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HomeMy WebLinkAbout04-0827Name of Decedent: Date of Death: Will No.: ]'X4 0 To the Register: CERTIFCATION OF NOTICE UNDER RULE 5.6(A) [.x.) ~ kL-. Admin No.: 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 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: Capaoity: Sigma]ur*" [ Name Address Telephone ~t Personal Representative [~' Counsel for personal representative Register of Wills of Cumberland County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of also known as Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE "A" OR "B" BELOW:) , Deceased Social Security No. A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut Decedent, dated named in the Last Will of the and codicil(s) dated State relevant circumstances, e.g., renunciation, death of executor, etc. Fxcept as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after75;xeoution oE~he docuff~etTts offered for probate; was not the victim of a killing and was never adjudicated incompetent: I B. Grant of Letters of Administration Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by~rt~e follo~g spouse (if any) and heirs: , -' (_,'~ Name Relationship Residence ~013 (COMPLETE IN ALL CASES:) Attach additional sheets if necessary, Decedent was domiciled at death in County, Pennsylvania, with his/her last family or principal residence at Decedent, then q~ years of age, died AO~og~ g~ ~ '~;O4- , at ~5{~ (Location) Decedent at death owned prope~y with estimated values as follows: (If domiciled in PA) All personal prope~y .................................................... ~ [ O~ ~ ~ - CO (If not domiciled in PA) Personal property in Pennsylvania ...............................................~ (If not domiciled in PA) Personal property in County ....................................................... ~ Value of real estate in Pennsylvania ................................................................................................... $ Total ................................................................................................................................ ~ Real Estate situated as follows: ~ ~ C~ - ~ Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Form RW-1 Page 1 of 2 ICumbedand County) - Rev. 9/92 Typed or printed name and residence McNees Wallace & Nurick, LLC 100 Pine Street, P.O. Box 1166 ~ Harrisburg, PA 17108-1166 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT 280601 HARRISBURG, PA 17128 0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) 004654 JAMOUNEAU WILLIAM C 1326 S BROAD STREET PHILADELPHIA, PA 19146 ........ fold ESTATE INFORMATION: SSN: 198-36-2579 FILE NUMBER: 2104-0827 DECEDENT NAME: JAMOUNEAU HELEN E DATE OF PAYMENT: 11 / 19/2004 POSTMARK DATE: 11/19/2004 COUNTY: CUMBERLAND DATE OF DEATH: 08/28/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $4,275.68 REMARKS' JAMOUNEAU TOTAL AMOUNT PAID: $4,275.68 SEAL CHECK//2001 INITIALS: CCP RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS I~'=V-I~O EX (8-00) REV- 1500 ~ PENNS~VANIA ~~~ DEP~TMENT OF REVENUE INHERITANCE TAX RETURN ~HA~ISBURG, PA17128~601 RESIDENT DECEDENT DECEDE~S NNdE (LAS[ FI~T, AND MIDDLE INITIAL) JAMOUNEAU, HELEN E. DATE OF D~ (MM-DO-YEAR) I DATE OF BIR~ (MM-D~YE~) 08-28-2004 O7-21-1910 IU ~oo I- Z O O FILE NUMBER SOClN. SECURITY NUMBER 198- 36 0_0_8__2 7 -2579 THIS RETURN MUST BE RLED IN DUPLICAIE WITH THE REGISTER OF WILLS (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER r-~2. Supplemental Return --J 4a. Fulura Interest Compromise (da~ofda~h .f~.r 12-12-82) '--I. Decedent Maintained a Living Trust (A~ac~ copy o~Trust) J--~ 10. Spousal Pover~ Credit (d,t~ o~d~m ~ 12-~-m .r~ ~-~-~5) ~[-I 1. Original Return --]4. Limited Estate