HomeMy WebLinkAbout01-0531
REV-1500E,.X(6-t'11
w
,.,
~~cn
U"'''
W"U
",00
U"'''''
..Ill
..
..
c.--<
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT 280601
HARRISBURG, PA 17128-0601
/ ~~~ ~ rf- ?_~___~~~_
FILE NUMBER
2.~-.Q~ ~S 3-L_
COUNTY CODE YEAR NUMBER
I-
Z
w
Q
w
o
W
Q
DECEDENn NAME (LAST, FIRST, AND MIDDLE INITIAL)
tte-V-S e W \ \ \
DATE OF DEATH (MM<DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
S- - 25- LoO I 1- 31- I q sS-
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
SOCIAL SECURITY NUMBER
2-l0 -
'P
(gCf 6 Z
1, Original Return
D 4. limited Estate
o 6. Decedent Died Testate (Attacl1 copy of Will)
o 9, litigation Proceeds Received
o 2. Supplemental Return
o 4a, Future Interest Compromise (date ofdealh afler 12-12-S2)
o 7. Decedent Maintained a Living Trust (Attach copy of Tll,lsl)
o 10. Spousal Poverty Credit (date ofdealh belwee~ 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 lax under Sec. 9113(A) (Atlacl1SchO)
,.,
Z
W
o
Z
o
..
'"
W
'"
'"
o
U
FlRM NAME (If AppilcaWej
if'-/- SO~ fuV\Dvex- sty-cd-
CO\r-l\S\~) fA l7013
4 Cfs-o. ~~
tT"
fPO
<')0
. () ()
2..E^<f3.71
&5''5"'
1. Real Estate (Schedule A)
2. Slacks and Bonds (Schedule B)
1 Closely Held Corporation, Partnership Of Sole-Proprietorship
(1)
(2)
(3)
(4)
(5)
Cl OFF!P.JI USE ONLY
N rp.,
.,.,
rr1
CD
I
z
o
~
::l
I-
Q:
<(
o
w
~
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Properly
(Schadu", E)
6. Jointly Owned Properly (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non.Probale Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
(8)
5"'1 9B. 38"
~4g0..51
/ 2,1 t 8 .8 tj
--1' t 73. II?
}
-0.. () (j
:J
(6)
, 0(:)
1~~
0-.
(7)
,00
-r-7 7 -3.7/
(9)
(10)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liablllties, & Liens {Schedu~ \)
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 tax has not been
made (Schedule J)
(11)
(12)
(13)
14. Net Value Subject to Tax (Line 12 minus Line 13)
-'I, & 7S, 18'
.
(14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
z
o
~
I-'
::l
D..
==
o
o
g
i5. Amount of Une 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x.O_ (15)
x.O_ (16)
x .12 (17)
xy (18)
(19) O. 00
16. Amount of Line 14 taxable at lineal rate
17. Amounl of Line 14 taxable at sibling rate
18. Amounl of Line 14 taxable at collateral rate
19. Tax Due
200
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS
CITY
STATE 'fA
~
tc.s;:
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1)
2. Credits/Payments
A. Spousal Poverty Credit
B. Poor Payments
C. Discount
ZIP
17013
()
Total Credits ( A + B + C ) (2)
o
3. InteresVPenally if applicable
D. Interest
E. Penally
TotallnteresVPenally ( 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)
(5B)
B. Enter the total of Line S + SA. This is the BALANCE DUE.
()
o
d
()
o
Make Check Payable to: REGISTER OF WILLS, AGENT
lilrl1lll1lm_~ur~~~ 1\11 ~ Illllllr Y T'." "
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and:
a. retain the use or income oftha 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? . .................
Yes
o
...0
....0
....0
o
......0
........0
No
["'(
c:Y
~
W
G--"""
cW
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
~ /711/3
DATE
-3D-02.
DATE
/ - 02-
ADDRE if'!- S. I-ta f'ldVe-r Street- I ~I"Jt~1 fA- J7 0 13
~\\1lIll__.~I_~\\\1lIlt.\l1',\\Ijl_.\\1lIl!l!ll1_~,~lliIlllIIJl[JI_llll 11" Jill "II Hrnllll!1lli Iflllll_
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) (i)].
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 retum 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 vaiue 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)J.
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)J. A sjbllng 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~+(1-97)
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENl
ESTATE OF IL L_
m:.~S:~ y \ Wi "'A.~ l
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market lJalue is defined as the price at which property would be exchanged
between a wimng buyer and a willing seller, neither being compelled 10 buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with
right of
survivorshin must be disclosed on Schedule F.
ITEM
NUMBER
1.
FILE NUMBER
::LI - () I - 0 S3 ,
DESCRIPTION
Decedent's only "real estate" when he died
was a mobile home located on a rented
lot located at
VALUE AT DATE
OF DEATH
,950
62 Spring Garden Estates
Carlisle, PA 17013
It is a 1973 Squire Model, Title No. 25619580106,
VIN 2683AB. Its dimensions are 12X 65. See attached
Certificate of Title and Transfer
docUlllent dated 7/10/01. The condition is noted as fair.
The assessed valuelFMV of the trailer for real estate tax
purposes was $4,950.00 according to the recent
Cumberland County reassessment.
Parcel No. 40-09-0531-009D
The trailer is set up on a rented lot; local mobile home
dealers in Carlisle have verbally stated that the home's
Blue Book value is not more than $3000 - $4000 because
of the age of the trailer (almost 30 years). None, however,
would provide a written appraisal.
I
TOTAL (Also enter on line 1, Recapitulation) I $ Lf f~(J
(If more space is needed, insert additional sheets of the same size)
R""'~"".""'.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DE EDENT
ESTATE OF
WI \hcA\fY\ \>.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
\kN~nu.y
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were recei~ed by 1he estate. An property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE A T DATE
NUMBER DESCRIPTION OF DEATH
1.
L.
.3
4.
~ I"" "",el~ee... txl..1'\ "-.
tM~\I'\~ o..CCoU"\~ % 0 32.08313\ 7 30 .53
PCA."lcMeck (\t\s;t-) ~~l ~A~;- '113. ,'8'
Mo-\-or vc\\\~t~ _-ucd ~\o~ [&It/( I 600. 07)
ll\t\ t\e- A .'1..&-.
:) 0 \ d. mlOL-O) h ~e<...J i( \ ~~tovJ V] ,rKJ ~ u
so:A.es (5)>J ~)
Pev-S.OY\Q \ ~ 'IOtle.~ (&e.- o.\-\-o-cl\cd. '+00 . 00
C.Rl"rc.S~~ --J~~ ~~ avrl .
[)~ \ So ("'c \::A 11" e.s.. . \'YI \ S W", e)I ~\Ci'\ VI)
'\-k. \a..cX. (:l~. r~ \(\ ~\S es~.
TOTAl(Alsoenteronline5,Recapitulation) $ 211'13. 7/
(If more space Is needed, insert addijional sheets of the same size)
REV-151i EX+ (12'99)
, '*..
.'.,;',0
\ffl )."(\
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ITEM
NUMBER DESCRIPTION
A, FUNERAL EXPENSES: AMOUNT
1. G~\~ 'Oro-\1\~'" f\){\",,^' ~c::.- S.2.1 S. 00
&l"'~Ve S\tt- - fdvJl t\ \::: . \4-eKSY\e.<.&) S,-. LaO. crD
B. ADMINISTRATIVE COSTS
1. Personal Representative's Commissions
Name of Personal Representative(s) B~ev"Clc.\ A. ' ~o\~dorf
Social Security Number(s)fEIN Number 01 Personal Representative(s)
Street Address ~ 2. .spl""" l r"Ij btnk-r'\ <:; S~
City Co.. (" \, s \e... State P fit Zip 17013
Year(s) Commission Paid: 0. oC>
2. Attorney Fees Kcd-h ke.X\ \( S'v\o..U- h-s ) "E9'1 ' 25'0 rOO
Lt'-f S;;. ~o..Y10~ S;-t Jb"rl, \ S\e ) ~ A \70(3
3. Family Exemption: (If decedent's address is not the same as claimant's, atlach explanation)
Claimant
S\reet Address
City State _ Zip
Relationship of Claimant to Decedent
4. Probate Fees Tc...P~
I'e~~ern) Sh~~~J;') S::r,O{J
5. Accountant's Fees
~o:~'hk~ K 8\1avllS 1 Esq. tQ5'. 00
6. Tax Return Preparer's Fees
7. L.e3o, \ A,ch/e..r-n$\~ .
Co.... \ \ S\e.. 'Scn-T1 Y(e I 77. ~3
01\'\'\ b€lr \(V,e\. Cv. LL^-uJ 3"0 <.J Y"' v-.cJ 7'5'. 00
<;5. Mob, 'e. ~e.. \'rCAV\<;~ re~s;; '-Ig. 7S
So'\~be~ ~e5S~e.r ~l..c..G
TOTAL (Also enler on line 9. Recapitulation) $ SQ8fL3g
I1Grs~ )
WI \ \ I o,vY\ ~
Debts of decedent must be reported on Schedule I
FILE NUMBER
2..1 - 01-053\
ESTATE OF
(If more space IS needed, Insert addItional sheets 01 the same sIze)
REV.1512 EX. (l-SIJ
ESTATE OF
'*
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
) Wt\ \ 10. W\ ~.
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
\-\-~~\1e '-t-
FILE NUMBER
2.-1 - 0 \ - OS 3 I
Include unreimbursed medical expenses.
ITEM
NUMBER
1.
2-.
3
DESCRIPTION
5'\, n Y\0I Go. r (\eX\ E: So -\cr..-\e.S.
e-j 0 r'Y-o~e-I-h.t- \}J\oI.V\CI...~l ~
'?O ~O)<. (P2Z-
LeMay \Ie) PA \7D4-3 ll-D+ ReY\~)
VA P l +-0. \T~x CJlJ 1\ t' c;::ho-n ~
2..000 Ecn-V\.ee- m(.(){Y\e. K)C.. \)e_-~Kj-o'\.~
SY\\r\~O; \ 0JC'YY)~(A?
5 S-o t:, ~\~ -:;,t-fee
'York \ vA \7 Lf oS
G.Jm \:)e;r- \tX Y\ c:\.. ~~T~ CJo.. \ ..:- B\.)Y-~~
\ Cou'l"t-houSe- ~uan:::.
CRr\\s \e. ) P^ l 70 ] '3
Iv\*A'"'V\OI.\ ReN'eru..AL ?'erv~
DeM~~
AMOUNT
320.00
I.LO. 4-- L
25"(0 {oq
Li~- 90
[ ~,
S; 357, s-o
't.
s.
TOTAL (Also enler on line 10, Recapitulation)
$ ~ -1 gD. 5/
REV-1513 EX+ (9-00)
. '.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF I , .
[1~Y"\ec.r
) \Ah\\\C'\vy\
?
FILE NUMBER
2/-01-053/
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not ListTrustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and trans1ers under 1000/0
Sec. 9116 (a) (1.2)J F nc.nd
1. B""e,,~ 1\ . 150\ \elf'CQ r\2-
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE. ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART Il- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is neeckld, insert additional sheets of the same size)
~,m - --~:~~~.:u!fk~WJIf!!B"..NF,d.1i\': _::
DEPARTMENT OF TRANSPORTATION ,',_,
CERTIFICATE OF TITLE FOR A VEHICLE .' d- \ './
. -'\?
D~r)
""",~ ISQU~ivm:~~~~,",~~b"HE~
'iHf~~~~i;'<~F--;:E:'.'~~':!:,~~~~, -t'-'~~~~l~~r-~~~~~!~:J:-
~ ~=~=""!:I:';~wb.71![~"S ~
0Al'E PA TITlED DA.TEOFISSUE =r UNl.AOEN~1
)-
. ~.~. "-,.----.,.,....."""-
12.488
\
~72b00043002072-001
abll~)f1l
-~- .--
VEHIClE ID€NTlFJCATION HOUSER
~
,
OOO~ETER DISCLOSURE EXEMPT 8Y
~_ 1
WIL~IAM P HERSHEY
b2 SPRING GARDEN ESTATE
CARiIS~E PA 17013
."
j
.1
\
FllWTUENFAVOROF:
.j ...
INMC MORTGAGE HOLDINGS ~
INC'
I
I ...
RASTUElI........ - ~
031007
IN"C MORTGAGE HOLDINGS
INC
15050 AVE OF SCIENCE
SANDIEGO CA ~2128
1t>>rtilyllaollhed8teolluoa.llwofflclalreeordl;oIl11eP....,......~
~ TI~ relled:1fWllhe per.onll) OfC(llllplll1'fnBlNdhtrwin_!hlIlllWlulCIM*
otlheuldvehlcle.
i
I
I
i
,
I
I
I
I
I
I
"
o
0:
N',
to:
(0'
-.J
W
CO
C.!J
<J1GN.4fURl! OF CO.',,"PUC.l'fr,1"m.E OF ilU:l1ORIZEO SIGNER
.w _ ~~ ~!~"REiN.'~-S~fE PLASE:I~L9S~Tf.PPLY-~~R At;ui'iis:.uf: .1'1_"''1 AL!~R~A'il.ON Of? EAA..,~y~~~ V9IDSTHIS!r1U -'~ ~"t'C , ~
-
OCWR
\QOt'ItEtalIlJ'TA'TUS
O*1lCf\IAl1ill.l!AGE
t.~~THlIMEeHANIcAL
j
" -. t .
FEDeRAL
~
,- ""
~_Mln''ME.JCIUlIL.
-
". SlBIPT"",*
"""''''''''
'LAW
",..
.................. ~
c..~\I&<<Ui
O.~YrHCl..l -
F.OUTOI'~
::==......~-
L..I.DdGlMBVEtClJ':
P"~YA
..""""""",
S .. snl&;f ADO
T..Al!QOVIAIDntE!'T
Y..lI9IICI..f:eoHTAlMSPiI!'lSSVl:OVIN
W..fUlCOYEl<<U! t'
:C..RJllMEIILY"T~~
SECCINDU9IFAIIOAOf:
. ~
". Ml:llInd.......... ..1If;Md.......... cf.,.*-......~
~,;;~-=."'~ ~ ...~~ "*"~~~?
J .... . <. ~
SECCH)tlENAEI.E.tSED . ~
BY
AlJttiOl:UZED REPAES&NTATIVE
8RADLEY L "AlLORY
'MlefI~1llt........._,llIlW__.,..........dWIlI_o;lt
~~llnDblDc*III~.....be__.."T_lnc-i'.
A 0 JeIInIT.........RIgtIQlSuM\ooNhpCCllt....ot__._oo-
br. --.g-.rl.
BOT.... In eon- ton dMlh or _ _, ..... of........
o-lO'"OI"."....Of......
UEN
DATE;
FIRST
......
STREET
C>TV
STATE
Ul!N
OATE:
SecoND lI.ENHOl...OeR:
......
z.
STREET
C>TY
STATE
"p
! WAR N I NG - ~oe8.~~l~~ 5~A~~~~~~~~lr~e "m.jl~~T~ ~~u,{IfTt1~~ I~ ~~~6~9,~t~bW~~fl'AANsfER OF OWNERSHIP. FAILURE
A. ASSIGNMENT OF TITLE- ====~~'a=~:/=: lAST ~ T ..1.1.
SldKlrtODll"'''llI'llollh,slotfftmuslll<l<:ompleud.
~.J':th8 ylour knovtll!Og6 tMtlM 0l;\0mI!1er f&fK\lng IS
~,_ _' -TX rMesandrellect$theaCl\Jalmlteageolth9vetliCle.
unlllS!oneollhelotlo....iflqOO>'.es\&~ke&
RefMclllh.ilmounlc./~ 0 IINOTIhe~~ .
;n.-..oIiU1~~11IlIt$ WAANING;~~
!.We Mercertilyltlln1he'lehid8ll1freeolart'f~IIDBIIla1~.henIbJ
"-' ro ItIe pw.on('l or an. ...... Jisled.
'"
~
~
'"
'"
,-
~
~
~
~
t!
~
~
i!
iii
en
iii
;::
~
-<
1lI
~
~
~
'"
Gi
"
~
-<
"
i!
'"
"tI
::n
rn
'"
Ii
'"
o
."
,.
"
o
."
Jl
()
'"
::n
'"
~
1;\
::n
gj
C
,.
'"
~
~
::n
~
i!
'"
fl'UFlCtl.>.SEP,OP.fl.; \.
IlU5INE SNAME
CO'PU~l1ASER
""m
ADOi'll:
~
'""
...J
ili
.,
~
. .. .
,k)lI'lebllCotmyioul'k1lowledll8tna1tn.odom8Illf"l9l!Il;iinglS .
X milHandreflKtlllhtladUal~OIItlll~
urtIIUGnlloftNloIIoWlngblJXel.ilchecked: ;
O Rel**'ItIeamountd-llliIlMge 0 ItlNOTIhoIIICIU8lm-. ~
irI_oIb~"" WARNING;OdI:IInItIIr~
l/Wa~oeltilyltlato.whidIoislrMoIVIY~_!hI.lownetS/IiDilllINtby
~IOIhoIPMOR(.'CM''''''''''~,
""""""''''-
IlU8lNESSNAME
""""""....
...""
AODAESS
'""
SUBSCRIBED AND SWORN
TO BEFORE ME;
"'"
YEAR
"'"
'"
-""'"
OR.'
