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Home My WebLink About01-1041 .... . PETITION FOR PROBATE and GRANT OF LETTERS Estate of PAUL K. WILSON a/so known as Deceased Social Security No. 182-22-5887 No. .:J/ -0 I - J 0'11 To: Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner is 18 years of age or older and the Executrix named in the last will of the above decedent, dated December 6, 1996,and codicil(s) dated [none]. Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last family or principal residence at 940 Walnut Bottom Road, Carlisle, Pennsylvania. (~u...-fh (hidcle~ 7(.()[J.) Decedent, then 73 years of age, died November 6, 2001, at Holy Spirit Hospital, Camp Hill, Cumberland County, Pennsylvania. 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: [none] 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 situated as follows: $ 5,000.00 $ $ $ WHEREFORE, petitioner respectfully requests the probate of the last will and codicil(s) presented herewith and the grant of letters testamentary thereon. ~d..Jj.J:;~ Debra L. Fraker --------------------------------------------------------------------- --------------------------------------------------------------------- OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA ) : SSe COUNTY OF CUMBERLAND ) The p~titioner above-named swears or affirms that the statements in the foregoing petition are true and con.ect to the besl of the knowledge and belief of petitioner and that as personal representative of the above decedent, petitioner will well and truly administer the estate according to law. Sworn to or affim'ted and subscribed before me this 13th day of November , 2001. 7Yk.v e,~ I t.,..~.P,.~ Register ~uM~if 0tdlv ~ Debra L. Fraker If"[---~o - t~ ... . No. 21-01-1041 Estate of PAUL K. WILSON, Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW, NOVEMBER 14 , 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 December 6, 1996, and described therein be admitted to probate and filed of record as the last will of Paul K. Wilson and Letters Testamentary are hereby granted to Debra L. Fraker. Will Book # Page ~~.~ <-- RegIster of WIlls TOTAL $ 25.00 $ 18.00 $ $ 9. 00 5.00 $ 57.00 Stephen L. Bloom, Esquire Sup. Ct. I.D. No. 49811 2100 Longs Gap Road Carlisle, PA 17013 (717) 249-7717 FEES Probate, Letters, Etc. Short Certificates( ) Renunciation x-pages JCP Filed NOVEMBER 13,2001 C:\LAS\EST ATES\501 4-3pet.I r~ ~If\-'::: ~~~'. . . . formation here iven is correctly copied from an original certificate of death. dul~ filed with I his IS to .cernfyTthhat t~e. mal 'fi twill gbe. forwarded to the State Vital Records Office for permanent filmg. LDcal RegIstrar. e ongm certI Ica e WARNING: It is illegal to duplicate this copy by photostat or photograph. 21-01-1041 me as No. 2i:-~. ~~~~~ Local Registrar Fee for this certificate, $2.00 p 7714435 NOV 8 2001 Date Hl05.:43 FIe>I. 21117 COMMONWEALTH OF PENNSYLVANIA' OEPARTMENT OF HEALTH' VITAL RECORDS CERTIFICATE OF DEATH ~T NT 'K ""';L.SO,,", /SIt UNClER 1 Y€AA Mcroh8 Days SEX 2. M STAll F'll NIJ"KR SOCIAl. SECURITY NUMBER 3. 182 - 22 DATE OF OERH .McnoI1. ~ '-J o. N"''J'<.y.J:)~... ~ .).<:"C'I. UNDER 1 DItY HourI 11I_ ! 81RTHI'I.ACE (C"" M1d Sla.. Of FC/ooon C"""",,, =iIYlO DECEDENT'S USUAl. OCCUPRt()Iol (~_""::'.::o ~':::~:'f o II&. Maintenance Man mo. Carlisle Barracks OICEOENT'S MAILING AOOI'lESS (SIr.... CIIyITown. s.... z,p ~I DECEDENT'S ACTUAL RESIDENCE !See""""""""'" on 0Ih.. _I 17a. Stat. ..ARITAL STIO'US._ N....... Married. WicIrawed. ~ (SC>OCIIyl 10. Wid::Med 17..KI _. __In RACE '__".IlWIl. WIla.. Olc \SpocIIyI ". White SUA\I1VING SPOUSE ,U_.___I .. Cumberland tlb. Cumberland Did - We... _;p1 rwp. 940 v~alnut Botton Rdo l~rlisle, PA 17013 17d.0 :;'=-=01 CllyibDn>. FRHER'S NAME (F.sr. MOCIdIe. latll 1I.:Ro W. Wilson INFONWIT'S NAME (T YI*I't..... 2Ila. Debra L. Fraker METHOO OF OISPOs1TlOH O ..... 0 c/__ ~ __Sl...o Ooowlian 0lIwt (SpecIIyI . 11.. . SlGHArUR& OF F OATE OF DISPOSITION (Manl/l. Day. -, 0211.. Nov'_ a. J~QO\ PERSON ACTING AS SUCH LICENSE NUI.A&a\ m.FD 012633 L To... boll 01 my k~. .ath OCCU<fod at the hm.. ela'a """ plac:.lll1od. (SigMIura 0I><l TiIIo) MOTHER'S NAME iF.II. _. _ 5uf"amol II. Florence M. Chamberlain INFORMANT'S MAlUNG ADOAESS.t5l!.... Chlbm. _. ~ Cqpel . .7100 W. Park .Kd. N.E., u=aar Rapl.ds, IA 52402 Pl.ACE OF OI$POSITION. N..... 01 c_.,.,. c,....atOlY LOCIO'ION . Cilylbm. Slate. r", CocM Of Ol"*_ 210.Fast Harrisburg Cem/Cran. 21,,~rrisburg, PA 17109 NAME AND ADORESS OF FACl\.JTY . no.Ewing Brothers Funeral Hare, Carll.sle, PA 17013 LICENSE NUM8ER 010'( SIGNED (M<d\. o.v. -I no T....E OF DEATH DATE PRONOUNCED DEAD (Monln. Day. Year) 24. II'. S'CAIII. 25. /)':~.....,lo"-... L, J..oa I 27. MItT I: E"'.. 1M -.... ..._ Of ~at_""" eoIUSOd 'he death. 00 not ant.. ,he modo at <lying, sucn.s cardiae 0' ra~rllOrv I".... _ 0< heort 'ailuol l.. onty one ca.... on IlIClIliM b. ~ CASE REFERRED TO ME ,...,0 a. f3NO' 5;-I\C>c: CO I'D DUE 10 lOR AS A CONSEQUENCE OFt. r.4.;(5U(lOj..,o, h I :: OUE 10 lOR ASA CONSEQUENCE OF): DUE 10(00 AS A CONSEQUENCE 01'): d. , Appro:l~.t. 1==; I I Ol"* .;gniftCanl-.cllliona ~... death. but """'""lliI19"'" ~_ ~ il ""'" I :ei,.. I : Wf:I\E AUlOf'SY FINDINGS MANNER OF DEATH DATE Of INJURY ~E PAIOA 10 (Mon",. Day. Year\ COMPLETlOH OF CAUSE Nal",of rj1 0 OF 0ERI11 Homic;"o Aceiclont 0 P.ndtng Inveshgllfon 0 V.. D No 0 Suic;"o 0 Could not boe d".n"r'UnBd 0 TIME OF INJURY INJURV 10' WORK? DESCRIBE HOW INJURY ClCCUAAEO. ..... 0 NoD o -. 2... 21. ClJn'lI'lEfIlCrooc- ""'" onoI .CEJtTlnlNC PHYSICIAN fPhysc.an Cfl:rt~ c.auM r::J dl-Mf'I >Nt\er olno1"'" OhVSC.an has D'OI'lOt/rtCeo d@alh at\O comOl~led"em 23) To II\e be.. of Illy knowledge. d..th OC'Curr.-d dye 10 m. CIUle(s) Ind mann.' .. IlltH. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 'I'fIONOUNCING AND CERTIFYINC .......SlCIAH (~ bOIr. "',,"ouocong ~NIh and C"""lM9 '0 cause 01 ""a"" To the beet of my ItftG"'led1A, ~.tt\occ~rred at 1he Urn_, ct.,., and plKe. and due to the cauI.(I) and m.n".,.. st.ted '.~OIC.u. EXAMINERlCOflONER 31a~:::'b::i:t::~.~~~~~t.I~~.'.~~ ~~~~~t~~~t.i~~: in. ~.y. ~pi.n.'~~: ~~~~~ ~~~~~~e.~ ~~ ~~~ "Rlt. dat~: ~~~.~I~~~: ~~~.~~~ ~~ ~~~ ~~~~~~~).~~~ 0 REGISTRAR'S SIC.NATU~M8ER :1:1 _owe ~. ~ ~III~I , 10 I .aOO\ F:\FILESIDA T AFILE\WILLS\5014WIL LAST WILL AND TESTAMENT I, PAUL K. WILSON, of Upper Frankford Township, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. 