HomeMy WebLinkAbout01-0182
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REV-1500
INHERITANCE TAX RETURN
RESID T DECEDENT
* COMMONWEAlTHOf
PEt-tlSYLVANlA
DEPARTMENT OF REVENUE
DEPT. ~1
HARRISBURG. PI'. 17128-OlKl1
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DECEPfNrs NAIIE (~~ F~, AND Il10000E ',NfT
KUS lr\ o.4llin
DATE OF DEATH (lIU.oD.YEAR) DArt; OF 81R1Jt ..._YEAR)
Da-O\ -bl 1\-0(,,- 51
(IF APPLICABlE) SURVlVt:} S\0E'S NAME (LAST. FIRST. AND ~ 1lITW.)
~ 1. DnginoJ RelUm 02. S,_ RoIum
o 4. limbcl EstI1B 0.... FunnIMlitl8ltComc1oromile"af"'_1~.12.&l
o 6.OecedeftOied--'(AUIdlr;:q>>rdWlI 0 7.Decedenl:Mainblinecl.LMngTrust~CZlP'YItT,,*J
09. Ltigetion ~Realived 0 10.~. P<W8rty C~:(_afdWI"""" l2-31.1i'\ ...,.,..\
L..
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FILE MUMBER
<lL-iLL
CWNTY lXlIE '!'EM
.QD.liJ-
......
\ SI~L SECURITY NUUIIER
S- -=-Y-J.. - ~L9le_
TIIIlI_ IlU8T II! RLED IN IlUPLICAT! WITH THE
I REGISTER OF WILLS
SOCIAl SECURITY NUII8ER
o :3. RemIiI:IM'......".IlI.._D12.1U2j
o 5. foMW _ TIIlIIRJm Roqolrod
8. TOIBJN_oISo1o__
o \\.Elottionlo'""'_SOC.9113(At.......o:
I
NAME Qrll CI ' .
fIRM NAME (,:-;~') f\ --.ld~h__________
TELEPHONE NUMBER,I,_ ~ /P\:::y. --~---'---
QO,^ ko~ eOC-<.A.
Hfma(\lc..::,1o U (J, PA
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2
5
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t::
a.
oil(
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I. R.. e.... (Scl1ed.. A)
2. Stocks and 80nds (S_,. B)
3. c_, Hold Corpor_. PII1nor>hip or S%.Pr_"hip
4. MO!1gag.. & N_ _blo (Sd1edulo O)
5. Caan. BlInk 08poslls & MiacellBneous Peraonaf Propef1y
(_,.E)
6. Joj"~ Owned P_ (Schodull f)
o Sepa.... BiNog Req..-
7. Il\tIIf-'li'los. T1'8Tl$Ms &. Uisctlllilnaoos Non-Probllte PropIfty
(Sd1edulo G or l)
8. ToloI__III(..., Unos ,.7)
9. FUlIOlII El<pensos & /ul..~_ C_ (_. H)
(1)
(2)
(3)
(4)
(5)
~l '1~~()
(S)
(7)
(9)
11Y:JQ,OQ
10. 00b1s '" ~nt.IIo_liebillloo 8. L.... (Sd\ed\.1o I) (10)
1\. T...._ltellII 1.iIlos9 & 10)
12. Not V"" 01_ (LiIlIB nlIlUO Lint 11)
13. Cha$ab'e aM Gowlmment8t BequestsJSlc 9113 Trusts bl' which an ~Iection to tax hu oot."
...do (Sd1edu\e J)
14. Nil VIlut 1lIIIjtcl.. Tu(Lint12 ninuo Uno 13)
BEE ,__ 011 _~ SlOE FOR APPUCAlILl RATES
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15. Amoont of Une '" tallabIe 81: the S4J0uul tax
1'818, or Ir8fIstIIS urtder Sec. 9116 (.}{1.21
_~_____~,..__n__...._~' '.0 __ (15)
x .0 _nO (16)
16. An'otInt of Line 1... taxable at lineal ..
11. MlountdLlr'te ,. taxable at sil*lg ralI
n I( .12
16. Mw:wt<<l1l".14taxableatcol8ten!llnM
x ,15
19. Ta 0..
17D9)
(B) ___3.,1 ~ [p /-!-o
(II)
(12)
(13j
lBD,QO
- ~ !.o<1d...( 00
,
(14)
- 3 f (P;)~ ,(a 0
(17)
(IB)
(19)
200
~<<'
Decedent's Complete Address:
1"'''''''''3~_~" ~"~ ..... ..
