HomeMy WebLinkAbout03-17-14 _ . `
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---� REV-1500 1505610143
EX(02-11)
� OFFICIAL USE ONLY
PA Department of Revenue pennsylvania counry code Year File Number
Bureau of Individual Taxes DEPARTMENTOFREVENUE
Po sox.2soso� INHERITANCE TAX RETURN 2 1 13 0 5 5 8
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
12 26 2012 10 05 1930
DecedenYs Last Name Suffix DecedenYs First Name MI
JESSICK SHIRLEY M
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
� 1. Original Return ❑ 2. Supplemental Return � 3.Remainder Return(Date of Death
Pnor to 12-13-82)
� 4. Limited Estate � 4a.Future interest Compromise � 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
� g Decedent Died Testate � � Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy ot Wilq (Attach Copy of Trust)
� 9. Litigation Proceeds Received � 10.Spousal Poverty Credit(Date of Death � ��,Election to tax under Sec.9113(A)
between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
LISA MARIE COYNE ESQ 717 737 0464r,,
�
REGISTER��ILLS US�NLY* �
m f`- C�
��,� �p t� -Y�
First Line of Address �' —� "- `—'
�"""'-_.. r.,,_ s_.,�
t_G'7' . "^� .'. i�7
3 9 O 1 MARKET STREET �r`>. �;' �'>
C�j�:�, _ ..,
Q�: =r-�
Second Line of Address � -t: � ;��" �
D '� .. `- �
.C"
City or Post Office State ZIP Code DATE FILED CJ
CAMP HILL PA 170114227
CorrespondenYs e-mail address: I I S 8@ C O y e 811 d C O y Il @.c o m
Under penalties of perjury,I declare that I have examined this return,inGuding accompanying schedules and statements,and to the best of my knowledge and belief,
it is true,correct and complete.Declaration of preparer other than the personal representative is based on all information of which prepa er has ny knowledge.
SIGNATURE PERSON RESPONSIBLE FOR F RETURN DA
,� ��,Q/� Joseph Jessick 3�' �� 1
ADDRE /
315 Wesley Drive,Apt. 3107, Mechanicsburg, PA 17055 �
SI TURE OF P E OTHER T REPRESENTATIVE DATE
� LISA MARIE COYNE Esq
AD RES
e&Coyne, P.C.
39 1 Market Street,Camp Hill, PA 170114227
Side 1
� 1505610143 1505610143 �
,�
�
� 1505610243
REV-1500 EX
DecedenYs Social Security Number
Decedent�sNema: JESSICK� SHIRLEY M.
RECAPITULATION
1. Real Estate(Schedule A).......................................................................................... 1.
2. Stocks and Bonds(Schedule B)............................................................................... 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C).......... 3.
4. Mortgages&Notes Receivable(Schedule D).......................................................... 4.
5. Cash,Bank Deposits&Miscellaneous Personal Property(Schedule E)................ 5. 5 0 0 . 0 0
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............. 6. 1 , 0 0 0 . 0 0
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) � Separate Billing Requested............. 7.
g. Total Gross Assets(total Lines 1 through 7).......................................................... g. 1 , 5 0 0 . 0 0
9. Funeral Expenses and Administrative Costs(Schedule H)..................................... 9. 5 , 8 9 4 . 9 5
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................. 10.
11. Total Deductions total Lines 9 and 10........................................................ 5 , 8 9 4 . 9 5
� ) .......... 11.
12• Net Value of Estate(Line 8 minus Line 11)............................................................. 12. - 4 , 3 9 4 . 9 5
�3. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)................................................. 13.
14. Net Value Subject to Tax(Line 12 minus Line 13)................................................. 14. - 4 , 3 9 4 . 9 5
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.00 15•
16. Amount of Line 14 taxable
at lineal rate X .045 16.
