HomeMy WebLinkAbout03-0794Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of HIRSCHMAN, Clara J
also known as
, Deceased
Social Security No. 275034219
Alice Rose Heefner and Sharon E. Donfrio, f/k/a Sharon Elaine Schaefer
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 Petitioner(s) is/are the execut rices
r~ Decedent, dated 8/5/1982 and codicil(s) dated
Harold HIrschman died September 26, 1999
named in the Last Will of the
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 the victim of a killing and was never adjudicated incapacitated:
B. Grant of Letters of Administration
(c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse
(if any) and heirs:
Name Relationship Residence
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal
residence at Shippensbur.q Health Care Center, Shippensbur,q Township, Cumberland County, 121 Walnut Bottom Road
(list street, number and municipality)
Decedent, then 86 years of age, died September 20 ,2003, at 121 Walnut Bottom Road, Shippensbur.q, Pa
(Location)
Decedent at death owned property with estimated values as follows:
(if domiciled in PA) All personal property ......................................... $
(if not domiciled in PA) Personal property in Pennsylvania .................... $
(If not domiciled in PA) Personal property in County .............................. $
Value of real estate in Pennsylvania ........................................................................................ $
Total ..................................................................................................................... $
800~000.00
800,000.00
Real Estate situated as follows:
none
Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in
the appropriate form to the undersigned:
Signature
Typed or printed name and residence
Alice Rose Heefner
3836 Pine Grove Road, Bi,cjlerville PA 17307
Sharon E Donfrio, formerly Sharon Elaine Schaefer
11761 Maqnolia Falls Dr, Jacksonville FL 32258
RW-7
Oath of Personal Representative
Commonwealth of Pennsylvania
County of umberland
The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent,
Petitioner(s) will well and truly administer the estate ac_cording to la.~.
Sworn to and affirmed and subscribed
Alice R...ose/~eefner
before me this 1st da, o,
October, 2003
~~'/~'~ (.~ar~n Elaine-Schaefer '"-~- ~'
DECREE OF REGISTER
Estate of HIRSCHMAN, Clara J
also known as
Cumberland County, Pennsylvania
Deceased
No.
Social Security No: 275034219 Date of Death: 9/20/2003
AND NOW, October / , 2003 , in consideration of the Petition
on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters I~1 Testamentary [~ of Administration
(c.t.a., d.b.n.c.t.; pendente lite; durante absentia; durante minoritate)
are hereby granted to Alice Rose Heefner and Sharon E Donfrio formerly Sharon E Schaefer
in the above estate and that the instrument(s), if any, dated
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters .................................... $
Short Certificate(s) ............... $
Renunciation .......................... $
Affidavit ( ) ....................... $
Extra Pages ( ) .............. $
Codicil ................................. $
JCP Fee ................................. $
Inventory & Tax Forms ............. $
Other ...................................... $
TOTAL ............................. $
RW-7A
10.00
- F~egis!er of V~lls .... ~"
Forest N Myers, Esquir~~:~---
Attorney:
I.D. No: 18064
Address: 137 Park Place West
Shippensburg
Telephone: 717 532-9046
PA 17257-9212
DATE FILED:
his is to certify that the info~'mation here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 9450082
No.
~oocal Registrar
TYPE/PR/NT
PERMANENT
COMMONWEALTH OF PENNSYLVANIA o DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
Clara J. Hirschman ,.Female 3. 275 ~ 03 --4219 4. 9-20-03
. ~ ~ c ~ ~O.~. ~ '
~ Cmberland , ~~.~, . ~ ~ ~ ~ ~.~o~.~, ~ite
'
(G~ ~ ~k ~ ~ U.S. ~D F~ES? I (~h~c~ ~ ST~US - ~ I ~V~ S~
~u~ ,~.~ · ,~,.~ ~.~ Shippensburg Twp.
121 Walnut Bottom Road
,~hippensburg, PA 17257
I
Joseph Albert ],.. Alice Meeke
~. alice H. Heefner [~. 3836 Pine Grove Road Bi~lerville, PA 17307
_ ~ ~[,m.9-28-03 [,~ St. Joseph Cemetery [,,, Loc~ourne, OH 43137
I-. //
I
I
.............................................................
WILL
OF
CLARA JOSEPHINE HIRSCHMAN
I, CLARA JOSEPHINE HIRSCHMAN, of Cumberland County, Pennsylvania,
declare this to be my will and hereby revoke all prior wills and codicils
made by me.
1. Personalty. I bequeath to my husband, Harold Hirschman, all of my
tangible personal property not used in business or for the production of
income, including without limitation furniture, furnishings, clothing,
jewelry, objects of art and decoration, and the like, and any motor vehicles
which I own, together with the insurance thereon, if he survives me. If my
husband does not survive me, then I bequeath all said property, together
with the insurance thereon, to my issue, Alice Rose Heefner and Sharon Elaine
Schaefer, per stirpes. If my issue are not all competent adults, or if they
cannot agree on the divisions, then my executor(s) shall make the division,
and may sell any items passing hereunder and distribute the proceeds.
2. Residue. I bequeath, devise, and appoint all the rest of my prop-
erty, of whatever nature and wherever situated, including property over
which I hold a power of appointment, except that I do not exercise any
power of appointment given to me by my husband, to my husband, Harold
Hirschman, if he survives me, or, if he does not survive me, per stirpes to
my issue.
3. Survival. If any beneficiary should die within sixty (60) days
after me, then he shall be deemed to have predeceased me for all purposes
of this will.
4. Spendthrift Clause. No interest of any beneficiary hereunder
shall be subject to anticipation, pledge, assignment, sale or transfer in
any manner, nor shall any beneficiary have power in any manner to charge or
encumber his interest, nor shall the interest of any beneficiary be liable
or subject in any manner while in the possession of my fiduciaries for any
liability of such beneficiary, whether such liability arises from his
debts, contracts, torts, or other engagements of any type.
5. Facility of Payment for Minors or Incompetents. Any amounts or
assets which are payable or distributable to a minor or incompetent
hereunder may, at the discretion of my fiduciaries, be paid or distributed
to the parent or guardian of such minor or incompetent, to the person with
whom such minor or incompetent resides, or directly to such minor or incom-
petent, or may be applied for the use or benefit of such minor or incom-
petent.
6. Powers. In addition to such other powers and duties as may be
granted elsewhere herein or which may be granted by law, my fiduciaries
hereunder shall have the following powers and duties, without the necessity
of notice to or consent of any court:
(a) To retain all or any part of my property, real or per-
sonal, in the form in which it may be held at the time of its
receipt, including any closely held business in which I have an
interest and the stock of any corporate fiduciary hereunder, as
long as in the exercise of their discretion it may be advisable so
to do, notwithstanding that said property may not be of a
character authorized by law.
- 2 -
(b) To invest and reinvest any funds held hereunder in any
property, real or personal, including, but not by way of limita-
tion, bonds, preferred stocks, common stocks and other securities
of domestic or foreign corporations or investment trusts, mortga-
ges or mortgage participations, mutual funds with or without sales
or redemption charges, and common trust funds, even though such
property would not be considered appropriate or legal for a fidu-
ciary apart from this provision.
(c) To sell, convey, exchange, partition, give options to
buy or lease upon, or otherwise dispose of any property, real or
personal, at the time held by them, at public or private sale or
otherwise, for cash or other consideration or on credit, and upon
such terms and for such price as they may determine, and to convey
such property free of all trusts.
(d) To borrow money from any person, including any fiduciary
hereunder, for any purpose in connection with the administration
hereof, to execute promissory notes or other obligations for
amounts so borrowed, to secure the payments of such amounts by
mortgages or pledges of any property, real or personal, which may
be held hereunder.
(e) To make loans, secured or unsecured, in such amounts,
upon such terms, at such rates of interest, and to such persons,
firms, or corporations as they may deem advisable.
- 3-
(f) To renew or extend the time for payment of any obliga-
tion, secured or unsecured, payable to or by them as fiduciaries,
for as long a period or periods of time and on such terms, as they
may determine, and to adjust, settle, and arbitrate claims or
demands in favor of or against them.
(g) In dividing or distributing any property, real or per-
sonal, included herein, to divide or distribute in cash, in kind,
or partly in cash and partly in kind.
(h) Without limitation of powers elsewhere granted therein,
to hold, manage and develop any real estate which may be held by
them at any time, to mortgage any such property in such amounts
and on such terms as they may deem advisable, to lease any such
property for such term or terms and upon such conditions and rent-
als as they may deem advisable, whether or not the term of any
such lease shall exceed the period permitted by law or the prob-
able period of retention under this instrument; to make repairs,
replacements and improvements, structural or otherwise, in connec-
tion with any such property, to abandon any such property which
they may deem to be worthless or not of sufficient value to warrant
keeping or protecting, and to permit any such property to be lost
by tax sale or any other proceedings.
(i) To employ such brokers, banks, custodians, investment
counsel, attorneys, and other agents, and to delegate to them such
duties, rights and powers as they may determine, and for such
periods as they think fit.
-4-
(j) To register any securities at any time in their own
names, in their names as fiduciary, or in the names of nominees,
with or without indicating the trust character of the securities
so registered.
(k) With respect to any securities forming a part of the
trust, to vote upon any proposition or election at any meeting of
the corporation issuing such securities, and to grant proxies,
discretionary or otherwise, to vote at any such meeting; to join
or become a party to any reorganization, readjustment, merger,
voting trust, consolidation or exchange, and to deposit any such
securities with any committee, depository, trustee or otherwise,
and to pay out of the assets held hereunder, any fees, expenses
and assessments incurred in connection therewith, to exercise con-
version, subscription or other rights, and to receive or hold any
new securities issued as a result of any such reorganization,
readjustment, merger, voting trust, consolidation, exchange or
exercise of conversion, subscription or other rights and generally
to take all action with respect to any such securities as could be
taken by the absolute owner thereof.
(1) To engage in sales, leases, loans, and other transac-
tions with the estate of my husband or any trust established by
either of us, even if they are fiduciaries or beneficiaries
thereof.
(m) To exercise all elections which they may have with
respect to income, gift, estate, inheritance and other taxes,
- 5-
including without limitation execution of joint income tax
returns, election to deduct expenses in computing one tax or
another, election to split gifts, and election to pay or to defer
payment of any tax, in all events without their being bound to
require contribution from any other person.
(n) To operate, own, or develop any business or property
held hereunder in any form, including without limitation sole
proprietorship, limited or general partnership, corporation, asso-
ciation, tenancy in common, condominium, or any other, whether or
not they have restricted or no management rights, as they in their
discretion think best.
7. Taxes. I direct that all estate, inheritance, and succession
taxes that may be assessed in consequence of my death, of whatever nature
and by whatever jurisdiction imposed, other than generation-skipping taxes,
shall be paid out of the principal of my general estate to the same effect
as if said taxes were expenses of administration, except that any such
additional taxes (and interest and penalties thereon) imposed on account of
my interest in or power over any trust established by my husband shall be
paid out of the property held in such trust, and all other property inclu-
dible in my taxable estate for federal or state tax purposes, whether or
not passing under this will, shall be free and clear thereof; provided,
however, that my executor(s) may in the discretion of my executor(s)
request that any portion or all of said taxes (to be paid out of the prin-
cipal of my general estate) shall instead be paid out of the principal of
- 6-
any trust established by me, to the extent expressly authorized under the
terms of said trust.
8. Fiduciaries. I appoint as executor hereunder my husband, Harold
Hirschman, of Cumberland County, Pennsylvania. If he should be unwilling
to serve to the complete the administration of my estate, then Alice Rose
Heefner of Biglerville, Adams County, Pennsylvania, and Sharon Elaine
Schaefer of Downers Grove, DuPage County, Illinois, shall serve as co-
executrices in his place. My executor, or co-executrices as the case may
be, shall serve as guardian of the property of any minor beneficiaries
hereunder, under any instrument of trust executed by me, under any policies
of insurance on my life, and in any other situation in which the power to
make such appointment exists under the laws of Pennsylvania. No indivi-
dual fiduciary shall be liable for the acts, omissions or defaults of any
agent appointed and retained with due care or of any co-fiduciary. No
fiduciary named herein shall be required to furnish bond or other security
for the proper performance of his duties hereunder.
9. Gender. Unless the context indicates otherwise, any use of mascu-
line gender herein shall also include the feminine gender.
IN WITNESS WHEREOF, I, CLARA JOSEPHINE HIRSCHMAN, herewith set my hand
to this, my last Will, typewritten on nine (9) sheets of paper including
- 7 -
the self-proving attestation clause and signatures of witnesses, this
day of .~~-- , 1982.
CLAR~/]~SEPHINE HIRSCHMAN
Witnessed:
~ '~ · 0 ~ residing
COMMONWEAL~ OF PENNSYLVANIA :
: SS:
:
CLARA JOSEPHINE HIRSCHMAN (the testatrix), '~. '£¥ ~[7. *.'
/~.~r,~' ~ i~ ~,'c~ , and f~A':~ ~. [d/~.'~,~ (the witnesses),
whose names are signed to the foregoing instrument, being first duly sworn,
each hereby declares to the undersigned authority that the testatrix signed
and executed the instrument as her last will in the presence of the wit-
nesses and that she had signed willingly, and that she executed it as her
free and voluntary act for the purposes therein expressed, and that each of
the witnesses, in the presence and hearing of the testatrix, signed the
will as witness and that to the best of his knowledge the testatrix was at
that time eighteen years of age or older, of sound mind and under no
constraint or undue influence.
WITNESS:
TESTATRIX:
-8-
WITNESS:
WITNESS:
Subscribed, sworn to and acknowledged before me by CLARA JOSEPHINE HIRSCHMAN,
the testatrix, and subscribed and sworn to before me by ~ _i. in~,~ ,
(SEAL)
ALLYN 4. LITZEI. M^N ~OIARY PUBLIC
My Commissio~ Exmre~. Seoi. 23 1985
Harrisburg, Pa. oa-phin ¢(m~t]~
-9 -
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent:
Date of Death:
Estate No.:
To the Register:
Clara J Hirschman
September 20, 2003
21-03-0794
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
October 06, 2003.
Name Address
Alice Rose Heefner
Sharon Elaine Donfrio
3836 Pine Grove Rd, Biglerville PA 17307
11761 Magnolia Falls Dr, Jacksonville FL 32258
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None.
Forest N Myers, Esquire
Attorney I.D. #18064
137 Park Place West
Shippensburg PA 17257
Phone 717.532.9046
Fax 71 7.532.8879
e-mail fnmyers@earthlink.net
Capacity: _X Counsel for Personal Representative
LAW OFFICE
November 24, 2003
FO~ES? N. MY~:~s
137 Park Place West, Shippensburg,
Pennsylvania 17257
717/532-9046
Fax 717/532-8879
fnmyers@earthlink.net
Mary C Lewis, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle PA 17013
Re;
HIRSCHMAN, Clara J, deceased
Estate No. 21-03-0794
Dear Ms Lewis:
Enclosed is Check No. 102 of the Estate of Clara J Hirschman in the amount of $36,000.00
as advance payment on the above estate account.
Please return the receipt to me.
I also enclose my check in the amount of $6.00 for two short certificates in the Margaret
Hinkle Estate.
Sincerely,
Forest N. Myers
FNM/ash
Loo~for u~ on the ~ve5 at forestmyers.lawoffice.com
LAW OFFICE
SHIPPENSBURG, PA 17;=57
137 PARK PLACE WEST
I,,,111,,,111,,,,,,11,,11,1,,I,I
Mary C Lewis, Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle PA 17013
i,,,ili,,,lij ...... li,,Ji,,,li,,,iJ,Ii ......
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 O03287
MYERS FOREST N ESQ
137 PARK PLACE WEST
SHIPPENSBURG, PA 17257
........ fold
ESTATE INFORMATION: SSN: 275-03-4219
FILE NUMBER: 2103-0794
DECEDENT NAME: HIRSCHMAN CLARA J
DATE OF PAYMENT: 11/26/2003
POSTMARK DATE: 11/25/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 09/20/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $36,000.00
TOTAL AMOUNT PAID:
$36,000.00
REMARKS: ALICE HEEFNER&SHARON DONFRIO
C/O FORREST N MYERS ESQUIRE
SEAL
CHECK# 102
INITIALS: JA
RECEIVED BY:
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
~11-1 OF PENNSYLVANIA
DEPARTMENT OF REVEMJE
DEPT. 280~1
~, PA 17128.-0~01
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21
COUNTY CODE
0FFIC ~L USE C, NL ~'
03 00794
YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Hirsehman, Clara J
275-03-4219
DATE OF DEATH (;.',;.', DD--YEAR) DATE OF BIRTH (MM,~)D-YEAR)
· 'tNIS RETURN MUST BE FILED IN DUPUCATE WTFH THE
09/20/2003 01/14/1917
REGISTER OF WILLS
IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
[] [] 2. SupplementelRetum
[] []4a. Future Interest Compromise (date o~ deat~ alter
12-12-82)
[] [] 7. Decedent Maintained a Living Trust (At~ac~
ce~y o~ Trust)
12-31-91 and 1-1-95)
1. C.~it.al Retum
4. limited Estate
6. Decedent Died Testete (Attach cow
of Wa)
9. Litigation Proceeds Received
] 3. Remainder Retum (date of death pdor to 12-13-82)
[] 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
[] 11.ElecfiontotaxunderSec. 9113(A)(AttachSchO)
NAME
Forest N Myers
;IRM NAME (If appicable)
Law Offices of Forest N Myers
tELEPHONE NUMBER
717/532-9046
COMPLETE MAILING ADDRESS
137 Park Place West
Shippensburg, PA 17257
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
Net Value of Estate (Line 8 minus Line 11)
(2)
None
719,159.28
None
None
203,679.24
None
None
65,889.35
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Properly (Schedule F) (6)
[] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12.
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
OFFICI,&L USE OlXlLY
(8)
922,838.52
65,889.35
856,949.17
856,949.17
(11)
(12)
(13)
(14)
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)
x .iN)
(15)
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
856,949.17
20. []
x .045
x .12
x .15
(16)
(17)
(18)
(19)
38,563.00
38,563.00
>> BE 81JRE TO ANSWER ALL QUESTION8 ON REVER~E ~ AND RECHECK MATH <<
Copyright 2000 form sofiware only The Lacknsr Group, Inc. Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
crr¥ Shippensburg
STATE PA ZIP 17257
Shippensburg Health Care Center
121 Walnut Bottom Road
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
36,000.00
1,895.00
Total Credits (A + B + C) (2)
(1) 38,563.00
37,895.00
0.00
668.00
668.00
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. (4)
Check box on Page I Line 20 to request a refund
5. If Line I + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF VVILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACIHG AN "X" IN THE APPROPRIATE BLOCKS
Did decedent make a transfer and: Yes No
b. retain the right to designate who shall use the property transferred or ils income; ....................................
c. retain a reversionary interest or .............
d. receive the promise for life of either payments, benefits or care? ........................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ....................................................................................................................... [] []
3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death? ......... [] []
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 pe,ia,-ueS of perjury, I ,~,.~,-e that I have examined this return, including accompanying schedules and statements, and ~ the best of my know~ and belief, it is true, correct and complete. Declaration of
ipmparer other than the personal representative is based on all irffomlation of vfftich preparer has .ny k,x~.e.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
Aliee H Heefner
S~NATURE OF PERS~)N RESPONSII~'FOR FILING RETURN
X'~TURE O]c ~r[iPARER OTHER THAN ~-'~-~';~ESENTATIVE
Forest N Myers
ADDRESS
3836 Pine Grove Road
Biglcrville, PA 17307
ADDRESS
11761 Malmolia Falls Drive
JacksonvilTe, FL 32258
ADDRESS
137 Park Place West
Shippensburg, PA 17257
DATE
DATE
DATE
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rote imposed on the net value of transfem 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 ne{ 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 retum are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116
1.2) [72 P.S. §9116 (a) (1)].
The tax rate imposed on the net value of transfem to or for the use of the decedent's siblings is 12% [72 P.S. §9116 (a) (1.3)]. A sibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
SchedubH
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
E~TATE OF Hirschman, Clara J FILE NUMBER
21 03-00794
3
4
5
6
7
Pharmacare, medical bill
Balhara Medical
Checks cleared from account #951029546 after date of death
Shippensburg Health Care Center, final bill
Cumberland Valley EMS, medical transport 9/10/2003
533.00
24.00
50,000.00
1,210.00
43.00
Page 2 of Schedule H
ESTATE OF Hirschman, Clara J ' FILE NUMBER
21 - 03 - 00794
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
l
FUNi=~L EXPENSES:
Fogelsanger Bricker Funeral Home, Shippensburg, Pennsylvania
Maeder-Quint-Tiberi Funeral Hone, Columbus Ohio
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zip
Year(s) Commission paid
Attomey's Fees Law Ofl~ce Forest N Myers
Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation)
Claimant
Street Address
C~ State
Relationship of Claimant to Decedent
Probate Fees Register of Wills Cumberland County
Register of Wi{Is Cumberland County, filing fees
Zip
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
Cumberland Law Journal, advertisement of letters
New Chronicle, advertisement of letters
Total of Continuation Schedule(s)
TOTAL (Also enter on line 9, Recapitulation)
4,490.00
3,914.03
5,000.00
500.00
15.00
75.00
85.00
51,810.00
65,889.35
REV-I~t$ EX+ {~4~)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Hirschman, Clara J
SCHEDULE J
BENEFICIARIES
FILE NUMBER
21 - 03 - 00794
NUMBER
II.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
Alice H Heefner
3836 Pine Grove Road
Biglerville PA 17307
Sharon Elaine Donfrio
11761 Magnolia Falls Drive
Jacksonville FL 32258
RELATIONSHIP TO
DECEDENT
D~N~L~Tn ' .':
daughter
daughter
Enter dollar amounts for distributions shown above on lines 15 through 18, es appropriate, on Rev 1500 cover sheet
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
AMOUNT OR SHARE
OF ESTATE
one half
one half
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Hirschman, Clara J
FILE NUMBER
21 - 03 - 00794
Inclu.de th.e procee~l, s. of litigation and the date the proceeds were receJved by the estate. All property jointly-owned with the right of
survlvorsnlp must De disclosed on schedule F.
ITEM
NUMBER
DESCRIPTION
Checking Account, M&T Bank, #951029546
Checking Account, Citizens Bank, g6100681645
Checking Account, Waypoint Bank, #703011306
Certificate of Deposit, Waypoint Bank, #700003173
Certificate of Deposit, PNC Bank, #31000177292
Money Market Account, Merrill Lynch
Great American Finance, dividend
Blue Cross/Blue Shield, refund of medical insurance
TOTAL (Also enter on Line 5, Recapitulation)
VALUE AT DATE OF
DEATH
68,932.00
20,782.00
9,174.00
25,413.00
73,897.00
4,911.00
1.00
570.00
203,680.00
ESTATE OF
H~chman, Clara J
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
21 - 03 - 00794
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION UNIT VALUE VALUE AT DATE OI
DEATH
1 Evergreen PA Municipal Bond Fund 11.58 117,300.00
2 Alliance Bernstein Muicipal INcome Fund 10.34 126,231.00
3 Eaton Vance Investment Trust 9.92 179,307.00
4 Merrill Lynch Multi State Municipal Fund 11.17! 167,939.00
5 Franklin Tax Free Trust Fund 10.48 127,862.00
6 Pennsylvania Railroad Company, Penn Central Corporation now American Financial 22.45 449.00
Group
7 American Annuity Group, now Grest American Financial Resources 14.00 70.00
TOTAL (Also enter on line 2, Recapitulation) 719,158.00
80~dubH
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
E~TATE OF Hirschman, Clara J FILE NUMBER
21 - 03 - 00794
Pharmacare, medical bill
Balhara Medical
Checks cleared from account /1951029546 after date of death
Shippensburg HEalth Care Center, final bill
533.00
24.00
50,000.00
1,210.00
Page 2 of Schedule H
REV-1513 EX+ (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
HLrschma~, Clara J
SCHEDULE J
BENEFICIARIES
!FILE NUMBER
21 - 03 - 00794
NUMBER
II.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outfight spousal distributions)
Alice H Heef~er
3836 Pine Grove Road
Biglerville PA 17307
Sharon Elaine Donfi'io
11761 Magnolia Falls Drive
Jacksonville FL 32258
RELATIONSHIP TO
DECEDENT
Bo Nm um Trr .....
daughter
daughter
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI
AMOUNT OR SHARE
OF ESTATE
one half
~ne half
COMM(~NWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
MYERS FOREST N ESQ
137 PARK PLACE WEST
SHIPPENSBURG, PA 17257
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003548
........ fold
ESTATE INFORMATION: SSN: 275-03-4219
FILE NUMBER: 2103-0794
DECEDENT NAME: HIRSCHMAN CLARA J
DATE OF PAYMENT: 02/11/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUM BERLAN D
DATE OF DEATH: 09/20/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $668.00
i R~EMARKS:
CHECK//107
SEAL
TOTAL AMOUNT PAID'
$668.00
INITIALS' JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMi 1ONWEALTH 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 003564
MCCALEB MARLIN R
219 E MAIN STREET
MECHANICSBURG, PA
17O55
........ fold
ESTATE INFORMATION: SSN: 196-14-3141
FILE NUMBER: 2103-0889
DECEDENT NAME: ST JOHN MILDRED L
DATE OF PAYMENT: 02/17/2004
POSTMARK DATE: 02/1 2/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 07/30/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
04101744 $30.08
REMARKS:
TOTAL AMOUNT PAID:
RECEIVED OF GLORIA J GURKOFF
C/O MARLIN MCCALEB, ESQ.
$30.08
SEAL
CHECK# 2548
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
BUREAU OF TNDZVZDUAL TAXES
I'NHERTTANCE TAX DZVTSTON
DEPT. 280601
HARRTSBURG, PA 17128-D601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLONANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
FOREST N HYERS
F N HYERS LAW OFFICES
157 PARK PLACE WEST
SHIPPENSBUR$
*04 li/ R 26
DATE
.~ESTATE OF
~DATE OF DEATH
FILE NUHBER
COUNTY
05-29-2004
HIRSCHHAN
09-20-2005
21 05-0794
CUMBERLAND
101
CLARA
Amount Remitted
.~HAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~- RETAIN LOWER PORTZON FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HIRSCHHAN CLARA J FILE NO. 21 05-0794 ACN 101 DATE 05-29-2004
TAX RETURN NAS: { X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
$. Closely Held Stock/Partnership Interest (Schedule C) ($)
O`. Mortgages/Notes Receivable (Schedule D)
$. Cash/Bank Deposits/Hlsc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
B. Tote1 Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule l) (10)
11. Total Deductions
12. Net Value of Tax Return
15.
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J)
Net Value of Estate Subject to Tax
719/159.28
.00
205/679.Z4
.00
.00 NOTE: To insure proper
credit to your account,
submit the upper portion
.00 of this form with your
tax payment.
.00
(8)
65,889.55
.00
NOTE=
922,858.52
(11) 65.889.35
(12) 856,949.17
(15) . O0
(lo`) 856,949.17
Zf an assessment Nas issued previously, lines 14, 15 and/or 16, 17,
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line lo` at Spousal rate
16. Aeount .of Line lo` taxable at Lineal/Class A rate
17. Amount of Line lo` et Sibling rate
18. Amount of Line 1o, taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
PAYHENT RECETpT DISCOUNT (+}
DATE NUHBER INTEREST/PEN pAID (-)
11-25-2005 CD005287 1,894.74
02-11-2004 CD005548 . O0
18 and 19 Nil1
ZF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADD/TZONAL INTEREST.
(1~i) .00 x O0 : .00
(16) 856,949.17 x 045= $8,565.00
(17) . O0 x 12 = . O0
(18) .00 x 15 = .00
(19)= $8,563.00
AHOUNT PAID
$6,000.00
668.00
TOTAL TAX CREDZT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
$8,562.74
.26
.00
.26
( TF TOTAL DUE ZS LESS THAN $1, NO PAYHENT IS RE~UTRED.
ZF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR}, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
Lj.
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Register of Wi Us of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent: j-\)r~rY1CtI)) clOf0LJ
Date ofDeath ~~ ~rpl ~3
Estate No.: ~0 J11Bq ~
@)
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~l)tther administration of the estate is complete:
Yes 1S?1 No 0
2. lfthe 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 person~resentative file a final account with the Court?
Yes 0 No M
b. The separate Orphans' Court No. (ifany) for the personal representative's
account is:
c. Did the personalftpresentative state an account informally to the parties in
interest? Yes 121 No 0
c. Copies of receipts, releases, joinders and approval of fonnal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
Date:
~ -8- OS
c- -y~
Signature
%e~t iJ ~efS ) [~.
Name
J:3 =t- &d~ fLJ;J I Sh1 tJ()?AStM1' fA
Address
-:t/:t. 53), ,9 r/:;%
Telephone No.
co
_:-r
('';
I'
0_
('-J
t r'.":'
c'"
c:.:>
(,-...i
(
Capacity:
DJ'ersonal Representative
M Counsel for personal representative
(Ii
Cumberland County - Register Of wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 8/30/2005
MYERS FOREST N ESQ
137 PARK PLACE WEST
SHIPPENSBURG, PA 17257
RE: Estate of HIRSCHMAN CLARA J
File Number: 2003-00794
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
9/20/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~~i/k.L.uP
~~
GLENDA FARNER STP~SBA~GH
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
C2J~