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Pa. O.C. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF Cum ar2��4N� COUNTY, PENNSYLVANIA
Name o f Decedent:_ Q r a 0 (P I` an 01
Date of Death: 5 1201201 File Number: _Q1 — (3 -100!7
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 ❑No
2. If the answer is No, state when the personal representative'
reasonably believes that the administration will be complete:
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J. If the answer to No. 1 is YES, state the following: M c n
a. Did the personal representative file a final account with the Court?? 5F"Y No
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b. The separate Orphans' Court No. (if any) for the personal ?y w C),
.
representative's account is:
c. Did the personal representative state an account
informally to the parties in interest? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑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 report.
Ionto � � �)� 2,
Si ntw•e ojPerson Filing its F m
Capacity: ER
'ersonal Representative ❑Counsel
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Wane ojPerson Filing this Foran
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Form RW-l0 rev. 10.13.06
IN RE: IN THE COURT OF COMMON PLEAS
ESTATE OF CLARA R. CLELLAND CUMBERLAND COUNTY,
PENNSYLVANIA
LATE OF CARLISLE BOROUGH
CUMBERLAND COUNTY, PENNSYLVANIA ORPHAN'S COURT DIVISION
NO. 21-2013-1003
RECEIPT RELEASE and REFUNDING AGREEMENT
KNOW ALL PERSONS BY THESE PRESENTS, that I, William B. Clelland, acknowledge
that I have received from Kenneth P. Clelland, Executor of the Last Will.and Testament of Clara R.
Clelland, an Informal First and Final Account and Proposed Schedule of Distributions.
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I hereby waive the filing of a Formal Account with the Orphan's Court and accept and approve the
Informal Account as stated with the same force and effect as if it had been duly filed in the Office of the
Register of Wills, adjudicated and confirmed absolutely, and the amounts proposed to be distributed to me
had been duly awarded by the Court.
In consideration of the same promise of the other legatees, I hereby.agree to refund to the Executor,to the
extent of the distributions received, any amount to which I may not be properly entitled, or, pro-rata, any
amount which may be necessary in the future to discharge any liabilities of the Estate or claims against the
' Estate which were unknown to the Executor during the period of his administration.
,
,.
Ido hereby remise, release, exonerate and forever discharge the said Executor of and from the said
payment and transfer, and of and from any further liability to me of any nature arising out of his
r administration of the Estate.
1
12
1
IN WITNESS WHEREOF,I have hereunto set my hand and seal this 2� day of
2014.
Witness:
(SEAL)
WILLIAM B. CLELLAND
i
COMMONWEALTH OF PENNSYLVANIA REV-1162 EX0 1-96)
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT.280601
HARRISBURG,PA 17128-0601
PENNSYLVANIA
RECEIVED FROM: INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT NO. CD 019559
CLELLAND KENNETH P JR
130 N OLD STONE HOUSE RD
CARLISLE, PA 17015
ACN
ASSESSMENT AMOUNT
CONTROL
NUMBER,
-------- fold --- --------
. 101 $1,893.00
ESTATE INFORMATION: SSN: 232-24-0375
FILE NUMBER: 2113-1007
DECEDENT NAME: CLELLAND CLARA R
DATE OF PAYMENT: 08/18/2014
POSTMARK DATE: 08/1812014
COUNTY: CUMBERLAND
DATE OF DEATH: 05/20/2013
TOTAL AMOUNT PAID: $1,893.00
REMARKS:
ci
CHECK# 1008
INITIALS: -DB.1
SEAL RECEIVED BY: LISA M. GRAYSON, ESQ.
REGISTER OF WILLS
TAXPAYER
RECEIPT FOR PAYMENT
-------------------
--------------------
LISA M. GRAYSON, ESQ.. Receipt Date: 8/18/2014
Cumberland County - Register Of Wills Receipt Time : 12 : 08 :55
One Courthouse Sauare Receipt No. : 1078922
Carlisle, PA . 17{T13
CLELLAND CLARA R
Estate File No. : 2013-01007
Paid By Remarks: KENNETH CLELLAND JR
DBI
------------------------ Receipt Distribution ------------------------
Fee/Tax Description Payment Amount Payee Name
ADD PROBATE FEE 200 . 00 CUMBERLAND COUNTY GENERAL FUN
----------------
Check# 1011200 . 00
Total Received. . . . . . . . . H00. 00
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