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Home My WebLink About04-0559 STATUS REPORT UNDER RlJLE 6.12 Name of Decedent: Elsie M. Kroener Date of Death: June 5, 2004 Estate No.: 2004-00559 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 0 No lliJ } If the answer is No. state vvhen the personal representative reasonably believes that the administration vvill be complete: September 5. 2006. 3. If the answer to No. I is Yes. state the f()llowing: a. Did the personal representative file a final account with the Court'? Yes 0 '\10 0 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 0 No 0 Date: c. Copies of receipts. releases. joinders and approval of f(mnal or informal accounts may be filed with the Clerk of the' Or ph' " 'lot aI1an1'~' be attached to this report. , ./ ~ ,/~ ~c;;>'- ,~ Signature H. Broujos June 5, 2006 Name \,.,,'; 4 North Hanover Street. Carlisle. PAl 70 I 3 Address 717-243-4574 Telephone No. Capacity: D Personal Representative IX] Counsel for personal representative r '~ lN~ PETITION FOR PROBATE and GRANT OF LETTERS Estate of ~-[St ~ t31. Kt-o~q et- also known as Deceased. Social Security No. /8 ~- ¥ 2. - al '"lifo ,o. 21-ou-55q To: Register of Wills for the County of (2-~,¢erlan.,~ Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(a~, who is/-m~ 18 years of age or older an the execut r ~ ~'. in the last wilt of the above decedent, dated and codicil(s) dated ~m,~.a in the named , 19 '"/? (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cut u'v. [~ r la,, e~ County, Pennsylvania, with h ~ last family or principaljesidence at ~ov ,~,ltC ~ u I - (list street, number and muncipality) Except as follows, decedent did not marry, was not divorced and ~id not have ~child born or adopted after execution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: ~ Decendent at death owned property with estimated values as follows: domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (I5 not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) respectfully presented herewith and the grant of letters theron. request(s) the probate of the last will and codicil(s) (testamentary; adminis(ration c.t.a.; a.d_n3i~istration d.b.n.c.t.a.~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF Q.3.xvv~eO_~o.a-xc~ f 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 knowledge and belief of petitioner(s) and that as personal represen- tative(s) of thc above ~eccdent petitioner(s) will well and truly administer the estate according to law. Sworn to or affir~c~and subscribed before me this day of Estate of DECREE OF PROBATE AND GRANT OF LETTERS , Deceased AND NOW ~ ~0 , ~ the reverse side h~eof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated described therein be a. dmitted to probate and filed of record as the last will of and Letters are hereby granted to~3~ ~,~~ ' ~ 19 , in consideration of the petition on FEES Probate, Letters, Etc .......... $ ~.~, Short Certificates(3 ) .......... $ Renunciation ................ $ ZFc-~ 4%e._ $ TOTAL __ $fir~ .~-~ riled . ..~.. 7. i .~0..~..,:~...c~...~.. ............. ATTORNEY (Sup. Ct. I.D. No.) 4 N.Hanover St, Carlisle,PA 17013 ADDRESS 717-243-4574 PHONE ~egi~ter of ~iI1~ of Cuml~erlan~ (~ountp OATH OF NON-SUBSCRIBING WITNESS Estate of ~"') ~'~ C I°Yh }~/f'OqDO (- Also known as No. '2 ~- o q - ~5~ .,Deceased (each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and~y(s) that ~2~X~.~_ familiar with the signature of ~-~1~1¢~ ~rx ~r-c~o~r~,oF- ,testatF',)~of (one of the subscribing wimesses to) the codicil/will presented herewith and that ~}~ believes the signature on the codic6is in the handwriting of ~-'t ~;',~_. fY'x l'{~¢'vor~0U' to the best of ~v' knowledge and belief. (Address) Sworn to or affirmed and subscribed Before me this [ ~o~._~ day of ~-~, ~_ ,20 O~ For the Register~~o~. (Address) RENUNCIATION In Re Estate deceased. To the Register of Wills of County, Pennsylvania. The undersigned ~ ~ ~'~ ~ c_._ cc'~--o~ of the above decedent, hereby renounce(s) the fight to administer the estate and respectfully ask(s) that Letters WITNESS hand this / ~-'7'~day of (Signature) (Address) :(Signature) (Address) (Signature) (Addre~) OATH OF NON-SUBSCRIBING WITNESS Estate of Also known No..9.1- ,Deceased ~ a subscriber hereto, .