..,,,,,,..,,
"'" ..
~
"""
...J
ili
.,
( ~~
DO NOT NOTARIZEJNLESS S1GNE9
IN PRESENCE OF A NOTARY AND I
P~~~g~~~{~~~~~iA~~~E~ t'
_rutealHl.l.b
~SI!I'In:Fl
,
. . .. .
,1o_tlelCoI':.lu1QiIMeOgelNtlhe~,..gjng. i
--==- - X miles anIIl8IKts lh8 8dUalmIeege oI"~,
un/8IIoneof"'~bOIleI.c:twckecl:
O RllIec:tslt,.oall'llMlnlolmilMgll 0 rsNOTtlwaetualn'll_.
in___oI'b~1invl$ W~~~
vw.lul'lherc.ltlfylhllllhllwllicleiS""QlWIY~analhal--~"hetWOy
~lOthf~IOfltw....,liMC.
P\J1IaIAUROFlFUU
8USl~SS"""'1!
~"'SER
~~s
e""
SUBSCRIBED AND SWORN
TO BEFORE ME:
""
"'"
'EA"
sun
..
Pt-"CI-lA$EPAICE
~OIN
.... "'~
~'"
PlJIIICIlASEAS/GNA,YUI.lt
~
W
.,
.
,
DO NOT NOTARIZE '~NLESS SIONE:l
,
IN PRESENCE OF A NOTARY AND;
PURCHASEP'S NAME IS LISTED ,
AND SELLER IS A DEALER .~
\ i
~~HEAE
WI'I.IIICHASUlSlllNATUM:
Sf ANOIOA
CO-PtJRCtiASEI'lIMJST
~ HEAE
...."""'"
\1 plJn;h<lser 1'1 NO! a rcql~lcred dealer Section 0 Orllhe hont of tillS torm must
Pf'com leWd
.=-:-_~~--:!~?X miIeIandre"'lheadualmllNgeofttMi~, I't/ACf'ASER01'FUU.
unIeu orw of IhtlIOllclwmg bo1ra. ctledl.ed: 8UStt4UfW"t,E
0 AeIIIda...._ot.......... 0 r. NOT 1/18 ac:lUaI rrweq CO-PURIOIASER
lr\_gl_~liorNt W"'ANING;OI:Iorne*~ ""'''
l/Welul'ltw~ItIal""...noc.......o/any.~_tN.l.~i$1""*f 1oQOIlESS
~lll_~C.IOl"'dQllW_ ''''
SUBSCRIBED AND SWORN -"""
TO BEFORE ME: STATE .. OROlM
"", "'" YEA"
~ _"TIJIlI'Ol' Pl!A!IONAO"""I8TEAlNO o..T>I ~Sf.A'i5lGMIo"_>M
,
,..,... ~;C- >iC'~ - - '. '. . . ,-:.) ~\i"5E1'lSKVUo''''E
- '- - ~ -.... - PURCHASER AND/OR
...J " J~'=~-':: ,~ , r\'" - .. CO.PURCHASER MUST
~ <( HANOPRINTNAME H <RIO
, W '~I ,.'"',....' ~ .:J ,- lS. -,... " ~
Ul -
> - .. -- -
.. '. '1G},,,r'mEr;F -<f"l,~;<
SELLe'" !lUS't
HANDP""NTNAME HERE
C. 0 CHECK HERE IF APPLICATION FOR OEALER TITLE ANO COMPLETE SECTION D. mLING FEES S I
I
. :. ... ..
8Q1rtity,lOlhebeslot'"'f/OlJtIll'1OWlfOQett\atU\eotiol'l\eWf\'UlWlljJlS
'''V. I j U;:) 4 j ~
It
PA TfTLE NUMBER (AS SHOWN ON ATTACHED TTTLE)
-, -
~ c.
i
.
;
~
A-
o
~=
~<-
~~
i
.
.
.
.
B-
<<
j
=
.
.
.
.
D.
~
~ <<
~ i
, ~
~ ~
E.
~O
~i
F.
CX>f'URCHASeR
STREET
"~:,~.
CITY
ZP COllE
.
.
.
.
.. '"
.
Send"""
..-.. .
--
.
.
51lOE
.
MAKE OF VEHIClE
vetClE IDENI1FIC.<I1ON NUI.1IlER
7. no.. Fee
.
MOOEL YEAR
CONIlIT1ON
_. ._4
"""
o FAIA
GOOD
o 1RANSFER OF PRE1IIOUSLY ISSUED PUlIE
o 1RANSFER. ~OF PUlIE
o TllANSfER................ OF PUlIE
o "TRANSFER OF PlATE & REPLACEMENT OF ST1CKER
POOR
.
0R1GIIW. PUlIE ./ ..- """
o Pl.J<!E 10 BE ISSUED BY
BUREAU (PROOF OF IN-
SURANCE MUST BE AT-
l>CHEl>1
DE"""""'" PUlIE 10 BE
ISSUED BY BUREAU
o TEMPORARY PlATE
ISSUED BY FUlL AGENT
101>l. """
(1dd 11hnJ8)
.
~Z
~i
i~
POUCY EXPlR.<nON
DATE
0......
nust Fcrm MV-44.
REI.o<JTONSHp 10 APPUCANT
mAP.'1UIE IlO.
VEHICLE PURCHASED
WEIGHT INFO.
F APl'lJCABLE
NSUAANCE COMPNN' NAME
G.
I CERTIFY THAT ON MONTH DAY_YEAR _ ISSUING AGENT (PRWT NAME)
I HNE CHECKED to DETERMINE THAT THE VEHICLE IS INSlJAED AND
lSSUED TEMPORARY REGISTAAllON 10 nE ABOVE APPlJCANT. IN ISSUING AGENT SIGNATURE
COMPl.JANCE WI1H AU. APPUCABl...E PRCMSIONS OF THE VEHICLE CODE
AND OEAUmotENT REGlJLtJ1QNS. ( )
I/WE CERTlFY lliAT IIWE HoWE EXAMINED N<<J SIGNED THIS FORM AFTER ns COMPlETION AND THAT 1liE 1NF0AMAn0N GIVEN IS mue AND CORRECT. IF AN EXEMPTlON
IS ClAIMED. THE PUK:HASER FURTHER CERTFE5 THAT HE/SHE IS AUTHORIZED 10 ClAIM lHIS EXEMPTlON.11WE ACI<NO'M..EDGE TI-fAT I/WE MAY lOSE MY/OUR 0PERAT1NG
PRIVl..fGEfS) OR VEHICLE REGl5TRATlONfSI FOR FAILURE 10 MAINTAIN FJNNrICIAL. RESPONSIBUTY ON "l'HE CURREtm..Y REGlS'rEAED VEHIClE FOR TtE PEFIIOD OF
REGlSmAllOM. I/WE ACKNC1M..E.OGE lHAT I/WE MAY BE SUBJECT 10 A FINE NOT EXCEEOlNG $5,000 AND IMPRISONMENT OF NOT MORE 'THAN TYtO YEARS FOR ANY
FAlSE STATEMENT THAT I/WE MAKE ON THS FORM..
FIf3I or Signer
ISSUI<G
""EN<
INFOO.
MAllON
AGENT NO.
TEI.EPHClrE NO,
I
~
u
TELEPHONE NUMBER
17.." '760- r.:: rs
.Sf
ASSIGN-
....NT
Signature of Second PurchalIer or Authorized Signer
TELEPHONE NUMBER
( I
Signatureol5ellBr
2ND
ASSIGN-
....NT
SiQnlltln of Co-PurchasiIlr/rllle of Authonzed Signer
Sionattn 01 Co-SelIBr
H_ z
;i 9
Zo:!
~gv:
o 0
o .
. .
NOTE: If a co~purchaser other than your spouse is listed and you want the title to be listed as MJoint Tenants Wit!
Right of SurvivorshipM (On death of one owner, title goes to surviving owner.) CHECK HERE O. Otherwise, the tith
will be issued as -Tenants in CommonM (On death of one owner, interest of deceased owner goes to his/her heirs 0
estate).
NOTE: IF THE VEHIClE IS TO BE USED AS A DAllY RENTAL OR LEASED VEHICLE. CHECK nus BlOCK 0 . IF 8I..OCK IS CHECKED, COMPlETE AND ArrACH FORM MV-IL.
MESSENGER NUMBER:
?1 .,,"=... ~-: '1~7.""':: 0:::
Table View
public tax file 12-20-0l.fp5
S-rch
Matches 1 of 8a011
District_Number
ParceUdentifier
Map_Suffix_Number
1. 40
40-09-0531-0090
TR06082
http://205.247.227.57:59IfFMResfFMPro
House_Number
62
Ho~ I H_ID
Street
SPRING GARDEN
ESTATE
.......0"'........... ...
OWner_HI
BOLLENr
BRENDA
1/212002
NEW KINGSTOWN AUTO SALES INC.
P.O. BOX 413-73 EAST MAIN STREET
NEWKINGSTOWN PA 17072
PHONE (717) 766-1000
BILL OF SALE
VEHICLE INFORMATION:
YEAR: 9:2 MAKE: ~cJ MODEL: Gplo~
VIN# l~fVI OC\3l/)(~NU.A7~S9 /
BODY TYPE: ~ COLOR: LJLu& MILES: /gg,.)U
, ere Mlo.. 8c I /<f'f1~f (lRANSFEROR'S NAME)'STA TE mAT
IRE ODOMETER NOW READS ~~=5 (NO TENTHS) MILES AND TO THE
3EST OF MY KNOWLEDGE THAT IT REFLECTS THE ACTUAL MILEAGE OF THE
VEHICLE DESCRIBED ABOVE, UNLESS ONE OF THE FOLLOWING STATEMENTS IS
:::HECKED.
DATE: 310101 Of
:] 1. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE THE
ODOMETER READING REFLECTS THE AMOUNT OF MILEAGE IN EXCESS
OF ITS MECHANICAL LIMITS.
. J 2. I HEREBY CERTIFY THAT THE ODOMETER READIN'G IS NOT THE ACTUAL
MILEAGE.
"Br f.. rd-A. ~ l k du R-f SOLD THE ABOVE STA~J'E~LE.
ro NEW KIN'GSTOWN AUTO SALES INC. FOR THE AMOUNT OF $ 60 V ' .
NO LO~R HAVE ANY INTEREST IN THE ABOVE STATED VEHICLE.
(8 ~~~.;tJ:~ DATE: g> Id-O 1 ()/
)EALER DIN # bL =t:f d- '-J 34-& 7 d-~
. (SELLER ONLY)
IF ANY.
-THE LAw OFFICES OF
KATHLEEN K. SHAUUS, ESQ.
44 SOUTH HANOVER STREET
CARUSLE, PA 17013
PHONE: (717) 243-6655 FAX: (717) 243-6618
EMAIL: JRS037CARLISLE@SPRINTMAIL.COM
February 5, 2002
PA Department of Revenue
Inheritance Tax Division
5th Floor Strawberry Squire
Harrisburg, PA 17128
Re: Estate of William P. Hershey
File No. 21-01-0531
Dear sir or madam:
The lack of personal assets in William P. Hershey's estate is explained by the fact that the
decedent's relatives seized his assets before my client, Brenda Bollendort: the estate's executor
and the decedent's former girlfriend and sole heir, could secure the assets. The relatives were
not aware that the decedent had executed a will in favor of my client two years before his death,
leaving her everything. When she tried to take possession of the trailer, the automobile and other
items, the decedent's relatives called the police. She then was appointed executor of the estate
and engaged my services to marshal the estate's assets. I drafted the attached Petition to the
Orphans' Court in Cumberland County but did not have to file it when the decedent's relatives
agreed to turn over the property provided my client agree to pay the funeral expenses and $200
to a relative for the grave. The relatives' compliance with the agreement has not exactly been a
good faith effort. See attached correspondence. The executor has decided that further efforts to
secure any other assets would be a waste of time and money.
If you have any questions, please contact me.
Sincerely, ~
~~iS
IN RE THE ESTATE OF
WILLIAM P. HERSHEY
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
:
ORPHAN'S COURT DIVISION
NO. 2001-00531
21-01-0531
000 5/28/2001 SS# 210-44-6962
PRAECIPE
FOR ENTRY OF APPEARANCE
To the Register of Wills
Kindly enter my appearance as the attorney for the duly
appointed Executor Brenda A. Bollendorf of the Estate of William
P.. Hershey.
Kathleen K. Shaulis, Esq.
Attorney for the Executrix
44 South Hanover Street
Carlisle, PA 17013
(717) 243-6655
I.D. No. 37445
Dated: June 6, 2001
I have engaged Kathleen K. Shaulis, Esq., 44 South
Hanover Street, Carlisle, PA 17013, to act as the
attorney for me as the Executor of the Estate of
William P. Hershey.
June 6, 200.1
Brenda A. Bollendorf
Executor
DRAFT
:tN RE THE ESTATE OF
WJ:LLUIM P. HERSHEY
:tN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVAN:tA
ORPHAN'S COURT D:tV:tSION
NO. 2001-00531
21-01-0531
DOD 5/28/2001 SS# 210-44-6962
EMERGENCY PET:tT:tON FOR ORDER TO GAIN ACCESS TO AND
POSSESSION OF DECEDENT'S MOBILE HOME, MOTOR VEHICLE AND
OTHER PERSONAL PROPERTY FOR PURPOSES OF EFFICIENT
ESTATE ADMINISTRAT:tON
AND NOW, comes the Petitioner, Brenda A.
Bollendorf, Executor of the Estate of William P.
Hershey, by her attorney, Kathleen K. Shaulis, Esq. and
respectfully represents as follows:
1. Petitioner, Brenda A. Bollendorf, is an adult
individual who resides at 32 W. High Street,
Apartment 301, Carlisle, PA 17013.
2. Decedent William P. Hershey died on May 28, 2001,
leaving a Last Will and Testament dated April 17,
1998 naming the Petitioner as Executor of his
estate. A copy of the Will is attached hereto and
incorporated herein as Exhibit "AN.
3. Petitioner was duly appointed Executor of the
Decedent's estate on June 5, 2001. A copy of the
1
appointment is attached hereto and incorporated
herein as Exhibit "B".
4. Since his death, relatives of the Decedent
including Mary J. Hurrell of 20 Spring Garden
Estates, Carlisle, Pennsylvania, illegally have
denied Petitioner access to the Decedent's mobile
home, his motor vehicle, his personal property and
his personal papers.
5. Since his death, Decedent's relatives including
Mary J. Hurrell illegally have removed Decedent's
motor vehicle as well as personal property and
personal papers from Decedent's mobile home,
frustrating any efforts of the Petitioner to
perform her fiduciary duties.
6. Petitioner has no knowledge of the present
location of the Decedent's motor vehicle or his
personal property and personal papers.
7. Title to Decedent's property passed to the
Petitioner pursuant to 20 P.S. ~ 301 on the date
of his death.
8. Petitioner has not been able to obtain names and
addresses of any other relative of the Decedent
who may have removed or who have knowledge of the
removal of the personal property and personal
2
papers of the Decedent from the Decedent's mobile
home.
9. Petitioner does have general knowledge of the
names of the Decedent's other relatives besides
Mary J. Hurrell because of Decedent's Obituary,
but does not have exact addresses for them. A
copy of the Wednesday, May 30, 2001 Sentinel
Obituary is attached hereto and incorporated
herein as Exhibit RCN.
10. Mary J. Hurrell's address was obtained by the
Petitioner from the Decedent's Death Certificate.
11. Petitioner has contacted the Pennsylvania State
Police and local Constables to help her obtain
access to Decedent's property but they would not
help because she did not have an Order from the
Court.
12. Petitioner cannot fulfill her fiduciary duties to
Decedent's creditors or beneficiary without having
access to and/or possession of Decedent's
property.
WHEREFORE, Petitioner prays this Honorable Court
use its legal and equitable powers to issue an Order
requiring that Mary J. Hurrell and other relatives of
the Decedent return the personal property including
motor vehicle and papers of the Decedent to the mobile
3
home and turn over all keys to Decedent's motor vehicle
and mobile home to the Petitioner immediately.
Respectfully submitted,
Kathleen K. Shaulis, Esq.
Attorney for Plaintiff
44 South Hanover Street
Carlisle, PA 17013
(717) 243-6655
LD. No. 37445
Dated: June
2001
4
LAW OFFICES
IRWIN McKNIGHT & HUGHES
ROGERS. IRWIN
MARCUS A. McKNIGHT. 1II
JAMES D. HUGHES
REBECCA R. HUGHES
MARK D. SCHWARTZ
DOUGLAS G. MILLER
WEST POMFRET PROFESSIONAL BUILDING
60 WEST POMFRET STREET
CARLISLE, PENNSYLVANIA 17013-3222
(717) 249-2353
FAX (717) 249-6354
E-MAIL: IMHLAW@5UPERNET.COM
HAROLDS.1RWIN (1925-1977)
HAROLD S. IRWIN, JR, (1954-/986)
IRWIN, IRWIN & IRWIN (/956-J91?6)
IRWIN, IRWIN & McKNIGHT (/986-/994)
lR WIN. McKNlGHT & HUCHES f 1994. )
June 19,2001
Via Facsimile and Rel!\llar Mail
Kathleen K. Shaulis, Esquire
44 South Hanover Street
Carlisle, PA 17013
Re: Estate of William P. Hershev
Dear Ms, Shaulis:
I have enclosed a revision of the Agreement you prepared. All the items will be given to
you including the correspondence and furniture, provided your executor agrees to pay for the
funeral, the grave marker and its engraving, and pay for the costs of the grave.
