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OATH OF PEI{SONAL I{EPI{ESENTATlVE
COi\l!\lO'iWb\I.TII OF I'E1\''iS\'I.\"A'iIA ! "
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COMMONWEALTH OF PENNSYLVANIA. DEPARtMENr OF HEAUU. VITAL RECOHDS
CERTIFICATE OF DEATH
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LAST WILL AND TESTAMENT
BE IT REMEMBERED THAT
I, RUTH A. JUMPER, a resident of Cumberland County,
Pennsylvania, being of sound and disposing mind, memory and
understanding, do make, publish and declare this to be my LAST WILL
and TESTAMENT, hereby revoking any and all Wills and Codicils
previously made by me.
I
I declare that I am not married, my beloved husband, MARLIN B.
JUMPER, having predeceased me, and that I have two (2) children,
ROGER M. JUMPER and MARLENE C. BRICKER.
II
I direct that all my just debts and funeral expenses shall be
paid from my residuary estate as soon as practicable after my
decease.
III
I direct that all taxes that may be assessed in consequence of
my death, of whatever nature and by whatever jurisdiction imposed,
shall be paid from my residuary estate as a part of the expense of
the administration of my estate.
IV
I give and bequeath the sum of ONE THOUSAND FIVE HUNDRED
DOLLARS ($1,500.00) to my brother, ELMER E. VOGELSONG, per capita.
V
I give and bequeath my furniture and personal possessions to
my son, ROGER, and my daughter, MARLENE, to be divided between them
as they agree.
VI
All the rest, residue and remainder of my property, whether
real or personal, wherever situate, including any property over
which I may have a power of appointment, including all of my
jewelry, I give, devise and bequeath to my daughter, MARLENE, per
stirpes.
AIV 1\00 Ill. l' Q~I
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(TO BE FILED IN DUPLICATE
WITH REGISTER OF WILLS)
~~~
(OMMOt~W(AUlt Of r1HtH.'tIVAt'Io\
01 rAIIIMItH 0' Al V(tUJI
niP' 2110Ml
1.1":~.~I.!II_URG,~~~ ~ ~ I.~~ OMI
. OICI(JIUI!. UAM'IIA\J. 1111\1, AtlOMii'iiii'iiiiiiiii-----
rOA DAllS OF DIAl" AnlA 12/31/91 CHICK HIAI
IF A SPOUSAL
POVIArT CREDIT IS CLAIMID I
FIll NUMBIA
21
COU,lIY COO!
'Jr,
Y[AR
0585
NUMBER
iiHIUIHI \ (OMPIl II A[l(jlll!.\
.... Jumper, Ruth A. 106 E. Hllin Street
ffi \cXiAi !.fciiiii,pjiii.l;iiHU_. [11AII or mA11l In,,!! 01 Ililll Hechanicsbur~, "^ 17055
~ 180-26-62011 7/19/'J6 2/2/11, c..", Cumberland
___~___ I:;.~:'~:~.:~;~~~' """" '".~ "~."'" ';'0 :"" ,;, ;", ..."OCi" IICt..,iij<<JM'" ~.. - -riM:U~"'ICI"':i~~'~:~~o""~.=-_____=~~~=
w li'a l. Original Return I I 1. Supplemllnlol Relurn 1.1 3. Remainder Return
:tIC;"" (for dall" of deoth prior to 12.13.821
hHE~ [J 4. limited Eltote L I 40 fUlur" Intere'l Compromi,,, r] 5. federal Ellate Tall Return Required
~g9 (lor dote, of deolh after 12-12.82)
t a:I {}O 6. Decedent Died Teltate 1 I 7 Decedent Maintained 0 living TrUll _ 8. T 0101 Number of Safe Depolil BOl(el
-!: IAllach copy of Will) (Anath copy of TrUll)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO.
,....
