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HomeMy WebLinkAbout95-00598 ,.'.': .~. 1- 4" \,~,'S:ii::~tt';f~; ,.' ,..-). ,- ::~ . j' .',".' .... , Mt~"- .' , 'k' . '.'-,":, l ".~. ,.~ :. ,.' <..} --,., -1', ;.~. ",.; ; ;-~:; " j' .' " .'!': .., E"alc' "I Clara M. W~lso!l,_______ al.lll/alUlI'II as I)ETITION I:OI{ I) ROllA TE and GRANT OF LETTERS No, ____01 t~ - !f!Jff To: 'm____ Regl,ler of \Vllh g" lite ioJ;;Tz=ll9591J,...,.t/,\('t/, ('011111)' or Cum er and in Ihe St/rit/I S,'..II,il)' Nu, ('onllllonwellllh of I'ennsylvllnlll The pellllon of Ihe IIl1llersigned re'peclflllly rel"e,ell" Ilml: YOllr pell1loller(,), who h/llre 1M )'eurs of uge ur older IIl1lhe e'eclllr ix in Ihe IU'1 will of Ihe uhow decc'denl, dilled _ _ March 31 IInd e",lklll,) dilled December 1, 198"2 nllmed . 1912- (\Hue rdl'\3nl ~:h"'IlI11\II1I1~'I.'\, I.',il, u'nundnlinn, dl'i1lh ul' C\I.'l'U1ur, Cle,) Decendenl wu, domiciled 11\ dell\h in Cumberland h er 1I1S1 fllmll)' or prlnclplIl re,idenee III 1203 Indian ~.J;:g .MOru:oe......TololnFlhip (11\1 \lr,,',,'I, numher Ulld l11U1h:ilmlil)') ..._ COllnty, Pennsylvania. wilh ...eg Road PA 17055 Deeendenl.lllen 91 )'eurs of uge. died November 13 , 1993 al-HQ1Y_Jl-Rio t Hospital. Camp Hi 11, PA , E,eepl as follows, decedem did n'" mllrry, was nol <ilvureed IInd did nol have a child born or adopled afler e,eculion of Ihe will offered fur prollllle: wus nOllhe vlcllmof II killing and was never adjudicated Ineompelem: Deeendenl III demh owned propen)' wllh eslimaled ,'aloes I" follow,: (If domkiled in I'll,) Allpersonulpropeny S 500.00 (If not domiciled in I'a,) I'ersonalpropeny in I'enn,ylvllnla S (If nol domiciled in I'a,) I'er,onulpropeny In ('oumy S Vnhu,' uf rcal':\IUh,' In Pcnl1\)'lvnnin S lUU. UU ,l1uulc'd a, rollow,: .J"pL241J Section 16, Treasure Lake Subd1v1s1on, sandy-To_wnahip~ Clearfield Countv WHEREFORE, "ethiuner(,) re,peclfull)' request(s) Ihe prohulc of Ihe last will and eodlell(s) pre'ellled herewilh IInd Ihe grunluf lellers--'l'es.t~ry , Ih.'\lill1lt:ll1IU~; lIdmini\lrnllul1 c,l.a.: admlnhtrallon d,h,n.t.I,A,} theron, 'I , ~ ~ .,j- GF. '" " c ].g ~~ E: ~ " ';. (Wh6~~n___ _~.C a.ro l_F r..ee land --'l203.JndialLPeg~Qad___ uuMechanicsburg ,-PA--.L7J155__ I ! -_..~._- ____n__ OATH OI:I)lmSONAL REPRESENTATIVE COI\IMONWEAI.TII UF I'ENNSYI.VANIA }::I::I COUl'OT\' OF Cumberland The l,elllionerls)lIho\e-nllll1ed ,wearl') or IIffirm(s) 11111\ Ihe sllllemenls in Ihe foregoing pelilion arc Irue ilud CUllecl 10lhe he" uf Ihe ~11ll\,ledge IInd hellef of pelilioaer(s) and thai as persooal represen- tlllivel\l of 11ll' IIhovc' decedent "elilioner(,) will weIlJ1'~d In I)' IId~r Ihe estate aecording~ law, SilO'" III 111 IIffirmed ulld ,"hscrlhed r-.at '-fj J~' ;> - 7.> '" me 1Il).l~~t=-'~~--U]ffJJ1~~&,_~ ~a oLF.r.e.e1.lind l' d ll~dwis Hc'~i,\It" -11 ~ /0- Lf9 - if No, ?1 _ Q~ _ ~QR Estate of Clara M. Wilson , Deceased DECREE OFI)ROBATE AND GRANT OF LETTERS AND NO\V AUGUST 10. 19-1L. In consideration of the pelltion 011 Ihe reverse side hereof. sUllsfllctory proof hllvlng been presented before me. IT IS DECREED tllllllhe Inslrumen1(s) dilled March 31, 1979 & December 1, 1982 described therein be adlllllled 10 probale and filed of record liS Ihe 11IsI will of Clara M. Wilson and lellers Testamentrv are hereby granled 10 Carol Freeland "lI/(Lu"~'~/';^~" fJn7~' d ~'~!'I" or WUh MARy C. LEWIS FEES Probate. lellers, Ele, ,,""", S 18.00 Short Cerllfieales( 4) ..,.. , .. "S 12.00 ~e'1fne'rllon ..,..,.....,.... L-, x~p~ij~s S-2Y'oH- JCP TOTAL _ S 5.00 Filed "~~,~~?!, ,1,9~, ,1,~~?,5, ,.,. ,,1l6, liP" Kent H. Patterson ATTORNEY (Sup, Cl, 1,1>, No,) 15307 221 pin.. Sl:r....t- Al>llRESS Harrisburq. PA 17101 1'1I0NE (717) 238-4100 nn C(f;" "l r, . ~'il :u :Um t" ,I. Mailed letters and order to attorney on 8-10-95. ~.... E-: W"1 I -.J " L.J ~' I. 'UI_ );. .-'. :< co lI~ '? , ' .; '; , . , . 11Iast 3IIlIUl anb Wegtament of CLARA M. WILSON I, CLARA M. WILSON, now of the County of Centre, in the Common wealth of Pennsylvania, being of sound disposing mind and memory, do make, publish and declare this my Last Will and Testament and I do, by the act of executing this Will, revoke and render null and void any and all wills, papers testamentary and writings in the nature thereof at any time heretofore executed and declared by me. Item One. I direct the Executrix or the Executor of my estate hereinafter appointed to pay all my just debts and funeral expenses as soon after my decease as shall be convenient. Item Two. I direct that there shall be paid out of my residua y estate all estate, inheritance and like taxes, together with any interest or penalty thereon, imposed by the government of the United States, or any state or territory thereof, or by any foreign govern- ment or political subdivision thereof, in respect to all property required to be included in my gross estate for estate, inheritance or like tax purposes by any of such governments, whether the property passes under this Will or otherwise, excluding, however, any property over which I have a taxable power of appointment, provided, however, that no residuary beneficiary shall, by reason of this provision, be denied the benefit of any deduction, credit, favorable rate of tax or other benefit which by law enures to such benoficiary. Item Three. I grant to the Executrix or the Executor of my estate hereinafter appointed the powers, discretions and authority to sell real estate that I own, or any interest therein or subdivision t ere- I, . I- " of, which is not specifically devised herein, at either private or public sale without filing or entering a bond or other security, and to make, execute, acknowledge and deliver a deed or deeds or other assurances necessary to transfer the title to, or'vest the title in, the purchaser or purchasers thereof. Item Four. I give and bequeath the following: (a) To my granddaughter, Carol Freeland, now of Dil1sburg, Penn- sylvania, if she shall survive me: (1) My wall recliner chair, (2) All of the fishing equipment which belonged to my late husband, Jerome G. Wilson, and (3) My white gold wedding ring. (b) To my daughter, Lenora Moore, now of JUlian, Pennsylvania, if she shall survive me: (1) My ruby ring, given to me by my father, and (2) My antique drop-leaf table, formerly owned by the Blauser family. (c) To my granddaughter, Dortha Moore, if she shall survive me, my yellow gold wedding ring. (d) To my granddaughter, Hilda Custred, if she shall survive me: (1) My turquoise ring, and (2) My jewelry box and the contents thereof. Item Five. If any of the beneficiaries named in ITEM FOUR of this my Last Will and Testament shall not survive me, then the beques to such individual shall lapse and the subject property, along with all of my clothing, jewelry, personal effects, household goods, furni ture, furnishings, and automobiles and all other tangible personal roperty