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Home My WebLink About06-04-13 (3) J 1505611185 REV-1500 EX(02-11)(FI) OFFICIAL USE ONLY PADepaRmentotRevenue CountyCode Year FileNUmber Bureau W Individual Taxes Po sox zeosoi INHERITANCE TAX RETURN 21 12 1059 Harrisburg, PA�7128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Dale of Death MMDDYYVV Date of Birth MMDDVVVv 09032012 05221928 DecetlenYs Last Name Suffix Decedent's First Name MI SHUEY RICHARD D (If Applicable) Ente�Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name M I Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE - - REGISTER OF WILLS FIIL IN APPROPRIATE BOXES BELOW � 1. Original ReNm � 2. Supplemental Retum � 3. Remaintler Retum(Date of Death Priorto 12-13-82) ❑ 4. Limited Estate ❑ 4a. Future Interest Compromise(date of ❑ 5. Federal Estate Tax Return Requiretl death after 72-12-82) � 6. Decedent Dietl Testate � 7. Decedent Maintained a Living Trust � 8. Total Number of Safe Deposit Bmces (Attach Copy of Will) (Attach Copy ot Trust.) ❑ 9. Litigation Proceeds Received ❑ 10. Spousal Poverty Credit(Date of Death ❑ 1 t. Election lo Tax untler Sec.9113(A) 8etween 7231-97 and 1-i-95) (Attach Schedule O) CORRESPONDENT• THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TA%INFORMATION SHOULD 8E DIRECTED TO: Name Daytime Telephone Number KATHLEEN B. MURREN, ESQ. 717-23�1000 w � m m � REGIm FF�F W�LS IOSG ONL� � .-7 b. r ['t� First Line of Address r a m ..-.- 7,:`' `� ? � R � C __ 17 SOUTH SECOND STREET :� �, �., -� -� Second Line of Address `� "" �� _ z FLOOR 6 ' �� ~ '` � -, —` � v> City Of POSt OfflC2 Sta1B ZIP COde '"� DATE FILED� HARRISBURG PA 17101 corresPOndenes a•ma��aac�ess: KBM@SKARLATOSZONARICH.COM Untler penalties of perjury, i declare lhat I hava exemined this retum,inclu0ing accompanying schedulas antl statemants,and lo the bast of my knowledBe and beliH, it is true,correct antl completa. Declaration ot preparer othar then the personal rapresentative is based on ell infortnation of which preparer has any knowiedge SIGI�TUIjE O�P�ON�SIBL��F�NG RETURN �nq�I� hClll.lt, i� � ADDRESS 505 WARREN STREET LEMOYNE, PA 17043 SIG R R�iA42Eq07}I�R�V�R1EPRESENTATNE � � 1✓ 1W.i l. CA'I �('��I a�i � ADDRESS , 17 SOUTH SEC D STREET, FLOOR 6 HARRISBURG, PA 17101 PLEASE USE ORIGINAL FORM ONLY Side 1 � 1505611185 oMaea�a000 1505611185 � `� �' � 1505611285 REV-1500 EX(FI) oa�aaa�rsNeme: SHUEY RICHARD D RECAPITULATION 1. Real Estate(Schedule A) , �69,900.�0 2. StoCks antl Bontls(SChedule B) , Q.Q� 3. Closely Held Corporation, Parinership or Sol�Proprietorship(Schedule C) �yp�p�piV �.Q� 4. Mortgages antl Notes Receivable(Schedule D) O.OQ 5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E) � �p,270.00 6. Jointly Owned Property(Schedule F) � Separate Billing Requesled � 2]2,$37.QQ 7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property (Schedu�e G) � Separate Billing Requested 53,356.00 8. 7otai Gross assets(totai Lines � through 7) 506,363.00 9. Funeral Expenses and Administrative Costs(Schedule H) . 2�,044.00 10. Debis of Decedent, Mortgage Liabilities,and Liens(Schedule I) � 967.�0 11. 7otal Deductions(total Lines 9 and 10) . ZZ,011.00 12. Net Value of Estate(Line 8 minus Line 11) 484,352.00 13. Charitable antl Governmental Bequesis/Sec 9113 an election to tax has not been made(Schedule J) Q.�� 14. Net Value SubjecttoTax(Line 72 minus Line 13) 484,352.00 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate,or transfers uruier Sec.9176 (a)(12)X.OU 0.00 ie. 0.00 i6. Amount of Line 14(axable at iineai rete x.0 40 484,351.00 �s. 21,796.00 17. Amount of Line 14 taxable atsiblingrateX.12 Q.QO 17. Q.Q� 1 B. Amount of Line 14 tazable atcollateralrateX.15 Q.Q� 16. Q.Q� 19. TAXDUE , 2�,796.�� 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑ Side 2 � 1505611285 1505611285 � OM4648 3.000 REV-1500E%(FI) Page3 FileNUmber Decedent's Com lete Address: 21 12 1059 DECEDENTS NAME SHUEY RICHARD SIREETADDRESS CUMBERLAND CI7Y STATE ZIP LEMOYNE PA 17043 Tax Payments and Credits: 1. Tax Due(Page 2,Line 19) �i� 21.796.00 2. Credits/Payments A. Prior Payments 2�,��.�� B. Discount 1.053.00 Tocai aeu�c5 c A�a) (z� 21,053.00 3. Interest (3) �.0� 4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refuntl. (4) �.00 5. If Line 1 + Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 743.�0 Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: No a. retain the use or income of the property transferred � b. retain the right to tlesignate w 4 ! � c. retain a reversionary interest � d. receive the promise for life of either payments,benefits or care? � 2. If death occurred after Dec. 12, 1982, did I � without receiving adequate consideretion? ❑ 3. Oid decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ❑X 4. Did decedent own an individual retire contains a beneficiary designation? ❑ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPIETE SCHEDULE G AND FILE �T AS PART OF THE RETURN. For tlates of death on or after July 1, 1994, and before Jan. 1, 1995,the tax rete imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent[72 P.S.§9116(a)(1.1)(i)). For dates of death on or after Jan. 1, 1995, the [ax rate imposed on the net value of Iransfers to or for the use of the surviving spouse is 0 percent [72 P.S.§9116 (a) (1.1) (iij�. The staWte does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets antl filing a tax return are still applicable even if the surviving spouse is the only beneficiary. F ates of death on or after July 1,2000: e tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a naturai parent, an adoptive parent or a stepparent of the child is 0 percent[72 PS,§9116(a)(12)�. e tax rate imposetl on the net value o!transfers to or for the use of the decetlenPS lineal beneficiaries is 4.5 percent,e�ept as notetl in[72 P.S.§9116(a)(1)�. e tax rete imposed on the net value of transfers to or for the use of the decedenCs siblings is 12 percent [72 P.S.§9116(a)(1.3)j, A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the Oecetlent,whe[her by blood or a0option. OM46]1 2.000 REV-1502 EX+(0140) pennsylvania SCHEDULE A pEPARTMENTOFREVENUE REAL ESTATE INHERITANCE TPX RETURN ftE510EMDEGEDENT ESTATE OF: � FILE NUMBER: Richard D. Shuey 21 12 1059 All real proparty owned solaly or as a Unant In wmmon must be reportetl at fair market value.Fair market value is tl�ned as ihe price at which propetly would be exchanged batween a willing buyer and a willing seller,nei�her being compelled to buy or sell,both having reasonable knovAeCge W ihe relevant(ads. Real property thal is jointlyawnad wilh right of survivorshlp must be disclosad on Schedule F. Attach a copy o(ihe settlement sheel Hthe propeny has been soltl. ITEM Inclutle a copy of tha deed showing decedenfs inlerest if ovmed as tenant in common. VAW E AT DATE NUMBER DESCRIPTION OF DEATH 1. 505 Warren Street, Borough o£ Lemoyne, Cumberland County, PA 169,900 70TAL (Also enter on Line 1,Recapitulation.) S 169,900 swaess z.000 If more space is needed, use additional sheets of paper of the same size. REV-150B EXa(1140) pennsylvania SCHEDULE E oEanaan.+�r�oF neveNUe CASH, BANK DEPOSITS, 8 MISC. �aESO�rv"Ece eNTT�RN PERSONAL PROPERTY ESTATE OF: FILE NUMBER: Richard D. Shuev 21 12 1059 Include lhe procaeds of litigetion antl the tlate Ihe procaeds were received by Ihe estate. All ro ert ointl owned with ri ht of survivorahi must be disclosetl on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Penn National Mutual Casualty Insurance Company Automoile Insurance Refund; Account Number 3720376169 609 2 Penn National Mutual Casualty Insurance Company Homeowners' Inaurance Refund; Account Number 3755991991 163 3 Federal Income Tax Return 1,498 4 2006 Ford Focus 6,000 TOTAL Also enter on line 5,Reca itulation $ 10,270 owasno�000 It more spaca is needed,use atlditional sheets of paper of tha same s¢e. REV-1509 IX+(01-10) pennsylvania SCHEDULE F DEPPflTMENT C£REYENVE iNxeairnHOe,nzRe,oaH JOINTLY-OWNEDPROPERTY RESI�ENT OECE�ENT ESTATE OF: FILE NUMBER: Richard D. Shuey 21 12 1059 If an asset became joiirtty owned wMhin one yea�of the tlecetleM's tlate of death,it must 6e reportetl on Schetlule G SURVNINGJOIMT9d4lJr(S)N4ATj5) ADDRESS RBATIONSHIPTOOEC�B�f� A Shuey, James C 505 Warren Street, Lemoyne, PA 17043 Son B Shuey, Paul R 505 Warren Street, Lemoyne, PA 17043 Son JOINTLY OWNED PROPERTY: � '�,•EA a^TE DESCPoPfIONOFPROPB2IV %oF aa�oFOFnni ror�aprvr AMOE ixcwoeun�ariaexcwiwsnrunarinnoenH�nccwHrxur.senansiMwn �TE�F�T�"� �ECE➢�dPS VALUEOF M1hEFlE T[uan JOIM ioErsrimxcxu.e[a.n.r�cxoeeorcaaaxnrne�oxeuesrnrE. VALUEOFASSET IM62EST DEC�BdI'SIMFT�ST 1 B 10/11/19 9PNC HANIC NA; Acct. # 5130192285 63,939 50.0000 31,970 2 BA 12/25/1973 PNC Bank Acct 5140057976 23,128 33.0000 7,709 3 H 8/16/198 PNC Bank CD 21001030365 39,484 50.0000 19,742 4 H 8/16/198 PNC Hank CD 21001030364 88,975 50.0000 44,488 5 H 9/27/198 PNC Bank CD 21001030369 84,798 50.0000 42,399 6 B 7/29/199 PNC Bank CD 31500069744 91,328 50.0000 45,664 7 B 7/8/2003 PNC Bank CD 31000234041 89,865 50.0000 46,933 8 B 4/17/2007 PNC Bank CD 31300312256 71,667 50.0000 35,934 TOTAL (Also enter on Line 6, Recapitulation) E 272,837 9W/6AE 2.000 If more space is needed, use additional sheets of paper of the same size. REV-i510EX+(OB-09) SCHEDULE G pennsylvania DEPARTMENTOPREVENUE INTER-VIVOS TRANSFERS AND INHERITANCETA%RETURN MISC. NON-PROBATE PROPERTY RESIDENTDECEDEM ESTATE OF FILE NUMBER Richard D. Shue 21 12 1059 This schedule must be completed antl filed if the answer to any of questions 1 thmugh 4 on page three of the REV-1500 is yes. DESCRIPTION OF PROPERTY ITEM vsiwer�wJneorr�muasreReer�iAReunorsHVrooeceoervrnw DATEOFDEATH %OFDECD'S FXCLUSION TAXABLE NUMBE *�w��oFraas=Fn.nirr.�awavorr�oEEOFOaaeues.n.e VALUEOFASSET INTEREST iFaaPUCnELE VALUE �� PNC Bank CD 31100361194 47,199 100.0000 3,000 44,199 Transferee is Paul R. Shuey, son of decedent; created 9/23/2011 2 Wells Farqo IRA Acct #257410057641684 1,651 100.0000 0 1,651 Beneficiaries: Paul R. Shuey 6 James C. Shuey, sons o£ decedent 3 Wells Fargo IRA Acct # 257410083641146 7,505 100.0000 0 7,505 Beneficiaries: Paul R. Shuey and James C. Shuey, sons of decedent TOTAL(Also enter on line 7,Recapitulation)$ 53 356 If more space is ncetled,use atltlitional sheets ot paper of the same size. 9 W 46AF 2.000 R�.,S„�t"4o9, SCHEDULE H pennsylvania oeananneNroF ReveNUe FUNERAL EXPENSES AND wN�r+irnNCernxaeruaN ADMINISTRATIVE COSTS RESIDENTOECEDENT ESTATE OF FILE NUMBER Riehard D. Shuey 2� 1 �O5 Decetlent's debts must be reported on Schetlule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNER4LEXPENSES: �, Osiris Holding of PA, Inc. 6,186 Total from continuation schedules . . . . . . . . . 2,340 B. ADMINISTRATIVE COSTS: 1. Personal Representative Commissions: Name(s)of Pe�sonal Representative(s) Street Atldress Ciry State ZIP Year(s)Commission Paid: 2. Altomey Fees: 9�675 3. Family Exemption: (If decedent's address is not the same as claimant's,attach e�lanation.) 3,500 Claimant Paul R. Shuev Street Address 505 Warren Street Ciry Lemovne State PA ZIP 17043 Relationship of Claimantto Decetlent 4. Probate Fees: 480 5. AccountantFees: 250 6. Tax Return Preparer Fees: 7. 1 Skarlatos Zonarich LLC 125 2 Carlisle Sentinel 232 Total from continuation schedules . . . . . . . . . 