Loading...
HomeMy WebLinkAbout02-0745Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of Dean R. Updegraff also known as Elizabeth R. Updegraff Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A' or 'B' BELOW:) ,Deceased A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut the Decedent, dated and codicil(s) dated named in the last Will of 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: ^X B. Grant of Letters of Administration (c.t.a.; d.b.n.c.t.a; pendente life; durante absentia; durante minoritate) Pettioner(s) after a proper search has/have ascertained that decedent left no Will and was survived by the foNowing spouse (if any) and heirs: Name Relationship Qe~~.ae.,..e Elizabeth R. U de raff S ouse 1604 Kathr Street Christo her A. U de raff Son 409 Kunkle Land, Mech., PA 17050 Michelle L. Bonetti Dau hter 405 Summit Rd., N. Cumb., PA 17070 ,_ tI.UMYLtIt IN ALL t.AStJ:J attach adtlltlonal sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his/her last family or principal residence at 1604 Kathryn Street, New Cumberland, New Cumberland, PA 17070 (list street, number, and municipality) Decedent, then 54 years of age, died 06/12/2002 at Holy Spirit Hospital, Camp Hi11, PA (Location) Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property $ For 1ltlgation (If not domiciled in PA) Personal property in Pennsylvania $ purposes only (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ 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: ~! nature T ed or rinted name and residence (, ~ ~ ~ Elizabeth R. Updegraff ~~ ~ ~C~Jc~~N~11~_ 1604 Kathryn Street, New Cumberland. PA 17070 (~_ -Iz N~~ 21-02-7ys' Social Security No. 175-40-6790 Prepared by the Pennsylvania Bar Association Copyright (c) 7996 formsottwareoniyCPSystems,lnc. Form RW-~ (1991) Oath of Personal Representative Commonwealth of Pennsylvania County of Cumber 1 and 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. Sworn to or affirmed and subscribed E abeth R. U degr ff before me this 19thday of AUGUST 2002 For the Re 'ter ~~ ~ No. !~i"O2-"'lLls Estate of Dean R. U degraff Deceased Social Security No: 175-40-6790 Date of Death: Ob/12/2002 AND NOW, AUGUST 19, 2002 , in consideration of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT IS DECREED that Letters ~ Testamentary ~]X Of Administration (c.t.a.; d.b.n.c.t.a.; pendente life; durante absentia; durante minoritate) are hereby granted to Elizabeth R. U de raff in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters . $ 18.00 Short Certificate(s). $ 12.00 Renunciation. $ Attorney: Shelly J. Kunkel - Affidavits ( ) $ I.D. No: 64485 Skarlatos & Zonarich, LLP Extra Pages ( ) . $ Address: 204 State Street Codicil .. ... .. $ Harrisburg , PA 17101 JCP Fee . $ 5.00 Telephone: 717/233-1000 Inventory. $ Other $ TOTAL. $ 35.00 Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, lnc. Form RW-1 (1991) F{ ,;x ~~ ~:~,; '['his is to certify that the information here given is correctly copied from an original certificate of death duly tiled with me as Local Registrar. The l:n-iginal certificate will he forwarded ro the Stare Virif Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee fur this certificate. $2.00 o. * `;- , yam.. ; ~- ~ ' ~ '~ 0~~,~ ~y~ P 8 3 8 4 4 5 9 ='9jMfNT,oE;?``P,,;I~ ~~,. Local Regisn-ar J~1N i y ~`. t ~.~~ a7 Rev. 2197 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH STATE ~~LE WM9ER NAME OF DECEDENT(F est. Mitldw. ;a9) ~ ~ SE% SGCIAL SECURITY NUMBER DATE OF DEATH ,MCnm. Oar. year) raff de ~ Dean R U 175 - 40 - 6790 . Male ] 2 ~ Ia '~ g . . p . . . ~, z_ a~ y AGE ILas 9Mndayl UNDERt YEAR UNDERI OAY GATE OF BIRTH 91RTHPLACE:Cay and PLACE OF DEATH tChttFrrly~rnn-~.en:nsu«:u«~.v nngrei s~del MoMN . Days Mourn . Minutae ~.MOnln. Oay. veerl dale «FCregn COUnnyl HOSPITAL OTHER: 5 4 Yrs. Jan 5 ,19 4 8 Harrisburg , PA Irpatwnl ~ ER,oulpar~.nt ^ I70A ^ Han"p ^ Raaaferwe ~ ~~, ^ • s. a. 7 w. COUNTY OF DEAR CRY, BORO, TWP OF OEATN FACILT' NAME III nul ~nsnnreon. yrve sheet antl numherl WAS D ECEDEN T OF HISPANIC ORIGINT RACE ~ Amartcan Indian, Black, Whae. elc. - Cumberland ast Pennsboro T {~ Q ~I S -~ ~~ Ir oo ~ No U~' Yea LJ 11 Yee, speury Cuban. ealw pwnpRaan wd ISpecsyl ~ m ~ -- , ,1, -,, , , . „white DECEDENT'S USUAL OCCUPATION KIND OF 9USgiESSlINDUSTRV WAS DE EDENT EVER IN DECEDENT'S EDUCATION MARITAL STATUS-Manwd SURVIVING SPOUSE (Gwe kmd d work done dwng mss U S. ARMED FORCES? S ~ onl n, s ace c«n wletl Naru Marrwd. Widowed, Ill «aa. gne maiden name) pl wak%tq el.: do nol I,a. rMrad) Mechanicsburg ~ Y" "°~ E4menrarylSewrwary ColNge Divorced IStlemryl • ,,.. arehouseman W „b. ,:. `~'2' "°«5" ,,. Married ,.. Elizabeth Revercom DECEDENT'S MMLING ADDRESS (SlreaL CSy/TOwn, Slale.Lp Code) DEC HT'S CT ^ y t7 f d pA 1604 Kathryn Street A UAL 17 RESIDENCE p I ace eM Wedm a. Stale pid 0. twp. aeceaenl New Cumberland, PA 17070 oseae,aK,Kawn` n aver stlel ~`~` Cumberland '°'^'n'"ip' y-~ "°•d"'di11i0 New Cumberland 11. ,7b. Counry-- 1Td.L' wane, adua,kmaad cay,~p,p. F/JMER'S NAME IFas, Midde Las) Richard D. Updegraff MOTHER'S NAM IF,rs. M~tldle. M wen Surname) Dorot~y Ric~Lwine ,9 9 INFORMANT'S NAME (1ypa~Pmq INFORMANT'S MAILING ADDRESS 1$rreal, Cay/Town, $IBIe. Zip Code) 29a-Elizabeth R. U de raff X1604 Kathryn Street, New Cumberland,PA 17070 METHOD OF DISPOSITI O N GATE IDF DISPOSITION PLACE OF DISPOSITION - Name of Csmelery. Crematory LOCATION-GiglTown, SIaN. Zip Cod. ] (~~ ( 8ww1 l Cremation ^ Removal nom Slaw^ • (MOMh, Oay, Year) a Dlner Place _ }q Daw,pn^ a^•r(specMl ^ Tune 18 2002 Olivet Cemetert Mt Y New Cumberland, PA 1707 21a. 215. , . 