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COMMOUWEAlTtI OF pa;rmSYlVAfIIA. Dt.PAH1MWT OF UEAL1U. VITAL UECOflDS
CERTiFICATE OF OEATH
(Coroner)
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I. HEVEHEND ^NDHEW C. IIELLEH. of 550 Ne:wiah Village. Nechan-
icsburg. Pennsylvania. 17055. being o( sound and disposing mind.
memory. and understanding, do hereby make. publish. and declare the
(allowing as and for my Last Will and Testament. in the manner and
form following, hereby revoking all Wills and Codicils by me here-
tofore made.
FIRST: larder and direct that all my just debts and funeral
expenses be paid as soon after my decease as reasonably possiole by
my hereinafter named Executor.
SECOND: All the rest, residue. and remainder of my estate,
I give. devise. and bequeath to the Primitive Nethodist Investment
Foundation. as Trustee. to hold, administer. and distribute for the
following uses and purposes:
(a) The Trustee shall payor apply the income to. or for the
use of. my son, David C. Heller, Sr., in quarterly or
other convenient installments during and for his life-
time.
(b) Upon the decease of my son, David C. Heller, Sr.. the
Trustee shall distribute the entire balance of the prin-
cipal and accumulated income of the Trust as follows:
(1) One-half (1/2) to the Primitive Nethodist Pocono
Mountain Bible Conference; and
(2) One-half (/2) to the primitive Methodist Invest-
ment Foundation.
Upon payment. aforesaid. the Trust shall terminate and end.
THIRD: The interest. whether in principal or income, of any
beneficiary hereunder shall not be subject to voluntary anticipa-
tion . incumbrance. alienation. or assignment, either in whole or
in part. nor shall any such interest while in the hands of the
Executor or Trustee, be subject to any judicial process to levy
upon or attach the same for or on behalf of such beneficiary's
creditors or claimants.
FOURTH: I make the above bequests due to the fact that I, and
my beloved deceased wife, Beulah, have spent our entire adult lives
in the work and service of the Church. It seems proper and fitting
that any residue be returned to our Church to continue such work
and service.
FIFTH: I hereby nominate, constitute. and appoint Reverend
Kerry R. Ritts to be the Executor of this my Last Will and Testa-
ment.
IN WITNESS WHEREOF, I have hereunto set my hand and seal to
this my Last Will and Testament this J ~ ,^ day of June, One
Thousand Nine Hundred Ninety-two (1992). I
), /
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'.}.(("Ji,Li-<'<< '.C _:~((.t.. (L S )
. .
Rev. Andrew C. Heller
Signed, sealed. published. and declared by Reverend Andrew C.
Heller. the above named Testator. as and for his Last Will and
Testament, in the presence of us. who at his request, in his pre-
sence, and in the presence of each other. all being present at
the same time, have hereunto subscribed our names as witnesses.
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LA\\' Ofrll'l:S
BRINSER &. WAGNER
II NORTH RAILROAD STREET
".0. "OX lZ I
"ALM\'RA,I'A 1707K
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IIARY CLEW I S REG OF IIlLLS
CUtlBERLAND CO COURTHOUSE
S HANOVER ST
CARLISLE PA 17013
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September 10, 1996
Dear Ms. Mary C. Lewis
Enclosed is a check for $5,700.00 for a deposit on the "Inheritance Taxes" for the Estate
of Rev, Andrew C. Heller, # 21-96-0561.
Respectfully Submitted,
~i?A-
Rev. Kerry Robert Ritts
Executor of Heller Estate
(::1./'S) 67S-;j.63'j
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DfClDIN 'i NAMIII'" . III . AND ""IOOH INI IAII
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NDREW C
K>C1"l UeUIIIY HUMUI
105-14-2296
PAn: or Of At"
6/11/96
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'Ol DAns 0' DIA'H Amll2/31191 CHICK HI"
.. A SPOUSAL
'OVlllY CUDIY " CLAIMID 0
rill HUMI..
o ClDIH '
21
COUNTY CODE
OMm [ 1.001"
96
YEAR
0561
NUMBER
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
pI ""IIUtlll 'Uh'ly.'fQ "''Oust-, ..........,,1'..". 'II" "....0 ..loon 1....111..11
N/A
DAII 0' tlllH
9/15/18
550 DOGWOOn DRIVE
MEC IIAN I CSBURG. PA 17055
c~"' CUMBERLAND
"'MOUNI UUlVID I~U UUllUC110NSI
03.
