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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE DEPT.
280601 HARRISBURG, PA 17128-0601
REV -1500 INHERITANCE
TAX RETURN RESIDENT DECEDENT
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SHAEFER, Har W.
DATE OF DEATH (MM-DD-YY) DATE OF BIRTH (MM-DD-YY)
5/12/2005 4/1/1925
(IF APPLICABLE) SURVIVING SPOUSE'S NAME
1]
OFFICIAL USE ONLY
FILE NUMBER
21-05-0560
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
175-24-8006
THIS MUST BE FILED IN DUPLlC TE
WITH THE REGISTER OF WILL
SOCIAL SECURITY NUMBER
1. Original Return 0 2. Supplemental Return
4. Limited Estate 0 4a. Future interest Compromise
6. Decedent Died Testate 0 7. Decedent had Living Trust
o 3. Remainder Return
o 5. Fed. Est. Tax Return Req'd
8. Total number of SDB's
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COMPLETE MAILING ADDRESS:
(8) $114,074.54
$14,172.24
$826.18
$14,998.42
$99,076.12
NAME:
Patricia R. Brown, Esquire
FIRM NAME:
Salzmann Hughes, PC
TELEPHONE NUMBER
717249-3024
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3.Closely Held Corporation, Partnership or Sole-Prop.
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Misc. Personal Prop.(Sch.E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Misc. Non-Propate Prop.
8. Total Gross Assets (total lines 1-7)
9. Funeral Expenses & Administration Costs (Sch H)
10. Debts of Decedent, Mortgage liabilities, & Liens
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 (13)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amnt of Line 14 taxable at the spousal rate,
or transfers under Sec.9116(a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
(1 )
(2)
(3)
(4)
(5)
(6)
(7)
(9)
(10)
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$0
$0
$99,076
$9,811.00
$35,813.54
$68.450.00
(11 )
(12)
Patricia R. Brown, Esq.
10 W. Pomfret St.
Carlisle, PA 17013
r'_')
$0.00
n
$99,076.12
x.O_
x.045
x.12
x.15
$0.0
$0.0
$0.0
$14,861.4
$14,861.4
(15)
(16)
(17)
(18)
(19)
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e~e ent's amp ete Ad ress:
STREET ADDRESS
3 Scenic Lane
CITY STATE ZIP
Newville PA 17241
Tax Payments and Credits:
1. Tax Due
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discounts
$14,861.42
(1 )
$13,800.00
690.00
$l4,490.00
(2)
Total Credits (A+B+C)
InteresUPenalty if applicable
D. Interest
E. Penalty
3.
(3)
(4)
(5) $37 .42
(5A)
(5B)
TotallnterestlPentalty (D+E)
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.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: yes no
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a. retain the use or income of the property transferred:
b. retain the right to designate who shall use the property transerred or its income:
c. retain a reversionary interest: or
d. retain the promise for life of either payments 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 fo(' 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 disignation?
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 a d complete.
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ADDRESS
SIG~AT7'5E~F PRE~ARER OT~~ THA~fEPRESENTATIVE
Y .?<--2....--..... c. -':--r f }'--7__~--J
ADDRESS
DATE i 0
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% [72P.S. Sec. 911f<a)(1.1 )(1)].
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 e ~. I)(ii)]. i
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosur< ,.l./~)C q 0 CJ 0 'en if the survivinp spouse is the
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only beneficiary.
For dates of death on or after July 1, 2000:
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)arent,
The tax rate imposed on the net value of transfers from a deseased child twenty-one years of age or younger at d.
or a stepparent of the child is 0% (72 P.S. Sec. 9116(a)(1.2)].
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:.9116(a)(1).
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%,
)2, as an
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. See
individual who has at least one parent in common with the decedent. whether by blood or adoption.
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I, HARRY W. SHAEFER, of Newville, Cumberland Coun~y,
Pennsylvania, declare this to be my last Will and revoke al~
prlor Wills and Codicils.
