HomeMy WebLinkAbout08-01-08oral is
15056041125
'~ REV-1500 EX (06-OS) OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year Fi{e Number
PO BOX 280601 INHERITANCE TAX RETURN --Y
Harrisburg PA 17128-0601 RESIDENT DECEDENT _ ~~ ~~ ~~
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
2 1 0 4 0 1 4 4 0 0 4 0 6 2 0 0 8 0 8 3 1 1 9 4 ri
Decedent's Last Name Suffix Decedent's First Name MI
F R Y S T E V E N L~
+Jlf Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name
Spouse's Social Security Number
FILL IN APPROPRIATE OVALS BELOW
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
MI
1. Original Return ~ 2. Supplemental Return ~ 3. Remainder Return (date of death
prior to 12-13-82)
4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5 Federal Estate Tax Return Required
death after 12-12-82)
6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9 Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
P A U L B O R R E S Q U I R E ~ 1~ ~' r' `~ " r~ `'
Firm Name (If Applicable)
REGISTER OF WILLS USE ONLY
L A W O F F I C E S O F P A U L O R R C~ ~~=
First line of address ' t~ --
5 0 E A S T H I G H S I R E E T ~, ~~ `;~~ ~-' --
,
-
Second line of address _
-- - ~'
-~ i
_- ,
City or Post Office State ZIP Code ~R'~E FILED ~°
~~--, ..
C A R L I S L E P A 1? 0 1 3 c»
r~~
Corres on nt's -ail ad ss: P RR EMBARQMAIL.COM
Under p n Itie of p rlu I ear that I h v e mined this return, including accompanying schedules and statements. and to the best of my knowledge and bebef
it is true. rr t and co plete ration f r arer other than the personal representative is based on aN information of which preparer has any know) dge
SIGNAT E P ON R SP NSI E ING RETURN T
ADDRE
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
50 EAST HIGH STREET CARLISLE PA X701
PLEASE USE ORIGINAL FORM ONLY
Side 1
15056041125 15056041125
15056042126
REV-1500 EX
Decedent's Social Security Number
decedent's Neme: STEVEN L. FRY 2 1 ~~ 4 0 1 4 4 0
RECAPITULATION
1. Real estate (Schedule A) 1.
2. Stocks and Bonds (Schedule B) .. 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) 3.
4. Mortgages & Notes Receivable (Schedule D) 4.
5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 5.
5 3 6 7 4
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ~ Separate Billing Requested 7.
8. Total Gross Assets (total Lines 1-7) ....................... .... 8. 5 3 3 6 7 4
9. Funeral Expenses & Administrative Costs (Schedule H) 9. 5 g 2 0 4 2
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
10. 2 ~ R 2 5
11. Total Deductions (total Lines 9 & 10) 11. ~ ~~ 5 ~ 6 ~
12. Net Value of Estate (Line 8 minus Line 11) 12. - 7 2 1 9 ~
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) 14.
- 7
2
1
9
3
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .o 0 0 0 15. 0 0 0
16 Amount of Line 14 taxable
at lineal rate X .0 ~ 0 0 0 16 Q U ~l
17. Amount of Line 14 taxable
0
0
0
at sibling rate X .12 17 ~ (1
18. Amount of Line 14 taxable
at collateral rate X .15 0 ~ ~ 18 ~~ _I ~ ~
19. Tax Due
..................
....
...
.....
..19. ~ ~~ ~
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ^
Side 2
15056042126 15056042126
?Jlf/AR6~ttdfa: 6t i~ ittegal to duplicate this copy by phatostat or phut®graph.
?ee for ti]is certificate, $6.00
Certificatio), Number-
['his is to certify tl2at the information here given i~.
•on-ectly copied from an original Certificate of Deatt
t(Ily filed with me as Local Registrar. The origins
:ertil~icate will be forwarded Co the State Vita
tecords (9#~fice for permanent filing.
