HomeMy WebLinkAbout94-00665
E
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Blaleol :r~.....:, ~\"7,>",,'n
also known as
c:?/~ 94 -(P&5
Deceased.
Social Securlly No. I € 1- 3"Z... ~c:.:I '\
No.
To:
Register of \'iJlls for lhe
County of ("L,./l,...(...J In the
Commonweailh of I'ennsylvanlu
The pelillon of lhe undersigned respectfully represenls 11m!:
Your petilloner(s). who Islare 18 years of age or older. appllt.J
for lellers of admlnlslratlon
on the eSlale of
(d.b,n.; (X'ndcnle lite: duranle absentia; durante mlnorllule)
lhe above decedent.
Decendent was domiciled at death In (Ju....6-.. (~..( Count~, l'e~Ylvanla. wilh
b 1"..- .Jastfamllvorprlnelpalre,ldenceal ''71 'd~...:J(..(;I... r<-J:. (1)....(..<- II.. 1"'oG.
WQ~'" PQ" n ~ 1,.0 .- c ,. W f' (1151 iHtel, number and munlclpalll)')
Deeendent, then 5'2 years of age. dlerJ ~(. v. I '7 , 19 "1.3
at '-crt -a....n ~t,'- FOOd. (O"..{,u_.. fl. '-'''>13
Decendent at death owned property wilh eSlimated values as foil lows:
(If domiciled In Pa.) All personal property
(If not domiciled In I'a.) I'ersoual property In Pennsylvania
(If not domiciled in I'a.) I'ersoual property In County
Value of real estate In Pennsylvania
siluated as follows:
$ 3,102.30
$
$
$
Petilloner_ after a proper search hIlL.- ascerlalned that decedentlefl no will and was survived by
~t 011 .11!.,g s~ousCTif1v1y) and heirs:
In";."! Relationship Residence
. ~ ~ ,-..
.. .
~9 ~\3",," ~ '[? (lJc/.Jo
(~ --:?... L CH ~
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THEREFORE, pelilloner(s) respeelfully request(s) lhe grant of lellers of administration lu the
appropriate form to lhe undersigned.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
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The pelilloner(s) above. named swear(s) or affirm(s) that lhe
statements In the foregoing petillon are true and correct to the best
of the knowledge and belief of petilloner(s) and that as personal
representatlve(s) of the above decedent petilioner(s) will well and
truly administer the estate according to law.
,.)
-J
M Y C. LEWIS
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Sworn to or
before me this
Reglsler
Estate of
No. 21 - 94 - 665
JERI A. PASCO
I Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW AUGUST 2, 19~, In consideration or the petitIon on
the reverse side hereof, satisfactory Jlroof having been presented before me,
IT IS DECREED that RICHARD J. PASCO
islare enliUed to Letters or Administration, and In accord with such finding, Letters of Administration
are hereby granted to
RICHARD J. PASCO
In the estate of
.t..0
Roalsl" 01 Will.
MARY C. LEWIS
~
FEES
Lellers of Administration ..... $
Short Certlficates( 2) .. . . . . . . .. $
Renunciation ................ $
JCP S 5.00
TOTAL _ S 36.00
Flied... Mj;.~ST. Z....... A.D. 19--9.L
25.00
6.00
ATTORNEY (Sup. C'. 1.0. No.)
ADDRESS
PHONE
Mailed letters to Administrator on 8-2-94.
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Thi~ i, tu n.ltif)' ,h.lI till' illtUl'lllalillll hell' gin'" i:-. (Iii In t1)' t'IlP"'" hum .111 tlli.~1I1.d ll'llifll.lll' Illth-.1I1l dHI)'
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lilttl \\'1111 Illl" .l~
WARNING: Ills Illegal to duplicate this copy by photostat or photograph.
Fl'C IIII' this u'nificlIc. 52.0()
213179G
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COMMDtmEAl.TH OF rttINSY\.VANIA' DEPARTMENT Qf tiEA\.TH' vnALRECOADS
CERTIFICATE OF OEATH
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K'ClAl.IlCU'lI'''_NtIl
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,Novomber 19, 1993
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John 1\. Hiller
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Richard J. Pasco
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21 - 94 - 665
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20. II line 191. greale, than line IB, enl., the diff.rence on line 20. Thill, the OVERPAYMENT.
