HomeMy WebLinkAbout03-0846Estate of
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
ROSS R. SHEESLEY
Deceased
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
NO.
Social Security No. 159-24-8187
(COMPLETE "A" OR "B" BELOW:)
A. Probate and Grant of Letters and aver that Petitioner is the Executor named in the Last Will of
the Decedent, dated July 27, 1999
State relevant circumstances, e.g, renunciation, death of Executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of
the documents offered for probate; was not to victim of a killing and was never adjudicated incompetent:
B. Grant of Letters of Administration
(d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following
spouse (if any) and heirs:
Name
Relationship Residence
COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in
Decedent, then
Cumberland County, Pennsylvania, with his last family or principal residence at
505 Geary Avenue, Borough of New Cumberland
(kist streot, number and municipality)
90 years of age, died October 9, 2003 at Holy Spirit Hospital
(Location)
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 ...................................................................................................................... $
Total ......................................................................................................... $
850,000.00
None
Real Estate situated as follows:
Wherefore, Petitioners respectfully request the probate of the last Will presented with this Petition and the grant of letters in the
appropriate form to the undersigned:
Signature
Typed or printed name and residence
Floyd Becker
207 Old York Road
New Cumberland, PA 17070
/y.-/'?o-
.i
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are
true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s)
of the Decedent, Petitioner(s) will well and truly administer the estate according to law.
Sworn to and affirmed and subscribed FL~t'D BECKER
Before me this 16th day of
October ,2003.
Donna M. Otto, lst Deputy
No. 21-2003-846
Estate of
Social Security No:
ROSS R. SHEESLEY
159-24-8187
Date of Death:
, Deceased
October 9, 2003
AND NOW, October 17th, ,2003, in consideration of the Petition on the reverse side
hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters Testamentary
d.b.n.c.ta.; pendente lite; durante absentia; durante minoritate
are hereby granted to FLOYD BECKER
in the above estate and that the instrument(s) dated July 27, 1999
described in the Petition be admitted to probate and filed of record as the last Will of the Decedent.
FEES
Letters ........................... $ 480.00
Short Certificate(s) 4 $ 12.00
Renunciation .............. $
Affidavit ( ) .................. $
Extra Pages (4) ....... $ 12.00
Codicil ............................ $
JCP Fee ....................... $ 10.00
Inventory ...................... $
Other .............................. $
TOTAL ......... $ 514.00
Mailed Letters to Attorney on 10/17/03
Register of Wills '
Donna M. Otto, lst Deputy
Attorney: C. Roy Weidner, Jr.
I.D. No: 19530
Address: Johnson, Duffle, Stewart & Weidner,
301 Market Street, P.O. Box 109, Lemoyne, PA 17043-
Telephone: 717-761-4540
I05.805 REV 9/86
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 t(~ the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 9648411
No.
Local Registrar
OCr 1 8 2003
Date
143 Rev. 2/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
Sheesley
AGE (Lest Bi.ay) [ UNDER 1 YE~ I UNDER t ~AY I DATE OF B RTH
I M~ms ] Oa~ I Houm I U~utas I(~, Day, Y~r) I Sme or F=e~n C~nW)I HOSPIT~.
COUN~ OF DEATH I Cl~ BORO ~p OF D"''- ' - - ' I
~ ~ I , , ~/H IPA~lLl~NAME(Ifnotlns~thl~ givestr~tandnu~r) IWASDECEDENTOFHSP~CORGN? I~CE ~n ~n B~ w~-
DE~EN~S USU~ ~CU PATION [ KIND OF BUS NESS I INDUSTRY ~AS DECEDENT EVER IN ] DECED '
DECEDENUS ~IUNG ADDRESS (S/reel, Ci~own, Stale, Zip ~) OECEDENT'S StatePennsylvania
RESIDENCE
FATHE~E (F~st. Mi~. Last) MOTHER'S
1~. Sheesley I,,. ~race
Embtck
INFO--US N~E (T~Pr~t)
I
~ INFerNOS MAILING AD'ESS (S~t. Ci~ow,. Smta. ~ C~e)
ZO,. Floyd A, Becket ~20b'207 Old York Rd,, NewCumher]and. PA 17~7~
I DATE OF DISPOSITION
OonapOn []Burial [] Cremation E]R .... I from State [] ( ........... )
2~.. oth.(s~) [] ~.ctober 14,2003
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24-26
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IMMEDIATE CAUSE (Final
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Sequantial~ list conditions
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cause. Enter UNDERLYING
CAUSE (Disease ~ inju r/
resulting on death ) t.A~T
onset and death
PANT I1: Other signilicanl condiUons con~ibutthg ~o death, b~t
not resulting in the undoltyk~g cause given in PAJ~T I.
WAS AN AUTOPSYWERE AUTOPSY FINDINGS MANNER OF DEA DATE OF I ·
PERFO ED, IAV'" P.,ORTO I Y IT'MEOF'N'UNY I'"mYATWON 'IDESCR'.EHOW,. URYOCCURRED.
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CERTIFIER (C~
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DATE FILED (M~. Day. Wear)
21-2003-846
OF
ROSS R. SHEESLEY
I, ROSS R. SHEESLEY, of the Borough of New Cumberland, County of Cumberland, and
Commonwealth of Pennsylvania, being of sound and disposing mind, memory and understanding, do
hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking all other
Wills heretofore made by me.
ARTICLE I
I direct the payment of my legal debts and the expenses of my last illness and disposition of my
remains from my estate as soon after my death as conveniently may be done. All of the foregoing shall
be considered expenses of the administration of my estate.
ARTICLE II
I devise and bequeath all of my estate of whatever nature and wherever situate as follows:
Fifty percent (50%) thereof to my brother, BERNARD G.