~ocal Registrar Date Issued
s
} N1054.3 REV nrtooe l: V MMUN W tAL I H Uh F'tNNLi Y LVANIA • UtYAH I MtN l OF HtALI H • VI I AL HtOUHU7i
~R~Nr" CERTIFICATE OF DEATH
e+AOC ~ {See instnlcrions and examples on reverse)
STATE FlLE NUMBER
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1. Nar d OentlaA IRr.L nidie, beL edfap 2. Su 8. SooW Seouely NunDSr i. DeM d Oeetli IMaiCL d.Y. Mal
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REGISTER OF WILLS
CUMBERLAND COUNTY
PENNSYLVANIA
CERTIFICATE OF
GRANT OF LETTERS
ADMINISTRATION
No . 2008- 00539 PA No . 21- OS- 0539
Estate Of : STEVEN L FRY
(First, Middle, Lastl
Late Of : SOUTH MIDDLETON TOWNSHIP
CUMBERLAND COUNTY
Deceased
Social Security No : 210-40-1440
WHEREAS, STEVEN L FRY
(First, Middle, Last/
late of SOUTH MIDDLETON TOWNSHIP CUMBERLAND COUNTY
died on the 6th day of April 2008 and,
WHEREAS, the grant of Letters of Administration
is required for the administration of the estate.
THEREFORE, I, GLENDA EARNER STRASBAUGH Register of Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, have
this day granted Letters of Administration to:
CLARABELLE FRY
who has duly qualified as ADMINISTRATOR (RIX) of the estate
of the above named decedent and has agreed to administer the estate
according to Iaw, all of which fully appears of record in my office at
CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYL VANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 15th day of May 2008
* *NOTE* * ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
Senior Checking Plzui Account Statement PNCBANK
?NC Bank (~,
~./ ~ p imary account number: 50-0443-6322
Page 1 of 1
For the period 04/15/2008 to 05/13/2008 Number of enclosures: 0
c
H STEVEN L FRY ~] For 24-hour banking, and transaction or
24 PINE ST ~ -''interest rate information, sign on to
CARLISLE PA 17013-3136 'iQ' PNC Bank Online Banking at pnc.com.
For customer service call 1-888-PNC-BANK
between the hours of 6 AM and Midnight ET.
Para servicio en espariol, 1-866-HOLA-PNC
Movingt Please contact trs at 1-888-PNC-BANK
® Write to: Customer Service
PO Box 609
Pittsburgh PA 15230-9738
~~.Visit us at pnc.com
TDD terminal: 1-800-531-1648
For hc,rin~ impaired rlienrs only
Sometimes bigger dreams require larger loans. tl~ith highly competitive rates and low doe~~'I payments, eve can offer more mortgage options
and better financing solutions. VlThether yo>,t'tr shopping for a new piltna>y residence, a second ItOII1C, or considerittg a n:finance, we cart tailor
a jumbo mortgage that Gts your big plans perfectly.
I~orR~ore Information:
> Visit your local PNC IIank branch
> Visit pncmortgage,com
> Call I-300-778-6673
Senior Checking Plan
Regular Checking Account Summary
Account number: 50-0443-6322
Balance Summary
Beginning Deposits and Checks and other
balance other additions deductions
Ci,185.39 .OU 1~I8.(i5
Ending
balance
~i,33f.71
Charges
and fees
.110
Average monthly
balance
b,40`f.37
Steven L Fry
Please see the Activity Detail section for
additional information.
Activity Detail
Amount Description "°"""""`""-- --
~d 1#3.tiri I)irrct Payment -CPA EIT IliKhma,l: \Xt~:\?5)99
Daily Balance Detail
pate Balance Date Balance
04j 15 ~i,4$fi.3J 04/'23 Ci,3.`t4i %'}
There was 1 Online or Electronic Banking
Deduction totaling $148.65.
Payittg for college?
PNC Bank can provide solutions to all your education financing needs. Call now to review your options with an experienced loan counselor.
Call PNC Bank: I-800-762-1001
If you prefer to apply onluee, ~risit us at pnconcarnpus.com.
