HomeMy WebLinkAbout04-1102Estate of
Ruth S. Graffius and Frederic G.
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Doris Q. Stevenson No. ~i~O'~ -Iii.')''~-~
. Deceased Social Security No 164-16-0543
Stevenson
Petitioner(s). who is/are 18 years of age or older, apply(les) for:
(COMPLETE 'A' or 'B' BELOW:)
A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut
the Decedent. dated and codicil(s) dated
named in the last Wilt of
State relevant circumstances, eg. renunciation, death of executor, etc.
Except as follows. Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
] B of Letters of Administration c t a
Grant
(c t a.; d.b n.c.t.a; pertdente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent en no will aha was su viveo u¥ he ollowing spouse if any and
heirs:
Name Relationship Residence
James P. Stevenson Son 11 Luzerne St., West Pittston, PA
Frederic G. Stevenson Son 4 Colony Court, Hanover, PA 17331
Ruth S. Graffius Daughter 944 Indiana Ave., Lemoyne, PA 17043
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland
County. Pennsytvania with his/her last family
or principal residence at 944 Indiana Avenue, Lemoyne, PA 17043
Oecedent. then
89 years of age. died 03/22/2004
(list street, number, and municipality)
at Holy Spirit Hospital, East Pennsboro, PA
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) Ali 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
(Location)
$ 40,000.00
situated as follows:
Wherefore. Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of
letters in the appropriate form to the undersigned:
/.~' . Si~/qatu r~? /?
Typed or printed name and residence
Ruth S. Graffius
944 Indiana Avenue, Lemoyne, PA 17043
Frederic G. Stevenson
4 Colony Court, Hanover, PA 17331
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (199
Estate of
also known as
Register of Wills of Cumberland County, Pennsylvania
AMENDED PETITION FOR GRANT OF LETTERS
Doris Q. Stevenson No ~-
, Deceased Social Security No t64-16-0543
Ruth S. Oraffius and Frederic G. Stevenson
Petitioner(s). who is/are 18 years of age or older, apply(les) for:
(COMPLETE 'A' or 'B' BELOW:)
] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execut __
the Decedent. dated and codicil(s) dated
Dean T. Stevenson, named Executor, died November 6, 1994
named in the last Will of
Reverend Canon Kermit L. Lloyd, named alternate Executor, died Jan. 28, 2000
State relevant circumstances, eg. renunciation, death of executor, etc.
Except as follows. Decedent did not marry was not divorced, and dia not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
] B. Grant of Letters of Administration C. t. a.
(cra; db n c t a; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
Name Relationship Residence
James P. Stevenson Son 11 Luzerne St., West Pittston, PA
Frederic G. Stevenson Son 4 Colony Court, Hanover, PA 17331
Ruth S. Graffius Daughter 944 Ind'iana Ave., Lemoyne, PA 17043
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in Cumberland
County, Pennsylvania with his/her last family
or principal residence at 944 Indiana Avenue, Lemoyne, PA 17043
(list street, number, and municipality)
Decedent. then 89 yearsofage died 03/22/2004 at Holy Spirit Hospital, East Pennsboro,
(Location)
Decedent at death owned property with estimated values as follows:
(If domiciled in PA) All personal property
(If not domiciled in PA) Personal property in Pennsylvania
(If not domiciled in PA) Personal property in County
Value of real estate in Pennsylvania
PA
40,000.00
situated as follows:
Wherefore. Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of
letters in the appropriate form to the undersigned:
Sit, nature Typed or printed name and residence
Ruth S. Oraffius
944 Indiana Avenue, Lemoyne, PA 17043
Frederic G. Stevenson
4 Colony Court, Hanover, PA 17331
Prepared by the Pennsylvania Bar Association
Copyright (c) 1996 form software only CPSystems, Inc. Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumberland
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
Petitioner(s) will well and truly administer the estate~l)ording to law. ~f /
the
Decedent.
Sworn to or affirmed and subscribed"~ L;I >~P~ ~. Craffius /, /////g
before me this /-_/ day of t', ~' ~
Frederic G. Stevenson
FoL~he Registei~ , / ;
Estate of Doris Q. STevenson Deceased
Social Security No: 164-16-0543 Date of Death: 03/22/2004
AND NOW, ~ l b E C-L~~Y~, IB~ ~- . 2004~ , in consideratio?
of the Petition on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters [] Testamentary [] Of Administration c. t. &.
(cra; dbn cta.; pendente lite; durante absentia; durante minoritate)
are hereby granted to
Ruth S. Graffius and Frederic G. Stevenson
in the above estate and that the instrument(s) dated
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
FEES
Letters ..... $
Short Certificate(s) . $
Renunciation .... $
70.00
9.00
5.00
21.00
10.50
10.00
Attorney:
Register of Witls
':
James O. Morgan, Jr.
Affidavits ( ) . $
Extra Pages ( ) · · $
Codicil ..... $
ID. No:
Address:
06897
Tucker Arensberg, P.C.
111 N. Front Street
P.O. Box 889
Harrisburg, PA 17108-0889
JCP Fee $
Telephone: 717/234-4121
Inventory ..... $
Other .... $
TOTAL $ 125.50
Prepared by t he Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems. Inc. Form RW-1 (1991)
Register of Wills of Cumberland County, Pennsylvania
RENUNCIATION
Estate of Doris Q. Stevenson, Deceased
The undersigned, Son of the above Decedent, hereby renounce(s) the right to
administer the estate and respectfully request(s) that Letters be issued to Ruth S. Graffius and
Frederic G. Stevenson.
