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FAMILY SETTLEMENT AND FINAL RELEASE �Q '�' =T? ��
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IN °rn°-�-- �- '-'�`--'
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ESTATE OF SARAH H. SEILHAMER, DECEASED ��'� �' � � __
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KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, SARAH��. ,.—
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SEILHAMER, late of 1615 High Street, Enola, Cumberland County, Pennsylvania, deceased,
died testate on August 10, 2013, having made her last will and testament, which was duly
executed on Apri128, 2009;
WHEREAS, letters testamentary for the estate of the said decedent were duly issued on
September 17, 2013, by the Register of Wills of Cumberland County, Pennsylvania, to DORIS
REDFERN and JOAN WAGNER, Executrixes, hereinafter called personal representatives, for
the Estate of SARAH SEILHAMER, Number 2013-00996;
WHEREAS, the said personal representatives have gathered the assets of the estate of the
said decedent and the assets consist of personal property, to a total value of$35,563.32, as set
forth in Exhibit A, which is the estate tax return prepared by said personal representatives, and
which is attached hereto and made a part hereof, and marked Exhibit A;
WHEREAS, the debts and deductions, including the payment of inheritance tax in the said
estate have been paid, leaving a balance for distribution of$20,735.06, for which a schedule of
distribution is set forth in Exhibit A;
WHEREAS, the balance for distribution as shown in said E�ibit A has been reduced to
cash and has been distributed as herein indicated in accordance with the last will and testament of
the said decedent;
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NOW, THEREFORE, KNOW YE, that we, DORIS REDFERN and JOAN WAGNER,
being the testamentary heirs of the said decedent, and being the persons entitled to inherit under
said last will and testament, do hereby, acknowledge that we have this day had and received from
the aforesaid personal representatives, in full satisfaction and payrnent of all sum or sums of
money, the amount due each of us under said last will and testament, as illustrated in E�ibit A,
which amount she has received this day, and which amount is set opposite her name in the table
and schedule of distribution in said statement attached hereto and marked Exhibit A, unless
modified herein;
AND, we do hereby stipulate that in order to avoid the expense and time involved in the
filing of a formal account and schedule of distribution, we agree that no account is necessary and
we do hereby agree that we consent to distribution being made without the filing of an account
and schedule of distribution, the same to be with the same force and effect as if they had been filed
and confirmed by the Orphans Court Division of the Court of Common Pleas, Cumberland
County Branch, Pennsylvania.
THEREFORE, we do hereby remise, release, quitclaim and forever discharge the said
personal representatives, their heirs, executors, and administrators and assigns, of and from the
said estate and from all actions, suits, payments, accounts, reckonings, claims, and demands
whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever
touching upon the estate of the said decedent, and we do further hereby covenant and agree that
should any liability come due to the estate of the said decedent after the signing of this agreement,
we do hereby covenant and agree that we will contribute our share of the estate to satisfy any and
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all claims, demands, suits, or causes of action which may be successfully prosecuted against the
said estate or the aforesaid personal representatives after the signing, sealing and delivery of this
family settlement agreement and final release.
IN WITNESS WHEREOF, WE, DORIS REDFERN and JOAN WAGNER, hereunto set
our respective hands and/or seals on the date indicated beside our respective names;
WITNESS:
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1. �'r'�' �� (SEAL) �—d���(Date)
�
DORIS REDFERN
2.
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1• C�- (SEAL) 7o`�a � (Date)
JOAN WAGNER
2.
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COMMONWEALTH OF PENNSYLVANIA :
. SS:
COUNTY OF CUMBERLAND .
nd-
On this, the �— day of , 2014, before me, a Notary
Public, the undersigned officer, personally appeared DORIS REDFERN, known to me to be
the person whose name is subscribed to the within instrument, and acknowledged that she
executed the same for the purpose therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
NOTARIA � �ti . �
CAROLE A ROSE �
Nohry Public Nota Public
LOWER ALLEN TWP.,CUMBERLAND CNTY rY
My Commission Expires Dec 6,20/5
My Commission Expires:� . (.P�Z.C�Is
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_ _ _ _ _
. .
COMMONWEALTH OF PENNSYLVANIA :
. SS:
COUNTY OF CUMBERLAND .
