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Home My WebLink About01-0968 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of E \l'G IOd2- Z1 W. l!.. ~ 0 Y Lee. No. ':V..::OJ - q ~ B also known as -1-1 rr:" r{ (jY J r) J To: Register of Wills for the p Deceased. County of t1 l~ ~ f3 GAlAftln the Social Security No. ~ct -. 1 z.. -de;; 7 L- Commonwealth of Pennsylvania The petition of the undersigned resp~IlY represents that: Your p~ti!ioner(s), who is/are 18 years of age or older, appl y G. V l;::~;;;-;r l JJ, 0 R (1 ~ LE- (d.b.n.; pendente lite; durante absentia; dura te mmontate) the above decedent. for letters of administration on the estate of Decendent was domiciled at death in C' Ul).,1 0EfRL~ tv 0 County, Pennsylvania, with h \ c: last family or principal residence at I Dq [\. G- ~ L (; nJ() LT d J,... PI (II E E.. ~ ~ I- (list street, number an municipality) I-::::t? IV-IV S ~tI '" d 7 c.vl d ,~2~/ 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: 5l- ( ~ W ~ R'T =6 V (t-L.. & + ~itJqS~~tl&Nni-T 1 A-tVji;Z/ $ $ $ $ t> '2. ,. 2 a-d-l7 OCJ ,) ,1rJ ~ <J ~D E fVtJ I..., A -S-S>2. t,1J-eJ vv Efl)~ L u4 ~/.l F+ /."Ir1, ~ ~D ,I . ' . 3 CJ M-O .00 I Petitioner_ after a proper search h~ ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name Relationship Residence ~ '\ IE? S r" 1./ 'e .. ('7CFl:....1' THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. .e II) u r::: II) ~3 II) .... t:':~ ~o co.;::: ~..;: 3~ II),+-< 50 ~ r::: bI) iJ5 t/- ~j//~ 8. ~ f 6 q S G- k , tS- IlJ t!J L r:- 1 Ll- ,uS L? tv t) L v=l-j .p J!I } ...., CJ z... J" /7-/5-1/ PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of E I/'G: jIJ, l2- '1 Wl. C!. ~ () Y Lh. No. :V -Q 1- q ~ a also known as j' P/ F{ (j)" , f")1 To: Register of Wills for the t? Deceased. County of tt l\ 1A.-( B E~U(Mn the Social Security No. ~'1 ~ 1 z.. -de;; 7 7-... Commonwealth of Pennsylvania The petition of the undersigned respe~llY represents that: Your p~ti!ioner(s), who is/are 18 years of age or older, appl r G.V t=:~;;;-;r l tJ, (\ oR. (? 'i LE (d.b.n.; pendente lite; durante absentia; dura te mlOontate) the above decedent. for letters of administration on the estate of Decendent was domiciled at death in (\ UlM 0EfilLr4 tv D County, Pennsylvania, with h \ c: last family or principal residence at I D9 \.~'G- ~ L G nJ()LT d /..... A f\lE E.. ~ ~ .,- (list street, number an municipality) I~Jt.I'IZ/,g I3tJtJ,d 7a; d 't9=:'2.dJ / 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: ;;. ( 6 WE f(""T =6 V "_.t-.. & + ~i ocr S(i:/'<.I&Nnl-r L I+IUGZJ $ $ $ $ ~'23Z ~CJ(:') ,) ~H'1 1< (j e*[) E rv tJ (, A .i' ~2 IYMJ vv Etl)(j L L4 ~A. J:f J,'1({ ~ ~D " . . 3 CJ ~ oa l Petitioner_ after a proper search haL.. ascertained that decedent left no will and was survived by the following spouse (if any) and heirs: Name Relationship Residence fZ' G= srr;lU 'G? .. .r 7 d'l:.. "1' THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. ~ v u c: v ]3 v.... p::~ -00 c: '';: ~.;::: 3~ v,- 30 ~ c: bO en v' ~//~.~ e. ~ I 6 q S G-I? , c:;. II.J t'JL. r: 1 A ,tJS f?1V~Lvtl PJ!I JfOZ.~ /7-/5-1/ This is to certify that the information here given is correctly copied fron: an original certificate of death dul~ filed with me as Local R~gistrar. The original certificate will be forwarded to the State Vital Records Office for permanent fIlmg. WARNING: It is illegal to duplicate this copy by photostat or photograph. p, 7691431 ~~~MI rf[1,~ ~rf Local Registrar Fee for this certificate, $2.00 No. (J(' ~ 1 5',1 d-()O L Date 21-2001-0968 Hl05.143R....2J87 COMMONWEALTH OF PENNSYLVANIA · OEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH TYPE/PRII'll IN PERMANENT BLACK INK W UNDER I YEAR _ Do~ SEX I a.JYlA e. s....n ,..