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HomeMy WebLinkAbout03-15-121505610101 REV-1500 °` ~01_l0> ~ OFFICIAL USE ONLY PA Department of Revenue P~~Ylvanie County Code Year File Number Bureau of Individual Taxes ~`"~` i'O BOXsBosDi INHERITANCE TAX RETURN HarrisburcJ, PA sous-o6o1 RESIDENT DECEDENT ENTER DECEDENT tNFORMATWN BELOW Social Security Number ~r Date of Death MMDDYYYY / f P / e2 y' aP I"r !~, o ~ a2 9 d oT/~ Det~denYs. Last Name Suffix R ~ C ~.~ (If Appltcablej Enter Surviving Spouse's Information Below Date of Birth MMDDYYYY 1 / /9 9a°~~ De edent's First Name MI c S~'~ ^~E Spouse's Last Name Suffix Spouse's First Name MI RG' ~ .C ES TT /~ Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE ~iT~ y~ 6 0 9 6 6 REGISTER Of WILLS FILL INAPPROPRIATE OVALS BELOW ® 1. Original Return O 4. Limited Estate ® 6. Decedent Died Testate (Attach Copy of Will) O 9. Litigation Proceeds Received O 2. Supplemental Return O 4a. Future Interest Compromise (date of death after 12-12-82) O 7. Decedent Maintained a Living Trust (Attach Copy of Trust) O 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) O 3. Remainder Return (date of death prior to 12-13-82) O 5. Federal Estate Tax Return Required ~ 8. Total Number of Safe Deposit Boxes O 11. Election to tax under Sec. 9113(A) (Attach Sch. O) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTU\L TAX INFORMATION SHOULD BE DIRECTED T0: Name Daytime Telephone Number P G S N ®/ '7 7 P 6 REGISTER WILLS USE ~LY First line of address ~ ~ • ~~:, r q ~ ~ _~ c'_ . Second line of address ~~~ ~ c}., ~ ~~ City or Post Office State ZIP Code ATE FILED t'V '~ c c y s ® ~ o ~ ~~ Correspogdent's a-mall address: A0oc1, ~i~ eaM6re,~ Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, coned and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS"" ~~ Lyt /`Y~c.~~ J~tn.d, /9v ~ . !h t, ~9oif y `g~° y.r /°A ! ?o of S SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE ADDRESS PLEASE USE ORIGINAL FORM ONLY Side 1 1505610101 1505610101 * r 1505610105 REV 1500 EX Decedents Soul Security Number DeoedeM's Name: , ' ~ f .? o /~ a~ /°. /Yl ~ ciC RECAPfTULATION 1. Real Estate (ScheduleA)......" ...:..:..........................~...:.. 1. 2. Stocks and Borx~ (Sdiedule B) .. ............ 2. 3. Cbsely Hey Corporation, Partnership or so{e-Propriemrship (scheaute c) ..... s. _ 4. Mortgages and Notes Receivable (Schedule D) ........................... 4. 5. Cash, Bank Dep~its arxf Miscellaneous Personal Property (Schedule E)....... 5. ~ ~ 6 6. Jointly Owned Properly (Sc~eduie F) p Separate Bi1Nng Requested .:..... 6. 9 0 0 ., e o 7: Inter-Viva Tra-~sfers 8 Miscellaneous NarProbate Property (Schedule G) p Separate Billing Requested...:.. '.. 7. 8. Total Gross Asseffi (totaLLines 1 through 7) .............:............... 8. / 6 7 9. Funeral Expenses and Administrative Costs (Sch~ule H) ................... 9. 10. Debts of Decedent, Mortgage Liabilities, and Liens (Schedule I) ... . ...:...... 10. 11. Tota! Deductfons`(total Lines 9 and 10) .........:..............:.... : ... 11. 12. Net Value of Estate (Line 8 minus Line 11) .............................. 