��
On this, the �2— day of , , 2014, before me, a Notary
Public, the undersigned officer, personally appeared JOAN WAGNER, known to me to be
the person whose name is subscribed to the within instrument, and acknowledged that she
executed the same for the purpose therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
NOTARIAL SEAL �
CAROLE A ROSE
Notary Public °
LOWER ALLEN TWP.,CUMBERLAND CNTY
My Commission Expires Dec 6,2015 Notary Public
My Commission Expires: 1�,�c.,� ����S
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EXHIBIT "A"
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_ _ _ __ _
J 150561�1�1
REV-15a0 r>:��:_�o> �
PA Department of Revenue Pennsylvania oFFiCIAL USE oNLY
��:P �-.-.=,�� Count��Code Year File Number
BureauofIndividualTaxes 6NHER[TANCE TAX RETURN
PO BdX z8o6oi
Harrisburq,PA 1'71z8-o6oi RESIDENT DECEQENT
ENTER DECEDENT INFORMATfON BELOW
Social Security Number Date af Death h4P�1DDl'YYY Date of Birth IUhADDYYI'Y
_ _
_ _ _
' � ,� �� �' ���� Zc�J�� V� � � ��%Z�✓
DecedenYs Last Name Suffix DecedenYs Firsf Name MI
J �� l��%!m �'�^ ,J GI/'�3 h �
(tf Appficable) Enter Surviving Spouse's fnformation Below
Spouse's Last Name Su�fix Spouse's First Name AAI
Spouse's Social Security Number
iH{S RETURN MUST BE FILED IN DUPLICATE WITH THE
R�G�STER C3F WfLLS
FILL!N APPROPFZIATE OVALS BELOW
� 1. Original Reiurn O 2.Supplem=ntal Return O 3. Remainder Return(date of death
prior io 12-13-62)
O 4. Limited Estate p 4a. Future Interest Compromise(date of O 5. Federal Estate Tax Return Required
death after 12-12-82)
�? 6. Dec=dent Died Testate Q 7. Decedent Mainiained a Living Trust _ 8. Total Number of Safe Deposit Box.es
(Attach Copy of Vdill) (Attach Copy of Trust)
O 9. Litigation Proceeds Received O 10.Sp�usal Poverty Cradit jdate of death O 11. Election to tax under Sec.9113(A)
between 12-31-91 and 1-1-95) (Attach Sch.Ol
CORRESPONDENT— THIS SECTION f�UST BE COMPLETED.ALL CORRESPONDENCE AND CONFIaENTIAI TAX INFORNATION SHOULD BE DfRECTED TQ:
Name Qaytime Telsphone Number
_. _
_.--
J���s �✓. G�//��s _ _ �i� �.���/6�,� -:�
REGISTER 0�0.L�I S USE OPit•5'' T3�''�i
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�:7^��.,- � C.%:` r77
First line of address � - � � •
' _ _. �G'' ; � 7
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�D �l�s� F ��<�� �o� =�: - ;
... ..._._ � � ._... ....... _._.. ....... ......... ......... �(`_, . ., � � 1 `7`F
Second line of addross -- � ::; 'r?
__ _. . . _ _ �<._.
_ < �; ;-�-rC7n
l� O�f �Pr�v�v�.c��?�-'����H� �c� ,� �05' a Y � ��
_._. _....._ __._._._ .. __ y_.. _... __ DATE FILED f V �
City or Post OfiFice State ZIP Code �
_ __ _ _ __ _ ___ _ . _ _ _..__.
C�n-,�� �%// /�.� ��o./� _ __ __...
_ _ _
Correspondent's e-mail address: J�'�''�e� � ��//�� -�,��'7G��P✓/✓7 PC�y- Gd�'^
Under penalties of perjury,I declare that I have examined ihis return;including a�compans ing schedules and statements,and to ihe best of my knowledge and beli=i,
it is true,corroct and compleie.Declaration of preparer other than the personal representa:ive is based on all information of which preparer has any knowledge.
�ATURE OF PER Of ESPONSIBLE FOR FILING RETURN ❑ATE
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A RESS
�O d T-�6c�i /':o%e l'c' j /Lf'� t�/��' P�9 %�1 '�G/j /-/i" � Jf Fols /�/� �JZs'
SIGNA���RE�THAN REPRESENTATIVE DATE
DRE
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PLEASE USE ORIGENAL FORM ONLY
Side 1
� 1,5�561,�],OI, 15D567,0],01 J
� Z5�561�105
REV-1500 EX
DecedenYs Social Security Number
Decedent's Name: SO/�.s�l y JP�/f'J�rry e�r � ��,��
RECRPITULATION
1. Real Estate(Schedule A). . . ... . . . . .. .. . .. . . .. .... . . . .. . . . . .. ... . .. . . . 1. �
`
2. Stocks and Bonds(Schedule B) .. . ... . . . .. . . . . ...... .. . .. . .. . .. . .. .. . . 2. ��/
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . ... . 3. X/.
