HomeMy WebLinkAbout01-1164
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of I~ /fl /tlJ; c) 5 ~.le /J}t
also known as
Register of Wills for the
County of CUMBERLAND in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut C Ii 5
in the last will of the above decede;, datej
and codicil(s) dated /2. :2;:) Of/
/
Social Security No. /6 b - =I,J.... .: Itbaffd.
No.
To:
2J-OI-1J64
named
,19_
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Oecendent was domiciled at death in t!.. t//17
h ,f~~(l, . last faJl1ily 9J. princi~I residence at
1./.--'4;/1 AJ./illv U",;., S~
(list street, number and muncipality)
Dec)D,den~ then 0 years of age, died O~_ . , tf//!J' ;)(/0/,
at LP- (;.). /A -) '),Ii /? (/
Except as follows, decedent id not marry, was not divorced and did not have a child born or adopted
after execution of th ill IfQer~.d. I for probate; was not the victim of a killing and was never adjudicated
incompetent: :/ AI
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
$
$
$
$
:3 Pi pc) O. t?t/
/
WHEREFORE, petitioner(s) respectfully
presented herewith and the grant of letters
of the last will and codicil(s)
theron.
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tlOn c.I.a.; administration d.b.n.c.t.a.)
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gH/t=LDS
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA I ss
COUNTY OF CU.rVll18R l ft-1.Jy J
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(') of the above decedent petitione,(,) will welI and lyadmin"t the e"at"),,ff~g to law.
Sworn to or affirmed and subscribed ~A ~ ~~ V)
before me this day of ~vJ~ 11. ~~~ i'
~
~
No. 21-01- 1164
Estate of
EMMA S SHIELDS
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW DECEMBER 2.1L__.._..-
_ xx.20UL, iI; cl;mici,::raliun,
I ~ . - 1 . , -, fi
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated December 20. 2000
described therein be admitted to probate and filed of record as the last will of
EMMA S SHIELDS
and Letters TESTAMENTARY
are hereby granted to WILLIAM THOMAS SHIELDS AND JOANNA E SHTET.nS
Yr}luyt2;f,<u_~AU~
Re ; er of Wills ' ~ 7 I
FEES
Probate, Letters, Etc. .........
Short Certificates( )..........
x-pagep .
RenunCIation ................
JCP
$
$
$
S 5.00
TOTAL _ $ 82.00
.DECEMBER.21... .2001..............
60.00
6.00
6.00
ATTOR~EY (Sup. C:. !.D. ~o.)
ADDRESS
Filed
PHONE
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~qUlll~)
ur:r~)
9Z: Qlti lZ 310 lO.
f)t3H
10')88
l' , (' C; __~'f\"
This is to certifY that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
No.
rfJLc/ldJi-Y1U(j/. ~1
Local Registraf
p
7915045
,,"\;.0
Ut0
Date
21-01~ 1164
H 105 ; 43 Rev 2/87
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
JPRINT
'.
U,NfNT
r;K INt(
v"
UN~~-r'-l'f!.~__
MOflthS ! Days
~FX
STATE ~'lE NUMBER
<;Cj('IAl SECURITY NUMBER
OA'EOFDfATH\Mcnlt1_nl'l~. ""alj
NAME OF DeCEDENT II 'f~I MIl1f1If' t itSlI
.. I1lma S. Shields
AGE II,l~ H"'''IHV)
-'--iiiR"TtipLAcu+;.;:;;;j--
3taloOl ~cfP'l:lnL04Jr,n'l.
2. Female ,. 166 - 32
.. 96
CQtJNTY OF OE,lJH
HOSPITAL
Inpal."cO
PLAC~_~E_~:"~~~.~K:I"."~_~_~I
.. Decembe~~
,~
E~ltenll....J
=1f'1)0
2/
... Cumber land
OECEDENl'S USUAL OCCUP,lJiON
(G,,,e klOOj oI'.WOfk I10ne dUrI"9 mOOr
of WOIklf'lQ IIf.; do not use fellfed J
RACE. Am.flC&n lndI.n, Black, Whlte_ ltlC
(Spec"",)
,.. White
SURVIVING SPOUSE
{II wole. ::JOve maodon rnvne)
,,,.Re istered Nur. llD.
OECEDENT"S MAILING ADDRESS lSl.~ C<lyrTown Sl.lIot.ll() COOP\
Mess5-ah V5.11aCle
100 Mt. Allen"Drive
'0. Mechanicsb r PA 1 0
FATHER'S NAMe tFlfst. Moddl&_ laSl)
'0. John Brown
INFORMANT'S NAME (T YPNPrlolj
~William Shields
METHOD OF OISPOSJTlON
BuNt Ql Cfem.lion 0 Remo<wal fforn Sla'. 0
Ottwf (Speclfyl.