(:~.la) being duly qualified according to law, depose(s) and say(s) that 51~ ;~ familiar with the signamre of ~ [3~_ ~, {Q~'o~,testato,- of (one of the subscribing witnesses to) the codicil/will presented herewith and that cia e. believes the signature on the codicil/will is in the handwriting of ~ ~,~ ~ ~ '~. [,~___.w o e ~ e ~ to the best of [e~ knowledge and belief. (Name) ~.O. (Address)' Sworn to or affirmed and subscribed Before.~..~e~ this / {= 7k day of 3tl oe_ ,200~z For the Register COMMONWEALTH OF PENNSYLVANIA Notarial Seal Vicki L. Hopkins, Notary Public West Pennsboro Twp., Cumberland County My Commission Expires Jan. 15, 2008 Member, Pennsylvania Association Of Notaries (Address) his is lo certify that 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 lbr permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 ; 43 Rev 2/87 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH - VITAL RECORDS CERTIFICATE OF DEATH ',. Elsie H. Kroener AGE (Lasl B~ff~3a¥) I' UNO~n!~ YE,AR 98 ~. : Cumberland ~cEr~m's USUAL OCCt~-~.... I ~-m O~ ~UmNESSaNOUSVSY (C~ve im~cl d w~ik d~nl du~g mci Homemaker 210 Big Spring Avenue Newville, PA 17261 Carl Sylvia K. Camp ,. Female DATE OF ~l~fH BI~T HPI~CE (C~ Io,~ ~ 3-5-1906 Read~ng, PA ; L ,. ~, ~. ~ OF ~e~ille ~..~ 0 o~(s~a 0 .. C'~-re.e ~;d:~e 6 Ie I". I" 8 ,*,z I ( ~., ,. Widowed ,,. ,m.~ Cumberland ~' ,,,.~~ Neville E~a He' ~.~. ~. Z~ 40 Eemlock Circle, ~e~tlle, PA 17261 White PLACE OF OI~M'U~I ilON' Nllal M CW, CrMItMMy Cremation Society of PA Crematory ~,,~ Harrisburg, PA 17109 Cremation Society of PA ~100 Jonestown Road, Harrisburg, PA 17109 ~.~NUU~. [~. ~.~) ~ ~pJ~ A~ A'C(~q~Q~JE NCE I, ELSIE [I. KROENER, of the Borough of i~lyomissing, Berk.~ County, Pennsylvania, declare this to be my last ~.~ill and revoke any will previously made by me. FIi~ST: I direct that all my just debts and funeral expenses be paid as soon as convenient after my decease. SECOI"~D: All the rest_ , residue and remainder of my estate, of whatever nature and wheresoever situate, I give, devise and bequeath as follows: A. Thirtlv per cent (30%) thereof to iny then living grandchildren, in equal shares; and B. The balance to my daughter, Sylvia C. Camp, if she survives me, and if she does not survive me, to her then livin:3 children, in equal shares. THIRD: I direct that all taxes that may be assessed in consequence of my death, of whatever nat~tre and by whatever jurisdiction imposed, shall be paid from ray residuary estate as a part of the expenses of the ad~ninistration of my estate. FOURTH: I appoint my daughter, Sylvia C. Carap, and her husband, Peter E. Camp, or the survivor of them, executors of this my last will. IN WITNESS WHEREOF, I, the said ELSIE ?~. KROENER, the testatrix, have hereunto subscribed my name and affixed ray seal this ~/ ~ -- day of ~ , A.D. 1979. Signed, Sealed, Published and Declared by the said ELSIE iq. KROENER to be ]]er last will in the presence of us, who (SEAL) CERTIFICATION OF NOTICE UNDER RULE 5.6 (a) Name of Decedent: Date of Death: Will No.: To the Register: Elsie M. Kroener June 5, 2004 Admin. No.: 21-04-0559 I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on Name Address Sylvia K. Camp 40 Hemlock Circle, Newville, PA 17241 Joanna Bowlin Jonathan Camp Susanna Camp 118 Dudley Oxford Road, Dudley, MA 01571 21 Collins Street, Amesbury, MA 01913 3 Greenwood Way, Mill Valley, CA 94941 Notice has now been given to all persons entitled thereto trader Rule 5.6(a) except: none Signa/sl~fe ~' Name: Sylvia K. Camp Address: 40 Hemlock Circle Newville, PA 17241 Phone: 717-776-8410 Capacity: Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENTOEREVENUE BUREAU OFINDIVlDUAL TAXES DEPT. 280601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT REV 1162 EX(11-96) NO. CD 004246 BROUJOS JOHN ESQ 4 N HANOVER ST CARLISLE, PA 17013 fold ESTATE INFORMATION: SSN: 184-42-9780 FILE NUMBER: 2104-0559 DECEDENT NAME: KROENER ELSIE M DATE OF PAYMENT: 08/06/2004 POSTMARK DATE: 08/06/2004 COUNTY: CUMBERLAND DATE OF DEATH: 06/05/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $85.00 REMARKS: TOTAL AMOUNT PAID: ~85.00 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER Of WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIA I'-- Z KROENER, ELSIE M. LU ' t-~ DATE OF DEATH (MMDD-Year) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT OFRClAL USE ONLY ~iI.E NUMBER 2 1 -0 4 0 5 5 9 SOCIAL SECURITY NUMBER 1 8 4-4 2-9 7 8 0 UJ DATE OF BIRTH (MM DD-Year) 0610512004 0310511906 (rF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE iNITIAL) ~ [] 1. Odginal Return ~ ~'~l [] 4. Limited Estate o ~== [] 6. Decedent Died Testate (AtfachcopyofWij]) Z