HomeMy WebLinkAbout01-0020
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of ELEANOR C. MUSSELMAN
also known as
Deceased.
Social Security No. 203-10-8128
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NO. (~I- ot-GOAD
TO:
Register of Wills for the County
of Cumberland in the Commonwealth of
Pennsylvania.
The petition of the undersigned respectfully represents that:
Your Petitioner is 18 years of age or older and the executrix named in the last will of the above
decedent, dated 27 September 1991 and codicil(s) dated nla.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with her last family ~r
principal residence at 222 Messiah Circle, Mechanicsburg, Pennsylvania. ['*\~ ~\le... \~W?)~
II Decedent, then 86 years of age, died on 8 February 2006, at Holy Spirit Hospital, Camp Hilt
Cumberland County, Pennsylvania.
Except as follows, decedent did not marry, was not divorced and did not have a child born or
adopted after execution of the will offered for probate; was not the victim of a killing and was never
I adjudicated incompetent: nla
Decedent at death owned property with estimated values as follows:
(if domiciled in Pa.) All personal property
(if not domiciled in Pa.) All personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
Situated as follows:
$1.037.000.00
$
$
$
WHEREFORE, Petitioner(s) respectfully request the probate of the last will and codicil(s)
presented herewith and the grant of letters testamentary. '
Signature and residences ofPetitioner(s):
, f ~ r ,,/.
" / l' ,~h"7 "j/
j;k< .~:~;J-~~ ~
Deborah L. Musselman
2304 Edgewood Road
Harrisburg, PAl 71 04
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEAL TH OF PENNSYLVANIA ) SSe
COUNTY OF CUMBERLAND )
The petitioner above-named swears or affirms that the statements in the foregoing petition are true
and correct to the best of the knowledge and belief of petitioner and that as personal representative of the
above decedent petitioner will well and truly administer the eft//rdiryo 1~~7? ..c:::,
Sworn to or affiImed and subscribed ,iif~ ~ /,/;/?:d;kfb?' ~~"'--
before me this ].. L day of Deborah L. Musselman I.? / " /
FCBKlA.~~~~ ' 2006. L"'\ 2304 Edgewood Road tlt~ ~;r~,~""2/~
\, I .' _, ", . '/; Harrisburg, PA 17104 1.0 ,-r;M
}J lU LdAl htU\L.I\lii.Ll~J{[ L {q /~// ~1J/?-/j
( Regi~ "r)' //4
'rtlW~'~,Y-HLtR\.'f )- .
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H IO::;;.SO:'i REV 1/0)
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.
No.
Fee for this certificate. $6.00
Local Registrar
P 12225651
Date
Rev.01Kl6
'RINTIN
ANENT
:KINK
1 Name of Decedent (First, middle, lasl)
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH STATE FILE NUMBER
3. Social Security Number
'7.03
10
c;LUO(Q
Cumberland
East Pennsboro
o Other-S ci
10, Race: American Indian, Black. White, etc.
(Specilyj
hite
:., 11 Decedent's Usual OCcu alion Kind of work done durin most of workin lile; do not stale retired
Kind of Work Kind 01 Businessllndustry
homemaker own home
Deceden!'s Ma~ing Address (Street, cityrtown. state. zip code)
222 Messiah Circle
Mechanicsburg, PA 17055
12.
hi hest radeco !eted
College (1.4 or 5+)
14 Marital Status: Married, Never married. 15. Surviving Spouse (il wile, give maiden name)
Widowed, Divorced (Specifyj
17b. County
Did Decedent
liveina 17C.)( Yes,Deceden!livedin TTpppr A 1 1 pn
Townsh~?
17d 0 No, Deceaenl Lived wllhin
,4.clualLimi!sof
Twp.
CitylBoro
18. Father's Name (Firsl, middte, tast)
19. Mother's Name (First, middle, maiden surname)
Raymond W. Sawyer, Sr.
Alma Trostle
Deborah L. Musselman
2Cb, tnforman['5 Mailing Address (Street, cityr'lown. stale, zip code)
2304 Edgewood Rd.Harrisburg, PA17104
lOa. Informant's Name (TypeJprint)
FD 013163 L
PA17043
Musselman FH&CS,324 Hummel Ave.,Lemoyne
22c. Name and Mdress of Facility
21d. Location (cpown. state, zip code)
Lower hHR1.rwp
21b. Date 01 Disposition (Month, day, year)
21c. Place of Dispos~ion (Name of cemelery, crematory or other place)
o ReroovalfromState
o Donation
Feb.11,2006
22b. License Nurrber
Slate Hill Cemeter
ete Items 23a-c only when certifying
physK:ian is nol available at lime 01 dealh to
certify cause 01 death
Items 24-26 must be co~leted by person
who pronounces death
death occurred althe ~me, date and place slaled. (Signature and title)
23b. License NulTiler
23c. Date Signed (Monlh, day, year)
: Approximaleinlef\lat.
