HomeMy WebLinkAbout06-10-13 IV 1505610101
.REV-1500 EX(ot-,e) . _
OFFICIAL USE ONLY
T �t
PA Department of Revenue pe mm�a County Code Year File Number
PO 80601 ualTaxes INHERITANCE TAX RETURN
PD BOX rg,PA 1 23 / ZI
Harrisburg PA 17tz8-o6ot RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW _ .1. ' % •
101 9 1174A 17 6:7 TIM
Decedent's Last Name Suffix Decedent's First Name MI
5H �4D � i'2 ® m l c ok � D ❑E
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
I I I I I I= ® I I I I I I n7l= ❑
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
111 P 17110 REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
® 1.Original Return O 2.Supplemental Return O 3. Remainder Return(date of death
t . 1 •111' '- 6 r - prior to 12-13-82)
p 4. Limited Estate O 4a.Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
6.Decedent Died Testate O 7.Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
r (Attach Copy of Will) (Attach Copy of Trust)
O 9. Litigation Proceeds Received O 10.Spousal Poverty Credit(date of death O 11. Election to tax under Sec.9113(A)
. . r. between 12-31-91 and 1-1-95) (Attach Sen.O)
CORRESPONDENT- THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name T' Daytime Telephone'P
Cy � QLeS SHIELDS / / I 7iMag - 2'oy
rrItI ZERO ILLS E PLY
znr t-' mm
f- °
First line of address Z o 0
6 Cl. ouS it Oto � D 3
Second line of address A C-J
t— CD
cn
_ n ti
City or Post Office State ZIP Code DATE FILED
WgAc nvIcs $ uQ6- P� / -7os1s7m- '
Correspondent's e-mail address: Ce5h 1'e1ds30 ea1naast• d,9t
Under penalties of perjury,I declare that I have examined this return,including accompanying schedules and statements,and to the best of my knowledge and belief,
It is We,correct and complete.Declaration of preparer other than the personal representative is based on all Information of which preparer has any knowledge.
SIGNATURE P�rESP NSIBLE FILING RETURN DATE
x
ADDRESS I[SS L G. SAM PErQ 7 OI"cha Dr) /W4rySw%/e, Ai¢ /7,OS3
SIGNATURE REPA R O7H&1j TH RES r IV DATE
X _/v P �r rt l r//�j 3
ADDRESS CNi4QLES E, r5///EGVS /!_1/ (v Clomter R41, 1nec1n1i os6d4i7,A L /7OSJ
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610101 1505610101 J
1505610105
REV-1500 EX
•
RECAPITULATION
1. Real Estate(Schedule A). ..... ...:....fir.................:.:...`.....Y 1. , •,QUO
2. Stocks and Bonds(Schedule B) ....................................... 2. 0
1 J . ,
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ... .. 3. +,Q o
4. Mortgages and Notes Receivable(Schedule D)..................... ...... 4. O Q
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 3 2 9 9 9 r7
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. Jq0
7. Inter-Vivos Transfers 8 Miscellaneous Non-Probate Property
(Schedule G) p Separate Billing Requested.. ...... 7.8. Total Gross Assets(total Lines 1 through 7)........ ........ ............. 8. y '�
9. Funeral Expenses and Administrative Costs(Schedule H)...... ....... ...... 9.
,
10. Debts of Decedent, Mortgage Liabilities,and Liens(Schedule 1) .. ............ 10. O
11. Total Deductions(total Lines 9 and 10)..... .... .... .................... 11. SY S Z, 9 , a 7
12. Net Value of Estate(Line 8 minus Line 11) .. ........ .................... 12. 3
an election to tax has not been made Schedule J rusts for which -,
13.,Charitable and Governmental Beques(slSec 9113; 1 13 ' ..., .� -� 1 ,,
J
14. Net Value Subject to Tax(Line 12 minus Line 13) ........................ 14. 3 8' li b (p 3
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 �t _
(a)(1.2)X.00-
16. Amount of Line 14 taxable - u
at lineal rate X.0 3 8 Lf , 16. 6 9 , O
17. Amount of lane 14 taxable
at sibling rate X.12 Q 17. : 00
18. Amount of Line 14 taxable A
at collateral rate X.15 F I Q �,0 0 18. �j : 0 O
19. TAX DUE ............... .......... .... .:..:::..`........,.. .
-20...FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Side 2
1505610105 1505610105
COMMONWEALTH OF PENNSYLVANIA - - REV-1162 EX(1'1-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES _
DEPT.280601
HARRISBURG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 016895
SHADER RUSSEL G
7 ORCHARD DRIVE
MARYSVILLE, PA 17053
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
---------- ________
101 $4,702.50
ESTATE INFORMATION: SSN: 201-18-2188
FILE NUMBER: 2112-1084
DECEDENT NAME: SHADER MILDRED E
DATE OF PAYMENT: 12/07/2012
POSTMARK DATE: 12/07/2012
COUNTY: CUMBERLAND
DATE OF DEATH: 09/12/2012
TOTAL AMOUNT PAID: $4,702.50
REMARKS: RECEIPT TO ATTY
CHECK# 104
INITIALS: WZ
SEAL - .RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
TAXPAYER
i
.].•..w�� ..v� 3 o-.,:1 .� �r y:-/.� ruifi
i
REV-1500 EX Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
M ;ldred F. Nader
STREETADDRESS
lloo Crandon Guar
CITY IP r r STATE Z
Nam/x�u� Twrt�i�P, /yleclaa��cs6ti.- P.F I7oso
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1)
2. Credits/Payments
A-Prior Payments _ S 749%1.6-49
B.Discount f J_y7,6•pj
Total Credits(A+g) (2) , 9 5-0-04D
3. Interest y
4. If Line 2 is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT. .(3) O
Fill in oval on Page 2,Line 20 to request a refund. (4)
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) ¢�� Zff$.OZ
Make check payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;......................................................................................... ❑
b. retain the right to designate who shall use the property transferred or its income;............................................ ❑
c. retain a reversionary interest;or.........................................................:................................................................ ❑
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑
2. If death occurred after Dec.12,1982,did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................................. ® ❑
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑
4. Did decedent own an individual retirement account,annuity or other non-probate property,which �q
contains a beneficiary designation? .....�.rrQYA�.rblc.TryS}.._,µ}._Qa(p.._�f'tnt..3.htn4itt!.bClx, la ❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate 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 tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percen
[72 P.S. §9116(a) (1.1) (ii)].The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets an(
filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
• The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death to or for the use of a natural parent, ar
adoptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or fot, the use of the decedents lineal beneficiaries is 4.5 percent, except as noted it