WITNESS his hand this ~-~' day of ~'~ jo%..... , 2004
,lames P. Stevenson
11 Luzeme St.
West Pittston, PA 18643
Sworn to or affirmed and subscribed
before me this O~ day
-[q]-O~ u blic - -
---- Notarial SeaJ
My Commission Expires: JP~.a. ullnePa~Thornas, NotaryPub~c
/Ciiy Of Ha~sburg, Dauphin County
L_My Commission Expires Mar. 24, 2007
ARNING: It is il!egai to duoi c~t~ ~r~s 5,i¢:,':/ c,~ photostat or photograph,
,,-,, 4 4 200_4
COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS
CERTIFICATE OF DEATH
Doris Stevenson z. Fe~le], ]64 - ]6 -
89 Y~' ~. 3-21-15 ~. Bethlehem,PA ~,.
DECEDENT'S USUAL OCCUPATION KIND OF BUSINESS / INDUSTRY ~WAS DECEDENT EVER [N OEC[D~NT S EDUCATION MARITAL STATUS Marded SURVIVING SPOUSE
J~es A. Quiet m- Violet Va~
Ruth S. Graffius [~. 944 Indiana Avenue, Lemo~e, PA 17043
O~er(S~°~) ~ 2~ ~"'~'~ ~ PA Cremato~ :~.Harrisburg, PA 17109
WAS AN AUTOPSY ~RE AUTOPSY FINDINGS IMANNER OF DEATH
I
CERTIFIER (Check only one)
~o he bes of my kno~dedge, death occurred due to the ca ..... ,nd ma.her as sated L.~
NUMBER J DATE SIONE,~ )ohm Oa~ Year)
NAME AND ADDRESS OF PER ON OCOM ETED CAUSE OF DEATH
stev.will. D/ppt/June 7, 1994
WILL
I, DORIS Q. STEVENSON of Lemoyne, Cumberland County,
Pennsylvania, declare this to be my last will and revoke any will
previously made by me.
ITEM I. · give all my automobiles, and all other articles
of personal and household use, together with all insurance relating
thereto, to my below~d husband, DEAN T. STEVENSON, if he survives
me by thirty days. if he does not so survive me, I give all such
property and insurance to my children who so survive me, to be
divided among them as they may agree or, in the absence of
agreement as my executor may think appropriate.
ITEM II. I give my engagement ring and wedding ring ~o
my daughter, RUTH M. GRAFFIUS.
ITEM III. I give all the residue of my estate, real and
personal, to my husband, DEAN T. STEVENSON provided that he
murvives me by thirty (30/ days; if he does not so survive me, I
give the resid%]e of my estate, real and personal, in equal shares
to my beloved children, JAMES P. STEVENSON, EREDERIC G. STEVENSON
and RUTH M. GRAFFIUS, provided that the share of any child who
predeceases me or d~es on or before the thirtieth day following my
death shall be distributed to his e~ her issue per stirpes living
on the thirty-first day following my death and in default of any
Page 1 of 5 pages.
stev.will.D/ppt/June 7, 1994
such then-living issue such shares shall be added to the share or
shares for my other children.
ITEM IV. No interest in income or principal shall be
assignable by, or available to anyone having a claim against, a
beneficiary before actual payment to the beneficiary.
ITEM V. Ail federal, state, and other death taxes
payable on the property forming my gross estate for tax purposes,
whether or not it passes under this will, shall be paid out of the
principal of my residuary estate just as if they were my debts,
and none of those taxes shall be charged against any beneficiary.
ITEM VI. I authorize my ex'ecutor:
A. to retain and to invest in all [orms of real
and personal property, regardless of ~i) any limitations imposed
by law on investments by executors or trustees, (ii) any principle
of law concerning delegation of investment responsibility by
executors or trustees, or (iii) any principle of law concerning
investment diversification:
B. to compromise claims and to abandon any
property which, in my executor's oDinion, is of little or no value;
to borrow from, and to sell property to others, and to pledge
property as security for repayment of any funds borrowed;
Page 2 of 5 pages.
stev.will.D/ppt/J~me 7, 1994
or to lease
and to give
C. to sell at public or private sale, to exchange
for any period of time any real or personal property,
options for sales or leases;
D. to join in any merger, reorganization,
voting-trust plan or other concerted action of security holders,
and to delegate discretionary duties with respect thereto;
E. to use administrative er other expenses of my
estate as income tax or estate tax deductions and to value my
estate for tax purposes by any optional method permitted by the
law in force when I die, without requiring adjustments between
income and principal for any resulting effect en income er estate
taxes; and
F. to distribute IN KIN[} and to allocate specific
assets among the beneficiaries in such proportions as my executor
may think best, so long as the total market value of any
heneficiary's share is not affected by such allocation.
These authorities shall extend to all Foal and
personal property at any time held Oy my executor and shall
continue in full force until the actual distribution of all such
property.
Page 3 of 5 pages.
stev.will. D/ppt/June 7, 1994
All powers, au{horities, and discretion granted by
this will shall be in addition to those granted by ].aw and shall
be exercisable without leave of court.
ITEM VII. I appoint my husband, DEAN T. STEVENSON,
executor under this will. Shhuld he fail to qualify or cease to
act as executor, I appoint THE REVEREND CANON KERMIT L. LLOYD
executor under this will. No personal representative appointed
hereunder shall be required to give bond or furnish sureties in any
jurisdiction.
ITEM VIII. The term "executor" and "tuustee" or any
pronoun used to indicate the executor, trustee, any other fiduciary
or any beneficiary shall be deemed to apply to one or more than one
person or corporation and to~ the masculine, feminine or neuter
gender as the case may be.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
to this, my last will, this /~ day of June, 1994.
Stevenson
Page 4 of 5 pages.
stev.will. D/ppt/June 7, 1994
SIGNED, SEALED,
testatrix, as and for her
thereupon at her request,
each other, have hereunto
PUBLISHED, and DECLARED by the above
last will, in the presence of us, who
in her presence and in the presence of
subscribed our names as zitnesses.
Page 5 of 5 pages.
stev.will. D/ppt/,lune 7, 1.994
STATE OF PENNSYLVANIA
COUNTY OF DAUPHIN
We, DORIS O~. STEVENSDN, ,.j~ _ q · , and
the testatrix and witnesses,
respectively, whose names are signed to the attached or foregoing
instrument, being first duly sworn de hereby declare to the
undersigned authority that the testatrix signed and executed the
instrument as her last will a~
that she executed it as her fr~
therein expressed, and that ea
and hearing of the testatrix,
to the best of ouu knowledg
eighteen years of age or o
constraint or undue influence
~d that she had signed willingly and
~e and voluntary act for the purposes
ch of the witnesses, in the presence
signed the will as witness and that
, the testatrix was at that time
der, of sound mind and under no
/Dorls O. Ste,~ens~
%,-{ tress R
SUBSCRIBED, swo~n t®or aff~rmep, and Rckn2,,.ledged before
me by the above-~med testatNix and b} the ~,.itness whose names
appear abeve 01, ~ ~], ~994.