. CITY HecW:.I\'LSbLt~ ,Pf' --~-
Tax Payments and Credits:
1. Tax Due (Page 1 Line 191
2. CredilslPaymerlf8
II. Spousal Pow/ty Credil
B.PriorPal!ll8flls
C.DisOOllnl
- .. ---''lsTATE- ~----
1"'1 ib57J
---fy
j
(1)
3.
lote<esIn'.noIty ff "IlPiic:abl.
O. inler.st
E. Petlally
ffL". .--."..-.. TolaIlnto_aIly(D+E)
lne 2 IS grealer than Line 1 . LiIl6 3, enter the <i1feronce. This is lhe OVERPA~T
Choc:k box on Pogo 1 Lint 20 10 ,"",,",I "'uncl .
it Line 1 + Line 31s greater than Line 2. _the diff8rence. Th~ is the TAX DUE.
Total Credits (II> B + C )
(2)
4.
(31
14)
.....
5
B. EnlM the totai Of Line 5 + SA. Thi< 1$ the IlAl.AIICE DUE.
III
{Uf
(5111
Make Check Payable to: REGISTER OF ftLs...--.r
(>:",::':',';'J/{I'i-,,' M:r.m";:i.~,Jt":"I;1\ ':A)'~,i'l;i:~:f,',,~" \;''<\'''';!:'~il~'>~\'i'i~',l' .;"t.'~'-'''''-''' ,;;;-,
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN 'X" IN THE APPROPRIATE BLOCKS ~ <
1. Did decedenl make IIranS1er 1Ild: Yes No
I. relain tho use or ,,,.,,,,..,Of the pmpeny translorred;............................."..............."....,........"....................... 0 0
b. retein tho rigllllo designato """ shall use the property transtBlrod 01 its income; ...............,....................... 0 ~
c. relain. r.-nary into...; or.............."................................................,................._..........,.. ,.,........ ......... 0 ~
d. _ve the promise for tile Of "'Ihor payments. benefits Olea,"? .............".................................................... 0 liZl
2. If death OCClI'red aller Decembe< 12. 1982. did decadent transfer ~... U _ __
""'hout receiving adequale ccnsideIation? ....................................,.,......,...."....,.,.....,."..,.,........... ..,.. .,.. '.'."..".".", 0
3. Did decedenlown an'n IN8lto<"orpayabl.upon__IQlIIU'1IOIMaJri/v.lhitlorh..dealh?.........,.... 0
4. Did decedent own an 1~ua1 Relirement_. annuity, or oller ""'"9_....IL fII_h
oonlaine. bene!ieIery desig_? ...,. ....."..""...".'". .....".. ."......."", ,..""".,...,,,,,..,,,,..,,..,,,,...,,,, ..... ..",,,...,,,,. 0
A. Enter the ,_ on tho lex due.
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If THE ANSWER TO AtlY OF THE ABOVE QUESTIONS IS YES, YOU 1lIS1 COllPlE1J ICIlEOULE G AND FU IT AS PART OF THE RETIlRH ,
l/ndlll' penalties ofpefjury, j del::I8relhet I htve eun\lWl:11t1t Mlm, indldng ac:r;ompmymg 9dledul81 MId ..........._ Ic~ rJ" kMt'!edilP IlI'iO ':iliMtf, h i$llUe, (>>J'ltlCl1l11(j~.
