HomeMy WebLinkAbout01-08-15 (4) pennsytvania ,
1505614105
OkPMiNQlTOF FEVLNl1E EX(03-14)(FI) ;' 7
REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURNI` ,
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 1 l q{
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYW
04192014 11151917
Decedent's Last Name Suffix Decedent's First Name MI
Shaffer Sophie L
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Deceased (03/25/87)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
CMD 1.Original Return O 2.Supplemental Return O 3. Remainder Return(date of death
prior to 12-13-82)
O 4.Agriculture Exemption(date of C= 5.Future Interest Compromise(date of O 6. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
OD 7. Decedent Died Testate O 8.Decedent Maintained a Living Trust 0 9. Total Number of Safe Deposit Boxes
(Attach copy of will.) (Attach copy of trust.)
O 10. Litigation Proceeds Received O 11,Non-Probate Transferee Return O 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
O 13. Business Assets 0 14.Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT— THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
Mary L. Mills (717) 938-1344
First Line of Address
ry
481 Old Stage Road
9 c Cr-,
Second Line of Address
> 'r`— —{
17' .171
City or.Post Office State ZIP Code co
Lewisberry PA 17339 'tai
`D C1,
Correspondent's email address: '`} rV r` C'r1
REGiCrER OF WILLOSE ONLYS
REGISTER OF WILLS USE ONLY
DATE FILED MMDDYYYY
DATE FILED STAMP
PLEASE USE ORIGINAL FORM ONLY
Side 1
4' �5����� 1505614105
1505614205
.J
REV-1500 EX(FI)
Decedent's Social Security Number
Decedent's Name:
RECAPITULATION
1. Real Estate(Schedule A). ........ .......... .. . ....................... 1. 147,000.00
2. Stocks and Bonds(Schedule B) ....... ........... ..... .......... ...... 2.
3. Closely Held Corporation,Partnership or Sole-Proprietorship(Schedule C) ..... 3.
4. Mortgages and Notes Receivable(Schedule D) ............ .......... ..... 4.
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).... ... 5. 2,741.27
6. Jointly Owned Property(Schedule F) O Separate Billing Requested ....... 6. 9,813.12
7. inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) O Separate Billing Requested.... .... 7.
8. Total Gross Assets(total Lines 1 through 7).. ........................... 8. 159,554.39
9. Funeral Expenses and Administrative Costs(Schedule H)................... 9. 4,017.94
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)..... .......... 10. 44,354.51
11. Total Deductions(total Lines 9 and 10).. .............. ................. 11.
12. Net Value of Estate(Line 8 minus Line 11) .... ... ........ ............... 12. 111,181.94
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. 111,181.94
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.045 16. 5,003.19
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. 5,003.19
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O
Under penalties of perjury,I declare 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. Declaration of preparer other than the person responsible for filing the return is based on all information of which preparer has
any knowledge.
SIGNATURE QF PERSON RESPONSIBLE/RESPONSIBLE FO FILING RETURN DATE
ADDRESS
SIGNATURE OF PREPARER OTHER THAN PERSON RESPONSIBLE FOR FILING THE RE URN DATE
ADDRESS
Side z
p 1505614205
I
i
REV-1500 EX (FI) Page 3 File Number
Decedent's Complete Address:
DECEDENT'S NAME
Sophie L. Shaffer
STREETADDRESS
Emeritus at Creekview
55 Grandon Way
CITY STATE ZIP
Mechanicsburg PA 17050
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 5,003.19
2. CreditslPayments
A.Prior Payments _
B.Discount
(See instructions.) Total Credits(A+B) (2)
3. Interest
(3)
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) 5,003.19
i
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.......................................................................................... ❑
b. retain the right to designate who shall use the property transferred or its income ............................................ ❑
c. retain a reversionary interest .............................................................................................................................. ❑ 0
d. receive the promise for life of either payments,benefits or care?...................................................................... ❑ E
2. If death occurred after Dec.12, 1982,did decedent transfer property within one year of death
without receiving adequate consideration?.............................................................................................................. ❑
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death?.............. ❑
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
containsa 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 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 21 years of age or younger at death to or for the use of a natural parent, an
adoptive parent or a step-parent 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)
i j pennsylvania SCHEDULE A
DEPARTMENT OF REVENUE
REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Sophie L. Shaffer 21-2014-06S13
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 or 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.
ITEM Include a copy of the deed showing decedent's interest if owned as tenant in common. VALUF AT DATE
NUMBER OF DEATH
DESCRIPTION
1 Brick ranch-type house at 6007 Robert Drive,iNoll Acres, Mechanicsburg,Pa., 17050. 147,000.00
Home has been vacant since 08101/2012, Assessed value on DOD was$148,200.00,
An average of three comparable sold and pending home prices in the area,one in the
same development, (submitted by Coldwell Banker Listing Agent)and the assessed
value is$146,953.75.
There is currently an offer of$147,000.00 with a settlement date of 1/16/2015.
I
TOTAL(Also enter on Line 1, Recapitulation.) $ 147,000.00
If more space is needed,use additional sheets of paper of the same size.
