The URL can be used to link to this page

Home My WebLink About96-0925{ ~ ~~`- Register of Wills of Cumberland County a = STATUS REPORT UNDER RULE 6.12 Name of Decedent: Delbert H. Smith, Sr. Date of Death: October 2, 1 9 9 6 ' Estate No.: 21 96-0925 ' 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: ] . State whether administration of the estate is complete: Yes n 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 fina] account with the Court? Yes n No n 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? Yes n No n c. Copies of receipts, releases, joinders and approval of forn~al or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: - o p~ ~ ~' Signature Anthony L. DeLuca, Esquire Name 113 Front St., P.O. Box 358 Boiling Springs, PA 17007 Address 717-258-6844 Telephone No. Capacity: n Personal Representative nX Counsel for personal representative .... '. - ......" ,-. "", _~_. < "'_ . ....., - r'o _ ,'- \ -' i" -', ,- BUREAU G~-{I;~pIyrD~4!,.;rA~s_, INHERITANCE,'t.~, D.IVISIQN pO BOX 2B06&~-. - " HARRISBURG PA 171 2 B-c 0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX '* REV-1547 EX AFP (06-05) DATE 02-19-2007 ESTATE OF SMITH DELBERT H DATE OF DEATH 10-02-1996 FILE NUMBER 21 96- 0925 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 04-20-2007 ( See reverse side under Objections) A.ount Remittedl I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ..... RETAIN LOWER PORTION FOR YOUR RECORDS +- ------------------------------------------------------------------------------------------- REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SMITH DELBERT H FILE NO. 21 96-0925 ACN 101 DATE 02-19-2007 2001 FEE 23 Pi'j I: 05 UP)!' ORD' '\' "C' "; I' ~ it"',' \; '~,-' ~JU.IAH' S DANIELS STE 205 1 W HIGH ST CARLISLE PA 17013 TAX RETURN WAS: ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) (6) (7) 339,440.00 .00 .00 .00 10,002.92 .00 .00 (8) NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 1. Real Estate (Schedule A) 2. 3. 4. 5. 6. 7. 8. Closely Held Stock/Partnership Interest (Schedule C) Mortgages/Notes Receivable (Schedule D) Cash/Bank Deposits/Misc. Personal Property (Schedule E) Jointly Owned Property (Schedule F) Transfers (Schedule G) Total Assets 349,442.92 APPROVED DEDUCTIONS AND EXEMPTIONS: .00 9. 10. II. 12. 13. 14. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) Debts/Mortgage Liabilities/Liens (Schedule I) (10) Total Deductions Net Value of Tax Return Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) Net Value of Estate Subject to Tax .00 (11) (12) (13) (14) .00 349,442.92 .00 349,442.92 NOTE: If an assess.ent was issued previouslY, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) .00 X DO .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) .00 X 06 .00 17. Amount of Line 14 at Sibling rate (17) .00 X DO .00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 349,442.92 X 15 52,416.44 19. Principal Tax Due (19)= 52,416.44 'AX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-02-1997 AA185031 552.63 10,500.00 INTEREST IS CHARGED THROUGH 03-06-2007 TOTAL TAX CREDIT 11 , 052.63 AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 41,363.81 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 27,297.76 TOTAL DUE 68,661.57 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN *1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) V \l~ REV-1470 EX (6-66) *' INHERITANCE TAX E>f.