17b.Counl'y
C>d
de<.-o
Mna
Cunberland lcWmiftip? 17d.D =~.:::.=of
MOTHER'S NAME IFlfSI. M'ddle, Mal(le(l Sutname)
",.,-
DATE OF DISPOSITION
(Month. Day. 'lMt)
D 210. December 19, 2001
E OR PER~TtNG AS SUCH LICE NSE NUMBER
,~. 21.& I 2_-?~ - L.-
b lhe be" 01 my knO)wledQo!l. dealh occurr8<j .lIthe time, dale and placlt s.alP-d
l'Sognatv.eano Tolle)
". Mar aret Cline
INFORMANT'S MAILING ADDRESS (SI,"I. Cltyfbwn, SIlIIe, Zip Code,
_. 3806 Copper Kettle Rj.
PLACE OF DISPOSITION - Name of Ceme(ery, Crematory
orOli,*P1~
n.
j ApproxImate
: inlerval between
I on~ and &I.1tt
,
:
..Il'l
2te:.
"..
TIME OF DEATH DATE PAONOUNCl:DOEAOlMol1th ['avo "ear)
u__ ______________ ,,_\\~5 "u ~u" JO__ \')\\5\Q\ __u_ _ __u__ .____
21. PART I: fnl.f the dlSfllI'VI'l. .nl'Jfte'l '.I' comphr ,)Ioon.. whl( h (.au~Pd ll1e (jP;,lh On no! f1nlm Ine mo". 01 <ly'nq_ ~"cll as r;l,l1oar. (}. rf!~V"::l!nry d"ll'if, shock 01 healt 'adurfl
llSlonlyoo.tcauMlonflllwl",..
PART II: Other sigrliflcant condiCions contributing to dealh, but
not ,.sunll'lg in 11M undettytng cauM ow.n in PAAT I
P"C'v", . ,,,,'
DUE TO lOA AS A CQNSEOUE NCE06~------~
( '-~I .>,)
( .' ( ) I,?~ .,., ) ( < I J11 (' h.
DUE TO(ORASA CClNSEQUfNCE OF)
d
'HERE AUTOPSY FINDINGS
AVAILABLE PRIOR TO
COMPLETION OF CAUSE
Of DEATH?
1
,
OUETOIORA.SACONS[aUE.NC[-~---~---'------~-----r--
.
~
TIME Of" IN.JURY
MANNER Of OE.ATH
Y$! LJ
NoLI
Nah;rlll Ill< Hom'CI€HI []
Ncldenl rJ f'ltOldlng InV'85'oq.all0n 11
s.u.c,de I J Could no1 be dete,mmO!'(! I 1
OAT E OF INJURY
i~(>r'!tl Oay ""a')
INJURY AT 'NOAK1 DESCRIBE HOW" INJURY OCCURRED
,.. D NoD
.PRONOUNCING AND CERTIFYING PHYSICIAN IPhySIC"''' t~,,1 ,'0"""'00;;"'<) <.1<',11" .J"d ct'<"'v'''tJ lo.,},,',e n' "p,,'hl
To Ihe be.t of my knowt.dg"', de...'" OCCUfred allhe time, dalf', ,nd plllce, .and due 10 the CaU5e(s) ..nd manner", "'atO!'(!
JO. JOb M, JOe, 3Od,
PLACE-6f:-it..iJURV :-AI-~~;-. i~.m. ~'f~ei_ !acl~, otiiC;- -~~L,OC... ,Q-Ki;'-l'5TrMtcotyrfowro. 518101
bu,k.fjnq,elc lSpac,t,,\
'Do
SIGNATURE AND TiTlE OF CERTIFIER "
11(1' "D. ~'?-~1L I) -- /- '----
LICENSE N BER . -'". IOAIE StGNEOlMonth. Oaf' ...,
[I".. (L-Oc-l'1'i'';S''~LI17 01
NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH
(IIem 27) Type or Prinl 1.-"-;'v .),-1 <.. l....
I -:)~. L-~':':> ,-..... rt. ;; ..--
(,-1:/'" ~l ;_..... 5 IJi'~ ('J :.\.( ~
[ J
a.. 21b.
CfATI'IEA ICr-eck oruv noel
'CIEATIFVINC PHYSICIAN tPhysl(;'i!o ~..'l"~""l ca,,~ (.J deilt" "'r"'P" _'''''1'''-'' l.Jh",;,( clr' t1.l~ tJ'0"()I,n("~ '1",~'" ,lI'O ~l.n(~H,'<1 "f>fn ,'31
fa the belt of ~'t' kl'lOwledoe, dell'h lJ'CcurrPd due 10 Ihe cau"..(., and manneo a" 51.led
'MEDICAL EXAMINER/CORONER
On the bl.lil or ...minIlJon andror ,nveslig.tion, in my op'mon, dealh occurred allhe- lime, dale. .and pia!:!!, ,lnd due 10 lhe Cau5e(s) and
Jt.mlnnef,u,talttd_. , . . . . . . ",.