PAYABLE TO: 'BILL M 9182 CUMBERLAND VALLEY SCHOOL DISTRICT 2014/2015 REAL ESTATE TAX NOTICE,
RETURN THIS PORTION WITH A PAYMENT FOR SECOND INSTALLMENT BILL M 9182
Michael Langan,Tax Collector SHAFFER,HOWARD L&SOPHIE L
230 S.Sporting Hill Road .OFFICE HOURS
Mechanicsburg,PA 17050 BILL DATE: Property Location
7/1/2014 10-20-1840-037 Jury through November:
Mon.,Tues.&Thurs.—gam to 4:30pm
6007 ROBERT DRIVE Also Fri.8/29 and Fri.10/31,-9am to 4::
NOLL ACRES December:Tues.&Thurs.-9am to 4:30
Closed December 22,2014-January 5,
LOT 153 PB 9 PG 43 r Call for appointment if needed in Decem
SHAFFER,HOWARD L&SOPHIE L
481 OLD STAGE RD Phone:717-737-4822
LEWISBERRY,PA 17339-9319 Please Indicate: f
0 SECOND INSTALLMENT 0 SECOND INSTALLMENT WITH PENALTY
Mpaidon
NO DISCOUNT
If or before 9/30/14 $439.56
If paid after 9/30/14 $483.52
TAX • •- •• ••
PAYABLE TO: BILL M 9182 CUMBERLAND VALLEY SCHOOLDISTRICT 2014/2015NOTICE '
RETURN THIS PORTION WITH A PAYMENT FOR FINAL INSTALLMENT BILL M 9182
SHAFFER,HOWARD L&SOPHIE L
Michael Langan,Tax Collector OFFICE HOURS
230 S.Sporting Hill Road Property Location
Mechanicsburg,PA 17050 BILL DATE: 10-20-1840-037 July through November:
7/1/2014 Mon.,Tues.&Thurs.—gam to 4:30pm
6007 ROBERT DRIVE Also Fri.8/29 and Fri.10/31,-9am to4::
KOLL ACRES December.Tues.&Thurs.-9am to 4:30
Closed December 22,2014-January 5,
SHAFFER,HOWARD L&SOPHIE L LOT 153 PB 9 PG 43 Cell-for appointment If needed in Decem
481 OLD STAGE RD
Phone:717-737-4822
LEWISBERRY,PA 17339-9319 Please Indicate:
0 FINAL INSTALLMENT FINAL INSTALLMENT WITH PENALTY
NO DISCOUNT
If 7onefore 10/31/14 $439.56
er 10/31/14 $483.52
PAYABLE TO: BILL#:9182 CUMBERLAND VALLEY SCHOOLDISTRICT 2014/2015NOTICE
Michael Langan,Tax Collector Hours:See Reverse MUNICIPALITY:Hampden Twp. BILL NO:9182
230 S.Sporting Hill Road Phone:717-737-4822 PROPERTY:6007 ROBERT DRIVE BILL DATE:7/1/2014
Mechanicsburg,PA 17050 MAP CODE:10-20-1840-037 SHAFFER,HOWARD L&SOPHIE L
IMPROVEMENTLAND •
ASSESSMENT $38,900 $109,300 $148,200
HOMESTEAD EXCLUSION $0
FARMSTEAD EXCLUSION $0
RIE TAX RATE 8.898 8.898
a; i FU L RIE TAX $346.13 $972.55 $1,318.68
THIS TAX IS DUE AND PAYABLE.YOU ARE HEREBY REj
STED j LESS TEAD CREDIT $0.00 ]
TO MAKE PAYMENT THEREOF. LESS FARMSTEAD CREDITDISC UNT FACE PENALTY
0.00
SHAFFER,HOWARD L&SOPHIE L AUG 27ector
7 ''
481 OLD STAGE-RD AMOUNT DUE $1,292.31 $1,31 8 $1,450.5:
LEWISBERRY,PA 17339-9319 Ham de
P31f Paid On or Before 8/3 31/14 12/15/14
Tax Co! O CHECKS ACCEPTED AFTER DECEMBER 15, 2014
• • • • • 1.
