HomeMy WebLinkAbout04-0174Name of Decedent: Henry D. Attig
Date of Death: February 10, 2004
Will No. Admin. No. 21-04-0174
To the Register:
I certify that notice of beneficial interest required by Rule 5.6(a) of
the Orphans' Court Rules was served on or mailed to the following
beneficiaries of the above-captioned estate on April 12, 2004:
Name Address
Eunice Benoist, 10 Hartzdale Drive, Camp Hill, PA 17011
Notice has now been given to all persons entitled thereto under Rule 5.6 (a)
except None ~ ~
Date: April 12, 2004 ~~-~ /~ A ..,/~
Name
Addre s s
Richard C .~u~s qui~
355 N. 21 st St:, Suite 205
Camp Hill, PA 17011
Telephone (717) 761-3459
Capacity:
X
Personal Representative
Counsel for Personal
Representative
Estate of Henrv D. Attic
also known as -
PETITION FOR PROBATE and GRANT OF LETTERS
No. 7-1q
To:
,Deceased.
Social Security No. 193-24-1154
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older and the executor
in the last will of he above decedent, dated December 19
and codicils(s) dated
Register of Wills for the
County of Cumberland in the
Commonwealth of Pennsylvania
named
2003
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decedent was domiciled at death in Cumberland County, Pennsylvania,
with his last family or principal residence at
at
(list street, number and municipality)
Decedent, then 72 years of age, died February 10 ,20 04
Except as follows, decedent did not marry, was not divorced and did not have a child bom or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent: No exceptions
Decedent at death owned property with estimated vales as follows:
(If domiciled in Pa.) All personal property
(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: None
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters Testamentary
thereon. " .......' ..... ~-:~'~""~ :.t.a; ~-:~: .... *~ ....
d.b.n.c.t.a.)
EUNICE BENOIST
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ] ss
. The petitione[(s) ab?ye-named swear(s) or affirm(s) that the statements in the foregoing petition are
tree and correct to the i~est otthe knowledge and belief of petitioner(s) and that as personal representative(s)
of the above decedent petitioner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed
before me this ~-~/? 7-..~' day of
Estate of Henry_ D. Attig , Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW ~0Oa D-,C(~ 20OL/, 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 December 19, 2003
described therein be admitted to probate and filed of record as the last will of
Henry D. Attig
and Letters Testamentary
are hereby granted to Eunice Benoist
FEES
Probate, Letters, Etc ..........
Short Certificates (~) .........
TOT~
Filed ......... .~. ~..l~.q .................
- Registei 6fWills /]~'~Wije~(/.,bL, lSd~
355 N. 21st St., Ste. 205, Camp Hill, PA 17011
ADDRESS
717-761-3459
PHONE
OATH OF SUBSCRIBING WITNESS
codicil
(each) a subscribing witness to the will presented herewith, (each) being duly qualified according to
' - ,~,,.5, ,,~5+ ~q~,~ /~r-C_.. present and saw
law, depose(s) and say(s) that. ~-~, x t~
the testat ex% , sign the same and that ~r<dC n~ ~l ~ signed as a witness at the
request of testatC ~ in h cf presence and (in the presence of each other) (in the presence of the
other subscribing witness(es)).
Sworn to or affirmed and subscribed before
me this o?~ day of
~ (Name) ^
(Name)
(Addressj
I~GISTER OF WILLS OF COUNTY
~TH OF NON-SUBSCRIBING WITNESS
o
(each) a sub~g'criber hereto,
testat__ of (one of
that
(each) being duly qualified according to law, depose(s) and say(s) that
familiar with the signature of ,
codicil
the subscribing witnesses to) the will presented herewith and
codicil
believes the signature on the will is in the handwriting of
to the best of
knowledge and belief.
Sworn to or affirmed and subscribed before
me this day of
19
Register
(Name)
(Address)
(Name)
(Address)
LAST WILL AND TESTAMENT
TTIG
I, ~ ATTIG, of Cumberland County, Pennsylvania, do hereby make
this my Last Will and Testament, revoking any former Wills and Codicils made
by me.
FIRST.: I authorize my Executor pay all of the expenses of a funeral
or memorial service, the interment of my remains, including the costs of grave
site, if necessary, and the installation and inscription of a suitable marker at the
grave site. I further direct my Executor to pay'all of my just and lawful debts
as soon after my decease as is convenient.
SECOND: I give, devise and bequeath all the rest, residue and
remainder of my Estate, real, personal and mixed, wheresoever situate, to my
sister, EUNICE BENOIST, per stirpes, as she has been the one who has always
taken care of me these past few years.
Initials
THIRD:
powers:
My Executrix appointed under this will shall have the following
A. To retain any or all assets of my estate, real or personal,
without regard to any principle of diversification, risk, or
productivity.
