HomeMy WebLinkAbout94-00469
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COMMONWI!Al.HI 01 I'I!NN!lVI YANIA
OEPAIITMENT 01 tllNlIl VITAl. II 'COIIO!!
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
CERr. NO, 216 G 840
3 - f~ - fy
. ~.---liiiiifl(Ti;lwii1T,;;j-r.;I~;;[~li<<I;'"
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N.moo' D""""I.-l1~1.t<<.t . . ~'~~""':'{~{ . "m
s".. _.:L.___.s",., S""'ify No. II, .ji- .l'!p 'I :. m;t 01 O""if, IhiA".6.s:,lt'f'/
Date of Blr:)tl"""fr.ILLt-.1''''''"OO'' M' ~~ .. .----....-
Place of Death ~~l.d4..i:L._.1; . =1'YJr1.1t. .. .{ ,,-,.1. (i4(~....p'nO"k'""
Race JJJ~.r~~::;~.~ on.___ (Jjul!..- I ", I Annocl For~c:~~ ';~'~~' ~';"~~). 11-.__..___
, Decedont's I' ,
L ~j",.,r." ;1"',,1 1(;lIi"'I""", 1\/~ll~I~L
~~~::~l Add~~ss ~j__n --=; ,I ~'~T_ Fllnor,z;ro~or i \ 4,.... . n. "'l;:.~' .
Funeral Establishment _ Y.cJU.fLJLJV/'J'jJ. ~ . tu:""",..:' yr. .... n... ..L_~'f(.. . ... .___
, I I nlervnl Between
Part I: Immedlatrrse . i Onset and Denth
(a).._L~-4L...L~{J~d IlL{t~ ._ ..... . .:n_....__.____._
[b) ~W"'. M~-t *,..i<W._mu ,--
(c)_10 '.. ..,..t2ti4.//1 ~ ;k.it..-~:~h ....__..1.._._..__
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,
Part II: Oth~~~~I~nl~~':~~'~~~ ~ _ Ai.-. /I-,-~ /Jj, t/. oJ. ~ __. /_II~^...____m.u_:-_._.-___-.
4J.c - --... nL_/l....~ IILU:.UUI. -LvjJJ.P.rk1kL0t:-__~___
Descrlhe how Injury occurred:
Manner of De~:
Natural 0'
Accident 0
Suicide 0
Homicide
Pending Investigation
Coulet not be Determined
n
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N.m. "'d Till, " C,"I11" - ~ ,.e '~":i'T--""""'"--''''' ..._.m.__
Address./lt..L.../Jb.d:ly-__ . __ ..d.":k/_~ ...... ....mitt ~_....___(~,~~D,O:..~.~:~__~.:~~~~
This Is to certify thnt tho Information horo (Jlv8n Is correctly copied frol11 nn orlglnnl certificate of
death duly filed with mo as Local Ruglstrnr. Tho orlginnl cortlllcnte will be forwmded to the State
Vital Records Office for permnnent filing.
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J REVo1547 EX AFP (12094'.
COHHOHWlAl TIt or PENNSYLVANIA ACN 101
DEPARTW'W! DF REVEwU' NOTICE OF INHERITANCE TAK
BURtAU DF INDIVIDUAL TAXES APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
~miS~m~lpA 17118-0601 OF IlEOUCTlONS AND ASSESSHENT OF TAK DATE 03-20-95
ESTATE OF ~[jRtRVnTI= MARGi I! FILE NO. -7;'=0469
DATE OF DEATH 03-25-94 COUNTY CUMBERLAND
NOTE I TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAK
PAYHENT TO THE REOISTER DF WILLS, HAKE CHECK PAYABLE TO "REGISTER OF WIllS, AGENT"
REMIT PAVMENT TOI
)
,
')1
JEREO L HOCK ESQ
METZGER ETAL
PO BOX 93
HBG PA 17108
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
E.
Anount Rlnl Uld
J
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FOR YOUR RECORDS ~
11 'EV'- i Sfj; - E if -A i: ii - f i if: 94 Y -iioYi c r -li F- INti Eii i;: AN-O' E - Yi. X - A"PPRA is Ei.fEllr;- A 1. rliwA NO' E - iiFi -. - - - - - - - - - - - -. -.