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21. If line 18 I, g,eol.r thon line 19, enl., the difference on Line 21. Thl,l, the TAX DUE.
A. Enler thelnl.,.,. on ,he bolonce due on line 21A.
B. Enl., ,he 10101 of line 21 and 21 A on line 218. Thil II .he BALANCE DUE.
Malle Ch.de Pavabl. tal Regll.e, of Will., Agent
~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH 00( 00( in",;"" 'i,,'L,j
Under penalti.. of perjury, I declar. that I have examined !hl. r.'urn, Including accompanying schedule. and .tolemenlt. and to the bell of my knowledge and bell,f.
II Is true, corred and complete. I d,c1ar. .hot 011 real ."01. has be.n reported allrue mark.t value. a.deration of prepare' other Ihan the perlonal ,epr.llnlollve I,
based on 011 Informal ion of which pre ar.r has any ~nowledge.
$IGNAIUU U$ON JlU'ON$IIU f 'IUN nUIN ADORU$ DAll
REY.1500 ['t (7.9'1
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lOR DATlS OF DIATH AnlR 12/31191 CHICKHlRl
INHERITANCE TAX RETURN ~o~::~yU~:~DIT 15 CLAIMID 0
RESIDENT DECEDENT FIUNUMBlR 21 94 06f:5
(TO BE FILED IN DUPLICATE - l
WITH REGISTER OF WILLS) COUNTY CODE YEAR NUMBER
OlUOfNI'$ COMmn ADDRlU
691 BlIrnstable Rd
ClIrliale, PA 17013
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COMMONWEALTH Of PENNnlvAHIA
DEPARtM(Nt Of REVENUE
DEpr 280601
HARIlI5IUIIO. PA 17128.0601
OICIOfN' NAMIIIA . m~l. AND MIOIHl INllIAlI
PASCO, JERI A.
SOCIAL $lCURn... NUMUR
OAII O' IIRIH
OAn or DUIH
181-32-3633
11-19-93
1-6-1.1
COII"I
I" ol"II("IL" tUIVIVII'fOII'OI.I"'1 N""" ILollI.fll"olI10"'IPOtllt;III"11
AMOUN' IICIIVID IUIIN5I1UCf.0~nl
PASCO, RICHARD J.
~1. Original Relurn
D ... lImUed E,lal.
Db,
03,
OS,
o 2. Supplemental Relurn
Remalnd.r Return
(for do'.. 01 deoth prior 10 12.13.821
hd"al Eslat. Tall, R.lurn R.qulltd
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31e
o "D. Fulur. Inl.r,sl Compromise
(for doles of deolh oh.r 12.12.82)
Decedenl DI.d Teslot. 0 7. Dec.denl Malntolned 0 living TrUll
(Altoch copy of Will) (Allach tOpy of T,ull)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
NAME (OMPUIE MAiliNG "DOUU
RICllAkU J. PASCO 691 JlornBtable Road
_.' "'p'_'.;'f'
'--~i-:"j ", .",;'. ':t' ^
_ 8. Tolal Numbe, of Safe Deposit Boul
lUIPHONI HUMIU
Carlisle, PA 17013
(I)
(2 ) 1.138.00
13 )
14 )
IS I 2,896.04
I b I
171 4,034.04
(8 )
19 ) ---2...ll4., 13
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1. Real ellate (Sth.dul. A)
2. Slac~s and Bonds (5th.dule B)
3. C1al.ly Hold Slat~/Partn.nhlp Inl.,..1 (Schedule q
A. Morlgages and Not.. ReceIvable ISchedule D)
S. Cosh, Bonk Deposits & Mileelloneoul Penanal P,operly
(S,hedule EI
6. Jointly Owned P,operly (Schedule F)
7. Tron.f... IS,hedule GI(S,h,dul. II
8. Tolal Gran Anels (tolallln.. 1.7)
9. Funeral Expense., Admlnlstrollv. COlh, MII,,!Ioneous
Exp.nse. (Sthedul. H)
10. Debh, Morlgage lIabllllles, liens ISthedule I)
11. T 0101 Deduclions (10101 lIn'l 9 & 10)
12. Nel Value of ellale (lIn. 8 mlnusUne 111
13. Cha,itable and Governmenlal aequeI" (Schedule JI
IA. Ne. Value Sub eet 10 Tak (line 12 mlnul line 13)
15. Spoulal Transfen (far dot.. of death after 6.30.9A)
See Inlt,ucllonl for Applicable Per"nlaoe on Revene 11 5)
Sid.. (Indud. values f,om Schedule K 0' Schedule M.)