FIR S T:
I glve all my tangible personal prop rty
and any insurance thereon to TIMOTHY BARRICK and KAREN BARR CK,
or the survivor, who shall pick and choose such items as th y
desire.
S E CON D: All my remaining tangible persona
property not selected by TIMOTHY BARRICK and KAREN BARRICK shall
be sold and the net proceeds added to my residuary estate.
T H I R D:
A. I give the residue of my estate, real
and personal, in equal shares to TIMOTHY BARRICK
and KAREN I
me, then i~
BARRICK, or the survivor, and if both predecease
equal shares to the living children of the marriage of TIMO HY
BARRICK and KAREN BARRICK, who shall take per capita and not per
stirpes.
B. Any share of my residuary estate otherwise ble
to a beneficiary or more remote descendant who has
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age 18 shall be retained by my Executor as Trustee
trust for such beneficiary. This trust and any income there rom
may, in the sole discretion of Trustee, be used for the
beneficiary1s maintenance and education and any income if not so
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used shall be added to principal. All property in the trust
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shall be paid to the beneficiary at age 18. If the benefici~ry
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dies before age 18, all property in the trust shall be paid, Iper
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stirpes, to those of his issue who are his nearest of kin
(subject, however, to the provisions of this clause in the cases
of those under age 18) unless the beneficiary dies more thtn 21
years after the death of all his issue living at my death tn
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which event all such property shall be paid to his estate. \
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F 0 U R T H: No beneficiary may assign or tran~fer
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his interest under this Will or any Codicil hereto and no ~erson
with a claim against a beneficiary may reach any such inte1est
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before it is distributed to the beneficiary. I
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F I F T H: In addition to powers given them by !law,
all fiduciaries acting under this Will, whether or not nam'd
herein, shall have the following powers, applicable to all I
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property held by them, effective without Court order and un~il
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actual distribution: I
( a)
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without \
without refard
To retain any property received by themi
(b)
To invest in all forms of property
restriction to investments authorized by law and
to any principle of investment diversification;
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(c) To exchange or sell real or personal propertt
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publicly or privately without order of Court, for such pricts
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the i
and
on such terms as they deem proper without liability on
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purchasers to see to application of the purchase moneys; toilease
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for any term and to give options for these purposes without'
obligation to repudiate them in favor of a higher offer;
(d) To compromise controversies without order of Court
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or consent of any beneficiary;
(e) To hold investments in the name of a nominee;
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(f) To exercise any discretionary power to use
principal or income for a beneficiary by paying the benefibiary's
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expenses directly or by distributing funds to any person ot
organization they select to disburse the same for the
beneficiary's exclusive benefit; in like manner to payor
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distribute principal or income to which any beneficiary is I
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entitled if the fiduciary deems the beneficiary incapable 4f
receiving the same by reason of any illness, infirmity or ~egal
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incapacity; and to distribute to a minor notwithstanding m~nority
any principal or income which they have discretion hereund~r to
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use for a minor or to which a minor is entitled;
(g) To assume continuance of the status of any
beneficiary with reference to death, marriage, divorce, ill~ess,
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incapacity or other change In the absence of information dermed
reliable without liability for disbursements made on such
assumption;
(h) To exercise any option permitted by law to u~e
deductions for Estate or Income Tax purposes as my fiduciary
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deems advantageous of overall tax reduction even though thel
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effect may be to increase income at the expense of principai or
vice versa, and to make or not to make adjustments with reswect
thereto as my fiduciary, whose decision shall be conclusive!and
not subject to review by any Court, deems appropriate in vi~w of
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the nature of the transaction and the amounts involved; and
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(i) To employ and compensate such brokers, adviisors,
professional persons, and other agents as the fiduciary de~ms
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advantageous or as I may have directed, whether or not an '
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individual fiduciary hereunder performs the services or har any
pecuniary interest in the firm performing the services, wifhout
liability for payment of compensation at a higher rate that might
have been negotiated elsewhere and without diminution of aty such
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individual's fiduciary commissions hereunder.
