HomeMy WebLinkAbout04-0013
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate Of~o. y r 11\ L,!VI 0 7)-re..
also known as A)(v.."" J'nf')7)fP
P,M"!j L~e lYldv'L
Deceased
Socwl Secunty No J 5S'-C; - ,::1,b - '-J (" I. c;-
No
To
c:;./-ov- 1...3
Register of WIlls for the
County of Ci.Ambt<^faYld.. m the
Commonwealth of Pennsylvama
The petltlOn of the undersIgned respectfully represents that
,
Your petltloner(Olj, who Is/..... 18 years of age or older, applle!".
for letters of admmlstratlOn
on the estate of
(d b n . pendente lite, durante absentia, durante mmontate)
the above decedent
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.
Decendent was domicIled at death m C /Ambe rlCl.-Vl " . iounty, Pennsylvama, wIth
hiS last famIly or pnnclpal resIdence at qSo Ore)", oV'd A-lIf " 3;;1., UJ/,uf .rAI/e.Y) 1DWYlShV
(hst street, number}'1d mUnIcipality)
D~.c5:.ndent, then 57 years of age, died "Pe.CQ-fY\be-v 01/1, ~003 ,1'9":
at !1QP DieIMUD. Av--t, it '3 d, /""H r 411 CIA 1l..>r> j C It.-I\\f l'<!i II ) P r. 110 II
Decendent at death owned property with estImated values as folllows
(If domIcIled In Pa ) All personal property
(If not domIciled In Pa ) Personal property m Pennsylvama
(If not dolmcIled In Pa ) Personal property m County
Value of real estate In Pennsylvama
situated as follows No,.,c.
$ ,;;1,0, DOO ES-t
$
$
$
Petltloner_ after a proper search haS..- ascertamed that decedent left no Will and was survIved by
the follOWIng spouse (If any) and hem
Name Residence
L., f'l\OO.('
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THEREFORE, peuuoner(s) respectfully request(s) the grant of letters of admInistratIOn In the
appropnate form to the undt;rSlgned
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF
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The petltlOner(s) above,named swear(s) or affirm(s) that the
statements In the for~goIng petition are true and correct to the best
of the knowledge.and,behef of petltloner(s) and that as personal
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representatlve(s)'of-ttie,above decedent petltlOner(s) wIll well and
truly adn;lmstertjie~a~~1rdIng to law. . ~A --K..
affirmed' 'ang, subscnbed lr ~1>>di4. c(titrrv-
~~G.{. :;/,::: day of
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No.....~/-O ~- /..E
Estate of ---..BAR R ( J
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L _ ~,RS
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW JAn! "" 1'<.1 t l.n ~1-. In conSIderation of the petItIOn on
the reverse SIde hereof, satlsfacto y proof havIng been presented before me,
IT IS DECREED that fYlE:.RF()\TI-I L fVj(TPE
ISlare entitled to Letters of AdmInIStratIOn, and In accord wIth such fIndIng, Letters of AdmInIstratIon
rtE.R.EDIT14
rr'cY,1( E
are hereby granted to
In the estate of 'l?-A1<.:l'1 I ~O<F
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$ /rJ,=
TOTAL _ $
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FEES
Letters of Admlmstratlon
Short CertIficates( )
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A TfORNEY (Sup Ct [D No)
6G [[\1 S- NWr \70,
ADDRESS
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\_ ~~ lJ;U~I-~PHONE
This IS to cernfy that the mformatlOn here given IS correctly copIed ftom an ongInal cernficate of death duly filed WIth me as
Local RegIstrar The ongInal certIficate will be forwarded to the State Vital Records Office for permanent filmg
WARNING: It IS Illegal to duplicate this copy by photostat or photograph.
No
~/l(~
Local RegIstrar
Fee for this certIficate, $2 00
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9812995
JAN 0 2 2004
Date
144 Rev 1191
COMMONWEALTH OF PENNSYLVANIA. OEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
L
Moore
Male
llWE"FlLENUMBER
SOCIAl. SECURITY NUMBER
185-36-4615
).. O.IJ"EOF DERH(MonIh Day 'IMI)
4 ~D~~~~ber~29 2003
'E<
em
BlRTHPLACEl(:cy....:!
SWIOlFOI-'ot>CounIrjI
UNDER 1 YEAR
........ ..,.
UNOER101<<
Hours M"'UI"
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ER/OuIpm....O
g:,:",o
Cumberland
Lower Allen
950 Orchard Avenue
17. Stale PE'..nnsv 1 van~a
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MAArTALSWUS Mun.d
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llURVlVlOOsPOUSE
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DECEDENT A UPATION
~~.J:1oO::'::~~
11 Barber t1b. Barner S
DECEOEHT SMAlUNQAOQf\ESS($lrBlll CoIyfTown Stale ZlpCode)
950 Orchani Ave. Lot 32
Camp H~ll, PA 17011
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FAlHEA S NAUE iFnl Middle laII)
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DECEDENT 8 EOl..ICA1ION
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MOTHEA S NAt.lE(F~SI. Ulddle MadenSurnMlOl)
L<ir.1er Allen
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{Sognalw..ndTIII8)
Ilorothy"'Hanna~,~\..;r .
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INFORMANTjMAlLlNGAOORfSSp_ ~ SIlllf Z-'p,Ca;1e)..., "" '10 .:',>~, \..i
187U Beacon ~t. Apt, 4, Brook~ne, MIl 02445
PLACEOf'DtSPOSlTIOH KameolCemel...,Cr~ LOOATIOH f1bwn Stal..ZIpCodl
orOtIlef~
Vemcl.l A. Moore
M~th Moore
RelTlO'o'allfllftlSlMeD
PER~ACTING AS SUCH
1-5-04
LICENSE NUMBER
012755-L
2,past
Harnsburg cran,
NAME AND ADDRESS OF FAClUTY
Wers-Hamer Fll,
LICENSE NUUBER
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21d. Harrisbur ;~ PA
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1903 Mkt St, ,00",.,PA 170H'"
DAfESlGNED
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WAS CASE REFERRED 10 UE~ EXAMINERICOAONER7
u. JPF VH j.Xl FD ..>4l-) l"~iNo~ l' ;,:
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TlMEOF DE,tJH Aprx. DA1EPROHOUNCEDOEAD(MonIh Oey Vaet)
2. 9: 00 A. U 21 December 30, 2003
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Probable M ocardial Infarction
DUE TO (OR AS A cONseauENCE Of).
