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Home My WebLink About11-12-11COMMONWEALTH OF PENNSYLVANIA REV-1162 EX111-96) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128.0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD Q 15233 LEWIS FORREST R 301 S STONER AVE SHIRMANSTOWN, PA 17011 ACN ASSESSMENT AMOUNT CONTROL NUMBER -------- told ESTATE INFORMATION: ssN: i ~a-3s-s4t 8 FILE NUMBER: 2110-0487 DECEDENT NAME: LEWIS SHERRY A DATE OF PAYMENT: 1 1 f 21 / 201 1 POSTMARK DATE: 1 1 /21 /201 1 couNTY: CUMBERLAND DATE OF DEATH: 04/18/2010 REMARKS: RECEIPT TO ATTY SEAL CHECK# 6129 101 ~ $217.76 TOTAL AMOUNT PAID: INITIALS: HEA RECEIVED BY: $217.76 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: LEWIS FORREST R 301 S STONER AVE SHIRMANSTOWN, PA 17011 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV-1162 EXi11-96) NO. CD 015234 ACN ASSESSMENT AMOUNT CONTROL NUMBER fold ESTATE INFORMATION: SSN: 173-38-6418 FILE NUMBER: 2110-0487 DECEDENT NAME: LEWIS SHERRY A DATE OF PAYMENT: 1 1 /21 /201 1 POSTMARK DATE: 1 1 /21 /201 1 CouNTY: CUMBERLAND DATE OF DEATH: 04/ 18/2010 101 ~ 51,935.34 TOTAL AMOUNT PAID: REMARKS: RECEIPT TO ATTY SEAL CHECK# 3919461 INITIALS: HEA RECEIVED BY: 51,935.34 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Tax Parcel No. 13-23-0555-085 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHAN'S COURT DNISION In Re: : S? -~_- -- ,', °, ESTATE OF SHERRY A. LEWIS, A/K/A :Estate No. 21-10-0487 '~'> `~= SHERRY A. FREUNDEL, z `.~' `-; Late of Lower Allen Township, ~ ;~ , -~ Cumberland County, Pennsylvania, deceased =~~ %-_' ' ' _ - - _ ~Ji _. .z,' .~ ~.. =ri L~ r. ~ ~~'~ C~ "r-t DISCLAIMER I, Michael J. Freundel, a/k/a Michael Freundel, hereby declare that I am the only surviving child of Sherry A. Lewis, a/k/a Sherry A. Freundel, who died on April 18, 2010 (the "Date of Death"). I hereby irrevocably and completely disclaim and refuse to accept any and all rights, title and interests pursuant to the intestacy laws of the Commonwealth of Pennsylvania, see 20 Pa.C.S.A. § 2102(4), in property being known and numbered as 301 South Stoner Avenue, Shiremanstown, Lower Allen Township, Cumberland County, Pennsylvania, bounded and described by a Deed dated June 18, 2007, and recorded June 22, 2007, in the Cumberland County Recorder of Deeds Office in Deed Book 280, Page 2998, to wit: BEGINNING at a stake on the southern side of Chesnut Street at a point adjoining lands now or formerly of Harry L. Stephenson and Betty M. Stephenson, his wife, formerly of Lloyd F. Miller; thence along the southern line of Chestnut Street North 77 degrees 15 minutes East, a distance of 145 feet to a point in a line of Lang conveyed by Jay A. Dentler and Alva M. Dentler to Gerald W. Freundel and Jean Freundel, his wife; thence along said Lang now or formerly of Freundel South 15 degrees 23 minutes East, a distance of 96.36 feet to a pipe in line of land of Lot No. 17 of Keewaydin; thence along said Lot and along Lot No. 14 of Keewaydin South 57 degrees 30 minutes West, a distance of 156 feet to a stone monument; thence along land now or formerly of Harry L. And Betty M. Stephenson North 13 degrees 45 minutes West, a distance of 149 feet to a stake on the southern side of Chestnut Street, the place of BEGINNING. CONTAINING .41 acres according to a survey of D.P. Raffensperger Associates dated June 21, 1972. HAVING thereon erected a one story brick dwelling house with frame garage being known and numbered as 301 South Stoner Ave. (Lower Allen'I'ownship), PA. J BEING THE SAME PREMISES which Diane Freundel and James A. Ulsh, Co- Executors of the Estate of John M. Spangler, granted