HomeMy WebLinkAbout03-0722PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
also known as To:
Deceased.
Social Security No.
Register of Wills for the
County of
Commonwealth of Pennsylvania
in the
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl
for letters of administration
on the estate of
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
Decendent was domiciled at death in ~",~,~/.~.~,,~e ~ County, Pennsylvania, with
h ,~"-%c last family or principal residence at
(list street, number and municipality)
Decendent, then ,~7 years of age, died ~,'~,*- ~/ ,4-9-,~'ff ,
Decendent at death owned property with estimated values as folllows:
(If domiciled in Pa.) All personal property $
(If not domiciled in Pa.) Personal. property in Pennsylvania $
(If not dGmiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
Petitioner.__ after a proper search ha
the following spouse (if any) and heirs:
/~....~/~/~,,,~. Name~ --
ascertained that decedent left no will and was survived by
R~ R~tionship
THEREFORE,
appropriate form to the undersigned.
petitioner(s) respectfully request(s) the grant of letters of administration in the
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ]
COUNTY OF ~ ~mbe~\o,~,~
SS
The petitioner(s) above-named swear(s) or affirm(s)that the
statements in the foregoing petition are true and correct to the best
of the knowledge and belief of petitioner(s) and that as personal
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to or aff'~rneO and subscribed
be~re me this __. [~)~-c~ day of
~(5 ' ~ ~~ : ORegister
No.
Estate of ~a~_ ,5 /~f~l,c,~.~h ,& . , Deceased
G~NT OF LETTERS OF AD~NIST~TION
AND NOW ~t./3~"~ ,'~ c~O0 5 -l~ , in consideration of the petition on
h ~
t e reverse side hereof, s~t, isfactoryovro, o,f having, been presented before me, ' ~ ~ ·
IT IS DEC~ED that OmS~ O ~~ ~eh ~.. ~a ~~ {k ~~~
is/~e entitled to Letters of A~stration, and in ac~rd with such finding, Letters of Ad~s~tion ~
in the estate of ~n~0 ,~ rO~~a~ ~.
0
FEES
Letters of Administration ..... $ 5 0 · OLD
Short Certificates( ) .......... $ { ~> . 0 CD
Renunciation ................ $ .%, OD
,Z,t° $./O · oo
TOTAL __ $ ~-//. oO
Filed ..................... A.D. 19__
Register ~f Wi,l:
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
RENUNCIATION
In Re Estate of
deceased.
To the Register of Wills of
County, Pennsylvania.
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
(Signature)
(Address)
(Signature)
(Address)
· II"! 1500 EX
' '~ . COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
USE ONLY
FILE NUMBER
'2_L-05_ -7.2..z
COUNTY CODE YEAR NUMBER
[]1. Original Return
[~4. Limited Estate
E~6. Decedent Died Testate (Attach copy of Will)
[~9. Litigation Proceeds Received
[~2. Supplemental Return
E~] 4a. Future Interest Compromise (date of death after 12-12-82)
[~7. Decedent Maintained a Living Trust (Attach copy of Trust)
["~ 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
] 3. Remainder Return (date ofdeath priorto 12-13-82)
r-~5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
~111. Election to tax under Sec. 9113(A) (At. ch Sch O)
FIRM NAME (If Applicable)
TELEPHONE NUMBER
7/,7- ~.5" Z- Z.~ 77.
COMPLETE MAILING ADDRESS
o , ,
Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13) (14)
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
--]Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
13.
OFFICIAL USE ONLY
(8)
(11)
(12)
(13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2) x .0 __ (15)
16. Amount of Line 14 taxable at lineal rate -~'-.~-" ~ x .0 L~,5 (16)
17. Amount of Line 14 taxable at sibling rate x .12 (17)
18. Amount of Line 14 taxable at collateral rate x .15 (18)
19. Tax Due (19)
20. []
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
DAT~ OF DEATH (MM-OD-YEAR) / ' DATE OF BIRTH (MM-DO-YEAR)
~'-o,o,£ /Z ~,¢o.3 ~/¥
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
SOCIAL SECURITY NUMBER
/.¢o - /3"-/7
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
Decedent's Complete Address:
CITY
STATE
I z~P/7~'7~
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
Total Credits ( A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
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 designation? ........................................................................................................................ []
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, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
ADDRESS
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. §9116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1)
The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even
the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive paren'
or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as a~
individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV21502 EX+ (6-98~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined 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 property which is jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
RE~-1,503 EX+ (6-98~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF FILE NUMBER
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
TOTAL (Also enter on line 2, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
RE~-1.504, EX+ (1- 97~_.~.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C
CLOSELY-HELD CORPORATION,
PARTNERSHIP OR
SOLE-PROPRIETORSHIP
ESTATE OF FILE NUMBER
Schedule C-1 or C-2 (including all supporting information) must be attached for each closely-held corporation/partnership interest of the decedent, other than a
sole-proprietorship. See instructions for the supporting information to be submitted for sole-proprietorships.