Please call me if you have any questions.
Very truly yours,
IRWIN, McKNIGHT & HUGHES
1~:ictt
MAM/mln
Enc!.
cc: Ms. Mary Hurrell
Ms. Patricia McCommons
Ms. Karen Potter
Ms. Nora Shearer
Mr. Edwin E. Hershey, Sr.
44 SOUTH HANOVER STREET
CARUSLE, PA 17013
PHONE: (717) 2436655 ' FAX: (71'1) 2436618
EMAIL: JRS037CARLISLE@SPRINTMAlL.COM
~THLe;e;N 1\.. :)HAULIS, t:.SQ.
June 19, 2001
Marcus A McKnight ill, Esq,
Irwin, McKnight and Hughes
60 West Pomfret Street
Carlisle, PA 17013
Re: Estate of William p, Hershey
Dear ML McKnight:
Enclosed are two executed original copies of the agreement revised as per your request,
The only change that I made to this agreement was in paragraph 3: the Executor's address to
send any additional correspondence regarding the estate was changed, Because of the strained
nature of the situation between our clients, I suggest that your clients deliver the keys and other
items to you and that I pick them up at your office on behalf of my client, I can also pick up an
executed copy of the agreement at tbat time, Thank you for your cooperation in this matter,
Sincerely, , , ' \
'- tral:l~L.,~~It'--f.J-~
Kkhleen K Sbaulis
Enclosures
cc: Brenda A, Bollendorf
',_ --==~-;:---o;,;;."~:;".-=>=>~~~""'I!li"~~it.-=:;;:.,--=,-.,,-~~--""= j
r;~~ern · - -:6_25~~;:3~n_~.,
;jz,..<'"V":~2; ~
~
PAY EXAcn. Y
",,t(' ," .?J. 7
PAYTOTHE ;'''d.w 'f 1:::-. .H;,,-r.cJrV,ir 5i:..,,__~_____.._~~~!_~1' .~~$~z.c..::~f:{l
ORDEROi_.=. ___l_~ I" , , ' ,,~ _ _ _~ l>l~~~~~.,:~~'~"~.if2~.T:":I:\~ j
Z 't 7 5f'M;t(#lJIL:::;..-;. /}A d11J!.i01~"-J..~ -.' ffrt/r;'"-' - '.
. .~-~ ..Jt.~--=-!::. "h."~'r~i..r7(
, . .
lk.~~h.-~~~'~~"" "'_; "'-->b._..JO::"'~~_~~'~ -~:."~:-~~~~L~7F~'1x'-"Y-~
,:.02.ool,001: l,oob 25 5B 5!, 5 j? .11"
LAW OFFICES
IRWIN McKNIGID' & HUGHES
ROGER B. IRWIN
MARCUS A. McKNIGHT. III
JAMES D. HUGHES
REBECCA R. HUGHES
MARK D. SCHWAR7Z
DOUGLAS G. MILLER
WEST POMFAET PROFESSIONAL BUILDING
60 WEST POMFRET STREET
CARLISLE, PENNSYLVANIA 17013-3222
(717) 249-2352
FAX (717) 249-6354
E-MAIL: IMHLAW@SUPEANET.COM
HAROLDS./RWIN (1925-1977)
HAROLD S, IRWIN. JR. (1954~J986)
IRWIN, IRWIN &: fRWIN (/956-1986)
IRWIN. IRWIN &: McKNIGHT (1986-1994)
IRWIN, McKNIGHT &: HUGHES (1994~ )
June 25,2001
Kathleen K. Shaulis, Esquire
44 South Hanover Street
Carlisle, PA 17013
Re: Estate of William P. Hershey
Dear Kathleen:
I have enclosed the Agreement signed by Mary Hurrell regarding the estate of William P.
Hershey. In addition to the Agreement, I have enclosed bills, a death certificate, title to the car
and mobile home, and his last payroll check in the amount of Nine Hundred Thirteen and 18/100
($913./8) Dollars.
Please contact me if you have any questions.
IRWIN,
MAM/mln
Enc!.
cc: Ms. Mary P. Hurrell
Ms. Patricia McCommons
Ms. Karen Potter
Mr. Edwin E. Hershey, Sr.
Ms. Nora Shearer
i!
Ii
H
~~
~(e!t\cQQ
8olJenJorF
60-,.....
~
.
SIGN IiER! FOR CASH RECEIVED ~IF REQUIRED) *
r
~
~
(OflTOT~FlDMOTlE!lSlll!l
SUB TOTAL II>
'73053-
," -','..
DATE
DEPOSITS MAY NOT BE AVAILABLE FOR IMMEDIATE WITHDRAWAL
.
.,
'0
~;
~8
U
n
5:!;
.
Commerce
~Bank / 1Ianisbu<g, NA
WI' ..60 CARLISLE PIKE
MIECHANICSlSURCil, PA 17Gao-:soae
* LFfeSd"ervAeSJf ....
$
7.,3'o.?3
-t: 50 2 10"'0 loB 1,1:
",,:,'
510 :i2bl,b5
511'
~.~
-;:*{ii~
_' '''::' ';f':',,;;;~~fr:. .. .. , ,:oa-':ml'8!i:o:;;,}5i::;;;;:)\:<~.
. ,:~;, ::, ,~~[~~~~}~> :~Jt~~.:i}~~~::;;~:;j~i';i~~;~_~*~\;i
ICSllIJ!IG, PA 17055 ",. .", . '. . "',:. '....,- .'.' ,t1> '0 . .,.. , , ~w . .,~
~:,\t,','i~>,1"'l~~':'.~'c~"" ',' ". '_',.:."'. .",.-}.:t',::~ ,,~j~~?,-~~,,""','::'~.r:/~:,~';;:~~~{:i;~,;,~',--,^~';;,,:fftFf~,,',: .'_:"::"~:-Kt~\;~~4;i#~,.~:-~~"'c'" ,":-C,f,:/:~,';~'
" ~,k:f~
WILiiMfZB~w,;KSH~i****'***~***"'****,*~ :$i130-~**' - - 't"
~f;~i\,~i,~;:,":~,:". "~. ~l';. ,:", ".~~,. _;:';'.';~<~;"'1:~2:t;t~ ;;{C4
',kf='i'~'; " ,,' ~'...~Ci['~3-' '~,..,' "~'t"~ ijl ,g~,~"~".-'"!,~"",,~::,,,,,,'F':""'''' 'I "00":"
~",,- ""'OlifiJI:!fl5~~
~~~~:(~
.'~L Jr
~'!:"F",
'::""',
"..,......,..:..r\.
Cole .'Ii' 01?08313i
....,;..\
~,;"",
,:.,t-"l,,',~' "(.
e,"..' .. _,",'
II'O.;J,ci ~B?BII'
l:oh3o loB I, 1;1:
51.
'iaaaa :i
811'
.,......
Yo",;'
~
"~~ '
,-,'"
.
.,
THE LAw OFFICES OF
KATHLEEN K. SHAULIS, ESQ.
44 SOUTH HANOVER S'rREET
CARUSLE, PA 17013
PHONE: (717) 243-6655 FAX: (717) 243-6618
EMAIL: JRs037cARLISLE@SPRINTMAlL.COM
July 6,2001
Marcus A. McKnight ill, Esq.
Irwin, McKnight and Hughes
60 West Pomfret Street
Carlisle, PA 17013
Re: Estate of William P. Hershey
Dear Mr. McKnight:
It seems that the relatives of William P. Hershey have not lived up to their part of the
agreement to return all ofMr. Hershey's personal property and papers to his mobile home.
Ms. Bollendorfwas aware that Mr. Hershey had a "yard sale" business on the side for
which he received shipments of knickknacks via UPS. She has knowledge that at least one
delivery was made to Mr. Hershey's mobile home since his death, but that delivery was rerouted
to Lot 20 as per instructions placed on the mobile home's door. Ms. Bollendorfhas left the sign
that directs the UPS to make all deliveries to Lot 20 in my custody. Ms. Bollendorf demands the
immediate return of all items that were delivered to Lot #20 on Mr. Hershey's behalf and any
other "business assets" of Mr. Hershey.
Furthermore, the key to the locking gas cap that was installed on his motor vehicle has
not been turned over to Ms. Bollendorf and an old black and white television set has been
substituted for a console color set that Ms. Bollendorf has personal knowledge that was there
when she left Mr. Hershey in the spring of 1999. For some reason, Ms. Bollendorffound a
photograph of this console on the floor where this television had sat. She demands immediate
return of these items.
A large wooden closet that Ms. Bollendorfhad purchased for $200 from Mr. Hershey's
sister Nora Shearer was missing from one of the bedrooms of the mobile home as was a
lawnmower that belonged to Ms. Bollendorf. This should be returned immediately.
Only a few sweaters of Mr. Hershey's were returned. No coats, jackets, shoes, jeans,
trousers, jewelry etc. were returned. As for household items, Ms. Bollendorf mentioned that the
vacuum cleaner was gone. Also, appliances such as a toaster, or can opener, pots and pans,
towel, washcloths and blankets are missing from the premises. Again, everything is required
under the agreement to be returned.
Marcus A. McKnight IlL Esq.
Irwin, McKnight and Hughes
Page Two
July 6,2001
Also, no bank records evidencing the payment of his bills or his personal checks have
been returned. Copies of his tax returns that will demonstrate the reason for the federal and local
tax deficiencies have not been returned. Ms. Bollendorf demands that these items be turned over
immediately.
I realize that only one of the relatives signed the agreement before it was sent to me with
some of his personal papers and the keys, but in your letter of June 19, 2001, you copied all of
Mr. Hershey's siblings, not just MJuy Hurrell. Furthermore, you asked that a special provision
be written into the agreement whereby Edwin E. Hershey, Sr. would be paid $200 for the grave,
yet he did not sign this agreement. Thus, it is fair to say that you were representing all of the
siblings and they all should be held accountable for returning Mr. Hershey's property. Ms.
Bollendorfhas acted in good faith, contacting the funeral home to pay for the funeral and the
taxing authorities to pay Mr. Hershey's outstanding debts. She needs all of Mr. Hershey's assets
to raise the funds to meet the obligations ofthe estate. Please advise as soon as possible.
Sincerely,
, /,/ '/ ,'---ft:"-.
\{;~'::Fr....c~r_~,- /\ > ~':'-f''-.; '- ......~,.,..
\
Katilleen K. Shaulis
cc: Brenda A. Bollendorf
LAW OFFICES
IRWIN McKNIGHT & HUGHES
ROGER B. IRWIN
MARCUS A. McKNIGHT, /I[
JAMES D. HUGHES
REBECCA R. HUGHES
MARK D. SCHWARTZ
DOUGLAS G. MILLER
WEST POMFRET PROFESSIONAL BUIWING
60 WEST POMFRET STREET
CARLISLE, PENNSYLVANIA 17013.3222
(777) 249-2353
FAX (717) 249.6354
(i.MAIL: IMHLAW@SUPERNETCOM
HAROLD S./RWIN (1915./977)
HAROLDS. IRWIN, JR. (/954-/986)
IRWIN, IRWJN & IRWIN (1956-/986)
IRWIN, IRWIN & McKNIGHT (1986-1994)
IRWIN. McKNIGHT & HUGHES (1994- )
July 12,2001
KATHLEEN K. SHAULIS, ESQUIRE
44 SOUTH HANOVER STREET
CARLISLE, PA 17013
RE: ESTATE OF WILLIAM P. HERSHEY
Dear Ms. Shaulis:
Enclosed is a copy of the Agreement signed by Brenda A, Bollendorf, Mary J. Hurrell
and Edwin E. Hershey, Sr. 1fyou have any questions, do not hesitate to contact me.
MAM:sls
Enclosure
-.
IN RE THE ESTATE OF
WILLIAM P. HERSHEY
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHAN'S COURT DIVISION
NO. 2001-00531
21-01-0531
DOD 5/28/2001 SS# 210-44-6962
AGREEMENT
WHEREAS Decedent William P. Hershey died on May 28,
2001, leaving a Last will and Testament dated
April 17, 1998 naming the Brenda A. Bollendorf --
Executor of his estate; and
WHEREAS Brenda A. Bollendorf was duly appointed
Executor of the Decedent's es~ate on June 5, 20'1;
and
WHEREAS undersigned relatives of the Decedent made
arrangements for the Decedent's funeral, the
expenses for which they we~e responsible to pay
less any funeral/burial benefits to which the
Decedent may have been enti~led; and
WHEREAS undersigned relatives of the Decedent have ceen
in control and/or possession of Decedent's mobile
home, his motor vehicle, his personal property ano
his personal papers since his death; and
WHEREAS Brenda A. Bollendorf cannot fulfill her
fiduciary duties as Executor of William 2.
Hershey's Estate to Deceden~'s creditors or
beneficiary without having access to and/or
possession of Decedent's property and papers:
THEREFORE, it is hereby agreed ~hat
1. The Estate of William P. Hershey will pay the funeral
expenses incurred by the Decedent's ~elatives less any
funeral/burial benefits to which the Decedent was entitled
upon presentation of a copy of the bill prepared bv Ewinc
Brothers Funeral Home. The Estate of William P. He~shev ~~l:
~ay for che ~Qst of his grave mar}:e~ ~s well as its ~
E1scripcion. I t also agrees to rei:nDurse Edwin E. Hersr,e';,
Sr. the sum of Two Hundred and no/IOO ($200.00) Dollars, -
being t~e cost of the grave.
2. Decedent's undersigned relatives will return all personal
property including but not limited to all furniture,
appliances, clothing, tools, sporting equipment and any
motor vehicle owned by the Decedent and all personal papers
of the Decedent including but not limited to titles to the
Decedent's mobile home and motor vehicle, insurance
policies, bank accounts and credit cards, to the Decedent's
mobile home and that all keys to said mobile home and any
motor vehicle owned by the Decedent on the date of his death
be turned over to the Executor immediately.
3. Decedent's undersigned relatives have a continuing
obligation to forward any correspondence that they receive
in regards to the Decedent's estate immediately upon receipt
to the Executor of the Decedent's estate at 247 S. Spring
Garden Street, Carlisle, PA 17013.
~ -.7;J-cJ (
Date
&./A~ ~ ~n/
Brenda A. Bollendorf ~v~X-
Executor
Estate of William P. Hershey
(!}~JP f:~rf-O
i~-/t?-c)1
Date
7//2/ 0 I
Dare'
~ ~ 1~~ 71/4
Date
2
LAW OFFICES
IRWIN McKNIGHT & HUGHES
ROGER B. IRWllV
MARCUS A. McKNIGHT. III
JAMES D. HUGHES
REBECCA R. HUGHES
.\fARK D. SCHWARTZ
DOUGLAS G. MILLER
WEST POMFRET PROFESSIONAL BUILDING
60 WEST POMFRET STREET
CARLISLE, PENNSYLVANIA 17013-3222
(717) 249-2353
FAX (717) 249-6354
c.MAIL IMHLAW@SUPcRNcT.COM
HAROLDS. IRWIN (1925-/977)
HAROLD S. IRWIN, JR. (/954-1986)
IRWIN, IRWIN &-IRWIN (/956-1986}
fRWfN. IRWIN & McKNIGHT (1986-1994)
IRWIN. McKNfGHT&HUGHES (/994- )
July 12, 2001
KATHLEEN K. SHAULIS, ESQUIRE
44 SOUTH HANOVER STREET
CARLISLE, PA 17013
RE: ESTATE OF WILLIAM P. HERSHEY
Dear Ms. Shaulis:
I met with my client, Mary Hurrell and reviewed your letter dated July 6, 2001. The
following is her response:
1. The Yard Sale Business: No deliveries were made to my client, Mary Hurrell by
UPS. Roger Hurrell did order some items including a ring which he paid for through the late
William P. Hershey. That ring and other items have not yet been delivered. When these are
delivered to your client, they need to be turned over to Roger HurrelL
2. Kev to Lockinl! Gas Cap: My client does not have that key and she does not know
its whereabouts. She never saw it.
3. The Color Console TV: This TV was owned by my client, but it was returned along
with the black and white TV to the Trailer. The current girlfriend ofMr. Hershey was still living
in the trailer. My client does not have the color TV and your client is invited to examine her
trailer and belongings if she wants to do so.
4. The Larl!e Wooden Closet: Your client last lived with William in 1998. I was able
to speak with the girlfriend of William who lived with him in the spring of 1999. The wooden
closet was placed on the porch in 1999 for your client to pick U!l. She failed to do so and it was
picked up by South Middleton Township in the spring of 1999 clean up. I have enclosed her
statement. My client does not have the wooden closet nor does she know of its whereabouts.
Kathleen K. Shaulis, Esquire
Page 2 of 2
July 12,2001
Re: Estate of William P. Hershey
5. Personal Items: My client returned everything of which she took temporary
possession. The present girlfriend, Donita Duerr, did leave and take some items including his
Last Will and Testament. My client does not know her current location. The only jewelry was a
watch which the family forced Donita to turn over to the funeral home. The watch was buried
with William.
