HomeMy WebLinkAbout94-00848
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Etlllle oJ Ethel S~_C!:Qs~t;!Y.________
"'.W kllOIl'1I lI,r -..-----
IIETITION Hm PROIJATE l\IId GUANT OJ" LETTEI{S
0)/-14 - flfJ
No.
To:
..__.___. Itegl"er of Will. for Ihe
_ __ ,'kn'II.I"c/. COllnly of _C\.ImbPrlancl III Ihe
Sm""' Sel'llrlty No. OQ1-()S- &171/ COllllnonwenllh or Pennsylvnnln
The pellllon of the IInde"lgned re'pebfnllY rep.e..nl. Ihlll:
Your petllloner(.), who Is/nre 18 yeRrs of nge or older IInlhe exeelll nr
In the lasl will of Ihe IIbove deeedenl, dllted _Decernber...li.-J989
nnd codlcll(s) dRied
nnmed
,19__
('lilt 1t'ICVltlll tlrtllllutalU:CS, c.,_ 1t'IlUndallnn, dealh or Ut'('utOI, tiC.)
Oecellde," wns domiciled III deRlh In C'lnnh>rl,mn County. Pennsylvania, wllh
'I er last family or prln~~altisldence at ~~1~~;~ !bad. Mechanicsburcl.
PennElYlvania 170 _tJ.1!~/i7? }
(Il'llllccl, l1umber and mUlldralllY)
Oecendent, then 95 yenrs of IIge, died September 19 , 1994
al 1051 1\1lpnn"le Road.J!lechanicsburg, Pennsylvania 17055 .
Except as follows, decedenl did nolmarry, wns nol divorced nnd did not hnve a child born or ndopled
nfler execution of Ihe will offered for probRle; wa. notlhe victim of a killing and was never adJudlcnted
Incompetent:
Oecendent al denth owned property with e.tlmnted vnlues ns follow.:
(If domiciled In Pa.) All personal properly
(If not domiciled In Pa.) Personnl property In Pennsylvnnln
(If nol domiciled In Pn.) PersonalllloperlY In CoulllY
Value of real estale In Pennsylvanln
situated as follows:
S less than $26,000.00
S
S
S
WHEREFORE, petllloner(s) respeclfully
presented herewllh nnd Ihe granl of lellers
theron.
re<lllesl(.) Ihe probate of Ihe last will and codlell(s)
test:anent-"ry
(tcslnmcruar)'; admlnlslrallon c.I.a.; admlnlslrallon d.b.n.c.I.I.)
1-1- ~~~
'9. MPchanicsb~5 Pl\ 17055-
:. (717) 697-36
i'o
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OATH OI~ IIEnSONAL UElJHESENTATIVE
COMMONWEALTII m'l'ENNSYLVANIA }' 88
COUNTY OJ1 CUMBERIJIND
The pelltloner(s) nbove-nnllled sweRr(.) or nrrlrlll(s) thnl Ihe stntemenls In the foregoing pellllon are
true und correclto the best of Ihe knowledge nnd belief of pelllloner(s) nnd Ihal as personal represen-
tatlve(s) of the above decedenl Ilelltloner(s) will ~ld truly udn sle he estate according to law.
Sworn 10 or IIfflrllled 3.l1Bd subscribed JLLIJ'vt<..IA 1.<.1.{ !'l
before lIIe this K dn of 'S'
1fn l @Y~;~8~@);; . - 697~36~5 Pl\ 170~~ ~
~ARY C, LEWI 1I"lllsle~ ~
llJ.{-~~- JLI.
No.' 21 - 94 - 84B
Eslale of
, Deceased
E'I1lEL S. CROOLEY
DEClmE OI~ IIIWIJATE AND G1{ANT 01<' LETTERS
AND NOW OCTOBER 5. 19~, III consideration of the petition on
Ihe reverse side hereof. satisfactory proof having been presellled before me.
IT IS DECREED that the IlIstrumellt(s) dated DECEMBER 6. 1989
described therein be admllled to I!robate and flied of record as the last will of
ETHEL S. CROSLEY
TESTAMENTARY
THOMAS J. SWIDERSKY
and Lellers
are hereby granted to
FEES
Pro bale, Lellers, Etc, ......... S 60.00
Short Certlncates( 3) .......... S q .00
Renunciation ...,.,.."".,.. S
X-Pages S 6.00
JCP 5.00
TOTAL _ S Rn nn
Flied ....... .QCrP.q~~. .5.. . ) ~.!\4. . .......
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(J ROils... or WII1. '"7J (/
fiJ# ~RY, C,,+~WIY./ A-
~ C.( ~"er~.J r,<<. .
Charles E. shie ds, III, Esquire #38513
A1TORNIlY tSup. CI. 1.0. No,)
M3l1on Bank Building
2 West Main Street. Mechanicsburg, PA 17055
ADDRIlSS
1717\ 766-0209
PHONIl
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Mailed letters and order to attorney on 10-5-94.
IVAIlNllHi: 11 IS ILlU1Al 'll AU 1:11 f lil!i COPV Oil
TO UIJPIICAH nv PIWI05lAr 011 PIIOrOGIlAl'lt.
COMMONWEAL TU OF IIENNSVlYAN1A
OEPA,nMENT or ttEALTti VITAL RECORDS
LOCAL REGISTRAR'S CERTIFICATION OF DEATH
CERT. NO. 2388590
'hZR-!l4
Pal, ,iT..u.o 1O h.t'C...,.llWh.)n
Name 01 Decedent
Sex Feme1e
Ethel
tt".
___.5.,
M'O,I'"
C r lllll.a.y.
l...
Social Security No, 047-05-B2..l!l
Dale of Death
9-19-94
Date 01 Birth
B-29-1B99
Blrlhplace
L eru! i SJ~.!1I:9.._ P A
R.Jl..J12
Place 01 Death Residence
ra,.hltN"".
Cumber lend
Cilunl,
Upper Allen Two.
r..l,UOlo.k>llhu. To"nlhlll
Pennsvlvanla
Race White Occupation Assemb1~r Armed Forccs? (Yes or No) No
Decedent's Apt. #1055 P
Marital Status Widow Mailing Address 1051 A11~lliUL1e Rd. Mechsnicsburg PA 17055
N"",l>fo' bh...... C,l,ollow" filII.
lnlormant Thomes J.
