HomeMy WebLinkAbout03-0815
PETITION FOR GRANT OF LETTERS
Estate of Robert D. Hill No. d- J -0 3 - '2 /5
also known as
, Deceased Social Security No 190506541
Petitioner(s), who is/are 18 years of age or older, apply)ies) for:
(COMPLETE "A" OR "8" BELOW:)
0 A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut named in the Last Will of the
Decedent, dated and codicil(s) dated
State relevant circumstances, e.g., renunciation, death of executor, etc
Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incapacitated:
IIIUIIIN_ - --,-_., '_W'''--"r:-''""'-- "'---".".'. ".",,"""'-- ."'RIIII~IUllnllllnIHlUIIWIUHI"."'""'''"I1I111""'''''''''''' "..._u
Gl B. Grant of Letters of Administration Sharon ~y ~Y:..\~
(c.I.a., d.b.n.c.l.a.: pendente lite, durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse
(if any) and heirs:
Relationship Residence
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his/her last family or principal
residence at 22 E. Orange St.,Mt. Holly Springs, PA 17065
(list street, number and municipality)
Decedent, then 42 years of age, died August 27 ,2003 ,at 1500 Block Holly Pike - MVA
(Location)
Decedent at death owned property with estimated values as follows:
(if domiciled in PA All personal property ......................................... $ 2,000.00
(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 ..................................................................................................................... $ 2,000.00
Real Estate situated as follows: none
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:
Typed or printed name and residence
3532 Chestnut S1. Carn Hill PA 17011
/7-/08 _.f?
, Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
The Petitioner(s) above-narned swear(s) and affirrn(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
Decedent, Petitioner(s) will well and truly administer the estate according to law.
Sworn to and affirrned and subscribed
before me this 3rcl day of
Od.Ob.~2003 'lJf
~8Jlqr 1Yl.tlihIat '~ U cP
Donna M. Otto, 1st IJE:!puty 1JIj.~. "ffl~
--........."' "-- ...... '__IIIIIIIIUII!HUHIIHI"nIU___ _1l1ll....'._'"""'"III''''''' ""''''"~III11III1II11Ullllllll.''lUl.'''IIIIIIIIIIIIIIIIIIIIHIIII''IIII.<mIlIIIIIIItIIIIllIRIIIIIIIIIIIIIIIIIIIHllllllmllm""II~lIl11lR1lmll"''''''nIIllDIBIHIUlI.n_ '" "1IIIIIIRIDIIH""_"._m, .
DECREE OF REGISTER
Estate of Robert D Hill Deceased No. 21-2003-815
also known as
Social Security No: 190506541 Date of Death: 8/17/03
AND NOW, October 9th 2003 , in consideration of the Petition on the
,
reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters 0 Testamentary 00 of Administration ((c.t.a., d,b.n.c.t.; pendente lite; durante absentia; durante minoriate)
i-. tJ....lk.:JJ..,. I.' ~
are hereby granted to Sharon Mackey, sister of the decedent
in the above estate and that the instrurnent(s), if any, dater!
described in the Petition be admitted to probate and filed of record as the Last Will of Decedent.
FEES
Letters............... ..................... $ 25.00 1rJ. Via-l 41-
$ 15.00 Donna M. ~
Short Certificates(s) ....~.........
Renunciation.............. J......... $ 5.00
Extra Pages ( ) ............... $
................................................ $
I.T.R....................................... $ Signature
JCP Fee ................................. $ 10.00 Attorney: Williarn P. Douglas
Inventory............................... . $ I.D. No: 37926
Other..................................... . $ Address: 27 W. High St.
Carlisle PA 17013
TOTAL ............................$. 55.00 Telephone: 717-243-1790
Called Attorney William P. Douglas DATE FILED: 10/2/03
on 10/9/03
RENUNCIATION
21-2003=815
.
In Re Estate of ~~-\- b. \\\\ \ deceased.
.
To the Register of Wills of ~ 'V "'^- ~ \ 0..-. L County. Pennsylvania.
-
.
The undersigned ~("""'- \( ~.\\ ~ ffi",cW. J" \\-,\ \. of
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
~ .~
4~"'^',_,~~ ~
be issued to ~ \r-...().~ r'>- L. <<\~'L\< :-'1
WITNESS o~c hanc!sthis ~~ day of <0 c&-~r- .~.
?~~~~:a(#
r (Signature)
PO, 8~ '~l? ~;J~ ~
R)/t-/ ~ ~ k /7 () I. 5- ~ 0 ';). I :3
(Address)
');l ~ ;ko
f~"'-) ( '8M'::! ~
. . 9 'j~ .
f. d. 04 :l.l:?
I 'ltVLi ~~ ~ r t:L l'7 6 ~5'-u~l,:)
- (Address)
(Signature)
(Address)
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
"/PRINT CERTIFICATE OF DEATH
IN (Coroner)
lANENT #29-099 ST,IJ'E FIlE NUMBER
:KINK SEX SOCIAL"SECURITY NUMBER D....E OF DeATH iMonIIl. 0.,. _I
D Hill 2. Male .. August 27, 2003
UNDER 1 YEAR UNDER 1 DAY BIRTHPLACE (City and PLACE OF DEATH (Check only one Me instrUCliona Or'! other Iide)
Mon,'" 0.,. Houn Minute, Stale or Foreign Country) HOSPITAL: OTHER:
Inpalien' 0 ~o ~10(
7. ...
eJTY, BOA FACILITY NAME (II no! institution, give S1reet and number)
10.
