The URL can be used to link to this page

Home My WebLink About04-0793PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of Patrick M. Sullivan also known as Social Security No. Deceased. 166-58-9236 No. ! -oq - qq3 To: Register of Wills for the County of Cumberla~ld 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, appti_es for ~t~s: of administration (d.b.n.; pendente lite; durante absentia; durante minoritate) ~ the above decedent. ~, ::~ Decendent was domiciled at death in Cumberland Couiity, Penn[~Jvania, wi~h his last family or principal residence at ~-~-~-ive. Enola.~ast P~t~nsbo~b:~., Cumb. Co, (list street ~ number an~t[~u~icipalit~ PA :5;f~025 Decendent, then 27 years of age, died August 2 .~ %. ~ 2~4&, at U.S. Rt. 15 N/B MP 41.5, Lower Allen Twp.~ Cumberland 1~o:;'¥ PA_~ Decendent at death owned property with estimated values as folllows: domiciled in Pa.) All personal property (If (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 the following spouse (if any) and heirs: Name Jalp&e L. Sullivan lv~ckl s on Sullivan .. ascertained that decedent left no will and was survived by Relationship Residence ¢/~±e 230 Sam 5neact Circle, ~rters, PA 1731~ ~aughter (age lJ " THEREFORE, petitioner(s) respectfully request(s) the grant of letters of adminis[ration in the appropriate form to the undersigned. 230 Sam Snead Circle Etters, PA 17319 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ~ ss COUNTY OF Cumberland Thc petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of thc 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 affirmed,and subscribed b, eT~re me thi~ c~ day of No.£1- 4- Estate of Patrick M. Sullivan ., Deceased GRANT OF LETTERS OF ADMINISTRATION AND NOW C~ XkCll ~ ¢~ ~.1~.0_4 in consideration of the petition on the reverse side hereof,(~j~tisfactor~ proo~f having b~.en presented before me, IT IS DECREED that-- J&nJ_e L. Sf~klllvan is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to in the estate of Jamie L. Sullivan Patrick M. ~ulliVan FEES Letters of Administration ..... $~'~. Short Certificates{[:~) .......... $_~,~_~3~>___ TOTAL $1~ .lDO Filed ..................... A.D. 19 John F.A]~g~f~' c~;~ff~)61919) 600 N. Second St., 5th Flr.~ Harrisburg, PA ADDRESS 17101 (717) 236-8000 PHONE his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 ~ ? 10528741 No. ~ Date Local Registrar ~ 44 P*v t~ CERTIFICATE OF DEATH ~29-329 (Coroner) Patrick M Sullivan . ~ 27 yr, Mar. Z7,197~ , Pa [:~,~, [] £~,,, [] Cumberland Lower Allen US Rt. 15 N/B MP 41.5 ,~'~"~"~.~ ,.~hite ltaubert Co ~,, ~'~ U k t,.*~,~ -, Marr~e~ amie Summy 4 Johns Drive Enolat Pa 1 7025 ~,~1 Cumberland Joseph Sullivan ,,. Gayle Rutkowski "~m's~"z~n'lJamie L. Sullivan m~30 Sam Snead Circle, Etters, Pa 17339 ~[~ o~.~,~ [],,~.Aug 4, 2004 ~vans Eagle Cremation ~l~eola, Pa I~,.F.D.011897-L I~,SullJvan FH. 51 N. Enola Dr. .. 6:10 P., [as, August 2, 2004 ,, ~'~ ' Multiple Traumatic Injuries Struck by Tractor Trailer N~., [] ,o~. [] Aug. 2,2004 ~ ~ ~U~ ~ ~'m'~ ~ Highway Intentionally ran in front of moving.vehicle 15, Camp Hill, PA Coroner Michael L. Norris, Coroner 63?5 Basehore Road, Suite #1 Mechanicsburg, Pa. 17050 November i3, 2004 Cumberland, Register Of Wills One Courthouse Square Carlisle, PA 017013 WELTMAN, WEINBERG & REIS CO., L.P.A. ATTORNEYS AT LAW 323 W. Lakeside Avenue, Suite 200 Cleveland, Ohio 44113o1099 216.685.1000 www.weltman.com BURLINGTON, NJ 609.914.0437 CHICAGO, IL 847.940.9812 CINCINNATI, OH 513.723.2200 COLUMBUS, OH 614.228.7272 DETROIT, MI 248.362.6100 PHILADELPHIA, PA 215.599.1500 PITTSBURGH. PA 412.434.7955 Estate of Patrick Sullivan Case No. 21-04-00793 Our Client: Bank of America, N.A. Account No. 4427103018989532 Balance Due: $5,954.35 Our File No. 3976869 Dear Clerk of Courts: This law £n'm represents Bank of America, N.A. in connection with its claim which we wish to file on our client's behalf into the estate of Patrick Sullivan, deceased. Enclosed is our check in the amount of $5.00 which we understand is the filing fee for this claim. Our client's claim is based upon its account number 4427103018989532 in the amount of $5,954.35. As of the date of this letter, this is the amount due. Included with this letter is the claim form which we wish to present to this court and which we are forwarding to the attorney and/or fiduciary of this estate. It would be appreciated if all correspondence and disbursements with respect to this matter be forwarded to our office and to the attention of the undersigned. Additionally, it would be appreciated if any notices of any heatings also be forwarded to the undersigned. Thank you for your cooperation in this matter. ;.ff~i~cerely YourA Veda Flowers : 3 C' , Legal Assistant (216) 685-1171 VLF:iar Enclosures cc: Jamie L Sullivan Stephame Kleinfelter,Esq., November 13, 2004 WELTMAN, WEINBERG & REIS CO., L.P.A. ATTORNEYS AT LAW 323 W. Lakeside Avenue, Suite 200 Cleveland. Ohio 44113-1099 216.655.1000 BURLINGTON, NJ 609.914.0437 CHICAGO, IL 847.940.9812 CINCINNATI, OH 513.723.2200 COLUMBUS, OH 614.228.7272 DETROIT, MI 248.362.6100 PHILADELPHIA, PA 215.599.1500 PITTSBURGH, PA 412.434.7955 Jamie L Sullivan 230 Sam Sneed Circle Etters PA 17319 CERT~IEDMAIL Estate ofPattick