HomeMy WebLinkAbout04-0447 Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estataof Jack G. Sittman No. 2{-
also known as
, Deceased Social Security No. ~
Sandra Lee Cameron
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 Testamentary and aver that Petitioner(s) is/are the execut nazr~in the last Will of
the Decedent, dated 07/07/lCAi~ codicil(s) dated None
Decedent's spouse, Jean A. Sittman, predeceased testator (Date of Death-1/12/04)
State relevant circumstances, e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
none
[--~ B. Grant of Letters of Administration
(c.t.a.; d.b.n.c.t.a; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs: 7,~
[ Name Relationship '~' Residence
I
(COMPLy- I u. IN ALL CASES:) Attach additional sheets if necessary. ·
Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her last~mily
or principal residence at 3117 Yale Ave., Borough of Camp Hill, Camp Hill, PA 17011
(list street, number, and municipality)
Decedent, then '~/ years of age, died 04/28/200Zat _~'~.~'~.~/2J.4~L. ~"~-~'(Location) /'~Z/-~/'/I ~;/X,,[-/~f /~.
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property $ 3,000o 00
(If not domiciled in PA) Personal property in Pennsylvania $
(If not domiciled in PA) Personal property in County $
Value of real estate in Pennsylvania $ 136,000.00
situated as follows: 3117 Yale Ave., Borough of Camp Hill, Cumberland Co., PA
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of
I,etters in the appropriate form to the undersigned:
/
Signature Typed or printed name and residence
· )~..~.. ~.. //~/~..~ Sandra Lee Cameron
_ _ ~ J; . ~r;-~ 1928 Jody Lane, Carlisle, PA 17013
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of
the Decedent, Petitioner(s) will well and truly administer the estate according to law.
Sandra Lee 6~ameron
before me this~j~fa¥ et
,
Estateof Jack G. Stttman Deceased
Social Security No: Date of Death: 04/28/2004
ANDNOW, ~ ~._\ ~,_p ,2C,~. ,inconsideration
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters [-~---~tamentary ~ministration
(c.t.a.; d.b.n.c.ta.; pendente lite; durante absentia; durante minoritate)
are hereby granted to Sandra Lee Cameron
in the above estate and that the instrument(s) dated 07/07/1988
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ........... ,
Short Certificate(s) ..... $
· I
Renunciation ........ $ Attorney: Robert. C. Saidis
Affidavits ( ) .... $ I.D. No: 21458
Saidis, Shuff, Flower & Lindsay
Extra Pages ( ) .... $ ~ ~, . C:~ ~ Address: 2109 Market Street
Codicil ........... $ Camp Hill, PA 17011
JCP Fee .......... $ ~ 13 , C.~ ~ Telephone: 717/737 - 3405
Inventory .......... $
Other ........... $
TOTAL ......... $ ~(~C~. C~'~
Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form RW- 1 (1991)
105.805 REV 9/86
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
1,ocal.Registrar'. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 0040578
No. ~ - 'Date
H105 t43 Rev ~e7 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH ° VITAL RECORDS
~.,'E,~...T CERTIFICATE OF DEATH
........Bt ACK ,NKT NAME OF DECEDENT (Firs,. M. ) ...... iSEX~ i S~,AL SECURITY NUMBER DATE OF OEATH ( ...... Day)
,,. ~ e&
~5 ~5[~ RESIDENCE de~nl
(S
INFOR~N~S MAIL~DD~ESS (SI~. q~ff~. SI~ ~p ~} /
,~7~ .......... .. ....... f~, o...~ LO~TION {S ........ ~ .......
I
I
~O~NCI~G A~D CERIIFYINfi PHY$~N (Ph~sicmn ~ ~on~ang ~Nh ~ ~i~i~ to ~u~ o¢ ~a~ I . __ [ DA1 E ~IGNEO (M~lh Day Year)
. .......... , ..... ..,. ....... ~ ...... , ........... ., ...... ..-.,. ..... ~., .............. ,. ...................... o ...~o-oH0~ I I'cI,,..q/qloq
Page 1 of 5
LAST WILL
OF
'04 i'i~%¥ -6 '.ii! "t JACK O. SITTMAN
I, Jack G. Sittman, domiciled and resident of the Borough of Camp
Hill, County of Cumberland, Commonwealth of Pennsylvania, declare that
this document is my last will and that I hereby revoke any wills
previously made by me.
IDENTIFICATIONS
I am married to Jean A. Sittman ("my wife"). We have two children,
Sandra Lee Cameron and Ella Jean Poland; neither is a minor.
II.
PAYMENT OF EXPENSES, DEBTS, AND TAXES
I direct my executrix to pay medical, funeral and administrative
expenses and all taxes payable by reason of my death, before any
division of my estate. My executrix shall not attempt to have any part
of such taxes apportioned among the recipients of property includible in
determining the amount of such taxes.
Proceeds of insurance on my life up to the maximum allowable as an
exemption from Pennsylvania Inheritance Tax and distributions from pension
plans exempt from federal estate tax, all of which are payable to any
beneficiary (other than my estate), shall not be used to pay debts, taxes
Page 2 of 5
expenses of administration or other charges against my estate.