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF SOMERVILLE MARGARET I FILE NO. 21 94-0469 ACN 101 DATE 03-20-95
TAK RETURN WAS, (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST 0 SEE REVERSE ("J("J -. 1 :-D
r. ,.;' ',~-l
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL :.) III ,I i,.'
, ,
I. RI.I E,tltl (Sohldull A) 11) .00
2. Stooks Ind Bonds ISohsdul1 B) 12) 7,050.00 :u
S. ClOSlly Hlld Stook/Plrtnlr,hlp Intlrlst ISohldul1 C) IS), ,00
-~
4, Hortglgls/Notls Rlollvsbll ISohldul1 D) 14) ,00 ,/
$, C..h/B.nk Deposits/Hilc. Plrlonll Property I Sohldull E) 15)_ 3,620,02 ..'
6, Jointly Ownld Proplrly (Sohldull F) 16) ,00 \:-,
" .00 ~.. ( ,
7, Trlnlflrl ISchedull OJ (7) " ,
B. Tohl A..lh 181\0 10,670,02
APPROVED DEDUCTIONS AND EXEMPTIONS:
9, FUnlrl1 E,plnus/Adn, Co.h/Hho, E'Plnsll ISohldull II) 191
10, Dlbh/Hodglgl lhbllltl../Lhn. (Sohldull I) 1101
II. Totll Olduotlon.
12. Nit Vllul of TI. Rlturn
IS. Chlrltlbll/Govlrn..ntll BlqUI.t. ISohldul1 J)
14, Nit Vllul of Eshtl Subjlot to To.
2,417.28
491,46
Ill)
112)
1151
114)
?9D8.74
7,761.28
.00
7,761.28
will
11 an alsalsment wal issued previoullY. linel 14. 15 and/or 16, 17 and 18
re1lact 1igurel that include the total 01 Abh raturns alsalled to date.
ASSESSMENT OF TAXI
IS. Anount of Llnl 14 It Spousll rlt. liS)
16. Anount of L1nl 14 hKlbl1 It Ilnul/CIIIs A roto 116)
17. Anount of L1nl 14 hKlbl1 It Collltlrol/ClI.. B roh 117)
18, Prlnolpll TI. OUI
TAX CREDITS I
PAYHENT
OATE
06-23-94
12-21-94
NOTEI
, 0 ~ x ,00,
,00 x ,06,
7,761.28 x ,15,
118)
,00
,00
1,16(" 19
1,164,19
RECEIPT
NUHBER
MM886213
M022625
DISCOUNT It I
INTEREST (-)
52.63
,00
AHOUNT PAlO
-----'1,000.00
111.56
TOTAL T,\ ~ CREDIT
---- .
BALANCE OF TAX DUE
-----+
IIlTEREST ,00
-------------.-r
TOTAL DUE ,00
_______.____________ _______J
-
1,164,19
.00
. IF PAlO AFTER DATE INOICATED, SEE REVERSE
FOR CAlCULATION OF ADDITIONAL INTE~EST,
IF TOTAl. OUE IS LESS TIIAN tl, NO PAYHENT IS REQUIREO.
IF TOTAL DUE IS REFLECTEO AS A "CREOIT" ICR), YOU HAY IE DUE
A REFUNO, SEE HEVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
, ,
RESERVATION I Estatu of dlcldents dYing on or blforl aecub.r 12, 1982 -- If IIny futurl Inhr..t In thl ..tatl II tran.f.rr.d
In pOlllulon or InjoY"lnt to Clft" B (collatlrft1) bln.f1clarlll of the docldent after the uplrfttlon at IIny ..tate for
life cr for year., the Cc~_onwealth herlby eMpre..ly r"lrve. the right to appral.. and a..... tran.flr Inheritance TaM"
at the lawful Cia.. B (collahr81) rah on any .uch futuro Interfllt.
PURPOSE OF
NOTICE I To fulfill the rlquirlunt. of S.ctlon 2140 of thl Inhlrltllncl nnd E.tatl TaM Act, Act lZ of 1991. 72 P.S.
Seetlgn 2140.
