HomeMy WebLinkAbout04-0892 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of ,_ ~. ~, ,~, L. .r ,:. t., ~ e ,'
also known as To:
Register of Wills for the
Deceased. County of in the
Social Security No. ' · ;'- c 3 ' ~t~ (~ Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl for letters of administration
on the estate of
(d.b.n.; pendente lite; durame absentia; duranle minoritate)
the above decedent.
Decendent was domiciled at death in. "~, ~ )~, ~ ,.. t~, ~-,,L County, Pennsylvania, with
b~ last family or principal residence at ' '/ ,~r~,,i ~ r ~,, v t ~ Si ~ \ ~c~. -
(list street, number and municipality)
Decendent, then '-3~[ _ years of age, died '~ I'~T ~,,, t9 -~c ~ ~,
Decendent at death owned property with estimated values as folllows:
(If domiciled in Pa.) All personal property $ '. '~(;c' ~'r'>
(If not domiciled in Pa.) Personal property in Pennsylvania $
(lf not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
Petitioner after a proper search ha ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Name Relationship Residence
THEREFORE, petitioner(s) respectfully request(s) the grant of letters o[ ;a'~lministration in the
appropriate form to the undersigned.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF C ~ ~:i i5 ~i~. ~ Pc~-d ~
The petitioner(s) above-named swear(s) or affirm(s) that the
statements in the foregoing petition are true and correct to the best
of the knowledge and belief of petitioner(s) and that as personal
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to or affirmed and subscribed
before me this -~ 'T~4~' ~ day of~
~ CCTc, l~m : ,,~ zcc:q J
No.
(~'. L_ [: i~/4~- k ~l~-~5~i:31-{'(?()5,- Deceased
Estate of ~ ,
GRANT OF LETTERS OF ADMINISTRATION
~:(~ [ (~) [~ ~ , in consideration of the petition on
AND NOW ~ ~ [ '->
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that D~ k C ~[:
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to DOLC~%
in the estate of C:ED~ L. E~SF~ ~ '~' '
FEES '
Letters of Administration ..... $~,
ATTORNEY
(Sup.
I.D.
No.)
Short Certificates( ) .......... $~
Renunciation ...... ~- :~ $_ ~
~ ~ ' ADDRESS
TOTAL ~
Filed ..................... A.D. 19~
pHONE
SEP 5
,. CERTIFICATE Of DEATH
F 175- 03 -- 2060 9/3/2004
~ ~rl~d Noz~h Middleton ' 158 ~y Drive ~, ~c~
~ 15~ ~y ~rlve; ~r~ls~e, ~ ~70~3
o,~us~o~)~ 9/8/2004 ~rl~d Valley M~]. G PA 17013
RENUNCIATION
In Re Estate of ~ '
To the Register of Wills of _~__.AJ~gA ~ ~ County, Pennsylvania·
The undersigned ~'~
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
be issued to ·
WITNESS .9 f
~"X: ~~~ (Address)
(Signature)
(Address)
(Signature)
CERTIFICATION OF NOTICE UNDER RULE 5.6 (c)
Name of Decedent: CLEDA L. EASTERBROOK
Date of Death: September 3, 2004
Will No.: 21-04-00892
To the Register:
I certify that notice of (beneficial interes0 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: October 13, 2004.
Name Address
Dolores A. Loseh, 158 Amy Drive, Carlisle, PA 17013
Richard Easterbrook, 333 Dillon Lane, Hilham, TN 38560
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None.
JSt~san J. Harm~ Esquire
Duncan & H~, P.C.
One Irvine Row
Carlisle, Pennsylvania 17013
Telephone (717) 249-7780
Capacity:__ Personal Representative
X Counsel for Personal Representative
IMPORTANT NOTICE
NOTICE OF ESTATE ADMINISTRATION
UNDER RULE 5.6(a)
THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE
ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTH ~RWISE.
Whether you will receive any money or property will be determined wholly or partly by
the decedent's will. If the deccdent 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 CUMBERLAND, PENNSYLVANIA
In re Estate of Cleda L. Easterbrook, deceased,
Estate No. 21-04-00892
TO: Dolores A. Losch Richard Easterbrook
158 Amy Drive 333 Dillon Lane
Carlisle, PA 17013 Hilham, TN 38560
Please take notice of the death of decedent and the grant of letters to the personal
representative(s) named below.
Dolores A. Losch
The Decedent, Cleda L. Easterbrook, died on the 3'~ day of September, 2004, at Carlisle,
Cumberland County, Pennsylvania.
The Decedent died intestate (without a Will).
