HomeMy WebLinkAbout01-1105
PETITION FOR PROBATE and GRANT OF LETTERS
Estate of Zora 8. Helm No. .:21-0/ - / / () 5'
also known as To:
, Deceased.
Register of Wills for the
County of Cumberland
Commonwealth of Pennsylvania
in the
Social Security No. 180-01-9737
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut or
in the last will of the above decedent, dated December 9. 1983
and codicil(s) dated None
named
(state relevant circumstances. e.g. renunciation. death of executor. dc.)
Decedent was domiciled at death in Cumberland County, Pennsylvania. with
h er last family or principal residence at 210 Big Sprinq Road. Newville. Pa. 17241
(West Pennsboro Township)
(list street, number and municipality)
Decedent, then 85 years of age, died 11/21/01
at Green Ridqe Villaqe. Newville. Cumberland County. Pa.
Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim ofa killing and was never ajudicated
incompetent: None
Decedent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $ 6.000.00
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $ 75.000.00
situated as follows:
improved lot of qround Iyinq and beinq situate in Southampton Township, Cumberland County
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters testamentary
thereon. S H (testamentary; administration cta.. admilllstration dbncta)
- CJ /l ~. 14.1. Il 1245 Baltimore Road
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA} ss
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 represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
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No.
21-2001-1105
Estate of Zora B. Helm
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW December 4th, 2001 , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated 12/9/83
described therein be admitted to probate and filed of record as the last will of Zora B. Helm
and Letters Testamentary
are hereby granted to
Samuel Helm
.UU't44.J J1,) ;" ,fJ J'1/4-
"of w,u, Mary C. Lewi';;~;l
FEES
l
H. Anthony Adams
25502
x-Pages (2)
JCP
. . . $ 200.00
). . . . . . . $ 6 _ 00
....... $
$ 6.00
TOTAL _ $ 5.00
Filed. Decanber. 4th., 200.1. . .$. 217.00.
Probate, Letters, Etc. .
Short Certificates ( 2
Renunciation. .
ATTORNEY (Sup. Ct. I.D. No)
128 East King Street
ShiDDensburq
Pa. 17257
ADDRESS
717-532-3270
PHONE
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HIT LETI'ERS IN ATIORNEY ADAMS FILE
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21-2001-1105
LAST WILL AND TF.ST.MHfI'
I, ~ B. HEUM, being of sound mind, memory and
understanding, do make, publish and declare this ~ Last Will
and Testament, hereby revoking all prior wills and codicils
made at any time before by me.
FIRST. I direct that all ~ funeral expenses be paid as
soon as practicable after ~ death.
SBOOND. I give, devise and bequeath, the small lot,
known as the Lemon Lot, on which is located the house of
Samuel Helm, to by brother, SAMUEL HEUM, per stirpes.
THIRD. I give and bequeath ~ great grandfather's
bureau to ~ brother, SAMUEL HELM.
FOURTH. I give, devise and bequeath the rest and
residue of ~ estate, be it real, mixed or personal, to ~
brother, SAMUEL HELM, ~ brother, CHALMER HEUM and ~ sister,
JANICE HERST in equal shares, to share and share alike, per
stirpes subject however to the life estate set forth in
paragraph five of this will.
FIFTH. I hereby grant to PAUL FRY the right to live in
my present residence and to occupy the land upon which the
said residence is situated for as long as he shall live.
a. The said life tenant shall be responsible for
reasonable maintenance, the payment of property
taxes, utilities or other assessments against the
land during the life tenancy.
b. If the said life tenant in his sole discretion
H. ANTHONY ADAMS - ATTORNEY AT LAW - 132 EAST KING STREET - SHIPPENSBURG. PENNSYLVANIA 172S7
~
should decide not to reside in the residence or
should he move away from the same, I direct that the
said residence shall become part of the residual
estate as aforementioned.
SIXTH. I nominate and appoint my brother, SAMUEL HEUM,
as the Executor of this, my Last Will and Testament.
IN WITNESS WHEREOF, I, ~ B. HEUM, to this my Last
Will and Testament set my hand and seal this ~ day of
December, 1983.