210. 21d. ' SIGN OF FUNE 5 VICE LICEN E OR PERSON ACTING UCH LICENSE NUMBER NAME AND ADDRESS OF FACILITY (~ Ic ~ ~ ~ ~ - FH408 3rd St New Cumberlan~?PA ~; D 012342-L stone&Murra ~..- - _ n.. y 2 , w aems 21s<only wMn (gmrylnq n d Fro letlga, learn accursed al the nme, data and place stared. LICENSE NUMBER DATE SIGNED wet a rld avadabN al nme al deem ro ~ ISg ore Tale) (Moron, Oay, year) ' cMlrty cAOaa d death. 23a. 27b. 23c. Hams 2a-2E moat W rnmpleted Dy TIME OF DEATH DATE PRONOUNCED DEAD IMOnm. Day year) WAS CASE REFER RED TO MEDICAL E%AMINERICORONER? • parson wro prorpuncesd~~m. / S ~ (I T ~Y c n L I ^ Vea . 2a. M. 25. • J ~ d- 2!. 27. PART C Emu Iha diseases, in)«res or comphcarnns wnkn caused the aeatn Do r,or enter Ina moan of dying, such as carduc or respiramry anesl. shock or need ladure t Approaunab PART II: OrMr signilkaM cortdiG«ts twn,ribu,irg to death, bul Lot Dory one cause on each Few. ~ WervN WlweM not naullinq in tM urlaenynng cause given n PART I. I orwl arr0 deem IMMEDIATE CAUSE IFmm dsease « c«raoon S aaWUrgn deaMl--- a.~ ~ '~ ~ ~. ~ - DUE TO ~R AS ACONSEO ENC OF): ~ S- ' SepueMia9y as corwi,~. b c~24.scz ' J--- ' l eery, Madirrq w mKnedare DUE (OR AS A CONSEOUENC F, OFI~ cause. En[u UNDERLYING • C~ D { S o ~ s ; ~ CAUSE IDrsease p mryry ~ n 1 [~/ l ~ c.~ ~ _ • foal wrwed events UE 10 ( AS A CONSEQUENCE OFl: 1 restdup n t>eun) IA,4T • d. ___ _ _____ _ _ _ __ J WAS AN AUTOPSY WERE AUTOPSY FINDINGS MANNER OF DEATH DATE OF INJURY TIME OF INJURY INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED. PERFORMED? AVAILABLE PRIOR /O IM«~m. Day. Yearl COMPLETION OF CAUSE ^ 1b Nat ral tl ^ OF DEAM1 u mw:~ a Y a ^ No ^ AccWOn, ^ Pending ln vesrgalwn ^ ]pa ] M e 30 ] 1d ~,r YN !QU No ^ Yea ^ No ^ SuMWS ^ Could n« ba determuwd ^ . e. . pLACE OF INJURY - Al home. term, sheer. lact0ry, pflica r . LOCATION (Sheer C~ryRown. Stater bwldirp, arc-l5pecnvl 29a- 280. 29. 3M. ]pr, CERTIFIER lCreck only Dever IGNA7URE ryl ERtIF1Eq 'CERTIFYING PHYSN:IAN IPnys¢.ancennyv,q cause of ceam caner an«ner physw~an has pronounced ,Seem anu c«nplered Darn 271 To 1M b h l f k N d d l// -_ /^ V1 ~ my rlow H o dga, eat xcurtad w to m• cause(s) aro Mannar as staled ...... ............................................... _ ) ],b. r ' C ' IICENSE NU BER DATE SIGNED rMOnm Day. year) 'PRONOUNCING AND CERTIFYING PHYSICIANIPnys¢~an nrnr ypnour~iny Uealn and <erulyinq b~ause ul ~]enmr _ y1 •'7j L Z ~ L ~~ ~ / /Q ~ / ~ ~ ' Te Il,a beat 01 my knowledge, deem occurred al IM Ilme, data. and place, and due to ma caua e(a) arM Mannar as oared ........................ . . ( ] u U 31c. I __ _ ]10. _ W / ]' a NAME AND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH • 'MEDICALE%AMINER/CORONER 1!Iem L71 Type a Pdnl Karen Frantz, MD On the buie of eaamina,ion andlw Invasflga,ion, in my optmon, death occurred al the time, date, and place, and due to the csuse(a) and ~~ manner as ale,W ................................................................................... ..... .. .. ...... 8 9 0 Pop 1 a r Church Ro a d ]ta. . ~ ]2. REGISTRAR'S SIGNATURE AND NUMBER /l ~ /'A DATE FILED, nm Day raa~i ff i ~ j;7 f~/~/ 'r< ~ L.~-~ ~ D .! " ]]. t. ~_~ r it ...~ r.,s ~ ] /.- L--_~lL I- __ v ~~ CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: DEAN R. UPDEGRAFF Date of Death: JUNE 12, 2002 Will No. 2002 - 00745 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 ?~TO~TembPr 22, 2002: Name Elizabeth R. Updegraff Christopher A. Updegraff Michelle L. Bonetti 1604 Kathryn Street New Cumberland, PA 17070 409 Kunkle Land Mechanicsburg, PA 17050 405 Summit Road New Cumberland, PA 17070 Notice has been given to all persons entitled thereto under Rule 5.6(a). Dated: Nov. 22, 2002 ~ Signature ~ AC-~~~-~. Name: Shelly J. Kunkel, Esquire Skarlatos & Zonarich LLP Address: 204 State Street Harrisburg, PA 17101 Telephone: (717)233-1000 Capacity: Counsel for Personal Representative l/ ~~. STATUS REPORT UNDER RULE 6.12 Name of Decedent: DEAN R. UPDEGRAFF Date of Death: JUNE 12, 2002 Will No.: 00745-2002 Admin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report that following with respect to completion of the administration of the above-captioned estate: complete: 1. State whether administration of the estate is 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. Date: May l3, 2004 Signature U Shelly J. Kunkel Name (Please type or print) Skarlatos & Zonarich LLP ___. 