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Home My WebLink About04-1002 PETITION FOR PROBATE and GRANT OF LETYERS Estate of /q ~ / ~ f,~" ' l , ' ' "~ ~: t ')~ .... NO. also known as To: Register of Wills for the iCJ- 2~'~'- ~c'"~ . Deceased. County of f:~ c~ //,'--'~1 in the Social Security No. ~ ,' / -/~. ' ?~ (? ~ Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the cxecut ~-~/~/ ~ /~'~ L/f~-: ~,' 'ham in the last will of the above decedent, dated _ ., ~ and codicil(s) dated Decendent was domiciled at death in C o,~'~,'1'~,"-',? County, Pennsvlvania, wth h last family or principal residence at 1~3' (lis! slreet, number and muncipality) Decendent, then ~' years of age, died /~' ~ _,3.9 ~:'~, at Except as follows, decedent did not marry, was not divorced and did not have a child born or adopt after execution of the will offered for probate; was not the victim of a killing and was never adjudica! ~d incompetent: Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ (If not domiciled in Pa.) Personal property in Pennsylvania $ (If not domiciled in Pa.) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: WHEREFORE, petitioner(s) resln~tfulty request(s) thee probate of the last will and codicil is) presented herewith and the grant of letters ~ -/,,~ . ~ / ~ 7-~ / 7'. ~' ~'~ Ctestamenta~; adminis~ratioa theron. ~ · OATH OF' PERSONAL REPRESENTATIVE COMMONWEALTH~OF PENNSYLVANIA COUNTY OF C ~ ¥'1 ~ ~'l~ l.- PC'N/i.3 f Thc petitioner(s) above-named swear(s) or afFu-m(s) that the statements in thc foregoing petition ~ rc true and correct to the be~t of the Imowledge and ~ of petitioners) and that as personal repres~ n- tative(s) of the above decedeot petitioners) will well and truly admi~'~r the e~tate according to la ~. bef~p~e me thts .,.) day of~ [' _ ~ i ~ ,-, f Register t ~ Estate of /~{ (L~ i)(~.bLl ~ iYI t'~. ~-JLL. ., Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW ~x,~() ~/~,{, 1 ~/~ ~ ~, , ~ ~id~fion of ~e ~ition ,n · e r~se side h~eof, ~fisf~o~ pr~f ha~ng b~a prcsent~ ~fore me, IT IS DEC~ED that ~e ~s~ment(s) ~ted ~ L((] ~ '~: ~ 0 C: L d~cfi~ ~ere~ be ~tt~ to probate ~d fil~ of r~ord ~ the l~ ~ of ~d L~ers ~,~TI~VI~'O~ ' OCT ~ 8 ~004 ~ COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH A1 ice '. Mixel I 2 Female ~ 201 -- lo -- 4647 4 October 23, 2004 81 /10/1923 7.W~sC Eairview Cumberland a~East Pennsboro . [ ~,~,~ m.~o ~,~ .~c e 133 Columbia Rd. ACTUAL WILL OF ALICE P. MIXELL I, Alice P. Mixell, of Enola, Cumberland County, Pennsylvania, declare this to be my last Will and hereby revoke all prior Wills and Codicils. 1. I direct that all my just debts, funeral expenses, gravemarker and administrative expenses shall be paid from my residuary estate as soon as practicable after my death. 2. I direct that all inheritance, estate, transfer, succession and death taxes of any kind whatsoever which may be payable by reason of my death shall be paid out of my residuary estate. 3. I leave my entire estate of whatever nature and wherever situate to Harry D. Mixell, Sr. Should Harry D. Mixell, Sr., predecease me, I leave my entire estate in equal shares to Doris Shoemaker, Paul E. Robinson, Kenneth Robinson, Dennis Robinson and Dale Thomas. In the event that any of the above named children should predecease me, their share shall lapse and go to the remaining children. 4. I appoint Harry D. Mixell, Sr., as Executor of this my last Will. If Harry D. Mixell, Sr., should predecease me or cease to act in such capacity, I name Paul E. Robinson as tho Executor. 5. The Executor of this Will shall have the power to distribute my estate in kind or in cash, or partly in either. 