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HomeMy WebLinkAbout04-0419 Estate of fYla.1'1 tv.;n t:Jorr:=- also known as PETITION FOR PROBATE and GRANT OF LETTERS 21-01-119 No. To: Register of Wills for the , Deceased. County of c........"'1.b e..r\ CL~ in the Social Security No. I, Lf, .2A> - 8 (g c.o" Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: y our petitioner~, who is/'Me 18 years of age or older a<<-the execut fN" named in the last will of the above decedent, dated S .p~ _ If, ~ 0 ,~_ and codicil(s) dated ~od 5 ~e. (1. ~~~ r->d' W ~J ~ r:Qc:t. tS- ~l>, / ( (state relevant circumstances, e.g. renunciation, death of executor, etc.) Oecendent was domiciled at death in he..(" Oecendent, then '{ '" years of age, died ;:r fJ n ' { / to , }.j ..2. 00'1, at c;, .,. e~,,- R ,'lit L V,-( I ~- . Except as follows, deceaent 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: ~~ Oecendent at death owned property with estimated values 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: .u:> I3r;&\eu..J~ f(~{ AJ\?uJlri\IL ;2 ( tJtn.:::> , $ $ $ $ fO'J,lff'O I 2-<fr "780 request(s) the probate of the last will and codicil(s) -t-e<;;+.s OM "E"nk...y (testamentary; administration ct.!) li<!ministrat!on d.b.n.c.!..,\.) .;:;,; (I' 0 ;'" =5 -- J::::,. C'" WHEREFORE, petitionerW----respectfully presented herewith and the grant of letters theron. ~ " ;e ;:; ~Z " ~ 0::" c: ,,0 C"'= ~.= ~<lJ ~o.. V:"'-' ;:; 0 C;; c: OJ) Vi ltikL '2",,',..12., ~ o ~ f'\ ~,-. '<-/<. "" 0 c.:rr e--- " ~1? ,of" eaSCitt1' Dr,'(/'e Af~~ (~ fA '70(:] / = W :::0 r-.J OJ U 1,.,..1 -.j OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA I s'" COUNTY Of' c.UiY\ 13 l?Rk-,:r-N [) f ~ 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 represen- tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. swor.nto or affirmed and subscribed 1 \\ ~ [~L ~ Vl before,p1e this __2... '? day or..., =JJ ,}Q' A V I~ I L ...t<1 2-0 u. ~ ~~~~~~ I No. Z/-04- 4/DJ Estate of V\!l rrR'1 \f\J. YV\ UORE.. , Deceased DECREE OF PROBATE AND GRANT OF LETTERS M) ZB 1001 AND NOW n r R I L --l4'_, 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 q ~,,~ -00 described therein be admitted to probate and filed of record as the last will of rYIA 1<'--1 W, YY\.QDRE: and Letters TE-:.S- ~l?N TPrR>1 are hereby granted to 0Dt-h\.\ l?R lCK. rYllfVP--.C FEES 2. 35. 00 -30 .00 (P.OO Probate, Letters, Etc. ......... Short Certificates( ).......... Renunciation ................ :::ref ~. $ $ $ $ I o. O'l:) TOTAL _ $ ~r/. 00 4 N.Hanover St, Carlisle,PA 17013 ADDRESS Filed 717-243-4574 PHONE YJOJ~ ~I~ j,r ~ ~d~r:J1WJ'U- ~!Jiv l' l~D<J . H105.ROS REV ll/~f, This is to certify that the information here given is correctly copied from an original ce~ifi~~te of death du~!'. filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records OffIce for permanent fIlIng. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 No. 1\..... t.\. ~~.. J,.~ Local Registrar p 10328877 APR 2 7 2004 -rx- ~ :-t_~-~~----i\.--'----;;-- --- ~l.~,--_Jl---=-_<1~='l~_ ,...., ,.. ...';11... =: {!"\ :::l- r- Date g = W :::0 N OJ U I..JJ -...J H105.143.....2117 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH lINT -EMT iNK NAMEOfDECEDEOITlF""""""'''Mary W. Moore ,. -(\.aII_ 76 UNDER , YEAR - Ooyo I.INXR t OAr ~! """".. STATE '1lI MJMU:A SEX SOCIAl, SECURITY NUM8E:R ..Female 3. 388 _ 64 _3643 v". PlACE OF DERH fCt>eck 0f'Ily 'lr'e - 'SIN ".rUCloMl on 0It'ttI ... HOSl'tlAL _...0 . COUNTY Of DERH c4l . Cumberland DECEDENT'S USUAl OCCUIWION ....:=:.-:o c:.-::~"j' ,OffIce Manager "~ -S--_S8_~._ZO~ . 20 Bridge Water Rd. Newville PA 17241 ... Ml>tElrSNMlE_ _...., , Carl Wiser Sr. ----(T_ Kurt Dennis Moore MET>tOO Of 0ISP0SIfj(jjj . 0 _0 c-...[:J --_0 - 0lIw_ " ~'--'SE ... w.u DECEDENT EVER IN u.s. AAMEOFORCES? .... 0 ...u DECEDEOIT'S ACTUAL RESlDE_ .......... an__ 11..81_ PA _swus._ --- Wi8OW'~ I.. I~""'__" -- (I...... ~maoen nemet 12. 1710. Old - _... Cumberland -' ,Hi] ::"'''':':'::'.. MOTHER'SNMlE(f,,__,_~ ,t. Ollie Clu ston "'ONWIT'S__S8_~_.ZO~ ~1020 Green Spring Rd Apt 3 Newville PA 17241 Pl.ACEOfDlSl'OSmON'_..c:--.c._ ~'fibi1--~eo. 8r11nger Crematory t. Hot706SPrings PA 210. 2t.. Home Inc 15 Big Spring Ave ..... /tJ ~(X)1.f ~ ,- :=--= I I I MIlT I: 0IMr IiQnIIcanI concIIiaN........ ....... bull ............1n1N ~ca.....in AUn' I. { : DUE lOlOfl AS ACONSEOUENCE ~ WIlIlE AU1I:lP$Y'1NOlNGS MANNER Of DEATH -....a.E PtlIOR 10 ~ COW\ET1ON Of CAuSE - - HorniCidl No~ - 0 ,,",-_Ian ...0 - 0 Coutd nof blI ~."'**' ORE OF INJURY 1_.,,",,_1 TIME OF INJUAY INJURY iii 'NORK7 DESCRIBE HOW IMJUAY ClCCURAEO. ~ _0-__ ~""'1IMYSICIAIlI ~cerw,.ng c:a....d dMI'I....... ~ pt'lnc.-n,,- pronouncecl de.'" anoCClr\"lCllllle..... 231 ..........,.,-...........occurrM.........C*IM(.,IIndMaftfMf................................... ............... ............ ... o o o PlACE: '" IN.AIRY. AI honMr.Ianft....... e.c..y. aMct II. -....- ... .... 0 NoD -IllAMINeIllCOlOONER On lite..... oI...........1on MdI-lnYeltigatioft.1n my optnton, cte.n. OCCU,," allklime. d.te, and place, Met due 10 the c"Mfl) Met J1.........It~ed.................... ._.. .... .... ......................................... ....... .................. AEGtST'RAA.S SlGNA1'UA€ AND NUM o 172..'<( 'PfIONOUNaHa AND cunnING Ptt1'SCIAN ~ baIh gronounclfl9 0HltI M'd '*"'yrtglOcause d 0UIh~ ............"'Y'knowIedgct. ....00CUffM.............. and plec.......... IOlhecMtM(.) and "'.nnw.. ................... ............. ~I(I~\IOI ... ~ ~ \J ~ \>v ~ .0 -~ ~ ~ ~ ~ r~ ..- Y'" ....J ", . __ JJ 1.'1-. r.. ,~-) Will c:5 .c. ~~ :T..J I Mary W. Moore of 20 Bridgewater Road, Newville, Cumberland County, Pennsylv~, declare this to be my last will and revoke any will previously made by me. -:J Item One: I direct that all my debts and funeral expenses including my gravemark~ shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. Item Two: I give, devise, and bequeath my entire estate to my husband Enoch S. Moore, Jr. if he survives me by 60 days. In the event that he predeceases me or is not then living on the 61 st day after my death, then I give, devise, and bequeath the remainder of my estate to my four children, equally, share and share alike, per stirpes. Item Three: I appoint my husband Enoch S. Moore, Jr. Executor of this my last will. Should he fail to qualify or cease to act as Executor, I appoint my son John Erick Moore, to act as Executor with the same rights, powers, and duties. Item Four: I appoint my son John Erick Moore guardian of any property which passes to any person under the age of 22 years and with respect to which I am authorized to appoint a guardian/trustee and have not otherwise specifically done so. Should he fail or cease to act as guardian/trustee, I appoint John H. Broujos to act with the same rights, powers, and duties. Guardian shall establish separate guardianship accounts and shall have the power to use income from time to time for the beneficiary's education, including technical and vocational training and graduate school, travel, support, and welfare without regard to his or her parent's ability to provide for such education, travel, support, and welfare, or to make payment for these purposes, without further responsibility, to the beneficiary or to the beneficiary's parents or to any person taking care of the beneficiary. Guardian shall administer the account until he or she becomes 18 years of age, at which time the guardian shall transfer the principal and income remaining in the separate guardianship account to my trustee, being the same person as my designated guardian, who shall then administer a trust account, of both principal and income and any other funds transferred to the accounts designated, for the beneficiary's education, including technical and vocational training and graduate school, travel, support, health, and welfare. When the guardianship or trust account is less than $5,000.00 or the beneficiary of the separate trust becomes 22 years of age, the share of the beneficiary remaining in the account shall be paid to the beneficiary in full and the guardianship or trust terminated. In the event of the death of any beneficiary after my decease and prior to reaching the age of 22 years, his or her share shall be distributed equally among his or her children, equally; otherwise to my surviving children or child to be administered in accordance with the guardianship and/or trust provisions. No interest under this instrument shall be transferable or assignable by any beneficiary, or be subject during its life to the claims of creditors. Guardian and trustee shall not be required to file accountings with any court. In the event that any provision of this will shall be interpreted to violate the Rule against Perpetuities, then the remaining provisions of this will shall not be invalid. Trustee shall administer the trust and dispose of assets so as not to violate the rule, making distribution as required to a life or lives in being plus 21 years. Item Five: All estate, inheritance, succession, and other taxes, imposed or payable by reason of my death, and interest and penalties thereon, with respect to all property comprising my gross estate for tax purposes, whether or not such property passes under this will, shall be paid out of the principal of my residuary estate, without apportionment or right of reimbursement. Item Six: I direct that my personal representative or guardian shall not be required to give bond for the faithful performance of their duties in any jurisdiction. Item Seven: In addition to the rights and powers given to the fiduciaries by law or elsewhere in this will, I give to my Executor during