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Home My WebLink About01-0820 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of Dennis M. Barto also known as No. To: ~/-Ol-~~O Deceased. Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania Social Security No. 165-42-1317 The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older, applies for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante rninoritate) the above decedent. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at Lot 41, Shippensburg Mobile Estates. Shippensburg, PA, 17257. (list street, number, Twp. or Boro.) Decedent, then 49 years of age, died February 3, 2001 :lft'x at Greenridge Nursing Home, Newville, PA. Decedent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: None 12,000.00 $ $ $ $ Petitioner__ after a proper search ha~ ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name . Barto Bra Relationship Survivin souse Dau hter THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. ~ '" ~ U U C U -o~ .- '" "'~ U ... Q'.U C -00 c';:; os';:; ~~ 'U'- 50 (;j c OIl Vi ~nna J. Barto 6r'nn4O\ rf 6~ Shirrpn~hl1rg. PA 1/-5-/ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF Cumberland } 58 The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal representative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law. Sworn to or affirmed and subscribed J <tJrfl)fiA / 6~ before me this 4 t h day of _ seDte~ u~ t~4ew1s t/UA Regut~ - '" 'is' ... =' <<i Q ... fI) No. 21-2001-820 Estate of Dennis M. Barto , Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW September 4 th a2ilil.L, in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that Donna J. Barto islamKentitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to Donna J. Barto i~he estate of J5"ennfS11.-:Birto-------- Lewis iJ:ifi FEES Letters of Administration Short Certificates(7 ) . . . . . . . . . . Renunciation ................ JCP $ 56.00 $ 21. 00 $ $ TOTAL _ $ Filed ?~P.t;E?!T!l:;>~X..4 t.t!.. A.D. ~~ ~.UO Steven C. Skoff. ESQ. 8~2q8 ATTORNEY (Sup. Ct. tD. No.) 3211 North Front Street, PO Box 5300 HarriRbllrg, PA 1711n-n~no ADDRESS 717-218-8187 PHONE MAILED LETTERS TO ATTORNEY HIO'.80' REV 9/86 This is to certify that the information here given' is correctly copied fro~ an original certificate of death dul~ filed with Local Registrar. The original certificate will be forwarded to the State VItal Records Office for permanent filmg. WARNING: It is illegal to duplicate this copy by photostat or photograph. me as No. 2i- ~~~:;;~~ Fee for this certificate, $2.00 p 6948183 FEB ' 6 2001 Date 21-2001-820 'c) Hl05.143Flev.2l87 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH liNT AOE (La., B~vt uNOEA 1 YEAR folontt\s Days SE. ..Male STATE FILE NUMtlEFI SOCiAl SECURIT't NUMBER .. 165 - 42 - 1317 ~ .;l001 ENT NK NAME OF DECEDENT IFIl'Sl', MiOclIe, l_1 .. Dennis Barto s. 49 Vrs. COUNTY OF OEA:rH UNDER 1 DAY Hours ! t.Iinut.. BIRTHPlACE (CoIy iIInd PlACE CY DE.c:rH IC"ecA aNy Ilf'e -- "" tnSlluct.ons on ort'oeI' !IOel H~tI~ga~V' HOSPITAl.; onu PA '''''- 0 :::=0 iii 7. ... FACIlIT"t NAME", no! 1nSI'1\JtIQn. gwe SlfHt and number. =.,,0 DECEDENT'S USUAL OCCUPRION (~.,.~.:':"~:::':l,=r Ie. RACE .Amenc:an tndlaIn, StKk. Whit.. etc. _I ... White SUR\IMNQ SPOUSE (n......grYllmac:Jennatnel ~I .... Cumberland _. ,71>. Cumberland 17..0 :... "=" -'= of MOTHER'S NAME ,F.II. MGIe. MIlden SurNmeJ '1. Erlma Shultz INFORMANT'S MAIUHO AODRESS $wt. CiIy/Town, $&Me. Zip Code! l' M:Di.1 EBtates, Shi nsbu , PA 17257 PLACE OF DISPOSITION. N...... of c.m.t.". ClemMOry LOCRlON. c;r.,JTown, State. Zip Code <<Other ~ Westminster Memorial 21c. _. DATE OF DISPOSITION _.Oov. _, o February 6, 2001 2lb. H UCENSE NUMBER Carlisle PA 17013 211.. ....llE AHDADDRESS Of' FACILITY ff 1 ....219 N. HanoverHgc. rneRr~~~~eEtlRert70~~ LICENSE NUMBER ORE: $tGHED (MonIh. 0.,. ...., 2311. ~~YIUO L ....bi 'MS CASE REFEARED 10 MEDtCAl EXAMINERlCQRONER? _0 II. I ApptolirMle I.....,.,., *'-"n : onMI and dealh , : PART R: { .. c. .. WEAE AUlOPSY FINDINGS .tMUl.A8LE PRJOA 10 COMPI.ETIOH Of' CAUSE 01' DEArH? /~~~ DuE 10(00 AS ACON$EOUEHCE Of), MANNER OF DEATH N..... [9"" o o DATE OF INJURY (Month. 0Iy. ......., TIME OF INJURY INJUAV IC1 VIORI<? DESCRIBE HOw' INJURY OCCURRED. Homicide o o o PlACE OF INJURY. AI home, farm, .rut. factory. omc. ... building. eIC.ISpec.tyJ .... .... 