~cl prep',.-other thin the pn:InIll rep..~e is b-.edon allnforndonof~ ~ hatny .
g,:NA1fj' OF PERSCN RESPONSIBLE NO ~
~,2~_____ ,,___._,,__ _"____"'_~_______"" "'_"_ --_"..__,,"_ .__~d fe..:9. J
n36LV n-,1"lli~_tiecliJJlLc.5h..L..lL<._i-ft_.1Jb5.l) __Z:IJ.p:-D 3_
SIGNAliJRE OF ~R OTHER lHIIN REPRESENTATlVE:::r-- om:
-,-"_._-~._--,--------_._.- ----~, ,--------~,._~...._.~-----_.-_._------.._.._---_._..._-~-,---- .-.....-.-.--..-.---
IIODflESS
~
.._-_..--..._------,----_...__._-_._---_._--_._~--,._.---,-_.__._,_.,"--_.-._--~------- ----..-----.-.-------.. ----- -
k 'f .h,'~^.I,0':;~l!~j~(;~ - :t;"",(~,,.:r' ,;"~ ,#C'-;
For da"" of doatl\on or aller Ju~ \. 1994 and belora January 1,1995, lh. tax rate "'posed on tl1. n.hllu. of lra",lG ""'01 IJle U.. of tho .urvivirl\l ""ou" ..3%
[72 P.S. ~91161') (11) (ill.
For dales 01 lIeoth on or aile< Januory I. 1995. the tax llIle imposed OIllho net value of IIIlnsfers 10 01' for tl10 uso olmo '.Ni'li"ll $pOll" $ 0% [72 P.S, ~9116 la) (1. \) (iI';,
T!\e statute dot! Mt 81l!lnmt 8 transfer \0 a surviVing spouse from tal, and the statutory requirements for disclosurG or assets and iling a (3:( return ve stilt ap~\\cab\e ''1M i1
tho .uNlving spouse is lbo only be_ry.
For daleS of d..lh 011 01' aller July 1, 2llOO:
The tax rate imposed on the net value of transfers from 8 deceased ctlild wenty-one years of 3Q11 or younger at death to or for Ihe use ot a "atural parent, an aciClpt1v~ parent,
or a stoppalOnI of the child is 1l% 112 P.S, ~9116(a)(1.211.
Th. tax rate imposed on tl10 net val.. of bansfors 10 or for tho use ot Iho _t.s Iioeal bene~ciarie' is 4.5%. OllOllpt.. nofod in 12 P.5, ~9116(1 ,2) [72 P.S. !9116(.X1)l,
The tax rate tmposed on I\e net value of 1rans1llrs to or for the U88 of tile decedllnl's Siblings is 12% [72 P.S. S9116(.)(1.3}J. A llibUng is defined, under Section 9102, as aN
individual who has at I88st one parent in CCtmmOl\ witi\ the decedent. whether by !)\ood Of adoption.
ESTA'I! OF
REV-l5Oe EX- (6-98) ...
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
~ lYIor\,L b. ell ,1'\
'ndude 1he proceeds of IltigItion and IhI date Ihe proceeds were received by the estate.
AII_1\y Jolntlr- _ rlgtIIalIlIN.........' ...1111I_.... on _.It F.
ICHIDUU I
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
FILE NUIIBER
01[-61 -6v/~J--
ITEM
NUMBER
DESCRIPTION
VAlUE AT DATE
OF DEATH
\.
d-
li-l'fflb-erl~ l St
Vet.r.; cJ-L--
kd--- CA.tJ.d Lt,uM
1,lql.tAo
d oou,00
,
TOTAL (Also enter OIl line 5, Recepituletion) $ I
(If 1l"IOf' space is needed. insert addltionat Iheetll of the sam'size)
-
31q~.LtD
,
REV-'." EX- ('2-991*
COMMONWEALTH OF PENNSYL.VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE Of n
KO-~ mor0.
SCHIDULI H
FUNERAL EXPENSES &
ADMINISTRAJlVE COSTS
L.
~u~h
lloOta of _ 1I.lt bo fIIIOrtId 011 S._II 1.
FIlE NUlIIIlER
JI-OI- 60fXd-
ITEM
NUMBER
A.
DESCRIPTION
AMOUNT
,.