72 P.S.§9116(1.2)[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)1.A sibling is defined,unde!
Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
PEV4SOB •(187)
SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE RESIDENT TAX RENT PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
In;ldred �. 5hadcr 2 1-Ia- /o8rf
Include the proceeds of litigation and the date the proceeds were received by the estate.All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
Safe 4 Personatt-y 6y Hizars Attchbn �2S9.00
gS4rle Dv.S"Z b'x .�n✓en�Dy �1a� no 4s sessmble nuns --O
3, /nf-/NaEgs /sf rep. CRFD. uN/onl
ff �Sav;n9s AW /ro, 22280-0o � z&ys. 'fs
8. 4,1,E I,rt. for P.o. ,>. se Zl'ew•F .70
C. C4ecX,' 0641, Nc. 2?.2,fO -// ¢/, 573.ZZ
,F. /Eden <.rf
F. -q8 � ?, ZtXW
G. /leer. 1nt t v.o. a. oa
Z. deer. .Lnf. to
(set 3fnfemeot a/fnclelel)
Sov erei5►1 13a"K
f}. oerf-4' 4 Deposit ;P /A$ Sa.l 053q le5, SD0. 22
6, A aw, .int. fn P-04) on 39
.l, iJes Tiyc Qeft4ri 1, 067.00
Gr ill Ir 6 8.7 3
7 lfems of /Jersonaffy 40t' .--c/o/ W uuzho,m
(S« ScparA a :femiazyYPn altAckd)
/� {[ 1�
Ate colu;a,g (J 130.00
L A
TOTAL(Also enter on line 5,Recapitulation) $ .jy1 g Fy 9D
(If more space is needed,insert additional sheets of the same size)
UAYL 1 z-26-201
www. haars. com HAAR' S AUCTION 717--432-8246
Settlement RUSS SHADER 421-5876 Rage :
Seller: 8000
7 ORCHARD DR
MARYSVILLE PA 17053
Item Description Price Qty Total
- Box lot - cookie jar 1 0. 2500
- Box lot - kitchen item=_ 1 1. 00
- Box lot - flatware 1 2. 00
- Box 13ot - mirror - bear 1 2. 00
- Pox lot - 1 1. 00
- 3 box lots - kitchen items 1 0. 2500
- DVD player 1 10. 00
- 2 players VCR 1 5. 00
- Box lot - stem glasses - 1 1. 00
aeon
- box lots - glassware 1 3. 00
Lox lot - light=_ I 0. 2500
- Chest of drawers-dresser 20. 00 c 40. 00
Pox spring-mattress 25. 00 2 50. 00
- Rack 1 0. 2500
- Cart 1 0. 2500
Table 1 5. 00
- Table 1 0. 2500
Hamper- 1 0. 2500
Walker 1 3. 00
Floor- lamp 1 1. 00
Oak hutch 1 70. 00
Chair 1 0. 2500
Mirror 1 3. 00
- Dresser 1 60. 00
Items : 24 Amount : 259. 00
Commission at 30. 000% 77. 70
Less adjustment=_ : --77. 70
Net d1Ae to 5eller: 181. 30
www. haai-s. com HAAR' S AUCTION 717-432-8246
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MEMBERS 1"
FEDERALCREDrr UNION
SAVINGS ACCOUNT:
Account Number/Suffix 22280-00
Date Account Established 07/1311979
Principal Balance at Date of Death $2845.45
Accrued Interest to Date of Death $0.20
Total Principal and Accrued Interest $2845.65
Name of Joint Owner None
CHECKING ACCOUNT:
Account Number/Suffix 22280-11
Date Account Established 08/29/1986
Principal Balance at Date of Death $1573.22
Accrued Interest to Date of Death $0.00
Total Principal and Accrued Interest - $1573.22
Name of Joint Owner None
CERTIFICATE OF DEPOSIT:
Account Number/Suffix 22280-03
Date Account Established 021282010
Principal Balance at Date of Death $9143.83
Accrued Interest to Date of Death $6.81
Total Principal and Accrued Interest $9150.64
Name of Joint Owner None
CERTIFICATE OF DEPOSIT:
Account Number/Suffix 22280-48
Date Account Established 0629/2010
Principal Balance at Date of Death $2784.44
Accrued Interest to Date of Death $1.94
Total Principal and Accrued Interest $2786.38
Name of Joint Owner None
CERTIFICATE OF DEPOSIT:
Account Number/Suffix 22280.49
Date Account Established 07/192010
Principal Balance at Date of Death $9194.08
Accrued Interest to Date of Death $6.59
Total Principal and Accrued Interest $9200.67
Name of Joint Owner None
SAFE DEPOSIT BOX None
MEMBERS 1sT FEDERAL CREDIT UNION
Tessa LK �
Lending Insurance Support Specialist
November 7,2012
Estate of: MILDRED SHADER
Date of Death:0911212012
Social Security Number: 201-18-2188
5000 Louise Drive • P.O.Box 40 • Mechanicsburg,Pennsylvania 17055 • (800) 283-2328 • www.memberslst.org
Sovereign I C=
a Court Ordered Processing\Decedents- MAl-MB3-02-10 - P.O.Box 841005 - Boston,MA 02284
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E
November 20, 2012
Charles E. Shields, III
Attorney at Law
6 Clouser Rd
Mechanicsburg, PA 17055
k
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a RE: Estate of Mildred E Shader
Date of Death:09/12/2012
g Dear Charles E. Shields, III:
S
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Per your request, enclosed please find the account information as of the date of death
for the above-named decedent. For your information, accrued interest is not included in
the date of death balance.
