HomeMy WebLinkAbout04-0584PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
also known as
Deceased.
Social Security No. ] ~ /' ~.~ - ~ /,~ I
To:
Register of Wills for the
County of ('~ t.~cc~/b£stCAL~/)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 lite; durante absentia; durante minoritate)
the above decedent.
Decendent was domiciled at death in ~ .[~_.~ L~
County, "~en ylvama, w~t
h I-5 last family or principal residence at ! ~ '- ~d · /_ 0 q/a~ i 0''7-
(list street, ~umber and muniCii~ality)
Decendent, then ~9~ years of age, died '~"(.Jdk~ ~ / ~ ,(~90C) L[ ,
at
Decendent at death owned property with estimated values as folllows: ~'! 09 o
(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
the following spouse (if any) and heirs:
Name Relationship Residence
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF
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 affirme~ and subscribed
be~6i~ me this e2~e~P:c~-~' .d~y of
Estate of ~(~yw- ~-"~ I~<~-~
,Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW , ~ k ? h ~. ~ ~'~, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that
is/are entitled to Letters of Ad'ministration, and in accord with such finding, Letters of Administration
are hereby granted to
/ I
in the estate of ~ '~
FEES
Letters of Administration ..... $
Short Certificates( ) .......... $
Renunciation ................ $
ATTORNEY(Sup. Ct.I.D. No.)
ADDRESS
PHONE
his is to certify that the information here given is correctly copied from an original certificate of death
l.ocal Registrar. The original certificate will be forwarded to thc State Vital Records Office for pe]'manct}~
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
No.
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
Robert L. Blosser . - -- -- 5 31 - 6/12/2004
, M 3 161 3'2 1 ·
63 ',,.. i B. 8/30/1940 arrisburg, PA .'"..-'--~ ~o~,,.~ Ci ~
~rl=d I-. ~uth ~d~e~n' _~. ~r ~re H~lth Se~i~s ,~'--.~ ..... ,0. ~ite
~thleh~ Stol ~. -- 12~'a / (,,~.,
,,~ Steel Cutter
140 W. Locust St., Apt C
Carlisle, PA 17013
,.. Merle - Blosser
~, Kimberly A. Myers
PA
~.~-~ Carlisle
.-.. c,,..., Cumberland
,.. Eli~th S. Va~er
~ 401 Potato Rd.; ~rlisle, PA 17013
~ ... 6/15/2004 I~st Harrisburq ~Crm ~,,,. Harris~rq, PA
~~~~ ~2., ....... J:,~:~ ~:~3. ~ l~in, B~thers ~eral H=. Inc., ~rlisle, PA
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Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717)240-6345
Date: 10/05/2004
MYERS KIMBERLY
401 POTATO ROA]D
CARLISLE, PA 17013
RE: Estate of BLOSSER ROBERT
File Number: 2004-00584
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.7 (a) 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 ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of Wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing will become delinquent on 10/02/2004
Your prompt attention to this matter will be appreciated.
Thank You.
CC:
File
Counsel
Judge
GLENDA FARNER STRASBAUGH
Clerk of the Orphans' Court
Adm/n. No.
To the Regismr:
I certify that notice of (bene~dal interes0 ~ required by Rule 5.6(ahqf the Orphans' oun Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on /__~) ~ ~,,V~) ~/ :
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Capacity: __
. Personal Representative
Counsel for personal representative
Cumberland County - Reglscer ur Wl~~~
One Courthouse Square
Carlislel PA 17013
Phone: (717) 240-6345
Date: 4/25/2006
MYERS KIMBERLY
401 POTATO ROAD
CARLISLE I PA 17013
RE: Estate of BLOSSER ROBERT
File Number: 2004-00584
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 I NO. 103
SUPREME COURT RULES DOCKET NO. 11 for decedents dying on or after
July 11 19921 the personal representative or his counsell within two
(2) years of the decedent's deathl shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
6/12/2006
please feel free to contact this office with any questions you may
have. If you have already filed your Status Report I please disregard
this notice.
SincerelYI
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
r'ol1nsel
In Re: Estate of
BLOSSER ROBERT
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 2004-00584
NOTICE OF FAILURE TO FILE STATUS REPORT
Personal Representative:
MYERS KIMBERLY
Counsel for Personal Representative:
Date of Decedent's Death: 6/12/2004
The Orphans' Court record indicates that neither the above named personal representative
nor the above named counsel for the personal representative have filed with the Register of Wills
or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme
Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court
Orphans' Court Rules, is hereby given by that the you have ten (10) day to file the Status Report.
Tfthe required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notified of
such delinquency and the undersigned will requests that a Court conduct a hearing to determine
whether sanctions should be imposed upon the delinquent personal representative or counsel for
the delinquent personal representative.