0 HoD -.. Pending Ift\lftCigation _0 Ho~ - Coutd noc be determtMd ,p,,11 I~ \ 101 /W 2eII. 2.... CEllTWlUlICheQI en-, orwt oCER'flfrYtHQ PHYSJC1AN (Ph~n certJtyong caused dftth"llYherl M'lOthef ptlyscoan has pronounced death ana c~ Item 23) TOthebeacOf""know~.de.thoceU"""duetDthec.uH(a).ndm.n,.r..at.t8d.,.....".".........,.....,.,. . zo. .~NCING AND CElIlITIFYINQ PHYSICIAN (~bolh ;)I'onounell'lO Oflltl.nd CSfllfytroc) 10 cause Of delltl'll To the blMt of my kl"lOwe.dQft. dealhocc"'rH at d'Ie 1InM, date. and ,.... and due to the cause(a) and mann.r.. a.ated...... . . ... , , ., , ... ., , . ... ."EOtCAL lXAMIHERlCOROHEA ~~~~ ~:~t::~~~~.j~~~l~~...~~~ ~~~~~t~~~~~~: ~ ~~ ~~~n.i~~: ~~~~~ ~~~~~~~ ~~ ~~~ ~I~~',~~t~: ~~,~I~~~: ~~,~~~ ~~ ~~~ ~~~~~~).~~ 0 31a. REGISTR....R.S SIGNATURE ANO N /7.2..2,11 ~COI CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent Date of Death Will No.: Dennis M. Barto February 3, 2001 Admin. No.: 2001-00820 To the Register: I hereby certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on December 19,2001 Name Address Donna J. Barto Lot 41, Shippensburg Mobile Estate, Shippensburg, P A 17257 Jessica J. Barto 65 West Louther Street, Carlisle, PA 17103 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None Date: January ~, 2002 D-y ;,,- .;e:/~ ~ Signature Name David H. Martineau, Esquire Address 3211 North Front Street P.O. Box 5300 Harrisburg, PA 17110-0300 \0 ':") ("-..l c::: Telephone (717) 238-8187 0\ N z d:: -., Capacity: _ Personal Representative .:' ;",... ::.) 'GJ Qcr.: a: ~ ,v .. .0 t:s:: .JJ=: ~'-".~ -'" '..)(; X Counsel for Personal - Representative Document #: 223157.1 t U.S. Postal Service CERTIFIEf) MAeL RECEIPT (Domestic Mail Only; No Insurance Coverage Provided) r I Postage $ Certified Fee Postmark Return Receipt Fee Here (Endorsement Required) Restricted Delivery Fee (Endorsement Required) Total Postage & Fees $ ....Il .::r ITl ru ITl ....Il r=I IT" CI r=I CI CI CI I"- ....Il r=I Sent T03\~ c... ~ CI -----------------------------------------------------~---------------------------- CI Street, Apt No.; or P~ No. CI ____~_~-------------at--~---OJ--~--~d:-Q------------------- I"- City, State, ZIP+4 pc:. t 0111 j8\ f) M l~ ((J()( Sep Reverse for Instructions . Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. . Print your name and address on the reverse so that we can return the card to you. . Attach this card to the back of the mail piece, or on the front if space permits. 1. Article Addressed to: S\~ C- ~ 6;1\\ ~~~ ~ 1>.0. \?:Pi. 5300 ~~l>A \\\\0 2. Article Number tl 000 (Transfer from service label) PS Form 3811, March 2001 x flJ Agent D Addressee DYes ~ D. Is delivery address d' m item 1? If YES. enter delivery address below: 3. Seryce Type rir Certified Mail D Express Mail D RegistereO D Return Receipt for Merchandise D Insl$ed Mail D C.O.D. 4. Restricted Delivery? (Extra Fee) D Yes '1\\0"6 ~tc \LD"lD - ():)ID " 102595-01-M-1424 Domestic Return Receipt " " JRD/fune 30, ,.992117858 JAN 0 3 2002. yb- Estate No.: 21-01-820 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA In Re: Estate of Dennis M Barto Late of Shippensburg Township NO. NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT ORPHANS' COURT RULE Personal Representative: Donna J Barto Counsel for Personal Representative: Steven C Skoff Date of Grant of Original Letters: September 5, 2001 Date of Delinquency Notice: December 15, 2001 The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court Orphans' Court Rules, was given by the Register of Wills on December 7, 2001, and that the ten (10) day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6(e) the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: January 2 2002 Distribution: Personal Representative Counsel for Personal Representative Estate File A hearing is scheduled for );;tlALiJ / .5;~~ at f7, '3 iJ In Courtroom No.3. If the Certification of Notice is filed prior to the hearing date, the hearing will automatically be cancelled. b~~&.- l-~_Q~ STATUS REPORT UNDER RULE 6.12 1/ ~ Name of Decedent Date of Death Will No. 2001-820 BARTO, DENNIS M. February 3, 2001 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 No. X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: Upon receipt ofInheritance Tax Assessment from Dept. of Revenue 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: ?f~ ~-q-'~, Signature -~ Name David H. Martineau, Esquire Address 3211 North Front Street P.O. Box 5300 Harrisburg, PA 17110-0300 v ~~oo '0\ ()~ Telephone (717) 238-8187 Capacity: Personal Representative X Counsel for Personal Representative Document #: 260868.1 t .