HomeMy WebLinkAbout01-0377
Estate of 1"1 /~Q#!.~ /'? ..r~/~/I'J'<J/
also known as
PETITION FOR PROBATE and GRANT OF LETTERS
~~- 03'7'7
Register of Wills for the
, Deceased. County of in the
Social Security No. /1 If / 8 :; '1 j1 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the executDI2
in the last will of the above decedent, dated , / /:r ~7
and codicil(s) dated
No.
To:
named
, 1917-
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in c..V;41(Jta--L'rr'''' County, Pennsylvania, with
h fa last family or principal residence at PtI'11"()1f. C'1-I1-t. ,wv4~} #.,.,C
/ 71'1~ J. ,., /9 4.A:. r r t/r L-",..... If' /~,/ <:.€ ~ ~ /;1 () 1/
(list street, number and muncipality)
Decendent, then ;>" years of age, died 3/7/4'. , 19 IS / ,
at .... ~ "'''011. ~"".tt..'I.. /IIv.J,~ I /+tJ~ '1' /7./- A'.~r ~-." H-,'c...c. r't9/., D //
Except as follows, decedent did not marry, was no't 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:
Decendent 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:
$
$
$
$
o
o
~
6
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters /7 /r~ "" c -p '1
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
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OATH OF" PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } sa
COUNTY OF C~LlfnBr RLA l"-l b
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
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No. Ji/-Ol- OJ ']'7
Estate of fY\ I LD KJ::..D (11. 5c.t-\ fYl i Dr
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW A.rK \ L I L ~i, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated NO vr- rYl 13 E: R 00.1 ,9Q'7
described ther~in be admitted to probate and filed of record as the last will of ('\'\ I l-Di=<"ED
rn.. Sc t-\ YY) I DT
and Letters T~TA YvlENTAR'I
are hereby granted to V\J I LLI A tY\ t-\. ~\-t ILl j N(16~-ORJ)
Yr
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Probate, Letters, Et;~~~. . . . .. $ ! ~ . ( G
Short Certificates~ . . . . . . . . .. $ Lv . DD
R{'uum.ic1lioTi~:- .rG.::>. . . . . . . .. $1-8, DC
,:rc.P $ 5 CC'
TOTAL _ $ Yl CO
Filed ..~.: J .~: . O.l. . . . . . . . . . . . . . . . . . . . . .
rr1 rt1 I_L/t) 0 K.D EK l{.- Lf T TE-[(S T[\
A ITORNEY (Sup. Ct. to. No.)
ADDRESS
PHONE
E^t:C u. TOR.. ..
"NAqN!NG: IT IS ILLEGAL TO ALTER THIS COpy OR
TO JUPLlCATE BY PHOTOSTAT OR PHOTOGRAPH.
~\I OF DEA.TH
4 5, 8 ~, ~~~ ~~: 6
3...10...2001
Mildred
M.
Schmidt
Female
174-18-3957
Date 'J)
3-7-2001
OdIC:
March 29, 1916
Mi fflint_o~Ql P A
Pi ,-"':'.-.'
Manor Care Nursing Home
Cumberland
Camp Hill
f=l ,:1' f
White
Homemaker
_ ArrnecJ ForCf-7S'>
No
M,..::
Widow
2151 St. Clair Court
Harrisburg
PA 17110
William Shilli~gsford
Funeral [),reciCt
David M. Myers
o a v idMye:t:'s F u nera 1 H ome,~ e~port, P Ai? 07 4
p~
CAD
Pel rt Ii.
Ma:':'
DpSCnrJH how
Nail.,
xx
~VCi
N ".1" ' ,
Peter M. Brier
M.D.
I\ud;
108 Lowther Street, Lemoyne, PA 17043
'f II here ,ven cnreet' Oplf:'
nl-;;1! ReDlstrar The C)!iql ell eerlILcc~tiC:
e fin" 11 e 11 t f j:! ng I '. . ...'>fJ ...:' ".. . ...... /). ..' .' .' .'
.11~ttW ..LL.~~v !iOc~455
II Barnett S~., New Bloomfield, 'PA 17068
". : f i
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3-9-2001
dlb\wills\schmidt.mm
November 6, 1997
LAST WILL AND TESTAMENT
OF
MILDRED M. SCHMIDT
I, MILDRED M. SCHMIDT, of Harrisburg, Dauphin County,
Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby make, publish and declare this my Last
will and Testament, hereby revoking any and all prior wills and
codicils thereto by me at any time heretofore made.
FIRST
I direct that all my just debts and the expenses of my last
illness and funeral shall be paid from the assets of my estate as
soon as practicable after my decease.
