1986 10% .OD0274 1995-1998 9% .000247 2003 5% .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computaticn date shown on the Notice, additional interest must be calculated. REV-7470 EX (68B) - ~ INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME FILE NUMBER Hattie Sheaffer 2102-1153 REVIEWED BY H~iv Emerson Luciano 03106253-03106254 SCHEDULE I INO EXPLANATION OF CHANGES The above referenced ACN has been reduced to zero, as this account was reported on the probate return. Page 1 COMMONWEALTH Of PENNSYLVAPJIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES ~ EPT. ;I~C"~601 +HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT HENCH ALLEN E 224 MARKET ST NEWPORT„ PA 17074 ~o~d ESTATE INFORMATION: ssN: 1~7-24-52ss FILE NUMBER: 2102-1 153 DECEDENT NAME: SHEAFFER HATTIE M DATE OF PAYMENT: 04/20/2004 POSTMARK DATE: 04/20/2004 couNTY: CUMBERLAND DATE OF DEATH: 1 0/ 1 5/2002 ACN ASSESSMENT CONTROL NUMBER REV-1162 EX111-961 NO. CD 003847 AMOUNT 101 ~ 5526.59 TOTAL AMOUNT PAID: REMARKS: 5526.59 CHECK# 2645 INITIALS: JA sEaL RECEIVED BY: GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~~ '~ ~~, ~ :~. ~ ~ ' ``~ ~~, `~ J "" ~~~-~ ~ \ - ~ '~ .J {` J ~ \t _. .,, ~ ~ v "~~ ~\ `~~ -~ -~ ~~ _.~..~ r ~;. ,d ep ~ ~".;~ ® ti ,~ m 0 t;:' ~. ... LL~~:~N~ U ~ ..• ~ m O~ ~~ zz ~ ~ ALLEN E. HENCH LAW OFFICES 220 MARKET STREET (CORNER OF Market AND Second & One-Half STREEt) NEWPORT, PENNSYLVANIA I 7074 (717) 567-3 ! 39 FAX NUMBER (717) 567-3130 Email: attorney@pa.net April 19, 2004 Cumberland County Courthouse Register of Wills 1 Courthouse Square Carlisle, PA 17013 Dear Sirs: Enclosed are an original and two copies of the Inheritance Tax Return in the Hattie M. Sheaffer Estate. Please clock in all three copies and return one copy to my office in the envelope provided. I also enclose a check, payment of inheritance taxes in the Hattie M. Sheaffer Estate. Please let me know if you need anything further. AEH:bsz Enclosures 4-19-04-2-1 Sincerely, Allen E. Hench REV-1500 EX + (6-00) LU I-- Z DJ Z o It. U,J o COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL Sheaffer, Hattie M. DATE OF DEATH (MM-DD-Year) 10/15/2002 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT 07/11/1928 OFFICIAL USE ONLY Fr' =. NUMBER .oi, -0 2 0 COUNTY COOE YEAR SOCIAL SECURITY NUMBER 1 7 7-2 4-5 1 1 5 3 NUMBER 2 8 6 DATE OF BIRTH (UU-DD-Year) (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER [-"-~ 1. Odginal Retum r--] 4. Limited Estate r~6. Decedent Died Testate (Attach copy of Will) E~]9. Litigation Proceeds Received r~2. Supplemental Retum r-'~ 4a. Future Interest Compromise (date ofdea~ alter 12-12-82) r-'] 7. Decedent Maintained a Living Trust (Attach copy orrrust) ~] 10. Spousal Poverty Credit (date of deah between 12-31.91 and 1.1.95) E~]3. Remainder Return (date of death prior to 12-13-82] --]5. Federal Estate Tax Retum Required __ 8. Total Number of Safe Deposit Boxes [-"~ 11. Election to tax under Sec. 9113{A) (Attach Sch O) THIS SECTION MUST BE COMPLP. i cu. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME Allen E. Henchr Esquire FIRM NAME (If Applicable) Allen E. Hench Law Office TELEPHONE NUMBER 717-567-3139 COMPLETE MAILING ADDRESS 220 Market Street Newport PA 17074 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) -"] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 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) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) ,.o.oo 0.00 11,701.92 (8) OFFICIAL USE ONLY 0.00 0.00 (11) (12) (13) (14) 11,701.92 0.00 11 ~701.92 11,701.92 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) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. X .0 (15) 11,701.92 X .04.5 (16) X .12 (17) X .15 (18) (19) 526.59 526.59 > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedeot's Complete Address: STREET ADDRESS Thornwald Home, 442 Walnut Bottom Road CITY Carlisle ISTATE PA Jzip 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Povedy Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty (1) Total Credits ( A + B + C ) (2) Total Interest/Penalty ( D + E ) (3) 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) 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. (5A) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 526.5,,. O.OC O.OC 526.5.c 526.5.. 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; ........................................................................... [] [] 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? ............................................................. [] [] 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 SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, t declare that [ 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 ADDRESS Kathy A/. 'l~e!~ghter - R.E~2, 8 ~f'~ekview Drive Newport//, .d'~ ///// ,/J / ADDRESS Allen/E. Hench, Esquire - 224 Market Stre/~t Ne.y/port DATE PA 17074 DATE PA 17074 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 3% [72 P.S. {}9116 la)(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 0% [72 P.S. §9116 la) (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 retum 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 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedenrs 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 decedenrs 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. REV-1509 EX * (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F' JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER Sheaffer. Hattie M. 2Q 02 011 ~$ If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. Kathy A. Reighter daughter B Nell A. Sheaffer C Beverly K. Sheaffer R.D.#2, 8 Creekview Drive Newport, PA 17074 4809A Thomas Paine Circle Scott AFB, IL 62225 626 North Pitt Street Carlisle, PA 17013 son daughter JOINTLY-OWNED PROPERTY: LETI'ER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for joinlyheld real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERE~ 11. A. See attached list of recently discovered U.S. Savings 6,200.10 50. 3,100.0! Bonds with total value of $6,200.10 12. B. See attached list of recently discovered U.S. Savings 10,042.04 50. 5,021.0: Bonds with total value of $10,042.04. 13. C. See attached list of recently discovered U.S. Savings 7,161.70 50. 3,580.8~ Bonds with total value of $7,161.70 TOTAL (Also enter on line 6, Recapitulation) $ 11,701.9: (If more space is needed, insert additional sheets of the same size) 110/2002 i Update i I H*!P · i Series Denomination Serial Number Bonds ?~,"[ $1~°° ~ I # Bonds Total Price Total Interest 55 $2,225.00 $3,975.10 Issue Serial Number Issue Date Series Denom Price Interest Value C126713840EE 12/1986 EE $100 $50.00 $68.44 $118.44 Cl16916868EE 11/1986 EE 100 50.00 68.44 118.44 Cl16916738EE 10/1986 EE 100 50.00 82.48 132.48 Cl16916465EE 08/1986 EE 100 50.00 82.48 132.48 Cl16917107EE 06/1986 EE 100 50.00 82.48 132.48 Cl16917010EE 05/1986 EE 100 50.00 82.48 132.48 Cl16917219EE 07/1986 EE 100 50.00 82.48 132.48 C107234822EE 04/1986 EE 100 50.00 85.12 135.12 C107234741EE 03/1986 EE 100 50.00 85.12 135.12 C107214772EE 01/1986 EE 100 50.00 85.12 135.12 C107214771EE 01/1986 EE 100 50.00 85.12 135.12 C249334700EE 12/1990 EE 100 50.00 48.68 98.68 C272428830EE 01/1991 EE 100 50.00 48.68 98.68 C249334335EE 11/1990 EE 100 50.00 48.68 98.68 C249334334EE 11/1990 EE 100 50.00 48.68 98.68 C249333975EE 10/1990 EE 100 50.00 51.64 101.64 C249333678EE 09/1990 EE 100 50.00 51.64 101.64 C249333418EE 08/1990 EE 100 50.00 51.64 101.64 C249333163EE 07/1990 EE 100 50.00 51.64 101.64 C249333162EE 07/1990 EE 100 50.00 51.64 101.64 C233659374EE 06/1990 EE 100 50.00 51.64 101.64 C233660140EE 05/1990 EE 100 50.00 51.64 101.64 C126713965EE 01/1987 EE 100 50.00 68.44 118.44 C233660141EE 05/1990 EE 100 50.00 51.64 101.64 C233659878EE 04/1990 EE 100 50.00 53.68 103.68 C233659667EE 03/1990 EE 100 50.00 53.68 103.68 C233659167EE 02/1990 EE 100 50.00 53.68 103.68 C217623239EE 01/1990 EE 100 50.00 53.68 103.68 Total Value $6,200.10 Issue Date I Interest Rate 3.73% 3.73% 4.00% 4.00% 4.00% 4.00% 4.00% 4.0O% 4.00% 4.00% 4.00% 6.00% 6.00% 6.00% 6.