J--"] 6. Decedent Died Testate (Ata=h co~/of W~) ~"] 9. Liligalion Proceeds Received --I. Remainder Return (date ofd~ath p~a-to 12-13-82) ~'15. Federal Estate Tax Return Required -.L1 8. Total Number of Safe Deposit Boxes ~"'"J 11. Election I~ tax under Sec. 9113(A) (Atach Sch O) NAME TELEPHONE NUMBER (215) 732-5230 COMPLETE ~LING ~DRESS 1326 South Broad Philadelphia, PA Street 19146 uJ I. Real Estete (Schedule A) (1) 2. Stock~ and Bonds (Schedule B) (2) 3. Qosely Held Corporation, Partnemhip or Scle-Proprie[o~ship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Scheduie E) 6. Jointiy Owned Pmperb/(Schedule F) (6) I I Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses &Administrate Costs (schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequeste/Sec 9113 Trusts for which an election to tax has not been made (schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) $ 96,696,74 25,664.3~~ (8) 9,7/,~ nn 12:6c10.22 (11) (12) (13) ~:~22,361.11 22,345.22 (14) !00,015_89 100,015.89 SEE IN~J KUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 iaxable at ~he spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0 (15) 16. Amount of Line14 iaxable at lineal rate x.0 45 (16) 17. Amount of Line 14 texabte at sibling rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 08) 19. Tax Due (19) 4~500.72 4,500.72 Decedent's Complete Address: STREI::~ ADDRESS CITY Messiah Village 100 Mount Allen Mechanicsbur~, Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credita/Paymenta A. Spousal Poverty Credit B. Prior Paymenta C. Discount 3,, Drive JSTATE PA (1) Intarest/Penalty if applicable Total Credils (A + B + C ) (2) D. interest E. Penalty Total IntarestJPenalty ( D * E ) If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the lax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (3) (4) (5) (5A) JAP17055 $ 4.500,72 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the properly transferred; .......................................................................................... [] [] b. retain the right to designate who shall use the property transferred or its income; ............................................ [] [] c. retain a reversionary interest; or ............................................................................................... [] d. receive the promise for life of either payments, penefita or care'~ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without mcaiving adequate consideral~on? .............................................................................................................. [] [] 3. Did decedent own an "in bust for" or payable upon death bank account or secudty at his or her death? .............. [] 4. Did decedent own an Individual Retirement Account, annuity, or other non-pmbata property which contains a beneficiary designation? IF THE ANSWER TO ~ OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under .p~. --~?~. of peqlX~, I ~,,.~,eb',latl have a~,,~-thls retum, in~-~ ~i.;.¥r~ ~;.~aa. a~ ~;~ii~,b ~.~a h.,~.~,~ Dec~ of pi'aparer o(her ~ Ihe pemmal repmil~talive i. 13~ on all~dofmafion of ~hidl prl~*~, ha~ my knJ':Z':~ ........ j, .,.,.,.ge .rd ~,,i,, it 18 b~Je, correct and complete. $~GNATURE OF PJt'.R$OI~ RESPONSIBLE ~ FILING RE'~U:~I~'" ""'"'~ ' DATE ADDRESS ~"~',~ b ~--~'- -~~~...~,..,,.._, 1326 South Broad Street, Philadelphia, PA 19146 SR~NATURE OF PREPARER OTHER THAN REPRESENTATIVE OATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, Ihe tax rata imposed on the net value of tmnefem to or for the use of the surviving spouse is 3% [72 P.S. §9118 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of lhe surviving spouse is 0% [72 RS. §9116 (a),(1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from lax, and the statutory requirements for disclosure of assets and filing a lax return are still applicable even if the su~ving spouse is the only benefidary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of tmnefers from a deceased child Iwen¥one years of age or younger at deah io or for the use of a natural parent, an edoplJve parent, or a stepparent of the child is 0% [72 RS. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedents lineal benefidades is 4.5%, except as noted in 72 RS. §9116(1.2){72 P.S. §9116(aX1)]. The lax rate imposed on the net value of ~ansfers to or for the use of the decadents siblings is 12% [72 RS. §9116(aX1.3)]. A sibling is defined, under SectJon 9102, as an individual who has at least one parent in common with Ihe decedent, whelher by blood or adoption. ~V-1~0~ EX+ (~-g8) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HELEN E. JAMOUNEAU SCHEDULE B STOCKS & BONDS FILE NUMBER 2! - 04 - 0527 ITEM NUMBER 1. All properly jointly-owned with right of survivorship must be di~He_~ on Schedule F. DESCRIPTION 'SEE ATTACHED EXHIBIT ~ VALUE AT DATE OF DEATH $ 96,696.74 TOTAL (Also enter on line 2, Recapitulation) $ $ 9 6,6 9 6.7 4 gf mo,-e spaoe is needed, insert additional sheets of lhe same size) REV-1508 EX+ (6-98) ~ '~' COMMONWEALTH O~ PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF rSCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY HELEN E. JAMOUNEAU FILE NUMBER 21 - 04 - 0827 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disolosed on Schedule F. ITEM NUMBER DESCRIPTION Schwab Money Market Account No. 2949-1525 (See Exhibit 1) PNC Bank checking account No. 5080056372 (See Exhibit 2) Miscellaneous personal property (Furniture, lamps, 2 rugs! gravesite deeds) Proceeds from sale of ring (See EXhibit 3) TOTAL (Also enter on line 5, Recapitulation) $ VALUE AT DATE OF DEATH $ 10,277.69 10,586.68 300.00 4,500.00 25,664,37 (~ m~ ~a~ ~ need~, in~ a~itional sheets oft~ ~me s~e) REV-1511 EX+ (12-99) COMM~LTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HELEN E. JAMOUNEAU SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21 - 04 -0827 Debts of decedent must be reproved on Schedule I'. DESCRIPTION ITEM NUMBER 2 3 4 5. 6. 7. FUNERAL EXPENSES: John E. Neumeyer Home, Father O'Neill, Pastor, (Honoraria) Funeral day luncheon (8 'Ken Gibson Grave marker lettering .(See Exhibit ADMINISTRATIVE COSTS: Personal Representalive's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address Funeral Immaculate Lock Haven, people) Inc. (See Exhibit 4) Conception Church, 'PA 5) City Stale ~ Zip Year(s) Commission Paid: Attorney Fees Family Exemption: (If decedents address is not the same as claimant's, attach explanalion) Claimant Street Address City State Relalionship of Claimant to Decedent ~ Zip PrebemFees Cumberland County Register A~untant'sFees of Wills Tax Return Preparer's Fees Capital Self Storage 5160 East Trindle Road Mechanicsburg, PA 17050 September, 2004 $ 70.60 October, 2004 56.00 November, 2004 56.00 TOTAL (Also enter on line 9, Recapitulation) j (If more space is needed, inse~t addilional sheets of the same size) AMOUNT 8,990.00 100.00 120.00 90.00 263.00 182.60 $ 9,745 CO RE¥o1512 EX+ (12-03) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HELEN E. JAMOUNEAU SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS FILE NUMBER 12 - 04 0827 Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM NUMBER DESCRIPTION Messiah Village (Nursing home room & board) Alert Pharmacy Services (Final bill from pharmacy) (See Exhibit 6) (See Exhibit 7) TOTAL (Nso enter on line 10, Recapitulation) (If r,~u~u space is needed, insed additional sheels of the same size) VALUE AT DATE OF DEATH $ 12,416.90 183.82 12,600.72 REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF HELEN E. JAMOUNEAU SCHEDULE J BENEFICIARIES NUMBER ! NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distribu~io.s, and transfers under Sec. 9116 (a) (1.2)1 W. Jeffry Jamouneau 55 Hidden Springs Road 'Dillsburg, PA 17019 William C. Jamouneau 1326 South Broad Street Philadelphia, PA 19146 71 - RELATIONSHIP TO DECEDENT Do Not List Tr,,_~t~(s) SON SON FILE NUMBER ~4 - ~7 AMOUNT OR SHARE OF ESTATE 1/2 1/2 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX iS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) SCHWAB Schwsb Independent investing Signature"' ~hwab One~ Aocou,t Account Number: 2949-1525 EXHIBIT 1 vtstt our web$tte at: a~hwal).corn Queetion$? C~t 1.800-435.9050 Statement Perioa: August 1, 20~ to August 31, 2004 Last ~t~ent: Ju~ 31, ~4 ' ~c~fint Op~n~ ~n'~' HELEN E JAMOUNEAU ~ 326 S BROAD ST PHI~DELPHIA PA 191~55 'I SCHEDULE ee'_~. ;nd Money Market Funde CASH Svmbo/ E, ITEM Ouant/ty Lone/Short # I 0..277.69 $~GATE ?EC~NOLOGY E~ROW PENDING F~URE OlSTRIBUT!ON A F L A C INC ~L~ GENERAL CORP ~NER~ ELECTRIC COMPLY MUNI~LD ~UND ~VEEN MUNI MKT OPPTY NUVEEN PENN PREM INCM I~OME ~PAL FD PUB SVC ENT GROU~ ~ LE~UT& HAUSPIE XXX REGI~RATION REVOKED BY THE SEC EFF 0~04~03 100 L AFL 100 L DG 326 L GE 100 L USA 1.844 L MYD 1,700 L NMO 600 L NP¥ 1.735 L ~,200 L $ 40.1000 $ 4,010.00 19.7000 6.422.20 32.7900 3,279.00 8.6100 ! 5.876.84 · ~3.44oo ~,e4e. oo 14.2840 8,~70,40 15.0800 Z6,163,80 42.3400 9,52§.50 N/A NVA SCHEDULE B Account Valua (excludes unprtcaa securltile) 96.696.74 $c, hwab ,10/957 '~ Co- I,¢. ,~t, t~ghts ?asetved. Member: SLCC/New York Stock E~'*.~m;-.ge~ CR$ 2 ~ 270 (OO0, ..G3;~6) STP! O479RP--O2{03/O2) EXHIBIT 2 PNCBAN< September 20, 2004 Mr. William Samouneau 1326 S Broad St. Philadelphia, PA 19146 sep Estate of Helen E Jamouneau (Deceased) SSS: 198-36-2579 DOD: 08-28-2004 Dear .Mr. Jamom~eau: In response to your request for Date of Death balances for the customer noted above, our records show the following: Checking Account Account #5080056372 Established 11-12-1993 HELEN E IAMOUNEAU DOD balance: $10,586.68 + $0.47 accrued interest Safe deposit box It is located at: The decedent maintained safe deposit box #136. It was in two names. I-FI~.LEN E SAMOUNEAU IEFFRY JAMOUNEAU, AGENT EAST PENNSBORO 29 HUNTER LANE CAMP HILL PA 17011 717-763-8265 Page 1 of 2 Please note that this office, only provides date of death balances for deposit accounts (IR.As, CDs, Checking and Savings accounts). We do not process any financial transactions or provide statement~, ffyou need assistance with any of these items, please call 1-888-PNC-BANK (1-888-762-2265) or stop by your local PNC Bank branch office. Sincerely, Erica L Schlegel 1-800-762-1775 P7-PFSC-0,~-F 200 First Ave. Pittsburgh, PA 15219 Member FDIC Page 2 of 2 EXHIBIT 3 LIST OF JEWELRY Quantity Description (Watch. Rings, Bmcelet-lnitla s, Weight, Inscription, Etc.) Value September 3, 2004 Mr. Jeffry Jamouneau 55 Hidden Springs Road Dillsburg, PA 17019 EXHIBIT 4 1334 N. 2nd Street * Harrisburg, PA 17102 (717)233-7814 * (717)233-6314 Kenneth D. Horst, Supervisor The Funeral Service for Mrs. Helen E. Jamouneau We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. feel free to contact us if you have any questions in regard to this statement. THE FOLLOWING IS AN ITEMIZED STATEMENT OF THE SERVICES. FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAT YOU SELECTED WHEN MAKING THE FUNERAL ARRANGEMENTS. Services of Funeral Director/Staff Embalming Other preparation of body Vehicle to transfer remains to Funeral Home Hearse (Casket Coach) Out of town transportation 18ga. Steel Guardian Ca.nket Acknowledgement Cards Rose Registm- Book Prayer Cards Croci fi xes THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED Forwarding remains to Yost-Gcdon F.H. AT THE TIME FUNERAL ARRANGEMENTS WERE MADE, WE ADVANCED CERTAIN PAYMENTS TO OTHERS AS AN ACCOMMODATION. THE FOLLOWING IS AN ACCOUNTING FOR THOSE CHARGES. Certified Copies of thc Death Certificate TOTAL CASH ADVANCES AND SPECIAL CHARGES SUB-TOTAL TOTAL COST of ALL SERVICES MINUS ANY PAYMENTS / CREDITS TOTAL AMOUNT DUE TERMS: NET 60 Day~ ARer 60 Days lS~ Inte~-st per annum o~t Unpaid Balance, JOHN E. NEUMYFR FUNERAL HOME IN¢. ] Please $895.00 $6O0.OO $250.00 $225.00 $275.00 $300.00 $2715.00 $15.00 $60.OO $60.00 $35.OO $$430.OO $3540.00 $20.0O $3560.00 $8990.00 $4000.00 $4990.00 EXHIBIT 5 TO STATEMENT III ADDRESS TERMS ~ i AMOUNT PAID PLEASE RETURN THIS PORTFON WITH YOUR PAYMENT DATE DESCRIP~rlON CHARGES CREDITS BALANCE -- EXHIBIT 100 MOUNTALLEN DRIVE, MECHANiCSBURG, PA 17055 6 08/09/2004 08/27/2004 WILLIAM JAMOUNEAU 1326 S. BROAD ST. PHILADELPHIA, PA 19146 PAYMENT RECEIVED - THANK YOUlll *** NursinR Care *** RM/EIRD - NURSING - SEMI-PVT 08t01-08/27 ESTATE OF HELEN E. JAMOUNEUA W. J. JAMOUNEAU WILLIAM C. JAMOUNEAU 2'71 5,724.00 6,045.93{ 6,692.90 ' 12,416.90 PAST DUE 10415 5,724.00 6,692.90 0.00 0.00 0.00 { $12,416.90 REStDENT NAME Mrs HELEN E. JAMOUNEAU ~o~,~, A 1% finance charge may be assessed on accounts for which payment has not been received by the due date. Thank you: If you have any questions or concerns about ),our bill, please address them directly to Fiscal Serviec~ at 790-8220. Thank You! Alert Pharmacy Services, Inc 219 North Baltimore A. ve Mt Holly Springs, PA 17065 800-266-9954 ® (717) 486-8606 EXHIBIT 7 A FINANCE CHARGE OF 1.50 % PER MONTH (AN ANNUAL PERCENTAGE RATE OF 18.0%) WILL BE CHARGED ON ALL A/~0UNTS 30 DAYS OR MORE PAST DUE STATEMENT OF ACCOUNTI .~' p~.~E RE ~ .:.:, . . .' MIT BY.9/25/04. THANK YOU. Date 09/03/2004 fi':' :ii~i~!~ ',=~.~:,'~. '-'/~" '~, JAMOUNEAU, HELEN E WILLIAM JAMOUNEAU 1326 S BROAD ST PHILADELPHIA PA 19146 JAMOH GRP- 7S PAGE PLEASE DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT ALERT PHARMACY SERV. INC. 219 NORTH BALTIMORe. AVE. MT.HOLLY SPRINGS,PA 17065 Amount Paid .................................... ~ ...... -~'EOEND~- -~ NOt~L-~"~h'~~ FOR MONTH FOR MO1TTH · ; ....' :":':., .1. ": ":."''. ' :-I I :'...: :..-:: ! . . ...........'... ;:.,..-':.:.. , .. ,.. _.:.. . .00 AMOUNT DUE Oath of Personal Representative Commonwealth of Pennsylvania County of Cumberland The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s~d that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate a,~.o~n_g t~ law. Sworn to and aff rmed and subscribed before me this . /(~-~') day of r-.E)eceaS, led i, ,o. Estate of~-~ ~ ~.~,,0 ~ ~ ~ AND NOW, _~p~m~F q~ , 20 OV , in consideration of the Petition on the reverse side hereo~, satisfactory proof ha~g been presented before me, IT IS DECREED that Letters ~ Testamentary ~of Administration are hereby granted to ~. ,)~ ~ ~ ~; I/,'~ ~- ~ ~UU ~ in the above estate and that the instrument(s) dated described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ........................... Short Certificate(s) Renunciation .................. Affidavit ( ) ................. Extra Pages ( ) ............ Codicil .......................... JCP Fee ........................ Inventory ....................... Other ............................ TOTAL ................ Register of Wills ~ Attorney I.D. No. Address: Telephone Form RW-1 Page 2 of 2 (Cumberlsnd County) - Rev. 9/92 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, $2.00 1O530252 No. Local Registrar AUG 3 0 2004 Date 8? "' ,, :. 2 '' COMMONWEALTH OF PENNSYLVANIA - DEPARTMENT OF HEALTH · VITAL RECORDS ~[: ;,. ' LJ'I CERTIFICATE OF DEATH tlelen E. Jamouneau I,female_ 1,.1~ -- oo z~/~ i,.