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Home My WebLink About04-0441-Register 0f Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of MARGARET A. TERREL No. ~ i also known as Petitioner(s), who is/are 18 years of age or older, apply(les) for: , Deceased Social Security No.175540344 (COMPLETE "A" OR "B" BELOW:) A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut --I Decedent, dated and codicil(s) dated .'7.; C namgd in the L_a~t Will of the State relevant circumstances, e.g., renunciation, death of executol~qtc Except as follows, Decedent did not marry, was not divorced and did not have a child bom or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incapacitated: ~ [ B. Grant of Letters of Administration ~ (c.t.a., d.b.n.c.t.a.: pendente lite, durante absentia; durante minodtate) Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence EDWARD C. TERREL SPOUSE 1024 AUDUBON ROAD BILLIE J. LEE DAUGHTER MECHANICSBURG, PA 17055 024 AUDUBON ROAD MECHANICSBURG, PA 17055 (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with his/her last family or principal residence at 1024 AUDUBON ROAD, MECHANICSBURG, PA 17055 (LOWER ALLEN TWP) (list street, number and municipality) Decedent, then 45 years of age, died APRIL 17 ,200.__~_4, at ROBERT PACKER HOSPITAL, SAYRE, PA (Location) Decedent at death owned property with estimajed 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 ........................................................................................ $ Total Real Estate situated as follows: 500.00 500.00 Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: J Signature Typed or pdnted name and residence EDWARD C. TERREL 1024 AUDUBON ROAD MECHANICSBURG, PA 17055 Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and afffirm(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 weil and truly administer the estate according to law. Sworn to and affirmed and subscribed before me this ~,~ TI~j day of ~ [~ (~ ~j~j¢ j~ ,d~"~j~C//~DWARD C. TERREL DECREE OF REGISTER dF WILLS OF CUMBERLAND COUNTY Estate of MARGARET A. TERREL Deceased No. 2,1-04-4 also known as Social Security No: 175540344 Date of Death: 4/17/2004 AND NOW, I¥~'L'( ',~ , 2004 ,in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters I~ Testamentary ~ of Administration (c.t.a,, d.b.n.c.t,; pendente lite; durante absentia; durante rninodtate) are hereby granted to EDWARD C. TERREL in the above estate and that the instrument(s), if any, dated N/A described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters .................................... $ Short Certificate(s) ............... $ Renunciation .......................... $ Affidavit ( ) ....................... $ Extra Pages ( ) .............. $ Codicil ................................. $ JCP Fee ................................. $ Inventory & Tax Forms ............. $ Other ...................................... $ TOTAL ............................. $ Attorney: FRANK J. NIEMIEC, ESQUIRE I.D. No: 17755 Address: 427 MAIN STREET TOWANDA PA 18848 Telephone: (570) 265-2147 DATE FILED: DECEASED A/K/A CERTIFICATION OF NOTICE UNDER PA SUPREME COURT RULE 5.6 & 5.7 MARGARET A. TERREL ESTATE NO. 21 04 0441 TO THE REGISTER OF WILLS OF CUMBERLAND COUNTY: I certify that Notice of Estate administration required by rule 5.6 and 5.7 of the PA SC NS ORPHANS' Court Rules was served on or mailed to the following beneficiaries of the above- captioned estate. JUNE o,~., 2004 NAME ADDRESS EDWARD C. TERREL 1024 AUDUBON ROAD, MECHANICSBURG, PA 17055 BILLIE J. LEE 1024 AUDUBON ROAD, MECHANICSBURG, PA 17055 Notice has now been given to all persons entitled thereto under Rule 5.6 and 5.6 except DATE: Capacity ~(SIGNA~) EMILY K. DIETRICH, ESQUIRE NIEMIEC, SMITH & PELLINGER LLP 427 MAIN STREET TOWANDA, PA 18848 (570) 265-2147 Personal Representative X Counsel of Record for Personal Representative/Estate ~REV_1500EX.j.(6-00) J:>:>~ 235.0':: $ -')d iog.CO PI.y.\) 211 00 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG. PA 17128.0601 ~ Z W C W U w C w .. :lC::!;tn 0"'''' w~o za:9 00-'" 0- < DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITlAL) TERREL, MARGARET A. DATE OF DEATH (MM-DD-Year) DATE OF BIRTH (MM-DD-Yaar) [K] 1. Original Return o 4. Limited Estate o 6. Decedent Died Testate (Attach copy 01 WillI [g] 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise (date 01 death after 12-12-82) o 7. Decedent Maintained a Living Trust (Mach OO\I~ ofTm$\} o 10. Spousal Poverty Credit (date of death tletween 12-31-91 and 1-1-95) OFFICIAL USE ONLY FILE NUMBER 2 1 -0 4 0 4 4 1 com:rTYOO1iE ----vEAR- - - 'FruM8ER-- SOClAl SECURITY WJMBER 175-54-0344 THIS RETURN MUST BE FilED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 03. Remainder Return (dateoldeathpnono12-13-82) o 5. Federal Estate Tax Retum Required ..Q.. 8. Total Number of Sa1e Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Atlach$ch0) nuS'Sl!i'mOHMUS'J'lilECOMPI.;I!TEl>..ALl;CORflE$l'OtiIl>l!lIllll!!'~ND~l"IDl!Ntl'AL.tM'.IN""'RtDiI'IQN;[$iEllillllili\E;DIRECtEIl to~ NAME COMPLETE MAILING ADDRESS NIEMIEC, FRANK J. 427 MAIN STREET FIRM NAME (It Applicable) NIEMIEC, SMITH & PELLlNGER, LLP TELEPHONE NUMBER 570 265-2147 TOWANDA PA 18848 OFFicIAL USE-ONLY v 04/17/2004 11/30/1958 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) TERREL, EDWARD C. .. z w c z o 0- m w '" '" o o (1) (2) (3) (4) (S) (6) (l) (8) (9) (10) z o i= c:( oJ :> ~ ii: c:( u w a: 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule Dj 5. Cash, Bank. Deposns & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. InterNivos Transfers & Miscellaneous Non-Probate Property {Schedule G or L} 8_ Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule I) 11. Total Deduclions (total Lines 9 & 10) 12. Net Value of Estate (line 8 minus Une 11) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for wt\ich 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 z o ~ ~ :> Q. :::E o U ~ ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 37.666.31 7,666.31 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 1axable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due (11) (12) (13) (14) X ~(15) X .045 (16) X .12 (11) X .15 (18) {19} 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 105,840.50 ( i 0.00 ~..... 105,840.50 51,000.41 9,507.47 60,507.88 45,332.62 45.332.62 344.98 344.98 . UO!ldope JO poOlq 'q J.41.4M 'lu.paoaP .41 4l!M uowwoo U! IUaJed .uo Ise.lle se4 041'; lenplA'pUl" ue se 'ZOI6 UOlp.S ,"pun 'P.U!I.P S! 5ullq!S V '[(n)le)9~ 169 'S'd U] %Z~ S! s5ullq!S S,lu.paoaP .4110 .sn .41 JOpO 01 SJ.IsueJjjo .nleA I.U .41 uo p.sodw! .leJ XBI.41 '[(I)(e)91~69 'S'd U] In)91169 'S'd U U! P.IOU se Idoox. '%9'v S! s.!Jep~.u.q le.U!1 S,lu.poo.p .4jjO .sn .41 JOI JO 01 sJ.jsueJllo .nleA I.U .41 uo p.sodw! .leJ XBI.41 '[Iz' ~)(e)9~ 169 'S'd U] %0 S! 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'z .un ue41 J.le.J5 Sl t .U!l + I .U1lll '9 ~L"llvE$ lN3!)tf (89) 1'19) (9) Iv) punjaJ 1,.anOO, 0' OZ aU1l1 a61d uo xoq ~oa4:J 'lN3WAlfdH3^O .41 S! S!41 '.ou.J.U!P .4IJ.IU. 't .Un + ~ .un ue4IJ.le.J5 S! Z.U!l II 13+ a) '1Ieu.dnS.J.lulleI01 'v ~L'llvE$ EL"E$ It) EH$ 'lIeu.d '3 IS.J.lul 'a .Iqeolldde I! '1Ieu.dnS.J.IUI 'E Iz) 1:)+ 8 + V) SI!p8J:) lel01 IUnOOS!a ':) slu.w,ed JO!Jd '8 I!PaJ:) 'V.AOd lesnods ''1 slu.w,edlsllp.J:) 'z 16~ .Unl.5ed) .na xe1 '1 :sJ!peJ:) pue sJuew,{ed xel B6'vVE$ (I) 990H dlZ I V'd 3"lS I 8}:jnSS::JINV'H::J3V'l Ale aV'o}:j NOSnanV' VZO ~ SS3"OOV 133"lS :SS8J 8 elifwo S U8 8:l8 PP'lt J I ::> .J P o .,"''''''';''''. COMMONWEALTH OF PENNSYLVANIA INHERll ANCE lAX REI URN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC, PERSONAL PROPERTY ESTATE OF TERREL MARGARET A FILE NUMBER 21 04 0441 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. DESCRIPTION PROCEEDS OF SETTLEMENT OF SURVIVAL ACTION, FILED TO BRADFORD COUNTY COURT OF COMMON PLEAS NUMBER 04 CV 000369 VALUE AT DATE OF DEATH $105,000.00 2. CEPA UNITED METHODIST FEDERAL CREDIT UNION $839.00 3. INCOME TAX REFUND $1.50 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 105,840.50 ."''''',,.,:,,'. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAA RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF TERREL MARGARET A. FILE NUMBER 21 04 0441 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. GERALD W. VICKERY, JR. FUNERAL HOME, INC. $7,555.56 2. STULL'S FLOWERS & GIFTS $125.00 3. GLENWOOD CEMETERY $800.00 4. HEADSTONE $2,905.00 5. CLERGY $200.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative (5) Social Security Numbe~s) I EIN Number of Personal Representative(s) Street Address City State Zip Year{s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedenfs address is not the same as claimanfs, attach explanation) $3,500.00 Claimant EDWARD C. TERREL Street Address 1024 AUDUBON ROAD City MECHANICSBURG State PA Zip 17055 Relationship of Claimant to Decedent HUSBAND 4. Probate Fees CUMBERLAND COUNTY REGISTER OF WILLS $58.00 5. Accountanfs Fees 6. Tax Return Preparers Fees 7. PA DEPT OF VITAL RECORDS - 5 DEATH CERTIFICATES $45.00 8. TRANSUNION (CREDIT REPORT) $9.00 9. CUMBERLAND COUNTY LAW JOURNAL (ADVERTISING) $75.00 10 THE SENTINEL (ADVERTISING) $149.99 11. COSTS OF LITIGATION (30%) IN BRADFORD COUNTY COURT OF COMMON $581.36 PLEAS 04 CV 000369 (SEE ATTACHED LIST) 12 ATTORNEY FEES OF LITIGATION (30%) IN BRADFORD COUNTY COURT OF $34,996.50 COMMON PLEAS 04 CV 000369 (NIEMIEC, SMITH & PELLlNGER) TOTAL (Also enter on line 9, Recapitulation) $ 51,000.41 (If more space is needed, insert additional sheets of the same size) """"Ex.r,,,,. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES & LIENS ESTATE OF TERREL. MARGARET A. FILE NUMBER 21 04 0441 Include u",elmbuBed medical expen.e.. ITEM NUMBER DESCRIPTION AMOUNT $120.79 1. JC PENNEY CHARGE CARD 2. SEARS CHARGE CARD $620.71 3. OLD NAVY CHARGE CARD $79.50 4. GUTHRIE CLINIC MEDICAL BILLS $113.50 5. CARE FIRST BLUE CROSS BLUE SHIELD (SUBROGATION COLLECTED BY PRIMAX RECOVERIES. INC.) $8,572.97 TOTAL (Also enter on line 10, Recapitulation) $ (If more space IS needed, Insert additional sheets of the same size) 9,507.47 . REV-1513EX<l9* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF SCHEDULE J BENEFICIARIES FILE NUMBER T R"T A ?1 OLl OLlLl1 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not Ust Trustee{s) OF ESTATE I. TAXABLE DISTRIBUTIONS [include ounight spousal distnbutions, and lnlnsfers under 5,",. 9116 (a) (1.2)] 1. EDWARD C. TERREL HUSBAND FIRST $30,000.00 PLUS 1024 AUDUBON ROAD ONE-HALF OF THE MECHANICSBURG, PA 17055 BALANCE 2. BilLIE J. lEE DAUGHTER ONE-HALF OF THE 1024 AUDUBON ROAD BALANCE MECHANICSBURG, PA 17055 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space IS needed, insert additional sheets of the same size) 03/31/2005 Page 1 Civil, Records - 10/15/2004 v v EDWARD C TERREL, mdlVldually and as AdmImstrator of the Estate of MARGARET A TERREL, P]aml1ffs : IN THE COURT OF COMMON PLEAS . OF BRADFORD COUNTY, PENNSYLVANIA v : CIVIL ACTION-LAW - = = -= AMY JENNINGS and. g j .... SMITHFIELD TOWNSHIP, I Defendants NO 04 CV 000369 ....J : . : . : . . : : . . : : . : : . : : . : : . : . : . : : . : : . : : . : : : : : ; : ; . . : . : : ; ; : : ::1>: ;.: , . ORDER ;,~ o AND NOW, tins 1"1\01. day of n~ 2004, upon consideratIOn of the ) Pel1l1on for Approval of Settlement of Edward C. Terrel, It IS hereby ORDERED AND DECREED that the Petil10n IS GRANTED and the settlement set forth herem IS hereby approved It IS FURTHER ORDERED that Pel1l1oner, as adnumstrator of the Estate of Margaret A. Terrel, IS authonzed to enter mto and execute all necessary settlement agreements, releases and checks and make appropnate dlstnbul1ons, consistent WIth the terms of the settlement as outlined in thiS Order and the attached Pel1l1on Further, thiS Court directs that the dlstnbul10n of the settlement proceeds shall be as follows: ]) SUrviVal Acl1on: a) Nlenuec, SmIth & Pelhnger, LLP, combmed attorney fees and costs of personal mJury actIon: ThIrty-FIve Thousand FIve-Hundred Seventy-Seven Dollars and EIghty-FIVe Cents ($35,577.85), b) Edward C Terrel, retmbursement for payment of estate's btlIs- Twelve Thousand Four-Hundred and SIX Dollars and F1fty-S.x Cents ($]2,406 56); c) Robert Packer HOSpItal: Three-Thousand Seventy-Three Dol1arsand No Cents ($3,073 00), d) Guthne Chmc' One-Hundred T1nrteen Dollars and FIfty Cents ($11350), e) NIemIec, SmIth & Pelhnger, retmbursetnent of costs advanced as set forth r;CGCI~., :1> OCT -6_ NIEMIEC. SMITH & PEWNGER COURT r .' :~ii~ISITWION ill 03/31/2005 Page 2 Civi1,Records - 10/15/2004 , ......... v above m Paragraph 20, above, TIrree Hundred ThlIty-SIX Dollars and Nmety- l'Iine Cents ($336.99); and t) Edward C Terrel. Forty-Thousand Seven Hundred Fifty-Three Dollars and Nmety-Flve Cents ($40,753.95); and g) Bilhe J. Lee: Ten Thousand Seven Hundred FIfty-Three Dollars and Nmety- Five Cents ($10,753.95). 2) Wrongful Death Action: a) NiemIec, Smith & Pelhnger, LLP, combmed attorney fees and costs of personal Injury action. Eighty-Three Thousand Fifteen Dollars and No Cents ($83,015 00); and b) to Edward C. Terrel, the sum of One-Hundred Sixty-One Thousand Nme- Hundred EIghty-Five Dollars and No Cents ($161,985.00). ThIs Court retmns JurisdiCtIon of the subject matter of thiS agreement to effectuate, rmplement and enforce thIS agreement and the Court's orders related to It and any related agreements executed and dehvered pursuant to the terms of the settlement. BY THE COURT c1fl, J. ill COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO BOX 280601 HARRISBURG, PA 17128-0601 T e/ephone 9/29/2004 717-783-0972 Frank J Niemiec, Esquire Niemiec et al 427 Main Street Towanda PA 18848 COpy Re: Estate of Margaret Terrel File Number: 2104-0441 Court Number: Unknown Dear Mr. Niemiec: . , The Department of Revenue has received a letter conceming the Petition for Approval of Settlement Claim to be filed on behalf of the above-referenced Estate in regard to a wrongful death and survival action. It has been forwarded to this Bureau for the Commonwealth's approval of the allocation of the proceeds paid to settle the actions. Pursuant to the letter, the 45 -year-old-decedent died as a result of motor vehicle accident. Decedent is survived by the decedent's spouse and one adult issue. Please be advised that, based upon these facts, our discussion of the settlement and for inheritance tax purposes ouly, this Department has no objection to the allocation of the gross proceeds based on our discussions. The estate has agreed to supply the court with a petition allocating this action, $ 245,000.00 to the wrongful death claim and $ 105,000.00 to the survival claim. Proceeds ofa survival action are an asset included in the decedent's estate and are subject to the imposition of Pennsylvania inheritance tax. 42 Pa.C.S.A. ~8302; 72 P.S. ~~9l06, 9107. Costs and fees must be deducted in the same percentages as the proceeds are allocated. In re Estate of Merrvrnan, 669 A.2d 1059 (Pa. Cmwlth. 