HomeMy WebLinkAbout07-26-111505610101
REV-1500 Ex X01.1°' ~ ~' -
OFFICIAL USE ONLY
PA Department of Revenue Pennsylvania Coun Code Year
Bureau of Individual Taxes fIEPAP lMI.kf tlf PEYiiNUf h,
PO BOX 280601 INHERITANCE TAX RETURN `~'
Harrisbur , PA i'7i28-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
_ _
............................
_.._ _
___ _. __
190-12-0804 :02/05/2011 01/15/1924
_ _ __
__
Decedent's Last Name _
File Number
O~
Suffix Decedents First Name MI
_ __ __
Schmuck Arlington R
__ _
_ __
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
__ _
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
~ 1. Original Return O 2. Supplemental Return O 3. Remainder Return (date of death
prior to 12-13-82}
O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
Ci1D 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust D 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
O 9. Litigation Proceeds Received O 10. Spousal Poverty Credit (date of death O 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name
Daytime Telephone Number
Nathan C. Wolf, Es uire
q (717) 241-4436
REGISTER OF 1I~I~JSE ONLIh--~
-~TJ C
e~ ~ ~ C~ti
~.
.~
~
rw.,
~/ ~
--1
~L7 .... _.
r, :~
DATE-~TI.ED .~"...,~
Carlisle PA 17013-2922
Correspondent's a-mail address: nathancwolf chi embargmail.com
un°er penalties of penury, 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.
_--
I E FOR FIL RETURN ~ DATE
07/26/11
ADD SS
2 West Penn Street, Apartment 205, Carlisle, PA 17013
PARER OTHER THAN REPRESENTATIVE
DATE
07/26/11
ADDRESS
10 West Hi Stree , isle, PA 17013-2922
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610101
1505610101
~~
+~
-~--~ r7
:; --?
~_ .,
~' - S'~"!
1".__
~ :~
J~
1505610105
REV-1500 EX
Decedent's Name: AC'llllgtOtl fZ. SCh111UCk
Decedent's Social Security Number
10n_~ 2 nQn~
RECAPITULATION
1. Real Estate (Schedule A) ............................................. 1. I'
2. Stocks and Bonds (Schedule B) ....................................... 2.
.............. ...
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3.
4. Mortgages and Notes Receivable (Schedule D} ........................... 4,
_...
5. Cash, Bank Deposits and Miscellaneous Personal Property (Schedule E)....... 5. ! 15,053.22
6. Jointly Owned Property (Schedule F) O Separate Billing Requested ....... 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property -
(Schedule G) O Separate Billing Requested........ 7.
,:,:
8. Total Gross Assets (total Lines 1 through 7) ............................. 8. ' 15,053.22
9. Funeral Expenses and Administrative Costs (Schedule H) .............. ..... 9. 5,260.51
10.
Debts of Decedent, Mortgage Liabilities, and Liens {Schedule I) ..........
.... 10. ._
371.56
11.
Total Deductions (total Lines 9 and 10) .............................
.... 11. ..,
5,632.07
12. Net Value of Estate (Line 8 minus Line 11) .......................... .... 12. 9,421.15
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which ` ` °•
an election to tax has not been made (Schedule J) .................... .... 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) .................... .... 14.
9,421.15
TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116 _ __ __ _ __ __ _
(a)(1.2) X .0_
15.
16. Amount of Line 14 taxable - -
_ ...
at lineal rate X .0 45 9,421.15 16. ' 423.95
17. Amount of Line 14 taxable
at sibling rate X .12 17
18. <:
Amount of Line 14 taxable
°° °°°
at collateral rate X .15 18
19.
TAX DUE .....................................................
....19.~I' ...........
423.95
__ __..
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
L 1505610105
Side 2
15056101,05
O
J
REV-1500 EX Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Arlington R. Schmuck
STREETADDRESS
41 Ashburg Drive
Apartment 11
ciTY
Mechanicsburg sTATE Z1P
PA 17050
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19) (1) 423.95
2. Credits/Payments
A. Prior Payments 35.0.00
-- -----18.42
B. Discount
Total Credits (A + B) (2) 368.42
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. (3) 0.00
Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 55.53
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 :............................................... ^
........................................... ^ x
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 Dec. 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. ^ 0
3. Did decedent own an "in trust for" or payable-upon-death bank account or security at his or her death? .............. ^
4. Did decedent own an individual retirement account, annuity or other non-probate property, which
contains a beneficiary designation? ........................................................................................................................ n n
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994, and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is
3 percent [72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[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 21 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 percent [72 P.S. §911fi(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 percent, 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 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-i5o8 EX+ (11-10)
~~x7 ~ ~ pennsylvania
DEPARTMENT Of REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT SCHEDULE E
CASH, BANK DEPOSITS & MI5C.