THIS RETURN MUST BE FILED IN DUPLICATE WrrR THE REGISTER OF WILLS SOCIAL SECURITY NUMBER J--12. Supplemental Return J--] 4a. Future Interest Compromise (date ol dea~ a0er 12-12qJ2) J~7, Decedent Maintained a Living Trust (A~ac~ copy of Trust] r~3, Remainder Return (~a~ofdeath pdo~to 12-13~82) [~5. Federal Estate Tax Return Required 0__ 6. Total Number of Safe Deposit Boxes [] 9. Litigation Proceeds Received [] 10 Spousal Poverty Credit Ida o~de~ between 12+31-91 and 1-1-95) [] 11, Election to tax under Sec. 9113(A) (A,ach Sch OI THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: NAME ~AILING ADDRESS BROUJOS & GILROY~ P.C. / TELEPHONE NUMBER j 1. Real Estata (Schedule A) (1) 2. Stocks and Bonds (Schedu~ B) (2) 3, Closely Held Corporation, Partherahip or Sole-Proprietorship (3) 4. Mo~ages & Notes Receivable (Schedule D) (4)., 5. Cash, Bank Deposits & Miscellaneous Personal Properly (5) (Schedule B) " 6 Jointly Owned Property (Schedule F) (6) ] Separate Billing Requested 7~ InterNivos Transfers & Miscellaneous Non-Probate Properly (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costa (Schedule H) (9) 10. Debta of Decedent, Uodgage Liabilities, & Liens (Schedule I) (10) ,, 11. Total Deductions (total Lines 9 8, 10) 12. Net Value of Estate (Line 6 minus Line 11) 13. Charitable and Governmental Bequests/Sec 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) SEE INSTRUCTIONS OH REVERSE SIDE FOR APPLICABLE RATES 3~993.721 c:: (6) (11) ,. (12)., (13) . (14) 3~993.72 211875.62 17,197.29 39~072.91 -35~079.19 -35 079.19 15, Amount 01Line 14 taxable at the spousal tax rate, or transfers under Sec 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at siblbg rate 18~ Amount of Line 14 taxable at collateral rate 19. Tax Due 20. X X .12 X .15 (15) (16) (17) _ (18) . (19) · > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < 0.00 0.00 Decedent's Complete Address: ISTRE£TADDRESS Green Ridge Village - Swaim Health Center 210 Big Spring Avenue C~TY Newville Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 85.00 3. Interest/Penalty if applicable D. Interest E. Penalty 4. if Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT, Check box on Page 1 Line 20 to request a refund 5 If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. STATE PA I Z~ 17241 (1) Total Credits ( A + B + C ) (2) (3) (4) 0.00 85.00 85.00 (5) (5A) Total Interest/Penalty ( D + E ) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Yes No 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 ...................................................................................................... [] d. receive the promise for ~ife of either payments, benefits or care? ........................................................... ,. [] [] 2. if death occurred after December 12, 1982, did decedent transfer property within °ne year °f death without receiving adequate consideration? ........................................................................................ ' ...... [] [] 3. Did decedent own an "in trust for" or payable upon death hank account or security at his or her death? ................. [] [] 4. Did decedent own an Individual Retirement Account, annuity, or other non"probate pr°pertY which ~ i nation'~ ' [] [] contains a benenciary Des g .................................................................................................. IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Underpenatie$o perjury declaretha haveexarnned[hisreturn, includingaccompanyingschpeu~esandstatements~andt~thepest~fmykn~w~edgeandpe~ief'itistme~c~rrectandc~mp~ete DATE SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Syt~"a K. Camp, Executrix, /-/ 40 N, emlc~ck, Circle, N~wville GarliC'S' PA 17241 DATE PA 17013 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a survivin9 spouse from tax, and the statutory requirements for disclosure o[ assets and filing a tax return are still app[icable even if the survivin9 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 stepparent of the child is 0% [72 P& §9116(a)(1 2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]~ The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. {}9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY ESTATE OF KROENER. ELSIE M. FILE NUMBER 21 04 Include the proceeds of l/t~gation and the date the proceeds were received by the estate. All property joint/y-owned with the right of survivorsh ITEM NUMBER DESCRIPTION &dams County National Bank checking acct #182796 Lake Sunapee Bank checking acct #8234198690 Bluesheild Premium Refund 05~ , must be ~;i~;uaed on Schedule F. VALUE AT DATE OF DEATH 1,44902 2,197.78 346.92 TOTAL (Also enter on line 5, Recapitulation) (If more space is needed, insed additional sheets of the same size) COM~OHNEWR~A. iT~r~H_O~ PENNSYLVANIA FUNERAL EXPENSES & ESYATEOF~'~H^~'~rAXRETURN ADMINISTRA IVE 0 T ~ FILE NUMBER Debts of decedent must be reported on Schedule I. rTEM NUMBER 8. 