HomeMy WebLinkAbout03-0018Estate of
Also known as
Register of Wills of CUMBERLAND, County, Pennsylvania
PETITION FOR GRANT OF LETTERS
ANNA MAE PUTT No.
DANIEL F. PUTT
, Deceased
Social Security No. 193-24-2357
Petitioner(s), who is/are 18 years of age or older, apply(ies) for:
(COMPLETE "A" OR "B" BELOW:)
A. Probate and Grant of Letters and aver that Petitioners are the executors named in the Last Will of
the Decedent, dated July 3, 1985 and codicil(s) dated
State relevant circumstances, e.g. renunciation, death of Executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of
the documents offered for probate; was not to victim of a killing and was never adjudicated incompetent:
B. Grant of Letters of Administration
(d.b.n.c.t.a.: pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following
spouse (if any) and heirs:
Name Relationship Residence
COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania,
with her last family or principal residence at
2335 PUTT LANE, HAMPDEN TOWNSHIP, CUMBERLAND COUNTY,
(List street, number and municipality)
Decedent, then 90 years of age, died December 29, 2002 at
(Location)
Decedent 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 ...................................................................................................................... $
Seidel Hospital Skilled Nursing
$ 2,500.00
$266,O60.00
Total ......................................................................................................... $ $268,560.00
RealEstate situated asfollows: No. 2335 PUTT LANE, HAMPDEN TOWNSHIP, CUMBERLAND COUNTY, PA
Wherefore, Petitioners respectfully request the probate of the last Will presented with this Petition and the grant of letters in the
appropriate form to the undersigned:
Signature
Typed or printed name and residence
DANIEL F. PUTT
6001 ,M~=~-~'~'
ENOLA, PA 17025
Oath of Personal Representative
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are
true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s)
of the Decedent, Petitioner(s) will well and truly administer the estate according to law,
Sworn to and affirmed and subscribed
Before me this _,~7',¥ day of
¢~_~Rru~ ¢~ ,2003.
!
DANIEL F. PUTT
DECREE OF REGISTER
Estate of ANNA MAE PUTT , Deceased No. ~.,~/- ~'-
Social Security No: 193-24-2357 Date of Death: December 29, 2002
AND NOW, JF~r~u~.~, 9 ,2003, in consideration of the Petition on the reverse side
hereon, satisfactory proof ~naving been presented before me,
IT IS DECREED that Letters Testamentary
d.b.n.c.t,a.; pendente lite; durante absentia; durante minoritate
are hereby granted to DANIEL F. PUTT
in the above estate and that the instrument(s) dated July 3, 1985
described in the Petition be admitted to probate and filed of record as the last Will of the Decedent.
FEES
Letters ........................... $
Short Certificate(s) $
Renunciation .............. $
Affidavit ( ) .................. $
Extra Pages ( ) .......$
Codicil ............................ $
JCP Fee ....................... $
Inventory ...................... $
Other .............................. $.
TOTAL .........$
I~-~g~t~r of Wills
Attorney:
I.D. No:
Edmund G. Myers, Esq.
20558
Address: Johnson, Duffie, Stewart & Weidner,
301 Market Street, P.O. Box 109, Lemoyne, PA 17043-
Telephone: 717-761-4540
his is to ceftin' that the information here given is correctly copied fi'om an original certificate of death duly filed with me as
Local Registrar. The original cert'if]cat¢ will Joe forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee £or this certificate, $2.00
P 8647025
No.
Local Registrar
JAN 0 2 2003
Date
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
Anna Mae Putt. ~Female ~.193 -- 24 -- 2357
~ ~ e /22/1912 Enola, Pa. Ho~. []
JJ' Pennsboro ,t o_/ t}l No~ ~.y.~,~c~...
DECEDENT'S USUAL OCCUP/KTION J Of wock~ng Ide; ~ ~ u~ t ~r~r ~d
Housedut les
Seidle Hospital Skilled Nursing~[,uo~t.c
120 S. Filbert St.
,,.Mechanzcsburg, Pa. 7025
,,. Daniel Comp
2o.. Rebecca Sherman
METHOD OF DISPOSITION
KIND OF SUSINESSIINDUSTRY
',,~A S DECEDENT EVER INI OECEDENT'S e oUcAnON I MARITAL STATUs- Ma~r~l I
J OS. ARMEDFORCES? I [Spec,N onty ~,!the~ qradec~Ul~ed)
I
17.. s,~. P a.
,m. co~.~ Cumberland ,o~, ,,~.~~'~ ~. o, ~echanicsburg
iMMEDIATE CAUSE (F,nal
DATE O~ OISPOSITION
Bunal]~ CremalionE] R®movaltromSlale[~] (Monln, Day,~}
~<s~w~ ~J~,b~anuary 3, 2003
PER~N ACTING AS SUCH
,,.Annie M'_ae Harder
2280 Putt Lane Enola~ Pa. 17025
JP~-~o~C, Ee?~?c,eSPOSmON- N C ry. C Dry ILOCAT,ON .City/Tovm. Sim.. Z,~ Code ..... ....... .....
