HomeMy WebLinkAbout04-0264PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of
also known as
To
Regtster of Wills for the
Deceased County of tn the
, Commonwealth of Pennsylvama
Social Security No /~/~ ~ ~- ~ d -~'g'
The pettt~on of the undersigned respectfully represents that
Your pettt~oner(s), who ~s/are 18 years of age or older, appl [~-~ for letters of admtmstrat~on
on the estate of
(d b n, pendente hte, durante absentm, durante mmontate)
the above decedent
Decendent was domiciled at death ~n Cc, r~
h Er last family or pr nc pal residence at ~v~/~a~ ,~ 7-o~r~ ~lZ3-c-b~le~/r~ V ,Or, / ]Ec,~c~ ~ ~c.] __
Decendent, then ~'/ years of age, d~ed
at De-'fl~v,~t Tc~er.s
Decendent at death owned property w~th estimated values as folllows
(lf dom~cded ~n Pa ) All personal property $
(If not domiciled m Pa ) Personal property ~n Pennsylvama $
(If not d6m~cded m Pa ) Personal property in County $
Value of real estate m Pennsylvama $
s~tuated as follows
Petitioner after a proper search ha
the following spouse 0f any) and he,rs
ascertmned that decedent left no wdl and was surwved by
onsh~p Residence
THEREFORE, pet~t,oner(s) respectfully request(s) the grant of letters o~-mm,s~t,on~_ ~r~m c~
appropriate' form to the undersigned c~
~°
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY Or
The pet~noner(s) above-named swear(s) or affirm(s) that the
statements ~n the foregmng petmon are true and correct to the best
of the knowledge and behef of petitioner(s) and that as personal
representaUve(s) of the above decedent pem~oner(s) will well and
truly adm~mster the estate according to law
Sworn~' --to'-or- ~-affirmed and subscribed c' K ~--~-~*.~
before me this }'~-'fi day of [ 6/
No. ~,l-
Estate of C~o_c,~ X'~ '--)
GRANT OF LETTERS OF ADMINISTRATION
, Deceased
AND NOW ~"~2L~C~ k-"k '~'~000~ IR', , ~n consideration of the petition on
the reverse s~de hereof, satisfactory proof hawng been presented before me,
IT IS DECREED that
is/are enmled to Letters of Adm~mstranon, and m accord w~th such fin&ng, Letters of Adm~mstrat~on
are hereby granted
tn the estate of
Register of W II (" '
FEES
Letters of Adm~mstraUon $
Short Certificates( ) $ I ~-- ~L~ ATTORNEY (Sup Ct I D No )
Renuncmtton
TOTAL __ $ t4-g c~ ADDRESS
Fried 3- ~"-?
PHONE
RENUNCIATION
TO the Register of Wills of C ~t'/9'~ t~ C f'/c~/3 ~/
The unders,gned ~-~c~ fo/~ /-- /&--e_//~,o3 /e_ < of
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
deceased
County, Pennsylvania
WITNESS hand this day of ., 20__
(Sssnature)
(Address)
(S~gnature)
(Address)
(S~gnaturc)
'Vd ' oO
Off: Ed Lt
SlIJN~ jo
(Address)
Date of Death: ,:~.//~ ~/~ ~
Will No. o~ }- Oq ' ~.Le ~ Admin. No.
To the Register:
I ceffi~ ~at notice of (~nefici~ intent) ~m~ a~stmfion required by Rule ~.6(a) of ~e O~hans' Court Rules was
served on or m~led to the following benefici~es of the above-captioned estate on :
Nme Ad.ess
Notice has now been given to all persons entitled thereto under Rule $.6(a) except
Date:
. ~!:! 4gnature / /
Name
Address
Telephone ( )
Capacity: ~ Personal Representative
~.Counsel for personal representative
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REV-1500
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
OFFICIAL USE ONLY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
J) 0 a.lo i
NUMBER
~
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FILE NUMBER
().. -L -12 ~
COUNTY CODE YEAR
SOCIAL SECURITY NUMBER
M,
DATE OF BIRTH (MM-DD-YEAR)
~riginal Return
o 4. Limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
o 9. Litigation Proceeds Received
1(,1
-3~ - O~?
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 2. Supplemental Return
o 4a. Future Interest Compromise (dale 01 death after 12-12-82)
o 7. Decedent Maintained a Living Trust (Attach copy of Trust)
o 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
o 3. Remainder Return (date 01 death prior 10 12-13--82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
...
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/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
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(2) f\One
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(4) n 01'1 e...
(5) 10, 7...3 $'.",/
(6) "'one
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14. Net Value Subject to Tax (Line 12 minus Line 13)
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(8)
/(), 73~.y/
(9)
(10)
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(11)
(12)
(13)
1 ~ ,:1. .5'7. 7J
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non e.
