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HomeMy WebLinkAbout02-0692 PETITION FOR PROBATE and GRANT OF LETTERS EstateofDONALDl\IJ.l~iIl...-,SHAW ~iV" No. a/so known as DON A L1> Vl1LfY1E:1\ ..sH-mi\r' To: Deceased. Social Security No. 251-64-3766 Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner is 18 years of age or older and the Executrix named in the last will of the above decedent, dated May 31,1990 and codicil(s) dated [none]. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 1201 White Birch Lane, Borough of Carlisle, Cumberland County, Pennsylvania. Decedent, then 70 years of age, died July 25, 2002, at Holy Spirit Hospital, East Pennsboro Township, Cumberland County, Pennsylvania. Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: [none] Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: $ 26,000.00 $ $ $ WHEREFORE, petitioner respectfully requests the probate ofthe last will and codicil( s) presented herewith and the grant ofletters testamentary thereon. \\ n . .1 \ eX] i1,-1B<T7(dl ,~aw Joan Ferrall Shaw 1201 White Birch Lane Carlisle, PA 17013 I --------------------------------------------------------------------- --------------------------------------------------------------------- OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA) : SS. COUNTY OF CUMBERLAND ) The petitioner above-named swears or affirms that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner and that as personal representative of the above decedent, petitioner wil! well and truly administer the estate according to law. Sworn to or affirmed and subscribed bef~e this ..:b day of ~~~ ,2002. /u'{/,hu);()/! J:)~.on'Y RegIster I?- ?f-3 No.r::2/-002 - b9C:V Estate of Donald Palmer Shaw, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW, a,&//..~ _"')/ / reverse side hereof, satisfactory proof having been presented before me, , 2002, in consideration of the petition on the IT IS DECREED thatthe instrument(s) dated May 3 I, 1990, and described therein be admitted to probate and filed of record as the last will of Donald Palmer Shaw and Letters Testamentary are hereby granted to Joan Ferrall Shaw. Will Book # I~ Page '79 -\.3 ?N'i(l~Uh Mu///k/ ~~(~ Regifter of Wills FEES Probate, Letters, Etc. ~~o~ertificates (3) ~n"Uric~ffofi .JU $ b.oCJ $ c;l.~ 0.0 $ /G:" 00 $ ~OCJ $ /1"J.y!no Stephen L. Bloom, Esquire Sup. Ct. 1.0. No. 49811 2100 Longs Gap Road Carlisle, PAl 70 1 3 (717) 249-7717 TOTAL Filed ~ 0:2.. I 0 a2,.I Cc~\ \~~:STATEC:~tOf \\ ~'--\ "- o {\ 1()... ~ - O~ D'G THE LAST WILL AND TESTAMENT Q/-Oc{).- 69.:2/ OF DONALD PALMER SHAW Being of lawful age and sound and disposing mind and memo~y and not acting unde~ any du~ess, f~aud, undue i nf I uence o~ inducement of any pe~son, I, DONALD PALMER SHAW, a domic:ilia~y of Cadisle, Pennsylvania: ITEM 1 He~eby make, publ i sh, and decl a~e thi s my I ast Wi 11 and Testament, ~evoki ng and rendering null and void other Wills and codicils heretofore made by me. ITEM 2 I di ~ect that my E'-:ecuto~ to pay the fol I owi ng as soon afte~ my death as may be p~acticable: a. All of my just debts and the expenses of my last illness, fL\ne~al and of the administ~ation of my estate; but my Executo~ need not accele~ate and pay t.hose unmatured obli.gations which, in hi~) opinion, it might be proper and more advantageous to ~etain o~ '-enew and pay as they be come due and payable. b. All inhedtance, t~ansfe~, estate and simila~ ta:-:es (including inte~est and penalties) assessed o~ payable by ~eason of my death, on any p~ope~ty o~ illte~est in my estate fo~ pu~pose of computing taxes. My E"ecuto~ shall not requirE any beneficiary l,.,tnder- this will to reimburse my estate fm- taxes paid on p~ope~ty passing unde~ the te~ms of this will. ITEM .e. TESTATOR - The te~m "Testato~H as used in this Will refe~s to the make~ of this Will, whethe~ male o~ female. EXECUTOR - The te~m HE:.'ecuto~H as used in this Wi 11 ~efe~s to the pe~son I appoint to execute this Will, whethe~ male o~ female. SURVIVAL - Wheneve~ a p~ovision of this Will conditions a beneficia~y's taking by that beneficiary surviving the Testator, sLlch condition of survival shall be const~ued as a condition p~ecedent to the validity of the gift, devise (J~ beq\..teath; and such condition shall be satisfied only upon survival by the benefiCla~y fo~ a pe~iod of thil--ty days afte~ the date of death of the Testato~ or until this Will is probated, whichever shall be the first to occur, unless ei{pressly stated other-wise in a pr-ovision of this Will. SPOUSE - The term IISpollsell as ltsed in thi s Wi 11 refers to Joan Ferrall Shaw. PAGE k~ll~ ONE OF SIX PAGES }dd a:r-- ~ CHILDREN - The term "children" as used in this Will shall include any children hereafter born to or adopted by me, and any minor stepchildren living with me at the time of my death, as well as the children I now have, Peter D. Shaw, David F. Shaw, and W. Palmer Shaw, unless expressly stated otherwise in some provision of this Will. MINOR - The term "Minor" as used in this Wi 11 means a person under 18 years of age. DESCENDANTS - The term "Descendants" as used in this Will means the immediate and remote lawful lineal descendants or offspring by blood or adoption of the person referred to who are in being at the time they must be ascertained in order to give effect to the reference to them. PER STIRPES - The term "Per Stirpes" as used in this Will means that whenever distribution is to be made per stirpes, the estate or portion of the estate, to be so distributed, shall be divided into as many shares as there are surviving heirs in the nearest degree of kinship to the decedent and