6. Bank Records: My client never found or took any bank records or personal checks.
There were some unused checks which the bank shredded for security reasons.
To the best of our knowledge none of the items you mentioned are in the possession of
any member of Mr. Hershey's family. They have kept their agreement and they expect your
client to also honor it.
Very truly yours,
lllW:1::00&1HU07S ~ &.,:or.
;;~st: McKnight, 1I1 ~
MAM:sls
Enclosures
cc: Ms. Mary J. Hurrell
THE LAw OFFICES OF
KATHLEEN K. SHAUUS, EsQ.
44 SOUTH HANOVER S"rREET
CARUSLE, PA 17013
PHONE: (717) 2A3-66SS FAX: (717) 243-6618
EMAIL: JRS037cARUSLE@SPRINTMAlL.COM
July 18,2001
Marcus A. McKnight HI, Esq.
Irwin, McKnight and Hughes
60 West Pomfret Street
Carlisle, PA 17013
Re: Estate of William P. Hershey
Dear Mr. McKnight:
This responds to your letter of July 12, 2001 concerning your clients Mary Hurrell and
Edwin E. Hershey, Sr.'s knowledge of the whereabouts of William P. Hershey's assets. Quite
frankly, it is unbelievable that the relatives do not have knowledge of what happened to his
clothes and his household goods. Mr. Hershey died suddenly and did not have time to dispose of
these items prior to his death.
Furthermore, as a close neighbor and sister of the decedent, it is really unbelievable that
Ms. Hurrell does not know the identity of the persons wbo were hauling things out of Mr.
Hershey's mobile home with a pick-up truck. I would guess that she would have telephoned the
police if someone that she did not know was removing items from the mobile home. Moreover,
since she had possession of the key to the mobile home, the chances that someone else gained
access to it without her knowledge are quite slim. Despite what you say, it seems that the
relatives of William P. Hershey have not lived up to their part of the agreement to return all of
Mr. Hershey's personal property and papers to his mobile home.
Again, a copy of your letter ofJune 19, 2001 was sent to all of Mr. Hershey's siblings,
not just Mary Hurrell. Edwin E. Hershey, Sr. did not sign the agreement until my July 6, 200 I
letter pointed out that he was to receive money under the agreement but had not signed it. Yon
led us to believe that you were representing all ofthe siblings in obtaining tbis agreement from
my client. I drafted the agreement based on this representation that you were representing all of
the relatives to cover all of Mr. Hershey's relatives that had possession or control of Mr.
Hershey's assets, not just those who selectively chose to sign this agreement. All of the relatives
should be held accountable for returning Mr. Hershey's property. Brenda Bollendorfhas acted
in good faith as the Executor of William P. Hershey's estate and, to further demonstrate this,
enclosed please find Western Union money order #06-255854537 for $200.00 to pay Mr.
Hershey's cost ofthe gravesite used for his brother. Ms. Bollendorfneeds all of Mr. Hershey's
assets to raise the funds to meet the obligations of the estate. Please advise as soon as possible.
Enclosure
cc: Brenda A. Bollendorf
~.~iere}~,. It& LJ
atf"...uJl.; r...U
thleen K. Sliau is
- '-0......... .c'u ~.. e '""
en u~ u..s ",0 .5 =0=
CD~:g ~~ "9"e .s ~:c.8
E'~~ ~,~ ~~ ,,8 \:0-' .,:.~=-=--;,-:.:_~.>._~= :... .........:t...ibi,) >..C"';I.....~C1n...<<,)..c'
ftI ';,.;; C;; is 0 >. Q) '_0 -d l1J..Q ,; _0.... :s 9 ~ 0 .2--0 ";;; , u u;:= 0 CI) -... 1: '''' ...S- =0.... N ~ 1: co.
_.-:0,,", >,- c-:..c u "0_' ...=.sU~ ..:.c:r--'-51' !! "gu 8= u .u.c.,g ,"51 "MOO'.,=,
... ClU ->. -.. ":8> ~::.. UU<,:--t,J ....."'..."t: .......= =.c r::eCfI1 .oC;." 'ce,
U O.t= "B ~ tU ~ '0 ~ ~"O ~... c:::g.... ... 1:I..c CI:I ~ ~ a u e.- "'l:t V,l c. = <<) _ a,..t: ~ c: .c"
. '1;~ bO> .."= c> ~.9 0.-5 ._~.u~~t.J_w....j:::S='~'.zS'~":cS_ceu...!'= ~o~.2~:
_CD ~2l~ ~.~ c- .0.5 -o:i'C'Cl ofell")::E(lt .~o= "_'- 0. =I;u=.o ..-...U)O"tff""l..c:U-=~
- 'iiltbtl) uCJ ~ =CJ.~ u=lI")~_ '~~..c:~_o.s~c .."N5'=&CI')-~coc'=,,:,:u:!~ G1Slt
.- "0 - "0= ~= .-51.>'0;.... -";lea ~ UoC'lSuoooo..O.....cy = -co'- -.-...t
= s = "u, '0 .e, it: ....= u u -='C 'f.I.I 0 ct ~ - -. co '=~'... ::'u u \of u oo.~.-.:: ~ i:i.l; O'.~ _ _ (
.... 'Ou -8~ .55 u- e~1n -2u; ..~o uS= 8~c:-S-'\:'i:I.:~-~. ,::eg~--~s '''-:a...:C:>-'~u..:
.... - >. ~"O lU U C -..>" ..=~.. e e..C).: e'.>Q'- aJ"VJ ~~ ....ctii..Q.:'J~s.{;J; ~~ r" .:.
> 9'h. ='.2t~; .:S'..g Q ~ ~a..."'01U ~-InQ"OIoo 'S'-- U)::sO.U InIooJ>o._ -="'u= ,.c;G
= =-0 u~..c:at"'c:J..~ 'E'="O~~u=C'l:le ....c~~~..eo> ca..Q-5ciiaujC:~N'> ','e~.3=St .f
.-. U'" ,-.._.-...."o-.,j;j =at.,gca... ..c2~ u= ..s: u^_..... .... erlcu ~__" ca~ OO";..cc
,..0 ~;a-," -u ~ow"9 ;,:u-;a- =UlU-Ci=-~c o,_uc-cu:::-..-_..DD ._r-a--o_~.
C ,... ."51", l!o"'-;;;~ "'-"'c....:: 51 liO'...~'I:,..-e" .. 00,,_ =~0"'.c.1:...
.! "'<.:"'f3-_'","~.a..",~o-:::;~!l;"U;::'~ -oo==f.I.I- ~ f.I.I=,oGlS - ,..c:GIS.cf.l.l':='-'-~.."5!, .- :'oo::l U....uc
.. ~..." "... <:=.~ 0....'" -:= '" a~~ ,,'" ..:!-o.c Q,Q,s::;:.c" 51-...i:t ",.. -Ill.
.. .",... ....::rito "'..- -.....0 i!..S.-...."'.. ~o '" ,""=!l E
.. '" r-o 11<l!-o. ...c 0 00. ~..>!:! "51. o! "Q"".I:...... ~.-.~......o 0 ,,'C. .g:;;-.co. c
.: it.", -.:;.. ....c _...' UUlllF'.. ~u~ ","'.Q, .......'" >.,o"':x: Q,Q, ......oU.... to;
::;:;a..!F j'g'g 1Il1ll.g-.e.]...; ~.li:E=S''''; li i 'g..,: ':i C . .;;i:J':.:'C';-:'H..., ~ a'~::iS: 15e'
g>Jl- i!.... . lii'iit:; t<l .E.:!" ~'5"" .. '" ~~ ~l!l:E~oO;"..~ - ~ '~~=..'~ ~ ~
:;l'@';;:;;sag]~~ i:t ....s~~]~~.sJ== ~,..:,!l.g~'~51.l~ c~..::::J ~ >.""........ PO>.
'::s1U G1Scu'o::t GIS. ~ ..co -..c~.MVJto-l c ,.c; ucaU,.,i .... CWO Q,N'ca u
QIllZ.... OI"::;;""Ill~i:!.i!l;;~~":,,,,"Oii'6h"""'''e'''''';'' , ...:.:..: "'2..: - '.en'" 'g :'1~';,,,,oS
.. ~ ~ ..: >=- =~&! =,.co u C Q!$ ..y t"S .2 "'" U) 'C .~_~ is<<:I '.-0 - ca '" c;:;;l ....... 0
:;:>"'~... .;r".... '>-" .c..Q.o!!:>_""'{;"'.I".;!' ._OOl.. '<::N .t, ~A ,'._..."'...._:
Co).... c: f.I.I Ilt" - ~..c "", u e VJ - .... ..co .... -...----. . - IIll!.l .. C'lI !- _ v, U) '0 ._ 0 C:'-
f.I.I f.I.I:W ~ =~~ r: ~e~..l ~:--{ ~ ~ ~~;:~2 ~~'51 ~ ~.!! u '''0 QO~ : ~!'J -.:... c:l..~..c~.E::..c ~
O"a"-a.i!l:::5''''Ill.c,,'a~'''o 'tJO'2~~",.",r;'a'_u ..>0. .-e:::t:; ..c.;~. .- ca,aJ '''''_.. = ill!
lO....~-. ~""C:....1 -... cz-- co~. ,,=> ,.ca~ . c::-=<<I.u"O c:
,.....-"..:; ".c.. ".~..;o",.. Ill,....... ....it......"'._;oo moo ~_...._
.........". .. .... 'Z"'-Ill-Il . ...,..~""" .,. ":::;;"'",,'5-'" C ..-.. ~."""
:ji";~0ii.8~~i~.li~.8eallQ~;:;;I'itS2Z~!;; ",g~"~1;:O~l --o_'~ ~.:s li~:f
...Ift .....&I~ bOGI).5 ,B;,Q.....l -" -e...... r:f-' M'=.-_e2~./lio..co 'CCO=::sk"OOC;;'=
i~~~trf<~~~ [f~~~~~I:x:~~;E'j~~z l~~~i<~~f. ,"2 ~tt51j~.~~:~
o .. I U .... I . .....: uf....,I .. .. ....." . "~'J ............ ->... _~~. .~#U ~<;".~>","'>.s.:,~.:,..:i.r
- Qj"u-"''''''lJl ..;;; .:=,......J!..."'-~.... Q..:.. o.",,.."!!....'._'JI...,~'..':e. C<'l"-~ "t-
.. "'.. j 0 - """1" 51 .. ~'A .... o~".~ ' .- -' ...~'...... . 15' CIII,G '. "
. ": (J - ... cU _"4 ,O"Q:t.-, ,..:o.,,~ co ..:'.,.~", .. ->.,'U::s __Q ca
~... ,~,lt;e.sl:s'~.L--=>-,,~.8 . '~It::.!l-~li' 2 ~ ! e ..l! ~ '. II." ""'0". Do '"
... $---' l-"jICj CS,.:: GIS -= --I:: ==-,1: lU oa>.u ~-t: -cO:>. "'-S_-o2ou~'" c:::i
-S'7.:lt5"'< .......u 1lr:ldiS S! ~-~ 10'" .l2..;oO ~!... ,o.lo~ ....0;; c:;.... Q ~.. ..., 'a""" it,..Q, .-,It
.. l:' .... ,.." "... lJl - ,.. - ... ' , .. llIi ;:: - .c ceo" - to.,.. Q,
"C .. '1).== ",.c;C ..ca'o ..~ ..".'rJ'J'o. =~,...,-"",=..; _(11 'o\~Qoo-,~:::s
IS t ~_..Q.ccn ..2~'2'""" :C..Js~:;-;u~ &~.x:.. uaW,:-;'::- ~-r:::J A' -ofi-Q.."CJ-'~-'-
,,'::"OQ'fi~~~'=~<:i~ .~'d 15~~"S~u!YQ'~ --.-tJ o.~ 4,) C -1111 .__~ ~ .::1(1).
3~1l1";<;'''''- ~=o ......Illg;~'* .fi':".,=,,",:>..jf~=5'_""'~o :f:E'..:::;;'5 g;.. ..'en 1ii~~=.S-8 ."s
... fllli ...... .-Ii: :x: <(!:l 'l2!i'::::;; a 1:b00iil 21''" ~ .!! ~ U " III ~ .", U i:c.... , . ; ~<l III 15 ~ lS 5 il a
:'=,.j ~ilt:;,.. ..sf;;; .~. ~.s;/:~~QOll:f<.;O~ ~'g:;:a.;..:'" > C D:Qiis"''2'~~o
=.... .::::::;;~"lJl~"~,,,"U.g..!:;J!Hi=dt:...:! ""~~-t1~ "'..: ~ ca 11"0 ...:ga.:;.!!u
j~~t~fe~~ ~~~E!f~~filj:~j d'~j jj ~l~'t~] ~ ~ !lH ~ri;f
~ ~..~~ <.c~ ""Z oo=oz",~ ~ :x: Ill"" u,.. lllw .c ...,,__0... U
'iil
~~
:'C;
:~
~"'O
:a
,1
'"
"
!a
",;:
-Ai
~
)il
~
If
:>
"
~
~
~
"
Q
,
=
'"
~
.
,
~...
"
,
,
:
;
;
,
2
,
,
.. ,s.8.s. =-~. .;..~"
~ 0_= >. ~_ :;-l!
~~ ='i~ ~~ 2~
"..." . it'iil-51" e..51 "0'-
0) _ "'1: .--' '"
3..5-Q~ ~ u =0 ~'-"
gii 5~.U ~:n ~j.
~,-aci3=~'a~>'- g~:i
;!lSCUU-.3C1#O c.r:::
3 l:: -zo'E~:J e; :l Iii "51
.)Q. 1U..c:-d'W)~ tJW)cu
~:l ~Q.,cn.=u~..:.: lObO
"':lcO-St::C:- .c~=
:. Sl-5i "",-s,:!!-'fi.!!~ l!
':: U 0.'- ~ ';:::1 ~ e g; - a
~:c .!i.a:l.~ = c:~ O..c:< '-
: U'J u,._r;I,I .::: U z C)
:'O::'OtlO ~=~~
~ c: ~ ... "E= s..c: a'i
;or.r..~ C;UUQP)
, VJ U 0 ~ .._:c ~ ....'_
u GIS '0"'" 00 ~ .-
-5::e'i.a~ C5..~'~0:5
I/) ~_ <;A co.c._
~ GIS "'0 ~:= . C'# e c, at
~ ~ ~w .8~"O'=': ~
".."':)tn_~cauc
'oC c 'O.c ~=
...: cu= '- ....."'0_.,
.... cu 0:.1,
.'~ :u,'C.~,
O:x: ~~'
>.oC::I: :
~"~ 0:.1 r:
~ E~..::!.
;:>:tnuU
~ 0
r3~
='3
Sl:J
.. .
,.,:1
.c-&,
-a 'u
~=
'C O"'CI\toof.!!"OJ,~ ....~.. - ,81;;:-
.~ t Iii:: $l Iii'o Iii .g'1: t:' S .- iii
.u ~'SM~.,,;~" Qag~ .g,;a~.",
llIi .", :X:.8 el" '" ~ z.; ~ .... ,.. g '" " 15...;
.Jl l!" rn Z .; Ii::: . U 8 U.i].... 6" "",
-.:;I "EzaJ roo; CO"'tI) oJ:: = ... ff.I' -'cl'.::I,,,, u~
"""'s _,,0 .g~""~'~~ .8""'-
a~",'a~~]'a2]~~~~~~i~~
,,'ll.!Il ..: 0 !i 'iil 11 [;b" 0 ~... u 6:;l .
l; ~ 11 "': '": .. III ~,.. .", Q " ..l ~~" ~ ~ ~
.,g < ;: 0 t Gi'O J3 - ~ > co VJ .!:;; ";ltt ("of.15
5 el ~ "S llIi cs '" ..;.: lib ~ 'g .!! :::l ~ .'g 0 . el
='i .c" .lfj!u.~<:a~ =.8:: ",I; e -~.8
s.c~ '-oJl:"u~O "''''''""..,.
~~ ~~~uu . . --8'CN~~~~
II ... il =c",,' i5'ON' :::::: "',,"" "a"''<;
.c U F' .. ... lJl.... ,,- :. ;J it '" U u
UJ
I'll
'0
:>
'-r!!. ot:J" I loooctS I ,gclsClfibg -=
Ji~~ N lJ~I~~~=~~ .;;
'" ':::;;.5 ,.. '" ~o.l~ ~ - i;'it '"". ll.o"
s~ ctS CIf CIf ~~ S~ ~...
$l;:;;.::;; ;:;;,;.""'g MtcJ~~ oJ
:> . e. . llI'- " .. '2 "'''' ~ .. i Q :;u
lS,g ci,lJl ~2~oS..,; ad M ...;u;! .c_
~.- ~ ~'-~~I.-~=~ ~ e~
V'.l~Nr""I c:::~ ..Cl2C ='-CI.lcGc...c:: u:';
8al;;. ..."ooil.c If)1lil;:'o~ So
.~ - ... t) COlli::" -.... - V 0;':: . J! ~ ... u ~ ..c
.c:-.~~ft..,Cl2~ _4j
(1)..,9 gc.:~<:;-6'g =~
.-: CIS !:l. C::"t) <<l CIS ~
=-s'l:l' .- = lio-,; ~'"
,.O;;>'\ooo8:C<<l O~G)aJ
-e.g~ 0 CO..C7I ,g-~.,;
.- '- ~ -< ::s,~;; u "0 '" C
~o 0 St::-(f.)U '=>
~
~
;:!
a
::z :_nz.~ ...
