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PETITION .'OR PROBATE and GRANT 0.' LETTERS
No, ____dl.:_CfI{-::- 7~_.__
To:
Rcglstcr of Wills for lhc
----.----------, DI'C'I'II.IWI, COllnty of __(.~::::!.~~l:LLS1_ III thc
Social SeL'l/rllY No, _...clC' >' . IC'___CL2_:i3.. COlllmonwclllth of I'cnmylvlInlu
Thc pctltlon of thc IIndcrsigncd rcspcclflllly rcprcscnts thlll:
YOllr pClltlollcr(s), who IS/lIrc IN ycars of IIgc or oldcr IInthc CXCClltu,,_.______ ,_lla~.lcq.
Illlhc,llIst,wlII of lI~c llbovc dcc('(~cl)t,,\llIlcd .....__..nnoo._____..lLl.<!~1_~ / '1_, 19-!2L
IIlld codlcll(s) dlllcd -----"'''"''///:..---.--..--..--....-.----.---00-----
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('lUll' rc1C\'llnll'ir~'IIIll'illln~\'~, qt. rl'lllll1dullnll. dl'lllh uf ~"u'Clll(lr. Cle,)
()cccndcnl wns domlcllcd III dC:llh In._~~!!.:")"" LL,2J'(L.__ COllllly, PCIlIl}3'lvllnla, with
h Ills I fllllllly or principal rcsldcncc lit ._.._--..3~~'h-S.,~L:1.!:.-::c:"'''''(-' l' 'I .... <-
--.------- ..-n.---..-----._____c.....a~jJ.:.!J."'___.,_.L_/l__.L2c.1 ."
t1ht slreet, 1I111llbl'r lllld 11l1l1l1.'lPllll1Y)
Dceclld~1I1, lhcn o-~'---- YCllrs of lI~e, dlcd __, ----..--7!.Z~'/~'U-711 -~_, 19 ? l/,
III ( v_.,. )". v 1 !J.LJ._-.'-<'-LL,I.z-,.oo_.(.n"'-l_U..!J,._f/._ ,. ..1' 0-' ,
Except as follows, decedl'l1l did notlllllrry, WIlS not dlvorccd ulld (lid 1101 hllvc II child born or adopled
after executloll of the will offer5d for probUle; WIIS notthc victir,n of II kllllllg IInd WIlS never adjudicated
Incompetcut: __'_.&.1_.2. --_____.___
Dcecndcntat dClllh owned propcrlY wilh cSllmuled vlIlucs us follows:
(If domiciled III Pa,) All pcrsonlll propcrty
(If 1101 domicil cd In 1'11,) I'crsonul propcrlY IlIl'ellnsylvllnill
(If 1101 domiciled ill I'u,) I'crsolllll propcrty ill County
Yulue of rcul cSlutc III I'cllnsylvunlu , ) )
sillllltcd as follows: ____.f"', ,< .1/ ,
$--L'j C'tV'
$ ,
$,
$
WHEREFORE, pctilloncr(s) rcspcctfully rcquest(s) t:1C problltc of Ihe lasl will lInd codlell(s)
presenled hcrewllh lInd the graut of Icllers__ '7 ~ '. -I <I ~::L47k-
(tl.'\lllIl1ClllllrYi udllllnhlrutlol\ C.I,lI.j admlnlstratlun d.h.ntc.l.n.)
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OATH 01<' PERSONAL REPRESENTATIVE
COMMONWMI.TH 01<' l'ENNsnVANIA }. Hti
COUNT\' (}I<' J:.UMBERLAND ______. . .
Thc pctltloncr(s) lIbovc'num~d swcur(s) or ufl'll'lll(s) thul thc stulcmcnts IlIlhe forcgolng pClillon arc
trlle lInd corrcet 10 thc hcsl of tilc knowlcdgc and bclll'!' of pctltlollcr(s) ulld lhlllUS pcrsollal rcrresen.
lUllvc(s) of thc ubovc dcccdcnt pctillollcr(s) will wclllllld trllly udmlnlstcr lhe cslutc according 10 law.
