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01-1061
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of Sc-.c..k k'l'O\; })ov&-\~~ , also known as ,;';1 - 01 ... / {)(PI Deceased. ~ () \ - 1(., - C:, ~g (, No. To: Register of Wills for the County of C~ \'~.r '\c,,"-& in the Commonwealth of Pennsylvania Social Security No. The petition of the undersigned respectfully represents that: Your petitioner(s), who 'is/are 18 years of age or older, appl ,e.<;. for letters of administration on the estate of (d.b.n.; pendente lite; durante absentia; durante minoritate) the above decedent. Decendent was domiciled at death in c..,.J""'\o:)'.r \c:..v-.6 County, Pennsylvania, with hI" last family or principal residence at \<).1..\ ~~o.~ ~~ S"'--~~c:",<,,\ov'o vi' (list street, number and municipality) 16 0<:..'. ~ \ \ Z. '^ ~" ~- \(.. , . I -\,... \ ~ \ - . (. r - \--\~\~~\\o'N.s l.)VO\\v. \~o~P\'c..\.\ '\ Decendent at death owned property with estimated values as folllows: (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: No..... <.. ,;., /;)cc, -, , .,:...; $ luOO- $ $ $ Petitioner_ after a proper search h~ ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name 'Rc;;..'=>c.r~ )"'c......\ Relationship So .3 THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. ~ '" u <:: " ~~ "'~ " .... 1:>::" <:: "g.g t";Io;::: 3~ ,,"-< 3 0 (il <:: Ol) c;:; .)Cl,^ '" \..... ~(!) \ ~ -:r ~ . ~,\, ~B' 10)\ (Y\C~'h":.'>'''<'' ~~ $h"P(h",,,~c;.\:'~'6 ?" \ "J.d.';? J 7 -;z d.. .-'-/ OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CIJMRF.Rr.AND } SS 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 before me this 16th NOVEMBER ~TY] c.. ~ ~ iL~.~~ subscribed day of ~2001 f ~v,~ ~ I L ,....., '" '-" Q) .... ~ ...... ~ s:: I:lIl US Register No. 21-01-1061 ~ Eslite off if JACK LEROY DOUGLAS , Deceased o "'.1 6: . \0 GRANT OF LETTERS OF ADMINISTRATION ..- """'q 1".,.1 " ,;;:" ~ ~::~ ,,- 'C'. "I) o i:"':: .' b as ~ND N~W ,..~~ E NOVEMBER 20 ~2001, in consideration of the petition on ~he reverse side ~, satisfactory proof having been presented before me, IT IS DECREED that JOHN L. mLFE,JR. is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration are hereby granted to JOHN L. WOr.FF., llR. in the estate of JACK LEROY DOUGLAS ~mfl.., ('. ~ fv: 9p,\)"f'X. I R.:gister 0 Wills ~ FEES Letters of Administration Short Certificates( 5) . . . . . . . . . . Renunciation ................ JCP $ 18.00 $ 15.00 $ 5.00 $ 5.00 TOTAL _ $ 43.00 .... .t:19Y... .49... . .... A.D. ~2001 ATTORNEY (Sup. Ct. J.D. No.) ADDRESS Filed PHONE lY'o.M ctl~ 'Le almv... /I -~t::)-ol 21-01-1061 RENUNCIATION In Re Estate of ,) c,.. ~ \ <.. \..... (. ('0'\ Oov' \o.-~ <J deceased. To the Register of Wills of Qu-v...S-,c ,~\c".,,-:~ County, Pennsylvania. The undersigned Sc,...,,", of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters (~\ o'~\J"~" '.-" \~::::>-\ "c..\.,,,,,-_ be issued to ~c\"....", \...., VDc~. ~I-. WITNESS hand this day of ,19_. ~.~ t(~ ~ture) ~ r /1? t)/l /J - ~..(1r - W<2B S ?~Z11t ~6e,klcll 6f,rma/tJ (Address) (Signature) ";t :"t o :;:r '~o~ (Address) \D ..- , , ::> <::) z ,:::( -' ....". ,....".',1 r.) (l} COO: a: p I,",.. (].) /.0 .;:: s:: \U = 00 (Signature) (Address) ::"/- 0 I .- /0& J COMMONWEALTH OF PENNSYLVANIA ) )ss: COUNTY OF FRANKLIN ) I certify that the attached copy of a death certificate dated October 31,2001 is a true, correct and complete copy of the original death certificate. In witness whereof, I here unto set my hand and offiCial~al. / ,;9 Notarial Seal .~ . ~ ~ . . ~ A ~ L . "/'~/7/l\~_ ( Bruce W. Hockersmith, Notary Public ~ ~ _~~ Shippensburg Bore, Franklin count~ Notary Public l My Commission Expires Nov. 26, 20 1 November 15, 2001 Frankfurt am Main, Germany CONSULAR MORTUARY CERTIFICATE Federal Republic of Germany) Land Hessen City of Frankfurt am Main Consulate General of the. United States of America ) ) SS ) ) I, Margaret C. Sula. Vice Consul , ~:1I!1 of the United States of America in and for the consular district of Frankfurt am Main, Federal Republic of Germany, duly commissioned and qualified, hereby certify that the attached documents are to accompany the remains of Jack Leroy DOUGLAS a citizen of the United States, who died on October 31, 2001 ; that the remains are to be shipped from the Frankfurt airport on or/about November 10, 2001 at about 11:15 am, flight no. 893 ; that the remains are encased in a container to which is affixed a transit label corresponding with the attached transit permit; and that the remains are to be entered at the port of Philadplphia. PA arriving via Frankfurt/Main, Germany on or about November 10, 2001 continuing at abou~ 4:50 pm ~ith ~light Harrisburg, PA. hEr/ollowing documents are attached and made part of this certificate: no. 3746 to (a) official death certificate (d) transit permit (b) affidavit of Mr. Seppich (c) embalming certifi~ate tness whereof I have herunto set my hand and official seal this November 7 t ::>001 r~ Margarcl C. SuJa Vicc Consul of thc United Sl~i!es of ^Itlcrica AaatlEtatlCountry Bundesrepublik Deutschland Standesamtsbeh6rde 2 Service de I'etat civil de Heidelberg Civil Registry Office of - Auszug aus dem Sterbeeintrag Nr. 2401/2001 Extrait de I'acte de deces nO 3 Extract from death registration no. Tag und Ort Jo Mo An 4 des Todes Dale et lieu du deces/ 31 10 2001 Heidelberg ---------------------------------------- Date and place of death 5 Name Douglas ---------------------------------------------------------- Nom/Name Vornamen Jack Leroy ------------------------------------------------------- 6 Prenoms/Forenames 7 Geschlecht Saxe/Sex M ---------------------------------------------------------------- Tag und Ort Jo Mo An 8 der Geburt Date ellieu de naissance/Dale 24 07 1928 Chambersburg, Pennsylvania, Vereinigte Staaten ---- and place of birth Name des letzten Ehegatten ------------------------------------------------------------------ 9 Nom du dernier conjoinVName of the last spouse Vornamen des 10 letzten Ehegatten ------------------------------------------------------------------ Prenoms du dernier conjoinVForenames of the last spouse 12/ Vater 13 Mutter Pere/Father Mere/Mother 5 Name Nom/Name -- -- 6 Vornamen Prenoms/Forename Tag der Ausstel. Jo Mo An 11 lung - Dale de delivrance/ ~..~' "tID~ Date of issue ;0 2001 cJ2 I. q;p I / U",:::S~i9"""" Flef)SCh ~... .A 'SiegellSCeau/Seal - SYMBOLES/ZEICHEN/SYMBOLS/SIMBOLOSILYMBOAA/SIMBOLI/SYMBOLEN/SfMBOLOS/ISARETLERISIMBOLl Jo: JourlT ag/Day/Dial' H I-lEpa/Giorno/Dag/Dia/G un/Dan Mo: Mois/MonatlMonth/Mes/Mrj v/Mese/Maand/Mesl Ay/Mesec An: Annee/Jahr/Yearl AnorE TOC;/ Anno/Jaarl Ano/Yil/Godina M: Masculin/Mannlich/Masculine/MasculinorApPE v/Maschile/Mannelijk/Masculino/ErkeklMuski F: Fem ininIWeiblich/Feminine/Femenino/8ij Au/FemminileNrouwelijklFeminino/Kadin/Zenski Gebuhr bezahlt J I 1. J j i I I , I I i i I I I i , I 'If,t' St'il't'I,lry "rS"ll1' of the {/nilt'd SId It'.! oj (J meritd hfrdn l'l'ifUCJlldlllrlJOfIl il Iii,,)' {(JIltt'm II) pam it Ibeuti.:enl ;/.11;011<11 of Ihe UlII/ed S'dII'J I/i/flled hfrf//I I" P.14 /lltlbO/l1 dcl,ry or h;mln1fl((! ,md I!I I{/Jf O/II/'ft! 10 ).:I/lf all/'llljid'lttlll1ld prillmiof/. Le Setreldi"eil'EMI tin EIdtJ- UIIIs(/'J-!ff,ir;qllf prif Jf"r In J'1'I.:,mles IIJlltf:J dlll()rlthriJmj>!lf1IteJ ilt' /,/IIft'1' fhliJfr Ii' n/oym Oil If.f.!or/W,wl des EI(1IS.l}Il;f/flula;r/, tlu /1(';'0/1 I'uu/'f'orl. fd/lJ .1/1,,; II; diffimltt: f/, fit f,U dc' he,IIII", .If III i all ordo' 10111.' ,lldt' (I