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No. 21 - 95 - 817
Estate 01'
GRACE MILLAR
, Deceased
nEClum 01: 1)I{OnATE AND GRANT ()I<' LETTERS
AND NOW. NOVE.MBER ~_ 19~~, In con,iderallon of Ihe pelitlon 011
Ihe rel'er'e ,Ide hereof, ,all,fllolor)' 11Illllf lu\\'ing heen preSCIlled hefore me,
IT IS DECREED HUlllhe inMrlll11enl(') dllle,L,_1\.UGUST 3~ 1981
de,cribed Iherdll he IIdl1lltted 10 probllle IInd med of record "' Ihe 111'1 will of
GRACE MILLAR
TESTAMENTARY
SHIRLEY 0 TUCKER
IInd Lellers
lire hereby grllllled 10
FEES
Probllle. Lellers. Elc. ......." $ 115.00
Shorl Cerlificlltes(2) .......... $ 6.00
R~'/I1c1nlion ................ $ 5.00
- age S 3.UO
JCP TOTAL S :'.00
NOVEMBER 1.-rgg5---1~4.o0
Filed ................................,..
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MARY C. LEWIS
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COMMONWEALTH OF PENNBVIlIANIA . DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
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De uty Coroner
DAlIIlOHlO~.Dtt""l
Se t. 13 1995
MWl AHO,lDON" "q()HWtC)ClOtM'LIlIOCAUII 0# PUfH
,..,,,,.......... Gerald R. Stei91eman e8pQ~~r
~ II 405 Fairway Drtve,Mech. PA 17055
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LAST WILL AND TESTAl-IENT
OF
GRACE~. ILI.AR
I, GRACE H. ILLAR, now residing in the City of
Cleveland, County of Cuyahoga and State of Ohio,
being of lawful age and of sound and disposing
mind and memory, and under no restraint, do make,
publish and declare this Document to be my Last
Will and Testament, hereby revoking and annulling
any other Will, Wills, Codicil or Codicils by me
heretofore made.
ITEI1 1.
I direct that all of my funeral expenses and expenses of my last illness shall
be paid out of the principal of my Estate, first of all and as soon as prac-
ticable after my decease.
ITEI1 II.
I give, devise and bequeath all the rest, residue and remainder of my Estate,
of whatsoever kind and deacription the same may be and wheresoever the same
may be situated, which I may own or have the right to dispose of at the
time of my decesse, to my Son, JOliN C. TUCKER. In the event my said Son,
JOliN C. TUCKER, shall fail to aurvive me, and only in that event, I give,
devise and bequeath all the rest, residue and remainder of my Estate, as
aforesaid, to his living issue per stirpes.
ITEH III.
I hereby nominate and appoint my Son, JOHN C. TUCKER, as Executor of this
my Last Will and Testament. In the event my said Son, JOliN C. TUCKER, shall
fail to survive me, or surviving me, shall be unable to qualify as my said
F.xecutor, or having qualified as such Executor, shall become disqualified,
or shall become deceased during the pendency of the administration of my
Estate, then I nominate and appoint SHIRLEY D. TUCKER us Successor Executrix
in his place and stead.
Having full confidence in both of the persons named herein to serve as my
Executor and Successor Executrix, respectively, I direct that they shall,
in each instance, serve in such capacity without the giving of bond.
I hereby authorize and empower my aaid Executor, or his Successor as named
herein, to compound, compromise, settle and adjust all debt:s and claims
-
~ !JILL AND TESTAHENT
(IF
GRACE!!. ILLAR
ITEM 111. (Continued')
which may be presented against my Estate, and which may be due my Estate,
and to sell at public or private sale, at such prices snd upon such terms
of credit or otherwise as my said Executor, or his Successor as named herein
may deem best, .the whole or any part thereof, specifically including my
real estate, and to execute and deliver proper instruments of conveyance
thereof to the purchaser or purchasers, and I further direct that no pur-
chaser or purchasers from my said Executor, or his Successor as named herein,
shall be required to follow the proceeds of said sale, but they and each of
them shall be exempt from any liability for purchasing said property from
my said Executor, or his Su ccessor as named herein, as they would if they
were purchasing it from me personally.
In order that my Estate may be expeditiously administered, I hereby author-
be and empower my said Executor, or his Successor as named herein, to
distribute any of the assets of my Estate in kind, at their discretion,
without the leave or confirmation of any Court.
IN WITNESS WHEREOF, I have hereunto set my hand at the end of this
Instrument, consisting of two (2) pages, which I declare to be my Last IHll and
Testament, and I have identified the preceding page by writing my name on the
margin of same. Done at Cleveland, Ohio, this 3 day of a7/~~.J r ,1981.
A..,l..l.- 1;11 JtL~'-'0
The foregoing Instrument was signed by the said GRACE H. ILLAR, in our presence,
and was by her to us acknowledged and declared to be her Last Will and Testament,
and we, at her request and in her presence, and in the presence of each other,
have her nto set ur hands liS sUbilryibing witnesses, this :3"( day of
. "/" . , 1981.:d
",' ((:.l~7. residing at;.] 7. A/
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This Instrument Prepared By:
PAYNTER AND KOHLER
Attorneys and Counsellora at Law -2-
8905 Lake Avenue Suite 0210
Cleveland, OhIo 44102
651-2070
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21 - 95 - 817
REGISTER OF WILLS OF CUMBERLl\ND COUNTY
OATH OF SUBSCRIBING WITNESS
codicil
(each) a subscribing wltnC5s to the will presented herewith, (each) being duly qualified according to
law, deposc(s) and say(s) that prC5ent and saw
the tC5tPI . sign the same and that signed as a witness at the
request of teswl In " presence anti (In the presence of each other) (In the presence of the
other subscribing witness(es)).