RE~RA"SSiGNAiiJ"~:'Ni) ;''';''-B' ':, v'/} <:]) ,
,,~t!....:~1!::'}~~~Y,-,,"fe_t.. ~'7"
"
IOlllt7II~1
O,.,TE. FIlED IMonlh Day veal!
YJeu,Je1.- /\' 2001
J4 I
--"- -~----
21-01-1162
LAST ~ILL AND TESTAMENT
OF
EMMA S. SHIELDS
I, EMMA S. SHIELDS, of 100 Mt. Allen Drive, Mechanicsburg, Pennsylvania, being of
sound mind, memory and understanding do make, publish and declare the following to be my
LAST WILL AND TESTAMENT, hereby revoking all Wills and Codicils by me, at any time,
heretofore made.
FffiST: I direct my Co-Executors, as hereinafter named, to pay all my just debts and
funeral expenses as soon as convenient after my death.
SECOND: I give, devise and bequeath my engagement and wedding ring to my
granddaughter, BETH ANN LOUCKS SHANNON.
THmD: I direct that all personal or household gifts given to me by my children shall be
returned to the child who gave me said gift. All the remaining household furnishings and personal
possessions shall be divided equally between my four (4) children as hereinafter named, with the
Co-Executors herein named to have the final decision as to which child shall receive which items.
FOURTH: All the rest, residue and remainder of my estate, real, personal or mixed,
whatsoever or wheresoever situate, of which I die seized, possessed or entitled to, in four (4)
equal shares, share and share alike, as follows:
a. One-fourth (1/4) share to the natural children of my daughter, BEVERLY ANN
MORRISON;
b. One-fourth (1/4) share to my daughter, MARILYN JEAN LOUCKS;
c. One-fourth (1/4) share to my daughter, JANICE ELIZABETH GUSHEE; and
d. One-fourth (1/4) share to my son, WILLIAM THOMAS SHIELDS.
In the event that any of my children should predecease me, I hereby give, devise and
bequeath the deceased child's share of my estate to his or her surviving child or children.
SIXTH: I hereby name, nominate, constitute and appoint as Co-Executors of this, my
LAST WILL AND TESTAMENT, MARILYN JEAN LOUCKS and WILLIAM THOMAS
SHIELDS. Iffor any reason MARILYN JEAN LOUCKS cannot serve as Co-Executor, I then
name my daughter-in-law, JOANNA E. SHIELDS, to be Co-Executor.
"
I do hereby exonerate my said Co-Executors from giving bond for the faithful
performance of their duties as such, and I hereby authorize and empower my said Co-Executors at
any and all times from the time of my decease, to assign, bargain, sell, convey, transfer, invest,
reinvest, lease or otherwise dispose of and deal with all the property of my estate, real and
personal during their administration, and to execute, acknowledge and deliver any and all
conveyances and instruments which may be necessary or convenient to fully execute the powers
conferred upon them without application or report to a court for leave or confirmation.
I do also confer upon said Co-Executors full power and authority in the settlement of my
estate, to compound, compromise, settle and adjust any and all claims and demands in favor of or
against my estate. for such sums and upon such terms of credit and in such manner as my Co-
Executors shall deem best, and generally to do any and all things deemed by them necessary or
advantageous to my estate or conducive to the beneficent administration thereof.
IN WITNESS WHEREOF, I, EMMA S. SHIELDS ,the Testatrix above named, have
hereunto subscribed my name to the preceding sheets and subscribed my name and affixed my seal
to this sheet, this d r day of ~
, 2000. . f
- ,T /1:/.';' ...;'1 'l.,
r! (' , //!. l,<-" "--'
...: Y I / !-t-.
"-4$r1"oV'Y' "-' -'
Emma S. Shields
We, whose names are hereby subscribed, do hereby certify that on the
day
of
, 2000, the above and foregoing Will, consisting of two pages,
was subscribed by EMMA S. SHIELDS, Testatrix, in our presence and at the time of subscribing
said Will, the Testatrix did publish and declare said Will to be her LAST WILL AND
TESTAMENT, and each of us, at the request of the said Testatrix, and in her presence and in the
presence of each other, did sign said Will as witnesses thereto, and that each of us is of the
opinion that the said Testatrix is now of age and sound and disposing mind and memory.
residing at
residing at
COMMONWEALTH OF PENNSYLVANIA
)
COUNTY OF BLAIR
) SS:
)
WE, EMMA S. SHIELDS,
, and
, the Testatrix and the witnesses, respectively, whose
names are signed to the foregoing Will, being first duly sworn according to law, do depose and
say that the Testatrix signed and executed the foregoing instrument as her Will, that she
signed willingly, that she executed it as her free and voluntary act for the purposes therein
expressed, that each of the witnesses, in the presence and hearing of the Testatrix , signed the
Will as witnesses and that to the best of the knowledge of each of them, the Testatrix was at
that time eighteen (18) years of age or older, of sound mind and under no constraint or undue
influence.