and conveyed unto Jean L. Freundel by deed dated October 17, 2003, and recorded in the Office of the Recorder of Deeds for Cumberland County, in Record Book 260, page 2773 on November 26, 2003. UNDER AND SUBJECT to any and all existing covenants, restrictions, easements, and conditions of record, if any. The foregoing rights, title and interests shall collectively herein be referred to as the "Disclaimed Interests". I hereby state and certify that I have not accepted. any benefits or interest with respect to the Disclaimed Interests on or following the Date of Death. This document is intended to qualify as a disclaimer under Section 2518 of the Internal Revenue Code of 1954, as amended, and under Chapter 61 of the Pennsylvania Probate, Estates and Fiduciaries Code. Dated this ~b Witness: day of ~~()G'Cl~ ~'V _, 2011. ~" ~ ~ G r (SEAL) MICHAEL J. FRE DEL alkla MICHAEL FREUNDEL ~.:. t....._~ _ . i ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA . SS COUNTY OF CUMBERLAND On this ~"~ day of `~o dr~ , 201 1, before me, the undersigned officer, a Notary Public in and for the said county and state, :personally Appeared Michael J. Freundel, who, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Disclaimer are true and correct to the best of her knowledge, information, and belief and that she executed the same as her voluntary act and deed far the purposes therein contained. GIMLA. ~OQM, NOUIR/ MIBt1C ""~~' ' ~ O '`~ ~ e0. dNo r Notary Public Yr001r1lIQN F)(~3 NOYEA3~t 1~, 2013 r IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHAN'S COURT DIVISION In Re: ESTATE OF SHERRY A. LEWIS, A/K!A :Estate No. 21-10-0487 SHERRY A. FREUNDEL, Late of Lower Allen Township, Cumberland County, Pennsylvania, deceased RECEIPT OF DISCLAIMER Forrest R. Lewis, being duly sworn according to law, deposes and says that he is the Administrator of the Estate of Sherry A. Lewis alk/a Sherry A. Freundel, and that on the date and place as hereinafter set forth, he received the foregoing signed Disclaimer from Michael J. Freundel, a/k/a Michael Freundel. ESTATE OF SHERRY A. LEWIS A/K/A SHERRY A. FREUNDEL, Deceased Forrest R. Lewis, Administrator Date: ~ ~ - ~ ~' - 1 J Place: Z Z t ~ t*~: t s~ ~ ~ l ~~ ~r. -- S -.~ ~ 3 ~' SWORN TO AND SUBSCRIBED before me this ~ ~-~`day of ~i~cwe~-,-~~, 201 ~. Notary Public ...;-~ . r , r r ;_ __ . -- - :K ....., l . Register of Wills of Cumberland County, Pennsylvania INVENTORY Estate of Lewis, Sherry A No. 21 - 10 - 00487 also known as Date of Death 4/18/2010 Deceased Social Security No. 173-38-6418 Forrest R. Lewis The 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 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. Attorney: Mindy S Goodman I.D. No.: 7840? Personal Representative Signature. Forrest R. Lewis Signature: Signature: Address: 2215 Forest Hills Drive Address: 301 S. Stoner Avenue Suite 35 Shiremanstown, PA 17011 Harrisburg, PA 17112 Telephone: 717!540-8742 Telephone: Dated: Personal Propert 2005 Nissan Maxima -very poor condition Total Persona! Property $3,000.00 C7 __ . ~. C7 ~-~ .__. _ -z:~ r -' __~ 3,000.00 (Attach additional sheets if necessary) Totai Personal Property and Real Estate $2b2,800.00 ~ ~. ' Register of Wilts of Cumberland County, Pennsylvania INVENTORY continued _ _ z__ Estate of Lewis, Sherry A No. 21 - lU - 0048? also known as Date of Death 4118!2010 Deceased Social Security No. 173-38-6418 Rea{ Estate 301 S. Stoner Avenue, Shiremanstown, PA -- recent countywide assessment valued property at 171,800.00 $171,800 400 East Chestnut Street -- owned as tenants in common with Decedent's son 88,000.00 FMV - $176,000 Total Real Estate $259,800.00 2