MARITAL STRUS. Married SURVIVING SPOuse
William Stan$field ~~~. (If wile. give lNiden name)
1 Constroct~an ,.Never Married -
' .
DECEDENT'S MAlUNG ADDRESS (Street. CityfTown, S1a1e. ZIP Code) DECEDENT'S PA 17..o,"._ntIlYOd..
ACTUAL 17.. Stale Oid ...'
RESIDENCE ---
(See inltruclion8 ......
onOCher1ide1 Cumberland _7 11d.[3 :h~=of Mt. Hall y Sprinqs
l7b. Coun _.
MOTHER'S NAME (PtrSI, Middle. Maiden Surname)
1.. Madelyn J. Caufman
INFORMANT'S MAILING ADDRESS (Street, CityfTown Stale Zip Code)
8 Larken Lane, Mt. Holly Springs, PA 17065
PLACE OF D1SPOSITK)N. Name of Cemetery. Crematory lOCATION. CltyfTown, St.a, Zip Code
or Other Place
Carlisle, PA 17013
Hane, Carlisle, PA 17013
DATE StGNED
(Month, Day, -'r)
2:1b. ....
prx. DATE PRONOUNCED DEAD (Mooltl. Day. Year) ""'$ CASE REFERRED TO MEDICAL EXAt.tINERICOAONER?
8:25 P. M. August 27, 2003 .....~ ...0
... 2'. H.
27. PART I: Enl., the diHasea. in;une. or complbtions which c.lUMd lhe death. 00 not enter the mode 01 dying, such." cardiac or respiratory .rrest, shock or h..rt laUura. ,Appn:ndmete PART": Other Iignlftc8m condItionI oontrIbutlng 10 de.h. but
liM only one cauI8 on each Itne. : 1m.,.,., between not resuftlng in the undertyIng ClMIM gMtn In PAAT r.
IOnaet end death
.. Multiple Traumatic Injuries I
DUE 1O(OA AS A CONSEOUENCE 0Fj, ,
Motor Vehicle Crash i
.
DUE 10 (OR AS A CONSEOUENCE 0Fj, !
..
DUE 10 (OR AS A CONSEQUENCE OF): I
I
d
WERE AUlOPSY FINDINGS MANNER OF DERH DATE OF INJURY TIME OF INJURY INJURY AT WORK? DESCRIBE HON INJURY OCCURRED.
JUJLA8LE PRfOR 10 (Month, DaV. Yearl Aprx. Motorcycle operator
COMPlETION OF CAUSE 0 o August 27,2003
OF OERH? - Homlcldo struck car, ejected
'" " NoD '"9tt NoD - ,g PM\dIng lnveltlgltlon 0 8:25 P M
0 PLACE OF INJURY. AI home. farm. etreet. factory. office
- Coutd not be determtned o ;::"ng.....(Spec;~1 Rural Road
.... 21b. H.
CERTIFIEIt (Check only one) SIGNJO'URE AND
.cafITlFYlHQ ""SICIAN (Phyaicien certiIying caJIe rA deMh when anaItw physician hat pronounced death and compleled Ilem 23) 0.. Coroner
TO....btetor""IrnowIedge........~dulttotheOMl8l(e)lInd.....nner..~....,.....,',..,............ ......,.......,.".......
LICENSE NUMBER
.1tROHOuNcINQ AND CDn"PYIHQ ItHYSICIAN (PhytIiciM boI'l pronounclng death.nd certifying 10 cause at de8th) 0.. 31d. Au ust 29, 2003
Tothebe.aofmylrnowledte.dMthOOCurNd..thetlrne.....enctpMce.MddurllOtheC8UM(.).ndm.nner..etated.......,.".,...".,..... .
NAME AND ADDRESS OF PERSON WHOCOMPLETED CAUSE OF DERH
.MEDlCAL ElCAMINERICOIIONEIl Olem27)TypeorPrint Michael L. Norris, Coroner
On the...... of nMtfnatlon enellor 11IWettptfon. In my opinion. death OCCUrred at the "me. data, and piKe, Md due to the cau.....) and RI 6375 Basehore Road, Suite #1
fnIInMI'''~.........................o...o. .0...0.. .........0...................0....... ..........,........... Mechanicsburg. Pa. 17050
"L ...
REGISTRAR'S StGNRuRE AND N ~. ~t.u.~~ 1<11 II d.J I I 0 I DREFJLED(Monlh, De)', 'fMr)
...
- . .
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: ~~01 1> \-\ ,\ \
Date of Death: ~)..ll0~
2. \ - Os - ---
Will No. O~l~ Admin. No.
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the orhans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on 2-J ~ 0 y :
~ Address
CJ1e.je.fI ne 8 I II coJf\J ~
~~('o('\ M~J ~ .
,
35~2 Che.. sr (\ 0 T )T~
~(Jl,*.ll\ PL^ (,0 1\
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except ~
Date: 2-{ S-JD tf Sig.,,~~ >. ~
N,meLo L \ \\<UX\ ~ boo,,! k~ [~
Address .:2-- I Lu 4l ~ ~ 5r
r~, li~~C- fA- (tD 15
Telephone-(] v7 "2- 'f- -?> 114D
Capacity: _ Personal Representative
L"J fo< pe,ro.,J repre..."'ive
.