: onset to death
26 Was Case Referred to a Medica! Examiner/Coroner?
o Yes )1\NO
Part II: Enter other sionificant cond~ions contributina to dq!lth,
bul not resulting In the underlying cause given in Part 1
28. Did Tobacco Use Contribute 10 Death?
DYes 0 Probably
,..'1( No 0 UnkooWl1
29. It Femate.
XNot pregnant within past year
o Pregnant atUme of death
o Not pregnant, but pregnant within 42 days
01 death
o Not pregnant. but pregnant 43 days 10 1 year
beforedealh
o Unknown if pregnant within the past year
32c_ Place of Injury: Home. Farm, Street, Fac1ory, Office
Building.elc, (Speci/yl
24
zD06
IMMEDIATE CAUSE (Final disease or
cond~ion resulting in death) ----7 a.
Sequentially list cond~ions, if any,
n leatfiillg to the cause listed on Line a
- Enler the UNDERLYING CAUSE
_ (disease or iniury that in~iated the
events resulting in death) LAST
b.
avcf f()L..-r
Due to (orasaconsequenceo~:
Due to (or as a consequence of):
d.
JOb. Were Autopsy Findings
Performed? Ava~able Prior to Completion
Yes )l No I of Cause of Death?
D~ DYes DNa
33a. Certifier (check only one)
Certifying physICian (Physician certifying cause of dealh.when another physician has pronounced death and COl'T'4'teled Item 23)
To the best of my koowledge, death occurred due to the cause{s) and manner as stated .......'"
Pronouncing and certifying physician (PhysICian both pronouncing death and certifying 10 cause 01 death)
To the best of my knowledge, death occurred at the time, dale, and place, and due to the cause{s) and manner as stated.",...
Medical examinerlcoroner
On the basis of examlnadon andlor lnvestlgation, in my opinion, death occurred at the time. date, and place, and due to the cause{s) and manner as stated ........0
36, Dale Filed (Month, day. year)
31. MannarofiJeath
>' Natural 0 Homicide
o Accnent 0 Pending Investigation
o Suicide 0 Cculd Not Be DeleftTtned
32a. Oateoflfljury (Month, day, year)
32b. Deserbe how Injury Occurred:
32d, Time of Injury
32e.lnjuryatWork?
DYes 0 Ne
321. 11 Transportatiofllnjury (Spedf)'l
o DriverlOperator 0 Passenger
o Pedestrian 0 Other - Specify:
33b. Signature and Title 01 Certifier
~~
33c. License Nurroer
32g. Location (Street, cityllown. state)
M
.....0
II , k.P
tftJ- tJ62.121-L
33d Dale Signed (Month, day, year)
1ft;( )
2.,')0(2
.. ................0
Fe.h.uav
1021/1....<1/1/1
34 Name and Address 01 Person Who Co~leted Cause of Death (lIem 27) TypelPrint
LE,uJe'E ;3-k!i<'I) !'f,p ,_'"
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No,~ - LI- ! ;(1),0
Estate of Eleanor C. Musselman, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW, r'l:J3f\UJl'R'-( i~ (j ,2006, in consideration ofthe Petition for Probate
and Grant of Letters, satisfactory proof having been presented to me, IT IS DECREED that the instrument
dated 27 September 1991 described therein be admitted to probate and filed of record as the last will of
Eleanor C. Musselman and Letters Testamentary are hereby granted to Deborah L. Musselman.
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I Register of Wills 'i)) { 11/\'/1-.=-.'; , I.: ..{'j A ~. h
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FEES
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Probate, Letters, Etc. ...........$ 'II L.I (
~ ., ',iIU_ $
~@al:!ftelaYeB...){ N................
\Yep~. It'f-
TOTAL
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, -7.
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$ r;5..~' c~ C
S . Ari
Attorney-at-Law (I.D. No. 17225)
525 North 12th Street
Lemoyne, P A 17043
(717) 761-5361
Short Certificates ( 3 )..........$ I ~ ' co
Filed
CRW/September 26, 1991/10192
1East ltIill aub Qestantent
OF
ELEANOR c. MUSSELMAN
I, ELEANOR c. MUSSELMAN, of the Township of Silver Spring, County of Cumberland, and
Commonwealth ot Pennsylvania, being of sound and disposing mimi, memory and understanding, do hereby
make, publish and declare this as and for my Last Will and Testament, hereby revoking all other Wills
heretofore made by me.
