HomeMy WebLinkAbout04-1083 PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
also Rnown as To:
Register of Wills for the
Deceased. County of £~.I//'ot3~Rt.,~/~'O in the
Social Security No. /qB- 6 F - 77~'-/ Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl for letters of administration
on the estate of
(d.b.n.; pcndente lite; durante absemia; durame minoritate)
the above decedent.
Decendent was domiciled at death in ffS-UPq BCR L.~3,,./19 County, Pennsylvania, with
hT~ last family or principal residence at /2~3
(l[sl street, number and municipality)
Decendent, then 2~ years of age, died ,{;/r£/.B£/) /l, 200~' , t9 fiO0~- ,
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:
Petitioner after a proper search ha~f.~ ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Name Relationship Residence
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~
COUNTY OF ~c~ Ti ~_~ {-~3 ) ss
The petitioner(s) above-named swear(s) or attilmis) 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 petitiouer(s) will well and
truly administer the estate according to law.
a fi m<
oe[or~e,~t)is ~~. day of
I h' ~ ~i~ter
Estate of ~¢[~33 ¢ . ~< 7~ , Deceased
GRANT OF LETTERS OF ADMINIST~TION
J.0__ , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that ~C,~
~re entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to g0 b(~-D
iu the estate of ~bI~L .
Letters of Administration ..... $
Short Certificates( ) .......... $
Renunciation .. ~ $~
Filed ......... AD
PHONE
Register of Wills of Cumberland County, Pennsylvania
RENUNCIATION
;tate of ADAM L. REITZ No. ~/-i- (~ -~- t~. ~ ~
al ;o known as , Deceased
The undersigned, MAURA KELLER, wife of the above Decedent, hereby renounce(s) the right to administer
tbs, estate and respectfully request(s) that
Letters of Administration be issued to RONALD L. REITZ.
Witness rnv hand this ( (: day of November, 2004.
MAURA KELLER (Signature)
t"~' .)(/ i
Address:
S,¢ ~rn to or affirmed and subscribed
be ,remethis I~_¢ dayof I ' NOTA, I~IAt.'~.AI.
' ~ Kathy L. Mummert, Notary Public
z , ~Borough of Carlisle, Cumberland Co. PA~
My ~mr~ssion Expires:
COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH · VITAL RECORD~
CERTIFICATE OF DEATH
September Il, 2004
Gunshot to Head
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717)240-6345
Date: 02/28/2005
KERWIN JOSEPH D
27 NORTH FRONT STREET
HARRISBURG, PA 17101
RE: Estate of REITZ ADAM L
File Number: 2004-01083
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.6 (a) in the above captioned
estate.
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 ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing is due by:
03/05/2005
Your prompt attention to this matter will be appreciated.
Thank You.
~~
GLENDA FARNER ~:~
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
Judge
Cumberland County - Register Of wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717)240-6345
Date: 02/28/2005
REITZ RONALD L
80 POWELLS RIDGE ROAD
HALIFAX, PA 17032
RE: Estate of REITZ ADAM L
File Number: 2004-01083
Dear Sir/Madam:
It has come to my attention that you have not filed the
Certification of Notice Under Rule 5.6 (a) in the above captioned
estate.
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 ten (10) days after giving proper notice to the
beneficiaries and intestate heirs as required by subdivision
(a) of Rule 5.7, shall file with the Register of wills or Clerk
of the Orphans' Court his/her Certification of Notice.
This filing is due by:
03/05/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sr~~
GLENDA FARNER STRASBAUGH
Clerk of the Orphans' Court
cc: File
Counsel
Judge
CERTIF1CATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Adam L. Reitz
Date of Death: September 11, 2004
Will No.
Admin. No.
2004-01083
To the Register:
1 certify that notice of (beneficial interesl) estate administration required by Rule 5.6(a) of the Orphans' Court Rilles was
served on or mailed to the following beneficiaries of the above-captioned estate on J anuarv 6. 2005
Name
Address
Maura Keller
1253 Rebert Drive. Mechanicsburg, PA 17055
Notice has now been given to aU persons entitled thereto under Rule 5.6(a) exce
Signature
N
Dale: 3/4/05
Name Joseph D. Kerwin, Esq.