9. 10. FUNERAL EXPENSES: DESCRIPTION Cremation Society of PA - for coroner - inscription on gravestone Department of Public Welfare Class 3 ADMINISTRATIVE COSTS: Personal Representative's Commissions Nameof Pemonal Representative (s) Sylvia Camp Social Secudty Number(s) / EIN Number of Personal Representative(s) StmetAddress 40 Hemlock Circle City Newville State PA Year(s) Commission Paid: 2004 AttomeyFees Broujos & Gilroy, P.C.; EIN 23-2267691 Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant N/A Zip 17241 Street Address State Relationship of Claimant to Decedent None Zip Probate Fees Register of Wills ccountant s Fees Tax Retum Preparer's Fees Register of Wills - Inheritance Tax Return filing fee Register of Wills - Inventory filing fee Register of Wills ~ Famiry Settlement Agreement filing fee TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 25.00 95.00 20,264.62 700.00 700.00 49.00 15.00 10.00 17.00 Z X COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL KROENER, ELSIE M. DATE OF DEATH (MM-DD-Year) 06/05/2004 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT DATE OF BIRTH (MM-DD-Year) 03/05/1906 OFFICIAL USEONLY FILE NUMBER 2 1 -0 4 0 5 5 9 SOCIAL SECURITY NUMBER 1 8 4-4 2-9 7 8 0 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER [] 1. Odginal Retum [] 2. Supplemental Retum [] 3. Remainder Return (,~a~eor~a~ pr~or~ 12-13-821 [] 4. Limited Estate [] 4a. Future Interest Compromise (,~ ofd~a~ a~r 1242-82) [] 5. Federal Estate Tax Retum Required [] 6 Decedent Died Testate (A~ach copy of WillI [] 7, Decedent Maintained a Living Trust lA, ach copy of Trust) 0~ 8. Total Number of Safe Deposit Boxes [] 9. Litigation Proceeds Received [] 10. Spousal Povedy Credit (date of 8e~ be~e~ 12.31-81 and 1-1-95) [] 11. Election to tax under Sec. 9113{A) IAttach SCh O) THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: COMPLETE MAILING ADDRESS 4 NORTH HANOVER STREET NAME JOHN H. BROUJOS1 ESQUIRE FIRM NAME (If Applicable) BROUJOS & GILROY~ P.O. TELEPHONE NUMBER 717-243-4574 CARLISLE PA 17013 1, Real Estate (Schedule A) (1) 2 Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnemhip or Sole-Prepdetorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5~ Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Pmperiy (Schedule F) (6) ] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probato Property (7) (Schedule G or L) 8. Total Gross Aesets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent. Mortgage Liabilities. & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Govemmental Bequests/Sec 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) F. ~ OFFICIAL USE ONLY CJ 3~993.72 (8) (11) (12) (13) 3~993.72 21~875.62 17~ 197.29 39~072.91 -35,079,19 (14) -35~079.19 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at ~he spousal tax rata, or transfers under Sec. 9116 (a)(1.2) X (15) l& Amount of Line 14 taxable at lineal rate X __ (16) 17. Amount of Line 14 taxable at sibling rate X .12 (17) 18. Amount of Line 14 taxable at collateral rate X ,15 (18) 19. Tax Due (19) 0.00 0.00 · · BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < < Decedent°s Complete Address: STREET ADDRESS Green Ridge Villa~le - Swaim Health Center 210 Big Spring Avenue CiTY Newville I STATE PA ZIP 17241 Tax Payments and Credits: 1. Tax Due(Page 1 Line 19) Credits/Payments A. Spousal Poverty Credit B. Prior Payments C, Discount 85.00 3, Interest/Penalty if applicable D, Interest E. Penalty (t) Total Credits ( A + B * C ) (2) Total Interest/Penalty ( D + E ) (3) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) If Line I + Line 3 is 9rearer than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 85.00 85.00 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedect make a transfer and: Yes No 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 ...................................................................................................... [] [] d. receive the promise for life of either