HomeMy WebLinkAbout04-0952 PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Mary Ann R. Shughart NO. ~t-04-q~5~).~
also known as To:
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
· Deceased.
SocialSecurityNo. 180-01-3567
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut o r ~
in the last wilt of the above decedent, dated December 29, 2003
and codicil(s) dated
named
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Cumber land County, Pennsylvania, with
her last family or principal residence at 271 South College
Carlisle. PA 17013 -
(list street, number and muncipality)
Decendent, then 87 years of age, died October !7. ?NN4 ,x~ ,
at Sarah Todd Memorial Home, 1000 West Soutl~ Street. C:~rl~l,., PA 17013
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(1 f domiciled in Pa.) All personal property $ 1,000.00
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in~Ee, nnsylvanigt $. 4 9,0 0 0.0 0
situated as follows:~/l South College Street
Carlisle, PA 17013
WHEREFORE, petitioner(s) respectfully request(s) the vrobate of the last will a--n~ codicil(s)
presented herewith and the grant of letters t ~ s t a m~ n t a r y ~o
theron.
25 Rolling Drive
Carlisle, PA 17013
ro
(testamentary; administration c.t.a.;.achninistration d.b.n.c.t.a.)
C-~'B ar bara ~rake
2366 North Quincy
Arlington, VA 22207-5112
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 3
COUNTY OF CUMBERLAND ; 88
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly admin~ter~..AOn~estate according to law.
Sworn to or aff~rm~e&and subscribed ~- ./~"A-~/~ ~x
bet&re.me this *~. day of [ I/D~ ;~ ~h,~.~J~/..~ ~ ~
~.~-Register(~-- ~a~rbara S. I5.r_~a4c~ - -- ~
Estate Of M^~v AMN I~ g51TTO51A'RT , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW C'~d'~e
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated
described therein be admitted to nrobate~and filed of record as the last will of
and Letters Te~amentar¥
are hereby granted to
~ o~. CI.~L ~ , in consideration of the petition on
Dale F. Shughart, Jr. and Barbara S. Drake
FEES
Probate, Letters, Etc ..........
Short Certificates( ) ..........
Renunciation ................
~O..P
TOTAL
Filed . .~ 7.~ ~ .~
Register of Wills ~ ~.
Dale F. Shughart~ Jr.
ATTORNEY (Sup. Ct. I.D. No.) 19373
35 East High Street, Suite 203,
ADDRESS.Carlisle, ~A 17013
(717) 241-4311
PHONE
I]is is to certify that the infi, rmation here givcn is correctly copied from an original certificate of death duly filed with me as
I.oca] Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It ia illogal to duplieato this copy by photostat or photograph.
Fee fbr this certificate, $2.00
P 10783271
No.
Local Registrar
OCT 2 0 200
Date
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
2. Female ~. 180- 01 -- 3567 ~ Oct. 17~ 2004
271 South College St.
Carlisle, PA 17013
Michael Ratway
r.18,1917 ?William. Penn,
DATE OF DISPOSITION
[]
014819 L
17013
219 N. Hanover St., Car]~a],, PA 17013
LAST WILl, AND TF~STAMF~NT
I, MARY ANN R. SHUGHART, of the Borough of Carlisle, Cumberland County,
Pennsylvania, declare this to be my Last Will and Testament and revoke any Will or Codicil
previously made by me.
ITEM I: I direct that all my just debts (except as may be barred by a Statute of
Limitations) and my funeral expenses (including my gravemarker and expenses of my last illness)
shall be paid from my residuary estate as soon as practicable after my decease as a part of the
administration of my estate.
ITEM II: I give and bequeath all my tangible personal pro~, in ~e~ding b~.u.~.~ot
limited to, any and all automobiles and other motor vehicles, household goods a~fumi~and
furnishings; china, silverware, jewelry, ornaments, works of art, books pictures, ~aring apparel
and personal effects, but excluding cash on hand and tangible evidences of int~ble personal
property together with any policies of insurance applicable thereto including any prepaid
premiums thereon to such of my children DALE F. SHUGHART, JR. and BARBARA S.
DRAKE, as shall survive me, in as nearly equal shares as is practicable.
ITEM III: I devise and bequeath the residue of my estate of every nature and
wherever situate in equal shares (per stirpes) to each of my children, DALE F. SHUGHART, JR.
and BARBARA S. DRAKE, as shall survive me by thirty (30) days.
ITEM IV: In the event that both of my children should predecease me or die on or
before the thirtieth day following my death, and should I not be survived by issue, then I devise
and bequeath the residue of my estate of every nature and whenever situate as follows:
A. One-Half (1/2) thereof to the DICKINSON SCHOOL OF LAW of the
PENN STATE UNIVERSITY, for its scholarship fund, to endow scholarships for
deserving students. These scholarships shall be, if feasible, known as the "Mary Ann R.
and Judge Dale F. Shughart Memorial Scholarships."
B. One-Half (1/2) there0f to the GRACE UNITED METHODIST CHURCH
of Carlisle, Pennsylvania.
ITEM V: I direct that all taxes that may be assessed in consequence of my death, of
whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as
part of the expenses of the administration of my estate.
ITEM VI: I appoint my son, DALE F. SHUGHART, JR., and my daughter,
BARBARA S. DRAKE, Co-Executors of ~his my Last Will. Should both of my said children
fail to qualify or cease to act as Executors, I appoint, HAMILTON C. DAVIS, of Newville,
Pennsylvania, substitute Executor, of this my Last Will.
ITEM VII: I direct that my Executors or their successors shall not be required to give
bond for the faithful performance of their duties in any jurisdiction.
ITEM VIII: My individual fiduciary shall be entitled to reasonable compensation for
his and/or her services rendered from time to time and to reimbursement of out of pocket expenses.
IN WITNESS WHEREOF, I hereunto set my hand and seal to this my Last Will and
2
2003.
(SEAL)
MARY ANN R. SHUGHART
The preceding instrument, consisting of this and (3) other typewritten pages, each identified
by the signature or initials of the Testatrix, was on the day and date thereof signed, published and
declared by the Testatrix therein named, as and for her Last Will, in the presence of us, who, at her
request, in her presence, and in the presence of each other have subscribed our names as witnesses
hereto.
residing at ~ ~
r e s i ding ad.4~.,/t~Pj~/~jb~/~t~/
COMMONWEALTH OF PENNSYLVANIA:
: SS.
COUNTY OF CUMBERLAND :
I, MARY ANN R. SHUGHART, the Testatrix whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will; and that I signed it willingly and as my free
and voluntary act for the purposes therein expressed.
ANN R. SHUGHART
Sworn to or affirflaed and acknawled, eed
before me by j~///JJ Ltl
~..,~atrix, this ~_ day of
"' "~ary Public"'
I' Notar a Seal ~
Hamilton C. Davis, Notary Public ~
Shippensburg Bore, Cumberland County|
My Comm~smon Expires Sept. 27, 20041
Member, Pennsylvania Association of Noleries
COMMONWEALTH OF PENNSYI~.VANIA:
: SS.
COUNTYDF CUMBERLAND
..... and. :.~ _ ~
We, ~b~ ,.J~'~. ~/JlJ)/J'f IL) J~, (~'/~/('~-, J(fff-d( e~witness whose names
are signed~to 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 heating 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
eighteen (18) or more years of age and of sound mind and under no constraint or undue influence.
e
i' Notarial Sea
Hamilton C. Davis, Notary Public
Shippensburg Eloro, Cumberland Coun Yl
My Commission Expires Sept. 27, 2004
4
CERTIFICATION OF NOTICE UNDER RULE
Name of Decedent: Mary Ann R. Shughart
Date of Death: October 17, 2004
Estate No. 21-04 952
To the Register:
I certify that notice
Rule 5.6(a) of the Orphans'
the following beneficiaries of
October 2004.
5.6 (a)
of estate administration required by
Court Rules was served on or mailed to
the above captioned estate on
Name Address
1. Dale F. Shughart, Jr. 25 Rolling Drive
Carlisle, PA 17013
2. Barbara S. Drake 2236 Quincy
Arlington, VA 22207-5112
Notice has now been
under Rule 5.6(a) except:
Date: November ~---, 2004
Capacity:
given to all persons entitled thereto
Dale F. Shugharkt~,[Jr/.
35 East High Street/ Suite 203
Carlisle, PA 170t~7
Telephone (717) 241-4311
Counsel for Personal Representatives
Dale F. Shughart, Jr. and ·
Barbara S. Drake
IMPORTANT NOTICE
NOTICE OF ESTATE ADMINISTRATION
THIS NOTICE DOES NOT MEAN THAT YOU WILL
RECEIVE ANY MONEY OR PROPERTY FROM
THIS ESTATE OR OTHERWISE
Whether you will receive any money or property will be
determined wholly or partly by the decedent's will. If the
decedent died without a will, whether you will receive any money
or property will be determined by the intestacy laws of
Pennsylvania.
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA
In re Estate of Mary Ann R. Shughart, deceased
Estate No. 21-04-952
TO:
Dale F. Shughart, Jr.
25 Rolling Drive
Carlisle, PA 17013
Please take notice of the death of decedent and the grant of
letters to the personal representative(s) named below.
The Decedent Mary Ann R. Shughart, died on the 17th day of
October, 2004, at Carlisle, Cumberland County, Pennsylvania.
The Decedent died testate.
The personal representatives of the Decedent are:
Dale F. Shughart, Jr. Barbara S. Drake
25 Rolling Drive 2236 Quincy
Carlisle, PA 17013 Arlington, VA 22207-5112
Phone: (717) 241-0711 Phone: (703) 243-2312
The will has been filed with the Office of the Register of
wills of Cun~erland County. 1 Courthouse Square, Carlisle, PA
17013. Phone No. 717-240-6345.
A copy of the Will or Petition may be obtained by contacting
the Register of Wills and payi,,ng the charges for duplication.
