HomeMy WebLinkAbout03-0107Estate of
Also known as
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
MIRIAM J. SCHEFFER
, Deceased Social Security No. 199-07-5281
DA VID C. BEARD
Petitioner(s), who is/are 18 years of age or older, apply(les) for:
(COMPLETE "A" OR "B" BELOW:)
A. Probate and Grant of Letters and aver that Petitioners are the executors named in the Last Will of
~' the Decedent, dated November 25, 2002 and codicil(s) dated
State relevant circumstances, e.g. renunciation, death of Executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of
the documents offered for probate; was not to victim of a killing and was never adjudicated incompetent:
LJ B. Grant of Letters of Administration
(d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate)
* Petitioner after a proper search has ascertained that Decedent left no Will and was survived by the following heirs.
Each of the following heirs have renounced their right to administer the Estate and have all requested that Letters of
Administration be granted to the Petitioner, Myra Platts, who is a Grandniece of the Decedent (*See Intestate Heirs Chart
Attached hereto).
Name Relationship Residence
COMPLETE IN ALL CASES: Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at
3116 Beverly Road, Borouqh of Camp Hill, Cumberland County, Pennsylvania
(List street, number and municipaliLv.) ~
Decedent, then 90 years of age died January~'~'~'~'~'~'~'~'~'~8, 20733, at Stonebridge Nursing & Rehab Center, Perry County, P~nnsylvania
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property ..................................................................... $ 100,000.00
(If not domiciled in PA) Personal property in Pennsylvania ..................................... $
(If not domiciled in PA) Personal property in County .................................................... $
Value of real estate in Pennsylvania ...................................................................................................................... $ 148,000.00
Total ......................................................................................................... $ 248,000.00
Real Estate situated as follows: 3116 Beverly Road, Borou.qh of Camp Hill, Cumberland County, Pennsylvania
Wherefore, Petitioners respectfully requests that the grant of letters of administration in the appropriate form be granted to the
undersigned:
Signature
Typed or printed name and residence
DAVID C. BEARD
885 Powells Valley Road
Halifax, PA 17032
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner above-named swears and affirms that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner and that, as personal representative of the
Decedent, Petitioner will well and truly administer the e,~e a,~ding to law,
Sworn to and affirmed and subscribed
DAVID C. BEARD
Before me this day of
~--~~ ,2003
Estate of MIRIAM J. SCHEFFER
Social Security No: 199-07-5281 Date of Death: January 28, 2003
AND NOW, ~-~._t,o..-~,.~.~.~ ~' ,2003, in consideration of the Petition on the reverse side
hereon, satisfactory proof h~dving been presented before me,
IT IS DECREED that Letters d" Testamentary [] of Administration
d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate
are hereby granted to David C. Beard in the above estate and that the instrument(s) dated November
25, 2002 described in the Petition be admitted to probate and filed of record as the last Will of the
Decedent.
FEES
Letters ...........................
Short Certificate(s)
Renunciation ..............
Affidavit ( ) ..................
Extra Pages (~) .......
Codicil ............................
JCP Fee .......................
Inventory ......................
Other ..............................
TOTAL .........
$ /D, oo
$
Register °flVV~ll~- ........ ~-
$ /o.oc~ Attorney: EDMUND G. MYERS
$ I.D. No: 20558
Address: Johnson, Duffle, Stewart & Weidner,
301 Market Street, P.O. Box 109,
Lemoyne, PA 17043
Telephone: 717-761-4540
004727-00002/11.15.02/EGM/KLT/165213.2
anl Ee tament
OF
MIRIAM J. SCHEFFER
I, MIRIAM J. SCtlEFFER, of the Borough of Camp Hill, Cumberland County,
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 and making void
any and all Wills or Codicils at any time heretofore made by me.
ARTICLE I
DEBTS AND TAXES
I direct the payment of all my legal debts, and the expenses of my last illness and funeral
from my Estate as soon after my death as conveniently may be done. I direct that all taxes that may
be assessed in consequence of my death, of whatever nature and whatever jurisdiction imposed,
shall be paid from my Residuary Estate as part of the expense of the administration of my Estate.
ARTICLE II
TANGIBLE PERSONAL PROPERTY
I give and bequeath my automobiles, household and personal effects and other tangible
personalty of like nature (not including cash or securities), together with any existing insurance
thereon, unto my nieces, LOIS ISENBERG BUCH and BARBARA ISENBERG BEARD, or
the survivor of them, to be divided between them in as nearly equal shares as practicable as they
shall agree, and if there be a disagreement as to the disposition of any item or items, I direct that the
same shall be disposed of under Article V hereof.
004727-00002/11.15.02/EGM/KLT/165213.2
ARTICLE III
SPECIFIC BEQUESTS
I give and bequeath the sum ofTEN THOUSAND ($10,000.00) DOLLARS unto each of
the following:
My niece, LOIS ISENBERG BUCH, New Cumberland, Pennsylvania; and
My niece, BARBARA ISENBERG BEARD, Halifax, Pennsylvania;
provided that should either of the persons named in this Article predecease me, I give and bequeath
the same unto her then-living issue, per stirpes.
ARTICLE IV
SPECIFIC BEQUESTS
I give and bequeath the sum of TWO THOUSAND ($2,000.00) DOLLARS unto each of
the following:
My great nephew, HAROLD A. BUCH, III, Dover, Pennsylvania;
My great nephew, GARY L. BUCH, Portland, Maine;
My great niece, KAREN RESSLER JEFFERIES, York, Pennsylvania;
My great niece, TERRI RESSLER JOHNSEN, Clarksville, Maryland;
My great nephew, CHARLES DONALD BEARD, Beaver Falls, Pennsylvania; and
My great nephew, DAVID C. BEARD, Halifax, Pennsylvania;
provided that should any of the persons named in the Article predecease me, I give and bequeath
the same unto his or her then-living issue, per stirpes.
004727-00002/11.15.02/EGM/KLT/165213.2
ARTICLE V
REST, RESIDUE AND REMAINDER
I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatever
nature and wheresoever situate in equal shares unto my niece, LOIS ISENBERG BUCH, and my
niece, BARBARA ISENBERG BEARD, provided that should either of the persons named in this
Article predecease me, I give and bequeath the same unto her then-living issue, per stirpes.
ARTICLE VI
PERSONAL REPRESENTATIVE
I name, constitute and appoint my great nephew, DAVID C. BEARD, Executor of this my
Last Will and Testament. In the event my great nephew, DAVID C. BEARD, fails to qualify or
ceases to so act, I name, constitute and appoint my great nephew, CHARLES D. BEARD,
alternate Executor to complete the administration of my Estate. I direct that no fiduciary appointed
herein shall be required to post bond for the faithful administration of the duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal, this -~,-q;'/~day of
~ ,2002.
(SEAL)
004727-00002/11.15.02/EGM/KLT/165213.2
Signed, sealed, published and declared by the above-named Testatrix, as and for her Last
Will and Testament, in the presence of us, who at her request, in her presence and in the presence of
each other, have hereunto subscribed our names as witnesses.
4
004727-00002/11.15.02/EGM/KLT/165213.2
AFFIDAVIT AND ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA :
:SS
COUNTY OF CUMBERLAND :
We, J. SCI-IV. , and
~,:~h.'-~.h...~3. C--,_~a_~X..~ , the Testa~x ~d ~e witn~es, respectively,
whose nines ~e si~ed to the a~ach~ or foregoing ins~ent, being first duly sworn, do hereby
decl~e to the undersized auth~h~ that the Testatrix si~ed ~d executed the inst~ent as her
Last Will ~d that she had si~ed willingly ~d that she executed it as her ~ee ~d volunt~ act for
the pu~oses therein expressed, ~d that each of the wimesses, in the presence ~d hemng of the
Testatrix, si~ed the Will as wi~ess ~d that to the best of ~s~er ~owledge the Testa~x was at
that time ei~teen ye~s of age or older, of sold mind ~d under no cons~aint or ~due influence.
