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HomeMy WebLinkAbout97-00438 Eslnto 01 ...m____,_'LiHmil"!, .k'_.JLiL\:,yS!l'. , Cumberland , Register of Wills of kl!lltCOOt0X County, POllllsylvarlla PETITION FOil GR^NT OF LETTERS No,..~~L:-(tl- 1.* Q.td___ 01.0 known os ,__._._._______,__,___.".,.......~._'..'.' ..~._. _____~_____.~_...._.__._~._~..._~_.n~~_ .m_T_~_'_ ..-.....,---',--- . .on._' DocoaRod Soolol Seourlty No. 332 - 2 8.. 5 905 Debora .J. s~htf3h_ FOijtk;'WII.)~wh~'1i1V(;~/i- nr~gii -olojJ;f~ ;pj;iYffa-, In/: --~-- .. ., (COMPtE TE 'N on '0' OELOW:) . -",~~-.~-_."--""-----'---"--'.."- o A, PlChalo and Grunl ollollol' "lid nVOIlhall'lIll1lonol(S) IR/a,o Iho "'oclIl_".~ Mmed III the Lasl Will (lllloe ()eoodonl, dalod...."..,_....,,_ ,..._,..,,_,.. _.ond codldl(s) dnloR. --- -.- _~_._____~________.. _..__.. ... ...w .__..~_._."._... .-.-<-.- __ ,.......,_'''__________.____....''.n__'.._._ _ .__ ~_...._~__.._........_..__'Nn~_'___'"'' .....-- . __.____..___+~____.___" --_.... .~~~~m.~-_~'_~ -. -. +---- -~-. 8Inl~'nia-vi\;,itji r.-u~.i,~n~~.'.i,. o,-;;ll;rw-l;ii~n:~doRthQf .1I.cIlIQr, .to EKcopl ARlal/owl, Ilnc4J<lonl did nol IHnllY, Wft& 1101 dlvolend nnel didf\Qt hnvo n ohlld hOIll or ndoJllod nllor olCooutlon 01 tho dOCU010nll of(olOd lor plohRto; wnl not tho vie 11m of n kUling nnd WAS /lol,lor ndjqtllt.nlort lllnnJln(lllnl()(t~ ll\! 0, G,onl 01 \.0110" (ll Admllll.IJnllon n.."".__._~_+_ . '(eX n-~ i1 h' flc-i 'H-;- pnndnn'tu'iiiit','ritifnni; "hS~.nti,,:+di;;;~.-,;;ino,ii;leT~-------~.~'--- f'otlllonnr(.) 01110' 01 P'"PO' so",e1, h.,/hovo osc(lIlnlllOd 1100 llocodollllollllO Will and WOR Ru,vlvod by tho lollowlng 'pot/so (II OilY) ond hohs: ['-."~'-----'-NA~~ ~.- .... -..--. ...---~... . n...~n'" ... f;.;ioil~~ ;i;ip'''''.--'''''-.'''--'''-' ..---fi;;~ldonc;;.---.--~-1 '~~b~~-;~' S~h.l~h---"-"'- -~.~~.t;t~r.. ..........."----,,,.-.... "3TffWaTii-ut st. PO'l36Xl13 .__.",.....,__.___,....__........._...__..'..' .9. .,.,.. . ".._.._,.." Columb.i.a+--.EA...D.~2....--...- ...Gao.r-~,-Ha.r~.y...._. ..____.. ..Bro,the.r... .._..... L , . _.. 14_7.06..I~ c e ~ s i ~.L.....1~1:!.i r a d a, C 1\ 4902 Carlisle pike #115 90638 .J.ames.,M...,Jiar.v:e}'..._....."..~...__ ...Son ..... ,.,..--' Mech;nT'h::"stnrrg-;-'f";a;,.-tw'~' .rii!;.h~_!.Q..I"..QQQREl..__._... ,_.J),aug.hter ""..____ ...",. (i).8.Q",Q.i.i.LLi s l-'LP.J kel,..1QJ;". 5 2 3 Mechanicsburg, PA 17055 ~--~_.._...__.--~--_.._~.- ......- .------.-.-- ----............-.--.- _._...------.~_._---~._--_..._-~.- (GOMPl.ETF.IN AU. CASES:) Allnch nclditlonnl Fillonl!; if 1l0cfI,uimy. Doc.donl wo. domlcllod RI d.olh In."