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HomeMy WebLinkAbout95-0202This is to certify that the certificate hereunto attached is a true and accurate copy of the original death record on file with the Division of Vital Records, and that Frank Yeropoli, whose name is subscribed thereto, was at the time of subscribing the same and now is Director, Division of Vital Records of the Department of Health, for the Commonwealth of Pennsylvania, duly appointed and commissioned as directed by Act 66 of the General Assembly, approved 29 June 1953, P.L. 304. auc i s-2007 ? ' Date Fran eropoli, ' ect Division of Vital Records P.O. Box 1528 New Castle, PA 16103 ~ COMMONWEALTN OF PENNSYLVANIA • DEPARTMENT OF NEALTH • VITAL RECORDS '.f Z ~ `~ 3 q N+~ +*~~~ ~' CERTIFICATE OF DEATH sovE RLE M1LeER TYpEIPNINT gE,I SODIAL SECURm NUMBER DaE OFDEJaNOaa+n. D•Y. Y•eC ~ NAME oP oECEDENr IFrL Midd•. L•!j ,. Samuel W. Stouffer a.Male a. 174 -05 -1072 ..February 16, 19 uNDEn,rEAR UNDER1 Dl6/ oaE OFawrN EwnwtACE (CiV rb PLACE OFDEraN~.XX edY aria-a.•iraucrioram a•i.,itl•) OrNER ~ACiEN,I Siaitl•A Mw.Iw D.w Nou. s Mw•A« ce.or*.Dw.w•n sm.«fa«on Camtrr) Feb 22,190 Centerville,Pa ~""~ E"~Oi°"`""^ Dw^ Nom. ^ RWtlrc•^ tso~r)^ 85 vn ~ a ~. NNSDECEDENrOF1ASPANICORroIN4 ~„,I„y.i,•SroL,wna., courmoFceRN cRr,sogD.rwPOPDEaN r-ACartrNA~nERm;wm,um.d~+ee.i,nan~.~a«) ,~cn.^nY....P.w~ria~. Mrkr.Pwrlo Rkr.•'IC ,a. White ~, Cumberland ~ Carlisle Carlisle Hospital ,. ~ suRVnnNDSPausE gNDDP SUSINESSM7WSTRY •ns DECEDE+rr EVERw pECEOEM'9 EDlICRIDN ~,~„~, ~,,,,~, mw.. d~+~•^A°^10) DECEDENT'S USUKDCCURQION U.S.AAMED Pg1CESi DAVOW (SOXdY) a~ qw mn°onso~urn~w h.^ rb ~( ~a+21 8 n~e°5`) ,s. Widowed ,s. Repairman , Tire Service ,Z ,a. i eton DECEDENT•s a ,x.~a.tl•e•tl.Awr DECEDENrsMAAHIDADDRESS~•M,caY~.sur.zp,cotl•1 ~~ ,nslr. ~ tlk•a.A 1446 Walnut Bottom Rd. "E~"~ """" Carlisle Pa 17013 I~°pirid" ,,., Cumberland 1pwniNp4 „a.~. •dW~ bd -` ,~. MDTNEa'8 NAME IP.r. Mitla•, Mr,en Swrerl FN/ER'SNMIE IF.,L Latltl•.LM ,~ Lillie Paaton ,~ Samuel Stouffer INPDRMANPaMAEJNDADDNE88 D,FDiM1Al/f'S NAME (TyprPrn9 150 Gordon D Gu W. Stouffer ~ pISpDSRgN•Nrwd ME'T,OD aF oaE of DEtPOSrtaN po,rbn^ o . G"""b"^ R.mwr tiom s~d.^ .Dw.`b•n ^ a,~ Feb 21, 1995 a,aCumberland Va LICENSE NUMBER NAME ANDADOq e,oNqur~°cP~NEflALe°~rw°ASSUCN „. 012748-L 219 N. M. wMd~ Mtus•O tlM tl.YI~. DD 1101•IMf tlt• npd•db,iq. rcA rwdia a nyb•Iay mM, dgtJta IM•111•IWn p.-AIYf l• L ~IX•~an •~ed ~M NIYEaATE DAYSE (F ~eI 7"' -11 ~- •:/~ ~oc,rr~A.~' ~, '•~'""o"0e°'I')-'-' ' rooRASnc auENCEOe: - ~..p. /~--a-L. SC ~- wa E DUEro(OR ASACONSECUENCE OFJ: aanY. M•tlinpb bnrA•r crr.EduYNDNrYINO CAUtE (OWrv+4.Y ~ DuEroroR ASA CONSEDVENCE OF}. trollop rtin )MStli LAf7 d DATE OF INJURY NME OF WA9 /d1 AUR'WSV WERE AUTOPSY RNDN(i5 MANNER OF DE/SH / (NmMi. DaY. `bar) ~~~~~ COIS'LETION OFCAUSE NHwd F•~-'// NaMCiOe ^ OF DEATNt ^ ~cm.d ^ P•nd~pMA~.rprb^ Yr ^ No sWCIa. ^ coda ndatl.cw~r~.tl ^ ~ ~~~unum..am4 w~•w. a•a r. ' CB1TiIER ICMCM eMY onN d tlsa•~ wlrn •noWer MYSaee Ms paawc•tl tleYh xW canPbl•tl a•m 23) l7 •CaTIPYNNiPNYSIfJAM p~nyicien ewOY+gew .................. • Toar O.Rd •ry bgWtlf•.OrIDe•eund Ar b •n e•rN•) rttl m•nwrawd ................................... w •pppNOlM1CM1DAND CERTIFYENi P11Y81CIAN(Y~Y9w+e~OoN proriountinp tlrNantl wrlrylgbea+rdtleahl tea. Maof•ry lmnelee0•.daN Oxwntl•ttlw tlm•,Mn,nd Ol•••.•MtlW bM•w•r+•)•M•rnrrM•Ib .......................... U 0 OR ~n.wwdn IonRa MV«npMlon, In my uWntnn.d«mouurn.ewuu elm..er...ndWe.'rb dwam. e•u.N•1•~ ^ ,1,•IMYp Wl•d .................................... ............................... ul at•. Z p.E/~Q(I~$~i~RAR'3 SNiNRURE AN 1 ~ ~l \I .. CL X1~1h2 ~ - e.J`~~~ ~C' 1~ LJ Mem Gar. `W. E.ITY o man- ver ST. Carl uMeEA l33oba(, i gEFERREpIO MEDICAL E7 `M ^ Yr ^ No v Yrn R PC r/~n~ik, »• o aR-~-~~ S ~~ /7i~ 17~ i ~~, moo. \°I`1~ s t LAST WILL AND TESTAMENT OF SAMUEL W. STOUFFER I, SAMUEL W. STOUFFER, widower, of South Middleton Township (R. D. 7, Box 370, Carlisle) Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void any and all Wills by me at anytime heretofore made. 1. I direct my hereinafter named Executor to pay all of my just debts and funeral expenses as soon after my death as may be found con- venient to do so. I direct that my funeral services be conducted by the Hoffman-Roth Funeral Home, 219 North Hanover Street, Carlisle, Pennsyl- vania, and that my body be interred on my burial lot located in Cumberland Valley Memorial Gardens near Carlisle, Pennsylvania. 2. I give and bequeath the sum of $500. 