Sulhvan Case No. 21-04-00793 Our Client: Bank of America, N.A. Account No. 4427103018989532 Balance Due: $5,954.35 Our File No. 3976869 Dear Sir or Madam: This law firm represents Bank of America, N.A. with respect to the claim which we wish to file in the estate of Patrick Sullivan. It is our understanding that you are the Attorney of the estate. We are asking that you please accept our client's claim which is based upon its account number 4427103018989532 in the amount of $5,954.35. As of the date of this letter, this is the amount due. Please direct all correspondence and disbursements with respect to this estate directly to our office. It would also be appreciated if you contact us to advise us when you anticipate making disbursements in this matter so that we may mark our file for follow-up at that time. Thanking you in advance for your cooperation in this matter. This law f'mn is attempting to collect this debt for our client and any information obtained will be used for that purpose. Lastly, do not hesitate to contact us to further discuss this matter. VLF:iar erely Yo~s, Veda Flowers Legal Assistant (216) 685-1171 Enclosures cc: Jamie L Sullivan Stephanie Kleinfelter,Esq.,- regular mail WWR#3976869 FORM 93-O.C. DIVISION IN THE COURT OF COMMON PLEAS of CUMBERLAND, REGISTER OF WILLS, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE:ESTATE OF No. 21-04-00793 Patrick Sullivan Deceased For a creditcardwith BankofAmefica, N.A., Account No. 4427103018989532 CLAIM. To the Clerk of Orphans' Court Division: Index and make proper entry in your official records of the claim of Bank of America, N.A. c/o Weltman, Weinberg & Reis Co., L.P.A., 323 West Lakeside Avenue, Suite #200, Cleveland, Ohio 44113-1099 (Claimant) in the amount of $5,954.35 against the estate of the above named decedent. This claim is filed under Section 3532 (b) (2) of the Probate, Estates and Fiduciaries Code. The said decedent, who resided at 159 Ashford Dr Enola PA 17025 _, died on 08/02/04 (Address) Written notice of this claim was given to Jamie L Sullivan & Stephanie Kleinfelter,Esq., on (Personal representative, if any, or counsel) 230 Sam Sneed Circle Etters, PA 17319 & PO Box 1166 Harrisburg PA 17108/I . ~ Address or Personal Representative, if any, or counsel (Claimant) Veda Plowers, Agent for the Claimant c/o Weltman, Weinberg, & Reis Co., L.P.A. 323 W. Lakeside Ave., Suite200 Cleveland, Ohio 44113 (Claimant's Address) WWR#3976869 FORM 93-O.C. DIVISION IN THE COURT OF COMMON PLEAS of CUMBERLAND, REGISTER OF WILLS, PENNSYLVANIA ORPHANS' COURT DIVISION INRE:ESTATE OF No. 21-04-00793 Patrick Sullivan , Deceased For a credit card with Bank of America, N.A., Account No. 4427103018989532 CLAIM To the Clerk of Orphans' Court Division: Index and make proper entxy in your official records of the claim of Bank of America, N.A. c/o Welmaan. Weinber~ & Reis Co., L.P.A., 323 West Lakeside Avenue, Suite #200, Cleveland, Olfio 44113-1099 (Claimant) in the mount of $5,954.35 against the estate of the above named decedent. This claim is filed under Section 3532 (b) (2) of the Probate, Estates and Fiduciaries Code. The said decedent, who resided at 159 Ashford Dr Enola PA 17025 , died on 08/02/04 (Address) Written notice of this claim was given to Jamie L Sullivan & Stephaine Kleinfelter,Esq., on (Personal representative, if any, or counsel) 230 Sam Sneed Circle Etters, PA 17319 & PO Box 1166 Hamsburg PA 17108 . Address or Personal Representative, if any, or cotmsel ~/~ ] ~/ ~ ]Tnn_sa,3~ la&~ Veda Flowers, Agent for the Claimant c/o Wellman, Weinberg, & Reis Co., L.P.A. 323 W. Lakeside Ave., Suite200 Cleveland, Ohio 44113 (Claimant's Address) WWR # 3976869 STATEMENT OF ACCOUNTS FOR: Bank of America~ N.A. DECEDENT'S NAME: Patrick Sullivan ADDRESS: 159 Ashford Dr CSZ: Enola, PA 17025 SSN: 166-58-9236 ACCOUNT #: 4427103018989532 DOD: 08/02/04 BALANCE DUE: $5r954.35 EXHIBIT A Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717)240-6345 Date: 12/06/2004 PO BOX 1166 HARRISBURG, PA 17108-1166 RE: Estate of SULLIVAN PATRICK M File Number: 2004-00793 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 12/04/2004 Your prompt attention to this matter will be appreciated. Thank You. CC: File Personal Representative(s) Judge GLENDA FARiqER STPuASBAUGH Clerk of the Orphans' Court Cunfoerland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717)240-6345 Date: 12/06/2004 SULLIVAN J~JMIE L 230 SA/~ SNEED CIRCLE ETTERS, PA 17319 RE: Estate of SULLIVAN PATRICK M File Number: 2004-00793 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 12/04/2004 Your prompt attention to this matter will be appreciated. Thank You. cc: File Counsel Judge Sincerely, LENDA FARNER ~ Clerk of the Orphans' Court ~ ~ il?ltcnbll jfllrttrr ~tras:batlgIJ .cl)Hstcr of u)iH~ anti \[\ct'" of tht @rp\}ans' ((amt One Courlhousc Square Culisk:, PA 170\:<,-D\l.7 - --- - - - - - - - -ii -. -. -M--'. .r:. -.. - - _.~ - ~. ,; : 4 .4 2 : 7003 1010 0001 1203 8465 U.S. POSTAGE SULLIVAN JAMIE L 230 SAM SNEED CIRCLE ETTERS PA :7319 o~ s urvCLA 1m 8l J /,J 7 D INSUFFICIENT ADDRESS ~ D ATTEMPTED NOT KNOWN lilt OTHER D NO SUCH NUMBERI STREET Ir'" D NOT DELIVERABLE AS ADDRESSED - UNABLE TO FORWARD . . . 