Rret a r y Pul~i~
IODICIL
I, DORIS Q. STEVENSON
Pennsylvania, declare this to
dated June 14, 1994.
ITEM I. I have by sepa
and myself, the property located
Cumberland County, Pennsylvania
right of survivorship.
of Lemoyne, Cumberland County,
be the sole codicil to my last will
~ate document deeded to my daughter
at 944 Indiana Avenue, Lemoyne,
17043, as joint tenants with the
ITEM II. I hereby decl~
house are to go to my daugh~
WILLIAM GRAFFIUS, as follows:
The office furnit~
matching oak swivel
Bedroom furniture
Bedroom furniture
bedroom.
~re that the following items in the
er, RUTH GRAFFIUS and her husband,
re - one oak
chair;
partner's desk and
One oak sectional f~le cabinet;
One oak sectional b~okcase with drop desk integral;
One oak three shelf book case;
my daughter, RUTH GRAFFIUS' bedroom;
my granddaughter, ALLISON GRAFFIUS'
ITEM III. Ail other
television in the family rc
dryer, piano, items marked ar
items in those two bedrooms, the
om, kitchen appliances, washer and
initialed by RUTH GRAFFIUS.
ITEM IV.
children. Those items they d
disposed of in a manner to max~
to be divided as follows: the
in cash to my son, JAMES ST~
daughter, RUTH GRAFFIUS and
divided equally between my
STEVENSON.
Ail personal p~operty shall be divided between my
not wish to take IN KIND shall be
~ize the proceeds. The proceeds are
first $10,000.00 in monies shall go
VENSON, the second $5,000.00 to my
.he remainder of the money shall be
sons JAMES STEVENSON and FREDERIC
ITEM V. In all other re
republish my last will dated J
codicil, as and for my last w
IN WITNESS WHEREOF, I hz
day of /~~ , 1995.
SIGNED, SEALED, PUBLIS
~pects,
lne 14,
Lll.
I hereby ratify, confirm and
1994, together with this sole
ve thereunto set my hand this
DORIS Q. STEVENSON
HED, and DECLARED by the above
individual, as and for her Codicil, in the presence of us, who
thereupon at her request, in
each other, have hereunto sub
her presence and in the presence of
scribed our names as witnesses.
STATE OF PENNSYLVANIA )
( ss
COUNTY OF DAUPHIN )
We, DORIS Q. STEVEN~
~/ C~t~) ~J ~/~'i the tesl
whose names are signed to th
being first duly sworn do
authority that the testatrix
.atrix and witnesses, respectively,
attached or foregoing instrument,
ereby declare to the undersigned
igned and executed the instrument as
expressed, and that each
hearing of the testatrix, si~
the best of our knowledge, th
years of age or older, of so
undue influence.
her last will and that she/had signed willingly and that she
executed it as her free and vqluntary act for the purposes therein
of the witnesses, in the presence and
~ed the will as witness and that to
testatrix was at that time eighteen
SUBSCRIBED, sworn to or
me by the above-named testat~
appear above on ~-~ ~>>~/~Jt
[nd mind and
under no constraint or
Witness
affirmed, and acknowledged before
ix and by the witnesses whose names
':'7, 1995.
NOtary Public
Notarial Seal
Jacquetyn A Zettlemoyer, 'gotary Publc
Harrisburg Dauphin County
My Commission Expires Jan. 29, 1,399
In the Court of Common Pleas of
IN RE:
Estate of Doris Q. Stevenson
Cumberland County, Pennsylvania
ORPHANS' COURT DIVISION
NO. 21-04-1102
Certification of Notice Under Rule 5.6(a)
Name of Decedent: Doris Q. Stevenson
Date of Death:
03~22~2004
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 12/0912004
Name
Ruth S. Graffius
Frederic G. Stevenson
James P. Stevenson
Address
944 Indiana Avenue, Lemoyne, PA 17043
4 Colony Court, Hanover, PA 17331
11 Luzerne Street, Pittston, PA 18643
N
Notice has now been given to all persons entitled thereto under R~5.6(a) except.
/ ~
Signature ~ '
Name: //' James G. M~rgant Jr.
Address// 111 N. Front Street
// Harrisbur~l, PA 17108-0889
Telephone: (717) 234~121
Capacity:
Personal Representative
X Counsel for Personal Representative
aEV-~SO0 EX + (~-00) OF-'FICJAL USE ONLY
oF REV- 1500
PENNSYLVANIA
DEPARTMENT OF REVENUE INHERITANCE TAX RETURN F.E NuMaE.
DEPT. 280601 21 04
HARRISBURG. Pa '7128-0601 RESIDENT DECEDENT COUN~CODE ~EAR
1102
NUMBER
DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER
Stevenson, Doris Q. 164-16-0543
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
03-22-2004 03-21-1915
(iF APPLICABLE] SURVIVING SPOUSE'S NAME ( LAST FIRST AND MIDDLE INITIAL)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
__ REGISTER OF WILLS _
SOCIAL SECURITY NUMBER
x 1. Original Return 2. Supplemental Return 3. Remainder Return (date of death prior to 12-13-82)
'~ ~ 5 Federal Estate Tax Return Required
,, 4. Limited Estate 4a. Future Interest Compromise (date of death after
a. o 12-12-82)
O= O~ VX~I 6. Decedent Died Testate (Attach 7. Decedent Maintained a Living Trust (Attach 1 8 Total Number of Safe Deposit Boxes
o ~ ,n copy of Will) copy of Trust)
< 9. Litigation Proceeds Received 10. Spousal Poverty Credit (aate of death between [~ 11. Election to tax under Sec. 9113(A) (Attach Sch O)
12-31-91 and 1-1-95)
]THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
James G. Morgan, Jr.
0
_ (7!_7) 234-4_121 ....