._.Gumberland" ......_.Counly, Ponl\sylvanlR, willi hls~lOII..t fRmlly 0' prlnclpol ,..Id.nco 01 _,_42S_.w...l,m\.t" ..Ro.t...t.om Roa,d,,. Sh i p.csns.bllL'CI, ,PA..l.725'1..~,_____, - ..----,- II!!'I lIlInol, Ill/rullO' nrld munlr.fpl1l1tv) O.cadont, Ihon__6.Q.. yoo" of .go, dlod, MaY.LS ... , 1996., 0162.5 ".Waln !JtnBQ.U.Q.llL~_~h_tp,Ren s h!! rg, P A (Iocnllon) Ooentlonl 01 donth o.....nocl propOlty wltil ostlmnlod ...nluf!!; EU lolloWFi (II dnmlr.lI\Id In PA ^"IHJI!'.ollnl ,,'opOI1)',. . (II not dOlllldlod In PA r'OfflOllnl IHopurly In Ponnsylvnnln_, (II nol dOIllIr.llod In PA POIl>ounl "rorOlly In CQunty, VnluA of ronl or.lalO In Ponnfiylvnllin Tchd " Runl Eslf1lo r;llunlod os follows: , $ '1, OOO..D,(L.....____._ $ -.-, ,..- ..- ..,.,,"---- $...:, ", $ ",,- ..---.-,.-"",-..-...." $ --!i, 0 0:r...J}Q;~_-==--= Whorolof, Polllionor(s) fOlipoc:llully IOflU011(fl) HID "rohnl" of 11ln 11l~1 Will nntl Cocllcil(1i) pf"rHllllod with Ihls Polltlo" nnd 1110 Olnnl olfotl(lll In lho nppruprlnto 101111 10 Iho UlalorslgflOd: [~~~=~.~==.~~=~~..~~;'~~I;:;~=~~.... . ..... _.MaR_.:1:__S.cJlL.dk___._.""._..~.__ .., ."".....-."..~--"."...-.._.-."'-------_."'., -....- I TVpod or p,lnlod nomo and ,esldQncn __~__~..__........ ..... .._._~_....__ ... ,on .~_____~__._.__~.______'_... -____._~,..._..__.... ------~-----~.__...".-----~.-.._._.._-~.~..."........_._.~.-.-......- I}Qb/;>.l;...J.-,Scil.1.4ln..,..----" .,,, .3.38._fu'l.10J.tt..S.tu ,fiL.nQLlll.t.__9 0 1 u m b i ~,' P A 17512 .~-_._---~.~--~,_...__..-.~.._----_.._._-_.--~-.-.-,............ ....---. -------..,_._---~- ----... _._._.~~-_. --- _._----_._._-~-_..... . .~ _._~__~_____......_m~______.___.._ I\Wl Oalh of Porsonal Hoprosonlalivo Cornnlonwealh 01 Ponnsylvanln County 01 Lancastor Tho I'etltlollor(s) ohovu IWlllOd swum(s) alld olllllll(S) tllllllho slatoll1onts 1111110 torogo!ng I'otllion tHO truo and corrocl 10 Iho bost 01 tho knowlodOfl and hollol 01 l'otlIl0Ilor(8) omt 11101, os porsonolroprosonlolivo(s) of Iho Docedent, Petltlonor(s) will woll olld trllly admllllSlur Iho oslolo occordlllolo law, . . . 6.16c{,;\., .'J ,~(!iJ &.11-,__,__..._.,_",_... ".___",,, Sworn 10 and allllmod alltl sUhscrlbed )2'< beloro mo l~_,,__,:::_,,_.,.__. day 01 ~ 1997 :~~~=~--"~:._?c!~"9~:._... Chj~y Register DEcnEr: OF RF.GISTEn - '----_._-._..,-_......_".~........_._-..._---~_.~----_.. ..'. . .-.-._-_. -..-.-. .-.-. .-~._----.-.._~.. --. - .--- .'... .~..__. E sloto ol___._.__._qj~.!m!L~_~-'-.!i<,:lIYt1 Y ._" _ ,.. ,.,."_.,,...____.Iloco asod also known as"___,,_._~___,_,.,,'""_,.,,.,,_._'",.,... '___""'__'""'_,__", No, -__2l_.