HomeMy WebLinkAbout96-00888
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Esrare of Suzanne N. Beam
also known as
No. ~I. q fa' ~8~
To:
Register of Wills for the
County of Cumberland in Ihe
Commonwealth of Pennsylvania
Df..'c'I'ClSt'II.
Social Securiry Nfl. 192 - 60- 2982
The petition of lhe undersigned re'pectfully represenls that:
Your pelilionerW. who is/~Ir 18 years of age or older, applY(os
for lellers of adminislralion
on the estale of
(d,h.n.; pendeRIl: lile; dur:mlc ah\rnlia; dur3nlC I!llntlfllillC'
the above decedent.
Decedent was domiciled at death in Cumber land _ CounlY, Pennsylvania, with
~ er lastfamilyorprincipalresidenceal 303 Country Club Rd. '0 Carlis1e,..i.A 17013.
tllat. street.. n'JITlbt!r, Twp. or Doro.: f}! I () i\ L L ":>( '/
-Tel (J
al
Decedent, then 16 years of age, died Seotemb",r 29.
Cumberland County. Pennsylvania.
. 19.95
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property S
(If nOI domiciled in Pa.) Personal properlY in Pennsylvania S
(If nol domiciled in Pa.) Personal properlY in County S
Value of real estale in Pennsylvania S
situated as follow,:
Pelitioner_ after a proper search ha.lL- ascerlained that decedent left no will and was survived by
the following spouse (if any) aud heirs:
Name Relalionship Residence
.,
e, PA 17013
~
Carlisle PA 17013
THEREFORE. petiliollerisi respectfully request(s) the grant of lellers of administralion in the
appropriate form 10 Ihe under<igned.
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Kathy A. l23n
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
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The pelitloner(s) above.named swear(s) or affirm(s) lhat the
stalemenlS in lhe foregoing pelition are lrue and correct to the besl
of the knowledge and belief of petitioner(s) and lhat as personal
representative(s) of the above decedent petilioner(sl will well and
truly administer the estate according to law.
Sworn to or amnncd oand subscribed f
be me thi5 ..:J (' .. day of
. ,t. "1,-, I ,j 19 r? (.-,
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No 21-96-888
.
Estate of ~ 17.<rrP M. B:m1
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW NOVEMBER 4 19~, in consideration of the petition on
the reverse side hereof. satisfactory proof having been presented before me,
IT IS DECREED lhat EARL L. BEAM
is/are entitled 10 Lellers of Administration, and in accord with such finding, Lellers of Administration
are hereby granted to EARL L. BEAM
in the estate of
SUZANNE M. BEMI""----
FEES
Lellers of Administration ..... S I B.CO
Short Certificates(5 ) .. . .. . .... S 1 ~ m
Renunciation ................ S
J r!if'i"l Projtt S 5.CO
TOTAL _ S 3&00
Filed . ~.qYm~~u........ A.D. 19....2L
\/) )t 101 (I ,X; /1 .., ^::'i (ili ? i. I ~,I( : :, L,'.;. (/'1
/, \Rt!il"; ~t WillJ
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t'lrlroo C. ~):I.;l~ I, E:.~. t-b. 7J:fJj2
.JtillHN & t-IIl1<rn
ATTORNEY (Sup. CI. 1.1). No.)
52 E. Higj1 St., G:n:Us1e. FA 17013
ADDRESS
(717) 249-fA27
PHONE
ATTORNEY CALLED NOVEMBER 6, 1996
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COMMONWEALTH OF
PENNSYlVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
KARRISBURG. PA 17128-0601
,
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY t!/
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FILE HUMBER
l....L-96 888
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DECEDEHT'S NAME I\AST. FIRST. AHD MIOOlE INITIAL)
Beam Suzanne
DATE OF DEAIli IM\I.lIO.YEAR) DAlE OF BIRTH IMM.DOYEAAI
09-29-95 08-30-79
liF APPLJCABU) SVRVMNG SPOUSE'S NAME lLAST. FIRST. AHa MOotE 1N11lAl)
SOCIAL SECURITY HUMBER
192 - 60 2982
IliIS RETURH MUST BE FILED IN DUPU~TE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
~
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o 4o.Futlnill....sl~I_~_...II.Il." 0 5.F_EslOltTuR,IumR.qund
o 7. Oealdonl....inlIlned IlMngTNsl_...~I""'l 6. TOCII NumbOfol SaIl OepacilBoxIl
o lO.SpousaIl'oYII1yCted<tI_~__Il.I.""""'''' 0 II.Eie<llonlDw...,.,Sec.911J{Alt......",
ALL CORRES IlDEN E 1: IHFORMA SHOO B.O
COMPlffi t.lAJlING ADDRESS
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THIS SECtION MUST BE COMP
NAME
Earl L. !: Kath A. Beam Mministr tor
F1c'JW"E~"'1Il'\"~ino & Rovner, P.C.
TElEPHONE NUMBER
(717) 238-6791
Angino & Rovner, P.C.
4503 North Front Street
Harrisburg, PA 17110-1708
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t. RIll EslalI (SdIecUo AI
2. _rIII_I_O)'
3. Closely Held CapcntIon, Plltnetlhip or SdH'roprilIonhip
4. Mortgogot & IleUs _blo ISche<UI 0)
5. CIsl1._0ep0sI~6"'_ PenonolPrope<ty
I-El
6. Jointly Ownod Pr1lpIlty (Scho6.ft F)
o Sepllllllliling ~1Bcl
7. Inlo<.VlYos TrwIn & MtsClllonlous Non-PrcbIII Property
ISdle<UtGorll
6. TotaIOnloaAAltl(1alllUnllI'7)
I. FIIIIIsl EJponsn & AdmIrlsIratlve Costs ISchedllo H)
to. 0IIlIs 0I1lI<:edn, MoI\gIge Ulbilities, & IJons ISdloduIt II
It. ToIII Dtductlonll'>tllli1ls 9 & to)
12. HtI.V~UI or Esllte llile 6 minus line It)
(t)
12)
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(4)
(5)
OFFICIAL USE ONLY
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92,375
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(7)
(8)
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92 :~75
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(9)
(101
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(12)
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Il. CIlarilablo IIld GoYImmen1al OoquestslSlc 9t13 TN'Is knh<llon elecbon \0 lax has nol been (ll)
modi (Sd1oduIo J)
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14. HIl V~III Subjlct \0 Tu (Uno 12 minus lile III
SEE IHSTRUCT10HI ON REVERSE SIDE FOR APPlICABLE RATES
IS. AnIl<.rI 01 Uno t4 _ 11110 spousaIlal
..... cr nnsfo" undo< See. 9116 (0)(1.2)
..0_ (IS)
6 (16)
..D_
. .12 1171
. .15 (18)
1191
5,542.50
(14)
92,375
92,375
5,542.50
16. AnIl<.rIoIUnoI4_01l1one1l..lo
17. Amount of lile 14 Io..bl..l ~bl#1g rail
16. Amount of lile 14 Ioubl. II toIlal.raI..to
19 Tu 0.1
200
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPi\YMENT
. .. BE SURE TO ANSWER ALL QUESTlONSON REVERSE910EAND RECHECK YArn ~c..:.,~1' . .'1!,',!--
Oecedenr. Complete Addre.s:
uzanne Beam
303 Count Club R~~
CITY
Tax Payments and Credits:
1. Till lluI (P1gI1 LIne 19)
2. CrldllIIPIyments
A. SpousaII'oYtrty CId
B. Priof' P.yments
C.DlICXlUIII
(1)
5.542.~O
Tala! CI1!dits(A+ B + C I
(2)
-0-
3. InIerlsUPenllly NlppllcabIe
O.lnllml
E. PtnIIty
TotaIlnl!f8sVPenalty ( 0 + E )
4. Kline 2 bgrllletlhan line 1 + line 3, enter 1I1e difference. Thls Is !hi OVERPAYMENT.
Chtdl box on PlglIl Un. 20 10 I1qUtll1 ralund
(l)
(4)
(5)
(SA)
-0-
5. "line 1 + LIne 3 b grealelll1ln line 2. enter 1I1e ddf.rence. Thls Is !hi TAX DUE.
A. Enter !hIlnlelesl on th. III due.
-0-
5,542.50
B. Enter !he IoIaI oIlile 5 + SA. ThIs Is 1I1e BAlANCE DUE. (59)
Make Check Payable to: REGISTER OF WILLS, AGENT
r;;;::.~i!l.'!;;'.iI..~.!td'.,..,~ -~____._~I~~~~""'F~~.~
PLEASE ANSWER THE'FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedenl make I ~3nsl.r and; Yes No
I. relaln th. use or Income 01 !he property lranshllTed;.......................................................................................... 0 liiJ
b. retain th. righl1D designate who shall us. !he property transfened or Its Income; ............................................ 0 liiJ
c. relaln. rewrsJonaty InllllllSt or.......................................................................................................................... 0 liiJ
d. recelw 1I1e promise lor lils 01 eithe, payments. benefits or care?..................................................................... 0 liiJ
2. K death OCQJned after December 12. 1982. did decedenllranslar property within one year 0' death
wilhout receiving adequate oonsld...tion?............................................................................................................. 0
3. Did dacedenl own an rll1lrust for" or p.yable upon death b.nk accounl or security al his or h., da.!h?.............. 0
4. Did decedant own an Individual Retirement Aa:oun~ .nnuity. or oth.r non-probale property which
oonlalns a beneficiary designation? ........................................................................................................................ 0
IRI
IRI
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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 RETUF
l.IndIf C*'II'n of ~.l dedIrt hi I twYI turnnId '" "Un, ncwng ..............rYI!J ldlIdeHl'" Slallmlnts, If1d b.. bnI of my ~.., bNf. lIS 1M. amd end COl1'$IItI.
_oI__.......__..."_on.._oI__has""~
SIGIlAT\J OF P S RESPONSI9LE FOR FILING RETURN
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ADD"'SS~
~. 303 Country Club Road Carlisle, PA 17013
SIGNAT\JRE OF PREPARER OTHER THAN REPRESENTATIVE
DATE
01/02/02
DATE
ADDRESS
lY.;~4l!if.;m!m~.,w='r.illJt~~~.!l;l'=:~I~~.:A~C.'i'il~,:r~mtfl1~\1;I.l:\:~-
For dates of de.th on or after July I, 1994 and before Janu.ry 1, 1995. the lax ,.Ie Imposed on 1I1e 001 value or transfers III or lor the use 01 !he SlIYiYing spouse ts 3%
(12 P.S. 59116 (a)(I.1) (I]~
For dates of de.th on or .ftar January '. 1995, tha lax r.la "l'4lOsed on !he nel v.lue 01 ~.nslers 10 or lor Iha us. of Ihe surviving spousa Is 0% (12 P.S. 59116 (I) (1. 1
The slalula does not Ilemot a transfer III a surviving spousa horn tax, and the sl.lutory requirements ror dlsclosura 01 .ssets and filing. lax relum a'e still .ppIlcable e
!he survtving spous.ls I1e only benaficiart.
For dales of de.th on or .fter July 1. 2000;
The lax ,.t.lmposed on !ha net v.tu. of lranslers horn a dece.sed child twenty-one years 01 .ge or younger at de.th 10 or for !he use 01 a nalur.1 parent. an .doptive p
or. slapp.rent of the child Is 0% (12 P.S. 59116(.)(1.211
Th.lax r.le imposed on the n.t value of lr.Insfers \0 or for the use 01 !he decedent's hne.1 benefio.nes Is 4.5%, except.s noled In 72 P.S. ~9116(l.21 (12 P.S. ~91 16('1(111
The la, ..I. imposed on th. n.1 v.lua 01 ~.nsfers 10 or for !he use of !he decedent's siblir )S is 12% (12 P.S. ~9116(.)(1.3H. A ~b1ing is defined, under Section 9102.
individu.1 who has .Iteast one parent In convnon With the deceden~ whether by blood or .doption.
VI
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ClJoIIClH'tIt.I1HOfPE/llSl'lVNIA
IHJITAHCE TAX IlflURH
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
Beam, Suzanne
FLE NUIlBER
21-96-888
ESTATE OF
IncUllIle pIll*dI oIl1l1;1l1an nile dIIIIlle praoeedI_1IC8iwId bJ Ile_ AI plVporlJ JoInII\ D.......... III right 01 ~ _ Ill".. ,,, lid ..Icll
ITEM VAlUEATDi
NUMBER DESCRIPTION OF DEAn-
1.
Proceeds fran Survival Action
Cumb&land County, No. 97-2069 Civil
$92,375
PRCX::EED5 REx::ElVED ON JANUARY 9, 2002
NJl'E: The supporting documents for this tax return
have been supplied to the Department of Revenue
only for the purpose of confidentiality. Order
and Petition sealed by the Court.
. . 92,375
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CO...."'ON\\[AlTtl or I'IW.'iHVI.r,IA
OIl'AR1...."H C! IllV!tlUl
UUIIIAU Of IMJIVI[JU^ll.'~1 So
D[PT ~1l0(,OI
"AlII1I~IlUI1(j, I'A lnnl O~UI
RECEIVED FROM:
ANGINO & ROVNER PC
4503 NORTH FRONT STREET
HARRISBURG, PA 17110-1708
........1....'
PENNSYLVANIA
INHEmTANCEANDESTATETAX
OFFICIAL RECEIPT
ESTATE INFORMATION: SSN: 192'00.2982
FILE NUMBER: 21-1996- 0888
DECEDENT NAME: BEAM SUZANNE M
DATE OF PAYMENT: 01/09/2002
POSTMARK DATE: 0010010000
COUNTY: CUMBERLAND
DATE OF DEATH: 09/29/1995
REMARKS: ANGINO & ROVNER PC
CHECK/l12624
SEAL
ACN
ASSESSMENT
CONTROL
NUMBER
101
TOTAL AMOUNT PAID:
INITIALS: VZ
RECEIVED BY:
IlcGIs'n"~ OF WILLS
III V 11112 l XII 1 UOI
NO. CD 000732
MARY C. lEWIS
REGISTER OF WillS
AMOUNT
$5,542.50
$5,542.50
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
OEPT 260601
HARRISBURG, PA 17128.0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
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~~~
Mlv,un u 111") PC
EARL L BEAM
-,\
C/O ANGINO & ROVNER
4503 N FRONT ST
HBG PA 17110
NOTICE OF INHERITANCE TAX
APPRAISEMENT, AllOWANCE OR DISAllOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NO,
COUNTY
ACN
04-01-2002
BEAM SUZANNE M
09.29.1995
21 96-0888
Cumborland
501
Amount Remitted
..
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
Register 01 Wills
Cumb.~and County Cou~hous.
Carlisi., PA 17013
CUT ALONG THIS LINE Q RETAIN LOWER PORTION FOR YOUR RECORDS ~
"Fley:i547 eif(06-97yPC............. 'Notii:"E"CiF "fNifERlfiiNCn';it" A F'PRAHfe;.;E"Nt":A"LI:.OWAN'ci:' OR........................ ........
DISAllOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
SUZANNE M FilE NO. 21 96.()666 ACN 501
TAX RETURN ~AS: (~) ACCEPTED AS FILED ( 0 ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: liTIGATION RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Hortgeges/Notes Recelveble (Schedule D)
5. Cash/Benk Deposits/ Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Aa.. Costs/Hlsc. Expenses (Schedule H) (9) 0.00
10. Oebts/Hortgage liabilities/liens (Schedule I) (10) 0.00
11. Toul ~eductions (11) 0.00
12. Net Value of Tox Return (12) 92,375.00
13. Chnrtuble/Govcrrmcntal Bequests: Non.clcctcd 9113 Trusts (Schedule (13) 0.00
14. Net Value of Estate Subject to Tax (14) 92,375.00
NOTE: lI.n ......m.nt was I..u.d pr.vlously, IIn.s 14, 15 and/or 16, 17 and 16 will roll.ct ligures
that Includ. tho tot.1 01 All r.turns a......d to d.t..
,.
.1
ESTATE OF
BEAM
DATE 04-01.2002
(1)
(2)
(3)
(4)
(5)
(6)
(7)
0.00
0.00
0.00
0.00
92,375.00
0.00
0.00
(6)
NOTE: To Inlure proper
credit to your lecount.
submit the upper portion
of this fonn with your
tax payment.
92,375.00
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousol rote
16. Amount on Line 14 taxable at lineal/Class A rote
17. Amount of Line 14 taxable at Sibling rote
16. Amount of Line 14 taxable at Collateral/Closs B rote
19. Principal Tax Due
TAX CREDITS:
PAYHENT
DATE
01'09-2002
RECEIPT
NUHBER
C0000732
DISCOUNT (+)
INTEREST/PEN PAID (-)
0.00
(15 0.00 X .00= 0.00
(16 92,375.00 X .06= 5,542.50
(17 0.00 X .12 = 0.00
(16 0.00 X .15 = 0.00
(19) 5,542.50
AHOUNT PAID
5.542.50
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST
TOTAL DUE
5,542.50
.00
.00
.00
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
(IF TOTAL DUE IS LESS THAN $1, NO PAYMENT 19 REQUIRED.
IF TOTAL DUE IS REFLECTED AS A CREDIT (CR). YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR
INSTRUCTIONS.)
RESERVATION
Estates of decedents dying on or before December 12. 1982 -If any future Inlerest in the estale II transferred In possession or enjOymenllO Class B
(collateral) beneftdaties of the decedent after the Bllptratlon of any estale for life or for years. the Commonwealth hereby Bl(pressty reserves the right to
appraise and assess transfer Inhenlance Taxes at the lawfuf Class B (COllateral) rate on any such future interest.
PURPOSE OF
NOTICE:
PAYMENT:
To fu1filllhe req....remenls of Section 2140 of the Inhentance and Estate Tax Ad. Ad 21 of 1905. (72 P_S Section 9140)
Detach the top portIOn of ltlis Notice and SUbmit ....,th your paymenllo the Register of Wills pOnIed on the rever18 side. Make check or money order
payable 10 REGISTER OF WILLS. AGENT.
A refund of 8 tax credit wtlich was not requested on the Tax Return. may be requested by CX)fTlplebng an -Application for Refund or PeMsylvania
Inhentance and Estate Tall. (REV.1313). Applicabons are available at the Office of the Register of Wills or any of the 23 Revenue District OffICeS. or by
caUing the spedal24-hour answeting service number1 for forms ordering In Pennsylvania 1..e00.362.2050. outSide PeMsylvanla and wilhin local
Hamsbu'V a..a (717) 787-8094. TOOl (7111 772.2252 (Heanng Impaired Only)
REFUNO (CR)
OBJECTIONS
Any party In interest not satisfied with the appraisement allowance or disallowance of deductIons, or assessment of tall: (including discount or Interest) as
shown on this Notice must object Wllhin sixty (60) days of receipt of this Nobce by
-Wrlllen pretest to the PA Department of Revenue Board of Appeals. Dept 281021. Harrisburg. PA 17128.1021. OR
-election to have !he mailer determined at audit of the account of !he personat represenlative OR
-appeal 10 the Orphans' Court
AOMINISTRATIVE
CORRECTIONS: Fadual errors dIscovered on lhis assessmenlshould be addressed In wnbng to PA Department of Revenue, Bureau of Individual Taxes. ATTN: Post
Assessment Review Umt Dept. 280601 Harrisburg, PA 17128.0601 Phone (7171787-6505. See page 3 of the booklel"lnslrudlons ror Inherilance Tax
Relum for a ReSident Oecedenr (REV.15011 for an explanation of administratively COllectable errors.
DISCOUNT: If any tall: due Is paid within three (3) calendar months after the decedenfs death a live pertent (5%) discount of the tax paid is allowed
PENALTY: The 15% tax amnesty non.partlCipation penalty is computed on the total of the tax and Interest assessed. and not paid before
January 18.1996, the first day after the end of the tax amnesty periOd This non.partidpation penalty Is appealable In the same manner and In the same
time period as you would appeal the tax and interest thai has been assessed as IndiCated on this notice
INTEREST: Interest is charged beginning with first day of delinquency. Of nine (9) mon!hs and one (1) day from the dale of death. to the dale of payment Taxes
which became delinquent befOftt January 1, Hl82 bear inlerest at the rale of sill: (6%) percent per annum calculated ala daily rate of .000164. All taxes
which became delinquent on and after January 1. 1982 will bear interest al a rale which will vary from calendar year 10 calendar year wI!h that rate
announced by the PA Department of Revenue The applicable interest rates for 1982 through 2001 are.
YEAR INTEREST RATE OAILY INTEREST FACTOR YEAR INTEREST RATE CAlLY INTEREST FACTOR
1982 20'l1 0005<18 1992 9% 000247
1983 18% 000438 1993.1994 7% .0001g2
1984 11% 000301 1995.1998 9% .000247
1985 13% 000358 1999 7% 000192
1988 10'l1 000274 2000 8% .000219
1987 9% 000247 2001 9% 000247
1988.1991 11% 000301 2002 8% .000184
-Interest Is calculated as follows
INTEREST. BAlANCE OF TAX UNPAIO X NUMBER OF CAYS OELINOUENT X OAIL Y INTEREST FACTOR
-Any Notice issued after the tax becomes delinquent 'Mil renect an Interest calculallon 10 fifteen (15) days beyond lhe date of the assessment. If payment
is made after the inlerest computation date shown on the NotlCQ. addltionallnteresl must be calculaled
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riLE NUMUER
2 1 9 l> IJ
INHERITANCE TAX RETURN
RESIDENT DECEDENT
IJ IJ
OLC[O[tH S Im,lL IlAS! rlllSI. ^,lU M'IlIlI L 1I1IIIMI
l3cam, Suzanne
CiAl'E O,'OEA1Ii'ltll,lUO.Y[AlII II'A'L OIllllmll~II,l-IlOVLAIlI
09-29-95 01J-30-'/9
------~~---"-_._"-_.. . ,...-._---_._~.__._------
I" APPliCABLE I SURVIVlljG SPOUSE S flAML IIAS1. rllISI. AIlD MIOUlL IIllHAll
n/a
'."1-111
(",fil,!ltl "n,
~O(;IM SrCUHlI'f 'lLIt.lUlH
192
60
2982
III1S RETURN MUST BE filED IN OUPLlCATE WITIIIIIE
REGISTER OF WILLS
SOCIAL SlLUlllIY IMIIlIIl
[] 2 SUl11J!cmcnl,11 ReluIn
I~J 4a Fulufe Interest Compmmlso 1J.ali'oI~dl', ,I~M 1111 ~;I
[-I 7 O(!({)dcnl f,l.1lnl,lllll>d a llVllll] 11usl l"lt1<'1> fJ.'f ,) IMII
[~11O Spolls'" Po~cr1y CfCdttlll!l'd~~"'brll.......li 11 ", ....J', '1'.'
t.] 3 f~el!l.1l1ldt'r UIJlurrl I ~.I'" tJ 1'. ''''l'..l' Ii II ~.'I
[] 5 rNlelal bl.llc lil_IMulIIf:LlIUlrcd
6 1o\il1 UUlIlllCr 01 Sale Oel~l~'l HUJcs
[~111 Eledlflll lu 1.1l tinder SCt. 111111^I l'\ll...-h ';'hl)l
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'THIS C ON MU BE.COMPLETED. ALL CORRESPONDENCE AND .CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME JIdm' , t COMPLETE MAllIllGADORESS
Earl L. & Kathy A. 13eill11, W1S ators
FIRM NAME l""<<....~l
C/O Angino & Rovner, P.S-'--___
TELEPHONE tlUMBER
717 238-6791
J Closely Held Corporation. Partnersh'p or Sole'PfOprictOfshlp
4. Moo19'ges & Noles Rece"a~e (Sdledule 01
5. Ca!J1, Bank Deposits & M,scellaneous Persooal Propclly
(Schedule E)
6. J~nUy Cffloed Prope~y (Schedule F)
o Separate Billing Requesled
7. Inler.v1VOS Transfers & Miscellaneous Non.PfOb.11e Propcl1y
(Schedule G O! L)
8. Total Groll Assel. (Iolal Unes ,.7)
9. Funeral Expenses & Admmistrall~'e Costs (Schedule H)
10. Debls of Decedenl, Mortgage ltarnl+bfls, & liens (Schcdulu I)
11 Total Deduction. (Iolal Unes 9 & 10)
12. Nel Value of Estate tUno 8 minus line 111
13. Challtablo and Governmental Bequests/See 9113 Trusts for wt\lch an electloo 10 li!_ h.1S not becn
made (Schedule JI
16. Amount of Une 141axablo alllne,ll mlc
17 Amount ollme 141axatJlc al Sibling rate
18. Amount 01 line 14 talable al coll,lteral rale
19 Tn Due
Angino & Rovner, P.C.
4503 North Front Street
Harrisburg, PA 17110-1706
III lJI rtCIAL USI llfllV
121
(J)
(4)
III $10,000.00
(6)
(7) -_....-- .-..- - .. n - ...
181 $10,000.00
(91 $10,000.00
(IO)
1111 $10,000.00
(III ____.__ -0-=--____
(131
(14)
14. Net Value Subject to Tu tline 12 mJllus line 13)
SEE INS7RUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
, 0 _ (151 _, ________._.___'
-0- 0 6
________, ___ (I I
. 11
1111
. IS
1181
(191.
-0-
,. Real EslalelSchedule AI
2. Sleds and Boods ISchedule BI
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15. Amount 01 Une 14la.able allhe spousallal
rale, O! Iransle" under See 9116 (a)11 21
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENt
20. 0
'l :,'.' > > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address:
SlIllU ^OlllllSS
____. __-.-1511?-illllle.-'3eLllII
-clji--m-.
303 Country Club
Car lisle
l'^
Ilcxxl
51^1I
Tax Payments and Crodlts:
I. T.. Due (Page I line 19)
2. Crod,lslPaymenls
A. Spous.I Po'e~y Credll
B Pnor Paymenls
C. Dlscounl
III
3.
Tolal Credlls ( A . B . C ) (II
InlcresVPenally If applicable
D.lnleresl
E. Penally
4.
TolallnlcresVPenally ( 0 . E )
II line 215 grealer Ihan line I . line J, enle' Ihe dllle,"nce This IS Ihe OVERPAYMENT,
Check bo. on P.ge 1 Line 20 10 requesl. refund
(3)
(4)
IS)
(SA)
(5B)
5. II Line I . Line 3 is grealer Ihan Line 2, enler Ihe dlffe,ence. ThIS is Ihe TAX DUE,
A. Enler Ihe inleresl on Ihe la. due.
B. Enler Ihe lolal of Line 5 + SA This is Ihe BALANCE DUE,
J "I'
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- ... ~==I
17013
Make Check Payable 10: REGISTER OF WILLS, AGENT
"'~\\\:~IlJ'''''t?_ ,,_ ~~..J;;.~h~..;>J~I,...Jl:Iii{;,i~';A1~;;...;~",~^~1",.;,:.;.ll';,';(..I\...'.;'""""i':\ol~1llI
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
I. Did decedenl make a lransrer and
a. retain the use or income ollhe properly transferred,.
b. retain the righllo designate who shall use the properly lranslerred or lis income;.
C. relain a reversionary interest; or...... ........... ..... ...... ............,....
d. receive the promise lor life of Clther payments. benefIts or care? .. .........._, .,_ ....... ... .._......
2. II dealh occurred aller Deoember 12, 1982, did decedenll,ansfer property wllIlIn one year 01 death
without receiving adequate consideration? ,. . ..........._._.....
3. Did decedenl own an *in lrusl for* or payable upon death bank account or security al his or her dealh?
4. Did decedenl own an IndIVidual Relllemenl Accounl, annUlly, or olher non.probate property which
contains a beneficiary designation? ................. ,..'.............._..
Yes
[]
[I
LJ
...... ... ... [I
. [I
[J
No
IXl
[Xl
1X1
IXI
IXl
~l
................ [J ~l
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
Undl!1 ~!~, 01 ~r/UfY I dPdare lhal I h.1~e fllarTllf'lf'1j ltlo\ leh,fI'l lfl(.tU(j'I'9 iU tort'l~ll1~lr'9 Sf I""J\ll(1~ <1"1<1 ..1.I~r";..rh O!f'lIllo IhP. be,' or m~ h)()...lfc<~JO an'l IIH.ol " ," ""r ((1'110( I ,'1><1 ((''l'I)r!(>
'aloon or pr~parPl' ol~ Ih.lll lhe ~\OO<l1 r(lpr~~mt"'l~1! IS b.l\~ on .,Q mlorm,llro ol....~ th p"1'p..l!1!I h.n ,1n~ .nav.If'd<Jl'
:i 't'. ~.....
..1.. t.
DATE
r , t.i, \'" , 8/30/01
; '.,....\.,
.,.','
303 Country Club Road Carlisle, P^ 17013
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
ADDRESS
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. ....,.. ""-...~J'~..~:~r.~':;..t,..;......:.;.': :'.' ",-":
DATE
.;
For dales of death on or aller July " 1994 and belore January t, 1995, Ihe la' rale imposed orr Ihe nel ,alue or I,ansfers 10 or ro, Ihe use of Ihe sUf'llYlng spouse IS J%
(72 P.S. ~9116 (a) (1.1) (ill.
For dales of death on or aller January I, 1995, Ihe la, r.le Imposed on Ihe nel value oll,",,,Iers 10 or for Ihe us. or Ihe Sllf'llVIIIg sp<Juse IS O"~ 172 PS ~911& I') III) 1"11
The slatute does nol clemol a transfer 10 a survlvmg spouse from tal. and the statutory reqUIrements for dIsclosure 01 assels ilnd flhng a I.,. r(!!lJrn are SIII1 ill'phcahle Clfcn II
Ihe sUJ'llving spouse Is Ihe only beneficiary.
For dales or death on or alier July I, 1000
Thc lal rille Imposed on Ihe nel value of lransfcrs from a deceased child t....ellty.one yetlrs 01 age or younger al death to or for the use 01 .1 natural Ilarent. an Jdopth'p. parenl.
or a slepparenl or Ihe child is 0% 172 PS ~91161aJlI 2i1
The la, r.'e Imposed on Ihe nel ,allle of Iransfers 10 or ror Ihe use ollhe decedenls line.11 ben.flClan., IS 4 5~,. e>cepl as noted In 71 PS ~YII&111, 171 PS ~911&lal(111
The la.. rate ImposEld on the nel value of transfers 10 or for the use of the decedent's siblings is 12% {72 P.S ~91t6talt t 3J1 ^ Sibling IS lIr.fuled. ullder SI~cl1tJll 9102. ,15 an
indl\<ldual who has al leasl one parenlln common wllh Ihe decedenl, ~hether by blood or adopllon.
W_UU.llMi
.
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COIoNOIMtAl rn Of PENNSYl V_
_"TANC( TAX RETURN
I NT
BEN>!, Sazanne
FILE HUMBER
21-96-11BB
ESTATE OF
Debts 01 d.ced.nt mUll be reported on Schedul. I.
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
I.
FUNERAL EXPENSES:
Ewing Brothers Funeral Hare
630 S. Hanover St Carlisle,PA 17013
- Funeral (bill attached)
S 5,455.
Cunberland Valley Memorial Gardens
1921 Ritner Highway Carlisle, PA 17013 - Memorial(bill attac
950.
Wayne Noss Flowers
525 Mountain Rd. Boiling Springs, PA 17007 (bill attached)
106.
B. AOMINISTRATIVE COSTS:
1. P......, R...-IlYe', CoIm1iIIIonI
Namo 01 PmonaI RepIllIef1lallYe (.)
Scdal Soan1Iy Numbelj'll EIN Numbol of P"""",,I RepresenlabYe(.)
Sb'eel Address
CIIy
Slalll
l.l>
2.
3.
Yea~.) CommissJon Paid:
AlIllmay FOOl
Famiy E,emplioo: (If _enl. address b noc IIIe same II damanl.. altad1l1p1anation)
Clamant Earl L. & Kathy A. Beam
StreelAdd..,..303 Country Club Road
CIIy Carlisle Slalll PA
RelallonshjJ 01 Clamant b Decedent
3,436.*
Zi>
17013
4. PIOlJaIll FOOl
5. Aooounlanra FOOl
6. TII Return Prepal1ll" Fe..
7. ldministrative Cost 3B.
Inheritance Tax Filing Fee 15.
Note. The Family exemption deduction has been reduced
by the amount needed to reduce assets to "0" when
excess deductions from the original return are applied
TOTAl (Also enler on line 9. Recapilulation) S 10,000.
~.III"I"~.
COIolM()HW(AlIH Of P1HNSll V/>H.A
INHtRtIAHCI: 1M REIURH
H HI
SCHEDULE J
BENEFICIARIES
BEJIM, Suzanne
FILE NUMBER
21-96-888
RELATIONSHIP TO DECEDENT
Do Not L1sl TlIlsleelll
AMOUN r OR SHARE
OF [STAlE
ESTATE OF
NUMBER
I.
NAME ANO AOORESS OF PERSON\SI RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (indude oulrighl spousal dlslnbulions)
,.
Earl L. & Kathy A. Beam
303 Country Club Road
Carlisle, PA 17013
Parents
100%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIA IE, ON REV 1500 COVER SHEET
11. NON.TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
,.
B. CHARITABLE ANO GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II. ENTER TOTAL NON.TAXABLE D1S1RIBUTIONSON LINE 130F REV 1500 COVER SHEET S
III mr<P ,p","p j, nI'Prlprl in,prl :W1llinml .hnnl, rllhn qmn ,i'n\
d ~ 'I' fI'__ _It, "
Cumberland Valley Memorial Gardem
1921 RITNER HIGHWAY
CARLISLE, PA 17013
November 2. 1995
"'''K 0""%
a.....,... c..Yl'TI
PHOI\lI! '0.>>41
..1Il........WT '''DO*lD CUt
NOff..lr:1A""""
Mr. & Mrs. Earl L. Beam
303 Country Club Rd.
Corllsle. Po. 17013
Dear Mr. & Mrs. Beam;
We arc pleased to acknowledge receipt, through our representative, of your signed applicalion
which provides protection as follows:
One Individual Bronze Memorial for daughter Suzanne.......S950.00
Downpayment- $950.00
Terms- Cash Paid in Full
We operate solely for the interest of our lot owners and you can be assured that the officers and
employees arc antious to assist you at all times on any problem thot may arise. All of our
facilities and services will be available to you at any time.
We feel sure that you will have many occasions to express satisfaction witb your selection and
know you will reconullemJ your P81k to your frien\ls.
Cordially yours,
Staff and Management of
CUMBERLAND VALLEY MEMORIAL GARDENS
> .
.'Yi.!P $' , .A'- ~ &w.
_'0
ADORI"
CITY/SlATE
WI."
0.. 0 0I1T
ROM'
ADDRESS
o ...._lIl1!NT
DESC"....11ON
OCC"'ON
CAAOTOR!AD
CM.uI.. TO
AOOAE!ls
CrTY,'STATE
CHAAOf CARD YYP5
OJ-hJ '
L.~~\". CR.
. r"\c.\~
WAYNe NOSS FLoWeRS
525 Mount.ln Rd.
BO/UNG SPRINGS, PA 17007
PhOM (717) 258-64311
53836
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BY
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o CUT FI.OWIIlll
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c~ry
atl~.
)')1,' /-u~ a f
100 ,J
c. 0 tars
TAX
TllTAL
7Iu- F~(IJ
Int.OATI!!!
o CAGH a CHARCIE 0 coo 0 NEW ACCOUNT
THANK YOU
;S-/37_')
BUREAU OF INDIVIDUAL TAXES
IN'I:RIlANC[ lAX DIVISlnN
ocrr. 180601
IlARPISBURG. IIA 1I1111-0bOI
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INNERITANCE TAX
APPRAISENENT. ALLOWANCE DR DISALLOWANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
10-22-2001
BEAM
09-29-1995
21 96-0888
CUMBERLAND
101
EARL L BEAM
C/O ANGINO &
4503 N FRONT
HBG
ROVNER
ST
PA 17110
r
Anount R...t tt.d
/~.
V~
III.lU'1I II. III-III
SUZANtIE
M
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 ....
iiE"v:mTEiCAFP-nZ:OoY-NoYicE--OF-i-tiHEiiiTAifcE-,:"AX"i\'PPRAiSEHENT-,--"i.UiwAifcniR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BEAM SUZANNE M FILE NO. 21 96-0888 ACN 101 DATE 10-22-2001
TAX RETURN WAS, I 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 AI
2. stocks and Bonds (Schedule OJ
3. Closely Held stock/Partnership Interest (Schedule CJ
4. Hartg.ges/Notes Receivabl. (Schedule OJ
S. C.sh/Sank Deposits/Hlsc. Personal Property (Schedule EJ
6. Jointly Owned Property (Schedule fJ
7. Transfers (Schedule G)
8. Tote1 Assats
CHANGED
III
121
131
141
151
161
171
.00
.00
.00
.00
10,000.00
.00
.00
18)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funerel Expenses/AdM. Costs/Hisc. Expenses (Schedule HI
10. D.bts/Nortg.g. LI.blliti.s/Li.ns ISch.dul. II
11. Total Deductions
12. N.t Value of TaK Return
13. Charitable/Govern"ent.l Bequests; Non..lected 9113 Trusts ISchedule J)
14. Net Value of Estate Subject to TaK
If an assessment was issued previOUSly, lines 14, 15 and'or 16, 17, 18 and 19 will
reflect figures that include the total of ahh returns assessed to date.
ASSESSMENT OF TAX:
15. Anount of Line 14 .t Spousal rat. (15)
16. A.ount of Lln. 14 taxable at Lineal/Class A rat. (16)
17. A~ount of Lln. 14 at Sibling rat. 1171
18. Anount of Line 14 taxable 8t Collateral/Class Brat. (18)
19. PrIncipal Tax DUB
D
NOTE:
DATE
C .
INTEREST/PEN PAID I-I
NUHBER
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
191
1101
10,000.00
.00
NOTE: To insure proper
credit to your account,
submit the upper portion
of this forn with your
tax pay.ant.
10,000.00
1111
112)
113)
114)
In.non nn
.00
.00
.00
.00 X 00 =
.00 X 06 =
.00 X 00 =
.00 X 15 =
ANOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
1191=
.00
.00
.00
.00
.00
.00
.00
.00
.00
IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR I, YDU NAY BE DUE
A REFUND. SEE REVERSE SIDE DF THIS FORN FOR INSTRUCTIONS. I
"
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l "~""""mo I "'"'''' 2'., "dc>banaI.._.. I also Wish to receive the
· "~"'" ll.m. 3. <'. 'nd <0. fOlloWing services (for en
I "P",,-...... And....... onlh. """"0'''" loon 10 'h., ""CAn ..,""',,,. ell1ro fee):
",d 10 you.
"All.", '''' 'onn '0 Ilia ',or< 0' Ilia ma;,llioco. ., on Ilia o.a. it ...ea <loa. not I. Cl Addressee's Addre..
e po",,!.
. " "Wn"'R",umR_PlR<qUOII"'on'lIamaiflliocobalo..lh..,,;a.numoa.. 2. Cl Restricted Delivery
'ii "Tha Rot"", ROCOlp".U Ihow '0 Whom '1Ia .,,"'. .... ........ And'1Ia .11.
I e dol"..... Consult POstmaster tor tee.
o
I 11 3. Arlicle AddresSed 10: 4e. Apc/e NUmber
'~ ~i>RE1\ C J"r'\CCBSE-N,r:~. 4b.se";c;TYP~- 3 ~-755
! 5> .. If"," Sr., 0_ ~..,
C~ LI ::"Lf: PA /10/3. 0 Express Moll 0 InSured
' 0 Retum Recelplfor Merchan<Sse 0 COD
7. Dote of oellve
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PS Form 3811, oocember 1994
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DomeSlIc Return Rece/pl
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JRD/June 30, 1992117R5R
UCI () 'I l'I(J~
In Re: Estate of SUZ!INNr~ M. UI'/IM
Late of MIOOI,r.:sEX 1U1NSIII P
ORPHANS' COURT DIVISION,
COURT OF COMMON PLEAS OF
CUMIIERLAND COUNTY
PENNSYLVANIA
21.1996.0888
No.
Estate No.: 21.1996.0888
NOTICE OF FAILURE TO FILE SfATUS REPORT AND REQUEST TO
CONDUer A HEARING PURSUANT TO RULE 6.12, SUPREME COURT
ORPHANS' COURT RULE
Personal Representative:
Counsel for Personal Representative:
/lNDfll-':'1\ C. IN\Jl3SI::N, E6Q.,
Date of Decedent's Death:
9.29.1995
Date of Delinquency Notice:
8.11.1999
The undersigned. Mary C. Lewis, Register of Wills. in aWlrdance with Rule 6.12. Supreme
Court Orphans' Court Rules, hereby notifies the Orphans' Court Division. Court of Common Pleas of
Cumberland County, that neither the above named personal represenlalive nor the above named counsel
for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his,
, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite
notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules. was given by the Register of Wills
on 8.llal999 , 19_, and that the ten (10) day notice to file the Status Report has expired.
Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the
undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed
upon the delinquent personal repr~entati~e or counsel for the delinquent persona~presentative.
Date: 10.4.199.2.- 1 ~la)u~\-' ~ 'll/) W1,i.
Mary ,Lewis. Regi. ter of Wil s
Distribution: Personal Reprc.~entative
Counsel for Personal Representative
Estate File
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WILL ^lJ1\MI\TICI\LLY BE O\NCELLED.
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STATUS REPORT UNDER RULE 6.12
Name of Decedent: Suzanne l3ciun
Date of Death: Septanlx~r 29, 1995
Will No.
Admin. No.21-1996-888
Pursuant to Rule
Court Rules, I report the
the administration of the
6.12 of the Supreme Court Orphans'
following with respect to completion of
above-captioned estate:
1. State whether administration ot the estate is complete:
Yes X* No *(Litigation settled-Final Inheritance Tax Return
will be filed when ranaindcr of monies received fran ClIT Fund - 12/31/01)
. 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 be filed with the
Cerk of the Orphans' C.ourt and may b~e attachej to this report.
*SEITLEMENl' UNDER SPAL BY ORDER OF ~
Date: ~'~kJ . 1;1
I~ 5'ign e
Neil J. Havner, ESC1\Ii re
Name (Please type or print)
4503 North Front Street. Hllrl"isbur9' PA 17110
Address
( 717) 238-6791
Tel. No.
Capacity: Personal Representative
~ _.Counsel for personal
representative
(MH: rmt/AM3)
RW-27
I
.
.
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
SLI~:IJ1I1(, N. Ixsun
Date of Death:
Sl'pwllIbl'r 29 , 1995
Will No.
21-1996-0888
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 ad~inistration of the estate is complete:
Yes No XX"
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete: Unknown; pending litigation
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: 10/26/98 ()(..., .Q ~
Signat.ure ( '\_ _
ANDREA C. JA~SEN, ESQ.
Nj~eoh~eNa~eNf~~~sor print)
52 East lIigh Strcet
Addre~s
Carllslc, PA 17013
( 71, 249-6427
Te 1. No.
*Estate is unresolved.
pending Ijtigation.
Casc is
, .
.,
Capacity:
Personal Representative
XX Counsel for personal
representative
. .
r , ,. ~
...... ~.
(MAH: rmf/ AM3)