pro//'lfiol//t'gilllll/1J. C\'. i; \';.l;'J . -{).k4--J.,z,/ if '\ ~II:N\ TtltE OF G NOTVAUD AFFIDAVIT ederal Republic of Germany ) Land HBsse ) City of Frankfurt am Main ) SS Consulate General of the ) United States of America ) Before me, Margaret C. Su1a. Vice Consul ,~fmSUtofthe United States of America in and for the consular district of Frankfurt am Main, Federal Republic of Germany, duly commissioned and qualified, personally appeared: HRns Friedrich Seppich who being duly sworn, deposes and says as follows: MY NAME IS: I AM THE Hans Friedrich Sennich OF FUNERAL HOME manager Seppich GmbH AT Dossenheimer Landstrasse 79, 69121 Heidelberg I certify that the remains of Tel: (011-49-6221) 401014; Fax: (011-49-6221) 41 12 14 a citizen ofthe United States who died on October 31, 2001 , have been embalmed; that I witnessed the packing of the remains for the shipment to the United States; that the casket and case contain nothing but the said remains, together with the necessary clothing and packing; and that the outer container is marked and addressed to: Fogelstan~er-Bricker Funeral Home 112 West King Street Shippenburg, PA 17257, U.S.A. I Subscribed and sworn to before me this November 7, 2001 v~G~I'~ (seal) Vice CIllls1d Ilfthe lIllitcd .';1;11.', Ill' Americ;1 Dr.l1led 1viallfred Bauer Neuropath%g. A bteilung Psych. Lalldeskrallkellhaus Postfach 14 20 D- 69156 Wies/och Betr. Einbalsamierung Herrn / Frau: Jack Leroy DOUGLAS Hiennit bestatigen wir der/m Verstorbelle/ll Herr Lawrence Jack DOUGLAS Geburtsdatum: 24.07.1928/ Pennsylvania ( U.S.A.) Sterbedatum : 3].] 0.200] in Heidelberg ( B.R.D) Anschrift : 124 Cottage Road, Shippenslmrg Pennsyllvania ( U.S.A.) lege artis zur Uberflihrwlg eillbalsamiert zu haben. ~ I.inb h.... er eRe eI~Igw"-ng Der Sarg wurde gem. Stra13burger Abkommen yom 26.10.1973 Artikel6 yerlotet und ist luftdicht yerschlossen. Heidelberg, den 6 .November 2001 8UNDESREPUBLlK DEUTSCHLAND REPUBLlQUE FEDERALE D'ALLEMAGNE ,te: FEDERAL REPUBLIC OF GERMANY _stado: REPUBLICA FEDERAL DE ALE MANIA Stato: REPUBBLlCA FEDERALE 01 GERMANIA Staal:' BONDSREPUBLlEK DUITSLAND Devlet: FEDERAL ALMANYA CUMHURIYETI Drlava: SAVEZNA REPUBLlKA NJEMACKA Estado: REPUBLICA FEDERAL DA ALEMANHA Xwpa: OMO:mONIIIAKH IIHMOKPATtA THr rEPMANIAr Bezeichnung der Behorde Standesamt Heidelberg als Ortspolizeibehorde -/- f---- Nachdem aile gesetzlichen Vorschriften Ober die Einsargung beachtet worden sind, soli die Leiche yon Les dispositions legales concernant la mise en biere ayant ete respectees, Ie corps de - Having been put in the coffin in compliance with all the legal regulations pertaining to same, the remains of - ObselVadas lodas las prescripciones legales sobre el amortajamiento, el cadaver de - Essendo state compiute tutle Ie prescrizionllegali relative 81 confezionamento del feretro. la salma di - Wanneer aile wettelijke voorschriften aangaande het kisten zijn nagekomen, dient het lichaam van - Tabutlama hususunda tOm yasal mevzuata uyulduktan sonra, ceset 'den - Poslije uvalavanja svih zakonskih propisa 0 stavljanju u lijes, Iransportirat ce se mrtvo tijelo - Ap6s a observa~ao estricta de todas as prescrl~es legais referente ao amortalhamento, 0 cadaver de - EXOVTOe; TTJP!\O&I TIe; lllallIKaoi&e; nou npo~AtnovTOI an6 TOV No~o, TonoB&T!\BTJK& OlO cptp&TPO TJ owp6e; TOU LeichenpaB Carte mortuaire - Corpse transport permit - Pasaporte para cadaver - Passaporlo Mortuario - lijkepas - 010 Gecis Belgesi _ Mrtvacki pasos _ AutorizaQao de transporte de cadaver - A6EtQ f.ua6tpopac; owpou " Familienname, ggf. Geburtsname, Vornamen des Verstorbenen nom de famille, Ie cas echeant nom de jeune fille, prenoms du defunt - family name ar name at birth, first name of the deceased - apellido, nombre de nacimiento. nombres del Doug I as Jack Leroy / fallecido - cognome, eventualmente cognome di nascita, nome del defunto - familienam, , - _ ev!. meisjesnaam, voornamen van de overladene - 610nOn sayad" gerekti(jinde do(ju~laki sayadl, adlan - prezime. svtl. rodana ime, imena umrloga - apelido, avt. nome de srnteira, nome proprio do defunto - Enwvu~o. ytvoc; Eni CYYOllwV YUVOlKtiw, DVOJ-lQ verstorben am decade Ie - who died on - fal/eeida el - morta iI - gestorven op - alum tarihi - 31. 10.2001 _ /_ umrlog/umrle dana - morta a - 8avwv/8avouoa lllv in a - in - en - a - in - clOm veri - U - em - tIC:; Heidelberg -/- an (Todesursache) de (cause du deces) - of (cause of death) - de (causa de la defuncion) - di (causa della morte) - op (doodsoorzaak) - 610m nedeni - od (razlog smrti) - de (causa da morte) _ ano (OIlia eavoTou) jm Alter yon Jahren (wenn moglich genaues Geburtsdatum) a I'age de ans (mentionner si possible la date de naissance exacte) - at the age of years (if possible please give the exact date of birth) - de anos de adad (si posible, indicar fecha de naco exacta) - di anni (indicare la data di nascita, se possibile) - op de leeftijd van (indien mogelijk precieze geboortedatum) - ka~ ya~mda 61dO(j0 (mOmkOnse tam olarak do(jum tarihi) - u starosli od godina (po moguenosli tocan datum rodenja) _ na idade de (indicar aqui, se for passivel, a data exacta de nascimento) - OE '1^lKia (va avacp&pB&[ TJ TJ~&po~TJvia YEVV!\O&We;) Herz-Kreislaufversagen -/_ 24.07.1928 -/- durch (Beforderungsmittel) dolt etre transfere (mode de transport) - shall be transported by (means 01 transport) _ debe ser transportado por (medio de transporte) - vem, trasportala tramite (mezzo di trasporto) - door (transportmiddel) - ne ile naklolundu(ju - sa prevozno sredslvo _ sera transportado par (meio de transporte) - Ba ~&TOcp&pB&i (~toov ~&Tacpopcie;) Auto und Flugzeug -/_ von (Absendeort) de (lieu de depart) - from (place of dispatch) - de (Iugar de despacho) - da (Iuogo di partenza) - van (plaats van verzending) - nereden g6nderildi(ji - od (mjesto oda~i1janja) - He i de I be rg _ / _ de (iugar de expedi~ao) - ano (Tonoe; &KKIVTJO<le;) ----------_.~._---~--~------~ Ober (Strecke) via (route) - via (state route) - a traves de (a trayecto) - via (strada da percorrere) _ via (naar traject) - gonderildigi yol (gOzergah) - preko u relacija -via para -lllaox[~ovTae; Frankfurt am Ma in _ /_ nach (Bestimmungsort) befOrdert werden. il (lieu de destination) - to (point of destination) - lugar de destino - luogo di destinazione - plaats van bestemming getransporteerd te worden -gidece(ji yer- odradi~te -Iugarde Ha rri sburg, pennsy I V an i a, USA _ /_ destino tinal- &Ie; (aKpl~!\ Tono npooplo~oti) f------- _ Da diese Leichenbeforderung genehmigt ist, werden aile Behorden der Lander, auf deren Gebiet der Transport stattfinden soli, gebeten, ihn frei und ungehindert passieren zu lassen. Etant donne que Ie transfert du corps est autorise, toutes les autoritE~s des pays sur Ie territoire desquels Ie transport circulara sont priees de Ie laisser se deplacer librement et de ne pas entraver sa circulation. - Permission has been granted for the transport of this corpse. All authorities in the countries/states through which the remains are to be transported are, therefore, requested to allow it to pass freely and unhindered. - Dado que este transporte de cadaver esta autorizado, se ruega alas autoridades de los pafses por donde deba pasar el transporte dejarlo pasar libremente y sin impedimentos. - Trattandosi di un trasporto di salma autorizzato, tutte Ie autorita dei paesi di transito sana pregate di farlo passare liberamente e sanza atcun impedimenta. - Aangezien dit lijktransport ward goedgekeurd, wordt aan aile instanties der landen, op wier gebied het transport dient te geschieden, verzocht, dit vrijelijk en ongehinderd te laten passeren. - Cesedin nakline mOsaade olundu(jllndan, nakliyatm yap'ldl(j1 Olkelerin resmi makamlanndan, cenazeyi serbest olarak ve engellemeksizin gec;:irtme hususu rica olunmktadlr. - Kako je transport mrtvog tijela odobren, umoljavaju se svi organi vlasti zemalja, preko cijeg ce se podru~ia vr~iti transport, da ga se pusti slobodno i nesmetano proei. - Tratando-se no caso do presente transporte de um transporte de cadaver autorizado, raga-se a todas as entidades oficiais dos paises por cujo territorio 0 transporte sera efectuado, que 0 deixem passar livremente. - .6.ec5ol-ltvou on YtO T'1V I-lETOCPOpa T'1, napouOTlC; awpou EXel XOP'lY'l8el 66elo. nopoKOAOUVTat 01 APXt, TWV xwpwv eni TaU Ellacpou, TWV onolwv Sa npaYIJOTonOI'18r..f '1 JleTocpopa va T'1V ennptt,J.touv OKWAUTW, Kat EAeu9tpwC;. -- Ort, Datum Heidelberg, 06.11.2001 :(1\ Dr ~ -----:\ . t . ~?" . :(;;.lgell.