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 3.73% 4.00% 4.00% 4.00% 4.00% 4.00% Page 1 of 3 Savinc YTD In' $224. ~(o Next Final Accrual Maturit3 12/2002 12/201( 11/2002 11/201( 04/2003 10/201( 02/2003 08/201( 12/2002 06/201 ( 11/2002 05/201( 01/2003 07/201( 04/2003 04/201( 03/2003 03/201( 01/2003 01/201( 01/2003 01/201( 12/2002 12/202( 01/2003 01/2021 11/2002 11/202( 11/2002 11/202( 04/2003 10/202( 03/2003 09/202( 02/2003 08/202( 01/2003 07/202( 01/2003 07/202( 12/2002 06/202( 11/2002 05/202( 01/2003 01/2013 11/2002 05/202( 04/2003 04/202( 03/2003 03/202( 02/2003 02/202( 01/2003 01/202( .avings Bond Calculator Page 2 of 3 C81991611EE 10/1985 EE C85125184EE 10/1985 EE C85125072EE 09/1985 EE C85098309EE 08/1985 EE C81991521EE 07/1985 EE C81991522EE 07/1985 EE L38329922EE 06/1981 EE L38329923EE 06/1981 EE L38329263EE 05/1981 EE L38329264EE 05/1981 EE L38328954EE 04/1981 EE L38328301EE 03/1981 EE L38328302EE 03/1981 EE L17604943EE 02/1981 EE L17604944EE 02/1981 EE L17603671EE 01/1981 EE L53549417EE 07/1981 EE L53549416EE 07/1981 EE L53549796EE 08/1981 EE L53550155EE 09/1981 EE L53550154EE 09/1981 EE L53550546EE 10/1981 EE L53550545EE 10/1981 EE L53550892EE 11/1981 EE L53550893EE 11/1981 EE L72055348EE 12/1981 EE L72055347EE 12/1981 EE Viewing Bonds 1-55 100 50.00 100 50.00 100 50.00 100 50.00 100 50.O0 100 50.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 87.84 87.84 87.84 87.84 87.84 87.84 77.86 77.86 77.86 77.86 84.58 84.58 84.58 84.58 84.58 84.58 77.86 77.86 77.86 77.86 77.86 77.86 77.86 75.84 75.84 75.84 75.84 137.84 137.84 137.84 137.84 137.84 137.84 102.86 102.86 102.86 102.86 109.58 109.58 109.58 109.58 109.58 109.58 102.86 102.86 102.86 102.86 102.86 102.86 102.86 100.84 100.84 100.84 100.84 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.O0% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 04/2003 10/2015 04/2003 10/2015 03/2003 09/2015 02/2003 08/2015 01/2003 07/2015 01/2003 07/2015 12/2002 06/2011 12/2002 06/2011 11/2002 05/2011 11/2002 05/2011 04/2003 04/2011 03/2003 03/2011 03/2003 03/2011 02/2003 02/2011 02/2003 02/2011 01/2003 01/2011 01/2003 07/2011 01/2003 07/2011 02/2003 08/2011 03/2003 09/2011 03/2003 09/2011 04/2003 10/2011 04/2003 10/2011 11/2002 11/2011 11/2002 11/2011 12/2002 12/2011 12/2002 12/2011 Note Description NI Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty ME Matured (Exchangeable for HH) MN Matured (Not Exchangeable for HH) Please rate this service. ~,qa~ings Bond Calculator 110/2002 I Update.t I, Help Series Bonds Denomination $1 I # Bonds Total Price Total Interest 98 $3,875.00 $6,167.04 SerialNumber Issue Date Series Denom C126714094EE 02/1987 EE C126714209EE 03/1987 EE C126714497EE 05/1987 EE C126714614EE 06/1987 EE C145810322EE 07/1987 EE C145810444EE 08/1987 EE C145810578EE 09/1987 EE C145810744EE 10/1987 EE C145811048EE 12/1987 EE C145811049EE 12/1987 lEE C188347159EE 01/1989 EE C188347350EE 02/1989 EE C203850139ElE 04/1989 EE C203850336EE 05/1989 EE C203850548EE 06/1989 EE C217621834lEE 07/1989 EE C217622068EE 08/1989 EE C217622302EE 09/1989 EE C217622531EE 10/1989 EE C217622532EE 10/1989 EE C217622779EE 11/1989 EE C17623017EE 12/1989 EE C217623018EE 12/1989 EE C272429415EE 05/1991 EE C272429416EE 05/1991 EE C272429744EE 06/1991 EE C272430042EE 07/1991 EE C272430441EE 08/1991 EE Issue Price $100 $5O.0O 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.0O 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 Interest Page 1 of 4 Savinc Serial Number Issue Date Total Value YTD In' $10,042.04 $361. ~- Interest Next Final Value Rate Accrual Maturit3 $68.44 $118.44 3.73% 02/2003 02/201' 68.44 118.44 3.73% 03/2003 03/201' 65.00 115.00 3.78% 11/2002 05/201' 65.00 115.00 3.78% 12/2002 06/201' 65.00 115.00 3.78% 01/2003 07/201' 65.00 115.00 3.78% 02/2003 08/201' 65.00 115.00 3.78% 03/2003 09/201' 65.00 115.00 3.78% 04/2003 10/201' 62.24 112.24 4.00% 12/2002 12/201' 62.24 112.24 4.00% 12/2002 12/201' 57.88 107.88 4.00% 01/2003 01/201c~ 57.88 107.88 4.00% 02/2003 02/201c~ 57.88 107.88 4.00% 04/2003 04/201c, 55.76 105.76 4.00% 11/2002 05/201c~ 55.76 105.76 4.00% 12/2002 06/201c~ 55.76 105.76 4.00% 01/2003 07/201c~ 55.76 105.76 4.00% 02/2003 08/201c~ 55.76 105.76 4.00% 03/2003 09/201c~ 55.76 105.76 4.00% 04/2003 10/201c, 55.76 105.76 4.00% 04/2003 10/201c, 53.68 103.68 4.00% 11/2002 11/201c~ 53.68 103.68 4.00% 12/2002 12/201c~ 53.68 103.68 4.00% 12/2002 12/201c~ 45.84 95.84 6.00% 11/2002 05/2021 45.84 95.84 6.00% 11/2002 05/2021 45.84 95.84 6.00% 12/2002 06/2021 45.84 95.84 6.00% 01/2003 07/2021 45.84 95.84 6.00% 02/2003 08/2021 ~.+,-.// ........... *,];,.a~},t t,-oaq onv~C/gBCPrice 3/25/04 javings Bond Calculator Page 2 of 4 C272431150EE 09/1991 EE C272431151EE 09/1991 EE C272431500EE 10/1991 EE C272431855EE 11/1991 EE C272431856EE 11/1991 EE C272432170EE 12/1991 EE C272432566EE 01/1992 EE C27243290EE 02/1992 EE C272433183EE 02/1991 EE C272433184EE 02/1991 EE C272433429EE 03/1991 EE C272433642EE 04/1991 EE C324168036EE 03/1992 EE C324171567EE 12/1992 EE C324171913EE 01/1993 EE C324171914EE 01/1993 EE C408216031EE 02/1993 EE C410922202EE 03/1993 EE C415764812EE 04/1993 EE C417667087EE 05/1993 EE C427345457EE 06/1993 EE C427345458EE 06/1993 EE Ll14997072EE 01/1983 EE Ll14997073EE 01/1983 EE Ll14997375EE 02/1983 EE L114997711EE 03/1983 EE Ll14997712EE 03/1983 EE L124019851EE 04/1983 EE L124019852EE 04/1983 EE L127396579EE 05/1983 EE L127396580EE 05/1983 EE L127578173EE 06/1983 EE L127578174EE 06/1983 EE L127590771EE 07/1983 EE L127628030EE 08/1983 EE L127628031EE 08/1983 EE L142274143EE 09/1983 EE L142274144EE 09/1983 EE 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 45.84 45.84 45.84 43.04 43.04 43.04 43.04 43.04 48.68 48.68 48.68 48.68 43.04 37.68 37.68 37.68 37.68 29.60 29.60 27.60 27.60 27.60 66.58 66.58 66.58 60.40 60.40 60.40 60.40 55.96 55.96 55.96 55.96 55.96 55.96 55.96 55.96 55.96 95.84 95.84 95.84 93.04 93.04 93.04 93.04 93.04 98.68 98.68 98.68 98.68 93.04 87.68 87.68 87.68 87.68 79.60 79.60 77.60 77.60 77.60 91.58 91.58 91.58 85.40 85.40 85.40 85.40 80.96 80.96 80.96 80.96 80.96 80.96 80.96 80.96 80.96 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 6.00% 3.75% 3.75% 3.80% 3.80% 3.80% 6.00% 6.00% 6.00% 4.01% 4.01% 4.01% 4.01% 3.95% 3.95% 3.95% 3.95% 3.95% 3.95% 3.95% 3.95% 3.95% 03/2003 09/2021 03/2003 09/2021 04/2003 10/2021 11/2002 11/2021 11/2002 11/2021 12/2002 12/2021 01/2003 01/2025 02/2003 02/2025 02/2003 02/2021 02/2003 02/2021 03/2003 03/2021 04/2003 04/2021 03/2003 03/2025 12/2002 12/2025 01/2003 01/2022 01/2003 01/2022 02/2003 02/2022 03/2003 03/2022 04/2003 04/2022 11/2002 05/2022 12/2002 06/2022 12/2002 06/2022 01/2003 01/2012 01/2003 01/2012 02/2003 02/2012 03/2003 03/2012 03/2003 03/2012 04/2003 04/2012 04/2003 04/2012 11/2002 05/2012 11/2002 05/2012 12/2002 06/2012 12/2002 06/2012 01/2003 07/2012 02/2003 08/2012 02/2003 08/2012 03/2003 09/2012 03/2003 09/2012 ~,avings Bond Calculator Page 3 of 4 L142316054EE 10/1983 EE L142316055EE 10/1983 EE L151412225EE 11/1983 EE L153614996EE 12/1983 EE L153614997EE 12/1983 EE L156829559EE 01/1984 EE L156829560EE 01/1984 EE L156829839EE 02/1984 EE L156829840EE 02/1984 EE L156830162EE 03/1984 EE L156830163EE 03/1984 EE L156830434EE 04/1984 EE L156830712EE 05/1984 EE L156830713EE 05/1984 EE L170759111EE 06/1984 EE L170759112EE 06/1984 EE L170759349EE 07/1984 EE L170759350EE 07/1984 EE L2137639327E 09/1979 E 2162665023E 01/1979 E L2162665773E 02/1979 E L2162666407E 03/1979 E L2162666923E 04/1979 E L2162667542E 05/1979 E L2162668259E 06/1979 E L2162668852E 07/1979 E L2162668853E 07/1979 E L2162669314E 08/1979 E L2189950024E 10/1979 E L2189950632E 11/1979 E L2189951224E 12/1979 E L2189951225E 12/1979 E IView 1~0 II Viewing Bonds 1-98 Note Description NI Not Issued NE Not Eligible for Payment 50 50 50 5O 50 5O 5O 50 50 5O 50 5O 50 5O 50 5O 5O .50 5O 5O 50 50 50 50 50 50 50 50 50 50 50 50 25.00 25.00 25.00 25.00 25.00 25.00 25.00 25.00 25.00 25.00 25.00 25.00 25.00 25.00 25.00 25.00 25.00 25.00 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 37.50 55.96 55.96 52.64 52.64 52.64 52.64 52.64 52.64 52.64 52.64 52.64 52.64 49.14 49.14 49.14 49.14 49.14 49.14 128.60 129.92 129.92 129.92 129.92 128.22 128.60 128.60 128.60 128.60 128.60 126.88 126.88 126.88 80.96 80.96 77.64 77.64 77.64 77.64 77.64 77.64 77.64 77.64 77.64 77.64 74.14 74.14 74.14 74.14 74.14 74.14 166.10 167.42 167.42 167.42 167.42 165.72 166.10 166.10 166.10 166.10 166.10 164.38 164.38 164.38 3.95% 3.95% 3.58% 3.58% 3.58% 3.58% 3.58% 3.58% 3.58% 3.58% 3.58% 3.58% 3.56% 3.56% 3.56% 3.56% 3.56% 3.56% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 04/2003 10/2012 04/2003 10/2012 11/2002 11/2012 12/2002 12/2012 12/2002 12/2012 01/2003 01/201~ 01/2003 01/2014 02/2003 02/2014 02/2003 02/2014 03/2003 03/2014 03/2003 03/2014 04/2003 04/201~ 11/2002 05/2014 11/2002 05/201,~ 12/2002 06/2014 12/2002 06/2014 01/2003 07/2014 01/2003 07/201,~ 03/2003 09/200c~ 01/2003 01/200c~ 02/2003 02/200c~ 03/2003 03/200c~ 04/2003 04/200c~ 11/2002 05/200c~ 12/2002 06/200c~ 01/2003 07/200c~ 01/2003 07/200c~ 02/2003 08/200c~ 04/2003 10/200c~ 11/2002 11/200c~ 12/2002 12/200c~ 12/2002 12/200c~ .