I authorize my personal representative to expend funds from my
estate, in such amounts as my personal representative shall
consider necessary and desirable, for the purchase, erection and
inscription of a suitable marker for my grave.
SECOND
I give and bequeath all automobiles, household effects and
other tangible personal property, not including cash or securities,
owned by me at my death, together with all policies of insurance
1
dlb\wills\schmidt.mm
November 6, 1997
thereon, to my son, WILLIAM H. SHILLINGSFORD, providing that he is
living on the sixtieth (60th) day after the date of my death.
Should my son, WILLIAM H. SHILLINGSFORD, not be living on the
sixtieth (60th) day after the date of my death, I bequeath his
share to his issue, per stirpes.
THIRD
I give, devise and bequeath the residue of my estate, of every
nature and wherever situate, to my son, WILLIAM H. SHILLINGSFORD,
providing that he is living on the sixtieth (60th) day after the
date of my death. In the event my son, WILLIAM H. SHILLINGSFORD,
is not living on the sixtieth (60th) day after the date of my
death, then I give, devise and bequeath his share to his issue, per
stirpes.
FOURTH
All principal and income, until actual distribution to the
beneficiaries, shall be free of the debts, contracts, assignments,
alienations and anticipations of any beneficiary, and the same
shall not be subject to any levy, attachment, execution or
sequestration.
2
dlb\wills\schmidt.mm
November 6, 1997
FIFTH
I direct that all taxes that may be assessed in consequence of
my death, of whatever nature and by whatever jurisdiction imposed,
shall be paid from my residuary estate as a part of the expenses of
the administration of the estate.
SIXTH
My personal representative shall have the following powers in
addition to those vested in them by law and by other provisions of
this will:
A. To retain any or all assets of my estate, real or
personal,
without
regard
to
any
principle
of
diversification, risk or productivity.
B. To invest in all forms of property as my fiduciary may
deem proper, without regard to any principle of
diversification, risk or productivity.
C. To purchase investments at a premium or discount.
D. To exercise all rights of a security holder or
shareholder in any corporation; to give proxies; to join
in any merger, consolidation, reorganization, voting
trust plan, or other concerted action of security
holders; and to delegate discretionary duties with
respect thereto.
3
dlb\wills\schmidt.mm
November 6, 1997
E. To sell at public or private sale, to exchange or to
lease, for any period of time, any real or personal
property, and to give options for sales, exchanges or
leases, for such prices and upon such terms or conditions
as my fiduciary deems proper.
F. To allocate receipts and expenses to principal or income,
or partly to each.
G. To borrow money from my corporate fiduciary or others and
to mortgage or pledge any real or personal property as
security therefore, in my fiduciary's sole discretion.
H. To compromise any claim or controversy without order of
court or consent of any beneficiary.
I. To exercise any option, right or privilege granted in
insurance policies or arising from ownership of
investments.
J. To permit my minor children to occupy any real estate
retained or acquired.
K. To make any distribution herein provided for in cash, in
kind, or partly in each, at valuations fixed by my
personal representative at the time of distribution.
L. My fiduciary may, in his or her sole discretion, donate
any part or all of my tangible personal property to any
charitable organization(s) which would benefit from such
4
dlb\wills\schmidt.mm
November 6, 1997
donation.
My fiduciary is then instructed to use the
value of said donation(s) as an tax deduction for any
inheritance tax return which may be required to be filed
as a consequence of my death.
SEVENTH
I appoint my son, WILLIAM H. SHILLINGSFORD, Executor, of this,
my Last will and Testament.
EIGHTH
My Executor shall not be required to post security in any
jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to
this, my Last will and Testament, consisting of five (5)
typewritten pages, the first four (4) of which bear my signature in
the margin for the purpose of identification, this
3D
day of
November, 1997.
I,.,
/'&j~~L~~
MIL' RED M. SC lOT, Testatrix
5
dLb\wiLLs\schmidt.mm
November 6, 1997
Signed, sealed, published and declared by the above-named
Testatrix, MILDRED M. SCHMIDT, as and for her Last will and
Testament, in the sight and presence of us, who, at her request, in
her sight and presence and in the sight and presence of each other,
have hereunto subscribed our names as witnesses.
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Address
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6
dLb\wiLLs\schmidt.mm
November 6, 1997
~
COMMONWEALTH OF PENNSYLVANIA
SS:
COUNTY OF {j(, f d
I, MILDRED M. SCHMIDT, the Testatrix, whose name is signed to
the foregoing instrument, having been duly qualified according to
law, do hereby acknowledge that I signed and executed the
instrument as my Last will and Testament; that I signed it
willingly; and that I signed it as my free and voluntary act for
the purposes therein expressed.
Sworn or affirmed to and
SCHMIDT, the Testatrix this
COUNTY OF
tk (. ~ 1...'
