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HomeMy WebLinkAbout03-0739PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of MILDRED M. SHELLER No. also known as To: 73 9 Register of Wills for the Deceased. County of Cumberland in the Commonwealth of Pennsylvania Social Security No. 189-09-4658 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, appl_iea_~ for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decendent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or principal residence at 166A McAllister Church Road_. I4. pann.nboro Twp. (list street, number and municipality) Decendent, then 88 years of age, died July 5 ,1~ 2003 , at Chapel Pointe at Carlisle, Carlisle PA Decendent at death owned property with estimated values as folllows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ 8~000.00 $ $ $ Petitioner s after a proper search ha ye ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name Shirley C. Sheaffer David L. Sheller Relationship daughter son Residence 144 McAllister Church Road Carlisle, PA 17013 131FernAvenue Carlisle, PA 17013 Jean E. R/chw~ne daughter 101 Skyline Drive Mechanicsburg, PA 17050 Vivian M. Kugle daughter 414 Swatara St., Steelton, PA THEREFORE, petitioner(s) respect~lly request(s)the grant of letters of administration in the appropriate ~rm tothe undersigned. 17113 Shirley C.~ S~e~ff~- ~ 1-- - 144 M~lister Church Road 1 Carlisle. PA 17013 717-24~-3600 71 7-TA~-OO~6 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF C~.R~.A~ The petitioner(s) above-named swear(s) or affirm(s), that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed c ~ca-4t~Jo~J~ .... /9. ~d~/'~/._ before me this 8th ~ ~ day of ] ~hxrZey ~ Sheagger No. 21-0}- 739 Estate of l~ldred M. Sheller , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW September 9th ~l~ 2003, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that Shirley C. Sheaffer and David L. Sheller is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to Shirley C. Sheaffer and David L. Sheller in the estate of l~ldred M. Sheller FEES Letters of Administration ..... Short Certificates(2 ) .......... $ 6_ nn Renunciation ................ $ 5 o 00 JCP $10. O0 TOTAL $. 61.00 Filed Soptember. ~h; .... A.D. ~1~ 200~ 60 W. Pomfret Street, Carlisle, PA 17013 ADDRESS 717-249-2353, PHONE Call~ 21-2003-739 RENUNCIATION In regard to the Estate of To the Register of Wills of MILDRED M. SHELLER Cumberland County, Pennsylvania. ,deceased. The undersigned children of the above decedent hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters of Administration be issued to Shirley C. Sheaffer and David L. Sheller WITNESS our hand(s) this day of September ,2003. S IGt~qATIJt~E Vivian M. Kugle 414 Swatara Street Steelton, PA 17113 ADDRESS  SIGNATURE Je E. Richwine 101 Skyline Drive Mechanicsburg, PA 17050 ADDRESS 21-2003-739 FAMILY SETTLEMENT AND FINAL RELEASE IN THE ESTATE OF MARY R. SMITH KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, Mary R. Smith, late of Cumberland County, Pennsylvania, died testate on November 22, 2002, having first made her last will and testament duly executed on February 16, 1999; WHEREAS, the said, Mary R. Smith, by the aforesaid last will and testament, named Paul J. Smith, as Executor of said last will; WHEREAS, letters testamentary on the estate of the said decedent were duly issued by the Register of Wills of Cumberland County, Pennsylvania, to the said Executor, Paul J. Smith, hereinafter called personal representative. WHEREAS, the personal representative has gathered the assets of the estate of the said decedent and the assets consist of personal and real property, to a total value of $254,767.62, as set forth in Exhibit A, which is a statement of account of the said personal representative, and which is attached hereto and made a part hereof, and marked Exhibit A; WHEREAS, the debts and deductions, including the payment of inheritance tax in the said estate, amount to $51,600.00, as further referenced on Exhibit A; WHEREAS, a partial distribution was made to the heirs in the amount of $25,000.00 each, totaling $75,000.00 as referenced on Exhibit A, leaving a balance for distribution of $129,488.52, also as set forth in the statement of the said personal representative, which is attached hereto and marked Exhibit A; " Ii:': ::' ? ~-(!'~? ':"9, WHEREAS, the balance for distribution as shown in the said statement marked Exhibit A has been reduced to cash and is available for distribution in accordance with the terms of the last will and testament of the said decedent. NOW, THEREFORE, KNOW YE, that we, being all of the named beneficiaries of the will of the said decedent, do hereby each of us, acknowledge that we have this day had and received from the aforesaid personal representative, in full satisfaction and payment of all stun or sums of money, legacies, bequests, and devises as are given, devised and bequeathed to each of us respectively by the said will of Mary R. Smith in the amounts due us under said will, which amounts we have received this day, and which amounts are in the amount set opposite our respective names in the table and schedule of distribution in said statement attached hereto and marked Exhibit A; AND, each of us does hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, we each agree that no account is necessary and we do hereby agree that we do consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if they had been filed and confirmed by the Orphans' Court Division of the Court of Cumberland County. THEREFORE, we and each of us, do hereby remise, release, quitclaim and forever discharge the said personal representative, heirs, executors, and administrators and assigns of and from the said estate and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever, touching upon the estate of the said decedent, and each of us do further hereby covenant and agree that should any liability come due to the estate of the said decedent after the signing of this agreement, we and each of us do hereby covenant and agree with each other and the aforesaid personal representative, that we will contribute pro-rata, our share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal representative after the signing, sealing and delivery of this family settlement agreement and final release. 1N WITNESS WHEREOF, we have hereunto set our hands and seals this day of (SEAL) STATE OF PENNSYLVANIA · SS. · COUNTY OF CUMBERLAND · On this, the ,? 0 t~I day of .~'t~ D {~c r¢D 6~' ,2003, before me, a Notary Public, the undersigned officer, personally appeared Paul J. Smith (known to me or satisfactory proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Amanda L. Fisher, Not.~ry Public My ~ Expires Apr. 17, ' tNanc~Ja~e Foster (SEAL) STATE OF PENNSYLVANIA · SS. · COUNTY OF CUMBERLAND · On this, the //~' day of~ ~,~{-a'~1 ,2003, before me, a Notary Public, the undersigned officer, personally appeared Nancy Jane Foster (known to me or satisfactory proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. 1N WITNESS WHEREOF, I hereunto set my hand and official seal. Patricia Ann Martin (SEAL) STATE OF PENNSYLVANIA · SS. · COUNTY OF CUMBERLAND · On this, the q -'- day of ,2003, before me, a Notary Public, the undersigned officer, personally appeai'6d Patricia Ann Martin (known to me or satisfactory proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. 1N WITNESS WHEREOF, I hereunto set m'~ hand and official seal. Jennifer S. Lindsa~, Notat'V Carlisle Bo;'o, Cumberland C. our¢.v My Com~ssion Expires Nov. 29, 2003 Member, Pennsy~ania Associati~ ot Notaries Date of Death: Date of Executor's Appointment: Accounting for the period: INFORMAL ACCOUNT OF Paul J. Smith, Executor for Estate of Mary R. Smith November 22, 2002 December 2, 2002 December 2, 2002 to September 1, 2003 Summary of Account Proposed distribution to Beneficiaries Page 5 Current Value Fiduciary Acquisition Value Principal Receipts Savings Accounts, Certificates of Deposit, Checking Accounts Interest Earned Sale of 3085 Spring Road, Carlisle Miscellaneous Personal Property (sold at auction) New Gain (or Loss) on Sales or Other Disposition Less Disbursements: 4 Debts of Decedent Funeral Expenses Administrative Expenses Federal and State Taxes Fees and Commissions $ $ 81,978.60 127,500.00 7,206.50 19,033.33 2,738.80 22,786.00 Balance before Distributions Partial Distributions to Beneficiaries Principal Balance on Hand $ $ $ 204,488.52 75,000.00 129,488.52 Receipts of Personal Representative Asset Savings Accounts, Certificates of Deposit, Checking Accounts M&T Bank, Classic Account Citizens Bank, Citizens Circle Account Realty 3085 Spring Road, Carlisle, PA 17013 Personalty Miscellaneous personal property (sold at auction) Stocks and Bonds 409 shs. of Cinergy Corp. 400 shs. of Carlisle Companies, Inc. 105 shs. of First Energy Corp. 144 shs. of Daimler/Chrysler AG Value (Date of Death) $ 51,280.09 $ 30,698.51 81,978.60 $ 127,500.00 $ 127,500.00 $ 7,206.50 $ 7,206.50 $ 13,267.96 $ 16,350.00 $ 3,368.40 $ 5,096.16 $ 38,082.52 Miscellaneous Refund from State Auto Insurance Federal Income Tax Refund (2001) Pennsylvania Income Tax Refund (2001) $ 23.90 $ 1,126.00 $ 171.00 1,320.90 TOTAL: 256,088.52 Debts of Decedent Continuing Care Rx Presbyterian Homes, Inc. Disbursements of Principal $ $ Funeral Expenses Ronan Funeral Home Administrative Expenses Auction (commission) The Sentinel (legal advertisement) Cumberland Law Journal (legal advertisement) Probate Fees Cleaning of Property/Preparation for Auction Settlement Charges at sale o£real estate Commission paid to realtor- $7,650.00 Real estate transfer tax-$1,275.00 Radon Mitigation-S350.00 Seller Assistance-S3,000.00 PP&L Dauphin Oil Tristan Associates Nancy Sheibley, Real Estate Taxes State Auto Insurance Calaman's Lawn Service $ $ $ $ $ $ 535.86 2,335.00 2,738.80 $ 1,827.62 146.57 75.00 308.00 1,020.00 12,275.00 214.04 497.92 3.43 372.52 137.90 127.20 2,870.86 2,738.80 Federal and State Taxes Pennsylvania Inheritance Tax (net of estimated payment and refund) Federal Income Tax (2002) State Income Tax (2002) TOTAL: 8,973.28 125.86 $ $ 17,008.20 9,099.14 31,717.00 4 Fees and Commission Executor's Commission, Paul J. Smith O'Brien, Baric &Scherer, attorney fees $ 11,393.00 $ 8,500.00 $ 19,893.00 TOTAL: $ 51,600.00 Partial Distributions To Beneficiaries Paul J. Smith Patricia Ann Martin Nancy Jane Foster Proposed Distributions To Beneficiaries: Patricia Ann Martin $ Paul J. Smith $ Nancy Jane Foster 43,162.84 43,162.84 43,162.84 $ 25,000.00 $ 25,000.00 $ 25,000.00 TOTAL: $ 75,000.00 Balance On Hand TOTAL: $ 129,488.52 PETITION FOR PROBATE & GRANT OF LETTERS Estate of MILDRED M. SHELLER also known as Social Security No. 189-09-4658 NO. , deceased. 21-03-0739 To: Register of Wills for the County of Cumber/and Commonwealth of Pennsylvania The Petition of the undersigned respectfully represents that: Your Petitioners, who are 18 years of age or older and the Co-Executors named in the Last Will of the above decedent dated October 28, 1999 , and codicils dated none The Executor named none died Renunciations for Vivian M. Ku,qle and Jean E. Richwine are attached hereto. Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal residence at 144A McAIlister Church Road, West Pennsboro Township, Carlisle Decedent, then 88 years of age, died July 5 ,2003, at Chapel Pointe at Carlisle. Except as fo{lows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the Will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in PA) Personal property in PA (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania, situated as follows: $8,000.00 $ $ $ WHEREFORE, Petitioners respectfully requests the probate of the Last Will and Codicil(s) presented herewith and the grant of letters testamentary thereon. Signature(s) and Residence(s) of Petitioner(s): Shirley ~.°Sheaffer ' ' 144 McAIlister Church Road Carlisle, PA 17013 717-243-3600 David L. Sheller 131 Fern Avenue Carlisle, PA 17013 717-243-0036 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA · COUNTY OF CUMBERLAND · SS The Petitioner(s) above named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that as personal representative of the above decedent, petitioner(s) will well and truly administer the estate according to law. Sworn to or affirrr~,..d,~nd subscribed before me this .,..')' - day of October ,2003. Regtst~ Shirley Cf. Sheaffer /" -- Davi(:]'~. ~hell~r -- lq- No. 21-03-0739 Estate of MILDRED M. SHELLER , deceased. DECREE OF PROBATE & GRANT OF LETTERS AND NOW, October I-'~ ,2003, in consideration of the Petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated October 28, 1999 described therein be admitted to probate and filed of record as the Last Will of Mildred M. Sheller ; and Letters Testamentary _ are hereby granted to Shirley C. Sheaffer and David L. Sheller FEES Probate, Letters, Etc ........ $ Short Cedificates( ) ....$ Renunciation(s) ........... JCP .................... $ Other .... $ TOTAL: .... $ Filed. I.E)..-.~..-3..- .~. r,.~.oZ5 .............. __ . LRegister of Wills-f 0-i- IRWIN & McKNIGHT Marcus A. McKni,qht Ill, Esquire ATTORNEY (Sup. Ct. I.D. No.) 60 West Pomfre~ St., Carlisle, PA 17013 ADDRESS 717-249-2353 PHONE In regard to the Estate of To the Register of Wills of RENUNCIATION MILDRED M. SHELLER Cumberland County, Pennsylvania. , deceased. The undersigned children the right to administer the estate and respectfully ask(s) that Letters issued to Shirley C. Sheaffer and David L. Sheller WITNESS our hand(s) this 1~'~ day of October Testamentary_ of the above decedent hereby renounce(s) be ,2003. S'IGN'A~UI0E Vivian M. Kugle 414 Swatara Street Steelton, PA 17113 ADDRESS SIGNATURE Jean E. Richwine 101 Skyline Drive Mechanicsburg, PA 17050 ADDRESS I, MILDRED M. SHELLER, of West Pennsboro Township, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. ONE: I direct my Co-Executors to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. TWO: I give, devise, and bequeath all of my estate of every nature and wherever situate as follows: a. To SHIRLEY C. SHEAFFER .......................................... 20%; b. To VIVIAN M. KUGLE ................................................. 20%; c. To JEAN E. RICHWINE ................................................ 20%; d. To DAVID L. SHELLER ................................................ 20%; e. To DANIEL GLENN RHOADS .................................... 6.67%; £. To RICHARD LEE RHOADS ....................................... 6.67%; g. To JASON POWELL RHOADS .................................... 6.67%. If any of the above named individuals have predeceased me, the share of said individuals will be distributed in equal shares to the living issue of said individuals. If RICHARD LEE RI-lOADS has predeceased me without living issue, his share will be divided equally by his brothers who survive me. THREE: I appoint my children, SHIRLEY C. SHEAFFER, VIVIAN M. KUGLE, JEAN E. RICHWINE and DAVID L. SHELLER, as Co-Executors of'this my Last Will. FOUR: My Co-Executors may, at their discretion, compromise claims, borrow money, retain property for such length of time as they may deem proper; lease and sell property for such prices, on such terms, at public or private sales, as they may deem proper; and invest estate property and income without restriction to legal investments. FIVE: No Co-Executors acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 28TM day of October, 1999. MILDRED M. SHELLER (SEAL) Signed, sealed, published and declared by MILDRED M. SHELLER, the above named Testatrix, as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other have subscribed our names as witnesses hereto. ACKNOWLEDGMENT AND AFFIDAVIT WE, MILDRED M. SHELLER, CHERYL L. CLELAND and MARTHA L. NOEL, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will, and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or undue influence. L. CLELAND COMMONWEALTH OF PENNSYLVANIA : : SS: COUNTY OF CUMBERLAND : Subscribed, swom to and acknowledged before me by, MILDRED M. SHELLER, the testatrix herein and subscribed and sworn to before me by CHERYL L. CLELAND and MARTHA L. NOEL, witnesses, this 28m day of October, 1999. Notarial Seal Betzi A. Morrison, Notary Public Carlisle Boro, Cumberland County My Commission Expires Dec. 15, 2000 Member, Pennsylvania Association oi' Notaries IV- HILl)RED lt. SHELLER LAW OFFICES IRWIN, MCKNIGHT & HUGHES WEST POMFRET PROFESSIONAL. BUILDING 60 WEST POMFRET STREET CARLISLE, PENNSYLVANIA 1701:3-3222 (717) 249-2353 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 003084 MCKNIGHT MARCUS A III 60 W POMFRET STREET CARLISLE, PA 17013 fold ESTATE INFORMATION: SSN: 189-09-4658 FILE NUMBER: 2103-0739 DECEDENT NAME: SHELLER MILDRED M DATE OF PAYMENT: 10/03/2003 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 07/05/2003 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $2,289.87 TOTAL AMOUNT PAID: $2,289.87 REMARKS: MARCUS MCKNIGHT ESQUIRE SEAL CHECK# 020307 INITIALS' VZ RECEIVED BY: DONNA M. OTTO DEPUTY REGISTER OF WILLS REGISTER OF WILLS REV- 1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE D E C E D E N T cAFB HpRL EpIO CRAC KOTK ES Co. DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME(LAST, FIRST, AND MIDDLE INITIAL) Sheller Mildred M. OFFICIAL USE ONLY I FILE NUMBER 21-03-0739 COUNTY CODE YEAR NU M B ER SOCIAL SECURITY NUMBER 189-09-4658 DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR} 07/05/2003 04/15/1915 ( F APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) THIS RETURN MUST BE FILED IN DUPUCATE W1TH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER  1. Original Return ~ 24i SupplementaIReturn 4. Limited Estate · Future Interest Compromise (date of death after 12-12:-82) 6. Decedent Died Testate Decedent Maintained a Living Trust (Attach copy of Will) (Attach copy of Trust) ~-]9. Litigation Proceeds Received I110. SpousaIPoverty Credit (date of death between 12-31-91 and 1-1-95) U (date of death 3. Remainder Return prior to 12-13-8:=) 5. Federal Estate Tax Return Required 0 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch O) NAME Marcus A. McKni~ht Esq. FIRM NAME (If Applicable) IRWIN & McKNIGF1T 717./249- 2353 COMPLETE MNLING ADDRESS 60 West Pomfret Street West Pomfret Professional Bldg. Carlisle, PA 17013 R E C A P I T U L A T I O N x T I O N 1. Real Estate (Schedule A) (1) None z. Stocks and Bonds (Schedule B) (2) None 3. Closely Held Corporation, Partnership or (3) None Sole -Proprietorship' 4. Mortgages & Notes Receivable (Schedule D) (4) None 5. Cash, Bank Deposits & Miscellaneous Personal Property ($) 6,618.99 (Schedule E) 6. Jointly Owned Property (Schedule F) (6) None ~ Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9t 13 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) 49,972.83 1,652.60 1,375.00 OFFICIAL USE ONLY (8) 56,591.82 (11) 3,027.60 (12) 53,564.22 (13) (14) 53,564.22 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax . rate, or transfers under Sec. 9116(a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 53,564.22 X .0 0 X .0 45 X .12 X .15 '(lS), , , o.oo (16) 2,410.39 (17) 0.00 (18). 0.00 (19) 2,410.39 Copyright (c) Z000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS 144A McAllister Church Road CITY STATE ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 120.52 (4) Total Credits ( A + B + C ) (2) 2,410.39 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 I Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Ente~ the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB) Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; ......................... b. retain the right to designate who shall use the property transferred or its income; ........... c. retain a reversionary interest; or .................................... d. receive the promise for life of either payments, benefits or care? ................... 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate c~nsideration? ................................ ['---] ~ 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? ................................ IXI I I IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN, 120.52 0.00 0.00 2,289.87 0.00 2,289.87 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. SIGNATUREOFPERSONRESPONSIBLEFORFILINGRETURN David L. Sheller DATE [ 131 Fern Avenue ........................... {9 .½c, / ~ _~/ / // 60 West Pomfret Street ~ ~ / J . ~ ~- --~%~l-fJig-~-Pk---i~i~ ........................... ~~ For dates o~ on or after JulyS994 and before Janua~ 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving2 P~)(~1)(i)]. For date~h on or aEer Janu~ 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. 9~A ~~tute does not exempt a tran~er to a surviving spouse from tax, and the statuto~ requirements for disclosure of assets and filin0 a tax return are still applicable even if the surviving spouse is the only beneficial. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twen~-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2) [72 P.S. 9116(aX 1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(aX1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. Copyright (c) 20~ form software only The Lackner Group, Inc. Form REV- 15~ EX (Rev. 6-00) ADDITIONAL Personal Representatives Estate of Mildred M. Sheller SS# 189-09-4658 07/05/2003 Under penalties of perjury, the undersigned declare that they have examined this return, including accompanying schedules and statements, and to the best of their knowledge and belief, it is true, correct and complete. Signature N~e Address Line 1 Address Line 2 City, State, Zip Date Shirley C. Sheaffer 144 McAllister Church Road Carlisle, PA 17013 REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mildred M. Sheller SS~/ SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY 189-09-4658 07/05/2003 FILENUMBER 21-03-0739 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 DESCRIPTION 1 M&T Bank, checking account TOTAL (Also enter on line 5, Recapitulation) VALUE AT DATE Of DEATH 6,618.99 6,618.99 (If more space is needed, insert additional sheets of the same size) Coovri(3ht (c~ 1996 form software only CPSystems, Inc, Form REV-1508 EX (Rev. 1-97) REV-1510 EX + (1-97) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mildred M. Sheller SS~/ 189-09-4658 07/05/2003 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. FILE NUMBER 21-03-0739 DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAMEOFTHETRANSFEREE, THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. NUMBER ATTACH A COPYOF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) 1 SunAmerica Financial - 49,972.83 49,972.83 annuity f/026850 TOTAL (Also enter on line 7, Recapitulation) $ 49,972.83 (If more space is needed, insert additional sheets of the same size) Copyrfght (c) 1996 form software only CPSystems. Inc. Form REV-I$10 EX (Rev. 1-97) REV- 1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mildred M. Sheller SS¢~ SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS 189-09-4658 07/05/2003 FILENUMBER 21-03-0739 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT 1 2 3 FUNERAL EXPENSES: Carlisle Memorial Service Hoffman~Roth Funeral Home ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: Attorney's Fees IRWIN & McKNIGHT 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 Cumberland Law Journal - Register of Wills filing fees The Valley Times Star - estate notice estate notice publication publication 125.00 301.60 1,000.00 72.00 vt 00 25.00 54.00 TOTAL (Also enter on line 9, Recapitulation) $ 1,652.60 (If more 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) REV-1512 EX, (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Mildred M. Sheller SS~/ SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS 189-09-4658 07/05/2003 FILENUMBER 21-03-0739 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT Chapel Pointe at Carlisle Omnicare Pharmacy TOTAL (Also enter on line 10, Recapitulation) $ 1,303.00 72.00 1,375.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV~ 1513 EX +(9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Mildred M. Sheller SS~/ 189-09-4658 07/05/2003 21-03-0739 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE 4 II. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1,2)] Vivian M. Kugle 414 Swatara Street Steelton, PA 17113 Daniel G. Rhoads 1214 Centerville Road Newville, PA 17241 Jason P. Rhoads 11 Chestnut Street Newville, PA 17241 Richard L. Rhoads 117 N. Middlesex Road Carlisle, PA 17013 Jean E. Richwine 101 Skyline Drive Mechanicsburg, PA 17050 Daughter Grandson Grandson Grandson Daughter 20% 6.67% 6.67% 6.67% 2O% 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 $ 0 . 00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) Estate of: Mildred M. Sheller Soc Sec #: 189-09-4658 Date of Death: 07/05/2003 Continuation of Schedule J, Part (Taxable Bequests) Item Name and Address of Beneficiary Relationship Amount or Share of Estate Shirley C. Sheaffer 144 McAllister Church Road Carlisle, PA 17013 David L. Sheller 131 Fern Avenue Carlisle, PA 17013 Daughter Son 20% 20% 1..,4 $ 7' ~I1..1.. ,4ND rES 7',,~4E'N 7' I, MILDRED M. SHELLER, of West Pennsboro Township, Cumberland County, Pennsylvania, declare this instrument to be my Last Will and Testament, hereby expressly revoking all Wills and Codicils heretofore made by me. ONE: I direct my Co-Executors to pay all of my debts, funeral and administrative expenses as soon as may be done conveniently after my decease. TWO: I give, devise, and bequeath all of my estate of every nature and wherever situate as follows: a. To SHIRLEY C. SHEAFFER .......................................... 20%; b. To VIVIAN M. KUGLE ................................................. 20%; c. To JEAN E. RiCHWiNE ................................................ 20%; d. To DAVID L. SHELLER ................................................ 20%; e. To DANIEL GLENN RHOADS .................................... 6.67%; f. To RICHARD LEE RHOADS ....................................... 6.67%; g. To JASON POWELL RHOADS .................................... 6.67%. If any of the above named individuals have predeceased me, the share of said individuals will be distributed in equal shares to the living issue of said individuals. If RICHARD LEE RHOADS has predeceased me without living issue, his share 'will be divided equally by his brothers who survive me. THREE: I appoint my children, SHIRLEY C. SHEAFFER, VIVIAN M. KUGLE, JEAN E. RICHWINE 'and DAVID L. SHELLER, as Co-Executors of this my Last Will. FOUR: My Co-Executors may, at their discretion, compromise claims, borrow money, retain property for such length of time as they may deem proper; lease and sell property for such prices, on such tc~s, at public or private sales, as they may deem proper; and invest estate property and income without restriction to legal investments. FIVE: No Co-Executors acting hereunder shall be required to post bond or enter security in this or any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal this 28TM day of October, 1999. MILDRED M. SHELLER (SEAL) Signed, sealed, published and declared by MILDRED M. SHELLER, the above named Testatrix, as and for her Last Will and Testament, in the presence of us, who, at her request and in her presence and in the presence of each other have subscribed our names as witnesses hereto. ACKNOWLEDGMENT AND AFFIDAVIT WE, MILDRED M. SHELLER, CHERYL L. CLELAND and MARTHA L. NOEL, the testatrix and witnesses respectively, whose names are signed to the foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the testatrix signed and executed the instrument as her Last Will, and that she had signed willingly, and that she executed it as her free and voluntary act for the purpose herein expressed, and that each of the witnesses, in the presence and hearing of the testatrix, signed the Will as a witness and that to the best of their knowledge the testatrix was, at that time, eighteen years of age or older, of sound mind and under no constraint or {indue influence. M LDR-ffD-M. SIiEI LER dHERY L. CLELAND ' L. OEL COMMONWEALTH OF PENNSYLVANIA : : SS: COUNTY OF CUMBERLAND : Subscribed, sworn to and acknowledged before me by, MILDRED M. SHELLER, the testatrix herein and subscribed and sworn to before me by CHERYL L. CLELAND and MARTHA L. NOEL, witnesses, this 28TM day of October, 1999. Notarial Seal Betzi A. Morrison, Notary Public Carlisle Boro, Cumberland County My Commission Expires Dec. 15, 2000 Member, Pennsylvania Association of Notaries SunAmerica Life Insurance Company I~LX ed Annuity Administration P.O. Box 9006 Amarillo, TX 79105-9006 SunAmerica Financial Augustl2,2003 Shirley Scheaffer 144 McAllister Church Road Carlisle, pA 17013 Re~ Deceased: Mildred Sheller Supplemental Policy Number: Reference #: A637124990A Dear Ms. Sheaffer: 02685O We are sorry to learn of the death of your mother, Mildred Sheller. We wish to extend our sympathy to you and your family. According to the terms of the contract, this was a Life policy with Installment Refund. Mildred Sheller elected this option effective November 6, 2002 with a contract value in the amount of $49,972.83. Mildred Sheller received payments in the amount of $540.68 monthly from November 6, 2002 through July 6, 2003, which equals a total of 9 payments for a total value of $4,866~ o 12 disbursed to Mildred Sheller. This policy only allows for an Installment refund to the beneficiary only if the contract value ($49,972.: 83) applied to provide the annuity is greater than the total amount of annuity pafftments issued ($4, 866.12) to the annuitant. The balance of the amount applied remaining for this contract is'~5,106.71. Since the total amount of payments disbursed does not exceed the contract value that was applied to provide for the contract, payments of $54.~8 will continue to the beneficiary, David Sheller (son) in installments as sc'heduled until the balance of the amount applied for this contract is exhausted. To enable us to process the necessary changes in this policy, please have the beneficiary(ies) complete the highlighted sections(A-D, F on page $, G) on the enclosed Death Claim form and sections (A and F) of the Change qfOwnership/Beneficiary form. Please return the completed forms in the enclosed business reply envelope. Meanwhile, we have placed this policy in a non-paying status until we have received all of the required documents from the beneficiary(ies). Should you need furhhera~Lan~.e,~: .... please do -,,ot ~',,eo,[at,.~:~ ~ *Lo call our toll-flee number, 1-888-333-2349 to speak with a representative in our Customer Care Unit. We appreciate this opportunityT6 serve you. Sheila Lockridge, Claims Analyst SunAmerica Life Insurance Company Sun America Life Insurance Company · Anchor National Life Insurance Company First SunAmerica Life Insurance Company · Administrator for The Central National Life Insurance Company of Omaha Administrator for John Alden Life Insurance Company Member of American International Group, Inc. 499 Mitchell Road, Millsboro, DE 19966 Mail Code 501-120 Irwin, McKnight & Hughes Attorneys At Law West Pomfret Prof. Bldg. 60 West Pomfret Street Carlisle, PA 17013-3222 Re: Estate of Mildred M. Sheller Social Security: 189-09-4658 Date of Death: duly 5, 2003 Phone (302)934-2909 Fax (302)934-2955 August26,2003 AUG 2 9 200g Dear Sir or Madam: Per your inquiry dated August 5, 2003, please be advised that at the time of death, the above-named decedent had on deposit with this bank the following: Type of Account Checking Account Account Number 436887 Ownership ~ames oJ) Mildred M. Sheller, Owner Shirley C Scheaffer, POA Opening Date 09/01/67 Balance on Date of Death $6,618. 99 Accrued Interest $ O. O0 Total $6,618. 99 (302) 934-2909 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND Shirley C. Sheaffer and David L. Sheller being duly sworn according to law, deposes and says that them are the Co-Executors of the Estate of Mildred M. Sheller late of West Pen_npb~oro~ Township ., Cumberland County, Pa., deceased and that the within is an inventory made by them , the said Co-Executors of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. ~:~[~ ~ ~.~. ~ Jacqueline L Drawbaugh, Notary Public My ~ Expires Aug. 14, 2007 Dav~idhirley Cd Sheaffer ! ~ · ' $ ~¢ufor - Ad'm~'~nis'frefor -144 McAllister Church Rd., Carlisle, 131 Fern Avenue, Carlisle, PA 17013 PA 17013 Address Member, Penmy~a~ ~ O~ Nota~ Date of Death 5th July 2003 Day Month Year INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal represenfaflve. 2. A supplement inventory must be filed wifhln thirty days of discovery of additional assets. 3. Addlflonal sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. , 0 'O Inventory of the real and personal estate of MILDRED M. SHELLER deceased M&T BANK, CHECKING ACCOUNT $6618 99 IN RE: ESTATE OF MILDRED M SHELLER, DECEASED BEFORE THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PEN NSYLVAN IA NO. 21-03-739 ORDER OF THE REGISTER OF WILLS AND NOW, This 17th day of October, 2003, Letters of Administration having been granted September 9, 2003 to Shirley C. Scheaffer and David L Sheller in the Estate of the above-named Decedent, and the instrument dated October 28, 1999, having been admitted to probate as the last Will of the above-named Decedent, it is hereby ordered that the Letters of Administration which were Granted September 9, 2003, to the aforementioned Shirley C Scheaffer and David L Sheller are hereby revoked. Date Donna M Ott~ 1 Deputy (') ~// Acting Register of Wills '-" COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD OO3691 HARSHBARGER MARY ANN 40 WILLIAM PENN DRIVE CAMP HILL, PA 17011-6669 ........ fold ESTATE INFORMATION: SSN: 207-07-8509 FiLE NUMBER: 2102-0739 DECEDENT NAME: CARSON OPAL M DATE OF PAYMENT: 03/17/2004 POSTMARK DATE: 03/03/2004 COUNTY: CUMBERLAND DATE OF DEATH: 08/08/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $66.42 RiEMARKS: SEAL CHECK# 1225 TOTAL AMOUNT PAID: $66.42 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS MILDRI~D H. S~'.L,~.R 4b q' LAW OFFICES IRWIN, McKNIGHT & HUGHES WEST POMFRET PROFESSIONAL BUILDING 60 WEST POMFRET STREET CARLISLE, PENNSYLVANIA 17013-3222 ( 717 ) 249-2353 BUREAU OF ZNDZVZDUAL TAXES /NHER/TANCE TAX D/VISTON DEPT. 28060! HARRTSBURG, PA 1712&-0601 COHHONWEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE NOTZCE OF ZNHERZTANCE TAX APPRAZSEMENT, ALLORANCE OR DZSALLO#ANCE OF DEDUCTZONS AND ASSESSMENT OF TAX RE¥-16~i? EX AFP C01-05) MARCUS A MCKNIGHT ESQ IRWIN & MCKNIGHT 60 W POMFRET ST CARLISLE PA 17615 DATE 11-17-2005 ESTATE OF SHELLER DATE OF DEATH 07-05-2005 FZLE NUHBER 21 05-0759 COUNTY CUHBERLAND ACN 101 Amoun'l: Remi 'l:'lced MILDRED H HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF WILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THZS LZNE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS 4 REV-1547 EX AFP (01-03) NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLOWANCE OR DZSALLOWANCE OF DEBUCTZONS AND ASSESSHENT OF TAX ESTATE OF SHELLER MILDRED HFZLE NO. 21 05-0759 ACN 101 DATE 11-17-2005 TAX RETURN #AS: ( X} ACCEPTED AS FZLED ( } CHANGED RESERVATZON CONCERNZNO FUTURE ZNTEREST - SEE REVERSE APPRAZSEB VALUE OF RETURN BASED ON: ORIGINAL RETURN I Real Es~a~a (Schedule A) 2 S*ocks end Bonds (Schedule B) 3 Closely Held S~ock/Per~nershlp In~aras~ (Schedule C) ~ Nor~geges/No~as Receivable (Schedule D) 5 Cash/Bank Deposi~s/M/sc. Personal Propar~y (Schedule E) 6 Jo/n~ly Owned Propar~y (Schedule F) 7 Transfers (Schedule G) 8 To,al Asse~s APPROVED DEDUCTZONS AND EXEMPTZONS: 9. Funara! Expenses/Ada. Cos~s/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabi11~/es/L/ens (Schedule 1) 11. To,al Deduc~/ons 12. Na~ Value of Tax Re~urn (1) (2) (3) (~) (5) (6) 6/618.99 .00 (7) {9) .00 NOTE: To insure proper .00 cradi~ ~o your account, .00 subm/~ ~ha upper por~/on .00 of ~h/s fora w/~h your ~ax payment. 1,652.60 (10) 1,$75.00 (11) 3.027.60 (12) 53,56~.22 19. Pr/nc/ TAX CREDZTS PAYIIENT DATE 10-05-2005 13. li. NOTE: ASSESSHENT OF TAX: 15. Amoun~ of L/nB lq a~ Spousal ra~e 16. Amoun~ of L/ne Ii ~axabla a~ Lineal/Class A re~a 17. Aaoun~ of L/ne lq a~ S/bl/ng ra~e 18. Aaoun~ of L/no lq ~axabla a~ Collateral/Class B re~e )el Tax Duo (15) .00 x O0 = .00 (16) 53,56~.22 x 0~5 = 2,~10.$9 (17) .00 x 12 = .00 (18) .00 x 15 = .00 (19)= 2,~10 .$9 Cher/~able/Governaen~al Bequests; Non-alac'l:ad 9113 Trusts (Schedule J) (13) . O0 No*i: Value of Es~a~e Subjec~ ~o Tax (1fi) 55,56q.ZZ Zf an assess;ant ~as issued previously, 11nas 1~, 15 and/or 16, 17, 18 and 19 reflect figures that include the total o~ ALL returns assessed to date. K~CE~PT NUMBER CDOO$O8R ~F PAZD AFTER DATE ZNDZCATED, SEE REVERSE FOR CALCULATZON OF ADD/T[ONAL ZNTEREST. DISCOUNT (+) ZNTEREST/PEN PAZD (-) 120.52 AHOUNT PAZD 2,289.87 TOTAL TAX CREDZT BALANCE OF TAX DUEI ZNTEREST AND PEN. TOTAL DUE Z,fi10.~9 .00 .00 .0O ( 1F TOTAL DUE ZS LESS THAN $1, NO PAYMENT 1S RE~UZRED. ZF TOTAL DUE 13 REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE S/DE OF TH/S FORH FOR ZNSTRUCTIONS.) R91972.85 (8) 56,591.82 RESERVATION: PURPOSE OF NOTICE: PAYNENT: REFUND OBJECTIONS: ADNIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 1Z) 198Z -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for iifa or for years) the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the lawful Class B (collateral) rate on any such futura interest. To fulfill the requirements of Section ZlqO of the Inheritance and Estate Tax Act, Act Z$ of ZOO0. (TI P.S. Section 91~0). Detach the top portion of this Notice and submit with your payment to the Register of #ills printed on the reverse side. --Hake check or money order payable to: REGISTER OF NZLLS, AGENT A refund of a tax credit) which was not requested on the Tax Return) may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1315). Applications are available at the Office of the Register of #ills, any of the 25 Revenue District Offices, or by calling the special Zq-hour answering service for forms ordering: 1-800-56Z-ZOSO; services for taxpayers with special hearing and / or speaking needs: 1-800-~7-50Z0 (TT only). Any party in interest not satisfied with the appraisement) allowance) or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZI) Harrisburg) PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative) OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit) Dept. gE0601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6SOS. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) 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 (SI) discount of the tax paid is allowed. The 1SI 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 end 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 (l) day from the date of death, to the date of payment. Taxes which became delinquent before January l) 198Z bear interest at the rate of six (6X) percent par annum calculated at a dally rate of .00016q. All taxes which became delinquent on and after January 1, 198Z will bear interest at a rate #hJch will 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 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Year Rate Factor 198Z ZOZ .0005q8 1987 9Z .O00gq? 1999 7Z .000192 1983 16Z .000~38 1988-1991 IIZ .000301 ZOO0 8Z .000219 198q IIZ .000301 199Z 9Z .000Z47 ZOO1 9Z .O00Zq7 1985 132 .000356 1993-199q 72 .O0019Z gOOZ 62 .O0016q 1986 IOZ .O00Z?q 1995-1998 9Z .O00Zq7 ZOO3 5Z .000137 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DELINQUENT X DALLY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (IS) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Estate No.: MILDRED M. SHELLER JULY 5, 2003 21-03-0739 To the Register: I certify that notice of the beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on October 1, 2003 Name Address Shirley C. Sheaffer 144 McAllister Church Road, Carlisle, PA 17013 Vivian M. Kugle Jean E. Richwine David L. Sheller Daniel G. Rhoads 414 Swatara Street, Steelton, PA 17113 101 Skyline Drive, Mechanicsburg, PA 17050 131 Fern Avenue, Carlisle, PA 17013 1214 Centerville Road, Newville, PA 17241 Richard L. Rhoads Jason P. Rhoads 117 N. Middlesex Road, Carlisle, PA 17013 11 Chestnut Street, Newville, PA 17241 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none . Date: 12/17/03 d~~/~/ ~'~~ & McaTt IRWIN Name Marcus A. McKnight III, Esquire Address 60 West Pomfret Street Carlisle, PA 17013 Telephone (717) 249-2353 Capacity: X __ Personal Representative __ Counsel for Personal Representative STATUS REPORT UNDER RULE 6.12 Name of Decedent: Date of Death: No. 21-03-0739 MILDRED M. SHELLER JULY 5, 2003 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: X Yes __ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes X No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? X Yes No Date: 12/19/03 d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of Orphan'sdrourt and may be attached tO this report. S~g /~ ~/') ~/C / ~'-"~~ /'"'~/, ~ 5~,, t IRWIN & McKNIGHT - Marcus A. McKnight IH, Esquire · ' Name (please type or print) 60 West Pomfret Street Address Carlisle, PA 17013 ~' City, State, Zip (717) 249-2353 Telephone Number Capacity: X Personal Representative Counsel for Personal Representative JUREAU OF TNDZV~.~[x~.~.L TAXES TNHERZTANCE TAX ~)ZVTSrON DEPT, 280601 HARRZSBURG, PA ].7128-0601 JASON H HARSHBARGER 1510 CHATHAN RD CANP HZLL RUT ALON; ~' PA 17011 COHHONWEAL?H OF PENNSYLVANZA DEPARTHENT OF REVENUE NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTZONS AND ASSESSHENT OF TAX RE¥-IE~i7 EX &FP (01 05-01-2004 CARSON 08-08-2002 21 02-0759 CUHBERLAND 101 Amoun~ Remi~ed OPAL HAKE CHECK PAYABLE AND RENZT PAYHENT T; REGZSTER OF Wl'LLS CUHBERLAND CO COURT HOUSE ,,u-q ( CARLZSLE, PA 1701:5 -- 296! 'Z! - Mr. Harold E. Harshbarger 40 Wn Penn Dr. Camp Hill, PA 17011 Zip Code PA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG PA 17128-0601 h,,llh,,h,,Ih,hlh,hlh,,,Ih,lh,,,,,Ihh,