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LAS/I' H~UI l\ND 'l'EB!N'IEN'l'
I, DAISY S. IlIGlllJlNDS, of 321 East Garfield Street, I30rough of Shippensburg,
C'\.m1bfolrlwu County, Pennsylvw1ia, being of sOlmd mind, mEm:lry and understanding, do
make and publish this my Last Hill and 'I'estament, hereby revoking and nv.1king void any
and all former wills and codicils by me at any tirre heretofore made.
FIHS'l'. I direct my hereinafter named Executor to pay all my just debts and
funeral ex!JUll~es ilti ~oon as conveniently may be after my decease; I further direct
that all taxes that may be assessed in consequence of my death, of whatever nature
and by whatever junsll1chon llnposelt, shall be paid as part of the expense of the
a~nistration of my estate.
SEC'OND. I give, devise and bequeatJ1 all my property, real, personal and mixed,
whatsoever and wheresoever situate, in four (4) equal shares, share am share alike,
as follows: One (1) equal share to my brother, DAVID STINE; one (1) equal share to
my sister, IlE1'1'Y CHNlIlERLIN; one (1) equal share to my slster, MARY PIPER; and one (1)
equal share to my sister, VES'l'A CLIPPINGER, absolutely, or to the survivor or sur-
vivors of than tJ1en livinCJ at the tune of my decease, in equal shares, share and share
alike, to wit, eitJ1er DAVID S'I'INE, IlE.'1TY C1WffiERLIN, MARY PIPER or VES'l'A CLIPPINGER.
THIRD. I hereby nominate, constitute and appoint my brother-in-law, JAY ClIA/.ffiERLIN,
as the Executor of this my Last \~ill and Testament; provided, hC1Never, that in tJle
event my said brother-in-law, ,JAY C1WlBERI,W, is tmable to serve as said Executor for
any reason, then .in that event, I hereby namnate, constitute and ap[:oint my brother-in-
law, HERl31':R'I' PIPER, as tr.0 Executor of this my Last \~ill and 1'estament, my sald Executor
as the case may be, to have full pO\~er and authority to do any and all things necessary
for the CCIllplete aclIlllnistration of my estate, includin<J tJle [Xl',ver to sell any and all
real and personal propert.y of which I lllZlY die seized, at public or private sales, in his
discretion, and wi tJlout any Oruer of any Court 1 and I further direct that my said
Executor not be requirE,a to file any Bond in connection Wlth the settlElnent of my said
Estate .
IN \'II'INESS \'illEllliOF', I, DAISY S. lIIGHUINDS, have hereunto set my hand and seal to this
Iny Last \li11 and Testament, written on two (2) sheets of pilper, tJ1is 12th day of Septanber,
1986.
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Signed, sealed, publishlXl and declnrlXl by DAISY S. IIIGIILIINDS, the 'I'estatrix, as and for
her Last Will and 'l'estament, wri Uen on l'WO (2) sheets of paper, in the presence of us
who have, at her request, si<.II1OO our names an witnesses hereto in the presence of the said
Testatr~x anu of each otl1or.
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEAltH 0' PENNIVIVANIA (TO BE FILED IN DUPLICATE 1991 ()() 342
O"ARIMENT Of REVENUE ' -' 034 2
HARRllm:bJ~n:le,0601 WITH REGISTER OF WILLS) COUNT'Wllf 21 'EAH 94 NUMBER
..--~--CEDi~7~j~~: ~1~1~ ~'~ST. ~N: ~;~IE '~'~'^ii .. .-.. .-- ----.~;":\ :~::~~I~~~-~-~ Sl r e e l~=
J!()r.I~~1~;_~~?;:~H~;~_~-~_-_-r;:-r3b;~~ ID;';;'~";T;'(l'l CO~"~,h ~~::~ :~::~:' I'A 17257
I!! r.~ 1. Original Relurn [I 2. Supplomonlal Rolurn I I 3, Remalndor Rolurn
,,~..t'l 115, Ilardale,aldoalhpriarI012.13.82}
U 0 1.1 4, lImllod Ellalo [140, Fuluro Inloro.1 CompromllO Fodo",1 E,'alo Tax
wOO I I d
0.... (lor dolOl 0 doalh 0 10,12.12.821 Roluln Roqulro
~lll I ~ 6, Docod.nl Dlod To'lale I I 7, Docodonl Moinlainod a living T ru.1 J.. 8, Talal Numbor 01 Sulo Dopa,11 80xoI
Cl; (Allach copy 01 WIlI)____J~."och copy ul Trull) . .___,_..___________
ALL CORResPONDENCE AND CONfiDENTIAL TAX INfORMATION SHOULD BE DIRECTED TO.
