HomeMy WebLinkAbout06-08-06
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REV-15GO EX (6-00)
,
REV-1500
OFFICIP.:L. USE ONLY
'*' COMMONWEALTH OF
PENNSYLVANIA
, DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21 05
0951
COUNTY CODE YEAR
NUMBER
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
DRAKSLER, JOHN J.
SOCIAL SECURITY NUMBER
164-34-6456
DATE OF BIRTH (MM-DD-YEAR)
03/04/41
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
DATE OF DEATH (MM-DD-YEAR)
10/03/05
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
~ 1. Original Return
D 4. Limited Estate
o 6. Decedent Died Testate (Attach copy ofWUI)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (dale of dealll after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copy otTrust)
D 10. Spousal Poverty Credit (oate of dealh between 12-31-91 and 1.1-95)
D 3. Remainder Return (date of death plior to 12-13-82)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (At.llChSch0)
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NAME
Andrew C. Sheely, Esquire
FIRM NAME (If Appicable)
Andrew C. Sheely, Attorney at Law
TELEPHONE NUMBER
(717) 697-7050
COMPLETE MAILING ADDRESS
Andrew C. Sheely, Esquire
127 South Market Street
P.O. Box 95
Mechanicsburg, PA 17055
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1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses &AdministraUve Costs (Schedule H) (9)
10. Debts of Decedent. Mortgage Liabilities. & Liens (Schedule I) (10)
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)
11,586.02
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13,700.78
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2,909.76
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94,104.63
122,301.19
(8)
12,243.77
5,007.76
(11)
(12)
(13)
17,251.53
105,049.66
(14)
105,049.66
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a}(1.2)
x.O _ (15)
105.049.66 x.O ~ (16)
4,727.23
16. Amount of line 14 taxable at lineal rate
x .12
(17)
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
x .15 (18)
19. Tax Due
(19)
4.727.23
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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Decedent's Complete Address:
,
STREET ADDRESS
1107 Rana Villa Avenue
Apartment 6
CITY Camp Hill I STATEpA I ZIP
17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
4,727.23
Total Credits (A + B + C ) (2)
3, Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4, If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due.
(5A)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
4,727,23
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Ves
a. retain the use or income of the property transferred;.......................................................................................... 0
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0
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
No
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Under penalties of perjury, I dedare that I have examined this return, induding accompanying sdledues 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 of whidl prepare( has any knowledge.
SIGNATURE PERSON RESPONSIBLE FOR FILING RETURN DATE
ADDRESS
Jennifer . Lepley, 4121 Kittatinny Avenue, Mechanicsburg, PA 17050
:~: _________________.________ __:~E?12/P-'
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F or 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 offor the use ofthe surviving spouse is 3%
[72 PS. !j9116 (a) (1.1) (i)], .
For dates of death on or after January 1, 1995, the tax rale 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 al death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. 89116(a)(1.2)].
The tax rale 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)).
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a}(1.3)]. 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 adopUon.
REV-l502P' (1-97)
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
JOHN J. DRAKSLER
21-05-0951
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged
between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of
sUNivorshiD must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
Real Estate located in Brush Valley Township,
Indiana County, Pennsylvania.
See Deed Book Volume 872, Page 681,
(See attached Deed).
Decedent owned 1/2 interest as tenants in
common with brother.
Parcel #08-015-105
Assessed value
$ 11,586.02
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T~~AL~ter on line 1, RecaPitUlat~:r$- ;~ 586 . 0-; -
(If more space is needed, insert additional sheets of the same size)
IMMMMMMMMMMMMMMMMl\1MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM!\ ~MMM;
REA L EST ATE - Q U B R Y - CURRENT R/B MASTER
GDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDODDDDDDDDDDDDOnDODnDnnO:: :>DDDDDDDD6
DS/CONTROL: 8-005360 ITEM#: 320
NAME1: DRAKSLER1 GEORGE AL
ADRS1:
ADRS2: 505 LONGS ROAD
ADRS3: HOMER CITY
MAP #.: 015105
P DESC:
DESC 1:
DESC 2:
DESC 3:
DESC 4:
C/O: C/O THERESA D GROVE
STATE:
TAX STATUS:
COAL DESC. :
LOCATION. . :
REMARKS. . . :
ACREAGE. . . :
DEED-l: 872 -681
DEED-3:
HO CB MT CO FO GA CP OB IN SC CH DR
IMPROV: 1 0 0 0 0 0 0 0 0 0 0 0
MARKET VALUES ASSESSED.VALUES
COUNTY SCHOOL COUNTY SCHOOL INTERIM..:
L- 2270 2270 2270 2270 LAST RUN#: 206001 YEAJ;: 2006
B- 2040 2040 2040 2040 TRAN DATE: 07/20/2005
c- 0 0
T- 4310 4310 4310 4310 OVERRIDE: 0 Cont (Y/N): _ :
HMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM~1MMMMI~ tIMMMMMMMM<
T/C:
ZIP: 15748
LAND USE:
s.: -rOOL:
56.69
2 :
FEE:
INTEREST: LAND: 100.)0 \
BLDG: 100.)0 %
4310 divided by 18.6%= $23,172
18.6 is common level for 2006 in Indiana County PA
tEbt~
BOOK 872 PAGlCSl
ilttb,
MADE THE &M day of /174'1
of QUI' l.,n'd one th.Otls4nd nine Ittmdred 2~9ht.y-f~ve (.1985).
ill th.e '!lelll'
BETWEEN
JOAN DaAKSLER, Widow,
G,,'a1ltor .
and
JOAN DRAKSLBR, as a t.enant. fo~ her life, and G~ORGE E.
DRAKSLER and JOHNJ. DaaKSLER as ~emaindermen to hold as tenants
in common,
Grantells :
WITN1!iSSETH, th.atinoollsitUration of One and 00/100 -----------------------
_________________________________ ($1. 00) ____________________-DoUarl!,
itt h4n.d paid, the recl!ipt wh.ereof w herel1y acknowledged. the said granto1' do /1.erebll orant
and. CtJ1W81l to tM ,aid grantee .
ALL those two certain pieces, parcels or tracts of land,
THE FIRST THEREOF, situate in the Township of Brushvalley,
Count.y of Ind iane and Stat.e of Pennayl v~n.i&, bounded an~
described as.follows, to-wit.t
BEGINNING at a red oak on lands formerly of James C. Dill's
Beirs, now the Smokeless Coal Company, thence by same NOrth
thirty-five degrees East, one hundred and twelve (112) perches,
~re or less, to stones, thence by second described tract North
forty-two degrees East, thirty-four (34) perches to a Spanish
oak, thence NOrth fifty-three degrees west, seven-tenths (lO.7)
of a perch to,stones) thence along land. of Jefferson McCormick
South fifty-two degrees West, forty (40) perches to stones;
thence by same North fifty-one degrees West, one hundred three
and Qne-half (103 1/2) perches to a post in road, thence by land
now or formerly of Prudence Altimus, South fifty-three degrees
West, th~rty-.ix and six-tenths (36.6) perches to a hickory tree;
thence by land formerly of David Moore, now LUdwig, SOuth twenty
and ~le-half degrees East, forty-one (41) perches to a white oak1 ,
thence by same South thirtY~8even degrees East, forty and four-
tenths (40.4) perches to a rock oak, thence by same South sixteen
and one-half degrees East, sixty-six and one-balf (66 1/2)
perches to a red oak, the place of beginning, containing forty-
six ac:res and sixty (60) perches.
THE SECOND THEREOF, situate partly in Brushvalley TOwnship
and partly in Buffington TownShip, Indiana County, Pennsylvania,
bounded and described as follows, to-wit:
BEGINNING at stones on line of land formerly of James C.
