HomeMy WebLinkAbout04-0609PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
also known as ~ ~ To:
Social Security No. /7 7- z~O~ '--,'~-q "'3-
Register of Wills for the
Deceased. 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 lite; durante absentia; durante minoritate)
the above decedent. ~ ~'~rn6~f/~.~_ ~,
Decendent was domiciled at death in'~~6;~~'
County, Perlnsylvan~, w~th, ~ .
h ! % last family or principal residence at C-5~cZ ~])6~C/~, / ,~/~ ~.. ~]O~c~/~ .
(list stree~ number anti'municipality) /
Decendent, then ~ ~ years of age, died x._J(z/~ ~ ~.~ ~B , J~ ,
at /:
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 wa~-gUrvived 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 ~
COUNTY OF ~t~ 5'C//~ L~1~ 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
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to or affirme~d and subscribed c'
before me this 2°! __ __dayof ~ !
Estate of
ava 3'-. fVL(l.~fft.a~Lixl ~,Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW ~3-~L.L Ik~ E- ~G{ Iff , in consideration of the petition on
the reverse side hereof, satisfactory proof having been pres~ented before me,
IT IS DECREED that
(~are ~ntitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to ~/x,f ~c- /~.
in the estate of
q0.00_
Letters of Administration ..... $
Short Certificates(2.) .......... $ {~ ' C) O
.$
Renunciation ....... TOTAL'~{~' ~~
Filed ..................... A.D. 19
Register of Wills ~,~ ~/~,
/
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 duly filed witL mr as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permane0,t filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
Fee for this certificate, $2.00
P 10372329
No.
Local Registrar-
Date
PERMANENT
BLACK INK
143Re¥ ~a7 COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
$ ECURiT ~' ;;EMLtERNua*~'R
OF
DECEDENT
,.Monroe J. McCauslint Sr. ],.Male 1~177 --24 --5592
~,75 '~l I I I 1.210/192 I. ~1~
COUNTY ~ D~H ~ CI~. ~RO, ~ OF ~TH ~ FAClLt~ ~ME (if ~ in~, ~ ~ ~ ~) lW~ ~CE~ OF HI~IC ~IGINI IRACE
~,. mu~xn I,.~ P~n ~,. ~t~c ~spi~l I~.'~'~"""'""' 1,o. White
DECEDENT'S USUAL OCCUPATION I KIND OF BUSINESS I INDUSTRY AS DECEDENT EVER INDECED~ NT'S EDUCATIONMARITAL STATUS - Ma~d. SURVIVING S~USE
,,. Butch~ I,~. ~t Pressing ilz I'~' I b4. ~i~ ~ ,~ A. M~list~
DECEOEm'S MAILI~ A~ESS (S~. ~a~n, ~m, Zip ~) IACTUAL~CEDENFS ~7..
389 Shyly ~ .ES,~.~
~. ~lCS~g, PA 17055 I~)
MOTHER'S NAME ( FL-'~, Middle. Maiden Surname)
.. Hazel Stoner
I,~. 389 Sheel~ l_~ne Mechanicsburg, PA 17055
IDATE OF DISPOSITION(MOe~, Day. y--) IPLAcE°ED's~'T'°No, ~. ~ ....
[] z,b. June 28, 2004 ,,cStone Church Cemetery ,~,.Enola. PA 17025
I,~,. FD-014889 I,~.MalDezzi 8 M~Ret P]a~ 9~v M=rf~ni~=h~o. PR 1~55
(Signature and T,tie) I IlMonth, Day Yea0
/.'tS 2-%. 2OOH I'". Y,,I-I "o Z]
Yes [] NO
CERTIFIER (CheCk o~y O~e)
' ~OE tRhlleFl~tOorRY~dclA 'NO~ (?hy$ .~ai] c~llf~ing ~ausa Of ..... he ...... r phys~ ..... p ............. r~ com~ete~i ilem 23)
'PRONOUNCING AND CERTIFYING PHYSICIAN (Physicmn bo~h Ixo~ouncmg (leath and c~r~ifying Io c~use of OeeC)
*MEDICAL EXAMINER/CORONER
AVAILABLE PRIOR TO (M~lh. Day
COMPLETION OF CAUSE Nature/~'/ Homic~de []
~- 13Od.
~ LICENSE NUMBER DA~ ~IGNED (M~ Day. Year)
I NAME J~ND ADDRESS OF PERSON ¥'~10 COMPLETED CAUSE OF DEATH
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717)240-6345
Date: 10/05/2004
MCCAUSLINANNA A
389 SHEELEY LANE
MECHANICSBURG, PA 17055
RE: Estate of MCCAUSLIN MONROE JR SR
File Number: 2004-00609
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 D24ENDMENTS 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 10/09/2004
Your prompt attention to this matter will be appreciated.
Thank You.
cc:
File
Counsel
Judge
Sincerely,
Clerk of the Orphans' Court
JRD/June 30, 1992/17858
In Re: Estate of Monroe Jr McCauslin, Sr.