159 TOTAL(Also enter on Line 9,RecapiWlation) $ 21 044 swasnc z.000 If more space is needed, use additional shee[s of paper of the same size. Estate of: Richard D. Shuey 21 12 1059 Schedule H Part 1 (Page 2) Item No. Description Amount 2 Musselman Flineral Home & Cremeation Services 561 3 woodlawn Memorial Gardens 1,779 Total (Carry forward to main schedule) 2,340 _ Estate of: Richard D. Shuey 21 12 1059 Schedule H Part 7 (Page 2) 3 Cumberland County Law Journal 75 4 Dauphin County Register of Wills 20 5 Cumberland County Recorder of Deeds 66 Total (Carry forward to main schedule) 159 0.EV-154 E%.(R-OB) pennsylvania SCHEDULE I oePrarn+eNTOF aeveNUe DEBTS OF DECEDENT, iNHeaiTnNCevaaeruRN MORTGAGE LIABILITIES & LIENS RESIDENTDECEDENT ESTATE OF FILE NUMBER Richard D. Shuey 21 12 1059 Report de6ts incurred 6y the decedent prior to death that ramainetl unpaitl at the tlate of tleath,inclutling unreim6ursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH �� Verizon 19 2 Pennsylvania American Water 148 3 PPL 50 Q UGI 25 5 Comcast 71 6 west Shore EMS - SLS 109 7 Penn Waste 45 8 Heartland 500 TOTAL Also enter on Line 10,Reca itulation $ 967 ewoenH z.000 If more space is needed, insert additional sheets of[he same size. REV-1513EX+(0140) SCHEDULE J pennsylvania °E""""EM°F RE�E"°E BENEFICIARI ES INHERITANCE TAX RETURN RESIDENTDECEDENT ESTATE OF: FILE NUMBER: Richard D. Shue 21 12 1059 RELATIONSHIP TO DECEDEM AMOUNT OR SHARE NUMBER NAMEANDADDRESS OF PERSON(S)RECEIVING PROPERN Do Not List Trustee(s) OFESTATE I TAXABLE DISTRIBUTIONS�Include outright spousal tlisiributions and iransters untler Sec.9116(a)(1.2).] i. Paul R. Shuey 505 Warren Street Lemoyne, PA 17043 PNC BANK NA; Acct. # 5130192285 Inventory Value: 15,985 PNC Hank Acct 5140057976 Inventory Value: 3,855 PNC Bank CD 31100361194 Inventory Value: 44,199 Wells Farqo IRA Acct N25741005764168Q Inventory Value: 826 PNC Hank CD 21001030365 Inventory Value: 9,871 EMER DOLLARAMOUN75 FOR DISTRIBU110NS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE. II NON�TA%ABLE DISTRIBUTIONS A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN: 1. B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS'. 1. TOTAL OF PAR7 II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. S 0 swasai z.000 I(more space is neetled,use additional sheets of paper of the same size. _ _ _ 21 12 1059 Estate of: Richard D. Shuey Schedule J Part 1 (Page 2) ICem Relation Amount No. Dasaription 1 PNC Bank CD 21001030364 Inventory Value: 22,244 PNC Bank CD 21001030369 Inventory Value: 21,200 PNC Hank CD 31500069744 Inventory Value: 22,832 PNC Bank CD 31000234041 Inventory Value: 22,466 PNC Bank CD 31300312256 inventory Value: 17,967 One Hal£ o£ Residue: Son 330,557 149,114 2 James C. Shuey 505 Warren Street Lemo}me, PA 17�43 PNC Bank Acct 5140057976 Inventory Value: 3,855 Welle Fargo ZRA Acct #25741005764168Q Znventory Value: 826 One Half o£ Residue: Son 153,796 149,114 _ _ hJ � �._. C� N T�_L^ �a.l C� ��!'1i LAST WILL AND TESTAMENT �T�, � �;,\:=; OF ��,-�, N ;:_; ;,; LCfi=;=. J ..?:) !_- RICHARD D. SHLJEY °c�; . -. �;;`r; �'� -<: - -�, c-_ . - I, RICHARD D. SHUEY, now of 505 Warren Street, Lemoyne, Cumbe�an8 Coun, �� Pennsylvania, being of sound and disposing mind and memory, do make, Z>ublish and declare�s �'' to be my Last Will and revoke any Wills and codicils previously made by me. ARTICLE ONE Specific Beauest of Taneible Personal Pronertv and Other Proaertv I give and bequeath all of my tangible personal property, including, but not limited to, all my automobiles, fiuniture, fiunishings, books, pictures, jewelry, china, linen, silver, clothing, household effects and personal effects, and other tangible personal prope.rty of like nature (not including cash, securities and other property used for the production of income), together with any existing insurance thereon to my issue, PAUL R SHUEY and JAMES C. SHUEY, in equal shazes,per stirpes. ARTICLE TWO Residuarv Estate I give, devise and bequeath all of the rest, residue and remainder of'my estate of whatever nature and wherever situated (my "Residuary Estate"), to my issue, PAUL R SHUEY and JAMES C. SHUEY, in equal shazes, per stirpes; provided that, if I am survived by my son, JAMES C. SHUEY, I give, devise and bequeath his shaze of my Residuary Estate to my Trustee to be held in trust (this trust being hereinafter designated as the "JAMES C. SHiJEY TrusY'), and managed, administered and distributed as provided in ARTICLE THREE for the benefit of my said son; provided fiuther that, if any of my issue, per stirpes, is under the age of twenty-five (25) yeazs, I give, devise and bequeath each such issue's shaze of my Residuary Estate to my Trustee to be held in trust (this trust being hereinafter designated as the "DescendanYs TrusY'), and managed, administered and dishibuted as provided in ARTICLE FOUR for the benefit of each such issue. ARTICLE THREE JAMES C. SHUEY Trust My Trustee shall hold, manage, administer and dish-ibute the assets of the JAMES C. SHUEY Trust as follows: (A) During the lifetune of my son, JAMES C. SHUEY("James"): (1) Income Distributions. My Trustee shal] pay to James, or expend for James' benefit all of the income of the JAMES C. SHUEY Trust estate in quarterly or more frequent intervals. 9G11�A7i1�R�7A1NAR1(N u�' LAST WILL& TESTAMENT OF RICHARD D. SHUEY ATTORNEYS AT LAW /'¢ge 1 of 9 (2) Princinal Distributions. My Trustee may pay to James, or expend for James's benefit as much of the principai of the JAMES C. SHUEY Trust estate as my Trustee shall determine to be necessary, from time to time, for James's health, welfaze, support, and maintenance, in the manner of living to which James is accustomed. (B) Upon the death of my son, JAMES C. SHUEY ("James"): (1) If James is survived by issue, Trustee shall diviiie the balance of the JAMES C. SHUEY Trust estate, if any, into sepazate shares for James's issue, per stirpes, and Trustee shall retain each such sepazate shaze as a sepazate trust estate (each such separate trust being hereinafter designated as a "DescendanYs TrusY'), to be held, managed, administered and dishibuted as provided in ARTICLE F��UR for the benefit of the issue, per stirpes, of James; or, (2) If James is not survived by issue, Trustee shali distribute the balance of the JAMES C. SHUEY Trust estate, if any, to my son PAUL R. SHLTEY; or if he does not survive me, to my then living nieces and nephews in equal shares, per stirpes. ARTICLE FOUR Descendant's Trust My Trustee shall hold, manage, administer and distribute the assets af a DescendanYs Trust as follows: (A) During the lifetime of the beneficiary of the DescendanYs Trust(the"DescendanY'): (1) Income and Princinal Distributions. My Trustee may pay to the Descendant, or expend for the Descendant's benefit as much of the income and/or principa] of the Descendant's Trust estate as my Trustee shall detexmine to be necessary, from time to time, for the DescendanYs health, support, education and maintenance, in the manner of living to which Descendant is accustomed. (2) Additional Princinal Distributions. Notwithstanding the foregoing upon the Descendant attaining the age of twenty-five (25) years, my Trustee shall distribute to the Descendant the then remaining balance of the DescendanYs Trust estate. (B) Upon the death of the Descendant, my Trustees shall distribute the balance, if any, of the DescendanYs Trust estate to the DescendanYs issue, per stirpes; or, if the Descendant is not survived by issue, to the issue,per stirpes, of the Descendant's pazent who was an issue of mine; or, in default thereof, to my issue,per stirpes;provided, that if any such beneficiary under this Paragraph (B) is then a beneficiary of a trust created hereunder, the shaxe of such beneficiary shall instead be added to the principal of such trust (which when added to such trust shall become a part thereo�, to be held, managed, administered and distributed according to the terms thereof. �� LAST WILL & TESTAMENT O,F RICHARD D. SHUEY ATTORNEYS AT LAW Page 1 of 9 _ _ _ ARTICLE FIVE Payment of Taxes. Debts and Administrative Exneases Subject to the limitations and restrictions contained elsewhere in tkiis Will, I direct that all estate, inheritance and other death taxes (other than generation-skipping transfer taxes), and all interest and penalties thereon imposed by reason of my death with respect to property subject to such tases by reason of my death, whether or not passing under this Will, and payable to any federal, state or foreign taxing authority, whether payable by my estate or tiy any recipient of such property, and all my just debts, funeral expenses and estate administration expenses, shall be paid to the extent possible out of my residuary estate passing under ARTICLE TWO hereinabove. ARTICLE SIX Protective Provisions The principal of my estate and any trusts created hereunder and the income therefrom, so long as the same ue held by my Executor or Trustees, as the case may be, shall not be subject to anticipation, assigrunent, pledge, sale or transfer in any manner, nor shall any beneficiary have power in any manner to chazge or encumber his/her interest therein, nor shall the said interest of any beneficiary be liable or subject in any manner while in the possession of my Executor or Trustees, as the case may be, for any liability of said beneficiary, whether such liability arises from said beneficiary's debts, contracts, tor[s, or other engagements of any type. ARTICLE SEVEN Powers of Executor and Trustees In addition to and without limiting the powers conferred by case ]aw, by statute, and by other provisions hereof, my Executor and Trustees shal] have the following rights and powers exercisable without the need for court approval: (A) Accent and Retain Investments. To accept and retain any form of real or personal property received by transfer, devise, bequest or otherwise without being required to diversify and without being limited to the types of investments in which fiduciaries aze authorized by law to invest. This authority shall specifically include the authority to accept and retain any stock of a corporate fiduciary hereunder, or in any corporation which controls or is controlled by it, or any other corporation in which it holds any ownership interest, together with any stock dividends received thereon, or any stock acquired in the exercise of subscription rights, or received by reason of any consolidation, merger or reorganization, without liability for such retention. (B) Invest. To invest and reinvest in any form of real or personal property without limitation by any law applicable to investments by fiduciaries. 