00 to the trustees of First United Methodist Church, 64 East North Street, Carlisle, Pennsylvania, their successors and assigns, to be used for such purposes as said trustees shall deem best. 3. All the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath as follows: a. One-third to my sister, Helen Shade, wife of William Shade, her heirs and assigns, provided she shall survive .me by a period of Ninety (90) days and should she fail to so survive me then the same shall lapse and be added to the balance of my estate hereinafter disposed of in subparagraph b hereof. Page 1 of 3 Pages r b. The remaining two-thirds shall be divided equally among such of .my nieces and nephev~~s and the nieces and nephews of my laiewife, Goldie E. Stouffer, their heirs and assigns, per capita, who shall survive me by a period of Ninety (90) days, the share any niece or nephew failing to survive me by said period of Ninety (90) days to pass to his or her issue per stirpes, all of said nieces and nephews being the following persons: (1) The 2 children of my sister, Mrs. Miriam hawk, they being Linda Harris and Nancy By¢rs~. (2) The one child of my sister, Mrs. William Shade, he being Gregory Shade. (3) The 2 children of my brother, Guy H. Stouffer, they being Guy W. Stouffer and Arlene Stouffer. (4) The one child of my brother, Earl P. Stouffer, he being Jeff Stouffer. (5) The 2 children of my brother, Paul Stouffer, they being Paul Lee Stouffer and Rebecca (6) The 4 children of .my deceased brother, Glenn R_. Stouffer, they being Ronald Stouffer, Samuel Stouffer, Paul Stouffer, and Patricia Deutsch. (7) The one child of .my wife's deceased brother, Earl Hofsass, she being Marie Hoffman. (8) The 3 children of my wife's deceased brother, Russell C. Hofsass, they being Ronald Hofsass, Douglas Hofsass, and Raymond Hofsass. (9) The 7 children of my wife's sister, Blanche Shade, they being Donald Shade, Ernest Shade, Tucker Shade, Audrey Eshelman, Alice Linda and Cynthia ~lQ) The 2 children of my wife's sister, Vivian Moats, they being Gary Moats and Gloria Fink. (11) The 2 children of my wife's deceased sister, Catherine Swartly, they being Harper Swartly and Shirley Hershman. Page 2 of 3 Pages 4. Should any person less than Eighteen (18) years of age be entitled to distribution from my estate, in such event I nominate, constitute and appoint Farmers Trust Company and its successors, 1 West High Street, Carlisle, Pennsylvania, as guardian of the estate of each such person, and authorize and direct it to receive and to invest the same, and to pay the income arising therefrom, together with so much of the principal thereof as in its opinion is necessary or desirable to be expended for the proper maintenance, support and education of such person, to or for the benefit of such person, and upon such person attaining Eighteen (18) years of age to pay to him or her the then remaining principal together with any un- distributed income. 5. I hereby nominate, constitute and appoint Farmers Trust Company and its successors, 1 West High Street, Carlisle, Pennsylvania, as Executor of this my Last Will and Testament and further direct that it shall not be required to post any bond to secure the faithful performance of its duties in the Commonwealth of Pennsylvania or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on 3 pages this 23rdday of April, 1981. Samue W. Stouffer (SEAL) Signed, sealed, published, and declared by SAMUEL W. STOUFFER, the Testator above named, as and for his Last Will and Testament, in our presence, who, in his presence, at his request, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. n.... Paara '~ of ~ Paa'pQ TO: Register of Wills Cumberland County Courthouse Carlisle, PA 17013 CERTIFICATION OF NOTICE UNDER RULE 5.6(al Name of Decedent: Samuel W. Stouffer Date of Death: Will Number: To the Register: February 16, 1995 21-95-202 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 April 14, 1995. Linda Hawk Hill 303 E. Garfield St. Shippensburg, PA 17257 Guy W. Stouffer 150 Gordon Dr. Carlisle, PA 17013 Paul Lee Stouffer 20215 Beaver Creek Rd. Hagerstown, MD 21740 Samuel Stouffer 12496 Polomino Pl. Lake Ridge, VA 22192 Marie H. Hoffman 218 South 7th St. Steelton, PA 17113 Nancy Hawk Byers 12594 Stonewall Rd. Shippensburg, PA 17257 Arlene Stouffer 1974 Fry Loop Carlisle, PA 17013 Rebecca S. Mummert 5201 Gate House Ct. Sykesville, MD 21784 Paul E. Stouffer 1315 Doubling Gap Rd. Newville, PA 17241 Ronald Hofsass 943 Emily Dr. Mechanicsburg, PA 17055 Gregory Shade 80 Carlisle Rd. Newville, PA 17241 Teff Stouffer P.O. Box 310 Sharpsburg, MD 21782 Ronald M. Stouffer 85 S. High St. Newville, PA 17241 Patricia S. Deutsch 12420 Conde Dr., Highpoint Brookville, FL 34613 Douglas Hofsass 1953 Miller Rd. Hummelstown, PA 17036 Raymond Hofsass Donald Shade Ernest Shade 1277 Ash Lane 13743 Welty Rd. 125 Frick Ave. Lebanon, PA 17042 Waynesboro, PA 17268 Waynesboro, PA 17268 r t~ t COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION N0.21-95-0202 ESTATE OF SAMUEL W. STOUFFER, DECEASED LATE OF THE BOROUGH OF CARLISLE FIRST AND FINAL ACC.'OUNT OF FARMERS TRUST COMPANY, ADMINISTRATOR Date of Death: February 16,1995 Letters Granted: March 15, 1995 First Complete Advertisement of Grant of Utters: May 6,1995 Account Stated to December 8, 1995 SL7MMARY AND INDEX Page Princi al 2 Receipts $292,170.87 2 NetGain/(Loss} on Conversions 0.00 $292,1.70.87 3 Less Disbursements 66,999.94 $225,170.93 4 Less Distnbutions to Beneficiaries 500.00 Principal Balance Remaining $224,670.93 Income 4 Receipts $9,748.32 4 Less Disbursements 327.19 Income Balance Remaining 9,421.13 Combined Balance Remaining $234.092.06 PRINCIPAL RECEIPTS Inventory Filed 5/24/95 MetLife Policy #6677805C 7/3/95 Sprint United Telephone Refund 7/10/95 Arnold Fuel Oil Refund Credit Balance Total Principal Receipts PRINCIPAL CONVERSIONS TO CASH Gain $290,920.40 1,082.65 5.64 162.18 $292,170.87 Loss 3/?.3/95 Farmers Trust Co CD #4188 Proceeds $31,907.09 Inventoried at 31,907.09 $0.00 4(1/95 Meridian CD #4001970591 Proceeds $45,854.52 . Inventoried at 45,854.52 $0.00 4(1/95 Meridian CD #3064087574 Proceeds $39,086.67 . Inventoried at , 39,086.67 $0.00 4/1/95 Meridian CD #3064061587 Proceeds $18,782.69 Inventoried at 18,782.69 $0.00 SrLS/95 US Series E Bonds Proceeds $11,137.55 Inventoried at 11,137.55 $0.00 6/16/95 1446 Walnut Bottom Road, Carlisle, PA Proceeds $60,000.00 Inventoried at 60,000.00 $0.00 Net Gain/ (Loss) on Conversions 2 $0.00 PRINCIPAL DISBURSEMENTS 2128/95 Register of Wills, letters testamentary $296.00 3/3/95 United Telephone Service of PA 19.62 3/6/95 Robert Cairns, 1995 real estate taxes 128.87 322/95 PP&L, electric service 31.22 322/95 Joan Fry, Oath of Subscribing Witness Fee 25.00 3/23/95 Paid Farmers Trust check drawn on acct prior to DOD 52.67 324/95 Carlisle Imaging Associates 130.79 324/95 Arnold Fuel Oil 162.18 324/95 Hof6man-Roth Funeral Home 5,373.40 328/95 Arnold Fuel Oil 162.18 328/95 Diversified Appraisal Services, real estate appraisal 225.00 4/6/95 United Telephone Service of PA 19.62 4/18/95 Carlisle Imaging Associates 1.92 4/18/95 PP&I, electric service 23,28 4/20/95 Federated Investors Insurance prenuum 103.00 427/95 Arnold Fuel Oil 114.33 427/95 Carlisle Community Ambulance Service 20.87 5/1/95 Cumberland Law Journal, advise letters testamentary 40.00 5/3/95 Tom Oiler, lawn care 90.00 5/5/95 Belvedere Medical Center 23,98 5/5/95 RWC Emergency Physicians 20,78 5/5/95 United Telephone Service of PA 19.65 5/8/95 Register of Wills, PA Inheritance Tax estimate 33,000.00 5/9/95 Carlisle Cardiopulmonary Associates 31.86 5/15/95 PPBcI,,, electric service 24.19 5/19/95 Bidelspach Motors, clean & detail Chevrolet Celebrity 75.00 523/95 Short Certificate ~ 3.00 526/95 David Shiebley, hauling trash 65.00 6/6/95 Tom Oiler, lawn care 190.00 6/6/95 United Telephone Service of PA 19.52 6/8/95 Chimney Sweep Systems, inspect chimney 50.00 6/7/95 Carlisle Hospital 716.00 6/8/95 Shevlin's Maintenance Svc, cleaning 58.30 6/8/95 The Seminal, executor's notice & proof of publication 65.48 6/8/95 Gilberts Pest Control, inspection 55.00 6/13/95 Peck's Septic Service, pump septic tank 200.00 6/16/95 Cumberland Co 1°!o Real Estate Transfer Tax 600.00 620/95 PP&L, electric service 19.89 7/7/95 Tom Oiler, lawn care 40.00 7/18/95 Register of Wills, Balance on PA Inheritance Tax 4,424.78 7/18/95 Register of Wills, filing fee for PA Inher Tax Return 15.00 8/9/95 Rodney K. Hough, MD 57.33 Reserved: Frey & Tiley, Attorney Fee 6,568.41 Farmers Trust Company, Executor Fee 13,136.82 Closing and filing costs 500 00 Total Principal Disbursements 3 $66,999.94 PRINCIPAL DISTRIBUTIONS TO BENEFICIARIES 10/12/95 First United Methodist Church Total Principal Distributions INCOME RECEIPT S 3/9/95 Interest, Meridian CD #306406L587 3023/95 Interest, Meridian CD #3064087574 3/13/95 ~ Interest, Farmers Trust Company CD #4188 3x13/95 Interest, Farmers Trust Company Savings 4/7/95 Interest, Meridian CD #4001970591 4x1/95 Interest, Meridian CD #3064061587 4x7/95 Interest, Meridian CD #3064087574 4/10/95 Interest, Meridian CD #3064061587 4/12/95 Interest, Meridian CD #3064087574 5x15/95 Interest, US Series E Bonds 11x1/95 Interest, Fed Fund 3x1195 to 11/8/95 11x1195 Interest, Temp Fund 3x1/95 to 11/8/'95 Total Income Receipts INCOME DISBURSEMENTS 7x7/95 Farmers Trust Company, trust department fee 10/6/95 Farmers Trust Company, trust departmentfee Total Income Disbursements $500.00 $500.00 $56.55 88.70 85.55 81.77 135.12 55.31 115.14 62.62 98.22 136.02 8,701.61 131.71 $9.748.32 $116.59 210.60 $327.19 Farmers Trust Company, Executor Samuel W. Stouffer Da 'd C. Gority, Vice widen and Trust Officer 4 COMMONWEALTH OF PENNSYLVANIA: COUN'T'Y OF CUMBERLAND: David C. Gority, Vice President and Trust Officer of Farmers Trust Company, .being duly sworn according to law, deposes and says that the Account as stated is true and correct and that the Grant of betters and the first complete advertisement thereof occurred more that four months before the filing of the Account ~GG~C Ida d C. Gority, Vi reside t and Trust Officer Sworn and subscribed to before me Nobulal ~~ this day of December, 1995. so h~~ wwpp ~~ tyty My Commission Expires Oci. 25,1~99J iWember, Pennsylvania Association of Notariez ~ . ota Pub c ~a ' _ ` ry F 5 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION IN THE ESTATE OF SAMUEL W. STOUFFER LATE OF THE BOROUGH OF CARLISLE SCHEDULE OF PROPOSED DISTRIBUTION Balance for distribution as per Fast and Final Account filed December 8, 1995 Distribution Children of Miriam Stouffer Hawk (Sister) Linda Hawk dill Principal Cash $8,321.15 Income Cash 348.93 Nancy Hawk Byers Principal Cash $8,321.15 Income Cash 348.93 $234,092.06 $8,670.08 8,670.08 Children of Mrs. William Shade (Sister) Gregory Shade Principal Cash $8,321.15 Income Cush 348.93 Children of Guy H. Stouffer Guy W. Stouffer Principal Cash $8,321.15 Income (;ash 348.93 Arlene S. Faesel Principal Cash $8,321.15 Income Cash 348.93 8,670.08 8,670.08 8,670.08 Children of Earl P. Stouffer (Brother) Jeff Stouffer Principal Cash Income Cash $8,321.15 348.93 8,670.08 Distribution Children of Paul Stouffer Paul Lee Stouffer Principal Cash Income Cash Rebecca Stouffer Mummert Principal Cash Income Cash Children of Glenn R. Stouffer (Brother) Glenn R. Stouffer Principal Cash Income Cash Samuel Stouffer Principal Cash Income Cash Paul E. Stouffer Principal Cash Income Cash Patricia Stouffer Deutsch Principal Cash Income Cash Children of Earl Hofsass (Brother-in-Law) Marie Hofsass Hoffman Principal Cash Income Cash Children of Russell C. Hofsass (Brother-in-Law) Ronald Hofsass Principal Cash Income Cash $8,321.15 348.93 8,670.08 $8,321.15 348.93 8,670.08 $8,321.15 348.93 $8,321.15 348.93 8,670.08 8,670.08 $8,321.15 348.93 8,670.08 $8,321.15 348.93 8,670.08 $8,321.15 348.93 $8,321.15 348.93 8,670.08 8,670.08 2 Distribution Douglas Hofsass Principal Cash Income Cash Raymond Hofsass Principal Cash Income Cash Children of Blanche Shade (Sister-in-Law) Donald Shade Principal Cash Income Cash Ernest Shade Principal Cash Income Cash 'I~cker Shade Principal Cash Income Cash Audrey Shade Eshehnan Principal Cash Income Cash Alice Shade Provard Principal Cash Income Cash Linda Shade Hovis Principal Cash Income Cash Cynthia Shade Miller Principal Cash Income•Cash $8,321.15 348.93 $8,321.15 348.93 $8,321.15 348.93 8,670.08 8,670.08 8,670.08 $8,321.15 348.93 8,670.08 $8,321.15 348.93: 8,670.08 $8,321.15 348.93 8,670:08 $8,321.15 348.93 8,670.08 $8,321.15 348.93 8,670.08 $8,321.15 348.93 8,670.08 3 Distribution Children of Vivian Moats (Sister-in-Law) Gary Moats Principal Cash $8,321.15 Income Cash 348.93 8,670.08 Gloria Moats Fink Principal Cash $8,321.15 Income Cash 348.93 8,670.08 Children of Catherine Swartley (Sister-in-Law) Harper Swartley Principal Cash $8,321.15 Income Cash 348.93 8,670.08 Shirley Swartley Hershman Principal Cash $8,321.15 Income Cash 348.93 8,670.08 $234,092.06 STATEMENT OF THE REASONS FOR THE PROPOSED DISTRIBUTION This distribution is proposed in accordance with Sections 2103 and 2104 of the Probate, Estates and Fiduciaries Code, Title 72 of Consolidated Pennsylvania Statutes. ~c David C. Gority, Vice P widen and Trust Officer 4 COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND: David C. Gority, Vice President and Trust Officer, being duly sworn according to law, deposes and says that he is Trust Officer of Farmers Trust Company, the Accountant in the Estate above named;' and that the facts set forth in the Statement and Reasons for the Proposed Distribution are true and correct. ~(,~~ Cam= '~ ~. David C. Gority, Vice elide and Trust Officer Sworn and subscnbed to before me this ~_ day of December, 1995. ~~'~ ~u y lion E~xpinss Oct. 25, 1999 , Member, Pennsylvania Association o Notaries ~ - otary Pub 'c 5 ~ ~~ j~-a/--~' ~U.~~~~~1 ' FOR DATES OF DEATH AFTER 12/31/97 C COMMON LT INHERITANCE TAX RETURN HERE IFA SPOUSAL HOFPENNSYLVANIA DEPAgTMENTOFREVENUE RESIDENT DECEDENT POVERTY CREDIT IS CLAIMED DEPT. 2806p, HAR-li7SBURG, PA 1 7128-0607-~ - ~- - --" - (TO BE FILED IN DUPLICATE FILE NUMBER 21-s5~-2o2 WITH THE REGISTER OF WILLS _ ~ "co i c ~ D DENT'S NAME (LAST, FIRST, AND MIDDL E INITIAL) uNn oDE YEAR _ NUMBER Z W Stouffer, Samuel W. DECEDENTS COMPLETE ADDRESS ' Ip SO L SECURITY NUMBER E OF DEATH DATE OF BIRTH 1446 Walnut Bottom Road Carlisle PA 17013 v W 174-05-1072 SURVIVING SPOUSE'S NAME (IF APPUCAB 2-16-95 2-22-09 , co~„ty Cumberland ~ SOCIAL SECURITY NUMBER -AMOUNT RECEIVED (SEE INSTRUCTIONS) W a y =00 Vam d Q I ~ ~ z W W ~ 0 ¢ z O 0 U a z O H a Q U W 0: Z O H a O U x H ~J 1. Original Return /~ 4. Limited Estate 6. Decedent died Testate (Attach co of~l~_ L CORRESPOryp(*p n E David W. Maclvor C LEPHONE NUMBER 717-243-3212 0 2. Supplemental Return 4a. Future Interest Compromise (for dates of death after 12-12-82) 0 7. Decedent Maintained a Living Trust (Attach copy of trust) n nn 3. Remainder Return (for dates prior to 12-12-82) [~ 5. Federal Estate Tax Return Required 0 8. Total number of Safe Deposit Boxes CTEDi TO ' _ - - COMPLETE MAILING ADDRESS Farmers Trust Company Trust Department P.O. Box 220 1. Real Estate (Schedule A) ~ 60 000 00 2. Stocks and Bonds (Schedule B) , . 11 137 55 3. Closely Held StocWPartnership Interest (Schedule C) , . (3) None 4. Mortgages and Notes Receivable (Schedule D) (4) None 5. Cash, Bank Deposits $ Miscellaneous Personal Prop S erty {,5 219,782.85 ( chedule E) ~ 6. Jointly Owned Property (Schedule F) (6) None 7. Transfers (Schedule G) (Schedule L) (7) None 8. Total Gross Assets (total lines 1-7) 9. Funeral Expenses, Administrative Costs, Miscellaneous ($J' 27,619.41 Expenses (Schedule H) /`/ 10. Debts Mortgage Liabilities, Liens (Schedule I) (1 1,723.53 11. Total Deductions (total lines 9 $ 10) 12. Net Value of Estate (line 8 minus line 11) 13. Charitable and Governmental Bequests {Schedule J) 14. Net Value Subject to Tax (line 12 minus line 13) ~__..__, {e) 290, 920.40 (1 1) 29,342.94 (1 ~ 261, 577.46 500.00 (14) 261, 077.46 -~ - ---^~ .,~„~ ~~ ~~~~ uaiesaaerC-3D-94) S ee Instructions for Applicable Percent on Reverse (15) Side. (Include values from Schedule K or Schedule M.) 0.00 16. Amount of line 14 taxable a 6% rate (16) (Include values from Schedul K 0.00 e or Schedule M) 17. Amount of line 14 taxable at 15 % rate (17) (Include values from Sched l K 261 077.46 u e or Schedule M) 18. Principal tax due (Add tax from line 15, 1 B and from line 17) 19. Credits Spousal Poverty Credit Prior Payments Discount Interest 0.00 + 33,000.00 + 1736.84 - 0.00 20. If line 19 is greater than line t 8, enter the difference online 20. This is the OVERPAYMENT 21. If line 1 t3 is greater than line 19, enter the difference online 21. This is the ,TAX DUE. A. Enter the interest on the balance due on line 21 A. B. Enter the total of line 21 and 21 A on line 21 B. This is the BA LANCE DUE. Make Check Pa able to• Re ister of W'll X 0.03 = 0.00 x .os = 0 00 x .1 s 39 161.62 (18) 39 161.62 (1 s) 34,736 84 (20) (21) 4 424.78 (21 A) 0 00 (21 B) 4,424 78 • ~ s, A ent B~$URE'f0 %lN$1NER ALL QU~STIt?NS ON REV~RSf„$4p~,r~Np TO REC EC Under penakies of perjuryy, l ddeclare that I have examined this return, including accompanying schedules and statements, and t the best of my knowledge and belief, R is true, correct and complete. I declare that all real estate has been reported at true market value. Declaration of preparer other than personal representative is based on all information of which re arer has an knowled e. SIGNATURE OF PERSON RESPQ1ySIBLE FOR FILING RETURN ADDRESS Date David W. Maclvor, CFP ~~~~O~IG/~fbt j SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS %~/~~ Date ~'oP`I ~C~'om i~vPX~u~ Act #48 of 1994 provides forthe reduction of the tax ratesamposed on the net~alue of trans#ers to or-for- ----- the use of the spouse. The rates prescribed by the statute will be: - __ - 3% (.03) will be applicable for the estates of decedent's dying-on or after 7/1/94- and before 1/1/96 2% (.02) will be applicable for the estates of decedent's dying on or after 1/1/96 and before 1 1 / /97 1 % (.01) will be applicable for the estates of decedent's dying on or after 1 /1 /97 and before 1/1/98 Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (X) IN THE IN THE APPROPRITATE BLOCKS. 1. Did decedent make a transfer and: 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 a ~~~~~~~~~""""""""""""""""' p yments, benefits or care? .......... 2. If death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate consideration? 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 'intrust for' bank account at his or her death? .............. ............................... YES ~ NO X X X X X IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE C AND FILE IT AS PART OF THIS RETURN. COMMOMVEALTH OF PENNSYLVANIA SCHEDULE A INHEARANCETAx RETURN REAL ESTATE R FSIDENT DECEDENT ESTATE OF SamU21 W. StOUffer FILE NUMBER (Property joirriy-owned wittr Right of Survivorship must be disclosed on Schedule F) Alf real estate should'be5reported at-fair market-value which is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to bu or sell ,both having reasonable knowied a of the relevant facts. ITEM NUMBER DESCRIPTION VALUE AT DATE, OFbEATH 1 • 1446 Walnut Bottom Road, Carlisle, Pennsylvania 50, 000.00 on line t, recapitulation) 60 000 COMMONVIEALTH OF PENNSYLVANIA .. INHERRANCE TA% RETURN RESIDENT DECEDENT SCHEDULE B STOCKS AND BONDS ~I propert 'ointl -owned with ri ht of survi ITEM NUMBER 1 ~ US Series E Bonds @ DOD FILE NUMBER 21-95-202 lip must be disclosed on Schedule F) DESCRIPTION o~a~ talso enter on line 2 recapitulation} (If more space is needed, insert additional sheets of same size) E AT DATE 'DEATH -~_ _ 11,137.55 11,1~f.55 COMMONWEALTH OF NNNSVIVANIA ' INHERRANCE TAK R7URN RESIDENT DEC~oENr CaIHIt ~r Samuef W. Stouffer - All ro ert 'aintl -owned with the Right of S SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY ITEM V~~"DESCRIPTION losed on Schedule F. NUMBER 1. Cash 2. Savings, Farmers Trust Comparl~ 3 3 `` 3. Farmers Trust Company D@a # 4-40388 4. Certificate of Deposit, Farmers Trust Company CD# 4188 5. Certificate of Deposit, Meridian CD# 4001970591 ~ 6. Certificate of Deposit, Meridian CD# 3064087574 ~ 7. .Certificate of Deposit, Meridian CD# 3064061587 ~ 8. Net Proceeds Sale of Personal Property 9. Pro-Rated Real Estate Taxes Total (also enter on line 4 recapftulati~ (If more space is needed, insert additional sheets of same size) FILE NUMBER 21 -95-202 VALUE AT DATE OF DEATH 2, 365.74 31, 531.53 `~ 43, 224.46 `f 31,907-.09 45;854.52 `~ 39,086.67 'f 18, 782.69 ~/ 6, 928.00 102.15 2 COMMONWEALTH ~FPpNSVLVANIA SCHEDULE H ~NHEMANCETPXRNRN FUNERAL EXPENSES, `~81OEH7O~~`"7 ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES ESTATE OF Please T e or Print Samuel W. Stouffer Fly NUMBER ITEM ~ 21-95-202 _ NUMBER DESCRIPTION AMOUNT A• Funeral Expenses 1 • Hoffman Roth Funeral Home _ 5, 373.40 B• 1 Administrative Costs : Farmers Trust Company P • ersonal Representative Commissions 13,136.82 Social Security Number of Personal Representative: Year Commissions paid 2• Attorney Fees Frey & Tiley . L 6 3• Family Exemption ,568.41 7 Claimant Relationship Address of Claimant at decedent's death Street Address City State 0.00 4• Probate Fees Register of Wills, Letters Testamentary 296.00 C• Miscellaneous Expenses: 1 • Joan Fry, Oath of Subscribing Witness Fee 2• 3• Diversified Appraisal Services, 1446 Walnut Bottom Road Short Certificate 25.00 225.00 4• Cumberland Law Journal, Advertising Letters Testamentary 3.00 5• Tom Oiler, Lawn Care for 1446 Walnut Bottom Road 40.00 6• Bidelspach Motors, Clean and Detail Chevrolet Celebrity 280.00 7• 8 Chimney Sweeps Inspections, 1446 Walnut Bottom Road ' 75.00 • 9• Shevlin s Maintenance Service, Cleaning 1446 Walnut Bottom Road Gilberts Pest C t l 50.00 58 3 on ro , Inspection 1446 Walnut Bottom Road . 0 10. Pecks Septic Service, 1446 Walnut Bottom Road 55.00 11. 12• Cumberland County, 1 °k Transfer Tax on Sale of Real Estate, 1446 Walnut Bottom Road The Sentinal, Executor's Notice 200.00 600.00 13. David Sheibly, Hauling Trash 65.48 14. Federated Investors Insurance, Trust Insurance 65.00 15. Miscellaneous Filing & Closing Costs 103.00 400.00 ~~a~ also enter on line s, reca itulation 27,6 .41 (If more space is needed, insert additional sheets of same size) • C•OMMOMNEALTH OF PEI~gVLVANUI INHERfTANCE TA7( F41gN HESIOEHT OEC'EDBr SCHEDULEI DEBTS OF DECEDENT MORTGAGE LIABILITIES AND LIENS Samuel W. Stouffer Fiji= NuMSeR _ - -- 21 95 2Q2 ITEM NUMBER DESCRIPTION AMOUNT 1. 2. United Service Company, Telephone Service Arnold Fuel Oil, Fuel 78.41 3. ~ Carlisle Community Ambulance 438.69 4. Robert C. Cairns, 1995 Real Estate Tax, 1445 Walnut Bottom Road 20'87 5. PP&L, Electric Service 128.87 6. Carlisle Imaging Associates Balance Due 78.69 7. , _ Belvedere Medical Corp, Balance Due 132.71 8. IRWC Emergency Physicians Balance Due 23.98 9. , Carlisle Cardiopulmonary Associates Balanc D 20.78 10. , e ue Carlisle Hospital, Balance Due 31.86 11. BFI, Waste Disposal Services 716.00 52.67 i o[a~ taiso enter on line 10 recapitulation) 1 (If more space is needed, insert additional sheets of same size) • 'COMMONWEALTHOF Po.INSVLVANIA INHERffANCE TAX ~yRN RESioEKr cEC~tENr ESTATE OF Samuel W. Stouffer ITEM NAME AND ADDRESS OF BENEFICIARY NUMBER A. Taxable Bequests: See Attached List ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY B. Charitable and Governmental Bequests: 1 • First United Methodist Church 64 East North Street Carlisle, PA 17013 SCHEDULE) BENEFICIARIES FILE NUMBER 21-95-202 RELATIONSHIP aoyERNMENTAL BEQUESTS (Also enter on line 13 Recapitulation) (If more space ~s needed, insert additional sheets os same size) AMOUNT OR SHARE OF ESTATE AMOUNT OR SHARE OF ESTATE 500.00 7 00 Samuel W. Stouffer Estate Children of Miriam Stouffer Hav6k (Sister) Linda Hawk Hill Niece 303 East Garfield Street Shippensburg, PA 17257 Nancy Hawk Byers Niece 12594 Stonewall Road Shippensburg, PA 17257 Children of Mrs. William Shade (Sister) Gregory Shade Nephew 80 Carlisle Road Newville, PA 17241 Children of Guy H. Stouffer Guy W. Stouffer Nephew 150 Gordon Drive Carlisle, PA 17013 Arlene S. Faesel Niece 2105 Cedar Lane Enola, PA 17025 Children of Earl P. Stouffer (Brother) Jeff Stouffer Nephew P.O. Box 310 Sharpsburg, MD 21782 Children of Paul Stouffer Paul Lee Stouffer Nephew 20215 Beaver Creek Road Hagerstown, MD 21740 Rebecca Stouffer Mummert Niece 5201 Gate House Court Sykesville, MD 21784 3.7037% 3.7037% 3.7037% 3.7037% 3.7037% 3.7037% 3.7037% 3.7037% Children of Glenn R. Stouffer (Brother) Glenn R. Stouffer 8 Midland Road , Nevwille, PA 17241 Samuel Stouffer 12496 Polomino Place Lake Ridge, VA 22192 Paul E. Stouffer 1315 Doubling Gap Road Newville, PA 17241 Patricia Stouffer Deutsch 12420 Conde Drive Highpoint Brookville, Florida 34613 Children of Earl Hofsass (Brother-in-Law) Marie Hofsass Hoffman 218 South 7th Street Steelton, PA 17113 Children of Russell C. Hofsass (Brother-in-Law) Ronald Hofsass 943 Emily Drive Mechanicsburg, PA 17055 Douglas Hofsass 1953 Miller Road Hummelstown, PA 17036 Raymond Hofsass 1277 Ash Lane Lebanon, PA 17042-9618 Children of Blanche Shade (Sister-in-Law) Donald Shade 13743 Welty Road Waynesboro, PA 17268 Nephew Nephew Nephew Niece Niece Nephew Nephew Nephew Nephew i 3.7037% 3.7037% 3.7037% 3.7037% 3.7037% 3.7037% 3.7037% 3.7037% 3.7037% Ernest Shade 125 Frick Avenue Waynesboro, PA 17268 Tucker Shade 203 Harbaugh Avenue Waynesboro, PA 17268 Audrey Shade Eshelman 126 Northeast Avenue Waynesboro, PA 17268 Alice Shade Provard R.D. # 10, Box 218N York, PA 17404 Linda Shade Hovis 312 Geiser Avenue Waynesboro, PA 17268 Cynthia Shade Miller 204 North "W' Street Lompoc, CA 93436 Children of Vivian Moats (Sister-in-Law) Gary Moats 545 N. Railroad Street Palmyra, PA 17078 Gloria Moats Fink 102 Sun Valley Road Elizabethtown, PA 17022 Children of Catherine Swartley (Sister-in-Law) Harper Swartley 121 South Locast Street Shiremanstown, PA 17011 Shirley Swartley Hershman 825 West Main Street Princeton, KY 42445 Nephely = ,: - 3:7037% Nephew 3.7037% Niece _ 3.7037% Niece 3.7037% Niece 3.7037% Niece 3.7037% Nephew 3.7037% Niece 3.7037% Nephew 3.7037% Niece 3.7037% LAST WILL AND TESTAMENT OF SAMUEL W. STOUFFER i I, SAMUEL W. STOUFFER, widower, of South Middleton Township (R. D. 7, Box 370, Carlisle) Cumberland County, Pennsylvania, being of sound and disposing mind, memory and understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking and making void; any and all Wills by me at anytime heretofore made. 1• I direct my hereinafter named Executor to pay all of .my just debts and funeral expenses as soon after my death as may be Found con- venient to do so. I direct that my funeral services be conducted by the Hoffman-Roth Funeral Home, 219 North Hanover Street, Carlisle, Pennsyl- vania, and that my body be interred on my burial lot located in Cumberland Valley Memorial Gardens near Carlisle, Pennsylv~ia. ,%y 2. I give and bequeath the sum of $500. 00 to the trustees of First United Methodist Church, 64 East North Street, Carlisle, Pennsylvania, their successors and assigns, to be used for such purposes as said trustees shall deem best. 3. All the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever the same may be situate, I give, devise and bequeath as follows: a. One-third to my sister, Helen Shade, wife of William Shade, her heirs and assigns, provided she shall survive me by a period of Ninety (90) days and should she fail to so survive me then the same shall lapse and be added to the balance of my estate hereinafter disposed of in subparagraph ,~~H b ixeof. ~ ~III~ ~~ hli.i;j (ir, ~I .~ ~ ~~ Page- 1 of 3 Pages r_; b. The remaining two-thirds shall be divided equally among Bch of my nieces and nephews and the nieces and nephews of my labewife, Coldie E. Stouffer, their heirs and assigns, per capita, who shall survive me by a period of Ninety (90) days, the share any ~iiece or nephew failing to survive me by said period of Ninety (90) days to pass to his or her issue per stirpes, all of said nieces and nephews being the following persons: (1) The 2 children of my sister, Mrs. Miriam Hawk, they being Linda Harris and Nancy B3=ers•. (2) The one child of my sister, Mrs. William Shade, he being Gregory Shade. (3) The 2 children of my brother, Guy H. Stouffer, they being Cuy W. Stouffer and Arlene Stouffer. (4) The one child of my brother, Earl P. Stouffer, he being Jeff Stouffer. (5) The 2 children of my brother, Paul Stouffer, they being Paul Lee Stouffer and Rebecca (6) The 4 children of my deceased brother, Glenn R. Stouffer, they being Ronald Stouffer, Samuel Stouffer, Paul Stouffer, and Pat ri cis Deutsch. (7) The one child of my wife's deceased brother, Earl Hofsass, she .being Marie Hoffman. (8) The 3 children of my wife's deceased brother, Russell C. Hofsass, they being Ronald Hofsass, Douglas Hofsass, and Raymond Hofsass. (9) The ?children of my wife's sister, Blanche Shade, they being Donald Shade, Ernest Shade, Tucker Shade, Audrey Eshelman, Alice Linda and Cynthia 4T0) The 2 children of my wife's sister, Vivian Moat a, they being Gary Moats and Gloria Fink. (11) The 2 children of .my wife's deceased sister, Catherine Swartly, they being Harper Swartly and Shirley Hershman. 4. Should any person less than Eighteen (18) years of age be entitled to distribution from my estate, in such event I nominate, constitute and appoint Farmers Trust Company and its successors, 1 West High Street, '' ..Carlisle, I'ennsylvania,~' as guardian of the estate of each such person, and ~, authorize and direct it to receive and to invest the same, and to pay the income arising therefrom; together with so much of the principal thereof i. as in its opinion is necessary or desirable to be expended for the proper maintenance, support and education of such person, to or for the benefit of such person, and upon l3uch person attaining Eighteen (18) years of age to pay to him or her the then remaining principal together with any un- distributed income. 5. I hereby nominate, constitute and appoint Farmers Trust Company and its successors, 1 West High Street, Carlisle, Pennsylvania, as Executor of this my Last Will and Testament and further direct that it shall not be required to post any bond to secure the faithful performance of its duties in the Commonwealth of Pennsylvania or in any other jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament written on 3 pages this 23rd day of April, 1981, .~E~~! (SEAL ) Samue Stouffer Signed, sealed, published, and declared by SAMUEL W. STOUFFER the Testator above named, as and for his Last Will and Testament, in our presence, who, in his presence, at his bequest, and in the presence of each other, have hereunto subscribed our names as attesting witnesses. ~~~~._ ~ '~ ~~ ~~ ~ '' ~~ ~ I~~~ ~~C i~~~:i~ ~I ~ f ~. ,~ .~. ~, ;; , . Page 3 of ;3 Pages COMMONWEALTH OF PENNSYLVANIA BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION INHERITANCE TAX DEPT. 280601 HARRISBURG, PA 17128-0601 STATEMENT 0 F ACCOUNT REY-1Spl E% AFP (pS-9)) DAVID W MACLVOR FARMERS TRST CO TRST DP PO BOX 220 CARLISLE PA 17013 06-23-97 STOUFFER SAMUEL W TM ,::gg~'16-95 `' 21 95-0202 "`'CUMBERLAND 101 Amount Remitted DATE ESTATE OF DATE OF DEA FILE NUMBER COUNTY ACN MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE NOTE: To insure CARLISLE, PA 17013 proper credit to your account, submit the upper portion of this form with your tax payment. ------------------- CUT ALONG THIS L_I__N_E - RETAIN LOWER P_ORTI_O__N__F_OR YOUR RECORDS __ REV-1607 EX AFP --- ----°-°--- (03-97 ) ------------ *~~ INHERITANCE TAX --------- STATEMENT OF ACCOUNT ~(~(~( ESTATE OF STOUFFER SAMUEL W FILE NO. 21 95-0202 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN CTHE NAMED ESTATED SHOWN BELOW 97 IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-16-95 PRINCIPAL TAX DUE: .........._ PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) OS-08-95 AA047732 07-18-95 AA048019 1.736.84 .00 * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A '•CREDIT•• (CR), AMOUNT PAID 33,000.00 4,424.78 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 39,161.62 39,161.62 00 00 ------_ .00 REV-1547 EX AFP (12-94) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX ACN 101 APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX DATE 10 - 23 - 9 5 DATE OF DEATH 02-16-95 ~~~~ ~ FILE N0. 21 9 - 202 COUNTY CUMBERLAND NOTE: TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM WITH YOUR TAX PAYMENT TO THE REGISTER OF WILLS. MAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT^ REMIT PAYMENT TO: DAVID W MACLVOR FARMERS TRST CO TRST DP PO BOX 220 CARLISLE PA 17013 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 Amount Remitted CUT ALONG THIS LINE- - RETAIN LOWER.POR_TION FOR YOUR RECORDS ~ ----------------------------------------- _ ____ REV-1541 EX AFF t1P-94) NOTICE OF TNHEkT`i'AFi~E 'ftix-aww~a~§t~ie~s; ALLOWANCE 0'i~ ------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF STOUFFER SAMUEL W FILE N0. 21 95-0202 ACN 101 DATE 10-23-95 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Or-nad Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expanses/Adm. Costs/Misc. Expanses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Begwsts (Schedule J) 14. Net Value of Estate Subject to Tax (1) 60 , 000.00 (2) 11 .137.55 (3) .00 (4) .00 (5)__ 219 .782.85 (6) .00 (7) .00 (8) 290,920.40 27, 619.41 (9) (lo) 1. 723 53 (11) 99.342 9 (12) 261, 577 .46 (13) 500.00 (14) 261,077.45 NOTE: I1' an assessment was issues previously, lines reflect figures that incl d 14, 15 and~or lti, ii and 1Fs wiii u e the total of ASSESSMENT OF TAX: ALL returns assessed to date. 15 . Amount of L ine 14 at Spousal rate (15 ) • 0 0 X . 0 0_ . 0 0 16. Amount of Line 14 taxable at Lineal/Class A rate (16) .00 06 0 17. Amount of Line 14 taxable at Collateral/Class B rate (17) 261,077.46 X . = X .15. . 0 39 161 62 18. Principal Tax Due . TAX CREDITS: (18) 39,161.62 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST (-) AMOUNT PgID 05-08-95 AA047732 1,736.84 33,000.00 07-18-95 AA048019 .00 4,424.78 TOTAL TAX CREDIT 39,161.62 BALANCE OF TAX DUE .00 INTEREST .00 TOTAL DUE .00 ~ IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN 51, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE Zl - pennsylvania DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX REV-1607 EX AFP (12-14) INHERITANCE TAX DIVISION PO BOX 280601 ����RD.=D OFFICE OF' STATEMENT OF ACCOUNT HARRISBURG PA 17 6 1 REGISTrr; GF VILLS DATE 02-09-2015 ?01 Cg �"� C� ESTATE OF STOUFFER SAMUEL W L DATE OF DEATH 02-16-1995 G LE C c FILE NUMBER 21 95-0202 MACLVORORPHAN'SDAVdD7• T W COUNTY CUMBERLAND ACN 101 FARME6i KTRST,LCO':T'RST',DP,`: Amount Remitted PO BOX 220 CARLISLE PA 17013 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE _-_-)_ RE_TAIN LOWER PORTION FOR YOUR RECORDS _ F- _ - - - - - _ _ _ _ _ _ _ _ _ _ REV-1607 EX AFP C12-14) *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF:STOUFFER SAMUEL W FILE NO. : 21 95-0202 ACN: 101 DATE: 02-09-2015 THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-16-1995 PRINCIPAL TAX DUE: 39,161 .62 PAYMENTS (TAX CREDITS) : PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 05-08-1995 AA047732 1,736.84 33,000.00 07-18-1995 AA048019 .00 4,424.78 TOTAL TAX PAYMENT 39,161.62 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. (� V�\