MI~ J. SCH~R ~
Witness
Wimess ',~
Subscribed, sworn to and acknowledged before me by MIRIAM J. SCHEFFER, Testatrix,
and subscribed and sworn to before me by ~._~ ~ ~~'~t"'~M~ and
"'"x'"x% ;.~*h---.,~. q._ ~"r~. q--n-~L~',. ~_~..~ , witnesses, this . - day of
"'x-"h.~.~,x,,&...w.__.. ,2002.
Notary Public
NOTARIAL SEAL
DIANNE LENIG, Nolary Public
Lemoyne Borough Cumberland Co.
My Commission Expires Dec. 21, 2005
r ~
CERTIFICATION OF NOTICE UNDER RULE 5.6{a)
Name of Decedent: MIRIAM J. SCHEFFER
Date of Death:
Janua~ 29,2003
Wi//No. 2003-00107 Adm~.No.
To the Register:
I certify that notice of estate administration as required by Rule 5.6(a) of the Orphan's
Court Rules was served on or mailed to the following testate and intestate beneficiaries of the
above-captioned estate on February 26, 2003.
Name Address
LOIS ISENBERG BUCH
24 Timber Lane
New Cumberland, PA 17070
BARBARA ISENBERG BEARD
887 Powells Valley Road
Halifax, PA 17032
HAROLD A. BUCH, III
255 Conewago Drive
Dover, PA 17315
GARY L. BUCH
1085 Washington Avenue
Portland, ME 04103-3629
TERRI RESSLER JOHNSEN
7343 Hallmark Road
Clarksville, MD 21029-1808
KAREN RESSLER JEFFERIES
3692 Winfield Drive
York, PA 17402
CHARLES DONALD BEARD
429 Market Street
Beaver, PA 15009
DAVID C. BEARD
887 Powells Valley Road
Halifax, PA 17032
Notice has now been given to all persons entitled thereto
Date: February 26, 2003
Signature
Name
Address
Telephone
Capacity:
under Rule 5.6(a) except: None.
EDMUND G. MYERS
Johnson, Duffie, Stewart & Weidner
301 Market Street
P.O. Box 109
Lemoyne, PA 17043-0109
(717) 761-4540
Personal Representative
X Counsel for personal representative
JERRY R. DUFFLE
RICHARD W STEWART
C. ROY WEIDNER, JR.
EDMUND G. MYERS
DAVID W DELUCE
RALPH H. WRIGHT, JR.
DAVID J. LANZA
MARK C. DUFFLE
MELISSA PEEL GREEVY
MICHAEL J. CASSIDY
ROBERT M. WALKER
LAW OFFICES
JOHNSON, DUFFLE, STEWART & WEIDNER
a Professional Corporation
301 MARKET STREET
P. O. BOX 109
LEMOYNE, PENNSYLVANIA 17043-0109
W'EBSITE: www.jdsw, com
TELEPHONE 717-761-4540
FACSIMILE 717-761-3015
E-MAIL mail@jdsw, com
.,/
HORACE A. JOHNSON
COUNSEL TO THE FIRM
E-MAIL dlw@jdsw.com
April 29, 2003
Register of Wills Office
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re:
Estate of Miriam J. Scheffer
SSN: 199-07-5281
File No. 2003-00107
Our File No. 4727-2
Dear Register:
Enclosed please find Estate Check No. 1024 in the amount of $50,000.00. This payment
represents the three-month prepayment in order to qualify for the discotmt. The decedent died on
January 29, 2003. Please provide a receipt along with the enclosed copy of this correspondence,
time stamped and returned in the enclosed self-addressed stamped envelope.
Should you have any questions, or require any.additional information, please feel free to
contact the undersigned.
Very truly yours,
Dana L. Wieseman
Legal Assistant
CC:
#212744
David C. Beard, Executor
?,:T
LAW OFFICES
JOHNSON, DUFFLE, STEWART & WEIDNER
301 MARKET STREET
P. O. BOX 109
LEMOYNE, PENNSYLVANIA 17043-O109
Register of Wills Office
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
ATTN: CHERYL
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 002509
MYERS EDMUND G ESQUIRE
301 MARKET STREET
P O BOX 109
LEMOYNE, PA 17043
........ fold
ESTATE INFORMATION: SSN: 199-07-5281
FILE NUMBER: 2103-0107
DECEDENT NAME: SCHEFFER MIRIAM J
DATE OF PAYMENT: 04/30/2003
POSTMARK DATE: 04/29/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 01/29/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $50,000.00
TOTAL AMOUNT PAID:
$50,000.00
REMARKS: DAVID C BEARD
EDMUND G MYERS ESQUIRE
SEAL
CHECK# 1024
INITIALS: CW
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
REV- 1500 EX + (6-00)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
FILE NUMBER
21-03-0107
COUNTYCODE YEAR NUMBER
CAPB
HpRL
EpIO
cRAC
KoTK
ES
C
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R
E
S
R
E
C
A
P
I
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A
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I
O
N
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
SCHEFFER MIRIAM J. 199-07-5281
DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM~DD-YEAR) THIS t<~- i[IRN MUST BE FILED IN DUPLICATE~/ITH THE
01/29/2003 I 12/16/1912 REGISTER OF WILLS
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MI DDLE INITIAL) SOCIAL SECURITY NUMBER
1. Original Return ~ 247! Supplemental Return
4. Limited Estate . Future lnterest Compromise (date of death after 1;~-lZ-8Z)
6. Decedent Died Testate Decedent Maintained a Living Trust
(Attach copy of Will) (Attach copy of Trust)
[~ 9. Litigation Proceeds Received U 10. SpousaIPoverty
Credit
NAME
Edmund G. Myers
FIRM NAME (If Applicable)
Johnson, Duffie, Stewart
TELEPHONE NUMBER
717./761 - 4540
H (d .ate .of .d~e a.t
3. Remainder Return prlor~o
5. Federal Estate Tax Return Required
i 8. Total Number of Safe Deposit Boxes
[ 11. under Sec. 91
Election
to
tax
13(A)
(date of death between 1Z-31 - 91 and 1 - 1 - 95) (Attach Sch O)
~*. ,,..::~:. :::.:.:. ,~.~ .................. :':.'-:~ '" ':~":::-:- ~":" ~:~:~ ~ .................. :~:~:~:~" :" ~"~'~'"~:' ~': · ' ~ ~F""ir '""'*':~ :'~?~ '""" ~: ':~' ~"¥~ iii:: ::i
COMPLETE MAILING ADDRESS
P. O. Box 109
301 Market Street
& Weidner Lemoyne, PA 17043-0109
1. Real Estate (Schedule A) (1) 169,
65,807;52
None
None
209,368.63
None
8,441.72
45,341.00
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or (3)
Sole-Proprietorship
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)
Total Gross Assets (total Lines 1-7)
Funeral Expenses & Administrative Costs (Schedule H) (9)
12,262.52
OFFICIAL USE ONLY
9.
10.
11.
12.
13.
