HomeMy WebLinkAbout01-1079
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of ~ '3- U)-:t-fso n
also known as
No.
To:
2J-OI-I079
Deceased.
Social Security No. 020 (p '- E (p - 9 ,) 8 ?
Register of Wills for the
County of CUMBERLAND in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl '1'9
for letters of administration
on the estate of
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
Decendent was domiciled at death in (lIm be,.... }ond . County, Pennsylvania, with )
h e.... last family or principalresidence at t..J.. 8 EJ.-I'f't- ;e.d / IJ'fU/hu rr (uf' p'fr" m;~ Itll
(list street, number and municipality)
Decendent, then t.}O years of age, died ~ C +. cA~
at y. 8 EH-er- !Ul I L}oflA.Jbv"i
, ~,;2.. 00
Decendent at death owned property with estimated values as folllows:
(If domiciled in Pa.) All personal property $
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
Petitioner_ after a proper search h~ ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Name
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
j (l) ~ W~ -
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF C \.A rvl b'i'r- t c1ncl
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The petitioner(s) above-named swear(s) or affirm(s) that the
statements in the foregoing petition are true and correct to the best
of the knowledge' and belief of petitioner(s) and that as personal
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law. ~ J\ J . ~, ~
Sworn to or af!irmed and subscribed f - ~ ~-
before me this ---.1.7 th day of 0 h {.J..Jt1 {soY)
~NOVEMBER ~2001
'fo/'wf-")PJ4~," I
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No. 21-01-1079
Estate of
KATHY WATSON
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW NOVEMBER 26 :Jl~ 2001, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
lT IS DECREED that RON WATSON
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to RON WATSON
in the estate of KATHY WATSON
7q<LYc1 d!:jh~t) ~ .!,o/,~
ister of Wills
FEES
Letters of Administration $ 25.00
Short Certificates( ).......... $ 6 . 00
Renunciation ................ $
JCP $ 5.00
TOTAL _ $ 36.00
Filed . .~qY~~lj:~. .Zf?. .... A.D.}(:1) 2001
ATTORNEY (Sup. Ct. I.D. No.)
ADDRESS
PHONE
't..P r<:;}U)" REV ~l.Q(;
This is to certify that the information here given is correctly copied fr.om. an:originalcertificate 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.
No.
Fee for this certificate, $2.00
p
7782724
u{Z?
Date
~@/
(
21-01-1079
:"lev. 11'91
COMMONWEALTH OF PENNSYLVANIA. D!PAATMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
t.
Kathy
L
SEX
..Female
aTAr! !IlL! NUMBER
SOCIAL secuAlTY NUMBER
UNDER 1 YEAR
Months Oaya
.. 206-56-8289
October 26; 2001
NAME OFOECEDENT (First. MIOdIe, La81)
UNDER 1 DAY
Hours MlnutH
om OF BIRTH
(Month, Day, 'lMr)
8IFlTHPlAC! (ClIy and
Slate Of Forl'lionCounlry)
PLACE OF DERH (Check only 0118 left 1Il41'ruchori~ 011 olhltf !Iidfl)
HOSPITAL:
._0
~I~'fl')[]
em,
48 Etter Road
to. Newburg, PA 17240
FATH!R'S NAME (Firll. Middle, lMt)
'I. Maxwell Snouffer
INFORMANT'S NAME (TypelPfInI)
Ron E. Watson
METHOO
......00 e.........,O
oa... _
1711.
Old
-..
llvelna
CUmberland _"",1 t1d =:t..-='~::::of
MO'tH '$ NAME (f'Ii'M, MldCfIe, ~ &/Theme)
1t Lois
I
MARITAL STAlUS. M.rritIcI
Never Married. WIdowed,
OlvorcMljf>Pft';;lfv)
.Married
11c.GG ....,__In UDDer
SURVIVING spouse
(1I...."IA,q...."''',.,'rj....''',1m'')
DECE'OEN'T'S USUAL OCCUPlCfION
~::.~II;:w:O~U~f;~I~~
, CaShler , Weis Market
DECEDENT'S MAILING ADDRESS (Street, CilylTown. Slate, lip Code) DECeDENT'S
ACTUAL
RESIDENC!
(See lnatrucllon.
00 oIl'1er aide)
KIND OF BUStNESSlINOUSTRV
17..._
Ron E. Watson
Miffl in
._.Twfl
ell/boto
_0
1
SKlNAT~ OF..JUNEAAL ~RVICE
0.. or ^""""^. ::> .
