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HomeMy WebLinkAbout02-0288 PETITION also known as Deceased. Social Security No. ~ ~ - ~ ~ ~ k~ .~'q The pelition of the undersigned respectfully represents that: Your petitioner(s), ~xho is/are 18 years of age or older an the executi~3'~. in the last wilt o! the above decedent, dated ~ - I$ and codicil(s) dated FOR PROBATE and GRANT OF LETTERS No. To: Register of Wills for the County of °-.b~¢.e-h~.~xc~ in the Commonwealth of Pennsylvania named ,19 ~8 (state relevant circumstances, e.g. renunciation, death of executor, elco Decendent was domiciled at death in last family or principal residence at \ (list street, number and muncipahty) County, Pennsylvania, with Decendent, then ~M ___ years of age, died "~ - ~ , I~ .~c~o~ , Except as follows, decedent did not ma~rry, 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: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters '¥¢~5"~.xvxe,exX',.,e',ox theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ COUNTY OF Q._~_a'2cx_~e.-e\~.t,A_ f ss The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed c ~~ ~' ~_~ ~ before me this _ 19~ day of { ~' No. ~o/- C),9_-,-.2~,' Estate Of su~, F SHEAFFER , Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW t~ARCH 20: 2002 x:lOr2c~r-.~, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated 04-13-1988 described therein be admitted to probate and filed of record as the last will of SUE F SHE/~FER and Letters TESTAMENTARY ROBYN E MALONE are hereby granted to FEES copies 1.50 Probate, Letters, Etc .......... $ 60.00 Short Certificates( ) .......... $ 6.00 ~ effera, peges. · · $ 5.90 jcp $ 5.00 TOTAL__ $ 78.50 Filed ...0.~.~ 9.~2002 ..................... mailed to ~ on 3-20-2002 ATTORNEY (Sup. Ct. I.D. No.) ADDRESS PHONE LAW OFFICES CHORPP CARLISLE, PENNSYLVANIA I ?01 ~ [, ~ F. SHEAFF]~, of South Niddleton ~p, ~lar~l County, Pennsylvania, make this Will, revoking all my former wills and codicils. ~ I: I direct that all my just debts, funeral expenses and administration expenses, including my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. ~ II: I bequeath the amounts or items herein specified to each of the following-named beneficiaries who survive me: a. To Dwayne S. Malone, my grandson, of 632 Holly Pike, Carlisle, Pennsylvania, $1,000.00; ~ TTT: I devise and bequeath all of the residue of my estate, of every nature and wherever situate, to my daughter, Robyn E. Malone, providing she shall survive me by thirty (30) days. ~ IV: Should my daughter, Robyn E. Malone, predecease me or die on or before the thirtieth day following my death, I devise and bequeath the residue of my estate, of every nature and wheYever situate, to my grandson, Dwayne S. Malone. ~ V: I appoint ~ Trust Company, Carlisle, Pennsylvania, guardian of any property which passes, either under this Will or otherwise, to a minor. Said guardian shall hold, manage, invest and reinvest any property received by the guardian, shall collect the income therefrom, and shall apply so much of the net income, and, if the net income is insufficient, so much of the principal of said property held for such beneficiary as the guardian shall deem necessary or advisable for such beneficiary's health, maintenance, support and co~-~lete education. The guardian shall accumulate any surplus net inccm~ annually and add the same to the principal of the property held for such beneficiary. When such beneficiary attains the age of eighteen (18) years, all property shall be distributed to such beneficiary, or to such beneficiary,s estate in the event of death prior thereto. ~ V/: No interest of any beneficiary hereunder in either the principal or income of my estate shall be subject or liable in any manner to anticipation, pledge, assignment, sale, transfer, charge or encumbrance, whether voluntary or involuntary, or for any liabilities or obligations of such beneficiary whether arising from his or her death, debts, contracts, torts or engagements of any type. ~ VII: I direct that all taxes which may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction LAW OFFICES LANDIS, BLACK, ~ & SCHORPP CARLISLE, PENNSYLVANIA 1701 ] imposed, shall be paid frc~ my residuary estate as a part of the expense of the administration of my estate. ~ VIII: I appoint my daughter, Robyn E. Malone, Executrix of this, my Last Will. Should my daughter, Rmbyn E. Malone, fail to qualify or cease to act as Executrix, I appoint Farmers Trust Company, Carlisle, Pennsylvania, Executor of this, my Last Will. ~ IX: I d/rect that neither my Executrix, guardian, nor her successor shall be required to give bend for the faithful performance of their duties in any jurisdiction. · . I , 1988. --Sue F. ~heaffer The preceding instrument, consisting of this and one (1) other typewritten page, each identified by the signature of the Testatrix, SUE F. SHEAFFER, was, on the day and date thereof, signed, published and declared by SUE F. SHEAFFER, 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 thereto. Page 2 of 2 Pages LAW OFFICES LANDIS, BLACK, ~i~l[ & SCHORPP CARLISLE, PENNSYLVANIA 1701 ~ OF PENNSYLVANIA ) : OOUNTY OF ~ ) Testatrix and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her ra.~t Will, and that she had signed willingly (or willingly directed another to sign for her), and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witness, and that to the best of their knowledge the Testatrix was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. Testatrix Sue F. V~a-f fer Witnes~ 'Rok~ R. Black Subscribed, sworn to and acknowledged before me by Sue F. Sheaffer, Testatrix, NAIW ANN 60Ii, AN, Notary Pul)11C Cerltsle, Cumberland Co,, PA. CERTIFICATION UNDER NOTICE UNDER RULE 5.6 (a) Name of the Decedent: Susan F. Sheaffer Date of Death: March 18, 2002 Will No. 00288 of 2002 Admin. No. 2002-00288 To the Register: I certify that notice of a beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was mailed to the following beneficiaries of the above- captioned estate on March 21, 2002. Name Address Robyn E. Malone 632 Holly Pike Mt. Holly Springs, PA 17065 Dwayne S. Malone 1590 Randow Road York, PA 17403 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: May 3, 2002 Sig~[ure Name: Kathleen K. Shaulis, Esq. Address: 44 South Hanover Street Carlisle, PA 17013 Telephone: (717) 243-6655 Capacity Personal Representative X Counsel to Personal Representative NOTICE OF BENEFICIAL INTEREST IN ESTATE BEFORE THE REGISTER OF IVILLS, COUNTY OF CUMBERLAND In re Estate of Sue F. Sheaff~, deceased No. 2002-00288 TO: Robyn E. Malone 632 Holly Pike Mt Holly Springs, PA 17065 Please take notice of the death of decedent and grant of letters to the personal representative named below. You may have a beneficial interest in the estate as follows: You are named as one of only two beneficiaries under Mrs. Sheaffer's Last Will and Testament. Name of the Decedent: Sue F. Sheaffer Last Known Address: Cumberland Crossings Retirement Community I Longsdorf Way, Carlisle, PA 17013 Date of Death: March 18, 2002 Place of Death: Cumberland Crossings Retirement Community County of Grant of Original Letters: Cumberland Decedent dies X testate ~ intestate A copy of the will __ is X is not attached. Name(s), address(es) and telephone number(s) of all personal representatives appointed Name Address Telephone Robyn E. Malone Dwayne S. Malone 632 Holly Pike Mt. Holly Spring~ PA 17065 1590 Randow Road (717)486-3055 York, PA 17403 Name(s), address(es) and telephone number(s) of all counsel Name Address Telephone Kathleen K. 44 South Hanover Sweet (717) 2434655 Shaulis, Esq. Carlisle, PA 17013 Additional information may be obtained from the undersigned. Date:C~7 ~ '2~O02.