~L~~A TION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17128-0601 DECEDENT'S NAME Delbert H. Smith FILE NUMBER REVIEWED BY Steven James ACN 21 96-0925 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES This assessment is issued under Section 2141 ofthe Inheritance and Estate Tax Act and is not based on any tax return filed by a representative of the estate. The Department reserves the right to revalue the property at any time a bona fide return is filed as well as to issue a supplemental appraisement for the value of any additional assets that may exist. If taxes are not paid within 60 days of this notice, a lien will be filed against the real estate. ROW PaQe 1 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 DELBERT H SMITH JR 5 HEDGE ROW LANE CARLISLE, PA 17013 ______u fold ESTATE INFORMATION: SSN: 187 -16-5667 FILE NUMBER: 2196-0925 DECEDENT NAME: SMITH DELBERT H SR DATE OF PAYMENT: 08/03/2007 POSTMARK DATE: 08/03/2007 COUNTY: CUMBERLAND DATE OF DEATH: 10/02/1996 NO. CD 008496 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $971.23 I I I I I I I I TOTAL AMOUNT PAID: $971.23 REMARKS: RECEIPT TO ATTORNEY CHECK# 444 INITIALS: AJW RECEIVED BY: SEAL REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS .1. INVENTORY /' REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYL VANIA COMMONWEALTH OF PENNSYLVANIA } SS 1996-00925 COUNTY OF CUMBERLAND File Number Delbert H. Smith, Jr. and Walter J. Smith Personal Representative(s) of the Estate of Delbert H. Smith, Sr. deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwea1th of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I verify that the statements made in this Inven- } 1tJj~?I~ Q tory are true and correct. I understand that false state- 6Zk ments herein are made subject to the penalties of (/'y(~ jl.J~t( 18 Pa.C.S. ~ 4904 relating to unsworn falsification to . authorities. Attorney -- (Name) Anthony L. DeLuca, Esquire ~d~~~ P.O. Box 358, 113 Front Street, (Felephone) 717 -2 58-6844 (Supreme Court lD. No.) 1 8067 Boiling Springs, PA 17007 DATE OF DEATH 10/2/96 LAST RESIDENCE DECEDENT'S SOC. SEC. NO. 422 Walnut Street, Boiling Springs, PA 187-16-5667 FIGURES MUST BE TOTALED. Residence situated at 422 Walnut Street, Boiling Springs, Pennsylvania $58,900.00 2. Lot of land situated at 420 Walnut Street, Boiling Springs, Pennsylvania "-> Q g <:~17 , 5fTT1. OQ,. .n') ~ - u,....... c:: I...... l:i"). , ;;.= ~ , 5 ~),U . 0 " .~ :JJ . V) ;;>, W CJ r) - C:J '.,' -u ,= ':3, 87J!5 . 00 :. .::0 W T,--j :: 16,86;a.16 .::- 3. Cabin on lot of land situated at 1376 Indian Peg Road, Boiling Springs, Pennsylvania 4. Miscellaneous items of personal property. 5. Certificate of Deposit, #064060126-4060432, at Corestate Bank Accrued Interest 163.71 6. Savings account, #8338013605, at Corestates Bank Accrued Interest 3,811.90 7. Checking account, #1322672, at Farmers Trust Company Accrued Interest 1,975.31 .97 8. Savings account, #29-000239, at Farmers Trust Company (AlMc1i~aJ.n/ft!fsfGfjJeded) See Attached 25,935.15 3.77 TOTAL: NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative include the value of each item, but such figures should not be extended into the total of the Inventory. (See 20 Pa. C.S, f 3301(b)) Form RW-09 rev, /0.13.06 ~ INVENTORY CONTINUATION SHEET Estate of Delbert H. Smith, Sr. File No. 1996-00925 9. Checking account, #182-842-5841, at Mellon Bank $1,190.61 Accrued Interest 1.04 10. Certificate of Deposit, #018-A 49000-C, at Mellon Bank 3,646.00 Accrued Interest 18.39 11. Certificate of Deposit, #180-001135-C, at Mellon Bank 20,000.00 Accrued Interest 91.57 12. Certificate of Deposit, #180-001303-C, at Mellon Bank 1,000.00 Accrued Interest 14.56 13. Certificate of Deposit, #180-001384, at Mellon Bank 1,000.00 Accrued Interest 9.39 14. Certificate of Deposit, # 180-068931, at Mellon Bank 1,000.00 Accrued Interest 16.90 15. Certificate of Deposit, #180-092628-C, at Mellon Bank 10,000.00 Accrued Interest 72.22 16. Certificate of Deposit, #2100105699, at PNC Bank, N.A. 24,000.00 Accrued Interest 44.99 17. Certificate of Deposit, #21001056757, at PNC Bank, N.A. 1,629.63 Accrued Interest 421.51 18. Personal Income Tax Return 367.15 19. 