PAVHENTI 011 tach thll top portion (If this Notlco and sub~1t with your pnYl'llnt to thl Rllglttllr of Wills printed on thl rl"trll .lda,
~-HakQ chock or 1I0nlY ordllr pnynbh tOI REGISTER or HILLS, AGEtlT
All paYlIIllnt. reoalvld shall first bl nppll"d to tiny Interllt whiCh 11:18... bl due with nny rllntllnder applied to thl tllX,
REFUND (CR)I A rahmd of a taM crldlt, which was not "quilted on thl TaM Return, IIlUY be requo.hd b'i cUllplet!ng an "Application
for Refund of P.nnsylvanla Inheritance nnd f..toh TMC" (REV-15131, Application. nrellvrdlabla nt thlOfflca
of the Rllgl.tar of Will., nny of the Z3 Ravlnue District Offlc.l, or by calling thl IP.elnl Z4-hour
answ.rlng s.rylco nUlIlbar. for forlls ordarlngl In Penn.ylvanla 1-800-362-20~O, outsldl Plnnsylvanla and
within locol flarrl.burg nrOll 11171 787-8094, TOO' (711) nZ.ZZS2 (!toarlng IlIpolrod Only),
OBJECTIONS I Any plIrty In Intorost not Intllflod with the appral,ulnt, nllowlmco or dlsallownnce of dllductlon., or "'su.unt
of taM (Inoludlng dhcount or Intarestl 01 shown on thlt NoUcallult objlct within shl'i {60l days of rocllpt of
thl. NoUel bYI
~-wr1tt"n protut to thl PA lJapartlllont of ~avanuq, Board of APPOllls, DliIPt. 281021, Itarrl'b~trg, PA 171Z8-UZ1, OR
--llIotlon to hOYI thl 118ttar datorllllnlu <'It audit of tha account of the personlll rlPrlUntlltlvl, OR
utlppaal to tha Orphan,' Court.
ADHIH
ISTRATlVE
CORRECTIONS I
Factual Irror, dl.coYlrld on thJs alsls.mlnt should be addras$ld In writing tOI PA Olpert..nt of Rlvlnu.,
Bureau of Indlvldulll TOlCl., ATTNI Post AslII.....nt Reyll... Urdt, nlPt. 280601, ttllrrlsburg, PA 171,8-0601
Phonl <1171 787-6!iOS, See page 3 of tho booklot "Instructions for Inharlttlncl TaM Rlturn for a Ruldent
Dleldlnt" (REV-1S01) for lln IMPhnatlon of adllllnhtratlvllv corrllctoblo errors,
DISCOUNT,
If any talC duo 11 paid within throo (5) callndar 1I0nths nftar thl docodlnt's danth, II f1YI percent (S;O discount of
thl tlM paid II allowld.
INTEREST I
Intl"l t It charglld hilg Inn Ing with fir s t dllY of dlllnqulncy, or nino (l) I Mnth. nnd ani <ll d.W frail 'hi date of
duth, to tho dntll of pnYllenl, TalCo. which bacnllll dellnqullnt bafore Jnnuary I, 1982 bur Intarut at thl ratll of
.1M (6%1 percant plr Ilnnum clllcullltad nt n dnlly ratll of ,000164, All tnlCIII which blCllu dOllnqulnt on and afhr
January I, 1982 will bGllr Interltt nt n rntll which will vary fro~ calondnr YOllr to cllhndnr ylllr with that rnt.
"nnauncld lJy the PA Dapnrtlllnt of AaYlnua, The nppllcnbl. Intoro.t rntOl for IlJ82 thro\Jgh 11)9S nrll
~ Interllt Rnt. Oallv IntarOlt fllc~ ~ Intlrllt Rllta Dnlly Inhrllt fllctor
1982 20% .00O!i48 1987 q% ,000147
1983 16% .000438 1988.191)1 11% ,00010\
1984 \\% ,000301 1992 9% .000147
lOas 13% ,0003!)6 11)93-1994 7% ,000191
19116 10% .000274 199!i 9% ,000147
..Jnter..t I. colcullltlld no followlI
INTEREST' BALANCE or TAX UNPAID X NUMSER or DAYS DELINQUENT X DAILY INTEREST rACTOR
'-Any Ilotlc. Itluad nftar the tOIC blOOlllll dellnqulnt will rafloot nn Inttrlllt onlcullltlon to flftlln (1SI day.
blVond th. dati of thu ".....lIIln" If pay..nt I. IIIIdl lIftar thlt Intarut cOll\putnllon dlltll Ihown on thl
HOtlCI, nddltlonal In1Qrut lIlu.t ha cftlculntud,
" .