, (J'
acknowledged before me by MILDRED M.
50 day of November, 1997.
?!J!!~~~/) Aljyn)J/~
MILDRED M. SCHMIDT, Testatrlx
" . lJ rl
,;;(. "-L'" )t, } ~_. r ()l.A,-l~-
Notary Public
1 No'r'\!1IN. SEAL
, CONNA T. ~~urj"! ., i;;~)11ry Public
S S::i Mlilerstowlo,
~ My Commission Expires ~uJ:.~?01
COMMONWEALTH OF PENNSYLVANIA
We, -.S;I't\c..,., J l?4.\' and -.(({IV t C~.I(('rt. ,
the witnesses whose names are signed to the foregoing instrument,
being duly qualified according to law, depose and say that we were
present and saw the aforesaid Testatrix sign and execute the
instrument as her Last will and Testament; that she signed
willingly and that she executed it as her free and voluntary act
for the purposes therein expressed; that each of us in the hearing
and sight of the Testatrix signed the will as witnesses; and that
to the best of our knowledge the Testatrix was at the time eighteen
(18) ir more years of age, of sound mind and under no constraint or
undue influence.
Sworn or affirmed to and
day of November, 1997.
t::
ltnes ~~/~
~~)J%P
,!-/L') [/Y C'f- ) ,,~72( l
Notary Public
NOTARIAL SEAL
\]~V-' T. POTTER, Notary Public
.;town, Perry County
, Expires Aug. 26. 20Q:!..
7
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG. PA 17128-0601
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
No.AA
*
496555 REV-1162 EX (11-96)
RECEIVED FROM:
I
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
~_ ('/'/' ~..! :.-~; r": :~~ '... ~_. i :\J C~ ~:~ {"" [J ~ L>
('~
5~:S c: (:; . :;j t~
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n_ FOLD HERE
FOLD HERE
ESTATE INFORMATION: I
FILE NUMBER
~. I ~ 1
c-: .:: \ ;" !
",) '"...'- - ~
1~7L~.'-'.i-'~j :3t?~j~)
NAME OF DECEDENT
l~,,; ".,.J -'\.j " :"'."-:
...' I " ~ ....,.
(LAST)
~-;: ~ L~.f) . ~ --
(FIRST)
(MI)
DATE OF PAYMENT
r'~ ... ;~.'I...."1
i,-' "d.,1
POSTMARK DATE
,- I
:) I .' \
'-~.. ...' ...
COUNTY
~I ~j i~ ~~~l . ~5 (,_:
tj :'.'~ ~,'~ ~ ~'< L_l~ r'~ j ,
TOTAL AMOUNT PAID
DATE OF DEATH
;.~) f!
,. /... -.., ! E~ f) (.'
('1"'-"- .;.HM l~"_~ :':':i:_: l:=:\..= l."h}'..~!' Ur'.'L' '/ '.' f .... ~ I L
:',:JI'L-:: '-l-~.;.::'~__"LfR~~ENt)~~:J T!~~W--~~Itr;~D TO RECEIV~~4~\: >C~~;r:;
i>lE C ...rt .. 1:.. OUR.. r-" ..,q... . I ". '"
L ',.' --.,; ~J 0 F F I CE f"': L u 1. ~:J I c, ~,;: O~-7 ,..,; J. '... L. ::.;
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REMARKS
.r: ('/:.(..'-(.< .' . /'d-.r"
.'
SEAL
REGISTER OF WILLS
~
--
Name of Decedent:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Je. /,/"" .,~T
P7
M,.{,D ~s..Q
Date of Death:
7/7/0/
Will No.
'-DO/- OtJ177
Admin. No. f'~ IV" '2/-b/- 6.:177
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the O~s' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on ~ 0/ :
Name
Address
l-v l tL/ 4~ /1 J /1, t~ ~cJ) r.~ <J
~/.rl .I'"...~r CL~.~ Cr
fI"~"'/J(?1.J~~ /(9 /7//C)
{J
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
)(7/0/
t~;v#'~
Signature
Name I. ',t-Ir ~ "9"" _II- J/-/; L t..AJ /.J .J:;i74d
~ (,.
Address 1,.-/S/ ..flf,.,.,f CL"9,~ tr
/It?I'f-''':./ /:!~/Vf r'9 /7//0
. V .