9W�A7Yl6&7�41t�t w� LAST WILL & TESTAMENT OF RlCHARD D. SHUEY ATTOFNEVS AT LNW Page 3 of 9 (C) Voting Riehts. To vote a security in person or by praxy, to participate in or consent to any merger, reorganization, dissolution, liquidation, voting trust plan, or other action affecting any securities heid hereunder, and; to exercise conversion, subscription, and other rights of whatever nature. (D) Title To Pronertv. To register or hold securities and/ar other property in the name of a nominee or nominees, including that of a clearing coiporation, a depository, in book entry form, or to retain securities and/or other property unregistered o:r in a form permitting transfer by delivery. (E) Sale, Lease and Other Dealings with Propertv. To sell, from time to time, at public or private sale, exchange, lease, encumber, option or otherwise dispose of all or any portion of assets held hereunder; to make, execute and deliver deeds, mortgages, leases, assignments and other documents necessary to carry out any of the powers granted hereunder, which shall specifically include the authority to grant leases which extend beyond the period authorized by law, and; to partition, subdivide, improve and impose any restrictions on real estate held hereunder and enter into agreements concerning the partition, subdivision, improvement, zoning or management of any such real estate. (F) Borrow. To bonow money from any person or institution and pledge property as security for repayment of funds. (G) Distributions in Kind. To make distributions in cash or in kind, or partly in each, and; to allot different kinds of property to different shares without xegazd to differences in the income tax basis of such property. Any such designation, division, allocation, apportionment or valuation of property shall be binding and conclusive on all parties. (H) Power to Distribute Outrieht. In any instance where property would be immediately dish-ibutable to a beneficiary of a trust created hereunder, or created elsewhere by me during my lifetime, distribution may be made directly to such beneficiary without funding such trust. The receipt of any such distribution by any such beneficiary shall be a full acquittance of the fiduciary making such distribution as to any amounts so distributed. (I) Settle Claims. To institute, prosecute and defend any and all legal proceedings; and compromise, release, adjust and/or settle any debt or claim. (J) Emplovment of A e�nts. To employ agents including attorneys, accountants, and others to perform administrative duties. (K) Disclaimer. To disclaim any interest in property which would devolve to me or to my estate by whatever means, including but not limited to the fallowing means: as a beneficiary under a will, as an appointee under the exercise of a power of appointment, as a person entitled to take by intestacy, as a donee/beneficiary of an inter vivos transfer, as a beneficiary under any insurance policy, as a beneficiary under an individual retirement account or annuity, and as a beneficiary under any qualified or non-qualified retirement plan. (L) Propertv Distributable to Minors. Any property (whether income or principal) distributable to a beneficiary of my estate or any trust created hereunder, other than my Spouse, who is under a disability may be paid directly to such beneficiary, to the parent or guardian of such beneficiary, to a custodian selected by my Executor or Trustees, as the case may be, (other ��&�� LAST WILL & TESTAMENT OF RICHARD D. SHUEY!1 ATTORNEYS AT LAW P¢ge 4 ofY than my Executor or Trustees) under the Pennsylvania Uniform Transfers to Minors Act or under a similar act of any other state, ar to persons caring for or having custody of such beneficiary (other than my Executor or Trustees), or may be applied for such b�,neficiary's benefit by payment to such other persons, organizations or institutions (other than my Executor or Trustees) as my Executor or Trustees, as the case may be, may select, and the receipt of any such payee shall be a full release therefor. The receipt of any such payments by any such person shall be a full acquittance of my Executor or my Trustees, as the case may be, as to any amounts so paid. Any beneficiary hereunder shall be considered to be under a disability while under the age of twenty-one (21) years or at any time when, in the opinion of my Executor or Trustees, as the case may be, such beneficiary is incapacitated in any way so as to be unable to properly manage his/her affairs. ARTICLE EIGHT Accentance of Prouertv Subject to the other provisions of this Will, my Trustees shall accept, receive and add to the principal of the trust estate hereby created any money or property which at any time may be payable, tendered, given or transferred to my Trustees by any person, natural or legal, by deed, gift, Will, or in any other manner. All property received by my Trustees, whether under this Will or othenvise, shall be added to the principal of the trust estate hereby created as provided in this Wiil, and shall be administered by my Trustees in accordance with the terms and provisions herein set forth; provided, that in the absence of a specific direction as the ttust hereunder of which such property should become a part, my Trustees shall have the discretion to allot or allocate particulaz securities, real estate or other property, or an undivided interest therein, to or among any of the trusts herein created, subject nevertheless to the other prnvisions of this Will. ARTICLE NINE Fiduciaries (A) Appointment of Executor and Trustee. I appoint my son, PAUL R. SHUEY, as Executor of this Will (my said Executor and any successor Executor or co-Executors shali be refened to herein as my "Executors" or"Executor") and as Trustee of any trusts created hereunder (my said Trustee and any successor Trustee or co-Trustees shall be referred to herein as my "Trustees" or "Trustee"). ilpon the death, renunciation or resignation of my son, I appoint PNC BANK as successor Trustee only of any husts created hereunder. Notwithstanding the foregoing, the current beneficiary of any trust hereunder who is sui juris shall have the power to remove a Trustee of said beneficiary's trust, at any time or times, with or without cause, upon at least thirty (30) days' written notice given to such current Trustee; provided, however, that such removal and replacement shall only be effective upon the date said beneficiary shall have appointed a Corporate Fiduciary as successor Trustee and such Corporate Fiduciary shall have accepted the appointment as successor Trustee of such trust. 5�-47L�&�CN�'A�li W' LAST WILL & TESTAMENT OF RICHARD D. SHUEY ATTORNEYS AT LNW Page 5 oj9 (B) Miscellaneous. Any successor Executor or Trustee shall succeed to the capacity of its predecessor without re-conveyance or transfer of property and have all of the rights, powers, authorities and discretion conferred upon the original Executor or Trustee. No successor Executor or Trustee shall be obligated to examine the accounts, records, or acts of a previous Executor or Trustee, nor shall any such successor Executor or Trustee in any way or manner be responsible for any act or omission to act on the part of any such previous Executor or Trustee. No Executor or Trustee serving hereunder at any time shall be required to file any bond or enter security in any Court or jurisdiction in which such fiduciary may be called upon to act. ARTICLE TEN Internretation (A) Child. Children, Grandchild Grandchildren and Issue. Whenever the terms "child," "children," "grandchiid," "grandchildren" and "issue" are used h.erein, such terms shall be interpreted to include adopted persons as well as natural persons, pravided in each instance that the adoptee is under the age of eighteen (18) years at the time of adoption. Such terms aze also intended to include persons in gestation at any pertinent time under this Will, provided such persons survive birth by thirty(30) days. (B) Corporate Fiduciary. As used herein, the term "Corporate Fiduciary" refers to any other corporation or association which is authorized to act as a fiduciary in the Commonwealth of Pennsylvania. (C) Survival Clauses. If any beneficiary hereunder should die within ninety (90) days after my death or within ninety (90) days after any other person the survival of whom determines such beneficiary's rights hereunder, then such beneficiary shall be deemed to have predeceased me or such other person, as the case may be, for all purposes hereunder. (D) Beneficiaries Rieht to Income. Each trust created hereunder shall be entitled to a proportionate shaze of income accruing &om the event as of which it is to be set apart (for example, the date of my death in the case of the JAMES C. SHUEY 'I'rust). But all income undisfributed at the death of a beneficiary of any trust created hereunder shall be treated as if it had accrued thereafter. (E) Gender and Number. Where appropriate except where the context othenvise requires, whenever used herein, the singular includes and plural, the plural the singular and words of any gender shall be applicable to all genders. (F) Headines/Cantions. The headings/captions of Articles, Sections and Pazagraphs used herein aze for convenience of reference only and shall have no significance in the construction or interpretation of this Will. `.7CAI�A'[�16&�NAf�►u� LAST WILL & TESTAMENT OF RICHARD D. SNUEY/� ATTORNEYS AT LAW Page 6 af Y IN WTTNESS WHEREOF, I have hereunto set my hand and seal and caused this my Last Will and Testament, consisting of Nine (9) typewritten pages, including th.is attestation clause ar�d the followin Acknowledgment and Affidavit, to be executed, deciazed and published this yr�-� day of S�EPr��,�2 , 2003, at Harrisburg,Pennsylvania. '�i�1�ec.�ePiD. � o.v' RICHARD D. SHUE;Y On this � day of �GP��Ih��(1�3, Richazd D. Shuey declazed to us, the undersigned, that the aforegoing instrument was his Last Will, and he requested us to act as witnesses to the same and to his signature thereon. He thereupon signed said Will in our presence, we being present at the same time. We now, at his request, in his presence, and in the presence of each of us, hereby subscribe our names as witnesses thereto. By so doing, each of us declazes that he or she believes this testator to be of sound mind and memory. =-�Y`a;�..��fA1Ci .`� ��+-'�..�,�-- r J � .�i �.� _-- ��- � i� �. � , `�-4��y LAST WILL& TESTAMENT G�FWCHARD D. SHUEY ATTORNEYS AT LAW P¢ge 7 of 9 ACKNOWLEDGMENT COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF DAUPHIN ) I, RICHARD D. SHUEY, the Testator,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 Wili; that I signed it willingiy and that I signed it as my free and voluntary act for tt�e piuposes therein expressed. Ra;�,.�,,.� �� $�.� . RICHARD D. SHUEY —�-- Swom or affirmed to and acknowledged before me by RICHARD D. SHUEY,the Testator this�dayof� Lf�(( ,_ f7 �' � � � (SEAL) tary Public Commission Expires: �_y _�� .v --- ---___ � ., nr , ,� Y� Lr� aA , c s f r — ' ( �.w �.k�Ma j r r L r _.. , ' r _�� ,..t r� _� .,_ 9{ARIA'¢�6&�I�tiAR�-7 uY LAST WILL � TESTAMENT CF RICHARD D. SHUEY ATTORnEVS AT LAw Page 8 oj9 AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) ) SS: COUNTY OF DAUPHIN ) 7_i; � ' We, �'Y`'tv �LY1'rc_�. tc7,YVar�i � ,,;�.,,, .� . „ � and Jo IcEN (2- �U N,�R�c ,tf the witnesses, whose names aze signed to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw RICf�ARD D. SFIiJEY, sign and execute the inshvment as the Testator's free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as wifiesses; and that to the best of our lrnowiedge, the Testator was at the time twenty-one (21) or more yeazs of age, of sound mind and under no constraint or undue influence. �7'e•��1(7� 5 �+-c, �.-.--- Residingat c��"C=. LCC��,;T �-f-1vE ��rirris}��rr��(-`i 1rlIC'�� 1��,:,��. _�� t , :r��" Residingat IYiU J?y;;^,rau %;;°;. r-i�!'�,s;`�� c: Pi? i ;,;.�.. �� Residing at � ��S _�. ✓�u . l7uS'U 1 ' •� Swom or affirmed to and aclmowledged before e y _ � �° ��_ ., p f ' �� /�- and the � ,.-. , wimesses, this��ay of e Jy�b e ,a3'U_�. � � �, � f\ ''�� \,.�,SEAL) Not Public My mmiss' �xpares:--__.__, �. _ ,.... _._ ns. .�� .�a� r �r'-�dl k+ ]r1-. a� Np' 1�nitp (:hfirf 1 � 1'.r� 3�{ ..lJ! SV .iP(� n �- H'd 5A .�:) A i'.;,.. ,. .�..y.,..,n.