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PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Eslalr of _~_c cf~~:'.-" Z~L \iAr"'l,,1_0\1"I~..-
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No. _~l:!l..~ - d-.5 ~__
To:
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Re~i\ter of Wilt- fur the
COlllllY of ~l!Mf3E.RI~ND__ in the
('olUmnn\\callh of Pennsyl\'ill1ia
____.~__________+._._________ /Jt'('('a,~'(I.
Snd,,1 Srl'II,;IY ,vII. ......__J:l..ll1... ---.. - ,-
The re'ition of the Ullder\i~lIed re\pe,"fully rerre\enl\ Ihat:
Your retitioner(\l. who Klare IR yea" of a~e or older. arrL,,,d______ for lelle" of administration
\nD c:~ i\\:__l.\...~J-=:!_~.~-kJ'-J.!.-!~}l>.!:-7--\).i1-1Ji.~.r=-J.~.::.!-"-h.,..J.,.;..LL on (he estate of
(d.h.n.; ('(rllklll~' Illl': i1l1f:lI1IC ;IIHl'Illht: JIlI.lIlh' 1l1l1l1'Ilt.l!l{
the above deeeden'.
Decedent was domiciled at death in __+-,,_J~"'-r..b,..J ,_ County, Pennsylvania, with
h ,,, last family'" rrinciral re\ideneeat ...\_9L'" jlL c\.,.1.LJl 1""\,,""0,,o~~
IIi Nt ~lrl'lll.llul1lhN. '('wp. or llow,f'i"'hl.l) 0....- J
Decedent, then l years of age, died ____~~~ i1'-'/ _,19'/'{
a,_U;..;L"..ii.",)--- \~U# ---
Decedent at death owned properlY with estimated values as follows:
(If domiciled in Pol.) All re"onal properlY
(If not domiciled in Pa.l Per~onal properlY in I'enn~ylvania
(If nol domiciled in Pol.) Personal property in County
Value of real estale ill Pennsylvania
situated as follows:
,
$ "
$ (I
$ c,
$__L
Petitioner S_ after a proper ~eardl hai:...... a"erlained lhal deeedentlcflno will and wa~ ~urvived by
the following ~pou~c (if any) and heirs:
Namr Relalionship Residence
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('H;nJ~ \.qli:L '~~I\1:i'-- ')..L C;-;,H, 'I'" 5l~. '1'"
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THEREFORE. pelitioner(~) re~reetfully reqne\t(s) Ihe gram of lelters of administration in the
appropriate form to the nndersigned.
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WARNING: 1115 IIIcgnlto dupllcnlc this copy by pholostnl or phologrnph.
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3790902
, MAR 2019960."'--
Il.lll'
No
001050
COMMONWEALTH OF PENNSYlVANIA. DEPARTMENT OF HEALTH . VITAL RECOROS
CERTIFICATE OF FETAL DEATH
Stelo Filo Numbor
('0 n/)/A/ Il.h L
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,.., OF HISPANIC ORIGIN?
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IS, RACE - Am.rlc.n Indl.n.
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PART I. F.I.I Of mlt,rnal eondlUon
dIr1<tty caumg fetal death.
lntef ontr OM calM pet 1M '01', b, Md c.
ntM(D(A'TI CAUl!
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DUE TO (OR AS A C3H!lOUVtCE OF):
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{ auE TO lOR AS . CONSEOUENCE OF),
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20 I Milby ellf1, hIS lelul ....u delrveled dead on the da!. atattd
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Splctfy F"1l'& or Matemal
SpKIlyFllaJorMII.rnll
FIl.Ii ~ mallfnal condrllona. If .".,.
9"WIIil .... to tht irnfMdllll cauM(II,
.tatlnQ the u....rtylng caUM lUl
SPKIIy FilII or Mllernal
FWlT II Olhitf 'IQn,11Cln1 condl!1Ona 01' l.lu. Of moIhI, conlrlbullllO 10
'''alMIIII bu1 rd tnulllng In the undMtylog au.. ~n In Plrt I
19 FETUS DIED BEFORE LABOR,
DURING LABOR OR DELIVERY.