the full time necessary and for the administration of my estate the following rights and powers to be exercised in his or her sole discretion. A. To retain any real or personal property which may at any time form a part of my estate so long as he or she deems it advisable. B. To invest in any real or personal property without restrictions to legal investments. C. To repair, alter, improve or lease for any period of time any real or personal property and to give options for leases. D. To sell at public or private sale, for cash or credit, with or without security, to exchange or to partition, to mortgage or pledge real or personal property, and to give options for leases. E. To make distribution in kind. F . To compromise claims. IN WITNESS WHEREOF, I have hereunto set my hand this 8th day of September, 2000. Signed 7;t~1 {J~~<z- M W. ore l The preceding instrument, consisting of this and two other typewritten pages each identified by the signature of the Testatrix was on the day and date thereof signed, published and declared by the Testatrix therein named as and for her last will, in the presence of us, whpat her request, in her presence and in the presence of each other have subscri ur n s. ~"'') COMMONWEALTH OF PENNSYL VANIA ss COUNTY OF CUMBERLAND We John H. Broujos and To'(c..e Si-e-f+ , witnesses whose names are signed to the attached or foregoing instrument being duly qua~ according to law, do depose and say that we were present and saw the Testatrix sign and execute the instrument as her last will; that she signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; and that to the best of our knowledge, the Testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. Notarial Seal Bridget Ann Corcoran, Notary Public Carlisle Boro, Cumberland County My Commission Expires June 10, 2002 COMMONWEALTH OF PENNSYL VANIA ss COUNTY OF CUMBERLAND I Mary W. Moore whose name is signed to the attached document, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last will; that I signed it as my free and voluntary act for the purposes therein expressed. Sworn and affirmed to and aCknO~dged before me this day of September, 2000. -iU~f2J-"~A^- &CSZ/~ NOT Y PUBLIC .~ f{}.~(,- . .' oore, Testa 'x Notarial Seal Bridget Ann Corcoran, Notary Public Carlisle Boro, Cumberland County My Commission Expires June 10, 2002 CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Mary W. Moore Date of Death: April 16, 2004 Will No.: Admin. No.: 21-04-0419 To the Register: I certifY that notice of beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on July 16,2004: Name Address Karl David Moore 2024 Third Avenue, Apt. 518, Seattle, W A 98121 Enoch Stillman. Moore, III 606 Westwind Court, Woodstock, GA 30188 John Erick Moore 1128 Pheasant Drive North, Carlisle, P A 17013 Kurt Dennis Moore 1020 Greenspring Rd #3, Newville, PA 17241 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: none Date: July 16, 2004 \)~fJ>.~t,~ \;:uc.. Si!iiJ1;ture Name: Address: <. ~ John Erick Moore 1128 Pheasant Drive North Carlisle, PA 17013 Telephone: (717) 245-0347 I __-:J --) Capacity: Personal Representative f'-. COMMONWEALTH 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 NO. CD 004171 BROUJOS JOHN ESQ 4 N HANOVER ST CARLISLE, PA 17013 __n__n fold ACN ASSESSMENT CONTROL NUMBER AMOUNT ESTATE INFORMATION: SSN: 174-20-8666 FILE NUMBER: 2104-0419 DECEDENT NAME: MOORE MARY W DATE OF PAYMENT: 07/16/2004 POSTMARK DATE: 07/1 6/2004 COUNTY: CUMBERLAND DATE OF DEATH: 04/16/2004 101 I $4,500.00 I I I I I I I I TOTAL AMOUNT PAID: $4,500.00 REMARKS: CHECK#1007 SEAL INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WillS COMMONWEALTH OF PENNSYLVANIA *' DEPARTMENT OF REVENUE ~-,- " - - -- n ICE '--':,[-;<.::-- NOTICE OF INHERITANCE TAX BUREAU OF INDIVIOllAL' TAMES' INHERITANCE TAX DIVISION: :." APPRAISEHENT, ALLOWANCE OR DISALLOWANCE PO BOX Z606Dl OF DEDUCTIONS, AND ASSESSHENT OF TAX ON HARRISBURG PA 171Z8-06Dl JOINTLY HELD OR TRUST ASSETS REV-l548 EX AFP (03-05 zn" l""{ '0 P' 12: 38 DATE 05-23-2005 <.lU;,J H\ t..' ESTATE OF MOORE MARY W DATE OF DEATH 04-16-2004 CLERK OF FILE NUMBER 21 04-0419 Or.'-'W-"\i,n ('f llPT COUNTY CUMBERLAND r;l~; ,,-4,,~~} .J-.~ - ,-~~< j rl :~ ;'-)':' ',t ._' "- 'f-~- SSN/DC 174-20-8666 ENOCH ",. "S-HOORE J ACN 04125036 20 BRIDGEWATER RD I Mount R_i tt.d I NEWVILLE PA 17241 MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE _p ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ IlW-"1!,y'tr~".TGr-~'... ................................................................................ NOTICE OF INHERITANI E TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS, AND ASS SSMENT OF TAX ON JOINTLY HELD OR TRUST ASSETS DATE 05-23-2005 ESTATE OF MOORE MARY W DATE OF DEATH 04-16-2004 COUNTY CUMBERLAND FILE NO. 21 04-0419 S.S/D.C. NO. 174-20-8666 ACN 04125036 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED JOINT OR TRUST ASSET INFORMATION FINANCIAL INSTITUTION: PN( BANK ACCOUNT NO. 21001053717 TYPE OF ACCOUNT: ( ) SAV NGS ( ) CHECKING ( ) TRUST (Xl TIME CERTIFICATE DATE ESTABLISHED 08-22-j 996 Account Balance 2,079.49 NOTE: TO INSURE PROPER CREDIT TO Percent Taxeble y 0.500 YOUR ACCOUNT, SUBMIT THE Amount Subject to Tax 1,039.75 UPPER PORTION OF THIS NOTICE Debts and Deductions - .00 WITH YOUR TAX PAYMENT TO THE Taxable Amount 1,039.75 REGISTER OF WILLS AT THE Tax Rate y .15 ABOVE ADDRESS. MAKE CHECK Tax Due 155.96 OR MONEY ORDER PAYABLE TO: "REGISTER OF WILLS, AGENT." TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) INTEREST IS CHARGED THROU eH 05-31-2005 TOTAL TAX CREDIT .00 AT THE RATES APPLICABLE A 5 OUTLINED ON THE BALANCE OF TAX DUE 155.96 REVERSE SIDE OF THIS FORM INTEREST AND PEN. 2.88 TOTAL DUE 158.84 . IF PAID AFTER THIS DATE, SE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. . I IF TOTAL DUE IS LESS THAN: ' NO PAYHENT IS REIlUIRED. IF TOTAL DUE IS REFLECTED ,-A "CREDIr' I CR), YDU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FO FOR INSTRUCTIONS. ) Q"'~{.. UJ VI /) - , .0 \ - J;; - t .- \ .. ~ ~- ~ - ~ - 0 ('f"'t .- '" '-.J .. :;) -0 ..J 0 r- - r - - to 3 ..J '" , <", \ - l:) :c.-;i. , \ <1: ~: ,'. '. j LL C - -" i ':2 a.... ~;;\ - 'Cl - } ."" t ~ ..... - II, ' iil :~. lli ~ :J ill - .J - ~ r--.J .. V" '" UJ ..... .. cO ..) - II) \!J ~ ~ ~ o:i crJ \.U :> et. 0'- c:::J V (; ('.! ~6 v- !TI 0 ',}j() l":. t- UJ - ,- i':' r.:: C " .s:: as <( I') 0 en n- .,.., -:> (l'J ~7 I "~ () (!) "J . r- ' ~, r-.. ~n:. '..J .,.., ~w .-i ~ ('.J 0 'r- ~..- ...,.. ,. ..... < H Z <III >:;) ~Z >111 (I)> ZIII ffia: A. 1.1. 1.1.0 Ot- :z:Z t-III ~z: <t- ilia: ;s< ZA. 0111 z:A z: o U WZ Uo z .ex :J:.e 01-111 X :L.. I- .e.eoW 1-111 III HI-Ill WClZ.e !{Qi ~', I- .eoC;;~ 1-111 HWW ac=UIIII- ~ZlIIlIi: Z~.eO H9iCl II.-,.e-' O.e W "':c W "Ill> U I-.Z-, ;;!i5~1- 0,:1: }oOZ ZWUH Ifl:;)~ HCI .eW lIi:CI D. D.II. .eO III W X .e I- ~~ c;: :;)'" '" CI Ul co H'" I ~~ ~ ~~ ~ .............c COQ. lo.LIJ'" O~;;~ :;)~Niil .e"'XUl ~;:ii i~~~ :n co I .., co .... 3: Q. LJ.. .. X lJJ CO q '" ... I :> lJJ a< > l:t: c:z: ::E ...0 'tl Ll'l ~OICl...o III CI C1~Z...o :::: CI CI ~ < CO...o ... N NCI...III'o')S-t- ~w~~f5~~ ~ ~ Nl:t:~C1= IN... lei :E~~c: Ll'le~~~",~ :J C1:EClNU~C1 i .e :z: t- <a: 111111 ~AI ~ 1.1. :;) <eoz~g 1II1l(1II111Z' t-c~ t- ~ :;)'Z Z <-0<HO(l)U RM:! A 1.1. U, (I) < I,,_~:,- t1 c: ,,~ l:t: ., c:z: a.. Wcl l:t:l:t: e el:t: :Ew \- VI<C 3: W (!)W Cl...l .... ...I :J:l:t:.... U=> e 3: ZClW WNZ o t- t- Z III z: > < A. t- H z: III a: \-1'0') A VI~~ Z ...Ie", < ...I U ~ lII~e ~ U<C aa lL. a.. <eCl > z.. ~ l:t: <C u.' ... W ...I ...I :.: \- l:t: VI U VI W.... III .... = ...I :z: (!) z: l:t: U ~G(j III :.: < z: ~ ~ N '" ~ W VI ~ e :J: '0 ~ ;g ~ :s .... 19 ~ ~ 0 III .... t'1 ~ ., i III .... ~ .. 0 It n :s .. ;!. t Dl ., n 1<' 1/1 'j 0 ... 1D 1D " ... 9'- '" .... 3- ~. ... 1D ... ... 1D 0. ... ~ \" g- O 9'- ... 'tl 1D 0 'tl .., ., 0 1D II ., -@ 0 .... " .... .... ~ 0 ., " III 0 II 0 ~ ., ... ir .... ~. 1/1 ., 0 'tl 1/1 ... ~ ~ III ~ 1D .... n ... .... .... III n .... III 0 .... " 0 Dl " .... 0. ... ... 1/1 0 a c i 0 ... .... .... ~ .... 9'- ~ :L III .... .... ~ 9'- 3- '" III lC 0 ., .... c .... r- ., .... r- 'tl ~ ~ Dl n '" III .. .. .,., Ul Dl '" :::I :::I ~ .... 0. ;r t'1 1/1 g. ~ Ul 'It '" .... III Dl 'e. x 1/1 .. 'It n ., ~ 0 .. ... n lC .... .... t:l ~ 1/1 0 'tl ... ., .... .... 0 ::l 0 'It ;' 0. 0 '" .... " .... 9'- '0 III III 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 NO. CD 005430 MOORE JOHN ERICK 1128 PHEASANT DRIVE NORTH CARLISLE, PA 17013 ACN ASSESSMENT AMOUNT CONTROL NUMBER n_nn_ fold --.------- -------- 04125036 I $158.84 ESTATE INFORMATION: SSN: 174-20-8666 I FILE NUMBER: 2104-0419 I DECEDENT NAME: MOORE MARY W I DA TE OF PAYMENT: 06/14/2005 I POSTMARK DATE: 06/13/2005 I COUNTY: CUMBERLAND I DATE OF DEATH: 04/16/2004 I I TOTAL AMOUNT PAID: $158.84 REMARKS: CHECK#1045 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX ZSD60l HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT *' REY-16D7 EX AFP (03-05) i I f:,; I?: ,2 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 07-05-2005 MOORE 04-16-2004 21 04-0419 CUMBERLAND 04125036 A.oLrtt Rem! tted MARY W n ENOCH S1'IOORE JR 20 BRIDGEWATER RD NEWVILLE PA 17241 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 for. with your tax pay..nt. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ................................................................................................................ REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF MOORE MARY W FILE NO.21 04-0419 ACN 04125036 DATE 07-05-2005 THIS STATEHENT IS PROVIDED TD ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMNARY DF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PRDJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 05-23-2005 PRINCIPAL TAX DUE: 155.96 PAYMENTS (TAX CREDITS): ~ PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 06-13-2005 CD005430 2.88- 158.84 TOTAL TAX CREDIT 155.96 BALANCE OF TAX DUE .00 INTEREST AND PEN. .28 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .28 . 