HomeMy WebLinkAbout04-0734 PATTERSON & KIERSZ, P.e.
ATTORNEYS A T LA W
239-B East Main Street 20 West Baltimore Street
Waynesboro, PA 17268-1681 Greencastle, PA 17225-1408
(717) 762-3170 Toll Free 800-261-1194 (717) 597-3180
Telefax (717) 762-0988 E-mail: pklaw~pattersonandkiersz~com Telefax (717) 597-5121
Stephen E. Patterson
Gregory L. Kiersz, CELA *
R. hom ,,u hy
August 4, 2004
Register of Wills
Cumberland County Courthouse
1 Courthouse Square
Carlisle, PA 17013
LETTER OF INTRODUCTION
Re: Estate of Lloyd R. Foreman Wk/a Lloyd Ralph Foreman
Date of Death: June 20, 2004
Dear Sir or Madam:
This letter of introduction is on behalf of Ruth R. Foreman, the Executrix named under the Last
Will and Testament of Lloyd R. Foreman.
Mrs. Foreman will be delivering the original will, a Death Certificate, and an original Petition
and Estate Information Sheet to you, together with the attached check in the amount of $108.00
representing the initial probate fee and filing fees.
After Mrs. Foreman has been sworn in as the executrix of Lloyd R. Foreman estate, would you
please send me two (2) Short Certificates via mail in the enclosed self-addressed stamped
envelope.
Sincerely,
w~tateXGC\Foreman, Lloyd R\Introduction Itt.doc
*Certified Elder Law Attorney, as certified by the National Elder Law Foundation
PETITION FOR PROBATE and GRANT OF LETTERS
also known as Lloyd R~lph Ynrom~n To:
Register of Wills for the
, Deceased. County of Cumberland in the
Social Security No. 186-28-4341 Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(~, ~ is~}l~ 18 years of age or older an the executrix named
in the last will of the above decedent, dated December 14, ~ 2000
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in Eumherl ~nd County, Pennsylvania, with
h is last family or principal residence at 316 I~11 ~ nE anvrt; ._qh~ ppen_ob,_,rg Borough
Cumberland County, Pennsylvania
(list street, number and muncipality)
Decendent, then .69_ years of age, died June
at Chambersburg Ho.qp-it~l.. E.h~mhor~h,,rg~ PA 17201
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent: No Exceptions
Decendent at death owned property with estimated valUes as follows:
(If domiciled in Pa.) All personal property $ 50,000.00
(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: __
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters Testamentary
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
~ . Forem6n
-~ o 314 Dwelling Court -
~ Shippensburg. PA 17257 ....
go ~,-~. ~
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF Cumberland
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 the above decedent petitioner(s) will wel~d truly~dmi~ter the estate, according to law.
Sworn to or affkmed and subscribed
before me this ~ day of J 'R~th
... ~ ;~,.~.~ ~:~ WARNING: IT IS ILLEGAL TO ALTER THIS COPY OR
~r~:~ ~:~ :~!I, TO DUPLICATE BY PHOTOSTAT OR PHOTOGRAPH.
¢;Fi:q,i I:2,~ F ,:' ~,:, COMMONWEAL}H OF P~'(NN~.YLrVANtA
DEPARTMENT OF HEAL] H VITAL ~ECOR[)~
LOCAL REGISTRAR'S CERT'IF~C~TiON OF DEATH
Sex ......... ~~'l~'cial Security No..(_~6- "'~ ~''''
...............
Date of Birlh ~~' ~, ~~rthplace ~,~
PaceofDeath~--~ ~" __.__ _~ ................. ; .... ; ...... ~~Pennsylvan,~
.ace ..... ~cupation _~ ~~rmed ~orces? (Yes pr No) ~_~__f~ .....
Decedent's * ·
,rfformant .... ~.~~%t_~~~___ Funeral Director
Funeral Establi~~- ~_~..~/ .........