'';F... /
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Z. ) ~/c't_ ~~ > y
.
Emma S. Shields
~. (} / {'
/~:..,/t-t..-L'[;::' ~,
<-It ;/1-
Witness
Y? "S-r.-OjJJ (2A.) /::tC-.,
Witness
Subscribed, sworn to and acknowledged before me by EMMA S. SHIELDS, the
Testatrix, and subscribed and sworn to before me by witnesses, this ~() tt<... day of
~,2000.
0~Yh.~
Notary Public
My Commission Expires
Notarial Seal
Karen M. Turner, Notary Public
Upper Allen Twp., Cumberland County
My Commission Expires May 29, 2004
Mamoer. Pennsylvania Association of Notanes
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2J -01- 1164
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
codicil
(each) a subscn . g witness to the will presented herewith, (each) b .ng duly qualified according to
law, depose(s) and s s) that present and saw
the testat__. sign the sam
request of testat_ in h
other subscribing witness(es)).
signed as a witness at the
presence of each other) (in the presence of the
(Name)
~...
'~ress)
.....,
..."'.....
(Name) ,
(Address)
'----
~GISTER OF WILLS OF ~-B0ZLIfND COUNTY
OATH OF NON-SUBSCRIBING WITNESS
(each) a subscriber hereto. (each) being duly qualified according to law. depose(s) and say(s) that
VV [ A1<'E:: familiar with the signature of [4yJ 1Yl/\ 0111 E::L r::>.5 ,
test~ of . the ~ pr~s~nted herewith and
that VV S believe{> the signature on t~e~ the handwriting of
E1V\M A___~th~D5
to the best of _ OUJ<. - knowledge and belief. I; () /2 ----r-- ~;:; 4/
Sworn to or affirmJ:d and sllbscrih~d before fA) ~[~ / ~Jj
j)'U'iS Z-i ~I ~d;;;rl lBo' (Nam!l:/J;; /{/ fA", J/~
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21-01-1164
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: ~mmo S. Sh:i E'l d S
Date of Death: ~ i:i ! 0 1
np~pmhpr 15/7001
Will No. 2001 01 1 64
Admin. No. 21 01 1 1 61
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on 2 / 1 3 /02
Name Marilyn J". Loucks
Address 1 011 6 Berrymeade Pl. Glen Allen, VA2306C
Janice E. Gushee
2104 Post Rd. Vienna, VA 22181
Martin P. Morrison
72214 Colerain/Mt. Pleasant Rd Colerain,OH43916
Kathy B. Morrison
2600 Brouse ST N.W. Uniontown, OH 44685
Prill 1 To, Morri!":on
2950 17th ~t. ROlllopr,ro H0104
William T. Shields
3806 Copper Kettle Rd. Camp Hill, PA 17011
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
None
Date: 2 " 1 3 / 0 2
Signatur
(
Name William T. Shields
Joanna E. Shields COExecutors
A~re~806 Copper Kettle Rd.
Camp Hill, PA 17011
Telephone V 1 7) 76 1 - 7 7 7 4
:0
Capacity: --X- Personal Representative
("1
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_Counsel for personal representative
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IMPORTANT NOTICE
NOTICE OF ESTATE ADMINISTRATION
THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE
ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE.
Whl'lhn you will J"el'\:i,,' ;1I1Y l1l\ll1l'Y or property will he deter-
mined wholly or partly by the de.:edent's will. If the uc.:edent
died without a wilL whether you will receive any money or prop- _,
erty will be determined by the intestacy laws of Pennsylvania.
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA
In re Estate of Emma S. Shields
, deceased,
Estate No. 21 - 0 1 -1 1 64
(Name and Address)
Marilyn J. Loucks 10116 Berrymeade Place Glen Allen, VA 23060
TO~anice E. Gushee 2104 Post Rd. Vienna. VA 22181
William T. Shields 3806 Copper Kettle Rd. Camp Hill, PA 17011
Martin P. Morrison 72214 Colerain-Mt Pleasant Rd. Colerain, OH 43916
Kathy B. Morrison 2600 Brouse st. N.W. Uniontown, OH 44685
Paul L. Morrison 2950- 17th st. Boulder, CO 80304
Please take notice of the death of de.:edent and the grant of Iellers to the personal representative(s) named hel(l
William T & Joanna E Shields CoExecutors
3806 Copper Kettle Rd. Camp Hill, PA 17011
The Decedent Emma S. Shields , died on the~__
day of December ,2001, at Cumberland County,
Pennsylvania. 100 Mt. Allen Dr Mechanicsburg, PA 17055
X The Decedent died testate (with a Will); or
The Decedent died intestate (without a Will).
~.:
The personal representative of the Decedent is
(name, address and tdephone number).