ARTICLE I
I direct the payment of my legal debts and the expenses of my last illness and disposition of my
remains from my estate as soon after my death as conveniently may be done. All of the foregoing shall be
considered expenses of the administration of my estate.
ARTICLE II
I bequeath all of my tangible personal property (excluding cash or securities), together with any
existing insurance thereon, to my daughters, DEBORAH MUSSELMAN GRIFFITHS, of Upper Allen
To\vnship, Cumberland County, PennGylv~nia, and P~\~'1ELA r,lUSSEL1\ff..N ROSEl'"~BLUI'~I, of r~ew
York, New York, share and share alike, to be divided between them as they may agree. In the event of
disagreement as to any item, such item shall pass in accordance with Article III hereof.
ARTICLE III
I devise and bequeath all of the residue of my estate to my daughters, DEBORA MUSSELMAN
GRIFFITHS and PAMELA MUSSELMAN ROSENBLUM, share and share alike. Provided that should
either of my daughters predecease me, I direct that the share of such deceased daughter shall pass to her
CRW/September 26, 1991/10192
issue per stirpes. In the event that a daughter shall predecease me without issue, the share of such deceased
daughter shall pass to my surviving daughter, or to her issue, per stirpes.
ARTICLE IV
I appoint my daughter, DEBORAH MUSSELMAN GRIFFITHS, Executrix of this my last Will.
In the event of her inability or unwillingness to act or continue to act as Executrix, I appoint my son-in-law,
DANIEL W. GRIFFITHS, Executor.
ARTICLE V
I direct that my Executrix, or her successors, shall not be required to give bond for the faithful
performance of their duties in any jurisdiction in which they may be called upon to act, insofar as I am able
by law to do so.
IN WITNESS WHEREOF, I hereunto set my hand and seal this Zlltt, day of September, 1991.
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Eleanor C. Mussleman '
. (SEAL)
Signed, sealed, published and declared by the above-named Testatrix as and for her Last Will and
Testament in the presence of us, who at her request, in her presence and in the presence of each other have
hereunto subscribed our names as witnesses.
iJ/ZLL l~I~~.::;...' --2
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CRW/September 26, 1991/10192
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
ss:
COUNTY OF CUMBERLAND
I, Eleanor C. Mussleman, Testatrix, whose name is signed to the foregoing instrument, having been
duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my Last
Will and Testament; that I signed it willingly; and that I signed it as my free and voluntary act for the
purposes therein expressed.
;;,- 0\ /-
----Ll. l~ nt<, C- (f) 'vv. ;0"';' L',I<:< <'._
Eleanor C. Musselman
Sworn or affirmed to and acknowledged before me, by Eleanor C. Musselman, the Testatrix, this
.,'<"
j 'day of September, 1991.
\-..
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Notary Public
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-------.-----J
NOTAR Pl StAL
OIANrlE U'I,G, NDT'\~Y PUBLiC
lEMOYNE BOR,). c.uMBERlANO co.
MY COMMISS\ON. EXPIRES DEC. 21, 1~93
CRW/September 26, 1991/10192
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss:
We, Co . ,Z ,~....,\,:: ,}'" y '1.. ,'\', and\'~ ~')"'\V" \:\ \1<' "1'- ..tX ,"~" the witnesses
::> ! , ..
whose names are signed to the foregoing instrument, being duly qualified accortting t~'iaw, do depose and
say that we were present and saw the Testatrix sign and execute the foregoing instrument as her Last Will
and Testament; that she signed willingly and that she executed it as her free and voluntary act for the
purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the Will as
witnesses; and that to the best of our knowledge, the Testatrix was at least 18 years of age, of sound mind
and under no constraint or undue influence.
~ L "
1. '_.__
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Sworn to or affirmed to and subscribed to before me by C. (), ,.... \.-\, ;,.~~ <r;r,";'''/j
\. '. ".
, witnesses, this ') I '1"aay of Septemo'er, 1991.
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Notary Public
NOTARIAL SEAL
DIANNE LENIG. NOTARY PUBLIC
LEMOINE. r;GRO. CUMBERLAND co.
MY COMmSS!I)N EXPfRES DEC. 21. 1993
--.--------
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Eleanor C. Musselman
Date of Death:
8 February 2006
Will No.