~ugus.~. ~, .... 9 4 ~,, / : I : / .... ~ ~ I~.. I "~' ~ ..~.~. ,~1 ,s~ [] Cumberland I Upper Allen 1~. /~. o~m~,.~) Self ~"U ~ (~,2~ ~ z <,,=5. Widowed Homemaker ,,t OECEDEN~'S U~LIAL OCCUPATION ;~,~.~ ~DE NT '5 MAILING ADORE SS ~ e~. C~y/Tow~. S~ll. Z~) COde} [I~CEO~NT'$~TU~ 100 Mt. Allen Drive .~.~<E ;.Hechanicsburg,., Pa. 17055 ~,~, Penna. Cumberland William oey ,,.. Helen Porret Jeffry Jamouneau ~5 Hidden Springs Road~ Dillsburg~Pa. 17019 [ St. Hary's Cemetery L~ock Haven, Pa. 177~5 ~ c,--,-~ ~,--s,,.D U]~.ept. 1, 2004 '~'~ ~'~' / , I"~. ' .... 1334 N.Znd Stree ~,u~ }~~ 1-- FD 138182 I~eumver Funeral Home~Inc.Harrlsburg,Pa 17102 ,~ ,*~y. ~n~ tO ~e D~ d:~R a'~' ~- C~SEOUENCE I" EXAMINER/CORONER Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717)240-6345 Date: 12/06/2004 JAMOUNEAU W JEFFRY 55 HIDDEN SPRINGS ROAD DILLSBURG, PA 17019 RE: Estate of JAMOUNEAU HELEN E File Number: 2004-00827 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 12/19/2004 Your prompt attention to this matter will be appreciated. Thank You. CC: File Counsel Judge GLENDA FARNER STRASBAUGH Clerk of the Orphans' Court Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717)240-6345 Date: 12/06/2004 JAMOUNEAU WILLIAM C 1326 S BROAD STREET PHILADELPHIA, PA 19146 RE: Estate of JAMOUNEAU HELEN E File Number: 2004-00827 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 12/19/2004 Your prompt attention to this matter will be appreciated. Thank You. CC: File Counsel Judge GLENDA FARNER STRASBAUGH Clerk of the Orphans' Court CERTIFCATION OF NOTICE UNDER RULE 5.6(A) Name of Decedent: HELEN E. JAMOUNEAU Date of Death: __ 0R-28-2004 \¥ili No.: ;: i -.. ~ 7 Admin No.: 21-04-0827 To the Register: I certify that notice of (beneticial interest) estate administration required by Rule 56(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate oil : Name Address W. Jeffrv Jamouneau 55 Hiddmn Springs Roa~, Dill~hurg: PA 1326 South Brnad Strmmt: Phqladolph~a; William C. Jamoun~au 17019 PA 19146 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: ~/_~z-,/ ~,, Signature (' William C. Jamouneau Name None l q?,q R~_,_,th ~-_~ad Street~hiladelphia, Address (215) 551-0684 Telephone Personal Representative Counsel for personal representative PA 1914 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INO~'i'f~lll($~~[('E OF INHERITANCE TAX orvts':r:Pk>-.J - -' v , .0 If' PO BOX 2.80691 ;;,:::!). ' , ':--. HARRISBURG PA 17128-'06t1f . , -.' NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR OISALLOWANCE OF OEDUCTIONS AND ASSESSHENT OF TAX 2005 Jrii Ilf Pfi 3: 15 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN CLEPK Or: On~L!"" I'" ('('! ""-1 n;-'II,"",]' 'J 'j_"'",';; WI L '-i!!,!",cCJAMlWNEAlf:'fSQ 1326 S BROAD ST PHILA PA 19146 01-17-2005 JAMOUNEAU 08-28-2004 21 04-0827 CUMBERLAND 101 Allaunt Re..itted * REY-1541EXAFPI12-04l HELEN E 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 :!AW"EX""AFP""Cfi1"-"6!')""iioTYcl"OF"'i:'NilER"I"TAiI'cl!"TA"X"'A"PPRAi'sEM"ENT~""ALLOWANcl!"oii""""""..."""". .." DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF JAMOUNEAU HELEN E FILE NO. 21 04-0827 ACN 101 DATE 01-17-2005 TAX RETURN WAS: (X J ACCEPTED AS FILED J CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. stocks and Bonds (Schedule BJ 3. Closely Held stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule DJ 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets IlJ (2J 13J 141 (5J (6J 17l .00 96,696.74 .00 .00 25.664.37 .00 .00 (8J APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Hortgage liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Govern.ental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax 19J 1l0J 9,745.00 12.600.22 (llJ 1l2J 1l3J 114J NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payltant. 