�A,,u.va�Ca�u(h'o�r's ��u��►�' LAST WILL & TESTAMENT OF RICHARD D. SHUEY ATTORNEVS AT LAW . Page 9 of 9 -- � � . . . . _ .. . . _ _ _. _.. ._ . . _. _ _ . a�� oF �NO��ow�.Ta�ES Pennsylvania lnheritance Tax f pe�nSJ�Van�a Ii PO e07t IB0601 Information Notice DEPppTMENT OF REVENUE . HMRiSBURG PA ll128-O601 �a-�s�s cx o..[nc�o-�:e And Taxpayer Response Fi�E No.zi�2-toss ACN 12159294 " ` REVISED NOTICE " ' DATE 12-03-2012 Type of Account Estete o(RICHARD D SHUEY �Sevings SSN Checking Date ot Death OB-03-2012 Trust PAUL R SHUEY Counly CUMBERLAND Certificale 505 WARREN ST � � lEHOYNE PA 17043-2037 PNC BANK Na provided the department with the information below indicating ihat at the death of the above-named decedent ou were a oint owner or beneficia of the account idendfied. Remlt Payment and Forms to: AccountNo.5730192285 � Date Establfahed 72-25-1973 REGISTER OF WILLS Account Balance $63 939.00 � 1 COURTHOUSE S�UARE CARLISLE PA 170Y3 Percenl Taxable X 50 Amaunt Subjed to Tax $31 969.50 _ Tax Raie X 0.045 NOTE': It tex payments are made withln three months of the Potential Tax Due $1 438.63 dacedenCs date oi tleaih,deduct a 5 percent discount on the tex With 5%Discount(fax x 0.85) $(see NOTE') due. Any inheritance tax due wfll become delinquent nine months ai[er the date of death. PA� Step 1 : Please check the approprlate boxes below. /+ Q No tax is due. I em the spouse of the deceased or I em the parent of a decedent who was 21 years'old or younger ai date of death. Procsed to Sfep 2 on reverse. Do�rot check any other boxes a�dlsregard the amount sfrown above as Potential Tar Due. g �Tha into�mation is The above Information is correG,no deductlons are being taken,and paymentwiil be sent conect. wHh myresponse. Proceed to Step 2 on�everse. Do not check any other boxes. � �The tax rate is incorrect. � 4.5% I am a Iineai beneficiary(pareM,child,grendchild,etc.)ot the deceased. (Select correct tex rate at rlght,and complete Part � �p� I am a sibling of the deceased. 3 on reverse.) � 15°h All other relationships(i�lu�ng none). p ❑Changes or deductions The Inlormation above is incorrec[and/or debts and deducfions were paid. Ilsted. Complete PaR 2 and pert 3 as appropriate on the back o/thla lorm. E Asset w91 be reported on The above•identified asset has been or will be reported and lax paid with the PA Inheritance Tax inheritance tax form Return filed by the esteie representative. REV-1500. Praceed!o Step 2 on reverse. Do nof check any ofher boxes. Please sign a�d date the back of the form when finished. ,- °w��° °F '"°I�IOw�.Ta�ES Penns Ivania lnheritance Tax � pennsylvania Pa e0X Ieocot ' y DEPApTMENY OF REVENUE iWtRISBUR6 Pp 17128-060] Information Notice - And Taxpayer Response '"�""`�°"°""'-"' FILE N0.2112-1059 " ' REVISED NOTICE " " DATE 12-03 2012 I Type of Account Estale oi RICHARD D SHUEY Savings SSN Checking Daie at Death 08•03-2012 Trust PAUI R SHUEY County CUMBERLAND Certificate 505 WARREN ST LEMOYNE PA 17043-2037 � � PNC BANK Nn provided the department with the information below indicating that at the death of the above-named decedent ou were a oint owner or beneflcia of the account identified. Account No.5130Y92285 Remit Payment and Forms to: Date Estebllahed 12-25-1973 REGISTER OF WILLS Account Balance $83,939.00 � 1 COURTHOUSE 3QUARE Percent 7axable X 5p CARUSLE PA 17013 Amou�t Subject to Tex $31,969.50 Tax Rate X 0.045 NOTE': I(tex payments are made withln three months o(the Potential Tax Due $1,438.63 decedenPs date of tleath,deduct a 5 percent discount on the tax Wth 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance te�c due wi0 become delinquent nine moMhs after the dete oi death. PART Step 1 : Please check the approprtate boxes below. 1 /+ �No tax is due. I em the spouse of the deceased or I am the parent of a decedent who was 21 yeafs°oid or younger ai date of death. Proceed fo Step 2 on reverse. Do not check any other boxes and dlsregaro'the amount shown above as Pofenfial Tar Due. g �The information is The above fn(orma4ion is correct,no deductlons are being taken,and payment wiil be sent correct. wfth my response. Proceed to Slep 2 on reverse. Do rtot check any ather boxes. � ❑The tax rate is fncorrect. � 4.5�, I am a lineal beneficiary(parent,child,grendchild,etc.)ot the deceased. (Selecl conect iex rate at rlght,and complete Part � �pyy I am a sibling of the deceased. 3 on reverse.) . � 15% Ail other relationships(including none). p D Changes or deductions The informatlon above is incorrec[and/or debts and deductions were paid. Ifsted. Complete PaR 2 and pert 3 as appioprlete on the beck ot this/orm. E Asset wdl be reported on The above-identified asset has been or will be reported and tax paid wfth Ihe PA Inheritance Tax inheritance tax form Return filed by ihe estete representative. REV-1500. Proceed to Step 2 on reverse. Do nof check any other boxes. Please sign and date the back of the form when tinished. . . ___ _ _ . .. ... .._ ._ I I ' � PART Debts and Deductions 2 Ailowable deb[s and deductlons mus[meet both o1 the foliowing criteria: A. The decadent was legally responsible for payment,and the estate is insuHicient to pay the deductlMe items. B. You paid the debts atter the death of the decedent and can furnish proof ot payment ii requested by the departmen[. (If addidonal space is required,you may attach 81/2"x 11"sheels of paper.) Date Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Catculation $ PART Tax Calculation � 3 It you are meking e correction to the establishment date jLina 1)eccount balance(Line 2),or parcent taxable(Line 3), please obteln a written comection from the financlai instltution end attach It to thls fortn. 1. Enier the date the account was established or tiiled as it existed at the date of deaih. 2. Enter the total balance of the account includng any interest accrued at ihe daie of death. 3. Enter the peroentage of the accounf that is taxable to you. a. Ftrst,determine the percentage owrred by ihe decedent. i. Accounts that are heki'In trust for'enother ar others were 100%owned by the decedent. ii. For Joint accouMs established more tnan one year prior to the date ot death, [he perceMage taxable is 100%divfded by the taial number af owners including the decedeM. (For example:2 owners=50%,3 owners=33.33%,4 owners =2S°h,efc.) b. Next,divide ihe decedenCs percentage owned by the number of surviving owners or beneticiaries. 4. The amount subject to tax is determined by mult�plying Ihe account balance by the percent texable. 5. Enter the total of any debts and deductions claimed fram Pad 2. 8. The amount laxable fs determined by subtracting ihe debts and dedudibns from Ihe amount subject to ta�c. 7. Enter the appropriate tax rete from Step 1 based omyout relationsfitp to the decedent. If indicafing a dlHerent tex rete,please state your relationship to the decedent: t. Date Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount SubJect to Tax 4 $ 5. Debis and Deductions 5 - 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due g $ 9. With 5°k Discount(fax x.95) 9 X Step 2: Sfg�and date below. Retum TWO complefed and signed copies to[ha Register of Wills listed on the front ot thls form, along with a check for any payment you are making. CRecks must be made payable to"Regfster of Y4ills,Agent" Do no�send payment direcNy to the DepartmeM of Revenue. Under penalry of perJury, I declare Ihat ihe facts I heve repated above are true,correct and complete to the bes[of my knowledge and belief. Work Home Taxpayer Signature � J� .S Telephone Number ��. �-�y -S�cs Date S-a q - ,3 IF YOU NEED FURTHER ASSISTA CE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 . r � � 9�R�� oF ,uo�Y�ow��E: Pennsylvania lnharitance Tax � pennsylvania l PO Imf 2E06�1 DEPARTMENTOFHEVENUE HARRISlURG P� 1712E•O601 Information Notice And Ta�cpayer Response "�'°�s a a..�nc�unse I fILE N0.2112-1059 ACN 12168266 DATE 12-10•2012 I Type of Accaunt Estate of RICHARD D SHUEV Savings SSN Checking Date of Death 09-03-2012 Trust PAUL R SHUEY County CUMBERLAND Certtiicate 505 WARREN ST LEMOYNE PA 17043-2D37 - �,HC BANK NA provfded the department with the information below indicating thai at the death of the above-named decedent you were a joint owner or beneticia of the account identified. Account No.5140057976 Remit Payment and Forms to: Date Establlahed 01•01-1878 REGISTER OF WILLS Account Balance $23,128.00 1 COURTHOUSE S�UARE Percent 7axable X 16.687 CARLISLE PA 77013 Amount Subject to Tax $3,854.74 Tax Rate X 0.045 NOTE': it ta�c payments are made wflhin three months of the Potentlal Tax Due $173.46 decedent's date ot deaih,deduct a 5 percent dtscount on lhe tax Wlih 5°/,Discount(Tauc x 0.95) $(sea NOTE') due. A�inherita�e tax due will become delfnquent nfne morrths after the date of deeth. PART Step 1 : Piease check the approprlate boxes beiow. . 1 A QNo tax is due. I am the spouse of the deceased or 1 am the parent of a decedent who was 21 years old or younger at date of death. Proceed!o Step 2 on reverse. Do not check any other boxes and disiegard fhe amount shown above as PotenNal Tax pue. g �The Informatlon fs The above information is carect,no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on raverse. Do not check any olher boxes. � ❑The lax rate is incorrect. � 4.5% 1 am a Iineal beneflciary(parent,child,grandchild,etc.)of the deceased. (Select correct tax rate a[ rfgM,and compfete Part � �2q, i am a sibling of the deceased. 3 on�everse.) _ � 15% All other relationshfps(Inciuding none). p �Cha�es or deductlons The Informatlon above is incorrect and/or debts and deductions were paid. Iisted. Complete PaA 2 and paA 3 as appropriete on the bacN of thls form. E �Asset will be reported on The abc,ve-identiTied asset has been or will be reported and tax paid wiih the PA Inheritance Tax Inheritance tax form Retum flled by the estate represantative. REV-1500. Proceed to Sfep 2 on reverse. Do not check any ofher boxes. Please sign and date the back of the form when finished. . . , , i PART Debts and Deductions 2 Allowable debts and deductions must meet both ot the fallowing criteria: A. The decedenl was legally responsible(or paymenl,and Ihe estate is insufficient to pay the deductibie items. B. You paid the debls after the death of ihe decedent and can(urnish proof ot paymen[if requested by fhe departmeni. (If additlonal space fs required,you may attach 81l2"x 11"sheets ot paper.) Date Paid Payee Descriptlon Amount Paid I Total Enter on Line 5 of Tax Calculatlon $ PAR7 Tax Calculat+on 3 If you ere making a correction to the estebllshment dete(Line 1)account balance(Line 2),or pereent taxable(Llne 3), please oWaln e w�itten correctlon from the Sinsncisl InatNUtion and altach It to thfs form. 1. Enter the date the account was established or tlUed as it existed al the daie of death. 2. Enter the total balance oi the account including any interest accrued at the date of death- 3. Enter ihe percentage of the account that is iaxable to you. a. First,determ(ne the percentage owned by the decedent. (. Accounts that are held"in trust for"anoiher or others were 100%owned by tha decedent. ii. For oint accounls established mare than one year prior to Ihe date ot death,the percentage taxable is 100%divided by 1 e totai number ot owners including the decedent. (For example:2 owners=50�0,3 owners=33.33%,4 owners =25�0,etc.) b. Next,dfvide the decedenPs percentage owned by Ihe number ot survlving owners a beneflciaries. 4. The amount subject to tax is determined by muittplying the account balance by the percent iaxable. 5. Enter the total of any debts and deductions claimed(rom Part 2. 