HomeMy WebLinkAbout01-0178
PETITION FOR GRANT OF LETTERS
Estate of MARY E. BLOCHER No. c:J- /- 0 1- I 7 ~
also known as N/A
, Deceased
Social Security No.207-22-1974
Petitioner(s), who is/are 18 years of age or older, apply)ies) for :
(COMPLETE "A" OR "B" BELOW:)
o
A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut
Decedent, dated and codicil(s) dated
.
.
named in the Last Will of the
State relevant circumstances, e.g., renunciation, death of executor, etc
Except as follows, Decedent did not marry, was not divorced and did not have a child born or adopted after execution of the documents offered
for probate; was not the victim of a killing and was never adjudicated incapacitated:
Gl
B. Grant of Letters of Administration
(c.I.a., d.b.n.c.l.a.: pendente lite, durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained the Decedent left no Will and was survived by the following spouse
(if any) and heirs:
I Name Relationship Residence 1
FRANCIS SANDERSON BROTHER 536 W. LOUTHER ST., CARLISLE, PA
WINIFRED BLOCHER SISTER 114 MEDIA RD., CARLISLE, PA
ROBERT SANDERSON BROTHER 105 AMY DR., CARLISLE, PA
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.
Decedent was domiciled at death in CUMBERLAND County, Pennsylvania, with his/her last family or principal
residence at 6690 WERTZVILLE RD., E. PENNSBORO TOWNSHIP, ENOLA, PA 17025
(list street, number and municipality)
Decedent, then 70 years of age, died JANUARY 20 ,2001, at 41 PINE RIDGE COURT, ENOLA
(Location)
Decedent at death owned property with estimated values as follows:
(if domiciled in PA All personal property................................. $
(if not domiciled in PA Personal property in Pennsylvania .................... $
(if not domiciled in PA Personal property in County........................... $
Value of real estate in Pennsylvania ........................................................................................ $
Total ......... ........... ...... ............... .......... ................................................................. $
10,000.00
10,000.00
Real Estate situated as follows: NONE
Wherefore, Petitioner(s) respectfully request(s) the probate of the Last Will and Codicil(s) presented with this Petition and the grant of letters in
the appropriate form to the undersigned:
Typed or printed name and residence
FRANCIS SANDERSON
536 W. LOUTHER ST.
CARLISLE, PA 17013
RW-1 I fo - J..-I {t.- ~_.-
Oath of Personal Representative
Commonwealth of Pennsylvania
Cou nty of CUMBERLAND
The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the
Decedent, Petitioner(s) will well and truly administer the estate according to law.
Sworn to and affirmed and subscribed
b~;: ~eLt~:J1lI/'</~ .9C,G~ay of ~ _ ~~~
(' j/"'j-
'-/ryu {c (1 ~.Ie -L<-t~J F.{' (I 11. JX~Yl/LTA.A
(J L~jUL1)
Estate of MARY E. BLOCHER
DECREE OF REGISTER
Deceased
No.
21-01-178
also known as N/A
Date of Death: 1/20/01
Social Security No: 207-22-1974
AND NOW, FEBRUARY 15th 2001
reverse side hereon, satisfactory proof having been presented before me,
, in consideration of the Petition on the
IT IS DECREED that Letters 0 Testamentary ~ of Administration
((c.I.a.. d.b.n.c.l.; pendente lite; durante absentia; durante minoriate)
are hereby granted to FRANCIS SANDERSON
in the above estate and that the instrument(s), if any, dated none
described in the Petition be admitted to probate and filed of record as the Last Will of Decedent.
FEES
Letters.......... ..... ...... ... .... ........
Short Certificates(s) ...............
Renunciation........................ ..
Extra Pages (
) ...............
I. T. R.. .. .. .. . . . .. .. . . .. . . .. . . .. . .. . . .. . . .. .
JCP Fee .................................
Inventory ................................
Other..................................... .
$ 40.00
~ . /' J," ;",
Y))ak?; (), ,'A. l'T'.l) p4' (Z. Ii. 'lA((/}.e/?.p ,lJ....fjJI.Lb.,_
Register of Wiils /~ / ,
W1(/111
Signature
3.00
$
$ 10.00
$
$
$
$
$
$
5.00
Attorney: MURREL R. WALTERS, III, ESQ.