( NUM8l!A SOCIAl. SECURITY NUMBER 3.0S't - IJ... DAJEOfOEATH,_.Oa.. ..., 4. Mcbt.(" 12, .J.DO I BIRTHPLACE IC'" and 3aaIe Or fa""Jl"l COtJNryl PLACE Of DEnH ICtoeck ClI'ly """.. '" 'not......,.,. on _ _I HOSPITAL: ,,-_0 :=1v,O I. COUNTY Of DEATH RACE ._IndIa... _. _. ..., (SilecIvI lviII TI SURVIVING SPOuSE 'M_.\IO"'-_' NAP,,- Tl;".,J/4 ..... ~ ./ o UJ ell ::l ell 4: :; 4: ,?;/ J De. !ME Of ~H /. /1/- :N. I r':> III 27. PAfIT I: Enear 1M ......... intufies 01' c:ompk:a-... which caused the death 00 not: enlerlhe mode ot dVinG, sucn u card&ae or '.spifiltQ#y ."01, ahocIl Of heM failure L.. 0RIy one ca..- 01\ um.... 1- ~ ~--eA- dc-'c~ I: WERE AUlOPSY FINDlNGS AIAllA8LE PfllOR 10 COMPLETION Of CAUSE OF DEATH? -..... {} o DnE OF INJURY (Month Oay, "".., TIllIE OF INJURY INJURY n WORI<? DESCRIBE HOW INJURY OCCURRED. Homocide o o o Yee 0 NoD Ace_ Pendtng lnve......lton \.,.. ~ _ 0 No~ Yee 0 >>e. 2.... CERTII'IER IC~,_ oroy oneI .canlf'YlNG PHYSICIAN (Physctal'l cet'1II>t1f\g cause ~ dealtt wI'1ef1 olfIOIhef otIVSlC.an has pronounced dealh ana CallplQled l1em 23) To... be.. 01 lilY k......IecIge. deOlh occu.... _10.... C.uoe(oI_ m......' .. .10..... . . . . . . . '. No)4 _ode Coutd naI be del.rm&n8d l,;u l,aZ.J .'1021 I. (9J;Z~V IS; v1 00 / I as. ~ ~ tcl o o UJ ~ Z 'PRONOUNCING AHa ClERTII'YING I'tfTSICJAN ,Physoc"", bolI1 ;J<o'"",tlOOg <Ie'" a..d <""~yong '0 cause 01 ""a",1 To &he be-a1 o. my "now~. aaahoccur'"........... d.... and place. and due 10 the CauM(I) and menn.,.. 1..tN. 'MEDICAL EXAMINER/CORONER ~~~::~:i:t::=~~.i~~t.I~.a.n.~~ ~~~~~t~~~..~~: i.~ ~.y. ~~~~i~~: ~~~~~ ~~~~~~~~ ~~ ~~~ ~,~~..~~t~: ~~.~'~~~: ~~~.~~~ ~~ ~~~ ~~~~~~~).~~ 0 Jh , JRD/Ju1fe 30, 195\211785\ NOV <<>> 3 2004 In Re: Estate of Everett W Croyle Late of East Pennsboro Township ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA Estate No.: 21-01-0968 NO. 21-01-0968 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: Mary E Croyle Counsel for Personal Representative: Henry F Coyne Date of Decedent's Death: 10/12/2001 Date of Delinquency Notice: 08/11/04 The undersigned, Glenda Famer-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 ~ ~ ~-,kN.jJ Glenda Farner Strasba~- J..... Clerk of the Orphans' Court Distribution: Personal Representative Counsel for Personal Representative Estate File ~~IV lai~~oif q~~D A. M. 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. i} A":' :f-/' -,' f' _~.,' Jo.".- ~. ri '-"} )i'" ".:' "..'"......\1.... .tf;u.\ J ,;/,",.." George ~;/Hbf{et, P-)J'l U") IT1 IT1 r-=I .::t" CJ ru r-=I r-=I CJ :;€. :1: led Fee CJ CJ !!l' Ro:' :1 apt Fee , I' B n nllll'quired) Postmark Here CJ ,..:j ( " CJ r-=I I ; (tIC Del v 3ry Fee "'1111 nt ,: IE quired) IT1 CJ CJ I""- p,,~ ago .~ Fees $ ~ I :~ i No:;' .--.---(~~~---------------------------------------________ 3o.r 10. , > a'tl;: ~ip.::r-.------"--------------u------u----------------______-------_____ . II~II~I 111,1' .1 0, June 2002 See Reverse for InslruclIons I::[J nJ IT1 r=1 U.S. Postal ServiceTM CERtiFIED MAILTM RECEIPT (Domestic Mail Only; No Insurance Coverage Provided) .::t" CJ ru r=1 r=1 CJ CJ CJ CJ r=1 CJ r-=I IT1 CJ Sent To C ~ SiRi9i,AiifNii.;-n----~9-t~f--------nm-----------.-uu---------mum----- or PO Box No. Ci,y,-State;Zipt.4--u----------..