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HomeMy WebLinkAbout04-0754 PETITION FOR PROBATE and GRANT OF LETTERS also known as To: Register of Wills for the - . ~12.eceased. County of in the Social Securily No. ~ ! ~1 ~. 6a -1 ~t~ Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age ar.o~e,r an the execute- i X/ named in the last wil} of the above decedent, dated ~i~[~ ["Z. O0'2,. , 19__ and codicil(s) dated ~ · (list slreet, number and muncipality) Dec,eg~e~g,t,,l, hen ~ ye, a~_of age~ ,died. ~X~ ~ ,19 2~ Except as follows, dec~nt did not ~arr3, was~ot divorced &nd did not have a child bbrn [; a~o~ted 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: (If domiciled in Pa.) All personal property $ ~t O~O (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 r. eq.uesg(.s)5~_e pr~obate of the ~-h~s~c will and codicil(s) presented herewith and the grant of letters ~'L~'~5'/'~t:L,L4'/I- , t-4 (testamentary; admin~tion . ~ ' '~ ~ c.t.a; admm~stratmn d.b.n.c.t~a.) theron. ~.= ~ ~, H~ 170/I ~ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF (-..LLt ]'~. B f-~t~D J~ 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 well a~ruly admirer th~st~t~ according to law. Sworn to or affirmed and subscribed ~~ ~' !~ before me this i~ dgy.~f~ ~ ~ Estate0f l~qL-~)~k/~) ]). M~/~c7'~ ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS , m consideration of ;he petition on the ~everse side hereof, satisfactory proof having been presented before me, IT ~S DECREED tha; ;he nstrument(s) da;ed__ ,~ .;)~ [' :~ described therein be admitted ;~robate and filed of record as the las; will of and Letters ~A I¥1~~T~ Ik / are hereby granted to ~[~ (!. Probate, Letters, Etc ......... Short Certificates(5) $~ ATTORNEY (Sup. Ct. I,D, No) .%1o,-. TOTAL Filed ................................... PHONE LAST WILL AND TESTAMENT OF HILDRED P. BARTON I, HILDRED P. BARTON, of Cun~berland County, Pennsylvania, declare this to be my Last Will and Testament. I revoke all other Wills and Codicils that I may have previously made. Article I My just debts and expenses of my last illness, funeral, and administration of my estate shall be paid by my Executor from the principal of my residuary estate as soon as practicable after my death. Article II All inheritance, estate, and succession taxes (including interest and penalties thereon, but not including any generation skipping tax) payable by reason of my death shall be paid out of and be charged generally against the principal of my residuary estate without reimbursement from any person. This provision is not a waiver of any right which my Executor has to claim reimbursement for any such taxes which become payable as the result of any property over which [ have the power of appointment. Article 1II I give, devise and bequeath in accordance with any memorandum which ! have either handwritten or signed, located with my Will or with my valuable papers and found within 30 days of the probate of my Will. Gifts may only be to persons who survive me or to organizations which exist at my death, and if there is a conflict, the memorandum having the latest date shall govern. Article IV All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, I give, devise and bequeath to my niece, JANE C. ALLEN, of Cumberland County, Pennsylvania. In the event that JANE C. ALLEN predeceases me or fails to survive me by thirty (30) days, I give, devise and bequeath the remainder of my estate, of whatsoever nature and wheresoever situate to THE ENDOWMENT FUND OF ST. MARK'S EPISCOPAL CHURCIt, or its successors, of South Main Street, Lewisto~vn, Pennsylvania. Article V I nominate, constitute, and appoint my niece, JANE C. ALLEN, Executrix of my Last Will and Testament. In the event of the renunciation, death, or inability to act, for any reason whatsoever of my Executrix, I nominate, constitute and appoint OMEGA BANK, or its successor, of Le~vistown, Pennsylvania, successor Executor of my Last Will and Testament. I direct that my Executrix or successor Executor be permitted to serve without bond and in addition to those powers granted by law, I grant them power to distribute in cash or in kind in like or in unlike shares and to -2- file any qualified disclaimer I could have filed