deceased persons in the same degree of kinship who left issue who survive the decedent. This degree of kinship shall be termed the root generation. Each surviving heir in the root generation shall take one full share. Those remaining heirs, i.e. the surviving issue of the deceased persons in the root generation, shall take the share of their deceased ancestor in the root generation, such share being divided in the following manner: each surviving issue shall take the fractional share that his or her immediate ancestor would have taken had he or she survived; and when there are two or more such surviving issue in the same degree of kinship they shall divide such fractional share equally among them. F'ER CAPITA - The term "Per Capi ta" as used in thi s Wi 11 means that whenever distribution is to be made per capita, the estate or portion of the estate, to be so distributed, shall be divided into as many equal shares as there are surviving issue, standing in the same degree of kinship to the decedent. Distribution shall be made without reference to right of representation of the surviving issue. ISSUE - The term "I ssue" as used in thi s Wi 11 means all persons who are descended from the person referred to, either by legitimate birth to or adoption by that person or any of that descendant's legitimately born or legally adopted descendants. INTENTIONAL OMISSION - I have intentionally omitted to provide for any relative or other person, not named as a beneficiary, under this my Last Will and Testament, whether claiming to be an heir of mine or not, unless otherwise provided for in this my Last Will and Testament. 4~/,4J&I?' TWO OF SIX PAGES :I4/!::I ~ ~ ITEM 4 I he~eby give, devise and bequeath all the ~est, ~esidue and ~effiainde~ of my said estate and prope~ty of which I may die seized and possessed, and to which I may be entitled at the time of my death, of whatsoeve~ kind and natu~e, and wheresoever it may be 5i tuated, be it real, personal or mi ;.~ed i ncl udi ng any power' of appointment that I may have, absolutely and in fee simple foreve~ to my spouse, if surviving. I make this gift to my spouse, specifically e>:cluding any present afterborn, or adopted children. ITEM 5 In the event that my spouse shall not su~vive me, I he~eby give, devise and bequeath all the rest, residue and remainder of my said estate and property of whi ch I may di e sei zed and possessed, and to whi ch I may be enti tl ed at the time of my death, of whatsoever kind and nature, and wheresoever it may be situated, be it real, personal or mixed including any power of appointment that I may have, absolutely and in fee simple foreve~ to my children, who shall ~_;;ut-vi ve me, in equal shares, and to the issue, 1 i vi ng at my death, of such children who shall predecease me, pe~ stirpes and not per capita. ITEM 6 I he~eby appoint Joan Fe~~all Shaw as E;,:ecutor of my Wi 11. If my E>:ecutor fails to serve, or- for any reason fails to continue to serve, I then appoint David F. Shaw to serve as E;;ecutor. ITEM 7 I designate my Executor to be an Independent Executor to the fullest extent permissible unde~ the laws of the State of Pennsylvania. I direct that no bond or othe,- secur'ity be required. I furthe~ direct that no action be had in dny COLwt relative to the administration of my estate other than to prove and record this Will G~nd to return an inventory, appraisal and list of claims of ,"y estate. ITEM 8 My E,.,ecutor and/or Trustee, if applicable, shall have the following powers, which are to be construed in the broadest manneF consistent with the validity of this Will and with their duties as fiduciaries. The powers stated herein are not intended to be exclusive, but shall be in addition to those g~anted by law and shall also per'tain to any administrators o~ trustees who succeed the fiduciaries I have appointed. These powers are: a. to take possession of property, to keep it safely, and to segregate it f~o," other property owned o~ held by the fiducia~y; ~u/I( ;/#.11;'" THREE OF SIX PAGES ~ ~ J.J~ b. to retaIn and to invest in property, or an undivided interest in property, including residential real estate, for any periOd, whether or not the property be of the chal"'acter permissible for investmen.t by fiduciar'ies; c. to sell, transfer, exchange, lease, rent, mortgage~ pledge, give options upon, parti tion and otherwise dispose of real or personal property, at private Dr public sale, for cash or upon wha.tever terms the fiduciary deems advisable, without notice or order of court; d. to render liquid my estate, in whole or in part, and to hold cash or readily marketable securities of little or no yield for such period as my fiduciary deems advisable; e. to borrow in the name of my estate or of the trust, upon whatever terms and conditions and for whatever periods my fiduciary deems advisable for the purpose of preserving, protecting or improving property held by him; f. to pay, compromise, adjust, settle, compound, renew or abandon claims held by my fiduciar-y and claims asserted against my fiduciary, on whatever terms he deems advisable, without prior court authority; g. to distribute in cash or in kind, or partly in cash and partly in kind, in divided or undivided interests, notwithstanding the fact that distributive shares may as a result be composed differently; h. to insure the property he holds as fiduciary against the risks, and in the amounts he, in his disc~etion, deems expedient, and to obtain and pay fo~ life, health, liability and other forms of insurance for the benehciaries of the trust1 in his disc~etion; i. to employ attorneys, accountants, investment