B. To invest in all forms of property, including stocks,
common trust funds and mortgage investment funds, without
restriction to investment authorized for Pennsylvania fiduciaries as
they deem proper, without regard to any principle of
diversification, risk, or productivity.
C. To sell at public or private sale, to exchange or to lease,
for any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms and conditions as they deem proper.
Initials
D. To borrow money from any person or institution including
my Fiduciaries and to mortgage or pledge any or all real or
personal property as my Fiduciaries in their sole discretion shall
choose, without regard for the dispositive provisions of this
instrument.
E. To compromise any claim or controversy.
F. To exercise any option, right or privilege
granted in insurance policies or in other investments.
FOURTH: (1) I appoint as my Executrix my sister, EUNICE BENOIST,
of this, my Last Will and Testament.
(2) I direct that my Executrix serve without bond in any
jurisdiction in which called upon to act.
FIFTH:
1. I direct that all federal and Pennsylvania estate taxes payable as
a result of taxes assessed on property, whether passing under this Will or not,
shall be paid from my residuary Estate as a part of the expenses of the
administration of the Estate.
Initials
2. I direct that the Pennsylvania inheritance taxes payable as a result
of my death, whether assessed on property passing under this Will or not, shall
be paid out of my residuary Estate and shall not be deducted or collected from
any beneficiary under this Will or other transferee.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
day of ~, 2003.
Witnesses:
(SEAL)
residing at ~,4.c~ ~ ~,~
residing at~
4
FORM 16 REG. WILLS
INVENTORY
'!::: v D. II{...J.,' 'J
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(Number and street)
of all real and personal estate of
deceased, late of
who died
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All. . I ../ County, Pennsylvania,
PERSONAL ESTATE SCHEDULE
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Copyright 2000 David James Thorpe, Esq.
AFFIDAVIT OF EXECUTOR OR ADMINISTRATOR
<<:ommonbJeaIt~ of ~tn~!,lbllntll
<<:ount!' of
}
ss:
Personally before me,the undersigned authority, a
in and for said County
who, being duly swam according
and State, appeared
EUNICE BENOIST
to law, deposes and says that he is the executor or administrator of the estate of
HENRY D. ATTIG
, deceased, that the foregoing schedules constitute a complete inventory
and appraisement of the real and personal estate of
HENRY D. ATTIG
deceased, except real estate outside the Commonwealth of Pennsylvania, that the figures opposite each item of real and
personal estate in the foregoing schedules are determined and stated by the undersigned to be fair value of said items as
of the date of the decedent's death.
O:t-Ic.A
this
S'/'SFA aRB 9tJ8~aRl5al'l eefBffi. me
:ttt""'- day of .A-f1ro'j
~C>O s'
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EXECUTOR-ADMINISTRATOR
ADDITIONAL INSTRUCTIONS
1. The inventory shall be filed no later than the date the account is filed or the due date, including any extension, for the
filing of the Inheritance Tax Retum (9 months from the date of death) whichever comes first.
2. A Supplemental inventory must be filed within thirly days of discovery of additional assets.
3. An original and two copies must be filed.
4. Additional sheets may be attached as to personalty or realty.
5. See Section 3301 et seq. Of the Probate Estates and Fiduciaries Code of 1972, as amended.
6. The inventory must be typed.
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Copyright 2000 David James Thorpe, Esq.
LAW OFFICES
RUPP AND MEIKLE
HERBERT G. RUPP, JR.
RICHARD C. RUPP
A PROFESSIONAL CORPORATION
355 NORTH 21ST STREET, SUITE 205
CAMP HILL, PA 17011
(717) 761-3459
MAILING ADDRESS
P.O. BOX 395
CAMP HILL, PA 17001-0395
ANN MEIKLE ERIKSSON (1954-82)
E-M....IL: RUPPL....w10....0L.c:OM
May 3, 2005
TELEFAX: (717) 730-0214
Register of Wills of Cumberland County
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re: Henry D. Attig Estate 2004-00174
Dear Register of wills:
Please file the enclosed Inheritance Tax Return and
Inventory and a copy of each.