Date: ~ , 2004
Dale F. Shugha~,/~r.%
Attorney Supreme Court I.D. #19373
35 East High Street, Suite 203
Carlisle, PA 17013
Telephone (717) 241-4311
Capacity: Counsel for Personal Representatives
Dale F. Shughart, Jr. and
Barbara S. Drake
IMPORTANT NOTICE
NOTICE OF ESTATE ADMINISTRATION
THIS NOTICE DOES NOT MEAN THAT YOU WILL
RECEIVE ANY MONEY OR PROPERTY FROM
THIS ESTATE OR OTHERWISE
Whether you will receive any money or property will be
determined wholly or partly by the decedent's will. If the
decedent died without a will, whether you will receive any money
or property will be determined by the intestacy laws of
Pennsylvania.
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA
In re Estate of Mary A~n R. Shughart, deceased
Estate No. 21-04-952
TO:
Barbara S. Drake
2236 Quincy
Arlington, VA 22207-5112
Please take notice of the death of decedent and the grant of
letters to the personal representative(s) named below.
The Decedent Mary Ann R. Shughart, died on the 17th day of
October, 2004, at Carlisle, Cumberland County, Pennsylvania.
The Decedent died testate.
The personal representatives of the Decedent are:
Dale F. Shughart, Jr. Barbara S. Drake
25 Rolling Drive 2236 Quincy
Carlisle, PA 17013 Arlington, VA 22207-5112
Phone: (717) 241 0711 Phone: (703) 243-2312
The will has been filed with the Office of the Register of
Wills of Cumberland County. 1 Courthouse Square, Carlisle, PA
17013. Phone No. 717-240-6345.
A copy of the Will or Petition may be obtained by contacting
the Register of Wills and paying the charges for duplication.
Date: /f/p/~ , 2004 _~j~_~
Dale F. Shugha~ ~r/.
Attorney Supre~ C~drt I.D. #19373
35 East High Street, Suite 203
Carlisle, PA 17013
Telephone (717) 241-4311
Capacity: Counsel for Personal Representatives
Dale F. Shughart, Jr. and
Barbara S. Drake
0
~t
0
0
o~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT,280601
HARRISBURG. PA 17128-0601
AEV-1162 EX{11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SHUGHART DALE F JR
35 EAST HIGH STREET
SUITE 203
CARLISLE, PA 17013
u___n_ fold
ESTATE INFORMATION: SSN: 180-01-3567
FILE NUMBER: 2104-0952
DECEDENT NAME: SHUGHART MARY ANN R
DATE OF PAYMENT: 01/14/2005
POSTMARK DATE: 01/14/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 10/17/2004
NO. CD 004839
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $29,975.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$29,975.00
REMARKS: DALE SHUGHART JR
CHECK# 1035
SEAL
INITIALS: RSK
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
.
'.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
V:;F Ct~L~'
REV-l500EX+lb-OOl
/'
FILE NUMBER
21
COUNTY CODE
04 00952
YEAR NUMBER
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Shughart, Mary Ann R.
SOCIAL SECURITY NUMBER
!Z
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180-01-3567
DATE OF DEATH (MM-DD-YEAR)
DATE OF BIRTH (MM.DD.YEAR)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
10117/2004
04/18/1917
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST AND MIDDLE INITIAL)
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o 2. Supplemental Return
D 4a. Future Interest Compromise (date of death after
12.12.82)
o 7. Decedent Maintained a Living Trust (Attach
copy of Trust)
o 10, Spousal Poverty Credit (date of death between 0 11,Election to tax under See, 9113(A)(Attach Sch 0)
12.31.91 an~ H.95) _
THIS SECTION MUST BE COMPLeTED. ALL CORRI!SPONDENCS AND CONFIOENTlAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME - -- - - . ~-- ----~-~~ ~,~, "~~-"-~~-"..-._-co-MPLETEMAILINGADDRE$--~ <-----~,--~~'~<,-,,~~-"-..--~~--"'~
Dale F Shughart, If. Esquire
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3. Remainder Return (date of death prior to 12-13-82)
1, Original Return
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5. Federal Estate Tax Return Required
4. Limited Estate
6. Decedent Died Testate (Attach copy
of Will)
9, Litigation Proceeds Received
8. Total Number of Safe Deposit Boxes
I-
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FIRM NAME (If applicable)
1, Real Estate (Schedule A)
2, Stocks and Bonds (Schedule B)
35 E. High Street, Suite 203
Carlisle, P A 17013
0
(1) 225,000,00 s: ,'01
C-)
CDI C)
iTl
(2) 408.505,63 '-0 _0 :'0
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(3) None CJ
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(4) None .'") (Ji, "n
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:..:)c c5
. ::0 ~
(5) 146,328.93 ::o-l \___ f'rl
p U1 f../) c:>
(6) None \.0 .~l')
(7) 16,000.00
TELEPHONE NUMBER
717/241-4311
3. Closely Held Corporation, Partnership or Sole-ProprietDrship
4. Mortgages & Notes Receivable (Schedule D)
5, Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6, Jointly Owned Property (Schedule F)
o Separate Billing Requested
7, Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9, Funeral Expenses & Administrative Costs (Schedule H)
(8)
795,834,56
10, Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
(9)
(10)
46,965.30
5,652.21
11. Total Deductions (total Lines 9 & 10)
(11)
52,617.51
12, Net Value of Estate (Line 8 minus Line 11)
(12)
743,217,05
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14, Net Value Subject to Tax (Line 12 minus Line 13)
(13)
(14)
743,217.05
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15, Amount of Line 14 taxable at the spousal tax rate, x .00 (15)
or transfers under Sec. 9116(a)(1.2)
z 743,217.05 .045 (16)
0 16,Amount of Line 14 taxable at lineal rate x
F
"
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.. 17, Amount of Line 14 taxable at sibling rate x .12 (17)
'"
0
"
>< 18, Amount of Line 14 taxable at collateral rate
~ x .15 (18)
19, Tax Due (19)
33,444.77
33,444,77
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
,,- . -" -~. ----~-~~',~""~-"~~
>> BE SURE TO AN$W&R AU. QUIi!S'ltoN.s~ REVJ5RSi:.SIOE AHo f1ECHI!CK MATH<<
Copyright 2000 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00)
D,ecedent's Complete Address:
STREET ADDRESS
271 South College Street
CITY
Carlisle
STATE PA
i ZIP 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
33,444.77
29,975.00
1,577.63
Total Credits (A + B + C)
(2)
31,552.63
3. InteresVPenalty if applicable
D. Interest
E. Penalty
TotallnteresVPenalty (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.
(3) 0.00
(4)
(5) 1,892.14
(SA)
(5B) 1,892.14
Make Check Payable to: REGISTER OF WILLS, AGENT
11#I~A""",,_.I!!i" li._~~ 1Jj!~*. "... 11
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"'N THE APPROPRIATE BLOCKS
y~ i
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II
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;................................................................................
b. retain the right to designate who shall use the property transferred or its income;.....................................
c. retain a reversionary interest; or...............................................................................................................
d. receive the promise for life of either payments, benefits or care? .............................................................
2. If death occurred alter December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?......................................................................................................................
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.........
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?.....................................................................................................................
D
D
D
~
~
~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
DATE
ADDRESS
2366 North ouipB~treet
Arlington, VA _. Q'?rYl
35 E. High Street, Suite 203
Carlisle, P A 17013
7/;//ly
DATE
~~s-
'/ )If!():;;-
35 East High Street
Carlisle, PA 17013
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 99116 (a) (1.1) (i)l.
For dates of death on or after January 1, 1995. the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 99116 (a) (1.1) (Ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the sUNiving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116
1.2) [72 P.S. 99116 (a) (1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P .S. 99116 (a) (1.3)]. A sibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
'.
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Shughart, Mary Ann R.
FILE NUMBER
21 - 04 - 00952
All real property owned solely or as a tenant in common must be r~l?orted at fai~ marke.t value. Fair market value is defined as the price
at which property would be exchanged 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 of survivorship must be disclosed on
schedule F.
ITEM
NUMBER
I
DESCRIPTION
VALUE AT DATE OF
DEATH
225,000.00
House and lot located at 271 South College Street, Borough of Carlisle, Cumberland County, PA; Prior
deed reference: Deed Book "U", Vol. 13, Page 459. Cumberland County Tax Parcel #04-21-0322-185.
Value based upon actual sale price. HUD-I attached.
TOTAL (Also enter on Line 1, Recapitulation)
225,000.00
.
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Shughart, Mary Ann R.
FILE NUMBER
21 - 04 - 00952
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
I
DESCRIPTION
UNIT VALUE
VALUE AT DATE OF
DEATH
157,666.88
9,684.698 shares Vanguard Windsor Fund
CUSIP # 922018106 @ 16.28 per share
16.28
2
615.3508 shares Orrstown Financial Services,
common stock, CUSIP #687380105 @42.675 per share
42.675
26,180.75
3
3,600 shares Carlisle Corporation, common stock,
CUSIP # 142339100 @ 62.405 per share
62.405
224,658.00
TOTAL (Also enter on line 2, Recapitulation)
408,505.63
ESTATE OF
'.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Shughart, Mary Ann R.
FILE NUMBER
21 - 04 - 00952
Include the proceeds 01 litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on schedule F.
ITEM
NUMBER
I Cash on hand.
DESCRIPTION
VALUE AT DATE OF
DEATH
6.71
2
Retainer on deposit in Dale F. Shughart, Jr. Escrow Account.
500.00
3
Household goods, furniture and furnishings distributed in kind or sold at appraised value, value based
upon attached appraisal of Alyssa Loney.
11,996.50
4
Household goods, furniture and furnishings, sold at public acution, value is actual sale price.
3,527.00
5
1997 Buick sedan, value based upon actual sale price.
5,995.00
6
Orrstown Bank, checking account 11400440
Principal 5,502.03
Accrued interest .32
5,502.35
7
Orrstown Bank, checking account # 106210114
Principal 112,303.77
Accrued interest 88.92
112,392.69
8
Tax proration of sale ofreal estate
1,373.40
9
Hoffman-Roth Funeral Home, refund
201.00
10
Dalton Books, refund
158.05
II
Agway, refund
861.14
12
Patriot News, refund
46.35
13
The Sentinel, refund
11.48
14
Corneas!, refund
4.59
15
Attorney Group Life Insurance Trust, refund
186.13
16
Travelers, auto insurance refund
224.00
17
AT&T, refund
5.29
18
Sprint, refund
25.25
Total of Continuation Schedule(s)
TOTAL (Also enter on Line 5, Recapitulation)
3,312.00
146,328.93
.*
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Shughart, Mary Ann R.