Dill's Heirs, now the Smokeless Coal Company; thence by same
North four degree. East, forth-four (44) perches to a fallen
chestnut, thence by same North eighty-one degrees West, slxty-
nine (69) perches to a post; thence by first described tract
North thirty-nine degrees East, thirty-two (32) perches to sto-
nee, thence by land formerly of John RAy'. Heirs, now David and
George Wi~son, NOrth eighty--eight degrees East, seventy-six (76)
perches to stones; thence by land of ~ith South four degrees
West, eighty-eight (88) perches to a chestnut; and thence by land
formerly of Martha J. Stiles, now Emma Young, west twenty-seven
(27) perches to the place Ff beginning, containing twenty-five
i.. (25) acres, more or less.
.
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BOOK 872 PAGlOS2
EXCEPTING AND RESBRVIblG, however, from the operation of this
deed, all the ooal of whatever kind lying or being in or upon the
above described tracts of land, together with mining rights and
release of damages as fully eet forth in deed from Boaton G.
Blackstone and Caroline, bis wife, to Jobn J. Long, dated the
17th day of September, 1902, and recorded in Deed Book "B" Vol.
.74, page 600.
BEING the same property which Floryan A. Lichota conveyed to
Joseph Draka1er and Joan Draka1er at Indiana County Deed Book
365, Page 58, on June 28, 1947. Joseph Draksler died leaving
Joan Draksler to survive him as his surviving tennant by the
entiretiea.
This is a conveyance between parent and children and is
exempt from Pennsylvania Transfer Tax.
The Grantor herein state that the hereinabove property is
not presently being used for the disposal of hazardous waste nor
to the best of her knowledge, information and belief has it ever
been used for the disposal of hazardous waste. This statement is
made in compliance with Section 405 of the Solid waste Management
Act of July 7, 1980, P.L. 380, No. 97, as amended (35 P.S.
S6018.405).
662 A
NOTICE
he/th:~ :~.~:nb: ~b~~ Isr=ee,s} hereby certifies that he/they know and understend tha1
mining operations, .nd th~~l~e urc"C.~t protection agoinst subsidence resulting from ~al
mine subsidence by a private CO:trac+ ith ~perty maofY thbe protected ,from damage due to
, , IN . owners . economic:. Interests in the coal.
Witness 51 res of sr ntee (irantees) this cf f
.. , . 4'...... .:' . . .. . .. .Y 0 . .. .. . ., 19. . . .
Wi . fo . . (SEAL)
o ........... rSEAli
BOOK C / (., PAGtu~~5
A.ND tke Baid I} 11&11 tor
'WiU 'warrant generally
hereby covtmant B a.!\d rtgree 1iI tl~at she
th.e propertll M-reb~ conve1led,
IN WITNESS WHEREOF, ,aid gf'Unt01' 11.111 hereunto Bet he:r: hand and aeal
th.e dati 4ftd 116(1.1' first a.bove writtllft. ./ r/ /J ) /
",",,,, ....,.. ,., ..".."', ~~-~~e
'. . in tl)t tlrelmet of ) ..........m...............__... ...m........................................__ e
~~~/.h.......\ ........................................--.......................--..........m..e
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.......... ............... .....................................h.......... ........................................... .....................................h e
Sta.te 'If PenneylvaniA
Count!1 of /11I1:)/1111111
O'I~ this, the ~ iJ4.
tBB'
d411 of MA Y
, 1985 . before mr.,
theu'/Itit",.,ign6d office1', per,onallll OiJlPe4red JOM DraksJ,er, widow t
known tel me (or tlatiJJta.ctoril'll pr01lfht) to bf the 1'67"011. ulh.o,e name is subscribed to the
wit/r.in in"C,wnent, 4M nektwwledged tha.t ,}u /'!:J:ecuted the .ami: jur tke PUJ.WOS&l therein.
C01l.tai7,t(t. ' . . . .', \'. c: ...... ,.. :
11; WITNESS WHEREOF. I ..".~.~.~:~-:...Ml:, "_~.;:":>~~
lllCHARD l. MIIIIII CII. 111\1 RY p\I,ue ' , ~.J .
ern: SIt 'if.LHY IWP.. IMI>II\HA COUNTY :..... " , .' - ~.
1.l1"{\ouiAissi6inii/>lll'fr.lKai:fOl. '1'98' ....:-.' ,; ~"'.\'~"" -.: :........ ','
Ibll1beJ, Ptnnsylv.nll ~wd.llon 0' '~ollri"Ttt.ze.,~. 9.f.c~~..
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aaOK 872 PACt GS4
State uf PennsylvAnia
COl<1l.t'lI af 1N'VI,lfN A-
On. this, the ~ TJf
day 01
1
_8ll.
.\
MAY
, 19 85 . before me"
tlw 'Und.e1'lIigned ufficer. pel'soMlllI Q:ppea1'ed
lmmvn to me (or liatillfactfJI'iLv !)'I'I)t,en) to Ut' thl' pusan whose llculte IS subscribed to the
'within inst1'ument, a,11d acknowledged that.s he e:r{lt;1ttt'd the same lor th.e PIl1'PC)lj/J~.th.e,t'eill
contaIned. " "C' J, ....
IN U'lTNESS WHEREOF, 1 ket'slenia se~: ~~~ ~nd otfteiaJ. seal. .- .,':: "'.
....._.,..~.-;;;,;;-~.i!!!!!:=i4!.~f~ ---- ~ --
...lWJlt.'iAl.ln.UJP~JJ(OIAflA~Y,-", ..... .;.-.. .'-,... .'..... ....,... ':' '
MY eOMMISSIOII EXPIRfS IlWCll Jl. 191t TitJe~oJ, Officer. " .... ....
Iltllllt".I'.IIA'~A".d.tl.nolIfQr"itt '.."I,'i' 'i:, (~"
I d(. hereby eel.tily that th:' ,AJI'ecisl' /'uideltl'e (lnd COli let~(Ult office add,'/lHII
of tl,e witkin named g1'4lltel' III is If'. I). .,., P't#?< 581' I r;.... 15'9.2..0
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1985
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COMMONWEALTH OF PENNSYI.VANIA }
. 88.
Co'unty of ..~............._................
RECORDED on this . .........._.~........ da.v of ......~........,.... ..
.4.. D. 19..85... in the Recorder's vffice of the Ba.id COl/llty. in Deed Book
Vol, ,..,..71/9........, Paye ........,.21........
Giv~-n mule,. mlJ ha/ld (Inti tile 'ctal of the Muid aqice. the date <tOOI:!:' lVl'iUM,
....~..d..~., Reco1'der.
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REV~1508 EX. (6~98l ..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF JOHN J. DRAKSLER
21-05-051
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1.
Citizen's Bank
Checking Account #6100687910
Date of Death value
$1,959.10
2.
Manulife Financial
Account #125149829479
Number of shares - 53
Date of death value - $51.70/share
3.
2003 Chevy Monte Carlo
VIN #2G1WW12E939108529
30,679 miles
$2,740.10
$9,000.00
4.
Verizon refund
$
1.58
TOTAL (Also enter on line 5. Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
S1.1700.78
,.~ Citizens Bank
Account Number 6100687910
Account Title JOHN H DRAKSLER
Date Opened 5/17/1979
Account Type Checking
Principal Balance as of DOD $1959.10
Interest from Last Posting to DOD $.00
Account Balance as of DOD $1959.10
YTD Interest to DOD $ .00
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REV-l509 EX + (1-97)
.
SCHEDULE F
JOINTLY-OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
JOHN J. DRAKSLER
FILE NUMBER
21-05-0951
If an asset was made joint within one year of the decedent's date of death, It must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A.
