HomeMy WebLinkAbout04-0295PETITION FOR PROBATE and GRANT OF LETTERS
also known as
Deceased
Social Security No j.~c].--/~,
The petition of the undersigned respectfully represents that
Your petmoner(s), who is/are 18 years of age or older an the execult~ t' ~-~'
In the last will of the above decedent, dated /'O ~'?~
and codicil(s) dated ~"~'/"d~. Z/''z~'/~ ?
To
Register of Wills for the
County of ~2ig~ff~-~:'~ln the
Commonwealth of Pennsylvanta
named
,19___
(state relevant ctrcumstances, e g renunciation, death of executor, etc )
Decendent was domiciled at death in ~ 6/.,~q~"'/q.Z~/4//.~ County, Pennsylvania, with
~/h~.. last family or princtpal reside~lce at ~a,4'~.//' ~/~"' ~'~-o/3 /-//d./'~/'.z~' ---- r'-'- ,D
.AI~qA/r)v~'R :q ?. (J,4,~l/,~-/~- .~9.~ /~'~ / ~ ~//)~/7-/-/ ,qT/bD/Jcfd~ ~bO/~
(list street, number and munclpahty)
Decendent,~ the~ '~_~ years of age, dle~d /~/~//q t~ ~'/~. /~
at LT../~RL/5~- ~6 /~ AA~L /~Z~o?o' /°~l--
Except as follows, decedent did not marry;, ~vas not ~hvo{ced ~n~t did not have a child born or adopted
after executlo,~n of the,will offered for probate, was not the victim of a killing and was never adjudicated
incompetent,""
Decendent at death owned property with estimated values as follows
(If domlctled in Pa ) All personal property
(If not domiciled in Pa ) P-ort. onak'p~uvc, ty in Pennsylvamw
(If not domiciled in Pa ) Pecr, onal_ga~pertyJn_County
Value of real estate in Pennsylvania
situated as follows ~A./,Od//-~'"-
WHEREFORE, petitioner(s) respectfully request(s) the probate of tile. last wtll and codicil(s)
presented herewith and the grant of letters ~fi~/~O'~A_/~/qA~/~
(testamentary, admlmsnation c t a , admimstratlon d b n e t a )
'~ ~ ~ OA~21-1 OF PERSONAL REPRESENTATIVE
C~I~'~MON~EALT~I OF PENNSYLVA~NIA q~ ,~
The petitloner(s),a"er~-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 represen-
tative(s) of the above decedent petitioner(s) will well and truly ad, mlmster the estate according to law
)
before rile this _c2~-~ X--, day of / t~\ ~,,t.~. ,~J/~ /~ I ~'~.~"t g
Estate Of
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW ~3.r-C-V~ C~(o , ~Lbq 1~ , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated oQ- ~ ~ - t C~ -~ C)
described therein be admitted to probate and filed of record as the last will of ~x/t O10. 6-' ~'5~ rxe}O&._
and Letters -"~-'~ c~7~%._.?C~-T
are hereby granted to
FEES
Probate, Letters, Etc ..........
Short Certificates( ) .......... $
m:~ti~ .x.~.~.~.,-.~,.. $ '~.(..:,o
TOTAL
Filed ...~.: ~ .to.-: ~ .~...~..%c. .............
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
Re0ister of Wills of-Bar-ks County, Pennsylvania
OATH OF NON-SUBSCRIBING WITNESS
also known as
, Deceased
(each) a subscriber hereto, (each) being duly quahfied according to law, depose(s) and say(s) that (I amore are) famd~ar w~th the signature
of ¥~ 0 ~-~r ~ ~'i~,J ~) ~ , testat ~)1 ~ of (erie ~f th~...e~subscr, b~,~no w~tn_.~J.~...%to th~
presented herewith and that ~J~ ~-- behaver the signature on th~ m the~andw~ntl~lg~of
~/{ 0 L~- ~ ~L~%,~'b~--~ to the b~s~"o'f 0~-,-, knowledge and behef
Sworn tooraffirmedandsubscnbed%'~ -' '~ ' '- ~. ~f"' ~, ~~
;efore~eth,s~~ d;;of ~ ~(S,gnature)~ . --
Sworn to or a~ed and subscnbed
(S~gnatum)
before me this day of
,20__
(Signature)
For the Register
i05 805 REV 9186
Th~s ~s to cemfy that the ~nformauon here gtven ~s correctly cop~ed from an original cemficate of death duly filed w~th me as
Local Rcgtstrar The ortg~nal cemficate will be forwarded to the State V~tal Records O~ce for permanent fihng
WARNING: It Is illegal to duplicate this copy by photostat or photograph.
