HomeMy WebLinkAbout02-1131PETITION FOR PROBATE and GRANT OF LETTERS
Estate of 't~c~J? Wl (M(" - ~~
also known as
Deceased.
Social Security No. ~ [ :~ -- 3 _ f~ ~ (~
The petition of the undersigned respectfully represents that:
the
Your petitioner(s), who is/are 18 years of a or older an the executs~ 2
in the last will of the above decedent, dated - ct- ~ named
and codicil(s) dated , 19 ~ 7
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in t , M so i2 ~ f} 1,.1 ~
Count ,Pennsylvania, with
last family or principal residence at is ~ ~ .
A ~-ts' Lc ~ P A- i ?at3 yi-Lc
0
(list street, number and muncipality)
Dependent, then 7 ~ years of age, died Cit - ~~~wt ~p~2 ,2~
at CC..'' A i2.~.f L E= IZ ~~ o i c°1K A~ Wl ~ ~ ~, c.; , .del " iJ .:L ,
~~ ~ ~ tZ
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 of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property $ ~Cp, ~~
(If not domiciled in Pa.) Personal property in Pennsylvania $
(If not domiciled in Pa.) Personal property in County $
Value of real estate in Pennsylvania $
situated as follows:
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters ~Z'S`~-L1 Wi,~,n~'J~i2L
theron. (testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF Cumberland
NO. - 01' ~ '~Ua ..! a
To:
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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.
Sworn to or affirmed and subscribed r ,,
be~6r me t~iisM 10th day of I
Donna M. Otto, ].st Doputy
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OATH OF PERSONAL REPRESENTATIVE
if fv
Register of Wills for the
County of Ctunberland in
Commonwealth of Pennsylvania
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No.
21-2002-1131
Estate of Esther M. Miller
Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW December 12th ~ 2002 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 Ait tct ~+h,r lAg7
described therein be admitted to probate and filed of record as the last will of
Esther M. Miller ;
and Letters Testamentary
are hereby granted to David L.Miller _
FEES
Probate, Letters, Etc. ......... X235.00
Short Certificates( lp.......... $ 30.00
~~ast~t~~txx...x.-Pages• {.3) ~ 9.00
JCP ~ 10.00
TOTAL ~ 284.00
Filed . Iecember. 12th, 2D.02 ........... .
MAILID LETTERS TO EXECU`T'OR
/.,~
.~- ~,~
Register of Wills
Donna M. Otto,lst Deputy
ATTORNEY (Sup. Ct. LD. No.)
ADDRESS
PHONE
ON DECII~IBER 12TH, 2002.
11is I~ to cl )r~f~• that tht~ information here give.Z is ~orrecrly copied }prom an original certificate or 1?e~tz cte1~~ ;`ilea ~~-irh me as
i,ocal Reglsna~. -I~he origina; certificate will be.forwarded to the Stare t~ital Records Office fol- permanent tllilg.
VIi~ARNING: It is illegal to duplicate this capy by photostat or photograph.
`.~ t~)r this ~_r;itica~:e, S'.O(1
I_i1.z1 (~L:~isrrar ----
P X703979
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M,OS.taJ Rev. 2/87 COMMONWEALTH Of PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
RINT CERTIFICATE OF DEATH
TENT NAME OF DECEDENT (F rrp. MiOdo, Lda, ~~~ ~~"- ___ 4TRE FILE NUMBER
INK ,. Esther M . M i 11 e r SE% SOCIAL SECURITY NUMBER
male 213 .34 1046 DATEOFpUTNIMppn Wy'.e„)
AGE(Las BvlMey) UNDER,YEAR UNDER,DAY DATE OF &RTH '• ,vember 20.2002
Momb r Da M IaManln `Mrl ,jByljR i~NOL~,Ca~ ,ACE OF DEATH 2np~w
70 r Howe ~ M„„., 7'I (SS'S aw nro-See Malrlrcwnsmana soel
Y 4 HOSPITAL: OTHER:
Yn ~ 1 32 ,Cambridge '^al~^t^ E
.. R/OIM„laaJ Dw ^ HN«'•'"~9i ^ R.me.n~. ^ DI"'r
COVNTYOF DEAM CITY, BORO.TWPOF DEATH FAGLfTY NAME Ilnd a9~ "~ isP.~m^
I ( lutan, pve me„ antl number, VMS DECEDENT OF HISPANK ORIGINt RACE -Amerean Inoian, Bbek, WMe. ate.