12. / 6 13. Charitable and Govemrr~ntal Bequests/Sec 9113.Trusts for which an election to tax`has not been made Schedule J .. :...>.. `::... 13. 14. Net Value Sub)ect to Tax (Line 12 minus Line. 13) ........................ 14. /. ~ 7 TAX CALCULATION -.SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (axr.2) x.o_ 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 1 1~ 1 ~1 i. 's. I. 3. 19. TAX DUE .. . _ .. , .... ...... ................ . 1 20. FILL IN THE OPAL IF YOU ARE REWlESTtNG A REFUND OF AN OYERPAYf16ENT O Side Y 1505610105 1505610105 J REV 1500 EX Page 3 Decedent's Complete Address: Frk Number ~ECEOarrs wvuE sTt~r aooRESS ya /Ym/ cmr sraTE ztP Tax Payments and Credits: t. Tax Due (Page 2, Line 19}. 2. CrediLglPaymer~s A. Prior Paymrerrls B. D-t 3. Interest 4. ft Lure 2 is greater than Lure t + Line 3, enter the difference. This is the OVERPAYMENT. t=iN in oval on Page 2, Lhre ZO to request a rBfund. (1) ~ Total Credits (A + B) (2} (3) (4} 5. B Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5} Make check payable to: REGISTER OF WILLS, AGENT. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Dkf decedent make a transfer and: Yes lVo a. retain the use or inoorrre of the property transferred :....................................................................................... ... ^ b. retain the right to designate who shah use the properly transferred or its income : ......................................... ... ^ c. retain a reversionary interest; or ....................................................................................................................... ... ^ d. receive the promise for life of either payments, benefits or care? ................................................................... ... ^ 2. tf death oa,urreci after Dec. 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ........................................................................................................... ... ^ 3. Did decedent own an 'in trust for' or payable-uporHdeath bank accx~nt or security at his or her death? ........... ... ^ 4. Did decedent own an individual retirement acxount, annuity orothernon-probate property, which contains a beneficiary desgnation? ..................................................................................................................... ... ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMRLETE SCHEDULE G AND FILE R AS PART OF THE RETURN. For dates of death on or after Juty 1,1994, and before Jan. 1, 1995, t~e tax rate imposed on the net value of transfers to or for the use of the survivir~ spouse is 3 percer-t ]72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent [72 P.S. §9116 (a) (1.1) (a~]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirerner-ts for disclosure of assets and fling a tax return are stiA applicable even -rf the surviving spouse is the only beneficiary. For dates of death on or after July 1,2000: • The tax rate imposed on the net value of transfers from a deceased child 21 years of age or younger at death. to or for the use afi a natural parent, an adoptive parent or a sthpparent of the child is 0 percent [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 