SHEESLEY. If he does not survive me, I bequeath his share to
his wife, JUNE C. SHEESLEY. If neither Bernard G.
Sheesley or June C. Sheesley survive me, I bequeath such share,
in equal shares, to their children, JOSEPH B. SHEESLEY and
SUSAN B. CRISPEN, or all to the survivor.
Bo
Ten percent (10%) thereof to my stepdaughter, BEVERLY A.
KOONS. If she does not survive me, I bequeath her share, in
equal shares, to her children, LINDA L. GROSS, THOMAS F.
KOONS and CHENLYE A. LAUER, provided each shall
survive. Should any of my stepdaughter's children predecease
me, I bequeath their shares to the survivors of them, share and
share alike.
Ten percent (10%) thereof to MARKET SQUARE
PRESBYTERIAN CHURCH of Harrisburg, Pennsylvania, to
be used for general purposes of the Church.
Do
Ten percent (10%) thereof to LEBANON VALLEY
COLLEGE of Annville, Pennsylvania, to be used for general
purposes of the College.
Ten percent (10%) thereof to LORRAINE REILEY of New
Cumberland, Pennsylvania.
Five percent (5%) thereof to FLOYD BECKER of New
Cumberland, Pennsylvania.
Go
Five percent (5%) thereof to ELMER WERTZ of New
Cumberland, Pennsylvania.
Should any of the above shares lapse by reason of failure of all of the persons named to receive such
share to survive me, or the failure to exist at the time of my death of any institution named to receive such
share, such share shall be added to the other shares of my residuary estate in the same proportion as they
now bear to each other.
ARTICLE HI
I appoint FLOYD BECKER, Executor of this my last Will. In the event of his inability or
unwillingness to act or continue to act as Executor, I appoint my brother, BERNARD G. SHEESLEY,
Executor.
ARTICLE IV
I direct that my Executor liquidate my estate in order to pay the expenses directed to be paid in
Article I hereof and to make the distributions directed to be made in Article II hereof. I further direct that
no distribution of property in kind be made from my estate.
ARTICLE V
I direct that my Executor, or his successors, shall not be required to give bond for the faithful
performance of their duties in any jurisdiction in which they may be called upon to act, insofar as I am
able by law to do so.
IN WITNESS WHEREOF, I hereunto set my hand and seal day of July 1999.
Ross R. Sheesley
Signed, sealed, published and declared by the above-named Testator as and for his Last Will and
Testament in the presence of us, who at his request, in his presence and in the presence of each other
have hereunto subscribed our names as witnesses.
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS:
I, Ross R. Sheesley, Testator, whose name is signed to the foregoing instrument, having been
duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my
Last Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the
purposes therein expressed.
this
Sworn or affirmed to and acknowledged before me, by Ross R. Sheesley,
~ --~'x~ day of July 1999.
Notary Pu~i~ k.~'
the Testator,
NOTARIAL SEAL
DIANNE LENIG, Notary Public
Lemoyne Borough Cumberland Co.
MY commission Expires Dec. 21, 2001
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS:
We, C..,.Q~ ~o,,~-~x..%(%. and'~r-~ ~ -~ , the wimesses
whose names are signed to the foregoing Instrument, being duly qualified according to law, do depose and
say that we were present and saw the Testator sign and execute the foregoing instrument as his Last Will
and Testament; that he 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 best of our knowledge, the Testator was at least 18 years of age, of sound mind
and under no constraint or undue influence.
Sworn to or affirmed to and subscribed to before me by
~ ~ '~~ - , witnesses, this ~ '~X'Y~ay of July 1999.
Notary Public ~
and
:124800
NOTARIAL SEAL
DIANNE LENIG, Notary Public
Lemoyne Borough Cumberland Co.
_My Commission Expires Dec. 2'1, 2001
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: ROSS R. SHEESLEY
Date of Death: October 9, 2003
Will No.: 2003-00846
Admin. No.:
To the Register:
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphan's' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
October 21, 22, 23 and 24th, 2003.
Name
Address
Bernard Sheesley 313 Wedgewood Rd., Harrisburg, PA 17109
Beverly A. Koons 40 Sioux Dr. Millsboro, DE 19966
Market Square Presbyterian Church 20 S. Second St., Harrisburg, PA 17101
Lebanon Valley College 101 N. College Ave., Annville, PA 17003
Lorraine Reiley 505 Geary Ave., New Cumberland, PA 17070
Floyd Becker 207 Old York Rd.,New Cumberland, PA 17070
Elmer Wertz 1003 Bridge St., New Cumberland, PA 17070
Office of Attorney General Strawberry Square, Harrisburg, PA 17120
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None.
Name C. Roy Weidner, Jr.
Johnson, Duffie, Stewart & Weidner
Address 301 Market St.
P. O. Box 109
Lemoyne, PA 17043-0109
Telephone (717) 761-4540
Capacity: Personal Representative
X Counsel for personal representative
TO
Register of Wills Office
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013-3387
SUBJECT:
Estate of Ross R. Sheesley
No. 21-03-00846
DOD: October 9, 2003
FROM
.~OHNSON~ DUFFIE~ STEWART & WE]:DNER
Attorneys at Law
P.O. Box 109
i "~': Lemoyne, PA 17043
(717) 761-4540
Fax: (717) 761-3015
DATE: December 30, 2003
Enclosed is a check in the amount of $40,000.00 as a payment on account of Inheritance
Tax for the above-captioned Estate, being made within the 90 days to allow for the 5% discount.
A very "Happy New Year" to everyone.