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
7' '7 ,.., ~
x .0_ (15) /1(,)/1 ~
- r.:J. / r y.s-
x .o~ (16)
x .12 (17) /J 011 <..
x .15 (18)
(19) a:J.1,.~.s-
Decedent's Complete Address:
STREET ADDRESS
CITY
ZIP /'? as- ...J-
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) ~ /. ,yS-
Total Credits (A + B + C) (2) 0,00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
~
5.
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
(5A)
~ I. ';'5*
? f".6s--'
tj ~; 0
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.......................................................................................... 0 ~
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0 ~
o. retain a reversionary interest; or.......................................................................................................................... 0 1:8
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 gJ
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. 0 Ikt
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 3
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? .......................................................... ................... ........................................... 0 ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct
and complete.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SON RESPONSIBLE FOR FIL G RETURN
.~ /~ I<
ADDRESS
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
DATE
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)].
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The lax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV-1508EX.jl-S?)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH 01' PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
sheely, MQ.rt
M..
FILE NUMBER
~ao'l-~o~G.7"
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER DESCRIPTION
1 IT /?IW.s fl'
SO-ufn. ~ 1l('p>U" t Il./tJI7/~~d -.../- ~ t? S'3, '1-s )>
~ ~. J..J..i. ~/t:?t? ?/:J 8't?& --' / I..s-/~.. ??.5
c. h e...c.I<'1 ~ 1Jc'(.cI.I, T ~
C a-.sh m()t1~i
1 n II pa-rfmet'+
\J ef'j-z.cn Crc..d,.
&Jo.t1c.~ ~ p..,,.
ch~1<
E,...;e.IYls. Ho
Prc+ed-() r R<r
iu"... R.;f'....nd.
l3e+hAJ\ '/ lOur
5e",.."" r f-y 0 e. -
po.>;+ RG~""'d..
U(lco.s~~J ~.
5 e.c.urt+t ct..u./O
rG(r'lvU$~t1 to
"""iyY\c:l......'s
It"s~e..I:4loy
rn () r <. un c.c...sJ..-
~d S(J(;. !i;Gc.....rl.ty
cAu.t<s re......uU'-
$<' J. +4 ........."1 man>
esfAfe. 31c~
/'Y1 Y rnon'\ ff().;d Vel' y Old FurVl"+U r-e" e-l-c.. the... chly Tl.f'''fJ~
wed I,d", 'f f>u+ auf -ro +h ~ 1ro..s h /50 o...S' -f<J //ou.Js :
(f) 19 $#10./1 dY'<l,;d lea.,t> K,';c I,<'Y} 1-0..6/e, G,c.J j, ,~/, / It 0.. ~
I"e G en fly 60 u(l), the,."
(/f> C)n-e 6.et:/~d,..e~sc!U' .uJA,c..A she 6oueA-f /'11
rh -c=. 19i/d ~ ~ n-,y clo..u~A fe,... ;0 ur /1') A e.r S"~;-c..
rtOc rn .
(J) tJ/Je. d--6S'~e..r wi,e 1 / (' )
h?l ,-n y .sa/? n a..s /,/ er yo/cI'
~ cJn-e. ht.UrlQ roc,..y'\ A. A' /
L .IV G 4-~"" W I<:'h ..-ny S"/<S'~e;')
r/o-$ ~ u,.)~ CC '1.?A~ ~ h' ..LJ
's rar n'1 y /?'Jam,
W t!!.,.., done.-r-e d ra .s-O-/v_""OI7
lI~r Glor~~.s
/frl"1 y
VALUE AT DATE
OF DEATH
..,t ~5~ fi";Z~
$#,/ -
.,....s~t::)O
..t- 5"O'S-'
..J. ss: 0 C)
..& ..r G .. ~..3
F..r; ?fS': ~/
.I /~ i'?1~Qj
.$.3, a~().o(} _
/ tJ1 '7.3'1 ,1/1
TOTAL (Also enteron line 5, Recapitulation) $ I (J, ?.3 y: <Y/
(If more space is needed, insert additional sheets of the same size)
O~5H EX+ (12-99)
-
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
COMMONWEALTH OF PENNSYLVANIA
INMERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
.;1 () 0 'I -t:J()~~ JI
1.