204 State Street Harrisburg, PA 17101 Address (717)233-1000 Tel. No. Capacity: Counsel for Personal Representative STATUS REPORT UNDER RULE 6.12 Name of Decedent: DEAN R. UPDEGRAFF Date of Death: JUNE 12, 2002 Will No.: 00745-2002 Admin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report that following with respect to completion of the administration of the above-captioned estate: complete: State whether administration of the estate is 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 account informally to the parties in interest? Yes X No an 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:. Ma~il3, 2004 >-- Signature~ - Shelly J. Kunkel Name (Please type or print) Skarlatos & Zonarich LLP 204 State Street Harrisburg, PA 17101 Address (717) 233-1000 Tel. No. Capacity: Counsel for Personal Representative PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of DEAN R UPDEGRAFF also known as .Deceased Social Security Number 1 File Number 2.002-00745 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 last Will of the Decedent dated and codicil(s) dated (State relevant circumstances, e.g., remmciation, death of executor, etc.) ° .a.t ' : C ~ r,-i ~::.:~ ~; ?~ ~ N ~ fir.. `,::i~r »~ ~ named in .~ ` :-n .:~ c ~ Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the ins(tument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ~L}ette}}rsPP~~}ofjj~~Administration d.b.n. ; Elizabeth ~. Up egra ow ® B.G~~to~ettgi3"SfAdmibi3tr9t~oQin died 8/7/10; survived by issue Chris~o~her A Updegraff (If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendentelite; duranteabsentia; duranteratno>ritate)and Michelle L Petitioner(s) after a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (i$any) arUd~aeg(F.1a f f Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) Name Relationshi Resideneq CHRISTOPHER A UPDEGRAFF SON 652 BAMBERGER ROAD, E PA 17319 MICHELLE L UPDEGRAFF DAUGHTER 652 BAMBERGER ROAD, ET'I'ER PA 17319 (COMPLETE !N ALL CASES:) Attach additional sheets if n~r~ gam. CC KO Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his 1 her last principal residence at 1604 KATHRYN STREET. NEW CUMBERLAND. PA 17070 (List street oddness, town/eiry, township, county, state, zip code) Decedent, then 54 years of age, died on 06/12/2002 at HOLY SPIRIT HOSPITAL, CAM)ti HI~.L, PA Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property S n (lf not domiciled in PA) Personal property in Pennsylvania S 5 only (If not domiciled in PA) Personal property in County S Value of real estate in Pennsylvania ~ F 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: Si lure T or Tinted name and residence CHRISTOPHER A UPDEGRAFF, 652 BAMBERGER ROAD, ETTEIrS P~- 17319 • MICHELLE L UPDEGRAFF, 652 BAMBERGER ROAD, ETTERS PA 17$19 Form RW-01 rev. 10.13.06 Page I Of 2 ti Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of the irnowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will 'Iwell and truly administer the estate according to law. Swom to or affirmed and subscribed before me the __c~ day of o~/~ For a Reg,. Signature oJPersonal Represe»tative ~ ~ ~ iV t" `:~ File Number: `2 0 0 2- 0 0 7 4 5 ~ w '~'' cz w Estate of DEAN R UPDEGRAFF _ ,Deceased Social Security Number: 175-40-6790 Date of Death: JUNE 12.2002 AND NOW ~ .~V~ , in consideration of the foregoing Petition, sajtisfactory proof Navin been rescnted befo~ DEC ED that Letters of Administration d . b . n . g P are hereby granted to Christopher A Updearaf f and Michelle L. Updegr>af ~~I ~n the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Wiil (end Codicil(s)) of Decedent. n FEES Letters ............... $ Re s Short Certificate(s) ........ $ Attorney Signature: ~ Renunciation(s) .......... $ Attorney Name: JO ZONARICH, Q , ... $ ... $ Supreme Court LD. No.: 19632 ' $ Address: 17 S SECOND STREET, 6TH F$,.OOR ... $ . , $ HARRISBURG, PA 17101-2039 ... $ ... $ • • • $ Telephone: 717.233.1000 ... $ TOTAL .............. $ 0.00 Form RW-01 rev. !0.13.06 Page Z Of 2 Signature of Personal Representative I I u7ns cp9 RSV rp7J071 LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. $6.00 Fee for this certificate This.. is to certify .than the information here given is , correctly copied from an original Certificate of Death duly filed with me' as Local Registrar:. The original certificate will be forwarded to .the State Vital Records Office for permanent filing. P 16588Q47 ~J ~~ u to ~ Certification Number Local Registrar Date. Issued ~a o ;~ r r r ' 3s - j rn t;'~ c ~r ~ c~ +~ ~ CT ~x . ~~:7 - ~ 7 C'~ .~ ~i = = `' - C..1 ~~' , ~ N ee co ~oNw~ni of ~r>r+svl.vu~u- . oEarrr of r+~r-~n+ • vrru. nECOnns ~ ', ~.