SIGNED: ~indy H~r, Estate Le~lal Assistant
LAW OFFICES
JOHNSON, DUFFLE, STEW^RT g WEIDNER
301 MARKET STREET
P. O. BOX 109
LEMOYNE, PENNSYLVANIA 17043-0109
REGISTER OF WILLS OFFICE
CUMBERLAND COUNTY COURTHOUSE
1 COURTHOUSE SQUARE
CARLISLE, PA 17013-3387
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 003398
WEIDNER C ROY JR, ESQ.
P. O. BOX 109
LEMOYNE, PA 17043
........ fold
ESTATE INFORMATION: SSN: 159-24-8187
FILE NUMBER: 2103-0846
DECEDENT NAME: SHEESLEY ROSS R
DATE OF PAYMENT: 12/31/2003
POSTMARK DATE: 1 2/30/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 10/09/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $40,000.00
TOTAL AMOUNT PAID:
$40,000.00
REMARKS: FLOYDBECKEREXEC.
C/O ROY C WEIDNER ESQUIRE
SEAL
CHECK# 1004
INITIALS: JA
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT 280601
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SHEESLEY, ROSS R.
DATE 0F DEATH (MbI-DD-YEAR) ! 6ATE OF BIRTH (~M:DD:YEAR)
.10/09/2003 10/18/1912
(IF APPLICABLE) SURVIVING ~PousE;~iqAME~ LAST, FIRST AND MiDDlE iNiTIAL)
INHERITANCE TAX RETURN F,LENUMBER
RESIDENT DECEDENT 21 03 00846
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
159-24-8187
TR,S RETUR~UST BE ~I'ED i" DU".CATE VV~T.
REGISTER OF WILLS
' SOCIAL S~LIRITY NUMBER
] 1. Original Return [] 2. Supplemental Return
q: ~o [] 4. Limited Estate [] 4a, Future Interest Compromise (date of death after
~ o:: :~ 12-12-82)
~oo
,,, .~ [] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach
O ~ m of Will) copy of Trust)
'~ [] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between
3. Remainder Return (date of de~th ~rior to 12-13~82)
[] 5, Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
[] 11. Election to tax under Sec. 9113(A) (Attach Sch O)
NAME
C. ROY WEIDNER
FIRM ~AME (Ii applicable)
JOHNSON, DUFFLE, STEWART & WEIDNER
TELEPHONE NUMBER
717/761-4540
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions(total Lines 9 & 10)
ICOMPLETE MAILING ADDRESS
301 MARKET STREET
P. O. BOX 109
LEMOYNE, PA 17043-0109
None
262,561.88
None
None
541,368.71
None
70,000.00
65,096.99
228.44
OFFiCiAL. '.JSE ONLY
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)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15.Amount of Line 14 taxable at the spousal tax rate, x ,00
or transfers under Sec. 9116(a)(1.2)
16.Amount of Line 14 taxable at lineal rate 73,860.52 x .045
17.Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
369,302.58 x .12
217,721.04 x .15
20. []
(8) 873,930.59
(1~) 65,325.43
(12) 808,605.16
147,721.02
(13)
(14) 660,884.14
(15)
(16) 3,323.72
(17) 44,316.31
Hs) 32,658.16
(19) 80,298.19
Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
CFFY
505 Geary Avenue
New Cumberland
STATE
PA
ZIP
17070
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable
D. Interest
E. Penalty
40~000.00
2,105.26
Total Credits (A + B + C)
Total Interest/Penalty (D + E) (3)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENI (4)
Check box on Page I Line 20 to request a refund
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + SA. This is theBALANCE DUE (5B)
(1) 80,298.19
(2) 42,105.26
0.00
38,192.93
38,192.93
ADDRESS
301 MARKET STREET
P. O. BOX 109
LEMOYNE, PA 17043-0109
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 statutedoes not exempta 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.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
FI,QJI/D~BECKE R ,t .~9
S I G N ATU RE'~O F~ R L~°~E~TiVE
C. ROY WEIDNER
hDDREg§
ADDRESS
207 OLD YORK ROAD
NEW CUMBERLAND, PA 17070
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ............................................................................. [] []
b. retain the right to designate who shall use the property transferred or its income; ................................
c. retain a reversionary interest; or. ...........................................................................................................
d. receive the promise for life of either payments, benefits or care? ...........................................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ................................................................................................................. [] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death2 ....... [] []
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
containsabenefcarydesgnaton?. ............................................................................................................... [] ' [~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true. correct and complete. D(~claration
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
SHEESLEY, ROSS R.
FILE NUMBER
21 - 03 - 00846
All property jointly-owned with right of survivOrship must be disclosed on Schedule F.
ITEM
NUMBER
1
DESCRIPTION UNIT VALUE
256.926 Shares - Lord Abbett Affiliated Fund
Class A @ $11.98 per/share
VALUE AT DATE OF
DEATH
3,077.97
6
240.000 Shares Federated Stock and Bond Fund,
Inc. A (formerly Income Foundation Fund) ~ $17.17 per/share
39 Shares - MetLife ~ $33.0386 per/share
105 Shares - Prudential Financial Common
~ $38.10 per/share
Edward Jones Investment Acct. No. 270-03996-1-7
Consisting of:
$100,000.00 Bank of America Corp. Internote
Date of death value ~ $100,875.00
$100,000.00 Consumers Energy Co. Senior
Secured Insured Quarterly Note
Date of death value $ 98,250.00
4,739.285 Shs. Van Kampen High Yield Municipal
Fund CL B ~ $10.47 per/share $ 49,620.31
76 Shares - Conectiv (now Pepco Holdings) Class A
@ $17.484 per/share
4,120.80
1,288.51
4,000.50
248,745.31
1,328.79
TOTAL (Also enter on line 2, Recapitulation) 262,561.88
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
OOMMONWE*LTH OF PENNSYLVA,,* PERSONAL PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
SHEESLEY, ROSS R.