if living. My Executrix and successor Executor shall receive reasonable compensation for services rendered to my estate. Article VI In addition to the powers conferred by law, I authorize my Executrix and successor Executor, in his/her absolute discretion: (a) to retain in the form received and to sell either at public or private sale, any real estate or personal property except that which I specifically bequeath herein, (b) to manage real estatc, (c) to invest and reinvest in all forms of property without being confined to legal investments, and without regard to the principal of diversification, (d) to exercise any option or right arising from the ownership of investments, (e) to compromise claims without court approval and without consent of any beneficiary, (f) to file any federal income tax return for any year for which 1 have not filed such return prior to my death, (g) to make distributions in cash or in kind, or in both, and to determine the value of any such property, (h) to employ any attorney, investment advisor, or other agent deemed necessary by my Executor; and to pay from my estate reasonable compensation for ail their services, (i) to conduct alone or with others, any business in which I am engaged in, or have an interest in at time of my death, and -3- (j) to receive reasonable compensation in accordance with their standard schedule of fees in effect while their services are performed. IN WITNESS WHEREOF, I, HILDRED P. BARTON, hereby set my hand to this my Last Will and Testament, on /V/d,-.,~.,~ ' ,2002, at Harrisburg, Pennsylvania. HILDRED P. BARTON In our presence, the above-named HILDRED P. BARTON signed this and declared this to be her Last Will and Testament, and now at her request, in her presence, and in the presence of each other, we sign as witnesses. Name Address -4- I, HILDRED P. BARTON, Testatrix, who signed the foregoing instrument, having been duly qualified according to law, acknowledge that I signed and executed this instrument as my Will, and that ! signed it willingly as my free and voluntary act for the purposes therein expressed. Sworn to or affirmed and acknowledged before me by HILDRED P. BARTON, the Testatrix, on .3 . :~- ,2002. Public HILDRED P. BARTON We, the undersigned witnesses who signed the foregoing instrument, being duly qualified according to law, depose and say that we were present and saw the Testatrix sign and execute this instrument as her Will that she signed and executed it willingly as her free and voluntary act for the purposes therein expressed; that each of us in her sight and hearing signed the Will as witnesses, and that to the best of our knowledge, that she was at that time eighteen (18) years or more of age, of sound mind, and under no constraint or undue influence. Sworn to or affirmed and subscribed to before me and~.fe' hS,r'c~_ 'X-J, /~//~)T)/' Witn4ss - - ~ ~ -- ,vitnesses, on :5- '~ ,2002. -~;C~Jx~((6~-' ~[' ///;/:q --/~/~ ~/ ~ Public' - 3 COMMONWEALTH OF PENNSYLVANIA REV-1162 EX( 11 90) DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA RECEIVED FROM: INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 004542 ALLEN JANE C 210 GARRETT LANE CAMP HILL, PA 17011 ACN ASSESSMENT AMOUNT CONTROL NUMBER ........ fold .................. 101 I $12,000.00 ESTATE INFORMATION: SSN: 177-10-2674 I FILE NUMBER: 2104-0754 DECEDENT NAME: BARTON HILDRED P DATE OF PAYMENT: 10/25/2004 POSTMARK DATE: 10/25/2004 COUNTY: CUMBERLAND DATE OF DEATH: 08/02/2004 TOTAL AMOUNT PAID: $12,000.00 REMARKS: CHECK//103 INITIALS: JA SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 11/01/2004 ALLEN JANE C 210 GARRETT LANE CAMP HILL, PA 17011 RE: Estate of BARTON HILDRED p File Number: 2004-00754 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 11/23/2004 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, GLENDA FARNER STRASBAUGH Clerk of the Orphans' Court cc: File Counsel Judge CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: /~'///~-/~ & Date of Death: ~/,~/~t~ ¢ To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of th~Qrpha~s'~/// Coun,,~Rules was served ot~ or mailed to the following beneficiaries of the aboYe-captioned estate on ¢/,~/Z~/cf- Name Address Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Signature