FILE NUMBER
21 - 04 - 00952
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorshIp must be disclosed on schedule F.
ITEM
NUMBER
19 U.S. Treasury, 2004 income tax refund
DESCRIPTION
VALUE AT DATE OF
DEATH
2,605.00
20
P A Department of Revenue, 2004 income tax refund
214.00
21
National Grange Mutual Homeowners Insurance, refund
493.00
Page 2 of Schedule E
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Shughart, Mary Ann R.
FILE NUMBER
21 - 04 - 00952
ESTATE OF
ITEM
NUMBER
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes.
DESCRIPTION OF PROPERTY
Include the name of the transferee, their relationship to decedent and the date of transfer.
Attach a copy of the deed for real estate.
DATE OF DEATH
VALUE OF ASSET
%OF
DECD'S
INTEREST
EXCLUSION
(IF APPLICABLE)
TAXABLE VALUE
Cash gift to son, Dale F. Shughart, Jr. on 1/11/04
11,000.00 100%
3,000.00
8,000.00
2
Cash gift to daughter, Barbara S. Drake on 1111/04,
11,000.00 100%
3,000.00
8,000.00
TOTAL (Also enter on line 7, Recapitulation)
16,000.00
.*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUlERAL EXPENSES &
ADIIIINSTRA11VE COSTS
ESTATE OF
Shughart, Mary Ann R.
FILE NUMBER
21 - 04 - 00952
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
Hoffman-Roth Funeral Home, funeral expenses
9,673.50
2
Carlisle Memorial Service, engraving
285.00
3
Lydia Hazlett, family reception
217.00
B.
ADMINISTRATIVE COSTS:
1.
Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City
Year(s) Commission paid
State _ Zip
2.
Attorney's Fees
Hamilton C. Davis (estimated)
5,000,00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
Probate Fees Register of Wills
State
Zip
4.
464.00
5. Accountant's Fees
6.
Tax Return Preparer's Fees Mentzer & Co.
300.00
7.
I
Other Administrative Costs
Register of Wills, Short Certificates
35.00
2
Orrstown Bank, checks
34.85
Total of Continuation Schedule(s)
30,955.95
46,965.30
TOTAL (Also enter on line 9, Recapitulation)
ESTATE OF
'.
SchecUe H
Fu1eraI Expet ISeS &
Ach1illisbali\le CosIs contirLled
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Shughart, Mary Ann R.
FILE NUMBER
21 - 04 - 00952
3
Larry Lebo, commission on auto sale
1,630.00
4
IBIS Appraisal Service, personal property appraisal
420.00
5
Postmaster, certificd mail
4.42
6
UPS, overnight mail
15.69
7
Cumberland Law Journal, advertise Letters
75.00
8
The Sentinel, advertise Letters
129.47
9
Anthony Moore, electric rcpairs
1,500.00
10
Ebener & Associates, realtor's commission
6,775.00
II
ERA NRT, Inc., realtor's commission
6,725.00
12
Recorder of Deeds, transfer tax
2,250.00
13
Darlene Moyer, county/bnrough real estate taxes
983.03
14
Borough of Carlisle, sewer and water
84.39
15
Rowe's Auction Service, commission on auction sale
881.00
]6
Jane Wallace, cleaning, snow removal, maintenance, security, packing and moving, repairs
3,170.08
17
Steve Cornman, plumbing repairs
140.00
18
PP&L, electric
134.64
]9
Suburban Energy, fuel oil
853.07
20
AT &1, phone
21.96
2]
Walnut Bottom Landscaping, yard care
381.60
22
Jumper's Electric, electric repair
37.43
23
Sprint, phone
59.05
24
Michael D. Blumentha], home repairs
59495
25
L & M Heating, furnace repair
950.69
Pagc 2 of Schedule H
'.
SchedUe H
fu1eraI Expet 1005 &
AmirisbativeCosls ca1IirU!d
COMMONWEAL TH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Shughart, Mary Ann R.
FILE NUMBER
21 - 04 - 00952
26
Shirley Harrison, house cleaning
787.50
27
Stitzel's Mechanical, plumbing repairs
300.00
28
Veri Williams, trash removal
250.00
29
Barbara Drake, reimburse out of pocket expenses
647.73
30
Dale F. Shughart, Jr., reimburse out of pocket expenses
624.25
31
Register of Wills, filing inheritance tax return and inventory
30.00
32
Reserve for Accounting
500.00
Page 3 of Schedule H
.*
COMMONWEALTH OF PENNSYL VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
ESTATE OF
Shughart, Mary Ann R.
FILE NUMBER
21 - 04 - 00952
Include unreimbursed medical expenses.
ITEM
NUMBER
I
DESCRIPTION
AMOUNT
Checks written before death, clearing after death:
4347 National Grange, ins. premium
4348 PP&L, electric
4344 Laura Shughart, airline tickets
4345 Wayne Noss, flowers
4330 AT&T, electric
4315 P A Department of Revenue, taxes
4341 BonTon, charge account
4350 Citicard, Mastercard account
3,752.27
1,456.00
40.53
1,074.74
13.25
13.80
190.00
44.97
918.98
2 Jane Wallace, personal care and cleaning services 473.00
3 Jumper's Electric, tim repair 28.00
4 AT&T, phone service 23.80
5 Sprint, phone service 160.46
6 Citicorp Mastercard, account balance 53.22
7 PP&L, electric 26.54
8 Comcast, TV cable 12.01
9 L & M Heating, heating repairs 324.80
10 Carlisle Borough, sewer and water 16.18
II Walnut Bottom Landscaping, lawncare 267.85
12 Met Ed, electric 124.08
13 Sarah Todd Home, nursing care 390.00
TOTAL (Also enter on Line 10, Recapitulation)
5,652.21
REV-1513 EX+ (9-110)
'.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
Shughart, Mary Aim R.
FILE NUMBER
21 - 04 - 00952
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
RELATIONSHIP TO
DECEDENT
00 Not UstTrustee(s}
AMOUNT OR SHARE
OF ESTATE
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
Dale F. Shughart, Jr.
25 Rolling Drive
Carlisle, P A 17013
Son
One-half estate
2 Barbara S. Drake
2366 North Quincy Street
Arlington, VA 22207-5112
Daughter
One-half estate
Enter dDllar 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 II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
A. Settlement Statement
u.s. Department of Housing and Urban Development
B. Tvoe of Loan OMB ADDroval No. 2502-0265 (exDires 9/30/2006) FINAL
1. OFHA 2. DFmHA 3. DCom. Unins. I 6. File Number I 7. Loan Number I 8. Mortgage Insurance Case Number
4. nVA 5. nConv.lns. MT2005-136JDF
C. Note" It;~~~:,,~..{~I~~J'~~~;' =~Ii:..m~ elOflin~; lhey.~:=n'."'for~IIl~~'" andar.:t=: in thelOtall1. I TilleExpress Settlement System
:'~~11~G~~lind::~ ~trWl~ci~~::~:e FS:~=~~:~Telt~n~~~~lltg~~ ~h~:.,~ora~~~:~~~i1~~eltlell upon Printed 03/29/2005 a116:18 KLL
D. NAME OF BORROWER: Anthony J. Moore and Jennifer L. Moore
ADDRESS:
E. NAME OF SELLER: Estate of Mary Ann R. Shughart
ADDRESS:
F. NAME OF LENDER: Cash
ADDRESS:
G. PROPERTY ADDRESS: 271 S. College Street, Carlisle. PA 17013
Carli.le Borough
H. SETTLEMENT AGENT: Saidis, Shuff, Flower & Lindsay, Telephone: 717.243.6222 Fax: 717.243.6486
PLACE OF SETTLEMENT: 26 We.t Hlah Street Carlisle PA 17013
I. SETTLEMENT DATE: 03/30/2005
J. SUMMARY OF BORROWER'S TRANSACTION: K. SUMMARY OF SELLER'S TRANSACTION:
100. GROSS AMOUNT DUE FROM BORROWER 400. GROSS AMOUNT DUE TO SELLER
101. Contract sales mice 225 000.00 401. Contract sales price 225 000.00
102. Personal Prooertv 402. Personal Prooertv
103. Setllement charaes to borrower (line 14001 3901.25 403. .
104. 404.
105. 405.
Adiustments for items caid bv seller in advance Adjustments for items paid by seller in advance
107. Count'y' taxes 03/30105 to 12/31/05 746.02 407. County taxes 03/30/05 to12/31/05 746.02
108. School Taxes 03/30/05 to 06/30/05 627.36 408. School Taxes 03/30/05 to 06/30/05 627.38
109. 409.
110. 410.
111. 411.
112. 412.
120. GROSS AMOUNT DUE FROM BORROWER 230 274.65 420. GROSS AMOUNT DUE TO SELLER 226 373.40
200. AMOUNTS PAID BY OR ON BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER
201. Deoosit or earnest money 5 000.00 501. Exce.s Deoo.ill.ee instructionsl
202. Princioal amount of new loans 502. Settlement charnes to seller (Ijne 140m 16 768.68
203. Existino loanlsl taken subiecl to 503. Existino loan(s\ taken subiect to
204. 504. Pavoff of First Mortaeoe Loan
205, 505.
206. Seller Assist 1 500.00 506 Seller Assist 1 500.00
207. 507.
206. 506.
209. 509.