21 - 03 - 00846
Include the proceeds of litigation and the date the proceeds were received by the estate~,ll property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM
NUMBEF
DESCRIPTION
Waypoint Bank: Checking Account No. 703005506
Date of death balance, plus accrued interest.
PNC Bank - Certificate of Deposit No. 31600196368
Date of death balance, plus accrued interest.
PNC Bank - Checking Account No. 5140057132
Date of death balance, plus accrued interest.
Fulton Bank - Certificate of Deposit No. 052-0167007
Date of death balance, plus accrued interest.
Commerce Bank - Savings Account No. 0626041867
Date of death balance, plus accrued interest.
New Cumberland Federal Credit Union - Savings Account No. 2012
Date of death balance, plus accrued interest.
PP&L - refund
Civil Service Fund - Lump Sum Death Benefit
TOTAL (Also enter on Line 5, Recapitulation)
VALUE AT DATE OF
DEATH
94,468.30
40,002.19
226,234.45
100,022.61
50,725.17
29,000.44
17.88
897.67
541,368.71
,"~, SCHEDULE Gl
COUMONWEA,T, OF PEN.S¥'VANI^ INTER'VIVOS TRANSFERS &
INHERITANCE TAX RETURN MISC. NON'PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF
SHEESLEY, ROSS R.
FILE NUMBER
21 - 03 - 00846
ITEM
NUMBER
This schedule must be completed and filed if the answer t° any of questions 1 throug~h 4 on page 2 is yes.
DESCRIPTION OF PROPERTY
Includethe name of the transferee, their relationship to decedent and the date of transfer DATE OF DEATH I % OF I
Attach a copy of the deed for real estate. 'IVALUE OF ASSETI DECD'S i EXCLUSION
' INTEREST: CF APPLICABLE)
Lorraine Reiley, Friend 731000.00 3,000.00
Cash - 5/2003 5,000.00
Cash - 6/2003 65,000.00
Cash- 8/2003 3,000.00
TAXABLE VALUE
70,000.00
Mark Reiley, Friend 1,000.00 3,000.00i
Cash- 8/2003
0.00
TOTAL (Also enter on line 7, Recapitulation)
70,000.00
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATNE COSTS
ESTATE OF SH~ESLEY, ROSS R. FILE NUMBER
21 - 03 - 00846
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A.
1 /
FUNERAL EXPENSES:
Parthemore Funeral Home
Blue Ridge Memorial Gardens - cemetery charges
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
FLOYD BECK_ER
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address 207 OLD YORK ROAD
City NEW CUMBERLAND State PA Zip 17070
Year(s) Commission paid
Attorney's Fees Johnson, Duffle, Stewart & Weidner
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State
Relationship of Claimant to Decedent
Probate Fees Register of Wills - Cumberland County
ziP
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Cumberland Law Journal - legal advertisement
The Patriot-News - legal advertisement
9,159.70
810.00
27,000.00
27,000.00
514.00
75.00
205.69
Total of Continuation Schedule(s)
332.60
TOTAL (Also enter on line 9, Recapitulation) i 65,096.99
.~ i Schedule H
COMMONWEALTH OF PENNSYLVANIA Funer'~ Expemes &
INHERITANCE TAX RETURN
RESIDENT DECEDENT Administlalive Cosls continued
ESTATE OF
SHEESLEY, ROSS R.
3 Register of Wills - Short certificates
FILE NUMBER
21 - 03 - 00846
27.00
PNC Bank - Charge for Estate checks
Register of Wills - file Inventory & Inheritance Tax Remm
Reserve for close-out costs/filing Account
27.60
28.00
250.00
Page 2 of Schedule H
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
FILE NUMBER
SHEESLEY, ROSS R.
21-03-00846
Include unreimbursed medical expenses.
ITEM
NUMBER
1
Nei~hborCare - Pharmacy Account Balance
DESCRIPTION
PA Water Company - decedent's account balance
TOTAL (Also enter on Line 10, Recapitulation)
AMOUNT
218.94
9.50
228.44
REV-~I513 EX+ (,q-o0) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
ESTATE OF
NUMBER
I.
SCHEDULE J
BENEFICIARIES
RESIDENT DECEDENT
SHEESLEY, ROSS R.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
Bernard G. Sheesley
313 Wedgewood Road, Harrisburg, PA 17109
Beverly A. Koons
40 Sioux Drive, Millsboro, DE 19966
Lorraine Reiley
505 Geary Ave., New Cumberland, PA 17070
4
Floyd Becker
207 Old York Road, New Cumberland, PA 17070
FILE NUMBER
21 - 03 - 00846
RELATIONSHIP TO AMOUNT OR SHARE
DECEDENT OF ESTATE
Do Not List Trustee(s)
Brother 50% Residue
Stepdaughter 10% Residue
Friend
10% Residue
Friend 5% Residue
II.
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
~'
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
i B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
Market Square Presbyterian Church
, 20 S. Second Street, Harrisburg, PA 17101
Lebanon Valley College
101 N. College Avenue, Annville, PA 17003
73,860.50
73,860.50
TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 14")',721.00
' SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BEN EFICIARIES continued
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SHEESLEY, ROSS R.