Please also find enclosed a check for the filing fee and a
check in the sum of $1,850.92 to pay the inheritance taxes.
l
Richard C. Rupp
RCR/egs
Encl.6
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en
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU Of INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128.0601
REV-,,62 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
BENOIST EUNICE
10 HARTZDAlE DRIVE
CAMP Hill, PA 17011
uuun fold
ESTATE INFORMATION: SSN: 193-24-" 54
FILE NUMBER: 2104-0174
DECEDENT NAME: ATTIG HENRY D
DATE OF PAYMENT: 05/04/2005
POSTMARK DATE: 05/04/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 02/10/2004
NO. CD 005287
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,850,92
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TOTAL AMOUNT PAID:
$1,850.92
REMARKS: E BENOIST
CHECK# 4
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
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COMMONWEALTH OF
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DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17126-0601
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INHERITANCE TAX RETURN FILE NUMBER
RESIDENT DECEDENT
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
ATTIG, HENRY D,
DATE OF DEATH DATE OF BIRTH
2/1012004 06125/31
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
X 1. Original Return
2. Supplemental Return
4. Limited Estate
4a. Future Interest Comprise (dale otdealh after 12-12-82)
6. Decedent Died Testate (Attach copy of Will)
7. Decedent Maintained a Living Trust (AIlocI1 iI copy of Trust)
9. Litigation Proceeds Received
10. Spousal Poverty Credit(diilleofdealh tJetween 12-31-91 and 1-1.95)
2..1
COUNTY CODE
NUMBER
00174
SOCIAL SECURITY NUMBER
189-09-7148
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
193-24.1154
3. Remainder Return (dale ofde8lh prior 10 12-
13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
011. Election to tax under Sec. 9113(A)
(AItach SdI 0)
=
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THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
RICHARD C. RUPP ESO 355 N, 21" STREET
SUITE 205
CAMP HILL, PA 17011
FIRM NAME (II Applicable)
RUPP AND MEIKLE
TELEPHONE NUMBER
717-761-3459
1. Real Estate (Schedule A)
(1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
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4. Mortgages & Notes Receivable (Schedule D)
(4)
(5)
(6)
5. Cash, Bank Deposits & Misc. Personal Property (Schedule E)
6. JoinUy Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Misc. Non-Probate Property
(Schedule G or L)
(7)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
(9)
(10)
10. Debts of Decedent, Mortgage Liabilities & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
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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)
x
$
16. Amount of line 14 taxable at lineal rate
x
$14,799,30
$500,00
17. Amount of line 14 taxable at sibling rate
x
,12
x
,15
18. Amount of line 14 taxable at collateral rate
19. Tax Due
20'D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
OFFiCIAL USE ONLY
$0,00
$0,00
$0,00
t..)
$19,801.30 C..il
$0,00 -'
$1,000.00
(8)
$5,491.00
$11.00
(11)
(12)
(13)
(14)
(15)
(16)
(17)
(18)
(19)
$20,801.30
SfifiO? 00
$15,299.30
soon
$15,299.30
$0.00
$
$1,775.92
S7fiOO
$1,850.92
~>
- .~:i\l$.S'.$ORet
Copyright 2000 David James Thorpe, Esq.
Dlicedent~s Complete Address:
STREET ADDRESS
10HARTZDALE DRIVE
CITY
CAMP HILL
IZIP
117011
TotallnterestIPenalty (0 + E) (3) $0.00
4. If line 21s greater than line 1 + line 3. enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If line 1 + line 31$ greater than line 2, enter the difference. This is the TAX. DUE. (5) $1,850.92
A. Enter the Interest on the tax due. (SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
_ J EJil1':~_l~!i~!I;t~\:r:i^lr~,:~id;'l\'&;,,:it~t~~iJ:\^^l/;;,i(-!i;)\i^;'(i~~~.iI!~!0:";i1t!5r:l!!w$\il~,.t'!~~!('~!:!lr ;~~:lI!R!tlM]jjli~1)~
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN X IN THE APPROPRIATE BLOCKS
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES. YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under pena1tie8 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.
Dedaration of preparer other than the personal representative is based on all the information of which preparei'" has any knowledge.
SI~RE OF PERSON RESPONSIBLE FOR FILING RETURN
# ....<-. ..,.
i _ .J.
ADDRESS
10H.
S ATU
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. CreditslPayments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A + B + C)
3. InterestlPenalty if applicable
D.lnterest
E. Penalty
1. Old decedent make a transfer and:
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 revisionary interest; or
d. receive the promise for life of either payments, benefits or care?
2. If death occurred on or before December 12, 1982, did decedent within two years
preceding death transfer property without receiving adequate consideration? If death occurred
after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?
3. Old decedent own an .'n 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?
L.PA17
AN REPRESENTATIVE
ADDR SS
355 N. 218T STREET SUITE 205 CAMP HILL PA 17011
ISTATE
IPA
(1)
$1.850.92
(2)
$0.00
Yes
~
No
;
B
ffi
DATE
04/29/05
DATE
6
lttf,M L,<,~l{~t;~~~~~"" 'it" j',':;;?)4t~'M-1i~~~JiJttt~,..,
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
SpouSB is 3% [72 P.S. ~9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% {72 P.S. ~9116
(a) (1.1) (ii)). The statute does no exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax
retum are still 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 twentyoQne years of age or younger at death to or for the use of a natural parent. an
adoptive parent. or a stepparBnt of thB 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. 99116(1.2) [72 P.S.