11"11\,1111\1"",1\,,1\,,,1\,,11\,1,\'11,1,1\1\,,1,111,,1\,1 )1A?~l'l!r"<""~"_ ...___-.:.:.~',...' . ,",, _.. ,ow' ,~.,,~ff-,~... . , ... ..."'. ......"l......,,;.;.. " -- \ E F{ ,~~:~ ,~..<,". '-;" V SENDER: COMPLETE THIS SECTION '09/ / ?Q{r . Complete items 1 J 2, and 3. Also complete item 4 if Restricted Delivery is desired. . Print your name and address on the revmse so that we can return the card to you. . Attach this card to the back of the mail piece, or on the front if space permits. ,. Article Addressed to: ~. ',s ----., 3o...m'~ L.5.A\\wa-.Y'1 23C) $AM Srt-u..d GRch' D*(h: ~..' 1,3JCl -- 04--,q,3 1\. Eignature :< . . . 'l. Feceived by (Printed Name) o Agent o Addressee C. Date of Delivery ), I'; delivery address different from Item 1? I' YES, enter delivt3fY address below: Dyes EfNo t t ,eplice Type rf Certified Mail [] Registered {] Insured Mall o Express Mall o Return Receipt for Merchandise DC.O.D. k Ilestricted Delivery? (Extra Fee) DYes ~OU3 ]010 0001 1203 8465 10259S-Q2-M-1540 2. Article Number (Transfer from service label) PS Form 3811, February 2004 D()rne~d; Fldur 1 Ftt<:eipt JRD/June 30. 1992/17858 JAN 1 9 :!OOSj! Estate No.: 21-04-0793 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYL VANIA In Re: Estate of Patrick M. Sullivan Late of East Pennsboro Township NO. 21-2004-0793 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: Jamie L. Sullivan Counsel for Personal Representative: John F. King, Esq. Date of Grant of Original Letters: 08/24/2004 Date of Delinquency Notice: 12/04/2004 The undersigned, Glenda Famer-Strasbaugh, Clerk of the Orphans' Court, in accordance with Rule 5.6, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas ofCumberJand 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 Orphans' 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 December 4, 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 undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. ~~.~ Date: 01119/2005 Glenda Farner Strasbaugh Clerk of the Orphans' Court Personal Representative Counsel for Personal Representative Estate File 'mo.n&-' 't, ').ooS '1:30AM 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 be cancelled. ,11 Distribution: Geor JRDlJune 30, 1992117858 In Re: Estate of Patrick M, Sullivan Late of East Pennsboro Township ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYL VANIA Estate No.: 21-04-0793 NO. 21-2004-0793 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: Jamie L. Sullivan Counsel for Personal Representative: 30~.... ~. K.","I''t:kq; Date of Grant of Original Letters: 08/24/2004 Date of Delinquency Notice: 12/04/2004 The undersigned, Glenda Farner-Strasbaugh, Clerk ofthe Orphans' Court, in accordance with Rule 5.6, Supreme Court Orphans' 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 Orphans' 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 December 4,2004, 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 undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 01/19/2005 ~=~ Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File rm~"'I.:lOoS q:~oAM A hearing is scheduled for at in Courtroom No.3. filed prior to the hearing date, the hearing will automatically be If the Certification of Notice is e /> Geor' CERTIFCATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: f..b:frIGL H. Su\\\0CU\ Date of Death: B 1.21 04- Will No.: ;J:Jne Admin No.: To the Register: c2) - ()If -1<13 I certify that notice of (benelicial 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 Address --i1vue LJ>...Cl.S /l 0 C S -tct- fe.., Name CJCA.rVJle SUf'r\N\j h:21 cu.J Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: 3/3/0'5 ~~ C\o.N\ If' Name 51. l~f'(\.j ~35 O\d.. --rv-ci \ Rei .-k\i\e.fS pA Address 113l<1 =it -=1-- 43R . otlo 3 Telephone Capacity: 2:f Personal Representative D Counsel for personal representative if U1 ..D ::r to In Cl ru r-'l r-'l Cl Cl Cl Cl r-'l Cl r-'l In Cl n Cl I"- "Sir7i orl cii SULLIVAN JAMIE L 230 SAM SNEED CIRCLE ETTERS PA 17319 oy.--,q~ See Reverse for In PS Form 3800, June 2002 Postmal Here Certified Mail Provides: . A mailing receipt (SSJEM3C1J ~OOE eunr 'OOSE WJOd Sd . A unique identifier for your mallplece . A record of delivery kept by the Postal Service for two years ImJJortanr Reminders: . Certified Mail may ONLY be combined with First-Class Mail" or Priority Mail",. . Certified Mail is not available for any class of international mail. . NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables, please consider Insured or Registered Mail. . For an additional fee, a Return Receipt may be requested to provide proof of delivery. To obtain Return Receipt servIce, pfease complete and attach a Return Receipt (pS Form 3811) to the articie and add applicable postage to cover the fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USPS", postmark on your Certified Mail receipt is reqUired. . For an additional fee, delivery may be restricted to the addressee or addressee1s authorized agent. Advise'the clerk or mark the mailpiece with the endorsement "Restricted-oelivery". . If a postmark on the Certified Mali receipt Is desired, pleas~ present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed. detach and affix label with postage and mail. IMPORTANT: Save this receipt and present it when making an Inquiry. Internet access to delivery Information is not available on mail addressed to APOs and FPOs. I Date: 5-5-05 In the estate of: PATRICK M. SULLIVAN Estate No: Date of Death: 21-04-793 8-2-04 -.