- Signature:~~'~<~-'t-~-j Name: Kath~en IC Shaulis, Esqf' Address: 44 South Hanover Street Carlisle, PA 17013 Telephone: (717) 243-6655 Capacity: X Personal Representative Counsel for Personal Representatives NOTICE OF BENEFICIAL INTEREST IN ESTATE BEFORE THE RF~ISTER OF WILLS, COUNTY OF CUMBERLAND In re Estate of Sue F. Sheaffer, deceased No. 2002-00288 TO: Dwayne S. Malone Randow Road York, PA 17403 Please take notice of the death of decedent and grant of letters to the personal representative named below. You may have a beneficial interest in the estate as follows: You are named as one of only two beneficiaries under Mrs. Sbeaffer's Last Will and Testament. Name of the Decedent: Sue F. Sheaffer Last Known Address: Cumberland Crossings Retirement Community 1 LongsdorfWay, Carlisle, PA 17013 Date of Death: March 18, 2002 Place of Death: Cumberland Crossings Retirement Community County of Grant of Original Letters: Cumberland Decedent dies X testate ~ intestate A copy of the will _X is is not attached. Name(s), address(es) and telephone number(s) of all personal representatives appointed Address Telephone Name Robyn E. Malone Dwayne S. Malone 632 Holly Pike Mt. Holly Sprin~s, PA 17065 1590 Randow Road (717) 486-3055 York, PA 17403 Name(s), address(es) and telephone number(s) of all counsel Name Address Kathleen K. 44 South Hanover Street Telephone (717) 243-6655 Shaulis, Esq. Carlisle, PA 17013 Additional information may be obtained from the undersigned. Address: 44 South Hanover Street Carlisle, PA 17013 Telephone: (717) 243-6655 Capacity: __ X Personal Representative Counsel for Personal Representatives IJ~'~/OFFICES HORPP I':I.F... PENN.gY I. VANIA I, SUE F. SHEAFFER, of South Middleton TowP~p, Cumberland County, Pennsylvania, make this Will, revoking all my former wills and codicils. ~ I: I direct that all my just debts, funeral expenses and administratic~ expenses, including my grave mar~r, shall be paid f~-cm-~ the assets of my estate as soon as practicable after my decease. ~ II: I bequeath the amounts or items herein specified to each of the following-named beneficiaries who survive me: a. To Dwayne S. Malone, my ~, of 632 Holly Pike, Carlisle, Pennsylvania, $1,000.00; ~ m: I devise and bequeath all of the residue of my estate, of every nature ar~ wherever situate, to my daughter, Rcbyn E. F~lone, providin~ she shall survive me by thirty (30) days. ~ IV: Should my daughter, Robyn E. Malone, predecease me or die on or before the thirtieth day following my death, I devise and bequeath the residue of my estate, of every nature and whe~-ver situate, to my grandson, ~ V: I appoint Farmers Trust C~mpany, Carlisle, PenDsyl~ia, guardian of any property which passes, either under this Will or otherwise, to a minor. Said guardian shall hold, ~nage, invest and reinvest any property received by the ~ian, shall collect the income therefrc~, and shall apply so much of the net inoc~e, and, if the net income is insufficient, so much of the principal of said property held for such beneficiary as the ~,a~clian shall deem ne~ or advisable for such beneficiary's health, ma{ntenance, support and complete education. The guardian shall acommulate any surplus net income annually and add the same to the principal of the property b~ld for suc~ beneficiazy. When such beneficiary attains the age of eighteen (18) years, all property sba'Il be di~cL"i~:x~r, ed to sud~ beneficiary, or to such beneficiary's estate in the event of death prior thereto. ~ VI: No interest of any beneficiary hereunder in either the principal or incc~ of my estate shall be subject or liable in any manner to anticipation, pledge, assignment, sale, transfer, charge or encumbrance, whether voluntary or involuntary, or for any liabilities or obligations of such benefic~ ~ arising fkom his or her death, debts, contracts, torts or engag~ of any type. ~ %rJi[: I direct that all taxes which may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my resic~,ary estate as a part of the expense o the adm/nistration of my estate. ~ VFTT: I appoint my daughter, Pn~yn E. M~] one, Executrix of this my Last Will. Should my daughter, Robyn E. Malone, fail to qualify or cea to act as Executrix, I appoint Farmers Trust Company, Carlisle, Pennsylvania, Executor of this, my Last Will. ] IX: I direct that neither my Executrix, guardian, nor her suooessor shall be required to give bond for the faithful performance , I have hereunto set my hand this /~ ~day of --sue F. ~heaffer The preced/ng i~strtm~lt, consisting of this and one (1) other typewrittmn page, each identified by the signature of the Testatrix, SUE F SHEAFFER, was, on the day and date thereof, signed, published and declared by SUE F. SHFAPT]ER, the Testatrix therein named, as and for her Last Will, in the ~ of us, who, at her request, in her presenoe and in the presence of each other, have subscribed our names as witnesses thereto. CC~IgDNWEAT.W~ OF PENNSYLVANIA ) : OOUNTY OF ~ ) _/ // Testatrix and the witnesses, respectively, whose names are signed to the attactaed or foregoing ir~tr~e~t, being first dLLly sworn, do hereby declare to the undersigned authority that the Testatrix signed and ew~cuted the instrument as her Ta.~t Will, and that she had signed willingly (or willingly d~r~-~ed ~ to sign for her), and that she ~ it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in th~ presence and hearing of the Testatrix, signed the Will as witness, and that to the best of their knowledge the Testatrix was at the time eighteen years of age or older, of sound mind and under no constraint or undue influence. Testatrix -Sue F.V~ffer Witne~ I~ R. Black Rmbert R. Black and ~.'~/.w~ / ,~,. -~/~d~ CF~./3 , witnesses, thi.~ /.~'~ day of /~_.~/ , 1988. / .L/_,/ L,~.. . 'L.I~/_ lc Carlisle, Cad. fiend Co., PA. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(11-96) CD O01435 MALONE ROBYN E 632 HOLLY PIKE MT HOLLY SPRINGS, PA 17065 ........ fold ESTATE INFORMATION: SSN: 189-09-4657 FILE NUMBER: 2102-0288 DECEDENT NAME: SHEAFFER SUE F DATE OF PAYMENT: 07/22/2002 POSTMARK DATE: 00/00/0000 COUNTY: CUMBERLAND DATE OF DEATH: 03/18/2002 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 9383.99 REMARKS: ROBYN E MALONE TOTAL AMOUNT PAID: 9383.99 SEAL CHECK# 98 INITIALS: DO RECEIVED BY: MARY C. LEWIS REGISTER OF WILLS REGISTER OF WILLS REV-1500 EX (6-00} COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 Z LU 1:3 U.I 1.1.1 I- Z 1:3 Z o o 8. 9. 10. 11. 12. 13. 14. INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DATE OF DEATH (MM-DB-YEAR) DATE OF BIRTH (MM-gU-YEAR) 03 - 18 --o-& o--t- o¢,- i.