'~'d
Address 4245 Route 209
;~";,
Elizabethville, PA 17023
Telephone (71 Q 362-3215
Capacity: .2S- Personal Representative
_Counsel for personal representative
\J'
SEND ALL WRITTEN REPLIES TO:
ARIZONA OFFICE:
64 E. BROADWAY ROAD
SUITE 175
TEMPE, AZ 85282
DIANA THEOS - AZ, CO
SANDRA TANG-Al, CA
MINNESOTA OFFICE:
JAMES A. BALOGH - MN
GARY W. BECKER. DC, Fl, Il, MN, WI*
.CREDITOR'S RIGHTS SPECIALIST
AMERICAN BOARD OF CERTIFICATION
CHELSEA AWHrniY"-=-MN, wf-
ANGELAM. HORN-MN
MICHAEL D. JOHNSON - MN
MARy EllEN WEEMAN - KS, MN, MO
THERSIA O. LEE - MN
CHAD J. BOLlNSKE - MN
STEVEN M. TOMS - MN
JASON R. FOSTER - MN
MEAGAN M. PROBST - MN
MICHAEL J. DOUGHERTY - MN
MICHAEL D. BOLlNSKE - MN, OR
JILL M. GEMLO - MN
EMilY l. FINGER - MN
ANDREW S. MILLER - MN
KAMJLtE R. DEAN - CA
BALOGH BECKER, LTD.
ATTORNEYS AT LAw
4150 OLSON MEMORIAL HIGHWAY, SUITE 200
MINNEAPOLIS, MINNESOTA 55422-4811
TELEPHONE 763-852-8440
FAX 763-852-8499
TOLL-FREE 866-234-0513
OF COUNSEL:
lITOW LAw OFFICES, P.c.
(IOWA)
LUSTIG, GLASER & WILSON, P.c.
(MAsSACHUSETTS)
02/24/05
REGISTER OF WILLS
CUMBERLAND COUNTY COURTHOUSE
1 COURTHOUSE SQUARE, #102
CARLISLE, PA l70B
Re: In the Estate of
ADAM L REITZ
co
Probate Case No.
Social Security No:
Last known residence:
Our Client:
Account Number:
Amount of Debt:
21-04-1083
198647567
SUNBURY, PA 17801
CITICORP CREDIT SERVICES INC.
5410654600513110
$611944
-':"1
<::1
0)
Dear Sir or Madam:
Enclosed please find a Creditor's claim to be filed in the record with the above-referenccaEstate.
Please return a file stamped copy of the claim in the enclosed self-addressed, stamped envelope. Thank you
for your assistance. If you have any questions or if this is a duplicate claim, please call our finn toll free at 1-
866-234-0513
Cordially,
Balogh Becker, Ltd.
Attorneys at Law
Enclosures
A check for $10.00 for the filing fee.
cc: Attorney for Estate
Personal Representative
This letter is an attempt to collect a debt and any infonnation obtained will be used for that purpose. This
letter is from a debt collector.
5678
2r21r2005
1274372
0'
COMMONWEALTH OF PENNSYLVANIA
COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
ORPHANS' COURT DIVISION
NOTICE OF CLAIM
In Re: The Estate of:
ADAM L REITZ
Court File No: 21-04-1083
Deceased
TO: THE CLERK OF THE ORPHANS' COURT DIVISION:
Notice of claim by creditor, Pursuant to Section 3532(b)(2) of the Probate,
Estates, and Fiduciaries Code, 20 PA.C.S.A. 93532(b)(2).
CITICORP CREDIT SERVICES INC.
1) Claimant's name:
2)
CIO BALOGH BECKER LTD, 4150 OLSON MEMORIALC)
Claimant's address: HWY #200 (;'0
.-:',)
MINNEAPOLIS, MN 55422 '~d Q
866-234-0513
.'.' i~Ti
Cu
3)
"of",...""
Creditor listed below is the owner and holder of a claim in the amdurifof
$ 6119.44Y,;
4)
The facts upon which this claim is based:
This claim is based on an account for credit evidenced by the attached C,)
Affidavit of Account Stated.