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation. Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable ISchedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
z 6. Jointly Owned Pro0erty (Schedule F)
-- Separate Billing Requested
<~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
-~ (Schedule G or L) Separate Billing Requested
n 8. Total Gross Assets (total Lines 1-7)
o 9. Funeral Expenses & Administrative Costs (Schedule H)
LU
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
(1) None
(2) 17,000.00
(3) None
(4) ._N.0.ne
(5) 60,684.88
(6) None
(7) None
~=IRM NAME (If applicable)
Tucker Arensberg, P.C.
TELEPHONE NUMBER
111 N. Front Street
POB 889
Harrisburg, PA 17108-0889
(9) 5,553.16
(10) 26.94
(8) 77,684.88
(11)
5,580.10
72,104.78
0.00
12. Net Value of Estate (Line 8 minus Line 11)
(12)
13. Charitable and Governmental Bequests/Sec 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)
z
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15.Amount of Line 14 taxable at the spousal tax rate, 0,00
or transfers under Sec. 9116(a)(1.2)
16. Amount of Line 14 taxable at lineal rate 72,10 4.78
17.Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
0.00
0.00
(13)
(14)
x .00 (15)
x .045 (16)
x .12 (17)
x .15 (18)
19. Tax Due (19)
72,104.78
0.00
3,244.72
0.00
0.00
3,244.72
20. r--I
: ~> BE SURE TO ANSWER ALL QUEST ONS ON REVERSE SIDE ~D RECHECK MATH <<
Copyright 2002 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00',
Decedent's Complete Address:
ISTREET ADDRESS
944 Indiana Avenue
~iT~'~ '-~.e m oy n e .......
STATE PA IZIP
17043
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
0.00
Total Credits (A + B + C) (2)
(1) 3,244.72
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty (D + E) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT. (4)
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 theTAX DUE. (5) 3,244.72
A. Enter the interest on the tax due. (5A)
B. Enter the total of Line 5 + 5A. This is theBALANCE DUE. (5B) 3,244.72
Make Check Payable to: REGISTER OF WILLS, AGENT
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; .............................................................................
b. retain the right to designate who shall use the property transferred or its income; ................................
c. retain a reversionary interest; or ............................................................................................................
d. receive the promise for life of either payments, benefits or care? ........................................................... ; ~x;
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ................................................................................................................. i :X
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... ! ' : X
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ................................................................................................................
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct and
complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATUF~ ! OF PERSON RESPO
leric G.
ADDRESS
ADDRESS
OTHER ~ENTATIVE ADDRESS
DATE
944 Indiana Avenue , c.../
Lemoyne, PA 17043 ~
4 Colony Court
Hanover, PA 17331 j ~..
111 N. Front Street
Harrisburg, PA 17108-0889
For ;ath on or after J~ 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving is 3% [72 116 (a) (1.1) (i)].
For 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 (a) (1.1) (ii)]. The statutedoes not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1,2000:
The tax rate imposed on the net value Df transfers from a deceased child twenty-one years of age or younger at death to or for the use of a
natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. {}9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S.
§9116 1.2)[72 P.S. §9116 (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. §9116 (a) (1.3)]. A sibling is
defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Rev-1503 EX+ (6-98)
COMMONV~.ALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Stevenson, Doris Q.
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
21-04-1102
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM CUSIP VALUE AT DATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 U.S. Savings Bond - $50.00 Series EE; Issued on 50.00
03/89; Serial No. L387526327EE
2 U.S. Savings Bond - $50.00 Series EE; Issued on 50.00
03/89; Serial No. L387526328EE
3 U.S. Savings Bond - $200 Series EE; Issued 02/1989; 200.00
Serial No. R52501689EE
4 U.S. Savings Bond - $200 Series EE; Issued 02/1989; 200.00
Serial No. R52501690EE
5 U.S. Savings Bond - $500 Series EE; Issued 08/1989; 500.00
Serial No. D24080314EE
6 U.S. Savings Bond -$500 Series EE; Issued 11/1987; 500.00
Serial No. DI7370421EE
7 U.S. Savings Bond -$500 Series EE; Issued 10/1987; 500.00
Serial No. D17792696EE
8 U.S. Savings Bond - $500 Series EE; Issued 09/1990; 500.00
Serial No. D26983781EE
9 U.S. Savings Bond -$500 Series EE; Issued 02/1990; 500.00
Serial No. D24231240EE
10 U.S. Savings Bond -$500 Series EE; Issued 08/1988; 500.00
Serial No, DI7314179EE
11 U.S. Savings Bond -$500 Series EE; Issued 0111989; 500.00
Serial No. D19539717EE
12 U.S. Savings Bond -$500 Series EE; Issued 12/1988; 500.00
Serial No. D17625657EE
Total of Continuation Schedule( ;) See attached page
TOTAL (Also enter on Line 2, Recapitulation) 17,000.00
(if more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group. Inc. Form PA-1500 Schedule B (Rev. 6-98)
Rev-tS03 EX+ (6-98)
SCHEDULE B
STOCKS & BONDS
continued
COMMONWEALTH OF PENNSYLVANIA
~NHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Stevenson, Doris Q. 21-04-1102
ITEM
NUMBER
13
14
15
16
17
18
19
2O
21
CUSIP
NUMBER DESCRIPTION
U.S. Savings Bond -$500 Series EE; Issued 0111989;
Serial No. DI9539716EE
U.S. Savings Bond - $1,000 Series EE; Issued 0811989;
Serial No. M25792076EE
U.S. Savings Bond -$1,000 Series EE; Issued 08/1989;
Serial No. M25792084EE
U.S. Savings Bond -$1,000 Series EE; Issued 07/1992;
Serial No. M45694174EE
U.S. Savings Bond -$1,000 Series EE; Issued 08/1989;
Serial No. M25792078EE
U.S. Savings Bond - $1,000 Series EE; Issued 08/1989;
Serial No. M25792077EE
U.S. Savings Bond -$1,000 Series EE; Issued 01/1989;
Serial No. M32335400EE
U.S. Savings Bond -$1,000 Series EE; Issued 0911988;
Serial No. M26057809EE
U.S. Savings Bond -$5,000 Series EE; Issued 11/1990
Serial No. V2107390EE
TOTAL (Also enter on Line 2, Recapitulation)
VALUE AT DATE
UNIT VALUE , OF DEATH
500.00
1,000.00
1,000.00
1,000.00
1,000.00
1,000.00
1,000.00
1,000.00
5,000.00
17,000.00
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule B (Rev. 6-98)
Rev-l$08 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONV~ALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Stevenson, Doris Q. 21-04-1102
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 VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
4
5
6
Fulton Bank - Certficate of Deposit #220-00976182
Fulton Bank - Certificate of Deposit #220-0096160
Accrued income on Item 2 through date of death
Accrued income on Item 2 through date of death
Fulton Bank - Certificate of Deposit #221-0022807
Accrued income on Item 3 through date of death
Fulton Bank - Certificate of Deposit #221-0022963
Accrued income on Item 4 through date of death
Fulton Bank - Checking Account No. 1218-15261
Fulton Bank - Money Market Acct. No. 9900-65086
16,000.00
13,185.70
287.66
40.55
18,958.67
54.68
7,934.32
213.69
1,589.33
2,420.28
TOTAL (Also enter on Line 5, Recapitulation) 60,684.88
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule E (Rev. 6-98)
Rev-1502 EX+ (6-98)
SCHEDULE H-A
FUNERAL EXPENSES
continued
COMMONWIEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Stevenson, Doris Q. 21-04-1102
ITEM
NUMBER DESCRIPTION AMOUNT
1 Cremation Society of PA - funeral expenses 1,354.00
Subtotal 1,354.00
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-A (Rev. 6-98)
REV-Il51 EX+ (12-99) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Stevenson, Doris Q. 21-04-1102
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
See continuation schedule(s) attached
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Social Security Number(s) / EIN Number of Personal Representative(s):
Street Address
City State Zip
Year(s) Commission paid
Attorney's Fees
Family Exemption:
Claimant
Tucker Arensberg, P.C.