Occlusive Coronar A ter Di ea e
DUE 10 (OR ASACONSEOUENCE OF)
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WERE AUlOPSV FINOINGS
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COMPLETION OF CAUSE
OF DEATH?
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DA1EQFINJURY
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TIMEOFINJURY
INJURY IiI WOflI(? DESCRIBE HOoV INJURY OCCURRED
w.mIER OF DEATH
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PRONOUHClNO AND CERTtl'YINQ PHYSICIAN (Phyadan bQltl plQI'lI.U'oClI\Q dealh and l*liylng 10 CIIU&II '" ...Ih]
TO u.._lolmyk.-lHge, dull'I occutrecl.l_ U.... ute andplKtl ancl.w.toUM cauM(.landmanllM...teleod
DAfE6KlNED(UanIl,Oey"-) 'U
o 310 31d December 31, 2003
N.fJ.lE AND ADDRESS OF PERSON WHOCOMPLETED CAUSE OF DEATH
(Uem21)TypeOl'Prinl Michael L. Norris, Coroner
6375 Basehore Road, Suite #1
Mechanicsburg, Pa. 17050~'>r;1
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MEDICAL EXAMIHERICOAONER
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JRD/June 30, 1992/17858
MAY U 6 2004 ~
In Re: Estate of BARRY L MOORE
Late of LOWER ALLEN TOWNSHIP
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
Estate No.: 21-04-13
NO. 21-2004-13
NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT
ORPHANS' COURT RULE
Personal Representative: MEREDITH L MOORE
Counsel for Personal Representative:
Date of Grant of Original Letters: 01-06-2004
Date of Delinquency Notice: 04-16-2004
The undersigned, Glenda Farner-Strasbaugh, Clerk of the Orphans' Court, in accordance
with Rule 5.6, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court
Division, Court of Common Pleas of Cumberland County, that neither the above named personal
representative 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 certification required by Rule
5,6(e), Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e),
Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on APRIL
16,2004, and that the ten (10) day notice to file the certification has expired. Accordingly, in
accordance with Rule 5.6( e) 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 representative or counsel for the delinquent personal
representative.
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
Date: 05-06-2004
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
~ :L ;L.10'l 9; J () Jl,ftI,
A hearing is scheduled f6r I I at I in Courtroom No.3.
filed prior to the hearing date, the hearing will automatically b
If the Certification of Notice is
c I .
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: ~ I!.... '1h trf!/'tJ2;
Date of Death: ~ "()..9, a....oo 3
Will No.
Admin. No. ,) 00'+- 000/3
To the Register:
I certify that notice of (lteReAeiel iRwl'e8t) estate lldministration required by Rule 5.6(a} of the Qrphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on ~IY\4./I. CAt, d <6 1 aooi :
~
Address
~ ~'lh~
allJ-. tUfA;ct~ k, CtLnlf M) PA- 1701/
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except "'0 elfC6fYj1 oJJs
Date: 0pnlL q I ao O~
Signature
Name ih flU ~ ;(. fn (}17\{.
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Address ! 8,70 (dJe.a. UTY\.. Mru..e..t-) O~pt, 'f
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Capacity: ~ Personal Representative
_Counsel for personal representative
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG. PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MOORE MEREDITH L
1288 TIMBERVIEW DRIVE
MECHANICSBURG, PA 17050
_h_Uh fold
ESTATE INFORMATION: SSN: 185-36-4615
FILE NUMBER: 2104-0013
DECEDENT NAME: MOORE BARRY L
DATE OF PAYMENT: 09/17/2004
POSTMARK DATE: 09/14/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 12/29/2003
NO. CD 004396
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $5,386.42
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TOTAL AMOUNT PAID:
REMARKS: MOORE
CHECK# 1035
SEAL
INITIALS: CCP
RECEIVED BY:
REGISTER OF WILLS
$5,386.42
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
22 Chiswick Road #12
Brighton, MA 02135
832-264-9000 (M)
617-432-7836 (W)
September 14, 2004
Mary C. Lewis
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013-3387
Re: Estate Tax Return for Barry L. Moore
Ms. Lewis,
Enclosed, please find two copies of the Estate Tax Return for the Barry L. Moore
Estate as well as payment in the form of check #1035 in the amount <!p$S,386.42. Ify.9o;::
have any questions or concerns, please to not hesitate to call. My cor$et info~ation;is;-
listed above. ,.,
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Thank you for your cooperation.
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Sincerely,
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Meredith L. Moore, Ph.D
Administrator, Barry L. Moore Estate
22 Chiswick Road #12
Brighton, MA 02135
832-264-9000 (M)
617 -432-7836 (W)
September 14, 2004
Chris Puogar
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013-3387
Re: Estate Tax Return for Barry L. Moore
Ms, Puogar,
Enclosed, please find check #1036 in the amount of $15.00 for the filing fee of
the estate tax return for the estate of Barry L. Moore, If you have any questions or
concerns, please to not hesitate to call. My contact information is listed above.
Thank you for your cooperation.
Sincerely,
(V~~~
Meredith L. Moore, Ph.D
Administrator, Barry L. Moore Estate
REV.lSOO EX (6~0)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
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DECEDENT'S NAME (lAST, FIRST, AND MIDDLE INITIAL)
MOORE, BARRY L.