ITEM NUMBER VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
TOTAL (Also enter on line 3, Recapitulatior
(If more space is needed, insert additional sheets of the same size)
. REV-I~ ~. (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C.1
CLOSELY-HELD CORPORATE
STOCK INFORMATION REPORT
ESTATE OF FILE NUMBER
Name of Corporation
Address
City State Zip Code
2. Federal Employer I.D. Number
3. Type of Business
10.
Product/Service
11.
12.
State of Incorporation
Date of Incorporation
Total Number of Shareholders
Business Reporting Year
TYPE TOTAL NUMBER OF NUMBER OF SHARES VALUE OF THE
STOCK Voting / Non-Voting SHARES OUTSTANDING PAR VALUE OWNED BY THE DECEDENT DECEDENT'S STOCK
Common
Preferred $
Provide all dghts and restrictions pertaining to each class of stock.
5. Was the decedent employed by the Corporation?
If yes, Position
6. Was the Corporation indebted to the decedent?
If yes, provide amount of indebtedness $
[] Yes [] No
Annual Salary $
[] Yes [] No
Time Devoted to Business
7. Was there life insurance payable to the corporation upon the death of the decedent? [] Yes [] No
If yes, Cash Surrender Value $ Net proceeds payable $
Owner of the policy
8. Did the decedent sell or transfer stock of this company within one year prior to death or within two years if the date of death was pdor to 12-31-827
[] Yes [] No If yes, [] Transfer [] Sale Number of Shares
Transferee or Purchaser Consideration $ Date
Attach a separate sheet for additional transfers and/or sales.
9. Was there a wdtten shareholder's agreement in effect at the time of the decedent's death? [] Yes [] No
If yes, provide a copy of the agreement.
Was the decedent's stock sold? [] Yes [] No
If yes, provide a copy of the agreement of sale, etc.
Was the corporation dissolved or liquidated after the decedent's death? [] Yes [] No
If yes, provide a breakdown of distributions received by the estate, including dates and amounts received.
Did the corporation have an interest in other corporations or partnerships? [] Yes [] No
If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest.
A. Detailed calculations used in the valuation of the decedent's stock.
B. Complete copies of financial statements or Federal Corporate Income Tax retums (Form 1120) for the year of death and 4 preceding years.
C. If the corporation owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have been
secured, attach copies.
D. List of principal stockholders at the date of death, number of shares held and their relationship to the decedent.
E. List of officers, their salaries, bonuses and any other benefits received from the corporation.
F. Statement of dividends paid each year. List those declared and unpaid.
G. Any other information relating to the valuation of the decedent's stock.
REV: 3,06 EX+ (9-oo
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE C-2
PARTNERSHIP
INFORMATION REPORT
ESTATE OF FILE NUMBER
1. Name of Partnership Date Business Commenced
Address Business Reporting Year
City State Zip Code
Federal Employer I.D. Number
Type of Business
3.
4.
5.
Decedent was a [] General [] Limited partner.
Product/Service
If decedent was a limited partner, provide initial investment $
A,
B.
C.
D,
6. Value of the decedenrs interest $
7. Was the Partnership indebted to the decedent? ................................. [] Yes
If yes, provide amount of indebtedness $
8. Was there life insurance payable to the partnership upon the death of the decedent? ..... [] Yes
If yes, Cash Surrender Value $ Net proceeds payable $
Owner of the policy
[] No
[] No
Did the decedent sell or transfer an interest in this partnership within one year prior to death or within two years if the date of death was
prior to 12-31-827
[] Yes [] No If yes, [] Transfer [] Sale Percentage transferred/sold
Transferee or Purchaser Consideration $ Date
Attach a separate sheet for additional transfers and/or sales.
10. Was there a wdtten partnership agreement in effect at the time of the decedent's death? ...... [] Yes [] No
If yes, provide a copy of the agreement.
11. Was the decedent's partnership interest sold? ....................................... [] Yes [] No
If yes, provide a copy of the agreement of sale, etc.