Interval Between
Part J: Immediate Cause , Onset and Death
~d'
Manner of Death Describe how injury o~Ur.red ~ ~:~.,,
C)-'
Natural ~ Homicide i-
Accident .... :- Pending Investigation FF
Suicide i ] Could not be Determined L]
Name and Title of Ce~fie _
Address -/- ~_ (M.D., D.O., Coroner, M.E)
This is to certify that the information here given ~s correctly cop~ed from an original certificate
of death duly filed with me as Local Registrar. The original certificate wilt be forwarded to the
State Vitai Records Office for permanent filJn~~~~
Estate of Lloyd R. Foreman a/k/a Lloyd Ralph Foraman ,Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW August ~'~L~ ~ 200~4, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated December 14, 2000
described therein be admitte41 $oprobate and filed of record as the last will o'f
Lloyd R.' Foreman ~a~j~ RgJ2PH FOr'~ ~. ;
and Letters Testamentary
are hereby granted to Ruth R. Foreman
Register of Wills ~
FEES
Probate, Letters, Etc .......... $ ~tg. ® Gregory L. Kiersz 21928
Short Certificates(d) .......... $ ~. o~ ATTORNEY (Sup. Ct. I.D. No.)
R~noha~on .~i~ ~.~-~ !~) $ t ~' aZ) 20 West Baltimore Street
~_D $ IO OO Greencastle: PA 17225
~ t ADDRESS
TOTAL__ $ !0~. 00
Filed .~."..~.~J... t" .~L/.t'¢¢..~ ........ (717) 597-3180
PHONE
W:kXWkDOCS\WILLS\GC\Foreman, Lloyd R. Will.doc
LAST WILL AND TESTAMENT
I, Lloyd R. Foreman, of 314 Dwelling Court, Shippensburg,
Cumberland County, Pennsylvania, declare this to be my Last Will
and revoke any will previously made by me.
I. The expenses of my last illness and my funeral expenses (if
not pre-paid at the time of my death) shall be paid by my
estate.
II. I give all of my estate of every nature and L~erevqr
situate to my spouse, Ruth R. Foreman.
III. I specifically give the following:
A. To my grandson, Andrew J. Wrabella, my 1955
aut omob i 1 e.
B. To my granddaughter, Susan K. Iverson, a cash bequest
equal to the fair market value of my 1955 Chevrolet
automobile.
C. To my son-in-law, Peter C. Wrabella, all guns,
ammunition and gun accessories.
IV. In the event my spouse shall predecease me, I direct that
the residue of my estate be divided into twenty (20 shares
and I give to each of the following who survives me the
number of shares set forth below:
A. To Anne Marie Wrabella, my daughter, seven (7) shares.
In the event Anne Marie Wrabella fails to survmve me,
W:\XW%DOCS\WILLS\GC\Foreman, Lloyd R. Will.doc
I direct that her shares shall be given to her
husband, Peter C. Wrabella.
B. To Carol Jean Foreman, my daughter, seven (7) shares.
In the event Carol Jean Foreman shall predecease me,
the shares should be divided equally between Andrew J.
Wrabella and Susan K. Iverson, my grandchildren, or
the survivor of them.
C. To Andrew J. Wrabella, my grandson, three (3) shares,
or his issue per stirpes. In the event Andrew J.
Wrabella fails to survive me without issue, I direct
that his shares be given to Susan K. Iverson.
D. To Susan K. Iverson, my granddaughter, three (3)
shares. In the event that Susan K. Iverson fails to
survive me, I direct that her shares shall be given to
Justin Iverson, or his per stirpes. In the event that
Justin Iverson shall die without issue, I direct that
his shares shall be given to Andrew J. Wrabella.
In the event that any of the above-named beneficiaries
fails to survive me without a successor beneficiary then
surviving, I direct that his or her share be given to my
surviving beneficiaries in the same proportions they now
bear to each other.
V. Any property passing to a minor beneficiary (herein defined
as any beneficiary under the age of twenty-one (21) years)
W:\XW\DOCS\WILLS\GC\Foreman, Lloyd R. Will.doc
shall be held by Peter C. Wrabella, Custodian, under the
Pennsylvania Uniform Transfers to Minors Act, and my said
Custodian shall use said income and principal for the
benefit of the minor beneficiary as my Custodian alone
shall deem appropriate, pursuant to the terms of the Act.
Upon each minor beneficiary attaining twenty-one (21) years
of age, all remaining principal and interest in said
account shall be paid to him or her.
VI. All administrative costs, including inheritance taxes,
estate taxes and transfer taxes imposed upon my estate
passing under my Will or otherwise shall be paid out of the
principal of my residuary estate.
VII. I appoint as Executrix of this, my Last Will, Ruth R.
Foreman. In the event alternate or successor Executrices
may be required, I appoint as such Anne Marie Wrabella and
Carol Jean Foreman, or the survivor of them. I direct that
no trustee, executor, guardian or other fiduciary named,
nominated, or appointed in this Will shall be required to
post any bond or give any security of any type for any
purposes whatever.