JENNIFER J. LEPLEY
4121 Kittatinny Dr.
Mechanicsburg, PA 17050
Daughter
B.
c.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A.
t~/19/82 PSECU
0164346456 - regUlar shares
Date of Death Balance $ 549.16
Accrued Dividend $ 0.02
Date of Death Value $ 549.18
A Jennifer J. Lepley 50% $ 274.59
2 t~/19/82 PSECU
0164346456 -Christmas shares
Date of Death Balance $ .13
Accrued Interest $ 0.00
Date of Death Value $ .13
A Jennifer J. Lepley 50% $ .07
3. M/19/82 PSECU
0164346456 - Checking account
Date of Death Balance $ 3,658.95
Accrued Dividend $ .05
Date of Death Value $ 3,659.00
A Jennifer J. Lepley 50% $ 1,829.50
TOTAL (Also enter on line 6, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
t
, "",.,.."."." *'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTL Y.OWNED PROPERTY
ESTATE OF
FILE NUMBER
~ORH ~. DRAK&~~R
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
?1_nl:O_nQl:Ol
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A.
JENNIFER J. LEPLEY
4121 Kittatinny Drive
Mechanicsburg, PA 17050
Dal ghter
B.
c.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifying number. Attach DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A.
4. O.ori 1112182 PSECU
0168541039 - Regular Shares
Date of Death Balance $ 97.26
Accrued Dividend $ 0.00
Date of Death Value $ 97.26
A Jennifer J. Lepley 50% $ 48.63
5. o. 112182 PSECU
0168541039 - MoneyHandler
Date of Death Balance $ 225.39
Accrued Interest $ 0.00
Date of Death Value S 225.39
A Jennifer J. Lepley 50% $ 11269
6. b6/22J~ SOVEREIGN BANK
Savings Account #574124509
Date of Death Balance $ 1,078.25
A Jennifer J. Lepley 50% $ 539.12
TOTAL (Also enter on line 6, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
,,,,,"',,-,... '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
FILE NUMBER
If an asset was malcQ:Hlirithii one ~ SilaclilrJIs date of death, it must be reported on Schedule G.
21-05-0951
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A.
JENNIFERJ.LEPLEY
4121 Kittatinny Drive
Mechanicsburg, PA 17050
Oat ghter
B.
c.
JOINTLY -OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank account number or simila- identifying number. Attach DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A.
(J 4/28/04 SOVEREIGN BANK
Checking Account # 0571147143
Date of Death Balance $ 210.33
A JenniferJ.Lepley 50% $ 105.16
TOTAL (Also enter on line 6, Recapitulation) $ 2,909.76
(If more space is needed, insert additional sheets of the same size)
I
PSE(~
the financiallinkTM
November 15, 2005
Account # 0164346456
ANDREW C SHEELY
127 SOUTH MARKET ST
PO BOX 95
MECHANICSBURG, PA 17055
Dear MR SHEELY:
The following is the status of JOHN J DRAKSLER's account with PSECU as of the date of death.
Joint Owner's Name
Date of Death
Date of Birth
JENNIFER LEPLEY, ADDED 04.19.1982 AS JOINT TENANT W/ROS
10.03.2005
03.01.1941
Share
S 01
S 03
S 04
Description
Regular Shares
Christmas Shares
Checking
Open date
04.10.1979
04.08.1994
Balance
$ 549.16
0.13
3,658.95
Accrued Dividend
$0.02
0.00
0.05
Loan Description* Open Date
L 01 PSL Loan 06.20.1996
*Insured - loan paid off CUNA Mutual Insurance Group
Balance
$1,163.96
Accrued Interest
$6.97
The dividend earned from January 1, 2005 through the date of death was $2.80. We do not have safe deposit boxes
for our members.
If you have any questions, please call 234-8484 in Harrisburg or our toll-free nlUllber, (800) 237-7328. At the menu
prompt, enter 6 and then extension 2227.
Sincerely,
I~t
Meacle Fairfax~/
Member Service Representative
Finance Support Unit
Pennsylvania State Employees Credit Union
Main Address: 1 Credit Union Place, Harrisburg, PA 17110-2990 . (717) 234-8484 . (800) 231-7328
lei.. Mailing Address: :-O.Box 67~13,Harrisburg, PA 17106.7013 . (717) 777-2100 (TOD) . (800) 472-1967 (TO D)
'-.: .' Savings federally Insured up to $100,000 by the National Credit Union Administration www.pseclI.com
NOV-16-2005 15:38
I PSECItP
PA STATE EMPLOYEES CU
717 783 9251 P.02/02
the financial linkTM
November 16, 200S
Account # 0168541039
ANDREW C SHEELY
127 SOUTH MARKET ST
PO BOX 9S
MECHANICSBURG, PA 17055
VIA FACSIMILE 717~697.706S
Dear:MR SHEBL Y:
The following is the status of JENNIFER LEPLEY's account with PSECU as of the date of death of her father on
October 3,2005
Joint Owner's Name JOHN J DRAKSLBR, JOINT TENANT W /ROS
Share Dacription Open date Balance Acerued Dil'idend
SOl Regular Shares 04.12.1982 $ 97.26 SO.OO
S04 MoneyHandler 225.39 0.00
Loan Description Open Date Balance Accrued Interelt
LO! PSL Loan 03.09.1994 $ 0.00 SO.OO
The dividend earned fromJanuuy 1,2005 through the date of death was $0,&1. We do not have safe deposit boxes
for our members.
'This is in addition to date-of..death values mailed. to you. on November 15,2005. If you have any questions, please
call234-8484 in Harrisbura or our toll-free number, (800) 237-7328. At the menu pIontpt, enter 6 and then
extension 2227.
Sincerely,
~'f
Member Service ReprC$C11tative
Finance Support Unit
~~ .,...
'ennaylvanla State Employn~ Orod,t UHion :
Main Addreu: 1 Credit Union Place, Horrisburg, PA 17110-2990 & (717) 234.8484 · (800) 237.7328
'_ Moiling ~dl'eS$: P.O. BOl( 67013.. Harrisburg, PA 17!.~013 . (717) 77?_-11Q.O rrOO) · (800) 472-196.1. (!P!:?l .....
. . w........."...........l .t ..., 4' . .r.....I.II_C__ ^.J_:_:~:...... WWW.DSeCU.\;iOm I
TOTAL P.02
Sovereign Bank
ESTATE OF
SOCIAL SECURITY #:
DATE OF DEATH:
John J Draksler
164-34-6456
October 3,2005
Account #: 0571147143 Type: Checking
In the name of: John J Draksler or Jennifer J Lepley
Date of Death Balance: $210.33
Int.(YTD) from 1/1/2005 to 10/3/2005
Accrued interest to date of death: $0.00
Other Info:
Open date: 4/28/2004
$0.00
Account #: 0574124509 Type: Savings
In the name of: John J Draksler or Jennifer J Lepley
Date of Death Balance: $1,078.25
Int.(YTD) from 1/1/2005 to 9/30/2005
Accrued interest to date of death: $0.05
Other Info:
Open date: 6/22/2004
$1.71
Page 1 of 1
"",'''O~.l'." *'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER..VIVOS TRANSFERS &
MISC. NON..PROBA TE PROPERTY
ESTATE OF
JOHN J. DRAKSLER
FILE NUMBER.ll _ 0 5 - 0 9 5 1
This schedule must be completed and filed if the answer to allY of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY %OF
ITEM INCLUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
ATTACH A COpy OF THE DEED FOR REAL ESfATE.
NUMBER VALUE OF ASSET INTEREST IiF APPLICABLE)
1.
1. us Allianz Annuity Contract #DAG08047 94,104.63
TOTAL (Also enter on line 7, Recapitulation) $ 94,104.63
(If more space is needed, insert additional sheets of the same size)
USAllianz Service Center
PO Box 1122
Southeastern PA 19398-1122
Action Required Claim P ~lDg
COPY 81 OriliDal 51i II ;;ojo~
USAllianz~
October 27, 2005
ANDY SHEELY ATTORNEY
PO BOX 95
MECHANICSBURG PA 17055
JOHN M MAURO
CUSO FINANCIAL SERVICES L P
ONE CREDIT UNION PLACE
HARRISBURG PA 17110
RE: Contract # DAG08047 - JOHN J DRAKSLER
Dear Mr. Sheely:
We recently received notification of the death of John J. Draksler, who owned a flexible-premium deferred
variable annuity. We would like to do whatever we can to assist you.
According to our records, the named beneficiary of the annuity is Jennifer L. Lepley. This variable annuity
may be invested in options subject to market fluctuation. Please provide the following information that will
assist us in processing the claim request as quickly as possible.
. Original certified copy of the death certificate of the Contract Owner named above.
. The enclosed Annuity Claim form completed entirely and signed by the beneficiary, in Part IV and
Part V.
. The original contract, if available.
As requested, the death benefit value on October 3, 2005 was $94,104.63. As of the close of business on
October 19, 2005 the lump sum payment amount available is $92,091.07 . Since the contract is not
valued until claim proofs are received in our office this value is subject to change. Please be aware
that the funds remain invested in the allocations elected by the Contract Owner of the variable annuity and
could be subject to market fluctuations. The investment options may be reallocated by written request,
signed by the beneficiary. Please contact the registered representative of this contract or me for further
information on reallocation.
The beneficiary has several options available to receive the proceeds. The enclosed death benefit
information guide was developed to answer some of the most commonly asked questions concerning the
benefits available. Please refer to it for assistance. If you would like to receive a current prospectus that
details the variable annuity and the investment options available, please contact the registered
representative or me.
US,,,-lii3n: vrJliible plOdliClS i>le issued hI' Ailianz Lilt Instil am!: Cl1ITlpany of North America, and in New Yor~ by Aliianz Life IllSlIrarlCf COmpdl1\! of I'Jew York. and dis!ilblJtf>d
by 'flelr ;;:;1116'0 USAlliallZ Inwstor Se/\'ICeS, LLc; 5!tH Colden Hills Drive, Mmneapolis. MN 5:)41ti.129/. m\)(l) 542-")421 i:I',mb,~ 1.;1\'.[') Please selld iJlI correspondence
lC) the US_;\ll;Jr.~z Service Center, PO Bm~ 1122, Southeast.ern, Pi\ 1939.3.l1:U
AmariZ GTiOlllp
REV-1511 EX. ("-99J*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
JOHN J. DRAKSLER
FILE NUMBl:R 1
21-05-095
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
FUNERAL EXPENSES:
1.
2.
3.
4.
PARTHEMORE FUNERAL HOME
GINGRICH MEMORIALS
JDK CATERING, INC. - FUNERAL LUNCHEON
ROLLING GREEN CEMETERY COMPANY
$ 4,413.12
$ 1,050.00
$ 1,565.00
$ 195.00
B. ADMINISTRATIVE COSTS:
1 . Personal Representative's Commissions
Name of Personal Representative(i~NNIFER J. LEPLEY, EXECUTRIX
168-54-1039
Social Security Number(s)/EIN Number of Personal Representative(s)
City
4121 KITTATINNY DRIVE
MECHANICSBURG PA
State _Zip
$
0.00
Street Address
17050
Year(s) Commission Paid:
2.
Attorney Fees ANDREW C. SHEELY, ESQUIRE, PER AGREEMENT
$ 3,750.00
3. Family Exemption: (If decedenrs address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
State _Zip
Relationship of Claimant to Decedent
4.
Probate Fees
$ 110.00
295.05
75.00
160.00
15.60
5.
CUMBERLAND COUNTY REGISTER OF WILLS
THE PATRIOT-NEWS LEGAL ADVERTISING
CUMBERLAND LAW JOURNAL LEGAL ADVERTISING
Accountanrs Fees DECEDENT'S 2005 INCOME TAX-DAVID HAMILTON, CPA
POSTAGE
Tax Return Preparer's Fees
6.
7.
FILING FEES FOR INHERITANCE TAX RETURN
15.00
Reserves ~o conclude adminis~ra~ion of Estate,
First and Final Accounting
Accounting Fees, taxes, preparation/mailing
and copy charges of necessary Fiduciary Returns
$ 600.00
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
$12,243.77
A.Family Tradition Of Carin, ~
PARTHEMORE Fuperal ;Home" & Cremation Ser' 'ice's, Inc
Mrs. Jennifer. J. Lepley
'4121 'Kittatinny Drive
. MechfUlicsburg, P A 17050
Fo~ the services of John f. Draksler
10/5/2005
. ,
We sincerely appreciate the cQnfidenceyou have placed in us and will continue to assist :>u in every way
we can. . Please feel free to contact us if you have any questions in regard to t.1,.is .statemet . The following
is an itemized statement of the services, facilities, automotive equipment and merchandis that you selected
when making the funeral arrangements. '
Terms
Net 30
Due Date
11/4/2005
Account # .
2005092.3
1303 Bridge Street
P.O. Box 431
New Cumberland, P A 17070
(717) 774-7721
(Fax) 77.4-5546
www.parthemore.com
. Description
SER VICES & MERCHANDISE
Cremation with Memorial Service'
. Solid Wood t1Country Lane" Urn
Polystyrene Urn Vault
Gilbert w. Parthemore,
Founder
Total Services and Merchandise
Gilbert 1. Parthemore,
Supervisor
CASHADV ANGR ITEMS
. Death Notice, Ramsburg Patriot.
Death Notice, Indiana G~zette
16 Certified Copies of Death Certificates
Clergy Ho~oraii.um
Honor Guard
.Pauphin COunty Coroner Fee, Cremation Authorization
) Flowers, UIll, Arrangement
Flowers, BasI,<et Ammgement
Flowers, Bubble Vase
- Flowers, (4) Live Mums
Stephen K. Parthemore,
CFSP
Bruce R Parthemore.
Pre-lileed Coordinator, CPC
Professional Membershins:
NFDA ·
. DCFDA l~ilO &-u~..-
G~
, The Rule J
The PeoplE
mJi
rrt1- . eM
Total Cash Advances
. lriu;nediate Pay Discount ~ Thank you! .
{
fJ.l a/J~ W J1 'iJ . It .
~k eLid ~
Ct~N..iJl.. 10
4l
to ~} tV 12.vl
~ f,tJr.ltl h/iIU it.;
pClO' ~ W~tL..( .
l
!
I
I
j
I
I
,
~ t,,-..L.l :,.~ rJrO'o1..tN1J OJ.;'j-l.
72'O,!{o7 - ~{
Total
Payments/Credits
Balance O'ue
flJ!::~/. .v~~0 !lu;').! _
-- J'<\.IL:ful....
\mount ..
3,119.00
305.00 .