~
NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND,
PENNSYLVANIA
IN RE: ESTATE OF ROBERT D. HILL, DECEASED
NO. 21-03-0815
TO:
CHEYENNE HILL
SHARON MACKEY, GUARDIAN AND ADMINISTRATOR
3532 Chestnut St.
Camp Hill, PA 17011
Please take notice of the death of decedent and the grant of letters to the
personal representative named below. You may have a beneficial interest in the
estate under the Intestate laws of the Commonwealth of Pennsylvania.
Name of decedent: Robert D. Hill
Last known address of decedent: 22 E. Orange St., Mt. Holly Springs, P A 17065
Date of Death: August 27, 2003
Place of Death: Carlisle, Pa.
County of Grant of Original Letters: Cumberland
Decedent died intestate.
Name, address and phone number of all personal representatives:
SHARON MACKEY
3532 Chestnut St.
Camp Hill, PA 17011
Name, address and phone number of counsel:
William P. Douglas, Esquire
27 W. High St.
Carlisle, Pa. 17013
Phone: 717-243-1790
Additional information may be obtained from the undersigned:
Dougl sLaw ffice
By
Willi . Douglas, Esquire
27 W. High St.
Carlisle, Pa. 17013
717-243-1790
Dated: Feb. 5, 2004
J::x)€- So.CQ f\ . j:>. l)J.S. 0\)
?d d.. 5. db
REV.l500EXi&OO) REV-150~1l., OFFICIAL USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE INHERITANCE TAX RETURN FILE NUMBER
DEPT. 280601 2 1 0 3 o 8 1 5
HARRISBURG, PA 17128.0601 RESIDENT DECEDENT -
-----
COUNTY CODE YEAR NUMflER
DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
t- Hill, Robert D. 190 - 50 - 6541
Z
W DATE OF DEATH (MM.DD.YEAR) DATE OF BIRTH (MM.DD.YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
0
W 8/27/03 7/30/61 REGISTER OF WILLS
0
W (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
0 - -
None
w g 1. Original Return o 2. Supplemental Return o 3. Remainder Return (date of deall1 pilot to 12-13-82)
...
::.::~U) o 4. Limited Estate o 4a. Future Interest Compromise (date 01 dealh after 12-12-82) o 5. Federal Estate Tax Return Required
o .",
w"O
",00 o 6. Decedent Died Testate (Attach copy of Will} o 7. Decedent Maintained a living Trust (AlIachcopyofTrusl) 8. Total Number of Safe Deposit Boxes
00:-'
.... -
.. o 9. litigation Proceeds Received o 10. Spousal Poverty Credit {date ofdealh between 12--31.91 aoo 1-1-95) o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
'"
I-
z COMPLETE MAILING ADDRESS
w NAME
0
z 27 W. High St.
0
.. FIRM NAME 1"_1
.. Carlisle, PA 17013
w
0:
0: TELEPHO N BER
0
0 717-243-1790
1. Real Estate (Schedule A) (1) OFFICIAL USE ONLY
,
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) ~--.
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 16.732.00
Z (Schedule E)
0 6. Jointly Owned Property (Schedule F) (6)
~ o Seperate Billing Requested (~:)
::l 7. Inter-Vivos Transfers & Miscellaneous Non.Probate Property (7) -
t- (Schedule G or L)
ii: 16,732.00
c( 8. Total Gross Assets (total Lines 1-7) (8)
0 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 15,345.85
W
0:: 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & (0) (11) l'i.14'i.R'i
12. Net Value of Estate (Line 8 minus Line 11) (12) 1,386.15
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been (13)
made (Scl1edule J)
14. Net Value Subject to Tax (line 12 minus Line 13) (14) 0 (minor ('hi 1 rl)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
Z 15. Amount of Line 14 taxable at the spousal tax
0 0
!;( rate, or transfers under Sec. 9116 (a)(1.2) x .0_ (15)
I-' 16. Amount of Line 14 taxable at lineal rate x.O_ (16)
::l
Q. 17. Amount of Line 14 taxable at sibling rate x .12 (17)
:E
0 18. Amount of Line 14 taxable at collateral rate x .15 (18)
0
~ 19. Tax Due (19) Q (minor ollila)
20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address: ( .
STREET ADDRESS
I,on ^ _'- ~>
Carlisle, PA 17013
CITY I STATE I ZIP
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) 0 (minor child)
2. Credlts/Payments
A Spousal Poverty Credit
B. Prior Payments
C. Discount
Total Credits (A> B + C) (2)
3. InterestlPenally ~ applicable
D. Interest
E. Penally
TotallnterestlPenally ( 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) 0 (minor child)
A. Enter the interest on the tax due. (SA)
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (5B) g (miH9r eailEl)
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 property transferred;...............................................................................,.......... D fKJ
b. retain the right to designate who shall use the property transferred or its income: ............................................ D 6U
c. retain a reversionary interest; or.......................................................................................................................... D fKJ
d. receive the promise for I~e of either payments, benefits or care? ...................................................................... D fKJ
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? .............................................................................................................. D 6U
3. Did decedent own an 'in trust for" or payable upon death bank account or securily at his or her death? .............. D liS]
4. Did decedent own an Individual Retirement Account, annuily, or other non.probate property which
contains a beneficiary designation? ........................................................................................................................ D liS]
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 thai I have examined this return, including accompanying schedules and statements, and 10 the best of my knowledge and belief, it is true, correct and complete.