Teleph°ne 757, Capacity: /Personal Representative Counsel for personal representative Glenda Farner Strasbaugh Register of Wills and Cierk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE Bill To: InvoiceNo: Invoice Date: Estate of: Estate No: 358 5/12/2005 HILDRED P. BARTON 21-04-0754 JANE ALLEN 210 GARRETT LANE JA CAMP HILL, PA 17011 130.00 Total $130.00 Qty 1 Fee Description Additional Probate Fee Total: $130.00 Olecks should be made payable to the Register of Wills. Terms: Net 30. Please rerum one copy of this invoice with your payment. Thank you. .fV.15DOEx(6.00J COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT w .... ll'~Cf.l "0:,, w"" :coo ,,0:.... ..m !l: I- Z W C W (,) W C DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL) H,IJNJ -p D"'I"'-'O,.J DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) ~ /2-/0.f /0/ nf/ /3 (IF APPliCABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST. AND MIDDLE INITIAL) .... z w c z o .. "' W 0: 0: o " gJ 1. Original Return o 4. Limited Estate D 6. Decedent DIed Testate (Mach copy of Will) o 9. litigation Proceo<Js Received 'tfUS1 NAME o 2. Supplemental Return o 4a. Future Interest Compromise ,dale of death alter 12-12-82) o 7. Decedent Maintained a Living Trust (AlI&dl eopyolTrusl) o 10. Spousal Poverty Credit\da\eolde&\l1~12-:)1'@121)(\1-'.95) OfFICiAl- USE O\'~L"{ FILE NUMBER 2-~-.!l~ COUNTY CODE YEAR .E2~3_ NUMBER SOCIAL SECURITY NUMBER 177 - 10 - 2(,74 THIS RETURN MUST BE FilED IN DUPUCATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return (dale 01 death prior to 12.1:J.a2\ o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election !o !"" under Se~ 911J(A) IA""',," 0) --- .:..J A,.;G. 4//~,..{ COMPLETE MAiliNG ADDRESS -:L 10 G~"-<2T"- L4N';:: c.~p 1-1 ,-II 1"174 ("70 I I FIRM NAME (II ApplicabIa) TELEPHONE NUMBER 7/7-73'7 - /lrO I (I) (2) (3) (4) (5) z o !;t ...I ::l I- a:: <( (,) W D:: 1. Real Estate (Schedule A) 2. Slocks and Bonds (Schedule B) 3. ClOsely Held Corporation, partnership or Sole-Proprietorship 4. Mortyages & Notes Recar..b\e (Schedule D) 5. Cash, Bani< Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly cmned Property (Schedule F) o Separate Billing Requested 7, Inter-VIVOS Transfers & Miscellaneous Non-Probate Property (Sche<Ju1e G or l) 8. Total Gross Assets (Iotal Uoes 1-7) 9, Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Oeceden, Mortgage Uabillties, & Uens (Schedule I) 11. Totallleduc:tions (Iolal Unas 9 & 10) 12. Net Value of Estate (Une 8 minus line 11) 13. Charitable and GovemmentalBequestslSec 9113 Trusts for which an election to tax has nol been made (Schedule J) (8) 'is/107 9//7'17 (6) (7) (9) (10) 14. Net Value SUbject to Tax (line 12 minus Lina 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES z o ~ I-' ::l a.. :i: o (,) ~ 15. Amount of line 14 taxable at the spousal tax rale, or lransfe!s under Sec. 9116 (a)(1.2) x .0_ (15) X.O_ (16) 16. Amount of Une 14 taxable at lineal rate 17, Amount of Une 14 taxable at sibling rate x .12 (17) '83/(..90 x .15 (18) 18. Amount of Una 14 taxable at collateral rate 19. Tax Due zol8l CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT :h ! _I i-~8 1...._.:.'>' 'r:' ~:; I L OFFICIAL USE ONLY 1'., c::,~ ~': :~') (:';"1 1'0 f'..) en 9/,7Q7 (11) (12) (13) ~,{07 83. (.,'70 (!4) ~3,G.'i'o (19) /2,5::>'-1 I 'Z-,5S'-l i.~. :i;\,!l&t"iij; Decedent's Complete Address: STREET ADDRESS...., /" .L. / 0 w~"e;rr 1.w.J,: C/h'>1 P .J/,- / j Tax Payments and Credits: 1. Tax Due (Page 1 una 19) 2. CreditslPayments A. Spousal Poverty'Credi\ B. Prior Payments C. Discount I STATE -p t4- I ZIP / 7a I f Cln' (1) /2,000 /4Zg Total Credits (A+ B + C) (2) /2, c.z.8" 3. InteresUPenalty ~ applicable D. Interest E. Penalty ,I-( TotallnteresVPenalty ( 0 + E ) (3) 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 10 request a refund (4) /Z,5$'-I 5. If Line 1 + Line 31s greater than Line 2, enler the difference. This is the TAX DUE. A. Enter the interest on the tax due. (5) (SA) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT ~..,,~~~I~.ilif...J\.'!;k_,g:~,~~;~!,~~~1!!;',~~;\lf1~T~i~~i!f.ii'Z~~.L1L il..__:- m~;ll1i~",,;:,t. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN .X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes a. retain the use or income of the property transferred;.......................................................................................... 0 b. retain the ri9ht to designate wh'o shall use the property transferred or its income; ............................................ 0 c. retain a reversionary interest; or...........................,.............................................................................................. 0 d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 2. If death occurred after Deoernber 12, 1982, did decedent transfer property .,;thin one year of death without receiving adequate consideration? .............................................................................................................. 0 3. Did daredent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 4. Did deeedent own an Individual Retirement Accoun~ annuity, or other non.probate property which contains a beneficiary designation? ........................................................................................................................ 0 No IKI I!(] ~ 8'1 I&l 181 18'1 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 ~of pel}Isty, 'dedafe thall hcwe exam'rned ttris rEIUIm, irlduding 9CCOIJlpanying scfledtjes Md stal8m9nts, and to the basi of my knowledge end belief, it is true, COllect and complete. Dedaration of other than !he personal . is ba!6ll on all information 01 which preparer has eny knowkldge. P SON fl,ESPON }L1NG RETURN J/,I/ ~p , ~N<E SENTATIVE <:04-n."Z..crr OF PREPARER OTHER THAN --p ,4- ADDRESS -~OL4 -=A... _ ( r'T ,tf'3o ;V C,.JO L-0>4 ya.-IV':: 170z..5 /701/ DATE '-I 2...7/0:) ifii~~~~1?,tlN~~~~~Sii~!f~!fr,a~'1i~~i~t1f~~~~~~~Z"*Ji,.~~~~~;~i,~:: For dates of death on or after July 1, 1994 and before January I, 1995, the tax rele 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)J. For dales of death on or after January 1,1995, the tax rate imposed on the net value of ~ansfers to or for the use of the sUMvin O't --, ,I - - --"-" ,. .. .." The statule does not exemot a transfer to a surviving spouse from lax, and the statutory requiremenls for disclosure of assets ane -, CS "1 \30 r-l- Co r-- the surviving spouse is the only beneficiary. For datesot dealh on or after July 1, 2000: ~"- :leo.60 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 th, 'Pc'. ,""'......... or a stepparent of the child is 0% [72 P.S. ~9116(aX1.2)]. ..., .......... The tax rate imposed on the net value of transfers to or for the use of the decedenfs lineal beneficiaries is 4.5%, except as ooled in 7 'A ()r) \ ::'0. 00 The tax rate imposed on the nel value of transfers to or for the use of the decedenfs siblings is 12% [72 P.S. ~9116(a)(1.3)]. A-=#:.35 <;) individual who hes at least one parent in common with the deoedent, whether bv blood or adoption. <} .:r ~ REV-t5DlIEX4(1.e7j *' SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONMAl.TH OF PENNSYLVANIA INHEflITANC€ TAX RETURN RESIDENT DECEDENT ESTATE OF #/d"eJ 7. D.q..-..rorJ FILE HUMBER 2 . / 5 fO.,..-07 '7 Include the proceeds of litigation and the dale the proceeds.... received by the -.e. All p~ joIntIy-owned wlIh the right oI8UrvI1Io,.hIp mat be _sed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. CJ/Yl~64 t54NJ\ -# 23,'-/.%/ 2.. 3. ,-!-. 5, (" 4r-r>e"'C4r-J t;.x('""ss- /ft-<<-rrfO, .34S8'S~O.;l.-Oz., VV4'1pOj~"-- &.-. '" C-A-$/-I "i?E~"',-.Jt;) - L3",d'1<'.5 c;.J OGNr Cr'ee "'- G I/:::'r€ D -ro ~€. 4/1,6"'/ /1/11><:" 4,S1-I -R.E~"'r-JD'> "1, 7- '3 2.. "-10'1 ~S99 .5'1/62.0 So TOTAl (Also enter on line 5, Recapitulation) $ '71 , 7 9 '7 REV"1511 EX+ (12-99) . 1A,,t,f ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF /-Ir i J N J 7. /34-L,--0--J FILE NUMBER .;;2 /"'4 - 07:5<-1 Debts 01 decedent must be reported on Schedule J. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. ;-Ioe", 5h~~ h..-Jp/"4--t- h6"",,,,-- -If 7,1/ :5 B. ADMINISTRATIVE COSTS: 1. PefSOM! Representat\ve's ~kms Nams 01 Personal Represantative(s) Social Security Numbe~s)IEIN Number of Persona' Representative(s) Street Address City State _Zip Year(s) Commission Paid: 2. Attomey Fees 3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation) Claimant Stree\. Address City State _ Zip Relationship of Claimant to Decedent 4. Probate Fees /a..., 5. Accountant's Fees ( r= 1',..., ~ C I ~ to- r:;.zLv I ;.oa...) ~oo 6. Tax Return Preparer's Fees 2.50 rn (5~e.I/-1-'eou > .