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HomeMy WebLinkAbout94-00502 of the Small Estate Actl and Letters of Administration wer.e issued to them, i.e. the Petitioners, on June 7, 1994. 4. The total assets of thedeoedent's estate, consists of a 1991 Honda Prelude, Title No. 4407474ll01CR, of a reasonable fair market value of $9,900.00, and one $25.00 U.S. Savings Bond, L 2l44086641E, of a present value of of $50.00. 5. The Petitioners have seen to it that the decedent was properly and decently buried, but have incurred reasonable, but substantial expense in attending to the last repose of the decedent. 6. That the Petitioners have paid the decedent's funeral bill with the Musselman Funeral Home, of $6,465.20, and the burial charges $995.00 to the Catholic Cemeteries. There are no known unpaid creditors or obligations of the decedent. 7. That the decedent was a single woman, who had not married, and solely survived by your Petitioners, her mother and father, and there are no other persons in priority under the Intestate Laws of the Commonwealth of Pennsylvania. 8. That in consideration of your Petitioners making the payment of the said funeral and burial expenses and costsl and paying costs of $54.00 to the Register of Wills for the issuance of the Letters of Administration and legal costs and expense of $450.00 to John J. Krafsig, Jr., Esquire, for the - 2 - , , I, filing of the preparation and filing the Small Estate Petition and necessary Inheritance Tax Return, the Petitioners pray that the said 1991 Honda Prelude and the $25.00 U.S. Savings Bond, be awarded to theml and in addition, the payment of the estimated Inheritance Tax of $113.18, which Return shall accompany this Petition, shall also be paid by them, in consideration of the same. 9. That your Petitioners therefore desire and request the approval of your Honorable Court to settle the Estate, without the necessity of incurring any further costs of Adminis- tration and desire to invoke the provisions of the Small Estate Actl and pray that an Order of Court be entered forthwith, authorizing and approving the administration of the said Estate, without the necessity of making legal advertisement thereto, or to conduct formal administration. WHEREFORE, your Petitioners pray your Honorable Court to order and direct that the said 1991 Honda Prelude, Title No. 4407474ll01CR and Veh. I.D. #JHMBA4230MC012057, together with the $25.00 U.S. Savings Bond bearing No. L 2144086641E, be awarded to your Petitioners in consideration of their payment of the obligations of the said Estate, and by virtue of their priority and right to receive the same, under the Intestate Laws of the Commonwealth of Pennsylvania. That an Order.of Court issue, - 3 - -, 'i, " ~;.', ': " '\"'ll .:,1\',_" . , "'.' ":, ',.'i/"" ,',' .....:,\.:. "I " , " , ,\\ :1 ,;1 " . ,~'" .' . '" ...:....::' ~:, ,o' ,I; ( C'I','Y":-;,,' "', .'r ,.j ,,'" '. , , "'1 , ,~.' :: \ . ',<1 , I ~ ',' Ir,' '" j , I" I,' " " >"1" , . !'