S I X T H:
All taxes and interest and penaltie
together with all administration expenses thereon payable y
reason of my death with respect to property comprising my ross
taxable estate, whether or not passing under this Will, sh 11 be
paid from my residuary estate. Taxes on future interests ay be
prepaid.
S EVE NTH:
(a)
I appoint TIMOTHY BARRICK
Executor of this Will.
If he for any reason does not act or
continue to act, I appoint KAREN BARRICK Executrix in his place
with the same powers and duties. If she for any reason does not
act or continue to act, I appoint JOSHUA BARRICK Executor i her
place with the same powers and duties.
(b) No Executor, Trustee or Guardian acting
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Will shall be required to post Bond or enter security in ant
jurisdiction.
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under
this
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IN WITNESS WHEREOF, I have hereunto set my hand and
seal this I ~!+-h.
day of Novel'Y\ b.0r , 2004.
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SIGNED, SEALED, PUBLISHED AND DECLARED by the above named
Testator, HARRY W. SHAEFER, as and for his last will and
Testament, in the presence of us, who at his request, in
presence and in the presence of each other, have hereunto i
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subscribed our names as
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witnesses.
~ (1A.J'(J_u--~. hu'1t/'Iv~
I witness
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(SEAL)
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ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF C~lt ty\ bt..\/ I (Lr\c(
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I, HARRY W. SHAEFER, the Testator whose name is ~igned
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qualified according to law, do hereby acknowledge that I s~gned
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and executed the instrument as my last will; and that I si~ned it
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willingly and as my free and voluntary act for the purposes
to the attached or foregoing instrument, having been duly
therein expressed.
Sworn to or affirmed and acknowledged before me b
HARRY W. SHAEFER, the Testator, this f ,?-I11 day of NOv'.embt'1( , 2004.
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Andrea A Crider. Notary Public
Newville 801"0. Cwnbcrland County
My Commission Expires July 27. 2006
Member. Pennsylvania .~ssociation of Notaries
al\wL~,- (L. CA-liL t/\
NOTARY PUBLIC
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AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ClA-t'Y\ be.r- I<A-n c~
We ,-rhOYY\C\5 E, Gs~t \
and Bo..rl7tu-A.-1Y\ /'1'\ ,,,,,',-e r I the wi tj:nesses
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whose names are signed to the attached or foregoing instru~ent,
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being duly qualified according to law, do depose and say t~at we
were present and saw the testator sign and execute the ins~rument
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as his Last Willi that the testator signed willingly and e~ecuted
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it as his free and voluntary act for the purposes therein I
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expressed; that each subscribing witness in the hearing an9 sight
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of the testator signed the will as a witness; and that to t~e
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best of our knowledge the testator was at that time 18 or mbre
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years of age, of sound mind and under no constraint or influence.
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Sworn to or affirmed and subscribed to before me ~y
ThorY'to...s E. GSe.1l and Bo--V'bo..-ro.- IV) , (Y) l~(l',cr I witnesses I this /gfh day
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of
Residing at
, 2004.
td'6 (i(IJCM//'-- ,b;fl 'j/E
1'/1; 1/fA({&/ ~ &' ;4- / /.::? S )
f~iM~ ~, fL~
Wltness
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Resid ng at { Vd- 1/
MMONWEALTH OF PENNSYLVANIA
Nowial Seal
Andru A. Crider, Notary Public
NewviUe Boro, Cwnbcrland County
My Commiasion Expires July 27. 2006
M,mber, Pllnnllylvlnla AIsoclatlon of Notaries
(ly\d-~ (1. C\.0C1
Notary Public
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ESTATE
SCHEDULE D
MORTGAGES AND NOTES RECEIVABLE
Shaefer, Harry W.