~~!!!~Il,j
,CJIL. ..
I
~ I "C:I rh''O tIC ==i - do) t:: ell ..
UQC >.. .-.- .Qas8
..glii_.... .0 ilitedlii"51J
sid g:,a.::: '" oS !l'iil'iil .g e ":x:,, ~
z :::;; 'S '5 5 ~ I'! is .~ 'C ,..,g '" ..::;; J!
...:PotUQ.~ -5,..;g..c:ad -! 5~ ~
~..."'"... 51.....51 01:;0''''-0\
.... .. . J:X: ",,, ~ II" "-s
'--0 >-.'0 0 ~ i~ u::E C.D UQ~
, '5'5 'S'a'g:; . ~ ~.,,~- J! . ~-;'g~-8
Ucf~'1: ",51 OS :::.e-,..oS B.. eN
"- - co ="0 .I: ctS ..c:
il:' 01!:::;;1"'0.. ~>~i[Qe.51'iil-.~.~.
- .. '''.. . Ill!! " .."'''' ..~o:;;"'"
ii =t'a:::;;....~;J..:llIi.!l~~1!~ -';;"'S
~ Q a en.. ....w u j ~ GIS U Q. 41 0 "r--
.!! ~.8 Sa ~ i.:~:l! ~~',8!! 5if"'Q~~ ::lS;:
-:x:", ....c~.. 0 Do _ a<(llIi~
a:
E
:l!
i
Q,;'<<,)OO' .. .'I~O~>> .__..
i;l.c ",rn 00 .!!<.c.c:x: "''' 0"'"
lio=I~'" ~"I~ ..~ ~...t:'
:::oo';uJ.", ~ i~ .~~>.> ~'"'~..
i;: '" c' .... u,,:> o._a " '" ::;;
:>'C ......cP..c:t .....>.'Q.-""~ >
Q,J! . e .,s il oS e ui;l <,;: .;: ,.; ...
~ tI] rIJ e Q .:>> ~ tl:l ~ U . ~ ...... ~ ....
~N=~~i~ ~~ ~~tI]~ -~ 8J
'00" _._"'0 ,""0 -CIlI._ '4)- <<=f.I.Il/J
~~~MCIlIi~o~- ~_,=~ ~~~....
.~o _,tuOe~~"Oo~oe >.~ ~
t: ..,;-"'" ::;;,g......a....".c= . ""'!;?:::
l'A; ~ ~tf..!'~ ~ H-="': >'0 -uo~wu::::e
'2 ~.;!;o.~~.~:aQ,-rJ)l! ~.s.",g u ~.!i'O
g~~f~~~.5~:f5~1~~~~~'"
~5~~e~~8~~~~o~~~i~~~
~~~~~ N CIlIXO~~_~ ~z~
Ewing Brothers Funeral Home
630 South Hanover Street
Carlisle, P A 17013-
(717)243-2421
JllllC 25, 200 I
Estate of Willi p, Hershey
TIle Funeral Service for William p, Hershey
We sincerely appreciate the contidence you have placed in us and will continue to assist you in every way we can.
feel tree to contact us if you have any questions in regard to this statement.
THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES. FACILITIES. AUTOMOTIVE EQUIPMENT.
AND MERCHANDtSE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
1. PROFESSIONAL SERVICES
Services of funeral Director/Staff
FIJNERAL HOME SERVICE CHARGES
SELECTED MERCHANDISE:
20G Silver Non Sealer
4 1/2 Regular
THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED
'\1' THE TIME FUNERAl. ARRANGEMENTS WERE MADE, WE ADVANCED CERTAIN PA Y'\IENTS TO OTHERS AS AN
ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES.
CASH ADVANCES
Opening Grave
Cenified Copies of the Death Certificate
TOT AL CASH ADVANCES AND SPECIAL CHARGES
SUB.TOTAL
INITIAL PA YMENT / DISCOUNT / CREDITS
TOTAL AMOUNT DUE
The statGlncnt is net and payable in futt on or before June 27, 2001.
Please
52995.00
$2995.r.O
$925.00
$875.00
$4795.00
$400.00
520.00
$420.00
$5215.00
55215.00
r-"o""",U'-'_:_--~~~~-~~~.
- ' 'UESTi!P;~~i lMO~{::'
1.:JI '.JN10;\~j k1':f~{j€~~
lw
-ifj-~.fr_--.~ -vq ~,-~~=~~~,j
"
I
~
06-255854537
iS1-'iiV'll!21
PAY EXACTLY
.r ' /' 7
5f~~__~_ __'z'~::~!?d h:tt?!::!t!:..'t
PI;~ lA !P!'-1l\~. CoI,;~' 1.::' rn I'.~E
. ':!."fj;tefUi'itlE'ill:of ,
5/",J,"I(k"')Jd.:,-;:;;~J:-_,X_ 17-<", Y __ "_ ~.'-' '
._ . w. IJ.l.:"t ',..IS",,"":!; 'l,
PAYTQTHE- " . ... _I.c <-
""OER or """:'.:.JJ.i.V..11l.. ~. n;' 1""""< V
Z'-/7
1':S""~~~_,:e.~:1"':-.--'---""",~ _........_~:...,....:__.~~~-~~~XET.e,..~~~':"
.:.02.001.001: 1.00b 2SSSS!, SH .11'
THE LAw OFFICES OF
KATHLEEN K. SHAUUS, ESQ.
44 SOUTH HANOVER STREET
CARLISLE, PA 17013
PHONE (717) 24~655 FAX (717) 243-6618
EMAIL: JRs037cARLISLE@SPRINTMAIL.COM
January 3. 2002
Invoice submitted to:
Brenda A.
62 Spring
Carlisle,
Bollendorf
Garden Estates
PA 17013
Re:
Estate of William P. Hershey
No. #10221-02001
Account to Date
Hrs/Rate Amount
6/6/2002 Correspondence 3.0 hr/$50/hr 150.00
to marshall estate
assets
1/3/2002 Preparation of
Inheritance Tax
Return N/A 100.00
1/3/2002 Reimbursement for
Estate Advertising N/A 152.63
Balance 1/3/2002
$402.63
RECEIPT FOR PAYMENT
===================
Cumberland County - Reqister Of wills
Hanover and Hiqh StreeE
Carlisle, PA 17013
Receipt Date
Receipt Time
Receipt No.
6/05/2001
10:41:35
1025811
HERSHEY WILLIAM P
File Number 2001-00531
Remarks BOLLENDORF BRENDA A
SK
Transaction Description
PETITION FOR PROBA
SHORT CERTIFICATE
EXTRA PAGES
JCP FEE
Distribution Of Receipt ------------------------
Payment Amount Payee Name
40.00 CUMBERLAND COUNTY GENERAL FUN
6.00 CUMBERLAND COUNTY GENERAL FUN
6.00 CUMBERLAND COUNTY GENERAL FUN
5.00 BUREAU OF RECEIPTS & CNTR M.D
Cash
Total Received...... ...
$57.00
$57.00
(O~l/
THE LAw OFFICES OF
KATHLEEN K. SHAUUS, ESQ.
44 SOUTH HANOVER STREET
CARLISLE, PA 17013
PHONE (717) 243-6655 FAX (717) 243-6618
EMAIL: JRS037CARLlSLE@SPRINTMAIL.COM
January 30, 2002
Invoice submitted to:
Brenda A.
62 Spring
Carlisle,
Bollendorf
Garden Estates
PA 17013
Re:
Estate of William P. Hershey
No. #10221-02001-A
Account to Date
Hrs/Rate
Amount
1/30/2002 Preparation of
Income Tax
Returns
N/A
65.00
Balance 1/30/2002
$65.00
r REMITTANCE ADDRESS I BILL 10
THE SENTINEL - LEGAL LAW OFFICES SHAULIS, KATHLEEN K
P.O. ~ox 130, CARLISLE, PA 17013
AD NUMBER r CLASS SALESPERSON BILLING DATE LINES
203904 10 PUBLIC NOTICES 15 07/18/01 22
AD DESCRIPTION START DATE STOP DATE
EXECUTRIX NOTICE LETTERS TESTAMENT 06/30/01 07/14/01
PUBLICATION INSERTIONS RATE NET AMOUNT GROSS AMOUNT
3 THE SENTINEL - LEGAL 3 LGL 71.28
TOTAL AD CHARGE 71.28
3 2001 PROOF OF PUBLICATION 01PRF 6.35
DAYS RUN {~ht) ?/7 <t'?Ji/
PURCHASE ORDER PAY THIS AMOUNT 77.63 93.16*
Wm. P. Hershey
. AFTER 08/17/01
RETAIN THIS PORTION FOR YOUR RECORDS
MESSAGE:
Thank you for advertising with The Sentinel.
Deadlines for in-column legal advertisements: Monday is Friday at
11 a.m.; Tuesday is Friday at 4 p.m.; Wednesday is Monday at 12 Noon;
Thursday is Tuesday at 12 Noon; Friday is Wednesday at 12 Noon; Sunday
is Thursday at 12 Noon.
If you have any questions regarding your Legal bill please call
Dauris Henry at 243-2611, ext. 202 or Sherry Clifford ext 201.
Fax your legals to 243-3754, attention Sherry Clifford
You can also EMAIL yourlegalto:classad@epix.net. Please include
a cover letter and the ad as an attachment.
PROOF OF PUBLICATION
State of Pennsylvania,
County of Cumberland.
Sherry Clifford, Classified Ad Manager 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 THE SENTINEL on the following dates, viz
Copy of Notice of Publication
June 30 and July 7 and 14, 2001
EXECUTRIX NoncE
Lehers Testamentary on
the Estate of WILUAM P.
HERSHEY, late of the
Township of South Middle-
ton, Cumberland County,
PA. deceased. have been
granted to the undersigned.
All persons knowing
themselves to be indebted
to 'aid Estate will make
payment immediatetly. and
those having claims will
present them for settle-
rn.ntto:
Brenda A. Bollendorl
247 S. Spring Garden St.
Carlisle, PA 11013
Kathleen K. Shaulis
_mey
44 S. Hanover St.
Carlisle, PA 17013
Affiant further deposes that he is not interested in
the subject matter of the aforesaid notice or
advertisement, and that all allegations in the
foregoing statement as to time, place and character
of publication are true,
~::'j". d;~A
/'/ ' v
~' /
July 19, 2001
Sworn to and subscribed before me this 19th
day of July , 2001.
r&~/ O. :-:i:JU/UU t'f
I
Notary Public
My commission expires:
CUMBERLAND LAW JOURNAL
2 LIBERTY AVENUE
CARLISLE, P A 17013
JULY 20,2001
Cumberland Law Journal is published every Friday by the Cumberland County Bar
Association and is designated by the Court of Common Pleas as the official legal publication for
Cumberland County and the legal newspaper for publication of legal notices.
TO:
Kathleen K. Shaulis, ESQUIRE
William P. Hershey, ESTATE
RE:
Legal advertisements must be received by Friday Noon. All legal advertising must be
paid in advance. Make all checks payable to: Cumberland Law Journal.
Advertisement inserted on following dates:
July 6, 13,20,2001
Advertising Cost
$ 75.00
$ 0.00
$ 0.00
$ 0.00
--------..----
$ 75.00
----
---
Proof of Publication
Second Proof Request
Payment received
Total Amount Due
Payment received
by
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16, 1929), P. L.1784
STATE OF PENNSYL VANIA :
ss.
COUNTY OF CUMBERLAND :
Roger M. Morgenthal, Esquire, Editor of the Cumberland Law Journal, of the County
and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland
Law Journal, a legal periodical published in the Borough of Carlisle in the County and State
aforesaid, was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Journal on the following dates,
VIZ:
JULY 6, 13,20,2001
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time, place and character of publication are true.
I ~
Roge/M. Morgenthal, Editor
Henhey. William P.. dec'd.
Late of the Township of South Mid-
dleton.
Executrix: Brenda A Bollendorf.
247 S. Spring Garden Street. Car-
Usle. PA 17013.
Attorney: Kathleen K. Shaulis. Es-
quire. 44 S. Hanover Street. Car-
lisle. PA 17013.
SWORN TO AND SUBSCRIBED before me this
20 dayof JULY. 2001
LOIS E. SNYDER. Nolary pt;/JUc
Carlisle Boto, Cumbc'llland County
I My CommiIIsion E>.1im-; March 5, 2005
- _.',cor .
1"11f?!::.Sf:'":nqE"(" :3f:'-~"'1ice Hecpiut:.
SOLLENBERGER'S MESSENGER SERVICE INC.
29 WESTIMINSTER DRIVE
CRRLISLE. PR 17013
717-;::1.9--B149
For: BRENDR BOLLENDORF
62 SPRING GRRDEN EST
CRf<LISLE, PA 171i)l:~
71 7-9&ILl-93'3~;
J'nvo:;.Cf.:~ :fJ:~ 7''116
Date, 07/10/1211
Tim e: ~~3, ;::8 Pi'l
Clerks I1Jitials: DMS
Fil. Name, CARL01
2C:;619~::.d3ell 1216
Title # or Date of Birth:
VIN or Driver1s Number'
_Tag Number or Eve Color
YeRr-M~ke or Soc. Sec.#
Tt"'ansi-:!ct i on
OdDlnE;'1".: E~("
Comment.s.:
/VIRlL
r i \; I. On I \l
(~
'rtlis item will be Mailed to 'lOLl.
WAf~NING: Bureau t~eq~Jlation r~eouire ttlat any
item left ill O'lr o1:fice for &0 days be
returnecj to tr'~e BUrealJ of Motor Vetlicles as
unclaimed.
I/~e swear that I/we have aoolie(i for ttle
above itpli1 (5).
Swo'r'n & subset-'ioed to ber=o'r~~ me ()f1 07/lIZI/~!.'I.t..
.._...._.~..,..._-._..-_......_,..._.-.._.~_______. "m., " _..~.m...___.h.._.
j\.Io i:_: <::iY",,;,
::3i~<:), 1.
I
I
I Tit.l. F.e.............
J Enc~Jrnl)ral'Ce Fee.......
J Tay Transf.r..........
I Re~i5tration......~...
I ,OU(). Fee.... ~. . . . . . . . .
I Increase Fee..........
I R.olae.men\; Fee.......
I Tax-On .0.00....
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
State Fees
c~2.. ~)IZI
Tcd::ti.l State F(ee...... It
CI',,'d< ',I...............
0.00
0. il1!;~
0. 04~
0.00
0.1lI,h,
O. ~"0
~~. ~~O
0. o Ii.,
O. ~~0
22. ~:;~:1
t;pt-'v:i.ce Fees
MeS5eJlyer Fee..........
feme T~q Fee..........
NOI;'::1r"'v r~-e-e...............
Copv/Fax Fee..........
Doc~\ment Fee............
Chec~{ 0)"" f'.1. o. F<ee......
Total ~3ei"...vice Fee....."
~.;e.f'v:i.CE' F,;;'e Chec'k .1*....
~~" ~~~)
(~. ~%1
1/). Q\\Zt
1lI.01i'1
;':~~:,'),. ~~ll?l
1 . 2~";:.;
0,.lj1lZl
,;). ~"lri'l
~~6. ;:?','::;
Ci:::!!.:,h
Grand Tutal............
Tu"tal Due.................
Rmuunt Paid.............
[:11,,:t{I~;IE' L3-i \"'f~n. . . . . . . . .. ..
i'-..Io ::~e.,.;.llnd!:;. dn :3li'r....":ic.e Dr"'
r-Jotii:ll'-'V ff~es. ~~p B,r'e not
j'-' (.? S {) () n ~,; .i. J;j 'I. E'~ (00,1'" (,0,10 r" I... I: I' '11'-:'
::;-~:~te fB~ls to P)~D{~ESS.
40.1:5
4E\.. 7~.:,:;
::,~j0. OIZi
J .. ;.::~-:Ci
SPRING GARDEN ESTATES
C/O PROPERTY MANAGEMENT, INC.
P.O. BOX 622
LEMOYNE, PA 17043
(717) 730-4141
~~td
JUNE 11, 2001
TT-007-00-0062 -03
HERSHEY, WILLIAM *
62 SPRING GARDEN ESTATES
CARLISLE PA 17013
C/O MARY HURRELL
20 SPRING GARDEN ES
CARLISLE PA 17013
FIRST NOTICE / * SECOND NOTICE *
TOTAL DUE: $317.00
NOTICE IS HEREBY GIVEN, PURSUANT OF PA ACT NO 261 OF 1976, THAT:
THIS OFFICE HAS NOT RECEIVED RENT AND/OR RELATED CHARGES WHICH WERE DUE THE
1ST OF THE MONTH. YOUR CURRENT TOTAL BALANCE SHOWN DOES NOT INCLUDE THE $3.00
PER DAY LATE CHARGE. IF YOU FEEL YOU R~VE RECEIVED THIS NOTICE IN ERROR,
PLEASE CONTACT OUR OFFICE IMMEDIATELY. OTHERWISE, WE LOOK FORWARD TO
RECEIVING YOUR PAYMENT IMMEDIATELY.