- 7. C:xl'~-- ~" 5 ~ 6_1/trJIA. ?'-eA-v't: ~ Zc:r /11 EO f ~4-Z.-- ?'<Af'~/,p~ &<1 /I'?/.}-r..ro.- U 42- ",-,c TOTAL (Also enter on line 9, Recapitulation) $ ;j, / 0 7 tlf ..........0 eon.......,.... ...."""""' ;.......... ..A~~........l _~nf" ...1 fk... ~.._... ..;_~l REV'1513 EX+ (9-00. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF ,/_ rfr/dreJ -;::" D__/r"J SCHEDULE J BENEFICIARIES FILE NUMBER NUMBER I RELATIONSHIP TO DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not UsI T,uslee(s) TAXABLE D1STRIBUTIOrlS [include outrighl spousal distributions, and transfers under Sec. 9116 (a) (1.2)J ::::T;j",.=: A/Ie ,,/ '2 ro GA-/l.rt..cr-r {...",~c 1. ;V /6:c.6 CA-n--.r ;/; (/ ,74 Iro/f 2/o<-r'-075'Lf AMOUNT OR SHARE OF ESTATE /06 "70 ENTER DOlLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES t5 THROUGH 16, AS APPROPRIATE, ON REV.1500 COVER SHEET II NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART n - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON UNE 13 OF REY-1500 COYER SHEET $ ,I{............... ~ \.... ........"'_ .......... ....I.allol.......1 __....... _I ""... ___" ..:~...\ We have retained a copy for processing This copy is for your records Jon Brenneman Pa Dept Revenue Inheritance Tax Document Processing (717) 787-3942 I .fV.lfi(Kltx~ COMMONWEAlTH OF PENNSYLVANIA D'EPIIRTMENT OF REVENUE DEPT,280601 HAR~\SBURG, PA 17128-0601 I- Z W C W o W C w '"' "'~., u"'''' w"u ",00 u"'.... ..Ill !ll E" )(V\CA- e~-p Y\J REV-1--500 INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAl) H,IJr..J JP.~A~rO~ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) ?/2.-/o-l /O/I~/I:3 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) l8J 1. Original Return o 4.l.imited Estate o 6. DecedemDiedTestate (AlIachCOPYolWilll o 9. Litigation Proceeds Received o 2. Supplemenlal Retum o 4a. Future Interest Compromise (dale of daathaller 12-12-82) o 7. Decedent Maintained a Living Trust (Alladl copyofTrusl) o 10. Spousal Poverty Credit (dale of death bl!\weefl12+31-91 and 1.1-95\ ~ OFFICIAL USE ONLV _.__.__._._,.~.__e'_.__'_'__'_~+ FILE NUMBER 2.. .!... -..!2 '--I COUNTY CODE YEAR 07'5'-/ - NUMBER- - -- SOCIAL SECURITY NUMBER 177 - /a '2-<:'74- THIS RETURN MUST BE ALED IN DUPLIGATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. Remainder Return (data of lIea1h prl?t 10 12-1].82) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9\I~A) \All>d>'""O) '"' z l!l z o .. ., w '" '" o u NAME 411~"/ FIRM NAME or....._1 TELEPHONE NUMBER 7/7-73'7 - /lrO' z o ~ :;) ... ii: c( o w a: 14. Net Value Subject to Tax (Line 12 minus Line 13) COMPLETE MAIUNG ADDRESS -:2. 'e G4rt.n."'rr L4Ni: CA-.->-> (> 1--1 ,-,I I ---;::> A 1"7'" I (1) (2) (3) (4) (5) (6) (7) (9) \101 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPUCABLE RATES 1. Real Estate (Schedule A) 2. Slecks and Bonds (Schedule B) 3. C1ose~ Held Corporation, Partnership or Sole~Proprielorship 4. Mo<tgages & Notes Receivable (SdIeduIe D) 5. Cas/l, Bank Deposi~ & Miscellaneoos Personal Property (Schedule E) 6. Jointly Owned Properly (Schedule F) o Separete Billing Requested 7. Intar-VIVOS Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Deb\s of Oecede.~ Mot\9aae Liabilities, & liens (Schedule I) 11. Totel Deductions (Iolal Lines 9 & 10) 12. Net Value of Estate tUne 8 minus line 11) 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to lax has nol been mede (Schedule J) z o !cc I-' :;) Do :E o o ~ 15. Amount of line 14 taxable at the spousal tax rete, or transfers under Sec. 9116 (a)(1.2) 16. Amount of line 14 taxable at lioeal rate 17. Amount of Una 14 taxable at sibling rate 18. Amount of Line 14 taxable al collateral rate 19. Tax Due g 3, L90 9/, 7 q 7 (8) '8',107 ,,0_ (15) '.0_ (16) x .12 (17) , .15 (18) (19) CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 2O(gl :i:i~:~~f:}kJ~ih;tf'~" ;i!i OFFICIAL USE ONLY 51'!