Declaration of preparer other than the personal representative is based on all infonnalion of which preparer has allY knowledge.
SIGNATURE 0 PERSON RESPONSIBLE 0 F G RET RN DATE 3/17/05
I. William P. Douglas, Esquire, attorney
ADDRESS 27 W. ., Carlisle, PA 17013 717-243-1790 3/17/05
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposad on the net value of transfers to or for the use of the surviving spouse is 3%
[72 P.S. 99116 (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 tha use of the surviving spouse Is 0% [72 P.S. 99116 (a) (1,1) (i1)I.
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 datas of death on or after Juiy 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, 99116(a)(1.2)1.
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficianes is 4.5%, except as noted in 72 P,S, 99116(1.2) [72 P.S, 99116(a)(1)).
The tax rate imposed on the net value of transfers to or for the use of the decedent's ~blings is 12% [72 P.S, 99116(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.
"".'.."'."..n* SCHEDULE E
COMMONWEALTH OF PENNSYLVANIA CASH, BANK DEPOSITS, & MISC.
INHERITANCE TAX RETURN PERSONAL PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Robert D. Hill 21-03-0815
Indude the prnceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned _ the right 01 survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
Buddy Mobile Home, appraised value 500.00
2. 1990 Ford Bronco (mileage - 171,921) sale price 1,200.00
3. Cumberland County Court restitution payment 32.00
4. American Modern Home Ins. Co., motorcycle policy payment
on the personal injury case. (Mr. Hill was killed as
a result of an auto/motorcycle accident- this policy
paid the coverage of $15,000) See attached declaration 15,000.00
page copy
TOTAL (Also enter on line 5, Recapitulation) $ 16,732.00
(If more space is needed, insert additional sheets of the same size)
SEP 12 2003
September 10, 2003
William Douglas, Esq.
27 W. High SI.
Carlisle, PA 17013
Re: Robert Hill
Dear Bill,
Pursuant to your request, I have done an inspection of the Robert Hill mobile home
located at 22 Orange Street in MI. Holly Springs. It consists of a 2 bedroom, 1 bath, 1970
Buddy mobile home in poor condition. The home is on a rented lot in a mobile home
park, so there is no real estate involved.
Based on this data, I believe the market value of the mobile to be $400- $500 dollars.
Please note that this is not an appraisal, but a simple market analysis.
Feel free to contact me should you have any further questions.
Sincerely,
RElMIlC Sterling Assoc., Inc.
1909 Ritner Hwy., Suite 1
Carlisle, PA 17013
~ Office: (717) 245.2600
Fax: (717) 245-2255
Each office independently owned and operated
E 4CA RENEWAL DECLARATION PAGE 1 940
^ AMERICAN MODERN HOME INSURANCE ':OMPANY
MOTORCYCLE POLICY DECLARATIONS POLICY NUMBER: 0774303736192
(~,
NAMED INSURED: AGENT 020090:
ROBERT D HILL SHOEMAKER & BESSER ASSOC INC
22 E ORANGE ST 4396 W MARKET ST
MT HOLLY SPRINGS PA 17065-1721 YORK PA 17404-5999
BROKER 014453:
MAIL TO: N077 020090 4303736192 37 T60 MILLER INSURANCE ASSOCIATES INC
ROBERT D HILL 19 BROOKWOOD AVE SUITE 1 02
22 E ORANGE ST CARLISLE PA 17013
MT HOLLY SPRINGS PA 17065-1721 PHONE: (717) 243-4400
POLICY PERIOD:
FROM: JULY 28, 2003 TO: JULY 28, 2004
12:01 A.M. STANDARD TIME
AT GARAGE LOCATION ADDRESS
GARAGE LOCATION: LIENHOLDER 1:
22 E ORANGE ST NONE
MT HOLLY SPRINGS PA 17065
THIS POLICY PROVIDES ONLY THE FOLLOWING COVERAGES FOR THIS UNIT:
I SECTION ITEM COVERAGE LIMIT PREMIUM I
1 COVERAGE A BODILY INJURY-EACH PERSON $15,000 $40.00
1 COVERAGE A BODILY INJURY-EACH ACCIDENT $30,000
1 COVERAGE A PROPERTY DAMAGE-EACH ACCIDENT $10,000 $9.00
ENDORSE PASSENGER LIABILITY INCL.
ENDORSE PEDESTRIAN PERS INJ PROTECTION $5,000 $2.00
ENDORSE UM BI-EACH PERSON ** $15,000 $9.00
ENDORSE UM BI-EACH ACC ** $30,000
MINIMUM WRITTEN AND/OR EARNED MAY APPLY TOTAL PREMIUM $60.00
** UM STACKED COVERAGE APPLIES
.....RENEW AL CREDIT APPLIED.....
(CONTINUED ON REVERSE SIDE)
ENDORSEMENT FORMS APPLICABLE TO THIS POLICY:
VM037 05/01; VMEOO 01/01; VMJOO 01/01; VMN11 08/01; VM737 05/01;
VM537 06/01;
81LL TO INSURED
DATE PREPARED: JUNE 20. 2003
FORM NO. 0110-4269 (5/92) INSURED'S COpy
!