FUNERAl. EXPENSES:
H~.f{~ ,(uMrc;...Q ~,H.eJ\ .--h~J o-f (jooJs i 6~O (~I'd<'{ect
t1,nj{,(.h M--e(Y\()(\cJ:, - heo(i':::.~ f..1\:Yf.ivj^5
I, d-dL/-. 00
I CJS. 0 ()
B. ADMINISTRATIVE COSTS'
1. Personal RepresentatJve's Commissions
Nome of_IIR_ntall>o(s)
Social_{_~s}IEIN N.mboro/Porsooll R""",o_ll)
S_ Address
City._________________SIate___Lp
Year/s) CommISsion Paid:
2. Attomey Fees
3, Family Exemption: (tfd8C8dent', itdchss is not the same as claimant's, attach explltl8tion)
Claim8(l1
S__
City ..
ReIatio\"lship of eMant 10 C>eoecWnt
_____Sla\e __....Zip
4. Probate Fees
5. Accoumsnt's Fees
6. Tax Retum ~.rer's Fees
7
~._---
TOTAl (Also em., en line 9, Recapitul8lioo) S...:J I +1 q. DO __
{" more space is J'l8eCt8d. insert atlalliol"l8!l shHle of the sam6l81zel
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of Ka~ n'\6nd lee- 1<ush
also known as
No. -.-ZJ-OI - ,~ 2-
To:
Register of W~s for the
County oflunhertal\J in the
Commonwealth of Pennsylvania
Deceased.
Social Security No. I LD S - Y d. - do I L1 L"
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl (<!.s
for letters of administration
on the estate of
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
h I".
,""" ZOO I,
Decendent at death owned property with estimated values as folllows:
(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:
;1j/1l
$ 3,,790,00
$ -(~ AJ~
$ f AJ
$
Petitioner_ after a proper search ha2- ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
Na e
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYL VANIA
COUNTY OF Q,u..m6~L~ j)
} 5S
The petitioner(s) above-named swear(s) or affirm(s) that the
statements in the foregoing petition are true and correct to the best
of the knowledge and belief of petitioner(s) and that as personal
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to ~r affillJd, ~d subscribed
b,Xfore me this TH- _ day of
t- _ " COI
'-if; or
c
r~
-
fI)
'U'
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bI)
Vi
Estate of
No. 2'-DI-IIL.
f<A '-I mOJ~l) LEE M.A,~B-
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW F" ~ . t.5- 2--~i~ c~nsideration of the petition on
the reverse side hereof, satisfactory proof having been ented efore me,
IT IS DECREED that ~
is@ntitled to Letters of Administration, and in accord with such finding, Letters of Administration
m?rR '-I -f:\ - -=\?uoH-
A
are hereby granted to
in the estate of
FEES t5
Letters of Administration ..... $. . ~
Short Certificates(1 ) .......... $ 0.
RenunciatiOn......~~~.~ L~~
Filed .:f~.~.{~...... A.D. yJ~\
ATTORNEY (Sup. Ct. 1.0. No.)
ADDRESS
PHONE
H IO':l,i:105 REV 9i86
This is to certify that the information here given is correctly copied from an original certificate of death quly filed with me as
Local.Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent' filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
J-f.tf4dj~J;'~~_
Local Registrar .
Fee for this certificate, $2.00
p
7121446
chf>>.Wl ~t /.}. J .)-dnl
Date
Ht05. 144 Rev. 1191
COMMONWEALTH OF PENNSYLVANIA' DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
(Coroner)
TYPE/PAINT
IN
PERMANENT
BLACK utK
CITY, BORO,
STATE FilE NUMBfR
SEX SOCI'!'6S'URITY NUM42 2196
2. Male 3.
BIRTHP_LACE (Cily afId PLACE OF DEATH (Check only one see Instruchons ()(l othef side)
TOW~~ed;,Ql~~~syivani HOSPITAL:, O~~R.
InpatlSnl 0 EA/Outpatlent 0 OOA 0 ~Bg 0
7. ...