/,/' l 9/,7Q7 (11) (12) (13) '8,107 83,(.,90 (14) 8'3,(.,'70 12,5S,--/ I ?,SS'-I ." :i! Decedent's Complete Address: STREET ADDRESS..., /' ...../0 w~err / .JkAj € CITY I STATE 7,4- I ZIP /70 J f ~p 11/1/ Tax Payments and Credits: 1. Tax Due (Page 1 Une 19) 2. Crll<ItslPayments A. Spousal Poverty'Credit B. PMor Payments C. Discount (1) /2,000 f.,Z8 Total Credits ( A + B + C ) (2) 12, c::.z.8" 3. InterosVPenalty n applicable D. Interest E. Penalty TotallnteresVPenalty ( 0 + E ) (3) 4. If Line 2 is 9reater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Une 20 to request. rafund (4) ;z.,55"-1 '7'-{ 5. If Une 1 + Line 3 is grealer than Une 2, enter the difference. This is the TAX DUE. (5) (SA) (58) A. Enter the inlerest on the tax due. B. Enter the lotal of Line 5 + SA. This Is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT ~~""''''''' -..-. !illJ.~~~!,~~Jlill',gj'.~1M~,1!jj!'i~~~1\~~! r!li'11~~,Jkt1j"',.., PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN .X. IN THE APPROPRIATE BLOCKS 1. Did decedent make a lnlnsfer and: Ves a. retain tlte use or income 01 the property lnlnsferred;.......................................................................................... 0 b. retain the right to designate wh'o shall use the propertY transferred or its income; ............................................ 0 c. retain a reversionary interes~ or.......................................................................................................................... 0 d. receive the promise for Ine 01 either payments, benefits (l( care? ...................................................................... 0 2. If death occurred alIer December 12. 1982, did decedent lnlnSfer propertY ..thin one year of death without receiving adequate consideration? .............................................................................................................. 0 3. Did decedent own an "In trust for" or payable upon death bank account or secuMty at his or her death?.............. 0 4. Did decedent own an Individual Retirement Aocount annuity, or other non.probale propertY which contains a beneficiary designation? ........................................................................................................................ 0 No IKJ ~ ~ 81 IBI jgj ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. x D~~_ 04n'2..Crr SIGNAnJ F PREPARER OTHER THAN RE C+-. p /I, 01/ , --;;z;> .4- ADDRESS -rJO CI4 ---0/",,- .... ( r '7 q,'3o ;V crJO LA --;l>a.-II/6: 170Z.!!> 0"-"'.- 170// DATE '-f Z-?/Q:) N~~~ltIIi$!WIffiOOi;~-.&__.t~_st_~r~~~&\~~J~~~::il~.i:tt:;~{:~':.:"; F(l(datesof death on or after July 1,1994 and before January 1, 1995, the tax rale imposed on the net value of transfers 10 or for the use 01 the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (I)]. For dates of doalh 00 or after January 1, 1995. Ihe tax rate imposed on Ihe net value of transfers to or for the use of !he surviving spouse is 0% 172 P.S. ~9116 fa) (1.1) (ii) The statute does nol exemol a transfer kl a surviving spouse tram tax, and Ihe staMory relluirements for disclosure of assets and filing a tax retum are still applicable even the surviving spouse is the only beneficiary. for dates 01 dealh on (l( after July 1, 2000: The tax rate imposed on the net value of tranSfers from a deceased chiid twenty-one years of age or younger at dealh to or for the use of a natural parent, an adoptive paren or a stepparent ollhe chiid is 0% [72 P.S. ~9116(aX1.2)1. The tax rate imposed on the net value of lnlnslers kl or for the use of the decedenrslineal heneflciaMes is 4.5%,eXC<ll1t as noled in 72 P.S. ~9116(t2) (72 P.S. fi9116(a)(I)]. The tax rale imposed on the nel value of transfers to or for the use of the deeedenrs siblings Is 12% [72 P.S. ~9116(a)(t3)). A sibling Is defined, under Section 9102, as al Individuai who has alleast one oarenl in common wilh the decedenl. whelher by blood or adoption. ""...".,..". COMMONWEAl.TH OF PENNSYLVANIA INHERiTANCE TAX llETURN . llESID NT DE OENT EST ATE OF SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ~/dreJ 7. D-qn.ro"" Fl.E ItUM8ER 2 ((Ji.{.-07S,-/ Indude the proceeds of 11Iig"1ion aod the date the proceeds _ RlCeived by the eslale. All pRlIIOI\y joIntIy-owned with the rlght of IUlYlvorshlp must be disclosed on Schedule F. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. O~~64 ?3A.-.J 1\ #> 23,4%'7 2. 3. 4-. s, (" /}-rnerlC4r-' t;.xf"'l>SS - /k.-"-r r/o, .345 K5>r-o;;J.