~ C~ r ceanac~-re oR e~-rH w Ise» M.avodon.ea ort ewerNl .~.,~ ~. ~ ..,.~ +.wnbrorrwrtR+.+rdr,rKrwd teb aarwerrbw~rr ao~rM ep;y.rl Female 229 =62- 5110 Au at 7, 2010 a ~ pr e~anr,- wrt + a ar a sn r re' "ar down _ 63 ~ ra ~ ~r ,raw June 4, _1947. Richmond, VA ^,„„r„e p~,,. ^oa D frr ^ce.r- e-arwdo.w eaar.wa+~Rao.rn rpp,p~ eawaMrrr..plaabA~Nr,drr.r.rr~aer) axwara.+aMgdeoeeM xe Y fahrMwkrf~,an,ewr,a++~,r¢ Cumberland EaBt Fennsboro Holy Spirit Hospital w,b~,,b:-, ~ 1 to iZ Wr Or.Or1 a~ b M - ta Dr~e4 Easkn ~1 •N' M+rr OW ~' MAdsr4 Ohao~0lMrd. Nbw Mrerd, 16. 8pou. (e ab, ~ mien rmh OffiC~"awat p nt uawareraert g~,l8retlrYp~te! carslk+aa«- Widowe i ^ Yr ro , n.crrarra~~..IM•d.da/aM,rw,aaaaan ' worhr. oaowe~r _ r .~~r _ T.w AaudNwdrr tnarr PP' u+ 632 Batnberger Road .r~.r~. ~ + , Qt York tm.coay : ~ruara arreao 'iaarei~comb, Jr. 11t~.rq~Yy 1 ! '!~~!!~"bQ§i~&~' A. Updegraff em ti.~.r.w~o>~a-w tebwt dMl a~n:++., ~o ma~1 652 Bomber er Road, Etters, $ 1'7319 su.w~oetloroowa~ ~ '^Cwreon ^Drrr s+aoM~apporm0~r+hdr,+w) 2fan~aadprreeRwrdar~Mr,raa~warrl s+d' lbm.wr,egeod~i ®~ ^~~~ ~~~ ugust 14 2010 Rolling Green Memorial Park Carp dill, PA 17011 ^Yr^ • , iMrNteNO~ali~raYd1- 776. lloMM.Rirb r~ L- FO '012342-L Nrrryr AAiredfr~ PA_ 17070 -New ~ ~mb~rland 4018 3rd St Stone -8 MurrayF H y .. ~,, ., , . . . ., ' Iie~t7.e~.aeU:~>~MV <tilafe ':rb+w,4~,e~r~men.era.+rr.w~wege.wra.taar-wrrnrl. ap:uo.~r~wee. sk.or.egraldr,r•A YMtYrYhdMdMMb raNaYrdlber. Aaf4>fiw.Ihaa~YYeMP~ 41.1bMdOrU f6.OW NmanadDW lMorR en',Yrrl i{,. bar Cw RAMrtlbAbdod BriNrw! fora arreriGrreona DarYan9 ~Yr ^~ ~~~ 7:30 ~. u. a ~a CAbrICfOMTM~wlrrabrMNrMMI ) r :Matz.Patt&rrh~~yl~-drrR~~ldKaan~l~4r•1.ti~ah'oYd'/rYrLDOrdIMerMniiYwNer~Mrard~eaMl I. drMbOrli 6rirfwMlFO„bugrpYVrarO~'rMWrl1. b YM ^aahWy.. le~'eIlM,afrrrlelr MelOe M/oedbMYlrl Mrbgi.lYl OIe,901rWa11 rd11114 ~ ~i I ^1b ^i1Nea+m P:~"'rr+rS~;~`~ ~ aML=ZASTA?IG PANCR>rATIG CA~NCE(2,, ~ moNTHS 7fabefi,~g_„ '. ~." r„p,r,,,,,w,,,,,„,~„ llrmb~rr.mwprsdl~ L ~I r PnPw! Mm/bR~dM. •ti !7l.7r I erlL ~~ _I ~YT ` b. ifr b (ar r. mrgrm aA: ; - d ht pgre wNn rt hp er a b 1 r 6a CJ N e p d d ^ awr r~--lAaY. yr o pgw4 p. P e r lAb b Mr r ~ mwprrnr dk i ~ a , I E.br. earn [} u+en.n eplprd when er o.f rw ~ foawrrApl4M. am.rww~rw~+v at.awwdo.ra saoraMwO~ea,YrA afe.o.oa~lbw~roeanaa sa.I~aw~rx~$r«tcmw Parloeret MYe~I~ AW b crpYldi ^ Nrrl ^ Fladole. ~q ^ Yr 1b ~ ^ Yr ^ Ib ^ MeeMe ^ Wrdp ~r 7ed lbw d byry er: rp, r Mrik'1 A0. eTmapaYratb}ry P4~d~i7 uaer ^ Prrnpr ^ M6iYbn ^dharrO 804lnorlen d tlvll>b'Mt 1 brYn, rea- T ' ^ ease. ^ caea far ar.rre M p ^ Yr ^ ND , ~, ~, escrrrd.a<aera~l r~,f.a»a.dt .d~.~.,.r,~ra arw~r~a +~« + w 37aegrrnaallM-aGrrrr eSP tvt© ~-1 AWS T ~ ~m ~.e ~ • «~w l~ T.rwr.egrnir~,irrpbrM/rrtlriMwhlribw~rrrMM-__--_-_____ ~ _---.--- . ------'-- •.lbrrrrrwN MIIMMIfMdNrOelrp~i~rdarrMOba~pwd/ill.... »..wr.rwri.w+errr.,am,wMw.wwbwarld•e.r.r~rw--------- ^ ~antkrr MD 440 4-'10 MaIA ~yrr) g ''log polo arrr~t.:.w..rlwwrr~bara~n,wrrr+rrbrn.wtiwNwarer.rw..wWre..rrrw. ^ at-wwea..d~..onvnooob~reawdar~l~rq, rrne. AR ~~ SEK As~RRPu ° ,~ ,, , ,,,, , r~ H GµANDRA , j"'or"` ''M'. 1.2.1 ~ I ~I ~ 1 ~ I , ,, ,~ a P~/o/ ey' Goa S03 /1/orT/ /3rST~ ' /~;// ~9 /70// cad/ e a " OYpotllm PwM ra 0~-~~Y S Skarlatos~~onarichLL~ Sound Advice. Smarter Decisions. 17 South Second Street, 6t° Floor Harrisburg, PA 17101-2039 717.233.1000 Voice 717.233.6740 Fax wwwskarlatoszonarich.com Bridget M. !Whitey, Esquire bmw(rc~skarlatosulnarich.com August 25, 2010 Glenda Farner Strasbaugh Register of Wills for Cumberland County 1 South Court House Ave., Room 102 Carlisle, PA 17013-3322 Re: Estate of Dean Updegraff No. 2002-00745 Date of Death: June 12, 2002 Dear Ms. Strasbaugh: -- .. --~~77 C ~ ~ c..? f`i'1~ an 4..i-r TJ t `~ ~iX ~ Q1 yt_~ ='~ ~ _ C.~,~ -v ` -i -~ w ca Your office issued letters of Administration to Elizabeth R. Updegraff on Augusltt 19, 2002 in connection with the above-referenced Estate. Mrs. Updegraff, who re-married >~nd was then known as Elizabeth U. Wilson, died on August 7, 2010, survived by her two chi~dr~n, Michelle Updegraff and Christopher Updegraff, who were also the only children of I~earl. Updegrai~ I enclose a copy of the death certificate of Elizabeth U. Wilson for the file. In order to fill the vacancy in the office of personal representative of the Estate df Dean Updegraff, I have prepared a Petition for Grant of Letters of Administration D.B.N. to 11~Iichelle Updegraff and Christopher Updegraff, and I enclose it with this letter, together with a check in the amount of $20.00, to cover your fee in this matter. Please forward the Letters of Administration D.B.N. to me. I enclose a self-addrlessed, stamped envelope for your use. Enclosures Sincerely, ~~ c~ Bridget M. Whitley A Member of LawPactTM - An International Association of Independent Law Firms ~ ~ ~ ~_ N ~ ~ ~ tD ~ tD ~ = N :.. O J~ ~~ W .II .