not otherwise specifically bequeathed (not including cash or shall be sold by my Executrix or my Executor at public r private sale, and the net proceeds of such sale shall become a of my residuary estate hereinafter disposed of. . Item six. I give and bequeath to each of my grandchildren who -2- . ., '" " .tEl living on the date of my death, the sum of Two Hundred ($200.00) Dollars. Item Seven. If my daughter, the aforesaid Lenora Moore, is not living on the 30th day following the date of my death, I give and bequeath, (a) To each of my grandchildren who is living on the date of my death, the sum of Five lIundred ($500.00) Dollars, (b) To each of my great grandchildren who is living on the date of my death, the sum of One Hundred ($100.00) Dollars. Item Eight. If my daughter, the aforesaid Lenora Moore, is living on the 30th day following the date of my death, I give, devis and bequeath all of thEkrest, residue and remainder of my estate, real, personal and mixed, and wheresoever situate, which I own, or have the right to dispose of at the time of my decease to First Seneca Bank and Trust Company, a banking corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with it principal office in the City of Butler, Butler County, in the Common wealth of Pennsylvania, and a banking office in the City of oil City Venango County, in the Commonwealth of Pennsylvania, as Trustee, to be held under the terms of my Trust Agreement dated 1979, and any amendments thereto or substitutions therefor, or if such agreement is not in effect at the time of my death, to hold in trust under the terms specified in 'said agreement on the date of this Will or of its last publication by Codicil or otherwise. Item Nine. If my daughter, the aforesaid Lenora Moore, is not living on the 30th day following the date of my death, I give, devis and bequeath all of the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever situate, which I own, or have the right to dispose of at the time of my death to my then-1ivi g issue, absolutely and per stirpes, PROVIDED that if none of my three (3) children, Lenora Moore, Robert Allison and Donald Allison, are living on the 30th day following the date of my death, I give, devis and bequeath the aforesaid rest, residue and remainder of my estate -3- . .. .. " to my grandchildren, share and share alike, provided that the share of any. grandchild who is not living on the 30th day following the date of my death shall be distributed to his or her issue living on the 30th day following the date of my death, per stirpes, and in default of any such then-living issue, such share of a deceased grandchild shall be added, in equal proportions, to the share or shares for my other grandchildren and/or then-living issue of de- ceased grandchildren. Item Ten. I hereby nominate, constitute and appoint First Seneca Bank and Trust Company, aforesaid, or its successor by merger or otherwise, testamentary guardian of the estate, real and personal of each minor receiving any property by reason of my death, if such property is in excess of the amount which may be paid to the minor or to the parent or other person maintaining the minor. Item Eleven. I hereby nominate, constitute and appoint Carol Freeland, my aforesaid granddaughter, Executrix of this my Last Will and Testament; if the said Carol Freeland is unable or unwilling to serve as Executrix, then, and in substitution, I hereby nominate, constitute and appoint First Seneca Bank and Trust Company, aforesai , Executor of this my Last Will and Testament; and I direct that the Executrix or the Executor of my estate shall not be required for any reason to file a bond or other security in this or any other juris- diction in order to qualify to this appointment, or in connection with either the administration or distribution of my estate. Item Twelve. At any time prior to the vesting of a future interest in possession and enjoyment, my Executrix or Executor or any Trustee to whom my residuary estate has been distributed shall have the discretion to 'elect to prepay all or any part of the estate inheritanc~ or 1ike:taxes thereon, and such election shall be bindin upon all parties in interest. IN WITNESS WHEREOF, I, CLARA M. WILSON, testatrix, have here- unto set my hand and seal to this my Last Will and Testament, con- -4- . . . . FIRST CODICIL TO 1Ea6t 111m attb We6tmtttut of CLARA M. WILSON I, CLARA M. WILSON, do hereby make, publish and declare this to be the First Codicil to my Last Will and Testament dated Maroh 31, 1979. FIRST: I do hereby amend Item Four of my Last Will and Testament dated Maroh 31, 1979, so that after amendment it will read as follows: "Item Four. I give and bequeath the following: (a) To my granddaughter, Carol Freeland, now of Harrisburg, Pennsylvania, if she shall survive me: (11 My wall recliner chair, (2) All of the fishing equipment which belonged to my late husband, Jerome G. Wilson, and (3) My white gold wedding ring. (b) To my daughter, Lenora Moore, now of JUlian, Pennsylvania, if she shall survive me, my ruby ring given to me by my father. (c) To my granddaughter, Dortha Moore, if she shall survive me, my yellow gold wedding ring. (d) To my granddaughter, Hilda Custred, if she shall survive me: (1) My turquoise ring, and (2) My jewelry box and the contents thereof. (e) To my grandson, Robert L. Moore, Sr., my .22 caliber pistol." SECOND: I do hereby revoke in its entirety Item Six of my Last Will and Testament dated March 31, 1979, and substitute in lieu thereof a new Item with the same number, which Item shall read as follows: '" , .' . . . . . "Item Six. I give and bequeath to each of my sons, Robert Allison and Donald Allison, who is living on the date of my death, the sum of Five lIundred ($500.00) Dollars." THIRD. I do hereby revoke in its entirety Item Seven of my Lalt Will and Testament dated March 31, 1979. FOURTII. I do hereby amend Item Eight of my Last Will and Testament dated March 31, 1979, so that after amendment it will read al follows. "Item Eight. If my daughter, Lenora Moore, is living on the thirtieth (30th) day following the date of my death, I give, devise and bequeath all of the rest, residue and remainder of my estate, real, per- sonal and mixed, and wherescever situate, which I own, or have the right to dispose of at the time of my decease, to First Seneca Bank and Trust Company, a banking corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with a bank- ing office in the City of Oil City, Venango County, Pennsylvania, as Trustee, to be held under tho terms of my Trust Agreement dated April 6, 1979, and any amendments thereto or substitutiono therefor, or if such agreement is not in effect at the time of my death, to hold in trust under the terms specified in said agreement on the date of this Will or of its last pub- lication by Codicil or otherwise, and any amendments thereto or substitutions therefor." UIFTII. I do hereby amend Item Nine of my Last Will and Testament ated March 31, 1979, so that after amendment it will read as followBI , -2- . . WItem Nine. If my daughter, Lenora Moore, is not " living on ths thirtieth (30th) day following the date of my death, I give, devise and bequeath all of the rest, residue and remainder of my estate, real, personal and mixed, and wheresoever situate, which I own, or have the right to dispose of at the time of my death, to such of my grandchildren as shall be living on the thirtieth (30th) day following the date of my death in equal shares, provided, however, that the then-living issue of a de- ceased grandchild of mine shall take per stirpes the share their parent would have taken had he or she been then living. W SIXTH: I hereby republish and reaffirm my said Last Will and Testa- ment dated March 31, 1979, as modified, amended and supplemented by this First Codicil as if the same were set out here in full and do incorporate the same by this reference thereto, and do hereby republish and declare my said Last Will and Testament as so amended, modified and supplemented as my Last will and Testament. IN WITNESS WHEREOF, I, CLARA M. WILSON, testatrix, have here- unto set my hand and seal to this, the First Codicil to my Last Will and Testament, consisting of four (4) typewritten pages, at Franklin, Venango County, Pennsylvania, this /51 day of December, 1982. (j /dH..tT '-n1 ~ ~h~" (SEAL) Clara M. Wilson Signed, sealed, published and declared by the said Clara M. Wilson, testatrix, as and for the First Codicil to her Last Will and Testament, in the presence of each of us, who, at her request and in the presence of each other, have subscribed our names as witnesses thereto. ~~"r_ a, CY<Jk.Ad ~~~':J ;r=' 97Z~L- ~~4- -3- . ' . , We, Clara M. Wilson and Julia A. Osborne, Patrioia L. Mac- Cartney and Sheila F. Jacoby, testatrix, and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the under- signed authority that the testatrix signed and executed the instrument as the Firs~ Codicil to her Last Will and Testament and that she had signed willingly, and that she exeouted it as free and voluntary aot for the purposes therein expressed, and that each of the witnesses, in the presenoe ~nd hearing of the testatrix, signed the Codicil as witneDs and that to the best of their know- ledge the testatrix was at that time eighteen (18) years of age or older, of sound mind and under no oonstraint or undue influence. C!..L.., -v .'f '-~;r) LU_Y~/ Subscribed, sworn to and aoknowledgod before me by Clara M. Wilson, the testatrix; and subsoribed and sworn to before me by Julia A. Osborne, Patricia L. MacCartney and Sheila F. Jacoby this )St- day of December, 1982. 0-. (9~. · J -4- , ,.." ;I'" , , - ': .. ~ . -. ~ - , ,,- '. '. . . I 'I I . . CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of decedent Date of death . Will No. N/A CLARA M. WILSON November 13, 1993 Admin. No. 21-95-598 To the Register: I certify that notice of beneficial interest 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 ~anuarv 25, 1996 : Name Robert L. Moore Darlene Reigle Marlene E11ersick Carol J. Freeland Hilda Runk (nee: Custred) Albert Moore Dortha Weaver Robert M. Allison Joan M. Marshall Richard L. Allison Patrick L. Bielby Allan Allison Demming Allison Mark Allison Robert Allison Irving Allison, a/k/a Donald Allison Address 3008 West Country Club Drive Irvinq, TX 75038 1285 North Vine street Middletown, PA 17057 301 Lauberman Cres. Rochester, NY 14620 1203 Indian Peg Road Mechanicsburq, PA 17055 R.R. 1, Box 305 Sprinq Mills, PA 16875 303 Vanessa Drive Pleasant Gap, PA 16823 7397 Otisco Valley Road Preble, NY 13141 Box 37 Central Bridqe, NY 12035-0037 Box 61 White Lake, NY 12786 Rt. 2, Box 213, Cora Street Gassvil1e, Arkannas 72635 R.D. 2, Box 230 - Saltzman Road B1ossva1e, NY 13308 43738 Beech Avenue Lancaster, CA 93534 43738 Beech Avenue Lancaster, CA 93534 43738 Beech Avenue Lancaster, CA 93534 10 Willey Street A1banv, NY 12203 43738 Beech Avenue Lancaster, CA 93534 1 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: January 25, 1996 ~ 17~C~~___ Sig'nature Name Kent H. Patterson Address 221 Pine Street Harrisburq, PA 17101 Telephone (717) 238-4100 Capacity: Personal Representative X Counsel for Personal Representative 2 l(V.l5oo u:. 11.9'1 ~ ..:5= 1I11!:!:j ~I- z ~ ~ . B a '* /.5 -1-jCJ-I-J. ~J '01 OATIS 0' DIATH Ann 12/31'" CHICK HIU INHERITANCE TAX RETURN ~o~::g.umDITISCLAIMID 0 t RESIDENT DECEDENT 'ILl HUM.II G (TO BE FILED IN DUPLICATE .;J. I q 5 5 I WITH REGISTER OF WILLS) COUNTY CODE YEAR NUMBER DfClDfN '. COIl_I'll I ADDal 15 lil III .. COMMONWfAltH Of PfNNSYlVANIA DfPAR'MfN' Of RlVfNUf om, 210601 HAllIl$lUIIO. PA 17 21.0601 o IN ' HAM ILA ,'11 . AND .1041 Dlf INI IA'I Wilson Clara M. lOCIA' Iteulny NUMIIII DAn or DIA'H II) 121 (3) I ~ 1 151 161 P) 191 (101 (15) (16) (171 + 1203 Indian Peg Road Mechanicaburg. PA 17055 COUIlI AMOuNtalellVID IUIINUIUClIONII ~ I, O,I&lnal Rllurn o ... lImlt.d E,'at. 0 "a, fUlur. Inl.r..t Comproml.. I'or dol.. of dlOlh oft.r 12.12.82) P!J 6. D.c.d.nt Di.d T.,'ol. 0 7, O.c.d.nl Malntaln.d allYing Tru" (Attach cop)' 0' Will) (Anach cop)' of Tru't) ALl. CORRWONDINCI AND CONPID!NnAL TAX INPORMAnON SHOULD BE DIRECTED TOI NAMt COMI'Un MAiliNG AOOIUI Kent H. Patterson 221 Pin" Street U:UPHONINUMIU Hit t"r isburg, PA 163-12-0959 o 2. Suppl.menlal R,'urn :il15 .... "z BIe z 5 I I, Roal E,la,. ISchodul. AI 2, Stock. and Bond. ISch.dul. 8) 3, Clolll)' H.ld Slock'Partn.nhlp Int.r,,' (5ch.dul. q ... Martgog.. and Not.. R.c.lvabl. (Sch.dul. D) 5, Caaht Bank D'po.lla & Mlac.llon.ou. P.nonal Prop.rly ISc..d.l. E) 6, Jaln.ly Own.d Prap.rty ISch.dul. FI 7, Tran.'", (Sch.dul. G)ISchodul. L) 8. Total Gran Au... (10101 Un.. 1.7) 9. Fun.ral bp.n.", Admlnlalratl.... Call., Mlte.llan.ou. bp.n... (5ch.dull HI 10. D.bta. Mortgog. lloblllll.., U.na (Sch.dul. II 11. Total D.ductlona (10101 Un.. 9 & 10) 12, Ntt Valu. of E,'at. (L1n. 8 mlnua L1n. '1) 13. Charitable and Gav.rnm.nfol B.qu..tt (Sch.dul. J) U, N.t Valu. Sub'.ct 10 Tax lIn. 12 mlnu. Lln. 13) 15, Spou.al Trand.,. (far dOl.. of death oker 6.30.9.4) 5.. Inllructlan. for Ar,pUcoble P,runlag. on R.y.,.. Sid., (Includ. yalu.. rom Sch.dule Ie or Sch.dul. M,I 16. Amount of L1n. ,.. loxabl. at 6% ral. I'nclud. yalu.. from Sch.dul. Ie or Sch,dul. M,) 17. Amoun. 0' lIn. ,.. taxabl. 01 15% rol. (Includ. volu.. from Sch.dul. K or 5ch.dul. M,) 18. Prlnclpolla.ll due (Add tax from L1n.. 15, 16 and 17.) 19. C,.dlll Spou.al POy.rt)' Cr.dlt Prior Poym.nla + o 3, R.malnd.r R.tur" Ilor do'" of d.ath prla, '0 12,13,821 o 5, f.d.rol e,'ol. TOIt R.tur" R.qulr.d ...Q 8, Talal Number of Safe Oepo.1I 80xII 17]01 942.56 : ~J ;') , , 579.96 ]0876.99 l" .i , !') -- 4706.95 987.38 (8) 12399.51 111) (12) (13) (t~) 5694.32 6705.18 )(,_11 6705.18 )( ,06 . 402.31 )( .IS. (18) DI.caunl Inl.r'll 20, II L1n. 191. gr.aler than L1n. 18, .nllt the diff.r.ncI on Lint 20, Thl. i. the OVERPAYMENT, a O...rrl!":I..OI......_ ....-OI....I..H'I~'"..._'_I..ft'I"l1'l~_'....I_..'.IJItllJ...I"I...1 . (t9) (20) 21. It L1n. 18 It greal.r than lIn. 19, .nter the diff.r.ncI an L1n. 21. Thl.I.lh. TAX DUE. A, Enler the Int.r.., on th. balonct due on lIn. 21 A, B. Ent.r the latal of lIn. 21 and 2lA on lIn. 21 B, Thl. I. the BALANCE DUE. MaSe. Ch.eSe Payabl. t,:,! R'a','.r of Will., A-'!I~nt ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH -<-< Und.r p.nalti.. of p.rjury. I d.c1ar. that I hove .xamln.d Ihl, relurn, Including occomponying I(h.dul.. and ,'alem.nll, and 10 the be,' of my knowl.dg. and b.li.f, .1 i. tru., carr.c! and compl.te, I d.c1or. Ihal all ,.01 ."01. ha, bun reported otlru. marh, yalu.. O.doralion 01 pr.parer olher Ihan th. p.nanal r'pr..enlatiy. is IIDI..~_~~_ol~~~~rmalion D'_~~~ ~r'pare' .'!.~~..!!..n)' k,!.!..wJ!~.___~_ ______._.. _.. _ ___.___..._.._,_~_____ "_. '.1 rAJUU '!UONIUI'O"~IIU' rtUNGR IURN ADDlIl.5o$ Carol J. Freeland, Executrix DAn . C; <:/-c""....,i;,,,,,,, 1203 Indian Peq Road 10/14/98 ',. "A UfO. I'AR ROIHUIHAN (I'RUENI..., l ADDUS, Mechanicsburg, PA 17055 DAn (21) 121A) 171B) 402.31 142.28 548.59 Act '48 of 1994 provld.. for the r.ductlon of the tax rot.. Impo..d on the n.t valu. of trond." to or for the u.. of the .pou... Th. rot.. a. pr..crlb.d by the .totut. will b., · 3'l1o (.03) will b. appllcobl. for ..tot.. of d.c.d.nt. dyIng on or aft.r 711/94 and b.for. 111/96 · 2'l1o (.02) will b. appllcobl. for ..tat.. of d.c.d.nt. dyIng on or aft.r 111/96 and b.for. 111/97 · 1'l1o (.01) will b. appllcabl. for ..tot.. of d.e.d.nt. dying on or oft.r 1/1/97 and b.for. 1/1/98 e Spou.al tranal." oceurrlng on or aft.r 1/1/98 will b. .xempt from Inherltanc. tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (....) IN THE APPROPRIATE BLOCKS. 1. Old decedent make a transfer and, a. retain the use or Income of the property tronsferred, ....,..,..................,........,......,............ b, retain the right to designate who shall use the property transferred or Its lacome, ..,............ c. retain a reversionary interelt; or ..........,........."...,.....................,...................,............... d. receive the promise for life of either payment., benefit. or care' ......................,..,......,...... 2, If d.ath occurred on or before December 12, 1982, did decedent within two y.ars preceding death transfer prop.rty without r.celvlng adequote conslderotlon' If death occurred aft.r December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration' ......" ,........"...."..., ,.,.,., .....,...., .... t. ........,............, '..... .......... ........ 3. Old decedent own an 'In trust for' bank account at his or her death'...................................,.. YES 0 'Ie )( )< IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. " " " UY,1l0' IX. 112.u] '*' CllMMONWIAIT" O' P1HHIYlYAHIA - INHI'"AHCI TA. mUON UllDIHt DICIDI!"t ISTATI O' SCHEDULE A REAL ESTATE .iLi1lUMIIR Clara M. Wilson IP.....t1y 1.lnlly..wn.d with RI,hl.' SuovIY...hlp mU'1 b. dlscl...d.n Sch.dul." All r.;';.la,;;h.uld bo ..p.;....'d ~I ';'Ir mark., valu. whish II d.hned allhl prlc. al which p..polly would bo ..chan,.d bo!woon a wlllln, buy.r and a wlllln, 1.11.., n.lth.. b.ln, comp.lI.d Ia bu ar 1111. balh hayln ..allnabl. knawl.d,. a' Ihl ..I.vanl 'ad.. NU~rIR DISCRIPTION VAb~V~lr~TI I, Lot 241, section 16, Treasure Lake Subdivision, sandy Township, Clearfield County, PA (see attached settlement sheet from sale) 942.56 " 'I ;1 TOTAL AI.o .n'" an IInl 1, Rica Itulotlon (11 more 'pace ;, n..ded, Ins.rt addi'ional .he." of lome ,'ze., s 942.56 I, ...". Md ~ 01 BcImMIf Im.;1~'~~r.':'nd. I'xecutrix ,,_..._oI~ N/II ,arcn M. zc1be 126 Barley Dr ve E/O Clara M. wilson :luncannon, PA 17020 1203 Indian Peg Roa~ .,n<." ;:.__, ..~~ . PA 1,__ H, IW....~.. AgIN Kent II. Patterson Lot No. 241, sec\:ion No. 16 T...O No 23-2457515 Treasurc Lake s~ivision ..... 01 ~II~..._A I. w....,.... 0tI0 , ~ , sandy Township 221 pinc Street a~d~w.A Harrisburg , PA 17101 .. __T...D No, 163-12-0959 I, SUMMARY OF BORROWER'S TRMSACTlON K, SUMMARY OF SElLER'S TRANSACTION 100, GROSS AMOUN1'DUE FROM BORROWER: 400, GROSS AMOUNT DUE TO SELLER: 101- Conl..el ..I" o<lct 'U~ ..,(. 401- Contrlct "I.. oriel 'r.~L rC"t. 102, P.llon.1 Pro"""" 402, Pellon.lmo""rl" '03, Seltl.menl ch......IO borrow.. (/in. 14001 :;,~ I ~(., 403, 1().4, 404, 'OS, 405, Idiutrmen" (D' 111m. tJlld by ,./1" in '<N.ner ' II ~'Hd AdIU.I"""'" (D' illm. p.id by ,./1" In .<NMlCl'" egrHd 06, School TIM \.~ ~1\\..Jc. I!::J, 406, School r.. 07. TIM 407, TIM DB TIM 40B, T.. ,09, Sew.. 409, Sewer 10, Tr.sh 410, Trl.h It. WI'''' 411, W,,., 12, 4", 20, GROSS AMOUNT DUE FROM BORROWER /7.J. 'T,.. ~20, GROSS AMOUNT DUE TO SELLER '/4L Sf, 00, AMOUNTS PAID BY on IN 8EtlALF OF 1I0RIlOWER, bUO, IlElJUCTIONS IN AMOUNT DUE TO SELLER, 01- Depo.U or ..,n..' manlY 50t. Elect" depos.. c..ln,tructiOl1') 02, Prlnc~ .moun' 01 n.w lo.nld li02, Selllemenl chlrllftS 10 lillie, 'f/nll 14tXn 'Ti, s:6 03, hl.llnn lo.nl.' Ilk In .ublecllo 503, h.lli"" 10lnlslllken .ubilCI to " ().4, 604, PI_all . 05, 505 PI_all I 06, 506, I 07 507 DB, 50B, 09, 509, diut""."" (", 111m. untJIld by III'" , .. ",owd Adiu.rmen" fOf I1M" unp.ld bv ../I" . II ...reed 10, s.."ool TIM 510, Sehool TIX 1" TIM SIt. TIM 12, TIM 512, TIM 13, Sew.. 513, Sew.. 14, Tro.h 514, Trail, 16, WI'" 515, WI'" 16, 516, 17. 617, 18, SIB, 10, 619, 10, TOTAL PAID BYIFOR BORROWEn - ~"' - (.;JU. TotAL R~DUClION AMOUNT DUE SELLE II U.l l-/ ".) 10, CASH AT SETTLEMENT FROMITO nonRowrn noD, CASH Al SETTLEMENT TOIFROM SELLER J1- Grall .mount dUI Irom bonow" (IIn. 1201 q" ( -j,J B01. GrOll Imoun' dUI 10 ..II" IIln. 4201 '1 J.,) :"~{l /.. 12, Lell Imounll fllirl hv/for horrnw.r lIin~ :>:>01 I .. 1 no,. leu r"rtur.'inn\ in .moun' riut! ullll' IIIn.520t ,- r)'';' 58 )3, CASH I ill FROMl (" TOI BORROWF R q74 Iq~ 603, CASH 1'0/ TOI ,,, FROMl SELLER -0 .. SOlIC1T,.T10N -/ 995 "Setttement Sl8ttmtnt U,a. DI, ,~..... of HouIInI Md \JrbM DI.11c.. LIlMt APPliCATION . HIJOo'!MIl MlII'A,H843OIl2 OIolB No ~-o?ft~ ..._~~'lIT.A. T1llII...-~ IT afLDIn DfllA . D'...... :lPCorw,u.- a VA J a ec.w I.- HOrt: rNllbtrftlllumleMdfiOf#wet'D"..,.,....",oI.'....",."..,.'eoefil A~pMd,.,~"""....",."..,.''''''''...,.,.., """""""",..0.'- .....peId.,...... "..efN/nf'''''''''' """"' '*' lot 1n1Ot"..,.",.,~ .,wi,,. tto4 ~kJdfd""'" fofM &,..- , loen Number . _,_c..- You IN reQUIred by I.. '0 pt'~ thII MttltfM"' 10"" wtth your correct I._ p.y.r Id."IIUeaUon nu",,*. "you do not pnrrktl the..".......,., eo-m wtttl your coned lPpllyM' 1denllllCl1lon "u"''*, you m.y be .ublect to cl...1l or crlmln.1 pen.IIl..,,,,poMd by I'. CERTIFICATION U"dtt "",I,n.. of _jury,' oMUy tN, the ""mbtr ~ on ''''I O'I,,",,nll' my eorr", ta.,.,.,.....tftClI1tOn ftUfNiIf, S.n,r',51 n.turI 9.U.'" ~l n.lur. SaU.,., 51 "1Iur. Slln~'ITUff ,oqq Th,lnlo''''llIon contllned In hlockt E, 0, H,l, M '"d on IInfl4011,I"'JH)III"III- In"",,,.llnn Ind II belnQ lu.nl,hed 10 IhI lnl"nl' A.wlnu, Sarwln II vou "I 'eQulrld 10 III'. return, L ~lIve"C' Pln'Ily or olh" ..ntIIO" will be Impoud on yOU Illhtl 111m II requl'''' fa be ~td Ind lhalRS dllttmlnet Ihlll, hll nol been reported, .~ APPLICATION' PAGr 2 L, SETTLEMENT CHARGES 100, TOTAL SALESIBROKE R'S COMMISSION hllP" on I'"'' $ ~ 'lI.' PAID FROM PAID FROM /J'~/sj(Jn of Cumm;ulon (1m, IOOJ,s lollows BORROWER'S SELLER'S IUI. $ 10 FUNDS AT FUNOS AT 102. $ 10 SETTLEMENT SETTLEMENT 103, Comrnlulon oaid.t Selllemenl 104, 70S, , 1100, ITEMS PAYAOLE IN CONNECTION WITH LOAN HO\. lo.n O,igin,lIon FfltI 'llo 1102, Lo.n Oilcount '110 1111:1 Am".,..1 Fn ." 1104, C,edlt f1l'pOft '0 R05 lende,', Irnooellon Fu IIU6, Mort~agl' In,uraner ^Ilpllcation F"r 10 U07, Auumplion Fee IIOU, ilU~l. UIO, ,000. ITEMS REOUIRED BY LENDER TO U~ PAID IN ADVANCE ,001. Interest from 10 "'$ Id.v , 001, Mortgdge Il1Iur.nce P,emlum for months to ~ 003, HoI/ard Imurlnr:t' PremIum tor yellin to 004. yur, to ! !lO5. ! 1000, RESERVES DEPOSITED WITH LENDER t'UU\. H./,urlm"Ir,UII;l! mUlltln (ill $ pN munlt' 1002, Mortgago insuranco monlh, @ $ p'" monlh 1003, City flfoperty lue, munth, (Ill S pl'r month -,U04, County property ...el munths Ciil S IlI!r month 1005, School property tues monthl tfi) S per munth 1006, lotn,im .nenmunt momhs ~... S l)er mnlllh 1007, munth, (pi S I)r.r mOn1h 'OOR, month, r~ S IHlrmfllllh 1100, TITLE CHARGES \':>\J-;/ER 1.)10 fJd r w f\ 'fT "TIT Le 1101. Sellleme"t or e1o'lng 'eu 10 .-l....,..IS v,z. A ~./(~ (r drJ- 'rl U~_ <;:e-A4.r..N 1102, AbUnct or title ,earch 10 1103, Title !kamlnation 10 1\04, Title imurance binder 10 1105, Document pre~arallDn 10 1106, NOla,v I.., lu 1107, Allornev', fco, to line/lid". ,bovlI itom, nu",/Jlffl,' I 1106, Tille Insurance to T,A. TUlelnlurllncB Co. (lncludl1s If' '0' 101'04 I I I 1100, Lunder', cover.ge premium . $ 1""'IlIUIII CUVUI' bUill 1101l "" 1110 1\ 10, Ownnr', coverage $ ,.,."uo 01. 1111. Disbursoment cherge to 1112, End #100, End #300, End # 10 1\ 13, 1200, GOVERNMENT RECOROING AND TRANSH R CHARGES 1201. Aocnuhng hUI': DudS 13,50 , Mortgsl,!' S ; Rnluw $ I::' ';''1 12U2, Cily/county lu/"amp,: D..d $ . MUlII","" S '-, 13 12U3, Slale tax/Uamp,: Deed S ; MOIll1'Otl S "'I I.. 1204, 1205, 1300, ADDITIONAL SETTLEMENT CHAnGES Nor ASSllONAIlU TOANOIHrll CATEGOny 1301. Sur VI!Y to 13U2, Pit" I",peclion \0 1303. Broku,', "rvlee, 1304, Deed preparalion 1305, -rAy r:t.",I'v' (1t/~,..",.... fCI~f'I~ (J "'A"'.~ v, '~?9: 't"J "lq4"'tY\ .,.s 9?" ,,/ 1306, I...~.~ IS IV"''/ r"fI,,,,r. T.c, , " '1 " '17' .;~ .- "I I.. , 1307, 1308, 1309, 1310. 1400, TOTAL SETTl EMrNT CHAnGFS /t'1I1r'r on IIII",~ 10.1 S,.rrmn J dlU/,lin:' 54'rlm" J(J ~ ';r-. "'''/'-;' =" 11111 u/lI''''''1IIII'11 I,rltlllY ,II .II"WI"I/I/I' "", ,..,,,III1,,lflllll ."111 '1"'Jlf/~,,1 "I 0'" \1,""11,,'11' ,lit.' "'11"'" '"II I 1I/1r (.11I1I''''''~ u. &JI"'l"'" ,1/11 ,lIiiml"/I'U hi m"." dlJIl/bllllon alld ptfynl'tU, lit ICco,cJtlnrto hrH'Wflh 'nil" It "y","d 0"" ''''''''''''y ,IUlIm".I till Iltl/HMy'm ,,'" tlcru'"'y III ".",lIIy III ","US ", "I.,g" no' 'r"o..d by tOfnlJ,ny or IIJ' ",l"", 10 Includ" on "II' Sf.lflm.nl ""m. I" ,II..,g..\ nol d,Jf/"..!,d'O tOfT'plny ", ..""m"", BUYERS: ,\,', , " .'",\_v_ SELLERS: (J.,df,\I'''(d~.r. ti..,,,l,,',, , ' I A/lDI/ESS: NEW ADDI/ESS: , lrv.uoeUtpollJ '* SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Ploo.. Print or l' 0 FilE NUMBER ~"~~~tlr.l1~lll"HIA 'll1SlD'iHT" oic'iDiHi Clara M. Wilson " (An ...-otY 1olo11\ ........ with .... ...", .. ...........hlp ..." ... d'"....d .. Sc........ ') ITIM NUMBIR DISCRIPTION YAWl AT DATI OF DEATH 1. Pa Dept. of Revenue tax refund 539.96 40.00 2. Ring S 579.96 (Attach addU'....I.". .. 1t~ .......,1..... IflOCO" .HCIecI,1 ,_~fJ .' ',~. 'C! c .f'l.lJOtl1+ (11-11I . COMMQNWIAUH 0' PENNIYLVANIA lNHUI1ANC! TAX Il:UU.N .(IIDINT DIClDINT SCHEDULE F JOINTLY-OWNED PROPERTY ISTATI 0' PILE NUMBER Clara M. Wilson JoIn' 'onon'I.I. A. NAME Carol J. Freeland ADDRESS 1203 Indian Peg Drive Mechanicsburg, PA 17055 ----_.__.- -_._----_.~-_..'.,... -.-., . RELATIONSHIP TO DECEDENT Granddaughter B. C. Joln,IYoOwMd proparty. ITIM LITTIR DATI I'OR NUMBil JOINT MADE DESCRIPTION 0' PROPERTY TOTAL VALUE DECD'S DOLLAR VALUE OF TlNANT JOINT OF ASSET '"' INT. DECEDENT'S INTEREST 1. A 1990 PNC Bank Acct.#5l40469292 21753.98 50% 10876.99 TOTAL (AI.o ont.r on lino b, Rocapllulatlan) S 10876.99 (II moro 'poco It n..dod In.orl odd/Ilona' .h..I. 0' .omo .1..) .. 1I\l.1J1I fl. p.,'1 J:~'~ -~ COMMONWEAlTH O' 'ENNSYlVANIA INHUIrANCE TAX irWIN IlUIDIN'DfcrOINT ISTATIO'C1 . - - ara M. Wilson ~ SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES PI.a.. P,lnt or Typ. ITIM NUMBER A. " B, 1. DESCRIPTION AMOUNT 2, Attom~Fo.. Kent H. Patterson 1500.00 Fun.ra'bpon..., Cocklin Funeral Home Tionesta United Methodist Church Lucille Wilson 231. 00 100.00 25.00 Admlnl.tratlvo Ca.t" Porlonol R.pro..ntotl.. Comml..lon. Soclol S.curlty Numbor 01 Perlonol Repro..ntoti..: Yeor Comml..lon. paid 3, Famtiy Ex.mptlan Claimant Relation.hlp Addro.. 01 Claimant at decedent'. d.ath Stroel Addro.. 4, C. 1, 2, 3, 4, 5, 6, 7, 8, CIty State Zip Cad. Prabate Fo.. 66.50 MI...llan.ou. Exp.n..., Register of Wills 25.00 3.60 7.00 95.00 The Guide West Shore Shopper Cayman Landing(Treasure Lake Assessment) The Bargain Sheet Naco(Treasure Lake) 4.00 104.00 100.00 87.14 Joseph Falcetta Rivera Utility TOTAL IAI.o enlor on line 9, R.capltulation) (If mOrl .pac. I. n..d.d, In.." additional .h.... of .am. .1...) s .. .1~1J111" 1'011I . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE L1ABLlTIES AND LIENS PI.a.. Print ar T . fIll NUMBER COMMOHWlAUH Of PlNN''f'l'-aHIA tHHI......kCllA..UU.H InIOINlOle'OINI mATI Of Clara M. Wilson ITIM DISCI'mON AMOUNT NUMB!R " Internists of PA 6.69 2. Surgical Physcians 8.38 3. White Rose Ambulance 76.05 4. Therapy Care, Inc. 572.00 5. White Rose Ambulance 25.87 6. Dale, Woodard, Montgomery & White 283.00 7. ATS Medical Services 15.39 TOTAL (Aloo .nt" on IIn. 10, Rocopllulollonl (If mol'l 'Pa.. I. nHdod, In..'' addillonal .h.." 01 .am. "..,) $ 987.38 . ,-; ,<r~' '~"'!"jto~~!J1~W.t~J'I!ltlo/l....~:~,hi;y~J .;(.jJ.,::2~;;;:28.:~t2V'';-*'1.'l]]';j--,:~'~~fl;;':i .. SCHEDULE H (continued) Estate of Clara M. Wilson 9. Naco(Treasure Lake) $ 99.50 10. Cumberland Law Journal 60.00 11. Patriot-News Co. 67.30 , . 12. Tax Claim Bureau of C1earfie1d County 876.97 13. Lee Ann COllins, Tax Collector 65.59 14. Naco(Treasure Lake) 15.00 15. Reserve for Costs 50.00 16. Treasure Lake property Owners Assoc., Inc. 17. Gary W. Fisher 51. 50 18. Treasure Lake property Owners Assoc., Inc. 1072.85 Total $4706.95 'i '. ~= " IIV.I~IHI. 1"1) * (o-OltWIAlIH Of '1 NkinVANIA INHII,'AH(I ,.. IUUIH ..... _ _~!JI~IH' DlCIOIH' J SCHEDULE J BENEFICIARIES ISTATI O. .ILE NUMBER Clara M. Wilson ITlM NUMBER NAME AND ADDRESS O' BENEPlCIARY RELATIONSHIP AMOUNT OR SHARE O'ESTATE A. Talilabl. BaqulIlIl 1. See attached list. ITEM NUMBER NAME AND ADDRESS O' BENEFICIARY AMOUNT OR SHARE OF ESTATE B, Cha,llabl. and Gavornm.nlal BoqUlIlII \, TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (AIlo .nlor an lin. 13. Rocapllulallon) S (If more .pan I. ft..d.d, In..rt additional .h,.tl 0' 10m. II..) Name Address Relationship Amount or Share of Estate Robert L. Moore 3008 West Country Club Grandson 1/14 Drive, Irving, TX 75038 Darlene Reigle 1285 North Vine Street Granddaughter 1/14 Middletown, PA 17057 Marlene Ellersick 301 Lauberman Cres. Granddaughter 1/14 Rochester, NY 14620 Carol J. Freeland 1203 Indian Peg Road Granddaughter 1/14 Mechanicsburg, PA 17055 Hilda Runk (nee. R.R. 1, Box 305 Granddaughter 1/14 Custred) Spring Mills, PA 16875 Albert Moore 303 Vanessa Drive Grandson 1/14 Pleasant Gap, PA 16823 Dortha Weaver 7397 Otisco Valley Road Granddaughter 1/14 Preble, NY 13141 Robert M. Allison Box 37 Grandson 1/14 Central Bridge, NY 12035-0037 Joan M. M Box 61 Granddaughter 1/14 Marshall White Lake, NY 12786 Richard L.Allison Rt.2, Box 213, Cora Grandson 1/14 Street Gassville, Arkansas 72635 Patrick L. Bielby R.D. 2, Box 230- Grandson 1/14 Saltzman Road Blossvale, NY 13308 Allan Allison 43738 Beech Avenue Grandson 1/14 Lancaster, CA 93534 Deunning Allison 43738 Beech Avenue Grandson 1/14 Lancaster, CA 93534 Mark Allison 43738 Beech Avenue Grandson 1/14 Lancaster, CA 93534 Robert Allison 20 Willey Street Son $500.00 Albany, NY 12203 Irving Allison, 43738 Beech Avenue Son $500.00 a/k/a Donald Lancsa tar, CA 93534 Allison ATTACHMENT SCHEDULE J BENEFICIARIES CLARA M. WILSON ~_,-~~~:_'~'~<",-';"__ ..0..-_........_ . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUR!AU OP INDIVIDUAL TAXEB DEPU8Oe01 HARRISBURG, PA 1712lJ.OllOI RECEIVED FROM: r KENT PATTERSON eel PINE STREET HARRISBURG, PA 17101 FClO HERE . ESTATE INFORMATION: FILE NUMBeR , -- -, ~... - .,..~... --... , , .."-'-'--'--';";"; -,;";-,,;,,._.;"'_..~....,--"';-'-'~----__________-i.; PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT '* No.AA 324353 REV,,,",, '"' I""" ACN ASSESSMENT CONTROL NUMBER AMOUNT tn, ...l.all=fl ~Q ,- FaD""'" (Mil . -.":P-:. / NAME OF DECEOENT lLAST) N CLARA M OATE OF PAYMENT I 4 99B POSTMARK DATE COUNTY R OATE OF OEATH REMARKS KENT PATTERSON SEALCHECK" NO CHECK .. (FIRST) TOTAL AMOUNT PAID $548.59 PB I 'I I REGISTER OF WILLS RECEIVED BY MARY C. REGISTE I ~-------------""'---:::'"..~~.-.~-"~7"""-'---------------7-:"-'-:---r. ....: , ' . . ' . . ." \' " ~, . ""' ~ ..t ~._-."- , .,--------....;J 1i~ ~-~,' .....':-. ,I : \, --- ,-' --'" -.....'" ...,.- . L. __. ._. _._.____... __ - - ".n .... _._ "' ~ >_.~- ---...----.--.. -'-- _._- -- COMMONWEALTH OF PENNSYLVANIA OEPARTMENTOFREVENUE BUREAU OF INDIVIDUAL TAXES OEPT,280601 HARRISaURQ, PA 11128_1 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT . No.AA 324443REY'''''U(''''', RECEIVED FROM: r ACN ASSESSMENT CONTROL NUMBER AMOUNT -, CAROL FREELAND 1203 INDIAN PEG RD t 01 "~bD "'0 MECHANICSBURG. PA 17033 ~. ;' """HERE ESTATE INFORMATION: FILE NUMBER RllD HERE (loll) NAME OF DECEOENT (LASn W L ON ARA M DATE OF PAYMENT 12/22/1998 POSTMARK DATE 0/0010000 COUNTY CUMBERLAND DATE OF DEATH TOTAL AMOUNT PAID $548.59 REMARKS CAROL JEAN FREELAND DO RECEIVED BY /.. l.tA, t "'" MARY C. L 18 ll/ /).Ar~ REGISTER F' WILLS/-r)1U!,1 q V' SEALCHECKlt 1993 REGISTER OF WILLS --- ----- ---- - - - - -- --- - ---------- ----.,--- -~___---,.,.I 'J. "I t, of . ,\ ' , . ~.. . ' ... .. . ; " " ok' .~ ~ . . ,) I r' , -, ", \' ~, r .... . 'f .._-- , -~ ~~-A-d 4. -~. ........- : , ,,~.- . --:--...,..- r \., BUREAU OF INDIVIDUAL TAXES JNItRlTAHCE TAl( DIVISION DEPT. ZIID6DJ IIARRISIURG, PA 171Zft-D60J COMMONWEALTH OF PENNSYLVAN.' DEPARTMENT OF REVENUE .. NDTICE OF INHERITANCE TAX APPRAISENENT. ALLDWANCE DR DISALLOWANCE Of DEDUCTIONS AND ASSESSHENT Df TAX ....unn "'ltt-". KENT H PATTERSON 221 PINE ST HARRISBURG " 1 ~ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN M 03-22-1999 WILSON 1]-]3-]993 21 95-0598 CUMBERLAND ]0] CLARA PA ~~101 r:"UI. A_aunt Re.l Hed MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CD COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ..... RiV:is4rix--AFP--ioii:m--iioTici--OF-i-riHiififAN-CE-;'iiX-A-ppiiiiisiif€iiT~--Ai:rciwAiicE-O-R----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WILSON CLARA M FILE NO. 21 95-0598 ACN 101 DATE 03-22-1999 TAX RETURN NAS. I X) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..l Eat.t. (Schedule A) 2. Stocke and Bonda (Schedul. 8) 3. Clo..ly Hald stock/Partnarship lnt.r..t (Schadul. C) 4. Harig_g../Not.. Receivable (Schedule DJ S. C..hl8ank Deposlta/Hisc. Per.onal Property (Schadul. E) 6. ~olntly Owned Property (Schedul. F) 7. Transfera (Schedule 0) 8. Tot.l A...t. I CHANGED III 121 13) (4) 15) 161 171 942,56 ,00 ,00 .00 579,96 10.876,99 ,00 181 HOTEl To insure proper credit to Your account I sub.it the upper portion of thia for. with your t.x p.Yllent. 12,399,51 APPROVED DEDUCTIONS AND EXEMPTIONS: 4,706,95 9. Funeral Expens../Ade. Co.ts/Hi.o. Expans.. (Sch.dul. H) (9) 10. n.bt./Hortgag. li.bilitJ../L1.ns (Sch.dule X) (10) 987.38 11, Tot.l D.duotion. 1111 12. N.t Value of T.x R.turn (12) 15. Charit.ble/Govarn..nt.l B.qu..ts, Hon-.l.ct.d 9113 Tru.t. (Schedul. J) (13) 14, N.t V.lu. of E.t.t. Subj.ot to T.. 1141 NOTE: I~ an assessment wes issued preViously, lines 14, 15 and/or 16, 17 end 18 will reflect figures that include the total of ~ returns assessed to date. ASSESSMENT OF TAX: 15. A.ount of Lin. 14 .t Spou.al r.t. 115) ,00 X, 00. ,00 16, A.ount of Lin. 14 t...ble at Lin..l/Cl... A r.t. 1161 6,705,18 X ,06. 402,31 17. A.ount of Lin. 14 t...ble .t COU.ter.l/Cla.. B r.t. 1171 ,DO X ,15. ,00 18, Princip.l T.. Dun 1I8) 402.31 ~,6q4 ~? 6,705,18 ,00 6,705,18 TAX CREDITS: PAYHENT DATE 12-22-1998 RECEIPT NUHBER AA324443 DISCOUNT 101 INTEREST/PEN PAIU 1-) 146,28- AHOUNT PAID 548,59 BALANCE OF UNPAID INTEREST/PENALTY AS OF 12-23-1998 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 402,31 ,DO 8,82 8,82 · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN fl, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT"' ICR), YOU HAY BE DUE t ",.,.,..,.. "'r... .."',.......... ........ ..... _.,..... ........ ....... ...,..._......_..._.._ . Inventory 01 the real and personal estate 01 Clara_M~,Wi.Laon.______._ decoased No. 1995-00598 Real Estate - Lot 241, section 16, Treasure Lake Subdivision, Sandy Township, Clearfield County, PA PA Dept. of Revenue Refund Ring 1. 2. 3. t- " ,',' Y',\ ;~\, f'J C"c, '<t - >- "" ~.:: .; ~ ,- ~ rC -- "f :::; iJc..: 942 56 539 96 4000 TOTAL 1522 52 r COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUM.IRLAND UI Carol Freeland b.lng duly sworn .ccordlnll to I.w, d,poslI .nd s.ys th.t sh. ---------,.- is the Exec~~___ of tho EIl.t. of Clara M. Wilson lat. of __J10ru:.oe ,ToWIl.snip. __.'. n.___ _____, Cumba,land County, Pa" d....s.d and thl! tha within Is an Invontory made by ...___..CarDLJ:'J:.ee.lAnd.-. ,__ _ --.-, th. ,ald-IDl.ecutrix ,_.- of tho .ntl,o ..t.to of ,aid d.c.d.nt, conshtlng of .11 th. p.non.1 p,op.,ty and ro.lllt.t., ....pt ,..1 ..tat. ouhld. tha Commonwoalth of Ponn'ylvanl., .nd thot tho flllu,os oppollt. ..ch Itom 01 tho Invento,y rop,ount It', f.l, valuo .. of tho d.to 01 docodont', d..th, Sworn .nd ,ubscrlbod boloro mo, fLjJ~M Eltul., . Admlnl,",'.r Carol Freeland 1203 Jndian Peq Road Mcchanicsburg, PA 17055 19 .,,~ NOTARIAL SEAL ---, TIM R SPR1NKLElHotary Public I Mechanlcaburg eoro. Cumbtttlnd CaUl '~, , M Com I 'II!" Add,... D.to of D..th 13 NOV~illper 1993 DIY Month v.., INSTRUCTIONS I. An Inventory mull b. fll.d within thr.. month, .flor .ppolntmont of p.nonol roprount.t1vo. 2. A ,uppl.m.nt Inv.ntory mull bo fll.d within thirty d.ys of discovery of .ddltlon.llluh. 3. Addltlonol ,huh moy b. ett.chod II to po"on.lty or roolty 4. S.. Artlcl. IV, Flduclorlll Act of 1949. 0. '" <Xl .c .... en E c Ul III W 0 ~ .. C M 0 ~ ~ Ul .. 0 0 M 0 u Ul .... !1i u I 0 'rl E-t u .. ... III 0 w 3: Q '" Q) ~ a:: .. .. en l- i!: .... u. Q) .; A- ~ E en Z -' . 0 ~ 0 ..... u. -' ~ 0 :i: ... A- ~~ W 0 < c i: > z a:: III 0 ~ 0 ... :Ii: c Q ~ . on Z III ~ II: 0 a:: M Z W < ... A- U ." ~ c C ... .. Q) "C 0 u :.; .J) ... ... .. E . .. 0 .. ~ u: 0 -' U ... _,-. __...'...~.._-o, , - , _.__ _._ _.._. .________.__w"________......._-_. ~.^~..-.. "-~-..".. - ~-.---.--....- _....__ __.______.___.....~___ __0__-__- COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF REVENUE BUReAU OF INDIVIDUAL TAXes OEPT,2B0601 HARRISBURG, PA1712S.0601 '* No.AA 354832REV'''''EXI'''''1 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT RECEIVED FROM: r ACN ASSESSMENT CONTROL NUMBER AMOUNT ,j PATTERSON KENT H eel PINE ST 101 lSR.RP HARRISBURG, PA 17101 . . FOIDHW FCllll H<RE "- ESTATE INFORMATION: FILE NUMBER 21-1990-0098 SSN 1b3-12-09~9 NAME OF DECEDENT (LAST) IFIRSTI (MI) WILSON CLARA M OATE OF PAYMENT 3/14/1999 POSTMARK DATE 0/00/0000 COUNTY CUMBERLAND OATE OF DEATH 11/13/1993 REMARKS KENT H PATTERSON ESQUIRE TOTAL AMOUNT PAID S8.62 PB / RECEIVED SY MARY C. L REGISTER Fl~ILLS W~fAA}4..'.~ SEAL CHECK" 3853 REGISTER OF WILLS 01 . . 1 .. ~__,....,.,.,_____..__ __....~._____......,,~..o_._._..:~.~._-.__.~..,........._____.______ ; .-_.. ..~ ., -i' ,I . I " \' ", ., ' ", I . . ,( ...... -." "---- ... ~---..AJI .. _ -~" ...... ~ . j ~ )'-- ---~. 1- BUREAU OF INDIVIDUAL TARES INHERITANCE TAX DIVISION DEPT. U060l HARA151URG, PA 171rl-D6DI COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE J:NHERJ:TANCE TAX STATEMENT OF ACCOUNT ~* .n.lur".,'lll-.,. KENT H PATTERSON 221 PINE ST HARRISBURG I " 1 DATE ESTATE OF DATE OF DEATH FILl! NUHBER COUNTY ACN 06-14-1999 WILSON 11-13-1993 21 95-0598 CUMBERLAND 101 Aooount R..l Hod CLARA M " ! PA\~7101 ell MAKE CHECK PAYABLE AND REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE I To In.u.... proper credit to your .cc~t, .ubIIlt the upper portion of thl. fa'" with your tax pa)fltel'1t. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ii!'y:i6ii7'-ix-"FP"COy:97y------iiiii;-iiiiiiR'iTAiicE"i'Ax-si'A'TEHE'IWOF-;.crciiuNr-iiiii--------------------- ESTATE OF WILSON CLARA M FILE NO.21 95-0598 ACN 101 DATE 06-14-1999 THIS STATEMENT IS PROVIDED TO ADVISE DF THE CURRENT STATUS OF THE STATED ACN IN THE MANED ESTATE, SHOWN BELOW IS A SUllttARY OF THE PRINCIPAL TAR DUE, APPLICATlOll OF ALL PAYIIENTS, THE CURRENT BALANCE, AND. IF APPLICABLE. A PROJECTED INTEREST FIGURE, DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT, 03-15-1999 PRINCIPAL TAX DUE" 402,31 PAYMENTS (TAX CREDITS), PAYMENT DATE 12-22-1998 05-14-1999 RECEIPT NUMBER AA324443 AA354832 DISCOUNT (+) INTEREST/PEN PAID (-) 146.28- 8,82- AMOUNT PAID 548.59 8.82 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE 402,31 ,00 .00 ,00 . IF PAID AFTER THIS DATE. SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST, I IF TOTAL DUE IS LESS TMAN U, NO PAYMENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YDU HAY BE DUE A REFUND, SEE REVERSE SIDE OF THIS FORM FOR INSTR\lCTlOllS. I PAMNTI DetMlh U. top portion 0' thh Hotlc. MIl tut.1t .,lth your ptI)'Hnt .... p.yetll. to the ,... .xl eddr... printed on the rev.r.. aide. If AUIDEKT Il(CEDDfT .... check or ~y or"'r p.vlld. tOI REGISTER OF WILLS, AGENT. If NON..Rtl.IDOtT Il(CEDEHT ... check or ~Y order p.vllbl. tal CottttONWEALTH OF PENNSYLVANIA. RUUND (CA)I A r.fund of a talC credit, Wllch .,a. not reque.ted on the hlC R.turn, ..y be r.....ted by cOIIPI.tlna an -Application for Ra'lI'td a' Penn'Ylv.nla l""'rltanc8 .xl E.tat. Tn:- lREV"UU). Applle.t1on. ar. ""U"'la at the O'flca 0' the RIlI1st.r of "Uh, ."v of the lS R.venue DI.trlct Offlc.. or 'rOIl thl Dep.erbMlnt'. 24"haur ~..,.rlna ..rvlea nuaber. 'or far.. orderlngl In Penn.vlvanla 1"laa"S6Z"ZISa, out.lde Penn.vlv."la ..s ..athln loc.1 Hlirrlsburll ar.. (717) 717-IOM. TOOl (7171 77Z"Zl52 U..arlng I.alred onlyl. REPLV TOI ...Uon. rqardlng .rror. contained on thl. notice Ihould bft eddr...'" tal PA Pepar....,t a' R.v...... lur... of Indlvl~1 TalC", ATTNI po.t A....seant R,vlew unit, Pept. '10611, Hlirrllburll, PA 17121"0601, phone (7171 717"6505. DISCDLIIT I PEHAL TV I INTEREST I If MY tax 0.. II paid within thr.. UI ulllndllr .x1th. .ft.r the decedent's ....th, a flv. pareent (5XI dhc~t of the tax ptI1d I. allowed. The 15% talC ~.tv non"partlolpatlon pen.lty I. coaputad on the tot.1 0' ~ t.lC and Int.r..t .......d, .xl not paid before J.nuIry 11, 1996, the flrst d.y .ftar thl end of the t.x ..-.ty period. Int.r..t I. ch.rged bftglnnlna with flr.t d.v of delinquency. or nine (91 eonth. ~ onI (11 day froe the dlt. of death, to ~ dlt. of Plv-ant. Tlx., which bee... delinquent b.for. Janu.ry I, 19" bftlr Int.r..t .t the r.t. of .1. CAXI plrcent par ~ calcul.ted at a dally rat. of .000164. All tIXI. which bee... delinquent on .xl .ft.r J.nuary 1, 1912 ..111 bft.r Int.r..t at a r.t. which will vlry froe c.lender YI.r to c.lendar Yllr ..Ith that rat. announced by the PA Dlplrtsent of R.v~. The ~llc"'l. Int.r..t rat.. for 19" through 1999 .r.. V..r Int.r.at R.t. DeilY Int.r..t FlOtor V.er Inter..t Rat. D.llv Int.r..t FlOtor ,... lOX .00054_ 19&1"1991 IlX .IOUOl 1915 lOX .00041. I... OX .101147 1914 IIX .010SOI 1995"I994 n .100192 ,..S 15>. .0"S56 1995"199_ OX .001147 '916 lOX .IIIZ74 1999 n .000192 1..7 9X .100247 --Int.r..t I. celcul.tad .. follow'l IIlTEIlEIIT . BALANCE OF TAll UNPAID X "UnDER OF DAYB DELI"QUEHT X DAILY IIlTEIIEIlT FACTOR -..Any Notice Issued .ft.r the t.x bacOll. delinquent will rlfl.ct ~ Int.r..t c.lculatlon ta fifteen (151 dey. bftyond the data of the .....lMOt. If pev.ent Is .... .ft.r the Int.r..t coaputaUon data shown on the Notle.. addItional Int.r..t .u.t be c.lcul.ted. " JRD/June 30, 1992/17858 REGISTER OF WILLS Cumberland County Courthouse . 9ne Courthouse Square Carlisle, PA 17013 NOTICE pURSUANT TO RULE 6.12 PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULES To: Personal Representative Counsel: KENT H. PATTERSON, ESQ., REI E5\ate of C'r,lI.RII. M WlT,!mN I Deceased, Late of MONROE TWP E5\ale No.: 2l~95~59B Date of Decedent's Death: NOVEMBER 13 , 1993 Pursuant to Rule 6,12, the above named personal representative or the above na,"ed auomey, If applicable, within two (2) years of the decedent's death, and annually thereafter until administration 15 completed, Is required to file with the Register of Wills a Status Report as required by Rule 6,12. In substantially the prescribed form, showing the date by which the personal representative, or auomey, as applicable, reasonably believes administration w1\l be completed, The purpose of this Notice Is to advise you that ualess the requisite Status Report Is filed with the Register of W1\Is or Clerk of tho Orphans' Court, as appropriate, within ten (10) calendar days after the date of this Notice that the Register ofWUls Is requited to ootlfy the Orphans' Court Division, Court of Common Pleas of such delinquency and to request that said Court conduct a hearing to detennlne whether sanctions should be Imposed upon the delinquent penoD81 representative and the delinquent personal representative'S counsel, If any. Accordingly, If the requisite Status Report Is not filed by DEC. 20 . 19.,2?you are hereby advised that a request wU\ be submlUed to the Court in accordlllCC with Rule 6,12, Date: DECEMBER 4, 1995 '--l0./cuJ))'~ltu,j].1!t1L..d-lf Deputy Register or. 1\Is Distribution to Estate File JRD/June 3D, 1992/17858 Or:r: :' liOr.f5 Ii' InRe: Estateof C1araM Wilson Late of MONROE TOWNSHIP ORPHANS' COURT DIVISION, COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA Estate No.: 21 - 95 - 598 No, NOTICE OF FAILURE TO FlLE CERTlFlCATlON AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE S.6(e), SUPREME COURT ORPHANS' COURT RULE Personal Representative: Carol Freel and Counsel for Personal Representative: Kent H. Patterson Esq. Date of Grant of Original Leners: AU9ust 10, 1995 Date of Delinquency Notice: December 5, 1 '195 The undersigned. Mary C, Lewis, Register of Wills, in accordance with Rule 5,6, Supreme Court Orphans' Court Rules, hereby nOlifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal represelllative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or Its certification required by Rule 5.6(d), Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 5,6(e), Supreme Court Orphans' Court Rules, was given by the Register of Wills on December 5. , 1995, and that the ten (10) day notice to file the certlficallon has expired. Accordingly, In accordance with Rule 5,6(e) the Court is hereby notified of such delioquency and the undersigned requests tbat a Court conduct a hearing to determine whether sanctions should be Imposed upon the delinquent personal representative or counsel for the delinquelll personal representative, @ Date: December 20, 1995 Distribution: Personal Representative Counsel for Persooal Representalive Estate File 0 .n/_ A HEARING IS SET FOR ~:J hJJ. 7 ./1Pt2-AT I/:(f() /1.111. IN COURTROOM NO. 1. ~ " IF THE CERTIFICATION OF NOTICE IS FILED PRIOR TO THE HEARING DATE. THE HEARING WILL AUTOMATICALLY 8E CANCELLED. ~ ~ L ~,,1 F ~~<z O-tZ -&-u...e9.. .;)- \ -L( 10 .fTrJ LD E. SHlELY, .. !t....,.. " , STATUS REPORT UNDER RULE 6.12 Name of Decedent: Clara M. wilson Date of Death: November 13. 1993 Will No. Admin. No. 598 of 1995 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: Yell No xx 2. If the answer is No, representative reasonablY believes complete: February 1997 3. If the answer to No.1 is Yes, state the following: state when the personal that the administration will be 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. ~ t- /ff~ ll"ignat.ure Date: 2/16/96 ("\ c - Kent H. Patterson Name (Please type or print) 221 pine street Harrisubrg, PA 17101 Address -- \i .' ('; ",-1 ~ ~_l <..;,1 (7171 738-41 nn Tel. No. ,,- \...... " lIt) Capacity: Personal Representative )( Counsel for personal representative (MAH:rmf/AM3) , . JRD/June 30, 1992/17858 In Re: Estateof CLARA M. WILSON Late of MONROE TWP ORPHANS' COURT DIVISION, COURT OF COMMON PLEAS OF CUMBERLAND COUNTY I'ENNSYL VANIA No. 95-598 Estate No,: 21-95-598 NOTICE OF FAILURE TO ALE STATIJS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: CAROL. FREELAND Counsel for Personal Representative: KENT PATTERSON, ESQ., Date of Decedent's Death: NOVEMBER 13. 1993 Date of Delinquency Notice: DECEMBER 4. 1995 The undersigned, Mary C, Lewis. Register of Wills, in accordance with Rule 6,12, Supreme Court Orphans' Court Rules. hereby notifies the Orphans' COUrl Division. Court of Common Pleas of Cumberland County, that neither the above named personal represenlative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his. her or its Status Report required by Rule 6,12, Supreme Court Orphans' Court Rule and that the requisite notlCClbPursuantto Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Register of Wills on EC. , 19:':. and that the tell (10) day notice to file the Status Report has expired. Accordingly. in accordallce with Rule 6,12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative, Date: n"''''''MR'''R-2.B. 1995 "-/) (C/.;'t..l,.jC, 'iu~ fU"c&)11,~Lt( J ~u Mary C,lewis, Register of Wills I Distribution: Personal Representative Counsel for Personal Representative Estate File A HEARING IS SCHEDULED FOR FE..IJ....t" ~1t3t- IN COURTROOM NO. 1. I F THE STATUS -REP~ is' FILED DATE. THE HEARING WILL AUTOMATICALLY BE CANCELLED. AT II: (/~ A.",. PRIOR TO THE HEARING ~u \.l!...LL.lul :2.. :22-CILP , C/ Register of Wills, Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedentl Clara M. Wilson Date of Deathl November 13, 1993 will No. Admin. No. 598 of 1995 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 1 Yes -1L No 2. representative complete 1 If the answer is reasonably believes No, state when the personal that the administration will be 3. If the answer to No.1 is Yes, state the following 1 a. Did the personal representative file a final account with tho Court? Yes No -1L 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-X- The heirs have been notified that the estate is insolvent and that there will be no distribution. d. Copies of receipts. 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 report. Datel ,,~- 22.-1'7 {~A1J .;:- /LU~ Signatur ' '-'j c_ Carol J. Freeland Name (Please type or print) e, N 1203 Indian Peq Road , . ''''.. 'J\ :J\ .:: _1 (..J C.: Mechanicsburq. PA 17055-9798 Address (717) 245-2404 Tel. No. Capacity I -X- Personal Representative Counsel for Personal representative