OFFICIAL USE ONLY
FILE NUMBER
21 ~L -D.Oill L __
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
185 - 36
4615
DATE OF DEATH (MM-DD.YEAR)
12/29/2003
DATE OF BIRTH (MM-DD-YEAR)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. Remainder Return (daleoldealh prior 10 12,13-82)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Anech Sch 0)
12-13-46
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
None
~ 1. Original Retum
D 4. Limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
D 4a. Future Interest Compromise (daleoldeathaner 12,12-82)
o 7. Decedent Maintained a Living Trust (Attach copy olTmst)
o 10. Spousal Poverty Credit (data oldeath belweeo 12,31,91 and 1,1,95)
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NAME ,
Danlel J. Clement, Esquire
FIRM NAME !!! ~ic8b1e)
Law Ottices of
TELEPHONE NUMBER
570-524-2277
COMPLETE MAILING ADDRESS
25 S. 4th street
p.O. Box 93
Lewisburg, PA 17837
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or l)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which An election to tax has not been
made (Schedule J)
90,837.79
(6)
(7)
52,244.71
(9)
18,815.25
4,569.04
(10)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x.O_ (15)
x .0 45 (16)
x .12 (17)
x .15 (t8)
(19)
16. Amount of Line 14 taxable at lineal rate
119,698.21
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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OFFICIAL USE ONLY
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143,082.50
(11)
(12)
(t3)
23.384.29
119~98.21
(14)
119,698.21
5,386.42
5,386.42
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PA Central
MAIN - 959 East Park Drive
Harrisburg, PA 17111
BRANCH - 25 West Main Street
Shiremanstown, PA 17011
BRANCH - 5137 Jonestown Road
Harrisburg, PA 17112
FEDERAL CREDIT UNION
www.pacentralfcu.com
800-356-3875
FAX 717-564-1503
August 2, 2005
Glenda Farner Strasbaugh
Clerk of Orphans Couq
Cumberland County
One Courthouse Square
Carlisle, Pa. 17013
Re: Estate of Barry Moore, Deceased
Ashley R. Moore, a minor
Restriction of account
Dear Ms. Strasbaugh:
P A Central FCU has opened an account and it has been marked with the required
restriction in accordance with paragraph 15 of the Statement of Proposed Distribution in
the Estate of Barry L. Moore, Deceased, No. 2004-00013, approved June 21, 2005.
Sincerely,
~~.w~
Sharon M. Lehman
Loan Officer
P A Central FCU
564-4661 ext 205
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REV. 1508 EX. (1.971
'*'
. SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BARRY L. MOORE
FILE NUMBER
21-04-00013
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with the right of survivorship must be disclosed on Schedule F,
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
168.37
2.
3.
4.
5.
6.
7.
8.
Waypoint Bank Checking Account 0100674324
PO Box 1711
Harrisburg, PA 17105
Waypoint Bank Savings Account 8978017096
PO Box 1711
Harrisburg, PA 17105
393.73
CCFNB Checking Account 3000076216
Orangeville, PA
1,228.15
CCFNB Certificate of Deposit 5000096713
Orangeville, PA
73,460.00
Guns
1,450.00
1988 Victorian Mobile Home (value based upon sale at
VIN IV7514CK0212 fair market value in arms length
transaction)
1996 Ford Truck (value based upon sale at fair
VIN 1FTCR10A9TT48214 market value in arm~ length
transaction)
12,000.00
2,000.00
Insurance Refund
137.54
TOTAL (Also enter on line 5, Recapitulation) $ 90, 83 7 . 79
(If more space is needed, insert additional sheets of the same size)
"~..".,," '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
BARRY L. MOORE
FILE NUMBER
21-04-00013
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
ITEM
NUMBER
1.
DESCRIPTION OF PROPERTY
INCLUDE THE NAME OF THE TRANsrEREE. THEIR RELATIONSHIP TO DECEDENT AHD THE OATE or TRANsrER
ATTACH A COPY or THE DEED rQR REAL ESTATE.
DATE OF DEATH
VALUE OF ASSET
%OF
DECO'S
INTEREST
EXCLUSION
Ir APl'lICABlE \
TAXABLE VALUE
Meredith L. Moore - daughter. Inter-vivos nla
Cash gift made by decedent within one
year of death.
o
o
25,553.31
2.
Ashley R. Moore - daughter. Inter-vivos
cash gift made by decedent within one
year of death.
nla
o
o
25,553.31
3. Phoenix Investment Partners
PHX-Seneca Strategic Theme - Fund A
00005477894-8
Statestreet Bank & Trust Co.,
Custodian for IRA Rollover of Barry L
Moore
101 Munson Street
PO Box 88
Greenfield, MA 01302-0088
Meredith L. Moore and Ashley R. Moore
were designated sole beneficiaries
in equal shares.
1,138.09
100
1,138.09
TOTAL (Also enter on line 7, Recapitulation) $ 52, 244 . 71
(If more space is needed, insert additional sheets of the same size)
!lfV.IS1lex, (hll
'*'
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
BARRY L. MOORE
FILE NUMBER
21-04-00013
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
A.
DESCRIPTION
FUNERAL EXPENSES:
1.
Myers-Harner Funeral Home
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representalive(s) Meredith L. Moore
Social Security Number(s) I EIN Number of Personal Representative(s) 1 7 0 - 5 4 - 5 5 4 4
Street Address 22 Chiswick Road, Apt. 12
City Brighton State MA Zip02135-7178
2.
3.
4.
5.
6.
7.
8.
9.
10.
11 .
12.
13.
14.
(s) Commission Paid:
2004
AllomeyFees Daniel J. Clement
Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation) n / a
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
Probate Fees
Accountanfs Fees
Daniel J. Clement
Tax Retum Preparer's Fees
Advertising Letters of Administration
Shuler Realty - lot rent
Eshenaurs - propane and repairs
PP&L - electric
PA American Water - water
Safe Auto - insurance payments
Trinity Lutheran Church - Columbarium
Providian - VISA bill
Mary Ann Klementik - trailer maintenance & funeral
*continued*
TOTAL (Also enteron line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
AMOUNT
4,323.00
4,500.00
2,500.00
90.00
250.00
174.19
1,100.00
1,643.17
153.96
98.49
384.00
680.00
314.86
759.20
SCHEDULE H - Continued
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF BARRY L. MOORE
FILE NUMBER 21-04-00013
16.
17.
18.
19.
20.
21 .
22.
23.
24.
Larry's Auto Salon - clean and detail truck
Kramer Brothers Glass - repair screens and windows
Verizon - phone bill
Bonnie K. Miller, Treasurer - real estate tax
Commonwealth of PA - trailer title
PA Dept of Revenue - income tax
Postmaster - stamps
Allied Roofing - net cost after insurance proceeds
for trailer roof repairs
Mary Ann Klementik - Reimbursement for miscellaneous
administrative expenses
25. Bob ott - painting
TOTAL
$
185.45
620.00
166.31
68.12
22.50
40.00
37.00
85.00
150.00
470.00
$18,815.25
REV,I512 EX -(1-81)
ESTATE OF
'*
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
BARRY L. MOORE
FILE NUMBER
21-04-00013
Include unrelmbursed medical expenses.
ITEM
NUMBER
1.