Fee for th~s ceruficate, $2 00
P ~0039864
No
COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
Viola Ellen Bender Female = 159- 16 - 5649
Cumberland
Waitress
Hanover Street
Carhsle, Pennsylvama 17013
Nov 30 1920 Cafhsle PA [,~-.-~[]
Carhsle Carhsle Regional Medical Center
James Moffitt
Jeanette R Watts
W~dowed
PennsyNanla o,~ ~¢ [] ¥~ ~oc~o~.~,~,~ North Mlddleton
6004 Robert Drive Mechamcsburg Pa 17050
Mar 17, 2004
LAST WILL AND ~.STAMENT OF VIOLA E.~ BENDER
I,.VI.OLA E. BENDER, pf the Borough of~Mechanmcshurg,' Co. dnty
of Cumb,~rland arid State ~of..Penns'ylvanma, bemng of sound 'and dxs-'
poscng m~nd~ memory and un~ersgsnd~ng~ do m~ke, publish and de-
clare th~s my Last W~ll and Testament.
I dmrect the payment of, all my just d~bts ~nd fuheral ex-
penses~as soon afte~ my .decease as the s. ame can conven~e'ntly be
done. ' '
I gmve and bequ6~th ~tl'th~ regt, resmdue '~nd' r~e'~na:~hder o£
my estat,e, 'of whatsoe~ver nature and ';whe,resoev, er smtuate', to my
daughter~,* Dor-zs J ' Bender' a~d "Jea~ette . ' ....
· ,R. Watts~.,share and ~ha~e
almke. ..... .
LASTLY~ I nominate, cons~ztute and appomnt m dau rs,
Dorms J. Bender, gnd. Jeanette R. Watts, Executrzces of thm~ my .
Last Wmll and Testament. '
.. IN WITNESS WHE~EgF,~I have~ herednto set ~my. h~nd and'.sea,1 t'h.'ms
' ''
day of'Februa~ry, A.D. .
V~l "cO ,:6u~uequln3
im¢":" ~ "u', ,O->p81O
SlP, A ~'o
1o eomO-pepm~aH
( SEAL )
V~ola E. Bender
-1-
Signed, sealed, publmshed and declared by the aboYe named
Viola E. Bender, as and for her Last Will~'a~nd Testament, mn the
~presence of us w~o haze subscribed our names hereto a~ w~ne~ses
request of s.ald test~atrmx, mn her presence and in the
at the
presenc, e.of each other.
:EV-1500 ~X (6-00) ·
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
LU
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
DATE OF DEATH (I~M-DD-YEAR) J. I DATE OF BIRTH
"'12-2o, Y /I - EA__.)
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
~"l~riginal Return
ited Estate
edent Died Testate (Attach copy of Will)
[~9. Litigation Proceeds Received
1~2. Supplemental Return
~14a. Future Interest Compromise (date of death after 12-12-82)
I-~7. Decedent Maintained a Living Trust (Attach copy of Trust)
[~10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
TELEPHONE NUMBER
'7/7- g
OFF CA. USE
FILE NUMBEb
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
r~3. Remainder Return (date of death prior to 12-13-82)
I~"] 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
r--1 11. Election to tax under Sec. 9113(A) (Attach Sch O)
COMPLETE MAILING ADDRESS
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
[~ Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13.
14.
OFFICIAL USE ONLY
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
(13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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.
20.
x .12
x .15
(15)
(17)
(18)
REV-1508 EX * (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
ESTATE OF Z~':~~ /'x/~/x~ ~
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
TOTAL (Also enter on line 5, Recapitulation)
t ?~, I0
(If more space is needed, insert additional sheets of the same size)
Wag B~tter Banking onlg from Wagpoint Bank
Receipt -acct. ~: ~$~g~5063
T~ ~:o4~7 ~ C~o~o~t ~/ ~ ~ ) 5~
TR ~: i53 TR ~NT: 196.i0 /
Date: 0~/0i/200~ Time: 13:3i
Checks and other items received for deposit are subject to the provisions of the Uniform Commercial Code. Certain
deposits are subject to delays in availability according to Bank policy.