6. The amount taxabfe is determined by subtracting the debts and deductions Irom the amount subject to iax. 7. Enter the apprapriate tax tate tram Stap 1 based an your relatlonshlp to the decedent. If indicating a diiferent tax rate,piease s(ate your refationsMp 10 ihe decedeM: 1. Data Established i 2. Account Belance 2 S 3. Perce�t Taxable 3 X 4. Amounl Subjec�to Tax 4 S 5. Debts and Deductions 5 - 8. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 S 9. With 5Yo Discount(Tax x.95) 9 x Step 2: Slgn and date betow. Return TWO comple�ed and signed copies to the ReQlsier of Witls Iisted on the front of this form, along with a check tor any payment you are maktng. Checks must be made payable to"Register of Wilis,Agent" Do not send payment direcNy to the Department of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true,cor�ect and complete ro the best of my knowledge and bellef. Work �� K � Home Taxpayer Signa e Telephone Number�. ��" ��y Da e -a 9-r j IF YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPAR7MENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AfVDlOR SPEAKING NEEDS ONLY: 1-800-447-3020 � • � f s��aF t��,o��:��ES � enns lvania «o eaz zeoeo� Pennsylvania lnheritance Tax P y NMRISeURG PA 1712i-o6ot Information Notice DEPARTMEN70FNFVENUE �n-�sa a o..EUC�u.�zf And Taxpayer Response FILE NO.2�12-�o5s ACN 12166267 DATE 12•10-2072 Type of Account � Estate ot RICHARD D SHUEY �Savings SSN Checkfng Date of Death 09-03-2012 Trust JAMES C SHUEY CountyCUMBERLAND Certilfcate 505 WARREN ST � LEMOYNE PA 17043-2037 � � aNC eaNK Na provided the department with the information below indicating that at the death of the above-named decedent ou were a'olnt owner or beneficia of the account identified. Remit Payment and Forma to: AccountNo.5140057978 Date Establlshed Ot•01-7978 REGISTER OF WILLS Account Baiance $23,728.00 1 COURTHOUSE S�UARE Perceni Tauable X 16.667 CARLISLE PA 170Y3 Amount Sub�ect to Tax $3,854.74 Tax Rate X 0.045 Potent(al Tax Due $173.48 NOTE': If tax payments are mede within ihree monihs of ihe decedent's date of death,deduct a 5 percent discount on the tax Wlih 5%Discount(Tax x 0.95� $(see NOTE') due. Any inheritance tax due will become delinquent nine months aHer the date of deaih. PART Step 1 : Please check the appropriate boxes below. t A �No tax is due. I am the spouse of the deceased or I am the pare�t of a decedent who was 21 yeare otsJ or youreger at da!e cf deaih. Proceed to Step 2 on reverse. Do not check any other bwces and dlsregard 4he amount shown above as PotenNal Tax Due. g �The Information is The above information is correct,no deductlons are being taken,and payment will be sent correcl. with my response. Proceed to Sfep 2 on reverse. Do not check any other baxes. � a The tax rate is incorrect. � 4.5% I am a Iineal beneficiary(parent,child,grandchild,etc.)of the deceased. (SeleCt correct tax rate at righi,and complete Part � �p>/, I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships(including none). p O Changes or deductions The Intormation above is incorrecl and/ar debts and deductions were pa(d. Ilsted. Compfete Part 2 and part 3 as appropriate on the back o/fhls/orm. E dASSet will be reported on The above-ideniiFied asset has been or wAI be reported and tax paid with the PA Inheritance Tax inherifance tax form Return Iiled by the estate representetive. REV-1500. Proceed to Step 2 on ieverse. Do not check any ofher boxes. Please sign and date the back of ihe form when finished. • - .� � � P 2RT Debts and Deductions I Allowable debts and deductions must meel both o(the following cri[eria: A. The decedent was legally responsible for payment,and the estate is insuiticlent to pay the deductible items. B, You peid the debGS after Ihe death ot the decedent and can furnish praof of payment if requeated by the department. (If additfonal space is required,you may attach S 1/2"x 11"sheets of paper.) Da[e Paid Payee Descriplion Amount Paid ' Total Enter on Line 5 of Tax Calculatlon $ PART T8X CBICUIBtlOf1 3 If you are makfnp a correctlon to the establishment dete(Llne 7)account balance(Line 2),or percent laxable(Line 3), please oblaln e wrltten correctlan trom the tinancial Inatttutlon end edach it to lhis form, 1. Enter ihe date the account was eslablished or titled as it existed at the date oT death. 2. En[er the total balance of ihe account including any inlerest accrued at ihe date of death. 3. Enter the percentage of the account that is taxabie to you. a. First,determine ihe percentage owned by the decaient. i. Accounts that are held"in trustdo�"another ar olhers were 100%owned by the decadent. ii. Fa jo(nt accounta esteblished more than one year prlor to the date of death,the percentage taxab�e is t 00Y>dlvided by tha total number ot owners including the decedent. (For example:2 owners=50%,3 owners=33.33qo,4 owners °25%,etc.) b. Next,dlvide the decedent's percentage owned by the number of survfv(ng owners or beneticlaries. 4. The amount subjeci to tax is determined by multiplying fhe account balance by the percent iaxabie. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and dedudfons from the amount subject to tax. 7. Enter the appropriate tax rate from Step i based on your relationship to the decadent. If indicating a ditferent tax rate,please state your relationshlp ta the decedent: 7. Date Established i 2. Account Balance 2 $ 3. Percent Taxable 3 x 4. Amount Subject to Tax 4 S 5. Debts and Deductlons 5 - 5. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 $ 9. With 5°�Discouni(Tax x.95) 9 X Step 2: Sign and date below. Return TWO completed and sfgned copies to tha Ragister ot Wllls Iisted on the Iront of this form, along with a check for any payment you are making. Checks must be made payable to"Register ot Wllls,AgenL" bo not send payment directiy to the Department ot Revenue. Under penalry of pery'ury, I declare thai the fects I have reparted above are true,correct and complete ro the best ot my knowledge and belfet. �� Work F a Home "11�-1?�F-- J(�J 5-Z1-13 Taxpayer Signature V Telephone Number • Date IF YOU NEED FURTHER ASSISTANCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 euaEnu oF iNOrvmun� Taxes Pennsylvania lnheritance Tax � pennsylvania Po BoX 28U6o1 DEPARTMENT OF REVENUE HARRISBURG PA 17128-06 01 Information Notice � �-- eev �sae ex oe�exec eoeaa And Taxpayer Response FILE NO.2170 ACN 12155569 DATE 10-OS-2012 Type of Account Estate of RICHARD D SHUEY Savings SSN Checking Date of Dea[h 09-03-2012 Trust PAUL R SHUEY CountyCUMBERLAND X Certificate 505 WARREN ST LEMOYNE PA 17043-2037 PNC BANK NA provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Account No.21001030365 Remit Payment and Forms to: Date Established OS-16-1989 REGISTER OF WILLS Account Balance $39,484.00 1 COURTHOUSE SaUARE Percen[Taxable X 50 CARLISLE PA 17013 Amount Subject to Tax $ 19,742.00 Tax Rate X 0.045 NOTE': If tax payments are made within three months of the Potential Tax Due $888.39 decedenYs date of death,deduct a 5 percent discount on the tax With 5% Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A �No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. g �The information is The above information is correct, no deductions are being taken, and payment will be sent cerrec?. with my respenee. Proceed to Step 2 on reverse. Do not check any other boxes. � �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent, child,grandchild, etc.) of the deceased. (Select correct tax rate at right, and complete Part � �2% I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships (including none). p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Comp/ete Part 2 and part 3 as appropriate on the back of this form. E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other bozes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment, and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is required,you may attach 8 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If you are making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), please obtain a written correctfon fram the financial institution and attach it to this form. �. Enter the date the account was established or titled as it existed at the datc of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First,determine the percentage owned by the decedent. i. Accounts that are held"in trust for"another or others were 100%owned by the decedent. ii. For joint accounts established more than one year prior to the date of death,the percentage taxable is 100%divided by the total number of owners including the decedent. (For example:2 owners= 50%, 3 owners=33.33%,4 owners =25/o, etc.) b. Next,divide the decedenYs percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate, please state your relationship to the decedent: 1. Date Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 $ 9. With 5% Discount(Tax x .95) 9 X Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of Wilis, Agent." Do not send payment directly to the Department of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and belief. Work Home TaxpayerSignature j�� S TelephoneNumber ;��. ��y_S��S DateS _��- �3 IF YOU NEED FURTHER ASSIST NCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 _ B�R�nu oF �NO�vro�A� TAXES Pennsylvania lnheritance Tax � pennsylvania Po BOX 2EO6o1 DEPARTMENT OFREVENUE HARRISBIIRG PA P128-0601 Information Notice p¢v-isae ex m�exec �oe-�n And Taxpayer Response FILE NO.2170 ACN 12155570 DATE 10-OS-2012 Type of Account Estate of RICHARD D SHUEY Savings SSN Checking Date of Death 09-03-2012 Trust PAUL R SHUEY CountyCUMBERLAND X Certificate 505 WARREN ST LEMOYNE PA 17043-2037 PNC BANK NA provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: AccountNo.21001030364 Date Established 08-16-1989 REGISTER OF WILLS Account Balance $88,975.00 1 COURTHOUSE SQUARE CARLISLE PA 17013 Percent Taxable X 50 Amount Subject to Tax $44,487.50 Tax Rate X 0.045 NOTE': If tax payments are made within three months of the Potential Tax Due $2,001.94 decedenYs date of death,deduct a 5 percent discount on the tax With 5%Discount(Tax x 0.95) $ (see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART $tep 1 : Please check the appropriate boxes below. 1 A �No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potentia/Tax Due. g �The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. � �The tax rate is incorrect. � 4.5% I am a lineal beneficiary (parent,child, grandchild,etc.) of the deceased. (Select correct tax rate at right, and complete Part � 12% I am a sibling of the deceased. 3 on reverseJ � 15% All other relationships (including none). p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Comp/ete Part 2 and part 3 as appropriate on the back ol this lorm. E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment, and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is required, you may attach 8 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total (Enter on Line 5 of Tax Calculation) $ PART Tax Calculation 3 If you are making a correction to the establishment date(Line 1)account balance(Line 2),or percent taxable(Line 3), please obtain a written carrection from the financial institution and attach it to this form. 