CompMtI ~ 23e-conly when cmIfyIng
phyItc....nat..,...,..fltllmeofc:Ie.thto
certIfy~ofdMth
17240
H
PA
17257
ltema 2.we mUll be comptetlld by
peqon who pt"OI'lOUnC" dUm.
....
TIME OF DE~H prx. 0 DEAD !Month, OIly. 'Met)
... A. M October 26, 2001
21. MAT I: E"~ 1M dl.......1nfut'IM or compllalllons which ceUHd thl daslh. Do noI.,,'lr the mode of dying, such.. cardlaeOl' rupk.l~ an'.,.mck or hNrt 'allur.
Lilt onty OM CIIUM on -.ch line.
NoD
-,..,...-
If MY,..... to IrrlmtdIMe
~. erur UNDeN.YING
CAUSI (0leMIe or injury
fhalinitiatedllV'Mll
fe8lJlTinQ In dMIfl) LAST
b.
......-
llntervaf betwMn
! 0I'IMt and death
PART n: Other slgnlf~nt eondIllol1s contributing 10 dealh. bill
not molting in 11M Underlying CIUM giIMn in PART 1
~CAUII(Final
diMMe or condItiOn
fMUltlng In dMthj--"
HyDertrollhi~_1).!tJ!J,J_a~.e...9__
Cardiomyopathy
'" OF lNJ
(Month. Dey. 'TNt)
ot -- 0
Ac,idoftt 0 __lgat... 0
Suicide 0 CouIdnDIbedetermlntd 0 =~~~V~Athome,f.rm.lllr..l.ltlctOfy,
III. ... 21. ..
~.,f"~~:;l..(PhY*iMIC.ftifyingc:aUgeol dNth whenano!h81 ptlyticlanhlll pronounceddMlh endcomplelfld 118m 23)
1b.........,""k,............... CIODUn'M due to......,..)and 1I'IIInnef......... .........,.................,........................
Nfltural
Coroner
DUE 10 (OR AS A CONSEQUENCE OF):
VMS AN AUTOPSY
PERFORMED?
d.
WE E AUtOPSY FINDINGS
NN\1lA8LE PAIOR TO
COMPLETION OF CAUSE
OF DEMH?
MANNER OF DE,;rH
.... ~ NoD
....~
NoD
~/ ~I I~
DATE SIGNED (Month DIl';-v;.~tl
o t d. October 26, 2001
NANE AND ADORE S OF PF.AaDN WHO COMPlE'T[O CAUSF: or orATH
(lIom2nT_o,P"", Michael L. Norris, Coroner
6375 Basehore Road, Suite HI
Mechanicsburg~ Pa. 17050
(M DaY, )
.~ AND CIfI'TIFYINCI PHYSICIAN (Ptly8lCiAn boIh prOl"lOUnciog dedi 8nd eenlfylng to 0&1.. o! dMlh)
To.... beat or"" Ie...,....... dMth oocurrecl8'llMttme...... and pI8Oe,"'dulI Ia" NUMf.) and mMMI''' ......... . . . . . . .
.MeDICA&. IXAMNlI!AlCClIIONeR
On the... of exemlnMton .nellor 1~1fetkm.ln my opinion, dMth OOOUITMI...... tf,.,....., end,...,.,..... due to the....., end
m.n,..,....lIted......................................................................................,.......... .
"..
FlEGlSTRAFl'S StON.-;rURE AND NUMBEA
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N.
2. 9 '2.-O<!J I.
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ESTATE OF
KATHY WATSON
, Deceased
No. 21-01-1079
of 2001
To the Clerk of the Orphans' Court:
Enter the claim of CAPITAL ONE
Acct. 4305721711308366
In the amount of
$6,602.46
, against the above entitled estate.
The decedent, who resided at 48 ETTER RD NEWBURG PA 17240
died on
10/26/2001
. Written notice of said claim was given
to RON WATSON
,if known to claimant, at.
(Personal Representative or counsel)
48 ETTER ROAD, NEWBURG, PA 17240
on
February 13, 2002
(Date)
~~~_. ~
(CI . nt)
Address:
5330 East Main Street, Suite 200
Columbus, Ohio 43213
r-jft
Claimant's Counsel
, c~:juln8
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(~: OlV ZZ 83.:1 ZOo
Address
CERTIFCATION OF NOTICE UNDER RULE 5.6(A)
Name of Decedent: Ji((J-M'! L. Wa-kon
Date of Death: rf) or. ~ (, J I CJ (p J
Will No.:
Admin No.: J I.. 0/- 11t1!J
To the Register:
I certify that notice of (beneficial 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
Address
Ron
(A.JohcJn J
1- 8 Eff'f.'f t2d
tV'-(uJhvt"Cf I f'A-
/ '7 ~ '1-0
.