Adiustments for Items unpaid by seller Adiu.tments for items unpaid bv seller
213. 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220. TOTAL PAID BY/FOR BORROWER 6 500.00 520. TOTAL REDUCTION AMOUNT DUE SELLER 1 B 26B.6B
300. CASH AT SETTLEMENT FROM OR TO BORROWER 600. CASH AT SETTLEMENT TO OR FROM SELLER
301, Gross amount due from borrower IlIne 120\ 230,274.65 601. Gross amount due to seller !line 4201 226 373.40
302. Less amounls naid bvnor borrower nine 220\ 6 500.00 602. Less reduction amounl due seller lline 520l 18268.68
303. CASH FROM BORROWER 223774.65 603. CASH TO SELLER 206 104.72
SUBS!ITUTE FORM 1099 SELLER ST~TEMENT: The inforn:'atlon COl1~lned herein illmpcrt.-.tlax information and i. being fumi....ed 10 the IntltfT'lllll R.~enu. Service. If you are requir.d to file II retum,
~neyb~=.::a~~i~l~~l~ =i~;:.,'::n~~t~~li~.lllem IS required 10 be reported and the IRS determines that it has not bevn reported. Th. Conlrect Sales Price described on
~~~~ 1::~I~~eN~rt~ ~i~~ :~~j~ ~~~~r~~c:l=~b 'I;~~~~~, Sale Of &change of Principal Resldenca, for any gain, wilh you'" income I8x return; for othar Iransactions,
~~::,t~~a~ b~I:",~~g%~:ilt7: ~~~I~I:~ tirn~~X ~~I~~: Under penalties of Plt~~~ ~~~ ::~:ber~=\~~~l ~:re~~~~~~:~~de~lfl~~~J:~CC1tiOf1
TIN:
SELLER(S) SIGNATURE(S);
SELLER(S) NEW MAILING ADDRESS'
U,S, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
S~TTLEMENT 8T A TEMENT
File Number. MT2005-136
FINAL
PAGE 2
~ TitleExnress Settlement System Printed 03/29/2005 al lS:18 KLL
L. SETl'LEMENT CHARGES PAID FROM PAID FROM
70Q, TOTAL SALES/BROKER'S COMMISSION based on Drlce $225 000,00 [Q) 6,000 = 13 500,00 BORROWER'S SELLER'S
Division of commission IIine 700\ as follows' FUNDS AT FUNDS AT
701, $ 6 775,00 to Ebener & Associates . SETTLEMENT SETTLEMENT
702, ~ 6 725.00 to ERA NRT Inc.
703, Commission naid at Setllement t3500.00
704. Transaction Fee to ERA NRT Inc. 125.00
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
801, Loan Orinination Fee %
802, Loan Discount %
803, Aooraisal Fee
804, Credit Reoort
805, Lender's InsMdion Fee
80S. Moriaaoe Aoolleation Fee
807, Assumotion Fee
80S,
809,
810,
811,
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901 Interest From to 11il$ /dav
902. Mortaaae Insurance Premium for to
903, Hazard Insurance Premium for to
904.
905,
1000. RESERVES DEPOSITED WITH LENDER FOR
1001, Hazard Insurance mo, 11il$ Imo
1002, Mortoaae insurance mO,I1il$ /mo
1003, CItv Prooertv Tax mo, 11il$ Imo
1004. County Prooertv Tax mO,11il $ 81.92 Imo
1005, School Taxes mo. (al $ 205.19 Imo
1009, Aaareoate Analvsls Adiustment
1100. TITLE CHARGES
1101. Settlement or closino fee
1102. Abstract or title search
1103, Title examination
1104, Title insurance binder
1105. Document Preoaration
1106. Natarv Fees to Said is. Shuff Flower & Lindsav 4.00
1107, Attomev's fees
/includes above items No: I
110S. Title Insurance to ACCP, Inc. 1 483.75
(Includes above items No: 1
1109. lender's Policy
1110, Owners Palic' 225000.00 .1 483.75
1111.
1112.
1113.
1200. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201. Recordlnn Fees Deed $ 38.50 . Moriaane $ . Release $ 38.50
1202. Cltv/Count'taxlslamas Deed $2 250.00 ' Mortaaae $ 2 250.00
1203. State T axlstamns Deed $2 250.00 . MortaaDe $ 2 250.00
1204,
1205.
1300. ADDITIONAL SETTLEMENT CHARGES
1301. 2005 CtvlTwa Tax to Darlene Mover 983.03
1302. Final WaterlSewer Acct #04480Ala BorouQh of Carlisle 35.65
1303, Home Insoeetion to Buver POC
1304,
1305,
1306,
1307,
1308.
1400. TOTAL SETTLEMENT CHARGES (enter on lines 103 Section J and 502 Section Kl 3 901.25 16768.68
HUD CERTIFICATION OF BUYER AND SELLER
I nave carefuUy reviewed the HUD 1 Seltlemenl Statement and to the belt of my knowledge and belief. it III e true end accurate ltatement of atl rec:i) and dlsbUflementll metht on my account or by me
'""""~td"':'_'L::",""'''''''~~''d'~PY''f1''''HUD-1 S..'"".nISIaI.m",' ~ F. 'tr1 ~
MUlOny J Mock~ Jennl1er l. Mil
,
WARNING. IT IS A CRIME TO KNOWINGLY FALSE S ATfMENTS TO THE
UNITED STATES ON THIS OR ANY SIMILAR F RM, PENALTIES UPON CONVICTION
CAN INCLUDE A FINE AND IMPRISONMENT. FOR DETAILS SEE TITLE 18
U.S. COOE SECTION 1001 AND SECTION W10
The HUQ-1 Settlement Sta(em8llt which I have preplU"Eld is a true anrl ~cc:urlllilllccounl 01 this transactiOn
Illsvll causllld or will cause the funds 10 be disbt.irsed in accordallCll with this alat@fll8nl.
~(LUJ~~G)~ ~-'3'-0""
Data of Death Stock Values:
Carlisle Corp CUSIP 142339100
10/15/2004: Hi 62.71, La 62.10; aye 62.405
10/18/2004: Hi 62.31, La 61.70, aye 62.085 (Though this was
Columbus Day, market was open.)
Date of death value: 62.405
Stock was not ex-dividend either day.
Orrstown Bank CUSIP 687380105
10/12/2004 (last day traded before 10/17): Hi 43.50, La 42.75; aye
42.75
10/18/2004: Hi 43, La 42.30; aye 42.65
Date of death value: 42.675
Stock not ex-dividend either day.
Dale,
The Vanguard Windsor fund close share price on October 15, 2004, was
$16.27, and on Octoberl8, 2004, was $16.29.
On October 17, 2004, there were 9684.698 shares in the account. At the
average of those two prices, $16.28, the value of the shares was
$157,666.88. Our respective tax basis would be half of the number of
shares, and half of the dollar value. The same number of shares will be
liquidated, as there have been no additions since that time.
Barbara
PS The share price as of the close on November 4th was $17.22, so unless
it drops before the liquidation, we will have a longterm gain to report.
(Our holding period is the same as Mom's).
.
4
UPDATED & REVISED
, APPRAISAL REPORT
'.......... OF'
. ',PERSPNALPROPERTY
Olf
,"\;
,"-,",
hI'
r'
,
t.: ; ~,
.
APPRAISAL CER TIFICA TE
I hereby certify that, upon the request for the estate appraisal of the personal property of
Mary Ann Shughart, deceased, 271 South College St. Carlisle, P A 17013, I have
personally and physically inspected the listed personal property. The personal property
was appraised to determine the FAIR MARKET VALUE, AS OF d.o.d. October 17,
2004 & reported on January 13,2005. The date of inspection was January 10,2005.
The information and values contained in this report are based upon my experience as an
appraiser and other reliable sources. The personal property was found to be in GOOD to
EXCELLENT condition, unless otherwise noted. Values are reported piece-by-piece,
and/or as a whole. All values reported have been determined with consideration to the
condition of the item, market conditions, and salability factors.
. IBIS APPRAISAL
_:&~;g~. ~~---
Alyssa i:-P;~I~tC:A.P.t>.
3
.
APPRAISAL SUMMARY
It is in my opinion, that as of d.o.d. October 17,2004, the Fair Market Value of the
personal property of Mary Ann Shughart, deceased, 271 South College St. Carlisle, P A
17013:
(Eleven Thousand Nine Hundred Ninety Six Dollars and Fifty Cents)
($11,996.50.00)
IBIS APPRAISAL
SERVICES
1J~'/
----~~~~- -,~~~;~------------
Alyssa L. ~~n y, _1[.1 .1 .
I
The report must be read in its entiretv. The Appraisal Summarv ONLY is
not the appraisal report.
4
.
Photograph and CD-ROM Instructions
Ibis Appraisal Services has provided you with a CD-ROM that houses all of the digital
photographs of all of the items appraised. The CD-ROM also contains a saved copy of
the appraisal report. This CD-ROM may be kept with the paper copy of the appraisal
report or kept off-site, such as a safety deposit box.
The photographs are saved in the JPEG picture format, meaning that all of the file names
end with a ".JPG".
The file names correspond to the written appraisal report's Corresponding Photograph
File that is included at the end of each item appraised.
Getting started with your CD-ROM
1. Insert the CD-ROM into your computer's CD-ROM Drive. If you do not have a
computer or access to a CD-ROM Drive--a copy store, office supply store, or public
library will be able to help you view and/or print your pictures.
2. Your computer may contain one or several different software programs that will
allow you to view your pictures. Examples of these programs are Draw, Photo Editor,
Picture It! Express, Photo Suite, My Photo Center, Photo Studio Lite, Photo Shop
Pro, Picture CD, or Photo Deluxe. The program that is included with a digital camera
is another way to view your pictures.
· Select the program for viewing photographs and open the program.
3. Click FILE, and Click OPEN.
4. Use the Pull-Down, "Look in" Menu and select the D Drive (D:) or whichever drive
is designated as your CD-ROM (sometimes this may be the E Drive (E:) on your
computer).
.. NOTE
· Your CD-ROM Drive is designated with a small CD-ROM graphic Icon or a
cartoon representing the drive.
· The drives of your computer can be found under My Computer section of the Pull-
Down "Look in" Menu. Common Drives are: A Drive (floppy disc drive), the C
Drive (hard disc drive), the D Drive (CD-ROM Drive), and the E Drive (sometimes
CD-ROM Drive; sometimes an external drive, like a CD-ROM Writer, Zip, or Jazz
Drive).
5. Double-click on the photograph you wish to view.
5
.
4
5
8
17
24
25
26
Personal Property Listing
Workbench. Vmtage wood work bench. Location: Basement.
Corresponding Digital Photograph Files: r0304575-r0304576.jpg
$10.00
Bench Grinder. Black and Decker 5" bench grinder. #7900 Type 3.