~!V.1500 EX. (Mll
l!!
..S'"
....lf~
~o9
....~..
..I-
UJilj
a:c
a:z
Sit
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li<l.I3,- L/
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
1. R.ol E,'a'. ISch.dul. AI
2. Slack! and Band, ISch.dul. BI
3. ClalOly H.ld Slack/Pa,ln",hlp InlOroIl (Sch.dul. CI
4. MartgagOl and Nal., Rec.l,abl. ISch.dul. 01
5. Cash, Bunk Doposlll & Miscellaneous PlIrwnal Properly
ISch.dul. EI
6. Jainlly Own.d Properly (Sch.dul. FI
7. TraOlfer'ISch.dul. GI(Sch~dul. LI
B. Talal Grall All.h Ilalallln., 1.71
9. Funeral EKpenso$, Admlnhlratlve Co,", MI1collaneous
hponlO' (Sch.dulo HI
10. D.bl', Marlgago llobllillOl, lions (Sch.dulo II
11. T 0101 Doduclians Ilololllno' 9 & 101
12. Nol Valuo of E'lalo Ilino a mlnu. lino 111
13. Charilable and Ga,oromonlal aoquo\II(Schodul. JI
14. Nol Value Subl.c' 10 To, 11IIIo 12 mlnUl lIno 131
15. Spou,al Trans!." Ifar dolo. of doolh alt" 6.30.941
See InuructlO"1 for Applicable Percentage nn Reverl~ (151
Side. (Includo ,oluo, from Sch.dulo K 0' Schouulo M.I
1 b. Amounl 01 Line \ 4 taKable 01 6% rale
Ilnclud. ,aluo, from Schodul. K or Schedul. M.)
17. Amounl 01 LIII. 14 lo,ahle a' 15% ra"
(Includo ,aluo, from Schodulo K or Sch.dulo M.I
la. Principal la, duo IAdd la, from UII.. 15, 16 and 17.1
19, Credits Spousal Povorty Credil Prlor Paymon!l Dilcount
.__________._ + .HL()OO.OQ.. d_.52.63
'*
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IKII. Original Rolurn
o 4. lImil.d E.lol.
06.
[J 2,
ll4a.
[J 7.
COMMONWEAlTH OF PENNSYlVANIA
DEPARTMENT OF 'EVENUE
DEPT. 28060\
HARRISBURG, PA 17 28.0601 . ._
D!CEOfN"~ NAM~ IlAST, fIRSt, AtlO MIDDlE INITIAij-
Somerville. M. l~ene, a/k/lI Mi~ret 1.
57;~~E;~:~~U;~E' [0'" ~;;~~ 91'~ ~'-~~H/ 0 1
II' .U'IIC.....III tLl~vIVI'1O \POUSI'S "AlII (L....SI, ".~I MIOAIIOOlIIUlll....11 SOCIAL SfCURI1Y PlUMIER
ESQuire
717 I
238-8187
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I-
fOR DATlS Of DIATH AmR 12/31/91 CHICK HIRE
If A SPOUSAL
POVIRTY CRIDIT IS CLAIMID 0
PILI NUMBIR
21
COUNTY CODE
91,
YEAR
NUMBER
469
D!CfOENl'S COMPUl[ ADDRUS
Church of God Home, lnc.
801 North Hanover Street
Carlisle! PA 17013
Coo", Cumber nnd
AMOUNlIt!C!I'r'!O ISEE INSTRUCTIONS)
Supplllmonlal Rlllurn
03.
05,
.!L.S.
Rllmalnder Return
Ifor dolo. of d.olh prior 'a 12.13.S21
Federal Ella" Ta, R.lurn R.qulred
T 0101 Number of Safo D.pall. SOXII
(61_.
( 71
Metzger, Wickershnm, Knnuss & Erb
P.O. Box 93 n. on :Xl
Hnrrisbur . ~ ~08-oEJ3 :tIro
0',' ~
ru) 0 ....(\
" - '/..