FACIUTY NAME (If nOllnSlllulion. gIve stleel and numbef)
DATE OF DEATH (MontH. Di:lY. Yedr)
~ February I, 2001
...
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UNDER 1 DAY
Houf. Minut8$
g~,t",8
Cumberland
Ie. Hampden
=I~~erican Indi~i\~ White. etc
,0.
DEe DENT' USUAl OCCLJAl(J'ION
'(~,":oWfkl~r
11.. 11b.
DECEDENT'S MAJlING ADDRESS ($tfeef, CityfTown, State, ZiP Code)
302 Kay Road
Mechanicsbufg, Pennsylvania 1705
MARITAL STATUS. Married
Never Married, Widowed,
~IMelR'ied
SURVIVING SPOUSE
{n Wile glv8 maiden namtlj
Cumberland
Did
decedenl
Iiveina
township?
11c.0 Yes, deCedent lived in
'Wp
l7a.Slat\!!
17b. Count
ctfylboro
'0.
INFORMANT'S!l62"K'89'm
20b.
PLACE Of otSPOS\.TION. Name ot Cemetery. Crematory
0' OI.e, Place 51. John's Cemetery
10.
NAMEANOA~<jfJft\jHli''Home, Inc. 37 East Main Street Mechanicsburg,
22c.
LICENSE NUMBER
DATE SIGNED
(Monlh. OilY, Yetll)
Hypothermia
ExpJ:J':':s AigNSi?~lNdE Of)
DUE TO (OR AS A CONSEQUENCE Of).
23b. 23c.
WASCASE AEFEAREOlO MEDEL EXAMINER/CORONER?
'i8$~ NoD
21.
tApprollimate PAAT II: Other signifiesnI conditiOnS conlfiDutmg 10 de.lh, but
: interval between not resulting in the undertying cause giyen in PART I
r"'''''deelh
DUE TO (OR AS A CONSEQuENCE OF)'.
.
WERE AUlOPSY fiNDINGS
A\WLABLE PRIOR TO
COMPLETION OF CAUSE
OF DEATH?
CERTIFtE.R (Ct\ec\<..only one)
'CltATIFYING PHYSICIAN (PhY$lClan <.:;efl'fying cause 01 death when i:lI)Oltll~1 phYSICian hi:ls pronounc~ dealh dnd cOlllplded Item 23)
To Ihe bdt of my kno~. d..th OGCurQl:t dUll to the cauH(a) ana man,..,.. alllled.
o
Unconscious in field
to cold elements
MANNER Of OEA.TH
DATE OF INJURY
(Month. Oa\!,. Ywr)
TIME OF INJURY
No ex
Natural []
Accidenl !)5
Suicide []
20.
Homlci08
[J
030. Feb I, 2001 b. Unk
[1 :t:a~~~~~~i:c~t~;"1 home. farm, Slre8C, factory. office
301.
,...0
Pending lnveshgalion
Could no! be delermmed
21b.
'PAOHOUNCaN(J AND CERTIFYING PHYSlCJAH (ph)':;lclan bOlh pronounCing OOCllh and cerhlyulg 10 cau~;;I ut lIeal!l)
To the be.1 of my llnow~, ..th occurred at the Ume, dew, and ptac., and due \0 the cMlMt.) and mannw.. .tated..
o
*~:~~~::~::;~I~~:or Inv..tlgaUon, In my opinion, de.th occurred at the time, d.te, and piKe, and due 10 the c.u..(.) and
m.nner......ed...........",....,............ ...............................,
31a.
REGIS1
"
lA/I~/i~
3'.
'ebrULfU /;l... c2 CO}
E:
-
Name of Decedent:
Date ofDoath ~'Yt / _d c9- # ~ /
Will No. ~ t) 0 I t1 0/ ~dmin. No.