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date: 3 -0 2.. - 0 '2.
~
~~
Name
kJ~
\.JJo-b-o n
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V -u.J..J b v I"~
Address
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+;23-~'33i
Telephone
Capacity: ~ Personal Representative
D Counsel for personal representative
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BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'*
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-IS.1 EX AFP 101-02>
48 ETTER RD I Allount Rellitted I
NEWBURG .. ~. PA 17240
f:t
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 ~
REv=is4i-iX--AFP-llff=o2Y-NoTici--oF-YtiliiiiiTii.fcE-TAitA'ppRA'isiMENT-,--AL1-owiNCE-oi-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF WATSON KATHY L FILE NO. 21 01-1079 ACN 101 DATE 05-06-2002
TAX RETURN WAS: ( X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) .00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2) .00 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 subllit the upper portion
4. Mortgages/Notes Receivable (Schedule D) (4) .00 of this forll with your
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 4,531.77 tax paYllent.
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 4,531.77
APPROVED DEDUCTIONS AND EXEMPTIONS: 10,305.40
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 6.911.96
11. Total Deductions (11) 17 .217 36
12. Net Value of Tax Return (12) 12,685.59-
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 12,685.59-
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15) .00 X 00 = .00
16. Allount of Line 14 taxable at Lineal/Class A rate (16) .00 X 045 = .00
17. Allount of Line 14 at Sibling rate (17) .00 X 12 = .00
18. Allount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 = .00
19. Principal Tax Due (19)= .00
TAX CREDITS:
..---. l+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
RON WATSON
'02
Ii.';'!' 10
. r~ . .'.4
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-06-2002
WATSON
10-26-2001
21 01-1079
CUMBERLAND
101
KATHY
L
. ~stal Ser~ice
ERl1FIEP ~~IL RECEIPT
Domes~f: Mail OnlY;l No Insurance Coverage Provided)
~~
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~ Postage I $
c:(J r----
Ul CI'ltifled Fee i
....D Return Feceipt Fee t
o (E ndorsemen ~eq wed)
o Ilestricted D, Ivery Fee ~
o (E ndorsemerY ~equlred)
~ fatal Postage & Fees ~
L1l
nJ
Postmark
Here
~ i~'!!;}CLlft;;t::!~
o Cty, State, Z/P->4- A)
["- Va...... /.-
I
7001 2510 0006 5861 ~~86
i III I f
Reb,Jm Receipt
~1840
"
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--
...
JRD/June 30, 1992/17858
NOV 0 5 2003
Estate No.: 21-2001-1079
ORPHANS' COURT DIVISION
COURTOFCO~ONPLEASOF
CUMBERLAND COUNTY
PENNSYLVANIA
21-2001-1079
In Re: Estate of Kathy Watson
Late of Upper Mifflin Township
NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE
Personal Representative: Ron Watson
Counsel for Personal Representative:
Date of Decedent's Death 10-26-2001
Date of Delinquency Notice: 09-09-2003
The undersigned, Donna M. Otto, Register of Wills, in accordance with Rule 6.12,
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 Status Report required by Rule 6.12, Supreme Court
Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court
Orphans' Court Rules, was given by the Register of Wills on 09-09-2003, and that the ten (10)
day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 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: 11'-03-2003
Distribution: Personal Representative
Counsel for Personal Representative
Estate File
l~otf-tJ'-I Y',')~)I-,/ltl
A hearing is scheduled for at in Courtroom No.3. If the Status Report is filed
prior to the hearing date, the hearing will automatically be canc d.
~~
~'~~
STATUS REPORT UNDER RULE 6.12
Name of Decedent: K'a~ \1\1 a+sc)t\
Date of Death: 10 - d.(/J - 0 )
Will No.: Admin. No.: J-I- 0 J - /0'7 ?
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration ofthe above-captioned estate:
1. State whether administration of the estate is complete:
Yes~ NoD
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 ~sentative file a final account with the Court?
Yes _ No ~
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representa~tate an account informally to the parties
in interest? Yes 0 No ~ -
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the. Orphans' Court
, and maybe attached to~~. , /> ,
Date:~-30 -03 ~'--=== --- LVLJ~--
Signa e
Ron
.
Name
48 Sf-fer
Nf-UJbu14 ,.