~9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section
9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyright 2000 David James Thorpe, Esq.
(N -I 1'-1
LAST WILL AND TESTAMENT
H j) If OF
R~F..~P.
AnlG
4f}Jfr
~e Allt.'10,
I, ~ ATIIG, of Cumberland County, Pennsylvania, do hereby make
this my Last Will and Testament, revoking any former Wills and Codicils made
by me.
FIRST:
I authorize my Executor pay all of the expenses of a funeral
or memorial service, the interment of my remains, including the costs of grave
site, if necessary, and the installation and inscription of a suitable marker at the
grave site. I further direct my Executor to pay.all of my just and lawful debts
as soon after my decease as is convenient.
give, devise and bequeath all the rest, residue and
SECOND:
remainder of my Estate, real, personal and mixed, wheresoever situate, to my
sister, EUNICE BENOIST, per stirpes, as she has been the one who has always
taken care of me these past few years.
Initials 11-'&'. {& '
~
powers:
THIRD:
My Executrix appointed under this will shall have the following
A. To retain any or all assets of my estate, real or personal,
without regard to any principle of diversification, risk, or
productivity.
B. To invest in all forms of property, including stocks,
common trust funds and mortgage investment funds, without
restriction to investment authorized for Pennsylvania fiduciaries as
they deem proper, without regard to any principle of
diversification, risk, or productivity.
c. To sell at public or private sale, to exchange or to lease,
for any period of time, any real or personal property and to give
options for sales, exchanges or leases, for such prices and upon
such terms and conditions as they deem proper.
Initials
~,J-OC,
/
2
D. To borrow money from any person or institution including
my Fiduciaries and to mortgage or pledge any or all real or
personal property as my Fiduciaries in their sole discretion shall
choose, without regard for the dispositive provisions of this
instrument.
E. To compromise any claim or controversy.
F. To exercise any option, right or privilege
granted in insurance policies or in other investments.
FOURTH: (1) I appoint as my Executrix my sister, EUNICE BENOIST,
of this, my Last Will and Testament.
(2) I direct that my Executrix serve without bond in any
jurisdiction in which called upon to act.
FlnH:
1. I direct that all federal and Pennsylvania estate taxes payable as
a result of taxes assessed on property, whether passing under this Will or not,
shall be paid from my residuary Estate as a part of the expenses of the
administration of the Estate.
Initials #-,Jr tl -
3
--~
2. I direct that the Pennsylvania inheritance taxes payable as a result
of my death, whether assessed on property passing under this Will or not, shall
be paid out of my residuary Estate and shall not be deducted or collected from
any beneficiary under this Will or other transferee.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this J!1iI..
day of D~. 2003.
e&5
~'^')(i ,G 1/ d} ~,
(SEAL)
Witnesses:
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COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
HENRY D. ATTIG
FILE NUMBER
2004-00174
Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jointly-owned with the right of survivorship must be disclosed on
Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
M+TBANK
CHECKING ACCOUNT
ACCOUNT # 11482761
$9.611.15
2.
M+TBANK
CERTIFICATE OF DEPOSIT
ACCOUNT # 031003913938676
$10.060.01
3.
VERIZON REFUND
$5.01
4.
CAPITAL BLUE CROSS REFUND
$125.13
TOTAL (Also enter on line 5, Recapitulation)
(If more space is needed. insert additional sheets of the same size)
$19,801.30
Copyright 2000 David James Thorpe, Esq.
Ju 1 21 04 11: 04..
p. 1
Pm M&I'Bank
t../
499 Mkchel1 Road, Mill.boro. DE 19~ Mail Coce DE-MB-12
Phone (888) 502-4349
Fax (302) 934-2955
luIy21.2004
Fax: 717-730-0214
Rupp and Meikle
Attorneys At Law
355 North 21" Sf. Suite 205
Camp Hill, P A 17011
Re: Estate of Henrv Don Attill
Social Securitv: 193-24-1154
Date of Death: Februarv 10, 2004
Dear Sir or Madam:
Per your inquiry received July 15,2004, please be advised thar or the time of death, the above-named decedent had on
deposit with tlili1 bank the following:
I.
Type of Accrmnt
Checking Acccnml
AccOll1ll Number
/148276/
Ownership (Names qf)
Henry Don Attig
Eunice J Benoist, POA
Opening Date
Balance on Dale of Death
03/28/69 (Closed 617/04)
$9,6/1.]5
Total
S 0.00
--$9.61Tis-------------.---.-----------.-
Accrued Interes.