~ -r' ;, ' ,..,_ ...J...... ~ I' .,. \'("';\ ....,./ ...' ~E~Y Cue ~ cLcvn c--R ... <=> '" <=> <=> <=> 0> ro ~ r "':I: >.0 ~a ~ "'~ E'" ",E C1E iij _ro ~ ~~ '5'" ~~ 0 <0 <0 <=> /.4bescheinigung:_ nichl vertraulicherTeil- "onalangaben .fl1~eburtsname. Vorname BlallA: Slandesamt Zulreffendes bille ankreuzen oder ausfUllen. (' /212 Geburtsdatum Sterbezeitpunkt, ggf. Datum der Leichenauffindung 2. Idenlifikalion Aufgrund eigener Kenntnis 3. Ort und Zeilpunkl des Todes Nach Einsicht in den Personalausweis/Reisepass nicht mOglich Stralle. Hausnummer (Name des Krankenhauses a.ii.) c"~?, ~l.U2 / V - k"// ~~ ,r~~"/_ ~,? c. A. PLZ. Ort. Kreis /La dr-Idc'/. r._ Tag Monat Jahr 3 X ~. (.'" 2'~j (~) .-( Tag Monat Jahr Sterbezeitpunkt Nach eigenen Feststellungen Nach Angaben von Angeh6rigen/Dritten t Falls Sterbezeilpunkt unbekannt bzw. tot aufgefunden: Zeitpunkt der Leichenauffindung 4. Warnhinweise Uhrzeit Minuten Herzschrittmacher Infektionsgefahr (z.B. Meldepflichlige Erkrankungen gem. ~ 3 BSeuchG bzw. ~~ 6 und 7 IfSG nach dem Inkrafltreten des SeuchRNeuG) Sonstiges (z.B. Tatbestand gem. ~ 16e ChernG) 5. T odesart nalUrlicher T od (Tod aus krankhafter Ursache. der v611ig unabhiingig von rechllich bedeutsamen Faktoren (z.B. Unfall) eingetreten ist) Anhaltspunkte fiir (Tod durch Unfall, Selbstt6tung, Tod durch strafbare Handlung, sonslige Gewalteinwirkung (z.B. Sturz), Vergiftung und bei Ver- nicht nalUrlichen Tod dachlsfiillen der vorgenannten Kalegorien) (Eine ungekliirte Todesart wird dann angenommen, wenn keine Anhaltspunkle fUr einen nicht naliirlichen Tod erkennbar sind. die T odesart ungeklart T odesursache nicht bekannt ist und trotz sorgfalliger Untersuchung und Einbeziehung der Vorgeschichle keine konkreten Befunde einer lebensbedrohlichen Krankheit vorliegen, die einen Tod aus krankhafter naliirlicher Ursache und v611ig unabhiingig von rechllich bedeutsamen Faktoren (z.B. Unfall) plausibel erklaren) ! 6. Zusalzangaben bei T otgeburten (T otgeborene oder in der Geburt verslorbene Leibesfriichte von mindestens 500 g) Als lote Leibesfrucht geboren in der Geburt verstorben Arztliche Bescheinigung Aufgrund der von mir sorgfaltig und an der unbekleideten Leiche durchgefUhrten Untersuchung bescheinige ich bestem Wissen. Ort.~eitpunkt derTeichensCha~u--------~~-~--------~- Unlerschrm und Stempel der Arztinfdes Arztes 2. 4'/. 0/ Die Erdbeslatiung ist erfaigt am aur Stempel Die Verwallung des BestaUungsplatzes-- ~-------------~ Diese Todesbescheinigung ist von dem Trager des Bestattungsplatzes fiir die Dauer der Ruhezeit aufzubewahren. Die Todesbescheinigung wird fUr die Oberfiihrung in eine Leichenhalle oder an einen anderen Ort sowle fUr die Bestattung ben6tigt. Sie muss dem Slandesamt vorgelegt und danach im Falleder Erdbestattung derVelWaltung des Bestattungsplatzes iibergeben werden. .. - C:- I() t;,r OF-180 (Rev. 03-1998) In accordance with 5 CFR 1320 51b}, persons are not required to respond to the collection OMS APPROVAL NO. 1405-0096 of this information unless this form displays a currently valid OMB control number. 'ESTIMATEEt~~~5~~~-i~6S~~ REPORT OF THE DEATH OF AN AMERICAN CITIZEN ABROAD _A~~~IlQ~Il_~~~~~~~!~_~~,._q~~~Il~.__~}_~~~~~Q()~_______ ----- (Post & date of issue) 201-16-6886 SSA N 0.._ _ _ _ _ _ _ _ _ _ ____________ _ _ _ _ _ _ _ ____ ___ Name in full J~_~~n~~roxPQ~q~A~mmmmm_nnmnmm..mnnnnmmm_ unmmm ....uummm Ageu7.~_nu Date and Place of Birth J~~~}~,_}~~~__~Il_~~~~~~_~~~~~,__~~IlIl~X~~~~~'n~.._~:_~..m_ ________mm..m_________n..nun . . . . USPPT no. 152970066 iss. June 15, 1995 at National Passport Center EVidence of U. S. Citizenship. n. mmm..mm..... mmh"U.m 00..... .mm__nmmmmmh"U 00..... mmm...mmmmmm__._____.. n. ---- Address in U. S .A. .~.~~.~~~~~Z~..~~~~_'..~~~PP.~!?_.~~~~~:__~A..~7.~.~.?....................... ..._......nnm.........mnn....... .......-. Permanent or Temporary Address Abroad n~~~..~~E.~~!}?~.t!:~.I~~n~~n~~.~~~__~~.~~~n~~.~n~:..?~~.7.~.~~~~rf~.l.~m.m Date of death .......mnmQc~~~~!n......mn___. m.nm~}...mmm.....mnmQ.?mmm. _....nn~~.l).~..m __._.......~.()()1... (Month) (Day) (Hour) (Minute) (Year) Place of death .~~~~~~~~!Z_'__q~~~.Il~m h.. 00............. m mmmmnn..... mmm.___m......... mmm.. ____...... m.m. ..- (Nwnber and street) or (Hospital or hotel) (City) (Country) Cause of death .. ~~~~~.?y.~.s~\lI~~..f~!!~~~.~~_~.._.~~.g.~.~~~Il.~~~J??.~~y.~.~;.ge.r~~.~.~~~~. .c_e!~iQ~.~~.~... ...... .. _._... _. _.... (Including authority for statement - if physician, include full name and official title, if any) .Il~:..~.~()I./~QQ.!..!~~.... ~ ~~~~~~~.~:..~~~~.~y..~~~.~.~Z.~~~!~!.'.~. ~.f!!-.~~. ~.Il. ~~!~~!~~~.~.:.q~~~Il~.... .__._..m....... ... Disposition of the remains J.~~~.i.Il~nr~~~~~ .~~. ~~.IlIl~y'I~~.Il~~:,~"'~:~"n_mnm..... mmmm..__ _ _. m. 00... mmmm.m' Local law governing disinterment of remains provides that .~~A-.mmnnmm.mm....mnmnmmmmm...__m.mmnnmmmm..__ Disposition of the effects n~()~~rt.~()\l~!~~.:. ~~Iln. m..___..n.nm...... 00............ _"00' m..n......... mmnm" Person or official responsible for custody of effects and accounting therefore mm.m...n__nnnnnm.m.mm... same as above Traveling/residing abroad with relatives or friends as follows: NAME ADDRESS Informed by telegram or telephone NAME ADDRESS DATE NOTIFIED Copy of this report sent to: NAME .~?~~.~~.P.?~~~~~_,. .~.()Il....... ...... ADDRESS DATE SENT .~~~.~~~~~~.~~~~~~.~............mmm..._.._. _._._......... ....~.~!.()~~~~~}.... .7.~~7.~..~~~~!.~~~~:ng.~~~~.......nm.............. -------------------------------------------------------------------------- ---- ----------------------. Other IRS - Berlin (State Agency) The original copy of this document and information concerning the effects are being placed in the permanent files of the Department of State, Washington, D.C. 20520 Remarks: Above cancelled U. S. passport returned to Mr. Robert Douglas. Additional copy sent to Vital Records, PA. Notification or copy sent to Federal Agencies: SSA x CSC VA ,-I'i. (Continue on reverse if necessary.) ~cr~ (Signature on all copies) [SEAL] Erin C. Brandt, Consul of the United States of America. Additional certified copies available from the Correspondence Branch, Passport Services, Department of State, Washington, D.C. 20520. Each copy $10.00. tj o e o t"'" ?:> ~ en ::s 3 ~ '-< :> n ~ >T1 ::t. ~ ::s '" 3 ~ ~ Q; 0.. <> ::s '" 3 ~ t"'" trI ~ o -< Bo '" 1> v.