Telephonef7J~ 7.10 - .?7/1 (#"'7)
Capacity: ~rsonal Representative
_Counsel for personal representative
v /~-~.:3"/)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX~IVISION
DEPT. 2'0601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-18-2001
SCHMIDT
03-07-2001
21 01-0377
CUMBERLAND
101
WILLIAM H SHILLINGSFORD
2151 ST CLAIR ST
HBG PA 17110
91-
(/
v'
REY-1541 EX AFP (12-00)
MILDRED
M
Amount Remitted
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
721.00
17,530.00
.00
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 ~
REv=is4j-Ex-AFP--ci"2:oo1--No'ficE--oF-'rtiHEifiTANcE-TAX-APPRAisEHENT-;-Aii-oWANCE-oi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF SCHMIDT MILDRED M FILE NO. 21 01-0377 ACN 101 DATE 06-18-2001
TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Hortgage 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
NOTE: If an assessment was issued previously, lines
reflect figures that include the total of ALL
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
(9)
nO)
6,794.98
(8)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
18,251.00
6.794 98
11,456.02
.00
11,456.02
14, 15 and/or 16, 17, 18 and 19 will
returns assessed to date.
.00
515.52
.00
.00
515.52
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-03-2001 AA496555 25.78 520.56
TOTAL TAX CREDIT 546.34
BALANCE OF TAX DUE 30.82CR
INTEREST AND PEN. .00
TOTAL DUE 30.82CR
.00
(11)
(12)
(13)
(14)
.00 X 00 =
11 J 456.02 X 045 =
.00 X 12 =
.00 X 15 =
(19)=
* 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" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
REV-1470 EX (6-88)
~
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME
INHERITANCE TAX
EXPLANATION
OF CHANGES
MILDRED M SCHMIDT
FILE NUMBER
John Kealy
ACN
2101-0377
101
REVIEWED BY
SCHEDULE
ITEM
NO.
EXPLANATION OF CHANGES
The value of the estate has been adjusted as the result of the correction of an error in
arithmetic.
ROW
Page 1
'\,..
/~'c:2c:.J3-//
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG. PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*
REV-l'07 EX AFP el2-0D)
FE8 -1
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-31-2001
SCHMIDT
03-07-2001
21 01-0377
CUMBERLAND
101
MILDRED
M
WILLIAM H SHILLINGSFO;~Z
2151 ST CLAIR CT
HBG
P 1 :44
Amount Remitted
PA Gun
ClImb;;;; :
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
RE-\j: i6oj-ix--AFP-fi'2-:ooY------...--iNifERli'-ANc'E--TAx--STjrfEM'E-tiT-OF-ACCouiff--.-..--------------- - - - - --
ESTATE OF SCHMIDT MILDRED M FILE NO.21 01-0377 ACN 101 DATE 12-31-2001
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-18-2001
P R I NC I PAL TAX DUE: ...........................................................................................................................................................................................................................
515.52
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-03-2001 AA496555 25.78 520.56
12-17-2001 REFUND .00 30.82-
TOTAL TAX CREDIT 515.52
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
C/~K
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
/'1ll On '0 PI J"e././ /'I . ;':T
Date of Death: 7/7/lJl
'2/- 2- 001 - ;'77
Will No.
Admin. No.
J1.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1 .
State whether administration of the estate is complete:
Yes V No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No ~ .
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative sta~ an
account informally to the parties in interest? Yes vr No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date:
U/J,joJ
~ // t/?,.---
Signature
?Jtt"tI4A }J '1.f.t-t';"I/~(J~<:J
Name (Please type or print)
'Z/JI Jr (LR-;,f1,. (;7 1I1f-/l./L1./~&J7/d.
Address I 7 1/ ()
(,/?) J''IO- 1761
Te l. No.
Capacity:
v Personal Representative
Counsel for personal
representative
(MAH:rmf/AM3)
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
0#
Date: 2/07/2003
WILLIAM H SHILLINGSFORD
2151 SAINT CLAIR COURT
HARRISBURG, PA 17110
RE: Estate of SCHMIDT MILDRED M
File Number: 2001-00377
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 3/07/2003
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~~T~~j2~. .
DEPUTY REGISTER OF WILLS ~
cc: /File
Counsel
Judge
REV-1500:;(6-,;'i
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128.0601
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REV-1500
OFFICIAL USE ONLY
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
FilE NUMBER
1L~-~...L ~~..22_
COUNTY CODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
..[~II,..,;"r /1?;lPPfc P7
DATE OF DEATH (MM.DD.YEAR) DATE OF BIRTH (MM.DD.YEAR)
J/b7/ZDO/ J/'19//'/6
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
IY/R
SOCIAL SECURITY NUMBER
/'?V -Iff
J9f'71
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WillS
SOCIAL SECURITY NUMBER
[f11. Original Return
o 4. Umited Estate
06. Decedent Died Testate (AAactlco\l~olwml
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (dale of death after 12-12-82)
o 7. Decedent Maintained a Uving Trust (Attach copy of Trust)
o 10. Spousal Poverty Credit ((late of death between 12-31-91 and 1-1-95)
o 3. Remainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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NAME I,
VJIu',-"''''
FIRM NAME (If p,pplicab\e)
./ rID A./D
COMPLETE MAILING ADDRESS
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)frfIU",J (lV4 ;,/"17 /7//0
TELEPHONE NUMBER
71 7- ~6 -.i' J /1
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
OFFICIAL USE ONLY
(1)
(2)
(3)
(4)
(5)
3, Closely Held Corpora1ioo, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
721.00
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-VIvos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
/ 7,J-:Jo
(6)
(7)
/S,-,.n
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses &. Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens {Schedule \)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (line 8 minus line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to lax has not been
made (Schedule J)
/ e, 2. J/
(8)
(9)
b 79'/, 99
(10)
14. Net Value Subject to Tax (Line 12 minus line 13)
(11) b 7t:;'(. o/e
(12) /2. 176. '11- .