----u----------u--u-------n__________n_u________ Postage $ Certified Fee Postmark Retum Reclept Fee Here (Endorsement Required) Restricted Delivery Fee (Endorsement Required) Total Postage & Fees $ PS Form 3800, June 2002 See Reverse for Instructions SENDER: COMPLe;; rE 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: CROYLE MARY E 109 SRIGNOLI LANE EKOLA PA 17025 o\~ \\ \ /~ ...... VQLllJed Mail 0 Express Mail o Registered 0 Retum Receipt for Merchandise D Insured MaU 0 C.O.D. 4. Restricted Delivery? (Extra Fee) Dyes 2. Article Number /Transfer from service label) PS Form 3811, February 2004 Domestic Return Receipt 7003 1010 0001 1204 1328 102595-()2-M-1540 .. . . COMPLETE THIS SECT/eN ON DELIVERY . 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: ived by ( PrlntedName) IJItL. 11. 0" L ~ D. Is delivery address different from item 17 tar delivery address below: COYNE HENRY F 3901 MARKET STREET CAMP HILL PA 17011 / ,pe rI Certified MallO' Express Mall DRegistered 0 Return Receipt for Merchandise o Insured Mall 0 C.O.D. 4. Restricted Delivery? (Extra Fee) 0 Yes 2. ArtIcle Number (Transfer from service label) PS Form 3811 , February 2004 7003 1010 0001 1204 1335 Domestic Return Receipt 102595-02-M-15<W E ---- CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: EVERETT W. CROYLE Date of Death: 10-12-2001 Will No.: 21-01-0968 To the Register: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on October 17, 2000: Name: Address: Mary E. Croyle 109 Sgrignoli Lane, Enola, P A 17025 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: None COYNE & COYNE, P.C. Date: fC\ tJd \I {; ) . BY: <'L isa Marie Coyne, Es 901 Market Street Camp Hill, P A 17011-4227 (717) 737-0464 Pa. Supreme Ct. No. 53788 Counsel for Personal Representative N ',j- () 'r':' t,:: ~ ,""' ....' ,J 1.,.1". ,') 'j - ...... ~ i.:~~ ,t', OL:,' om O>cc a: N :::;::... o z . f~~ p (j) ~.o -.... s:: 1.1) = DO \ /?-/6-:-/~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. Z8D6Dl HARRISBURG, PA 171Z8-D6Dl NOTICE OF INHERITANCE TAX APPRAISEMENT I ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE '02 DATE ESTATE OF DATE OF DEATH FILE NUMBER D 1 50 COUNTY ACN Nj\ Y 31 LISA M COYNE ESQ COYNE & COYNE 3901 MARKET ST CAMP HILL 05-27-2002 CROYLE 10-12-2001 21 01-0968 CUMBERLAND 101 *' REV-1547 EX AFP (01-02> EVERETT W L PA 1704!1T::.:, Allount Rellitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLEI PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ HE-V =is4j-ix--AFP--rcff=ozi--Ncji--ici--OF-'rNHiiiiTiifcE-i"A'x-'1rpPRA-isiiiENT~--AL1-owiNcE-(ri------------ ----- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF CROYLE EVERETT W FILE NO. 21 01-0968 ACN 101 DATE 05-27-2002 TAX RETURN WAS: (X) ACCEPTED AS FILED CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and 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 F) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) (5) (6) (7) 91.000.00 51.475.60 .00 .00 19.317.31 .00 83.854.79 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 25,414.54 68.730.45 (11) (12) (13) (14) (15) 1511502.71 X 00 = (16) .00 X 045 = (17) .00 X 12 = (18) .00 X 15 = (19)= NOTE: To insure proper credit to your accountl subllit the upper portion of this forll with your tax paYllent. 2451647.70 94.144 99 1511502.71 .00 151,502.71 TAX CREDITS: . .... ........ ""'...."'....