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HomeMy WebLinkAbout04-0402 PETITION FOR PROBATE and GRANT OF LETTERS Estate of. r: ~>L+l.. ~ I' '1 (> c; - ~ ,l~ :...:.:../J TNoO',' 2..1 - 04 - 40"l- also known as C. c-<..-t -'" " '" I" G) _ ___ ' f Register of Wills for the 1. , Deceased. County of C 1):'IA h~ f' lOt "dUn the Social Security No. I C; '< -- I.::? - 9' ~/7 ..3 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut P- r )( in the last will of the above decedent, dated Fe f.:, f' ~.. f ' ~ I q ~ ~ and codicil(s) dated named , 19_ (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in {' I J t'Vl :::: l ~--: h eA. last family or principal residence at (Vt "'I Count]lp~~vania, with C a..... -'. (list street, number and muncipality) Decendent, then 9' I years of age, died ~' .P at fI/I. i7l--v'ld1 ('~ rA~ \ ~ i Except as follows, decedent did not marry: was not divorced and did not have a child born or adopted after execution of the will offered fo probate; was not the victim of a killing and was never adjudicated incompetent: ;;;0 , , -l-9 ;:J U2;) ~ Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ 3- 3, (;?'V -rfD $ 0 $ (] $ o WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters (testamentary; administrau n c.I.a.; ;0ministration d.b.n.c.t.,..;;t.) .........' iI, . . ..;,.;) ~" .' Cl . ..t::>- .-) - theron. -- S,D~ ~ ~ '" u c: '" 'O~ 'Vi~ '" .... I:t:~ '00 t::'O ctJ'';: ~'" ~o... '" '- :;0 OJ c: OIl iZi /( ~ -?e~j~ I 4!i<~'" f;('f/7'7 . Cf : (::~~-'" II" ~ ~::rA=t- 'e 1/1 c~k,(/ C, ('..... I /O.5..-S--~ {/; :;>..:;> r '. = -0 ?:J N .J ;.:;;. OJ \u4 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA l ss COUNTY OF ~m'oe.c-\o..~A ; , The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- taHve(,) of the ahove deoedent petiHonec(,) will well and trul~,administec 'if'tate accmding to law. Sworn to or affirm~ and subscribed { 7/6</7---Y Wy__ ~ be re met this ~ day of ( ~ ~ ~ . ~ ~ ~ Regi r ~ hanicsbur PA 17055 PlACE OF D1SPOSI11ON. Name ofC..-tery, Clematory LOCATION. CItyITown, ~. Zip eoc. ",00...- Franklin County. .... Lurgan Twp.. PA MARITAL STATUS. u.rried ~MarriM,WICIDw<<f. -- '4. Widowed 17c.D .......".1Md1rl RACE. Amencan lndiIIn, 81i1c:k. WtriI:.. etc:. _I 10. White SURVIVING SPOUSE I" wile. gMI maldeo namel .. Cumberland DECEDENT'S USUAl OCCUPRK>N I~MJrk~~a::=:&:)' "L Homemaker ".. DECEDENT'S MAILING ADDRESS (SIr.... Civfbvn. sc.. Zip Code) Ie. - 17.. Carlisle ""'-.0. ~IromSt..O C O-r-f.l9,"j. ),~ ~ OUETO(ORJ.CONSEOUENCE Of): vvL H. I ApproxUnaI. IIr1Ierwt ......n : onMI and dNU'I , : PART..: Otherligniftcanlc:onctltioNc:oncrIluIIngtodnth,buI noI rnuItIng in... undIrtying __ giwn in FAAT I. { : d. DUE 1O{OA AS ACONSEOUENCE Of): DUE 10 (OR AS A CONSEOUENCE Of): WERE AUTOPSY FINDINGS AtAILABlE PNOR 10 COMPt.E11ON OF CAUSE OF DEATH? MANNER OF DEATH ORE OF INJURY (........Ooy.-I TIME OF INJURY INJURY Kf 'M)RK1 DESCRIBE HOW INJURY OCCURRED. o o Coutd not be det.muned 0 PLACE OF INJURY. AI home, "nn, SI~..t. factory, office M. building, etc. lSpea!v) 2Ie. 21b. 8. ... CER'TIFlER1Check only onel \' 6CERTIFYING PHYSICIAN (Physoan cer1lfytng cause d dNlh whero anoIhC!r DhYSICI8I\ has pronounced dealh ana completed tlern 231 To~bntor",yknowllldgll,de.thoecurndduetotNewse(.).ndmalfw"'f...tated,.............................. . ........ IXI o o HomiCida v. 0 NoD - Pending lnvNtlgalton "PRONOUNCING AND CERTIFYING PHYSfClAN IPhV$IC1ilI1 both ."onounclfIQ oealh andcef1llyJOg 10 cause 01 de8ltl) To lhe besI of my knoW'Jedp, death occ....,., al ttw..... date, and pe.ca, and d....to Ihe cau..(a) and manne, a. .Ialed o o .,.. UCENSE NUMBER 00 10 SIGNATURE AND mLE .,..0 NoD ....... JOe. -MEDICAL EXAMINER/CORONER On the b..ls of examlMtton ~or Investlgallon. in my opinion. de.lh occuned al the time, d.'... manner.. stated.. . . . . . . . . , . . . . . . . . . . . . .. . . . . . . 31a. REGISTRAR'S SIGNATURE AND NUMBER nd due 10 the cause(a) and o 14(1 2r 11)f 34. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF :ttDf~rrANC1:(M~(T (" APPRAISEMENT, ALLO~E.DR~DrSA~~O~ANCE OF DEDUCTIONS AND:ASSE~HEtH Of,. TAX ..... tiMT~" f" :'7: 'tJ7-18-2005 __ -,r .~ ._ .e: -J 1:, I I ~ u ESTATE OF SHUMAN DAl'E--QFr.DEATH 04-20-2004 I '__..__.'. _ ... .