~ (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) E~l. Original Return ---]4. Limited Estate ~6. Decedent Died Testate (Attach copy of Will) [~19. Litigation Proceeds Received /7- ~-o- /~/ OFFICIAL USE OR LY FILE NUMBER ,1 /$98, Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) (8) (11) (12) (13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 0 x .0_ (15) ~"~.;J. JO x .0 ~;$- (16) O x .12 (17) O x .15 (18) (19) 20. [] COMPLETE MAILING ADDRESS G3~ H-o ~l,f P~ E~3. Remainder Return (date of death pdor to 12-13-82) [~5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes E~11. Election to tax under Sec. 9113(A) (Attach Sch O) Real Estate (Schedule A) (1) Stocks and Bonds (Schedule B) (2) Closely Held Corporation, Partnership or Sole-Proprietorship (3) Modgages & Notes Receivable (Schedule D) (4) Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) Jointly Owned Property (Schedule F) (6) E~ Separate Billing Requested Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) O (Schedule G or L) Total Gross Assets (total Lines 1-7) Funeral Expenses & Administrative Costs (Schedule H) (9) Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) Total Deductions (total Lines 9 & 10) Net Value of Estate (Line 8 minus Line 11) OFFICIAL USE ONLY ~.5 ~3. '~o 0 NAME _,~ 0~1~ ~,r~ FIRM NAME (If~ppli~ble) TELEPHONE NUMBER E~2. Supplemental Return r'~ 4a. Future Interest Compromise (date of death after 12-12-82) [-'-~ 7. Decedent Maintained a Living Trust (Attach copy of Trust) [~10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) SOCIAL SECURITY NUMBER SOCIAL SECURITY NUMBER /89 - oc~ - N~5"'7 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS COUNTY CODE YEAR NUMBER Decedent's Complete Address: STREETADDRESS CITY STATE p(~)~ ZIP ~'~0 ~ Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Interest/Penalty if applicable D. Interest E. Penalty (1) Total Credits ( A + B + C ) (2) O Total Interest/Penalty ( D + E ) (3) 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 (4) O If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT ~ii ' .... ~11 f - PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decadent make a transfer and: Yes No a. retain the use or income of the property transferred; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] c. retain a reversionary interest; or .......................................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ...................................................................... [] [] 2. If death occurred after December 12, 1982, did decadent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. [] [] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete, DecLaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. DATE SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE r' ' ~ ' DATE 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% [12 P.S. §9116 (a) (1.1) (i)]. 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. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax 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. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. LAW OFFICES CHORPP Ic.I_E. PENNSYLVANIA 17OI I, SUE F. SHEAFFER, of South Middleton Township, Cumberland County, Pennsylvania, make this Will, revoking all my former wills and codicils. ~ I: I direct that all my just debts, funeral expenses and administration expenses, including my grave marker, shall be paid from the assets of my estate as soon as practicable after my decease. ~ II: I bequeath the amounts or items herein specified to each of the following-named beneficiaries who survive me: a. To Dwayne S. Malone, my grandson, of 632 Holly Pike, Carlisle, Pennsylvania, $1,000.00; ~ TI/: I devise and bequeath all of the residue of my estate, of every nature and wherever situate, to my daughter, Robyn E. Malone, providing she shall survive me by thirty (30) days. ~ IV: Should my daughter, Robyn E. Malone, predecease me or die on or before the thirtieth day following my death, I devise and bequeath the residue of my estate, of every nature and wherever situate, to my gl-andson, Dwayne S. Malone. ~ V: I appoint Farmers Trust ~y, Carlisle, Pennsylvania, guardian of any property which passes, either under this Will or otherwise, to a minor. Said guardian shall hold, manage, invest and reinvest any property received by the guardian, shall collect the income therefrom, and shall apply so much of the net income, and, if the net income is insufficient, so tach of the principal of said property held for such beneficiary as the guardian shall deem necessary or advisable for such beneficiary's health, maintenance, support and complete education. The guardian shall accumulate any surplus net incc~e annually and add the same to the principal of tb~ p~x~, held for such beneficiary. When such beneficiary attains the age of eighteen (18) years, all property shall be distributedto such beneficiary, or to such beneficiary's estate in theevent of death priorthereto. ~ VI: No interest of any beneficiary hereunder in either the principal or incc~ of my estate shall be subject or liable in any manner to anticipation, pledge, assignment, sale, transfer, charge or encumbrance, whether voluntary or involuntary, or for any liabilities or obligations of such beneficiary whether arising frc~ his or her death, debts, contracts, torts or engagements of any type. ~ VII: I direct that all taxes which may be assessed in consequence of my death, of whatever nature and by whatever jurisdiction EA'~ OFFICES LANDIS. BLACK, ~ & SCHORPP (~ARI.ISLE. PENNS'fI.V&NIA 1701 imposed, shall be paid frc~ my residuary estate as a part of the expense of the administration of my estate. ~ VIII: I appoint my daughter, Robyn E. Malone, Executrix of this, my Last Will. Should my daughter, Robyn E. Malone, fail to qualify or cease to act as Executrix, I appoint Farmers Trust Company, Carlisle, Pennsylvania, Executor of this, my Ta~gt Will. her successor shall be required to give bond for the faithful performance of their duties in any jurisdiction. IN W~ .WHEREOF, I have hereunto set my hand this /~ ~day of ?.K/t I , gheaffer The preceding instrument, consisting of this and one (1) other typewritten page, each identified by the signature of the Testatrix, SUE F. SHEAFFER, w~s, on the day and date thereof, signed, published and declared by SUE F. SHEAFFER, the Testatrix therein named, as and for her Tart 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 thereto. Page 2 of 2 Paoes STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND SHORT CERTIFICATE I, MARY C. LEWIS Register for the Probate of Wills and Granting Letters of Administration &c. in and for said County of CUMBERLAND do hereby certify that on the 20th day of March A.D., Two Thousand and Two, Letters TESTAMRNTARY in common form were granted by the Register of said County, on the estate of SHEAFFER SUE F , late of SOUTH MIDDLETON TOWNSHIP in said county, deceased, to MALONE ROBYN E (bAs'r, ~'l~S'~', and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 20th day of March A.D., Two Thousand and Two. File No. PA File No. Date of Death s.s. # 2002-00288 21-02-0288 3/18/2oo2 189-09-4657 Register NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL REV-1 ~8 ~ + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER NUMBER TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) 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 VALUE AT DATE DESCRIPTION OF DEATH LOOK FOR US. WE'LL GET YOU THERE. P.O. Box 1711. Harrisburg. P;nnsglvania 1710S-1711 Member FDIC