DESCRIPTION
AMOUNT
Commonwealth of Pennsylvania, Department of Revenue
Inheritance Tax paid on Certificate of Deposit,
CCFNB No. 5000085243
4,569.04
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$ 4,569.04
, . ,
REV.15t3 EX. 11,97)
'*'
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
BARRY L. MOORE
ESTATE OF
NUMBER NAME AND ADDRESS OF PERSON{S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
t Meredith L. Moore
22 Chisw~ck Road, Apt. 12
Brighton, MA 02135-7178
2. Ashley R. Moore
2112 Wentworth Drive
Camp Hill, PA 17011
FILE NUMBER
21-04-00013
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
daughter
daughter
AMOUNT OR SHARE
OF ESTATE
50%
50%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
none
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
hone
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DANIEL J CLEMENT ESQ 'CJ~
D J CLEMENT LAW OFFICE
PO BOX 93
LEWISBURG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-06-2004
MOORE
12-29-2003
21 04-0013
CUMBERLAND
101
-3
;~ ..~~ : ,-.~~, 1
.
REY-1547 EX AFP 109-04)
BARRY
L
Allount Rellitted
,
PA \7~37
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=is4-j-EX--AFP--CoY:oiY-NOTYCE-OF-YNHEififAifcE-TAX-A-PPRXisEifiNi':--ALDiwAifcE-OR'-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MOORE BARRY L FILE NO. 21 04-0013 ACN 101 DATE 12-06-2004
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
IS. Allount of Line 14 at Spousal rate (IS)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19, Principal Tax Due
TAX CREDITS:
.00 X 00 = .00
119,698.21 X 045 = 5,386.42
.00 X 12 = .00
.00 X 15 = .00
(19)= 5,386.42
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5, Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6, Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
,00
,00
.00
.00
90.837.79
.00
52.244.71
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9, Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10, Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
18,815.25
4.569.04
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
143,082,50
(11)
(12)
(13)
(14)
23.384 29
119,698.21
,00
119,698.21
, ~"'_n. IU::L.C.LI" I l+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
09-14-2004 CD004396 .00 5,386,42
TOTAL TAX CREDIT 5,386,42
BALANCE OF TAX DUE .00
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 PAYMENT IS REQUIRED. <: tI'
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DU~'\
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RESERYATION: Estates of decedents dying on or before December lZ, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of eny estete for
life or for years, the Commonwealth hereby expresslY reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
PURPOSE OF
NOTICE:
PAVMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIYE
CORRECTIONS:
DISCOUNT:
PENAL TV:
INTEREST:
To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act Z3 of ZOOO. (7Z P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Wills printed on the reverse side.
--Make check or money order payable to: REGISTER OF HILLS. AGENT
A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an
"Application for Refund of Pennsylvania Inheritance end Estate Tax" (REY-1313). Applications are available
online at www.revenue.state.pa.us. any Register of Wills or Revenue District Office, or from the Department's
Z4-hour answering service for forms orders: 1-8oo-36Z-Zo5o; services for taxpayers with special hearing and/or
speaking needs: 1-8oo-447-30Zo (TT only).
Any party in interest not satisfied with the appraisment, allowance or disallowance of deductions or assessment of tax
(including discount or interest) as shown on this Notice may object within 60 days of the date of receipt of this notice
by filing one of the following:
A) Protest to the PA Department of Revenue, Board of Appeals. Vou may object by filing a protest online at
www.boardofappeals.state.pa.us on or before the expiration of the sixty-day appeal period. In order for
an electronic protest to be valid, you must receive a confirmation number and processed date from the
Board of Appeals website. Vou may also send a written protest to PA Department of Revenue, 80ard of Appeals
P.O. Box Z810Z1, Harrisburg, PA 171Z8-10Z1. Petitions may not be faxed.
B) Election to have the matter determined at the audit of the account of the personal representative.
C) Appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box Z80601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. See pege 5 of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REY-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (5%) discount of
the tax paid is allowed,
The 15% tax amnesty non-participation 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-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January 1, 198Z bear interest at the rate of
six (6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through Z004 are:
Interest Daily Interest Daily Interest
Rate Factor Vear Rate Factor Vear Rate
~:orom n!il-1991 --rrr- ~ Zii01 -w--
16% .000438 199Z 9% .000Z47 ZOOZ 6%
11% .000301 1993-1994 7% .00019Z Z003 5%
13% .000356 1995-1998 9% .000Z47 Z004 4%
10% .000Z74 1999 n .00019Z
10% .000Z74 ZOOO n .00Dl9Z
Vear
1m
1983
1984
1985
1986
1987
Daily
Factor
.~
.000164
,000137
.00ollO
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID X NUKBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation date shown on the
Notice, additional interest must be calculated.
IN RE: ESTATE OF
BARRY L, MOORE,
Late of Lower Allen
Township, Cumberland County,
Pennsylvania
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PA
ORPHANS' COURT DIVISION
NO. 21-04-0013
FIRST AND FINAL ACCOUNT
MEREDITH L. MOORE, ADMINISTRATRIX
FOR THE
ESTATE OF BARRY L. MOORE, DECEASED
Date of Death:
Date of Administratrix's Appointment:
First Complete Advertisement
of Grant of Letters:
Accounting Stated for the period:
December 29, 2003
January 6, 2004
September 3, 2004
December 29, 2003 to
Purpose of Account: Meredith L. Moore, Administratrix, offers
this account to acquaint interested parties with the
transactions that have occurred during her administration.
The account also includes a Statement of Proposed Distribution
of the estate.