(8) 453,517.87
Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
Total Deductions (total Lines 9 & 10) (11)
Net Value of Estate (Line 8 minus Line 11) (12)
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13)
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 395,914.35
57,603.52
395,914.35
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
T UP 15. Amount of Line 14 taxable at the spousal tax
A T rate, or transfers under Sec. 9116(a)(1.2) X .0 0 (15) 0.00
X A 16 Amount of Line 14 taxable at lineal rate 0 O0 X 0 ~5 (16) ~.. ~'-~
OI 17. Amount of Line 14 taxable at sibling rate ___ X .12 (17) 0.00
N 18. Amount of Line 14 taxable at collateral rate 395,914.35 X .15 (18) 59,387.15
19. Tax Due .... (19) ~~"~
Copyright (c) ZOO0 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
3116 Beverly Road
CITY
Camp Hill
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
Z. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
0.00
50,000.00
2,631.58
STATE ZIP
PA 17011
(1)
59,387.15
Total Credits ( A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to re~luest a refuncl (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
52,631.58
0.00
0.00
6,755.57
0.00
6,755.57
1. Did decedent make a transfer and: Yes No
a. retaintheuseorincomeofthepropertytransferred; ......................... ~ ~
b. retain the right to designate who shall use the property transferred or its income; ...........
c. retain a reversionary interest; or ....................................
cl. receive the promise for life of either payments, benefits or care? ...................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................................ ~] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? .............................................. [] E~]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation? ................................ [] ~-]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true,
correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGN/~RE OF PERSON RESPONSIBLE FOR FILING RETURN
DAVID C. BEARD
885 Powells Valle Road
Halifax, PA 17032
DATE
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE Johnson, Duffle, Stewart & weidner DATE
/'~; ' ~7 ~"~ P.O. Box 109 /, Y'~ '0
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 exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 P.S.
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)1. 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.
Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
REV- 1502 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MIRIAM J. SCHEFFER SS~/
199-07-5281
SCHEDULE A
REAL ESTATE
01/29/2003
FILE NUMBER
21-03-0107
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price
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 right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION
OF DEATH
1 Real Estate located at 3116 Beverly Road, Borough of Camp Hill,
Cumberland County, Pennsylvania with Deed filed in Deed Book O
20, Page 233. Property sold on August 15, 2003. Settlement
Sheet is attached hereto showing Contract Sales Price.
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
169,900.00
$ 169,900.00
Copyright lc) 1996 form software only CPSystems, Inc. Form REV-1502 EX (Rev. 1-97)
REV-1503 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MIRIAM J. SCHEFFER SS#
SCHEDULE B
STOCKS & BONDS
199-07-5281 01/29/2003
FILENUMBER
21-03-0107
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION UNIT VALUE OFDEATH
1 1,504 shares PNC Financial Services Group, Inc., CUSIP 43.755 65,807.52
#693475105. EstateVal Valuation for Date of Death
Value is attached to this Return
TOTAL(A~soenteronline2, Recapitulation) 65,807.52
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1503 EX (Rev. 1-97)
REV- 1508 EX + (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MIRIAM J. SCHEFFER
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
SS# 199-07-5281 01/29/2003
FILENUMBER
21-03-0107
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1
2
6
8
9
10
11
12
13
14
15
16
DESCRIPTION
Keystone 0il - Reimbursement
Allfirst Certificate of Deposit Account No. 80000002180560
Accrued income on item 2 through date of death
Allfirst Certificate of Deposit Account No. 80000002180756
Accrued income on item 3 through date of death
Allfirst Certificate of Deposit Account No. 80000002181238
Accrued income on item 4 through date of death
Allfirst Certificate of Deposit Account No. 80000002181347
Accrued income on item 5 through date of death
Allfirst Bank Relationship w/ Interest Checking Account No.
0075788667
Accrued income on item 6 through date of death
Allfirst Bank Money Fund Savings Account No. 0098190083
Accrued income on item 7 through date of death
Cash in Checking account
Cumberland County VA - Refund
New Cumberland Federal Credit Union Savings Account Account No.
000447
Parthemore Funeral Home Refund on Account
Peerless Insurance
Pennsylvania Blue Shield Refund
Pennsylvania Blue Shield Refund
PP&L - Refund on overpayment
Return of prepaid premium from Homeowners Insurance
Total of Continuation Schedule(s)
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
VALUE AT DATE
OF DEATH
1,241.87
17,614.69
110.28
16,452.62
59.61
20,764.47
162.46
6,128.62
5.68
12,409.44
0.68
15,592.85
3.55
79.77
100.00
236.00
255.25
1.90
53.15
40.78
100.51
246.00
117,708.45
$ 209,368.63
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97)
Estate of: MIRIAM J. SCHEFFER
Soc Sec #: 199-07-5281
Date of Death: 01/29/2003
Continuation of Schedule E
(Cash, Bank Deposits & Miscellaneous Personal Property)
Item Description
Value at Date
of Death
17 Verizon Telephone - Refund for Overpayment on Account
18 Waypoint Bank Certificate of Deposit Account #3100013128
Accrued income on item 18 through date of death
19 Waypoint Bank Certificate of Deposit Account No. 3165304006
Accrued income on item 19 through date of death
20 1997 Chrysler Sedan
21 Bridal Ring Set Appraised by Morrow Diamond's. Appraisal
attached. Item No. 4 on Appraisal
22 Gentleman's Hamilton Watch 14K. Gold - Appraised by Morrow
Diamond's. Appraisal Attached. Item No. 5 on Appraisal.
23 Gentleman's Diamond Masonic Ring. Appraised by Morrow Diamonds.
Appraisal Attached. Item No. 2 on Appraisal
24 Imitation Pearl Ring with 3 faux diamonds - Appraised by Morrow
Diamond's. Appraisal Attached. Item No. 6 on Appraisal
25 Ladies Three Stone Diamond White Gold Ring - Appraised by Morrow
Diamond's. Appraisal Attached. Item No. 3 on such Appraisal
26 Masonic, Diamond Lapel White Gold Pin - Appraised by Morrow
Diamonds. Appraisal is attached. Item No. 1 on Appraisal.
27 Personal Property. Appraisal attached
28 Yellow Gold Band Ring Appraised by Morrow Diamond's. Appraisal
Attached. Item No. 8 on Appraisal.
3.17
50,000.00
263.89
50,000.00
263.89
7,000.00
25O.O0
500.00
250.00
10.00
250.00
50.00
8,850.00
17.50
117,708.45
REV-1510 EX +(1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
MIRIAM J. SCHEFFER SS~/
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
199-07-5281 01/29/2003
FILENUMBER
21-03-0107
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
DESCRIPTION OF PROPERTY % OF
ITEM INCLUDETHE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER.
NUMBER ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE)
1 Delaware Medallion Annuity. 8,441.72 8,441.72
Payable to the Estate. No
Beneficiary Designation was
made on Contract.
TOTAL (Also enter on line 7, Recapitulation) $ 8,441.72
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1510 EX (Rev. 1-97)
EV-l~11 EX +(1-97) SCHEDULE H
FUNERAL EXPENSES &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF
MIRIAM J. SCHEFFER 01/29/2003
FILE NUMBER
21-03-0107
Debts of decedent must be reported on Schedule I,
ITEM
NUMBER
1
2
3
4
4
5
DESCRIPTION
FUNERAL EXPENSES:
Hardings Restaurant - Funeral Luncheon
Parthemore Funeral Home Funeral Service
Rolling Green Cemetary
Romberger Memorials Remaining Balance
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) DAVID C. BEARD
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address 885 Powells Valley Road
City Hall fax State PA
196-48-3824
Zip 17032
Year(s) Commission Paid:
Attorney's Fees Johnson, Duffie, Stewart & Weidner
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
Probate Fees Register of Wills
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Chuck E. Bricker, Auctioneer
Cumberland County Register of Wills Office
Inheritance Tax Return and Inventory
Filing Fee for
- Reimbursement for Sale signs at Decedent's
David C. Beard
Residence
David C. Beard - Reimbursement for Postage Stamps
Morrow Diamonds - Jewelry Appraisal
AMOUNT
562.04
7,833.40
995.00
90.00
21,887.57
12,500.00
310.00
90.00
40.00
31.52
14.80
350.00
Total of Continuation Schedule(s) 636.67
TOTAL (Also enter on line 9, Recapitulation) $ 45,341. O0
(If mo~:e space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97)
Estate of: MIRIAM J. SCHEFFER
Soc Sec #: 199-07-5281
Date of Death: 01/29/2003
Continuation of Schedule H-B7
(Other Administrative Costs)
Item Description
Amount
6 RESERVE: Miscellaneous Adminstration Expenses
7 The Cumberland Law Journal
8 The Patriot News Notice of Estate Administration
450.00
75.00
111.67
636.67
REV-1$12 EX +(1-97)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, AND LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MIRIAM J. SCHEFFER SS~/ 199-07-5281 01/29/2003 21-03-0107
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
Allfirst Bank - Lost Key Fee for Safe Deposit Box
Allfirst Bank Fee
Allfirst Bank Fee - Analysis Fee
Camp Hill Borough - Payment of Sewer Bill
Camp Hill Fire Company ~ Final Ambulance Bill
Checks clearing after date of death
Choice Security Service
Comcast Cable Television
HGS Administrators
Internal Revenue Service 2002 Federal Income Tax Liability
3ames Snyder - Snow removal at Residence
Keystone Oil
Metro Med Services - Ambulance Transportation
Michael W. Harling, Tax Collector - 2003 Real Estate Taxes
Michael W. Harling, Tax Collector - 2003 Personal Taxes
Michael W. Harling, Tax Collector - 2003-2004 Real Estate Taxes
Pechart Lawn Service - Maintenance of Decedent's Property
Pennsylvania American Water
Penn Waste Trash Removal
Pennsylvania Department of Revenue - 2002 PA Income Tax Return
Liability
Pinnacle Health Hospitals Account No. 223460762
PP&L
10.00
0.77
10.00
60.00
40.78
94.16
45.00
17.11
122.15
507.00
55.00
362.00
88.00
594.00
4.90
1,657.03
254.40
114.65
40.74
63.20
161.51
514.71
Total of Continuation Schedule(s) 7,445.41
TOTAL (Also enter on line 10, Recapitulation) $ 12,262.52
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software onJy CPSystems, Inc. Form REV-1512 EX (Rev. 1-97)
Estate of: MIRIAM J. SCHEFFER
Soc Sec #: 199-07-5281
Date of Death: 01/29/2003
Continuation of Schedule I
(Debts of Decedent, Mortgage Liabilities and Liens)
Item Description
Amount
23
24
Sandra Buch - Services for cleaning Decedent's Residence
Settlement Charges from Sale of Residence - Deductions taken at
time of sale of Residence. Settlement Sheet is attached to this
Return:
Settlement Charges:
Initial Deposit
25 Stonebridge Health & Rehab
26 Stonebridge Health & Rehab
27 Vertus Medicare Services
28 Verizon Telephone
$1,766.00
$5,000.00
Remaining Balance of Invoice
100.00
6,766.00
158.75
105.00
163.23
152.43
7,445.41
REV-1513 EX + (9-001
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
MIRIAM J. SCHEFFER SS~/ 199-07-5281 01/29/2003 21-03-0107
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
NUMBER
4
II.
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and
transfers under Sec. 91 l~a)(1,g)]
Barbara Isenberg Beard
887 Powells Valley Road
Halifax, PA 17032
Charles
Donald Beard
429 Market Street
Beaver, PA 15009
Niece
Great Nephew
David C. Beard
885 Powells Valley Road
Halifax, PA 17032
Gary L. Buch
1085 Washington Avenue
Portland, ME 04103-3629
Great Nephew
Great Nephew
Ten Thousand
Dollars, 1/2
of the
Tangible
Personalty and
1/2 Residue
2,000.00
2,000.00
2,000.00
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET
(If more space is needed, insert additional sheets of the same size)
$ 0.00
Copyright (c) 2000 form software on y The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00)
Estate of: MIRIAM J. SCHEFFER
Soc Sec #: 199-07-5281
Date of Death: 01/29/2003
Continuation of Schedule J, Part I
(Taxable Bequests)
Item
Name and Address of Beneficiary
Relationship
~gnount or
Share of Estate
Harold A. Buch III
255 Conewago Drive
Dover, PA 17315
Lois Isenberg Buch
24 Timber Lane
New Cumberland, PA
17070
Karen Ressler Jefferies
3692 Winfield Drive
York, PA 17402
Terri Ressler Johnsen
7343 Hallmark Road
Clarksville, MD 21029-1808
Great Nephew
Niece
Great Niece
Great Niece
2,000.00
Ten Thousand
Dollars, 1/2
of the
Tangible
Personalty and
1/2 Residue
2,000.00
2,000.00
LISTING OF EXHIBITS FOR
ESTATE OF MIRJAM J. SCHEFFER
EXHIBIT A
Last Will and Testament of Miriam .L. Scheffer signed and
dated on the 25th of November, 2002.
EXHIBIT B
Settlement Sheet for the sale of Decedent's residence
located at 3116 Beverly Road, Camp Hill. Property sold
on August 25, 2003.
Schedule A.
EXHIBIT C
Estate Val Valuation of PNC Financial
Schedule B.
EXHIBIT D
Morrow Diamond's Appraisal of Decedent's Jewelry
Schedule E
EXHIBIT E
Appraisal of Decedent's Personal Property by Chuck
Bricker.
Schedule E.
EXHIBIT A
il[ e tament
OF
MIRIAM J. SCFrEFFER
I, MIRIAM J. SCI:[EFFER, of the Borough of Camp Hill, Cumberland County,
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 and making void
any and all Wills or Codicils at anytime heretofore made by me.
ARTICLE I
DEBTS AND TAXES
I direct the payment of all my legal debts, and the expenses of my last illness and funeral
from my Estate as soon after my death as conveniently may be done. I direct that all taxes that may
be assessed in consequence of my death, of whatex)er nature and whatever jurisdiction imposed,
shall be paid from my Residuary Estate as part of the expense of the administration of my Estate.
ARTICLE H
TANGIBLE PERSONAL pROpERTY
I give and bequeath my automobiles, household and personal effects and other tangible
personalty of like nature (not including cash or securities), together with any existing insurance
thereon, unto my nieces, LOIS ISENBERG BUCH and BARBARA ISENBERG BEARD, or
the survivor of them, to be divided between them in as nearly equal shares as practicable as they
shall agree, andifthere be a disagreement as to the disposition of any item or items, I direct that the
same shall be disposed of under Article V hereof.
ARTICLE III
SPECIFIC BEQUESTS
I give and bequeath the sum ofTEN THOUSAND ($10,000.00) DOLLARS unto each of
the following:
My niece, LOIS ISENBERG BUCIt, New Cumberland, Pennsylvania; and
My niece, BARBARA ISENBERG BEARD, Halifax, pennsylvania;
provided that should either of the persons named in this Article predecease me, I give and bequeath
the same unto her then-living issue, per stirpes.
ARTICLE IV
SPECIFIC BEQUESTS
I give and bequeath the sum of TWO THOUSAND ($2,000.00) DOLLARS unto each of
the following:
· My great nephew, ItAROLD A. BUCH, llI, Dover, Pennsylvania;
My great nephew, GARY L. BUCIt, Portland, Ma/ne;
My great niece,.KAREN RESSLER JEFFERIES, York, Pennsylvania;
My great niece, TERRI RESSLER JOHNSEN, Clarksville, Maryland;
My great nephew, CltARLES DONALD BEARD, Beaver Falls, Pennsylvania; and
My great nephew, DAVID C. BEARD, Halifax, Pennsylvania;
provided that should any of the persons named in the Article predecease me, I give and bequeath
the same unto his or her then-living issue, per stirpes.
ARTICLE V
REST, RESIDUE AND REMAINDER
I give, devise and bequeath all the rest, residue, and remainder of my Estate, of whatever
nature and wheresoever situate in equal shares unto my niece, LOIS ISENBERG BUCIt, and my
niece, BARBARA ISENBERG BEARD, provided that should either of the persons named in this
Article predecease me, I give and bequeath the same unto her then-living issue, per stirpes.
ARTICLE VI
PERSONAL REPRESENTATIVE
I name, constitute and appoint my great nephew, DAVID C. BEARD, Executor of this my
Last Will and Testament. In the event my great nephew, DAVID C. BEARD, fails to qualify or
ceases to so act, I name, constitute and appoint my great nephew, CItARLES D. BEARD,
alternate Executor to complete the administration of my Estate. I direct that no fiduciary appointed
herein shall be required to post bond for the faithful administration of the duties in any jurisdiction.
IN WITNESS WItEREOF, I have hereunto set my hand and seal, this -,~,-~-----day of
~ ,2002.
.3
Signed, sealed, pubhshed and declared by the above-named Testatrix, as and for her Last
Will and Testament, in the presence of us, who at her request, in her presence and in the presence of
each other, have hereunto subscribed our names as witnesses.
AFFIDAVIT AND ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA :
:SS
COUNTY OF CU1VIBERLAND :
We, MIRIAM J. SCHEFFER, "~~-...X~_'"x'x'-,~.t,.,~ and
"X"~_h,.-.~, ~ ~. Q,~ '-'~--'~K',,' , ~e Tesm~ ~d ~e ~m~es, re~ecfively,
whose nines ~e si~ed to ~e a~che3 or forego~g ~ent, berg ~st duty ~o~ do h~eby
decl~e to ~e ~de~i~ au~oh~ ~at ~e Tesm~ si~ ~d ex~uted ~e ~ent ~ her
~t Will ~d ~at she had si~ M~gly ~d ~at she ex~uted it ~ her ~ee ~d vol~t~ act for
· e p~oses ~ere~ expressed, ~d ~at each of ~e ~messes, ~ ~e presence ~d he~g of ~e
Tes~, si~ed ~e Wi~ ~ ~mess ~d ~t to ~e best of ~s~ ~owl~ge ~e T~m~ w~ at
· at ~e ei~teen ye~s of age or old~, of sold mind ~d ~der no co~t or ~due influence.
Wi~ess
Wimess
Subscribed, sworn to and acknowledged before me by MIRIAM J. SCI:IEFFER, Testatrix,
and subscribed and sworn to before me by ~ .c~_-~..,~,, ~ and
Notary Public ~ -'~"
NOTARIAL SEAL
DIANNE LENIG, Notary Public
Lemoyne Borough Cumberland Co.
My Commission Expires Dec. 21,2005
EXHIBIT B
OMB NO. 2502-0265 ~l-r
H
B. TYPE OF LOAN:
A. ., I 1.[~FHA 2.[-~FmHA 3.[~CONV. UNINS. 4. F'~VA 5.[~CONV. INS.
U.S. DEPARTMENT OF HOUSING & URBAN DEVELOPMENT 1 6. FILE NUMBER: I, 7. LOAN NUMBER'.
I
1687230229
SOW319-03
SETTLEMENT
STATEMENT
8. MORTGAGE INS CASE NUMBER:
C. NOTE: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the Bafflement agent are shewn.
Items marked "[POC]" were paid outside the closing; they are shown here for informational purposes and are not included in the totals.
1,o 3/98 (SOW31~O3.PFD/SOW31~03/I 7)
D. NAME AND ADDRESS OF BORROWER: E. NAME AND ADDRESS OF SELLER: F. NAME AND ADDRESS OF LENDER:
CATHY L SOWERS MIRIAM J SCHEFFER, ESTATE CHASE MANHATTAN MORTGAGE CORP.
302 E. MAIN STREET 3116 BEVERLY ROAD 6000 Freedom Square Drive, Suite 260
CAMP HILL, PA 17011 CAMP HILL, PA 17011 Independence, OH 44131
H. SETTLEMENT AGENT: 25-1619811 I. SETTLEMENT DATE:
ANDREW C. SHEELY, ESQ
August 15, 2003
G. PROPERTY LOCATION:
3116 BEVERLY ROAD
CAMP Hill, PA 17011
CUMBERLAND County, Pennsylvania
PLACE OF SETTLEMENT
3414 CHESTNUT ST
CAMP HILL, PA 17011
J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION
100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER:
169,900.00
101. Contract Sales Price f 169,900.00
102. Personal Proport7
103. Settlement Charges to Borrower (Line 1400) 6,424.45
104.
Adjustments For Items Paid By Seller in advance
106. Cit~/'rown Taxes 08115/03 to 01101104
107. County Taxes to
108. SCHOOL TAX 08/15103 to 07/01104
226.21
1,453.30
401. Contract Sales Price
402. Personal Proporb/
403.
405.
Adjustments For Items Paid By Seller in advance
Ci~/TownTaxes 08/15103 to 01/01104 226.21
to
1,453.30
406.
407. County Taxes
408. SCHOOL TAX
08115103 to 07/01/04
409.
110. SEWER 08/15103 to 01101104 45.33 ,410. SEWER 08115/03 to 01/01/04 45.33
111. ~ 411.
112. I 412.
120. GROSS AMOUNT DUE FROM BORROWER 178,049.29 420. GROSS AMOUNT DUE TO SELLER 171,624.84
200"~. AMOUNTS PAiD BY OR IN BEHALF OF BORROWER: 500. REDUCTIONS IN AMOUNT DUE TO SELLER:
5,000.00 501. Excess DepoSit (See Instructions)
201. Deposit or earnest money
202. Pdncipol Amount of New Loan(s)
203. Existing loan(s) taken subject to
204.
125,000.00
205.
206.
207.
208.
;209.
Adjustments For Items Unpaid By Seller
210. City/Town Taxes to
211. County Taxes to
212. SCHOOL TAX to
213.
214.
215.
216.
217.
218.
219.
220. TOTALPAIDBY/FORBORROWER 130,000.00
300. CASH AT SETTLEMENT FROM/TO BORROWER:
301. Gross Amount Due From Borrower (Line 120)
302. LessAmount Paid By/For Borrower (Line220)
303. CASH( X FROM)( TO)BORROWER
502. Settlement Charges to Seller (Line 1400)
503. Existing loan(s) taken sub)ect to
504. Payoff of first Mortgage
505. Payoff of second Mortgage
506. Deposit retained by seller
507.
508.
509.
Adjustments For Items Unpaid By Seller
510. City/Town Taxes to
1,766.00
5,000.00
511. County Taxes to
512, SCHOOL TAX to
513.
514.
515.
516.
517.
518.
519.
520. TOTAL REDUCTIONAMOUNTDUESELLER 6,766.00
600. CASH AT SETTLEMENT TOIFROM SELLER:
178,049.29 601.
130,000.00 602.
48,049.29 603. CASH ( X TO)(FROM) SELLER
Gross Amount Due To Seller (Line 420)
Less Reductions Due Seller (Line 520)
171,624.84
6,766.00i
164,858.84
The undersigned hereby acknowledge receipt of a completed copy of pages 1&2 of this statement & any attachments referred to herein.
I HAVE CAREFULLY REVIEWED THE HUD-1 SETTLEMENT STATEMENT AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, IT IS A TRUE AND
ACCURATE STATEMENT OF ALL RECEIPTS AND DISBURSEMENTS MADE ON MY ACCOUNT OR BY ME I~THIS~NSACTION. I FURTHER CERTIFY
THAT I HAVE RECEIVED A COPY OF THE HUD-1 SETTLEMENT STATEMENT. ~,j~. ~.._ ~ ~
Borrower ////3 / / J/ ,~. /..- ~ Seller
CATHY L.~ERS MIRIAM J SCHEFFER, ESTAT~
TO THE BEST OF MY KN~L~E~~LEMENT STATEMENT WHICH I HAVE PREPARED IS A TRUE AND ACCURATE ACCOUNT OF THE
FUNDS WHICH WERE~EI~ ~~ OR WILL BE DISBURSED BY THE UNDERSIGNED AS PART OF THE SE~LEMENT OF THIS
TRANSACTION. ~ ~ U~
~LEMENt OFfIC~U
Se~lement Agent
WARNING: IT IS A CRIME TO KNOWINGLY MAK~ FALS~ STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMI~R FORM P~NALTIES UPON
CONVICTION CAN INCLUDE a FIN~ AND iMPRISONMENt. FOR DETAILS SEE: tiTlE 18 U.S CODE SECTION 1001 & SECTION 1010.