Name and Address 01
Funeral Establishment
Swiderskv
Funeral Dlrcctor _
James F, Nickel
Nickel Funere1 Home.~svi11e, PA 17047
Part I: Immediate Cause
(a) Cardiovasculsr collaRs a
Interval Batwcen
Onset and Death
(b)
(c)
(d)
Part II: Othsr Significant Conditions
Mannar 01 Death:
Natural ~
Accident 0
Suicide 0
Describe how Injury occurred:
Homicide 0
Pending Investigation 0
Could not be Determined 0
Neme and Title 01 Cerllller
John M. Sullivan
M.O,
(M.D" 0.0" Coroner. M.E.)
Address
1001 S. Market St., Mechanicsburg, PA 17055
This Is to certify that the Information here given Is correctly copied from an original certlflcbte of
death duly filed with me os Local Roglstrnr. Tho original corllllcate will be forwardod to Iho State
Vital Records Office for permanent filing, /l
-7//Juf!"t,i:.-#;, v.", ,a.-t.ffin.-~/v ,,,.,,,,.2 0...4.5!i
9-20-94 ..A.Q.LELElrnett_SJ;......l:!!tw Bloomfield , PA 170GB
0.1. fteu'..d ht LtK.A1 1It>gltt'." :.In..'^,lll''''l C,t, lIu'fJlIUh, TU"""IIl'JI
21 - 94 - 848
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.QE
ETHEL S. CROSLEY
..
LAST WILL AND TESTAMENT
I, ETHEL S. CROSLEY, of the Borough of Mechanicsburg,
Cumberland county, Pennsylvania, being of sound and disposing
mind, memory and understanding, do hereby make, publish and
declare this as and for my Last Will and Testament, hereby
revoking and making void any and all wills by me at any time
heretofore made.
1. I direct that all my debts and funeral expenses be
paid as soon as practical after my death by my Executor
hereinafter named.
,
2. All the rest, residue and remainder of my estate,
real, personal and mixed, and wheresoever the same may be
situate, I give, devise and bequeath to my niece, DORIS J.
LIGHTNER, of Landisburg, Pennsylvania, her heirs and assigns,
provided my said niece, DORIS J. LIGHTNER, shall survive me by a
period of sixty (60) days.
~
3. should my niece, DORIS J. LIGHTNER, predecease me or
fail to survive me by the aforesaid period of sixty (60) days,
then in such event, all the rest, residue and remainder of my
estate, real, personal and mixed, and wheresoever the same may be
situate, I give, devise and bequeath to NElLA I. SWIDERSKY, her
heirs and assigns.
4. I hereby nominate, constitute and appoint THOMAS J.
LAW o.."cn
ONELOAKER. ELICKER SWIDERSKY, of Mechanicsburg, pennsylvania, as Executor of this my
IN WITNESS WHEREOF, I hRve hereunto set my hand and seal to
this my Last Will and Testament written on two (2) pages this 6th
day of December, 1989.
l?Jii oS ra/l.()).f:}(,-t.
Ethel S. Cros1e~
(SEAL)
Last Will and Testament. I further direct my Executor herein
named shall not be required to post any bond to secure the
faithful performance of his dutics in the commonwca1th of
pennsylvania or in any other jurisdiction.
signed, sealed, published and declared by ETHEL S. CROSLEY,
the Testatrix above named, as and for her Last Will and
Testament, in our presence, who, in her presence, at her request,
and in the presence of each other, have hereunto subscribed our
names as attesting witnesses.
~11
't{.'1//,J \,/tftt.1{T(<<J{.h..
(SEAL)
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~:,;:M . a. 7' c{1
(SEAL)
LAW a,,,CCB
BNELDAKER a ELICKER
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8NELDAKER 1lI CLICKER
.
COMMONWEALTH OF PENNSYLVANIA)
COUNTY
OF
: S5.
CUMBERLANO)
We, ETHEL S. CROSLEY, KEITH O. BRENNEMAN, and SUSAN A.
McCOY, the Testatrix and the witnesses, respectively, whose names
are signed to the attached or forgoing instrument, being first
duly sworn, do hereby declare to the undersigned authority that
the Testatrix signed and executed the instrument as her Last will
and Testament and that she had signed willinglY, and that she
executed it as her free and voluntary act for the purposes
therein expressed, and that each of the witnesses, in the
presence and hearing of the Testatrix, signed the Will as witness
and that to the best of his or her knowledge the Testatrix was at
that time eighteen years of age or older, of sound mind and under
no constraint or undue influence.
rOJl;! /f b(l.f~'
Testa r x
dtltli. &I/U(~auu'"
Witness
xL---- d, '11/c- eLf
Witness (j
SUbscribed, sworn to and acknowledged before me by ETHEL S.
CROSLEY, Testatrix, and subscribed and sworn to before me by
KEITH O. BRENNEMAN and SUSAN A. McCOY, witnesses, this 6th day of
December, 1989.
e2A~~") C). ::11~
Notary Public
NOTARIAL SEAL
PATRICIA J. TIOISOH, NOTARY PtJDLlC
HECllAHlCSUUnG aoRO. CIDlBERLlNa co
MY COHHISSION EXPIRES DEC. 31. 1990
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... COMMONWEALTH OF PENNSYLVANIA .. ·
D NO. AA 047726 DEPARTMENT OP RIVINUI ; l>
....", II I""OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATETAX .~ . .
RECEIVED FROM:
i
ACN
ASSESSMENT I!'
CONTROL IiJI
NUMBER
AMOUNT
SHIELDS CHARLEO E )1)
e W MAIN STREET
101
"ll:3.14
I
,
-. 1010 Hur
MI:CHANICSDlJRG PA 17055
lOIOHur
ESTATE INfORMATION:
I!:'I fiLE NUMBER
5i e 1-1994-0949
EJ NAME Of DECEDENT. (LASTI
II OATE Of PAYMENr
m POSTMAR
COUNTY
SSN 0/17-05-ee78
(fiRST) (MI)
DArE Of DEATH
THOMAS J SW)OERSKY
m TOTAL AMOUNT PAID
.' .J
C-')"/
RECEIVED BY LJ.