It is important that
Requests for additional
can be discussed with:
the account be carefully examined,
information or questions or objections
Daniel J. Clement, Esquire
25 S. Fourth Street
P.O. Box 93
Lewisburg, PA 17837
(570) 524-2277
-1-
SUMMARY OF ACCOUNT
PRINCIPAL BALANCE ON HAND
Fiduciary
Current Acquistion
Page Value Value
3 $90,837,79
$90,837.79
3 $ 4,569.04
4 17,141.67
4 7,000.00
4 $28,710,71
4 $62,127.08
4 200.00
4 $61,927.08
4 $ 200,00
PRINCIPAL
Receipts
TOTAL PRINCIPAL RECEIPTS
Less Disbursements:
Debts of Decedent
Administration Expenses
Fees and Commissions
TOTAL PRINCIPAL DISBURSEMENTS
Balance before Distributions
Reserve for future estate
settlement expenses
Distributions to Beneficiaries
INCOME:
Receipts
TOTAL INCOME DISBURSEMENTS
4 $ 1,950.54
4 $ 1,950.54
3 $90,837.79
4 $63,877.62
4 $ -0-
4 $ 200.00
Balance Before Distributions
Distributions to Beneficiaries
Income Balance On Hand
Combined Balance on Hand
-2-
RECEIPTS OF PRINCIPAL
Fiduciary
Acquisition
Value
Assets Listed in Inventory
Filed with Court and simultaneously
with this Account, valued as
indicated therein (copy attached
and incorporated herein as
Exhibit 1) $90,837.79
TOTAL INVENTORY $90,837.79
DISBURSEMENTS OF PRINCIPAL
Debts of Decedent
Commonwealth of Pennsylvania, Dept, of Revenue,
Inheritance Tax due in the amount of $4,569.04
on Certificate of Deposit, CCFNB No. 5000085243,
paid September 14, 2004
Total Debts of Decedent
Administration Expenses
Myers-Harner Funeral Home
Cumberland County Law Journal - advertise Letters
Patriot News - advertising Letters
Shuler Realty - lot rent
Eshenaurs - propane and repairs
PP&L - electric
PA American Water - water
Safe Auto - insurance payments
Trinity Lutheran Church - columbarium
Providian - VISA bill
Mary Ann Klementik - mobile home maint.
and funeral
Larry's Auto Salon - clean and detail truck
Kramer Brothers Glass - repair screens & windows
Verizon - phone bill
Bonnie K. Miller, Treasurer, real estate tax
Commonwealth of PA - moblie home title
PA Dept, of Revenue - income tax
Postmaster - stamps
Allied Roofing - net cost after insurance proceeds
for mobile home roof repairs
-3-
$ 4,569,04
$ 4,569.04
$ 4,323.00
75.00
99.19
1,100.00
1,643.17
153.96
98.49
384.00
680.00
314.86
759.20
185.45
620.00
166.31
68.12
22.50
40.00
37.00
85,00
Mary Ann Klementik - reimbursement for miscellaneous
administrative expenses
Bob Ott - painting, mobile home
PA Inheritance Taxes
Register of Wills, Probate Fees
Register of Wills, Filing fee for Account
Total Administrative Expenses
Fees and Commissions
Meredith L. Moore, Administratrix Commission
Daniel J. Clement, Esquire - Attorney's fee
Total Fees and Commissions
TOTAL DISBURSEMENTS OF PRINCIPAL
RECEIPTS OF INCOME
CCFNB - Interest on Certificate of Deposit
Sovereign Bank - Interest through 3/13/05
Waypont Bank - Interest for 2004
Total Receipts of Income
TOTAL INCOME AVAILABLE FOR DISTRIBUTION
150.00
470.00
5,386.42
150.00
130.00
$17,141.67
$ 4,500,00
2,500,00
$ 7,000.00
$28,710.71
$ 296.86
349.75
1,303.93
$ 1,950,54
$ 1,950.54
DISTRIBUTIONS OF PRINCIPAL AND INCOME TO BENEFICIARIES
TOTAL PRINCIPAL AND INCOME AVAILABLE FOR
DISTRIBUTION TO BENEFICIARIES
A,
B.
Meredith L. Moore
Ashley R. Moore
PRINCIPAL BALANCE ON HAND
Fees and costs to finalize
estate settlement
TOTAL PRINCIPAL RESERVE
PRINCIPAL BALANCE ON HAND
-4-
$63,877,62
$31,938.81
$31,938,81
$ 200.00
200.00
$ 200.00
COMMONWEALTH OF PENNSYLVANIA
UNION
58:
COUNTY OF
MEREDITH L, MOORE, Administratrix of the Estate of
Barry L. Moore, Deceased, hereby declares under oath that
she has fully and faithfully discharged the duties of her
office; that the foregoing First and Final Account and
the facts set forth in the Statement of Proposed
Distribution are true and correct and fully discloses all
significant transactions occurring during the accounting
period; that all known claims against the Estate have
been paid in full; that, to her knowledge, there are no
claims now outstanding against the Estate; and that all
taxes presently due from the Estate have been paid.
lllli ((j)jj (c(' cI/i~
MEREDITH L, MOORE,
Administratrix
Sworn to and subscribed before me
this 6th day of April
, 2005,
~VJC~ ,f; ~
NOTARIAL. SEAI~
SUSAN G. STULL, NOTArw PUBLIC
LEWISBURG BOROUCH COUNTY OF UNION
MYCOMMISSIO;i ,XiiHlS W,V ;:4, 2007
~._..,...--,.,.,~,~.,.-
E8T\MOORE,ACC
-5-
IN RE: ESTATE OF
BARRY L, MOORE,
Late of Lower Allen
Township, Cumberland
County, Pennsylvania
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PA
ORPHANS' COURT DIVISION
NO.
CERTIFICATION OF NOTICE
Daniel J. Clement, Attorney for Meredith L. Moore,
Administratrix of the Estate of Barry L. Moore, Deceased,
verifies that written Notice by United States First Class
Mail was given of the filing of the Account and Statement
of Proposed Distribution to every unpaid claimant who has
given written notice of his/her claim to the
Administratrix and to every other person known to the
Administratrix to have or claim an interest in the Estate
as creditors, beneficiary, heir
the written Notice is attached.
or next of kin. A copy
I understand that false
statements herein are subject to the penalties of 18 Pa.
C.S.A. ~4904 relating to unsworn falsification to
authorities.
, Clement, Esquire
Attor y for Meredith L. Moore,
Administratrix of the Estate of
Barry L, Moore, Deceased
Date: Lj.-'l-oS-
-6-
IN RE: ESTATE OF
BARRY L, MoollE,
Late of Lower Allen
Township, Cumberland County,
Pennsylvania
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PA
ORPHANS' COURT DIVISION
NO. 21-04-0013
NOTICE TO THE BENEFICIARIES
OF THE ESTATE OF BARRY L. MOORE, DECEASED
Meredith L. Moore, 22 Chiswick Road, Apt. 12, Brighton, MA 02135
Ashley R. Moore, 2112 Wentworth Drive, Camp Hill, PA 17011
Melody J. Moore, Guardian of the Estate of Ashley R, Moore,
2112 Wentworth Drive, Camp Hill, PA 17011
You are hereby notified that Meredith L, Moore, Administratrix
of the Estate of Barry L. Moore, Deceased, has filed her First and
Final Account and Statement of Proposed Distribution and verified
inventories of all property of the estate of the deceased in the
Office of the Clerk of the Orphans' Court Division of the Court of
Common Pleas of the 9th Judicial District, Cumberland County,
Pennsylvania, One Courthouse Square, Carlisle, Pennsylvania 17013-
3387. Copies of these documents are attached.
If you object to any part of the Account or Statement of
Proposed Distribution you must file objections by 8:30 a.m. on June
21, 2005. If no objections are filed on or before 8:30 a,m. on
June 21, 2005, the Court may confirm the Account on June 21, 2005.
