HomeMy WebLinkAbout04-0731 COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500 [OFFICIAL USE ONLY
~L~ NUMB~I~
INHERITANCE
TAX
RETURN
/
RESIDENT DECEDENT /:o.~oooE Y~a .**a ----
I--
Z
U.I
LU
LU
C~
L~
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
DATE Of DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DO-YEAR)
0'5 - 7.':5 - ZOe,--~ 1'2. - I 5 - t9 z?_
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
lOY"5- i(¢ -115
THIS RETURN MUST BE FILED IN DUPLICATE WITH Th~
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
[~]1 Original Return
[~4. Limited Estate
[~6. Decedent Died Testate (Attach copy of Will)
E~g. Litigation Proceeds Received
[~2. Supplemental Return
[~4a Future Interest Compromise (date ol death after ~2-12-82)
E~7. Decedent Maintained a Living Trust (Attach copy of Trus~)
E~]10 Spousal Poverty Credit (dat~ of death between 12-31-91 amd 1-1-95)
] 3. Remainder Return (date of dealh prior to 12-13~2)
E~5 Federal Es~te Tax Return Required
8. Total Number of Safe Deposit Boxes
[~11. Election to tax under Sec 9113(A) lA,ach sch O)
.AME IN RoTH
FiRM NAME (if Applicable)
TELEPHONE NUMBER
'7 ~"7
COMPLETE MAILING ADDRESS
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Properly (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
E~] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10, Debts of Decedent, Uodgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12~ Net Value of Estate (Line 8 minus Line 11)
3W53.gZ
~5 '719,
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)
L q' 05,
(11)
(12)
(13)
50 951, ~
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line14 taxable at the spousal tax ,~O 95l (,,Dx .o (IS>
rate, or transfers under Sec. 9116 (a)(1.2) ' --
16~ Amount of Line 14 taxable at fineal rate x.0__ (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)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
All prebeF~y jointly-owned with right of su~ivomhlp must be dlsc~sed on Sch~ule F.
FILE NUMBER
SCHEDULE B
STOCKS& BONDS
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
TOTAL (Also enter on line 2, Recepitulation)
(If more space is needed, insert additional sheets of the same size)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
FILE NUMBER
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON.PROBATE PROPERTY
This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reveme side of the REV-1500 COVER SHEET is yes.
DESCRIPTION OF PROPERYY % OF
ITEM INCLUDE THE NAME OF THE TRANSFEREE' TI4EIR RELATIONSHIP TO DECEDENT AND THE DATE OF T~SFER' DATE OF DEATH DECD'S EXCLUSION TAXABLE VALU[
ATTACH A COPY OF THE DEED FOR REA- ESTATE.
NUMBER VALUE OF ASSET INTEREST CF APPLICABLE)
1.
TOTAL (Also enter on line 7, R~pitulation) $ 53, ~ J 9,
(If more space is needed, insert additional shee~s of the same size)
R ',V-1
OOMMONWEA'THOF E 500
PENNSYLVANIA
DEPARTMENT OF REVENUE
IN H E RITAN C E TAX RET URN
DEPT. 280601
~H*~.~SBU.G, ,* ~712S-0,0~ RESIDENT DECEDENT
Z
W
uJ
uJ
DECEDENT'S NAME (LAST, FIRSTr AND MIDDLE INITIAL)
Ro-f-H ~fH~l~,H
L
DATE OF DEATH (MM-DD-YEAR)
0'5 - z~ - 2oc~H-
DATE OF BIRTH (MM-DD-YEAR)
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE iNITIAL)
~]1. Original Return
[]4. Limited Estate
~16. Decedent Died Testate (Attach copy of Will)
1~9. Ldigation Proceeds Received
[]2 Supplemental Return
[~4a. Future Interest Compromise (date of death after 12-12-82)
[~7~ Decedent Maintained a Living Trust (Attach copy of Trust)
[~10 Spousal Poverty Credit (date of death betWeen 12 31-91 and 1-1-95)
~AME H~L,J I~F~ RO'¥H
FIRM NAME
TELEPHONE NUMBER
OFFICtAL USE ONLY
FILE NUMBER
COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
l~.~-i~ - ll5~
THIS RETURN MUST BE FILEB IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
[~]5. Federal Es~ata Tax Return Required
B. Total Number of Safe Deposit Boxes
[~11. Election to tax under Sec 9113(A) (A~Ch Sch O)
COMPLETE MAILING ADDRESS
1~4e)9 L/} 6;/g~/
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Padnership or Sole-Proprietorship (3)
4. Modgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned properb/(Schedule F) (6)
[~] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Proper[,/ (7)
(Schedule G or L)
8. Total Gross Assets (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 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)
(s)
3q-53,~7
(11)
(t2)
(14)
5q- q-oS, u7
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15 Amount of Line 14 taxable at the spousal tax
rate, ortransfersunderSec. 9116(a)(1.2) ,~O 95 J, 69x.0__ (15)
16. Amount of Line 14 taxable at lineal rate x 0 (16)
17. Amount of Line 14 taxabte at sibling rate x .12 (17)
18. Amount of Line 14 taxable at collateral rate x .15 (18)
19. Tax Due (19)
Decedent's Complete Address:
5~Kbb~ADDRESS
CITY I STATE ' [ZIP ~ ~,
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits ( A + B + C )
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E )
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.