advisors and other professional assistants including deposita~ies, proxies, agents, and E:\Ppt- ai set-s; j. to enter into tran5actions with other fiduciaries including e;{ecu.tors or tr-ustees of estates and trusts in which my beneficiaries have an interest, c:\nd including him as fiduciary for other estates and t.rusts; k. to engage in the powers necessary to the effective administration of corporate securities, including, without limiting the generality of this power: 1. power to vote in person or- by pro>:y upon all securities held by the fiduciary; 2. power to engage in a voting trust or voting agreement with respect to secw-ities; ~t1IdfJt&ll '''' FOUR OF SIX -W!Jf ~ ~ ~. power to consent or become a party to , or participate in, mergers, consolidation, sales of assets, rEcapitalization, reorganizations, dissolutions or other alterations of corporate structure, including adjustments in capital strclcture affecting securities held by the fiduciary, whether or not these adjustments involve payments by or to the fiduciary; and 4. powEr to hold securities in unregistered form or in the name of a nominee; 1. to pay himself reasonable compensation for his services. ITEM 9 If any part of this Will, or any trust hereby created, shall be invalid, illegal, or inoperative, for any reason, it is my intention that the remaining parts, so far as possible and reasonable, shall be effective and fully operative. My E~<ecutor may seek and obtain court instructions for the purpose of carr"ying out as nearly as may be possible the intention of this vJill shown by the terms hereof, Including the term held invalid, illegal or inoperative. ITEM 1 (; Ei ther I or my spouse have served in the Armed Forces of the Uni ted States. Therefore, I direct my Executor to consult the Legal Assistance Officer at the nearest military installation to ascertain if ther-e are any benefits to which my estate or my descendants are entitled by virtue of such service. Regardless of my military status at the time of my death, I direct my E,<ecutcor to consult wi th the nearest Veteran's Admini stration Off ice tco ascertain if there are any benefits to which my survivors may be entitled. ITEM 11 My spouse and I may, at approximately the same time, execute similar Wills in which each of us is the r'ecipient cof the other's bounty to a greater or 1 esser e~:tent; however, such Wi 11 5 are not the resul t of any contract or agreement between us, and either Will may be revoked or amended at any time at the sole discretion of the maker thereof. ITEM 12 I have made, or may from time to time make, a written memorandum expressing my desire to give certain items of personal property to speCific persons. I urge my E>:ecutor and beneficiaries to respec:t these wishes. Such a memorandum, if made, shall be stored in conjunction with this Will. ~/jJllL;'" F;\!E OF SIX -:f)J I( d/'"" ~ r the wi of IN WITNESS WHEREOF I have he~eunto set esses whose names a~ea~ he~eafte~l 19 Q. my hand and seal in the p~esence of published this 3/'i:j-day ,!I,JI/(t/r!lJl&ffff (SEAl) ATTESTATION On thi s ,,;1 '-1 day of ;tt~ 19q() , DONl'\LD PALMER SHAW! the Testato~! pe~sonally Published an Decla~ed ~fo~egoing Last Will and Testament, in the presence of each of us and all of us together, who, at the Testator's requesty personally witnessed the Testator Sign and Seal the same. We then, at the Testatoc's ~equest, and in the p~esence of the Testato~ and of each othe~! also Signed each page of the said document as witnesses. We fu~the~ state that each of us believes that at the time the Testato~ e,.:ecuted the foregoing instr-ument said Testator was of sound mind and memory, of lawful age, and did so e,.:ecute it as a f~ee act and deed and not unde~ the unlawful influence of any person. NAME: 52-'AI.L{.Il )1 ~ .--. /- C' ~ ~ ///~ v: ~J/-L ADDRESS: /t1,p {:f-;~>- (hkL {o;r~&/# NAME: ADDRESS: /<7..2 t/IK {; 11"1.4 ;?t/ii- _ C4,(tlfLE; /,61 NAME: (j/~ ry ADDREss/01~~,f~ ,. ~#d k . ./ /7C'*, PAGE SIX OF SIX Commonwealth of Pennsylvania Self-P~oving Clause STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND I, DONALD PALMER SHAW, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified acco~ding to law, do hereby ac~~nowledge that I signed and executed the inst~ument as my Last Will; that I signed it willingly; and ttlat I signed it as AIY free and volLlntary act for the purposes ther-ein E.::;.;pt'-E;?~;sed. I j} ;/;} . l!.&t/~.-.- PALt1E!::: SHI-\W ~3worn 01'- a-F.f- i r"(fif:fcj t:.o and acknowl ~erJ h(~-f or"e me 'I rJY D()Nr~L..D i"'P,L..!"fF:R :'SHAW, the To""t.atot", th~2z~~' Notary fO".Hid NolaiiaI Seal Wanda K. Hunter, NOlary Public v i. ~arl,'1c 80~, Cumberland County "My ComrrusslOn Expires ()ct. 18, 1993 Member; Penns.ylvanfaA~~ Of Ndtatkttl STATE OF PENNSYLVANIA COUNTY OF: CUMBERLAND We, .0001\l'f:L.Al.jde!f_~'f2..._. , A€!:lJ..._..c::..:._!.2.{z~~____ , . and ~~_~-~.....;z::-~...~ko..a::J.:, the WI tnt~~:_:.sE-?S ~.oJh(Jse names;, ar-e Sl gned to the attached or foregoing instrllment, being duly qualified accDn:J 1. ng to 1 aw, dD (jepDse and Si~.Y that WE-2 wet'~e pt'Mf?Sent and saw the Testator sign and execute this Will as his Last Will; that DONALD PALMER SHAW signed willingly and that DONALD PALMER SHAW 8}!ecuted it as his free and voluntary act for the purposes therein expressed; that each of us in the hearillg and sight of tile Testator signed the Will as witnesses; and that to Jest of our knowledge the Testator was at that time eigt1teen (18) or more year-s of age, of sOLAnd mind and under no constr'air,t or undue inf1.uenCt2u W-'C'["'T-~I=C'~O --- ._~:l.._~_..mm. . F~--'-"'-----"---------- ~jIl.,~-.f:--..