If decedent's address is not the same as claimant's, attach explanation)
Street Add ress
City State Zip
Relationship of Claimant to Decedent
Probate Fees
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs
See continuation schedule(s) attached
TOTAL (Also enter on line 9, Recapitulation)
1,354.00
3,500.00
125.50
573.66
5,553.16
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H (Rev. 6-98)
Rev-1502 EX+ (6-98)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Stevenson, Doris Q. 21-04-1102
ITEM
NUMBER DESCRIPTION AMOUNT
1
2
3
4
5
6
7
Cumberland Law Journal - proof of publication
Griswold Special Care - Private nursing care final bill
Hershey Kidney Specialists - physicians bill
Holy Spirit Hospital - hospital care
Internists of Central PA - Final medical bill
Life Line - emergency transportation
Quantum Imaging - MRI
75.00
296.00
113.11
5.84
19.85
35.00
28.86
Subtotal 573.66
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-1512 EX+ (6-98)
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONV~=ALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Stevenson, Doris Q. 21-04-1102
Include unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Fulton Bank Visa - Acct. No. 4756211000016940 26.94
TOTAL (Also enter on Line 10, Recapitulation) 26.94
(if more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule I (Rev. 6-98)
REV-1513 EX+ (9-00) ~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF FILE NUMBER
Stevenson, Doris Q. 21-04-1102
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT
Do Not List Trustee(s) (Words) ($$$)
TAXABLE DISTRIBUTIONS [include outright spousal
distributions, and transfers
under Sec. 9116(a)(1.2)]
Ruth S. Graffius
944 Indiana Avenue
Lemoyne, PA 17043
Frederic G. Stevenson
4 Colony Court
Hanover, PA 1733'1
James P. Stevenson
'11 Luzerne Street
Pittston, PA 18643
Daughter
Son
Son
one-third
residue
one-third
residue
1/3 residue of
estate
Total
Enter dollar amounts for distributions shown above on lines 15 through 18, as appropriate, on Rev 1500 cover sheet
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 II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEE'I'
Copyright (c) 2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule J (Rev. 6-98)
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of Doris Q. Stevenson
also known as
~ Deceased
Ruth S. Graffius Frederic G. Stevenson
No.
Date of Death
Social Security No.
2004-01102
03~22~2O04
164-16-0543
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 date 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. I/We verify that the statements made in this Inventory
are true and correct. I/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.
Personal Representative J / /~ (~ ~,
Attorney: ~u ~
James G Morgan, Jr Signature' ' '
I.D. No.: 06~97 ...... Signature: s . //
Firm:
Address:
Telephone:
Tu~cker Arensbe_rg, P,C._
111 N. Front Street
POB 889
Harrisburg, PA 17108-0889
(717) 234-4121
Address: 944 Indiana Avenue
Lemoyne, PA 17043
..... Telephone: (717) 761-2572
Dated:
Personal Property
Cash ...............................................................................................
Miscellaneous Property ................................................................
Stocks/Listed .................................................................................
Stocks/Closely Held ......................................................................
Bonds .............................................................................................
Partnerships and Sole Proprietorships .....................................
Mortgages and Notes Receivable ...............................................
Total Personal Property .........................................
Total Real Property ................................................
Total Personal and Real Property .........................
Total Out-of-State Real Property ..........................
60,684.88
17,000.00
77,684.88
77,684.88I
TUCKER ARENSBERG
Attorneys
Januaw 5,2005
Cumberland County Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re:
Estate of Doris Q. Stevenson
File No. 21-04-1102
Dear Sir or Madam:
Enclosed please find a check payable to "Register of Wills, Agent" in the amount of
$3,244.72 which represents the inheritance tax due on the above-referenced file. The
return was filed on December 22, 2004.
Should you questions please do not hesitate to contact me. Thank you for your
cooperation in this matter.
Very truly yours,
Tucker Arensberg, P.C.
Theresa A. Wheeler
Legal Assistant to
James G. Morgan, Jr.