. " , l,' , .' , ,\'" ,I' ", , I, ,'_1, ~'l :'. '. ,j, :"',," I. " , ,. " I' ,', ", ",' " , " " ",f '(': .",1 ," (I., It" ',', Ill' .V' ~ ~.' '1 L \,',: 'I,' , ~ ' '.', 'i,' ,', ': .i " " ,;'.., _"I; ,I; "<' , " ,., . I" , \ ,'. ~ , " , 1 '~: ' ',,- " I" '''''1' , ,. '1,,1:', ,I " ~ 1\ , I l' '~'. '/.; '1 ; '! ",' 1'1' ]..:,\ ,I, ,\ , ,,' ',,' 'i 'II' lit' " , .1" {' '. ,.' ,H "': ,-.,' 'j','..lt'.- ';;,', ,'i'I' ':/.:.':'!:,,:,:,;:,;';"',':'., .1 , , '!"\' ,f:',;; .1 .' .\,- , , ~ l I I'" , , i.'.~ . .:" ';i , ".., "J"", II " ,: ,', :" ~- . , ,', .' ., ,,,. ,I, ',' .J.;' "I ',f, . " ," , , ',J', ., . . ~. i ".', ,,' , ~. 'e .' ,," ".' ""., ~': , '1" ~ ,. t ,',1, '" I' 'I: .. 'If, ;' j," , .,1 ,1'\' \"" ,,-r"/,. ." '.:1.' " , 1/ , \.' ,'11. , 'I' ': i .' '/1.' ,,' ,] I:' ',',', "," ,. , " '\' ,,-'I . '1\" , "'1 ,-.', II ,.I- 'I /,j, II 'j' " I. 'j,: I' " , d I. i !",I" ,'.' , " ." , , " , " , , " 'I< .;,<ll, " " ',I' "t. 'I, , ' ~ " 't, ... '" , ... " I,,' ,I,' " " " ,Rr<:,Il00'X, 111.911 .. 19. If IIno 18 II groolor Ihon IIno 17, onlor Iho dlfforonco on IIno 19, ThllII Iho OVERPAYMENT, 110 20, If IIno 171, groolor Ihon IIno 18, onlor Iho difforonco on IIno 20, Thl'lllho TAX DUE. A. Enler ,ho InlerOlI on Iho bolonco duo on IIno 20A. B, Enler Iho lotol 0' IIno 20 and 20A on lino 20B. Thll il Iho BALANCE DUE. Mako Chock Payablo to, ROlllller 01 Willi, AlIont .. II SUII '0 ANSWII ALL QUUnONS ON IIVIRSI SIDI AND '0 IICHICK MA'H.... Under penaltl.. of perlury, I dicier, thai I ha.... examined Ihh return, Including accompanying Ich.'dul.. and Ilalemenll, and 10 the bl.1 01 my knowledge and beU.I, It I, Iru., correct Clod comple'.. I d.C!r,H. thai all reallula't hat be.n report"d at true markt' value. Oeclarollon of prepar., other than th. plrlanal reprelontall". h baled on all Inform allan of which prepare' hOI any knowledge. E f PERSON RESPON5i~IlINO RE1IlRN' \ AO~'" 9 0 'F l'o';;-t-S t r~-;t--'---"- D'A'tE-.-.-- r A {( /i. 1\ o.~~ ( X{k~. l ~.~e s t-Y.ili r_'{ll!.\\1.~__!?~!..J~~~_~ mi'L.:..t; /94 as gn e ~ L. r!' ~ ale 2 21 N, Front St., Hilrrisburg, Pa. 6/...2-h /94 jr.;-"EsquJ.re ---.-.-- ----------..-f7TIlf- ----.--- l!! ~ii :c il oz u2 z o ~ 5 ~ ~ ~ ,. .... / '/ . Q I S '-6 C/ 'OR DATU 0' DIA'H Ann 12/31191 CHICK HIU If A IPOUSAL POVI..,' CIIDI' II CLAIMID [J PILI NUMIII '. ~~:~*;~ COMMONWEAllH 01 PENNSYlVANIA DePARTMeNT m REVENUE om. l80001 HARRI!IURO, PA 17128.0601 INHERITANCE TAX RETURN RESIDENT DECEDENT (TO BE FILED IN DUPLICATE WITH REGISTER OF WILLS) t:')0 ., " - (.':>\ NUMBER q'l YEAR ~I COUNTY CODE I'S COMPLElf A5m'rr' 92 Front Street West Fairview, Penns1vilnia 17025 I Q MIDOLe INITIAll CROGNALE, MARY BETH l lCuRifYNUMII'--IAfrorufA1H---lOATEO' 81RtH 160-58-8031 5/20/94 12/25/60 RJ 1. Original Rolurn 0 7, Supplomontol Rolurn o A, Llmllod Ellolo [] Ao, Fuluro InlorOlI Compromllo lIar dolOl of doolh oker 12. I 2.82) rJ 6. Decodonl Dlod TOIlolo [] 7, Decodonl Malnlolnod 0 Living Trull (Alloch co y 0' Will) (Alloch copy a' Trulll AU. coalUPONDlNCI AND CONPlDIImAL 'AX INl'OlMAnON SHOULD .1 DIIICTID '01 E =rYE MAUING ADDRESS John J. Krafsig, Jr., Esquire 2921 N, Front Strcet l NENUMBE -----.