percent, except as noted in 72 P.S. §9116(1.2)172 P.S.: §9116(aK1)]. • The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individuat who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508IX • (7-8~ COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER /!'7~QG ~ /~GLrG~ a3a/.j- oo ids Indude fhe 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 VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. ~4nI'{. SoVist91' CLCCOCen~ Jo/c/cf. '~.!/~.l7 ®c.vn ~ d /~j/o //y /~iKc /h ~, /~s~o /y rf~ 9 J. ~A / 70 6.f' /~/c .~' /.Togo y'a ~ 0 9 y 9 /6 7 TOTAL (Also enter on line 5, Recapitulation) I S y.9s.: , 6T (If more space is needed, insert additional sheets of the same size) ' M&T B ACCOSINT NO.. :. `ACC01111T TYPE - 15004220949167 RELATIONSHIP SAVINGS 00 0 04331N NM 017 STATEMENT PER10D PAGE NOV.11-FEB.10,2012 1 OF 1 44000 MAE MARCH 640 HOLLY PKE MOUNT HOLLY SPRINGS PA 17065-1905 _._ _ __ INTEREST EARNED FOR STATEMENT PERIOD. 0.26 NT HOLLY SPRINGS INTEREST PAID YEAR TO DATE 0.16 w nf~nu-IT CIIYY.ADV .. _ . . NO. AMOUNT .110. AMOUNT 3 653.92 4 ,6 3.0 0.26 4 312.67 A f`f`f111YT Af TTVT~TV .. ` . ._ 1011 DESiCRIMION =: , . B OTHER..A#1TI0liS .' S1i11TR,AiCTI0ii5 ~ E- 11-11-.11 BEGIMIIIIC BALANCE f3, 653.92 1i-21-11 In Branoh Transfer/D~posit 4,281.49 7,935.41 12-01-11 CUSTOMER NITHDRANAL 499.00 7,436.41 12-05-11 CUSTOMER NITHDRANAL 2,175.08 5,261.41 12-12- IMTTfREST PAYNEIIT 0.10 5,261.51 Oi-06-I. "CL1ttTDMER NITNDRANAL 499.00 4,762.51 01-12-1 LiTEREST PAYMENT 0.09 4,762.60 01-19-1 CUSTOMER NITHDRANAL 450.00 4,312.60 02-10-1 INTERESt PAYMENT 0.07 4,312.67 ENDING BALANCE t4 312.67 ANNUAL PERCENTAGE YIELD EARNED = 0.01 DID YOU KNOM THAT YOU CAN SAVE TIME 8Y USING MiT NEB OR MOBILE BILL PAY? IMIICINE ELIMINATING THE STRESS OF HAVIi1G TO NRITE A CHECK, OR MATTING IN LIME TO BUY STA1~S. NITH MiT NEB AND MOBILE BILL PAY, YOU CAN SKIP THE .HASSLE AND MAKE PAYMENTS QUICKLY AND EASILY. LEARN MORE AT MTB.COM/BILIPAY. MEYB~R FDIC. wosA (sro~> REV-1509IXt(ib~ SCHEDULE F COMMONWEALTH OF PENNSYLVANIA JOINTLY-OWNED PROPERTY INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER /Yla~ ~ /~d'cfi ~c~d_ oo/8d N an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME I ADDRESS I RELATIONSHIP TO DECEDENT 6 ~+~ /~-/i9~f /ai, cC Ave . /~. tea //y ~sio y .r. po / 7o~r .Ti°o ~.r E B. C. JOINTLY-0WNED PROPERTY: ITEM NUMBER LETTER FOR JOINT TENANT DATE MADE JOINT DESCRIPTION OF PROPERTY Include name of financial institution and bank acxount number or similar identlfying number. Attach deed forjointly-held real estate. DATE OF DEATH VALUE OF ASSET 96 OF DECD'S INTEREST DATE OF DEATH VALUE OF DECEDENT'S INTEREST 1. A. 9~6 /,~acit'< /oca~`d a-z` 6do //ol/y >°~ke, /Pub. /s/a/~, .Tog s. f'A J~o~.f TOTAL`(Also enter on line 6, Recapitulation) I ; ~ too, o c (If more space is needed, insert additional sheets of the same size) ,~ ~~- '',.; G.J.' t South .'it3~??a'~o~ `~':'!;~'., ~t~rnba "~.; ?'a, h F a '~t' . ~u? ~esz ' rr_ ~P ~;o' T~os'~~r ~. ~f~~o~ aril i~.s ;r« 4'~.r^I~, ~. r g°~~-45 Jofin C.`Clar$ ComDa~, ~'hilsdelphi~. 76b -.~ ~~~~ `. .,~` ~~ ~ ~ ` ~ f ~» ~t ~ '. , .~ ~: ,` ~: ~^rY+~. ~+ ~~ pSlIIC~ LHd..