INSURED NAME: ROBERT D HILL POLICY NUMBER: 0774303736192
DATES OF SURCHARGED MAJOR VIOLA TION(S): NONE
DATES OF MINOR VIOLA TION(S)/ ACCIDENT(S): NONE
DRIVER INFORMATION:
NO. NAME SOC. SEC. NO. DRIVER'S LICENSE NO. STATE
1 ROBERT D HILL 11111111111111111111 PA
ADDITIONAL INSURED: LIENHOLDER 2:
NONE NONE
PLEASE REVIEW THE INFORMATION CONTAINED IN THIS POLICY.
IF ANY INFORMATION IS INCORRECT, PLEASE CONTACT CUSTOMER SERVICE:
MILLER INSURANCE ASSOCIATES INC
PHONE: (717) 243-4400
CLAIMS TELEPHONE NUMBER: 1-800-543-2644
HOURS: 8:00 A.M. - 7:00 P.M. EST/EDT
AMERICAN MODERN INSURANCE GROUP
MAILING ADDRESS MAIN ADMINISTRATIVE OFFICE
POST OFFICE BOX 5323 7000 MIDLAND BOULEVARD
CINCINNATI. OHIO 45201-5323 AMELIA, OHIO 45102-2607
RfV.'511EX+(1-97) '*
SCHEDULE H
FUNERAL EXPENSES &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF Robert D; Hill 21-03-0815 FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Ewing Brothers funeral: 5,669.00
Flowers from family for funeral 131.70
Mt. Holly Springs Church of God, funeral meal 75.00
Westminster Cemetery, grave opening 945.00
Memorial plaque 1,643.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s)
Sodal Security Numbe~s) I EIN Number of Personal Representative(s)
Street Address
City State Zip
Yea~sl Commission Paid:
2. Attorney Fees Douglas Law Office - Estate fee 1,000.00
Dou~las Law Office, fsersonal injury fee (25%) 3,750.00
3. Family Exemption: (If decedenfs a dress ~ not1he same as claiman s, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees
63.00
5. Accountanrs Fees
6. Tax Return Preparer's Fees
7. Madelyn Hill, mother, reimbursement for bills paid by her 628.35
Jenny Lee Shue, landlord, water, sewer trash bill 127.67
Jenny Lee Shue, lot rent for trailer, June through Jan. 200
@$100 800.00
Cumberland Law Journal, adv. 75.00
Evening Sentinel, advertising 108.95
Dr. Craig Anzur, last medical bill 80.00
Met Ed, final bill 198.18
Clerk of Coruts 7.00
Com. of PA motor vehicle registration 5.00
Filing fees, for inheritance tax, petition to close 39.00
TOTAL (Also enter on line 9, Recapitulation) $ 15,345.85
(If more space is needed, Insert additional sheets of the same size)
REV.,,,,,,.,,..n. SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER 21-03-0815
Robert D. Hill
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1. Cheyenne Hill, a minor, dab: 4/2/97 daughter 100%
429 Arch St.
Carlisle, PA 17013
(Susan Karichner, guardian and natura mothe"said funds
To be placed in a bank account or C
pursuant to an order of court, mark d
not to be withdrawn until age 18, 0 on
further order of court)
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
II. NON.TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART n. ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
Marjorie A. Wevodau
Glenda Farner Strasbaugh First Deputy
Register of Wills
and Kirk S. Sohonage, Esq
Clerk of Orphans' Court Solicitor
Register of Wills and Clerk of the Orphans' Court
County of Cumberland
One Courthouse Square
Carlisle, PA 17013
(717) 240-6345
FAX (717)240-7797
I INVOICE I
Bill To: InvoiceNo: 276
Invoice Date: 3/29/2005
WIlliAM P DOUGLAS Estate of: ROBERT D HILL
27 W HIGH ST Estate No: 21-2003-0815
JA
CARLISLE, PA 17013
Qty Fee Description Fee Total
1 Additional Probate 25,00 $25.00
Total: $25.00
Checks should be made payable to the Register of Wills. Terms: Net 30.
Please return one copy of this invoice with your payment. Thank you.
.
Marjorie A. Wevodau
Glenda Farner Strasbaugh First Deputy
Register of Wills
and Kirk S. Sohonage, Esq
Cierk of Orphans' Court Solicitor
Register of Wills and Clerk of the Orphans' Court
County of Cumberland
One Courthouse Square
Carlisle, PA 17013
(717) 240-6345
FAX (717)240-7797
I INVOICE I
Bill To: InvoiceNo: 276
Invoice Date: 3/29/2005
WIlliAM P DOUGLAS Estate of: ROBERTD HILL
27WHIGHST Estate No: 21-2003-0815
JA
CARLISIE, PA 17013
Qty Fee Description Fee Total
1 Additional Probate 25.00 $25.00
Total: $25.00
c.y~
---- \ 1..SS
<:\.l."- -*-
Checks should be made payable to the Register of Wills. Terms: Net 30.
Please return one copy of this invoice with your payment. Thank you.