-
$439.56 $439.56 $439.56
Lei
On or before 8/31/14 1 On or before 9/30/14 1 On or before 10/31/14
10261048 10250240 10251653
4-1
t ..1
k
Pending Sold Sold
6 Donald Street 4816 Virginia Road 4609 S Clearview Drive
Noll Acres Delbrook Manor
Cumberland Valley Cumberland Valley Cumberland Valley
Hampden Hampden Hampden
Mechanicsburg Mechanicsburg Camp Hill
17050-6820 17050 17011
Original $155,000 Original $140,000 Original $150,000
List Price $155,000 List Price $140,000 List Price
$145,000
Sold Price Sold Price $143,000 Sold Price $141,615
Seller Help Seller Help 4,290.00 Seller Help 0.00
Close Date 12/8/2014 Close Date 5/15/2014 Close Date 8/27/2014
Yr Built 1958 DOM 8 Acres 0.200C Yr Built 1957 DOM 4 Acres 0.260C Yr Built 1973 DOM 99 Acres 0.160
Sq Ft 1,516 $/Sq Ft $102.24 Sq Ft 1,109 $/SgFt $128.94 Sq Ft 1,120 $/Sq Ft $126.44
BR/FB/HB/FP 3 BF/FB/HB/FP BR/FB/HB/FP
Type Detached Type Detached Type Detached
Design Ranch Design Ranch Design Ranch
Style 1 Story style 1 Story Style 1 Story
Wtr/Swr Public Sewer, Public Wtr/Swr Public Sewer, Public Wtr/Swr Public Sewer, Public
Ext Vinyl Ext Vinyl Ext Vinyl
Parking 1 Car Garage, Detached, Parking 1 Car Carport Parking Off Street Parking
Off Street Parking, On
Heat Forced Air, Natural Gas Heat Forced Air, Natural Gas Heat Forced Air, Natural Gas
Cool Ceiling Fan, Central Air, Cool Central Air cool Central Air
Bsment Full, Unfinished Bsment Concrete Floor Bsment Partially Finished,
Const Stick Built Const Stick Built Const Stick Built
Tax $ 1,928 2014 Tax $ 1,595 2014 Tax $ 1,689 2014 est
DTBrlisle Pike to right on Donald St. Destination on left. DERdisle Pike to L/Sporting Hill Road to L/onto Delbrook DIRFrom Camp Hill,W on Market St,L onto St Johns,R
Road,L/Virginia Road to home on right. Hampden Ave,L onto E.Clearview,R onto S.Clearview
Drive,Home on the right
Get ready to enjoy this wonderful ranch Mint-condition,original owner&impeccably Very nice 3 bedroom Ranch with partially
home,located close enough to everything, maintained! Premium Hampden loc w/full finished basement. Gas heat and air
but far enough away to enjoy privacy. Home basement—a rarity in Delbrook Manor! Bright conditioning. Screened in porch with off
features hardwood floors,family room,and faro rm w/oversized windows,updated kit street parking for 2 cars,
beautiful fireplace in living room. Outdoor w/Corian tops,newer firing,tiered brkfst bar,
space includes detached garage,shed and gas range,wall oven.Cory screened porch,
large deck,ready for you to entertain. Close ceramic bath. 1st-fir laund provides for total
proximity to shopping and dining,and major main-flr living.Gas heat. Level homesite,
routes. This home is a must see. Call list 1-car caport w/shed.HW firs under carpet.
agent for details! Immaculate.Shows beautifully!
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6009 Robert Drive Mechanicsburg,PA 17050
$126,936 � �� ? $168,264
LOW ' HIGH
VALUE ESTIMATE
Value Estimate $147,600 a Beds 2
Payment Estimate $5811 mo ? Baths Full
Rent Estimate $1,180 ? Baths Half j
Tax Estimate $1,818 2 Sq Ft 1,240
HomeScore 55 ? Lot Size 0.10
InvestorScore 52 2 Construction
Last Sale Date Style
Last Sate Price Year Built 1970
Get Homesnap Mortgage Rates Get Pre-Approved Edit Home Facts Share Home c
6009 Robert Drive is located in Mechanicsburg,PA.At this time,the property has an estimated value of$147,600 and
yearly taxes of 51,818.This home has 2 bedrooms and approximately 1,240 sqft of living space.The property was built in
1970.Similar homes nearby have 2 bedrooms and sell for around$150,000.
MECHANICSBURG PUBLIC SCHOOLS _
A child living at 6009 Robert Drive,Mechanicsburg,PA would typically attend one of the following public schools:
Hampden Elementary School,Good Hope Middle School,or Cumberland ValleyHigh School. '
i
Cumberland Valley Schoo=District
Hampden Elementary School Elementary
Good Hope Middle School Middle 10
Cumberland Valley High School High 10
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REV-1508 EX+(o8-12)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
Sophie L. Shaffer 2120140683
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, Value of contents of room at Emeritus at Creekview assisted-living facility(decedent's residence from 270.00
08/01/2012 until DOD). $100 flat-screen TV;$40 wooden bookcase;$20 four boxes of books;$20
table lamp;$20 quilt;$40 mini fridge and$30 chair, Personal clothing donated.
2 Deposits into joint checking account after DOD of$1,102.00 pro-rated refund from assisted-living and a 1,340.98
$238.98 refund from funeral home.
3 Estate checking account opened on 08/27/2014 with the following deposits
$3,145.44 Decedent's Life Inurance Policy (Exempt from PA Inheritence Tax) 0.00
$127.07 Health Provider Refund 127.07
$1,002.63 Unclaimed Property held by PA Treasury Department 1,002.63
4 Interest on checking accounts 0.59
TOTAL(Also enter on Line 5, Recapitulation) $ 2,741.27
If more space is needed,use additional sheets of paper of the same size.
REV-15o9 EX+(oi-io)
i Pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
SOPHIE L. SHAFFER 2120140683
If an asset became jointly owned within one year of the decedent's date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A.Mary L. Mills 481 Old Stage Road Daughter
Lewisberry, PA 17339
B.
C.