2.
Type of Accaun/
Cer.ificate ofDeposiJ
Account Number
03]0039/3938676
Ownership (Names of)
Heruy Dan Attig
EWfice I Benoist, POA
Opening Date
] 1108/99 (Cl05ed 6I7I04j
$/0,056.8]
Balance on Dale cfDeath
Accrued Interest
$
1.20
Total
-Slif06o.oT------ -----------. ------
Please be advised, the... was no safe deposit box found for the above decedent. For further account infonnation, regarrling
ownership, closures andlor ...imbursement offunds, please call the We" Shore Plaza Office # 717.255-0??71.
Sincerely,
~~
Nancy Clagett
Rec0rd3 Management
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF
HENRY D. ATTIG
FILE NUMBER
21-04-0174
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV~1500 COVER SHEET Is yes.
ITEM DESCRIPTION OF PROPERTY DATE OF DEATH % OF DECO'S EXCLUSION TAXABLE
NUMBER INClUDE THE NAME OF THE TRANSFEREE. THEIR RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER. VALUE OF ASSET INTEREST (IF APPLICABLE) VALUE
ATTACH A COPY OF THE oeeD FOR REAL ESTATE.
1. 1986 FORD RANGER $500.00 100% 0 $500.00
TRUCK DEC 2004-GIFT
2. EUNICE BENOIST-GIFT $500.00 100% 0 $500.00
01/21/04
TOTAL (Also enter on line 7, Recapitulation) $1,000.00
..
(If more space is needed. Insert additional sheets of the same size)
Copyrighl 2000 David James Thorpe, Esq.
Kelley Blue Book Used Car Values
_!!!"~
anD CAlli
~EIl'EWS &. RATINGS ADV!CE FINANCING & 'NSURANCE
o.....O'....P~QuoIa O_Uoodc.rUsliI1QlO ,
BLUE BOOK PRIVATE PARTY REPORT
Pennsylvania. June 7, 2004
1986 Ford Ranger Short Bed
Engine: 4-Cyl. 2.3 Liter
Trans: 5 Speed Manual
Drive: 2 Wheel Drive
Mileage: 216,000
Search Listinas for This Car
List Your Car For Sale Online
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Auto Loans from 3.85% APR
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pavment Calculator
Equipment
AM/FM Stereo
Consumer Rated Condition: Good
"Good" condition means that the vehicle is free of any major defects.
The paint, body and interior have only minor (if any) blemishes, and
there are no major mechanical problems. In states where rust is a
problem, this should be very minimal, and a deduction should be
made to correct it. The tires match and have substantial tread wear
left. A clean title history is assumed. A "good" vehicle will need some
reconditioning to be sold at retail; however major reconditioning
should be deducted from the value. Most recent model cars owned by
consumers fall into this category.
Private Party Value Search Local Listinas for This Car $500
Private Party value represents what you might expect to pay for a used car
when purchasing from a private party. It may also represent the value you
might expect to receive when selling your own used car to another private
pa rty.
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BL.uE SOOK VAWE
FEEDBACK
Page 1 of2
http://www.kbb.com/kb/ki.dll/kw.kc.ur?kbb.PA;528837;P A041&17011 ;+p&722;Ford; 1986... 6/7/2004
Kelley Blue Book Used Car Values
Page 2 of2
Copyright @ 2004 by Kelley Blue Book Co., All Rights Reserved. May-Jun 2004 Edition. The
specific information required to determine the value for this particular vehicle was supplied
by the person generating this report. Vehicle valuations are opinions and may vary from
vehicle to vehicle. Actual valuations will vary based upon market conditions, specifications,
vehicle condition or other particular circumstances pertinent to this particular vehicle or the
transaction or the parties to the transaction. This report is Intended for the Individual use
of the person generating this report only and shall not be sold or transmitted to another
party. Kelley Blue Book assumes no responsibility for errors or omissions.(v.04055)
http://www.kbb.com/kb/ki.d11lkw.kc.ur?kbb.P A;769672;P A041 & 17011 ;+t&39;Ford; 1986%... 6/7/2004
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
21-04-0174
HENRY D. ATTIG
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER
DESCRIPTION
AMOUNT
A.
$0.00
1.
B.
1.
2.
3.
4.
5.
6.
7.