J J~Stone Church Cemetery ~. Silver Springs Twp. Pa.
I ~13~E OF DEATH DATE PRONOUNCED DEAD imonth Day,
b
jc.
d
WERE AUTOPSY FINDINGS
PERFORMED?
AVAID. SL E PRIOR ~
COMPLETION DP CAUSE
OF OE~YH?
DUE TO (OR AS A CONSEQUENCE OF}:
JMANNER OF DEATH
CERTIFIER ~Ct'~ck Dray
JNAME AND ADORE SS OF FACILITY
22¢.RichardsonF.H. 29S.EnolaDr.Enola, Pa. 17025
LICENSE NUMSER D~TE SIGNED
I, ANNA MAE PUTT, of Hampden Township, Cumberland County, Pennsylvania,
being of sound and disposing mind, memory and understanding, do hereby make,
publish and declare this as and for my Last Will and Testament, hereby revoking all
other Wills and Codicils heretofore made by me.
ARTICLE I.
I direct payment of all my just debts and the expenses of my last illness and
funeral from my Estate as soon after my death as conveniently may be done. I
authorize my Executor to expend funds from my Estate for the purchase, erection
and inscription of a suitable grave marker. Ail the foregoing shall be considered
expenses of the administration of my Estate.
ARTICLE II.
I give, devise and bequeath all the rest, residue and remainder of my Estate, of
whatever nature and wherever situate, unto my children, SARAH MAE ESSIG,
DANIEL F. PUTT, and REBECCA E. SHERMAN, in equal shares, the share of any
d~e. ceased child to pass to his or her issue per stirpes by representation.
ARTICLE III.
I name, constitute and appoint my son, DANIEL F. PUTT, to be Executor of this
my Last Will and Testament. Should he fail to qualify or cease to so act, I name,
constitute and appoint my daughter, SARAH MAE ESSIG, Alternate Executrix of this
my Last Will.
IN WITNESS WHEREOF, I have hereunto set my hand and seal on this the
day of ~ , 1985.
Anna Mae Putt
(SEAL)
Signed, sealed, published and declared by the above-named Testatrix, as and for
her Last Will and Testament, in the presence of us, who, at her request in her
presence and in the presence of each other have hereunto subscribed our names as
witnesses.
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA :
: SS:
COUNTY OF CUMBERLAND :
I, Ann Mae Putt, whose name is signed to the foregoing instrument, having been
duly qualified according to law, do hereby acknowledge that I signed and executed
the instrument as my Last Will and Testament; that I signed it willingly; and that I
signed it as my free and voluntary act for the purposes therein expressed.
Anna Mae Putt
(SEAL)
Sworn or affirmed to and acknowledged before me, by ANNA MAE PUTT, this
~ day of ~ , 1985.
Notary Ptfoil'~ ~-~'
NOTARY PUBLIC
MY IX~AMISSlON EXPIRES DEC. 2t, 1985
~EMOYI~, PA CUMBERLAND CO.
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA :
: SS:
COUNTY OF CUMBERLAND :
whose names are signed to the foregoing instrument, being duly qualified according
to law, do depose and say that we were present and saw the Testatrix sign and
execute the foregoing instrument as her Last Will and Testament; that she signed
willingly and that she 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
that time eighteen (18) or more years of age, of sound mind and under no constraint
or undue influence.
Sworn or affirmed to and subscribed to before me by ~~~.~.~~ and
~.~ ~. ~.~witnesses, this ~)~ day of '"~ , 1985.
PdiA. c
OF
ANNA MAE PUTT
MYERS, MYERS, FLOWER & JOHNSON
ATTORNEYS AT LAW
LENIOYN E, PENNSYLVANIA
CARLISLE, PENNSYLVANIA
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: ANNA MAE PUTT
Date of Death: December 29, 2002
Will No.: 21-03-00018
Admin. No.:
To the Register:
I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
January ].6 ,2003.
Name
Daniel F. Putt, Executor
Sarah Mae Essig
Address
6001 Michaele Dr., Enola, PA 17025
4 Rockaway Dr., Camp Hill, PA 17011
Rebecca E. Sherman 2280 Putt Lane, Enola, PA 17025
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None.
Date: January 16, 2003
Capacity:
Signature
Name: Edmund G. Myers, Esq.
Johnson, Duffle, Stewart & Weidner
Address: 301 Market St.
P. O. Box 109
Lemoyne, PA 17043-0109
Telephone: (717) 761-4540
Personal Representative
X Counsel for personal representative
August20,2003
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPARTMENT 280601
HARRISBURG, PA 17128-0601
Law Offices of
Johnson, Duffle, Stewart & Weidner
301 Market St.
P.O. Box 109
Lemoyne, Pa. 17043-0109
Telephone
(717) 787-3930
FAX (717) 772-0412
Dear Mr Myers:
Re:
Estate of Anne Mae Putt
File Number 2103-0018
This is in response to your request for an extension of time to file the Inheritance Tax Return for
the above estate.
