HomeMy WebLinkAbout02-0583PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of ~--~ ~' ~ ~~/ .~ 5~~~~~_~.
also known as
Deceased.
Social Security No. '~ ~ ~ " ~ ~ ~ '7 ~ .3
No. a I-Q.'t-583
To:
Register of Wills for the
County of~^-"'~' ° ~~' `- ~' '' `? in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl for letters of administration
on the estate of
(d.b.n.; pendente liter durante absentia; durante minoritate)
the above decedent.
Decendent was domiciled at death in ~ ~'~ `~'~ b' `"t ~ '`~ Count, Penns yania, with
h i `~ last family or principal residence at t ~ `t ~ Z e un "~`' ~ `~ ~ ~P M ~' ~i' ~`` ' ~ ~~
(fir f~~;.~~.-`s~3~:~ ~. ' ; e~~' ~~ (list street, number and municipa~ty) ~ ~ r i ~~
Decendent, then `r ~ years of age, died -~ a ~-' L t ~{
u
Decendent at death owned property with estimated values as folllows:
(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:
Petitioner after a proper search ha ascertained that decedent left no will and was survived by
rhP fnll~wine spouse (if any) and heirs:
(~1 Name
~ 'i~ `3 :~i=' ~ ~ ~i~-~ Z%l; £ ~r Relationship
~ ~ ~~ i L~~ "k'... _ xestaence
l O 4:: C l=ie S ~. 2 C; a
~-7 -/_.
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA 1 ss
COUNTY OF cUMSERLArm J
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
before me this 20tIz day of
J box
._...
MARY C IS Register
a~
on
No. 21-02- 583
Estate of HARRY J BEARER ,Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW JUNE 24 , 2002 ~ , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS .DECREED that A SHOVER
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to BARBARA A SHOVER
in the estate of HARRY J BEARER
FEES 40.00
Letters of Administration ..... $
Short CertificatesO .......... $ ~z nn
Renunciation ... • • $ s `~ ~~ ' ~~' "~'!~'
.. --~--- $ ~=~9
TOTAL $ -Q~oo
Filed ..6_2.4--02••••••••••• A.D. 19
mailed to atty 6-34-02
,~
MARY C LEVv'I egister of Wills
t~..J
ATTORNEY (Sup. Ct. LD. NoJ
"..).
ADDRESS
PHONE
his is to certify that the information here given is correctly copied from an original certificate t~f r~~zad) dul}~ filed wirh The as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for ~-~trmanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fez fur this certificate, $2.00 '~~ }~ :° 'd
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~a3 Rev. 2/87 COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
-~-~ '~"~"i-°-~"~~°~'. __ __ STATE FrIE CUMBER
NAME OF DECEDENT IF ray. Middle. _aal T ~ SEx ~~
SGCIAL SECURITY NUMBER DATE OF DEATH MCntn. Day, roar)
+. H~ry J. Searer _ finale ~10 - 18 -7633
AGE (Last B.mday) UNDER 1 YEAR UNDER t DAY DATE OF BIRTH BIRTHPUCE :Ca ~ ~~ I r ( ~ ~~ ~ ~~ }
Monet. Da vend PUCE OF DEATH t n ay ro ,ee nsGw.l,unrm caner soar
Month r Days HotKa . Miou, des Y ~re9rl 'dale a rcreyn CeunuYl HOSPITAL --- r
' _- OTHER: --
s 75 rrs. S e. r.24,1927 LewistoWri, PA ~ Irerrl .~ Ewotap,rrent u DDA ^ "b'"'"'°,. ^ Rrngente ^ Sav drl ^
COUNTY OF DErQM CRY BORO. T WP OF DEATH FACILIII' NAME III nnl ~nv~NUOn
\ gwe west antl nu/mtxrr VMSpD/ECEDENT OF HISPANIC ORIGIN? RACE - Amancan Indan, tWCk, Whee. etc.
n/~ II ~ ~, 1 I (,^~:fit T~ NO lA lM L^ "r,a. aWtdyCuban. ISPetMI
~l)LA./i, /"FI X7vv~ lr~ ~' i-'.it"a r~~lu c kNarcan.PwneRican,ac Whlte
DECED M'S USUAL OCCUPQION KIND OF BUSINESS/INDUSTRY WAS DECEDENT EVERIN a 9. tC.