Address
vUafsorL
~
fA
'7) It] .. 't.2. P-(I' ?, 3 i
Telephone No.
Capacity: ~ersonal Representative
o Counsel for personal representative
v
~~'~~
Cl
Cumberland County - Register Of Wills
Hanover and High Street
Carlislel PA 17013
Phone: (717) 240-6345
Date: 9/03/2004
WATSON RON
48 ETTER ROAD
NEWBURG I PA 17240
RE: Estate of WATSON KATHY
File Number: 2001-01079
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES I NO.
103 SUPREME COURT RULES DOCKET NO. 11 for decedents dying on or after
July 11 19921 the personal representative or his counsell 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 will become delinquent on: 10/26/2004
Your prompt attention to this matter will be appreciated.
Thank You.
SincerelYI
~~~
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
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Po' Form 3811 . f:'3tJn"r~I)
)~rnesti(: Rlll:lI"n F:ee li~ I
o Agent
o Addressee
C, Date of Delivery
1 address diffenlnt from item 1? 0 Yes
lter delivery address below: 0 No
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001 1204 1427
102595-02-M-1540
"
"JRD/June 30, 1992/17858
. '
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\ IJ'J\('4~
Estate No.: 21-01-1079
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
In Re: Estate of Kathy Watson
Late of Upper Mifflin Township
NO. 21-01-1079
NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE
Personal Representative: Ron Watson
Counsel for Personal Representative:
Date of Decedent's Death: 10/26/2001
Date of Delinquency Notice: 08/11/04
The undersigned, Glenda Farner-Strasbaugh, Clerk of Orphans' Court, in accordance
with Rule 6.12, 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 Status Report required by Rule
6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12,
Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on April 30,
2004, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in
accordance with Rule 6.12 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: 11/08/04
~~~
Glenda Farner Strasbaugh .
Clerk of the Orphans' Court
Distribution:
Personal Representative
Estate File
~~ IOj ~eoy. q::iO (\. )\1\.
A hearing is scheduled for at in Courtroom No.3. lfthe Status Report is filed prior to
the hearing date, the hearing will automatically be cancelled.
uJ
STATUS REPORT UNDER RULE 6.12
Name of Decedent: ~'1 GlJa+...sofl
Date of Death: /0 - c;. I - .)00
Will No.:
:l \ -0 l- 10'79
Admin. No.:
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:
yesp 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 ~ No 0
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal ~3Ysentative s. tate an account informally to the parties
in interest? Yes k:::r No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts maybe filed with the Clerk of the Orphans' Court
and may be attached to ~ r"? .:.- .
Date: ~ 0 2-- 0 Y \ Vl{) C'~
/ Sign\.ture
'\< 0 (\ c.Aj ats cJ ('\
Name
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Lf- 8.> c J-+ .ff"
AJ-fvv ht/r-"1\
Address \
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Capacity: ~Personal Representative
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT 280601
HARRISBURG, PA 17128-0601
REV-1500
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INHERITANCE TAX RETURN
RESIDENT DECEDENT
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
L
DATE OF BIRTH (MM-DD-YEAR)
(.\\':C1Ci;\t USE"
/2- ~ ;::( -
..---- ._.__..~~- ---,,-_.-..-.....---~-
FILE NUMBER
cQ..1 _.hI
__ .L.:!._
COUNTY CODE YEAR
2l
DATE OF DEATH (MM-DD-YEAR)
0- -01 CJ -.;l vI
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
W
~ 1. Original Return
D 4, Limited Estate
D 6. Decedent Died Testate (Attach copy of Will)
D 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 copy of Trusl)
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
_LC22-0
NUMBER r
SOCIAL SECURITY NUMBER
;2o~ ~~
8;l.89
THIS RETURN MUST BE FILED IN DUPLICATE WITH T
SOCIAL SECURITY NUMBER
,
D 3. Remainder Return (date 01 death prior to 12-13-82)
D 5. Federal Estate Tax Return Required
o 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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FIRM NAME (II Applicable)
18 15 ff-.er ~
N'fVbl.fr<1 I PA
TELEPHONE NUMBER
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4 Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6, Jointly Owned Property (Schedule F)
o Separate sted
(6)
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
(7)
8. Total Gross Assets (total lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total lines 9 & 10)
12. Net Value of Estate (line 8 minus Line 11)
(9)
(10)
/0, 305. '10
(P)9/1. 7'0
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to lax has not been
made (Schedule J)
14. Net Value Subject to Tax (line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SlOE FOR APPLICABLE RATES
15. Amount of Line 14 taxable atlhe spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x .0
16. Amount of line 14 taxable at lineal rate
x .0
17. Amount of Line 14 taxable at sibling rate
x .12
18. Amount of Line 14 taxable at collateral rate
x .15
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
ft;~'fO
OFFICIAL USE ONLY
(8)
1,531 77
(11) ~1',~8~.~~
(12) ( )
(13) pan -e
(14) 0.00
(15)
(16)
(17)
(18)
(19)
Decedent's Complete Address:
I "~"=c: :;t; RJ
. CITY Ny: ~
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
I STATE
fA
I ZIP I?.;l '10
(1)
0-00
Total Credits (A + B + C) (2)
3. InteresVPenalty if applicable
D. Interest
E. Penalty
TotallnteresVPenalty ( 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. (5)