< -.J _!'"'1 CLAIM AGAINST DECEDENT'S EST~TE r",.) ()"'l (J' The Claimant certifies that there is due and owing by the PATRICK M. SULLIVAN in accordance with the attached statement of account the sum of $ together with interest at the rate of from until paid. deceased, 436.31 On behalf of the claimant 1 do solemnly declare and affirm under the penalties of petjury that the information and representations made herein are true and correct of the best of my knowledge, information and belief. KOHL'S DEPT. STORE lure of Claimant or person authorized to make verification on behalf of creditor Name of Claimant 9441 LF FREEWAY Adtlook BeA 30 Dallas,rx 75243 Address of Claimant 972-644-6360 Phone Number Phone Number FILED: THIS FORM MAY BE FILED WITH THE ORPHANS COURT UPON PAYMENT OF A FILING FEE OF $10.00. A COPY MUST ALSO BE SENT TO THE PERSONAL REPRESENT A TIYE. r PROBATE COURT Cumberland County, State of Pennsylvania Patrick M. Sullivan, Deceased Case #21-04-793 Proof of Mailinq I mailed the creditors claim to the fiduciary (and attorney, if applicable) as follows: I deposited a copy/copies of the claim with the United States Postal Service in a sealed envelope with the postage fully pre-paid. I used first-class mail. I am employed in the county where the mailing occurred. The envelope(s) was/were addressed and mailed as follows: Ms. Jamie Sullivan c/o John F. King, Esq. 600 N. Second Street Harrisburg, PA 17101 Date of Mailing, /~4/ County of Mailing: Dallas, Texas I declare under penalty of perjury that the foregoing is true and correct. Date, c.5~~J~ . Albertson, Agent for Kohl IS Departme~t store P.O. Box 741026 Dallas, TX 75374 scse~O/l 03/29/2005 KOHL'S ACCOUNT STATUS DISPLAY 03/29/2005 13:40 Acct : 0387780638 52 Cycle: 90 Bi: 03/28/2005 Due: 04/22/2005 HYC: N S~/Lc: 90 601 CBS - DECEASED Op: 04/17/2004 Closed: 10/25/2004 Namel: PATRICK M SULLIVAN Home: 717 443 - 8832 D Pull: Name2: Bus1: AScr: Addr 4 JOHNS DR Srce: I 00000001 Emp: NScr: R N CiS : Rstr: ENOLA PA 170252696 AdChg: 11/12/2004 Instr: PRMENT DECEASED 08/02/04 pymnt H: 77765432NMM- Last Stmnt Curr Stmnt 436.31 436.31 ID: JMB VIP: N Ins: N 620 04/04 Auths Dun H: 777654321000 Last Reage: Avl Credit: Disputes Last Pymnt: Cr Lmt E Li.lnit Ext : MVC Pur Issued Cards 038778063800 -136.31 Prv Bal: Pur/Adv: Returns: Fee/Int: Cr/Dr pymnts : Cls Bal: 436.31 436.31 Min Due: 21.00 Min Non-Dl: OverDue: 152.00 Min Deals Ttl Due: 173.00 Interest Avd FC : 436.31 Ttl Due ACCTS4 PF1=Read PF5=Hist PF6=Updte Record read OK 40.00 06/17/2004 300 10% 09/25/2004 436.31 21.00 Cnt Sts Issue date 1 100 04/17/2004 173.00 PF7=Comment ,- COMMONWEALTH OF PENNSYLVANIA COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHANS' COURT DIVISION TO: THE CLERK OF THE ORPHANS' COURT DIVISION: Notice of claim by creditor, Pursuant to Section 3532(b)(2) of the Probate, Estates, and Fiduciaries Code, 20 PA.C.S.A. 93532(b)(2). WORLD FINANCIAL NETWORK NATIONAL BANK', ;::0 <' -r1 ": -- ~ NOTICE OF CLAIM In Re: The Estate of: PATRICK M SULLIVAN Deceased Court File No: 21.2004.793 1) Claimant's name: 2) C/O BALOGH BECKER L TD, 4150 OLSON MEMORIAL Claimant's address: HWY #200 MINNEAPOLIS, MN 55422 877.768.4502 3) Creditor listed below is the owner and holder of a claim in the amount $ 2792.73 4) The facts upon which this claim is based: This claim is based on an account for credit evidenced by the attached Affidavit of Account Stated. 5) Decedent's address: 4 JOHNS DR ENOLA, PA 17025 6) Date of Death: 08102/04 7) That the claim arose prior to the death of the decedent on or about 8) That the claim is secured by \ "'-;- Dated: - -l -tJ ...;~.. r:-? c.n CP ean, Atty-in-Facl Written tice of aim was given to Personal Representative and/or his/her counsel as state below: JAMIE SULLIVAN Name 230 SAM SNEED CIRCLE .)' IN RE ESTATE OF: PATRICK M SULLIVAN AFFIDAVIT OF ACCOUNT The undersigned, being first duly sworn deposes and states the follows: 1. Your Affiant is authorized by the Claimant as its Attorney-In-Fact to make this Affidavit. 2. Your Affiant has reviewed the account records of the Claimant with respect to the decedent. Your Affiant is familiar with these records and accounts and reviews them as a regular part of hislher duties. 3. The Decedent purchased merchandise in the amount of $ 2792.73 account number 005856370728492688 evidenced by 4. The unpaid balance does not include any post-death late payment charges, accrued interest, collection costs or attorney's fees. Further your affiant sayeth not By: ./"' Attorneys-in-Fact: ~ Chelsea A. Whitley _ Angela M. Horn_ Mary Ellen Weeman _ Thersia O. Lee_ Chad 1. Bolinske Karnille R. Dean 4150 Olson Memorial Highway, Suite 200 Minneapolis, MN 55422-4811 Subscribed and sworn before me This ~ 7 day of ~ ,2005. e SlEP . JOHNSON ". NOTARY PUBUC - MINNESOTA ,. MY COMMISSION EXPIRES 1131108 COMMONWEALTH OF PENNSYLVANIA COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHANS' COURT DIVISION NOTICE OF CLAIM In Re: The Estate of: PATRICK M SULLIVAN Deceased Court File No: 21.2004.793 TO: THE CLERK OF THE ORPHANS' COURT DIVISION: Notice of claim by creditor, Pursuant to Section 3532(b)(2) of the Probate, Estates, and Fiduciaries Code, 20 PA.C.S.A. s3532(b)(2). WORLD FINANCIAL NETWORK NATIONAL BANK 1) Claimant's name: C/O BALOGH BECKER LTD, 4150 OLSON MEMORIAL 2) Claimant's address: HWY #200 MINNEAPOLIS, MN 55422 877-768-4502 3) Creditor listed below is the owner and holder of a claim in the amount of $ 2792.73 4) The facts upon which this claim is based: This claim is based on an account for credit evidenced by the attached Affidavit of Account Staled. 