6. I direct that no Executor acting under this Will shall be required to enter bond in any jurisdiction. IN WITNESS WH,EPtEOF, I have hereunto set my hand this ~ , STEPHENJ. HOGG Alice P. Mixell 19 S HANOVER STREET SUITE 101 CARLISLE, PA 17013 The preceding instrument consisting of this and one other page was on the day and date hereof signed, published and declared by Alice P. Mixell, as and for her last Will in the presence of us, who at her request, in her presence and in the presence of each other have subscribed our names as witnesses hereto. LAW OFFICES OF $1~P[-~N j. HOGG 19 S. HANOVER STREET SUITE 101 CARLISLE, PA 17013 ACKNOWLEDGMENT State of Pennsylvania ss County of Cumberland I, Alice P. Mixell the testatrix, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I signed and executed the instrument as my last Will; that I signed it willingly and as my free and voluntary act for the purposes therein expressed. / Sworn to or affirmed and~acknowledged before me by. Alice P,. Mixell, the testatrix, this ; * ¢ day of 2002 I~;'I ;;~;'~ J ublic/Attorney ~" ' '=~DAVlT State of Pennsylvania ss Oounty of Oumberland We, ~,~--~ ~,/~,~ and 1~'7~,~, witnesses whose names are signed to the att~ohed or foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw the testatrix sign and execute the instrument as her last Will; that the testatrix signed willingly and executed it as her free and volunta~ act for the purposes therein expressed; that each subscribing witness in the hearing and sight of the testatrix signed the Will as a witness; and that to the best of our knowledge the testatrix was at that time 18 or more years of age, of Sworn to or affirmed ~-subscribed tp before me by witnesses, this ~:Z~dayof ( C S~P~NJ. HO~ _ Nota Public/Attorne' ,9 S. HANOVER STREET ~ '"~'~ ~~ SUITE 101 ~H~ CARLISLE, PA 17013 ~C~L~L ? ~~, :; CO,, PA · OOMMO. VEALTHO. REV' 1500 OFr. C,A. USEO.LY ~ PENNSYLVANIA .e,~~. DEPARTMENT OF REVENUE ~';~1-~,7~-~,1~'~ DEPT280601 INHERITANCE TAX RETURN ~HARRISBURG, PA17128-0601RESIDENT DECEDENT c~eeE- %~ o,~E~e / o o 2.. DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURI~' NUMBER I-- DJ DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) ~'~ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE DJ /O -- ..~,,_,~ ~,.o ~, ~Z_ ~.-~'--/O -- /?~-v.-~ REGISTER OF WILLS DJ (If APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER [] 1. Original Return [] 2. Supplemental Return [] 3. Remainder Return (date death ~ ~ ~ [] 4. Limited Estate [] 4a. Future Interest Compromise (date of death a~r 12-12-~2) [] 5. Federal Estate Tax Return Required ~ [] 6. DecedentDiedTestate(At~chcopyofW,,,) [] 7. DecedentMaintainedaLivingTrust(Aaachco~yo~Trust) (~) 8. TotalNumberofSafeDepositBoxes ~ [] 9. Litigation Proceeds Received [] 10. Spousal Povedy Credit (date of de~th between 12-3~-91 arid ~-~-95) [] 11. Election to tax under Sec, 9113(A)(Attach Sch FIRM NAME (if AppliCable) ~ TELEPHONE NUMBER q-_ o ?oe-?~'~ - 713 ~ =. , I::-OFFICIAL USE ONLY 1. Real Estate (Schedule A) (1) ./~/~/,/~_ r 2, Stocks and Bonds (Schedule B) (2) ~/o/J e.... I 3, Closely Held Corporation, Partnership or Sole-Proprietorship (3) ,K~,~J ~ 4. Uodgages & Notes Receivable (Schedule D) (4) ~,/O ~ (> 5. Cash, Bank Deposits & Miscellaneous Personal Property ~',,.~' ,, ¢30 (Schedule E) ~ 6. Jointly Owned Property (Schedule F) (6) ~ [] Separate Billing Requested ,-I '-s 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Properly (7) ~/O,~J ~ I-" (Schedule G or L) ~ 8. Total Gross Assets (total Lines 1-7) ,g~ (8) ¢1~ DJ 9. Funeral Expenses & Administrative Costs (Schedule H) (9) '~' ~'.,/~ ~. ~ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) ~r ~ ~) ~ ..Tots, D...o,,o., (tote, L,~es9 ~ lO) (11~/.~- / ~.