> o _ ...., o..N g 0 2:8 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF JACK L DOUGLAS , Deceased No. 21011061 of 2001 To the Clerk of the Orphans' Court: Enter the claim of CAPITAL ONE Acct. 5291491900443951 In the amount of $3,646.88 , against the above entitled estate. The decedent, who resided at 124 COTTAGE RD SHIPPENSBURG PA 17257 died on 10/31/2001 . Written notice of said claim was given to JOHN L WOLFE JR. ,if known to claimant, at (Personal Representative or counsel) 151 MAINSVILLE ROAD, SHIPPENBURG, PA 17257 on February 13, 2002 (Date) ~/~.~ (CI . ~ Address: 5330 East Main Street, Suite 200 Columbus, Ohio 43213 ~Pt Claimant's Couns ...... ,.. ..'/\'ttt ,... ~- - C"..., :; 2; r:: (f- ci N Address ..,., rrl = N N "r~ C::. STATE OF PENNSYLVANIA IN THE REGISTER OF WILLS/ORPHANS COURT: CUMBE~ ("AT IlI.TTV ~ ESTATE~ IN RE: ESTATE OF JACK L. DOUGLAS STATEMENT OF CLAIM 1. MBNA America hereby presents for filing against the above estate this statement of claim in the amount of $ 4,056.71. 2. The basis for the claim is MBNA account number 4264 2962 5208 4006 which was opened on 08/03/1993. 3. The tax identification number of the claimant is 510331454. 4. The name and address of the claimant is MBNA America, 1000 SAMOSET DRIVE WILMINGTON, DE 19884 ;.) " .: :.:; < c::5 N :n ~. 5. This claim IS NOT contingent. $ ;.'0 I .r:::. 6. This claim IS NOT secured. 7. The last payment made on the account was $ 200.00 on 10/03/2001. ",J ",j "..., .- Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true, to the best of my knowledge and belief. 31 , 2002 _ Claimant State Of Delaware, County of NEW CASTLE IN WITNESS WHEREOF, I have set my hand and notarial seal this 3 f daYOf~fU{~ '20024!Aj{wfcuUQ~ Q../lJ. Notary Public My Commission Expire . Wo/Qli) ~3 JACK L*DOUGLAS CUSTOMER INFORMATION SYSTEM 01/31/02 * 4264296252084006 * 09:37:49 CURBAL: 4247.62 CYCLE: 07 N 0000000000000000 CR LIN: 15200.00 STATUS: 5 CHANGED: 11/07/01 ***************************** OCTOBER STATEMENT ***************************** POST -------REFERENCE------- TRAN --------DESCRIPTION------- BC ---AMOUNT--- PAYMENTS AND CREDITS 0926 24717051249582490927196 DOUGLAS/J 1003 27657303297 PURCHASES AND ADJUSTMENTS 0908 24435651250286878462024 0908 74435651250200878465015 1003 24661001275120271010235 0905 AGENT FEE 8908142428 09/05 XAA/XAO ON EWAY PAYMENT - THANK YOU 15.00CR .00 200.00CR X165-1 0907 AAA SHIPPENSBURG-R 0907 CASH AAA SHIPPENSBURG- 1001 ROBERT T. HENRY PHARM C C C 47.69 700.00 39.21 ***************************** OCTOBER STATEMENT ***************************** PREV BAL - $3436.72 PAY + $215.00 SALE + $786.90 CASH + $0.00 F/C $48.09 = NEW BAL $4056.71 PF10=PAGE FORWARD PFll=TRANSACTION SUMMARY 4-@ 1 MBNAIS PF09=NOVEMBER STMT PF18=SEPTEMBER STM 192.168.14.20 PA1=BEGIN AGAIN 1 PA2=SYSTEM MENU HACN WDA41Q08 2/31 IN THE COURT OF COM-ION PLEAS, CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF JACK L DOUGLAS Register's # 21011061 Deceased CLAIM To the Clerk of the Orphans' Court Division: Index and make proper entry in your official records of the claim of UNIVERSAL BANK N.A. in the amount of $651.06 against the estate of the above-named decedent. This claim lS filed under Section 3532 (b) (2) PEF Code, 20 Pa. C.S. ss. 3532 (b) (2). .. ... The said decedent, whose last known residence was at ~ COTTAGE RD. SHIPPENSBURG PA 172578756 Written notice of this claim was given to Executor. 151 MAINSVILLE RD. SHIPPENSBURG. PA 172570000 JOHN L WOLFE JR on December 19. 2001. ~ UJ ~..Q ....1= .u= Go (~ Tammy Anze1one, Manager of Citicorp Credit Services, Inc. under limited power of attorney for UNIVERSAL BANK N.A. 7930 NW 110 Street, Kansas City, MO 64153 (Claimant's Address) -.:::r .- ::1 ".I (Y") 0- -.:::r .- "..,,\ r"" ~ a::: :z c:::c: -, 12/12/2001-15 Acct. #5491130023491046 . . Your A1B' Universal Card Statement ~ _ October 18 - November 15, 2001 JACK L DOUGLAS Account 5491 1300 2349 1046 Calling Card +PIN No Annual Fee/Platinum Card Minimum Payment Due............................................$199.73 Due Date"................................................ December 5, 2001 'Payment must be received by 1:00 pm local time on the payment due date. Amount Past Due ......................................................$103.09 Credit Line ........................................................ ....$17,000.00 Available Credit ............................................................. $0.00 Cash Advance Limit..................................................$500.00 Available Cash Advance Limit ..................................... $0.00 Previous Balance Payments and Adjustments MasterCard@ Activity Total AT&T Services New Balance Note: Detailed activity starts on page 2. $4,209.84 0.00 -3,584.02 49.74 $675.56 Payment Record Amount Paid: Page 1 of 3 .A~T 3 How to Reach Us Account Online: www.universalcard.com Account OnCall: 1 800636-8330 (For Automated Service Only) Customer Service: 1 800423-4343 or write Universal Card Services Corp., PO Box 44167 Jacksonville, FL 32231-4167 The Annual Percentage Rate on your account may increase due to one of the following reasons stated in your Card Agreement with us: if you fail to make a payment to us or any other creditor when due, you exceed your credit line or you make a payment to us that is not honored by your bank. Reminder: You may be assessed an over-the-credit- line fee if your balance exceeds your Total Credit Line as stated above. Date Paid: Check Number: Please follow payment instructions in the 'Important Instructions for Making Payments'" section of the original statement. Account Number Pa ment Due New Balance Minimum Pa ment Enter Amount Enclosed 5491 1300 2349 1046 12105101 $675.56 o xx 549113 11 00 C JACK L DOUGLAS 124 COTTAGE RD. SHIPPENSBURG PA 17257-8756 549113DD23491D4bDDDD19973DDDDb755b4 $ $199.73 Make chang.. to address and phone number below: Add..ss Apt./Suita City State Zip Home phone ( ) Business phone ) Make check payable to: Universal Card PO BOX 8211 SOUTH HACKENSACK NJ 07606-8211 STATE OF PENNSYLVANIA IN THE REGISTER OF WILLS COURT: CUMBERLAND COUNTY ESTATE NO. 2001-01061 IN RE:ESTATE OF JACK L DOUGLAS STATEMENT OF CLAIM 1. MBNA America hereby presents for filing against the above estate this stajement of claim in the amount of $ 4110.30. 2. The basis for the claim is MBNA account number 4264296252084006 which was opened on 8-03-93. 3. The tax identification number of the claimant is 510331454. 4. The name and address of the claimant is MBNA America, 1000 SAMOSET DRIVE WILMINGTON, DE 19884 5. This claim IS NOT contingent. 6. This claim IS NOT secured. 7. The last payment made on the account was $ 200.00 on 10-03-01. Under penalties of perjury, I declare that I have read the foregoing, and the facts alleged are true, to the best of my knowledge and belief. /" Executed this;}!J day of , 2002 Claimant State Of Delaware, County of IJ 13 W c-/l672-t, IN WITNESS WHEREOF, I have set my hand and notarial seal this Z1) day o~ ~CenL(~ , 200*~(u)(Q~/ Q, J;rJu~duJ IA Notary Public My Commission EXPiresQ {J1WkM da:1~ I . 139510 COUNTY COURT 10987558 - . . . X165-1 CUSTOMER INFORMATION SYSTEM 01/25/02 * 4264296252084006 * 07:26:34 JACK L*DOUGLAS CURBAL: 4247.62 CYCLE: 07 N 0000000000000000 CR LIN: 15200.00 STATUS: 5 CHANGED: 11/07/01 ***************************** NOVEMBER STATEMENT ***************************** POST -------REFERENCE------- TRAN --------DESCRIPTION------- BC ---AMOUNT--- PURCHASES AND ADJUSTMENTS ~ ~ 1106 00000000000000 1106 LATE CHARGE FOR PMT DU C ~ ~ n~ PAY YOUR MINIMUM PAYMENT T ~OO ~ YOUR 0% APR PROMOTION. PAY .00 BALANCE TOTAL IN FULL EACH .00 CYCLE TO AVOID PERIODIC RA .00 CHARGES ON PURCHASES. DURI .00 PROMOTION, NO PERIODIC RAT .00 CHARGES ACCRUE ON CATEGORI .00 ***************************** NOVEMBER STATEMENT ***************************** 6<.161, r~;A. PREV BAL - $4056.71 PAY + $0.00 SALE + $0.00 CASH + $0.00 F/C $53.59 + LATE CH = NEW BAL $29.00 $4139.30 PF10=PAGE FORWARD PF11=TRANSACTION SUMMARY 4-@ 1 MBNAIS PF06=DECEMBER STMT PF15=OCTOBER STMT 192.168.14.20 PA1=BEGIN AGAIN 1 PA2=SYSTEM MENU HF15 WDA41Q57 2/31 ~ (!