SUE F SHEAFFER 632 HOLLY PIKE MT HOLLY SPRINGS PA 17065 22 STATEMENT DATE 4/08/02 PAGE 1 FOCUS ACCOUNT 0091015628 TYPE OF ACCOUNT: FOCUS 50 FREE INTEREST INTEREST PAID YEAR TO DATE 5.41 ANNUAL PERCENTAGE YIELD EARNED (APYE) .55 % DAYS IN CYCLE 29 AVERAGE BALANCE 2,129.53 PREVIOUS BALANCE 1.942.57 DEPOSITS 4.000.00 DATE ACTIVITY DESCRIPTION 3/18/02 DEPOSIT 3/19/02 CHECK #250 3/21/02 CHECK #252 3/21/02 CHECK #253 ~ 3/25/02 CHECK #251 4/08/02 INTEREST PAID AT CLOSING 4/08/02 CLOSING DEBIT DATE CHECK NO. AMOUNT 3/19/02 250 29.10 3/25/02 251 35.25 WITHDRAWALS 5,943.50 CHARGES .00 DEPOSITS 4,OO0.OO CHECK SUMMARY * indicates ski~ in cnec~ numbers' DATE CHECK NO. a/21~02 252 INTEREST .93 WITHDRAWALS 29.10 4.,169.45 28.33 ~ 35.25 ~ 681.37 DATE 3/21/02 CHECK NO. 253 ENDING BALANCE .00 BALANCE 5.942.57 5,913.47 1,744.02 1,715.69 1,680.44 1,681.37 .00 AMOUNT 28.33 Come talk to us now during our Spring held you borrow the funds you need. Streamlined ve rates and and solid Waypoint advice are just three of the many reasons to point yourself in our direction when you need ~o borrow. To apply, stop by any Waypoint Bank branch office today, or call our Customer Service Center at 1-866-WAYPOINT. POD-502 (2,/02) Customer S~rvic~ TolI-Fr~ 1-866-WAYPOINT (1-866-929-7646) · In York Ar~a 717/815-4500 ww~v. wag point ban k.com "~*'"~*""~ ~ SCHEDULE F COMMO.W~LTN OFPENNS~'VAN,A JOINTLY'OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. FILE NUMBER SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT JOINTLY-OWNED PROPERTY: U- [ ] t::P, DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENTS INTERES TOTAL (Also enter on line 6, Recapitulation) $ ~ ~ Oq q. '7.,.5-- (If more space is needed, insert additional sheets of the same size) LOOK FOR UC;. W6'LL GET YOU TH6R6. P.O. Box 1711. Harrisburg. Pennsglvania 17105-1711 Member FC)~C SUE F SHEAFFER ROBYN E MALONE 632 HOLLY PIKE MT HOLLY SPRINGS PA 17065 lO//9 STATEMENT DATE 3/29/02 PAGE I SAVER'S ADVANTAGE 5500011359 ACCOUNT 5500011359 TYPE OF ACCOUNT: SAVER'S ADVANTAGE INTEREST PAID ANNUAL PERCENTAGE YIELD DAYS IN CYCLE YEAR TO DATE EARNED (APYE) 82.56 1.25 ~ 31 AVERAGE BALANCE 24.293.04 PREVIOUS BALANCE 26.099.49 DEPOSITS .00 .DATE 3/18/02 3/29/02 ACTIVITY DESCRIPZION WITHDRAWAL INTEREST EARNED WITHDRAWALS CHARGES INTEREST 4.000.00 .00 25.58 DEPOSITS WITHDRAWALS 4,000.00 25.58 ENDING BALANCE 22,125.07 BALANCE 22.099.49 22,125.07 Online Bill-Payment:is Way Better! Just think...no more wrftlng checks, stuffing envelopes, or pasting stamps! Paying all your bills~with just a few clicks is simple - and way more convenient! Visit us online at www.waypointbank.com to find out how easy Online Bill Payment is! POD-502 (6/01) CustomEr SErViCE Toll-FrEE 1-866-WAYPOINT (I-866-9i~9-7646) · In York ArEa 717/81~;-4c;00 wv~v. wag point ban k.com This is to inform you that the Waypoint Bank Savings account #5500011359 was opened on 6/25/01 using $5000.00 from a $30,000.00 Certificate of Deposit from M & T Bank (formerly Farmers Trust Co.) established jointly by Robyn E. Malone and Sue F. Sheaffer on 12/23/96 and matured on 6/23/01. The balance of $25,000.00 was added onto Certificate of Deposit #7100006355 which had been opened jointly by Robyn E. Malone and Sue F. Sheaffer at Waypoint Bank on 1/2/01. Please find attached a copy of the original Certificate of Deposit for $30,000.00 at M & T Bank , a letter from M & T Bank informing us of the account being closed, a copy of the check from M & T Bank for $30,000.00, a copy of the deposit ticket opening the savings account #5500011359 for $5000.00 at Waypoint Bank, a copy of Certificate of Deposit #7100006355 opened at Waypoint Bank on 1/2/01, a copy of the deposit ticket for $25,000.00 added to C.D #7100006355 on 6/25/01, a copy of the receipt closing C.D.#7100006355 on 1/4/02 and a copy of the deposit ticket adding $35004.73 to savings account #55000113599 on 1/4/02. 006 ~29850 NON-NEGOTIABLE I NON TRANSFERABLE BRANCH DESIGNATION DEPOSITOR(S) Sue F. Sheaffer or 189-09-4657 Robin Malone - ADDRESS 588 Park Drive 60.472 Carlisle, PA 17013 486-3055 313 PHO,NE NUMbeR MEMBER FDIC TIME CERTIFICATE OF DEPOSIT FINANCLqI_ TP, UST ONE WEST HIGH STREET, P.O. BOX 220 CARLISLE, PENNSYLVANIA 17013 717-243-3212 $ I 30,000.00 .AS DEPOS,TED ,. T.,S BANK '~' * ~_~s _~ :: ~.. _..'.., '~- O U. U U O ~*~ ! ~ O U ~ ~ 2 PAYABLE TO SAID DEPOSITOR(S), SUBJECT TO THE CONDITIONS PRINTED ON THE REVERSE SIDE OF CERTIFICATE. ISSUE TERM OF MATURITY PERCENTAGE RATE ~ INTEREST PAYABLE ~ MAIL CHECK ~ COMPOUNDING DATE CERTIFICATE DATE p~R ANNUM ~ ~ MONTHLY ~SEMI-ANNUALLY ~ CREDIT CHECKING _~ I ~ ANNUALLY 12/23/96 18 mos. 0~23/98 5.10% ~ QUARTERLY ~ ATMATURI~ ~CREDITSAVlNGS 7-26753  UNDER PENALTIES OF PERJURY I CERTIFY THAT THE ABOVE NUMBER IS MY CORRECT TAXPAYER IDENTIFICATION NUMBER. ~ SIDLE ~ C~A~ (~ 3 ~ BACK) UNDER PENALTIES OF PERJURY I CERTIFY THAT I AM NOT SU~ECT TO BACKUP WITHHOLDING. EITHER BECAUSE I HAVE ~ N~TBEENN~T~F~EDTHAT~AMSU~ECTT~BACKUPW~THH~LD~NGAsARESULT~FAFA~LURET~REP~RTALL~NTEREST ~ AUT~A~CALLYR~ABLEC~A~(~4ONBACK) OR DIVIDENDS, OR THE INTERNAL REVENUE SERVICE HAS NOTIFIED ME THAT I AM NO LONGER SU~ECT TO BACKUP __ ~ A~STABLE ~TE (ITE ON BAC~ ~ WITHHOLDING. ~ SIGNATURE ~ ~_~ ~. V~~ ~ SIGNATURE /~J~ ~~.. ~~ Manufacturem and Traders Trust Company BUFFALO, N.Y. 14240 REMITTER TO THE O.DER O~ ~ DATE~ltllIt~ 2~_. 2{~! OFFICIAL CHECK No. 137603 60-295 313 Plaza, Buffalo, New York 14240 MaTBSnk MT Holly Springs June 29, 2001 1607 SUE F SHEAFFER ROBYN MALONE 1 W PENN ST APT 108 CARLISLE PA 17015-2553 Re: CD Account Closing Notice Account # 31003911179157 Dear Sue F Sheaffer, We are writing to confirm that on 06/'25/01, your CD account was closed or transferred. At that time, the balance was $30,000.00. We'd like to remind you that M&T Bank is committed to providing you with solutions to all your financial needs. To find out more about the many ways we can help you with those needs, simply stop by any M&T Bank office or call the M&T Telephone Banking Center at 716-626-1900 or 1-800-724-3222. Or if you'd like, visit the M&T website at www.mandtbank.com. Thank you for banking with M&T Bank. Sincerely, ggehe£e ¢o£e-Hee~o~ Michele Cole- Hector Customer Service Manager SMACCL AZRCSI Look for us. We'll get gou there. RECEIPT Acct# 5500011359 T 1 r# 4501 5,000.00 2$avin~qs Deposit TRRN,~ 94 ON 6/25/2001 G/25/200£ 10: 21: 56 ~ Ledger 8a ]ance .00 Check and other items receivad for deposit ara subject to the provisions of the Uniform Commercial Cods. Certain deposits are subject to delays in availability according to Bank policy. TEL*009 (10/00) THIS IS YOUR RECEIPT Member FDiC Look for us. We'll get gou th~.=re. T ! r# 450! ~, nnn 00 70Certi ficate DePosit TRRN# 93 ON 6/25/2001 6/25/200J. 10: 20: Or~ Ledger Sa ]ance 10,000,00 Check and other items received for deposit are subject to the provisions of the Uniform Commercial Cods. Certain deposits are subject to delays in availability according to Bank policy. TEL-O00 (I0/00) THIS IS YOUR RECEIPT M~nber FCIC Opened: ~ / 2 0 / 2 0 0 i Term: 12 M©NTHS CERTIFICATE OF DEPOSIT COPY CERTIFICATE OF DEPOSIT SIGNATUR~ CARD Amount of Deposit: ~ ~ous~vo ~ro oo/~oo 189-09-4657 Number: Account Number: This Time Deposit is Issued to: Issuer: PEN'ROSE PLACE, WAYPOINT BA_~ 269 PENROSE PLACE CARLISLE, PA 17013 7100006355 10,000.00 SUE F SHEAFFER ROBYN E MALONE 623 HOLLY PIKE MT HOLLY SPRINGS PA 17065-0000 Not Negotiable - Not Transferable - Additional terms are below. By Additional Terms and Disclosures This form contains the terms for your time deposit. It is also the Minimum Balance Requirement: You must make a minimum deposit to Truth-in-Savings disclosure for those deposztors emifled to one. There are additional terms and disclosures on page two of this form. some o~ open this account of $ ! 