-FlLENUMB.ER-:- 21 04-0402 i : COUNTY CUMBERLAND ACN 101 APPEAL DATE: 09-16-2005 (See reverse side under Objections) AmDunt Rami tted I Sf C. ~ . ~.s- I 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 +- ------------------------------------------------------------------------------------------- ~EV~lS47 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX CATHERINE G FILE NO. 21 04-0402 ACN 101 DATE 07-18-2005 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value o~ Estate Subject to Tax 1- ... , BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 NANCY E FLYNN 703 CHARLES ST MECHANICSBURG PA 17055-6633 ESTATE OF SHUMAN RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets NOTE: I~ an assessment was issued previOUSly, lines re~lect ~igures that include the total o~ ALL ASSESSMENT OF TAX: 15. Amount o~ Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: OATE 03-29-2005 NUMBER CD005133 INTEREST/PEN PAID (-) .00 INTEREST IS CHARGED THROUGH 08-02-2005 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM ~ IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. REV-1547 EX AFP (06-05) CATHERINE G (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 53,925.25 .00 2,953.43 (8) 56,878.68 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. (9) (ID) 5,425.00 3.218.32 Cll) Cl2) Cl3) (14) R.643 32 48,235.36 .00 48,235.36 14, 15 and/Dr 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = 48,235.36 X 045 = .00 X 12 = .00 X 15 = Cl9)= .00 2,170.59 .00 .00 2,170.59 AMOUNT PAID 2,127.70 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 2,127.70 42.89 20.96 63.85 IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAV BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CDRRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession Dr enjDymant to Class B (collateral) beneficiaries af the decedent aftar the expiration of any estate for life or for Years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritanca Taxas at the lawful Class B (collataral) rate on any such future interest. To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S. Section 9140 J. Detach the top portion of this Notice and submit with your payment to the Registar of Wills printed on the reverse side. --Make check or money order payable to: REGISTEROFWD..LS,AGENT. Failure to pay the tax, interest, and penalty due may result in the filing of a lien of record in the appropriata county, or the issuance of an Orphan's Court citation. 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 online at www.revenue.state.pa.us. any Register of Wills or Revenue District Office, or from the Department's 24-hour answering service for forms orders: 1-800-362-2050; services for taxpayers with special hearing and/or speaking needs: 1-800-447-3020 (TT only). Any party in intarest not satisfied with the appraisement, allowance or disallowance of deductions or assessment of tax (including discount or interest) as shown on this Notice may object within 60 days of the date of receipt of this notice by filing one of the following: A) Protast to the PA Department of Revenue, Board of Appeals. You may Object by filing a protest online at www.boardofaooeals.state.oa.us on or before the expiration of the sixty-day appeal period. In order for an electronic protest to be valid, YOU must receive a confirmation number and processed date from the Board of Appeals website. You may also send a written protest to PA Department of Revenue, Board of Appeals P.O. Box 281021, Harrisburg, PA 17128-1021. Petitions may not be faxed. B) Election to have the matter determined at the audit of the eccount of the personal representative. C) Appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. See page 3 of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. If eny tax due is paid within three t3) calendar months after the decedent's death, a five percent (5%) discount of the tax paid is allowed. 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 is charged beginning with fir$t day of delinquency, or nine (9) months and one (I) 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 2005 are: Interest DailY Interest DailY Interest Rate Factor Year Rate Factor Vear Rate 2DX .000548 I988-1991 117. .OD0301 ~ 9~ 16% .000438 1992 9% .000247 2002 6% 11% .000301 1993-1994 7Z .000192 2003 5Z 13Z .000356 1995-1998 9% .000247 2004 4% 10Z .000274 1999 7Z .000192 Z005 5% 9Z .000247 2000 8i.: .000219 Vear Rn 1983 1984 1985 1986 1987 Daily Factor .000247 .000164 .000137 .000110 .000137 --Intere$t is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any NotIce issued after the tax becomes delinquent will reflect an intere$t calculation to fifteen (15) days beyond the date of the aS$eSSRent. If payment is made after the interest computation date shown on the Notice, additionel interest Rust be calculated. " A