-w ~ O wO ~~ N O C !N N~~C ~. ~ ~ ~ N -_ ~ C7 O C 7 ~' ,' ~~~il~ ~~ ~~ ~d 9Z ~(1~ 0 -~;rr r !. .~~ v .. .. .~. t ~.. 1 .,, ~`` ~.. '~ `:: ;u ,. ~ ~, .~ ~' o. q `. Q. O rp. • ro. -- x .'f ~~ ~. G "~ ;, '"~ rs t .rte ~, ~. . ~+ ~" fr? COMMONWEALTH OF PENNSVIVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0801 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 013196 KUNKEL SHELLY J 204 STATE STREET HARRISBURG, PA 17101 -------- foltl ESTATE INFORMATION: SSN: 175-4o-s~9o FILE NUMBER: 2102-0745 DECEDENT NAME: UPDEGRAFF DEAN R DATE OF PAYMENT: 08/11/2010 POSTMARK DATE: 08/10/2010 COUNTY: CUMBERLAND DATE OF DEATH: 06/12/2002 REMARKS: RECEIPT TO ATTY CHECK#10374 SEAL ACN ASSESSMENT AMOUNT CONTROL NUMBER 101 ~ 5822.00 REV-1162 EX111-96) TOTAL AMOUNT PAID: INITIALS: WZ RECEIVED BY: 5822.00 GLENDA EARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS SkarlatosZ~o ~~ arf ~-1z LLP Sound Advice. SrnarterDecisions. 17 South Second Street, 6`~ Floor Harrisburg, PA 17101-2039 717.233.1000 Voice 717.233.6740 Faz wwwskarlatoszonarich.com August 10, 2010 Register of Wills Office Cumberland County Court House One Courthouse Square Carlisle, PA 17013 RE: Estate of Dean R. Updegraff No. 213-0745 To Whom It May Concern: Sharon I{. Shaffer, Estate Administrator sharonQskarlatoszonarich.com Enclosed for filing is an original and one copy of the Inheritance Tax Return and Inventory for the above-referenced estate. Please time-stamp the extra signature pages and return in the envelope provided. Also enclosed is a check in the amount of $30.00 representing the filing fees. Thank you. Sincerely, ~~ ~'lCJ Shazon K. Shaffer Estate Administrator Enclosures n cQ t~~ ~~rn .--~~ r--~ C i C~ C ~G-n ~} C b rv 0 ~. -;,;r; c c ~ _'7 ~•-,;,~ - T; ~, :~ ~'~i ~ _ -r 7 N _ .'~'Ji ~ .:. 7 C~7 .~. N A Member of LawPactT"' - An International Association of Independent Law Firms oszsooosssasn L••\fJ~]YIYY• OIWN~o F ~~g~o~~. o~ ~g~o~ ~ ?~~ y~Q ~ _ ~ __ ~ .~ t~U r ~ - `~ >, = M ~ M _ ~' ~ i O ~ ~ ~U ~~ ~ c o Q ~-~° = a a3 m v, ~ ~ m ~ ~, CAE O .L - a~ ~ U c~ ~ U .- U 1 1505610101 ~.~I REV-1500 ~t°'.'°' .~p~. PA Department of Revenue Prr~ t)FPICtAL uaP. was Bureau of Individual Taxes """"`" °~""` CouMy Code Year File Number PD BOx 280601 INHERITANCE TAX RETURN ~' DZ ~?~S Harristwrti, PA 1718-D6o1 RESIDENT DECEDENT ENTER DECEDENT INFORMATION BELOW Social Secudty Number Oats rN Death 175-40-6790 06!12/2002 Decedent's Last Neme Updegreff (N Appllcablel Enter SurvNing 8pouse'a Information Below Spouse's Last Nine Updegr~afr Wilso MMDDYYYY Gate of BirUr MMDDYYYY 01/05/1848 Suffix Decedent's First Neme Dean SufDx Spouse's First Name Elizabeth MI R MI spouse's soda! security Number THIS RETURN MUST BE FlLED IN DUPLICATE YMITH THE 229-62-5110 REGISTER OF WILLS FlLL UV APPROPRWTE OYA1.8 BELOW m 1. Original Ratum O 2. SUppktmental Ratum O 3. RamaMder Ratum (date of deaUr prior b /2-13.82) O 4. Limited Estate O 4a. Future Interest Compromise (date of O 5. Federal Estate Tax Ralum Requhed death sitar 12-12-82) O 6. Decedent Dlad Testate O 7. Decedent Maintained a Living Text 0 8. Total Number d safe Oepoait Soxea (Attach Copy d WIII) (Attach Copy of Trust) OD 8. Litigatbn Proceeds Received O 10. Spousal Poverty Gredit (date of death O 11. Election to tax under sec. 9113(A) between 12-31-gt and 1-1-g5) (Attach Sch. O) CORRESPONDENT - TNIS SECTION MUST BE COMPLETED. ALL t'ARRE8PONDENCE AND CONFlDENTIAL TAX INFORMATION SHOIAD BE DIRECTED T0: Name Daydme Tebphone Number Bridget M. Whitley (717) 233-1000 First Iine of address Skarlatos 8r Zonarich Seeond Nne of address 17S2ndStFL6 City or Post Office Harrisburg Sfste ZIP Code PA 17101 RBOIS~t of MrNa.s tip oNtr 0 ~,.0 y,,. ~- ;. z? -~,. r r ~_ rrt :~. ~ , ~ '. ~~Q 'n C ;~~+-r1 ~~;~ D~ FILED fU rs .T- rv correspondent's e-maU addrosc bmw~skarlatoszonarich.COm tbrdor penakk+a d per)ury, I dsdere Ihel I have exemkrod This realm. NrdtKNrg exanpsnykp sdNdWas end s4bmenb, erM b the beet d my knowledge and ba1M. it fs We, wired end canpNe. Dsdara8on d prepersr other IMn the psrecnel rePreeenlalivs k based on aN kNarratUon d wfikh praparer has any krwwlatlga. SIf3NATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE Side 1 1505610101 1505610101 J 17 5 2nd St FL 6, Hamsburg, PA 17101 PLEASE U8E ORIGINAL FORM ONLY J 150561D105 ~ / „ Oa^,Q.'~~ 1 REV-1500 EX Decedent's Social Secwrity Number Dacsaenra wma: Updtagraff, Dean R. 175-40-6790 RECAPITULATION 1. Real Estate (Schedule A) ............................................ . 1. 2. Stocks and Bonds(Soheduk B) ...................................... . 2. 3. Cbseiy Held Corporetbn, Partnership or Sole-Proprietorship (Schedule C) .... . 3. 4. Mortgagee and Notes Receivable (Schedule D) .......................... . 4. 5. Cash, Bank Deposits and Miscellaneous Psreonai Property (Sdiedule E)...... . 5. 187,500.00 8. Jointly Owned Properly (Schedule F) Q Separate Billing Requested ...... . 