"N1M1 ________~_.._.~_u_.____, O.'___'_U cOMPiffE-'i.f^i(j~~d -^ntJi(E~r..__.n.-__-
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o Z TelEPHONe NUMBER
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1. Rool Ellalo (Schodulo AI ( 11
2. Slack, and Bond. ISchodulo BI ( 2) .
3. ClolOly Held Slack/Parlnershlp Inlero'IISchedulo q I 31
A. Morlgage. and Nolo' Recelvablo (Schodulo 01 ( 41
5. Calh, Bank Dopa.II' & Mlscellanoou, Portonal Plaporly( 51
(Schedulo EI
6. Jolnlly Owned Properly (Schedule F)
7, T ran,fors ISchodulo GllSchedulo L)
8, Tolal Grall AlloII Ilolalllno. 1.7)
9. Funeral Expon.e., Admlnl,'rallvo Coli., Mhcollanoou, I 91 . 12 I 56 1 .2.2 .
Expen,o, (Schodulo H)
10, Dobl', Morlgage Llabllille" Lien, (Schedule I)
II. T 0101 Doductlan, 110101 line. 9 & 10)
12, Nel Value 01 E,lale (II no 8 mlnu,lino II)
13, Charllablo and Gov.rnmonlal Bequo," ISchodulo JI
_____________ ~4, ~lol ~alue~~locIIO Tax IlIne_~.111i"~~n."_.!.3J.__
15, Amounl allino 14 laxablo 01 6% role
Ilncludo valuo, Irom Schodulo K or Schedulo M.)
16. Amounl alli"e 14 laxable 01 15% ral.
Ilnclude value, from Schodule K or Sch.dulo M,I
17, Prlodpalla. duolAdd lax from line 15 and Irolo line 16,1
la, Cr.dlll Spau,al Poverty C.redll Prio, Poymonll Dlscounl
____n'__ +10,667,25+ 561,44
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'OR DATES 0' DIATH AnlA 12/31/91 CHICK HI.I
Ir A SPOUSAL -
POVIRTY CRIDIT IS CLAIIlIID II
rill NUMUIR
10000 Molly pitcher lIighway
Shippensburg, I'A 17257
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90,128.34
I 61
171
-0-
-0-
( 81
90.-1 28,-34___m ..._ __._
1101
2..}09. 16____._.
(II) .15~_~7~.~~..__..
(12) __74_.851.,9.11-__
113) _..~Q-:___n_
.m__u__J.l~Ljc~~~,8 5 7c_~,2,6-
(151
, x .06 =
(161. 74,857.96
11,228.69
x ,15 =
(17)
11,228.69
InlorOll
19, II line 18 I. grealor Ihan IIn. 17, onlor Iho dlfforon,e on line 19. TllitI. Ihe OVERPAYMENT.
ml]
(18)
(19)
I 1..22.8...69
Ch(l(~ hOHl if you (HO rO(IUo,linU (I rolunel 0 your ovofp(lymonl.
20, II II no 17 I. groalor Ihan IIn. 18, onle, ,he dlfforen,e on Ilno 20, Thlt II Iho TAX DUE, (20) I I , 228 . 69
A. Enlor Iho Inlo,o.1 an ,ho balance due an IIno 20A, (20A)
B, Enler Iho 10101 of IIno 20 and 20A an Ilno 208, Thl. it lite BALANCE DUE. (20B)
.._~ak_e_~h~~~.~ava!!!!_t~!_~~~I'leraf Will" Agonl __. ... __u________
~------.---- . . BI SUR. TO ANSWIIR ALL QUES'iicfNS ON REVERSE'SIDE AN[) TO R"ECH'ECK MAfH".- .------.--.-.-
Und;;P;;;llje$-~Tp;;i~;y, I doclare Ihall haye eltaminod Ihil ro,u;';:-,nc'udinl' \1~~o~ponyi~~9"i;,;'(Mo1 on;rll~;~onh, ;nd 10 j"f;;bfl11 of my knowledge and bellof,
II It Iruo, couoel and cumplete. I declare Ihal nil real ollole hOl hoon roporlo( 01 Iruo nHH~ol Yllluo DllclClrclllon of proporor olhar Ihon Iho rorlonal reprolenlali\le h
baled on 011 informallon of which preparer hot any knowledgo.