~o 12. Net Value of Estate (Line 8 minus Line 11) (12)f~-- .~. 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES ~ 15. Amount of Line 14 taxable at the spousal tax ~, rate, or transfers under Sec. 9116 (a)(1.2) x .0 (15) ~) 16, Amount of Line 14 taxable at lineal rate x ,g (16) 17 Amount of Line 14 taxable at sibling rate x ,12 (17) O ~O~ 18. Amount of Line 14 taxable at co~lateral rate x .15 (18) 19. Tax Due (19) Decedent's Complete Address: Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) O 2. Credit~Payments ~ A. Spousal Pove~ Credit B. Prior Payments ~ C. Discount ~ Total Credits (A + B + C ) (2) ~ 3. InteresFPenalty if appli~ble D. Interest ~ E. Penalty ~ Total InteresFPenaity ( D + E ) (3) ~ 4. IfLine2isgreaterthanLinel+Line3, enter the differen~. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) O 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the T~ DUE. (5) O A. Enter the interest on the tax due. (SA) O B. Enter the total of Line 5 + 5A. This is the BA~NCE DUE. (5B) ~ Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY P~ClNG AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the propeAy transferred; .......................................................................................... ~ ~ b. re~in the dght to designate who shall use the prope~ transferred or its in,me; ............................................ ~ ~ c. retain a revemiona~ interest; or .......................................................................................................................... ~ ~ d. re~ive the promise for life of either payments, benefits or care? ...................................................................... ~ ~ 2. If death o~urred after December 12, 1982, did decedent transfer prope~ within one year of death without re~iving adequate consideration? .............................................................................................................. ~ ~ 3. Did decedent own an "in trust for" or payable upon death bank account or secudty at his or her death? .............. ~ ~ 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate pmpe~ which con,ins a beneflcia~ designation? ........................................................................................................................ ~ ~ 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 penal~es of pedu~, I declare that I have examined [his return, including accompanying schedules and statements, and to the best of my knowledge and ~lief, it is ~e, ~rrect and ~mplete Dedaragon of preparer other ~an the per.hal representative is based on all inflation of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE ADDRESS SIGNATURE OF PREPARER OTHER THAN RE~ESENTATIVE DATE ADDRESS For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 RS, §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfem to or for the use of the surviving spouse is 0% [72 RS. §9116 (a) (1.1) (ii)]. The statute does not exemct a transfer to a sun/lying 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 dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 RS. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 RS. §9116(1.2) [72 RS. §9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedenrs siblings is 12% [72 RS. §9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. SCHEDULE E C~'~'W~LrNO~,NS¥~V^.~^ CASH, BANK DEPOSITS, & MISC. INHERITANCE TAX RETURN .~S~.~C~.T PERSONAL PROPERTY ESTA~ ~ FI~ ~M~R AL/cz ? Mj.~LL ~- ~1~ I~ ~e ~s ¢ I~ and ~ ~ ~ ~ ~ ~ ~ ~ ~. All ~ ~ ~ ~ ~M ~su~mhip ~ ~ d~ on ~h~u~ F. ITEM VALUE AT DATE NUMBER DE~RIPTION OF D~TH ~o0, oo TOTAL (Also enter ~ line 5, Recapitulation) (If more space is needed, insed additiona~ sheets of the same size) CO~.W~LTH OF PE.