TEL-010(08/02) Thank You For Banking At Wagpoint Member FDIC
Wag Better Banking onlg from Wagpoint Bank
Receipt - 2cct, ~: 0!0067i007
TLR ~:0437 DD~ Cioseout
TR ~: 15i TR ~NT: 51684.05
Date: 04/01/2004 Time: 13:30
Checks and other items received for deposit are subiect to the provisions of the Uniform Commercial Code. Certain
deposits are subject to delays in availability according to Bank policy.
TELq)IO(08/02) Thank You For Banking At Wagpoint Member FDiC
000
CHURCH
OF GOD
HOME
OF GOD HOME, INC.
80t N. HANOVER STREET
CARLISLE, PA 17013
(7 [7) 249-5322
RESIDENT NAME RESIDENT NUMBER
BENDER VIOLA E 000002369
AMOUNT OF
$
PAYMENT
STATEMENT DAT~'.
04/01/20~
JEANETTE WATTS
6004 ROBERT DRIVE
MECHANICSBURG PA 17050
PREVIOUS
BALANCE
PLEASE DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT
DATE TRANSACTION DESCRIPTION UNITS REFERENCE # AMOUNT
03/11/200 & 11 INTERMEDIAT DAYS @ 172.0( 1892.00
03/15/200& BEAUTY/BARBER 1.00 18.0f
03/15/200~ PAYMENT, THANK YOU! 1544 -5401.0~
cVRRE~AcCT, s~-~NCE ADVANCE CHARSES
ST^TEME~ OAT~ ~a~VioU§ S~NCE ' cURrENT CH^~eES ~D~:USTMENTs
04/01/2004 69.00 i 1910.00 -5401.00 I .00 --3422.00 .00
THISAMOUNT -- I - -3422.00
TO REORDER CONTACT: CONSOUDATED GRAPHIC COMMUNICATIONS · KEVIN MANN · (570) 3684
REV-1511 EX+ (12-9~)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A.
1.
FUNERAL EXPENSES:
x~'-~/,~' /rZ~ / ~_. ~/~
ADMI~STRAT'~~ ~ 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:
Attorney Fees
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
Probate Fees ,.-...-- ~:2 ,,~-~-/
Accountant's Fees
Tax Return Preparer's Fees
.)
TOTAL (Also enter on line 9, Recapitulation) $ 7¢O 7" 5 ~)
(If more space is needed, insert additional sheets of the same size)
REV.1512 EX * (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULEI
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES,& LIENS
FILE NUMBER
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
AMOUNT
$
RE~'1513 EX+ (9 00~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
NUMBER
I
1.
II
1.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
FILE NUMBER
'R~EL~AATIONSHIP TO DECEDENT
Do Not List Trustee(s)
AMOUNT OR SHARE
OF ESTATE
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
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)
REGISTER OF WILLS
CUMBERLAND County, Pennsylvania
CERTIFICATE OF GRANT OF LETTERS
No. 20 04- 00295
Estate Of: BENDER VIOLA E
(Last, First, Middle)
PA No. 21-04-0295
Late Of:
NORTH MIDDLETON TO WNSHIP
CUMBERLAND COUNTY
Deceased
Social Security No: 159-18-5849
WHEREAS, on the 26th day of March 2004 an instrument dated
February 18th 1970 was admitted to probate as the last will of
BENDER VIOLA E
(Last, First, Middle)
late of NORTH M/DDLETON TOWNSH/P, CUMBERLAND County,
who died on the 12th day of March 2004 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
WA TTS JEANETTE R and BENDER DORIS J
who have duly qualified as EXECUTOR(RIX)
and have agreed to administer the estate according to law, all of which
fully appears of record in m.v office at CUMBERLAND COUNTY COURTHOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 26th day of March 2004.
eg~ter of Wills
**NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE)
LAST WILL'AND'TESTAMENT OF'ViOLAtE[ BENDER
I, VIOLA E. BENDER, of the Borough of Mechanicsburg, County
of Cumberland and State of Pennsylvania, being of sound and dis-
posing mind, memory and understanding, do make, publish and de-
clare thi2 my Last Will and Testament.
I direct the payment of all my just debts and funeral ex-
penses as soon after my decease as the same can conveniently be
done.
I give and bequeath all the rest, residue and remainder of
my estate~ of whatsoever nature and wheresoever situate, to my
daughters, Doris J. Bender. and Jeanette R. Watts, share and share
alike.
LASTLY, I nominate, constitute and appoint my daughters,
Doris J. Bender and Jeanette R. Watts, Executrices of this my
Last Will and Testament.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
'/~F~ day of February, A. D. 1970.