FORM953R-1005
REV-1511 EX + (12-99)
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA FIfNERAL EXPENSES &
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
STEVEN L. FRY
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
t. HOFFMAN-ROTH FUNERAL HOME & CREMATORY, INC. 4,448.92
B.
2.
3.
4
5
6
7.
8
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
dame of Personal Representative (s)
Social Security Number(s)IEIN fJumber of Personal Representative(s)
Street Address
Gty State ,
Year(s) Commission Paid:
Attorney Fees PAUL BRADFORD ORR, ESQUIRE
Family Exemption Ilf decedent's address is not the same as claimant's. attach explanation)
Claimant
Street Address
City State
Relationship of Claimant to Decedent
Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS
CUMBERLAND COUNTY COURTHOUSE, CARLISLE, PA 17013
Accountant's Fees
Tax Reborn Preparer's Fees
CUMBERLAND LAW JOURNAL- ESTATE NOTICE
THE SENTINEL-LEGAL- ESTATE NOTICE
Zip
87.00
75.00
209.50
TOTAL (Also enter on line 9, Recapitulation) ` $ 5,820.42
Zip
1,000.00
(tf more space is needed, insert additional sheets of the same size)
Hoffman-Roth Funeral Home & Crematory, Inc.
219 North Hanover Street
Carlisle, PA 17013
(717)243-4511
April 16, 2008
Clarabelle Fry
24 Pine Street
Carlisle, PA 17013
The Funeral Service for Steven L. Fry 15303-93
We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please
feel free to contact us if you have any questions in regard to this statement.
THE FOLLOWING 1S AN ITEMIZED STATEMENT OF THE SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT,
AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS.
OUR SERVICE:
Traditional Funeral Service Package $4150.00
FUNERAL HOME SERVICE CHARGES $4150.00
THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE
THAT YOU HAVE SELECTED $4150.00
Cash Advances
Newspaper Obituary Notice- Sentinel , $79.92
Clergy Offering $75.00
Certified Copies of Death Certificates . $60.00
Flowers. $159.00
Clergy declined honorarium, $-75.00
TOTAL CASH ADVANCES AND SPECIAL CHARGES . $298.92
Total
Total Cost . $4448.92
TOTAL AMOUNT DUE $444$.92
This statement is net and payable in full within 30 days of receipt.
RECEIPT FOR PAYMENT
GLENDA FARNER STRASBAUGH
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17613
FRY STEVEN L
Receipt Date: 5/15/2008
Receipt Time: 10:33:16
Receipt No.: 1052687
Estate File No.: 2008-00539
Paid By Remarks: LAW OFFICES PAUL BRADFORD ORR
AJW
-------------------
Fee/Tax Description
PETITION LTRS ADM
SHORT CERTIFICATE
JCP FEE
AUTOMATION FEE
Check# 2035
Total Received.........
Receipt Distribution -------------------- ----
Payment Amount Payee Name
45.00 CUMBERLAND COUNTY GENERAL FUN
12.00 CUMBERLAND COUNTY GENERAL FUN
10.00 BUREAU OF RECEIPTS & CNTR M.D
5.00
---------------- CUMBERLAND COUNTY GENERAL FUN
72.00
72.00
CUMBERLAND LAW JOURNAL
32 SOUTH BEDFORD STREET
CARLISLE, PA 17013
Tele: (717) 2493166 Fax: (717) 249-2663
June 27, 2008
Cumberland Law Journal is published every Friday by the Cumberland County
Bar Association and is designated by the Court of Common Pleas as the official legal
publication for Cumberland County and the legal newspaper for publication of legal
notices.
TO: Paul Bradford Orr, Esquire
Steven Fry Estate
RE:
Legal advertisements must be received by Friday Noon. All legal advertising
must be paid in advance. Make all checks payable to: Cumberland Law Journal.
Advertisement inserted on the following dates:
June 13, June 20, and June 27, 2008
Advertising Cost $ 75.00
Proof of Publication $ 0.00
Second Proof Request $ 0.00
Payment received $ 0 .00
Total Amount Due $ 75.00
Payment received by
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16, 1929), P. L.1784
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss.
Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and
State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law
Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid,
was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all 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
Journal on the following dates,
viz:
June 13, June 20 and June 27, 2008
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time, place and character of publication are true.
r ~`
L' a Marie Coyn ,Editor
SWORN TO AND SUBSCRIBED before me this
27_day of June, 2008
Fry, Steven, deed. Notary
Late of South Middleton Town-
ship.
Executrix: Clarabelle Fry, 24 Pine
Street, Carlisle, PA 17013.
Attorney: Paul Bradford Orr, Es- _ _
quire, 50 East High Street, Caz- NOiAR1Al SEA- L
lisle, PA 17013. DEBORAH A COLLINS
Notary Public
CARLISLE BORO, CUMBERLAND COUNTY
My Commission Exptres Apr 28, 2010
RETAIN THIS PORTION FOR YOUR RECORDS
THE~SENTINEL - LEGAL PAUL BRADFORD ORR
P.O. BOX 130, CARLISLE, PA 17013
AD NUMBER CLASS SALESPERSON BILLING DATE LINES
350571 10 PUBLIC NOTICES wolfC 06/25/08 42 * 2
AD DESCRIPTION START DATE
06/11/08 STOP DATE
06/25/08
ESTATE NOTICE LETTERS TESTAMENTARY
PUBLICATION INSERTIONS RATE NET AMOUNT GROSS AMOUNT
3 THE SENTINEL - LEGAL 3 LGL 167.58
TOTAL AD CHARGE 167.58
3 PROOF OF PUBLICATION OlPRF 7.00
YS RUN
ASE ORDER - _ PAY THIS AMOUNT
Est.Steven Fry r es.
MESSAGE:
Thank you for advertising with The Sentinel.
174.58
209.50*
Deadlines for in-column legal advertisements: Monday is Friday at
11 a.m.; Tuesday is Friday at 4 p.m.; Wednesday is Monday at 12 Noon;
Thursday is Tuesday at 12 Noon; Friday is Wednesday at 12 Noon; Sunday
is Thursday at 12 Noon.
If you have any questions regarding your Legal bill please call
Tammy Shoemaker 717-240-7176
Fax your legals to 717-243-3754 attention Tammy Shoemaker
You can also EMAIL your legal to Classified ads: classified@cumberlink.com
Please send a cover letter including your name and address as an attachment
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REV-1512 EX + (12-03)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE 1
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
STEVEN L. FRY
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION VALUE AT DATE
OF DEATH
1. FOREST PARK HEALTH CENTER 10.00
WALNUT BOTTOM ROAD
CARLISLE, PA 17013
2. FOREST PARK HEALTH CENTER 68.18
WALNUT BOTTOM ROAD
CARLISLE, PA 17013
3. COMCAST CABLE 80.17
339 BALTIMORE RD.
SHIPPENSBURG, PA 17257
4. ROBERT C. CAIRNS, TAX COLLECTOR 4.90
PO BOX 40
BOILING SPRINGS, PA 17007
5. CUMBERLAND-GOODWILL FIRERESCUE 75.00
PO BOX 12910
PHILADELPHIA, PA 19176-0910
TOTAL (Also enter on line 10, Recapitulation} I $ 238 25
(If more space is needed insert additional sheets of the same size)
DATE DESCRIPTION UNITS REFERENCE AMOUNT BALANCE
PREVIOUS BALANCE .00 .00
03/28/2008 BEAUTY/BARBER 1 10.00 10.00
i
ENDING EAL~'3NCE ~ ~ ~ `~ . ^ 0
YOUR PAYMENT OE
C~.~~.1Z ~ ~~-- D ~
~.-~ 1~~ C~3..5~~
10.00 IS DUE UPON RECEIPT
Forest Park Health Cent 1-888-880-7090 FRY STEVEN L 22720
DATE DESCRIPTION UNITS REFERENCE AMOUNT BALANCE
PREVIOUS BALANCE 10.00 10.00
04/14/2008 PRIVATE PAYMENT CK#1356 -10.00 .00
04/02/2008 TRANSPORTATION/FACILITY 1 i 30.00 30.00
04/02/2008 TRANSPORT ATTENDANT 1 8.50 38.50
04/06/2008 TELEPHONE 1 i 29.68 68.18
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YOUR PAYMENT OF 68.18 IS DUE UPON RECEIPT
PLEASE ACCEPT OUR CONDOLENCES IN THE LOSS OF YOUR LOVED ONE.