~~~....._.--- ~~._.1::1'&;7?,~_.._....._..__.... by clnd Sworn or affirmed to and subscribed to before me .~Lr,;L..J1/~.<:.e.._._. ,:..f?t5!::::.-__.f;::._---c 17.";7 E LfCL>9 t:/ --J,...t:.in..s:;;..__I..__<.BtC.8?J::::.. , w 1 t n eo,:;, Ull E _':!t/..&?Z1!!ff;l-z..Cm...mm q4~-..~~~ Notar'y_ ~ Notariel Seal Wanda K. Hurner, Nolary Public Carllsle Bora, Cumberland Cou My Commission Expires Oct. 1 O. ~3 M~m~r, N!1~gplh NaOflfUtion Of Nolnries .' 0 0 " ~ " " 0 U> ~ om c". . e; m- :DO ~ o~ ~ S Ilig C" I E '" ~ ~ ...... ; m:t ~ " ~m ." I .-+ g, - :D"'ll :>- I~ a :Do r;;: S ~lJ) M I "'... I^' J1> <- ~ -. en a. ;:: "lie:: ~ 1"0 ~G'l elm ;f> "'0 8< "'0 0 ~ m -- ,-"--~"".,,,~--,--~-'._~~"---"-' CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: DONALD P. SHAW, a1k1aDONALD PALMER SHAW Date of Death: July 25, 2002 File No. 21-02-0692 To the Register: I certifY that Notice of Beneficial Interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above estate on August21, 2002: Name Address Mrs. Joan F. Shaw 1201 White Birch Lane, Carlisle, PA 17013 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: N/A ~~ - Stephen L. Bloom, Esquire 2100 Longs Gap Road Carlisle, PA 17013 (717) 249-7717 Date: August 27,2002 Capacity: Counsel for Personal Representative C:\LAS\Estates\ I 022Q-2cert. not . .( \f REV-1500 EX + (6~OO) CAPB HpRL EplO CRAC KOTK ES REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 0/ OFFICIAL USE ONLY 21-02-0692 o E C E o E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME(LAST, FIRST,AND MIDDLE INITIAL) Shaw Donald P. DATE OF DEATH (MM~OD-YEAR) COUNTY CODE YEAR SOCIAL SECURITY NUMBER 251-64-3766 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE R E C A P I T U L A T I o N 17 249- 1 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabifities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an ejection to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) DATE OF BIRTH (MM-DD-YEAR) NUMBER REGISTER OF WILLS SOCIAL SECURITY NUMBER Shaw, Joan F. X 1. Original Return 4. Limited Estate X 6. Decedent Died Testate (AttaCh copy of Will) D 9. LItigation Proceeds Received 2. 4a. 7. Supplemental Return Future Interest Compromise (date of death after 12-12-82) Decedent Maintained a LIving Trust (Attach copy of Trust) Spousal Poverty Credit (date of death between 12-3t-91 and 1-1-95) o 3. date of death . Remamder Return prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) (Attach Sch 0) 010. o P NAME COMPLETE MAILING ADDRESS C 0 0 Ste hen L. Bloom, Es uire R N FIRM NAME (If Applicable) 2100 Longs Gap Road R 0 E E Ste hen L. Bloom, Es uire Carlisle, PA 17013 S N T TELEPHONE NUMBER C o M P T U A T X A T I o N (1) (2) (3) None 22,166.58 None OFFICIAL USE ONLY (8) 172 ,424. 02 (11) 0.00 (12) 172,424.02 (13) (14) 172,424.02 (15) (16) (17) (18) (19) 0.00 0.00 0.00 0.00 0.00 (4) (5) None 501. 29 (6) None 149,756.15 None None SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)(1.2) 172,424.02 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at te 19. Tax Due 20, x X X X .0 0 .045 .12 .15 Copyright (cl 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS CITY I STATE I ZIP Carlisle PA 17013 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 Total Credos ( A + B + C) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty """",!m!'!~:t:g~~~"~~~t!~!!~!A!g:"~~:t!t~!I~~!::~~g,~~~~!~~m~~m~t~d'l'~!~::~~: 1. Total Interest/Penalty ( D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 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) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WillS, AGENT !~~m~A!g'!~~~'~!~~'~!I~~~m~t~d:~'~' 0.00 0.00 0.00 0.00 0.00 "X" Did decedent make a transfer and: 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 December 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 YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN. Yes No ~~ D D [KJ [KJ D []] 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 bellef, it is true, correct and complete. Declaration of preparer other than the personal representative Is based on all Information of which preparer has any knowledge. SIGNATURE OF PERS N RESPONSIBLE FOR FILING RETURN Joan Ferrall Shaw DATE 'vYuJ ---2~~h~~-:~p~-~"i~6W'_<:----__------------------ (7 EPRESENTATIVE Stephen L. Bloom, Esquire DATE _ _ _2.~99_}:,?!'J~~_9_~I'_ ~_"~cl___ _ _ __ _ ___ __ _ _ __ _ __ _ __ _ ___ Carlisle PA 17013 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (il]. 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% [72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and 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 twenty-one 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% [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%, except as noted in 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% [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. Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) REV-1503 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE B STOCKS & BONDS ESTATE OF FILE NUMBER Donald P. Shaw SSfl 251- 64- 3766 07/25/2002 21-02-0692 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION UNIT VALUE VALUE AT DATE NUMBER OF DEATH 1 254 shares A1cate1 5.295 1,344.93 2 332 shares Harley Davidson 46.125 15,313.50 3 310 shares Penn National Gaming 13.24 4,104.40 4 50 shares Pfizer 28.075 1,403.75 TOTAL (Also enter on line 2, Recapitulation) 22,166.58 (If more space is needed, insert additional sheets of the same sl2e) Copyright (e) 1996 form software only CPSystems, Inc. Form REV-1503 EX (Rev. 1-97) REV-1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCET/JIX RETURN RESIDENT DECEDENT ESTATE OF Donald P. Shaw SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY SSII 251-64-3766 07/25/2002 FILE NUMBER 21-02-0692 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 NUMBER 1 DESCRIPTION 501.29 shares Money Market Fund VALUE AT DATE OF DEATH 501.29 TOTAL (Also enter on line 5, Recapitulation) $ 501.29 (If more space is needed, insert additional sheets of the same size) Copyright{c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97) REV-1S10 EX + (1-97) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Donald P. Shaw SS11 251-64-3766 07/25/2002 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. FILE NUMBER 21-02-0692 DESCRIPTION OF PROPERTY % OF ITEM RELA Wg~~frl~ t~ b~~~5~~lt;WJ~~~~fT~E6F t~~~RSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE NUMBER ATTACH ACOPYOFTHE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IF APPLICABLE) 1 1,103.292 shares Capital 44,716.42 44,716.42 Income Builder, American Funds Rollover IRA, Acct. 116088-9942-12 2 417.19 shares EuroPacific 9,682.98 9,682.98 Fund, American Funds Rollover IRA, Acct. 116088-9942-16 3 1,423.878 shares 30,969.35 30,969.35 Fundamental Investors, American Funds Rollover IRA, Acct. 116088-9942-10 4 745.961 shares Investment 17,067.59 17,067.59 Company of America, American Funds Rollover IRA, Acct. 116088 - 9942 - 04 5 399.586 shares Main Street 10,245.39 10,245.39 Growth & Income, Oppenheimer Rollover IRA, Acct. 117007009106482 6 581.426 shares New Economy 7,471. 32 7,471.32 Fund, American Funds Rollover IRA, Acct. 116088-9942-14 7 604.888 shares New 10,531.10 10,531.10 Perspective Fund, American Funds Rollover IRA, Acct. 116088- 9942-07 8 Panorama Premier Annuity 19,072.00 19,072.00 TOTAL (Also enter on line 7, Recapitulation) S 149,756.15 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1510 EX (Rev. 1-97) REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF Donald P. Shaw SSfI 251-64-3766 07125/2002 NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] RELATIONSHIP TO DECEDENT Do Not List Trustee(s) 1 Joan F. Shaw 1201 White Birch Lane Carlisle, PA 17013 Wife FILE NUMBER 21-02-0692 AMOUNT OR SHARE OF ESTATE 100% Estate Residue ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS, A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON- TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. 0.00 Form REV-1513 EX (Rev. 9-00) ~ ~ Q) THE LAST WILL AND TESTAMENT OF DONALD PALMER SHAW Being of lawful age and sound and disposing mind and memory and not acting under any duress, fraud, undue influence or inducement of any person, I, DONALD PALMER SHAW, a domiciliary of Carlisle, Pennsylvania: ITEM 1 Hereby make, publish, and declare this my last Will and Testament, revoking and rendering null and void other Wills and codicils heretofore made by me. ITEM 2 I direct that my Executor to pay th~rnnowfng--as soon after my death as may be practicable: a. All of my just debts and the expenses of my last illness, funeral and of the administration of my estate; but my Executor need not accelerate and pay those unmatured obligations which, in his opinion, it might be proper and mare advantageous to retain or renew and pay as they be come due and payable. b. All inheritance, transfer, estate and similar taxes (including interest and penalties) assessed or payable by reason of my death, on any property or interest in my estate for purpose of computing taxes. My Executor shall not require any beneficiary under this will to reimburse my estate for taxes paid on property passing under the terms of this will. ITEM 3 TESTATOR - The term "Testator" as used in this Will refers to the maker of this Will, whether male or female. EXECUTOR - The term "Executor" as used in this Will refers to the person I appoint to execute this Will, whether male or female. SURVIVAL - Whenever a provision of this Will conditions a beneficiary's taking by that b,m..f i ci ary ..urvi vi ng the --T....t..tor, ..uch condi t i on of ..urvi v.l shall b.. construed as a condition precedent to the validity of the gift, devise or bequeath; and such condition shall be satisfied only upon survival by the beneficiary for a period of thirty days after the date of death of the Testator or until this Will is probated, whichever shall be the first to occur, unless expressly stated otherwise in a provision of this Will. SPOUSE - The term "Spouse" as used in this Will refers to Joan Ferrall Shaw. PAGE 411tf#~ ONE OF SIX PAGES Ji1Id ~ ~ CHILDREN - The te..m "c:hild..en" as used in this Will shall include any child..en he..eafte.. bo..n to 0" adopted by me, and any mino.. stepchild..en living with me at the time of my death, as well as the child..en I now have, Pete.. D. Shaw, David F. Shaw, and W. Palme.. Shaw, unless exp..essly stated othe..wise in some p..ovisian of this Will. MINOR - The te..m "Mi no.." as used in thi s Wi 11 means a pe..son unde.. 18 yea..s of age. DESCENDANTS - The te..m "Descendants" as used in this Will means the immediate and ..emote lawful lineal descendants 0.. affsp..ing by blood 0" adoption of the pe..son ..efe....ed to who a..e in being at the time they must be asce..tained in o..de.. to give effec:t to the ..efe..enc:e to them. PER STIRPES - The te..m "Pe.. Sti..pes" as used in this Will means that wheneve.. dist..ibution is to be made pe.. sti..pes, the estate 0.. portion of the estate, to be so distributed, shall be divided into as many sha..es as the..e are su..viving hei..s in the nea..est degree of kinship to the decedent and deceased persons in the same deg..ee of kinship who left issue who survive the decedent. This degree of kinship shall be