A BREAKDOWN OF YOUR ACCOUNT BALANCE IS SHOWN BELOW.
06/01 L LATE CHARGE
06/01 R RENT
-3.00
320.00
AN EVICTION PROCEEDING MAY BE COMMENCED AGAINST YOU IF YOUR PAST DUE BALP~CE
IS NOT PAID WITHIN 30 DAYS FROM THE DATE OF SERVICE OF THIS NOTICE. AN
ADDITIONAL NON PAYMENT OF RENT OCCURRING WITHIN SIX (6) MONTHS OF THIS NOTICE
MAY RESULT IN IMMEDIATE EVICTION PROCEEDINGS.
* NOTICE OF SECOND NONPAYMENT OF RENT *
YOU ARE HEREBY NOTIFIED, DUE TO YOUR SECOND NONPAYMENT OF RENT WITHIN SIX
MONTHS OF A PRIOR NONPAYMENT OF RENT, THAT SPRING GARDEN ESTATES MAY COMMENCE
EVICTION PROCEEDINGS AGAINST YOU WITHOUT FURTHER NOTICE.
SINCERELY,
MANUFACTURED HOUSING DIVISION
00 \ 'f
)?o.oc
5e( t%
111...1 una'll Of ,.......nlL. 10, '::UVI IV:
CAPITAL TAX COLLECTION BUREAU
Se~..clenerallnstruction Sheet"
this ~cket for mailing address labels ill
see back of return for address~~ClB
phonEl numbers, and office hotJl'!f."
\
';SQU1H 1I100LETOII
(OUA SOCIAL SECURITY 'fi:\
NlMlEl'l \:J
SPOUSE'S SOCIAL :fEj\
SECURITY NUMBER \J
TMP
ua ! "It
/
,''' .....,"OlOIIIUU: rnuvr vr rlUnb, ,ne 'AAPAn:JnS lOUI'T MlI:il 81; VALIDA'
BY THE BUREAU. TO HAVE YOUR COPVVAUDA1'ED BY MAIL., RETlJRN BOTH 1
BUREAU'S AND TAXPAYEWS CaPlES ALONG WITH A SELf ADDRESSED STAMF
ENVELOPE.
~ WOO
LOCAL EARNED INCOME'
TAX RETURN (FORM 531)
][;I AP~ 1 1; l\\l.l1
TAX OFFICE USE ONLY. DO NOT WRITE IN THIS AREA.
060781 000039 06/07/2001 .00
5 I'
r
1
I
8 I
1
9 ').O60<{ :1[(
10 J..o6 IO~
11 I. "'.'13
12
13
, ,).
I::
.. ,
,.
I'
Ii
14 '<d~
I
15
18
17
18
19
20
l3J
W.2 EARNINGS (From aUached W-2's) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . 1
EMPLOYEE BUSINESS EXPENSES (Atlach Federal Form 2106 & State Schedule UE). . ... .. . . . . . . . .
TAXABLE. W-2 EARNINGS (Subtract Line 2 from Line 1).......... .'............................ 3 }.ObV Lf
OTHER TAXABLE EARNED INCOME (NO INTEREST OR DIVIDENDS) Complete Section B on Back . .. 4
TOTAL TAXABLE EARNED INCOME (Add Lines 3 and 4). . . . .................... . .... . .. ......
NET LOSlO FROM BUSINESS, PROFESSION, OR FARM (ATTACH FEDERAL OR STATE SCHEDULE C, K or F) . .
SUBTOTAL (Subtract Line 6 from Line 5) I I' LESS THAN ZERO, ENTER ZERO. ... .. .. . . . . . . . . . . . ,.' .
NET PROFIT FROM BUSINESS, PROFESSION, OR FARM (ATTACH FEDERAL OR STATE SCHEDULE C, K or F)
TOTAL TAXABLE EARNED INCOME AND NET PROFITS (Add Lines 7 and 8). . . . . . . . . . . . . . . . . . . . .
TAXLlABIUTY: 1% OF LINE 9 (Mul1iply Line9by .01).........................................
TOTAL LOCAL INCOME TAXES WITHHELO EXCEPT PHILADELPHIA INCOMETAX (From allil~eo W-2's, Box 21) . . . . .
QUARTERLY PAYMENTS AND/OR LAST YEAR'S OVERPAYMENT CREDITED TO THIS YEAR. . . . . .
CREDITS FOR TAXES PAID TO PHILAOElPliIAANDIOR STATES OTHER THAN PA (ATTACH LOCAL SCH. Gj AND/OR CREDITS FOR CERTlFlEO
RESIOENTS OF THE HARRISBURG KEYSTONE OPPORTUNITY ZONE (KOl)......................................................
TOTALWITHHOLDINGS & PAYMENTS (Add Lines 11, 12 and 13)............ ....................
TAX BALANCE DUE (SublraclUne14fromLine 10) PAYMENT NOT NECESSARY IFLESS THAN $1.00. . . . . ... @ .
INTEREST & PENALTY (See Instruclions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
TOTAL BALANCE DUE (Add Lines 15 and 16) Make check payable to'CTCB" .............. . .......
OVERPAYMENT (Subtract Une 10 from Line 14) IF LESS THAN ZERO, ENTER ZERO. ...... ." @ .
OVERPAYMENT TO BE REFUNDED...................................................
. OVERPAYMENT TO BE CREDITED TO NEXT YEAR'S TAX. ................................
OVERPAYMENT TO BE CREDITED TO SPOUSE'S BALANCE DUE FOR THIS FILING YEAR. . .. "
/3'i.12.
.1'1.70
11.0.'12.
"I'~~'.J_
d;
.f'"
I"
,'.
"
,
l.i
:IIYCD4'Q...........ec.L01..R~t
.35522348100011401 .
~fR$~ElWlttlAK ~ (Ql.fJ
! U6Z,
/
SPOUSE'$' NAME
(LAST. FIRST, MI)
HOME ~,,'\1 \)'4-
. ADDRESS \
61 s~~Ri~~'J:C;~Rd~N ~Est .&STAT' ..\U
CA&USa.E fPA ~l1C13-9.
IF Yes. COMPLETE SECTIONS
A & C ON REVERSE SIDE OF THIS
FORM.,.
YOlJA~e~~:
La,bj1
SPOUSE'S OCCUPATION (ONLY IF ALSO AUNG ON THIS FORM)
DATE
LQP493RS1
Customer Number:
Customer Name:
~'c6\lm: &'.L'iili'c~:
La.st Payment Date:
Payment Amount:
Type options, press
Opt
Date
5/17/01
4/26/01
~o-
F3=Exit
Open Item Display
OPEN ONLY
273623
WILLIAM HERSHEY
i~6. 69'
5/17/01
ere-aft Li'mi"t:
Last Sale Date:
Start:
5=Display Details
Invoice
Enter.
Bill Dollars
Remain Dollars
~Shipl~ .
Bus. 717-B48-410(
600-839-184<
~ax 717-854-549€
www.shipleyenergy.corr
NANCY E_ POWERS
CUSTOMER SERVICE REPRESENTATI'JE
550 E. KING STREET . P. O. BOX 946 . YORK. PA 17405
Menu Option: _
DP
Billing Id
967
967
50.00-
306.69
256.69
01
01
PAYMENT
KEROSENE
~ \>-e. ~+lb (\ ~ rC-t.--k & 1'--J-.rL
F5=Refresh
F6=Show ALL Trans
F12=Cancel
~
c--4
Cv
Bottom
'-- R-U-
l1l:~
., "
,--",,>
/ /.
-'
~v~
\', c- , ~
~ -J v
v0
-,
~,
:>
\"--
{'
/~
,;;,
i!(;
:/i/ ,{
- 1
/ ,{~~-,}
~, '/
;...:.
~ lJ\
.\ -0"
)
-,
-'"\:))
~
r::>
-...-.Jp-
D
---
...j
()
f..:.
},.
.:t~ ,
j',)
(,'1
1;'1; ~
1.')
w
~.~.
d
Q
--
-,
~
:J
\:'---
<:'0
"
-1:
)>
c.
c.
iD
~
~
f/)
m
<
1;'
m
:Il
1D
.0
<:
m
~
a;
c.
ti I"
f,,~il'
~ ~ ~ V,
7'co!T1 ....
:UOA ,.,
~~~ -Pi-
5i0lf/) m V
? ~~-
<:: m:J]~
)> ~ Gl---
~ '~
...
o
'"
6
"'
...
m
'.
".,-:"--, '
, !.~.,.~.,
~ ~ l'
~-o\l
~~~~~f'ft'
~? ?f,) l~,
~ b ':"',i~~ll
r----~
I:: ' " i,",'"
. 0 .~t
'l,~ u.. itt'
l~ .. It
\.;; HI q
I.~ ....
" --1
, .~...... t """ .
--
_.~
~~!~lil~~i~i~g~~
3-g)~iilo53-~0I .In:i;l~
i!~~g~i~am~ln~l~~
~~~~a~g~~tg~~a~i
g~!~!:~~lit~~~~l
~~l~~.'< ~~",)o~a~f ~~.
~~m~~~~~~~a~Nm !
id!~ii~ ~.a ~Q~a&?~
g:~l!1lih'~~g~ ~~., 3" 5-
S .!<.itcC"i1ii" !!l;;l-="ng'm
~~~'5l 18 =(h ii el ~i~
;>>rO OI~~l5.mn~ c1i\
;~ifam.i~~a~gmia~
i1l!ill~!I;~'~!
;::::1il~!;l ., ~!!l"'n"'mii
~ !g,{5 ~ !~i~~~"i li~~
g~~~~mCL~~~Cllli!. i
iwg'I~U~iU~~~i
i~~_!;ll<<3.alil..o~~'<i
l&"g~.Ei~ ~6"~g ~a ~~"
u-<'-'7:n=r;:
JJC:I:ro1UJ
Ocl1J:jO-<
~:::Ju....j:rJo
;~~s
,<, ~, ~ -"1
Z '.J;>
--1 _ n X
~OOm
'cJ ,"- c: en
, CJ Z
-< _J r1 ......, }:>
----~FQ
G
r"' :;J -f
o
Ci
0'''-'
--..0,
~'5
mfTl
:JJ
<
~
~
Z
m~
-< 'f:
~ ,-
o
'-..;
;~ i: ri
I ~
m
2:
~.
:'1 ;::
cr,(.(;
~,:::
~ ,-';::;
n
.
3
~
"
Ji
0.
G
> < --I 'r;
C r.-' :n
t~ L-
I
o "
r
o
r,
,; 11
:JJ
c
~"
JJ
q
~'::> 2: ~
;~ ~-;;; J) :>
r~ J.-.---
> c,' d
~SJ'--JJ
vt:--!--I
C' "
-iJ;.
IQ
mm
~
~
-:r~
)::> '",
<GO
I'TI _ JJ
O"':r
)>"'m
..,,:DOO:D
rw r- '1J(/)
,.. r;;:D:r
.->-. ,-m
~mti:<
\ ~C):E
....>r=
......... ~:DC
,-I; ;;;:i1~
\~. Z
""' 13m
",00
"'~
-i
m
~ :!
ffi !=
:II Z
~ i
ill ;
"0
C
-f
m
C
~
z
m
:D
(:lv
pO
-?
'"
'^
\'
\"7\
15
~ :;# 01
c:: ~-
P- .
~ };
~
I;::)
r>
a~aen~ena-u:;E"-U()-<:;:!'"
o~)o)o-)or:Il-:Il:OOO-
C '" r r ~ r )0 0 -< )> 0 .~ C ^ -<
Z .... r [11 [Xl!'1 f -U ..... 9 -U C;; :II m 0
.....9-< m-< mI-,mrn~rC
-<0>0 ;1;::II-O:O.~ um
>~c ,"C~..:j::;:!~ z ::<:~ElG)~
~9>:O-<~:os:l~~o iii-u~r
-< >Om-u - "s: m)o.....
mo=1CO:Il~~a->;g~aO
~ :II ~ ~ ~ ~ !< z ~ iri '< i~ -< 5 ~.
m ~ Z <:)0 s:l:'" ~ s: ~ [Xl [~;!i; z-<>
iH...mmo..... [Xl-m':lr..........:D
:II . .-<)0 < -< '" m m :0 :;; r 0 ;!;z
~~.....z-<s:l~~en~~enoomaen_z
~~ffi .....F. O:Il- ;0 I,,-I
en Q ,-10 en r ~ 5 m 3i15 --i ~ ~ ~"
m )>cmz...... <-m :Lrr
:IlC1l)(ms:o C-l moma
~~a~~-lm'ii!<~~m~~~
[11 ~ > 0 iri [Xl C3 -<.:-> r:Il:~ =i m s:
",_2 m:llO",c xI.....O
O>S:Jf.l~enmC>![I1)omg~:D
O~;1!:Df2)o~j\S- v.>.....en'"
:D :D m en 0 a -< -< " en .< -< a ~
.....m)oC[Xl~.....O-<s:Oo>r
I)ocen~c)o~co~cc;;;:.....
m m~.....rC/):DCr:O:D:-O
~2
o
.- Step 1: Fo/d & Tear Along Perforal/on -.
;!2-< ~>
... me o;>!
~ -0; ~ ~m
~ h n I ~F
U ~ilIi1i ~-j!! ~
:>>0 ~~ ~i~ i!li~ ~
il: !Jl!Jl l!!n ~ 8 I'l
m~ UJ~ !l1 c >.
~?? ~ i~ m~~ ~m~ i
lll8 8...... ,.~ n~'< g~ri
.. "';: iliz~ "'$n
~ ~.~. gfii ~~}' hi
~~_" ~ gEJ !
~ .~ fI! mii ~
~ ~ !;
C
~~~S
~~~~--
0-1"0',..
~~~ ':'Br
i"-<!!j 8
~~g .~
~~~ ---~
~ -<>~"'
gj~ ~~~.~
<=> m-",o
~~% i.,,"
.... :lm~ -
8 ~~~m
8 ml:; :u
-I ~ !c:
i"~ ~
~~ ~
i", Bit...
illl'l~
~'" 2S
0<: -
.~
~
f;
.~
lB
'" I' '- ,. ~ ,. ;::
qJ (:; ~ ~ ~ ;g ~
~gj~~~~~
- -
[Il '" n
S~~
~
:0
~"",,,.';'''''',flo.
~~O;NOElg
~i;;~~ill'::li;;
~
Q )>
8 ~
aH.n:::!~:O
-<.....j......, 0
cn>r{,lrn
~gi~~~
::;;0 mCl'
,,_ ):tom
." c:D
C3 g
00 _
nl
o
t3 I
8 ~
~...",
~O"lJ
",-<:D
cnc>>z
0"''''
S '"
:D )>
m :D
<:>
m
Z
m
'"
~
nl
~"O
",(l5
"0
m
:D
~~
~R
"'~
>-
:DO
<:>z
m.,
;5-
000
~m
-i(f)
mn
:c
:!j
(5
z
'" :E1\ _
.. 0< I\)
i "8 1;l
6 ~~ <n
Z ln~
_0
ill1
('5'<
~:t
:a- ecn
il: "'~
g J!!e
~ ~-
l:
~
~
~
E!
m
'Ii
F
~
n
~
:E
c
m
o
:;;
~ 8 ~
~ ~ ~
~
~ ~ g
<n <.> :!!j
8~
ru
c
-"
c
~
.<=
~
ru
"..
c
C
c
C""f';f>' ,
,. ~
iil.. .
"'6e'
m.,....
!B!:n
<=...m
~mii
:::~~
Stl!i:a
~~~
_~8
III
-.... -
......-f' ..'
....-.
...-..~
..
,,,! ",,"
"!.Ul 0", .
~~'2.~li~
~~~.~\\
'If.'in"'-olllDQ.
Q. a:'"
C~
-
..
c.,-J ~.,,\,
20.'
-;;S<:-t;. .
~-;
q:a
0::-.
. -.
a: :
g~ UI
~=: ~
~j 1-0:\6
. -. (Il '"
too-: lU<>>
t-: ...,,~
': :"(U-r-
:-:C:C.O~
. ':!~~..-
~;d4.<(
":~C)(l.
'"1 R C) U1
;?iJ~d>
~~t~
.;. tt:. v, '::i
~~~O
-
Cl
~
'S ~
~~
,. ~
3 W.
U <Jl
.. z
\~
~ a:
--------
,
.,,;
WI
fJj
Department of the Treasury
l\'ltamal Revenue Service
PHIL~DELPHI~, PA 19255
Oalp of this notiCf1: Sf? .
T<1xpayer klentityinq Nlllnher
Form: 1040 .(",PeriNI:
3, 2001
210-44-6962
DEC. 31, 2000
For (I;::.~i~t:'\nce- YOll m<lV
call us at:
1-800-829-8815
1"II.,I,..\,II.,I,I.I.,III"I.."n.,I..I,II""",II,",1111,1
CALLER ID: 980003
WILLIAM P
62 SPRING
CARLISLE
HERSHEY
GARDEN EST
PA 17013-9263620
WE CHANGED YOUR ACCOUNT 16221-057-43954-1
WE APPLIED A CREDIT TO YOUR 2000 TAX ACCOUNT DUE TO NEW LEGISLATION. WE USED
(OFFSET) ALL OR PART OF YOUR CREDIT TO PAY YOUR PAST DUE FEDERAL TAX AS THE LAW
REQUIRES. WE WILL SEND A SEPARATE NOTICE TO YOU ABOUT THE. OFFSET.