!I~NAi(jRI7; t'1"iifif- n~RIiUNO-RrmfN--/Ao~Rt~' J " I) I >/l~/ bAtcH. __,__U____,
!I~I:/ii~-ci' PR['PAR'r'R 6;;[ :~~'~;[~;E!EN1AlIVf ,I /(~~R~~;' I /"',,/iJJ/ /J.;~Jly;Y.VI.../.F/J'f/ . o;{ / /f-
.~~...-. ~._~_. IC,t:."fJ f"\<..~,:,~~ \)I'~'\L-""_ \4t........, '1_0.'-:-?i__
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ESTATE Of
ITEM
NUMBER
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COMMONWEAltH O' PENNSYlVANIA
INHERITANC! TAX RETURN
R!SIOENT O!C!OENT
SCHEDULE H ~_
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES Pllall Print or TYPI
I fiLE NUMBER
1994 -0034 2
DAISY S. HIGHLANDS
DESCRIPTION
AMOUNT
1.
A. Funllal Explnllll
FOGEI,SONGER-BRICKER Funeral Home
$5,995.00
1,
B. Admlnlltratlvl COI"I
201 - 16 - 1112
2,
3.
4.
C.
I.
2.
3,
4,
5,
6,
7,
8.
Personal Representative Commissions
Social Security Number of Personal Representative: -
Year Commissions paid I 994
4,506.42
Attorney Fees FOREST N. MYERS
1,750.00
Fomily Exemption
. Clalmanl
AddreS! of Claimant 01 decedont's death
Street Address
City
Relationship
Stole
Zip Code__
Probate Fe..
220.00
MllelllanlOUI Explnllll
Advertisement - Cumberland County Law Journal
40.00
Advertisement - The News-Chronicle
39.80
FiUng Fees, Inheritanc~ Tax Return
10.00
TOTAL (Also enter on line 9, Recapitulation)
(If more Ipaee II n"dld, Inllrt addltlanallh.... of lame II...)
$12,561.22
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LllST IfiLL lIND TJ.ISTAMEm'
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I, DAISY S. HIGlllJlNDS, of 321 Eust Garfield street, I30rough of Shiwensburg,
CU11berlard County, Pennsylvania, being of sound mind, marory and understanding, do
make and publish this my L:lst Hill and 'restamont, hereby revoking Ul1d making void any
and all former wills and cooicils by I1'C at: ilny time hf'xetofore made.
~. I direct my hereinafter named ,r,;xecutor to pdy all my just debts and
funeral expenses as soon as conveniently JTh:'1Y bo after my decease; I further direct
that all t.axes tJ1at may be assp.ssed in consequence of my ueath, of whatever nature
and by whatever jurisdictJ.on imposod, shall be paid as part of the expense of the
a~istration of my estate.
~D. I give, devise and bequeath ull my property, real, personal and mixed,
whatsoever and wheresoever situate, in foltr (4) equal shares, share ard share alike,
as follO'lIs: One (1) ocjl.wl share to my brother, DAVID STINE; one (1) equal share to
my sister, IlE'I'l'Y C1WlBERLINI one (1) equal share to my slster, MARY J?IPER, and Olle (1)
equal share to my sister, VESTA CLIPPINGER, absolutely, or to the survivor or sur-
,
vJ,vors of than then living at the t:Une of my decease, in equal shares, share and share
alike, to wit, eitl1er DAVID S'I'INE, IlE'lTY C1IAMIlERLIN, MARY PIPER or VESTA CLIPPINGER.
~. I hereby nominate, oonstitute and appoint my brother-in-law, JAY Q!N.lBERLIN,
as the Bxecutor of this my liIst \~ill and Testamont; provided, hCMover, that in the
event my said brother-in-law, JAY C1l!\MBERLIN, is unable to serve as said Executor for
any reason, then in that event, I hereby naninate, constitute and appoint my brother-in-
law, HERBERT PIPER, as the Executor of tJlis my WSt \~ill and Testament, my sald Executor
as the case may be, to have full p:11Ier and authority to do any and all things necessary
for the canplete a~istration of my estate, including the p::l\>'Or to sell any and all
real and personal property of which I nny die seized, at public or private sales, in his
discretion, and without any Oruer of any Court I and I further direct tl1at my said
Executor not be requil;ed to file any Ilond in connmction with the settlanent of my said
Estate.