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" ICRJ, YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/07/2006 BROUJOS JOHN 4 NORTH HANOVER STREET CARLISLE, PA 17013 RE: Estate of MOORE MARY W File Number: 2004-00419 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: 4/16/2006 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, J,~~~ /,' Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) H Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (71 7) 240 - 6345 Date: 3/07/2006 MOORE JOHN ERICK 1128 PHEASANT DRIVE NORTH CARLISLE ( PA 17013 RE: Estate of MOORE MARY W File Number: 2004-00419 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 If 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: 4/16/2006 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 ,~ Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: Cr'\(lr{~ W, (//I\{)C,(~, Date of Death: A p.ciJ ~l ~-) I'. 1)(t:>4 Estate No.: l~;< {- ()/t -O/{L1 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 ad~~tration of the estate is complete: Yes 0 No h6 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: < i luZ.lj 1 () 1 _~~)DO( , 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 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.pftheOrphans' Court and Q1ay be attached to this report. \"~, Date: April j.:--'), I S<CC L J,_.". .',} - Signature \ )t l/1 n f-L (" '; Name!l N.6r~h H(lno " (' ~)i- , C/trll~')l~ Pf\ ['10(~) I Address " /" '~ If i 7~_;J.-I-+ 2) .' 45 '7/-{ Telephone No. 0...._........:+..~. va.p a.... a .Y . n u......_...,,,.............l D 'O'..........'O{"1a......+I")+~"'I: TC>. Ll ~. \.d..;)VIJ.(.U ~'-\.I!-/1.\.I~\".IJ.u.u.I..l" \.I Ga''counsel for personal representative QJ Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: 1'\\ AiV{ \\.;. ,v\(.~O IU:. Date of Death: ;-\ 'Pi2. i L f G '2.(' ('\ 4 J Estate No.: 2.c04- 0(4 ,q 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 00 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: C.1"ILEr0!).'\I2.. ";'E::i ReF Leo t. 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 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 offormal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: 4/14 Jo(. I~' '.,,' '\\ S'" '-:;; lsu.cLI\ ~LcCu. eX t:-( J<'~ltJ EiOCiL J"lex,ru:: Name "'2'2, ?"'l(.,,\ ').<\ 1'--'\ Dll.. IV. Address C,~f2. U SLE . p,,-\ 170 t 3 I 111~~l4"; -U~4 7 Telephone No. 0.....__.....;+-".. r\7l D................,........".l DCIIo..........oro'O.....+I'l+;'r.o \....a.pa\.dLY'" .l.b J.. ......J..:)vJ.H.U J..'-'"'p1.v.;:JvJ.u,u.u".... o Counsel for personal representative ..." 'J\,}1-' j L,,~"!, /{ '\J ,../ STATUS REPORT UNDER RULE 6.12 Name of Decedent: Mary W. Moore Date of Death: April 16, 2004 Estate No.: 21-04-0419 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 [Xl 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: Januarv 16, 2007 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 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 Date: c. Copies of receipts, releases, joinders and approval of formal or informal accounts may. be filed with the Clef the 0 n.".. s' C~url2'aY be attached to thIS report. ) \ " \ , I ---,. July 14, 2006 I \ Signatur \ / John H. Brouios "-----" Name 4 North Hanover Street Carlisle, P A 17013 Address I .'-.~ 717-243-4574 Telephone No. Q7 ..~ ... (" .(. {lj -lnr son Capacity: 0 Personal Representative [Xl Counsel for personal representative /\ L-- Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (71 7) 240 - 6345 BROUJOS JOHN ) CJ ~; ) i; "-." Date: 3/26/2008 , ~ 4 NORTH HANOVER STREET CARLISLE, PA 17013 I',) ---1 " .} RE: Estate of MOORE MARY W File Number: 2004-00419 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 vJills a Status Report of completed or uncompleted administration. This filing lS due by: 4/16/2008 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, ~ ~.., "" < ~' A<~ . ~1.t;:?J t, '4Uii.JJ r~ ;u4E ,/' / 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: (71 7) 240 - 6345 Date: 3/26/2008 "'^-.'\ MOORE JOHN ERICK 1128 PHEASANT DRIVE NORTH CARLISLE, PA 17013 (\.) '-.1 RE: Estate of MOORE MARY W File Number: 2004-00419 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: 4/16/2008 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, H I'~ .,6'kh- '~ffi#JJjfJ;W~ / , Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF Cum her) c; J} J COUNTY, PENNSYLVANIA Name of Decedent: l1 dry ~ /'loa r:e Date of Death: /l;;r i / /~ /<007 File Number: ~ 00"// -00 ~/ .9 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 JKI No 2. lfthe answer is No, state when the personal representative reasonably believes that the administration will be complete: Lt)tiA;/\ 5;;< I~) mc~nths 3. lfthe answer to No.1 is YES, state the following: a. Did the personal representative file a final 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 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. Date lit/'/ I / )'2. cJtJ g { Signature of Person Filing this Form .., 'iV, Vd 1,......T"i ..,Ji "J1IJ lUI'I(\'~' C ,'\)\1-10'80 o ivJ ...),1 ..' jO )!,.tBl8 Capacity: ~PersonaI Representative D Counsel Johl1 H, J3rOlJ /06 Name of Persoll Filing this Form r- J _. I if Iv'ydh HOI1{l/Ct ~C:;if'cet- Address 'YJ ./J Cell !i:.5Ir:.~1 /" rt /7t1/3 //7- (~/I,.~-40 -7// Telephone L t'j :Zl Wd 9 I Hd~ enOl \; .", i ,,'-. ,-,H"I' I( ,,',', I -J'J':~ ..1./ \ .: ; "'\l i'-~, \ l-.\......i -1' ;__1.....1 \...._....~ t....J\....Ii....;~,'"',_j Form RW-10 rev. 1013.06 ~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 3/24/2009 ~~ ^' , - ~__~ _ ..~ BROUJOS JOHN - -- 4 NORTH HANOVER STREET ~ ~~~ CARLISLE, PA 17013 ..~ ': { ___ ~~_ r.~ RE: Estate of MOORE MARY W File Number: 2004-00419 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. A:~ 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 t~~~o (2) years of the decedent's death, shall file with the Register of Walls a Status Report of completed or uncompleted administration. Tlzis filing is due by: 4/16/2009 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, ~J ~1~~~ 'may {Jo'/ f ~ i~ ~i- . ~`~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court c~~ : File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 3/24/2009 c7 ''.~ _ ~_ S _ r1 ~ _ MOORS JOHN ERICK ~-~ _. `~ 1 i 2 8 PHEASAIvTT DRIVE NORTH ~ ~~ : CARLISLE, PA 17013 --`.~ -b:- --,.~ N RE: Estate of MOORS MARY W File Number: 2004-00419 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, 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: 4/16/2009 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, J,n} ~ J` 1 ~` ~~ ~\_.' Glenda Fanner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Via. ®.C. ~,%u~e 6.1? S'T~'~1JS ~P®~~ REGISTEROF WILLS OF Lk~7B~RC.~4-~t/„a COU?VTY, PE~,~tiS`~'LV~NI~ Name of Decedent: ~A/2 Y IN . ~O®k'E Late of Death: ~~i 2/L ~~ , -~~i ~ 7 File i'~Iumber: 2~ "~ ~' ~ 7 ~ ~~...-~..~.,++„ D~ n T' A„lo r; 1 ~ T ,-o„r„-t tl,a fnllntz~ina ~ziith ,-acriPnt to r.mm~letirn~ of the administratioII of tl.1e above-captioned estate: 1. State whether administration of the estate is complete :.................... []Yes ~No 2. If the answe>"is No, state when the personal representative reasonably believes that the administration will be complete: ~O rah ~~S - - 3. If the answer to No. 1 is YES, state the following: (~ No a. Did the personal representative file a final account with the Court? ....... i Yes 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 foi7nal or informal accounts maybe filed with the Cleric of the Orphans' Court and may ~-arched to this report. o~te ~~ICP~D y C''7 <_ ., ~ i ~ ~ ~_ i ~ ~-, . - to ~d _ cy.vT; __ .... ~ ~ ~ ~ d4.,• C~~I ' r. `'; IZ ~ . CL __ ~, o . o U rson Filing this FZfrm QPersonal Representative Counsel Nmne ofPzrson Filing this Form Address ~ft,~[-/S"G.€~ /~i~ /71/3 ~~i ~)~~3 - ys ~y Telephone rorni R61~-10 rev. I0Jj.06 IN RE ESTATE OF MARY W. MOORE DECEASED IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. Z I -C~- - Ut-E- ~~ TERM PETITION FOR CITATION TO THE HONORABLE THE JUDGES OF SAID COURT: AND NOW, this ~~'~ day of ~~,,,~~~ ~~ , comes the Commonwealth of Pennsylvania, by Robert Freedenberg, Deputy Secretary for Taxation, for Stephen H. Stetler, Secretary of Revenue, who avers: 1. That Mary W. Moore, deceased, (hereinafter referred to as "the Decedent"), died on April 16, 2004. 2. That a Petition for Probate of the Last Will and Testament and for Grant of Letters Testamentary was made by John E. Moore, Executor, (hereinafter referred to as "the Executor"). Letters Testamentary were granted to the Executor on Apri128, 2004. Attached hereto and made a part hereof is a copy of a document attesting to said date on which Letters were granted marked Exhibit "A." r-~ - - ~ ;; ~ ._~:; ~ r ~ E..__ ... .._, ~~ ~` ' 3. That on June 27, 2008, a certified demand letter was sent to the Executor, advising that the Inheritance Tax Return for the Decedent had not been filed. A receipt was signed and returned to the Department of Revenue. Attached hereto and made a part hereof is a copy of said letter and receipt marked Exhibit "B." 4. That as of the date of this Petition no Inheritance Tax Return has been filed by the Executor of this estate as required by Section 1736 of the Act of December 13, 1982, P.L. 1086, No. 255, (72 P.A. C.S. § 1736). 