12. Was the partnership dissolved or liquidated after the decedent's death? ................... [] Yes [] No
If yes, provide a breakdown of distributions received by the estate, including dates and amounts received.
13. Was the decedent related to any of the partners?
If yes, explain
.................................... [] Yes [] No
14. Did the partnership have an interest in other corporations or partnerships? .............. [] Yes [] No
If yes, report the necessary information on a separate sheet, including a Schedule C-1 or C-2 for each interest.
A. Detailed calculations used in the valuation of the decedenrs partnership interest.
B. Complete copies of financial statements or Federal Partnership Income Tax returns (Form 1065) for the year of death and 4 preceding years.
C. If the partnership owned real estate, submit a list showing the complete address/es and estimated fair market value/s. If real estate appraisals have
been secured, attach copies.
D. Any other information relating to the valuation of the decedent's partnership interest.
REV:,1507 EX+ (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
ESTATE OF FILE NUMBER
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
TOTAL (Also enter on line 4, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
· REV-lr:~8 EX ~"(I-77) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of sup, ivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1,
TOTAL (Also enter on line 5, Recapitulation) i
(If more space is needed, insert additional sheets of the same size)
EX + (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF FILE NUMBER
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT
A.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
iTEM FOR JOINT MADE include name of financial institution and bank account number or similar identifying number, Attach DATE OF DEATH DECD'S VALUE OF
NUMBER TENANT JOINT deed for jointly-held real estate. VALUE OF ASSET INTEREST DECEDENT'S INTERES
1. A.
TOTAL (Also enter on line 6, Recapitulation)$
(If more space is needed, insert additional sheets of the same size)
REV-I§i0 E'X +,(1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
ESTATE OF FILE NUMBER
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY % OF
ITEM INCLUDETHE NAME OF THE TRANSFEREE, THEIRRELATIONSHIP?ODECEDENTANDTHE DATE OF TRANSFER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
ATrACH A COPY OF THE DEED FOR REAL ESTATE.
NUMBER VALUE OF ASSET INTEREST {IFAPPLICABLE)
1.
TOTAL (Also enter on line 7, Recapitulation} $
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99) .·
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE .H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A.
1.
5.
6.
7.
FUNERAL EXPENSES:
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s
Street Address -~--~-,~',_,~ ,.~o.;;-/~\
City /::~.,/z;/~,,~.¢~¢/c~ State ~'~2--,. Zip
Year(s) Commission Paid: ,-"//~/~C. ,
/?/H
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State __ Zip
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
TOTAL (Also enter on line 9, Recapitulation) $ ,.~E¢;-~'~'. //~_.
(If more space is needed, insert additional sheets of the same size)
REV-1512 EX * (1-97) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF FILE NUMBER
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
TOTAL (Also enter on line 10, Recapitulation) $
AMOUNT
-gT. 74
(If more space is needed, insert additional sheets of the same size)
REV-'?13 EX+ (9-00~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
FILE NUMBER
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 distributions, and transfers under
Sec. 9116 (a) (1.2)]
!
1.
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE K
LIFE ESTATE, ANNUITY
& TERM CERTAIN
(Check Box 4 on Rev-1500 Cover Sheet)
FILE NUMBER
This schedule is to be used for all single life, joint or.successive life estate and term certain calculations. For dates of death
pdor to 5-1-89, actuarial factors for single life calculations can be obtained from the Department of Revenue, Specialty Tax Unit.
Actuarial factors can be found in IRS Publication 1457, Actuarial Values, Alpha Volume for dates of death on or after 5 -1-89.
Indicate the type of instrument which created the future interest below and attach a copy to the tax return.