1984 Chrysler Automobile 2,000.00 TOTAL $205,013.29 ~ 15056051047 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN RESIDENT DECEDENT Date of Birth Decedent's Last Name Suffix Decedent's First Name MI (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WillS FILL IN APPROPRIATE OVALS BELOW ~ 1. Original Return <::) 4. Limited Estate <::) 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required <::) 2. Supplemental Return <::) <::) <::) 4a. Future Interest Compromise (date of death after 12-12-82) <::) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) <::) 10. Spousal Poverty Credit (date of death <::) 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT _ THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number 1 8. Total Number of Safe Deposit Boxes ., 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received Correspondent's e-mail address: Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, It is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. co?-sx 7- l.-7-o 7 Side 1 L 15056051047 15056051047 ~ ~ ---' REV-1500 EX Decedent's Name: RECAPITULATION 15056052048 1. Real estate (Schedule A). ... . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . _ . .. 1. 2. Stocks and Bonds (Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) . . . .. 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) . . . . . . .. 5. 6. Jointly Owned Property (Schedule F) c:::::) Separate Billing Requested . . . . . .. 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) c:::::) Separate Billing Requested.. . . . . .. 7. 8. Total Gross Assets (total Lines 1-7). . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . . . . . .. 8. 9. Funeral Expenses & Administrative Costs (Schedule H). . . . . . . . . . . . . _ . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I). . . . . . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 11. Decedent's Social Security Number 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . . . . . . . . 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . . . 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) X .0_ 16. Amount of Line 14 taxable at lineal rate X.O + 17. Amount of Line 14 taxable at sibling rate X .12 18. Amount of Line 14 taxable at collateral rate X .15 15. 16. 17. 19. TAX DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 18. 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT s ~ ~L '<- 15056052048 Side 2 c:::::) 15056052048 ~ REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME ~~elbeE.~!!~_ Smi_th, Sr. File Number STREET ADDRESS 422 Walnut street ~- --~------~-~--- ~- f--CITY -----TSTATE - ! PA ZIP i 17007 Boiling Springs, Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1 ) 11,625.86 -0- -_._.._-~.._--_._--~---_._----- _~~L500.00____ 55~~______ Total Credits ( A + B + C ) (2) 11,052.63 3. Interest/Penalty if applicable D. Interest E. Penalty ----~--~ Total Interest/Penalty ( 0 + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) -0- B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (5B) 573.23 398.00 971.23 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. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred;.......................................................................................... D 0 b. retain the right to designate who shall use the property transferred or its income; ............................................ D 0 c. retain a reversionary interest; or.......................................................................................................................... D KJ d. receive the promise for life of either payments, benefits or care? ...................................................................... D Kl 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. D KJ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. D [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ D KJ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 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 three (3) percent [72 P.S. 99116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. 