(13)
(14) 12./7(,. 92-
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at \he spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x.O_ (15)
x .0 Y.r (16) S'2t>.S'{,
x .12 (17)
x .15 (18)
(19) r Zo..r6
16. Amount of LIne 14 taxable at linear rate
/ :2. 17~, '1->--
,
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREoTADDRES?
CITY
I STATE
I ZIP
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credil
B. Prior Payments
C. Discount
Total Credits ( A + B + C ) (2)
3. InleresUPenalty if applicable
D. Inlerest
E. Penalty
TolallnleresUPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enler 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 Ihe difference. This is the TAX DUE. (5)
B. Enter the lolal of Line 5 + SA. This is the BALANCE DUE.
(SA)
(5B)
A. Enter the interest on the tax due.
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. relain Ihe use or income of Ihe property lransferred;.......................................................................................... 0 Er
b. relain the right to designate who shall use the property transferred or its income; ............................................ 0 Er
c. retain a reversionary interest; or........................................................................................................................... 0 ~
d. receive the promise for life of either payments, benefits or care? ...................................................................... D ~
2. :~~:~ r~:~;~ :::~~a~:~~::d:~~I~:;:~I~.~~~~~".I~".~f~r~r~~~~.~i~'n.."."...y..ar".f~~~t~............... 0 ~
3. Did decedent own an -in trust for" or payable upon death bank account or security at his or her death? .............. 0 ~
4. Did decedent own an Individual Retirement Account, annuity, or other non~probate property which
contains a beneficiary designation? ............... .. ........................................ .................................... ....................... 0 c::f"
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of pe~ury, , declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct
and complete.
Declaration of preparer other than \he personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERS N RESPONSiBLE~O FlUNG RETURN
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ADDRESS
DATE
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SIGNATURE OF PflEPARER OTHER THAN REPRESENTATIVE
lIiTrt."':./ /fv7 ~"9- /7//0
W'''/6/
DATE
ADDRESS
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. 39116 (a) (1.1) (i)l.
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)l.
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 stepparenl of the child is 0% [72 P.S. 39116(a)(1.2)].
The lax rate imposed on Ihe net value of Iranslers 10 or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)].
The tax rale imposed on the nel value of transfers to or for Ihe use of the decedent's siblin9s is 12% [72 P.S. 99116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has al least one parent in common with the decedent, whether by blood or adoption.
'''''''''".,,.''.
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COMMONWEALTH OF PENNSYLVANJA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
111.(..0,.1" ,..., .(..11;00.07
FILE NUMBER
Indude the proceeds of litigation and the date the proceeds were received by the estate. All property joinUy-owned with the right of survivorship must be disclosed on SChedule F.
ITEM
NUMBER
1.
f i1-..I f2 ~ F",..-JO ;r ~~"-'
fl'tFf p'fp &u/T Qo:f..
~oo
,
VALUE AT DATE
OF DEATH
6 re:;. 00
.r1'. "ill
b..ao
DESCRIPTION .
c.,rrJ (f
TOTAL (Also enleron line 5, Recapitulation) $ 7 Z/. 0 0
(If more space is needed, insert additional sheets of tne same size)
William H. Shillings ford CLU
DATE 4/24/01
Re: Inheritance Tax
Mellon $ 24,198.81
Allfirst 5,211.38
PNC 5,649.53
Income Tax Refund 659.00
Safe Deposit Box 55.90
Cash 6.00
TOTAL $ 35,780.62
Expenses j;.' (. ~
" --
Register Of Wills
Funeral Home
Country Meadows
Manor Care ?
. . "'Ff.
~''''J~'$
94.00
47.00
5,874.20
581:78
198.00
TOTAL
$ 6,794.98
THE FASTEST WAY to communicate with you is with
this brief note. We hope you won't mind emphasis
on speed over formality.