1995). "--. I trust that this letter is a sufficient representation ofthe Department's position on this matter. As the Department has no objections to the Petition, an attorney from the Department of Revenue will not be attending any hearing regarding it. Please contact me if you or the Court has any questions or reqnires anything additional from this Bureau. Finally, the approval of this allocation is limited to this estate and does not reflect the position that the Department may take in any other proposed distribution of proceeds of a wrongful death / survival action. J P I ibert Business & Trust Valuation Manager Inheritance Tax Division Bureau ofIndividual Taxes OCT - 1 21JO+ Primax Recoveries Incorporated P.O. Box 4003 Schaumburg, IL 60168-4003 December 20, 2004 Mr. Frank Nemick Attorney at Law 427 Main Street Towanda, PA 18848 Claimant: Our Case ID: Date of Loss: Our Client: Margaret Terrel 5453906 04/17/2004 CareFirst BlueCross BlueShield (National Accounts) RELEASE OF LIEN Primax Recoveries Incorporated, as subrogation and reimbur~ement agent for Care First BlueCross BlueShield (National Accounts), in consideration of the paym omt of the sum of $8,572.97, hereby accepts said payment in full satisfaction of its claim for lien and hereby releases its aforesaid lien. It is also our understanding that this agreement is contractuEd, not a mere recital, and is intended to represent a full and final settlement of the claims of the parties. In consideration of this agreement, Primax Recoveries Incorporated waives and releElses any claim for reimbursement for medical expenses advanced on behalf of your client for injuries arising out of the loss described above. In consideration of this agreement, you, on behalf of your client, hereby waive and release any claim against Primax Recoveries Incorporated arising out of its claim of lien for reimbursement of medical expenses arising out of the loss described above, whether at law or at equity. This release is based upon representation that your client ha~; submitted all medical bills resulting from the aforesaid accident for payment to CareFirst BlueCross BlueShield (National Accounts). Any bills for medical services rendered prior to the date of this release but not yet submitted for payment will be denied payment based upon the aforesaid representation. This withdrawal is not for any other subrogation interests ":hat CareFirst BlueCross BlueShield may have because of [your client's orthe claimant's] coverage in another CareFirst Health benefit product that Primax Recoveries Incorporated does not represent. Acknowledged: o PHONE 570-297-3030 FAX 570-297-4093 GeraldW. Vickery, Jr., Supvr. Gerald W. VICKERY, Jr. Funeral Home, Inc. 110 W. Main Street Troy, PA 16947 Account No:VIC-204018 Marqaret A. Terrel FUNERAL SERVICES FOR: Date of Service: 04/21/04 TO: Edward C. Terrel 1024 Audubon Road Mechanicsburg, PA 17055 AMOUNT 1,495.00 275.00 765.00 470.00 585.00 180.00 325.00 290.00 no.oo 45.00 85.00 45.00 1,695.00 895.00 20.00 38.00 177.56 60.00 7,555.56 7,618.00 -62.44 FUNERAL GOODS AND SERVICES SELECTED Reprint Basic Services of Funeral Director & Staff Transfer of Deceased to Funeral Home Embalming Other Preparation of Deceased Staff and Facilities for Service Staff for Visitation other than one hour prior; Staff for Graveside Service & Accessories ' Hearse to Final Disposition Service Van - Disposition of Flowers Guest Register Memorial Folders or Prayer Cards . Hairdresser Casket Selected - Primrose Vault Selected - Salute Death Certificates Local Newspapers Out-of-Town Newspapers Cemetery Equipment (Tent, Greens,Lowering Device) TOTAL BILLED CASH RECEIVED BALANCE DUE TERMS: Finance charge of ~8.00% per annum (~.50% per month) on the unpaid balance for each month or fraction thereof commencing on the 1st day after Date of Service. CUMBERLAND LAW JOURNAL 32 SOUTH BEDFORD STREET CARLISLE, P A 17013 JUL Y 16, 2004 Cumberland Law Journal is published every Friday by the Cumberland County Bar Association and is designated by the Court of Common Pleas as the official legal publication for Cumberland County and the legal newspaper for publication of legal notices. TO: Emily K. Dietrich, ESQUIRE Margaret A. Terrel, ESTATE RE: Legal advertisements must be received by Friday Noon. All legal advertising must be paid in advance. Make all checks payable to: Cumberland Law Journal. ===================================================================== Advertisement inserted on following dates: July 2,9, 16,2004 Advertising Cost $ 75.00 Proof of Publication $ 0.00 Second Proof Request $ 0.00 Payment received $ 0.00 Total Amount Due $ 75.00 -------- -------- Payment received by Marjorie A. Wevodau First Deputy One Courthouse Square Carlisle, Pa. 17013 Glenda Farner Strasbaugh Register of Wills & Clerk of the Orphans' Court (717) 240-6345 FAX (717) 240-7797 Kirk S. Sohonage, Esquire Solicitor OFFICES OF l\tgister of Mtills anb (!Clerk of tbe <!E>rpbans' (!Court QCountp of QCumberlanll TO: TINA DRIESBAUGH ESTATE OF: MARGARET A TERREL 21-04-441 ll-.i RE: Short Certificates Dat~: 06-29-04 As requested, enclosed you will find (5) Short Certificate(s). Please remit a check in the amount of$ 15.00 to the Register of Wills. It would be appreciated if you would mail the check to the attention of JACKIE. Thank you. '. \G...Rk;.L , . \ :j (.j~\).~'k- RECEIPT FOR PAYMENT * DUPLICATE * --~---------------- ------------------- Cumberland County - Register Hanover and High Street Carlisle, PA 17013 Of Wills Receipt Receipt Receipt Date: Time: No. : 5/05/2004 13:24:30 1036505 TERREL MARGARET A Estate File No.: Paid By Remarks: 2004-00441 F J NIEMIEC ESQ VZ ------------------------ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name PETITION LTRS ADM SHORT CERTIFICATE JCP FEE Check# 6117 Total Received...... ... 18.00 15.00 10.00 CUMBERLAND COUNTY GENERAL FU CUMBERLAND COUNTY GENERAL FU BUREAU OF RECEIPTS & CNTR M. $43.00 $43.00 " "v 0 2004 I'll ,iii :~. IJ, I " :=> NIEMIEC SMITH & PELLINGER GENERAL ACCOUNT 427 MAIN STREET ~mw"~ '^ ,_ ~€~~OF' (eL J:;V O~ W~ ll; ~lJlv~ Jo\..lc;~s- ~ GE ~ NATIONALBANK. Laceyville. fA 18623 ~\(,ls 6117 60-12101 313 DATE':) r5-0 f I $ c!f-3( (f()' DO:~ARS IT) ="::' OO...ObB S"'?1i ... TERREL PERSONAL INJURY COSTS Conrad Siegel Actuaries Robert Abadie (1/3 Investigation fee) Records - Family Medicine Records - Robert Packer Hospital Records - Harrisburg Hospital Filing Fee for Civil Complaint Service of Complaint by Sheriff Photocopies of medical records, medical bills and wage information 520 pages at .35 per page 1/3 of Accident Report 1/3 of copies of Accident Report Total TERREL ESTATE COSTS Advertising - The Sentinel Advertising - Cumberland Law Journal Cumberland County Register of Wills Filing Fee Short Certificates (5) PA Department of Vital Statistics (5 Death Certificates) TransUnion (Credit Report) Total $800.00 $451.09 $130.63 $50.73 $149.39 $90.00 $60.00 $182.00 $2.67 $21.34 $1,937.85 $149.99 $75.00 $43.00 $15.00 $45.00 $9.00 $336.99 Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE Bill To: InvoiceNo: Invoice Date: Estate of: Estate No: 292 4/6/2005 MARGARET A. TERREL 21-2004-0441 FRANK J. NIEMIEC 427 MAIN ST JA TOWANDA, PA 18848 217.00 Total $217.00 Qty 1 Fee Description Additional Probate Fee Total: $217.00 Cltecks should be made payable to the Register of Wills. Tenns: Net 30. Please return one copy of this invoice with your payment. Thank you. NIEMIEC, SMITH AND PELLINGER L.L.P. ATTORNEYS AND COUNSELORS AT LAW Robert J. Murphy (Retired) Frank J. Niemiec Mark W. Smith 427 MAIN STREET TOWANDA, PA 18848 ...... 146 W. LOCKHART STREET SAYRE, PA 18840 Scott D. Pellinger Michael J. Niemiec Emily K. Dietrich Please respond to the Towanda Office April 4, 2005 Cumberland County Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 RE: Estate of Margaret A. Terrel Estate No.: 21 040441 Dear Ms. Strausbaug: Enclosed please find a three copies of the Inheritance Tax Return for the Estate of Margaret Terrel, a check made payable to the Register of Wills, Agent in the amount of $344.98, a check made payable to the Register of Wills, Agent in the amount of $3.73, a check made payable to the Cumberland County Register of Wills in the amount of $15.00, and a self address stamped envelope. Please return the time-stamped file copy of the Inheritance Tax Return in the envelope provided. If you need anything further, please contact my office. Very truly yours, NIEMIEC, SMITH & PELLlNGER Jrm~~ Tina Driesbaugh, secretary Enclosure TOWANDk Phone (570) 265-2147 . Fax (570) 265-8613 . SAYRE, Phone (570) 882-8818 . Fax (570) 888-1127 E-MAIL: Towanda-ns-pt{).!i_ll!