00.00 . - which explain or expand on those below. You should keep one copy, fi/ ~ ........... 7--' th,~:, c~,v,,,. ~'- :~a~, ,, xou must ma~ntam mis. mtmmum, oatance on a daily basis to earn the Maturity Date: This account matures 1/.f~.e7' 20~6 ~.x) annual percentage yield disclosed. (See below for renewal information.) Withdrawals of Interest: Interest [] accrued [~Tcredited during a Rate Information: The interest rate for this account is 5.75000 % term can be withdrawn: with an annual percentage yield of 5.90 %.This ratewillbe AT ANY TIME WITHOUT PENALTY paid until the maturity date specified above. Interest begins to accrue on Early Withdrawal Penalty: If we consent to a request for a withdrawal the business day you deposit any noncash item (for example, a check), that is otherwise not permitted you may have to pay a penalty. The Interest will be compounded MONTHLY penalty will be an amoum equal to: Interest will becredited END OF MONTH 3 MONTHS LOSS OF INTEREST BY DEPOSIT TO ACCOLrNT ~ 91015628 interest on the amountwithdrawn. [~The annual percentage yield assumes that interest remains on deposit Renewal Policy: umil maturity. A withdrawal of interest will reduce earnings. [] Single Maturity: If checked, this account will not automatically [] If you clos~ your account before interest is credited, you will not renew. Interest [] will [] will not accrue after maturity. receive the accrued interest. ~ Automatic Renewal: If checked, this account will automatically The NUMBER OF ENDORSEMENTS needed for withdrawal or any renew on the maturity date. (see page two for terms) other purpose is: 1 Interest [~.Xvill [] will not accrue after final maturity. ACCOUNT OWNERSHIP: You have requested and intend the type of account marked below. [] Individual {J~k3oint Account - With Survivorship [] ~oint Account- No Survivorship ~,, [] Trust: Separate Agreement Dated [] Revocable Trust Designation as defined in this agreement (Beneficiaries' names and addresses) BACKUP WITttHOLDING CERTIFICATIONS TIN: 189-09-4657 [~kTaxpayer I.D. Number - The Taxpayer Identification Number shown above (TIN) is my correct taxpayer identification number. [~kBackup Withholding - I am not subject to backup withholding either because I have not been notified that I am subject to backup withholding as a result of a failure to report all interest or dividends, or the Internal Revenue Service has notified me that I am no longer subject to backup withholding. :~ Exempt Recipients - I am an exempt recipient under the Internal Revenue Service Regulations. SIGNATURE - I certify under penalties of perjury the statements checked in this section. ~xo~n, cx ~. - ono2ka~ ' ~ o ~ DATE SIGNATURES: I AGREE TO THE TER/~S STATED ON PAGE ONE AND PAGE TWO. X .x-~ ~- X © 1993 Bankers Sv~tems, Inc., St. Cloud, MN Form CD-AA-NPO 12! 3/24/99 R~AD PAGE TWO FOR ,~I~I']YA¢~004/?~e ~ of 2~ Look for us. We'll get gou ther. e. RECEIPT Rcct~ 5500011259 T!r~ 4502 35,004.73 2Savings Deposit TRRN# 38 ON 1/07/2002 1/04/2002 !6:09:31 PM Ledger Balance 5,037.78 Check and other items received for deposit are subject to the provisions of the Uniform Commemial Code. Certain deposits are subject to detays in availability according to Bank policy. TEL-O09 (10/00) THIS IS YOUR RECEIPT Meier FDiC Look for us. We'll get gou there. RECEIPT acct~ 710000G355 Tlr# 4502 35,004.73 74CD Close Out TR~N~ 37 ON 1/07/2002 1/04/2002 16:08:15 PM Ledger Balance ,00 Check and other items received for deposit are subject to the provisions of the Uniform Commercial Code. Certain deposits are subject to delays in availability acco~ing to Bank potic~ TEL-~9 (10/00) THIS IS YOUR RECEIPT Member FDiC EV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF ITEM NUMBER 5. 6. 7. Debts of decedent must be reported on Schedule I. DESCRIPTION FUNERAL EXPENSES: ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) f~oB ~1~ ~- - ~ Q. iO/~ ~,. Social Security Number(s)/EIN Number of Personal Representative(s) Street Address (.~,.~ ~'~it~,,.~ ~.k~.-. City ~'¥'t"'- ~'~,~ ,~,~&,r"t~&' State ! Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address FILE NUMBER AMOUNT TOTAL (Also enter on line 9, Recapitulation) $ City State __ Zip Relationship of Claimant to Decedent Probate Fees - ..5~"~C~' q.~%..~ '~:x.¥~b.. Accountant's Fees Tax Return Preparer's Fees 'I ~ . $o (If more space is needed, insert additional sheets of the same size) Hollinger Funeral Home & Crematory, Inc. Eric L. HolIinger, Supervisor SUE F SHEAFFER FUNERAL EXPENSES DATE OF DEATH MARCH 18,2002 ORGINAL AMOUNT DEPOSITED 495.00 APRIL 11,1988 IN BURIAL ACCOUNT FUNERAL EXPENSES DIRECT CREMATION $ 795.00 DEATH CERTIFICATES 8.00 FLOWERS & TAX 79.50 MINISTER 75.00 Engraving Stone 95.00 Tota~ Expenses 1052.50 AMOUNT OF BURIAL FUND $ 923.06 Funera£ Expenses PAID IN FULL By Forethought Life Insurance 3/19/2002 Thank you, ERIC L. HOLLINGER FD 501 NORTH BALTI~MORE AVENUE ' MOUNT HOLLY SPRINGS. PENNSYLVANIA 17065 - (717) 486-343.3 ,, FAX (717) 486-3215 THE LAW OFFICES OF KATHLEEN K. SHAUUS, ESQ. PHONE: (717) 2436655 EMAIL: SOUTH HANOVER STREET CARLISLE, PA 1701:3 FAX' (717) 2436618' j RS037CARUSLE~SPRINTMAIL.COM Robyn E. Malone 632 Holly Pike Carlisle, PA 17013 Re: Estate of Sue F. Sheaffer Advertising No.#1036-2002 Account to Date Hrs/Rate 5/3/2002 Preparation of Notices to Beneficiaries, Review Inheritance Tax Return N/A 5/6/2002 Reimbursement for Sentinel Advertising N/A (See Attached) 5/13/2002 Reimbursement for CC Law Journal N/A Amount $100.00 87.33 75.00 Balance 5/30/02 $262.33 RECEIPT FOR PAYMENT Cumberland_County - Register Of Wills Hanover and Hiqh Street Carlisle, PA !7013 Receipt Date ~eceipt Time Receipt No. 3/20/2002 08:29:25 1028732 SHEAFFER SUE F File Number Remarks 2002-00288 ROBYN E MALONE JA Transaction Description PETITION FOR PROBA EXTRA PAGES JCP FEE SHORT CERTIFICATE COPIES Cash Total Received ......... Distribution Of Receipt ........................ Payment Amount Payee Name 60.00 6.00 5.00 6.00 1.50 CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN BUREAU OF RECEIPTS & CNTR M.D CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN 78.50 78 50 RETAIN THIS PORTION FOR YOUR RECORDS  TTA;~CE'A'DDRESS . I BILL TO EN~INEL - LEGALI LAW OFFICES SHAULIS, KATHLEEN P.O. BOX 130r CARLISLEr PA 17013 AD NUMBER J Ct. ASS SALESPERSOI~ BILLING DATE LINES 222437J 10 PUBLIC NOTICES c31 05/22/02 25 "AD DESCRIPTION START DATE STOP DATE EXECUTRIX NOTICE LETTERS TESTAMENTA 05/06/02 05/20/02 F~UBLICATION INSERTIONS RATE NET AMOUNT GROSS AMOUNT 3 THE SENTINEL - LEGAL 3 LGL 81.00 TOTAL AD CHARGE 81 . 