~S~LV^.IA FUNERAL EXPENSES & ~,HER~.CE T~ ,~U,, AOMINIST~TIVE COSTS ESTATE OF FILE NUMBER ~ ~d~ ~ ~ ~ on ~u~ I. ITEM NUMBER DESCRIPTION AMOUNT A. FUNE~L EXPENSES: B, ADMINISTRATIVE COSTS: 1. pemonal Representetive's Commissions Name of Personas Representative (s) SOmal Secudty Numben[s) I SIN Number of Personal Representetive(s) /~" c~ ~,"'c/,/u,,v3 stat~ X,)~T zip o~o~ Year(s) Commission Paid: 2 Attorney Fees 3. Family Exemption: 0f denedent's address is not the same as claimant's, attach explanation) Claimant Sb'eet Address City State Zip Relationship of Claimant to Decedent 5. Accountant's Fees 6 Tax Return Prepamr's Fees ,~ /~ 7, TOTAL (Also enter on line 9, Recapitulation) $ ~'~ / ,J3-.,'~. O ~ (If more space is needed, insert additional sheets of the same size) '~'~'~- SCHEDULE I COMMONWEALTH~"'~'"~"'~'OF PENNSYLVANIA DEBTS OF DECEDENT, INHERITANCE TAX RETURN RES~DENT[~ECEDENT MORTGAGE LIABILITIES, & LIENS ESTATE OF FILE NUMBER Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT TOTAL (Also enter on line 10, Recapitulation) $ ~ ~ ~, ;2,,,,0 (If mere space is needed, insert additional sheets of the same size) REV-1513 EX+ (9-00). ~, ~ SCHEDULE J COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER 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, and transfers under Sec. 9116 (a) (1.2)] ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, 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 [1 - 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) CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Date of Death: / 0 - ~ 3 - & 0 0 f~ To the Register: I ce~ aat notice of ~enefi~l in~t) ~ requfl'ed by Rule 5.6(a) of ~e O~h~s' Co Rules se~ed on or mailed to ~e fogowing benefici~es of ~e above-captioned estate on /7-~ -~.a o ~ was: Ad.ess Noti~ has now been given to a~ pe~ons entitled ~ereto under Rule 5.6(a) except Date: 1/- ~., &- ~,o o ~ ignature, .,p Address ~O~ ~: c: . Telephone (~0~ ~ Capacity: .~ Personal Representative Counsel for personal representative IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be deter- mined wholly or partly by the decedent's will. If the decedent died without a will, whether you will receive any money or prop- erty will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, CARLISLE, PA In re Estate of /'~/'C~ fro, / 4 Xq£k ,deceased, ]0~ EstateNo. ~OO~ - (Name and Address) Please t~e notice of the Oeath of decedent~nd the gr~t of letters to ~e personal representative(s) named below. The Decedent /~ ~ ) (5 ~. /0, ~ / ~ ~,~ L ~ , died dayof ,at (~K/~N~ County, Pennsylvania. ~e Decedent died testate (wi~ Will); The Decedent died intestate (without a Will). ~e ~rsonfl representative of the Decedent is (name, address and telephone number). ' If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 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 Cumberland County, 1 Courthouse Square, Carlisle, Pa. 17013. Phone No. 717-240-6345 A copy of the Will or Petition may be obtained by contacting the Register of Wills and paying the charges for duplication. Date: //- ignature:5: o.. _ Name (print) Address ~ ~;~ o ~ Telephone (~o~ Capacity'~ersonal Representative Counsel for personal representative ~ STATUS REPORT UNDER RULE 6.12 NameofDecedent: /57/x/'c_~' ~, Date of Death: /O - ,,~$ - &oo q- Will No.: ~,Oo g: -o/~o ~ Admin. No.:,~/.O te_/oc~,~ 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 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: /p/~./t c./q /j ,,n,,oo,S-"' 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 r--] 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 [--] 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://-.i~ ~oo~7 ~~ Signature Name · ",' Address ..... !