}.Q.~~qservices.com.Sayre~nsosavre(WcQservices.com ;;-. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NIEMIEC FRANK J 427 MAIN STREET TOWANDA, PA 18848 -------- fold ESTATE INFORMATION: SSN: 175-54-0344 FILE NUMBER: 2104-0441 DECEDENT NAME: TERREL MARGARET A DATE OF PAYMENT: 04/06/2005 POSTMARK DATE: 04/04/2005 COUNTY: CUMBERLAND DATE OF DEATH: 04/17/2004 NO. CD 005168 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $3.73 I I I I I I I I TOTAL AMOUNT PAID: $3.73 REMARKS: CHECK# 523 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WilLS GLENDA FARNER STRASBAUGH REGISTER OF WillS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV- 1162 EX( 11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NIEMIEC FRANK J 427 MAIN STREET TOWANDA, PA 18848 ____un folo ESTATE INFORMATION: SSN, 175-54-0344 FILE NUMBER: 2104- 0441 DECEDENT NAME: TERREL MARGARET A DATE OF PAYMENT: 04/06/2005 POSTMARK DATE: 04/04/2005 COUNTY: CUMBERLAND DATE OF DEATH: 04/17/2004 NO. CD 005169 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $344.98 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 522 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $344.98 GLENDA FARNER STRASBAUGH REGISTER OF WILLS -, ;;.lr~;' .' 0(., " I'.' ~f \ """ r o::r(',='I,=i'l (',"'-.':- ;':-,'"'I\r',:--,' !-\, nr~fJr'r rr- Vl J""" > I', , (j) , .' ' - Vl 1".1 ' 0 ::> C) ~ 0 :,' (j) ,C b - - .~ ~ OJ ::> (j) 0 (j) "'I ,n. ,,, U ~ 0<: a >- >- ::> - - 0 c c V) C') ::> ::> 0 0 (j) 0 U U Vl ::> 1'- -0 -0 0 c c ,C <( - a a ~ ::> (L -;:: -;:: 0 (j) (j) (j) .0 .0 U Vi r- E (j) -c C ::> ::> c a U U 0 U ; \:~ " 0- -' -' 0:: W (!) Z ::; -' W co 0- <t co odl-CO :cW""- I-W<( -0::0- ::Ef- <fJ<fJ<i. ,z Cl u-z W<(<( ~::;:s: W""o Z~f- ,m; } "" ;,,;{\ ,~;"jt" r' ;;J~ ~" "'" , t" - . 1'.1 I,' r"'] n :"1 ,-' (.) , ,.-':, ;; :',1~t p; ''I1:''i I" ; jo";V, r:ri\':;"",:rl r'--'~-'-'-:-- !"".:__,~.(\C'"'' T, (\r'CII~'r r-,' V> ,""" > <1l '-0- V> o :J ~ 0 <1l.r: - - V> ~ 0l:J <1l 0 <1l ~UO >->-:J - - 0- CCV)~ :J:J ,-, OO~O UU:Ji'- "D"DO CC~<( DD:;ll... ~ ~ 0 <1l <1lU <J5 .D.D Vi EE<1l-c :J :J C 0 uuou I', I I '.i i i 1 1 \ i , "~ . . 0- --' --' 0:: W r.:> z ::; --' W co 0- <t co odl-CO :cW""- I-w<( -0::0- :;Ef- UlUl<i, - Z Cl u-z W<(<( ~:;;:3!: wr-o Z~I- ::'" JUT Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE Bill To: InvoiceNo: Invoice Date: Estate of: Estate No: 292 4/6/2005 MARGARET A TERREL 21- 2004-0441 FRANK J. NIEMIEC 427 MAIN ST JA TOWANDA, PA 18848 217.00 Total $217.00 Qty 1 Fee Description Additional Probate Fee Total: GOOD Sq 5d- $217.00 r'O'_, ".--' -"'-j ",." ',."." Checks should be made payable to the Register of Wills. Terms: Net 30. Please return one copy of this invoice with your payment. Thank you. v 06-20-2005 TERREL 04-17-2004 21 04-0441 CUMBERLAND 101 APPEAL DATE: 08-19-2005 (See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE _ RETAIN LOWER PORTION FOR YOUR RECORDS _ REy:is47-EX-AFP-io3:0si-NOTicE-OF-iNHERiTANCE-TAX-APPRAiSEMENT:-ALLOWANCE-OR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX MARGARET A FILE NO. 21 04-0441 ACN 101 BUREAU Of INDIVIDUAL TAXES INHERIIANCE TAX DIVISIDM' - - PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEIIENT, ALLOWANCE DR DISALLOWANCE Of DEDUCTIONS AND ASSESSMENT Of TAX j-i . I I -, : ::;4 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN r'l CD\': Ul....,-' ,,", O-HC;'~"Y'" ri t,-'\I" '-' FRANK J CIU~f(IEC NIEMIEC ETAL 427 MAIN ST TOWANDA PA 18848 ESTATE OF TERREL '* REV-l~47 EX AFP (06-DS) MARGARET A TAX RETURN liAS: I X I ACCEPTED AS fILED I CHANGED DATE 06-20-2005 I~ an assess.ent was issued previouslY, lines 14, 15 and/or 16, 17, 18 and 19 will rei'lect 1'igures that include the total oi' ALL returns assessed to date. ASSESSMENT OF TAX: IS. bouni. of Line 1'1 at Spousal rate (15) 16. A.ount of Line 14 taxable at Lineal/Class A rat. (16) 17. Anount of Line 14 at Sibling rat. (17) 18. A.ount of Line 14 taxable at Collateral/Class 8 rat. (18) 19. Principal rax Du. C RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. stocks and Bonds (Schedule B) 3. Closely Held stock/Partnership Interest (Schedule Cl 4. ttortSJaglls/Notes Receivable (Schedule D) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transiers (Schedule G) 8. Total Assets (lJ 121 131 141 (51 161 (71 .00 .00 .00 .00 105.840.50 .00 .00 181 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. FUleral Expenses/Ada. Cost.s/Kisc. Expenses (Schedule H) 10. Debts/Mortgage Li8bllities/Llens (Schedule Xl 11. Total Deductions 12. Net Value of Tax R.turn 13. Charitabl./Governnental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estat. Subject to Tax 191 I1BI 51,000.41 9.507.47 I1lJ 1121 1131 1141 NOTE: 37,666.31 X 7,666.31 X .00 X .00 X T . INTEREST/PEN PAID (-I .00 3.64- AMOUNT PAID 344.98 3.73 DATE 04-04-2005 04-04-2005 NUltBER CD005169 CD005168 ~ TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . If PAID AfTER DATE INDICATED, SEE REVERSE fOR CALCULATION Of ADDITIONAL INTEREST. 00 = 045 = 12 = 15 = 1191= NOTE: To insure proper credit to your .ccount~ s~lt the upper portion oi this iorm with your tax P.Yllent. 105,840.50 60 ~07 88 45,332.62 .00 45,332.62 .00 344.98 .00 .00 344.98 345.07 .09CR .00 .09CR IF TOTAL DUE IS LESS THAN aI, NO PAYMENT IS REQUIRED. If TOTAL DUE IS REfLECTED AS A "CREDIT" ICRI, YOU MAY BE DUE A REFUND. SEE REVERSE Sl'DIE 01=' TNT'C:. II:'nlll.. II:'nD T.-...__......_.._ .. Cumberland County - Register Of Wl~~S One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/07/2006 NIEMIEC FRANK J 427 MAIN STREET TOWANDA, PA 18848 RE: Estate of TERREL MARGARET A File Number: 2004-00441 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 IS death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/17/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, G~/G~~!!::!;;/ Clerk of the Orphans' Court cc: File Personal Representative(s) VY cumberland County - Register Of WlllS One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/07/2006 TERREL EDWARD C 1024 AUDUBON ROAD MECHANICSBURG, PA 17055 RE: Estate of TERREL MARGARET A File Number: 2004-00441 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 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/17/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~J~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Yy COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX 06-20-2005 TERREL 04-17-2004 21 04-0441 CUMBERLAND 101 APPEAL DATE: 08-19-2005 ( See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WIllS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ~~!_~~9~~_!~~~_~~~~______~___~~!~!~_~g~~~_~g~!!9~_~9~_rg~~_~~~g~~~__~____________________ REV-1S47 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX MARGARET A FILE NO. 21 04-0441 ACN 101 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN FRANK J NIEMIEC NIEMIEC ETAl 427 MAIN ST TOWANDA PA 18848 ESTATE OF TERREL REV-1547 EX AFP (06-05) MARGARET A TAX RETURN WAS: (X) ACCEPTED AS FILED DATE 06-20-2005 ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 105.840.50 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax NOTE: IT an a5sessmen~ was issued previoUSly, lines reTlect Tigures that include the total OT ALL ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due TAX CREDITS: + INTEREST/PEN PAID (-) .00 3.64- DATE 04-04-2005 04-04-2005 NUHBER CD005169 CD005168 ,-, ;~~ . I (" U . ! f'""\ * IF PAID AFTER DAt'E'iNDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. (9) (10) 51,000.41 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. 