(All property jOintly-owned with Right of Survivorship must be disclosed on Schedule F)
ITEM DESCRIPTION
NUMBER
Promissory Note (15 yr for $55,000.00 -8% interest)
TOTAL (also on line 4, Recapitulation)
"
File No. 21-05-0560
VALUE AT DA
OF DEA T
$9,8111
$9,8 1
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SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANIOUS PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
Sheafer, Hal cry W.
(All property jointly-owned with Right of Survivorship must be disclosed on Schedule F)
ITEM DESCRIPTION
NUMBER
21-05-0560
VALUE AT DATE
OF DEATH
Forethought Life Insurance Co ( Funera])
2 F & M Trust (Checking Acct.# 33-16610
3 F & M Trust Savings Acct.#08-008528
4 John Deere Gator (Farm A TV) 2001
5 ] 995 Blazer (Chevro]et)
6 John Deere Lawn Mower
7 Troybui]t Lawn Mower (2004)
8 Carport
9 Waste Management Refund
10 Sprint PCS Credit (Cell Phone)
11 Highmark B]ue Shield Refund
$7,054.27
$18,455.13
$682.97
$2,700.00
$2,000.00
$3,000.00
$500.00
$900.00
$8.05
$5.28
$507.84
TOTAL (also on line 5, Recapitulation)
$35,8]3.54
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SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE
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File Number: 21-05-0560
Shaefer, Harry W.
Joint Tenant (5):
NAME
ADDRESS
RELA TIONSHIP T
DECEDEN
A
B
C
Clara E. S. Roe
1 Longsdorf Drive, Carlisle, P A 17013
Sister
Jointly-owned property:
ITEM LETTER DATE DESCRIPTION OF TOTAL DECD'S DOLLAR VALUE OF
NUMBER FOR MADE PROPERTY VALUE % INT. DECEDENT'S
JOINT JOINT OF ASSET INTEREST
TENANT
1 A Oct. 2004 See Attached Deed 50% $68,450
Note: This property was purchased by
surviving joint tenant solely with her
funds for her brother Harry W. Shaefer
TOT AL (also on line 6, Recapitulation)
$68,450
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,:,,~:'103&'WAYNE'A.VENm;<;i ',';,c,;:;":',,:,:i:'
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Lisa Castellino, joined by her husband, Christopher W. Gergich, of 3 Scenic Lane, Newville, Pen~ylviffii:~ :"0
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1 7241 ______________________________________________________h____ (heremafter called the Grantors) of the one ~t aarl . \ -
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Harry W. Shaefer, single, and Clara E.S. Roe, single, as joint tenants with the right of survivorshipt.and riOt ~ ~j
as tenants in common _____m______________________m____________ (hereinafter called the Grantees), of the o~pa~;~ ',n '
This Indenture
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Made the J ).