Sworn to or affirmed and subscribed before
me this day of
19
(Name)
(Address)
Register
(Name)
(Address)
REGISTER OF WILLS OF CUMBERLAND COUNTY
OATH OF NON-SUBSCRIBING WITNESS
JOliN C. 'I'UCKER and SHIRLEY D. TUCKER
(each) a subscriber hereto, (each) being duly qualified according to law, deposc(s) and say(s) that
they familiar with the signature of GRACE M. ILLAR
lt~
will
testal r i x
that
they
presented herewith and
codicil
believes tbe signature on the will Is in the handwriting of
of (one of the subscribing witnesses to) the
Grace M. Illar
to the best of their
knowledge and belief.
Sworn to or affirmed Ilnd subscribed before
me this 27TH day of
,OCTOBER , 19 95
, 4" ' "I ",/ '/'! II. l \ /
,),..,~{ .j" 1(".' f-I-I ~ i - tf'~Jt~1
. IMAR~ C. LEWI S ' Registe~' I
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(Name)
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21 - 95 - 817
RENUNCIATION
In Re Estate of
GRAce /\1 T:L.LllfC,
deceased.
To the Register of Wills of
rUMI1FI! I_A,,'17
County, Pennsylvania.
The undersigned
:Jt'j (J tV c... "'f'" II t'_ k L-~ fJ.. !j Co' JJ
,
of
the above decedent. hereby renounce(s) the right to administer thc cstatc and respectfully ask(s) thai Lellers
S)-finLP:Y 1) "'i"-i.J...../~iFR
be issued to s"'i(~L(!'f " ~l)f-.I<("fn
WITNESS
hand this
day of
.19_.
4169
LI\V'~E,-h.I~MRf:,&'leC 111,
(Addres.) J
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(SI8nnlure)
(Addr...)
(SI8nalur.)
(Addres.)
JRDlJune 30, 1992117858
(.lili:: n 7 1$16/1'
In Re: Estate of GRACE MILLAR
Lale of LOWER ALLEN TOWNSH I P
Estate No.: 21 - 95 - 817
ORPHANS' COURT DIVISION,
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSVL V ....NIA
No.
NonCE OF FAILURE TO FILE CERTIFICATION AND REQUFST TO
CONDUCT A HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT
ORPHANS' COURT RULE
Personal Representative: SHIRLEY D TUCKER
Counsel for Personal Representative: JOHN HAVAS ESQ
Date of Granl of Original Letters: NOVEMBER 1, 1995
Date of Delinquency Notice: FEBRUARY 2. 1996
The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6, Supreme Court
Orphans' Court Rules, hereby nOlilies the Orphans' Court Division. Court of Common Pleas of
Cumberland County, that neither the above named personal represcnt:uive nor Ihe 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 Orphan.~' Court Rule and thaI the requlsile
nOlice, pursuanlto Rule 5.6(e), Supreme Court Orphans' Court Rules, was given by Ihe Register of Wills
on FFRRIIARV? . 19....26 and that the ten (10) day notice 10 file the certificalion has expired.
Accordingly, In accordance with Rule 5.6(e) the Court is hereby notified of such delinquency and the
undenlgned requests tbat a Court conduct a hearing 10 determine wheUler sanctions should be Imposed
upon the delinquent personal representalive or counsel for the delinquent personal represenlative.
Date: MARCH 7, 1996 '7'('L. A. ,-(0 ~Dl J!./.l..Yl) A fJ-Jn rGt::w {JAXi::u
'Mt;drLe~is, Regi:ler'of Wills. U (j'
G~'
Distribution: Personal Representative
Counsel for Personal Representative
Estate File y ~ , I 00/- II . A7l A /YI
A HEARING IS SET FOR /YJ/t -'\7i /r1JCJ AT .vV ,,,,,
IN COURTROOM NO.1. ./
IF TIlE CERTIFICATION OF NOTICE IS FILED PRIOR TO THE HEARING DATE THE HEARING
WILL AUTOMATICALLY BE CANCELLED. ~ I . ( \' (
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,(:, h rl ,\ II :/(,- 1fI\ROLD E SHEELY P J
.
CERTIFICATION OF NOTICE UNDER RULE
Rocor(I.' . 1,1i,~o 01
Rctj 'k c:l V'/illr.
5.6 { a}
Name of Decedent:
Date of Death:
Will No. 1995-00817
To the Reglster:
Grace N. ILLIIH
'?6 APR 17 1'12 :13
09/10/95
Clo~:. .-.. I '. ~ ~I,i Court
liurt:'. t.,.,.. ';""0' rA
Admin. No.
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
Name
JcH.\l C, 'TL-'c.I..;:e/~
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Address
470'1 l..AuRG'L DR.,~'r;; HARt.:;6 (\1IJ<!C~, f'
"110
Notice has now been given to all persons entitled thereto under
Rule 5.6(a) except Nor-lIE'
Date:
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Signd'ture if
Name S H i ~ La: 'I D l'u t:. kG R
Address '+'0 9 LA u,q L=-L D /Q.', \/e
H/\ R. ,;z j .s r:l v Rt"_ PA 17/1 0
Telephone ( ,,") .:t.'!:.? "'1"\ <;/ >I
Capacity:
x Personal Representative
Counsel for personal
representative
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RG PA 1? J
PM
OCT
3
1996
4ARRISBURG PA ]
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...\~ t-',. g
I
,
FIRST CLASSI1AIL .
I
I
.
..---
---. -. .----. ".-..4lf.~ -, .''11..
; ... - - ,
I s- /.;t.f- :r
"',!!,'O ,.. ,"" INHERITANCE TAX RETURN
lOW.lttJ,'.IJ.lIII III 1"I'#I"'L~'''f,A RESIDENT DECEDENT
<I"'''.''''' Of ""fr. ITO BE FILED IN DUPLICATE
{'HI 1~[1f;1l
"""""'''''. ,., u,,, ,.'n' WITIl REGISTER OF WILLSI
~--=::::--- -j'\ltir'[~lt=1IiI.4f~(i~1.,7jTf,~f--:ArlC\-:fn,r'(lli-~"ill' --, --
If line 19 is Ufealer than line 18, ~n't!' the dlfferencu on line 10, This IS the OVERPAYMENT.
A. 0 Check he,e II you .,e roque.lIno e ,olund 0' you, ove'p.yment.
If lme 18 IS u,ute, than line 19, enter Ihe Ihffelenct! un LUlu n lIlIs IS the TAX DUE.
A. rnler the mterest on 'he balllnct! dllll onllllt! l1A.
n. [nle, the 101al ollme 21 and 21A Oil Line 211I. TIllS is lht! BALANCE DUE.
Mike ChICk PI ,bl. to: hglller 01 Wills, A.~nl
~ ~ BE SURE TO ANSW~U QUES.Il!!N.S ON REVERSE~E AND TO RECR~A TH ~ ~
Un~" ~.n."'" of f"July. I ~.:I.I. Ihrl I II... ."lTIontJ lh'l 1.'llln, m,!ud.n} ':C(f"f."~'n, ,,"'.J"ln .~~ IHlpmllnll, an1 10 Ih. hll {,t m'j' ~nc"I.,., ..,1 ht"t, 11'1 "u', CellI:1 I"J
cempl'I' I dler"e lhal ,II Inl IIlIle hll hen IIperted 'l!ru' mlthl _IILle O,~II'lllu" ~I fl~pllr {Jlhll H,ln lh, p~ltrI1.t If'PI..nl.I._. '1 tlnd en all,nlcffTlllwn lil ,,""th fllfl'4t
"'II any ~no"l.d~.
~
""..
.. -..
u"u
~tg
U :: m
..
""
...
"Z
......
.."
..Z
""
u..
Z
"
I"
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~
0:
""
u
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"
I"
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..
lLLAR,_GRACE.M,_._____j_...._ . 824 LISBURN ROAD APT 510
\OW.l ..tllof-,Ih 11....4b11i [lid 1 01 1'1':'111 P':'f1 Of hlFiltt CAMP HILL, PA 17011
28S.:.09.:AB13 09/10/95._ . 03/26/1L_ """,I-CUMBERLAND-------.---...
(I' AHU(AfLlI S\Jfl"I~'I'j!i 51'{JllS( Ii 1IA1"IILAH_II~~_' "'10 ',':_:~:. ~,[){.IAI <'((.1+11, Ij'I',lfill, ~,.IDtfH Htlli'lO I"H Irl')TI"J(.TjO'j~'l
LX] Ollglnal flelllln 0 '], Suppll!l1l1!lllal III! 1111 II l_J J Ilr""1111l!er IIl!hlln
tlllt dlltes ofdl!ath pllOl tll !1.1J,1I11
D 01. lllntell Ls1ltl! 0 h ft/tllll! Intt'''~'' Cn".lJOllnn O!j l..d"'81 ht8le Ia. Relurn Reqlllfl!t1
IIllf dalu 0' d!!llll nilI'I 1'1.1'1.11'11
[X] 6
..
Z
...
"
...
u
...
..
"AME
PETER A. GERBERICH
TUEh1Qtl[ U\JMBER
ill1J.ill.:!!6
1. fleal htah! (Schedule AI
2. Sloch and Bonds lSchedule 01
3, Closelv Ueld Sloc..'Paltnenhlp Inletest IStht!dule CI
.. Motlgagn and Uoln ReceIVable ISchedule hI
!J. Cluh, Oan~ Deposits & Mlltellaneous Penonal P,ope"..,
lSchedule U
G. JOlntlv Owned ProperlY (Schedule FI
7, Tnnllen ISchedule GllSchedule LJ
8. Tolal Gfon Anels 110111 Linel 1.11
9 runefal hpenses, AdlJlnistrallve Costs. Miscellaneous
hpenseI ISchedule '"
10. Debls, Motlglgu Liablhtlu. Liens ISchedule II
II. 1011I1 DeductIons UOllllmes 9 & tOt
12, "el Value ot Estate lLine II IJlnus Lme III
13 Challtable and Govelnmenlal Bequuts ISchedule JI
u. flet Valtlll Sub'nel to Tullmo 12 IIlnus lmll 1:11
I!J. Spousal T'anllen 1101 datn of death altel6.30,O"1
Sea InsHUello"' 101 Apphtable Pt!lcelltnglt on fltlY.llSt!
Side. Untlude vlllun hlllll Schedulll K Of Sthl!t1ule M,I
16.
Amount 01 Lino 101 tRllllblu at 6% lalu
lInclude valul!I horn Schedule K III Schedule M.I
Amount ofUne U IDublo nll!j", fnle
tlnclude valutls ham Schedule K 01 Sthl!dule M I
Pllncipal tilt dUll IAtld lu frolll Lmes I!J. 16 nntl In
Cledns SpoUSllI PovetlV C,edlt Puo, PaVlIIents
1011 DalES Of DUl" AJUIl "/Jl/Il
If A SPOUSAL 1 I
'6Vlft'L~ftlPIl II Cl'''''IP ._ ..
flU NUMBER
.:;;
HUll
II.
18.
19.
7P.
n
CIUCIl
!-Itrlltjl',
21 95
(Ot_IT. to[{ IIJ.I<
.. (;j"'i.li'ti-c;.ti~i.,;,,-;
0817
1~r1,'Hf'
it 8
fnlalllultiler of Safe Oepo!"'t UOles
SHOULD BE DIRECTED TO:
COMJ1.ET[ MAlllflfi AOON'>S
P. O. BOX 6595
HARRISBURG, PA 17112
I II
171
I 31
141
I 61
o
80 ,.3.BL.Jl..
o
o
1 .9..5.4....3.6..
. -;
I 6 I
171
4,083.46_
0_
18'
86.425.13
191
7.0BLK
liD I
2...0.5.3...5.9...
1111
1171
tlJl
"
9.138.43
77.286.70
0.00
8 0
ll!i1
,.
110 I
77 ..211..L1O..' .06-
4.,..6.3L.21_
1171
)l .15_
1181
4 ..6.l1,.ll.
OISClltml
IntereS!
110 ,
170 I
1711
171A I
17111 I
4.637.21
4.~.JL.21_
SIG/jATUl1[ Of f'lRSOII '~[Sf'otj"lDL[ fOil fIlUm RElUltfl AOtH',s
_ ~((4."L..., D...l. "'T" .-'od'ji~,v: 1"/C~. 47.0!L~UREL_PRIY'LMMISBJJRG,._PA__17.l1P_
5Ift;4i"iJi\i Of "'~(I'~Ul HtAIl f\(I'NSlIHATlVl"" A{J(:f,[\';
__r~ lA. J)~k.1A.___J.1.~L._t-.L._I'I../,.,_C(\'~_~!.llLIt ~L'-'LJ..JJL~
~\'IU~' IODn
DATE
_J!,t--~L_
[lion
'0_1.01.
__J____.LI"__.
COMMOIIWEAllll 01 !'[llIISYI VAIIIA
IIlllIlllIAIICE 'AXIIIIUIIII
IIESIIIUI1 1I1CIIlIIlI
ESTATE OF
SCHEDULE B J
STOCKS AND BONDS
. ,:=::~=:;;,:,-:=;;:"-:=-:C:;:'--"'_~-=~:;;;'=-;:C;';.:;;-=~'_ '
filE NUMBER
fI(v.I!lO] Ell tlAUl
GRACE M..JLW 285-09-4873 ..2.L?.5 0817
lAlLJwrJW1v o1ollV:llwnd...wl1hJ1lgbLIIUUI.diRuhlp_mul Lb ,-dll~lul .Lun..ichuduluJ.
IIJ~E~II OISCIlI!'lI01I
I 1271.789 SHARES OF USAA INCOME STOCK FUND. VALUE PER WALL STREET
JOURNAL ACCOUNT NUMBER 35900502527. $ 15.24
VAlUE AT UA IE
or OEA 111
19,382.06
2.
3901.246 SHARES OF USAA INCOME FUND. VALUE PER WALL STREET JOURNAL
ACCOUNT NUMBER 40900803335. $ 12.32
US SAVINGS BONDS H SERIES FACE VALUE $13000. VALUE PER BANK
48,063.35
12,941. 90
3.
1_0TAL l^"a .."IN on line 2, Ill'upilllll'!,olll
11'",tl' If'(' I' ".d.d. ,,,..!! .H",~".I I~"'I [;1.,"" .,,.1
s
8.0.1.3-8.1....31.
'WUllttlOll
fif v '~nll Il. Ii I'll
WMMO'h"lAlltl 01 HI'i\ll~Alr"
IHHlRIUHC( 1 All: flnUflH
_____~ ~~...flJIIOlHl. .Ol~lD~HJ __
ElffA-ifoF---. ._._..m____._.-________ - -." "'"
SCHEDULE E
CASH. BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
..__.._-~-~-. -----~ -- - - -- -----
,-,"-----"" ",,-,,----
I
m. L______-"I!'_"l'l!n,-" Iypo__.__ .__.
. -. - fllfNuriBEii- ----.------
.GRACE_M.. ILLAR.___ 2 85 :.1)2.:4 813___._.. _____.__._.
_____ .______.--21...95-0.81.7
l!!!.1!!I!!!LJ!!!.~! :!'!w-,!!~!,!~~_~~jl~~~!l,vlw!!!.~j'~...!I!I.-!!_~I~~~!!!~._~~ _'_~~1I~1. ,J ,__
ITEM
NUMBER
1.
~WUOIIOJO
DESCRIPTION
VALUE AT
OA TE Of OEA TH
2.
FURNITURE . VALUE BASED ON SALE-.PRICE-OF. FURNiTURE
PERSONAL EFFECTS . NO APPRAISAL THE DECEDENT LIVED FRUGALLY IN A
RETI~ COMMUNITY
USAA DIVIDEND FROM INCOME STOCK FUND
USAA DIVIDEND FROM INCOME FUND
PENSION RECEIVED 9/1/95
REFUND RENTERS INSURANCE
REFUND FROM BLUE CROSS FOR PRESCRIPTIONS
REFUND FROM DOCTOR
100.00
275.98
312.10
174.46
55.00
661. 97
74.85
300.00
3.
4.
5.
6.
7.
8.
TOTA~ IAllu t!1I1~' 11/1 111Il! !I, n..cllpllullt1/11/l1 S
tAllith IdJ,t,cnal (! 1/1' . 11. Ih"U II",,,,, If';:' IIIIIIIhrl I
..9.5.4..3_6_
H ~ IlU~ II. (11 fl'l
[[)f..I'-'Ofh'.I'11t1 {I' 1-1111',11\41....
II,UIl1lUIII:1 UI HILI"',
PlSlr'trH (HIl'f'"
ESTAliof~'~c==~~=,=,c=....c=-:=:=,
SCHEDULE F
JOINTL V.OWNED PROPERTY
.O'.....c..c=,.= f1IE-liuMBER=="=====
.GRACE...M..-ILLAR
2B5.: 01:.4B 1.3 _____ _...
2L9..5_0.817
J.lnll,n,nllll:
NAME
A.JOHN TUCKER
__~PI!JlE~L_
4709 LAUREL DRIVE
HARRISBURG, PA 17110
RHA TIONSHIP TO DECEDENT
SON
B. SHIRLEY TUCKER
4709 LAUREL DRIVE
HARRISBURG, PA 17110
DAUGHTER-IN-LAW
C.
J,ln11r.,wad prop'rly:
LETTER DATE
ITEM fOR MADE DESCRIPTIDN Of PROPERTY TOTAL VALUE DECD'S DOLLAR VALUE Of
NUMBER JOINT JDINT Of ASSET 'I. INT. DECEDENT'S INTEREST
TENANT
1. A * US SAVINGS BONDS FACE VALUE 5,673.56 50 2,836.78
$1200 VALUE PER BANK
2. B * FULTON BANK CHECKING ACCOUNT 2,072.24 50 1,036.12
NUMBER 3219-05383
3. C * PNC BANK SAVINGS ACCOUNT 421.12 50 210.56
NUMBER 51-3043-2752
* = ALL ASSETS WERE JOINTLY
OWNED FOR MORE THAN ONE YEAR
PRIOR TO DEATH OR WERE
PURCHASED WITH ASSETS SO OWNED
TOTAL 'Also enllll 1111 IllIe O. nl!tHplIulallOll1 S 4,083.46
SWU011000
1I11MI. 1~1:" .. "..1.1, In..I! IH,'nllll I~"l. ul II"" ""1
!1(V .I~ 11
fI,'.P.'Pl
:J SCHEDULE H
FUNERAL EXPENSES,
to""~;~;'~'~~:~1 ~,:I~:I;'~~r~"" ADMINISTRA TIVE CDSTS AND
",,,,,,"I "''''..,,_____.u__N.lJS.CELLAN_EOU~_. EX~H~.S.E_S__._____ Pi.... Prlnl" T,P'
=~ LLAA-~~-;~02.4~;;3 __uu__~_u__ _.- ,-,u-u~u_---~=-r:;:M:.:~
ITEM
NUMBER
A.
2.
B.
1.
DESCRIPTION
AMOUNT
1.
fun,.al ExPInI":
BRICKMAN & SONS, INC. Ftnl~~ HOME
CEMETARY, FLOWERS, MEMORIAL SERVICE, AIR FARE, REGISTER OF WILLS
4,994.87
1,839.97
Adrllnllulllu COIU:
Perlonal Representllive Conr"Ulons
Socill Security UUlmer 01 PersDnal Rep,esentative:
Yur ConninlDn. plid
2. A ttorney Feu
3, famly herJ1ltion
..
C.
1.
2.
3.
..
I.
6.
1.
6.
!W4rG4100G
Cllimanl
Relalionship
Addrul 01 Claimant II decedent'1 death
Street Add,e"
cny
Statl!
Zip Code
P'obale Feu
MlluUanuul Explnsn:
JOSEPH J. MACK & ASSOCIATES, P. C. ACCOUNTANT FEE FOR PREPARATION
OF 1995 INCOME TAXES
250.00
TOTAL IAllo tlOlll' un Imu U. fleupllllhlllonl
s
Ui.
III ria,. 'pIC' II nndad. Inn.. ,dlllllon,I Ihll'l .1 "'" IIII,J
. ' , .
fl(V.I~1J it. 11871
SCHEDULE J
BENEFICIARIES
COMMOtIl't'UUH OJ I'lfll':ilLVA',U.
INH(RITANC[ TAX fI[TUflN
flUIDENT DICtD(NT
~
fiLE i'-UMBER
ESTATE Of
LW,
13.5.....o.B 7
285-09.487.3
ITEM
NUMBER
AMOUNT OR
SHARE Of ESTATE
NAME ANO ADDRESS Of BENEfiCIARY
RHA T10NSHIP
A. huble Bequests:
1.
JOlIN TUCKER
4709 LAUREL DRIVE
HARRISBURG, PA 17110
100.00
SON
ITEM
NUMBER
NAME AND ADDRESS Of BENEfICIARY
AMOUNT DR
SHARE Of ESTATE
B. Charihble Dnd Oove,nltl6nlal DequllIll:
I.
TOTAL CIIA",IAhLE Aim OOVtlUIMtllIAl UEQUES1S IAI.o n,,'" 0" hn. 13. O".pllnl"..,,1
III..". "IU I. ......, I...,t '''i11...1 ...." ,I ..... ,III'
S
swmllOOO
,!-AST illh h!iQ :P;ST A1l1m!
91'
QM.~~ !.t. I.~y.y.
ITJ:Il III. (Continued)
~Iich ~ay be presontod apainst ~y rostato, nnd which ~ay be due ny EBtato,
aud to 6011 at puulic or priveto BOle, lit such pricos and upon such tet'1:'JI
of crudit Dr othONi". n~ r.:y said r.y.ccutor, Dr hiH SUCCe"HOr ns nn,.,,,d hcroin
l!\IIY deon ueHt, to\(.! IIholn or nny part thereof, np"cificnlly inclu,!inr cy
relll estate, nnd to ey."cut. nnd deliver proper inntrumentH of convuyance
thereof to the purchaser Dr purchaAero, and I further direct thnt no I'ur-
chasor or purchasoru frol'll oy said txocutor, Dr his Succeusor a6 nn!:ed herein,
shall be required to folloll the proceed. DC snid sale, but the>' nnd uer:h of
thoc ohell uti exempt from eny liability for purchaBins said properey fro~
my aoid Extlcutor, Dr hio Su ccosoor liS Dal.ed herein. aB they would if they
IIere purcheBin~ it froo me personally.
In order thAt my Eotate 03Y be expeditiously adminhtered, I hereby author-
he and empoller my odd (;"ocutor, or hio SucceaBor os named herein. to
distribute any of the usets of oy Estote iD kind, at their diocretion,
IIithout the leovo or confirmation of any Court.
,
I
r
I
I
I
I
m IHT!I!:S!l IIlIERf.OF, I hav" hereunto sat my hand at the end of this
InotrulWnt, consisting of two (2) pagos, which I declaro to be my !..Aat \:111 nnd
Testaoent, nnd I hnve idcntif1N! the prucedin~ PIlRe by IIritinr. I11Y nnme OJl the
margiD of BlIl'lle. Done at Clevelond, Ohio, thio a dny of ~~~__,1981.
tf/ .
-.L.~J"-(~~ .m
..a.[(~
1'he fotC!.lloinn Instrur.umt IIno sio,nnd by the anid Gl,,\Cr. H. ILLAP., in our preuenc!!,
and WlIG by her to un ncl:no,'l~.!rl,J an.! duclRrod to be her l"'Ht Will Ilnd .cntlllllont,
lInd \JD, at her re~ueBt and in ller I'regenCe, nnd in the preneneD oC ench other,
ha:l9 hereunto aet our hands no Rubncr1hinR ,,1tneu~s, this ....2.__ doy DC
C"U~}(..~ . l\l~l.
,f
/I)
~.
~., ac-e
A'C/-1e- tD;'
f
(~
/1
't"'-/;;:x...:..____ r<!" id 111/\
.~. / ."//'
3 t. )- ~L?I f-t-r ft': C1.
. ./
" - //., ~
..u:tC(/P tN.-it ~ / "t:.--t--
/It _.L~.3.2 /2b'7'--lr~~/ __
_.f.t::L;(.~_t~'t. ~( c-d~__
renidinR nt
1niu Instrument rrupore~ By:
PA\':lnk ANI) KOIlL!:r.
Attorneys And Counnollon Bt La"
6\105 Lake Avenue Suite /210
Cleveland, Ohio ~~l02
G51-2070
-2-
C.!'ti..J(
,
;; / c :h.<-<,{~.,/
/l . "./"
/'tl'r;.. t~.(..... I'-d~ {P../
I.r;:~; ,! Y
BUREAU OF INDIVIDUAL TAXES
IHlllA.lANe[ laIC DIVISION
D[Pt. 2BOUI
UARRISBURG, PA 111la-OUI
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NDTlCE OF INItERITANCE TAX
APPRAISEHENT. ALLOWANCE OR DISALLOWANCE
DF DEDUCTIONS AND ASSESSHENT OF TAX
PETER A GERBERICH
PO BOX 6595
HBG PA 17112
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
02-03-97
ILLAR
09-10-95
21 95-0817
CUMBERLAND
101
~
AMount R_hilt.d
c/
~......
~r6J1 . . ~,\
"'J}
'''-:'"'01'' III.hl
GRACE
M
MAKE CHECK PAYABLE AND REMIT PAYHENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiili: is'4TEif -liF'P-n Z:9&Y" HiiWe n)'F-YNH Eiii filiic E - "fAX - iipiiiiii i 5 Eif€Hi'-;- Ii [i.-owA NCE- cli-- - - - on -- - -- - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF IlLAR GRACE M FILE NO. 21 95-0817 ACN 101 DATE 02-03-97
If an assessment was issued previouslY, lines 14, 15 and/or 16, 17 and 18 will
reflect figures that include the total of ahh returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Lin. 14 .t Spousal
16. Anount of Lina 14 t.~.bl. at
17. Anount of Line 14 taxabl. at
18. Principal Tax Due
TAX RETURN WAS I C X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST . SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I Estat. CSchedule A) el)
2. Stocks and Bonds ISchadule OJ 12)
3. Closely Held stock/P.r-tnarshlp Int-rast ISchadul. C) (3)
4. Hodgagu/Noha Racalvabl. (Schadule DJ (4)
S. C..h/Bank Deposits/Hlsc. Parsonal Property ISchadule EI (51
6. Jointly Owned Property ISchedule F) (6)
7. Transfers ISchedule G) 171
8. Total As..h
I CHANGED
.00
80.387.31
.00
.00
1.954.36
4.083.46
.00
CBI
APPROVED DEDUCTIONS AND EXEMPTIONS.
9. Funerd Expenses/Adm. Cosh/Misc. Expensu (Schedule HI (91
10. Debts/Mortgage Liabilities/Liens ISchadule I) (10)
11. Total Deduction.
12. Net Value of Tax R.turn
15. Ch.rit.bla/GoYern~ental aequests (Schedule J)
14. Net V.lu. of Esht. Subject to Tax
7.084.84
2.053.59
Clll
U21
U31
U41
NOTE:
rat.
Line.l/Cl.ss A r.t.
Coll.t.ral/Class a rat.
USI
UbI
1171
.00
77 . 286 . 70
.00
x .00=
X .06=
X .15=
llBI
TAX CREDITS:
PAYHENT
DATE
10-03-96
DISCDUNT "1
INTEREST C-I
131.72-
RECEIPT
NUHBER
AAI46815
AHDUNT PAID
4,637.21
INTEREST IS CHARGED FROM 10-04-96 TO 02-11-97
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
NOTEI To in sur. proper
credit to your account,
subftit the upper portion
of this forn wi th your
hJ( pay",ent.
86.425.13
q . 138 43
77.286.70
.00
77.286.70
.00
4.637.21
.00
4.637.21
4.505.49
131.72
4.26
135.98
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION DF ADDITIONAL INTEREST.
IF lOTAL DUE IS LESS TItAN n. NO PAYHENT IS REQUIRED.
Ir TOTAL DUE IS REFLECTED AS A "CREDIT" ICR) I YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FDRH FOR INSTRUCTIONS. I
RESERVATIONI E.tata. of d.c.d.nt. dvlng on or b.for. D.c..b.r IZ, 191Z .. If anv future Int.r.'1 In Ih. ..Iel. I. Ir.n.f.rr.d
In po.....lon or .nJoy..nt to Cle.. I Ccoll.l.r..) b.n.f.cl.rl.. of the d.C.d.nt .flar the ..plratlon of .ny ..t.t. for
Ilf. or for y..r., the Coa.onw..lth h.r.by ..pr...lv r...rv.. the right to appr.I.. and ...... tr.n.f.r Inh.rllanc. T....
.1 Ih. I.wful CI... a Icoll.l.rel) rala on .ny .uch future Inlar..t.
PURPOSE OF'
NOIICEI
To fulfill tha raqulra.ants of S.cllon ZI4D 01 Ih. Inharlt.nca and [.t.la Ta. Acl, Act ZZ of 1991. Il P.S.
Sactlon 1l"0.
PAVMENTl
Datach tha top portion of this Notlca and subalt with your payaanl to the Ragl.tar of Will. prlnt.d on the r.var.. .Ida.
..H.... chac" or .on.y order pavabl. tal REGISTER OF HILLS, AGENT
All pay.ant. r.c.lvld .hall flr.t ba appllad to anv Int.r..t which .ay b. dua with anv r..alnd.r appllad to the ta..
RErUND tCR), A r.fund 01 at.. cradlt. which wa. not r.qua.tad on tha Ta. Raturn, .av ba raqu..tad by co.platlng an "APplication
for R.fund of p.nn.rlvanla Inharlt.nca and [.tata Ta." CREV.ISIS.. Application, .ra av.llabla at tha Office
of tha R.gl't.r of Wills, anv of the lS R.v.nue Ol.trlct Dfflca., or bV c.lllng the .pacl.1 Z4.hour
.n'warlng ,.rvlc. nueb.r. for lor.. ordarlngl In Pann.vlvanla 1-IOO'S6Z.Z0S0. oul.lde P.nn.ylv.nla and
within local H.rrl.burg .r.a (717) 717-1094, TOO' (717) 77Z-225Z (H.arlng I.p.lr.d Only).
OIJECTIONSl Any parly In Int.r..t not .all.fl.d with Ih. .ppr.I....nt, .llow.nc. or dl.allow.nca of d.ductlon., or ........nl
of t.. (Including dl.count or Int.r..t) .. .hown on thl, Notlca au.t ObJ.ct within .I_tv C6D) d.y. 01 r.c.lpt of
this Nollu bYl
"wrlthn prot..t to the PA aep.rtlll.nt of R.v.nu.. lo.rd of App..Is. a.pt. l1ll021, tt.rrhburg, PA 11Iza.IOll, OR
--.I.ctlon to hlva the ..tt.r d.t.ralnud .t audit of the .ccount of the p.r.on.1 r.pt...ntatlva, OR
--.pp..l to the Orph.n.' Court.
AOHIN
ISTRAIIVE
CORRECTIONSI
rlctu.1 .rror. dl.cov.r.d on Ihl. ........nt .hould b. addr....d In writing tal PI D.p.rt..nt of R.v.nue,
Bureau of Indlvldull T.IlI', A"NI Po.t A.......nt R.vl.w Unit, a.pt. l.o.OI, tlarrhburg, PA 111l1'0601
Phon. (111. 711'650S. S.. p.g. S of the boo"l.t "In,trucllon. for Inherlt.nc. T.. Return for. RI.ld.nt
D'c.d.nt~ (REV'ISOIJ for an ..pl.natlon of adalni,tr.tlvelv corr.ctabl. .rror..
DISCOUNt I
If .ny taw due Is p.ld within thr.. U) caland.,. .onth. .tt.,. the d.ced.nt', d..lh, a flv. p.rc.nt CS~) dllcount of
the t.. p.ld I. allaw.d.
PENAl TVI
th. 15~ ta_ ..n..ty non-p.rtlclp.tlon panalty I. co.puted on the total 01 the t.. .nd Int.r..t .......d, .nd not
p.ld b,'or. J.nuary II, .9U, tho Ilr.t d.y .tt.r the and of the taw a.nnh p.rlod. This non'p.rtlclpaUon
pen.lty I. app.alabl. In the .... _.nn.r and In the the .._. tl.. p.rlod a. you would app..1 the ta. .nd Int.r..t
Ihat ha. b..n .......d a. Indlcet.d an thl. notlc..
INTERESTI
Int.r..t I. ch.rged b.glnnlng with fltst d.y of d.llnqu.ncy, or nln. '9. .onth. .nd one (1) d.y froa tho d.t. of
d..th, to the d.l. of pay..nt. T.... which b.ca.. d.llnqu.nt b.for. Janu.rv I, I"Z b.." Int.r..t at the "at. of
.1. (6~) p.rc.nt p.r .nnu. calcul.t.d at a d.lly r.t. of .00016~. All t.... which b.c... dellnqu.nl on and altl,.
J.nuarv I, 19'2 will b..r Int.r..t .t a rat. whiCh will vary Irol calandar y..r to cal.nd.,. y.ar with that ,.el.
.nnounC.d by the PA D.part.ant of Rav.nu.. Th. .ppllcabl. Int.r..t rat.. for 1911 through 1991 ar'l
'!!!! Inl.r..t Rill. Dally Inte,.nt Factor !!!! Inla,...1 R..t. allllY Int.r..t ractor
I'al 2'U .OO05U 1911 "' .000l47
1915 16~ .0001011 191.'1991 1I~ .000501
191" IU .000501 1991 "' .0002'101
I9IS U~ .000356 199J-199~ " .000192'
1986 10~ .000:14 199\'1997 "' .OODh7
--int.,nt II c'lcul.t.d .. follawlI
INTEREST . BALANCE or TAX UNPAID X NunSER or DAYS DELINQUENT X DAILY INTEREST rACTDR
--Any Nolle. 1.lu.d .,I.r Ih. ta. b.co... d.llnqu.nt will r.fl.ct an Inl.r..t calculation to Ilft..n II'. d.YI
b.yond Ih. d.t. of Ihl ........nl. I' p.y..nt I. .IId. .ft.r Ih. Int.r.'1 co.pul.tlon data ,hOw" on the
Notln. addlllon.1 Inl.'n' au'l b. c..lcul.l.d.
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DNo.AA185145
uY.lw.a......
COMMONWEALTH OF PENNSYLVANIA
DI'ARTMINT 0' RIVINUI
OffiCIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
..
RECEIVED FROM,
i
ACN
ASSESSMENT III
CONTROL IilI
NUMBER
AMOUNT
SHIRLEY 0 TUCKER
4709 LAUREL DR
101
$1:1::'.90
HARRISBURG, PA 1?110
'OI;D"'"
ESTATE INfORMATION,
f:II FilE NUMBER
g 21-1995-0817
f:II NAME Of DECEDENT (LAST)
I;iI I LLAR GRACE M
~ DATE Of PAYMENT
Iii Oe/0b19?
m POSTMARK DATE
COUNTY
SSN 285-09-1,873
(fiRST)
IMII
CUMBERLAND
DATE Of DEATH
09110/95
REMARKS SH I RLEY 0 TUCKER
m TOTAL AMOUNT PAID
1lI135.98
PD
:1
SEAL
CHECK II 0699
REGISTER OF WILLS
RECEIVED BY , .
$IGNATUlE .
MARY C. LEWI!3 .,'.' I{
REGISTER OF WILLS
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: (.. v... PIt. ( ~ r L L f-\:.J.
Date of Death: q-\.J.Qjq)
Will No. J.1-C,5-li!1'7 Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Ruled, I report the following with respect to completion of
the administration of th~ above-captioned estate:
1. State whether administration of the estate is complete:
Yes)( No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
J. If the answer to No. 1 is Yes, state the following:
a. Did the personal re~sentative 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.
Date:~
pJL. Cv 9J~
Signat.ure
J(f{ Jl. I'f C-(f[/!r, rLn.w
Name (Please type or print)
p.~, Of;.: CStj] '~d6- Pit 17/1"1-
Address
C,l
1",
1--
r_"
~~-)
[.:
0::
n,
p-,
- -
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fjc.;
(111) (J-r.- 1l6G"l.-
Te 1, No.
Capacity:
Personal Representative
Counsel for personal
representative
AJ11\o9-r UP
f( t.. [),.(C.II'fItJ,Ie
(HAHI rmf/AMJ)
.J5-
R. JAMES REYNOLDS, JR.
JOHN HAVAS
MICHAEl M. BAOOWSKI
STEPHEN L. BANKO, JR.
ROLF E. KROLL
BARRY A. KRONTHAL
LAURALEE 8. BAKER
MICHELE J. THORP
REYNOLDS & HAVAS
"""OfISSIONAI. COltPOl'l"'1ON
AnORNEYS AND COUNSELORS AT LAW
101 PINE STREET
POST OFFICE BOK e32
HARRISBURG, PENNSYLVANIA 11101.0932
TELEPHONE
17171235.3200
FAK
1717/235.5553
E-MAIL
'...h......pl..n.'
October 27, 199B
Mary C. Lewis, Deputy Register of Wills
Office of the Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re: Estate of Grace M. Illar
Estate No. 21-1995-0B17
Date of Decedent's Death: 9/10/95
Dear Ms. Lewis:
On Monday, October 26, 199B, I received a "Notice Pursuant
to Rule 6.12 of the Pennsylvania Supreme Court Orphans' Court
Rules" from your office in respect to the above captioned estate.
Please be advised that neither I nor my firm ever opened a file
on this matter, and never entered our appearance as counsel for
the estate. Upon receipt of your Notice, I reviewed the file on
this Estate in your office, and I certainly do recall Shirley and
John Tucker coming to see me about a couple of metters years ago.
I have no records of them ever being charged, and it is my
recollection that this meeting was rather informal and that
ultimately on some matter, I'm not sure if it was the Estate or
another matter, I recommended that the Tuckers see another
Harrisburg lawyer.
From my review of the papers filed, I see that someone, not
me, did set forth in handwriting an indication that I was counsel
for the Estate. However, on the inheritance tax form, it lists
Peter A. Geberich, a CPA, located at P. O. Box 6595, Harrisburg,
PA 17112, as the individual to whom all notices should be sent.
None of the papers set forth in the Estate file were completed by
me or ever sent or reviewed by me.
I attempted to contact the Tuckers, but I determined that
they no longer live at the address listed on the Estate papers.
I then called Mr. Geberich at (717) 652-9692, and he advised me
that the Tuckers have moved to Arizona. He indicated that he,
indeed, did assist the Tuckers in respect to this Estate. He
advised me to send a copy of the forms that I received, and a
copy of this letter to him. Pursuant to his instructions, I am
doing that.
Mary C. Lewis, Deputy Register of Wills
october 27, 1998
Page 2
From what I can ascertain from the Estate papers, it appears
that there is only one heir under the subject will, that heir
being John Tucker. To the extent that any further papers need to
be filed, I believe Mr. Gerberich or the Tuckers themselves will
handle the same. If they request my assistance, I will be happy
to give it, but at this time I do not consider myself counsel on
this matter. To the extent that you have me listed as counsel
for the Estate, please consider this letter as a motion to
withdraw as same unless you hear otherwise from me.
If you have any questions, please do not hesitate to contact
me.
JH/jen
cc: Peter A. Geberich, CPA (w/copy)
JRD/June 30, 1992/11858
RRGlSTER OF WILLS
Cumberlond County Courlhouse
One Courthouse Squore
Carlisle, PA 17013
NOTICE PURSUANt'TO RULE 6.12
PENNSYLVANIA SUPREME COURT ORPHANS' COURT RULE'S
To: Persoaal Representative
Counsel: JOON HAVAS, ESQ.,
RE: Estate of GRAm M. ILIAH
LaiEH ALLEN WP
Estate No.: 1l~199~~U811
Date of Decedent's Deoth: 9~1O~95
, Deceased, Lute of
Date:
Pursuant to Rule 6.12, the above named personal rep..esenlative or the above named attorney, If
applicable, within two (2) years of the decedent's death: and annually thereafter until administration is
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 attorney, as
applicable, reasonably believes administration will be completed. The purpose of this Notice is to advise
you that unless the requisite Status Repon is filed with the Register of Wills or Clerk of the Orphans'
Coun, as appropriate, within ten (10) calendar days after the date of this Notice that the Register of Wills
Is required to notify the Orphans' Court Division, Court of Common Pleas of such Jelinquency and to
request that saId Court conduct a hearing to detennlne whelher sanctions should be Imposed upon the
delinquent personal representative and the delinquent personal representative's counsel, If any.
Accordingly, If the requisite Status Repon Is not filed by 1l.9~9f:1 , 19_, you are hereby
advised that a request will be submitted to the Court In accordance with Rule 6.12.
In~ (J.X'uuM /)lI/tll)~;Jy-
Deputy Register of Wills I
1O.22~98
Distribution to Estate File
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
Will No.
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the admInistration of th~ above-captioned estate:
1. State whether administration of the estate is complete:
Yes No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
J. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date:
Signature
Name (Please type or print)
Address
( )
Tel. No.
Capacity:
Personal Representative
Counsel for personal
representative
(HAHlrmf/AHJ)