///.Savings Bond Calculator 0/2002 i ,Up date Page 1 of 3 Savinc Series Denomination lEE Bonds ~ $1zoo # Bonds Total Price 58 $2,500.00 Serial Number Issue Date Series Denom C324168398EE 04/1995 EE $100 C324171118EE 11/1992 EE 100 C324171119EE 11/1992 EE 100 C324170785EE 10/1992 EE 100 C324170439EE 09/1992 EE 100 C324170118EE 08/1992 EE 100 C324169757EE 07/1992 EE 100 C324169374EE 06/1992 EE 100 C3241693733EE 06/1992 EE 100 C324168729EE 05/1992 EE 100 C324168397EE 04/1992 EE 100 C188346967EE 12/1988 EE 100 C188346761EE 11/1988 EE 100 C188346570EE 10/1988 EE 100 C187471751EE 09/1988 EE 100 C170065698EE 07/1988 EE 100 C170065557EE 06/1988 EE 100 C170065410EE 05/1988 EE 100 C170065267EE 04/1988 EE 100 C170065123EE 03/1988 EE 100 C170064951EE 02/1988 EE 100 C81991428EE 06/1985 EE 100 C78183987EE 05/1985 EE 100 C78183986EE 05/1985 EE 100 C78183907EE 04/1985 EE 100 C77870111EE 03/1985 EE 100 C7787010EE 03/1985 EE 100 C77870082EE 02/1985 EE 100 Serial Number I Total Interest Total Value $4,661.70 $7,161.70 Issue Interest Price Interest Value Rate $50.00 $22.56 $72.56 3.74% 50.00 37.68 87.68 6.00% 50.00 37.68 87.68 6.00% 50.00 40.32 90.32 6.00% 50.00 40.32 90.32 6.00% 50.00 40.32 90.32 6.00% 50.00 40.32 90.32 6.00% 50.00 40.32 90.32 6.00% 50.00 40.32 90.32 6.00% 50.00 40.32 90.32 6.00% 50.00 43.04 93.04 6.00% 50.00 57.88 107.88 4.00% 50.00 57.88 107.88 4.00% 50.00 60.04 110.04 4.00% 50.00 60.04 110.04 4.00% 50.00 60.04 110.04 4.00% 50.00 60.04 110.04 4.00% 50.00 60.04 110.04 4.00% 50.00 62.24 112.24 4.00% 50.00 62.24 112.24 4.00% 50.00 62.24 112.24 4.00% 50.00 87.84 137.84 4.00% 50.00 87.84 137.84 4.00% 50.00 87.84 137.84 4.00% 50.00 91.20 141.20 3.87% 50.00 91.20 141.20 3.87% 50.00 91.20 141.20 3.87% 50.00 91.20 141.20 3.87% Issue Date I Next Accrual 04/2003 11/2002 11/2002 04/2003 03/2003 02/2003 01/2003 12/2002 12/2002 11/2002 04/2003 12/2002 11/2002 04/2003 03/2003 01/2003 12/2002 11/2002 04/2003 03/2003 02/2003 12/2002 11/2002 11/2002 04/2003 03/2003 03/2003 02/2003 YTD In' $244. Final Maturit3 04/2025 11/2025 11/2025 10/2025 09/2025 08/2025 07/2025 06/2025 06/2025 05/2025 04/2025 12/201~ 11/201fi 10/201 ~ 09/201 ~ 07/201 ~ 06/201 ~ 05/201E 04/201 ~ 03/201~ 02/201 ~ 06/2015 05/2015 05/2015 04/2015 03/2015 03/2015 02/2015 htt~ ://wwws.nubl icdebt.treas. ~,ov/R C/,RRCPrice 2/9 q/(]a Savings Bond Calculator Page 2 of 3 C77870081EE 02/1985 EE C75727759EE 01/1985 EE C75727758EE 01/1985 EE C75727672EE 12/1984 EE C75727571EE 11/1984 EE C75727570EE 11/1984 EE C68103595EE 10/1984 EE C68103596EE 10/1984 EE C68103507EE 09/1984 EE C68103415EE 08/1984 EE C68103414EE 08/1984 EE L2189954081E 05/1980 E L2189954080E 05/1980 E L2189953536E 04/1980 E L2189953017E 03/1980 E L2189952512E 02/1980 E L2189951820E 01/1980 E L17603670EE 01/1981 EE L17603263EE 12/1980 EE L17602986EE 11/1980 EE L17602985EE 11/1980 EE L17602608EE 10/1980 EE L17602607EE 10/1980 EE L17601837EE 09/1980 EE L17601838EE 09/1980 EE L17601430EE 08/1980 EE L17601429EE 08/1980 EE L17600863EE 07/1980 EE L17600862EE 07/1980 EE L17600193EE 06/1980 EE Viewing Bonds 1-58 100 5O.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 100 50.00 50 37.50 50 37.50 50 37.50 50 37.50 50 37.50 50 37.50 50 25.00 50 25.00 50 25.00 50 25.00 50 25.O0 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 50 25.00 91.20 91.20 91.20 91.20 91.20 91.20 98.28 98.28 98.28 98.28 98.28 125.30 125.30 126.88 126.88 126.88 126.88 84.58 84.58 84.58 84.58 96.94 96.94 96.94 96.94 96.94 96.94 96.94 96.94 96.94 141.20 141.20 141.20 141.20 141.20 141.20 148.28 148.28 148.28 148.28 148.28 162.80 162.80 164.38 164.38 164.38 164.38 109.58 109.58 109.58 109.58 121.94 121.94 121.94 121.94 121.94 121.94 121.94 121.94 121.94 3.87% 3.87% 3.87% 3.87% 3.87% 3.87% 3.56% 3.56% 3.56% 3.56% 3.56% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 4.00% 02/2003 02/2015 01/2003 01/2015 01/2003 01/2015 12/2002 12/201,~ 11/2002 11/201,~ 11/2002 11/201,~ 04/2003 10/201 a 04/2003 10/201/, 03/2003 09/201,~ 02/2003 08/201,~ 02/2003 08/201,~ 11/2002 05/201( 11/2002 05/201( 04/2003 04/201( 03/2003 03/201( 02/2003 02/201 ( 01/2003 01/201( 01/2003 01/2011 12/2002 12/201( 11/2002 11/201( 11/2002 11/201( 04/2003 10/201( 04/2003 10/201( 03/2003 09/201( 03/2003 09/201( 02/2003 08/201( 02/2003 08/201( 01/2003 07/201( 01/2003 07/201( 12/2002 06/201( Note Description NI Not Issued NE Not Eligible for Payment P5 Includes 3-month interest penalty ME Matured (Exchangeable for HH) !.~III~ OFRCE ~ ~,LLEN E. 220 Market Street N~rt, PA 17074 ~oo Z COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OEPT 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST AND MIDDLE INITIAL Sheaffer, Hattie M. DATE OF DEATH (MM DO-Year) 10/15/2oo2 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DATE OF BIRTH (MM-DD-Year) 07/11/1928 (IF APPL C~BLE) SURV!VING SPOUSE'S NAME (LAST FIRST, AND MIDOLE rNITIAL) OFFICIAL USE ONLY FILE NUMBER 2 0 -0 2 0 1 1 5 3 SOCIAL SECURITY NUMBER 1 7 7-2 4-5 2 8 6 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ] ! OnglnaJ Return ] 4 Limited Estate [~9 Litigation Proceeds Received r"~2 Supplemental Return ] 4a Future [nteresi Compromise (date of death after 12-12.82) ] 7 Decedent Maintained a Living Trust [Aft~;hcopyofTrus[I r"~5 Federal Estate Tax Return Requtred -- 8 Total Number of Safe Deposit Boxes E~l 1 Election to tax under Sec 9113(Al (Attach ,THtS sEc~N:MUST BE C~MP~ED, ALLCORRES~DEN~E A~i~iAE TAX NF~ATfON SH~CD NAME I COMPLETE MAILING ADDRESS Allen E. Hench, Esquire I 224 Market Street FIRM NAME (ILApptcable) Allen E, Hench Law Office TELEPHONE NUMBER 717-567-3139 Newport ? ~. .~ ~ 17074 ~' .... I OF~/~USE ONLY 1 Real Estate (Schedule A) (1) 133~08~.90 Stocks and Bonds (Schedule B) (2) Closely Held Corporation. Partnership or Sole-Propnetorship (3) Mortgages & Noles Receivable (Schedule D) (4) Cash. Bank Deposits & Miscellaneous Personal Property (5} (Schedule E) Jointly Owned Property (Schedule F) (6) ] Separate Billing Requested 7 Inter-V~vos Transfers 8, Miscellaneous Non-Probate Property (7) (Schedule G or L) 8 Total Gross Assets (total Lines 1-7) 9 Funeral Expenses & Admimslrahve Costs (Schedule H) (9) 10 Debts of Oecede~tr Mortgage Liabilities, & Liens (Schedule I) (10) 1 i Total Deductions (total Lines 9 & 10) 12 Net Value of Estate (Line 8 minus Line I1) 13 Char:robie and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14 Net Value Subject to Tax (Line 12 minus bne 13) 45~970.09 (8) 183,543.10 (11) 17~289.48 1,768.93 19,058.41 164,484.69 (12) (13) (14) 164,484.69 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15 Amount of L~ne 14 laxable at the spousal tax ra!e or transfers under Sec 9118 (al(1 2) !E Amc,,nt of bne 14 taxable at hneal role 17 Amount of L~ne 14 taxable at sibhng rate 18 Amount of Uno 14 !axable at collateral rate 19 Tax Due 2O x 0 (15) 164r484.69 X 04.5 (16) X 12 (17) X 15 (18) (19), 7~401.81 7,401.81 Decedent',s Complete Address: fTR~ETAODRESS Thomwald Home, 442 Walnut Bottom Road ITY Carlisle ] STATE ] ZIP PA 17013 Tax Payments and Credits: 1 Tax Due (Page 1 Line 19) 2 Credits/Payments A Spousal Poverty Credit B Prior Payments C Discount 7,000.00 368.42 3 Interest/Penalty if applicable D Interest E. Penaity 4 (1) Total Credits ( A + B + C ) (2) Total Interest/Penalty ( O + E ) (3) 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) 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. (5A) B Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 7~401.81 7~368.42 0.00 33.39 33.39 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: ........................................................... .!