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Home My WebLink About03-0712 PETITION FOR PROBATE and GRANT OF LETTERS Estateo/ F ,,NKS.EMON No. erJ-/--C-a ' also known as To: , Deceased. Social Security No. 178-22.8518 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the executors in the last will of the above decedent, dated February 25~ 2003 and codicil(s) dated NONE Register of Wills for the County of CUMBERLAND Commonwealth of Pennsylvania in the named (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with h is last family or principal residence at MT. HOPE ROAD~ MESSIAH VILLAGE~ MECHANICSBURG~ CUMBERLAND COUNTY~ PENNSYLVANIA UPPER ~T,T,FIJq TQ~Ilq$ttTP (list street, number and municipality) Decedent, then 74 years of age, died 0/24/03 at MESSIAH VILLAGE~ CUMBERLAND COUNTY~ PENNSYLVANIA Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never ajudicated incompetent: Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ 6007000.00 $ o.oo $ o.oo $ 250.000.00 255 Reil¥ St; 1419 Susquehanna St.; 1420 Susquehanna St; 1421 Susquehanna Continued on a Separate Pa,qe WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters TESTAMENTARY thereon. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) DONALD SHEMON, 75 Stoney Point Rd New Oxford PA 17350 Circle A~MON, 6154 Ludgate Mechanicsbur9 PA 17050 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ SS COUNTY OF CUMBERLAND J The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well an~ni~ording to law. Sworn to or affirmed and subscribed ~. · before me this t,~? z'// day of I DQNAV.D~ SHEMON, FRANK SHEMON Continuation of Petition for Probate and Grant of Letters Page 1 Real Estate in PA 1422 Susquehanna St, 1424 Susquehanna St, 1426 Susquehanna St, 1428 Susquehanna St, 1430 Susquehanna St, 1432 Susquehanna St and 1522 Susquehanna Street, Harrisburg, Dauphin County, Pennsylvania Estate of FRANK SHEMON , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~--~--.*~5 e~.~ in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated ~25103 described therein be admitted to probate and filed of record as the last will of.FRaNK SNEMON and Letters TESTAMENTARY are hereby granted to DONALD SHEMON and ANTHONY SHEMON; Co-Executors FEES Probate, Letters, Etc ......... S.ho~(~e3-tLfi_cates ( ) ...... non ............ TOTAL Filed.~__~..~,0_,.~...~*. MURREL R. WALTERS III #24849 ATTORNEY (Sup. Ct. I.D. No.) 54 EAST MAIN STREET MECHANICSBURG PA 17055 ADDRESS 717-697-4650 PHONE ARNING: IT IS ILLEGAL TO ALTER THIS COPY OR TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH. COMMONWEiALTH OF PENN~'f'i_'~h J41,: DEPARTMENT OF HE,ALTt't VtYAI. ~H~CO;d:}F LOCAL REGISTRAR'S CERTIF~CATIOI1 OF DE, A'IH CERT. NO. T 5075264 r ' August 28, 2003 Date of Iss,m of This Certification Name of Decedent Frank Shemon Male 178-22-8518 August 24, 2003 Sex ........... Social Security No ..................... Date of Death Date of Birth' ............ 9-17-1928 Birthplace Messiah Village, Cumberland County, Place of Death ............. White Raikoader Race ............ Occupation Never l~am-ied Decedent's Marital Status Mailing Address Donald E. Shemon Informant Name and Address oP Funeral Establishment Par! I: Part II: Uniontown, Pennsylvania Upper Allen Township _ ~pn_ns~v!von!a Yes Armed Forces? (Yes or No) Mt. Hope Road, Messiah Village, Mechanicsburg, PA 17372 M. Le~ Dugan Funeral Director ................................... Dugan Funeral Home, Inc., Bendersville, PA 17306 Immediate Cause Metastatic prostate cancer. (a) (b) (c) (d) Other Significant Conditions Manner of Death Natural ,~ Accident [ ~ Homicide [] Interva! Between Onsei and Death 9 Months Describe how injury occurred: Pending Investigation Suicide [_' Could not be Determined Nar'ne and Title of Certfier Address Joseph A. Cincotta, M.D. Mechanicsburg, PA 17055 (M.D., ,D.O., Coroner, M.E.) This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filinrg. o,.o,o Au~st 28, 2003 124 ~ce Av~ue,BiCeMle, PA 17307 LAST WILL AND TESTAMENT ~f_ ~)~,_ .