The personal representative of the Decedent is:
Dolores A. Losch, 158 Amy Drive, Carlisle, PA 17013 (717) 249-4634
If the Decedent died testate, the will has been filed with the Office oftbe Register of Wills of
Cumberland County, One Courthouse Square, Carlisle, PA 17013. Phone No. 717-240-6345
One lrvine Row
t~ (717) 249-7780
Capacity: __ Personal Representative
'-~ X Counsel for personal representative
REW EX , , REV 1500
COMMONWE LTH OF
PENNSY, ANnA
DEPARTMENTOD~PT. 21 ~01"EV[NUE INHERITANCE T~ RETURN
iHARR SBU.G, P ~7~0~01 RESIDENT DECEDENT 2
DECE DEN~S NA~ (~ST. FIRST. Al~ MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Easterbroqk, CledaL. 1 7 5- 0 3-'2
REGISTEi
09/03/2004
08/29/1
91
5
(IF APPLICABLE)~RVIVING (~ST, FIRST, INITIAL) SOCIAL SECURI~ NUMBER
SPOUS
NAME
AND
MIDDLE
~ I O~inaIRet~ ~ 2. Supp~men~lRe~m
~ 4. Lim~ D 4a. FutumlnterestComprom~(~2~2~2) D 5, F~emlEstateT~Re~ Required
D 7. D~dent~in~in~aL~ingTm~(~h~y~Tms0 0 8. To~lNum~rof~afeDe )sitBoxes
D 9. L~a~Pr~sR~i, D 10. S~usalPove~C~it(d~n12.31.gl~Ol~95) D 11. Ele~on~u,derS~ 9113(A)(A~h~h~
Susan ~. ~man, fisq~ ro Duncan & Harman, PC
FIRM NAME (lfl~ic~)
Dun~n & ~a~man, P.C One I~ine Row
TELEPHONE ~UMSER '
717-249-7~80 Carlisle PA 17013
OF :IClAL SE ONLY
1. R~I Es~te (Sch~u~ A) (1) ,
2. St~ andi~nds (Sch~u~ (2)
4. Mo~g~ ~ Not~ R~ivabl (S~ule D) (4) I
5.¢ash, Ban~¢~iB$~is~ m~mPe~nalPm~ (5) 7~5~0.3~ : I
(sche~u~ [1
7. In~rNivos Tmn*~om & M~ neou~ ~on-Pm~a~ Pmpe~ (7)
(Schodu~ ~ or k} ~
8. To~l Gm~ Ass~ (to~l Lin ~1-7) (8) 7,510.3~
9. Funeral Ex~ns~ & Administ ~e Co~ (Sch~ule H) (9) 8,283.50
made ~S~ule ~)
SEE ~NSIRUCTIONS C m R~RSE SIDE FOR APPLICABLE ~TES
~.or~munder~.~ 16(a)(1.2) X ~ (15) ,
16. AmountofUne14~xableat~ ~lmte X 0.45 (16)
17. AmountofUne14axableat: )lingBte X .12 (17)
18. AmountofLine14~xableat, IlatemlB~ X .15 (18)
19 Tax Due f19~
Decedent's Cqmplete Ad Iress: ! ,
STREETADORESS15~ Amy Drive
CITYCarlisle I STATE PA I ZIP 1~013
Tax Payments and Credi~ ~:
I Tax Due (Page 1 Dee 19) (1) 0
2. Credits/Payments
A. Spousal Poverty Credit !
B Prior Paymentsii
C, Discount ] :
Total Credits ( A + B + C ) (2)I
3. Interest/Penalty ifapplicoble I
D. Interest i
E. Penalty J
Total Interest/Penalty ( D + E ) (3) I
4, ifLine2isgreateithanLinel+Li .~3, enterlhedifference. This is the OVERPAYMENT. I
Check box on P e 1 Line 20 to request a refund (4) I
5. IfLinel+Line31sgreaterthanLi ~2, enter the differenco. ThisistheTAXDUE. (5)
I
A. Enter the interest on the tax du( (SA)I,
B. Enter the total bf Lir~ 5 + SA. T s is Be BALANCE DUE. (5B) 0
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER 'f IE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCI~ S '
1 Didldecedentmake; iraesferand: Yes No
a. mtain the use or ,come of the property transfermd; ........................................................................... [] i []
b. retain the right t¢ lesignate who shall use the property transferred or its income; ........................................ [] i []
c, retain a reversiol ~ry interest; or ...................................................................................................... [] I []
d, receive the prom e for ife of ether payments, benefits or Core? ............................................................. []i [] i
2. If death occurred affi December 12, 1982, did decedent transfer pmpody within one year of death
without receiving ed~ a e Cons dera on? .............................................. [] []
3. Did idecedent own a~ ' ' ?
~n trust for' or payable upon death bank account or secunty a h s or her death .................. [] []
4. Did idecedent own a~ Individual Retirement Account, annuity, or other non-probate properly which
contains a beneficial designation? ....................................................................................................... [] I ®
IF THE ANSWER TO ANY OF THE ~,BOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART 3F TH -' RETURN.