William H. Shillingsford CLU
2331 Market St. Suite 100
Camp Hill, PA 17011
717.730-3711 VOICES 717-730-3712 FAX
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTL Y.OWNED PROPERTY
ESTATE OF
1'1 ,t-t:>,ltJ: 0
.m ..rcll'-.~T
FILE NUMBER
tf an asset was made joint within one year of the decedenfs date of death. it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RElA T10NSHfP TO DECEDENT
A t4n t-LI/l'" 11 J'1f, u.. "'r/ .t t:i. .4
~/.rl -r/f-";,.,r CL,,""" Cr-
114~.rdt./JC-J/,8 /7//~
fa"",
8.
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JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PRoPERTY %OF DATE OF DEATH
['(EM FORJOlNT MADE Include name of 'financial 'Institution and bank account number or similar identifying number. Attach DATE OF DEATH DECO'S VAlUE OF
NUMBER TENANT JOINT deed forjointly-held real estale. VAlUE OF ASSET INTEREST DECEDENrSINTEREST
1. A 'f/.#/~7 tJ-tt- ;:,/U/ 0 oS' (>0 (. 08'7 '). I, /]'J.. 2. r .)470 ~f~r..
16/'''/~ If II /1 8 7t>og IIH> J If,,7'J..r ~ o7Q. /7 P7- '-." .,0
]/1,,/6 mt;.u#-, (/1,,/1: ).'1.117 67.1"J 1.'1 J8 . 1/> f7> ,. 7':.J"
n?tUo"" Af~,.,g z.6rofl' Y'fl(-c. 2. Y11.?%.. fb7. I ~/'
'1/ '/ 'I ~ , 1'171
,. il" ,.,. '-JIG 1>;1 - c. 1 <;['3.16 J7>7.
'11:;/'! , 1'11f-'c.",,., Ii"'",/~ [$1 C. /6, 16"2.. 'l11 f1> 7. ~/Sl
d ,..1& "t.-li ~ qg 'J. -
{ ~/"I If 1'11. ,t-. ..,,, J I. ,j7 'f I .n. If'l. fj JD"J. :L{JZJ""
7/{,/~' p,vC. t!"...K F1'f6 ,
. ( 3J,tJ{,8)
TOTAL (Also enter on line 6, Recapitulation) $ /? .):10
" -
(If more space is needed, Insert additional sheets of the same size)
--
~ allfirst
Allfirst Financial Center N.A.
p.o. Box 900
Millsboro. DE 19966
March 14,2001
William Shillingsford
2331 Market Street, Suite 100
Camp Hill, PA 17011
RE: Estate of Mildred M. Schmidt
Date of Death: March 7, 2001
Social Security Number: 174-18-3957
Dear Mr. Shillingsford:
In response to your request, please be advised that at the time of death, the above-
named decedent had on deposit with this bank the following accounts.
1. AccountType........................... Checking Account
Account Number....................... 0050060872
Ownership(Namesoj).............. Mildred M. Schmidt, William H. Shillingsford
Opening Date........... ............... .04/28/87
Balance on Date of Death... .... ..$1, 132.25
Accrued Interest
$
0.00
Total...................................... .$1.132.25
2. Account Type........................... Certificate of Deposit
Account Number........... ... ......... 87008100394725
Ownership (Names of).............. Mildred M. Schmidt or William H. Shillingsford
Opening Date................... ....... .10/24/94
Balance on Date ofDeath.........$4,056.81
Accrued Interest
$ 22.32
Total....... ... ........................ .....$4,079.13
I!J
Account
Number
282-117-6753
128-443
Mellon Bank
Monday, March 26,2001
Account Type: 00
Account Sal
as of DOD
$1,450.90
Account Type:
YTD Int to
DOD
$0.59
SO
Account Title
Mildred Schmidt
William Shillingsford
Date Opened: 03/14/1989
Principal Sal Int from Last Account Sal
as of DOD Posting to DOD as of DOD
Mildred Schmidt
William Shillingsford
Date Opened: 11106/1990
Mildred Schmidt
William Shillingsford
Principal Sal Int from Last
as of DOD Posting to DOD
$1,450.90 $0.00
Date Opened: 04/28/1989
YTD Int to
DOD
285-086444-C
Account Type: TO
28-A25803-C
28-A48289-C
Mildred Schmidt Or
William Shillingsford
Principal Sal Int from Last
as of DOD Posting to DOD
$2,431.72 $161.08
Date Opened: 04/03/1990
Mildred Schmidt Or
William Shillingsford
Principal Sal Int from Last
as of 000 Posting to DOD
$3,953.36 $251.55
Date Opened: 12/04/1990
Principal Sal
as of DOD
$16,362.83
Int from Last
Posting to DOD
$251.55
Account Sal YTD Int to
as of DOD 000
$2,592.80 $14.73
Account Type: TO
Account Sal YTD Int to
as of DOD DOD
$4,204.91 $23.88
Account Type: TO
Account Sal
as of DOD
$16,614.38
YTD Int to
DOD
$0.00
Page 2 of 2
~PNCBAN<
Decedent Reporting
Firstside Center
500 First Avenue, 4th Floor
Pittsburgh, PA 15219-3128
SCP
March 14,2001
William H. Shillingsford
2331 Market Street #100
Camp Hill, PA 17011
RE: Estate of Mildred Schmidt, Deceased
SSN: 174-18-3957
DaD: 03/07/2001
Dear Mr. Shillingsford:
Please find the date of death balances you have requested listed below.