99116 (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 zero (0) percent [72 P.S. 99116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is four and one-half (4.5) percent, 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 twelve (12) percent [72 P.S. 99116(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 adoption. REV-1502 EX+ (6-9_ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE A REAL ESTATE ESTATE OF FILE NUMBER Delbert H. Smith, Sr. 2196-0923 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 survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION Residence situated at 422 Walnut Street, Boiling Springs, Pa. See Attached appraisal. VALUE AT DATE OF DEATH $58,900.00 2. Lot of land situated at 420 Walnut Street Boiling Springs, Pa. See attached apprai~al. 17,500.00 3. Cabin on lot of land situated at 1376 Indian Peg Road, Boiling Springs, PA. See attached appraisal. 9,500.00 TOTAL (Also enter on line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 85,900.00 REV-l503 EX. (1-97) SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Delbert H. Smith, Sr. 2196-0925 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH -0- NONE TOTAL (Also enter on line 2, Recapitulation) $ - 0- IIf morA !mace is needed. insert additional sheets of the same size) REV-l504 EX + (1-97) '* SCHEDULE C ClOSEl Y.HElD CORPORATION, PARTNERSHIP or SOlE.PROPRIETORSHIP COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Delbert H. Smith, Sr. 2196-0925 Schedule C-1 or C-2 (Including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships. ITEM NUMBER 1. DESCRIPTION VALUE AT DATE OF DEATH TOTAL (Also enter on line 3, Recapitulation) $ - 0- (If more space is needed, insert additional sheets of the same size) REV-1507 EX+ (1-97) , * COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE D MORTGAGES & NOTES RECEIVABLE ESTATE OF FILE NUMBER Delbert H. Smith, Sr. 2196-0925 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH 1. NONE -0- TOTAL (Also enter on line 4, Recapitulation) $ - 0- (If more space is needed, insert additional sheets of the same size) REV-1508 EX... "1-97) '* SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Delbert H. Smith, Sr. FILE NUMBER 2196-0925 ESTATE OF ITEM NUMBER 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. VALUE AT DATE OF DEATH DESCRIPTION 1. Miscellaneous items of personal property. See attached appraisal. 2. Certificate of Deposit, #064060126-4060432, at Corestates Bank Accrued Interest 3. Savings account, #8338013605, at Corestates Bank Accrued Interest 4. Checking account, #1322672, at Farmers Trust Company Accrued Interest 5. Savings account, #29-000239, at Farmers Trust Company Accrued Interest 6. Checking account, #182-842-5841, at Mellon Bank Accrued Interest 7. Certificate of Deposit, #018-A 49000-C, at Mellon Bank Accrued Interest 8. Certificate of Deposit, #180-001135-C, at Mellon Bank Accrued Interest 9. Certificate of Deposit, #180-001303-C, at Mellon Bank Accrued Interest 10. Certificate of Deposit, #180-001384, at Mellon Bank Accrued Interest 11. Certificate of Deposit, #180-068931, at Mellon Bank Accrued Interest 12. Certificate of deposit, #180-092628-C, at Mellon Bank Accrued Interest 13. Certificate of Deposit, #2100105699, at PNC Bank, N.A. Accrued Interest 14. Certificate of Deposit, #21001056757, at PNC Bank, N.A. Accrued Interest 15. Personal Income Tax Return 16. 1984 Chrysler Automobile $3,845.00 16,853.16 163.71 3,811.90 .36 1,975.31 .97 25,935.15 3.77 1,190.61 1 .04 3,646.00 18.39 20,000.00 91.57 1,000.00 14.56 1,000.00 9.39 1,000.00 16.90 10,000.00 72.22 24,000.00 44.99 1,629.63 421.51 367.15 2,000.00 $ 119,113.29 TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insert additional sheets of the same size) REV-1509 EX. (1-97) SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Delbert H. Smith, Sr. 2196-0925 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. Walter J. Smith 422 Walnut Street Boiling Springs, PA 17007 Son 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 join~y-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 10/2: /Certificate of Deposit, #1-92713, 90 $10,096.56 50% $5,048.28 at Farmers Trust Company, Carlisle, PA. TOTAL (Also enter on line 