HomeMy WebLinkAbout11-27-13 (3) Y t
� 1505611185
REV-1500 EX�°Z-",�F',
OFFICIAL USE ONLY
PA Department of Revenue County Code Year File Number
Bureau of IndMdual Taxes
PO BOX 280601 INHERRANCE TAX RETURN 21 13 0 9 3 9
Hanisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social SecuMy Number Date of Death MMDDYYYY Date of Birth MMDDm�r
Ob182011 � 04131935
Decedent's Last Name Suffix DecedenYs First Name M I
SHIV�LY GEORGE R
(If Appllcable)Enter Sunriving Spouse's information Below
Spouse's Last Name Suffix Spouse's First Name M I
SHIVELY NANCY
Spouse's Social Security Number THIS RETURN MUST BE FILEO IN DUPLICATE WITH THE
300-24-7729 REGISTEROFWILLS
Flll.IN APPROPRIATE BOXES BEIOW
� 1. Originai Retum � 2. Suppiemental Retum Q 3. Remafnder Retum(Date of Death
Priorto 12•13-82)
❑ 4. Limited Estate ❑ 4a. Future Interest Compromise(date of ❑ 5. Federal Estate Tax Retum Required
death after 12-12-82)
� 8. Decedent Died Testate � 7. Decedent Maintained a Living Trust �., 8. Total Number of Safe Deposit Bo�aes
(Attach Copy of Will) (Attach Copy of Trust.)
❑ 9. Litigation Proceeds Reoeiv�ed ❑ 10.Spousal Poverty Credit(Date of Death ❑ 11. Electlon ta Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT• TH�SECTION MUST�COMP�ETED.AL�CORRESPONDENCE ANp CONFIDENTIAL TAX INFORMATW�,�OUl.D 8E DIRECTEO TO:
Name , D�ne Telephon�umbe� :�
w t"'��11
CRAIG A• HATtH, ESQ, CELA �';�731-�Q0� �
.�
� ER QF_Wl�t�8 . LY
rv
:'� � --.] � �7
First Line of A�ddress �
� � � '�; "T1
� �
21�9 MARKET STREET - � �'' � ,�
Second Line of Address � � r rn
� � �
� �
CT)
City Or P08t Offi08 Stete ZIP COde DATE FILED
CAMP HILL PA 17011
Corr�spond�nY:a-�,Ni.da�: C•H A T C H�H H G L L P•C 0 M
Under penaltiea of perjury,i declare that i have examined this retum,induding accompanyfn�achedulea and statemeMs,and to the beat d my kna�wledge a�d belief,
it ia tn�e�corn�:t and complete.Declaration of preparer other than the personal repreaentative ia based on�1 Mbrtnatlon of which
preParer haa any knoiMsdys.