CHECKING ACCOUNT
#5140365741 Established 07/06/1984
MILDRED SCHMIDT
WILLIAM H SHILLINGSFORD
DaD Balance: $5,649.53 (non interest bearing)
Our office only provides date of death balances for IRA's, CD's, Checking and
Savings accounts. We do NO Financial Transactions or Statement Orders. For
Further information please call1-800-4-BANKER or your local PNC Branch and
ask to speak with a Financial Services Representative.
Sincerely,
~
c;.....:;;;:-~-
Erica A. Bishop
1-800-762-1775
A member of The PNC Financial Services Group
PNC Bank NA Pittsburgh Pennsylvania IS26S
.R~''''M'~.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
/l1 ( L D /2--(.P
fZ1.
.
)C /l-A7/oT
FILE NUMBER
r ~ 2:.-(_0/_ Of? 7
Debts of decedent must be reported on Schedule I.
. ITEM
NUMBER DESCRIPTION AMOUNT
A FUNERAL EXPENSES:
1. -P,p--V( "6 I>?V-e.iJ' rJ"-' J2- ;t-/1. '-
/h >--<-- S17'7 Z.J
C ov,...-7TY /7~dv....l ..r Fl. ??
hJ;;-/'-"b ;- C~ / 51: -
J::t-T> f'-t . (OS-r ) Lf I. 00
B. ADMINISTRATIVE COSTS: 'ly'uu
1. Personal Representative's Commissions
Name of Personal Representative (s)
Social Security Numbe~sll EIN Number of Pe!Wnal Represenlative{s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach eXplanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
~-Z- ~a-<--;..J...e cP C"tP7
l.e /77. ,?Y
TOTAL (Also enter on line 9. Recapitulation) $ e::::-c '7<../"7.'
(If more space IS needed. Insert additional sheets of the same Size)
HCR.ManorCare
MANORCARE CAMP HILL 583
1700 MARKET STREET
CAMP HILL, PA 17011
(717) -737-8551
WILLIAM SHILLINGFORD
FOR MILDRED SCHMIDT
2151 ST. CLAIR COURT
HARRISBURG, PA 17110
SCHMIDT, MILDRED M
1009
------------------------------------------------------------------
CREDITS
I
,
I
CODE !
SERVICE RENDERED
DATE OF
SERVICE
03/01/01 BALANCE FORWARD
03/01-03/06/01 CO-INSURANCE 6
DAYS AT
~ ' J'Od..L'J.::; 1"/ 1fJot><>)
C O..!:!"f !- p~,,' !J."
PAYMENT DUE BY THE 10TH
OF THE MONTH
THIS HAS BEE!\I !jILLED TO
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WILL BE BILLED F(!VATELY.
Statement
MEDICARE A
MCR CO INS
ROOM 228 -A
Please Return This Portion
With Your Payment
02/26/01 03/07/01 03/31/01
99.00
I
CHARGES I
594.00
594.00
1,188.01
AMOUNT DUE
Mead Living Ctr West Shore 4
Meadows Living Ctr West Shore
4837 East Trindle Road
Mechanicsburg, PA 17050
Resident Statement
Date: 04/01/2001
Re: Mildred Schmidt
Account#: 17056
Balance Due:
.00
William Shillingsford
2331 Market Street, Suite 100
Camp Hill, Pa 17011
Amount Enclosed
I'll \Sf 1\( I [f)J jOP I'OIH 10'\ (H I IfIs HII I \\Illl\m J.l. 1'\\\11" \))DRls:-;(f\
RI \1 RSI SII)). \11 Sill) ,'\ \\I'\DO\\ 0'\ I '\, II 01'1 f:\( I 0"" n
581.78.
RECEIPT FOR PAYMENT
-------------------
-------------------
Cumberland County - Register Of Wills
Hanover and Hiqh Street
Carlisle. PA 17013
Receipt Date
Receipt Time
Receipt No.