=-".21-=-.AltL____. '..---. _.-~-~..._-._-..__.._--------_._---.,--- Social Secllrlly NO:__.3.l2.=28,~.59.a~i,_,_."". Dale 01 Dealh: -.lliLy....1.a,__.1.9.9.Ii.___..h____ ^ND NOW,.._____._._"M~,Y ..1 "'..__n 'm . ...,,,__,.._, 19,9,7"." In conslderolloll 01 the Pellllon 011 Iho roverse side hereon, sallsfaclory prool havlno beell presenlod holore 1110, . ..- .... --- _.~_.__..---_._--~--~.__._-_.- - --..,.--.----~.~--., ._-. .. ...----.-.--.-..... ._.~,... ..... '. H.H...... .._,_..~._._....._. M"" - -- ,'. .--.........~...---....---_.._~__*~~___._n~_,_ In Ihe above eslolo and thollho Instrumont(s). II any, datod dl.lscrlbed In the Polltlon be odl11l1lod 10 probato a/Hl f1lod of ;oc~;di,s Iho ia.s.i"wi,i"Ot [)oc;;(j;;i~~--..--.""--.--"--.-- FEES Leltors """ ",.,.".,.",.,...."",,,. $__25...0.0_." '__ Shorl CeI1lflcOles(s) ,(,3,)" ,,,, $______~..'"9.Q._,,, n<lnunc1alion,,,,,,,,,,,,,,,,, '''''''' $---.-.,5...0,0,.._ ... Extra Pagos ( ) .."",,,,,,,,,,, $____"."",,,.. p,.. """""'''''''''''''''''",,,,,, "",,"" $____..,,,.,,,,__,,,,,, I,T,n.""""",,,,,,,,..,,,,,,,,,,,,',,,,, $_____, JCr Fee,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, $___~..,QQ,... Inventory,,,,,,,,,,,..,,, """""'" $____"...,,"".,__",__ Olhor "",,,,,,,,,,,,.. ""..", """ $____.."__,, ___.,. TOT^L""""" """",,, $=!lA,-O.o..."", 7/!J&~<=.C1.L.JJ~ c:I ,ry ~~''-, -r no&fil.~ . MARY CLEWIS (')0 ' I::; ITI '" ",:'0 ^lIornoy: _,Micha.el. S. Clral5"~ 'E:\>0 uiJr"f,l, ":'; I,D, No: "'--55981-., '__""'_'_" ~_"._._______ Mdress: ..-3.2.7,J,p_GJ1Jlt _.1;Lli~.L_-;:.".. ________ - "-'. ,-, ,Co ll.lml:d"a_,,, EA._l.15.l2_.,_c.L,..,.________, f': T 010p110no: 71 7-.6114 dl422____:._____.LL,,,,,.,__~:JL_,__ . 0'/ IJ^,EIIIEIl: MA Y1')!_~~97'h. Mailed letters and order to attorney on ')-15-97, Docedent's Complete Address: ~Si.RmA[)O.Ri'S.S..' .., 105 Rehobeth Road C1iYShippensburg .. -----.--.- -..~ ...._~~~~_._=.,~-==~ PII ~17257 =J l~ Tax Payments and Credits: 1. Ta, Oua (Pogo 1 L1na 191 2, Crodils/Paymants A, Spousal Poverty Crodil 8, P,lor Poymonls C,Olst<lunl (1) 3, Tolal Cradils ( A t 6 t C ) (2) InlerosVPooally Iloppllcahle O,lnlerosl E, Ponaily 4, TolallnlarosVPonalty ( 0 t E ) If L1no 21s graator thon L1no 1 tUna 3, enler tho difforanco, This Islho OVERPAYMENT, Check box on Page I L100 20 to requoat a refund (3) ---0-- (4) ---.-- (5) ---.-- Make Check Payable /0: REGISTER OF WILLS, AGENT . ..., ... - -'.'" . ., - ... '-".." _.': r PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. 