PERSONAL PROPERTY
ESTATE OF:
Arlington R. Schmuck FILE NUMBER:
21-11-0204
Include the proceeds of litigation and the date the proceeds were received by t:he estate
.
All property jointly owned with right of survivorship must be disclosed on Schedule
F.
ITEM
NUMBER DESCRIPTION VALUE AT DATE
~F DEATH
1. Members 1st Account 287386-00
5.47
2 Members 1st Account 287386-11
500.47
3' Members 1st Account 287386-48 (Certificate of Deposit)
2,093.55
4 M&T Bank Account 9840523501
466.11
5 M&T Bank Account 25004920160659
300.02
6 2007 Ford Fusion -Fair Condition -Sold to Third Party buyer
10, 750.00
7 Motorized Scooter purchased used for $300.00
250 00
g MetLife annuity payments
393.52
g Refund of Health Insurance Premium -State Farm Insurance Co
. 211.39
10 Refund of Car Insurance Premium -State Farm Insurance Co
. 82 69
TOTAL (Also enter on Line 5, Recapitulation} $ 15,053.22
If more space is needed, use additional sheets of paper of the same size
RE11-1511 EX-~ {1(~-~9?
Pennsylvania
DEPARTMENT Of REVENUE
INHERITANCE TAX RETURN
SCHEDULE H
FUNERAL EXPENSES AND
ADMINISTRATIVE COSTS
Arlington R. Schmuck
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A• FUNERAL EXPENSES:
1
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative Commissions:
Name(s) of Personal Representative(s) Linda L. Bernhelmer
2.
3.
4,
5.
6.
7.
s
s
10
city Carlisle state PA zIP 17013
Year(s) Commission Paid: 2011
Street Address 2 West Penn Street Apt 205_. _ _
Attorney Fees:
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.}
claimant Linda L. Bernheimer
__.
street Address 2_West Penn Street Apt 205._________.
- -- ---- - - - --- - ~- -~ -R --
City Calisle State PA ZIp 17013
Relationship of Claimant to Decedent Dau hter
----- --~--g-
Probate Fees:
Accountant Fees:
Tax Return Preparer Fees:
Cumberland Law Journal -Legal Advertising
The Sentinel -Legal Advertising
Reserve for outstanding expenses
TOTAL (Also enter on Line 9, Recapitulation) ~ ~
AMOUNT
753.00
1,053.71
3,000.00
112.50
75.00
166.30
100.00
5,260.51
FILE NUMBER
21-11-0204
If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+ i 12-fJ€3?
~~~ pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
--
FILE NUMBER
Arlington R. Schmuck 21-11-0204
Report debts incurred by the decedent prior to death that remained unpaid at the date of death. inc~udinn ~~r,rp~n,h~~rcod ~..od;~~~ e.,.,e.,~„~
~~ nwre space is neeaea, mser[ aaaitionai sheets of the same size.
REV-1513 EX+ (01-10)
xs- ..~.z
y
~ a ~ pennsylvania
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE ~
BENEFICIARIES
ESTATE OF: FILE NUMBER:
Arlington R. Schmuck 21-11-0204
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec. 9116 (a) (1.2).]
1• Linda L. Bernheimer, 2 West Penn St. Apt 205, Carlisle, PA 17013 Daughter
2 Michael Schmuck. 2723 Paine Lane, Orlando, FL 32826 Son
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET, AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed, use additional sheets of paper of the same size.
50%
50%
r
LAST WILL AND TESTAMENT
I, Arlington R. Schmuck, of Middlesex Township, Cumberland County, Pennsylvania, do
hereby make, publish and declare this to be my last will and testament, hereby revoking all wills
heretofore made by me.
1. I direct my personal representative to pay all of my debts, funeral and administrative
expenses as soon as convenient after my demise. I direct that all inheritance taxes imposed or
payable by reason of my death and interest and penalties thereon with respect to all property,
whether or not such property passes under this Will, shall be paid by my personal
representative out of my estate.