payments, benefits or care? ............................................................. [] [] If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?. .............................................................................................. [] [] Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ................. [] [] Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ................. ~ ..................................................................................... [] [] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of pedury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete, Declaration of preparer ether than the personal representative is based on all ~nformation of which preparer has any knowledge. ADDRESS Syl~vf'a K. Camp, Executrix, 40 I~emk~'c.K, Circle, I'~wville SIGNATURE OF PREPA'I~ER O~'HI~R THAN RE1~R'~NTATIVE ADDRESS 4 N.¢a~over Street ~ Carli~ ~ DATE PA 17241 DATE PA 17013 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% F2 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after 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 stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. COMMONWEALTH OF PENNSYLVANIA INHERtTANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS,& MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER KROENER. ELSIE M. 21 04 O~O~ Include the proceeds of litigation and the date the proceeds were received by the estate. All proper~y jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1,449.02 Adams County National Bank checking acct #182796 Lake Sunapee Bank checking acct #8234198690 Bluesheild Premium Refund 2,197.78 346.92 TOTAL (Also enter on line 5, Recapitulation) $ 3,993.72 (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF KROENER. ELSIE M. Debts of decedent must be reported on Schedule I. FILE NUMBER ITEM NUMBER DESCRIPTION AMOUNT 8. 9. 10. FUNERAL EXPENSES: Cremation Society of PA - for coroner - inscription on gravestone Department of Public Welfare Class 3 ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative (s) Sylvia Camp Social Secudty Number(s) / EIN Number of Personal Representative(s) StreetAddress 40 Hemlock Circle City Newville State PA Year(s) Commission Paid: 2004 AttomeyFees Broujos & Gilroy, P.C.; EIN 23-2267691 Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation) Claimant N/A Zip 17241 Street Address city Relationship of Claimant to Decedent None Probate Fees Register of Wills Accountant% Fees Tax Return Prepare¢s Fees State Zip Register of Wills - Inheritance Tax Return filing fee Register of Wills - Inventory filing fee Register of Wills - Family Settlement Agreement filing fee TOTAL (Aisc enter on line 9, Recapitulation) $ 25.00 95.00 20,264.62 700.00 700.00 49.00 15.00 10.00 17.00 21~875.62 (If more space is needed, insert additional sheets of the same size) COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF R. ELSIE M. NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS (include outdght spousal distributions) Sylvia K. Camp 40 Hemlock Circle, Newville, PA 17241 Joanna Bowlin 118 Dudley Oxford Road, Dudley, MA 01571 Jonathan Camp 21 Collins Street, Amesbury, MA 01913 Susanna Camp 3 Greenwood Way, Mill Valley, CA 94941 FILE NUMBER 21 04 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) daughter granddaughter grandson granddaughter 0559 AMOUNT OR SHARE OF ESTATE 70% 10% 10% 10% TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS NON-TAXABLE DISTRIBUTIONS; A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE ON REV 1500 COVER SHEET COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX .,22 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-14-2005 KROENER 06-05-2004 21 04-0559 CUMBERLAND 101 JOHN~H BROUJOS ESQ BROUJOS & GILROY 4 N HANOVER ST CARLISLE PA 17013 *' REV-1547EX AFP U2-04) ELSIE M Allount Rellitted 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 ~ ilE-y :rAl,"f-Ex--i.FP--Cilr:6'!rtlllft'CE"'jjj!"J;NHER"I"i'AN"CE"TAX"APPRA"iSEiI"€Nt~"-i.i:t'jjWANCE-OR"---------"-""""" DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KROENER ELSIE M FILE NO. 21 04-0559 ACN 101 DATE 02-14-2005 TAX RETURN WAS: (X J ACCEPTED AS FILED J CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. stocks and Bonds (Schedule 8) 3. Closely Held stock/Partnership Interest [Schedule C) 4. "ortgages/Notes Receivable (Schedule DJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property {Schedule fJ 7. Transfers (Schedule Gl 8. Total Assets IlJ (2J (3J (4J (5J (6J (7] .00 .00 .00 .00 3,993.72 .00 .00 (8J APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9J nOJ 21,B75.62 17.197.29 1l1J 1l2J 1l3J 1l4J NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total o~ ~ ASSESSMENT OF TAX: 15. Amount of line 14 at Spousal rat. (15) 16. Amount of line 14 taxable at lineal/Class A rate (16) 17. Amount of line 14 at Sibling rate (17) 18. Amount of line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due DITS: NOTE: To insure proper credit to your account~ submit the upper portion of this form with your tax payment. 