JOINTLY OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENT'S VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 06128177 M&T Bank Joint Checking Account 19,626.23 50% 9,813.12
Note: Complete Account History attached. ALL ACCOUNT
ACTIVITY SINCE DOD DEDICATED SOLELY TO
DECEDENT'S AFFAIRS.
M&T BANK DOD STATEMENT ATTACHED
TOTAL(Also enter on Line 6, Recapitulation) $ 9,813.12
If more space is needed,use additional sheets of paper of the same size.
v
Q MBTBank
499 Mitchell Road,Millsboro,DE 19966 Records Management
Phone 888-502-4349
F ax (302)934-2955
August 4,2014
Sophie L. Shaffer
Mary L. Mills
481 Old Stage Road
Lewisberry,PA 17339
_Re: .,Estate of Sophie L. Shaffer
Social Security:
Date of Death: April 19,2014
Dear Sir or Madam:
Per your inquiry on July 29,2014,please be advised that at the time of death,the above-named decedent had on
deposit with this bank the following:
1. Type of Account Checking Account
Account Number 76953343
Ownership(Names oi) Anita J.Everhard(POA)
Mary L.Mills
Sophie L.Shaffer
Opening Date 06/2811977
Balance on Date of Death $ 19,626.19
Accrued Interest $ .04
Total $19,626.23
For any additional information on the above accounts,including ownership and any changes,closures and/or reimbursement of funds,
please call the Hampden at 717-255-2293.
We,were unable to-locate-any safe deposit box-for the above-mentioned decedent
This letter does not include any accounts in which the deceased may have been listed as Power of Attorney,Custodian of Uniform Transfers,
Representative Payee,or Trustee under a Written Agreement
Sincerely,
Valarie Mercer
Adjustment Services
Ir
Estate of Sophie L. Shaffer
File No. 21-2014-0683
DOD: 04/19/2014
Joint Checking Account
Established 06/28/1977
Account History — Page One of Two (source M&T Bank)
04/19/2014 - DOD $19,626.23 Balance DOD
04/24 UGI Utilities Bill 53.00 Auto Pay
04/25 Check#1138,Hetrick-Bitner Funeral Home 3,437.00 Cremation Costs
04/28 PPL Electric Service: 25.39 Auto Pay
04/28 Check#1139, Foremost Ins. Co. 351.36 Vacant House Ins.
05/01 Hampden. Twp. Utilities —Trash.& Sewage 155.05 Auto Pay
05/13 Deposit ($1,102.00 pro-rated refund from assisted-
living facility & $238.98 refund from funeral home) 1,340.98 Refunds
05/15 Check#1141 Cash for supplies and machine 800.00 Home Maintenance
rental for weekend to refinish hard wood floors
and buy new front door, locks, & commode
05/15 Interest Payment .15 Interest
05/15 Pennsylvania AME — Water Bill 24.59 Auto Pay
05/15 Check#1140, Keystone Foundation Repair- deposit 1,995.00 Basement Wall Repair
05/15 Check#1142, Keystone Foundation Repair 1,995.00 Completion of Job
05/19 UGI HVAC Service 11.00 Auto Pay
05/20 Check#1144 — Cash for paint/supplies 500.00 Home.Maintenance
05/27 UGI Utilities 53.00 Auto Pay
05/28 PPL Electric 27.31 Auto Pay
05/28 Check#1145 — Foremost Ins. Co. 160.08 Vacant House Ins.
05/29 Check#1146 — Cash for stove to replace one with 500.00 Safety/Maintenance
frayed wiring plus cleaning products
06/03 Check#1143 —Tiger Trash for dumpster—for 610.00 Safety/Maintenance
removal of gazebo and shed from back yard
06/13 Interest Payment .08 Interest
06/13 Pennsylvania AME —Water 24.59 Auto Pay
06/17 -UGI. HVAC Service Contract 11.00 Auto Pay
06/24 Check#1147 — Foremost Ins. Co 160.08 Vacant House Ins.
06/25 UGI Utilities 53.00 Auto Pay
06/27 PPL Electric 28.59 Auto Pay
07/01 Check#1148 — Cash for gas hot water heater, 700.00 Home Maintenance
additional paint & misc. material to refresh
basement rec-room
07/15 Interest Payment .09 'Interest
07/15 Pennsylvania AME —Water 22.54 Auto Pay
07/17 UGI HVAC Contract 11.00 Auto Pay
07/23 Check#1149 — Foremost Insurance Co. 160.08 Vacant House Ins.
f
Estate of Sophie L. Shaffer
File No. 21-2014-0683
DOD: 04/19/2014
Account History - Page Two of Two
07/25 Check#1150 - Recorder of Wills- Probate 368.50 For Probate
07/28 UGI Utilities 53.00 Auto Pay
07/29 PPL Electric 30.67 Auto Pay
07/31 Hampden Township Utilities 155.05 Auto Pay
08/13 Pennsylvania AME Payment 67.48 Auto Pay
08/15 Interest Payment .07 Interest
08/19 UGI HVAC Contract 11.00 Auto Pay
08/20 Check#1033-The Sentinel Newspaper 137.44 For Probate Ad
08/25 Check#1032 - Cumberland Law Journal 75.00 For Probate Ad.