6, Recapitulation) $ 5,048.28 (If more space is needed, insert additional sheets of the same size) REV.1510 EX. (1.97) '* SCHEDULE G INTER.VIVOS TRANSFERS & MISC. NON.PROBA TE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Delbert H. Smith, Sr. 2196-0925 This schedule must be completed and filed if the answer to any 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 ESTATE. NUMBER VALUE OF ASSET INTEREST IF APPLICABLE) 1. NONE -0- TOTAL (Also enter on line 7, Recapitulation) $ -0- .. (If more space is needed, insert additional sheets of the same size) REV-1511 EX+ (12-99) . '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN )'!ESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Delbert H. Smith, Sr. FILE NUMBER 2196-0925 ITEM NUMBER A. Debts of decedent must be reported on Schedule I. DESCRIPTION 1. FUNERAL EXPENSES: Hoffman Roth Funeral Home 219 North Hanover Street Carlisle, PA 17013 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State _ Zip 2. Year(s) Commission Paid: William S. Daniels, Esquire Attorney Fees Anthony L. DeLuca, Esquire 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State _ Zip Relationship of Claimant to Decedent 4. Probate Fees Register of Wills 5. Accountant's Fees 6. 7. 8. 9. 10. Tax Return Preparer's Fees Legal Advertising - Cumberland Law Journal Legal Advertising - The Sentinel George L. Ebeners Realtor - Appraisal of Real Estate Spahr's Antiques - Appraisal of Personal Property See attached sheet. Short Certificates - Register of Wills Filing fee Inheritance Tax Return and Inventory 11. 12. AMOUNT $5,500.90 5,000.00 5,000.00 287.00 60.00 80.26 200.00 120.00 24.00 25.00 TOTAL (Also enter on line 9, Recapitulation) $ 1 6 , 297 . 1 6 (If more space is needed, insert additional sheets of the same size) REV"1512 EX+ (12-03) '*' SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Delbert H. Smith, Sr. FILE NUMBER 2196-0925 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. NONE -0- TOTAL (Also enter on line 10, Recapitulation) $ - 0- (If more space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00) SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT Delbert H. Smith, Sr. FILE NUMBER 2196-0925 ESTATE OF 1. RELATIONSHIP TO DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Delbert H. Smith, Jr. Son 2544 Kingston Drive Florence, South Carolina 29505 AMOUNT OR SHARE OF ESTATE NUMBER I 50% 2 Walter J. Smith 422 Walnut Street Boiling Springs, PA 17007 Son 50% ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. 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- (If more space is needed, insert additional sheets of the same size) I APPRAISAL REPORT OF DELBERT H. SMITH, SR. ESTATE LOCATED AT 422 WALNUT STREET & INDIAN PEG ROAD BOILING SPRINGS, PENNSYLVANIA 17007 I FOR WILLIAM S. DANIELS, ESQUIRE 1 W. HIGH STREET CARLISLE, PENNSYLVANIA 17013 as of OCTOBER 2, 1996 By: GEORGE L. EBENER CHARLES L. WENGER, G.R.I. 139 W. High Street Carlisle, PA. 17013 GEORGE L. EBENER & ASSOCS., REALTORS I I f i . t t GEORGE L. EBENER & ASSOCIATES REALTORS [B PEAlTOR' Residential, Commercial & Farms Appraisals · Sales · Rentals MULTIPLE /iis 139 West High Street, Carlisle, PA 17013-2991 (717) 243-6195 November 4, 1996 f William S. Daniels, Esquire 1 West High Street Carlisle, PA. 17013 Re: Delbert H. Smith, Sr. Estate 422 Walnut Street Indian Peg Road Boiling Springs, PA. 17007 Dear ,William: In compliance with your request, George L. Ebener and Charles L. Wenger personally inspected the above captioned properties on October 24, 1996 at 1:00 o'clock P.M. with walter J. Smith, to estimate their market value for InheritaQce Tax purposes. The value shown has been arrived at after careful study of the location and type of improvements, their physical condition and their present use. Therefore, we believe it to reflect a true measure of the present market value as of October 2, 1996, the date of death of Delbert H. Smith, Sr.. Value Reported: 422 Walnut St. - house and lot - Fifty-Eight Thousand Nine Hundred Dollars ($ 58,900.00 ). 