5. That under Section 2176 of the Act of August 4, 1991, P.L. 97, No. 22, (72 P.S. § 9176), the Secretary of Revenue is authorized to request the Court to issue a Citation directed to those subject to any duty imposed by the aforesaid Act, commanding such persons to appear and show cause why the requirements of this Act should not be met. WHEREFORE, your Petitioner prays your Honorable Court to issue a Citation upon the Executor, directing the Executor to appear and show cause why said Inheritance Tax Return in the estate of the Decedent should not be filed as required by law; and to further direct that the costs of this action shall be borne by the Execul~Qr. COMMONV~E~~,T~1O~ PENNSYLVANIA BY "1 ~ ~l Robert Free nberg, Deputy Secr ary for Taxation FOR: Stephen H. Stetler Secretary of Revenue COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF DAUPHIN Robert Freedenberg, Deputy Secretary for Taxation, for Stephen H. Stetler, Secretary of Revenue, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Petition are true and correct to the best o~ h~s~khpv~ledge, information and belief. Robert Freede berg Deputy Secret for Taxation For: Stephen H. Stetler Secretary of Revenue Sworn to and Subscr~i/bled 1 ~i- before e this ~ da Y of ~ ~~~g ~- C MO WE LTH OF PENNSYLVANIA Notarial Seal Sue E. Hetrick, Notary Public City Of Harrisburg, Dauphin County My Commission Expires Apr. 10, 2010 Member, Pennsylvania Association of Notaries Page i of 1 !:slate of ~ ~1Z`! ~ . ~ D-D ~~ , I)ece~sed Ilk:CRF.I:, Ui+ P~OBATF, ANQ GRANT OI: LETTERS ~(TUQ AN[.) NOW _ ~~ ~ ~- Z~ _.-#~ __;...,., in considrrotion of the ~ctition ort the reverse side hercpl, satisfactory groof harins been ptcscnted``llbefore me, IT 15 DLrGR~RD thal the instrumtnt(s) dated- W " SL_ d<si;ribccl thuein bG aJmitted to probate and filed of record as the last will of ...___ anti Letters ~E'~7~~"~7J T~-`-~ _....._~~. ~..................~_~._ _.~ arc hereby granted to ~~T ~V~~~ ~y~~~ ~,~..._,...._w..._..~,_..,.....,__ ~~.~t.d.~(,•~C~1~1-t c.c,~l~ .- Rq~sta ~~~~9cmt---.-~ ~l I ~~ ~ ~ t~e1=s z 35 ~ ~ ~ ~ -~. Pcobatc, Letters, 1?re.......... S ____ John- 6rau o~ ias i 6Z6 ___,, ...v, Shrrt Certificatca( ) ........... S. ~O .~ ~~ nrrOkrlr:Y ts+,~. ~. I.t~. No.> ltcnunciatlotti . . .......:...... S_......~?~_~ ~ t, tt.l{ano~er St ,-- Carli_p~e., PA_ 1701 ~ TQTA 1, S~.V Filed ...............................,... r1~-243-4574 PNONt' }~ , Page 1 of 1 PI:'I'I'i'1c)N i''t)R PR(3~3A'i'F and GRANT o~~ I~~;TTr:R~ l.•_~wte• of ~A r ~ ltl../fJ o.w r G.- _.._ _. Na. ~ f '~ ~ ~ '+' + 1 ~~ utso finoun a.t ,__....._....._._...__.__._._......_..,....-_.._._.___.._.. To: __:._..~..n.---..M~..........-..._____.__________...._...._.....______._ Rcgisttr of ~~fi#Is far the _._.._~ --___--- _., UttY'~vctd. ("'ottnty of ~u "sb!~!'.~_4 *,c~ in the Sveyu! Stcurlle+.Yo. ! 3_Y -_.•~-+t? ~ ~~ Cornmonwtalth of Ptnttsylvania fhc txtitian of the trndctsiggeei rrsprctfutly rcptcscnts that: Your l+rtitioncr~, >`•ho is/err 18 years of aga cx older a~#hrr c~xccut_K_...W_.___, ttnn-ed in the last will of tha Alive dcccdcm~ elated ~_ _...f~aat ,_--~',,- ~~' t' .-t4__---- and cc~iit:tt{s) dated ,~..._ ._ -- ----~- - . __ _..~ d~c~-~. x -------_ _w.........,.~ ~.~ ~.,..~.~..~,.~. _. ___._.._.~w_.....,..__.~.._......__ry~kart tck.ant nte~+rn~lanct+, t ~. ttntxtriltUon, +ttJ~t11 A~ tltti4eM, tlt.)'._~~J__._~_._.___ th~rndent N•as dotnicitcci at death in ~-~ ~ County, l'rnnsylvenis, with h.t?.f _____ fast farnily or principal resldcns~e at -. CL~ ~~.1_ 't~t-~~t i .t._T __ --__.-..____-- ----~-----_.____ Yea..~~~.__.~pcwT_...R_,,1f~~,,-_ll~..,~..~~~t~~. (riu carat, numt~ and m~~ru+Fa'+t~) ,Ut.df`art,. 1)cccncknt, tt,en _._ .._.~~...__._ years o! age, dircf _...._._._,______..____./~.~lr ~~ .__..~ ~_, ~'2 °S' + at ...__G.tr_s t..~-/~.e'ot_ _a,._Y.r.'tl.~at.~-.~. ~__.___ , Except Ai frtlle~v-s, etcec~rnt did not marry, Was not Jivurcetf and tHd nest Ita+•t a ihHct brain M aei+iptcd a11er cas~uli~rtl of the will utletrel fur preri.+itr; was nest Ihr victirn in rr Aitlini; ari-i H~as:tr~~rr ~acljutlictstc~i lkccndcttt at death auncd ptuperiy~ with estimated va#ucs as fo##nH•s: (If domiciled in I'a.i Ail persona# property 5......_._...~f,Q~~:,,,,.___-,_., (ir nul dornitilcd in f'at.i 1'ctsonal property !n Pcnnsyfvatna S._.___...._.._._.._._~___... . (H not tlC+rnirilt~{ in f'a.) t'rtsunxl proprrtY ht C'uunty S_~.._.___.. __._.._ Vaiuc at' rral rstatc in #'tirnsy!>:•enia S.._.._____ situated as follows; ._._._14? -/~.L~.+~+~~.t~._~~~~t.l~~r._/V.4~.~_~.~ :}1_t,..,_.........._.._._L.~t.~r_7fi~_~ ~~'llrltl:F()Itl:, t*etitiorttt~,s?-tesrrcth-ny trqug~t(i) fife probate cs1 fife last +eiu :end refelicli(s) hresentr~l hctew~itlt and the gternt t>T Irttcrx_.__._~>i..a,,..~nf~.r..y..__...____..__,._.__._....... ____ ttexankre;tty; idminictrauun c t ¢) Gamin++assiun J.b.n c.t;a t tltrrern. i• ~ ~ ^_._..Gt...t>f..~ ~4.~~_n t ..~ ~,:trs ~St ~_ .T~>,~. ~ . . ....~_.._..~__... ._.._. __~ ~_. v ._. _. _.____..._,~...___V...._.._ __..~. _. ~_~..~._....__..__._..._.._...__..,_._..._ ~S.____._.._..._........ .f ..... . .. . .__ ._ _. .. ~.~. .._. . . . _ . . .. . , ..__......'b?&~.e!.7'~7b:?.- _ ~. a .~T:i~SFA.~'aB:n!:?r:~~: ~..s~.: •_:•:.:'.- __ _~..-..._ t.)ATH O~ Pk:RSO~A~.. IZ~:t'ItF;SFftTATIVI: .__.~ C't)11~lAiC)NlYt:Ai:l'tt rat" t'F:NNSYt.YAN1A ~ ~ ~~ C:()U M't'Y (]1' ._......C. t!lrYl ~ C't~1. t?-t~! n Tltc pctiliuncrls) nt~o+•c•nnntcJ s~t•car(s) of affirm(s) that the slzttrntcnts in tttt farcgain$ t~cttttcln art true ansi cctrrr~t t+~ ttta ttcsl ui tlrr krruwtr<tgr anef t~ciie(ta~f pctitic~r.e~r(st anti that ~~ pcnona) tcpa~sen- r;itisct+l r+l tNc :rhos-c cttct.tcri[ petiric~ntr{s) uiU ><~cli andnnerttlp adrrriniucr elte estate ;t«~ntdnt~ tr 1,1a•. ti-~nrrt to frr a(tirtned ar~rl eubeerityrd ~ .,_. t?~:~ ~ ~.~C_QG.....Y.`~.~*e.~~.rL........ ~r ttiit+ r rte (ttii __-__~.Y. _... tta} cif .._ _..._.. .........._._. _.___._..__..._...-._-._-- •~. to ~ ~,~ t. _ .... _ .._ _..._~~_~.. G.t ._._.-~..__.._..__._._. ... - .._.__.._...._.....______.. •y (, / lt(~isti`r ~ iL1Ri~[.R13UR(i i)1.4TRiCi' OFFit'E WHERRY.9Q d k W.1I.NUT 91':S HARRl3HUR0 PA 1112R-0[Ol COMMON~4'CALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE RF.V-f+69F0 AF~(Dl-Ob) DATE: 6/27/2008 JOHN E MOORS 1128 PHEASANT DR N CARLISLE PA 17013 Dear JOHN E MOORS: Estate of: MOORS MARY W Date of Death: 4/ 16 / 2 0 0 4 File Number: 21 0 4 - 0 419 CCertified Mail-Return Receipt Requested) A review of Department records has disclosed that you are responsible fo~• the settlement of the above estate, or that you represent the responsible pasty. As of this date, you have failed to respond to prior contacts to resolve this matter. This is to again advise you that the above estate is in a delinquent status. According to Depaihnent records, as of this date, the estate is still. not settled. The Inheritance and Estate Tax Act mandates the filing of a tax return and payment of all outstanding liabilities by a personal :•epresentative of the estate oi• a h•ansfeiee within nine month of the decedent's death. The Depai•hnent's records show that this estate remains open because: AN INHERITANCE TAX RETURN HAS NOT BEEN FILED. If the retu~-:l has been filed, it is important that you contact us immediately. If this estate was opened for the purpose of filing a lawsuit, please provide this office in writing with the teen and docket number of the lawsuit so that we may postpone any further action. This notice shall serve as a formal demand on you oi• youl• client from the Deparhnent of Revenue. If you fail to file the return, the Deparment may institute legal action requiring you to appear in court to show cause for youY• failure to comply with the laur. A finding of contempt in this tnatteY• could subject you to additional penalty and/or incarceration by the Orphans' Court of Cumberland County. RETURNS SHOULD BE FILED AND C~IECKS MADE PAYABX.,E TO: REGISTER OF WILLS, AGENT Any questions regarding this estate, please CONTACT: Sincerely, Anastasia DiBartolomeo HARRISBURG DISTRICT OFFICE 1717)787-3863 STRAWBERRY SQ cc~ 4TH & WALNUT STS JOHN H BROUJOS HARRISBURG PA 17128-0].01 4 N HANOVER ST CARLISLE PA 17013 ~IRI~-8 d' ; • a ~;, K ' !~ i~, ~.~. L ~, ~•"~ 3' ~ :: ~~i=='= J' . ~'~ ~':. '+';~ . r ~. ~- . :~,:~ . .. Y. ~: ~>,.~ ~'; :''. '~' ~.~ is ; ; ~' ~~;:. °' {,l.: ~1 .i?i ~;..''..~ ': ~ ' t:.~~:~..:...: . 3...; }fix ~ r. ;. 4::::. F' .: . ~;~.. Y ~: ...:,. ~s . ,,::- s,;, ~v%`° :7~ %.:. ~4~... N,fi.: . [.}.;; '. CX:::.. . ~~'.:: ~::~ C'~': ,' . :' C :::': ~~':' 'r {{..;.;. . P~:. ~~ r~ ~~ .. ', /$(~ 14i::`~' ~'.. k,, kC: gtr`;:. :a_` N ~ ~' ~ j 1 ,~ z .... N ~V O o 3 ~ 0"' A ~ o aoi :, .. 0 '- ~o ~ ~ i Q -~ ° to DDC ~ ~ ~ ~ o o ~ ~ v ~ ~ ~ ~ ~~ o ,~ -` a ~ .. .~ ~ ~ J ...~ n '^~ ~ z ~ a ^ . ^ `: ~v ~ ~ ~~ 3 ~I~~ ~~ , r ~~ o Dv'O ~ ~ ~'~ ~ ~ 1 ~ ~ ~ ~ ' O w. Q WZ ~y-t M ~ Al.~~ ~~~ O c4 cD c~ ~ rn ~~ a ~ ~ w ~ ~ ~ ~ ;; °~ ~~ d ~ ~ ~ f W ~[ ~ ~, ~ . ~G~ ~.~ • 1) ~ ~ I ~ I ~iwt ~ I N R E ESTATE IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA MARY W. MOORE ORPHANS' COURT DIVISION DECEASED NO. 2 ~ -Cu-! -1,~~-} Irj TERM ORDER Now, to wit this the (~~ day of ~vl~ 2 obq ,upon consideration of the (J i l foregoing Petition, it is ORDERED and DECREED that YOU, John E. Moore, Executor for the Estate of Mary W. Moore, deceased, are hereby cited to be and appear at Courtroom No. ~ , on the S~, day of ~024~'i~a~the Courthouse of Cumberland County, Pennsylvania, at % = ..3d .M., then and there show cause, if any there be, why the Inheritance Tax return in said estate should not be filed; and to further direct that the cost of this action be borne by the said Executor; said citation returnable at ~ =~~v P .M., on the S~- 20 ©~ day of .y,~~~ ~--~ c=n ~. -~:~ ,_~ ~:~ ~-'~ -- :: -; ~-- ~- , -, '; ~,~ ";,; {: :~-, rti~ ,_.. ~: v RY THF. C' (~T TR T I N R E ESTATE IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA MARY W. MOORE ORPHANS' COURT DIVISION DECEASED NO. Z ~ ~-C:.'