-;: Telephone No. Capacity: ]~' Personal Representative [--} Counsel for personal representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 28D60l HARRISBURG PA 171Z8-0601 NOTICE OF INHtRITANCE TAX APPRAISEMENT, ALLOHANCE OR DISALLOHANCE OF DEDUCTIONS AND ASSESSMENT OF TAX PAUL E ROBINSON 4205 CLUB CT WATCHUNG -,..DAT..f: -,'EStATE OF DATE OF DEATH FILE NUMBER , 'COUNTY ACN 02-07-2005 MIXELL 10-23-2004 21 04-1002 CUMBERLAND 101 *' REV-1547EXAFPC12-D41 ALICE P NJ 07069 Allount Rellitted 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 ~ fl1v:rA~".EX..AFp..Cli1":6!'..Noi'.I.CE.OF.i'N\lITlTfAN.CE.i'AX.APPRAYSlWNT:..ALL.OWAil'CI!.OR'................. DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF MIXELL ALICE P FILE NO. 21 04-1002 ACN 101 DATE 02-07-2005 TAX RETURN HAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Re.l Estate (Schedule A) 2. stocks end Bonds (Schedule B) 3. Closely Held stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule fJ 7. Transfers (Schedule GJ 8. Total Assets (1) [2) [3) [4) [5) (6) (7) .00 .00 .00 .00 7,636.00 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule HJ 10. Debts/Mortgage Liabilities/Liens (Schedule Il 11. Total Deductions 12. Net Value of Tax Return 13. Cheritable/Govern..ntal Bequests; Non-elected 9113 Trusts (Schedule J) 14. Nat Value of Estate Subject to Tax (9) (10) 6,182.00 8.940.20 (11) (12) (13) (14) NOTE: I~ an assessment was issued previously, lines reflect ~igures that include the total o~ ~ ASSESSMENT OF TAX: IS. Amount of Line 14 at Spousal rate (15) 16. A.ount of Line 14 taxable at Lineal/Class A rate (16) 17. Amount of Line 14 at Sibling rat. (17) 18. Amount of Line 14 taxable at Collateral/Class B rate (18) 19. Principal Tax Due NOTE: To insure proper credit to your account} submit the upper portion of this form with your tax paymant. 7,636.00 l~.l?? ?D 7,486.20- .00 7,486.20- 14, 15 and/or 16, 17, 18 and 19 will returns assessed to date. .00 X 00 = .00 X 045 = .00 X 12 = .00 X 15 = (19)= .00 .00 .00 .00 .00 TAll DITS: , ,+, AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 ~ . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. - ( /\i 1 IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. v . IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE I( A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~,\ Cumberland Count~-RegfsEer-Ot W~llS One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/14/2006 ROBINSON PAUL E 4205 CLUB COURT WATCHUNG, NJ 07069 RE: Estate of MIXELL ALICE PAULINE File Number: 2004-01002 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: 10/23/2006 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, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ~ Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: Ai...,c.e.. P/li.t!;Ne'_ 1J1;~t':..i....L Date of Death: /0 -:<....3 - :J..oo.'f... Estate No.: 1.00'(- - O/d:?:/"" 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: I. State whether administration of the estate is complete: Yes ~~ No iJ 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 tbe personal representative file a final account with the Court? Yes U 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 JXl No 0 c. Copies of receipts, releases, joinders and approval offormal or infom1al accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: -.L () - ;"'1 - 6(; ~dt$~- Signature o 0..... lf? N ?A ({/ t::- J /(.oi /Nfd ,>oJ Name ..-::::< U. 1f~<5- J..Ak-,~.. .fv(.,v/ D\;'o J..eJ,;4"'/j'V, 6ft I~ t;f'c3b , Address '-l7" ~) (~"~1 . t/<;t:-5:<"7-/i'3J, Telephone No. !-- L.' o ,""l:? = C.:~~"' ':"'---.i n cc .. 0--< cl Capacity: ~ Personal Representative o Counsel for personal representative .tf