Under dena~s of perjury. I d, clam '~at I have exa~ ~de this rethm, including accompanying schedules a~d slaterrenth, and to the best of my k.,x)wthdge and belthfr it is tree, correct and co~ ~ete.
SIGNATURE OF PERSO I RESPONSIBLE OR FILING RETURN DATE--
ADDRESS Dolores A. Losdc.¢, ~,dministratrix / I
158/~my Drive, C~ 1isle PA 1701
SIGNATURE OF PR~EPARER OTHER THAI REPR.ES..~TATIVE DATE
ADDRESS-' Susah J. Hartm~R Esquire
Duncan & Hartma P.C., One Irvine Row, Cadisle PA 1701;
I
For dates of death on ~r after July 1, 19! l and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the sur, lying si ~se is 3%
[72 P.S, §9116 (a) (1,1} (i)] I
For dates of death on qr after January 1 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 I~.S. §91 16 (a) (1.1) (ii)],
The slatate ~ a transfer 1 a surviving spouse from tax, and the statutory requirements for disclosure of es,sets and filing a tax return ire still ~pplicable even if
the surviving spouse is the enly benefici 'y.
For dates of death on dr after Juty 1,201
The tax rate imposed of 1 the net value o ransfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural p~rent, a i adoptive parent,!
or a stepparent of the child is 0% [72 P.: §9116(a)(1.2)].
I
I
~ i r SC.EDULE E
COMMONWEALT OF P~NNSYLVANI
INHERITAN~ETAXRETURN CASH. BANK DEPOSITS. & MISC.
RES,DE~,~C[~,, PERSONAL PROPERTY
ESTATE OF FILE NUMBER
Easterbrook. Cleda L. 21 04 0~ 92
[ncludetheprOCee!tSofliligal~onand edatethepr~ceedswererecewedbytheestate~A~pr~per~/j~inUy-~w~edwiththeri~ht~fsu~mhipm~ disclosMonScheduleF.
i
ITEM VA .UE AT DATE
NUMBER DESCRIPTION )F DEATH
1. M&T Bank, ch ~cking account 7,510,~
TOTAL (Also enter on line 5, Recapitulation) $ _7,510.3'
I
499 Mitchell Road, M Isboro, DE 19966 Mail Code DE-MB-12 Phone (888) 502-4 ~49
F~x (302) 934-2 }55
October 22, 2004
Duncan, Hart ~an & Douglas, P.C.
AttOrneys At ] aw
One Irvine Rc ~
Carlisle, Penn ~lvania 17013
e: Estate of: Cleda L. Easterbrook Social SecuritF: 175-03-2060
Date of Death: September 03, 2004
Dear Sir or Ma [am:
Per your inquiry d Ied October 11, 2004, please be advised that at the time of death, the above-named decedent htd on
deposit with this b~ ~k the following:
/
I. Typeof ccount CheckingAccount
Accoum Vumber 707996
Owners (Names oj) Cleda L Easterbrook
Dolores A Losch, POA
Openin~ ~ate 9/1/67 Closed 10/4/04
Balance ~n Date of Death $7,351.76
Ac'cruet Interest $ 0.00
Total $7,351.76
Please be advised ,ere was no safe deposit box found for the above decedent.
For further acer t information, regarding ownership, closures and/or reimbursement of funds, etc., please ca I the
Higl~ Street Carli! ~ Office # 717-240-4536.
Sincerely,
Nancy Clagett
Records Managem
SCHEDULE H
COMMONWEALTH O~ PENNSYLVAN FUNERAL EXPENSES & I
INHERITANCE '[AX RETURN
RESIDENT D~CEDENT ADMINISTRATIVE COSTS i
ESTATE OF FILE NUMBER I
Easterbrook. Cleda I.. 21 04 0~92
Debts of decedent must be re ~rted on Schedule I.
ITEM I
NUMBER DESCRIPTION AMOUNT
A. FtJNERAL EXPE ;ES:
1. Ewing Brothe Funeral Home, Inc., professional services 4,722.51(
B. ADMINISTRATIVf COSTS:
1. Personal Repre .~ntative's Commissions
Name o :)erso~al Representative (s)
Socials :urity Number(s) / EIN Number of Personal RepresentalJve(s)
Street A Jmss
I
City State Zip
Year(s) 3mmbsion Paid:
2. :^ltomey Fees ~ncan & Hartman, P.C.
