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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~ - ]3 ~ uJcrt:5df) "''-'- ~~ -g.g ~'';::: ~'" ~o... '" "- 50 OJ c 00 i:/3 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF C \.A rvl b'i'r- t c1ncl }s~n =ctl ::s~ g:.. d ..... :D~ roo (~1. Q '? ;i;. 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 Reglst r l ( .',....,, ::t)c )> :::. 15 <: N 0'\ -0 W i.i1 VJ ~:~ f.~ ;, C o - .-- '" '-' Q) .... ~ ..... tIS s::: bIl iJi 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 lC ... "'E ... 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 :;'~) (~: 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 f8 t:.--fJ~'- V -u.J..J b v I"~ Address /2-d' ;f>A- I ? ;).,'/- 0 +;23-~'33i Telephone Capacity: ~ Personal Representative D Counsel for personal representative >r ~: t.n I ~/ 2: :r= N P -'..1 ':" s:: ~u :: . .- ~)C \,. /?-~..3-c? 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) ~~ rr I '-- ~ 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 " " -- ... 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 r ~n:;:l'fr T'IlI"l"'1lT . 'I' I , Iii llel I I l"- I 'i' . :~~ i~ . f ru ~!~ IIII' I It[' .:r Lilli, j , Ih M I ""'I"! 1 I "i " ':1 ! ~~IIII IIII III. ;,t I ..~., ,.11 .:r CJ ru M M CJ PI). . 1< CJ CJ I.et, ", n<k'SE' CJ II: 51 ie~ 1 l M 1de'SE' CJ M fA, IF' I 3 ITI ~~t :0" .,.--....-." CJ CJ I"- t,iii ;-)1 PC B: ,', ;~~~. ~t.s' !I!!! ' ! ~ ~ ~ II I II II m !!Il!l!'!!1 !II !I~~ ! II !~I II CornfJete t'lrns 1, item "if Restri1~tec [)" II PrintoUi' name ar,:J .' 11 SO thl' w~ car Illtu'n '1 II Attac'l th" ewel to ," or on the tTn if sr "c.. Cj:] JI) 1"1 C l d : I ~': L'~ r t r lei !f:j" ::, "lose i,~ce. Article IIdclc '15,,1 ':>: 'vJA~30N ilJl< 4: 8 E'~'TER E()A~; NEvJBURG ]'A 1-.' 2 4 2. Artlcle Nun I,,' ,Trallsf"r frC'1 ,', ser'i<:S'a!" A\ Si , I' ~:~~l:' I-::'~~ I 0, ,c; je '7 OIl:: 1,[11] 'I. R,.st" -----.-.-........--...u....-U._::: ~_,~~.~.:=.::.:;.=.; 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 / 0' C, L:: R, c: In:. /P8 act Mall 0 Express Mail ~ered . 0 Return Receipt for Merchandise . d Mail 0 C.O.D. j Delivery? (Extra Fee) 0 Yes 001 1204 1427 102595-02-M-1540 " "JRD/June 30, 1992/17858 . ' ,} (i ," c,'OO' \ 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 ""-'" iI', Lf- 8.> c J-+ .ff" AJ-fvv ht/r-"1\ Address \ /2-d fA !'l ';;)..':f 0 ".-, t' ;:; '71'(- 'f2-5-u3'?<7' Telephone No. Capacity: ~Personal Representative o Counsel for personal representative '" ,,< .t~'~~!J ."~,, J 'tlfV- 1500 EX ,:6~: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT 280601 HARRISBURG, PA 17128-0601 REV-1500 I- Z W C W U W C w .... ~:!(J) 0."" w"o ",00 0"'-' ..", .. " 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) .... Z W o Z o .. '" w '" '" o o z o !;;: ..J ::J l- ii: <( u w r:t:: z o !;;: I- ::J ll.. :::i: o u >< ~ () FIRM NAME (II Applicable) 18 15 ff-.er ~ N'fVbl.fr<1 I PA TELEPHONE NUMBER ;()on '( ,;()on-e Ii )"ne ,V,n<-- of, 5:3;. 7'7 AJ ..-() e- M on'L '71'7- 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. .""'~m'l"". 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) ~~ 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 .. ~ ~ . ~ z. , . . . > > - . . > > > . "). 'to ;, '-. 7. .. . ~-ec... it'> T 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~