Cumberland Carlisle Ne...^6T'..awoKrGen.n
b. k, M. Plane Rtrn. «~ ~l t e
OECEDEM'S USUAL OCCUPRION KING OF BUSINESS^NDUSiRY ~
(Give aegdwerw done our Y.AS DECEDENT EVERT f' t6. '
D CEDENT'S EDUCATION
awork.glxa;donausere~arM U.S.ARMEDfORCES7 n ~~ MARtTµSTRU$-ManIW SURVIVING SPOUSE
Never Marrid,
• , t• S e c r e t a r 1 naT~ No ^ Elml.ngry/Seco,gary C.f.ys ~,~ wi°0M'•o• Ip rrH, q„~ ny,tl„, ~,,,,wl
Y „$,t. John s Churc(~, ~~~ o•ors., jSpeOn") _
DECEDENT'S MAILING ADORES MC aZp COtlef DECEDENT'S t7• ta. W1dOW 1!.
• 1545 Longs Gap ~oa~ E~ ~ ,,..3,„. Pennsy vania Q, „a-~.,w„~ad~~, ort i e on
Carlisle, Penna. 17013 ISeea~I~M Cumberland
,,, anolneraael awnanipi Ne,a„w.afed
FATNER'3 NAME (Fe9.M uml /~'~^~ ,7d.^ walr„d„„Ilnysd
'~learold T. McEvoy MOTHER'SNAMEjEvSMpd.eT„tl„,$,,,n~ eapeor
'f' t Tnh M._il`11icholson
INFORMANi'S NAME (TypdPrim) If.
20.. David R . M i 11 e r INFpR,~~az S MAlllNp~ DDRES ($Ire„.GarrtyeR Stel. Dey,)
METHOD Df 01$PQ$ITION ~4L3L B riea t~row l.our~,, Harrisburg, Pa.
DATE OF DISPOSITION PUCE OF POSq IpN-N aCem„
Blnal^ Cram„ion~ Ramov„kem $1„e^ (Mpen, DeY. ~1 aO1Mr PMC r•m„dY LOCATION-C.y/bwl. Slal.. Tjp (`,pa
^ om.rlso.~,N, ~nQlan'~own ~iap
'21 ^2,eNov. 22 2002 National Cemetery Harrisburg, Pa.
• SKiNRURE UNERAI SERVKE LKENSEE OR P R$ON ACTy/O AS SUCH 21e. 2,0.
LKENS~t~r~19-L AME ANDA ESS OFF LRY
22'' :2e. ing~rot~lers: OYt anov@r r
'" '"'^u^^y"g ~•~la anat. .,.,thotcw,ad„IMtinn.G,. arks a Penns lvanlag~l 13
Myatcians Mibtaa„,inn olWnn,o IS~9rlanrre ,ay) ~ Plaq aratso. LICENSE NUMBER OQESIGNED
' «rw aa„n. ~j f'yDo5/~/~f2G l~+•Dn:+e.n
• pama 2426 rnu„ M rnr,IPl„atl ~'• /
~~ wno PrerlouncM Wam. M TIME OF DEATH DATE PgON NCED DEAD (Mmm, Day Ye„) 77e. 2fe. / / 1~0 / O Z
t` ~~ VMS CASE REFERRED 70 MEDICAL,E%AMINERICOgpNEg7
37. M11T 1: Enlar6n aa.aa.s, ifry'UrNS ar 2a' /R7 M. 2S. 'jib ~ Z~ ~•/(~~wY'1 Ne^
rMlpliCetigra whim uused 6,a deals. Do nd enter IM mode of tlltirp, SWI as rdiac or ~'
Lei oM/ oM uuae on eepl Wn. rsapiralory arrest. Stack «Man leilura. I Appreaim„a PMT U: OIMr apni6ean, corldeiorr
~ imerv„ tNlwNn nq raallein! M tln ~^^~ b Oealll, tM
tlnaYa a CorlOilanE (Final I enM arM deem ~N+,q cwaliren in PART 1.