08/26 UGI Utilities 53.00 Auto Pay
08/26 Check#1035 - Foremost Insurance Co. 160.08 Vacant House Ins.
08/27 PPL Electric 45.27 Auto Pay
09/02Check#1034 - Michael Langan 1,292.31 Property Tax
09/05 Check#1036 - Cash for Drywall & Paint 200.00 Repair/Maintenance
09/15 Interest Payment .07 Interest
09/16 Pennsylvania AME 64.42 Auto Pay
09/23 Check #1037 - Steve Miller 625.00 Lawn Care
09/25 UGI Utilities 53.00 Auto Pay
09/26 PPL Electric 40.00 Auto Pay
09/26 Check#1038 - Foremost Insurance Co. 160.08 Vacant House Ins
10/15 Interest Payment .04 Interest
10/21 Check#1039 - Foremost Insurance Co. 160.08 Vacant House Ins.
.10/28 PPL Electric 60.81 Auto Pay
10/31 Hampden Township Utilities 155.05 Auto Pay
11/03 UGI Utilities 48.00 Auto Pay
11/13 Pennsylvania AME 10.74 Auto Pay
11/14 Interest Payment .05 Interest
11/21 UGI Utilities 48.00 Auto Pay
11/26 PPL Electric 44.12 Auto Pay
11/26 Check#1040 - Foremost Insurance Co. 160.08 Vacant House Ins.
12/15 Interest Payment .04 Interest
12/15 Pennsylvania AME 23.56 Auto Pay
12/15 Service Charge 14.95
12/15 End of November/December Bank Statement $ 4,782.41 Ending Balance
12/16 Check#1041 - Foremost Insurance Co. 160.08 Vacant House Ins.
12/20 Check#1042 -W.S. Carey Electric 78.25 Condition of Sale
12/30 Check#1043 -Archer Pest Control 159.000ondition of Sale
$ 4,385.08
Note: All transactions on this account from DOD dedicated solely to Decedent's affairs.
REV-1511 EX+(08-13)
-�� pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
SOPHIE L. SHAFFER 2120140683
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1' Hetrick-Bitner Funeral Home($3,437.00 copy of cancelled check attached. REFUND OF 3,437.00
$238.98 SHOWN ON SCHEDULE E AS DEPOSIT AND REFLECTED IN FINAL INVOICE).
Note: Opening of grave,burial and memorial services to be held in Spring. A supplemental and final
accounting will be filed at that time.
B. ADMINISTRATIVE COSTS:
1, Personal Representative Commissions: 0.00
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid: Norte
2. Attorney Fees:
0.00
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation.)
0.00
Claimant None
Street Address
City State ZIP
Relationship of Claimant to Decedent
4. Probate Fees: 580.94
5. Accountant Fees: 0.00
6. Tax Return Preparer Fees: 0.00
7.
NOTE: Probate fees consist of$368.50 to Register of Wills,$75.00 to the Cumberland Law Journal
for advertising and$137.44 to The Sentinel for advertising.
TOTAL(Also enter on Line 9, Recapitulation) $ 4,017.94
If more space is needed,use additional sheets of paper of the same size.
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Check #1138 Paid :04/95/2014 $3437.00 Check #1138 Paid :04/35/2014 13437.00
_ _.................,. o
RECEIPT FOR PAYMENT
LISA M. GRAYSON, ESQ. Receipt Date : 7/23/2014
Cumberland County - Register Of Wills Receipt Time : 10 : 18 : 18
One Courthouse Square Receipt No. : 1078634
Carlisle, PA 17613
SHAFFER SOPHIE L
Estate File No. : 2014-00683
Paid By Remarks : MARY MILLS
DB1
------------------------ Receipt Distribution ------------------------
Fee/Tax Description Payment Amount Payee Name
PETITION LTRS TEST 260 . 00 CUMBERLAND COUNTY GENERAL FUN
WILL 15 . 00 CUMBERLAND COUNTY GENERAL FUN
JCS FEE 33 . 50 BUREAU OF RECEIPTS & CNTR M.D
SHORT CERTIFICATE 25 . 00 CUMBERLAND COUNTY GENERAL FUN
AUTOMATION FEE 5 . 00 CUMBERLAND COUNTY GENERAL FUN
INVENTORY 15 . 00 CUMBERLAND COUNTY GENERAL FUN
INH TAX RETURN 15 . 00 CUMBERLAND COUNTY GENERAL FUN
----------------
Check# 1150 $368 . 50
Total Received. . . . . . . . . $368 . 50
CUMBERLAND
LAW JOURNAL
LX
No.38 Carlisle,PA,September 23,2011 268-274
Legal •
Edition
CUMBERLAND LAW JOURNAL
(LISPS 140-000)
Published every Friday by
CUMBERLAND COUNTY BAR ASSOCIATION
Editor
Lisa Marie Coyne, Esq.