[] Will [] Intervivos Deed of Trust [] Other
LIFE ESTATE INTEREST CALCULATION
NAME(S) OF NEAREST AGE AT TERM OF YEARS LIFE ESTATE IS
LIFE TENANT(S) DATE OF BIRTH DATE OF DEATH PAYABLE
[] Life or [] Term of Years __
[] Life or [] Term of Years __
[] Life or [] Term of Years __
[] Life or [] Term of Years __
1. Value of fund from which life estate is payable $
2. Actuarial factor per appropriate table
Interest table rate - [] 3 1/2% [] 6% [] 10% [] Variable Rate %
3. Value of life estate (Line 1 multiplied by Line 2) $
ANNUI~ INTEREST CALCULATION
NAME(S) OF NEAREST AGE AT TERM OF YEARS
ANNUITANT(S) DATE OF BIRTH DATE OF DEATH ANNUITY IS PAYABLE
[] Life or [] Term of Years
[] Life or [] Term of Years
[] Life or [] Term of Years
[] Life or [] Term of Years
1. Value of fund from which annuity is payable $
2. Check appropriate block below and enter corresponding (number)
Frequency of payout- [] Weekly (52) [] Bi-weekly (26) [] Monthly (12)
[] Quarterly (4) [] Semi-annually (2) [] Annually (1) [] Other( )
3. Amount of payout per period $
4. Aggregate annual payment, Line 2 multiplied by Line 3
5. Annuity Factor (see instructions)
Interest table rate [] 3 1/2% [] 6% [] 10% [] Vadable Rate %
8. Adjustment Factor (see instructions)
7. Value of annuity - If using 3 1/2%, 6%, 10%, or if vadable rate and pedod payout is at end of pedod,
calculation is: Line 4 x Line 5 x Line 6 $
If using variable rate and pedod payout is at beginning of period, calculation is:
(Line 4 x Line 5 x Line 6) + Line 3 $
NOTE: The values of the funds which create the above future interests must be reported as part of the estate assets on
Schedules A through G of this tax retum. The resulting life or annuity interest(s) should be reported at the appropriate tax rate on
Lines 13, 15, 16 and 17.
(If more space is needed, insert additional sheets of the same size)
CC~,~MONWE~,LTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO.
REV-1162 EX(11-96)
CD 003671
DIFFENBAUGH GEORGE S JR
6253 S HIGHLAND CIRCLE
HARRISBURG, PA 17111
........ fold
ESTATE INFORMATION: SSN: 160-16-1347
FILE NUMBER: 2103-0722
DECEDENT NAME: DIFFENBAUGH GEORGE S SR
DATE OF PAYMENT: 03/15/2004
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 06/12/2003
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $251.98
REMARKS:
~'~ SEAL-
CHECK//299
TOTAL AMOUNT PAID'
$251.98
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
JRD/June 30, 1992/17858
In Re: Estate of GEORGE S DIFFENBAUGH
Late of NEW CUMBERLAND BOROUGH
Estate No.: 21-03-722
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21-2003-722
NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT
ORPHANS' COURT RULE
Personal Representative: GEORGE S DIFFENBAUGH, JR.
Counsel for Personal Representative:
Date of Grant of Original Letters: 09-03-2003
Date of Delinquency Notice: 12-13-2003
The undersigned, Glenda Famer-Strasbaugh, Register of Wills, in accordance with Rule
5.6, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of
Common Pleas of Cumberland County, that neither the above named personal representative nor
the'above named counsel for the personal represefitative have filed with the Register of Wills or
Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court
Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court
Orphans' Court Rules, was given by the Register of Wills on DECEMBER 13,2003, and that
the ten (10) day notice to file the certification has expired. Accordingly, in accordance with Rule
5.6(e) the Court is hereby notified of such delinquency and the undersigned requests that a Court
conduct a heating to determine whether sanctions should be imposed upon the delinquent
personal representative or counsel for the delinquent personal representative.
Date: 02-05-2004
Glenda Farn~r strasb~ugh, Register~)ills
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
A heating is scheduled for ,~,~,~_~ ~ ~ 0,~ c/' at ~-'3d# ~ Courtroom No. 3. If the
Certification of Notice is file(t prior to'the hearing date~ the heating will automatically be '
cancelled.
George ~. l~ft~er, ~b.j! "~
Register of Wills & Clerk of Orphans' Cour
Cumberland County Courthouse
Carlisle, Pennsylvania 17013
7003 1010 0001 1203 7871
' A
GEORGE S DIFFENBAUGH, JR
6253 S HIGHLAND CIRCLE
[] INSUFFICIENT ADDRESS
[] ATTEMPTED NOT KNOWN [] OTHER
[] NO SUCH NLJMBER/STREET
[] NOT DELIVERABLE AS ADDRESSED
- UNABLE TO FORWARD
Name of Decedent:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Will No. Admin. No. .~/ ~.~ d)~ ~ 7~----
To the Register:
I certify that notice of (beneficial interest) estate admini.~tration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on :
Name Address
/ ,
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:.