16. Amounl of lIn. IA lakabl. at 6% ,ole 116)
(Include valuel f,om Sch"dule K or Sthedule M.)
17. Amounl of line 1A faxable at 15% '01. 117)
(Indude valuel from Sch.dule K 0' Sthedule M.)
lB. Principal tax due (Add tak from lIn.. 15, 16 and 17.)
19. Credih Spousal Pover.y Credil P,lor Pa)'menlt Discount
Inhuelf
5,274.13
-0-
(ll)
(12)
(13)
(14) _
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x .06.
x .15 .
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(181
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(19)
(20)
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Chet" here if you arc roquelling 0 .ofund of your avorpaymonl.
(21)
(21A)
(218)
691 Jlarnstnble Rd., Cnrlis1e, PA 17013
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ADORU!.
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Act #48 of 1994 provide. for the reduction 0' the tax rate.lmpo.ed on the net value of tran.'e" to or for
the u.e of the .pou.e. The ratp. a. pre.crlbed by the .tatute will bel
e 3% (.03) will be applicable for e.tate. of deeedenll dying on or after 7/1/94 and before 1/1/96
e 2% (.02) will be applicable for e.tate. of decedent. dying on or after 1/1/96 and bofore 1/1/97
e 1% (.01) will be applicable for e.tate. of decedent. dying on or after 1/1/97 and before 1/1/98
e Spau.al trande" occurring on or after 1/1/98 will be exempt from Inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (.....) IN THE APPROPRIATE BLOCKS.
YES NO
1. Old dec.d.nt moka 0 trons'.r ond:
a. ratain th. us. or incom. 0' the prop.r1y trons'.rr.d, .......................................................
b. r.taln the right to d.s1gnot. who shall us. th. prop.rty transf.rr.d or Its Incom., ...............
c. retain a reversionary interest; or ...................................................................................
d. r.c.lv. th. promise for Iif. of .lth.r paym.nts, b.n.flts or car.' .......................................
2. If d.ath occurr.d on or bafor. O.c.mbar 12, 1982, did d.c.d.nt within two y.on pr.cadlng
d.ath tronsf.r prop.r1y without r.c.lvlng odaquot. consid.ratlon' If daath occurr.d oft.r
O.cemb.r 12, 1982, did d.c.d.nt transf.r prop.r1y wilhln on. y.or of d.oth without r.c.lving
adequate consideration' ......0........, ....... .t.. 10......... to IO... .to...... ......... ............. .......,. 00' .....0.....
3. Old d.c.dent own on 'In trust for' bonk account at his or h.r d.othL....................................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST SOMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
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SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
COMMONWfAUH Of PINNSYlVANIA
INHUITANCf fAX RfJURN
RUIDfN'DfClDfN'
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Ploa.o Print or T 0
ESTATE OF
JERI A. PASCO
ITEM
NUMBER
A. Funoral Expon,o"
1.
B.
1.
2.
3.
4.
C.
I.
2.
3.
4.
5.
6.
7.
B.
DESCRIPTION
Aclmlnl.tratlvo Ca.h.
Penonal Repre.enlatlye Com minion.
Social Soeurlty Number of Penonol Ropro.onlatlvol
Yoar Com minion. paid
Allornoy Foo.