~0~ ~7 Jp~n (,' (']. iT1C {'+Os 14s~' ~. PfII~ ~Q~iiY1. A~Sril' ~n:th8 ~e~ ~2n+E~~fi~ huz~dred a~2d ~ar~t•~-si.x ~~'~`~'~~': ~'~.~.x ~ rt~eldexl, an~# ~c~nt~ ~h~ r~^'t r~en~ b s Sri f¢, n#' thn Tn~~hirs . ._ _ . Sn~~-hh t~icid].eta~, Co~tn-~-.= a~' Cur?~~~rla~;~i ~r.~- SLate c"' :~enr±stlro~ania f (hereinafter called the Grantors 1, j ~ ~~C~°. "' _ "._~1 ..,_ T~'., ~? r".. %3. x'C}j.~ ;fin. ,^; fl` c. ~''.r: .. ?rl w~ ~.'. ~'" .'.~'^,L - ~ - "J~1~'T' L41 tW E3L'L^. °Pa ~r .-.a tis`~z.4.E .9_ -- y$ , ' W.s.i`tti \herelliiil,~! '.6"ilii~s LfLG ~ $J) #~e~~~ef~~ That'in co»aideration of Six z-t,,~,~re~ ~ .~~~y~R00) Dallnr a, in hand paid, the receipt rahereof is hereby acknowledged, the said Grantors do hereby grant aced cortneg to the said Grantee s,, ~he7.r heirs and aaaipn$, ALL ~~~~ ~:Q3''~z.in in South `P~idd.leton Township, lot of ~r~~.zici~'~loa:n ~.nl ~esi_,xl€S.~e~? ~:.s }.ot -'~" in thr~.~ cer'r;:~in n1.~.r~ oT" ?:c~-~s.l~a~m as /1i;f;T1 __~r^; 4°^TTTf1'.! ~~,3.(' nt7'i ~?" '`~9 ry]^'1,-"~~OY'S ~"!°I'E7.Z1 e.?1!' ~''!?~~~' Y'~'CC'Y'~G'r~ 7:11 ~"}'8 gff'ica of ~h~ ?~~corder of ~Jeeds 7.rt €:r_~? nor ';tee ".'ouni;~- of ^tt~b~r''~xrd in ~bA State o~ ~~;nr_s~r?.~r~rii~ 7-n F7:?.n ~on'_.- :3 g.t z3Q^e ~?6r Sa~~ 1-ref; bey-~"~ mare -~e.r~~.ou;:~rl~~ c3es- cr~be~? +~s °ol~t~~„ss Se~innz^c ~.~ a ::o;int an the e~,s-~-erl~;* ..'~?e a~' S-~s.~e Fi~h~ray Rou'~e 34 s.s..nd7_es,'~e4 bar 1}~ ; , ~.bo~e n~ an` ~±n~~ referrer? acs ~ ~-:era;.n as ~~,1tiz~orQ Stre~-~ E~:tnndt~~' end e4'cer_~in,. r~e~~frcrr~. in ~ no~t:.~Er?.,r firse-~cn, ~S.I~r_~ say? s~-reet sa.xt;~ X60` feed to ~ no~.~-~; thanes ~~. €~n p~,ster3.~r ~?7:rectinn ~?:on^~ t~zn lax~P d~.z-iain:~ acts rLimbF:Z' `~', R~~ `~? E?1r: }1LlnG~Z'8'? ~-^~t t+~-Pv^r fl.~~~ s'PCf ~:`J c^. t~C3?21~'.; ~?~Pi''C;? 7.n. ~, °..01:~fi~"2f3r~~2' (iJ.S'!'.l;~~.<Y22 ~'I ?-t,a l.?.?"t.''^n ~n~-S ? s3:~;? `~~ ~3'. ..i', f:~~~' 'C'a^-,~ ~n ~ 1iE7.`1't`,~, °Grl'iPz?CE a.31 ~1. 'SRf95'~V- ~r~~.. r~ ~1''~.rJ1'?:C:1 C7~.. tl~a l~ r~.,~ GT~' ZOLS ~_ n'••~i `~. ~'.1~ ~~_:T?C_a °.,.. "--3 - . ?~:` ~'E:6~i ~"irJ '~.~?2. L~~.°C° n~ JP, 1 "`in ~~ ;~.i~ ~J~ ~~v1n;` ?7~?'J i`ii' 0,. 1i,~'~.CV r3~ ~,~;IC1' CC?:?'rE'7<3CQ VC '=rE c"S`8.~'~,02'S ~`-BY'r:7.TL ~,.~ 'ct`p~ad. of ~`~ "'~ars.~ '~al~t~ell anr~ '~.~*~ia ~ysr~ze~~!_ his vri ~s d~~esi ~,x~r31 1; ` Iv~R.':t~d recorc?ed'n ~e~d nr~..E1_SIs ~~s~~~ ?7~:~s .r~~'erenre here=}nt;o ~:~.~3. ~;ri?1. ~r~e~re ~u~.?~r ~rrer~r. Tl~~.. r_cn~m-anoe as ma.~.i~ sub;;ect ~o a~I o£ tho 1.i~it~~ic*ns ~.nd °restr3ctions e~~~ablisl~8d fior this sub-€liviszon ~s rect~rded ~ritlz; ~:he ~~.s.n. oi' 2c~~s s~bove mentioned. -~ `'~ E'' 6tor s .do hereby' o~eltaett cued ag.Y~a,tt~d tbTi the'satid ~~ ' +,~ r~- the Grantors ~ - e i r heirs, executors and. administrators, SgALL atnd WILL ~' R'ARRANT and foreoer DEFEND the herein above `described premises, with the hereditaments and appurtenances, unto the-said Grarrfee s ~: r, vi r ti heirs and assigns,. ,against the said ,Grasetors and. against eel vtteer Pell t eluming o~ rodeo eha11 hereafter claim the some or areg part #hereof. r_ ~ ~e~s ~~ert~f said Grantors ha ~dtertureto set t`a~?^ hands' and sett the day. 