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HomeMy WebLinkAbout04-0307 PETITION FOR pROBATE and GRANT OF LETTERS F~tat~ of BARBARA FORNEY NO. aim known ~s To: ' . .... Register of Wills for the County of Cumberland , Deceased. Commonwealth of Pennsylvania Social Security No. 168-36-3171 The petition of the undersigned respectfully represents that: Your petitioner(s) is/are 18 years of age or older and executor named in the last will of the above decedent, dated March 2~, 2003 X~ and codicil(s) dated NA Decedent was dominciled at death in C6mberlan&Co.., Pennsylvania, with h er last family or .principal residence at 120 Creek Road, Newville (Lower Mifflin Township) PA 17241 (list street, number and municipality) Decedenti then 59 years of age, died 3anuar¥ 7, 2004 ~ , at The Manor Care Nursing' Home~ Walnut Bottom Road~ Carlisle~ PA 17013 Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ 1.500.00 (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitifner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and'. the' grant 'of letters TESTAMENTA-RY ' .... thereon. (Testimentary, Administrator, C.T.A., Administration, d.b.n.c.t.a.) ~ WrLLIAM L. FORNEY ~ · OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I SS COUNTY OF CU~BZRLA~ The petitioner(s) above named swear(s) or affirm(s) that the statements in the foregoing petition ar~e true and correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s), of truly ~minister the estate accordS§ to law. the above decedel~t petitioner(s)will well and ~__._,~. _ ~~ ~_ Sworn to or affirmed ~d su~ ~,~I~LI~ L. FOrE ' scribed ~fore mc this ~day of ~> ~ . ~, For the Reg~ter .... DEC~E OR PROBATE AND G~NT OF LE~ERS AND NOW, ~'~Ck,x'-c'-~Z~- ?')0 o-~ OOq ~ , in consideration ~ of th~ p~tition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s), dated dcscrib~ therein b~itted to probate and filed of record ~ the last will of ~ Reg~ter of Wii~C~ ~ This ~s to cerufy that the ~nformauon here given Is correctly copied from an original cernficate of death duly filed w~th me as Local Registrar The original cernficate will be forwarded to the State Vital Records Office for permanent fihng WARNING: It ~s illegal to duplicate th~s copy by photostat or photograph. No Date ZI --oq 3o-1 ~I0S ~3~ Z~? COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH (~ , Barbara B Forney ,Female ~ 168 --36 --3171 ~anuary 7, ~004 59 ~ I, o~ i 4/9/1944 Newport PA ~--0 E~O ~ ~ ~ ~ ~t ~Cumborland South Mldleton Manor Care ~'~" '~hite PA ~0 ~ O,,,1/10/2004 Newvllle Cemetery Newvllle PA 17241 LAST WILL AND TESTAMENT OF BARBARA FORNEY I, BARBARA FORNEY, domiciled and resident at 120 Creekvtew Road, Township of Lower Mifflin, County of Cumberland, Newville, Commonwealth of Pennsylvania, declare that this document is my W~I1 and revoke all my previous Wills and Codicils I IDENTIFICATIONS AND DEFiNITIONS I am single I have one (1) child, WILLIAM L FORNEY, he is referred to ~n the W~II as "my son" II PAYMENT OF EXPENSES, DEBTS, AND TAXES I direct my Executor to pay medical, funeral, and admimstrat~ve expenses and all taxes payable by reason of my death, before any division of my estate My Executor shall not attempt to have any part of such taxes apportioned among the recipients of property includible in determining the amount of such tfixes Proceeds on insurance on my hfe up to the maximum allowable as an exemption from Pennsylvania Inheritance Tax and distributions from pension and profit shanng plans exempt from federal estate tax, all of which are payable to my Trustee or any beneficmry (other than my estate), shall not be used to pay debts, taxes, expenses of administration or other charges against my estates III CHILD SURVIViNG I d~spose of my property as follows Taaglble Personal Property. I give my tangible personal property to my son Residue I g~ve all other property which I own or over which I have a testamentary power of appointment, to and for the benefit of my son IV FIDUCIARIES Executor I nominate and appmnt my son, WILLIAM L FORNEY, as Executor of this Will to serve w~thout bond In testimony of which I now s~gn tNs Will, ~n the presence of w~tnesses whose names will appear below, and request that they w~tness my s~gnature and attest to the execution of tins Will, this 24th day of March, 2003 at 1237 ~.o![y P~ke, Carhsle, Cumberland County, Pennsylvanta · BARBARA FORNEY, ~n our presence, s~gned~ tNshnstmm, ent-: ;- Before., . she s)gne, d ~t, sh.el ~. ~' declared to us that ~t was her Wall and requested that~we act as'w~tnesses to tts execution" ' We believe her to be of sound mind, possessing testamentary capamty, an.d n. ot subject to undue ~nfluence, fraud, or coermon We now, ~n her presence, and ~n the presence of each other, s~gn below as w~tnesses, all on th~s 24th day.of March, 2003 at 1237 Holly P~ke, le, Cumberland County, Pennsylvania ' ~ x ~ ~q., ,x , ~ s~&ng at 1237 Holly P~ke, C~l,]sle, P.A.,.170.13 ·. ..