__ [] [] b retain the right to designate who shall use the property transferred or its income4 ............................. ; .... [] [] c. refain a reversionary interest; or ............................................................................................. [] [] d. receive the promise for life of either payments, benefita or care? .......................................................... [] [] 2 If daath occurred after December 12, 1982, did deoedent transfer property within one year of death w~thout receiving adequate consideration? ...............................................................................~.. [] ,[] 3 Did decedent own an "in trust for" or payable upon death bank account or security at his or her death2 ............. [] [] 4. Did decedent own an Individual Retirement Acoount, annuity, or other non.probate property which contains a beneficiary designatien~ [] []. 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 petrify, I declare that I ha~e examined this return including accompanying schedules and staterne~ s, and o he best o my knowbdge and he e, s true, COrTeCt and compb~e Oeclara~on 311 reformation of which preparer has a~y krowbdge S:GNATURE OF PERSON RES ~CDRESS Kathy / JRN DATE SIGNATUF ADDRESS reekview Drive E PA 17074 DATE AIh Market Street PA 17074 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 3% r72 PS §9116 (a) (1.1) (i)]. For dates of death on or after January , 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)] ,heTnesurv v'n~Statute dOeSspousenOt iseXemptthe ontya transferbeneficiaryto a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if Fo,' 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 0% [72 P S. {}9116(a)(1.2)I. The tax rate imposed on the net value ot 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 PS §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. §91 t6(a)(13)]. A sibling s defined under Section 9102, as an individual who has at least one parent in common with the decedent whether by blood or adoption. I, HATTIE M. SHEAFFER, of Newport Borough, Perry County, Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all Wills by me heretofore made. FIRST: I direct payment of the expenses of my last illness, funeral and burial costs from my residuary Estate, as an expense of my Estate, as soon after my death as conveniently may be done. All Federal, State and other death taxes payable because of my death, with respect to the property forming my gross Estate for tax purposes, whether or not passing under this Will, including any interest or penalty imposed in connection with such tax, shall be considered a part of the administration of my Estate and shall be paid from my residuary Estate without apportionment or right to reimbursement. SECOND: I give and bequeath: A. my automobile to my son, Nell A. ~Sheaffer in Urbana, Ohio; and B. all my tangible personal property, such as furniture, household goods, and personal effects, if ~any, and other tangible personalty of like nature, not including cash or securities, together wit~ any existing insurance thereon, in equal shares, to my three children, Kathy A. Reighter, Nell A. Sheaffer, and Beverly K. Sheaffer. THIRD: I give and bequeath to each of my grandchildren the sum of One Thousand ($1,000) Dollars each. FOURTH: Ail the rest, residue and remainder of my estate, whether real, personal or mixed, of which I shall die seized and possessed, and to which I may be entitled at the time of my decease~ and wheresoever the same may be situate, I give, devise and bequeath, in equal shares, unto my three children, Kathy A. Reighter, Nell A. Sheaffer, and Beverly K. Sheaffer. In the event a child fails to survive me, I give and bequeath that deceased child's share to his or her issue, per stirpes, or in default thereof, to my other children. II1~ ...... ' ............ [[llll'l'~ 11 [ [ [ [n[[ (RT. ~4) · FIFTH: In addition to all powers granted by law, I give my Executrix(tor), hereunder, the following powers, which may be exercised without leave of court: to retain and to invest in all forms of real and personal property; to compromise claims and to abandon any property which is of little or no value, if deemed appropriate to my Executrix(tor); to sell at public or private sale, to exchange, or to lease for any period of time, any real or personal property, or interest therein, and to give option for sales or leases, and to give a good deed of conveyance or bill of sale for the transfer thereof; to allocate any property received or charge incurred to principal or income or partly to each, without being obliged to apply the usual rules of Trust accounting; to distribute in cash or in kind (according to the fair market value prevailing at the time of distribution) or partly in each. SIXTH: I nominate, constitute and appoint my daughter, KATHY A. REIGHTER as the Executrix of this my Last Will and Testament and my Estate. In the event KATHY A. REIGHTER is unable or unwilling to serve, I nominate, constitute, and appoint my son NEI~ A. SHEAFFER as Executor of this my Last Will and TestameT~t and my Estate. ' SEVENTH: I direct that no Executrix(tor) acting? under this Will shall be required to enter bond for the faithful performance of duties, in any jurisdiction. ~ IN WITNESS WHEREOF, I, the said HATTIE M. SHEAFFER, have hereunto set my hand and seal, to this my Last Wil-1 and Testament, this~ day of January, 1996. HATTIE M. SHEAFFER' The writing contained in this and the preceding sheet was signed and sealed b~ the above named, HATTIE M. SHEAFFER, and by her publishes and declared as/and for her the Last Will and Testament, in the ~resence ~f us, who have hereunto subscribed our names/as,~i~nes~es at/~er request, in her presence. ~ ~/~ / /// ¢. ' '" " ' H-S~EAFF.WIL ~ - t / / COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF Sheaffer. Hattie M. All property jointly.owned with right of sun/ivorship must be disclosed on Schedule F. FILE NUMBER 20 02 01153 ~TEM NUMBER DESCRIPTION 47 shares of Prudential Financial stock (closing price of $29.50/share) 2,880 shares of Coca Cola Co. stock (closing price of $45.98/share) TOTAL (Also enter on line 2, Recapitulation $ (If more space is needed, insert additional sheets of the same size) VALUE AT DATE OF DEATH 1,386.50 132,422.40 133,808.9u COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT E~TATE OF SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY FILE NUMBER ~Sheaff~r. Hattie M. 20 Q;~ 011,53 Include the proceeds of litigation and ~he date the proceeds were received by the estate All proper[,/jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 2. 3. 4. 5. 6. 7. 8. Sprint Life Insurance ($5,000 non-taxable) 2 Prudential Life Insurance policies ($5,000 each - non-taxable) AAA Life Insurance policy ($5,000 non-taxable) Refund from Thomwald Home Reimbursement of United Commercial Travelers insurance premium Sprint retirement Prudential Homeowner's Insurance refund AARP Pharmacy Service refund 0.00 0.00 0.00 2,373.50 423.27 888.34 64.00 15.00 TOTAL (Also enter on line 5, Recapitulation) $ 3~764.1 I (Ii' more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FiLE NUMBER Sheaffer. Hattie M 20 02 01153 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURV]VING JOINT TENANTCS) NAME ADDRESS RELATIONSHIP TO DECEDENT A Kathy A. Reighter daughter a Nell A. Sheaffer c Beverly K. Sheaffer R.D.