ralAn, n tlnm,-~ a,
DVE TO TOR AC~EOUENOE r L ~D
. 'I •^K Iaeo1^! b alenaQata DUE 70108r A CONSEQUENCE QFl: r
ee,... Emr wroERLrxa IpqyyS~__ ^- ~ I /~ /~
• fl„.aa„stla e.erlbd •YVrv C. (~~07r ~-~ ~~L-C 1 Y~I
DUE 70 (OR ASA COHSE NCE UF): I
reel.krp n aa„I,) LAST
a. I
• VMS AN AUTOPSY V/ERE AUTOPSY FINglN35 MANNER Of pEATM '
PEi1FORMEDt AWUBIE PRgR 10 DATE OF ULIURY TIME OFIWURY IWURYRNa7gK7 DESCRIBE NOW INJURY
COMPLETKk1 OF CAUSE (~y IMOnm. DaY Year) OCCURRED.
OF DFAN7 N„ur„ W Hanicaa ^
Aceaanl ^ WnCnf kweatlgetbn ^ YM ^ No ^
r~ ^ Ne qa ^ No ^ sakes ^ coea na M wl.rtnnnd Q 7tro. M. 7t1e, Tod
PUCE OF IW URY-AI lama, brm, acre„, bpory, o16ce LOCATION (Sbe„. CiylTewr, Stwl
~' 2f0. 29. Maanl, aa.15peCM1
CERTNIER IC!`ept odY oriel ~' ]Ot.
'CERTIFYING PNYSIGAN(Pnyalaan c•nW^5 causad~em wnan saps„pnySKWl naa poraunud tleam arqcomp„eo Gem 271 SKiNATU AN TI CEgTIFI
Te 6M Mat of my bW`nMdfe, W stn oaurrW dw b 1M eau ~/~
• Y(a) and manMr as Si„ed ...................... ,
710.
'PRtN10UNCINO AND CERTIFYHIO -NYSICIAN (Pnyscun tam poraunc,rg de„n era can LKENSSEE NUMRFp DATE SN3NED IMwIn. .,qrl
' Te Ilia M„ a my krowledge, deem aeeumd a1 IM tknq dab. and Ilylnq a cause d tleeml // p /jT (j ~31 -
' paee, and dualolM Cause(a)arM manner as staled ................ ^ 71e. 7 7/d. ~~ L/ ~~
' NAME AND ADORE Of PERSON WNO COMPLETED CAUSE
• 'MEDICAL EXAMINER/CORONER h T
On the Mao of eaminatlon and/or Investlgatlon, In my opinion, cloth etcurted at the tlme, d„e, and pgca, and tlue to the eavae(a) aM ( ,~/~,r.P ~~- ~ r~~~/ /
menmr as stated ................ ^ ~! O h/6-Qi6tN / GIJYl "V'.1 ~ ~~
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REGISTRAR'S SIGNRURE AN Ian ER 72. /' O
V_ - - ~• I~.~.~~ I', , 1 ,'` , , / I DATE FILEDfMOran. Oa%'bal ,t
~• _ IUo~, ad ~OOa-
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~~st 3~i11 ~n~ (~1PSt~m.ent
OF
ESTHER M. MILLER
I, ESTHER M. MILLER, of 1545 Long's Gap Road, Carlisle, Cumberland
County, Pennsylvania, being of sound and disposing mind, memory and understanding,
do make, publish and declare this as and for my Last Will and Testament, hereby
revoking and making void any and all former Wills, Codicils, or writings in the nature
thereof, by me at any time heretofore made.
FIRST: I hereby order and direct my Executor, hereinafter named, to pay
all my just debts, funeral expenses, testamentary expenses and all Inheritance, Estate,
Transfer and Succession Taxes, as soon as may be conveniently done after my death,
out of my residuary estate.
SECOND: I hereby give, devise and bequeath my residuary estate to my
children, DAVID L. MILLER, of 103 Allen Hall, Harrisburg, PA 17104; ELIZABETH J.
WEAVER, 220 Linden Street, Vermillion, South Dakota 57069; and ELLEN R. BUSSEY,
of 25 Yankee Drive, Mt. Holly Springs, PA 17065, in equal shares, per stirpes.
LASTLY: I nominate, constitute and appoint my son, DAVID L. MILLER,
to be the Executor of this my Last Will and Testament. In the event that the said son shall
be unable to serve as Executor for any reason, I appoint, my daughter, ELIZABETH J.
WEAVER, as Executrix. No Executor or Executrix shall be required to file bond in this or
any other jurisdiction.
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IN WITNESS WHEREOF, I have hereunto set my hand and seal this
._~- ~ ~~. day of f ~~' ~ ~ _, 1997.
~~.
/~~„ ~'1 ~'~i("~'~
Esther M. Miller
SIGNED, SEALED. PUBLISHED and
DECLARED in the presence of:
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss
I, ESTHER M. MILLER, Testatrix, whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby
acknowledge that I signed and executed the instrument as my Last Will; that I signed it
willingly; and that I signed it as my free and voluntary act for the purposes therein
expressed.
Sworn or affirms to and acknowledge before me by ESTHER M.
MILLER, the Testatrix, this ~~-- day of C 1997•
r
Esther M. Miller, Testatrix
_~
Notary
NOTARIAL SEAL
MERLENE AIARHEVKA Noury Rblic
Garble, Cumbn'Mnd Courpr, Pa.
My Commbeion E>~Yae 618198
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss
We, James D. Flower, Jr. and James D. Flower ,
the witnesses whose names are signed to the attached or foregoing instrument, being
duly qualified according to law, do depose and say that we were present and saw
Testatrix sign and execute the instrument as her Last Will; that she signed willingly and
that she executed it as her free and voluntary act for the purposes 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 18 or more years of age, of
sound mind and under no constraint or undue influence.
Sworn or affirmed to and subscribed to before me by James D. Flower, Jr
and J mes D Fi ow _r this ~' day of ~; ~ , 1997.
Witness
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Wi Hess
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Notarv P
4
CERTIFICATION OF NOTICE UNDER RULE 5.6(al
Name of Decedent: L 5~~1 ~i2 ~ ~ 1 ~-~- ~ ~`
Date of Death: ~J c~t~ _ 2-C> , ZJ~
Will No. ~ y~~ Z "' U ~ ~,~ ~ Admin. No.
To the Register:
I certify that notice of (benef"icial interest) estate administration required by Rule 5.6(a)^of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on Yc~ ~? i C~, 2c7C)2
Name
Address
~4.~ t ~ ~ _ ltii~1 c-~~ 12 ~t23 ~ 3 ~-f. ~ ~~ t f cecx~7 C~ G-~~ ~~s~O„~2 ~--- (P-~
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Notice has now been given to all persons entitled thereto under Rule 5.6(a) except ~/1 l'7~ '~
Date: 3 ~ l 2 ~ U 3
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Signature. ~~
Name'J~.~l~n L. ~~~-~.~
Address ~23 a '~ ~~ L-~ ~ (.~ j~~ ~ ~-
Telephone (~~ ~ ~ ~ ~~Cl_
Capacity: l/ Personal Representative
Counsel for personal representative
r,'1-1500 EX 16-001 ,
ll-IO<6- 10
REV-1500 ~
INHERITANCE TAX RETURN
RESIDENT DECEDENT
.' COMMONWEALTH OF
~ . PENNSYLVANIA
'. .'illii.. DEPARTMENT OF REVENUE
DEPT 280601
e,. HARRISBURG, PA 17128-0601
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DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
f'VI I LL~R [:'ST \" e~ VVl
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
(I - d 0 - ) 00 ;;L S- - a y: - l q 3 ;;l.,
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
5a.1,OriginaIReturn
~4,LimitedEstate
[)J 6, Decedent Died Testate (Attach copy of Will)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (date of deatt', after 12.12.82)
D 7. Decedent Maintained a Living Trust (Attach copy of Trust)
D 10. Spousal Poverty Credit (date of death between 12.31.91 and 1.1.95)
OF~~;Clf\L USE ONLY
FILE NUMBER
c2L-~:2. i.L~L_
COUNTYCQDE YEAR NUMBER
SOCIAL SECURITY NUMBER
?.1-3 - 3
b
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
D 3, Remainder Return (dale of death prior to 12.13-82)
o 5, Federal Estate Tax Return Required
8. Tolal Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (AtlachSch0)
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NAME
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COMPLETE MAILING ADDRESS
TELEPHONE NUMBER
717
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17!O'l
FIRM NAME (If Applicable)
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1)
(2)
(3)
(4)
(5)
(, y.. I ~ 13. .s-S-
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3 Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
D Separate Billing.Requested
70 1l..J-Ci&. '3 ~
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G orL)
8. Total Gross Assets (total Lines 1-7)
9, Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
(9)
(10)
37&0.05
;;I&33-3Y-
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to lax has not been
made (ScheduleJl
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15, Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(l .2)
xO~(15)
XO~6)
16. Amount of Line 14 taxable at lineal rate
134,&1&,48
17. Amount of Line 14 taxable at sibling rate
x .12 (17)
x .15 (18)
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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(8) I '-II , 1J09 . 8 7
(11) C,3O,:s, 3 9
(12) .---J 3 4- (,., I i.. ~ 8
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(13)
(14)
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(,()~ - 7C/
(19)
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Decedent's Complete Address:
STREET ADDRESS
CITY
A
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
Total Credits (A + B + C ) (2)
3. interesVPenaity if appi/cabie
D.lnteresl
E. Penaity
TotallnteresVPenalty ( D + E ) (3)