"'._"
5)
Decedem's address: SUNBUHY, PA;!801
6)
Date of Death:
09/11/04
7) That the claim arose prior to the death of the decedent on or about
8) That the claim is secured by
On behalf of the claimant, I do solemnly declare and affirm nder the penalties of
perjury that they Information and representatio ma h rein are true d correct
to the best of my knowledge, information and lief.
Dated: 1 ~ 1.. ~ - 0 5"'
Chelsea A. Whitley/Angela M" Ho r ary Ellen Wee n/Chad BolinskelThersia Lee, Attorney-In-Fact
Written notice of claim was given to Personal Representative and/or his/her counsel
as stated below:
JOSEPH KERWIN
Name
4245 RTE 209
Address
ELlZABETHTOWN, PA 17023
City/Stat Zip
IS 0,
Date not ce ailed
IN RE ESTATE OF: ADAM L REITZ
AFFIDAVIT OF ACCOUNT
The undersigned, being first duly sworn deposes and states the follows:
I. Your Affiant is authorized by the Claimant as its Attorney-In-Fact to make this Affidavit.
2. Your Affiant has reviewed the account records of the Claimant with respect to the
decedent. Your Affiant is familiar with these records and accounts and reviews them as a
regular part of hislher duties.
3.
The Decedent purchased merchandise in the amount of $ 6119.44
account number 5410654600513110
evidenced by
4, The unpaid balance does not include any post-death late payment char~s, accruea'.';
interest, collection costs or attorney's fees. . <;;:2 .- ,
BALO
0:)
Further your affiant sayeth not
"
By:....,
Atto eys-in-Fac. - =
(.,)
Che'seaA. Whitley _ AngelaM. Horn_
Michael D. Johnson Mary Ellen Weeman_
Thersia O. Lee Chad J. Bolinske +-
4150 Olson Memorial Highway, Suite 200
Minneapolis, MN 55422-4811
Subscribed and sworn before me
This cZ f day of
~,
,2005.
(41-.-
ry Public
e-S STEP ,JOHNSON
~i NOTARY PUBUC - MINNESOTA
\~& HENNEPIN cOUNTY
s. . My eommlssloll Expiros Jon. 31. 2006
, I
REV' 1500 EX + (6-00)
.
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
~-_._-----":~:;----------"-""-l
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG. PA 17128-0601
FILE NUMBER t::1-I
21 ~
COUNTY CODE YEAR
01083
NUMBER
DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Reitz, Adam L 198-64-7567
....
z DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
w
Q
w 09/1 1/2004 01/06/1 975 REGISTER OF WILLS
u
w
Q (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST. FIRST AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Keller, Maura
I8J 1. Original Return 0 2. Supplemental Return 0 3. Remainder Return (date 01 death pribr to 12-13-82)
~ 0 Limited Estate 0 4a. Future Interest Compromise (date 01 death after 0 Federal Estate Tax Return Re~uired
,,~Ul 4. 5.
ull:" 12-12-82)
w...u 0 0 0
]:00 6. Decedent Died Testate (Attach copy 7. Decedent Maintained a Living Trust (Attach 8. Total Number of Safe Depos~ ~oxes
ull:..1
...CD otWill) copy 01 Trust) -
... 11. Election to tax under Sec. 911 ~(A) (Mach Sch 0)
c( 0 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (dale 01 dealh belween 0
12-31-91 and 1-1-95\
THISSEcttONMIISf BECOMPl.E1EI); Al.l. CORFlESPONDENCEAND CONFIDENTIAL TAXINFc>RMAnONSHOULDBE 'OIRECTEDTO:'.11 .. "
NAME COMPLETE MAILING ADDRESS
..... Joseph D Kerwin ,
UlZ
Ww IRM NAME (If applicable)
11:0 4245 Route 209
II:z Kerwin & Kerwin
00 ,
u... Elizabethville, PA 17023-9765
ELEPHONE NUMBER i
717/362-3215 I
,
. J~ --'-
1. Real Estate (Schedule A) (1 ) None ~- -" ~ ' \ F f i ,~ :\1 .~r.J
I'~'::-. :j;~ . '-1
---~.~--- (--) fl ;
, 1 '1/) (')
2. Stocks and Bonds (Schedule B) (2) 83.44 i" C)
~--_._------~.-~--~ 'F',; :.,\J
:,:J
3. Closely Held Corporation. Partnership or Sole-Proprietorship (3) None +- , i \ '\
;1'-) .--,
"'_~J
-r-tj
i-"
t".:
f._!