:taw
Enclosure
Tucker Arensberg, P.C. 111 North Front Street P.O. Box 889 Harrisburg, PA 17108 www. tuckerlaw.corn
p. 800.257.4121 p. 717.234.4121 f. 717.232.6802
TUCKER ARENSBERG
Attorneys
111 North Front Street RO. Box 889 Harrisburg, PA 17108
Cumberland County Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
i ? 0 i .5'.~.?..5:0 i
I,,,11i,,,1ii,,,,,,i1,,11,,,i1,,,11,11,,,,,,111,1,,
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-96)
NO. CD 004803
MORGAN JAMES G JR
111 N FRONT ST
P O BOX 889
HARRISBURG, PA 17108-0889
........ fold
ESTATE INFORMATION: SSN: 164-16-0543
FILE NUMBER: 2104- 1102
DECEDENT NAME: STEVENSON DORIS Q
DATE OF PAYMENT: 01/06/2005
POSTMARK DATE: 01/05/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 03/22/2004
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 $3,244.72
TOTAL AMOUNT PAID:
$3,244.72
REMARKS' TUCKER ARENSBERG
SEAL
CHECK//1
INITIALS: RSK
RECEIVED BY:
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
'*
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX ZB0601
HARRISBURG PA 171Z8-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT. ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REY-1547 EX AFP 112-D4)
JAMES G MORGAN JR
TUCKER ARENSBERG
PO B:D~ 889
HBG PA 17108
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
03-07-2005
STEVENSON
03-22-2004
21 04-1102
CUMBERLAND
101
DORIS
Q
Allount Rellitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
CUT-ALONG ~"BIS L_ ... RETAIN LOWER PORTION FOR YOUR RECORDS ......
REv:r!l;'f-QrAFir-m;!6!'r-NoT'ICE-OF-iNHErtI-TlNCi-TAX-l-PPRl-fsE'iEN'~--A[towlNCE-oR-----_._._-----_.
c--! ,,-) DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF STEVENSON DORIS Q FILE NO. 21 04-1102 ACN 101 DATE 03-07-2005
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)
.00
17.000.00
.00
.00
60.684.88
.00
.00
(8)
NOTE: To insure proper
credit to your account.
subllit the upper portion
of this forll with your
tax paYllent.
77.684.88
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 Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
5.553.16
26.94
(11)
(12)
(13)
(14)
5.580 10
72.104.78
.00
72.104.78
I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
AX C ITS:
NOTE:
.00 X
72.104.78 X
.00 X
.00 X
00 =
045 =
12 =
15 =
(19)=
.00
3.244.72
.00
.00
3.244.72
DATE
01-05-2005
NUMBER
CD004803
+
INTEREST/PEN PAID (-)
.00
AMOUNT PAID
3.244.72
BALANCE OF UNPAID INTEREST/PENALTY AS OF 01-06-2005
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
3.244.72
.00
5.43
5.43
~
. IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( 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.)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX( 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MORGAN JAMES G JR
111 N FRONT ST
POBOX 889
HARRISBURG, PA 17108-0889
n______ fold
ESTATE INFORMATION: SSN: 164-16-0543
FILE NUMBER: 2104-1102
DECEDENT NAME: STEVENSON DORIS Q
DATE OF PAYMENT: 04/04/2005
POSTMARK DATE: 04/01/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 03/22/2004
NO. CD 005155
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $247.56
I
I
I
I
I
I
,
,
TOTAL AMOUNT PAID:
REMARKS: RUTH GRAFFIUS
CHECK#13
SEAL
INITIALS: RSK
RECEIVED BY:
REGISTER OF WILLS
$247.56
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
TUCKERIARE~~~~,I~R
April 1, 2005
Cumberland County Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re: Estate of Doris a. Stevenson
Dear Sir or Madam:
Enclosed please find an original and two (2) copies of a supplemental PA
Inheritance Tax return for filing. Please time-stamp and return the file copy in the
enclosed self-addressed stamped envelope. Also enclosed is a check payable to
"Register of Wills, Agent" in the amount of $247.56 which represents the tax due.
The check for the filing fee in the amount of $15.00 is also included.
Should you have any questions, please do not hesitate to contact me. Thank
you for your cooperation in this matter.
Very truly yours,
Tucker Arensberg, P.C.
;1~tly~
Theresa A. Wheeler
Paralegal to Attorney
James G. Morgan, Jr.
:taw
Enclosures
, ,".
'-' ;
Tucker Arensberg, PC. 111 North Front Street PO. Box 889 Harrisburg, PA 17108 www.tuckerlaw.com
p.800.257.4121 p,717.234.4121 f,717.232.6802
~ i..% ~~., ~~ t \~~
REV-1500 EX + (6-00)
*'
~,~.Q.\)
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I OFFICIAL USE ONLY
IFllE NUM~'~n_..
; II 04
~_________j___ _GPJJt!IY GQQ~_~~6f(_____~___NUMB~~___ ___
- ----~----
SOCIAL SECURITY NUMBER
4a. Future Interest Compromise (date of death after
12-12-82)
X i 6. Decedent Died Testate (Attach 7. Decedent Maintained a Living Trust (Attach
copy of Will) copy of Trusl)
9. Litigation Proceeds Received 10. Spousal Poverty Credit (data of death between 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
, 12-31-91 and 1-1-95)
. [THiS;SEC~''''~TBE-CO~PLETe~iAill]~gRREsPO~OENCeP:NDCONFI~'!iI~~I~FBRtAAl-!ONSHOUl,Qi~E'DiRE'cT~bTO:'
i NAME COMPLETE MAILING ADDRESS
L-"-am e s G. M 0 r 9 al!.o........~___ _ ._.. i
1 FIRM NAME (If applicable)
! Tucker Arensberg, P .C.
.-- -~--_.__._---~-_.._~~_._---,..-
J TELEPHONE NUMBER
1 (?'--~_?) .~~4-~121~-==-=--=~~=c==-=
DECEDENT'S NAME (LAST. FIRST, AND MIDDLE INITIAL)
I-
Z
W
C
W
()
W
C
Stevenson, Doris Q.
DATE OF DEATH (MM-DD-YEAR)-
DATE OF BIRTH (MM.DD-YEAR)
i 03-22-2004
03-21-1915
i (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST. FIRST AND MIDDLE INITIAL)
I
w
....
~.o:rn
()ii!~
wo..()
%og
()!l:1II
0..