17. Amount of Line 14 taxable
atsibling rateX .�2 ��•
18. Amount of Line 14 taxable
at collateral rate X .15 �$•
19. TAX DUE................................................................................................................... 19. O . O O
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. ❑
Side 2
� 1505610243 1505610243 J
.
REV-1500 EX Page 3 File Number 21 - 13 - 0558
� Decedent's Complete Address:
NT' NAM
Jessick, Shiriey M.
STREET ADDRESS
4150 Nantucket Dr.
CITY STATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 0.00
2. Credits/Payments
A• Prior Payments
B. Discount
Total Credits(A +B) (2) 0.00
3. I nterest (3) 0.0 0
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
Check box on Page 2,Line 20 to request a refund
5. If Line 1 +Line 3 is greater than Line 2,enter the difference. This is the TAX DUE. (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. retain the use or income of the property transferred:.................................................................................. ❑ ❑x
b. retain the right to designate who shall use the property transferred or its income:.................................... � �
c. retain a reversionary interest;or.................................................................................................................. ❑ ❑x
d. receive the promise for life of either payments,benefits or care?.............................................................. � �x
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?....................................................................................................................... ❑ 0
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?......... � �
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?...................................................................................................................... ❑ ❑x
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 January 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)]. The stafute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disclosure of
assets and filing a tax refurn 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,an
adoptive parent,or a stepparent of the child is 0 percent[72 P.S.§9116(a)(9.2)].
•The tax rate imposed on the net value of transfers to or for the use of the decedenYs lineal beneficiaries is 4.5 percent,except as noted in
[72 P.S.§9116(a)(1)1•
•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)1. A
sibling is defined under Section 9102,as an individual who has at least one parent in common with the decedent,wfiether 6y blood or adoption.
. _._ . _ _
:�_� pennsylvania SCHEDULE E
DEPARTMENTOFREVENUE CASH BANK DEPOSITS AND MISC.
INHERITANCE TAX RETURN 7
RESIDENTDECEDENT PERSONAL PROPERTY
FILE NUMBER
ESTATE OF �eSSICk, Shirley M. 21 - 13 -0558
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 OF
NUMBER DESCRIPTION DEATH
1 Misc. personal property 500.00
TOTAL(Also enter on Line 5, Recapitulation) 500.00
REV-1b08 EX+(07-10)
.� ���� pennsylvania
DEPARTMENTOFREVENUE SCHEDULE F
INHERITANCETAXRETURN JOINTLY-OWNED PROPERTY
RESIDENT DECEDENT
ESTATE OF Jessick, Shirley M. FILE NUMBER
21 - 13-0558
If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G.
SURVIVING JOINT TENANT(S)NAME ADDRESS RELATIONSHIP TO DECEDENT
Joseph Jessick 4150 Nantucket Dr. Husband
A
Mechanicsburg, PA 17050
JOINTLY OWNED PROPERTY:
LETTER I DATE C�F�SCRIPT.lO��F PRO�ERT�Y ' °/a OF DATE OF DEATH
ITEM FOR JOINT MADE �nclude name o inanaal ins i u ion an ban account number DATE OF DEATH ' DECD'S VALUE OF
NUMBER TENANT '; JOINT or similar identifying number.Attach deed for jointly-held reai,VALUE OF ASSET INTEREST DECEDENT'S INTEREST
estate.
1 A I, Timeshare Interest-Unit 816, Week 12--Ocean' 2,000.00 'I 50% 1,000.00
' Cove, Hilton Head Is. '
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TOTAL(Also enter on line 6, Recapitulation) 1,000.00
DEED T(#PROPERTY IN PALMETTO DUNES 1'��'F�y� �
/
Hilton Head Island,S.C.
^ d
�OO�i1EtJi'i@ 5�3lYI�JS
The State of South Carolina, �o����t� . .