III.
WIFE SURVIVING
If my wife survives me, I give, devise and bequeath to her all
property which I own, or over which I have a testamentary power of
appointment.
IV.
WIFE FAILING TO SURVIVE
If my wife does not survive me, then I give, devise and bequeath
all property which I own or over which I have a testamentary power of
appointment in equal shares to my children.
If either of my children does not survive me, her share shall be
distributed to her children, per stirpes. If any issue is a minor at the
time of such division, his share shall be held in trust by his father
until said issue attains the age of twenty-one (21) years. If his
father does not survive me then said issue's guardian is hereby appointed
trustee.
V.
FIDUCIARIES
Executrix: I nominate and appoint my wife as executrix of this
will to serve without bond. If she does not survive me, declines to act,
or, having qualified, resigns, dies or is removed, I nominate my
daughter Sandra Lee Cameron as executrix. If she does not survive me,
Page 3 of 5
declines to act, or, having qualified, resigns, dies, or is removed, I
nominate my daughter Ella Jean Poland as executrix. All successor
executrix' are to serve without bond.
Powers: I give my fiduciaries, including successor fiduciaries,
all the powers contained in Chapter 71 of the Pennsylvania Decedents,
Estates and Fiduciaries Code at the time of the execution of this will,
and those powers are incorporated by reference.
VI.
MISCELLANEOUS
Survival Defined: No person shall be deemed to have survived me
or to be living at my death if he shall die within ninety (90) days
after my death.
Issue Defined: The term issue means all lineal descendants,
immediate and remote, living on the date the persons who comprise that
class must be ascertained. When distribution is to issue, per stirpes,
distribution shall be by right of representation, my children to be
the stocks.
No Implied Contract: This will is being executed on the same date
as is the will of my wife; but in no event shall our wills be considered
joint or mutual, it being our express intention that the survivor shall
in no way be restricted in the use, management, enjoyment, or
disposition of his separate estate of property received under the other's
will.
IN TESTIMONY of which I now sign this will, in the presence of
Page 4 of 5
witnesses whose names will appear below, and request that they witness
my signature and attest to the execution of this will, this ~-day
of ~ , 19~ , at Harrisburg, Dauphin County, Pennsylvania.
Jack G. Sittman, in our presence, signed this instrument. Before he
signed it he declared to us that it was his will and requested that we act
as witnesses to its execution. We believe him to be of sound mind,
possessing testamentary capacity, and not subject to undue influence,
fraud, or coercion. We now, in his presence, and in the presence of each
other, sign below as witnesses, all on this ]~J~- day of ~ , 19 ~,
at/~sbu~, Daup~ ~y, Pennsylvania.
,7 r n
~~/~~'--~~~~ , esidi g at
C0~0N~E~TH OF PENNSYLV~IA~
s~gned to the foregoing ~nstrument, beSng duly qual~fSed according to law,
do depose and say that we were present and saw testator s~gn and execute
the ~nstrument as H~s Last ~11; that Jack G. 8~ttman s~gned
Page 5 of 5
and that Jack G. Sittman executed it as his free and voluntary act for the
purposes therein expressed; that each of us in the hearing and sight of the
testator signed the will as witnesses; and that to the best of our
knowledge the testator was at that time eighteen (18) or more years of age,
of sound mind, and under no constraint or undue influence.
SWDRN OR AFFIRMED to and subscribed to before me by~~. ~Jh ,
ANNE MARIE SYPNIEWSKI, Notary Publ:c
Dauphin County
Ny Commission Expires July 2, 1990
REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA
CERTIFICATION OF NOTICE UNDER RULE 5.6(A)
Name of Decedent: Jack G. Sittman
Date of Death: April 28, 2004
Will No. 21-04-0447 Admin. No.
To the Register:
I certify that notice of Estate Administration required by Rule 5.6(a) of the
Orphans' Court Rules was served on or mailed to the following beneficiary of the above-
captioned estate on April 27, 2004.
Name Address
Sandra Lee Cameron 1928 Jody Lane, Carlisle, PA 17013
Ella J. Poland 433 Sioux Drive, Mechanicsburg, PA 17050
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except none
Robeff C. SardiS, Es~ire
2109 Market Street
Camp Hill, PA 17011
(717) 737-3405
Capacity: ,,, Personal Representative
X Counsel for Personal
Repres ve c5
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(1 ] -96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 1 ? 128 0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND FSTATE TAX
OFFICIAL RECEIPT
NO. CD 0O4206
CAMERON SANDRA LEE
1928 JODY LANE
CARLISLE, PA 17013
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
- fold ..........