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Sworn 10 or IIftlrmcd IInd subscribcd l ~"'!.' ~'1'\'h__' (r. . \(1
heforc 'XD~j\ls~, : 1911:1 " du~'f ~I I ./ _ _ _ __. / ~'
1JJiiLlilt~ illuiJ/< -llJ/JJClti lc,l.j. _ _ .. .- ~ "___ ~
r (JARY . LEWIS Hl'!:i.\'(l'I' If' -....----_~___ ~
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This i"i 10 t'(:rdl}' lh.tt llt~' illflll'li1llll1111 11':11' ).:I\'l'lI i., ~'(}11l'~11~' Itllllt'd 11'11111 Illlllri.I~i111tll('l'lifltiltl' 01 dl',nh duly IIlt:d with lilt: 1I!\
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COMMONWEALTN O~ PINNaVL.,.N1A' OIPAATMINT O~ HIALTH' YITAL AICOAoa
CERTifiCATE Of DEATH
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COMMONWEALTH OF PENNSYLVANIA .1
I
COUNTY OF CUMBERLAND ". I
We, ROBERT E. BA~1R AND KNllILEEN tll. KI!:i'INb."Y and SHARON L. SCHilJ\J14
the Testator'and the witnesaaa teapeotively, whose names are
signed to the nttached or foregoing instrument, being ~irst duly
sworn, do herebydeolare to the undersigned authority that
the Tostator nigned nnd exeouted the instrument as his Last.'
Will and Testament and that he han aigned willingly (or willingly
direoted anothor toaien for him), and that he exeouted it .
as his fl'ee nnd voluntnrysct fOI' t.ho purpQRO therein expressed,
and that ouch of the wit.noanoa, in the presence and hearing,
of the Testator, siRned the Will us witnessos and thnt to
~he beat of their knowledge the Testator was at the time eighteen
years of age or older, of sound mind and under no constraint
or undue influenoe. .
~ L .~
ft..-':!:i~ r;;/ //.J., -....
. B IRT Ii: :t,BJl:ER
Testator
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~itness .
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. Subsoribed, sworn to and aoknowledged before me by ROBERT
E. BAER, the Testator, nnd subsoribed and sworn to before me by
witnesses, "
this 111\;h day of Janual'Y ,1988.
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CERTIFICATION OF NOTICE UNDER RULE 5.6 ( a)
Name of Decedent: l\oh~...1 t=. !5/1f!V
Date of Death: /1"'9,.,,1- J..3 J /17'1
" .
Will No. l?'l'l- o CO? 33 Admin. No.
To the Registerl
I certify that notice of beneficial interest required by
Rule 5,6(a) of the Orphans' Court ~ules was served on or mailed to
the following beneficiaries of the above-captioned estate on
.f1L"vJ1 171 I.J71 I
t'
Name
Address
r= d,th 5v..''''.v ;:;1-1"'1"
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44-'1 y b/ f! :'it I fi1e c h ..,,,,,'c..bu '''7' fit
Notice has now been given
Rule5,6(a) except
to all
~/A
persons entitled thereto under
-,//" ..it'r!:...5
Date I I /10 /,,_~-
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Address I 7 t..~.v9"-c"'v.:i.~ t."'f,v~
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f4,,1; fll 1730/
Telephone ( 61"1 .6 'I 'I - /~;).. '/
Capacity: ^ Personal Representative
Q~
~ Counsel for personal
representative
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWfAlTH 01 PENNSYlVANIA (TO BE FILED IN DUPLICATE '/
DEPARTMENT OF REVENUE n<
HA~IS~SJ~ ~~nbe.o60' WITH REGISTER OF WILLS) COUNTY CODE
l , - - M'-' O-RE'SS
f)A t':" J 1\,,/)(.' " t E. (_l/,~IJ, t_,' /..,.ih.l C..(H/."!.Y (,.-:'0.' "'/ IJ"...,~_.
OCiA1SECUR"VNUM~~DA1EOF01Am-~jj'^ir6niRftl---- ", ,'.5 c./"" ,^.",/ ()~""L
I I PI! /7?'/,
A I J" '" I"~ C A' ,., ",
;J.,,?,). I"" O.~ 'l:i ~ """I'1t ''',),'l1..t.'....,..'. '11'J ,. Co~ntt Lv"" It"r/~",,"
.______________________.__.______..__ ...._____...__.___.L..__._....__.
)8( 1. Original Rolurn [J 2. Supplomontal Rolurn rJ 3. Romalnder Roturn
(far dalOl of doath prior 10 12,13.821
[) 5. Fodoral E'talo To.
