HomeMy WebLinkAbout94-00984
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RaglslU! 01 Wills
'95 FEB -3 Pl :\0
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OATH OF PERSONAL REI)lmSENTATIVE
COMMONWEALTH OF I)ENNSYLV ANIA
COUNTY OF CUH8ERLANll
} S8
The petlllonerls) above-named swearls) or arnrmls) thaI the
statements In the foregoing pelltlon arc true and correct to the best
of the knowledge and belief of petlllonerls) and that as personal
representatlve(s) of the above decedent I'etltloncrls) will well and
,roO ,'ml.,,,, ... ...." ..,"'", ,. low. ~ A.
Sworn to or arnrmed and subscribed ~ ,~I V~
"'r"'io,;,~n~ . 18TH "d., .r~ l!~,I"J SF"~';?L. I'" '
l)if'!J~' ~~LL'Yl .'" .frylJ!~ '
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; . ' '-: Reglsler Iii
, , ; , MARY C. LEWIS
No.
21 - 94 - 984
..
11.':
Estate of.,
ur..>
BRIAN L. CLOUGH
1 Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW Nnv..mh.. , 22. 19.-!llL-.ln consideration of the petlllon on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that I:..n,s.. 1 r.l nllsh nnrl ~nnrl'n J, r.l nllgh
*"lare entllled to Letters of Administration, and In accord wllh such finding, Letters of Administration
are hereby granted to Geors!e 1., C I ounh and Sand ra J, C I ouah
In the estate of BRIAN L. CLOUGH
91.
FEES
Letters of Administration ..... S 70.00
Short Certlficatesl 5) , . . , , , . . ., S 1" nn
Renunciation ................ $
JCP S 5 DO
TOTAL __ S 90.00
Flied ,..~qy~!'1~~~..~~ I.... A,D. 19..2L.
FaREST N. MYERS (I.D, No. ISa64)
ATTORNEY (Sup, C.. 1.0, NO'1
10000 Holly pitcher H 8hway
~11rppnnahl'PB. UA 17251
ADDRESS
(717) 532-9046
l'Il0NE
Mailed letters and order to attorney on 11-22-94.
~.,
PETITION FOR GRANT OF LETIERS OF ADMINISTRATION
Estate 01 BRIAN I.. Cl.aUGII
also k no wn as
;2/- qt./- - qRtf
Social SecurIty No,
Deceased.
163-54-7495
No,
To:
Reglst~r of Wills for the
Countyof Cumherland In the
Commonweahh of Pennsylvania
The pethlon of the undersigned respectfully represcnts that:
Your pethloner(s), whoisllare 18 years of age or older, appl y
for lellers of administration
on the eslale of
(d.b.n.; pendente IlIei durante abient I.: durante mlnorllale)
the above deeedenl,
Deeendent was domiciled at dealh In Cum be rIa n d CounlY, Pennsylvania, with
~_Iast fall)!.lY 01 grlncl'lal resld~at 373 Thorney Grove Road , Sh i ppens~u r g
~ 0.. " (IIn 'trcet. number and munlclratilY)
Deeendenl, then 29 years of age, died November 4 .19 94 .
~ 373 Thornev Grove Road. ShippensburR. SouthamPton Township,
Decendent at death owned property with estimated values as folllows:
(If domiciled In Po.) All personal property
(If not domiciled In Po.) Personal property In Pennsylvania
(If not domiciled In Po.) Personal property In County
Value of real estate In Pennsylvania
situated as follows:
s ", lJ'Ou. ..~
S
S
S "2 S, 00<1 . -::>
Petltloner-lL- after a proper search hlULlL ascertained that decedent left no will and was survived by
the following spouse (If any) and heirs:
Name
Relationship
Residence
oad
257
THEREFORE, petltloner(s) respectfully rcquesl(s) the grant of lellers of administration In the
appropriate form to the undersigned.
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Local Hlogisuilr. The oligill,d H'rcilltilll' will hI' lnrw,lr,kd III thl' ~1.lll' Vil.11 HC'lIlllh t Hliu'lol pl'II1l;llll'llllilil1J.:.