V~¢la E. Bender
Signed, sealed, published and declared by the aboYe named
Viola E. Bender, as and for her Last Will and Testament, in the
presence of us ~ho'haV'~ subscr~bed our names hereto as witnesses
at the request of said testatrix, in her presence and in the
presence of each other.
his is to certify, that tl~e information here given is correctly copied fi'om an original certificate of death duly filed with me as
l,ocal Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent ~ling.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 10039861
No.
Local Registrar
NAME OF DECEDENT (First. Middle, t. ast)
83 Yrs
Cumberland
vvaltress
(Slreel, Cily/Towll, Stale, Z~p Code)
Hanover Street
Carlisle, Pennsylvania 17013 <See
on other side)
James Moffitt
(Type/Print)
Jeanette R. Watts
METHOD OF DISPOSITION
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
JSEX I SOCIAL SECURITY NUMBER IDAFEO n( D i ..... ..... .......
Viola Ellen Bender 2. Female 3. 159- 18 - 5849 . March 12, 2004
~Nov 30, 1920 Carlisle, PA. J ......... ,~ ............[] .o,~ [] J
· 7. _ /".. I ....[] .........[],s,.c,l,} ..... []
CITY, BORe, TWP OF DEATH J FACILITY NAME (If Del instdution, gwe slreel and numbe0 WAS DECEDENT OF HISPANIC ORIGIN? J RACE - American Indian. BlaCk Wh~Ie otc
Carlisle Carlisle Regional Medical Center j ~ex~n, P.edo ~* .... t~ ~Sp..,~v~
8.. No ~ Y~. ~ g ~,, .~,~ c.~.~, ~o. White
Restaurant ~ No la (~,2) 11 N~o,*.) ,~. Widowed
~.. s~a,~ Pennsylvania Din lIc. ~ Yes. a~eaenl ~ved in North Middleton
,~ co..t~.Cumberland towns~p? ~?d. ~ No. ~ocedenl
J ~o.. 6004 Robert Drive Mechanicsburg, Pa. 17050
~ St. John's Cemete~ ~u Camp Hill, Pa. 17011
.......... [] ...... [~C ........ OR ..... ~rom State E]
2~a (spec~) .FI Mar 17, 2004
j 2L~:.EN S ...... ~FD-012662-L
o the bom DJ my kpowledge, death occurred el Ina time, da~e a~ ~ece staled
physician ~s not evasive at time of death Io (Si~ature and Ti/le~
con,fy cause of death
(Mont~. Day. Year)
person w~ pr~u~es ~alh 2:40 PM March 12, 2004
Sequentlaily Iisi conditions
g any leading to ~nmediale
Enter UNDERLYING
CAUSE IDisease or illlt*~
· PRONOUNCING AND CERTIFYING PHYSICIAN (Phy siman tX)Ih proflounclng death and celtlfyJn9 Io cause el death)
To the best of my knowledge, death occu~ed at Ihe time. date, and place, and due to Ihe causes(s) and manner as slated .................... ~
· MEDICAL EXAMINE~CORONER
On Ihe basis of examination afl~oc Investigation, In my opinion, deem occurred at Ihe time, dale, and place, and due lo the causes(s) and
31a~lanner as state~ ......................................................................................................................................... ~
J2N2;~E ~l~yOer^sO~nSeSra°~l~l;~t~,T~nc. 37 East Main Street Mechanicsburg, Pa 17055
LICENSE NUMBER IDATE SIGNED
1
(Monlh, Day Year)
23b, 23c.
WAS CASE REFERRED TO A MEDICAL EKAMINER/CORONER?
; ApproximatePART Ih Diner srgnfflcam conddlons contrlbuhng to death, but
PERFORMED? AVAILABLE PRIOR TO [] (M~mth, Day, Yead
COMPLETION OF CAUSE Natural ~.~.] Heroic*de
To the heal of my knowledge, deatU occurred due to the causesis) and inanner as sta~d
INJURY AT wOr~? j-~;~Ti~ T~;oT~a~;;~ii~;;, ' ....
/
Yes[] No[]
30c. / 30d
NAME AND A~RfiSS OF PERSON ~O COMPLETED CAUSE OF DEATH
Decedent's Complete Address:
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Interest/Penalty if applicable
D. Interest
E. Penalty
(1)
Total Credits ( A + B + C ) (2)
Total Interest/Penalty ( D + E ) (3)
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)
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + SA. 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
IF THE ANSWER
Did decedent make a transfer and: Yes
a. retain the use or income of the property transferred; .......................................................................................... []
b. retain the right to designate who shall use the property transferred or its income; ............................................ []
c. retain a reversionary interest; or .......................................................................................................................... []
d. receive the promise for life of either payments, benefits or care? ...................................................................... []
If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. []
Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ..............[]
Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................................................................................................ []
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 preparerS, as any knowledge.