Admin. No. 2001-0020
To the Register:
I certify that notice of beneficial interest 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 1 March 2006
Name
Address
Deborah L. Musselman, 2304 Edgewood Road, Harrisburg, P A 17104
Pamela M. Rosenblum, 711 Amsterdam Avenue, New York, NY 10025
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None
Date:
'1 M ~J, 2.cN~
~JlQ~
Signatur't-
Name: Sa L. Andes
Address: 525 N. 12th Street, Lemoyne, PA 17043
Telephone: (717) 761-5361
Counsel for personal representative
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX( 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MUSSELMAN DEBORAH L
2309 EDGEWOOD ROAD
HARRISBURG, PA 17104
n______ fold
ESTATE INFORMATION: SSN: 203-10-81 28
FILE NUMBER: 2101-0020
DECEDENT NAME: MUSSELMAN ELEANOR C
DATE OF PAYMENT: 04/26/2006
POSTMARK DATE: 04/26/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 02/08/2006
NO. CD 006610
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $40,000.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$40,000.00
REMARKS: DEBORAH L MUSSELMAN
CHECK# 112
SEAL
INITIALS: CM
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
SAMUEL L. ANDES
ATTORNEY AT LAW
525 NORTH TWELFTH STREET
P. O. BOX 168
LEMOYNE,PENNSYLVANIA 17043
TELEPHONE
(717) 761-5361
25 April 2006
FAX
(717) 761-1435
Register of Wills
Cumberland County Court House
1 Courthouse Square
Carlisle, P A 17013
RE: Estate of Eleanor C. Musselman
No. 21-2001-0020
Ladies and Gentlemen:
I enclose a check for $40,000.00 to make a deposit against the inheritance tax owed in the
above estate. Please issue your receipt and mail it to my office at your convenience. Please call
my office if you have questions or need anything else.
Sincerely,
5~LAwLc,
Samuel L. Andes
Ie
Enclosure
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REV-1500 EX (r;.oO)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
OFFICIAL USE ONLY
FILE NUMBER
21-2001-0020
COlMY CODE
YEAR
~BER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
I-
Z Musselman, Eleanor C. 203-10-8128
W DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DlJPUCAIE WITH THE
C
W 02-08-2006 10-27-1919 REGISTER OF WILLS
0
W (IF APPLICABLE) SURV1V1NG SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
C
none n/a
LLJ o 1. Original Retum D 2. Supplemental Retum D 3. Remainder Return (dale 01_ JIior 1012-13-82)
~~en D 4. Umited Estate D 4a. Future Interest Compromise (dale or death after 12-12-82) D 5. Federal Estate Tax RetlJTl Required
c..>O::~
UJo..o D 6. Decedent Died Testate (Allam copy of Wil~ 0
:x: 00 7. Decedent Maintained a Uving Trust (Mach copy of Tf\5Q _ 8. Total Number of Safe Deposit Boxes
oO::...J
0.. CD
0.. D 9. Litigation Proceeds Received 010. Spousal Poverty Credit (date of death between 12-31-91 am 1-1-95) D 11. Election to tax under See. 9113(A) (AltachSchO)
<(
I- l"Hls SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: ."
z NAME COMPLETE MAILING ADDRESS
w
0 SAMUEL L. ANDES
z
0 FIRM NAME Of Appicable) P.O. BOX 168
0..
en
w LEMOYNE, PA 17043
0::
a:: TElEPHONE NUMBER
0 717-761-5361
0
1. Real Estate (Schedule A) (1) OFFICIAL IJ.SE ONLY
0 c::>
(~ ..:.:.?
2. Stocks and Bonds (Schedule B) (2) :::-=0 CT"
-~ ::0 (/) r -
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) C,L;-OO f"ll ,;
:~r- -u
4. Mortgages & Noles Receivable (Schedule D) (4) t7rTl ,
...c-~::o -.J ... ,
1,036,943.50 0')7' ,
5. Cash, Bank Deposits & Miscellaneoos Personal Property (5) (') (J \
-0
Z (Schedule E) ,:n ),0 -~~ l :JL
C-)C~ ~ ' )
0 6. Jointly Owned Property (Schedule F) (6) 3,352.69 ~ - ::u "-> ,'\
~ :_,)-1 ..
