HomeMy WebLinkAbout01-0005
Estate of
also known as
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
G R Z . No. /} / - 0 ( -,.... 0 ~
eorge . Immerman ~ ~ ~
, Deceased
Social Security No. 183 -12 - 3134
John H. Zimmerman
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE 'A' or 'B' BELOW)
o A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut
the Decedent, dated and codicil(s) dated
named in the last Will of
State relevant circumstances, e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
[]] B. Grant of Letters of Administration
(c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
r-,
Residence
DOD 11-23-1995 (File No. 21-95-896)
Name
Julia A. Zimmerman, deceased
John R. Zimme::rmaR-
, .::l./
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland
County, Pennsylvania with his/her last family
or principal residence at 2831 Ritner Highway, West Pennsboro Township
(list street, number, and municipality)
Decedent, then ~years of age, died 04/27/1992 at Carlisle Hospital, PA
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in PAl All personal property
(If not domiciled in PAl Personal property in Pennsylvania
(If not domiciled in PAl Personal property in County
Value of real estate in Pennsylvania
$
$
$
$
800.00
situated as follows:
- no real estate -
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of
letters in the a ropriate form to the undersi ned:
Si nature
----
N
HARRISBURG, PA
17112
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc.
I (p ~ I q <(- 10
Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
Coun~of Cumberland
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of
the Decedent, Petitioner(s) will well and truly administer the estate according to law. ""-
. _ /:i..
before me thiS c)q day of
JUSTIN L ZIMMERMAN
~,a~~xx
----
Sworn to or affirmed and subscribed
[) l' .t.t./rn fuVl..) , dD 0 6
YJn >-0(1 .lh J I-'~ ,1fJVA (f (J 6~1r~~
For the Register AJ.-Lj2 a
No.
21-01-005
E~~eof George R. Zimmerman
Deceased
Social Security No: 183 -12- 3134 Date of Death: 04/27 /1992
AND NOW,
JANUARY 4, 2001
, in consideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters D Testamentary [J9 Of Admini~ration
(c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
are hereby granted to
JUSTIN L. Zimmerman
in the above estate and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters. . . . . . .
$
18.00
'tI}tL1--:;;J. f~U A ~. /? /L ~ JLwJ . 02/2/1.1.1--
Register of Wills I /
Short Certificate(s). 2 .
$
6.00
Renunciation. $
Affidavits ( $
Extra Pages ( ) . $
Codicil. $
JCP Fee. $
Inventory. $
Other $
TOTAL. $
5.00
Attorney:
Gary L. James, Esq.
I.D. No:
27752
James, Smith, Durkin & Connelly
134 Sipe Avenue
Address:
Hummelstown, PA 17036
5.00
Telephone: 717/533 - 3280
MAILED LETTERS AND ORDERS TO ATTORNEY 1-04-002
34~00
Prepared by the Pennsylvania Bar Assoclatlon Copyright (e) 1996 form software only CPSystems, Inc.
Form RW-1 (1991)
21-01-005
RENUNCIATION
In Re Estate of
6F.D~~~ :t<- ZIMMEQ.1J1At-J
deceased.
To the Register of Wills of
r,t)MBE12L~D
County, Pennsylvania.
The undersigned
5a~
of
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
OF AD,,^IUI,STQA--r-/O~
~uSll~ \-. 7.(MMB2fV1~
be issued to
WITNESS
hand this 2fp day of D ~BQ2, 182COO
2/8 SOllTI-l V I t:=w Dl!/VE
(Address)
DEA-121t1J( Ai J 08075-/520
(Signature)
(Address)
(Signature)
(Address)
H105.905 REV. (09/00) 21-01-005
This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
G\~s.~/~'
Robert S.~erman, Jr., MPH
Secretary of Health
No.