day of DC./-uAJ. r--
,2004,
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Between
Witnesseth, that the said Grantors for and in consideration of the sum of One Hundred Thirty-Six
Thousand Nine Hundred And 00/100 Dollars ($136,900.00) lawful money of the United States of America,
unto them well and truly paid by the said Grantees, at or before the sealing and delivery hereof, the receipt
whereof is hereby acknowledged, have granted, bargained and sold, released and confirmed, and by these
presents do grant, bargain and sell, release and confirm unto the said Grantees, their heirs and assigns,
ALL the following tract of land lying, being, and situated in Lower Mifflin Township, Cumberland County,
Commonwealth of Pennsylvania, bounded and limited as follows:
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BEGINNING at a point in Shed Road (T-412) at a common property corner of Lot #24 and Lot #25 at a 50-
foot private access for Lots #25 and #27 as shown on the Preliminary/Final Subdivision Plan of Scenic View;
thence from said point of beginning along Shed Road (T-412), South 30 degrees 37 minutes 30 seconds East, a
distance of 50.56 feet to a point at a common corner of Lot #25 and Lot #26; thence through Shed Road and
along Lot #26, South 67 degrees 56 minutes 28 seconds West, a distance of 563.37 feet to a point at a common
property corner of Lot #25, Lot #26 and Lot #27; thence along a portion of Lot #27, North 21 degrees 30
minutes 00 seconds West, a distance of 24.54 feet to a point; thence continuing along Lot #27, South 67
degrees 31 minutes 53 seconds West, a distance of 162.92 feet to a point at a common property corner of Lot
#25, Lot #27 and Lot #19; thence along Lot #19, North 47 degrees 10 minutes 06 seconds West, a distance of
226.33 feet to a point at a common property corner of Lot #25, Lot #19 and Lot #20; thence along Lot #20 the
following three (3) courses: 1) North 39 degrees 30 minutes 35 seconds East, a distance of 152.08 feet to a
point; thence 2) North 09 degrees 17 minutes 22 seconds East, a distance of 178.87 feet to a point; thence 3)
North 63 degrees 30 minutes 55 seconds East, a distance of 75.43 feet to a point at a common property corner
of Lot #25 and Lot #22; thence along a portion of Lot #22 and Lot #23, South 26 degrees 29 minutes 05
seconds East, a distance of 228.87 feet to a point at a common property corner of Lot #25, Lot #23 and Lot
#24; thence along a portion of Lot #24, South 67 degrees 56 minutes 28 seconds West, a distance of 3259 feet
to a point at a common property corner of Lot #25 and Lot #24; thence continuing along Lot #24 the following
two (2) courses: 1) South 26 degrees 29 minutes 05 seconds East, a distance of 181.65 feet to a point; thence
along Lot #24 and through Shed Road (T-412), 2) North 67 degrees 56 minutes 28 seconds East, a distance of
513.4 7 feet to a point, said point being the place of beginning.
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BEING identified as Lot #25 as shown on a plan of lots prepared for Realand, Inc. by Hoover Engineering
Services, Inc., dated March 30, 2000 and recorded July 25, 2000 in the Office of the Recorder lof Deeds in
and for Cumberland County, Pennsylvania in Plan Book 81, at Page 93. :
THE ABOVE DESCRIBED REAL ESTATE is the same premises which Haubert Land and Itnprovement
Company, by its deed dated August 16, 2002 and recorded August 23, 2002 in the Office of the Recorder of
Deeds of Cumberland County, Pennsylvania in Deed Book 253, Page 1441, conveyed to Lis~ Castellino,
married woman. Lisa Castellino, joined by her husband, Christopher W. Gergich, are the Grantort herein.
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SUBJECT to all rights of way, conditions, easements, restrictions, and reservations of record. !
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THE SCRIVENER OF TillS INDENTURE (Keller, Keller, Frey and Beck, LLC) is in no way cedifying to the
status of the title of the above premises, and has not searched the records pertaining thereto.
Together with all and singular the buildings and improvements, ways, streets, alleys, driveways,
passages, waters, water-courses, rights, liberties, privileges, hereditaments and appurtenances, whatsoever
unto the hereby granted premises belonging, or in anywise appertaining, and the reversions and !remainders,
rents, issues, and profits thereof; and all the estate, right, title, interest, property, claim Jnd demand
whatsoever of them, the said grantors, as well at law as in equity, of, in and to the same. !
To have and to hold the said lot or piece of ground described above, with the bJildings and
improvements thereon erected, hereditaments and premises hereby granted, or mentioned and intended so to
be, with the appurtenances, unto the said Grantees, their heirs and assigns, to and for the only prqper use and
behoof of the said Grantees, their heirs and assigns, forever.
And the said Grantors, for themselves and their heirs, executors and administrators, do, by th~se presents,
covenant, grant and agree, to and with the said Grantees, their heirs and assigns, that they, the said Grantors,
and their heirs, all and singular the hereditaments and premises herein described and granted, or m~ntioned and
intended so to be, with the appurtenances, unto the said Grantees, their heirs and assigns, again~t them, the
said Grantors, and their heirs, and against all and every other person and persons whosoever law~lly claiming
or to claim the same or any part thereof, by, from or under him, her, it, or any of them, shall and till
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In Witness Whereof, the parties of the first part have hereunto set their hands and seals. Da.ed the day
and year first above written. I
Sealed and Delivered I
IN THE PRESENCE OF US: I
~
Lisa Castellino
: {SEAL}
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!
~ 7
Christopher W. Gergich
I
I_{SEAL}
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S71tir ar- Ncrz'771 crktcv iVlJ
r€eHlGl9R\','ealtk lilf PilHlsylnlsia
County of .ctunb,Illlftd /Vf?W }I~..,,(!Lss I
I
On this, the /271{ day of OC~ , 2004, before me, a Notary Pub1l' for the
Commonwealth of Pennsylvania, residing in the County of Cumberland, the undersigned Officer, ersonally
appeared Lisa Castellino and Christopher W. Gergich, known to me (or satisfactorily proven) 0 be the
persons whose names are subscribed to the within instrument, and acknowledged that they executed the same for
the purposes therein contained. I
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
ccO'tbtYL ~ ;;"~{J 7
BOOK 2.65' ,Dl~-3766
, I
, At. .
SCHEDULE H
FUNERAL EXPENSES, ADMINISTRATIVE
COSTS AND MISCELLANEOUS EXPENSES
ESTATE
File Number: 21-05-0560
Shaefer, Harry W.
(All property jointly-owned with Right of Survivorship must be disclosed on Schedule F)
A.
ITEM DESCRIPTION AMOUNT
NUMBER
Funeral Expenses:
I Ewing Brothers Funeral Home $7,417.80
Debits (Sentinel - Bucks Co), Service, Merchandise, Flowers, Death Certs.
2 Luncheon for Funder! Participants - Bonanza $320.00
3 Memorial Reception (Cumberland Corssings) $407.74
4 D'siris Holding ofPa (Opening/Closing Grave) $1,045.00
Administrative Costs:
1 Personal Representive Commissions
Social Security Number of Personal Representative:
2 Attorney fees to Patricia R. Brown Salzmann Hughes, PC $3,500.00
3 Family Exemption
Claimant Relationship:
Address of Claimant at decedent's death:
Street:
City: State & Zip
4 Probate Fees to Register of Wills $79.00
IPetition, Short Cert. Adv vertise: Cumberland Law Journal - Valley Ti $137.70
5
6
7 Misc. Filing Fees $50.00
8 Property -3 Scenic Lane
Newville, PA - Annual Grass Cutting Contract (2 acres) $1,200.00
9 F & M Trust - Charge to provide DOD Balance $15.00
10
11
12
13
TOTAL (also on line 9, Recapitulation) $14,172.24
8.
, ,. ....
SCHEDULE I
DEBTS OF DECEDENT
MORTGAGE LIABILITIES AND LIENS
ESTATE OF
FILE NUMBER
Shaefer, Harry W.
21-05-0560
ITEM
NUMBER
DESCRIPTION
AMOUNT
Visa Bill (4792 2227 9004 2735)
$82.50
2
Sprint (Phone Bill)
$33.68
3
Attorney Fees (Patricia R. Brown)
$710.00
TOTAL (also on line 10, Recapitulation)
$826.18
." ,.-4
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
Shaefer, Harry W. 21-05-0': 60
ITEM NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP AMOUNT OR SHA RE
NUMBER OF ESTATE
i
1 Timothy Barrick N/A 5b%
4817 Enola Road, Newville, P A 17241 i
2 Karen Barrick N/A 5b%
4817 Enola Road, Newville, P A 17241
ITEM NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHA RE
NUMBER OF ESTATE
B. Charitable and Governmental Bequests:
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (also enter on line 13, Recapitulation)