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First,determine the percentage owned by the decedent. i. Accounts that are held"in trust for"another or others were 100%owned by the decedent. ii. For joint accounts established more than one year prior to Ihe date of death, the percentage taxable is 100%divided by the total number of owners including the decedent. (For example:2 owners=50%, 3 owners=33.33%,4 owners =25%, etc.) b. Next,divide the decedenYs percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deduc[ions from the amount subject to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate, please state your relationship to the decedent: 1. Date Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 $ 9. With 5%a Discount (Tax x .95) 9 X Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of[his form, along with a check for any payment you are making. Checks must be made payable to"Register of Wilis, Agent:' Do not send payment directly to the Department of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. Work Home Taxpayer Signature P� � �� Telephone Number,��.�, � �y .S��,SDate S.a9_ �3 IF YOU NEED FURTHER ASSIS NCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ON LY: 1-800-447-3020 BoR�� oF INOIVIOUAL TAXES Pennsylvania lnheritance Tax � pennsylvania PO BOX 250601 DEPARTMENT OFREVENUE HPRRISBORG PA 77128-0601 Information Notice . wE.-,��,Ex uo�excc �oeav And Taxpayer Response FILE NO.2170 ACN 12155571 DATE 10-08-2012 Type of Account Estate of RICHARD D SHUEY �Savings SSN Checking Date of Death 09-03-2012 Trust PAUL R SHUEY CountyCUMBERLAND X Certificate 505 WARREN ST LEMOYNE PA 17043-2037 PNC BANK NA provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: AccountNo.21001030369 Date Established 09-27-1989 REGISTER OF WILLS Account Balance $84,798.00 1 COURTHOUSE S�UARE Percent Taxable X 50 CARLISLE PA 17013 � Amount Subject to Tax $42,399.00 Tax Rate X 0.045 Potential Tax Due $1,907.96 NOTE`: If tax payments are made within three months of the decedent's date of death,deduct a 5 percent discount on the tax With 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A �No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potentia/Tax Due. g �The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. � �The tax rate is incorrect. � 4.5% I am a lineal beneficiary (parent, child,grandchild, etc.) of the deceased. (Select correct tax rate at right, and complete Part � 12% I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships (including none). p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Comp/ete Part 2 and part 3 as appropriate on the back o/this lorm. E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do no�check any other boxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment, and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. pf additional space is required,you may attach 8 V2"x 11"sheets of paperJ Date Paid Payee Description Amount Paid Total (Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If ou are makin a correction to the establishment date Line 1 account balance Line 2 ,or Y g ( ) ( ) percent taxable(Line 3), please obtain a written correction from the financial institution and attach it to this form. 1. Er.ter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First,determine the percentage owned by the decedent. i. Accounts that are held"in trust for"another or others were 100%owned by the decedent. ii. For joint accounts established more than one year prior to the date of death, the percentage[auable is 100%divided by the total number of owners induding the decedent. (For example:2 owners=50%, 3 owners =33.33%, 4 owners =25%,etc.) b. Next,divide the decedent's percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate,please state your relationship to the decedent: 1. Date Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 $ 9. With 5% Discount (Tax x .95) 9 X . , Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills, Agent." Do not send payment directly to the Department of Revenue. Under penalty of perjury, I declare that the Facts I have reported above are true,correct and complete to the best of my knowledge and belief. Work Home Taxpayer Signature �� Telephone Number,��,� . ��y .S��S Date S-ag - I j IF YOU NEED FURTHER ASSISTA CE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ON LY: 1-800-447-3020 a�R�,� oF INDIVIOUAL TAxES Pennsylvania lnheritance Tax � pennsylvania Po eoX 280601 DEPARTMENT OFREVENUE NARRISBURG PA 1�128-0601 Information Notice NEV-1543 E%DocEXEC (OB-13) And Taxpayer Response FILE NO.2170 ACN 12155572 DATE 10-OS-2012 Type of Account Estate of FiICHARD D SHUEY �Savings SSN Checking Date of Death 09-03-2012 Trust PAUL R SHUEY County CUMBERLAND X Certificate 505 WARREN ST LEMOYNE PA 17043-2037 aNC BANK NA provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: AccountNo.31500049744 Date Established 07-29-1996 REGISTER OF WILLS Account Balance $91,328.00 1 COURTHOUSE SQUARE CARLISLE PA 77013 PercentTaxable X 50 Amount Subject to Tax $45,664.00 Tax Rate X 0.045 NOTE": If tax payments are made within three months of the Potential Tax Due $2,054.88 decedent's date of death,deduct a 5 percent discount on the tax With 5% Discount(Tax x 0.95) $(see NOTE`) due. Any inheritance tax due will become delinquent nine months after the date of death. PART $tep 1 : Please check the appropriate boxes below. 1 A �No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tax Due. g �The information is The above information is correct, no deductions are being taken, and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. � �The tax rate is incorrect. � 4.5% I am a lineal beneficiary(parent, child, grandchild, etc.)of the deceased. (Select correct tax rate at right, and complete Part � �p��o I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships (including none). p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. lis[ed. Comp/ete Part 2 and part 3 as appropriate on the back of this form. E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the es[ate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. PART Debts and Deductions 2 Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment, and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is required,you may attach 8 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Calculation $ PART Tax Calculation 3 If ou are makin a correction to the establishment date Line 1 account balance Line 2 ,or Y 9 ( ) ( ) percent taxable(Line 3), please obtain a written correction from the financial institution and attach it to this form. 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First, determine the percentage owned by the decedent. i. Accounts that are held"in trust for"another or others were 100%owned by the decedent. ii. For joint accounts established more than one year prior to the date of death, the percentage taxable is 100%divided by the total number of owners including the decedent. (For example:2 owners=50%, 3 owners=33.33%, 4 owners =25%,etc.) b. Next, divide the decedenYs percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate,please state your relationship to the decedent: 1. Date Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 $ 9. With 5% Discount (Tax x .95) 9 X Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills, Agent" Do not send payment directly ro the Department of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true,correct and complete to the best of my knowledge and belief. Work Home TaxpayerSignatureN�j � J TelephoneNumber,�� , ��y S�GS Date S-�y- �� IF YOU NEED FURTHER ASSIS ANCE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 BUREAU oF INDiVIOUAL TAXes Pennsylvania lnheritance Tax � pennsylvania Po BOX 280601 DEPARTMENT OFREVENUE HARRISBURG PA 17128-0601 Information Notice .. . __ aE,-„�, Ex mccxEC �oa m And Taxpayer Response FILE NO.2170 ACN 12155573 DATE 10-OB-2012 Type of Account Estate of RICHARD D SHUEY �Savings SSN Checking Date of Death 09-03-2012 Trust PAUL R SHUEY CountyCUMBERLAND X Certificate 505 WARREN ST LEMOYNE PA 17043-2037 PNC BANK NA provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. RemitPaymentand Formsto: AccountNo.31000234041 Date Established 07-08-2003 REGISTER OF WILLS Account Balance $89,865.00 1 COURTHOUSE SoUARE CARLISLE PA 17013 Percent Taxable X 50 Amount Subject to Tax $44,932.50 Tax Rate X 0.045 Po[ential Ta�c Due $2,021.96 NOTE`: If tax payments are made within three months of the decedenYs date of death, deduct a 5 percent discount on the tax With 5%Discount(Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART Step 1 : Please check the appropriate boxes below. 1 A �No tax is due. I am the spouse of the deceased or I am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potential Tar Due. g �The information is The above information is correct, no deductions are being taken,and payment will be sent correct. vaith my response. Proceed to Step 2 on reverse. Do not check any other boxes. � �The tax rate is incorrect. � 4.5% I am a lineal beneficiary (parent,child, grandchild, etc.) of the deceased. (Select correct tax rate at right, and complete Part � 12% I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships (including none). p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Complete Part 2 and part 3 as appropriate on the back of this form. E Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. PART 2 Debts and Deductions Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment, and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is required, you may attach 8 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total (Enter on Line 5 of Tax Calculation) $ PART Tax Calculation 3 If ou are makin a correction to the establishment date Line 1 account balance Line 2 , or Y 9 ( ) ( ) percent taxabie(Line 3), please obtain a written correction from the financial institution and attach it to this form. 1. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First, determine the percentage owned by the decedent. i. Accounts that are held"in trust for"another or others were 7 00%owned by the decedent. ii. For joint accounts established more than one year prior to the date of death,the percentage taxable is 100%divided by the total number of owners including the decedent. (For example:2 owners= 50%, 3 owners=33.33%, 4 owners =25%, etc.) b. Next,divide the decedenYs percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. It indicating a different tax rate, please state your relationship to the decedent: 1. Date Established 7 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 $ 9. With 5% Discount(Tax x .95) 9 x Step 2: sign and date below. Return TWO comple[ed and signed copies to the Register of Wills listed on[he front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills, Agent:' Do not send payment directly to the Department of Revenue. Under penalty of perjury, I declare that[he facts I have reported above are true,correct and complete to the best of my knowledge and belief. Work Home Taxpayer Signature a� � � Telephone Number,� ,� 779 -SO(�5 Date j_�� , � IF YOU NEED FURTHER ASSISTA CE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 I BUREAU oF INOIVIOUAL TAxES Pennsylvania lnheritance Tax � pennsylvania Po BoX 2BO6a1 DEPARTMENTOFREVENl1E HARRISBURG PA 1 7128-0601 Information Notice . pE,-,,,,Ex oe=exe< <oean And Taxpayer Response FILE NO.2170 ACN 12155574 DATE 10-OS-2012 Type of Account Estate of RICHARD D SHUEY �Savings SSN Checking Date of Death 09-03-2012 Trust PAUL R SHUEY County CUMBERLAND X Certificate 505 WARREN ST LEMOYNE PA 17043-2037 rHC BANK NA provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: AccountNo.31300312256 Date Established OM17-2007 REGISTER OF WILLS Account Balance $71,867.00 1 COURTHOUSE SQUARE CARLISLE PA 17013 PercentTaxable X 50 Amount Subject to Tax $35,933.50 Tax Rate X 0.045 NOTE`: If tax payments are made within three months of the Potential Tax Due $1,617.01 decedenYs date of death,deduct a 5 percent discount on the tax With 5%Discount (Tax x 0.95) $(see NOTE') due. Any inheritance tax due will become delinquent nine months after the date of death. PART St@p 1 : Please check the appropriate boxes below. 