IGrve krndd work done du DECEDENT'S EDUCAT MARITAL STATUS-Msrtad SURVIVING SPOUSE -
r^9r^~+ U. S. ARMED FORCE57 5 d orN n estr tide rmr len NewrMUrrad, Widmeed, IN was. Dive rnartlen runnel
d working YN: do na use refired) EGmynta lSecontla
Vaa ~ No ^ ry' ry Calega Dworced ISlxcdy)
,te. travel a ent „e. travel Iolz) It aa5.l I~11VOI'Ced
,2. ,,.12
DECEDENT'S MAILING ADDRESS 1SVeet. Cay/TOVm. State. Ly Catel DECEDENT'S ,~-
ACTUAL ,,,.S,,,e- Pennsylvania oa „a~vp.aacedereGveakl East pennSbOrO -
1049 Oyster Mill Rd. RESIDENCE ee<.eery r_
See m9ru000S
ts. C'-amp Hill, PA 17011 °'^e's°°I Clunbe:rland w""w~anwi N,.atwn+G„w
17D. county __-- 17d.^ wefrin a[IUa1 limb a_
FATHER'S NAME (Post. Mrdde. Last) -_ CMrEor
,~ Harry Clayton Searer MOJ~R'SNAME,F.sI Marden$urn
OrenCe eanor ~"atson
INFORMANT'S NAME (TyperPrud) t9.
INFORMANT'S MAILING ADDRESS IS1reeL Crry/6wn, Skue Zip Code)
2a. Charles A- Carroll,Jra ,~30 S. Third St-,Harrisburg,PA17101 #815
METHOD OF DISPOSITION DATE OF DISPOSITION PLACE OF pISPOSITION - Name d CemNe Cremat LOCATION .
BurW Cremala,~ Removal kom Stan ^ IMadrt, DaY. Marl Ollwr Plate ry' dry' Cily/TOwn, Sala. IrpCod, -.
ah.r,swt ^ June 17,2002 Con-0-Cite Crematory chaefferstown,PA17088
2,a, x1k.
' SIG NE LICENSEE OR PE ACTT AS UCH LICENSE NUMBER 21c. 2,4.
NAME ANO ADDRESS OF FACILITY ---
~-013163-L Fi:I & C5,324 Hur-tel AAve.,Iarr~ne,PA17043
dema 27a<only wMn Genrlyirp TD dIe Deaf of my know I" occurred at tM Gme, date arW plate stated LICENSE NUMBER
.• pnysicun o nd avaeaDN at Gme of a.am m 15rgrawre and Truel DATE SIGNED - - -
• CeMY Uufe d deem.
(Matlh, Day Year)
220.
Ilems 21-ri must M completed Dy TIME OF DEATH 23D. 23c.
OA7E PRONOUNCED DEAD,Maan. Day. Year) WAS CASE REFERRED TO ME AL XAMINERICORONER7
pewon who pronounces dulh -T~ p~I$y -
r 21. /- U(] 23. ~J L1r~~~ ~ (~ ~'L)~)~ ri. Yea/ ' ~ F p, Ne^
27. PART I: Enter tM disaaxa, inryries a comprcahons wMth caused lM death. Do rIOI rater IM ngde o1 dying, sutra as tardrac or respualory arrest. snack or roman lad~re
LiN oNy one taros on aaU lira,. ~ Approarmate PART 11~ OUlOr apnrAcard CpMilpna cordrrbulktg to seam, bin --- -
I imaryal Delwean nq restlMYtg n me undedywg utRe given in PART I
WYEDIATE CAUSE (Fetal ~ , orrael arw data
disease a cmdurm
resupatq rn dealhl -- ~ ~ /'G ~4~---j if n r f 7-
a I
~
DUF,jUIOR ASA ON.SEOUENCEO
seatwrxww kr tdllddidns D S <
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dairy, kvadrg b •nmerAale Ut/E 10IOR AS A CONSEQUENCE Off:
taus0. Ertler UNDERLYNIB I
CAUSE IOreease a mNtY c. I
~ Ihal YWrated everda DUE TOIOR AS A CONSEQUENCE OF)~ r
resusay n oealn) LAST
I
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GVAS AN AUTOPSY
PERFORMED? WERE AUTOPSY FINDINGS
AVAIUBLE PRIOR TO MANNER OF DEATH DATE OF INJURY TIME OF INJUR
COMPLETION OF CAUSE
yr„ IMmm. Day, Year)
OF DEQH? ^
Natural I~L~i` Hp,rKq,
Attrdenl ^ POrWrrp lnveslgalrpn ^
Yp ^ No~ Yea ^ No ^ Suicide ^ Couq rapMdetsrmmed ^ ~~ ~'
2M.