-"I. !r' ;t" .-"I rll1II_l ...~ " ~ It i i 1 i I IIIIJ OJ ..D <:D LI'J Postage Certified Fee ..D CJ CJ CJ Return Receipt Fee (Endorsement Required) Restricted Delivery Fee (Endorsement Required) ~ Total Posta e & Fees $ LI'J OJ .-"I CJ CJ ['- ;t.;~~. 'J Ill, . Complate items 1, 2, and 3. Also complete . item 4 if Restricted Delivery is desired. . Print your n.ame and address on the reverse so that we can return the card to you. . Attach this card to the back of the mailplece, or on the front if space permits. COMPLETE THIS SECTION ON DELIVERY i< .] - ~J,)A-h ~ 3=21/ 7J ~~:i. f!tY6o')( S360 /~)Ib-I7I/':1 i', \.Or35S different from item 1? 'r! d~livery address below: L..._____.... i.J .' filsil 0 Express Mail "!l 0 Return Receipt for Merchandise I'ai, 0 C.O.D. [.!I"'ery? (Extra Fee) Dyes 2. Article Number (Transfer from service label) PS Form 3811, August 2001 7001 2510 0006 r:. Ii ,'J ..' ,.J t,] .c.. 14~1 Domes+ ,; 102S9S-Q2-M-0835 " JRD/June 30, 1992/17858 ~ J. .~., .. MAR 1 0 2003 ~ In Re: Estate of Dennis M. Barto Late of Shippensburg Borough ORPHANS ' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA Estate No.: 21-2001-0820 NO: 21-2001-0820 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative Counsel for Personal Representative: Steven C. Skoff, Esquire Date of Decedent's Death: 02-03-2001 Date of Delinquency Notice: 01-06-2003 The undersigned, Donna M. Otto, Register of Wills, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor 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, was given by the Register of Wills on 01-06, 2003, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Distribution: Personal Representative Counsel for Personal Representative Estate File Date: 03-10-2003 A hearing is scheduled fotcl-(/l) 3 at 7';:J.() in Courtroom No.3. If the Status Report is filed prior to the hearing date, the hearing will antomatically be c~ . ~~\~7 ' ~\} ,L (j\\ r " f Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 Date: 1/06/2003 BARTO DONNA J LOT 41 SHIPPENSBURG MOBILE ESTATES SHIPPENSBURG, PA 17257 RE: Estate of BARTO DENNIS M File Number: 2001-00820 Dear Sir/Madam: It has come to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 2/03/2003 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, DONNA M. OTTO DEPUTY REGISTER OF WILLS cc: jFile Counsel Judge May 4, 2004 SINCE 1888 3211 Nortl1 Front Street P.O. Box 5300 Harrisburg, PA 17110-0300 717-238-8187 Fax: 717-234-9478 Mary C. Lewis, Register of Wills Office of Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, P A 17013-3387 Other Offices Colonial Park Mechanicsburg 717-652-7020 717-691-5577 Millersburg Shippensburg 717-692-5810 717-530-7515 Re: Estate of Dennis M. Barto No. 2001-820 Dear Ms. Lewis: Enclosed is a copy of our letter to J. Paul Dibert of the Department of Revenue, Inheritance Tax Division and a Rule 6.12 Status Report, which indicates that administration of the estate is complete. Please kindly return a time-date stamped copy of the status report to me in the self addressed stamped envelope provided herein. ,-..,. ,... ;./ ~ d .c:,. Very truly yours, s:-, -<:' METZGER, WI4KE SHAM, KNAUSS & ERB, P.C. \ . \~ ~ "7- Diane McKay, Paralegal Enclosures E w cc: Donna J. Barto, Administrator ,..,-,t, , .~. 304019-1 James F. Carl Edward E. Knauss, IV' Jered L. Hock Steven P. Miner Clark DeVere Milton Bernstein Bruce J. Warshawsky Francis J. Lafferty, IV David H. Martineau Andrew W. Norfleet Andrew C. Spears Young-Suh Koo . Board Certified in civil trial law and advocacy by the National Board of Trial Advocacy \'-. ~ ,~ STATUS REPORT UNDER RULE 6.12 Name of Decedent Date of Death Dennis M. Barto February 3. 2001 Will No. Admin No. 2001-00820 Pursuant to Rule 6.12 ofthe 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. Ifthe answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No X account is: b. The separate Orphans' Court No. (if any) for the personal representative's c. Did the personal representative state an account informally to the parties in interest? Yes No X (this was a "no asset" estate) 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. PLEASE NOTE: The foregoing is based upon the fact that there was a personal injury suit opened by our firm. The personal injury suit was not ursued and, according to our information, there are no probate assets. Date: Mav 4. 