D Separate Billing Requested I;.-' N
.-
::::> 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
I- (Schedule G or L)
0: 8. Total Gross Assets (total Lines 1 - 7) (8) 1,040,296.19
<
0 9. Funeral Expenses & Adminis\rative Costs (Schedule H) (9) 17,150.65
W
c:: 10. Debts of Decedent, Mortgage Liabil~ies, & Liens (Schedule I) (10) 13,018.97
11. Total Deductions (total Lines 9 & 10) (11) 30,169.62
12. Net Value of Estate (Line 8 minus Line 11) (12) 1,010,126.57
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13) 0.00
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 1,010,126.57
SEE INSTRUCTIONS FOR APPUCABLE RATES
Z 15. Amount of Line 14 taxable at the spousal tax
Q
~ rate, or transfers lJ1der Sec. 9116 (a)(1.2) x .0_ (1S)
$1,010,126.57 X.O~ (16) $45,455.70
~ 16. Amount of Line 141axable at lineal rate
::::>
a. 17. Amount of Une 14 taxable at sibling rate X .12 (17)
:E
0 18. Amount of Une 14 taxable at collateral rate X .15 (18)
0
~ 19. Tax Due (19) $45,455.70
20. D I CHECK HERE IFYOU ARE REQUESTING AREFUND OFAN OVERPAYMENTl
SlFPA42021F.1
>>BESURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address:
STREET ADDRESS 222 Messiah Circle
CITY Mechanicsburg I STATE PA I ZIP 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) $45,455.70
$40,000.00
$2,000.00
Total Credits (A + B + C) (2) $42,000.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (0 + E) (3)
4. If Une 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 Une 1 + Une 3 is greater than Une 2, enter the difference. This is the TAX DUE. (S)
A. Enter the interest on the tax due.
(SA)
B. Enter the total ofUne5 + SA. This is the BALANCE DUE. (58) 3,455.70
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOVVlNG 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 I2r
b. retain the right to designate who shall use the property transferred or its income; . . . . . . . . . . . , . . . . . ., 0 'KI
c. retain a reversionary interest; or ............,'........... . . . . . . . . . . . . . . . . . . . , . . . . , . , . .. 0 ~
d. receive the promise for life of either payments, benefits or care? .............................,. 0 ~
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . . .. . .. . . . . . . . . . . .. . . , . .. . . . .. . .. , .. . .. . .. .. . .. . .. 0 ~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . . . .. 0 ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .. .. .. . .. .. . . .. .. .. . . .. .. .. . . .. . .. .. .. .. . .. . .. . . . . .. . .. 0 El
IF THE ANSWER TO Am OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjll)', I declare that I have examined this return, including accompanying schedules and statements, and to the best cJ my knowledge and belief, it is true, correct CI1d COJllllele.
Declaralioo of preparer othec1han the personal representative is based OIl all information of which preparer has any koo.vIedge.
SIGNATURE OF P:.~~0;~t:~NS~_~ FOR f~lre~~~'~(:7-e;.~,/,- ,/ Z,( ~ p~~ . ~/ ,:,: l
ADDRESS I '
!
17104
DATE .
7.<-
.... I... >
Samuel L. Andes, P.O. Box 168, Lemoyne, PA 17043
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) 0)].
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 exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even
if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child 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)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%, except as noted in 72 P.S. 99116(1.2) [72 P.S. 99116(a)(1)1.
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)1. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
STF PA42021F.2
REV-150B EX + (1-97) (I)
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
Musselman, Eleanor C.
21-2001-0020
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
Money Market Account and five mutual fund accounts held with ISI Financial Group,
Inc. as are more particularly described on the attached letter.
$1,036,943.50
TOTAL (Also enteron line 5, Recapitulation) $ 1,036,943.50
(If more space is needed, insert additional sheets of the same size)
STF P A42021 F.9
April 26, 2006
Samuel LAndes
525 North Twelfth Street
P.o. Box 168
Lemoyne, P A 17043
Dear Mr. Andes,
Enclosed, please the information you requested for the account of Eleanor
Musselman. The first item is the account value as of February 8, 2006.
You will note that this is on T.D. Waterhouse Institutional Services
letterhead due to the fact that they are the actual custodian of the funds.
Secondly, the account for Eleanor C. Musselman was an individual
account and her daughter Deborah Musselman was the power of attorney
on this account.
If you require any additional information, please give our office a call.
Sincerely,
~
Christine K. Weit
Director of Client Services
ISI Financial Group
Enclosure
.unrn/Jirlino finonria! spmritu fnr unll and fhnse who denend on Imll.