1. I direct that my earthly remains be cremated and buried in Westminster Cemetery, Carlisle, Pennsylvania, beside those of my deceased son. 2. I direct that all my just debts, funeral expenses, testamentary expenses and all inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any property) shall be paid from my residuary estate as soon as practicable after my decease and as part of the administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. 3. I give the two pictures of my father to my grandson, JEREMIAH JACOB WILSON, provided that, in my Executrix's sole discretion, she feels they will be appreciated by him. Otherwise, they shall be given to my sister, ESTHER L. MYERS. 4. I give my truck to my Trustee to hold in trust for my said grandson, JEREMIAH JACOB WILSON, until he attains the age of eighteen (18) years, at which time she shall distribute said truck to him in kind. 5. I give and bequeath the balance of my personal effects and household contents to my said grandson, JEREMIAH JACOB WILSON. 6. I direct that my Executrix shall payoff all premiums on the existing policy of life insurance 9 \~ k.1 · P.K.W. Page 1 of 4 Pages on the said JEREMIAH JACOB WILSON owned or co-owned by me at my death. 7. I give, devise and bequeath all the rest, residue and remainder of my estate, both real and personal property, unto my Trustee, in trust, for the following purposes: a. I direct that my Trustee shall hold, invest and reinvest the same, collect the income arising therefrom, and after paying all expenses incident to the management of the trust, to use and apply as much of the income and principal as may be necessary in the sole discretion of my Trustee for the support, well-being and education of my said grandson, JEREMIAH JACOB WILSON. b. I direct that my said grandson, JEREMIAH JACOB WILSON, shall have the right of withdrawal of the principal and any accumulated income of said trust as he attains the age of twenty-one (21) years. c. To the extent that the same is permitted by law, none of the beneficiaries hereunder shall have any power to dispose of or to charge by way of anticipation any interest given to such beneficiary; and all sums payable to such beneficiaries hereunder shall be free and clear of the debts, contracts, alienations and anticipations of the beneficiaries, and all liabilities for levies and attachments and proceedings of whatsoever kind, at law or in equity. 8. I nominate, constitute and appoint my said niece, DEBRA L. FRAKER, as Executrix of my estate. In the event she shall be unable or unwilling to serve in such capacity, then I appoint my sister, ESTHER L. MYERS, to act in such capacity. 9. I nominate, constitute and appoint the said DEBRA L. FRAKER as Trustee under the terms of this Last Will and Testament. In the event she shall be unable or unwilling to serve in such capacity, then I appoint my said sister, ESTHER L. MYERS, to act in such capacity. 10. I direct that my personal representative and Trustee shall not be required to file a bond to secure the faithful performance of her duties in any jurisdiction. 9 ~ """ P.K.W. Page 2 of 4 Pages 11. I authorize and empower my personal representative and Trustee, in her sole and absolute discretion, to purchase or otherwise acquire and retain any investments of which I die seized or any real or personal property of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind forming a part of my estate for such terms and such prices as she may deem advisable; to borrow money for any purposes connected with the protection and preservation of my estate; to mortgage or pledge any real or personal property forming a part of my estate or to join in or secure the partition of same; to compromise any claims or demands of my estate against others or of others against my estate; to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; to employ agents, attorneys and proxies and to delegate to them such power as my personal representative and Trustee considers desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; and to execute and deliver such instruments as may be necessary to carry out any of these powers. IN WITNESS WHEREOF I have hereunto set my hand and seal this f..o fIv day of FJ~ ,1996. ~c#'&'1-<\ W~ Paul K. Wilson (SEAL) SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, have hereunto subscribed our names as witnesses thereto, in the presence of the said Testator and of each other. ~~~~V~ ~a~ ,.. ' Page 3 of 4 Pages COMMONWEAL TH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) I, Paul K. Wilson, Testator, 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. ~~~ r~ Paul K. Wilson tA) ~ 1.1. ~?<I . G~ Notarial Seal Co.rrine L. Myers, Notary Public Carlisle !3oro, Cumberland County My CommIssIon Expires May 27,1999 COMMONWEAL TH OF PENNSYL VANIA ) : SS. COUNTY OF CUMBERLAND ) We, S+<ph'C-n j,.. t3J blTW, ~ .:Jecc ~fLJ1~ A. "b-a-/<.Lr) 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 Paul K. Wilson, the Testator, sign and execute the instrument as his Last Will; that the Testator signed willingly and that the Testator executed it as his free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the Testator, signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ~~~ ~ Address te/\ ~s+ 1-1; ~t. S+reC"-f~ L~i~f..(e. t/A 170/3 , A~t:OdJ1;v1'~~ ~ J711/3 Notarial Seal Corrine L. Myers, Notary Public Carlisle Bora, Cumberland County My Commission Expires May 27, 1999 Page 4 of 4 Pages ". CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: PAUL K. WILSON Date of Death: November 6,2001 File No. 21-01-1041 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 estate on November 28, 2001: Name Address Jeremiah J. Wilson 501 Windy Hill Road, Lot 107, Shermans Dale, P A 17090 Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: N/A d- Date: January 29, 2002 00 If:1 N C:.... '-D I Stephen L. Bloom, Esquire 2100 Longs Gap Road Carlisle, P A 17013 (717) 249-7717 Capacity: Counsel for Personal Representative c::o L..1.J l..L.. : ~"'~ ~ "f iJ) ex: N P ';, . _0 ':;':: s:: .:1)= -,"" --'" ~-'G C:\LAS\Estates\50 14-3cert.not C/ *' . FORM 93 - O. C. DIVISION IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION INRE: ESTATE OF } } } } } } No. 21-2001-1041 of 2001 PAUL K WILSON (Deceased) CLAIM To the Clerk of Orphans court Division: Index and make proper entry in your official records of the claim of OMNJPM FINANCIAL RECEIVABLE SERVICES for MBNA (Claimant), account # 4264297999232437, in the amount of $8,463.75 against the estate of the above named decedent. This claim is filed under Section 732 (b) (2) of the Fiduciaries Act of 1949 as amended. The said decedent, who resided at 5 MATTHEW CT, CARLISLE, PA 17013-4364, died on November 6,2001. Written notice of this claim was,~iven to D,.t,1(i( Fra ~ r '11 b. () w lfl (t fJ J (\ -II ^ -. () Ii n' -~ -1: Y1 5~ If O~ V()lL0( w'-'^1'\ 05 ,', (Personal representative. if any. or counsel). December 4 , 2002 t~~ /imldd~ OMNIUM FlNANCIAL RECEIVABLE SERVICES 1941 SOUTH 42ND STREET SUITE 380-25 PO BOX 6618 OMAHA, NE 68105-0618 800-999- 3 778 (Claimant's Address) CLIENT: MBNA-CREDIT CARDS BACKLOG ACCOUNT: 77590226 ~ ST~TUS: ACTIVE STATUS CLI REF#: 4264297999232437 REASON: 42-CLAIM FILED PACKET: More. . . ~ :;~~~~~~~TION I ~~~:~~ ~~~~~~~~~NU L~~~ : RNGT.SH ~HU~~ TY~~: WRKPHN PREFIX: RESP: PRMRSP AREA CODE: n:l...- ADDRESS TY~~: PRMHOM STREET: 5 MATTHEW CT FIRST NAME: PAUL PREFIX: 249 MIDDLE NAME: K CITY: CARLISLE NUMBER: 3511 LAST NAME: WILSON STATE: PA EXTENSION: 00000000 EXTENDED: ZIP CODE: 17013 4364 ANSWER CODE: SUFFIX: SSN: 182225887 COUNTRY: US M AIL CODE: MVDNOA CALL CODE: CALL I ~V~N~ W;; HL:: I I y C ~TAT~5T~C~ CUKRE:~ ~~C : 8463.75000 uSTED 0000 ~~ST~~u BA~~c~: 8463.75000 PROMISED PAYMENTS: 0.00000 PRINCIPAL 0000 LOCAL LISTING BAL: 0.00000 ADuUSTMENTS Ii B~ANCE : 0.0 PAYMENTS: 0.0 More. . . ACTIVITY: S42 CLAIM FILED 4521 12/04/2002 08:10:00 L...- Register of Wills of CUMBERLAND County, Pennsylvania INVENTORY Estate of Paul K. Wilson No. 21- 01-1041 also known as Date of Death 11/06/2001 ,Deceased Social Security No. 182-22-5887 Debra L. Fraker, 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 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 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. l!We understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Name of Attorney: Stephen L. Bloom, Esquire Personal Representative Signature: ~ r;/?, ~ Debra L. Fraker I.D. No.: 49811 Signature: Address: 2100 Longs Gap Road Address: 7100 West Park Road, N.E. Carlisle, PA 17013 Cedar Rapids, IA 52402 Telephone: 717/249- 7717 Telephone: 319/378-4462 Dated: 7/..3// ~:f0' , , Description Va:We /"', . (See continuation page(s) attached) r\'.,J (Attach additional sheets if necessary) Total: 6,192.62 NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal representative, include the value of each item, but such figures should not be extended into the total of the Inventory. Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc. Form ##RW-7 (1992) \, /'7-aCJ -I'~ BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX STEPHEN L BLOOM ESQ 2100 LONGS GAP RD CARLISLE PA ,17013 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 09-16-2002 WILSON 11-06-2001 21 01-1041 CUMBERLAND 101 *' REY-1547 EX AFP COl-D2) PAUL K Allount Rellitted 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 ~ REY=is4-j-ix-iFP--fol-:02i--Ncii"-ici--oF-'rtiliiifiTAN-cE-T-AX-A-PPRjrisiiiENT~--iLLoWANCE-(fR----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF WILSON PAUL K FILE NO. 21 01-1041 ACN 101 DATE 09-16-2002 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 abb 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 RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedul. A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Hortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Hisc. 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 .00 .00 .00 6.192.62 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H) 10. Debts/Hortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governllental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. N.t Value of Estate Subject to Tax (9) (10) 4,296.87 37.625.68 (11) (12) (13) (14) NOTE: .00 X 00 = . 00 X 045 = .00 X 12 = .00 X 15 = NOTE: To insure proper credit to your account, subllit the upper portion of this forll with your tax paYllent. 6,192.62 41.922 55 35,729.93- .00 35,729.93- (19)= .00 .00 .00 .00 .00 TAX CREDITS: . ~.. ._n . n____. . l+J AHOUNT PAID DATE NUHBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 · IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.) REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT REV -1500 EX + (6-00) CAPB HpRL EplO CRAC KOTK ES o E C E o E N T COMMONWEAL TH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Wilson Paul K. DATE OF DEATH (MM-DD-YEAR) / OFFICIAL USE ONLY ., FILE NUMBER 21-01-1041 NUMBER COUNTY CODE YEAR SOCIAL SECURITY NUMBER 182-22-5887 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER o 3. date of death . Remainder Return prior to 12-13-82) 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes DATE OF BIRTH (MM-DD-YEAR) X 1. Original Return 4. Limited Estate X 6. Decedent Died Testate Supplemental Return Future Interest Compromise (date of death after 12-12-82) Decedent Maintained a Living Trust o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) (Attach copy of Will) (Attach copy of Trust) o 9. Litigation Proceeds Received 010. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95) Es uire COMPLETE MAILING ADDRESS P NAME C 0 0 Ste hen L. Bloom, R N FIRM NAME (If Applicable) R 0 E E Ste hen L. Bloom, S N T TELEPHONE NUMBER Es uire 2100 Longs Gap Road Carlisle, PA 17013 249- 1 Real Estate (Schedule A) Stocks and Bonds (Schedule B) 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) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 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) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (1) (2) (3) None None None OFFICIAL USE ONLY R E C A P I T U L A T I o N (4) (5) None 6,192.62 None None 4,296.87 37,625.68 (8) 6,192.62 (11) 41, 922 . 55 (12) (35,729.93) (13) (14) (35,729.93 ) (6) C o M T P A ~ X A T I o N SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)( 1.2) 16. Amount of Line 14 taxable at lineal rate (35,729.93) 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate x X X X .0 0 .0 45 .12 .15 (15) (16) (17) (18) (19) 0.00 0.00 0.00 0.00 0.00 Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS CITY I STATE I ZIP Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 Total Credits ( A + B + C) (2) 0.00 3. InterestlPenalty if applicable D. Interest E. Penalty TotallnterestlPenalty ( D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line S + SA. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT !:::;!mmm:i::~!t~~~i~!i~~~!~~;I~~~';~i~~t~!li~~::j~~~~~1~~!~ii!~yll~t~~II!~::~~m..I~,!I,~~m~~:g.:~~~~,~~~IIX~~,'~~~16~j~li:WW 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; . 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 []] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ...... 0 []] 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 []] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 0.00 0.00 0.00 0.00 0.00 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. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Debra L. Fraker, Executrix _ _X~99_ _"!~~_~_~~_~~ _ ~_~~9-_'__~ ~ ~_'_ _ _ _ __ _ __ _ h _ __ - - _ -- Cedar Ra ids, IA 52402 Stephen L. Bloom, Esquire _ _ _~~99_ }:9?J~~ _ 9_c:I:? _ ~_~~9-_ _ _ _ _ _ _ _ _ _ _ - - _ - - - - - - - - - - - -- Carlisle, PA 17013 DATE ~~/t'..:2--- DATE ;:::!'f:: ;;j;;j;~L~/f.2~<;;; 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 P.S. 9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 9116 (a) (1.1) (ii)]. The statute does 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. 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.S%, 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. Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1 SOD EX (Rev. 6-00) REV -1508 EX . (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Paul K. Wilson SCHEDULE E CASH; BANK DEPOSITS, & MISC. PERSONAL PROPERTY SS1! 182-22-5887 11/06/2001 FILE NUMBER 21-01-1041 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 ManorCare, Cash in personal care account VALUE AT DATE OF DEATH 895.00 2 CornerStone, Savings Acct. #7597-01 150.42 3 CornerStone, Checking Acct. #7597-07 607.17 4 Cumberland County VA Benefit 100.00 5 Members 1st, Savings Acct. #50412-00 25.08 6 Members 1st, Checking Acct. #50412-11 2,799.90 7 Members 1st, Club Acct. #50412-02 40.05 8 1993 Skyline Mobile Home, Repossessed by secured lender, PNC, and sold to third party for $1,500.00 (See attached printout receivec from PNC confirming sale price). 1,500.00 9 Personal Property (Television) 75.00 TOTAL (Also enter on line 5, Recapitulation) $ 6,192.62 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1508 EX (Rev. 1-97) REV-1511 EX+(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Paul K. Wilson Debts of decedent must be reported on Schedule I. ITEM NUMBER A. B. SS{f 182-22-5887 11/06/2001 FILE NUMBER 21-01-1041 DESCRIPTION AMOUNT 1 FUNERAL EXPENSES: Ewing Brothers Funeral Home 2,564.00 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. 3. Attorney's Fees Stephen L. Bloom, Esquire 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 1,500.00 4. Probate Fees Register of Wills 57.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. 1 Other Administrative Costs Inheritance Tax Return/Inventory Filing Fee 20.00 2 The Cumberland Law Journal - Publication of Legal Notice 75.00 3 The Sentinel - Publication of Legal Notice 80.87 TOTAL (Also enter on line 9, Recapitulation) $ 4,296.87 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems,lnc. Form REV-1511 EX (Rev. 1-97) REV-1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Paul K. Wilson SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SSff 182-22-5887 11/06/2001 FILE NUMBER 21-01-1041 Include unreimbursed medical expenses. ITEM NUMBER 1 DESCRIPTION 2001 School Taxes, Delinquent AMOUNT 210.10 2 AllianceOne, Balance of collection of PNC Acct. 2,789.19 3 CornerStone, Visa Acct. #4457-4900-0002-3088 4,862.11 4 Department of Public Welfare, Claim for restitution of medical assistance 14,206.09 5 PNC Bank, Consumer Loan #30-02-003009304211 (1993 Skyline Mobile Home) 14,083.19 6 Thomas Rodas, Outstanding lot rent for mobile home 1,475.00 TOTAL (Also enter on line 10, Recapitulation) $ 37,625.68 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV-1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Paul K. Wilson ssg 182-22-5887 SCHEDULE J BENEFICIAR IES 11/06/2001 FILE NUMBER 21-01-1041 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)( 1.2)] 1 Jeremiah J. Wilson c/o Phillip R. Myers 122 East Old York Road Carlisle, PA 17013 Nephew 100% Estate Residue ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON- TAXABLE DISTRIBUTIONS; A. SPOUSAL DISTRIBUTIONS UNDER SEC. 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 $ (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. 0.00 Form REV-1513 EX (Rev. 9-00) > @1 @ (0) . FIFILESIDA T AFILEIWILLSI5014WIL LAST WILL AND TESTAMENT I, PAUL K. WILSON, of Upper Frankford Township, Cumberland County, Pennsylvania, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills or Codicils by me made. 1. I direct that my earthly remains be cremated and buried in Westminster Cemetery, Carlisle, Pennsylvania, beside those of my deceased son. 2. I direct that all my just debts, funeral expenses, testamentary expenses and all inheritance taxes (whether such taxes may be payable by my estate or by any recipient of any property) shall be paid from my residuary estate as soon as practicable after my decease and as part of the administration of my estate. My Executor shall have no duty or obligation to obtain reimbursement for any such tax so paid, even though on proceeds of insurance or other property not passing under this Will. 3. I give the two pictures of my father to my grandson, JEREMIAH JACOB WILSON, provided that, in my Executrix's sole discretion, she feels they will be appreciated by him. Otherwise, they shall be given to my sister, ESTHER L. MYERS. 4. I give my truck to my Trustee to hold in trust for my said grandson, JEREMIAH JACOB WILSON, until he attains the age of eighteen (18) years, at which time she shall distribute said truck to him in kind. 5. I give and bequeath the balance of my personal effects and household contents to my said grandson, JEREMIAH JACOB WILSON. 6. I direct that my Executrix shall payoff all premiums on the existing policy of life insurance " ,~ k.? . P.K.W. Page 1 of 4 Pages on the said JEREMIAH JACOB WILSON owned or co-owned by me at my death. 