Rolurn Roqulrod
_Q.8. Total Number a' Sofo Dopallt Ba...
;1
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'OR OATIS O' PlATH AnIl 12/3' /91 CHICK Hili
,. A S'OUIA~
PO.YIRTT CUPIT IS C~AIMID O.
PILI HUMIIA
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NUMBER
YEAR_
[] 40. Fuluro Intoro,I Compromlto
lIar dalol of doalh aftor 12.12.821
Decodonl Dlod T 011010 [] 7, Docodonl Malnloinod a living Tru,I
(Allach copy of Willi IAllach copy of Trull)
ALL COIRISPONDINCI AND CONFIDENTIAL TAXIN'ORMATlON'SH'OULDBEDIRECTIO'yO,
N ME jCOMPITlEMAiiiNOADDRESS
.).. "'f. h ,) () '" v>lM'''''E'}' E /' L
n[!;riR'iljf'NUM'ER--.-.-.----.-.~--...~._. -- / 7 I,~. '~)<"II;''''''I':' ~c;/".....~ ,
('11.' /, V /
lJi II' 1.6 'l~ 76 J..? .. . . _c_~_~~=.-.--'
[) 4.
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lImllod E,tat.
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I. Rool Eltal. (Schodulo AI ( 11
2. SIackl and BondI ISchodulo B) ( 2) ~
3 Clololy Hold SIack/Partno"hlp IntorOll ISchodulo C) (3).
4, MortgagOl and NalOl Recolvablo (Schodul. 0) I 4) .
5, Calh, Bank Dopalill & MII"lIonoaul Po"onol Prapertyl 51 ____
15chodulo EI
6. Jolnlly Own.d Property ISchodul. FI
7, TruOIlo" (Schodulo GI ISchodulo LI
8. Tolal Gro.. A..oII IIalallinol 1.71
9, Funoral E'?OnlOl, Admlnlllrallvo Co,II, MlscollanooUl I 9)
E.ponlOl IS(hodulo HI
10. Dobll, Mortgago LloblliilOl, Lionl (Schodulo I) (10) __00_.___________0______
11. T alai Oodu(ilaOl (latalllnOl 9 & 10)
12. Not Valuo of Ello'olllno 8 mlnu.llno III
13, Charltablo and Govornmonlal aoquOltl 15chodulo J)
14. Nol Valuo SubjOd to To. (IIno 12 mlnul lino 13)
15, Amaunl of lino 14 lo.ablo 01 6% rolo
Ilncludo valuOl from S(hodulo K or Schodulo M.)
16. Amaunl of Ilno 14 taxablo at t5% ral.
Ilncludo voluOl from S(hodulo K or Schodulo M,I
17. Principal lax duo (Add lax from lino 15 and from IIno 16.1
18. Crodlll Spaulal Pavorly Crodlt Prior Poymonll Discount Intoroll
.u"u._.__...._....... + __n_._~.... + .. ..~. .
19. If IIno 18 II groulor than IIno 17, onlor tho dlfforonco an line 19. Thi. I. Iho OVERPAYMENT,
1'.110
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(151, u__ ,,:<AC'..~_u~.u____n_X ,06 ".________ J.d....L!;."':.._____
116). u
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( INIt IU'f(.' if you cue fccluq\linfJ (l f(.fund of your ovo'pnvmonl.
20. If Ilno 17 II groaler Ihan IIno 18, onl,,'lho dlfforonce on Iino 20. Thlll'lho TAX DUE, 1201
A. Enler Iho InlorOl' on tho balance duo on IIno 20A. 120A)
Q, Enlor Iho tolal olllno 20 and 20A an IIno 20B. Thl. il Iho BALANCE DUE, 120BI
.. __/.Ioke Cho_.k Pavablo tal Roglelor .~f ~III., ..A_g.ont_____ .... ~.. u.__mm ___________________
.... II lUll TO AN5WIR ALL QUESTIONS ON Rlyiisi'SIDEAND.TO.RicHICKMATH....-..------
Under pencil I.. of perjury, I declare thai I ha'/e uamlned Ihh relurn, Including aCtomponylno";che'dulel clnd Holamen!., nnd to the betl of my knowledge and bellel,
II II Itue, corracl and complele. I declare Ihal all real ellale hal been repotled altrue markol '1olve. Declaration of pre pater olher than Ihe personal reptellnlall'/. II
balod on alllnlormnllon 01 which preparer hat any knowledqe.