420 Walnut St. - adj acent lot - Seventeen Thousand ~~ Hundred Dollars ( $ 17,100.00 ). 1376 Indian Peg Road - cabin and lot - Nine Thousand Five Hundred Dollars ( $ 9,500.00 ). We hereby certify that we have no financial interest, present or contemplated in these properties and that neither the employment to make the appraisal nor the compensation therefrom is contingent upon the value reported. su~lttehd by ..,-~_. /<:~;,' r ,>~_"f ./~&c".~~c~ J .~ %'7 Geor L. ~Dener S '. Broker ~~~/ Charles L. wenger,~RI Broker/Partner 8tptt~r's Antiques - AUttiuns !\urtinueeriug & Appraisals 44 N. i1,bfnrb &t. aIurUslt. 'a. 17013 mtltplJnnt: 717-243-5U1U 5 November, 1996 William S Daniels, Attorney One West High Street Carlisle PA 17013 Dear Mr. Daniels The following is my appraisal of the Delbert H Smith Estate at 422 Walnut Street, Boiling Springs P A 17007. Kitchen 1. Frigidaire refrigerator with freezer on top 2. Frigidaire upright freezer 3. Formica top table with chairs 4. Zenith color television 5. Misc. pots, pans, cangoods, kitchen items etc. $ Dining Room 1. Seven pc. mahogany dining room suite 2. Wheelchair 3. Zenith floor model color television 4. Upholstered sofa and chair 5. Floor and table lights 6. Misc. items North West Bedroom 1. Three pc. bedroom suite 2. Folding cot 3. Small pine chest of drawers 4. Misc. clothing exerciser, beddings, fans, books, etc. 35.00 35.00 60.00 20.00 15.00 145.00 5.00 35.00 5.00 30.00 20.00 225.00 10.00 25.00 60.00 -2- East Bedroom 1. Maple bed 2. Folding cot 3. Rocker 4. Sewing machine 5. Cedar chest 6. Metal wardrobe 7. Pine gun case 8. Contents of gun case 9. Misc. luggage, clothing, etc. $ 25.00 10.00 20.00 20.00 35.00 10.00 50.00 500.00 20.00 Basement 1. Fishing items 2. Paint, cangoods, jars, etc. 20.00 10.00 Shed 1. Honda H.S. 70 Snowblower 2. Sears Craftsman lawnmower 3. Troy rototiller 4. Metal wheelbarrel 5. Misc. garden tools 350.00 75.00 175.00 15.00 30.00 Garage 1. 30 foot aluminum extension ladder 2. Misc. lumber, stepladder, garden tools, etc. 3. 1984 Chrysler E class four door sedan with power steering and brakes. Automatic transmission. 8, 927 miles 30.00 40.00 1,600.00 Outside 1. 1980 Dodge Aspen four door sedan with power steering and brakes. 28, 752 miles (poor condition) 2. Metal porch glider and two chairs 3. Misc. items 50.00 25.00 10.00 Total - $ 3, 845.00 Sincerely, ~~ Charles Spahr CS/ab BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2B0601 HARRISBURG PA 1712B-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE --~. (I~IUTANCE TAX STATEMENT OF ACCOUNT *' REV-1607 EX AFP (03-05> ANTHONY L DELUCA 113 FRONT ST POBOX 358 BOILING SPRINGS ('l EP!( (iF \,..1 _ I 1. \ -' OQDLf \ i'C; 0('! JOT ): i! ~ i-" '\ ..' \) \._:' \::.' l I 01 ,t . . \.)".' '"' DATE M'lll: 2J ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-04-2007 SMITH 10-02-1996 21 96-0925 CUMBERLAND 101 DELBERT H zen? SEP I 7 Amount Remitted PA 17007 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insu~e p~ope~ c~edit to you~ account. submit the uppe~ po~tion of this fo~m with you~ tax payment. CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +- REV-1607 EX AFP (03-05) --------------------------------------------------------------------------- *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF SMITH DELBERT H FILE NO. 21 96- 0925 ACN 101 DATE 09-04-2007 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYMENTS. THE CURRENT BALANCE. AND. IF APPLICABLE. A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-18-2007 PRINCIPAL TAX DUE: 52,416.44 PAYMENTS (TAX CREDITS): INT AT REV PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 01-02-1997 AA185031 552.63 10,500.00 08-03-2007 CDo08496 .00 971.23 EREST IS CHARGED THROUGH 09-19-2007 TOTAL TAX CREDIT 12,023.86 THE RATES APPLICABLE AS OUTLINED ON THE ERSE SIDE OF THIS FORM.