HomeMy WebLinkAbout08-04-14 J 1505610105
REV-1500 EX(ozap(Fu I
PA Department of Revenue pennsyytvania OFFICIAL USE ONLY
o�..n..., ,...� r
Bureau
BO 2Individual Taxes County Code Year File Number
PO BOX Z8D6oi INHERITANCE TAX RETURN `-- '---- ----
Harrisbur ,PA 17128-0601 RESIDENT DECEDENT Z I Z I !J—
ENTER DECEDENT INFORMATION BELOW _..
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
06/28/2012 09/24/1923
J
Decedents Last Name Suffix Decedents First Name
Stuart I Jacquelyn -. i MI
J
(If Applicable)Enter Surviving Spouse's Information Below --"
Spouse's Last Name Suffix
Spouses First Name MI
�.
Spouse's Social Security Number - ---' -- -- --- L _
.. ....................................
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
- - REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
OD 1. Original Return O 2.Supplemental Return
O 3. Remainder Return(Date of Death
Prior to 1243-82)
O 4. Limited Estate O 4a. Future Interest date Compromise of
p ( O 5. Federal Estate Tax Return Required
death after 12-12-82)
11 6. Decedent Died Testate O 7. Decedent Maintained a Living Trust
(Attach Copy of Will) 9 8. Total Number of Sale Deposit Boxes
(Attach Copy of Trust.)
O 9.Litigation Proceeds Received O 10.Spousal Poverty Credit Date of Death
( O 11. Election t Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT- THIS SECTION MUST eE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name
Daytime Telephone Number
ohnna J Kopecky Esquire
(717)221-1111
REGISTER OF W"S USE ONLY r�
First Line of Address CO
�53 rn
r
The - . 111 Law Group r c
=2'.;T 1 e it T,
Second Line of Address -- - _--- ---- �C,6
,120 South Street
_--
City or Post Office ._ - - -� — °---� _
----- .__._ _.—_,-- _-- _-_ , _State ZIP Code DATE F
Harrisburg PA 17101 D rT
Correspondent's e-mail address:1ko2ecky7180Dyah00 cone
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 true,correct and complete.Dacia bon of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATU NE,OOFF PERSON RESPONSIBLE FOR FILIN/G/^RETURN
DATE y
ADDRESS 7
z MSE r L1. �7i/s6ur &
SIGNATURE OF PREP ER OTHER TH��Nq R�EPRESENTATIVE
O7??.L r-ix0 DATE
ADDRESS v 4/p Zg /7
/zo elrr .J� S ep ^ �r4 , �'�9 19iDl
PLEASE USE ORIGI AL FORM ONLY
Side 1
L 1505610105 1505610105 J
1505610205
REV-1500 EX(Fl)
Decedent's Social Security Number
Decedent's Name: Stuart, Jacquelyn J
RECAPITULATION
1. Real Estate(Schedule A). .. ..... .. ... .... ... . ...... ... ....... ...... .. 1. 96,926.56
2. Stocks and Bonds(Schedule B) . ... .. ... ..... . ... ......... ...... ...... 2. 0.00
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) . .. .. 3. 0.00
4. Mortgages and Notes Receivable(Schedule D). . ... ....... ........... 0.00
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E)....... 5. 25,797.01
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 0.00
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property -
(Schedule G) O Separate Billing Requested........ 7. 0.00
8. Total Gross Assets(total Lines 1 through 7)... ...... ... ............. .... 8. ; 122,723,$7 I
9. Funeral Expenses and Administrative Costs(Schedule H).. .......... ... .. .. 9. 6,123.91
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)........... .. .. 10. 3,971.21
11. Total Deductions(total Lines 9 and 10)............. ... . ................ 11. 10,095.12
i
12. Net Value of Estate(Line 8 minus Line 11) .............................. 12. 112,628.45 !:
13. 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. ; 112,628.45
TAX CALCULATION-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 .0_ 15.
16. Amount of Line 14 taxable -'
at lineal rate X.0 45 112,628.45 16. 5,068.28
17. Amount of Line 14 taxable � �
at sibling rate X .12 ! 17.
18. Amount of Line 14 taxable
at collateral rate X.15 18.