-. (+J 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 INDICATEDI SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $11 NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)I YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) REV. 1500 EX + (&.10' . COMMONWEAlTH OF PENNSYLVANIA DEPARTlolEHT OF REVENUE DEPT. 2llO601 HARRISBlRi. PA 17128-0601 REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT ~ OFFICIAL US~ Oi'le Y /~- 16./~ / I / FILE NUMBER 21 2001 0968 NUMBER DECEDENT'S NAME (lAST. FIRST. AND MIDDLE INITIAL) CROYLE, EVERETI W. COUNTY CODE YEAR SOCIAL SECURITY NUMBER 059-12-0572 to- Z III C III o III C 10/12/2001 THIS RETURN MUST BE RLED IN DUPLICATE WITH THE III to- lC:~~ ldILg :J:~... OILm ~ (IF APPLICABLE) SURllMNG SPOUSE'S NAME ( LAST. FIRST AND MIDDLE INITIAL) CROYLE, MARY E. aa 1. Original Relm1 C 2. Supplemental Return C 4. Limited Eslale C C 6. Decedent Died Testate (Attach copy C of Will) C 9. Litigation Proceeds Received C REGISTER OF WILLS SOCIAL SECURITY NUMBER 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach copy of Trust) 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) o 3. emaln er e um e ea pnor 0 o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sell 0) rhto- l:!ifi lRM NAME (If applicable) 3901 Market Street o:!i! Coyne & Coyne, P.c. . 00 Camp Hill, PA 17011-4227 OIL ElEPHONE NUMBER 717/737-0464 1. Real Estate (Schedule A) (1 ) 91,000.00 OFFICIAL USE ONLY 2. Stocks and Bonds (Schedule B) (2) 51,47 Y.:-,"60', C 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) NEjne r.......j 4. Mortgages & Notes Receivable (Schedule D) (4) None 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 19,317_31 (Schedule E) l'J 6. Jointly Owned Property (Schedule F) (6) None z o Separate Billing Requested 0 5 7, Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) 83,854.79 :> (Schedule G or L) to- 8. Total Gross Assets (total Lines 1-7) -'(8) 245,647.70 ;;: < 0 III 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 25,414.54 0: 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 68,730.45 11. Total Deductions (total Lines 9 & 10) (11 ) 94,144.99 12. Net Value of Estate (Line 8 minus Line 11) (12) 151,502.71 13. Charitable and GDvemmental Bequests/Sec 9113 Trusts for which an election to tax has not (13) been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 151,502.71 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, 151,502.71 x .00 (15) 0.00 or transfers under Sec. 9116(a)(1.2) z .045 (16) 0 16. Amount of Line 14 taxable at lineal rate x !;i !; 17. Amount of Line 14 taxable at sibling rate (17) IL x .12 ::E 0 0 ~ 18. Amount of Line 14 taxable at collateral rate x .15 (18) 19. Tax Due (19) 0.00 20. 0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) *' SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CROYLE, EVERETT W. I FILE NUMBER 21 - 2001 - 0968 All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged between a willing buyer and a willing sellerL neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property whicti is jointly-owned witn right of survivorship must I)e disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 91,000.00 816 Wertzville Rd., East Pennsboro Township, Enola, Cumberland County, PA See Attached Settlement Sheet TOTAL (Also enter on Line 1, Recapitulation) 91,000.00 . A. Semement Statement U.S. Dlp"'lIIlnl III HlI\Illng .nd Urliln Olnlllpnllnl ttr " I OMB No. 2502.0285 (E1lp. 12-3'.... L. tIM ot t.oM II. Fit - I:' I-. - II. ......... -- COlI - l. 0 FHA .2. 0 FmHA 3. 0 ConY. UnlnL ".0 VA 8.0 ConY. '111. -.579- 0/ 0. Nllle: r'~~Ir':' :~k~'~~O.:~! =. ~tr:::r''': =. ';=1I~1~~~ = ='1": J:,lcI".:f~'1 ~~~ ':.!.:t":::":.J'CU: In IhI 1011'1. D. ..... end Addr... .. lor..,... :i)I1UIO K. ;3V1U..~ '/11-'/ w~~rZvli..<..t' "f"....o . C..){u..;1, ;1.4 /10:2S Q. "-" loA.... J' / G, oJ.: /l Tl. 11/ LL E- ,.fa A D E"vtllJ1, jJ,4 17<J.;zs- 1._"'__"_ P._..._....llonlIo< AlAteV C. (?