William T & Joanna Eo Shields CoExecutors
3806 Copper Kettle Rd. Camp Hi~PA 17011
Phone (717) 761-7774
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SHIELDS WILLIAM THOMAS
3806 COPPER KETTLE ROAD
CAMP HILL, PA 117011
_n___u fold
ESTATE INFORMATION: SSN: 166-32-4268
FILE NUMBER: 2101-1164
DECEDENT NAME: SHIELDS EMMA S
DATE OF PAYMENT: 03/04/2002
POSTMARK DATE: 0010010000
COUNTY: CUMBERLAND
DATE OF DEATH: 1 2/ 1 5/ 200 1
NO. CD 000915
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,876.06
I
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I
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I
I
TOTAL AMOUNT PAID:
$1,876.06
REMARKS: WILLIAM SHIELDS
CHECK# 8
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
(/
STATUS REPORT UNDER RULE 6.12
Name of Decedent: f "1 fYJ /1 5 S ~ Ie /1J
Date of Death: )J- / Jr: / (J )
j /
Will No. J- 1'- 0) ~ / / 'Y Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
1.
State~ether administration of the estate is complete:
Yes No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal repr~entative file a final
account with the Court? Yes No ~.
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative stat~an
account informally to the parties in interest? Yes ~ No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date:3/'!/CJ)- ,(. y~ ~
7 S~~~t:fL. .) 1Jj~-
lJ; 1//~./7) r~7)( . {
Name (Please type or print)
~r::;r:Jr~ ;( ~RF e-"y jI fa
! (: , v~:J ) J, C-) 17/</
Capacity: ~personal Representative
Counsel for personal
representative
(MAH:rmf/AM3)
\, /?-02?-":v
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
'02
fjDO 10
H J \. -'
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
("I :;ciidNTY
ACN
04-15-2002
SHIELDS
12-15-2001
21 01-1164
CUMBERLAND
101
WILLIAM T SHIELDS
3806 COPPER KETTLE RD
CAMP HILL PA 17011 l;;~
Clan".
*
REV-1547 EX AFP [01-02)
EMMA
S
Allount Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
ifEV = i5'4j-EX-AFP-('OY:O 2Y-NoT'icE"-OF-YNHEififANcrT'Air APPRAisE i..-iNT-:--ALi.-OWANCE-OR'----------- - -----
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF SHIELDS EMMA S FILE NO. 21 01-1164 ACN 101 DATE 04-15-2002
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Hortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
U)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
62,849.58
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequestsj Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
UO)
10,604.62
8.360.40
(11)
(2)
(3)
(4)
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
62,849.58
18.965 02
43,884.56
.00
43,884.56
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate
16. Allount of Line 14 taxable at Lineal/Class A rate
17. Allount of Line 14 at Sibling rate
18. Allount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
US) .00 X 00 = .00
(6) 43,884.56 X 045 = 1,974.80
(7) .00 X 12 = .00
(8) .00 X 15 = .00
(9)= 1,974.80
...~... ft~~~~' . \+J AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
03-04-2002 CDOO0915 98.74 1,876.06
TOTAL TAX CREDIT 1,974.80
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
RESERVATION: Estates of decedents dying on or before December 12, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE:
To fulfill the requirements of Section 2140 of the Inheritance and Estate Tax Act, Act 23 of 2000. (72 P.S.
Section 9140 J.
PAYMENT:
Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side.
--Make check or money order payable to: REGISTER OF HILLS. AGENT
REFUND (CR):
A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications are available at the Office
of the Register of Wills, any of the 23 Revenue District Offices, or by calling the special 24-hour
answering service for forms ordering: 1-800-362-2050; services for taxpayers with special hearing and I or
speaking needs: 1-800-447-3020 (TT only).
OBJECTIONS:
Any party in interest not satisfied with the appraisement, allowance, or disallowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-1021, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
ADMIN-
ISTRA TIVE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
DISCOUNT:
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of
the tax paid is allowed.
PENALTY:
The 15% tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
INTEREST:
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1982 through 2002 are:
Year Interest Rate Daily Interest Factor Year Interest Rate Daily Interest Factor
1982 20% .000548 1992 9% .000247
1983 16% .000438 1993-1994 7% .000192
1984 11% .000301 1995-1998 9% .000247
1985 13% .000356 1999 7% .000192
1986 10% .000274 2000 8% .000219
1987 9% .000247 2001 9% .000247
1988-1991 11% .000301 2002 6% .000164
--Interest is calcula.ted asofollo.ws~
INTEREST : BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
RE""--,,,-OO'
REV-1500
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I-
Z
W
o
W
o
W
o
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
DATE OF DEATH (MM-DD-YEAR)
DATE OF BIRTH (MM-DD-YEAR)
N.A.
w
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::.:::$00
u"''''
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",00
U"'-'
,,-al
"-
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~ 1. Original Return
o 4. Limited Estate
06. Decedent Died Testate (Attach copy ofWillj
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (date o/death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy of Trusl)
o 10. Spousal Poverty Credit (daleofdeathbetwee~ 12-31.91 and 1-1-95)
C:,:;::'jr'",\L U:~;C
c..