SIGNA RESPONSIBIE FOR FIL E'TURN ,,,� DATE
LISA A• MYERS, EXECUTRIX ZZ
Aoo�ss . �
26 K4SER LANE SHIPPE BURG, PA ?25? .
SIGNA7URE OF PREPARER 4THER THAN REPRESENTA TE
CRAIG A. HATCH, ESQ• , CELA ._ �i
n�o�ss
2109 MARKET STREET CAMP HILL, PA 17011
PLEASE E RI INAL F RM ONLY
Side 1
� 1505611],85 OhA46�73.000 1505611185 ,�,.,
t �
� 1505611285
REV 1500 EX(FI)
Decedent's Social Security Number
oecedent�sName: SHIVELY GEORGE R
RECAPITULATION
1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. 0•�0
2. Stocks and Bonds(Schedule B). . . . . . . . . . . . . . . . . . . . . . . . . 2. 0•0�
3. Ctosely Held Corporation,Partnership or Sole-P�oprietorship(Schedule C), , , , , 3. 0•0�
4. Mortgages and Notes Receivable(Schedule D) , , , , , , , , , , , , , , , , , 4, �•0 0
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E) , , , , , 5, �t{.,5�Q•Q Q
6. Jointty Owned Property(Schedule F) � Separate Billing Requested , , , , g, �•��
7. Inter-�vos Transfers 8 Miscellaneous Non-Pr�ate Property
(Schedule G) � Separate Billing Requested . . . . 7. �•�0
e. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . 8. 7 4,5 0 0•0 0
9. Funerai Expenses and Administrative Costs(Schedule H). . . . . . . . . . . . . g. 3��Q�•�0
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) , , , , , . . . . 10. �•��
11. Total Deducdons(total Lines 9 and 10), , , , , , , , , , , , , , , , , , , , , ��, 3��0�•��
12. Net Value of Estate(Line 8 minus Line 11� , , , , , , , , , , , , , , , , , , , �2, 71�5�0•��
13. Charitable and Governmentai Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J), , , , , , , , , , , , , , , , �3, �•��
14. Nat Valu4 Subj�ct to Tax(Line 12 minus Line 13) , , , , , , , , , , , , , , , �q, ?1�5��•��
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers unsler Sec.9116
(ax1.2)X.O�� ?1,500•00 15. 0•00
16. Amount of Line 14 xable
at Iineal rate X.0 4� 0•0 0 16. 0•0 0
17. Amount of�ine 14 taxable
at sibling rate X.12 �.�� �� Q•Q Q
18. Amount of Line 14 taxable
at collateral rate X.15 �•�0 18. �•0 0
19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. �•��
20. Ft�L IN THE BOX IF YOU ARE REQUE3TING A REFUND OF AN OVERPAYMENT ❑
�
$Id@ Z
� 1505611285 1505611285 J
OM4648 3.000
1 �
REV 1500 EX(FI� Page 3 Ffle Number
Deceder�t's Com lete Address: 21 13 0 9 3 9
DECEDEM'S NAME
Y R R
s�Er�ss
� STATE ZIP
PP -
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) � •0�
2. Credits/Payments
A.Prior Payments � •�0
B.Discount 0•�0
Total Credits(A+B) (2) 0•�0
3. Interest
(3) 0•0�
4. If Line 2 is greater than Line 1+Line 3,enter the difference.This is the OVERPAYMENT.
Fiti in box on Page Z,Line 20 to request a refund. (4) �•��
5. If Line�1 +Line 3 is greater than Line 2,e�ter the difference.This is the TAX DUE. (5) �•��
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. r�ain the use or income of the property transfened . . . . . . . . . . . . . . . . . . . . . . . . ❑ X
b. retain the right to designate who shall use the property transfened or its income . . . . . . . . . . ❑
c. retain a reversionary interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d. receive the promise for life of either payments,benef'ds 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
contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑ �
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YE3, YOU MUST COMPLETE SCHEDULE G AND F�.E R 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 survivfng spouse is 0 percent
[72 P.S.$8116(a)(1.1)(ii)].The statute does�ot exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of assets and
filing a tax retum are still applicable even if the surviving spouse is the oniy 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 y�ars 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 P.S.§9116(a)(1.2)].
• The tax rate imposed�on the net value of transfers to or for the use of the decedent's lineal beneficia�ies is 4.5 percent,e�acept as noted in[72 P.S.$9116(ax1)J.
• The tax rate imposed on the net value of transfers to or for the use of the deCedenYs siblings is 12 percent[72 P.S.§9116(a)(1.3)].A sibiing is defined,
und�Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
OM4871 2.000
RE1f 1b08 EX+(�1-10)
pennsylvania SCHEDULE E
OEPARTNENTOF REYENUE CASH, BANK DEPOSITS, �MISC.
�r�E�R" PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
Georae R. Shively 21 13 0939
Include the proceeds of litigation and the date the p�oceeds wene received by the estate.