* BALANCE OF TAX DUE 40,392.58 INTEREST AND PEN. 29,072.32 " IF PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE 69,464.90 SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN tl. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" {CR>. YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. > y I: O,ATE 10 -22-2007 ESTATE OF SMITH DELBERT H DATE OF DEATH 10-02-1996 FILE NUMBER 21 96-0925 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 12-21-2007 ( See reverse side under Objections) A.ount Re.lttedl I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE -+ RETAIN LOWER PORTION FOR YOUR RECORDS +- ------------------------------------------------------------------------------------------- REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SMITH DELBERT H FILE NO. 21 96-0925 ACN 101 DATE 10-22-2007 If an assess.ent was Issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that Include the total of ~ returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE -..iOTICE" OF: INHERITANCE TAX APPRAI~EMENT, .lLOWANCE OR DISALLOWANCE OF IlEJ;lUCT.J.ONS AIlI) ASSESSMENT OF TAX BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO lOX 2110601 HARRISIIURG PA 17128-0601 7;1117 r,!0\} -? h\,1 ,",' r t"....... f- t:l" ( I: ANTHONY L DELUCA 113 FRONT ST PO BOX 358 BOILING SPGS r.....' ,- \.;c.:':: Oni' I/o h;'~l' i'-', r: I', r'- v\.....",. ESQ PA 17007 TAX RETURN WAS: ( X) CHANGED ) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: SUPPLEMENTAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule D) (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets NO. 01 85,900.00 .00 .00 .00 119,113.29 5,048.28 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage 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) ClO) 16,297.16 .00 Cl1) Cl2) Cl3) Cl4) NOTE: Cl5) (16) Cl7) (18) .00 X 193,764.41 X .00 X .00 X A DATE 01-02-1997 08-03-2007 + INTEREST/PEN PAID (-) 552.63 397.13- AMOUNT PAID NUMBER AA185031 CDo08496 10,500.00 971 . 23 * REV-1547 EX AFP (06-05) SEE ATTACHED NOTICE NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 210,061.57 1 Ii .797 .1/i 193,764.41 .00 193,764.41 00 06 00 .. 15 .00 11,625.86 .00 .00 11 ,625.86 (19)= TOTAL TAX CREDIT 11,626.73 BALANCE OF TAX DUE .87CR INTEREST AND PEN. .00 TOTAL DUE .87CR ( IF TOTAL DUE IS LESS THAN *1, NO PAYMENT IS REQUIRED. (' -- IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YDU MAY BE D~ A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~ IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. r REV-1470 EXJ-l . . '* INHERITANCE TAX EXPLANATION OF CHANGES COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17128-0601 DECEDENrS NAME FILE NUMBER 21 96-0925 101 Delbert H. Smith REVIEWED BY ACN Steven James ITEM SCHEDULE NO. EXPLANATION OF CHANGES The Inheritance Tax Return filed by the estate has been accepted as a Changed Supplemental Return based on the Department's previous assessment of Real Estate. ROW PaQe 1 Pa. O.C. Rule 6.12 STATUS REPORT REGLSTER OF WILLS OF~~~- C COUNTY, PENNSYLVANIA r f ~. S~ , fig ~~,~' Name of Decedent: ..-_~/ ~1 ~ ~. Date of Death: r~ ~~ ~ ~ File Number: Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: ' ~'~~- ~ Yes 0 No 1. State whether admmistration of the estate is complete:...... . 2. If the answer'is No, state when the personal representative reasonably believes that the administration willnbe ~co~m,plete: e~~/~~~~ r~~ 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Cow-t? ....... Yes f]No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account ~]I'es ONo ...... informally to the parties in interest . ........................ . d. Copies of receipts, releases, joinders and approvals of formal oz' informal accounts maybe filed with the Clerk of the Orphans' Court and may be attached to this report. ~~ U r~ -~-~ ~ Dnte Signature of Person Filing this Form ~ Capacity: QPersonal F:epresentative Counsel ~ ~~~. ~~ , ~- _ - r' ~~~-' !' Nnme of Person Filing this Forr~i I ~L~=_-` --- ~j ..L G ~ ~_,' Address o 1 WEST HIGH ST. STE 205 Telepl3one ~~~/ ~~'~ ~~ " v~~~{/ l/ ~ "~ ~/~' Form RN'-JO rev. 10.13.06 Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 9/21/2009 ° '~, (-S^ `r_ DANIELS WILLIAM S GO ~ ~'~ "~ ONE W HIGH STREET STE 205 -p~m N ;~~ CARLISLE, PA 17013 ~ ~ `. - np r, ~ - ~ ?