5, IIl10e 1 . L1no 31s graolo' than lIno 2, onlo, Ihe difference, This Is Iha TAX DUE, A, Enlar Ihalntore91 on Ihot" duo. (5A) (58) B, Entor Ihololol 01 L1no 5 t 5A, This Is Iho BALANCE OUE, . Old decedent maka a transler and: Yas a retain the use or Income of !tIe proporty lranshmod,,, . ,:] b. retain the right to doslgnale who slwll uso lilt! propmty trallsferred ur its income: . ,,,,. .. ..,,, ".""" "",.. ,." [J c, 'olain a rovorsiona,y inloro,l, or" , ,,,,,,,,,,,,,,,, """"",,,,,,,,,, " """""",,,,,,,,,,,,,,,, [.1 d. ,ocalva Iho plOrni'o 10' illo 01 oilhor paymon!s, bonofils 0' care? ", ",,,,,,,,,,,,,,,,, " [J 2, If dealh occurred ellor Decomber 12, 1982, did decede"l Iransler plOporly wilhin ono yoar of dea!h wllhoot ,ocelvlng adaqualo considoralion? ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ",,,,,,,,,,,,,,,,, 0 3, Old decedent own an "in trLJsl for" or payablo upon doalh bank acr,ount or securily at hiS or her doath? '.,....,.... [] 4, Did d.cadant own an Individual Rollromonl Aecounl, annuily, or otllor nOIl,probalo propilrly which conlains a bon.liclary doslgnahon? "",,,,,,,.,,,,,,.,.,.,,.,.,,.,,.,,,,,,,,,,.,,,,.,,,,,,,,,,,,,,,,,,,,,,,,,,,,,""'''''''''''''''''''''''''''''''''''' 0 ---.-... ---~-- ---.-- ---.-- No t1 f.1I ~ :a fil fil IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN, u;;,;;-p;;rn;. oll*~LKY. I doclart thilll havu f)(amlnlld thiS lolom, inr.ludillg aCWlllli>lnylrljJ ,dl{lllultU ~nd 'lalumonls. and to Iho bosl of my knowl6dQll and blllillf, lIlt 11U6, COIra<;t 100 complete pedal.1Ion 01 preparer ~~r lhan the p!liOndl r'lIJfIlSllnl~~~~~~n 01) InfO/ma!iun 01 v.hi(h pfl;pilllll ha~ any kllowtetluu SIGN TURE OF PERSON RESJ\ONSIBlE FOR..FIUNG RETURN ""l\L 'J' Uc !,i~. ADORESS Debora J. SchJeh, Administ.ratrix P. 0, Box 11 - ~ e-1U~A 17S1? SIGNATURE OF PR)~~~H,AJ>I PRESENTATIVE _____ ~ ;J. /; .- C-:. A :ESS MiChael'~Gra~ E~~ ire . _ ~~7 LOCI s~;; :~":'".(';..n.~~::,~.::_,~~ 17~1? _. _ i dalos of doalh on or alior July 1, 1994 and belor. Jdllllary 1, 1995, Ihe la, ralo Imposod on Ihe nel value ollrallslars II) or for Iho use ollha surviving spous.ls 3% 172 PS, ~9116 (a) (11) (ill. LATE 1;2 'I!DO , " Z /~, L/47.) For dalos of daalh on or oiler ,Jalluary " 1995,1110 la' ralo impo,"" olllho nel valu. of Iranslers 10 or lor Ih. use of Ihe surviving spouso Is 0% 172 P,S, ~9116 (01 (1,1) Ih)1 The statute DMOm..eM.mul a transfer 10 a surviving spouso frolll lux. and Ihe IItalulory requlrenlfmls for disdosure of assets and filing a tax return ore still applicable even if the surviving spouse Is the only bonoficiary, For dales 01 doalh on or aflor July 1, 2000: Thlllax rate imposed on the nol valUtl of transfors from a dtlcoased clli1d lwenty-one yams of ago or youngor