3. i Family Exemptior f decedent% address is not the same as claimant's, attach explanation) 3,500.0~
Claiman Dolores A. Losch 'i
St.~etA ~ress 158 Amy Drive I
C~y C~ 'lisle State PA Zip 17013
Relation ~ipofClaimanttoDecedent Dau,(]hter
4. Probate Fees R ~gister of Wills i 61'0/0'
5. Accountant's Fee
6, Tax Return Prepa r's Fees I
I
lOIN. (Also eater on lino 9, Recapitulation) $ i 8,283.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
r ':F ~F 'Jf
i,\; '\,:, \. NOTICE OF INHERITANCE TAX
.,tFi\J.S APPRA.ISEMENT, ALLOWANCE DR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
'*
BUREAU OF INDIVIDUAlntr~Cr"
IHHERt~AHCE l~X DI~ISION
PO BOX 280601
HARRISBURG PA 17128-D601
2005 JAN I 0 r\l4 9: 49
CLERK OF
ORPHAN'S COURT
SUSAN J HiOO1r.\ii.,{i'E~4) CO. P,l\
DUNCAN & HARTMAN
1 IRVINE ROW
CARLISLE PA 17013
RU-1S41EX AFP nZ-04)
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-10-2005
EASTERBROOK
09-03-2004
21 04-0892
CUMBERLAND
101
CLEDA
L
Allount Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CD COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
RE-Ii' =is4"f-ix--AFi.--riiFo3Y-NoT"Ici--oF-i:'NHiififAN-cE-YAx-A-PPR7iiSEiiiNT~--ALLiiwANCE-OR----'--------- ---
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF EASTERBROOK CLEDA L FILE NO. 21 04-0892 ACN 101 DATE 01-10-2005
TAX RETURN WAS: (X I ACCEPTED AS FILED
I CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. R.al Estate (Schedule AJ
2. stocks and Bonds (Schedule Bl
3. Closely Held stock/Partnership Interest {Schedule CJ
~. Hortgages/Notes Recelvable {Schedule OJ
S. Cash/Bank Deposits/Misc. Personal Property {Schedule EJ
6. Jointly Owned Property (Schedule F)
7. TransferS (Schedule G)
8. Total Assets
111
(21
(31
(41
(51
(61
(71
.00
.00
.00
.00
7.510.31
.00
.00
(81
NOTE: To insure proper
credit to your account~
subMit the upper portion
of this for. with your
tax paYllent.
7,510.31
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/"isc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Velue of Tax Return
13. Charitable/Govern..ntal Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
TAY CR!;nTTS:
" ,., AMOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-I
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
NOTE: If an assessment was issued previouslY, lines
reflect figures that include the total of ~
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rete (16)
17. Allount of Line 14 at Sibling rete {171
18. Allount of Line 14 taxable at Collaterel/Class B rete (18)
19. Principal Tax Due
~
[91
1101
8,283.50
.00
1111
1121
1131
1141
8.:;083 GO
773.19-
.00
773.19-
14, IS and/or 16, 17, 18 and 19 will
returns assessed to date.
.00 X 00 .
.00 X 045.
.00XI2.
.00 X 15 .
1191'
.00
.00
.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" (CRI, YOU MAY BE DUE <:'k
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I ~/\
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/27/2006
LOSCH DOLORES A
158 AMY DRIVE
CARLISLE, PA 17013
RE: Estate of EASTERBROOK CLEDA L
File Number: 2004-00892
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 adTninistration.
This filing lS due by:
9/03/2006
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,
//,1 c....4: ~
~L U't:~tt:~J j.&~ ~i
Glenda Farner Strasbaug!
Clerk of the Orphans' Court
cc: File
Counsel
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
.-'
~
20 ~
'416 ''0
:S\ -r. (} \
" d ) <37.\-0 0\
" " ':2:: -f",
',.,". . r) 7- ...-0
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the~J<&~{ng ~
with respect to completion of the administration of the above-captioned estate: ~.:-./;?-,-. r:-
;';0 "
~- -;:::..\ -
'0 -1
--;'7
G t t" (~ C\...
\.-. .
-t2 c~.._ L"7) t .:-~. \; : - f r -, ~
Date of Death:
q I "7; I ~J.cc 'l-
I
\ \
Estate No.:
J DO'1 - CO 'iYr .J.
1. State ~ther administration of the estate is complete:
Yes ~ No 0
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the persont!-.;~sentative file a [mal 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 persoI1a1 representative state an account informally to the parties in
interest? Yes a 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 chis report.
f" ," ///:.
//Si~a~e)/ '. ,,) 7t:>.~cn
~ -
<S"~ "'".)/ " -i. r 1(, t " ,'" [. ,.\
"
Date:
"/ c /-'y;,
I ,J /,' .
I '
Name
I .1
Address
t' L' . '" c'
~/.~.,. .
"
( ~'t
I, ~ I"
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-/ ('/. d Y q '0 ~ (~
Telephone No.
Capacity:
o Personal Representative
!8;,Counsel for personal representative
C~~\-'
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