1.0. No: 24849
Address: 54 EAST MAIN STREET
MECHANICSBURG
PA 17055
TOTAL .............................$ 58.00
Telephone: 717-697-4650
DATE FILED: FEBRUARY 15. 2001
CALLED ATTORNEY FEBRUARY 16, 2001 PUT IN PROTHO.
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COMMONWEALTH OF PENNSYLVANIA · OEPARTMENT OF HEALTH. VITAL RECOROS
CERTIFICATE OF DEATH
(Coroner)
TYPE,PRINT
IN
PERMANENT
BLACK INK
~!
:J
~
SEX
2. Female 3. 207
~::II,,)D
E
Blocher
STATE FILE NUMBER
SOCIAL SECURITV NUMBER
22
January 20, 2001
UNDER 1 VEAR
Days
UNDER 1 DAV
Minules
DATE OF BIRTH BIRTHPLACE (Cily and PLACE OF DEATH (Check only one see Inslructlons on Gillet Side)
(M011111 DdY Yt:arJ SIdle Of hAE!lgn Country) HOSPITAL
Carlisle, Pennsylvania Inpa"enlO
7. 8a.
FACILITY NAME (II n01IJIslt1IJIIUn, give street dnd numl)er)
MOTHER'S NAME (hrsl Middle. Mdlden Surname)
Beatrice M. Clouser
19.
INFORMANT'S MAILING ADDRESS (Streel, City/Town, SI31~. 71p C>de)
20b. 536 West Louther St. Canisle, Pa. 17013
PLACE OF DISPOSITION" Name of Cemetery, Crematory lOCATION. CityfTown, Slale, Zip Code
or Other Place
Cumberland
DECEDENrs USUAL OCCUPATION
\Glve }...,nd of wOlk done dUllng muSl
of WOlklng life, do not use rdut:d )
. ".. Crystal Grinder l1b.
DECEDENrs MAILING ADDRESS ,Slreel CllyfTown Sidle. Zip Code)
WAS DECEDENT EVER IN
US ARMED FORCES?
Ves [] No Il(l
6690 Wertzville Road
Enola, Pa. 17025
17b. County
Cumberland
Harry F. Sanderson
Jan 24, 2001
21c
LICENSE NUMBER
FD-012662-L
DATE PRONOUNCED DEAD (Mc)f'lh Udy. Yei..u)
10:50 A'M January 20, 2001
Probable Myocardial Infarction
DUE TO lOR AS A CONSEQUENCE OF)
DUETO(OA AS ACONSEOUENCE Of)
RACE - American India,), Black, White ale
(Specll)')
White
10
Did
decedenl
11I(81na
lownsh.p?
MARITAL STATUS - Married SURVIVING SPOUSE
Never Married, Widowed, (II ",lIe give ma.den nam~)
Di....orced ($pt.'u1y)
Widowed
15
17C.~ Yes. decedent lived In East Pennsboro
Iwp
17d.O ~~h~e~~1~~7~,~j~: of
clty/boro
Kutz Church Cemetery
Carlisle, Pa. 17013
21d.
NAME AND ADDRESS OF FACILlTV
Myers Funeral Home, Inc. 37 East Main Street Mechanicsburg, Pa 17055
LICENSE NUMBER DATE SIGNED
(Mof1th Ddf 'rhlfl
23b. 23c.
WAS CASE REFERRED TO MEDICAL EXAMINER/CORONER?
Ves ~ Nol]
I Approximate
: interval between
j ons.1 and d.ath
PART II; Other signifIcant conditions contributing to death but
nOl resulllng in the underlying cause gi...en In PART I
I
-.-.-.-~i-.---
DUE TO lOA AS A CONSEQUENCE OF)
d
WERE AUTOPSY FINDINGS
AVAILABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
MANNER OF DEATH
DATE OF INJURY
(MUIIIt\, Dd)". 'ieur)
)CL
[J
o
Homicide
li
[J 30a. JOb
[-J ~t:d~;9~~~N(~~~~t~_jAI home, farm, slresl, factory, altiee
JOO.
Natural
V.s 0
Accident
Pending Invesligation
No 0
Could not be determined
SuiCide
29.
28e 28b.