'tend year first above rorittea. ~tiale~ <s~.ab ~cl~ttereh ix ~ ~s~xCB ox _... ~ _ r.._. ~:.:.. _. e~orn . s~.~ State ref Penn s;~lvaxzia s8. Coon y of jner~~sc~ ,On 'tlie T~~~nLr X11 of ~nr; ~ ,19 ~fi , beftsre ate a ~<o~ar~~ ~ublic ~u1-T cr~?~-iss~ c;r~~,~ -, , ~~P „nT-,-_,~rr,ealt~? c,f , ~nn~ssr?va,nia, the undersigned o~lcer, personally appeared ~ -~ - . `' ~ ~. r: en ~ n ? r~ r~ ~ n. _ ."Lx? d en known to me (or satisfactorily grrvven) to be the persons zahose names are secbscribed to the' .within instrument, and acknazoledged that ~ he ~ executed the sate for the ;purposes therein contained, arc~l desired the same might be recorded us such. In ~treess W7eereof, Thereunto set my hand anr~"a$leia~al. f _ ~. -- The address of the within-named Grantee .. ..._.~ ........ .. ~`.L.x••~ ~.~~ i n .O ~ .. ~ :;~ is ~~.... 20yif .~?r~G~...._... _.~..:.... .. ................. .... _ w ~Li~. ~~" ehalf o t ` n 3v~j r~~'~%~`,4" ~~ . i ~ ..n.....~rw. ~.ww~ .a . w...,wun +w~ ~. ;Settlement Statement Q ` T.w.w ws 1 ..sw U.$. Department of Housing and Urban Development Aluu~t Annmvwl No_ 2502.0265 . OFHA 2. (]FmHA 3. (]Cotrv. Utrive. 6. F8e Numba~ 7. Loan Number 8. Mortgage Iaetuance Case Nttmbm~ --_ _ - b qua yet a etaternara d aetwt teNerrrerrt eah. Arrroreaa paid b arM by Hr eaHMrnant aperd aro alwwn. C. Note:. Meatpmarbd •(p.o,cr wws p~ds nu da~aro a1,o~rn hra for hlortnetlon pavoeae and era not r+w,dsa In tna taxis. W H k a aMrra b mob Aelaa b tlra 1JrMled 8faNa on Hra or oHwr NmNr form. PanaWa upon TitleExpress Setdemerrt Systa~ Printed f»M7I2Q12 nt 08.22}SS< D. NAME OF BORROWER: Timothy A. Dole ' E. NAME OF SBLLER: Lester R March, by and through his agent F. NAME OF LENDER: N/A d. pRQPBRTY ADDRESS: 640 Holly Pike, Mount Holly Springs, PA 17065 x.sgt-i"f.0~1TACi@1T: PA item Estate Settlement Services, LLC, Telephone: 717-249-6333 Fax: 717-249-7334 ' TI 'S TRAN_SAGTI4N: 7a ooo.oo ~e_,_ooo.o_c 1 568.75 seller in ~rance_ _ -- 0 27 12 06 30 12 319.61 02 37 1 m06/30/1? _.______. 319_.6? __ 79 888.36 8El1.EEt- ___ 78, 319.6? SELLEB__ - - 1 00 .00 -- 4,834_.3 seN er ___ Ol Ol 12 2 7 12 40.66 01 Ol 2 02 27 12--_ _____ 40.5E 1 040.66 .^sELLER __ 4,875.02 t I FR _ _ _ __ 79 8 8.36 __ 78.,.319.6? 040.6 _ _ ____ 4 , 875 ._02 303, 78 847.70 _73,444.58 St)BSTffUTE FQf W 10~ SELLER STATFJA6HT: Ttw bdonnatlon oadained harm h hnpartant tax kHannatlan and b batrp furniatred b the Mumsl Raarws SerNa. H you aro roquked b file a roam. a neafaar~oa parr4y a otlw a~rxtton vsi ba bnppaad an you tf tfl~ Hem h nqufrad b ba reported and the IRS dete~nea tlfat k -ae net been -eporMd. Tha Caitraa 8dse Prioa deaatbaa m IMe dt)1 atfws aorM>rada the C,iroee Praxede d Hde traroadfon. ta~eyer IdanHficalbn anwoua wmons aro oowrora mrtn nu~r~ ~sraa~ rsr narwoooic asw.~ Ht~ CBt'fIFIC11110N OF BUYER AND 9EIlER I lava nMawad YN HtID-18amsmart 8ta and' b tlN bed d my WwwNdp~ and beAd h b ~ true ane acamaos statermrA d all mcaipb and dabusemaMs made an my aooar~t a by ms in MaY ~M~ona ~ANr pqt Llava npiwld i~coPY d Ih~ MJD-18ai6ertient l~abmwK. .' .` feeler R Maseh, by and tlxouph//Ns spent ~Q/YL~ s~~ ~i~s+ i W - /BOA ~O.ii By: Pamela . 