Cumberland Law Journal Telephone: (717)249-3166
32 South Bedford St. FAX(717)249-2663
Carlisle, PA 17013 Toll Free PA 1-800.990-9108
www.cumberlandbar.com
Copyright@ 2011,Cumberland County Bar Association
Carlisle,Pennsylvania
Containing reports of cases decided by the various Courts of Cumberland
County and selected cases from other counties.
Designated by the Court of Common Pleas as the official legal publication of
Cumberland County and the legal newspaper for the publication of legal notices.
Legal advertisements must be received by Friday Noon.All legal advertising
must be paid in advance.Subscription$36.00 per year.
Please note:All legal notices must be submitted In typewritten form.Neither
the Law Journal nor the printer will assume any responsibility to edit,make spell-
ing corrections,eliminate errors in grammar or make any changes in content.
Periodical postage paid at Carlisle,PA 17013 and additional offices.
POSTMASTER:Send change of address to:Cumberland Law Journal,c/o
Clare Printing,206 S.Keystone Avenue,Sayre,PA 18840.
LXH135 CUMBERLAND LAW JOURNAL 08/29/14
ESTATE AND TRUST NOTICES Hoelscher,Barbara M.,deed.
Late of Carlisle.
Notice is hereby given that,in the Executor:Christian N.McAdoo, I
estates of the decedents set forth be- Crossgate Circle, Lemoyne, PA
low,the Register of Wills has granted 17043.
letters testamentary or of administra- Attorney:None.
tion to the persons named.Notice is
also hereby given of the existence of Holler,Kermit W.,dec'd.
the trusts of the deceased settlors Late of Camp Hill Borough.
set forth below for whom no personal Executor: Michael A.Homsey.
representatives have been appointed Attorneys:Bangs Law Office,LLC,
within 90 days of death. All persons 429 South 18th Street,Camp Hill,
having claims or demands against PA 17011.
said estates or trusts are requested
to make known the same, and all Hopkins,Foster Q.,deed.
persons indebted to said estates or Late of Lower Allen Township.
trusts are requested to make pay- Executor: Franklin Hopkins.
ment,without delay,to the executors Attorneys: Murrel R.Waiters,III,
or administrators or trustees or to Esquire, Waiters & Galloway,
their attorneys named below. PLLC, 54 East Main Street, Me-
chanicsburg,PA 17055.
FIRST PUBLICATION
Bowen, Carolyn E. a/k/a Lynn Love,Mignon J.,deed.
Late of Penn Township.
Bowen,deed. Administrator:Administrator: F&M Trust
Late of East Pennsboro Township. Manson Law Offices,10 East High
gh
Executrix:Sandra L.Youngblood,
1
117 York Street,Enola,PA 17025. Street,Carlisle, Otto,
IH
Attorneys:Ivo V.Otto,,III,,Esquire,
Attorney:Luther E.Milspaw,Jr., Manson Law Offices.
Esquire, Attorney-at-Law, 130
State Street, Harrisburg, PA Priest,Hazel A.,deed.
17101. Late of East Pennsboro Township.
Executor: David H. Stone, Es-
Erb,Edna M.,deed. quire, Stone LaFaver & Shek-
Late of East Pennsboro Township. letski,P.O. Box E,New Cumber-
Co-Executors: Keith A. Erb and land,PA 17070.
Denise A.Erb. Attorneys: David H. Stone, Es-
Attorneys:Craig A.Diehl,Esquire, quire, Stone LaFaver & Shek-
CPA,Law Offices of Craig A.Diehl, letski,P.O.Box E,New Cumber-
3464 Trindle Road,Camp Hill,PA land,PA 17070.
17011.
Rockey,Vivian I.,deed.
Gilson,John I.,deed. Late of Carlisle Borough.
Late of Upper Allen Township. Administratrix: Barbara C. Oyler
Executrix: Pamela L. Kelley, 11 c/o Robert G. Frey, Esquire, 5
West Winding Hill Road,Mechan- South Hanover Street,Carlisle,PA
icsburg,PA 17055, 17013.
Attorney:Marlin R.McCaleb,Es- Attorneys:Frey and Tiley.
quire,219 East Main Street,P.O.
Box 230, Mechanicsburg, PA Shaffer,:Sophie L,,deed.
17055. Late of Hampden Township.
8
PROOF OF PUBLICATION
State of Pennsylvania, County of Cumberland
Cathy Clark,Advertising Director, of The Sentinel,of the County and State aforesaid,
being duly sworn, deposes and says that THE SENTINEL,a newspaper of general
circulation in the Borough of Carlisle,County and State aforesaid,was established
December 13th,1881,since which date THE SENTINEL has been regularly issued in said
County,and that the printed notice or publication attached hereto is exactly the same as
was printed and published in the regular editions and issues of
August 20,2014 and August 27,2014 and September 3 2014
COPY OF NOTICE OF PUBLICATION
EXECUTR XON TICE
Letters Testamentary on the Estate of SOPHIE L.SHAFFER,late of the Affiant further deposes that he/she is not
Township of Hampden,Cumberland County,Pennsylvania,deceased, interested in the subject matter of the
have been granted to the undersigned. -
All persons knowing themselves to be indebted to said Estate will make' aforesaid notice or advertisement, and that
payment immediately and those having claims will present them for
settlement. all allegations in the foregoing statement as
Mary L.Mills,Executrix s to time, lace and character of publication
a81 Old Stage Road i p p Lewisberry,PA 17339 1 are true.