00 3 2002 PROOF OF PUBLICATION 01PRF 6.35 DAYS RUN PU.C,ASEORDER PAY THIS AMOUNT 87 35 104 82* Sue F.Sheaffer ' · AFTER 06/21/02 MESSAGE: Thank you for advertising with The Sentinel. Deadlines for in-column legal advertisements: Monday is Friday at 11 a.m.; Tuesday is Friday at 4 p.m.; Wednesday is Monday at 12 Noon; Thursday is Tuesday at 12 Noon; Friday is Wednesday at 12 Noon; Sunday is Thursday at 12 Noon. If you have any questions regarding your Legal bill please call Lori Saylor 243-2611 ext. 201 Fax your legals to 243-3754, attention Lori Saylor You can also EMAIL your legal to Classified ads: ads@cumberlink.com. Please send a cover letter including your name and address as an attachment DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT THE SENTINEL - LEGAL P.O. BOX 130, CARLISLE PA 17013 Sue F. Sheaffer AD NUMBER-' .................. CLASS0 START DATE STOP DATE 222437 PUBLIC NOTICES 05/06/02 05/20/02 AD DESCRIPTION BILLING DATE TELEPHONE NUMBER EXECUTRIX NOTICE LETTERS TESTAMENTA 05/22/02 717-243-6655 GROSS AMOUNT O 104.82 DUE AFTER 06/21/(::: LAW OFFICES SHAD-LIS, KATHLEEN K. 44 SOUTH HANOVER STREET CARLISLE, PA 17013 TOTAL AMOUNT DUE 87.35 ENTER AMOU-~ ~=~IC--'~SED CUMBERLAND LAW JOURNAL 2 LIBERTY AVENUE CARLISLE, PA 17013 MAY 31.2002 Cumberland Law Joumal is published every Friday by the Cumband County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication of legal notices. TO: Kathleen K. Shaulis, ESQUIRE Sue F. Shearer, ESTATE Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. Advertisement inserted on following dates: MAY 17, 24, 31, 2002 Payment received MAY 13, 2002 by Becky H. MorgenthaVExecutive Director Advertising Cost Proof of Publication Second Proof Request Payment received Total Amount Due $ 75.00 $ 0.00 $ 0.00 $ 75.00 $ 0.00 ~- t.D.. t, at- o .g REV-1512 EX+ (6-98) I SCHEDULE II cou~:~w~.T, o~ ~.ns~w,^ DEBTS OF D~EDENT, ,~.~T~ T~.E~a.~OEm D~mO~T MORTGAGE ~BIU~S.'& URNS ESTATE OF FILE NUBBER I~l~e un~ ~ e~. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. $,5'. ,~5 TOTAL (Also enter on line 10, recapitulation) $ '70 (~ ~-/ (If more space is needed, insert additional sheets of abe same size) Z '"~' Z C3 C:3 0 i-. 0 ~ O0 ~0 0 \\ t11\ O0 0000 0 CUMBERLAN.? CROSSINGS CUMBERLAND CROSSINGS RETIREMENT COMMUNITY 1 LONGSDORF WAY CARLISLE, PA 17013 1-717-245_9941 SUE F. SHEAFFER ROBYN MALONE 632 HOLLY PIKE MT HOLLY SPRINGS, PA For.: SUE F. SHEAFFER 17065 108-A STATEMENT 03/31/2002 J TOTAL AMT. ~,647.._ DATE )3/20/2002 ~3/01-03/17 '3/18/2002 i3/18/2002 3/18/2002 3/18/2002 :3/i8/2002 3/18/2002 3/18/2002 -- DE.CH AND RETURN UPPER PORTION ~TH REMIT~NCE -- DESCRIP~ON Balance Fopwapd: PR PRIVATE IN MONTHLY ROOM CHARGE OXYGEN CONCENTRATORS SNF PERIGUARD 40Z OINTMENT ADULT BRIEFS-REG/SLEEVE OXYGEN NASAL CANNULA OXYGEN TUBING 7 FT YANKAUER SUCTION CATH W/VENT OXYMIZER 4~169.45 2'516-00 79.20 30.80 1.21 1.10 7.92 9.16 For.: SUE F. SHEAFFER 108-A DAYS O0 90 DAYS CURRENT TOTAL ~ ' E IMBERLAND CROSSINGS RETIREMENT COMMUNITY CREDIT 4,169.45- I69.45 -00 516.00 2,597.15 ,627.95 2,630.26 ,638.18 ,647.34 ~STATK_..Mi_KNT DATE ACCOUN~r ~tunER ' PATIENT "" NAME LOCATION OF SERVICE ' "~ 1~03/07/02 CIA-9218449 SUE F SHEAFFER CARLISLE HOSPITAL OP DATE DOCTOR CODE DESCRIPTION AMOUNT '~ 02/13/02 DEBBIE B DURISE]; 76775 ECHOSCAN RETROPERITONEAL LIMI~ 78.00 03/01/02 0202 MC PAID/AMOUNT DUE IS DEDUCTIE 0.00 03/01/02 9200 MEDICARE WRITE OFF -49.67 03/07/02 0499 DENIAL BY BLUE SHIELD 0.00 MEDICARE DEDUCTIBLE NOT COVERED BLUE S! IELD HAS DENIED YOUR CLAIM. THE ~ANCE DUE IS YOUR RESPONSIBLITY $ 28.33 This Billing office is open 8:30-4:00. If you have questions concerning your Bill, please call the number shown above. 348 STATEMENT CARLISLE IMAGING ASSOCIATES PO BOX 382 900 BRYAN ST - STE 2 HUNTINGDON, PA 16652 Tax ID #: 251643689 SEE REVERSE SIDE FOR IMPORTANT BILLING INFORMATION (~l~[{~::~i0~: I.:~d..) ~ I',led i ~::'a~'" e t,~' i .1~ e ~. :3. "a~l' e d ,.t,:~'b i 1:] ]. e ~ ~:~ 'b c o v e I.~ e d YELLOW BREECHES FAMILY PRACTICE 1358 Lutztown Road Boiling Springs, PA 17007 Tax ID ~23-2221983 ~:~. :L PLEASE RETAIN THIS PORTION OF STaTEMEnT FOR YOUR RECO~OS ~ccount ~nalysis Total Curro.t 3~-~0 ~l-eO e1-120 '~1 Insurance Balance ~: ~3. ~)~ ./+Ji~)~. ~l~L~ ~. ~Z~ L~. ~L~'Z~ BALANCE Patient Balance ~9. ]. ~} ~:9. 1L~ ~. ~ ~-) I~, ~'1 IZl. ~1~1 '"1 AMOUNT DUE PINKER & ASSOCIATES PODIATRIC MEDICINE AND FOOT SURGERY MARK E. PINKER, DP.M, FA.C.FA.S. MARK S. GOLEC, DP.M. 47 BROOKWOOD AVENUE CARLISLE, PA 17013 (717) 243-2236 SUE SHEAFFER CUMBE~ CROSSINGS 03/06/02 13709 (1) 01/25/02 02/06/02, 02/06/02.. 02/12/02 SUE SHEAFFER (13709.0) DEBRIDE MYCOTIC NAILS 60.00 $35.25 was applied to your deductible Adjustment 24.75 Reject-BLUE SHIELD 0.00 TOTAL FOR SUE SHEAFFER BALANCE DUE"04/07/e2** IF NO PAYMENT RECIEVED BY DUE DAT] A 1.5% FINANCE CHARGE WILL BE ADDED TO BALANCE IF YOU HA~ TOTAL DUE I CURRENT I 31-60 DAYS I 61-90 DAYS I 91 -120 DAYS [OVER 120 DAYS 35.25 35.25 0.00 0.00 0.00 0.00 YELLOW BREE CHES FAMILY PRACTICE 1558 LUTZTOWN ROAD · BOILING SPRINGS, PA 17007 Phone: (717) 258-3274 · West Shore: (717) 697-0001 [] Donald J. Kovacs, M.D. [] Bradford J. Wood, M.D. M.D. 019737-E. B.S. No. K0060936 M.D. 024822-E · B.S. No. W0141016 Group B.S. No. YE 153146 Tax ID No. 23-2221983 ~]ue F Sheaffer ~32 Woiiy Pike ~,loun'~. Hoiiy Spr"ings,PA 17Eib5 Tax ID # 23-2221983 ACCOunt No. Amount Due --~h eas u-Ol 7.32 Date Amount Enclosed 04/~;'~ i 10~ Make checks payable to: YELLOW BREECHES FAMILY PRACTICE Payment by Credit Ca'rd: Visa MC ~$ Exp Please remove and return this portion with your paymen~ i g n ~ ~ YELLOW BREECHES FAMILY PRACTICE i ~ Tax ID 823-2~19~ Account Analysis Patient Balance NORTH BALTIMORE AVE. MT.HOLLY SPRINGS,PA 17065 ]3/04/02 ~* ACTIV] )2/24/02 )3/06/02 ]3/10/02 ~3/11/o2 33/13/02 33/14/02 ~3/15/o2 33/17/02 ~3/17/o2 iTY FOR SI 6584515 6584520 6586148 6589818 6584523 6590539 6585130 6591152 2011327 Payment-Thank You SUE SYNTHROID 0. 075MG ZYPREXA 5MG TABLE ZESTRIL 10 MG GLIPIZIDE 5MG HCTZ 25MG INTRASITE GEL DRE PLAVIX 75MG TABLE GLUCAGON 1MG EMER ROXANOL 20MG/ML S IU 136 . 6.00 6 00 6 00 6 00 6 00 100 88 6 00 6.00 6.00 136.45 + 148.88 YTD FIN LEGEND NON-LEGEND ~uA~w. ..~ FOR, MONTH .00 136.4 '~ .oo 6.ooF. 00 6.00c 00 6.00c 00 6.00C oo 6.ooc 00 100.881 00 6.00C 00 6.00C oo 6.00¢ · 001 148.88 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outright spousal distributions) FILE NUMBER RELATIONSHIP TO DECEDENT Do Not List Trustee(s) AMOUNT ORSHARE OF ESTATE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, 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 $ (If more space is needed, insert additional sheets of the same size) BUREAU OF ZNDTVZDUAL TAXES TNHERTTANCE TAX DTVTSZON DEPT. 280601 HARRTSBURG, PA 17128-0601 ROBYN E MALONE 632 HOLLY PIKE HT HOLLY SPRGS COHHONNEALTH OF PENNSYLVANZA DEPARTHENT OF REVENUE NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLO#ANCE OR DZSALLONANCE OF DEDUCTZONS AND ASSESSHENT OF TAX 17065 DATE ESTATE OF DATE OF DEATH FZLE NUHBER COUNTY ACN 09-10-2002 SHEAFFER 03-18-2002 Z1 02-0288 CUMBERLAND 101 Aeoun~ Remit:~ad SUE F HAKE CHECK PAYABLE AND REHZT PAYHENT TO: REGISTER OF HILLS CUHBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS ~ REV-Z547 EX AFP (01-02) NOTZCE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLONANCE OR DZSALLONANCE OF DEDUCTZONS AND ASSESSHENT OF TAX ESTATE OF SHEAFFER SUE F FZLE NO. 21 02-0288 ACN 101 DATE 09-10-2002 TAX RETURN NAS: (X) ACCEPTED AS F/LED ( ) CHANGED RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE APPRAZSED VALUE OF RETURN BASED ON.' ORZGZNAL RETURN 1. Real Es~a~e (Schedule A) (1) 2. S~ocks and Bonds (Schedule B} (2) $. Closely Held S~ock/Par~narship Tn~eres~ (Schedule C) ($) q. Nor~gages/No~as Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) (S) 6. Jointly Owned Proper~y (Schedule F) (6) 7. Transfers (Schedule g) (7) 8. To,al Assa~:s APPROVED DEDUCTZONS AND EXEHPTZONS: 9. Funeral Expanses/Adm. Cos~s/Hisc. Expanses (Schedule H) (9) 10. Debts/Hot,gage Liabilities/Liens (Schedule Z) (10) 11. To,al Deductions 12. Ne~ Value of Tax Re~urn 5z942.57 11z049.75 , .00 " (8) 1,393.35 .00 NOTE: To insure proper .00 credi~ ~o your account, .00 submi~ ~he upper por~ion .00 of ~his form wi~h your ~ex payment. 