Location: Basement.
Corresponding Digital Photograph File: r0304577
$25.00
Filinll Cabinets. Three horizontal drawer metal filing cabinets.
Location: Basement & Office.
Corresponding Digital Photograph Files: r0304580 &
r0304750.jpg
$25.00
Chairs. Four metal folding chairs.
Location: Basement.
Corresponding Digital Photograph File: r0304589.jpg
$6.00
Bench. Nineteenth century soft wood bench/box. 36" tall, 67"
wide, 13 Yt" deep.
Location: Basement.
Corresponding Digital Photograph File: r0304597.jpg
$325.00
Bar. Contemporary wood bar. 43" tall, 96' wide, 25" deep.
Location: Basement.
Corresponding Digital Photograph File: r0304598.jpg
$150.00
Bar Stools. Four contemporary bar stools.
Location: Basement.
Corresponding Digital Photograph File: r0304599.jpg
$40.00
6
.
27
29
31
36
38
39
40
41
Desk. Primitive soft wood school-type desk. 35" tal~ 25" wide, 33"
deep.
Location: Basement.
Corresponding Digital Photograph File: r0304600Jpg
$225.00
Oak Chairs. Set of four vintage oak chairs. 36" tall.
Location: Basement.
Corresponding Digital Photograph File: r0304602.jpg
$40.00
Drvsink. Primitive pine Drysink. Three drawers over Drysink over
two doors. 47" tall, 47" wide, 22 y," deep.
Location: Basement.
Corresponding Digital Photograph File: r0304604.jpg
$350.00
Prints. Selection of miscellaneous framed and matted prints.
Location: Throughout the Residence.
Corresponding Digital Photograph File: r0304609Jpg
$20.00
Table. Long pine 1able. 28" ~ 72" wide, 34" deep.
Location: Basement.
Corresponding Digital Photograph File: r0304611.jpg
$225.00
$30.00
$45.00
$25.00
7
.
42
43
48
50
51
55
56
60
$30.00
Gnmiteware. VIntage graniteware.
Location: Kitchen.
Corresponding Digital Photograph File: r0304615jpg
$12.00
Chairs. Three vintage wood chairs. 35" tall.
Location: Kitchen, First Floor Bedroom & Second Floor Front
Bedroom #2.
Corresponding Digital Photograph File: r0304620jpg
$60.00
Tin Plate. Vintage child's tin alphabet plate.
Location: Kitchen.
Corresponding Digital Photograph File: r0304623.jpg
$38.00
Tin Plate. Vintage tin plate with beaded edge.
Location: Kitchen.
Corresponding Digital Photograph File: r0304624jpg
$25.00
Television. Quasar 13" older model color television.
Location: Kitchen.
Corresponding Digital Photograph File: r0304627jpg
$25.00
Print. Framed and matted western motif print. 24" x 19".
Location: Dining Room.
Corresponding Digital Photograph File: r0304631jpg
$25.00
$85.00
Serving Items. Miscellaneous selection of glass and silverplate
serving items including covered vegetable bowls, open vegetable
bowls, platters, cake stands, and relish dishes.
Location: Dining Room.
Corresponding Digital Photograph Files: r0304635. r0304639,
r0304641. .
8
62
65
69
74
76
82
Silver Case. Contemporary mahogany silver & jewelry case. 32"
tall, 15" wide, }3" deep.
Location: Dining Room.
Corresponding Digital Photograph File: r0304637.jpg
$125.00
Salt & PeDDer Shakers. Sterling silver salt and pepper shakers by
Duchin.
Location: Dining Room.
Corresponding Digital Photograph File: r0304640.jpg
$60.00
Drvsink. Vintage primitive drysink: with one drawer and two doors.
Has copper insert. 33" tall, 45" wide, 18" deep.
Location: Dining Room.
Corresponding Digital Photograph File: r0304647Jpg
$800.00
Candlestand Leather top candlestand 20" tall, 13 y," diameter.
Location: Dining Room.
Corresponding Digital Photograph File: r0304652Jpg
$20.00
Comer Cuuboard. Vintage comer cupboard. Two door over two
door. 76" tall, 37" wide, 23" deep.
Location: Dining Room.
Corresponding Digital Photograph File: r0304654.jpg
$1,050.00
Carving Set Sheffield horn handle carving set: Three piece.
Location: Dining Room.
Corresponding Digital Photograph File: r0304666.jpg
$40.00
9
84
85
86
88
89
90
91
~. Oriental wool carpet with red field., navy and beige border
and medallion center. Shahistan. 12' x 9.5'.
Location: Dining Room.
Corresponding Digital Photograph Files: r0304668 &
r0304669.jpg
Cake Stand American Fostoria cake stand. 7 Y:," tall, 10" diameter.
Location: Dining Room.
Corresponding Digital Photograph File: r0304673.jpg
Bowl. Gold toned carnival glass rose with rose motif. 4 \1," tall, 10
\1," wide.
Location: Dining Room.
Corresponding Digital Photograph File: r0304674.jpg
Box. Spoon carved wood box by Joseph Biirche11937. 5" tall, 7 \1,"
wide, 5 %" deep.
Location: Dining Room.
Corresponding Digital Photograph File: r0304675.jpg
Prints. Two framed and matted print of Germanic European cities.
Signed. 16 \1," x 13 \1,".
Location: Dining Room.
Corresponding Digital Photograph File: r0304676.jpg
Chairs. Set of six Chippendale reproduction chairs with music harp
motif. 34" tall
Location: Dining Room.
Corresponding Digital Photograph File: r0304677.jpg
Table. Wood dining room table. 29" taIl, 61" wide, 40" deep.
Location: Dining Room.
Corresponding Digital Photograph File: r0304678.jpg
$450.00
$45.00
$40.00
$30.00
$30.00
$300.00
$375.00
10
117
121
123
124
126
130
Print. One framed and matted print. 21" x 17".
Location: Living Room.
Corresponding Digital Photograph Files: r0304703 &
r0304704jpg
$25.00
Dresser Box. Ceramic Royal Copenhagen dresser box. Crackle
glaze. 2" tall, 6 W' wide, 4" deep.
Location: Living Room.
Corresponding Digital Photograph File: r0304708jpg
$23.00
Painting. Oil on canvas. Subject: Stream under road. Artist: Mary
Ann Shughart Dated: 1975.28 y," x 24 W'.
Location: Living Room.
Corresponding Digital Photograph File: r0304711 jpg
$40.00
Paintinl!. Oil on canvas. Subject: Tools against building. Artist:
Mary Ann Shughart. Dated: 1976. 23" x 19".
Location: Living Room.
Corresponding Digital Photograph File: r0304712jpg
$30.00
Chair. Contemporary plush blue chair.
Location: Living Room.
Corresponding Digital Photograph File: r0304714jpg
$40.00
$20.00
Air Conditioner. One air conditioning unit
Location: Sun Room.
Corresponding Digital Photograph File: r0304719Jpg
13
134
139
140
141
142
146
ManiagelBirth Certificate. Cumberland County band painted
maniage and birth certificate. 1857. Waggoners by James Shaw.
26" x 22".
Location: First Floor Hallway.
Corresponding Digital Photograph Files: r0304722&r0304723.jpg
$275.00
Embroideries. A selection of miscellaneous framed embroideries
and cross stitches.
Location: First Floor Hallway.
Corresponding Digital Photograph File: r0304728.jpg
$30.00
~ Oriental wool runner. Red field, multi-color border.
Sarouk. 2.2' x 11.3'.
Location: First Floor Hallway.
Corresponding Digital Photograph File: r0304729.jpg
$200.00
Chair. Vintage rounded wood chair. 26" tall, 19" wide.
Location: First Floor Hallway.
Corresponding Digital Photograph File: r0304730.jpg
$45.00
Cabinet Pine cabinet, one door. 34" tall, 20" wide, 10 Yz" deep.
Location: First Floor Bathroom.
Corresponding Digital Photograph File: r030473/.jpg
$35.00
$225.00
_ Washstand. Oak vintage washstand with towel rack. One drawer
over two door. 53" tall, 31" wide, 18" deep.
Location: First Floor Bathroom.
Corresponding Digital Photograph File: r0304735.jpg
14
148
149
150
152
153
Chair. Victorian Eastlake chair.
Location: Office.
Corresponding Digital Photograph File: r0304738.jpg
$75.00
Bookcases. Set of oak barrister bookcases, five units.
Location: Office.
Corresponding Digital Photograph File: r0304741.jpg
$625.00
Chair. Vintage softwood chair. 31 \12' taIl.
Location: Office.
Corresponding Digital Photograph File: r0304739.jpg
$45.00
Lamp. Brass table lamp. 22" taIl.
Location: Office.
Corresponding Digital Photograph File: r0304743.jpg
$10.00
Desk. Vmtage oak roll top desk. 44 \1," tall, 44" wide, 30" deep.
Location: Office.
Corresponding Digital Photograph File: r0304742.jpg
$325.00
15
154
158
160
161
163
164
165
Chair. Metal mid twentieth century office chair. All Steel
Equipment.
Location: Office.
Corresponding Digital Photograph File: r0304744jpg
$5.00
Trunk. Hump back trunk with tin sheeting.
Location: Office.
Corresponding Digital Photograph File: r0304748.jpg
$150.00
Bookcases. Set of oak banister bookcases, four units
Location: Office.
Corresponding Digital Photograph File: r0304749jpg
$500.00
Desk. Oak three drawer desk. 24" taIl, 47" wide, 23 Y:z" deep.
Location: Office.
Corresponding Digital Photograph File: r0304751.jpg
$40.00
Desk. Oak desk. 2T' taIl, 20" wide, 28" deep.
Location: Office.
Corresponding Digital Photograph File: r0304753.jpg
$50.00
Jellv Cupboard. Pine primitive jelly cupboard with shelf. 65" tall,
45 Y:z" wide, 18 Y:z" deep.
Location: Office.
Corresponding Digital Photograph File: r0304754.jpg
$625.00
Print. Framed and matted print Title: Historic Carlisle. Artist:
Alice Rockwall. 152/301. 18" x 21 Y:z".