~~
2. I authorize and empower my personal representative to sell any realty and/or
personalty owned by me at my death and not specifically devised or bequeathed herein, at
public or private sale or sales and to give good and sufficient deeds aild/or bills of sale
therefore, in fee simple, as I could do if living. My representative is authorized and empowered
to engage in any business in which I may be engaged at my death, for such period of time after
my death as seems expedient to said representative.
3. I give, devise and bequeath all of my estate of whatever nature and wherever situate
to my children, Linda L. Bernheimer and Michael R. Schmuck, per .rtir~e.r.
4. I hereby nominate and appoint Linda L. Bernheimer, individually, to be my personal
representative of my estate, to serve without bond. If Linda L. Bernheimer cannot or does not
serve, then I appoint Michael R. Schmuck, individually, to be my substitute personal
representative also to serve without bond.
5. I suggest that my personal representative retain the services of Wolf & Wolf,
l~ttorneys at Law of Carlisle, Pennsylvania in the settlement of my estate.
Vie' ~
IN WITNESS WHEREOF, I have hereunto set my hand and seal this -~ day of
2010.
~~~~ r f t
'~'~" / (SEAL)
Signed, sealed, published and declared by the above-named perso~z as and for a last will and
testament, in our presence, who at said person's request, in said person's presence and in the
presence of each other have hereunto set our names as subscribing witnesses.
~~
/ ~- ~"
~~
~D_
WE, Arlington R. Schmuck ,Stacy B. Wolf and Stephanie L. Hamilton, the testator
and witnesses respectively, whose names are signed to the foregoing instrument, being first duly
sworn, do hereby declare to the undersigned authority that the testator signed and executed the
instrument as his last will and that he had signed willingly, and that he exf~cuted it as his free and
voluntary act for the purpose herein expressed, and that each of the witnf~sses, in the presence and
hearing of the testator, signed the will as a witness and that to the best of their knowledge the
testator was, at that time, eighteen years of age or older, of sound mind acid under no constraint or
undue influence.
~ /r '~`' 4~Y~°
Arlington R. Schmuck
r
i~ ~ o~
Stacy B, if v '
Stephanie L. Hamilton
COMMONWEALTH OF PENNSYLVANIA
. ss:
COUNTY OF CUMBERLAND
Subscribed, sworn to and acknowledged before me by Arlington R. Schmuck ,the testator
herein, and subscribed and sworn to before me by Stacy B. Wolf, and Stephanie L. Hamilton,
witnesses, this `~ ~ day of O~ ;-~,~~ (°~ , 2010.
,,~ ,.
Notary~ublic
~.... ~fe~t~ri~l ~ ~a~ ---_...__.
Natttar~ C. Vlialf; ~3atUSy ~t~%i;c
~~tii~fe Coro, i>u~r~u~rland ~:~;~,-;ry,
~Y t`t~f}'fflliSSio91 Expires Apri! 19, ~`~J 1c? .~..~
~^..~ ..,ry -..._..___---___- _ . _
~s~i~ ~n~~syiu~~„~ As~s~~ci~ti~n ~~r r'~Jc~Y~:rs~s
~~}}..
lL
00
MEMBERS 181
FfiUbltAL CRBIIIT UMON
REGU AR SAVINGS ACCOUNT:
Account Number/Suffix 287386-00
Date Account Established 06/16/2006
Principal Balance at Date of Death $5.47
Accrued Interest to Date of Death $.00
Total Principal and Accrued Interest $5.47
Name of Joint Owner None
CHECKING ACCOUNT:
Account Number/Suffix 287386-11
uate Account Established 06/16/2006
Principal Balance at Date of Death $500.47
Accrued Interest to Date of Death $.00
Total Principal and Accrued Interest $500.47
Name of Joint Owner None
CERTIFICATES OF DEPOSIT:
Account Number/Suffix 2873868
Date Account Established 05/18/2007
Principal Balance at Date of Death $2,093.55
Accrued Interest to Date of Death $.1 g
Total Principal and Accrued Interest $2,093.73
Name of Joint Owner None
MBERS 1 sr FEDERAL CREDIT UNION
Danielle A. Kline
lending Insurance Support Specialist
February 23, 2011
Estate of; ARLINGTON SCHMUCK
Date of Death: 02!0512011
Social Security Number: 190-12-0804
5000 Lotusc~ give 1'.C), Box 40 Mechanicsburg, Pcnnsylvar~ia 17()55 (~i(>()) 2H3-232H wwwiil~nil~~rslst.org
Z~Z'd LSb~T~ZZtiZ:ol 8ZZSS6ZLTZ l~idflS SNI~ON:31 1STW:wo~~ OS~BT ITBZ-~Z-BSS
~~.