1 Please feel free to contact me if I can be of any further assistance.
Very truly yours,
E
e
Gonna Penta
Lead Specialist
t
617-514-5189
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Sovereign Bank
ESTATE OF Mildred E Shader
SOCIAL SECURITY#: 201-18-2188
DATE OF DEATH: September 12, 2012
Account#: 1685210534 Type CD Open date: 10/27/1988
In the name of: Mildred E Shader
Date of Death Balance: $5,500.22
Int.(YTD) from l/l/2012 to 8/31/2012 $7.33
Accrued interest to date of death: $0.39
Otherinfo:
Page 1 of 1
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KU Mo M`,S
l/JI 34 WEST MAIN STREET
MECHANICSBURG.PA 17055
APPRAISAL Phone:717-766-9471 APPRAISAL
Appraisal for.
Estate of Mildred Shader November 27, 2012
1. Lady's 14 karat necklace.The necklace includes 11 light blue sapphires with five small,single-cut
diamonds.The chain the necklace is hanging on is gold-filled.
Estate valuation: $35.00
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2. Lady's earrings consist of blue sapphires and small,single-cut diamonds set in yellow cluster mountings.
Estate valuation: $25.00
4;,. VVAII
3. Engagement ring set with three small diamonds and mounted in 14 yellow karat gold..
Estate valuation: $25.00
This appraisal constitutes our carefully studied opinion of
❑the retail replacement cost through our facilities
W the distress sales nature value
of the articles)described above insofar as the mounting(s)have
permitted observation.We assume no liability with respect to any
action t at rpo taken on the basis of this 000raisai.
L� Q C `y1 v �u
Appraiser
MGM u p J
M*S
�Etve&y t0•Ls
34 WEST MAIN STREET
MECHANICSBURG,PA 17055 .
APPRAISAL Phone:717-766-9422 APPRAISAL
Appraisal for
Estate of Mildred Shader November 27, 2012
E.
4. Lady's wedding band in 10 karat yellow gold with three small diamonds.
Estate valuation: $15.00
5. Various pieces of costume jewelry )no photos).
Estate valuation: $35.00
This appraisal constitutes our carefully studied opinion of
❑the retail replacement cost through our facilities
X the distress sales nature value
of the article(s)described above insofar as the mounting(s)have
permitted observdfion.We assume no Iiablty with respect to any
action t t rn tok(�n�p�\1 the basis of this ooaralsal-
Appraiser
(r
A, r
rE ZVF— Y cJ to-tz
34 WEST MAIN STREET
MECHANICSBURG,PA 170.55
APPRAISAL Phone:717-766-9422 APPRAISAL
Appraisal for:
Estate of Mildred Shader(Russ Shader) February 04, 2013
1. Lady's miscellaneous costume jewelry.
Estate valuation: $5.00
2. Lad is 1 4 karat rose pin, with a .05 oint diamond, marked "Tiffan ".
,y
Estate valuation: $125.00
This appraisal constitutes our carefully studed opinion of
❑the retail replacement cost through our facilities
N the distress sales nature value
of the orticlefs)described above insofar as the mountingls)have
permitted observation.We assume no liability with respect to any
action that mov token on the basis of this cooraisal.
L p1�V/AI{
G A6f :yap4
�`� tr praiser
KuM m4S
47r—&y
34 WEST MAIN STREET R.:. ,.P� • n.t.
t.6
MECHANICSBURG,PA 17055
APPRAISAL Phone:717-766-9422 APPRAISAL
Appraisal for. " ter l;
Estate of Mildred Shader December 10,2012
M
1. Lady's Paloma Picasso Magic reversible white/gold pendant in sterling silver and 18 karat gold,
manufactured by Tiffany and Company.
Estate valuation: $25.00
This appraisal constitutes our carefully studied opinion of
❑the retail replacement cost through our facilities
X the distress sales nature value
of the article(s)described above insofar as the mounting(s)have
permitted observation.We assume no IiabTty With respect to any
acttio�5\thQ{[I bet ken nth/e/,1�a'I�is of this appraisal.
Appraiser
REVA510IX•119i)
SCHEDULE G
INTER-VIVOS TRANSFERS&
COMMONWEALTH OF PENNSYLVANIA -
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF m;ldred e. c ha der FILE NUMBER a/`/,2 _/OS T
This schedule must be completed and filed'dthe answer to any of questions i through 4 on the reverse side of the REV-1500 COVER SHEET is yes. -
DESCRIPTION OF PROPERTY %OF
ITEM mauDE THE NME OF THE T NSFEREE.THURR TMWPTO DECEDENT AND THE EUTEOF TRAN� DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER ATMHACOFVOFTHE DEED FOR REM ESTATE. VALUE OF ASSET INTEREST IIFAPaKc e
1. /y)ild/ed E. charier )cnIn;/y, =rrnt/oca.ble
'/rust. �}eCatet/ Se✓cn &1ays pflrior
dde d decede4s Weag, ,Wept
pfd apt. /Z ao/2 respeeNIe/ •
rs" copy all4irchied)
feet:nh 5/ //ro✓•des lor e 'i'd c%'sfi�b-
ul/iorlS Qr110?9 decedents
Chi%dreh t4p*w herdealei , as s Fv//ows: x g37000.0D
10090 3 000.
(,B•J Rr[ssa/ G. �hader Y3 = �D,ODD•O0 �
/�SCQAt ys �lfo,oDO.DO �0090 f3,�o °o 000.00
fie) Cons�a•,r� �. 6%ler }/3 -jf9,°00.D0 /0090 3.0 37,000.00
7e Tif"C t'7. o.Q• li/1•LL<E
j�4m.4,pxel Afotz : 71rc 13
�"jafre,n{f semarr0 t eswh °f A lAree 63)
has been 5d oaf Per doanse/s
Xsectbs:on w/A 8111 Lyons 00 or-t
S, o'tor 2.
all „
�I �0, DOD•° ew,n ufav �,�jeed'tm li'
me,,* r lyt Mderml Creel;} Gin;on area"t
-*,g7638a. 4r 1riW5{u-1Crtd,t far abo✓e
relayed a4id at r-heA Trust.