IF YOU HAVE ANY QUESTIONS, PLEASE CALL US AT THE NUMBER LISTED ABOVE.
STATEMENT OF ACCOUNT
ACCOUNT BALANCE BEFORE THIS CHANGE
CREDIT ADDED -- OTHER
ADDITIONAL LATE PENALTY SINCE PRIOR NOTICE
INTEREST CHARGED
AMOUNT YOU NOW OWE
$5,520.10 DUE
300.00CR
27.14
109.81
$5.357.05
THE AMOUNT YOU OWE INCLlIDES THE INTEREST ON THE PREVIDUS AMOUNT(S) OWED. THE
INTEREST IS FIGURED ro THE DATE OF THIS NOTICE.
PLEASE PAY THE FULL AMOUNT BY SEP. 13. 2001. IF YOU'VE ALREADY PAID YOUR TAX
IN FULL OR ARRANGED FOR AN INSTALLMENT AGREEMENT, PLEASE DISREGARD THIS NOTICE.
IF YOll HAVEN'T PAID, MAIL YOUR CHECK OR MONEY ORDER AND THE TEAR-OFF STUB
FROM THE LAST PAGE OF THIS NOTICE. MAKE YOUR CHECK PAYABLE TO UNITED STATES
TREASURY AND WRITE YOUR SOCIAL SECURITY NUMBER ON IT. IF YOU CAN'T PAY IN FULL.
Pl.EASE CALl. US TO DISCUSS PAYMENT.
PAGE 1
PHILADELPHIA SERVICE CENTER
210-44-6962
TAX PERIOD, DEC. 31, 2000
EXPLANATION OF PENALTY ANO INTEREST CHARGES
THE PENALTY AND INTEREST CHARGES ON YOUR ACCOUNT ARE EXPLAINED 011 THE FOllOWING
PAGES. IF YOU WANT A MORE DETAILED EXPLANATION OF YOUR PENALTIES AND INTEREST,
PLEASE CALL US AT THE TELEPHONE NUMBER LISTED ON THE TOP OF THIS NOTICE.
l!
$27.14 PAYING LATE - IRC SECTION 6651
WE CHARGED A PENALTY BECAUSE, ACCORDING TO OUR RECORDS, YOU DIDN'T PAY YOUR TAX
ON TIME. INITIALLY, THE PENALTY IS 1/2% OF THE UNPAID TAX FOR EACH MONTH OR
PART OF A MONTH YOU DIDN'T PAY YOUR TAX.
NOTE, EFFECTIVE FOR MONTI1S BEGINNING AFTER DECEMBER 31, 1999, THE FAILURE TO PAY
TAX PENALTY (FTP) FOR INDIVIDUALS WHO FILE A TAX RETURN ON OR BEFORE THE DUE DATE
(INCLUDING EXTENSIONS), IS LIMITED TO HALF THE USUAL RATE (0.25%, RATHER THAN
0.5%) FOR ANY MONTH IN WHICH AN INSTALLMENT PAYMENT AGREEMENT IS IN EFFECT.
IF WE ISSUE A NOTICE OF INTENT TO LEVY AND YOU DON'T PAY THE BALANCE DUE WITHIN
10 DAYS FROM THE DATE OF THE NOTICE, THE PENALTY INCREASES TO 1% A MONTH.
NOTE: WE WILL NOT REDUCE THE 1% FTP EVEN IF YOU FILED TIMELY AND HAVE A VALID
INSTALLMENT AGREEMENT.
TilE PENALTY CAN'T BE MORE THAN 25/; Of THE TAX PAID LATE. IF YOU THINK WE SHOULD
REMOVE OR REDUCE THE PENALTY, SEE "REMOVAL OF PENALTIES - REASONABLE CAUSE."
*
$109.81 INTEREST - IRC SECTION 6601
WE CHARGED INTEREST BECAUSE, ACCORDING TO OUR RECORDS, YOU DIDN'T PAY YOUR TAX ON
TIME. WE FIGURE INTEREST FROM THE DUE DATE OF YOUR RETURN (REGARDLESS OF
EXTENSIONS) TO THE DATE WE RECEIVE YOUR FULL PAYMENT OR THE DATE OF THIS NOTICE.
THE FOllOWING TABLE SHOWS THE TOTAL INTEREST CHARGES ON YOUR ACCOUNT. IT
MAY INCLUDE AMOUNTS CHARGED BEFORE THIS ADJUSTMENT. THE CALCULATION USED
FOR COMPUTING THIS INTEREST IS PRINCIPAL X FACTOR.
From Date
04/15/2001
OS/2812001
06/3012001
To Date
OS/28/2001
06/30/2001
09/03/2001
Days
43
33
65
Rate
6.0%
6.0%
7.0%
Factor
0.009466161
0.001256299
0.012542565
Total
Principal
5426.00
5520.10
5560.11
Interest~
Interest
51.39
40.07
69.74
161. 20
WE COMPOUND INTEREST DAILY EXCEPT ON LATE OR UNDERPAID ESTIMATED TAXES FOR
INDIVIDUALS OR CORPORATIONS.
WE CHARGE A SPECIAL INTEREST RATE OF 120 PERCENT OF THE UNDERPAYMENT RATE IF,
- THE RETURN, NOT INCLUDING EXTENSIONS, WAS DUE BEFORE JANUARY 1, 1990,
- THE UNDERPAYMENT WAS MORE THAN $1,000. AND
- THE UNOERPAYMENT CAME FROM A TAX-MOTIVATED TRANSACTION.
WE CHARGE INTEREST ON PENALTIES FOR LATE FILING, OVER OR UNDERSTATING VALUATIONS,
AND SUBSTANTIALLY UNDERSTATING THE TAX YOU OWE. ALSO, WE CHARGE INTEREST ON FRAUD
AND NEGLIGENCE PENALTIES IF THE TAX RETURNS, INCLUDING EXTENSIONS, ARE DUE AFTER
DECEMBER 31, 1966.
WE CONTINUE TO CHARGE INTEREST UNTIL YOU PAY THE AMOUNT YOU OWE IN FULL.
l! ADDITIONAL INTEREST CHARGES
IF THE AMOUNT YOU OWE IS $100,000 OR MORE, PLEASE MAKE SURE THAT WE RECEIVE YOUR
PAYMENT WITHIN 10 WORK DAYS FROM THE DATE OF YOUR NOTICE. IF THE AMOUNT YOU OWE IS
LESS THAN $100.000, PLEASE MAKE SURE THAT WE RECEIVE YOUR PAYMENT WITHIN 21 CALENDAR
DAYS FROM THE DATE OF YOUR NOTICE. IF WE DON'T RECEIVE FULL PAYMENT WITHIN THESE
TIME FRAMES, THE LAW REQUIRES US TO CHARGE INTEREST UNTIL YOU PAY THE FULL AMOUNT
YOU OWE.
INTEREST PAID
BEGINNING WITH TAX YEAR 1991. YOU CAN NO LONGER DEDUCT INTEREST YOU PAID TO THE
INTERNAL REVENUE SERVICE (IRS) AS AN ITEMIZED DEDUCTION ON YOUR FORM 1040, SCHEDULE A.
PAGE 2
PHILADELPHIA SERVICE CENTER
210-44-6962
TAX PERIOD, DEC. 31. 2000
-OTHER, THAN U.S. MAIL
INTERNAL REVENUE SERVICE
NET RATE INTEREST NETTING CLAIM
1160 WEST 1200 SOUTH
MAIL STOP 6800
OGDEN, UT 84201
FOR INTEREST YOU OWED THE IRS OR THAT THE IRS OWED YOU ON OR AFTER OCTOBER 1. 1998.
THE IRS WILL TAKE REASONABLE STEPS TO IDENTIFY THESE PERIODS AND APPLY THE NET
INTEREST RATE OF ZERO. HOWEVER. TO ENSURE THAT YOU RECEIVE THE NET INTEREST RATE
OF ZERO FOR OVERLAPPING PERIODS. YOU SHOULD FILE A FORM 843 FOLLOWING THE PROCEDURES
DESCRIBED ABOVE.
REMOVAL OF PENALTIES - REASONABLE CAUSE
THE LAW LETS US REMOVE OR REDUCE THE PENALTIES WE EXPLAIN IN THIS NOTICE IF YOU
HAVE AN ACCEPTABLE REASON. IF YOU 8ELIEVE YOU HAVE AN ACCEPTABLE REASON. YOU MAY
SEND US A SIGNED STATEMENT EXPLAINING YOUR REASON. WE WILL REVIEW IT AND LET YOU
KNOW IF WE ACCEPT YOUR EXPLANATION AS REASONABLE CAUSE TO REMOVE OR REDUCE YOUR
PENALTY. THIS PROCEDURE DOESN'T APPLY TO INTEREST AND. IN SOME CASFS. WE MAY ASK
YOU TO PAY THE TAX IN FULL BEFORE WE REDUCE OR REMOVE THE PENALTY FOR PAYING LATE.
ERRONEOUS WRITTEN ADVICE FROM IRS
WE WILL ALSO REMOVE YOUR PENALTY IF,
-YOU WROTE TO IRS AND ASKED FOR ADVICE ON A SPECIFIC ISSUE.
-YOU GAVE IRS COMPLETE AND ACCURATE INFORMATION.
-IRS WROTE BACK TO YOU AND GAVE YOU A SPECIFIC COURSE OF
ACTION TO TAKE OR EXPLAINED WHAT ACTIONS NOT TO TAKE.
-YOU FOLLOWED OUR WRITTEN ADVICE IN THE MANNER WE OUTLINED. AND
-YOU WERE PENALIZED FOR THE WRITTEN ADVICE WE GAVE YOU.
TO HAVE THE PENALTY REMOVED BECAUSE OF ERRONEOUS WRITTEN ADVICE FROM IRS.
YOU SHOULD,
-COMPLETE FORM 843, CLAIM FOR REFUND AND REQUEST FOR ABATEMENT,
-REQUEST THAT IRS REMOVE THE PENALTY, AND
-SEND FORM 843 TO THE IRS SERVICE CENTER WHERE YOU FILED YOUR
RETURN FOR THE YEAR YOU RELIED ON ERRONEOUS ADVICE FROM THE IRS.
THE THREE DOCUMENTS YOU MUST ATTACH TO YOUR FORM 843 ARE:
-A COpy OF YOUR ORIGINAL REQUEST FOR ADVICE FROM IRS.
-A COpy OF THE ERRONEOUS WRITTEN ADVICE FROM IRS, AND
-A NOTICE (IF ANY) SHOWING THE PENALTY WE CHARGED THAT
YOU NOW WISH US TO REMOVE.
RETURN THIS PART TO US WITH YOUR CHECK OR INQUIRY
YOUR TELEPHONE NUMBER BEST TIME TO CALL
( )
64.289
16221057439541
57.089
o
AMOUNT YOU OWE.................. .$5.357.05
LESS PAYMENTS NOT INCLUDED. $
PAY ADJUSTED AMOUNT........ $
200134
07,09
16254-999-05099-1
INTERNAL REVENUE SERVICE
PHILADELPHIA. PA 19255
WILLIAM P HERSHEY
62 SPRING GARDEN EST
CARLISLE PA 17013-9263620
21A
1..,11I,1....1.1.1.1..1.1,1..1.1
210446962 VO DODO 30 0 200012 670 00000535705
PHILADELPHIA SERVICE CENTER
210-44-6962
TAX PERIOD: DEC. 31, 2000
. INTEMEST REDUCED
IF WE REDUCE INTEREST THAT YOU PREVIOUSLY REPORTED AS A DEDUCTION ON YOUR TAX
RETURN, YOU MUST REPORT THIS REDUCTION OF INTEREST AS INCOME ON YOUR TAX RETURN
FOR THE YEAR WE REDUCE IT.
INTEREST REMOVED - ERRONEOUS REFUND
THE LAW REQUIRES US TO REMOVE INTEREST UP TO THE DATE WE REQUEST YOU TO REPAY
THE ERRONEOUS REFUND WHEN:
- YOU OION'T CAUSE THE ERRONEOUS REFUNO IN ANY WAY, AND
- THE REFUNO DOESN'T EXCEED $50,000.
THE IRS MAY REMOVE OR REDUCE INTEREST ON OTHER ERRONEOUS REFUNDS BASED ON THE
FACTS AND CIRCUMSTANCES INVOLVED IN EACH CASE.
ANNUAL INTEREST NETTING
EFFECTIVE JANUARY 1. 1987, THROUGH DECEMBER 31, 1998, THE INTEREST RATE WE PAID
ON THE OVERPAYMENT OF TAXES WAS 1% LESS THAN THE INTEREST RATE WE CHARGED ON THE
UNDERPAYMENT OF TAXES. AS OF JANUARY 1, 1999, THE OVERPAYMENT AND UNDERPAYMENT
RATES OF INTEREST THAT WE PAY AND CHARGE ARE THE SAME. EXCEPT FOR CORPORATE
OVERPAYMENTS. IF WE REFUND AN OVERPAYMENT WITH INTEREST AND WE HAVE TO INCREASE
THE TAX AT A LATER DATE, WE GIVE SPECIAL CONSIDERATION TO THE INTEREST ON THAT
ACCOUNT.
IlN THE TAX INCREASE MADE AFTER THE REFUND, WE WILL CHARGE THE LOWER REFUND
RATE OF INTEREST (UP TO THE AMOUNT OF THE REFUNDl FOR THE SAME TIME PERIOD THAT
WE PAID INTEREST ON THE OVERPAYMENT.
REQUEST FOR NET INTEREST RATE OF ZERO
GENERAL RULE - IF YOU OWE INTEREST TO THE IRS ON AN UNDERPAYMENT FOR THE SAME PERIOD
OF TIME THAT THE IRS OWES YOU INTEREST ON AN OVERPAYMENT, YOU MAY BE ENTITLED TO
RECEIVE A NET INTEREST RATE OF ZERO (THE SAME RATE OF INTEREST APPLIES TO YOUR UNDER-
PAYMENT AS YOUR OVERPAYMENT).
TO RECEIVE THE NET INTEREST RATE OF ZERO FOR INTEREST YOU OWEn (OR PAID) THE IRS, OR
INTEREST THAT WE OWED (OR PAIDl YOU BEFORE OCTOBER 1, 1998, YOU MUST FILE A FORM 843,
CLAIM FOR REFUNO AND REQUEST FOR ABATEMENT. FOR MORE INFORMATION ON THE FILING
REQUIREMENTS FOR THE FORM 843, SEE REVENUE PROCEOURE 99-43, 1999-47 I.R.B. 579.
REVENUE PROCEDURE 99-43 ANO FORM 843 ARE AVAILABLE ON THE WORLD WIDE WEB AT
WWW.IRS.USTREAS.GOV
TO QUALIFY FOR THE NET INTEREST RATE OF ZERO, THE PERIOD OF LIMITATION FOR CLAIMING A
REFUNO OF INTEREST ON AN UNOERPAYMENT AND THE PERIOD OF LIMITATION FOR CLAIMING
ADDITIONAL INTEREST ON AN OVERPAYMENT MUST HAVE BEEN OPEN ON JULY 22, 1998.
GENERALLY, THE PERIOO OF LIMITATION FOR CLAIMING A REFUND OF INTEREST ON AN UNDERPAY-
MENT IS 3 YEARS FROM THE TIME YOU FILED YOUR TAX RETURN, OR 2 YEARS FROM THE TIME
YOU PAID THE INTEREST, WHICHEVER IS LATER. THE PERIOD OF LIMITATION TO REQUEST
AODITIONAL INTEREST ON AN OVERPAYMENT IS 6 YEARS FROM THE OATE OF THE REFUND.
YOU MUST FILE FORM 843 ON OR BEFORE THE CLOSING DATE OF THE LATER STATUTE OF
LIMITATION PERIOD. MAIL FORM 843 TO:
U.S. MAIL
INTERNAL REVENUE SERVICE
NET RATE INTEREST NETTING CLAIM
P.O. BOX 9987
MAIL STOP 6800
OGDEN, UI 84409
PAGE 3
~ U<" <" lV \-CUll Y wa( me mtorm-anun here given IS correerty copIed tram ;1.n original certificate of death duly filed with me as
Local Registrar.' The original ceniflcue \\'ill be forwarded ro the State Vital Records Office tor permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
lI""~"""~ii
11/,r~~\.\H.QF pl;:t.~~._
f~Y~1'.f/.o'\,-
!/i,;....!l'.Iii.......... . '\; <':::'<-.'
Il~; .<,. . \~1
::''''''=',....:a '_,
!~II'}h' ,~~~
t*'~ . _" ,-', y.*~
'i. *,,, ;.. . "~/
..~A~~~l"
'---~rA/fNT U\~""",
~""",.""",,""J1JIIJ
'5:i',_~, ~tu.~~~
Local Registrar
Fee for this certificate, 52.00
P 7402195
JUN n;, 2 2001
Dace
Hl05_,<<~..... '191
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
P~INT
,
~Nli:NT
KINK NAMEQFOECEOENT(f"""M'''''",Le..\
UNOEII'YEA'"
N(l<lrll. 0..,.