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
[in~iude outr~ht spousal diStribuiions and transfers under
L TAXABLE DISTRIBUTIONS Sec. 9116(a)(1.2)] '
5 Elmer Wertz
1003 Bridge Street, New Cumberland, PA 17070
FILE NUMBER
21 03 00846
RELATioNsHi~ -r0
DECEDENT AMOUNT OR SHARE
DO Not List Trustee(s)_ OF ESTATE
Friend
5% Residue
Page 2 of Schedule J
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of SHEESLEY, ROSS R. No. 21 - 03 - 00846
also known as Date of Death 10/9/2003
, Deceased Social Security No. 159-24-8187
FLOYD DECKER
The Personal Representative(s) Of th~above Estate, deceased, verify 'that the items appearing in the following inventory
include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania
of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the
Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that
which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true
and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904
relating to unsworn falsification to authorities.
Personal Representajiv¢~ ~ ~
Attorney: C. ROY WEIDNER S ig n at u re.;~W/~~ ~..,~.~ ~,/¢_..~¢~
FLOYilYBECKER
I.D. No.: 19530 Signature:
Signature:
Address:
301 MARKET STREET
P. O. BOX 109
LEMOYNE, PA 17043-0109
Telephone: 717/761-4540
Personal Property
Address: 207 OLD YORK ROAD
NEW CUMBERLAND, PA 17070
Telephone: (717) 774-3379
Dated:
256.926 Shares - Lord Abbett Affiliated Fund
Class A @ $11.98 per/share
3,077.97
240.000 Shares Federated Stock and Bond Fund,
Inc. A (formerly Income Foundation Fund) ~ $17.17 per/share
4,120.80
39 Shares - MetLife @ $33.0386 per/share
1,288.51
05 Shares - Prudential Financial Common
$38.10 per/share
4,000.50
(Attach additional sheets if necessary) Total Personal Property and Real Estate ' ' $803,930.59
Register of Wills of Cumberland County, Pennsylvania
Estate of SHEESLEY, ROSS R.
also known as
INVENTORY
continued
No. 21 - 03 - 00846
Date of Death 10/9/2003
, Deceased
Social Security No. 159-24-8187
Edward Jones Investment Acct. No. 270-03996~ 1-7
Consisting off
$100,000.00 Bank of America Corp. Internote
Date of death value $100,875.00
$100,000.00 Consumers Energy Co. Senior
Secured Insured Quarterly Note
Date of death value $ 98,250.00
4,739.285 Shs. Van Kampen High Yield Municipal
Fund CL B ~ $10.47 per/share $ 49,620.31
248,745.31
76 Shares - Conectiv (now Pepco Holdings) Class A
~b~ $17.484 per/share
Waypoint Bank - Checking Account No. 703005506
Date of death balance, plus accrued interest.
PNC Bank - Certificate of Deposit No. 31600196368
Date of death balance, plus accrued interest.
PNC Bank - Checking Account No. 5140057132
Date of death balance, plus accrued interest.
Fulton Bank - Certificate of Deposit No. 052-0167007
Date of death balance, plus accrued interest.
Commerce Bank - Savings Account No. 0626041867
Date of death balance, plus accrued interest.
New Cumberland Federal Credit Union - Savings Account No. 2012
Date of death balance, plus accrued interest.
PP&L - refund
Civil Service Fund - Lump Sum Death Benefit
1,328.79
94,468.30
40,002.19
226,234.45
100,022.61
50,725.17
29,000.44
17.88
897.67
Total Personal Property
$803,930.59
2
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 2806O1
HARRISBURG, PA 17128-0601
RECEIVED FROM:
WEIDNER C ROY JR, ESQ.
P. O. BOX 109
LEMOYNE, PA 17043
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003528
........ fold
ESTATE INFORMATION: SSN: 159-24-8187
FILE NUMBER: 2103-0846
DECEDENT NAME: SHEESLEY ROSS R
DATE OF PAYMENT: 02/04/2004
POSTMARK DATE: 02/02/2004
COUNTY: CUM BERLAN D
DATE OF DEATH: 10/09/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $38,192.93
;REMARKS'
CHECK# 1006
SEAL
TOTAL AMOUNT PAID:
$38,192.93
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
PENNSYLVANIA ORPHANS' COURT DIVISION
NO. 21-03-0846
ESTATE OF ROSS R. SHEESLEY, DECEASED
Late of New Cumberland Borough
FIRST AND FINAL ACCOUNT
OF
FLOYD BECKER, EXECUTOR
Date of Death:
Date of Executor's Appointment:
Advertisement of Letters:
Accounting for the Period:
October 9, 2003.
October 17, 2003
Cumberland Law Journal:
October 31, November 7, 14, 2003
The Patriot-News:
October 29, November 5, 12, 2003
October 17, 2003 to May 15, 2004
Purpose of Account: Floyd Becker, Executor offers this Account to acquaint interested parties with the
transactions that have occurred during his administration.
It is important that the account be carefully examined. Requests for additional information or questions or
objections can be discussed with:
Floyd Becker, Executor
207 Old York Road
New Cumberland, PA 17070
(717) 774-3379
or
C. Roy Weidner, Jr., Attorney
Johnson, Duffle, Stewart & Weidner
301 Market Street
P.O. Box 109
Lemoyne, PA 17043-0109
(717) 761-4540
SUMMARY OF ACCOUNT
Fiduciar~
Acquisition
Principal
Receipts
Net Gain on Sales
Adjusted Balance
Less Disbursements:
Debts of Decedent
Funeral Expenses
Administration Expenses
Inheritance Tax
Fees and Commissions
2003 - Income Tax
Reserves
228.44
9,969.70
879.29
78,192.93
27,000.00
125.00
27,135.00
Page
3-4
5-6
7-8
Va/ue
$804,967.16
3,176.82
808,143.98
-143,530.06
Principal Balance on Hand
Information
$664,613.92
Income
Receipts
Less Disbursements
10-11
12
12,836.44
Income Balance on Hand
Proposed Distributions to Beneficiaries
Combined Balance on Hand
consists of Cash.