~/I~
Charles Hardester
State Registrar
1267864
NOV 17 2000
Date
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COMMONWEALTH OF PEN"SYLVANI~ . DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH r,'
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034503
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SOCIAL SECURITY HUMSER
I, 183 - 12. - 3134
Dl,NOI'~H~Oo,._)
.: Ap,ril,27, }.992
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EV - 1500 EX * (7-94)
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I FOR DATES OF DEATH AFTER IZ/31/91 CHECK HERE
INHERITANCE TAX RETURN IFASPOUSAL
POVERTY CREDIT IS CLAIMED [~
RESIDENT DECEDENT FILE NUMBER
COMM NWA OFP ANIA
D~P~^R~E~,?FF~R~SNYuL~ (TO BE FILED I" DUPLICATE 21-01-0005
HARRIS~,~ACO~I 1ga'0601 WITH REGISTER OF WILLS) COUNTYCODE YEAR NUMBER
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) DECEDENT'S COMPLETE ADDRESS
Zimmerman, George R. 2831 Ritner Highway
SOClALSECURITYNUMBER DATEOFDEATH DATEOFBIRTH I Carlisle, PA 17013
183-12-3134 04/27/1992 04/08/1917
Cumberland
',IFAPPLICABLE) SURVIVINGSPOUSE'S NAME(LAST,FIRSTAND MIDDLEINITIAL)zimmerman, Julia A S1OC~$L-S~;U-F;I~;;MBER AMOUNTRECEIVED(SEEINSTRUCTIONS)0.00
[~4[]1: OriginalReturn []2. SupplementaIReturn [~3. RemainderReturn
Limited Estate LJ 42. Future Interest Compromise (for dates of death prior to 12-13-82)
(for dates of death after 12-12-82) [] 5. Federal Estate Tax Return Required
[] 6. Decedent Died Testate [] 7. Decedent Maintained a Living Trust 0 8. Total Number of Safe Deposit Boxes
(Attach copy of Will) (Attach a copy of Trust)
ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME
Gary L. James, Esquire
tELEPHONE NUMBER
717/533-3280
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
CO M P~Ei: ~ U ;:ti~;~ E;Si e t t e r i ck
P.O. Box 650
Hersheyf PA 17033
(1) None
(2) 278f35~
3. Closely Held Stock/Partnership Interest (Schedule C) (3) _~f
4. Mortgages and Notes Receivable (Schedule D) (4) N~
5. Cash, Bank Deposits & Miscellaneous Personal Property (Sch. E) (5) ~0-
6. Jointly Owned Property (Schedule F) (6) None
7. Transfers (Schedule G)(Schedule L) (7) N~ne
8. Total Gross Assets (total Lines 1-7)
g. Funeral Expenses, Administrative Costs, Miscellaneous (9) 2 ~ 060 .~ 00
Expenses (Schedule H)
10. Debts, Mortgage Liabilities, Liens (Schedule I) (10) N~e
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests (Schedule J) (13)
14. Net Value Subject to Tax (Line 12 minus Line 13)
& Connelly, LLP
(~' 278.54
(11) 2,060.00
(12) (1,781.46)
(14) (1,781.46)
15. Spousal Transfers (for dates of death after 6-30-94)
See Instructions for Applicable Percentage on page 2.
(include values from Schedule K or Schedule M.)
16. Amount of Line 14 taxable at 6% rate
(include values from Schedule K or Schedule M.)
17. Amount of Line 14 taxable at 15% rate
(Include values from Schedule K or Schedule M.)
18. Principal tax due (Add tax from Line 15, 16 and 17.)
19. Credits/Sp Poverty Prior Payments Discount
+ +
(1s) 0,00 x = 0.00
(16) 0.00 x .06: 0,00
(17) 0.00 X .15: 0.00
(18) O. 00
Interest
(is) o. oo
(2o)
20. If Line 19 is greater than Line 18, enter the difference on Line 20. This is the OVERPAYMENT. 0.00
[] [] checkher~ifY~U:ar~requestngarefundofYOur~wr~me,t,I
21. If Line 18 is greater than Line 19, enter the difference on Line 21. This is the TAX DUE. (21) 0.00
A. Enter the interest on the balance due on Line 21A. (21A) 0.00
B. Enter the total of Line 21 and 21A on Line 21B. This is the BALANCE DUE. (21B) 0.00
Make Check Payable to: Re,~lister of Wills, A~ent
· · BE SURE TO ANSWER ALL QUESTIONS ON PAGE ~ AND TO RECHECK MATH · ·
Under Panaltles of peri u~/, I declare that I have ex&i~i;i ~G this return, Including ~,.,~.*~ylng schedules and statements, and to the best of my knowledge and belief, It is true,
correct and complete. I declare that all real estate has been reported at true market value. Declaration of preparer other than the personal representative Is based on all Information of
which preparer has any knowledge.