4. If Line 2 is grealer than Line 1 + Line 3, enter Ihe difference. This is the OVERPAVMENT.
Check box on Page 1 Line 20 to request a refund (4)
(')057.7'-)
Go~7_7Y
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A Enter the interest on the tax due.
(5)
15A)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B)
Make Check Payable to: REGISTER OF WILLS, AGENT
bOS? 7 <-f
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. Did decedent own an Individual Retirement Account, annuity, or other non.probate property which
contains a beneficiary designation? . ........ ....................
Ves
........0
.........0
.......................0
......0
........0
.............0
..........I'l\l 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
No
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Under penalties of perjury, r declare that I have examined lhis relurn, including accompanying schedules 8ild statements, and to the best of my knowleege 8rW belief, i! is lrue, correct
and complete
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
ADDRESS
4 J 3 d.. '6 l-t~lIT..H: lZ..GW ex
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
H<'\~.J~_IS~h)12(...- P.I+ \ 11 ocr
,
ADDRESS
DATE
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. ~9116 la) (1.1) Ii)].
For dates of dealh on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of Ihe surviving spouse is 0% [72 P.S. ~9116 la) (1.1) Iii)
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
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 paren
or a stepparent of the chiid is 0% [72 P.S. ~9116(a)(1.2)J.
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. ~9116Ia)(1)].
The tax rale imposed on Ihe net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116Ia)(1.3)]. A siblin9 is defined, under Section 9102, as a,
individual who has at least one parent in common with the decedent, whether by blood or adoption.
"':M""rWI..
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF . FILE NUMBER
E<::;1~2" vYl. Yv11LL~ R
All real property owned solely or as a tenant in common must be reported at fair market value. Fair mart<et value is defined as the price at which propelt1 would be ex.changed
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
survivorshiD must be disclosed on Schedule F,
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1.
SCHEDULE A
REAL ESTATE
'PR.u p~iC.\'i \ OC~ \IUV' :
IS~S LuV)(,-\ c2-Af RcJ
C ~lt-L\ SL<= J P 0t \l 0 l3 G Y- 5"1 S - S 0
TOTAL (Also enteron line 1, Recapitulation) $ &Jif 5" r 3 . S $'
(If more space IS needed, Insert additional sheets of the same size)
REV"5OBEX'(1-97)~
,.~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
t: ~l ke.e VVt lfrtl LG:: IC
FILE NUMBER
Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of sUlVivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
\~ T I 'B R- 111 k
tJ0LS""G'f - 13
d
rYlev\'lGe.\'C.$ Fli2..SI FedelLRL Cvc ed 1+ UV1.IOVl
I ~ 84q .77
3
I q 98 Sa...t0~\fI
4 500 00
I
I-f
Jo l\ Y\ \-t A V) cock. h) vds
dl311 .7Q
co.