Waterhouse
Institutional Services
TD Waterhouse Institutional Services
100 Wall Street
New York, NY 10005
T:800-431-3500
ACCOUNT # 506-80226-1-4 ELEANOR C. MUSSELMAN
VALUE AS OF FEBRUARY 8, 2006
POR.TFOLIO POSITIONS LONG .>i
MARKET MARKET
PRICE VALUE
ACCT QUANTITY DESCRIPTION SYMBOL
I . CASH & CASH EQUIVALENTS I 1001
I CASH 15,632.18\TD WATERHOUSE MONEY MARKET CMFMZ 15,632.18
PORTFOLIO (SWEEP)
MUTUAL FUNDS
CASH 23,278.802 DF A FIVE YEAR GLOBAL FIXED DFGBX 10.23 238,142.14
INCOME PORTFOLIO
CASH 21301.46 DF A INVT DIMENSIONS GROUP DFGFX 9.82 209,180.33
INC- TWO YR GLOBAL FIXED INCOME
PORTFOLIO
CASH 11,859.205 SEI INSTL MANAGED TRUST TRMVX 21.73 257,700.52
LARGE CAPITAL VALUE PORTFOLIO
CASH 9,048.523 SEI INSTL MANAGED TRUST SELCX 20.01 181,060.94
LARGE CAP GROWTH PORTFOLIO
CASH 10,507.179 SEI INTERNATIONAL EQUITY SEITX 12.87 135,227.39
FUND CL A
TOTAL-MUTUAL FUNDS 1,021,311.32
TOT AL ACCOUNT 1,036,943.50
A division of TD Waterhouse Investor Services. Inl. Member NYSF/SIPC
National Headquarters: 100 Wall Street. New Y"rk. NY 10005
REV-1509 EX + (1-97) (I)
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
FILE NUMBER
Musselman, Eleanor C.
21-2001-0020
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVMNG JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. Deborah L. Musselman
2304 Edgewood Road, Harrisburg, PA 17104
Daughter
B.
c.
JOINTLY-OWNED PROPERTY:
lETTER DATE DESCRIPTION OF PROPERTY 'I, OF DATE OF DEATH
ITEM FOR JOINT MADE IWe name of finardallnslitliion arK! bariI account rumber or similar identifying number. DATE OF DEATH DECD'S VAlUE OF
NUMBER TENANT JOINT Attach deed for jointly-reld real estate. VAWE OF ASSET INTEREST DECEDENTS INTEREST
1. A. Checking account #50-0202-6215 with PNC Bank $6,705.38 50% $3,352.69
TOTAL (Also enter on line 6, Recapitulation) $ 3,352.69
(If more space is needed, insert additional sheets of the same size)
~TI:'p4..d?n?1J: in
REV-1511 EX + (1-97) (I)
COMMONWEALTH OF PENNSnVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
Musselman, Eleanor C.
21-2001-0020
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
Musselman Funeral Home, Lemoyne, PA (funeral expense) $5,000.00
Gingrich Memorials (gravemarker) $110.00
Pete's Cafe and The Bricker House (post-funeral reception) $1,075.90
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative( s)
Social Security Number(s) I EIN Number of Personal Representalive(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Attorney Fees SAMUEL L. ANDES $10,000.00
3. Family Exemption: (W decedent's address is not the same as c1aimanrs, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees Register of Wills $774.50
5. Accountanrs Fees
6. Tax Retum Preparer's Fees
7.
Cumberland Law Journal - advertising $75.00
Carlisle Sentinel - advertising $115.25
TOTAL (Also enter on line 9, Recapitulation) $ 17,150.65
..
(If more space is needed, Insert additIOnal sheets of the same size)
REV-1512 EX + (1-97) (I)
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
FILE NUMBER
Musselman, Eleanor C.
21-2001-0020
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
1.
U.S. Treasury - federal income tax for 2005
$1 ,191 .00
2.
PA Department of Revenue - state income tax for 2005
$6.00
3.
Messiah Village - final bill
$5,249.92
4.
Associated Cardiologists, P.C. - medical services
$74.11
5.
Bankcard Services - Visa card balance
$6,340.15
6.
Alert Pharmacy
$132.35
7.
AT&T - final phone bill
$14.82
8.
Verizon - final phone bill
$10.62
TOTAL (Also enter on line 10, Recapitulation) $ 13,018.97
(If more space is needed, insert additional sheets of the same size)
STF PA42021 F.13
REV-1513 EX + (9-DO)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
21-2001-0020
Musselman, Eleanor C.
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
1. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
1. Deborah L. Musselman Daughter 50%
2304 Edgewood Road
Harrisburg, PA 17104
2. Pamela M. Rosenblum
711 Amsterdam Avenue Daughter 50%
New York, NY 10025
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 BEl NG MADE
1.
none
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1. none
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ 0.00
..