-.--. Harrisburg, Pa, 1711 0 717 I 236_-2109 . 1. Rool Ellolo (Schodula A) ( 1) .._______....N.()I:l~__. 2, Slack I and Bnnd'lSchodulo BI I 2) ..__.___...$.5Q.,.Q..!L... 3. Clollly Hold Slock/Porlnlrlhlp Inloroll (Schadulo q (3) _.___NQ,nc_._.._ A. MartgogOl and NolOl Recolvablo (Schodulo 01 ( AI -__...NQ.Q,(L,_._. 5, COlh, Bonk Dopo,lll & MI"ollonooul Po"onol Properly( 5) -_.....$..2.....2..0.0...Jl.O.._ ISchodulo E) 6. Jolnlly Ownod Property (Schodulo FI ( 6) ___..lt2..t..9_?..h2.~ 7, Tronlf... (Schodule G) (Schodulo L) ( 7) ____~e __ 8. Tolol Gran Anol' (lololllnOl 1.71 9, Funeral ExponlOl, Admlnlllratlvo COllI, MlscollonooUl ( 91 ExponlO' (Schodulo H) 10. Dobll, Mortgogo L1obllltlOl, Llonl (Schodulo I) 11. Talol Doductlonl (lololllnOl 9 & 10) 12, Not Valuo of Ellolo (Ii no 8 mlnUlllno 11) 13. Chorlloblo and Governmonlol BoquOlII (Schodulo JI lA. Nol Voluo Sub oct 10 Tax (IIno 12 mlnUlllno 131 15. Amounl 0' IIno 1A loxoblo 01 6% ralo (Includo volu.. from Schodulo K or Schodulo M.) 16. Amounl of IIno I A loxoblo 01 15% rolo (Includo voluOl from Schodulo K or Schodulo M.I 17, Principal lox duo (Add lox 'rom IIno 15 and from IIno 16,1 18, Crodlll Spousal Poverly Crodll Prior Poymonll DI"ounl Inleroll _N/A + _..NlA___ +_$.5.....2_6.. - __._N/.A_ cO"."!L....Qumber1and [13, Romolndlr Rolurn (for dolOl 0' doolh prior 10 12.13.82) [J 5, Fodorol Ellolo Tax Rolurn Roqulrod _ 8, T 0101 Number of Solo Dopo.1t BoxOl z o 3 E ~ ( 8) $9.950.00 :U~64. 20 (10) None (11) $"Ll..64. 2L_ (12) $1.985.80 (131 __-1J.on.e___ (14) .tL_2.a2....Ji!2_..__ (151 .--.--UJ.a5.......8..Q_~ .06 a --.-.--$li..9..LS._____ (16) None ~,15a ____None (17) _________._.__ (ht.(~ 1H'11' If you UII' Il'qul'~llIlH (l It,fund of VOUl OVI''IlClY"ll'llf (181 .-....--..__.$.5....9.6__ (191 -______.......NCJllfL-___ (201 .-----_1U.3~.L2--__ 120AI_._ _____NQIlQ....._..__ (20BI........_..._$.J1)....1.2.....__ uv.uor..U t In'''l 1\~"~i:9~ '''l,lf117w COMMONWfAITH m PfNN!YlVANIA INHfRIIANCf TAl WURN Mflla!NT afCID!NT SCHEDULE F JOINTLY.OWNED PROPERTY _ + + ___n_.__.~...._ _.<_ ESTATE OP MARY BETH CROONALE PILE NUMBER ---.--.-----..---- .---.-.------------+.-.--..--.--------..-.---..-- Join' ',non'I'll _____~_.__.._ NAME A. Thomas N. Crognale ADDRESS --'.'-_00_- 90 Fr.ont Street West Fairvifw, Pa. _______ .___ RELAT!QNSHIP TO DECEDENT Father 17025 B. C. Joln,ly.own,d prop,rtYI ITEM LEnER DATE POR TOTAL VALUE DECD'S DOlLAR VALUE OP NUMBE JOINT MADE DESCRIPTION OF PROPERTY OF ASSET % INT. DECEDENT'S INTEREST TENANT JOINT 1. A 2/29/77 3 Accounts under Acct. #08858 with Harrisburg Be1co Federal Credit Union: Regular Savings - $14,547.62 Money Mangt. Savings - $2,705.00 Checking Savings - $2,448.64 wi Interest on all accounts - $ 214.66 $19,915.92 50% $9,957.96 *N.B. The said T s N. Crogna1e is assuming tho payment of t e tax liability or the ne-ha1f interest in this joint account, as e the surviving oint te ant. A check for the tax Ii i1ityof $597. 