L.'\,ere.e'ST' OVl [;0rPt\~ ac.c..OtN\. r
( G..)V\'\", e. vW .e 1, ~ V\ k ')
VYlISC.
gl.o:J-
6-
79.0 I
TOTAL(Alsoenteronline5,Recapitulation) $ 70 If 9c... .~~
(If more space IS needed, Insert additional sheets of the same size)
,tV.ISIO EX. (2871 . SCHEDULE G
___:~~~~:~r~~r&~iJ~~~ANI~__J .__. TRANSFERS
- __ ____ __ ______________________n_____________..___
---..---
ESTATE OF
THIS SCHEDULE MUST BE COMPLETED AND FILED IFTHE ANSWER TO ANY OF THE QUESTIONS ON THE REVERSE SIDE OFTHE COVER SHEET IS YES.
----~TEM--:---------- DESCRIPTION OF PROPERTY --------l-~~~~us~~-I~~~-~-~~E I- D~~-D.---r--- gp6lE~~-rit~~,~--
NUMB-'''l'nd,,,.n.'''".-''fth~'':''",f.,..,'~.;,~.Ia'':on,!,;pt~"''~.,'', dol"-Of',O"'f.,_t____"'-+_OF ASSET___It'~. I . INTERE,ST___...
I ~okil\. \-t~V\(~,oc1..L\v~ ~1Il~\Jt.A~I' 0 ,17JSS-tt:h IOC) J7Jr$'.0b
kAIIl'S ~.h.<.~~: , I
, ,
, I
"D/'t l) l '0 L. \'l1. I u...r:v< IJ/J(O ~ I
EU2(\-lDd~\ ~. Vv1ILLt::~ 1
ELL-SO (<. Buss~~ . -4 I
mel C-t?<- I 1S"'\7S'"'81 100 ISl1S-8'-1
!;.Av1S f>eR ~e3 I I
<DCU.H~ L \NlIU€~ I/I~O I
~L{ 2 4beyk S MILlE.JZ I
E [_l \:;- V1 R. 'l30sse'1
Jo hV\ btA-Vt Qcdc ~L)\lt.d. S
~Vl:O L.. YVlILL'Evc
E;=LlzAneTh .\, MIUL~
EL~EIO R- ~0':>S~
d.
3
i
I
L u___~t..EASE PRINT ORj..YPE_
--------------.-.---
FILE NUMBER
["s-r\.te e VV1, \NLl LLa<
\QlISS,
100
18,IS$".SS-
~2Jf03
t
______L-______..__
I
. -----______ . _--=__~;;T~~IAI'ol:,: oo..Eo. ~,R.<OP;'"loIiOol k~o J ~87()~
(/f more space is needed, insert additional sheets of same size.)
""""",'''~1I.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Ew IV\(r ~ (I...() T~ e\"L'S; j:" u 'll:I e.ttAL Hu VI-t ~ 33~ 8.00
fr e.0 Rqels fl 0 w Q't.S' 6-8.30
B. ADMINISTRATIVE COSTS
1. Personal Representative's Commissions
Name of Personal Representatlve(s) _TII+LJlll L. '>1A It (<;i(
Social Secunty Number(s)/EIN Number ot Personal Representatlve(s) JiIlI> - ,
SlreetAddress ~ ~ ~ ~E'A +IA"IU"),.:) C, 0
City l-lA. . (j I State _P B:_zIP 17/09
Year(s) Commission Paid:
2. Attorney Fees 0
3. Family Exemption: (If decedenfs address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State Zip 0
Relationship of Claimant to Decedent
4. Probate Fees a 84.oU 018'+.ou
5. Accountant's Fees
6. Tax Retum Preparer's Fees
1<"1AL no tlQ..~ - 7Y;. 7~
7. t-<:::.~
~le- sol LJ€.ytl r- <.. €. 15':.00
TOTAL (Also enter on line 9, Recapitulation) $ 3 7C.o. O~
(If more space is needed, insert additional sheets of the same size)
REV-1512EX+II-97J~~
~ SCHEDULE I
COMMONWEALTH OF PENNSYLVANI,\ DEBTS OF DECEDENT,
INH~~~~~~~ioTt[E~i~~RN MORTGAGE LIABILITIES, & LIENS
ESTATE OF
Fs,l)elR vYI. \fY1ILL~v?