~/~ BE IT REMEMBERED THAT I, FRANK SHEMON, a resident of Dauphin County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this to be my LAST WILL AND TESTAMENT, hereby revoking any and all Wills and Codicils previously made by me. I I declare that I am not married. I have a nephew, ANTHONY SHEMON, a brother, MICHAEL SHEMON, SR., a nephew, DONALD SHEMON, and a nephew, MICHAEL SHEMON, JR. II I direct that all my just debts and funeral expenses shall be paid from my residuary estate as soon as practicable after my decease. III I direct that all taxes that may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction ira_posed, shall be paid from my residuary estate as a part of the expense of the administration of my estate. I give and devise the following City of Harrisburg properties to my nephews, DONALD SHEMON and ANTHONY SHEMON, in equal shares, per stirpes: 253 Reily Street 255 Reily Street 1419 Susquehanna Street 1420 Susquehanna Street 1421 Susquehanna Street 1422 Susquehanna Street 1424 Susquehanna Street 1426 Susquehanna Street 1428 Susquehanna Street 1430 Susquehanna Street 1432 Susquehanna Street 1522 Susquehanna Street V I give, devise and bequeath, all the rest, residue and remainder of my property, whether real or personal, wherever situate, including any property over which I may have a power of appointment to my nephews, ANTHONY SHEMON, DONALD SHEMON and MICHAEL SHEMON, JR., in equal shares, pursuant to the terms of the hereinafter included Trust. VI TRUST I appoint my nephews ANTHONY SHEMON and DONALD SHEMON, as Co- Trustees of the property that I have given to my nephews, ANTHONY SHEMON, DONALD SHEMON and MICHAEL SHEMON, JR. A. The assets that are transferred to the Trust shall be divided into approximately equal shares for each of my nephews. B. Each year at a time convenient for the Trustees, ten percent (10%) of the principal, plus accumulated interest shall be distributed to each of my nephews. C. My nephews, as beneficiaries of this Trust, shall not have any right to alienate, encumber, or hypothecate their interest in the principal or income of the Trust in any manner, nor shall any interest be subject to claims of his creditors or liable to attachment, execution or other process of law. D. In order to carry out the purposes of this Trust established by this Will, the Trustees, in addition to all other powers granted by this Will or by law, shall have the following powers over the Trust estate, subject to any limitation specified elsewhere in this Will: 1) To retain any property received by the Trustee estate for as long as the Trustee considers' it advisable. 9.) To spend funds for the maintenance and repair of real property. To sell at public or private sale, exchange or lease for a period of time any real or personal property and give options for sale of the lease. 4) To execute and deliver any deeds, leases, assignments or other instruments as may be necessary to carry out the provisions of this Trust. 5) To borrow money and to mortgage or pledge any real or personal property. The Co-Trustees shall maintain accurate records and accounts and shall render statements to my beneficiary hereunder showing receipts and disbursements of principal and income no less frequently than annually. The Co- Trustees shall serve without bond and shall receive fair and reasonable compensation for administration of this Trust, not to exceed five (5%) percent of annual income. 7) To distribute property in kind. 8) To do all other acts that are in his judgment necessary or desirable for the proper management, investment and distribution of the Trust estate. VII I nominate, constitute and appoint my nephews, ANTHONY SHEMON and DONALD SHEMON, as Co-Executors of this LAST WILL, to serve without bond. If either of my nephews, ANTHONY SHEMON or DONALD SHEMON is unable or unwilling to act in that capacity, then I nominate, constitute and appoint my nephew, MICHAEL SHEMON, JR to act as Co-Executor of this LAST WILL, to serve without bond. IN WITNESS WHEREOF, I, FRANK SHEMON, have set my hand to this LAST WILL this ~ ~-- day of ~;~"~, , 2003. FRANK SHEMON Signed, sealed, published and declared by the above-named FRANK SHEMON, as and for his Last Will and Testament, in the presence of us, who, at his request and in his presence, and in the presence of each other, have'hereunto subscribed our names as witnesses. ACKNOWLEDGEMENT COMMONWEALTH OF PENNSYLVANIA · SS. COUNTY OF CUMBERLAND · I, FRANK SHEMON, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my LAST WILL; that I signed it as my free and voluntary act for the purposes therein expressed. Ft~kNK SHEMON Sworn or affirmed to and acknowledged before me by FRANK SHEMON, Testator, this oP~-~ day of ~]e.Z~ , 2003. Notary Public AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA · SS. COUNTY OF CUMBERLAND · the witnesses wl~ose names are signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw Testator sign and execute the instrument as his LAST WILL, that FRANK SHEMON signed willingly and that he executed it as his free and" voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to the bes~t.bf our knowledge, the Testator was at the time 18 years offage or mpr~, of ~o~i. mind and under no constraint or undue influence. ///~~/ Sworn ~_af_ afirmed to and acknowledged before me thisc~ -dayof ~ ,2003. Notary Public I" NOTARIAL SEAL DEBORAH L. RYAN, NOTARY PUBLIC CITY OF MECHANICSBURG, CUMBERLAND C0U.TYI ~ MY COMMISSI0fl EXPIRES JUNE 11, 2006 CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Frank Shemon Date of Death: August 24, 2003 Will No. 2003-00712 To the Register: Admin. No. 21-03-0712 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 September 9, 2003. Name Address Donald Shemon Anthony Shemon Michael Shemon 75 Stoney Point Road, New Oxford, PA 17350 6154 Ludgate Cirde, Mechanicsburg, PA 17050 444 Brown's Dam Road, New Oxford, PA 17350 / Notice has now been given to all persons entided theret7 underJ~ 5.6(a)~x/~pt: Date: September 9, 2003 Murrel tL Walters, III, Esquire 54 East Main Street Mechanicsburg, PA 17055 (717) 697-4650 Capacity: Personal Representative X Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003269 WALTERS MURREL R III 54 E MAIN STREET MECHANICSBURG, PA 17055 ........ fold ESTATE INFORMATION: SSN.' 178-22-8518 FILE NUMBER: 2103-0712 DECEDENT NAME: SHEMON FRANK DATE OF PAYMENT: 11/21/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 08/24/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $85,000.00 REMARKS: TOTAL AMOUNT PAID: RECEIVED DONALD/ANTHONY SHEMON IN CO MURREL R WALTERS III ESQ $85,000.00 SEAL CHECK#II8 INITIALS: VZ RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD 003942 WALTERS MURREL R III 54 E MAIN STREET MECHANICSBURG, PA 17O55 ........ fold ESTATE INFORMATION: SSN: 178-22-8518 FILE NUMBER: 2103-071 2 DECEDENT NAME: SHEMON FRANK DATE OF PAYMENT: 05/18/2004 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 08/24/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $42,590.39 REMARKS: TOTAL AMOUNT PAID' $42,590.39 SEAL INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS REV.1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280.601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFFICIAL USE ONLY FILE NUMBER 2 t -0 3 0 7 1 COUNTY COOE YEAR NUM~ER DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAl SHEMON~ FRANK DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) O8124/2OO3 O9/17/2028 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 2 I 7 8- 2 2- 8 5 I 8 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER [~]1. Original Retum D4. Limited Estate r"-~ 6. Decedent Died Testate (At,ch copy of Will) D g. Litigation Proceeds Received [~]2. Supplemental Retum --'] 4a. Futura Interest Compromise (date of death after 12.12.82) r~7. Decedent Maintained a Living Trust (Attach copy of Tn~t) O10. Spousal Poverty Credit (date of dealh beh~een 12-31-91 and 1-1-95) D3, Remainder Return (date of death p~orto 12-13-82) r'-~ 5. Federal Estate Tax Return Required m 8. Total Number of Safe Deposit Boxes Oll. Election to tax under Sec. 9113(A) (Attac~ Sch O) THIS SECTION MUST BE COMPLu. I ~D. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS MURREL R. WALTERS III?~ESQUIRE FIRM NAME (If Applicable) TELEPHONE NUMBER 717-697-4650 54 EAST MAIN STREET MECHANICSBURG PA 17055 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnemhip or Sole-Propdetomhip (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) O 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) (8) (11) (12) (13) (14) 253.L24~.29 320~975.35 1i~701.4~ 117,00t.33 205;079.34 7;388.84 OFFICIAL USE ONLY 915;390.60 24;650.00 11;804.70 36,454.7, 878;935.90 878;935.90 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 Une 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at coilateral rate 19. Tax Due X .12 878~935.90 X .15 20. (15) (16) (17) (18) (19) 131 ;840.39 131;840.39 · · BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent's Complete Address: STR~-~-TADDRESS MY. HOPE ROAD,~MESSIAH VILLAGE CITY MECHANICSBURG Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 85~000.00 4~250.00 Interest/Penalty if applicable D. Interest E. Penalty STATE PA IZlP 7055 (1) 13t ;840.39 Total Credits ( A + B + C ) (2) 89,250.00 42;590.39 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 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 42~590.39 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 dght 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 secudty at his or her death? ................. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiaryidesignafion? ....................................................................................................... [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ADDRESS DONALD SHEMON 75 STO~t~PO~T RD., NEW OXPORD, PA 17350 ANTHONY SH~YI~ON ~¢5~4/~UDGATE CIRCLE, MECHANICSBURG, PA 17055 ADDRESS M~R~. ~ALY~~ 54 ~ST MAIN ST.~ MECHANI~SBURG DATE 3/17104 DATE 3117104 PA 17055 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 not exemDt 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. §9118(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. SCHEDULE A PENNSYLVAN,A REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDI~NT ESTATE OF ~ FILE NUMBER SHEMON. FRANK 21 03 071;~ All real property owned solely or as a ~ei~a~ in common must be reported at fair market value. Fair market value is defined as the pdce at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is Jointly-owned with dght of survivorship must be disclosed on Schedule F. ITEM NUMBER 4 5 6 7 8 10 11 DESCRIPTION 255 REILY STR,-,-r, HARRISBURG ASSESSED VALUE 1419 SUSQUEHANNA STREET, HARRISBURG ASSESSED VALUE 1420 SUSQUEHANNA STREET, HARRISBURG ASSESSED VALUE 1421 SUSQUEHANNA STREET, HARRISBURG ASSESSED VALUE t422 SUSQUEHANNA STREET, HARRISBURG ASSESSED VALUE t424 SUSQUEHANNA STREET, HARRISBURG ASSESSED VALUE 1426 SUSQUEHANNA STREET, HARRISBURG ASSESSED VALUE 1428 SUSQUEHANNA STREET, HARRISBURG ASSESSED VALUE 1430SUSQUEHANNA STREET, HARRISBURG ASSESSED VALUE 1522 SUSQUEHANNA STREET, HARRISBURG NET SALE PRICE 1432 SUSQUEHANNA STREET, HARRISBURG ASSESSED VALUE TOTAL (Also enter on line 1, Recapitulation) (If more space is needed, insert additional sheets of the same size) VALUE AT DATE Of DEATH 60,348.00 32,100.00 1,284.00 8,774.00 1,284.00 29,425.00 . 9,737.00 9,737.00 t0,807.00 13,564.29 76,184.00 REV-1503 F.X + (1.97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF ,SHEMON, FRANK All property jointly-owned with right of survivorship must be disclosed on Schedule F. FILE NUMBER :~1 03 0712 ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. WAYPOINT COMMON STOCK 304,744.35 16735 SHARES @ 18.21 PPL COMMON STOCK 300 SHARES @ 38.87 RITE AID COMMON STOCK 1000 SHARES ~} 4.57 11,661.00 4,570.00 TOTAL (Also enter on line 2, Recapitulation) $ 3~_0~975.3,~ (if more space is needed, insert additional sheets of the same size) REV-I~7 ~ + {1-9~ ~ COMMONWEALTH OFPENNSYLVANIA INHERITANCETAXRETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF SHEMON, FFqANK All property jointly-owned with the right of survivorship must be disclosed on Schedule F. FILE NUMBER 21 03 ITEM NUMBER 1. DESCRIPTION ROBERT BUSH ENCUMBERING 127 SOUTH YORK ROAD, DILLSBURG, PA 071:~ VALUEAT DATE OF DEATH 11,701.45 TOTAL (Also enter on line 4, Recapitulation) $ 11~701.45 (if more space is needed, insert additional sheets of the same size) REV-1.508 EX + (1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER SHEMON. FRANK; ;~1 03 0712 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 2 DESCRIPTION FULTON BANK 6382 FULTON FINANCIAL 6961 WAYPOINT BANK 7710 MONY GROUP 1844 MONY GROUP 854 FDS 4651 AND 5871 JOHN HANCOCK 6242 TOTAL (Also enter on line 5, Recapitulation) VALUE AT DATE OF DEATH 7,131.95 4,735.50 ,582.97 20,883.67 20,883.67 12,484.87 39,298.70 117~001.33 (if more space is needed, insert additional sheets of the same size) REV-1509 EX + (1-97) ~ CI~MMONWEALTH OF PENNSYLVNqlA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER SHEMON. FRANK ;~1 0;~ 071~ If an asset was made joint within one year of the decadent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. DONALD SHEMON NEPHEW B JUDY SHEMON C ANTHONY SHEMON 75 STONEY POINT ROAD NEW OXFORD, PA 17350 75 STONEY POINT ROAD NEW OXFORD, PA 17350 6154 LUDGATE CIRCLE MECHANICSBURG, PA 17055 NEPHEW'S WIFE NEPHEW JOINTLY-OWNED PROPERTY: LETrER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of linancial institution and bank account number or similar identifying number, Attach BATE OF DEATH BECD'S VALUE OF NUMBER TENANT JOINT deed for jointiy-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES 1. C & D 9/13/02 FULTON BANK 2,044.68 100. 2,044.68 4109 2 A&C 8/14/03 FULTON BANK 50,152.57 100. 