TOTAL(Also enter online 7,Recapitulation) $ 000 so
(If more space is needed,insert additional sheets of the same size)
THE SHADER FAMILY IRREVOCABLE GRANTORS
TRUST
ANSTINE & SPARLER
JOHN R. ELLIOTT ESQ.
117 EAST MARKET ST.
YORK, PA 17401
717-846-8811
lelliott@anstinesparler.com
I
DECLARATION OF TRUST
THE SHADER FAMILY IRREVOCABLE GRANTORS TRUST
The Trust Agreement is effective the TZI day of c -eJW 4r'
2012, by and between MILDRED E. SHADER, (the ' rantor"), and
RUSSELL G. SHADER, who will serve as Initial Trustee, (the "Trustee"),
with reference to the following facts:
Section 1. Funding the Trust
Grantor hereby transfers to the Trustee Ten Dollars ($10.00) to be held
and administered according to the terms of the Trust. The Grantor and any
other person may transfer additional property to the Trustee, acceptable to
the Trustee, to be held and administered according to the Trust's terms. The
Trust shall be known as "THE SHADER FAMILY IRREVOCABLE
GRANTORS TRUST."
Section 2. Irrevocability
The Trust and all interests in it are irrevocable, The Grantor has no
power to alter, amend, revoke, or terminate any Trust provision or interest
herein.
Section 3. During the Lifetime of the Grantor
During the lifetimes of the Grantor, the Trustee shall hold and
administer all funds remaining as follows:
a. After paying the expenses and charges of the Trust, the Trustee
may, in the Trustee's discretion, pay to or apply for the benefits of the Trust
Beneficiaries, as much of the net income and principal of the Trust as the
Trustee, in the Trustee's discretion, deems necessary for the reasonable
health, support, maintenance, and education of the Beneficiaries. The
Trustee may pay more to one Beneficiary than to other and the distributions
hereunder shall be counted against the Trust as a whole and not against each
Beneficiary's distributive share. Any income not distributed shall be
accumulated and added to Trust principal. In exercising the Trustee's
discretionary powers hereunder, the Trustee shall be guided by the following
statement of the Grantor's purpose and intentions, but the Trustee shall
nevertheless be free to make his decisions without direction from the
2
Grantor. Since Trust principal includes annuities, Grantor requests, but does
not direct, the Trustee to defer making discretionary income and principal
distributions until after the Grantor's death and receipt of the annuities'
proceeds. However, the Grantor understands that circumstances may arise
which would make distributions advisable prior to Grantor's death and the
Trustee may effect such distributions and convert the Trust into cash in order
to accomplish the distributions.
Section 4. Upon the Death of the Grantor
Upon the death of the Grantor, the Trustee shall hold, administer and
distribute the Trust Estate as follows:
A. One third (1/3) to Grantor's son, Russell G. Shader; if he
should predecease Grantor then this share shall go to his wife, Linda Shader;
B. One third (1/3) to Grantor's daughter, Mary J. Ascani; if
she should predecease Grantor then this share shall go to her husband, John
Ascani;
C. One third (1/3) to Grantor's daughter, Constance L.
Stoner; if she should predecease Grantor then this share shall go to her
husband, John Stoner.
1. Guardians and Conservators. If a guardian or
conservator of the person or the Estate, is appointed by a court of competent
jurisdiction for any beneficiary hereunder, the Trustee may distribute such
monies as would otherwise become distributable to the beneficiary to such
guardian or conservator, and the voucher of such guardian or conservator
shall be a full acquaintance to the Trustee for any sums so distributed; but
the Trustee may in its sole and absolute discretion, require such reports and
take such steps that it may deem requisite to insure and enforce the due
application of such money to the purposes aforesaid.
2. Certifications of Beneficiaries. In exercising its
discretion hereunder, the Trustee shall be entitled to rely upon written
certification of the beneficiary, guardian or conservator of the beneficiary as
to the nature and extent of the beneficiary's needs and the inadequacy of the
beneficiary's resources apart from the Trust. As to these matters, when
relying upon such certifications, the Trustee shall not be required to make
further inquiry into the authenticity of the need or to the availability of other
resources to satisfy the need. As to these matters, it is the Grantor's desire
3
that the Trustee consider the needs of the beneficiary in keeping with the
standard of living that has been previously enjoyed by the beneficiary.
Section 5. Spendthrift Clause
a. To the fullest extent permissible by law, no interest in the
principal or income of any Trust created hereunder shall be anticipated,
assigned, or encumbered or subject to any creditor's claim or to legal process,
prior to its actual receipt by the Beneficiary.
b. Except as herein otherwise expressly provided, all income or
principal to be paid to any of the Beneficiaries shall be paid by the Trustee
directly and only to the Beneficiary, to the personal representative or
guardian of the Beneficiary, or, where, authorized, applied for the benefit of
the Beneficiary. If any creditor or other claimant attempts to subject to the
satisfaction of the claim of such creditor or claimant the interest of any
Beneficiary to receive income or periodic payments from the principal or
income, or both, then notwithstanding of any other provisions herein, and in
the absolute discretion of the Trustee, the Trustee may suspend such
Beneficiary's payments from the Trust provided, however, that during the
time the payments are suspended the Trustee, in his absolute discretion may
pay to or expend for the benefit of such Beneficiary as much of the Trust net
income, not to exceed the income to which such Beneficiary would otherwise
be entitled, as the Trustee deems necessary for the health, support,
maintenance and education of such Beneficiary. All income determined by
the Trustee to be in excess of the amount necessary shall be accumulated and
added to the Trust principal.