.11~ 'H
REMARKS
REGISTER OF WILLS
I1ARV C. LEWJ
REGISTER OF WILLS
SEAL
CHECK" '7
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CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Nwne of Decedent: Ethel S. Crosley
Date of Death: September 19, 1994
Will No.
Admin. No. .:1.1-14- iJ./ 9'
TO THE REGISTER:
I certify that notice of beneflclallnterest required by Rule 5.6(a) of the Orphans' Coun
Rules was served on or ~~ to the following beneficiaries of the above-captioned estate on
OcJrdo........ \4,IQQ ;
~
Address
Doris J. Lightner
RD 2, Box SO, Landlsburg, Pennsylvania 17040
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except 1\lC> N6.
Date:
~E~
CHARLES E. SHIELDS, In
Mellon Bank Bldg., 2 W. Main St.
Mechanlcsburg, PA 17055
Telephone; (717) 766-0209
Counsel for Personal Representative
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CERTIFICATION 01' NOTICE UNDER RULE 5.6(u\
Nwne of Dcccdenl: Elhel S. C1uslcy
Dllte of Dcath: Scplcm\Jcr 19, 1994
Will Nu.
Admin. No. J} I Gj.j - 0 'N~
TO THE REGlS'l'UR:
I certify thatnolicc uf bencnclllllntcrcst rcqulrcU by Rule 5.6(11) of the Orphans' Court
Rules WIIS servcd on ur mulcU tu the fulluwlng bcncnclarles of the IIlx>ve-cllptloncd cstate on
DcA \qq ;
~
Addrcss
Doris J, L1glllncr
RD 2, Uux 50, Lundlsburg, Pcnnsylvanla 17040
Notice hils now becn glventu 1111 persuns clllltlcU thcrcto under Rulc 5.6(11) cxcept !\ID NE.
Date: /1-2f/-9f
~~~~~
CIIARLES E. SHmL S, III
Mcllon Ullnk llIdg., 2 W. Main St.
Mcchanicsburg,PA 17055 0~'
Tclcphone: (717) 766-0209
COllnscl for Pcrsonal Rcprescntatlve
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I 1II 21-1994-0848
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RECEIVED FROM,
a
ACN
ASSESSMENT Ii'
CONTROL Ii:,I
NUMBER
AMOUNT
SHIELDS CHARLES E III
2 W MAIN STREET
101
.::J,:io!oc.::JO
MECHANICSBURG
PA 170:55
'CHDHU' -
SSN 047-03-Be78
R M
CROSLEY ETHEL S
M
I
CUMBERLAND
I
II TOTAL AMOUNT PAID
RECEIVED ;;/2:);
MARY C. LEW
REGISTER OF
_3,562.:50
C
REMARKS
THOMAS J. aWIDERSKY
SEAL
CHECK" 3
REGISTER OF,WILLS
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fOR OATIS Of DIATH AnlR 12/31/91 CHICK HIRI
If A SPOUSAL D
POVIRTY CRlDIT IS CLAIMID
fILl HUM"R
IIlV.HOO Ix. 179"1 ,.
*
COMMONWeAlTH Of PfNNiYlYANIA
DfP...I'MfN1Of .[...(NUE
om 21000\
H....IIS~U.O. ,_"'__" 2',0601
o ct N' N"-MI I'" . .1 ,AND MIODt
cnooLEY E'lllEL S.
.OCIAI S(cut." NUMUI
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE 21
WITH REGISTER OF WILLS) COUNTY COOE
orcrolN'" COM', Tl "'001t
Wh M~~~~le Rd.
Mechanicsburg, PA
INIIA\I
15
III
III
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DAn O' 01...114
-JiiA11 A. IIIIH
8-29-1B99
iOCIAl UCUIU'I' '4UMlia
CUVIII
AMOUN' 1((fIVIO ISH IN.UUCtlO',"'1
9-19-94
047-05-B27B
1" 10'''1(''1111 'U.~I""HG ''<N1t . 11"'" I"'" 1,111 "Nil ""0011 "1"'''11
94
YEAR
84B
NUMBER
(upper Allen 'IWp.)
17055
o A. Limited Ellalt
o 3. Remalnde, Return
- (lor dales of death prior to 12.13.82)
o 5. Fed.ral Ellol. Yak R"ur" Required
JL 8. Tolal Numb., of Soft Oepo.1t BOUI
2 W. ~l-:1in Street
Mechanicsburg, ~Y1vaill-a
( I ) -lKlNE
(2) _U,~25
(3) NONE
(4) NONE
(5) -s31,812.06
KJ 1. Original R,'ur"
[J 2. Supplemental Retufn
20. If line 19 Is great., rhon line 18, enter lh. difference on line 20. This Is the OVERPAYMENT.
Ii! 0
21. If line 18 Is gr.oler Ihon line 19, enler .he difference on line 21. This Is tho TAX DUE.
A. Enler the Inlerest on the balance due on line 21A.
B. Enter the tolol of lIn. 21 and 21A on line 218. This Is Ihe BALANCE DUE.
Malee Ch.ck Payabl. '01 Aegl.t.r of Willi, Aglnt
I ' ~~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE StDE AND TO RECHECK MATH -<-<
Undlr Plnolll" of perjury. I declare tholl have examined thh relurn, Including accompanying schedules ond slatemenll, and 10 Ihe besl a' my knowledg. and belief.
It Is true, correct and complele. I declare Ihol 011 real "Iole has bun reporlecf at Irue markel value. Oeclorallon of pre parer olher than Ihe personal represenlallve Is
bosed on alllnformallon of Ich pre parer has any 1nowledge.