~1 ~..o c;., RE: Estate of SMITH DELBERT H SR File Number: 1996-00925 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedents death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 10/02/2009 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, I~~~iV~G~ Glenda Farner Str asbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 9/21/2009 DELBERT H SMITH JR e~ 0 ° rp N m :7 5 HEDGE ROW LANE o r*i G?<J CARLISLE, PA 17013 =. ~ ~ N rr~ rn ~ cri ~ _ _zs c_ y 0~ C ry rt 7 = a -n F ~ ~ ~ ~ CIt i.: <:'.~ , RE: Estate of SMITH DELBERT H SR _ ,n File Number: 1996-00925 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 10/02/2009 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Cumberland Count - Y Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/21/2009 N ~ , ,-, ~' - WALTER J ~ N r^ r rYr~- ~ SMITH ~~~ o .J,~ 422 WALNUT ST ~~~ ~~°> nx N awJ BOILING SPRINGS, PA 17007 c <~c>~ a ~~~ [A "' RE: Estate of SMITH DELBERT H SR File Number; 1996-00925 Dear Sir/Madam: This notice is to serve as a reminder that the Status Personal Representative under Rule 6.12 is due on the date. Report by below listed As per the AMENDMENTS TO SUPREME COURT ORPHANS' SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992 COST RULES, NO. 103 (2) years of thee personal representative or his counsel Wills a Status Reportdoftcompleted orall file with the Registernofwo uncompleted administration. This filing is due by; 10/02/2009 Please feel free to contact this office with an have. If you have already filed your Status this notice. Y questions you may Report, please disregard Sincerely, Glenda Farner Strasbau h Clerk of the Orphans' Court cc: File Counsel ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF In Re: Estate of CUMBERLAND COUNTY SMITH DELBERT H SR PENNSYLVANIA NO. 1996-00925 NOTICE OF FAILURE TO FILE STATUS REPORT Personal Representative: DELBERT H SMITH JR Counsel for Personal Representative: DANIELS WILLIAM S Date of Decedent's Death: 10/2/1996 The Orphans' Court record indicates that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, is hereby given that you have ten (]0) days to file the Status Report. If the required 6.12 fore is not filed in accordance with Rule 6.12 the Court will be notified of such delinquency and the undersigned will request that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 11/9/2009 I~~~~ 6?'LJriG/XI~LW~~ z' Glenda Famer Strasbaugh `] Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File C ° O w :~ r T~ p i 'J r ZZZZZ y~ t ~ ~ = ~ J "F w ' ~ -.yc~ ...,r1 ~~ Tj E ' ~ , V~ Name of Decedent: • + Register of Wills of Cumberland County ,sue, ~~~..~,~/~.r ~~". s Date of Death: ~ ~ w~. Fatale No. ~ . ~ ~~` .-- ' G'G G~ ~ S~ . Pursuant to Rule 6.12 ofithe 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: /~~ •, Yea` No ^ ~ /~ 2. If the answer is No, state when the personal representative reasonably believes that the administration wild be,complete: 3. If the answer to No. 1 is Yes, state the following: a. 'Did the personal representative file afinal account with the Court? Yes ^ No ^ °, b. The separate C-rplians' Court No. (if any) for the personal representative's ~ . c. Did the personal representative state an account informally to the parties in interest? Ycs [] No ^ c. Copies of receipts, releases, joinders~and approval'of f 1 or informal accounts maybe filed with the Clerk of the Orph Co and may be ~ attached to this report. '" ~,~ Datc• ,//- ~ - 2--~// `mac-''~ ~ ~~ . ~-~-~~ Signature ~'- C. ~ `'' ~ ~~ `~ ~ ~ : - Name HUMER d~ DANIELS • . . _ _.._ L _ ,, . , 1 WEST HIGH ST. STE 205 c-' ~ ~ =Y~v,_ q ~ ~__ ~_; ~ -2Y3 - 3 ~3/ ~ ~,, ~' ' t.a ~ C -. _ ~ .~ Telephone No. Capacity: ^ Personal Representative -, ~Counscl for personal representative ~rr~a-r~~ ~~