FUNERAL EXPENSES:
REVEREND FELTY
$50.00
$200.00
ST. JOHN'S CEMETERY-GRAVE OPENING
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
Attomey Fees RUPP AND MEIKLE
Family Exemption: (If decedent's address is not the same as claimanfs, attach explanation)
Claimant EUNICE BENOIST
Street Address 10 HART2DALE DRIVE
City CAMP HILL State PA Zip 17011
Relationship of Claimant to Decedent
$1,660.00
$3,500.00
Probate Fees-CUMBERLAND COUNTY REGISTER OF WILLS
$81.00
Accountanfs Fees
Tax Return Preparer's Fees
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$5,491.00
Copyright 2000 David James Thorpe, Esq.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
HENRY D. ATTIG
FILE NUMBER
21-04-0174
Include unreimbursed medical expenses.
ITEM
NUMBER
1.
DESCRIPTION
AMOUNT
ALISHA D. STINE-TAX COLLECTOR
PERSONAL TAX
$11.00
TOTAL (Also enter on line 10, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$11.00
Copyright 2000 David James Thorpe, Esq.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
HENRY D. ATTIG
FILE NUMBER
21-04-0174
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER Do Not list Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1. EUNICE BENOIST SISTER 100%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. INUN- "'UN::>:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $0.00
(If more space is needed, insert additional sheets of the same size)
Copyright 2000 David James Thorpe, Esq.
AFFIDAVIT OF EXECUTOR OR ADMINISTRATOR
<<:ommonbleaItb of ~entm!,lbania
<<:ountp of
}
ss:
Personally before me, the undersigned authority, a
in and for said County
who, being duly sworn according
and State, appeared
EUNICE BENOIST
to law, deposes and says that he is the executor or adminislrator of the estate of
HENRY D. ATTIG
, deceased, that the foregoing schedules constitute a complete inventory
and appraisement of the real and personal estate of
HENRY D. ATTIG
deceased, except real estate outside the Commonwealth of Pennsylvania, that the figures opposite each item of real and
personal estate in the foregoing schedules are determined and stated by the undersigned to be fair value of said items as
of the date of the decedent's death.
this
Sworn and subscribed before me
day of
}
ct:-.
"
-
""
6-.-" ".
i ~ _
EXECUTOR-ADMINISTRATOR
ADDITIONAL INSTRUCTIONS
1. The inventory shall be filed no later than the date the account is filed or the due date, including any extension, for the
filing of the Inherilance Tax Return (9 months from the date of death) whichever comes first.
2. A Supplemental inventory must be filed within thirty days of discovery of additional assets.
3. An original and two copies must be filed.
4. Additional sheets may be attached as to personalty or realty.
5. See Section 3301 et seq. Of the Probate Estates and Fiduciaries Code of 1972, as amended.
6. The inventory must be typed.
Q 6: ~ "T1 "T1 Q <
ei" CD CD. ei" Q.
a. CD a:
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3 '" (1) Q Q 3 Q z
CD '" CD
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m "tI
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CD
a.
Copyright 2000 David James Thorpe, Esq.
07-25-2005
ATTIG
02-10-2004
21 04-0174
CUMBERLAND
101
APPEAL DATE: 09-23-2005
( See reverse side under Objections)
Amount ReIIl:ittedl I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE _ RETAIN LOWER PORTION FOR YOUR RECORDS +-
REv:is4'-Ex-AFP-io3:osj-NoTIcE-OF-INHERITANCE-TAx-iPPRAIsEHENT:-iLiowANCE-OR---------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
HENRY D FILE NO. 21 04-0174 ACN 101
TAX RETURN liAS: I ) ACCEPTED AS FILED I X) CHAlIllED SEE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
_ ~_o ro ro NDTICE DF INHERITANCE TAX
BUREAU 0; INDIVIDUAL T~ "T',~C DH-:)~"~llAISEHENT, ALLONANCE OR DISALLOIIANCE
ItolERnANCE TAX DIVISION - - - - , ,OF DEDUCTIONS AND ASSESSHENT OF TAX
PO BDX Z80601 " : I "
HARRISBURG p.., 171ZB-1J601
z'C"c~ ,-~I J) ~ ~: 2
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
r.. ~.. ^7
1'-, c... L
r.-
t>
0r--,
..-'....,.1'.-7
RICHARD C RUPPESQ
RUPP & MEIKLE"
355 N 21ST STE
CAMP HILL
205
PA 170ll
ESTATE OF ATTIG
*'
REV-lS47 EX AFP (06-05)
HENRY
D
DATE 07-25-2005
ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Est.t. (Schedule AJ
2. Stoeks and Bonds ISchedule B)
3. Closely Held Stock/Partn.~ship Interest (Schedule C)
4. Hortgages/Notes Receivable (Schedule DJ
S. CaSh/Bank Deposits/Misc. P.~sonal Property (Schedule E)
6. Jointly Owned Property ISchedule F)
7. Transfers (Schedule G)
8. Total Ass.ts
(1)
(2)
(3)
(4)
(5)
(6)
In
.00
.00
.00
.00
19.801.30
.00
1,000.00
(8)
NOTE: To insure proper
c....cut to your account",
s~lt the UPP8r portion
of this for. with your
tax paYllen'\..