IIO~r;'J~fi~~~m~:~:'~R, ';I~:~I;fURN--'.~~'i~'C<"IC ~",.,' ' L ., '''~'' r:,~ Ii: "fli '/~~~'I Dg:~(:':~;,',:~"-~~';-;? 1
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ITEM
NUMBER
A.
B.
2.
3,
4,
C.
1.
2,
3,
4,
5,
6.
7,
8,
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COMMONWIAllH O. P1NNIYlVANIA
INHIRIIANCI lAX RIlURN
R11IDINl DICIOINI
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Pleall Print ar T e
f\,,/,cd' E. B/lo
DESCRIPTION
1.
Puneral EJcpenlell
F""" ,.,.1 H..",,~ ,.\ ~;J. ~
Cj!:;/< ~ r ~), S',,')
Vrl"lt t.~ICt
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Admlnlltratlve COltt. /
Pellonal Repr..enlatlve Com million I ,)...., I, ,J, ()~ .'.-\ .vA/<' r; '"-'.P
Social Security Number of Perlonal Repr..enlatlvel / (,. / - ,J r - ":!.t!,'!..
Y~ar Com million I paid 1,9 '7 'I
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Attorney F...
'J".....r). J p., v','JA-'.-t/E 0 E"Jl
Family Exftmptlon
Clalmont R.latlonlhlp
Addrlll of Claimant 01 decedent'l dealh
Slreet Addr.1I
City
Stat.
Zip Cod.__.........
Probale Fe..
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Mlleellaneaul EMpenle,.
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TOTAL (Allo onlor on IIno 9, Rncapllulatlnnl
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(If more Ipacell ne.ded. Inllrt additional ,hllll 01 lame 1111,1
AMOUNT
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I // REV"1547 EX AFP (12-94 *1 1
(/ i~~m:~:\ l~f O:r:~~~~VlV'NI' NOTICE OF INHERITANCE TAK ACN 101
BURE'U Of INOIVIOUIl TAKES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
~:~~is:e:~~t". 11128-0601" OF DEDUCTIONS AND ASSESSMENT OF TAK DATE 02"15-95
@'ST;(TrOF='B1iE'R"=~~=~~ "ODtil'1' -~''i:=~~===='=-~==-FITE NO. ----2T9~~O'Tn-=-~---=
DATE OF DEATH 08-13-94 COUNTY CUMBERLAND
NOTE I TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBMIT THE UPPER PORTION OF THIS FORM ~ITH YOUR TAK
PAYMENT TO THE REGISTER OF WILLS, MAKE CHECK PAYABLE TO "REGISTER OF WILLS, AGENT"
REMIT PAYMENT TOI
JOSEPH J DEVANNEY ESQ
1'/ LONGCOURSE I.N
PAOLI PA 19301
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
t..-:= A.ounl R.!..lltld__.~ ]
CUT ALONG THIS LINE .... RETAIN LOWER PORTION FOR YOUR RECORDS .....
REV: is'i;" Elf -Ai: ii - f i '2-: 94 Y"NoYi c r "OF" IN Ii ER" i;: AilC' E" fAX "AP PRA i 9 EM! Ni'"; -A L. r oWAiiC' E - cfli"""" - -""...."""" - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BAER ROBERT E FILE NO. 21 94-0733 ACN 101 DATE 02-15-95
TAK RETURN WAS, (X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST .. SEE REVERSE
AP~RAISED VALUE OF RETURN BASED ONI ORIGINAL
1. Rool E.toto (Schldulo Al II 1
2, SIock. ond Bond. (Schodulo 8) (21
3, elollh Hold SIock/Portno"hlp Inlorost (Schldlllo C I (31
4, Mortglgls/Nolo. Rlcll.obll (Schldull 01 (41
S, Cosh/Bonk DIPol! to/Mho. Porsonll Proplrty (Sohodull E I (S I
b, Jolnlh OWnld ProPlrty (Schldull Fl Ibl
7, Tron.fll" ISchldulo 01 (7)
8. Totsl AUlto
APPROVED DEDUCTIONS AND EXEMPTIONS:
9, funlrll Ex~.n.../Ad", COlts/Hisa. Expense. (Schedull HI (9)
10, Dlbl./Mortgsgl Lllbllllll./LI.n. (Schldull II 1101
II, Toto! Dlductlon.