13-14
12,836.44
677,450.36
#228668
RECEIPTS OF PRINCIPAL
Fiduciary
Acquisition
Value
Cash - Bank Accounts:
WaYpoint Bank:
Checking Account No. 703005506
Date of death balance, plus accrued interest
PNC Bank
Certificate of Deposit No. 31600196368
Date of death balance, plus accrued interest
PNC Bank:
Checking Account No. 5140057132 -
Date of death balance, plus accrued interest
Fulton Bank:
Certificate of Deposit No. 052-0167007
Date of death balance, plus accrued interest
Commerce Bank:
Savings Account No. 0626041867
Date of death balance, plus accrued interest
New Cumberland Federal Credit Union:
Savings Account No. 002012
Date of death balance, plus accrued interest.
Stocks:
Lord Abbett Aff'fliated Fund Class A
256.926 Shares @ $11.98 per/share
Federated Stock and Bond Fund (formerly
Income Foundation Fund)
240.000 Shares @ $17.17 per/share
MetLife - Common
39 Shares @ $33.0386 per/share
Prudential Financial, Inc. - Common
105 Shares @ $38.10 per/share
Conectiv (now Pepco Holdings)-Class A
76 Shams @ $17.484 per/share
$94,468.30
40,002.19
226,234.45
100,022.61
50,725.17
29,000.44
3,077.97
4,120.80
1,288.51
4,000.50
1,328.79
540,453.16
13,816.57
-3-
Receipts of Principal, Continued:
Investment Account:
EdWard Jones - Account No. 270-03996-1-7
consisting of:
$100,000.00 Bank of America Corp. Internote
Dtd- 12/27/2001- Callable- 12/15/2006@ 100.00
Interest rate: 7% - date of death value
$100,000.00 Consumers Energy Co. Senior
Secured Insured Quarterly Note
Dtd - 10/29/1998 - Callable anytime @ 100.00
Date of death value
Van Kampen High Yield Municipal Fund CL B
4,739.285 Shares @ $10.47 per/share
100,875.00
98,250.00
49,620.31
248,745.31
Cash:
Civil Service Fund - lump sum death benefit
Fulton Bank - uncashed interest check
PNC Bank - uncashed interest check
PP&L- refund- overpayment
Verizon- refund- overpayment
Refund of overpayment of 2003 U.S. Individual
Income tax
Refund of overpayment of 2003 PA Individual
Income tax
897.67
63.72
32.87
17.88
98.98
724.00
117.00
1,952.12
Total Receipts of Principal
$804~967.16
#228375
-4-
GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS
11/18/03
11/21/03
12/12/03
12/02/03
01/26/04
04/30/04
256.962 Shares - Lord Abbett
Affiliated Fund Class A
Proceeds
Fiduciary Acquisition Value
$3,579.48
3,077.97
240 Shares - Federated Stock and Bond
Fund, Inc A
Net Proceeds
Fiduciary Acquisition Value
$4,137.60
4,120.80
39 Shares - MetLife Common
Net Proceeds
Fiduciary Acquisition Value
$1,288.51
1,288.51
105 Shares - Prudential Financial
Common
Net Proceeds
Fiduciary Acquisition Value
$4,094.12
4,000.50
76 Shares - Conectiv, Class A
Proceeds
Fiduciary Acquisition Value
$1,328.79
1,328.79
4,739.285 Shares Van Kampen Tax
Exempt TR, High Yield Municipal
Fund CL B
Proceeds
Fiduciary Acquisition Value
$49,715.10
49,620.31
Ga&
501.51
16.80
-0-
93.62
-0-
94.79
Loss
-0-
-0-
-5-
Gains and Losses on Sales, Continued:
Gain
Loss
04/30/04
04/30/04
$100,000.00 Consumers Energy Co.
Sr. Secured Insured Quarterly Note
6.5% interest.
Net Proceeds
Fiduciary Acquisition Value
$100,000.00 Bank of America
Internotes- 7% interest.
Net Proceeds
Fiduciary Acquisition Value
$98,370.05
98,250.00
$103,225.05
100,875.00
120.05
2,350.05
Total Gains
$3,176.82
#228431
-6-
DISBURSEMENTS OF PRINCIPAL
10/21/03
11/04/03
Debts of Decedent
PA Water Co. - final charges not paid
when decedent's residence was sold
NeighborCare - Account balance
9.50
218.94
228.44
10/21/03
11/05/03
10/15/03
10/17/03
10/27/03
10/30/03
11/14/03
11/25/03
12/08/03
01/12/04
01/29/04
12/30/03
01/29/04
01/30/04
01/30/04
Funeral Expenses
Parthemore Funeral Home - funeral expenses
Bernard Sheesley - reimbursement for payment
of cemetery charges - Blue Ridge Memorial
Gardens
Administration Expenses
New Cumberland Federal Credit Union -
Remm Mail Fee
Register of Wills - Probate
Cumberland Law Journal - advertising letters
PNC Bank - Estate checks
Register of Wills - Short Certificates
Register of Wills - Short Certificates
The Patriot-News - advertising letters
Register of wills - Short Certificate
Register of Wills - File Inventory and Inheritance
Tax Return
Inheritance Tax
Register of Wills, Agem - 90 day Inheritance Tax
payment - eligible for 5 % discount.
Register of Wills, Agent - balance of Inheritance
Tax
Fees and Commissions .