19. TAX DUE ............................ .......................... .. . 19. E 5,068.28
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT p
Side 2
L 1505610205 1505610205
REV-1506 EX(F!) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Stuart, Jacquelyn J
STREETADDRESS v
129 16th Street
CITY STATE ZIP
New Cumberland PA 17070
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 5,068.28
2. Credits/Payments
A.Prior Payments _
B.Discount
Total Credits(A+B) (2)
3. Interest
(3) 201.67
4. If Line 2 is greater than Line 1+Line 3,enter the difference. This is the OVERPAYMENT.
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) 5,269.95
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............._..........._.............................................................. ❑ N
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑ 0
c. retain a reversionary interest.... ......................................._..............---..............................................
.... ❑
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑
2. If death occurred after Dec.12,1982,did 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?.............. El 2
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 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 percent
[72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from lax,and the statutory requirements for disclosure of assets and
filing a tax return are still applicable even 9 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)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[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)].A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
REV-1502 EX+ (12-12)
pennsylvania SCHEDULE A
7� DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN L REAL ESTATE
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Stuart, Jacqulyn J 21-12-1115
All real property owned solely or as a tenant in common must be reported at fair market value.Fair market value is defined as the price at which property
would be exchanged between a willing buyer and a willing seller, neither being compelled to buy 0r sell,both having reasonable knowledge of the relevant facts.
Real property that is jointly-owned with right of survivorship must be disclosed on Schedule F.
Attach a copy of the settlement sheet if the property has been sold.
REM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUE AT DATE
NUMBER OF DEATH
DESCRIPTION
1 129 6th Street New Cumberland Cumberland County PA(see attached HUD-1 Settlement) 96,926.56
TOTAL(Also enter on Line 1, Recapitulation.) ; 96,926.56
If more space is needed,use additional sheets of paper of the same size.
OMB Approval No.25024265
A. Settlement Statement (HUD-1)
0. Type of Loan
1.❑FHA 2.0 RHS 3.DK Conv.Unins. 6. File Number 7, Loan Number, 8, Mortgage Insure noe Case Number:
4.0 VA 5.0 Conv.Ins. IS L513-107
C. Note: TMs form is famished to give you a statement ofsdual settlement casts. Amounts pad 0 and by the settlement sgentore shown,
Items marked Yp.0 c.1'were paid outside ft closing,they are shown hem formilent alinnstpu"ses andam not mcludedin ft totals.
O. Name and Address of Bomawer' E. Name and Address of Seller. F. Name are Address of lender:
Kingdom Vest Macennan,LLC Anthony A,Stuart Executor of
237 Wolgemuth Drive the Exists of Jacquetyn J.Stuan
Lancaster.PA 17602 12916th Street CASH TRANSACTION
New Cumberland,PA 17070
G. Property Location: H. Settlement Agent: L Settlement Date:
129 181n Sheet Independent Setibment It Land Somme,Inc.
New Cumberland,PA 17070 4230 Jonestown Road August 14,2013
Cumberland County,Pennsylvania Harrisburg,PA 17109 PK (717)695-3641
Place of Settlement
4230 Jonestown Road
Harnsburq,PA 17109
J. Summary of Bor7osvar's transaction K. Summary of Sollaesthmactlpn
100. Gross Amount Due trom Borrower, 400. Gross Amount Due to Seller
101. Centred sales once 98,000.00 401. Contract ce sales prim 98 000.00
102. Personal property 402. Personal orcpeRy
103. Settlement Charges to Borrower Line 1400 1,99100 403,
104. 404. --.-- i.-.
105. 405.
Adjustments for items paid le Seller in advance Adjustments for Kemp pald Seilerin advance
106, C ?own Taxes 0811513 to 01101114 237,54 408,C !Town Taxes 08fi Sri3 to 01101114 237.54
107, Coup Taxes 0815113 to 01101114 138.50 407,County Taxes 0IV W13 10 01!01114 138.50
108, School Taxes 0815113 to 07/01/14 1,318.05 408.School Taxes 08/1513 to 07/01114 1318.05
109, Sewer Fees 08/15/13 to 10/01113 39.15 409.Sevwd Fees 08/15/13 to 10101/13 39.15
110, 470.
111. 411.
112. 412.