/~J31 M~(SEAL)
Sworn to and subscribed,
declared and published by
~ B. HEUM, as her
Last Wi II and Testament,
and so done in the presence
of we the witnesses, who
sign at her request, and in
her presence and in the
presence of each other.
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H, ANTHONY ADAMS - ATTORNEY AT LAW - 132 EAST KING STREET - SHIPPENSBURG, PENNSYLVANIA 17257
.
. .
CUVlVDNWEALTH OF PENNSYLVANIA:
SS
COUNTY OF aJMBERLAND
I, Zora B. Helm, the Testatrix, whose name is signed to
the foregoing instrument, having been duly qualified
according to law, do hereby acknowledge that I signed and
executed the instrument as my Last Will and Testament; and
that I signed it willingly; and that I signed it as my free
and voluntary act for the purposes therein expressed.
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Sworn to acknowledged, before .
me by Zora B. Helm the
Tes 't~ix this _9 day of
De el1)ber, l~g3.-
..~
ary Public
SHARON COLEM,"N NJNv\S, N01ary Public
Shippensburg. Curnbcri"ncJ Co.. Pa.
My Commi::sion Expir,;s /\pril 25. 1985
CUVlVDNWEALTH OF PENNSYLVANIA:
:SS
COUNTY OF aJlVBERLAND
We, H. Anthony Adams and Carma L. Cooley, the witnesses
whose names are signed to the foregoing instrument, being
duly qualified according to law, do depose and say that we
were present and saw the Testatrix, sign and execute the
instrument as her Last Will and Testament; that she signed
willingly and that she executed it as her free and voluntary
act for the purpose therein expressed; that each of us in the
hearing and sight of the Testatrix signed the Will as
witnesses, and that to the best of our knowledge the
Testatrix was at that time at least eighteen (18) or more
years of age and of sound mind and under no constraint or
undue influence.
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Sworn to and subscribed before
me by H. Anthony Adams and
Ca~R1a-L. Cooley, the wi tnes"ses;
tis.ll dll~ of December>( 1983.
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H. ANTHONY ADAMS - ATTORNEY AT LAW - 132 EAST KING STREET - SHIPPENSBURG. PENNSYLVANIA 1 7257
I~hj~, is to certifY that the information here given is correctly copied from an original certificate of deJth duly filed with me as
LOGd Registrar. The original certificate will be forwarded to the State Vital Records Office for permanem tiling.
WARNING: It is illegal to duplicate this copy by photostat or photowaph.
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No.
Fee fCH this certificate, $2.00
p
7783088
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21-2001-1105
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COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
,AGE(LatlBtrthdlft
UNDER 1 YEAR
Montfl. O.p
SEX
.. Female
STATE Fllf NUM8(~
SOCIAL SECURITY NUMBER
.. 180 - 0 \
NAME Of DECEDENT If"." Middle. Lalli
.. Zora B. Helm
..
COUNTY OF OERH
85
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BtR'THPLACE IColy atId PlACE OF DEArH lCt>kk (lroIy <)f'e -~ '1M '''!I''lIC'~ on Olhet 'IOde1
$'-1e'" FCleqIlCounlry) t+OSPllAt..
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7. ~ppensburg. PA ...
FACItJ,.... NAME (II no! ,nlIl'l\J1IOl'I. g,.... SlINt .nd r'IIJITlb."
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RACE . A~ IncH". BlK.... WtI.. -tc
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.. Cumberland
DECEDENT'S USUAl OCCUMI'ION
1~~.:a~:::L;r
tie. Ins ector ,,It.L' ai
DECEDENT'S WAIliNG ADDRESS (StY... CIyI'blwn. s... ZIP CodIt)
210 Big Spring Road
... Newville. PA 1724\
FRHER'S NAME lFir.. MIddle. LUll
to. Robert T. Helm
.tWOAMANT'S HAW( (TypeiPrinl)
Loulid Helm
METHOO OF OISPOSlT~
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SUfMvtNG SPOUSE
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MOTHER'S HAM! (Fif.. M~. M~ Solr.MleJ
to. Dora S. Helm
INFORMANT'S MAILING ADORESS1StrMt. CityfrowrI, S&*. Zip Code,
1245 Baltimore Road Shi ensbur PA \7257
Pl.ACE OF DISPOSITION. NafM ofc.m.t~, CremMOry lOC.cnoN - CityITawn. Stat_, lip Code
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DATE OF INJURY
(Month. Cay. '\INrI
TIME OF INJURY
INJUIW ICf WORk?