12, Nit Vllul of Tox Rlturn
13. eh.rltoblo/Govlrn.lnlll 81quIsts ISchldul1 Jl
14, Nil Volul of E.tlto Subjlct 10 TIX
) CHANGED
,00
,00
,00
,00
11.051.99
..J!Q.
,00
181
11,051.99
7,847,54
,00
( III
1121
1131
1141
7,847.54
3,204,45
,00
3,204,45
If an aBBeBBmBnt waB iBBued previously, lines 14, 15 and/or 1&, 17 and 18 will
reflect figurBB that include the total of MJ.. retUrnB aBBBBBed to datB.
ASSESSMENT OF TAXI
l~. A"ount of line 14 .t Spousel rete
lb. A.ount of Llno 14 tlxlblo .t LlnooI/CII.. A rlto
17, A.ount of Llno 14 tlxobll It CollotlrII/CII.' 8 rotl
18, PrincipII TIX DUI
TAX CREDITS I
-'P~hEENi--- ------- RNEy:~:;--.---T------~~~~~~~~ : ~: -~~~~~~~~~;---I
--''''I2:'O Fi14 .---MM913fS.s.u---. ------------------;-ifll---.-------T<ii: 27-
NOTEI
lISI ,00K,03.
llbl__3,204,45 K ,06.
(171 .00K,15.
1101
,00
192,27
,00
192,27
__ ________._____.______ ________...__ _____00..... ___1__... ., '__00.,.....____
TOTAL TAX CREDIT 192,27
ii,LANCii-oii'TAicui------ ---......,'00. .
._~_____.. __..~ _,'_n" .______ __... _ ______ ____~~____.__
INTEREST ,00
---.---------..---. _._._,_._._~- -~-~~-- ~------~..
______TOTA~_E~_E__..__ _________n._'.~.~_.j
( IF TOTAL DUE TS lESS THAN .1, NO PAYMENT IS ~EQUIRED,
IF TOTAL DUE IS ~EFLECTEO AS A "CREDIT" CCRI, YOU MAY BE DUE
A REFUND, SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS, 1
,I
, IF PAiD AFTER OATE INDICATEO, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
RESERVATIONI !It.t.1 of decldentl dying on or b.far. D.o.ab.r 12, 1912 ~- 'f any future Int.rl.t In the Ilt.tl I. tran,f.rrld
In pOII.I.lcn or ,nJaY'lnt to Cllll . (calllt'rll) blnlflcl.rll' of thl d.c,d,nt .ft.r the Iwplratlon of any "tit. far
lIf, or for VI.rl, the Co..on....lth h.r.by twpr...lv r..lrVII thl right to apprahl and 1"1" trln.flr Inherlt.ncl TlKlI
It the hNful C1I.. I Ccoll.tertil ration any luch futurl Int.rllt,
PURPOSE Of
NOTICE,
PAVHEHI'
AEFUHD (CRI,
OIJECTlOHS.
AIl!tIH
ISIAATI!E
COAAEtllOHS.
U1SCD~T .
IHTEREOT.
To fulfill thl r.quir...ntl of S.ctlon 211t0 of the InharltancI and flut. Tax Act, Act 2l of 1991. 7Z P.S.
lIotlon ZUO.
D.taeh the top ~ortl~n of thl, Notlcl Ind lub.lt with your pay..nt to thl Algl,t.r 0' Will, prlntld on the rlv.r,. ,Idl.
..HIk. ch.ck or lon.y ordlr p'Y!'bh tOI REDISTER OF HILLS, ADENT
All ply..ntl rec.lv.d 'h,l1 flrlt bl applhd to any Int.r..t which ..y bl due with any r"!llneNr 1"II.d to thl tex.