You are warned that if no objections are filed, the Account will be
confirmed and distribution will be made in accordance with the
Schedule of Distribution. If you have any questions concerning
-1-
this Notice, you should
Administratrix's attorney.
.
Date: April 8, 2005
contact
the
your
attorney or
Da el . Clement, Esquire
Att n I.D, No, 10222
25 S. th Street
PO Box 93
Lewisburg, PA 17837
(570) 524-2277
Attorney for Administratrix
-2-
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
INVENTORY
Estate of Barry L. Moore, Deceased
No, 21-04-0013
Date of Death: December 29, 2003
Social Security No. 185-36-4615
Personal Representative(s) of the above Estate, deceased, verify
that the items appearing in the following Inventory include all of
the personal assets wherever situate and all of the real estate in
the Commonwealth of Pennsylvania of said Decedent, that the
valuation placed opposite each item of said Inventory represents
its fair value as of the date of the Decedent's death, and that
Decedent owned no real estate outside of the Commonwealth of
Pennsylvania except that which appears in a memorandum at the end
of this Inventory. I verify that the statements made in this
Inventory are true and correct. I understand that false statements
herein are made subject to the penalties of 18 Pa.C.S. Section 4904
relating to unsworn falsification to authorities.
Attorney: Daniel J. Clement, Esquire
25 S, 4th Street
P,O. Box 93
Lewisburg, PA 17837
570-524-2277
I,D, No.: 10222
( OILttd,i/{:R- J~tdcTl-L.
Meredith L, Moore
Administratrix of the
Estate of
Barry L. Moore, Deceased
Date:
4/6/05
Description
Value
Waypoint Bank - Checking Account No. 0100674324 $
Waypoint Bank - Savings Account No. 8978017096
CCFNB - Checking Account No. 3000076216
CCFNB - Certificate of Deposit No, 5000096713
Guns
1988 Victorian Mobile Home (value based upon sale at
fair market value in arms length transaction)
VIN IV7514CK0212
1996 Ford Truck (value based upon sale at fair
market value in arms length transaction)
VIN 1FTCR10A9TT48214
Insurance Refund
168.37
393.73
1,228,15
73,460.00
1,450,00
12,000.00
2,000.00
13 7.54
Total
$90,837.79
EXHIBIT A
IN RE: ESTATE OF
BARRY L. MOORE,
Late of Lower Allen
Township, Cumberland County,
Pennsylvania
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PA
ORPHANS' COURT DIVISION
NO.
STATEMENT OF PROPOSED DISTRIBUTION
OF THE ESTATE OF BARRY L, MOORE, DECEASED
FILED BY
MEREDITH L. MOORE, Administratrix
AND REQUEST FOR ORPHANS' COURT APPROVAL
Meredith L. Moore, Administratrix, represents to the Court in
regard to the distribution of the Estate of Barry L. Moore,
Deceased, the following material facts and information, to wit:
1. Barry L, Moore died December 29, 2003.
2. The decedent died intestate and his daughter, Meredith L.
Moore, was appointed Administratrix on January 6, 2004.
3. The granting of Letters of Administration was published
in the Cumberland Law Journal on September 3, 10 and 17, 2004 and
The Patriot News on August 17, 24 and 31, 2004. Proof of
Publication is attached hereto and made a part hereof.
4. The decedent had no spouse at the time of his death,
5. The decedent died leaving to survive him as sole heirs
and next of kin his two daughters, Meredith L. Moore and Ashley R.
Moore. Ashley R. Moore, born May 2, 1991, is a minor,
6. Melody J. Moore of 2112 Wentworth Drive, Camp Hill, PA
17011, mother of Ashley R. Moore, was appointed sole guardian of
the Estate of Ashley R. Moore on April 23, 2004 by Order of the
-1-
Cumberland County Court of Common Pleas, Orphans' Court No, 21-04-
356 [It is observed that the appointment of Melody J. Moore as the
sole guardian fails to fully comply with the 20 Pa.C.S.A. ~5112(3),
since Melody J. Moore is the mother of Ashley R. Moore who is
eligible for appointment as guardian of the estate of her minor
child only where a co-guardian is appointed] .
7. The Administratrix has completed her responsibility of
administering the Estate and is ready to distribute the estate
assets consisting of cash in the amount of $63,877,62, (after
reserving $200 for future estate settlement expenses). The
Administratrix proposed to distribute the estate assets in equal
shares to the intestate heirs, namely Meredith L. Moore and Ashley
R, Moore in the manner provided hereinbelow.
8. There are no unpaid credi tors from whom the
Administratrix has received written or actual notice of a claim.
9. No charitable bequests are involved.
10. The decedent held no fiduciary capacity.
11. The Pennsylvania inheritance taxes have been paid in
full. The Notice of Inheritance Tax Appraisement, Allowance or
Disallowance of Deductions and Assessments of the Tax received from
the Pennsylvania Department of Revenue is attached hereto.
12, The Estate is not subject to Federal Estate Tax.
-2-
13. A reserve in the amount of $200 has been established for
fees and costs to finalize the estate settlement and payment of the
final expenses for preparing and filing the final fiduciary tax
return.
14. This is the First and Final Account of the estate,
15. The Administratrix proposes to distribute the assets as
indicated hereinabove, as follows:
The amount of $31,938.81 directly to herself in cash and
the share of her sister, Ashley R. Moore, to be deposited in a
Certificate of Deposit with Pennsylvania Central Federal Credit
Union in the name of Melody J. Moore, Guardian of the Estate of
Ashley R. Moore, subject to the restriction to be noted on the
records of said depository that no withdrawals may be made from
such account until the minor Ashley R, Moore obtains the age of
majority on May 2, 2009, except as authorized by prior Order of the
Court, [Evidence of the marking of such account to indicate the
restriction shall be promptly filed of record] .