DESCRIBE tf()YII' INJURY OCCURRED
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To the IMet of IftY knowteclv-, death oceurNd at.......... da'a. and piKa. and due to the uUM(al and mann".. ,talled
"_OtCAL IXAMINEAlCOAONER
On the blNl. of e..mlNltlon and/or ktvaat...tlon, 'n my opinion. .ath ace",," at the Uma, data. and pi".. and due to lhe aauHfa) and
manner a. ...ted.. . . , . . . . . . . , . . , . . . . , . , . , . , . . . . . . . . . . . , . , . , , . . , , . . , . . . . . . . . . . . . . . . . . . . , , . , . . . . . . , . . . . . . , . . . . .
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REGISTRAR'S SIGNATURE AND NUMBER
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REV_1500EX+(6_00)
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Zora B. Helm
DATE OF DEATH (MM-DD-Year)
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
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FILE NUMBER
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SOCIAL SECURITY NUMBER
DATE OF BIRTH (MM-DD-Year)
80--0-197
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
11/21/2001 08/23/1916
(IF APPliCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
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00 1. Original Return
o 4. Limited Estate
00 6. Decedent Died Testate {Attach copy of Will)
o 9. Litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (dale of dealh after 12.12-82)
D 7. Decedent Maintained a Living Trust (Attach copy oITrusl)
o 10. Spousal Poverty Credit (dale of dealh between 12-31-91 and 1.1-951
o 3. Remainder Return (date of death prior to 12-13-82:,
D 5. Federal Estate Tax Return Required
.:L 8, Total Number of Safe DeposilBoxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
THIS SECTION MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
H. Anthon Adams 49 West Orange Street
FIRM NAME (If Applicable)
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TELEPHONE NUMBER
717-532-3270
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Pa. 17257
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1, Real Estate (Schedule A)
(1)
98,900.00
OFFICIAL USE ONLY
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
4. Mortgages & Notes Receivable (Schedule 0) (4)
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)
(5)
19,795.58
(6)
23,56035
(7)
(8)
142,25593
(9)
19,868.18
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)
19,868.18
122,387.75
(11)
(12)
(13)
13, Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
122,387.75
14. Net Value Subjectto Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
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15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17, AmountofLine 14 taxable at sibling rate
18, Amount of Line 14 taxable at collateral rate
19. Tax Due
X _(15)
X _(16)
116,737.33 X .12 (17) 14,008.48
5,650.42 X .15 (18) 847.56
(19) 14,856.04
20. D
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
Decedent's Complete Address:
STREET ADDRESS
1239 Baltimore Road
CITY I STATE I ZIP
Shippensburg Pa. 17257
Tax Payments and Credits:
1 Tax Due (Page 1 Une 19)
2 Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
4.50000
Total Credits (A + B +C)
(2)
3. InteresUPenalty if applicable
D. Interest
E. Penalty
TotallnterestlPenalty (0 + E) (3)
4. If Une 2 is greater than Une 1 + Une 3, enter the difference. This Is the OVERPAYMENT.
Check box on Page 1 Une 20 to request a refund (4)
5. If Une 1 + Une 31s greater than Une 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due. (5A)
B. Enter the total of Une 5 + 5A. This is the BALANCE OUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
14.856.04
4,50000
10,356.04
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1, Did decedent make a transfer and:
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? ...
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?...
3. Did decedent own an "In trust for" or payable upon death bank account or security at his or her death? .
4 Old decedent own an Individual Retirement Account, annuity. or other non-probate property which
contains a beneficiary designation? ...
Yes
o
o
o
o
o
o
o
10,356.04
No
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IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE iT AS PART OF THE RETURN.
ADDRESS
ADDRESS
Pa. 17257
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 PS 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 PS 99116 (a) (1.1) (Ii)]
The statute does not exemot 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 PS. 99116(a)(1.2)].