L. SETTLEMENT CHARGES
700. TOTAL COMMISSION r~,~,~ on Price $
%
~ Division of Commission (line 700) as Follows:
701. $ to
702. $ to
703. Commission Paid at Seffiement
704. TRANSACTION FEE to
BOO. ITEMS PAYABLE IN CONNECTION WITH LOAN
PAiD FROM PAID FROM
BORROWER'S SELLER'S
FUNDS AT FUNDS AT
SETTLEMENT SETTLEMENT
801. Loan Od~lination Fee 0.5000 % to CENTRAL PENN MORTGAGE COMPANY
802. Loan Discount % to
803. Appraisal Fee to
WILLIAM DAVIS
CENTRAL PENN MORTGAGE COMPANY
625.0C
275.0(
600.00
804. BROKER FEE to
805. Lender's inspection Fee to
806. Mortgage Ins. App. Fee to
807. Assumption Fee to
808. TAX SERVICE FEE to FIRST AMERICA 69.00
809. UNDERWRITING FEE
to CHASE MANHATTAN MORTGAGE CORP.
810. FLOOD CERT FEE to FDSI
811. FLOOD DETERMINATION FEE to
812. YIELD SPREAD PREMIUM TO BROKER
FDSi
CENTRAL PENN MTG.
to CENTRAL PENN MORTGAGE COMPANY
to CHASE MANHATTAN MORTGAGE CORP.
275.00
7.00
813. PROCESSING FEE
014. EXPRESS MAIL FEE
11.00
LENDER PD 781.25
300.00
14.00
g00. ITEMS REQUIRED BY LENDER TO SE PAID IN ADVANCE
901. Intamst From 08/15103 to 09/01/03 @ $ 19.690000/day ( 17 days %) 334.73
902. Mortcja~e insurance Premium for months to
903. Hazard Insurance Premium for 1.0 years to
1000. RESERVES DEPOSITED WITH LENDER
1001. Hazard Insurance 3.000 months I~ $ 42.25 per month J 126'75I
1002. Mort~la~e insurance months (~ $ per month
1003. City/TownTaxes months ~ $ per month
1004. County Taxes 7.000 months ~ $ 49.50 per month 346.50
1005. SCHOOLTAX 3.000 months @ $ 138.09 per month 414.27
1006. months (~ $ per month
1007. months ~ $ per month
1008. AGGREGATE ADJUSTMENT months ~, $ per month -198.0~
1100. TITLE CHARGES
1101. Settlement or Closin~l Fee
1102. CLOSING PROTECTION LETTER
to
35.00!
to FIRST AMERICAN TITLE INSURANCE COMPANY
1103. SEARCH/HUD PREP FEE to TRI-COUNTY ABSTRACT SERVICE 125.00
1104. Title Insurance Binder to
1105. Document Preparation to
1106. Notary Fees to CASH 10.00
1107. Attorney's Fees to ANDREW C. SHEELY, ESQ 538.75
(includes above item numbers:
1108. Title Insurance to TRI-COUNTY ABSTRACT SERVICE~ AGENT 545.00
~ndudes above ~emnumbers: )
1109. Lender'sCoverage $ 125,000.00 102049655
102105013
1110. Owner's Coverage $ 169,900.00 545.00
1111. ENDORSEMENTS 100, 300, 8.1 to TRi-COUNTY ABSTRACT SERVICE 150.00
1112.
1113.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recording Fees: Deed $ 40.50; Mortgage $ 66.50; Releases $ [ 1,699.00
1202. Cib//Count¥ Tax/Stamps: Deed 1,699.00; Mort~la~le 107.00 1,699.00
I
1204.
1205.
1203. State Tax/Stamps: Revenue Stamps 1,699.00; Mort~a~le
1300. ADDITIONAL SETTLEMENT CHARGES
1301. Survey to ACCT; 241614.50
1302. Pest Inspection to
1303. SEWER 7-1 TO 12-31~3 to CAMP HILL BOROUGH 60.00
1304. TAXCERTFEE to MICHAELW. HARLING 01-21-0273-118 7.0u
1305. EXPRESS MAIL FEE to TRI-COUNTY ABSTRACT SERVICE
6,424.45 1,766.00
1400. TOTAL SETTLEMENT CHARGES IEnter on Lines 103, Section J and 502, Section K)
SE~'I-rLEMENT OFFICER ~
Settlement Agent
Certified to be a true copy.
( $OW319-03 ! SOW319-03 117 )
EXHIBIT C
Date of Death: 01/29/2003
Valuation Date: 01/29/2003
Processing Date: 02/14/2003
Estate Valuation
Shares Security
or Par Description High/Ask Low/Bid
Estate of: Estate of Miriam J. Scheffer
Account: 4727-1
Report Type: Date of Death
Number of Securities: 1
File ID: SCHEFFER
Mean and/or Div and Iht Security
Adjustments Accruals Value
1)
1504 PNC FINL SVCS GROUP INC (693475105)
NYSE
01/29/2003
44.45000 43.06000 H/L
43.755000
65,807.52
Total Value:
Total Accrual:
Total: $65,807.52
$0.00
$65,807.52
Page 1
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please contact EVP Systems at 1818) 313-6300. (Revision 6.4.0)
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EXHIBIT D
04/21/2003 07:03 FAX 7178968281 Beard
MO OW
Where every selection ts brilliant.
MORROW DIAMONDS
3750 MarkekStreet
Camp Hill, PA 17011
(717) 737-5808
Fax: (717) 737-5981
www. morrowdiamoads.com
NAME/OWNER:
David Beard
885 Powells Valley Road
Halifax, PA 17032
DATE OF APPRAISAL: March 24, 2003
APPRAISER: Jill MorroW, Graduate Gemologist (GIA)
PURPOSE OF APPRAISAL: The purpose of this appraisal is to grade and estimate the
value of this jewelry for estate distribution. This jewelry is appraised at FMV (Fair
'Market Value) which is detrmed as "the price at which the property would change hands
between a willing buyer and a willing seller, neither being under any compulsion to buy or
sell and both having reasonable knowledge of relevant facts."
1. ITEM DESCRIPTION: This Masonic, diamond lapel pin is white gold. It has a screw
15ack and post.
ITEM EVALUATION: The single cut diamond in this pin measures approximately 1.8
mm x 1.25 mm depth and weighs an estimated .02 CT. It is I1 (included 1) in clarity and
H-I in color. The culet is scratched and the diamond has no fluorescence. The pin is in fair
condition.
MARKET LEVEL: This pin would be found in the secondary market; .i.e., those dealers
and jewelers who handle used, estate, or antique jewelry.
FMV: $50.00
2. iTEM DESCRIPTION: This gentleman's diamond, Masonic ring is stamped "14K"
g01d. The shank is yellow gold and the head is white gold. The diamond is prong set. The
ring has the hallmark "Craft" and is a size 9 ¼.
ITEM EVALUATION: The diamond in this ring is Old European Cut. It measures
approximately 3.4 mm x 2.2 mm depth and weighs an estimated .15 CT. The diamond is
SI2 (Slightly Included 2) in clarity and J-K in color. The culet is large and the diamond has
no fluorescence. The ring is in good condition, showing normal wear.
04/21/2003 07:04 FAX 7178968281 Beard
Page 2 - Beard
MARKET LEVEL: This ring would be found in the secondary market; i.e., those dealers
and jewelers who handle used, estate, or antique jewelry.
FMV: $250~00
3'i') ITEM DESCRIPTION: This lady's three stone diamond ring is stamped "14 ICY" white
gold. The three diamonds are prong-set in a bezel-style, filigree mounting. The ring is a
size 6 ¼.