Sworn to and subscribed before me this
1-14-hcin.uJdV A\D c anb 2014
Nota4 Public
My commission expires:
COMMONWEALTH p NN IVMIA
Notarlal Seal
Bethany M.Holt y,Notary,public
Carlisle Do%Cumbepand County
My Commission Expires sept 26�2015
MEMBER.PENNSYLVAN7R+1.a5oCIATION Of NOTARIES
-The sentillet
Chrissy Gorica
ne sentinel
Inside Sales Executive M OR E N EWS FO R YO U
4S7 East North Street,Carlisle,PA 17013 457 East North S
Phone:(717)240.7171 Carlisle,PA 1'
Fax:(717)243.3754 717-243-11
ccorlca@cumberlink.com
- NOTICE Fax:717-243-:
79 W.King S
EXECUTE6L -_ Shippensburg,PA 1'
717-530
Fax:717-5304
s�.4d�gi�is#ra;~ioa
Letters on the Estate of �o.��/ L• °sy,���E�C' --
Testamentary
late of the of
Cumberland County,Pennsylvania,deceased,have been granted to the undersigned.
All persons knowing themselves to be indebted to said Estate will make payment immediately and those having
claims will present them for settlement.
%ecutor Executrix)Administrator-Adminstratrix
to W (address)
D '
DATE �.'
DOLLARS eY
FROM
D �
0 FOR RENT
0FOR OCASH TO
ACCT• OoHECK FROM A1152
.7.4161.
`/OADER - eks.
PAID �Mwe17 GAi1D gY
oue Name: /!/�•��l/ G. .�IrLGS
Address: !ZP/ 4T'.e6:2r 'go"
City:
State: Zip: ZZZA- g
Phone: 7z"?!— 4.3.&— Xz4e5-
$7 for notarized proof of publication. _Yes No
Return to: The Sentinel, 457 E. North St., Attn. Legal Advertising, Carlisle, PA 17013
Phone: 717-240-7130 or fax 717-243-3754 or email to classified@cumberlink.com
dHETRICK-11ITNER U RONALD C.L.SMITH U JESSE H.GEIGLE
FUNERAL HOME,INC. FUNERAL HOME FUNERAL HOME,INC.
3125 Walnut St.Hbg.,PA 17109 A branch of Hetrick-Bitner Funeral Home,Inc. 2100 Linglestown Rd.,Hbg.,PA 17110
(717)545-3774 Fax(717)545-2325 325 North High St.,Duncannon,PA 17020 (717)652-7701
Nathan A.Bitner,Supervisor (717)834-4515 Vaughn Miller,Supervisor
Graham S.Hetrick,Funeral Director Ronald C.L.Smith,Supervisor
Funeral Expense Agreement
This is an explanation of charges as well as a sales agreement presented in accordance with the regulations of the PA State Board of
Funeral Directors.
-STATEMENT OF FUNERAL GOODS AND SERVICES SELECTED
Charges are only fir those items that you Selected or are required.If we are required Inj law or by a cemetery or crematory to use any items,we
will explain the reasons in writing below.If you selected a funeral which may require embalming,such as a funeral with a viewing,you may
We to pay for embalming,You do not have to pay for embalming you did not approve,if you selected arrangements such as direct cremation
or immediate burial.If we charge for embalming we will explain why below.
Legal,cemetery,crematory or other requirements compelling the purchase of any items listed below:
Reason for Embalming; t1 ='•''' r "`
Funeral Services for i': t'. ' Date of Death -4;1`'f 1 Ll Date of Service
' GOODS AND SERVICES SELECTED
TYPE OF SERVICE AUTHORIZED TO BE PROVIDED Register Book............................. $
U Traditional Full Service U Viewing day of Service Prayer Cards.............................. $
Crucifix...................... $
C1 Graveside service only Flo Viewing Temporary Grave Marker.................. $
' 3 Cremation U Immediate Disposition Memorial Board Rental.................... $
U Public Viewing U Anatomical Gift Casket Rental............................. $
U Private Family Viewing U Memorial Service Clothing.................................. $
U Evening Viewing U Shipping Service Flag Case................................. $
Other $
U Receiving Service Total of Merchandise Selected(C).............. $_`--
A.