4. Mortgages and Notes Receivable(Schedule D). . ... . .... . .. . .. . .. . .. . . . . . 4.
5. Cash, Eank deposits and Miscellaneous Personal Property(Schedule E). . .. ... 5. �S ,��,� 3 Z
J
6. Jointly Owned Property(Schedule Fj O Separate Billing Requested . . ..... 6.
�`
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property �
(Sch2dule G) O Separate Billing Requested... .... . 7. �'�
S. Total Gross Assets(total Lines 1 through 7). �S� � �j� �
. .. . . .. . ... .. . . . . .. . . . ... .. . 8. > Z
9. Funeral Expenses and Administrati��e Costs(Schedule H).... . . . . ... . . . .. . . . 9. �3l �'S�_ �'"�
10. Debts of Decedent, Niortgage Liabilities, and Liens(Schedule I) . . .... .. . . . . . . 10. �
11. Total Qeduetions(total Lines 9 and 10).. . ... . .. ...... .. ........ . . .. .. . . 11. I� ���' � �
� __ _
12. Net Value of Estate{Line 8 minus Line 11) ... . . . . ......... .. . .. . . . . . .. . . 12• Z� �j S-� �5--
13. Charitable and Govemmental Bequests;Sec 9113 Trusts for which � � `
an election to tax has not been made(Schedule J) . ..... .. . .. . . . . ... . ..... 13.
14. Net Vaiue Subject#o Tax(Line 12 minus Line 13) . ....... .. . .. . . . . .. . . .. . 14. ��� G S�_ ��
T.4X CALCULATiON-SEE[NSTRUCTION3 FOR APPLlCABLE RATE3 J
15. Amount of Line 14 taxable
at the spousal tax rate,or
__ _ _ _ .
__
trans ers un er 5ec.91i6 �
(a)(1.2)X.0_ 15.
16. Amount of Line 14 taxable
at lineal rafe X.0� Z l ���� �-S: 16. � �� � �
_ _ __ � .
17, h,mount of Line 14 taxabie � �
at sibiing rate X.12 � i 7.
18. Amount ofi Line 14 taxable �
at collateral rate X.15 /� 18.
r- _ _ '
19. TAX DUE .. . .. . .. . .. . . . . ...... ... .. . ... . .. .. . . . . .. ...... . .. ... . . . . 19. � �`7- � T
__ _ _
20. FILL IN THE OVAL!F YOU ARE REQUESTiNG A REFUND OF AN QVERPAYMENT O
Side 2
� 7,5D561,01,�5 1,5�561,OZ05 �
REV-1500 EX Page 3 File Number
DecedenYs Campiete Address: Z��3 — JO���
DECEDEhT'S NAME /
SGl/'�� � n ��� /v/�s�i P r
STREETADDRESS
G /,5-' �/` � S���f
CITY STATE. ZIP
� >�<, ,� /� a �
Tax Payments and Credits:
1. Tax Que(Page 2:Line 19) (1} � �� ���
2. Credits/Payments
A.Prior Payments
B.Discount
Totai Credits(A+B) (2}
3. Interest
(3)
4. If Line 2 is greater than Line 1 +Line 3,entzr th2 difference. This is the QitERPAYMENT. �_
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) � �� �, �
Make check payable to: REGISTER OF WILLS, AGENT.
FLEASE ANSVitER THE FOLLC3WIR[G QUESTIONS BY PLACENG AlV "X" [N THE AFPRQPR[ATE BLOCKS
1. Did decedent make a transier and: Y2s No
a. retain the use or income of the property transferred:.......................................................................................... ❑ �
b. retain the right te designate who shall use the property transferred or its income:............................................ ❑ .�
c. retain a reversionary inierest;or.......................................................................................................................... ❑ �
d. receivz the promise for life of either payments,benefits or car2?...................................................................... ❑
2. If death occurred after Dec.12,1982,did decedent transfer property within ane year of death �
without receiving adequate consideration?.............................................................................................................. ❑
3. Di�decedent own an"in trust for`or payabie-upon-death bank account or security at his or her death?.............. ❑ �
4. Did decedent o�vn an individual retirement account,annuity or other non-probate property,vdhich
contains a beneficiary designaiion? ........................................................................................................................ ❑ �
IF THE ANSWER TO ANY OF THE AB4VE QUESTIONS IS YES,YOU MUST CONfPLETE SCHEDULE G QND F{LE iT AS PART OF THE RETt1Rh(.