16, It is requested in addition to authorizing distribution
of the Estate assets as indicated hereinabove that Melody J. Moore,
Guardian of the Estate and person of Ashley R. Moore, as above
indicated, be authorized by the Court to execute and deliver to
said Administratrix a Receipt and Release or other similar
instrument conditioned on the deposit of the minor's share of the
estate proceeds as indicated hereinabove,
-3-
IN WITNESS WHEREOF, Meredith L, Moore, Administratrix of the
Estate of Barry L. Moore, Deceased, hereby requests your Honorable
Court to approve the First and Final Account as stated and to
decree confirmation and distribution of the Account in accordance
therewith.
GrrlAuL'ctt~ ce(\;t Lou~.9----
Meredith L, Moore, Administratrix
of the Estate of Barry L, Moore,
Deceased
-4-
.
THE PATRIOT NEWS
THE SUNDAY PATRIOT NEWS
Proof of Publication
Under Act No. 587, Approved May 16, 1929
Commonwealth of Pennsylvania, County of Dauphin} ss
Joseph A. Dennison, being duly swom according to law, deposes and says:
That he is the Assistant Controller of The Patriot News Co., a corporation organized and existing under the
laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market
Street, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-
News and The Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market
Street, in the City, County and State aforesaid; that The Patriot,News and The Sunday Patriot-News were established
March 4th, 1854, and September 18th, 1949, respectively, and aU have been continuously published ever since;
That the printed notice or publication which is securely attached hereto is exactly as printed and published
in their regular daily and/or Sunday! Metro editions which appeared on the 17th, 24th and 31st day(s) of August
2004. That neither he nor said Company is interested in the subject matter of said printed notice or advertising, and
that all of the allegations of this statement as to the time, place and character of publication arc true; and
That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this
statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed
and adopted severally by the stockholders and board of directors of the said Company and subsequently duly
recorded in the office for the Recording of Deeds in and for said County of Dauphin in Miscellaneous Book "M",
Volume 14, Page 317.
COpy
OTARYPUBLIC
'ssion expires June 6, 2006
PUBLICATION
InI,tratlcm tor the ..tate 0' !
late 'of Lower Allen Town- I
County, Pennsylvania,
IthL.fMOn".Tlm.
bel" VI.. DrlMeChanlc:abUrv. f'A 17050.
An'tOM haYl lust claims agalntt the ...
tate shoUld- t them, duly authenticat-
ed. to the Admlnl,tratorwlthDutdelGV,
MEREDITH MORRE
1288 TIMER VIEW DRIVE
MECHANICSBURG, PA. 17050
Statement of Advertising Costs
To THE PATRIOT-NEWS CO.
For publishing the notice or publication attached
hereto on the above stated dates 99.19
Publisher's Receipt for Advertising Cost
The Patriot News Co., publisher of The Patriot-News and The Sunday Patriot-News, newspapers of general
circulation, hereby acknowledge receipt of the aforesaid notice and publication costs and certifies that the same have
been duly paid.
By....................................................................
PROOF OF PUBLICA'IION OF NOTICE
IN ClJIVIBERI.AND I.A W JOURNAL
(Under Act 1'0.537, "pproved May 16,1929), P. L.1784
STATE OF PEN]\'SYLVANIA :
ss.
COUNTY OF CUMBERLAND :
Lisa Marie Coyne, Esquire. Editor orthe ('umberland Law Journal, of the County and
State aforesaid, bClI1g duly sworn, according to law. deposes and says that the Cumberland Law
JoulIlal, a legal "cl'lllclical published in t!,e !Jor'll'J ,,''Carlisle in the County and State aforesaid,
was established J"nuary 2,1952. "nd designated by the local courts as the official legal
periodical for the publication of "II legal notices, and has, since January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Jout"nal on the j()llowing dates,
v\z:
SEPTEMBER 3,10,17,2004
Affiant further deposes tll"t he is 'lUthorized III verify this statement by the Cumberland
Law Journal, a legal periodical of general circulat;,.n. and that he is not interested in the subject
matter of the allll'c",id notice or advertisement, and that all allegations in the foregoing
statements as to time, place and character orpublic"tion are true.
Moore, Barry L.. dee'd.
Late of the Township of Lower
Allen.
Administratrix: Meredith L. Moore,
1288 TImber View Dlive, Mechan-
icsburg. PA 17050.
Attomey: Daniel J. Clement. Es-
quire. 25 South Fourth Street,
Lewlsburg. PA 17837.
SW 1''10 AND SUBSCRIBED before me this
---11_dayof SEPTEMBER 2004
N SEAL
LOIS E. SNYDER. Notary Public
Carlisle Bora, Cumberland County
My Commission Expires March 5, 2005
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU QF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG~ PA 17128-0601
NDTICE DF INHERITANCE TAX
APPRAISENENT, ALLDWANCE DR DISALLOWANCE
OF DEDUCTIONS AND ASSESSNENT OF TAX
DANIEL J CLEMENT ESQ
D J CLEMENT LAW OFFICE
PO BOX 93
LEWISBURG PA 17837
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-06-2004
MOORE
12-29-2003
21 04-0013
CUMBERLAND
101
Amount Re..itt.d
..
IEV-l!;nniFPID,.a41
BARRY
L
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 ~
RE-,;:is4-j-EX--AFP--riiFciin:jiiYicE--OF-iNiiEififAiicrTAX-j("pjiRj("isEi"-iNT~--ALroMAiicE-iiR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MOORE BARRY L FILE NO. 21 04-0013 ACN 101 DATE 12-06-2004
TAX RETURN WAS: (X I ACCEPTED AS FILED
I CHANGED
I~ an assessment was issued previously, lines 14, 15 and,or 16, 17, 18 and 19 will
reflect ~igures thet include the tote1 of abb returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rat. (15)
16. Allount of Line 14 taxable at Lineal/Class A rat. (16)
17. hount of Line 14 af Sibling rat. (17)
18. Amount of Line 14 taxable at Collateral/Class Brat. (18)
19. Prlnclpal Tax Due
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R..l Est.t. (Schedul. A)
2. Stocks and Bonds (Schedul. B)
3. Closely Held stock/Partnership Interest (Schedule CJ
4. "artgas-s/Nates Receivable (Schedule DJ
5. Cash/Bank Deposits/"lsc. Personal Property (Schedule E)
6. ~olntly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
III
121
(31
(41
(51
(61
(7)
.00
.00
.00
.00
90.837,79
.00
52,244.71
(81
APPROVED DEDUCTIONS AND EXEMPT~ONS:
9. Funeral Expenses/Ad.. Costs/"isc. Expenses (Schedule H)
10. Dobts/Hortgage Liebilities/Liens (Schedule II
11. Total Deductions
12. Net Value of Tex Return
13. Charltable/GoYer~entel Bequests; Non-elected 9113 Trusts (Schedule ~)
14. Net Value of Estata Subject to Tex
(91
1101
18,815.25
4.569.04
(111
1121
1131
1141
NOTE:
.00
119,698.21
.00
.00
X 00 =
X 045 =
X 12 =
X 15 =
1191=
DATE
09-14-2004
INTEREST/PEN PAID (-I
,00
AHOUNT PAID
5,386.42
NUHBER
CD004396
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST,
NOTE: To insure proper
credit to your account,
sub.it the upper portlon
, of this for.. with your
tax payltent.