-4- - C?~-} ~~ TERM PETITION FOR CITATION TO THE HONORABLE THE JUDGES OF SAID COURT: AND NOW, this ~~'~ day of ~y~~~. ~~ comes the Commonwealth of Pennsylvania, by Robert Freedenberg, Deputy Secretary for Taxation, for Stephen H. Stetler, Secretary of Revenue, who avers: 1. That Mary W. Moore, deceased, (hereinafter referred to as "the Decedent"), died on April 16, 2004. 2. That a Petition for Probate of the Last Will and Testament and for Grant of Letters Testamentary was made by John E. Moore, Executor, (hereinafter referred to as "the Executor"). Letters Testamentary were granted to the Executor on Apri128, 2004. Attached hereto and made a part hereof is a copy of a document attesting to said date on which Letters were granted marked Exhibit "A." ~ -~, . =rte -e..s~. -- `~ :.,' ~ :L? .F~ .~ s 3. That on June 27, 2008, a certified demand letter was sent to the Executor, advising that the Inheritance Tax Return for the Decedent had not been filed. A receipt was signed and returned to the Department of Revenue. Attached hereto and made a part hereof is a copy of said letter and receipt marked Exhibit "B." 4. That as of the date of this Petition no Inheritance Tax Return has been filed by the Executor of this estate as required by Section 1736 of the Act of December 13, 1982, P.L. 1086, No. 255, (72 P.A. C.S. § 1736). 5. That under Section 2176 of the Act of August 4, 1991, P.L. 97, No. 22, (72 P.S. § 9176), the Secretary of Revenue is authorized to request the Court to issue a Citation directed to those subject to any duty imposed by the aforesaid Act, commanding such persons to appear and show cause why the requirements of this Act should not be met. WHEREFORE, your Petitioner prays your Honorable Court to issue a Citation upon the Executor, directing the Executor to appear and show cause why said Inheritance Tax Return in the estate of the Decedent should not be filed as required by law; and to further direct that the costs of this action shall be borne by the COMMONV~E~~,Tf~~O~ PENNSYLVANIA BY Deputy Secretary for Taxation FOR: Stephen H. Stetler Secretary of Revenue COMMONWEALTH OF PENNSYLVANIA ss COUNTY OF DAUPHIN Robert Freedenberg, Deputy Secretary for Taxation, for Stephen H. Stetler, Secretary of Revenue, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Petition are true and correct to the best off h~s~k~pv~ledge, information and belief. Robert Freede~berg Deputy Secret, for Taxation For: Stephen H. Stetler Secretary of Revenue Sworn to and Subscribed <- "~~- before me this f / day %~ ~;~G~~t% ~~ /~ T- COQ 1MONWEALTH OF PENNSYLVANIA Notarial Seal Sue E. Hetrick, Notary Public City Of Harrisburg, Dauphin County My Commission Expires lapr. l 0, 2010 Member, Pennsvh.~ania .association of Notaries Page 1 of 1 N~.._ ~i o~ ~ r ~.~.. Ls1~fe of M~~y ~ . MU-~ R~ , Deceased 1)k:CREF. OF PROBATF, AI'~ID GRANT OF LETTERS ~,{~ p zvv9 ,~~p hyptti~ _ r3f I'~ I L ~U _ __-~ _~~_., in cansiderdtion of the Ixtition nn the reverse sldc hcrtat, aatistacrory proof harlne bec~~n,"pt~~cppse__nl~~eJd~before me, IT IS D~CR~t~D that the instrumrntts) dated C'-~"0 ~"~_ _ descrilsed ihotsin be admitted tv proba-c and fired of record as the tasl x[II of __. _. and t_cUCrs ! ~. arc hereby grarsted to l~ t~f~~s z35 tX~ Probate, Letters, fllc..... .. .. S Shaft Ccrtificalca( ) ....... _ . S_ 3y •~' Itcntlnclation . . .......:.... .. S__~___p TbTAL _ S_~~L• ~U 71]-`1.-41-457G I%i left .. .-..._, ., ,..: ~....~_ z,.:..„._. PHONk ~, jl ~t''4, ~ ~ ~ ~ ~ ~ tt~~l.~L. )rl, y~ t~'C~-~/ 6(. try'' ~, , 4 N.Ilanoyer St,__Carlf_@1e~PA_ 1701a ADDRF!il' _~ Pale 1 of 1 PI~;7'I'I'I(}N FOIL PR()13A'I'1? and C:RAN'T /OAF I.f';^T'rr);Rs l:+rurr• aj !~? a ~ lt~ /yl o.? i- G-, _ . _ _._- , ln. --- ~ ~ 'r V ~ ' " 1 ,! ~f y--_ . - -- ___ - .__. _.-______._ .__.____.__ Register of Wills for the Utrasr•d. ('omuy of Cu~tb~.-la.,a~ in the Sut-1ul SctuN(r rvo. / ~_Y -__a~ =~~ Comrnonx•caph of t'cnnsyh~ania the petition of the nndetsigned r<spccttulEy represents that Your prHtioncr(s~, xho is/ere 18 years of alts or older afftlhe exc<ut M...-__~ _,~-_~ rtxnud in the last will vi the iabore tlc:edtnt, t4ltotl _____~_~__ _-,F•~ya~ -__~r_ 7~-s'+~ e~ , ~q_____ and ct+tllcit(s) dalyd ..-.____.____ --- ----_--.__._~a•~ ~G_ri.~----- tQalt rek:an! aanm!ianct+, c j, anuntilt~en, JtAtA n/ ntcu M~, tlt) U~titndtnt Nas domiciled nt death in (++~~ er-(~a Couury, Pcnns)iranis, with hr&~ ~ fast family or priricipr:l residen+~ al _C~r•~r~,_J_ 'L'V p.,L._i{x-t-sgre ,- _ r (tit! oral, n;tmbtr !lrtd to 1.Y.tI~C..r.~..~~ ~ -r .w.. ~i. Ikccn<tcnt, then _._ ._~~. __ yc;rs of age, dird _._._..._.__._.__.,__.iQ j>_rr ~~.___.~_~-_, Y~'2 at" , lixctpt as follows, dc:cdrnt did not marry, was not dlvirned and did not ha+c a rhltd born or ad4ptcd after r.+s.•s'utEun of the sill ulYrrrtl fur probate; was nut Ihr +icliur ul a Aill'tng and wa- nr+cr adjlutistdtcd incompetent: ___._ nr~p,, Dcccndent at death uuncd pnrpcrly with estimated vaAres as I"oliw++: (If domiciled in lsa.j Ali personal property b ._..-.~f .Q.:~„___,,_-_-___ (If not domiciled in l'a.l 1'crsonal prolxriy in I'ennsyiranta S___.._.___._-__-_.___ (1f trot dontlriicJ in f'a.) t'ersunxl property hr C'uunty 5_~ __ __._._ Vnluc of real cslntc in I'trrns)•Iwsrnra y--_ __- siluatcd as follows; .___-~f? ./9L.s~;.~_5~'n'_~Q~.IQdr._/Ve~•_~t :~I_~ ~ 19.3r_"f8~.__~ 'S'UGR(a~ORI:, trctil(Vnti~Yitll`Cttfolly rC'tlU@5l(1) the probate of the 1i31t ++111 ;rnd trodis-II(s) prrsentcd herewith and tic grant of letters-.___~~x~,,~nfd.r_y ___.____________._,___ (lncanxnemy: aJrrinnunuon c t Q'.}!>Imin;xra<~ion J.b.n e.t.a r thcrun. / ~a Z Y fj~ ~ ~ ~.~ y( F F t.t_i i' ~ea.~~r+t.Iyr-.v_<_.1SlQr.T~~ .1 .~.~ OATH OF Pr;RS01~'A1. I2El'Rr;SFNTATIV!'s GC)111MON1V1?A1:1'!I C)1~ 1'F:NN~YI.VAAr1A ~ ~~ C:C)UN"I'Y UP .-__„CI.LrYI F3 C_t71_t1`t.l fl._ ._.:_~._ fhc petitioner(s) ntx»•c•nnmcd swear(s) or affirm(s) that the stattntcttts in the foregoing Itehttort are tore and conrtt us the best at dtt knuwlc<tgc pod trrti<( of pctitinr.cr(s1 and chat a~ personnl rcpr~•scn- rati+clsl ut the shoat dtctdcnt txtitioncr(s) will well and truly edarinivrr the t•stprc arroubrsg to Imv titsnltr t0 frr affirmed and subscrihrJ __ ~r- ~ h~C44_ Yy1+?~ ~r~- . ._ ,i, hc•[ss c nc thi; _Z.Y day of _ __-- n --- - --- ..-. t r~}t,16~'~7~f..t-ftCj~,~ xt'1rJsrr•r COMMONV~'EALTH OI' PENNSYLVANIA tuRKtstJtJRCO>,srRtcroFrtce DEPARTMENT OF REVENUE SCR.\\VOPARY ~A 4TH do WAt.HUT 'TS HARR15tJEJRG PA 1712RAt01 RF.V-Rb9F1J AFp (01.06j DATE: 6/27/200$ JOHN E MOORS Estate of 1128 PHEASANT DR N MOORS MARY W CARLISLE PA 17013 Date of Death: 4/16/2004 File Number: 21 0 4 - 0 414 Dear JOHN E MOORS: (Certified Mai].-Return Receipt Requested) A review of Department records has disclosed that you are responsible far the sett{ement of the above estate, or that you represent the responsible party. As of this date, you have failed to respond to prior contacts to resolve this matter. This is to again advise you that the above estate is in a delinquent status. According to Department records, as of this date, the estate is still. not settled. The Inheritance and Estate Tax Act mandates the filing of a tax retu~m and payment of all outstanding liabilities by a persona( representative of the estate or a transferee within nine month of the decedent's death. The Depa2-Unent's records show that this estate remains open because: AN INHERITANCE TAX RETURN HAS NOT BEEN FILED, If the return has been filed, it is important that you contact us immediately. If this estate was opened for the purpose of filing a lawsuit, please provide this office in wrtdng with the term and docket number of the lawsuit so that tive may postpone any further action. This notice shall serve as a foi7nal demand on you or your client fiom the Department of Revenue. If you fail to file the return, the Department may institute legat action requiring you to appear in court to show cause for your failure to comply with the law. A finding of contempt in this matter could subject you to additional penalty and/or incarceration by the Orphans' Court of Cun-berXand County. RETURNS SHOULD BE FILED AND CIIECICS MADE PAYABLE TO: REGISTER OF WILLS, AGENT Any questions regarding this estate, please CONTACT: HARRISBURG DISTRICT OFFICE (717)787-3863 STRAWBERRY SQ cc: 4TH & WAi.NUT STS JOHN H BROUJOS HARRISBURG PA 17128-0101 4 N HANOVER ST CARLISLE PA 17013 Sincerely, Anastasia DiBartolomeo ~a~r- ~~. ~~ ~;..:. ~> . ~;; ~`"' dlu s ~~ t' ~'~, s=., ~;.~ i '; t\' ~'- ~;: .} ,,.; ~ Y,, v 0 W OC 0 °a o~ m N n m c 3 m A a a N 3 0 N -' ~ ~ ` ~ ~' D '' O ~~z D j ism ro co ~~~ a O DDO ~~qa ~i ~ p W O '-0 o a z m O N ^ ^ ~ ~ ~. ~ ~a~ m ^oo ~~~ ~ o~~ ~~ w v O m ~ ~ a e ^ M ^ O D(n -pin ~~°~.~o .-. ~ .-. ~~ .~ ~i;p~i `G A$ M m~gc`^,ro. y ~ 3 ~ ~ w~~~~3 =+; Q- ~ m ry~ rn w f~k1 ~ .