GUARDIAN ELDER CARE AND FOREST PARK HEALTH CENTER WILL HAVE YOU
IN OUR THOUGHTS AND PRAYERS DURING THIS DIFFICULT TIME. ANY
QUESTIONS, PLEASE CALL.
Forest Park Health Cent 1-888-880-7090 FRY STEVEN L 22720
comcast® NUMBERT DUEE AMOUNT DUE ~~®
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Visit us on the web at 09547377236-01-8 05/07!08 $$0.17
www.comcast.com services you subs n6e to
STEVEN FRY I How to reach us...
For service at:
24 PINE sT
CARLISLE PA 1 701 3-31 36
News from Comcast
Thartk you for your prompt payment. For your convenience, we
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Hearing t Speech Impaired Call 71 i
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How to reach us:
339 Baltimore Rd.
Shippensburg, PA 17257
717-243,4918or 800-995-6545
Telephone Customer Service
24 hours a day, seven days a week
Summary of Charges statement Prepared 04/14/08
Billed from 04/23/08 to 05122/08
Previous Balance 80.17
Payments {received by 04/14/08) 80.17 cr
Comcast Cable Television 79.15
Taxes, Surcharges & Fees 1.02 T
Tote! Due $Bp,17
Detail of Charges on back
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Cumberland-Gaodwilt FireRescue
PO BOX 12910
PHILA, PA 19176-0910
Phone #: (800) 367-0512 Federal Tax ID: 23-2298422
PATIENT NAME: STEVEN FRY
INSURANCE: MEDICARE B 210401440A
CG0801394
STEVEN FRY
24 PINE ST
CARLISLE, PA 17013
DESCRIPTEON OF CHARGE
BLS RESPONSE AND TREATMENT A0998
DE5CRIP'T40N OF PAYMENT
PATIENT NAME: FRY, STEVEN
f PATIENT NUMBER.: 10916
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THIS ACCOUNT IS PAST DUE! Send your payment now or contact
our office to make payment arrangements. vrsa ~~a5f
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Cumberland-Goodwill FireRescue PO BOX 12910 PHILA, PA 19176-0910
PATIENT NUMBER
CALL NUMBER:
DATE OF CALL.:
TIME OF CALL:
CALLER
FROM:
TO:
REASON(Sl
FOR
TRANSPORT
INV®lGE
10916 PRIV
CG0801394 A
o4/os/2oos
Police/Fire/911
FOREST PARK NURSING HOME
700 WALNUT BOTTOM RD
CARDIAC ARREST
QUANTITY UNI7 PRICE
1.0 75.00
RECEIPT PAYMENT DATE
AMOUNT
75.00
'Total Charges 75.00
Arnt~uNT
i
j
i
Total Credits 0.00
___ .__W ___._.______ ~W.___.__.__~_. ..._._.~__.~._.___._._____.__~ ~ ._._..._...._._._,_~_a_._~......~..._,.._._..~..;
PLEA~F ~'~~`~ ?"i-If ~ Alilff~E.INT' ---~. '; $75.00
i
DETACH ALONG PERFORMATSCSN Ara _r LRETJF~N STUB WE i H PAYMENT j
AMOLsN° s;~.lr 75.00
CALL NurUiE>EE CG0801394 eaEll4/~"JN ~ ,; -_______._._.~.u_
BR_LiNG CJATE: 05/13/2008 ENCLOi~E~:r
___,__.~____~_.__ i
REV-1513 EX ~ (9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
STEVEN L. FRY
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [include outnght spousal distnbutions and Transfers under
Sec 9116 (a) (t 2)]
1. CLARABELLE FRY Lineal
24 PINE STREET 0.00
CARLISLE, PA 17013
2. CHRISTY L. SLOAN Sibling
618 WEST PINE STREET 0.00
MT. HOLLY SPRINGS, PA 17065
3. ROXANNE ROSS Sibling
123 BIG SPRING TERRACE 0.00
NEWVILLE, PA 17241
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, O N REV-1500 COVER SHEET
-~. NON-TAXABLE DISTRIBUTIONS:
1. A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1. B. CHARITABLE AND GOVERNMENTAL D1STR18UTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
IIT more space Is needed, Insert addltlonal sheets of the same size}
n
PETITION FOR PROBATE AND GRANT OF LETTERS