A. Enter the interest on the tax due.
(5A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
~,. '''''-!!I'.-'-' '11_1 11 - ]illlllillir~'" I Jmlll~ iIIllIl'lIllll..'tiIlIIIIl:
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 I'B
b. retain the right to designate who shall use the property transferred or its income; .................... ............ 0 Jg]
c. retain a reversionary interest; or.. ......................... ............................ ...................................... ............... 0 ~
d. receive the promise for life of either payments, benefits or care? ............................................... ..... D ~
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? ................... ...................................................................... ........... D ~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ............. D ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................................ ..................... ......................................................... D ~
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 pe~ury, I declare that I have examined this return, including accompanying schedules and statements, and to the best 01 my knowledge and belief, it is true, correct
and complete
Declaration ofpr therthan the personal representative is based on all information of which preparer has any knowledge
SIGNATURE
G RETURN
DATE
o
-02.
ADDRESS ~
'f8 E~, f2rJ iJ'CLUhuC7 It
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE )
11 C).~ ()
()s -1'1-0?
DATE
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, Ihe lax rale 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)].
The statute does not exemot 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 dales 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 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)].
The tax rale 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)]. 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.
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
:L.
s.
tj-.
5,
/6.
DESCRIPTION
o ;ornond CAJ-ecld l'n1 \<-~n~
Opa I ~ ,'nDJ
Gold r>-ect"loc<'
VALUE AT DATE
OF DEATH
q SO. ce;.
.;250. c;f!:.'
IOO.~
(P.
O,'amoncf eO'r- e,ll\,
Other d"amond f:~')()1
ro(l.t'\\(\"} &ecl (l,'t y.-ear-.> old)
f978 FOf'd tn<l5+an", JL
198'7 Fbrd T-($,'rd
[ ;). E;. 0/
/IO,o!::
,;z 00. "';:'-
'I.
So.CY
L 1.)0 ~
8.
-~..--...~
9.
S pac e S htJ ++I e.. S +om?
9'7. c)cJ
Dr-e55-eS I S~oeS i etc..
9'0, ~
~ ' .
II.
C.cDh
~-..-~-<._.-
t'f. '30
,
- ... . ... -
12....
Cn-ec...K ('('11 0 Cc. <!) tin \ .~
- ...... - -- --- -- ..
[8'-1.J..~
~ , .
13.
40 IK (LUlYif sum 41's~\7t.1~1'0l')) c.~-tcks l7.. ')
fd-Lfo ,8B
TOTAL (Also enter on line 5, Recapitulation) $ 4-, 5" 3 I , I] 7
(If more space is needed, insert additionai sheets of the same size)
REV-f511 EX+ (12-99)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF k aM~
ITEM
NUMBER
A
B.
1.
2.
L.
u)crfsofJ
FILE NUMBER
Debts of decedent must be reported on Schedule I.
DESCRIPTION
1.
FUNERAL EXPENSES:
\3<1':; f,- Ser-vl'~e~
Casl<~'I' ,.
vauJ+
Cler,/y , >. .
o pe"-ll\~ Cft-av<.
G ~"e. ffla"l(e.r
~at)"~,... .I~<m>H ~n
ADMINISTRATIVE COSTS:
, .
l'nclud"nj.
emb(/)lf)I,II\'1
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. . > > > .
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'to
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7.
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Personal Representative's Commissions
>
8. FOod ~ <c:i,,~c.r. .
q. F/o<<J<rS
Name of Personal Representative(s}
Social Security Number{s)/EIN Number 01 Personal Representalive(s)
Street Address
City ____
_____ State __ Zip
Year(s) Commission Paid:
Attorney Fees
aqvl'c.e I COUfl'5>eS<'i-
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
4.