All ro oi�tl owned with ht of survivonhi must be dbclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
�• 2005 Pine Grove Mobile Home, VIN: GP46523ABAC; sales
pric� 74,500.00
TOTAL Also enter on line 5,Reca itulation i 74,500.00
OwasAD 2.00o If more space is needed,use additional sheets of paper of the same size.
REV-1811 EX+(70-09) SCHEDULE H
" pennsylvania
OB�ARTNBJT'OF REVENUE FUNERAL EXPENSES AND
M�M�RITMIGETAXRETURN ADMINISTRATIVE COSTS
�ENTDECEDENT
ESTATE OF FILE NUMBER
Geo=co R. 3hively , 21 13 0939 , „
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FIHVVERAL EXt�ENSES:
�, None
B. ADM�VISTRATNE COSTS:
1. Personal Rep�esentative Commissions;
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2. Attomey Fees: 3,000.00
3. Family Exemption:(If decedent's address is not the same as claimant's,attach explanation.)
Claimant
Street Address
City State ZIP
Relatfonship of Claimant to Decedent
4. �Probate Fees:
5. Accountant Fees:
6. Tax Retum Preparer Fees:
7.
None
TOTAL(Aiso enter on Line 9,Recapitulation) S 3 000.00
awasn�2.00o If more space is needed,use additional sheets of paper of the same size.
REU-1513 EX�(01_,0, SCHEDULE J
pennsylvania
DEPARTA�ENrOF REVENUE BENEFICIARIES
II�ERtTANC;E TAX RETURN
RESIOEN'T DECEDENT
ESTATE OF: FILE NUMBER:
Geor . hiv 1 2113
REIATIONSHIP TO DECEDEfJT AMOUNT OR SHARE
NUMBER NAME AND AODRESS QF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
1 TAXABLE DISTRIBUTIONS[Include outright spousal dist►ibuutions and transfers under
Sec.9116(a)(1.2).j
�, Nsncy Shively
610 West Whitehall Road
Stats Colleg�, PA 16801
100� of Residue: 71,500.00 Surviving Spouse 71,500.00
EM'�R DOLLAR ANI�UM'S FOR DISTRIBU110NS SHOWN ABOVE ON IINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
�� NON-TAXABLE D(STRIBUTIONS
A.SPOUSAI.DISTRIBUT10N5 UNDER SECTION 9113 FOR WHiCH AN ELECTION TO TAX IS NOT TAKEN:
1.
B.qiARITABLE AND GOVERNMENTAt DISTRIBUTIONS:
1.
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBIJTIONS ON UNE 13 OF REV-1500 COVER SHEET. S 0.0 0
8W48AI 2.00o If more space is needed,use additional sheets of paper of the same size.
_ _ _
_ __ _ _ _ ____
Jun�251312:14p 310-417-8989 p.2
.
. • .
" . ...,,...... �.�.,..,...
_�.
WI LL
�
� �
z, GEQRG� R. SHIVELY, currently of Mifflin Cou�tty.
Pennsylvania. being of sound mind� ac►esao�ry and ur�derstanding,
do cn�k�e and publish this �r.y Last �v'i 11 and Tes taxaant. hersby
revoking and �a.king vofd all former Will.s by me at any �i�
heretaf�re aeade.
x�EM ONE: I direct a1J. m� debts w�ich �tay be 1�egally
collecti.ble, and funeral expet�ses , ta be paid by my Executrix
1 hereinafter name�.
ITEM TW�: All federal, state and other death taxes pap-
_______
able because of my death, with respect to the property forming
`v` .my gross es�a�e ror tax puiposes`, WL CVtiCt �i i�� rNs�-==n "n��
�
t�is Will, including anp interest �r penalty imposed in
�
connection with such tax, shall be considered a part of th�
expense of the adrninistsatiion of my estate and shall be pa�,d
from my residuary estate under IT'EM 'TH�E without apport�.onmer�t
or riaht of reimbursemenc. All suc�. taxes on pxesent or
future inter�sts shal-1 be paid a� such time or times as my
Executria o� Txustees may thin`K proper r�gard��ss of �ahether
such taxes are then due.