7. I give, devise and bequeath all the rest, residue and remainder of my estate, both real and personal property, unto my Trustee, in trust, for the following purposes: a. I direct that my Trustee shall hold, invest and reinvest the same, collect the income arising therefrom, and after paying all expenses incident to the management of the trust, to use and apply as much of the income and principal as may be necessary in the sole discretion of my Trustee for the support, well-being and education of my said grandson, JEREMIAH JACOB WILSON. b. I direct that my said grandson, JEREMIAH JACOB WILSON, shall have the right of withdrawal of the principal and any accumulated income of said trust as he attains the age of twenty-one (21) years. c. To the extent that the same is permitted by law, none of the beneficiaries hereunder shall have any power to dispose of or to charge by way of anticipation any interest given to such beneficiary; and all sums payable to such beneficiaries hereunder shall be free and clear of the debts, contracts, alienations and anticipations of the beneficiaries, and all liabilities for levies and attachments and proceedings of whatsoever kind, at law or in equity. 8. I nominate, constitute and appoint my said niece, DEBRA L. FRAKER, as Executrix of my estate. In the event she shall be unable or unwilling to serve in such capacity, then I appoint my sister, ESTHER L. MYERS, to act in such capacity. 9. I nominate, constitute and appoint the said DEBRA L. FRAKER as Trustee under the terms of this Last Will and Testament. In the event she shall be unable or unwilling to serve in such capacity, then I appoint my said sister, ESTHER L. MYERS, to act in such capacity. 10. I direct that my personal representative and Trustee shall not be required to file a bond to secure the faithful performance of her duties in any jurisdiction. p\.(~ P.K.W. Page 2 of 4 Pages 11. I authorize and empower my personal representative and Trustee, in her sole and absolute discretion, to purchase or otherwise acquire and retain any investments of which I die seized or any real or personal property of any nature; to sell, lease, pledge, mortgage, transfer, exchange, dispose of or grant options in regard to any or all property of any kind forming a part of my estate for such terms and such prices as she may deem advisable; to borrow money for any purposes connected with the protection and preservation of my estate; to mortgage or pledge any real or personal property forming a part of my estate or to join in or secure the partition of same; to compromise any claims or demands of my estate against others or of others against my estate; to make distribution in kind and to cause any share to be composed of cash, property or undivided fractional shares in property different in kind from any other share; to employ agents, attorneys and proxies and to delegate to them such power as my personal representative and Trustee considers desirable and to pay reasonable compensation for such services as may be rendered by such agents, attorneys and proxies; and to execute and deliver such instruments as may be necessary to carry out any of these powers. IN WITNESS WHEREOF I have hereunto set my hand and seal this Co #V day of fJ~ ,1996. ~.p,.S1 .1'( W'~ Paul K. Wilson (SEAL) SIGNED, SEALED, PUBLISHED AND DECLARED by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who at his request, have hereunto subscribed our names as witnesses thereto, in the presence of the said Testator and of each other. ~~~ ~a~ Page 3 of 4 Pages COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) I, Paul K. Wilson, Testator, 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. ~~~ r~ Paul K. Wilson tAl ~ ,~ _?<I . / (I, Sworn orAffirmed to and acknowledged before me by Paul K. Wilson, the Testator, this lJ'~ day of AJ-<~ , 1996. Notarial Seal Nol1taryV rip AU "'bli 'c"" ~J? \ ~ .~ A ^ II ' Corrine L. Myers, Notary Public ~u~ 11 ~ Carlisle Boro, Cumberland County My Commission Expires May 27, 1999 COMMONWEAL TH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) We, S~ 'C-n h.. r3J 0 lTh1 ~ J ~C ~~( (n'e- A .- D ~.e)CQA ) 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 Paul K. Wilson, the Testator, sign and execute the instrument as his Last Will; that the Testator signed willingly and that the Testator executed it as his free and voluntary act for the purposes therein expressed; that each of us, in the hearing and sight of the Testator, signed the Will as witnesses; and that to the best of our knowledge the Testator was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. ~~~ ~ Address -re", ~.s-t- /-t "1t. :;;+~c-r L <'^-rL ...{e. PA /70/3 , A~~~ . J1d/3 Sworn or affirmed to and subscribed before me this ~fI'- Notarial Seal Corrine L. Myers, Notary Public Carlisle Boro, Cumberland County My Commission Expires May 27,1999 day of Al.uR/f'l'l~/L" 1996. ('~7}1(f'~ Notary Public Page 4 of 4 Pages -'13 VAX 249820~ .01/21/02 MON 10. I' \...IV) 1.111;:;.1. ~ "" .....a......... ..- I~ ~~~~~~~:?n~~ Member founded - Service based P.O. Box 1181, 5 East Gate Drive, Carliile, PA 1701 TelephonE (717) 249-1661 FAX (717) 249-B208 January 16,2002 Stephen L. Bloom 2100 Longs Gap Road Carlisle, PA 17013 RE: Paul K. Wilso n Dear Sir: Account number 7597 was opened May 11,2000 in Mr. Wilson's name only. On May 15, 2000 Debra L. Fraker was added as the POA. The following are date of death balances: Account Type Balance 10/1/01 >II Interest Earned thro 11/6/0 1 D-O-D Balance Savings /o( Checking - ..n $150.04 $606.25 $ .38 $ .92 $150.42 $607.17 Mr. Wilson also has an outstanding Visa balance, as ofthe closing datt~ of 11/6/01, of $4,862.11. The Visa account number is 4457-49~OOO2-3088. Please call jf I can be of further assistance. *10/1/01 was the last dividend posting date. There was no intervening activity. cry' ~ c=~~: Operations Representa::ive ,tEMBE~ :iAVINGS ACCOUNTS FEDERALLY INSURED TO $1 00,000 BY THE NATIONAL CREDIT UNION ADMINISTRAT~ n~r MemberslST FEDERAL CREDIT UNION INSURANCE DEPARTMENT 5000 Louise Drive P. O. Box 40 Mechanicsburg, PA 17055 1-800-283-2328 or (717) 697-1161 REGULAR SAVINGS ACCOlTNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner 50412 -00 03/01/1973 $25.00 $.08 $25.08 None CHFCKING A('('OITNT' Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner 50412 -11 12/31/1979 $2,799.55 $.35 $2,799.90 None BOY .JD A Y CLlJB ACCOITNT: Account Number/Suffix Date Account Opened Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner 50412 -02 11105/1980 $40.04 $.01 $40.05 None CREDIT UNION December 12,2001 Estate of: PAUL K. WILSON Date of Death: 11/06/2001 Social Security Number: 182-22-5887 Z an Ed Wd [[:z ZO/~Z/L uE~~llns 'V ~JO~ OJ vIl8 Z9L Zlv WOB3 0 ;J;>'~Z '"'0 ~ '"'0 0000000000 '"CI'O() ~ )It;;l:;o \l.l rt fo;j w..to...to..to..to..r:.""'''''''''''