COMMONWEALTH OF PENNSYLVANIA *'
DEPARTMENT OF REVENUE
~ .'" NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAxes APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX
PO BOX 280&01
HARRISBURG PA 17128-0601 REV-1547 EX AFP (06-05)
I':' SO DATE 06-13-2005
iJ
ESTATE OF HILL ROBERT D
DATE OF DEATH 08-27-2003
FILE NUMBER 21 03-0815
WILLIAM P DOUGLAS COUNTY CUMBERLAND
ACN 101
DOUGLAS LAW OFFICE APPEAL DATE: 08-12-2005
27 W HIGH ST ( See reverse side untier Objections)
CARLISLE PA 17013 A.ount Re.ittedl I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS -
--------------------.--------------------------------.-------------------------------------
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HILL ROBERT D FILE NO. 21 03-0815 ACN 101 DATE 0&-13-2005
TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON. ORIGINAL RETURN
1. Real Estate (Schedule A) 0) .00 NOTE: To insure proper
2. Stocks anu Bonds <Schedule B) (2) .00 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 16.732.00
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (1) .00
B. Total Assets 'B) 16,732.00
APPROVED DEDUCTIONS AND EXEMPTIONS: 15,345.85
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) .00
11. Total Deductions Hi) lli.~41; 8S;
12. Net Value of Tax Return (12) 1,386.15
". Charitable/Governmental Bequests; Hon-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 1.386.15
NOTE: If an assess.ent was issued previously, lines ltf, 15 and/o.. 16, 17, 18 and 19 will
..eflect fiuu..es that include the total of ~ ..etu..ns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15) .00 J{ DO = .00
16. AMount of line 14 taxable at lineal/Class A rate (16) 1,386.15 J{ 045 = 62.38
17. Amount of Line 14 at Sibling rate (17) .00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) . DO J{ 15 = .00
19. Principal Tax Due (9)= 62.38
TAX CR"DIT"':
PAYHo. , RECEIPT nISCOUHT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (~)
INTEREST IS CHARGED THROUGH 06-28-2005 TOTAL TAX CREDIT .00
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 62.38
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 3.03
TOTAL DUE 65.41
. 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.) __~~
REV_1410 EX (6.88)
'* INHERITANCE TAX
EXPLANATION
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE OF CHANGES
BUREAU OF INDMDUAL TAXES
PO Box 280601
HARRISBURG PA 17128-0601
DECEDENTS NAME FILE NUMBER
Hill, Robert D. 2103-0815
REVIEWED BY ACN
Daniel Heck 101
ITEM
SCHEDULE NO. EXPLANATION OF CHANGES
J 1 Lineal heirs are taxable at the rate of 4.5% for dates of death on or after 07-01-2000.
..
-
-
~j
ROW Page 1
.-
.
COMMONWEALTH OF PENNSYLVANIA '*
.~ DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
INCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT DF TAX
'80601 , ~."-': , 13
JRG PA 17128-0601 i i I i C REV-1547 EX AFP (06-05)
DATE 06-13-2005
ESTATE OF HILL ROBERT D
DATE OF DEATH 08-27-2003
FUE NUMBER 21 03-0815
COUNTY CUMBERLAND
WILLIAM P DOUGLAS ACN 101
DOUGLAS LAW OFFICE APPEAL DATE: 08-12-2005
27 W HIGH ST ( See reverse side under Objections)
CARLISLE PA 17013 Amount Remitted I I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
ILONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-
--------------------------------------------------------------------------------------
547 EX AFP C03-05J NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
-E OF HILL ROBERT D FILE NO. 21 03-0815 ACN 101 DATE 06-13-2005
TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
~VATION CONCERNING FUTURE INTEREST - SEE REVERSE
IISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) Cl) .00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) (2) .00 credit to your account,
.00 submit the upper portion
S. Closely Held Stock/Partnership Interest (Schedule C) (3) of this form with your
.. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 16,732.00
So Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
B. Total Assets (8) 16,732.00
IVED DEDUCTIONS AND EXEMPTIONS: 15,345.85
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)
o. DebtS/Mortgage Liabilities/Liens (Schedule I) (10) .00
1. Total Deductions (11 ) lli.341i BIi
2. Net Value of Tax Return (12) 1,386.15
5. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
4. Net Value of Estate SUbject to Tax (14) 1,386.15
If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of &1.. returns assessed to date.
;SMENT OF TAX:
5. Amount of Line 14 at Spousal rate (15) .00 X 00 = .00
6. Amount of Line 14 taxable at Lineal/Class A rate (16) 1,386.15 X 045 = 62.38
7. Amount of Line 14 at Sibling rate (17) .00 X 12 = .00
B. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 = .00
9. Principal Tax Due (19)= 62.38
:REDITS:
IVMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
lEST IS CHARGED THROUGH 06-28-2005 TOTAL TAX CREDIT .00
IE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 62.38
ISE SIDE OF THIS FORM INTEREST AND PEN. 3.03
TOTAL DUE 65.41
..... ,...... a..........,....... .,........r- or ......,....... ............. ....,...r- ....r-................ , ...... ...."...... I .......... ...... . ............ ........., ..... ...... .... ."...r-...... ....... ....,......... ...........'"