Late of Hampden Township
Estate No.: 21-04-609
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21-2004-0609
NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT
ORPHANS' COURT RULE
Personal Representative: Anna A. McCauslin
Counsel for Personal Representative:
Date of Grant of Original Letters: 06-29-2004
Date of Delinquency Notice: 10-09-2004
The undersigned, Glenda Farner-Strasbaugh, Clerk of the Orphans' Court, in accordance
with Rule 5.6, Supreme CourtOrphans' Court Rules, hereby notifies the Orphans' Court
Division, Court of Common Pleas of Cumberland County, that neither the above named personal
representative nor the above named counsel for the personal representative have filed with the
Register of Wills or Clerk of the Orphans' Court his, her or its certification required by Rule
5.6(e), Supreme Court O '
rphans Court Rule and that the requisite notice, pursuant to Rule 5.6(e),
Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on October
09, 2004, and that the ten (10) day notice to file the certification has expired. Accordingly, in
accordance with Rule 5.6(e) the Court is hereby notified of such delinquency and the
pndersigned requests that a Court conduct a hearing to determine whether sanctions should be
~mposed upon the delinquent personal representative or counsel for the delinquent personal
representative.
Date: 11-08-2004
Distribution:
'Glenda Farner Strasb,augh'~-°"~-GA..
Clerk of the Orphans Court
Personal Representative
Counsel for Personal Representative
Estate File
A hearing is scheduled for at in Courtroom No. 3. If the Certification of Notice is
filed prior to the hearing date, the hearing will automatically ~j414/l~
George~. ~ff~er,~.J.Ir **
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name ofDecedent: //~ftq~ ~j ~ (/7~]~5/~'/~/ 9/ ~
Date of Death: d~]')~ 6~,~. ~,~0~F
Will No.
To the Register:
Admin. No. c~/-t~J~--~7
I certify that notice of (beneficial interest) ~ required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on
Name
?
Address
71/?
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
Signature
Address ~/
Telephone (~]~)
Capacity: ~Personal Representative
Counsel for personal representative
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 4/25/2006
MCCAUSLIN ANNA A
389 SHEELEY LANE
MECHANICSBURG, PA 17055
RE: Estate of MCCAUSLIN MONROE JR SR
File Number: 2004-00609
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:
6/23/2006
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
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Register of Wills of Cumberland County
Name of Decedent:
STATUS REPORT UNDER RULE 6.12
/J1t/Y1 ('0 l- (YUL ~
(0 (Q&1dIJ
a bb<.\ - \)~
Date of Death:
Estate No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes tj 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. I is Yes, state the following:
a. Did the person~c:B.resentative file a final account with the Court?
Yes 0 No I::r"
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal r~sentative state an account informally to the parties in
interest? Yes gr -- No 0
Date:
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. Q,~
'6f7((){f; &~ ~/
Signature
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Name
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Capacity:
I!1 Personal Representative
o Counsel for personal representative
~
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPA~TMEN'i• OF REVENUE
'~j ~~j`~~~ ~~ }'•~~,,~ ',lfbTICE OF INHERITANCE TAX
.kryk~•if•, ~APRRAlSEMENT, ALLOWANCE OR DISALLOWANCE
`, ,,..,., vlLL[l LJi Of~~~DEDUCTIONS AND ASSESSMENT OF TAX
zee ~u~ - ~ ~n ~ ~ oa,
~~IS
ANNA A MCCAUSLI~(~RI.AND CQ,
389 SHEELEY LN
MECHANICSBURG PA 17055
REV-1547 EX AFP (06-05)
DATE 06-30-2008
ESTATE OF MCCAUSLIN SR MONROE J
DATE OF DEATH 06-23-2004
FILE NUMBER 21 04-0609
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 08-29-2008
(See reverse side under Objections)
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 C03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MCCAUSLIN SR MONROE J FILE N0. 21 04-0609 ACN 101 DATE 06-30-2008
TAX RETURN WAS: C ) ACCEPTED AS FILED C X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
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
cl) .00
C2) .00
c3) .00
c4) .00
c5) .00
c6) .00
t7) .00
ca)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
.00
APPROVED DEDUCTIONS AND EXEMPTIONS: .00
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) C9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions X11) .00
.0 0
12. Net Value of Tax Return X12)
.00
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) C13)
.00
14. Net Value of Estate Subject to Tax C14)
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:
00
00
.0 0
15. Amount of Line 14 at Spousal rate C15) • X =
16. Amount of Line 14 taxable at Lineal/Class A rate C16) • 00 X 045 = . 00
17. Amount of Line 14 at Sibling rate (17) .00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate C18) •00 X 15 = .00
i
l
19
P
i T e
D (19)= .00
nc
pa
.
r ax u
1 J
PA NT
DATE
CEIPT
NUMBER
ISCO ~+
INTEREST/PEN PAID C-)
AMOUNT PAID
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
^ IF PAID AFTER DATE INDICATED, SEE REVERSE C IF TOTAL DUE IS LESS THAN 81, 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.)
REV-1470 EX (&88) }~" '
INHERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDIVIDUAL TAXES
PO Box. 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME FILE NUMBER
Monroe J. McCauslin 2104-0609
„~..~..~~u~ Eunice Baker ~ 101
ITEM
SCHEDULE NO, EXPLANATION OF CHANGES
This is a Commonwealth Appraisement to waive the filing requirement of the above estate.
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