.to. :;r ::T ~, 0. 0. PJ tu (J t':l ... I,Q ro ""'",,'o~~~o.~3 X O:l>'W C\l !:A: O~~~NNN~~NtuO~~~~ro rtOO'\ ro I-' 0\ en 0'\ 0'1 0\ 0\ \,D \,D 1,0 rt Hl 0 rtl (() z. I 0 "< ......"......""............lDHl~. (I) tIl . 0 . Ioj I--' -.l (fJ 0000000000 ~. (I) (Jl . , N~~NN~~~~N 0 N 0 01 ...0010U1001""'Il'>.J>>OCO.....JO N '*' ::;;:: I--' 0 0 ...... 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U'I 01 O1\,D~I.Of-J 0....... ~ \,0 I--' I--' I--'A.....JNlli 00 U1 ::l N ....... ex> -.l -.l -.l 01 m 0'\0 000 0 U1 0 0 0 OWW[J) 000 N SCHEDULE E ~1Il1ll/;::lIllIll'rl );::l))qRb) T.) T.h:nl bT.T.R ;::lq) ;::IT.b ~1':l~~H "'HTI':lrl~:I.In>-l-l 1Il~:bT. ;::lllllll;::l-~;::l-..,nr The Funeral Service for Paul K. Wilson, Sr. We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us if you have any questions in regard to this statement. THE FOLLOWINO IS AN ITEMIZED STATEMENT OF nm SERVICES, FACILITIES, AUTOMOTIVE EQUIPMENT, AND MERCHANDISE THAt YOU SELECTED WHEN MAKINO TRB FUNERAL ARRANOBMBNTS. 1. PROFFSSIONAL SERVICES StIl'Vices of Funetal DltcctorlStaft' 2. FACILITIES AND SERVICES MemoriBl Servil:Cl 3. AUTOMOTIVE EQUIPMENT o..t of town tranlpOnation lI'UNERAL HOME SERVICE CHARGES THE COST OF OUR SERVICES, EQUIPMENT, AND MERCHANDISE THAT YOU HAVE SELECTED AT THE TIME FUNERAL ARRANGEMENTS WERE MADE, WE AnV ANCED CERTAIN PAYMENTS TO OTHBRS AS AN ACCOMMODATION. THE FOLLOWING IS AN ACCOllNTINO FOR. THOSE CHARGES. CASH ADVANCES 0peninJ Grave Certified CopiClll oftbe Death Certificate Coroncn Fee Cremation Urn TOTAL CASH ADVANCES AND SPECIAL CHARGES Ewing Brothers Funeral Home Slnee 1853 630 South Hanover Street Carlisle, PA 17013.4103 (717)243-2421 Seymour A. Ewing, PO William M. Ewing. FD Steven A. Ewing, FD July 29, 2002 Debra L. Fraker 7100 W. Park Rd. N.E. Cedar Rapids, IA 52402- SUB-TOTAL INITIAL PAYMENT / DISC01JNT / CREDITS TOTAL AMOUNT DUE The stlll:ement is net lIJ\d payable in full on or before S_._ 6.~ee t. $1250.00 $500.00 550.00 51800.00 SI800.to $500.00 514.00 $25.00 $225.00 5764.00 $2564.00 $2564.00 STEPHEN L. BLOOM ATTORNEY AND COUNSELLOR AT LAW 2100 Longs Gap Road Carl is Ie, Pen n s y I van i a 1 701 3, Tel 717-249-7717 Federal EIN 25-1851818 Invoice submitted to: Wilson, Paul K. Estate c/o Debra L. Fraker, Executrix 7100 West Park Road, NE Cedar Rapids, IA 52402 January 25. 2002 In Reference To: Estate Administration Invoice #821 Professional Services H rs/Rate Amount 11/8/01 SLB Preliminary preparations for administration; Conference with Executrix 0.14 25.28 175.00/hr 11/9/01 SLB Telephone conference with Executrix and advice; Draft memo to file 0.27 46.57 175.00/hr 11/8/01 PL Administrative Matters; Office conference with Executrix re probate 1.75 166.25 95.00/hr 11/9/01 PL Preparation of Petition for Probate, IRS Form SS-4 and 1.33 126.67 correspondence to IRS 95.00/hr 11/13/01 PL Appearance at Register of Wilts Office with Executrix to present 0.75 71.25 Petition for Probate 95.00/hr 11/19/01 PL Research priority distribution rules for insolvent estate; Administrative 2.00 190.00 and accounting matters 95.00/hr 11/26/01 PL Correspondence to Executrix; Administrative matters; Insolvency 1.83 174.17 matters 95.00/hr 11/28/01 PL Telephone conference with Ms. MeIser re Death Certificate for Death 2.08 197.92 Benefits claim for Jeremiah; Telephone conference with Executrix; 95.00fhr Accounting information; Telephone conference with Social Security; Correspondence with Social Security and Department of Public Welfare; Research re unclaimed property at PA Treasury Department; Prepare IRS Form W-9 for beneficiary; Draft required Notice of PRACTICAL COUNSEL >I< CHRISTIAN PERSPECTIVE Wilson, Paul K. Estate Page 2 Hrs/Rate Amount Beneficial Interest and correspondence with beneficiary; Correspondence with Executrix 11/29/01 PL Research re reimbursement of Executrix for out-of-pocket funeral 1.00 95.00 expenses; Administrative matters 95.00/hr 11/30/01 PL Review correspondence from IRS re Tax Identification Number; Update 2.25 213.75 Accounting and Administrative Information; Correspondence with 95.00/hr banks; Correspondence with Executrix 12/7/01 PL Correspondence with Banks; Telephone conference with Ms. Eberts @ 5.25 498.75 Cornerstone re Short Certificate; Telephone conference with Ewing 95.00/hr Brothers re Funeral Bill; Telephone conference with Manor Care re personal care account balance; Telephone conference with Mr. Rodas re past due lot rent; Telephone conference with PNC re mobile home loan information; Correspondence with Executrix 12/10/01 PL Telephone conference with Manor Care re approval status of Medical 0.17 15.83 Assistance; Telephone conference with PNC re repossession of mobile 95.00/hr home 12/11/01 SLB Conference with paralegal re estate administration matters 0.33 58.33 175.00/hr PL Administrative Matters 0.33 31.67 95.00/hr 12/12/01 PL Telephone conference with Manorcare re payment status of personal 0.25 23.75 care account; Telephone conference with Executrix re Manorcare 95.00/hr account and miscellaneous matters 1/8/02 PL Review correspondence from PNC Bank re mobile home loan; 0.33 35.00 Telephone conference with Ms. Crow at PNC Bank re overdue account 105.00/hr for mobile home 1/10/02 PL Telephone conference with Cornerstone representatives re date of 0.25 26.25 death account balances and Visa account 105.00/hr 1/11/02 PL Telephone conference with M&T Bank representative re account status 0.25 26.25 105.00/hr 1/15/02 PL Review correspondence from Attorney Livaditis re claim for outstanding 0.08 8.75 trailer park rents 105.00/hr 1/21/02 SLB Review correspondence from Cornerstone 0.02 4.21 185.00/hr 1/25/02 PL Draft Certification of Notice to Beneficiary; Calculate debt vs. assets to 3.08 323.75 determine insolvency status; Draft letter of notice of insolvency to 105.00/hr general creditors; Correspondence to client; Administrative matters PRACTICAL COUNSEl. 