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~9. PucE DF IwuaY . At rom., rarm.
Wddkrq, wc. ISpecdv)
70e aue.t. taclory,
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CERTIFIER ICneck oroy onel
'CERTIFYING PHYSICIAN IPhysrcan cerldymg cause d death when ananer
To IIN Mal of m know pnvsrcian has gorgUnt,W dean ano comp) yad u0n 231
Y Ndge
death ottumd dw b m SIGMA
,
e cauxia) and manner tie stated ................................. .
................... ^
710.
'PRONOUNCING ANO CERTIFYING PHYSICIAN IPn
Ysrtan DOIn ~mnuurrung Uealn and terldyrng to cause of dealnl LICEN
7 IM Deaf of m kMwl
y edge, death xcwrad al IM tlme, dale, arW place, and dw b IM cauulsl eras manner as stated ...................... 1~ 71t. ~
NAME
'MEDICAL EXAMINER/CORONER (Ile e
On the basis of examination and/or investigation, m my oprmon, oath occurred a1 the lima, dale, and lace, and due to the caux(s) and
mmn0r as stated ....
......................
.....
7,a. .................................................... ~,
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REGI R $ $IGNATUR~ AND NU ER ~ ~ ~ ~ ~ ~
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CERTIFICATION OF NOTICE UNDER RULE 5.6(al
Name of Decedent: __ ~ //~~f~V cJ• JL~~~
Date of Death: _ J(;(N~ ~ y 2030
Will No. ~ `~ O CcJ r LL Admin. No.
To the Register:
I certify that notice of (beneficial interest) 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
Name
Address
/yl~H,9ti' /c~-s
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Signature
Name ~ ~~~
Address l0 ~ ` j ~~?~~ C_, ~ r%~2~
Telephone ( ) ~ ~ ~~ ~ ~)~ 3 -- ~3~
Capacity: ~ Personal Representative
Counsel for personal representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 002207
SHOVER BARBARA A
1063 PEBBLE CT
MECHANICSBURG, PA 17050
fold
ESTATE INFORMATION: ssN: 2~o-is-~sss
FILE NUMBER: 2102-0583
DECEDENT NAME: BEARER HARRY J
DATE OF PAYMENT: 02/24/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 06/ 1 4/2002
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ $224.95
TOTAL AMOUNT PAID:
REMARKS: BARBARA A SHOVER
CHECK#1073
SEAL
INITIALS: SK
RECEIVED BY: DONNA M. OTTO
REV-1162 EX111-96)
5224.95
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
*' COMMONWEALTH OF
PENNSYLVANIA
1,' ' DEPARTMENT OF REVENUE
r, DEPT. 280601
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REV.1500EXll3-OOj
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OFFICIAL USE ONLY
C-V
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
rZL-fL~
COUNTY CODE YEAR
t20,5~3-
NUMBER
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THIS RETURN MUST BE FilED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
SOCIAL SECURITY NUMBER
:<./() - 18
7633
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
~ 1. Original Return
D 4. Limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (dateo/death after 12.12.82)
o 7. Decedent Maintained a Living Trust (Attach copy of Trust)
D 10. Spousal Poverty Credit (date a/death between 12.31-91 and H-95)
o 3. Remainder Return (date of death prior to 12-13-82)
o 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to lax under Sec. 9113(A) {Attach Sch 0)
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FIRM NAME (If Applicable)
COMPLETE MAILING ADDRESS A .L'L
fJ4R.bpA-1I . '-In(J/I~1L
/~ 6:>3 ~-e6" l-e (!;f.
/11'echal1l/'5.6u~ 'fJA.
/7()Sd
TELEPHONE NUMBER
(717
7(,/-7.30A
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
-. ,,,"," "" '""--',
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1___________J
(B) q;f 0 "g3. q~
3. Closely Held Corporation, Partnership or Sole-Proprietorship
(1)
(2)
(3)
(4)
(5) 0' 1; 683. 9S
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4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
(7)
(6)
a. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
(9) ~ ~ ~o9. 3.t)
(10)
11. Total Deductions (total Lines 9 & 10)
j fJJ()Q.3S"
Ij 9 '11-- "'.3
(11)
(12f{#
(13)
12. Net Value of Estate (Line a minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
IJ-
(14)
/ 117~,~3
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x.O_ (15)
x.O_ (16)
~ o1~'I9S-
x .12 (17)
x .15 (1B)
~ ~.:l"l 9 S-
(19)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
1$ J. g7.tf.. to 3
"
18. Amount of Line 141axable at collateral rate
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS
CITY
"
ZIP / 7~1.
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1) o!t c1~J/.. 90-
Total Credits (A + B + C ) (2) - tJ-
3. InleresVPenalty if applicable
D.lnterest
E. Penally
TotallnteresVPenally ( D + E ) (3)
4. If Une 2 is greater Ihan Une 1 + Une 3, enler Ihe difference. This is Ihe OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Une 1 + Une 3 is greater than Une 2, enter the difference. This is Ihe TAX DUE. (5) W c1~ -iL. 9 !:J-
A. Enter Ihe interest on Ihe tax due. (5A) _ () _
B. Enler the tolal of Une 5 + 5A. This is the BALANCE DUE. (5B) # ~ 01 J/-. 9 S-
Make Check Payable to: REGISTER OF WILLS, AGENT
- 0-
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred;.....
b. retain the right to designate who shall use the property transferred or its income;..
c. retain a reversionary interest; or.. un..- ........
d. receive the promise for life of either payments, benefits or care?.. ....... ............
2. If death occurred after December 12. 1982, did decedent transfer property within one year of death
without receiving adequate consideration? . .................. ... 0 !XI
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ... 0 ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ...... ...... ................. 0 5{1
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN,
Ves
o
.....0
o
...0
No
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00
~
Under penalties of perjury, I declare that ) have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct
and complete
Declaration of preparer 0 rthan lhepersonal representative is based on all informalion of which preparer has any knowledge.
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
DATE
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value af 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 Ihe surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if
the surviving spouse is the only beneficiary,
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent,
or a stepparenl of Ihe child is 0% /72 P.S. ~9116(a)(1.2)J.
The tax rale imposed on Ihe net value of transfers to or for the use of Ihe decedent's lineal beneficiaries is 4.5%, except as noled in 72 P.S. ~9118(1.2) [72 P.S. ~9116(a)(1)].
The tax rale imposed on the net value of Iransfers 10 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.
RE"~EX'~''''.
COMMONWEALTH OF PENNSYLVANJA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF J C'
/I A R.-Il ':J . v~ ~IU: IV
FILE NUMBER
\oclude the proceeds of Iitigauon and the date the proceeds were receIved by the estate. All property jointly-owned wfth the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
CV)'ee)::'u1i h('Jt.mf-/ aJ47ft.JII1'f- ,(}'J/.I)/!. O/(JOcfl"J.j.~f)8
VALUE AT DATE
OF DEATH
oJ 1 683, 98
/
TOTAL (Also enter on line 5, Recapitulation) $
(If more space IS needed, Insert add.t,onal sheets of the same size)
~ ~S3, '18
,
REV-1511 EX+ (12-99) _
~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
FILE NUMBER
ce en mus e reported on Schedule I.
ITEM
NUMBER DESCRIPTION
A. FUNERAL EXPENSES: AMOUNT
1.
m/..l~S~/tn4n 5 f:U n !:il.14 ( )./cr>>>c. Lem~'j;1!e. J0. q ~I 17~.7j..
!hIlI 179 rt!1l.:e>€ n I
C!-e WI ~i.u-,'J .J./gM- (j()
B. ADMINISTRATIVE COSTS:
1. Personal Representarlve's Commissions
Name of Personal Representative(s)
Social Security Number{s)/EIN Number of Personal Representative(sl
Street Address
City State
___ lip
Year(s} Commission Paid:
2. Attorney Fees ~d w-eLf ~ ~jHtn5 /00,00
3. Fam'lly 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 &e:; fO'-Ie-e 0-1' Mils 5/. 00
5. Accountant's Fees
6. Tax Return Preparer's Fees
I!.en-l- LftOtP- ,t)O
7.
g. -r.a-kphone (hn/.-I fM'1"uYI+) j/e.Jll.l;'<YYl .$0- 1"1
9. CYreef.!s ~.(L E~k ~ </It-f J. 00
ID. 4/ed(~41 G~l'Ises (s","e. 4-1rAdted LKf) ~~M;.11
TOTAL (Also enJer on line 9, Recap',tulat;on) $ 7 ~o9. as-
(If more space is needed, insert additional sheets of the same i -/
Debts of de d t tb
sze)
HARRY J. SEARERESTATE: MEDICAL EXPENSES PAID
1. East Pennsboro Ambulance Service
2. Hershey Medical Ct. Physicians Group
3. Riverside Anethesiologists
4. Neurology Center
5. Heritage Cardiology
6. Pinnacle Health
7. Quantum Imaging
8. Jeffries Bronstein., P A
9. Penn Rehab
10. Shaffer Cardiovascular
11. Pulmonary and Critical Care
12. Associated Cardiologists
13. Central P A Hematology & Oncology Associates
14 . Vascular Associates
15. Stanley Goldman Associates
$ 29.00
102.32
166.43
36.46
1.74
877.04
63.87
111.97
42.50
478.13
220.17
269.02
106.21
6.00
157.63
Total
$ 2,668.49
Barbara A. Shover
1063 Pebble Court
Mechanicsburg, PA 17050
`~~-7~-~
Y BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
BARBARA A SHOVER
1063 PEBBLE CT
MECHANICSBURG PA 17050
DATE 04-14-2003
ESTATE OF BEARER HARRY J
DATE OF DEATH 06-14-2002
FILE NUMBER 21 02-0583
COUNTY. CUMBERLAND
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~
----------------------------------------------------------------------------------------------------------------
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BEARER HARRY J FILE N0. 21 02-0583 ACN 101 DATE 04-14-2003
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) (1) .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) (3l .00 submit the upper portion
4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this form with your
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 9,683.98 tax payment.
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7l .00
8. Total Assets (g) 9,683.98
APPROVED DEDUCTIONS AND EXEMPTIONS:
7,809.35
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions (11) 7 .809 _ ~
12. Net Value of Tax Return (12) 1,874.63
13. Charitable/Governmental Bequests; Non-elected 9113 Tru sts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 1,874.63
NOTE: If an assessment was issued previously, lines 14, 15 andior 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) • 00 X 00 = . 00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) • 00 X 045 . . 00
17. Amount of Line 14 at Sibling rate (17) 1,874.63 X 12 = 224.95
18. Amount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 - .00
19. Principal Tax Due (19)= 224.95
TAY CRCi1TTC~
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
02-24-2003 CD002207 .00 224.95
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX xev-i54~ ¢x ~FP col-oar
TOTAL TAX CREDIT 224.95
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 51, 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.)
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 4/30/2004
SHOVER BARBARA A
1063 PEBBLE CT
MECHANICSBURG, PA
17050
RE: Estate of SEARER HARRY J
File Number: 2002-00583
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: 6/14/2004
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
STATUS REPORT UNDER RULE 6.12
Name of Decedent: ~
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[-]
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 ~
Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
this report.
and may be attached to ~ ~
Nalne
Capacity:
Address
Telephone No.
[~/Personal Representative
[--] Counsel for personal representative