$35.00
16
166
167
170
174
176
ISO
182
Delft. Miscellimeous pieces of delft by Royal Goedewaagen.
Location: Office.
Corresponding Digital Photograph File: r0304755jpg
$150.00
Chair. Child's red painted Windsor chair. "Our Darling". 18 Yo"
tall.
Location: Office.
Corresponding Digital Photograph File: r0304756jpg
$25.00
Crock. White glaze five gallon crock.
Location: First Floor Bedroom.
Corresponding Digital Photograph File: r0304759jpg
$25.00
PaintinlZ. Oil on canvas. Subject: Farmland. Artist: Mary Ann
Shughart. Framed. 30" x 23 %".
Location: First Floor Bedroom.
Corresponding Digital Photograph File: r0304763jpg
$30.00
Chair. Plush and wood chair. 34" x 22 Yo".
Location: First Floor Bedroom.
Corresponding Digital Photograph File: r0304765.jpg
$50.00
RockinlZ Horse. Child's toy sit-in rocking horse.
Location: First Floor Bedroom.
Corresponding Digital Photograph Files: r0304771 &
r0304772jpg
$100.00
Paintinl!:. Oil on board. Subject: Portrait Mary Ann Shughart.
Artist: Ronald S. Keyes. Dated: 1951. Framed. 31 Yo" x 25 Yo".
Location: First Floor Bedroom.
Corresponding Digital Photograph File: r0304774.jpg
$45.00
17
190
192
193
194
199
200
Plant Stand Two tier wood plant stand. 25" tall, 18" diameter.
Location: Second Floor Landing.
Corresponding Digital Photograph File: r0304783.jpg
$40.00
Rocking Chair. Vintage oak pressed back rocking chair.
Location: Second Floor Landing.
Corresponding Digital Photograph File: r0304784jpg
$80.00
Washstand F.:j~ll1l<p. washstand with one drawer over two drawers
and one door. 39 Yo" tall, 31" wide, 17 Yo" deep.
Location: Second Floor Landing.
Corresponding Digital Photograph File: r0304785.jpg
$275.00
Paintine:. Pastel. Subject: Portrait Artist: Wittben Framed and
matted. 23" x 19 W'.
Location: Second Floor Landing.
Corresponding Digital Photograph File: r0304786jpg
$15.00
Paintinl1. Oil on canvas. Subject: Sea shore & gulls. Artist: Mary
Ann Shughart. Dated: 1976. Framed. 27" x 21".
Location: Second Floor Landing.
Corresponding Digital Photograph File: r0304791.jpg
$30.00
Shoe Rack. Primitive wood shoe rack. 49" tall, 44" wide, 8" deep.
Location: Second Floor Landing.
Corresponding Digital Photograph File: r0304792jpg
$115.00
18
203
204
207
208
211
212
Painting. Oil on canvas. Subject: Boats. Artist: Mary Ann
Shughart. Dated: 1976.23 'I." x 19".
Location: Back Bedroom.
Corresponding Digital Photograph File: r0304795jpg
$30.00
Drawers. Contemporary chest of drawers. Painted white. 32" tall,
36" wide, 13" deep.
Location: Back Bedroom.
Corresponding Digital Photograph File: r0304796jpg
$35.00
Painting. Oil on canvas. Subject: Chickadees. Artist: Mary Ann
Shughart. Dated: 1976. Framed. 17" x 13".
Location: Back Bedroom.
Corresponding Digital Photograph File: r0304799jpg
$20.00
Blanket Chest Softwood blanket chest 18" tall, 36 'l2" wide, 17 'l2"
deep.
Location: Back Bedroom.
Corresponding Digital Photograph File: r0304800.jpg
$225.00
Mirror. Round framed mirror. 32" diameter.
Location: Second Floor Front Bedroom # 1.
Corresponding Digital Photograph File: r0304806jpg
$10.00
Air Conditioner. Quasar air conditioner.
Location: Second Floor Front Bedroom # 1.
Corresponding Digital Photograph File: r0304807jpg
$40.00
19
..
213
214
215
219
220
222
Painting. Oil on canvas. Subject: Beach. Artist: Mary Ann
Shughart. Framed 23" x 19.
Location: Second Floor Front Bedroom # 1.
Corresponding Digital Photograph File: r0304808.jpg
$30.00
Painting. Oil on canvas. Subject: Wooded stream. Artist: Mary Ann
Shughart. Dated: 1977. Fmmed. 26 'l'," x 20 'l',".
Location: Second Floor Front Bedroom #1.
Corresponding Digital Photograph File: r0304809jpg
$30.00
Painting. Oil on board. Subject: Farm house. Artist: Mary Ann
Shughart. Fmmed. 25 'l'," x 21 'l',".
Location: Second Floor Front Bedroom # 1.
Corresponding Digital Photograph File: r030481O.jpg
$30.00
Chair. Victorian Eastlake chair with caned seat. 35" tall
Location: Second Floor Front Bedroom #2.
Corresponding Digital Photograph File: r03048J4.jpg
$50.00
Ouilt Rack. Wood primitive quilt rack. 32" tall, 29" wide, 18"
deep.
Location: Second Floor Front Bedroom #2.
Corresponding Digital Photograph File: r0304815.jpg
$45.00
Chest Wood four drawer chest. 44" tall, 32" wide, 18" deep.
Location: Second Floor Front Bedroom #2.
Corresponding Digital Photograph File: r0304818.jpg
$40.00
20
, .
APPRAISAL SUMMARY (COPY)
It is in my opinion, that as of d.o.d. October 17,2004, the Fair Market Value of the
personal property of Mary Ann Shughart, deceased, 271 South College S1. Carlisle, PA
17013:
(Eleven Thousand Nine Hundred Ninety Six Dollars and Fifty Cents)
($11,996.50.00)
IBIS APPRAISAL
SERVICES
The report must be read in its entiretv. The Appraisal Summarv ONLY is
not the appraisal report.
23
#oo~
ORRSTOWN BANK
January 3, 2005
TO: Dale F Shughart Jr.
Attorney At Law
38 East High Street Suite 203
Carlisle, PA 17013
FROM: Timothea Moose
Cust. Servo Op.
P.O. BOX 250
SHIPPENSBURG PA 17257-0250
RE: ESTATE OF Maryann R Shughart
DATE OF DEATH: October 17, 2004
IT IS HEREBY CERTIFIED THAT THE ABOVE NAMED DECEDENT HAD, ON THE ABOVE DATE, THE
FOLLOWING ACCOUNTS WITH ORRSTOWN BANK:
CHECKING ACCOUNTS
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST
400440 Maryann R Shughart 3/25/94 5,502.03 .32
106210114 MaryannRShughart 3/31/98 112,303.77 88.92
SAVINGS ACCOUNTS
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST
CERTIFICATES OF DEPOSIT
ACCOUNT NO. TITLE OF ACCOUNT DATE OPENED PRINCIPAL & ACCRUED INTEREST
P.O. BOX 250
SHIPPENSBURG, PA 17257
TEL. (717) 532-6114
LAST wn ,r. ANn TF,ST AMENT
I, MARY ANN R. SHUGHART, of the Borough of Carlisle, Cumberland County,
Pennsylvania, declare this to be my Last Will and Testament and revoke any Will or Codicil
previously made by me.
ITEM I: I direct that all my just debts (except as may be barred by a Statute of
Limitations) and my funeral expenses (including my gravemarker and expenses of my last illness)
shall be paid from my residuary estate as soon as practicable after my decease as a part of the
administration of my estate.
ITEM II: I give and bequeath all my tangible personal property, including but not
limited to, any and all automobiles and other I?otor vehicles, household goods and furniture and
furnishings; china, silvenvare, jewelry, ornaments, works of art, books pictures, wearing apparel
and personal effects, but excluding cash on hand and tangible evidences of intangible personal
property together with any policies of insurance applicable thereto including any prepaid
premiums thereon to such of my children DALE F. SHUGHART, JR. and BARBARA S.
DRAKE, as shall survive me, in as nearly equal shares as is practicable.
ITEM III: I devise and bequeath the residue of my estate of every nature and
wherever situate in equal shares (per stirpes) to each of my children, DALE F. SHUGHART, JR.
and BARBARA S. DRAKE, as shall survive me by thirty (30) days.
ITEM IV: In the event that both of my children should predecease me or die on or
before the thirtieth day following my death, and should I not be survived by issue, then I devise
and bequeath the residue of my estate of every nature and whenever situate as follows:
~
A. One-Half (1/2) thereof to the DICKINSON SCHOOL OF LAW of the
PENN STATE UNIVERSITY, for its scholarship fund, to endow scholarships for
deserving students. These scholarships shall be, if feasible, known as the "Mary Ann R.
and Judge Dale F. Shughart Memorial Scholarships."
B. One-Half (1/2) thereof to the GRACE UNITED METHODIST CHURCH
of Carlisle, Pennsylvania.
ITEM V: I direct that all taxes that may be assessed in consequence of my death, of
whatever nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as
part of the expenses of the administration of my estate.
ITEM VI: I appoint my son, DALE F. SHUGHART, JR., and my daughter,
BARBARA S. DRAKE, Co-Executors of this my Last Will. Should both of my said children
fail to qualify or cease to act as Executors, I appoint, HAMIL TON C. DAVIS, of Newville,
Pennsylvania, substitute Executor, of this my Last Will.
ITEM VII:
I direct that my Executors or their successors shall not be required to give
bond for the faithful performance of their duties in any jurisdiction.
ITEM VIII: My individual fiduciary shall be entitled to reasonable compensation for
his and/or her services rendered from time to time and to reimbursement of out of pocket expenses.
IN WITNESS WHEREOF, I hereunto set my hand and seal to this my Last Will and
1npJ
2
Testament, written on (4) sheets of paper, dated this ~qM day of /;)c/&J() biJr)
2003.
'1h~ ~ ;f~~~
MARY ANN R. SHUGHART
The preceding instrument, consisting of this and (3) other typewritten pages, each identified
by the signature or initials of the Testatrix, was on the day and date thereof signed, published and
declared by the Testatrix therein named, as and for her Last Will, in the presence of us, who, at her
request, in her presence, and in the presence of each other have subscribed our names as witnesses
hereto.
residing a
3
COMMONWEALTH OF PENNSYL VANIA:
: ss.