Und~rst,~i~n~ wt's ~~~
Help ~ Forget me on this computer
Secured Message Reply-
From: JESSICA REESE <JLREESE@mtb.com>
To: nathancwolf@embargmail.com
Date; February 16, 2011 2:25:16 PM EST
Subject: Fwd: Re: prod -Date of Death Request
Jessica L. Reese
Relationship Banker II
Carlisle High Street Office
M & T Bank
717-240-4S4S
»> DATE OF DEATH REQUESTS 2/16/2011 2:22 PM »>
Per you request, please find below the date of death values for Arlington Schmuck., SS#190-12-0804.
ACCOUNT NUMBER
1 9840523501
2 25004920160659 ~
Let me know if there's anything else you need :-)
Thanks,
Tammy Spencer
Records Management /DOD Unit
M&T Bank- "Understanding what's important."
»> <JLREESE@mtb.com> 2/15/2011 11:16 AM »>
Account Information
Date of death: 02/05/2011
Account Number: 25004920160659
Product Type: Deposit Account
Account Number: 9840523501
6783192597
Metropolitan Life Insurance Company
PO Box 14710 • Lexington, KY 40512-4710
Apri14, 2011
VIA FAX 717-241-4437
Estate of Arlington R. Schmuck
C/o Nathan Wolf, Attorney
10 West High St.
Carlisle, PA 17013
Re: Group Annuity Contract 001277A
Annuitant: Arlington R. Schmuck (Deceased)
Joint annuitant: Patricia A. Cox (Deceased)
Dear Estate of Arlington R. Schmuck:
02:04:29 p.m. 04-04-2011 1 /2
et ~
e
In accordance with the terms of the above contract, Arlington R. Schmuck began receiving
annuity payments of $196.76 monthly on July 1, 1991. This benefit was payable until the later of
June 1, 2001 or, the first day of the month of the Last to die. A review of our file reveals that
there are outstanding payments due the Estate of Arlington R. Schmuck totaling $393.52.
In order to process the claim, please provide us with the following:
1. Copies of both Death Certificates
2. Letters of Testamentary /Administrative Papers
3. Estate Tax Identification Number
4. Tax Withholding Election form
Upon receipt of the appropriate documentation, we will issue the one-time payment due.
If you have any questions, please do not hesitate to contact our Customer Sales & Service Group
at 1-800-638-2704, Monday through Friday between 8:00 AM and 11:00 PM, Eastern Time.
Sincerely,
Linda M. Williams
Annuity & Investment Operations
Attachment
Estate of Arlington R. Schmuck
21-11-0204
Inheritance Tax Return
Schedule H
Explanatory Statement for Discrepancy between
Decedent's Address and Claimant's Address
Linda L. Bernheimer is the claimant of the family exemption though her address listed is
different from the address of the decedent. At the time of the decedent's death on February 5,
2011, the claimant was residing at 41 Ashburg, Dr. Apartment 11, Mecharucsburg, PA 17050. She
subsequently relocated to her current address on May 28, 2011.
RECEIPT FOR PAYMENT
-------------------
-------------------
GLENDA FARNER STRASBAUGH
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17613
SCHMUCK ARLINGTON R
Estate File No.: 2011-00204
Paid By Remarks: WOLF & WOLF
SAP
-------------------
Fee/Tax Description
PETITION LTRS TEST
WILL
SHORT CERTIFICATE
JCS FEE
AUTOMATION FEE
Check# 3098
Total Received.........