Family Exomptlon
Clalman' RICHARD J. PASCO
Addron of Clalman' a' doeodon". doa,h
S'ree' Addren 691 BARNSTARI.E nn
City CARLISLE 51010 PA Zip Codo 1701 ~
Rolatlon.hlp
HUSBAND
Probale Feo.
MI.eollanoDu, Expen...,
TOTAL (AI.o on'er on IIno 9, Rocopltulotlon)
(If more .paeo I. noodod, In.ort addltlonal .hoot. of .amo .1.0.)
21 94-0665
AMOUNT
$3,274.13
2,000.00
S 5,274.13
, 1... ,'; OJ ')
~EV-1547 EX AFP 112"94*
\II F CO~AlTH OF PENNSYLVANIA
DEPARTHENl Of REVEHUE
IUREAU Of INDIVIDUAL lAkES
DEPT. 110601
ItARRISlURa, PA 17U.~06Dl
I ~ - d-d-lo - I~
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ACN 101
NOTICE OF INHERITANCE TAX
APPRAISENENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
DATE 04-10-95
o FILE NO.
DATE OF DEATH 11-19-93 COUNTY CUMBERLAND
HOTE. TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBNIT THE UPPER PORTION OF THIS FORN WITH YOUR TAX
PAYNENT TO THE REGISTER OF WILLS. NAXE CHECX PAYABLE TO "REGISTER OF WILLS, AGENT"
REMIT PAYMENT TO:
RICHARD J PASCO
691 BARNSTABLE RD
CARLISLE PA 17013
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
A.ount R..Hted
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiEY=i54i-Ex-"FP'-n2':94Y"iiiiYicE""tiii-YtiiiEififliNcE-Yliin-pjiRA"isEiiiii;--;-"Li.-tiwliNCE-oimm-------m-
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF PASCO JERI A FILE NO.21 94-0665 ACN 101 DATE 04-10-95
TAX RETURN WAS. I X) ACCEPTED AS FILED
CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE \, I'" J ~ .:JJ
c _.
APPRAISED VALUE OF RETURN BASED ONI ~!" .am
ORIGINAL 0, n
1. R..l E.t.t. (Schedule A) 1I) c .00 ' ~-)
, ~. ,:/
2. stock. and Bonda (Schedule BJ 12! 1.138.00 0 (0:
=
S. Clo..ly Hald stock/Partnarship Int.r..t (Schedule C) IS! .00 -
4. Hortg.ga./Not.. Receivable (Schedul. DJ 14) .00 0
5. C..h/Bank Depolita/Hi.c. Parsonal Property ISchedule E) 15) 2,896.04 ..'
~ ...,
6. Jointly Owned Property (Schedule F) (6) . .00 l"i. ('J
7. Tran.fara (Schedule 0) In ",\~ ~, 00 ,':.
N 4.034.04
e. Total A...t. ce)
APPROVED DEDUCTIONS AND EXEMPTIONS I
5,274.13
9. Funeral Exp.n.e./Ad.. Coat./Hi.c. Expen... (Schadula H) (9)
10. Dable/Hodgaga Liabilitla./Lien. <<Schedula I) (10) .00
11. Total D.ductlon. 111)
12. Hat Va1u. of Tax Raturn (12)
13. Charit.b1a/Govarn.antal Baqua.t. (Schadul. J) (13)
l~. Hat Value of Eat.ta Subjeot to Tax (14)
NOTE I If an assessmant was issued previously, lines 14, 15 and/or 16, 17 and 18
reflect figures that include the total of Abh re~urns assessed to date.
ASSESSMENT OF TAXI
1S. AMount of Lina 14 .t Spou..l rat. US)
1'. Aaount of Lina 14 taxabl. at Lineal/C1a.. A rata (16)
17. AMount of Lina 14 taxabl. at Col1ataral/Cl... 8 rata (17)
18. Principal Tax Dua
G ."4 1:\
1,240.09-
. 00
1.240.09-
will
.00
.00
.00
X .00.
X .06.
X .15.
lie!
.00
.00
.00
.00
TAX CREDITS I
PAYNENT
DATE
DISCOUNT Ct)
INTEREST 1-)
RECEIPT
NUNBER
ANOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
.00
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF AJOITIONAL INTEREST.