County of Beaufort , `
�---�-- __
Beaufart �ounty, �.C,
KNOW ALL MEN BY THESE PRESENTS, that PALMETTO DUNES RESORT, INC., a corporation duly " ,
organized and existing under the laws of the state of Delaware, au[horized.to do business in the state of South
Carolina and having a place of business on Hilton Head Island,Beaufort County,South Carolina in consideration of ,
che sum of Three Thousand F;�nt Hund��7 and on/�on (�,�nn nnl Dollars �
and other valuable consideration to it in hand paid at and before the sealing of these presents,by �
JOSEPH C TF� T K nnm CNTRTF'V M rF9STC�t, 19 Manor Drive Mechanicshiir�,
Penns lvania 17055 s �
the receipt whereof is hereby acknowledged has granted,bargained,sold and released,and by these Presents do grant, k `_
bargain,sell and release,unto the said TCI.SFPH r TF4�Tf`K Anm 4HTRT F'Y M ,]��5��,�, th P i r
heirs,successors,and assigns forever,the following described property,to-wit: `
An undivided One and Ninety-Nine Hundredths (1.99%) percent interest in : -
all that certain apartment lying and being on Hilton Head Isl'and, Beaufort '
County, South Carolina and being lmown as Apartment 16-B of Ocean Cove .
Club Horizontal Property Regime and being more particularly shown and ,
described by reference to the Master Deed of Graves Construction Crnnpany,
Inc., establishing said Horizontal Property Regime, said Deed being
dated the 2nd day of April, 1975, and recorded in the Office of the � i '
Clerk of Court for Beaufort County, South Carolina in Deed Book 227 at � �
Page 1272. - , .
Also, all right, title, interest and privileges extending to time period . .' •
`" owner Nimiber Twelve (12) as contained in those certain Supplemental �
Declarations of covenants, conditions and restrictions for condominiwn
unit 16-B, Ocean Cove Club Horizontal Property Regime, Hilton Head
Island, Beaufort County, South Carolina dated .7anuary 10, 1977 and being ,
recorded in the Office of the Clerk of Court for Beaufort County, South �
Carolina, in Deed Book 243 at Page 1950.
:.
Also, all the rights, privileges and cammon elements appertaining to the
above described apartment as set forth in the Master Deed and By-Laws of
the Ocean Cove Club Horizontal Property Regime.
B�aufort County Qa3 P�aP Reference ,��
Mor U/� Parce�BII�L�Dist.� ••�
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�„�.�...�.�.,�, M'.�..,.�o..w.„� ��.�.,...�e.,�..� �..�..,.�.�..,�
4
The above described property is conveyed by the Grantor and accepted by the Grantee subject to all Easements as
shown on plats of record,and to that certain Declaration of Rights,Restrictions and Affirmative Obligations which
constitute covenants running with the land, which Covenants are recorded in the Office of the Clerk of Court for
Beaufort County,South Carolina in Deed Book 7n1 at Page__1522_ hereby made applicable to this property
conveyed by this deed.
The property conveyed herein is all or a portion of the property conveyed to the within Grantor by deed recorded
in the Office of the Clerk of Court for Beaufort County,South Carolina in Deed Book_���_ at Page�r�_•
on April 10, 1975.
This Deed was Prepared in the Offices of Harvey,Battey,Mac(oskie&Bethea,P.A.
Hilton Head Island,South Caro[ina
�+ FF�,��„�
t
TOGETHER with all and singular the Rights,Members,Hereditaments and Appurtenances to the said Premises
belonging,or in anywise incident or appertaining.
TO HAVE AND TO HOLD,all and singular the said premises before mentioned unto the said
JQSEPH C JESSICK ANn SHIRT�'Y M TFSSIC;K, th P i r Heirs,Successors and
Assigns forever,subject,however,to the rights, restrictions and conditions which constitute covenants running with
the land,all as set forth above.