143,082.50
23.384 79
119,698.21
.00
119,698.21
.00
5,386.42
.00
.00
5,386.42
5,386.42
.00
.00
.00
IF TOTAL DUE IS LESS THAN 01, NO PAYftENT IS REQUIRED.
IF TDTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU NAY BE DUE
A REFUND, SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.I
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
INVENTORY
Estate of Barry L, Moore, Deceased
No. 21-04-0013
Date of Death: December 29, 2003
Social Security No, 185-36-4615
Personal Representative(s) of the above Estate, deceased, verify
that the items appearing in the following Inventory include all of
the personal assets wherever situate and all of the real estate in
the Commonwealth of Pennsylvania of said Decedent, that the
valuation placed opposite each item of said Inventory represents
its fair value as of the date of the Decedent's death, and that
Decedent owned no real estate outside of the Commonwealth of
Pennsylvania except that which appears in a memorandum at the end
of this Inventory. I verify that the statements made in this
Inventory are true and correct. I understand that false statements
herein are made subject to the penalties of 18 Pa.C.S. Section 4904
relating to unsworn falsification to authorities.
Attorney: Daniel J. Clement, Esquire
25 S, 4th Street
P.O, Box 93
Lewisburg, PA 17837
570,524-2277
I.D. No.: 10222
, ilU<<.tlac..:-R j/!t~c~
Meredith L. Moore
Administratrix of the
Estate of
Barry L. Moore, Deceased
Date:
4/6/05
Description
Value
Waypoint Bank - Checking Account No. 0100674324 $
Waypoint Bank - Savings Account No. 8978017096
CCFNB - Checking Account No. 3000076216
CCFNB - Certificate of Deposit No. 5000096713
Guns
1988 Victorian Mobile Home (value based upon sale at
(~ fair market value in arms length transaction)
VIN IV7514CK0212
1996 Ford Truck (value based upon sale at fair
.market value in arms length transaction)
VIN IFTCRI0A9TT48214
~nsurance Refund
168,37
393.73
1,228.15
73,460.00
1,450,00
12,000.00
2,000.00
13 7.54
Total
$90,837.79
'~"'BbV certify thai written nolice of lIle filing 01
,iI;S Ar..<:ount, and of the date. time and place
.~er; the same will be preeeoted 10 \he Court
" confirmation and of \he \BIt day to lIIe written
,Bctlons to satd Aooounl, hM been given to
.." ulpaid claim8fll and to avety other pelson
";" .,0 to \he accounliBflllo have or cleim an
" ",; ;1" :\;a es\ate '*' Cl'OOltor. benali!:iIlry,
"~~( nf io:in.
0 P>H
'i ~OOO
~ ..... rT 0 o~oc:: o t:H/l "I
<Q 'i (D , 'tl3:3: ":IH0-3H
~ ..... C 'i ::03:01 {Jl>,~
~ ::l (0 rT N:l>Ot'J o:l0-30-3Ul
D P> /-'. ~~~::d :l>::dt'J0-3
~ ......P> ,.." lUlL' >:1H3:
N ... ::l'<: 0 - 'U ;>> >:1tJjt'J;>>
~ " ~ a. .. L'Z ~C::~Z
" ~ rT I nt'Jo 0-30-30
0 ~
'iI ~ c t"' ~ () ::l' 00;>> L'H
" > 0 \lJ , 00"1
I " OC::Uln
~ 0 d~ 'irT ~::d 0 ZhjH
7, w 00 'i W0-3 c:: 3: Z
0 c " (1) rT 00'tl:>>
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><: w n () ::l' 0 0-3 Ohj:;dL'
" w o t"' ~ rT(1) H >< >:1 0
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'<: ::l' 0 ::d t'JtI:!oc::
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,!~ ;0 j;<aIJ JO l!<l\l . NePll9U8Q
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Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 11/15/2005
MOORE MEREDITH L
1288 TIMBERVIEW DRIVE
MECHANICSBURG, PA 17050
RE: Estate of MOORE BARRY L
File Number: 2004-00013
Dear Sir/Madam:
It has corne to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by: 12/29/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~~~
,_/
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
ll.
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
BARRY L. MOORE
Name of Decedent:
December 29, 2003
Date of Death:
Estate No.:
21-04-0013
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
I. State whether administration of the estate is complete:
Yes QU No 0
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 0
b. The separate OfP.hans' Court No. (if any) for the personal representative's
account is: 'N7 A
c. Did the personal representative state an account informally to the parties in
interest? Yes 0 No IE
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
attached ~o this report.
Date: 12-8-05
~
\
(.
Daniel J. Clement
Name
-.
(7)
25 South 4th Street
Lewisburq. PA 17837
Address
570 524-2277
Telephone No.
c,.')
I
Capacity: 0 Personal Representative
[l Counsel for personal representative
(-,,'
~t
LAW OFFICES
OF
DANIEL J. CLEMENT
25 SOUTH FOURTH STREET
P.O. BOX 93
LEWISBURG, PENNSYLVANIA 17837
(570) 524-2277
FAX: (570) 523-6247
December 8, 2005
Ms. Glenda Farner Strasbaugh
Cumberland County - Register of Wills
One Courthouse Square
Carlisle, PA 17013
In re:
Estate of MOORE BARRY L.
File Number: 2004-00013
Dear Ms. Strasbaugh:
On behalf of the personal representation in the above estate,
we are submitting herewith the Rule 6.12 Status Report as required
by the Orphan Court Rules.
Should you have any questions, do not hesitate to call.
Very truly yours,
D
DJC/cwl
Enclosure
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