Receipt Date: 2/15/2011
Receipt Time: 10:55:03
Receipt No.: 1064436
Receipt Distribution ----- -------- -------- ---
Payment Amount Payee Name
45.00 CUMBERLA]D COUNTY GENERAL FUN
15.00 CUMBERLAND COUNTY GENERAL FUN
24.00 CUMBERLAND COUNTY GENERAL FUN
23.50 BUREAU O:E' RECEIPTS & CNTR M.D
5.00 CUMBERLAND COUNTY GENERAL FUN
----------------
$112.50
$112.50
CUMBERLAND LAW JOURNAL
32 SOUTH BEDFORD STREET
CARLISLE, PA 17013
Tele: (717) 249-3166 Fax: (717) 249-2663
March 25, 2011
Cumberland Law Journal is published every Friday by the Cumberland County
Bar Association and is designated by the Court of Common Pleas as the official legal
publication for Cumberland County and the legal newspaper for publication of legal
notices.
TO: Nathan C. Wolf, Esquire
RE:
Arlington R. Schmuck Estate
Legal advertisements must be received by Friday Noon. ,All legal advertising
must be paid in advance. Make all checks payable to: Cumberland Law Journal.
Advertisement inserted on the following dates:
March 11, March 18, and March 25, 2011
Advertising Cost $ 75.00
DO NOT DETACH THIS VOUCHER
PAYMENT OF THIS CHECK WILL BE REFUSED, UNLESS /
RECEIPT IS SIGNED AND CHECK ENDORSED.
dQ ~ ZZ tall
CHECK NO. DATE
RECEIVED OF:
PERSONAL R ENTATIV EXECUTOR E%ELUTRI% ADMINISTRATOR ADMINISTRATRI%TRUSTEE GUARDINANr
OF THE ESTATE OF
~W..~NU~'uN ~~ SCN~~(,~
~Vt~ O
THE SUM OF
IN PAYMENT OF~ ~~~~
SIGN HERE __.-_-ALSO ENDORSE BACK OF CHECK
No. c~3
60-1503 s
,~ ~~~~ 313
DAl"E
PAY
TO THE F ~U~pt~! L~~ ~.,pl1r~ ~OV~lvR~ ~ $ ~ S. ~C7
ORDER O
fDOLLARS LtJ ~l~~~~
Se,U~~~ ~ i~/~z I Ll~ ,s t~'~~
r ESTATE OF
ORRSZ`pWNBANK
A Tradition ofF.zcel[ence _,___^__~~__ M'
' ~ PERSONAL REPO ESENTATIVE EXECUTOR EXF CUTRI%AOMINISTRATOR ADMINISTRATRI%TRUSTEE GUAPDIAN
,~:0 3 L 3 L 50 36~: L08 008 L 2 Lip'
THE SENTINEL
c/o LEE NEWSPAPERS
PO BOX 540
WATERLOO IA 50704-0540
~~~~,,,,kk 000338
i~ WOLF & WOLF ATTORNEYS
10 WEST HIGH STREET
CARLISLE, PA 17013
Return this portion with your payment
^ Check # ^ Credit Card
^®^ v, ^^
Acct #: ID
F~cp. Date: m m
Name on credit card
Signature
Please make checks payable to: THE SENTINEL
Legal
Ad Number 394910
Billing Date 03/24/11
Amount Due $ 166.30
Amount
Einclosed` ~
$ ~ ~~
i fJ~ .t,U
THE SENTINEL
c/o LEE NEWSPAPERS
PO BOX 742548 .
CINCINNATI OH 45274-2548
~~~u~~~~~n~~~~~~~~~~~n~i~~~~~~~~n~u~~i~~n~i~~~i~~~~~~~~~
21540200000003949100000000000000001995600000166300
DO NOT DETACH THIS VOUCHER
PAYMENT OF THIS CHECK WILL BE REFUSED, UNLESS
RECEIP
T
IS S
IG
N
ED AND CHECK ENDORSED.
J
J~
//
J(
/
CHECK NO. ~I~ DATE ~ ~ ~ ~~
RECEIVED OF:
r-~
Nr
PAY
_ _ __
PERSDNAI REPRESENTA E E%ECUTDR EXECUTRIX ADMINISTflATOR ADMINIST _____
RATRI%TAUSTEE GUARDIAN TO TH E
OF THE ESTATE
F ORDER OF
j/
60-1503 8
313
DATE
P ~
-r' ~~..
Saa.ly FWUn-
_ f ~ DOLLARS ' ~ BRCN.