;,
Y e ,
• ,- And PALMETTO DUNES RESORT,INC.,does hereby bind itself and its successors,to warrant and forever defend
" all and singular the said premises unto the said JOSEPH C TFSSICK AT� SHIRL�'Y M JESSICK th e i r
Heirs, Suceessors and Assigns, against itself and its successors lawfully claiming or to claim the same, or any part
� ` thereof.
IN WITNESS WHEREOF PALMETTO DUNES RESORT,INC.,has caused these presents to be executed in its
� name by Rober't C Onorato , its President,and by Wi l l i am T RPthPa, Tr.. ,
its�ssTSeeretary � and its corporate seal to be hereto affixed this .3� day of
, ' _�Gl�LCIti/ in the year of our Lord one thousand nine hundred and ,
and in the two hundred year of the Sovereignty and Independence of the
United States of America.
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: - Signed,Sealed and Delivered PALMETTO DUNES RESORT,INC.(SEAL)
. in Presence of .
� � � � �r� - �
� $y 1
Witness Rober't �. Onor3 President
� ��'�` �_l�'L�.;
Attest:
, itness William L. Bethe"� or�
��
. � ��1�l� ' . .
�`
The State of South Carolin&, ,�
County of Beadfort _ � ,
PERSONALLY appeared before me JaCk H Biel � '
who,on oath,says that he saw the within named PALMETTO DUNES RESORT,INC.,by
,its President,sign the within Deed,and
Willi�rrt �, $�t�P�3—dr ,its attest the same,and the said Corporation,by
said officers,seal said Deed,and,as its act and deed,deliver the same,and that he with
T t�c� Wingard witnessed the execution thereof. ' ,
.�'
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(Witness) `
� �: _
3rd March 77 ,
SWORN to before me,this day of A.D.19_
,
��' �-"`-�l, Seal '
� C� �. `�I��� � NotaryPublic .
�;ota .i�blic Scuth `a;o!�n:•o,,.�ai L�rge , i �
MY�Cammission Ezpires/�pril 25,1432 . ' .
My Commission Expires • •
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REV•1511 EX+�10-09)
;��� pennsylvania �H
DEPARTMENT OF REVENUE �����
INHERITANCE TAX RETURN Ary��wnCTpw��
RESIDENT DECEDENT tYJ111N1�Ih71 IV1
FILE NUMBER
ESTATE OF Jessick, Shirley M. 21 - 13-0558
DecedenYs debts must be reported on Schedule I.
ITEM
NUMBER ; FUNERAL EXPENSES: DESCRIPTION i AMOUNT
A. ',
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B. �, ADMINISTRATIVE COSTS:
�. ! Personal Representative's Commissions �
Name of Personal Representative(s) �I
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' li
' Street Address '
' City State Zip
Year(s)Commission Paid
2. �''I Attorney's Fees COyne&COyne, P.C. ! 900.00
3. �, Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation) I
! Claimant Joseph Jessick ' 3,500.00
Street Address 4150 Nantucket Dr. i
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' city Mechanicsburg state PA zip 17050
Relationship of Claimant to Decedent SpOUS@
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4. ; Probate Fees Register of Wills 138.50
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5. 'I AccountanYs Fees i
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6. Tax Return Preparer's Fees ; 200.00
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7. � Other Administrative Costs
1 �I Patior News-Legal Advertisement , 116.45
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TOTAL(Also enter on line 9, Recapitulation) 5,894.95
� Schedule H
Funeral E�er�ses&
COMMONWEALTH OF PENNSYLVANIA q,�ynisfiativ�e Cos1s c�r�tinued
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Jessick, Shirley M. FILE NUMBER
21 - 13-0558
2 ', Cumberland Law Journal- Legal Advertisement ' 75.00
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3 I�I Postage ' 50.00
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4 I Estate Checks � 50.00
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5 i inheritance Tax Return Filing Fee I, 15.00
6 � Wilson SC Law Firm 850.00
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Page 2 of Schedule H
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: - ���;��,�.�� �: v: ; i �
: " LAST WILL AND TESTAMENT. ��(�j��'- _�r � a S "_"' ;�
,- ,-,;
� �'���� i#R 1� �Ti ca ��� -
' I, SHIRLEY MAY JESSICK,of the Township of Upper Allen, County o'f`�umber�and,
. � and Commonwealth of Pennsylvania,being of sound and disposing mind,memory and ��'`�`�' � w
, - (3�f���Po�' �,.f�.��:;�.