REGISTER OF WILLS OF Cumberland
Estate of Steven L. Fry
also known as
Deceased
COUNTY, PENNSYLVANIA
File Number ~ ~ _ . _
,~
___ ~ ~ ~ ~ ,
Social Security Number 210-40;~4~9~ ~ -
Petitioner(s), who islare 18 years of age or older, apply(ies) for: ~~' %~ ~ `J
(COMPLETE 'A' or 'B' BELOW.) ' ~' ~ ~ ~, ~' ~ `-y~
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® A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is !are the ,;~ --i ~amed tn; the:
last Will of the Decedent dated and codicil(s) dated ~ -- ~ ,
(State relevant circumstances, e.g., renunciation, death of executor, etc.)
Except as follows, Decedent did not marry, was not divorced, and did not have a child bom or adopted after execution of the instrument(s) offered
for probate, was not the victim of a killing and was never adjudicated an incapacitated person:
B. Grant of Letters of Administration
(lfapplicable, enter: c.t.a.; d.b.n.c.t.a.;pendentelite; duranteabsentia; duranteminoritate)
Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If
Administration, c. t. a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.)
Clarabelle Fry Mother 24 Pine Street, Carlisle, PA 17013
Christy L. Sloan Sister 618 W. Pine Street, Mt. Holly Springs, PA 17065
Roxanne Ross Sister 123 Big Spring Terrace, Newville, PA 17241
(COMPLETE INALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at
24 Pine street, Carlisle, South Middleton Township Pennsvlvania 17013
(List street address, town/city, township, county, state, zip code)
Decedent, then 59 years of age, died on Apri16, 2008 at Forest Park health Center
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 5,485.39
(If not domiciled in PA) Personal property in Pennsylvania $ 0.00
(If not domiciled in PA) Personal property in County $ 0.00
Value of real estate in Pennsylvania $ 0.00
situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Wil] and Codicil(s) presented with this Petirion and the grant of Letters in the appropriate form to
the undersigned:
Si nature T ed or rimed name and residence
Clarabelle Fry, 24 Pine Street, Carlisle, PA 17013
Form nw-oz rev. 10.13.06 Page 1 of 2
0
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF Cumberland
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of
the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly
administer the estate according to law.
Sworn to or affirmed and subscribed
Signature of Personal Representative
before me the day of
Signature of Persona[ Representative
For the Register Signature of Personal Representative
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File Number:
Estate of Steven L. Fry ,Deceased
Social Security Number: 210-40-1440 Date of Death: April 6, 2008
AND NOW, , in consideration of the foregoing Petition, satisfactory proof
having been presented before me, IT I5 DECREED that Letters
are hereby granted to
in the above estate
and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent.
FEES
Register of Wills
Letters ............... $
Short Certificate(s) ........ $ Attorney Signature:
Renunciation(s) .......... $
Attorney Name: Paul Bradford Orr, Esquire
... $
• • • $ Supreme Court I.D. No.: 71786
... $
Address: 50 East High Street
... $
• • • $ Carlisle, PA 17013
... $
... $
" ' $ Telephone: (717) 258-8558
... $
TOTAL .............. $ 0.00
Form RW-02 rev. 10.13.06 Page 2 of 2