/ Cu /I) cj//O,8J ~.... . I A. · r:r ". .. , 0" . 0'- " '"' ~l I ------,----- U1 r:r U1 r=l Postage ------- Certified Fee -- Return Receipt Fee ~ (Endorsement ReqUired) __ CJ CJ Restricted Delivery Fee (Endorsement Required) f--- Postmark Here CJ Total Postage & Fees $ CJ '-'-- ~ o~~CiP; t_~iu~:cn~r Cf __'__~_:1A1~--~mn CJ Street, Ap';'1to_; or PO Box CJ CJ -air, -Siate,-ZiP~4 --00 -- w_ -- - - _m_ - n 00 nm__ _mnnm_m_nn nn W -- n n om_ m I"- SENDER_ COMPLETE THIS SECTION . Complete items 1, 2, and' 3. Also complete item 4 If Restricted Delivery is desired. . Print your name and address on the reverse so that we can return the card to you. . Attach this card to the back of the mail piece, or on the front if space permits. 1. Article Addressed to: JOHN L WOLFE JR 151 MAINSVILLE RD SHIPPENSBURG PA 17257 2. Article Number (Transfer from service IabeQ PS Form 3811, March 2001 .~ 3. Serv9 Type l3"tertified Mail D Registerad D Insurad Mail D Express Mail D Return Receipt for Merchandise DC.a.D. 4. Restricted Delivery? (Extra Fee) Dves ~o 0 - O~oa-Oo Domestic Return Receipt 102595-01-M-1424 " ,- JRD/June 30, 1992/17858 , . APR 11 2002 ~ In Re: Estate of JACK LEROY DOUGLAS Late of ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA Estate No.: 21-01-1061 NO. NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT ORPHANS' COURT RULE Personal Representative: JOHN L WOLFE JR Counsel for Personal Representative: Date of Grant of Original Letters: NOVEMBER 20,2001 Date of Delinquency Notice: MARCH 2, 2002 The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court Orphans' Court Rules, was given by the Register of Wills on MARCH 2, 2002, and that the ten (10) day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6(e) the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: APRIL 10, 2002 Distribution: Personal Representative Counsel for Personal Representative Estate File A hearing is scheduled for ~1 <~ rPod-' at ~~rJo If.. ~Jn Courtroom No.3. If the Certification of Notice is file/;rior to the hearing date, the hearing will automatically be cancelled. George . ~. . ) . . Name of Decedent: Date of Death: O~. 6\ ~OOI Will No. ~ 00 l - 0 \ 0 " , Admin. No. t1'\ 0\ - lOCo \ To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on Name Address Rc)~<<'-\- \~ .\)O'V~\~ (~ ') \\er-'^"o..""..... - \-\e.~~c. - Lu~ 3 7l.1 ~ 'I ~ :z ~~ ~ ~c:- \d G-e.- ~'VV'- Cvv.., Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: lY\~ I L{ I ~ 0 O~ ~~~~~ SignatuU- Name Jo",^" b. \.00\ k. 'T t'" r- ('1 . . Address 15l (\(\c:.""'-'E.v'\\\.e. ~ ~. ~~\~~~~~ ?~ 1'1~~7 Telephone ( '71 t'J 5""3~ - ~O? ;.......J p ;.,.- I ':-- .....- ...-:C Capacity: -X- Personal Representative _Counsel for personal representative CJlvK STATUS REPORT UNDER RULE 6.12 Name of Decedent: :rOl.c..k )....(.\0 1 Date of Death: )O-3t-~6.1 Will No. ~OO\ - O\C~ I 1>0 '-> ~ \u,,5 Admin. No. dl-Ol-JO~I 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 X 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 1a..1"!> I }b~ 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 may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: x/~/tL) Si~ ~+1 -:ro ~ \.... lvI) \ k Name (Please type or I'\. ~1.S("~e.\,\ ~~ \.., .... "~CJ\". N ~ Address T~ print) o8!.33 C'-J N (90& 83.j - OS'~~ Tel. No. ~Y') ~::::J Capacity: y Personal Representative ,r .-- ....--'" Counsel for personal representative (MAH:rmf/AM3) r Lr) ....D 3" r-=I U.S. Postal Servicew ~ERflFIED MA}Lw RECEIPT (Domestic Mail Only; No Insurance Coverage Provided ~ I "0 F' Fie I A L nJ r-=I USE 1 Postage $ r-=I CJ CJ Return Reclept Fee CJ (Endoreernenl Required) CJ Restricted Del1very Fee r-=I (Endorsement Required) CJ r-=I Totel Postage & Fees $ Certified Fee Postmark Here IT1 CJ nt To CJ I"'- -~!f,f!/:::':::::;------........--.------......-------------...'".--------........--------- Ci,y,.srai9;Z1P+4-...........................----...............---...............-...... PS Form 3800, June 2002 See Reverse for Instructions SENDER: COMPLETE THIS SECTION . . . . . . Complete items 1, 2, and 3. Also complete item 411 Restricted Delivery is desired. . Print your name and address on the reverse so that we can return the card to you. . Attach this card to the back of the mailpleca, or on the front if space permits. 1,. Article Addressed to: D. Is delivery address different from Item 1? ,. vr<' __0_- -lelivery address below: A. x WOLFE JOHN L JR 151'MAINSVILLE RD SHIPPENSBURG PA 17257 L Mail D Express Mail D R~lstered D Return Receipt for Merchandise D Insured Mail D C.O.D. 4. Restricted DelIvery? (ExtnI Fee) DYes 2. ArtIcle Number (Transfer from setV/CI8 /8beI) PS Form 3811, February ~004 7003 1010 0001 lE04 1465 Domestic Return Receipt 102595-02-M-1540 \ JRD/June 30, 1992/17858 rWV 0 3 2004 . ........~ Estate No.: 21-01-1061 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA In Re: Estate of Jack Leroy Douglas Late of Shippensburg Borough NO. 21-01-1061 0\ - \Ole \ NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: John L Wolfe Jr Counsel for Personal Representative: Date of Decedent's Death: 10/31/2001 Date of Delinquency Notice: 08/11/04 The undersigned, Glenda Farner-Strasbaugh, Clerk of Orphans' Court, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on April 30, 2004, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 11/08/04 ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court Distribution: Personal Representative Estate File ~~"t. 101 ;l..eOlf- '1:'3.0 (\,t-i\. A hearing is scheduled for at in Courtroom No.3. If the Status Report is filed prior to the hearing date, the hearing will automatically be cancelled. uJ STATUS REPORT UNDER RULE 6.12 Name of Decedent: '00 u ~ \ Q S Date of Death: )0 1'3 i I ~ 00 , Will No.: ~ 00 I - 0 , t;) ~ I ) - - o v.. c.. \ <. le ,0 'J Admin. No.: ~ \ - () , - } b b I Pursuant to Rule 6.12 ofthe 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 0 No 00 2. If the answer is No, state when the personal re:eresentative reasonably believes that the administration will be complete: r" c, r c. '" 3 I a 0 0 '5" I 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 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 ~~~ ~ ~o ~<" . C) \" oY'-' )- ~:) \ ~ c. Copies of receipts, releases, joinders and approval of formal or informal accounts maybe filed with the Clerk of the Orphans' Court and may be attached to this report., , , + Date:~/{)lf \~J).L J lo-l ~ (f h We' ~ "'Jr ~ N j 08833 j 0,,", ".... Name '""':\ 11 ~u ("-l' e \l le ~~~ Address 908 .- 8'3~ -OS'~9 Telephone No. '. ~ Capacity: JKl Personal Representative o Counsel for personal representative " .( 8 Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 phone: (717) 240-6345 Date: 9/15/2005 WOLFE JOHN L JR 19 BURRELL RD LEBANON, NJ 08833 RE: Estate of DOUGLAS JACK LEROY File Number: 2001-01061 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. 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: 10/31/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~~ GLENDA FARNER STRASB~DGH REGISTER OF WILLS cc: File Counsel Judge \-~ I c,.5(/, U...J c::> t;~ ~; r~: ~~"j '_~Oo\ ... 