, C~)'
I
'1',
- c5
171
z
o
~
~
....
ii:
c(
u
W
II:
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
(4) None
(5) 26,340.51
--~-)I
~"
_______.+__.__J
I
(8) i 26,423.95
~----+_.~--,~.
(6) None
(7) None
10. Debts of Decedent, Mortgage Liabilities. & Liens (Schedule I)
(9) 11,025.22
--~-_.--~-_._~--
(10) 14,085.18
11. Total Deductions (total Lines 9 & 10)
(11 )
i 25,1 10.40
i
. 1,313.55
12. Net Value of Estate (Line 8 minus Line 11)
(12)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
(13)
(14)
1,313.55
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax rate.
or transfers under Sec. 9116(a)( 1.2)
1,313.55
x .00
(15)
-- .------- ---.--------.1--
0.00
z
o
~
t-
~
...
:l!
o
o
~
....
16. Amount of Line 14 taxable at lineal rate
x .045
(16)
17. Amount of Line 14 taxable at sibling rate
x .12
(17)
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.
>> BE SURE TO ANSWER AU. QUESTIONS ON REVERSE SIDE AND RECHECK MATH <<
; i
I
Form REV-1500 EX I(Rev. 6-00)
Copyright 2000 form software only The Lackner Group, Inc.
Decedent's Complete Address:
STREET ADDRESS
1253 Rebert Drive
CITY
I STATE PA
I ZIP 17055
Mechanicsburg
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
Total Credits (A + 8 + C)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (0 + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(1 )
0.00
(2)
0.00
(3) 0.00
(4)
(5) 0.00
(5A)
(58) 0.00
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;.................................................................................. ~ ~
~: ~:~::~ :h;e~;~~i:~~;:~~;~s~~~. .~~~~~. ~~~. ~~~. :.~.o.~.~.~ .tr~~~f~~~~.d. ~.r .i.~~. .i~~~~~.; :...... ::::::.':::::: ~: .'~ ~ ~:: .': ~ ~ ....: ~ ~ ~ ~
d. receive the promise for life of either payments, benefits or care?.............................................................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ....................................................................... ................................................ 0 ~
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?........ 0 ~
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?...................................................................................................................... 0 ~
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF T~E RETURN.
-Under penatties 01 perjury, I declare thaI I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, h is true, correct and c~mPlete. Declaration of
preparer other than the personal representative is based on all information of which preparer has any knowledge.___.____ _ --------L......-.~
SIGNATUR ERSON RESP. NSIBLE OR FILING RETU ADDRESS bATE
n . Rei 80 Powells Ricige Road 9 ~, rr ~ r--
Halifax, PA 17032 ll. VJ
ADDRESS ATE
For dates of de th pn or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the
survi~ing spou e ir 3% [72 P.S. 99116 (a) (1.1) (i)].
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 99116 (a) (1.1) (Ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the st
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. Due
For dates of death on or after July 1, 2000: I
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger < PeA
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116 (a) (1.2)].
ADDRESS
4245 Route 209
ElizabethvilIe, P A 17023-9765
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5
1.2) [72 P.S. 99116 (a) (1)).
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~
under Section 9102, as an individual who has at least one parent in common with the decedent, whether by bl,
(d')
50
0:'::)
( y.::p
~~b
c<J)
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....) ~.. sT'
.
SCHEDULE B
STOCKS & BONDS
COMMONWEALTH OF PENNSYLVANIA
INHERIT ANCE T AX RETURN
RESIDENT DECEDENT
I FILE NUMBER
21 - 05 - 01083
ESTATE OF
Reitz, Adam L
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
---+~_.~----_..-
83.44
U.S. Savings Bond - Series E
TOTAL (Also enter on line 2, Recapitulation)
83.44
*'
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Reitz, Adam L
I FILE NUMBER
21 - 05 - 01083
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
I
DESCRIPTION
VALuE AT DATE OF
DEATH
---+~,.~-~.._~
18,101.70
Zero Coupon Williamsport School District Bond
2
Ford Escape - insurance proceeds
8,238.81
TOTAL (Also enter on Line 5, Recapitulation)
26,340.51
I I
.