te..med the ..oat generation. Each surviving heir in the root gene..ation shall take one full share. Those ..emaining hei..s, i.e. the su..viving issue of the deceased pe..sons in the ..oat generation, shall take the share of thei.. deceased ancestor in the ..oat generation, such share being divided in the following manne..: each surviving issue shall take the f..actional share that his 0" her immediate ancesto.. would have taken had he 0.. she su..vived; and when there a..e two or more such surviving issue in the same degree of kinship they shall divide such f..actional share equally among them. PER CAPITA - The term "Pe.. Capita" as used in this Will means that whenever distribution is to be made pe.. capita, the estate 0.. portion of the estate, to be so distributed, shall be divided into as many equal sha..es as the..e are su..viving issue, standing in the same deg..ee of kinship to the decedent. Dist..ibutlon shall be made without ..efe..ence to right of ..epresentation of the su..viving issue. ISSUE - The term "Issue" as used in this Will means all persons who are descended f..am the pe..san referred to, either by legitimate bi..th to or adoption by that person or any of that descendant's legitimately born or legally adopted descendants. INTENTIONAL OMISSION - I have intentionally omitted to p..ovide fo.. any ..elative or othe.. person, not named as a beneficia..y, unde.. this my Last Will and Testament, whether claiming to be an hei.. of mine 0" not, unless othe..wise p..avided fo.. in this my Last Will and Testament. ~ "" 'OJ 0' ". ~ flU;J~mr PAGES -:I4/I::f ~ ~ ITEM 4 I he~eby give, devise and bequeath all the ~est, ~esidue and ~emainde~ of my said estate and p~ope~ty of which I may die seized and possessed, and to which I may be entitled at the time of my death, of whatsoeve~ kind and natu~e, and whe~esoeve~ it may be situated, be it ~eal, pe~sonal o~ mi~ed including any powe~ of appointment that I may have, absolutely and in fee simple fo~eve~ to my spouse, if su~viving. I make this gift to my spouse, specifically excluding any p~esent afte~bo~n, o~ adopted child~en. ITEM 5 In the event that my spouse shall not su~vi ve me, I he~eby gi ve, devi se and bequeath all the ~est, ~esidue and ~emainde~ of my said estate and p~ope~ty of which I may die seized and possessed, and to which I may be entitled at the time of my death, of whatsoeve~ kind and natu~e, and whe~esoeve~ it may be situated, be it ~eal, pe~sonal o~ mixed including any powe~ of appointment that I may have, absolutely and in fee simple fo~eve~ to my child~en, who shall su~vive me, in equal sha~es, and to the issue, living at my death, of such child~en who shall p~edecease me, pe~ sti~pes and not pe~ capita. ITEM 6 I he~eby appoi nt Joan Fe~~all Shaw as Executo~ of my Wi I 1. If my Executo~ fails to se~ve, o~ fo~ any ~eason fails to continue to se~ve, I then appoint David F. Shaw to se~ve as Executo~. ITEM 7 I designate my Executo~ to be an Independent Executo~ to the fullest extent pe~missible unde~ the laws of the State of Pennsylvania. I di~ect that no bond o~ othe~ secu~ity be ~equi~ed. I fu~the~ di~ect that no action be had in any cou~t ~elative to the administ~ation of my estate othe~ than to p~ove and ~eco~d this Will and to ~etu~n an invento~y, app~aisal and list of claims of my estate. ITEM 8 My Executo~ and/o~ T~ustee, if applicable, shall have the following powe~s, which a~e to be const~ued in the b~oadest manne~ consistent with the validity of this Will .nd with thei~ duties as fiducia~ies. The powe~s stated he~ein a~e not intended to be exclusive, but shall be in addition to those g~anted by law and shall also pe~tain to any administ~ato~s o~ t~ustees who succeed the fiducia~ies I have appointed. These powe~s a~e: a. to take possession of p~ope~ty, to keep it safely, and to seg~egate it f~om othe~ p~ope~ty owned o~ held by the fiducia~y; ~ "" ~ THREE OF SIX PAGES 1#d ~J~~ b. to ~etain and to invest in p~ope~ty, o~ an undivided inte~est in p~ope~ty, including ~esidential ~eal estate, fo~ any pe~iod, whethe~ o~ not the p~ope~ty be of the cha~acte~ pe~missible fo~ investment by fiducia~ies; c. to sell, t~ansfe~, exchange, lease, ~ent, mo~tgage, pledge, give options upon, pa~tition and othe~wise dispose of ~eal o~ pe~sonal p~ope~ty, at p~ivate o~ public sale, fo~ cash o~ upon whateve~ te~ms the fiducia~y deems advisable, without notice o~ o~de~ of cou~t; d. to ~ende~ liquid my estate, in whole o~ in pa~t, and to hold cash o~ ~eadily ma~ketable secu~ities of little o~ no yield fo~ such pe~iod as my fiducia~y deems advisable; e. to bo~~ow in the name of my estate o~ of the t~ust, upon whateve~ te~ms and conditions and fo~ whateve~ pe~iods my fiducia~y deems advisable fo~ the pu~pose of p~ese~ving, p~otecting o~ imp~oving p~ope~ty held by him; f. to pay, comp~omise, adjust, settle, compound, ~enew o~ abandon claims held by my fiducia~y and claims asse~ted against my fiducia~y, on whateve~ te~ms he deems advisable, without p~io~ cou~t autho~ity; g. to dist~ibute in cash o~ in kind, o~ pa~tly in cash and pa~tly in kind, in divided o~ undivided inte~ests, notwithstanding the fact that dist~ibutive sha~es may as a ~esult be composed diffe~ently; h. to insu~e the p~ope~ty he holds as fiducia~y against the ~isks, and in the amounts he, in his disc~etion, deems expedient, and to obtain and pay fo~ life, health, liability and othe~ fo~ms of insu~ance fo~ the beneficia~ies of the t~ust, in his disc~etion; i. to employ atto~neys, accountants, investment adviso~s and othe~ p~ofessional assistants including deposita~ies, p~oxies, agents, and appraisers; j. to ente~ into t~ansactions with othe~ fiducia~ies including executo~s o~ t~ustees of estates and t~usts in which my beneficia~ies have an inte~est, and including him as fiducia~y fo~ othe~ estates and t~usts; k. to engage in the powe~s necessa~y to the effective administ~ation of co~po~ate secu~ities, including, without limiting the gene~ality of this powe~: 1. powe~ to vote in pe~son o~ by p~oxy upon all secu~ities held by the fiducia~y; 2. powe~ to engage in a voting t~ust o~ voting ag~eement with ~espect to securities; ;AvJJd ~ "., FOUR OF SIX ~ c:::z..z..