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX(11-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 005464
DOUGLAS WILLIAM P
27 W HIGH STREET
CARLISLE, PA 17013
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
__n_n_ fold ---------- --------
101 I $65.41
ESTATE INFORMATION: SSN: 190-50-6541 I
FILE NUMBER: 2103-0815 I
DECEDENT NAME: HILL ROBERT 0 I
DATE OF PAYMENT: 06/21/2005 I
POSTMARK DATE: 06/21/2005 I
COUNTY: CUMBERLAND ,
DATE OF DEATH: 08/27/2003 I
I
TOTAL AMOUNT PAID: $ 65.41
REMARKS:
CHECK#1293
INITIALS: JA
SEAL RECEIVED BY: GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAffi~ORDED OFFICE OF INHERITANCE TAX
IIKRITANCE TAX DIVISION "Er.". Tr. (' - 'I "'1" STATEMENT OF ACCOUNT
PO BOX 280601 ~I '".Y:'j; tri \)r ~1jq :'
HARRISBURG PA 17128-0601 '-v.' ,- -.-_1
*'
REV-1607 EX AFP (03-05)
2005 JUL '5 PH 12: 03
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-11-2005
HILL
08-27-2003
21 03-0815
CUMBERLAND
101
AlIOunt R_l tteel
ROBERT
D
CLERK OF
ORPHAN'S COURT
WILLIAM P D~LAND CO.. PA
DOUGLAS LAW OFFICE
27 W HIGH ST
CARLISLE PA 17013
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to ~our account I subMit the upper portion of this for. with your tax pay..nt.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
................................................................................................................
REV-1607 EX AFP (03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT KKK
ESTATE OF HILL ROBERT D FILE NO. 21 03-0815 ACN 101 DATE 07-11-2005
THIS STATEIlENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NANED ESTATE. SHOWN BELOW
IS A SUNNARY OF TNE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYNENTS, TNE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT DR RECORD ADJUSTMENT: 06-13-2005
PRINCIPAL TAX DUE: 62.38
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
06-21-2005 CD005<06<O 2.97- 65.<01
TOTAL TAX CREDIT 62.<0<0
BALANCE OF TAX DUE .06CR
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .06CR
.
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRl,
YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORK FOR INSTRUCTIONS. 1
~'S ~
Register of Wills of Cumberland County
Date of Death:
STATUS REPORT UNDER RULE 6.12
~()~e\\ D. t-\-\ t\
qEJo3
2"o0,? - 0 c> 81 S'"'
Name of Decedent:
Estate No.:
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
1. State whether a~istration of the estate is complete:
Yes 0 No p<l..
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete: \, MoS.
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes 0 No 0
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties in
interest? Yes 0 No 0
c. Copies of receipts, releases, joinders and approval of [onnal or infOlma1
accounts may be filed with the Clerk of the Orphans' Court and may be
attached to this report.
Date: -r -AS..oS-
U-
~- :::-p~
Signature
(;J-[I.~ 1>- t,our
Name
2-1 u;iJ..'zf-Sr. ~M'~(~, ~ l'1of3
Address
r-
" -j
c;':;
(7'1
('.i
_J
~~;
/) 11 Z-'"t ~ 11 cr 0
Telephone No.
t,r"}
(~~)
c.:::::.~
c"-'
c;
Capacity: 0 Personal Representative
M Counsel for personal representative
)
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/27/2005
DOUGLAS WILLIAM P
27 W HIGH STREET
CARLISLE, PA 17013
RE: Estate of HILL ROBERT D
File Number: 2003-00815
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 is due by:
8/27/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~~?Aj~
~,'
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
v\
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/05/2006
DOUGLAS WILLIAM P
27 W HIGH STREET
PO BOX 261
CARLISLE, PA 17013
RE: Estate of HILL ROBERT D
File Number: 2003-00815
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:
8/27/2006
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,
/'.,., r 'f'!J'.. ~'~I ~.../
,[,/'$," ~/r r.. '. ..J'
. -<. /'. ,-", , . . I 1/. ." J: 'f
iJ.~.4.#,-, ~...I'Mra(04.,..i .)"...;' :, . (...I
I' /
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
{)
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Da t e : 7/05/2006
MACKI E SHARON L
3532 CHESTNUT STREET
CAMP HILL, PA 17011
RE: Estate of HILL ROBERT D
File Number: 2003-00815
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. I, for decedents dying on or after
July I, 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:
8/27/2006
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,
11' ~
' ...' . . 17
k~~ L~a:.A.JJ~.. ..... / ..v
( ./
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
~
'\
Reftister of Wills of Cumberland County
Name of Decedent:
STATUS REPORT UNDER RULE 6.12
'12o~~ b ~ ,((
I J
t'/2-7/03
I I
- -,..-
2-00 ?-cu~ J~
Date of Death:
Estate No.:
Pursuant to Rule 6.12 ofthe Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the ailiuinistration oft..l}e above-captioned estate:
1. State whether administration of the estate is complete:
Yes 0 NO"{J/
2. If the answer is No, state when the personal rrpresentative reasonably believes that
the administration will be complete: w l ~I Y'\ (., v~ S.
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a fmal account with the Court?
Yes 0 No 0
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties in
interest? Yes 0 No 0
c. Copies of receipts, releases, joinders and approval of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be
#' /' attached to this report. ,__ //-) , ~ \ //
Date: ' J.S U0 /~~ 7i~(j&'~
Signature
lu.;/1 V0nl ~ Duu.:{ {t- ,~
Name
d ') (p, ~'f <;)- (j~- 14-
Address .
11 f 2,,<( ~ 1-'~cJ
Telephone No.
Capacity:
O}efsonal Representative
&1' Counsel for personal representative
J
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone:(717) 240-6345
Date: 7/29/2008
DOUGLAS WILLIAM P
27 W SOUTH STREET
PO BOX 261
CARLISLE, PA 17013
RE: Estate of HILL ROBERT D
File Number: 2003-00815
Dear Sir/Madam:
c~
~ r-,,
~;
~,
.