20,801. 3D
I~ an assessment Nas issued previouslY, lines 14. 15 and'or 16. 17. 18 and
r~lect ~igures that include the tatal o~ ~ returns assessed to date.
ASSESSMENT OF TAX:
15. AlIOUI\t of Line 14 at Spousal rat. (lSl
16. A.aunt of Line 14 tax~l. at Lineal/Class A rat. (16)
17. AllDUnt of Line 14 at Sibling rete 1171
18_ ~ount of Line 14 taxable at Collateral/Class Brat. (18)
19. Principe! T-x Due
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Exp~s.s/Ad.. Costs/Misc. Expenses (Schedule H)
18. Debts/Nortgage Liabilities/liens (Schedul. Il
11. Tot.l Deductions
12. Net Value of Tax Return
13. Oharitable/tovern-ental Bequests; Non-elected 9113 T~usts
14. N.t Value of Est.te Subj~t to Tax
(9)
(10)
1,991.00
11. DO
Ill)
(12)
113)
114)
ISchedule J)
NOTE:
.00
.00
18,299.30
500.00
X 00 =
X 045 =
X 12 =
X 15 =
:
INTEREST'PEN PAID 1-)
.00
AHIlUNT PAID
1,850.92
DATE
05-04-2005
NUI1BER
CD005287
~
INTEREST IS CHARGED THROUGH 08-09-2005
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
(19)=
".no:;>> 00
18,799.30
.00
18,799.30
19 will
.00
.00
2,195.92
75.00
2,270.92
1,850.92
420.00
56.90
476.90
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY 8E DUE
A REFUND. SEE REVERSE SIDE OF THIS FORK FOR INSTRUCTIONS.)
ReV-'4'1OEX~
..
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEALTH OF PENNSYLVANIA
OEPARTMENT OF REVENUE
BUREAU OF INDMDUAL TAXES
PO Box 280601
HARRIOBi 'fm PA 17"8-0601
DECEDENT'S NAME
Henry D. Attig
FILE NUMBER
REVIEWED BY
Destiny S.R.Brown
ACN
2104-0174
101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
H 3 The claim for the family exemption has been disallowed. The claimant must be a spouse
or if no spouse, a parent or child living in the same household as the decedent as of the
date of death.
..",.,~
'i~~,
fi
I
"
I';
8,
ROW
Page 1
Cumberland County - Register Of wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 1/04/2006
RUPP RICHARD C
POBOX 395
355 NORTH 21ST ST SUITE 205
CAMP HILL, PA 17011
RE: Estate of ATTIG HENRY D
File Number: 2004-00174
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:
2/10/2006
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~~~
. .f
GLENDA FARNER STRASBAuGH
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
vG
~
f~~ \~ 't:,
~~ ~J
~
~ _ ,--= _."_ ._,_' _...:t""S 1\"'': ilii __ _ ~ .r1_____ :l_ __.....ii _ __.2 .n _....,--.~-
jl'f..(;::Z;JliSil\.<:;::Jl" lUll!. 'If'!} u.ll::;i \Uill "..A.lLJ!.UiU<CJi:n.i:lLUU -UUUlJ.l<.i!.j
STATUS REPORT Ul\l'DER RlJLE 6.12
Name of Decedent: /4....fI-IJ / J/er) 1"''1 f)
Date of Death: oZ - / () - ;1..00 f
Estate No.: .;2..0 C> ~ - cJ 0 / 7 c.f
.
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 0 No JIi
2. If the answer is No, state when the persoT1Ql representative reasonably believes that
the administration will be complete: \7'(,,( I v .;l. 0 cJ ~
I
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a fL.'1al account with the Coui:-t?
Yes 0 No 0
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the persop...a.l representative state an account informally to the pa.."iies in
interest? Yes 0 No 0
c.
,!H
k, 'c/:fI~ /~ C iL//,P
Name . 1 / I'? '/,.2(J /
3sS-(V.,2J s~S?-Ytc~1- ~Ulft
(?~.;?1 0 /-/ I'/~/ N /7(/ //
Address '
accounts may be filed with
attached to this report.
1ft, lOb
Date:
\,.'......
1,- ~-.J
/) 1'7 - ? Co / -.. ;><:/.s-f
T'elephone l'To.