CERTIFIER (Cr1e\..'" 0nly one)
.CERTlFYING PHYSICIAN (PhY::.lCI"r, --:t:( 111,11Ig (;dlj~ ~Jt lk~dlh ....Ilell '.lIiUU It:. pllpIClJ() I lei:> pI U11l!\jIICdd de.Jt! I ,11nl C, H r If,ldt;,j IlL! 11 :!J}
To the beat 01 my knowledge, death OCf;urred due to the cauae(aland manner a. alated. .
.PRONOUNCING AND CERTiFYING PHVSICIAN \PI\y::;"-_Idl\ l~utIlIJrU(IOUrl'~" '\J dUdlh dlld c<:rlltYlrl~ tLl Ldllse 01. ll'd!ll)
To the beat of mv knowledge, de.th occurred at the time, dat., and place, and due to the cause(l) and manner a8 staled
.MEDICAL EXAMINER/CORONER
On Ihe b..ls of examination and/or Inv..tigallon, In my opinion, death occurred at the time, dBle, and place, and due to Ihe cause(s) end
manner.. st.ted..
31.
. jlert tf
lJu~
TIME OF INJURV
DESCRIBE HOW INJURV OCCURRED
[J 'b. . _.._.. Coroner
[I ~~~EN ER~:ES~r;:~~~I~~dI2C2JJ 2001
NAMEAND ADDRESS OF PERSON WHO COMPLETED CAUSE OF DEATH
(118'" ?7) Type or Prinl Michael L. Norris J Coroner
~ 6375 Basehore Road, Suite #1
~ ~. Mechanicsburg, Pa. 17050
DATE FilED (Month. Day, Yoar)
34. J
RENUNCIATION
Estate of MARY E. BLOCHER
21-01-178
No.
also known as nfa
, Deceased
The undersigned,sister
of
(Relationship)
(Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Letters of Administration
be issued to brother, Francis Sanderson
Witness my
hand this :J / day of ~, 2001
l()( ~~I-~ r~
I I (Signature)
Winifred Blocher
114 Media Road, Carlisle
PA 17013
(Address)
(Signature)
(Address)
(Signature)
(Address)
Sworn to or affirmed and subscribed
before me this .3 /5 r day of
9J::::o;;'~
Notary Public
My Commission Expires:
Notarial Seal
Diane M. Smith, Notary Public
MechanicsburQ Bora. Cumberland County
My Commission Expires June 22,2004
(Signature and seal of Notary or other
official qualified to administer oaths. Show
dilte of expiration of Notary's commission.)
NOTE: Renunciations executed outside the Office of Register of Wills are
required in some counties to be notarized.
R''''/ -3
RENUNCIATION
Estate of MARY E. BLOCHER
No.
21-01-178
also known as nfa
, Deceased
The undersigned,brother
of
(Relationship)
(Capacity)
the above Decedent, hereby renounce(s) the right to administer the estate and respectfully request(s) that
Witness my
be issued to brother, Francis Sanderson
hand this li.,l day ot~':7' 2001
. .~r d;... ~~~~
(Signature)
Robert Sanderson
105 Amy Drive, Carlisle
PA 17013
Letters of Administration
(Address)
(Signature)
(Address)
(Signature)
(Address)
Sworn to or affirmed and subscribed
before me this 3 J s r
day of
, 020 (5 I
~
Notarial Seal
Diane M. Smith, Notary Public
Mechanicsbur~ 8oro, Cumberland County
My Commission Expires June 22, 2004
(Signature and seal of Notary or other
official qualified to administer oaths. Show
date of expiration of Notary's commission.)
NOTE: Renunciations executed outside the Office of Register of Wills are
required in some counties to be notarized.
RW-3
b
----
CERTIFICATION OF NOTICE UNDER RULE S.6(a)
Name of Decedent: Mary E. Blocher
Date of Death: January 20,2001
Will No. Admin. No. 21-01-00178
To the Register:
I certify that notice of (beneficial 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 February 23, 2001.