REv.14jIfE~ (1\..88) '* INHERITANCE TAX EXPLANATION OF CHANGES COMMON\IVEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17128-0601 DECEDENrs NAME FILE NUMBER Shuman, Catherine G. REVIEWED BY ACN Daniel Heck ITEM SCHEDULE NO. EXPLANATION OF CHANGES G 2104-0402 101 The date of death value of the IDS annuity of $953.43, has been placed on this schedule. ~, q~ ORIGINAL Page 1 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 171 28.D6D1 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT FLYNN NANCY 703 CHARLES STREET MECHANICSBURG, PA 17055-6633 ______n fold ESTATE INFORMATION: SSN: 193~ 1 2~9483 FILE NUMBER: 2104-0402 DECEDENT NAME: SHUMAN CATHERINE G DATE OF PAYMENT: 07/27/2005 POSTMARK DATE: 07/26/2005 COUNTY: CUMBERLAND DATE OF DEATH: 04/20/2004 ACN ASSESSMENT CONTROL NUMBER 101 TOTAL AMOUNT PAID: REMARKS: CHECK# 0099/37343 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS REV.1162 EX(11~961 NO. CD 005624 AMOUNT $63.85 $63.85 GLENDA FARNER STRASBAUGH REGISTER OF WILLS RENUNCIATION 21- 04- - 402.. In Roe Estate of {. a. the".,.. I 'vt 'L 6, SA U ~i?' rl d~ased. To the Register of Wills of etA VV1 /; t J' /-(;1 Yl / County, Pennsylvania.. The undersilJ1ed ) i e./fJ~ f n E,l 5 11(~ ~t2' ", of the above decedent, hereby renOl1nc:e(s) the right to administer the ~tatc and respectfully askCs) that Letters fe- s t a h1 e ~ -h. a i"\... / / be issued to Ala Y1 C)Y- ,J: /)/ n vI WITNESS hand this day of ,20_. iJl l~~ #- / ~.~ /'?/ ~~ (SilMture) co ~._.. 2 5' '37 FVI'~ vrdS'I.'J/ C/" I?d ~, c~ ;2 o/~d~'r ' I'- N a::: 0... = p "-" Q ,..~ }:: :'l == :JU (siplatur<) (Addrt!!;&) (Signatur,,) (Mdrcssl SAIDIS, GUIDO, SHUFF & MASLAND 2109 Market Street Camp Hill, PA LAST WILL AND TESTAMENT OF CATHERINE G. SHUMAN 2-' -- 04 - 40d.- I, CATHERINE G. SHUMAN of the Borough of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any will previ.D~sly dlade ..f?Y' me. .- J:::>. ' I - I direct the payment of all my just debts~~nd funeral N expenses out of my estate as soon as may be practical after my death. _":1 II - I bequeath my automobile to my granddaughter, JENNY MARIE 0' HANDLEY, should she be under the age when she can hold title to a motor vehicle, it shall be titled in the name of her mother, JOYCE O'HANDLEY until she comes of age. III - I bequeath certain articles of my furniture, household goods and personal effects in accordance with a written list made by me during my lifetime. In absence of a list or designation on the list, I authorized my executors to distribute said tangible personal property among my children, or sell the articles and add the proceeds to the residue of my estate as they in their sole discretion shall decide. IV - I devise and bequeath all the rest, residue and remain- der of my estate of whatever nature and wherever situate unto my SAIDIS, GUIDO, SHUFF & MASLAND 2109 Market Street Camp Hill. PA four children, DIANE KOCH, STEPHEN SHUMAN, NANCY FLYNN and JOYCE 0' HANDLEY, the share of a deceased child to be paid to his or her issue, per stirpes. v - I appoint my son, STEPHEN SHUMAN and my daughter, NANCY FLYNN, Co-executors of my estate. Neither of my personal representatives shall be required to post bond in this, or any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal on I this, the L~ day of cJ.::~ ,1998. eO~JA~~. (SEAL) CATHERINE G. SHUMAN Signed, sealed, published and declared by CATHERINE G. SHUMAN, Testatrix therein named, on this and one (1) other sheet of paper as and for her Last Will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. 41"0Ah7). M Name ------ y (' \ /It..w UJ.~ }:}kt45 '-..-/ Name- (JQftl {) I-It / / , Address I) Out; SAIDIS, GUIDO, SHUFF & MASLAND 2109 Market Street Camp Hill, PA II I I I. I I COMMONWEALTH OF PENNSYLVANIA) SS. COUNTY OF CUMBERLAND) WE, the undersigned, the Testatrix and the witnesses, respectively, whose names are signed to the foregoing instru- ment, being first duly sworn, do hereby declare to the under- signed authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she signed willingly (or willingly directed another to sign for her), and that she executed it as her free will and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix signed the Will as witnesses and that to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind, and under no constraint or undue influence. e~~~~ ~;~t.riX-1?k{) Witness ------ (k '( Witness Subscribed, sworn to and ackn testatrix, an~~t*scribed and sworn nesses, this day of before me by the me by both wit- , 1998. Notarial Seal Shelby L. Yingling. Notary Public . Camp HI". Bora. Cumberland County I My CommIssion Expires April 8. 