al doath 10 or for the use of a nalural parcnl, an adopllve parent, or a slopparanl 01 Ihe child is 0% 172 PS ~9116Ia)l1.2)1 The la, rale Imposed on the nol value ollransfers 10 or for Ihe u'o ollho decedent's linoal bon,fielalles is 4.5%, e"eplas noled In 72 PS, ~9115(1.21172 P,S, ~9116(a)lll1, The la' rale Imposod on Iha nel valuo ollranslers 10 or lor Iho use of Ihe dacadent's Siblings Is 12% 172 P,S. ~9116(a)ll,311 A Sibling is dafinod, under Socllon 9102, as .n Individual who has allo.sl ono parenl in common wllh Iha docedenl, whother by ',Iood or adoplion, ITEM NUMBER -- A. Fun.,al IMp.n'.'1 1. Myers Funera 1 Home, UV.ISI1.h (1."1 ~:i!t COMMONWeAltH 0' ,eNNUWANIA INHU"ANCI 'All ftEJUIIN MUIOfNT PI!CIDt!Nf SCHEDULE H FUNERAL EX"'ENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES PleaN Ptlnt or Typ. JAMES L. HARVEY 21 ~.1997-0438 _-1_, A~.OUN~=~ DHSCRIPTlON Inc. 5,944.41 8. Admlnlatrotlve CO.tal A. C. 1. 2. 3, 4, 5, 6. 7. 8, 1. 2, 3, Personal Repr..entollve Commlnlon, Social S.curlty Number of Personal Rep".entatlve, Year Commlulon. pold ~ Attorney fe.. Ni kolaus Ii. Hohenadel, LLP 656.00 family exemption Clolmont Addreu 01 Claimant at, dec~clent" death Street Addr.u Relotlon.hlp City Stale Zip Code Probate Fee. Register of wills of Lancaster County Register of wills of Cumberland County Mlte.llan.ou. Exp.n.... 20.00 44.00 Joanne L. Meiskey, Notary Fees NikOlaus Ii. Hohenadel - Reimb. for 2 Short Certifs. Register of Wills of Cumberland County Inventory Filing Fee Register Of Wills of Cumberland County Inheritance Tax Return Filing Fee 4.00 6.00 10.00 10.00 TOTAL (Allo enler an line 9. Recapitulotlonl S 6,694.41 (1/ mar. .paee I. n..d.d, In.ert addlllonol.h.... 01 .om. .1...) \, !i ~ 1'1!1\1.1'~H IRA StatclIlenl o CeIlU. Retire",ent ACCOllllts Cell 1800.225.8292 1800.622.0176 P'oe lull Septuml..r 29, 2000 f) Visit us on.Une W'NW,pionoorfunds ,com PGI IRII CUST FOR ESTIIT~: OF JIIMES L, 1IIII1VEY ImNfo: OF ;'IIMES [, IIMlVEY DEC' D C/O MICIIIIEL S GRIIB-NIKOLIIUS & 1I00IENII 1lI':L, 32'1 LOClIST ST COLUMIlIA, PII 175.12 t. Your R.pres.ntellve Inn I 1III/I/NOIIl KI NNIII/ I/IICKIII ASSlICIII II S YIIIlK :1!I~IIIIlIl\lWIJ"'JIlIJ \'IIIlK,I'A 11~m 1!,li1, ~!XJ!; ,01101 TolfllVfllue ., of $f1plomhcf 29, 2000 We've made more improvemenlfl to yow accoLlnt slalement. The "Overview and Activity,j of your relirernent account is now organized on one page, And, for your BAsy relerenoe, your account number also appears several',",e., Onlhe bock 01 enr:h page you con find tlelpful delrnrtioos, including llow change in value " calculaled, II you have qUestions, plesse call Pioneor all ,600-622,01 '76, Retirement Account Summary Assol C1UfI'Ory Fund Nam! Growth iiiliTl'nconlo !!