Section 6. Rule against Perpetuities
If it is determined that any provision of the Trust violates any
applicable rule against perpetuities or remoteness of vesting, the Trustee will
administer the affected portion for the maximum period allowed by law and
then pay that portion of the Trust funds outright and free of Trust to the then
Beneficiary of the Trust income.
Section 7. Trustee Powers
a. The Trustee is exclusively empowered to do the following; each
designated trustee may act independently as needed:
1. Hold and retain all or any property received from any
source, without regard to diversification, risk, productivity, or the Trustee's
4
personal interest in such property in any other capacity, and to keep all or
part of the Trust property at any place within the United States or abroad.
2. Invest and reinvest the Trust funds (or leave them
temporarily un-invested), in any type of property and every kind of
investment, including, but not limited to, corporate obligations of every kind,
preferred or common stocks, securities of any regulated investment Trust,
and partnership interest.
3. Participate in the operation of any business or other
enterprise and to incorporate, dissolve, or otherwise change the form of such
business.
4. Deposit Trust funds in any commercial savings or savings
and loan account.
5. Borrow money for any reasonable Trust purpose and upon
such terms, including, but not limited to, reasonable interest rates, adequate
security, and such loan duration as the Trustee deems advisable.
6. Lend Trust funds to such persons (including the estate of
the Grantor or a trust created by the Grantor) and on such terms, including
but not limited to, reasonable interest rates, adequate security, as such loan
duration as the trustee deems advisable.
7. Sell or otherwise dispose of Trust assets, including, but
not limited to, Trust real property, for cash or credit, at public or private sale,
and with such warranties or indemnifications as the Trustee deems
advisable.
8. Buy assets of any type from any person (including the
estate of the Grantor or a trust created by the Grantor) and on such terms,
including but not limited to, cash or credit, reasonable interest rates, and
adequate security, as the Trustee deems advisable.
9. Improve, develop, manage, lease or abandon any Trust
assets, as the Trustee deems advisable.
10. Hold property in the name of any trustee or any
custodian or nominee, without disclosing the Trust, but the Trustee is
responsible for the acts of any custodian or nominee Trustee so uses.
11. Pay and advance money for the Trust's protection and
for all expenses, losses and liabilities sustained in its administration.
5
12. Prosecute or defend any action for the protection of the
Trust, the Trustee in the performance of Trustee's duties, or both and to pay,
contest, or settle any claim by or against the Trust or the Trustee in the
performance of Trustee's duties.
13. Employ persons, even if they are associated with the
Trustee, to advise or assist the Trustee in the performance of Trustee's
duties.
14. Pay any and all income tax liabilities on Trust income
from Trust funds.
15. Distribute Trust assets in kind or in cash.
16. Execute and deliver any instruments necessary or useful
in the exercise of any of these powers.
17. Trust income or principal may not be used wholly or
partly discharge any legal obligation of the Grantor. This restriction
supersedes any contrary Trust language. When determining the legal
obligation to support any beneficiary, the Trust's existence shall not be taken
into consideration.
18. Except as otherwise specifically provided in the
Grantor's Will (or other dispositive instrument executed by the Grantor), the
Trustee shall pay any federal estate tax payable by reason of the inclusion of
any portion of the Trust in the taxable estate of the Grantor. The Trustee
shall also pay all state inheritance or succession taxes attributable to Trust
property and payable by reason of the Grantor's death. The Trustee shall
charge to or recover the payments from the persons entitled to Trust benefits,
as and to the extent provided by any applicable tax law or proration statute.
Section 8. Definitions
For all purposes, the term "issue", "descendant", "child", "children",
"grandchild" or "grandchildren" includes those who are legally adopted. The
term "child of the Grantor" or "issue of the Grantor" means a child, step-child
or issue of MILDRED E. SHADER.
Section 9. The Trustee
6
a. During the Grantor's lifetime, RUSSELL G. SHADER shall
serve as Trustee. In the event that Trustee is unavailable to serve, then
MARY J. ASCANI shall serve as Successor Trustee.
b. Any Trustee may resign by giving written notice, specifying the
Resignation's effective date, to the person or institution designated a
successor Trustee, if there is one, or otherwise to the current income
Beneficiary or Beneficiaries (including any Beneficiary entitled to Trust
payments for health, maintenance, support and education) or the custodial
parent of any such minor Beneficiary.
C. No Trustee shall be required:
1. To obtain the order of any court to exercise any power or
discretion under the Trust, or
2. To file any accounting with any public official, although
the Trustee shall maintain accurate records concerning the Trust and shall
furnish each current income Beneficiary (including any Beneficiary entitled
to Trust payments for health, maintenance, support and education) or the
custodial parent of any such minor Beneficiary an annual accounting of the
condition of the Trust, including receipts and disbursements, which may be
satisfied by a copy of the Trust's federal income tax return, if one is required.
d. Each individual Trustee is entitled to a reasonable
compensation for services in administering the Trust and to reimbursement
for expenses, and each corporate Trustee is entitled to compensation based on
its published fee schedule in effect at the time services are rendered.
e. Any successor Trustee may, without liability, accept without
examination or review, the accounts rendered and the property delivered by
any predecessor Trustee. Each Successor Trustee or Co-Trustee has the
same title, powers and duties as the Trustee succeeded, without any
additional conveyance.
f. No Trustee shall be liable for mistakes or errors in judgment
unless resulting from the Trustee's bad faith or gross negligence.
g. Any individual Trustee shall be deemed to have automatically
resigned, without further act on the Trustee's part, immediately upon receipt
by the next successor Trustee of an acknowledged, written instrument
executed by two licensed physicians. The physicians must state in writing
that they are certified by a recognized Medical Specialty Board. In addition,
the writing must indicate that they have examined the Trustee and
7
concluded that by reason of accident, physical or mental illness, progressive
or intermittent physical or mental deterioration, or other similar cause, the
Trustee has become unable to prudently exercise Trustee powers in the
beneficiaries' best interest. Examination expenses shall be paid by the Trust.
h. Until the Trustee receives written notice of any birth, marriage,
death or other event upon which payment rights may depend, they shall
incur no liability to the persons whose interest may have been affected by
that event for good faith disbursements.