05.
...J8.
o 2. Supplomental Retur"
o Aa. Fulur. Inle,es' Compromhe
(lor do", of d.oth olt.r 12.12.82)
D 7. Oecedenl Maintained a living Tru.'
IAllach copy 01 T rUl11
Remainder R'lurn
Ifor dalll of d.olh prior 10 12.13,821
fed.ral Ellale Tax Relurn Required
Tolal Numbe, of Safe Depollt Boxe.
COMPllTl ""AIUNO ADOIUS
22 N. RAILROAD STREET, P.O. BOX 323
PALMYRA, PA 17078-0323
HATBORO, PA
19040
[] I. Original Return
o A. limited Eslole
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ESQUIRE
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( 2)
131
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151
( 61
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1. R.ol ElIal. ISch.dul. A)
2. Slocks and 8and. ISch.dulo 8)
3. Clollly H.ld SloeklParln...hip In'"," IS,h.dul. q
4. Morlgages and Noles Receivable (Schedule 0)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Sch.dul. E)
6. Jointly Own.d Prop.rly (Schodulo FI
7, ',an,'... ISchldulo G)IS,h.dul. LI
B. Tolol Gran Anels (tolallinel 1.7)
9. Funeral E_penles, Administralive COlts, Milcellaneous
hpenl" (Schedule H)
10. Debts, Mortgage liabilities, liens (Schedule I)
11. Tolol Deductions (10101 lines 9 & 10)
12. Nel Value of EstatolLino B minus line 11)
13. Charitable and Governmental Bequests (Schedule J)
lA. Nol Voluo Subjoct 10 TaK (line 12 minus line 13)
15, SpoUlal 'rantlo.. (for dol.. of d.alh alt.. 6.30,9.1
See Inslrudlons for Applicable Percenlage on Revene
Sido. (Include volues ham Schodule K or Schedule M.)
16. Amount of line 1A lallable 01 6% role
(Include volues from Schedule K or Schedule M.)
17. Amaunl of line 1.4 taKable 01 15% role
(Include values from Schedule K or Schedule M.)
19. Principal taK due (Add tax. from lines 15, 16 and 17.)
19. Credits Spousal Poverty Credit Prior Payments
+ 5,700.00
35.66
121 ,962.95
(91
(101
19,535.23
2,051. 18
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121 ,998.61
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(16)
(17)
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100,412.20
)C ,06 =
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111)
(12)
(13)
IUI
21,586.41
100,412.20
+
Discount
300.00
Inlorest
20. If line 191s groaler than line 19, enler the difference on line 20. This is the OVERPAYMENT.
gO
100,412.20
6,024.73
(18)
6,024.73
Chock hore if you arc requt'sting a refund of your overpayment. .,
21. If line 191s greater Ihan line 19, onler the difference on Lin. 21. This is ,h. TAX DUE.
A. Enler Ih. lnter.st on the balance due on line 21 A.
B. Enlo, lhololal of Lin. 2\ and 21A on lIno 21B. Thi. It.hI BALANCE DUE.
Malee Check Payoble to: Regllter of Willi, Agent
(21)
(2IA)
1218)
(19)
120)
6,000.00
24.73
24./3
~ ' BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE,AND TO RECHECK:MATH .' " 1::' "!~~:
Under plnalties of p.rJury, I dectare Ihall have examined this return, including accompanying schedules and s'alemenls, and 10 Ihe bes' of my knowledge and belief,
It is frue, correct ond complete. I declare Ihal 011 real estate has been reportod allruo marbt value. Declaration of pro parer other Ihan Iho personal reprosenlotive j.
based an 011 information of which preparer has any knowledge.
'10 R1 0' u~o IU'ONSltl[' R fIlIN I(tURN AOOIUS DAft
.2.;).0 . rt'/
OAIl
;)1./77
723 PRESTON LN.
AOOIUS
1IY.11OI1ll+ lNII
COMMONWIALTH 01' PI!NNIVLVANIA
, INHI!RITANCB TAl< RBTURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE "B"
STOCKS AND BONDS
FILE NUMBER
21-96-0561
ANDREW C. HELLER
CAli roplf1y JalntlYoOwnld with Alght of 8urvlYGrthlp mutt b. dleclOled on Schedul. UP")
ITEM
NUMBER DESCRIPTION
1, (1) U.S. SERIES EE SAVINGS BOND, DATED 5/25/90, FACE VALUE $50
VALUE AT DATE
OF DEATH
35.66
TOTAL (Also enter on line 2, Recepltuletlon)
$
35.66
(If mort IPI~ I, needed I,....,., additional thHt1 of Mm. .Inl
Irw.uoe IX. 12.17)
.
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
COMMONWfALrH 0' ,eNNSYlVANIA
INHIIITAHC' 'AX lnulN
""DINT DIC'DlNT
ESTATE OF
PI. a.. Prinl or T .
FILE NUMBER
21-96-0561
ANDREW C. HELLER
IAII p,.,orty 1.1.'I~..d with the light ., Survlvollhlp mUll be dllCloMd .. Sch.dul. PI
N~~~ER DESCRIPTION
1. HARRIS SAVINGS BANK - C.D. #18-66-222382
ACCRUED INTEREST
2. DAUPHIN DEPOSIT BANK & TRUST CO - CHECKING ACCT #42123461
3. DAUPHIN DEPOSIT BANK & TRUST CO - C.D. #8000406802
ACCRUED INTEREST
4. PRIMITIVE METHODIST INVESTMENT FOUNDATION - TRUST ACCOUNT
#430-20
5. THE JACOB ENGLE FOUNDATION, INC. - C.D. #11489
ACCRUED INTEREST
6. POCONO BIBLE CONFRENCE - (2) C.D.'S
7. 1987 CHEVY CAVALIER - SOLD
8. CORESTATES BANK - IRA #951171704-8962790
ACCRUED INTEREST
9.. MESSIAH VILLAGE - REFUND OF EQUITY IN COTTAGE
10. MEDICAL REIMBURSEMENTS
11. MISCELLANEOUS PERSONALTY - SOLD
12. SOCIAL SECURITY CHECK DATED JUNE, 1996
13. BROTHERHOOD MUTUAL INSURANCE - REFUND
14. RETINA & OCULOPLASTIC CONS. - REFUND
(A"och oddlllonol8Mi- )( 11- ,h"'llf mort 'pac. II nud.d.1
VALUE AT
DATE OF DEATH
5,000.00
8.22
421.97
15,000.00
47.26
50,023.90
12,150.00
21.97
2,000.00
400.00
18,568.31
53.32
16,708.13
821.51
108.38
584.00
17.00
28.98
S 121,962.95
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COMMOHWlAl1H Of nNNSY\\IUl1A
INHllltANcl TAX lITUIN
IU~OINT DIClDINT
5CHIDULI H
FUNERAL IXPENSES,
ADMINISTRAnvE COSTS AND
MISCELLANEOUS EXPENSES
P1.a.. Prlnl or T e
ANDREW C. HELLER
21-96-0561
ITIM
NUMBER
A. Funeral Exp.na"l
DESCRIPTION
AMOUNT
1.
MALPEZZI FUNERAL HOME
ORGANIST
CLERGY, ETC.
5,796.92
35.00
200.00
2.
3.
B. Admlnlatratlv. Caalal
1, Personal Representative Commllllons
Social Security Number of Personal Represenlotlve: 6,150.00
Year Com millIons paid 1997
2. Allorney Fees - BRI NSER & WAGNER 6,150.00
3. Family Exemption
Claimant Relationship
Addrell of Claimant 01 decedenl's doalh
Streot Addro..
City Slato Zip Code
4. Probalo Fees - REGISTER OF WILLS 229.00
ADDTIONAL COST OF LETTERS - REGISTER OF WILLS 35.00
C. Mlsc.llaneoua Expens.a:
1. VITAL STATISTICS - (2) DEATH CERTIFICATES 11.00
2. CUMBERLAND LAW JOURNAL- LEGAL AD 60.00
3. THE SENTINAL - LEGAL AD 86.22
4. TERWOOD AUTO - INSPECTION, ETC. 493.73
5. P P & L - ELECTRIC 46.30
6. BELL ATLANTIC - PHONE 22.74
7. AMICO INSURANCE CO 203.94
8. BK CHARGE FOR CHECKS 15.38
TOTAL (Aloa enler on line 9, Recapitulation) S 19,535.23
(If more apac. la ne.ded, In a." additIonal ah..'a of aam. al...)
-
-.
iliast lJill anb QI~}JtCl1ttellt
I, REVEREND ANDREW C, HELLER. of ~~D Meeslsh Village. Mechan-
Icsburg. Pennsylvania. 170~~. being of aound and dlapoalng mind.
memory, and understanding, do hereby mako, pUblish, and declare tho
following as and for my Laat Will and Testament. in the manner and
form folloWing. hereby revoking all Willa and Codlcila by me here-
tofore made.
FIRST. larder and direct that all my juat debta and funeral
expenses be paid as 800n after my deceAso 48 rOAsonably possible by
my hereinafter named Executor.
SECOND: All the rost, residue, and remainder of my estate,
I give. dovlse. and bequeath to the Primitive Methodist Investment
Foundation, 8S Trustee, to hold, administer, and distribute for the
following uses and purposes.
(a) The Trustee shall payor spply the income to. or for the
use of, my 80n, David C. He110r, Sr., in quarterly or
other convenient installments during snd for his life-
time.
(b) Upon the deceaae of my aon. David C. Heller. Sr.. the
Truatee ahall diatribute the entire balance of the prin-
cipal and accumulated income of the Truat aa follows:
(1) One-half (1/2) to the Primitive Methodist Pocono
Mountain Bible Conference: and
(2) One-half (/2) to the Primitive Methodist Invest-
ment Foundation.
Upon payment. aforesaid. the Trust shall terminate and end.
THIRD: The interest. whether in principal or income. of any
beneficiary hereunder shall not be subject to voluntary anticipa-
tion , incumbrance, alienation, or assignment, either in whole or
in part. nor shall any such interest while in the hands of the
Executor or Trustee, be subject to any jUdiCial process to levy
upon or attach the BArno for or on behalf of such beneficiary's
creditors or claimants.
FOURTH. I make the above bequests due to the fact that I. and
my beloved deceased wife, Beulah, have spent our entire adult lives
in the work and service of the Church. It seems proper and fittin9
that any residue be returned to our Church to continue such work
and service.
FIFTH: I hereby nominate, constitute, and appoint Reverend
Kerry R. Ritts to be the Executor of this my Last Will and Testa-
ment.
IN WITNESS WHEREOF. I have hereunto set my hand and seal to
this my Lost \>fill and Tt'stament. this .~, 4,A: day of June, One
Thousand Nine Hundrod Ninety-two (1992).
:')/.1. i,.
1)...". :'kel/-t""-C',/.k'o!(,.<,, (L.S.)
Rev. Andrew C. Hsller
Signed, sealed. published. and declared by Reverend Andrew C.
Heller, the above named Testator, as and for his Last Will and
Testament. in the presence of us. who at his request. in his pre-
sence, and in the presence of each other, all being present at
the same time, have hereunto subscribed our names as witnesses,
L"_"1' .... to'.:"
A"~~..to' ~~'*"
t:;'
.,,,,,'
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I ...
I
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
U..RUAHC[ 'AX DIVISION
DlPT. :loUt
UAIlRISlURC, Pi I1UI-OltOI
NOTICE OF INHERITANCE TAX
APPRAISEHENT. ALLOWANCE DR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHEHT OF TAX
KEITH D WAGNER ESQ
22 N RAILRDAD ST
PD BOX 323
PALMYRA PA 17078
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
06-03-97
HELLER
06-11-96
21 96-0561
CUMBERLAND
101
A~ount R..itted
,'/'
-
1I,.lhlUIH 111-'"
ANDREW
C
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 ~
iiiv: is4i- Eie" - Aiiji-ioJ: 97 Y -iiii'fic E- -OF - ytiHEiii TAiici -"flix -APPRA is EHiiir;-Ai. L OiiANC i-oli-- - - no - -- - - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HELLER ANDREW C FILE NO. 21 96-0561 ACN 101 DATE 06-03-97
TAX RETURN WAS: I X) ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R.d Eliot. ISch.dul. A) 111
2. Stacks and Bonds (Schedule 8) t21
3. Closely Held stock/Partnership Int.r..t (Schedule C) 13J
4. Hartg.ga./Note. Receivabl. (Schedule DJ (4)
5. Cash/Bank Deposlt./Hlsc. Personal Property (Schedule EllS)
6. Jointly Owned Property (Schedule f) (6)
7. Transfers (Schedule G) 17J
8. Totel Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expens../Ad.. COlts/Hisc. Expense. (Schedule H) 191
10. Debts/Hortg.ge Liabilities/lIens (Schedule I) CI0)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governnental aequest, eSchedule JI
14. Net Value of Eltate Subject to T.x
I ) CHANGED
,00
35.66
,00
.00
121.962,95
.00
,00
18)
19,535.23
2.051.18
Ill)
112)
113)
1141
NOTE: To insure proper
credit to your account,
subnlt the upper portion
of this forn with your
hx paynent.
121.998.61
?I ,~R6 41
100.412,20
.00
100.412,20
If an assessment was issued previously, lines 14, 15 and/or 1&, 17 and 18 will
reflect figures that include the total of ~ returns assessed to date.
ASSESSMENT OF TAX:
15. Anount of Line 14 .t Spou.al rete e15)
16. Anount of Line 14 taxable .t Line.l/Cla.. A rat. C1&)
17. Anount of Lin. 14 taxable at Collet.rel/Cla.. a rate e17)
18. Princlpel Tax Due
NOTE:
TAX CREDITS:
PAYHENT
DATE
09-10-96
02-21-97
RECEIPT
NUHBER
AA146719
AA185195
DISCOUNT It)
INTEREST/PEN PAID (-J
300,00
.00
.00 X .00=
100,412,20 X ,06=
.00 X .15=
1181
AHDUNT PAID
5.700,00
24.73
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
.00
6.024,]3
,00
6.024,]3
6.024,]3
.00
,00
.00
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN tl. NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR). YOU HAY 8E DUE
A REFUND. SEE REVERSE SIDE OF THIS FDRH FOR INSTRUCTIONS.)
, '
,
,
c:~
'_J0
RESERVATION: E..,t., of dlcld.nt. dying on or blfor. Dlc..b,r Il, 1'8Z .. If any future Int.r..t In t~ ..t.t. I. tran,flrred
In po.....lon or MJoy..nt to Cl... B (coll.t,r,U ~"Ic"rl.. of thl dlcedent 1ft" the I.pl,.tlon of My .,ht, for
11'. or 'or y..r., thl Co..onw..Uh hereby ..pr...h ,...rv.. the tight to appr.lu IIftd ...... tren,'" InMtltenc. llu,
et the ....ful el... . (co111t.r.1I r.t. on any ,uc;h future Interut.
PURPOSE OF'
NOnCE:
PAMMY'
RtFUHD (CA):
OBJECTIONS;
ADHIH
ISTRATIVE
CORRECTIONS:
DtSCCUlT I
PENALTY:
INTEREST 1
To fulfill thl ,.qul,..ant. of Slctlon Zl~O of thl Inherltancl and [.t,t, T.. Act, Act 21 0' 1995. (ll P.S.
Section 'IU).
a.tlch thl top portion of thl. Hotlc. and .ubalt with your ply,."t to thl .Igl.t" of Will, printed on the r.v.r.. ,Ide.
....N... chick or .oney order pIYlbla tal REDISTER OF MILLS, ADEHT
A r.fund a' . te. cr.dlt, which we. not requ..t.d on the T.. R.turn, e.y b. r.qua.t.d by caapl.tlng an "Appllc.tlan
'or Re'und a' PeMulvanle Inheritance and Estllte T.... (REV.13UI. Appllcetlan. are available at the Offlc.
a' the Regl.t.r a' Will., any a' the Z] R.v.nu. DI.trlct Of,lc.., or by calling the .peclet Z~.hour
an.w.rlng ..rvlc. nuaber. far 'or.. ard.rlngl In Pennlylvanl. 1.800.]6Z.Z0~O, out.ld. P.nn'Ylvanla .nd
within 10c.1 tlarrhburg area 1711) 187.8094. 1001 17111 l1Z.ZZ5Z (tllarlng Iapalrad Only).
Any party In Intare.t not .atl.fl.d with the IPpr.I....nt, .llawanc. or dlllllawanc. of d.ductlon., or .......ent
of t.. (Including dllcount or Intlr..tl .. .hawn an thl. Notlc. .u.t ObJ.ct within .I.ty (60) day. of rec.lpt of
this Notice bYI
a-written prot..t to the PA D.p.rt..nt of R.v.nu., Board of App.al., D.pt, Z810ZI, tlarrl.burg, PA
--.I.ctlon to have the ..tt.r d.t.reln.d at .udlt of the account of the p.r.onal r.pr..antatlv.,
..appe.. to the Orphan.' Court.
OR
171Z8.1021,
OR
F.ctu.1 error. dllcav.r.d an thl. a.......nt .hould b. addr.I..d In writing tal PA D.part..nt a' R.v.nu.,
Bur.au a' IndividUal la..., ATTN; Po.t AII.....nt R.vllw Unit, D.pt. Z80601, Harrl.burg, PA I11Z8.0601
Phone (111) 181.6~05, S.. paga 5 of the bookl.t "In.tructlon. for Inh.rltanc. T.. R.turn far a R..ldent
Olc.d.nt.. (REV.15011 for an ..pl.natlon of adelnl.tratlv'ly corr.ctabl. .rror..
I' any ta. due I. paid within thr.. e]) c.lendar eonth. .,tlr the dec.dent'. d..th, . flv. p.rcent (5%1 dl.count 0'
the ta. peld Is allow.d,
Th. 15X t.. aane.ty non.p.rtlclpatlon psn.lty Is coeputed on the total of the ta. and Int.r'lt e..e...d, and not
p.ld b,'or. January 18, 1996, the flr.t d.y after the end of the t.. aao\lllty p.rlod, This non'partlc1p.tlcn
p.nalty I. .pp'alabl. In the .... eann.r and In the the .... tl.. p.rlod a. you would app.al the t.. and Int.r..t
that ha. b..n .......d a. Indlcat.d on thl, notlca,
Int.r..t I. chargld b.glnnlng with 'Ir.t day 0' d.llnqu.ncy, or nln. (91 .anth. end one (I) day 'roe the date of
d.ath, to the date of payeent. T.... which b.cae. d.llnquent b.fore January I, 198Z b.ar Inter..t .t the reta 0'
.1. (6X) percent p.r ~ celculetad at e dally rete of .000164, All t.... whIch bae... delinquent on and .,t.r
Januery I. 198Z will b.ar Inter..t at a rat. which will very froe calend.r yaar to cal.nd.r y..r with that rat.
announcad by tha PA Dapart.lnt of Ravlnue. The applicable Int.r..t rat.. for 198Z through 1997 aral
'!!!! Inlere.t Aat. Dally Int.r..t Factor ~ Int.r..t Rat. Dally Inl.r..t Factor
1911 zax .00054' 1981 .X ,OOOl41
1911 16% .OoaU8 19B8~1991 l1X ,000301
1984 llX .00nOl 1991 'X ,OOOZtt]
1985 UX ,oon~' 199]~19'" 7X ,OOOl9Z
I... lOX ,OOOZl~ 1995.1997 'X .00OZtt]
ulnt.rllt Is ulculetad .. follow.:
INTEREST = BALANCE or TAX UNPAID X NUNBER or OAYS DELINQUENT X OAILY INTEREST rACTOR
uAny Notice IIIu.d .ltar the te. baeo... d.lInquent will reflect an Inter..t ulculltlon to 'lft.an US) d.y.
beyond the dat. of the ......-.nt. If pay-.nt I. .ad. aft.r the Inter..t coeput.tlon date .hown on the
Notln, .dcUtlDn81 Interllt ...t be calculat.d.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: {{fAr (lit du w- e . (!t. {~i0
Date of Death: ~(~ II , /190-
Will No, :J. J - /11 - P. · 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 the above-captioned estate:
1. State whether administration of the estate is complete:
Yes V No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
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 filed with the
Cerk of the Orphans' Court and may be attac this report.
Date: 7/~ll!q;
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N'~e (Please type or print)
A,~ 'f), khJJ..cod Sf. ( Rtlin71f"C'- (fl
Address)
(717) P:~ 'i -(,3Y f
Tel. No.
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Capacity: Personal Representative
~counsel for personal
representative
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