8, 1 s discount f $29.8 , in the amount of $567.61 is being paid to the R gister of ills at the time of the filing of this Inheritance T Ret rn. TOTAL IAl,a enle, on line 6, Recapllulallanl (1/ mar. 'par.e I. needed /..e,' addillana',heel, a/some .ize) ~ .252..9_6_1~ . UV.15I1I11. (7.1'1 . SCHEDULE H FUNERAL F.XPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES Pllall Print or TV I J:IU NUMBER -------- - ~:@;~ COMMONWEALTH Of PENNSVlVANIA INHIRITANCE TAX RETURN RE31DINT nECIOENT mATI Of MARY m.'TH CROGNALE ITEM NUMBER A. Funeral Explnllsl 1. 2. B. 1. DESCRIPTION Musselman Funeral Home - Services for decedent Catholic Cemeteries - Burial charges Admlnlstrotlvl Cosll, Porsonol Reprosentallve Commissions Social Security Number of Personal Represenlatlve: Year Comml..lons paid ____.._.___ Allorney Fees - John J. Krafsig, Jr., Esquire - Preparation of Small Estate Petition and Inheritance Tax Return, etc. 3. Family hemplion Clalmonl _ Relationship Addroll of Clolmanl al decedent's death 2. 4. C. 1. 2. 3. 4. 5. 6. 7. 8. Stroel Addrell __.__ City ..__SIate Zip Code Probate Fees Mllelllanloul bpenll" Register of Wills - Letters of Administration Register of Wills - Filing Small Estate Petition and Inheri tance Tax Return TOTAL (Also enler on line 9, Recapltulatlonl (II mar. IpaCI II nledld, Inslrt additional .h.... al laml 1111. I = AMOUNT $6,465.20 $995.00 $400.00 $54.00 $50.00 $ 7, 964 . 20 ,.. ,,j ( ..:) ., 'd/$;1 c.. REVo1547 EX AFP (08094* COMHONWEtL TIt OF PENNSVLVANIA DEPAR'"E"' OF REVENUE \ OUREAU DF INDIVIDUAL lIMES DEPI. E00601 HARRISBURO, PI 17121-0601 NOTICE OF INHERITANCE TA~ APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAK ACN 101 DATI 11-07-94 o FILE NO. DATI OF DEATH 05-20-94 COUNTY CUMBERLAND NOTE I TO INSURE P~OPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TA~ PAYHENT TO THE REOISTER DF WILLS. HAKE CHECK PAYABLE TO "REOISTER OF WILLS, ADF.NT" REMIT PAYMENT TO: - JOHN J KRAFSIG JR ESQ 2921 N FRONT ST liBG PA 17110 REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 r Aoount Ro.ltted J CUT ALONG THIS LINE .. RErAIN LOWER PORTION FOR YOUR RECORDS ~ REV: iiliii-iif -r; Fin iis"- 94-; - Heifiiir- of" "i'NHEififAiic E -i'"Ax" iili PRA"i BiMEHT"; -AL lowAiicE - OR -- -". - ---- - - - - - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF CROGNALE MARY B FILE NO. 21 94-0502 ACN "101 DATE 11-07-94 TA~ RETURN WASI ( I ACCEPTED AS FILED 1 X) CHANDED SEE ATTACHED NOTICE RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL 1. Rool Eotote (Sahodulo A) III 2. Staa~o ond Band. (Sahodulo B) (21 S. Cla.oly Hold Staak/Portnor.hlp Intoro.t (Sahodulo C) (S) ~. Hartgogo./Nato. Rlaoi.lblo (Sahodull D) (~) S. CI.h/Bonk Dlpa.lt./Hi.a. Plr.anol Praplrty ISahldull EI (5) 6. Jointly OWnld ProPlrty (Sahldulo F) (6) 7. Trln.for. ISahldull 0) 171 B. Totll Alllto .00 50.00 .00 .00 9.900.00 9.957.96 .00 IBI 19,907.96 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funlrll E'Pln.I./Ad.. Co.t./HI.o. E.p.n.l. (Sohldulo H) (9) 10. Dlbto/Hortglgo LlobUitl../Liono ISah.duh I) llO) 11. Totol Dlduatlon. 