101 $7,600.00
ESTATE INFORMATION:
FILE NUMBER: 2104-0447
DECEDENT NAME: SITTMAN JACK G
DATE OF PAYMENT: 07/28/2004
POSTMARK DATE: 07/28/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 04/28/2004
TOTAL AMOUNT PAID: $7,600.00
REMARKS: S LCAMERON
CHECK# 1327
INITIALS: VZ
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA REV 1162 EX(q 1 96)
DEPARTMENT OF REVENUE
BUREAU OF INDfVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128 0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 004268
SAIDIS ROBERT C
26 W HIGH STREET
CARLISLE, PA 17013
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
..... laid
101 $2,522.48
ESTATE INFORMATION:
FILE NUMBER: 2104-0447
DECEDENT NAME: SlTTMAN JACK G
DATE OF PAYMENT: 08/13/2004
POSTMARK DATE: 08/1 3/2004
COUNTY: CUMBERLAND
DATE OF DEATH: 04/28/2004
TOTAL AMOUNT PAID: $2,522.48
REMARKS:
CHECK# 1330
INITIALS: JA
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
OFFICIAL USE ONLY
BEV-, oo x+l -ool REV-1500
OOMMONWE^LT' OFPENNSYLVAN'^ NHERITANCE TAX RETURN F LE
eEPA.TMENTOFRCVENUE RESIDENT DECEDENT 21-04-0447
DEPT. 280601 COUNTY CODE YEAH NUMBER
HARRISBURG, PA 17128-0601
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SCCIAL SECUR{TY NUMBER
D
E Sittman Jack G.
CE DATE OF DEATH (MM-DO-YEAR) [ DATE OF BIRTH (MM-DD-YEAR}
D 0g¢/~8~/'~04 I 12/24/1924 REGISTER OF WILLS
E (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
N
T
cAPB 4. Limited Estate . ~e~j~r~£§~ Comprornise (date of death after 12-12- 5. Federal Est at e Tsx Return
~ ~ A C (Ailach copy of Will) 6~e~opy of Tn~st)
TK
KOEs [] 9. U,igationProceedsReceived[~]10. Spousal Poverly Credit [] 11. Elect,ontotaxunderSec9
C .~. Robert C. Saidis
FIRM NAME (If App~icaDle} 2109 Market St.
i ~ Saidis, Shuff, Flower & Lindsay Camp Hill, PA 17011
S T TELEPHONE NUMBER
717/737-3405 - '-
1Real Estate (Schedule A) (1) 129 , 5(~ ~00 ~ OFFICIAL 0SE ONLY
2Stocks and Bonds (Schedule B) (2) ["]or~e
3Closely Held Corporation, Partnership or (3) 1,['~Tone
4Mortgages & Notes Receivable (Schedule D) (4) None
R 5Cash, Bank Deposits & Miscellaneous Personal Property (5) 58,500.25
E
C (Schedule E)
A 6Jointly Owned Property (Schedule F) (6) 68,632.49
[~ [~eparate Billing Requested
uT 7inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) None
L (Schedule G or L)
A (8) 256,632.74
T 8.Total Gross Assets (total Lines 1-7)
I 9Funeral Expenses & Administrative Costs (Schedule H) (9) 12,875.22
O
N 1O;)ebts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 9,924.71
11Total Deductions (total Lines 9 & 10) (11) 22,799.93
l~let Value of Estate (Line 8 minus Line 11) (12) 233,832.81
13Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been 13)
made (Schedule J)
l~let Value Subject to Tax (Line 12 minus Line 13) (14) 233,832.81
C
O SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
M
[ I~ 1 ~,mount of Line 14 taxable at the spousal tax
T rate, or transfers under Sec. 9116(a)(1.2) X .0 0 (15) 0.00
X
16~mount of Line 14 taxable at lineal rate 233,832.81 X .0 45 (16) 10,522.48
I 17Amount of Line 14 taxable at sibling rate X .12 (17) 0.00
NO 184kmount of Line 14 taxable at collateral rate X .15 (18) 0.00
19Tax Due (19) 10,522.48
Copyright (c) 2000 form software only I~e Lackner Group, Inc. Fo~m REV-1500 EX (Rev 6-00)
Decedent's Complete Address:
Sq'REETADDRESS
3117 Yale Ave.
CITY STATE ZIP
Camp Hill PA 17011
Tax Payments and Credits:
1.Tax Due (Page t Line 19) (1) 10,522.48
2Credits/Payments
A. Spousal Poverty Credit 0.00
B. Prior Payments 7,600.00
C. Discount 400.00
Total Credits (A + B + C ) (2) 8,000.00
3~nterestJPenalty if applicable O. Interest
E. Penalty
Total Interest/Penalty ( D + E) (3) 0.00
4if Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT,
Check box on Page 1 Line 20 to recluest a refund (4) 0.00
5if Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 2,522.48
A. Enter the interest on the tax due. (SA) 0.00
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE, (5B) 2,522.48
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1Did decedent make a transfer and: Yes No
a. rotain 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 lite of either payments, benefRs or care? ...................