13. NOTE: 16,992.32 (15), .00 x O0 = .00 (16) 8,533.30 x 045= 383.99 (17) .00 x 12 = .00 (18) .00 x 15 = .00 (19]= ~ 383.99 ANOUNT PAZD 383.99 TOTAL TAX CREDZT BALANCE OF TAX DUEI ZNTEREST AND PEN. TOTAL DUE ASSESSHENT OF TAX: 15. Amoun'l: of L/ne Zq a~ Spousal ra~e 16. Amoun*~ of Line lq taxable et Lineal/Class A rate 17. Amoun~ of Line lq a~ Sibling ra~e 18. Aeoun{ of Line lq {exabla a~ Collateral/Class B ra{e 19. Principal Tax Due TAX CREDZTS: PAYMENT KECEZPT DTSCOUNT (+) DATE NUHBER ZNTEREST/PEN PAZD (-) 07-22-2002 CD001435 . O0 ZF PAZD AFTER DATE ZNDZCATED, SEE REVERSE FOR CALCULATZON OF ADDZTZONAL ZNTEREST. 383.99 .00 .00 .00 ZF TOTAL DUE ZS LESS THAN $1, NO PAYNENT ZS REqUZRED. ZF TOTAL DUE TS REFLECTED AS A "CREDZT" {CR), YOU HAY BE DUE REFUND. SEE REVERSE SZDE OF THZS FORN FOR ZNSTRUCTZONS. ) Chari'cable/Govarnmen'cal Bequests; Non-elected 9113 Trusts (Schedule J) (13) . O0 Net: Value of Es~a~a Sub~ec~ ~o Tax (lq) 8,533.30 Zf an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. 7~065.67 (11) 8.~59.02 (12) 8,533.30 RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND (CR): OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes at the 1aclu1 Class B (collateral3 rate on any such future interest. To fulfill the requirements of Section Z140 of the Xnharitanca and Estate Tax Act, Act ES of 2000. (72 P.S. Section 9140). Detach the top portion of this Notice and submit atth your payment to the Register of Nills printed on tho reverse side. --Make check or money order payable to: REGISTER OF HILLS, AGENT A refund of e tax credit, ahich ams net requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office of the Register of Nills, any of the 23 Revenue District Offices, or by calling the special Z4-hour answering service for fores ordering: 1-800-362-2050~ services for taxpayers aith special hearing and / or speaking needs: 1-800-447-3020 (TT only). Any party in interest not satisfied aith the appraisement, allowance, or disallowance of deductions, or assessment of tax (including discount or interest) es shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601 Phone (717) 787-6505. Sea page 5 of the booklet "instructions for Inheritance Tax Return for a Resident Decedent" (REV-1501) for an explanation of administratively correctable errors. if any tax due is paid within three (3) calendar months after tho dacedent's death, e five percent (SZ) discount of the tax paid is allowed. The 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest that has been assessed es indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at tho rate of six (6Z) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary free calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOOZ ara: Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor m 1982 202 .000548 1992 9Z .000247 1983 162 .000438 1993-1994 7Z .000192 1984 11Z .000301 1995-1998 9Z .000247 1985 132 .000356 1999 7Z .000192 1986 10Z .000274 2000 8X .000219 1987 9Z .000247 2001 92 .000247 1988-1991 11Z .000301 2002 62 .000164 --Interest is calculated as follows: /NTEREST = BALANCE OF TAX UNPAZD X NUNBER OF DAYS DEL/N~UENT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. STATUS REPORT UNDER RULE 6.12 Name of the Decedent: Sue F. Shaeffer Date of Death: March 18, 2002 Will No. 288 of 2002 Admin. No.: 00288 of 2002 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: State whether the administration of the estate is complete: Yes X No If the answer is No, state when the personal representative reasonably believes that the administration will be complete: Date: If the answer to No. 1 is Yes, state the following: b o Did the personal representative file a final account with the court? Yes No The separate Orphans' Court No. (if any) for the personal representative's account is : Did the personal representative state an account informally to the parties in interest? Yes X No. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to his report. Sig~a~ture ~ Capacity: Kathleen K. Shaulis 44 South Hanover Street Carlisle, PA 17013 {717) 243-6655 X Personal Representative Counsel for Personal Representative BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. IS0601 HARRISBURG, PA 17128-0601 ROBYN E MALONE 632 HOLLY PIKE MT HOLLY SPRGS PA 17065 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DTSALLONANCE OF DEDUCTIONS A~ ASSESSHENT OF TAX DATE 09-10-2002 ESTATE OF SHEAFFER DATE OF DEATH 03-18-2002 FI'LE NUMBER 21 02-0288 COUNTY CUMBERLAND ACN 101 Amount Remitted SUE F MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17015 CUT ALONG THIS LINE ~'- RETAIN LOWER PORTION FOR YOUR RECORDS '"~ REV-lB47 EX AFP [01-02) NOTICE OF INHERITANCE TAX APPRAZSEMENT~ ALLOWANCE OR -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SHEAFFER SUE F FILE NO. 21 02-0288 ACM 101 DATE 09-10-2002 TAX RETURN NAS: (×) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRATSED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) ' (l) 2. Stocks and Bonds (Schedule B) (2) ~. Closely Held Stock/Partnership Interes~ (Schedule C) ($) fi. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Proper~y (Schedule E) 6. Jointly Owned Proper~y (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs~Misc. Expenses (Schedule H) (9) lO. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Ne* Value of Tax Re~urn 5~9q2.57 11~0q9.75 .00 .00 NOTE: To insure proper .00 credi~ *o your account, .00 submi~ ~he upper portion .00 of this form wi~h your tax payment. 1,393.35 7~065.67 (11) (12) 13. lq. NOTE: (s) 16,992.32 8.q59.02 8,533.50 Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) Net Value of Es~a~e Subject ~o Tax (lq) ~ an assessment ~as issued peeviously; lines 14. 