122,361.11 ??~41; ?:::' 100,015.89 .00 100,015.89 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. NOTE: I~ an assessment was issued previously, lines re~lect ~igures that include the total o~ ~ ASSESSMENT OF TAX: 15. Altount of Line 14 at Spousal rate (15) 16. Amount of Line 14 taxable at Lineal/Class A rate (16) 17. Altount of Line 14 at Sibling rate (17) 18. Amount of Line 14 taxable at Collateral/Class 8 rate (18) 19. Principal Tax Due A C ITS: + DATE 11-19-2004 NUMBER CD004654 INTEREST/PEN PAID I-J 225.04 .00 X 00 = 100,015.89 X 045 = .00 X 12 = .00XI5= 119)= AHOUNT PAID 4,275.68 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE .00 4,500.72 .00 .00 4,500.72 4,500.72 .00 .00 .00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRJ, YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.J ~ q..~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 7/05/2006 JAMOUNEAU W JEFFRY 55 HIDDEN SPRINGS ROAD DILLSBURG, PA 17019 RE: Estate of JAMOUNEAU HELEN E File Number: 2004-00827 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: 8/28/2006 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, ~. ; /} J"~vJ7~ /i / ' Gleuda 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 JAMOUNEAU WILLIAM C 1326 S BROAD STREET PHILADELPHIA, PA 19146 RE: Estate of JAMOUNEAU HELEN E File Number: 2004-00827 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: 8/28/2006 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, ~ I Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ~ In Re: Estate of JAMOUNEAU HELEN E ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 2004-00827 NOTICE OF FAILURE TO FILE STATUS REPORT Personal Representative: JAMOUNEAU W JEFFRY Counsel for Personal Representative: Date of Decedent's Death: 8/28/2004 The Orphans' Court record indicates 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, is hereby given by that the you have ten (10) day to file the Status Report. If the required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notified of such delinquency and the undersigned will 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: 8/29/2006 ~"i r-47 ,f 1/ I' /1 "-7,)c ~,~ l .. J(/ !/'1~"",../4 I 7tJ.h~j .M4>t/iAiAJi'iiU.iUiif"l_" /',-lA:.v"r-<!'4'_' ~ . , ~ Glenda Farner Strasbaugh Clerk of the Orphans' Court rr r'- r-=! o u- rn ....D ru :sentative lo, \~~f'O~-I(e.. rn o o o o u- rn o 'i\l\olo DQ-C8?"l Ul o o r'- _~'\~'\\\.D..V--. l0 c. _0' ,-;l~ ;J In Re: Estate of JAMOUNEAU HELEN E ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 2004-00827 NOTICE OF FAILURE TO FILE STATUS REPORT Personal Representative: JAMOUNEAU WILLIAM C Counsel for Personal Representative: Date of Decedent's Death: 8/28/2004 The Orphans' Court record indicates 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, is hereby given by that the you have ten (10) day to file the Status Report. If the required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notified of such delinquency and the undersigned will 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: 8/29/2006 f rd$ A ~ '//1 ~$' . '.'~/' . xth?'d~~ ~J J,~;'t4:-;r.c>i' / .I ....0 E:(] .-'l o 0- fT] ....0 ru fT] . o o o Glenda Farner Strasbaugh Clerk of the Orphans' Court :sentative to \d.~~'(~ q\,\ ole o 0- fT] o ott -l~dl Ul o o r- ~1Y'<)L1-neCl\A LU\\\ IC:\J\\ c.> 'I~lc S io'(tcd~ \ . hlCl ~ P \~I'-l;lf '\ ~ c:- ' Q)-...J ~~ Q) I O\~ rn 0 o\:.J ~,!,; ~ ,,-- 0 Y"- o o c-. ~ \!! .a '" c Ol (j) <i >< E 3 ~~ E .c ,g ~ C-Q Q) "1:J ~ ro '0 ~ ~ .2: -5~ -0 ~ '" .2l ~ai ~u5 <lJ u.J -Or $.= cO ci Q) <Ii .l!3 ~ g Q) Q) B- e. . ~ .'ro ~~~6E o '(i\,s >- <ll g~c.8,s . <!..!!l ~'Eo~ ",~~\3-DE -o<ll~<ll<<l<ll c .2: -0 .c .0 0. <<lQi1ij+-'Q)<ll C\io-oE,sg ~~~~.8g. 