I�BM T�1R�E: All �he rest, z�sidue a�d remainder of my
uwof�xs
NOUCKWC3�NGp�CH �state, real, personal arid mixed of whi.ch I ahall d�e seize
�5 N.�M�l�l@ SfAEE'f
.o.eoxsso and possessed or to which I shall be e�titled at my deceas2. ,
�«nsroNn�.�.,��• .
f
Jun 251312:14p 310-417-8989 p.6
. - � �
. ;
�`
w�.fe 1�IANCY SKIV�LY, gYO��ded
I g�ve, devise and bequeath to m►Y .
she suzvives me by thir�Y (3�} days.
id wife is not living on �he thirty-
;n t�e event �ny s a res i.due and
�i� �y death, I direct t�e reSt'
f�.rsC day follo �
estate be distzibuted as �ollows:
Yem��deY of �y �.nE CWA.LTER AN'�O1�Y
In the event any chiZd of
t8� . RIL JA13�1�E '�1';�S� J�►iQEI.LE
AP
g�{IVELY► LORRAINE D�NISE SOI.1�, e time of �Y deatb is
� LISA ARIA►L�tNE SKI'V�LY) at �h , . �
LYNNE K�� � e, (2� living at Y
g th� tk�irty �30} yQaYS of ��
(1) les and C�+) a�Paxated from
,�� resi dence, (3) �emP�Oyed,
curre hesei:'�af�er ��Ed ;
use and!o= u�rried, �. direc� �Y
his/hex �P� •dence and �ovsehold furn�slr���s
txustees to retain rny said resi chiidxen
..�� � �� eccupa�ncy and use o� any °f �y
�� therein "i-n kimd for without
s o� this su�Paragraph (�7 •
who rneet the YequiYem�t re�eive fYom �9'
urther direet my said trustees
charge• ; � in and nnaix�taininS said
p��.UO �or eXPenses af keep �
es tate �14� . no livi�S ��ild of rni�►g me��s
reside�nce and furnz.shi:tgs• �w♦ 9
Wk�en
� • w ,-at1T� ��� � ��a 4@�S P��
� nts of this su�p����y�-�
t�e requixe� distYibute the
• trtist ass etis an�
• v�i dat e the �e�s o f sub�
directed to llq
• ustees to tie held under the
s amo t o mY s a�.d tix'
aragraph Cb) o� ttzis xte,�• ir�der o�
p said rest, residue ��d zem�
(b� '�1e balance of �o �Y txusLe�s hereinaftE
�o���+ 8��, bequeath
...+.,r.K R GlisGAIGM },. Y a;_ve , devis e .,,a� i��e s�ment=
,,.,�......_ estaL� i �-- • in5µL�..
s�N.w�yNEs�� mY �o be �nvested in goverc��ae�t
rJD'oa'"'0 e d Itt Txus t b
�,M,s,owN,vU►.;,oea n�
��
Jun'251312:14p 310-417-8989 p.3
. ,
r c�ildren o� m�ne who mee� the YeQuiYe-
a�nd I direct any child o 1 be enLi.L�.G� ��
s af subparagraph (a� .of this �tem s1na�.
ment ra h (b} For
use �nt
erest fYO� the investnents of this subpara8 P
e enses. ArY unused iuteres� shall
m�oee aary. r_ormal 1 Lvix1g xP
to m ather children equallq• In ��king
be paid qu�=tezly Y
uxiused iaterest nty tYU�tees shoul�
such distributixan of �Y • d oz ch��.d.Yen W�O i��are
reserv� suffici�nt funds foz sa�d ck�i� .
re��iv�.ng i�t
eres t f or neces s ary. narinal 1 iv3.n� expens es•
. i� �ny�hir.g in thia ztem to t�e co�txaxy.