1 A �No tax is due. I am the spouse of the deceased or 1 am the parent of a decedent who was 21 years old or younger at date of death. Proceed to Step 2 on reverse. Do not check any other boxes and disregard the amount shown above as Potentia/Tax Due. g �The information is The above information is correct, no deductions are being taken,and payment will be sent correct. with my response. Proceed to Step 2 on reverse. Do not check any other boxes. � �The tax rate is incorrect. � 4.5% I am a lineal beneficiary (parent, child, grandchild, etc.) of the deceased. (Select correct tax rate at right, and complete Part � 12% I am a sibling of the deceased. 3 on reverse.) � 15% All other relationships (including none). p �Changes or deductions The information above is incorrect and/or debts and deductions were paid. listed. Comp/ete PaR 2 and part 3 as appropriate on the back of this form. E �Asset will be reported on The above-identified asset has been or will be reported and tax paid with the PA Inheritance Tax inheritance tax form Return filed by the estate representative. REV-1500. Proceed to Step 2 on reverse. Do not check any other boxes. Please sign and date the back of the form when finished. PART 2 Debts and Deductions Allowable debts and deductions must meet both of the following criteria: A. The decedent was legally responsible for payment, and the estate is insufficient to pay the deductible items. B. You paid the debts after the death of the decedent and can furnish proof of payment if requested by the department. (If additional space is required, you may attach 8 1/2"x 11"sheets of paper.) Date Paid Payee Description Amount Paid Total Enter on Line 5 of Tax Calculation) $ PART Tax Calculation 3 If ou are makin a correction to the establishment date Line 1 account balance Line 2 , or Y 9 ( ) ( ) percent taxable(Line 3), please obtain a written correction from the financial institution and attach it to this torm. i. Enter the date the account was established or titled as it existed at the date of death. 2. Enter the total balance of the account including any interest accrued at the date of death. 3. Enter the percentage of the account that is taxable to you. a. First,determine the percentage owned by the decedent. i. Accounts that are held "in trust for"another or others were 100%owned by the decedent. ii. For joint accounts established more than one year prior to the date of death,the percentage taxable is 100%,divided by the total number of owners including the decedent. (For example:2 owners =50%, 3 owners=33.33%,4 owners =25%, etc.) b. Next,divide the decedenYs percentage owned by the number of surviving owners or beneficiaries. 4. The amount subject to tax is determined by multiplying the account balance by the percent taxable. 5. Enter the total of any debts and deductions claimed from Part 2. 6. The amount taxable is determined by subtracting the debts and deductions from the amount subject to tax. 7. Enter the appropriate tax rate from Step 1 based on your relationship to the decedent. If indicating a different tax rate, please state your relationship to the decedent: 1. Date Established 1 2. Account Balance 2 $ 3. Percent Taxable 3 X 4. Amount Subject to Tax 4 $ 5. Debts and Deductions 5 - 6. Amount Taxable 6 $ 7. Tax Rate 7 X 8. Tax Due 8 $ 9. With 5% Discount(Tax x .95) 9 X Step 2: Sign and date below. Return TWO completed and signed copies to the Register of Wills listed on the front of this form, along with a check for any payment you are making. Checks must be made payable to"Register of Wills,Agent." Do not send payment directly to the Departmen[of Revenue. Under penalty of perjury, I declare that the facts I have reported above are true, correct and complete to the best of my knowledge and belief. Work Home Taxpayer Signature �� Telephone Number��,� ��y _SU�S Date 5 .��, _�� IF YOU NEED FURTHER ASSIS CE, CONTACT CUMBERLAND COUNTY REGISTER OF WILLS, PA DEPARTMENT OF REVENUE DISTRICT OFFICE, OR THE INHERITANCE TAX DIVISION AT 717-787-8327. SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND/OR SPEAKING NEEDS ONLY: 1-800-447-3020 _ _ . .__ _ _ i B(IREAU OF n�orvroua� if�XES e� pennsylvania Pa aax xaoso� Pennsylvania lnheritance Tax HAFRISeURG PA ll12B-06o1 Information Notice DEPHRTMENTOFREVENUE And Taxpayer Response �`�""E��`�'�� _� FILE NO. 2170 � ACN 721ti6447 . DATE 10-12-2012 Type oi Account Esta[e of RICHARO D SHUEY 8 Savings � � SSN Checking Date of Death 09-03-2012 Tmst PAUL R SHUEY County CUMBERLAND X Certificate 505 WARREN ST LEMOYNE PA 17043-2037 PNC HANK NA provided the department with the information below indicating that at the death of the above-named decedent you were a joint owner or beneficiary of the account identified. Remit Payment and Forms to: Account No.3170036719A Date Establlshed 09-23-2071 REGISTER OF WILLS Account Balance $47,199.00 1 COURTHOUSE S�UARE Percenf Taxable X 100 CARLISLE PA 17013 � Amount Subject to T2x $47,}gg.pp -. Tax Rate X 0.045 NOTE': lf tax payme�ls are made wiihin three months of ihe Potential Ta�c Due $2,123.96 decedenPs date of death, deduct a 5 percent discount on the tax With 5%Discoun[(Tax x 0.95) $(see NOTE`) due. Any inheritance tax due will become delinquent nine months atter the date of deaih. — - i PART Step 1 : Piease check the appropriate boxes below. 1 A �No tax is due. I am the spouse of the deceased or i am the parent of a decedent who was 21 years old or younger at date of death. Proceed fo Step 2 on reverse. Do not check any olher boxes and disregard the amount shown above as Pofenlial Tar Due. . g �The information is The above information is correct, no deduciions are being taken, and payment will be sent correct.- - - with my response. � � Proceed to Step 2 on reverse. Do not check any otlier boxes. � ❑The tax rate is incorrect. � 4.5°f 1 am a lineal beneiiciary(parent,chitd,grandchild,etcJ of the deceased. (Select correcl tax rate at «ght,and complete Part � }pgo I am a sibling oi the deceased. . 3 on reverse.) � 15 f All other relalionships �including none). p ❑Changes or deduciions The information above is incorrect and/or debis and deductions were paid. I listed. Complete Part 2 and part 3 as appropriate on the back of this form. E a Asset will be reported on The above-ident(tied asset has been or will be reported and iax paid with the PA Inheritance Tax inheritance tau torm Retum filed by ihe estate represeNative. REV-1500. Proceed to Step 2 on reveise. Do not check any oihe�boxes. Please sign and date the back of the form when finished. I I � Woodlawn Memorial Gardens HunalNo. CONTRACTNO. Osiris Holding of Pennsylvania � � 4855 Londonderry Road • Harrisburg,PA 17109 717-5453777 �. Property Deed No. ioday's Dazc: WTEHMENT/ENTOFIDMENT AUTHORIZATION AND ADEMNg'ICATION . � -DATA ONDECEASED- ' N�E� D.O.B. p.0.0. TASEOFDFATFI SIX AGE MARIiAL5fAT115 — �HfF .�r ADDRESS ' VEfERAN: � YES' / �Np . _ WAR RECURD : � PLACEOFDEnTH: - . . . _ : ' .'y' .. ; ; �, . : � -DATA ON NEXT OF KIN AND SECOND NEXT OF KII�OR REYItESENtATIVE- �'H�E- AEIATIONSF�-, PHONE: woarss, . - . ._ 2.NAME: RELATION51�: � PHONE: ADDRESS: -DATA ON PROPERTY OWNER- NAME: 0.ELATIONSF�: PHONE: � AD�RESS: �INTERMEMLEMfOMBIrIF..Nt/INURNMP,N7'DATA- - CALL RECErvID DATE: TQ� BY: FUNERAL HOME � ADDRESS: . PHONE FUNERh1NOtkCOMACI: £UN£IULDIXECIOR . ., :',i�y. . _.. . DAY: DAiEOFBIJiUAL: FUNflUL FUNER.U,HOM1� _CHURQi _�p.�TERy: ESfAiWywATCQ.ffT£AY stxn�,v: m.�: . .. -MAUSOLEUM- . . TEMP:_ MALISpI,EUTANAME�. SECilONNO. LEVELNO. G4YPfMICF¢N0. L£ITERMG:C0.YPiP[NE� - � P�: YES/NO IINCISWGISIROLLDEATHDATENEEDED: YES I NO I AEIJGIOUSAFFQIA'fION/OTEgR . .gjJRIAj�. . GAADEIJNAMFI LOTNO, GAAVE(S) SP1GL&REO.' TYPEOFO[ITERBNUALCOMAWER 011TtRBUAULCOMAINEY,Cq.: � SEClION NO. pq SIDEHYSID£ � t . CHAtELSERNCE �.GRAVESmE OTE6R OTk�li�ptlALQ.51'RUL1]ON55PECW.FQUIPI�SIi: . PNMAfOR1A1.MSfAl1ID:TES/Ji0 � � SCROLL DEATH pA2FJENGMV➢JG N££DFD: YES/}q � -CURRENT CBARGES AND PREPAID IIVFORMATION-.. . . PRENEED COMRACI': DATE NUhIBER SELLING PRICE AMOiINT DUE OPENMGIQOSPIG `;�� , . �VAULTNAVLT MSiw�� cnsxer MAItKER/BASE PROPERTY OTH£R AMOUNTDIIE'fOHERECENLDFROM: _PAAILLY _PVNER.U,DIRBCTOR TpTALDIK: �jl-:�{��. ' _ � : Thc wdcrsignetl hcecby¢etiGo�Nry M1avc Nc full lcgal auNonry b dirat Wc Intumm4�mmbmcnt,or Inumment of thc rcmik af Nc tleccvscd,and fiunby.uNm- iss Ihc ccmcmry ro make disponcon af Ne remaiv otNe dcacted u indinlyd.Tee wdvsignetl M1vcby fiutha certfy vM reprcpcut Maz thry ere ownn(e)or euthar- aed reprommuve(c)ef Nc owner(a)at fAc above desmbW Inierment Itights md M1veby autlweize use of said Intrmmmt Righ¢of ihe Iuremsn4�mmbment or In�mnmrnt of Ne fertdro of thc heeeir,nametl tleccased. ]Te rmetcy is hertby Ei�ectW W supwise irt�tallaGOn m mshll any ouror burial conhinv,b tLc ratrn� required by law,pu�eM1esed in connxnon wiN Nis Intmnent ub Ne In�ermmt Aigti6 tlambed haein. The undersipied hercby agrte m indemmify ond hold hsmile�s ihe ecme(vy,ih agenh�nd employees hom ury vW di LIABILITY,mcluding rcsson¢ble ammey's fecs,and eguinn any lou it m ihey nvy susvin in rumection witfi Ne lntemmmt��bmrn4 or In�axmxnt autM1orizM hceundec 7Te ecmetny raku grcat care W a.oiE ereoes,but in tlrt crnt w inadvertent error doee orcur,Ne mmctery shall fiave Mie nppt m.emrcct any mor m Ne Intvnmrnt,Fnmmbment w[nummrnS at ils own exyeeue,wiMout wy liabiliry for such ertor. NO]FS: Flowers Ni➢be remorN 3 days Gom burial J — �h[i�% . 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Funeral Expenses for Richazd D. Shuey Paul R. Shuey 505 Wazren Street Lemoyne, PA 17043 September 7, 2012 September 7, 2012 Cash Advance Items Flowers 150.00 Death Certificates 10 N/C Newspaper Death Notice 160.97 Gratuity for Clergy 200.00 Gratuity for Organist 150.00 Total 660.97 Credit Cumberland County Veterans 100.00 Total Due: $560.97 Terms: Net due 30 days. A charge of 1.5% per month (18%per annum) for li`nanficipated late payment will be chazged on any amount unpaid after due date. We accept Mastercazd and VISA chz�k s,�ti `I-�-ia P.O. Box 137 • 324 Hummel Avenue • Lemoyne, PA 17043-0137 • (717) 763-7440 � Fa�c: 717-730-9798 Brian C. Musselman, Supervisor• www.musselmanfunexal.com RECEIPT FOR PAYMENT GLENDA FARNER STRASBAUGH Receipt Date : 9/27/2012 Cumberland County - Register Of Wills Receipt Time : 09 : 03 :43 One Courthouse S quare Receipt No. : 1071516 Carlisle, PA 17613 SHUEY ROBERT D Estate File No. : 2012-01059 Paid By Remarks : SKARLATOS & ZONARICH LLP DMB -- --- -—-- Receipt Distribution - —- -- - —-- Fee/Tax Description Payment Amount Payee Name PETITION LTRS TEST 260 . 00 CUMBERLAND COUNTY GENERAI, FUN WILL 15 . 00 CUMBERLAND COUNTY GENERAI, FUN SHORT CERTIFICATE 16 . 00 CUMBERLAND COUNTY GENERAL FUN JCS FEE 23 . 50 BUREAU OF RECEIPTS & CNTR M.D AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN - ---—----- ----- Check# 24394 $319 . 50 Total Received. . . . . . . . . $319 . 