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m lJ:All,'')
FILE NUMBER
_2l - ~1_
COUNTY CODE YEAR
--1LQ4_ _ _
NUMBER
SOCIAL SECURITY NUMBER
166-
32 - 4268
THIS RETURN MUST BE FilED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return {date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (AtlachSch0)
NAME
William T. & Joanna E. Shields
FIRM NAME (If Applicable)
,..,
z
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COMPLETE MAILING ADDRESS
3806 Copper Kettle Rd.
Camp Hill, PA 17011-1418
TELEPHONE NUMBER
(717) 761-7774
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
h?Adq <;R
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....
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3 Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule OJ
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule GorL)
(7)
(6)
8 Total Gross Assets (total Lines 1-7)
9 Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
(9)
(10)
10.604.62
8,360.40
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)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
Z 15. Amount of Line 14 taxable at the spousal tax
0
!;( rate, or transfers under Sec. 9116 (a)(1.2)
I-' 16. Amount of Line 14 taxable at lineal rate
::::l
0.. 17. Amount of Line 14 taxable at sibling rate
:E
0 18. Amount of Line 14 taxable at collateral rate
0
>< 19. Tax Due
~ 0
20.
~r
;::....J....I
i-OFFICIAL USE ONLY l
1i3
t"
:5
[.
I
-1:0.
"',~
'---
(8)
h?R4q <;A
(11)
(12)
(13)
1 A 0(.;.1; II?
.
43,884.56
(14)
43,884.56
x .0 (15)
x .0 45.- (16) 1 q7d An
x .12 (17)
x .15 (18)
(19)
-----
Decedent's Complete Address:
STREET ADDRESS
100 Mt. Allen Dr.
STATE
PA
ZIP 17055
CITY
Mechanicsbur
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount 5 %
(1)
1.974.80
Total Credits (A + B + C) (2)
qR 74
3. InteresUPenatty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty ( 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)
1.876.06
B. Enter the total of Line 5 + SA. This is the BALANCE DUE.
(5)
(SA)
(5B)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
1.876.06
Make Check Payable to: REGISTER OF WILLS, AGENT
'.'V'-"\:r~ ill. if -"[IT' 111W_11I_IJ;lIlIli'-!Ulnlllr!r1111l11H'IIf!I~ Iii! 11' 'I:rI_~1I11ri1ll'lI1\llll'~!
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;....... . .............. . ..... 0 [!l
b. retain the right to designate who shall use the property transferred or its income;. . . 0 ~
c. retain a reversionary interest; or....... ......... .... . .... 0 [X]
d. receive the promise for life of either payments, benefits or care? .... .. ... 0 [Xl
2. If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration? .. .. 0 [Xl
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .......... . 0 ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary deSignation? ... . ... 0 ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return. including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct
and complete.
Declaration of preparer other than the personal representative is based on all information ofwhi reparer as any knowledge
I DATE
ADDRESS
3806 Copper Kettle Rd. Camp Hill, PA 17011-1418
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
DATE
ADDRESS
'",,"Yorlf;.,,_._mAlilm"'iWi!IiIlkrnWRW'2&W'"YMl''",,1'''''''k_Y'!\lY~4''''''-\f''-'''~ilI1\llll'ilI1\llll'll!Ii'll!IlIlJl'--"""'e"01'm"ml'il"-"cl'W1!"",,,
fi!u:n\1)ll!\!'itk"A:tr\L,X\ltMl1'M1:0ln"_tS%~~fll)J:~1'!0m~~?li~5fY;H(;iJ''l.;.dW:!j1tt;p,~"~&'l@".:"&1),1:\lJ'M}lffi'ljT1:S'<'HrNFt04:WA~Jffi\ ,^,' ." . .j .,jl., Wa:;f\V0V>f>>,XIl@tKth>0:-;Fv01;mw
"J30'.SlKtl4li!11l#11,lml
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. 99116 (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. 99116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child IS 0% [72 P.S. 99116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries IS 4.5%, except as noted in 72 PS. 99116(1.2) [72 P.S. 99116(a)(I)].
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. 99116(a)(1.3)]. A sibling IS defined, under Section 9102, as ar
individual who has at least one parent in common with the decedent, whether by blood or adoption.
Charles Schwab Trade Confirmation-Customer Copy ReI."" For Yo"r Record,
1 01 Mo'nlgDo,',;y Street, SaD F raDeiseo, CA 94104
Visil our Web site al schwab.com
Questions? Call 1-800-435-4000
Mail To
Account Number: 1821-3643
Page 1 of 1
l MFA <6 ooonl174 000000002282 0001 20011218
EMMA S SHIELDS
3806 COPPER KETTLE RD
CAMP Hit t PA 17011
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LORD ABBETT BOND
DEBENTURE FUND CL A
Cash Divs/Cash Cap Gains
AcNon SOLD
Symbol: LBNDX
Security No./Cuslp: 544004-10-4
Branch Code: HGYY
Trade Date: 12/17/01
Settlement Date: 12/20/01
Type: Margin.
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Total Amount !!
$61,724.35
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I Security Description
Quantitv
7,862.974
Price
$7.85
PrinciDBI
$61,724.35
Fees & Charoes
N/A
For all of the above:
Unless you have already instructed us differently, we will: hold proceeds in account pending further instructions.
Executed by fund
Unsolicited trade
Capacity code A
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Thank you for investing with Charles Schwab.
@2000CharlesSchwab & Co., Inc. Member SIPC/NYSE, Please see reverse for terms. conditions and capacity code definifions.
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REV-1504 EX+ (1-97)
~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C
CLOSELY-HELD CORPORATION,
PARTNERSHIP OR
SOLE-PROPRIETORSHIP
ESTATE OF
Emma S. Shields
FILE NUMBER
21-01-1164
Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a
sole-proprietors_hip. See instructions for the supporting information to be submitted for sole-proprietorships.
ITEM NUMBER
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
No None
TOTAL (Also enter on line 3, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
~-15OllH-I~r1)
..
COMMONWEAL TH OF PENNSYl VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT -.._
-
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Emma.n S. Shields
Indude the pmceeds of litigation and the date the proceeds were received by the estate. All property jolnUy-owned with the right of survivorship must be disclosed on Schedule F.
FILE NUMBER
21-01-1164
ITEM
NUMBER
1.
DESCRIPTION
Deposits See Schedule B
VALUE AT DATE
OF DEATH
62,849.58
;
T
i Bank
i
~.'*
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
~""~m'I;''',.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Emma S. Shields
FILE NUMBER
21-01-1164
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of sUlVivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
Bank Deposits See Schedule B
VALUE AT DATE
OF DEATH
62,849.58
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
.
REV-1511 EX+ (12-99)
.~:.J'i'~
~~~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Emma S. Shields
FILE NUMBER
21-01-1164
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES: 6,017.00
1
Stevens Mortuary, Altoona, PA Receipt Attached
Calvary Cemetery, Altoona, PA Receipt Attached 960.00
B ADMINISTRATIVE COSTS: 3,345.62
1 Personal Representative's Commissions
Name of Personal Representative{s) William T. & Joanna E. Shields
Social Security Number(s)/EIN Number of Personal Representative(s) 177 ,n ,ll'h
Street Address 3806 Copper Kettle Rd.
City~<!~ill -_________.__State~~_zip 17011-141
Year(s) Commission Paid: 2002
2. Attorney Fees 200.00
3. Family Exemption: (If decedent's address is not the same as claimant's. attach explanation)
Claimant
Street Address
City ---_______ Stale___Zip
Relationship of Claimant to Decedent
Probate Fees ,
4. 82.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $10,604.62
(II more space is needed, insert additional sheets of the same size)
."EVIS12EX-!1-Si1 ....)..
..'.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
ESTATE OF
Emma S. Shields
FILE NUMBER
21-01-1164
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
1.
Messiah Village Charges 11/1/01 Thru 12/15/01
RX Cost, Funeral Flowers, Church, other costs
W.T. Shields out of pocket expenses, Family Meal
Short Certificates 12/26/01 and 2/27/02
Ad Legal Notices, Patriot News 233.06 Cum Co Law Joura~
75.00
7,153.23
383.99
497.12
18.00
308.06
TOTAL (Also enter on line 10, Recapitulation) $ R < "n A n
(If more space IS needed, Insert additional sheets of the same size)
'MESSIAH VILLAGE STATEMENT
lO,Q Mt. "A lien Drive
P.O. Box :J.ulS
M~crantcsr-lllrg, PA 170552015
(717) 697 .'666
Resident EMMA 5 SHIELDS
Resident Number Date
000070006 12/21/2001
Page Amount Due
1 7,153.23
Discharge Date 12/1512001
B
I WILLIAM SHIELDS
L 3806 COPPER KETTLE ROAD
L CAMP HILL. PA 17011
T
o
Date I ,"
-
Description
Charge.
Credit.
Tol8l
Beginning Balance
12/01/2001
12/01/2001
OUTSIDE PHARMACY CHARGE
ROOM & BOARD - SEMI-PVT
14 DAYS AT 160.00 PER DAY
BARBER/BEAUTY SHOP
10.23
2,240.00
11.00
4,892.00
4,902.23
7,142.23
7,153.23
12/05/2001
.
~\>~
~ ~ '\~' " ,,-~
" vS" /
. '.-'
.... "
"
.'
,.
"
"
,.
nt Past 31.60 Days 61.90 Days 91.120 Days Over 120 Total Due EMMA S SHIELD
61.231 Due
4,89200 000 000 7,153.23
Statement End Date:
12/21/2001
~'~
MESSIAH VILLAGE STATEMENT
lQOMt :, Allen Drive
P,O, Box 2015
Me~hariicsburg, PA 170552015
(717) 697 4666
Resident: EMMA S SHIELDS
Resident Number Date
000070006 11/30/2001
Page Amount Due
1 4,892,00
B
I WILLIAM SHIELDS
L 3806 COPPER KETTLE ROAD
L CAMP HILL. PA 17011
T
o
Date ~=I..
-
Description
11/01/2001
11/01/2001
Beginning Balance
OUTSIDE PHARMACY CHARGE
MEDICAL
ORTHODERM MATTRESS
ROOM & BOARD - SEMI-PVT
30 DAYS AT 160,00 PER DAY
BARBER/BEAUTY SHOP
PAYMENT RECEIVED - THANK YOU!
BARBER/BEAUTY SHOP
Charges Credits Total
4,988.65
10.00 4,998.65
60,00 5,058.65
4,800.00 9,858.65
11.00 9,869.65
-4,988.65 '4,881.00
11.00 4,892.00
11/01/2001
11/07/2001
11/19/2001
11/20/2001
31-60 Days
61-90 Days
91-120 Days
Over 120
Total Due
EMMA S SHIELD
0.00
0.00
0.00
4,892.00
1% FIN
Statement End Date:
11/30/2001
REV.1513~X +.11-97:""
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Emma S. Shields
NUMBER
I.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outnght spousal distributions)
1.
(1) Marilyn J. Loucks
(2) Janice E Gushee
(3) William T. Shields
(5) Martin P. Morrison
(6) Kathy B. Morrison
(7) Paul L. Morrison
FILE NUMBER
21-01-1164
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
Daughter 25%
Daughter 25%
Son 25%
Grandchild 8.33%
Grandchild 8.33%
Grandchild 8.33%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABDVE ON LINES 15 THROUGH 17, 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 II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
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Ms. Kay Drawbaugh
Classified Legals
The Patriot - Evening News
Post Office Box 2265
HarriSburg. PA 17105
Re: Estate of Emma S _ Shields
100 Mt Allen Drive
Mechanicsburg, PA 17055
Dear Ms. Drawbaugh:
<
Enclosed herewith please tind an Estate Notice to be published once a week for the next
three (3) consecutive wceks in your newspapcr. Upon receipt of your invoice and proof of
publication. T will promptly remit payment.
Thank you for you assistance in this matter. Should you have any questions, please contact
the undersigned.
Very truly yours,
William T Shields Executor
3806 Copper Kettle Rd.
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Enclosurc
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Ms. Kay Drawbaugh
Classified Legals
The Patriot - Evening News
Post Office Box 2265
HarriSburg, PA 17105
Re: Estate of Emma S. Shields
100 Mt Allen Drive
Mechanicsburg, PA 17055
Dear Ms. Drawbaugh:
,
Enclosed herewith please find an Estate Notice to be published once a week for the next
three (3) consecutive weeks in your newspaper. Upon receipt of your invoice and proof of
publication, I will promptly remit payment.
Thank you for you assistance in this matter. Should you have any questions, please contact
the undersigned.
Very truly yours,
William T Shields Executor
3806 Copper Kettle Rd.
Camp Hill, PA 17011-1418
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Date 2 / 1 2 /02
Cumberland County Law Journal
II East High Street
Carlisle, PA 17013
''Re: Estate of Emma S. Shields
100 Mt Allen Drive
Mechanicsburg,PA 17055
Dear Sirs:
Enclosed herewith please find an Estate Notice to be published once a week for the next
three (3) consecutive weeks in your newspaper. Also enclosed is my check in the amount of
$75.00, covering the cost of the advertisement. Upon final publication, please provide this office
with proof of publication.
"
Thank you for you assistance in this matter. Should you have any questions, please contact
the undersigned.
Enclosure
Very truly yours,
William T @ Joanna E Shields
Co Executors
3806 Copper Kettle Rd.
Camp Hill, PA 17011-1418
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ESTATE NOTICE
NOTICE IS HEREBY GIVEN that Letters Testamentary have been
granted in the Estate of Emma S. Shields, late of
100 Mt Allen Dr. Mechanicsburg ,CumberlandCounty,
Pennsylvania, who died on Dpl"pmhpr 1 c; , 2001 to
William T & Joanna E Shield~ of3806 Copper Kettle Rd. C,mp Hill,PA 17011
Cumberland County, Pennsylvania 17070.
!'w,
All persons indebted to the said estate are required to make payment,
and those having claims or demands to present the same without
delay to the Executrix or her attorney named below.
, Executor
Executor Address
Executor Telephone No.
William T & Joanna E Shields
Co Executors
3806 Copper Kettle Rd.
Camp Hill, PA 17011-1418
Phone (717) 761-7774
.