#2, 8 Creekview Drive Newport, PA 17074 4809A Thomas Paine Circle Scott AFB, IL 62225 626 North Pitt Street Carlisle, PA 17013 son daughter JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH TEM FOR JOINT MADE Ircbde name of financial institution and bank account number or simibr identifying number Attach DATE OF D EA['~I DECO'S VALUE OF qUMBERTENANT JOINT deed for ~olnt y-held real estate VALUE OF ASSET INTEREST DECED~NT'S INTEREE 1 A. 10/9/84 FNB of Newport checking account #01-1053537-01, 6,101.39 50. 3,050.7£ date of death value of 6100.12 plus accrued interest of 1.26, per letter of Wanda Laughlin, dated 11/26/02 2. A. 10/9/84 FNB of Newport savings account #01-1053537-20, 7,728.33 50, 3,864.17 date of death value of 7648.31 plus accrued interest of 80.02, per letter of Wanda Laughlin,dated 11/26/02 3. A. 3/5/01 ~FNB of Newport CD#01-1053537-60, date of death value 5,483.52 50. o 2,741.76 of 5448.33 plus accrued interest of 35.19, per letter of Wanda Laughlin, dated 11/26/02, attached 4. A. 3/5/01 FNB of Newport CD#01-1053537-61, date of death value 49,351.56 50. 24,675.7( of 49034.85 plus accrued interest of 316.71, per letter of Wanda Laughlin, dated 11/26/02, attached 5. A. 3/5/01 FNB of Newport CD#01-1053537-62, date of death value 5,483.52 50. 2,741.7( of 5448.33 plus accrued interest of 35.19, per letter of Wanda Laughlin, dated 11/26/02, attached 6. A. 3/5/01 FNB of Newport CD#01-1053537-63, date of death value 5,483.52 50. 2,741.7( of 5448.33 plus accrued interest of 35.19, per letter of Wanda Laughlin, dated 11/26/02, attached 7. B. 10/94 PNC CD#000021001037802, date of death value of 3,043.06 50. 1,521.5: $3,039.91 plus accrued interest of 3.15. per letter of Rachelle Wells, dated 1/13/03, attached 8. C 10/94 PNC CD#000021001037803, date of death value of 3,043.06 50. 1,521 5: $3039.91 plus accrued interest of 3.15. per letter of Rachelle Wells, dated 1/13/03, attached 9. A. 10/94 PNC CD#000021001037801, date of death value of 3,043.06 50. 1,521.5: $3039.91 plus accrued interest of 3.15. per letter of Rachelle Wells, dated 1/13/03, attached 10. A. PNC CD#000021001037826, date of death value of 3,179.13 50. 1,589.5' $3,175.84 plus accrued interest of 3.29, per letter of Rachelle Wells, dated 1/13/03, attached ~, TOTAL (Also enter on line 6, Recapitulation) $ 45~97Q0! (If more space is needed, insert additional sheets of the same size) st First in Perry County T-HE FIRST NATIONAL BANK OF NEWPORT November 26, 2002 Mr. Allen E. Hench 224 Market St. Ne~vT~ort, PA 17074 Dear Allen: RE: Estate of Hattie M. Sheaffer At the time of her death, October 15, 2002,Hattie M. Sheaffer, had the following account(s? with our bank. Acct:Ol-1053537-O] Balance DOD $ 6,100.12 Accrued b~t. $ i.26 $ 6,101.39 Our records show that this Now Checking Account, which did earn interest, was opened October 9. 1984, the name(si of Hattie M. Sheaffer or Kathy A. Reighter. Acct: 01-1053537-20 BalanceDOD $ 7,648.31 Accrued [nr $ 80, 02 $ 7, 8.33 Our records show that this Passbook Savings Account, which did earn 'interest, was opened October 9, 1984, in the name[s) of Hattie M. Sheaffer or Kath)' A, Reighter. Acct: 01-1053537-60 Balance DOD $ 5,448.33 Accrued b*t. $ 35.19 $ 5,483.52 Our records show that this Certificate of Deposit, which did earn interest, was opened March 5. 2001, in the name(s) of Hattie M. Sheaffer or Kathy A. Reighter. Acct: 01-1053537-61 Balance DOD $ 49,034.85 Accrued Int. $ 316. 71 $ 49.351.56 Our records show that this Certificate of Deposit, which did earn interest, was opened March 5. 2001. in tile name(s) of Hattie M. Sheaffer or Katk¥ A. Reighter. :lcct: 01-1053537~62 Balance DOD S 5.448.33 Accrued blt. S 35. 19 $ 5,483.52 Our records show that this Certificate of Deposit, which did earn interest, was opened March 5. 2001, i. the name(s) of Hattie M. Sheaffer or Kathy ,4. Reighter. Center Square Office: P.O. Box 8 Newport, PA 17074-0008 (717) 567-3414 FAX (717) 567-7730 Duncaenon Branch 403 North Market Street Duncannon, PA 17020 (717) 834-3137 FAX (717) 834-6524 Red Hill Branch 18 Newport Plaza Newport, PA 17074 · (717) 567-6555 FAX (717) 567-2411 www. perrycounty.com New Bloomfield Branch I South Carlisle Street New Bloomfield, PA 17068 (717) 582-8188 FAX (717) 582-2727 Page 2. £state of'Hattie 114. Sheaffer Acct: 01-1053537-63 Balance DOD $ 5,448.33 Accrued Int. $ 35.19 $ 5,483,52 Our records show that this Certificate of Deposit, which did earn interest, was opened March 5, 2001, in the name(s) of Hattie M. Sheaffer or Kathy A. Reighter. The following is a listing of interest posted the each account from January' 1, 2002 through October 10, 2002. Acct: 01-1053537-01 $ 10.33 1/10/02 $ 7.25 2/10/02 $ 6.31 3/10/02 $ 6.82 4/10/02 $ 10. 69 5/10/02 $ 11.23 6/10/02 $ 8.55 7/10/02 $ 6.97 8/10/02 $ 7.62 9/10/02 $ 12.57 10/10/02 Acct: 01-1053537-60 Acct: 01-1053537-61 Acct: 01-1053537-62 $ 74,01 3/05/02 $ 76. 72 6/05/02 $ 77.84 9/05/02 $ 666. 05 3/05/02 $ 690. 51 6/05/02 $ 700.52 9/05/02 $ 74.01 3/05/02 $ 76. 72 6/05/02 $ 77.84 9/05/02 Acct: 01-1053537-63 $ 74.01 3/05/02 $ 76. 72 6/05/02 $ 77.84 9/05/02 Acct: 01-1053537-20 $ 202.20 6/30/02 Page 3. Estate of Hattie M. Sheaffer Regarding liquidation instructions, a Short Certificate must be on file and a letter of instruction is needed signed by the Executor of the Estate. All earnings are current[)' being reported under the Social Security number of Hattie M. Sheaffer, so a separate 1099 cannot be issued. If you have any questions or need any further information, please feel fi'ee to contact me at 567-3414 Ext. 214. Sincerely, ,~ Wanda Laughlin ~' Administrative Assistant PNCBAN<, January 13, 2003 Allen E. Hench 224 Market Street Newport, PA 17074 E~tat¢ of Hattie M. Sheaffer, deceased $SN: 177-24-$286 DOD: 10/15/2002 D~ar Mr. H~a~h: In r~$pome to your r~qu~t for D~e of Death balanc~ for the c~tom~r noted above, our records show thc following: Certificates of Deposit Accouat #21001037803 HA'f TIE M SHEAFFER OR BEVERLY K SHEAFFER DOD balance: $3,039.91 + $3,15 accrued interest Interes'~ Paid 1/1/2002- 10/15/2002- $69.87 Rate: 2.22% Established 10/25/1994 Account #21001037801 HATTIE M SHEAFFER OR KATHY A RE]GHTER DOD balance: $3,039.91 + $3.15 accrued in'~erest Interest Paid 1/1/2002 - 10/15/2002 - $69.87 Rate: 2.22% Account #210~ 1037826 HATTIE M SHEAFFER OR KATHY A REIGHTER DOD balance: $3375.84 + $3,29 accrued in~ere~ Iat~rest Paid 1/1/2002 - 10/15/2002 - $73.00 Rate: 2.22% Established 10/28/1994 . · E~tabliahed 10/28/199a, Account #21001037802 HATTIE M SHEAFFER OR .NELL A SHEAFFER DOD balance: $3,039.91 + $3.15 accru~ interest Intermt Paid 1/1/2002 - [0/15/2002 - $69,87 Rate: 2.22% Establish~l 10128/1994 Page 1 of 2 For Brokerage information, please call 1-$00-762-6111. INV #82156163 Please nOte',hat this office only provides date of death balances for deposit accotlnts (IItA. s, CDs, Checking and Savings accounts). We do not process any flnancisl ~'ansacflons or pro~lde statememts. If you need assis~snce with any of these items, please call 1-$88-PNC-BANK (1-888-762-2265) or atop by your local PNC Bank branch office. Rach~lle Wells 1-800-762-1 ?75 PT-PF$C-04-F 500 fi~t Ave, Pi~sbur~h PA 15219 Page 2 cf 2 M~"ab~r FDIC TOTAL P. ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF :ILE NUMBER Sheaffer, Hattie M. 20 02 01153 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A 1 4 5. FUNERAL EXPENSES: Myers Funeral Home ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s) / EIN Number of Personal Representative(s1 Street Address City State Year(s) Commission Paid AttorneyEees Allen E. Hench Law Office Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claiman~ Zip Street Address City Relahonship of Claimant to Decedent Probate Fees Cumberland County Register of Wills Accountant's Fees Tax Return Preparer's Fees Estate Notice - Carlisle Sentinel Estate Notice - Cumberland Law Journal Myers Funeral Home (death certificates) State Zip 7,331.05 9,175.00 257.00 88.43 75.00 13.00 Miscellaneous and final probate 350.00 TOTAL (Also enter on line 9, Recapitulation) $ 17=289.4R (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES,& LIENS ESTATE OF Sheaffer. Hattie M, Include unreimbursed medical expenses. FILE NUMBER ;~0 02 01153 ITEM NUMBER DESCRIPTION AMOUNT 2. 3. 4. 5. 6. 