Signature
Name
Telephone 7/b
Capacity: ~ Personal Representative
~.Counsel for personal representative
JRD/June 30, 1992/17858
In Re: Estate of GEORGE S DIFFENBAUGIt
Late of NEW CUMBERLAND BOROUGII
Estate No.: 21-03-722
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21-2003-722
NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 5.6(e), SUPREME ~RT ~
ORPHANS' COURT RULE ~ ~, .~
Personal Representative: GEORGE S DIFFENBAUGH, JR. iT' ~ :: :'
Counsel for Personal Representative: ~
Date of Grant of Original Letters: 09-03-2003
Date of Delinquency Notice: 12-13-2003
The undersigned, Glenda Farner-Strasbaugh, Register of Wills, in accordance with Rule
5.6, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of
Common Pleas of Cumberland County, that neither the above named personal representative nor
the above named counsel for the personal representative have filed with the Register of Wills or
Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court
Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court
Orphans' Court Rules, was given by the Register of Wills on DECEMBER 13,2003, and that
the ten (10) day notice to file the certification has expired. Accordingly, in accordance with Rule
5.6(e) the Court is hereby notified of such delinquency and the undersigned requests that a Court
conduct a hearing to determine whether sanctions should be imposed upon the delinquent
personal representative or counsel for the delinquent personal representative.
Date: 02-05-2004
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
A hearing is scheduled for ~.~.- ,~,c~o~c/' at ~'-3a~q/~ln Courtroom No. 3. Ifthe
Certification of Notice is filed prior to'the hearing date~ the hearing will automatically be
cancelled.
George ~E. l~ff~er, l~.J! ' '~
Postage
Ce~ifled Fee
Postmar~
Return Reciept Fee Here
(Endorsement Required)
Restricted Delivery Fee
(Endorsement Required)
L_.t-~,~_~_:~..~..-.~~!---~ ...........................
f~'~;~~~?'~-~ ~--~ .................
I"lAgent
[] Insured ~ [] C.O.D.
4. ~ Del~ ~ ~)
' PS F(~'~'n'3'81i.: A~t,~0(h' '
7003 1010_.,0001 1203 8120
~ -
.... oo~=~ ~ r~,~pt ~(~=~'~
Postage
Certified Fee
Return Reciept Fee
(Endorsement Required)
Restricted Delivery Fee
(Endorsement Required)
Postmark
Here
o Age.t
B. Received by ( Pr/r~ed Name) C. of
D. Isdeave~yaddmssdlffemnt fromitem 17 '1~I
~C__--ert~Ma~ [] F. xpm~Maa
Cl Registered Cl.R~tum Rec~pt ~ ~
[] Insured Mail I'1 C.O.D.
4. Restr~'ted D~h<.~ (Extra. Fee)0 Y~
7003 1010 0001 1203 7888
BUREAU OF INDIVIDUAL TAXES
INHERTTANCE TAX D/VTSZOH
DEPT. 280601
HARRISBURG, PA 17128-0601
COHHONNEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAZSEHENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
RE¥-1;47 EX AFP (01-;5)
GEORGE S DIFFENBAUGH JR
6255 S HIGHLANDS
HBG PA 17111
DATE
ESTATE OF
DATE OF DEATH
FILE NUHBER
COUNTY
ACN
05-05-200~
DIFFENBAUGH SR
06-12-2005
Z1 03-0722
CUHBERLAND
101
Amoun~c Remitted
GEORGE S
HAKE CHECK PAYABLE AND REHZT PAYHENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS 4
REV'lB47 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT, ALLOWANCE OR DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF DIFFENBAUGH SR GEORGE S FILE NO. 21 03-0722 ACN 101 DATE 05-03-Z00~
TAX RETURN WAS: (X) ACCEPTED AS FILED ( } CHANGED
RESERVATION CONCERNING FUTURE INTEREST ' SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~a~e (Schedule A) (1)
2. S~ocks and Bonds (Schedule B) (2)
$. Closely Held S~ock/Par~nership Znterest (Schedule C)
q. Hot,gages/No'es Receivable (Schedule D) (4)
$. Cash/Bank Deposi~s/Hisc. Personal Property (Schedule E) (5)
6. Jointly Owned Proper~y (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Tote1 Asse~s
APPROVED DEDUCTZONS AND EXEHPTXONS:
9. Funeral Expensas/Adm. Costs/Nisc. Expenses (Schedule H) (9)
10. Deb~s/Nor~gage Liabili~ims/Liens (Schmdula l) (10}
11. To,al Deductions
12. Net Value of Tax Re~urn
15.
14.
Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J)
Ne~ Value of Es~a~e Subjec~ ~o Tax
1~301.98
.00
.00 NOTE: To insure proper
.00 credi~ ~o your account,
.00 submi~ ~ha upper portion
.00 of ~his form wi~h your
~ax payment.
.00
(8)
8,609.12
93.99
NOTE:
lq,301.98
(11) 8.703. ll
(12) 5,598.87
(15) . O0
(14) 5,598.87
Zf an assessment was lssued previously, 11nas 14, 15 and/or 16, 17,
reflect f/gures that lnclude the total of ALL returns assessed to date.
ASSESSHENT OF TAX:
15. Amount of Line 14 a~ Spousal ra~e (15)
16. Amoun~ of Line 14 taxable et Lineal/Class A ra~e (16)
17. Amoun~ of Line lq a~ Sibling ra~a (17)
18. Amoun~ of Line 14 ~axable a~ Collateral/Class B re~e (18)
19. Principal Tax Due
RECEIPT
NUHBER
CD003671
DISCOUNT
INTEREST/PEN PAID (-)
.03-
· O0 X O0 =
5,598.87 X Oq5=
(19)=
AHOUNT pAID
'251.98
TAX CREDZTS:
PAYHENT
DATE
18 and 19 will
TOTAL TAX cRE'DxT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
03-15-200~
.00
251.95
.00
251.95
ZF PA/D AFTER DATE XNDICATED, SEE REVERSE
FOR CALCULATION OF ADD/T[ONAL INTEREST.
251.95
.00
.05
.05
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT TS RE{)U~RED.
IF TOTAL DUE ZS REFLECTED AS A 'CREDIT' (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYNENT:
REFUND
OBJECTIONS:
ADNIN-
ISTRATZVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on or before December ZZ, 198Z -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Coemonaealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the lawful Class B (collateral) rate on any such future interest.
To fulfill the requirements of Section Z140 of the Inheritance and Estate Tax Act, Act 25 of ZOO0. (TI P.S.
Section 9140).
Detach the top portion of this Notice and submit with your payment to the Register of Hills printed on the reverse side.
--Hake check ar money order payable to: REGISTER OF NZLLS, AGENT
A refund of a tax credit, ahich was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania XnherJtance and Estate Tax" (REV-1515). Applications are available at the Office
of the Register of Hills, any of the Z$ Revenue District Offices, or by calling the special Z4-hour
anseering service for forms ordering: 1-800-36Z-Z050; services for taxpayers eith special hearing and / or
speaking needs: 1-800-447-30Z0 (TT only).
Any party in interest not satisfied with the appraisement, allowance, or disallomance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object mithin sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. ZBIOZ1, Harrisburg, PA 171ZB-10Z1,
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
OR
Factual errors discovered on this assessment should be addressed in ariting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Roviem Unit, Dept. 280601, Harrisburg, PA 171Z8-0601
Phone (717) 787-6505. See page S of the booklet "Instructions for Inheritance Tax Return for a Resident
Decedent" (REV-1501) for an explanation of administratively correctable errors.
If any tax due is paid within three (3) calendar months after the decedent's death, a five percent (SI) discount of
the tax paid is allowed.
The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has bean assessed as indicated on this notice.
1985
1984
1985
1986
1987
--Interest is calculated as folloas:
ZNTEREST= BALANCE OF TAX UNPAZD
Interest is charged beginning eith first day of delinquency, or nine (9) months and one (1) day free the date of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (6Z) percent per annum calculated at a daily rate of .000164. AL1 taxes mhich became delinquent on and after
January 1, 198Z will bear interest at a rate mhich will vary free calendar year to calendar year eith that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through ZOO4 are:
Interest Daily Interest Daily Interest Daily
Rate Factor Year Rate Factor Year Rate Factor
ZOZ .ooo5fi8 ~)'~-1991 11Z .000301 ~ 9Z .000Z47
16Z .000438 199Z 92 .000247 ZOOZ 62 .000164
11Z .000501 1993-1994 7X .OOO19Z ZOO3 5Z .000137
I~Z .000356 1995-1998 9Z .000Z47 2004 4Z .000110
lOX .oooz74 1999 7Z .00019Z
IOZ .000Z74 ZOO0 7Z .00019Z
X NUHBER OF DAYS DBLZN(~UENT X DAZL¥ INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent mill reflect an interest calculation to fifteen (15) days
beyond the data of the assessment. If payment is made after the interest computation date sheen on the
Notice, additional interest must be calculated.