IF TOTAL OUE IS LESS THAN '1> NO PAYNE NT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREOI'T" ICR), YOU NAV eE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.)
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RESERVATION. E.t.t.. a' dec.d~t. d~l", on a~ b.'ar. o.c..o.~ lZ, I'IZ -- I' ~~ 'utur. Int.r..t In the ..t.t. I. trsn,'.rred
In po.....lon or ~Jov.~t to Cl... . (coll.t.r.l) b.ne'lci.rl.. 0' the d.c.dent ,'t.r the .xpiratlon 0' ~v I.t.t. 'or
il'. o~ 'or y..r., the COIIOftN..lth h.r.by .xpra..lv r...~v.. the right to .ppr.I.. end ...... tr~I'.r Inherltanc. T.x..
at the lI.w'ul Cia.. . (calhtareU ~ata on ImV .uch 'uture Intaralt.
PURPOSE OF
NOTICE. To 'ul,111 the raqulr..ant. 0' Sactlon ZI40 0' tha Inh.rltanca end E.t.t. Ta. Act, Act 22 a' 1"1. 7Z P.S.
Saatlon Z140.
PAYnEHTI
Detach the top portion 0' thl. Hotlca and .~It with your pav-ant to the Ragl.tar 0' Wills printed on tha rav.r.. 'Ida.
...."ek. check or .anay o~dar payllbl. to. REGISTER OF MILLS I AGENT
All p.yaent. received .hall 'Ir.t ba applIed to any Int.r..t which ..y b. due with any r...indar appll.d to the t...
REfUKD (CA)I A r.'und 0' . tax cradlt, which wa. not requ..t.d on the Tax R.turn, 'I~ b. reque.ted by cOlaplatlna an "Appllcltlon
'o~ A.,und 0' penn'Ylvanla Inherltanca and estatl Tax" (REV-ISIS). ApplicatIon. ar. av.llabl. at the offlc.
of the R.gI.t.r of WIlli, any of the 23 R'v,nu. DI.trlct O'flc.., or by callIng the .p.clal 24~hour
an....rlng ..rvlc. ~rs 'or 'or.. ordarlng. In Penn.ylvanla 1-IOD"S62.205D, out. Ida Penn.ylvanl. and
wIthIn loc.l Hlrrl.burg a~'a (717) 717"ID'., TOO. (717) 77Z-2252 (H'a~lng I.,.lr.d Only).
OBJECTIONS I Any p.~ty In Int.r..t not .atl.fl.d wIth the appr'....-nt, .Ilowanc. o~ dl..lloMlnc. of d~tlon., o~ ......-.nt
of t.x (Including dl.count or Int.r..t) .. .hown on thl. Notlc. lU.t obJ.ct within .1xty (6D) d.y. of recllpt of
thh NoUCI byl
.DltIH
ISlAATlVE
CORRECJlDHSI
....wrItten protl.t to the PA D.p.rta.nt of RIV'nu., lo.rd of App.el., D.pt. 211D21, Harrl.burg, PA 17121"1021,
-...llct1on to hav. thl ..tt.r dlt.r.lnad at .udlt of the .ccount of the p'~.on.1 r.pr...ntetlv., OR
-"app.al to the Orphan.' Court.
OR
DISCOUNT I
F.ctual .rror. dl.cov.r.d on thl. ......eant lhould b. addr....d In w~ltlng tal Pi D.p.rt..nt of Alvanua,
Bur.1U of Indlvlduel Tax.., ATTHI POlt A.......nt A.vl.w Unit, O.pt. 210601, Harrl.burg, PA 1712a"0601
Phon. (717) 717"6505. s.. pag. ) of tha bookl.t "In.tructlon. for Inh.rltancl T.x R.turn for I Ae.ldant
D.cadent" CREY-1501) 'or an .xplanatlon of adalnl.tratlv.1Y correctabl. .rror..
If any tax due I. paid withIn thr.. (5) c.l.nd.r aonth. eft.r the d.cadent'. d..th, a flv. p.rcant (5~) dl.count af
the tax p.ld I. allowed.