\1!:II!f1.!I:Cl^SS "-------- Account Numha, Janu.tV 1. 2000. Septllmber 30,1000 Addlll... Withdrawals mHUtltilt In Value n,I!!!!". Valllft + VII.Ho-Dft1e Vear.to.DlIla . Vn'-lo-Date . lotal Valt.!..____ $0.00 S4,66fl.O? M n6!i.O? $0.00 _.~ $0.00 M,66;,01 S4 66fl.02 $0.00 IUO 001,61011I1',101 ~~tt'ent l!!lftrter T otftl~JIIJc1.201!!!.~'!J!!.~",bor 30, ,0001 Retirement Account Ovel'lJiew and Activity Jallu,ry 1, 2000. Seplember 30, 2000 PIONEER II.CLASS A. Overview Account Informftllon Account No. AccounlOponOato @-G2071moz- 00120/2000 Owner rmlfli\WSTT1l1l r SIAlI Of' .JIIMES 1.IIAIlV[Y n1Nf' Of' .J^Mf'S I. IIAllVIY IIf'C'1l C/O MICII/lfl. S GIlIIIl-NIKOI.AUS &1I01IrNAUH 32/1 OCUSI Sl COl.lIMIM, I'll 17!112 Ea,nlngs Summ.rv Ullildond! Short 'form CAJlllal Gain! tonll TIIrm Call1lall1airl! Paid Voar.1 o.Ualo $0,00- $(1,00 $0,00 VUI.to-Oale T,ftns.clion Activity lloUM Sharo Numhor I olEtlShnrns Oato 1rllnsAcllOnlloscrtlhon Amount ; Prioo of SharoB OW/lIltl ~, 1 Be Inn In D.I.nce 120,61 O,lIlIlI OOfIR,I10 OrCHI'l or ^sms M,665.01 10~,660 1O~,060 mOM 601,O!l6I;3~8J8 $ 11 ,86 104.060 wao UINl1ICI^flV OISlIlBUllON 666,Oi' :06 '104.060 0,000 1I9 Endln. B.l.nce 6 O,lIlIlI lolaIAr.r.olllll Valuo SO,lIO $O,lIO 1111~llllilllllll~11 ...ole 11"0 Ot.\l\lI.... ....1144 Ulltt II"..... /..:.:,- t);i~ ' f') /(k/ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INOIV10UAL TAKES HflERlfANCE TAM DIVISION DEPT. 2110601 UAftRISBURO, PA 11128-0601 NOTICE OF INIIERITANCE TAK APPRAISEHENT, ALLOWAI~CE OR OISALl,OWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-05-2001 HARVEY 05-18-1996 21 97-0436 CUMBERLAND 101 E~<- ~_~~~-~R~~_ltt=-=~_J MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... REV: is'4f-EiCAFii- fi'Fiio Y- iiii'ficE - -oF" i:"NHEififiiN"CE - 'fAx "APpiiiixSEHEN'f;- A r.i"owAifcE -iili- ---- - - -- -- '. - - - -- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX JAMES L FILE NO. 21 97-0438 ACN 101 MICHAEL S GRAB ESQ NIKD~~US a HDHENADEL 327 ~.~rrl!ST ST COLUMBIA PA 11512 ESTATE OF HARVEY TAX REIURN WAS, (x) ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..I Est.t. (Schedule A) 2. Stocks and Bonds (Schedule 8) 3. Closely Held stock/Partnership Interost (Sch!lldule C) 4. HortQ.g_./Not.