-., res~&ng at 29B R. oyal American Clr,~Carhsle, PA 17013 COMMONWEALTH OF PENNSYLVANIA ss ,COUNTY OF CUMBERLA .ND We, Joseph D Buckley and Mary Z Ffl~bem, the w~tnesses whose names are s~gned to the foregmng instrument, bmng duly quahfied according to law, do depose and say that we were present and saw Testator sign and execute the ~nstmment as his/her Last Wall that he signed wflhngly and for the purposes thermn expressed, that each of us the heanng and s~ght of the Testator s~gned the Wall as w~tnesses; and that to the best of our knowledge the Testator was at that nme mghteen (18) or more years of age, of sound m~nd, and under no constrmnt or undue ~nfluence Sworn or affirmed to and subscribed to before me by Joseph D Buckley and Mary Z Ffl~bert~, wanesses, tins 24th day of Marc~ 2003 N°tary~/Pubhc / | KAREN KAY BUCKLEY, Nota~ Public ISouth M~ddletown REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA In re Estate of BARBARA FORNEY, Late of Cumberland County No: 2004-00307 PA No. 21-04-0307 CERTIFICATION OF NOTICE UNDER RULE 5.6{a) TO THE REGISTER OF WILLS: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on the following beneficiary of the above captioned estate on March 29, 2004: Name Address William L. Fomey 1302 Cleveland Avenue, Mt. Vernon, WA 98273 Notice has now been given to all persons entitled thereto under Rule 5.6(a). May 25, 2004 ~ ~1 ~s37 hH~i~ikkje y, Esquire Carlisle, PA 17013 (717) 249-2448 Counsel for the Estate of Barbara Fomey PENNSYLVANIA RECEIVED FI )M: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004 63 BUCK :Y JOSEPH D 1237 OLLY PIKE CARLI LE, PA 17013 ACN ASSESSMENT AMOUNt CONTROL NUMBER i 101 $872.0( ESTATE Ih ORMATION: SSN: 16836317~ FILE NUMI R: 2104 0307 DECEDEN' ',lAME: FORNEY BARBARA ~ DATE OF YMENT: 11/23/2004 I POSTMAR )ATE: 11/23/2004 I I COUNTY: CUM BERLAN D DATE OF I ~ATH: 01/07/2004 TOTAL AMOUNT PAID: $872.0I REMARK J BUCKLEY ESQ :CK#4103 INITIALS: VZ SEAL RECEIVED BY: GLENDA FARNER STRASBAU( H REGISTER OF WILLS REGISTER OF WILLS OO 'MON 'EALTHOF REV' 1500 ~'~ ~ ,~,,.'~¢ ~..¢~. PENNSYLVANIA ,~.~*~"1~2~ DEPARTMENT OF REVENUE .~/~!~"~,~. "~ DEPT280601 INHERITANCE TAX RETURN ~HARRISBURG. PA17128-0601 RESIDENT DECEDENT 2 i 0 4 0 3 0 7 30'.NTY CODE YEAR NJI/BER ~ DECEDENTS NAME (LAST FIRST ANB MIDDLE INITIAL) SOC!AL SECURITY NUMBER Z Eorney~ Barbara B. 168 36 3171 LB DATE OF DEATH (MM DD-YEAR) I DATE OF BIRTH (MM-DB-YEAR) t'~ J THIS RETURN MUST BE F~LED IN DUPLICATE WITH THE LB 01/07/2004 04/09/19A4 O I REGISTER OF WILLS LB (rF APPLICABLE) SURVIVING SPOUSES NAME (LAST FIRST. AND '~PDDLE INITIAL) SOCIAL SECURITY NUMBER ~_o~ ~ ~ ~ 5. Federal Estate Tax Return Required o~.m [] 6 Decedent Died Testate Atta;hc)p ti. , 8 TotalNumberof Safe Deposit Boxes <: [] 9 Litigation Proceeds Received .~ 11 Election to tax under Sec 9113(A) ~A~ta,:* sob o. z~- THiS SECTION MU$~ BE C~MPI,.ETED. ALL. coRREsPONDENCE AND CONF!DENTiAL TAX iNFORMATiON sHoULD BE DIRECTED TO: m NAME COMPLETE MAILING ADDRESS z Joseph D. Buckley~ Esquire O u~m~- FIRM NAME/IfApplicable~ ' I 1237 Holl Pik Law Offlce~ of Joseph D. Bucklev / y e ~ TELEPHONE NUMBER ' - ! Carlisle, PA 17013 o o (717) 2~9-2448 1 Real Estate (Schedule A) (1) 2 Stocks and Bonds (Schedule B) (2) 3 Closely Held Corporation, Padnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5 Cash, Bank Deposits & Miscellaneous Personal Property (5) 2,08 1. O0 ~ (Schedule E) ~ 6 Jointly Owned Properly (Schedule F) (6) [~ Separate Billing Requested -J 32,000.00 i "'~ 7 Inter-Vivos Transfers & Miscellaneous Non-Probate Proper~y (7) I"'- (Schedule G or L) D,.. ~ 8 Total Gross Assets (total Lines 1-7) (8) 34,081. O0 LB 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 11,679. O0 10 DePts of Deceden. Mortgage Liabilities. & Liens (Schedule i) (10) 3 ~ 04 1. O0 11. Total Deductions (total Lines 9 & 10) (11) 14 ~ 710. O0 12 Net Value of Estate (Line 8 minus Line 11) (12) 19,371. O0 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) -- 19,371.00 14 Net Value Subject to Tax (Line 12 minus Line 13) (14) 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)(12) x 0 (15) ~ 16 Amount of Line 14 taxable at lineal rate ]9,371.00 x 045 (16) 872.00 I~. 17 Amount of Line 14 taxable at sibling rate x 12 !17) O (,,) 18 Amount of Line 14 taxable at collateral rate x .15 (18) X 19 Tax Due ~ <19) > > BE SURE TO ANSWER ALL. QUESTIONS ON REVERSE SiDE AND RECHECK MATH < < Decedent's Complete Address: STREET ADDRESS 120 Creekview Road CITY NewvJ lie ISTATE PA I ZiP 1 701o Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments (1) 872. O0 A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable Total Credits (A + B + C ) (2) -O- 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. ~f Line 1 + Line 3 is grea~er than Line 2, enter the difference, This is the TAX DUE. (5) $ 72,00 A. Enter the interest on the tax due. (5A) 8. 