(If more space is needed, Insert additional sheets of the same sIze)
STF P A42021 F.14
C:JMMONWEiCLTH OF PEP,NSYLVAr"IA
D=PiCRTMEIJT OF REVErJUE
BUREAU OF If\JDI\/IDUAL TAXES
DEFT 280601
hARRISBURG, PA 17128-0601
REV~1162 EX(11~96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ANDES SAMUEL L
525 NORTH 12TH STREET
LEMOYNE, PA 17043
ESTATE INFORMATION: SSN: 203-1 0~81 28
FILE NUMBER: 2101-0020
DECEDENT NAME: MUSSELMAN ELEANOR C
DATE OF PAYMENT: 09/07/2006
POSTMARK DATE: 09/07/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 02/08/2006
NO. CD 007178
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $3,455.70
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$3,455.70
REMARKS:
CHECI<# 119
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
10-17-2006
MUSSELMAN
02-08-2006
21 01-0020
CUMBERLAND
101
APPEAL DATE: 12-16-2006
( See reverse side under Objections)
Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
~~!_~~9~9_!~~~_~~~g______~___~~!~!~_~g~~~_~g~!!g~_Eg~_yg~~_~~~g~~~__~____________________
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ELEANOR C FILE NO. 21 01-0020 ACN 101
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
A~P~~:t~E"'E~T .'.. ,ALlOWANCE OR DISALLOWANCE
OF'iDE~HONSAND ASSESSHENT OF TAX
SAMUEL LANDES
PO BOX 168
LEMOYNE
DATE
C! 'STATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
PA 17043
ESTATE OF
MUSSELMAN
REV-1547 EX AFP (06-05)
ELEANOR
C
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
DATE 10-17-2006
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
.00 X 00 = .00
1,010,126.57 X 045 = 45,455.70
.00 X 12 = .00
.00 X 15 = .00
(19)= 45,455.70
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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
1.036.943.50
3.352.69
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
17,150.65
13.018.97
(11)
(12)
(13)
(14)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
1,040,296.19
30.169 62
1,010,126.57
.00
1,010,126.57
. .........., ... (+J AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
04-26-2006 CD006610 2,105.26 40,000.00
09-07-2006 CDOO7178 .00 3,455.70
INTEREST IS CHARGED THROUGH 11-01-2006 TOTAL TAX CREDIT 45,560.96
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 105.26CR
REVERSE SIDE OF THIS FORM INTEREST AND PEN. .00
TOTAL DUE 105.26CR
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
~I
( 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.)
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
r'-:(:'<"'X~H~~:(,{A:~E TAX
:'STATEMENT'QF ACCOUNT
.
, ~ i."
REV-1607 EX AFP (03-05)
SAMUEL LANDES
PO BOX 168
LEMOVNE
200S NOV 27 Pt.1 3:Dj(JE
ESTATE OF
CLERK Or- DATE OF DEATH
ORnUI\t\\,'e, (",r\IIRTFILE NUMBER
,r.....II..r...,i~.,J \..It.;'"', ''1I~UNTY
CUI.' t"". n'l :"'n-/-L
,,' ..... ,'j., AcN
11-13-2006
MUSSELMAN
02-08-2006
21 01-0020
CUMBERLAND
101
AIIount R_l Heel
ELEANOR
C
PA 17043
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO' COURT HOUSE
CARLISLEI PA 17013
NOTE: To insure proper credit to your accountl subBit the upper portIon of this fOrM with your tax P.~t.
CUT ALONG THIS LINE
... RETAIN LOWER PORTION FOR YOUR RECORDS ...
---------------------------------------------------------------------------
REV-1607 EX AFP (03-05)
.** INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF MUSSELMAN ELEANOR C FILE NO.21 01-0020 ACN 101 DATE 11-13-2006
THIS STATEItENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE HAltED ESTATE. SHONN BELOW
IS A SUlltARY OF THE PRINCIPAL TAX DUEl APPLICATION OF ALL PAYltENTSI THE CURRENT BALANCEI ANDI IF APPLICABLE I
A PROJECTED INTEREST FIUURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 10-10-2006
PRINCIPAL TAX DUE: 451455.70
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
04-26-2006 CD006610 21105.26 401000.00
09-07-2006 CD007178 .00 31455.70
10-24-2006 REFUND . .00 105.26-
TOTAL TAX CREDIT 451455.70
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
. IF PAID AFTER THIS DATEI SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $11
NO PA YltENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR) I
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FO," FOR INSTRUCTIONS. )
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Eleanor C. Musselman
Date of Death:
02-08-2006
Will No.