2if death occurred after December 12, 1982. did decedent transfer property within one year of death
without receiving adequate consideration? ................................ [] []
3Did decedent own an "in trust for" or payable upon death bank account or security at his
or her death? .............................................. [] []
4Did 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 pedu[7.1 deClare that I have examined this return, including accompanying schedules and statements, and to the best c~ my knowledge and belief, it is tn~e.
correct and complete Declaration of preparer other than the personal representative is based on all inf etrnation of which preparer haS any knowledge
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Sandra Lee C~J]l, eron i~: / A
? ~ :, ~/~ //~ . 1928 Jody_ Lane /~/
SIGNATUREOFPREP~FJ;r~-EHERTHANREPRESENTAT]VE Saidis, Shuff, Flower & Lindsay
~/'~/L//~ 2109 Market St. A
.~' ........ ~i-f ~- i~-- iV6ii- ........................ T
E
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 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 Juty 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.
Copyright (c) 2000 form sofiware only T,e Lackner Group. Inc Form REV- 1{~00 BX (Rev 6-00)
REV-1502 EX + (1-97)
SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Jack G. Sittman 04/28/2004 21-04-0447
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price
at which properb/would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, beth having reasonable
knowledge of the relevant facts. Real property which is jointly-owned with ri~lht of survivorship must be disclosed on Schedule F.
VALUE AT DATE
ITEM DESCRIPTION OF DEATH
NUMBER
1 3117 Yale Ave., Borough of Camp Hill, Cumberland County, PA 129,500.00
(based on sale price -see settlement statement attached)
TOTAL (Also enter on line 1, Recapitulation) 12 9,5 0 0.0 0
(if more space is needed, insert additional sheets of the same size)
For~ REV-1502 EX (R~v 1-97)
Copynght (¢) 1996 form software only CPSystems, Inc.
REV-150§ EX + (1-97)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
COMMONWEALTH OF PENNSYLVANIA
,NHER~TANDET~<RETUSN PERSONAL PROPERTY
RESIOENT DECEDENT
ESTATE OF FILE NUMBER
Jack G. Sittman 04/28/2004 21-04-0447
nclude the proceeds of litigation and the date theproceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on Schedu · F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 2002 Ford Taurus automobile 5,795.00
(value based on Kelley Blue Book)
2 Bethany Center Apts., refunds 1,120.25
3 Bethany Village, refund of entrance fee 51,585.00
TOTAL (Also enter on line 5, Recapitulation) $ 58,500.25
(If more space is needed, insert additional sheets of the same size)
Copyfigh~ (c) 1996 form software only CPSystems, Inc Form REV- 1508 EX (Rev 1-97)
REV-1509 EX + (1-97)
SCHEDULE F
COMMONWEALTH OF RENNSYLVANIA JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Jack G. Sittman 04/28/2004 21-04-0447
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. Sandra L. Cameron 1928 Jody Lane daughter
Carlisle, PA 17013
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY % OF DATE OF DEATH
ITEM FOR JOINT MADE Include name ~ financial instit~ion and bar DATE OF DEATH DECD'S VALUE OF
account number or similar ~dentifying numb(
NUMBER TENANT JOINT Affach de. for jointly-held malest~e VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1 A 05/08/92 PSECU, regular share acct. 7,339.66 50.00% 3,669.83
~0207167797
2 A 05/08/92 PSECU, checking acct. 17,047.11 50.00% 8,523.56
~0207167797
3 A 05/08/92 PSECU, 6 month CD -1 29,796.49 50.00% 14,898.25
4 A 05/08/92 PSECU, 6 month CD -3 13,337.03 50.00% 6,668.52
5 A 05/08/92 PSECU, 6 month CD -4 9,561.50 50.00% 4,780.75
6 A 05/08/92 PSECU, 6 month CD -5 12,039.58 50.00% 6,019.79
7 A 05/08/92 PSECU, 6 month CD -6 8,333.08 50.00% 4,166.54
8 A 05/08/92 PSECU, 6 month CD 6,862.74 50.00% 3,431.37
9 A 05/08/92 PSECU, 6 month CD 6,889.32 50.00% 3,444.66
10 A 05/08/92 PSECU, 6 month CD 10,880.18 50.00% 5,440.09
11 A 05/08/92 PSECU, 6 month CD 683.74 50.002 341.87
12 A 05/08/92 PSECU, 6 month CD 2,088.23 50.001 1,044.12
13 A 05/08/92 PSECU, 6 month CD 6,217.03 50.00' 3,108.52
14 A 05/08/92 PSECU, 6 month CD 6,189.23 50.00%' 3,094.62
TOTAL (Also enter on line 6, R~apitul~ion) $ 68,632.49
(If more s~ce is ne~ inseR ~ditional she~s of the same siz~
REV*~ E× · 1~-971 SCHEDULE H
FUNERAL EXPENSES &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Jack G. Sittman 04/28/2004 21-04-0447
Debts of decedent must be reported on Schedule I.