In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for
filing the return is extended for an additional period of six months. This extension will avoid the
imposition of a penalty for failure to make a timely return. However, it does not prevent interest from
accruing on any tax remaining unpaid after the delinquent date.
The return must be filed with the Register of Wills on or before March 29,2004. Because Section
2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s)
will be granted that would exceed the maximum time permitted.
..... Claudia Ma;~e~upervisor~/
Document Processing Unit
"- ' Inheritance Tax Division
August 20, 2003
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
Re~PARTMENT 280601
HA~SURG, PA. ~'? 128-0601
FEB 11 P~2:23
Law Offices of G;e¢~
Johnson, Duffle, Stewart & Weidner Otjml::c, : r .
301 Market St.
P.O. Box 109
Lemoyne, Pa. 17043-0109
Telephone
(717) 787-3930
FAX (717) 772-0412
Dear Mr Myers:
Re:
Estate of Anne Mae Putt
File Number 2103-0018
This is in response to your request for an extension of time to file the Inheritance Tax Return for
the above estate.
In accordance with Section 2136 (d)of the Inheritance and Estate Tax Act of 1995, the time for
filing the return is extended for an additional period of six months. This extension will avoid the
imposition of a penalty for failure to make a timely return. However, it does not prevent interest from
accruing on any tax remaining unpaid after the delinquent date.
The return must be filed with the Register of Wills on or before March 29,2004. Because Section
2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s)
will be granted that would exceed the maximum time permitted.
SinceFely, ?. .........
Claudia Maffei, SUl~Crvisor
Document Processing Unit
Inheritance Tax Division
REV - 1500 EX + (6.00)
' REV 1500
,~ i OFFICIAL USE ONLY
-
OOM"ONW,A'THO~PENNS~.VA..A INHERITANCE TAX RETURN F"ENDM,E,
DEPARTMENT OF REVENUE
~.~.=~o~o,.~ ,.,~_o~o,RESIDENT DECEDENT , 21 03 00018
HARRISBURG,
- - ] COUNTY CODE ~_YEAR
D~cED~m'~ ~(L~ F~? ~.~ ~mDmE ~U,Tm~L~ ~ socm~L SECUhiW ~UUBm .U~BER
~'~K~t. A~A MAE 193 -24-2357
DATE OF DEATH (MM-DD-YEAR) [ DATE OF BIRTH (MM-DD-YEAR)
12/29/2002 06/22/1912 REGmSTER OF WmLLS
~ [] 1. Original Return [] 2. Supplemental Return
[] 4. Limited Estate [] 4a. Future Interest Compromise (date of death after
12-12-82)
[] 6. Decedent Died Testate (Attach copy [] 7. Decedent Maintained a Living Trust (Attach
of Will) copy of Trust)
[] 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between
] 3. Remainder Return (date of death prior to 12-13-82)
[] 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
[] 11 .Election to tax under Sec. 9113(A) (Attach Sch O)
NAME COMPLETE MAILING ADDRESS
, ~- EDMUND G. MYERS
~Oz
JOHNSON, DUFFIE, STEWART & WEIDNER P.O. BOX 109
TELEPHONE NUMBER LEMOYNE. PA 17043-0109
717/761-4540
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)
609,000.00
None~,
Non~
17,984.18
545.8t'
N o n
uF,"I~A[. UoE ONLY
24,635.92
45,621.00
12. Net Value of Estate (Line 8 minus Line 11 )
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax(Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax rate, x .00
or transfers under Sec. 9116(a)(1.2)
(8)
627,529.99
70,256.92
557,273.07
(11)
(12)
(13)
(14)
557,273.07
(15)
16.Amount of Line 14 taxable at lineal rate x .045
557,273.07
(16)
25,077.29
25,077.29
17.Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20. []
x .12
x .15
(17)
(18)
(19)
Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
ISTREET ADDRESS 2335 Putt Lane
cITY Enol;
i STATE PA II ZIP 17025
~ I
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
25,077.29
Interest/Penalty if applicable
D. Interest
E. Penalty
429.84
Total Credits (A + B + C) (2)
Total Interest/Penalty (D + E) (3)
If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is theTAX DUE
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + SA. This is theBALANCE DUE
0.00
429.84
25,507.13
25,507.13
(4)
(5)
(5A)
(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, benef ts 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.?. ....... r'-[ []
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 ~h~i I hav~amine~ ibis return including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete. Declaration
preparer o her than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS DATE
~D~aniel F. Putt, Executor~ 6001 Michaele Drive
~N~S'~RRE~ ~ Enola, PA 17025 ¢~q.~_.57- t~v
OR ADDRESS - DATE
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE ADDRESS DATE
EDMUND G. MYERS 301 MARKET ST.