SIGNATURE OF ~RSg~ESP.~ONSIBLE FOR FILING RETURN Just tn L. Zimmerman
~ ~'7 / 714 Rowe Lane
/ / ..... ...........................
S,GN~TUREOFPR~ROTH~T~ANR~TIVE J~es Smith Dletterlck & Connelly, LLP
- / X ..............................
Copyright (c)1994 form so, re o~te~. ,~.
DATE
Form 1500 (Rev. 7-94)
Act #48 of 1994 provides for the reduction of the tax rates imposed on the net value of transfers to or for
the use of the spouse. The rates as prescribed by the statute will be:
· 3% (.03) will be applicable for estates of decedents dying on or after 7/1/94 and before 1/1/96
· 2% (.02} will be applicable for estates of decedents dying on or after 1/1/96 and before 1/1/97
· 1% (.01) will be applicable for estates of decedents dying on or after 1/1/97 and before 1/1/98
· Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance tax.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A MARK (X) IN THE APPROPRIATE BLOCKS.
1. Did 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 reversionary 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. Did decedent own an 'in trust for' bank account at his or her death? ............................
YES NO
X
X
X
X
X
×
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Copyright (c) 1994 form software only CPSystems, Inc. Form 1500 (Rev, 7-94)
~1(~ ERIT A N ~'~EI:~O~ ERNEIT U R N
ESTATE OF
George R. Zimmerman
SCHEDULE B
STOCKS AND BONDS
SS# 183-12-3134 04/27/1992
FILE NUMBER
21-01-0005
(All property jointly-owned with Right of Survivorship must be disclosed on Schedule F.)
ITEM
NUMBER DESCRIPTION
1 9.344 shs 0ppenheimerFunds Account No. 3303300375606 -
valued per letter dated 3/1/01
29.81
TOTAL (Also enter on line 2, Recapitulation)
(If more space is needed, insert additional sheets of same size.)
Copyright (c} l~lg4 form software only CPSystems, Inc.
VALUE AT DATE
OF DEATH
278.54
$ 278.54
Form 1500 Schedure B
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
George R. Ztmmerman SS~ 183-12-3134 04/27/1992
ITEM
NUMBER
Please Print or T~pn
FILE NUMBER
21-01-0005
DESCRIPTION
Administrative Costs:
Personal Representative Commissions
Social Security Number of Personal Representative:
Year Commissions paid
Attorney Fees
Family Exemption
Claimant Julia A. Ztmmerman Relationship Spouse
Address of Claimant at decedent's death
Street Address 2831 Ritner I-li~hwa,y'
City Carllsle State PA Zip Code 17013
Probate Fees
Register of Wills
Miscellaneous ~pens~:
Register of Wills, Cumberland County - short certificate
Register of Wills, Cumberland County - filing fee for Return &
Inventory
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of same size.)
Copyright (c) 1994 form software only CPSystems, Inc.
AMOUNT
2,000.00
34.00
6.00
20.00
$ 2,060.00
Form 15~ Schedule H (Rev. ?-~
REV - 1513 EX + (Z-87) I
COMMONW ALTHOFP NNSYL ANIA
,NH ERF~ANCE TAX~ETUR~/
ESTATE OF
SCHEDULE J
BENEFICIARIES
George R. Zimmerman SS~ 183-12-3134 04/27/1992
FILE NUMBER
21-01-0005
iTEM~ AMOUNT OR
NAME AN[:) ADDRESS OF BENEFICIARY RELATIONSHIP
NUMBER SHARE OF ESTATE
A. Taxable Bequests:
1 Julia A. Zimmerman Spouse First $30,000
2831 Ritner Highway
Carlisle, PA 17013
ITEM AMOUNT OR
NAME AND ADDRESS OF BENEFICIARY
NUMBER SHARE OF ESTATE
B. Charitable and Governmental Bequests:
TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation)
$ 0.00
(If more space is needed, insert additional sheets of same size.)