SIGNATURE OF RERSON RESPONSIBLE FOR FILING RETURN' /' (~ ...~L /,--.% DATE
SIGNATURE OF PREPARER OTHER THAN REPR~ENTATIVE / / 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)i
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
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax 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 paren
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 a~
individual who has at least one parent in common with the decedent, whether by blood or adoption.
:EV-1500 EX (6-00) ·
COMMONWEAl_IH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
I'-
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
OFFICIAL USE ONLY
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
-/¢¢- ,¢,¢¢/?
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
[~riginal Return
ited Estate
edent Died Testate (Attach copy of Will)
---]9. Litigation Proceeds Received
--']2. Supplemental Return
E~] 4a. Future Interest Compromise (date of death after 12-12-82)
E~7. Decedent Maintained a Living Trust (Attach copy of Trust)
'---]10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
] 3. Remainder Return (date of death prior to 12-13-82)
[~5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
-'--]11. Election to tax under Sec. 9113(A) (Attach Sch O)
NAME d ~ ~/~.,~" ,~'.T~ ~ [~z'/,,,,'~ FY~
TELEPHONE NUMBER
COMPLETE MAILING ADDRESS
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
E~] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properly (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13.
14.
OFFICIAL USE ONLY
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
Net Value Subject to Tax (Line 12 minus Line 13)
(6)
(12)
(13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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.
20.
x .o_ (15)
x .o_ (16)
x .12 (17)
x .15 (18)
(19)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 0O3946
WATTS JEANETTE R
6004 ROBERT DR
MECHANICSBURG, PA
17050
........ fold
ESTATE INFORMATION: SSN: 159-18-5849
FILE NUMBER: 2104-0295
DECEDENT NAME: BENDER VIOLA E
DATE OF PAYMENT: 05/18/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUM BERLAN D
DATE OF DEATH: 03/12/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $2,067.18
REMARKS:
TOTAL AMOUNT PAID:
$2,067.18
SEAL
CHECK#2110
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
DEPARTMENT OF REVENUE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD O03946
WATTS JEANETTE R
6004 ROBERT DR
MECHANICSBURG, PA
17050
fold
ESTATE INFORMATION: SSN: 159-18-5849
FILE NUMBER: 2104-0295
DECEDENT NAME: BENDER VIOLA E
DATE OF PAYMENT: 05/18/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 03/12/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $2,067.18
F~EMARKS:
TOTAL AMOUNT PAID:
$2,067.18
SEAL
CHECK# 2110
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003946
WATTS JEANETTE R
6004 ROBERT DR
MECHANICSBURG, PA
17050
........ fold
ESTATE INFORMATION: SSN: 159-18-5849
FILE NUMBER: 2104-0295
DECEDENT NAME: BENDER VIOLA E
DATE OF PAYMENT: 05/18/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 03/12/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $2,067.18
REMARKS:
TOTAL AMOUNT PAID:
$2,067.18
SEAL
CHECK# 2110
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
DEPARTMENT OF REVENUE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-O601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003946
WATTS JEANETTE R
6004 ROBERT DR
MECHANICSBURG, PA
17050
........ fold
ESTATE INFORMATION: SSN: 1 59-1 8-5849
FILE NUMBER: 2104-0295
DECEDENT NAME: BENDER VIOLA E
DATE OF PAYMENT: 05/18/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 03/12/2004
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $2,067.18
REMARKS:
TOTAL AMOUNT PAID:
92,067.18
SEAL
CHECK//2110
INITIALS: JA
RECEIVED BY'
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717)240-6345
Date: 07/01/2004
WATTS JEANETTE R
6004 ROBERT DR
MECHANICSBURG, PA 17050
RE: Estate of BENDER VIOLA E
File Number: 2004-00295
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) 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 ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 07/06/2004
Your prompt attention to this matter will be appreciated.
Thank You.
CC:
File
Counsel
Judge
Clerk of the Orphans' Court
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717)240-6345
Date: 07/01/2004
BENDER DORIS J
312 VIRGINIA RD
MECHANICSBURG, PA 17050
RE:
Estate of BENDER VIOLA E
File Number: 2004-00295
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) 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 ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 07/06/2004
Your prompt attention to this matter will be appreciated.