3,993.72 ~9.n7:> 91 35,079.19- .00 35,079.19- 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = .00 X 045 = .00 X 12 = .00 X 15 = 1l9J= + INTEREST/PEN PAID (-J .00 .00 AMOUNT PAID 85.00 85.00- DATE 08-06-2004 02-07-2005 NUMBER CD004246 REFUND ~ TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 .00 .00 .00 .00 .00 .00 .00 .00 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)~ YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.J . ~ . . -- , -- BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* KEV-liD? EX AFP 112-D.) JOHN H BROUJOS ESQ BROUJOS & GILROY 4 N HANOVER ST CARLISLE PA 17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 02-22-2005 KROENER 06-05-2004 21 04-0559 CUMBERLAND 101 ELSIE M Allount Relli tted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ... 1~:r&&~.!5r~~~..rG1~if!'...........:rA~!~f1r~A1r.~'11r1~.~~.A~C!dO~....ii.........._.......... ESTATE OF KROENER ELSIE M FILE NO. 21 04-0559 ACN 101 DATE 02-22-2005 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-07-2005 PRINCIPAL TAX DUE:. .00 PAYMENTS (TAX CREDITS): ~ PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID " DATE NUMBER INTEREST/PEN PAID (-) 08-06-2004 CD004246 .00 85.00 02-07-2005 REFUND .00 85.00- TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00 . SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), .._u ~.v DC mil: A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. ) CERTIFICATION OF ESTATE FINAL INVENTORY OF ASSETS File No. 21-04-0559 In the Estate of Elsie M. Kroener, Deceased I, John H. Broujos, attorney for the Estate of Elsie M. Kroener certify the below is the final inventory of estate assets. DATE:MarchlL,2005 .) ITEM NUMBER 1. 2. 3. BY: DESCRIPTION Adams County National Bank checking acct #182796 VALUE AT DATE OF DEATH 1.449.02 Lake Sunapee Bank checking acct #8234198690 Bluesheild Premium Refund 2,197.78 346.92 v-- TOTAL (Also enter on line 5, Recapitulation) $ . (It more space is needed. Insert additional sheets of the same size) 3993.72 Family Settlement Agreement File No. 21-04-0559 THIS is an agreement entered into this -t/"-(' day of February 2005, by and between Sylvia K. Camp, Executrix and Beneficiary under the Estate of Elsie M. Kroener, of 40 Hemlock Circle, Newville, P A ] 7241, (Executrix), and Joanna Bowlin of 118 Dudley Oxford Road, Dudley, MA 0]57], Jonathan Camp of21 Collins Street, Amesbury, MA 0] 913 and Susanna Camp of3 Greenwood Way, Mill Valley, CA 9494], Beneficiaries, whose names are set forth as signatories at the end of this Agreement. WHEREAS: A. Elsie M. Kroener of Green Ridge Village, Swaim Hea]th Center, 2] 0 Big SpringRmid Newville, PA, died on June 5, 2004. B. On June 15,2004, Letters Testamentary were granted to Sylvia K. Camp at Cumberland' County File No. 21-04-0559 in the Register of Wills Office for Cumberland County, Pennsylvania. C. Executrix has administered the estate up until the present time and has paid all debts of the estate. D. The Estate has received assets as set forth in Schedule E and attached hereto and made part of hereof: has paid debts and expenses as set forth in Schedule Hand] attached hereto and made a part of hereof. E. There remains for distribution the sum of $0. F. Executrix and Beneficiaries desire to forego a formal accounting and schedule of distribution and desires to conclude the estate by virtue of the filing of this document. NOW, THEREFORE, Executrix and Beneficiaries, intending to be legally bound, state as fullc\vs: ]. The Executrix and Beneficiaries agree that the Executrix of the Estate of Elsie M. Kroener need not file a formal accounting or schedule of distribution. 