Copyright (c) 1994 form software only CPSystems, lr~. Form 1~00 Schedule J (Rev. Z-87)
March 1, 2001
Gary L. James
James, Smith, Durkin & Co.
134 Sipe Ave.
Hummelstown, PA 17036
A Division of OppenheimerFunds, Inc.
6803 South Tucson Way
Englewood, CO 80112-3924
Tel 1 800 525 7048
Dear Mr. James:
I appreciate this opportuniB, to provide information George R Zimmerman's account. The account
number and its value as of April 27, 1992 & November 23, 1995 is listed below.
Account Number Total Shares Share Price Total Value
3303300375606 9.344 $29.81 $ 274.54
3303300375606 159.680 $35.98 $5,762.83
If you have any questions or need our assistance in any way, please call us at 1-800-525-704& We are
available Monday through Friday from 8:00 a.m. to 9:00 p.m. and Saturday from 10:00 a.m. to 4:00 p.m.
Eastern time.
Sincerely,
(Ms.) L. Strawn
OppenheimerFunds
The Right Wa), to Invest
Is/ss
IDOC# 501418128
Register of Wills of
CUMBERLAND
INVENTORY
County, Pennsylvania
Estate of Georse R.
Zimmerman
also known as
No. 2001-00005
Date of Death 0/+/27/1992
Deceased Social Security No. 183-12- 3134
Justin L. Zimmerman,
Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the
personal assets wherever situate and all of the rea{ estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation
placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned
no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this
inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. Section 4904 re~ating to unsworn falsification to authorities.
Personal Representative
Name of
Attorney: Gary L. James, Esquire Signature:
~ustin L. Zimmerman
I.D. No.: 27752 Signature:
Address: 134 Sipe Avenue
Hummelstown, PA 17033
Address: 714 Rowe Lane
Harrisburg, PA 17112
Telephone: 717/533-3280
Telephone: 717/671- 9494
Description
9.344 shs Oppenhe±merFdnds Account No. 3303300375606 -
valued per lette~ ~ated
(Attach additional sheets if necessary)
Total: 278.54
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative,
include the value of each item, but such figures should not be extended into the total of the Inventory.
BUREAU OF ZNDZVZDUAL TAXES
TNHERZTANCE TAX DTVTSTON
PO BOX ZB0601
HARRTSBURG, PA 171za-n601
COHHONNEALTH OF PENNSYLVANZA
DEPARTMENT OF REVENUE
NOTZCE OF ZNHERZTANCE TAX
APPRAZSEHENT, ALLO#ANCE OR DZSALLOHANCE
OF DEDUCTZONS AND ASSESSMENT OF TAX
REV-15~i7 EX &FP
GARY L JANES ESQ
JAHES ETAL
P 0 BOX 650E
HERSHEY
PA 17033
DATE 11-ZZ-Z004
ESTATE OF ZZMMERNAN
DATE OF DEATH 04-Z7-199Z
FZLE NUMBER 21:=01- 000~:
COUNTY CuHBERLANJ~
ACN 10i:
I Aeoun~
GEORGE
MAKE CHECK PAYABLE AND RENXT PAYMENT TO:
REGXSTER OF NZLLS -*'
CUMBERLAND CO COURTi~OUSE
CARLISLE, PA 17015
CUT ALONG THZS LZNE ~ RETAZN LONER PORTZON FOR YOUR RECORDS 4
DZSALLONANCE OF DEDUCTZONS AND ASSESSMENT OF TAX
ESTATE OF Z/MHERMAN GEORGE R FZLE NO. 21 01-0005 ACN 101 DATE 11-22-2004
TAX RETURN NAS: ( ) ACCEPTED AS FZLED { X) CHANGED SEE ATTACHED NOTZCE
RESERVATZON CONCERNZNG FUTURE ZNTEREST - SEE REVERSE
APPRAZSED VALUE OF RETURN BASED ON: ORTGTNAL RETURN
1. Real Estate (Schedule A)
2. Stocks end Bonds (Schedule B)
:5. Closely Held S*ock/Partnarsh~p /ntarest (Schedule C) ($)
~. Mortgages/Notes Receivable (Schedule D) (q)
E. Cash/Bank Deposits~Misc. Personal Property (Schedule E)
6. Jointly O~nad Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
O0
278 54
O0
O0
O0
O0
O0
(8)
NOTE: To insure proper
credit to your account,
submit the upper port/on
of this form ~ith your
tax payment.