~~ c~
_
'} ~E~
_,,__ ~ -
- r-,
_. , ~
;? ~ ~„.. -- ,
~
-
~.
-.~
_-
; ~,.~
-~_
.
.:~
~, --~ c~
ca
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.
A.s per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET N0. 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.
'T'his filing is due by: 8/27/2008
F~lease feel free to contact this office with any questions you may
nave. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
c;c : File
Personal Representative(s)
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone:(717) 240-6345
Date: 7/29/2008
c7
;-- ~..~
HACKIE SHARON L ~_~, ~~
c-;,
3532 CHESTNUT STREET _%~_,_:., ~,,,,~ ~-
CAMP HILL, PA 17011 ~~.=~~ ~ - ~
_, ,_ ~~ -,
_ ~ -
c.,~ -
cz~
R.E: Estate of HILL ROBERT D
File Number: 2003-00815
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
clate .
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103
SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after
~Tuly 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: 8/27/2008
Please feel free to contact this office with any questions you may
Piave. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
Cc: File
Counsel
Pa. ®.C. Rine 6.1~ S'TA'~jJS RAP®RT
REGISTER OF WILLS OF ~ COUNTY, PEN~NTSYLVANLA
Name of Decedent: ~c~ ll1 -~
i
Date of Death:._T D ~ File Number: ~3` b~ ~j
D.,,- r f~, D., /1 (~ D ] ~ 1 7 T ,•o,~~rt tl~e f~ll~tixnna ~znfh recnPnt ttl cmm~lPtlnn Qf the ad7~l1T175tratl0Il Of
1. uLSuaii~ w i u. v.~. i~i.ii°v v.._, i "'Y "o r-" r--°--
the above-captioned estate:
1. State whether administration of the estate is complete :.................... []Yes ~livu
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 0 No
b. The separate Orphans' Court No. (if any) for the personal
representative's account is:
c. Did the personal representative state an account
- -_ _
info~n~aliy to the parties in interest? ............................... Yes ONo
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts maybe
fled with the Clerl_t of the Orphans' Court and may be attached to this report.
Dnte ~ '~ ~ ('V o
U~(~
~~a~~ ~ • V /1 V ~ VY ~ I l~~ V
7 U . ~ s~ ~ ~ ~ ~~n ~,1;~7
rant RbY-10 rev. 10.13.06
l"
Signature of Person Filin; this Forn:
Capacity: sersonal Representative Counse]
~,1 c ~~ ~ ~ ~ ~. ~~~~.~
Name of Person Filing this Fa~m
Rddress
t `7 U l 3
Telephaie
Ov
Cumberland County - Register
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 8/06/2009
DOUGLAS WILLIAM P
43 W SOUTH STREET
PO BOX 261
CARLISLE, PA 17013
RE: Estate of HILL ROBERT D
File Number: 2003-00815
Dear Sir/Madam:
Of Wills
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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
~Z;y 1, 1992, the personal representative or his counsel, within two
WillsearStatushReportdoftcompleted orauncompletedhadministrationof
This filing is due by: 8/27/2009
Please-.feel-free. o_contact_this..office_wi h_any_-questions you_ma
have. If you have already filed your Status Report, please disregard
this notice. y ---
Sincerely,
i~~~~l~~.wc'ce4~b
Glenda Farner Strasbaugh~
Clerk of the Orphans Court
cc: File
Personal Representative(s)
Cumberland County - Register Of
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Wills
Date: 8/06/2009
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HACKIE SHARON L ~ ~
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3532 CHESTNUT STREET ~~~n c~ ~
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CAMP HILL, PA 17011 i~'^ ~ --ic-`i
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RE: Estate of HILL ROBERT D
File Number: 2003-00815
Dear Sir/Madam:
This notice is to serve as a reminder that the Status Re
Personal Representative under Rule 6.12 is due on
date. Port by
the below listed
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES
SUPREME COURT RULES DOCKET NO. 1, for decedents d in
July 1, 1992, the personal ~ NO. 103
(2) years of the decedents representative or his counsel or after
Wills a Status Re ort s death, shall file with the Registernofwo
P of completed or uncompleted administration.
This filing is due liy: 8/27/2009
.Please _f eel _free_to_cQntact,_this_office with_an
have. If you have already filed
this notice. Y_questions you_may
your Status Report, please disregard
Sincerely,
Glenda Farner Strasbaugh
Clerk of the Orphans ~n
cc: File
Counsel
Pa. O.C. Rule 6.~~1""2 STATUS REPORT
REGISTER OF WILLS OF ~ u Ytn Uf1.f~ ~ ~ ~ COUNTY, PENNSYLVANIA
Name of Decedent: ~~'JQ~°T ~. ~~ tl1
Date of Death:? ~p ~ File Number:__ 2 a J 3 - d U8 ( ti
Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of
the above-captioned estate:
1. State whether administration of the estate is complete :................... .
Yes ~No
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? ....... Q yes ~o
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? ............................... QYes ~•„o
d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be ~~'
filed with thQe Clerk of the Orphans' Cou/rt an/d'm~/ay be attached to thi/s~report.
i Signature of Person Filing this Farm
Capacity: ^Personal Representative Counsel
~ Narneo Person Filmg lhu Fo\/rm,` ~t'~/I
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Fann RW-/0 rev. /0.!3.06