95.00
3,519.00
286.00
25.00
96.00
150.00
50.00
25.00
150.00
125.00
17.50
.40.00
964.50
-70.38
$4,413.12
$-4,055.62
$357.50
ORDER FORM
-No. ~ -20368
Foundation By \A .5.
o Carved _ Lettered _
o Drawing Required
o Drafter
o Sandblast By
Manufacturer
Supplier _
Ack. #: _
Date Rec'd
Found. Orc Ired
PositIon Ve ified
5243 Simpson Ferry Road, Mechanlcsburg, PA 17050
(717) 766-5622 · Fax (717) 766~8007
www.gingrichmemorials.com
SOLD TO: ~t'~~'\tv.. L~~\\'J
4 t 2 t ~ I 1t (1 t I ~\ r" ~' Lt r I v \:
t.....\ ~ t l" (n\ ~ <: 1 ,k, ! lV' ';' PAt., C) c;- C'
J J
Date of Order t\ ~ 1':~ . 0 \"
Cemetery -"R~'I ;\Il~ brf'h"
Location
Center Over , Graves
Approx. Date of Completion ~ h. W. U ~, II (, If
Phone (H) 7.' \~ . f I C'l
(W) f7(. <;";:'\,O
Lettering
o
0.) H4t
G) '48 ~
u 5 ~()l/'\I S~~t\a
;t Vt I,' X (')/\,' ft:(jtb(~,\ \
--
Mi\ ~ 1-4
t'\4\
o Ci "]
.J. ~ l L1'.. 'l.q~AWY
"H., 'ff1N~M
r~~b
0@
2'C 1;; ·
l J<H\U J. \)~AKSlER ,
Lo #
t
, ff I~g
''0<;''
'W- Spelling and dates ha e been approved.
p
Type of Memorial \'''',''lVl''L C. ;~... 01 f \Nt
I' \ .J
Size l.L X ~ X __ Finish
Size ~ X ~ X ~~ Finish
Misc.
Design
i'l~' [~)\" -Htlf<\ _I,.... -f.
'w / ~i" C~t rt 'C" (~v. -z <( e ~ l~ ("
Location
b( Vase
w ( L()~ ;v'. .~ ~ '\ ~ ~
\J ~'\"'f !)....... \) -~ i {. 'Y.)
510,,,
R';'J
o Corner Posts
Agreement: A 50% deposit is required to commencement of work.
Agree to pay slated balance upon erection regardless of labor troubles or shipments or any other good reasons. This order or contact
cannot be cancelled by cUS'lomer unless agreed by both parties. The article herein mentioned shall remain the property of James R.
Gingrich Memorials until paid If' full and they reserve the right to remove the same is not paid as stated.
I agree to carefully proofread all names and dates for accuracy and accept full responsibility for any errors or omissions. THERE
WILL BE AN ADDITIONAL CHARGE FOR ANY LETTERING ADOED TO THIS MEMORIAL AFTER ERECTeO ON THE
CEMETERY.
I further agree to pay the balance statEld for the work performed under this contract within thirty (30) days of receipt of the final invoice
and furtner agree that interest shall accrue at the rate of one and one-half percent (1 ~%) per month on the unpaid balance o,^'8d te
James A. Gingrich Memorials no! paiej within thirty (3D} days of the invoice date. In addition thereto. I agree If it becomes necessary
for James R. Gingrich to institute legal proceeding to collect any funds due from me fer my account beil\g past due thirty (30) clays.
to pay all court costs and attorneys fees incurred by James A. Gingrich Memorials to collect the same,
Price
Foundation
TOTAL
DEPOSIT
Balance Due
Upon Completion
Deaier
k.n....
n') .
\...._ o-.~j }",'}-I'\,.- .
Custom )(
(I further agree that the bove rames~ speUin~ and dates are corree
PINK-Customer GOLDENROD-Branch
\^'~ ITI=_l"'lffll''''
YFI lOW-Production
g rt_r;
t"?r
~- :>~
-
$
$
$
$
$ ( I') SO.
$ S '){). -
$
S .(}(;. .
Jk JDK CATERING, INC.
EI~~~~~:~RG ROAD
~MP HILL, PA...17011-7302
c:.;;m; PH: (717) 730-4061
"'_.--.' FAX: (717) 730-4662
Invoic:
___ .=_'~lfC'l[l1_
1~7/200S 16501
BILL 10.
JE1'.l'NIFER LEPLEY .
4121 KITTA TINNY DRIVE
MECHANICSBUR~, FA 17050
,r 11 '~:~ ~ ~,~ r' 'j \~. :~.. . ~
:..~ ~. ~~~J; ~~('f~~, j ,
"j" - - .
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: ~: {I ~1{ -::'R ,~l ~~. ~"/>, ~
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~~ I ,,:. ..< ...."t I J~,
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- <...~..~.... ,- ,.
," \': ..~.~:; $tk"ir
~":'a-
!IS r iI.NT In: l nr~r...lIlL....-...o;. ..
-~.JWiJBl11.1"lIIn~---~ . .1~UJTI.1 iJ stlli.A ,t]
------.-
.--.... .._---~=-
) (5104)
PRENEED COUNSELOR SALES RECEIPT
ROLLING GREEN CEMETERY COMPANY 624
1811 CARLISLE RD
CAMP HILL, PA 17011
717-761-4055 DATE/~ - ~-O~ --
RECEIVED FROM 0"-E' ~ ~ I Fe (<.. ,<.. ~ ~ -
THE AMOUNT OF t\ ..,. b- ~ J No. ...........-- · ~1"h:boLLARS '. L? ~- L!1
AS: DOWN PAVMENT 0 REGULAR PAYMENT 0 K..eL CREDIT CARD CHAR iE rn-
CASH 0 CHECK 0 m '.-... D CARDTY 'e 0
(! ~4 i.c(II.1t I d. () f..t:, 'IS
FOR THE PURCHASE OF INTERMENT RIGHTS AND/OR MERCHANDISE AND SERVICES FROM THE ABOVE NA lED CEMETERY.
itso ~~()t.J
No.OO 16384
DATE
S7F-
NAM
IP · /J '
~u.
RECEIVED BY CEMETERY
BY
GEN 8002 (6/02) ~ 2002 SCI Management LP.
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"tr.....,- ~ ,r.,"""'~' . 1-.101-'\1' . I (1.,,: lJ'f/'f.r.( ,.,) r.'" -. 1-' /,f.. ,f ,,, ~,...f ' . ' IF' 1 ,i,~ : .;._
RECEIPT FOR PAYMENT
===================
GLENDA FARNER STRASBAUGH
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17G13
Receipt Date:
Receipt Time:
Receipt No. :
10,27/2005
~3:52:39
1042352
DRAKSLER IJOHN J
Estate File No. :
Paid By Remarks:
2005-00951
ANDREW C SHEELY
JA
Fee/Tax Description
PETITION LTRS TEST
WILL
AUTOMATION FEE
SHORT CERTIFICATE
JCP FEE
Check# 2727
Total Received...... ...
Receipt Distribution ----------------- .------
Payment Amount Payee Name
60 . 00 CUMBERLAND COUNTY GENE AL FUN
15.00 CUMBERLAND COUNTY GENE:AL FUN
5 . 00 CUMBERLAND COUNTY GENE: AL FUN
20.00 CUMBER~~D COUNTY GENE:AL FUN
10.00 BUREAU OF RECEIPTS & a TR M.D
----------------
$110.00
$110.00
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Order Confirmation
Ad Order
0001415805
Sales .
rholton
Customer
ANDREW C. SHEELY
Pavor Customer
ANDREW C. SHEELY
Customer Account
11529
Pavor Account
11529
Order Taker
molton
Customer Address Pavor Address
ATTORNEY AT LAW,127 SOUTH MARKET S ATTORNEY AT LAW,127 SOUTH MARKET S
MECHANICSBURG PA 17055 USA MECHANICSBURG PA 17055 USA
Order Source
Fax
Customer Phone
717~697-7050
Pavor Phone
717-697-7050
PO Number
ESTATE OF L :PLEY
Ordered BY
ANDREW
Soecial Prlcina
None
Customer Fax
Customer EMs
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Invoice Text
Ad Order Notee
Materials
Net Amount
$100.95
Tax Amount
$0.00
Total Amount
$100.95
Pavment M8' l25!