8. 7, inter-Kivos Tranafere S MiscsWaneous Non-Probate Prtiparty (Schedule G) G 3eparete B811ng Requested....... . 7. 8. Total Oross AspTs (total Linea 1 Through 7) ............................. 8. 187,600.00 8. Funeral Expenses and Adminfstralhre Costs (Schedule H) .................. . 9. 10,953.00 10. Debts of Decedent, Mortgage Uab, and Uens (schedule I) ............. . 10. 110,035.00 11, Total Deductions (total Linea 9 and 10) ................................ . 11. 120,988.00 . 12. Net Value of Estate (Line B minus Line 11) ............................. . 12. 88,512.00 . 13. Charitable and Governmental Bequesta/Sec 8113 Trusts for whk:h an election to tax has not been made (Schedule J) ....................... . 13. 14. Net Value Subject m Taz (Line 12 minus Line 13) ....................... . 14. 66,512.00 TAX CALCULATION -SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Una 14 taxable eT the spousal tax rate, or trenefere under Sec, 8118 (ex1.z) x .o_ 48,258.00 15. 0.00 18. Amount of Une 14 taxable at lineal rate x .o ~ 16,256.00 ,s. 622.00 17. Amount of Llne 14 taxable at sling rete X .12 17, 18. Amount of Llne 14 Taxable ' ' at collateral rate X .15 18. 18. TAx DUE ........................................................ . 18. 822.00 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT O Side 2 15056101D5 15056101D5 REV•150a EX Pepe 3 Decedent's Complete Address: FlN Number 02 I- a z .- o ~~~ DECEDENT'S NAME Dean R. Updegraff _~___._...____ _._~ ____ _ ~._.._._ srR~raoDRESS 1604 Kathryn Street New Cumberland staTEPA ~P17070 Tax Payments and Credits: 1. Tex Dua (Page 2, line 19) 2. CrerfilslPayments A Prbr Payments ~,. B. Disoouni 3. Interest 4. If Line 2 is greater Ulan Line 1 + Line 3, enter the dflererxx:. This is Uie OVERPAYMEtiT, Flit in oval on Page 2, Una 20 to request a refund. 5. If line 1 + Line 3 is greater than Line 2, enter the dlfFerence. This is Ure TAX DUE. (1) 822.00 Total Credits (A + 8) (2) {3) (4) (5) 822.00 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: Ye8 ~ a. retain Uie use or Mcome of the property transferred :................................ .......................................................... o b. ret~n the right to designate who ahefi use the property transferred a its income; .......,._ ................................. ^ c. retain a reversior~y interest; or .......................................................................................................................... ^ d. receive the promise for Nre of efiher payments. benefits or cereT ...................................................................... ^ x^ 2. It death otxxrrred after Dec.12,1982, dkt decedent transfer property wxhin erne year of death wfifrout reCeivirtg adequate carakleration7 ........................................................................................... ................... a 3. Dkt decedent own an "fn trust for or payable-upon•daeth bank accamt or security al Ids or her death? .............. ^ ><^ 4. Did decedent own an IndNidual retlremant accamt, annulry or ottrer non-probate property, wtich contains a baneficary desigrretion7 ........................................................................................................................ ^ 0 IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT A3 PART OF THE RETURN. For dates of death on a after July 1, 1994, and before Jan. 1, 1995, Ure tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3 percent p2 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1985, the tax rate Nnposad on the net vapte of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (ii)J. The statute does trot exempt a transfer to a surviving spouse from tax, and the statutory requiremertis for discbsure d assets and fUing a tax return are sdU appUceble even fl the surviving spouse is the Doty beneficiary. For dates of death on or after Juty 1, 2000: • The tax rate imposed on the net value of transfers from a deceased dTik121 years of age or younger at death to or For the use of a rteiurel parent, en adoptive parent or a stepparent of Ure child is 0 percent p2 P.S. §9118(aJ(1.2)J. • The tax rate on the net vakre of transfers to or for the use of the decedent's Ideal bertefldaries is 4.5 percent, except as noted In 72 P.S. §9118(1.2 [72 P.S. §911B(a1(1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblinggss is 12 percent (72 P.S. §9110(aJ(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, vAreUrer by blood or adopUorr. REV-1S0! EX+ (6.0!) SCHEDULE E cw"'°'~'"~TM°Fa~n~v~v^"~, CASH, BANK DEPOSITS, A MISC. ~ Tx~~er PERSONAL PROPERTY w~n~c yr FILE NUh~ER --- Dean R. Us~dwQraff 21 02 0745 3weego t.tp0 Ut oars opete b needed. irwad eddNiptel eMele d the woe Nu) AEV-1611 Ex•(72A7~ SCHEDULE H ~-TM ~ P~nv~~ FUNERAL EXPENSES 8~ IN~Bi1TANCETA%RETIJItN ADMINISTRATNE COSTS