2004 --.:__ !-l~} SIgna Utt( Name Jered L. Hock. Esquire ") ell' ; c. " . ~, Address 3211 North Front Street P.O. Box 5300 Harrisburg. P A 17110-0300 II AW.j 170. Telephone (717) 238-8187 Capacity: Personal Representative Counsel for Personal Representative X 304390-1 c/ t1)( MARY C. LEWIS, REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA PETITION FOR GRANT OF LETTERS Estate of BERTHA M. BELTZ No.21 01 -~~I also known as , Deceased Social Security No. 201-18-0809 PAUL BERT Petitioner(s), who is/are 18 years of age or older, apply)ies) for: (COMPLETE "A" OR "B" BELOW:) CJ A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut OR Decedent, dated 7/1 a/99 .:TV L \ 2- D (; 0 and codicil(s) dated N/A named in the Last Will of the State relevant circumstances. e.g., renunciation, death of executor, ete 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: o B. Grant of Letters of Administration (c.I.a., d.b.n.e.l.a.: pendente lite, durante absentia; durante minoritate) Petitioner(s) after a proper search haslhave ascertained the Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with his/her last family or principal residence at MESSIAH VILLAGE, 100 MT. ALLEN DR., UPPER ALLEN TWP., MECHANICSBURG, PA 17055 (list street, number and municipality) Decedent, then 87 years of age, died AUGUST 22 ,2001, at MESSIAH VILLAGE, MECHANICSBURG, PA (Location) Decedent at death owned property with estimated values as follows: (if domiciled in PA All personal property ......................................... $ (if not domiciled in PA Personal property in Pennsylvania .................... $ (if not domiciled in PA Personal property in County.............................. $ Value of real estate in Pennsylvania ........................................................................................ $ Total ........................................................................................................:............ $ 3:2.. Ot:l~ - b 2 . a '-"'V Real Estate situated as follows: 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: Signature Typed or printed name and residence PAUL BERT R.D.#1 8543 MCCLAYS MILL RD. NEWBURG PA 17240 Oath of Personal Representative Commonwealth of Pennsylvania County of CUMBERLAND The Petitioner(s} above-named swear(s} and affirm(s} that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s} and that, as personal representative(s} of the Decedent, Petitioner(s} will well and truly administer the estate acco~g to law. Sworn to and affirmed and subscribed ~ Cv<-Lf ./J~ PAUL BERT before me this 4TH day of SEPTEMBER. 2001. ~~r~~~ DECREE OF REGISTER Estate of BERTHA M. BELTZ also known as Deceased No.21 01 821 Date of Death: 8/1/01 Social Security No: 201-18-0809 AND NOW, SEPl'EMBER 5 ,2001 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters (3 Testamentary 0 of Administration are hereby granted to ((c.t.a., d.b.n.c.t.; pendente lite; durante absentia; durante minoriate) PAUL BERT in the above estate and that the instrument(s}, if any, dated ,TIJLY 18.2000 described in the Petition be admitted to probate and filed of record as the Last Will of Dec~nt. FEES Letters.............. ............ .......... Short Certificates(s} .....?........ Renunciation .......................... Extra Pages (2 ) ............... I.T.R.............. ...... ................... JCP Fee ................................. Inventory ................................ Other.... .................................. TOTAL .............................$ $ 70.00 ~c.. ~n~~ e..- ~BS1F\ ...-"''''". $ $ $ $ $ $ $ $ 15.00 6.00 Signature 5.00 Attorney: GERALD J. BRINSER 1.0. No: 09655 Address: 6 E. MAIN STREET, P.O. BOX 323 PALMYRA PA 17078 Telephone: 838-6348 DATE FILED: SEPI'EMBER 5,2001 96.00 H 1U;.H05 REV 9/86 JllS is to certify t11at t\e inf::Jrmation here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The onginal certificate will be forwarded to the State Vital Records Office for permanent filing. Fee for this certificate, $2.00 WARNING: It is illegal to duplicate this copy by photostat or photograph. ~ Co"J Rcgim" //. 