$1 0' 'USON/ t ~ fOI fl I(1UIN ADORUS OAIl
{I . """ u< 601 Freedom Road Mechanicsburq, PA 17055 5-5-95
, 'U'.l" tHAN AODRU$ OAIl
5-5-95
lilffi
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o "0. future Inler,,1 Compromise
(lor dol" of dealh air., 12.12.82)
KJ 6, Oec.d.nt Died restole rJ 7. Deud.nt Maintained a living Trust
(Attach copy of Will) (Auoch copy of Trusl)
ALL CORRESPONDENCE AND CONfiDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
M OM'UU MAIliNG AODU
Charles E. Shields
tUI'HOHI NUMIlI
III
7171
766-02Q9
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1. R.ol Eolol. (Schedul. A)
2. Slacks and Bonds (Sch.dul. BI
3. Clollly H.ld Stock/Partnership Inl.r..t (Schedule C)
... MotlgoS" and Nol" R.ceivoble (Schedul. OJ
5. Ca'h\,Bank Depollls & Miscellaneous Penonol Prop.rly
(Sc .dul. EI
6. Jointly Owned Property (Sch.dule FJ
7. lran"... (Sch.dul. GI(Sch.dul. L)
8. Tolol Gran Anels (tololllnes 1.7)
9. Fun.rol bpensel. Admlnhtrallve COlli. Mlleellon.ous
Eapen"l (Sch.dule H)
10. D.b", Marlgog. Lioblllll.., Li." (Sch.dul. II
11. Talol D.duClla" (10101 Lin.. 9 & \01
12. Net Value of Eslole (lIno 8 ,"lnus line 11)
13. Charitable and Governmental Bequ'lIs (Schedule JI
U. Nel Value Sub ect 10 Taa Illne 12 minul llne 13)
15. Spoulal Tronllers (for dolel of deolh ofter 6-30.94)
Se. Inltructionl for Applicable Percentage on Reve,.e
Sid.. (Include values Irom Schedul. K or Schedule M.)
16. Amount of llne 14 fallable at 6% role
Ilnclude volulI from Schedule K or Schedule M.I
17. Amount of line 14 lOll able at 15% rote
(Include volulI from Sch.dulo K or Schedule M.I
18. Principal loa due (Add lOll 'rom lIn.. 15. 16 and 17.)
19. C"dill Spoulol Poverty Credit Prior PO.1menh
o + $3,56<!.50
Inlerelt
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(7 )
NONE
NONE
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$ 7,975.55
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(10)
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(15)
(16)
(17)
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$25,754.30
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+ $lB7.50
Check he,e if you 0'0 ,oquolling 0 .ofund of your ovo,paymonl.
(21)
(21A)
(218)
.'
Wa M..,in ~tl:ee.t., ~h;}ni.....c:::hurg... Pl\.
17055
, r"~'.
. .-~
17055
. T
;-.,
;r..
-.;
I
U1
'0
,.....
'0
lJ1
( 8) -S.ll. 77/i 11
(111
(121
(131
(14)
$ 8,022.01
$25,754.30
o
$25,754.30
-0-
-0-
_U,B63.14
(181 ~B63.14
(19)
(20)
$ 3,750.00
-0-
$ 113.14
-0-
$ 113.14
.
Act '48 of 1994 provld.. for the r.ductlon of the tax rat.. Impo..d on the n.t valu. of trand.r. to or for
the u.. of the .pou... Th. rat.. a. pr..crlb.d by the .tatut. will b.l
. 3% (.03) will b. appllcabl. for ..tat.. of d.e.d.n" dying on or aft.r 7/1/94 and b.for. 1/1/96
. 2% (.02) will b. appllcabl. for ..tat.. of d.c.d.nt. dying on or aft.r 1/1/96 and b.for. 1/1/97
. 1% (.01) will b. appllcabl. for ..tat.. of d.c.d.n" dying on or aft.r 1/1/97 and b.for. 1/1/98
. Spou.al trand.u occurring on or aft.r 1/1/98 will b. .xempt from Inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (.--) IN THE APPROPRIATE BLOCKS.
YES NO
1. Old decedent make a transfer and:
a. retain the use or Income of the property transferred, ...........................................,........... X
b. retain the right to d.slgnat. who shall us. the prop.rty transl.rr.d or Its Incom., ............... X
(I retain a reversionary Interest; or ......................"........"..,...................,....,..."........."..... X
d. r.c.lv. the promls. for Ill. of .lth.r payments, b.n.llts or car.9 ....................................... X
2. II d.ath occurr.d on or b.for. Oec.mb.r 12, 1982, did d.c.d.nt withIn two years pr.c.dlng
d.ath transf.r prop.rty without r.c.lvlng ad. quat. conslderatlon9 If d.ath occurr.d aft.r
O.c.mb.r 12, 1982, did d.c.d.nt transl.r prop.rty within on. y.ar of d.ath without r.c.lvlng
ad. quat. consld.ratlon9 ................................ ...........,... ................,..,. ............................... X
3. Old dec.d.nt own an 'In trust for' bank account at his or h.r d.oth9...................................... X
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
UV.1S0~ u. 1....1
~.j$
COMMOUWlAUIt or Pllm'YLvAUlA
IHUUIIANCf tAX IIUlN
aUIDINI DEcrDIN'
ESTATE Of
SCHEDULE B
STOCKS AND BONDS
E'lllEL S. CROSlEY
IAlI propl/ly lolnlly.ownod with RIghi 01 SUI.I.o..hlp mu'l bo dl..to.od on Schodulo F.)
ITEM
NUMBER
DESCRIPTION
I.
B1 shares of connen stock of /V:jUllrion OJnpany,
fomedy kna.m liS 'l'le IIYUrllulic COlplll1Y
CUSIP # 44B753 10 3
IIi $24.625 In $23.B75 Ave. $24.25 It B1 =
fl[fNUi;iliER
21-94-B4B
TOTAL Allo .nter on line 2, ReeD 1tulollon
(II more 'pan 11 n"eled, In..,' adclilionol .hllla 0' lome dn.'
-,,..,..----,-----------...--....----,,..--.- --.-.------,...."...--.. . ... .'
VALUE AT DATE
Of DEATH
$1,964.25
S 1,964.25
. --r-q;..... .
- . '1"
~ . ,. ..
,. . . I
,
,II\l.lm....IJ..r)
.