7. 8. 9. 'rhornwald Home Sprint Central Medical Equipment Co. - wheelchair Pharmerica ($251.19 + $16) Sprint - refund retirement check Accidental Death Premium ($4.95 + $4.95) Newport Ambulance USPO - certified mailing to Cumberland County Courthouse USPO - certified mailing to Coca-Cola Co. Miscellaneous 38.69 77.50 125.00 267.19 888.34 9.90 53.47 4.42 4.42 300.00 TOTAL (Also enter on line 10, Recapitulation) $ 1 ~768.9:~ more space is needed, insert additional sheets of the same si~e) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Sheaffer Hattie NUMBER I 2. 3. 4. 5. 6, 7. H. 1. 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) Kathy A. Reighter R.D.#2, 8 Creekview Drive Newport, Pa. 17074 Nell A. Sheaffer 4809A Thomas Paine Circle Scott AFB, IL 62225 Beverly K. Sheaffer 626 North Pitt Street Carlisle, PA 17013 Christopher Enck 586 West Philadelphia Street York, PA 17404 Ashley Reighter R.D.#2, 8 Creekview Drive Newpod, Pa. 17074 Dane Reighter R.D.#2, 8 Creekview Drive Newport, Pa. 17074 Meghan Sheaffer 4809A Thomas Paine Circle Scott AFB, IL 62225 FILE NUMBER 20 02 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) daughter son daughter randson randdaughter randson randdaughter ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATI 01153 AMOUNT OR SHARE OF ESTATE 1/3 residual estate 1/3 residual estate 1/3 residual estate $1,000 (distributed prior to death) $1,000 (distributed prior to death) $1,000 (distributed prior to death) $1,000 (distributed pdor to death) ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHE[ (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent Sheaffer, Hattie M. 20 02 Pa,qe 2 Schedule J - Beneficiaries - 1 01153 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE ! TAXABLE DISTRIBUTIONS (include outright spousal 8. Ethan Sheaffer 4809A Thomas Paine Circle grandson $1,000 (distributed prio~ Scott AFB, IL 62225 to death) 9. Alyssa Sheaffer 626 North Pitt Street granddaughter $1,000 (distributed prior Carlisle, PA 17013 to death) 10. Cory Simon 626 North Pitt Street grandson $1,000 (distributed pdor Carlisle, PA 17013 to death) ~c~v - ~: `~ K, COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 E% ~FP cai-o3) DATE 08-09-2004 ESTATE OF SHEAFFER HATTIE M DATE OF DEATH 10-15-2002 FILE NUMBER 21 02-1153 COUNTY CUMBERLAND ALLEN E HENCH ACN 101 220 MARKET ST Amount Remitted NEWPORT PA 17074 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1547 EX AFP [01-031 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SHEAFFER HATTIE M FILE N0. 21 02-1153 ACN 101 DATE OS-09-2004 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL AND SUPPLEMENTAL RETURN N0. O1 1. Real Estate (Schedule A) (1) .0 0 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) 133,808.90 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4) .0 0 of this fora with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 3,764.11 tax payment. 6. Jointly Owned Property (Schedule F) (6) 57,672.01 7. Transfers (Schedule G) (7) .00 8. Total Assets (g) 195, 245.02 APPROVED DEDUCTIONS AND EXEMPTIONS: 17,289.48 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 1,768.93 11. Total Deductions (11) 19.058.41 12. Net Value of Tax Return (12) 176,186.61 13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (14) 176, 186.61 NOTE: If an assessment was issued previously, lines 14, 15 andi~ ~~6, 18 .~ 19 will reflect figures that include the total of ALL returns asse~d tate .~, rF ASSESSMENT OF TAX: ~ 15. Amount of Line 14 at Spousal rate (15) •60 X 00 ~ .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 176,186.6'1 X 04 - `7;928.40 17. Amount of Line 14 at Sibling rate (17) • da X 12 ~© . 00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) .O,C1 X 15 .00 19. Principal Tax Due - (lq~ ~~~~',928.40 rr - TAX CREDITS: "" ~ ~ -° + AMOUNT PAID' ~ DATE NUMBER INTEREST/PEN PAID (-) 01-06-2003 CD002021 368.42 7,000.00 04-20-2004 CD003847 .00 526.59 INTEREST IS CHARGED THROUGH 08-24-2004 TOTAL TAX CREDIT 7,895.01 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 33.39 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 20.26 TOTAL DUE 53.65 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REBUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YDU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Comnonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: Tc fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and submit with your payment to the Register of Wills 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 "Application far Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Hills, any of the 23 Revenue District Offices, or by calling the special 24-hour answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 [TT only). OBJECTIONS: 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 (607 days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Oept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal 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 Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 5 of the bocklet ^Instructions for Inheritance Tax Return for a Resident Oecedent^ (REV-1501) for an explanation of administratively correctable errors. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%7 disccunt of the tax paid is allowed. PENALTY: The 15% 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 sane 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 (1] day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which 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 1982 through 2004 are: Interest Daily Interest -aily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor lr~ ~ .00 48 T~~8-1991 ~1'T -SCOT 211 ~ .OO~O r'r 1983 16% .000438 1992 9% .000247 2002 6% .000164 1984 11% .000301 1993-1994 7% .000192 2003 5% .000137 1985 13% .000356 1995-1998 9% .000247 2004 4% .000110 1986 10% .000274 1999 7% .000192 1987 10% .000274 2000 7% .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. ~O ~ ~ ~r o r- u~ q ~; I`- ~ ~O fV r 1`- 0(1 lD o m ~ F- ~a~ r 0_ 0 W ~, ti ~_ a ~ ~ rv-~ v, o .~ ~f,G~irNn(~ w K f13 d a o~ O U VJ ~ r OQ .7 x3 zaW~ W ~~~ x~~Q ,~~ W W w ~' z~~O wo~~ aF-,~w ,.~~Nz `U4 ~Ui; 30 ~i 4~ :(;~ 1 i ~c ^ V i'.~ l;~.} jai f ~'t i ~'~ :,..f ~...~ .,..f ~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 ALLEN E HENCH 220 MARKET ST NEWPORT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ~=t - ,t PA 1707.4 ,,f AF. °~ REV-1547 E% ~FP (01-03] DATE 08-09-2004 ESTATE OF SHEAFFER HATTIE M DATE OF DEATH 10-15-2002 FILE NUMBER 21 02-1153 COUNTY CUMBERLAND ACN 101 Anount Remitted S3 . (p 5~' MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1547 EX AFP (01-031 NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SHEAFFER HATTIE M FILE N0. 21 02-1153 ACN 101 DATE OS-09-2004 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN 8ASED ON: ORIGINAL AND SUPPLEMENTAL RETURN N0. O1 1. Real Estate (Schedule A) (1) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) 133,808.90 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this fora with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 3,764.11 tax payment. 6. Jointly Owned Property (Schedule Fl (6) 57,672.01 7. Transfers (Schedule G) (7) .00 8. Total Assets (g) 195,245.02 APPROVED DEDUCTIONS AND EXEMPTIONS: 17,289.48 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10l 1,768.93 11. Total Deductions (11) 19.058.41 176, 186.61 12. Net Value ofi Tax Return [1P) 00 13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) (13) . 14. Net Value ofi Estate Subject to Tax (l4) 176, 186.61 NOTE: If an assessment was issued previously, lines 14. 15 andior 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 00 15. Amount of Line 14 at Spousal rate (15) . X 16. Anount of Line 14 taxable at Lineal/Class A rate (16) 176,186.61 X 17. Anount of Line 14 at Sibling rate (17) •00 X 18 Anount of Line 14 taxable at Collateral/Class B rate [18) •00 X . 