The tax rate imposed on Ihe net value of transters to or for the use of the decedent's lineal beneficiaries is 45%, except as noted in 72 PS 99116(1.2) [72 PS 99116(a)(1 II
The tax rate imposed on the net value at transfers to or for the use of the decedent's siblings is 12% [72 PS. 99116(a)(1.3)]. A sibling is defined, under Secllon 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RE"IDENT D...."EDENT
ESTATE OF FILE NUMBER
Zora B. Helm
All real property owned solely or as a tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged
between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointly-owned with
right of
sUlVivorshin must be disclosed on Schedule F.
SCHEDULE A
REAL ESTATE
2.
DESCRIPTION
Lot of Ground together with improvements thereon lying and situate in Southampton
Township, Cumberland County, Pennsylvania as per deed book "P" volume 8 at page
461
Lot of unimproved ground lying and being situate in Southampton Township,
Cumberland County, Pennsylvania as per deed book "S" Volume 22 page 663
VALUE AT DATE
OF DEATH
83,000 00
ITEM
NUMBER
1
15,900.00
TOTAL (Also enter on line 1, Recapitulation) $
(If more space IS needed, Insert additional sheets of the same size)
98,900.00
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Zora B. Helm
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
Mellon Bank checking account # 412-227-2323
VALUE AT DATE
OF DEATH
6,02048
2
Return of Premium from Blue Cross/Blue Shield
106.15
3.
Adams Electric Patronage Refund
29.85
4.
Prudential Financial Services
625.68
5.
Household items sold at public auction (net sale receipt attached)
10,45540
6.
Household items sold at public auction (net sale receipt attached)
1,938.67
7.
Refund of county township tax
34.12
8.
Refund of school tax
585 23
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
19.79558
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
Zora B. Helm
FILE NUMBER
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELATIONSHIP TO DE'Ct'DEN I
A Louise Helm
B Samuel Helm
c Paul E. Fry
1245 Baltimore Road
Shippensburg, Pa. 17257
sister in law
1245 Baltimore Road
Shippensburg, Pa. 17257
brother
1239 Baltimore Road
Shippensburg, Pa. 17257
friend
JOINTL Y.OWNED PROPERTY
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE Include name affinancial institution and bank account number or similar identifying number Attach DATE OF DE.A. TH DECO'S VALUE OF
NUMBER TENANT JOINT deed for jointly-held real eslale VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1 A 10/99 TimeDeposit, Mellon Bank #00585190 24,519.00 50. 12,259.50
2. B,C 4/27/94 Time Deposit, Mellon Bank #0-4434-C 34,245.00 33. 11,30085
TOTAL (Also enter on line 6, Recapitulation) $ 23560.35
(if more space is needed, insert additional sheets of the same size)
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COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
Zora B. Helm
FILE NUMBER
Oebts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Fogelsanger-Bricker Funeral Home 5,73750
2. Robert Wyrick (open grave site) 300 DO
I.
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (s) Samuel Helm 5,515 DO
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address 1245 Baltimore Road
City Shippensburq State Pa. Zip 17257
Year(s) Commission Paid' 2002
2. Attorney Fees H. Anthony Adams 3,510.00
3 Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip
Relationship of Claimant to Decedent
4 Probate Fees Register of Wills 232.00
5. Accountant's Fees
6. Tax Return Prepare~s Fees
7 News Chronicle (estate ad) 4.00
8. Carlisle Sentinel (estate ad) 13.95
9. Adams Electric Co-op 4479
10. Continuing care rlx last illness 35.20
11. Adams Electic Co-op 26.40
12. Vivian Coy - real estate taxes 19765
13. Roy R. Monn Jr(property appraisal) 225 DO
14. Carl Bert & Associates (survey of real property) 667 50
15. Janet Grove (labor at sale) 100 DO
16. Samuel Helm (funs advanced for landfill, water and electric) 351.00
17. Vivian Coy - real estate school taxes 87544
18. Tim Gruver repair 40.35
TOTAL (Also enter on line 9, Recapitulation) $ 1986818
(If more space IS needed, Insert additional sheets of the same size)
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
ZDra B. Helm
PaQe 1
Schedule H - Funeral Expenses & Administrative Costs - 87
ITEM
NUMBER
DESCRIPTION
AMOUNT
19.