�ic tw�.ths tand �
lished in this Item sha�.3. ter�ctinat� when �Y
the tsust es�ab ears of age at
est living chi�d is twenMy-th�ee (23) Y
y°�g rg�.a �n tz�st s�a�.l
• 11 assets �ro� my estate being
� whiCh t7�nle � � �, �a`� ,.t��i�d�Cen
�� , rviceeds distributied zO �y
be �iquxdated and the p ther. ta h�.$lh�r
.. 1 or in t�e event a child is not liv��8
equ�l Y
� : ,,,,.,,. ..QT �vr.irves •
� ��su� �...+ � oint �Y
��g: Y no�ni-�at�� �onstitnte and apP
.� ITF'M Las�
�, a�d J A�T ELLE as trus tees un der t t�i s �Y
d a u g h t e r s A P R� d trus t e e s f a s l s
Wil�. and T�sta�t. xf oria vf the afoYenasne
or ceases to act in such ���a��-t�'
I nominat�► �o�'s���ute and
bstitute txustee fo= s�1d �hild.
appoint 'a�y' daughter LISA as su
� na�inate, const�tute ana apPoint my _
I'�'�M FI.VE: Last Wkll a�d �eSta
• t NCY SHIVEZX �� Executrix of� this my
w+r�FU�s wtf e tiA
H011GK�(ilN6AtGH In ��e event tny s a�d
�ife fax�s to act as saxd Executxs.x,
j¢�.�w►,���Y ment. o o in t �y daught ers AgR�I, and
�A.wo�.�a �p�stitt�te and a,P ;
iew��rowN,��.,�tw I AoYa:►.nate:
, /'
. Jun'251312:14p 310-d��.7-8989 p.4
. • ••
. . . ., . ... .. . . d
• e �xec�strices. If vn� of the aforena�
� J,�L� as substitut
substitute Ex�c
utrices f ai�s oY ceases to act in such cspa��t�',
,I nca�cinate, can
stituze and appo�.n� rnv dau�ht�= LISA as substitute
Egecutri.x f oz said ch�.ld.
ITEM SIX: Y
direct t�at rny Executrf,x, trust�es or the�r
� �ve ���CS'� f4r the �sithful
successors shal�. not be reqvired to g -
erfoYmancg o� their duti�s in any ju=isdiction.
p ' but not 1�ited ta
I'�EM SEVEN= �3o i�terest (:Lincluding,
a}1 shares of �rincipal an,d incame) af any
benefi.ci.arp under
this �il� ar any Codic
i.l he=eto shall b+� subject to antici�ation
or volutttal'Y' or invvluntary alienatiOn.
he even.t ariy b��efic�ary af niY eS�te is
ITEM EIGHT: In t esta��
ears of age �t the ti.me hel9�e shaYe$ in my
-.., 1ess thax� 18 y I ive, davise
- other trusts herein. �
� and is not covexed by �Y aforena��d ��st@65i
` and b equeath sa id benef iciarp�s sha=e to �
� � terms and �o�d��io'ns:
Iri 'T;rus t, up on tY�e f o 1lowing txu s t s,
he trustees hereinbefore na�u�de��he
A. Said �haYe to t owers and du���s
foz said benef�.c�-ary with the P $ra r�ph B• �
� terms and conditions set foYth �n s�b-p 8 �ollect the
re�invest �d �ng�e' xin�lpal af
�. To ha1d, invest, and so mnsch of the p
�ncome►, s�r.d use the it�'�g e s� ��xt,
� as �.n the solc artd abso1�or th cYepiott a
�he txust estat be n,ecessary o� pr�F��
said trustee9 �Y g� s�gical �d �ospita1 needs o�
maintex�ance, medic .