INTEREST.
Int.r..t I. ch.rged b.glnnlng wIth flr.t d.y of d.llnquency, ar nIne (" ~th. and ana (I) day froe the date 0'
d..th, to the dlt. of paw-ant. Taxa. whIch bac... delInquent ba'or. Janu.~y I, 19a2 b..r Int.r..t .t the rat. of
.Ix (6X) parc.nt p.r annua calcul.t.d at a dailv rata 0' .0DDI64. All tax.. which b.c... d.llnquent on snd aft.r
J~ry 1, 1912 wIll b..~ Int.re.t .t e r.t. which wIll va~y 'ro. c.lendar Y"~ to cllanda~ y..r with that rat.
~ed by the PA D.part-.nt of R.v~. Th. appllclbla Int.r..t r.t.. 'o~ 1912 through 1995 .r'l
~ Interalt A.t. Daltv Intar..t Factor ~ Intlr..t A.t. D.Uy Inter..t F.ctol"
1912 2'X .00054' 1917 OX .OD0247
1905 16% .000411 1,al"I991 IU .000301
".. IIX .000501 1992 'X ,000247
l,a5 UX .000556 1995"19M 7X .00DI92
l'a6 lOX .OD0274 .99. 'X .DOO247
--Int.~..t I. c.lcul.t.d .. follow'l
INTEREST. BALANCE OF TAX UNPAID X NUNBER OF DAYB DELINqUENT X DAILY INTEREST FACTOR
--Any Hotlc. I..u.d .,t.r the tax bacoaaa d.llnquent will ~.fllCt an Int.r..t calculation to fl't.an (15) day.
beyond thl d.t. of the .....lIInt. If p.y-.nt la alda .ft.~ the Int.r..t co~tatlon d.t. shown on the
Hotlc., addItional Int.ra.t BU.t ba calculat.d.
E
0(',
('
CERTIFICATION OF NOTICE UNDER RULE 5.6Ia)
Name of Decedent:
T.......\ ~. ~~ '$c...
f\C...,. 1.'\. I.,\q '2.
/..:
Date of Death:
Will No.
. .,
Admin. No. c:lJ-q4-&&6
N.6V\""'4-
To the Register:
I certify that notice of beneficial ~nterest required by
Rule 5.6(a) of the Orphans' Court :Rules was served on'or mailed to
the following beneficiaries of the above-captioned estate on
Name Address
.
No Lt.J-. I <.
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except
Date: 11-'Z.4-".....
~._:/Le ~___
Signature
Name ~:~ 3", ~ 1I'"-4
Address '-'ll ~..."- s*~ a
e..,..(:~(... .~. L'"10c3
Telephone('lt7) 'Z.49 ~ "l '\-, "I-
l-/uslo...6
Capacity: Personal Representative
Counsel for personal
representative
,.. ,. '. '. -... ....~ ";0
~ .-.- -----.-.'--..- .-.~...
STATUS REPORT UNDER RULE 6.12
Name of Decedent: T"...., N........ -~s' Go
Date of Death: Il-I'"l.-"l3
Will No. CJ./-CjLj-t,?J.'J
Admin. No. ..2/-9 '/-?~.S-
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:
1. State whether administration of the estate is complete:
Yes t< 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 final
account with the Court? Yes No .~ .
, ..
b. The separate Orphans' Court No. (if any) for
the personal representative's account is: /VO
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 may be attached to this report.
Date: /- ';;2 - 9?
-;; Q ~
( ./GA.]t.~~f '.j ~L-~....
Signat.ure
'\2;~..,)" -:T, S",.,,,
Name (Please type or print)
,-
G,<11
Address
''fh"", s(...c,(.. \?~ .
C-,,'~l,~',... 7""; '''"lOf.3
1'\
(~~
C /1-') Z ~ ''I - (1'(, I 4
Tel. No.
Capacity: ~personal
Representative
i
I
I.
I
I
f
:~~
u. I:' _ :....
(MAH:rmf/AM3Y.J
Counsel for personal
representative