iTEM
NUMBER DESCRIPTION AMOUNT
A. :UNERAL EXPENSES:
Neill Funeral Home 292.36
Funeral Luncheon 174.24
Flowers 80.29
B. ~,DMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2. Att0rney'sFees Saidis, Shuff, Flower & Lindsay 2,700.00
3, Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees Register of Wills 269.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
The Patriot News, estate notice 140.05
Cumberland Law Journal, estate notice 75.00
Register of Wills, filing fee for tax return 15.00
Settlement costs: 9,018.18
Realtor~s commission 9,065.00
Notary 10.00
Transfer Tax 1,295.00
Tax Certification 7.00
(less credit for pro-rated taxes in the amt. of $358.82)
Telephone and postage expenses 66.10
Thank you notes 24.00
Mileage expenses 21.00
TOTAL (Also enter on line 9, Recapitulation) 12,875.22
(if mere space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSyst ems, Inc For¢~ REV-1511 EX (Rev 1-97)
REV-1512 EX + (1-97)
SCHEDULE I
COMMONWEALTHOFP~NNS~LVA.,A DEBTS OF DECEDENT,
,..E.,T^NCE.AX.E~U...ES,~.T~C~.~ MORTGAGE LIABILITIES, AND LIENS
ESTATE OF FILE NUMBER
Jack O. Sittman 04/28/2004 21-04-0447
Include unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION AMOUNT
1 Verizon telephone 135.98
2 UCI utilities 328.63
3 Bethany Center 6,890.25
4 PA American Water 35.73
5 Hospice Residence 2,100.00
6 Penn Waste 50.74
7 PPL Utilities 65.24
8 Nationwide Insurance 189.05
9 SERS, reimbursement for pro-rated amount 129.09
TOTAL (Also enter on line 10, Recapitulation) 9,924.71
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 1996 form software only CPSystems, Inc Form REV-lsl 2 EX (Rev. 1-97)
REV-1513 EX + (9-00)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
~NHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Jack G. Sittman 04/28/2004 21-04-0447
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS [include outdght spousal dist~ butions, and
transfers under Sec 9116(a)(1 2)]
1 Sandra Lee Cameron daughter 1/2 of estate
1928 Jody Lane
Carlisle, PA 17013
2 Ella J. Poland daughter 1/2 of estate
433 Sioux Drive
Mechanicsburg, PA 17050
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18~ AS APPROPRIATEr ON REV 1500 COVER SHEET
II. ',ION-TAXABLE DISTRIBUTIONS:
SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00
(If more space is needed, insert additional sheets of the same size)
Copyright (c) 2000 form software only The Lackner Group, Inc, Form REV-1513 EX (Rev 9-00)
BETHANY CENTER APARTMENTS ACCOUNTS RECEIVABLE STATEMENT
3*-5 WESLEY DRIVE Statement Date: 05/05/2004
MECHANICSBURG PA 17055-
_~,~~.~_ Balance Due: (213.75)
JACK SITTMAN
OXFORD/128/A
Account Number: 2021
~lease detach and remit this portion with your payment Balance Forward: (213.75).
~ T Date ~ i Description i[Days/Un ts i Ch~r§e
C.M. DETWEILER, INC. TBA HOWARD HANNA DETWEILER REALTY
5
v~s~ ~oo~-~ o~/~/o4 ~o~.so 9o~.so o.oo o~.~o.)
TRX DESCRIPTION: SRES Rebate
$906.50
Bethany Village
Sittman Entrance Fee
Refund Calculation
Entrance Fee Type: Standard B (5 Year)
Monthly
Amortization
Entrance Fee Deposit 54,300
Feb-04 (905) 53,395
Mar-04 (905) 52,490
Apr-04 (905) ~~5,,
Entrance Fee Balance ~ 51,585/,),
* Calculated using A.V. Powell Entrance Fee SofTware
Kellex Blue Book Used Car Values Pa~ge I of 2
Kelley Blue Book
THE TRUSTED RESOURCE
BLUE BOOK TRADbIB VALUE
Pennsylvania · May '10, 2004
2002 Ford Taurus SE Sedan 4D
See Local Listings of This Car
List Your Car For Sale Online
Buy a New Car
Free Lemon Check
Auto Loans from 3.85% APR
Engine: V6 3.0 Liter Insurance Quote
Trans: Automatic Payment Calculator
Drive: Front Wheel Drive
Rileage: 40,000
Equipment
Air Conditioning Tilt Wheel Dual Front Air Bags
Power Steering Cruise Control Alloy Wheels
Power Windows AM/FM Stereo
Power Door Locks Cassette
Consumer Rated Condition: Good
"Good" condition means that the vehicle is free of any major defects.
The paint, body and interior have only minor (if any) blemishes, and
there are no major mechanical problems. In states where rust is a
problem, this should be very minimal, and a deduction should be
made to correct it. The tires match and have substantial tread wear
left. A clean title history is assumed. A "good" vehicle will need some
reconditioning to be sold at retail; however major reconditioning
should be deducted from the value, most recent model cars owned by
consumers fall into this category.
Trade-In Value $5,795
Trade-in value represents what you might expect to receive from a
dealer for this consumer owned vehicle. Keep in mind that the dealer
must then absorb the cost of making the ve.h c e ready for sale,
advertising, sales commissions, arranging financing and insurance
and standing behind the vehicle for any mechanical or safety
problems.