8~ansfemsn. POA WARHt~(s: R ~ A CRME 7'O KNOWINGLY MAID FAESE STATB~NT3 TO THE Ths HUD-7 Setgansrd 5teternant vAYCh 1 have prepared h a tole std axurefe accaisd dihb trarwcmon. tR~NTED STATES ON Tt~ OR ANY S~N,AR FOAM. PENALTES UPON COl~NICTKmI 1 have cnteed orw~! comae the funds to be dtibtsead it arpe vrilh caw tncxwe A t~ ADD fNT. FoA OETAU.s sty TITLE ~a: u.s. cocE s~~cTaN ipot ANf) St'.`CT10N •p~. :J 4 .. Purdon's Pennsylvania Statutes and Consolidated Statutes Title 20 Pa.C.S.A. Decedents, Estates and Fiduciaries Chapter 7.Orphans' Court Divisions Subchapter G. Procedure Orphans' Court Rules Rule 5. S. Notice to beneficiaries and intestate heirs (a) Requirement of Notice. Within three (3) months after the grant of letters, the personal representative to whom original letters have been granted or the personal representative's counsel shall send a written notice of estate administration in the form approved by the Supreme Court to~ (1) every person, corporation, association, entity or other party named in decedent's will as an outright beneficiary whether individually or as a class member; (2) the decedent's spouse and children, whether or not they are named in, or have an interest under, the wi1L' (3) where there is an intestacy in whole or in part, to every person entitled to inherit as an intestate heir under Chapter 21 of the Probate, Estate and Fiduciaries Code; (4) the appointed guardian of the estate, parent or legal custodian of any beneficiary who is a minor. child under the age of eighteen (18) years; (5) the appointed guardian of the estate or, in the absence of such appointment, the institution or person with custody of any beneficiary who is an adjudicated incapaatated person; (6) the Attorney General on behalf of any charitable beneficiary whose interest exceeds $25,000 or which will not be paid in full; (7) the Attorney General on behalf of any governmental beneficiary; (8) the trustee of any trust which is a beneficiary; and (9) such other persons and in such manner as may be required by any local rule of court. (b) DeSnition of Beneficiary. "Seneficiary~' shall be deemed to include any person who may have an interest by virtue of the Pennsylvania anti-lapse statute, 20 Pa.C.S. § 2514. (cJ Manner of Notices. Notice shall be given by personal service or by first•class, prepaid mail to each person and entity entitled to notice under subdivision (a)(1)-(9) whose address is known or reasonably available to the personal representative. (d) Certification of Notice. Within ten (10) days after giving tse notice required by subdivision (a) of this Rule, the personal representative or the personal representative's counsel shall file with the Register or Clerk a certification that notice has been given as required by this Rule. No fee shall be charged by the Register or Clerk for filing the certification required by this subdivision. (e) Failure to File Certification. Upon the failure by the personal representative or the personal representative's counsel to file the certification on a timely basis, the Register shall, after ten (10) days prior written notice to the delinquent personal representative and his counsel, notify