2. Executrix states that all costs of the estate are paid. 3. The parties agree that there are no assets remaining for distribution after payment of the above-mentioned fees. 4. The parties acknowledge that any distribution made by Executrix pursuant to this Agreement is an "at risk" distribution pursuant to 20 P.S. 3532. Beneficiaries hereby release Executrix with respect to acts or omissions in the administration and distribution of the estate and hereby agree to return such funds as were distributed wlder the administration of the estate as may be required for the payment of any proper claims not discharged prior to this distribution. 'v'- 5. The parties designate this statement as a "satisfaction of award" and hereby authorize and direct the Clerk of Orphans' Court to make satisfied of record any award which may subsequently be made by the Court with respect to the distribution made to the distributees in this Agreement. 6. The parties agree that this Family Settlement Statement shall be filed with the Clerk of Orphans' Court in final settlement of the estate of Elsie M. Kroener, subject to the provisions hereof. IN WITNESS WHEREOF, Executrix and Beneficiaries, intending to be legally bound, hereby set their hands and seals the day and year first above written. WITNESS: Sylvia K. Camp, Executrix and Beneficiary JoannaBowlin, ~Meuciary . .r...::.... . "'\d,~, ~" c,..-' ,,'"' "'--_--- Jonathan Camp, Beneficiary Susanna Camp, Beneficiary CUMBERLAND COUNTY REGISTER OF WILLS 1 COURTHOUSE SQUARE, CARLISLE, PA 17013 In the Estate of Elsie M. Kroener, Deceased File No. 21-04-0559 RELEASE I acknowledge receipt of the Family Settlement Agreement, Inheritance Tax Return, and letter from John H. Broujos, attorney for Estate, and do accept the contents thereof, and do hereby release, remise, quit claim and forever discharge the Estate and the Executrix, the heirs, successors, and assigns from any and all actions, payments, claims, and demands whatsoever arising out of the administration ofthe Estate. IN WTNESS WHEREOF, the undersigned sets the hand and seal of the releasor this 10 day of February 2005. BY ~~ r Px"JN-Z Beneficiary Family Settlement Agreement File No. 21-04-0559 THIS is an agreement entered into this ~ day of February 2005, by and between Sylvia K. Camp, Executrix and Beneficiary under the Estate of Elsie M. Kroener, of 40 Hemlock Circle, Newville, P A 17241, (Executrix), and Joanna Bowlin of 118 Dudley Oxford Road, Dudley, MA 01571, Jonathan Camp of21 Collins Street, Amesbury, MA 01913 and Susanna Camp of3 Greenwood Way, Mill Valley, CA 94941, Beneficiaries, whose names are set forth as signatories at the end of this Agreement. WHEREAS: A. Elsie M. Kroener of Green Ridge Village, Swaim Health Center, 210 Big Spring Road Newville, P A, died on June 5, 2004. B. On June 15,2004, Letters Testamentary were granted to Sylvia K. Camp at Cumberland County File No. 21-04-0559 in the Register of Wills Office for Cumberland County, Pennsylvania. C. Executrix has administered the estate up until the present time and has paid all debts ofjhe estate. D. The Estate has received assets as set forth in Schedule E and attached hereto and made'pl:lrt of hereof; has paid debts and expenses as set forth in Schedule H and r attached hereto and made';a part of hereof. ; ,: '" c E. There remains for distribution the sum of $0. F. Executrix and Beneficiaries desire to forego a formal accounting and schedule of distribution and desires to conclude the estate by virtue of the filing of this document. NOW, THEREFORE, Executrix and Beneficiaries, intending to be kgally bound, state as follows: I. The Executrix and Beneficiaries agree that the Executrix of the Estate of Elsie M. Kroener need not file a formal accounting or schedule of distribution. 2. Executrix states that all costs of the estate are paid. 3. The parties agree that there are no assets remaining for distribution after payment of the above-mentioned fees. 4. The parties acknowledge that any distribution made by Executrix pursuant to this Agreement is an "at risk" distribution pursuant to 20 P.S. 3532. Beneficiaries hereby release Executrix with respect to acts or omissions in the administration and distribution of the estate and hereby agree to return such funds as were distributed under the administration of the estate as may be required for the payment of any proper claims not discharged prior to this distribution. 5. The parties designate this statement as a "satisfacti,JU of award" and hereby authorize and direct the Clerk of Orphans' Court to make satisfied of record any award which may subsequently be made by the Court with respect to the distribution made to the distributees in this Agreement. 