5) Decedent's address: 4 JOHNS DR ENOLA, PA 17025 6) Date of Death: 08/02/04 -) 1 7) That the claim arose prior to the death of the decedent on or about 8) That the claim is secured by On behalf of the claimant, I do solemnly declare and affirm under the penalties of perjury that they Information and representations made herein are true and correct to the best of my knowledge, information and belief. Dated: 4 7- ~4:5 .. , / Chelsea Whitley/Angela Ham/Mary Ellen WeemanfChad Bo\\nskelThersia Lee ille Dean, Atly-in-Fact Written notice of claim was given to Personal Representative and/or his/her c nsel as stated below: JAMIE SULLIVAN Name 230 SAM SNEED CIRCLE Address EDDERS, PA 17319 City/State/Zip. / 1 5 _;73 LC J Date notice mailed ' IN RE ESTATE OF: PATRICK M SULLIVAN AFFIDAVIT OF ACCOUNT The undersigned, being first duly sworn deposes and states the follows: I. Your Affiant is authorized by the Claimant as its Attorney-In-Fact to make this Affidavit. 2. Your Affiant has reviewed the account records of the Claimant with respect to the decedent. Your Affiant is familiar with these records and accounts and reviews them as a regular part of his /her duties. 3. The Decedent purchased merchandise in the amount of $ 2792.73 accountnurnber 005856370728492688 evidenced by 4. The unpaid balance does not include any post-death late payment charges, accrued interest, collection costs or attorney's fees. Further your affiant sayeth not BALOGH BECKER, LTD. P ---------- By: -- Attorneys-in-Fact: ______ Chelsea A. Whitley _ Angela M. Horn_ Mary Ellen Weeman _ Thersia O. Lee Chad J. Bolinske Kamille R. Dean 4150 Olson Memorial Highway, Suite 200 Minneapolis, MN 55422-4811 Subscribed and sworn before me This 9 day of ~ ,2005. l-....., ST A . JOHNSON NOTARY PUBLIC - MINNESOTA MY COMMISSION EXPIRES 1/31/0B - COMMONWEALTH OF PENNSYLVANIA COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHANS' COURT DIVISION NOTICE OF CLAIM In Re: The Estate of: PATRICK M SULLIVAN Deceased Court File No: 21-2004-793 TO: THE CLERK OF THE ORPHANS' COURT DIVISION: Notice of claim by creditor, Pursuant to Section 3532(b)(2) of the Probate, Estates, and Fiduciaries Code, 20 PA.C.S.A. g3S32(b)(2). WORLD FINANCIAL NETWORK NATIONAL BANK. (~ ri 1) Claimant's name: (,' C/O BALOGH BECKER LTD. 4150 OLSON MEMORIAL Claimant's address: HWY #200 MINNEAPOLIS, MN 55422 877-768-4502 3) Creditor listed below is the owner and holder of a claim in the amount of $ 2792.73 2) (!"l C') 4) The facts upon which this claim is based: This claim is based on an account for credit evidenced by the attached Affidavit of Account Stated, 5) Decedent's address: 4 JOHNS DR ENOLA, PA 17025 6) Date of Death: 08/02104 7) That the claim arose prior to the death of the decedent on or about 8) That the claim is secured by On behalf of the claimant, I do solemnly declare and affir perjury that they Information and representations ma to the best of y k wledge' ation and belief Dated: ~ nder the penalties of rein are true and correct an/Chad BolinskelThersia Lee/Kamille Dean, Atty-in-Fact Written notice of claim was given to Personal Representative and/or his/her counsel as stated below: JAMIE SULLIVAN Name 230 SAM SNEED CIRCLE Address EDDERS, PA 17319 City/State/Zip/I S- /"1~h ) Date notice ;/lail d IN RE ESTATE OF: PATRICK M SULLIVAN AFFIDAVIT OF ACCOUNT The undersigned, being first duly sworn deposes and states the follows: 1. Your Affiant is authorized by the Claimant as its Attorney-In-Fact to make this Affidavit. 2. Your Affiant has reviewed the account records of the Claimant with respect to the decedent. Your Affiant is familiar with these records and accounts and reviews them as a regular part of hislher duties. 3. The Decedent purchased merchandise in the amount of $ 2792.73 account number 005856370728492688 evidenced by 4. The unpaid balance does not include any post-death late payment charges, accrued interest, collection costs or attorney's fees. Further your affiant sayeth not CKER, LTD. By: l' Attorneys-in-Fact: ./ Chelsea A. Whitley _ Angela M. Horn_ Mary Ellen Weeman _ Thersia O. Lee_ Chad J. Bolinske Kamille R. Dean 4150 Olson Memorial Highway, Suite 200 Minneapolis, MN 55422-4811 Subscribed and sworn before me This \ 'f day of~, 2005. ~_? ell. '.. Jk~ -i Notary Public C,,"', -- NON ELUOH ~.t<:.,\;J... PAIGE LAN ,INNFSOTA ~~:'~..'f.''f'''.