~he fin~noi~l
Ma) 4, 2004
Account # 0207167797
ROBERT C SAIDiS
C/O SAIDAS SItUFF FLOWER & LINDSAY
26 WEST ItlGIt ST
CAILLiSLE, PA 17013
Dea~ MR SAIDIS:
The following is the status of JACK SITTMAN's account with PSECU as of the date of death.
.]oint Ox~qmr's Name SANDiLA L CAMERON, ADDED 05.08.1992 AS JOINT TENANT W/ROS
Date Established 07.15.1979
Date of Death 04.28.2004
Date of Bir~h 12.24.1924
Share(s) Balance Accrued Dividend
Regular Shares (Si) $ 7,338.79 $ 0.87
Checking Shares (S4) 17,042.97 4.14
6 Month Certificate-I (S50) 29,765.88 30.61
6 Month Certificate-3 (S52) 13,323.33 13.70
6 Month Certificate 4 (S53) 9,530.41 31.09
6 Monflx Certificate-5 (S54) 12.027.22 12.36
6 Month Certificate-6 (S55) 8.328.60 4.48
6 Month Certificate (S56) 6,856.20 6.54
12 Month Certificate (S57) 6,880.72 8.60
6 Month Certificate (S58) 10,869.81 10.37
6 Month Certificate (S59) 683.04 0.70
6 Month Certificate (S60) 2,086.09 2.14
6 Month Certificate (S61) 6.210.64 6.39
6 Month Certificate (S62) 6,182.88 6.35
Loan(s) Balance Accrued Interest
Personal Sci-vice Loan (L1) $ 0.00 S 0.00
VISA (L9) 0.00 0.00
Thc dividend earned from January 1, 2004 tlu'ough the date of death was S737.26. The decedent had no
loans with us. We do not have safe deposit boxes for our members. If you have any questions, please call
234-8484 in Harrisburg or om toll-fmc number, (800) 237-7328. At thc menu prompt, enter 6 and then
extension 2227.
Sincerely,
Mcalcie F ail/'Pax
Member Service Representative
Finance Support Unit
PENNSYLVANIA STATE EMPLOYEES CREDIT UNION
Main Address: 1 Credit Union Place Harrisburg, PA 17110-2090 - (717) 234-8484 · (800) 237 7328
Maiim9 Address: PO Box 67613 Harrisburg PA 17106 7013 · (717) 777-2100 (TDD) - (800) 472 1967 (TDD)
Page 1 of 5
LAST WILL
OF
JACK G. SITT~E%N
I, Jack G. Sittman, domiciled and resident of the Borough of Camp
Hill, Oounty of Cumberland, Commonwealth of Pennsylvania, declare that
this document is my last will and that 1 hereby revoke any wills
previously made by me.
iDENTIFiCATiONS
I am married to Jean A. Sittman {"my wife"). We have two children,
Sandra Lee Cameron and Ella Jean Poland; neither is a miner.
Ii.
PAYMENT OF EXPENSES, DEBTS, 7d{D TAXES
I direct my executrix to pay medical, funeral and administrative
expenses and all taxes payable by reason of mI' death, before any
division of my estate. My executrix shall not attempt to have any part
of such taxes apportioned among the recipients of property includible in
determining the amount of such taxes.
Proceeds of insurance on my life up to the maximum allowable as an
exemption from Pennsylvania Inheritance Tax and distributions from pension
plans exempt from federal estate tax, ail of which are payable to any
beneficiary (other than my estate), shall not he used to pay debts, taxes
Paga 2 05 <
expenses of administraUion or o~her charges against my estate.
Iii.
WiFE SURVIVING
If my wire survives me, i give, devise and bequeath to her all
property which i own, or over which I have a testamentary power of
appointment.
IV.
WIFE FAILING TO SURVIVE
if my wife does not survive me, Then I give, devise and bequeath
all property which I own. or over which I have a testamentary power of
appointment in esual shares to my children.
If either of my children does not survive me, her share shall be
distributed tc her children, per stirpes. If any issue is a minor at the
time of such division, his share shall be held in trust by his father
until said issue aria±ns the age of twenTy-one (21) years, if his
father does no~ survive me then said issuers guardian is hereby appointed
V.
FIDUCIARIES
Exe£utrix: i nominate and appoint my wife as execuEr±x of this
will to serve without bond. If she does xot survive me, declines te ae~
or, having qualified, resigns, dies or is removed, I nominate my
PaRe 3 of 5
declines to act~ or, haviag qualified, resigns, dies, or is removed, I
nominate my daughter Ella Jean Poland as executrix. Ail successor
execu£rix~ are to serve without bond.
Powers: I give my fiduciaries, ±nc]uding successor fiduciaries,
all the powers contained in Chapter il os the Pennsylvania DecedenEs,
Estates and Fiduciaries Code at the time of the execution of this will,
and ~hose powers are insorporated by reference.
VI.