12. Not Voluo of To. Roturn IS. Chorit.blo/Dovorn.ontll Blquo.t. (Sahldulo J) l~. Nit VIluo of E.tltl Subjoat to T.. 7,964.20 .00 Illl U21 US) ll~) 7. CJli4 'D. 11,943.76 .00 11.943.76 NOTE I If .n ......m.nt w.. i..ued pr.viou.ly, lin.. 14/ 15 and/Dr 16. 17 and 18 will r.fl.ct figur.. that includ. the total of ah1 r.turn. a.....ed to dat.. ASSESSMENT OF TAXI IS. A.ount of Llno l~ .t Spou..l rot. 16. A.ount of Lln. l~ t..oblo .t Lino.l/Cl... A r.t. (16) 17. A.ount of Llno l~ t..obl. .t Coll.tor.l/Cl... B r.t. 1171 lB. Prinoipol T.. Du. (IS) . 00 ~ .00_ 11,943.76 ~ .06_ ,00~.15. Il8) .00 716.63 .00 716.63 TAX CREDITS: PAYHENT DATE 06-23-94 06-23-94 RECEIPT NUHBER MM886210 MM886209 DISCOUNT (t) INTEREST (-I 29.87 5.96 AHOUNT PAID 567.61 113. \ 9 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST TOTAL DUE 716.63 .00 .00 .00 . IF PAID AFTER DATE IHDICATED, SEE REVERSE FOR CALCULATIOH OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN II, ND PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY IE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) . Rf5tRVATIONl E,t.t.. of d,Cldlnt. dvlnt on or b,'ate Olcllbtr 12, 1,IZ .. If .ny future Int.r..t In the ..t.t. I. 'ran,flrr,d In po.....lon or ."Joy..nt to Clalt . (coll,t,r,l) bln,flel.rl,. of the dlced,nt "t.r the explretJon 0' tny ..tlt. far U'I or for Vllr., tho Co..onw..1th h"tby IlCprll.h r1ltrVII tht right to appr.h, end 1..11. trlnlflr Inh,rltlnOI TIM" It the l.w'ul el... I (col1It.r,1> rtt. on any lueh future Inter..t. P\Ml1l0SE OF NOTICE I To fulfill th, requlr..,nh 0' Slotlon 2140 of the Inherltlncl and E,tlt. TalC Act, Act 22 0' 1991. 72 P.S. $lct Ion ZUD, PAYItEHTI Detlch the top portion of 'hil Hotlcl Ind tUb,1t wUh your Ply..nt to the Rltglltlr of WUII prlntld on the r'Vlr.. 11d,. uHakt ohlck or lonty order Plvtbh tOI REGISTER OF MILLS, AGENT All Ply..nt. r.cllvlU .hall flr.t bt IPplltd to any IntArl.t which ~ay bt dut wIth .ny rt"lnd.r applltd to thl ta~. REFUND (CA)1 A r.fund cf I tlM cr.dlt, which WII not rtqullttd on tht TIM R.turn, IIY b. ,.quut.d by cOIJllltln, an "AppllolUon 'or IIlfund of PtnnulYlnl1 Inhtrltlnet and E.tlt. TalC" (AEY.lSlSJ. IppllolUon. Ir. IY.llabl. It th. Offlc. of the R.al.t.r of Wlllv, .ny of th, 23 R,vlnul Dlltrlct OfficI', or by oalllna thl ,peol"1 24.hour an.w.rlng slrvlc. nu.bar. for for.. orderlngl In Plnn.ylvtnll l.aOO.362-2nSO, out.ld' Plnn.ylvlnll Ind within 10011 Hlrrlsburg Ir.. (111) 111-8094, TOOl (717) 172'2252 (Hurlna I.p.lr.d Only), OIJECTIONSI Any plrty In Jntlrl.t not ..tl.fl.d with the appr.I....nt, Illow.net or dl..llowlnel of dtductlon., or .I......nt of tlX (Inoludlng dlltount or Inttr..t) a. shown on thl. Hotlcl aust objlot within GIICty (601 dlY' of