L The Trustee may, but need not, use the insurance proceeds
received, due to the Grantor death, to make loans to, and purchase assets
from, Grantor's estate or any Trust created by the Grantor. The Trustee
shall also, if they deem it to be in the best interest of all beneficiaries,
consider not making distributions of insurance proceeds to any beneficiary
until at least two (2) years after the date of each Grantor's death.
j. At any time after the creation of a property interest which may,
or does, benefit a person, or of the grant to a person of a power affecting
property, that person may disclaim all or a portion of the interest or power.
However, the disclaimer must be in writing, and in accordance with
applicable state laws and Internal Revenue Code of 1986, Section 2518, as
amended from time to time. A disclaimant shall be deemed to have
predeceased the event which caused the disclaimant's rights to mature.
k. The Trust, and all Trusts created under it, shall meet the
requirements of the Internal Revenue Code of 1986, Section 2033 through
2045, as amended from time to time. This is so that no part of the Trust shall
be included in the Grantor's gross estate for estate or similar tax purpose.
Therefore, the Trust provisions shall be construed, and each trust created
under it, shall be administered, so as to meet those requirements.
Section 10. Miscellaneous
a. The Trust shall be governed by and construed according to the
laws of the Commonwealth of Pennsylvania.
b. The Headings in the Trust are inserted for convenience only and
are not a part of the Trust.
C. Whenever the context or the Trust requires, the masculine
gender, includes the feminine or neutral, and vice versa, and the singular
number, includes the plural, and vice versa. If the Trust refers to the death of
8
the Grantor and there are two Grantors, then the clause shall be interpreted
as the death of the last living Grantor.
d. Except as otherwise specifically provided in the Trust
Agreement, the determination of all matters with respect to what is principal
and income of the Trust Estate and the apportionment and allocation of
receipts and expenses, shall be controlled and construed by the Pennsylvania
Uniform Trust Act (20 Pa.C.S. 7701 et. Seg.) as from time to time amended.
Any such matter not provided for either in the Trust Agreement or in the
Pennsylvania Uniform Trust Act shall be determined by the Trustee, in the
Trustee's discretion.
IN WITNESS WHEREOF, the Grantor and the Trustee have hereunto
set their hands as of the date first above written.
NOTAM&sm MILDRED E. SHADER, Grantor
JOINT E TOOMEY
Note►PUubk
sPRINOEn Y Tq ..YORK
My commisam EpaFw 6
-
RUSSELL G. SHADER, Trustee
COMMONWEALTH OF PENNSYLVANIA :
ss.
COUNTY OF
On this the 6�f� day of 711
e#f P( 2012, before me, a Notary
Public, the undersigned officer, personally appeared MILDRED E. SHADER,
GRANTOR, AND RUSSELL G. SHADER, TRUSTEE, known to be (or
satisfactorily proven to be) the persons named herein and who executed the
foregoing, and acknowledged that they executed the same for the purposes
therein contained.
MOTAnm SEAL Notary PubVr!
Jow E TOOMEY
Notary PuMk
spRiC iuRr EqW FO TWI.O 26,C OMM My Commission Expires
ao44
9
REV-1511 EX,(10-06) -
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
21-l�- �08�
Debts of decedent must be reported on Schedule L
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES: y /1 �Q M �7�•'
1. wvinfeofl st[l)(1��4r �f: fttArkS GuIKGrm aKrc6 °I /SIG tLS— ��/.7.00
bt�r3 {vr G�,narn� meal, use FeLlourdlu�HR//,e�. f
�, hfa��tZtt nerol �on4G Meedtamicsbur�, d��an� drtited. 75L5!
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions 7
Name of Personal Representative /
Representative(s) R k i5gl _'ihadU- ��!✓�D
Street Address -+ ore hard Dr-
City r1l a rv5 yi Ile State Pk zip ! 0 53
Year(s)Commission Paid:
2. Attorney Fees Charles C. c5h;eld5 1C f 3, N29_ So
3. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation)
Claimant WO 01I1F K-LIC16L6_
Street Address
City State Zip
Relationship of Claimant to Decedent 1 / T
4. Probate Fees "d Or t Ct r via 15e ttz of 5rfort CGrft Pl files �(D$,50
(Lbat' K F/ra.tr al Services e� B1ech&nics-
5. Accountants Fees arlC , Par L
b"'J „ryp IOLtD 040UPA P4 y'b, /o IN, P4- 9�LYc. �L('OD•00
6. Tax Return Pmparer's Fees/ !!'' or
z )-hers AuCk;0#1, Commllssioh oh 'Setae of ►�usonwl 77,70
(see 5'fithawt of aChedj
F Ad✓erf"is1g9 M eamber-land Law Tournal { 7S.Qo
9, ddrutisin, in e4de'516 5cWh d /I/eW_f1*Per— AI1/7.06
1,91 Reirn6. fo ✓Chas eS4ie/✓</sTs 4, li4hua/Soh lee- Ab
4519rereicfn Bank rSeL e.�h'�, sheaf) ado.00
TOTAL(Also enter online 9,Recapitulation) $ 5,5.Z 9.027
(If more space is needed,insert additional sheets of the same size)
i
SWED. K.
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'7.�.610 -
Tuesday, May 14,201312:51 PM Malpezzi Funeral Home 7176972414 p.01
Malpezzi Funeral Home
8 Market Plaza Way
Mechanicsburg,PA 1705 5
(717)697-4696
Michael J Malpezzi Owner FD Jeremy J Shartzer,FD Kyle C.Knipe,FD
May 14,2013
Russel G. Shader
7 Orchard Drive
Marysville,PA 17053
The Funeral Service for Mildred E.Shader
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every
way we can. Please feel free to contact us if you have any questions in regard to this statement.
THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES,FACILITIES,AUTOMOTIVE EQUIPMENT,
AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
1. PROFESSIONAL SERVICES:
Services of Funeral Director/Staff $5,475.00
FUNERAL HOME SERVICE CHARGES - $5,475.00
SELECTED MERCHANDISE:
20 Gauge Steel Casket $2,095.00
Rose Register Package $145.00
THE COST OF OUR SERVICES,EQUIPMENT,AND MERCHANDISE
THAT YOU HAVE SELECTED $7,71500
AT THE TIME FUNERAL ARRANGEMENTS WERE MADE,WE ADVANCED CERTAIN PAYMENTS TO
OTHERS AS AN ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FORTHOSE CHARGES.
CASH ADVANCES:
Certified Death Certificates $60.00
Newspaper Notices-Patriot $280.62
Clergy/Mass Offering $100.00
Flowers $230.00
TOTAL CASH ADVANCES AND SPECIAL CHARGES $670.62
CONTRACT PRICE $8,385.62
HISTORY:
09/13/2012 Discount Pre-Need Guarantee $2,291.88
09/21/2012 Payment Forethought $5,342.23
10/082012 Payment Cumberland County VA
10/12/2012 Payment Payment ,$?SL51
10/12/2012 Overpayment Refund Cumberland County VA Refund $100.00
TOTAL AMOUNT DUE $0.00
r
MUMMA'S JEWELRY STORE
34 WEST MAIN STREET
MECHMICSBURG, PA 17055-6249
(717) 766.9422
PHONE NO DATE `
NAME r�
1�__ S ate M Max
ADDRESS n cA4G.N 1 cS 10 E( r •"
COMM CASH CW.ROE LAY-AWAY ON ACCT. MOSS.RETO
LEIuti"+`9+ "�3' :'S;70CKi
'AFTIC N0"-."".'`AMOIJN..
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I
I
1
SPECIAL MSTPOCTIONS SUBTOTAL I
TAX
c n c
a.V �I � TOTAL I�•
AMOUNT
r`-tl✓h/�V\ PAID
� I
_! BALANCE I
Q71 2 n Rood by
O O AiL cTelms end r` 'Co,goods oMUST
/be accompanietl by this bill.
W-241-2 gnRi Ldgt, TOV'°` _
Printetl in USA. CCII
MUMMA'S JEWELRY STORE
34 WEST MAIN STREET
MECHANICSBURG, PA 17055-6249
(717) 7669422
ORO NO. PHONE Na )ATE
NAME
Sh4�-
ADDRESa
SOLD 9Y CASH CH RCE -AY-M pU ACCT. MDSE.RETD.
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SPECIAL NXII DONS $UBTOTAL
TAX
TOTAL
---AM ANT
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BALANCE I
P.cd by
0 0 U..Z r'urned goods MUST be accompanied by the bill. f
W-241-2
�/R[1111Z i+nm
Primed in U.S.A.
REV-1512 EXi(12-03)
SCHEDULE 1
COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES, & LIENS
RESIDENT DECEDENT
ESTATE OF t0d y ' F. C hater FILE NUMBER
IA/GA c.9 z/-is-low{
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
TOTAL(Also enter on line 10,Recapitulation) $
(If more space is needed,insert additional sheets of the same size)
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REV-1613 FX+Ill
t
COMMONWEALTH OFPENNSVLVANw BENEFICIARIES..
INHERITANCE TAX RETURN - -
RESIDENT DECEDENT
� ESTATE OF m FILE NUMBER
_ ;rdred E, a4der-
RELATIONSHIPTO DECEDENT AMOUNT OR SHARE
NUMBER _ NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustees) OF ESTATE
I TAXABLE DISTRIBUTIONS(include outright spousal distributions,and transfers under
Sec.9116(a)(12)]
1. .Sarah M. 5hader 5r"ddaa,hter pink rose a);Hl
clo Russal G- vhoder-, 7 orchard Dr. diamond p;n
iharysr:ll+E, PA 170 53 V&I'c 072, .x0
z. Ro1ph 5hnJer- p deeeasr.4 decedent
3. Constance L, Wvj)er dettl�hter Ya eF texraa;n;.l�deuela�
303 eheryl,4a,, /1?ee6aniesba. /lf!10 vc)ae It
Y3 1>nc;dme.
'� lllRr�+ �• ,�SC1tnt
303 Brandy Zane, 1Veehaw;C-c&rj, P417,0 dujh&r ys .rema%nr'n�
jwdry ✓a,lue "111
// washsla.�d elapsed
CSee ('on1��- s,lteef u7'fac�rtcl1 desK.---3tapsed
Y-3 resr`dme.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18,AS APPROPRIATE,ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
S. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART 11—ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ONLINE 13 OF REV-1500 COVER SHEET $
(If more space is needed,insert additional sheets of the same size)
i
P.2 5CHFD. T.
L-57 07;/dreal S&de,r .. __... .._. ..__ - X7ILC /1f . zr_lx-�o8y-
S. -a._ un_dra__�MIA --
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-- - - --- - - - - -
_ 106455el G._ Cy accr Son _--
_
I
._-_--._--
LAST WILL AND TESTAMENT
I, MILDRED E. SHADER, of the. Borough of Mechanicsburg,
County of Cumberland and Commonwealth of Pennsylvania, being of
sound and disposing mind, memory and understanding, do make,
publish and declare this as and for my Last will and Testament,
hereby revoking and making void all former wills and codicils by
me at any time heretofore made.
FIRST. I order and direct that all my just debts and
funeral expenses be paid by my Executor or Executrices, as the
case may be, hereinafter named, as soon as conveniently may .be
done after my decease.
SECOND. I give and bequeath my pink rose with diamond pin
unto my granddaughter, namely, SARAH M. SHADER, absolutely. I
authorize my Executor or Executrices, as the case may be, to
deliver said pin to a parent of said beneficiary if she is a
minor at my death and to accept the receipt and release of such
^5 parent in full discharge of this bequest.