MiSCELLf~NEOUS
Survival Deflned: No person shall be deemed to hsve survived me
or to he living at my death if ne shall die within ninety {90) days
after my death.
issue Defined: The term issue means all lineal desaendants,
immediate and remote, livin8 on ~he da~e ~he persons WhO comprise tha~
class muse be ascertained. R~en distribution is to issue~ per stirpes,
distribution shall be by right of representation, my children to be
the stocks.
No Implied Contract: This will is being executed on the same date
as is the will of my wife~ bu~ in no event shall our wills be considered
joint or muTual~ it being our express intention that the survivor shall
in no way be restricted in the use, management~ enjoymenE, or
disposition of his separate estate of property received under the other's
will.
IN TESTIMONY of which I now sign this will, in the presence of
Page 5 of 5
and that Jack G. Sittman executed it as his Lree and voluntary act for the
purposes therein expressed; that each of us in the hearing and sight o£ the
testator signed the will as witnesses; and that to the best of our
knowledge the testator was at that time eighteen (i$) or more years of age,
of sound mind, and under no constraint or undue influence.
ANNE MARIE SY?NIEWSKI, NotaPy PuDI:
Dauphin County
My Commission Expires July 2, 1990
12[)3. StateTaxiStamps
LAW OFFICES
SAIDI$, $HUFF, FLOWER & LINDSAY
A PROFESSIONAL CORPORATION
2109 MARKET STREET
JOHN E. SLiKE CAMP HILL, PENNSYLVANIA 17011 ~
ROBERT C. SAIDIS TELEPHONE: (717) 737-3405 - FACSIMILE: (717) 737-3407 26 WEST HIGH STRERT
CARLISLE, PA 17013
GEOFFREYS. SHUFF EMAIL: attorney@ssfl-law.com TELEPHONEi: (717)2496222
JAIV~S D. FLOWER, JR FACSIMILE: (717)243-6486
CAI~OL J. LINDSAY
MATI'HEW J. ESHELMAN't LiZard Certified CrcdlWr s'
THOMAS E. FLOWER Rights R=pr¢~enmnon
LINDSAY GINGRICH MACLAY
JACLYN SMITH ~ HILL
August 12, 2004
Register of Wills
Cumberland County Courthouse
Carlisle, PA 17013
Re: The Estate of Jack G. Sittman
File No. 21-04-0447
Dear Ladies:
Enclosed is an original and two copies of an inheritance tax return for the above estate.
Also enclosed are two checks, one for the filing fee and the other for the tax due. Please return a
time-stamped copy of the return in the envelope provided.
Thank you.
Very truly yours,
SAIDIS, SHUFF, FLOWER & LINDSAY
Shelby L./Ying?ng, Estate Paralegal
,
/sly
Enclosures
~..x~_ ~\C COMMONWEALTH OF PENNSYLVANIA
BUREAU OF INDIVIDUAL TAXES DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601 NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DZSALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
DATE
, ESTATE OF SZTTMAN JACK G
DATE OF DEATH Oq-Z8-200q
FILE NUMBER 210q-Oqq7
~'~ ~]~UNTY CUMBERLAND
ROBERT C SAIDIS ACN
SAIDIS ETAL I Amoun~ Reai~ed I
2109 MARKET ST
CAMP HILL PA 17011[~!;,~ ~
HAKE CHECK PAYABLE AND REMIT PAYHENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LZNE ~ RETAIN LOWER PORTION FOR YOUR RECORDS
REV-15~7 EX AFP [01-03) NOTICE OF INHERITANCE TAX APPRAZSEHENT~ ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF SZTTMAN JACK G FILE NO. 210q-O~7 ACN 101 DATE !0-11-200~
TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE ZNTEREST- SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~a~e (Schedule A) (1) 129~500.00 NOTE: To insure proper
2. S~ocks and Bonds (Schedule B) (2) .00 credi~ (o your account,
$. Closely Held S~ock/Per~nership In~eres~ (Schedule C) ($) .00 submi~ ~he upper pore/on
fi. Nor~gages/No~es Receivable (Schedule D) (~) .00 of ~his form wi~h your
$. Cash/Dank Depos~s/Hisc. Personal Proper~y (Schedule E) (5) 581500.25 ~ax payment.
6. Jointly Owned Proper~y (Schedule F) (6) 68;652.q9
7. Transfers (Schedule G) (7) .00
8. To~el Asse~s (8} 256,6~2.7~
APPROVED DEDUCTIONS AND EXEMPTIONS: !Z,875.22
9. Funeral Expenses/Ada. Cos~s/Hisc. Expenses (Schedule H) (9)
10. Deb~s/Nor~gege Liabilities/Liens (Schedule I) (10) 9; 92q. 71
11. To~el Deductions (11) 22.7~.
12. Ne~ Value of Tax Re~urn (12) 255,852.81
15. Chari*able/Governaen~al Beques*s; Non-elected 9115 Trusts (Schedule J) (15) .00
1fi. Ne~ Value of Es~a~e Sub5ec~ *o Tax (lq) 255,852.81
NOTE: Zf an assessment ,as Sssued prev$ous~y, 1Shes ~, ~5 and/or 16, 17, 18 and 19
reflect figures that include the total of ALL returns assessed to date.