DESCRIPTION
FUNERAL EXPENSES: _~ ~~e.-.u..-n C7.AO . /"I ,_ ....~
fl;P~~~ -.. C7~e..n'':.J OT v-,-c.J
rn o-I/, e <:.zf F" 1"1 e.r4,1 ~ o.rn c.. _, rh i..sr /11 c./~J~ ",e>rT""~" $ ,4,.j
-Flow ~rSI c/e. r~ 1',0..// ""Dr+-", "n s<..."'......r:..s , n C Iw <led
t=' ood.L rC I;.c..s";""'<.n +.s c:lurt":J /-''''' n e.ro./- L.o.-~e oS eo rGA...".," P"'(.~/'-cc:I
C41S-f o-P buri'-....I 1tJ-r - pur&ie;o,se.,d ~ro"'" tDur.-..rr/c..ud 0-";
r/m <::. ~T' I'YI Y _ .11- j, ;Y1cun 's dea...rh
EUeLYl$ Ce........e.+e...,,,.., e.,....or(t.d..s - f>w('(. ho.s e. oJ er~'+I'OI"\" p
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City
State _ Zip
Year(s) Commission Paid:
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
State _ Zip
Relationship of Claimant to Decedent
4. Probate Fees
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
'~-
AMOUNT
..s" 'O()-OtJ
..J-? B' IS; ll'.2.
I
...r / CO r Od
S ~"O.(JC
,J- 9'''1S".oo
$" 'I~(J(j
9:?J r, y:2.
RE\J-1srl EX... P-97)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SA cc. / ", ('f)a..ry fY) .
f
FILE NUMBER
~tJO,/ - (J&:2.t. ~
Include unreimbursed medical expenses.
L.'-'
Ta..
.&-
r~
ITEM
NUMBER DESCRIPTION AMOUNT
1't:~ ,/.JcI. /11em 6~.s C.....c=. qI', -r t:/ "., , 'Q'1 9'//3~,/ 1 1.0 ()
r G"ec..kt.~
CO;.../#
S-/~LI/(JY - 02.JI.. 9/
e ",'~On pd.
Ot'H. bi II
oVer H//('~ i'd. l3onnl" e flU 11.e,. - T".,~ 0... <;. '-I roC/" / ,:l.//S-/oy / /,. Ot}
yeS
rl1etl'1 y " ~ v e, .:l. LV c.-<./:: S TO G Ic'~ ,... 0 ,-,7 ~o../J +-p'Yl~,,-I- ... .;;1.~.ao
Pel To
s r<.,,-t -
31)f.Q/
TOTAL (Also enter on line 10, Recapitulation) $ 31 ~91
(If more space is needed, insert additional sheets of the same size)
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MARY M SHEELY 48
335 WESLEY DR
APT 526
MECHANICSBURG PA
17055-3565
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CD 12 03 01 46 PHILADE~~~_IA;~-P~
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335 WESLEY DR.l;.;,
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SSA R~.lD OFRCE
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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
RUPP JOANNE K
431 W MAIN ST
MECHANICSBURG, PA 17055-3242
------~- fold
ESTATE INFORMATION: SSN: 208-24-1418
FILE NUMBER: 2104-0264
DECEDENT NAME: SHEEL Y MARY M
DATE OF PAYMENT: 04/12/2005
POSTMARK DATE: 04/1 2/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 02/27/2004
NO. CD 005190
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $99.50
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$99.50
REMARKS: J KRUPP
CHECK#107
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
!~:~ NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
BUREAU OF INDIVIDUAi/-TAllES"
INHERITANCE TAX DIVISION
PO BO)( Za06Dl
HARRISBURG PA 17128-0601
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-30-2005
SHEELY
02-27-2004
21 04-0264
CUMBERLAND
101
Allount R...i Ueel
Pi'; 12: 35
eLm", OF
ORPH/N'S COURT
JOANNE KCWP'i"" '/,
431 W MAIN ST
MECHANICSBURG PA 17055
*'
REV-1547 EX AFP (03-05)
MARY
M
( I CHANGED
III
(2)
(31
('II
(51
(6)
(71
.00
.00
.00
.00
10.734.41
.00
.00
(8)
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
RESISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
Jtn.-~Il,."ft.'lnWm~'lI!'l.mft'1!l!.b'I!".!WI!A\"I'4M!1!'.m.lWtUmMM1'~.'Xi:r.'lN'4Flt'r.eW'.............. ...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF SHEELY MARY M FILE NO. 21 04-0264 ACN 101 DATE 05-30-2005
TAX RETURN WAS: (X I ACCEPTED AS FILED
I~ an asseSSMent was issued previously, lines 14, IS and'or 16, 17, 18 and
r~lect ~igures that include the total o~ ~ returns assessed to date.