.0:
x 2. Supplemental Return
1. Original Return
: 4. limited Estate
....
z
w
c
z
o
0..
rn
w
DC:
DC:
o
()
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
z
o
i=
:5
:J
l-
ii:
<(
()
w
0:::
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L) Separate Billing Requested
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
1102
164-16-0543
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
3. Remainder Return (date of death prior 1012-13.82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
111 N. Front Street
I POB 889
-i Harrisburg, PA 17108-0889
._..~_.__.._-_.. .---.-.-..--
(1 ) None
-_._-------~~----_.-
(2) None
-----------~-~--
(3) None
------~---_.--~----
(4) None
(5) 5,671.38
(6) None
(7) None
OFFIClJi,b USE ONLY
f::~:::::,)-
"
(':',)
'~..n
-"--"'i
.<~.-
(.II
(8)
5,671.38
(9)
170.07
(11 )
170.07
(12)
5,501.31
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has
not been made (Schedule J)
14. Net Value Subjectto Tax (Line 12 minus Line 13)
(13)
0.00
(14)
5,501.31
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
120. D
0.00
247.56
0.00
0.00
247.56
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
>> BE SURE TO ANSWER All QUESTIONS ON REVERSE SIDE AND RECHECK MATH <<
._~~~.--------'-'---~~-
15. Amount of Line 14 taxable at the spousal tax rate, 0.00 x .00 (15)
or transfers under Sec. 9116(a)(1.2)
z
0 .045 (16)
i= 16.Amount of Line 14 taxable at lineal rate 5,501.31 x
<(
I-
:J
ll.. 17. Amount of Line 14 taxable at sibling rate 0.00 x .12 (17)
:!!:
0
() 18. Amount of Line 14 taxable at collateral rate 0.00 x .15 (18)
)(
<(
I- 19. Tax Due (19)
Copyright 2002 form software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 6-00:
Decedent's Complete Address:
STREET ADDRESS
944 Indiana Avenue
CITY Lemoyne
-'-''--'"1:--- .-. ------T-.-- -"---.
iSTATE PA jZIP 17043
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1 )
247.56
0.00
Total Credits (A + B + C)
(2)
0.00
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnteresUPenalty (D + E)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is thEOVERPA YMENT.
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 theTAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + SA. This is theBAlANCE DUE.
(3)
(4)
(5)
(SA)
(5B)
247.56
247.56
Make Check Payable to: REGISTER OF WILLS, AGENT
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;............................................................................. x;
b. retain the right to designate who shall use the property transferred or its income;................................ t!J
c, retain a reversionary interest; or....................,.........__............................................................................ ['Xl
d. receive the promise for life of either payments, benefits or care?........................................................... ix~
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration?............................ .............. .............................................. ........................ L!I
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?.........
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?........................... ..................................-........................ .......................... ~..J
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare thai I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct
and
C<)ffiple.t.":.Declaralion of prepsrer other Ih.an the personal.rePresen~~is..b....~...9."."11. informatiorl_of which preparer~ any knowledg.~._._ ___
SIGNATURE OF PERSON RESPONSIBL FO ILlNG RETURN ADDRESS
Ruth ra us
l_~J
. ADDRESS'-
DATE
~:~,'~~~;:V:~;3 ___ ~ 3# ~
~;~~~~. ~~";'133-'- ____ . . 3 / ~r;h y
-A'DORESS-
111 N. Front Street
Harrisburg, PA 17108-0889
For dates of death 0 fter July 1, 1 a bef January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse is 3 [7 .S. 99116 (a) (1.1) . .
For dates of death on or e 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)]. he statutedoes not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure
of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a
natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S.
99116 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. 99116 (a) (1.3)]. A sibling is
defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
REV.1513 EX+ (9.00)
*'
SCHEDULE ,J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF I FILE NUMBER
Stevenson, Doris Q. 21-04-1102
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(S) RECEIVING PROPERTY DECEDENT (Words) ($$$)
Do Not List Trustee(s)
I. TAXABLE DISTRIBUTIONS [include outright sr,ousal
aistributions, and ransfers
under Sec. 9116(a)(1.2)]
PA
Ruth S. Graffius Daughter one-third
944 Indiana Avenue residue
Lemoyne, PA 17043
Frederic G. Stevenson Son one-third
4 Colony Court residue
Hanover, PA 17331
James P. Stevenson Son 1/3 residue of
11 Luzerne Street estate
Pittston, PA 18643
Total
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
TOTAL OF PART II. ENTER TOTAL NON.TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 ScheduleJ (Rev. 6-98)
Rev-1502 EX+ (6-98)
*'
SCHEDULE H-B7
OTHER
ADMINISTRATIVE COSTS
continued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
Stevenson, Doris Q.
FILE NUMBER
21-04-1102
ESTATE OF
ITEM
NUMBER
DESCRIPTION
AMOUNT
1
Register of Wills - short certificate
4.00
2
The Sentinel - proof of publication
166.07
Subtotal
170.07
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule H-B7 (Rev. 6-98)
Rev-1508 EX+ (6-98)
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Stevenson, Doris Q.
FILE NUMBER
21-04-1102
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 DESCRIPTION
1 M&T Bank Checking Acct. No. 81910819
VALUE AT DATE
OF DEATH
5.671.16
Accrued income on Item 1 through date of death
0.22
TOTAL (Also enter on Line 5, Recapitulation)
5.671.38
(If more space is needed, additional pages of the same size)
Copyright (c) 2002 form software only The Lackner Group, Inc.