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 5/03/2005
DIFFENBAUGH GEORGE S JR
6253 S HIGHLAND CIRCLE
HARRISBURG, PA 17111
RE: Estate of DIFFENBAUGH GEORGE S SR
File Number: 2003-00722
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after
July 1, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
6/12/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~V~~~~'A~
GLENDA FARNER ST~~A~'
REGISTER OF WILLS
cc: File
Counsel
Judge
cP
STATUS REPORT UNDER RULE 6.12
Name of Decedent: ac~-<- ~~ ,,~,,)j,H(.oui t.-.. .s:<:.,
h.-/2 - -?,c.(i"5
007Z2
-Adtm'11. 'N 0.:
Date of Death:
~~\~
WrltNo.:
ZI cJ]
Pursuant to Rule 6.12 of the Supreme Court Orphans' Comi Rules, I repOli 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.J€
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete: ./VO./- .-?6?:..' ,,-o./~ LAJ.7tt7
~//~;,...... ~//&:.I..b4"($~
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 0 No ~
f---
.~.,:- k 5/&1,10.5/':"
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
C;;;,~-'-~L ;/
~-Bignature . ~k..
( ,-jt~'fll .'
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t~:M4^- S-~i/T-frl'-'t/k,';/:i-
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62 Ss s.. HIgf..~f)ut G''L-
#.4ft.1V;,hVA/ /~ 17 Ilf
Address
Date: ~-O5-
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(~)
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o
7/7- CsZ-.f:.J7L
Telephone No.
Capacity: ~ersonal Representative
o Counsel for personal representative
uR
RECEIVED JUl15 2005 c
Estate No.: 21-03-00722
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
Estate of DIFFENBAUGH GEORGE S SR
La te of NEW CUMBERLAND BOROUGH
Date:
7/18/2005
NO.: 21-03-00722
DIFFENBAUGH WILLIAM A
7906 JUNIPER DRIVE
FREDERICK MD 21702
NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS I COURT RULE
Personal Representative: DIFFENBAUGH WILLIAM A
Personal Representative Counsel: ** NO INFORMATION FOUND **
Date of Decedent's Death: 6/12/2003
Date of Delinquency Notice: 6/12/2005
The undersigned, Glenda Farner Strasbaugh, Clerk of Orhans'
Court, in accordance with rule 6.12, Supreme Court Orphans' Court
Rules, hereby notifies the Orphans' Court Division, Court of Common
Pleas of Cumberland County, that neither the above named personal
representative nor their counsel, have filed with the Register of
Wills or Clerk of Orphans' Court, his/her Status Report required by
Rule 6.12, Supreme Court Orphans' Court Rule, and that the
requisite notice, pursuant to Rule 6.12, Supreme Court Orhans'
Court Rules, was given by the Clerk of Orphans' Court on 5/15/2005
and that the ten (10) day notice to file the status report has
expired. Accordingly, in accordance with Rule 6.12 the Court is
hereby notified of such delinquency and the undersigned requests
that a Court conduct a hearing to determine whether sanctions
should be imposed upon the delinquent personal representative or
their counsel.
cc: File
Personal Representative
Counsel
A hearing is scheduled for August 19, 2005 at 9:30 AM in
Courtroom No. 03. If the Status Report is filed prior to the
hearing date, the hearing will automatically be cancelled.
Geo~~:)
cJ
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 4/25/2006
DIFFENBAUGH WILLIAM A
7906 JUNIPER DRIVE
FREDERICK, MD 21702
RE: Estate of DIFFENBAUGH GEORGE S SR
File Number: 2003-00722
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:
6/12/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregarc
this notice.
Sincerely,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 4/25/2006
DIFFENBAUGH GEORGE S JR
6253 S HIGHLAND CIRCLE
HARRISBURG, PA 17111
RE: Estate of DIFFENBAUGH GEORGE S SR
File Number: 2003-00722
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
wills a Status Report of completed or uncompleted administration.
This filing is due by:
6/12/2006
please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregarc
this notice.
Sincerely,
~~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
8C: File
f'1_"~~r'"'l.1
Register of'\lViUs of CumberXand County
STATUS REPORTLJNDERRULE 6.12
Name of Decedent: ~~/~ s-; '~~hW24tAth ~,
Date of Death: -:.:;:; ,w,i:- /Z 2cJoY
Estate No.: .;t/ 03 06 7Z'L
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$
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete: (."'u~rw-- ~/- R/; T;:;H"':i
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 3'
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 .8
c. Copies of receipts, releases, joinders and approval offonnal or informal
accounts maybe filed with the Clerk of the Orphans' Court and may be
attached to this report.