r~aloENrlr~ear ESTATE OF Pj~ NUMBER Aeon R. Us~daaraff i p2 n~eg Debts of decadent must be reported on Schedule 1. ITEM NUMBER 069CRIPTION AMOIAdT A. FIJNIERAI. L7CPENSES: 1, atone & Murray ~uteral House B. 7,177 ADMN'IISTRATNE COSTS: 1. Personal Raprasantativa's Cammissbrrs Name of Personal Representatlue(s) SoGai Securliy Number(s) / EIN Number of Personal Representadva(s) Street Address Cfly Stela Zip Year(s) Commission Paid: 2. Attorney fees 3. Family 6remption: (If decedent's address is not the same as dairrranl's, altatlt explanalbn) 3 , 500 Claimant Elizabeth UPdegraff Wilson Slreel Address 652 Baubargar Road City Etterrs State PA Zip 17319 Relationship of Claimant to Decedent SURVIVING SPl'WSE 4. Probate Fees 276 5. Arxountenl's Fees 8. ~ Tex Raurn Preparer's Fees 7 None 3WABAG 1,000 Tl7TAL (Also miter on Ilne 9, Ri (If more apace is needed, heart additional sheets of tire same size) REV•1512 EX ~ (17•W) ESTATE OF __ _ FILE I~N1tdSlstt D®an R. Vndnaraff 21 02 07d~+ _ Report debts incurred by the decadent prbr to death which remeirml unpaid ~ a<tlle date of death, Including unnitnburwd madksl ems. ITEM VALUE AT DATE nuMeER oE9CRIP110N OF oEATH ~• Wilkes S MaHugh Peersonal injury attorneys' reserver for additional costs 2,500 2 (Wilkes 6 McHugh Attorney feels in connection with personal injury litigation 3 (Wilkes & McHugh Attorney costa in connection with personal injury litigation 4 I Meidiaare lion 5 PA. S~loy~ HanQfits Truest Fund Third party racov®ry SCHEDULE( DEBTS OF DECEDENT, ('GAGE LIABILITIES, 8 LIENS 75,000 23,435 7,370 1,730 aweenN z.ao5 (If more specs is needed, kroerl edrUUonal sheets of the same aim) REV 1573 EX+(g-00) CDAMAONINEALTH of PENNSYLVaNiA Me10iTANCETAX RETURN RI~EPITOEC®Bif SCHEDULE J BENEFlCIARIES FILE NUNN3Ht = 0 R6JITIOIJStNP TO DECEDENT AMOUNT OR SHARE NUAABER NAME AND ADDRESS OF PER90N(S) RECEMNG PROPERTY Do Not List Tne6w(s) OF ESTATE I TAXABLE DISTRIBUTIONS [include spousal dist~ibulbns, erM transfers under Sec. 9118 (s (1.2)j 1 Elisabeth R. Updegreff-Wilson 652 Hamberger Road Etters, PA 17319 Intestate share of spouse: first $30,000 plus one-half of residue 30,000 508 of Residue: 18,256 Surviving Spouse 48,256 2 Christopher A. Updegraff 409 Kunkle Land Mechanicsburg, PA 17050 One Quarter of Residue: 9,128 Bon 9,128 ENTER DOLLAR AMOUNTS FOR OISTRI&JTIOrS SHOWN A801IE ON LINES 15 T HROUGH 18. AS APPROPRIATE, O N REV-1600 COVER SHEET II NON-TAXABLE DISTRIBLT110NS: A 3POUSAI. DNiTRN3UTION5 UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART N - ENTER TOTAL NONTAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET = 0 ~W46rU 1.000 l~~ .~nav aFraw b navava, meat 8010190f1a1 aneeR Of eM 88RIe elLe) ELIZABETH R. UPDEGRAFF, individually, and as the Administrator of the Estate of DEAN R. UPDEGRAFF, Plaintiff, v. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CNIL ACTION -LAW N0.03-4966-Civil FILED UNDER SEAL PURSUANT TO ORDER OF MARCH 12, 2010 JURY TRIAL DEMANDED ORDER AND NOW, this ~ day of , 2010, on consideration of the Petition for Settlement of Survival Action and Apportionment of Settlement Proceeds with Wrongful Death Action of the plaintiff, Elizabeth R. Updegraff, as Administrator of the Estate of Dean R. Updegraff, deceased, the settlement in the above-captioned lawsuit by payment on behalf of the Defendants in the sum of $375,000.00 is hereby APPROVED. Defendants shall forward all settlement drafts or checks to Wilkes Bc McHugh, P.A. for proper distribution within twenty (20) days of the date of this Order. IT IS FURTHER ORDERED AND DECREED that the net settlement proceeds (after deduction of costs and attorneys fees) be allocated as follows: 1. Survival Claim 50% 2. Wrongful Death Claim 50% $ 86,565.01 $ 86,565.02 IT IS FURTHER ORDERED AND DECREED that the settlement proceeds be distributed as follows: 1. To: Wilkes & McHugh, P.A. $150,000.00 Counsel Fees, per Fee Contract 2. To: Wilkes & McHugh, P.A. $ 46,869.97 Reimbursement of Costs, per Fee Contract 3. To: Wilkes & McHugh, P.A. Future or Outstanding Costs $ 5,000.00 (to be held in escrow) Net Settlement Proceeds available for Wrongful Death Beneficiaries and the Estate of Dean R. Updegraff $173,130.03 4. Wrongful Death Claim $ 86,565.02 a. To: Adult Spouse: Elizabeth R. Updegraff $ 58,282.52 b. To: Adult Son: Christopher A. Updegraff $ 14,141.25 c. To: Adult Daughter: Michelle L. Updegraff $ 14,141.25 5. Survival Claim the sum of $ 86,565.01 Less the following estimated liens: a. To: Wilkes & McHugh, P.A. Maximum estimated lien to Medicaze $ 7,369.72 (to be held in escrow) b. To: Wilkes & McHugh, P.A. Maximum estimated lien to BCBS/PEBTF $ 1,730.48 (to be held in escrow) shall be paid to Elizabeth R. Updegraff, as Administrator of the Estate of Dean R. Updegraff, deceased. The Administrator is authorized to make disbursements, including attorneys' fees and costs, pursuant to the