(1)
(2)
(3)
(4)
(5)
(SA)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (SD)
Make Check Payable to: REGISTER 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; ............................................ [] []
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-probata 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 perjury, I declare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and complete
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN BATE
ADDRESS
SIGNATURE 01: PREPARER OTHER THAN REPRESENTATIVE BATE
ADDRESS
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 RS. §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 RS. §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 decedenrs siblings is 12% [72 RS. §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.
COMMONt/~cALTN OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
All proper~y jointly-owned with rlgM of survivorship must be disclosed on Schedule F.
FILE NUMBER
SCHEDULE B
STOCKS& BONDS
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1,
TOTAL (Also enter on line 2, Recapitulation) $ ~ ~ (~,
(If more space is needed, insert additional sheets of the same size)
SCHEDULE G
INTER-VIVOS TRANSFERS &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FiLE NUMBER
This schedule must be completed and filed if the answer to any of ques'dons 1 through 4 on the reveme side of the REVq 500 COVER SHEET is yes.
DESCRIPTION OF PROPERTY % OF
ITEM INCLUDE THE NAME OF THE T~NSFEREE TH~IR RELATIONSHIP TO DECEDEN3' AND THE ~ATE OF 1P'ANSFER DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
ATTACH A COFY OF THE DEED FOR ~ ESTATE.
NUMBER VALUE OF ASSET INTEREST IIF APPLICABLE)
1.
~TJ,.~lg~ b t~ ~ L R~T~E~I4T
OrCCOt3~'T ~
~ I
~Z3.367 SR~R~S-~~G~O~ ,~,~i ~eo ~,~o,~
(If more space is needed, insert additional sheets of the same size)
' REV-1511 EX+ (12-99) +~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
~~ L ROTH
Debts of decedent must be reported on Schedule L
ITEM
NUMBER DESCRIPTION AMOUNT
FUNERAL EXPENSES:
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
aF J T qL- C coRt),S
City State __
Year(s) Commission Paid:
Attorney Fees
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Zip
Street Address
City State __ Zip
Rel~ionship of Claimantto Decedent
Probate Fees
Accountant's Fees
Tax Return Pmparer's Fees
TOTAL (Also enter on line 9, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
BUREAU OF INDTVTDUAL TAXES
TNHERTTANCE TAX DIVTSTON
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONHEALTH OF PENNSYLVANIA
DEPARTHENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLONANCE OR D/SALLOHANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
MELVIN,:B ROTH '
].909~.Lt)OAN .~ : ~
CAMP HILL PA ~17011-38qq
DATE 09-27-2004
ESTATE OF ROTH
DATE OF DEATH O$-Z9-ZO04
FILE NUMBER 21 04-0751
COUNTY CUMBERLAND
ACN 101
Amount RemitS:ed
REV-1547 EX AFP ¢0]-05)
MARIAN L
MAKE CHECK PAYABLE AND REMIT PAYMENT TO.'