� � understanding,do malce,publish and declare this as and for my Last Will and Test��ef�,�,�'o.� � `�<j E '`,-
. revolcing and making void all former yvills and codicils b,y me at anytime heretofore made. , ;�'.-:, = •
. . _ °- . . ,r - � . � - ,. ,
� FIRST. I order and direct that all my just debts and funeral expenses be paid by my `
: : , ��'-';. .
; Executor or Executors,as the case may be,hereinafter named, as soon as conveniently may be
done after zny decease. �
: SECOND. 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
husband,JOSEPH CONRAD JESSICK, absolutely and in fee simple if he survives me by as
,
many as sixty(60)days. ' � � ��
THIRD. If my husband,JOSEPH CONRAD JESSICK,does not survive me by as many ` �.
as sixty(60)days,then and in th�t event,I g?ve,devise an�be�u�ath all thP reut�residuP�nd
rem�inder of my Estate,real,personal �nc�mixed,whatsoever and whe_res�ever situated;in equal �
�.
::'':.
shares unto my two (2)children;namely,JOSEPH LEE 7ESSICK and JANICE MAY LOSE,
share and share alike.
� �
If either of my said children sliall predecease me and leave lawful issue to survive me,I � ,
i
E '
order and direct that the foregoing share of my Estate attributable to such deceased child shall be �
distributed tulto his or her issue per stirpes by representation and not per capita; subject, .
however,to the protective trust provisions in Item Fourth hereinbelow.
If either of my said children should predecease me without leaving issue to suruive me,
+� a � ,� + t r �' d� t that t�:e for�goti^�share at±r.z��.:table to such�ece?::Pd
�aieil�.ii�4 ii7 �ii2.��'v'��ii� i C%T"�.�,'i?�Tlu ii.°•C� . .
child shall lapse and the subject matter be distributed to my surviving child.
LAW OFFICES
sNE�eAKER. FOURTH. I order and direct that the distributive sh'are of my Estate attributable to any ?
BRENNEMAN
& SPARE
beneficiary who has not attained the age of twenty-two (22)years at the time of distribution of
such share shall be paid over and del.ivered unto my testamentary trustee,hereinafter named,IN
,
TRLJST,NEVERTHELESS,to hold,manage;invest, accumulate income and reinvest for the
benefit of said beneficiary and until said beneficiary attains the age of twenty-two (22)years,at �.
which time said trust shall be terminated and the net proceeds thereof be paid over to the �. �
; beneficiary absolutely.
' I authorize and empower my said Trustee to invest the assets of said trust in any ,' �,
reasonable manner and not be limitec� or restricted to so-called"legal"or statutory ii�vestments i
: ; for fiduciaries. ;;`;: �
: l'
; , I designate any trust liereunder to be a spend-thrift trust. The beneficiary sha11 have no �.`'`
�.� �
; right to invade,pledge,assign ar otherwise dispose of the assets of said trust(including income)
c
inor shall any creditor of a beneficiary have any right to seize,levy or execute upon said assefs by '
ireason of any pledge, assignnient or other transfer,voluntarily or involuntarily,made by said � '
� beneficiary. � ; '
' .;�. ''.�
I further authorize and empower my said trustee to use, consume, expend,and apply from _ � '
tizne to time such amounts of income and principal of and from said'�trust which in the exercise of '
its sole discretion shall be determined to be reasonable and necessary for the beneficiary's '
education. The term "education°shajl�e�;,�L;�la��anci interpreted to mean college or other post- ' _
�;';..
high school training which is intended to improve the beneficiary's productivity as an adult or � -
enhance the quality of his or her life. In considering what is reasonable and necessary,my said •
Trustee will talce into consideration the primary respor.sibili`,y of the benenciary's surviving �' `
parent to provide such education. It is my will and intention that the foregoing discretionary
provision for education shall be supplementary to the parent's primary responsibility.