Y
THIRD. I give and bequeath all of my remaining jewelry in
equal shares unto my daughters, namely, CONSTANCE L. STONER and
MARY J. ASCANI, share and share alike, absolutely.
FOURTH. I give, devise and bequeath all the rest, residue
and remainder of my Estate, real, personal and mixed, whatsoever
and wheresoever situated unto my husband, namely, RALPH F.
SHADER, absolutely and in fee simple, if he survives me by as
many as sixty (60). days.
FIFTH. If my said husband, RALPH F. SHADER, does not
SNEERAKER. survive me by as many as sixty (60) days, then and in that event,
BREN NEMAN
e SPARE I order and direct that my Estate be distributed and disposed of
i
as follows:
A. I give and bequeath my antique rocking chair
and doll cradle unto my niece, namely, SANDRA SMITH
HANKIN, absolutely.
B. I give and bequeath my sterling silver
- flatware, washstand and desk unto my daughter, namely,
MARY J. ASCANI, absolutely.
C. I give and bequeath my sewing machine and the
chair used therewith unto my son, namely, RUSSEL G.
SHADER, absolutely.
D. I give, devise and bequeath all the rest,
residue and remainder of my Estate, real, personal and
mixed, whatsoever and wheresoever situated, in equal
_. shares unto my three (3) children, namely, CONSTANCE L.
STONER, MARY J. ASCANI and RUSSEL G. SHADER, share and
share alike, absolutely and in fee simple.
if any of my said children should predecease
me, I order and direct that the foregoing residuary
share of my estate attributable to such deceased child
C shall be distributed unto her or his issue, if any, per
stirpes by representation and not per capita.
LASTLY. I nominate, constitute and appoint my husband,
namely, RALPH F. SHADER, to be the Executor of this, my Last Will
and Testament, but if for any reason he should fail to qualify as
such Executor or cease so to serve, then and in that event, I
nominate, constitute and appoint my son, namely, RUSSEL G.
sHADER, to be the Executor hereof. If both of the above named
persons should fail to.qualify as my personal representative
hereunder or cease so to serve, then and in that event, I
i...w ar.wv
sNEisAxeR,
nominate, constitute and appoint my daughters, namely, CONSTANCE
BRENN£MAN
l SPARE
L. STONER and MARY J. ASCANI, to be the Executrices of this, my
Last Will and Testament.
I order and direct that none of the foregoing persons shall
be required to post bond or other security as a condition of
qualification hereunder.
IN WITNESS WHEREOF, I, MILDRED E. SHARER, have hereunto set
my hand and seal to this, my Last Will and Testament which
consists of three (3) typewritten pages to each of which .1 have
affixed my signature this 22nd day of December A.D., One
Thousand Nine Hundred Ninety-eight (1998) .
h _(SEAL)
Mildred E. Shader
The preceding instrument, consisting of this and two (2)
other typewritten page, each identified by the signature of the
Testatrix, was on the date thereof signed, sealed, published and
declared by MILDRED E. SHARER, the Testatrix therein named, as
and for her Last Will and Testament, in the presence of us, who,
at her request, in her presence, and in the presence of each
other, have subscribed our names ao itnesses hereto.
w oracc.
$NELBRKER.
BR£NN£MnN
a SPARE
-3-
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
We, MILDRED E. SHADER, RICHARD C. SNELBAKER and CHRISTINE M.
WHITE, the Testatrix and the witnesses, respectively, whose names
are signed to the attached or foregoing instrument, being first
duly sworn, do hereby declare to the undersigned authority that
the Testatrix signed and executed the instrument as her Last Will
and Testament-and that she had signed willingly, and that she
executed it as her free and voluntary act for the purposes
therein expressed, and that each of the witnesses, in the
presence and hearing of the Testatrix, signed the Will as a
witness and that to the best of his or her knowledge the
Testatrix was at that time eighteen years of age or older, of
sound mind and under no constraint or undue influence.
Testatrix
// �1'
�-^'�^-wi(�tn(yenysss
Witness
Subscribed, sworn to and acknowledged before me by MILDRED E.
SHADER, the Testatrix, and subscribed and sworn to before me by
RICHARD C. SNELBAKER and CHRISTINE M. WHITE, witnesses, this
22nd day of December, 1998.
&ai 9-.
�^w^ Nota y Public
$NELBAKER.
BRENNEMAN
$
SPARE
NOteAa19ed1,.." {'
PBNlrle
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US POSTAGE AND FEES PAID
JUN 072013 Mailed from ZIP 17055
Fat Rate .Pda3yMad
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endicia.com/mac 071M00625744
LISPS Priority Mail 0
CHARLES SHIELDS 0021
6 CLOUSER RD
MECHANICSBURG PA 17055-9751
r Ship To:
REGISTER OF WILLS
CUMBERLAND COUNTY COURTHOUSE
i COURT HOUSE SID RM 102
CARLISLE PA 17013-3322
Desune
USPS CERTIFIED MAIL
Of Des
9402 7102 0088 1793 3933 63
CHARLES E. SHIELDS, III
ATTORNEY-AT--LAW
6 CLOUSER ROAD
Corner of Trindle and Clouser Roads
MECHANICSBURG,PA 17055
GEORGE M.HOUCK TELEPHONE (717) 766-0209
(1912-1991) FAX (717) 795-7473
June 7, 2013
Register of Wills
Cumberland County Court House
1 Courthouse Square
Carlisle, PA 17013
Re: Estate of Mildred E.Shader
No.21-12-1084
Dear Register of Wills:
Please find enclosed for filing 2 copies of the Inheritance Tax Return for the Mildred E.
Shader Estate as well as Check No. 112 in the amount of$1,285.02 for the Inheritance Tax,
Check No. 113 in the amount of due $15.00 for additional Probate and Check No. 114, in the
amount of$15.00 for the filing fee.
Thank you for your kind attention to this matter.
Very truly yours,
t!i2ti6���sii
Charles E. Shields, III
Attorney-At-Law
CES/mjj _
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