COUNTY OF CUMBERLAND
I, MARY ANN R. SHUGHART, the Testatrix whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my Last Will; and that I signed it willingly and as my free
and voluntary act for the purposes therein expressed.
~M~(s;,.L)
ANN R. SHUGHART
Notarial Seal - ~-'i
. Hamilton C. Davis, Notary Public
Shlppensb~rg. BOrD, cumbo erland County
My Commission Expires Sept. 27, 2004
Member, Pennsylvania Assoclalion of Notaries
COMMONWEALTH OF PENNSYLVANIA:
: ss.
COUNTY OF CUMBERLAND :
we,II~ I hlm))aev and .AJ/cho/eJ Kd/elfiwitness whose names
are Sign~ 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
eighteen (18) or more years of age and of sound mind and under no constraint or undue influence.
LU~
Sworn to or affirmed and~~1'k:~.k, A/,'
before me by R\ol~ ~ 1V4l111iK-( a..tt! 4. ffie'
w.''l'V'cf')t''1egt''tRJf; this ~ ., ~day of
~~w ,2003.
Notary
1..-..---.-.-----....--.--- '..
. Notarial 8eal .i
. Hamilton C. Davis, NoialY Public !
.ShIPl2.SnSb':l'Y' BOr?, c'.<mb8'."an. d CQ\.".l. [".'./'.
My CornmrS(~~IOn J,:xplres Supt. 2.." 200.4..
.~\iI{~;r ~1)~;;n;~\:J.:!;;~;~i.!;~;.~;-~Zi~~rf!~~-~(;t..;7~;'.; I'; :-~~~
4
-..
I
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of
Shughart, Mary Ann R.
No. 21 - 04 - 00952
, Deceased
Date of Death 10/17/2004
Social Security No. 180-01-3567
also known as
Dale F. Shughart, Jr. Barbara S. Drake
The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory
include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania
of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the
Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that
which appears in a memorandum at the end of this Inventory. 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.
1.0. No.:
19373
Personal Representativde. ,,--
~ -tv
Signature - / v
ale F. Shu hart, Jr
Signature: "7i:v ./ .
~a';:'ts.
Attorney:
Dale F Shughart, Jr. Esquire
Signature:
Address:
35 E. High Street, Suite 203
Address: 35 East High Street
Carlisle, PAl 70 13
Carlisle, PA 17013
Telephone: 717/241-4311
Telephone: 717-241-4311
Dated: 7/1 Z /()~
9,684.698 shares Vanguard Windsor Fund
CUSIP # 922018106 @ 16.28 per share
o
~O
--:n
fD-o
:IJ~P
r---zrn
/~ -:::I1
;:~_ (f) ^
;'..)00
~')b-n
':JC
: :::0
--1
j.2
,.....,
<=>
c;:;:t :TJ
c...n --"'-1 ""1"'1
L i~::'l("~)
I ~666.~~ ~;::~
.:.,~ c.-::J
. '1 I--n
W :TJ o:':J
~180.7j; q
:::;:: :~':;0
~ ',: [1'1
2~65R.A6) q
Personal Prooertv
615.3508 shares Orrstown Financial Services,
common stock, CUSIP #687380105 @42.675 per share
3,600 shares Carlisle Corporation, common stock,
CUSIP #142339100 @ 62.405 per share
Cash on hand. (1.71 + 5.00)
6.71
Retainer on deposit in Dale F. Shughart, Jr. Escrow Account.
500.00
Household goods, furniture and furnishings distributed in kind or sold at appraised value, value
based upon attached appraisal of Alyssa Loney.
11,996.50
Household goods, furniture and furnishings, sold at public acution, value is actual sale price.
3,527.00
1997 Buick sedan, value based upon actual sale price.
5,995.00
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
$779,834.56
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
continued
Estate of
Shughart, Mary Ann R.
No. 21 - 04 - 00952
Date of Death lOll 7/2004
also known as
, Deceased
Social Security No. 180-01-3567
Orrstown Bank, checking account #400440
Principal 5,502.03
Accrued interest .32
5,502.35
Orrstown Bank, checking account 11106210114
Principal 112,303.77
Accrued interest 88.92
112,392.69
Tax proration of sale ofreal estate
1,373.40
Hoffman-Roth Funeral Home, refund
201.00
Dalton Books, refund
158.05
Agway, refund
861.14
Patriot News, refund
46.35
The Sentinel, refund
11.48
Comcast, refund
4.59
Attorney Group Life Insurance Trust, refund
186.13
Travelers, auto insurance refund
224.00
AT&T, refund
5.29
Sprint, refund
25.25
U.S. Treasury, 2004 income tax refund
2,605.00
PA Department of Revenue, 2004 income tax refund
214.00
National Grange Mutual Homeowners Insurance, refund
493.00
Total Personal Property
$554,834.56
2
r
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
continued
Estate of Shughart, Mary Ann R.
also known as
, Deceased
No. 21 - 04 - 00952
Date of Death 10117/2004
Social Security No. 180-01-3567
Real Estate
House and lot located at 271 South College Street, Borough of Carlisle, Cumberland County,
PA; Prior deed reference: Deed Book "U", Vol. 13, Page 459. Cumberland County Tax Parcel
#04-21-0322-185. Value based upon actual sale price. HUD-I attached.
225,000.00
Total Real Estate
$225,000.00
3
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 005561
SHUGHART DALE F JR
35 EAST HIGH STREET
SUITE 203
CARLISLE, PA 17013
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
fold
101
$1,892.14
ESTATE INFORMATION: SSN: 180-01-3567
FILE NUMBER: 2104-0952
DECEDENT NAME: SHUGHART MARY ANN R
DA TE OF PAYMENT: 07/13/2005
POSTMARK DATE: 07/1 3/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 10/17/2004
TOTAL AMOUNT PAID:
$1,892.14
REMARKS:
CHECK# 1077
SEAL
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
~r IrIID~E DF INHERITANCE TAX
RECORui:~&fRWlOO-, ALLOIlANCE OR DISALLOWANCE
Df"DSDUCfIDNS AND ASSESSHENT OF TAX
: <. i
*'
REV-1547 EX AFP (06-05)
09-13-2005
SHUGHART
10-17-2004
21 04-0952
CUMBERLAND
101
APPEAL DATE: 11-12-2005
( 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:is4;-Ei-AFP-io3:osj-NoTlcE-OF-INHERITANCE-TAi-APPRAISEMENT:-ALLowANCE-OR---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
MARYANN R FILE NO. 21 04-0952 ACN 101
('I CDI{ ('~
-..),-,-.1,\ '_
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
MARYANN
R
Znne C'1;"D \ 3 Pi'l \: 45
uu,J ..)1..-1
DALE F SHUGHART
STE 203
35 E HIGH ST
CARLISLE
2DD'J./
,'II,,""
JR ~.Q
PA 17013
ESTATE OF
SHUGHART
DATE 09-13-2005
TAX RETURN liAS: (X I ACCEPTED AS FILED
I CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL AND SUPPLEMENTAL RETURN NO. 01
1. R..l Est.t. (Schedul. Al III 225,000.00 NOTE: To insure ....o...r
2. stocks ..-.d Bonds (Schedule B) (2) 408.505.63 c....dit to your account,
sub.it the upper portion
3. Closely Held Stock/PartnershIp Interest (Schedule C) (3) .00 of this for. with your
4. "ortgages/Nat.s Receivable (Schedule D) (4) .00 t.x payment.
5. C..sh/Il&nk lJeposits,"1sc. P.rson..l Prop.rty (S_dul.. EI (51 146.328.93
6. Jointly D-.I Prop.rty (Schedul. Fl (61 17 .866.65
7. Trensf.rs (Schedul. GI (7) 16,000.00
8. Tot.l Ass.ts (81 813,701. 21
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Ad.. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Llabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. ChBritabl./Gover~tal Bequests; Non-elected 9113 Trusts (Schedul. J)
14. Net Value of Estate Subject to Tax
(9)
1101
47,020.30
5.652.21
(Ill
1121
1131
(141
Ii? .67' 1;1
761,028.70
.00
761,028.70
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~ abb returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rat. (15)
16. Amount of Llne 14 taxable at Lineal/Class A rat. (16)
17. Aaount of Line 14 ..t Sibling r.t. (171
18. A.aunt of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
.00 X 00 = .00
761,028.70 X 045 = 34,246.29
.00 X 12 = .00
.00 X 15 = .00
1191= 34,246.29
T6Y CREDIT!II,
1+) AHOUNT PAID
DATE NUKBER INTEREST/PEN PAID (-I
01-14-2005 CD004839 1,577 .63 29,975.00
07-13-2005 CD005561 .00 1,892.14
07-18-2005 CD005582 .00 801. 52
TOTAL TAX CREDIT 34,246.29
BALANCE OF TAX DUE .00
INTEREST AND PEN. .11
TOTAL DUE .11
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATIDN OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT'" (CRI, YDU HAY BE DUE \\'1
A REFUND. SEE REVERSE SIDE DF TMIS FORK FOR INSTRUCTIONS. I ~,
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Mary Ann R. Shughart
Date of Death: October 17, 2004
Admin. No. 21-04-0952
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court
Rules, I report the following with respect to completion of the
administration of the above-captioned estate:
1. State whether administration of the estate is complete:
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.
approvals of
Clerk of the
Copies of receipts, releases, joinders and
formal or informal accounts may be filed with the
Orphans' Court and may be attached to his report.
~te: September 28, 2005
c;;
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Shughart,
Court I.D. 1937
35 East High Street, Suite 203
Carlisle, PA 17013
(717) 241-4311
Counsel for Personal Representatives
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COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
DEPT,280601
HARRISBURG. PA 17128-0601
OFFICii':,.!. U~~F: (;rJI.\'
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FilE NUMBER
21 04
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
0952
NUMBER
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DECEDENTS NAME (LAST. FIRST. AND MIDDLE INITIAL)
Shughm1, Mary Ann R.