Date:
7/10/2006
~~~
U.S. Postal Service
CERTIFIED MAIL RECEIPT
(Domestic Mail Only; No Insurance Coverage Provided)
Glenda Farner Strasbaugh
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Register of Wills of Cumberland County
STATIJS REPORT ~ER RULE 6.12
Name ofDecedent: R 0&;-1 L. .a. ~d
Date of Death: ((7 -I ~ - 04
Estate No.: o~ J - OV - Sgl(
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. Stat~p.ether administration of the estateJslc3:?\,let~:r If -i i/v, . . '\
Yes.- . No 0 DO/J-r /C'/l.JOUj NU J-F'lr8j1Vn/XDOILJ
2. If the fu"1SWer is No, state v;.rhen the personal representative reasonably believes that
the administration will be complete: C) O.~7 ICAJ6(~ J.J6 IfLILI?6~o;t
3. If the answer to No.1 is Yes, state the following:
a. Did tpe personal representative file a fmal account with the Courfl
Yes... No 0 D6td-e1U6W ,0 6 l~rll7~
, ,
b. The separate Orphans' Court No. (if any) for the personal representative I s
account is:
c. Did the personill ;;cpresentative s~. j an Rormt infOrmallY. to the parties in.
interest? Yes "No 0 t:IJ-00 I )..J 3 C/i\rf." M~
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.
Capacity:
erS
3:9 C1rrt.g/ .$)- hJ:1J /7
Address (Yfi r+v L~'15 fO"(}J ( l2
{(7 - Y g(, --~1.:r4) SR?~ I
Telepl10ne No.
~onal Representative
o Counsel for personal representative
Date:
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cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 5/22/2007
MT HOLLY SPRINGS, PA 17065
~-J
MYERS KIMBERLY
32 CENTER ST LOT 17
r.v
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C)
RE: Estate of BLOSSER ROBERT
File Number: 2004-00584
c'
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.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 is due by:
6/12/2007
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 Strasbaugi
Clerk of the Orphans' Court
cc: File
Counsel
Pa. O.C. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF aPl~~t..4tJ6
COUNTY, PENNSYL VANIA
Name of Decedent: ~~ L#
g~ ~Jif
Date of Death: t, - / ;l~ (j t.f
File Number:"'::O~ cj -- (!) (J &) ?? ~/
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 of the estate is complete: . . . . . . . ... . . . . . . . . .. ~es DNo
2. If the answer is No, state when the personal representative
reasonably believes that the adririnistration 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? . . . . . .. ~es DNo
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. Did the personal representative state an account q
''& II h .,. ? · -bv..T
l11.Lorma y to t e partIes m mterest. ..............,................. ~ I es
DNo
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.
Dace
S-p'l h 7
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Ca~acity: 79Personal Representative D Counsel
/ift:!:!Itg~ 1;,. A'rn-
3.2 (L;6r sf- 1o~411
Address . / ..J
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Telephone
17{)f,6
Form R 1+'-/ 0 rev. J 0 13.0'15
'iiJ
NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES ~~~~' LLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIYISION ~ ,.~$~;I~S AND ASSESSMENT l1F TAX
PO BOX 288601 ~ ~~~~ ~~ f y~ ~~ :.
HARRISBURG PA 17128-0601
Pennsylvania ~
DEPARTMENT OF REVENUE
REV-1547 EX AFP C10-09)
ZDO~ DEC -4 PM I: 4~ DATE 12-07-2009
ESTATE OF BLOSSER ROBERT L
MM ~~ DATE OF DEATH 06-12-2004
r~+n ~ FILE NUMBER 21 04-0584
~~+~ COUNTY CUMBERLAND
KIM A MYERS ~,~ Qj~ ACN 101
401 POTATO RD APPEAL DATE: 02-05-2010
CARL I SL E PA 17 013 (See reverse side under Objections)
Aoount Renitted ~~
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 1--~
-------------------------------------------------------------------------------------------
REV-1547 EX AFP C10-09) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF: BLOSSER ROBERT LFILE N0.:21 04-0584 ACN: 101 DATE: 12-07-2009
TAX RETURN WAS: ( ) ACCEPTED AS FILED C X) CHANGED $EE ATTACHED NOTICE
APPRAI SED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) .00 NOTE: To ensure proper
2. Stocks and Bonds (Schedule B) (2) ,OQ credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion
of this form with your
4. Mortgages/Notes Receivable (Schedule D) C4) •00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) .0 0
6. Jointly Owned Property (Schedule F) (6) .0 0
7. Transfers [Schedule G) (7) .0 D
8. Total Assets (8) .00
APPROV ED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (g) .00
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions (11) .00
12. Net Value of Tax Return (12) .0 0
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .0 0
14. Net Value of Estate Subject to Tax (14) .00
NOTE: If an assesssent was issued previously,
reflect figures that include the total
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
lines 14, 15 and/or 16, 17, 18 and 19 will
of ALL returns assessed to date.
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
TAX CREDITS:
DATE ~ NUMBER ~ INTEREST/PEN PAID C-)
C15) .00 )(
C16) _ 00 X
(17) _ 00 X
(18) .00 X
AMOUNT PAID
00 .00
045 = .00
12 = .00
15 .00
(19)= .00
TOTAL TAX PAYMENT .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" CCR), YOU MAY BE DU~~Q
FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FDR INSTRUCTIONS. ~ \
L
REV-1470 EX (688)
r _
INHERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
PO Box 280601
HARRISBURG PA 17128-0601
DECEDENTS NAME FILE NUMBER
Robert Blosser 2104-0584
REVIEWED BY ACN
Eunice Baker 101
ITEM
SCHEDULE NO.
EXPLANATION OF CHANGES
Efforts to file an Inheritance Tax return have been exhausted in the above referenced
estate. Therefore, the filing requirements have been waived. The Department however,
reserves the right to assess any assets that may be recovered at a future time.
Row Page 1