IN \'II'lNBSS NHEREOF, I, DAISY S. IlIGlIL.lINDS, have hereunto set my hand and seal to this
my Last Hill and Testament, written on two (2) sheets of paper, this 12th day of Septernbel:,
1986.
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Signed, sealed, published und declared by DAISY S.C.HIGffillNDS, the Testatrix as und for
her liIst Will and 'l'est<'1ITIent, written on two (2) sheets of paper, in the pre~ence of us
who have, at her request, signed our names as witnesses hereto in the pre!;ence of the said
Testatrix and of each other.
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I.AW OFFICE
Forest, N. Mscrs ,.
10000 Molly Pilcher Highway Shlppensburg, Pennsylvania' 17257
717/532 - 9046
F'aH 717/532 - 6679
July I, 1994
Mary C. lewis,
Register of WlIIn
CUMBERLAND COUNTY COURTHOUSE
One Courthouse Square
High and Hanover Streets
Carlisle, PA 17013
Re: ESTATE of DAISY S. HIGHLANDS
No. 2194-0342
Dear Ms, !J~wls:
Enclosed herewith you will find the fully executed "lllhe/'I/(lIIce Tax Refll/'ll" as well as
the appropriate fees. for the above-referenced estate,
If you should have any questions or comments regarding this. please feel free to contact
me at your conl'enience,
Slncerel~ '
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FOREST N. MYERS
FNM:eg ()0 , 'n
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ENCLOSURES '1 i.-.. '.'
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LAW OFFICE of FOREST N, MYERS
10000 Molly Pilcher Highway
Shlppensburg, PA 17257
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Mary C. Lewis, RegIster of W1//s
CUMBERLAND COUNTY COURTHOUSE
One COUrthouse Square
HIgh and Hanover Streets
Carllsle, PAl 7013
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ID:
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REG OF WILLS
CHECK
OF CUMB :~O .
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~ RIVo1547 IX APP (08094*
COHHONWEAllH OF PEtftSYl,YANU
DEPARlHEHT OF 'EVEIU: NOTICE OF INHERITANCE TAM
. .- . ,.,"~, "". .m..".,",. ""..., '" ..""'"~.
~miS:e:~~lpA 11118-0601 OF OEDUCTIDNS AND ASSESSHEHT OF TAM DATE 11-21-94
!SYA'l'E OF HIGHLANDS- =PILE NO. 21 94-0342-
DATE OP DEATH 04-03-94 !:OUNTY CUMBERLAND
NOTE I TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHn THE UPPER PORTIOH OF THIS FORH WITH YOUR TAK
PAvHENT TO THE REGISTER OF WILLS. HAKE CHECK PAvABLE TO "REGISTER OF WILLS, AGENT"
REMIT PAYMENT TOI
/f/(plJ-1
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FOREST N MYERS ESQ
10000 MOllY PITCHER HWY
SHIPPENSBURG PA 17257
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ACN
101
REGISTER OF WIllS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
E~.ount Ro.ltt~ I
CUT ALONG THIS LINE .. RETAIN LOWER PORTION POR YOUR RECDRDS ~
R IV: iscij" E X"A jiii - (iiii: 94 T" NO'f i c r "oF' INH Eiii f AifcE" 'fAx "'A"p piiA"i S EifENr;' Ai. l"OWAN'C E - eiri.....""."""" -""""
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HIGHLANDS DAISY S FILE NO. 21 94-0342 ACN 101 DATE 11-21-94
If an assessment wal illuld previously, linal 14, 15 andlor 16, 17 and 18
reflect figures that include the total of Ahh returns Ilsessed to date.
ASSESSMENT OF TAX,
IS, A.ount of Llno 14 ot Spou.ol roto (151
16. Aoount of Llno 14 toxoblo ot Llnool,Clooo A roto (161
17, A.ount of Llno 14 toxoblo ot Collotorol/Clooo B roto (171
IB, Prlnolpol Tox Duo
TAK RETURN WAS, (X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST " SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL
1. R..I Eototo (Sohodulo Al III
2. Stook. ond aon~. (Sohodull BI (21
S, Clo.oly Hdd Stook/portnor.hln Int.rut (Sohodulo C I (S I
4, Hortgogo./Noto. Rooolvoblo ISohodulo 01 (4)
5, Cuh/Bonk Dopoolh/Hllo, Poroonol Proporty (Sohodulo El (51
6, Jointly Ow nod Proporty (Sohodulo FI (61
7, Tronoforo (Sohodulo 01 (71
a. Totol Ao.ot.