105,840.50 60.507 88 45,332.62 .00 45,332.62 14, 15 and/or 16, 17,""l8 and 19 will returns assessed to date. .00 344.98 .00 .00 344.98 345.07 .09CR .00 .09CR ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) 9.507.47 (11) (12) (13) (14) 37,666.31 X 00 = 7 , 666 .31 X 045 = .00 X 12 = .00 X 15 = (19)= AMOUNT PAID 344.98 3.73 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE NIEMIEC, SMITH AND PELLINGER L.L.P. ATTORNEYS AND COUNSELORS AT LAW Robert J. Murphy (Retired) Frank J. Niemiec Mark W. Smith 427 MAIN STREET TOW ANDA, PA 18848 ++++++ 146 W. LOCKHART STREET SAYRE,PA 18840 Scott D. Pellinger Michael J. Niemiec Emily K. Dietrich Please respond to the Towanda Office March 30, 2006 Cumberland County Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013 RE: Estate of Margaret A. Terrel Estate No.: 21 04 0441 Dear Ms. Strausbaug: We are in receipt of your notice dated March 7, 2006 in connection with the above referenced estate. I enclose for your review the Status Report Under Rule 6.12 along with the enclosures. If you require any further information, please contact my office. Very truly yours, NIEMIEC, SMITH & PELLlNGER ~etary Enclosure I -.,; ......,\,..../ so:\ S-c:l'l TOWANDA: Phone (S?O-),26~-4r47;+F~K5!PJ 265-8613 + SAYRE: Phone (570) 882-8818 + Fax (570) 888-1127 E-MAIL:j.Tow~hda----risPtowanda@cQservices.com+Sayre-nspsayre@cQservices.com In Re: Estate of TERREL MARGARET A ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 2004-00441 NOTICE OF FAILURE TO FILE STATUS REPORT Personal Representative: TERREL EDWARD C Counsel for Personal Representative: NIEMIEC FRANK J Date of Decedent's Death: 4/17/2004 The Orphans' Court record indicates 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 Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, is hereby given by that the you have ten (10) day to file the Status Report. lfthe required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notified of such delinquency and the undersigned will 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: 4/25/2006 Glenda Farner Strasbaugh Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File In Re: Estate of TERREL MARGARET A ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 2004-00441 NOTICE OF FAILURE TO FILE STATUS REPORT Personal Representative: TERREL EDWARD C Counsel for Personal Representative: NIEMIEC FRANK J Date of Decedent's Death: 4/17/2004 The Orphans' Court record indicates 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 Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, is hereby given by that the you have ten (10) day to file the Status Report. Ifthe required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notified of such delinquency and the undersigned will 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. ~{~Mj~~ Date: 4/25/2006 Glenda Farner Strasbaugh Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File Cumberland County - Register Ot Wllls One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/10/2007 -...l NIEMIEC FRANK J 427 MAIN STREET TOWANDA, PA 18848 \1:l C.:J RE: Estate of TERREL MARGARET A File Number: 2004-00441 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/17/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) \ ~ Cumberland County - Register Of wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/10/2007 TERREL EDWARD C 1024 AUDUBON ROAD MECHANICSBURG, PA 17055 :;:.,~ V'J CAi RE: Estate of TERREL MARGARET A File Number: 2004-00441 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/17/2007 please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel .cJ Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY,PENNSYL V ANIA Name of Decedent: MARGARET A. TERREL Date of Death: APRIL 17, 2004 File Number: 2004-00441 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 naNo 2. If the answeris No, state when the personal representative reasonably believes 'that the administration will be complete: ESTATE IS STILL IN LITIGATION AND IF THERE IS A SETTLEMENT A SUPPLEMENTAL INHERITANCE TAX RETURN WILL BE PREPARED 'AND FILED. 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 DNo b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account infomially to the parties in interest? ,............................... DYes DNo d. Copies of receipts, releases, joinders and approvals 0 Drmal or informal accounts may be filed with the Clerk 'of the Orphans' Court and may e attached to this report. iXI Counsel Dale t...I - ( 1- (')/ ' FRANK J.. NIEMIEC, ESQUIRE Name of P~on Filing this Form Address 427 MAIN STREET TOWANDA, PA 18848 (570) 265-2147 Telephone I ? : J I ':;1' - ,6! let! ...J,-,;... FOI11l RW.IO rey.IO.J3.06 ~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/26/2008 NIEMIEC FRANK J 427 MAIN STREET r.,) ~..J TOWANDA, PA 18848 . ~ .1 ........: RE: Estate of TERREL MARGARET A File Number: 2004-00441 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing lS due by: 4/17/2008 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, ~,~I~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 3/26/2008 r......) TERREL EDWARD C -,} 1024 AUDUBON ROAD MECHANICSBURG, PA 17055 RE: Estate of TERREL MARGARET A File Number: 2004-00441 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing lS due by: 4/17/2008 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, ~ ~~ ~ ,~ ,/ ,1 Ii A ~i'.~ " .~t.U J:. .'. .~~./ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel rocO \. 0...'6 c; ~\\ i~ ~ Ii .,.:; #~~\\ 01 ~ Ii ,~l .,~ ~ ~ ~......o <( ~ - ('l0~ ~6.. 00 :(',s- Q3llN('\ r- - 4- c- ~ ~ 0.- ....-: .~(;" -..';.-.... ~,-- ( .~ lbC:, ~ '&(~~, .~ U-\-:-,- _'.0 --->"~~- C',; , c- '.5:. -"i~ \o~~ c)c) ... .f~') .~ -<.... .) ,.,,_4 ~ -_\~ ) --"'." -- - 1.-:-) ')(- - Y',\ \;;~ (:) ~ (.. r \ ~ c;a ~ ~ ... ~ Q <,9 '-.s\ ;:: .e ~ ~"... J:I ~~ ;:l~ ~'a~ m Cl.l ........ g.. I ~-e~rJ1~ 0$ .... ~ " 0 ::Q~~~ EJJ' tilt "t ,-, 2 <( ~~,.. "... OJ 'e;I ~ p.., / ~ ~~~5~ v ~ p ~'U.r;:. " "'?;:: ;::,,~ <"", .e :. E <3 u "a ~ <,9 ~~ ~.... Q ~ 'Iii & ~ --~ m o ..... N o ...,. <t o l3\ o \ - t- _ e~ -:. \ :. o t.-:. \11 \j)-:. 1,'1 '" _ ill ('i-:' 1.:1 0-::: o (to . -:. o IXOo: ~ :. 1.:10~.... _ O<11i (';~ ~ ~'''O 0 _ \.11... t. '1\ -:. i/ld.... . ... OWO K r~r ..... ..... lj\-:' () ~([I.l.\ iJ\ _ I.tl.t~ ..... :::::. ?uhlo 0 <'l \-;-l\t (!) :: t- \111-1 -;. i:') ..; <'l I.tJ..... (0) _ Ul ~-= o Ul .... 7<, !'1 '1- \- o z co o o C'< - \.0 C'< - (<1 u ~ 4. t ~ ~ ~ ~ t-I - - o _ t-- _ ~ ~ ., o III \0 \0 o c- ,-I 4. ~~ ~ - ~ '3;:J 0)0) OW OB ~~ <rD ~~ (\) .\..l ro ~ P, ~ C/f) , \- - ~ Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMERLAND COlJNTY, PEN'NSYL VANIA Name of Decedent: MARGARET A. TERREL Date of Death: APRIL 17, 2004 File Number: 2004-00441 Pursuant to Pa. O.c. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: i. State whether administration of the estate is compiete: . . . . . . . . . . . . . . . . . . .. DYes [] No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: ESTATE IS STILL IN LITIGATION AND IF THERE IS A SETTLEMENT, A SUPPLEMENTAL INHERITANCE TAX RETURN WILL BE PREPARED AND FILED. 3. If the answer to No.1 is YES, state the foHowing: a. Did the personal representative file a final account with the Court? . . . . . . pEJYes ,~~~ J-O ; :1::' (j :-~ '-C:~ f- ~~:CJ ;0) ;:~. -' (;<"-) ~:} C) ~ :t:- . .1::0 3:: ~ --j a.. _....-....J c. Did the personal representative state an account '>.J:"" . ..' informally to the parties in interest? ............................... DYes .......ONo ~No = = J::>;o -0 :::0 I \0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: (-) 2.: ,;~ . "1 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 a hed to this report. Date J-f-?-D~ Capaci . i Personal Representative I[] Counsel FRANK J. NIEMIEC, ESQUIRE Name of Person Filing this Form 427 MAIN STREET Address TOWANDA, PA 18848 570-265-2147 Telephone Porm RW.10 rev. 101306 J Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 3/24/2009 NIEMIEC FRANK J 427 MAIN STREET 7'OWAIv'DA, PA 18 8 4 8 RE: Estate of TERREL MARGARET A File Number: 2004-00441 Dear Sir/Madam: r.i ~.~ _ ~Yw. ~:, _n -.. _~ J _~ ~~~ i .