-~ ~ ~ Af ~~i~?'ma ~~ ~'~ w oa vii ~~o ~ a~ 3°~m~~ acm•°-a -o ~ ~ A m ~ cD ~141T ~S. N ~. ro 3 3 ~ ~ ~. ~J d (lJ 0" R~ 0 t7 0 d 0 _n A ORPHANS' COURT-DIVISION COURT OF COMMON PLEAS OF In Re: MARY W. MOORS CUMBERLAND COUNTY PENNSYLVANIA NO.21-04-0419 CERTIFICATE OF SERVICE OF ORDER ORDER DATE: 08/11/09 JUDGE'S INITIALS: JWO TIME STAMP DATE: 08/12/09 IN RE: ORDER SERVICE TO: JOHN E MOORS ANASTASIA DIBARTOLOMEO METHOD OF MAILING: ® USPS ^ RRR ^ HAND DELIVERED ^ OTHER MAILED: 08/13/09 ENVELOPES PROVIDED BY: ® PETITIONER ^ JUDGE ^ CLERK OF ORPHANS COURT SERVICE TO: JOHN BROUJOS ESO METHOD OF MAILING: ® USPS ^ RRR ^ HAND DELIVERED ^ OTHER MAILED: 08/13/09 ENVELOPES PROVIDED BY: ^ PETITIONER ^ JUDGE ® CLERK OF ORPHANS COURT l rj i_ - ~fltl ~' Deputy Clerk Orphans' Court REV-1545 FO (6-05) DEPARTMENT OF REVENUE BUREAU OF COLLECTIONS & TAXPAYER SERVICES ~,DATE ``~ C7 ESTATE OF ~ '! ~, FILE NO ~,~~ ~ ~ ~ q ~~ - ~~ COUNTY NAME ~~ ~ti./ ,- x \~f'TATION ~ . '~~ ~" CONTROL VOUCHER (ORPHANS' COURT OFFICE) DATE FILED ~~\~~\~ ITEMIZED COSTS: HNYFiVVtU aun~ u yr ~.r-i -~ ---''"`._ TOTAL'?. ~'~ ~~ - it O 'ICE REVENUE RECA ATURE. CLER 'S; S G ATURE ~~~,,,,,:` ___.. -.. _.__~ _ REGISTER OF WILLS - EST T FILfE_~/ ~/~} ~'~"~„ REV-teoo Ex. (GOO) COMMONWEALTH OF REV 15 0 0 OFFICIAL USE ONLY PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RETURN FILE NUMBER DEPT. 280601 HARRISBURG, PA 17128-0601 RESIDENT DECEDENT 2 1- 0 4 0 0 4 1 9 NUMBER COUNTY COUE YEAR DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Z MOORE, MARY W. 1 7 4- 2 0- 8 6 6 6 U.1 ~ DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Year) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE W REGISTER OF WILLS U 04/16!2004 07/09/1927 Q (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER w - a 1 Original Return ~ 2. Supplemental Return ~ 3 Remainder Return (date of death prior to 12-1382) t Q ~ a v ~ 4. Limited Estate ~ 4a. Future Interest Compromise (date ordeatn otter f2-fz-azl ~ 5 Federal Estate Tax Return Required v a m ~ 6 Decedent Died Testate (Attacn copy of waq ~ 7 Decedent Maintained a Living Trust (Attacn copy of Tnist) 1 8 Total Number of Safe Deposit Boxes a a ~ 9. Litigation Proceeds Received ~ 1 O Sp0US8l POVerty Credit (date of death between 12-31-91 and 1-1-95) ~ 11 Election to tax under Sec. 9113(A) (Attacn set, of THIS SfGTION'MUST BE COMPLETED. ALL CORRESPONDENGE'AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED'TO: F w NAME COMPLETE MAILI~dG ADDR ESS °z JOHN H. BROUJOS, ESQUIRE 4 NORTH HANOVER STREET Oa FIRM NAME (If Appfcable) w a p TELEPHONE NUMBER 717-243-4574 CARLISLE PA 17013 OFF,1 AL USE ONLY' 03 780 00 1 Real Estafe (Schedule A) 1 O } ,~ , _ _,.~ , . 1 ~,' - ~~ 2 Stocks and Bonds (Schedule B) (2) l 2,573.76 ; ' --~ •_, ~ , , -~. ~ i-? 3 Closely Held Corporation, Partnership or Sole-P roprietorship (3) ~ ! ~ ) `~~ 4 Mortgages & Notes Receivable (Schedule D) (4) ~ ` I I - ? - --- - Z Q J H a Q U W Z ~_ H H a O U X Q F- I o,~00. I r I 5 Cash, Bank Deposits & Miscellaneous Personal Property (5) ~ - _ _ (Schedule E) - Q 6 Jointly Owned Property (Schedule F) (6) CiJ Separate Billing Requested II 7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) _..j ~, _,_t ~I l Li s 1 7) t t A t G (8) 122,639.93 ne - a sse s ( o ross 8 Total 9 Funeral Expenses & Administrative Costs (Schedule H) (9) 15,754.00 10 Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 8°228'68 tal Deductions (total Lines 9 & 10) 11 T (11) 23,982.68 o 11) i Li Li 8 E (12) 98,657.25 nus ne ne m state ( 12. Net Value of 13 Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) lue Subject to Tax (Line 12 minus Line 13) t V 14 N (14) 98,657.25 e a . SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17 Amount of Line 14 taxable at sibling rate 18 Amount of Line 14 taxable at collateral rate 19. Tax Due 20 ~X • • ~ • • X (15) 98,657.25 X .045 (16) 4,439.58 X 12 (17) X 15 (18) (19) 4,439.58 > > BE SURE TO ANSWER ALL QUESTIQNS ON REVERSE SIDE AND RECHECK'MATH <'< decedent's Complete Address: STREET ADDRESS Green Ridge Village 410 Big Spring Road CITY STATE PA ZIP 17241 Newville Tax Payments and Credits: 1 Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments 4.658.84 C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty (1) 4 439 58 Total Credits (A + B + C) (2) 4, 658.84 Total Interest/Penalty (D + E ) 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. {3) (4) 219.26 (5) 0.00 A. Enter the interest on the tax due. (5A) B. 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 BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred :......................................................................... ^ b. retain the right to designate who shall use the property transferred or its income; ...................................... ^ c. retain a reversionary interest;.or .................................................................................................. ^ d. receive the promise for life of either payments, benefits or care? .......................................................... ^ 2. 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" 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 beneficiary designatian~ .................................................................................................. ^ No O ^X ^X 0 a 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 penalties of perjury, I declare that I have examined this return, incVJding accompanying schedules and statements, and to the best of my knowledge and belief. it is true. correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS fJbhn Erlck Moore, Executor, 1128 Pheasant Drive North _ ~arnst PA 17013 SIGNATURE OF PRE AR OTHE~TF{A R ESENTATIVE DATE ADDRESS 4 N~ h Hanover Street Carlis e PA 17013 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% 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 not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even 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 at death to or for the use of a natural 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 beneficiaries is 4.5°!°, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% (72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. 0.00 REV-1502 EX + (6-98) SCHEDULE A COMMONWEALTH OF PENNSYLVANIA REAL ESTATE INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MOORE MARY W. 21 04 00419 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defned as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real roe which is 'ointl -owned with ri ht of survivorshi must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t. Clean & Green Land. 72 PS 5490.1 ff. 2004 Appraisal: Clean and Green $103,780 103,780.00 16.76 acres. Over 60% wetlands-flood-plains. Including Two room house. Wood. 16.76 acres. North Newton Township. Assessment Preferred Land Value $5,140. Improvement value $98,640 2004 TOTAL (Also enter on line 1, Recapitulation) ~ $ 103.780.00 (If more space is needed, insert additional sheets of the same size) REV-1503 EX + (6-98) SCHEDULE B COMMONWEALTH OF PENNSYLVANIA STOCKS & BONDS INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MOORE MARY W. 21 04 00419 All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Prudential Financial, Inc. 56 shares Common Stock 2,573.76 TOTAL (Also enter on line 2, Recapitulation) I $ 2,573.76 (If more space is needed, insert additional sheets of the same size) REV-1508 EX + (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER MOORE MARY W. 21 04 00419 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH t. F&M Trust, 9 West Big Spring Avenue (amt w/d to start estate ckg.4.30.04) 4,812.42 Newville, PA 17241 Checking acct # 34-22038 2. Certificate of Deposit CCNB now PNCB, 105 Noble Blvd, Carlisle, PA 17013 6,373.75 #21001053717 $2,079.49 # 31300220640 $4,294.26 3. Household items: Three rooms with kitchen. Utencils, appliances. Tables. 750.00 In poor condition. No carpet on floor. 4. Vehicles -- "87 Impala Chev 150,000 miles, rusted out. 3 remaining Junkers 350.00 Not insured and not licensed. 5. I4 burial plots- Cumberland Valley Memorial Gardens, 1921 Ritner Highway, I 4,000.00 Carlisle, PA 17013 TOTAL {Also enter on line 5, Recapitulation) I $ 16,286.17 (If more space is needed, insert additional sheets of the same size) EV-1511 EX+(12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER MOORE MARY W. 21 04 00419 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. Egger Funeral Home, Inc., 15 West Big Spring Avenue, Newville, PA 17241 (cremation) 1,500.00 2. Terrie Wiser, Green Springs, Newville, PA 17241 -catered funeral meal 212.00 B. ADMINISTRATIVE COSTS: ~ Personal Representative's Commissions Name of Personal Representative (s) John Erick Moore Social Security Number(s)/EIN Number of Personal Representative(s) Street Address 1128 Pheasant Drive North city Carlisle state PA zip 17013 Year(s) Commission Paid. 2 Attorney Fees John H. Broujos, 4 North Hanover Street, Carlisle, PA 17013 g Family Exemption. (If decedent's address is not the same as claimant's, attach explanation) Claimant 7,oao.oo 7,000.00 Street Address _ City State Zip Relationship of Claimant to Decedent 4. I Probale Fees 5 I Accountant's Fees 6. I Tax Return Preparer's Fees 7. Register of Wills -Inheritance Tax Return filing fee 8. Register of Wills -Inventory filing fee 9. Register of Wills -Family Settlement Agreement filing fee 15.00 10.00 17.00 TOTAL (Also enter on line 9, Recapitulation) I $ 15,754.00 (If more space is needed, insert additional sheets of the same size) REV-1512 EX + (6-98) SCHEDULE I COMMONWEALTH OF PENNSYLVANIA DEBTS OF DECEDENT, IN RESIDENTED ~ DENTRN MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER MOORE MARY W. 21 04 00419 Include unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. PP&L 166.43 2. Swaim Health Center, 210 Big Spring Road, Newville, PA 17241 3. Continuing Care RX Medications, prescribed at Swaim Center 4. ~Kough's Oil Service, Newville, PA 17241 6,242.82 1,337.45 173.48 5. Stephen Harry Naugle, Loan to Decedent, 84 Long Road, Newville, PA 17241 ~ 280.00 6. Commonwealth of Pennsylvania, PennDOT, Vehicle Title Transfer Chevrolet ~ 28.50 TOTAL (Also enter on line 10, Recapitulation) I $ 8,228.68 (If