1\1' C"J '
:.) ,:' .. "l
CI. :; ~ r;~"..
r".,' ,). ~
"';' ...!'/
:' ,.4) :=... ;.::.i(tJ
:"5->. 0 /ij'o
)1i:~ N ."
\0
111----
12 I __L1....Q~lh.00
131 _
14)
15 I _L_3. 62lhQ2
19) _ $ 2.417.28
(10)..L~1.1.6
(S)
$ 10,670.02
1161 ______-:-
117} ..J_?..!.~~1!!....
III) $ 2,908.74
112) -1.. 7.761,28
1131 0
1141 -1.. 7,761.28
><.__1:1
. .06 = .----
. .15 = ----L_.Llii.!G 19
IISI __LJ_,1.li.4..19
Inlero'l
20. II lIno 19 I, groalor .han llno IS, .nlo, Iho dlff.ronc. on llno 20. Thi. Is ,h. OVERPAYMENT,
mo
1191 ._$_l,.Q?.1....(iL....
1201 .___._..____._______.._
Check hore if you me roqucding a rofund of 'your oycrpoyrnenl.
$__....11 [,5L_
121)
(2IA)
(2181
$
------.
111,5Lm...
21. If line IS;, groaler Inan line 19, onlor Ihe dlfferonco on Lino 21. Thil i~ lno TAX DUE.
A. Enlor Ino inlorO$l on Ino balance dlJe on line 21 A.
a. Enlor ,ho 10'01 of lino 21 alld 21 A on Uno 21 a. Thil i. Iho eAlANCE DUE,
___._____ _c::::c-_...M.ake. C.heck P_~va~'e. tal Reglll" of Will". AgolIl
~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH <II( <II(
Under ponollioi of porjury. I doclare thai I hove oKaminod till 1 rolurn", induding occompQnying scnedule, and Halemont', and 10 lnr bOll 01 my kno.. :edgo and bllltef,
II it lruo, corroel and comploto, I dnc1oro tnot 011 rool o,lole no, boon roponed 01 Iruo markol value. Doclarolion of proparer olnor Inun Ino porlor.al repro'onlallve h
bautd q . ~~I .I~~~~~.a~~?_~ ~~ ~nicn proparer ntU any knowledgo.
\::~O:A) ..' ~~lt~\~.~{;:-;i"t"i" I'''''' ... "'^:~;'j\or~(lJ:co;,rtl"lIal' r JS~'lIl'g~';'~-l;;~"l--'-"-- ,,,.')'2/;119;.------.
" AI ~'I ,m,,"," ""'1'11'.11 'jfil)/ffH^'IVf ^[lll~(55 ('^I! -. .
on. CktiLl:.-L71>'.tC1r:.(._ 1'.0. Box 9J.Harrlshlll'll,I'A.17LOB..0093 )!.i 10,/91....
~.
"V.UIlU. P,UI
ESTAU Of
ITEM
NUMBER
'.
~~
COMMONWIAITH 0' '!NNIYlVANIA
INH!RIIANCI TAR RITURN
RIll OINT OICIOINT
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Pleau Print or Tv~
B R
N. Irene (Nargaret 1.) Somerville
DESCRIPTION
A. Puneral ExpenulI
B.
4,
C,
1.
2.
3,
4,
5,
6,
7,
8.
1.
Hetrick Funernl Home, services to decedent, funeral, death
certificates, clergy honorarium (bnl~nce prepaid)
1.
Administrative COsII:
Porsonal Roprosontallvo Commlulons
Social Socurlty Numbor 01 Porsonal Roprosontollve,
Voar Cammllllans paid
2.
Allarnoy Foos: Hetzger, Wickersham, Knauss & Erb
P.O. Box 93
Harrisburg, PA 17108-0093
Family Exompllan
Clalmont Relationship
Addreu 01 Claimant at decodont's deoth
Stroet Addroll
21-94-469
AMOUNT
$
406.00
(eatimated) , $ 1,550.00
3,
r.lly
Stalo
Zip Codo
Proboto Peos: Register of IHUs, Cumberland County, Letters,
Shorts, Renunciations
Mlscollaneous Expensell
Cumberland Law Journal, esCate nd
Carlisle Gentinel, estate ad
Register of Wills, inheritance tax inventory
Sandra E. Bixler, reimbursement for travel and advancement a
on behalf of decedent estate
Notzgor, Wickersham,
advanced and copios
Reserve for closing
Knauss & Erb, reimbursement for cost
TOTAL (AI.o onlor on lino 9, Rocapitulalion) ! S
(II maro spaco Is noodod, Insort additional sheots of samo silt.)