Form PA-1500 Schedule E (Rev. 6-98)
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MORGAN JAMES G JR
111 N FRONT ST
POBOX 889
HARRISBURG, PA 17108-0889
.------- fold
ESTATE INFORMATION: SSN: 164-1 6-0543
FILE NUMBER: 2104-1102
DECEDENT NAME: STEVENSON DORIS Q
DATE OF PAYMENT: 04/04/2005
POSTMARK DATE: 04/01/2005
COUNTY: CUMBERLAND
DATE OF DEATH: 03/22/2004
NO. CD 005154
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $5.43
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$5.43
REMARKS: RUTH GRAFFIUS
CHECK#14
SEAL
INITIALS: RSK
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
CJ
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM,
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
MORGAN JAMES G JR
111 N FRONT ST
POBOX 889
HARRISBURG, PA 17108-0889
___+_~n fold
ESTATE INFORMATION: SSN: 164-16-0543
FILE NUMBER, 2104-1102
DECEDENT NAME: STEVENSON DORIS Q
DATE OF PAYMENT, 06/14/2005
POSTMARK DATE, 06/13/2005
COUNTY: CUMBERLAND
DATE OF DEATH, 03/22/2004
NO. CD 005431
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $3.34
I
I
I
I
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I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 4139
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$3.34
GLENDA FARNER STRASBAUGH
REGISTER OF WillS
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BUREAU OF INDIVIDUAL TAxES
INHERITANCE TAX DIYISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
't, ,... ,_
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
Of:,:-'
JAMES G MDR&AN JR
TUCKER ARENS BERG
PO BOX 889
HBG PA 17108
*'
REV-1607 EX AFP (03-05)
07-05-2005
STEVENSON
03-22-2004
21 04-11 02
CUMBERLAND
101
Amount R_i tted
DORIS
q
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account~ sub.it the upper portion of this form with your tax p.y..nt.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
...............................................................................................................1
REV-1607 EX AFP (03-05) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ~..
ESTATE OF STEVENSON DORIS q FILE NO.21 04-1102 ACN 101 DATE 07-05-2005
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NANEO ESTATE. SHOWN BELOW
IS A SUNKARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYNENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-07-2005
PAYMENTS (TAX CREDITS):
PRINCIPAL TAX DUE: 3,492.28
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-05-2005 CD004803 .00 3,244.72
04-01-2005 CD005155 .00 247.56
04-01-2005 CD005154 5.43- 5.43
06-13-2005 CD005431 3.34- 3.34
TOTAL TAX CREDIT 3,492.28
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
.
~
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYNENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI,
YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORN FOR INSTRUCTIONS. I
TUCKERIARE~~~~~~
February 22, 2006
Cumberland County Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re: Estate of Doris a. Stevenson
Dear Sir or Madam:
Enclosed please find an original and one copy of the Status Report Under Rule
6.12 for filing. Please time stamp and return the file copy to me in the enclosed
self-addressed stamped envelope.
Should you have any questions, please do not hesitate to contact me. Thank
you for your cooperation in this matter.
Very truly yours,
Tucker Arensberg, P.C.
;1~/L2(td~~
f',)
r-'
-'0
Paralegal to Attorney
James G. Morgan, Jr.
j \ I
--
..
~."'1
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:taw
Enclosures
Tucker Arensberg, PC. 1500 One PPG Place Pittsburgh, PA 15222 p. 412.566.1212 f.412.594.5619 www.tuckerlaw.com
111 N.FrontStreet P.O. Box 889 Harrisburg,PA17108 p.717.234.4121 f.717.232.6802
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Doris O. Stevenson
Date of Death:
3/22/2004
Estate No.:
2004-01102
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:
Y es ~ 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 0 NoN
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 W No 0
"
c. Copies of receipts, releas,.es,.j,o, i n.,d,e ,rs. and .a p~, v~~.form" " al otinJ~rm,a 1 ",:}
accounts may. be filed ~lth.the Clerk of the ~,~~ ~ourt and mayl:!e ,..)
~attaChed to thIs report. """'" ", ". N~~'\ (\ \:\ \:<\. ~ .~o
Date: ' :',l .~. " ",."\\~J \. .
, Signa re'. '\ _ -:.
\ ~,
Jame G~ Morgan, Jr.
Tucke A ensberg, P.C.
.-)
c;",
," r"\
_...l
Name
III N. Front St.
Harrisburg, PA 17101
Address
~3 L( Y p_(
Telephone No.
Capacity: 0 Personal Representative
\\.!Il Counsel for personal representative
-f!1
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 2/17/2006
MORGAN JAMES G JR
111 N FRONT ST
POBOX 889
HARRISBURG, PA 17108-0889
RE: Estate of STEVENSON DORIS Q
File Number: 2004-01102
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:
3/22/2006
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,
~F::::~7t
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
f~
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 3/06/2006
STEVENSON FREDERIC G
4 COLONY COURT
HANOVER, PA 17331
RE: Estate of STEVENSON DORIS Q
File Number: 2004-01102
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:
3/22/2006
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,
~~J~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
v~
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 3/06/2006
GRAFFIUS RUTH S
944 INDIANA AVENUE
LEMOYNE, PA 17043
RE: Estate of STEVENSON DORIS Q
File Number: 2004-01102
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 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:
3/22/2006
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report, please disregard
this notice.
Sincerely,
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Counsel
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In Re: Estate of
STEVENSON DORIS Q
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 2004-01102
NOTICE OF FAILURE TO FILE STATUS REPORT
Personal Representative: GRAFFIUS RUTH S
Counsel for Personal Representative: MORGAN JAMES G JR
Date of Decedent's Death: 3/22/2004
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 form 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 determine
whether sanctions should be imposed upon the delinquent personal representative or counsel for
the delinquent personal representative.
Date:
4/3/2006
~.~.~~
J.
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
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In Re: Estate of
STEVENSON DORIS Q
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 2004-01102
NOTICE OF FAILURE TO FILE STATUS REPORT
Personal Representative: GRAFFIUS RUTH S
Counsel for Personal Representative: MORGAN JAMES G JR
Date of Decedent's Death: 3/22/2004
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 form 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 determine
whether sanctions should be imposed upon the delinquent personal representative or counsel for
the delinquent personal representative.
~~-U~
Date:
4/3/2006
..
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
Distribution:
Personal Representative
Counsel for Personal Representative
Estate File
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent: --D V \" S ~+t' i) ~O h
Date ofDeath: 31.22.-) 0 \{
Estate No.:
Pursuant to Rule 6.12 ofthe Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration ofthe above-captioned estate:
L ~~:e Dethe~:r."io" of the estate is corr-plcte:
2. If the answer is No, state when the personal representative reasonably believes that
the administration will be complete: ____l__vYl 0 h t-1--
3. If the answer to No. I is Yes, state the following:
a. Did the personal representative file a final account with 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 Orphans' Court and may be
~'" ' attached to this reporL ~
Date:
Signatu
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Address
Telephone No.
Capacity: JLrpersonal Representative
o Counsel for personal representative
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