-oz-/ v/4'1POJ:""'''''' &..-s.::. C.kS/-I "i?t:~",,...,1) - 6", 1;J'7~.5 <2.. 3~r C/'Re":; G (Pre D -?O ::;74,v<=. AI/E,"'; /t1 I>C ~t+ -K.E1=..,"'P5 CJI -z.. 3 2... 40'1 ~ S9 '7 .5'1/02..0 50 TOTAL (Also enter on line 5, Recapitulation) $ '11 . 7 9, RE\f!'1511 EX+ (12.99) )' .9,,~~ ~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF ~iJreJ 7, 64-<-ro,J FILE NUMBER ,;2 /.t! <I - c)''7':s '-I Deblll 01 decedent must be reported on Schedule). ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. #0,..", 5-h~~ ;=:u-./p ~ 4-<-. .J-,6.-.-.",-- 4 7,1/5 B. ADMINISTRATIVE COSTS: 1. Pen.<mal Repmsenta\Ne's Cornm\ss\ons Name of Personal Representative(s) Social Security Number(s}IEIN Number of Personal Representative{s) Street Address City State _Zip Year(s) Commission Paid: 2. Attomey Fees 3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation) Claimant Street: Address City Slale _ Zip Relationship of Claimant to Decedent 4. Probate Fees /Ci 7 5. Accoun1ant'sFees ( r,l,..J4--'Vcl~'- 4-ztV/~Oa..-) sac> 6. Tax Return Preparer's Fees 2.50 /YII S <-,,-/14-' ",:w > '" 7. C:xl'~~" " $, ~6_/~~ :{e/t./~~ 2.9 /I? eo r C:4-z.-- 5"';';1/'<>"> &<1 /I?~o.~ ~"(.b 412- TOTAL (Also enter on line 9, Recapitulation) $ y,107 IIf .....".... co""'...... ,... ...""..".... i........... ..;l...IiI;.......1 ...h......... ^' I~... ....._... ..:.....\ REV'1513 ex. (9"00. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT OECEDENT ESTATE OF j I - rttlclred 7. L3.+> j."J NUMBER I SCHEDULE J BENEFICIARIES FILE NUMBER 1. RELATIONSHIP TO DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not L18t T'U8te0(8) TAXABLE DISTRIBUTIONS {include outright spouse! distributions, and transfers under Sse. 9116 (e) (1.2)J ::::r;q N '" /1/1 e ,./ "2 10 04-rl-o't-iE'r-r ~,.v.E 2/c><!_ 07:'04 AMOUNT OR SHARE OF ESTATE I 0 0 "70 ENTER DOLlAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV.1500 COVER SHEET II NON. TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MAOE /'I 1~C:e= ~r ;lil/ ,74 170/1 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. TOTAL OF PART n - ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON UNE 13 OF REV.1500 COVER SHEET $ (" __ ......^'" l.. ......._.... ;......~ ........,........... -s........ ..' H... ......__ ~_..\ REV-1513 EX+ 19-D0*, COMMONWEAlT,H OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF NUMBER I ,. NAME AND ADDRESS OF PERSONIS) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (e) (1.2)] '~'e-o.,\C:.-tL q Z::. \f\A.bN-Ul'S ~q e. s~nV\C}\J\\:\~\. A-VL c..bV\.S\AO U.OC--~ v'\ ~o..' \,C\4t)'i( FILE NUMBER RELATIONSHIP TO DECEDENT 00 Not LlstTrustee(s) Wld6u) , AMOUNT OR SHARE OF ESTATE t\ tCCD., 60 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II NON.TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER 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 DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court Marjorie A. Wevodau First Deputy Kirk S. Sohonage, Esq Solicitor Register of Wills and Clerk of the Orphans' Court County of Cumberland One Courthouse Square Carlisle, PA 17013 (717) 240-6345 FAX (717)240-7797 INVOICE Bill To: InvoiceNo: Invoice Date: Estate of: Estate No: 358 5/12/2005 HILDRED p, BARTON 21-04-0754 JANE ALLEN 210 GARRETT LANE JA CAMP HILL, PA 17011 130,00 Total $130,00 Qty 1 Fee Description Additional Probate Fee Total: $130,00 pj V /crlo - " . vj C1Iecks should be made payable to the Register of Wills. Terms: Net 30. Please return one copy of this invoice with your payment. Thank you. 07-25-2005 BARTON 08-02-2004 21 04-0754 CUMBERLAND 101 APPEAL DATE: 09-23-2005 ( See reverse side under Objections) Amount Remitted I I 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 +- iEv:is47-Ei-AFP-co3:osi-NOTICE-OF-INHEiITANCE-TAi-APpiAISEMENT:-ALLowANCE-oi--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX HILDRED P FILE NO. 21 04-0754 ACN 101 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE n-f'f'nf'f'" r,rr,-" ,-," NOTICE OF INHERITANCE TAX BUREAU OF INDIVIDUAL TAXES',':j-:,"C' ",';"-iPPRAISEHENT, ALLOWANCE OR DISALLOIIANCE INtERITANCE TAX DIVISION -- .. ,-,^ ,- -,- - '. 'I . Of DEDUCTIONS AND ASSEsst1ENT OF TAX PD BOX 280601 HARRISBURG PA 11128-0601 '"'(\,,;- [1 ':J '!