Petition and to execute all necessary releases, endorse all checks and to make appropriate distribution. By the Court ~~"~ TRUE COPY FROM RECWtD In Testimony whereof, i herg unto set my hand and the sell of.sald rt~at~CaMate, Pe. This,L~day,pf~~~~ / 21) PfOQt10t10 ~'~/r`~ ~ INVENTORY REGISTER OF WILLS OF C~BERLAND COUNTY, PENNSYLVANIA COMMONWEALTH OF PENNSYLVANIA 1 COUNTY OF CUMBERLAND ` SS File Ntmmber 21-02-0745 Personal Representative(s) of the Estate of DEAN R. UPDEGRAFF deceased, depose(s) and say(s) 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 of the Commonwealth of Pennsylvania except that which appears iIr a memorandum at the end of this inventory. I verify that the statements made in this Inven- tory are true and correct. I understand that false state- ments herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. -,.--~.~._ 9. _t7o~ r 4 x-.g.9. P0.4 Bri M. Wtlitl Esq. Attotreey -- (Name) eY~ (Supreme Cotat I.D. No.) 33580 (Address) Skarlatos 8c Zonarich, 17 S. 2nd St, 6th Floor, Harrisburg, PA 17101 (Telephone) 717-233-1000 __ DATE OF DEATH LAST RESIDENCE DECEDENT`S SOC. SEC. NO. 06!12/2002 1604 Kathryn Strcet, New Cumberland, PA 17070 175-00-6790 FIGURES MUST BE TOTALED Proceeds of Litigation (cash) FV n O ~_ C7 t~ ~~ ~-~ ~ C '1] r~~ '-o N a ~, IV addttdoiysl skeds as 187,500.00 2J .'_' .,1 r,r....~ ... r; ; ~ C^ .. ~,~ fit... .....' T' ~.~ ~+ .__7 ~ fI iy -7 :'r~ ='~ i~ .~.~ 187,500.00 NOTE: The Mortwrmdum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal relmsantative include the value of item, but such figures should rest be extended like the tom! of the Inventory. (See 20 Pa C.S § 3301(61) Form RW-09 rev. 10.13.06 t BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 NOTICE OF INHERITANCE TAX ARPRAISE~EN,T, ALLOWANCE OR DISALLOWANCE OF DEDUCrTIONS AND ASSESSMENT OF TAX J ' ..~ ;- _ _ - . . ,_~ BRIDGET M WHIT'~L;E~ ~ - - 17 S 2ND ST FL 6 HARRISBURG PA 17101 cl) .00 c2) .00 c3) .00 c4) .00 C5) 187,500.00 c6) .00 c7) .00 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ ------------------------------------------------------------------------------------------- REV-1547 EX AFP C12-09~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: UPDEGRAFF DEAN RFILE N0.:21 02-0745 ACN: 101 DATE: 10-25-2010 TAX RETURN WAS: C ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE 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 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) ~~«~ pennsylvan~a ~ DEPARTMENT OF REVENUE 1 REV-1547 EX AFP (12-09) NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. c8) 187,500.00 ~9) 10 , 953.00 clo) 110,035.00 11. Total Deductions X11) 120,988.00 12. Net Value of Tax Return C12) 66,512.00 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .0 0 14. Net Value of Estate Subject to Tax (14) 66,512.00 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) 48,256.00 X 00 = .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 1 S . S6 _ 00 X 045 = 822.00 17. Amount of Line 14 at Sibling rate (17) .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)= $22.00 TAX CREDITS: PAYMENT DATE RECEIPT NUMBER DISCOUNT (+) INTEREST/PEN PAID C-) AMOUNT PAID 07-10-2010 WRITEOFF .00 346.75 08-10-2010 CD013196 .00 822.00 10-18-2010 SBADJUST .00 2.81 DATE 10-25-2010 ESTATE OF UPDEGRAFF DEAN R DATE OF DEATH 06-12-2002 FILE NUMBER 21 02-0745 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 12-24-2010 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 TOTAL TAX PAYMENT 822.00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. REV-1470 EX (010) 4 ~ enns lvan~a INHERITANCE TAX p Y DEPARTMENT OF REVENUE EXPLANATION BUREAU OF INDIVIDUAL TAXES OF CHANGES PO Box 280601 HARRISBUR PA 17128-0601 DECEDENT'S NAME FILE NUMBER Dean R. Updegraff 2102-0745 REVIEWED BY ACN Destiny S.R. Brown 101 ITEM SCHEDULE NO, EXPLANATION OF CHANGES Interest is abated in the amount of $346.75 from the delinquent date 03/12/2003 to 07/10/2010, the date of receipt of the proceeds of litigation. Interest is effective 07/11/2010. Row Page 1 Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Name of Decedent: DEAN R. UPDEGRAFF Date of Death: JUNE 12, 2002 File Number: 2002 - 00745 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 ofthe estate is complete :.................... . ~~ Yes ~ 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 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 accouints may be filed with the Clerk of the Orphans' Court and may be attached to this report. Daie MARCH 12, 2012 Signature of P son /'7llrlg t as FOYIn ~-' ~. .. ~j ~~,_, . ~a ~ Capacity: OPersonal Representative Counsel tom,.: r~ .-- ~~ ~_~ ~ r~ BRIDGET M. WHITLEY, ESQUIRE ~ ~- c'7'._~ Nnnre of Person Filing this Fornr --"-- ~-' ~_ > - ,~ ~ r:~~``- 17 S. 2ND STREET, 6TH FLOOR ;- •,r ~ ~, HARRISBURG, PA 17101 _ ~j '~~" 717-233-1000 Telephone Forrrr RYV-/0 rer. ]0.13.06 (~ h