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WARNING: Ills 1II0golto dupllcato this copy by photo slat or pholograph.
Fl'C (or thl!<llL"nifk.Hl'. $l.OO
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CO....ONWlALTH O. PINNSYLVANIA' DIPA"tUENt 0' HULtH' VlTAL AICOADS
CERTIFICATE OF DEATH
~Coro"e')
0II1Cl'DI_It(tolo'JoOl'I",-'
. Novombor 4.1994
Clough
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Sh<ppen4btlll9. PA 17257
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,OA DATlS 0' DIA'H AnlA 12/31/91 CHICK HIAI
I' A SPOUSAL
povlAn CAlDIT IS CLAIMID 0
fill NUM.IA 2 194 -09 84
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COMMONW\AltH or PINNsnVANIA
DIPA. MINt Of RfVfNUf
om "OliO I
HAllRIUURO. PA 11 1I 0601
r D N' NAM IIA I . AND MIOOI INI '''II
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'OCIAl ueUl' Y HUMI"
37] Thorny Grov~ Hood
Shipp~n9burg, PA 17257
Cl)lInl~bcr land
AMOUNt Ir(IIVID lur INSUUctlONSj
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
2..L
0984
YEAR I 9 94 NUMBER
COUNlY CODE
orClD Ht. (OM'l f A I S
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~ 1. Original R"urn [] 2. 5uppl.mlntal Allurn
o .. llmlt.d Ella" 0 Aa. Futur. Inllf." Compraml..
(for dOli I of dlath afl.r 12.12.82)
o 6. plC.d.n' Di.d T'lla'. 0 7. D.c.d.nl Malnlaln.d 0 living Trull
tAttach copy of Will) (Alloch copy of TruI11
COUUPONDINCI AND CONPIDINnAL TAX INPORMAnON IHOULD II DIRICTlDTO,'
(OM l , M I IN A
,:';'~i ';:~,' ";\{l~.,,,\'A ~;,~tft(j';:<:f~~'i ~1
03,
05.
R.ma!nd.r R.turn
tfor dalll of d.alh prior to 12.13.B2)
hd.,al Ellal. Toll. R.turn R.qulr.d
0- B. Tolal Numb., of Saf. D,pollt Bau.
g9 uire
t'ORgST N, MygHS
UUPHONf HUMI"
717 532-9046
10000 Molly Pitch~r ~i8hway
Shlpp~n9burg, PA 17257
111~,266.00
(21 -0-
(3) -0-
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(51 4,6J07UU
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I. Rool Elto.o (S,hodulo AI
2. Sloch and BondI15ch.dul. 81
3. Clo..ly H.ld Slock/Partn.rlhlp Inl.r,,' (5ch.dul. CJ
4. Mortgag.. and No'" R.c.lvabl. (5ch.dul. D)
5. Coah, Bonk D.po.itl & MlscellaneauI P.rsonal Prap.rly
IS,hodu!o EI
6. Jointly Own.d Prop.rly (5ch.dul. F)
1. T,onl'o" IS,hedulo GIIS,hodulo II
B. Total Gran AU'II Ilatal Un., 1.7)
9. Fun.rol Ellp.n"I, Admlnlslratlve COlli, Mllc.llon.ou.
bp.n... (5chtdul. HI
10. D.bts, Marlgag. Uabllill.., lI.nl (Sch.dule I)
11. T 0101 O.ductlonl 110101 L1n.. 9 & 10)
12. N.I Valu. of Ella" (lIn. B mlnul LIne 11)
13. Charitable and Gov.rnm.ntal B.que." ISch.dule J)
14. N'I Value Sub.et 10 Tall. (lln. 12 mlnulUn. 13)
15. Spaulal Trond.,. Ifar do'.. of d.alh aft.r 6.30.94)
S.. Inllructiana 'or Ar,pllcabl. P.rcenlag. on R.Vlr.. 115)
Sid.. (lndud. "alulI rom 5ch.dul. K or 5ch,dul. M.I
16, Amount 01 line U lo.oblo a. 6% '010 (161 $ 2 5 .44 5. 1 9
(In dud. valu" from 5ch.dul. K or Sch.dule M.)
17. Amaunl of L1n. U lall.abl. 01 15% rol.
(Indud. valu'l from 5ch,dul. K or Sch.dule M.)
lB, Principal loll. due (Add tOll. from lIn.. 15, 16 and 17.1
19. Credlh Spoulol Poverty C,.dll Prior Payment. Discount
+ + 7 ~ 1"-_
20. If lIn. 19 II greol.r than lIn. IB, .nl.r th. diff.r.nc. on lln. 20. Thl, II lh. OVERPAYMENT.
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21. If Line 18 It gr.ot.r than lint 19, .nl.r Ih. dlffer.nco on lIn. 21. Thlli, th. TAX DUE.
A. Ent., Ih. Inl.r," on th. balanc. du. on lIn. 21A.
B. En.o, the toto! olllno 21 and 21A an lIno 21B. Thh '"ho BALANCE DUE.
Mok. ChICk Payabl. tal R.gI,'" of Will., AD'"'
(21)
(21AI
12181
(6) 464. J 7
(71 -0-
191 7.21 1.08
(10) 6,704,18
I B)
39,360,45
1111
(121
1131
(1.1
13,915.26
25.445.19
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25.445.19
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$1,526.71
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1 ,526.7 1
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76.34
(19)
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Check here if vou ore wquesting (1 refund of vour ovvrpovmunl. .
1,450,37
$1,450.37
II SURI TO ANSWIR ALL aUlsnONS ON RIVeRS. SIDe AND TO RICHICK MATH',
Und.r p.nalll" of p.rlury, I declor. Ihat I hove uomln.d this r.turn, Including accamponylng tchedule. and .ta'.m.nh, and to lh. billa' my knawl.dg. and b.lI.f,
It It tru., corr.d and campI.,.. I d.dare Ihal all r.al e.lal. ha. b.en r'port.d 01 tru. markel valu.. D.c1aratlan of pr.par.r olhlt Ihan th. p'rlanal r.pr...nlallv. II
bOlld on ollln'armatlon of which pr'par.r hal any knawl.dgl.
~ON" at: 0' 'USON InroNsllI1 '01 m~nuIH AOOUSS '01)"1.'1 3ro\oL"'\"1,.,)C.. """n....... ~o OAll _
... . ~'-<:r' . .eeLlr-' OILit.l.W........ A>. 1'7l.'\L4 C.2- 9s;
TUlO" "nOT I'HAN_f,lurNI"IIVf AOOlffU \l.:)c..<:.r, \'-\ou.....'i p,t1-lr'-~ y,..-.....I'( 00\11
~. ~~ ~'''''I''\>Gt-he.~;. I'~ ,-ns, 2-2-9:,-
Act '41 .. 1994 provld.. for tho r.ductlon of tho tax rat.. Impo..d on tho n.t valu. of trand.r. to or for
tho u.. .. .... ....u... Th. rat.. a. pr..crlb.d by tho .tatut. will b.l
. 3~ (.NI wlU be appllcabl. for ..tat.. of d.c.d.nt. dying on Of aft.r 7/1/94 and b.for. 1/1196
. 2~ (.121 wllllHt .ppllcabl. for ..tat.. of d.c.d.nll dying on or aft.r 111'" and b.for. 1/1/97
. 1~ (.11) wiN IHt appllcabl. for ..tat.. of d.c.d.nt. dying on or aft.r 1/1/97 and b.for. 1/1/98
. 5....,.. tHInner. occurring on or aft.r 1/1198 will b. .x.mpt from Inh.rltanc. tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
IY PLACING A CHECK MARK (I"") IN THE APPROPRIATE BLOCKS.
YES NO
1. Old He.dent make a transler and:
a. retain the use or Income of the property transferred, .......................................................
x
b. retain the right to designate who shall use the properly transferred or Itl Income, .......,.......
x
c. retaIn a reversIonary tnterest; or ...................................................................................
x
d. receive the promlle far life 01 either payments, benelltl or care' ...............,....,..................
2. If delltl1 occurred an or belore December 12, 1982, did decedent within two years preceding
death tranller properly without receiving adequate conllderatlon' II death occurred alter
Dec.mber 12, 1982, did decedent tranller property within one year of death without receiving
adequate consideration' ............. .......... to. ..........It.. to ................. ...... ............ ........ ......... .....
x
x
x
3. Old decedent awn an 'In trultlor' bank account at hll or her death'..............,......,......,.........
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.
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COMMONWUltH 0' }fNNS't'LYANIA
INHUITANCe fA _nUIN
.____..._.___. ______~~!IP~~-'J~!~..P"~~I _"'..__HO__~
ESTATE"i'P---._,........,--_._.... 'U
SCHEDULE A
REAL ESTATE
.,J,,,
,.::,,~J ,'" ..i(iiN UMBER"" _:,,~=---,."---~.., _:. =,-
"-' --..-._"--
n...._._ ._____
BRIAN L. CLOUGH 2194-09B4
fp~;p.rty l~i~t1y.o-;;~~d wllh RighI ~iS';;;;I~;';,hip m~;i'b; dll~I.;;i ~n S;h.d~I.1'1 AU ;;;;I;;I;i.~,h..uldb;-;.P;;I~d;ii;i,;;;;;;I.~-I-;-.;i~;
which II d.lln.d 01 Ih. prl.. 01 which p,.p.rly would b. ..ch.ng.d b.lw..n a willing buy.. .nd a willing ..U.., n.llh.. b.lng c.mp.lI.d
10 bu 0' ..U. b.lh havln.@ 'lO!an.b!!Jc!!~~I.dg.nol. 'h.~!.!.!~IJ'I"'! _. __u ___ .___ . _.. .___' _ _...______
NUITMEMSER DESCRIPTION VALUE AT DATE
OF DEATH
I. Property located in Southampton Township, Cumberland
County, containing 8.2424 acres, more or less, being
known as:
373 Thorny Grove Road
Shippensburg, PA 17257
As recorded on September 13, 1991 in Deed Book '"H",
Volume 35, Page 763.
Assessed value 2,570 - .075 (common level ratio)
$34,266.00
TOTAL (Ah. .nlor on IIn. I. R"~eilulatl.n)
,,, mar. 'pac. ;1 n..d.d, in,.rl additiona' .h..,. or 10m. ,ill,}
s 34,266;00
u~UOt.1t CI~PJ
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SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
PI.D.. Print or l' .
COM'f.l'~:'7:Jl~'JMmvlll'NI'
BRIAN L. CLOUGH
CAI ,.....rty 1oI.tty.ew..4 whh .... II,hl 01 .....I__hl' ....1 ... 41......4 .. khe4.1o '1
N~~~IR D!SCRIl'TION
2194-0984
VAWI AT
DATI 01' DIATH
I. Checking Account - aRRSTOWN BANK
Account No. 3-42963
$3,030.08
2. 1978 Chevrolet Caprice
500.00
3. 1978 Ford Half-Ton Pick-Up
1,100.00
$4,630.08
(Attach addlllonaI8~- )( II- ,heet, If more 'pace Is nHdeel.1
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COMMQNWUIT" O' 'INNlnVAHIA
INHIII'ANCI U,I U1UIH
IUIOINt DtctDINI
IITATI O'
BRIAN L. CLOUGH
Jolntlonontl.).
SCHEDULE F
JOINTLY.OWNED PROPERTY
PILI NUMBIR
2 194 -09 84
------------ --- ------_._~- --_.------~.- ~---~.------- ----------. ----------------~_..-. .
RELATIONSHIP TO DECEDENT
Mother
A.
NAME
SANDRA J. CLOUGH
B,
C.
Jolntly.ownod proporty.
ADDRESS
10027 Sporting Hill Road
Shippensburg. PA 17257
ITEM LmER DATE
FOR TOTAL VALUE DECD'S DOLLAR VALUE OF
NUMBU JOINT MADE DESCRIPTION OF PROPERTY OF ASSET '"'INT. DECEDENT'S INTEREST
TENANT JOINT
" A 3/91 Savings Account -
ORRSTOWN BANK
No. 00a-751928 926.20 5a% $463.10
Intereat through 11/4/94 . 2.53 50% J. 27
TOTAL IAha on'or on IIno 6, Rocapl.ula.!an) S 464,37
(II mor, span ;1 n,.d,d inl.rt additional she." of sam. Ii",
11\l\l1l1.. P"'I
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COMMONWEAltH O' PENNSYLVANIA
INHUITANCr TAX UTUII:N
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
BRIAN L. CLOUGH
ITEM
NUMBER
A. Fun.ral Exp.n....
1,
2.
3.,
4,
5.
6,
7.
8.
DESCRIPTION
1,
FOGELSANGER-BRICKER Funeral Home
2.
3,
B.
4.
Mongul Cemetery Association - cemetery plot
Paul Runshaw - opening of grave
1.
Admlnl.tratlv. Co.t..
Personal Repre.entatlve Commllllon.
Social Security Number of Personal Repre.entatlvel
Year Commtlllon. paid
2.
A"orney Fee.
FOREST N. MYERS, Esquire
3.
Famtly Exemption
Claimant
Addrell of Claimant 01 decedent'. death
Street Addrell
City
State
Zip Code
Relatlon.hlp
Probate Fee.
C. MI.c.llan.ou. Exp.n....
Adams Electric Cooperative
United Telephone
United Telephone
Recorder of Deeds - Cumberland County
Adams Electric Cooperative
Timmons Oil, Inc.
United Telephone
Filing Fee - Inheritance Tax Return
TOTAL (AI.o enter on line 9, Recapitulation)
(If mar. .pac. I. n..d.d, In..rt additional .h..t. of .am. .1..,)
PI.a.. Print or T p.
2194-a984
AMOUNT
$ 5,320.50
4aO.00
275.00
825.00
90.00
64.81
26,48
24.56
13.00
18.84
114.85
23.04
15.00
S 7,211.0R
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SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES AND LIENS
Plaa.. P,lnt Dr T a
Fill NUMBER
~
\
COMMONWIAUH 0' 'INN"1\I"NI0\
INHllltAN(ltAl InUIN
IUIOINIDICIOIN'
~:
ESTATE OF
BRIAN L. CLOUGH
2194-0984
ITEM
NUMBER
DESCRIPTION
AMOUNT
1.
,Installment Loan - DAUPHIN DEPOSIT BANK
Account No. 14230538001
Interest through 11/4/94
$6,592.61
II J. 57
'.
TOTAL IAllo onlo' on IIno 10, Rocopllut.llon)
{II more .poce I. nllel.d, In..rl oelcJir/OIIo' .h..,. 0' .om. "n.}
$ 6,7 a4 . 18
IlV.lJU.'l.. ":''1
'*
(OMMONWIAUH 0' "NNlnVANIA
INHlIItA-NCI tAX InUIN
IIIIDINI DleIDIN.
SCHEDULE J
BENEFICIARIES
iSTATE OF
FlU NUMBER
BRIAN L. CLOUGH
2194-0984
ITEM
NUMBER
RELATIONSHIP
AMOUNT OR
SHARE OF ESTATE
NAME AND ADDRESS OF BENEFICIARY
A. Taxable B.qUIlIlt
l.
GEORGE L. CLOUGH
10027 Sporting Hill Rood
Shippensburg, PA 17257
Fother
1/2
2.
SANDRA J. CLOUGH
IOa27 Sporting Hill Rosd
Shippensburg, PA 17257
Mother
1/2
ITEM
NUMBER
NAMI AND ADDRESS OF BENEFICIARY
AMOUNT OR
SHARE OF ESTATE
B. Charitable and Gonrnmental a.queslll
I,
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IAloo onlo, on lino 13, Rocopltulollon) 5
(If ,.,or, .pac, I. n"ded, 'n..rt additional .h..t. of .am. sI..)
,. ...... .."__..._...._~AO..{_"'"~.,__-...............___.
.. ... ..- '.~. .... '- ..
,
.u____________________
_ w_ _ __ __ __ -- ---- - - -- - - - -- ---- ------
"",.--,','..'"',', , ',.: "C:, ,..",
,,,(<~"< '" ,,' ,\ 'Oi" COMMONWEALTH OF PENNSYLVANIA
a~~AJ.\'02~790,' " DEPARTMENT O' RIVINUI
:".'"'"1''''' . OffiCIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
.~
RECEIVED fROM,
a
ACN
ASSESSMENT '!'
CONTROL I,;i
NUMBER
AMOUNT
FOREST N. MYERS. ESQ.
P.O. 80ll F
101
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PI,'
:':,p.OHU'
SHIPPENSSURG PA 17ee7
'Ol.DHUI
ESTATE INfORMATION,
II!:t fiLE NUM ER
g el-1994-09S4
II!:t NAME Of DECEDENT (LAST)
I:,i CLOUGH BRIAN L
II DATE Of PAYMENT
m POSTMA~K DATE
COUNTY
SSN 163-l54-749l5
(fiRST) (Mil
CUMBERLAND
DATE Of DEATH
REMARKS
fa TOTAL AMOUNT PAID
SEAL
CHECK" 6664
RECEIVED BY
.1.4l50.37
B
FOREST N. MYERS, ESQ
,....
REGISTER OF WILLS
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JEV_1547 I!X AFP 112-94*
CDHMOHWrALTH Dr PENNSYLVANIA
Dl"PARTHEHT Of' REV(HUE
IURfAU Of INDIVIDUAL TAXEI
II(PT. rlDUI
HARRlIIUAG, PA '71rl.06D1
ACN 101
NOTICE OF INNERITANCE TAX
APPRAISE"ENT, ALLOWANCE OR DISALLDWANCE
OF DEDUCTIONS AND ASSESS"ENT OF TAX
DATE 04-10-95
S FILl! NO.
DATE OF DEATH 11-04-94 COUNTY CUMBERLAND
NOTE I TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUB"IT TNE UPPER PDRTION OF THIS FOR" WITH YOUR TAX
PAY"ENT TD THE REGISTER OF WILLS. "AXE CHECX PAYABLE TO "REGISTER OF WILLS, AGENT"
REMIT PAYMENT TOI
FaR EST N MVERS ESQ
10000 MOLLV PITCHER HWV
SHIPPENSBURG PA 17257
REGISTER aF WILLS
CUMBERLAND ca COURT HaUSE
CARLISLE, PA 17013
Aaount R..ltted
CUT ALONG THIS LINI! ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
ii!,v: isW-ix--iiiij>--nz-':94Y-Niirici""cWi-NHEiiifAifcE-TAx'jippRiiisiHENT-;-,U.i."ciwANCE-iili"-----,--m - m
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF CLaUGH BRIAN L FILE NO. 21 94-0984 ACN 101 DATE 04-10-95
TAX RETURN WASI (Xl ACCEPTED AS FILED
RI!SERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: aRIGINAL
1. Re.l Eatate (Schedul. AJ (lJ
2. stock. and Bondi (Schedule B) (2)
3. Clo.ely Held stock/Partnership Int.re.t ISchedule C) (3)
4. "orta'aea/Hot.. Racaivable (Schedule DJ (4)
I. C..h/Bank Depo.ita/Hi.o. Par.onal Property (Sch.dule E) (S)
6. Jointly Owned Property eSch.dul. FJ 16J
7. Tranlfer. ISchedul. OJ (7)
II. Totel A..et.
CHANGED
nn
c: ro \C}
34.2~700 u;
I' .00 :r:-
.00 ;g
.00 --*
4,630,08 Cl
4'64.37 ~
.'3 kOO ::
:r> ~ 1I1';j
:n~
(.) n
1'!.2
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iii 0
39'~60, 45
APPROVED DI!DUCTIONS AND EXEMPTIONS:
9. Funeral Ekp~.ea/Ade. Coat./Hiao. EXP.n... (Schedul. H) (9)
10. Debt,'Hortgaa' Liabllitiea/Llen. ISchedul. I) (lDJ
11. Totel D.ductlon.
12. N.t Velue of Tek R.turn
13. Charitable/Gov.rn.ental Bequ..t, ISch.dul. 4)
14. N.t Valu. of E.tata Subj.ct to Tak
7,211.08
6.704.18
Clll
llZI
IlSI
1141
l~.qll; ?Ii,
25.445.19
.00
25,445,19
NOTE I
If en essessmsnt wes issued previously, lines
reflect figures thet include the total of ~
ASSESSHENT OF TAX:
IS. A.ount of Lln. 14 .t Spou.al rat. (IS)
16. A.uunt of Line 14 taxabla .t Lineal/CIa.. A rat. (16)
17. A.aunt of Lln. 14 t.kabl. .t Coll.t.ral/Cla.. Brat. (17)
18. Prlnc1pel Tax Du.
14, 15 end/or 16, 17 end 1B will
returns essessed to date.
.00 X .03.
25,445.19 X ,06.
,DO X ,15.
Ilal
.00
1,526,71
.00
1 ,526 . 71
TAX CREDITS I
PAY"ENT
DATE
02-03-95
RECEIPT
NUNBER
AA022790
DISCOUNT Co I
INTEREST I-I
76,34
AtKlUHT PAID
1,450,37
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
1,526.71
.00
,DO
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION DF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN 'I, NO PAY"ENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU "AY BE DUE
A REFUND, SEE REVERSE SIDE OF THIS FDR" FOR INSTRUCTIDNS.I
~
RecordJd,(l;' LU of
Ranl~.:llr Ii Wills
'93 JAN 30 P3 :16
Nama of Dace dent:
BRIAN L. CLOUGH
Clark. --, ' ", -'1 r:ourt
CurniJo;,.unCl Co., PA
Data of Daath:
NOVEMBER 4, 1994
Administration No. 2194,0984
Pursuant to Rule 6,12 of tha Supreme Court Orphans' Court Rules, I report the following with respect
to completion of the administration 01 the above.captioned estate:
I, State whether administration of the estate Is complete:
Yes _ No--X-
2. If the answer is No, state when the personal representative reasonably beliaves that the
administration will ba complete: May 4. 1995
3. If the enswer to No. lis Yes, state the following:
a. Did the personal representative file a linal account with tha Court? Yes
No_.
b. The separate Orphans' Court No. iiI any I for the personal
representative's account is:
c. Old the personalrapresentative state an account informally to the
parties In Interest? Yes _ No_
d, Copies of raceipts. releases. Joinders and approvals of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this raport.
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. Slgnatura
,Date: JANUARY 27,1995
FOREST N. MYERS, Esquire
10000 Molly Pitcher Highway
Shlpponsburg, PA 17257
(7171632.9046
Capeclty:_ Personel Representetlve
....x.. Counsel for Personel
. Representative
".
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.
i}
f.
Name of Decedent: Brian L. Clough
Date of Death: November 4, 1994
Will No. 1994.00984 Admin. No, 21.1994,0984
Pursuant to Rule 6,12 of the Supreme Court Orphans' Court Rules,l report the following with
respect to completion of the administration of the abova,captioned estate:
1. State whether administration of the estate is complate:
Yes..K- No_
2. If the answar is No, state when thb personal rapresantatlve reasonably beliaves that the
administration will be complete:
3. If the answer to No, 1 is Yes, state the following:
a. Did the personal representative file e final account with the
Court? Yes _ No L.
b. The separate Orphans' Court No. (if any) for the parsonal
representative's account is:
c. Did tha personal represantativa state an account Informally to
the parties in interest? Yas...x.... No_
d, Copies of recaipts, releases, joinders end appro~9lHJf fo",!al or :D
Informel accounts may be filed with the Clerk of thiOrphans1'Court :u ~
,r_. (1
end may be ellached to this report. H' "
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Date: \0 .29-~
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Slgnalure
FOREST N. MYERS, Esquire
10000 Molly Pitcher Highway
Shlppensburg, PA 17267
(7171 632.9046
Capaclty:_ Personal Representative
L Counsel for Personal
Representative
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