50 The Sentinel AnORNEYS SKARLATOS 8 ZONARICH AD NUMBER PAGE NO. www.cumberllnk.com 17S.SECONDSTREET 415048 1 Of1 C��e'�"' 6TH FLOOR BILL DATE SALESPERSON �� HARRISBURG,PA 17701 717-233-1000 ��ZZ�Z� wolft c.+z�c s..��„+�w� r�;x�camrrv START DATE STOP DATE 10f06/12 'IO/20112 AD NUMBER AD DESCRIPTION CL4SS LINES 415048 ESTATE NOTICE LETTERS TESTAMENTARY 10 PUBLIC NOTICES 42 • 2 eols Publiwtfon Insertfons Rate Net Amount Gross Amount 3 THE SEHTINEL-LEGAL 3 LGL $223.02 TOTAL AD CHARGE $223.02 3 PROOF OF PUBLICATION 01 PRF $7.00 3 MOBILE SITE M0B2 $2.00 purchase order Est. R.D.Shuey PAY THIS AMOUNT $232.02 $278.42• `AFTER 11N6N2 THE SENTINEL Thank you for advertising with The Sentinel! Deadline for clo LEE NEWSPAPERS in-column legal ads is 4:00 p.m.two business days prior to PO BOX 540 date of insertion. For questions, call (717)240-7130. WATERLOO IA 50704-0540 �p1AND �� ti `J �a�sa.,P�°� CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 Tele: (7�7)249-3�66 Fax:(7��249-2663 November 2, 2012 Cumberland Law Joumal is published every Friday by the Cumberland 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: John R. Zonarich, Esquire RE: Richard D. Shuey Estate Legal advertisements must be received by Friday Noon. Ali legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. Advertisement inserted on following dates: October 19, October 26, and November 2, 2012 Advertising Cost $ 75.00 Proof of Publication $ 0.00 Second Proof Request $ 0.00 Payment received $ 75.00 ------------ Total Amount Due $ 0.00 Becky H. Morgenthal, Executive Director MARJORIE A.W EVODAU GLENDA FARNER STRASBAUGH �' FIRSr DEPU-n' REGISTER OF WILLS �e AND - CLERK OF ORPHANS' COURT � , a��;��. � j r�' ` KIRK S.SOHONAGE, ESQ SOLIQTOR °'°r-- — REGISTER OF WILLS AND CLERK OF THE ORPHANS' COURT COUNTY OF CUMBERLAI�ID ONE COURTHOUSE SQUARE CARUSLE, PA 17013 (717) 240-6345 FAX(717)24Q7797 INVOICE Bill To: InvoiceNo: 4268 Invoice Date: 3/4/2013 SKARI.ATOS & ZONARICH L.LP Estate o£ RICHARD D. SHUEY 17 SOUTH SECOND STREET, 6TH FLOOR Estate No: 21-12-1059 DMB HARRISBURG, PA 17101 Qty Fee Description Fee Total 2 Short Certificates 5.00 $10.00 Total: $10.00 Checks should be made payable to the Register of Wills. Tesms: Net 30. Please retum one copy of this invoice with your payment. Thank you. DAUPHIN COUNTY REGISTEFt OF WILLS/CLERK OF ORPHANS' COURT, DAUP4i{N COUtJTY, PA RECEIPT Inv Number: 60247 Invoice Date: 09/24/20'12 9:04:30 AM RECEIPT Reg/Drw ID: 0107 Customer: LastChange: By: pP RICHARD D.SHUEY Chg# Cbarge/Payment/Fee Description Amount Inst#!Inst Date Municipality 1 OATH-RW $20.00 Fee Detail: OATH FEE $20.D0 TOTAL CHARGES $20.00 PAYMENTS CHECK:24389 $20.00 TOTAL PAYMENTS $20.00 AMOUN7 DUE $20.00 PAYMENT ON INVOICE ($20.00) BALANCE DUE 80.00 Date:Sep 24,2012 9:05:02 AM Page 7 pcwunt Number p�pa�e Amount Due 717 774-5005 I894I31Y 1022/12 $2025 ver�'r�on pccountl�ormation " - s staamaeo�: ens��z -; -�"� Y8HZ411I4t'A1t1' .s HICHANO D SHUEY ��p��(Ra�y�#�� Phane: 777-774-5005 �.faa�rey*'R,pyeri"Yae7i�"�M� �BU,;Wa��!'�°`�`�� AccouMSummary Gupap�#rme+� ;, gis.is '�'"�� s PreviausBalance -� - -�----- �; {��F�, . ... . . _.___ ._ . . - � � -519.19 , .r i�, _ _..:; PaymemReceivedSeP10 _. _. _. - . _—.-- . , .:.. .� :.: .. _ _- .__ fD0 ____- ., ... . 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Availabiliiy varies Taxes,terms and�ees apply. p getter Bundle Just For You Order f�OS 15/5 M6ps IMeme1 and home ptane tor onry$79.99/mo.vrith/-year P�e 9��ntee and no term coMract required.LimRed-iime oflec Call 1-888-756-4417 or visil`rerizon.comtthemasl. pvailabiliry vanes_Taz?s,teans and tees aDV�Y� puestions ahout your bill or service? Want Automatic Payment? View your bills in de�ail at vedzoacan or call 1-800-VfAIZoN(�-�-837-496G). irstitNioo to deduct the amouM of your madMYt��rolm ideMifcalion dcade.Cuslaoers wilh di bo�s cal8 i�-80�d4-6006 TTY omer ihe accouM associaled wilh your e�closed check and se�d paymeM di2cty lo Verizon.To discominue Automatic Payment,call Verizon.Pkase keep a copy ot this aNFwriration. � Pkase retum remil slip with paymenl. - --..__._...--- ---- ......_ - .....--� -- -....___-- - ----_..... - ......__----- ---- ----- _ _ Customer Account InformaUon Billing Summary For Service To: R.Shuey •-----•---Prioc Balance---------------------- � 505WarrenSt PriorWaterBalance $74.43 Account�Numtier.24-06290674� Prio�WastewalerBalance $73.45 Premise Number: 24-0371671 " . Paymenfs p�ior fo Oct 70, 2072. ThaM<s! -147 .88 Total:prioc tiaiance,Oct 10; 2012 .00 Billing Period& Meter Information --,---.-Curreni water charges--•------- Billfng �atei Oct 10,.2012 .� :Service Charge � 13.75 BIIIIng�Periodi�Sep�O6.ro Oct 05(29 days) � Watec Valtrme�(.$.009101 ,e 5,900J 53.70 . Next reading onlabouh Nov OS, 2012 _ . DS7-PAWC�Charge 2.0545 � 1 .38 pate Type: ResidentiaL Toial water charges, Ocr, to,2012 68.83 Meter readings in curreni hiiling period: --------AMOUNT pUE ------------------ ,Sti8.83� Moter Num6er N045740836 is a��S18-inch metec � Present-aclual 1078400 . - Lasbac W al 10 72500 ' Gallons used 5900 � .f � � ''i L ;. . . Your Default Supplier Contact Info. Bitling Details - (eiu ncct. o�aaoaa000) Pa�e z �or questlons regarding the generation and transmisslon previous Balance $49.96 portions of this bill,piease contact your suppller at: payment Recefved Sep 10,2012-Thank You I i� PPL Electric Utilities Phone: -$49.96 I Customer Services � 1-80o-342-5775 827 Hausman Rd (1-S00.DIAl-PPL) Bolance as of Oct 4, 2012 $0.00 Allentown,PA 18304-9392 Charges(or-PPL Electric Utll(ties pplelectric.com Resldentlal Rate:RS for Sep 4-Oct 4 Distrlbution Charge: Customer Charge 8.75 Manage Your Account 256 kWh at 335900000C per kWh g,6p PA Tax Adj Surcharge at-0.3450Q000'� -0.06 VISit pplelectric.com tor self-service options Transmission Charge: Including: 256 kWh at 0.68700000C per kWh 1.76 -Vfew your bill,payment,and usage history. Generatlon Charge: -Make a payment,set up a payment agreement. Capacity and Energy •Start/stop service. Z56 kWh at 7.24300000t per kWh 18.55 -Enroll In paperless billing,automatic bill pay, PA Tax Adj Surcharge at-0.2S40q000% -0.05 budget bllling. Totai PPL Elertric Utiiities Charges $37.55 -Report an outage,check outage statu5,and more. , �„ �; � ,� w� .., , , Afiw�t pUR BX Oat 25;�Ql� s . n' ' ,s?$� r�5 Vlew your rate schedule at pp�electric.com/rates or = call 1-800-342-5775 to request a copy. Account Balance $37.55 General information Generation prlces and charges are set by the electric generation supplfer you have chosen. The Public Utility Comm(ssion regulates distributlon rates and services. The Pederal Energy Regulatory Commisston � regulates transmission prices and servfces. PPL Eiedric Utillties uses a6out$0.04 of this blll to pay state taxes and about$2.21 is used to pay the PA Gross Receipts Tax. Understanding Your Blli Customer Charge•MonthlY 6asic dlstribution charge to cover 7ransmission Charge-Charge for moving high voltage costs for billing,meter readfng,equipment,malntenance and- electricity from a generatlon facilityto the distrlbutlon Ilnes of advanced metering when in use. an electnc dlstrlhution company. D(stribution Charge-Charge for the use of lacal wlres, iype�s�of Meter R adlngs: transformers,substations and other equipment used to dellver Actual-Reading�y distributlon company. electricity to end-use consumers from the hlgh voltage transmission lines. Generation Charge-Charge for the production of electricity. kwh(Kilowatt-hour►-fie basfc unit of electric eneray for which most customerS are charged. The amount of electricity s� used by ten 100-watt Ilghts left on for 1 hour. Consumers are usually charged for electriclty in cents per kilowatt-hour. ftate RS-Rate for servlce to a private home. State Tax AdJustment Surcharge-Charge or credit on electric rates to retlect changes in varlous�tate taxes Included in your hill. The surcharge may vary by bill component $37.55 H Pasl BIII InformaUan-UGI Utility � �'� � j . _ ��.s r..�,�E The account balancs nn your last bill vraa ......_......... $25.30 � -^�� '� : Billing Summary fir 3arvia to: Thank you far yrour payment of..................................... -25.30 216544330401 R 0 SHOEY Your balance as of 09(28/2012 ................................."—�.pp 505 WA(iREN ST LEMOYNE PA 77043 Rate Claaaiflcatlare ResidenUal General Current Bill Infirma4on-UGI Udlity Billing Periad: Custumer Charge....................._....................................... 8.55 08/24/2012 ta 09/25l2012(3Z days) Cammadity Charge(20 CCF at$0.58850) ..._......... 7 7.77 Remote Device Read Oistrihution Charges (First 20 CLF at$0.40300) ... 8.06 Quaatiana? PA State Tax.Surcharga .................................................. -0.11 Cail 800-276-2722 or wnte tn I1GI at Tata�Current Charges-I1Gi tltility....__.................._._ 28,27 PO BOX 73009 UGI Utilily eharges awed thia bill .................._.._........_..............................__ ;2B 27 Reading,PA 19fi12-3009 Total Amaunt Due,Pleaae Pay by Due Date(10/1g/2012)..._.,,,__........................ S�2&27 � 'Your current I1GI charges indude State taxes tutaling atiaut$0.91. � I Cal�:�. l0 0 j %C� --�- /�i Average CCF Per Oay Mefer Inlarmatlon-Nexl Read Dafe Ocfoher 25,2012 1.60 Meler Num6er Prmrious fleading Present Reading CCF Ueed 1.44 1471817 209(remote) 229(remMe) 20 - 1.28 7.12 Measaqes from UGI 0.9fi 'Your current prica to compara is$O.fi0244/IxF. 0.80 � •Your tntal annual usage is 319 CCF. Your averaga monthly usage is 26 CCF. 0.64 0.48 •Help prevent pipelina damage,accidents and sennce disruptions.Call B11 hefure you dig. 0.32 •Save time.Sa�e the lanet Si n u tu viaw and a ' 016 P 9 P pyyaurUGl6illsonlineatwww.ugi.cam. 0.00 � SON �JFMAMJJAS - 2011 Montha 2012 Last This Average Year Year - CCF/day O.fi3 O.fi3 �f you pay at a paymant agent please take your entire hiil. Make check a hle to UGI. Daily temperature 68°f fi8°F p Ya Keep this part for your recards. Important laformation is on the back o}this bill. � � � :i �--------------------_—_�l Comcasto ( Account Number 09547 18042401-6 � j BiAing Date 09I07I12 � Total Amount Due $70.55 � Payment Due by 10/01/12 Page 1 of 2 � Contact us:�www.comcast,com�717-540-8900 �.--_-. --- -� � PAUL SHUEY ' 70:55 Previous Balance For serv�ce ai: PaymeM-08/1�f12-thank yau -�� 505 WARREN ST New Charges-see bek�w 7�•� LEMOYNE PA 17043-2037 To�il`At�a�n�t[�ue. + �'�4.5� News from Comcast Pa�yme�,t ��e by �aEa�f12' Thank you for your prompt paymeM. , , • , For your convenience,we now accept regular and �CJ� XFINITY'N �•� automatic moMhly credrt card paymerr[s and direct debit. Taxes>Surcharges 8�Fees 3.� Hearing/Speech Impaired Call 711 TE�ef New Cf�atgeS $7d;� ' , , �. ;<< s eil� dak 5 ti� , �, R y5 a i,rd'`�y"�u�r"4 ,�' 54�`i o � k r , . � a> y, �, "�,� � {,�.^6 „u�?�+ � y9r��r��, e " �� . 1 r � 4 � � �" z��F�tiP,F ^,�5� '��,RS� d�5. Y�xi��s.q.G� v ,� i� � n . �� '� �m`u�.h 51 : � r , k ri^1iS"a'�.Ari�6� i913K�xV ' u�$7.V ;� ,�`7" �,� r � DESCRIPTION OF CHAROE QUANTITY UNiT PRICE AMOUNT � Stretcher One Way Trans Member T2005 l.0 96.06 96.06 Transport Van Mileage S0209 3.4 3.74 12.72 C�� y y -i� ,1�, Total Charges 10$.78 �ESCRIPTION OF PAYMENT RECEIPT PAYMENT DATE AMOUNT Total Credits 0.00 PLEASE PAY THIS AMOUNT— INVOICE DUE UPON RECEfPT --► $108.78 RETURNED CHECK FEE—$31.00 PATIENT NAME: SHUEY, RICHARD D CAIL NUMBER: 232838W AMOUNT PAID: 09/13(2012 IMPORTANT MESSAGES: THIS SERVICE IS NOT COVERED BY MEDICARE OR MEDICAL ASSISTANCE. WEST SHORE EMS -6LS 205 GRANDVIEW AVE SUITE 211 CAMP HILL, PA 17011-1708