01< CHRISTIAN PERSPE-:CTIVE Wilson, Paul K. Estate Subtotal of charges * * * Preliminary FEE DISCOUNT granted in light of limited cash available in insolvent estate * * * For professional services rendered Additional Charges: 11/13/01 Probate Fee - Register of Wills of Cumberland County Publishing Fee - Legal Notice - Cumberland Law Journal 1/8102 Publishing Fee - Legal Notice - The Sentinel Total costs Total amount of this bill Balance due PAYABLE UPON RECEIPT - THANK YOU PRACTIC/\L COUNSEL + CHRISTIAN PERSPECTIVE Page 3 Hours Amount $2,359.40 ($859.40) 23.74 $1,500.00 57.00 75.00 80.87 $212.87 $1,712.87 $1,712.87 FROM :TAXCOLLECTOR SHIRLEY ARMOLD FAX NO. :7177766879 CUMBERLAND COUNTY' TAX CLAIM ONE COURTHOUSE SQUARE CARLISLE PA 17013 BUREAU Jul. 25 2002 02:20PM Pi =' Printed: 4/19/02 C TAX CLAIM RECEIPT 11:28:27 PHONE 717 240-6366 FAX 717 240-6354 Control Number: 43-000868 Receipt No.: Receipt Date: Page: -- Property Description: ...... PAUL K \. VI EW TERRACE } 17241 25272 4/~9/2002 1 MOUNTAIN VIEW TERRACE M H P LOT 34 , M9bi1e Home - No Land S1tus Information: 34 MOUNTAIN VIEW TERRACE ~ --",,--"- - Map No: 43-05-0417-024C TR03076 UPPER FRANKFORD TOWNSHIP Tax Year Description Costs Total Penalty & Interest Face 2001 ~~bG c::~RmG.. 2001 T"S- 169.35 20.75 20.00 Received For Year Of 2001 190.10 20.00 $210.10 Tendered > Received By > Paid By > Remarks > Total Received $210.10 CASH JK ARMOLD, SHERI Balance Due As Of Claim Balance: Receipt Number: 25272 Total Received: 4/19/2002 .00 'I~ \ \ ~. '\. , \~,\ ,.\, .,' , $2~O.~O FROM 7177766879 TO Lori A. Sullivan 7/25/02 2:08 PM Page 1 ALLIANCE ONE Collect Screen (B,l,l) - GCK - #pts/trd Account:13124133 Window: Disp:3600 CEASE COMMUNICATION Name:WILSON PAUL K Rp: Adr:MOUNTAIN VIEW Adr: Cty:NEWVILLE ~ Zip:17241 Clt:7371 PNC BANK II Lst:04/1B/02 Srv:03/30/95 - /DEF/ 2HECK MESSAGES TERRACI I I I Poe:CARLISLE Adr: Cty: St: Zip: 03 PITTSBU Ltrs:1 Time:32 Wait:05/06/2002 Ssn:1B2225BB7 Cbr: Ph:717-776-5422 Ssn: Rp Ph: RIBBON MILLI Lgl: Poe Ph: I Freq: Pay: 0.00 I Cane: Born:09/26/192B I Cof: Sal: 00000000B000194033 Org: Calls:5 ... 27B9.19 Bal: 2789.1S Int: 0.00 Mult Accts: Last:BLOOM First:STEPHEN L Ph:717-249-7717 Adr:2100 LONGS GAP RD I Adr: I Cty:CARLISLE I St:PA Zip:17013 I Firm: JRU 05/06/02 2:19P 3600 RL FR ATTY - REPRESENTS ESTATE OF Z JRU 05/06/02 2:20P Z DECEASED 11/6/01 - ATTY REQUESTS CURRENT STATUS OF ACCT JRU 05/06/02 2:20P SO EXECUTRIX CAN DETERME ASSETS AND LIABILITIES OF Z - NO JRU 05/06/02 2:20P LIQUID ASSETS IN ESTATE AVAIL FOR PMT OF DEBT - ORIG TO JRU 05/06/02 2:20P FILE - COPY OTO GCK ASB - 0 LPY 07/1B/2001 CR,CO,DA,RE,SSI1,SSI2,SSI5,SMT, SCHEDULE I 01/21.102 MO~ 15:13 FAX 2498208 Cornerstone FC l@OOl v I~ ~??r~~~~T9n~~ Member founded - Service based P.O. Box 1181, 5 East Gate Drive, Carliile, PA 1701 Telephon€ (717) 249-1661 FAX (717) 249-8208 January 16,2002 Stephen L. Bloom 2100 Longs Gap Road Carlisle, PA 17013 RE: Paul K. Wilso n Dear Sir: Account number 7597 was opened May 11, 2000 in Mr. Wilson's name only. On May 15, 2000 Debra L. Fraker was added as the POA. The following are date of death balances: Account Type Balance 1 O/l/OJ "" Interest Earned thru 11/6/0 A D-O-D Balance Savings Checking $150.04 $606.25 $ .38 $ .92 $150.42 $607.17 Mr. Wilson also has an outstanding Visa balance, as of the closing dab~ of 11/6101, of $4,862.11. The Visa account number is 4457-4900-0002-3088. Please call jf I can be of further assistance. *10/1/01 was the last dividend posting date. There was no intervening activity. cry' CM~~.~ Operations Representadve i\EMBE~ SAVINGS ACCOUNTS FEDERALLY INSURED TO $1 00,000 BY THE NATIONAL CREDIT UNION ADMINISTRAT! nJll.I *' COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG. PA 17105-8486 December 12, 2001 STEPHEN L BLOOM LORI A SULLIVAN LEGAL ASSISTANT 2100 LONGS GAP RD CARLISLE PA 17013 Re: PAUL WILSON CIS #: 720125976 SSN: 182-22-5887 Date of Death: 11/06/2001 Dear Ms. Sullivan: Please be advised that the Department of Public Welfare maintains a claim in the amount of $14,206.09 against the above-mentioned estate. This claim is for restitution of medical assistance granted on behalf of the decedent for which the Probate Estate is now responsible to reimburse the Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as amended by Act 20-95, effective June 30, 1995. Enclosed is the Department's itemized statement of claim. A portion of this medical expense, namely $.00, was incurred during the last six months of the decedent's life; therefo~it is a Class 3 claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $14,206.09, is to be entered as a priority Class 6 claim against the estate. Please acknowledge receipt of this letter and advise whether the Commonwealth's claim is admitted and when payment may be expected. If the estate accounting is complete, please provide a copy. If the estate contains real estate, please provide copies of the deed, the latest tax assessment, and a current appraisal, if available. Sincerely, tbu/;.2',d!J;W.J Carol J. Zellers TPL Program Investigator 717-772-6266 717-772-6553 FAX Enclosure ~ PNCBAN< December 27,2001 Attorney Stephen L. Bloom Attention: Lori A. Sullivan 2100 Longs Gap Road Carlisle, P A 17013 RE: Estate of Paul K. \Vilson Consumer Loan: 30-02-003009304211 Dear Attorney Bloom: Per your request this letter is to advise you of the following information on the above-mentioned account. This account is a Used Mobile Home Loan in the name of Paul K. Wilson and was opened on June 3, 1993. The amount due on Mr. Wilson's date of death, November 6, 2001 was $14,083.19. The current balance is $14,252.51 with a perdiem of $4.12. There is no credit life insurance on this loan. If I can be of any other assistance, or if you need more information, please feel free to contact me at 1-800-878-0027, extension 2-6774, Monday through Friday 8:00 A.M. to 4:15 P.M. EST. ~p Senior Credit Counselor PNC Bank, NA A member of The PNC Financial Services Group (jilt' PNC Plaz:l 24<1 Fifth Avemw Pittsburgh Pennsylvania 1 !i222 2707 Law Offices of Dorothy Livaditis Attorneys At Law 32 South Beaver Street York, Pennsylvania 17401 Telep.hone: (71 7) 846-4818 Teltfax: (717) 854-2256 DorotJry Livaditis Michelle Pokrif/ca January 10, 2002 Branch Office: 1939 Security Drive York, PennSJ!lvania 17402 Telephone: (717)741-4997 Stephen Bloom, Esquire 2100 Longs Gap Road Carlisle, PA 17013 Re: Paul Wilson Dear Attorney Bloom: Please be advised that our office represents Mr. Thomas Rodas, the owner of the trailer park located in Newville, Pennsylvania, in which Mr. Wilson resided. My client has advised me that Mr. Wilson recently passed away and that you are now representing his Estate. My client has contacted me concerning outstanding amounts due and owing to him by Mr. Wilson for rental of space at the trailer park More specifically, Mr. Rodas informs me that the outstanding balance due from Mr. Wilson is One Thousand Four Hundred Seventy-Five and 00/100 ($1,475.00) Dollars. Kindly consider this letter as notice to the Estate of Mr. Wilson of Mr. Rodas' claim for $1 ,475.00. I would appreciate an early response from you rega . is matter. DL:n pc: Mr. Thomas Rodas nly/rodas.ltr ,1 f1~:" f".,' ' \_.. \- \ ( j M~ 1 'l 2002 L) SCHEDULE I . Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 N f D d t Wilson, Paul K. ame 0 ece en : Date of Death: 11/06/2001 Estate No.: 2001-01041 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 0 No 0 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: Unknown -insolvent, no communication from PRep. 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 D D t March 4, 2005 a e: 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 attachod to th;s report. ~ --Signature Stephen L. Bloom Name 2100 Longs Gap Road Carlisle, PA 17013 Address 717-249-7717 Telephone No. Capacity: 0 Personal Representative o Counsel for personal representative ) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 10/10/2005 BLOOM STEPHEN L 2100 LONGS GAP RD CARLISLE, PA 17013 RE: Estate of WILSON PAUL K File Number: 2001-01041 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: 11/06/2005 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~h~J~ GLENDA FARt~ER STR~SBAUGH REGISTER OF WILLS cc: File Personal Representative(s) Judge \- (.... u- e:. U-,I g: u.- C)c:" Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: ----W 'il ~o('\ { 9~1 k. Date of Death: ~ ;;LOo I Estate No.: ~OO I - 0 I 04- t Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 0 No ~ 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: I )^k:r.oLo.)r'\ - ~solv~--r. ~o Co""'I""'-,,~cc..+'OI"'\ - ~"'"' P~o1\.C"-l t<epn::...s~-t:CA.-rl>Ie 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 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 A ~ J /~."//' ~ate: lofi1>Jos- ~:../ ~ . ; J' ~ature Y-e-f~ L. D/oo.-n ;I3CO. Name :;21 00 Lo~~ 6c.e. a c.d L.6-JI,-s(e, q.JA 77of:3 . Address c-:-, c: 7 1/- ;24-q - 7717 Telephone No. Capacity: o Personal Representative g[, Counsel for personal representative \\~ o 11.-::' (,1 ene " M" ~' (f.) 2 (.1") 0 lfj Ct: ~-') ~'- 1 ~s.:;. ~") (>~ ;~: ~.~- (=, Cl :E ~ '\) < ~y V-- ~ - :: ;; "=1 '" ::: '" == t:llr+ ;:l ~ ,Q 2(w~~~ 6j)/"" , l~'] i~ C ~$-t'~;~~ ~o ~ ~~fs)O- <" '"' "=1 - '€ 0:; ." ~,Q ~ g . da=U~ &J(A=~;': E=-~8a ~~ - Q '"' CW t\ '81 ~ <1' tr: o/~ --,n LL, C", l',~" , au" ~ ex: ',' ~.-,'l":.',:'!t.. ~,~ \,-.' '~ eft:) F c.:s ~j J} U ~ 'i ''^ \ \ \ \ V' '\ \f' ,~ \ 'j \ \:)\ \ (;"\ \ \ L /' \ :::.) 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I (" ':"1' N r'" +- N () .::t N tll In Re: Estate of WILSON PAUL K ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 2001-01041 NOTICE OF FAILURE TO FILE STATUS REPORT Personal Representative: FRAKER DEBRA L Counsel for Personal Representative: BLOOM STEPHEN L Date of Decedent's Death: 11/6/2001 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 detemline whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. ~~~ Date: 12/6/2006 Glene" H Clerk Distribution: Personal Representative Counsel for Personal Representative Estate File r- ....[] rn r:Q r:Q rn ....[] ru ~ .. - ..... . U.S. Postal Servicen. CERTIFIED MAILM RECEIPT (Domestic Mail Only; No Insurance Coverage Provided) Certified Fee 01-\ l.D\ \ ~ IcO notcf rn CJ CJ Return Receipt Fee CJ (Endorsement Required) CJ Restricted Delivery Fee IT' (Endorsement Required) rn CJ Postmark Here \ L\ ~bl.P Total Postaoe & Fees S; d BLOOM STEPHEN L CJ 2100 LONGS GAP RD r- CARLISLE PA 17013 In Re: Estate of WILSON PAUL K ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 2001-01041 NOTICE OF FAILURE TO FILE STATUS REPORT Personal Representative: FRAKER DEBRA L Counsel for Personal Representative: BLOOM STEPHEN L Date of Decedent's Death: 11/6/2001 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 detennine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. ~ ~wJ ~/.t//a/ Date: 12/612006 <:[) /Tl ...n ILl /Tl Cl Certified Fee Cl Cl Retum Receipt Fee (Endorsement Required) Cl Restricted Delivery Fee [J'"' (Endorsement Required) /Tl Cl b , - I DLf lod tbt,Lt Postmark I _ \ '\ Here '-.P I cj. l~gr6Lu Distribution: Personal Representative Counsel for Personal Representative Estate File Glen Cler] .:::t" ~ /Tl <:[) ~f I FRAKER DEBRA L 7100 WEST PARK ROAD CEDAR RAPIDS IA 52402 "--- :. . I SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY . Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. . Print your name and address on the reverse so that we can return the card to you. . Attach this card to the back of the mail piece, or on the front if space permits. 1. Article Addressed to: BLOOM STEPHEN L 2100 LONGS GAP RD CARLISLE PA 17013 v Jj". 3. Service"fypEl tz9Certified Mail 0 ~ Mail o Registered 0 Return Receipt for Merchandise o Insured Mail 0 C.O.D. 4. Restricted Delivery? (Extra Fee) -,'; 2. Article Number (Transfer from service ~ PS Form 3811. February 2004 7005 0390 0003 2638 8367 Domestic Return Receipt UNITED STATE\fBWkrs~~l~JRG PA l..tlllll (1/ DEC.2J.:.106 P(Vl s;; 't '~.,."" · Sender: Please print your name, address, and ZIP+4 in this box · ---....... Dl - \0'-\\ Qtr Glenda Farner Straslxugh He~nster of VI/ills and Clerk of Orphans' Court County of Cumberland One Courthouse Square CarlIsle, P A 17013 i 78SC;+04S5-SS Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF f...UM. ~2'2.LAND COUNTY, PENNSYL VANIA Name of Decedent: WU.SON. fJAlJL K. . Date of Death: l \ I b ! :.lOO \ File Number: 200 I - 0 I 04- I Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . .. ~ Yes 0 No 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? . . . . . .. 0 Yes ~ No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account . J:". 11 th rt' . . t t') L.-:f('\so\\I&lJV~-) 0 mlorma y to e pa les m meres. ............ .;............... . Yes ~No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this r ort. Date /2/7/0 t f f C"? 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