UNKNONN (Sp<<~J
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~\ DRESS Rt.. I DATE SIGNED 'I
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2t. METHOD OF DISPOSITlQN
I pe~nal I Oemaloon I :Rll!T'ICNallrom 51.'.
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22. SIONATUR[ OF FUr4ERAL S(R....ICE lICWSEE OR PERSON
A INO AS SUCjfH .
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21b !'LACE OF DISPOSI ON INa"" 01 ,."..teI)' ,"",""rory. 01 2'hU)cATlONs.-C""OI'TOliIIn,~'.;~CodI
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
F~E HUMBER
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HilS RETURN MUSl BE filED IN DUPLICATE WITII Tlt[
REGISTER OF WILLS
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D 10n.),nJIRctum 02 SUliplr.m['nIJ1Rclurn 03 RemalnderRelum(iUleol:)!oftOIpr....r,I]IH..;
o 4. limited Estale 0 4,} FU!clfc Inltrc'j! Compromise iJ.te<l~.1'!\nr 1].IH11 0 5 Fetleral Estale Ta. Return Reqwf€:(1
o 6 De<:e(lentDled TC!llil:e :1,:!.t:~[I", (.,1;, I 0 7. De<:etlefi! r,'alr:la'nM a lr.'lng Trusll,.:!"'~,COl,utlf"\tl _ 8 Tala1 r~umber af Safe DeposltB-:u!:s
D:.9lihgal.on Procet.'l1s Rece''W('d 0 10 Spousal Povert, Cledttl~"'l'rJ<jf:Dt-t~..~"~ II 'f111l(l1.H~i 011. ElectIOn to tal under See 9113~AI ',~r_.~'"
THIS SECTION MUST BE COMPLETEO. ALL CORRESPONDENCE ANa CONFIDENTIAL TAX 'NFORMATION SHOULO BE DIRECTED TO:
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1, Real ESlale IScne<Ju!e AI ill
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(.I. 0 C.
2 SIOC" and Bonds ISctle<Jule B) 121
3 Closely Held Corpora!lon.Partne~hlp or Sole,Propnelo~h'p (3)
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4 Mortgages & Noles Receivable (Schedule D)
5 Cash. Ban~ DepoSits & MIscellaneous Persona! Property
IScI1e<Jule EI
6 JomVy Owne<J Prope~f IScI1edule FI
7 Inter.Vlllos Transfers & MIscellaneous Non.Probate Property
(ScI1edule G or LI
8 Tolal Gross Assels II0tal [mes 1,7)
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1111
(4)
(5)
(6)
(71
9 Funeral E.penses & AdministratIVe Costs (Schedule H)
191
{101
10 Debts 01 Dereden!. Mongage L~b,ht>Cs, & Uens (ScI1e<Jule II
11. TOlal Deductions (!OlaIUnes 9 & 10)
12 Net Value 01 Estale{lme8 minus line 11} (12)
13. Chantable and Governmental Bequests:See 9113 Trusts for ....'hich an election to tal has not been (13)
made IScI1edule JI
14 Net Value Subjecllo Ta, (lone 12 m,nus lone 131 (14)
15. Amount 01 line 14 ta.able
at the spousal tal rale I
See InstruCllOns on reverse Side for apphCJbie percentage
16 Amount 01 hne 14 ta.able
at6%rate
17 Amounl01 hne 14t.lIab'e
at 15% rate
(151
06
(16)
15
1171
18 Ta, Due
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> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
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ADDRESS
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DATE
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DATE
Decedent's Complete Addrc&s:
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Tax Paymcnts and Crcdils:
1 Tax DUI~ (Page 1 lme lBj
2 Cff:J!S PJr'm(:nls
:.. Spousal Poverty Cn..'\1,1
B Pnor PaymenlS
C D,scount
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l_'i
T01al Creolls I:. . E . C) i2i
"-"--
3 InlerestPenatly If apphcab1e
o Inlerest
E Penally
;., Enter the Interest on lhe lJ:-: dJI:
C. E 13} ) -
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(4) ..