__ __ __ __ _ _ __ _ __ ___ _
_ _
For dates of death on or after July 1, 1994,and before Jan. 1, 1 p85,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 deafh on or affer Jan. 1, 1935, the tax rat2 imposed on the net value of transfers to or for fhe use of the surviving spouse is 0 percent
[72 P.S. §9116 (a) (1.1) (ii)]. The sfatute does n�t exempf a transfer to a surviving spouse from tax, and the statufory requirements for disclosure of assets and
fifing a tax return are still applicable even if the surviving spouse is the only beneficiary�.
Far dates of death on or after Juiy 1,20�G:
• The tax rate imposed on the net value of transfers from a deczased child 21 years of age or younger at death to or for the use of a natural parent, an
adaptive parent or a stepparent of the child is 0 percent[72 P.S.§9116(aj(1.2)].
• The tax rate imposed on the net value of transfers to ar for the use of the decetlent's lineal beneficiaries is 4.5 percent, except as noted in
72 P.S.�9116(1.2)[72 P.S.§9116(a)(1)].
s 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 sibling is defined,under
Section 9102,as an individual vrho has at least one parent in common with the decedent,whether by blood or adoption.
_ _ _
REV-1508 EX+(6-98)
���� SCHE�ULE E
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COMt�IONVJEALTH OF PENNSYLVANIA CAJH, BANK DEP�SITS� Oc lYIESC.
INHERITANCE TAX RETURN PERSONAL PRQPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Sarah H. Seilhamer 2013-00996
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Cash on Hand 25.00
2 Misc.Personal Property 25.00
3 Accounts(checking and savings)at M&T Bank 35,513.32
TOTAL(Also enter on line 5, Recapitulation) $ 35,563.32
(If more space is needed,insert additional sheets of the same size)
h�v-�sxr =x+ tzo-o=;;
� � ��� pennsytvar�ia SCHEDlILE H
� UEPART�MENI�OFRFVENUE FUNERAL EXPENSES AN�
� IP+HERIT.qNCETkXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTAFE OF FILE h[UMBER
Sarah H. Seilhamer 2013-00996
Decedent`s debts must be reparted on Schedule I.
iTEM
NUM6ER DESCFIPTIQN AP•10UNT
A. FUNERAL EXPENSES;
1� Richardson Funeral Home,funeral goods and services 8,318.00
2 Enola Sportsman Club,repast 573.12
s Funeral attire for decedent 91.00
B. ADMINISIRATIVE COSTS:
1. Persaral Representati��e Commissions: 0.00
Name(s)of Personal Representative(sj
Street P,ddr:ss
City State ZIP
Yearjs)Commission Paid:
2. Attorney Fees:
1,000.00
3. Family Ex.emption: (If decedent`s address is not the samz as claimant's,attach zxplanation,j
3,500.00
Claimant Doris Redfern
Street Address 1615 Nigh Street
City Enofa State PA Zip 17025
Rzlationship oi Claimant to Decedent D�uc]htef
4. Prob�te Fees: 371.45
5. Accountant Fees:
o. T;x R?turn PreF�arer Fzes:
7.
TdTAL(Also enter on Line 9, Recapitulation) $ 13,853.57
If more spa�e is needed,us�additional sheets of paper of the same size.
_ _ _ . _ _ _ _
' Rev-isis ex+�oi-io)
_...
' �, pennsy[vania SCHEDULE .7
�,�y UEPARTMFNT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Sarah H. Seilhamer 2013-00996
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS Of PERSON(5)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec, 9116(a) (1.2).�
1• Doris Redfern, 1615 High STreet,Enola PA 17025 Daughter 1/2
2 Joan Wagner,306 Timber Ridge Rd, Marysville, PA 17053 Daughter 1/2
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II NON-TAXABLE DISTRIBUTIONS
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1,
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size.