Claimant
Street Address
City
____ State ___ Zip
Relationship of Claimant to Decedent
Probate Fees t'e.+iTion /... TRS 4-Dm t ;Yc-P Fee..
~ ... ~ - - ~ ...
5. Accountant's Fees
7
6. Tax Return Preparer's Fees
8.
'to
Sho""+ c.er+,'~"...Q+-e.
>
. .
Ct:r-+,'F,'ed cop(eS . O=+h Cer-tl~I'C.Qt-e. (po.)
Tpa,!~l of -\-t-\\,~ [45cP mH-ts) , pOS-\a"le. I ph'n~ I e:h.
AMOUNT
"3,300. o..s>
d- ,45"0. ~
8oo.~
'75
815,
~
~
.. ~J :J.JS. ~
q '1. d..,S<-
d-qo.cJ~
53~
~.s. ~
30. cJ~
G>.(!)%
07 Y. c>~
I L3. 'fa
TOTAL (Also enter on line 9, Recapitulation) $ 10. 30 s-. '1()
(If more space is needed, insert additional sheets of the same size)
.
''''''''''''1'"''1''*
COMMONWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
)< a+A1
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
L( u) crI:son
RLE NUMBER
Include u"reimbursed medical expenses,
ITEM
NUMBER DESCRIPTION
1. m';D.' P In.naJe H-eal.fh fJdsp;+als
AMOUNT
15D.OO
2.
mG-D "
C o,..ll~k R €'1 iOf}Q I med. C -en~-er
(5. 00
3.
mev',
Bill e. mTn An-es-M. 901'n rnqmf)T
f'-lLf. so
~.
Cl'ed ,'T Car-d .
Ca,p ifal Of) e
(PI (P(j~ .I.f(p
TOTAL (Also enleron line 10, Recapilula1ion) $ (PI 9 f f . 9 C?
(~more space IS needed, Insert additional sheets of the same Size)
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 9/03/2004
WATSON RON
48 ETTER ROAD
NEWBURG, PA 17240
RE: Estate of WATSON KATHY
File Number: 2001-01079
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) 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 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 will become delinquent on: 10/26/2004
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
STATUS REPORT UN-DER RULE 6.12
Name of Decedent: .~'7'. O 4~ q ~a"~-SOlq
DateofDeath:/0 - ~ I ~ ~oO i
wi. No.: 2 ~ - e t -- / o 9 ? X~. No.:
Pursuant to Rule 6.12 of~e Supreme Cou~ OChans' Cou2 Rules, I repo~ the
following wi~ respect to completion of the ad~stration of the above-captioned estate:
1. State whe~er a~s~ation of the estate is complete:
Yes~ No ~
2. If ~e ~swer is No, state when the personal representative reasonably believes
that ~e a~s~ation will be complete:
3. ~e ~swer to No. 1 is Yes, state the follow~g:
a. Did th~sonal representative 51e a ~al accost with the CouP?
Yes ~ No ~
b. The sep~ate O¢h~' Co~ No. (if my) for the personal representative's
accost is:
c. Did the personal r~epr/esentative state an account informally to the parties
in interest? Yes ,L,_.M' No
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Cleric of the Orphans' Court
and may be attached to this r_r~ort.
SignXamre
Name
Address
Telephone %1o.
: "': Capacity: ~}'Pe~sonal Rem ~semz3ve
[-] Counsel for personal representative
JRD/June 30, 1992/17858
In Re: Estate of Kathy Watson : ORPHANS' COURT DIVISION
Late of Upper Mifflin Township : COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY
Estate No.: 21-01-1079 : PENNSYLVANIA
:
: NO. 21-01-1079
NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE
Personal Representative: Ron Watson
Counsel for Personal Representative:
Date of Decedent's Death: 10/26/2001
Date of Delinquency Notice: 08/11/04
The undersigned, Glenda Farner-Strasbaugh, Clerk of Orphans' Court, in accordance
with Rule 6.12, 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 Status Report required by Rule
6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12,
Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on April 30,
2004, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in
accordance with Rule 6.12 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: 11/08/04 /~~' t'~'~3~'-J~~
Glenda Famer Strasbaugh
Clerk of the Orphans' Court
Distribution: Personal Representative
Estate File
A hearing is scheduled for at in Courtroom No. 3. If the Status Report is filed prior to
the hearing date, the hearing will automatically be cancelled~~/~
Geor~hs ~offe'~, P'.J. I~