more space is needed, insert additional sheets of the same size) REV'-1513 EX+ (p-nrn SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER MOORE MARY W. 21 04 00419 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE TAXABLE DISTRIBUTIONS [include outright spousal distribuiions, and transfers under I Sec. 9116 (a) (1.2)] 1 Karl David Moore son 1/4 2024 Third Avenue, Apt. 518, Seattle, WA 98121 2. Enoch Stillman Moore, III son 1/4 606 Westwind Court, Woodstock, GA 30189 3. John Erick Moore son 1/4 1128 Pheasant Drive North Carlisle, PA 17013 4. Kurt Dennis Moore son 1/4 1020 Greenspring Road Newville, PA 17241 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I $ (If more space is needed, insert additional sheets of the same size) Will I Mary W. Moore of 20 Bridgewater Road, Newville, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by me. Item One: I direct that all my debts and funeral expenses including my gravemarker shall be paid from my residuary estate as soon as practicable after my decease as a part of the expense of the administration of my estate. Item Two: I give, devise, and bequeath my entire estate to my husband Enoch S. Moore, Jr. if he survives me by 60 days. In the event that he predeceases me or is not then living on the 61st ~' day after my death, then I give, devise, and bequeath the remainder of my estate to my four ~' children, equally, share and share alike, per stirpes. Item Three: I appoint my husband Enoch S. Moore, Jr. Executor of this my last will. Should he fail to qualify or cease to act as Executor, I appoint my son John Erick Moore, to act as Executor with the same rights, powers, and duties. Item Four: I appoint my son John Erick Moore guardian of any property which passes to any person under the age of 22 years and with respect to which I am authorized to appoint a guardian/trustee and have not otherwise specifically done so. Should he fail or cease to act as guardian/trustee, Iappoint John H. Broujos to act with the same rights, powers, and duties. ~~ Guardian shall establish separate guardianship accounts and shall have the power to use income ~; from time to time for the beneficiary's education, including technical and vocational training and -~`, graduate school, travel, support, and welfare without regard to his or her parent's ability to provide for such education, travel, support, and welfare, or to make payment for these purposes, ` without further responsibility, to the beneficiary or to the beneficiary's parents or to any person ~, taking care of the beneficiary. Guardian shall administer the account until he or she becomes 18 i' years of age, at which time the guardian shall transfer the principal and income remaining in the separate guardianship account to my trustee, being the same person as my designated guardian, \~ who shall then administer a trust account, of both principal and income and any other funds ~v transferred to the accounts designated, for the beneficiary's education, including technical and vocational training and graduate school, travel, support, health, and welfare. When the ~-~ guardianship or trust account is less than $5,000.00 or the beneficiary of the separate trust becomes 22 years of age, the share of the beneficiary remaining in the account shall be paid to the beneficiary in full and the guardianship or trust terminated. In the event of the death of any beneficiary after my decease and prior to reaching the age of 22 years, his or her share shall be distributed equally among his or her children, equally; otherwise to my surviving children or child to be administered in accordance with the guardianship and/or trust provisions. No interest under this instrument shall be transferable or assignable by any beneficiary, or be subject during its life to the claims of creditors. Guardian and trustee shall not be required to file accountings with any court. In the event that any provision of this will shall be interpreted to violate the Rule against Perpetuities, then the remaining provisions of this will shall not be invalid. Trustee shall administer the trust and dispose of assets so as not to violate the rule, making distribution as required to a life or lives in being plus 21 years. Item Five: All estate, inheritance, succession, and other taxes, imposed or payable by reason of my death, and interest and penalties thereon, with respect to all property comprising my gross estate for tax purposes, whether or not such property passes under this will, shall be paid out of the principal of my residuary estate, without apportionment or right of reimbursement. Item Six: I direct that my personal representative or guardian shall not be required to give bond for the faithful performance of their duties in any jurisdiction. Item Seven: In addition to the rights and powers given to the fiduciaries by law or elsewhere in this z~ill, I give to my Executor during the full time necessary and for the administration of my estate the following rights and powers to be exercised in his or her sole discretion. A. To retain any real or personal property which may at any time form a part of my estate so long as he or she deems it advisable. B. To invest in any real or personal property without restrictions to legal investments. C. To repair, alter, improve or lease for any period of time any real or personal property and to give options for leases. D. To sell at public or private sale, for cash or credit, with or without security, to exchange or to partition, to mortgage or pledge real or personal property, and to give options for leases. E. To make distribution in kind. F. To compromise claims. IN WITNESS WHEREOF, I have hereunto set my hand this 8`h day of September, 2000. Signed ~' ~ ` ~'~ _~'Z ~: ~- M y W.pore The preceding instrument, consisting of this and two other typewritten pages each identified by the signature of the Testatrix was on the day and date thereof signed, published and declared by the Testatrix therein named as and for her last will, in the presence of us, wlxo at her request, in her presence and in the presence of each other have COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss We John H. Broujos and 7-o Stef ,witnesses whose names are signed to the attached or foregoing instrument being duly qua ified according to law, do depose and say that we were present-and saw the Testatrix sign and execute the instrument as her last will; that she signed willingly and executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the Testatrix signed the will as witnesses; and that to the best of our knowledge, the Testatrix was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. Sworn an subscribed to before me this ~ day of Septe ber, 2000. NOTAR PUBLIC ~I Gas-~c~..~.~_ Notarial Seal Bridget Ann Corcoran, Notary Public Carlisle Boro, Cumberland County My Commission Expires June 10, 2002 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND ss I Mary W. Moore whose name is signed to the attached document, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last will; that I signed it as my free and voluntary act for the purposes therein expressed. Sworn and affirmed to and ackno ledged before me this day of September, 2000. . LS~C NOT Y PUBLIC y W. , ~ oore, Testa ix CS2~0..~1 Notarial Seal Bridget Ann Corcoran, Notary Public Carlisle Boro, Cumberland County My Commission Expires June 10, 2002 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN RE: ORPHANS' COURT DIVISION ESTATE OF MARY W. MOORE, DECEASED NO. 21 04-0419 PRAECIPE TO DISCONTINUE WITHOUT PREJUDICE To Glenda Farner Strasbaugh, Clerk of Orphans' Court and Register of Wills: The above-captioned action is a Citation for failure to file an inheritance tax return. Please mark this action discontinued as the Executor of the Estate filed the inheritance tax return. DATE: October 29, 2009 Lora li Attorney for Petitioner PA Department of Revenue Office of Chief Counsel P.O. Box 281061 Harrisburg, PA 17128-1061 Attorney I.D. No. 69436 ~~~~ ~~ ~~ y~ 5~ ;~~ ltd rt..s~a„ a ~r~ r~ ~~1._'y,f.+~. ;~~,,;~ '~~~ ~i,iMv NOV 0 4 2009 ~ IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA IN RE: ORPHANS' COURT DIVISION ESTATE OF MARY W. MOORS, DECEASED NO. 21 04-0419 ORDER OF COURT AND NOW, this ~ day of ~ p V ~ 2009, upon consideration of a Praecipe to Discontinue the within action, the Motion is granted, the Rule is dismissed and the Citation is discharged. BY THE COURT: C7 ra 0 ~ y 7 , ~ r~ `_-rn ' `J~ m 1 ~ ~' x~. .% ~~ 3 ~~ -i Cb O V _ :~ €` _-._ ~-. \\ In Re: Mary W. Moore, Deceased ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-04-0419 ORDER DATE: 11-5- JUDGE'S INITIALS: JWO TIME STAMP DATE: IN RE: CERTIFICATE OF SERVICE OF ORDER 11-6-09 Order of Court SERVICE TO: Lora A Kulick John Broujos METHOD OF MAILING: ® USPS ^ RRR ^ HAND DELIVERED ^ OTHER MAILED: 11-6-09 ENVELOPES PROVIDED BY: ^ PETITIONER ^ JUDGE ® CLERK OF ORPHANS COURT SERVICE TO: METHOD OF MAILING: ^ USPS ^ RRR ^ HAND DELIVERED ^ OTHER MAILED: ENVELOPES PROVIDED BY: ^ PETITIONER ^ JUDGE ^ CLERK OF ORPHANS COURT I s I ~} ~ ~~ ~ IY ~~?~ Deputy Clerk of Orphans' Court Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 ,..,,... , ~ , ,..r n Phone : 717 2 4 0 - 6 3 4 5 ~r^.~z ~- -_ ~ ,,~' -,~_,-~r, - - ~, fr ~r4- 2~~fl APR -- I A Ifl~ 58 Date: 3/29/2010 MOORE JOHN ERICK 1128 PHEASANT DRIVE NORTH CARLISLE, PA 17013 RE: Estate of MOORE MARY W File Number: 2004-00419 Dear Sir/Madam: ~~ F~F~ ~..},_.. ~ ,,. ~~; 1 1/ t . 