278.5q
APPROVED DEDUCTXONS AND EXEMPTZONS:
9. Funeral Expenses/Ada. Costs/N/sc. Expenses (Schedule H)
10. Debts/Mortgage LiabiXitias/Liens (Schedule Z)
11.
12.
15.
lq.
NOTE:
338.54
(9)
(~0) .00
Total Deductions (11)
Net Value of Tax Return (12)
Charttmble/Governeental Bequests; Non-eXacted 9115 Trusts (Schedule J) (15)
Net VmXue of Estate Subject ~o Tax
If an assessment ~as issued previously, lines 1~, 15 and/or 16, 17, 18 and 19
reflect figures that lnclude the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Aeount of Line lq at Spousal rate
16. Aeount of Line l~t taxable at Lineal/Class A rate
17. Amount of Line lq at Sibling rate
18. Aeount of Line lq taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDZTS:
PAYHENT RE~CEXPT DISCOUNT t+J
DATE NUMBER /NTEREST/PEN PA/D (-)
338.5~
60.00-
.00
60.00-
wlll
XF PAZD AFTER DATE ZNDZCATED, SEE REVERSE
FOR CALCULATZON OF ADDZTZONAL ZNTEREST.
(~5) .00 x O0 = .00
(~6) .00 x 06 = .00
(zT) .00 x O0 = .00
(18) .00 x 15 = .00
(19)= . O0
AMOUNT PA/D
TOTAL TAX CREDZT I
I
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
.00
.00
.00
.00
( XF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS RE~UZRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDZT' (CR)~ YOU NAY BE DUE
A REFUND. SEE REVERSE SZDE OF THZS FORM FOR ZNSTRUCTZONS.)__)
INHERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
PO Box 280601
HARRISBURG~ PA 17128-0601
DECEDENT'S NAME FILE NUMBER
Zimmerman, George R. 2101-0005
REVIEWED BY ACN
Daniel Heck 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
Reduced to $278.54. Family exemption can only be claimed against assets subject to will
H B-3
or intestacy.
ROW Page 1
STATUS REPORT UNDER RULE 6.12
Od¸
Name of Decedent:
GEORGE R. ZIMMERMAN
April 27, 1992
Date of Death:
Will No. Admin. No. 2001-00005
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:
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: December 31, 2004
3. If the answer to No. 1 is Yes, state the following:
Did the personal representative file a final account with the Court?
Yes No
b. The separate Orphan's Court No. (if any) for the personal
representative's account is:
Co
Did the personal representative state an account informally to the
parties in interest? Yes No
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.
Signature / /" /
Gary L. Jame.s; Esgfi)ge .
JMES, SMITHyrgETTERICK & CONNELLY
134 Sipe Avenue~,,~ ~---.
Hummelstown, PA 17036
(717) 533-3280
Capacity:
Personal representative
Counsel for personal representative
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
GEORGE R. ZIMMERMAN
Date of Death:
April 27, 1992
Will No. Admin. No. 2001-00005
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:
State whether administration of the estate is complete:
Yes X 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:
ao
Did the personal representative file a final account with the Court?
Yes No X
b. The separate Orphan's Court No. (if any) for the personal
representative's account is:
Co
Did the personal representative state an account informally to the
parties in interest? Yes No X
Date:
do
Copies of receipts, releases, joinders and approvals of formal or
informal accounts may be filed with the Clerk o~1~ the Orp~tns' Court
and may be attached to this report.
Signature // 1'
Gary L. Jan;les, F_]squire
j X ES, s/CgrJ, r EmCr & CON- LL¥
134 Sipe A'x, ffv, ue~
Hummelstown, PA 17036
(717) 533-3280
Capacity:
X
Personal representative
Counsel for personal representative