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 BLO6KS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; E~ [] b. retain the right to designate who shall use the property transferred or its income; E~] c. retain a reversionary interest; or [] [] d. receive the promise for life of either payments, benefits or care? ............................ [~ [] 2. if death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequa e cons dera on? 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ........ [] [] 4 Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a benefic ary designation? E~] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Declaration of prepa, rer other than the personal representative is based on a n o ma[cfi of which preparer has any knowledge Y3N~// Cleve]audmAvenue ,~OUl]t Vernon T,TA 98273 ...84G. NATURE O'¢'-"I~p.~RE,R OTH~ ~A~I RFS:~RES~N+ATI~E For dates of death on or after July 1, 1994 and be[ora January 1. 1995, the [ax 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) 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 PS §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 stirl applicable even if 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 8t death to or for the use of ana u 8 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 benef c a es ~s 45vo,~ except as noted in 72 P.S §9 16(2) [72 PS §9116(a)(1)] The tax rate imposed on the net value of transfers to or for the use of the decedents 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 '~'"~~ ,,~o. SCHEDULE E BANK & MISC. COMMONWEALTH OF PENNSYLVANIA ~.,~on, ~- rvoHo, iNHERITANCE T~ RETURN ~S,~.T ~O~.T PERSONAL PROPERTY ESTATE OF FILE NUMBER 5arba~e ~. ~o=ue~ 21-04-0307 Include the proceeds 0f litigation and Be date the proceeds were received by the estate All prope~ jointly-owned with the right of su~ivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1 BSgCD checkl~g account 1~581.08 2. I987 ~oyota Sedan, poo~ co~ditio~ ~00.00 TOTAL (Also enter on line 5, Recapitulation) $ 2.081,00 (if more space is needed, insert additional sheets of the same size) REV 1510 EX+ (2 87I ~o~,~o~,~,~T~ o~ ~,N~'~'~,~,~ TRANSFERS INHERITANCE TAX RETURN ~S~O~T DEC~O~T PLEASE PRINT OR TYPE ~s~z~ o~ ~[~ ~u~ ~e~be~ ~. ~o~ne~ 2~-0~-00]07 m~s sc.~u~ ~us~ ~ c°~ ~.~ ~ ~ m~ *.sw~, ~o *"~ o~ m~ au~s~0"s o~ m~ .~.~ ~ o~"~ co?~, s,~ ~v~s. I ~sc,~,~o, o~ ,~o~ ~o~ w~u~ ~c~. ~O~A, w~u~ NUMBERI Include name of fhe transferee, ~heir relationship to decedent, da~e of transfer EXCLUSION % OF DECEDENT'S OF ASSET INT INTEREST ~. ~ZZL~ ~. Po~ney, so~ ]2,000.00 ~00[~ ]2,000.00 TOTAL (Also enter on Jine 7, Recapitulation) S 32 ~ 000.00 (If more space ~s needed, insert additional sheets of same s~ze ) INSTALLMENT AGREEMENT OF SALE THIS AGREEMENT of sale is entered into this 2t:/r~day of March, 2004, by and betwccn William L., Forney ,_o~1302 Cleveland Ave., Mount Vernon, WA 98273 hereinafter called "Seller ', and ~.~ ~:e Weft of .~/t~ /~9'~,,12~,~ ~,~41J ~,?d~/~_/~ _//~ / ~ 2~)' Newville, PA 17241, hereinafter cad/lcd "Purchaser . IT 1S MUTUALLY AGREED AS FOLLOWS: 1. The Scller agrees to sell, grant and convey to the Purchaser, and the purchaser agrees to purchase and accept the conveyance of the real estate and improvements situate in Lower Mifflin Township, Cumberland County, Pennsylvania, more particularly bounded and described as part of thc prenfises recorded by Deed dated March 24, 2003 and recorded March 25, 2004, in the Office of the Recorder of'Deeds for Cumberland County in Deed Book 256, Page 1126, and ~own as 120 Creek Road, Newville, PA 17241. 2. Purchaser agrees to pay the sum of THIRTY- TWO THOUSAND AND 00/100 ($32,000.00) DOLLARS to the Seller as the full purchase price and consideration for said premises, payable as follows: a. $5,000.00 payable upon the signing of the contract; b. $5,000.00 payable on or before August 1, 2004; c. The balance of $22,000.00 shall be payable in annual installments of $5,500.00 first payment due on or before April 1, 2005 and each April 1~t thereafter until paid in full. d. Purchaser shall have the right fully satisfy this agreement ifa payment in the amount of $20,000.00 is made to Seller on or before the first day of January 2005. 3. Final settlement of this transaction shall be made in Carlisle, Pennsylvania, at The Law Offices of Joseph D. Buckley, or at a mutually agreeable location for the parties, and shall be made on or before April 1, 2008, at which time shall be of the essence, at which time of settlement the Seller shall tender to the Purchaser a properly drawn and executed deed of special warranty, conveying to thc Purchaser a good and marketable title in fee simple, free and clear o fall liens, tenancies and encumbrances, except easements or building and usc restrictions visible on the ground or of prior record. 