Admin. No. 21-01-0020
To the Register:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete: yesX no_
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
A. Did the personal representative file a final account with the
Court? Yes_ NolL-
B. The separate Orphans' Court No. (if any) for the personal
representative's account is:
C. Did the personal representative state an account informally to the
parties in interest? YesL No_
D. Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk of the Orphans' Court and
may be attached to this report.
Date: ~f \ } 07
'~gn~Jl
Name:
Address:
Samuel L. Andes
P.O. Box 168
Lemoyne, PA 17043
Telephone # 717 761-5361
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RELEASE
WHEREAS, Allfirst Trust Company of Pennsylvania, N.A., formerly known as Allfirst
Bank, formerly known as FMB Bank, Successor by merger to Dauphin Deposit Bank and Trust
Company, is the duly appointed Trustee under Agreement with Eleanor C. Musselman of
Cumberland County, Pennsylvania; and
WHEREAS, the said Trustee has submitted to the said Eleanor C. Musselman an account of
its Trusteeship, which has been examined and approved by the said Eleanor C. Musselman; and
WHEREAS, in order to save the expense and delay incident to filing said account in the
Orphans' Court Division of the Court of Common Pleas of Cumberland County and having the
same confirmed, the said Eleanor C. Musselman has requested her Trustee to make settlement
with her at once.
AND THEREFORE KNOW ALL MEN BY THESE PRESENTS that I, the said Eleanor C.
Musselman have this day had and received of and from Allfirst Trust Company of Pennsylvania,
N.A., formerly Allfirst Bank, formerly known as FMB Bank, Successor by merger to Dauphin
Deposit Bank and Trust Company, Trustee as aforesaid, the sum of One Hundred Eighty Two
Thousand, Six Hundred Ninety Five Dollars and Ten Cents ($182,695.10) in cash in full
settlement and satisfaction of all such sum or sums of money as are due me by reason of said
Trusteeship, and THEREFORE I DO BY THESE PRESENTS remise, release, quit-claim and
forever discharge the said Allfirst Trust Company of Pennsylvania, N.A., formerly Allfirst Bank,
formerly known as FMB Bank, Successor by merger to Dauphin Deposit Bank and Trust
Company, its successors and assigns, and of and from all actions, suits, payments, accounts,
reckonings, claims and demands whatsoever for or by reason thereof, or of and from all other
acts, matters, and things whatsoever including gross negligence, to the day of the date hereof.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 2b day of Ji ~...., /J
, 2000.~...A:~..
WITNESS:
jJU/1t G;I/~
r ,t'" ." i t"'n' I, ~(l "\"":;:t.-~
~~I~N.'/ \.. ..; l/.{'.,-,<- I (SEAL)
Eleanor C. Musselman
Notarial Seal
Dolores J. Metzler, Notary Pub:ic
Upper Allen !,wp., Cumberland County
My CommIssIon Expires May 10. 2004
Member, Pennsylvania ASsOC!fj.!L0nQf NQ:"!liJS
COMMONWEALTH OF PENNSYLVANIA )
) SS:
COUNTY OF CUMBERLAND )
On this, the1.fp~ay of pf.(!L/~V ,2000, before me, a Notary Public in
and for said State and County, personally appeared Eleanor C. Musselman, known to me (or
satisfactorily proven) to be the person whose name is subscribed to the foregoing Release and
acknowledged that she executed the same for the purposes therein contained and desires that the
same be recorded as such.
WITNESS my hand and Notarial Seal.
/J-~~71Y. ~
Notary Public ~
My Commission Expires:
Notarial Seal
Dolores J. Metzler. Notary Public
Upper Allen Twp., Cumberland County
My Commission Expires May 10. 2004
Member, PennsylVania AssoCIation 01 Nolarie~
iii allflrst
J.I ' o,,,,;lO c..-
Allfirst Trust
213 Market Street
Harrisburg, PA ]710]-2]27
7172552059
January 2, 2001
Cumberland County Courthouse
Register of Wills
1 Courthouse Square
Carlisle, P A 17013-3387
RE: Eleanor C. Musselman, Trustee uJa
Dear Sir or Madam:
Enclosed please find a Release to be recorded. We have also enclosed a copy of the Release to
be time stamped and returned to us in the self-addressed envelope provided. Our check for $7.00
is enclosed to record the Release.
If you have any questions, please feel free to contact me at (717) 231-6032.
Sincerely,
) / ((tty/'lo~~ ~+4..-
(Mrs.) M~ Alice Rodgers
Trust Associate
MAR/bb
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Enclosures
AFT-2007
~,