4/12/2001
10:10:38
1025307
SCHMIDT MILDRED M
File Number 2001-00377
Remarks W H SHILLINGSFORD
VZ
------------------------ Distribution of Receipt ------------------------
Transaction Description Payment Amount Payee Name
PETITION FOR PROBA
EXTRA PAGES
SHORT CERTIFICATE
JCP FEE
18.00
18.00
6.00
5.00
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
CUMBERLAND COUNTY GENERAL FUN
BUREAU OF RECEIPTS & CNTR M.D
Check# 2629
Total Received.... .....
$47.00
$47.00
'110 ...
----
5138833
-____v_~
~-----_._-- -
H&R Block
5072A JONESTOWN ROAO
HARRISBURG. PA
Office: 36637 (717)652-1202
Preparer: #00301 SHERRY MCGRAW
Client: MILDRED SCHMIDT
Tax Preparation 94.00
Total 94.00
Master/Visa/Discover 94,00
Change Due 0.00
Emp 1 oyee No. 00301
Thank You for choosing H&R Block
for your tax services.
AlJTIlCRiZAnON
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=e~":':.~-~~..~~.:,":.:'"~~1CJN.___
SIGN ..."'-......., '--' "'-..
suo
ltlTAL
SAu5S .
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TOTAl
4/10/2001 10: 10:41 AM
7970539
"8 guarantee quamy wonc.. It, U\6 unlIKely even' that your ralum hass"
error. H&RBIock peyalhe penally and 1n_l8Sll\ing from theanor.
.J' PerflOn;:di7M Ad~.nd lAxp6&nnlng hAAAd nn your sperilin A1fUlllltinn.
..I Vas'- round aulstanee.
~ AuditAssistance.
,/ Tax I'8tum maintenance for. ful three yeare or longer if Mquired by the BlaiS.
-./' AppointmentsavaiJable any lime, at your convenience.
"/1- 80(). HRBI.OCKa._leforclienlaeMceand off'''''''''''''lornoed9.
../ Wilhholdo,g rH' 'lplanning according toyourpl9lelencas.
../ Refund P.ewardacoupon9 - merchandise dlocoun19at your favorite placea.
../ lIyourrelumlaprepal8d anytlmebelWeenJanuary 1. 2001 toApriJ 16.2001
you will aulom9Ucally ba antered In Ihe 'Tha H&R Block $1.000,000 _ay'
. a.&k your p.ropare, for dotaibl
"t/' The convenience ofovsr9,00() IocatioM nattonvdde to 8eN&yOU.
v' H&RBIock Advantage Plus program, which pKWidostlpecialoftersfrom
partne~ ralal8d toYOllrfinancl:8l.MfJlds.
Addifianal SeIVlcesA.....ble tram H&R Book:
SoolroniG filing optiona, lndudirlg:
o Relund Anllclpetionloan- lIloan egain81you,refundavsUableinaafewa.lwodays.
o Re1und Anticipation Check - The ab~ily 10 withhold you, lees from the anllclpated ",,"nd.
o DlrAr.tOApoJltit- Vou'refl.nrirlAfll')A/tAf'lhyIRSintnvnllr[lArftllf\ill~nt.
. Pee"" of Mind (POM) Guarantee' E>dendayourguersn..... to Indllde \he rBimbu_1 of_dUB
to our error or other special sibJalions up to $4,000,
. Mortgage S8rv~ Including firBt- time homebuyers, debt consolidation and home improvement loans.
. Financial SelVlces, inoluding "'I_I planning and lnveslmBnland brokSt'age esrvk>e8 offered
Ihrough H&R Block _I MvIao.... Ine.. mambe, NYSE, SIPC, a subsidiary of H&R BIod<.lne.
H&RBIook, Ino.1e nol. reg_ brokeoldealer.
c. '
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;18
~J
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u
4..00
~n(j1ud8d
IndudArl
InGluded
Included
Inoluded
InGluded
Included
lneluded
Included
Included
Included
lneluded
R.g\der Oltte.V.,.)l:ln
Established in 1895
By Samuel D. Myers
'1 M~rr'h ?nnl
william H. Shillingsford
David M. Myers
Jack & Sally
IN ACCOUNT WITH
DAVID M. MYERS FUNERAL HOME
SECOND AND WALNUT STREETS
NEWPORT. PENNSYL V AN1A 17074
PHONE (717) 567-3138
7 March 2001
Complete funeral expenses for:
Mildred M. Schmidt
Traditional funeral with Yorktowne 18 gauge casket,
protective, with velvet interior
Rolling Green Memorial Park
Clergy honorarium
(6) Death Certificates
Flowers- Lana's Flower Boutique
$ 4,750.00
685.00
300.00
12.00
127.20
$ 5,874.20