.W:kXWkDOCS\WILLS\GC\Foreman, Lloyd R. Will.doc.
IN WITNESS WHEREOF, I, Lloyd R. Foreman, the above-named
Testator, have to this, my Last Will and Testament, set my hand
and seal this [~ day of 0~4~'~ , ~oo~
oreman
SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named
Testator, as and for his Will, in the presence of us, who at his
request, in his presence, and in the presence of each other,
have hereunto subscribed our names as witnesses in attestation
thereof.
~///~~ddr e s s
/~ //~~ Address
.W:\XW\DOCS\WILLS\GC\Foreman, Lloyd R. Will.doc.
COMMONWEALTH OF PENNSYLVANIA :
:SS
COUNTY OF FRANKLIN :
Lloyd R. Foreman, ~/C~/7 l' ~ ~ { 3~ , and
~~ ~. ~ ~ , t~e Testator and the witnesses
respectively,-- -- whose names are signed to the foregoing
instrument, being first duly sworn, do hereby declare to the
undersigned authority that the Testator signed and executed the
instrument as his Last Will and Testament and that he executed
it as his free and voluntary act for the purposes therein
expressed, and that each of the witnesses, in the presence and
hearing of the Testator, signed the Will as witnesses and that
to the best of their knowledge the Testator was at the time
eighteen years of age or older, of sound mind and under no
constraint or undue influence.
Witness ~ !
Subscribed, sworn to and acknowledged before me by the
Testator and subscribed and sworn to before me by
~-~. ~l~ ~. /~./FI~ ~ and _~ ~. ~"l~n'l.19~ .... ,
witne~ses~ this [~'-/z~ day of /~~ , ~
Notary Public ~
~ Notarial Seal
J ~Debra S. Pagach, Nora Public
M mr ~ ~ov. 12, ~
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Lloyd R. Foreman a/k/a Lloyd Ralph Foreman
Date of Death: June 20, 2004
Administration No: 21-04-0734 00734
To the Register:
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 September 2, 2004.
Name and Address:
Ruth R. Foreman
314 Dwelling Court
Shippensburg, PA 17257
Notice has now been given to all persons entitled thereto under Rule 5.6(a) without
exceptions.
Dated: September 2, 2004 ~
Gregory L. Kiersz, Coun~,sm~5~
Personal RepresSive
20 West Balti~n6re Street
Greencastle, PA 17225-1408
717-597-3180
COMMONWEALTH OF
PENNSYLVANIA REV'1500
DEPARTMENT OF REVENUE
DEPT. 28o o INHERITANCE TAX RETURN FILENUMBER
23. -- 04 00734
HARRISBURG,
PA
17128-0601
RESIDENT DECEDENT
DECEDENTS NAME (LA~T, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
~ Fore~n Lloyd R -
Z
UJ DA3E OF DEATH (MM-OD-YEAR) DATE OF BIRTH (MM-DD-YEAR) TH~ RETUI~I MUST BE FILED IN DUPUCATE '~qTH THE
UJ 6/20/2004 9/3.0/1934 REGISTER OF WILLS
(.3
i~1 (IF AFPLICABLE) SURVNING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCLAL BECUPJTY NUMEER
~ Ruth R. For~ 186-28-7375
<Mm r""~ t. Original Return [~] 2. Supplemental Return ~ 3. Remainder Return {date o, death
~ ~ r--] 4. Limited Estate ~] 4a, Fut[Jre Interest C~xllpromise {date of death ait~ 12-12-8~) [~ 5+ Federal Sst;Ae Tax ReAlm ReqMired
3:~O~' ~ 6. DscedentOledrestate(Attachcopya'W,ll) [] 7. Decedent Mai~teinedaLi'~ingTmst(AttachcopydTms,) 0 8. TotalNumberofSafeDepositSoxas
~[ [:'~ 9. LhigteJ~n Pn3ceeds Recstved [] 10. Spousai Po'~ty Credit (~ate of dea,h ~e~wee. ~2-3~.~ ~ t.~.~) E'~ t I. Etechon 10 tax under Sec. 9113(A)(^t~a~ Sc, O)
THIS SECTION MUST BE COMPLETED~ ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
~' NAME COMPLETE MAILING ADDRESS
o Gregory L. Kiers~ 20 W. Ba3.timore St.