/""'\ .r..... I~ T';.__~__""'_r"! "0 C~'~"-S-_"''''''';'''';--;'7'~
;......,apaCiLj: L-1 i Cl.~\J.L.I.a.l .L'",;""'}I.i.::; i;;.Lli..;;:ll..L', '-'
~ C.QiJIlsel for persoTial representative
~1;
8/16/2006
t\ENR'l D ~1'1'lG
e of: 04
of Deat~: 2/10/20
2104-0114
NU.ber: ~OUR PA~MEN1.
Of 1"1S PAGE W11"
SE SUBM11 A COP~
lnt.erest.
1'ot.al
penalt.y
SOS.S8
0.00
420.00
101' ~
~~~~/~~~r--r-'
J.-..-.-'6 ~~~ V~ ~ .-<-~:..;!G)
~ ~ ~ .~ ,..i...-o.-S-.' ~ ~d:::-
~ ----v---: ~ ~ ~ ~ ~ ~",-,-J
~_~~-!'-:;~~~~~JJ~
~ ~ '~~k:. '=f ~ .
~.~~.
1'a~
8S.S8
~CN
COMMONWEAL TH OF PENNSYL VANIA
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
BENOIST EUNICE
10 HARTZDALE DRIVE
CAMP HILL, PA 17011
nU_n_ fold
ESTATE INFORMATION: SSN: 193-24-1154
FILE NUMBER: 2104-0174
DECEDENT NAME: ATTIG HENRY D
DATE OF PAYMENT: 09/11/2006
POSTMARK DATE: 09/07/2006
COUNTY: CUMBERLAND
DA TE OF DEATH: 02/10/2004
NO. CD 007190
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $505.58
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: EUNICE BENOIST
CHECK#104
SEAL
INITIALS: CM
RECEIVED BY:
REGISTER OF WILLS
$505.58
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIYISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
RECORDED Ol8l11OO4ENT OF ACCOUNT
'*
REY-1607 EX AFP (03-05)
RICHARD C RUPP
RUPP & MEIKLE
355 N 21ST STE
CAMP HILL
CLER\< OF
RP' I ~,\'c' r'(\1 IRT
o r1t~,; '-~ .) \._\~jl.....1 II
CU!.,...cm PA
:'.'\. "
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
10-02-2006
ATTIG
02-10-2004
21 04-0174
CUMBERLAND
101
AIKKrIt R_i tted
HENRY
D
200G OCT 3 \ At1 \0: 22
205
PA 17011
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, sub_it the upper portion of this foNt with your tax pay_ant.
CUT ALONG THIS LINE
--+ RETAIN LOWER PORTION FOR YOUR RECORDS +--
---------------------------------------------------------------------------
REV-1607 EX AFP (03-05)
~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF ATTIG HENRY D FILE NO.21 04-0174 ACN 101 DATE 10-02-2006
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE HAMED ESTATE. SHOWN BELOW
IS A SUtltlARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 07-25-2005
PRINCIPAL TAX DUE: 2,270.92
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-04-2005 CD005287 .00 1,850.92
09-07-2006 CDOO7190 85.35- 505.58
TOTAL TAX CREDIT 2,271.15
BALANCE OF TAX DUE .23CR
INTEREST AND PEN. .00
III IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .23CR
SIDE 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 DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
cp
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
~
,~
Date: 1/25/2007
RUPP RICHARD CHARLES ESQUIRE
RUPP & MEIKLE PC
355 NORTH 21ST ST STE 201
CAMP HILL, PA 17011-3707
RE: Estate of ATTIG HENRY D
File Number: 2004-00174
.-
~
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 is due by:
2/10/2007
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
Personal Representative(s)
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 1/25/2007
BENOIST EUNICE
10 HARTZDALE DRIVE
..-:!:
__J.
CAMP HILL, PA 17011
RE: Estate of ATTIG HENRY D
File Number: 2004-00174
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 is due by:
2/10/2007
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.
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Sincerely,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
Pa. D.C. Rule 6.12 STATUS REPORT
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REGISTER OF WILLS OF~ COUNTY, PENNSYLVANIA
Name of Decedent: A T r ; G .J 4 E N Ii!- 'f 7;> ~
Date of Death: e:2../!/ 6/0 f File Number: r:;;;2.. &-0 ~ - <:::) 6/ 7 +
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 No
2. If the answer is No, state when the personal representative
reasonably believes that the administration will be complete:
3. If the answer to NO.1 is YES, state the following:
a. Did the personal representative file a final account with the Court? . . . . . .. ~s DNa
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 DNa
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be
filed with the Clerk of the Orphans' Court and may be attached to this report.
Dale
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Signature of Persoll Filing this F'orm .
Capacity: ~nal Representative D Counsel
Name of Person Filillg this Form
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Address
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C/frry,-;o ~'LL, PR. /7DI'/
Telephone 7/ 7 7 (... /~() /S7
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Form RW-JO ;:e0 )()}306-
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