,~~,~/,z~ ~ [~h~)OyNXEI, 0PgA 17043-0109 2/G('Ott'
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) (ii)]. The statutedoes not exempta 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)]. A sibling is defined,
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
PUTT, ANNA MAE
SCHEDULE A
REAL ESTATE
iFILE NUMBER
, 21-03-00018
All real property owned solely or as a tenant in common must be reported at fair market valu~air 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
NUMBER DESCRIPTION
~ Reai ESt;ie- House, farm buildings and vacant land consisting of 609,000.00
approximately 62 acres.
Deed Book H, Volume 13, Page 139
Sold - January 30, 2004 - Sale Price - $609,000.00
(Copy of Settlement Sheet attached)
TOTAL (Also enter on Line 1, Recapitulation)
VALUE AT DATE OF
DEATH
609,000.00
Settlement Statement u.s. Department of Housin9
TvDe of Loan [ itpd Urban Oevelo0rp;~t~ OMB No. 25J~2-0265
OFHA 2. I-]FmHA 3. OC .... Unins. I 6. FileNumber i 7. LoanNumber .MortgageI ....... C~Nun, ber
~VA s. ~Conv. ln~. [ 03-1284ICDFN
NAME OF BORROWER: CHARTER HOMES AT THE PRESERVE, INC.
ADDRESS: 114 FOXSHIRE DPJVE. LANCASTER PA 17601
NAME OF SELLER: ESTATE OF ANNA MAE PUTT
ADDRESS:
· NAME OF LENDER:
ADDRESS:
L PROPERTY ADDRESS:
L SETTLEMENT AGENT:
PLACE OF SETrLEMENT: 114 Foxshire Drive~J~neaster. PA 17601
. SETFLEMENT DATE: 01/30/2004
d. SUMMARY OF BORROWER'S TRANSACTION:
GROSS AMOUNT DUE FROM BORROWER 400.
2335 PUTF LANE, Enola, PA 17025
Hampden Township
Charter Land Exchange, L.P., 114 Foxshire Drive, Lancaster, PA 17601
00.
01. Conlracl sales brine
02. Personal Pronertv
103 Setllement charees to borrower fline 1400~
Adjustments for items said by seller
School Taxes 01/30/041006/30/04
Library_ Tax 01/01/041o 01/30/04
GROSS AMOUNT DUE FROM BORROWER
AMOUNTS PAID BY OR ON BEHALF OF BOR~
201. Deoosil or eamesl money
609,000.00 401.
402.
6,129.50 403
4O4
405,
n advance
1,024.70 408·
2.17- 409.
410.
411
41Z,
616,152.03 420.
:OWER 500,
500. on 501.
108.
LO9
110.
111
t12.
120.
200.
202 Princioal amount o! new loans 502.
203.Existing loan(si taken subiect Io 503.
204. 504.
205
2(36
207
208,
200
210.
211
214.
215,
2t5,
217,
215
219
220.
300.
301
~02.
Adjustments for items uneatd by selh
City/town taxes 01/01/04 lo 01/30/04
Counlv (axes 01/01/04 lo O1/30/04
TOTAL PAID BY/FOR BORROWER
CASH AT SETTLEMENT FROM OR TO BORROWER
Gross amount due from bo/Tower (line 120t
Less amounts tmid bv/for bo(rower flinn 220~
CASH FROM BORROWE[~
505
505
507
508
505
4.22 510.
43.25 51t.
513
514
515
516
517
515
619
547.47 520.
600.
616~152.03 601.
547.47 502.
615r604-56 603.
303.
K. SUMMARY OF SELLER'S TRANSACTION:
GROSS AMOUNT DUE TO SELLER:
Conlmct ~ale~ t~rice 609 t 000.00
Personal Prooenv
Adjuslments for Items Datd by seller in advance
School Taxes 01/30/04 ~o 06/30/04 j 1¢024.70
Library Tax 01/01/04 Io01/30/04 / 2.17-
GROSS AMOUNT DUE TO SELLER: 610t 022.53
REDUCTIONS IN AMOUNT DUE TO SELLER
Excess Deposit fsee Instruclions)
Selllement charoes Io seller flin~ 140~
Exislino loan(s1 taken subiecl to
Payoff of Firsl Morlrlage Loan
500.00
6t093.00
Ad!ustments for items un,aid by sell
Cilv/Iown laxes 01/01/04Io01/30/04
County laxes 01/01/04 tO 01/30/04
4.22
43.25
TOTAL R~SDUCTION AMOUNT DUE SELLER 6,640.47
CASH AT SETTLEMENT TO OR FROM SELLER
CASH TO SELLER
610e022.53
6,640.47
603r382.06
SUBSTITUTE FORM 109g SELLER STATEMENT: Tl~e inform~Uon con~ined herein is important tax informs§on and is being turnished to the Internal Revenue Service If you are requi ed to f lea leturn
a negBgence oenaR~ or other sanction v~ll be imposed on you W his item S equ red to be repotted and the IRS de ermines ha ~( has no been eported. The Contract Sa es P ce described on
ha. 401 above c~nsbtutes the Gross Ploceads el this transaction.