APPROVED DEDUCTIONS AND EXEMPTIONS,
9. Fun.rll Expln.../AdM. Co,tl/HiIC, E~p.n... (Soh.dull HJ (9)
10, Oobh/Hortgogo Uobllltlu/Llon. (~ohodulo II llOI
ll, Totol Doduotlon.
12, Not V.luo of Tox Roturn
IS. Chorltoblo/Govorn.ontol Boquo.t. (Sohodulo JI
14, Not V.luo of E.toto Subjoot to Tox
NOTEI
TAX CREDITS I
PAVHENT
DATE
07-01-94
RECEIPT
NUHBER
MM886259
DISCOUNT (+)
INTEREST (-I
561,43
-
PAYMENT MUST BE MADE BY 01-04-95R,
( I CHANGED
,00
.00
,00
.00
90.128,34
,00
,00
(81
90,128,34
12,561,22
2.709,16
(Ill
ll21
llSI
ll41
15.27G 36
74,857,96
,00
74,857,96
will
,00
,00
74,857,96
M ,00.
M ,06.
M ,15.
llBI
,00
,00
11,228,69
11 ,228.69
AHOUNT PAID
10,667,25
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
11,228,68
,01
.00
,01
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN U, NO PAvHENT IS REQUIRED,
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), yOU HAV aE DUE
A REFUND, SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
RESERVATION, E.tlt.. of deo.dlnt. dYing on or b.for.O.o..c.r Il, 1912 -- If .ny futur. lnt.r..t In the ..t.t. I. trtn.f.rred
In pa.l.llion or .njOYM.nt to CI..I a (collet.rll) bln.~lol.rl"'of the d.oed.nt .ft.r the 'MPlretlon of Iny I.t.t. for
I1f. or for Yllrt, the Co..onw..Uh her.by .lCprenly "''''VII the right to IIppr.11I end ....u transfer lnherlhnc. '11111
.t the hw'ul CI... " (aolllt.relJ ret. on Iny .uch future Int.rut.
PUlIPOIE OF
HOTICEI To fulfill the requlr...,," of S.otlon ZlftO af the Inherlt.no. and Elt.t. TIM .lot, Aot 22 0' 1991. 72 P.I.
S.ctlon UftO.
PAVHfm. O.t.ch the top portion of thh NoUc. .nd tub. It with your Ply..nt to the R.ghter of Willi prlnt.d on the ravlr.. lid..
--".k. chock or .ono. ordor p...bl. to, REGISTER OF HILLS. AOENT
All PlYllnh rec.ived tth.ll flr.t b. IppU.d to any Internt which .IY bl du. with any relllnder IPpll.d to th. tlM.
REFUND (eA)l A r.fund of . tl)( ar.dlt, which wat not re"",..t.d on the TIM R.ttlrn, IIY b. "qu..t.d by cOIIPI.tlng IIn "Appllaatl(ln
'or A.fund of P.nn.ylvanl. Inherlhnu and Elt.tt Tal(" (REY.UUJ. Application. ar. IvftlJablt It th.O"lel
of the R.ghter 0' Wlllt, Iny of the 2S R.v.nuI Olttrict Offlc.., or bV calUng the IPlol.1 24.hour
anlwlring urvlc. nutbl" for forll orderlngl In P.nnlvlvanla 1.800-362.2050, outeldl P.RrllvIYlnl. Ind
within local Harrltburg Ir.. (717) 711.a09lt, TOOt (117) 77~.2l5Z Olnrlng IlIpllred OnlY),
OBJECTIONS I Anv ptrtv In Int.rl.t net uth'lId with the appraltl.lnt, allowanc. or dlt.llowlncl 0' d.duotlonl, cr ........nt
0' tax (Inaludlng dhcount or InttruU tit .hown cn this Hotlcl .ust objlot within sll(ty (60) day. of rec.lpt 0'
thlt Notln b~l
uwrltt.n prot..t to the PA CIPart..nt of R.v.nu., BOlrd 0' Appeals. DEPT. l1102l, Harrisburg, PA
u.hctlon to hlVI the 'IttGr dlt.n!n.d at audit of the acecunt of th. p.rlonal r.pru.ntatlv.,
u'PPul to the Orphan.' Court.