20.
21.
22.
KeystDne Termite & Pest Control (on estate real property sDld)
Transfer Tax Dn transfer of estate real property
Leffler Fuel DiI (utility Dn estate property)
MiscellaneDus repair tD estate real prDperty
686 88
830.00
196.22
279.30
SUBTOTAL SCHEDULE H-B?
1,99240
HUD SETTLEMENT STATEMENT
Page 1
This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the
settlement agent are shown. Items marked (POC) were paid outside closing and are not included in the
Itotals.
~
INAME OF BUYER: NAME OF SELLER:
Estate of Zora B. Helm
Edward L. Stevens, Jr.
LENDER: LOAN TYPE: TITLE INS. NO.
Farmers and Merchants Trust Company Conventional/Fixed P 131-514
PROPERTY LOCATION: SETTLEMENT AGENT: SETTLEMENT DATE
1239 Baltimore Road WAYNE F. SHADE, ESQUIRE 29-0ct-2002
Southampton Township 53 WEST POMFRET STREET
Shippensburg, Pennsylvania CARLISLE, PENNSYLVANIA 17013
SUMMARY OF BUYER'S TRANSACTION SUMMARY OF SELLER'S TRANSACTION
100 GROSS AMOUNT DUE FROM BUYER: 400 GROSS AMOUNT DUE TO SELLER:
101 Contract sales price 83,000.00 401 Contract sales price 83,000.00
102 Personal property 402 Personal property 0.00
103 Settlement charges to buyer 403
(from line 1400) 2,507.38 404
104 ADJUSTMENTS FOR ITEMS PAID
105 BY SELLER IN ADVANCE:
ADJUSTMENTS FOR ITEMS PAID 405 Countyllocal taxes
BY SELLER IN ADVANCE: 29-0ct-2002 to 31-Dec-2002 34.12
106 County/local taxes 406 School taxes
29-0ct-2002 to 31-Dec-2002 34.12 29-0ct-2002 to 30-Jun-2003 585.23
107 School taxes 407 Assessments
29-0ct-2002 to 30-Jun-2003 585.23 408
108 Assessments 409
109 420 GROSS AMOUNT DUE SELLER 83,619.35
110 500 REDUCTIONS IN AMOUNT DUE SELLER:
120 GROSS AMOUNT FROM BUYER 86,126.73 501 Payoff of first mortgage
AMOUNTS PAID BY OR FOR BUYER: 502 Payoff of second mortgage
201 Deposit or earnest money 503 Settlement charges to
202 Principal amount of loans 78,850.00 seller (from line 1400) 830.00
203 Existing loans assumed 504 Existing loans assumed
204 505
205 506 .
CREDITS TO BUYER FOR CREDITS TO BUYER FOR
ITEMS UNPAID BY SELLER: ITEMS UNPAID BY SELLER:
206 County/local taxes 507 County/local taxes
1-Jan-2002 to 29-0ct-2002 0.00 1-Jan-2002 to 29-0ct-2002 0.00
207 School taxes 508 School taxes
1-Jul-2002 to 29-0ct-2002 0.00 1-Jul-2002 to 29-0ct-2002 0.00
208 Assessments 509 Assessments
209 510
210 511
220 TOTAL AMOUNTS PAID 520 TOTAL REDUCTIONS
BY OR FOR BUYER 78,850.00 IN AMOUNT DUE SELLER 830.00
300 CASH REQUiRED FROM OR PAYABLE 600 CASH TO SELLER
TO BUYER AT SETTLEMENT: FROM SETTLEMENT:
301 Gross amount due from buyer 601 Gross amount due seller
(from line 120) 86,126.73 (from line 420) 83,619.35
302 Less amounts paid by or for buyer 602 Less total reductions in amount
(from line 220) 78,850.00 due seller (from line 520) 830.00
303 CASH FROM (TO) BUYER: 7,276.73 603 CASH TO (FROM) SELLER: 82,789.35
TAX PRO-RATION 29-0ct-2002
2002 COUNTY/LOCAL TAXES 2002-03 SCHOOL TAXES
BILL DUE: BILL DUE
BILL PAID: 197.68 BILL PAID: 875.44
34.12 DUE SELLER 585.23 DUE SELLER
---- --_.._~ .-- 0.00 DUE BUYER 0.00 DUE BUYER --
SETTLEMENT CHARGES
PAID BY
BUYER
PAID BY
SELLER
~
1700 TOTAL REALTOR'S COMMISSION
Division of commissIon, as follows:
701 Listinn aaenl:
702 Selli;;aa;;enl:
800 ITEMS PAYABLE IN CONNECTION WITH LOAN
801 Laan orlnination fee
802 Rate lock refund
803 ADDfication fee to Farmers and Merchants $50 POC
804 Annraisal fee to Farmers and Merchants $250 POC
805 Credit renort fee to Farmers and Merchants $25 POC
806 Underwritina fee to Farmers and Merchants
807 Tax service fee to Farmers and Merchants
808 Flood certification fee to Farmers and Merchants
900 ITEMS LENDER REQUIRES BE PAID IN ADVANCE:
901 Interest for 3.00 davs@
902 Mortaaae insurance Dremium
903 Hazard insurance nremium
904
1000 RESERVES DEPOSITED WITH LENDER:
1001 Hazard insuran~
2.00 mos.
1002 Mortgage insur~ce
2.00 mos.
1003 County/local taxes
10.00 mos. I'iil
1004 School taxes
6.00 mos. I'iil
1005 Aggregate adjustment
%
%
000
(394.25
175.00
75.00
20.00
12.69
38.07
51.25
284.04 per year
23.67 Der mo.
615.00 per year
51.25 ner mo.
197.64 per year
16.47 Der mo.
875.40 per year
72.95 Der mo.
47.34
102.50
164.70
437.70
1310.43
1100 TITLE CHARGES:
1101 CIDsinn fee to
1102 Title search to
1103 DDcumentnrenaratiDn to Farmers and Merchants
1104 Notary fees to
1105 Attornev fees to H. Anthonv Adams, Esnuire POC
1106 Title insurance to Commonwealth Land Title
1107 Lender's coveraae
1108 Owner's coverane
1109 Endorsement 100
1110 Endorsement 300
1111 Endorsement 710
1112 Endorsement 8.1
1113 Closina Service Letter to Commonwealth Land Title
1200 GOVERNMENT RECORDiNG AND TRANSFER CHARGES:
1201 Deed 28.50 Mortaage 54.50
1202 Release
1203 Stlr>ulation anainst liens
1204 Local transfer tax 11%\
1205 Pennsvlvania transfertaXT1o/~
1206
1300 ADDITIONAL SETTLEMENT CHARGES:
1301 Survev to
1302 Pest insnection fee to
1303 Water test to
1304 Water and sewer to
1305 Federal Exaress
1306
1307
1400 TOTAL SETTLEMENT CHARGES:
(entered an lines 103 and 503)
~).pJ~~",
Edward L. Sieve.fs. Jr -; -
250.00
902.50
35.00
83.00
830.00
830.00
2,507.38
",y %$
/.Y, - <:1U L(J ea...-
"sr.1e af ~ora B Helm
830.00
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 12/01/2004
HELM SAMUEL
1245 BALTIMORE ROAD
SHIPPENSBURG, PA 17257
RE: Estate of HELM ZORA B
File Number: 2001-01105
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. 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 will become delinquent on: 11/21/2004
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
GLENDA FAR_NER STR_ASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
Will No.: Admin. No.:~~
Pursuant to Rule 6.12 of the Supreme Court Orphmns' Court Rules, I report the
followflag with respect to completion of the administration of the above-captioned estate:
1. State w~ether administration of the estate is complete:
Yesl~ No[-']
2. If the answer is No, state when the personal representative reasonably bel/eves
that the administration ~xdll be complete:
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 _ No []
b. The separate Orphans' Com't No. (/fany) for the personal representative's
account is:
c. Did the persona! r,..~presentative state an account in_formally to the parties
in interest? Yes~ No
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Name
- '
Address _~,,~,~ ~ t-
Telephone No.
Capacity: x~rsonal Remresentafive
~ounsel for ersonal representative
Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania
--
t
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Zora B. Helm
Date of Death: 11/21/01
Will No.
Ad . N "l' ('\._1 .r'. 'f!-:;:
min. 00.'1- u . \-,_
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphan's Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on 12/6/01
Name Address
Chalmer Helm 33 Lurgan Avenue
Shiooensbura Pa. 17257
Alice Faye Brookens 64 East Main Street
Favetteville Pa
Melba Jean Basore 9521 Shale Road
Shiooensbura Pa. 17257
John R Horst 2037 Bedford Road
Shiooensbura Pa. 17257
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except:
None
Date: 12/7/01
c-L~
Signature H. Anthony ,A.dams
Name: 128 East King Street
o
N
c...
Address:
Shiooensburg
Pa. 17257
o
-
,~~ "l:
Om
<.Do:
a:
c...J
o
Telephone(717) - 532- 327
..-
p
,)
.;. J::::l
'=': s:::
~~~ :;
~U
Capacity:
Personal Representative
X Counsel for Personal
Representative
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
ADAMS H ANTHONY ESQUIRE
128 E KING STREET
SHIPPENSBURG, PA 17257
n______ fold
ESTATE INFORMATION: SSN: 180-01-9737
FILE NUMBER: 2101-1105
DECEDENT NAME: HELM ZORA B
DATE OF PAYMENT: 11/19/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 11/21/2001
NO. CD 001858
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $10,106.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: H ANTHONY ADAMS ESQUIRE
CHECK#1009
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$1 0, 1 06.00
MARY C. LEWIS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HELM SAMUEL
1245 BALTIMORE ROAD
SHIPPENSBURG, PA 17257
h__h__ fold
ESTATE INFORMATION: SSN: 180-01-9737
FILE NUMBER: 2101-1105
DECEDENT NAME: HELM ZORA B
DA TE OF PAYMENT: 02/19/2002
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 11/21/2001
NO. CD 000871
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $4,500.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: SAMUEL E HELM
CHECK# 94
SEAL
INITIALS: SK
RECEIVED BY:
REGISTER OF WILLS
$4,500.00
MARY C. LEWIS
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
ADAMS H ANTHONY ESQUIRE
49 W ORANGE STREE SUITE 3
SHIPPENSBURG, PA 17257
n_nh_ fold
ESTATE INFORMATION: SSN: 180-01-9737
FILE NUMBER: 2101-1105
DECEDENT NAME: HELM ZORA B
DATE OF PAYMENT: 11/18/2003
POSTMARK DATE: 11/17/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 11/21/2001
NO. CD 003244
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $163.24
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: H ANTHONY ADAMS ESQUIRE
CHECK#10626
SEAL
INITIALS: VZ
RECEIVED BY:
REGISTER OF WILLS
$163.24
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
"
c,/
0)(
,.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: 2. 0 ~ ~ 13..
Date of Death: -4 } d ( J d 00 (
I I
Will No.:
\~\~
Admin. No.: ~ I -6110.5
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 ad~stration of the estate is complete:
Yes 0 No A
2. If the answer is No, state when the personal representative re onably believes
that the administration will be complete: I d- "3 l 0.3
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No 0
b. The separate Orphans' Court No. (if any) for the personal representative's
account is:
c. Did the personal representative state an account informally to the parties
in interest? Yes 0 No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Date:~JQ3 . G~~
'/ '''/' SIgnature
d~' ~ ~r<> ""~ \JL~~
Y'.\1J ~
Address S '\I ~~ l-N" ') \
II J - 5 .':?:>~) -- 3 d 70
Telephone No.
( 7 ;)57
Capacity: UJersonal Representative
~Counsel for personal representative
/ /) "') [- - ::?
/ -C-L '---:. -.-
~ BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
H ANTHONY ADAMS
STE 3
49 W ORANGE ST
SHIPPENSBURG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
11-17-2003
HELM
11-21-2001
21 01-1105
CUMBERLAND
101
*'
REY-1547 EX AFP (01-05>
ZORA
B
Allount Relli Hed
PA 17257
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: i5'4-j-Ex--AFP--foY:oiY-NoYicE--oF-YNHEifiTAifcE-YA'x-A-PPRAysEiiENT:--ALrowAi.fcE-cfi-------------- - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF HELM ZORA B FILE NO. 21 01-1105 ACN 101 DATE 11-17-2003
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of 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
TAX CREDITS:
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
Cl)
(2)
(3)
(4)
(5)
(6)
(7)
98.900.00
.00
.00
.00
19.795.58
23.560.35
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
ClO)
19,868.18
.00
CllJ
Cl2)
(13)
Cl4)
NOTE:
.00 X
.00 X
116,737.33 X
5,650.42 X
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
142,255.93
19.868 ]8
122,387.75
.00
122,387.75
00 =
045 =
12 =
15 =
.00
.00
14,008.48
847.56
14,856.04
Cl9)=
PAYMENT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-19-2002 CDOO0871 236.84 4,500.00
11-19-2002 CDOO1858 .00 10,106.00
INTEREST IS CHARGED THROUGH 12-02-2003 TOTAL TAX CREDIT 14,842.84
AT THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 13.20
REVERSE SIDE OF THIS FORM INTEREST AND PEN. 150.06
TOTAL DUE 163.26
· 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.)
/?-~--...E
~ BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISIDN
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*
REV-1U7 EX AFP <01-05)
H ANTHONY ADAMS
STE 3
49 W ORANGE ST
SHIPPENSBURG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-15-2003
HELM
11-21-2001
21 01-1105
CUMBERLAND
101
ZORA
B
Allount Rellitted
PA 17257
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, subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV: i6rfj-Ex-AFP--foY:oiY------...--zNifERITANc'E--TAx--STAyEME-NT-crF-Accouiff--.-i.---------------------
ESTATE OF HElM ZORA B FILE NO.21 01-1105 ACN 101 DATE 12-15-2003
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-17-2003
P R I NC I PAL T AX DUE: ........................................................................................................................
14,856.04
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
02-19-2002 CDOO0871 236.84 4,500.00
11-19-2002 CDOO1858 .00 10,106.00
11-17-2003 CD003244 150.03- 163.24
TOTAL TAX CREDIT 14,856.05
BALANCE OF TAX DUE .0ICR
INTEREST AND PEN. .00
IE IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .0ICR
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRJ,
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. J
L1._
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117- >"3'::> - 7D
Telephone No.
STATUS REPORT UNDER RULE 6.12
Name of Decedent: 2_0~ ~ b \ ~ \ 'fY"\
Date of Death: [ ( --;:) I ........ ~CZ) I
,
Will No.: Admin. No.:~~
Pursuant to Rule 6.12 of the Supreme Court Orphans' Comi Rules, I report the
following with respect to completion of the administration of the above-captioned estate:
1. Stat~ther administration of the estate is complete:
Yes ~ No 0
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No 0
b. The separate Orphans' Comi No. (if any) for the personal representative's
account is:
c. Did the personal~resentative state an account informally to the parties
in interest? Y es ~ No 0
c. Copies of receipts, releases, joinders and approval of formal or
informal accounts may be filed with the Clerk of the Orphans' Court
and may be attached to this report.
Date:~'b~
J-l.~."C
Signature
\~, ~,\~~~~\j''f'--S.
Name
co
C"')
f-- c~
gs~_:!
LL C (_,~'
ouc::\
::x-::: (/) ~>
0.: Z <~:
w<~
d :c E:
CLn:~;
0::0:.:;;
O~
C5
Capacity: ~rsonal Representative
~ounsel for personal representative
..
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o
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<=>
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I-
Cumberland County - Register Of Wills
One Courthouse Square
Carlisler PA 17013
Phone: (717) 240-6345
Date: 12/01/2004
HELM SAMUEL
1245 BALTIMORE ROAD
SHIPPENSBURGr PA 17257
RE: Estate of HELM ZORA B
File Number: 2001-01105
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULESr NO.
103 SUPREME COURT RULES DOCKET NO. 1r for decedents dying on or after
July 1r 1992r the personal representative or his counselr within two
(2) years of the decedent's deathr shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing will become delinquent on: 11/21/2004
Your prompt attention to this matter will be appreciated.
Thank You.
SincerelYr
i~, . \~'" ,_ 'U-. ,,' >'
/W4z:tu~ iJZ/.i>>;L1--0 )id1::~J<
,/to '-'
"-'"
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge