HomeMy WebLinkAbout04-0941Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of VIOIJF. T SARAH STAHL No.21-04- 0 ~t/[
also known as VIOLET S. STAHL
Late of of the Township of Lower Allen, County of Cumberland and
Commonwealth of Pennsylvania , Deceased Social Security No. 186-03-1857
_Cindy Ann Shelley .Petitioner, who is 18 years of age or older, applies for:
(Complete "A" or "B" Below)
A. Probate and Grant of Letters Testamentary and avers that Petitioner is one of the alt_.._e.mate
Co-Executors named in the Last Will of the Decedent, dated the 1 lth day of March, !997.
The primary Executor, namely, Harold Lavere Stahl, her husband, predeceased his wife in death having
died on the 14th day of February, 2001. The remaining alternate Co-Executor, namely, Harold Laverc~
Stahl, Jr., her son, renounced his right to administrator the Estate by Renunciation dated the 19th day of
October, 2004.
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 bom or adopted after execution of the
documents offered for probate; was not the victim of a killing and was never adjudicated incompetent:
NONE
B. Grant of Letters of Administration
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following
spouse (if any) and heirs:
Name Relationship Residence
Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family or principal
residence at 940 South 29th Street, Camp Hill, Lower Allen Township, Cumberland County, PA
Decedent, then 84 years of age, died October 04, 2004, at 940 South 29th Street, Camp Hill, PA
Decedent at death 6wned property with estimated values a follows:
( if domiciled in PA) All personal property $5,000.00
(if not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of Real Estate in PA $10,000.00
situated as follows: 940 South 29th Street, Camp Hill, Lower Alien Township, Cumberland County, PA
Wherefore, Petitioner respectfully requests the probate of the Last Will presented with this Petition and
grant of letters in the appropriate form to the undersigned:
Typed or printed name and residence
_ ._~;7~,~/ Cindy Ann Shelley 2071 Poplars Road, York, PA 17404
Page I of 2
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner above-named swears that the statements in the foregoing Petition are tree and
correct to the best of the knowledge and belief of Petitioner and that, as personal representative of the
Decedent, Petitioner will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed
before me this / ~P/X day of
For/a~ ~egister
r~~-- No.
21-04- 0~q /
Estate of Violet Sarah Stahl a/k/a Violet S. Stahl Deceased
Late of Lower Allen Township, Cumberlapd County, Comm~¢alth ~-3Penns~lvania
Social Security No. 186-03-1857 Date of Death: October 4~.2004
· C'~3 .
AND NOW, ,20 ,iin consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented bef0~ me,
IT IS DECREED that Letters X Testamentary ~ Of Administrati°n. are h~by granted to
Cindy Ann Shelley in the above estate and that the instrument dated the 1 lth day of l~ch, 1997
described in the Petition be admitted to probate and filed of record as the Last Will of Decedent·
FEES
Letters .................. $50.00
Short Certificate(s) $9.00
Renunciation ......... $5.00
Affidavits ( ) ......... $
Extra Pages (6) ......$18.00
(Will)
Codicil ................ $
JCP Fee ..............$10.00
Inventory ............. $
Automation fee ..... $
Other ................... $
Total ......... $92.00
I.D. No.
Address:
Telephone:
Register of Wills
Paul C. McCleary, Jr., Esqu~e
07408
Shiloh Professional Center
1998-A Carlisle Road
York, PA 17404
(717) 764-5926
,i- ~: o ccrlil'y thai thc inlbrmation here given is correctly copied from an original certificate of death duly filed with mc as
I ,t .l! l..cgislrar. Thc original certificate will be lbrwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this cerlificate, $2.00
P 10¢8S71¢
No,
Local Registrar
Uti 0 7 Z004
Dale
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
el=
DECEDENT
(Elm,
Middle,
SECURiT~I ~;EM;~;NUMBER
Last)
t Violet Sarah Stahl Iz female ~a 186 -- 03 --1857 ~aOctober 4, 2004
AGE (Last ~h~y) I UN~R 1 Y~R IUNDER 1 DAY I DATE OF B R/H I 81RTHP~CE (City a~ IP~ACE OF D~TH f~ o~v one- s~ ~st~i~s ~ ot~r '
COUNTY OF DEATH CITY, ~RO. T~ OF ~TH J FACILITY ~ME (If ~l mohican, g~ve s~eet and numbs) ~WAS DECEDENT ~ HISPANIC ORIGIN? I~CE - ~en~n Indian. Back ~t}ile et,
I
~0~ Cumberland I Lower Allen ~ I ........... ]No~Yes~lfyes, s~C~an I(S~ofy)
· i~' ~wp. I~. =qu ooucn zWt~ btreet IMe~,P~R~n, etc ' I --.
DEC~OENI'S USUAL ~CUPATION I KIND OF eaSINESS I INDUSTRY ' ~NT'o~ e El I ~,
~,. Assistant Manager I~b Publishing "~' ~
~O[CEDE~'S MAILING ADDRESS (StreW, Ci~wn ~late Zip ~3 ~ ~g~¢ ~ ~
Sou h XX ,
~,~. Camp Hill, PA I
"- George ~
INFORMANT'S NAME (ly~fiot)
tta. Assistant Manager Publishing
DECEDENT'S
ACTUAL
(See instructions
on other side)
940 South 29th Street
17011
FATHER'S NAME (Fl~t. Mille. LaSl)
Geor Yocum
!2ea. Harold L. Stahl~ Jr.
Donat,~ [3 ~na, ~] C~ma.~ E~emova ,mm Slate []
21a. Other(Sp~}...
DECEDENT'S USUAL OCCUPATION KIND OF BUSINESS / INDUSTRY
~VVAS DECEDENT EVER IN ~ DECEDENT'S EDUCATION ~ MARITAL STATUS - Mamed,
I U'SyesARMEDNoFORCES? I Ele~lmyISeconda~¥(SPeCi~ calf t~e~l _Fi~e eomCeted}co#age I Dsvorced (Specify} ' SURVIVING SPOUSE
'''. I ,. w.o.ed
~?a. sat. Pennsylvania Did 17c. [] Yes, decedenl~ivedm Lower Al%¢ll
live in a
~7~. Co~V Cumber land township? l?d. [] No, decedent #red
Elizabeth Byers
I INFORMANT'S MAILING ADDRESS (Streel, City/Town, Stale, Zip Code)
i~0~. 20 E. Green Street. Shiremansto~. PA 1701
I OATE OF DISPOSITION ~ PLACE OF DISPOSITION- Name of Cemetery Crematory ~LOCATION - C y/Town State Zip Code
I
' .......... 200 F ' 1
I--].=~h. =~.olling Green Memorial Pa :hal. Lower AllenTwp. ~PA 17011
SIGNAI~F FUNERAL,~'~IVI~(~I~EN~R PERSON ACIING AS SUCH I LICENSE NUMBER I NAME AND ADDRESS OF EACILIIY 13,
,~ =,/~,C-~. ~(u~T~ I==h FD 012 848L ',,c- -arthemore FH & CS, Inc.
~t-_ 2.( ~.~.~;,_-~,s23a:conlyWhenc~inO Irotfl~kemOfmvknowledaedeath^~..--:.' .......... I .Y,O.Box 431. New Cumberland.PA 17070-Cl4ql
~ pay ' ~ not available at lime of death to I tS ~ ~ ..~ .&,.~, '- -"t-' u~m u~ , I LICENSE NUMBER IDATE SIGNED
~ person who pronounces death. I.~, .',, I i oath, Day. Year) I WASCASE REFERREDTOA MEDICAL EXAMINER /COROhER?
_ ~,. .5o M. ,, 10 H o
YesD
IMMEDIATE CAUSE (Final
2AUSE (~sease ~ iqu~ c.
res~ti~ ~ ~a~ ) ~ST d
WAS AN AUtoPSY I ~"~ AUTOPSY mUmNaS I aANNE~ OF m**H
I
I ~Tg~L, ~T~¢N OF CAUSE
~"D ~o ~"~ NOD
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CERTIFIEFI (Check only of~e)
, e~ ) ,a ate¢~ ....................................[]
'PRONO~LINCING AND CERTIFYING PHYSICIAN (Physician both pronouncing death and certifying to cause of death)
To the Ibe~t of my knowledge, death occurred et the time, date, and place, and due to the ClUle~(i) lad manner as Iteted ...................... C
'MEDICAL EXAMINER/CORONER
On the halts of examination and/or investigation, In my opinion, death occurred at the time, dale, &r,d place and due to the causes $) and
S SIGNATU ~D' MBER ' ~ ~
I-.
Approximate
intel'va batweel
onset and deati'
PART I1: Other signdinant conditions contr~botmg to death Out
not resulting in the underlying cause given in PART I
I DATE OF INJURY I TIME OF INJURY IN~IURY AT WORK? I HOW INJURY OCCURRED
Pending Investigationn'_?t_ __ ,Oh. -- j Ye, [] No [] I
C°uldnotbedet~rmined ~ URY Athome farm street fac M 30c. ~30d.
j ~ At home, t.rm. ~,, Ioc~/. om~ ~AT,ON (Str~, O~//Tow., Stat°)
130,. .
SIGNATURE AND TITLE OF CE R
L CEASE NUMBER../' _ ?~ - -I DATE SIGNED (Mo~t~ Day, Year)
~ME AND A~RESS OF PERSON ~O COMPLETED d~U~F ~E~TH --
(Item 27) Ty~ or pflnt Z'~ ~
32. ' ' ~' : ~ / ~/ 2~
DATE FILED (M~¢Day~) ' -
Register of Wills of CU~ERL~ County, Pennsylvania
RENUNCIATION
E~i~e~ VIOLET SARAH STAHL
.o. 21-04-
Late of the Township of Lower Allen, Count~ of Cumberland and
- lvania _~ecea~ed
The undemlgned, HAROLD LAVERE STAHL, JR., SON and one of the alternate
(Relationship) (Cap~) Co-Executors ~
the above Decedent, hereby renounce(s) the right to admin~er the eata~ a~d respectfully request(s) fl~at
Lel~ersbe issued to CINDY ANN SHELLEY~ DAUGHTER and the remaining alternate Co-Executor
names in said Last Will.
WrrNES$ .my handbS~ 19th _day~ October X~_ 2004 .
Harold Lavere Stahl, J~$igna~ura) f/-
20 E. Green Street
Shiremanstown, PA 17011
(Addras.s)
Sworn to c~ affirmed and subscribed
before ma this 1 9t~h day
o~ nnt-nh~.r
(Signature)
(Addra~) ~-~
(Signature)
(Addre~)
Notary Public
My Commission Expires:
(S;gr, aaJm and ~eaJ of Not~y ~
~ o~ NOLO. comm~of~.)
Fom~ eRW..4
Renunciations executed outside the Office of Register o¢ W~lls
in rome counties a~e required to be notaAzed.
LAST WILL AND TESTAMENT
OF
VIOLET SARAH STAHL
I, VIOLET SARAH STAHL, A RESIDENT OF 920 SOUTH 29th STREET,
CAMP HILL, CUMBERLAND COUNTY, PENNSYLVANIA, BEING OF SOUND
MIND AND MEMORY, DO HEREBY MAKE, PUBLISH AND DECLARE THIS TO
BE MY LAST WILL AND TESTAMENT, AND HEREBY REVOKE ALL PRIOR
WILLS AND CODICILS AND WRITINGS IN THE NATURE THEREOF,
HERETOFORE MADE BY ME.
I. I DECLARE THAT I AM MARRIED TO HAROLD LAVERE STAHL, A~ND
THAT ALL REFERENCES IN THIS WILL TO "MY HUSBAND" ARE RF=~FERENCES
TO HIM. :'
II. I DECLARE THAT I AM THE MOTHER OF TWO CHILDREN: HAROLD
LAVERE STAHL JR., OF 20 SOUTH GREEN STREET, SHIREMANSTOWN,
PENNSYLVANIA; AND CINDY ANN SHELLEY, OF 2071 POLARS ROAD, YORK,
PENNSYLVANIA, AND THAT ALL REFERENCES 1N THIS WILL TO "MY
CHILDREN" ARE REFERENCES TO THEM.
III. I DIRECT THAT MY FUNERAL AND BURIAL EXPENSES SHALL BE
PAID FROM MY ESTATE PRIOR TO THE DISTRIBUTION OF MY ESTATE AS
PROVIDED FOR HEREIN.
IV. I GIVE, DEVISE AND BEQUEATH ALL THE REMAINDER OF MY
ESTATE TO MY HUSBAND, PROVIDED THAT HE SURVIVES ME.
V. IF MY HUSBAND DOES NOT SURVIVE ME, I GIVE, DEVISE AND
BEQUEATH ALL THE REMAINDER OF MY ESTATE TO MY CHILDREN WHO
SURVIVE ME, IN EQUAL SHARES PROVIDED, HOWEVER, THAT IF ONE OR
BOTH OF MY CHILDREN SHALL PREDECEASE ME BUT ISSUE OF SUCH
CHILD SHALL SURVIVE ME, THEN THE SHARE OF MY ESTATE WHICH
OTHERWISE WOULD HAVE GONE TO SUCH CHILD OF MINE SHALL BE
DIVIDED AMONG THE ISSUE OF SUCH CHILD OF MINE IN EQUAL SHARES.
VI. ALL SHARES OF PRINCIPAL AND INCOME HEREBY GIVEN SHALL
UNTIL ACTUAL DISTRIBUTION TO THE BENEFICIARIES BE FREE OF
CONTRACTS, DEBTS, ANTICIPATIONS, ASSIGNMENTS, PLEDGES OR
OBLIGATIONS OF ANY BENEFICIARY AND THE SAME SHALL NOT BE
SUBJECT TO LEVY, EXECUTION OR ATTACHMENT WHILE IN THE
POSSESSION OF MY PERSONAL REPRESENTATIVE.
VII. I DIRECT THAT ALL INHERITANCE TAXES THAT MAY BE
ASSESSED IN CONSEQUENCE OF MY DEATH SHALL BE PAID FROM MY
RESIDUARY ESTATE AS A PART OF THE EXPENSES OF THE
ADMINISTRATION OF MY ESTATE.
VIII. IN ADDITION TO THE POWERS CONFERRED BY LAW, MY
PERSONAL REPRESENTATIVE SHALL HAVE THE DISCRETIONARY POWERS
TO RETAIN FOR DISTRIBUTION IN KIND ALL MY PROPERTY OR TO SELL
ALL OR ANY PART OF SUCH PROPERTY UPON SUCH TERMS AS HE MAY
DEEM ADVISABLE; TO EXCHANGE OR LEASE FOR ANY PERIOD OF TIME
ANY OF MY PROPERTY; TO COMPROMISE ANY CLAIM OR CONTROVERSY
WITHOUT COURT APPROVAL; TO MAKE DISTRIBUTIONS IN CASH OR IN
KIND; AND TO DETERMINE THE VALUE OF ALL MY PROPERTY.
IX. I HEREBY APPOINT MY HUSBAND AS THE EXECUTOR OF MY
ESTATE, PROVIDED THAT HE SURVIVES ME. IN THE EVENT THAT MY
HUSBAND DOES NOT SURVIVE ME, I HEREBY APPOINT MY CHILDREN AS
CO-EXECUTORS OF MY ESTATE.
X. I DIRECT THAT MY PERSONAL REPRESENTATIVE SHALL NOT BE
REQUIRED TO GIVE BOND FOR THE FAITHFUL PERFORMANCE OF HIS
DUTIES IN ANY JURISDICTION.
IN WITNESS WHEREOF, I, VIOLET SARAH STAHL, THE TESTATRIX
ABOVE NAMED, HAVE HEREUNTO SUBSCRIBED MY SIGNATURE AND
AFFIXED MY SEAL THIS 1 lth DAY OF MARCH, 1997.
THE FORGOING INSTRUMENT WAS ON THE DATE THEREOF
SUBSCRIBED AT THE END THEREOF BY VIOLET SARAH STAHL AND BY HER
SIGNED, SEALED, PUBLISHED AND DECLARED TO BE HER WILL IN THE
PRESENCE OF US AND EACH OF US, WHO UPON HER REQUEST, IN HER
PRESENCE, AND IN THE PRESENCE OF EACH OTHER, HAVE SUBSCRIBED
OUR NAMES AND ADDRESSES AS ATTESTING WITNESSES HERETO.
, residing at
, residing at
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA }
} SS.
COUNTY OF DAUPHIN }
I, Violet Sarah Stahl, the testator, whose name is signed to the foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will; that I signed it willingly and that I
signed it as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and acknowledged before me by Violet Sarah Stahl, the
testatrix, this 1 lth day of March, 1997.
Violet Sarah Stahl
William H. Andring, Es~/
Pennsylvania /
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA }
} SS.
COUNTY OF DAUPHIN }
We, .~ t !~t4.:t .~,5, and
witnesses who~e~ames are signed tr~ the attached or foregoing instru'~nt, b'ein~'duly
qualified according to law, do depose and say that we were present and saw the testatrix
sign and execute the instrument as her Last Will; that the testatrix signed willingly and
executed it as her free and voluntary act for the purposes therein expressed; that each
subscribing witness in the hearing and sight of the testatrix signed the will as a witness;
and that to the best of our knowledge the testatrix was at that time 18 or more years of
age, of sound mind and under no constraint or undue influence.
_ Sworn to ofr)affi/~r~ ed and subscribed to before me by ~c"' ~Fl ~¢ 7
and~?.r/i~h C ?_~/~ &~ ~'/c; ~, witnesses, this l lth d~'~ ofl~ai:ch, 1997.~
Witness
Witness
~eillnnis~l?a~iTdring, Esy
ATTORNEY'S CERTIFICATION
COMMONWEALTH OF PENNSYLVANIA }
} SS.
COUNTY OF DAUPH1N }
On this, the ~,9t.,/77./ day of ~ M,J ~J/ , lllggt, before me
· , the undersigned offil~er, personally appeared
William H. Andring, known to me or satisfactorily proven to be a member of the bar of
the highest court of Pennsylvania, and certified that he was personally present when the
forgoing acknowledgment and affidavit were signed by the testatrix and wimesses.
In witness whereof, I hereunto set my hand and official seal.
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Violet Sarah Stahl also known as Violet S. Stahl
Date of Death: October 4, 2004
Will No. 21-04-00941 Admin. No.
To the Register:
I certify that notice of estate administration 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 20, 2004 :
Name
Harold Lavere Stahl, Jr.
Cindy Ann Shelley
Address
20 South Green Street, Shireman.~town, PA 17011
2071 Poplars Road, York, PA 17404
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except NONE
Date: October 20, 2004
Signature
Name Paul C. McCleary, Jr., Esquire
Shiloh Professional Center
Address 1998-A Carlisle Road
York. PA 17404
Telephone (717) 764-5926
Capacity: Personal Representative
X Counsel for Personal Rep.
PAUL C. MCCLEARY. .JR.
LAW OFFICES
AREA CODE 717
764-5926
WANDA L, STAHLE
LEGAL ASSISTANT
PAUL C. McCLEARY, JR.
FAX 764-5928
SHILOH PROFESSIONAL CENTER
KAREN A. GALBREATH
LEGAL ASSlST,o..NT-REAL E.STATE
\998-A CARLISLE ROAD
KARIN A McCLEARY
LEGAL ASSISTANT-REAL ESTATE
YORK, PENNSYLVANIA 17404-1412
MARY E, RUHLMAN
LEGAL ASSISTANT
VIA FEDEX
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July 18, 20W-i~!:~
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Attn: Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013-3387
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Re:
Violet Sarah Stahl, Deceased
File No. 21-04-0941
(,)
C;)
Gentlemen:
For and on behalf of my client, Cindy Ann Shelley, Executrix of the above-captioned Estate, we are
enclosing herewith the following documents for filing:
I) Original Inventory;
2) Original and one (1) copy ofPA Inheritance Tax Return, Resident Decedent (Form REV-1500);
3) Estate check No. 163 in the amount of$240.00 representing the filing fees for the above Inventory
($15.00) and Inheritance Tax Return ($15.00) together with the required fees for additional Letters
Testamentary ($210.00); and
4) Estate check No. 164 payable to the Register of Wills, Agent, in the amount of $4,545.33
representing payment of the tax and interest due on the above Return.
Also enclosed herewith are three copies of the cover pages ofthe above Inventory and Return. It will
be appreciated if you will clock-in these copies and return them with receipts for the above filings and
payment to the undersigned in the enclosed self addressed stamped envelope for our files and those of my
aforesaid client.
In the event that you have any questions concerning the above, or require any further information,
please give me or my Legal Assistant, Wanda Stahle, a call at the above telephone number.
PCMcC,Jr:mr
Enclosures
cc: Cindy Ann Selley, Executrix
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REV-T500 EX + (6-00)
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT 280601
HARRISBURG, PA 17128-0601
-jDECEDENTS NAi;iE;lAST, FIRST, AND MIDDLE INITIAL)
, Stahl, Violet Sarah
l--..-__~__.__~~
i DATE OF DEATH (MM-DD-YEAR)
! DATE OF BIRTH (MM-DD-YEAR)
I 08-27-1920
10-04-2004
I @ 1. Original Return n 2. Supplemental Return
I 0 4. limited Estate 0 4a. Future Interest Compromise (date of death after
I 12-12-82)
!xl 6. Decedent Died Testate (AHach 0 7. Decedent Maintained a Living Trust (Attach
I,~ copy of WIll) copy of Trust) .
I 1-' 9. litigation Proceeds Received 0 10. Spousal PovertY Credit (data of death between 0 ".Election to tax under Sec. 9113(A) (Attach Sch 0)
\ --.---J 12-31-91 and 1.1.~5)
-!TliISSECTIONMUSTBE COMPlETED.ALLCORRESPONOENCEANDCONFIOENTIALTAX INFORPilATION SHOULD BE DIRECTED TO: ~-
~ , NAME COMPLETE MAILING ADDRESS
~ I Paul C. McCleary, Jr.. Esquire
~ I FIRM NAME (If applicable)
::! I
8 t;:1 T.ELEPHONE NUMBER -
717/764-5926
~~ Real Estate (Schedule A)
I
I 2. Stocks and Bonds (Schedule B)
I
(JFAPPLlCABLE)SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL)
I
I
1--- .------- .-----
I FtLE NUMBER
i 21 04
I cou~~._ YEAR __
- ------1 SOCIAL SECURITY NUMBER -
1186-03-1857
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
--I SOCIAL SECURITY NUMBER
LJ 3" Remainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
o 8. Total Number of Safe Deposit Boxes
0941
. NUMBER
1998-A Carlisle Road
York, PA 17404
3. Closely Held Corporation, Partnership or Sole-Proprietorship
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4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Properly (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L) [1 Separate Billing Requested
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has
not been made (Schedule J)
I 14. Net Value Subjectto Tax (Line 12 minus Line 13)
----T-_n
I 15.Amount of Line 14 taxable at the spousal tax rale,
or transfers under Sec, 9116(a)(1.2)
!16.Amount of Line 14 taxable at lineal rate
, 17,Amount of Line 14laxabie at sibling rate
10. Debts of Decedent, Mortgage Liabilities, & Liens (Scheduie I)
11. Total Deductions (total Lines 9 & 10)
12, Net Value of Estate (Line 8 minus Line 11)
(1)
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(8)
110,000.00
(2)
None
(3)
None
None
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(4)
(5)
(6)
(7)
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10,725.95
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120,725.95
(9)
(10)
13,408.19
6,558.91
(11) 19,967.10
(12) 100,758.85
--~- ---
(13) 0.00
(14) 100,758.85
~----- ----------
x .00 (15) 0.00
--~-------
x .045 (16) 4,534.15
-----~ -------
x .12 (17) 0.00
x .15 (18) 0.00
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.0
0.00
100,758.85
0.00
0.00
(19)
4,534.15
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
-.
>>BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH<<
Copyright 2002 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00;
.
..
Decedent's Complete Address:
STREET ADDRESS
940 S. 29th Street
~-
CITY Camp Hill
I
iSTATE
-------,
PA IZIP 17011
---
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) 4,534.15
0.00
Total Credits (A + B + C)
(2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
11.18
(3) 11.18
(4)
(5) 4,545.33
(5A)
(56) 4,545.33
Total Interest/Penalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS. AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;......................................... ......................... [] [X]
~: ;::::~ ~;e~~~:i~on~~s:~~e~~s;~~..S~~." use the prope~y..t~~".sf~rr~~..~.ri.t~.I~~~me;.....:::::::::::::................ B ~
d. receive the promise for life of either payments, benefits or care?............................................................. 0 [!]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?. ................................. ................... ...................................... 0
3. Did decedent own an "in trust for' or payable upon death bank account or security at his or her death?........ 0
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?............ ............................................ ............................. 0 [!]
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 penalties of pa~ury, 1 declare that I have examined this return, including accompanying schedules and statements. and 10 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 know1edge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS
Cind Ann Shelley
, ~~k
SIGNATURE OF SON RESPONSIBLE FOR F1Ll~TURN
o
[!]
-------O~
2071 Poplars Road
York, PA 17404
AODRESS
~
DATE
ADDRESS
DATE
1b&loS
For dates of
surviving spouse is 3% [72 PS. 16 (a) (1.1) (i)l.
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfer:
[72 PS. 99116 (a) (1.1) (iI)]. The statute does not exempt a transfer to a surviving spouse from.
of assets and filing a tax return are still applicable even if the surviving spouse is the only benefi,
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 ag\
natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefi
99116 1.2) [72 PS. 99116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 1.. .y. :s" I 10 (a) (1.3)J. 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.
e of the
(\ ~~J)
, isO%
sclosure
a
J AlASI
S.
.
Rev-1502 EX+ (6#98)
*'
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Stahl, Violet Sarah
FilE NUMBER
21-04-0941
ESTATE OF
All real property owned solely or as a tenant In common must be reported at fair market value. Fair market value is defined as the price at whiCh property would be
excnanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts.
Real property which Is jointly-owned with right 01 survivorship must be disclosed on schedule F.
ITEM
NUMBER DESCRIPTION
1 Premises known and numbered as 940 South Twenty-Ninth Street, Camp Hill, PA
17011 - Being the same premises which A. Richart Bittle, Jr. and Dorothy M. Bittle,
his wife, by Deed dated the 7th day of August, 1964 and recorded in the Office of
the Recorder of Deeds in and for Cumberland County, PA in Record Book H21,
Page 776, granted and conveyed unto Harold L. Stahl, Sr. and Violet S. Stahl, his
wife. The said Harold L. Stahl, Sr. died on the 14th day of February, 2001, thereby
vesting title to the above described premises in Violet S. Stahl, surviving spouse,
by operation of law.
VALUE AT DATE
OF DEATH
110,000.00
TOTAL (Also enter on Line 1, Recapitulation)
110,000.00
(If more space is needed, additional pages of the same size)
Copyright (e) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule A (Rev. 6-98)
.--- ----..- --. .--......J -"-.J _.......,"',;.;l"TIoJ,
.UI'I-l\Ft.WO flU U~,~4 rJJ TluuLC/lII! LMH rL1Il1
t.JVI'.'.....V-..J IV."'O,""IIlIJ
rllh NU. 111 IQij O~t.O r. U(
.
AGREEMENT OF SALE
Al.L.~ MUST Ii' COMPLETIlO AHO DlaOLOSUltl! 'ORM ll/lJN~ 151:'ORE TfoIlS "liREI:.MEIH III &IBNEP
'tlll8 AGRe!ImIT It m:tde on Iho fII8 af June N :HlC5 ~y I4MllIlicatlon No. ...!!II!.:tHJ..M51-ClS2
1. PAR"l1~: IlelMln I. od .
A1.C~ .hereinderc;j/JldS.N.r,lnd , nd ~ . <"'aidIng"
_mg. """'bum ~6 lip Codl L.1m!Ll, _ I ",,"od BllYtr.
Z. PROPClt't'/: ....., hereby ogre". 10 MIl .no convey 10 'I.II/Ir, _ "'19llY aorell to Pl/IIlI1l1e' ALL THA. T CE~T "',N ""el
0/ glllund wfth ...~.Illlroon, W...." kn...... "' (end herelnafte' celled PRlpelly) f40 SIlUII'l29" 511n1 Ca"1Q t1~1 ._ . _
-lV.ii;;;; l1lP'&d. In 1lI1 munlclpel!ly Qf LOWll' AJ~ ~'"ll"hID Coun'" of CumberJ.nd
...,..,.,~ '. I 11011 . '--' tT
S. ZONING: 'TIle zoninQ _I~ of1hlt Proptlrt)ll$ It-1 Slnall Flrnl'" RMldentilll
~ PUReHASI ""'CI: 'tlul """"",..""e,,,"I en.l1undtadTon 'IllOIlM....nd DDl1D /1110,000.00) bolla';-'-'-'-
Ii. IJfP08lTS: Securl1y lor till purc/lUII.1O be U 1DIla...: . .
.) S~ ~ in .._ at.lgnlng of Ihlt IISJIllernenl \II bl neHl OY Paul C MoCIe8lY Jr. EIll L_I
CllIInulIo, .~
b) 70 Il* pold wflhln _ _tlM~.,. of ....",pten.. of III. A;reo- and hDld j~ ..e_.. __.
0)' To" plla on or ~1a1ll1l1$ ~ of .nd hold In ",aow.. Ibo...
G)$ NotedclinNdluignlnQollll15Ag""'tMnl, .-
I) $ , OIlIer (apooiIy) _ .
.. 'INAtICItlG CONTINGENCY: T1lJ& 11$10 ie con~l...o" ~/ obIaInlnll \1\.. fOIlowlng flnoneln,'
1l1_~fiIlancrng:"IIA . Te<mot: 1 """.l'ypeafIlnRPll'inIl:_ NIP..
tIIo (l'IncIIAlIjutlItw/IIltIlJed). Interul raw. ..tlIA.-%. -,. 8uYef ~ to _pi thl inllll&l roue ;~ moy he
commnled by mOltg.IMdor. nol 10 ......Ii . """1'11\I" _I ,... of ..vA ".
b} The II'Dimum flnwndng ~Clmonl re., otllllllllllon tIe,loon dll\;Gvnt I'll.. Gr .,mU... cha!'\11 il.ny. 10 1>& l'llid bv 8UVEA
.hl~ not owe.od NJA f. olllle fma<lCing being oblllnod.
g) '11\, "",'mumftnllnclllll__nlf86. QtiOinIlionfm!.laandioellunt IN. or Ilmalreharlll If ;ny, 10 be paid by SeLLEFt
""annat_.a NIP. "oll""~ol>olnIlD_e4.
d) 1lIr)'li,1IJ1lII1IlII." colll*'1d appllaotion to . "'IIO",1ble IIftCllnllln.lllulioh oMthin calende, d.y, /rom tlto dRre
of ...."*"'" Ilflllra Ac1reemenr. Should Ih, Buy""" 10 INIIt& Ouo::l\ compIolad "I'P\kdOn wllhirl tho ._eo time, ~ ~II be !no opt",n
of\!l<a ~1" dlOlorw Ihll .......rtIfIIl or~.,,, null."" Yoid Ilwhlch llmo" depaoIt~ ,*0 on o=unll>'f EI"YII." Iny. sholl b.
~ to llIll SeIet IIlIllquillllll'" dlmlge$ 1M III CIlfIieo 01 this ~"" .1\II111le m.moo 10 11'I1 Soli.. "" <:ancolllltien.
.)" -l!IortII'lII Ollmmillllfnl mull be obtained by the doll! of -Wf;u , II a written commitmon'
.. nlll reOillVed by IMI d.... euy.r ana SeIer "010 _nd till l!OlI1/IIIlnl.nl dllfe UMTs Ir 'Inn"lloo,IM. Ill_men! in wrijinll' and
If 6elltr.o _....lhil ~I. ~y dopIlIillhlll be ..lum<ld to l!l\lYltf.
n 8l1Wf' tdfllOwledaoa IhIt fBihlrolo _rile ." 1M _'ng el 11M ""'''Q~JIII loan opplic8ll.n wIIl<fl ...- I" In.
''lIlut.IO Obllllllpprovol or.1lI01\gIglt IOtrlwl! COnWlula. default an the port 01 Suye,. J
7. ADDmQNA\. TIIlMlI ..,.D CONTIMGiINClII A~E: _
"W~"'n.m>>pI...",or8llfWIlOllmlll\1oo0Il'-lno<lon"'boferD1I'lollol.oof: ~ 'i= o...Ji(">~ ;l\ '1, '~c>u'
b)8etdomenllllobeon<<boforwlll.~..ol' -mL~~I... 2..ne...-~ .
0) pg,,_"ion i. '" be d.1Nwod u ""IOWI: . dtl' '7 .
d) !IoyrMnl oIln1noro, _. wf~ Ito _jyi"~ lQually luylf and lIelle..
0) "II Inoom. a/lIl ~, Includl"ll but notllmfto" '" r.' ..,..IDeo. I\In~ ...11". .........0 ,"".. chorgH. conoo
lee.. ~. o"~tlon 10... and f1mlllr ens,,". pUblic 0' p~wlo. .nlll bl (lr01'I1ll~ 10 delft or (eellleml'nl/l)Q,'St!$Sirm) on . ft. I
)'IIlrbooll.
~ ""-'jl II .r~~.., f_,1/1,,41.M...fl. H._ ........:A...the \.... Jt..w.- -~ .....'1.,.. ,tdf Irf.J~J., Co'" 'O7~"~1.
g)
.. I'IXnIAiII, Tlll!H, SHltU...~, "eo AlI,lumblng, h..~no. IIi, _/Ilon.\t end ..."i..., ayoternf .n<! lIxlu... IInd
1)'Ilom. .pau"....nl tn..... In'" (Olnllna I p." lheNlOf; allle"n*" mUll llIll rolor .Ytltml; ........... .10111'1 ..$II .nd/o, dMIll: ~M~,,".
tIWfIIIlP. vene\lIn hllIlcIo. dl8pery and curl"n rodund "'_Iund ....ltllOK: couplfl\lll foIoppUlnoo.. r1dIlIO/ COVIll. krlchon ...binet..
.nd w.U v>...1I -'. Oil tro... Ih"d,llory. llflfI pilIming. now in 01 on I'/llPIrt)I, eM I'OlMInlng Ct;J0IUn!I ""If> .lOIOd on prom~OI. IXC9pt
II oIIlR II. Uled lor ordlnary elKlkfnll putpa... 10 II..... of .Olll"""on! end Rl!fnaol'ftOf .\<No lfIJ'SMr ond dNOr
elO
n 0
11>0
n) 0
D C
10. lTI\.E AND IJURV!Y:
a) Pr~~"'''' cvn-.1 fI'oo and _,otoll i'M. ontJllmb",nCC$ _ U_III"'. EXC~PTING.. _one publleand
prlvlll m.'_ ...__ or ObIJglll101l1. ol>llgldlon. to horn_",. 0' o:of\GOmlnium 8"odo\\OIIO, t:Xis~", liuild,ng ...maionl.
OI\ltJlUII""', _'"'1!ItI Ofmcll. ..somonla vlflbll upon the Qmund. plhIIllgn 0' ~gn" 0' pUllllC leMa ""mplII\ln, W _~y, OItlOPWIIe the
11l!61O ['",pOlly ohlll be to<lcll\nd marltwtablt Ind ~Ch II willllO I"",..ed .t rogut.. nil" I>)' I IIlpu....,. Utilln.\Il'Ia~ oo..,~"ny.
b) 111.,,,,,,,*",,0\ convwvo VIKld Ind "'"",_"lll1o. ,"... .....11"" insured al raguJo"eles by. ItPUllbl1 ~llolnlu..nC8
=mpany. tIIIn !uyor ha. tne apfan of I1l (oldnQ .uen ~ ii' Stilt( un giYewltn"'" Ibatom.m or PIlCO. Of (2) boing ",funded .11 deposil
monia peld on _ by Buyer, lIeny; .... s.lI.. WI" ro'rnbmlllluyor lorony _It _.. II)' Buyer for InllllcUon, por1o'"'''' ~nCIP.r
lhalMJl6e\i"" Mdlllldulll .ny~ium f""li1Io inl""'.... endl.. ~Uo ....... ....\.. ,," .."".I\ollon 01"''''0, """ ...noellllion fill 10' 110OO
inI\ImIOt ill\etrlll' tlIZlntlill\lrance wflll Ollwnlltll ~e. 'Murln.. blMer eI1.~... Of O8nOetlotlon foe ond IIftY 8Pl>rolul fe". ,nd In
(lie lot1Or """"~ 1Il~ an$1l ~ no1urthll Dlbtlhy orobllgofion on alth... of In. partiN t1oralO and Ihll Agreemenlllllll blc:crnUull an~ valet
C) Any WN8'i or SlINey> wIlieh mlY bl req.lred by 1M II\Ie ....ranco company or Ih.. ab"""CItng allamov, lor ,fie
p,;eo. Tho foIlowlnllllan\I.;;bCI.UIl!D trcm I/Ie ulo: NON!
NOne (1/ tIl. oIrove rIltlI\tiOl'l"" induded ttemo "-~ be feI'nO'Itd I>)' SoIle, !rtIm prlml_ stlef!110 dalo ol1nil Agtol!l'l_nt. 1$'"1< ~.(tlf>y
waNW\lS thollSl.a, WIll IMtIWlr gOd~ t1110 to .11 tho 111I.... de.erIMllln 111" p....,,.ph. and any o!her ftsturcs Of u_ or po,sona"y
sP_llllII)IlChldllled to bo Inc:lIudld 11\ \1111 00'-.
9. DlSCI.OSURES ANClINSP'ICTION': Tne toIlOwtng '!!'f!llan cIlIQ'lllI~'" OI811llend..... which a,e ""eeked balool.", ..II",........
'" Inl. Agreemen\ ond modo I pllll Mrtof, .nd Buyer KK/lOWIOdgoa n1colpt Dltha nm.:
Il %X SE~LeR'8 PROpeA1'YD1SCLOSUN~ SI II I ~M!NT roquimlro,oJIIM:Jperlywtlh U"I~ lou/(4) l1IoldlMllIlawlJling
units
II) C INSPECTION ~DINDUM.
0) IX HOUSlNO BUll. T IiFORE f97!: DI,dollft of lrtformltioll on Lead-Baootl P.int.nIl Lad-auld "llnl H_rd..
cI) C UND!IIELCPI!D LOT: SOWPfl' ~/IQIIR'" 1'j0000e for lIIIaOVOlOpelllo\ r.quirt<! by PCMtylvenie Sewag" F ecili~
Act.
HOLDING TANK: Sowto. Fdd.. NCIl1ce fgr holdlnSllnk /QqUI'od by F'.MIVIValll_ S.... ~.I;iIi\I.. "e.
EXeMPT SePTIC $VS'TSM: II"",,,,, Fecll1lle. NQlioe lot lime requlltltf by F'onnsy'""nJa SOW.g'l'acllftICS /let
CONDOMINIUM NOTICe _II PIOMlty lllwOlYoa a eondDl!1inium.
PLANN!D C.OMMUNITY NOTICE whor. p~ If\VIlIvtls . planne<l e...m~~llY.
1..'l4CUJOIiD in \1\0 ~I" and /lurch..."
.--- ----..- ---. -----, -..-., ..............-...........s
-.... ... .......... ~~u .....Vlrol III H""'~Utl"l ,,"n I JI\lI
w"",,-c.-'-v.J 1 V.......M1yIS
rM 1M "I IO~ :1:1.:0 ~', (jj
,d~C
==:~~C:~~'::~=~I::=:e'::"~=.=:::=pelatllfbySeINlr. However.
"~~a~e:~::==mSIl~ ~O'.' ,"llot:'hM. !.:M,dl'" otltla _don Of CIlIa AQreemIllt by ~r, Selltrr t.pre..~tf lwhicn
... - . ..... 0 Ul\IttnoInt andlllllU .-. l.nt_nll Ihl"
I' NIl ......,.nlJ. DIIltr 1I11n OllIrlln, Ill., 1M, er <horg.., for publle I~ Ilwe "';'n lM~ 11\I1"''' \he PnopfllTy
III Sill" hili M ~ at any IIaIlce or OMIlI by IIIIY IOYtl'nrntn..' body lor "'.....ei"". -. "",lUll.,; OUI noIUmite<l
10, -. Idler. JIfnW. -. ,,"""alllt and crnvawav conllNdlon or hi,"*" III bo doIle an ar.oUllll\ll the 'mperly.
el No IlDllIIMlInium or nom.a..,o,", I.HllitliDn _nil. .. or""'o, eM'll.o, ~ Iny, ,emaln unpllid
~ Siller lias "" ""CIWlIdee or ony ""'101 ar elder br erfmm ony lJD-""'t or pulllle .ooMority relallng to "''''.'10''''
of ZOtlUlg, hllWlllV, lUUdillg, 1Iftty. <<re, 01' O\Iter orllllllllOlI or-.
.) San. ho ,I\fomwd s.".. or IIfl)' hidden or INIII....... or WhIch SIII..- he. ~nowteIIge
~ """,,,10 ~nt 511ll1'__ ,"lI.aU_III orllOtiooo mWllicn.a netwin, UlelI SCllerlnlll ,,"mldi.'fIlI 91"u
~ ~';: In IUch "'ant, thl perlin Ih.. .tl....ptlo .-golf". tIMoterms orllll. Agreomonl, If .....bl.ta 10 10. Ihia ~gre_''''.1I
12. llIPltD_NTATl0N8 AND AOKHOWLIEOQI!M~Nlll OP BUYM:
I)" II untItI'ItllOCllMI81lYeI /'I, 1n'lIIleIHtlla PIllpIr\y. 0> tIwr.by.......1ne rltI"lIo 10 so, Ind he. lIgrM414 purehtt.
"U I nttwM at eudI cnslleClloll\ - nolllll....... of or ,n "'ian"" upon Iny .......Wlllcn IlOt tnoluded htltin. wheU..r lMllo "V Sa.., Qf
~ OIIIIrolloo" IlIIrIner. Ofmployee Of51111er, orDY an 19tftl,If,ny, 0/ s.ntrO/ IhlYIfOl DDlh. Th' 8..,.r"". Igrncr 10 purth... the
PI'OIltIlY In Ilt pre_ condtllllll unleo, DIhetwlI. .pIOIlIed hi...".
b) llu,.rl.Mllilldllleteeeeu to. publlo I'OOIdrnayrl'lllJAllnul_ at.. l1illhwlll_"ncy patl'II.t from III. D.,..""'onl
uI T"",.lIfJfldon.
n. lI!NPIR AMP Po.:SIl1UlON:
., Till. .""b llII ~ IIY Wly Oh..fl'I/\ljI d.n Inll pllo$~.ion fa to be il6I"'.,." Dy ,",y. \'0 'VICllnl budding (II lilY)
broom otean, ....at.llrit, or lIydnd Ind alignment at --"9-.(s) It time of nllle""""l if pmnil" it ""nl OO<>JJQd.' ,n. .f9n.ng
of \nil ~l. unl.., OIIlar'Wfll ap.ClIllell Mffin.
II) _..III "........,lmo any_I.._, orwrittenOlll.nllon ol"'llln9la",os,lIlny, olm. "'lIlpIlfywi1tullJt~e"ed
"'lIIan __otlhalluywr.
c) FDI'IMI"', /If en IllI/1JlIld d-.d llIICl punlhlr.. mOMy II hereby Wll_.
d) ~r~ 1he rlghlla "'e"'" p_.lllolMlllln.pldlon Of 1M PtllIlIl"Y.
14. MAlNTltlANCE AND RISK 01' LOe!:
11 SIIIoIr .h111 malllllln \he PropI/lY OrlC:ludlnq _n Mo ","ntionoll in I'" .,~, T_, $hNbbely, !Ie" ......graph
ebove) Ind Iny pa....n.1 propetly lplIeil1<lallY ICfllCluItd M"ln In lIS P"'",I a,,"d_. nomwl_IM IMr a_plld
~l eaRer .heft bur l/ltl Itlk of 10." (nm\ nil '" other CUlltlllel \MlR time of MIlI_nt. 'n 1M .vanl 01 dlmegela .ny
pr,,*,,, Illl:Iudeclln Ihlllll" by "Ill or alhet casually, /101..,...,..0 or I.plw<td plio' 10 Itlltemant, BUYCI' $tltIr h... till ftp~on of .awnes",;
\hi. ~ Ind .-ivlng lit monje. poid on ,_, or ol.-\IIIftt tnltJlfOPlllYln kllMn condition !dO'lIlerwith the "",oeeal of .'\Y
1l0U1-11mV11Y olllllll.lIleby "lIIr, If~YII io lleleby notllled lhat he ""Y intulI nls lItlulPI* 1IlI0001lln Ih. p~ II 0' Ihotim. ot
the e~ t*thll """'nt.
ts. RECOftlllNCl: ThIe All"IemenllheU no! b. ._f'lI'" In thl OtlloIlIlrlhe RIOOItIInO of o..da or 1II1ny 011>11 om.. ft, ~
o1l1UIilIC nICQnl.
fl. AtIIGIIMIKTI ,.hlt AIlMmenleh.1 De binding upon tlIapertfet.lIl8lr~'it lIells, ~llIp_nIItivN, guertlllns
and SIJ~ft. ll/Id to.... _1IlI.tIiiMbl., on 11\.. .nlan. of the p.nl.. h,reto,ll being ""I"""*IY underltoall. ~ft..ewr, InollM Hure'
lflIllllOl nntfer or efllQn lhle AIm,,*,,1 WIlI\flU\ 1ho writton COlllent /If II1e Setler.
17. DPAIILT: Tfn1I ahlM IIUltho __\WIll rotlKlIil pell'vlmlllCll If any obligatiOn _InO unall' IfIla ~DI"l!lInl SIloul~
B"l'Ir t) ""10 m.tullY _oJ peymenlt, II spedfted In... 'Oopoei!t' perogroph _bow. 0,2) Iumlan fa"'. or Incompll" inlafmllllon
Ilr seDer. Iny _t i__ honwlth or Ih. ~aO'"nt1l1 ClO''''''''IIS Iluyo(a legel 01 "n.n",.' IUtllla, 00 3) viu/;rtw 01 rail to fIIlftq .no
pI!form .ny tit 1IIe terms or condftlon. Of 11110 AcI"''''''''', Sill., mey M Slllef, o/lllon. al.OI;
I) to ~d 'II."'! Bunrfor SlHtfllClUIII aamegel; 0'
b) ItlOePltll.D'l"fdeleddamagea IPId\e.1 ho...n. tawanlwlllcllan dlpbtb morn-a palO on 1000000nT I>Y tluye" ~ any, oh.,'
be IPlllied.
It 8ellef ..... option a), ....lluyw...1o pey 1I/llIO anD upon 01lDll PIVm8rll, the w.r antr Buyer """II be reteased lrem .11
Iltbllily or oIDIi9ttlOl' hlllWllder..,II \IIl5 Agreemotll"'all become nUll .no VOUl.
"s.1Jat _. opIon bl, lluyel' ...... IhlI UOOtl the dIo1l1llUllen 10 301.., or cr.poak "",n".. u .t1~ In oPIlon ~). 811)'&f doll
hINIly '.".N !he pItOOn or.ntJly 11I4II\(119 ~ Illllribullo~ from M)' .M an Ii8bK/ty for RI'I\IQIlIIy real.n or ....." dl.lrlbullOl\.
ShcuId Seller vioIaIe or "'Jib ftl\1In w IlIrfom1 ttrt ollh. termt Incl Cll/ldlllans or this Agretomenl. Buyer may .1Icl:
0' Ie P....... 8"""'"lImtdy tor .peclftc pent>rmanca of ItlIl Ag"emem; Or
&I) ptacee.1 .1IIltW W... /or e..v.,," .ClIlat d_s: at
Q) llOOfIIllhellqultlQll/ damq" IfIICIfted M~I\.
UnIHIllIIIorw!.. "*"'*' In InICAtI_m, UqUldl'ecldemaglll hereund.r shIlIt be EII'I(,n 'Thq"..M Ma 001100 tSr 1 00tl 00\
~i, EXECU'nOll: ThIIAgrHIllen. end ""lI.....~d_.lllel'lto. ",av b.llfk\I.... "" Iho po... Ily..... Ol""nl~olon thlOllQll
. 'oOlImlIt (FAll) NCNna: aIICh e OOJll/lhlll hlll/e Ille ..m.log.'It)/orc:.aOIlIly=na binding Il'roCl upon Il1a parti" N 11I0\1111"1...... .,gned
Ily au ,ertlelln ortglnal fQmI,
11. BlTI,q AGIUlt!MENT. ThlaAG'OOI'/lIfII_iII.1he al1ll... ogrcem.t1ll>otwllan Sallw "n<lIl..,.r. TIIoq 1nl.1lO 6\7Illlle""a,
ollila. 110M, OOIIInln"'. "I'fINlI1ItlOIll, Nt_menta.., tO~dHian., oral or athanNIoe '" .", Idncl wn.lJoavlr _mlng llIiI; .."', P'"r1t>or,
Ihilllgnremonl "'-111101 be IfIeNd, __rMted. ~oa or modtllecl ellCepll1t wrlling eoeeu'*<l by .J part,el.
APPfttIVAI.. BY I\IVER! Buytr. 'rtll~dinS'o be legally bound Milby. llAo _M. I. ~"._nll'" dey end 'f"8( r""l._ wrillDn.
WlTNESS~?~ . ' ~ If? (L 8UyeR',jl (SEAll
WITNESS: ~~~.... BUYliq. ,(SEAl.)
l H z.tiIar
"""RO\IA!. Py Quail: S$IIerI1e~t:IlU""rolIIt& 1III.1lIlYI prop_I en ""'.., or
e1et. of I",. Agreemw IIllIlIbe I!IO ae,o on lIhlGh 1110 oIIor or "flY eoun_, la '''''''pled IS IIt/lClQnOed
InIIJ"lIof~'.
, ~. E.tal. ot VIONlI Sentl1 Stahl
WtTl'lF.38; ~{' ~ \ SE~I.eIl: IIkIt Vlalet S. SlIIlI. da_.~d
WITNl!:S$:\~\)J lO.- ~ ~ SEll,e":~eli~~&/hrCc.
(seAL)
(SEALl
.
CERTIPI~~ ",ue &. CURREn
:Copy OF OR161HAl OnCONUl
CS?~
MADE THE ~ day of ~u
\
, in the year of our Lord two thousand ~ltJL (2oo.i.l.
BETWEEN CINDY ANN SHELLEY, Executrix under the Last Will of VIOLET SARAH
STAHL also known as VIOLET S. STAHL, late of the Township of Lower Allen, Cumberland
County, Pennsylvania, deceased, party of the first part,
-AND-
JIM R. ZEIGLER and LINDA H. ZEIGLER, husband and wife, of Mechanicsburg, County of
Cumberland and Commonwealth of Pennsylvania, parties of the second part,
WHEREAS, Violet Sarah Stahl also known as Violet S. Stahl died testate on the 4th day of October,
2004, and her Last Will dated the 11th day of March, 1997, was duly entered for probate in the
Office of the Register of Wills in and for Cumberland County, Pennsylvania, where it remains of
record in File No. 21-04-00941; and,
WHEREAS, the said testatrix, by her Last Will appointed her husband, Harold Lavere Stahl as the
Executor and her two (2) children, Harold Lavere Stahl, Jr. and Cindy Ann Shelley, as the alternate
Co-Executors of said Last Will; and
WHEREAS, the said Harold Lavere Stahl predeceased his wife having died on the 14th day of
February, 2001, leaving her two (2) children, the alternate Co-Executors, to administrator the Estate;
and
WHEREAS, by Renunciation dated the 19th day of October, 2004, Harold Lavere Stahl, Jr.
renounced his right to administrator the decedent's Estate; and
WHEREAS, Letters Testamentary were granted by the Register of Wills of said Cumberland County,
on the 19th day of October, 2004, to Cindy Ann Shelley, the alternate Co-Executor named in the
Last Will of the within decedent; and
WHEREAS, the said Violet Sarah Stahl also known as Violet S. StaW, at the time of her death, was
the owner of the real estate hereinafter described; and,
.
WHEREAS, said real estate of the decedent was not specifically devised; and
WHEREAS, Cindy Ann Shelley, Executrix as aforesaid, acting under and pursuant to the authority
given her under the terms of the aforesaid Will and Section 3351 of the Probate, Estate and
Fiduciaries Code, has agreed to sell the hereinafter described real estate, at private sale, to Jim R.
Zeigler and Linda H. Zeigler, husband and wife for the sum of One Hundred Ten Thousand and
00/100 ($110,000.00) Dollars;
NOW, THIS DEED WITNESSETH, thatthe said Cindy Ann Shelley, Executrix under the Last Will
of Violet Sarah Stahl also known as Violet S. Stahl, deceased, for and in consideration of the sum
of One Hundred Ten Thousand and 00/1 00 ($110,000.00) Dollars, lawful money of the United States
of America, to her in hand paid by the parties of the second part, at and before the sealing and
delivery of these presents, the receipt whereofis hereby acknowledged, has granted, bargained, sold,
aliened, released and confirmed and by these presents does grant, bargain sell, alien, release and
confirm unto Jim R. Zeigler and Linda H. Zeigler, husband and wife, their heirs and assigns,
ALL that certain lot or piece ofland with the improvements thereon erected, situated in Lower Allen
Township, Cumberland County, Pemlsylvania, bounded and described as follows:
BEGINNING at an iron pin, said pin being two hundred thirty-four (234) feet from the northwest
comer of 29th Street and the Gettysburg Road; thence northwardly along the western side of 29th
Street sixty (60) feet to an iron pin; thence westwardly along the line of property now or formerly
of Paul 1. Cressman and Lenora G. Cressman, his wife, one hundred sixty (160) feet to an iron pin;
thence southwardly along the line of property now or formerly of Richard M. Biggs and Nancy J.
Biggs, his wife, and PaulL. Cressman and Lenora G. Cressman, his wife, sixty (60) feet to an iron
pin; thence eastwardly along the line of property now or formerly of Glenn M. Coover and Anna C.
Coover, his wife, one hundred sixty (160) feet to an iron pin, the place of Beginning.
Having thereon erected a dwelling known as 940 S. 29th Street.
BEING the same premises which A. Richard Bittle, Jr. and Dorothy M. Bittle, his wife, by Deed
dated the 7th day of August, 1964, and recorded in the Office of the Recorder of Deeds in and for
Cumberland County, Pennsylvania, in Deed Book H21, Page 776, granted and conveyed unto Harold
1. Stahl, Sr. And Violet S. Stahl, his wife. The said Harold 1. Stahl, Sr. died on the 14th day of
February, 2001, thereby vesting title to the above described premises in Violet S. Stahl, surviving
spouse, by operation of law.
The aforesaid Violet Sarah Stahl also known as Violet S. Stahl, being so seized thereof, died testate,
as aforesaid.
TOGETHER with all and singular the ways, water, water-courses, rights, liberties, privileges,
hereditaments and appurtenances whatsoever thereunto belonging or in anywise appertaining, and
the reversions and remainders, rents, issues and profits thereof; and also all the estate, right, title,
interest, use, trust, property, possession, claim and demand whatsoever, in law equity or otherwise,
of in to or out of the same.
TO HAVE AND TO HOLD the said lot of ground, the hereditaments and premises hereby granted
and released, or mentioned and intended so to be, with the appurtenances, unto the said Jim R.
Zeigler and Linda H. Zeigler, husband and wife, parties of the second part herein, their heirs and
assigns, to and for the only proper use and behoof of the said Jim R. Zeigler and Linda H. Zeigler,
husband and wife, parties of the second part, their heirs and assigns.
AND the said Cindy Ann Shelley, Executrix as aforesaid, covenants, promises and agrees to and
with the said Jim R. Zeigler and Linda H. Zeigler, husband and wife, parties of the second part
herein, their heirs and assigns, by these presents, that she, the said Cindy Ann Shelley, Executrix as
aforesaid, has not done, committed, or knowingly or willingly suffered to be done or committed, any
act, matter or thing whatsoever whereby the premises hereby granted, or any part thereof, is, are,
shall or may be impeached, charged, or encumbered, in title, charge, estate or otherwise howsoever.
IN WITNESS WHEREOF, the party of the first part has executed this Deed the day and year first
above written.
Witness:
/-;: .h;fhj ~ '\ {./
~~
~~ (SEAL)
ndy Ann Shelley, E,:fe;utrix of the
Estate of Violet Sarah Stahl also known as
Violet S. Stahl, Deceased
COMMONWEALTH OF PENNSYLVANIA)
,) .) ss:
COUNTY OF (; m be-/< 4N cI )
On this, the jt.jd day of Ju /y , 200J, before me, a Notary Public in and for said
Commonwealth and County, the undersigned officer, personally appeared CINDY ANN
SHELLEY, Executrix of the ESTATE OF VIOLET SARAH STAHL also known as VIOLET
S. STAHL, who is known to me (or satisfactorily 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.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
~ A ~/YU-~-~
, Notary Public
N TARIAL EAL
ANN B. SENSENICH, NOTAR'( PUBLIC
CARLISLE BORD., CUMBERLAND COUNTY
MY COMMISSION EXPIRES MAY 1 Z007
I do hereby certify that the precise residence and complete post office address of the within
named Grantees is / rK 8' D 'y t::>,f k. ~OA.-b 1-1 GCl-{llrVi U t3 uJe G" A 17os:;
~ JLj ,20.Q.S"
D. ?~
V ~i v\" -,/ ,..-n,--j
Agent! Attorney for Grantees
CERTIFICATION OF RECORDER OF DEEDS, CUMBERLAND COUNTY, PENNSYLVANIA:
A Settlement Statement
U.S. Department of Housing and Urban Development
B. Tvne nf Ln.n OMS No. 250?02RS RFV Hlln.l (3IBB\
\. OFHA '2, OFmHA 3. DCQnv. Unins. I 6. File Number I 7. Loan Number I 8. MOr1gage Insurance Case Number
4 OVA 5 Dc '" 7EIf'>J "0 ^ no
C. Note: Tl1is IOfm is l\lmished ~o give you a statement of a.cluaJ settlement costs. Amo,,!nts paid to and by the settlement agent are shown. I
Items marked :(p.o.9T were paid oulside the elostng; they are shown here for Information purposes and are not included in the totals TilleExpress Settlement Syster
WA~NING: 111~ a crrme, ~},n~~~IY '!lake 'alse statements IO.!~M~n!~~\ S,tal;.~ on this or any=olt1er similar for~, ~enaltiflS upon i" 15llB..Aa
D. NAME OF BORROWER: Jim R. Zeigler and Linda H. Zeigler
1280 York Road Mechanicsbur. P A 17055
E. NAME OF SELLER: Estate of Violet Sarah Stahl
AnT)'''.'.'' 1998-A Carli-Ie Roan Yor> PA 17404
F. NAME OF LENDER:
Anno......
G. PROPERTY ADDRESS: 940 S. 29th Street, Camp Hill, PA 17011
Lower Allen Townshin
H, SETILEMENT AGENT: P A Real Estate Settlement Services, LLC
PI ArJ; OJ; ,.~, ."."T. _10 West Pomfret Street radiole pA 1701'1
1. SETTl" .., 07114/2005
J. SUMMARY OF BORROWER'S TRANSACTION: K. SIIMMARY OF SELLER'S TRANSACTION:
J 00. "'~!'1~~ .nn r."n~o' UE TO SELLER:
1 111 r.nnl,~1 ..1.. n,ln. 110 000.00 dn. r.nnl,onl..,., ,"" 110 000.00
Tn2. P.<<nn.1 .,nno<lv d1l2.
In.' ,'''",'dnnl 1 655.67 dn'
lnA dM
.n< dn<
S for '.m. .,n k .11, . , .n".nn. Anh ,.Im.nl, for item< oaid bv seller ., Mvance
106 An.
107 r.. ",,,,. 07/14/05,012/31/05 216.45 An7 07/14/05 In 12/31/05 216.45
J n. .Or' '"' 07/14/05 I. 06/30/06 985.95 dn. 0 ,^",.. 07/14/05,006/30/06 985.95
109 AnD
110. "n
111 d11
'" d12
120 liNT DUE FROM 112 858.07 420. GRO~~ AM!'11 INT DUE Tn o~, , ~": ill 2 0LlQ..
200 ~ PAin BY OR ON RFHAIF OJ; son. RJ;Dllr.TIClN~ IN AMClI INT DI)J; T!'1 oJ;11 J;R
201. 5 000.00 <n. O.m. e. ,."
202 <n, 0..'., "'"', , 10 ,elle, tHne 140m 2 144.55
,"' ,."hl." In <00 <,,'"",' IMnl<\'
211d en, P.~ffnfl . Ln.n
,no <no
'no <no
207. <n7
20B. enD
.no. <no
. ifems "no. in _" , unnaid hv .ell r
,. o. r."./lnwn '.0" ..n ""..,," "'.
211 <H e. """.0.'
212. .12
013. ..,
"d "d
215. ...
016 ...
217 '17
". ".
"n ...
220 TOTAL PAID 5 000.00 <on TnTAI ","nflr'TI!'1"l AMOUNT nfl~ 0,"11 ~~ 2 144,~
..nn r.A"'H AT o.TTI A ClR TO RClR~I)WFR Ron r.A"'H AT er NT IIF
.01. ,,,,.,, ,,/line 1201 112 858.07 Ant ..", ,''', ,dOm III :l.~
'02 Le" 5 000.00 .n, , ,."" m, . .,n, 2 144.55
,no 101 858.01 60. ,~" 109 057.85
SUBSTITUTE FOAM '099 SELLER STATEMENT: The Intormatlon conttllned herein Is Important lax Inlormation and Is being lumished to the Internal Revenue Service. II you are required 10 fill'! a return,
~~e~~~ean~eV~~~~~"~~~t~re S~ig~I~~~e~~~m!t~~~dlr~~:~I~~~is Item Is required to be reported and the IRS determlne$ \hat It has not been reported. The Contract Sales Price described on
~~~~~~, r:o~u~e:y ~el:~bj~::~IJ(~~ ~~~~:,e;~~2r~~~ (imegos:ag ~~I~~: Under penalllEtS or pe~J~~~ 1~~~IT;ih~~\~~~~~b~~~h~~~~~n ~~~~it~~:~t~sd~;~~~~~;~:/pOe~e~~~nCt\f:~~~~~e~~~~~~I~Ca(ion
'1'\N:_-_.~/_-_._ SELLER(S)SfGNATURE(S):
SELlER(S) NEW MAILING ADDRESS:
SELLER(B) PHONE NUMBERS' (H)
(WI
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
File Number: ZEIGLER
PAG
SETTLEMENT STATEMENT OPV ""n.j 13/861 . 0.,,,_ . 0"... t 1"OBAB'
L SETTL''''"'''T PAID FROM PI'.\D FROM
300. TOTAL ',"I I ',oorl no orice $110 000.00 - BORROWER'S SELLER'S
, ",. . 7M'. ,fnllnw,' FUNDS AT FUNDS AT
-1ill _$ SETTLEMENT SETTLEMEN'
702. .
701 ,,"., 0."'. ., ,..,
-.8Q0. '" '" I WIT" , nAN
BDl. . - 0&
Bn2 ".
Rn, A ..I,.,
Rn4
. B05 Lender's .";M ...
B06. Martn.a. A"n"","_n ..
Bn7 A ..
AnA
Rna
BID.
BI1
900. 'PAtn IN
901. Int.,.,t <. tn rill< Irt"
an> . Mn ,.. In
903. Hezard 'M 'n
904.
an.
lnnn ,o""oqmR
1001 H.",d ,- .n., .t1b$ Ima
1002. mo. t8l $ Ima
100. ,T.. mn. t8l. In
lnn4 0., nt, mn "". in
100_ mn "". in
.!DOS.Aeereeale 0.00 0.00
1100.TITt
I1nl d.
-' 102. Abslreol ,,"I. ,....,
1103
1104 T
-' 1 OS. OecumenI p, .n..."""
11 06. Nat.", F..,
I1n7
,Nn' t
110R
, Nn' I
110S. L.nd.r', r. ."n.'
1110. 110 000.00 -
1111. t, PA Real Estate Set.tlement Services I.I.C 450.00
11"
1113.
1200. GOY RFr.nR"IW~ AN" TRAN~FFR r."AR(';F~
1>01 38.50 . R.I.". . 38.50
. 1202. CIN/Ceuot, ..i,'.moo n..n'l 100.00 . Mannon..' 1 100.00 '-
1203 n..n.1 100 00 . MM. . . 1 100.00
1704 n..n' . ,,-,, .. .D, .,
.1205.
1300. A ~F-rT1
1301. SUN.'
"n>
"m .'n.t', ..T. .._ ~ Lower Allen Town.h~c 12.18
..n4 .<, n'.nt tn Lower Allen 'l'ownshi:c 67.17
..n_ In Bonnie K. Miller - Treasurer 10" 00
130B. School T. o >nn, I" Bonnie K. Miller Treasurer 1 022.37
140n TOTAL SE-rTLF"',^1T ('".,,"~~ ,..,. ,no o. J, ,. en o. . ., 1 655.67 2 144.55
HUD ceRTIFICATION OF BUYER AND SELLER
I:~\: 1~:~~~~~~~\~~~~~~I~~;~afr~:~~~~~,t~~~~e;6pa:g! \~~M~~; ~~re~~~~t~~~~t~\\el, It is a true and accurate statement 01 all receIpts and disbursaments made on my account or by me
J;mj?Jz ~
~.jJ. 6).J,.cr 0..
Linda. &\g r cr
~/;;. ~ .L//Af.
E.stateollJkl\e\ 'afah ~ ~J.L!
35.675574
WARNING: IT IS A CRIME TO KNOWINGLY MAKE FA.LSE STATEMENTS TO THE
\jNllED STATES ON THIS DR ANY SIMILAR FORM. PENALTIES UPON CONVICTION
CAN INCLUOEA FINE AND IMPRISONMENT. FOA DETAILS SEE TITL.E 16:
U.S. cooe SECTION 1001 AND SECTION 1010.
~y.-('
The HIJD.' Settlement SUllamenl which 1 have prepared Is a Irue and accurate account 01 this transaction
I have caused or will cause the runds 10 be disbursed In accordance with this stalement
,Q p
By' I :.,r.~,..,,-"_..' "t. --I,,:'" "~'Y_
DArE
7 /''-I/2.0U;
,
Rev-1508 EX+ (6.98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEAlTH OF PENNSYl VA.N\A.
INHERITANCE TAX Fl:ETURN
RESIDENT DECEDENT
Stahl, Violet Sarah
FILE NUMBER
21-04-0941
ESTATE OF
Include the proceeds of fitigation and the date the proceeds were received by the estate
All property jointly~owned with the right of survi"onhip must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Comcast - Refund cable service 5.80
2 Highmark - Refund unearned premium of health insuranc 232.94
3 M&T Bank Checking Account #75244489 - Opened 8/28/82 in the names of Harold L. 4.841.09
Mike Stahl, Sr. (Deceased 2/14/01) and Violet S. Stahl 000 balance $5,369.06 less
due/outstanding checks for $527.97
Accrued income on Item 3 through date of death
0.09
4
Woodlawn Memorial Gardens-PA - Refund of vault cancellation
1.122.73
5
1987 Mercury Sdn - VIN #2MEBM74F2HX642431
500.00
6
Household ItemsfPersonal property - Sold at private sale
4.023.30
TOTAL (Also enter on Line 5, Recapitulation)
10.725.95
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
REV-1151 EX' (12-99)
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Stahl, Violet Sarah
Debts of decedent must be reported on Schedule I.
FILE NUMBER
21-04-0941
ESTATE OF
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
See continuation schedule(s) attached 8,412.40
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City State Zip
-
Year(s) Commission paid
2. Attorney's Fees 4,500.00
See continuation schedule(s) attached
3. 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
4. Probate Fees 92.00
See continuation schedule(s) attached
5. Accountant's Fees
6. Tax Return Preparer's Fees
7 Other Administrative Costs 403.79
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation) 13,408.19
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (6-98)
*'
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWEALTH OF PENNSYl\fANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Stahl, Violet Sarah
FILE NUMBER
21-04-0941
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Perthamere Funeral Home. Funeral Services and Merchandise
7,096.40
2
Rolling Green - Grave opening/closing
895.00
3
Rolling Hills - Lettering of Memorial
221.00
4
West Shore Evan. Free Church - Funeral Luncheon
200.00
Subtotal
8.412.40
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-A (Rev. 6-98)
Rev-1502 EX+ (6-98)
.
SCHEDULE H.B2
ATTORNEY'S FEES
continued
Cot.ol-AQNWEAl TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Stahl, Violet Sarah
FILE NUMBER
21-04-0941
ESTATE OF
ITEM I
NUMBER
DESCRIPTION
AMOUNT
1
Paul C. McCleary, Jr., Esquire - Attorney fee
4.500.00
Subtotal
4.500.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B2 (Rev. 6-98)
Rev-1502 EX. (6-98)
.
SCHEDULE H-84
PROBATE FEES
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Stahl, Violet Sarah
FILE NUMBER
21-04-0941
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Paul C. McCleary, Jr. - Reimburse advance to the Register of Wills, Cumberland
County - Petition for Probate - $50.00, Renunciation Heirs - $5.00, JCP Fee - $10.00,
Short Certificate - $9.00 and Extra Pages - $18.00
92.00
Subtotal
92.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B4 (Rev. 6-98)
Rev-150Z EX- 16-98)
*'
SCHEDULE H.B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Stahl, Violet Sarah
FILE NUMBER
21-04-0941
ESTATE OF
ITEM
NUMBER
DESCRIPTIO N
AMOUNT
1
Cumberland County, Register of Wills - Additional Letters Testamentary - $185.00,
Filing fees: Inventory- $13.00 and PA Inheritance Tax Return - $15.00
213.00
2
Paul C. McCleary, Jr. - Reimburse advance to the Cumberland County Barr
Association - Advertise Letters Testamentary
75.00
3
The Sentinel - Advertise Executrix's Notice
115.79
Subtotal
403.79
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-1512 EX+ (6.98)
.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Stahl, Violet Sarah
FILE NUMBER
21-04-0941
ESTATE OF
Include unreimbursed med\ca I expen5es.
ITEM
NUMBER DESCRIPTIO N
1 Bonnie K. Miller, Tax Collector - Personal Tax
VALUE AT DATE
OF DEATH
10.00
2 Bonnie K. Miller, Tax Collector - 2004.2005 School Tax
1.036.83
3 Bonnie K. Miller, Tax Collector. County tax - $462.03 less prorota share 7/14 to
12/31/2005 - $216.45
245.58
4 David Sannis Center - Car Repairslinspection
79.15
5 Derr's Trash Hauling - removal of debris from real estate
565.00
6 Expenses on sale of premises known and numbered as 940 S. 29th Street, Camp
Hill, PA -1% Realty transfer tax - $1,100.00, Tax Certification - $10.00, prorata share
sewer/refuse 7/1 to 7/14105 - $12.18 and 2005/2006 School tax $1,022.37 less 7/14 to
6/30/06 of $ 985.95 - $36.42
1.158.60
7 F. M. Oppel - Heating oil
230.72
8 F. M. Oppel- Heating oil
170.10
9 F. M. Oppel - Heating oil
279.97
10 F. M. Oppel - Heating oil
245.57
11 F. M. Oppel- Heating oil
224.16
12 Harold Lavere Stahl, Jr. - Reimburse for Patriot News - Advertise sale of real estate
148.00
13 Kirby's Paneling Center - Replace carpet
198.74
14 Lower Allen Township - Account # 1033820-0 Sewer and refuse rental for 10/1/2004
to 12/31/04
73.35
15 Lower Allen Township - Account #1033820-0 Sewer and refuse rental for 1/1/05 to
3/31/05
73.35
Total of Continuation Schedule(s)
See attached
pagels)
TOTAL (Also enter on Line 10, Recapitulation)
6,558.91
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
Rey-1512 EX- (6-98)
*'
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
stahl, Violet Sarah
FILE NUMBER
21-04-0941
ESTATE OF
16
DESCRIPTIO N
Lower Allen Township - Account # 1033820-0 Sewer and refuse rental for 4/1/05 to
6/30/05
VALUE AT DATE
OF DEATH
ITEM
NUMBER
79.35
17 M& T Bank Checking Account #75244489 - Origina I check return fee 5.00
18 M& T Estate Checking Account #9839274876 - NSF fee 74.00
19 M& T Estate Checking Account #9839274876 - Check order/printing of checks 11.75
20 Mike Stahl - Flowers, wreath and curtains for property 78.18
21 PA American Water - Account #24-1414943-1 Water rent 10/8/04 to 11/4/04 12.17
22 PA American Water - Account # 24-1414943-1 Water rent 11/4/04 to 12/08/04 12.17
23 PA American Water - Account #24-1414943-1 Water rent 12/8/04 to 1/10/05 12.22
24 PA American Water - Account #24-1414943-1 Water rent 1/10/05 to 2/8105 12.22
25 PA American Water - Account #24-1414943-1 Water rent 218/05 to 3/8/05 13.39
26 PA American Water - Account #24-1414943-1 Water rent 3/8/05 to 4/8/05 12.86
27 PA American Water - Account #24-1414943-1 Water rental 5/6/05 to 6/7/05 16.36
28 PA American Water - Account #24-1414943-1 Water rent 9/9/04 to 10/8/04 42.26
29 PA American Water - Account #24-1414943-1 Water rent 4/8/05 to 5/6/05 14.61
30 PPL Electric - Account #10930-74000 billing 10/18/04 to 11/16/04 134.98
31 PPL Electric - Account #10930-74000 billing 11/16/04 to 12/16/04 48.08
32 PPL Electric - Account #10930-7400 billing 12/16/04 to 1/18/05 57.38
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
Rev-1512 EX+ (6-98)
ESTATE OF
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Stahl, Violet Sarah
FILE NUMBER
21-04-0941
ITEM
NUMBER
VALUE AT DATE
OF DEATH
33
34
35
36
37
38
40
41
DESCRIPTIO N
PPL Electric - Account #10930-7400 billing 1/18/05 to 2/16/05
53.16
PPL Electric - Account #10930-74000 billing 2/16/05 to 3/18/05
55.55
PPL Electric - Account #10930-74000 billing 3/18/05 to 4/19/05
46.53
PPL Electric - Account #10930-74000 billing 4/19/05 to 5/15/05
49.09
PPL Electric
39.80
Ritters True Value Hardware - New knobs and pulls for kitchen and bath
41.50
39
Robert Shelly - Reimburse advance for paint and supplies
119.16
Robert Shelly - Reimburse for boxes
39.77
S. Hollerbusch - Parts and switch plate for repairs on property
36.57
42
Snyders Paint Store - Paint for property
56.29
43
Snyders Paint Store - Paint for property
164.92
44
Snyders Paint Store - Paint and supplies
43.99
45
The Sentinel - NFS charge
20.00
46
Traveler Insurance - Account #017254944 Monthly Homeowners fire insurance
42.33
47
Traveler Insurance
42.33
48
Traveler Insurance
42.33
49
Traveler Insurance
42.33
50
Traveler Insurance
42.33
Form PA-1500 Schedule I (Rev. 6-98)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Rev-1512 EX+ (6-98)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
continued
COMMONWEALTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Stahl, Violet Sarah
FILE NUMBER
21-04-0941
ESTATE OF
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
51
Traveler Insurance
42.33
52
Traveler Insurance
42.34
53
Traveler Insurance
42.34
54
Traveler Insurance
42.37
55
TTI - Final bill
0.93
56
tti National, Inc. - Account #X17 2817338 Balance due long distance calls
6.13
57
Verizon - Final phone bill - $34.56 less refund - $6_17
28.39
TOTAL (Also enter on Line 10, Recapitulation)
6.558.91
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule I (Rev. 6-98)
REV 1513 EX- (9 00)
, SCHEDULE .J
COMMONWEALTH OF PENNSYLVANIA BENEFICI ARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Stahl, Violet Sarah 21-04-0941
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$)
Do Not List Trustee(sl
I. TAXABLE DISTRIBUTIONS [include outright s~ousal
oistributions, and ransfers
under Sec. 9116(a)(1.2)]
Cindy Ann Stahl Daughter 1/2 of Residue
2071 Poplars Road
York, PA 17404
Harold Lavere Stahl, Jr. Son 1/2 of Residue
20 E. Green Street
Shiremanstown, PA
Total
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. 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 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule J (Rev. 6-98)
LAST WILL AND TEST AMENT
OF
VIOLET SARAH STAHL
I, VIOLET SARAH STAHL, A RESIDENT OF 920 SOUTII 29th STREET,
CAMP HILL, CUMBERLAND COUNTY, PENNSYL VANIA, BEING OF SOUND
MIND AND MEMORY, DO HEREBY MAKE, PUBLISH AND DECLARE THIS TO
BE MY LAST WILL AND TESTAMENT, AND HEREBY REVOKE ALL PRIOR
WILLS AND CODICILS AND WRITINGS IN THE NATURE TIIERBOF,
HERETOFORE MADE BY ME.
I. I DECLARE THAT I AM MARRIED TO HAROLD LA VERB STAHL, AND
THAT ALL REFERENCES IN THIS WILL TO "MY lillSBAND" ARE REFERENCES
TO HIM.
II. I DECLARE THAT I AM THE MOTHER OF TWO CHILDREN: HAROLD
LA VERB STAHL JR., OF 20 SOUTH GREEN STREET, SHIREMANSTOWN,
PENNSYLVANIA; AND CINDY ANN SHELLEY, OF 2071 POLARS ROAD, YORK,
PENNSYL VANIA, AND THAT ALL REFERENCES IN THIS WILL TO "MY
CHILDREN" ARE REFERENCES TO THEM.
III. I DIRECT THAT MY FUNERAL AND BURIAL EXPENSES SHALL BE
PAID FROM MY ESTATE PRIOR TO THE DISTRIBUTION OF MY ESTATE AS
PROVIDED FOR HEREIN.
IV. I GIVE, DEVISE AND BEQUEATH ALL THE REMAINDER OF MY
ESTATE TO MY HUSBAND, PROVIDED THAT HE SURVIVES ME.
V. IF MY HUSBAND DOES NOT SUR. VIVE ME, I GIVE, DEVISE AND
BEQUEATH ALL THE REMAINDER OF MY ESTATE TO MY CHILDREN WHO
SURVIVE ME, IN EQUAL SHARES PROVIDED, HOWEVER, THAT IF ONE OR
BOTH OF MY CHILDREN SHALL PREDECEASE ME BUT ISSUE OF SUCH
CHILD SHALL SURVIVE ME, THEN THE SHARE OF MY ESTATE WInCH
OTHERWISE WOULD HAVE GONE TO SUCH CHILD OF MINE SHALL BE
DIVIDED AMONG THE ISSUE OF SUCH CHILD OF MINE IN EQUAL SHARES.
VI. ALL SHARES OF PRINCIPAL AND INCOME HEREBY GIVEN SHALL
UNTIL ACTUAL DISTRIBUTION TO THE BENEFICIARIES BE FREE OF
CONTRACTS, DEBTS, ANTICIPATIONS, AS SIGNMENTS, PLEDGES OR
OBLIGATIONS OF ANY BENEFICIARY AND THE SAME SHALL NOT BE
SUBJECT TO LEVY, EXECUTION OR A IT ACHMENT WHILE IN THE
POSSESSION OF MY PERSONAL REPRESENTATIVE.
VII. I DIRECT THAT ALL INHERITANCE TAXES THAT MAY BE
ASSESSED IN CONSEQUENCE OF MY DEA TH SHALL BE PAID FROM MY
.
RESIDUARY ESTATE AS A PART OF THE EXPENSES OF THE
ADMINISTRATION OF MY ESTATE.
VIII. IN ADDITION TO THE POWERS CONFERRED BY LAW, MY
PERSONAL REPRESENTATIVE SHALL HA VB THE DISCRETIONARY POWERS
TO RETAIN FOR DISTRIBUTION IN KIND ALL MY PROPERTY OR TO SELL
ALL OR ANY PART OF SUCH PROPERTY UPON SUCH TERMS AS HE MAY
DEEM ADVISABLE; TO EXCHANGE OR LEASE FOR ANY PERIOD OF TIME
ANY OF MY PROPERTY; TO COMPROMISE ANY CLAIM OR CONTROVERSY
WITHOUT COURT APPROVAL; TO MAKE DISTRIBUTIONS IN CASH OR IN
KIND; AND TO DETERMINE THE VALUE OF ALL MY PROPERTY.
IX. I HEREBY APPOINT MY HUSBAND AS THE EXECUTOR OF MY
ESTATE, PROVIDED THAT HE SURVIVES ME. IN THE EVENT THAT MY
HUSBAND DOES NOT SURVIVE ME, I HEREBY APPOINT MY CHILDREN AS
CO-EXECUTORS OF MY ESTATE.
X. I DIRECT THAT MY PERSONAL REPRESENTATIVE SHALL NOT BE
REQUIRED TO GIVE BOND FOR THE FAITHFUL PERFORMANCE OF HIS
DUTIES IN ANY JURISDICTION.
..
IN WITNESS WHEREOF, I, VIOLET SARAH STAHL, THE TESTATRIX
ABOVE NAMED, HAVE HEREUNTO SUBSCRIBED MY SIGNATURE AND
AFFIXED MY SEAL THIS 11 th DAY OF MARCH, 1997.
'--~'J;~2 (SEAL)
THE FORGOING INSTRUMENT WAS ON THE DATE THEREOF
SUBSCRIBED AT THE END THEREOF BY VIOLET SARAH STAHL AND BY HER
SIGNED, SEALED, PUBLISHED AND DECLARED TO BE HER WILL IN THE
PRESENCE OF US AND EACH OF US, WHO UPON HER REQUEST, IN HER
PRESENCE, AND IN THE PRESENCE OF EACH OTHER, HA VB SUBSCRIBED
OUR NAMES AND ADDRESSES AS ATTESTING WITNESSES HERETO.
~ 04 .
J
C),~p{)h~
, residing at
i{~ 1f;t If!
I .
, residing at
9:Ji/ ~h"/( !2d
. UY1cJ.c/tl;C-<AI,//:1
I ... .
'"
~
ACKNOWLEDGMENT
COMMONWEAL TH OF PENNSYL VANIA }
} ss.
COUNTY OF DAUPHIN }
I, Violet Sarah Stahl, the testator, whose name is signed to the foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will; that I signed it willingly and that I
signed it as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and acknowledged before me by Violet Sarah Stahl, the
testatrix, this I I th day of March, 1997.
/'
-a~~~~.
Violet Sarah Stahl
William H. Andring, Es
Pennsylvania
.-~_.~_. ')
AFFIDA VIT
COMMONWEALTH OF PENNSYLVANIA }
} 55.
COUNTY OF DAUPHIN }
D /J C. /)
We, :1.:. 0r": r(yu(r/n~' and 1r/i'-r/Jt~ M./;d,14:J{f,4the
witnesses whose)names are signed t . the attached or foregoing instrument, being duly
qualified according to law, do depose and say that we were present and saw the testatrix
sign and execute the instrument as her Last Will; that the testatrix signed willingly and
executed it as her free and voluntary act for the purposes therein expressed; that each
subscribing witness in the hearing and sight of the testatrix signed the will as a witness;
and that to the best of our knowledge the testatrix was at that time 18 or more years of
age, of sound mind and under no constraint or undue influence.
.., Sworn to onffirmed and subscribed to before me by Be .H~ ~ ..-'(:/l. ~
and(j f {mil ([ Jid)/ let ~ t/ i {~t....-.- , witnesses, this 11 th day of March, 1 97,.J
~J/ t1J~
Witness
C~f~
Witness
..
..
ATTORNEY'S CERTIFICATION
COMMONWEALTH OF PENNSYLVANIA }
} ss.
COUNTY OF DAUPHIN }
,,;1.vo I
On this, the ...Jtjfif day of , ~, before me
, the undersigned offi er, personally appeared
William H. Andring, known to me or satisfactorily proven to be a member of the bar of
the highest court of Pennsylvania, and certified that he was personally present when the
forgoing acknowledgment and affidavit were signed by the testatrix and witnesses.
In witness whereof, I hereunto set my hand and official seal.
c:~ Qkd-_
CIeopa Notarial Seal
Harria~ Pherribo, Notary Public
My eommL._' ,,~8!lphin COunty
_n o;APlres June 28, 2004
Mernber,P<>n-...= 4~~_
. _.~l"""'~""OINolalies
Register of Wills of
Cumberland
County, Pennsylvania
INVENTORY
Estate of
Violet Sarah Stahl
No.
21-04-00941
also known as
-- -- -- ~Deceased----
Date of Death 10/04/2004
"-------
Social Security No. 186-03-1857
Violet S. Stahl
Cindy Ann Shelley
-------.-.------,-...---
fh-ePersonal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory
include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania
of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of
the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except
that which appears in a memorandum at the end of this Inventory. l!We verify that the statements made in this Inventory
are true and correct. l!We understand that false statements herein are made subject to the penalties of 18 Pa. C. S.
Section 4904 relating to unsworn falsification to authorities.
I.D. No.:
Paul ~. I\IIcC1e<il}', Jr., ~t;quire
07408
Personal Representativ~/] .
_____ Signature: _ (~4J./Pd s-~o
Ci~d;1n'n Shelley -r~ ;:~
Signature: . ",
r-..:l
C'::::'J
C:.:;>
W'.
Attorney:
( -
Firm:
Signature:
~ - - .
~J)
-rl
Address: 1998-A Carlisle Road
'(()r~A.17404
Telephone: 717/764-5926
Address: 2071 Poplars Road
__.__ York, PA 17404
-------------------
Telephone: 717/764-5644
'::'..J
(~
;'1
Dated:
~ul..l\ n, 2.Q9~
\
Personal Property
Cash...............................................................................................
Miscellaneous Property... ... .... ............ ..... ...... ..... ...... .............. ......
Stocks/Listed.... .... ...... .......... ... ... ....... ... ............. ...... ........... ...........
Stocks/C losely Held ........... ............. ..... ....... .......... ........... ..... ........
Bonds.............................................................................................
Partnerships and Sole Proprietorships .....................................
Mortgages and Notes Receivable...............................................
6,202.65
4,523.30
Total Personal Property.........................................
10,725.95
Total Real Property................................................
110,000.00
Total Personal and Real Property.........................
120,725.951
Total Out-ot-State Real Property..........................
.
Register of Wills of
Cumberland County, Pennsylvania
INVENTORY
Estate of
Violet Sarah Stahl
No.
21-04-00941
also known as Violet S. Stahl
Date of Death
10/4/2004
186-03-1857
~;i:jeceased
Social Security No.
Cash
Comcast - Refund cable service
5.80
Highmark - Refund unearned premium of health insuranc
232.94
M& T Bank Checking Account #75244489 - Opened 8/28/82 in the names of
Harold L. Mike Stahl, Sr. (Deceased 2/14101) and Violet 5. Stahl DOD balance
$5,369.06 less due/outstanding checks for $527.97
4.841.09
Accrued income on above item through date of death
0.09
Woodlawn Memorial Gardens-PA - Refund of vault cancellation
1.122.73
Total Cash
6,202.65
Personal Property
1987 Mercury Sdn - VIN #2MEBM74F2HX642431
500.00
Household Items/Personal property - Sold at private sale
4,023.30
Total Personal Property
4.523.30
Real Estate
Premises known and numbered as 940 South Twenty-Ninth Street, Camp Hill,
PA 17011 - Being the same premises which A. Richart Bittle, Jr. and Dorothy
M. Bittle, his wife, by Deed dated the 7th day of August, 1964 and recorded in
the Office of the Recorder of Deeds in and for Cumberland County, PA in
Record Book H21, Page 776, granted and conveyed unto Harold L. Stahl, Sr.
and Violet S. Stahl, his wife. The said Harold L. Stahl, Sr. died on the 14th day
of February, 2001, thereby vesting title to the above described premises in
Violet S. Stahl, surviving spouse, by operation of law.
110,000.00
Total Real Estate
110.000.00
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
120.725.95
LAST WILL AND TESTAMENT
OF
VIOLET SARAH STAHL
I, VIOLET SARAH STAHL, A RESIDENT OF 920 SOUTH 29th STREET,
CAMP HILL, CUMBERLAND COUNTY, PENNSYLVANIA, BEING OF SOUND
MIND AND MEMORY, DO HEREBY MAKE, PUBLISH AND DECLARE THIS TO
BE MY LAST WILL AND TEST AMENT, AND HEREBY REVOKE ALL PRIOR
WILLS AND CODICILS AND WRITINGS IN THE NATURE THEREOF,
HERETOFORE MADE BY ME.
I. I DECLARE THAT I AM MARRIED TO HAROLD LAVERE STAHL, AND
THAT ALL REFERENCES IN THIS WILL TO "MY HUSBAND" ARE REFERENCES
TO HIM.
II. I DECLARE THAT I AM THE MOTHER OF TWO CHILDREN: HAROLD
LAVERE STAHL JR., OF 20 SOUTH GREEN STREET, SHIREMANSTOWN,
PENNSYL VANIA; AND CINDY ANN SHELLEY, OF 2071 POLARS ROAD, YORK,
PENNSYL V ANlA, AND THAT ALL REFERENCES IN THIS WILL TO "MY
CHILDREN" ARE REFERENCES TO THEM.
III. I DIRECT THAT MY FUNERAL AND BURIAL EXPENSES SHALL BE
PAID FROM MY ESTATE PRIOR TO THE DISTRIBUTION OF MY ESTATE AS
PROVIDED FOR HEREIN.
IV. I GIVE, DEVISE AND BEQUEATH ALL THE REMAINDER OF MY
ESTATE TO MY HUSBAND, PROVIDED THAT HE SURVIVES ME.
V. IF MY HUSBAND DOES NOT SURVIVE ME, I GIVE, DEVISE AND
BEQUEATH ALL THE REMAINDER OF MY ESTATE TO MY CHILDREN WHO
SURVIVE ME, IN EQUAL SHARES PROVIDED, HOWEVER, THAT IF ONE OR
BOTH OF MY CHILDREN SHALL PREDECEASE ME BUT ISSUE OF SUCH
CHILD SHALL SURVIVE ME, THEN THE SHARE OF MY ESTATE WHICH
OTHERWISE WOULD HAVE GONE TO SUCH CHILD OF MINE SHALL BE
DIVIDED AMONG THE ISSUE OF SUCH CHILD OF MINE IN EQUAL SHARES.
VI. ALL SHARES OF PRINCIPAL AND INCOME HEREBY GIVEN SHALL
UNTIL ACTUAL DISTRIBUTION TO THE BENEFICIARIES BE FREE OF
CONTRACTS, DEBTS, ANTICIPATIONS, ASSIGNMENTS, PLEDGES OR
OBLIGATIONS OF ANY BENEFICIARY AND THE SAME SHALL NOT BE
SUBJECT TO LEVY, EXECUTION OR ATTACHMENT WHILE IN THE
POSSESSION OF MY PERSONAL REPRESENTATIVE.
VII. I DIRECT THAT ALL INHERITANCE TAXES THAT MAY BE
ASSESSED IN CONSEQUENCE OF MY DEATH SHALL BE PAID FROM MY
RESIDUARY ESTATE AS A PART OF THE EXPENSES OF THE
ADMINISTRATION OF MY ESTATE.
VIII. IN ADDITION TO THE POWERS CONFERRED BY LAW, MY
PERSONAL REPRESENTATIVE SHALL HA VB THE DISCRETIONARY POWERS
TO RETAIN FOR DISTRIBUTION IN KIND ALL MY PROPERTY OR TO SELL
ALL OR ANY PART OF SUCH PROPERTY UPON SUCH TERMS AS HE MAY
DEEM ADVISABLE; TO EXCHANGE OR LEASE FOR ANY PERIOD OF TIME
ANY OF MY PROPERTY; TO COMPROMISE ANY CLAIM OR CONTROVERSY
WITHOUT COURT APPROVAL; TO MAKE DISTRIBUTIONS IN CASH OR IN
KIND; AND TO DETERMINE THE VALUE OF ALL MY PROPERTY.
IX. I HEREBY APPOINT MY HUSBAND AS THE EXECUTOR OF MY
ESTATE, PROVIDED THAT HE SURVIVES ME. IN THE EVENT THAT MY
HUSBAND DOES NOT SURVIVE ME, I HEREBY APPOINT MY CHILDREN AS
CO-EXECUTORS OF MY ESTATE.
X. I DIRECT THAT MY PERSONAL REPRESENTATIVE SHALL NOT BE
REQUIRED TO GIVE BOND FOR THE FAITHFUL PERFORMANCE OF HIS
DUTIES IN ANY JURISDICTION.
IN WITNESS WHEREOF, I, VIOLET SARAH STAHL, THE TESTATRIX
ABOVE NAMED, HAVE HEREUNTO SUBSCRIBED MY SIGNATURE AND
AFFIXED MY SEAL THIS 11th DAY OF MARCH, 1997.
\--zL-u'd;~,.L
(SEAL )
THE FORGOING INSTRUMENT WAS ON THE DATE THEREOF
SUBSCRIBED AT THE END THEREOF BY VIOLET SARAH STAHL AND BY HER
SIGNED, SEALED, PUBLISHED AND DECLARED TO BE HER WILL IN THE
PRESENCE OF US AND EACH OF US, WHO UPON HER REQUEST, IN HER
PRESENCE, AND IN THE PRESENCE OF EACH OTHER, HAVE SUBSCRIBED
OUR NAMES AND ADDRESSES AS ATTESTING WITNESSES HERETO.
~UJ cLaL1
, residing at
i!~/j:;t ffL
CJ~?{/h~
, residing at
t}y/if 1&1/1 J2cJ
. /-{~c~j{;'!II'C-,Ai/rl
I .... . ,
<:'., ~'
ACKNOWLEDGMENT
COMMONWEAL TH OF PENNSYL VANIA }
} ss.
COUNTY OF DAUPHIN }
I, Violet Sarah Stahl, the testator, whose name is signed to the foregoing
instrument, having been duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will; that I signed it willingly and that I
signed it as my free and voluntary act for the purposes therein expressed.
Sworn to or affirmed and acknowledged before me by Violet Sarah Stahl, the
testatrix, this lIth day of March, 1997.
//-; "
- Z:i~~~" ~J2
Violet Sarah Stahl
William H. Andring, Es
Pennsylvania
.,
AFFIDAVIT
COMMONWEALTH OF PENNSYL VANIA }
} ss.
COUNTY OF DAUPHIN }
We, 11", f!"4'(~~' and c'J;"-r;,,, /l,bl.(4.,,/(,fhe
witnesses whose )names are signed t the attached or foregoing instrument, being duly
qualified according to law, do depose and say that we were present and saw the testatrix
sign and execute the instrument as her Last Will; that the testatrix signed willingly and
executed it as her free and voluntary act for the purposes therein expressed; that each
subscribing witness in the hearing and sight of the testatrix signed the will as a witness;
and that to the best of our knowledge the testatrix was at that time 18 or more years of
age, of sound mind and under no constraint or undue influence.
n
,~ Sworn to ofjiffirmed and subscribed to before me by /:jrc j~ {4 -(1-
and/.../Jiif';<1( ft'.//IC:/~I/IL~ , witnesses, this 11th day of March, 197.
(QA-l~ ~.
Witness 0
C~frVolo~
Witness
,....----,
William H. Andring, Es
Pennsylvania
. .
ATTORNEY'S CERTIFICATION
COMMONWEAL TH OF PENNSYLVANIA }
} ss.
COUNTY OF DAUPHIN }
_ ,;2.YO I
On this, the ..J'I'7tf day of 4,JJ , ~, before me
, the undersigned offi er, personally appeared
William H. Andring, known to me or satisfactorily proven to be a member of the bar of
the highest court of Pennsylvania, and certified that he was personally present when the
forgoing acknowledgment and affidavit were signed by the testatrix and witnesses.
In witness whereof, I hereunto set my hand and official seal.
-t ~ (}kwh_
Cleopatra ~~arial Seal
My ~1=g,errlExD:;P~~.1:.'tvbllc
n pires June 28, 2004
Member PAnn""'MA'_ "M~~
, _.._'....-~IIIlnOlNolaries
.
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128,0601
REV,1162 EX111-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SHELLEY CINDY ANN
2071 POPLARS ROAD
YORK, PA 17404
-------- told
ESTATE INFORMATION: SSN: 186-03-1857
FILE NUMBER: 2104-0941
DECEDENT NAME: STAHL VIOLET SARAH
DATE OF PAYMENT: 07/19/2005
POSTMARK DATE: 07/18/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 10/04/2004
NO. CD 005594
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $4,545.33
I
I
I
I
I
I
I
I I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK#164
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$4,545.33
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
10-03-2005
STAHL
10-04-2004
21 04-0941
CUMBERLAND
101
APPEAL DATE: 12-02-2005
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +-
REV:is47-EX-AFP-io3:0si-NOTicE-OF-iNHERiTANCE-TAX-APPRAisEMENT:-ALLOWANCE-OR---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
VIOLET S FILE NO. 21 04-0941 ACN 101
BUREAU OF INDIVIDlfAL'l'A~E~ri ,~.-
INHERITANCE TAX DIVISION-
PO BOX ZB060I
HARRISBURG PA I7IZB-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
1"10 ~":
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
c,
.,-
,
'1: 26
('I
,
PAUL C M~CLEARY JR ESQ
1998A CARLISLE RD
YORK PA 17404
ESTATE OF
STAHL
REV-1547 EX AFP (06-05)
VIOLET
S
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
DATE 10-03-2005
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 Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
llJ
(2)
(3)
(4)
(5)
(6)
(7)
llo,ooo.oo
.00
.00
.00
10.725.95
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
1l0)
13,408.19
6.558.91
Ill)
112)
113)
114J
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
120,725.95
]9.967 In
100,758.85
.00
100,758.85
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
.00 X 00 = .00
100,758.85 X 045 = 4,534.15
.00 X 12 = .00
.00 X 15 = .00
119)= 4,534.15
TAX CREDITS:
nun,,". RECEIPT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07 18 2005 ...... CDo05594 8.70 4,545.33
TOTAL TAX CREDIT 4,536.63
BALANCE OF TAX DUE 2.48CR
INTEREST AND PEN. .00
TOTAL DUE 2.48CR
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
Rl
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.J
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
REV-1607 EX AFP (03-05)
r-. . r-
,
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-05-2005
STAHL
10-04-2004
21 04-0941
CUMBERLAND
101
VIOLET
S
PAUL C MCCLEARY JR ESQ'
1998A CARLISLE RD
YORK PA 17404
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE
-+
RETAIN LOWER PORTION FOR YOUR RECORDS
......
REV-1607 EX AFP (03-05)
---------------------------------------------------------------------------
~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF STAHL VIOLET S FILE NO.21 04-0941 ACN 101 DATE 12-05-2005
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PRO~ECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-26-2005
PRINCIPAL TAX DUE: 4,534.15
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-18-2005 CD005594 8.70- 4,545.33
11-21-2005 REFUND .00 2.48-
TOTAL TAX CREDIT 4,534.15
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IE IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
Rf.
In the Court of Common Pleas of
Cumberland
County, Pennsylvania
IN RE:
ORPHANS' COURT DIVISION
Estate of
Violet Sarah Stahl
NO. 21-04-00941
Status Report Under Rule 6.12
Name of Decedent: Violet Sarah Stahl
Date of Death: 10/4/2004
,
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the fottowing with)
respect to completion of the administration of the above-captioned estate: --I
1. State whether administration of the estate is complete:
Yes X 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 No X
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:
Yes X No
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may
be filed with the Clerk of Orphans' Court and may be attached to this report.
Signature
Name:
Address:
Ji'- A"" ~~ /
Paul C. McCleary, Jr., Esquire
1998-A Carlisle Road
Date:
February 3, 2006
York, PA 17404
Telephone: 717/764-5926
Capacity: Personal Representative
X Counsel for Personal Representative
\\1;
PAUL C. McCLEARY, JR.
LAW OFFICES
AREA CODE 7 I 7
764-5926
WANDA L. STAHLE
LEGAL ASSISTANT
PAUL C. McCLEARY, .JR.
KAREN A. GALBREATH
LEGAL ASSISTANT-REAL ESTATE
SHILOH PROFESSIONAL CENTER
FAX 764-5928
KARIN A_ MCCLEARY
LEGAL ASSISTANT-REAL ESTATE
1998-A CARLISLE ROAD
YORK, PENNSYLVANIA 17404-1412
MARY E. RUHLMAN
LEGAL ASSISTANT
February 3, 2006
Attn: Glenda F. Strasbaugh, Clerk/Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013-3387
,.;"",
---.\
Re:
Violet Sara StahL Deceased
File No. 21-04-0941
C,,)
Dear Ms. Strasbaugh:
Enclosed herewith, please find the following documents which are being forwarded for filing
in your office:
1. Original and one (1) copy of the Approval of Account, Waiver, Receipt, Release
and Agreement of Indemnity;
2. Estate check number 174, dated February 2,2006, in the amount of$5.00, payable
to your order, representing the required filing fee; and
3. Original and one (1) copy of the final Status Report.
It will be appreciated if you will clock-in the copies of the Approval of Account, Waiver,
Receipt, Release and Agreement ofIndemnity and Status Report and return them to this office in the
enclosed self-addressed stamped envelope.
In the event that you have any questions concerning the above, please give my Legal
Assistant, Wanda Stahle, a call at the above telephone number.
Your help and cooperation are greatly appreciated.
PCMcC,Jr:mr
Enclosures
cc: Cindy Ann Shelley, Executrix
p:1~ M<- CA-; t/
Paul C. McCleary, Jr.
II
.
IN THE ORPHANS' COURT DIVISION
OF THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYL VANIA
ESTATE OF VIOLET SARAH STAHL, a/k/a VIOLET S. STAHL, DECEASED
r.... .)
:.;1-'
I
- ,--)
(" ~'
File No. 21-04-00941
APPROV AL OF ACCOUNT, WAIVER, RECEIPT,
RELEASE AND AGREEMENT OF INDEMNITY
; -')
The circumstances leading up to the execution of this instrument are as follows:
1. Violet Sarah Stahl also known as Violet S. Stahl died on the 4th day of October,
2004, leaving a Will dated the lIth day of March, 1997.
2. In her Will, she left the residue of her estate to her husband, namely Harold
Lavere Stahl and ifhe predeceased her, to her two (2) children, namely, Harold Lavere Stahl, Jr. and
Cindy Ann Shelley, in equal shares, per stirpes, and appointed her husband as Executor, provided
that he survives her and ifhe predeceased her, her two (2) children, namely Harold Lavere Stahl, Jr.
and Cindy Ann Shelley, as alternate Co-Executors.
3. Harold Lavere Stahl predeceased the decedent in death, having died on the 14 th
day of February, 2001, leaving the alternate Co-Executors, Harold Lavere Stahl, Jr. And Cindy Ann
Shelley, with the right to administer the Estate.
4. By Renunciation dated the 19th day of October, 2004, Harold Lavere Stahl
renounced his right to administer the Estate.
5. The Will of Violet Sarah Stahl also known as Violet S. Stahl was duly probated
and Letters Testamentary were granted to Cindy Ann Shelley the remaining alternate personal
Rt.
II
.
representative named in said Last Will, by the Register of Wills of Cumberland County on the 19th
I day of October 2004.
6. An Account of the administration of the Estate under the Will of Violet Sarah
Stahl also known as Violet S. Stahl has been prepared by Paul C. McCleary, Jr., Esquire, as Counsel
for the aforesaid representative, Cindy Ann Shelley.
7. It is the desire of the undersigned Harold Lavere Stahl, Jr. and Cindy Ann Shelley,
that their share of the Estate under the Will of Violet Sarah Stahl also known as Violet S. Stahl be
distributed to them without the formality of a court proceeding in order to save the expense, publicity
and delay incident to such court proceeding.
In consideration of the foregoing, the undersigned hereby:
(A) Represent and warrant that they have read and understand this instrument
and that the facts set forth above are true and correct to the best of their knowledge, information and
belief;
(B) Declare that they have examined the aforesaid Account of the
administration of the Estate and the attached Schedule of Distribution; that they find them to be true
and correct in all particulars; that they accept and approve them as if they had been duly filed,
audited, adjudicated and confirmed absolutely by the Orphans' Court Division of the Court of
Common Pleas of Cumberland County, and as if the amounts shown as distributable had been duly
awarded to them;
(C) Waive the filing and auditing of the Account of the administration of the
Estate in the Orphans' Court Division of the Court of Common Pleas of Cumberland County, and
agree that the Orphans' Court Division of the Court of Common Pleas of Cumberland County may,
by its decree, confirm the Account and approve the Schedule of Distribution;
(D) Agree that distribution of the principal and income be made in accordance
with the Schedule of Distribution, and effective upon delivery to them of the amounts shown as
respectively distributable, acknowledge receipt of such property. It is specifically understood and
II
~
. agreed that the balance, ifany, of the reserve set forth in the aforesaid Account in the amount of Six
Thousand One Hundred Eighty-Nine and 36/100 ($6,189.36) Dollars for acceptance of the P A
Inheritance Tax as filed, preparation and filing individual and fiduciary income tax returns and
releases and other expenses i.e. final utilities bills, shall be distributed to them in equal shares.
(E) Agree to refund to the Estate any amount which may at any time be
determined to have been an erroneous distribution to them regardless of the cause of such erroneous
distribution.
(F) Agree to indemnify and hold harmless, to the extent of the funds received
by them hereunder, Cindy Ann Shelley, individually, and in her capacity as Executrix from and
against any and all claims, loss, liability or damage (including legal fees and costs in connection
therewith) which she may suffer or to which she may be subjected by reason of her administration
of the Estate, the settlement of Executrix's Checking Account and the distribution of the assets of
the Estate without having the formal approval of the Orphans' Court Division of the Court of
Common Pleas of Cumberland County, including, but not limited to, any liability for any federal
estate tax, Pennsylvania Inheritance tax, or any other death taxes, together with interest and costs
incidental thereto, relating in any way to the Estate; and
(G) Declare it to be their intention that this instrument shall be governed by
the laws of the Commonwealth of Pennsylvania and shall be legally binding as an agreement under
seal upon them and upon their heirs, executors, administrators and assigns
IN WITNESS WHEREOF, the parties hereto have caused this instrument to be executed on
the dates set opposite their respective names.
Witness:
'\-'--
~ ~
~ ~'/
~Q.o .~ ~<:;>
.~~ L~ ~,-o;.
Date
U ;t~Q ~ I(SEAL)o;tY()J
Harold Lavere Stahl, Jr. ,p"
/I // /' '
/h"J ~~
Ann Shelley
(SEALk7 j;/;:~-
/ /
/
/I
SCHEDULE OF DISTRIBUTION
TO: Harold Lavere Stahl, Jr., Son
1/2 of Residue
CASH - Principal and Income
$45,000.00
TO: Cindy Ann Shelley, Daughter
1/2 of Residue
CASH - Principal and Income
45,000.00
Total
$90,000.00
II
I
COMMONWEAL TH OF PENNSYL VANIA)
) ss:
COUNTY OF YORK )
On this, the ~ day of ~ 1 , 2005, before me, a Notary Public in and for said
\
Commonwealth and County, the undersigned officer, personally appeared HAROLD LAVERE
STAHL, JR. and CINDY ANN SHELLEY, who are known to me (or satisfactorily proven) to be
the persons whose names are subscribed to the within instnunent, and acknowledged that they
executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
~~~r t ~ ~lo
Notary Public
COMMONWEALTH OF PENNSYLVAN
Notarial Seal .
Wanda L. Stahle, Notary ~~~~nty
West Manchester T~"N Vior 18 2007
M Commission Expires ov. , .
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