FILE NUMBER
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
1. 'VlZUfevd'f T Cl:~.e ~
a W-e.ST ~~()le..e E. \Il1 ~
3 'P .p +L Ununes;
<+ YO'R.k wQS It:: 'J)''S pOS'A-L
~ Sh,~\~y cV\e~~'i
0 ~.13 lQW\I\S
7 S'pRIVll
8 VVl c: '1
q T h -e. S; e.\.-\ 11 VI e... I
~48.0;;l
bllt.Q7
dG t .OB
Cf77.B2-
090.03
~ J-S"'. 00
70-. L \
Ol ~.31
IS"".UQ
TOTAL (Also enter on line 10, Recapitulation) $ J b 33. a Lf
(If more space 15 needed, Insert additional sheets of the same size)
''''''!3EX'''311*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
EST ~ e'f. W1 . VVz I u...E: r.e.
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
T . TAXABLE DISTRIBUTIONS (include outright spousal distributions)
1. 1)A l) 1<2\ 1..-. Vvz JL-"LE~
y.~ 3 a 13 f-t~~ n-t(<.Ow ~t
HAt1..~lS' Iou\'<..lr I PA lilocr
eX ELlZ4.BETH J VVlI<.LEV'C
I.J. L( W, Po\'<..\LAVlIll Ave l=lj)T 3~
f'l1el2-ltA ~1l<2S' bv.e-<..-- PA l70ST
,
3 Elle'l1 R. Buss;e~
~.r 'f JH'\ kee (DR..
I'Y1 T Ho \['1 ~ P (tiv) (,-~ I PA nObs
FILE NUMBER
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
SQVl
chl)Clk+~.J~
~ltteR
AMOUNT OR SHARE
OF ESTATE
Ol-te tll~cl
One... tltvz..Q[
oVte -ttl\LJ
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, AS APPROPRIATE, ON REV 1500 COVER SHEET
IT. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II. ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $
(If more space is needed, Insert additional sheets of the same size)
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 12/01/2004
MILLER DAVID L
4232 B HEATHROW COURT
HARRISBURG, PA 17109
RE: Estate of MILLER ESTHER M
File Number: 2002-01131
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: 11/20/2004
Your prompt attention to this matter will be appreciated.
Thank You.
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
Cumberland County Reglster ur Wlll~
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240 - 6345
Date: 10/11/2005
MILLER DAVID L
4232 B HEATH ROW COURT
HARRISBURG, PA 17109
RE: Estate of MILLER ESTHER M
File Number: 2002-01131
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 is due by: 11/20/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Si~C ...rel y'. '''''. .
. \~ ~...
. '7
, I.
~."t-<~;..tJ_ ... ...t".I
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
cc: File
Counsel
Judge
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C',
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 1 7 1 28-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
REV-1162 EX(11-961
NO. CD 002914
MILLER DAVID L
4232 B HEATHROW COURT
HARRISBURG, PA 17109
fold
ESTATE INFORMATION: SsN: 213-34-io4s
FILE NUMBER: 2102-1 131
DECEDENT NAME: MILLER ESTHER M
DATE OF PAYMENT: 08/ 1 8/2003
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 1 1 / 20/ 2002
REMARKS: DAVID L MILLER
CHECK# 1021
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
101 ~ 56,057.74
TOTAL AMOUNT PAID: 56,057.74
INITIALS:
SEAL RECEIVED BY: DONNA M. OTTO
REGISTER OF WILLS
DEPUTY REGISTER OF WILLS
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 28060]
HARRISBURG, PA 17128-0601
DAVID L MILLER
4232B HEATHROW
HBG
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
4/
REV-1547 E% AFP (R1-OS)
DATE 10-21-2003
ESTATE OF MILLER ESTHER M
DATE OF DEATH 11-20-2002
FILE NUMBER 21 02-1131
COUNTY CUMBERLAND
ACN 101
CT
PA 17109 Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS -~ _
-------------------------------------------------------------------------------
REV-1547 EX AFP (01-031 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF MILLER ESTHER M FILE N0. 21 02-1131 ACN 101 ner~ 7D-97-~nnz
TAX RETURN WAS: ( ) ACCEPTED AS FILED ( X) CHANGED SEE ATTACHED NOTICE
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
APPROVED DEDUCTIONS AND EXEMPTIONS:
(1) 64,513.55
(2) .00
t3) .00
(4) .00
(5) 76 , 496 .32
(6) .00
(7) .00
(8)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this fora with your
tax payment.