~:- _ -*7 _s ~. ~ _, =-=i ; ; C,~ N This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/17/2009 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, sir' ~~ ~ p :_ ~~ ~ x ~ ~. l,s Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 3/24/2009 ~> -- ~, .~ , ~~ TERREL EDWARD C '~.~ ,._. ~~ 1024 AUDUBON ROAD r.= MECHANICSBURG, PA 17055 -\ -~ ,; ~~~ _ -. _, '- w N RE: Estate of TERREL MARGARET A File Number: 2004-00441 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET N0. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/17/2009 Please feel free to contact this office with any questions you ma.~- have. If you have already filed your Status Report, please disregard this notice. Sincerely, _ ~ _ -- ~rfi ~ ~ T `-~-_ ~, 1 ~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ~-z r~ ~' 0 o N r_> '" N ~~ ~ ~~ ~ • ~ ,~ ©<~ o L- E~A' ~ N ~~ ~~ '~~ ~ ~: ti, ~~ a s ~z. 'a `ys ~,.. cti'. `` o d 0 ~~ r~ ~ tr ?z er~Ct .y,~y"ski' ~,a ,~~d;~ ~ .~ " ~ _s L ' t.4 ~ , a ti's c~ R'~ l ~ ~ x~~~ x~, ~ ~~" k3 ~ ~1. U ~~ ~ ~~ Y a `in ~ ~ ~~~ ~ o ~ : 9 y o o ~s f y ~ u ~ ~ Q r ~ ~' ~ o- O ,n of 9 '! N p~ i ~ ~ ~ ~ V ~ o w m d t°s ~.., C~ ~' r ~~ t~*- ~ ~~ ~- ,4 j, `~ L~_ ~'R 1 v v ti X .„ .. ~l ~ ~' .-% S' ~ e-~ ~-~^ i3 i}~} l ~ .`~~ ~ '•3t O ~{;:} ~ ~;•t P ~ d. O o U ~' c7 O W M 7/~ ~~ N .. ~cd W ~ ~ Q ~~. ®.C. ~~~e 6.12 ST'~~~JS P®~~' REGISTER Or WILLS OF Name of Decedent: CUMBERLAND COUNTY, PEN~tiSYLVA~tiI~ MARGARET A. TERREL Date of Death: APRIL 17, 2004 File Number: 2004-00441 p,,,-..,,.,,+ *„ D., Il ~' D„lo ~ 1 ~ T ,•o.,(„-t the fell ~tx,ino ~zrith :-acr~ar.t to rpmnl eti~l~ (lf the adllllTll Strata OT1 Of 1 Ll1JULLltI LV L u. V•L l~ul~. v.1., 1 lv1_+...~ "~ Y--- -" t the above-captioned estate: 1. State whether administration of the estate is complete :.................... Q Yes ~ No 2. If the answei is No, state when the personal representative reasonably believes that the administration will be complete: SUPPLEMENTAL PENNSYLVANIA INHERITANCE TAX RETURN WILL BE FILED IN THE NEXT TWO WEEKS. THE DEPARTMENT OF REVENUE TAKES~APPROXIMATELY FIVE MONTHS TO REVIEW THE RETURNS. WE EXPECT TO COMPAPPROVAL OFTTHE TAXHRETURNDAYS OF THE 3. If the answer to No. 1 is YES, state the following: -- - a. Did the personal representative file a final account with the Court? ....... []Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account - - informally to the parties in interest? ............................... Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. ~/~ ~ Dnte ~ V Signnture of"Persoix Filing this Fot-nx Capacity: QPersonalRepresentative ]Counsel ~ "OJ ~' ~~d~-!d 0 ~ l~non~ ~s~t.~r~ ~~! 71C7~ t~1 6S =zi ~a Z- ~av 6aaZ ~~t; 'lyt ~,.1 ' ;u. x __ ., . .~F 1 _._.... ~ . t ~. , Fam RNA-10 r21~. 10 /3.Oh MARK W. SMITH, ESQUIRE Nnme oJPerson Filing this Fa-m 427 MAIN STREET Address TOWANDA, PA 1.8848 570-265-2147 Telephaxe OI W(nchco ~ C7N~~ ~~ ~ "`* ~LLN ~'~ cp o t0 6S6S9~ ' ~ ;4a ,~ _~ f . L ~I,,J ' o _ ',LER~C r -IAN'S C ~...,` wW I ... f ~.. ~ ~s N ~'^ LL ~ Ci ~~ ~ c~_, ~~ ~ c> ~ n C: ~ - f"^} ~ ~ 5c U, -~- ~ ~+ a r+ ~. C _~~~~ , ~ ~ ~ ~ 3 . ~ O W -__ v i !'rt ~ ~ H x ~ . 00 H W' ~ ~ ~ ~ U ~ M ~ ~ ~ ~ H H O'O Q W ~ ~ a ~ ~ ~ o o ~ ~ ~ a ` N~ faAx ~ ~ ~ ~ ~ ~ W ~ W ~ U H W Z t~j~ W W P4 ~ O U U ^. O 1___ NIEMIEC, SMITH AND PELLINGER, LLP ATTORNEYS AND COUN8ELOR8 AT LAW 427 MAIN STREET William J. Davis (Deceased) TOWANDA, PA 18848 Mark W. Smith Robert J. Murphy (Retired) • ~ • • • • Scott D. Pellinger Frank J. Niemiec 146 W. LOCKHART STREET Michael J. Niemiec SAYRE, PA 18840 June 2, 2009 Cumberland County Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 RE: Estate of Margaret A. Tercel Estate No.: Z 1 04 0441 Dear Sir or Madam: Enclosed please find three supplemental inheritance tax returns for the above referenced estate along with a check in the amount of $661.86. Please file the return and forward atime-stamped copy to our office is the enclosed sel~ddressed stamped envelope. Q `~~` ` ~~ ~ ~ ~ Very truly yours, ~:...,~- ~ Cj ~~ ~ { ~ ~ ~~„~ NIEMIEC, SMITH 8a PELLINGER ~.~ ~ _~ t ~ r 4:"% _ ~ W ~:,, ~ 1 c )u; m s. r • `~ ' , +:r`: o ~ N ~ M rk .Smith, Esquire MWS/mis Enclosures ,-- cw Rf- ~~ ~:'.: :.~~ c'' LL? t~L..,: ~ -v i ~ _i ~ T C~7 ~;7 ~., .! TOWANDA: Phone (570) 265-2147 • Fax (570) 265-8613 • E-mail: nsotowandala~eoix.net SAYRE : Phone (570) 882-8818 • Fax (570) 888-1127 • E-mail: nspsayre@verizon.net Website: www.nsp-law.com COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 1 7 1 28-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT TERREL EDWARD C 1024 AUDUBON ROAD MECHANICSBURG, PA 17055 fold ESTATE INFORMATION: ssN: i 75-54-0344 FILE NUMBER: 2104-0441 DECEDENT NAME: TERREL MARGARET A DATE OF PAYMENT: 06/08/2009 POSTMARK DATE: 06/08/2009 COUNTY: CUMBERLAND DATE OF DEATH: 04/17/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 ~ 5661.86 TOTAL AMOUNT PAID: REMARKS: RECEIPT MAILED TO ATTY CHECK# 233 SEAL INITIALS: JN RECEIVED BY: 5661.86 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REV-1162 EXI11-961 NO. CD 01 1332 REGISTER OF WILLS 15056041125 REV-1500 EX (06-05) OFFICIAL USE ONLY PA Department of Revenue County Code Year File Number Bureau of Individual Taxes INHERITANCE TAX RETURN PO BOX 280601 2 1 0 4 0 4 4 1 Harrisbu , PA 17128-0601 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death Date of Birth 1 7 5 5 4 0 3 4 4 0 4 1 7 2 0 0 4 1 1 3 0 1 9 5 8 Decedent's Last Name Suffix Decedent's First Name MI T E R R E L M A R G A R E T A (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI T E R R E L E D W A R D C Spouse's Social Security Number 2 0 1 4 2 7 5 5 4 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE OVALS BELOW 1. Original Return Q 2. Supplemental Return ~ 3. Remainder Return (date of death prior to 12-13-82) 4. Limited Estate ~ 4a. Future Interest Compromise (date of ~ 5. Federal Estate Tax Retum Required death after 12-12-82) 6. Decedent Died Testate ~ 7. Decedent Maintained a Living Trust 8. Total Number of Safe Deposit Boxes (Attach Copy of Will) (Attach Copy of Trust) 9. Litigation Proceeds Received ~ 10. Spousal Poverty Credit (date of death ~ 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. O) CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number M A R K W S M I T H 5 7 0 2 6 5 2 1 4 7 Firm Name (If Applicable) ~ REGISTF~OF WILLS U~NLY N I E M I E C S M I T H & P E L L I N ~O ~ First line of address t . wo c.~ ,: ~ i` ~ -~,n C - --~ m ~~ 4 2 7 M A I N S T R E E T ~ G-- -x; ~ `~ C7 ~~ Second line of address `-~ !--' ~. _ ~; `' City or Post Office State ZIP Code ~E FILED ~ ~ .4 T O W A N D A P A 1 8 8 4 8 ~ ~ Correspondent's a-mail address: f1SptOWafldB eplX.net 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 comp e. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PER N SIBLE FO FILING RE~ DA~E ADDRESS EDWARD TE R L, R.R. #3, BOX 7 COLUMBIA CROSS ROADS PA 16914 SIGNATURE OF PR A R OTHER THAN REPRESENTATIVE DATE ADDRESS FRANK J. EC, 427 MAIN STREET TOWANDA PA 18848 \ PLEASE USE ORIGINAL FORM ONLY / Side 1 15056041125 15056041125 y 15056042126 REV-1500 EX Decedent's Social Security Number 1 7 5 5 4 0 3 4 4 decedent's Name: MARGARET A. TERREL RECAPITULATION 1. ...................................... Real estate (Schedule A) .. 1 • • 2. Stocks and Bonds (Schedule B) ................................ .. 2• • 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ... .. 3. 4. Mortgages & Notes Receivable (Schedule D) ...................... .. 4. • 4 5 0 0 0. 0 0 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ..... .. 5. 6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ..... .. 6• • 7 Inter-Vivos Transfers i3< Miscellaneous Non-Probate Property . (Schedule G) ^ Separate Billing Requested ..... .. 7. 0 0 4 5 0 0 0 8. Total Gross Assets (total Lines 1-7) ......................... .. 8. • g 1 5 5 8 4 0 5 9. Funeral Expenses & Administrative Costs (Schedule H) . 