REGISTER OF HILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~ RETAIN LONER PORTION FOR YOUR RECORDS ~
REV-1547 EX AFP (01-03) NOTICE OF INHERITANCE TAX APPRATSEMENT, ALLOHANCE OR DTSALLO#ANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF ROTH MARIAN L FILE NO. Z1 04-0751 ACN 101 DATE 09-27-2004
TAX RETURN t/AS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schadula A) (1)
2. Stocks and Bonds (Schedule B) (2)
$. Closely Held Stock/Partnersh/p Zntarast (Schedule C) ($)
~. Hortgages/Notas Racaivabla (Schedule D) (~)
-;. Cash/Bank Deposits/Risc. Personal Property (Schedule E) (-;)
6. Jointly Owned Proparty (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assats
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expansas/Adm. Costs/Hisc. Expenses (Schedule H) {9)
10. Debts/Hortgaga Liabilities/Liens (Schedule I) (10).
11. Total Deductions
12. Nat Value of Tax Return
15.
1~.
Charitabla/governeental Bequests; Non-elected 9115 Trusts (Schedule J)
Nat Value of Estate SubSact to Tax
.00
686.00
.oo
.00
.oo
.oo
55~719.67
(B)
$,455.98
.00
NOTE: To insure proper
credit to your account,
submit the upper port/on
of ~his fora w/th your
tax payment.
NOTE:
54,405.67
(11) 3 .~53.98
(12) 50,951.69
(15) . O0
(1~) 50,951.69
If an assessment Nas lssued previously, 1/nes 14, 15 and/or 16, 17,
reflect f/gures that include the total of ALL returns assessed to date.
18 and 19 Nill
ASSESSMENT OF TAX:
1.;. Amount of L/ne lq at Spousal rata
16. Amount of L/ne lq taxable at Lineal/Class A rata
17. Amoun~c of L/ne lq at Sibling rate
18. Amoun~ of L/ne lq taxable at Collateral/Class B rata
19. Pr/nc/pal Tax Due
TAX CREDITS:
PAYNENT RECE/PT DISCOUNT (+)
DATE NUHBER INTEREST/PEN pA'rD (-)
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
(1-;) 50,951.69 x O0 = .00
(16) .00 x 045 = .00
(17) .00 x 12 = .00
(18) .00 x 15 = .00
(19)= . O0
ANOUNT PAID
TOTAL TAX CREDIT
BALANCE OF TAX DUEI
INTEREST AND PEN.
TOTAL DUE
.oo
.oo
.oo
.oo
( IF TOTAL DUE ZS LESS THAN $1, NO PAYMENT ZS REQUIRED.
ZF TOTAL DUE ZS REFLECTED AS A "CREDZT' (CR), YOU NAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
RESERVATION:
PURPOSE OF
NOTICE:
PAYMENT:
REFUND (CR):
OBJECTIONS:
ADMIN-
ISTRATIVE
CORRECTIONS:
DISCOUNT:
PENALTY:
INTEREST:
Estates of decedents dying on er before December 1Z, 1982 -- if any future interest in the estate is transferred
in possession or enjoyment to Class B (collateral) beneficiaries of the decedent after the expiration of any estate for
life or for years, the Commonwealth hereby expressly reserves the right to appraise and assess transfer Inheritance Taxes
at the laeful Class B (collateral) rate on any such future interest.
To fulfill the requirements of Section ZlqO of the Inheritance end Estate Tax Act, Act Z3 of ZOO0. (72 P.S.
Section 91qO).
Detach the top portion of this Notice and submit with your payment to the Register of Nills printed on the reverse side.
--Make check or money order payable to: REGISTER OF NILLS, AGENT
A refund of a tax credit, ehich was not requested on the Tax Return, may ba requested by completing an "Application
for Refund of Pennsylvania Inheritance and Estate Tax" (REV-1313). Applications ara available at the Office
of the Register of Nills, any of the 23 Revenue District Offices, or by calling the special Z4-hour
ansearing service for forms ordering: 1-800-362-Z050; services for taxpayers with special hearing and / or
speaking needs: 1-800-447-3020 (TT only}.
Any party in interest not satisfied eith the appraisement, allowance, or disalloaance of deductions, or assessment
of tax (including discount or interest) as sheen on this Notice must object within sixty (60) days of receipt of
this Notice by:
--aritten protest to the PA Department of Revenue, Board of Appeals, Dept. Z810Z1, Harrisburg, PA 17128-1021, OR
--election to have the matter determined at audit of the account of the personal representative, OR
--appeal to the Orphans' Court.