_ 22 I', ,c. "'-, - ~'~. ,-:... DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN JANE ALLEN 210 GARRETT LN CAMP HILL PA 17011 ESTATE OF BARTON *' REV-1547 EX AFP (06-05) HILDRED P TAX RETURN liAS: I X) ACCEPTED AS FILED ) CHANGED DATE 07-25-2005 I~ an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect ~igures that include the total ~ ~ returns assessed to date. ASSESSMENT OF TAX: IS. AItount of Line 14 at Spousal rate US) 16. Amount of Line 14 taxable .t Lin..l/Class A rat. (16) 17. AIIount of Line 14 at Sibling r8t. (17) 18. Amount of Line 14 taxable at Collateral/Class Brat. (18) 19. Principal Tax Due TS: 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. Mortgages/Notes ReceIvable (Schedule D) 5. Cash/Bank DepositslHisc. Personal Property (Schedule E) 6. Jointly Owned Property ISchedule F) 7. Transfers (Schedule G) 8. Total Assets 11) (2) (3) (4) (5) (6) (7) .00 .00 .00 .00 91. 797 . 00 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expens.s/A~. CostslHisc. Expenses (Schedule H) 10. DebtslHortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. N.t Value of Tax R.turn 13. Charltab1e/GoYer~ental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Est.te Subject to Tax (9) 110) 8,107.00 DO Ill) 112) 113) 114) NOTE: .00 X .00 X .00 X 83,690.00 X 00 = 045 = 12 = 15 = TA AHllUNT PAID 12,000.00 73.70- + DATE 10-25-2004 07-18-2005 NlIHBER CD004542 REFUND INTEREST/PEN PAID 1-) 627.70 .00 ~ TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE NOTE: To insure proper credit to your account, sub.it the upper portIon of this for. with your tax payllent. 91,797.00 8.107 00 83,690.00 .00 83,690.00 119)= .00 .00 .00 12,554.00 12,554.00 12,554.00 .00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) prl'()Q~[J) f'\CC!I'E I'C BUREAU OF INOIVIO&II'-1Yl - ,,, I 'v V INHERITANCE TAX DIYISIQtC('-~~-.~.--:, ;,.! . ;.... PO BOX 280601 --',~,-; HARRISBURG PA 171Z8-06Dl COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT '* REY-16D7 EX AFP (03-05) 2005 WG 12 Pii I: 10 ,^ DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 08-01-2005 BARTON 08-02-2004 21 04-0754 CUMBERLAND 101 AIIO...,t R...l tt.d HILDRED P CtE::~::< f"ISC'!_' .-" \...)1'.: JANE AUEN 210 GARRETT LN CAMP HILL '-~T PA 17011 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, sub.it the upper portion of this forn with your tax pay.ant. CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS - --------------------------------------------------------------------------- REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ... ESTATE OF BARTON HILDRED P FILE NO. 21 04-0754 ACN 101 DATE 08-01-2005 THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED 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: 07-18-2005 PRINCIPAL TAX DUE: 12,554.00 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 10-25-2004 """ CD004542 627.70 12,000.00 07-18-2005 REFUND .00 73.70- TOTAL TAX CREDIT 12,554.00 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. I IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. J _ ,,- (C'^'::> ,,- Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 7/05/2006 ALLEN JANE C 210 GARRETT LANE CN~P HILLI PA 17011 RE: Estate of BARTON HILDRED P File Number: 2004-00754 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. I, for decedents dying on or after July 11 19921 the personal representative or his counsel, 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: 8/02/2006 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. SincerelYI ~" ~., i J;" . "~.4 / c__:c Y;;y~.tJ tij~~'7' . Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel \>' Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name ofDecedent: 1-1/ lei ~ed &ritJn Date of Death: ;f:/Z-tJt) ~ Estate No.: . 4-007~c.; 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 ~ No 0 2. If the an.swer is No, state ",hen 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 0 No fi(J 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 00 No 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 Date: 'lfi<fP;;;hed lo this report. ~AlL,{j)IA~..-J s~ :JfWC AilGN Name 0 6~// ~ ?hm.P fflU- I!IJ- 17t;/1 Address '711.137. J g-oL Telephone No. ,"7 ,.., 11. ..... ) ~J "::"', L i ~d L ./'", Capacity: ~ Personal Representative o Counsel for personal representative c