~6/ ~ ~(J ~ ~ ~ ESTATE OF
THE SUM OF (((/// JJJ~~_
ORRSTOWNBANK
//_) ~ A Tradition ofExcellenct ~'f
IN PAVME NT OF r`' ~ _____ ___-r_-f~ _________ ________~__-____
SIGN HERE __~__~______ ___ M' __ _ IYP
ALSO ENDORSE BACK OF CHECK ~M~ PERSDNAL fIEPRESENTATIVE E%ECUTDfl EXECUTflI%ADMINISTRATDR ADMINISTflATflI%TRUSTEE GUARDIAN
-~:0 3 L 3 L 50 3 6~: L08 008 L 2 L~~'
O DELUXE EBTNAB
No. ~~
PharMerica
PHARMERICA
PO BOX 59
LONGMONT, CO 80502-0059
RETURN SERVICE REQUESTED
31 1 1 1-90AA
CUSTOMER NAME: ARLINGTON SCHMUCK
• YI
f rl Please check box if address is incorrect or insurance
U information has changed, and indicate change(s) on reverse side.
0101
'I'Ill'Illlll'Illlllllllllll'Ill'III'I'llll'lllllll'll'lllll~llll
LINDA BERNHEIMER
41 ASHBURG DR STE 11
MECHANICSBURG, PA 17050-8241
IF PAYING BY MASTERCARD, DISCOVER, VISA OR AMERICAN EXPRESS, FILL OUT BELOW.
CHECK CARD USING FOR PAYMENT
AIAEgIfAM
VISA
MASTERCARD DISCOVER ~. VISA ar AMERICAN EXPRESS
CARD NUMBER AMOUNT
SIGNATURE EXP. DATE
DUE DATE
UPON RECEIPT PAY THIS AMOUNT
$371.56 ACCT. #
5713-48-04246
'I'I'I~1111~11111111~1111111'111'I1111~1111~11~~11"'lllllllllll'
PHARMERICA
P.O. BOX 644458
PITTSBURGH, PA 15264-4458
5713480004020406000371569
FN:90AAB308 31111-90AA'T600MZYL1001236
DO NOT DETACH THIS VOUCHER
PAYMENT OF THIS CHECK WILL BE REFU SEO. UNLESS
RECEIPT IS SIGNED AND CHECK ENDORSED.
No. ~~--
60-..1.503 8
CHECK NO. ~~ DATE ZZ 313
RECEIVED OF: DATE ~ ~ ~ ~~
___ ___ ____ ______ PAY
PERSDNAL REPRESENT VE E%ECUTDR E%ECUTRIX 0.0MINISTRATDR A MINISTRATRI%TRUSTEE GUARDIAN TOp TH pE ~ ~~ I ~ ~'Z~
OF THE ESTATE OF ORDER OF
(~;I..IN~~1~ SC+a~-n~c./~, I~'CJC~V /GI+'~~~~~ S~l~`'i" VIVL k~U-l~~ ~~I' - ~OLLARS IJ ~°«~k.
THE SUM OF ~ `~ ' ~•` ~ ,
~7 !3 - 4~_ C~~ l~l ~ ORRSTOWNBANK
~~IOICi4~~dsr's it Tradition ofExcrlltnce
IN PAYMENT OF ~~`
SIGN HERE ___-__-__-_-_-_-_-_-_ M'
ALSO ENDORSE BACK OF CHECK
ESTATE OF
_ PF RSDNAL REPRESENTATIVE E%EC UTOR E%ECUTRI% ADMINISTRATOR ADMINISTRATRI%TRUSTEE DUAfl DIpN ^^ ~^
--~:0 3 L 3 L 50 3 6~: L08 008 L 2 LII'
3600N015N:1.1
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 014429
BERNHEIMER LINDA L
41 ASHBURG DRIVE APT 1 1
MECHANICSBURG, PA 17050
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
-------- fold
ESTATE INFORMATION: SSN: 190-12-0804
FILE NUMBER: 211 1-0204
DECEDENT NAME: SCHMUCK ARLINGTON R
DATE OF PAYMENT: 05/06/201 1
POSTMARK DATE: 05/06/201 1
COUNTY: CUMBERLAND
DATE OF DEATH: 02/05/201 1
REMARKS: RECT TO ATTY
SEAL
CHECK# 4
101 ~ $350.00
TOTAL AMOUNT PAID:
$350.00
INITIALS: MAW
RECEIVED BY: GLENDA EARNER STRASBAUGH
REGISTER OF WILLS
TAXPAYER