~ov~e The First National Bank of I/</,.".v, J r.e" rl'(,,, ,oj Harysville 'n4e- fSI,,/~ '1' &uJ u/.Cc-oYLC 101 Lincoln Street /09 ..:klt,,,,,",,.,,-, ;:'/h"'- arysville I PA 17053 t~VL-JJ !7().2.S H. ..._ .-.... I. _ Dolt 17070 IO~~1 120. Groal AlIIlIIInl DII. FflIlII Borrower 200. Amounll PIId Iv Or In 8,11111 01 lonower . uo I n m 201. Dennsll or elrneal ITIOI1IV I/Jr)/). () , SOl. Excess derJoslI Isee Inslrucllonll 202. Prlne"'l lmount of new Ioenfll x,fO.~>? 00 S02. Selllemenl charaes la seller Itlne 14001 9/J'''l/. ()7 203. b'sUna loIn1sl liken subl.cl 10 S03. Exllllna Ioenlll liken Iublecl 10 204. 50.4. Plvoll of 11111 morlalae toen LtL (A5 a,3 0. -IS 205. 505. Plvoll ol I'cond lIIOIllI8ae Iolin / 208. 508. /D9 .:y.,4/~tO',", llf,,)~. t!:/f,Jo4.11 207. 507. 208. 508. , 209. 509. Adlullm.nl. 101' lI.m. unOlId I" liner Adlullmlnl. 101' IIlml unoeld bv 1111er 210. Cllvllown lexII 10 510. Cllv/lown 'Ixes la 211. tounlv Ilxea 10 5\1. CounIY llxes la 212. "'"umenls 10 512. "'Ieaamenll 10 213. 513. 214. 514. 215. 515. 218. 518. 217. 517. 218. 518. 2111. 5111. 220. Tolll ,.Id B,IFOI' Bllrrower cf'ft?/N. Id 128. Tol.1 Reducllon Amounl OUt .... 1~11PI... 5 ..L- I~// ~~ -, %- Paid From Borrowars Funds al Sattlamenl Paid From Seller's Funds al Settlament .J d.i The First National Bk. of Mar (!.. months months monlhs monlhs monlhs months monlhs months 10 10 to to 10 to \0 to $ $ 'r.o7 1400. Tol.1 S'llI.m.nl Ch"ll" tln'ar on Iln.. 103, Slellon J .nd 602, S.ellon KI ,00 ..._.... . _. ___............_ ..._.v.~""""""",u,"'~'U'Q~ . SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER I 21 - 2001 - 0968 ESTATE OF CROYLE, EVERETI W. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1 DESCRIPTION UNIT VALUE VALUE AT DATE OF DEATH 51,475.60 37 $1000.00 US Series EE Savings Bonds-- See Attached Inventory Calculation TOTAL (Also enter on line 2, Recapitulation) 51,475.60 M 4- e M Q) 0'1 rtJ a.. l- e 4-1 rtJ :::J U rtJ U "0 C o I:C Ul 0'1 C > rtJ (/) I I 1ft ~ ,. i I" < 10 ~ GI J:I E :J Z Ia 'i: GI U) C 1~ C -tIT GI o .... :00 ~~ SOO C'1"4 1-f0 ON t:iA- GlO :JU) . lain >" -'It Ia .. ....'P't Oln 1-iA- .... 1ft 0 ~U) GI . ....In C" 1-f0'l iaN ....M 0iA- I- Bg 'i: ci D.o -In Ia .. ....00 0'P't 1-iA- 1ft 'tI C" o . CD M =1:1: 11111111111111111 GI .... o z ~~~~~~~~~~~~~~~~~~ jij'i: 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 C:J N N N N N N N N N N N N N N N N N -...."""""""'" u"1a",, ~ ~ L/"') L/"') """" """" """" M M N N M M M N ~ooooooooooOOOOOOM NNMMMMNNNNNNNNNNM 00000000000000000 00000000000000000 NNNNNNNNNNNNNNNNN """""""'" M M N N M M """" """" """" M M N N M M M N OOMMMMOOOOOOOOOOM - .... Ia )( :J GI ~ z~ c( .... 1ft ;R;R GlGIO 0 ~.... 0 0 GlIaOO ....0:: C """" """" I-f ;R ;R ;R 000 M M M M M M ~ ~ ~ ~ M M M M M M M M ~~'#'# M M M M M M M M """" """" ~ o o """" """" o 0 0 0 00 """" """" """" """" ~ ~ ~ N L/"') L/"') L/"') M M M M .... .... ..... ..... MMMMM ;R o o o """" o 00 """" N M .. M """" o """" ~ L/"') M ... ... M M """" """" """" o 0 """" """" ~ ~ L/"') L/"') M M """" o """" ~ L/"') M ... """" """" """" o """" ~ L/"') M ... o """" ~ L/"') M ... M o """" ~ L/"') M ... M ... 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M M M M M M M M M M M M M M M M 1ft GI ~ W W W W W W W W W W W W W W W W W Glwwwwwwwwwwwwwwwww U) L/"') L/"') L/"') L/"') L/"') L/"') L/"') L/"') L/"') L/"') L/"') L/"') L/"') L/"') L/"') L/"') ~ 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 0'1 0'1 0'1 0'1 0'1 0'1 0'1 0'1 0'1 0'1 0'1 0'1 0'1 0'1 0'1 0'1 0'1 M M M M M M M M M M M M M M M M M """""""'" ""~~L/"')L/"')~~~MMNNMMMN oooooooooOOOOOOOM ~wwwwwwwwwwwwwwwww Glwwwwwwwwwwwwwwwww J:I0L/"')"0'IL/"')MOML/"')0'IL/"')0'I"",,"~NN" ENL/"')L/"')MOoo~O'IMO~MMM~MN :Joo"~MMNNO~~L/"')L/"')~MMMM Z N N N N N N N N " " " " " 0 0 0 0 _OOO'lO'lO'lO'lO'l"MMOOOL/"')L/"')L/"')L/"') 'w ~ ~ 0'1 0'1 0'1 0'1 0'1 0'1 ~ ~ ~ ~ """" M M M M ~O'IO'1oooooooooooo""""""""" ~ E E E E E E E E E E E E E E E E E GI GI :J.... 1ft Ia .!Jo Savings Bond Calculator Page 2 of 3 m7350086EE 11/1984 EE 1,000 500.00 856.40 1,356.40 4. 