15 and/or 16, 17, reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line lq at Spousal rate 16. A~oun~ of Line lq taxable a~ Lineal/Class A ra~e 17. Amoun~ of Line lq a~ Sibling rate 18. A~oun~ of Line lq taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS PAYHENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) 07-22-2002 CD00[q35 .00 .00 8,533.30 IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 18 and 19 will (lB) .00 x O0 : .00 (16) 8,533.30 x 0q5= 383.99 (17) .00 x 12 : .00 (lB) .00 x 15 = .00 (19)= 383.99 AMOUNT PAID 383.99 TOTAL TAX CREDIT BALANCE OF TAX DUE ZNTEREST AND PEN. TOTAL DUE 383.99 .00 .00 .00 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ZF TOTAL DUE IS REFLECTED AS A 'CREDZT' (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTZONS.) IN RE: ESTATE OF SUE F. SHEAFFER, DECEASED RECEIPT AND RELEASE The circumstances leading up to the execution of this instrument are as follows: o Sue F. Sheaffer died on March 18, 2002. Testamentary Letters were granted to Robyn E. Malone, daughter of the decedent and Executor of her Last Will and Testament dated April 13, 1988. Pursuant to his Last Will and Testament, her grandson, Dwayne S. Malone, 1590 Randow Road, York, PA 17403 was to receive a bequest orS1,000. The remainder of the estate was devised to Robyn E. Malone, 632 Holly Pike, Mt. Holly Springs, PA 17065. It is the desire of Robyn E. Malone and Dwayne S. Malone their shares of the estate of Sue F. Shaeffer, deceased, be distributed to them without the formality of a Court proceeding, and the said Robyn E. Malone is willing to make such distribution upon receipt of the Receipt and Releases l~om Robyn E. Malone and Dwayne S. Malone. An informal Accounting of the Administration of the Estate of Sue F. Sheaffer, has been prepared by Robyn E. Malone, Executor, and is attached hereto as Schedule In consideration of the foregoing and intending to be legally bound hereby, Dwayne S. Malone and Robyn E. Malone: A. Do hereby waive an audit of an account of the administration of the Estate of Sue F. Sheaffer, deceased, by the Orphans' Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania; B. Do hereby declare that they examined the attached informal account of the Estate of Sue F. Sheaffer, deceased, that they fred it tobe true and correct in all particulars; that they accept and approve it with the same force and effect as if it had been prepared and duly filed with, audited, adjudicated and confirmed absolutely by the Orphans' Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania, and as if their shares of the balance of principal and income had been duly awarded to them; C. Do hereby acknowledge that Robyn E. Malone, Executor, has distributed the assets of the Estate of Sue F. Sheaffer, deceased; D. Do hereby absolutely and irrevocably remise, release, quitclaim and forever discharge Robyn E. Malone, Executor, her heirs, executors, administrators and assigns, of and fi.om any and all action, reckonings, liabilities, claims and demands relating in any way to her administration of the Estate of Sue F. Sheaffer, deceased; E. Do hereby indemnify and hold harmless Robyn Malone, Executor, her heirs, executors, administrators and assigns, fi.om and against any and all claims, losses, liabilities and damage which they may suffer or to which they may be subjected by reason of her administration of the Estate of Sue F. Sheaffer, and the distribution of the estate without an account or the approval of the Orphans' Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania, 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 ~o the estate; and F. Do hereby declare it to be there intention that this instrument shall be legally binding upon them and upon their heirs, executors, administrators and assigns. Robyn J~. Malone Dwayne Sr. Malone Date Date ESTATE OF SUE F. SHEAFFER, DECEASED ASSETS Bank Accounts Waypoint Bank #5500011359 Saver's Advantage Savings Account #0091015628 Focus 50 Free Interest Checking Total Assets 11,049.75 5,942.57 16,992.32 DISBURSEMENTS Hollinger Funeral Home & Crematory Cremation Death Certificate Flowers and Tax Minister Engraving Stone Pennsylvania State Inheritance Tax Attorney's Fee Probate Fees Petition, Short Cert. Legal Advertising Cumberland Crossings Retirement Community Fee for February 2002 Fee for March 2002 Carlisle Imaging Associates 2/13/02 Echoscan Retroperitoneal Limit Yellow Breeches Family Practice 2/12/02 Hospital visit 2/13/02 Hospital visit Pinker and Associates 1/25/02 Debride Mycotic Nails Alert Pharmacy Serv., Inc. 2/24/02 - 3/17/02 795.00 8.00 79.50 75.00 95.00 383.99 100.00 78.50 162.35 4,169.45 2,647.34 28.33 29:I0 7.32 35.25 148.88 Total Disbursements 8,843.01 NET ASSETS 8,149.31 EXPECTED DISTRIBUTION EXPECTED DISTRIBUTION TO DWAYNE S. MALONE EXPECTED DISTRIBUTION TO ROBYN E. MALONE 8,149.31 1,000.00 7,149.31 RESERVATION: PURPOSE OF NOTICE: PAYMENT: REFUND OBJECTIONS: ADMIN- ISTRATIVE CORRECTIONS: DISCOUNT: PENALTY: INTEREST: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the e×piration of any estate for life or for years, tho Commonwealth hereby expressly reserves the r/ght to appraise and assess transfer Inheritance Taxes at the lawful Class 8 (collateral) rate on any such future interest. To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z$ of 2000. (7Z P.S. Section 91~0). Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side. --Hake check or money order payable to: REGISTER OF HILLS, AGENT A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1515). Applications ara available at the Office of the Register of Wills, any of the Z5 Revenue District Offices, or by calling the special Z4-hour answering service for forms ordering: 1-800-SSZ-Z050; services for taxpayers with special hearing and / or speaking needs: 1-BGO-44?-50Z§ (TT only). Any party in interest not satisfied with the appraisement~ allowance, or disallowance of deductions, or assessment of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of this Notice by: --written protest to the PA Department of Revenue, Board of Appeals, Dept. Z81021, Harrisburg, PA I?IZ8-1OZ1, OR --election to have the matter determined at audit of the account of the personal representative, OR --appeal to the Orphans' Court. Factual errors discovered on this assessment should be addressed in writing to: PA Department of ReVenue, Bureau of Indivldual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 171Z8-0601 Phone (717) 787-6505. See page 5 of the booklet "Instructions far Inheritance Tax Return for a Resident Decedent" (REV-150I) for an explanation of administratively correctable errors. If any tax due is paid within three (5) calendar months after the decedent's death, a five percent (SZ) discount of the tax paid is allowed. The 1SZ tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and nut paid before January 18, 1996~ the first day after the end of the tax amnesty period. This non-participation penalty is appealable in the same manner and in the the same tiaa period as you would appeal the tax and interest that has been assessed as indicated on this notice. Interest is charged beginning with first day of delinquency, or nine (9) months and one (I) day from the date of death, to the date of payment. Taxes which became delinquent before January I, 1982 bear interest at the rate of six (61) percent per annum calculated et a daily rate of .~00164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. The applicable interest rates for 1982 through ZOOZ are: Year Interest Rate Daily Interest Factor Year Interest Rate Dally Interest Factor 1982 ZOZ . O00=;48 1992 9Z .000247 1982 162 .000428 1992-1994 ?Z .00019Z 1984 llZ .000301 1995-1998 9Z .000Z47 1985 ISZ .000356 1999 7Z . OO019Z 1956 i OZ .000Z74 2000 82 .000Z19 1987 9Z .000247 ZOO1 9Z ~. 000247 1988-1991 ilZ .000501 ZOOZ 67. .n00164 --Interest is calculatad as follows: INTEREST = BALANCE OF TAX UNPAID X NU~BER OF DAYS DELINQUEHT X DAILY INTEREST FACTOR --Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (1S) days beyond the date of the assessment. If payment is made after the interest computation data shown on the Notice, additional interest must be calculated.