A Package Arrangement D. Special Charges
c Forwarding Remains to $
r' $
` B. Charge for Services Selected: Receiving Remains from
1. PROFESSIONAL SERVICES $
Basic Services Fee ..................... $ t t Immediate Burial.......................... $
1 -Embahni tg-or Refrigeration..........., $ Equipment Rental......................... $
I Cremation............................ $ :nC. Direct Cremation... ... .................. $ "ice
Other Preparation of Body Total of Special Charges(D)................... $
E.Cash Advances
1~ $ t, `
Opening of Grave......................... $
Transfer of Remains to Funeral Home ... $ W)c
Sub-Total of Professional Services(BCemetery Equipment...................... $1)..... $ Clergy/Mass Offering..................... $
Z ADDITIONAL SERVICES AND FACILITIES Flowers .................................. $
Visitation/ID View/Viewing ........... $ Hairdresser................ ....... .. $
Funeral Service........................ $ Certified Copies of Death Certificate .1 ;... $
Memorial Service...................... $ Newspaper Notice .':..:'.:................ $
Graveside Service .............•....... $ Cemetery Lot and Deed.................... $
Sub-Total of Additional Pallbearers................................ $
Services and Facilities(B2)................. $ Airfare..... $
3. AUTOMOTIVE EQUIPMENT Vault Service Charge....................... $
Funeral Coach ........................ $ Honor Guard............................. $
`
Lead/Clergy Car/Utility Car........... $ Organist. ....... $ 1
i Other ` ,rc,, $
Flower Car............................ $
i For your convenience,we will advance the cost of the foregoing items;however,any
Family Car............................ $ error made by any supplier of services shall be the sole responsibility of that supplier
and our funeral home is relieved of liability therefore by acting as your agent.Hetrick-
Other than local 20 mile Transportation.. $ Kitner Funeral Home,Inc.,Ronald C.L.Smith Funeral Home and Jesse H.Gei¢le
Sub-Total of Automotive Equipment(B3)... $ �, Funeral Horne, re e,Inc.aentitled to take and retain any discounts offered on e
' Total of Professional Services,Additional Services purchase of a cash advance item.
and Facilities,and Automotive Equipment(B) Total of Cash Advances(E).................... $
I C.CHARGE FOR MERCHANDISE SELECTED A. PACKAGE ARRANGEMENTS............. $
Casket B. ADDITIONAL SERVICES/FACILITIES .... $ 0
Description $ C. MERCHANDISE.......................... $ :Ga
Other Receptacle • $ D. SPECIAL.CHARGES.........r t."5 ............. $
r ,.
' Description '�� r ,;
1 -
Total of Funeral Home Charges............ $
Outer Burial Container
Description $ E. CASH ADVANCES........................ $ ='
1 Urn Total of Funeral Home Charges and
Description $ r{C ..........................
-' Cash Advances. '
} Acknowledgement Cards.................. $
llllmm�ldnl Anlrinrr �+
Invoice
Hetrick-Bi,tner Funeral Home, Inc.
3125 Walnut. Street.
Harrisburg PA 17109 Date Invoice#
4/21/2014 4182-Mike
Phone# 717-545-3774
I mvbi 105
Bill To
Mary L. Mills
481 Old Stage Rd.
Lewisberry, PA 17339
For billing inquiries please call the office Terms Due Date Family
Monday-I"riday 8AM-4PM
COD 4/21/2014 Sophie Shaffer
Qua.nc;r Description Rate Amount
Direct Cremation 2,495.00 2,495.00
Grey Cremation Container 390.00 390.00
12 Death Certificates 6.00 72.00
Coroner Fee 30.00 30.00
Obituary in Patriot News 211.02 211.02
TJjank you for allowing us to serve your familyin your time of
need. Total $3,198.02
Web Site www.HetrickBitner.com
Payments/Credits $-3,198.02
Balance Due $0.00
REV-1512 EX+(12-12)
i� pennsylvania SCHEDULE I
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
SOPHIE L. SHAFFER 2120140683
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Personal loan to pay Decedent's assisted-living costs until such time as property at 6007 Robert
Drive, Mechanicsburg, PA.,could be sold. Repayment of loan due when property is sold including
monthly payments made on the loan to that date. Loan Agreement signed by Decedent's POA on
10/09/2013.
Actual cash monies deposited into Joint Account(for convenience of POA) 24,488.08
Additional money loaned for new roof for Decedent's house(before DOD) 5,280.00
Payments on loan from 11/16/2013 through 12/31/2014 2,021.69
2 Vacant House Insurance-DOD through 12/15/2014 1,632.00
3 Auto Pay Utility Bills-DOD through 12/15/2014 1,478.18
4 Cost of Lawn Mowing-For Season 625.00
5 Keystone Foundation Repair-Basement Wall Repair 3,990.00
6 Cash for refinishing hardwood floors, new front door,paint and supplies,new stove, new hot water 3,310.00
heater,new commode,tile,dumpster for outdoor structure removal(safety hazard)
7 Hampden Township for Property Taxes 1,292.31
8 Electrical Panel inspection-Condition of Sale 78.25
9 Termite Inspection-Condition of Sale 159.00
TOTAL(Also enter on Line 10, Recapitulation) $ 44,354.51
If more space is needed,insert additional sheets of the same size.
i
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF; FILE NUMBER:
Sophie L. Shaffer 2120140683
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)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. Mary L Mills Child One-thirdShare
481 Old Stage Road
Lewisberry,PA 17339
2 Jacqueline L.Jumper Child One-thirdShare
1641 Main Street, Lisburn
Mechanicsburg,PA 17055
3 Warren D. Shaffer Child On-thirdShare
199 Blue Mountain Drive
Lewistown, PA 17044
4 Dollar amounts to be determined after Supplemental Form filed
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.
l
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.