Factual errors discovered on this assessment should be addressed in eriting to: PA Department of Revenue,
Bureau of Individual Taxes, ATTN: Post Assessment Reviea Unit, Dept. 280601, Harrisburg, PA 17128-0601
Phone (717) 787-6505. See page 5 of the booklet "Instructions for Inheritance Tax Return far a Resident
Decedent" (REV-IS01) for an explanation of administratively correctable errors.
If any tax due is paid eithin three (3) calendar months after tho decedent's death, a five percent (5Z) discount of
the tax paid is allowed.
The 152 tax amnesty non-participation penalty is computed on the total of the tax and interest assessed, and not
paid before January 18, 1996, the first day after the and of the tax amnesty period. This non-participation
penalty is appealable in the same manner and in the the same time period as you would appeal the tax and interest
that has been assessed as indicated on this notice.
Interest is charged beginning with first day of delinquency, or nine (9) months and one (l) day from the data of
death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of
six (62) percent par annum calculated at a daily rate of .000164. All taxes which became delinquent on and after
January 1, 1982 will bear interest at a rate which mill vary from calendar year to calendar year aith that rate
announced by the PA Department of Revenue. The applicable interest rates for 198Z through Z004 are:
Interest Daily Interest Daily Interest
Daily
Year Rate Factor Year Rate Factor Year Rate Factor
1982 ZOZ .000548 ~-1991 IIX .000301 ~ 9X .000247
1983 16Z .000438 1992 9Z .000247 2002 6Z .000164
1984 llZ .000301 1993-1994 7Z .000192 2003 52 .000137
1985 132 .000356 1995-1998 92 .000247 2004 4Z .O00110
1966 10Z .000274 1999 7Z .O00XgZ
1987 lOZ .000274 2000 72 .000192
--Interest is calculated as folloas:
INTEREST = BALANCE OF TAX UNPAID X NUNBER OF DAYS DBLTNQUENT X DALLY INTEREST FACTOR
--Any Notice issued after the tax becomes delinquent will reflect an interest calculation to fifteen (15) days
beyond the date of the assessment. If payment is made after the interest computation data shown on the
Notice, additional interest must ba calculated.
CERTIFICATION OF NOTICE UNDER RULE 5.6(a~
Date of Death:
Wi. No. q:. '-
To the Register:
Admin. No.
I certify that notice of (benefidal interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on
Name Ad.ess
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
6,3
Signature
Name
Address
Telephone (~{--~ ~-76!
Capacity: ~Personal Representative
Counsel for personal representative
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717)240-6345
Date: 11/01/2004
ROTH MELVIN B
1909 LOGkN ST
CA~4P HILL, PA 17011-3844
RE: Estate of ROTH MARIAN L
File Number: 2004-00731
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 0RPHA_MS' 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 11/16/2004
Your prompt attention to this matter will be appreciated.
Thank You.
cc:
File
Counsel
Judge
GLENDA FARNER STRASBAUGH
Clerk of the Orphans' Court
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 2/17/2006
ROTH MELVIN B
1909 LOGAN ST
CAMP HILL, PA 17011-3844
RE: Estate of ROTH MARIAN L
File Number: 2004-00731
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:
3/29/2006
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: ~^\J\~tt\~ L RoTH
Date of Death: M&\-ftCH ?<?) ZtJ ()tf-
Estate No.: 'LOr) tf 007 31
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 fXl 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 1XJ 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 ~ C"'"n. ,A I "'-"'7
interest? Yes [Xl No 0 eo f \ E ~ (:)(= L.v\ ST \J.-)\ LL A--M D \ -tZ ~l ( V \II rzr.,l (
DtST\R.\&..rT\fD {C~ A-LL t{lf-llRS
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
Date: ~H ;:c:~Zs report. \M ~ ~..~
Signature
M,~L\J t ~
Name
FS
RDn+
'~o~ LC6~ sf
Address I<\tlq? tM. u.. I P v1 \'1 () u,.. '3 ~lf-tf-
t\7 Llo' ~zld!-
Telephone No.
1 S : 11 ~ri 0 I ~\
L~:~Lj
.J.i~iL'Capacity:
00 Personal Representative
o Counsel for personal representative
'0'
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
phone: (717) 240-6345
Date: 3/06/2006
ROTH MELVIN B
1909 LOGAN ST
CAMP HILL, PA 17011-3844
RE: Estate of ROTH MARIAN L
File Number: 2004-00731
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:
3/29/2006
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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