I nominate, constitute and appoint the surviving parent of each such beneficiary to be tile
rustee of the trust attributable to such beneficiary, but if such person fails to qualify as such
ustee,then�nd in that event,i riominate, constitute and appoint my surviving Executor or '
xecutrix, as the case may be,hereinafter named,to be the Trustee of each such trusi. .
N OFFICES �
E�aAKeR. LAS.TLY. I nominate, constitute and appoint my husband,namely,JOSEPH CONRAD {
ENNEMAN
SPARE ESSICK,to be the Executor of this,my Last Will and Testament, but if for any reason he �
-2-
� . � ' ; , . .
.
should fail to qualify as such Executor or cease so to sei-ve,then and in t�at event,I nominate, `
constitute and appaint my two (2)children,namely JOSEPH LEE JESSICK and JANICE MAY . -
LOSE(or either of them in the event that one should fail to qualify or cease so to serve)to be the _ ,
Executors hereof,each and all to serve without bond or other security as a condition of '
qualification hereunder.
IN WITNESS WHEREOF,I, uHIRLEY MAY JESSICI�,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 I have affixed my signature this i��day of June,A.D. T�wo Thousand Two(2002). `l' ;
,
..� (SEAL) � �
SH EY M SSICK �
The preceding instnunent,consisting of this and two (2)other typewritten pages,each
identified by the signature of the Testatrix,was on the date thereof signed, sealed,published and � .
declared by SHIRLEY MAY JESSICK,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 as witne�ses�herPro, E>.
�:;;
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LAW OFFICES
SNELBAKER, ' t
3RENNEMAN
& SPARE
-3-
y . � .
COMMONWEALTH OF PENNSYLVANIA) � °
: SS. '
COUNTY OF CUMBERLAND ) . ,
We, SHIRLEY MAY JESSICK,RICHARD C. SNELBAKER and JANE J. COONEY, � . �
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 actfor the purposes therein .'
expressed, and that each of the witne5ses,in the presence and hearing of the Testatrix,signed the ''
' VJill 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. ,
,'-
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� Subscribed,sworn to and acknowledged before me by SHIRLEY MAY JES�ICK,the
Testatrix, and su�scribPd a.nd s���ozn to before me by RICHARD C. SNBL.BAKER an� TANE T. � '
COONEY,the wimesses,this � da of June 2002. �`��'°'
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Notary Pu lic �
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�t..2�s,Nctacy fiuF�ic
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LAW OFFICES -
SNELBAKER, ' " . $
BRENNEMAN -
& SPARE �-
COYNE & COYNE
A PROFESSIONAL CORPORATION
ATTORNEYS AT LAW
Henry F. Coyne 3901 Market Street 717-737-0464
Lisa Marie Coyne Camp Hill, Pennsylvania Fax: 717-737-5161
Bradley C. Baird 17011-4227 www.coyneandcoyne.com
March 14, 2014
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re: Estate of Shirley M. Jessick,Deceased
No. 21-13-0558
Dear Madam:
We represent the Estate of the Late Shirley M. Jessick.
Enclosed for filing are an original and two copies of the Inheritance Tax Return for this
Estate. Kindly docket the original Return and return a "clocked-in" copy to this office with the
enclosed envelope. Also enclosed is check No. 1932 in the amount of$15.00 for the filing fee
for the Return.
Thank you for your assistance. If you have any questions,please contact me.
Very truly yours,
COYNE & COI'NE, P.C.
Li Marie Coyne
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