0\0'\ Pursuant to Rule 6.12 of tlie Supreme Court Orphans' Court Rules, I report the "'lith to completion of the administration ofthe estate: 1, State \vhether administration ufthe estate is complete: o No i1l 2, !fthe answer is No, state \vhen the personal representative reasonably believes that the administration be complete: F~'b \ ~ ()Oc. 3. lfthe answer to No.1 is Yes, state the follO'lving: a. the personal representative Yes 0 0 a final account b. Orphans' accoUt'1t is: for c. state an account to the m o c. Copies of receipts, releases,joinders and approval accounts may be filed v,tith the Clerk attached to this report. Da~~~ ~J, ~ :\b"'- "" ~() \ ~ ~ c- Name If') tn _..~~~.~ur~\~,_..~~~,~__ \.-e.,'o~ N"J" o~8)) lqo&J r-,~ - OS-~~ h'(,. c.:::.: C'J r-- c.) C) w":) C~ = ('''-./ (.. J~ "'~ .. , -,", Register of Wills of Cumberland County Estate No.: ::ro.~\<. / () f3..L/ ~ 0 0 '" \ - C> I - J Ob I STATUS REPORT UNDER RULE 6.12 OOU~\~ hc.t"-O 1 Name of Decedent: Date of Death: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following wah respect to completion of the administration of the above-captioned estate: L State whether administration of the estate is complete: Yes 0 No ~ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: o C-\.o\>c(" 1:;'- ~OO i. I 3. If the answer to No.1 is Yes, state the following: a. DId the personal representative tile a final account with the Coun? Yes 0 No 0 b. The separate Orphans' Court No. (if any) for the personal representatlve'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 offormal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. ~h_l ~1W Sl re L Luo \~ Date: j4r~\ ~~ ~ OO~ , ~'^- Name - 0("' \q ~cye-\ \ ?J. Address ~.b~ tJJ" ()88~J tr'd . 00 t., ,. J.tlno:Fsvx JUJF1Wno dO }jiJJ'7!fdt/O 2e :Z HrJ ~C YcJV gOOl -.9 08 - 8 3~ - OS;)/ Telephone No. Capacity: rsa Personal Representative o Counsel for personal representative ,\'"'; ltl. !r': l l///; t .''''', < _ "':'U" . !~ (j";.' t .'{..' -., - ::JJu,Jn ",~~.i..i,)-';l I.:J.::JV 'nar '.' . ~'./ U.::JI t 'CIJ" ~... ....;! f -.i(1 [J) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/26/2007 CJ ~', 1 r..,,) -r,-') ,;- ~,:) --' WOLFE JOHN L JR C~ ( ~) -1 I r'0 19 BURRELL RD LEBANON, NJ 08833 :-:,. 'j:) (11 G~' RE: Estate of DOUGLAS JACK LEROY File Number: 2001-01061 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: 10/31/2007 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. Si~Cerel~y, ~ ' ,/'. ,I ~ . ,uv J/1';;.) , . Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF ~\(..('" \~ COUNTY, PENNSYLVANIA Name of Decedent: r. ~d(. "'~C"'t>1 ~O"a \ ~ Date of Death: 1 b \ ~ \ \ ~ 00 , File Number: ~OO I 1010'" 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: . . . . . . . . . . . . . . . . . . .. DYes ~No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: F~~. \ ~oo? 3. If the answer to No.1 is YES, state the following: a. Did the personal representative file a final account with the Court? . . . . . ., 0 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 informally to the parties in interest? ............................... DYes 0 No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date oo? Capacity: ~Personal Representative 0 COlillsel jo","- '- Wo\~ ~r Name of Persoll Filing this Form \ 0. ~ U'l"f"(,< \ \ ~J Address \...e~~~ tv::r oB8 3.3 TelePho~ ~ e 3d - OS~j r- w~ ~ In Re: Estate of DOUGLAS JACK LEROY ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 2001-01061 NOTICE OF FAILURE TO FILE STATUS REPORT Personal Representative: WOLFE JOHN L JR I >i Counsel for Personal Representative: r ~~ Date of Decedent's Death: 10/31/2001 The Orphans' Court record indicates that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, is hereby given by that the you have ten (10) day to file the Status Report. If the required 6.12 forn1 is not filed in accordance with Rule 6.12 the Court will be notified of such delinquency and the undersigned will requests that a Court conduct a hearing to detem1ine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. ~ ~.Lt- /) x/l4U&L ~vW~&U j4auh~;fA:.) Date: 10/31/2007 Glenda Farner Strasbaugh Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File p JRD/June 30, 1992/17858 In Re: Estate of Jack Leroy Douglas : ORPHANS' COURT DIVISION Late of Shippensburg Borough : COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY Estate No.: 21-01-1061 : PENNSYLVANIA : : NO. 21-01-1061 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: John L Wolfe Jr Counsel for Personal Representative: Date of Decedent's Death: 10/31/2001 Date of Delinquency Notice: 08/11/04 The undersigned, Glenda Farner-Strasbaugh, Clerk of Orphans' Court, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Clerk of the Orphans' Court on April 30, 2004, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Glenda Famer Strasbaugh Clerk of the Orphans' Court Distribution: Personal Representative Estate File A hearing is scheduled for at in Courtroom No. 3. If the Status Report is filed prior to the hearing date, the hearing will automatically be cancelled~,~ ~ ~ ,.~,, STATUS REPORT UNDER RULE 6.12 Name of Decedent: "~ O ~2 ~ lC&& ) '~-O,C~I <. L~ V'O¥ O/a, ] oo, Will No.: OO1 --Oleg i X n. No.: -0}' Pursuit to Rule 6.12 of the Supreme Corox Oph~s' Cou~ Rules, I repo~ the following with respect to completion of the adm~s~ation of the above-captioned estate: 1.State whe~er a~istration of the estate is complete: Yes ~ No ~ 2. If~e ~swer is No, state when the personal representative reasonably believe~ thru ~e a~s~ation will be complete: ~ c- e.*~ 3 ! ~ O O 5 t 3. If~e answer to No. 1 is Yes, state the follow,g: a.Did the personal representative 51e a ~al accost with ~e Co~? Yes _ No ~ b. The sep~ate OCha~' Co~ No. (if any) for the personal representative's accost is: c. Did the personal representative state an account informally to the parties in interest? Yes [~] No ~--]' c. Copies of receipts, re/eases, 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. Name [ ~ :::}~ Telephone No. '?4 , Capacity: [] Personal Renresentztive "" "~ ~1 Counsel for personal representative Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/15/2005 WOLFE JOHN L JR 19 BURRELL RD LEBANON, NJ 08833 RE: Estate of DOUGLAS JACK LEROY File Number: 2001-01061 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. 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: 10/31/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~~ 55;;~J.1&4 ~ ;J , ~ GLENDA FARNER STRASBAUGH REGISTER OF WILLS cc: File Counsel Judge \-Cr o ~~s 0:.: c, <:.5 LJl c,r.; :r ~t,,\( h('nJ,\ C(N~\ ~ _1S?J:UJ aO 0 ) ~f)O\ .. 0\0'\ Pursuant to Rule 6.12 of the Supreme to completion administration 1. whether administration o jj1 I report the foHowing estate: estate is 2. If the answer is No, state \vhcnthe personal representative reasonably believes that administration be complete: F~'b l A bOt. 3. If the answer to No. 1 is )res, state the lJ") If') - cz;:( f5 '-c" f;~:: (5 M l- t..) a I.r.> = => <---J a. b. The account c, o No rdeases,joinders accounts may be v,lth attacbed to this report. Date: ~&o~ c. state an account to the parties approval of formal or informal and may be ~~~ \..o()\~ 1"("' :rc.~ \... Name '0, ...~u~~\ \ ..~ \\J \-.e..'o~ N"J' o'l>8 \) lqo&) f'~.,. - ~_. 