_I
SCHEDULE H
RJNERAL EXPENSES &
ADMINSTRA11VE COSTS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TI\X RETURN
RESIDENT DECEDENT
ESTATE OF
Reitz, Adam L
I FILE NUMBER
21 - 05 - 01083
Debts of decedent must be reported on Schedule I.
ITEM DESCRIPTION
NUMBER
A. FUNERAL EXPENSES:
I Hoover's Funeral Home
2 Grave site marker
3 Halifax UCM - funeral meal
4 Pastor Barto - honorarium
5 Joe Bashore - organist
6 Kelly Heim - soloist
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Ronald L. Reitz
AMOUNt
5,225.86
726.00
411.07
75.00
50.00
50.00
2,000.00
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address 80 PowelIs Ridge Road
City Halifax
Year(s) Commission paid
State
PA
Zip 17032
2.
Attorney's Fees
Kerwin & Kerwin
2,000.00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
State
Zip
4.
Probate Fees
Register of Wills
78.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
I
Other Administrative Costs
Cumberland Law Journal - Advertisement of Estate
75.00
2
The Sentinel - Advertisement of Estate
144.29
Total of Continuation Schedule(s)
190.00
TOTAL (Also enter on line 9, Recapitulation)
',11,025.22
1 I
*'
Sc:hEnEH
FU1eraI ExpeIlseS &
Pd11irtisb~~ Cos1sconiooed
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I FILE NUMBER
21 - 05 - 01083
I
125.00
ESTATE OF
Reitz, Adam L
3 Coromer Report - copies
4
Register of Wills - Short Certificates
40.00
5
Register of Wills - Release
25.00
Page 2 of Schedule H
, r
.
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF .
Reitz, Adam L
I FILE NUMBER
21 - 05 - 01083
Include unreimbursed medical expenses.
ITEM
NUMBER
I CitiBank - credit card
DESCRIPTION
AMOUNT
4,500.00
2
Rusty Raker - debt owed
400.00
3
Doug Miller, Esq
867.00
4
Fortis Insurance Co.
38.93
5
Storage Shed Lock
40.44
6
Maura Keller - reimbursement for Ford Escape
8,238.81
TOTAL (Also enter on Line 10, Recapitulation)
14,085.18
REV-1513 EX+ (lHlO)
ESTATE OF
'I FILE NUMBER
u~____----"-____21 - 05 ~OI083_~_~~____
I RELATIONSHIP TO AMOUNT OR SHARE
---+-- DECEDENT OF ESTATE
.
1 SCHEDULE J 1
BENEFICIARIES
- -~~-~ ---~ -- ------ -
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Reitz, Adam L
NUMBER
---~-~r-~---
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I.
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
Maura Keller
1253 Rebert Drive
Mechanicsburg, PA 17055
Wife
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate. on Rev 1500 cover sheet
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
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CLAIM NO 38-K511-782
POLICY NO 7310-707-38F-001
LOSS DATE
9/11/2004
PAYMENT NO
DATE
AMCllNT
TIN
1 13 949909 J
9/28/2004
$7,967.29
'f:P;)t%.i~~'a:i:lihj:l~~e.HW~W!&iWiiii~iiiiWWi~\:i@1@W?::Mni~\ilii~imjlmQM't!;~l@;t#col:Wd~'I&i't;!f
COMPREHENSIVE - F~T. CAC, OR LOMV $7,967.29 390 3
RETAIN STUB FOR RECORDS
AUTHORIZED BY ALVIANI, NADINE
PHONE (717) 774-9052
REMARKS BALANCE OF VEHICLE VALUE AFTER PAYMENT TO THE LIENHOLDER
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. Order of; MAURA KELLER & THE ESTATE OF ADAM REITZ
1253 REBERT DRIVE
MECHANICSBURG PA 17055
~
~~
AUTHORIZED SIGNATWRE
.. ..
.