171l1'10lI.
OR
OR
AIHtI~
IlIAATlVE
tORREtTlONS,
Faotu.1 .rrnt'S dllcovlred on thlt ........nt lhould b. addr....d In wr I Ung tal PA O.par t..nt 0' R'v,nut.
Burtlu of Indlvldu.l TaM", AnNI Pest A.......nt R.vl.w Unit, DEPT. 280601, Hlrrlsburg, PA 17UI-0601
Phon. (711) 711-6505. S.. pagl 3 cf the bookl.t "In.tructlon. far Inh.rltlnc. Tall A.turn for a R..ld.nt
O.e.dent" (REV.1S01) for an IMPlanltlon 0' ad.lnl'tretlv'l~ c,rr.etlble .rrorl.
OlltllUllT.
If env tll( duo It plld within thr.. (3) aehnd.r Icnth. after the d.cldlnt'. dnth, a flvl perc.nt (5:1.1 discount of
thl tllC peld 11 .Uow.d.
INTEREIT,
Intlr..t It chargld blglnnlng with first dlY of dellnqu,ncy, or Illn. (9) aonthl and OM (I) dlY fro. the detl of
dlath, to thl d." 0' plv..nt. Till" whloh b,CIII d.llnqu.nt b.fore JanutrV 1, 1912 bllr Inter..t It the rat. 0'
,Ill (6~) perc.nt per Innu. ollcullt.d at e d.lh rat. of .000164. All tllC.. which byo... dlllnqulnt en end IUer
Jlnu.rv I, 19.2 will bl"r Int.r..t It . rltl which will vary fro. ell.ndar y..r to e.l.ndar ~'Ir with thlt r.tv
announc.d by the PA D.plrtl.nt of R.v.nuI. Th. appllcabl. Int.r..t r.tu. fcr 19B1 through 199ft er'l
'!!!!: Int.rllt RllItl Dally Inter..t Factor t!!! Interllt RIlIt. Dally Inter..t Flctor
Ill! lOX .0005". 1916 lOX .000214
IlII 16X , DOOm 1911 9X ,000211
1911 IIX ,000301 1911-1991 IIX ,000101
1915 IIX ,Doom 1992 9X ,000211
1991'1991 IX ,000191
--lnt.r..t I. a'lautat.d .1 'ollcMII
INTEREST . BALANCE OF TAM UNPAID M NUNBER UF DAYS Df,LINQUENT M DAILY INTEREST FACTOR
uAnv HotlGI Iuuld aft.r thl tal( b.ec... d.lInqulnt will r.fllot In Intlr..t clleul.tlon to ,IU"n US) d.VI
b.vond thl dlt. 0' th. ........nt. If P'Yltnt I, 'Id. eft.r the Intlr..t ~o.put.tlon date thown on the
HoUel, Iddltlonll Interllt IU.t b. nlaulat.d.
.,.
STATUS REPORT UNDER RULE 6.12
Name of Decedent I
D"",~ '-{ ~,~hc..,\u.......,.s
Date of Death I
'" - ~.<'l-l
Will No.
Admin. No. '2.1-19-)~-3,\'l-
Pursuant to Rule 6,12 of the Supreme Court Orphans'
Court Rules, 1 report the fol.lowing with respect to completion of
the aumlnlstraUon of the above-captioned estate:
I. State whether administration of the estate is complete:
Yes '>( No
2. 1 f the answer j s No, sta te when the personal
representative reasonably believes that the administration will be
complete I
3. If the answer to No. I is Yes, state the followingl
a. Did the personal representative file a final
account with the Court? Yes__ No~_,.
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c, Did the personal representative state an
account informally to the parties in interost? Yes__ No )(
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounLs may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Datel__:.Y1'f1 'ib_
~N.~
Signat.ure
C'4
.c-; ~r
/f) C'4
;:.' ,.;~ CI.
il' Ln
,
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1\ >-
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, , ;'. ~
..
Cr
lli'" ~
0:0:
to: <:(
"1ft.
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T~<,,,+ '" ~~-U
Name (Please type or print)
11JO.:D M ?\~
Address
SO\t'..c.., ?~ n1..",-1
.
I
"\
.0d
()(J
.tlD ) .;.-~.< -'iv-j b
Tel, No.
Capac ity I
Personal Representative
)I.' Counsel for personal
representative
(MAHlrmf/AM3)