141,009.87
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 3,760.05
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 2.38 5.32
11. Total Deductions (11l 6.14 ~7
12. Net Value of Tax Return (12) 134,864.50
13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 134,864.50
NOTE: if an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15) .00 X 00 _ .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) 134,864.50 X 045. 6,068.90
17. Amount of Line 14 at Sibling rate (17) .00 X 12 - .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 - .00
19. Principal Tax Due (19)= 6, 068.90
rex rocnrTC.
DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID
OS-18-2003 CD002914 .00 6,057.74
T\ITC[]cCT TP rllw r.~re~
AT THE RATES APPLICABLE AS OUTLINED ON THE
REVERSE SIDE OF THIS FORM
TOTAL TAX CREDIT 6,057.74
BALANCE OF TAX DUE 11.16
INTEREST AND PEN. .12
TOTAL DUE 11.28
* IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A ''CREDIT'' (CR), YOU MAY BE DUE
A REFUND. SEE REUERSF CTflF nc rurc eno~ rnn ~....r....,.~.~-.._
REV-1470 EX (6-88)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
NTS
BY
Esther M Miller
INHERITANCE TAX
EXPLANATION
OF CHANGES
Deborah Washington
ITEM
SCHEDULE NO.
EXPLANATION OF CHANGES
LE NUMBER
2102-1131
~N
101
Reduced to $-0-. Real estate taxes are not allowable deductions for the years after
decedent's date of death.
ROW
Panes 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 EX111-96)
N0. CD 003169
MILLER DAVID L
4232 B HEATHROW COURT
HARRISBURG, PA 17109
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER
fold
ESTATE INFORMATION: sSN: 213-34-io46
FILE NUMBER: 2102-1 131
DECEDENT NAME: MILLER ESTHER M
DATE OF PAYMENT: 10/24/2003
POSTMARK DATE: 10/22/2003
couNTY: CUMBERLAND
DATE OF DEATH: 1 1 /20/2002
REMARKS: DAVID L MILLER
SEAL
CHECK# 2774
101 ~ $1 1.28
TOTAL AMOUNT PAID:
INITIALS: AC
RECEIVED BY: DONNA M. OTTO
511.28
DEPUTY REGISTER OF WILLS
REGISTER OF WILLS
~ ~~ -ion- ~~
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
DAVID L MILLER
4232B HEATHROW CT
HBG PA 17109
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
REV-1607 E% 6FP (01-03)
DATE 11-24-2003
ESTATE OF MILLER ESTHER M
DATE OF DEATH 11-20-2002
FILE NUMBER 21 02-1131
COUNTY CUMBERLAND
ACN 101
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT T0:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~
----------------------------------------------------------------------------------------------------------------
REV-1607 EX AFP (01-03) ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT ~~~
ESTATE OF MILLER ESTHER M FILE N0. 21 02-1131 ACN 101 DATE 11-24-2003
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: 10-21-2003
PRINCIPAL TAX DUE:
PAYMENTS CTAX CREDITS):
6,068.90
PAYMENT
DATE RECEIPT
NUMBER DISCOUNT (+)
INTEREST/PEN PAID (-) AMOUNT PAID
08-18-2003 CD002914 .00 6,057.74
10-22-2003 CD003169 .10- 11.28
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
* IF PAID AFTER THIS DATE, SEE REVERSE ( TOTAL DUE
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN 51,
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. )
6,068.92
.02CR
.00
.02CR
;-~~.
........._1
LL1
C_J
(:1: "
(:-~5
C)
~
I.J r;
0:: --
Register of Wills of Cumberland County
STATUS REPORT UNDER RULE 6.12
Name of Decedent: E~, 4 e Je. Yl1 . M \ L<..~ ~
Date of Death:
AJOU-..l m C:Jf?R -:2.0, ?OQ<-
Estate No.: ;;Z I - 0 ~ -- L l 5 J
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes r;a No 0
2. lfthe answer is No, state when the personal representative reasonably believes that
the administration will be complete:
3. lfthe 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 ~ 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: /I-(J.(),r-
-J)~d of hLl~
Signature
('"'\.1
J)AvtO L. YVt IU m
Name
c::;
IZJl $'. 19i~ Sr
Address
ttIH~-f<.I~~U fC<r, f.A 17/o f.{
Telephone No.
Capacity: ~ Personal Representative
o Counsel for personal representative
Vb