rlo.lpt of thll NoUct bYI "written protut to the "'" O.Plrtllnt of Rlvlnu., Baud of Appult, OEPT. 281021, tlarrlsburg, P'" 17121.1021, OR ..tl.oUon to h..... tht .Ittar d.t"aln.d at audit of tht flceount of the Clr.onll rClprt..ntaUvI, OR ..apPlll to thl Orphan,' Court. ADIIIH ISTRATlVE CORRfCTIOHt I Faotual .rror. dl,cov'rld on thl. a.......nt .hould bl .ddr....d In writing tOI PA D.parta.nt of R.v.nu., Burllu of Individual TalClI, AnNI Po.t ..........nt R....llw Unit, DEPT. 280601, tlarrhburg, PA 17121.0601 Phonl (711) 787'6S0S, S.. plge 3 of the bookllt "In.truoUon. fer InhlrU.ncl Till R,turn fer I RI.ldlnt Dlc.d.nt" (REY.ISOI) for an .xpllnltlon of adtlnl.tr.tlv.lY corrlctablt Irror., DISCOUNT. If any tlM dUI Is plld within thr.. (3) eal.ndllr .onth. IIftar thl d.oAdent.. death, . five paro.nt (510 dltcount of the tlX Plld I. IlloWld. IHTEREST. Intere.t I. chargld beginning with flr.t day of dellnqulnoy, or nlnl (9) R~nth. and ani (I) d'i frcI the d,tl of dttth, to the dltl of plYRlnt. TI." which biOI" dlllnqulnt blfore January I, 1912 btlr Intlrllt It the rate of .he (6X) pare.nt P" ennuI ealeulatad at a dilly rat. of ,000164, All hXII which bloa.. dlllnqu.nt on and Ifter Jlnulry I, 19'2 will blar Intlrl.t at a r.t. which will Ylry fro. cal.ndlr Ylar to olllndlr y.ar wl,h th.t r.t. announc.d by the P'" D'Plrt..nt of Alv.nul, Th. appllelhl1 Intlrllt ratl' fer 1982 through 199" ,r', ~ Interllt Altl olUV Int.rut Factor Y!!r Intarllt Aetl UallY Intlr..t FI~ 1911 m ,OOO5ft1 1916 lOX ,00027' 19n 16X .ODO"U 1917 9X ,0002'7 191. m ,000lO! 1916-1991 m ,ooom 1915 ale ,000156 1992 9X ,000147 19n.199. 7% ,000192 ulnt.rllt I. cllcul.t.d I' feUow'1 INTEREST . BALANCE OF TAX UNPAID X NU"BER OF DAYS DELINQUENT X DAILY INTEREST FACTOR .....ny Notlet i..uld .ft,r the t.x btcc.., dtllnqutnt will rlfllot an Int.r..t c.leul.tlon to flftl.n (IS) dlV' beyond th. date of the ........nt. If plv..nt 11 'Id. lit., thl Interllt coltflutaUon d.t. .hown on the HoUel, Iddltlonel interut ~u,t bt celeultttd, / / t- , ,. ~ATUS REPORT UNDER RULE 6.12 /.I {1.-i,C, ,v /J L& i',1 Name of Decedent I ,( 11.Jt~ .6t.:~ol Date of Deathl -s/. ;l{.). '1 '{ u (:I,'. Will No. N., tV c Admin. No. ::i/~ 9c1- :::S't>-;), ,!I 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 I 1. State whether administration of the estate is complete I yes-K_. 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 followingl a. Did the personal representative file a final account with the Court? Yes No-lC--. 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 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 may be attached to this report. Datel NVI!' I~ -/H1 I. /I J:../un:~L,:.. U /I. . 77#.H/j"$ l';2L;,c;"v~1 u.r Name (Please type or print) C" ~. .r _ "/ ,- H<<> A.} r- -...)I'7.!..C'c,'''''' Address /,L/.:..'":S,r ~/?....vIL-r..J (71'1' 7:32 ~"S-r; 'l Tel. No. (-y ~~mMJ Signat-ure ~. 17'-!lJ (MAH: rmU AM3) Capacity: ~personal Representative Counsel for personal representative j