'-
To the Register:
Name
I~
5
..~
Jv/fY\~~4
)~7)!j! J~~ leA-
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of
served on or mailed to the following beneficiaries of the above-captioned estate on
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Date:
d t[)/ J
Signature
Name
Address
Telephone (
Capacity: _ Personal Representative
_Counsel for personal representative
/6-~o -9
\.. BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG. PA 171Z8-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
MARY A RUSH
302 KAY RD
MECHANICSBURG
.03
APR 28
~TE
\f'./'il:J:STATE OF
DATE OF DEATH
FILE NUMBER
P 2~9NTY
ACN
04-21-2003
RUSH
02-01-2001
21 01-0182
CUMBERLAND
101
*'
REY-1547 EX AFP (01-05)
RAYMOND
L
PA 17050 Clerk,
Gumbe,i8nc5
Allount Rellitted
PA
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV=i54"j-E;f-AFP-loY':03Y-NOifcE--OF-YNHEiffTANCE-TAX-j("PPRA-fsEMiNT~--Ai.'rOWANCE-OR------------ -----
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
RAYMOND L FILE NO. 21 01-0182 ACN 101
ESTATE OF
RUSH
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
DATE 04-21-2003
I~ an assessment was issued previoUSly, lines 14, lS and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
IS. Allount of Line 14 at Spousal rate (IS)
16. Allount of Line 14 taxable at L'ineal/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 (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(I)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
3.796.40
.00
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
nO)
7,419.00
.00
(II)
(12)
(3)
(14)
NOTE:
.00 X
.00 X
.00 X
.00 X
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forI! with your
tax paYllent.
3,796.40
7.419 00
3,622.60-
.00
3,622.60-
00 =
045 =
12 =
15 =
.00
.00
.00
.00
.00
(19)=
TAX CRJ;.DITS:
~, '~n' n~_~_. (+) AMOUNT PAID
DATE NUMBER 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 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.)
u;t<
STATUS REPORT UNDER RULE 6.12
Date of
Decedent: If ush J ;< rJ.V /J1 tII1t;L U L-
Death: c2 - / -- eX OOC)- I
Name of
Admin. No. cl/-~-J{XJ/ -- OO/JeJ-
Will No.
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\~inistration of the estate is complete:
Yes NO~
2. If the answer is No, state when the personal
representati~ reasonably believes tha~ the administration will be . )
complete: jjy f1 arU'l I jY-:} 00 =) Ulf'ed f,J ,50.0v~/f:: &J -/9-J-o .-Iv l(dl.t j'JlcLL
'6171/ .
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:
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
Cerk of the Orphans' Court and may be attached to this ~e~rt
Date: L -(C;-C3 LJJ7 t!::1 q fu~
Signature
M{)rV J( Klish
Name (PUease type or print)
A~ff.s kat 1&,/ MfeIJbj, fJ) /7j5ZJ
(1/7) 7!tI-i1tf&
Te 1. No.
Capacity: )( Personal Representative
Counsel for personal
representative
(MAH:rmf/AM3)
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 1/06/2003
MARY A RUSH
302 KAY ROAD
MECHANICSBURG, PA 17055
RE: Estate of RUSH RAYMOND LEE
File Number: 2001-00182
Dear Sir/Madam:
It has corne 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: 2/01/2003
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~?1tJH4;~4af~
DONNA M. OTTO .~
DEPUTY REGISTER OF WILLS '7"1'
cc: File
Counsel
Judge
/
~K
.
STATUS REPORT UNDER RULE 6.12
N....e of Decedent : tush I !<tJ'I hlILN!- Lee....
Date of Death; ~-I.-,.;{()OI
fI / /J. Admin. 110. dl-c2()Jl- 001! d-
Pursuant to Rule
Court Rules, I report the
the administration of the
Will No.
6.12 of the Supreme Court Orphans'
following with respect to completion of
above-captioned estatel
Stat~ether administration of the estate is complete:
Yes-A No.
2. If the answer is No, state when the personal
representative- reasonably believes that the administration will be
complete:
1.
3. If the answer to No.1 is Yes, state the following:
a. Did the pe{~nal 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:
c. Did the personal representative state an
account informally to the parties in interest? Yea No
~~
d. Copies ot receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and mfty be attached to this ;.port.
){ ~~ () lC:J
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MarY A kLlsA
Name (PYease type or print)
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Address '
t1/7) 711/-119&
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