ITEM EVALUATION: The center diamond in this ring is an Old European cut. It
measures approximately 3.9 mm x 2.65 mm depth and weighs an estimated .25 CT. The
clarity is I1 (Included1) and the color is I-J. The culet is large and the diamond has no
fluorescence. The diamond is loose in the mounting. The two side diamonds are single cut
and measure approximately 2.5 mm and weigh an estimated .06 CT each or .12 CTTW.
The clarity of the diamonds is SI2 (Slightly Included 2) and the color is H-I-J. The ring is
in fair condition.
MARKET LEVEL: This ring would be found in the secondary market; Lc., those dealers
and jewelers who handle used, estate, or antique jewelry.
FMV: $250.00
~.~ITEM DESCRIPTION: This bridal ring set is stamped ".90 plat and .10 irid." The
-lr~limark inside the three diamond engagement ring is "STRAUB - orange blossom."
Engraved inside this ring is "W.C.S. - M.I.M. 12-12-30" and inside the wedding band
"WCS to MIM 12-25-31." The ring is a size 3 ~.
ITEM EVALUATION: The diamond in this ring is an Old European Cut. It measures
approximately 4.35 - 4.4 mm x 2.8 mm and weighs an estimated .33 CT. It is SI1 (Slightly
Included 1) in clarity and H-I in color. The culet is extra large and the diamond has no
fluorescence. The two side melees are single cut and measure approximately 1.8 mm and
weigh an estimated .05 CTTW. They are SI1 (Slightly Included 1) in clarity and H-I in
color. The ring is in fair condition. The shank is thin and bent. The wedding band is 1.5
mm. It is well worn and in fair condition.
MARKET LEVEL: This ring would be found in the secondary market; i.e., those dealers
and jewelers who handle used, estate, or antique jewelry.
FMV: $250.00
04/21/2003
07:04 7178968281 Beard
Page 3 - Beard
i~TEM DESCRIPTION: This gentleman's Hamilton watch is 14 KT gold filled. It has a
brown leather band. The watch has a flip top so that it can be used as a watch or an
ornamental gold bracelet. The face of the watch is a rectangular shape with Arabic
numbers indicating the hour and slashes to indicate minutes. There is a separate, square,
second hand dial with slashes to indicate seconds. The face of the watch is gold-colored.
Inside the flip top is stamped with" Hamilton W Co, Lancaster, PA, 14 K gold filled,
413621." Inside the watch on the movements is stamped "Hamilton, USA, 17 jewels, 980,
G219679." Inside the watch back is stamped "PAT 1,930,416, Hamilton W Co, Lancaster,
PA, 14 K gold filled, SW."
ITEM EVALUATION: This watch is in fair condition. It appears that the crystal may
have been replaced because it does not allow the flip top to work correctly. The band
probably is not original. The watch is in working condition. The research indicated that
this watch was produced in about 1938. It is a unique style and brings premium prices if in
original condition.
MARKET LEVEL: This watch would be found in the secondary market; i.e., those dealers
and jewelers who handle used, estate, or antique jewelry.
FMV: $500.00
.ITEM AND EVALUATION: This imitation pearl ring with three faux
DEScRIPTIoN
'-diamonds is stamped "10 IC" It is a size 6 ~.
MARKET LEVEL: This jewelry would be found in the secondary market, at a flea
market, or it could be used for scrap value.
FMV: $10.00
7. ;ITEM DESCRIPTION AND EVALUATION: This ring has a synthetic material with a
~'W0man's head on it. It is tarnished and there is no stamp on it. It is a size 6
MARKET LEVEL: This costume jewelry would be found at a flea market.
FMV: N/A
ITEM DESCRIPTION AND EVALUATION: This 4.5 mm yellow gold band is stamped
--"~4KT" yellow gold. It is a size 5 ~. It weighs 5.30 grams or 3.40 dwt.
MARKET LEVEL: This jewelry would be found in the secondary, market, at a flea
market, or it could be used for scrap value
FMV: $17.50
EXHIBIT E
APPRAISAL
Personal Property of/l,'//,~/ff.,/// ,.~ C4,,,~.,,~,/~.- ~-T ,z? f-d ~//' ~ L.~E I/E,~-.? ,,,C_~,{,
Appraised by Chuck E. Bricker AU094-L Date
ITEM VALUE ITEM VALUE
' ~ ·
PA, Hous~ ~uF~T
Register of Wills of
Estate of MIRIAM J. SCHEFFER
also known as
CUMBERLAND
INVENTORY
County, Pennsylvania
, Deceased
No. 21-03-0107
Date of Death 01/29/2003
Social Security No. 199- 07- 5281
DAVID C. BEARD,
Personal Representative(s) of the 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 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 Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
Inventory. ~ Aa/e 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 Representative
Name of
Attorney: Edmund G. Myers Signature:
DAVID C. BEARD
I.D. No.: 20558 Signature:
Address: P. O. Box 109 Address: 885 Powells Valley Road
Lemoyne, PA 17043-0109 Halifax, PA 17032
Telephone: 717/761-4540 Telephone: 717/896-3874
Description
(See continuation page(s) attached)
(Attach additional sheets if necessary)
Dated:
Total: 465,245.74
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, inc. Form ~RW-7 (1992)
Estate of:
Date of Death:
County:
INVENTORY
MIRIAM J. SCHEFFER
01/29/2003
Cumberland
CASH:
Allfirst Certificate of
Deposit Account No.
80000002180560
Accrued income through date of
death
Allfirst Certificate of
Deposit Account No.
80000002180756
Accrued income through date of
death
Allfirst Certificate of
Deposit Account No.
80000002181238
Accrued income through date of
death
Allfirst Certificate of
Deposit Account No.
80000002181347
Accrued income through date of
death
Allfirst Bank Relationship w/
Interest Checking Account
No. 0075788667
Accrued income through date of
death
17,614.69
110.28
16,452.62
59.61
20,764.47
162.46
6,128.62
5.68
12,409.44
0.68
-1-
Allfirst Bank Money Fund
Savings Account No.
0098190083
Accrued income through date of
death
Cash in Checking account
Cumberland County VA - Refund
Delaware Medallion Annuity.
Payable to the Estate. No
Beneficiary Designation was
made on Contract.
Delaware Medallion Annuity
Federal Government Life
Insurance Proceeds
Keystone Oil - Reimbursement
New Cumberland Federal Credit
Union Savings Account
Account No. 000447
New Cumberland Federal Credit
Union Savings Account
Account No. 000447 Life
Insurance on Account
Parthemore Funeral Home -
Refund on Account
Peerless Insurance
Pennsylvania Blue Shield
Refund
Pennsylvania Blue Shield
Refund
PP&L - Refund on overpayment
15,592.85
3.55
79.77
100.00
8,441.72
6,164.17
3,524.45
1,241.87
236.00
28.91
255.25
1.90
53.15
40.78
100.51
-2-
Return of prepaid premium from
Homeowners Insurance
U.S. Treasury Federal Worker
Death Benefit
Verizon Telephone Refund for
Overpayment on Account
Waypoint Bank Certificate of
Deposit Account #3100013128
Accrued income through date of
death
Waypoint Bank Certificate of
Deposit Account No.
3165304006
Accrued income through date of
death
PERSONAL PROPERTY:
1997 Chrysler Sedan
Bridal Ring Set - Appraised by
Morrow Diamond's. Appraisal
attached. Item No. 4 on
Appraisal
Gentleman's Hamilton Watch
14K. Gold - Appraised by
Morrow Diamond's. Appraisal
Attached. Item No. 5 on
Appraisal.
Gentleman's Diamond Masonic
Ring. - Appraised by Morrow
Diamonds. Appraisal
Attached. Item No. 2 on
Appraisal
246.00
2,010.34
3.17
50,000.00
263.89
50,000.00
263.89
7,000.00
250.00
500.00
250.00
212,360.72
-3-
Imitation Pearl Ring with 3
faux diamonds Appraised by
Morrow Diamond's. Appraisal
Attached. Item No. 6 on
Appraisal
Ladies Three Stone Diamond
White Gold Ring - Appraised
by Morrow Diamond's.