o FiRM NAME (If Appl~a~e)
Patterson & Kiersz, P.C. Greencastle, PA 17225-1408
3~LEPHONE NUMBER
717-597-3180
1. Reel Estate (Schedule A) (1) 0 OFFiCL~. USE ONLY'
2. Stccks and B~lds (Schedule B) (2) 0
3. CIoselyHeldCorpomtion, PartnemhiporSote-Propdetorshlp (3) ~:~
4, Mortgages & Note~ Receivable (Schedule D) (4)
5. Cash. Ba~k Deposits & Miscellaneous Per~onai Prederty
(Schedule E) (5) 0 --~
6. Jointly Ova3ed Progefty (Schedule F) (6) 0
"~ (Schedule G or L)
t,,-r-~0
16. AnlountofLine14taxablea~llnealrate 0 X.0 45 (16) INSOLVENT ESTATE 0
INSOLVENT
ESTATE
~ t9. Tax Due (19) 0
> > BE SURE TO ANSWER ALL QUE~FIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address:
STREET ADDRESS
314 Dwelling Court
Franklin
CITY I STA3E JZIP
Shlppensburg PA 17257 -
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) 0
2. Credits/Payments
A. Spousal Poverty Credit 0
B. Prior Payments 0
C. Discount 0
Total Credits (A + B + C) (2) 0
3. Interest/Penalty if applicable
D. Interest 0
E. Penalty 0
Total Interest/Penalty (D + E) (3) 0
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 (4) 0
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0
A. Enter the interest on the tax due. (SA). 0
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE, (SB) 0
REGIS'I'E~ OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent 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; ......... r-~ []
c. retain a reversionary interest; or ................................ ~ []
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? ............................ [] []
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? [] []
4. 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 ~ES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
/
314 Dwelling Court Shlppensburg, PA 17257
20 W. Baltimore St. Greencastle, PA 17225-1408
[72 P.S.§ 9916 (a) (t.l} (i)].
C~VdV4~NVEALTH OF PENNSYLVANIA FUNERAL EXPENSES &
INHERn'ANC~ TAX RE~RN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FlUE NUMBER
Lloyd R. ForA~.~ 00734
A. FUNEP~ F~PENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Repr'--,~,entati~'s Commissions
Name of Personal Repreeentafiv~(s)
Social Security Number(s) / EIN Number of Personal Representative(s)
Street Address
City State __ Zip
Year(s) Commission Paid:
2. Attorney Fees 5 0 0
3. Family Exemption: {If decedent's address is not the same as claimant's, attach e:,plana~ion)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Prol~ata Fees 108
5. Accountants Fees
6. Tax Retain Prepar~*s Fees
i C~-.~erland Count~? Register of
Wills
File Inheritance Tax Return 10
TOTAL (Also enter on line 9, R-,-~pIh,l~tlon) 6 1 S
3W48AG 1.000 (If more space is needed, insert additional sheets of the same size)
SCHEDULE J
ca w wv _ BENEFICIARIES
INHERITANCE TAX RE~IJRN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Lloyd R. For~',w'~~ 00734
RELA'F1ONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) CF ESTATE
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
i Ruth R. Foreman
314 Dwelling Court
Shippensburg, PA 17257 Surviving S~ouse
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON UN~S 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS;
A. SPOUSAL DIS3~IBU'~ONS UNDEIR SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DIS3~IBLmONS ON LINE 13 OF REV-1500 COVER SHEET $ 0
3W4OAI 1 0Do (If more space is needed, insert additional sheets of the same size)
COMMON#EALTH OF PENNSYLVANZA
BUREAU OF ZNDZVZDUAL TAXES DEPARTNENT OF REVENUE _~
INHERITANCE TAX DTYZSTON NOTICE OF INHERITANCE TAX
PO BOX Z8060! APPRAISEMENT, ALLOHANCE OR DZSALLONANCE
HARRTSBURG, PA 171Z8-060! OF DEDUCTZONS AND ASSESSMENT OF TAX
RE¥-1647 EX AFP ¢09-04)
DATE 12-20-200~
ESTATE OF FOREMAN LLOYD R
DATE OF DEATH 06-20-200~
FILE NUMBER 21 0~-073~
COUNTY CUMBERLAND
GREGORY L KZERSZ ACN 101
PATTERSON & KIERSZ
20 W BALTIMORE ST Amount Remi~ed
,~. GI~NCASTLE~. PA 17225
I
L~--J~ ----~ _O~._C~:;_ HAKE CHECK PAYABLE AND REMZT PAYMENT TO:
¢~_ :~ .L.~O~ REGISTER OF ~ZLLS
0~:~ ~:. CUHBERLAND CO COURT HOUSE
~ ~ ~ ~:;~: CARLISLE, PA 1701~
C~ ~ON~HZ~~ ~ RETAIN LONER PORTZON F
...................................