-.- ~ 3. power to consent or become a party to , or participate in, mergers, consolidation, sales of assets, recapitalization, reorganizations, dissolutions or other alterations of corporate structure, including adjustments in capital structure affecting securities held by the fiduciary, whether or not these adjustments involve payments by or to the fiduciary; and 4. power to hold securities in unregistered form or in the name of a nominee; 1. to pay himself reasonable compensation for his services. ITEM 9 If any part of this Will, or any trust hereby created, shall be invalid, illegal, or inoperative, for any reason, it is my intention that the remaining parts, so far as possible and reasonable, shall be effective and fully operative. My Executor may seek and obtain court instructions for the purpose of carrying out as nearly as may be possible the intention of this Will shown by the terms hereof, including the term held invalid, illegal or inoperative. ITEM 10 Either I or my spouse have served in the Armed Forces of the United States. Therefore, I direct my Executor to consult the Legal Assistance Officer at the nearest military installation to ascertain if there are any benefits to which my estate or my descendants are entitled by virtue of such service. Regardless of my military status at the time of my death, I direct my Executor to consult with the nearest Veteran's Administration Office to ascertain if there are any benefits to which my survivors may be entitled. ITEM 11 My spouse and I may, at approximately the same time, execute similar Wills in which each of us is the recipient of the other's bounty to a greater or lesser extent; however, such Wills are not the result of any contract or agreement between us, and either Will may be revoked or amended at any time at the sole discretion of the maker thereof. ITEM 12 I have made, or may from time to time make, a written memorandum expressing my desire to give certain items of personal property to specific persons. I urge my Executor and beneficiaries to respect these wishes. Such a memorandum, if made, shall be stored in conjunction with this Will. 1M! jJlIAr "" FIVE OF SIX :12!4 ~ ~ the of IN WITNESS WHEREOF I have he~eunto set esses whose names a~ea~ he~eafte~, 19 O. my hand and seal in the p~esence of published this 3/Sl:f-day iLiI{/1({(ll.Mtu/ (SEAL> ATTESTATION On thi s 3l '"'I day of tUCfj 19q{) , DONALD PALMER SHAW, the Testato~, pe~sonally Published an Decla~ed ~fo~egoing Last Will and Testament, in the p~esence of each of us and all of us together, who, at the Testator's request, personally witnessed the Testato~ Sign and Seal the same. We then, at the Testato~'s request, and in the presence of the Testator and of each othe~, also signed each page of the said document as witnesses. We fu~the~ state that each of us believes that at the time the Testato~ executed the foregoing instrument said Testato~ was of sound mind and memo~y, of lawful age, and did so execute it as a f~ee act and deed and not under the unlawful influence of any pe~son. NAME: Q. __fLIP )1 ~ (J ~C/7?~ oJ: ~J?-o- ADDRESS: /c,;l ~(V~ fhkL 6~&f# NAME: ADDRESS:/t>"Z Vt.R.I"YI/'I- -9-V'L~C4,(L,f.Lr:; /.# , NAME: (//~ ry ADDRESS~~.f~ ' ~~~ ,/ /)bJb PAGE SIX OF SIX Commonwealth of Pennsylvania Self-Proving Clause STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND I, DONALD PALMER SHAW, Testator, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and :::;.: 0 S~;;~:S~~d~S m, 'c.. .Od;J;;;;?J &-uc 0 0,", DO ALD PALMER SHAW Sworn or affirmed to and acknowle PALMER SHAW, the Testator, this ~I DONALD Notary Affid Nolarlal Seal Wanda K. HunteJ: Notary PublIc vi t9arlisle BolO, CtMnberiana County """Commission ExpimsOct. 18, 1993 Member, P~~-RIiIlI',IlINelMN STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND We, ~^I(~ ~ee... , /Iff/.? C_ /1-fy€L, and ~<>-.... - , the wi tnesses whose names are si gned to the attached or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the Testator sign and execute this Will as his Last Will; that DONALD PALMER SHAW signed willingly and that DONALD PALMER SHAW executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testator signed the Will as witnesses; and that to best of our knowledge the Testator was at that time eighteen (18) or more years of age, of sound mind and under nQ constraint or undue i nf 1 t..lenc:e. Gn 4'4 J' ~ WI~ESS ~C }1 ~/J-, ::?/-~ WITNESS -. , A/J'~ ~ ~o-- NESS by and Sworn or affirmed to and subscribed to before me ~:' (/5l1itd · "'RiP C- I>"~~ ~ . =~ witnesses, t~ e ~!t? ~~~ ~- Notary NatatiaJ Seal Wand. K HUnteJ:, Notary Public Carlisle Bom, CUlTbal1andCounly My Commission ExpilllS Oct. lB, 1900 Menlger. 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" 0 1;l:I' ::l ::l '" 3 S Q."'I;l:I"'''." s. :> s:: ~ ~ ~ ~ ::r" ::s _. -. s:: = Pi' 0 0: :> 0..0:0=:1<< " l('pUlp.. - "0 .... :> .... 0 > ::l "0 , " ...., " 6' G :> ...... :>:>:>:> :;0 3 0 0 3 3 S. _. " 0 G " ...... ::l ::1. ...... ::1. ...... .... ...... 0 G >- " 0 (") < _. '" < :> (ll 3 (""l (ll ~ .... G (""l :> .... ...... 