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(5) , (
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TC~,1' 'nlE'Cst PCr:3 \1 :
.: If line 2 IS greater lt1an lme 1 . line 3 cnl~r lt1P. r1:f'ercr:)? i~; ii'S :"e OVERPA YMENT.
Check box on Page 1 line 19 fo requ,sf a rofund
f1 If Ime 1 + hne 3 is greater thart !'~e 2, rntcl tt1f~ (ll'er(~!':'I~ P::; -<.; !t-e TAX DUE.
(":,'"
8 Enlerthe tOlal of Une 5.5'; To,s 's 111.. BALANCE DUE. 158)
Make Check Payable to: REGISTER OF WILLS, AGENT
.~ ,.}: ': x"<';~~:~:!~,~mr..t'1',~~~ii~l~i_ ,.":,;:~~~.; :'i ;'I;X~~.::.:';;~:::,;;'.;::;'~}~';..!;~;::'.., :~ _:~;:' .,~;.; ':,:':. ~_~:~';;<':~'.S,,":';,;~~,~'f~t~~\7~1&iit~
PLEASE ANSWER THE FOllOWING QUESTIONS
BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
I, Old decedent make a Iransler and,
a, retain the use or income of the property transferred, '
b retain fhe nght to designate who shall use the prorerty transferred pr 115 Income.,
c retain a reversionary interest: or.
d receive the promise for Ille of eilher payments, benefits or care? ,
2 If dealll occurred on or before December 12.1982, did decedent Within two years
preceding death transfer property without recelvlllg adequate conSideration? If dealh occurred
after December 12. 1982. did decedent transfer property wllhin one year of death Without
receiving adequate consideration? , .., ...., 0 CD
3 Did decedent own an "In trust lor" or payable upon death bank account or secunly
at his or her death?.. .. ....,....,.. 0
4 Old decedent own an Individual retirement account, annuity. or olher non'probale property?.... 0
c.:.... ()
Yes
.",0
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.......,0
....0
No
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN
1P~V){~ ~~.i~,l i~~(rr...l~a~1d;:;:'4.-(~~rnrr"!,,,..T.!t~P,\\,I~'j.,.':,';,.~ ,::-' . "':C'.i(i'--r.';."l'rU~-~,. t/i,',' ::t~'-'~~~. ;.:;' ~.!f-:::1.\".:wr.t(t-.JM\ll_r~7}<71~l~-"~
..""....M..;.I.... ,,".. 4.t_'1,.~lti..__..l'I;;~14},jIJ:!rr;.'..."!II!--.'.;.... . ,>_ ," ,,' . J..I'_\,'k.'J... . ~.'.,...l~ .,'-....,t,:_...hI~. '. ',,0' ~.v"..., .r.Y.:~_~'l'L'Vi:~~i:'.:JJ
72 P,S, ~9116 (a) (1,1) (I) provided for the reduction of the lax rate Imposed on the net value oftransfers to or for Ihe use of the
surviving spouse from 6% to 3% for dates of death on or afler July 1. 1994 and before January 1, 1995,
72 P,S ~9116 (a) (1.1) (II) provided for the reduchon ofthe rate IInposed on the net value oftranslers to or for the use ofthe surviving
spouse from 3% to 0% for dates of death on or afler JanualY 1 1995, The statute does not exempt a transfer to a surviving spouse
from fax. and the statulory requrrements for disclosure of assets and filing a tax return are 511I1 applicable even tf fhe surviving spouse
Is the only beneficiary,
FOR DATES OF DEATH ON OR AFTER JANUARY 1, 1995" Please nnswer the follOWing question by placing an "x' in the
appropllate space,
Old the decedent creatc a trust or similar arrangement which is solely for the surviving spouse's benefit for his or her entire
lifetime? Yes 0 No OJ
If \'OU answered yes to the above question, the tax on the tlUSt or Similar arrangement '5 postponed until the death of the second
spouse. al which time It Will be fully taxnble at the rate(s) appl,cnllle to the remainder beneficlary(ies), Enter the value of the trust on
Schedule J, Pnrt II, In order to remove It from the calculnlion of the fax duc in thiS estate You may Wish to file Schedule 0 In order to
make the eleclion avnllabfe under Scclion 9113 lithe election IS made, the frust or Similar arrangement Is taxed In the estale of the
first decedent spouse, the portion of the trust or Similar Cllfill1gement which benefits the surviving spouse is taxed at the zero tax rate.
and the remainder IS tnxed at the rate(s) applicable to 1110 rema,,,der benefic,ary(les) If you choose to make fhe eleclion. you must
attach Schedule 0 to a timely,flled tax relurn, along VI,1I1 SCMdule(s) K nndlor M '" order to ShOW fhe apportionment of the trust or
SimIlar arrangement between the survlVln9 spousP. nnd the remillnder t'ienerlc1ary(If":S)
;:'} 113 ,')
BUREAU OF INOIVIOUAL TAXES
1Nt.NIIANCf tAlI II1Vl5IUN
1Jl11l. laObOI
UAMUI:i8IJrG, "'" 1/1111-0',01
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE Of INItERITANCE TAX
APPRAIS[H[NT, ALlOWANCl OR DISALLOWANCE
or OEDUCTJOH5 AND ASSESSHENI or TAK
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
JULIE A K WIn
lOO S CHESTNUT
MECHANICS BURG
ST
fA 17055
09-27-1999
FISIlER
06-23-1994
21 96-0258
CUMBERLAND
101
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AliQuot Re..itt.d
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11'.lh' II II' III.U'
LOGAN
z
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
iiEV: iS4TEX--AFi'--iiiy:m --iiii,.-icniF-i-tiHEiiiTAN-Cn:. Aic-A-ppiiA-isEHEiiT~--.\i.i:DwAiicE-i'-R-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF FISHER LOGAN Z FILE NO. 21 96-0258 ACN 101 DATE 09-27-l999
TAX RETURN WAS: C X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..I Est.t. (Schedule AJ
2. Stocks and Bonds ISchedule OJ
3. Closely Held stock/Partnership Interest (Schedule C)
4. Harts.ges/Notes Receivable (Schedule DJ
S. C.sh/Benk Deposits/Misc. Personal Property (Schedule EJ
6. Jointly Owned Property (Schedule fJ
7. Transfers (Schedule GI
8. Total Assets
CHANGED
III
C21
131
14)
(51
C61
C71
.00
.00
.00
.00
.00
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adn. Costs/Hisc. Expenses (Schedule HJ
10. Debts/Hortgage Liabilities/liens ISchedule IJ
11. Total Deductions
12. N.t Value of Tax Return
13. Charitable/Governnental aequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
NOTE:
If an assessment was issued previously, lines
reflect figures that include the total of ~
ASSESSMENT OF TAX:
15. AMOunt of Line 14 at Spousal
1&. AMount of line 14 taxable at
17. AMount of Line 14 taxable at
18. Principal Tax Due
rate
lineal/Class A rat.
Collateral/Class B rate
TAX CREDITS:
PAYHENT
DATE
RECEIPT
NUHBER
DISCOUNT C'I
INTEREST/PEN PAID C-I
· IF PAID AFTER DATE INDICATED, SEE REVERSE
FDR CALCULATION OF ADDITIONA[ INTEREST.
1,039.00
.00
Cll)
1l2)
1131
1141
191
Clel
NOTE: To insure proper
credit to your account,
subMit the uppar portion
of this forM with your
tax paynent.
.00
T .03'1 nn
1.039.00-
.00
1,039.00-
14, 15 and/or 16, 17 and 18 will
returns assessed to date.
1151
1161
Cl7)
.00 X .00:
.00 X .06:
.00 X .l5:
1181
.00
.00
.00
.00
.00
.00
.00
.00
1 IF TOTAL DUE IS [ESS THAN $1, NO PAYHENT IS REQUIRED.
If TOTAL DUE IS REFLECTED AS A "CREDIT" CCR I, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
AHDUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
RESERVATION: Estat.s of dec.donts dylno on or b.foro noe.-ber Il, 1~8Z -- If any futuro Intorost In the os tat. Is transforred
In possossion or enja~ont to Class B (collat.ral) beneflclarlos of the doeedent .ftor the expiration of any .state for
life or for y..rs, tho Co..onwoalth hereby expressly resorvas the right to appraise end asso.. transf.r Inhorltance Taxes
at the lawful Class B leal lateral) rato on any such future Int.r.st.
P\JRPOSEOf
NOTICE:
To fulfIll the roquir..onts of Soetlon ll~O of the Inheritance and [stato lax Act, Act Zl of 1995. (72 P.S.
Section 91,.0),
PAYHEHT:
Dotech the top portion of thl. Natlco .nd subelt with your pa~ont to the Roglst.r of will. prlntod on the r.verso side.
"Nake check or aonoy ord.r payable to: REGISTER OF MILLS, AGENT
REFUND (CR): A refund of a tax credit, which was not requo.ted on the Tax R.turn, .ay bo roque.ted by c~pletlng an "Application
for Rafund of PennSYlvania Inharltanco and E.tato Tax" (REV-Ill]). Applications .re available at tho Office
of the Ragl.tor of Will., any of tho Z] R.vonue DI.trlct Offlco., or by calling the sp.clal Z~-hour
an.werlng s.rvlca nuebers for for.. ardorlng: In Penn.ylvanla 1-800-]6l-l0S0, out.lda Penn.ylvanla and
wIthin loc.l Harrllburg area (717) 787-8094, TDDI 1-800-""7-3020 (Service for taxpayers with .peclal
hear lno and speak Ing nead.).
OBJECTIONS: Any party In Intore.t not latl.fled with tho appr.I....nt. .llawane. or dllallowanco of daductlon., or al...loont
of tax (Including discount or Intorest) as shown on this Natico oust Objoct within sixty (60) days of rocelpt of
thh Notica by:
.-wrltton protost to tho PA nepartoont of Rovonuo, Board of Appeal., Dopt. 2810ll, Harrisburg, PA
.-aloetlon to have the .att.r dotor.lnod at audit of tho account of the porsonal ropro.ontatlva,
.-appeal to tho Orphans' Court.
HIl8-IOll,
OR
OR
ADHIN
ISTRATIVE
CORRECTIONS:
Factual errors dlscovored on this .s.o.so.nt should be addre.sed In writing tal PA napart.ont of Rov~,
Bureau of Individual Taxa., ATTN: Post Ast.ssoont Ravl.w unit, nopt. Z80601, Harrl.burg, PA 171l8-0601
Phone (717) 787-650S. Saa pago S of tho booklet "In.tructlans for Inherltanco Tax Roturn for a Re.ldont
Decedont" (REY-1S0l) for an oxplanatlon of .dainlstratlvely corroctable .rrors.
DISCOUHT1
If any tax duo I. paId within throe (3) calondar oonths aft.r the docod~t's d.ath, a five percent (SX) discount of
tho tax paId I. allow.d.
PENalTY:
Tho 15% tax aana.ty non-participatIon penalty Is ca.put.d on tho total of tho tax and Int.r..t ......ed, and not
paid before January 18, 19~6, tho flr.t day aftor tho and of tho tax .onalty p.rlad. This non-participation
ponalty Is appealablo In tho sa.. .ann.r .nd In tho tho .ao. tl.o parlod .. you would app.al tho tax and Int.r..t
that ha. baon .......d a. Indicated on thl. notlc..
INTEREST:
Intoro.t I. charg.d b.ginnlng wIth flr.t day of delinquency, or nine (91 eanth. and on. (II day fro. tho dato of
d.ath, to tho date of pay..nt. Tax., which b.ca.. dalllKPU.nt bofor. January I, 1981 boar Intarost at tho rat. of
.ix (6XI porcant par ennua calculated .t e dally rat. of .000164. All tax., which beca.. d.llnquent on and aftor
January 1, 1~82 will b.ar Int.r..t at . rat. whIch will vary fro. calondar yoar to cal.ndar y.ar with that rate
announc~ by tho PA Dopart..nt of Rovenue. Tho appllcabl. Intorost rato. for 1981 through 1999 are:
t!!! Intar..t Rat. Dally lntorest Flletor ~ Intarest Rat. Dally lntar..t Factor
1982 zax .000SItft 1988-1991 lIX .000301
198] lOX .000~38 1992 9X .0002,.7
19M llX .000301 1993-199lt n .00019l
1985 13X .ODUS6 1995-1998 9X .000lle7
19.. lOX .000l74 1999 n .000192
1987 9X .OOOZU
--Intar.st I. calculat.d as follow':
INTEREST = BALANCE OF TAX UNPAID X NUNDER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
_.Any Notlca I..ued .ft.r tho tex baCOOOI delinquent will r.fl.ct an Intar..t calculation to fifteen (15) day.
bayond tho dato of tho as......nt. If payeont is .ada aft.r tho Intar.st coaputatlon data shown on tho
Hotlce, additional Intoro.t ou.t be c.lcul.tod.
~.'!'JI~IJJS_I!~; I'UH1:_lJ!l~)_~ R_l{ u I.E _~!_l ~
Name of Decedent:
FiHI!('..!:.L-J~ltn Zltchltrv
Date of Death:
.hlllP 7. 3-,.-!..2'.l.~___
Will No.
I (I<)('-0025R
Admin. No. I'^ No. 7.1(l6-025R
Pursuant to Rule 6.17. of the Supl-eme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the ill,nve-captioned estate:
1. State whether ndministration of the estate is complete:
Yes_ v' No
2. If the nnRwer iR No, stnte 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? Ye5____ No V"'_.
b. The s"pnrolt.? Oq)hilns' C<lurt No. (if anYl for
the personal rcprr:.>>s~nlillive's account is:
c. Did I.he pel"sonal l'epres,'nlative stale an
account informally to the P,H\.i(,S in interl'st? Yes No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Coul:l and may be attached to this report.
Date: Octohpr 7.. 1997
Case has been diHcnntinucd (Spc
attached)
Cn t lIP r i n(' N. ~lnhndv-SIlI i t h. ESQ.
Name (Please type or print)
3115-^ Nnrth Frnnt Strpel
'!i!,rJ:..L~hl]rl'.... P'\ 1 711 0
Address
L!_I...?L23f,_-620R
Tel. Nu.
Capaci \ y:
Personal Representative
\.
n Counsel for personal
representative
(MAil: rmf /AM))
, .
JULIE A. KIRBY and BRIAN FISHER
Individually and as Co-Administrators of
the Estate of Logan Fisher, Deceased
Plaintiffs
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNTY, PENNA.
vs.
: CIVil.. ACTION. LAW
GEORGE JEFFERIES, M.D., EMERSON
FLURKEY, M.D. and FLURKEY-
JEFFERIES ASSOCIATES, INC.,
Defendants
: NO. 96-1860 CIVil..
: JURY TRIAL DEMANDED
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PRAECIPE TO DISCONTINUE
TO THE PROTHONOTARY OF CUMBERLAND COUNTY:
Please mark the above-captioned action discontinued, with prejudice.
Respectfully submitted,
CATHERINE M. MAHADY-SMITH, P.C.
(!I/,t~uu )}. );~b/~J>I{
Catherine M. Mahady-Smith, EsAufre
I.D. #47252 ,.-/
3 I 15-A North Front Street
Harrisburg, PAl 71 10
(717) 236-6508
Counsel for Plaintiffs
Date: ':)- /2 '7 7
STATUS REPORT UNDER RULE 6.l2
Name of Decedent: ~1.s.Me J ~4M
Date of Death:....:J "'^"'- :I. ~ I q Cf "'_
I
Will No.
2~c.\..~
NO \q.,r. -00 'l ~8
Admin. No.PA.t.X). 2.11(, -02.5"8
-
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:
I. State whether administration of the estate is complete:
Yes NO~
2. If the answer is No,
representative reasonably believes
complete: I _ 0
state when the personal
that the administration will be
~ .fo.rL \\'hc;~~ f'MPO~
3. 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.
Da te: 1./-:t -q~
~tUlh.~
Signature I
A . - TI#
Name (Please type or print)
aH~ 1\ ~. ~ron\-- ~L "b".& "110
Address ,
(7171 2~ItJ0/2
Tel. No.
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Capacity: Personal Representative
~ Counsel for personal
representative
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