Name
Address
Winifred Blocher
114 Media Road
Carlisle, P A 17013
Robert Sanderson
105 Amy Drive
Carlisle, P A 17013
Francis Sanderson
536 West Louther Street
Carlisle, P A 17013
Date: 02/23/01
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except: q.6ne
Signature
Name:
Murrel R. Walters, III, Esquire
Address:
54 East Main Street
Mechanicsburg, P A 17055
717 -697 -4650
Telephone:
Capacity: _ Personal Representative
---1f_ Counsel for personal representative
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-16-2001
BLOCHER
01-20-2001
21 01-0178
CUMBERLAND
101
MURREL R WALTERS III ESQ
54 E MAIN ST
MECHANICSBURG PA 17055
REV-1547 EX AFP Cl2-DDJ
MARY
E
Amount Remitted
CHANGED
(1)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
16,914.57
.00
.00
(8)
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 ~
RE-V = ls4-j-Ex-iFP--fi"2-:oo-r-NcfffcE--oF--ftiHEiffTAifcE-TAx-jfPPRA-fsEHEN:r;-iil-owANcE-cfR"----------- - -- - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF BLOCHER MARY E FILE NO. 21 01-0178 ACN 101 DATE 07-16-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
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:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
2,107.84
.00
(11)
(12)
(13)
(14)
(9)
(10)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
16,914.57
?l0784
14,806.73
.00
14,806.73
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15)
16. Amount of Line 14 taxable at Lineal/Class A rate (16)
17. Amount of Line 14 at Sibling rate (17)
18. Amount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
.00 X 00 = .00
.00 X 045 = .00
14,806.73 X 12 = 1,776.81
.00 X 15 = .00
(19)= 1,776.81
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-25-2001 AA496693 .00 1,776.81
TOTAL TAX CREDIT 1,776.81
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 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.)
(/~/
,'~/
PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS O'-F-
THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY
UNTIL COMPLETION
STATUS REPORT UNDER RULE 6.12
Name of Decedent: MARY E. BLOCHER
Date of Death: 1/20/2001
Estate No.: 2001-00178
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 No_X_
2. If the answer is No, state when the personal representative reasonably believes that the
administration will be complete June L 2003
(date)
3. If the answer to No.1 is yes, state the following:
A. Did the personal representative file a final account with the court?
Yes No
B. The separate Orphans' Court No. (if any) for the personal representative's
account is: (Not Applicable in Dauphin County)
C. Did the personal representative state an account informally to the parties in
interest: Yes No
D. Copies of receipts, releases, joinders and approvals offi al or informal
I
accounts may be filed with the Clerk of the Orphans' , urt and may be
attached to this report. I
Date: ld-- \ \g 10 L-
MURREL R. WALTERS, III, ESQUIRE
54 East Main Street
Mechanicsburg, P A 17055
717-697-4650
Capacity:
_ _ Personal Representative
)( Counsel for Personal Representative
..,I
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 12/06/2002
FRANCIS SANDERSON
536 WEST LOUTHER STREET
CARLISLE, PA 17013
RE: Estate of BLOCHER MARY E
File Number: 2001-00178
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: 1/20/2003
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
MARY C. LEWIS
REGISTER OF WILLS
cc: )File
Counsel
Judge
~.~~y,
\'-'f~EV.1500 EX. (6-00}
'*
COMMONWEALTH Of
PENNSYLVANIA
DEPARTMENT Of REVENUE
DEPT. 260601
HARRISBURG. PA 17126.0601
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE 0Nl \"
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fL' .. liD -
FILE HUMBER
2 1 .0 1 0 1 7 8
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DECEDENrs NAME (LAST. FIRST. AND MIDDLE INITIAL)
BLOCHER MARY E
DATE OF DEATH (MM.DD-Year)
DATE OF BIRTH (MM.DD.Year)
SOCIAl BECURITY NUMBER
207-22-1974
THIS RETURN MUST BE FilED IN DUPLICATE WITH THE
REGISTER Of WILLS
SOCIAl SECURITY NUMBER
~
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UtID
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01/20/2001 07/19/1930
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST. AND MIDDLE INITIAL)
[R) 1, Original Return
o 4. limited Estate
o 6. Decedent Died Testate (Altach cop~ of WiUj
o 9. litigation Proceeds Received
o 2. Supplemental Return
o 4a. Future Interest Compromise (dala of death aft&{ 12-12-82)
o 7. Decedent Maintained a living Trust ~A\laclI copy oj 1M\)
o 10. Spousal Poverty Credit (dale of death beIW8e1l12.31.91 and 1-1-95)
o 3. Remainder Return (dal8ofdealhpriorIo12.13-82j
D 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (All""SohOI
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
MURREL R WALTERS III ESQ 54 EAST MAIN STREET
fiRM NAME (K 'WIicabIe)
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TELEPHONE NUMBER
717/6974650
MECHANICSBURG
PA 17055
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
(1)
(2)
(3)
(4)
(5)
OFFICIAL USE ONLY
16.914.57
(6)
(7)
(8)
16.914.57
6. Jointly Owned Property (Schedule F)
o Separate SiJJing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & liens (Schedule I)
11. Total DaducUons (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)
(9)
(10)
2,107.84
14. Net Value Subject to Tax (Une 12 minus line: 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate. or transfers under Sec. 91\6 (e)(1.2)
19. Tax Due
X _(15)
X_(16)
14.806.73 X.12 (17)
X .15 (1B)
(19)
(11)
(12)
(13)
2.107.84
14,806.73
(14)
14,806.73
16. Amount of line 14 taxable atlineaJ rate
1,776.81
1.776.81
17. Amount of Une 14 taxable at sibling rate
1;'-,:.;.'