110/0 11/2001 11/2014 [III , , m7350051EE 11/1984 EE 1,000 500.00 856.40 1,356.40 4.110/0 11/2001 11/2014 [III m7350039EE 10/1984 EE 1,000 500.00 923.60 1,423.60 4.160/0 04/2002 10/2014 .. m6425508EE 10/1984 EE 1,000 500.00 923.60 1,423.60 4.160/0 04/2002 10/2014 .. m6425495EE 09/1984 EE 1,000 500.00 923.60 1,423.60 4.160/0 03/2002 09/2014 .. m6425485EE 08/1984 EE 1,000 500.00 923.60 1,423.60 4.160/0 02/2002 08/2014 III m6425470EE 09/1984 EE 1,000 500.00 923.60 1,423.60 4.160/0 03/2002 09/2014 .. m6666307EE 08/1984 EE 1,000 500.00 923.60 1,423.60 4.160/0 02/2002 08/2014 .. m6425416EE 08/1984 EE 1,000 500.00 923.60 1,423.60 4.160/0 02/2002 08/2014 I_II m6425396EE 07/1984 EE 1,000 500.00 923.60 1,423.60 4.160/0 01/2002 07/2014 [III m6425368EE 07/1984 EE 1,000 500.00 923.60 1,423.60 4.160/0 01/2002 07/2014 .. m6425341EE 06/1984 EE 1,000 500.00 923.60 1,423.60 4.160/0 12/2001 06/2014 .. m6425319EE 06/1984 EE 1,000 500.00 923.60 1,423.60 4.160/0 12/2001 06/2014 III \ m6425294EE 06/1984 EE 1,000 500.00 923.60 1,423.60 4.160/0 12/2001 06/2014 [III " ., m6425282EE 05/1984 EE 1,000 500.00 923.60 1,423.60 4.160/0 11/2001 OS/2014 III " m5189111EE 05/1984 EE 1,000 500.00 923.60 1,423.60 4.160/0 11/2001 OS/2014 .. m5189096EE 04/1984 EE 1,000 500.00 990.80 1,490.80 4.190/0 04/2002 04/2014 [III m5189062EE 04/1984 EE 1,000 500.00 990.80 1,490.80 4.190/0 04/2002 04/2014 III ",,. m5189003EE 03/1984 EE 1,000 500.00 990.80 1,490.80 4.190/0 03/2002 03/2014 .. m51889911EE 03/1984 EE 1,000 500.00 990.80 1,490.80 4.190/0 03/2002 03/2014 III. 1_IViewing Bonds 1-37 leqend Note Description NI Not Issued NE Not Eligible for Payment M \I- o M Q) Ol CO a.. .......... ~ I I co .......... I.... C I ~ Q) I 0- I.... Q) +-> ~ .n Ul Q) CO I.... Q) Q) Q) .n Ol +-> co C c CO I.... Q) 0 ..c Ol ..c +-> +-> C U co C CO X :J 0 ..c w u E u +-> X 0 co I W Z U M ......... ......... "'0 Ul "'0 "'0 C Q) Q) Q) 0 "'0 I.... I.... CO :J :J :J U +-> +-> Ul C co co Ol ~ :E :E c > Ll) W Z co a.. :E :E (f) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21 - 2001 - 0968 ESTATE OF CROYLE, EVERETT W. Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 DESCRIPTION VALUE AT DATE OF DEATH 19,317.31 Waypoint Checking Account No. 900043035 TOTAL (Also enter on Line 5, Recapitulation) 19,317.31 ~l WayJ:tqi!1J LOOK FOR US. WE'LL GET YOU THERE. 03/01/2002 COYNE & COYNE 3901 MARKET ST CAMP HILL P A 17011 The information which you requested on the account(s) of EVERETT CROYLE DECEASED (Social Security Number 059-12-0572) is/are as follows: J ~. Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of 19317.31 Death Account Ownership SOLE Name of Joint Owner, if any Date Ownership Was Established 900043035 CHECKING 04/26/99 19317.31 Account Number Class of Account Date Opened Principal Balance Accrued Interest Balance at Date of Death Account Ownership Name of Joint Owner, if any Date Ownership Was Established Additional Information Requested ~R SENIOR SERVICES REP, P.O. Box 1711, HARRISBURG, PENNSYLVANIA 17105-1711 Toll Free 1-866-WAYPOINT (1-866-929-7646) . www.waypointbank.com . SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT CROYLE, EVERETT W. FILE NUMBER 21 - 2001 - 0968 ESTATE OF This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes. ITEM DESCRIPTION OF PROPERTY ~A TE OF DEATH %OF NUMBER Include the name of the transferee. their relationship to decedent and the date of transfer. ALUE OF ASSET DECD'S EXCLUSION TAXABLE VALUE Attach a copy of the deed for real estate. INTEREST (IF APPLICABLE) 1 American Express Slective Fund Class A IRA 11,580.76 100% 11,580.76 2 American Express Cash Management Fund Class A IRA 1,015.13 100% 1,015.13 3 American Express Extra Income Fund Class A IRA I 15,579.98 100% 15,579.98 4 American Express Fixed Retirement Annuity 55,678.92 100% 55,678.92 I \ \ I I TOTAL (Also enter on line 7, Recapitulation) 83,854.79 :.~~:: AMERla:N E>FRESS FINANCI~ AW PHa-E NO. 717 975 2700 ....oIId;" .~~.~.. --..... ~ .. .-...-.. ~... . --_..~ .... ...... ---~... -" ...------.-' . ..... ........ , ) ..- ---_.. --- j..aa ';J ......... .... ........-. .,-, .............-.._.. ------ - - .. ----. E dN _..~~-- un ~ .. - ..~..... . " 4 AXP Selective Fund Class A AYJ? Cash Management Fund Class A AXP Extra Income Fund Class A Fixed Ret:irenumt Annuity - Value Plus .. ----. .............- ..Ii_ ,.,. ..:~:=: :: . .. ............. -., ............. -.. ..............- _..~- .. ..... ,'.... . .........' . !II I.d --- ..Ii_ ,. -~.:~. ". ............. _. --- - . ...........-. "-' ~. .-.-.-..._- . - ..... , " ~verett w. Crovle IRA Account Number 0100 539398742002 0011 339398742002 0012 5393 9874 8 002 0931051948533004 Apr. 10 ~ 03: 00PM Pi .. Adnllced Advisor ljroup Wape A. Upe. CfP'I" Senior financial Advisor .CEif\ftD ftw&LfVI,lNER11O . ~onaC . AlRriCu Express Rauc:ial MYisOCS Inc. IDS Lilt ~ Conl,IIIY Suite 200 341 North Front Street WOnnIeysbutg. PA. 17043 Bus: m,97SJ)2(l2 Bus: 800.975.6680 Fu: 717.9751700 12ate of~th Valu~ S 11~580. 76 $1,015.13 $15.579.98 $55.678.92 AmerICan ExpIess financial AIMsoIS h'c. #MtrIbef NASD. An MfA amciatId firaIlcial ~ f1anchiaa.1nswanc& ami aMlli'lie.S art! issued by ItlS life 1nIInnce~. an ~~comllll'Y. A/IleriCIII Elqnss Company is ~t8Ie ftom Am.ran &press FnRial AcMl:Ollllnc. and is nat a bnIlreH1ealcr. . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H RJNERAL EXPENSES & ADIVIINISTRATIVE COSTS ESTATE OF CROYLE, EVERETT W. 'I FILE NUMBER 21 - 2001 - 0968 I Debts of decedent must be reported on Schedule J. ITEM NUMBER A. B. 1. FUNERAL EXPENSES: Neill Funeral Home, Inc. 2. Reception 3. Flowers 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions DESCRIPTION AMOUNT Social Security Number(s) I EIN Number of Personal Representative(s): 2. 3. Street Address City Year(s) Commission paid Attorney's Fees Coyne & Coyne, P.e. State Zip Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant MARY E. CROYLE Street Address 109 Sgrignoli Lane City Enola Relationship of Claimant to Decedent State P A Spouse 17025 Zip Probate Fees Cumberland County Register of Wills 4. 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 2 3 Other Administrative Costs Postage Certified Mail--DPW Filing Fee-- Inheritance Tax Return Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) 7,451.52 500.00 300.00 3,000.00 3,500.00 299.00 102.00 5.00 15.00 10,242.02 25,414.54 *' Schedule H Funeral Expenses & Adninistrative Cos1s continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT 5 Closing Costs I FILE NUMBER 21 - 2001 - 0968 I - I ESTATE OF CROYLE, EVERETT W. 4 Realtor's Commission-- Jack Gaughen 5,460.00 Tax Returns-- 2001 Prep. Fees Legal Advertisement-- Cumberland Law Journal Legal Advertisement-- Patriot News 3,596.07 800.00 25.00 200.00 75.00 85.95 6 