Thank You.
cc:
File
Counsel
Judge
GLENDA FARNER STRASBAUGH
Clerk of the Orphans' Court
Name of Decedent:
Date of Death:
Will No. o~ 1
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the .Orplaans' Court Rules was . ;~
served on or mailed to the following beneficiaries of the above-captioned estate on O~--~/,fi~-~
Name Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Signature
Telephone ~'l ?) ~ q 7'
Capacity: v/ Personal Representative
__Counsel for personal representative
~ERTIFICATION OF NOTICE UNDER RULE 5.6(a}
Name of Decedent: ~
Date of Death: _
Will No.
To the Register: . ~ '~- ~-:~' Interest} ~ required by Rule 5.6(a)~f,~¢ O.~h.~s~Co.~urt ~e,~/.~ ~
I ce~ ~at no~ce o~ t~ne~ · .... ~ .,~ ~_.;~.~a estate on ~ ~ ~ ~ ~ ~' /
served ~ or mailed to ~e following beneficences ot tne auo.~-~ag[~ ....... ~
~ me Ad.ess ~ ~
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except_
Date: _
Signature
Name
Telephone -- /
Capacity: A. Personal Representative
Counsel for personal representative
.%
BUREAU OF ZNDTVZDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. ZB0601
HARRISBURG, PA 1711B-060!
JEANETTE R WATTS
600q ROBERT DR
MECHANICSBURG
PA 17050
COHHONWEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
REV-15q7 EX AFP
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACH
07-05-200q
BENDER
O$-IZ-ZOOq
21 0q-0295
CUHBERLAND
101
Amoun~ Reeit~od
VIOLA E
HAKE CHECK PAYABLE AND REHZT PAYHENT TO.'
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF /NHERZTANCE TAX APPRAZSEHENT, ALLOWANCE OR
DZSALLOWANCE OF DEDUCT/ONS AND ASSESSHENT OF TAX
ESTATE OF BENDER VIOLA E FILE NO. 21 0q-0295 ACH 101 DATE 07-05-200q
TAX RETURN NAS.' (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Roe1Estato (Schedule A) (1)
2. Stocks and Bonds {Schedule B)
$. Closely Hold Stock/Partnership Interest (Schedule C) ($)
q. Nortgegos/Notas Receivable (Schedule D)
$. Cash/Bank Daposits/Hisc. Personal Property (Schedule E) (S)
6. Jointly Owned Propar~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEHPTZONS:
9. Funeral Exponses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10)
11. Total Deductions
12. Net Value of Tax Return
15.
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J)
Na~ Value of Estate Subject to Tax
56;Z75.SZ
.00
.00 NOTE: To insure proper
.00 credit ~o your account,
.00 subm1~ the upper portion
.00 of ~his form wi~h your
tax payment.
.0O
(8)
7,907.50
15.18
NOTE:
56,Z75.8Z
(11) 7. O20. $8
(la) q8,$55, lq
(15) .00
(lq) q8,355, lq
If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 #ill
reflect figures that lnclude the total of ALL returns assessed to date.
(15) .00 x 00 = .00
(16) qB,355.1q x 0q5 = 2,175.98
(17) .00 X 1Z : .00
(18) .00 x 15 = .00
(19)= 2,175.98
ASSESSHENT OF TAX:
15. Amount of Line lq at Spousal rate
16. Amount of Line lq ~axablo at Lineal/Class A rata
17. Amount of Line lq at Sibling rata
lB. Amount of Line lq taxable mt Collateral/Class B rata
19. Principal Tax Due
TAX CREDZTS:
PAYMENT
DATE NUMBER ZNTEREST/PEN PAID (-)
PAYMENT MUST BE MADE BY 1Z-1Z-200q~.
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
AMOUNT PAID
TOTAL TAX CREDZT I .00
BALANCE OF TAX DUEI 2,175.98
INTEREST AND PEN. I .00
TOTAL DUE ] Z,175.98
( TF TOTAL DUE TS LESS THAN $1, NO PAYMENT TS REQUTRED.
IF TOTAL DUE TS REFLECTED AS A 'CREDIT' (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE STDE OF THIS FORM FOR /NSTRUCTTONS.)
RESERVATION:
PURPOSE OF
NOT[CE=
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY=
INTEREST:
Estates of decedents dying on or before December 1Z, 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 any estate for
life or for years, tho Commonwealth hereby expressly reserves tho right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
To ~ulfill the requirements of Section 21q0 of the Inheritance and Estate Tax Act, Act 25 of 2000. (TI P.S.
Section 9140).
Oetach the top portion of this Notice end submit with your payment to the Register of Nills printed on the reverse side.
--Make check or money order payable to: REGISTER OF HILLS, AGENT
A refund of a tax credit, ahich ems not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-l[1[). Applications are available at the Office
of the Register of Hills, any of the Z[ Revenue Oistrict Offices, or by calling the special Z4-hour
answering service for forms ordering: 1-800-36Z-Z050; services for taxpayers aith special hearing and / or
speaking needs: 1-800-447-30Z0 (TT only).
Any party in interest not satisfied with the appraisement, alloeance, or disalloeanca of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--aritten protest to the PA Department of Revenue, Board of Appeals, Dept. 2810Z1, Harrisburg, PA 17128-1021, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in eriting to: PA Department of Revenuaj
Bureau of Individual Taxasj ATTN: Post Assessment Review Unit, Dept. lB0601, Harrisburg, PA 17128-0601
Phone (717) 787-6S05. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
Zf any tax due is paid eithin three (3) calendar months after the dscedent's death, a five percent (SI) discount of
the tax paid is aZZowad.
The 15Z 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 af
six (6Z) percent per annum calculated at a daily rate of .000164. At! taxes which became delinquent on and after
January 1, 198Z will bear interest at a rate which will vary from calendar year ta calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 ara:
Interest Daily Interest Daily Interest
Year Rate Factor Year Rate Factor
1982 ZOZ .000548 ~'~r8-1991 11z .000301
1983 16Z .O00~3B 1992 9Z .000247
1984 Ill .000301 1993-1994 7Z .OOOX9Z
1985 lSZ .000356 1995-1998 9Z .000Z47
1986 lOX .000Z74 1999 7Z .00019Z
1987 IOZ .000Z74 ZOO0 7Z .00019Z
--Interest is calculated as follows:
INTEREST = BALANCE OF TAX UNPAID
Daily
Year Rate Factor
~ 9Z .000247
ZOOZ 6Z .000164
ZOO5 5Z .000137
2004 4Z .000110
X NUNBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent ail1 reflect an interest calculation to fifteen (1S) 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.
BUREAU OF ZNDZVZDUAL TAXES
TNHERZTANCE TAX DZVTS]'ON
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
JEANETTE R NATTS
6004 ROBERT DR
HECHANICSBURG
PA 17050
COHHONNEALTH OF PENNSYLVANTA
DEPARTHENT OF REVENUE
ZNHERZTANCE TAX
STATEHENT OF ACCOUNT
DATE 07-1Z-ZOO4
ESTATE OF BENDER
DATE OF DEATH 05-1Z-2004
FILE NUHBER 21 04-0295
COUNTY CUNBERLAND
ACN 101
I Amoun~ Remi~ed
REV-1607 EX AFP (01-OS)
VIOLA E
HAKE CHECK PAYABLE AND RENIT PAYNENT TO:
REGISTER OF NILLS
CUHBERLAND CO COURT HOUSE
CARLISLE, PA 1701:5
NOTE: To insure proper credi~ ~o your account, submit: ~he upper por~ion of ~:his form frith your ~ex payment.
CUT ALONG THIS LINE ~'* RETAIN LONER PORTION FOR YOUR RECORDS
REV-1607 EX AFP (01-03) ~#~ ZNHERZTANCE TAX STATEHENT OF ACCOUNT
ESTATE OF BENDER VIOLA E F'rLE NO. 21 04-0Z95 ACN 101 DATE 07-12-2004
THIS STATEHENT ZS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN ZN THE NAHED ESTATE. SHO#N BELON
ZSA SUHHARY OF THE PRZNCTPAL TAX DUE, APPLZCATZON OF ALL PAYHENTS,, THE CURRENT BALANCE, AND, ZF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSHENT OR RECORD ADJUSTHENT: 07-05-2004
PRINCIPAL TAX DUE: ...........................................................................................................................................................................................................................
PAYNENTS (TAX CREDITS):
2,175.98
PAYHENT RECEZPT DISCOUNT (+)
DATE NUHBER INTEREST/PEN PAID (-) AHOUNT ~
05-18-2004 CD005946 108.80
ZF PAID AFTER THIS DATE, SEE REVERSE
SZDE FOR CALCULATION DF ADDITIONAL INTEREST.
( ZF TOTAL DUE ZS LESS THAN
NO PAYNENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDZT" (CR)j
TOTAL TAX CREDIT 2,175.98
BALANCE OF TAX DUE .00
ZNTEREST AND PEN. .00
TOTAL DUE .00
YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR ZNSTRUCTZONS. )
Name of Decedent:
Date of Death:
Will No.
CERTIFICATION OF NOTICE UNDER RULE 5,6(a)
~/~' ~)} & O q "'"t~?ll~ddmin. No.
To the Register:
I certify that notice of (beneficial interest) 'nj tr ti required by Rule 5.6(a)_of ~e Orphans' Court Rules wan
served on or mailed to the following beneficiaries Of the above-ca tioned estate on t~.~ ~-'~ ~ ~- ,~ ·
Name Address
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Signature
Address3/~ ]4 4 ~.//~//tt~ )
Telephone (~]~ ~ '"'~ ~'9 ..n
Capacity: '~ Personal Representative
Counsel for personal representative
JRD/June 30,1992/17858 SIP 0 1 2004
In Re: Estate of Viola E Bender
Late of North Middleton Township
Estate No.: 21-04-295
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21-2004-295
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: Jeanette R Watts and Doris J Bender
Counsel for Personal Representative:
Date of Grant of Original Letters: 03-26-2004
Date of Delinquency Notice: 07-06-2004
The undersigned, Glenda Famer-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 July 6,
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 o£ 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 c~ounsel for the delinquent personal
representative.
Date: 09-01-2004
Glenda Famer Strasbaugh
Clerk of the Orphans' Court
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
A hearing is scheduled for at in Courtroom No. 3. I£the Certification of Notice is
filed prior to the hearing date, the hearing will automatically be caj~llg~t./1
George ~. }/~r, i~.J.
JRD/June 30, 1992/17858
S£P 01 2004~-/
In Re: Estate of Viola E Bender
Late of North Middleton Township
Estate No.: 21-04-295
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21-2004-295
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: Jeanette R Watts and Doris J Bender
Counsel for Personal Representative:
Date of Grant of Original Letters: 03-26-2004
Date of Delinquency Notice: 07-06-2004
The undersigned, Glenda Famer-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 July 6,
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.
Date: 09-01-2004
Glenda Famer Strasbaugh
Clerk of the Orphans' Court
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
~ i~kt~ooh~t q:3o hlq
A hearing is scheduled for at in Courtroom No. 3. If the Certification of Notice is
filed prior to the hearing date, the hearing will automatically be cancelled.
Georg~E~fe~e~. ~l }
Cumberland County - Register Of
One Courthouse Square
0~~l~~lQ DA !~nl~
'-O~..!......l......l...;:=>.J...'-1 .;..~ -"-lV-l--'
T,.,~ ., , _
VV J.. J.. J.. '"
Phone: (717) 240-6345
Date: 2/02/2006
WATTS JEANETTE R
6004 ROBERT DR
MECHANICSBURG, PA 17050
RE: Estate of BENDER VIOLA E
File Number: 2004-00295
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:
3/12/2006
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
j13~_~._(~MJ~~.... .. ...
,
/
GLENDA FARNER STR~SBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
Cumberland County - Register Of Hills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 2/02/2006
BENDER DORIS J
312 VIRGINIA RD
MECHANICSBURG, PA 17050
RE: Estate of BENDER VIOLA E
File Number: 2004-00295
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.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:
3/12/2006
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
L~d1'Aj.~ ,L#~.,_.d..'
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GLENDA FARNER STP~,SBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
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Estate No.:
STATUS REPORT lJl\JuER RULE 6.12
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Name of Decedent:
Date of Death:
.
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 wh9her administration of the estate is complete:
Yes lia' No 0
2, Tfthe answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. If the ansv'er to No. 1 is Yes, state the following:
a. Did the person~resentative file a fmal accooot with the Court?
Yes 0 No~
b. The separate Orphans' Court No. (ifany) for the personal representative's
account is:
c. Did t.l}e personal represent~7 state fu"1 ac~urt informally to the parties in C 'VO'
interest? Yes 0 No 1.6' f.3 e ~ 't Te, c..\"' . f'" 0..., e .... ke 0 ~~ ~ j)l
o of ,,\-~fi -e,siC\. le
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 to this report. ~ C)
Date~ '1 1 en/, ~~tJ~
Signature
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Capacity: 0 Pei.~SGllal P...epresenta:ti"ve
r n_,f r": f ! n 0 C.ollDsel fOT persoTial represerltative
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