~ R.c~ivabl. (Schedule OJ S. Cash/Bank Deposits/Hisc. Personal Property {Sohedule E) 6. Jointly Ownod Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets ) CHANGED 11) (2) (3) (4) (5) (6)_ (7) _..J!J!.. ,00 .00 .00 6.694.41 .00 ,00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expens.s/Ad~, CO$t$/Hl$o. Expenses (Sohedule H) 10. Oebtv/Hortgage liabilities/liens (Schedule X) II. Tutal Deduotions 12. Net V.lue of Tax Retur'n 13. Charitable/Governnent.l Bequests; Non~el.ot.d 9113 Trusts (Schedule J) 14. Nat Value of Estate Subjuot to Tax If an asse\1sment was issued previously, lines 14, 15 and/or 16, 17, 18 and reflect figures that include the total of 6bh returns assessed to date. ASSESSMENT OF TAX: IS. AMount of line 14 at Spousal 16, AMOunt of line 14 taxable .t 17. A"ount of line 14 at Sibling 16. A.oul,t of line 1(. taxeble at 19, Prinvipal Tax Due r~ DATE NOTE: rat. lineal/Class A rata ,..t. Collateral/Class 8 rate --------ofECE'Il'r-.- - NUNBER DISCOUNT ( +J-'-' INTER~ST/PEN PAID (-) 6,694,41 .00 (11) 112) 113) 114) (9) 110) 115) (16) (I'll 118) .00 K .00 K .00 K ,05 K l'J, ~ 5~/~ uv.lt4/ n u, lll-UJ JAMES L AHOUNT PAID DATE 02-05-2001 NOTEI To insure proper or.dit to your a~count, sub~it tha upper portion of this for~ with your tax pay.ant. 6,694,41 6.69(,41 ,00 .00 ,00 19 will 00 = 06 = 00 = 15 = .00 .00 .00 ,00 .00 1191= TOTAL TAX CREDIT . OO.~ BALANCE 0-': TAX iiUE ~-~----:o;- INTEREST AND PEN. ,00 -~-_._----_..- TOTAL DUE ,00 ~--,-~---_._- -~_..__..__.._-----~.._...- . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAl. INTEREST, IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED, IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI, YOU HAY BE DUE A REFUND, SEE REVERSE SIDE OF TillS FORH FOR INSTRUCTIONS.) STATUS REPORT UNDER RULE 6.12 N.... of Decedent I CAf.-L C, o.te of Death I S (<K(j7 Will No. C] "7 -1'7 k, f3lA;vD1 Admj,n. No. Pur.uant to Rule 6.12 of the Supreme Court Orphans' Court Rule., I report the following with respect to compl~tion of. the administration of the above-captioned estatel 1. State whether a~inistration of the .state is completel Yes~ No 2. If the anllwer is No, state when the personal representative reasonably believes that the administration will be complete I 3. If the answer to No. 1 is Yes, state the following I a. Did the personal r.pr~entative file. final account with the Court? Yes_____ No ~. b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did t.he personal representative stat" 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. '2C; 0\ ell ^ n-. '""I _ W v " CRAt~ v,. '".;?,~N"" I ~ c...e MI. ... 'f)1-\~ ~""Q !-J'l,po.ll<lll \ G "..1 C tfj,1AjJJJT Name (Please type or printl 2 2~M l27'1 S"T ,I./1?w C{/"'-\IJ~Cik"J) fA- (70 7() Addrell8 (-7n) ')ll~4bt\ 2- (11'7) 77l(7b/O Tel. No. CapacitYI ~per80nal Representative Counsel for personal repre.entative lMAHlrmf/AM3)