the Court of such delinquency. Explanatory NoteThe 1998 amendment to subdivision (e) is not intended to limit the inherent power of the Court to impose sanctions upon a delinquent personal representative or counsel. Ct) Effect of Notice. This Rule shall not alter or diminish existing rights or confer new rights. Cg) Copies of Rule. The Register shall deliver a copy of Rule 5.6 and the forms of notice and certification approved by the Supreme Court to each personal representative and counsel at the time letters are granted. Explanatory Note It is not the intention of the Rule to require notice beyond the degree of consanguinity entitling a person to inherit under Chapter 21 of the Probate, Estates and Fiduciaries Code. Committee Comment--2006~ The form of notice and certification of notice required by Rule 5. 6 and formerly set forth in Rule 5.7 have been revised and moved to the Appendix. Subparagraph (11 has been restated to correct a typographical error in the prior version of the rule. ~~ IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION PURSUANT TO Pa. O.C. Rule 5.6 THIS NOTICE DOES NOT MEAN THAT YOU WILL RE ENE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE Whether you .will receive any money or property will be determined wholly or partly by the decedent's will.. If the decedent died without a will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF _u.,,L ~> a.~ .PENNSYLVANIA IN RE: ESTATE OF _ 1ne. ~ .o /~are~ ,Deceased File Number TO: ~C ~_ c ~~.- ~Q, m ~,,-~.~, (Beneficiary) ~~// ,r.~ ~/i land A~u nry,+• NolIT,~Soq.r iOq /706 (Address) Please take notice of the death of the Decedent and the grant of Letters to the personal representative(s) named below. The Decedent died on the day of of , a resident of r'~~ ~1~~- /Bird ounty, PA. The Decedent died: ~ testate (with a will) or ^ intestate (without a will). You may have a beneficial interest in the estate as follows: (If additional space is needed, use separate sh et) The name(s), address(es) and telephone number(s) of all personal representatives appointed are: NAME ADDRESS TELEPHONE N1.v If the Decedent died testate, the will has been filed with Office of the Register of Wills of __ ~s,~ ~ ~-9an~ County. If the Decedent died intestate, a Petition for the Grant of Letters of Administration was filed with the Office of the Register of Wills of County. The Register's address is __G~Q r /~t/gr P.o ~7n i ; d telephone number is A. <~opy of the Will or Perition maybe obtained by contacting the RF:f~.r~;ter.of Wills and paying the charges for 'duplication. Dare ~ .. ~~/~ Capacity:. {Personal Representative ^Counsel for Personal Representative Y~tJ/Y1L1Q. .~ L)A~u~ is w. Signature of Person Firing t is Form ~QJYf Cf~ ...f. .t~~'Cn., I/YfA /7 Name of Person Filing this Form 6y~ ~io~S ~Q/f/7r_ .4trt . Address /!9f . ~n/!~ ~"`~ ? ~s1 /7065" 7/7- 9'd'6- 7A.t'~/ Telephone t:nrn. AW_M d.. in i ~ n.r ~ r CERTIFICATION OF NOTICE UNDER Pa. O.C. Rule 5.6(a) REGISTER OF WILLS i~.n! .-~dar C©UNTY, PENNSYLVANIA Name of Decedent: /nQ~ ~ /Year cif Date of Death:. ~ ~ 9 /~ File Number: doi~ . va irk Date Letters Granted: To the Register: I certify that Notice of Estate Administration required by Pa. O.C. 