II- . ~ . ? '1 1. [Jl~ 0 liIu- I: 0 b . . . 2 ? a a I : 31 2 iii iii.. :I 5 2 1..'11
CLAIM NO 38-K511-782
POLICY NO 731 0-707-38F-OO 1
LOSS DATE 9/11/2004
PAYMENT NO
DATE
AMOUNT
TIN
113949910 J
9/28/2004
$120.00
:::::::::::t.a'\i;i.a>'~::b:€iiiBn'Ji.:tl~i#;:il:t!W(::::;:j!!Nj(i:~:(Hjj::tNi:i(::lj%l~'m~l$tj::Mj:~Wi:tetM:.<:::'l~a:j
RENTAL REIMBURSEMENT $120.00 5~1
RETAiN STUB FOR RECORDS
AUTH\JRIZEO BY ALVIANI, NADINE
PHONE (717) 774-9052
REMARKS payment of 12 days for non rental option on the vehicle
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ay to the
Orderof: MAURA KELLER & THE ESTATE OF ADAM REITZ
~ 1253 REBERT DRIVE
MECHANICSBURG PA 17055
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MINNESOTA OFFICE;
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BALOGH BECKER, LTD.
ATTORNEYS AT lAW
PAGE 112/112
ARllONA OilFi~!
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4150 OLSON MEMotIlAl HIGHWAY. $UITE ~OO
MINNEAPOLIS, MINNESOTA 55422-4811
TELEPHONE 763-852-8440
FAX 666-234-0503
Oi' (OUNSIL:
L1TC;W u..\,>o;' oJ!!~!~r.s. P. C
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4245 ROUTE 209
ELIZABETHVILLE P A. i 7023
l{c~
Eslate ()f:
ATl."').A'T TlT:'FT"7
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Our Cliene CITICOP~ CREDIT SE.R\'ICES, Il~C. (USA)
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Ba!ogh .Becker i~~CCQUnt No: 1384312
Dear jOSEPH D. KERWIN:
Tha:nk you for YOUr asslsianc6ln resoivlng this matter. Pei your request, this letter confirms a seittJement
in the liI:Jiount of $4500.00 for the above listed account. Receipt of this payment will close the a~count
It is our understanding that you wiil send this payment to our office by 09/29/05.
Please pay th~ ai,:'iOUfit to the aboye address. If you have any questions, piease feel free to COl'ltaclt our
office tali free at 1-866-234-0513.
[O",___--i._ 'I 'i. .
\.A.ilUlull)',
Balogh Becker, Ltd.
AnouJeys at Law
Thi;; kuer is an ,mempi iO COilCCi a debt and ailY information obtained will be used for that purpose.
This 1cU(;..ilS from a debt coilecror.
Register of Wills of Cumberland County, Pennsylvania
Estate of
Reitz, Adam L
also known as
INVENTORY
, Deceased
o~
NO.2] -.Q8 - 01083
Date of Death 9/1 ]/2004
Social Security No. ] 98-64-7567
Ronald L. Reitz
The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory
include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania
of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the dat~ of the
Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that
which appears in a memorandum at the end of this Inventory. l!We verify that the statements made in this Inventory are true
and correct. l!We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904
relating to unsworn falsification to authorities.
.1.
I
Attorney:
Joseph D Kerwin
I.D. No.:
52658
Address:
4245 Route 209
Elizabethville, P A 17023-9765
Telephone: 7]7/362-32]5
Personal Property
U.S. Savings Bond - Series E
Pe",onal RepcesentaUve ~
Signature: ~~ ;~_
Rona]d L. Reitz
Signature:
Signature:
Address: 80 Powells Ridge Road
Halifax, PA 17032
Telephone:
Dated:
Zero Coupon Williamsport School District Bond
Ford Escape - insurance proceeds
--
(Attach additional sheets if necessary)
I
$26,423.95
fA
q /1/05
Total Personal Property
Total Personal Property and Real Estate
18,101.70
r...:>
. J 8;t~8.81
:cJ .:::'."