1'lCl n L...J J~ Register of Wills of Cumberland County Name of Decedent: :r 0.. ~ \< Date of Death: 10 f~ ~ 0 0 Estate No.: ~ \ - C> I - JOb I STATUS REPORT UNDER RULE 6.12 Oou~\Ck) 'he~ '1 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following WIth respect to con1pletion of the adn1inistration of the above-captioned estate: 1, State whether administration of the estate is complete: Yes 0 No ~ 2, If the ans\ver is No, state vvhen the personal representative reasonably believes that the administration will be complete: 0 e:{o'o (r , ::>- ~ 00 6 , 3" If the ans'wer to No. 1 is Yes, state the following: a. Did the personal representative file a final account \vith 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. ~h~~ ~~~ Sl re ~.. luo \~ Date: j4r~"\ db J.OC)' , - JC)~_ Name - dr '" ~cv-c-\ \ ~. Address ~~h~ tvJ 088~J trd '()t! (i" '. .LCif]o::/g~ 1[[:JFJrvno :10 )fJj'f'jdliO Zt :Z /.lei 'TZ ~elV gOUe got) - 8 3.J - OSdl Telephone No. Capacity: JSa Personal Representative o Counsel for personal representative (-:"7 1/. t v I II/V; "'0 "1~ . -' ::JJI-J-I/J ,""'J -.I..., i.J ' ) /11 ( , !...J.JI I;' 'J " \.,j.c......) ....)1" ....i':J (!) Cumberland County - Register Of Wills One Courthouse Square Carlislel PA 17013 Phone: (717) 240-6345 '.:J 1') c::) t:::;.) -.l o C) -1 I N Date: 9/26/2007 C) c:;~ WOLFE JOHN L JR -:l " ~-::-.." 19 BURRELL RD LEBANON I NJ 08833 (~) -il ( "1) ~..... \1.:> C') ( 11 Ul O. ,-,.,.,....: RE: Estate of DOUGLAS JACK LEROY File Number: 2001-01061 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 I NO. 103 SUPREME COURT RULES DOCKET NO. 11 for decedents dying on or after July 11 19921 the personal representative or his counsel, within two (2) years of the decedent's deathl shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 10/31/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report I please disregard this notice. SincerelYI ~~d~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF ~\(..(" \~ COUNTY, PENNSYLVANIA Name of Decedent: r. ~~\(,. ~e.\"'t>1 Date of Death: ) t> \ ~ \ \ ~ 00 \ ~O"a \ !"N} File Number: ~OO I .. oJ 0 , f Pursuant to Pa. O.c. Rule 6.12, I report the following with respect to completion ofthe administration of the above-captioned estate: 1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . .. DYes f!rNo 2. lfthe answer is No, state when the personal representative reasonably believes that the administration will be complete: F~~. \ ~co? 3. lfthe answer to No.1 is YES, state the following: a. Did the personal representative file a final account with the Court? . . . . . .. DYes DNo 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? ............................... DYes D No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. oo? Date .pc \...... Capacity: nslPersonal Representative 0 COlillSel jo\.vw... \.... Wo \ ~ ~r Name of Person Filing this Form l <\ ~ V'rf"CI \ \ ?.cl Address \-e-~~",^_ N:r 08833 83d - OS~J t qoe) Telephone , ; (/.~ ~ In Re: Estate of DOUGLAS JACK LEROY ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 2001-01061 "'--' NOTICE OF FAILURE TO FILE STATUS REPORT Personal Representative: WOLFE JOHN L JR Counsel for Personal Representative: ( -~ Date of Decedent's Death: 10/31/2001 The Orphans' Court record indicates that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, is hereby given by that the you have ten (10) day to file the Status Report. If the required 6.12 fom1 is not filed in accordance with Rule 6.12 the Court will be notified of such delinquency and the undersigned will requests that a Court conduct a hearing to detem1ine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. ~ (4" ~ 11 ,I) ~I... - - - .,..~ o~- 1-7 I; .~ ~~_ ~~~U .;~" /&1y{"h'-<;~4ft/ Date: 10/31/2007 Glenda Farner Strasbaugh Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File Cumberland County - Register Of Wi_Lls One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 9/26/2008 WOLFS JOHI~T L JR 19 BURRELL RD LEBANON, IJJ 0 8 8 3 3 RE: Estatf= of DOUGLAS JACK LEROY File TJumber: 2001-01061 Dear Sir/Madam: N __~ `XJ ~.) N . y ~ _ i°T'~ ' ~ ; ""tJ _ .-_ .mil >~: ~ . _. l `A' s~ - . -~ ~ - ~ ~ -~ ~> GJ This notice is to serve as a reminder that the St<~tus 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 daring 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: 10/31/2008 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, cc: File Counsel Glenda Farrier Strasbaugh Clerk of the Orphans' Court ~a. ®.C. ~~~e 6.12 ST`~~'~TS ~~~~ REGISTER OF WILLS OF C U1rri~Q~' ~ ~ COUNTY, PENNSYLVANIA Name of Decedent: OV Date of Death: ~~ 3~r 01001 File Number: e~ 00 ~ ' d, ~ 6 1 D,,.-,,.,-„++„ D.. (l !~ D„ie ~ t'7 r ,-o,-.n,-t+ha Fnllnlx~ino tzrit}7 rPCnPrt to rnmr~lP.Yt(117 C1f t~le ad7111711St1"at1017 Of i ut~uuii~ ~v x u. v.~~. 1\UiIJ v..~, . l..rv... ~.... ..b t--`- r the above-captioned estate: 1. State whether administration of the estate is con~piete :.................... [~ Yes ~ I~To 2. If the answe>"is No, state when the personal representative reasonably believes that the administration will be complete: ~ e,~. ~ 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? ............................... ~I'es [~ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and maybe attached to this report. Dnte ~~ ~i ~ ~8 --r--T nr, ii ;~ y~ ~,~ .. ~-;c~v .. ~ t Si„ hire of Persai Filing t is Form Capacity: Personal Representative E]Counsel Nnme ofpzrson Firing tl~is Form 1 °~ ~vY~re,~,` 1~~ Address ~b~.,w.. N S o 8 8 33 Ca~1 83a a3-aq ~ etepnone Frrin R41'-i0 rev_ IO I~.D6 t _;~ ~~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 9/21/2009 WOLFE JOHN L JR 19 BURRELL RD LEBANON, NJ 08833 RE: Estate of DOUGLAS JACK LEROY File Number: 2001-01061 Dear Sir/Madam: r.~ 0 `j?~f m 'O c.,~ ~ " i - s ~~ _Ti ['7 c.70~i = ..z -T.~ c~c _ ~ O __ r'.i 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, N0. 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: 10/31/2009 Please feel free to have. If you have this notice. contact this office with any questions you may already filed your Status Report, please disregard S ince~«:~iL7tnV Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF _ (j . ~~r..~ Iqe c-1~ COUNTY, PENNSYLVANIA Name of Decedent: Date of Death: f b~ I ~ ayo I File Number:___ aZOo 1 ~ ~ 1 OG 1 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 ~?n 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: r-mob ~. ~ o ~~ 3. If the answer to No. 1 is YES, state the following a. Did the personal representative file a final account with the Court? ....... DYes ^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 pazties in interest? ............ Yes Q No ................... d. Copies of receipts, releases, joinders and approvals of formal or informal accounts maybe file6d1with the Clerk of the Orphans' Court and maybe 4attached to this report. Drtte~ ~ p 1 t~ ~ A. 111 Si n~re o~Person Filing this Fonn ~,, N Capacity: ®PersonalRepresentative ^Counsel ~... n. ~ ~ - a ~-. i1 , ~_ 6 "` `_~~. ~ Nrtme of Person Filing this Form ~ I U C'7 ll '= ~ ~r AAArest G ~7 ~ ~ V L> '- -~ rr 4~e,~wr.c>v., ~ ~ O 8 8~3 ~ ~ . ~. ~~ o ~ o cap g c> 0 8 8 ~~ O S a Q r ,N _ Telephone I Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone : { 717 ) 2 4 0 - 6 3 4 5 (. ~~'';~L~t;C~1 r~?