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: (If more space is needed, attach separate sheet,) Notice has now been given to all persons entitled thereto under Pa. O.C. Rule 5.5(a) except: Date .J - / o - /~ ~a.irt.r.La. ~ ~'S Signature of Pe•.^on Filing th Form Capacity: Personal Representative ^ Counsel ,pa.,r,.1 f, tgr -~ it e~ ~s Name ojPerson FI[ing this Form dddress - - - - - 7~7- yid- 7P~y Telephone Form RW-08 rev. 10.!3.06 . ` Purdon's Pennsylvania Statutes and Consolidated Statutes Title 20 Pa. C.S.A. Decedents, Estates and Fiduciaries Chapter 7.Orphans' Court Divisions Subchapter G. Procedure Orphans' Court Rules Rule 6.12. Status report by personal representative (a) Report of uncompleted administration. If administration of an estate has not been completed within two years of the decedent's death, the personal representative or counsel shall file at such time, and annually thereafter until the administration is completed, a report with the Register of Willa showing the date by which the personal representative or counsel reasonably believes administration will be completed. (b) Report of completed administration. Upon completion of the administration of an estate, the personal representative or his, her or its counsel shall file with the Register of Wills a report showing: (1) completion of administration of the estate; (2) whether a formal account was filed with the Orphans' Court; (3) whether a complete account was informally stated to all parties in interest; (4) whether final distribution has been completed; and (5) whether approvals of the account, receipts, joinders and releases have been filed with the Clerk of the Orphans' Court. (c) Form of report. The report required by this Rule shall be in substantially the form adopted by the Supreme Court. (d) No fee. No fee shall be charged for filing the report required by this Rule. (e) Copy of rule. Upon the grant of letters, the Register shall give a copy of this Rule to each personal representative and his, her or its counsel. (fl Failure to file a report. After at least ten (10) days prior notice to a delinquent personal representative and counsel, the Clerk of the Orphans' Court shall inform the Court of the failure to file the report required by this Rule with a request that the Court conduct a hearing to determine what sanctions, if any, should be imposed. Committee Comment--2006: The form of status report has been revised and moved to the Appendix. • 4 y ` Pa. O.C. Rule .6.12 STATUS REPORT REGISTER OF WILLS OF __ /'~,,,6~~iQ„d COUNTY, PENNSYLVANIA Name of Decedent: m~_ ,o. in ~.,,~ Date of Death: /- d 9- id File Number: d v i~ - oo ~~~' 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? ....... {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 report. Date J' - /o-/~ Signature ofPerc.zn Filing this F rm Capacity: ®Personal Representative ^Counsel Name ojPerson Filing this Form Address 717- ~/1.l.. ~.~~ ~ Telephone Form RW-/0 rev. !0./3.06 w o Q <L N OP ~~1 acttinr°-=~ «lo ya~j~~~ '~'°o ~ <i x c~ ~~~ ~~ M ~~ o r ~~~ ~, S"~'~ _ - ~~~~~ -~ p ~' N a i c~ hn4~ o s ~ 4 C ~~ c9 ~.~