3. All current and future real estate taxes shall bc the responsibility of Purchaser including the county and township taxes for 2004. Seller shall upon receipt of tax bills forward the same to Purchaser who shall pay the same within thirty days of receipt. 4. Pennsylvania Realty Transfer Tax and any other sale or transfer taxes to be paid equally by Seller and Purchaser at the final settlement. 5. The Seller assumes the risk of loss by fire or other casualty until transfer of title and agrees that the property shall remain in substantially its present condition until date of settlement, reasonable wear and tear excepted, and if it is not, the Purchaser may rescind this contract. Upon settlement Purchaser shall provide insurance listing Seller as loss payee in an amount of at least $15,000.00 lbr fire and casaulty and 100,00 for personal injury m~d property damage. 6. Should the Purchaser fail to make settlement as herein provided, the mnount paid down as hand money, to wit: $5,000.00, may be retained by the Seller as liquidated damages. Should the Seller fail or refuse to convey as hereinafter provided in addition to any other remcdics at law or in equity, the Purchaser may require the return of the hand money paid and reasonable title examination expeuses incurred by the Purchaser. 7. Seller is accepting the propert',' and any improvement AS IS- WHERE IS~ and Seller makes no representations as to the conditious of any improvements and only warrants that at final settlement he shall transfer title to the property free and clear of any liens and encumbrances. 7a. Purchaser shall be responsible for all repairs, maintanence and upkeep on the property. Should Purchaser default on this agreemenh he agrees that any moneys paid to Seller may be retained as liquidated damages and/or as reasonable rent on the property. Purchaser further agrees that upon default he will remove himself amicably from the property and if Seller is forced to bring action to remove Seller~ his heirs or agents~ Purchaser shall reimburse all legal expenses incurred by Seller. 8. Tis agreement may not be assigned by Purchaser without the prior written consent of Seller, which consent shall not be unreasonably withheld. 9. This agreement shall not be recorded except upon default of either party. 10. For the performance of the Agreement and intending to be legally bound hereby, the parties bind themselves, their heirs, personal representatives, successors and assigns, as witness their hands and seals the day and ycar first written above. WITN'~SS: . ~ SELLER WITNESS: PURCHASER COMMONWEALTH Or PENNSYLV^N ^ SS COUNTY OF CUMBERLAND On this the ~ day of ~ , 2004, before me, a Notary Public in and for the County of Cumberland, Commonwealth of Pem~sylvania, personally appeared WILLIAM L. FORNEY and DWAYNE WERT, known to me, or satisfactorily proven to be the persons whose names are subscribed to the above deed, and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ',I3~RLAND COUNTY ~ TH~ 24~ day o~cb in the yc~ oEO~ ~ord ~wo thous~d [~ee (2003). BETWEEN B~ FO~EY, single womb, of Lower Mifflin Township, C~berl~d Co~ty, Pe~sylv~ia, hereina~er called G~TOR ~D WILLIAM L. FORNEY, of Mount Vernon, Washington, hereinafter called GRANTEE, WITNESSETH, that in consideration of ONE AND 00/100 ($1.00) DOLLAR, and the love and affection a mother has for her son, in hand paid, the receipt whereof is hereby acknowledged, the said Grantor does hereby grant and convey unto the said Grantee, his heirs and assigns, as tenants by the entireties, ALL THAT CERTAIN tract or parcel of land situate in the Township of Lower Mifflin, County of Cumberland and Commonwealth of Pennsylvania, more particularly bounded and described as follows, BEGiNNING at a point, a property corner common to the lands now or formerly of Norman R. Hoover and Ethel A. Hoover, land of the Pennsylvania Turnpike Commission and the lands grantors, which point is South 40 degrees 58 minutes East, 114 feet, more or less, Rom Pennsylvania Turnpike center line Station 530 plus 55.38 feet; thence by the Southerly right-of-way line of the Pennsylvania Turnpike by a line parallel to and 100 feet distant from the center line of the Pennsylvania Turnpike, North 77 degrees 43 minutes East, a distance of 933.5 feet to a point at corner of land now or formerly of Dean W. Forney; thence by said land now or formerly of Dean W. Forney, in a Southerly direction, a distance of 225 feet, more or less, to a point on the Northerly bank of the Conodoguinet Creek; thence along the Northerly bank of the Conodoguinet Creek, South 85 degrees 47 minutes West, a distance of 39.3 feet to a point; thence still by same, South 62 degrees West, 363 feet, more or less, to a point; thence still by same, South 53 degrees West, 973.5 feet, more or less, to a point in the line of lands now or formerly of Norn~an R. Hoover and wife; thence by same, North 22 degrees 58 minutes West, 627 feet, more or less, to a point; thence still by same, North 62 degrees 52 minutes East, 478.5 feet, more or less, to a point; thence still by same, North 40 degrees 58 minutes West, 43 feet, more or less, to a point the place of BEGINNING.  SCHEDULE H FUNERAL EXPENSES, CO~O~WE~<T~ O~ ~N~S~V^~IA ADMINISTRATIVE COSTS AND ~NHERITANCE TAX RETURN MISCELLANEOUS EXPENSES RESJDENT DECEDENT Please Print or Type ESTATE OF FILE NUMBER Barbara B. Forney 21-04-0307 ITEM NUMBER DESCRIPTION AMOUNT A. Funeral Expenses: 1. Egger Funeral Home 6,993.00 B. Administrative Costs: 1. Personal Representative Commissions Social Security Number of Personal Representative: Year Commissions paid 2. Attorney Fees Joseph D. Buckley, Esquire 3,500.00 3. Family Exemption Claimant Relationship Address of Claimant at decedent's death Street Address City State Zip Code 4. Probate Fees 6/4.00 C. Miscellaneous Expenses: 1. Advertising Estate 212.00 9. Travel Expense 275.00 3. Storage charge - Lehmans 509.00 4. Expert Tire (battery for automobile) 76.00 5. Postage, overnight mail and telephone charges 50.00 6. 7. 8. TOTAL (Also enter on line 9, Recapitulation) 11,679.00 (If more space is needed, insert additional sheets of same size.) ~ SCHEDULE I I us~,~.~, I. P~ 2, o~.Y f~-~o~a c~,,~a,,~,<~ ~-~Lv~ DEBTS OF DECEDENT, ~ ~~"' ~s,~ MORTGAGE L~BILITIES~ & LIENS ~TATE ~ FI~ NUMBER Barbara ~. ~orney 21-04-00307 ~ 1 ~ ~ ~ ~, ~ ~ ~ ~ ~e P~ylv~ia r~ ~at w~e d~ ~ ~ng ~ ~ me ~ ~ ~rs ~ ~m~ ~ 2 ONLY ~ ~e pm~o~ ~ of ~ ~mpu~Uon b e~. P~ 1. Obli~a~o ts a~ainst P~ns~van~ ~ IT~ NUU~ DESk.ION ~ 1, TOTAL PART $ PART 2. NI ot~er debl3 of the decadent [TFJd NUMBER DE$CRJPTION AMOUNT 1. PSECU personal loans 2,760.77 2. Andora Radiology 380.00 TOTAL PART 2 $ 3,041.00 TOTAL (Nso e~' m ~ 10 $ (If mae space is needed, ~sen a(~d~tkm,~ shee[s of the same size) SCHEDULE J COMM©NWEALTH OF P~NN$¥LYANrA BENEFICIARIES ESTATE OF FILE NUMBER Barbara B. Forney 21-04-0307 ITEM AMOUNT OR NUMBER NAME AND ADDRESS OF BENEFICIARY RELATIONSHIP SHARE OF ESTATE A. Taxable Bequests: ~. William L. Forney 1302 Cleveland Avenue, Mt. Vernon, WA 98273 son 100% ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charitable and Governmental Bequests: 1. TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) $ (If more space is needed, insert additional sheets of same size) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL ~1tI;";-',:r"l rr:?!,C[ OF NOTICE OF INHERITANCE TAX INHERITANCE TAX DIVISION \"c.,-,v'-- --j ,... 1 APPRAISEMENT, ALLOWANCE OR DISALLOWANCE PO BOX 280601 " , , "OF DEDUCTIONS AND ASSESSMENT OF TAX HARRISBURG PA 17128-0601 7M5 J,\\\ 24 r.n 8: \ 9 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 01-Z5-Z005 FORNEY 01-07-Z004 Zl 04-0307 CUMBERLAND 101 AlIOunt Ralli t'ted rr'J Cr e! !f,:\ .. ,,-- G;'\~"':"':-"'C' ('(l',I'I'il ~O~E:~C~L:~~~~~~~~';"" . C'. lZ37 HOLLY PIKE CARLISLE PA 17013 *' IEV-1S~7 EX AFP n2-D4l BARBARA 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 ~ ~rv :r!l1;".iic..A~p..rll1":6'~".NiST'ici.iiF.'iNHlfti.i'AN.cl.TAx.'lipjlIiA'isiT<<'Ni;..AtliiwANi:'"I.o'R................- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX BARBARA FILE NO. Zl 04-0307 ACN 101 TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ESTATE OF FORNEY DATE 01-Z5-Z005 ATTACHED NOTICE If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ~ returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rat. (15) 16. Amount of Line 14 taxable at Lin..l/Class A rat. (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tex Due DIT : 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 OJ 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) (6) (6) (7) .00 .00 .00 .00 Z, 081. 00 .00 3Z.000.00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabllities/Liens (Schedule Il 11. Total Deductions 12. Net Value of Tax Return 13. Charltable/Governmental Bequests; Non.elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 11,679.00 3.041.00 (11) (12) (13) (14) NOTE: .00 X 19,361.00 X .00 X .00 X TA + AI10UIlT PAID 87Z.00 NUMBER CD004663 INTEREST/PEN PAID (-) .75- DATE 11-Z3-Z004 BALANCE OF UNPAID INTEREST/PENALTY AS OF ll-Z4-Z004 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE NOTE: To insure proper credit to your account, submit the upper portion of this for. with your tax pay.ent. 34,081. 00 14 7?D nn 19,361.00 .00 19,361. 00 00 = 045 = lZ = 15 = .00 871. Z5 .00 .00 871 . Z5 (19)= 871.25 .00 3.75 3.75 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUEL A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~~~ REV.1470E)O(&-88) '* INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG PA 17128-0601 DECEDENTS NAME FILE NUMBER Barbara B. Forney 2104-0307 REVIEWED BY ACN ANITA MCCULLY 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES The value of the estate has been adjusted as the result of the correction of an error in arithmetic. ROW Page 1 -- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 .;W'l;~~"", JNfIER;fT....E TAX APPRAI~EIlEN;\) AlllllfANct: 0" DISALLOWANCE DF DEiiIIiltt~'AND ~~~ESSNENT OF TAX JOSEPH D BUCKLEY ESQ J D BUCKLEY LAW OFCS 1237 HOLLY PIKE CARLISLE PA 17013 DATE 2DO~j JM! 25 ME!;I'FA'Ti OF DATE OF DEATH CIH:< ex' FILE NUMBER Or1CU'-,\1 " C'i"COl:lNTY '\:i i i :'-. 1 ,._,/, :'t \ r r', I'"'' -'/lCIt" u'.....'.' . 01-25-2005 FORNEY 01-07-2004 21 04-0307 CUMBERLAND 101 *' REV-l!!ii47 EIr 'FP tll~'4) BARBARA Anount H..Iltad .$ 3,75' MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE .. RETAIN LONER PORTION FOR YOUR RECORDS ... Rw:r!~"-!Y-A~i'--CIl1"--4'!"'NIIfY'~!-'l:I'l!-l'Nt1iriY'l'Allc!I!-1"A'"i-AWlRA-iA!Wil'~--A[l'liliAra-ijR------------- ---. DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX BARBARA FILE NO. 21 04-0307 ACN 101 ESTATE OF FORNEY TAX RETURN WAS: I ) ACCEPTED AS FILED I X) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. R..I Est.t. (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedul. C) 4. Hortg8uas/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule EJ 6. ~ointly Owned PropArty (Schedul. F) 7. Tr8nsfers (Sch.dule G) 8. Total Assets (1) (2) (3) (4) IS) (6) (7) .00 .00 .00 .00 2.081.00 .00 32.000.00 IB) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Ad.. CostslHisc. Expenses (Schedule H) lD. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Cheritable/Govern.ental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 11,679.00 3.041.00 Ill) (12) (13) (14) NOTE: I~ an assessment was issued previously, lines reflect ~igures that include the total of ALL ASSESSMENT OF TAX: IS. ~unt of Line 14 .t Spousel r.te (15) 16. A~t of Line 14 taxable at Line.l/Class A rat. (16) 17. Anount of Line 14 at Sibling rat. (17) 18. ~ount of Line 14 taxable .t Collateral/Class B rate (18) 19. Principal Tax Due SEE DATE 01-25-2005 ATTACHED NOTICE NOTE: To insure proper credit to your account, sub.I t the upper portion of this for. with your tax pay_nt. 34,081. 00 ]4.7:>0 DO 19,361.00 .00 19,361. 00 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = 19,361.00 X 045 = .00 x 12 = .00 X 15 = (19)= AHDUNT PAID 872 . 00 DATE 11-23-2004 IUlBER CD004663 INTEREST/PEN PAID 1-) .75- BALANCE OF UNPAID INTEREST/PENALTY AS OF 11-24-2004 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 871 . 25 .00 .00 871. 25 871. 25 .00 3.75 3.75 IF TOTAL DUE IS LESS THAN $1, NO PAYNENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU KAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) 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 BUCKLEY JOSEPH 0 1237 HOLLY PIKE CARLISLE, PA 17013 ______n fold EST A TE INFORMATION: SSN: 168-36-3171 FILE NUMBER: 2104-0307 DECEDENT NAME: FORNEY BARBARA DATE OF PAYMENT: 01/25/2005 POSTMARK DATE: 01/24/2005 COUNTY: CUMBERLAND DATE OF DEATH: 01/07/2004 NO. CD 004880 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $3.75 I I I I I I I I TOTAL AMOUNT PAID: $3.75 REMARKS: CHECK# 4113 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS GLENDA FARNER STRASBAUGH REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES(f/- INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REV-16Dl EX iFP 112-D41 r:"", ~.b DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 03-14-2005 FORNEY 01-07-2004 21 04-0307 CUMBERLAND 101 BARBARA JOSEPH D BUCKLEY ESQ J D BUCKLEY LAW OfCS 1237 HOLLY PIKE CARLISLE PA 17013 Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLEI PA 17013 NOTE: To insure proper credit to your account I submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ... IW:r&tI.,.!r.il!"..rllr:6!,......j(ji..'"tRMMIMer..,lr.~tlytAWf.b.,.ll:l:~OFN...ii................... ... ESTATE OF FORNEY BARBARA FILE NO.21 04-0307 ACN 101 DATE 03-14-2005 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUEl APPLICATION OF ALL PAYMENTS I THE CURRENT BALANCE I ANDI IF APPLICABLE I A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-25-2005 PRINCIPAL TAX DUE:. 871.25 PAYMENTS (TAX CREDITS): ~ PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 11-23-2004 CD004663 .75- 872.00 01-24-2005 CD004880 3.75- 3.75 TOTAL TAX CREDIT 871. 25 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATEI SEE REVERSE TOTAL DUE .00 II SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $11 NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRll YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l THE LAW OFFICES OF JOSEPH D. BUCKLEY 1237 HOLLY PIKE CARLISLE, PA 17013 TELEPHONE (717) 249-2448 FAX (717) 249-4103 December 7, 2005 Cumberland County Register of Wills One Courthouse Square Carlisle, P A 17013 Re: Estate of Barbara Forney File No. 2004-00307 To those concerned: Enclosed are an original and one copy of the Status Report Under Rule 6.12 for the above referenced decedent. Please time stamp the copy and return it to our office in the enclosed self-addressed, stamped envelope. Thank you and if you have any questions, please call my office. Very sincerely yours, JDB/clb Enclosures r.." " ./ c.) w -~ I l.,:; I - ; ~ --' :'~".., '-II ~ A~~ r.~f X'_\ ~~ ~ ~ Register ofV;Hls of CliiJ..lbedand Counry STATUS REPORT UNDER RULE 6.12 Name of Decedent: Barbara Forney Date of Death: Januarv 7. 2004 Estate No.: 2004-00307 . 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 whether administration of the estate is complete: Yes n No PD 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: March 6, 2005 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a fmal account with the Court? Yes 0 No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk t Orphans' Court and may be attached to this report. D t Decenber 7, 2005 a e: ~.. Joseph D. Buckley, Es~uire Name 1237 Holly Pike, Carlisle, FA 17013 Address -.- ,~) (717) 249-2448 Telephone No. \' '~J t ,.... . r\ I 1::, ,u Capacity: 0 Personal Representative Ii! Counsel for personal representative 'Jt Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 12/06/2005 BUCKLEY JOSEPH D 1237 HOLLY PIKE CARLISLE, PA 17013 RE: Estate of FORNEY BARBARA File Number: 2004-00307 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: 1/07/2006 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, J4 ('.tf) ~ ' y- ,. . ..~ ..Jt/'~ ~ !:. ,", - ~ CM~.f?... ,,-,,,7!lQ#!#AJ .,-. GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge ~1/ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 12/27/2006 BUCKLEY JOSEPH D 1237 HOLLY PIKE CARLISLE, PA 17013 RE: ESLate of FORNEY BARBARA File Number: 2004-00307 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. 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 lS due by: 1/07/2007 Please feel free to contact this offlce with any quesLions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, I I:J'\ j' -';p ;t;a;'<"~ /,. Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) \. r-r Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (71 7) 240 - 6345 Date: 12/27/2006 FORNEY WILLIAM L 1302 CLEVELAND AVE MOUNT VERNON, WA 98273 RE: Estate of FORNEY BARBARA File Number: 2004-00307 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. 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 lS due by: 1/07/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Cc- Pa. O.C.RuIe 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYL VANIA Name of Decedent: Barbara Forney Date of Death: January 7, 2004 File Number: 2004_00307 Pursuant to Pa. O.C Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . .. 0 Yes I]) No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: July 1, 2007 3. If the answer to No.1 is YES, state the following: a. Did the personal representa~fy'~Jile a final account with the Court? . . . . . .. 0 Yes 0 No b. ,The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ............................... 0 Yes 0 No d. Copies of receipts, releases, joinders and approvals of forrilal or informal accounts may be filed with the Clerk of the Orphans' Court and may b attached to this report. Personal Representative Kl Counsel Esquire Date }- 'L- "'Lo-o'7 1237 Holly j='ike Address Carlisle, PA 17013 (717) 249_2448 CE: :2/ lid '1- NVr LOOl Telephone ,,' , . F orzir ~ >>:::f} J r~t;' 1 ~ 13. 0, 6= "'j -,V' r ,',r, - "" '--I! I'-F"(' -, .... .......-J:....JGUv:~.:-J(/ J Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBE~LAND COUNTY, PENNSYLVANIA Name of Decedent: :t:e,rba.ra. Forney Date of Death: Ja.nuary 7? 2004 File Number: 20Q4~00-307 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . .. DYes E3I No 2. If the answer is No, state when the personal representative reasonably believes that the ammnistration will be complete: Pecembe:J;' 7? 2007 3. If the answer to No.1 is YES, state the following: a. Did the personal representative file a finat'account with the Court? . . . . ... DYes DNo b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ..............,.......,......... DYes ONo d. Copies of receipts, releases, joinders and approva of formal or informal accounts may be filed with the Clerk <?fthe Orphans' Court and m be attached to this report. OPersonal Representative i51J Counsel osepll b.. Bu.ckley? Ef?qui.;r:'e Name of Person Filing this Form Dale &,-1 ~ 0'7 1237 Holly. Pike Address Carlisle, FA . nl1:\3 I __ ,.,~I C.7171. 249-2448 . I! ! 1', '''l "'" ~ Telephone Form RW-IO rev. JO./3.06 <1<:f NOTICE: Please file this form with Register of Wills within two (2) years of decedent's death. STATUS REPORT UNDER RULE 6.12 Name of Decedent: Barbara Forney Date of Death: January 7, 2004 Will No. 2004-00307 Admin. No. Pursuant to Rule 6.12 ofthe Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes _ No X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: June 1, 2008 3. Ifthe answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ' Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Cou d may be attached this report. Date: J l~ vt/D 7 Joseph D. Buckley, Esquire Name (Please type or print) \70 ' , " 'i'.:f"''' I" - '-,~, ,IIJ ..LO" ;: V "n: [, \"/'J lua J .\,p.,j \);0 Ii \I! jl]r,:} J) \': I-l~~ .J\. /h:, U 1237 Holly Pike, Carlisle, PA 17013 Address tC :2/ Wd OS ADN LDGl ( 717 ) 249-2448 Telephone Number " ,~) Capacity: _ Personal Representative j'-''""'j , /:" "1~~ ,'",- J ~J~.r i f _,f 1\.'/ / Ii'," I V .J"':V U.JWU.jJC: ~ Counsel for Personal Representative G;i'"' Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Barbara Forney Date of Death: 01/07/2004 File Number: 2004-00307 Pursuant to Pa. O.c. Rule 6.12, I repOli the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration ofthe estate is complete: . . . . . . . . . . . . . . . . . . .. DYes ~ No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: November 20, 2008 3. If the answer to No.1 is YES, state the following: a. Did the personal representative file a final account with the Court? . . . . . .. DYes D No b. The separate Orphans' Comi No. (if any) for the personal representative's account is: c. Did the personal representative state an account i n forma 11 y to the parties in interest? ............................... 0 Yes 0 No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be ti led with the Clerk of the Orphans' Court and m be attached to this re n. Date. S;, -; f ,-00 Joseph D. Buckley, Esquire Name of Person Filing this Form VCi ,/.~(1 . .,," 1:'1''1''-'''.,'-' ,',. '-:'._.<~'-,,'~, /J J.''; I' I ' '"' '.fl II'/" '-'I ,".j ",1\'1 t-ddU -i n \i_~ T/',-;/ -../ /t....--.I-1 V 1237 Holly pike A ddres s Carlisle, PA 17013 ~~:I J../d ZZAVHeDGZ (717) 249-2448 Telephone Forlll RW-Io. rev Ia. 13,0.6 qj Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 12/09/2009 BUCKLEY JOSEPH D 1237 HOLLY PIKE CARLISLE, PA 17013 RE: Estate of FORNEY BARBARA File Number: 2004-00307 Dear Sir/Madam: N O Sl cO ~~ p -„ vT ~7 C:O -O C7 C7 C"i J ~ tD ~ 4 ~ c~,k T n0~ ~ U~ -_ :^~rn "~ t.;~ ~ a D O ~ This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 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: 1/07/2010 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ./~~2FiIL~C--L1LNYl~./ Glenda garner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 12/09/2009 FORNEY WILLIAM L 1302 CLEVELAND AVE MOUNT VERNON, WA 98273 RE: Estate of FORNEY BARBARA File Number: 2004-00307 Dear Sir/Madam: n o z0 `~° - _,~~ o r, ~,, ...a ' rn ~ T ' G CA>~ lD ~ fu' j.J ~~0~~ ~ a i; A n~ _ _ -`~i C ''% i=J W "' This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET N0. 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: 1/07/2010 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ,~~~%lel~,r~1~2~b Glenda Farner Strasbaugh a Clerk of the Orphans' Court cc: File Counsel ~a. ~.C'. ~ufe 6.1~ S'~'~~I15 ~P®RT REGISTER O WILLS OF CUMBERLAND COUZVTY, PENi~1S~'LV aNIA NanleOfDeCedellt: Rarhara Fnrna~ Date of Death: January 7, 2004 File Number: 2004-00 07 °ursuai,t to Pa. O.C. Rule 5.12, I report the follo~a~ino ~x,it, racn rt 1' nmp Lion of the administration of the above-captioned estate: "° ' 1 re o c____ le 1. State whether administration of the estate is complete:....... . ............ ~ Yes ~ No 2. If the answer'is No, state when the personal representative reasonably believes that the administration will be complete: June 21, 2010 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 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an accoutrt informally to the parties in interest? .......... Yes ~No d. Copies of receipts, releases, joinders and approvals o~ formal or informal accounts maybe filed with the Clerlc of the Orphans' Court and r y be attached to this report. Dnte_DP[~PmhPr 71 7 r--0-0 2-. ,nn ojPerso i Farm ~,_, ~ ~ Capacity: QPersonal Representative nse] `- ~ ...~ ~ `~' _ - N °- ~ Joseph D ~ B ,c•kl P ~ SC ~ ~ ~ 1_ ~ C ! C: c ~~ s-... ~.LI- F® Nmne ojPerson Filing this Form ~:. -- - ' cL ~ C-'~-~_-; 1237 Holly Pike _~ ~ ! w ~" ~'' Address i~t' ,.~ -:-, N V ,t~~~.: v~,_, Carlisle PA 17013 ;'i . -- o O~ (717) 249-2448 n+ Telephone hcrmRNC1U rn. /U.l3.06 Vv v