7 8 9 10 Coyne & Coyne, PC-- Real Estate Closing Death Certificates I I I I Page 2 of Schedule H . SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF CROYLE, EVERETT W. I FILE NUMBER 21 - 2001 - 0968 Include unreimbursed medical expenses. ITEM NUMBER 1 U.S. Income Taxes DESCRIPTION AMOUNT 1,000.00 2 Waypoint Bank-- Uncleared Checks from Checking Account 2,500.00 3 West Shore Ambulance Association 200.00 4 First National Bank of Marysville (Mortgage) 65,030.45 TOTAL (Also enter on Line 10, Recapitulation) 68,730.45 *' SCHEDULE J BENEFICIARIES COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I FILE NUMBER , 21 - 2001 - 0968 RELATIONSHIP TO I AMOUNT OR SHARE DECEDENT .~ OF ESTATE Do Not List Tn'stee's' _ I Wife 100% of Estate I ESTATE OF CROYLE, EVERETT W. I. 1 TAXABLE DISTRIBUTIONS (include outright spousal distributions) , Mary Croyle 1109 Sgrignoli Lane, Enola, P A 17025 , \ i \ Enter dollar amounts for distributions shown above on lines 15 through 17, as appropriate, on Rev 1500 cover she t II. NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHE T JRD/June 30, 1992/17858 In Re: Estate of Everett W Croyle · ORPHANS' COURT DIVISION Late of East Pennsboro Township · COURT OF COMMON PLEAS OF · CUMBERLAND COUNTY Estate No.: 21-01-0968 · PENNSYLVANIA · NO. 21-01-0968 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: Mary E Croyle Counsel for Personal Representative: Henry F Coyne Date of Decedent's Death: 10/12/2001 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 Farrier Strasbaugh Clerk of the Orphans' Court Distribution: Personal Representative Counsel for 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. George E.~::.I-t:0ffe~r, P~j.~ STATUS REPORT UNDER RULE 6.12 NameofDecedent: ~-l"'e'r't'Tz/ /~( c~.,~.,,.~ /~ Date of Death: /~ -- / 2 -Z~o ) Will No.: Admin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether 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 [-'] .o 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~- t S--o't c~._~.~;.._ , -.-:~'- _ ( ? Name / Address ~ - Telephone No. Capacity: ~ Personal Representative ~P~ Counsel for personal representative . STATUS REPORT UNDER RULE 6.12 Name of Decedent: E Vt~t# w. ~/o/. Date of Death: rJ (,- +: i L-) Zoo I ~ ~f- .. Will No.: RooI- OO1l68 Admin. No.: Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 0 No ,Kl 2. lfthe answer is No, state when the personal representative reasonably believes that the administration will be complete: F-e b. ZctJf 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 accooot is: c. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 Date: --Wo ~ 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. ~ ~ (':) ~e 1 L I~I'I ~ l-li' G 7 ~ Name 1~: ~ "'1 3~bl ~1- Sf- Address G..y I.JJJ. I A- t Cc1/f rl f.: '~ " _ f r 711-7 "'7~dl./6tf Telephone No. Capacity: 0 Personal Representative ;::::Q::.counsel for personal representative STATUS REPORT UNDER RULE 6.12 Name of Decedent: EVer-r# IV 4.'7 /...- Date of Death: / tJ - /2 - 2'''0) Will No.: Admin. No.: ~ /- o/-o9b? 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.JZL No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes _ No )2[ b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the persona:~resentative state an account informally to the parties in interest? Y es ~ 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. . r- ~ .~ tJ1~Lt C,,-; AI"", ESQ Date: 1\-1 S- -oi \.C .-- 31&/ ~j ~') (ay')/;f.( fir. Address 1701 I 7/7-7s7-0V(,; L( Telephone No. ;-J Capacity: n Personal Representative IS{ Counsel for personal representative ~