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In this box · D4-o~81 ~ o ~ Glenda Famer Strasbaugh ~55 ~ :.!, in Register of Wills and Clerk ~~ans'~urti_:-~; 8 County of Cumberland :;:~fB ' >;48 One Courthouse Square ~"'~ en ^ CJ'1 :::(J f9 Carlisle, P A 17013 f"', ("", .-~ lP \11 ':,j.::. ;;lL;l\ !:il " !l i I " "II ':;j)JH\tH ~ ". _} ,- ,r, Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: -t-\ C1LC5."-.J E' ~'''''''d,) l.,11'-.J 'i. en) Date of Death: Q. 2 't - u ~ Estate No.: '/.-(-;0 Lj -- C.cj61 f Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, 1 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 IK.l No 0 2. lfthe 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 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 I21 No 0 o M -;;( .'. a..: :: ~' ~ate:lI , a.. 0 c:. ~ (f:, M,' \0 a:_.J~, I lLJ~""" 0.. d:cC!-= LU a... u-; C/) 0: cG U3 0:::2 g {3 c--.... c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk ofthe Orphans' Court and may be attached to this report. OG ~A~u --> .Ai -e- AV Name <s '> \ \ '\"~ 1)~:jJ Sf ~ ) t- (/; ~-j) Address\\) tl C <; ~u~~, e f\ ) Ie ( 1 ,I, '2. '~ l- S 2 '30 Telephone No. Capacity: 0. Personal Representative o Counsel for personal representative ~. ~ ,'I ~"h.'1 lc&~~ C . ~,_. ""') c"p :1):1~ {\Nu ~"o 0, '--;)( ~ C~J--i.\) ~.~ c~.j)./Wv..-''V../::> V\:t\:-t---tV~ ~ L'd- ~ \ A- \-:>Cl..h, '. ' . ~~ ---tw ~ .~/\\..O-\ c('J...cuw/l '" ~ '" L) ~ i. ~ " ,p ::E 0 @ ~ ~ :;) "" 0 ~ uJ ::\ ~ <l: z ::J. -;; 0- 5 ci ::E 0 ~ "" ~ cr; ~ " :;) .c " to . B ~ <J) 'J :< 1i' 0 ~\ z -;; is .5 'It 0 :J: '" ~~ In <<S . r-: s ..., 0>- f-- '" ~ tt "' w N Q) a \j! r-: s u. 0 Iii <"" s 0 u. Ji l- S u.J ro ..., "' ;< z ~ 6- "" ro u... 0 . 3 0 0 <"" . '" N Ul '" "1 '" I- ~i ~ '" ~ ~ )< 0 ~ a:l I- ~~ 0 '..i 0- w I- . Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. . Print your name and address on the reverse so that we can return the card to you. . Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: JAMOUNEAU WILLIAI"l C 1326 S BROAD STR.EET PHILADE:SPHIA PA 19146 2. Article Number (Transfer from service label) PS Form 3811, February 2004 ..~ Agent ssee ;c::~~ of Delivery :_; C_~ 3. Service 'J1 , \ ~ Certified ~'_ ~istered . .... D Insured Mail ~Q; Express Mall "~etum Receipt for Merchandise DC.O.D. 4. Restricted Delivery? (Extra Fee) DYes 7005 0390 0003 2639 0186 102595-02-M-1540 : I Domestic Retum Receipt U S P l''''I\.'.U.L''ULIII'IIII'''I''''lj'''1 "I "t"IIII""I'" . . - NITED TATES O~T"l1 .::>l::If{Vlc!: First-Class Mall Postage & Fees Paid USPS Permit No. G-10 · Sender: Please print your name, address, and ZIP+4 in this box · ol..\ -:-t:e:9-""l ~. Glenda Farner Strasbaugh Register of Wills and Clerk of Orphans' Court County of Cumberland One Courthouse Square Carlisle, P A 17013 Pa. O.C. Rule 6.12 STATU/S REPORT REGISTER OF WILLS OF o~~~~~~C COUNTY, PENNSYLVANIA d ~~~ ~~~ ~._ Name of Dece ent. ,~~ - FileNumber:~~ ~~~ ~ Date of Death: - --- Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: Yes ~'No 1. State whether administration of the estate is complete :........... . ....... . 2. If the answeris No, state when the personal representative reasonably believes that the administration will be comJ"p'/~l~et'e: ~~ ie~ ~~7 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 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 ~No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts maybe filed with the Clerk of the Orphans' Court and maybe attached to this repo~t~ Ln C~ ~- 2 - ~ t_,, ( ~~.~~-: C.,,) ~~ .L ~- ,. O ~ ~° C.r ~-.: ~ignature o~Person Filing rhi.v'Forfh Capacity: QPersonal Representative Counsel Name oJPerson Filing this Forn: Address 1 WEST HIGH ST. STE 205 Telephone ~~~ ~~~/ ~~ Form RNA-!0 rev. 10.1.3.06 '