2000 ! Member Pennsylvania Association of Notaries Cumberland County - Register Of wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 08/02/2004 FLYNN NANCY 703 CHARLES STREET MECHANICSBURG, PA 17055-6633 RE: Estate of SHUMAN CATHERINE G File Number: 2004-00402 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 08/06/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~Jf=.~00H Clerk of the Orphans' Court cc: File Counsel Judge CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: t'A.+l\ e f'. "11 e G: - S~\v/V\~Tl Date of Death: 4rr' I d. 0 / :;;; 0-0 Lj Will No. ;;;< I - d 0 0 '( - ?' CJ,;J Admin. No. To the Register: I certify that notice of (beneficial Interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on ~ ( 0;;[.. u '" &, ,,) "D .. C1 ,.., C' rt}<::. OC {" Address (P&;;iC{ T ifY'-R...o~WY\. fZ.v C/o.d , 17/1(:) ~{'<;: b,~ (ie,. s: le P h.€ f1 S/"'u mcu} . Gr, ~+, Sc IIOS- S _ r-:r"f'n.drL-...';O ;:)c;t'/S- chlA f'C &. ~~ :(0 c S L-, "nfYI<'f t1 {}' J~ ( G-.:, I c1. .> b" I' 0, f\J c .;;J / S .? Notice has now been given to all persons entitled thereto under Rule 5.6(a) except iFo (::0eYl.r:-?eA. Cf-..,l.Arcl, !2.c""d -" Date: (iJr_~~ IY dCbY 1'~1 !- (-./~) ~~ Signature Name fl)"" r1 c.y e /03 C~(ps Ff'./fJn ( !;J"Cf'+ Address '} _1 :-l~lUI)):') l'~;_;) /2Ii. f C 0?1. n ('C ~ 10 u. f'q. t 11 . i 70 s-"S- Telephone ( 7} ") - 7 h b - 3 :J P / L 0: 8 V V l 180 VO. Capacity: L/"'Personal Representative '::! _Counsel for personal representative 0-. (() m a.... ~.2. 'I .:l ~ rs rr~J :J.Ju. t wnls ' ~ (' u(\,"QKN'-L~ ~ C.Jvv~ lA-J- L OJ\II, ~ ~ ('~ O\l\...c... C(}\JV' + t( u-J tl J ~ C (j.N- kl ~ PA- I ~)~ ( 4' (1 c.-~_:;;l~~ QLo- CJaJn~ 1 wV#l. 2/l..-o '-I .;. [) tfDL-- ~ (,fL t1, s....e.. ~ Lc.. -vkc... ~ do s-<. J ~ ~,,~ ~c..e -r~ ~ J ~ ~d ..~ ~ Q, ~'J ~ R fJ-,eA.. ~ oL>-o ~,v.,g, ~ J.,J A c).I..c...k .f't;- ~ .p. 'J ~ ~ "'- O~ vv ~ fv-'" IJ iJ 2.. / z.. '1', f')~ Iv f/~ ~ L~u ~ ~ rtQ~,~ ~~ LAW OFFICES HERBERT G. RUPP, JR. RICHARD C. RUPP ANN MEIKLE ERIKSSON (1964-82) RUPP AND MEIKLE A PROFESSIONAL CORPORATION 355 NORTH 21ST STREET, SUITE 205 CAMP HILL, PA 17011 (717) 761-3459 E-MAIL: RUPPLAWl@AOL.COM MAILING ADDRESS P.O. BOX 895 CAMP HILL. PA 17001-0395 / , TELEFAX: (717) 730-0214 r,_.') " '.. I t.1 C:":.i COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(1'-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT FLYNN NANCY 703 CHARLES STREET MECHANICSBURG, PA 17055-6633 -------~ fold ESTATE INFORMATION: SSN: 193.12.9483 FILE NUMBER: 2104-0402 DECEDENT NAME: SHUMAN CATHERINE G DATE OF PAYMENT: 03/30/2005 POSTMARK DATE: 03/29/2005 COUNTY: CUMBERLAND DATE OF DEATH: 04/20/2004 NO. CD 005133 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $2,127.70 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 0094 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $2,127.70 GLENDA FARNER STRASBAUGH REGISTER OF WILLS LAW OFFICES RUPP AND MEIKLE HERBERT G. RUPP, JR. RICHARD C. RUPP A PROFESSIONAL CORPORATION 355 NORTH 21ST STREET, SUITE 205 CAMP HILL, PA 17011 MAILING ADDRESS (717) 761'3459 P.O. BOX 395 ANN MEIKLE ERIKSSON (1954'82) E-MAIL: RUPPLAW1@AOL.COM CAMP HILL, PA 17001.0395 TELEFAX: (717) 730'0214 March 31,2005 Register of Wills Cumberland County Court House One Courthouse Square Carlisle, PA 17013 Re: Estate of Catherine G. Shuman Filing Fee - Inheritance Tax Return/Inventory Dear Ma'am: Please find enclosed two checks, each in the amount of $15.00 as filing fees for the above-referenced documents. Thank you for notifying us that the original check that had been enclosed was in excess of amount required for same. I apologize for any inconvenience this may have caused you. / ( RCR/cac Encls: 2 C...I..) en ~"'-'\~L FORM 16 REG. WILLS INVENTORY of all real and personal estate of CATHERINE G. SHUMAN (Number and street) CARLISLE (city) deceased, late of MANOR CARE (Borough or Township) ,Cumberland County, Pennsylvania, 17013 (Zip Code) CARLISLE 8@ROUGH who died APRIL 20, 2004 (date of death) PERSONAL ESTATE SCHEDULE .. AMERICAN PORT F~UP ACCOUNT Q2 Q~ $35,197.02 $'4,9:1'9;63 f" PNC BANK ACCOUNT #5140058215 $1~;8Q8.40 TOTAL $53,925.25 AFFIDAVIT OF EXECUTOR OR ADMINISTRATOR (;ommontutaltb of ~tnng!,lbania QCount!' of } ss: Personally before me, the undersigned authority, a in and for said County .-.....-........ --, and State, appeared tJ~ c.~ ~ . r::::-~ 1\'/).'/ who, being duly sworn according to law, deposes and says that he i the executor or administrator of the estate of C'^- ~,,~ C:r- . (h. V VVl tJo.... "" , deceased, that the foregoing schedules constitute a complete inventory ~ and appraisement of the real and personal estate of C 0.- ~ '-'LC2... G,. .( "'- J\./'Vl. .........\..-1 deceased, except real estate outside the Commonwealth of Pennsylvania, that the figures opposite each item of real and personal estate in the foregoing schedules are determined and stated by the undersigned to be fair value of said items as of the date of the decedent's death. this Sworn and subscribed before me day of } rf ~ ~XE~-:;;';;~TRAmR ADDITIONAL INSTRUCTIONS 1. The inventory shall be filed no later than the date the account is filed or the due date, including any extension, for the filing of the Inheritance Tax Return (9 months from the date of death) whichever comes first. 2. A Supplemental inventory must be filed within thirty days of discovery of additional assets. 3. An original and two copies must be filed. 4. Additional sheets may be attached as to personalty or realty. 5. See Section 3301 et seq. Of the Probate Estates and Fiduciaries Code of 1972, as amended. 6. The inventory must be typed. (') ::l> )> ." ." o' C. ..... CD CD' c. S- CD c: ="" ..., ...., :3 CD :;, CJ) CD ~ ~ CD CJ) '< (') (') ';II;' ="" Q ~ .~ 3 0' 0 .(11 <0 ,... ,... :3 :3 <0 (j) I < Q. 0 z Z ~ ~ < 7" n :3 (') m m <0 Fj' ? en ,... ~ Z 3 f -I -I <0 m "U 0 OJ (Q ~ ;0 CD ~~ I\) -< Q. 0 0' CD ,... n CD ~ 3 Ql lJl <0 CD a. ~ c.... ~ r f TOTAL $53,925.25 <1l ~~CfJ o~'" <1l 0. 0 ..ce.Q t) 8:00 <: ~ -\\$ ~~. I ~ ~,~~'-\ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128-0601 REV -1500 INHERITANCE TAX RETURN RESIDENT DECEDENT I- :z w o LU U LU Cl DE:CEDENT'S NAME (LAST, FIRST. AND MIDDLE INITIAL) SHUMAN, CATHERINE G. DATE OF DEATH DATE OF BIRTH 04-20-2004 05-05-1922 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) X 1. Original Return 2. Supplemental Return 4. Limited Estate 4a. Future Interest Comprise (date of deatl1 after 12.12.82) 6. Decedent Died Testate (Attach copy of Will) 7. Decedent Maintained a Living Trust (Allacha copyofTrust) 9. Litigation Proceeds Received 10. Spousal Poverty Credit (dale of death between 12.31.91 end 1.1.95) ~ ,~ . Q .~ . :::::::::::::::::::::: ~~~I~:~~: ~~~ :~:~:~ ~::::::::::::::::::::::I FILE NUMBER ~\ COUNTY CODE NUMBER \)"\~'L SOCIAL SECURITY NUMBER 193-12-9483 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 3. Remainder Return (date of death prior to 12. 13.82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 011. Election to tax under Sec. 9113(A) (Allacl1 Sch 0) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS C <1> -= <= C> =- en ~ 6 <..:> FIRM NAME (If Applicable) TELEPHONE NUMBER 1. Real Estate (Schedule A) (1) (2) (3) (4) (5) (6) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 6 4. Mortgages & Notes Receivable (Schedule D) I- 5. Cash, Bank Deposits & Misc. Personal Property (Schedule E) <( .....J 6. Jointly Owned Property (Schedule F) ~ D Separate Billing Requested a.. <( 7. Inter-Vivos Transfers & Misc. Non-Probate Property () (Schedule G or L) W 0:: 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Cos~(~ChedUle H) . JI'!" 1 O. Debts of Decedent, Mortgage Liabilities & Liens (Schedule I) (7) (9) (10) .. 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable 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 Line 13) z o j: ~~ f-:J a. ::2 o u 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) x $47,281.93 x .045 16. Amount of line 14 taxable at lineal rate 17. Amount of line 14 taxable at sibling rate x .12 18. Amount of line 14 taxable at collateral rate x .15 19. Tax Due 20.D CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT $0.00 $0.00 $0.00 $0.00 "'j $53,925.25 $0.00 $2,000.00 (8) $5,425.00 $3,218.32 (11) (12) (13) (14) .. (15) (16) (17) (18) (19) $55,925.25 $8 643 32 $47,281.93 $47281 93 $47,281.93 $0.00 $2,127.70 $0.00 $000 $2,127.70 > > ElEl$(JAe.::TQ~SWE~~LE:&QUESI{Q~S&OlllcRESCE~S.E:SIDEl(AND'-iECt:lECKl',M~:r:.ft;:.loQi~, .: TOTAL $53,925.25 Decedent's Complete Address: STREET ADDRESS MANOR CARE 940 WALNUT BOTTOM ROAD CITY CARLISLE I STATE IPA IZIP 117013 Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) $0.00 Total Credits (A + B + C) (2) $0.00 3. Interest/Penalty if applicable D. Interest E. Penalty 5. Total Interest/Penalty (0 + 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. (SA) B. Enter the total of Une 5 + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT $0.00 4. $2,127.70 $2,127.70 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN X IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: 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 revisionary interest; or d. receive the promise for life of either payments, benefits or care? If death occurred on or before December 12,1982, did decedent within two years preceding death transfer property without receiving adequate consideration? If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? Did decedent own an individual retirement account, annuity, or other non-probate property? Yes ~ No ; 2. 3. 4. @ 8 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 pe~ury, I declare that I have examined this retum, 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 the information of which preparer has any knowledge. DATE o 01 dooS- DATE ADDRESS 355 N. 21ST STREET SUITE 205 CAMP HILL PA 17011 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 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P .S. ~9116 (a) (1.1) (ii)]. The statute does no exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or 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 decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a) (1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. TOTAL $53,925.25 SAIDIS, GUIDO, SHUFF & MASLAND 2109 Market Street Camp Hill, PA LAST WILL AND TESTAMENT OF CATHERINE G. SHUMAN I, CATHERINE G. SHUMAN of the Borough of Camp Hill, Cumberland County, Pennsylvania, declare this to be my Last Will and Testament, hereby revoking any will previD~sly~ade_~~me. ;' ,:-' J:;: ;:::;,~ >~) :.) ~ ",.." I - I direct the payment of all my justdebts~~nd fUn.eral N expenses out of my estate as soon as may be practical after my death. ~-= ':':':1 II - I bequeath my automobile to my granddaughter, JENNY MARIE 0' HANDLEY, should she be under the age when she can hold title to a motor vehicle, it shall be titled in the name of her mother, JOYCE O'HANDLEY until she comes of age. III - I bequeath certain articles of my furniture, household goods and personal effects in accordance with a written list made by me during my lifetime. In absence of a list or designation on the list, I authorized my executors to distribute said tangible personal property among my children, or sell the articles and add the proceeds to the residue of my estate as they in their sole Idiscr::i~n shall decide. I devise and bequeath all the rest, residue and remain- der of my estate of whatever nature and wherever situate unto my SAIDIS, GUIDO, SHUFF & MASLAND 2109 Market Street Camp Hill. PA four children, DIANE KOCH, STEPHEN SHUMAN, NANCY FLYNN and JOYCE 0' HANDLEY, the share of a deceased child to be paid to his or her issue, per stirpes. v - I appoint my son, STEPHEN SHUMAN and my daughter, NANCY FLYNN, Co-executors of my estate. Neither of my personal representatives shall be required to post bond in this, or any jurisdiction. thiS,I:h:I~RE::~ :fhav~t my hand and seal on , 1998. eQ~/h~~. (SEAL) CATHERINE G. SHUMAN Signed, sealed, published and declared by CATHERINE G. SHUMAN, Testatrix therein named, on this and one (1) other sheet of paper as and for her Last will and Testament, in our presence, who, in her presence, at her request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. ~<;2!M2 ,./" . 'l.J2.4'1, ... Name ----- r-" ~ jJ I \ /It}; (J.\::.. /c}I~/~6 '-./ Name- ~ (Lrfq, ;/A-- Address (JOP1/) 1-It 7 / , Address SAIDIS, GUIDO, SHUFF & MASLAND 2109 Market Street Camp Hill. PA COMMONWEALTH OF PENNSYLVANIA) ss. COUNTY OF CUMBERLAND) WE, the undersigned, the Testatrix and the witnesses, respectively, whose names are signed to the foregoing instru- ment, being first duly sworn, do hereby declare to the under- signed authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she signed willingly (or willingly directed another to sign for her), and that she executed it as her free will and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix signed the Will as witnesses and that to the best of their knowledge the Testatrix was at that time eighteen years of age or older, of sound mind, and under no constraint or undue influence. Subscribed, sworn to and ackn testatrix, an~~~scribed and sworn nesses, this day of before me by the me by both wit- , 1998. Notarial Seal Shelb~ L. Yingling. Notary Public , Camp HI". BC!ro. Cumberland County i My Commission Expires April 8. 2000 : Member Pennsylvania Association of Notarie~' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF CATHERINE G. SHUMAN FILE NUMBER 21-04-0402 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH AMERICAN EXPRESS PORT FULlD ACCOUNT 000000112359432522002 00000011335943251002 $35,197.02 $4,919.83 PNC BANK ACCOUNT #5140058215 $13,808.40 TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) $53,925.25 Copyright 2000 David James Thorpe, Esq. o PNCBAN< May 6, 2004 Nancy Flynn 703 Charles St Mechanicsburg, P A 17055 scp RE: Estate of Catherine G Shuman (Deceased) SSN: 193-12-9483 DOD: 04-20-2004 Dear Ms. Flynn: In response to your request for Date of Death balances for the customer noted above, our records show the following: Checking Account Account#5140058215 Established 09-01-1956 CATHERINE SHUMAN DOD balance: $13,807.87 + $0.53 accrued interest Interest paid 01-01-2004 to 04-20-2004: $3.10 Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We do not process any fmancial transactions or provide statements~ If you need assistance with any of these items, please call1-888-PNC-BANK. (1-888-762-2265) or stop by your local PNC Bank branch office. 7ilv IJ.~. Helen A Cozad 1-800-762-1775 . .. P7-PFSC-04-F 500 First Ave 4thFL CIF PittsburghPA 15219-3128 Member FDIC e~~ /l-cd b~ I L/ 1 ? -7 J j - '1 c9.c;-! dole) i Advisor Connect - Account List by Product Page 1 of2 ONLINE SERVICE & TRANSACTIONS 'lil Group Account List by Product Find Next Client LOQ Off Account List - Active I Pending & Inactive Accounts View E-Statements I Arrangements Group 10: Grandfathered: 0359 4325 7 001 Yes Total value of accounts shown below. The total value of accounts does not include all products and accounts as shown on the client Consolidated Statement. The total value is not reduced by any outstanding Overdraft Protection or Card balances. Non-Qualified Accounts Cost Value as of Mutual Funds 1 Basis .. Shares 04/28/2004 DIVERSE BOND FUN - A CATHERINE G SHUMAN TOO $35,988.95 7,300.772 $35,197.02 00000011 235943252002 CASH MANAGE FD - A CATHERINE G SHUMAN TOO $4,918.60 $4,919.83 0000 0011 33594325 1 002 4,918.600 f Qualified Accounts - MRS CATHERINE G SHUMAN IRA Individual Plans IDS Life Annuity INCOME PAYABLE LIFE CATHERINE G SHUMAN 00000931033254935004 Contract Date Total Purchase Payments Value as of 04/28/2004 Notes: ~o '\ N/A ID0 )y '* \Ii" 0 IV .x> V (\ I' ;: If" Y cY 0, ~ f,.~!J' e}" 0 \ ~ ~ IV . The .cost basis may not be accurate if the fund's shares were transferred to the account as fAir a gift or inheritance. X- 03/25/1993 $22,067.01 Disclosures for Clients: 1This cost may not be accurate if your shares were transferred to you as a gift or inheritance. https://advisor4.aexp.com/OST/secure/ AccountListByProductJ AccountListBvProduct.aso?.. 4/29/2004 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF CATHERINE G. SHUMAN 21-04-0402 FILE NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER INCLUDE THE NAME OF THE TRANSFEREE, THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE ATTACH A COPY OF THE DEED FOR REAL ESTATE. 1. HARTFORD LIFE INSURANCE ANNUITY CONTRACT 10GA020360 2000 100% 0 2000 TOTAL (Also enter on line 7, Recapitulation) $2,000.00 (If more space is needed, insert additional sheets of the same size) Copyright 2000 David James Thorpe, Esq. .,. o 3 ~ ~ Gll-' 0:J::'0 tt1N ooGlO c::u.l:J::'o oO\o~' 80N8 1-1\0';0 oou.l:J::' ~u.lO\o wO\08 o N 3o-.Jrn rnotn ('"'IvJ-I ::l: ')>' ')>'('"'1-1 ~:x:rn 1-'')>' ('"'1:00 tn''''' OJrn c.tn('"'l :0 ')>' (i"ltn-l ... -I::S: :orn -orn:O ".rnl-' -I~ ~ rn -.J o tn V1 :x: V1 c. 3 ')>' ~ ---J ..- . . ~ o "" \ t ~ "- t ~' ~ t- ? f\ 4 8 o 8 :J::' L' o tt1 ,0 00 08 o ..,.Jo ~_c:: tx:Iov:1 Or' _0 8N:J::' , :J::' 0 8 0~0v:1 o .to w Gl 8 ';0 :J::'NO 8- W tt10W o 80l\:l , :J::" 0;;:: o~o~ o 08 ('"'I - o ~ ". Z ('"'I -< tt1 ~ o 0 1-1 v:1 8 W ,...:: w 8 t-I , :J::" ~ 0~08 o 0 ~ Ntx:I 8 o ol\:l 00;;:: ,~ 08 o f/l .... !\ tTI ~ ~ o -n ." ~ ~ tTI ~ .." , -< ~ ~ ... w tt1 ~ o o o ';0 ';0 tx:I w l\:l o ~ o v:1 ~ o tx:I 8 o rn ,..::. rn ('"'I 1-'';I\l\:lGlI-I::I: ,Ill' ti::iSU cptioo<.ti o ('\" >:: Cll ('\' o H\ 'd (II l-t\ \oo:! ('\'0 O\tio:J::'Sti ..,.Jp.~::iCllP. cp _ ::i::i \ I-'>::('\'L' N 0 lJ\ p' p' N8CP('\'l\:ll-t\ Cp u.l p. ti Cll o ~ 0 N sup.H ~ ('\'>::::i .to p. n (II .to 0('\'>:: , ::i (II ti SU ~ 8W::i Cp Cll Cll 0 u.l III ti (1) S <. 1-'" 0 o 0 Cll a w'd III ::i 1-'" (1) (II -" ~ tv -" 00 m o o 00 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF CATHERINE G. SHUMAN FILE NUMBER 21-04-0402 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. FOOD COST NEW HOPE UNITED METHODIST CHURCH USAGE FEE NEW HOPE UNITED METHODIST CHURCH EBY GRANITE WORKS MEMORIAL $150.00 $100.00 $318.00 2. 3. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) NANCY FLYNN Social Security Number(s) I EIN Number of Personal Representative(s) City MECHANICSBURG State PA Zip 17055 Year(s) Commission Paid: 2005 Attorney Fees RUPP AND MEIKLE Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent $2,400.00 B. 1. $2,300.00 4. Probate Fees SHORT CERTIFICATE Accountant's Fees $145.00 5. 6. Tax Return Preparer's Fees $12.00 7. TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) $5,425.00 TOTAL $53,925.25 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF CATHERINE G. SHUMAN FILE NUMBER 21-04-0402 Include un reimbursed medical expenses. ITEM NUMBER 1. DESCRIPTION AMOUNT MANOR CARE $3,118.32 $100.00 GUISTE WHITE FAMILY PRACTICE TOTAL (Also enter on line 10, Recapitulation) (If more space is needed, insert additional sheets of the same size) $3,218.32 TOTAL $53,925.25 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF CATHERINE G. SHUMAN FILE NUMBER 21-04-0402 NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER Do Not List Trustee(s) OF ESTATE I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1. NANCY FLYNN DAUGHTER 25% 703 CHARLES STREET MECHANICSBURG, PA 17055 DIANE KOCH DAUGHTER 6624 JONESTOWN ROAD 25% HARRISBURG, PA 17112 STEPHEN SHUMAN 1105 S. FRIENDSHIP CHURCH ROAD SON GRAY COURT, SC 29645 25% JOYCE 0' HANDLEY 780 EBENEZER CHURCH ROAD DAUGHTER GOLDSBORO, NC 27530 25% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON- T ITIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. Copyright 2000 David James Thorpe, Esq. BUREAU OF INDIV~f~~~ornCE CF INHERITANCE TAX DIVIS:1;1';!;:~~,''''''l:-' ("- ','11 ,(- PO BOX 280601 "_'_,_','1--., _ -- '., : " HARRISBURG PA 17128-06ftl,j;', " J - COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REV-16D7 EX AFP (03-05) CU~~,!< e,F nPF:-iL.' NANCY rirftYNN. 'V'_.", 703 CHARLES ST MECHANICS BURG 'CT DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-22-2005 SHUMAN 04-20-2004 21 04-0402 CUMBERLAND 101 CATHERINE G ?n"r, ~Llr. '10 p",",' li: 27 Lv...u..... -J'" Amount R_itt.d PA 17055-6633 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, sub.it the upper portion of this for. with your tax payment. . CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS - --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF SHUMAN CATHERINE G FILE NO.21 04-0402 ACN 101 DATE 08-22-2005 THIS STATEHENT IS PROVIDED TD ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELDW 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: 07-18-2005 PRINCIPAL TAX DUE: 2,170.59 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTERESTIPEN PAID (-) 03-29-2005 CD005133 .00 2,127.70 07-26-2005 CD005624 20.92- 63.85 TOTAL TAX CREDIT 2,170.63 BALANCE OF TAX DUE .04CR INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .04CR . ~ SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRJ, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/07/2006 FLYNN NANCY 703 CHARLES STREET MECHANICSBURG, PA 17055-6633 RE: Estate of SHUMAN CATHERINE G File Number: 2004-00402 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/20/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, A~&~~~ Glenda Farner Strasbaugh, Clerk of the Orphans' Court cc: File Counsel Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: C,x-+C,e.^. (\12 C' _ S i\ v( IV1 C>. 11 Date of Death: llyr:/ ;) 0, d tV Lj Estate No.: ;) I 0 ((- (.') <-I CJ ;) Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration ofthe estate is complete: Yes Q: No 0 -h.J + ~~e 60-1 (.,{ Nt i ~,~vJ I p ctq e 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. I is Yes, state the following: a. Did t~J?ersonal representative file a final account with the Court? Yes Gd No 0 b. The sepa:ate OrphanR' Court No. (if any) for the personal representative's account IS: fJ ( t.L c. Did the person~resentative state an account informally to the parties in interest? Yes No 0 ,::"/)0,,\ A){l..o-~-.--...L-\ ..;:> i . :;Jet) "S- c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: c' 3/:5'1 I!:b . ) ~~1 (, (--<i!~~-M~~' ) Ity,.t--- SIgnature I .. , - (' 1 . ~ { I U {~ 1"\ C ~I t-. - ( ::,"'- v"~,,,...tl1 ) t- <11111 Name :-1 --1 } 0 3 C kc{.^ It" 5, <;....t-f' FE' r {'v\ t" (. h. (,( /\ I' C s. 10 I-'\. "1 ,P r/ I ;0 .S~S -, (., h 2.:/ Address ~ ... 7/;- /hb :;:.'1?/ W,...,L. - 7/')- ~1'7 -)yL{' Y Telephone No. ('7 ~_):v 0..._...........:...... v"-l-'''-vay. ~......_....__....1 D.o__.or>.o'l"\+t'l.+~"(rA ~ .LL,.1,:)uuUJ. .1.'-""P1."""""'Ul.UU\'\,.I o Counsel for personal representative /10 ~///