SELLER INSTRUCTIOHS: If this real estate was your principal fesidence, tile Form 211 g. Sata o¢ E~change o P nc pal Res dance, lot any gain. *~th your income tax return; for other ~ansac~ons,
c~mf~lete the ~ppEcable paffs of Fo m 4797. Form 6252 and/or Schedule O [Form 1040)
You ere requited by blw to provide the settle~nt agent '~Ith your corr ec~ taxpeyet idenlificatlon number. If you do not br~ide your correc~ taxpayer identification
number, you may be sub est to c~v}i or c~i~nal penalties imposed by [av~ Under penalties o perjury I c~rtify thai the number sho~ on this statement is my collect taxpayer Identifl~tion ~umbef.
TIN I SELLER(R) RIGI JATURE(S):
SELLER(S) NEW MAILING ADDRESS
TideE×press Settlement System Printed 01/29/2004 at 16:16 P.~V. HUD-I (3/86)
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
SETTLEMENT STATEMENT
L. SETTLEMENT CHARGES
'00. TOTAL SALES/BROKER'S COMMISSION based on Brice $60S, 000. O0 ~
'01.
02.
03,
~0o.
;03.
$
ITEMS PAYABLE IN CONNECTION WITH LOAN
Loan Orioinalion Fee %
File Number: 03-12841C
PAO~ 7
PAID FROM
BORROWER'S
FUNDS AT
SEI-FLEMENT
PAID FROM
SELLER'S
FUNDS AT
SETTLEMENT
I. cy~)ll Qiscounl
ADDraisal Fee
Credit Reood
105Lender'slnsDeclion Fee
[06. Aoulication Fee
107. Tax Service Fee
[08Documenl Preoaralion
}O9Flood Cerliticafion
)10,
)11
900.ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
;)01. Inlerest From lo
~L~.Modoaee Insurance Premium for
;)03Hazard insurance Premium lot 10
~04.
905.
OOO. RESERVF_.~J~_EPOSITED WITH LENDER FOR
001. Hazard insurance mo. _~ $
1002. Modoaoe Insurance mo. I~ $
LD~.3. City Prouedv Taxes mo. ~) $
1004. County ProDedv Taxes mo. (~, $
1005. SchoolTaxes mo. ~ $
1009. Aooreoale Analysis Adiuslment
L100. TITLE CHARGES
/day
/mo
/mo
4,43 /mo
45,36 /mo
203.71 /mo
0.00 0.00
1101. Sefllemenl orclo$ino lee
1102. AbstraGI or litle seargh
t103Title examination
1104Title insurance hinder
1105. Documenl Pren~L[aJlon
1106Notarv Fees
1107. AIIornev*s fees
6ncludes above items No:
Title Insurance.
fincludes above items No:
1109. Lender'sCoveraae $
1110. Owner's Coveraoe $
I0 Notary Public
lo Chicaqo Ti%le Insurance Cor~pa~y
1101-1104r 1108 (P.O.C.)
1111.
1112. Wire Fee
1113,
Charter Land Exchanqe, L.P.
J2.00. GOVERNMENT RECORDING AND TRANSFER CHARGES
1201 Recordina Fees Deed $ 39.50 : Mortaage $ : Release
1202. Oilv/Onunlv tax/slamos Deed $ 6,090.00 : ~aae $
1203. Slale Tax/slamos Deed $ 6,090. O0 : Modoag~ $
1204,
39.50
6t090.00
6't090.00
1205,
1300. ADDITIONAL SE~I'LEMENT CHARGES
1301. Su~ev
1302. Pest Inspecliqn
130~.
1304
1305.
~06. Tax Cedificalion IQ Kathr~n W. Fetrow
3307
1308
~_4D~L~C)TAL SETTLEMENT CHARGES ienler nn lines 103. Section J ,nd SO2 S~clion KI 6 t 12 9.50
HUD CERTIFICATION OF BUYER AND SELLER
I have carefu~y reviewed Ihe HUD-1 Selt~emen/Statement and to the best olm knovdedge and beliet. It is a true and accurale stalement of mit
WARNING: IT IS A CRIME TO KNOV'vl NG LY MAKE FALSE STATEMENTS TO THE
UNITED STATES ON THIS OR ANY SIMILAR FORM PENALllES UPON COI, IVICTION
CAN INCLUDE A FINE AND IMPRISONMENT FOR DETAILS SEE TITLE 8:
U s. CODE SECTIOI,! 1001 AND SECTION 1010
']'hleE~nreg~ ~qetttemeHt S','stem Printed 01/29/2004 at 16:16
3.00
6r093.00
lhe HUD.1 Semement State,which I have pre0ared ~s a hue and accura(e accevnt el th~s Uansa~ion
have caused or ~11 taus e Junds to be disbur~d m ac~rdan~ ~(h th~ statenlenC
DATE
REV. I[UD-I
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
PUTT, ANNA MAE
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUMBER
21-03-00018
Include the proceeds of litigation and the date th~: proceeds were received by the estate~ll property jointly-owned with the right of
survivorship must be disclosed on schedule .
NUMBER
1
2
3
ITEM
DESCRIPTION
Blue Cross - premium refund
Cash in decedent's possession
Cash - Addendum to Real Estate Option Agreement between Kevin T.
Noonan, Buyer (Charter Land Exchange) and the Estate of Anna Mae Putt
granting buyer an extension of the settlement date to January 30, 2004.
Consideration paid by buyer.
TOTAL (Also enter on Line 5, Recapitulation)
VALUE AT DATE OF
DEATH
415.18
1,069.00
16,500.00
17,984.18
"~ SCHEDULE F
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN JOINTLY-OWNEDPROPERTY
RESIDENT DECEDENT
PUTT, ANNA MAE j FILE NUMBER
21 - 03- 00018
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 Rebecca E. Sherman 2280 Putt Lane Daughter
Enola, PA 17025
JOINTLY OWNED PROPERTY:
i LETTER ~ DATE ~ DESCRIPTION OF PROPERTY ~
ITEM i F~p ~nm~T ~ .... Jlnclude name of financ a institution and bank account numberJ DATE OF DEATH J ~o,.~° OF~ J DATE OF DEATH
NUMBER ~ ~'~:~"~'l~' '~'~ ior similar identify ng number Attach deed foriointlv-held real VA/H: C~ Aee:T I L---~,U'O VALUE OF
............... ].._estate ._ ' ' ............ -'IININTERES'I1 DECEDENT'S INTEREST
1 A 07/28/1972! Allfirst Bank - Checking Account ' 1,091.62~'~ 50°~ ~54~.81.81
No. 0069765138 [
/
TOTAL (Also enter on line 6, Recapitulation)
545.81
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
PUTT, ANNA MAE
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A. FUNERAL EXPENSES:
1 Eby Granite Works - marker lettering
FILE NUMBER
21 - 03- 000]g
AMOUNT
85.00
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Daniel F. Putt, Executor
Social Security Number(s) / EIN Number of Personal Representative(s):
198-30-4383
Street Address 6001 Michaele Drive
City Enola State PA Zip 17025
Year(s) Commission paid
Attorney's Fees Johnson, Duffle, Stewart & Weidner
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State
Relationship of Claimant to Decedent
Probate Fees Register of Wills - Cumberland County
Zip
Accountant's Fees
Tax Return Preparer's Fees
2,000.00
12,000.00
292.00
Other Administrative Costs
Cumberland Law Journal - legal advertisement
The Patriot-News - legal advertisement
75.00
105.73
Total of Continuation Schedule(s)
TOTAL (Also enter on line 9, Recapitulation)
10,078.19
24,635.92
ESTATE OF
PUTT, ANNA MAE
3 Waypoint Bank - charge for Estate checks
.~ Schedule H
COMMONWEALTH OF PENNSYLVANIA FuneralExpenses&
INHERITANCE TAX RETURN Admi~COSIS conlinued
RESIDENT DECEDENT
FILE NUMBER
Register of Wills - file Inventory & Inheritance Tax Return
PP&L - electric service - 1/2002 - 1/2004
Amerigas - gas service
Kathryn W. Fetrow, Tax Collector - County/Township real estate
taxes - 2003
Recorder of Deeds - 1% transfer tax
2003 - School District Real Estate Taxes - Hampden Township
Dunn Insurance - Farm Liability Insurance - annual premium
Kathryn W. Fetrow - Tax certification
County/Township real estate taxes due - 1/1/04 - 1/30/04
8
9
10
11
12
21 03-00018
3.00
28.00
192.41
43.16
612.48
6,090.00
2,395.67
663.00
3.00
47.47
Page 2 of Schedule H
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
EST^TE 0F
PUTT, ANNA MAE
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
FILE NUMBER
21 - 03 - 00018
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1 Department of Public Welfare - medical expenses incurred during the last
six months of the decedent's life - Class 3 claim pursuant to Section 3392 of
the PEF Code. (See attached).
2
3
4
5
6
7
Department of Public Welfare - priority Class 6 claim.
(See attached).
Community Lifeteam, Inc. - balance due for services not covered by
insurance or Medicare
West Shore Anesthesia - balance due for services not covered by
insurance or Medicare
Pinnacle Health Hospitals - balance due on decedent's account at
Seidle Hospital Skilled Nursing Facility
Daniel F. Putt - expenses paid for decedent while she was a patient at Seidle Hospital
Skilled Nursing Facility. Reimbursement for 2002 school district real estate taxes in
the amount of $2,317.97 and Old Guard Insurance - homeowner's insurance in
the amount of $511.00.
West Shore Emergency Medical Services
Transport and Mileage - Holy Spirit to Seidle
TOTAL (Also enter on Line 10, Recapitulation)
AMOUNT
22,290.61
18,096.44
506.50
11.25
1,811.58
2,828.97
75.65
45,621.00
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF PUBLIC WELFARE
BUREAU OF FINANCIAL OPERATIONS
ESTATE RECOVERY PROGRAM
PO BOX 8486
HARRISBURG, PA 17105-8486
January 22, 2003
JOHNSON DUFFIE STEWART & WEIDNER
EDMUND G MYERS ESQUIRE
301 MARKET ST
P 0 BOX 109
LEMOYNE PA 17043-0109
Re: ANNA PUTT (ESTATE)
CIS ~: 250156607
SSN: 193-24-2357
Date of Death: 12/29/2002
Dear Attorney Myers:
Please be advised that the Department of Public Welfare maintains a
claim in the amount of $40,387.05 against the above-mentioned estate. This
claim is for restitution of medical assistance granted on behalf of the
decedent for which the Probate Estate is now responsible to reimburse the
Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as
amended by Act 20-95, effective June 30, 1995. Enclosed is the Department's
itemized statement of claim.
A portion of this medical expense, namely $22,290.61, was incurred
during the last six months of the decedent's life; therefore, it is a Class 3
claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries
Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $18,096.44, is
to be entered as a priority Class 6 claim against the estate.
Please acknowledge receipt of this letter and advise whether the
Commonwealth's claim is admitted and when payment may be expected. If the
estate accounting is complete, please provide a copy. If the estate contains
real estate, please provide copies of the deed, the latest tax assessment,
and a current appraisal, if available.
Sincerely,
Elaine L. Andrews
Claims Investigation Agent
717-772-6608
717-705-8150 FAX
Enclosure
REV-1513,EX+ (9-00) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
PUTT, ANNA MAE
~ 21 - 03 - 00018
NUMBER
I.
1
II.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS (include outdght spousal distributions)
Rebecca E. Sherman
2280 Putt Lane, Enola, PA 17025
Sarah (Sara) Mae Essig
4 Rockaway Drive, Camp Hill, PA 17011
Daniel F. Putt
6001 Michaele Drive, Enola, PA 17015
RELATIONSHIP TO
DECEDENT
Do Not List Trustee(s)
Daughter
Daughter
SoB
i Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover shee
!NON-TAXABLE DISTRIBUTIONS:
iA. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
AMOUNT OR SHARE
OF ESTATE
One-third residue
One-third residue
One-third residue
TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of PUTT, ANNA MAE
also known as
, Deceased
No. 21 - 03- 00018
Date of Death 12/29/2002
Social Security No. 193-24-2357
Daniel F. Putt, Exe6utor
The PErsOnal Representative(s) of the above Estate, deceasedl verify that the items appearing in the following Inventory
include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania
of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the
Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that
which appears in a memorandum at the end of this Inventory. I/VVe verify that the statements made in this Inventory are true
and correct. I/VVe understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904
relating to unsworn falsification to authorities.
Attorney:
I.D. No.:
Personal Represe.nt~tive
EDMUND O. MYERS Signature: ,f~.4.~ P~
Daniel F. eutt~ EXe~ut~
20558 Signature:
Signature:
Address:
301 MARKET ST.
P. O. BOX 109
LEMOYNE, PA 17043-0109
Telephone: 717/761-4540
Personal Property
Blue Cross - premium refund
Address: 6001 Michaele Drive
Enola, PA 170,2~ C2.?
~ ~:'
Telephone: (717) 732-3073
Dated:
Cash in decedent's possession
1,069.00
Cash - Addendum to Real Estate Option Agreement between Kevin T.
Noonan, Buyer (Charter Land Exchange) and the Estate of Anna Mae Putt
granting buyer an extension of the settlement date to January 30, 2004.
Consideration paid by buyer.
16,500.00
Total Personal Property
$17,984.18
(Attach additional sheets if necessary) Total Personal Property and Real Estate $626,984.18
Register of Wills of Cumberland County, Pennsylvania
Estate of PUTT, ANNA MAE
also known as
INVENTORY
continued
, Deceased
No. 21 - 03- 00018
Date of Death 12/29/2002
Social Security No. 193-24-2357
Real Estate
Real Estate - House, farm buildings and vacant land consisting of
approximately 62 acres.