A refund of . ta)l eredlt, which .... not r.qullt.d on the T')l R.turn, lIy 1;\. "quilted by co.pleUng an "Appllcltlan
for A.fund of Plnnlylvant. Inhlrltlncl .nd f.ltatl Till" (REY~UI3), Applle.tlnnl arl avail.bl. at thl OffiCI
of the RIgllt,r of Will., .ny of thl 1.S R.vlnu. DI.trlct O,'IC.I, or by calling the Iplcl.1 Z~'hour
IOlwtrlng ..rvlc. nUlber. for 'or.. ord.rlngl In f1.MlylvanJ. 1.800-162-Z050, outsldl Plnf'lylvlnh and
within local Herrhburg tlrl' (717) 7&7.&094, TOOl (717) 172.2Z52 (Hurlng 1.p.lred Only),
Any p.rty In Int.r..t not .Itl.flld ..Ith the appr.I....nt, al10wanc. or dl.elloWlnCI 0' d.duotlon., or ........nt
of till (Including discount or Intlrl.t) II .hown on thlt Notlcl IU.t obj.ct within .hcty (601 dlY' of reo.lpt of
thlt Hotlc. byl
"wrlttln protllt to the PA OIPlrt..nt of Rlv.nu., lIolrd of ApPIIII, D.pt. 281021, Harrisburg, PA 1712&-1021, OR
"lllctlon to hllVI thl IIthr dltlrlllln.d It audit of thl account uf thl plr.onal rlpr...ntatlvl, OR
u"plll to the Orphan.' Cour to
F.ctuII .rror. dllaav.r.d on thl. a....I..nt .hould b. addr"lld In writing tal PA OIPlrtll.nt of RIV.nul,
IUrl'u of Individual TaMU, ATTNI po.t AI......nt R.vllw Unit, Olpt, 250601, Hlrrlsburg, PA 17128.0601
Phone (717) 7&7.6505, S.. pig' 3 of the book lit "Instruotlon. for Inh.rltanc. Ta~ Rlturn for a A..Jdlnt
Olcldlnt" CAEV.150IJ for an Iwpllnatlon of adlllnl.tratlv.lv corrlctabll Irror..
If .ny taM due II paid within thr.. (3) lIlllndar .onth. after the d.cld.nt'. duth, a fly. plrclnt (5X) dllcount of
the tlM paid It allow.d.
Intlr..t I' cherg.d b.glnnlng ..lth flr.t day of d.llnqu.noy, or nln. (91 .onthl and on. (I) day frol thl dati of
dllth, to the dati of p.y.."t. TllllI which ble... d.llnquent b.fore Januery 1, 1982 bur Inter..t It thl ret. of
thl (6%) p.rclnt plr annun calculahd at I dlUy ,..tl of ,000164. All \au. which blea.. dlllnqulnt on Ilnd aft.r
JIOUlry 1, 198Z will b..r Intlr..t at a rat. which will vary fro. oll.ndar YI.r to cal.ndar v.ar with that r,t4
announcld by tI._ PA DIP,rt..nt of Rlv_nul, Thl appllcabl. In\arlllt r.t.. for 1951 through 1995 arll
'!!!! Inter..t A,t, Dally Interllt fne'or Vllr Jnt.rut Rat. O,lly Inter..t Faa tar
1m zox ,00OS411 1911 9% .0002lt7
1911 I6X ,000418 19U'I991 1\% .000101
191" III .000101 1992 9% ,000247
1911 m .000556 1993.1994 IX ,00019Z
19a6 10% ,000Z14 1995 lJ% ,000Z41
.'Int.r..t 11 cnlcul.hd .. ful10wlI
INTEREST . BALANCE OF TAX UNPAID X NUHBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
"Any Notlcl IUUld a'Ur the tl'll b.ea... dlllnqulnt will refhot an Inter..t otlcul.tlon to flftfln (5) d'YI
b.vand the d"1 of the a.......nt, If PlYII.nt It tada aft.r thl Intlrut ClOllputetlon date .holiin on the
HOtlCI, additional Interllt .u.t bl celleulahd.
r
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STATUS REPORT UNDER RULE 6.12
I
[.1
Name of Decedent 1 t...C! },e t t
Date of Deathl lLfYI/'J .I-'l
Will No.
P- B-1"'/'"
h,l
.
) 99'/
, I
Admin, No. ).,j 9''1 -;'(:;.? .3.3 '
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 v' No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete I
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
b, The separate Orphans' Court No. (if any) for
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 may be attached to this report.
Date I ? hi / 7...5
( I
-41:,,~)'-"1
.Jo~~fh ,), j)e~'A,v.//r= y
Name (Pleas8 type or print)
17 L ~,(/9 <.-cPI/O e t.. /T,Vt! . f.4~1111I
Address ' / _3~1
(6/0) 6 '-/ '-I 76.;). 7
Tel. No,
CapacitYl vi Personal Represertative
_____Counsel for personal
representative
(MAH 1 rmfl AM3)