6. The parties agree that this Family Settlement Statement shall be filed with the Clerk of Orphans' Court in final settlement of the estate of Elsie M. Kroener, subject to the provisions hereof. IN WITNESS WHEREOF, Executrix and Beneficiaries, intending to be legally bound, hereby set their hands and seals the day and year first above written. WITNESS: Sylvia K. Camp, Executrix and Beneficiary Joanna Bowlin, Beneficiary Jonathan Camp, Beneficiary ~~C~ Susanna Camp, Benefic ~ CUMBERLAND COUNTY REGISTER OF WILLS 1 COURTHOUSE SQUARE, CARLISLE, PA 17013 In the Estate of Elsie M. Kroener, Deceased File No. 21-04-0559 RELEASE 1 acknowledge receipt ofthe Family Settlement Agreement, Inheritance Tax Return, and letter from John H. Broujos, attorney for Estate, and do accept the contents thereof, and do hereby release, remise, quit claim and forever discharge the Estate and the Executrix, the heirs, successors, and assigns from any and all actions, payments, claims, and demands whatsoever arising out ofthe administration of the Estate. IN WITNESS WHEREOF, the undersigned sets the hand and seal ofthe releasor this lif day of February 2005. BY~. CUMBERLAND COUNTY REGISTER OF WILLS 1 COURTHOUSE SQUARE, CARLISLE, PA 17013 In the Estate of Elsie M. Kroener, Deceased File No. 21-04-0559 RELEASE I acknowledge receipt of the Family Settlement Agreement, Inheritance Tax Return, and letter from John H. Broujos, attorney for Estate, and do accept the contents thereof, and do hereby release, remise, quit claim and forever discharge the Estate and the Executrix, the heirs, successors, and assigns from any and all actions, payments, claims, and demands whatsoever arising out of the administration of the Estate. IN WITNESS WHEREOF, the undersigned sets the hand and seal of the releasor this ....F'f day of February 2005. ,~:~ ";/ .:::'~- ~_..C-'- BY .'_t-{-. .... ,/: "c: Beneficiary .,..4f"~ r' t.-/ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/25/2006 BROUJOS JOHN 4 NORTH HANOVER STREET CARLISLE, PA 17013 RE: Estate of KROENER ELSIE M File Number: 2004-00559 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/05/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregarc this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 4/25/2006 CAMP SYLVIA K 40 HEMLOCK CIRCLE NEWVILLE, PA 17241 RE: Estate of KROENER ELSIE M File Number: 2004-00559 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 6/05/2006 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: ~{ C; ( t::: 1'1. 'K.ro-e.lney~ Date of Death: & /6 S-j :2 0 c t I ( Estate No.: ;2 0 C ~+ - c:: 0 Sd:; l' Pursuant to Rwe 6.12 of the Supreme Court Orphans' Court Rwes, 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 IZL No 0 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 III No 0 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!EL No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: ~1 c~')/ {} (; / f ;;;:f;A--C~ K u-,-,,/ Signature --S Y \ \J' ,ex.. ~,C~ ~Vv\.-p Name Lf () -H e '-'1A- " 0 ~-k C '- vel ~ \J e \-lJv" dl e -p;t Address ( 7 d Y{ 7 ( 7-77 {, -_. 8~( c Telephone No. Capacity: ~PeTsonal Representative o Counsel for personal representative (J~l . \(\ \ :tv) < \\lJ' STATUS REPORT tJNDER RULE 6.12 Name of Decedent: Elsie M. Kroener Date of Death: June 5.2004 Estate No.: 2004-00559 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules. I report the foll()\ving with respect to completion of the administration of the above-captioned estate: 1. State whether administration oCthe estate is complete: Yes 0 No [Xl 2. If the answer is No. state when the personal representative reasonably believes that the administration will be complete: December :5. 2006 3. If the answer to No. I is Yes. state the following: a. Did the personal representative tile a final account with the Court'? Yes 0 No C 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 0 No 0 Date: c. Copies of receipts. releases. joinders and approval of formal or informal accounts may be filed with the Clerk oCthe Orphans' Court and may be a[[achcd to this report. \ \ ~y ,...... September 5. 2006 \ ~~ 1, JC ex: -:..:t:. ~o.. a: c ,e) LLQC' OUr-' ~~ (/) 2:: o::~::- ~'. LU..... ..J C.. U. I.J.~ 0... l,. a:: ~..~ 05 u John H. Brouios \ iJ t/') Name C::. tr) I a... w (/) ...0 c=l <=> c-.... 4 North Hanover Street. Carlisle. PAl 7013 Address 717-243-4574 Telephone No. Capacity: D Personal Representative [Xl Counsel for personal repres{~ntative \ ijJ