car e. de
sa�.d beneficiaxy• � oses �9 be � �rdia
C. The paYa�ents for the�$hou��he �ntetv'ention °��e cur�ent
�y ��e trustees diYectl.y, w�.t 89 ���•, of
rustees ms.y pay to said bex�ef iciary
1'1cie
t . rincipa�- as t�e trtYSLees in thei
v►wo�,c� income, accu�aulated �ncome or P
HoucK a�iN�aicH
�s r�.w�►rNE stl�*
PA.eox•�0 `
�gTOwW�pe.t�O�a �
Il
, Jun"251312:14p , 310�17-8989 p.5
V �•
. � � • . � . •1. ' . �. . . �• •1�'.�• • �. . . V
. .r•v IIt...'1- . � . •.
absolute discre�io�n deem advisable for ttie suppoYt,
g°1e a�d of said beneficiary• �n $aid
educa�ion an� weil-be�tt�
neficiary reaches the age o� �.g ye��s said txustees are
be the re�inder of the
direct�d tb paY to such beneiic�ary
ther with al� accur�x�ated �ncot�e �d o fl said t�us t
tYUgt Cog� rocee
shall be terra.inated �d ��nt�to�the�intestate la�s of �r"
sha11 be d�str�buted pur roceeds of y
. .,��o�-t_ In t�e Qvent the p �,�,��;��$£ore
1 sylvania tn�i� i� � "'""'aid ovex to t�e tru����s .. y -
insusauce pa�.icieedsr ha11 be hel.d by the t�st�aa�this Will,
n�gd, such proce
sa�ae trusts, ter�s and �Or`�ti�de b atihe insurance cor�pany
aa
and as re�pect to any Pa�� s�all e u�de�r n= e�ob�Che tYUst
ta szi.d ti'ttsteeS��nsible�£oxyChe gropeX discha $
see to or be xesp - � such paya��t to said tr�3���,�e all
o.r any part thereof � and a y unt so paid; a
�u�,ly d�.scharge the con�Pan� for the a� S ate tz�s.st
cc,�oapany
sball nat be char�;ed with not��iss�seSOZeChe termi�az�Qn
instruraent, the death ef ��id�Cel thereof i s recoived at �ts
o� a trust utitll written�
hos�e office.
D, ;Ky trus tee s sh
all be .cQ�Pensaze� i� accordPennap v��-a
hedule of rates,in effect in �in�wh�.h heix sez�vices are
the sc t�e p�rlad
f xont �i�� to t ime duz in�
rendered.
E. �y t�ustees sha
11 invest in governmer.t �nsux�d invest-
tner.t s.
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• WARMtNG: It is illegal to duplica�this copy by photostat or pho#ograph.
Fee far dtis certificate,S6.Q0 ,,�� Thi.� is to certify that the u�farmation here given is
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2109 MARKET STREET•CAMP HILL, PENNSYLVANIA 17011
MARK E.HALBRUNER (717�731-9600•FAX:(717)731-9627
CRAIG A.HATCH,CELA BRANCH OFFICE:
Certified as an Elder Law Attorney by CORRESPONDENCE ADDRESS: 3 WEST MONUMENT SQUARE,SUiTE 304
the National Elder Law Foundation Camp Hiil OffiC@ LEWISTOWN,PA 17044
CLIFTON R.OUISE WEB SITE: (��7)248-6909
Also Admitted to practice before the www.hhglip.com STACEY L.NACE
U.S.Patent$Trademark Office
Paralegal
JOHN H.MCCULLOUGH TRACI L.SEPKOVIC
Of Counsel Para�ega�
TRACI L.HILFERDING
Paralegal
November 26, 2013
FEDERAL EXpRESS
Glenda Farner Strasbaugh,Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
RE: Estate of George R. Shively
File No.21-13-0939
Dear Ms. Strasbaugh:
I am enclosing a Pennsylvania lnheritance T�Return, Inventory and Sta.tus Report for
filing in the above estate. Please date stamp the extra copy of each document and return them to
me usmg the envelope provided. Thank you for your assistance.
Sincerely,
� - a�
ace Cl��ace .
Y
Paralegal
Enclosures
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