120. Gross Amount OW from Borrower 101,725.24 420.Grose Amount OW to Seller 99,733.24
200. Amounts Paid by or in Behalf of Borrower 500. Reductions In Arrt"M Due Seller.
201. Deposit or earnest money 501. Excess deposit see instructions)
202. Principal amount of new bans 502. Se0lement Charges to Seiler Inn 1400 9,306.68
203. Existing loans taken aub'ed to 503. Exhibit;lea s taken subject to
204. 504, Payoff First No
205 oub.vayon Second Mrrwke
206. 506.
207. 507,
208, 508.
209, 509.
Adjustments for items unibild by Seller Ad Wtmenb for Items unpaid by Seller
210. C' /town Taxes to 510.Cityllrosm Taxes to
211. CowntyTaxes to 511,Cou Texas to
212. School Taxes to 512.School Taxes to
213- 513.
214. $14-
215. $15.
216. $16.
217. 517.
218. 518.
219. 619.
220. Total pad tryffor Borrower 620. Total Reduction Amount Deal Seller 9,306.68
300. Cash at Settlement hemRO Borrower 880. Cash M aattlemsM taKfom Seller
301. Gross amounldue from Borrower line 120 101,72524 601, Gross mount due b Seiler line d20 9g 733.24
302. Less amount aid tfor Borrower(line 220) ( 602. Less Mdudlens d W Satter line 520 ( 9,306.
303.Cash �% From To Borrower 101,725,24 603. C h To From Seller 90,426.56
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Page 1 of 3 �. .MWEO'i.7
(iSLS 13.107.PFOIISLS 574016)-
SettlemenfChar es
3.Total Real Estate Broker Fees
Pak From m Pak From
Oms,��n olcommissbn(line 700)as 100w, pow Solana
5.$ to F.M.at Funds at
2.$ to Snteemern SINdament
).Commission Paid al settlement
3.
5.
),Items Payable in Connection with Loan
t.Our o' �nation aha M 5 from G E 01
1.Your credit or cha a inl for the specific interest fate 00ser, (from GFE N2
-Your adjusted origination changes to (from GFE kA .00
I.Appraisal fee U) m GFE 0
5.Credit Report to thwart GFE N3
Tax service to ffrum GFE N
T.Flood uMillot ion to Omm,GFE N
3. (train GFE
>. m OFF N
J. hem GFE 03
).Items Required by Lender to Be Paid to Advance
1.Daily interest cha s from to 0 $ from GFE N10
I.MM Tat Ins.for Life of Loan months to (from GFE 93)
1 Homepwrrers insurar far years to them GFE Nt t)
e. (from GFE 011
S. (from GFE 011)
00.Raserms Deposited with Under
)1.Initial deposit for your e5c,M=aunt (from GFEN9)
02.Homeowners insurance months @ $ Per month $
)3,Montage,insurance months $ per month S
34.Property texas $
05.
06. engfths @ $ per month $
D7. months @ $ per month $
08, $
09. S
00.Title Charges
01.Tate services arm lenders link insurance (from GFE 04)
02.Settlement or closing toe $
03.Owners title insurance to Old Republic National Title Insurance Company (from GFE 05) 889.00
04.Lenders fire insurance to Old Republic National Tine Insurance Comps S
05.Landers title policy limit $
06.Owners role policy limit $ 98,000.00 SALE
07. Agent's potkn of the total title insurance pramium to Independent Settlement&Land Services,Inc. $ 755.65
08. Underwriters portion of the total lee Insurance premium to Old Republic National Tait announce Coatm my $ 133.35
09.Wire Fees to Independent Settlement&Land Services,In& 30.00
10, $
11.Deed Preparation Fee to Independent Settlement&Land Services,d+& 150.00
12.Note Fees to Independent Settlement&Land Services,In& 5.00 10.00
13.Coune03veni ht fees to Independent Settlement&Land Services,inn. 20.00
00.Gavemment Recording and Transfer Charged
01.Govemment recordina charges to Cumberland County Recorderol Deeds from GFE 07 66-00
02-Deed S 68.00 Mortgage S Reform S Other$
03.Transfer taxes to Cumberland County Recorder of Deeds (from GFE 08) 980.00
:a4.CilytCounty mMslam s Heed $ 980.00 Mortgage $
105.State taxIstam Deed$ 980.00 Mortgage$ 980.00
106. Cumberland County Recorder of Deeds
07.
;00.Additional Settlement Charges
.01.Required services that you an shop for (from GFE 06)
X02.Tax Certfication Fee to amapendent Settkrtent&Land Sevices S 10.00
103. $
104. S
105.See alma'I dieb.exhibit to S 8,156,88
100.Total Settlement Charged(enter on lines 103,Section J and 502,SectiomK) - 1,992.00 9.306.68
•wno„aue moo+�ovremaxrcaf,wnsl.ananai.wnwwnm
Certified to be a true copy.
Page 2 of 3 HUD-1
(ISLS13-107.PFDfISLS11107116)
HUDA Attachment��
Borrower(s):Kingdom Vest Associates,LLC Sellegs): Anthony A.Stuart Executor of the Estate
of Jacquelyn J.Stuart the Estate of
Jacquelyn J.Stuart
237 Wolgemuth Drive 129 16th Street
Lancaster,PA 17602 New Cumberland,PA 17070
Settlement Agent•.Independent Settlement 8 Land Services,Inc.
(717)695-3641
Place of settlement•.4230 Jonestown Road
Harrisburg,PA 17109
Settlement Date:August 14,2013
Property Location:129 16th Street
New Cumberland,PA 17070
Cumberland County,Pennsylvania
Additional Adjustments For Items Paid By Seller in Advance(Borrower Debit)
Description Amount From/Through Prorated Amount
Sewer Fees 76.64 07101/13 through 09/30/13 39.15
Total Line 1091409 39.15
Additional Disbursements
PayeetDescription Note/Ref No. Borrower Seller
Robin Gasperetti,Tax Collector 1,503.40
201312014 School Taxes
New Cumberland Borough 76.64
Past Sewer Fees April 1 thru June 30
New Cumberland Borough 76.64
Current Sewer Fees July 1 thru Sept 30
Departmant of Revenue 6,500.00
Inheritance escrow
Total Additional Disbursements shown on Line 1305 $ 0.00E 8,156.68
Owner's Title Insurance BORROWER SELLER
Owner's Policy Premium 889.00
to Old Republic National Title Insurance Company
Total E 889.00 $ 0100
I have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,it is a true and
accurate statement of all receipts and disbursements made on my account or by me in this transaction. I further certify
that I have received a copy of the HUD-1 Settlement Statement.
Kingdom Vest Asso ' s, LL Anthony A.Stuart Executor of the Estate of Jacquelyn
J.Stuart
BY:
lea A. r BY:�
To the best of my knowledge,the HUD-1 Settlement Statement which I have prepared is a true and accurate account of
the funds which were received and have been or will be disbursed by the undersigned as part of the settlement of this
transaction.
lndepe ttte" M rvices,Inc.
e ementAge
WARNING: It is a crime to knowingly make false statements to the United States on this or any similar form. Penalties upon conviction can
include a fine and Imprisonment. For details see: This 18 U.S.Coda Section 1001 and Section 5810.
(ISL513407.PFD/ISLS13-107/16)
REV-1508 EX+(o8-iz)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE Tax RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF:
Stuart, Jacquleyn J FILE NUMBER:
21-12-1115
Include the proceeds of litigation and the date the proceeds were received by the estate.
ITEM All property jointly owned with right of survivorship must be disclosed on schedule F.
NUMBER DESCRIFTION VALUE AT DATE
OF DEATH
1. PNC Checking Account
13,748.92
2. PNC Certificate of Deposit
8,620.22
3, New Cumberland Federal Credit Union
1,816.48
4. Bushnell(IL)Savings Account
1,611.39
TOTAL(Also enter on Line 5, Recapitulation) $ 25,797.01
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+ (08-13)
apennsytvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF
Stuart, Jacquelyn J FILE NUMBER
21-12-1115
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Cremation: Oak Hill Cemetary, Canton, IL
1,769.00
2. Oak Hill Cemetery charge 450.00
3. Affordable Markers-grave marker 700.00
4. Affordable Markers-vault for urn 200.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative commissions:
Name(s)of Personal Representative(s)
Street Address
City state_ZIP
Year(s)commission Paid:
Z Attorney Fees: 500.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation.)
Claimant
Street Address
City State_ZIP
Relationship of Claimant to Decedent
4. Probate Fees:
273.50
5• Accountant Fees:
200.00
6. Tax Return Preparer Fees:
31.75
7 Notary fees
25.00
8. Additional Death certificates
18.00
9. United States Postal Service mailings 52.99
10. Airline ticket to bury decedent in Illinois, and expenses associated with travel and funeral arrangements 1,903.67
TOTAL (Also enter on Line 9, Recapitulation) $ 6,123.91
If more space is needed, use additional sheets of paper of the same size.
REV-1512 EX+ (12-12)
IV pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENTr
INHERITANCE SIDEN D ED RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF
Stuart, Jacqueline J FILE NUMBER
7PDReport debts incurred by the decedent prior to death that remained unpaid at the date of death,including un1-12-111 medical expenses.
DESCRIPTION VALUE AT DATE
OF DEATH
Depot/Walmart expenses to make home repairs prior to selling
ter 1,062.97
110.93
Electric 317.83
umberland Borough sewer and trash 230.48
mming and cutting down
325.00
deral Income Taxes due
7. Grass cutting and maintenance 1,014.00
8. Homeowner's Insurance 370.00
9. PNC Bank checking fee 536.00
4.00
TOTAL (Also enter on Line 10, Recapitulation) $ 3,971.21
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(01-10)
opennsylvania SCHEDULE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF:
FILE NUMBER:
Stuart, Jacquelyn J 21-12-1115
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSONS)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. Anthony A.Stuart 293 Dorsey Lane Dillsburg PA son 100%
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.
LAST WILL AND TESTIMENT
FOR JACQUELYN STUART, HORN ON 09/2411923 IN
BUSHNELL ILLINOIS, USA.
LAST RESIDING AT 129 EAST 16TH STREET NEW
CUMBERLAND , PA . 1707C
BEING OF SOUND MIND AND DYING BODY I HEREBY
BEQUEATH ALL MY WORLDLY ASSETS, BOTH SOLELEY
AND JOINTLY OWNED TO MY ONLY NEXT OF KIN, MY
ONLY CHILD ,
ANTHONY STUART BORN ON 10103/1959 , SSN 178543011,
RESIDING CURRENTLTY AT 293 DORSEY LANE
DILLSBURG, PA , 17019
IN ADDITION, I RE -CONFIRM POWER OF ATTORNEY
PAPERS THAY I SIGNED A FEW DAYS AGO,
LASTLY I REQUEST MY SON CREMATE ME AND TAKE ME
TO ILLINOIS TO BE INTERNED NEXT TO MY PARENTS
WITH A SIMILAR MARKER.
oQ� �'� cMY SON HAS AGREED TO DO THIS .
GOD REST MY SOUL.
=s SIGNED-JACQUELYN STUART
1_
�r
mmt
WITNESS OkNOTARY
NAME-- W-- - c.W'W A A
- � --..
COMMONWEALTH OF PENNSYLVANIA
SIGNANTURE------------ -----------------------{- G Notari31 s eo
------- [ -William D.Wittman,Notary Public
New Cumberland Soro,Cumberland County
(�
�Nfi,Commission Expires Sept 15,2012
SEAL CORNER> h:_,;PUer F,:nnSylVania Association of Notaries
THE SHAGIN LAW GROUP LLC
THE INNS OF ST.JUDE
120 South Street
Harrisburg,PA 17101
w ww.shaainlaw com
Johnna J.Kopecky,Esquire
ikopecky @shaginlaw.com 717-221-1111
Fax (717)221-1110
July 29, 2014
Register of Wills of Cumberland County
One Courthouse Square
Carlisle, PA 17013
Re: Estate of Jacquelyn Stuart
No. 21-12-1115
Dear Sir or Madam:
Enclosed for filing please find the Inheritance Tax Return for the above-captioned estate.
Kindly time-stamp the enclosed copy and return it to me, along with receipt of payment, in the
envelope provided.
Thank you for your kind attention.
Very truly yours.
cc: Anthony A. Stuart
Enclosures Johnna J Kopecky, Esquire
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