19. Principal Tax Due 00 _ .00 045= 7,928.40 12 .00 15 .00 (19)=_ DATE NUMBER + INTEREST/PEN PAID (-) AMOUNT PAID 01-06-2003 CD002021 368.42 7,000.00 04-20-2004 CD003847 .00 526.59 INTEREST IS CHARGED THROUGH 08-24-2004 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM TOTAL TAX CREDIT 7,895.01 BALANCE OF TAX DUE 33.39 INTEREST AND PEN. 20.26 TOTAL DUE 53.65 7,928.40 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for iife or for years, the Cammar,:~ealth hereby Expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such future interest. PURPOSE OF NOTICE: To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140). PAYMENT: Detach the top portion of this Notice and submit with your payment tc the Register of Wills 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 "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hcur answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). 08JECTIONS: Any party in interest not satisfied with the appraisement, allowance, ar disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60l days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. ADMIN- ISTRATIVE CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing tc: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 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 C3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% 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: Interest is charged beginning with first day of delinquency, or nine (9) months and one (17 day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent an 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 far 1982 through 2004 era: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor z~ .Dam 1~8-1991 -i"T .ogD of zoo 9T .DDDZ47 1983 16% .000438 1992 9% .000247 2002 6% .000164 1984 11% .000301 1993-1994 7% .000192 2003 5% .000137 1985 13% .000356 1995-1998 9% .000247 2004 4% .000110 1986 10% .000274 1999 7% .000192 1987 1D% .000274 2000 7% .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the ~ Notice, additional interest must be calculated. COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOFREVENUE BUREAU OFINDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EX(11-96) NO. CD 004319 HENCH ALLEN E 224 MARKET ST NEWPORT,, PA 17074 ........ fold ESTATE INFORMATION: SSN: 177-24-5286 FILE NUMBER: 2102-1153 DECEDENT NAME: SHEAFFER HATTIE M DATE OF PAYMENT: 08/30/2004 POSTMARK DATE: 08/30/2004 COUNTY: CUMBERLAND DATE OF DEATH: 10/15/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 953.65 REMARKS: CHECK# 2649 SEAL TOTAL AMOUNT PAID: 953.65 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS ~ ~ ~~ ~, '"~ ~.~ r~ .~ a d' ~ ~ ~ ~~~ ~. II ~y r+~i~. ~ ~~~ ~lu (~ •li.~i fU ~ cstag@ g r~ C] ! -~- -.. __. t- ~~IRfedF@@ d pi Hetnr F 3;EtrlFee ~~_~' (EndorseTfn, F'iVr~ir@d) p Postmark Re~strcteaJei~mfi~~Fee ~~~___..___ Here ~ (Fodor„er~u:rc 3,~~_ired) O Total °osixg, g pees m ~ O SentToL`--__. O ~,_. __ -'° City, Stale, 11F+:,..._._____________ .__-------._.._.._ ~ N ~" 1 .~ o ~ ~ . _--- ' ~ x ~ ,, ~ ~ _ ~ o a .. -~ vi ice ~ ~ ~ O 1 _ .. r .. ~ Q~ ~ C1 - ~, r} -- ~" --~pq ~ U iz, C3 ti"' ~ ~ ~~S ~ ~ ~ / 2~ ~ i~ ~ ~' a _ i~1 U ~ a ~ (Yl N Q ~~ N t1l ~ r--I Q ~ O ._.. i ~ a n' N N ~ o N Q ~ ~ ~ l~l O ~~ W 1- Z .~ ~ N -ri '~ a 0 3 W _~ 1 (D v c m N O A o ~ 3 n t m c 3 7^!' ;~,~ N ~ ~ 3 = w ~ ^ ^ J ~ ~_ y w a o o°i ~ ~ ~ N . ~ W 3 : m 7 . cn A O. ~. N O ~ ~ ^ ^ y s m ow ~ 3 ~p~,-.3 ~fA m ~NN7fpm p~x ~ ~a~~~•3 ~ ~ o . ~ ~j ~ c~a= y ~ N Q ~ 'UH(TJ < N ~ Ewa ~ yLTJ y•° ao y'D ~ ~o~mo y ~ o 3 ° ~ m ~ ~ a 3 ~ a• c •o ~• ~ coo m m `D v N ~ ~ `~ a ~ ~ m ~' .~ °: a ~ . ac~3. 3 ~ F 3 •v I ' ^ ~r o m JRD/June 30, 1992/17858 Gt~~~ ~ 1 ~~~~~~ In Re: Estate of Hattie M Sheaffer Late of Carlisle Borough Estate No.: 21-02-1153 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-02-1153 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Kathy Reighter Counsel for Personal Representative: Allen Hench Date of Decedent's Death: 10/15/2002 Date of Delinquency Notice: 08/11/04 The undersigned, Glenda Farner-Strasbaugh, Clerk of Orphans' Court, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on April 30, 2004, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date:ll/08/04 '~ Glenda Farner Strasbaugh ~f Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File ~.~;~ io, 2c~~ Q~3~ A . M . A hearing is scheduled for at in Courtroom No. 3. If the Status Report is filed prior to the hearing date, the hearing will automatically be cancelled. 6, ~' }}~r~ .•-.• to ~1 ~ 4 `~ c7 ~~ ~~ 00 m :I7 t~1 ~ Y 1~.a ~ W O *~` Z M .~r,,,.G.i~`~! GL r~ ,~`. ~` J ~f7 d O Q a°s ~, - "~ ~ ~ ~ ~ ~ ~ D R1 a ~~ rl O ~ O o ~~ O rl ~~ m .,,~. O C~ a~ x a~ w ,q o ~' x A ~ ~ r o N rt 11 cd r i ~ U ~ T~ ~ ~ W ~ U v c J m ~r ~ O t ~ .~ ~ ~ c '- w 3 aU. u ~ _ =s bW ~ ~: ~ A v ~' ~ d r!t L r 1 ~ W S r 0 ^ H H W r~ W G y3~ao W o N y Q OY~W3 o4rW~aC ooomo aLL Z W Z 7 0 V~SJJ d W ~ ~ O Q oWrnrz Zroo~ -_a~z , ~^ ¢O H x Q ~w a H W W ~ H HU~'~' p.' co 0.'. L~ ~,~3~~~s~c~~ Po;.trge g CI:lrtltied i~'ee Retum Feciept F'ee J (Endorsemen- Required) Restricted U ~Ilvery F=ee (Endorsemen Required) I ---- Total Posta 3e 8 Fees '; Sent To - -----------------------~h-------------------------.--------..------ S`Ireet Apt. No.; or PO Box No. Clry, State. 21P+4 ----------°------°-°--°-------- :ru rr .~ Certified Mail Provides: {~S,2~aH~ zooz a~~~ ~ooas W,o~ Sd ^ A mailing receipt ^ A unique identifier for your mailpiece - ^ A record of delivery kept by the Postal Service for two years Important Reminders: ^ Certified Mail may ONLY be combined with First-Class Maih or Priority Mailo. ^ Certified Mail is not available for any class of international mail. ^ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. ^ For an additional fee, a Return Receipt may be requested to provide proof of delivery. To obtain Return Receipt service, please complete and attach a Return Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mailpiece."Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USPS~ postmark on your Certified Mail receipt is regwred. ^ For an additional fee, delivery may be restricted to the addressee or addressee's authorized a ent. Advise the clerk or mark the mailpiece with the endorsement "Restricted~efivery'. ^ If a postmark on the Certified Mail receipt is desired, please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed, detach and affix label with postage and mail. IMPORTANT: Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mall addressed to APOs and FPOs. STATUS REPORT UNDER RULE 6.12 Name of Decedent: ~tt~ M. ~heaffer Date of Death: 10/15/2002 Will. No.: ~,1-rn.-115 Admin. No.: Pursuant to Rule 6.12 of the Supreaxae 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 Q 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 _ No nx 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 L] c. Copies of receipts, releases, joa~-aders and approval of formal or informal accounts maybe filed with the Clerk of the Orphans' Court and maybe attached to this report. '/.~ Date: 11 5 0+ C ~ `- ~` ~ /``~ ~'"~.- wm ~ Signature Allen E. ~Z Name 220 I`Iarlcet Street, Newport, PA. 17074 Address (717) 567-3139 Telephone I~To. Capacity: (~ Personal Representative `'~- Counsel for personal representative .; L~ COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION DEPT. 280601 INHERITANCE TAX HARRISBURG, PA 17128-0601 STATEMENT OF ACCOUNT REV-1607 E% RFP (R1-OSl ALLEN E HENCH 220 MARKET ST NEWPORT . ~. ~. PA~ 17074 -, 4 DATE 10-12-2004 ESTATE OF SHEAFFER HATTIE M DATE OF DEATH 10-15-2002 FILE NUMBER 21 02-1153 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1607 EX AFP (01-031 ~(*~ INHERITANCE TAX STATEMENT OF ACCOUNT ~~(~[ ESTATE OF SHEAFFER HATTIE M FILE N0. 21 02-1153 ACN 101 DATE 10-12-2004 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 08-09-2004 PRINCIPAL TAX DUE: PAYMENTS (TAX CREDITS): 7,928.40 PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID 01-06-2003 CD002021 368.42 7,000.00 04-20-2004 CD003847 .00 526.59 08-30-2004 CD004319 20.26- 53.65 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. [ IF " TOTAL DUE IS LESS THAN S1, i -~ NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) 7,928.40 .00 .02 .02 PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- If RESIDENT DECEDENT make check or money order payable to: REGISTER OF WILLS, AGENT. -- If NON-RESIDENT DECEDENT make check or money order payable to: COMMONWEALTH OF PENNSYLVANIA. REFUND (CR): A refund of a tax credit, which was not requested an the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-13137. Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices or from the Department's 24-hour answering service for farms ordering: 1-800-362-2050; services far taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). REPLY T0: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, Phone C717) 787-6505. DISCOUNT: If any tax due is paid within three C3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% 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. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%) percent per annum calculated at a daily rate of .000164. All taxes which 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. Tha applicable interest rates far 1982 through 2004 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20% .000548 1988-1991 11% .000301 2001 9% .000247 1983 16% .000438 1992 9% .000247 2002 6% .000164 1984 11% .000301 1993-1994 7% .000192 2003 5% .000137 1985 13% .000356 1995-1998 9% .000247 2004 4% .000110 1986 1D% .000274 1999 7% .000192 1987 9% .000247 2000 8% .000219 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. ~ BUFFAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 BEVERLY K SHEAFFER 626 N PITT ST CARLISLE PA 17013 rn .. ~,, ~~ DATE 08-11-2004 ESTATE OF SHEAFFER HATTIE M DATE OF DEATH 10-15-2002 FILE NUMBER 21 02-1153 COUNTY CUMBERLAND SSN/DC 177-24-5286 ACN 03106249 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 a tv CUT ALONG THIS LI,1~ - RETAIN LOWER PORTION FOR YOUR RECORDS ~ REV-1604 EX AFP (~-03) *~ INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ~~ r d' ;,~ "~ ~ '.`,, ~ DATE 08-11-2004 r. ESTATE OF SHEAFFER HATTIE M DATE OF DEATH 10-15-2002 COUNTY CUMBERLAND FILE N0. 21 02-1153 S.S/D.C. N0. 177-24-5286 ACN 03106249 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT N0. 21001037803 TYPE OF ACCOUNT: ( ) SAVINGS ( ) CHECKING ( ) TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 10-28-1994 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: .00 X 0.500 .00 - .00 .00 X .45 .00 NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN A80VE. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE ^ IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ~ ,l'~ [ IF TOTAL DUE IS LESS THAN Sl, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ' INHEF~ITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS REV-1604 EX pFR (O1-OS) PAYMENT: Detach the top portion of this Notice and submit with your payment made payable tc the name and address printed on the reverse side. -- Make check or money order payable ta: REGISTER OF WILLS, AGENT. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices or from the Department's 24-hour answering service for farms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). REPLY T0: Questions regarding errors contained on this notice should be addressed tc: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601, Phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% 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. INTEREST: Interest is charged beginning with first day of delinquency or nine (9) months and one (1) day from the date of death to the date of payment. Taxes which became delinquent before January 1, 1982 hear interest at the rata of six C6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent an and after January 1, 1982 will bear interest at a rate which will vary from calendar yea r to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20% .000548 1987 9% .000247 1999 7% .000192 1983 16% .000438 1988-1991 11% .000301 2000 8% .000219 1984 11% .000301 1992 9% .000247 2001 9% .000247 1985 13% .000356 1993-1994 7% .000192 2002 6% .000164 1986 10% .000274 1995-1998 9% .000247 2003 5% .000137 --Interest is calcul ated as follows: INTEREST = BALANC E OF TAX UNPAI D X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation d ate shown on the Notice, additional interest must be calculated. : ~... , ,.T;o RiV-1470 ER ~JrBB) INHEkITA'~VCE TAX COMMONWEALTH OF PENNSYLVANIA EXPLANATION DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME FILE NUMBER Hattie Sheaffer 2102-1153 P.FVIEWED BY ACN Emerson Luciano 03106249 SCHEDULE I INO. I EXPLANATION OF CHANGES The above referenced ACN has been reduced to zero, as this account was reported on the probate return. Page 1 ` BURERU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 28Db01 HARRISBURG, PA 17128-0601 NEIL A SHEAFFER 4809A THOMAS PAINE CIR SCOTT AIR FRC IL 62225 on ,. C';.. i REV-1604 E% RFP (01-OS7 DATE 08-11-2004 ESTATE OF SHEAFFER HATTIE M DATE OF DEATH 10-15-2002 FILE NUMBER 21 02-1153 COUNTY CUMBERLAND SSNiDC 177-24-5286 ACN 03106252 Anount Reeitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 C7 ty CUT ALONG THIS L`~VE i- RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---,... REV-1604.:;° EX: AFP ( 01-031; ~~?yINHER~TANC~:'~1X RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ~~ _ cc~~ , ~= `~" ~ ~;,~ DATE OS-11-2004 ESTATE OF SHEAFFER HATTIE M DATE OF DEATH 10-15-2002 COUNTY CUMBERLAND FILE N0. 21 02-1153 S.S/D.C. N0. 177-24-5286 ACN 03106252 ADJUSTMENT BASED ON: ADMINISTRATIVE CORRECTION JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PNC BANK ACCOUNT N0. 21001037802 TYPE OF ACCOUNT: C ) SAVINGS ( ) CHECKING ( ) TRUST (X) TIME CERTIFICATE DATE ESTABLISHED 10-28-1994 Account Balance Percent Taxable Amount Subject to Tax Debts and Deductions Taxable Amount Tax Rate Tax Due TAX CREDITS: .00 NOTE: X 0.500 .00 - .00 .00 X .45 .00 TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS AT THE ADDRESS SHOWN ABOVE. MAKE CHECK OR MONEY ORDER PAYABLE T0: "REGISTER OF WILLS, AGENT." PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID (-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE * IF PAID AFTER THIS DATE, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE s ~, `' INHERITANCE TAX RECORD ADJUSTMENT JOINTLY HELD OR TRUST ASSETS ~~ PAYMENT: Detach the top portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. -- Make check or money order payable to: REGISTER OF WILLS, AGENT. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application far Refund of Pennsylvania Inheritance and Estate Tax" (REV-13137. Applications are available at the Office of the Register of Wills, any of the 23 Revenue District Offices or from the Department's 24-hour answering service for farms ordering: 1-800-362-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). REPLY T0: Questions regarding errors contained on this notice should be addressed ta: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Oept. 280601, Harrisburg, PA 17128-0601, Phone (7177 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. PENALTY: The 15% 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. INTEREST: Interest is charged beginning with first day of delinquency or nine (9) months and one (1) day from the date of death to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six (6%l percent per annum calculated at a daily rate of .000164. All taxes which 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 1982 through 2003 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 1982 20% .000548 1987 9% .000247 1999 7% .000192 1983 16% .000438 1988-1991 11% .000301 2000 8% .000219 1984 11% .000301 1992 9% .000247 2001 9% .000247 1985 13% .000356 1993-1994 7% .000192 2002 6% .000164 1986 10% .000274 1995-1998 9% .000247 2003 5% .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (157 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. .: REV-1470 FX (8~8) j ~NH~RITANCE TAX COMMONWEALTH OF PENNSYLVANIA EXPLANATION DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME FILE NUMBER Hattie Sheaffer 2102-1153 P..F_VIEWED BY ACN Emerson Luciano 03106252 SCHEDULE I IND. I EXPLANATION OF CHANGES The above referenced ACN has been reduced to zero, as this account was reported on the probate return. Page 1