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
PI.ol. Prlnl or T .
fiLE NUMBER
21-94-B48
COMMONWEAl'" o. rrHNSY\YAHIA
INHllnANCI tAk _nUIN
IUIOINt DICIDINt
ESTATE Of
E'l11EL S. CROOlEi
(All prop.,'Y lolnlly-own.d with th. Right 01 S",,,lvouhfp mutl b. dlnlol.d on Sch.dul. '1
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
1.
Savings Account # 5130162369 PNC Bank
$ 693.06
$ 3.30
2.
Interest accrued to d.o.d. on Item No. 1
(see letter attached)
3. Money Market Savings Account # 160-070-2995
8. Dinette Set not sent to Auction
Mellon Bank $29,755.03
$ 32.30
$ 723.92
$ 115.00
$ 93.20
$ 50.00
$ 130.00
$ 216.25
4. Interest accrued to d.o.d. on Item No. 3
5. Personal Checking Account # 162-107-4B20
6. Refund fran Meadowland
7. Refund Pa. Blue Cross " Blue Shield
9. Private Sale of Bedroan Suite
10; Receipts fran Bricker's Auction
S 31 B12.06
(Attach additional 8~" M II"' ,h..lllf mort 'poc. I, n..d.d.)
I'N(1 Dank, N.A.
-t~H2 (:'u n"h' Illk..
OUUI' 11111. I'^ 171111
;
('1" 1/. <<;7 c.':.,'~f'.
t .'
.
December 2, 1994
PNClaANK
Charles E. Shields III
Attorney At Lall
Mellon Bank Building
2 West Main Street
Hechanicaburg, PA 1705
RE. Ethel S. Crosby
Date of Deathl september 19, 1994
Social Security No. 047-05-8278
Dear Hr. Shields.
As per your request for information on accounts the above
referenced decedent held with us, the information is as follows.
-Savings Account
Ethel S. Crosby.
interest. $3.30.
No. 5130162369 opened 03/31/83 in the name of
Balance at date of death. $693.06. Accrued
Hs. Crosby maintained no safe deposit box at PNCBank.
If I can be of any further assistance, please do not hesitate to
contact me at (717) 730-2321.
Sincerely,
&Cc.T;r( ~"c-c:.J)
Edith Tanci1
Miscellaneous Services supervisor
Bank operations
ET/mky
'!;~:";;';:;"id;
", ~,_..-"..-c.'.' _,,,
November 11, 1994
PNC Bank, National Association
Miscellaneous SelVice
4242 Carlisle Pike
Camp HllI, Pennsylvania 17011
Re; Estate of Ethel S. Crosley
Social Security # 047-05-8278
Date of Death: September 19,1994
Dear Sir:
Please be advised that I represent the eS\llte of Ethel S. Crosley. The Pennsylvania
Dep&rUnent of Revenue Inherl\llJ1ce Tax Division requires wrillen proof of the amounts of principal
and accrued interest in any account which is in the decedent's name,
It would be sincerely appreciated If you would send me a leller Indicating the amount of
principal and accrued interest as of the date of Ethel S. Crosley's death in tile account or accounts
which she held with your bank. Also, please Infonn me whether Ms. Crosley maln\lllned a safe
deposit box with you.
As per your request. I am enclosing a shon cenllicate.
Thank you for your kind allention to this mailer.
Very truly yours,
Charles E. Shields, m
CES:djr
Ene.
. '
~
....
@)
-~-
Mellon Bank
Mellnll IInnk, N.A,
Mellon IInnk C.'nter
nu. IInx 78UU
I'hIlRII.'llhIR,P^ 1U101.78UlJ
December 6, 1994
Charles E. Shields III
Attorney-At-Law
Mellon Bank Building
~ ~est Main Street
Mechanicsburg, PA 17055
ReI Estate at Ethel S. Crosley I
Dear Mr. Shieldsl
In accordance with your request, the tollowing intormation
is provided as ot September 19, 1994. Please see attached
letter.
Please contact this department it you have any questions.
Sincerely,
ctO~
Mellon Bank, N.A.
~ritten Communication (199-5380)
P,O. Box 7899
Phila., Pa. 19106-7899
PGldmd
482
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. ..... ','-
November 11, 1994
Mellon Bank, Commonwenlth Region
Att: F.F,C.
10 S. Market Square
P.O. Box 1010
Harrisburg, PA 17108-1010
Re: Estate of Ethel S. Crosley, Deceased
Social Security # 047-05-8278
Date of Death: September 19, 1994
Dear Sir:
Please be advised that I represent the estate of Ethel S. Crosley. The Pennsylvania
Department of Revenue Inheritance Tax Division requires written proof of the amounts ofprinclpnl
and accrued interest in any account which Is in the decedent's name.
It would be sincerely appreciated if you would send me a letter indicating the amount of
principnl and accrued Interest as of the date of Ethel S. Crosley's death in the account or accounts
which she held with your bank. Also, please infonn me whether Ms. Crosley maintained a safe
deposit box with you.
As per your request, I am enclosing a short certificate.
Thank you for your kind attention to this matter.
Very truly yours,
Charles E. Shields, III
CES;djr
PS A short certificate Is already on file at the Mechanicsburg Branch.
~ "
ttY,ISlIlill'lIl
J
Pleaoe Prlnl or Type
E NUMBER
.
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCEllANEOUS EXPENSES
COMMQUW(AtIIt OF '(UHSnV#lHIA
IHIIUIIAUC( IAIlIllIUIN
RUlonH D(CIOUU
mATE OF
ETHEL S. CROSLEY
21-94-B4B
ITEM
NUMBER
DESCRIPTION
AMOUNT
A, Funeral Expenoe"
1.
Nickel Funeral Hare, loysville, PA
$4,307.60
B. Admlnlolratlve Co.lI. 'lliares J. Swidersky $1,6B5.00
1. Penonal Repre.enlall.e Camml..lan. 165 - 3B - 1052
Social Securlly Number of Persanol Repre.enloll.e:
Vear Camml..lon. paid
2. Anarney Fee. Charles E. Shields, III $1,6B5.00
3, Family Exempllon
Claimant None Relallon.hlp None
Addre.. of Clalmanl 01 decedenl'o dealh
Slreel Addre..
City Slate Zip Code
4. Probate Fee. and Short certificates $ BO.OO
C. Mllcellaneoul Expenlels
1. J\dvertising Harrisburg Patriot ~Etro-West $ 4B.95
2. J\dvertising CulTberland law Journal $ 40.00
3. Steve Gift, Fiduciary Tax Return (estirn. ) $ 50.00
4. J\dditiona1 Probate Fee $ 10.00
s. certified Mailings for stock certificates, etc. (estirn. ) $ 2.75
6. Auctioneer's fees $ 51.25
7. Fl1ing Inheritance Tax Return $ 15.00
8.
TOTAL (AI.o enler on line 9, Recapitulation)
(If more opace 10 n..ded, Inoerl addltlonaloheelo of oame ol.e.)
5
7,975.55
r
,....."...,."-,.-..---.,..- ...-.-....,.-...-,.....,....-....---.........,.,..
~H:,
,"''''''''1''''1,*
COMMONWUltH 0' 'INNInYAN'A
IHHUllAHCI ,.... mUIH
_UIDIN1DleIOIH,
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
Ploalo PrInt ar T .
FILE NUMBER
21-94-B4B
ESTATE OF
IrnlEL S. CROSLEY
ITEM
NUMBER
I. PP&L
2. AT&T
3. Bell Atlantic
DESCRIPTION AMOUNT
$ 29.44
$ 3.92
$ 13.10
TOTAL (Alto .nlor on IIn. 10, Rocopltulollon)
(If more 'poce is n..d,d, Imlf' aC/cJifionD' .h..,. 0' lam. slu.)
$ 46.46
lIW.ULUh IJl11
ESTATE Of
ITEM
NUMBER
1.
ITEM
NUMBER
1.
,:;.:;,:-.,..,..,--..,.,.,,:,"~
*
(OMMONWIAUH Of ,'NNnlVAHI'"
IHHlln...NCI fAX .nUIN
IUIOINr orCIDINt
SCHEDULE J
BENEFICIARIES
fiLE NUMBER
NAME AND ADDRESS Of BENEFICtARY
RELATIONSHIP
A. Ta.ablo Boq.o'llI
D:>ris J. Lightner
R.D. 2, !lox 50
Landisburg, Pennsylvania 17040
Niece
NAME AND ADDRESS OF BENEFICIARY
B. Charitable and GOYlrnmental aeque.III
TOTAL CHARITABLE AND GOVERNMEIHAL BEQUESTS (AlIa onlor on lino 13, Rocaplt.lallon) S
III more .pac. It n.eded, In..rt additional .hee" 0' .om. .111)
.
AMOUNT OR
SHARE Of ESTATE
100%
AMOUNT OR
SHARE OF ESTATE
---- -'
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L^S'r III LL ^IIU TEU'I'^HEII'r
m::
E'j'nr.L S. CltllSLEY
I, r:;'l'IIEI, 8. CII()RI,EV, or tho nuruu':Jh uf Hochnnlcouurg,
cumlJorland CUIJnly, l'ellnnylvlIlIln, hotflY or Dound IIlIll disposing
mind, memory fwd umlurotondlny, tlo 1,0[01>y make, puLUsh Dud
declare thla no Ilnd [or my LRot WIll and 'l'osl:ament, hereby
revoking and mnklllY V<Jld nny Rlld .tl wIll. by ma nt any time
~. 11oretofore mOllo.
\'
direct that nIl my debts and funeral expenses be
r,
I,
,
palll aD ooon itO prnctlcnl BClor "'~' tlnoth by my Executor
hot'olnafter nBmod.
(,
,..:....
,
........
~,.
~
2. All the rcol, reolrlun nnd remainder of my ostate,
real, personal AlUl mixed, nnd WhOtCBOeyar the same Inay be
situate, 1 glvo, devisG nnd bequeat.h to fRY nIece, DORIS J.
LIOll'tUEII, oC I,BfldloLJurtj, flonnsylvnnla, hor helrs and Assigns,
provided my .nld IIlee., UOltIS J. LIGIITHEIt, .hall survive me by a
period of .Ixty (60) day..
J. Should my nip,cR, VORlS J. LIOII'l'UEII, predeceasQ me or
fall to .urvl.e me by ths afore.aId period of Blxty t601 days,
than 1n such event, all the rest, residue and remainder of my
estate, real, pllrsonRl and mixed, and whQrosoovor the same may be
situate, [ giVe, devlae alld bequeath to IIEIL^ I. SWIUERSKY, h.r
11e1ro and a8Bi~I'B.
u....o',.cn
.HILlAlCln . 1.l.1CICI"
4. 1 hereby nomLnat'l, constitute aml appoint TlIOHT\S J.
S\i'lUERSKY, of lIf!chnnLcRuurg, (1onlluylvnnLn, 08 Executor of this my
f
~
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'..
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Last. W 111 aUft 'feot.ame Ill.
rurlhor direct my Executor herein
II
lIamoll sholl lIul un requlrl:'d Lo pURL nllY hUlld to Recure tho
faithrul rerform.,ncn o[ hln dullnfJ In lllo COlnmunwQolth of
PennsYlvnnla ur If' OIlY olltor jlJrlSlllcllon,
lU UI'I.t1~:lm UII~;ItIW"', I hnVI} hnlf!lJlllu NUl my hOIll) and Boal lo
thle my Laol \/111 and Tuolamonl wI'lllou on lWo (21 pogoe thlo 6th
doy of becemuor, 1909.
~)~. . ,.f} ,
" /' / ,Jl i'!(.'J(i.t.L
Elhol B. Crooler
(SEIIL)
slc.Utod, oooll'd, publlnhod ntll) &.Jflclnroll hy ~'rIlEI, S, CROSLEY,
t.he Testnt.rlx alJove IIAmell, DO nnd ror hor a,noL Will nnd
Testament, in our proftcl1co, \1110, 111 her prescnce, nl her roquesl,
and In tho pruoence oC each olhor, have horlJunlo oulJocrlbed OUr
namos liS attootin9 witnoSROQ,
/' /'
A"f.
Ui,h I "rl,,-'( I ((L~t..\
(BEIIL)
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I LAWIl"fCU
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COHHOHIIEAJ.TII Uf
COUIITY Uf
l'ElIlISYI.v^lIt^1
I
CUIIIH:III,A111>I
SS.
110, E'l'III,I, /l, CIIOIII,r.V, KI:l'l'lI 0, 1I11"'ltIf:IIA", .11<1 /lUS^" A.
'lcCOY, lho "ofllllLrlx nllll llw wll.1l0nnUA, P1B1JfwllVQly, WhUBO I1tUnU8
flro oltjl1cll to Lho ntlnchr,,1 or foryulutj Il1nlrumonl, 1101119 Clrst
<luly oworll, do Iooroloy <locloro lo lloo III1<1or.lgllo<l .uthorlty th.t
lh. ,..tolrl. .Igno<l ond oxocut.<I tho Inotrument .. her L..t Will
ftIl<l 1'.nlonlont 0'") llool Rloo 100<1 olgllo<l wtlllllgly, olld tlo.t .10.
Q)CocutetJ Il no her [ton and voluntAry act Cor tho (Jurposos
thorein expruon.',), nnd thnt oneil .,r the wHunDRos, In the
proponce nnel hunting or thu 'I'oulnlrlx, Hlquod lho Will as witness
nnd that to lIw l.moL of his or her kllowledgn the Testatrix wao at
tllnl: lime ntght.noll YIM[" ur ntJl! or uldor, oC I)oulld mind and under
no const.ralnt or undue lnCluDllc*!.
,-,.J.,. . .',J -'t
. .. I \,. I..) J." .
..f t . I. 'C'r.-/
'l'oal" '[lX .r"
,
xL_.... d. '1J,/cd"
Wltn... V
"
SUbBcrllJod, sworn to GUll auknowJedgetJ before me by ETIIEL S.
CnOSLEY, Teotatrlx, anll subscribed and sworn to boforo mo by
K&ITII o. aIlEIlH&IlAlI .,,<1 GUS^" A. IIcCUY. wll"....., this 6th d.y of
Oecember, 1909.
c91c.t,,;~#) C). ~""L""',.J
"olory ('ull c
I U"'C1tflClt
! .tllL.~lttft. 'LICltln
InlAI:W.st^L
l,tAIlIltIA J. "I')I~.., MIA., ruellc
1 {11'ln1{'I'1'!1 BOllO, [lIl:'fr.t.'IHtI [0
II' [(JJlUlIl1llll"IrrSIKC, ii, ".0
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C"
.j-
REV-1547 EX AFP (12-94*
C~ALTH Of PENNSYLVANIA
DEPARTttENT Of" REVENU[
IURUU OF INDIVIDUAL TUEI
DfPr. 'ID60l
HARRISBURG, PA l,l,a.0601
NOTICE OF INHERITANCE TAM
APPRAISEHENT, ALLOWANCE DR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAM
ACN 101
DATI! 07-17-95
FILE NO.
DATI! OF DEATH 09-19-94 COUNTY CUMBERLAND
NOTEI TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAM
PAYHENT TO THE REOISTER OF WILLS. HAKE CHECM PAYABLE TO "REGISTER OF WILLS, AGENT"
REMIT PAYMENT TO:
CHARLES E SHIELDS III
2 W MAIN ST
MECHANICSBURG PA 17055
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
A.ount R..ttt.d
CUT ALONO THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
iiilj:isW-EX-AFP""n'2-:94"i"iiilYicE""oF-YNHERifANCE-YA'x-'APPR'AiiiEH€Ni'-;-,U.'LoiiAifcE-iili-mm__mmu
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF CROSLEY ETHEL S FILE NO. 21 94-0848 ACN 101 DATE 07-17-95
TAM RETURN WAS, I X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN
1. R..l Eat.t. ISchadul. A) III
2. stock. and Bondi (Sch.dule B) (2)
3. Clolely Held stock/Partnlrship Inter..t ISchadul. C) (5)
4. Hortgag.I/Note. Rlceivabll ISch.dul. D) (4)
5. C.'h/Bank DIPoIU,/H1Ia. P.r.on.1 Prop.rb (Sch.dule E) (5)
6. ~ointly Own.d Prop.rty (Schedule F) (6)
7. fran,ferl ISch.dull 0) (7)
8. Tot.l A.,.t.
) CHANOED
.00
1.964.25
.00
.00
31,812,06
.00
.00
(al
33.776.31
APPROVED DEDUCTIONS AND EXEMPTIONS I
t 7,975.55
9. Funlral b:p.n,.,/Ada. Cos ,/Hl,cl bpln,., (Schedule H) (9)
10. Debh/Hortg.g. Lhbl11U.,/L1.n. ISch.dull I) ClO) 46.46
11. Tot.l Dlduction, (11)
12. N.t Valua of Tax R.turn (12)
13. CharUabl./Govlrnllantel a.qu.et, (Schedule ~) (15)
14. Nat Value of Eltot. Subjact to ToM 1141
NOTE: If an assessment was issued previously, lines 14/ 15 and,or 16. 17 and 18
reflect figures that include the total of Abb returns assessed to date.
ASSESSHENT OF TAX:
15. Allaunt of Line 14 .t Spou,.l
16. A.aunt of Lin. 14 taxabl. .t
17. Allount of Line 14 taxable .t
18. Principal T.x Du.
TAX CREDITS:
PAYHENT
DATE
12-14-94
05-05-95
R. n:>:> 01
25,754.30
.00
25,754.30
will
,.at.
Line.l/C1.,. A ,..ta
Coll.~.I..,./C,.:a..~G n ,..~,.
(5)
(6)
117)
.00
.00
25.754.30
x.D3.
)( ,06.
M .15.
na)
.00
.00
3,863.14
3,863.14
RECEIPT
NUHBER
HH913289
AAD47726
DISCOUNT I.)
INTEREST (-)
187.50
.00
AHOUNT PAID
3,562.50
113.14
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
3,863.14
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN '1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
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RESERVATIONI E,tat.. of dec.dent. dylna on O~ before o.c..o.r 12, 19.2 .. If ~v future lnt.r..t In the ..t.t. I, tren.f.rr~
In po.....lon or enjo,.ent to CI... I (coll,'.r.1) beneflcl,rl.. of the dec.d~t .,t.r the Ixplratlon of ~y a.t.ta for
11'. or far y..r., thl Co.-onw..lth hereby expr...ly r...rv.. the right to appraS.. 8nd ...... trlnl'.r Inheritance Tlx"
at thl l~'ul C1... I (coll.t.r,l) rat. on ~v such future lnt.r..t.
PURPOSE OF
NOTICE I To fulfill thl r.qulr..ent. of Slctlon 2140 of the l~rltlnC' 8nd E,t,t, Tlx Act, Act ZZ of 1991. 72 P.S.
SHUon 2140.
Oetlch the top portion of thl, Notlel 8nd tubalt with your p.~nt to the Rlgl,t,r of willi prlntld on the r.ver.. ,Ide.
--Hell. check or ~w ord.r p.webl. tOt REGISTER OF MILLS, AGENT
All p.~t. rec.lv.d .h.ll flr.t be appllld to enw Int.r..t which ..w b. dUe with eny ra..lnd.r eppll.d to the t.M.
REFUND (CA)I A refund of . t.M credit, which wa. not reque.tM on tl,. TaM R.turn, '.W be requeat.d bW cOllPI.tlng en "Appllc.tion
for Rafund of Plnnaylvanl. Jnharlt~. ~ Eat.t. T'M" (REY-ISlS). Appllc.tlon. .r. .v.llabl. at the Offlc.
of the Ragl.t.r of Will., anw of the 23 R.venu. DI.trlct Offlc.., or by c.lllng the .p.clal 24-hour
en.werlng ..rvlc. nuablr. for for.. ard.rlngt In P~.ylvsnl. 1-100-362-2050, out.ld. penn'Wlvsnl. end
within local Harrl.burg .r.. (717) 717-1094, TOOl (717) 772-2252 (Hearlna lap.lr.d Onlw).
PAYHEHT I
DBJECTIONSI Any p.rtw In Int.r..t not ..tl.fl.d with the appr.I..-.nt, .llawanc. or dl..IION~' of deduction., or ......-.nt
of t.M (InclUdIng dl.count or Int.r..t) a. shown an thl. Notlc. lU.t obJ.ct wIthIn .IMty (6D) dlV' of r.c.lpt of
this Notle. bWI
--written prot..t to the PA O.p.rt.ant of RIV.,.., Bo.rd of Appaah, O.pt. 211021, H.rrhburll, PA 17121-1021, OR
--.lIctlon to hlv, the ..tUr det.r.lnad et IlUdlt of the account of thl p.rson.1 r.pre..nhtlv., OR
--app..1 tc the Orphen.' Court.
AOKIH
ISTAATlVE
CORRECTIOHSI F.ctual .rrcr. dl.cov.r.d on thl. .......ant .hould b. .ddr...ed In writIng tal PA aep.rt.ant of R.vanua,
Bur.au of Individual T'M", ATTHI po.t A......ant Rlvl.w Unit, Dapt. 210601, Harrl.bura, PA 17121-0601
Phone (717) 717-6505. S.. paa. S of the bookl.t ~In.ttuctlon' for Inherltanc. TIM R.turn for. R..ldant
Dlc.dant~ (REY-1S01) for an .xplan.tlon of adalnl.tratlv.lw correctabl. .rror..
If enw t.x due I. p.ld within thr.. (S) eel.nd.r lanthl .fter the decadent". deeth, a flv. p.rcent (S~) dl.count of
the tax p.ld II .llow.d,
DISCOUNTs
INTEREST.
Int.re.t II ch.ra.d big InnIng with flr.t daw of d.llnqu.ncw, or 1'111'1' (,) .anth. and on. (1) d.W fro. the data of
d..th, to the data of ply..nt. Tax.. which b.e... d.llnquent before January 1, 1'12 b..r Intar..t at the r.t. of
.Ix (6X) p.rcant po~ ann~ cllcul.tad .t I dilly rlt. of .000164. All t.x.. which b.c... d.llnquent an and aft.,.
January 1,1982 ..Ul b.~, Interllt at . rat. which w111 vary frol ulander Yllr to calendar y..r with that rat.
ennounc.d bW the PA O,pLrtaont of A.venu.. Th. eppllcabl. lnt.r..t r.t.. for l'IZ through 1995 .rll
~ Inhr..t R.ta O.Uy Inter..t Flotor ~ Int.ra.t Aat. aallY Intarllt FltCltar
1912 20' .ODDS'" 1917 OX .000247
1915 16X .aDDUI 1911-1991 m .GGnal
1914 II' .aDnDl ,... OX .Gao2..7
1915 U~ .DDnS6 1991-1994 7X .aaOI92
1916 10' .Da0274 '''' OX .GOOZ47
--Intarllt S. clleuhtad .. follow"
INTEREST . BALANCE OF TAX UNPAID X NUNBER DF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Anw Notlc. I.,ued ,ft.r the taM bacoea. d.llnquent will r.flect In Int.r..t c.lcul.tlon to fIfteen (15) day.
beyond the dat. of the ......aant. If payaant I. .ade .ft,r the Int.r..t caaput.tlon data Ihown an the
Hotlea, additional 1nt.r..t w.t be calculat....
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STATUS REPORT UNDER RULE 6.12
Date of Deathl
"'''''('I
C-,"" Ir./
\ '1 'I ,\
Name of Decedent I Et~\ ~.
Will No. ,'?I-(/'-I-:?'/1?
Admin. No. ,:';'1' "It' .Y'I,~'
1'1
.
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,phether administration of the estate is completel
Yes-&- No
2. I f the answer is No, state when the personal
representative reasonably believes that the administration will be
complete I
3. I f 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 is:
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.
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Signat.ure
Chflrle5 e.. S h,e1.J..s DI.
Name (Please type or print)
01 1110<,+ mflln ;'5t. f'nrllM 1VInk1'>,,,l!.<lloJIT'l."-".
Address '"
Date:
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Capac i ty:
Personal Representative
~ Counsel for personal
representative
(MAH:rmf/AM3)
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