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: 4/16/2010 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, ~` ,, ~. Glenda Farner Strasb h Clerk of the Orphans' Court cc: File Counsel Cumberland County - Register Of Wills One Courthouse Square _ Carlisle PA 17013 ~ '~ .rIr^'~ ~'~~ Phone: (717) 240-6345 „, !, ~;,~ ~.,. Z~ ~ 0 APR -- I A f0~ 5 ~' c~ ~.,t_E, F-< .; . ', ~4,i~ t P. F,-' Date: 3/29/2010 BROUJOS JOHN 78 E RIDGE STREET CARLISLE, PA 17013 RE: Estate of MOORE MARY W File Number: 2004-00419 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, 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: 4/16/2010 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, 9 ~' f,~---~ ` Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Via. v.~'. ~~jiy'~.x~ ~~ ~.~.~.~~ ~~ R.E CISTER OF WILLS OF' C,~rv~B~~l.ANO COLT'_vrTY, FL?v-IvSYLV'~NI~ Name of Decedent:-I~AS~`S yJ. VVLO(~~t _ -- --- _ Date o Death: 4 °- 1 ~ - 2.oc~ 4 File Number: ZoC~ 4 - C)C~ 4 ( ~ D• t «„ D.. ! ~ !~ D 1 ~ l7 T •~ ~~it the f.~lln,~xrina fix,;itl. _-~cnPct to rnmmhti~~,~ of rl,e administration of i urSu3:i. w L u. v.~~• i~L:.~ v. _, >. i.,t, ..~ _ t.-_. r _ the above-captioned estate: 1. State whether administration of the estate is complete :.................... ~ Yes ~No 2. If the answeris No, state when the personal representative reasonably believes that the administration will be complete: C gLE~O~lTZ '>r~A 2 2D10 3. If the aiiswer.to No. 1 is YES, state the followin;: a. Did the personal representative file a final~account with the Court? ....... ~ Yes ~ No b. The separate Oiphalls' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account infoirzally to the parties in interest? .:.................:........... ]Yes O No d. Ccpies of receipts, releases, joinders ai?d approvals of formal or infonral accounts maybe fled with the Clerlc of the Orphans' Court and maybe attached to this report. orrrP 4,~ ~ o f ~ o - ~1~1U1,~-•~. Sign re of Person Filing this Form Capacity:Personal Kepresentanve U~ounse~ ~,p ~L.^? ~ Qd.. 30NN ER.tC1L PV~OO2E ~XECUTUTL _ L ~1 s ~ C"7 ~ ~ Narne ofPersa~ Fiing this Fa•m c i ~~> °- c~ cz r ~ U7 -~ Address ~~,:' ~:~ ~ • w ~ ~_._ C -R 2 1, t S Lt 1~ /a i ~I D l 3 - l Z 51 . c.~ ~~ Q ~~ -111 25-034'1 ~ ~, ~ ' G ~v Felephone Ca Cv Fora, R Nr- f 0 rrn. 10.13.04 (`~ 1 Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone : (717 ) 2 4 0 - 6 3 4 5 `;~r~~: ~ f"'t~~ ^ ~ .r ,~~ r, • _ _ '. ~ ., k~~1. ~1.. ''~J~ ~~ ,~ _~i Z~~~l APR -- I A 1D~ 58 Date: 3/29/2010 MOORE JOHN ERICK 1128 PHEASANT DRIVE NORTH CARLISLE, PA 17013 RE: Estate of MOORE MARY W File Number: 2004-00419 Dear Sir/Madam: 0 p~ , ~ !~ ; a'f't' r R~ C"1~~Nt, v w~ ~ti,,~ Cvl t _ 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: 4/16/2010 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, ~~,,, /; "'.~ ~ Clt./ ~' Glenda Farner Strasb h Clerk of the Orphans' Court cc: File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF ~Llmd er~Gt~a~ COUNTY, PENNSYLVANIA Name of Decedent:- / %Q )'` ~/ Vt/, / "~/y~j r P Date of Death: ~ ~D File Number: ~D©~ DD~ 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 :.................... ~ Yes ~No 2. If the answeris Nv, state when the personal representative reasonably believes that the administration will be complete: •t, 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 l~No b. The sepazate 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 maybe filed with the Clerk of the Orphans' Court an~ may b to this report. Dnte ~~' ~O p~D/D V7 ~~ c.- ~ ~ d o ~..~ t~~ r ~ tr-- CV - ~- ~ ~_ ,_ - ~ J ~_- _> fr':; ;: z_ :. % p ~ ~ S .. ('T-' ' ...-~ •' (~ ~ ll ' : Q... .Q . ,r <. N Form RN%l0 rev. 10.13.06 Filing this { ' Plersonal Representative Q~ Counsel /~. ~r~vi o5~ ~s4~ui~ Name of~Pe/rson FiIL:'ng this Form) ,r-~ / Address lis 1e ~/3 Telephone 3P Cumberland County - Register Of Wills One Courthouse Square Carlisle PA 17013 ~ ~"~~~ ~ `"` '~ "~rj^;~ j~'- Phone: (717) 240-6345 ~~ -~ 20 ! 0 dP~ - ! !0~ 5 7 r~ ~,~: ~; x CI~P.°~''~ .. `~ ~':~ F"~. Date: 3/29/2010 BROUJOS JOHN 78 E RIDGE STREET CARLISLE, PA 17013 RE: Estate of MOORE MARY W File Number: 2004-00419 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, 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: 4/16/2010 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, Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) BUREAU OF INDIVIDUAL TAXES ~ `'~' --~=~' $ ~-I~'~~~~I~T~~~ " ~A~i INNERITANCf TAX DIVISION 1~'!-.~1 ~ ~ ~ ~ MINT OF ACCOUNT PO Bea 28001 U~~L ~ ,,, HARRISBURG PA 17128-0601 zo ~ o .~~~ ~ a P~ ~= az C~.ERK ~F t ~ ~~~ JOHN H BROUJOS E$~~~~~ ~Q,, PAi 4 N HANOVER ST CARLISLE PA 17013 pennsylvan~a DEPARTMENT OF REVENUE REV-1607 EX AFP C12-09) DATE 06-07-2010 ESTATE OF MOORE MARY W DATE OF DEATH 04-16-2004 FILE NUMBER 21 04-0419 COUNTY CUMBERLAND ACN l l? 1 AmArunt Raw3ttmd MAKE CHECK PAYAHLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 NOTE: To onsure propor credit to your account, submit the upper portion of this form with your tax psysant. CUT A40NC THIS LIME RETAIN LOWER. PORTION F R YOUR RECORD K~~ s~+rss~ ~ * *~~~~~~~ 1 ~i7C S~~I~~~F ~~~ - *~* ESTATE DF:MOORE MARY W FILE NO.s 21 04-0419 ACNs 101 DATE: 06-07-2010 THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARY OF THE .PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FiBURE. .~~,~~~ DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 04-19-2010 PRINCIPAL TAX DUE: 4,439.58 PAYMENTS CTAX CREDITS): PAYMENT .RECEIPT DISCOUNT f+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) 07-16-2004 CD004171 221.98 4,500.00 05-20-2010 REFUND .00 282.40- TOTAL TAX PAYMENT ~ 4,439.58 BALANCE OF TAX DUET .00 INTEREST AND PEN. ~ .00 TOTAL DUE .00 * IF PAID AFTER THIS DATE, !EE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. BUREAU OF INDIVIDUAL TAXES `r rr r T.~~~~TANCE TAX INHERITANCE TAX DIVISION ,;r -~TATE~1E~iT OF ACCOUNT PO BOX 280601 ;~ HARRISBURG PA 17128-0601 ~ ~"}'"~"'~' ~"' "'` ' + ~ ' ~~ ! ~ SEP 10 APB I i ~ ~ ~ ~~ ~~ aRP~N'S ~~~R~ JOHN H BROUJOS ESQ ~~~8~~`',~..,'~~~ ~~ ~A 4 N HANOVER ST CARLISLE PA 17013 pennsylvania DEPARTMENT OF REVENUE REV-1607 EX AFP C12-09) DATE 09-07-2010 ESTATE OF MOORE MARY W DATE OF DEATH 04-16-2004 FILE NUMBER 21 04-0419 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ................................................................................................................ REV-1607 EX AFP C12-09~ *** INHERITANCE TAX STATEMENT OF ACCOUNT *** ESTATE OF:MOORE MARY W FILE NO.: 21 04-0419 ACN: 101 DATE: 09-07-2010 THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. BELOW IS A SUMMARY 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: 04-19-2010 PRINCIPAL TAX DUE: 4,439.58 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 07-16-2004 CD004171 221.98 4,500.00 05-20-2010 REFUND .00 282.40- TOTAL TAX PAYMENT 4,439.58 BALANCE OF TAX DUE .00 INTEREST AND PEN. ~ .00 TOTAL DUE * IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. .00 Pa. O.C. Rule 6.12 STAT(~US REPORT REGISTER OF WILLS OF `' COUNTY, PENNSYLVANIA ~. Name of Decedent: ~, . ~ es~ ~ Date of Death: ~ ~ File Number: 2~~~ ~ _' 1 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion o$the administration of the above-captioned estate: 1. State whether administration of the estate is complete :.................... Yes 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: No 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? ........................... : ... ~es ~ No c,:, L . "' _ L.1` -- . ~~_ :~ ' ..f ,_ 1.t.~ iJ Cll r? ~_,~':. c: :: r:i~ ~.: ~ ~ d. Copies of receipts, releases, joinders and approvals of formal or inform~.~ accounts maybe filed with the Clerk of the Orphans' Court and maybe attached to this te~ort. } t~ Q ~' 1 a N ~ Signature of on Filing This Form (") F-- ~' Ca aci Personal Re resent~tive ounsel ~ ~ ~~~~:~ ~ ~ Nmne ojPerson Filing this Form 4J U~ o ~ ~ Address ~ ~ ~~~Z~ ~~ 1 `~d t '~ '7_•.1- ~ tL~ ? Telephone I_ __ __ __ REGISTER OF WILLS FOR THE COUNTY OF CUMBERLAND IN THE COMMONWEALTH OF PENNSYLVANIA IN RE: ESTATE OF MARY W. MOORE, DECEASED DATE OF DEATH: APRIL 16, 2004 TESTAMENTARY NO.: 21-04-0419 PRAECIPE TO ENTER APPEARANCE AS COUNSEL To the Register of Wills: Please enter my appearance as counsel on behalf of the above-referenced estate. Respectfully submitted, SALZMANN HUGHES, P.C. Date: ql~(~~ ~~- .n r~ .Q a p ~~ H- ~ i ~ } _ {.a.- U C.? ,... ._.. _ _ - ~~~': lp ~z _. ~, ~-~ C~ . a ~ G.J 11~ ay: - George F. Douglas, III, Esquire Attorney ID #61886 354 Alexander Spring Road, Suite 1 Carlisle, Pennsylvania 17015 Phone: 717.249.6333 Fax: 717.249.7334 REGISTER OF WILLS FOR THE COUNTY OF CUMBERLAND IN THE COMMONWEALTH OF PENNSYLVANIA IN RE: ESTATE OF MARY W. MOORE, DECEASED DATE OF DEATH: APRIL 16, 2004 TESTAMENTARY NO.: 21-04-0419 PRAECIPE TO WITHDRAW AS COUNSEL To the Register of Wills: Please withdraw my appearance as counsel of the above-referenced estate. Respectfully submitted, Date: 1 ~O ~ ~ 1 O ~~r `~~ ~~ Y By: Jo . Broujos, Esq. Attorney ID# 6268 4 North Hanover St. Carlisle, PA 17013 Phone 717-243-4574 ,, '.~ W x m ~-~ ~~) :_ ~ ::" r j. 4n Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: Mary W. Moore Date of Death: April 16, 2004 File Number: 21-04-0419 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 :.................... ~ Yes ~ 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? ....... 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' Court and may be attached to this report. Date March 26, 2012 tad l)1 U~'Yr' ~G~~I~"~~~~ i~70~ S,NdHd~O ~v ~1a3~~ ~ ~ ~1 gnature of P son Filing this Form Capacity: Personal Representative Counsel George F. Douglas, III, Esquire Name of Person Filing this Form Salzmann Hughes, P.C., 354 Alexander Spring Rd Address Carlisle, PA 17015 717-249-6333 Telephone t. 1- ,^ ~.-, ~n- Form RW-!0 rev. 10.13.06