0 ..... "'!1 rJJ ~ '"1 rJJ C rJJ ~ ::r "'!1 ::r ::l ::r S ~ S ~ .... ~ ... ... ... p.. '" - '" -- '" rn w I:I:l p.. -.J.-.J I:I:l -I>- v. - ":i>. 0\ -.J I:I:l '" ~ rn 00 w ~ - 00 0 N 0 -I>- ~ - - ;;; '" ~ NO'> ~ -.J - W w :I'" v. V. ;:I . -.J = ~ N 00 '0 = -.J . - 00 00 .., - .., '" N '" -.J 00 0'> .., 0'> '" '" 00 '" 0 0'> N 00 00 - '" z z z :> :> :> <: <: <: "l:j ." ." ... '" ... ... '" f:I} {;;A -bo"J {;lI9 -b'3 VJ '" ... ... ... N rJJ N rJJ N -I>- N N rJJ v. ::r N - ::r w rv 0 - -.J N ::r ~ 0 ~ tv V. ~ ~ ~ 0'> ... 00 ... 00 00 ... -I>- '" 00 0 '" - v. w V> - 00 '" ... >-l ... ... >-l ~~~~~~ >-l - Q Q +::0. V.J......- Q ... - - ... ... 0 ~ -.J-.J !. \0 -.J +:0. 0 O-.J !. 'N - \ow o.,~~\o~o -I>- <: 00'> <: 00 -.J _O"\wO'\ <: v. ~ 00 -.J ~ N 0'> '" -.J ~ W - ",. - '0 W ~\.;J v. ;: = = >0 '" - 00 '" 00 N N V> 0 '" '" Stocks Date Description Share Balance Average Total Value 07/25/02 Alcatel 254 $ 5.295 $ 1,344.93 07/25/02 Harley Davidson 332 $ 46.125 $ 15,313.50 07/25/02 Money Market Fund 501.29 $ 1.00 $ 501.29 07/25/02 Penn National Gaming 310 $ 13.24 $ 4,104.40 07/25/02 Pfizer 50 $ 28.075 $ 1,403.75 Panorama Premier Annuity Date 7/25/02 Total Value $ 25,000.00 (v l/V Register of Wills of CUMBERLAND County, Pennsylvania INVENTORY Estate of Donald P. Shaw No. 21- 02 - 0692 also known as Donald Palmer Shaw Dale of Death 07/25/2002 ,Deceased Social Security No. 251-64- 3766 Joan Ferrall Shaw, Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent. that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death. and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I !We verify that the statements made in this Inventory are true and correct. INJe understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representative Name of Attorney: Stephen L. Bloom, Esquire Signature: LD No., 49811 Signature: Address: 2100 Longs Gap Road Address: 1201 White Birch Lane Carlisle, PA 17013 Carlisle, PA 17013 Telephone: 717/249-7717 Telephone: 717/249-1439 1'1 / Ii / tJ:A I I Dated: Description Value (See continuation page(s) attached) (Attach additional sheets if necessary) Total: 22,667.87 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form#RW-7 (1992) INVENTORY Estate of: Date of Death: County: Donald P. Shaw 07/25/2002 Cumberland CASH: shares Money Market Fund 501.29 501. 29 STOCKS/LISTED: - . - - - ~ - - - - - - ~ - 254 shares AlcateI 332 shares Harley Davidson 310 shares Penn National Gaming 50 shares Pfizer 1,344.93 15,313.50 4,104.40 1,403.75 22,166.58 TOTAL RECEIPTS OF PRINCIPAL....... ........ 22,667.87 -1- /7-79-..3 "- BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX STEPHEN L BLOOM ESQ 2100 LONGS GAP RD CARLISLE PA DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-20-2003 SHAW 07-25-2002 21 02-0692 CUMBERLAND 101 *' REY.1547 EX AFP (OI-OJ) DONALD P 17013 Amount: Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ R"EV:is'4-j-Ex--AFiQiiFo3-r-Niii"-icnWYNHEifiTAt.feri"AiC-APPRAiSEHENT:--ALU)"WANCE-ifR"----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SHAW DONALD P FILE NO. 21 02-0692 ACN 101 DATE 01-20-2003 TAX RETURN WAS: (X) ACCEPTED AS FILED CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule AJ 2. Stocks and Bonds {Schedule BJ 3. Closely Held stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule DJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule EJ 6. Jointly Owned Property (Schedule f) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) 171 .00 22.166.58 .00 .00 501. 29 .00 149.756.15 IB) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule HJ 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax .00 .00 Ill) (2) (3) (4) (9) UO) I~ an assessment was issued previously, lines re~lect ~igures that include the total o~ ALL ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal 16. Amount of Line 14 taxable at 17. Amount of Line 14 at Sibling 18. Amount of Line 14 taxable at 19. Principal Tax Due TAX CREDITS. NOTE: NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 172,424.02 nn 172,424.02 .00 172,424.02 14, IS and/or 16, 17, 18 and 19 will returns assessed to date. 172,424.02 X 00 = .00 X 045 = .00x12= .00x15= (9)= rate Lineal/Class A rate rate Collateral/Class B rate US) (6) U7I (8) .00 .00 .00 .00 .00 . n.~.u . '" AHOUNT PAID DATE NUMBER INTEREST/PEN PAID 1-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) REGISTER OF WILLS OF CUMBERLAND COUNTY STATUS REPORT UNDER RULE 6.12 (For Resident Decedents Dying After July 1, 1992) Name of Decedent: DONALD P. SHA W, a/k/a DONALD PALMER SHA W Date olDeath: July 25, 2002 FileNo.: 21-02-0692 Social Security No.: 251-64-3766 Pursuant to Rule 6.12 ofthe Supreme Court Orphans' Court Rules, 1 report the following with respect to completion of the administration of the above-captioned estate: I. State whether administration of the estate is complete: Yes x No 2. If the answer is No, state when the personal representative reasunably believes that the administration will be complete: N/A. 3. If the answer to No.1 is Yes, state thefallowing: a. Did the personal representative file afinal account with the Court? Yes_ No X b. The separate Orphans' Court No. (if any) for the personal representative's account is: N/A. c. Did the personal representative state an account informally to the parties in interest? Yes No X d. Copies of receipts, releases, joinders and approvals offarmal or informal accounts may be filed with the Clerk olthe Orphans' Court and may be attached to this report. _---Kj~ Stephen L. Bloom, Esquire 2 I 00 Longs Gap Road Carlisle, PA 17013 (717) 249-7717 Counse I for Personal Representative Signature: Name: Address: Date: February 5, 2003 C:\LAS\Estatcs\I0220-2statrpt.l