Johnson, Duffle, Stewart & Weidner - one-half
attorney fee
Floyd Becker, Executor - one-half Executor's
commission
9,159.70
810.00
2.00
514.00
75.00
27.60
12.00
12.00
205.69
3.00
28.00
40,000.00
38,192.93
13,500.00
13,500.00
9,969.70
879.29
78,192.93
27,000.00
-7-
Disbursements of Principal, Continued:
03/23/04
03/24/04
03/24/04
2003 - Income Tax
Richard S. Simpson, II - preparation of
decedent's f'mal Federal and State Income Tax
Returns.
Internal Revenue Service Center - decedent's
final Form 1040 for 2003 filed. No tax due -
PA Department of Revenue - decedent's final
PA 40 for 2003 filed. No tax due
125.00
-0-
-0-
125.00
Reserves
Johnson, Duffle, Stewart & Weidner - balance
of attorney fee
Floyd Becker - balance of Executor's
commission
Register of Wills - file First and Final Account
13,500.00
13,500.00
135.00
27,135.00
Total Disbursements of Principal
$143,530.36
#228436
-8-
INFORMATION
Mr. Sheesley sold his residence at 711 Fourth Street, New Cumberland, PA prior to his
death. Settlement and transfer of title to the new owner took place on September 19, 2003, prior to Mr.
Sheesley's death.
This information is being provided to confirm the reason for the refunds the Estate received
from PP&L and Verizon shown under Principal Receipts and to verify the deduction for the final PA
Water Company charges shown under Disbursements of Principal.
-9-
RECEIPTS OF INCOME
Interest:
Waypoint Bank - Account No. 703005506
Interest- 10/9/03- 10/31/03
Interest- 11/1/03- 11/30/03
Interest- 12/1/03- 12/31/03
Interest- 01/1/04 - 01/14/04, date closed
PNC Bank - Certificate No. 31600196368
Interest- 10/9/03 - 10/21/03, date redeemed
PNC Bank - Checking Account No. 5140057132
Interest- 10/9/03- 10/21/03, date closed
Fulton Bank - Certificate No. 052-0167007
Interest- 10/9/03- 10/31/03
Interest- 11/1/03- 11/30/03
Interest- 12/1/03- 12/31/03
Interest- 01/1/04- 01/30/04, date redeemed
Commerce Bank -
Interest- 10/9/03-
Interest- 11/1/03-
Interest- 12/1/03-
Interest- 01/1/04-
Savings Account No. 0626041867
10/31/03
11/30/03
12/31/03
01/21/04, date closed
New Cumberland Federal Credit Union - Account No. 002012
Interest - 09/30/03
Interest- 10/01/03- 10/31/03
Interest - 11/01/03 - 11/30/03
Interest- 12/01/03- 12/31/03
Interest- 01/01/04- 01/31/04
Interest- 02/01/04- 02/19/04
Consumers Energy Co. Senior Note
Interest- 01/02/04
Interest- 04/01/04
Accrued interest - sold 4/30/04
Bank of America Corp. Internotes
Interest- 12/15/03
Accrued interest - sold 4/30/04
$ 30.59
39.61
41.73
19.12
12.06
10.09
39.05
63.72
61.66
63.72
30.44
41.51
42.93
27.64
23.84
24.65
23.87
24.69
18.48
-0-
1,625.00
1,625.00
523.61
3,500.00
2,625.00
-10-
Receipts of Income, Continued:
Dividends:
Prudential Financial, Inc.
Dividend- 12/18/03
MetLife
Dividend- 12/15/03
Conectiv, Class A (now Pepco Holdings)
Dividend
Lord Abbett Affiliated Fund, Inc.
Income Dividend - 11/25/03
Income Dividend - 12/19/03
Federated Stock and Bond Fund, Inc A
Income Dividend
Van Kampen Tax Exempt Trust
Dividend - 11/03/03
Dividend- 12/01/03
Dividend- 01/02/04
Dividend- 02-02/04
Dividend- 03/01/04
Dividend- 04/01/04
Edward Jones Money Market Fund
12/31/03- 03/22/04
Interest:
PNC Bank - Estate Money Market
Account No. 50-0439-5604
Interest- 01/27/04
Interest- 02/24/04
Interest- 03/26/04
Interest- 04/05/04
Interest- 04/27/04
52.50
8.97
-0-
12.85
6.42
-0-
220.41
220.41
220.41
220.41
220.41
220.41
1.43
75.16
134.43
159.31
48.17
476.73
Total Receipts of Income
$12,836.44
-il-
DISBURSEMENTS OF INCOME
Internal Revenue Service - Form 1041 - Estate
Income Tax Return for fiscal year beginning
October 9, 2003 and ending June 30, 2004
Final Remm
Tax Due
None
PA Department of Revenue - PA 4t - Estate
Income Tax Return for fiscal year beginning
October 9, 2003 and ending June 30, 2004 -
Final Return.
Tax Due
None
Total Disbursements of Income
None
-12-
PROPOSED DISTRIBUTIONS TO BENEFICIARIES
Balance for Distribution as per
First and Final Account
Added for calculation of bequest to Market Square
Presbyterian Church and Lebanon Valley College:
Pennsylvania Inheritance Tax
Calculation for Church and College distributions
$677,450.06
78,192.93
$755,642.99
TO:
TO:
Article II - C and D
Market Square Presbyterian Church
Cash
Lebanon Valley College
Cash
10% Residue
$ 75,564.3O
10% Residue
$75,564.3O
Calculation for remaining beneficiary distributions:
TO:
TO:
Pennsylvania Inheritance Tax -
Distributions to Church and College
Balance to calculate distribution to remaining beneficiaries
Article II - A
Bernard G. Sheesley
(Calculation: 50/80 x $526,321.46)
Cash
Article II - B
Beverly A. Koons
(Calculation: 10/80 x $526,321.46)
Cash
50% Residue
$328,950.92
10% Residue
$ 65,790.18
$755,642.99
(78,192.93)
051,128.6o)
$526,321.46
-13-
Proposed Distributions to Beneficiaries, Continued:
Article II - E
TO: Lorraine Reiley
(Calculation: 10/80 x $526,321.46)
Cash
Article II - F
TO: Floyd Becket
(Calculation: 5/80 x $526,321.46)
Cash
Article II - G
TO: Elmer Wertz
(Calculation: 5/80 x $526,321.46)
Cash
10% Residue
$ 65,790.18
5 % Residue
$ 32,895.09
5 % Residue
$ 32,895.09
-14-
COMMONWEALTH OF PENNSYLVANIA ·
:SS.