$ 64.00 .
$ 40,00
$ 90.51
$ 15.00
$ 205.40
$ 11. 37
$ 35.00
,....
2,417.28
;,' I "
ltIYolSUU+IU11
*
COMMONWfAIllt 01 .tNH$nYAtlIA
INHUlfAHCI f"X IIIUUI
IlltOI.NIOICIDINI
SCHEDULE J
BENEFICIARIES
ESTATE OP
M. Irene Somerville
FILE NUMBER
, 21-94-469
ITEM
NUMBER
NAME AND ADDRESS OP BENEPICIARY
RELATIONSHIP
AMOUNT OR
SHARE OP EST ATE
1.
A. TaKable Beque.",
Sandra E. Bixler
602 Oriole Gourt
Harrisburg, PA 17111
Niece
1/3
2, Robert J. Bricker Nephew 1/3
1507 North Second Street
Apartment 2
Harrisburg, PA 17102
3. Carol I. Hite Niece' 1/3 '
13 Honeysuckle Drive
Mechanicsburg, PA 17055
!
ITEM
NUMBER
,..
, NAME AND ADDRESS OP BENEPICIARY
AMOUNT OR
SHARE OF SST A TS
B, Charitable and Gavernmental Bequell"
1.
-----------.------..--..----
,
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IAho enlor on /in. 13, R"apltulallon} $
(II more IpOCO II n.ederl, Inlort addltlonollh.e" of 10m. 1110)
4___'__,_,__,,______u___ .._...._.._..,.._____~__.______
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: H. Irene Somerville, a/k/a HarAaret 1, Somerville
Date of Deathl 3/25/94
Will No.
Admin. No.
199/.-00469
Pursuant to Rule 6.12 of the Supreme Court Drphans'
Court Rules, 1 report the following with respect to completion of
the administration of the above-captioned estatel
1. State whether administl'ation ot the estate is complete!
Yes No X
--
2, 1 f the anRwer is No, st.ate when the personal
representative reasonably believes that the administration will be
complete: Upon receipt of Notice of Appraisement ann Assessment from Inheritllnce
Tax Bureau (Return has he en filed),
J, If the answer to No.1 is Yes, state the following!
a. Did the personal representative file a final
account with the Court7 Yes No
b, The separate Orphans I Court No. (if any) lor
the personal representative's account iSI
c. Did the personal representative state an
account informally to the parties in interest? Yes__ No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and m~y__~e attached to this report.
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Name (Please type or print)
P.O. Box 93
_~~rr~~buI~L~. 17108-0093
Aodress
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.L l!lU.3_8-818L_._
Tel, No,
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STATUS REPORT UNDER RULE 6.12
Name of Decedent 1 f\, Irene Somerville
Date of Deaths 03/25/94
Will No.
21-1994-469
Admin. No.
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 estatel
1. State whether administration of the estate is complete I
Yes X No__
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
completel N/A
3, If the answer to No. 1 is Yes, state the followingl
a. Did the personal representative file a final
account with the Court? Yes No--1__
b. The separate Orphans' Court No. (if any) for
the personal repr~sentative's account iSI
c. Did the personal representative state an
account informally to the parties in interest? Yes.-L.. No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and (y(tDe attached to, this report.
\ )~ A~/\' " Q__/~ ()-z-<.
Datel 04/18/96 ,j -
Signature-
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Jered L. 1I0ck, Esquire
Name (Please type or print)
f\etzger, Wickershnm, Knnuso & Erb
1'. O. Box 5300 , IIl1rrisburg I I'A 17110-0300
Address
LV7l 238-8187
Tel. No,
capacitYl
Personal Representative
__.1._Coun8el for personal
representative
(MAHtrmf/AM3)