Payment Amount
$0.00
Amount Due
$0.00
Ad Number Ad TVDe
0001415805-0 Legal Liners
Ad Size
:1.0X15Li
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<NONE>
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Ad Booker
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Ad Attributes
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311012006 9:19:~ 'AM
1
CUMBERLAND LAW JOURNAL
32 SOUTH BEDFORD STREET
CARLISLE, P A 17013
December 2, 2005
Cumberland Law Journal is published every Friday by the Cmnberland County Bar
Assc :iation and is designated by the Court of Common Pleas as the official legal publication for
Cum >erland County and the legal newspaper for publication of legal notices.
TO:
Andrew C. Sheely, ESQUIRE
RE:
John J. Draksler, ESTATE
Legal advertisements must be received by Friday Noon. All legal advertising must be
paid n advance. Make all checks payable to: Cumberland Law Journal.
AdVt :tisement inserted on following dates:
No' ember 18,25, December 2, 2005
Advertising Cost
Second Proof Request
$ 75.00
$ 0.00
$ 0.00
$ 15.00
----...-........-...--
$ .00
----...--
---.-
Proof of Publication
Payment Received
Total Amount Due
Payr ent received November 15.2005
by B :cky H. MoreenthallExecuti ve Director
REV-1512 EX.,. (6-98)
'*
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
21-05-0951
ESTATE OF
JOHN J. DRAKSLER
Include unreimbursed medical expenses.
DESCRIPTION
VALUE AT DATE
OF DEATH
ITEM
NUMBER
1,
2 .
3 .
4.
5 .
6 .
7 .
8 .
9.
Skye Alexander
Discover Bank-Account #6011002740202932
Chase Bank, USA, N.A.
Decedent's 2005 County/Township taxes
Capital City Carwash, Inc. - detailing
decedent's car
PP&L - final payment
Andrews & Patel Associates
Travelers Car Insurance - final payment
Apartment Rent - final payment
$
95.80
$1,400.00
$2,315.31
$
111.00
$ 206.65
$ 138.92
$ 90.00
$ 350.08
$ 300.00
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
$5,007.76
;. "L. :
.. '.. . ' .: -,- ---;: :.<<, ';:<;\:r-.~i';
'flE'."~\~'fajQI.~._
,'. .
'Orear Jdfni J. !)raRsf~r:
t<,'.
> .,' ", . , .', ",',-
Our cfient,.Skye Al.nd.,r valU$syoqr tri~n.llfp1..:~~t
asked to contaet you reg,a1tllingJ- ~Qijr ~oeQ:~~. _
. . . -
., ,; ,
. .
. , , .
Skye AleJCaAlter has triec.iseverw different ~hiill1s~OOi\tllctYGU. .a!lqf W/lich .
have gone unanswered. Our cJi$~t wants- t(j)res",me.t~-Y"'l)abJe 'retatr~'(l~hip 'You
shared and knows that there must be a good t'easonyou have not s~rit payment.
The amount due to clear your account is $95.81. .
If there is a problem which has caused you to withhOJdpaytnent for the above
mercnandfse, please ret us know. tf you have O\lerloOkedthi$ bifl, ta-ke care of It
today. Send us a check fo,.$95.80 made payable to Retrieval M'asters Creditors
Bureau. A repiy envelope is enclosed for your convenience.
It is our desire to help you straighten out this matter quickly and easily and trust
that you will give us your full cooperation. Take a few moments now to send us
'<yc-urp-djli'cllluf $a3.00~ lJi8:TrexptrUI(1livn for liUT/fJaynlerlL'----------------.-_ -.-__n_
Sincerely,
22~
Yau owe: Skye Alexander
In the amount of:
$95.80
022255 1]
0501008
WhiCh was charged on:
April 21, 2005
Your account number is:
SAUSSA550232321
NOTICE: SEE REVERSE SIDE FO~73
IMPORTANT INFORMATION
11.1. ',111111111I.1,11.',"1111I, I, i',I'IIII".III.',',II.II.,
RMCB
PO BOX 1234
ELMSFORD~ NY 10523-0934
11I./lII! 1111,1.111.11111,"",1,1, Ii 111111111,,11111.. I. If III
SAU09580SAUSSA55D2323214
IW.IrJi
r-nw 'I .,,r.'T'T"....T 4 """'......~.,._..
BROOKL YN HTS., OH
216.739.5100
BURLINGTON, NJ
609.914.0437
CHICAGO, IL
312.782.9676
CINCII\NATI, OR
513.723.2200
CLEVELAND,OR
216.685.1000
~~
1-~'1':i
0" IfltNOVAT10J
QAOWTH + M8l,JLTS
COI :MBUS,08
614.: !8.7272
DEI! tFIELD, IL
847.' fO.9812
DEl :OIT, MI
248: il.6100
PHn \DELPHIA, PA
215 ~ 19.1500
PITl iBURGH, PA
41V 4.7955
WELTMAN, WEINBERG & REIS CO., L.P.A.
ATTORNEYS AT LAW
December 16,2005
Andrew C. Sheely, Esquire
127 S. Market St.. P. O. Box 95
Mehenicsburgh, PA 17055
Fax: (717) 697) 7065
Re: Estate of John 1. Draysler
Our client: Discover Bank
Client Account No.: 6011002740202932
Our File No.: 04781985
Dear Sir or Madam:
Our client is offering to settle the above referenced Discover Card account in the amount of $1,400.00, if eceived
in our office by 12/28/05. This account currently holds a total balance of $1,689.74. Upon receir . of the
$1,400.00 payment, this account will be closed as settled.
Please forward payment to our office at P.O. Box 163428 Columbus, OH 43272, with check pa able to
Discover Bank. Please include on the check our eight (8) digit file number listed above.
Thank you for your assistance in this matter.
This law firm is a debt collector attempting to collect this debt for our client and any information obtaine( will be
used for that purpose.
Very truly yours,
~y~
Estate Specialist
email: probate@weltman.com
175 South Third Street, Suite 900. Columbus, Ohio 43215.800.325.9965.614.801.2710.614.801.2604 (fax). www.weltma .com
- "".. 'I1AR-23-2006 THU 11: 17 AM PHILLIPS 8t COHEN
FAX NO. 302 368 0731
I 02
PHILLIPS AND comm ASSOClA'mS, LTD.
258 Chapman Rd. Suite 205
Newark, De 19702
Ph (302) 3S5~3500
Fx (302) 368-0970
Office HOUlS: M- Th Sam. - 9am; Pti: 8am - 6pm; Sat: Sam - 12pm
Maroh 23.2006
ESTA lE OF JOHN DRAKSLBR
1107 RANA VILLA AVE, APT 6
CAMP Hn..L, P A 17011
Our Client: CHASE BANK, USA
Client AJJot#: 4417168591459080
Our AiJottf.:, 4377600
Prin. Balance: $2,894.14
Sett1Cnt<<1t: $2,31 S .31
, DEAR ESTA TB OF JOHN DRAKSLBR;
Pursuant to our telephone cooVersation on March 23, 2006, Phillips
and Cohen Assooiates, Ltd. Ha$ been Tetained to serve as au.,thorized
reprcswntativcs for CHASE BANK, USA.
Effective immcdiatc:ly, Phillips and Cohen Associates. Ltd. Has
been autb,adzcd to accept S2.315.31 as a settlement in full Qn above
referenced account if consummated. on or before April 07.2006',
Upon reciept of$ 2,31S,31, you. will be released from any further
obilption to CHASB BANK. USA Reaardi'n.g the above referenced
account.