Appraisal Attached. Item No.
3 on such Appraisal
Masonic, Diamond Lapel White
Gold Pin - Appraised by
Morrow Diamonds. Appraisal
is attached. Item No. 1 on
Appraisal.
Personal Property. Appraisal
attached
Yellow Gold Band Ring -
Appraised by Morrow
Diamond's. Appraisal
Attached. Item No. 8 on
Appraisal.
STOCKS/LISTED:
1,504.000 shares PNC Financial Services
Group, Inc.
REAL ESTATE/PA:
10.00
250.00
50.00
8,850.00
17.50
65,807.52
17,177.50
65,807.52
-4-
Real Estate located at 3116
Beverly Road, Borough of
Camp Hill, Cumberland
County, Pennsylvania with
Deed filed in Deed Book O
20, Page 233. Property
sold on August 15, 2003.
Settlement Sheet is attached
hereto showing Contract
Sales Price.
169,900.00
TOTAL RECEIPTS OF PRINCIPAL ...............
169,900.00
465,245.74
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 003087
MYERS EDMUND G ESQUIRE
301 MARKET STREET
P O BOX 109
LEMOYNE, PA 17043
........ fold
ESTATE INFORMATION: SSN: 199-07-5281
FILE NUMBER: 2103-0107
DECEDENT NAME: SCHEFFER MIRIAM J
DATE OF PAYMENT: 10/06/2003
POSTMARK DATE: 1 0/02/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 01/29/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $6,755.57
TOTAL AMOUNT PAID.
$6,755.57
REMARKS: DAVID C BEARD
C/O EDMUND G MYERS ESQUIRE
SEAL
CHECK# 1030
INITIALS: VZ
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
JOH~,~SON, DUFFle, STEWArt & WEIDNER
ATTORNEYS AT LAW
301 MARKET STREET
P.O. BOX 109
LEMOYNE, PENNSYLVANIA 17043
Fimt Class Mail
Register of Wills Office
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013
ATTN~ Cheryl
BUREAU OF ZNDZVZDUAL TAXES
ZNHERZTANCE TAX nZVI'SZON
DEPT. 280601
HARRTSBURG, PA 17128-0601
COMHONWEALTH OF PENNSYLVANZA
BEPARTMENT OF REVENUE
NOTZCE OF INHERITANCE TAX
APPRAZSEHENT, ALLONANCE OR DZSALLONANCE
OF DEDUCTZONS AND ASSESSMENT OF TAX
EDMUND G MYERS
JOHNSON ETAL
PO BOX 109
LEMOYNE
PA 170q$
BATE 11-2q-2005
ESTATE OF SCHEFFER
BATE OF BEATH 01-29-2005
FILE NUMBER 21 05-0107
COUNTY CUHBERLAND
ACN 101
F Amount Remitted
RE¥-ISq7 EX AFP
MIRIAM J
HAKE CHECK PAYABLE AND RENZT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORBS ~
REV-1547 EX AFP (01-03) NOTICE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLOWANCE OR
DISALLOWANCE OF BEBUCTZONS AND ASSESSHENT OF TAX
ESTATE OF SCHEFFER MIRIAM J FZLE NO. 21 05-0107 ACN 101 BATE 11-2~-2003
TAX RETURN NAS: (X) ACCEPTED AS FZLED ( ) CHANGED
RESERVATZON CONCERNING FUTURE ZNTEREST- SEE REVERSR
APPRAZSEB VALUE OF RETURN BASEB ON: ORIGINAL RETURN
1. Raal Estate (Schedula A} (1)
2. Stocks and Bonds (Schedule B) (2)
3. CZosaZy HaZd Stock~Partnership Zn~aras~ (Schedule C) (3)
4. Mortgages/Notes Receivable (Schedule D) (4)
E. Cash/Bank Deposits/Misc. Personal Property (ScheduZe E) ($)
6. JointZy Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7}
8. TotaZ Assa~s
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expansas/Adm. Costs/Hisc. Expanses (Schedule H) (9)
10. Deb~s/Hortgage Liabilitias/Liens (SchaduZa Z) (10)
11. Total Daductions
12. Ne~ Value of Tax Return
169~900.00
65~807.51
.00
.O0
209~368.63
.00
NOTE: To insure proper
credit to your account,
submit the upper port/on
of this for. with your
tax payment.
8~qql.7Z
(8) q53,517.87
q5,3ql.00
15.
14.
NOTE:
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spouse! ra~a
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 et Sibling rata
18. Amount of Line 14 taxable at CoZlatara1/Class B rata
19. Principal Tax Due
TAX CREDITS:
PAYMENT RECEiPi DISCOUNT (+)
DATE NUMBER INTEREST/PEN PAID (-)
Oq-Z9-ZO03 CD002509
10-02-2003
12a262.52
(11) 57.&03.52
(12) 395,91q.35
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (15) . O0
Net Value of Estate Sub~act to Tax (14) 395,91q.35
:[f an assessaent was issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
(1.;) .00 x O0 = .00
(16) .00 x Oq5= .00
(17) . O0 x 12 = . O0
(z8) 395,91q.35 x 15 = 59,387.15
(19)= 59,387.15
CD00~087
2,631.58
.00
AHOUNT PAZD
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULAT/ON OF ADDIT/ONAL INTERESTo
50,000.00
6,755.57
TOTAL TAX CREBZT
BALANCE OF TAX DUE
ZNTEREST ANB PEN.
TOTAL DUE
59,387.15
.00
.00
.00
( ZF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SZDE OF THZS FORH FOR INSTRUCTIONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December 1Z, 19BI -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B [collateral) rate on any such futura interest.
To fulfill tho requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (72 P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Hake check or money order payable to: REGISTER OF NILLS, AGENT
A refund of a tax credit, which was not requested on the Tax Return, may bm requested by completing an "Application
far Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office
of the Register of Hills, any of tho ES Revenue District Offices, or by calling the special Iq-hour
anseering service for forms ordering: 1-800-562-Z050; services for taxpayers aith special hearing and / or
speaking needs: 1-BO0-~q7-$OZO (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 af
this Notice by:
--written protest to the PA Department cf Revenue, Board of Appeals~ Dept. ZBL02L, Harrisburg, PA 171ZB-Lgz1, 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 in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. Ssa page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-iS01) for an explanation of administratively correctable errors.
If any tax due is paid within three ($) calendar months after the decedent's death, a five percent (52) discount of
tho tax paid is a11o~ed.
The 15Z 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 period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and 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 (67.) percent per annum calculated at a daily rate of .00016q. Al1 taxes mhich became delinquent on and after
January 1, 198Z mill bear interest at a rate which mill vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2003 ara:
Interest Daily Interest Daily Interest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 207. . 0005~8 1987 92 . O00Zq7 1999 72 . OOO 192
1983 16Z .000¢38 1988-1991 Ill .000501 ZOO0 8Z . 000219
198q llZ . 000501 1992 9Z . 000247 2001 9Z . 0002~7
1985 132 . 000556 1993-199q 72 . 000192 2002 62 . 00016q
1986 102 .00027q 1995-1998 92 . O002~7 2005 52 .000157
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUI{BBR OF DAYS DELINI~UENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on tho
Notice, additional interest must be calculated.
Name of Decedent:
Date of Death:
Estate No.
STATUS REPORT UNDER RULE 6.12
MI~AM J. SCHEFFER
January 29, 2003
2003-0107
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rule, 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 No X
b. The separate Orphans' Court No. (if any) for the personal
representative's Account is:
parties of interest?
Did the personal representative state an account informally to the
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.
Date: January 30, 2004 ~7/~~
EDMUND G. MY'ERS
JOHNSON, DUFFIE, STEWART & WEIDNER
301 Market Street
P.O. Box 109
Lemoyne, PA 17043
(717) 761-4540
Capacity: ~Personal Representative
(x) Counsel for Personal
Representative