Deed Book H, Volume 13, Page 139
Sold - January 30, 2004 - Sale Price - $609,000.00
(Copy of Settlement Sheet attached)
609,000.00
Total Real Estate
$609,000.00
2
COMk,~ONWEALTH 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 003550
MYERS EDMUND G
301 MARKET STREET
P O BOX 109
LEMOYNE, PA 17043
........ fold
ESTATE INFORMATION: SSN: 193-24-2357
FILE NUMBER: 2103-001 8
DECEDENT NAME: PUTT ANNA MAE
DATE OF PAYMENT: 02/11/2004
POSTMARK DATE: 02/09/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 12/29/2002
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 $25,507.13
REMARKS:
TOTAL AMOUNT PAID:
$25,507.13
SEAL
CHECK//126
INITIALS: JA
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
~STATE OF ANNA MAE PUTT
DANIEL PUTT, EXECUTOR
6001 MICHAELE DR.
ENOLA, PA 17025
60-7238.:110
2313 ---
0100491992
2/09/2004
· ~~_ REGISTER OF WILLS, AGENT
I $ 25,5o?. x3
· z-t-uo-O0018 ~,,,IJan~1~r=Putt. k-~ecutor ~ ~
BUREAU OF TNDI'VTDUAL TAXES
INHERITANCE TAX OIVI$ION
DEPT. ZSO&O1
HARRISBURG, PA 171Z8-0601
CONMON#EALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF ZNHER/TANCE TAX
APPRA/SEHENT, ALLO#ANCE OR DZSALLO#ANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
EDMUND 6 MYERS 'C)~
JOHNSON ETAL
PO BOX 109
LEMOYNE PA 27045
BATE 03-29-200q
ESTATE OF PUTT
BATE OF BEATH 12-29-2002
FILE NUHBER 21 05-001B
~.~;~ CUMBERLAND102
ANNA M
HAKE CHECK PAYABLE ANB REMIT PAYMENT TO:
REGISTER OF #ILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LO#ER PORTION FOR YOUR RECORBS 44
REV-1547 EX AFP C01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLO#ANCE OR
BZSALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF PUTT ANNA M FILE NO. 21 03-0018 ACN 101 BATE 03-29-Z004
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Raml Estate (Schedule A) (1)
2. Stocks K Bonds (Sdvidulo B) (2)
3. Closely Hold Stock/Partnership Interost (Schsdulo C) (3)
q. Hortgagas/Hotes Receivable (Schedule D)
S. Cash/Bank Deposits/Hisc. Parsons! Property (Schedulo E)
&. JointLy O~nad Property (Schedule F) (6)
7. Transfsrs (Schedule G~ (7)
8. Total Assets
APPROVED BEBUCTZONS ANB EXEHPTION$:
9. Funeral Expenses/Ada. Costs/Misc. Expenses (Schedule H) (9)
lO. Dobts/Hortgaga Liabilities/Liens (Schedule [) (la)
Tota! Deductions
I~ Value of Tax Return
609~000.00
.00
.00
.00
17~984.18
515.81
.00
(8)
2q,635.92
NOTE: To insure proper
credit to your account,
submit thou p par portion
of this fora ~ith your
tax payment.
627,529.99
45.621.00
(11) 70.26&. 9~
(12) 557,273.07
13.
14.
NOTE:
ASSESSMENT OF TAX:
15. Amount of Lina lq at Spousal rata
16. Amotm'*l: of Line lq taxable at Lln~l/Clmss A rmta
17. Amount of L/ne lq at Stbltng r~te
18. Amount of Line 1~ tax~ble at Collateral/Class B rets
19. PrtncJ ~el Tax DUO
TAX CREDITS:
PAYMENT RECEIP I DI:~vUNT (4..I
DATE I~BER /NTEREST/PEN PATD (-)
02-09-2004 CD003550 429.84-
Char/tablm/governmental Bequests; Non-alocted 9113 Trusts (Schedule J) (13) .00
Net Valuo of Estate Subject to Tax (14) 557,273.07
IY an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 wlll
re~lect ~igures that include the total o~ AkL ~etu~n$ assessed to date.
(is) .00 x 00 = .00
('!6) 557,273.07 X 045 = 25,077.29
(~7) .00 x 12 = .00
(].8) .00 x 15 = .00
(19)= 25,077.29
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADD/TZONAL INTEREST.
AMOUNT PAID
25,507.13
TOTAL TAX CREDIT
BALANCE OF TAX DUE
ZNTEREST AND PEN.
TOTAL DUE
25,077.29
.00
.0!
.01
( ZF TOTAL DUE ZS LESS THAN ~1, NO PAYMENT ZS RE;4JZRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIt' (CR); YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
PLEASE FILE THIS REPORT WITHIN TVVO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM
YEARLY UNTIL COMPLETION.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: ANNA MAE PUTT
Date of Death: DECEMBER 29, 2002
Will No.: 21-03-00018 Admin No.:
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 X No
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete: .
3. If the answer to No. 1 is yes, state the following:
A. Did the personal representative file a final account with the Court?
Yes No X
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 X 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.
Signature
P C Lcl P- X ~,1
Capacity:
Edmund G. Myers, Attorney
Johnson, Duffle, Stewart & Weidner
301 Market Street, P.O. Box 109
Lemoyne, PA 17043-0109
Address
(717) 761-4540
Telephone No.
Personal Representative
X Counsel for Personal Representative