COUNTY OF CUMBERLAND '
Floyd Becker, Executor under the Last Will and Testament of Ross R. Sheesley, deceased,
hereby declares under oath that he has fully and faithfully discharged the duties of his office; that the
foregoing First and Final Account is true and correct and fully discloses all significant transactions
occurring during the accounting period; that all known claims against the Estate have been paid in full;
that, to his knowledge, there are no claims now outstanding against the EState; that all taxes presently
due from the Estate have been paid and that the Grant of Letters and the first complete advertisement
thereof occurred more than four (4) months before the filing of the Account.
Subscribed and sworn to
by Floyd Becker, Executor
before me this ,2, ~
day of May, 2004
l~loy~Becker, Executor/- /
NOTARIAL SEAL
DIANNE LENIG, Nolary Public
Lemoyne Borough Cumberland Co.
My Commission Expires Dec. 21, 2005
-15-
BUREAU OF INDIVIDUAL TAXES
INHERXTANCE TAX DIVISION
DEPT. 280601
HARRISBURG~ PA 17128-0&01
C ROY WEIDNER
JOHNSON ETAL
PO BOX 109
LEMOYNE
COMMONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
'04 19
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
:4~OUNTY
ACN
05-22-2004
SHEESLEY
10-09-2005
2i 05-0846
CUMBERLAND
IO1
Amount Remitted
ROSS R
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~- RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP C01-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLONANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF SHEESLEY ROSS R FILE NO. 21 05-0846 ACN 101 DATE 05-22-2004
TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate CSchedule A)
2. Stocks and Bonds CSchedule B) C2)
$. Closely Held Stock/Partnership Interest CSchedule C)
4. Mortgages/Notes Receivable CSchedule D)
5. Cash/Bank Deposits/Misc. Personal Property CSchedule E)
6. Jointly Owned Property CSchedule F) C6)
7. Transfers CSchedule G) C7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses CScheduIe H) (9)
lO. Debts/Mortgage Liabilities/Liens (Schedule I) CIO)
11. Total Deductions
[2. Net Value of Tax Return
.00
262r561.88
.00
.00
541r568.71
.00
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form w/th your
tax payment.
70rO00.O0
(8) 875,950.59
65,096.99
15.
14.
NOTE:
228.44
ti2) 808,605.16
Charitable/Governmental Bequests; Non-elected 9115 Trusts CSchedule J) C15)
Net Value of Estate Sub~ect to Tax Clq)
If an assessment was issued previously, lines 14, 15 and/or 16, 17,
reflect figures that Include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of L/ne 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of L/ne 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID
12-50-2005 CD005598 2,105.26
02-02-2004 CD005528 . O0
147,721.02
660,884.14
18 and 19 w111
TOTAL TAX CREDIT,'1 80,298.19.
BALANCE OF TAX DUEl 00
INTEREST AND PEN. I .00
TOTAL DUE I .00
c IF TOTAL DUE TS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT°' (CA), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
58,192.93
AMOUNT PAID
¢t5) .00 X O0 = .00
(1~) 75,860.52 X OqS= 5,525.72
(17) 369,302.58 x 12 = 44,516.51
c18> 217,721.04 x 15 = 52,658.16
cig>= 80,298.19
I
ti'
w
ORPHANS ' COURT DIVISION
NO. 21-03-0846
ESTATE OF
ROSS R. SHEESLEY, DECEASED
LATE OF
BOROUGH OF NEWCUMBERLAND
FIRST AND FINAL ACCOUNT
AND PROPOSED DISTRIBUTION
OF
FLOYD BECKER, EXECUTOR
ereby certify .that wrltmn notice of the filing of
s _.Account, and of the date, ttme and place
,e~l Itm 8mine will be I~'eeeflted to the Court
oordtrmation and o~ the la~t day to file written
.ectione to said Account, has been give~ to
)wn to the accountar~ to have or claim an
~rest in the estate as creditor, beoeWc~,
' or next of kin.
LAW OFFICES
JOHNSON, DUFFLE. STEWART
& WEIDNER
THIRD & MARKET STREETS
P. O. BOX 109
LEMOYNE, PENNSYLVANIA. 17043-0109
A copy of said Statement was included wtlfl the nollce.
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: ROSS R. SHEESLEY
Date of Death: OCTOBER 97 2003
Will No.: 2003-00846 Admin No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete: .
3. If the answer to No. 1 is yes, state the following:
A. Did the personal representative file a final account with the Court?
Yes X No
B. The separate Orphans' Court No. (if any) for the personal
representative's account is:
C. Did the personal representative state an account informally to the
parties in interest? Yes 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.
Date:
Signature .... - ,~
C. Roy Weidner, Jr., Attorney
Johnson, Duffie, Stewart & Weidner
301 Market Street, P.O. Box 109
Lemoyne, PA 17043-0109
Address
(717) 761-4540
Telephone No.
Capacity: Personal Representative
X Counsel for Personal Representative