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule 1) ...... ...... 10. 11. Total Deductions (total Lines 9 & 10) ..................... ...... 11. 1 5 5 8 4 , 0 5 12. Net Value of Estate (Line 8 minus Line 11) ................... ...... 12. 2 9 4 1 5 , 9 5 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) ............ ...... 13. 2 9 4 1 5 • 9 5 14. Net Value Subject to Tax (Line 12 minus Line 13) ............ ...... 14. TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 1 4 7 0 7 9 7 15 (a)(1.2)X.oo . 16. Amount of Line 14 taxable 1 4 7 0 7 9 8 at lineal rate X .045 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. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 0. 0 0 6 6 1. 8 6 6 6 1. 8 6 Side 2 15056042126 15056042126 + File Number REV-1500 EX Page 3 r,_e_~_..a~~ ~...v...le~n A.~~1roQa• 21 04 0441 vvwwv..~ ...~.....r---- - ---- ---- DECEDENTS NAME MARGARET A. TERREL STREET ADDRESS CITY STATE I ZIP Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) (1) 661.86 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount Total Credits (A + B + C) (2) 0.00 3. Interest/Penalty if applicab-e D. Interest E. Penalty Total Interest/Penalty (D + E) (3) 0.00 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 661.86 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 661.86 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 : ................................................................. ..... ^ ^ X b. retain the right to designate who shall use the property transferred or its income; .......................... ..... ^ X^ 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? .................................................................................. " " ..... ^ or payable upon death bank account or security at his or her death? .... intrust for 3. Did decedent own an ..... 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ............................................................................................. ..... ^ 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE R AS PART OF THE RETURN. 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 three (3) percent [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 zero (0) percent [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-0ne 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 zero (0) percent [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 four and one-half (4.5) percent, 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 twelve (12) percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508 EX + (6-98) SCHEDULE E COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, Se MISC. INHERITANCE TAX RETURN PERSONAL PROPERTY RESIDENT DECEDENT ESTATE OF FILE NUMBER MARGARET A. TERREL 21 04 0441 Include the proceeds of litigation and the date the proceeds were received by the estate. All properly jointly-owned with right of survhrorship must be discbsed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. SETTLEMENT PROCEEDS FROM THE CASE OF TERREL VS. JENNINGS, ET AL, 45,000.00 #04CV000361; PLAINTIFF RECEIVED $150,000.00 X .3 ALLOCATED FOR SURVIVAL ACTION = $45,000.00 -SEE ATTACHED LETTER APPROVING 30% ALLOCATION FOR SURVIVAL ACTION TOTAL (Also enter on line 5, Recapitulation) ~ S 45.000.00 (If more space is needed, insert additional sheets of the same size) RE'V-1511 EX + (12-99) SCHEDULE H COMMONWEALTH OF PENNSYLVANIA FUNERAL EXPENSES ~ INHERITANCE TAX RETURN ADMINISTRATIVE COSTS RESIDENT DECEDENT ESTATE OF FILE NUMBER MARGARET A. TERREL 21 04 0441 Debts of decedent must be reported on Schedule L ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. 2. 3. 4. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Social Security Number(s)/EIN Number of Personal Representative(s) _ Street Address Cry State _ Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address Cry State Relationship of Claimant to Decedent Probate Fees Zip 5 Accountant's Fees 6. Tax Return Pn:parer's Fees 7 8. NIEMIEC, SMITH &PELLINGER ATTORNEY FEE FOR 1/3 OF RECOVERY ($45,000.00 DIVIDED BY 3 = $15,000.00) NIEMIEC, SMITH &PELLINGER FOR PRORATA SHARE OF ATTORNEY COSTS OF $3,244.71; 60% IS ALLOCATED TO DECEDENT'S CASE _ $1,946.83; 30% IS ALLOCATED TO SURVIVAL ACTION = 15,000.00 584.05 TOTAL (Also enter on line 9, Recapitulation) I S 15,584.05 Zip (If more space is needed, insert additional sheets of the same s¢e) RED/--1513 EX + (9-00) SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MARGARET A. TERREL NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2}J 1. EDWARD C. TERREL R.R. #3, BOX 7, COLUMBIA CROSS ROADS, PA 16914 2. BILLIE J. LEE R.R. #3, BOX 7, COLUMBIA CROSS ROADS, PA 16914 FILE NUMBER 21 04 044' RELATIONSHIP TO DECEDENT Do Not List Trustee(s) Spousal Lineal AMOUNT OR SHARE OF ESTATE 14,707.97 14,707.98 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAXIS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET I S (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG, PA 17128-0601 Telephone 9/29/2004 Frank J Niemiec, Esquire Niemiec et al 427 Main Street Towanda PA 18848 717-783-0972 COPY Re: Estate of Margaret Terrel File Number: 2104-0441 Court Number: Unlmown Dear Mr. Niemiec: The Department of Revenue has received a letter concerning the Petition for Approval of Settlement Claim to be filed on behalf of the above-referenced Estate in regard to a wrongful death and survival action. It has been forwarded to this Bureau for the Commonwealt!i's approval of the allocation of the proceeds paid to settle the actions. Pursuant to the letter, the 45 -year-old-decedent died as a result of motor vehicle accident. Decedent is survived by the decedent's spouse and one adult issue., Please be advised that, based upon these facts, our discussion of the settlement and for inheritance tax purposes only, this Department has no objection to the allocation of the gross proceeds based on our discussions. The estate has agreed to supply the court with a petition allocating this action, $ 245,000.00 to the wrongful death claim and $ 105,000.00 to the survival claim. Proceeds of a survival action are an asset included in the decedent's estate and are subject to the imposition of Pennsylvania inheritance tax. 42 Pa.C.S.A. §8302; 72 P.S. §§9106, 9107. Costs and fees must be deducted in the same percentages as the proceeds are allocated. In re Estate of Merryman, 669 A.2d 1059 (Pa. Cmwlth. 1995). I trust that this letter is a sufficient representation of the Department's position on this matter. As the Department has no objections to the Petition, an attorney from the Department of Revenue will not be attending any hearing regarding it. Please contact me if you or the Court has any questions or requires anything additional from this Bureau. Finally, the approval of this allocation is limited to this estate and does not reflect the position that the Department may take in any other proposed distribution of proceeds of a wrongful death /survival action. S ~ Y~ - -~ J P ibert Business & Trust Valuation Manager ~~~,;: Inheritance Tax Division ~j%T - 1 =-~~1* Bureau of Individual Taxes NIEMIEC, SMITH AND PELLINGER, LLP ATTORNEY8 AND COUNSELORS AT LAW 427 MAIN STREET William J. Davis (Deceased) TOWANDA, PA 18848 Mark W. Smith Robert J. Murphy (Retired) • • • • • • Scott D. Pellinger Frank J. Niemiec 146 W. LOCKHART STREET Michael J. Niemiec SAYRE, PA 18840 Please respoad to Towanda Office June 22, 2009 n r © .~ t ~ y J Cumberland County Register of Wills rn ,= ~ ~ Cumberland County Courthouse ~- ~, ~-, One Courthouse Square , ~~~ Carlisle, PA 17013 .~,~ "' RE: Estate of Margaret A. Terre) Estate No.: 21 04 0441 Dear Sir or Madam: I am in receipt of your letter dated June 8, 2009 in regards to the above estate, a copy of which is enclosed. Enclosed please find a check in the amount of X15.00 for your filing fee. I also enclose three original supplemental inheritance tax returns. Kindly time stamp this return, and then return one back to this office in the enclosed self addressed stamped envelope. If you need anything further, please contact my office. Very truly yours, NIEMIEC, MITH &PELLINGER M rk .Smith MWS/md Enclosure TOWANDA: Phone (570) 265-2147 • Fax {570) 265-8613 • E-mail: nsptowanda(c~epix.net SAYRE : Phone (570) 882-8818 • Fax (570) 888-1127 • E-mail: nsosavre aC~.verizon.net Website: www.nsp-law.com Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 ;. r ~,..r,f ;~,-.. ~ r ~~ ~- f^,~' ;, . ~ ;_ Phone: (717) 240-6345 ,- ;- , . __ _~ , . ~. ~ "i . , . Z -~ APR - I ~~ 6~~ 58 ~~ ~~~ {:= ~. ^Q~ M1 ? Ali M G~'i ~~=- - 'r. . Date: 3/29/2010 NIEMIEC FRANK J 427 MAIN STREET TOWANDA, PA 18848 RE: Estate of TERREL MARGARET A File Number: 2004-00441 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of wills a Status Report of completed or uncompleted administration. This filing is due by: 4/17/2010 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~ /~ r Glenda Farner Strasbaught Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carl i s 1 e , PA 17 013 ,.,F- ,_,;_~..~,.,~ ~.-~~- Phone: (717) 240-6345 .. ~ ~`- ;.,,~ t_ ~s ,- ~~~Q ~Q~ ~ ~ ~~ d~~ ~~ ,; ~~ ~~i~~ ~,'~~ 6A ¢r it E' ~ 1~ t ~,+-~ Date: 3/29/2010 TERREL EDWARD C RE: Estate of TERREL MARGARET A File Number: 2004-00441 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for. decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/17/2010 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~ J Glenda Farner Strasbaug Clerk of the Orphans' Court cc: File Counsel of wv~~~ ~~ t0 Qa~o°°o ~ (AUrn~ ~a~o N~o ~LLN O __ ::;BEST r .~_ i :.r t ~'!L J _~ 2Q09 JUi 25 i'r112~ 1 Z r"^+/ hr C~<<~~~ ; t~ '~:~,; ~T i ~ ~ ~ N T r ~ a ~~ otf + ao L ~ ~ ~ Q ~ ~ ~ ~ cC N ~ ~ ~ ~ ~_ Z a a H 3 w O W ~ ~ W O Hx ~ H H 4Y. W O R+ ~ U ~ M ~ ~ W ~ O O O ~ ~Qx ~ ~ P-.' W P4aa'O~ Pa W U ra z ~ U U O U O Cumberland County - Register Of Wills One Courthouse Square Carl i s 1 e , PA 17 013 . r.., ~_,,_~..,,.,~ ~-,~- Phone: (717) 240-6345 _~'~ ''" ~`,_`"' '~' ..... ~ r1 _~~'. { ~ j~ _ .. ~., _. 1 a,. ~ - . - Z~ ! 4 APR -1 ~~ !~ ~ ~ 8 Date: 3/29/2010 TERREL EDWARD C RE: Estate of TERREL MARGARET A File Number: 2004-00441 Dear Sir/Madam: G~ F~~C ~'1~_ C~ q2 s~ -~-;~ ~ `~~~~ '~~";~ mot) ; i This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for. decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/17/2010 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, `.~,~ ~ Glenda Farner Strasbaug Clerk of the Orphans' Court cc: File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: MARGARET A. TERREL Date of Death: APRIL 17, 2004 File Number: 2004-00441 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete :........................ ^ Yes ®No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: WE ARE WAITING FOR THE DEPARTMENT OF REVENUE TO APPROVE THE SUPPLEMENTAL INHERITANCE TAX RETURN FILED ON JUNE 2, 2009 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court?......... ^ Yes ^ No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ...................................... ^ Yes ^ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and ma be attached to this ep rt. Date: Signature of Person Filing this F Capacity: ^ Personal Representative ®Counsel taT c~ v? ~ Q. ~ a v :~ V E ~~ ~ ~! ~ ~~~ ~ / m r' . et ,.-` rL ~.. o _ A N MARK W. SMITH Name of Person Filing this Form 427 MAIN STREET Address TOWANDA, PA 18848 870-265-2147 Telephone Form RW-10 rev. 10.13.06 Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 _ ~ .~r,.,..,f .-.,_ `-~~~ ~,~- Phone: (717) 240-6345 ~ ' „, ~, 4 _. `,~ .._ r.i ~1 _ ,. __ . LGEI} ~~~ ~ 1 ~ ~~' ~V ~~1 ~ , r "C` rte, 1i..1f i7 Date: 3/29/2010 NIEMIEC FRANK J 427 MAIN STREET TOWANDA, PA 18848 RE: Estate of TERREL MARGARET A File Number: 2004-00441 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 4/17/2010 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ifs ,~ ~~ Glenda Farner Strasbaugh5 Clerk of the Orphans' Court cc: File Personal Representative(s) NOTICE OF INHERITANCE TAX BUREAU OF INDIVIDUAL TAxE~ '~' ~ APPRA~fMENT, ALLOWANCE OR DISALLOWANCE INHERITANCE tax DIV1s1oN 0~~ ~1EDUCTIONS AND ASSESSMENT OF TAX PO BOX 280601 -- HARRISBURG PA 17128-0601 ~ - ,:,<. _ ~+ MAR K W S M I 'P•N ! ~ .. ,-:., ,- `. , -, {~~ v ~, NIEMIEC ETAL 427 MAIN ST TOWANDA PA 18848 pennsylvania ~ ~ DEPARTMENT OF REVENUE REV-1547 EX AFP C12-09) DATE 07-26-2010 ESTATE OF TERREL MARGARET A DATE OF DEATH 04-17-2004 FILE NUMBER 21 04-0441 COUNTY CUMBERLAND ACN 501 APPEAL DATE: 09-24-2010 (See reverse side under Objections Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT-ALONG-THIS-LINE----- ~ --RETAIN-LOWER-PORTION-FOR-YOUR-RECORDS- ~ -- REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: TERREL MARGARET AFILE N0.:21 04-0441 ACN: 501 ----------------- OR DATE: 07-26-2010 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED APPRAISED VALUE OF RETURN BASED ON: LITIGATION RETURN 1. Real Estate (Schedule A) C1) •0 0 NOTE: To ensure proper 2. Stocks and Bonds (Schedule B) C2) ,Q 0 credit to your account, 0 0 submit the upper portion 3. Closely Held Stock/Partnership Interest (Schedule C) L3) . of this form with your 4. Mortgages/Notes Receivable (Schedule D) C4) •0 0 tax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 45, 000.00 6. Jointly Owned Property (Schedule F) (6) .0 0 7. Transfers (Schedule G) (7) .0 0 8. Total Assets c8) 45, 000.00 APPROV ED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 15,5 8 4.0 5 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .0 0 11. Total Deductions (11) 15,584.05 12. Net Value of Tax Return C12) 29,415.95 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13) .0 0 14. Net Value of Estate Subject to Tax (14) 29,415.95 NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) 14, 707.97 X 00 = . 00 16. Amount of Line 14 taxable at Lineal/Class A rate C16) 14.707.98 x 045 = 661.86 17. Amount of Line 14 at Sibling rate C17) .0 0 X 12 = .0 0 18. Amount of Line 14 taxable at Collateral/Class B rate (18) .0 0 X 15 = .0 0 19. Principal Tax Due C19)= b61.86 TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID C-) AMOUNT PAID Ob-08-2009 CD011332 .00 661.86 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX PAYMENT 661.86 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. Pa. O.C. Rnle 6.12 STATUS REPORT REaiISTER OF WILLS OF CUMBERLAND Name of Decedent: MARGARET A. TERREL COUNTY, PENNSYLVANIA Date of Dea APRIL 17 , 2004 File Number: 2004-00441 Pursuant to a. O.C. Rule 6.12, I report the following with respect to completion. of the administration of the above-c tinned estate: I I 1. Stan II whether administration of the estate is complete :........................ ~ Yes ^ No 2. If thd answer is No, state when the personal representative I~I reas ably believes that the administration will be complete: 3. If the answer to No. 1 is YES, state the following: ', a. D ~d the personal representative file a final account with the Court?......... ~ Yes ®No b. a separate Orphans' Court No. (if any) for the personal II re~iresentative's account is: ', i c. Dijd the personal representative state an account ~I ini~ormally to the parties in interest? ...................................... ®Yes ^ No d. Copies of receipts, releases, joinders and approvals of formal or informal accou~ts may be filed with the Clerk of the Orphans' Court and may be attached to this report. note: ~ 3 0 Signature of Perso» Filing this orm __ ~• ', Capacity: ^ Personal Representative ®~ounsel .} r .. '! MARK W. SMITH '~ ~ ~ - ~ ~~ Name ojPerson Filing this Form `~ a- ~;, _; 427 MAIN STREET ti ~ u C10~'- v s .. Address cr .~ ~ ~.+»--. -~; TOWANDA, PA 18848 w cL' 7-"== c 'I ~ 570-265-2147 cw V Telephone Form RW-10 rev. 10.13.06 j it i