UNOE"', o,o,y
I100n Minur..
Hershey
OATEOF!IllI.TIo\
(Mon1rID.av._'
'"
2.Kale
S1lVfFIU!NU"'~EIl
5OCtAl.SE:ClJMV~"
,. 210-44-6962
D#eOFOEATH(_, 010,\"""1
.. May 28. 2001
p
62 Spring Garden Estates
II. Carlisle, PA 17013
"",,"llf.A'SNAMElfinl,M_.l.uIl
,.. Lawrence A_ Hershey, Sr.
IN OfII""'NT"SN""'l yr;wPMQ 1
Mary J. Hune 1
~ET~OOftll ITION
IIIoIIal ~ C'MlIl""" 0 Rem<we\ln>mSW-O
OIl'...-($pecIy'
OECEOENl'"S
ACTUAL
AESrOEI'ICE
~,-""""".
~--
11',$1".
e:Fl/OuIQIl_~
:;::"'0
IT'I" 0
Dec 31.
..
POFOEATH
"'"
..."""'"
,......0
b.
FACILlTYNA~EllJnaI',*W\Ior1.g,.,.C1.._r.umbltl
BlM~Clii:{CdV_
SIPOfF.-gnCourCl'y)
Carlisle, PA
?
Cumberland
Carlisle
Carlisle Hospital
k. M.
l)E1(\"'S \iAl.OCCI.lPA.TION KINO BU~NIi:S$ljNOUSTIIV
~~~<l<>~~~"~ Party Outlet
I1t Fork11ft Driver 11 .
OECEOENT.SMAIUNOAOO/lESS($l,..._CtyfT"""_SIIl4l.IIflC<l<lI)
wo.SOECEOEI'lTEVElllN
IJ.:!L AAMEO'ORCES?
.....131 ~O
~ENT'SEOUC.o;I"lOlt
'-
(1-4Of5+)
"LSTATUS.W.l'fItd
,",*M~WiODloed.
--,
Divorced
South Middleton
SUflVlVlWQ SPOUSE
\Il.....~__J
l1b.eo....
""
-
~..
Cumberland -,;.,? n...D =~:::Ol
~'''mroE!'ly"\1~~'iS!,rt
INFO,IlMANT'SMAlUI'lOA o.qESS/Slrllll.~.SwII.l9~
20 S in Garden Estates. Carlisle. FA 17013
PLACEOFOlSPOSlTlOH. .....ol~.ry.C,.mllD'Y LOCAl"rQN. .~. CoOl
OtOl_~
lCenterville Merorial Park Newville, PA
N.O,MEAt40AOQ6f:SSOffACrLITY
22~.1.Ilg !jrotners Funeral Hare, Carlisle,
UCENSENlJ~8EA Ii:
1~,o.V."'l
n~......_1l'IeCI"
..,
"
I'Iv E ENSEE
/
'"
L
17241
FA
17013
OJQ"EP~UNCO AQ(MonL'1.D.a'l'_l
u M 21. May 28, '2001
21,"'ATI: Emer"'-cfj..._.ltlju....O'OCImpll<:.'oon......ic:nCII.....arr>.a....'h.oo""'.n'."....~olav..g..ucnu"."_Of~.rraol.Il\ocllOthH""'Me
Uelanlv......_on..oI1rine
, .
W'SCASEI'IEFEIIEOlO EOlCALEllAMlNE
...1lJ
...0
Occlusive Coronary Artery Disease
OUETO(OIIASACONSEOUENCEOf)
,ApIlra.imlle
:-~
~_.""""'"
n:O/lIeIolQIWIl<:lt'lt_~IO_.1\llI
MIl~"""'~_g;...,..l'IUlTI
OlJElO(OA-'SACONSEOUENCEOfl'
OUElO(OA ASACONSEQUEkC<:\P1:
..
WEREA PSVFINOINOS
1UlJ~!IUlPAIOATO
COtI.l'\.ETlOItOl'CAlJSE
OFOEAtH1
'-lANNEFlOFOEAl'H
CMfEOFII'tIUl'l.'<'
lMonlt1,~""r)
T\I\lECF1J'iJURY
IHJUIIVAT
"
OESCAIBEHOWINJUIlVOCCUIU!EO.
't.....al
!l
o
o
-~
p-....~
o
o "
O PlACEOf'lI'tIUflV,,oJ.IlOme.1."",11,,,,,,. Il000000olIIoI
tN-.g,..c,lSPIl>lvl
....
~ D NoD
...0
...0
-.
,,,. I...
Clll'Tll'lffl~""'v""'J
.CPTINlNQ""".ICIAJlII(Phyecer<.~_d__."""'..pi'1ve<:..,,....Pr""""rcldclMth.""."""~"""l3)
""'1l'IIo_0I"'Y_~,a."""_"'"llueIO....CI~M(.lellCl....n_..ot.Iec:I..
...~
N.
Coulclt1Olbedel_ined
Coroner
o
----
CMfE81GHEDIManm.
o 1.. J Ma 29
NAME AND AODflESS Of' PEASQf<I WI'lO COMPUrrEO CALISE OF OEJQ:H
l"1lITI271T'IlNafP'lnI Michael L. Norris, Coroner
6375 Basehore Road. Suite #1
Mechanicsbur , Pa. 11050
DATEFILEO(_.OI'1'~
-,
2001
'I"IIOHOLINClHGA~CllII'TII'YINQPHYSIClJlNIPhrsocOenbolllJlfo<'OUlll::ll'Q'""'nat<l~I<>'"'__..c_)
Ta..IIorM"'''''I'~,_1XC''''"It_"_.a..e.."apr"''e..''''a''''IO"...lyM(.II''''mln...r.....1ed
.tQ;DleAL DAMINI!NCOAONl!1'I
Ontht.....ot.._.".'kN>lIINUorlnYeetlptla<l,l<\myopimorl,c.llt1oc:.urredM'h.lI'".,...'.,.ndp'ace,.ncld...lOlhe_l.,"nd
_.._M.........., ,..........,..........................
31.,
i\E'1lST"-'WSSlDNATVAEANO
~".
~. ~tu..&..-t;
~,II;l,III()1
~.
.30 d,CO\
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SHORT CERTIFICATE
I,
MARY C. LEWIS
Register for the Probate of Wills and Granting
Letters of Administration &c. in and for said
County of CUMBERLAND do hereby certify that on
the 5th day of June A.D.,
Two Thousand and One,
'-
Letters
TESTAMENTARY
-
~
.'
in common form were granted by the Register of
said County, on the
, late of SOUTH MIDDLETON TOWNSHIP
estate of HERSHEY WILLIAM P
(LAOl, ~lKol, MluuL~j
in said county, deceased, to
BOLLENDORF BRENDA A
(LAol, ~lKol, MlUUL~)
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of said office at CARLISLE, PENNSYLVANIA, this 5th day of June
A.D., Two Thousand and One.
File No.
PA File No.
Date of Death
S.S. #
2001-00531
21-01-0531
5/28/2001
210-44-6962
~ (j ~ "b> ~~)
'f 41
Register
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL
LAST WILL AND TESTAMENT
OF
11
BEll KNOWN.\ltl,lV'//;'Cl..' f? 1I-er"Sh~'1
r<t",dJi" (fsl;':'i<5 c-<lr,IJ,"Collnly of C"H,b.,."r..,c!
, bei!li! ,olll1d mind, do l'wl;e and declare this to be my
expressly revol;;nQ ,ill my prillI' WiI!> ~Illd Clldici:S at uny tllne made.
, a resident of (;,.::1. oSf''- ''''1J
, in the State of ~ ~
Last Will ,md T,',lament
I. PERSONAL REl'UESENTATIVE:
I apPl,inl Dr^("YlJ<\ ,4- r3,'II~I,~~()yf: o1'b). S 1"""1' ...c,(el~", st.:tt.S
c..:::I'''' ,I. sloe. ~,/7"0.. as Per:;'JI1ul R"presentalivc uf this my Last Will and T<',slamcnl and provide if I '
111,\ f'nsollal Rl'J"cs,nt"livc is uuablc or unwilling to serve then 1 ,'ppoint
-z:-,,'It< I'" f" m ,1/ bn. "'~ ~ .. of c..... .-/,$)..... 1'",. . as
allcrnal\: P,:rs.jllal RCPlo.:',CIli.ltive, My Persona! Representalive shall he authorized to ".UT) ont aU
j" .,]vhi'1Ils .,,!Ilh Wil ;\nJ ['a:. my ju,.' dehts. ol'ligalion.s and funeral eXpt'nses I furlher provide my
ri.:f'~,on;11 RCPI'CS(i'.t;!tP.'c ~~kl1! Ik~l be'n.::quin:d tp po.';;l suret\- h,~l,\r j:t dw. ur ~::;~. !,'h'r H.,j..,fidjno. :md
llir(~lt lhatno ~,\I":n ~pprai"il b~ madc or my I,',"aW lI"!C":i IC'luirt'd by l~\~
,
, '
;1
i.
. '
,14':
II. (;l'ARDlAN:
In the cwnl 1 sh;,:1 ,Iic as the solt' parc'll of minor children, then I appoint "
as Guardian of ,aid minor children, If this nnJlled
Gumdian is un"blc or lIl1\nlling to S>:Irc, thcn l.\ppoint
a" alternatc Guardian,
I':
'I
I
!II HEQl!ESTS:
l direct that "ner payment or all my .i ,1st dcbts, my prop'~rty be bequcathed in thc manner
following:
,..
..... /.... e ((I,' e
-Co r3('~nc(('- 1'1 r)C'lle."lav F f1'\ Y he"., ~ c.....'t f.,)...
",,: G'i,
~:"~'~1
Sf,."i ilJ t:--'P,J<: 11 [sTc.t1:<.,> C C1 r Ii ~I ~ 14..., 1101 '].
I'1"J T L~l<Ve.. >>1'1 pr"F,r:; sllt\V;"'J"t" f:fn...,lc... 1"tOoll't."JetlT=
bJ... 5r~f";>1J {.-(\yc/~., tsTa.7:;-<~, carlIsi... 11'... 110/3
AY1J To t3 r't!',., J,.... 1-1 130/1<, \ J H P or {,A. >r,.."..... 'J [~Ct.,"Jtv1f [;5'ftl'f>: 5
(' C~1 I, ~ I ~~ i&. I'll' /3 1: Lee>." (" f.'tlf f'<'I'SC>1o(;L ( t,;. .tlC"'9 .- "'j; Cl.. " ,1 0." Y.
1J1C'1I'~1r. -c1'l\T "'''7 ~T'/I l;~ t'\<I,,",l 1;'" ,'1<.,'
Page .L "f _?__.
tv;::,~~g~~;;>-
Te~talor Signature ~
~c-:c ~ "fIIf'J1l1~. ~",f",,,.,.,.,... !.Ill'" ~.~... ....,,,.., ",...J ,j....<J 1,11 II1ll"1l< hl(;f1~':; Cfl$UI: i'l1i1WVl!f It vou (}rut ;tll"fornfa li1ness ~~f ",.~ purpooe ar.cl"n.
E-Z
t ~ F",m<; IlI'd u:e !claller 0'0..10;1"' ('('I m~()Slll'lIul,.':", or Wd:/<:II'IY. t:l~~"€SS or irrlj)llt'tt. ".r, ff)~~ tc 'r,e rfIF:'I::'.03f:l1Iblity t,j ~ 'Of,!", lor Qj' \11!endFK1II~""
or Pdt~
KIIJ7-IA
MilE,
'I -j1";'.~; :-.
, .':J'e
'j'
Execute and att~sl before a nO(llrv.
~ ' "'
Caution: Loui~la/la rcsidt'nts should consull an attorney before preparing a will.
:r- ev.:.cld.. Cd<t.. -Cc '''''-/.(~ vl.T.... -Clle<.':t. f'r'of,!" j/-ar;J 7$ <.</,"(;t...,
t"/""/;'1 ;4;.tct..~s Lr~ 0"cd''''nrJJ) ('F.h'<< L<>,-cc"t-<,( ih ,~.,:c.fJ("<n4..'tli
,,/ '7;/ /J
.!c.,t4~..c._I1:f~---
Test;Hor Signature /.,;;.---'
"
Page _L.:--~ Jf ..~.
. .. '1 l' . '. ~~(llii \_,j:; )'A..... '>I M' tIVl~llI)U 10'''1.5 lll/lll!>'ll ~ yo...r I"Kpr'!,I? <1.1<'1 l/506. f."~Z
P-~~fh. ~'i\': ~JJaer ~1~ria145~~mtfl~~~f,-~~~~ri~r (>\:~'(~~~~)lr ':~'r~~r'~~1 7rj,;~(;' If: !tie (l,HrdW,'_tlbilw ::,1 !hi" In~M ~llf """ ,l'U~"1o.rl ,...... ,",' ,,, .-.,..nA
KI07 iB
.t.
,
I
,
,:~
't"..,
':.'.'"
",
!
-?
IN WITNESS WHEREOF, , haVc' hereunto set my hand this
, Il/,l' ; { ,199 f" , to lhi~, illY LIst WiI! .mo Testament.
~t,i2~=- ~t.4"~~_
Testator Signature
I ?'I~ay of
i
,
,\
+
I
IV. WITNJ;~SSED:
,
The testator has signed Ihis will at ,he end and on each olher separate page, and has deda::td
or f>ignilicd in our prl,"enCt' thai il is hi;;/her last will and testament, and in the presence of Ihe testa-
lor and eiKh other we have hen:unlo subscribed our names this day of
19
flZttl..t'\"t ~lJxz(:r1.--
Witncss Signature
d:L~,4f<-4l!~~___ .-__'
Whness Signature
~""1.:~'Yl.J&.!::.~}!.~l'--~__
Williess S~~ture l.
_--.3Jj__J?:.>~"'.;......"_ C ,', c'\, \::.!;......._.
Address
(~~f'. ,
h2 5;'r, <<101e05 .€'sT r:Y..41"Ii/S
_..____._____,..p'--_."". .._____.._._____ <L
Address
~";.-"
"".
. '.:{
I';".
!C.
f
I'.
_2:L.z?e{'iJ'.fSb.;.~J2(.:...._(C< .-(. ?{-< ~
Address
tI ACKNOWLEDGMENT
Slate of r e:'{{'fl"-,.,(..v''>.f.//>\ }
, () ~
County of C VI",r:;"u....p,! g , ~
~;g:~(;Jf;"=~ ~;,d~~~~:J'~~,..1
the testato -Mid Ihe wilnesse', lespceli.-c!}, whose nam.:s ,Ire signed 10 the all.lehed ilod fOl'<.\oing
instrumcnt, were SWOln and declared to tI,e undersigned that the testator signed the instl1Jll1cnt as
his/her Last Wilt and Test,nncnt and that ca<:h of the witnesses. ill Ihe presence of the testator and each
~,ther, signe~ ~il~~t~~. :;, .
re~tator4..~.<:2'~.1$-..!.~ .:::::___ Witness; J!/1.L~ _
---- WinJess ~ ~
_ Witness; J*-~.ll.7~""j,t?.:^..!/ -Q..'---:' '."
1\ () a ')7 :> '" _..h r- '" N '-:>,\ \.. 't..:....-
On I-\(''''l-- AI (,I, before me. 'l->\<..<:.<'" A c... -', Ull' . ,
appeared -rf t v~ \ (;,.,." p. Idefu I:ff~
personally known to me (or proved to Ille on the basis of satisfactory evidence) to be the pcrson(s) whose
namc(s) is/an: subsctibeLl to the within instrument imll ircknowlcdged 10 l11e that helshclthey execlJted the
same in hislher/their anthori"ed capacily(ics), and thaI by his/her/their ~ignalllrc(s) on the ill,stnlfllcn( the
pcrson(s), or Ihe entity upon behalf of whieh the person(s) acted, elccul.:d tk instrument.
WITNES~,~~~offkial seoll. __ ,...
---t:- ~ --'--
~-..STgn"ture- - ___._____.____._
t.
....,
Notanal Sa;}l
8rClnda E. Snyder, Notary Public
Carl~~le Bora, Cumberland C01.IOly
My Commission ExplresJl.lty 2.1, 2000 3-
tlll' af "n.yvan it AS$CCI.afIOI'l, Cllftf.' c:. "Page _,__~_ of .,...___._'
? ''''rY''' (>, f . ,-- r,,'if c.! '-
,o;..r;:. V
C E-Z Legal form' 1992. n6kn~ you IJ:ot: l~l!~ Ivll~'. r'~;t(l ,., ""i in !r1i!11llanks Coo:J\JIt J :i:l\.\I'YEr II 'i'QU GOl.bt ~)fo! lorm'$ P!l16f;S br )"'.Iltr purpor.c;, al'd ujj,Il.
E.I
Le<;,al form' and the I'fJtai.." maJot.l m ffit.'r~:i'~I'I..d/CI1 Gr 'I";jfl<.tl'r,'. ~... ;,,'pI-I,.,..;w. ."..-..-t h.llhl. IIl1,~,;h"',19bjllfv ~Ilt~ 'orrr. 'Jf An illlellf'l9d use
or purpose
Aftiant. _+-:-!<rown____prOJuce~ ID~
Typ~ 01 ID ..IA-.j) L __--;--
(Seal)
KJOl.IC