180-01-3567
DATE OF DEATH (MM-DD-YEAR)
DATE OF BIRTH (MM.DD.YEAR)
THIS RETURN MUST BE FilED IN DUPLICATE WITH THE
10/1 7/2004
04/18/19 I 7
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
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~ 2. Supplemental Return
o 4a. Future Interest Compromise (dale of death alter
12-12-82)
o 7. Decedent Maintained a Living Trust (Al1ach
copy of Trust)
D 10. Spousal Poverty Credit (dale of death between D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
12-3tc9tand .U-95)... . ,.. .
. THISSECTI()III~IJ.~!J!I;J~()MP"~!'P.!I!d-: C;.Q!'IRESI'ONDI;,,~ AND CONFIDENTIAL TAX INFOIWATlON ~OU1.0 BE DIRECTED TO: _~.'-_."_
NAME COMPLETE MAILING ADDRESS
Dale F Shughart, Jr. Esquire
1. Original Return
4. Limited Estate
D 3.
D 5. Federal Estate Tax Return Required
Remainder Return (date of death prior to 12.13~82)
6. Decedent Died Testate (AtlaCI1 copy
olWiH)
9. Litigation Proceeds Received
8. Total Number of Safe Deposit Boxes
FlAM NAME (II applicable)
35 E. High Street, Suite 203
Carlisle, P A 17013
(1) None
(2) None
(3) None
(4) None
(5) None
(6) 17,866.65
(7) None
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TELEPHONE NUMBER
717/241.4311
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
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3. Closely Held Corporation, Partnership or Sole-ProprietDrship
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4. Mortgages & Notes Receivable (Schedule D)
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5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
55.00
(8)
17,866.65
(9)
10. Debts of Decedent. Mortgage Liabilities. & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
(11)
55.00
12. Net Value of Estate (Line 8 minus Line 11)
(12)
17,811.65
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net VBlue Subject to Tax (Line 12 minus Line 13)
(13)
(14)
17,811.65
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax rate, x .00 (15)
or transfers under Sec. 9116(a)(1.2)
z 17,811.65 .045 (16)
0 16. Amount of Line 14 taxable at lineal rate x
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" (17)
.. 17. Amount Df Line 14 taxable at sibling rate x .12
"'
0
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x 18. Amount of Line 14 taxable at collateral rate (18)
~ x .15
19. Tax Due (19)
801.52
801.52
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
20. 0
..mm -----__~- __ _ ~--;:> BESUIl~i~~N'sWER~~LQUESTlOIllS ON REVERSEsu;E- AIIlDRECHECK MATH <<
Copyright 2000 form software only The Lackner Group, Inc.
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Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
STREET ADDRESS
271 South College Street
CITY
Carlisle
STATE PA
ZIP 17013
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
801.52
Total Credits (A + B + C)
(2)
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
(3) 0.00
(4)
(5) 801.52
(5A)
(5B) 801.52
T otallnterest/Penalty (0 + 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 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
:i!:!:iiill!}:iffiii!ill)I't...____f~lli~n~! Iii UIIII Ai m,f!~:''q] .11",1 -.III~ IlilllJ_liI
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;................................................................................ ~ I
~: ~::::~ ~h;e~;~:i:~~: :~~e~:s~~~. ~~~~~ .~.~.~..t.~.~. .p.r~~e.~. t~.an.sf~~~~~ .~:. ~~~. ~~~~~.~~'.: ::..:....... :...........::::::::::::::::::
d. receive the promise for life of either payments, benefits or care? .............................................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?. .......... ..... .......................... ..... .................................................... ................... 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.
25 Rolling Drive
Carlisle, P A 17013
ADDRESS
ADDRESS
2366 North Ouincy Street
Arlington, VA 22207
35 E. High Street, Suite 203
Carlisle, P A 17013
For dates of death on or after J iy 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3% [72 P.S. 116 (a) (1.1) (i)l.
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.s. 99116 (a) (1.1) (ill]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P .S. 99116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116
1.2) [72 P.S. 99116 (a) (1)].
The tax rate imposed on the net vaiue oflransfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116 (a) (1.3)]. A sibling is defined,
under Section 9102. as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
SCHEDULE F
JOINTL V-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Shughart, Mary Ann R.
FILE NUMBER
21-04-0952
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G.
ADDRESS
SURVIVING JOINT TENANT(S) NAME
A Dale F. Shughart, Jr.
B Barbara S. Drake
25 Rolling Drive
Carlisle, P A 17013
2366 North Quincy Street
Arlington, VA 22207-5112
RELATIONSHIP TO DECEDENT
Son
Daughter
JOINTLY OWNED PROPERTY:
ITEM LETTER
NUMBER FOR JOINT
TENANT
A,B
DATE
MADE
JOINT
DESCRIPTION OF PROPERTY
Include name of financial institution and bank account number
or similar identifying number. Attach deed for jointly-held real
estate.
% OF DATE OF DEATH
DATEOFDEATH DECO'S VALUE OF
VALUE OF ASSET INTEREST DECEDENT'S INTEREST
53,600.00 33.3333
17,866.65
11/3011992 Two contiguous lots, combined for tax and future sale
purposes known as Lot #1, #IB and 2 on Dale F.
Shughart, Subdivision Plan recorded in Cumberland
County Plan Book 79, Page 102 known as 680
Mountain Road (South Middleton Township) Boiling
Springs, Cumberland County, P A 1007 and
Cumberland County Tax Parcel #40-13-0120-024
a. Lot #1 contains 1.3961 acres and is improved with a
one story seasonal cabin and shed. Conveyed by deed
dated 11130192 in equal 113 interests as joint tenants
with right of survivorship to Dale F. Shughart and
Mary Ann Shughart, husband and wife, as tenants by
the entirety, Dale F. Shughart, Jr. and Barbara S,
Drake. Deed reference: Deed Book "A", Vol. 36, Page
550.
b. Lot # IB and 2 contain 14.5467 acres of
unimproved land conveyed by deed dated 911/99 in
equal 1/3 interests as joint tenants with right of
survivorship to Dale F. Shughart and Mary Ann
Shughart, husband and wife as tenants by the entirety,
Dale F. Shughart and Barbara S. Drake. Deed
reference: Deed Book 207, Page 95.
Dale F. Shughart died 10109/2000 and his interest
thereby vested in his surviving spouse, Mary Ann
Shughart, whose 1/3 survivorship interest passed
equally to her two children Dale F. Shughart, Jr. and
Barbara S. Drake on her death. Value based upon
2005 assessed value. Copy attached.
TOTAL (Also enter on line 6, Recapitulation)
17,866.65
'.
SCHEDULEH
R.J-,IERAL EXP8\ISES &
ADMNSTRA11VECOSTS
CQMMOI\IWEAL TH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Shughart, Mary Ann R.
FILE NUMBER
21 - 04 - 0952
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A. FUNERAL EXPENSES:
DESCRIPTION
AMOUNT
B.
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Social Security Number(s) I EIN Number of Personal Representative(s):
Street Address
City
Year(s) Commission paid
State _ Zip
2. Attorney's Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Add ress
City
Relationship of Claimant to Decedent
State
Zip
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
I
Other Administrative Costs
Federal Express, overnight mailer
40.00
2
Register of Wills, filing Supplemental Return
15.00
TOTAL (Also enter on line 9, Recapitulation)
55.00
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT, 280601
HARRISBURG, PA 17128-0601
REV-1162 EX{11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 005582
SHUGHART DALE F JR
35 EAST HIGH STREET
SUITE 203
CARLISLE, PA 17013
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
nnun fOld
101
$801.52
ESTATE INFORMATION: SSN: 180-01-3567
FILE NUMBER: 2104-0952
DECEDENT NAME: SHUGHART MARY ANN R
DATE OF PAYMENT: 07/18/2005
POSTMARK DATE: 07/1 8/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 10/17/2004
TOTAL AMOUNT PAID:
$801.52
REMARKS:
CHECK# 1084
SEAL
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
Cumberlana County Board of Assessment Appeals
PROPERTY OWNER INFORMAL REVIEW ACCEPTANCE OR REJECTION FORM
. As of
-3 !nJ 01-/
(date), I/we have requested an appeal of our assessment.
. As of the above date, I/we have met with an official assessment representative to discuss my/our
property assessment in question.
. The parcel/account number of the subject property is as follows:
~ 0 ~ l~- VIJ0 -Od-L(
Parcel/Account Number
. The current Market Value of this property is $ ~OJ D qD
. The current Clean and Green value (if applicable) of this property is $
Review Appraiser's Recommendation:
C)l{~-\lV p
~choo (
Cff
~~
II t los
II I \ O~
I
Form 216 (v. 1.2)
I
to lower thli
ent \
thari
ent
Sf1. Qverall
pbi:~Q... 'iJ1CJ,rrJl, ,o$ep~rc", ,qi~ti$ that'
. . . . '" . y. mean ~'" rrespon iilci'eas~i,. . !ri~. ..hges in
taxes~i~1 depe' .... ..... .. '. '. . ...ropert}i's change asconip~re(t' to the. overall ch<i~gefC)~~l!~~iri9distfict.
. The E:S.TIMAtED'i1:np~pt,stEl~~'iiJ~~l,p~rit~?belo"'; is Qurbest estimate ~f change, baSE!dOr~OQ4;G()Uf'!Ty.tCP(figures. THIS
ESTIMATE DOES NOT INCLLJP~'~,A,tl.Y BOROUGH, TOWNSHIP; OR SC;HOOL DISTRlq I~PAvT~" .
" , '; '~,-:<\
$
$
$
$
,'-,- .-
2q04
2004.
2004'
2004
C::puBcy
Cdt1rtty
CClU#~Y:
County
TaX
'Tax.
Tax
Tax
Cur~,$!~_,~:_-:, 2q'-9,A\:j~~iffl',j:~, :~:i.~s =
Adjti~ted2004i9c>Utity lI1d,ll$ =
BEFoBE Reassessment based' ono~d Mark.~t'\Ta.l\le,
BEFORE, Reassessmeint based on old C~ea~ &Gr~e~.
AFTER ReCisseslil:ment based on above Market Val1,1e.
AFTER Reassessment based on above Clean & Green.
2.352
2.138