<-:\'~ NOTAR'I PUB~I:Pi~e~Jal1.3j, 2009 .j, >' Mv CommisSion ''')1$'.:) u; W . FRIEDMAN & KING, P.C. 600 N. 2nd Street, Fifth Floor P.O. Box 984 Harrisburg, PA 17108 (717)236-8000 (717)236-8080 (fax) friedmanandking@hotmail.com Richard S. Friedman John F. King February 10, 2006 Commonwealth ofP A Department of Revenue Bureau of Collections & Taxpayer Services P. O. Box 281041 Harrisburg, PA 17128-1041 ,,~- " ----, I__J - c) ~Ct In re: Estate of Patrick M. Sullivan File No. - 21-2004-0793 Dear sir or madam: I am in receipt of the Inheritance Tax Non-Filer Delinquency Notification dated February 10,2006. Enclosed herewith please find a copy of a letter which I previously sent to the Clerk of the Orphans' Court, which I believe is self-explanatory. I have had no communication from the Administratrix. I am forwarding a copy of your notice to Ms. Sullivan for her to respond accordingly. Very truly yours, John F. King JFK!bp Enclosure cc: Jamie Sullivan, Administratrix Cumberland County Register of Wills ~ J. , / FRIEDMAN & KING. P. C. ATTORNEYS .AT LAW 600 N. SECOND ST. FIFTH FLOOR P.O. Box 984 HARRISBURG, PENNSYLVANIA 17106 (717) 2136-8000 TELECOPIER No. (717) 2136-8080 friedmanandking@hotxnaiLcom RICHARD S. FRIEDMAN J ORN F. KINO March 3, 2005 FAX TRANSMISSION Glenda Farner Strasbaugh, Clerk of the Orphans' Court Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 In re: Estate of Patrick M. Sullivan No. 21-04-0793 Dear Ms. Farner Strasbaugh: This is to follow up on the Notice that you had sent originally to Attorney Kleinfelter, and which has now been forwarded to this office. Subsequent to a telephone conversation with a member of your office on March 1, 2005, I attempted to get a hold of the Administratrix/surviving spouse, Jamie L. Sullivan. Unfortunately, I have been unsuccessful. I have not spoken to Ms. Sullivan since last year on or about the time that she opened this estate. It is my recollection that the only purpose of Ms. Sullivan in opening this estate was to get Letters of Administration so that she could retrieve certain items that had been stored in a storage unit in her deceased husband's name alone. I am not aware of any estate actually being in existence, since these items were marital in nature and passed to her naturally upon his death. I apologize for not being able to give you further information, but since I have been unable to get a hold of my client, that is all the information I am able to provide at this time. I will, of course, contact you if Ms. Sullivan responds to correspondence that I have sent separately. ery truly yours, ::f)~ \\?R JFK/bp: corresaf\cumbregi. ps cc: Jamie Sullivan, Administratrix BUREAU OF COLLECTIONS & TAXPAYER SERVICES PO BOX 281041 HARRISBURG PA 17128-1041 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE Inheritance Tax Non-Filer Delinquencv Notification REV-834AFP (12-04) JOHN F KING 5TH FLR 600 N 2ND ST HBG DATE: ESTATE OF: PATRICK SSN: DATE OF DEATH: FILE NUMBER: 02/10/2006 M SULLIVAN 166-58-9236 08-02-2004 2104-0793 PA 17101 A review of Department records has disclo~ed that you are responsible for the settlement of the above estate, or that you represent the responsible party. The above estate is in a delinquent status. According to Department's records, as of this date, the inheritance tax return has not been filed. The Inheritance and Estate Tax Act mandates the filing of a tax return and payment of all outstanding liabilities by a personal representative of the estate or a transferee within nine months of the decedent's death. If this estate was opened for the purpose of filing a lawsuit, please provide this office in writing with the court term and docket number of the proceeding. The Department may postpone any further action regarding the Estate pending the completion of the lawsuit. If there is any other reason that a return has not been filed, please contact this office. To avoid further action, a return must be filed within 15 days from the date of this letter. If the return has been filed recently, please disregard this notice. CONTACT: RETURNS SHOULD BE FILED AND PAYMffiNTSMADE AT THE REGISTER OF WILLS LISTED BELOW: Harrisburg Call Center (717) 783-3000 TDD# 1-800-447-3020 (Service for taxpayers with special hearing and/or speaking needs) REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 Cumberland County - Register Of wills One Courthouse Square Carlisler PA 17013 Phone: (717) 240-6345 Date: 7/05/2006 SULLIVAN JAMIE L 230 SAM SNEED CIRCLE ETTERSr PA 17319 RE: Estate of SULLIVAN PATRICK M File Number: 2004-00793 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 RULESr NO. 103 SUPREME COURT RULES DOCKET NO. 1r for decedents dying on or after July 1r 1992r the personal representative or his counselr within two (2) years of the decedent's deathr 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 Reportr please disregard this notice. SincerelYr Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 7/05/2006 KING JOHN F 600 N SECOND STREET HARRISBURG, PA 17101 RE: Estate of SULLIVAN PATRICK M File Number: 2004-00793 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: 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. Sincerely, , ~~" !);,,~-" ~ .,f "~t"",dAlCL'A-, '*~Cfi~~__ / ,; Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) ~ Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: Patrick M. Sullivan Date of Death: 8/2/04 2004-00793 Estate No.: File No. 21-04-0793 Pursuant to Rule 6.12 ofthe 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 0 No ID: 2. If the ans'Vver is No, state ,x/hen the personal representative reasonably believes that the administration will be complete: 10 /02 /06 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 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 interest? Yes 0 No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with lerk of the Orphans' Court and may be attached to this report. . Date: 7/27 /06 John F. King, Esquire Name P. O. Box 984 Harrisburg, PA 17108 Address (717) 236-8000 Telephone No. Capacity: 0 Personal Representative IX21 Counsel for personal representative /' ( '------- i REV-1500 EX (6.00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 I- Z W C W (,) W C W I- :.::$(1) (,)11:::':: wlLU %00 ulI::..l lLlD lL <( . (;.jifljf INHERITANCE TAX RETURN RESIDENT DECEDENT DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Sullivan, Patrick M. DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) 08-02-2004 03-27-1977 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Sulli van, Jamie 1. ~ 1. Original Return o 4. Limited Estate o 6. Decedent Died Testate (Attach copy of Will) o 9. Litigation Proceeds Received D 2. Supplemental Return D 4a. Future Interest Compromise (date of death after 12-12-82) D 7. Decedent Maintained a Living Trust (Attach copyofTrust) D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) I- Z W o z o lL II) W II:: II:: o U OFFICIAL USE ONLY FILE NUMBER 2 1-0 4 -- -- 079 3 COUNlY CODE YEAR NUMBER SOCIAL SECURITY NUMBER 166 _ 58 9236 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Return (date of death prior to 12-13-82) D 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes D 11. Election to tax under Sec. 9113(A) (Attach Sch 0) x .0 _ (15) x .0_ (16) x .12 (17) x .15 (18) 19. Tax Due CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT NAME COMPLETE MAILING ADDRESS JOM F. King, Esquire FIRM NAME (UApplicable) F elm & K P C rie an ing,.. P. O. Box 984 Harrisburg, PA 17108 OFFICIAL USE ONLY ') TELEPHONE NUMBER (717) 236-8000 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) z o ~ ~ ::J !:: D.. < (,) w 0:: 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) (6) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-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) (7) (9) (10) 58.00 9,183.39 10. Debts of Deceden~ Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental BequestslSec 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) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ ~ ::J D.. ~ o (,) >< ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 20.0 .~ i~~~~::;'1':'fF~.c-"'-~:,"T~11..::t~.!"'"~''' '-'--"-1~~~'-:k"'~> .h~- ." """"'" "'~~':1:r,.. . ., '.- - -.,,'-~ ~-:t .~..~~~-:--;:~~~~t,:l.~I~~Jil.~,~.~L~=--~B~~7:~.:.~I~~(~~:'"'__~;~- ~~ ,,:- ,,~~ ~. ~ :=.:::: ~ Q ;.;J 1',) \:' '-.) ) :'1 (8) -0- ,r (11) (12) (13) 9,241.39 INSOLVENT (14) INSOLVENT (19) \ Decedent's Complete Address: STREET ADDRESS 4 Johns Drive CITY E 1 I STATE PA I ZIP 17025 no a Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) INSOLVENT Total Credits (A + B + C ) (2) 3. InteresUPenalty if applicable D. Interest E. Penalty TotallnteresUPenalty ( D + 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 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. INSOLVENT A. Enter the interest on the tax due. (5) (5A) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) Make Check Payable to: REGISTER OF WILLS, AGENT INSOLVENT 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;.......................................................................................... 0 :m b. retain the right to designate who 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 December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 129 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 m 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ 0 @ 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 penallles of pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, ~ is true, correct and complete. Declaration of preparer other than the personal representative is based on all infonmation of which preparer has any knowledge. SIGNATUR PA 17108 ADDRESS ADDRESS ~~ j ......::....-..:./:,.~:.> F~~.;._ .' ") I ..~""'~~....'-C.~....-...,.,-,<."...ov~"'<,- ~",,",,"_....... r . ,.... ~ ,_ :;';j)':',:,-\ ,~:r"t:, ;'- ~~h'!fk );.~("\d 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% ..'...fJ......A O.~,.. :..~".:,H,:.. ',,<",: +':r:.',' ':','1"";t~,~,,:,,, ;;':<;:;i::" .::, "',;. ,':{C.':, ,"c,' ::>:-7+\"'<'<';' :~.' . ,,', '" ",,,,"-,, ",", '5,'!:;-,;,-iJ .. '195, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)]. surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicabl~ ~y~n if ~' ,,::;h. .,...,'.,r'" 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, ":'. ;'-i:~-~ '!.~:~~i~r:'::.. ;,,:-s.'1!J , ~_'\ to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 12 P.S. ~9116(1.2) [72 P.S: . 9116(a)(1]. ..,::"". , ", ',:, '..,,;t;~:ia.~~i~~ :.,,::__f~~\:',;~;~'~;~'.c.;:-.~~l:(?!'~~~'~~~:;~;~~;::;..~.:.'.,.,,- \i::'>:':.~;.~:';?~~);;i;~.t?!?,~;~'f'tlti.z~:::"'_;~gtqkt,;~\~t.