21-01-821 p 7645657 ~ ;('1 AtJ7J I . No. Date ~ 2lfJ7 COMMONWEALTH OF PENNSVLVANIA . DEPARTMENT OF HEALTH. VITAL RECOROS CERTIFICATE OF DEATH NAME OF OEClDENT II ",., Middle, l'" ... nVI flU NUM8Vt SOCIAL SECURITY NUMBER .. Bertha M. Beltz AOE(l_~ UNDER' YEAR -- Doyo I.Female I. 20 I - 18 .. 8-22-01 1MAT~(C,tyoll'ld s....OIFor...CCIIJtllfV) PL4CI" 01 OEII.'tH ~t>eek or>Jy I'll" ." -lM ,n"'l,I(11oOl"" "" ~ .... HO ITAl' - -. '_ 0 ............ 0 :=IfItIO 87 v... , COUNTY OF DEArH Cumberland DECEDENT'S USUAl oecUIfIlln)N (~-=:~~':."':::~:r LPN RACE. Amenean tncIi.... 8Ilw:lII. w.w.. MC l$plle",,) .. ,.. White SUfMVINQ SPOU5E I"..... qrv. maooM twnel Townsh~___ ,.... Cumberland ,...0 ::...":".'.::'.. MOTHER'S NAMl! IF.... Middle. ......., Surn......) . Minnie B. Carmack tWOAMANrS MAIUNO ADDRESS (SIr... Cty/1:Mft, s..., l'lpCodlJ 8543 McClay's Mill Rd.. Newbur . PA 17240 W)N PlACIOfCOl .NI,..ofC........,.,.,C-.tofy lOCRION.C~.S1....lIocoo. ..0Ift00_ Air Hill Cemetery Of' .Fogelsanger-Bricker F .H. UCfN9E NUMBER - o 12984-L Co. PA 17257 ... 2441.... be completed by . ""'wflo~CIHI". TIME OF DEAfH OAfE PAONOUNCEO DEAD(Monlh. Oay, ""1 N. II y.Q M. O~-:2'l-OI 27. NII'T I: E...._....... injurtMOl' c:ompIceIlOnIIwNc" caused Iht dnlh Do nac enter ,'- mode of dying, 1UCh.1 urCfMlt or '...lOry .".,Ihoctl or hHIt f.i1an Lilt tllMtONl cauleOl'lellChh .... Noff _.c.--iF.... ~orconditlOn ~..~I-... ,-...... '-- lor.-.wId dMth I i PART'" OIIw~c:ondIIioM~lodNth,but nclIfHUltlngin.... ~CMIM~ '" PlUff I ~..~ b 11......._ ........ ~.E......~Y" CAIMe_....,.., I.. . ..~...... '.........,~ILM1' d. WOS AN Al/1'OPOV WEAl AU1OII'SY FtNDINOS MANNER CW Df:ATH PERFORMED? ..........e PAIOA 10 cor..t.ETIOHOF CAUSE li1 OF DeAJ'H7 --.. ........ 0 ....0 No!!!' ....0 NoD ....... 0 DAft Of INJuRY (Monlh. o.y. '*-, TIME OF INJURY tNJUAY R WORK? OESCRIBE HOW INJURY OCCUAAED - -- o o o PlACEOO,O<JUAv..._.........-.,.......-. ... building, C. ISpec1totI _. .... 0 NoD Couk:InafM~ _DlCAI. DAIIINI!RlCOllONeR On.......... 0' ...".lnatlon and/or Inveattgatlon. In my oplnktn. de.eh occurnHI at the .1".., dat., and place. and dlM to tt.. cauM(aJ and menner.....................................,.............. .................................................. J... REGISTRAR'S SIGNATURE AND NUMeER ~ /I~ I i:ST 0. UCfNSE NtJM8EA ~... " HAM!' ADOAESS OF PERSON WHOCOUPlETEO CAUSE ~ DEATH Plom21lT_OIP,ln' lOB L-o....t.h..r s~. 011. Le.t-'\ f'le, fA \ /OLf 3 DATE FllfD(MonIh 0..,. 'tQ(1 ~ ;f;z.-OCJ( - CEIIT""~-..~ aCIJITWYIJIQ PHYSICIAN (Ph~cllftlfylno ~ 01 deMtt.....".. anottIet' phySlClM h-.~ do"" aN:l compl.-d IWn 23) 'e.......Of "" .,.,......... de.. OCCUfNd", to.... C.UM(.}..IN....... ......... . . . . . ... e~AHDcatn.v1NQ ""SIClANt~ baltla>>onouncIOQOHthandcert/fylnQIOC......al 0U1tI1 To.... MIlt of My 111'10..... cr.....oecwred M!he....... 4.... aMI ptac:.. ~..... to the c.au....aJ and rn.nAft.. It"M u ,.. WILL OF BERTHA M. BELTZ I, BERTHA M. BELTZ, currently of Upper Allen Township, Cumberland County, Pennsylvania, realizing the uncertainty of this life, but with confidence in God and trust in His Son, my Lord and Savior, Jesus Christ, who died for my sins upon the cross and rose again to redeem me and give me eternal life, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all prior Wills and Codicils made by me. I. I direct that all my just debts and funeral expenses be paid from the assets of my estate as soon as practicable after my demise. II. I direct that each beneficiary of my estate under the terms of this my Will or as beneficiary by way of beneficiary designation on assets passing outside of this my Will shall be solely responsible for the payment of any death taxes assessed on the portion passing unto him or her. III. I intend to keep with this my Will a separate memorandum concerning disposition of certain items of tangible personal property. I bequeath the items on said list to the persons designated. IV. I bequeath the sum of Three Thousand Dollars ($3,000.00) each unto Henry Bertey, Paul Bert, Robert Bert and Eva Mae Brubaker, in appreciation for their counsel and help during recent years oftransition. If any of these individuals predecease me, his or her share shall lapse. V. All the rest, residue and remainder of my estate, of whatever nature and wherever situate, including property over which I hold a power of appointment, I devise and bequeath as follows: A. One-third (1/3) unto Messiah Village, Mechanicsburg, Pennsylvania, to be used in its Endowment Fund. ~ -1- ~QJ 'n), ~ B. Two-thirds (2/3) unto Brethren In Christ World Missions, Grantham, Pennsylvania, to be used as it determines best. VI. I appoint my nephew, Paul Bert, Executor of this my Will. In the event that he fails to qualify or ceases to act as Executor, I appoint Douglas R. Bert Executor in his place. VII. I direct that no bond be required of my fiduciaries for the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I, BERTHA M. BELTZ, herewith set my hand to this my Last Will, typewritten on two (2) sheets of paper including the attestation clause and signatures of witnesses, this I~day of %-,2000. ~/t~~Z;: (SEAL) BERTHA M. BELTZ (f Signed by BERTHA M. BELTZ, by her declared to be her Will in our presence, who have hereunto subscribed our names as witnesses in her presence and at her request, this 18f'tlay of ~ ,2000. /g,~z ~- residingat ~~f,!? Wmd.ij 'c/, Q, Pm-Jr9-V1...- residing at ~, KIJN Mlbul1l , f!/J -2- COMMONWEAL TH OF PENNSYL VANIA COUNTY OF LEBANON WE, BERTHA M. BELTZ, GERALD J. BRINSER and lA>v-JDj i.... CAAwroRD , the testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly affirmed, do hereby declare to the undersigned authority that the testator signed and executed the instrument as his Last Will and that he signed willingly (or willingly directed another to sign for him), and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the testator, signed the Will as witnesses and that to the best of our knowledge the testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~0..~ BERTHA M. BELTZ ~~~ W(TNESS /' I)J~ 2ft. ~1MIL WITNESS Subscribed, sworn or affirmed and acknowledged before me by BERTHA M. BELTZ, the testator, GERALD J. BRINSER and ~N..D~ L... Cft-A WFo f...{:) , witnesses, this J 8~ day of ~ ,2000. ~t.t~ Not Pubhc (SEAL) -3- MARY C. LEWIS, REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA f-. CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: BERTHA M._BEL.. T2 Date of Death: 8/22/01 Estate No. SSN: 201-18-Q809 File No. 21:QJ-:Q132~ ___. Date Letters Granted: 9/4/01 Will or Administration 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 beneficiaries of the above-captioned estate on 9[24[QJ MESSIAH VILLAGE Address 2840 LOUISIANA AVENUE _ . BAL TIMQRE __. 753 MESSIAH VILLAGE _MECHANICSBUBG 7514 COLUMBUS AVENUE __SOUTHRICHF1EJ-.D P.O. BOX 290 __GRl\NIHA~____ 100 MT. ALLEN DRIVE ME:CtiANICSBUB~__ MJL21227 Name HARRY BERGEY - EVA MAE BRUBAKER PA_J705!:>__ ROBERT L. BERT MN..55423 BRETHREN IN CHRIST FOUNDATION P A_J702I-Q290 PA .17055 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except PAULBERT,EXECUTOR Personal Representative X Counsel for Personal Representative A~ . I (l.~_j~ --71-~ --- ------- - - Signature ~I;RAL..D J. _BRIN.$E.R, ESQUJRE (#Q9E5!55) Name (Please type or print) Date: 9/24/01 Capacity: Address Ei~.". MAlt"L$TREE:ILP.O.BQX32~ f=l.A.LMYRA PA .17078 Telephone No. (717)8~8-:E534f:L LAW OFFICES BRINSER, WAGNER & ZIMMERMAN 6 EAST MAIN STREET - SECOND FLOOR (EAST MAIN & SOUTH RAILROAD STREETS) P. O. BOX 323 PALMYRA, PA 17078 PHONE: (717) 838-6348 FAX: (717) 838-6912 MECHANICS BURG OFFICE MESSIAH VILLAGE 100 MT. ALLEN DRIVE MECHANICS BURG, PA 17055 PHONE/FAX (717) 795-1737 GERALD J. BRINSER KEITHD.WAGNER JOHN M. ZIMMERMAN November 14,2001 Mary C. Lewis, Register of Wills Cumberland County Court House S. Hanover Street Carlisle, P A 17013 In Re: Bertha M. Beltz Estate No. 21 01-0821 Dear Ms. Lewis: Enclosed you will find a check in the amount of$I,71O.00 as payment towards the inheritance tax for the above-captioned estate. If you have any questions, please feel free to give me a call. Thank you. Very truly yours, BRINSER, WAGNER & ZIMMERMAN _~&.~~/~~ Gerald J. Brinser GJB/wlc Enclosure ~ /~~, I'. .1 eI_.' '\ 1'-' ,\ l'.:.' ""'"' .~ C1 \ . ,,~. ;:"'. '- .) J \~-;, '= ;'''/: \"" \ .I ;," - ~ I - a I ~ z ~ ~ ~ ~ ....... N I-< .:0 g ~ p::: u:: ('I") ~ -d 0 Z N rh o .... ~ <t; IJ) N ~ ]('1")..... ~ (/) ~ <t; lli j . E >< P-.~ .:::j:i <C 0 <C ~O~~ ~ P2~~q<a P=l....:l--oP-.P-. ~ rn ;:J o ::c: ~ ;:J o M rnu ....... ....:lO i=2== d u .......: rn~I""'\t-<......:::: ....... ~rn.......