~q7~AFP~03) NOTICE OF INHERITANCE TAX APPRAZS~k~~~'"
~ ~ O~ DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
E~TE OF~OREHAN LLOYD R FILE NO. Z1 0~-075~ ACN 101 DATE 12-ZO-ZO0~
TAX RETURN NAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATZON CONCERNING FUTURE INTEREST - SEE REVA~SF
APPRAZSED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Es~a*~ (Schedule A) (1) .00 NOTE: To insure proper
2. S~ocks and Bonds (Schedule B) (2) 00 credi~ ~o you~ accoun*,
~. Closely Held Stock/Partnership Zn~eres~ (Schedule C) (~) 00 submi* ~he upper
~. Hor*gages/No*es Receivable (Schedule D) (q) O0 of ~his form ~A~h your
~. Cash/Bank Deposi~s/Hisc. Personal P~oper~y (Schedule E) (5) O0 ~ax payment.
6. Jointly O~ned Proper~y (Schedule F) (6) 00
7. Transfers (Schedule G) (7) 00
8. To~al Asse*s (8) .00
APPROVED DEDUCTZONS AND EXEHPTZONS:
9. Funeral Expenses/Adm. Cos*s/Hisc. Expenses (Schedule H) (9) 618.00
10. Deb~s/Hor*gage LiabilA~ies/Liens (ScheduZe Z) (10) .00
11. To~al Deductions (11)
12. Net Value of Tax Re*urn (12) 618.00-
1~. Charitable/Governmental Beques*s; Non-elected 9115 Trusts (Schedule J) (1~) .00
1~. Ne~ Value of Es~a~e Sub~ec~ ~o Tax (lq) 618.00-
NOTE: Zf an assessment gas issued previously, lines 1~, 15 and/or 16, 17, 18 and 19 ~ill
reflect figures that lnclude the total of ALL returns assessed to date.
ASSESSHENT OF TAX:
15. Amoun* of Line 1~ a* Spousal ra~e (15) .00 X 00 = .00
16. Amoun~ of L/ne 1~ ~axable a~ Lineal/Class A ra~e (16) .00 X 0~5 = .00
17. Amoun~ of Line Zq a~ Sibling ra*e (17) .00 X 12 = .00
18. Amoun~ of L/ne 1~ ~axable a~ Collateral/Class B Pa~e (18) .00 X 15 = .00
19. Principal Tax Du~
TAX CREDITS: (~)= .00
PAYflENT J RECE/PI DZSCOUNT 1+)
DATE NUHBER ~NTEREST/PEN PA~D (-) AHOUNT PA~D
TOTAL TAX CREDZT J .00
BALANCE OF TAX DUEl .00
ZNTEREST AND PEN, ~ .00
TOTAL DUE ~ .00
~ ZF PAZD AFTER DATE ZND1CATED~ SEE REVERSE ( IF TOTAL DUE ZS LESS THAN ~1, NO PAYHENT ZS RE~UZRED.
FOR CALCULATZON OF ADDITZONAL INTEREST. ZF TOTAL DUE ~S REFLECTED AS A 'CREDZT" (CR)~ YOU HAY BE DUE
A REFUND. SEE REVERSE SZDE OF THZS FORH FOR ZNSTRUCTZONS.)~
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Lloyd R. Foreman a/'k/a Lloyd Ralph Foreman (Cumberland County)
Date of Death: June 20, 2004
Will No. 21-04-0734 Admin. 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 X No __
2. If the answer is No, state when the personal
representative reasonably believes that the ac[ministration 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 X No
d. Copies of ~eceipts, releases, joinders and
approvals[ of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
GreKory L. Kiersz
Name {Please type or print)
20 West Baltimore Street
Greencastle, PA 17225
Address
'¢~ (3-~ ~ i ~- m~,~ (717) 597-3180
~0 ~]~ Capacity: Personal ~epresentative
~0:Z~}~ 0gO]0~0~Z~ X Counsel for personal
representative