'. -:1 :-2$26,~~3.95
r.,)
Ii
+
83.44
,
-'
-'I
r~
-
COMMONWEALTH OF PENNSYLVANIA
p~~RTMENT OF REVENUE
vr'n~'Dt.D O~PC'NOY'fCE OF INHERITANCE TAX
, .L~.-, .A,PPRA't$EMf>NT, ALLOWANCE OR DISALLOWANCE
" OF tllODUCTIONS AND ASSESSMENT OF TAX
*'
DATE 11-21-2005
ESTATE OF REITZ ADAM L
DATE OF DEATH 09-11-2004
FILE NUMBER 21 04-1083
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 01-20-2006
( See reverse side under Objections)
Amount Remittedl ,
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +--
-------------------------------------------------------------------------------------------
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF REITZ ADAM L FILE NO. 21 04-1083 ACN 101 DATE 11-21-2005
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
I~u I). D'I.
,'i1 ,';' '"t
'inns 2.8
i~ L ~~
JOSEPH D KERWIN
4245 RT 209
ELIZABETHVILLE
PA 17023
REV-1547 EX AFP (06-05)
) CHANGED
TAX RETURN WAS: (X) ACCEPTED AS FILED
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)
.00
83.44
.00
.00
26,340.51
.00
.00
(8)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
26,423.95
11,025.22
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
nO)
14,085.18
(11)
(12)
(13)
(14)
?1;.110 40
1,313.55
.00
1,313.55
NOTE: If an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of !b1. returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15) 1,313.55 X 00 .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) .00 X 045 = .00
17. Amount of Line 14 at Sibling rate (17) .00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 = .00
19. Principal Tax Due (19)= .00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
0,'
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR). YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
Cumberland County - Reglster UI W1LU3
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/27/2006
REITZ RONALD L
80 POWELLS RIDGE ROAD
HALIFAX, PA 17032
RE: Estate of REITZ ADAM L
File Number: 2004-01083
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. I, 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:
9/11/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
.& C....? . /1;;/Aw/iJj
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Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
Cumberland County - Register Ot WlIIS
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 7/27/2006
KERWIN JOSEPH D
27 NORTH FRONT STREET
HARRISBURG, PA 17101
RE: Estate of REITZ ADAM L
File Number: 2004-01083
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:
9/11/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
;; r
/.;j" . . '--/' . Lt-,1 /
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f. !
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
Register of Wills of Cumberland. County
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Adam L. Reitz
Date of Death: September 11, 2004
Estate No.: 2004-01083
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 fiU 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 fmal account with the Court?
Yes 0 No @
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties in
interest? Yes]2g No 0
c. Copies of receipts, releases, joinders and a proval of formal or informal
accounts may be filed with the Cler f hans' Court and may be
attached to this report.
Date:
7/31/06
Q~
v-
Joseph D. Kerwin, Esq.
Name
4245 Route 209
Elizabethville, PA 17023
Address
717-362-3215
,.....,,!
Telephone No.
{-,.
Capacity: 0 Personal Representative
[] Counsel for personal representative
~
KERWIN & KERWIN
ATTORNEYS AT LAW
4245 ROUTE 209
ELIZABETHVILLE, PA 17023
GOVERNORS' ROW
27 NORTH FRONT STREET
HARRISBURG, PA 17101
PATRICK E. KERWlN (1913-1987)
(717) 362-3215
(717) 896-9089
FAX (717) 362-4459
E-maiLkkl@epix.net
(717) 238-4765
FAX (717) 238-8455
GREGORY M. KERWIN -
TERRENCE].KERWlN-
JOSEPH D. KERWlN -
HOLLY McCLURE
GMK@Kerwinlawfim..com
KK@Kerwinlawflon.conl
]D K@Kerwinlawiirm.com
KERWlN - KK@Kerwinlawfirm.com
please Reply To,
" ELIZABETHVILLE OFFICE
Cl HARRISBURG OFFICE
July 31, 2006
Register of Wills of Cumberland County
Cumberland County Courthouse
South Hanover Street
Carlisle, PA 17013
Re: Estate of Adam L. Reitz
Estate File No.: 2004-01083
Dear Sir or Madam:
Please find enclosed herewith the Status Report Under Rule 6.12 to be filed. Would you kindly time-stamp
the enclosed copy and return it to me in the enclosed envelope?
JDK:tll
Enclosures
Thank you for your assistancc with respect to this m. ajr
Very ~'17'
J
JOSEP!D. KERWIN
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