- ~~~~p... ~ ~gJPa~~ ~ Ut-<~Orn= ~6~~~ : ~~B;;cJ : . , i ,. - - - '" (:) '" 0" r'J r'J '" 1') ... " .... ... " " COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: BRINSER WAGNER & ZIMMERMAN 22 N RAILROAD STREET PALMYRA, PA 17078 ____n__ fold PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT ESTATE INFORMATION: SSN: 201-18-0809 FILE NUMBER: 21-2001- 0821 DECEDENT NAME: BEL TZ BERTHA M DA TE OF PAYMENT: 11/15/2001 POSTMARK DATE: 11/14/2001 COUNTY: CUMBERLAND DATE OF DEATH: 08/22/2001 ACN ASSESSMENT CONTROL NUMBER 101 TOTAL AMOUNT PAID: REMARKS: BRINSER WAGNER & ZIMMERMAN CHECK# 101 SEAL INITIALS: PB RECEIVED BY: REV-1162 EX(11-96) NO. CD 000534 MARY C. LEWIS REGISTER OF WILLS ftEGISTER OFWILLS"" AMOUNT $ 1,71 0.00 $ 1,71 0.00 MARY C. LEWIS, REGISTER OF WILLS CUMBERLAND COUNTY, PENNSYLVANIA INVENTORY Estate of BERTHA M. BELTZ No. 21 01 0821 , Deceased Date of Death 08/22/2001 Social Security No. 201-18-0809 also known as Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the Decedent's death, and that Decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. INVe verify that the statements made in this inventory are true and correct. INVe understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Personal Representative: Name of Attorney: GERALD J. BRINSER, ESQUIRE I.D. No.: 09655 Address: 6 E.MAIN STREET ~ BERT ~J ~ ~ Ll ~---- Dated 3/ I t...-/ ~ 't.. PALMYRA PA 17078 Telephone: (717)838-6348 Description Cash, Bank Deposits, & Misc. Personal Property: Value PNC BANK - CHECKING ACCOUNT #5000001102 12,648.60 BRETHREN IN CHRIST FOUNDATION (INCLUDES ACCRUED INTEREST OF $56.08) 24,425.37 BURIAL FUND - REFUND 1,221.08 BLUE CROSS/BLUE SHIELD - REFUND 316.90 VERIZON - REFUND 15.54 Total 38,627.49 (Attach Additional Sheets if necessary) NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. RW-4 ..... LAW OFFICES BRINSER, WAGNER & ZIMMERMAN 6 EAST MAIN STREET - SECOND FLOOR (EAST MAIN & SOUTH RAILROAD STREETS) P. O. BOX 323 PALMYRA, PA 17078 PHONE: (717) 838-6348 FAX: (717) 838-6912 March 12, 2002 MECHANICS BURG OFFICE MESSIAH VILLAGE lOO MT. ALLEN DRIVE MECHANICS BURG, PA 17055 a (iPHONE/FAX (717) ~5-] 737 ~ (" 0 xl CD ::5 ,. N (, ;~, (~.. .'-. .' r :5 ;::CJ GERALD J. BRINSER KEITH D. WAGNER JOHN M. ZIMMERMAN Mary C. Lewis, Register of Wills Cumberland County Court House S. Hanover Street Carlisle, PAl 70 13 --" w -0 Ld N C In Re: Bertha M. Beltz Estate No. 21-01-0821 Dear Ms. Lewis: Enclosed you will find two (2) copies of the Inheritance Tax Return and one (1) copy of an Inventory for the above-captioned estate. Also enclosed is a check in the amount of $25.00 in payment of the $10.00 filing fee for the Inventory and $25.00 filing fee for the Tax Return. The inheritance tax has already been paid. If you have any questions, please feel free to give me a call. Thank you. Very truly yours, BRINSER, WAGNER & ZIMMERMAN IAJhdtcJ Wendy L. Crawford Estate Secretary wlc Enclosures t z ~ U-l ~ ~ ........ N ).< ~ g ('() ~ u:: ~ U-l ;l 0 Z N 00 9 ....~ ~ :--c. :t N ~ ).<('(),...; _ ill N~ ~ Il) p ('() 0... U-l .~ .... ~ Cf):::t:i to 0 <i ZO~~ ~ S2~u.icj...E ~j-,Qp.;~ ~ ~ 00 ~ o ::c: ~ ~ o M OOU - ~O 0- _ r--= - U - = ~Cl~""" - j:.L,Zoo........ - O~~O'" : e3c2~~ ~ ~~Ooo= ooa:lZ-- G::E~c2 : ~~::c:~-: ~UooU-= Vd1i:dl):J _y ":"' 'r-) z~: - d f L MVll ZOo !<)r.;~58H 'r'lJo~atl ", " r z ~ U-l ~ ~ ........ N ).< <:0 g r() ~ u:: ~ U-l ~ 0 Z N 00 9 4-'~ ~ ~ :t N ~ .ti r() .-I _ (j)N~ ~ Il) pr()o... U-l .~ .... ~ (j)::t:1 ltl 0 <i ZO~~ ~ s2~u.iO...s ltl . ltl ~ .-ho 0... 0... ~ Vel 1.1nr..:~-', ~ 00 ::J o ~ ~ ::J o M OOU ...... ....:l 0- ....:lO r--= ........ U ...... = ~ClE-<...... - j:.I.,Zoo........ - O<~o... : fi3c2~~ ~ E-<~Ooo= OOC:OZ""""- G::E<c2 : ~::J~<-: ~UooU-= !U.n:J v 'C~,) Z~: - d f l MVl1 ZOo !<)1~',J)dH 'f).!O~aH " /"'? -..:5'- ~ \, BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z80601 HARRISBURG, PA 171Z8-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '* NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY-1547 EX iFP 100-O2l ['\HY -3 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 04-29-2002 BEL TZ 08-22-2001 21 01-0821 CUMBERLAND 101 BERTHA M '02 ",:1 ?O GERALD J BRINSER BRINSER ETAL PO BOX 323 PALMYRA ESQ Amount Rellitted G.. PA l(jUV!BJ 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=is4i-Ex--AFP-roY=02Y-No'TicE--oF-YNHERiTANcE-'TAx-APPRAisEiiENT~--AL1-oWANCE-OR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF BELTZ BERTHA M FILE NO. 21 01-0821 ACN 101 DATE 04-29-2002 TAX RETURN WAS: ( X) ACCEPTED AS FILED ( ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) U) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account. 