Date: 6 - _?"... () ,
""-"'--'-"""
~'~1~-'~
c- Si .~ tur '. .. /'
gna e /
_~ 1/ /,--'<0.> .;L1i Y"',v,5';:;' 4..>',:/
>-
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Name
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62 5"..7 s.- #5 t:.: 4,- G
Address
7/?- ~~2.-~'?3?'Z-
Telephone No.
c;c
,
/.v)/I/""..:/ --7;?//~..fiI3.;fu~/;
~, 0
Capacity: J2fPersonal Representative
o Counsel for personal representative
(..,I
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Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 5/22/2007
DIFFENBAUGH GEORGE S JR
:.-'.)
f'~.)
6253 S HIGHLAND CIRCLE
HARRISBURG, PA 17111
~.._-""']\
RE: Estate of DIFFENBAUGH GEORGE S SR
File Number: 2003-00722
0---"
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:
6/12/2007
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~
c...-
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 5/22/2007
--'
i',.,)
DIFFENBAUGH WILLIAM A
',I
7906 JUNIPER DRIVE
FREDERICK, MD 21702
i""""'-
......; ,
RE: Estate of DIFFENBAUGH GEORGE S SR
File Number: 2003-00722
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:
6/12/2007
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~
J f..,
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
,
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Pa. O.C. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF
COUNTY, PENNSYLVANIA
Name of Decedent: &J'OIl.tjC
Date of Death: ~#/L /2.
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s: 2J ,~b.lleUjh SZ
200 1 File Number: 2/ 03 00 7 Z "Z-
Pursuant to Pa. O.c. Rule 6.12, I report the following with respect to completion of the administration of
the above-captioned estate:
1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . ., DYes g"No
2. If the answeris No, state when the personal representative
reasonably believes that the administration will be complete:
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3. If the answer to No.1 is YES, state the following:
a. Did the personal representative file a final'account with the Court? . . . . . .. DYes ,8No
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? ..............,................. #t es ~
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.
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Capacity: ,BPersonal Representative 0 Counsel
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Name of Person Filing this Form
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Address
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Telephone
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Form RW./O rev. /0.13.06
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 5/14/2008
DIFFENBAUGH GEORGE S JR
6253 S HIGHLAND CIRCLE
HARRISBURG, PA 17111
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RE: Estate of DIFFENBAUGH GEORGE S SR
File Number: 2003-00722
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Dear Sir/Madam:
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This notice is to serve as a reminder that the Status Report by
Personal Representative under Rule 6.12 is due on the below listed
date.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after
July I, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing 1S due by:
6/12/2008
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"'fti.ft_ ,;,~;?~j IJ!:;:~
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Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
Cumberland County - Register Of wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 5/14/2008
7906 JUNIPER DRIVE
FREDERICK, MD 21702
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DIFFENBAUGHWILLIAM A
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RE: Estate of DIFFENBAUGH GEORGE S SR
File Number: 2003-00722
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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:
6/12/2008
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,
If ~ BA~'
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Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
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Pa. ®.C'. Yule 6.12 S'TA'TUS RAP®RT
REGISTER OF WILLS OF
Name of Decedent:
COUNTY, PENNSYLVANIA
~i~i~-y~~lf~ ~.
Date of Death: -~~i~k= /z ~0~.~ File Number: 2/ C>~ 00 7 Z Z
Pursuant to Pu. O.C. RLiie 5.12, I report the foll0lx~inQ ~z~it}i ,-ecnPnt ro r.mm~letin„ of the administration of
..b r^- r-------
the above-captioned estate:
l . State whether administration of the estate is complete :.................... Q Yes ~No
2. If the answeris No, state when the personal representative
reasonably believes that the administration will be complete:
/fop r SOG!!JS/Z ~S ~ "%~s ~i~fl_>
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
iepresentative's account is:
c. Did the personal representative state an account
infornlally to the parties in interest? ............................... . V`i'es ~ Nc
d. Copses of receipts, releases; oindes and approvals o f formal or informal accounts maybe .
filed with the Clerlc of the Orphans' Court and may be attached to this report.
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Sion ofPerso~s Fifing thi F rm
Capacity: ersonal Representative Q Counsel
Name of Person Filing this Form C--
Address
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Telephone
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