ASSESSHENT OF TAX:
15. Aaoun~ of Line lq e~ Spousal re~e (15) .00 X O0 = .00
16. Aaoun~ of Line 1~ ~exable a~ Lineal/Class A re~e (16) 255,852.81 x Oq5 = 10,522.q8
17, Amoun~ of Line 1~ a~ Sibling ra~e (17) .00 X I2 = .00
18. Aaoun~ of Line 1~ *axable a~ Collateral/Class B ra~e (18) .00 X 15 = .00
19. Princi)al Tax Due (19)= 10,522.~8
TAX CREDITS
PAYMENT RECEIPT DISCOUNT
AHOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
07-28-200~ CDOOq206 ~00.00 7,600.00
08-15-200~ CDO0~268 .00 2,522.~8
TOTAL TAX CREDZT 10,522.q8
BALANCE OF TAX DUE] .00
INTEREST AND PEN. .00
TOTAL DUE .00
TF PATD AFTER DATE ZNDZCATED, SEE REVERSE ( ZF TOTAL DUE ZS LESS THAN $1z NO PAYHENT ZS REI~UIRED.
FOR CALCULATION OF ADDZT/OWAL INTEREST. ZF TOTAL DUE ZS REFLECTED AS A 'CREDIT" (CR), YOU HAY BE DUE _
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ] [~.
RESERVATION: Estates of decedents dying on or before December 1Z, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Coeeonaeelth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the laaful Class B (collateral) rate on any such future interest.
PURPOSE DF
HOT[CE: To fulfill the requirements of Section Zl40 of the inheritance and Estate Tax Act, Act 25 of ZOO0. (TZ P.S.
Section 9140).
PAYHENT: Detach the top portion of this Notice and submit aith your payment to the Register of Rills printed on the reverse side.
--Hake check or money order payable to: REGZSTER OF NZLLS, AGENT
REFUND (CR)= A refund of a tax credit, ahich was not requested on the Tax Return, may be requested by completing an "Application
for Refund of Pennsylvania inheritance and Estate Tax" (REV-1513). Applications are available at the Office
of the Register of Hills, any of the ZS Revenue District Offices, or by calling the special 24-hour
ansaering service for forms ordering= I-BOO-36Z-20501 services for taxpayers with special hearing and / or
speaking needs= 1-800-447-30Z0 (TT only).
OBJECTIONS: Any party in interest not satisfied with the appraisement, aIIowance, or disaIIowance of deductions, or assessment
of tax (including discount or interest) as shown on this Notice must object within sixty (60) days of receipt of
this Notice by:
--written protest to the PA Department of Revenue, Board of Appeals, Dept. 281021, Harrisburg, PA 17128-10Zl, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
ADH[N-
[STRAT[VE
CORRECTIONS: Factual errors discovered on this assessment should be addressed in writing to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, Dept. Z80601, Harrisburg, PA 171Z8-0601
Phane (717) 787-6505. Sea page 5 of the booklet "instructions for Inheritance Tax Return for a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
DISCOUNT: [f any tax due is paid within three (3) calendar months after the decedant's death, a five percent (SZ) discount of
the tax paid is allowed.
PEHALTY: The 15Z tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January lB, lggB, the first day after the end of the tax amnesty period. This non-participation
penalty is appealable in tho same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
iNTEREST: interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of
death, to the date of payment. Taxes which became delinquent before January l, 198Z bear interest at the rate of
six (6~) percent per annum calculated at a daily rate of o000164. All taxes which became delinquent on and after
January 1, 198Z will bear interest at a rate which will vary from calendar year to calendar year with that rate
announced by the PA Department of Revenue. The applicable interest rates for 1gal through ZOO4 are:
Interest Daily Interest Daily [nterest Daily
Year Rate Factor Year Rate Factor Year Rate Factor
~ lOX .000548 1988-1991 llZ .000301 ZOOZ 9Z .000Z47
1983 16X .000458 199Z 9Z .000Z47 ZOOZ 6Z .000164
1984 IIX .OOO30Z 1995-1994 7Z .O0019Z 2005 5Z .000157
1985 13Z .000556 1995-1998 9Z .000247 2004 4Z .O001ZO
1986 IOZ .000274 1999 7Z .O0019Z
1987 IOZ .000274 ZOOO 7Z .O0019Z
--interest is calculated as follows:
~NTEREST = BALANCE OF TAX UNPA[D X NUHBER OF DAYS DELINQUENT X DAZEY ZNTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen ElS) days
beyond the date of the assessment, If payment is made after the interest computation date shown on the
Notice, additional interest eust be calculated.
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Jack G. Sittman
Date of Death: April 28, 2004
Will No. 21-04-00447 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
Name: Robert C. Saidis, Esquire
I.D. No. 21458
SAIDIS, SHUFF, FLOWER & LINDSAY
2109 Market Street ~ o -~- :~ ~-.~
Camp Hill, PA 17011
(717) 737-3405
Capacity: Personal Representative
X Counsel for Personal Representative ;}¢-~ ~ '~/~ C~