20. 0
CHECK HERE If YOU ARE REQUESTING A REfUND Of AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
18. Amount of Line 14 taxable at collateral rate
Decedent's ComDlete Address:
STREET ADIlRESS
6690 WERTZVILLE ROAD
.
CITY I STATE I ZIP
ENOLA PA 17025
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credil
8. Prior Payments
C.Discounl
(1)
1,776.81
Total Credits (A + 8 + C) (2)
3. InleresUPenalty If appilcabie
D. Inleresl
E. Penalty
T otallnteresUPenalty ( 0 + E ) (3)
4. if Line 2 is grealer Ihan Line 1 + Line 3. enler the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a relund (4)
5. If Line 1 + line 3 is grealer than line 2. enler the difference. This is the TAX DUE. (5)
A. Enler Ihe interesl on the tax due. (SA)
B. Enler Ihe lotal of line 5 + SA. This is the 8ALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
1,776.81
1,776.81
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X"IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ........................................................................... 0 1RI
b. relain the righllo designate who shall use the property Iransferred or its income: ........................................ 0 00
c. retain a reversionary interest; or ......................... ............................................................................. 0 00
d. receive Ihe promise for life of either payments. benefits or care? ............................................................. 0 00
2. If death occurred afier December 12. 1982. did decedent transfer property within one year of death
withoul receiving adequale consideration?......................................................... ....... .............................. 0 l&I
3. Did decedent own an "in trusl for" or payabie upon death bank account or security at his or her death? ................. 0 l&I
4. Did decedenl own an Individual Retirement Account. annuity. or other non.probate property which
conlalns a beneficiary designation? ............................... ................. ....................................................... 0 00
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalll6s of peljury, I declare thaI I have examined this relum. including accompanying schedules and stalameots. and 10 the besl of my knowledge and bellef.lt Is true, COIT8Ct
and comp/6le.
Declaration of preparer than the p8l'5ooal representative is based on all Information of which preparer has any knowledge.
SIGNATURE SONRESPONSIBlEF. 11INGRETURN DATE
<; 5125101
ADORES
PA 17013
DATE
5125/01
ADDRESS
MURREL R WALTERS III ESQ
54 EAST MAIN STREET, MECHANICSBURG
PA 17055
For dates of death on or after July 1, 1994 and before January 1, 1995.lhe tax rate Imposed on the net value of transfers to or for the use oflhe sUlViving spouse Is 3%
(72 P.S. ~9116 <a) (1.1) (i)l.
For dates of death on or after January 1, 1995. the tax rale imposed on the net value of transfers to or for the use of the sUlViving spousets 0% (72 P.S. ~9116 (a) (1.1) (ii)).
The statute does not exemot a transfer to a sUlViving spouse from tax. and Ihe statutory requirements for disclosure of assets and filing a tax relum are still applicable even n
the sUlViving spouse is lhe only beneficiary.
For dates of death on or after July 1. 2000:
The tax rale imposed on the net vatue of transfers from a deceased child twenty.one years 01 age or younger at death to or for the use of a natural parent. an adoptive parent.
or a stepparent of the child is 0% (72 P.S. 99116(a)(1.2)].