50,152.57 4160 3. A&B 4/4/02 FULTON BANK 6,792.66 33.3 2,261.96 4075 4 A&B 12/28/01 FULTON BANK 1,068.77 33.3 355.90 2850 5. A&B 2/5/03 :FULTON BANK 1,523.27 100. 1,523.27 4141 6 A&B 1111/02 FULTON BANK 4,075.971 100. 4,075.97 4125 7 A 2001 FULTON FINANCIAL ADVISORS 15,733.68 50. 7,866.84 6975 8 A & B t2/14/01 WAYPOINT BANK t08,601.00 33.3 36,164.t3 5302 9 A & B 02/01/02 WAYP~)INT BANK t05,520.83 33.3 35,138.44 4586 10 A & B 03/05/02 WAYPOINT BANK t05,034.66 33.3 34,976.54 5830 TOTAL (Also enter on line 6, Recapitulation) $ 205~079.34 (If more space is needed, insert additional sheets of the same size) Continuation of REV-1500 Inheritance Tax Return Resident Decedent SHEMON., FRANK 21 03 Pa,qe 1 Schedule F-1 - Jointly Owned Property 0712 SURVIVING JOINT TENANT(S) NAME ! ADDRESS RELATIONSHIP TO DECEDENT D. WANDA SHEMONa/IEaW. LEE*SHEMON 6154 LUDGATE CIRCLE NEPHEW'S WIFE E. DUSAN STANAR MECHANICSBURG, PA 17055 153t N. 3RD STREET APT. 713 HARRISBURG, PA 17102 NOT RELATED Continuation of REV-1500 Inheritance Tax Return Resident Decedent SHEMON, FP~NK 21 03 Paqe 2 Schedule F-2 - Jointly-Owned Property 0712 LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MABE 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 jointly-held mai estate, VALUE OF ASSET INTEREST DECEDENT'S INTERE~ 11 C & D 03/05/02 WAYPOINT BANK 63,020.78 33.3 20,985.9': 5831 12 A 2001 WAYPOINT BANK 17,567.40 50. 8,783.7( 804 SHARES COMMON STOCK @ 21.85 13 E 10/27/00 FULTON BANK 1,498.84 50. 749.4; 6697~ SUBTOTAL SCHEDULE F-2 30,519.04 GRAND TOTAL SCHEDULE F-2 $ 205,079.34 REV-1510 EX + (1-97~ ~ CO~IMONWEALTH OF PENNSYLVANIA' INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY ESTATE OF FILE NUMBER SHEMON. FRANK ;~1 03 0712 This schedule must be completed and filed if the answer to any of questjons 1 through 4 on the reverse side of the REV-1500 COVER SHEET is ~es. DESCRIPTION OF PROPERTY % OF ITEM INCLUOETHE N~ME OFTHE TRANS~REE. THEIR RE[ATIO~SHIPTODEC~.DENTAND THE DA'I'E O~TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER A33'ACH A COPY OF THE DEED FOR RF.N. ESTA'i'~. VALUE OF ASSET INTEREST 1. FULTON BANK 41t6 9,193.95 100. 6,000.00 3,193.95 JOINTLY OWNED WITH ANTHONY SHEMON & W. LEE SHEMON OPENED 10/0t/2002 2 WACHOVIA BANK 6587 10,194.89 100. 6,000.00 4,194.89 JOINTLY OWNED WITH DONALD SHEMON & JUDY SHEMON OPENED 12/t2/2002 TOTAL (Also enter on line 7, Recapitulation) $ 7~388.8.~ (If more space is needed, insert additional sheets of the same size) REV-l$11EX*(1-97) ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF SHEMON, FRANK Debts of decedent must be reported on Schedule I, FILE NUMBER 21 03 0712 ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Fersonal Representative (s) RENOUNCED Social Security Number(s) I EIN Number of Personal Representative(s) Street Address City State Year(s) Commission Paid: Attorney Fees MURREL R, WALTERS III ESQ Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zip Street Address city Relationship of Claimant to Decedent Pmbata Fees REGISTER OF WILLS CUMBERLAND COUNTY Accountant's Fees ~SELIGMAN FRIEDMAN & CO Tax Retum Prepare'r's Fees State Zip CPA TOTAL (Also enter on line 9, Recapitulation) $ AMOUNT 2'!,000.00 650.00 3,000.00 24;650.00 (lfmomspaceisneeded, inse~additionalsh~of~esames~e) REV-l$12 EX+ (1-9',') ,~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF SHEMON. FR,~N K Include unreimbursed medical expenses. FILE NUMBER 21 03 0712 ITEM NUMBER DESCRIPTION AMOUNT 1. 1,666.82 MICHAEL KANOFF ELECTRICAL SERVICE EARL NOSS PLUMBING SERVICE DONALD SHEMON PROPERTY REPAIRS ANTHONY SHEMON PROPERTY REPAIRS MICHAEL SHEMON PROPERTY REPAIRS PENNSYLVANIA DEPARTMENT OF REVENUE 2003 PERSONAL INCOME TAX INTERNAL REVENUE SERVICE 2003 PERSONAL INCOME TAX TOTAL (Also enter on line 10, Recapitulation) 1,050.88 3,260.00 1,380.00 760.00 170.00 3,517.00 11;804.70 (if more space is needed, insert additional sheets of the same size) REV-1513 EX + (9-nm COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN ' RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF SHEMOI~I. FRANK NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY [. TAXABLE DiS I ~IBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a)(1,2)] 1. DONALD SHEMON 75 STONEY POINT ROAD NEW OXFORD, PA 17350 2. ANTHONY SHEMON 6154 LUDGATE CIRCLE MECHANICSBURG, PA 17050 3. MICHAEL SHEMON, JR. ~-~-~- BROWN'S DAM ROAD NEW OXFORD, PA 17350 FILE NUMBER 21 03 O71;~ RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE NEPHEW NEPHEW NEPHEW 112 REAL ESTATE & 113 RESIDUE 112 REAL ESTATE & 1/3 RESIDUE 113 RESIDUE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUT!ONS 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 SHEET $ (If more space is needed, insert additional sheets of the same size) REV.1511EX + {1-97) ~ COUMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FALES. FRANCES E. Debts of decedent must be reported on Schedule I, SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ;ILE NUMBER ~1 04 ITEM NUMBER 1. 