ASSESSMENT OF TAX:
15. A.ount of Line 14 at Spousal rat. (IS)
16. Anount of Line 14 taxable at lineal/Class A rat. (16)
17. A.ount of Line 1'1 .t Sibling rat. 1171
18. Anount of Line 14 taxable at tollateral/Class B rate (18)
19. Principal Tax Due
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estat. (Schedule A)
2. Stocks and Bonds (SchBdul. BI
3. Closely Held Stock/PartnershIp Interest (Schedule C)
'i. ~rtgllges/Not.s Receivable (Schedule OJ
5~ Cash/Bank DepositslHisc. Personal Prop.rty (Schedul. El
6. JointlY Owned Property (Schedul. FI
7. Trens1.rs (Schedule G)
8. Total Assets
APPROVED DEDUCTIONS AND EXEMPTIONS:
,. Funeral ExP8nses/Adm. Costs/Misc. Expehses (Schedule Hl
10. Debts/Mortgage Liabilities/Liens (Schedule Il
11. Total llBductlons
12. Net Value of Tax Return
13. Ch.rit&bl./Gov.r~ental Bequestsj Non-elected 9113 Trusts
1~. Net Value of Estate Subject to Tax
NOTE:
:
IU1BER
CD005190
INTEREST/PEN PAID (-I
.38-
DATE
04-12-2005
~
(9)
1101
9,938.82
318.91
1111
1121
1131
11'11
NOTE: To insure prope"
credit to your account,
submi t the upper portion
of this for. with your
tax pay.ant.
10,734.41
10.;;>1;7 73
476.68
.00
476.68
19 w:ill
00 =
045 =
12 =
15 =
.00
21.45
.00
.00
21.45
(Schedule .JI
.00 X
476.68 X
.00 X
.00 X
AMOUNT PAID
99.50
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
1191=
99.12
71.67CR
.00
77.67CR
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN $1, NO PAYIIENT IS REIlUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE DF TMIS FORM FOR INSTRUCTIONS.I
nr-(\,.....,j'"...r'\;~:\ 0~rfr\l'"'-
BUREAU OF INDIVIDUAl,>..:TMM. ',' \:-:- .'.j-
INHERITANCE TAX DIVISION :--- - _ _ , .
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
2:'
>r
:0
REV-1607 EX AFP (03-05)
JOANNE KRUPP
431 W MAIN ST
MECHANICSBURG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
09-19-2005
SHEELY
02-27-2004
21 04-0264
CUMBERLAND
101
MARY
M
PA 17055
Anount Renitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
CUT ALONG THIS LINE
NOTE: To insure proper credit to your account, subnit the Upper portion of this form with your tax paynent.
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
REV-1607 EX AFP (03-05)
---------------------------------------------------------------------------
--+ RETAIN LOWER PORTION FOR YOUR RECORDS
4--
ESTATE OF SHEELY MARY M FILE NO.21 04-0264 ACN 101 DATE 09-19-2005
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
*** INHERITANCE TAX STATEMENT OF ACCOUNT ...
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-23-2005
PAYMENTS (TAX CREDITS):
PRINCIPAL TAX DUE: 21.45
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
04-12-2005 CD005190 .38- 99.50
09-06-2005 REFUND .00 77.67-
TOTAL TAX CREDIT 21.45
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
II IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J
~
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 1/13/2006
RUPP JOANNE K
431 W MAIN ST
MECHANICSBURG, PA 17055-3242
RE: Estate of SHEELY MARY M
File Number: 2004-00264
Dear Sir/Madam:
It has come 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. I, for decedents dying on or after
July I, 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:
2/27/2006
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~~~
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
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ST AIDS REPORT lJl\luER RULE 6.12
Name of Decedent: fi) a... r j ;72, sh e e../ )/
Date of Death: Fe /; r u a. r \j .;2.? I ,;2 c::? CJ '/
/
Estate No.: .:2. C) 0 y - 00 .,;Z" to 9"
.
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
1. State whe~ administration of the estate is complete:
Yes I!3"" No 0
2. lithe answer is No, state when the personal representative reasonably believes that
the administration will be complete: .-
3. lithe answer to No.1 is Yes, state the following:
a. Did the personal representative fiie a final account with "the CoUrt?
Yes 0 No ~
b. The separate Orphans' Court No. (if any) for the personal representative's
account is: -
c. Did the personal representativ~ sW;e an account' f rry.ally 0 th pa.."iies ip.tft;-~ ~
interest? Yes ~No D~'~~." I. .,~~
~.~ PI'1 <3~~'J . --rn.'Y '9'Y.l~
-tiL~~$f'..3i/,d2..r. ~ i.4Zct/J ~ ~4~';" ..;;'Q,
c. Copies of receIpts, releases, oinders and approval of formal or i.J.-lloTJJml ~...
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
4'}'
~~/? ,e7}/J
S~ature
J oa.nlle K', I?~ff
Name L/ 31 w~ ('Y) a... j n S:-f.
{Y) eGha.J)ICs.hurJ' PfI, /7tf)S~-...3;2 $/..<.
Date: 02../ ~/o~
I
Address
Capacit]:
(7/7) 7c,t- 7370
2~::::::esor.~hve
o COi..1TIsel for persorlal represel"'l.tative
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