SETTLEMENT TO BE CONSUMMATED AS FOLLOWS~
$2,315.31 CASHIER.'S OR BANK CHECK TO BE RBCEIVED BY PHD...LIPS AND COHEN
ASSOCIATES AT ABOVE ADDlU1SS ON OR BEFORE APRIL 07,2006. UPON
COMPLE110N OF THE SBTTLBMENT, mERE WILL BB NO FU1l1ER OBLIGATION
REGARDING THE ACCOUNT AND NO CLAIM wn..L FlLED AGAINST THE ESTATE
OF JOHN DRAKSLER.
Thank you for your prompt .ttention to this matter.
Sincerely,
~~I!!~
Co-Chairmar1/CEcf.'
This is an attempt to collect. debt and any jnformation obtained will be used for that pwpose.
This oommunoatlon is trom a debt oollcctoI'.
. .,
. t
ifenn yt~CC~ ~
PO BOX 988
HARRISBURG, PA 17108~0988
Formall: DonaldCDonaherr.lncDBA.CC
800 900"'1372 ~
Hours: Mon~ Thur 8am.1 OJ nf
FrI 8am-Spm, Sat 8am-2~ I
(Eastern Standard TlmE
. a"... ...
(;.I~j
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2006104123
Illlllm 111111111111111111I 11111111'1111I1111111111
10 S0087439
JOHN J. DRAKSLER
4121 KtTTAT1NNY DR
MECHANICSBURG, PA 17060.9136
CLIENT: Cumber I and Coun t
TOTAL BALP;NCE DUE: $111 JO
""_'d"OO'_' .RE.QU E 8:1= ..F-GRoo.PAYMENT...lN F U L-t------------
You have not responded to our attempts to contact you In reference to aU the montes owed our client.
In the abSence of payment, communication Is neceeil&ry.
Pay In fuR today or oontact: ourofffce to:IM,ke payment arrangements. We can help you.
S&RVICE RENOEJIIlD
SERVICE DATE ACCOUNT NUMBER
BALANCE
2005 COUNTY & TWP PeR CAPITA
2005/00/00 723234705
$111.00
'.. ,,' ,"" u" .',.;.' ..______...--..._.._.....~..~.._..'_....,.. ~_......,...'""..~.'-;O
--Tin. ietl8i-tifiom i"d8ttcl;)lieo.uon ~. ""fhl8i8li-;' .i;mli tocolleot .'_~~ ArfJ InformatIcnQbtained will be l eel for
that purpo&e. If you have ill 11 Attorney to represent you or have filed bankruptcy, pIeeee dlaregard this letter and fu ,leh us
WIth the approprlste Information so we may mark our files aocordlngly.
Detach and return with payment to expedite credit to your account
2006104I23
JOHN J. DRAKSLER
4121 KJTTATINNY DR
MECHANICSBURG, PA 17050-9136
10 NUMBER: 80067439
BALANCE OUE: $111 ,00
Can our toll free number and pay using check by
If you wish to pay by orecflt card, please enter the
information In the spaces provided.
Check one: 0 Visa
o i'VTastercard
Card": _____________
Expiration Date: --1--1
Signature:
1One.
lCIuuted
0000011100 11006743900002
P~NN CR\ IT CORPORATION
A03.C
. "
~ -
C&pital City Carwash:, Inc. - Detail Centre
3820 Hartzdale Drive
Camp Hill) PA 1701 t
Ilvoice
OA re JNVOlCE #
11/1/05 102434
BILL TO
Jennifer Lepley
\
L
I
P.O. NO. TERMS PROJECT MAKE & MOOEL COLOR YEAR I l
I
I -
Due on receipt Chcvrol~ Monte C... Silver 2003
i - .
QUANTITY DESCRIPTION RATE SERVICED
.-
PLATINUM DETAIL" 169.95
Soft cloth carwash
Wheels and wheel wells c1eanQi and reatored
~iQl' ~ bij,ff IW1 wax.. detail
Upholltry -lbam.poo and recondition
Vinyl and leetha' cleaned
I Instrument panel detail I
I Carpets and floonnats .. shampoo and recondition I
I I Trunk" wipe down tmd carpet shampoo
\ Tires dressed
I Enainc steam cleaned and shined. 2'.00
PA Sales Tax 6.00%
,
i
!
~\\~1 ~~J mGtJt ~. ;
j II/ ~i" (
I f I
I
I I
I f}q (tpX Total
I
I have rclld and aclmowled the &&We information as
CENSE #
\MOUNT
169.9ST
2'.OOT
11. 70
$206.65
sed
correct and agree to contrao terms, conditions and
. liabilities WI stilted on the reverse side aftbis form.
I I'
REV-1513 EX+ (9-00)
*'
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)1
JENNIFER J. LEPLEY
4121 Kittatinny Drive
Mechanicsburg, P A 17050
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Daughter
21-05-0951
AMOUNT OR SHARE
OF ESTATE
100% residue &
remainder of
estate
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART 11- 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)
.
. , .'
LAST WILL AND TESTAMENT
of
John Joseph Draksler
I, John Joseph Draksler, of 1107 Rana Villa Avenue, Apt. 6, Camp Hill,P A
Cumberland County, Pennsylvania, being of sound and disposing mind, memory and
understanding, do hereby make, publish and declare this my Last Will and Testament, hereby
revoking any and all prior wills and codicils thereto by me at any time heretofore made.
FIRST
I direct that all my just debts and the expenses of my last illness and funeral shall be
paid from the assets of my estate as soon as practicable after my decease.
I authorize my personal representative to expend funds from my estate, in such
amounts as my personal representative shall consider necessary and desirable, for the
purchase, erection and inscription of a suitable marker for my grave.
SECOND
I give and bequeath all automobiles, household effects and other tangible personal
property, including cash or securities, owned by me at my death, together with all policies of
insurance thereon, to my daughter, Jennifer J. Lepley. .
Page 1 of 7
. r \,.\
THIRD
I give, devise and bequeath the residue of my estate, of every nature and wherever
situate, to my daughter, Jennifer J. Lepley, providing that she is living on the sixtieth (60th)
day after the date of my death. In the event my daughter, Jennifer J. Lepley, is not living
on the sixtieth (HOth) day after the date of my death, then I give, devise and bequeath the
residue of my estate, of every nature and wherever situate, in equal shares her descendants,
per stirpes.
FOURTH
In the event any beneficiary who is entitled to a share of the residue under Item Third
has not yet attained the age of twenty-one (21) years at the time for distribution to him or
her, then I give, devise and bequeath the share of each such beneficiary to my trustee
hereinafter named, IN TRUST, nevertheless, upon the following terms and conditions:
A. The income and so much of the principal as may, in the sole discretion of
my trustee, be necessary for the maintenance, support, medical expenses,
and education of the beneficiary, shall be paid to the beneficiary or shall
be applied directly for his or her benefit.
B. Any income not so paid or applied shall be accumulated and added to
such beneficiary's share of the trust estate.
C. Any income and principal remaining in such beneficiary's share of the
trust shall be distributed to such beneficiary when he or she attains the
age of twenty-one (21) years.
Page 2 of 7
1 r ~ \
D. In the event any such beneficiary who has not yet attained the age of
twenty-one (21) years at the time of my death dies before distribution of
his or her entire principal share, then such share shall be distributed to
such beneficiary's then living descendants, per stirpes, absolutely; or in
default of such descendants, it shall be distributed in accordance with
Item Third of this Will.
E. Any income or principal payable to a beneficiary under this Item Fourth
may be accumulated or expended for the maintenance, support, medical
expenses, or education of such beneficiary as the trustee, in his sole
discretion, may determine. My trustee may, in her discretion, pay the
said income or principal directly to the beneficiary, to the person having
the care or control of such beneficiary, or to any institution entitled to
such payment by reason of services rendered to or to be rendered to said
beneficiary, without the intervention of a guardian.
FIFrH
All principal and income, until actual distribution to the beneficiaries, shall be free of
the debts, contrad,s, assignments, alienations and anticipations of any beneficiary, and the
same shall not be subject to any levy, attachment, execution or sequestration.
Page 3 of 7
I '..'
D. In the event any such beneficiary who has not yet attained the age of
twenty-one (21) years at the time of my death dies before distribution of
his or her entire principal share, then such share shall be distributed to
such beneficiary's then living descendants, per stirpes, absolutely; or in
default of such descendants, it shall be distributed in accordance with
Item Third of this Will.
E. Any income or principal payable to a beneficiary under this Item Fourth
may be accumulated or expended for the maintenance, support, medical
expenses, or education of such beneficiary as the trustee, in his sole
discretion, may determine. My trustee may, in her discretion, pay the
said income or principal directly to the beneficiary, to the person having
the care or control of such beneficiary, or to any institution entitled to
such payment by reason of services rendered to or to be rendered to said
beneficiary, without the intervention of a guardian.
FIFTH
All principal and income, until actual distribution to the beneficiaries, shall be free of
the debts, contracts, assignments, alienations and anticipations of any beneficiary, and the
same shall not be subject to any levy, attachment, execution or sequestration.
Page 3 of 7
I'
s ','
SIXT:{I
I direct that all taxes that may be assessed in consequence of my death, of whatever
nature and by whatever jurisdiction imposed, shall be paid from my residuary estate as a part
of the expenses of the administration of the estate.
SEVENTH
My personal representative and trustee shall have the following powers in addition to
those vested in her by law and by other provisions of this Will:
A. To retain any or all assets of my estate, real or personal, without regard to any
principle of diversification, risk or productivity.
B. To invest in all forms of property as my fiduciary may deem proper, without
regard to any principle of diversification, risk or productivity.
C. To purchase investments at a premium or discount.
D. To exercise all rights of a security holder or shareholder in any corporation; to
give proxies; to join in any merger, consolidation, reorganization, voting trust
plan, or other concerted action of security holders; and to delegate discretionary
duties with respect thereto.
E. To sell at public or private sale, to exchange or to lease, for any period of time,
any real or personal property, and to give options for sales, exchanges or leases,
for such prices and upon such terms or conditions as they deem proper.
F. To allocate receipts and expenses to principal or income, or partly to each, as my
corpo:rate trustee thinks proper.
Page 4 of 7
, (. .
G. To horrow money from my corporate fiduciary or others and to mortgage or
plt~dge any real or personal property as security therefore, in their sole
discretion.
H. To compromise any claim or controversy without order of court or consent of any
beneficiary .
I. To exercise any option, right or privilege granted in insurance policies or arising
from ownership of investments.
J. To ,loin with my daughter, Jennifer J. Lepley, or her personal representative, in
filing a joint income tax return, and to join in any gifts made by my daughter for
gift tax purposes. Any income or gift taxes due on such returns and any
deficiencies, interest, penalties or refunds thereon shall be allocated between my
estate and my daughter or her estate as my Executor and my daughter's
personal representative may agree.
K. To permit my minor children to occupy any real estate retained or acquired
upon such terms and conditions as my trustee may deem proper.
L. To luake any distribution herein provided for in cash, in kind, or partly in each,
at valuations fixed by my personal representative or trustee at the time of
distribution.
M. My "fiduciary may, in his or her sole discretion, donate any part or all of my
tangible personal property to any charitable organization(s) which would benefit
from such donation. My fiduciary is then instructed to use the value of said
donation(s} as an inheritance tax deduction for any inheritance tax return which
may be required to be filed as a consequence of my death.
Page 5 of 7
.~" .' ,
EIGHTH
I appoint my daughter, Jennifer J. Lepley, Executor, of this, my Last Will and
Testament.
NINTH
My Executrix and Trustee shall not be required to post security in any jurisdiction.
IN WITNgSS WHEREOF, I have hereunto set my hand and seal to this, my Last Will
and Testament, <:onsisting of seven (7 ) typewritten pages, thi 6 th day of August 2005.
Signed, sealed, published and declared by the above~nam.ed Testator, John Joseph Draksler,
as and for his Last Will and Testament, in the sight and presence of us, who, at his request,
in their sight and presence and in the sight and presence of each other, have hereunto
Bubsc' d our names as witnesses.
~<(~
Address I ~q /fJJ S Y)1I)'IIJ(!... /2,0.
/J1~.~{c~6u..':J f?~ /7o')r
Address jdla'!l ~5Smo'//le Rd.
/J1uhlV1€CSb"-'Y1 )J..... no ))
;t~ /JonuYlV>'-'
COMMONWEALTH OF PENNSYLVANIA )
58:
COUNTY OF CUMBERLAND
)
Page 6 of 7
" .
, . ."~ : ,. ..
I, John Joseph Draksler, THE TESTATOR, WHOSE NAME IS SIGNED TO THE
FOREGOING INSTRUMENT, HAVING BEEN nUL Y QUALIFIED ACCORDING TO LAW,
DO HEREBY ACKNOWLEDGE THAT I SIGNED AND EXECUTED THE INSTRUMENT AS
MY LAST WILL AND TESTAMENT; THAT I SIGNED IT WILLINGLY; AND THAT I
SIGNED IT AS MY FREE AND VOLUNTARY ACT FOR THE PURPOSES THEREIN
EXPRESSED.
SWORN OR AFFIRMED TO AND ACKNOWLEDGED BEFORE ME BY John Joseph
rp VV111 fy iFf.'"' ~~. ~"_..~. .,r
~. '.~
Notary Public { "...~~-'.., """:~" ~
NotarIal Seal ~ ':: ~ ""':~ 2 ~
COMMONWEALTH OF PENNSYLVANIA ) Am1caL8hosmak8r, Nc8yPdto :~ .:. \"'::..." <".::
SuIquehama 1\\1>., D8uphlnCounty -.-;' '.'~'. /'.. "".-
: SS: MyO:mmlsslonExr;iresAug.27,2006 '. '">;.. -', . ....-.'>.---,
. .-'. 0" - \
COUNTY OF CUMBERLAND ) Menbtr.PennsylvaniaAl8odallonOfNotadea ......~. ,~:;-,~--"\'-~:>.
.....~-...1'.,........,..................... ........
WE, ~l~~.)tLrJ t-kuyun&#\-AND ~ t&n/1l~HE WITNESSES WHOSE NAMES ARE
SIGNED TO THE FOREGOING INSTRUMENT, BEING DULY QUALIFIED ACCORDING
TO LAW, DEPOSE AND SAY THAT WE WERE PRESENT AND SAW THE AFORESAID
TESTATOR SIGN AND EXECUTE THE INSTRUMENT AS HIS LAST WILL AND
TESTAMENT; THAT HE SIGNED WILLINGLY AND THAT HE EXECUTED IT AS HIS
FREE AND VOLUNTARY ACT FOR THE PURPOSES THEREIN EXPRESSED; THAT EACH
OF US IN THE HEARING AND SIGHT OF THE TESTATOR SIGNED THE WILL AS
WITNESSES; AND THAT TO THE BEST OF OUR KNOWLEDGE THE TESTATOR WAS AT
THE TIME EIGHTEEN (18) OR MORE YEARS OF AGE, OF SOUND MIND AND UNDER NO
CONSTRAINT OR UNDUE INFLUENCE.
SWORN OR AFFIRMED TO AND SUBSCRIB~ BEFORE M,E, ,THIS 16 th DAY
OF August, 2005. fl/ f'. .
Wit~ess
~ I~ rn- <v>---.. _
()~d~QtL1-
Notary Public """"'-""--'~'"
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