2 3 4 DESCRIPTION FUNERAL EXPENSES: PARTHEMORE FUNERAL HOME FUNERAL RECEPTION JDK GATERING FAMILY DINNER GULHANES STEAKHOUSE HEAD STONE ENGRAVING BRACHENDORF MEMORIALS AMOUNT 1,210.00 2,553.00 608.00 150.00 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) DEBORAH E. PAJAK Social Security Number(s) / EIN Number of Personal Representative(s) Street Address 985 SILVER LAKE ROAD City LEWISBERRY State~ PA Year(s) Commission Paid: 2004 Attorney Fees MURREL R. WALTERS III ESQ Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Zip 17339 Street Address city Relationship of Claimant to Decedent State Zip Probate Fees REGISTER OF WILLS CUMBERLAND COUNTY Accountant's Fees Tax Return Preparer's Fees WAGGONER, FRUTIEGER & DAUB, CPAS FIDUCIARY INCOME TAX RETURNS PNC BANK ! ESTATE CHECKS TOTAL (Also enter on line 9, Recapitulation) 18,678,0~ 3~300.00 650.00 500.00 28.00 27~677.00 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (1-9TI ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULEI DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF FALES. FRANCES E. Include unreimbursed medical expenses. FILE NUMBER 0211 ITEM NUMBER DESCRIPTION AMOUNT 1. '196.00 2 7 8 9 10 11 12 13 14 15 VISA CREDIT CARD JC PENNEY CREDIT CARD SUSQUEHANNA INTERNAL MEDICINE MEDICAL MARY SHERMAN PRODUCT ORDER BEN FRANKLIN CREDIT ACCOUNT VERIZON TELEPHONE COMCAST CABLE TV PPL ELECTRIC HOLY SPIRIT HOSPITAL MEDICAL BOSCOV°S CREDIT CARD ST. STEPHENS PLEDGE TO CAPITAL CAMPAIGN WAGGONER, FRUTIEGER & DAUB, CPAS INCOME TAX PREPARATION PA DEPARTMENT REVENUE 2003 INCOME TAX SERS RETURN OF PENSION OVERPAYMENT PSERS RETURN OF PENSION OVERPAYMENT 30.00 50.00 315.00 100.00 33.00 44.00 38,00 300.00 17.00 100,00 200.00 39.00 68.00 ~0.00 TOTAL (Also enter on line 10, Recapitulation) $ 1 ~970.00 (If more space is needed, insert additional sheets of the same size) REV-1513 EX + (g.nm · COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FALES. F:RANCES E. NUMBER I. 1. 2 3 4 II. 1. 1. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] JANET F. MORRIS 421 GALLAHER ROAD ELKTON, MD 21921 ALICE V. HARPSTER 93 ONEIDA ROAD CAMP HILL , PA 17011 DEBORAH E. PAJAK 985 SILVER LAKE ROAD LEWISBERRY~ PA 17339 JOHN H. FALES III 19004 HEMPSTONE COURT POOLESVILLE~ MD 20837 FILE NUMBER ~1 04 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) DAUGHTER DAUGHTER DAUGHTER SON AMOUNT ORSHARE OFESTATE 1/4 114 1/4 1/4 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET BUREAU OF TNDTVTDUAL TAXES TNHERTTANCE TAX DTVZSZON DEPT. 280601 HARRZSBURG, PA 17zzs-06a! HURREL R WALTERS III ESQ 54 E HAIN ST HECHANICSBURG PA 17055 COHHONWEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE NOTICE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLOWANCE OF DEDUCTZONS AND ASSESSHENT OF TAX DATE 07-Z6-2004 ESTATE OF SHEHON DATE OF DEATH 08-Z4-ZO05 FILE NUHBER 21 05-0712 COUNTY CUHBERLAND ACN 101 Amount Remitted RE¥-1547 EX AFP (Bl-O$} FRANK HAKE CHECK PAYABLE AND REH'rT PAYHENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE I~ RETAIN LONER PORTION FOR YOUR RECORDS ~ REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DZSALLOWANCE OF DEDUCTIONS AND ASSESSNENT OF TAX ESTATE OF SHEHON FRANK FZLE NO. 21 05-0712 ACN 101 DATE 07-26-2004 TAX RETURN WAS: (X) ACCEPTED AS FILED { ) CHANGED RESERVATZON CONCERNZNG FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) $. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Hortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (S) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule 1) (10) 11. Total Deductions Z55~244.Z9 520~975.35 .00 11~701.45 117~001.53 205~079.34 7~588.84 (8) 12. Net Value of Tax Return ~: (12)~- 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)£~!!'i (13)~ 14. Nat Value of Estate Sub,act to Tax i:-).:.*(14) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 915,590.60 ?~:~ ~sa. 70 a gss. 9o .. , .~.~ . O0 878~955.90 NOTE: Zf an assessment was issued previously, 11nes 14, 15 and/or'.