~~ i~~ ~~~ zaEO s~P ~~ ~~ ~z= o~ c~~~ c~~vv~s c~u~r Date : 9 / 2 2 / 2 010 ~~~~~~`~~ ~ ~ ~~~ WOLFE JOHN L JR 19 BURRELL RD LEBANON, NJ 08833 RE: Estate of DOUGLAS JACK LEROY File Number: 2001-01061 Dear Sir/Madam: This notice is to serve as a reminder that the Status Repot by Personal Representative under Rule 6.12 is due on the belo~nr listed date. ' As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULE, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on o~r 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: 10/31/2010 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. cc: File Counsel Sincerely, /~L.lr° ~~..us~'J1f3'C/' r Glenda Farner Stra~baugh Clerk of the Orphans' Court i~.EC1STci: (;z 1'i"'.LS Gr - lin-'~.~1C.~~1~~~__.__ CQL;:vT'i~, P;=.~iNSYL~~"~.\;?. 1v3me oiDecedent:__ C"C.~~ ~'e c-otit t? ~ ~io~ _-~ D U .: _~ o Oi_' ~ ~ ?te o:'D~ath: t~ oo File i`iu::a~e~• ) '~' ~ ~ iii; jii:iiii iv Du. Q r ~' ie ~^ 77 i .•`., ,,•t t~~e f.~11:M ;:ni ' •a ~?` r_1 f?j thZ c~.vi~~;11jtCat101' Oi .`.~. •~~i v.as, a a t+~• :j L': 1-~~ 7. C`]~''.. tQ C.rm~ .~ Cllr above-ca;~tioued estate: 1. State whether administration of the estate is complete :.................... ~1'es f~N~~ 2. if the ans4vecis V'o, state when the personal representative reasonably believes that the administration will be complete: ~C~, 1 c~ 0 11 . ,. 3. If the answer to No.. l is YES, state tiie follo~~'in~: - . .. ,. ~.. _ _. _ . ; . . a. Did the personal representative file a final~acceunt with the Court?_....... ~YeS ©No b. The separate Orphans' Court No. (if any) fo: the personal representative's account is: c. Did the personal representative stag an account informally to the parties in interest? .:.... ....................... ' ~I'as ~ No . d. Copies o; receipts, rzleases, joinders and approvals of fo~Tnal or informal accounts ntiay be filed with the Clerk of tl~e Orpha„s' l;oui•t and >,nay be a~ ached to this repoil•. -r"r' S:gn .r, t of Ptr:on ;l:i:g ri+is !nr Capacity:Personal Representative [~Couiis'rl ~ _ =s ~.. c~ d ~ `~ q ~o l ~ J ~" tV f"r'" ~ h'r.+::e ojPrrsw, Fifiryrhs Farsr ~ ,.~ `-, ~ ~ ~ a • J`~` ~um1r ~ ~, `'~ Lebe N 3 v ~ ~ ----rte. ~..~ ~ ~.~ Cc~bB> 6 3 ~ - ©sa R -- .- o U Trlr;Sonr cya Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 10/03/2011 WOLFE JOHN L JR 19 BURRELL RD LEBANON, NJ 08833 RE: Estate of DOUGLAS JACK LEROY File Number: 2001-01061 Dear Sir/Madam: ~ T (-' s~ - ~`~~~ Gf ' c,~i ~; -t~`~ ._.~ -; r._. 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, N0. 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. This filing is due by: 10/31/2011 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, ~, ~~ ..___. t 1; .. .. ,...... y. ,. La <,1 Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ~ _ ...i . Y ~^ ` ~ ~. ~ ~,, , ~ -- _ ~~ , . In Re: Estate of DOUGLAS JACK LEROY ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 2001.-01061 NOTICE OF FAILURE TO FILE STATUS REPORT Personal Representative: WOLFE JOHN L JR Counsel for Personal Representative: Date of Decedent's Death: 10/31/2001 The Orphans' Court record indicates that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, is hereby given that you have ten (10) days to file the Status Report. If the required 6.12 form is not filed in accordance with Rule 6.12 the Court will be notified of such delinquency and the undersigned will request that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. .. ,v Date: 11/1/2011 ~ ~' ° ~ ` Glenda Farner Strasbaugh '~,-.~ Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF C v,[,^4j ~ r• ~ ,.. ~ n COUNTY, PENNSYLVANIA Name of Decedent: 1 ~ Date of Death: 1 b ~ ~~ ~ 0100 1 File Number: o~ 00 ] - D) 0 6 1 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: l . State whether administration of the estate is complete :.............. . ..... ^Yes ~O 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: v I X01 7 3. If the answer to No. 1 is YES, state the following: a. Did the personal representative file a final account with the Court? ...... . ^Yes ^No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? .... , ..... , ................... ^Yes ^No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date ~ (~~ ~,' I~ O 1 ~ Form RW-/0 rev. 10.13.OG V~ Signnt r of Person Frling [his For Capacity: [~ersonal Representative [~ Counsel ~ off, ~. lNO 1~ J a~ Name of Person Filing this Form ] ~ uY~c'G ~ I Adds ess ~ 908 83a -osa9 Telephone fi i;~.~ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 :-..: N ~ _~ O ~~ C'~ m / 1J J Date: 10/01/2012 ~~~~_ ~ -~--~F,:~~ V5- - PECHT WAYNE M ~ c'? ; ~„ ~- _~ - < 1205 MANOR DRIVE nC' ~ ~ V" ~~ =~} SUITE 200 ~ ~ ;--- MECHANICSBURG, PA 17055 ~' © `'`~ m RE: Estate of DUNSTAN RUSSELL File Number: 2005-00981 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, N0. 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: 10/28/2012 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, •TilZPr~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) Pa. O.C. Rule 6.12 STATIlUS REPORT REGISTER OF WILLS OF C'y~~Catrc~p,,~,~,t3 COUNTY, PENNSYLVANIA V Name of Decedent: ~o u s,,a, Date of Death: 1b ! 3 1 `ab0 ~ File Number: ~O o~ - O) D(s ~ 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 may be filed with the Clerk of the Orphans' Court and maybe attached to this report. Dnte ' ~ 105 , aQ, ~}. t,~ N ~:~ _~~ i~ r~~` ` - Q1 j ~ -. _~ ~ .. i~ ~ ~? ~J F- V , ~ ~ 1 ~ ~ ~ L,(,j O cv ~ (~ O ~ Signet of Person Filing this For Capacity: ®Personal RepresQentative ^Counsel Name of Person Filing this Form t g ~n-e1~ Address li,,cb ovhp h ~ . 3 C4o8~ 83.1 ''oSo14 Telephone FormRW-/0 rev. !0./3.06 Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 !, <_ Or 3,O P i uy Date : 9/30/2013 Cll( , COURT WOLFE JOHN L JR PA 19 BURRELL RD LEBANON, NJ 08833 RE: Estate of DOUGLAS JACK LEROY File Number: 2001-01061 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: 10/31/2013 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 Strasbau g Clerk of the Orphans ' Court CC : File Counsel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF C U Y%-_�Q COUNTY, PENNSYLVANIA Name of Decedent: ('C) �OJ \u S, Date of Death: 10 I 1 c d© 1 File Number: op 1 O (� 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: QDC-& 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 may be filed with the Clerk of the Orphans' Court and may be attached lto this report. Onfe r) V l � t V V C) CO '--{ � Si nt ire of Person Filing this Form LLJ �~ Capacity: MPersonal Representative ❑Counsel �a 01 ,1 cn w Name of Person Filing this Form 1 J � - IL J rCe1� lk X V) F V CL W Address 1 o �, co � o.x C> Telephone Form RH'10 rev. 10.13.06 Cumberland County - Register__Of Wills One Courthouse Square Carlisle, PA 17013 IRECORQED OFFICE OF Phone : (717) 240-6345 REGISTER OF WILLS 2019 SEP 30 F1,11-9 10 20 CLEF:;: OF ORPHANS' COU�-,y CUMSERL,.;;O 0% ;'A Date: 9/30/2014 WOLFE JOHN L JR 19 BURRELL RD LEBANON, NJ 08833 RE: Estate of DOUGLAS JACK LEROY File Number: 2001-01061 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: 10/31/2014 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. Sincerel Lisa M. Grayson, Esq. Clerk of the Orphans ' Court Pa. O.C. Rule 6.12 STATUS REPORT REGIS'T'ER OF WILLS OF ���„��,� c��c� COUNTY, PENNSYLVANIA Name of Decedent. 7exc-L. O Date of Death: L ' File Number: LSO C) i 0 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 FC]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 fonnal or informal accounts may be filed with the Clerk of flip Orphans' Court and may be attached to this report. f -1 co Date✓ C��7�� C7 . (J) G Sir ure of Person Filing this orm ._J i- r__H c Capacity: ®Personal Representative E]Counsel )©tip h, 1��:o C U3 Name of Person Filing this Form Lt.J N F•- Ga � Li.! U.T Address GJ C 7 M W c.� N Telephone Forst RW-10 rev. 10.13.06