::115
"'0
"'z
S~
UAM(
(OMN(I( MAllltlG ADOllns
!1lJrr~1_R...J{..1..lJ;_er_s_,~lU._E1HI '-._.. ___
IU(PtIOtlf NUMUIl
1717 I 697-1,650
z
o
;=
:5
~
0:
..
u
w
'"
1. Real Eltale ISchedule A)
2. Sloch and Bondi (Schedule BI
3. Closely Held StocUParlnetlhip Interel' (Schedule C)
4. Morlgogel and Nole' Receiyable ISchedule 0)
5. Calh. Bank Depo,iu & Miuellaneou, Perianal Properly
15ch.dul. EI
6. Jointly Owned Propefly (Schedule FI
7. Tronol." 15ch.dul. GI15ch.dul. L)
8. Tolal Gran AueU ltotalline, 1-7)
9. Funeral El(pen,e" Administratiye Co,U, Mim!lIoneou,
Ellpen'e' (Schedule HI
10. Debu. Morlgage liobililiel, lien, (Schedule I)
II. Total Deduction, Ilotallinel 9 & 101
12. Net Volue of Eltote (line 8 minu, line 111
13, Charitable ond Goyernmentol 8equtnU (Schedule J)
14. Nel Value Subject 10 Tal( (line 12 minu, line 131
IS. Spoulal Tran,f." Ifor datil of death after 6.30.94)
See In'truetian, far Ar,plicoble Percentage on Reverso
Side. (Include value, ram Schedule I( or Schedule M.I
16. Amount of Line 14 10l(oble 01 6% rate
(Include yalulIIl "om Schedule K or Schedule M.)
17. Amounl of line 14 tallable at 15% role
(Include yalue, from Schedule K or Schedule M,I
18, Principal lOll due (Add lOll from line, IS, 16 and 17.)
19. Crediu Spou,ol Poverty Credil Prior Poymenh
+ ---..----
z
o
;=
c
....
:>
..
'"
o
u
)(
..
....
54 Ellst Main Street
Hechnnicsburg, PA 17055
III .._..__._..:: D.~u__ _.__
121 __.____ _._-:.Q.:.~___
I ) -0-
3 ._..._.___.._.____~
14) -0-
I 5 I ==~=~Q; A~9 :Z?_.===
16)7.2~Z.)~___.
-0-
(7) _ . _____ _~_~.m...___
181 m.n~7.~!i2~117 ____
n...!...~66. Sf! _~__
191
(101__._ __UL!!?____
1,684.25
._-~---- ------.-----.-
____.2.5_..9.7 2_.11__
-0-
. ----------.--------.-
25..9.1:L 22
(III
(121
(131
(141
(151__...__.________ ____ox. =
(161_ __1~ ,-'!? 2..2.?_ . _. . x .06 =
(171 .__ ._1.,?OO-,-O.L......x .15 =
___1_,-,!68.,)IL___.
225.00
(181
1..69J.3L
Di"ounl
+ 84.67
-----~_._--
Interell
1191 ____3!t..61___
(201 ._. _ _... n _...._
1.608.67
20. If line 19 h greater than line 18, enter Ihe difference on line 10, Thil ilthe OVERPAYMENT.
Ii! 0
Check here if you ore roquesting 0 refund of your ovorpayment.
1211
121AI
121BI
..1.608.67.
21. If line 18 i, greater than line 19, enler the difference on line 21. Thil i, the TAX DUE.
A. Enter the inlerelt on the balance due on Line 21A,
8, Enter the 10101 of line 21 and 21 A on line 218. Thil h the BALANCE DUE.
Ma~lt ChICk Payable to: R.ghl.r of Willi, Ag.n.
~ ~ ~ BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH ~ ~
~~der penohiel of perjury, I declore thai I havo ellaminod Ihi, return, including accompanying uhedule, and .,'alemen", ond to Ihf' be" of my ~no.....ledg; and bll'ie~,
ItlllrUlI, carr eel and complete_ I dedarethnl all real ellol" ho, been reported allrue mar~1I1 value. Declorollon of prepar", alher than tho penonol f~prel"nloli.,.(' II
. ~l~::~:.~ ~~I ;~~~~:o:~~;o~:iii~i;~:~~~:.;rii~~h~~~~aA~~Il~~~' -1-1 arT c n e -. c :---nr ic K c r .~-.~2 sup r orne S 3-"1' 1. t o{ {i'-- .11 _:.. .1.1... - - u
"'" ~_~"'.'~.N-Jr...... u.... UotSP!:ingsVi11ngc, AlC.. 71909_ (-" . {I . 4'"
Aj~UTUIl(O'PllfrAlllll~lfltlllAIlIUrIB'flIA1I\1( --"AboiEf'R N J 35S. 1. R I oiii
r5Jfh 'n-l I r.~ oger .. umllcr. lnc alr '.,
..,:Hm_",_/'/ .'.u HecJHmicsburi\!~)A 17055, Iv fl....'"
i'{J( t/.v. f.lurrel R. \~a1t(,II;, ILl, LSr].
, . -- 51, E. ~lnin St.. Hechllnlcsburg, PA
.(ynOlIl.l"f!
9j~~,q
't\~~
COMMOuwrAl1lt 0' 'fUU~'lVAUIA
INHllnANCI TAX InUIN
IUIDIN' DICIDINf
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
_. _.~Ioale Prln~~~o
FILE NUMBER
21-96-0585
ESTATE OF
Jumper, Ruth A.
(All property lolnlly.own.d with th. Right 01 Survlvonhlp mu.1 b. dluto..d on 5th.dul. Fl
ITEM
NUMBER
DESCRIPTION
VALUE AT
DATE OF DEATH
1.
2.
3.
4.
PNC Bank - checkin~ U5070090606
PNC Bank - savinr,s 05030125093
1986 /\MC Ear,le automobile
5,810.66
13,850.30
500.00
furniture in apartment
250.1)()
5.
Old Pueblo Traders - ref.und for returned
rnerchanrlise
10.97
6.
National States Insurance - premiun refunn
27.35
TOTAL (Also enter on line 5, Recapitulation) S
20 449.28
IAllach additlonal8YJ- )( ,,- .hUII if mOil space I, "..d.d.)
'UYIW9II'lllltl
-t\~;3-
COMMOUW[AIHl or r"m\U..."lltA
ItUlfRllA.UCf IA.. R(IIlIl"
1I(!lIOWIO(((O(UI
SCHEDULE F
JOINTLY -OWNED PROPERTY
.Jumper, Ruth ^.
- -. -.--riifNjj~~E~~~)-~ 0 5!l5
ESTATE OF
Joint 'ononll.)'
NAME
-_._._._---_._--~~-.-_.. -.-
~ Marlene C. Bricker
ADDRESS
25 ProlOena PInee
lIot SpdnJ\H Vi 11al\'-' , ^K
71<JO')
RELA T10NSHIP TO DECEDENT
dnur,hter
B.
c,
Jointly-owned property:
ITEM
NUMBE
LEnER
FOR
JOINT
TENANT
DATE
MADE
JOINT
DESCRIPTION OF PROPERTY
TOTAL VALUE
OF ASSET
DECD'S DOLLAR VALUE OF
% INT. DECEDENT'S INTEREST
1.
^
/30/92 Putnam U.S. Government
Income Trust
^OY-1185031243BBCF
111,1114.37 50
7,207.19
TOTAL (AI,o ontl'r on li"~ 6, R~copitulo1ion)
s
7,21)7.19
(IF more spoce is n~ed~d im.e,' addItional ,heels 01 some ,izftJ
_IVl\III1,C'''l
. -.
... ...
....- .
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES PI.a.. Prlnl or Typ.
._m~ _...~.___~_____ _____~_J:U NU~~:R96_0~~5 ..-
DESCRIPTION AMOUNT
~~
COMMOfIWfA,l11f 01 'f,m~'lvAUIA
UUlUIIAucr 1A_ Rf 11I1"
Rf\IOUH VI (( or fH
ESTATE OF --,.-. _~.n_ -- m___"_
---- ---.-----....---..--..------
Ruth A. Jumper
ITEM
NUMBER
A.
I.
. ....-- ..._-------- ---...-.-
----_._.-_.__.._.-.._._---~ .--.-.--- --_._---
Fun.ral Exp.n.."
Myers Funeral I~me
I.
B. Admlnl.trallv. Co.ls:
2.
Personal Represenlolive Commissions
Social Socurily Numbor of Porsonal Roprosonlalivo:
Voar Commissions paid __.-
Allornoy Foos
Murrel R. Walters, III, Esq.
3. Family Exomplion
Cloimanl __~..____ ____ ...____ Rolotionship
Addross of Claimanl 01 docodonl's doalh
Slroot Addross _____...__._ -..-..--....--
Cily ___._ _.___ .___._.._ ___ _._Slolo ____~__ Zip Codo.______
d.
C,
I.
2.
3.
d.
5.
6.
7.
8.
Probal. Foos
Mlscollan.ou. Exp.nlO"
Cumberland Law Journal - estate notice publication
Patriot-News - estate notice publication
.-.--------.. ._---_.._-_.~--_._--_.,---_._-~
TOTAL (Also onlor on lino 9, Rocopilulalian)
(If mor. .pac. I. n..d.d, In..rl additional .h.... 01 .am. .110.)
prepaid
renounced
1,320.00
100.00
60.00
1l6.80
5 1,566.80
-'.. ..
'..V,1l62I1f',")
14 6 843 COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
.
DNO.AA
RECEIVED FROM:
D
ACN
ASSESSMENT r;If
CONTROL Iii
NUMBER
AMOUNT
MURREL R WALTERS EsQ
101
~J,ove.o7
~4 EAST MAIN SlREEl
MECHANJCSBURG, PA 17055
:-'CHDHUl
ESTATE INFORMATION:
!:I FilE NUMBER
~ 21-1996-0585
!:I NAME OF DECEDENT (LAST)
I;iI JUMPER RUTH A
II DATE OF PAYMENT
m POSTMARK DATE
COUNTY
SSN 180-26-620',
(FIRST) (Mil
CUMBERLAND
DATE OF DEATH
REMARKS
SEAL
MARLENE C BRICKER &
ROGER M JUMPER
CHECKII 6
~ TOTAL AMOUNT PAID
$1,608.67
REGISTER OF WillS
SK
~ ,. .
" '.-/1 ,.
RECEIVED BY t2!tV/'. . f ,.A II " ;) 1'1,1/
,// SIGNATJlIIJ /. . ,....
, , y; IJ ., I J J.1."I..~L
MARY C. LEWIS .' ;" I,. /:., ,1
REGISTER OF WILLS '
. -
..- ..........~........,--
-.'~M.~ 4 [".....-;1:.
1':" I j(.. :!
BUAEAU OF INDIVIDUAL TA~ES
.NK:AIIAHC[ 'AIC DIVISION
ocpr. :10601
HARRISIURG, Pi 111le'06Dl
COMMONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
n
1..-
NOTICE OF INHERITANCE TA~
APPRAISE"E"T, ALLOWANCE DR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TA~
MURREL R WALTERS
54 E MAIN ST
MECHANICSBURG
DATE
ESTATE OF
DATE DF DEATH
FILE NUMBER
COUNTY
ACN
I II ESQ
PA 17055
01-28-97
JUMPER
07-19-96
21 96-0585
CUMBERLAND
101
AMount R..itt.d
*'
'n.I""1I u. III.'U
RUTH
A
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT ALDNG THIS LINE .. RETAIN LOWER PORTIDN FOR YDUR RECORDS ......
REV:i5'4-j-EX--Af'ii-iiF9&Y"NO"ficE--O"-YNHEifii'AN-CE-YAX-'A-ppiiiiisEifENr-;-ALi-oWAiic,r(ffi-----------------
DISALLDWANCE OF DEDUCTIDNS AND ASSESSHENT DF TAX
ESTATE DF JUMPER RUTH A FILE ND. 21 96-0585 ACN 101 DATE 01-28-97
If an assassmant was issuad praviDusly, linas 14, 15 and/or 16, 17 and IB will
rBflact figuras that includa tha total of ~ raturns assassad to data.
ASSESSMENT OF TAX:
15. Amount of lina 14 at Spousal rat. (15)
16. ~t of lina 14 t.~.bl. at Lin..I/Cla.. A rat. 11&)
17. A80unt of Line 14 t.~~l. at Collateral/CI... Brat. (17)
18. Principal Tax Due
TAX CREDITS:
PAY"ENT
DATE
10-15-96
TAX RETlJRN WAS, (X I ACCEPTED AS FILED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE DF RETURN BASED ON: ORIGINAL RETURN
1. Real est.t. (Schedula AI (11
2. Stock. Md Bondi ISchedule OJ (21
3. Clos.ly Hald stock/Partnership Int.r..t (Schedul. C) (3)
4. Kortgag../Not.. Receivabl. (Schedule OJ (4)
5. C..h/Bank Deposits/Mllc. Parsonal Property (Schedule E) IS)
&. Jointly Owned P~oP.~ty (Schedul. FI (&J
7. T~ansf.~s (Sch.dul. G) (71
8. Tobl Au.ts
APPRDVED DEDUCTIONS AND EXEHPTIONS:
9. Fun.~.l Expens../Ad.. Co.ts/Hisc. Exp.ns.. (Schedul. H) (9J
10. D.bts/Ho~tgag. Liabiliti../Lians (Schadul. X) (10)
11. Total Deductions
12. Net Value of Tax Retu~n
13. Cha~itabl./GoYe~~t.1 a.qu..ts (Sch.dul. J)
14. Nat Valua of Estat. Subject to Ta.
NOTE:
RECEIPT
HU"BER
AA146843
DISCOUNT
INTEREST
1'1
I-I
84,67
I CHANGED
.00
.00
.00
.00
20,449.28
7,207.19
.00
(81
1.566.80
117.45
(Ill
1121
1131
1141
.00 X .00,
24,472.22 ~ ,06=
1.500,00 ~ .15=
1181
A"OUHT PAID
1,608.67
TOTAL TAX CREDIT
BALANCE DF TAX DUE
INTEREST AND PEN.
TOTAL DUE
· IF PAID AFTER DATE INDICATED, SEE REV[ tSE
FDA CALCULATION OF ADDITIDNAL INTEREST,
NOTE: To in.u~. p~op.~
c~adit to you~ account,
sub.it the UPP.~ po~tion
of this fo~. with your
tax pay..nt.
27,656.47
1 .684 ?~
25,972.22
,00
25.972.22
.00
1,468.34
225,00
1.693.34
1.693,34
.00
.00
.00
I IF TOTAL DUE IS LESS THAN fl, NO PAY"EHT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YDU "AY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FOR" FOR INSTRUCTIONS. I
110,
)1
f'
'~(I
'^" ~A
In,j LL'
f'1 :l)7
Ck
Cur
RESERVATION: E.tet.. of dec~~t. dying on or before Dec'~r 12, 1982 -- If any future Int.r..t In the ..tat. I, tran,f.rrad
In po.....lon or .nJoveent to Cla.t B (collat.rel) b~flclarl.. of thl dectd.nt .'t,r the Illplretlon of any I' tat. for
II'. or for y..r.. thl Co-.onwealth hlt,by expr...ly r...tv.. thl right to appral.. ftnd ...... tren,f.r Inheritance raxI.
at the lawful Cia.. B (collat.ral) rat. on any such future Int.r..t.
PURPOSE OF
NOTICE I
To fulfill the rltqUl,...."t. of Section 21,.0 of thl! IMlirltenc. Ilnd [,tat, 'Ill Act, Act ZZ of 1991. 12 P.S.
Section Zl"O.
PAVHEHT:
O.tl!K:h the top portion of this Hotlel and .ub_it with your pay.ent to thl R,,,ht,,. of Wills prlnt~ on the r.y.,... .Ide.
--Hakt check or 110M)' order payftbl. tOI REGISTER OF" MILLS, AGENT
All pay.ent. r'Cllvld .hall flr.t ba applied to any Int.r..t which .ay b. due with ftny r..alnd.r 8Ppll~ to t~ tax.
REFUND (CR) I
A rd\ftt of a tax credit, which wal not rltqU4llted on the TIUl R.turn, .ay be requelted by capl.tlng an ",tppllcetlon
far R.fund of Pennlylvanla Inherltanc. and E.tat. rax" (REV-IlIl). Appllcatlonl are avall~l. at the Offlc.
of the A-alstar of Wills, any of t~ 21 R.yenue District Offleal, or by calling the lpeclal 2"-hour
anrvarlng 1.~lc. ~rl far far. I orderlngl In P.nnlylvanla 1-800-362-20~O, autlld. Pennlylvanla end
within lacal HarrllburD ar.a (711) 787-8094, fDD' (117) 772-22~2 (H.arlnD lepalr.d Only).
DBJECfIDHSI Any party In Int.r..t not satlsfl.d with the appral....nt, allowanea or d1sallowMC. of deduction., or .....,.."t
of t.x (Including discount or inter.stl .. shown an thll Notlc. au.t Object within sixty (601 day. of recalpt of
this Motlea bYI
hwrltten prot..t to the PA Depart.."t of R.yenue, Bo.rd of Appea", Dept. 281021, Harrisburg, PA 17128-1021, OR
h.lectlon to hay. the .attar det.r.ln8d at audit of the ecCOl.W1t of the perlonal repr.lantetlv., OR
--appeal to the Orphans- Caurt.
AMIN
ISlAAfIVE
CORRECTIONS I
Fectuel .rrorl dllcov.red on thl. all.ll.ant ~Id be addr.lled In writing tal PA Oap.rt-.nt of ReY~,
Sur.au of lndlvlctual faul, ATTNI POlt An.....nt Review Unit, Dept. 280601, ttarr1sburg, PA 11128-0601
Phone (111) 781-6S0S. See P&08 S of the booklet "Inltructlon. for Inherltanc. ra. R.turn far a R.sldent
Decadent" (REV-ISOI) far an .xplanetlon of 8dalnlltratlv.ly correctabla .rror..
DISCOUNT:
If any tax ctu. I. paid within threa (31 calendar aonth. .ft.r the deced.nt', death, e five percent CSXI dllcount of
the tax paid" .lIowed.
PEHALTYl
Tht ISX tax __Ity nan-pertlclpatlan penalty I. COllPUt8d on the totlll of the tax end Int.r..t IIU'''*', end not
paid befor. January 18, 1996, the first dllY aft.r the and of the tax .....Ity period. This non-participation
panelty II 8PP8alabl. In the IIHMI .anner and In the t~ IIHMI t1.. period a. yau would app.al the tn and Int.r..t
that has bun a"'"ed as Indlcat.d on this notlc..
INTEREST I
Intlr..t 11 charged beginning with first day of delinquency, or nine (91 .unth. and ana 0) day froe the det. of
death, to the date of pa)'Hnt. Tax.. which bee.. delinquent before Jenuary I, 198Z beer Intar..t at the rat. of
six (6:1:) parcent par ~ calculat.d at a dally rat. of .000164. All tax.. which beelHMl dell~t on and nft.r
Jnnuary I, 1981 will baar Inter..t at a rftt. which will vnry froe cnlandar y.ar to calendar y.ar with that rat.
announced by the PA D.partaant of AeY~. rhe appllcabl. Inter.lt rat.. far 1981 through 1997 ar'l
'!!!!: Inter.st Rat. D_lly Inter..t Frw:tor !!!!' Intorest Rat. DftllY Intere.t Fftctar
1981 2Qj( .000~48 1987 .~ .000Z"7
1983 I.~ .000438 1988-1991 IU: .000301
I... 11% .000301 lqq2 .~ .000241
1985 13% .0003!t6 1993-1994 7> .000191
I'" IO~ .000Z74 (1)fI~-1997 .. .000247
nInt.r..t II cnlculatld .. follow.:
IHTEIIEST = BALANCE OF TAX lIlfPUD X IlUIlBER OF DAYS DELINQUENT X DAILY IHTEIIEST FACTDA
nAny Notice I..ued aft.r the tax becOM. delinquent will reflect M Int.r..t calculation to flft.." (1S) days
beyond the dllt. of the a....lunt. If paya."t .. .ade aftar the Int.rut coaputatlon dllt. shown on the
Notlc., additional Int.r'lt au.t be ealcullltad.
S1'A'l'US REPORT UNDER RULE 6.12
Decedent:~\"Ll~ (4- ---
Name of ,{ {(ltleU'
Date of Death: .., I, '1 jf)l,
Will No. Admi.n. No. ,) I t]l:, - (\ 5 b- 5
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, 1 report the following with respect to completion of
the admInistration of the auove-captioned estate:
1. State whether administration of the estate is complete:
Yes (,/ No
2. If the an~wer i.s No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. I is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No ,/.
b. The ~epil rate 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, re eases, joinders/and
approvals of formal or informal acco~r~s may ~~ftei~~~ w..!:h t e
Cerk of the Orphans' Court and may be/1 ~a~e(;tll1.~/;~~ t.
Date: 10/1,lq" ,It(:{f f/ '//.' t~
Signature
fnurrc\ ~<. (,Lh I +Wi , II f'!:Z'
Name (Please type or'print)
5L/ f:. /.ne'l." fJ St.
n,.. c he. 1"<''' hell'''S Pa. 1"/0 S:J-
Address '
..-~
(1)/':1) 1,Q'7-L1IoS0
Tel. No.
;J' )
Capilcity:
Personal Representative
K Counsel for personal
representative
( MAil: rmf/AM3)