~I6, ~, 18 ;arid will reflect ~igures that lnclude the total of ALL returns assayed too~ate.~ 5~ 19 ASSESSHENT OF TAX: (15) .00 x O0 = .00 (~6) .00 x 045= .00 (17) .00 x 1Z = .00 (1G) 878,935.90 x 15 = 151,840.59 ANOUNT PAID 85,000.00 42,590.59 151,840.39 152,064.07 ZZS.68CR .00 225.68CR 1S. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable et Collateral/Class D rate 19. Principal Tax Due TAX CREDITS PAYMENT RECEIPT DTSCOUNT DATE NUHBER INTEREST/PEN pAID (- 11-21-2005 CD005269 4,475.68 05-18-200~ CD00~9~2 . O0 ZF PAID AFTER DATE ZNDZCATED, SEE REVERSE FOR CALCULATZON OF ADDZTZONAL INTEREST. TOTAL TAX CREDZT I BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE ( ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REOUZRED. ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THZS FORH FOR ZNSTRUCTZONS.) RESERVATION: Estates of decedents dying on or before December Il, 1982 -- [f any Future interest in tho estate Es transferred in possession or enjoyment to Class D (coIlateraI) beneficiaries of the decedent after the expiration of any estate for life or for years, the Coemonmaalth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class 8 (collateral) rate on any such future interest. PURPOSE OF NOTICE: PAYHENT: REFUND (CR): ODJECTIONS: ADHIN- ZSTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: To fulfill the requirements of Sect[on 2140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (72 P.S. Section 9140}. Detach the top portion of this Notice and submit with your payment to the Rag[star of N[lls printed on the reverse side. --Hake check or money order payable to: REGISTER OF NILLS, AGENT A refund of a tax credit, which was nat requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" [REV-ISIS). Applications are available at the Office of the Register of N[lls, any of the 23 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-800-562-2050; services for taxpayers with special hearing and / or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 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. Factual errors discovered on this assessment should be addressed [n writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-650S. See page 5 of the booklet "Instructions far Inheritance Tax Return for a Resident Decedent" (REV-IS01) for an explanation of administratively correctable errors. If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5Z) discount of the tax paid is allowed. The lSZ 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 and of the tax amnesty par[od. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest that has been assessed as indicated on this not[ca. [nterast is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the data of payment. Taxes which became delinquent before January l, 1982 bear interest at the rate of six (6Z) percent per annum calculated at a daily rate cf .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate mhich will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 19DZ through ZO0~ ara: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor ~ 20X .0005q8 ~'~'B-1991 XIZ .000301 ~ 9Z .OOOZq7 1963 16Z .000438 1992 9Z .O00Zq7 ZOOZ 62 .000164 1984 112 .000301 1993-199q 72 .000192 2003 SZ .000137 1985 132 .000356 1995-1998 92 .0002~7 Z004 42 .000110 1986 102 .000Z74 1999 72 .000192 1987 lOX .000Z74 2000 7Z .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUtlBER OF DAYS DELTNQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. ZSOGDZ HARRTSBURG., PA 171ZS-O60Z NURREL R WALTERS 5q E HAIN ST HECHANICSBURG III ESQ PA 17055 CONNONWEALTH OF PENNSYLVANIA DEPARTNENT OF REVENUE ZNHER'rTANCE TAX STATEHENT OF ACCOUNT DATE 08-23-200~ ESTATE OF SHENON DATE OF DEATH 08-2~-2005 FILE NUNBER 21 05-0712 COUNTY CUHBERLAND ACN 101 Amoun~ R-,m i~c~md RE¥-Z[07 EX AFP [01-05) FRANK NAKE CHECK PAYABLE AND RENZT PAYNENT TO: REGISTER OF ~'~'~-LS CUNBERLAND (~"~OUR~OUSE~:':; CARLISLE, P~'~ 1701:5 :.,:' NOTE: To insure prop.r credi~ ~o your account, submi~ ~he upper portion of ~his form ~h yoGr: ~ax payment. CUT ALONG THZS L]NE ~ RETAZN LONER PORTZON FOR YOUR RECORDS REV-1607 EX AFP (01-03} "~ ZNHERZTANCE TAX STATEHENT OF ACCOUNT ESTATE OF SHEHON FRANK FILE NO. Z1 0:5-0712 ACN Z*01 C~ DATE lYS-2:5-200r~ THIS STATENENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN Ti~E NAHED E'"~I'ATE. SHONN BELON ZSA SUHHARY OF THE PRZNC'rpAL TAX DUE, APPLZCATTON OF ALL PAYHENTS, THE CURRENT BALANCE, AND, 