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 subllit the upper portion ~. Mortgages/Notes Receivable (Schedule D) (~) .00 of this form with your S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 38.627.49 tax paYllent. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 S. Total Assets (S) 38.627.49 APPROVED DEDUCTIONS AND EXEMPTIONS: 3.178.35 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) UO) 8.608.36 11. Total Deductions Ul) 11 .786 71 12. Net Value of Tax Return (12) 26.840.78 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 14.840.78 l~. Net Value of Estate Subject to Tax (1~) 12.000.00 NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ abb returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line l~ at Spousal rate US) .00 X 00 = .00 16. Amount of Line l~ taxable at Lineal/Class A rate (16) .00 X 045 = .00 17. Amount of Line l~ at Sibling rate (7) .00 X 12 = .00 lS. Allount of Line l~ taxable at Collateral/Class B rate US) 12.000.00 X 15 = 1.800.00 19. Principal Tax Due (19)= 1.800.00 rAX C DITS: 1"" II .n......... . (+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 11-14-2001 CDOO0534 90.00 1.710.00 TOTAL TAX CREDIT 1.800.00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 . IF PAID AFTER DATE INDICATED. SEE REVERSE ( IF TOTAL DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) STATUS REPORT UNDER RULE 6.12 'U( Name of Decedent: BERTHA M. BELTZ Date of Death: 8/22/01 Will No. 2001-00821 Admin. No. Pursuant to Rule 6. 12 of the Supreme Court Orphans I 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. account with the Court? Did the personal representative file a final 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 I Court and may be attached to this report. Date: 5/29/02 ~\J.~/wW Signature I GERALD J. BRINSER 91t.tL>-. Name (Please type or print . 6 E. MAIN STREET, P.O. BOX 323 PALMYRA PA 17078 Address ( ( 711) 838- 6349 Tel.No. Pj Capacity : Personal Representative .'-J P X Counsel for personal representative - ,. r "' -,,' ............ May 4, 2004 Mary C. Lewis, Register of Wills Office of Register of Wills Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013-3387 SINCE 1888 3211 North Front Street EO. Box 5300 Harrisburg, PA 17110-0300 717-238-8187 Fax: 717-234-9478 Other Offices Colonial Park Mechanicsburg 717-652-7020 717-691-5577 Millersburg Shippensburg 717-692-5810 717-530-7515 Re: Estate of Dennis M. Barto No. 2001-820 Dear Ms. Lewis: Enclosed is a copy of our letter to J. Paul Dibert of the Department of Revenue, Inheritance Tax Division and a Rule 6.12 Stares Report, which indicates that administration of the estate is complete. Please kindly return a time-date stamped copy of the status report to me in the self addressed stamped envelope provided herein. Very truly yours, METZGER, WICKE~RSHAM, KNAUSS & ERB, P.C. Diane McKay, Parale~: ,~""'~1 Enclosures ~_~ cc: Donna J. Barto, Administrator 304019-1 James F. Carl Edward E. Knauss, IV* Jered L. Hock Steven P. Miner Clark DeVere Milton Bemstein Bruce J. Warshawsky Francis J. Laffer~, IV David H. Martineau Andrew W. Norfleet Andrew C. Spears Young-Suh Koo * Board Certified in civil trial law and advocacy by the National Board of Trial Advocacy STATUS REPORT UNDER RULE 6.12 Name of Decedent · Date of Death · Dennis M. Barto February 3, 2001 Will No. Admin No. 2001-00820 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: 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: Did the personal representative file a final account with the Court? Yes No X account is: bo The separate Orphans' Court No. (if any) for the personal representative's Co in interest? Yes Did the personal representative stateanaccount informally to the parties No X (this was a "no asset" estate) 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. PLEASE NOTE: The foregoing is based upon the fact that there was a personal injury suit opened by our firm. The personal injury stat was~r~ there are no probate assets. Date: May 4, 2004 Sl~-'i'~a Ure~ Name Jered L. Hock, Esquire Address 3211 North Front Street P.O. Box 5300 Harrisburg, PA 17110-0300 Capacity: Telephone (717) 238-8187 ~ Personal Representative X Counsel for Personal Representative 304390-1