~f~~;; The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)].AOSjbJing is defined,lJnqe~. . .... n individual who has at least one parent in common with the deceden~ whether.by~~ ora~~~~e~"~;\~i~J~~g~,~i;i~~.j.;;;~'it~,\,,:;~5;~,~*?;i.;i'~'''K~:it'\;~:j:c~:~J'0i~.~~.'~I~r~;~&~0'r REV-1511 EX+ (12-99) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Patrick M. Sullivan SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-04-0793 Debts of decedent must be reported on Schedule I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNERAL EXPENSES: 1. B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address . City State _Zip Year(s) Commission Paid: 2. Attorney Fees 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State _Zip Relationship of Claimant to Decedent 4. Probate Fees 43.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Crnnberland Cotmty Register of Wills (filing of Inheritance Tax Return) 15.00 TOTAL (Also enter on line 9, Recapitulation) $ 58.00 (If more space is needed, insert additional sheets of the same size) REV-1512 EX+ (12-03) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF Patrick M. Sullivan 21- 0 4 _ ~lf9~UMBER Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. Bank of .Arrerica (#4427103018989532) 5,954.35 2. World Financial Network National Bank(#005856370728492688) Kohl's Department Store (#038778063852) 2,792.73 3. 436.31 TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 9,183.39 REV-1513 EX+ (9-00*, COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF FILE NUMBER 21-04-0793 Patrick M. Sullivan NUMBER I RELATIONSHIP TO DECEDENT NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Jamie L. Sullivan (now known as Jamie L. SJlTlJ1lY) Wife 37 S. 39th Street Camp Hill, PA 17011 1. 2. Mldison Sullivan 37 S. 39th Street Camp Hill, PA 17011 Daughter AMOUNT OR SHARE OF ESTATE 50% 50% 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 1. B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS 1. 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) FRIEDMAN & KING, P.C. 600 N. 2nd Street, Fifth Floor P.O. Box 984 Harrisburg, P A 17108 (717)236-8000 (717)236-8080 (fax) friedmanandking@hotmail.com Richard S. Friedman John F. King March 20, 2007 Cumberland County Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 In re: Estate of Patrick M. Sullivan No. 21-04-0793 Dear sir or madam: Enclosed herewith for filing please find an original and two copies of the Inheritance Tax Return. I have enclosed a check in the amount of $15.00 to cover the cost of filing. After filing, please return a time stamped copy in the enclosed envelope. ~.. truly yours, .:fJ:l!v\A \ ef J F. King I -. a JFK/bp Enclosures cc: Jamie L. Sullivan, Administratrix (now Jamie L. Summy) --.-J :- ,~l r-.,) ..; I I".] . I L') \ ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ., -,-,~ ,NOUCE OF INHERITANCE TAX APPRAISEMENr ; ALLoWANCE OR DISALLOWANCE OF DEDUCTIOtlS AloID ASSESSMENT OF TAX BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 2aUOl HARRISBURG PA 17128-0601 REV-1547 EX AFP (06-05) DATE 05-28-2007 ESTATE OF SULLIVAN PATRICK M DATE OF DEATH 08-02-2004 FILE NUMBER 2104-0793 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 07-27-2007 ( See reverse side under Objections) A.ount Re.ittedl I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 ~~!_~~~~~_!~!~-~!~~------~--_!~!~!~-~~~~!_~~!!!~~-~~!-!~~!_!~~~!~!_-~-------------------- REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF SULLIVAN PATRICK M FILE NO. 21 04-0793 ACN 101 DATE 05-28-2007 '7[11)7 -'- _'I " i -- J Pi; 12: i+L{. JOHN F KING ESQ FRIEDMAN & KING PO BOX 984 HBG PA 17108 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN Closely Held Stock/Pa~tne~ship Inte~est (Schedule C) Mo~tgages/Notes Receivable (Schedule D) Cash/Bank Deposits/Misc. Pe~sonal P~ope~ty (Schedule E) Jointly Owned P~ope~ty (Schedule F) T~ansfe~s (Schedule G) (1) (2) (3) (4) (5) (6) (7) .00 NOTE: To insu~e p~ope~ c~edit to you~ account. submit the uppe~ po~tion of this fo~m with you~ tax payment. 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. 4. 5. 6. 7. 8. Total Assets .00 .00 .00 .00 .00 .00 (8) .00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Fune~al Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mo~tgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Retu~n 13. Cha~itable/Gove~nmental Bequests; Non-elected 9113 T~usts (Schedule J) 14. Net Value of Estate Subject to Tax (9) ClO) 58.00 9.183.39 (11) Cl2) Cl3) Cl4) 9.?61 ~9 9,241.39- .00 9,241.39- If an assess.ent 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: 15. Amount of Line 14 at Spousal ~ate 16. Amount of Line 14 taxable at Lineal/Class A ~ate 17. Amount of Line 14 at Sibling ~ate 18. Amount of Line 14 taxable at Collate~al/Class B ~ate 19. P~incipal Tax Due NOTE: .00 X DO .00 .00 X 045.. .00 .00 X 12 .. .00 .00 X 15 .. .00 Cl9)= .00 AMOUNT PAID Cl5) (16) Cl7) (18) DATE NUMBER + INTEREST/PEN PAID (-) . IF PAID AFTER DATE INDICATED. SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE DO ( IF TOTAL DUE IS LESS THAN .1. NO PAYMENT IS REQUIRED~ ~) IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU MAY BE DUED A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)