The tax rate imposed on the net value of translers to or forthe use of the decedent's lineal benenclaries Is 4.5%. excepl as noted in 72 P.S. 99116(1.2) (72 P.S. 99116(a)(1)J.
The lax rate imposed on lhe net value of transfers to or for the use of the decedent.s siblings is 12% (72 P.S. ~9116(a)(1.3)1. A sibling is defined. under Section 9102. as an
individual who has atleasl one parent In common with the decedent. whelher by blood or adoption.
"""""":'.
COMMONWEAlTH OF PENNSYLVANIA
INHEAJTANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
BLOCHER. MARY E
FilE NUMBER
21 01
0178
Include the proceeds of litigation and the date the proceeds were received by the estate. All property Jolntly-owned with the right of survivorship mUlt be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
. VALUE AT DATE
OF DEATH
14,274.57
MELLON BANK # 190-404938
2
CASH
2,640.00
TOTAL (Also enter on line 5, Recapilulalion) $
(If more space Is needed, Insert additional sheets of the same size)
16914.57
""''''''''':'.
COMMONWEALTH Of PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
BLOCHER MARY E
FILE NUMBER
21 01
0178
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. LETORT CEMETARY ASSOCIATION 184.84
2 OBITUARY THE SENTINEL 20.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative (5) FRANCIS SANDERSON 845.00
Social Security Number(s} I EIN Number of Personal Represenlative(s)
SueelAddress 536 WEST LOWTHER ST
City CARLISLE Stale PA Zip 17013
Year(s) Commission Paid; 2001
2. Attorney Fees MURREL R. WALTERS III ESQ 960.00
3. Family Exemption: (If decedent's address is nol the same as claimant's, attach explanation)
Claimant
Street Address
City Stale Zip
Relationship of Claimant to Decedent
4. Probale Fees REGISTER OF WILLS 98.00
5. Accountant's fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ 2107.84
(If more space is needed, insert additional sheets of the same size)
REV"513E:'I*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FilE NUMBER
I'll 'E ?1 01 017R
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Nolllsl Truslee(sl OF ESTATE
L TAXABlE DISTRIBUTIONS pnclude oulIighl s~usal dislIibubons, and ~ansfers under
Sec. 91161a) 11. ))
1- FRANCIS SANDERSON BROTHER 1/3
536 W. LOWTHER ST
CARLISLE, PA 17013
2 WINIFRED BLOCHER SISTER 1/3
114 MEDIA RQ
CARLISLE, PA 17013
3 ROBERT SANDERSON BROTHER 1/3
105 AMY DR
CARLISLE, PA 17013
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAl DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
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 sheels of l/le same size)
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 12/16/2005
WALTERS MURREL RIll
54 E MAIN STREET
MECHANICSBURG, PA 17055
RE: Estate of BLOCHER MARY E
File Number: 2001-00178
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. I, for decedents dying on or after
July I, 1992, the personal representative or his counsel, within two
(2) years of the decedent's death, shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
1/20/2006
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~,. V
fit/):. .f .' r' #L,/ /J
J(I//l)!i~Af.'H A~k.k;?<?.p j~A~~(
.t G~ FA.R1TER' STp='75;.SBAIJ.~l1
REGISTER OF WILLS .
cc: File
Personal Representative(s)
Judge
~\;
PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF
THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.12 FORM YEARLY
UNTIL COMPLETION
STATUS REPORT UNDER RULE 6.12
Name of Decedent: MARY E. BLOCHER
Date of Death: 1/20/2001
Estate No.: 2001-00178
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_X_ No
2. If the answer is No, state when the personal representative reasonably believes that the
administration will be complete
(date)
3. If the answer to No.1 is yes, state the following:
A. Did the personal representative file a final account with the court?
Yes No_X
B.
The separate Orphans' Court No. (if any) for the personal representative's
account is: (Not Applicable in Dauphin County)
C.
in interest:
Did the personal representative state an account informally to the parties
Yes_X_ 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.
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Date:
r-1'o~
MURREL R. WALTERS, III, ESQUIRE
54 East Main Street
Mechanicsburg, P A 17055
717-697-4650
Capacity:
_X_ Personal Representative
Counsel for Personal Representative
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