'rF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSHENT OR RECORD ADJUSTNENT: 07-19-Z00~ PRINCIPAL TAX DUE: PAYHENTS (TAX CREDITS): PAYHENT RECEIPT DISCOUNT ¢+) DATE NUHBER INTEREST/PEN PAID ¢-) ANOUNT PAID 11-21-200:5 05-18-Z00~ 08-02-Z00~ CDOO:SZ69 CDOO:59~Z REFUND .00 .00 85,000.00 ~2,590.:59 2Z:5.68- ZF PAKD AFTER THKS DATE, SEE REVERSE SKDE FOR CALCULATKON OF ADDKTKONAL KNTEREST. { KF TOTAL DUE ZS LESS THAN $1, NO PAYNENT KS REQUKRED. KF TOTAL DUE KS REFLECTED AS A "CREDKT' {CR), TOTAL TAX CREDIT 1:51,8~0.:59 BALANCE OF TAX DUE .00 ZNTEREST AND PEN. .00 TOTAL DUE .00 YOU HAY BE DUE A REFUND. SEE REVERSE SKDE OF THTS FORN FOR KNSTRUCTKONS. ) PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION STATUS REPORT UNDER RULE 6.12 Name of Decedent: FRANK SHEMON Date of Death: August 24, 2003 Estate No.: 2003-00712 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes No___X__ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete (date) 3. If the answer to No.1 is yes, state the following: A. Did the personal representative fiJe a final account with the court? Y~ No A B. The separate Orphans' Court No. (if any) for the personal representative's account is: (Not Applicable in Dauphin County) c. Did the personal representative state an account informally to the parties X Yes No in interest: D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. (. ('''"> , r-::-" , L --...., ,,--,' ( " ttite: Ati-J st 102005 LU' LW LJ c; C_") c:~, (....J MURREL R. WALTERS, III, ESQUIRE 54 East Main Street Mechanicsburg, P A 17055 717-697-4650 Capacity: Personal Representative _x _ Counsel 1m Pe"onal Rep""entaJl Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 7/27/2005 WALTERS MURREL RIll 54 E MAIN STREET MECHANICSBURG, PA 17055 RE: Estate of SHEMON FRANK File Number: 2003-00712 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) 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 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: 8/24/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~~ (., GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge eX PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY UNTIL COMPLETION ST A TUS REPORT UNDER RULE 6.12 Name of Decedent: FRANK SHEMON Date of Death: August 24, 2003 Estate No.: 2003-00712 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes___X____ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete (date) 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___X_ B. The separate Orphans' Court No. (if any) for the personal representative's account is: (Not Applicable in Dauphin County) C. Did the personal representative state an account informally to the parties in interest: Yes ___X_ No D. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. !{,( It~ Date: July 6, 2006 MURREL R. W ALTERS, III, ESQUIRE 54 East Main Street Mechanicsburg, P A 17055 717-697-4650 Capacity: Personal Representative ___X___ Counsel for Personal Representative L'~ . .' Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 7/05/2006 WALTERS III MURREL R 54 E MAIN STREET MECHANICSBURG, PA 17055 RE: Estate of SHEMON FRANK File Number: 2003-00712 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: 8/24/2006 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 ~ ~/~i' .I) ~ vC!:rtfAJ~ I // ,r...J Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) ~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (71 7) 240 - 6345 Date: 7/05/2006 SHEMON DONALD 75 STONEY POINT ROAD NEW OXFORD, PA 17350 RE: Estate of SHEMON FRANK File Number: 2003-00712 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: 8/24/2006 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, ,(1' ~~. ;;.... .' .' V /~h. L ,J,~dU..J .... . / 7'" Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ~ '<... Cumberland County - Register Of Wills One Courthouse Square Carlislet PA 17013 Phone: (717) 240-6345 Date: 7/05/2006 SHEMON ANTHONY 6154 LUDGATE CIRCLE MECHANICSBURG, PA 17050 RE: Estate of SHEMON FRANK File Number: 2003-00712 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 RULESt NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July It 1992t the personal representative or his counselt within two (2) years of the decedent's deatht shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 8/24/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Reportt please disregard this notice. SincerelYt /fk~ ~j;4;-~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ~