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PETITION FOR PROBATE and GRANT OF LETTERS
'-"/ .
Estate of /-1 (~ /? 13 c r? -r i:/ j (-::c Tr -1I-
also known as HERBERT DALLAS PETTIT
No. ____ 21-01-410
To:
Register of Wills for the
County of c.. I..' .\1 (i i'r2 L- i~;..,1 1-) m the
Commonwealth of Pennsylvania
_ , Deceased.
Social Security No. ~?LL-L-.fi 1~'i- L-_
The petition of the undersigned respectfully represents that:
Your petitioneI(s), who i~\/are 18 years of age or older an the executGJ:+
in the last will of the above decedent, dated iiI' l' L.-) i q q ("
and codicills) dated _nL~ ' 4 (<( fI-""L
named
, 19_1l_
(state relc\ant circumstances, e.g. renunciation, death of cxecutor, etc.)
Decendent was domiciled at death in C U 1/1 ,,"?;3R 1"../'r-1v.-12-
hi-2__ last family or principal residence at 9 '2 '2 -.1'" j oX rAj
-:'1:1 C I\./ e n 1-" / up;) /.j..
County, Pennsylvania, with
DR. /f)':::'/I+.:r-/V I C ~d1,,)< ("
(list street, number and muncipality)
Decendent, then ----i~~2__- years of age, died
at
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: ____ IV /;/
Decendent 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: q ~ ~ {'J; A () "I D.(L /Y\ 1 ~ , ~.LH rd I
Iv r,J L~
, 7
.w...:;<o(" I
,._~,
-->()
-b L{t)
LiS
c) C1 ('~
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters !G~r4 m LiT...} T -=1 (-2.. 1/
(testamentary; administration c.t.a.; administration d.b.n.c.t.a.)
theron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA I s"
COUNTY OF CUMBERLAND j ::s
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
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~o. 21-01-2001
Estate of HERBERT DALLAS PETTIT aka HERBERT D PETTIT , Deceased
DECREE OF PROBATE A~D GRANT OF LETTERS
AND NOW JULY 9 ~200 1, 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 NOVEMBER 4, 1996 codicil dated JULY 14 1997
described therein be admitted to probate and filed of record as the last will of
HERBERT DALLAS PETTIT AKA HERBERT D PETTIT
and Letters TESTAMENTARY
are hereby granted to GEORGE H PETTIT
7~~H~d.A~ /A/'~'Y
_ eglster of Wills
FEES
Probate, Letters, Etc. .........
x-paCes
~~YHclrificates( )..........
Renunciation ................
JCP
$ 2PP:88
$ 6.00
10.50
$ 5.00
$ Ej . 00
TOTAL _ $ 238.50
. . . . . J.lJL Y. .2.,. .200.1. . . . . . . . . . . . . . . .
A TIORNEY (Sup. Ct. 1.0. No.)
ADDRESS
Filed
PHONE
21-01-410
REGISTER OF WILLS OF COUNTY
OATH OF SUBSCRIBING WITNESS
J ROBERT STAUFFER
codicil
(~) a subscribing witness to the E+ presented herewith, (dIDfK) being duly qualified according to
law, depose(~ and say(ij that he was present and saw
HERBERT DELLAS PETTIT
the testat OR , sign the same and that HE
request of testat~ in h~ presence and (in the p
other subscribing witness(es)).
signed as a witness at the
ence of each other) (in the presence of the
Z
Sworn to or affirmed and subscribed before
me this 2nd day of
JULY ~~
~~r:r~L-''- r/jA(4)(,~'z-~
r 7- Register
(Name)
(Address)
REGISTER OF WILLS OF COUNTY
OATH OF NON-SUBSCRIBING WITNESS
c ~ D (2 (~ i: I::> ):3--TT l,oT
(each) a subscriber hereto, ~) being duly qualified according to law, depose~ and say(s) that
he is familiar with the signature of HERBERT DALLAS PETTTT
~
testat~ of (ID\KXiiKX<<<<:X~H~~XJV~I9CXOO) the will presented herewith and
~~
that HE believes the signature on the will is in the handwriting of
HERBERT DALLAS PETTIT
to the best of ____ knowledge and belief.
-Ll; rZ=~.-J-o
(Name)
Sworn to or affirmed and subscribed before
me this 2nd day of
~ JULY NX 2001
/ /~Yo/J/h~-i~l) ;:;;::,4/
Register f/
(Address)
(Name)
(Address)
j~ to l.'l'Itity dUl (hr.: J!lt,'rnurl~ n ,1l'lC ~1\L'n 1\ elll l",'( tinn' 111 origin,d",'!ut'i"Jtc u! d,.'Jfh dul) flied with ml' ,l\
Rlp\lLll. !'!ll' U,i~!ILd I.,'nit], iCe \\tll L)" r()r\\Jidl.'~! (0 iill' SUll' \'!(;,\ iZ;'UHCl:, Ufficr h: !hrlli,lIknt j~iinh'
WARNING: It is illegal to duplicate this copy by photostat or photograph.
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21-01-410
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COMMONWEALTH Of PENNSYLVANIA' DEPARTMENT Of HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH
i....PfJPRINT
IN
PERWAkENT
Bl ACK INK
STAlE ~llE "UMBER
~AME Of DECEDENT If"~-M'd';'~---- ~~-;~~~ ~~~I-~~-~ett~~'-'--"'- -----.-. -..--- ~EX-~~~:-J:A; ;E;UR: NU"~~ __ -- -983 4. June 17. 2001
AGE Il aSl 8lrlfloay) UNDER 1 YEAR UNOER.l 01i.= --o.ATE-OF el~TH~~IRTHP_LACf ;~"y ..r.d -- PlXE OF DEATH ICt-ec... Of"'~ f)08 u ...ee ,(lSlrucl.or~ Of) ~l ~t
MonIhl Days Hour,. Mioul" ,MOtllh Day 'eRn :)1iI1tl QI rcrt:91 LOUflltYI HOSPITAL
87 y,. ! Sep 20,1913 Sybertsville, Inll"...",[J EAI~I"", [J :=..,,[J
~OUNTY Of DEATH cm. 8ORO. rw~ Of DEATH FACIlr:v NAME ~,..t ~nd ':./Oo"n RACE. Am.neon Indian. Illac.. WhlIe ole
ISpoUyI
...
Cumberland
MOTHER'S NAME IF.51. MlCtdie. Malden Sui name)
Cumberland
I/IIAS DECEDENT EVER IN
US AAMED FORCES?
Yo. 0 No Ga
DECEDENT'S USUAL OCCUPATiON
{Give IYnd oIWOtk done durlflQ rTlO$
of WOfluOQ hI.: do not use relll ed )
. ".. Master Mason lIb. ...
DECEDENT'S MAILING AOORESS (S"..... C'1y1Towo SIaIo. Z",Codel
12
11.. Stale
Pennsvlvania
1..
fATHER.S NAME (FIISI. MIOOOll. laSl)
11b. County_
Harry D. Pettit
White
MARITAL STAJUS . M_
N.ver Mm*" W~,
O_cod (Specllyl
Widowed
SUAVIVING SPOuSE
{If ~.. ;Jive maJOefl namtll
Did
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170.Gl Yao. doc_raliwd III
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Monore Twp
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ctly_
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INFORWANT'S NAME (T ypelP,onl)
RuthAnn McGarry
I.. Elsie Mae Young
INFOAMANT'S WAILING ADIlRESS ($1'001. CrlyfTown. SlaIO, lip Code'
2Gb 3006 Antietam Court Marina Ca. 93933
PlACE OF DISPOSITiON. Nama ol Cemelery. C,_alOry lOC.Q'iON . CilyfTown, $Ia'.. lip Code
Ot Othel PltlCe
2lI.
I Appfolllffial.
: tnlervaI behwMn
I QnMl and death
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OUElO(OIHSAC OlJENC OF) ~ ~ I
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WERE AUTOPSY FINDINGS MANNER OF DEAI'H DATE OF INJURY TIME Of INJURY INJUAY AI' WORK'
A\ARABlE PAtOA TO (Monltl. Day. Year)
COIr.lPLETION OF CAUSE
OF OENH,
200.
~HOO OF DtSPOSlTION
D. 0""", 0 CI.mo""" ex A"""",.. hom SIa', 0
Donahon 01 Spec...,'
. 21..
SlGNAT
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Jun 22, 2001
lICENSE NUMBER
22b FD-014318-L' 220,
s my no...~dge, death occurred allhe lime. dale and place slaled
~.nUfedf)(jT'11e1
:no.
llM, E OF OEATH , I. DII.IE PRONOUNCED DEAD IMonrh, Day. Vea,.
24 10.55 A.M. M 25 June 17, 2001
21. PART l: En'e( Ihe dlS4JaS8S. Intunes Qf comphcallOf'lS which caused the dIiIalh Do not8nlel 1M mode 01 dVlnQ. such as cafdi,.c 0; resplralory arrest shock 01 heart fallur.
list ontt O~ cause on each Itrwl
v.. D
NoD
e$
u
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Could noI be del ermined
Conolite Crematory
NAME AND AOORESS Of FACILITY
Schaefferstown, Pa. 17088
21d.
.....MYers Funeral Home Inc. 37 East Main Street Mechanicsbur Pa 17055
LICENSE NUMBER DATE SIGNED
lMonll1. Dav. '/ear I
23b 23c.
WAS CASE REFERRED TO MEDICAL EXAMINEAJCORONER?
Yo'~ 'rD.
NoD
PART II:
(:)tMr "gfuftcant co~ con&nbuling 10 de,ath, but
... ,....1llQ on Iho und.r1'1"'lI..... _ on PART I
DESCR'BE HOW INJURY OCCURRED
Pendmg Invesl'9a.lIOO
o
[J
[] ~CE Of INJUA~';;;-I.,~~;..r. 'acI"'Y. offic.
butkJiOQ. .u: lSpec,lv)
300.
Y.. 0 No r.J
Suocode
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CERTIFIER ICl'eck on.... one)
.CERTlFYING PH'tSICIAN /PhY'siC~n cetlllyultJ cause of llf!alfl whe(l ,)n0It1~' phv~'dn hdS ~ronounced dedlh ;}(\O clXn~t:'led Iltl'fn 2Jl
To the ~., 0' my knowd.dge, d.ath occurred due 10 the cau..(s) and m.nner.. a.ated
'~~~=C~~;Y~~~~~~~~:A~:::~~~~:':t;:;~~~ ~l:~~~~~~~~~~~ ~~~I~~~I~oL~~'~~~:(~~~S~O~~C:~~lr .. st.ted []
"MEDICAL EXAMINERICOAONER
~~~~:~::i:l::::.mln.tion and/or 'nvestlgllllon, In mv opinion, death occurred at the tame. date, and place, and due to the CauSe(5) and [J
JI.
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21-01-410
LAST WILL AND TESTAMENT OF HERBERT DALLAS PETTIT
I, HERBERT DALLAS PETTIT, of the Township of Monroe, County
of Cumberland and state of Pennsylvania, being of sound and
disposing mind, memory and understanding, do make, publish and
declare this my Last will and Testament, hereby revoking and
making void any and all prior wills by me at any time heretofore
made.
1.
I direct the payment of all my just debts and funeral
expenses as soon after my decease as the same can be conveniently
done, and in this respect, I direct that all estate, inheritance
and succession taxes that may be assessed in consequence of my
death, of whatever nature and by whatever jurisdiction imposed,
shall be paid out of the principal of my general estate to the
same effect as if said taxes were expenses of administration, and
that all property includable in my taxable estate, whether or not
passing under this Will, shall be free and clear thereof.
2.
I give and bequeath the sum of Two Thousand ($2,000.00)
Dollars to my good friend, NANCY M. CREIDER, of Mechanicsburg,
Pennsylvania.
3.
I give and bequeath the sum of six Thousand ($6,000.00)
- 1 -
. '
Dollars to my son, GEORGE PETTIT.
4.
I give and bequeath the sum of One Thousand ($1,000.00)
Dollars to my daughter, RUTH ANN PETTIT McGARRY.
5.
I give and bequeath the sum of Two Thousand ($2,000.00)
Dollars to my good friend, VITAI,INA CLAUDIO 4
6.
I give and bequeath the sum of Three Thousand ($3,000.00)
Dollars to the TRINITY LUTHERAN CHURCH, of Camp Hill,
Pennsylvania.
7.
I give and bequeath the sum of six Thousand ($6,000.00)
Dollars apiece to each of my following grandchildren, to wit,
SCOTT PETTIT, BRIAN PETTIT, TIMMY PETTIT, MARK McGARRY and
MICHELLE McGARRY, if they survive me.
8.
I give and bequeath all the rest, residue and remainder of
my estate, of whatsoever nature and wheresoever the same may be
situate, to my son, GEORGE PETTIT and my good friend, DALE
SCHOCK, share and share alike.
9.
For the purpose of facilitating the settlement and
distribution of my estate, I hereby authorize, empower and direct
- 2 -
my Executor, hereinafter named, to sell any and all real estate
which I may own at the time of my decease, as well as my personal
property, at either public or private sale or sales.
LASTLY, I nominate, constitute and appoint my good friend,
DALE SCHOCK, of Halifax, Dauphin County, Pennsylvania, Executor
of this my Last will and Testament, and direct that he be excused
from posting bond or other security for the faithful performance
of his duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
this
Lf
day of November, A. D., 1996.
'l/~p~k: -'SJ tPtJ-'lMt.Ll
H t alIas Pettit .
signed, sealed, published and declared by the above named,
HERBERT DALLAS PETTIT, as and for his Last will and Testament, in
the presence of us, who have subscribed our names hereto as
witnesses, at the request of said testator, in his presence and in
the presence of each other.
~~~<' tz, ~ C7
- 3 -
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
I, HERBERT DALLAS PETTIT, the 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 and Testament: that I
signed it willingly, and that I signed it as my free and
voluntary act and deed, for the purposes therein expressed.
Herbert Dallas Pettit
( SEAL)
Sworn and subscribed to
before me this Y'~
day of ~~ , 1996.
d~ob #4-1 ~
N ar'y Ppblic
COMMONWEALTH OF PENNSYLVANIA
, ~SeaI Putjc
MariIYrI Kay Eakin. ~oo eountY
~tg soro. qumooNov 6 1997
u.. Con'\ft'liSSiOO ExpIres ., --.'
'.'1. 'No,~...,,-.
Merroer. peMSylvanlaAsGOOano.1 0; :;;" '.,.>
)
COUNTY OF CUMBERLAND
We, the undersigned, J. ROBERT STAUFFER and SUSAN A. McCOY,
the witnesses whose names are signed to the attached or foregoing
instrument, being duly qualified according to law, depose and say
that we were present and saw the within testator, HERBERT DALLAS
PETTIT, sign and execute the instrument as his Last will and
Testament; that the said testator, HERBERT DALLAS PETTIT,
executed it as his 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 the time, eighteen (18) or
more years of age, of sound mind, and under no constraint, duress
or undue influence.
Sworn and subscribed to
before me this I..(tt-"
day of~ . , 1996.
fYlJ ~ CA.
Nota~ Publ c
.",. .'. ,-,.......~.. . ' -" .. ..-,.'-' '
._..._.-..~.__._...._,-_.".r"'.._____--'"-''''''''_''' ,_
r~o!ar;al S:;J~;
Marilyn Kay Eakin, Notary Fu;)~~
Med1anicSburg Boro. Cumberland U.,UiVY
My Commission Expires Nov. 6. 1997 , j
Men1[)er; PennsytvaniaAssociation of No~
- 4 -
"
21-01-410
COD I elL
I, IIERDJ;:nrr DALLAS PErrrrFC, of tho Tovrns hip of Honroe,
County of Cw~berland and State of Pennsylvania, being of sound
and disposing mind, memory and understanding, do make, publish
and de cl are this tho Pirs t Codicil to my Las t Hill and rl'es tament
dO.ted lTovem,ber t~, 1996.
1.
I hereby revoke the bequest under item "7." of' my Last
1-Jill and rrestament, Hhereby I bequeathed the SU1TI of Six Thousand
($6,000.00) Dollars apiece to each of my grandchildren as therein
named, and I hereby substitute in the place and stead of said
bequest, tbe folloHing bequest, to 'pit, "I give and bequeath the
sum of One Thousand ($1,000.00) Dollars apiece to each of my
grandchildren Hho are living at the time of my death."
2.
I hereby ratify and confirm my Last Hill and Testament
dated lToveTnbcr 4., 1996, in D.ll other respects and to all intents
and purposes not inconsistent hereHith.
IN HITNESS i!IHETIEOF, I have hereunto set my hand and seal
this i4d day of July, A. D., 1997.
H~<L~'1~ ~ (~~YU
Herbert Dallas Pettit
(SEAL)
-1-
. ,
Signed, sealed, published and declared by the above
named, HEJ1Bli;nr.r DALLAS PET~rIT, as and for the First Codicil
to his Last vJill and Testament, in the presence of us, who
have subscribed our names hereto as "t,;itnesses, at the request
of said testator, in his presence and in the presence of each
other~
/7 / ,/;
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-2-
21-01-410
RENUNCIATION
In Re Estate of
J.fG~A (r~ D A L t-IJS
fJ6/T;'J
deceased.
To the Register of Wills of
[(1111 IJ L;~_ L A--N LJ
County. Pennsylvania.
The undersigned
D Ir- L L:;--
A\
j c /;--z, (/~
of
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
be issued to
WITNESS y---f' VJJ ~ /): hand this .~. day of .J (/ l. Y
~o-o/
'-'
~ aie t? _JoI~J~-
(Signature)
g--7tf S , P ,'ven ~.I),
HAL I'FA--Y rfJ , I 7d 3:{
(Address)
(Signature)
(Address)
(Signature)
(Address)
. .' ,
.'
( ,
l-/
APR 2 5 2001 f/7
IN RE:
HERBERT DALLAS PETTIT
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
OF PENNSYLVANIA
an alleged incapacitated
person
ORPHANS' COURT DIVISION
NO. 4-10 2001
ORDER
AND NOW, this 2..5 ~L day of ---Rf C \' (
by George H. Pettit, it is ORDERED that:
, 2001, upon petition filed
A HEARING WILL BE HELD ON THE ;t;l!A, DAY OF ft}{(LcL
J
O'CLOCK -t-M IN COURTROOM NO. +- OF THE
2001 , AT J 'c3c:
,
CUMBERLAND COUNTY COURTHOUSE, 1 COURTHOUSE SQUARE, CARLISLE,
PA 17013, AT WHICH TIME THE COURT WILL CONSIDER THE ISSUE OF THE
CAPACITY OF HERBERT DALLAS PETTIT.
Personal service of the within Notice, Order and Petition shall be made by the
Petitioner upon Herbert Dallas Pettit no less than 20 days before the date of the
hearing. The contents and terms of the within petition shall be explained to the
maximum extent possible in language and terms Herbert Dallas Pettit is most likely to
understand.
Notice of the within Petition and hearing shall be given by Petitioner by certified
mail, return receipt requested to all persons residing within the Commonwealth who are
sui juris and would be entitled to share in the estate of the alleged incapacitated person
if he died intestate.
BY THE COURT: c"
l~ l,~-~I
fiW;l~i. -f}t</t
./ . I-{ IJ ') I () I ,1A-"
(
IN RE:
HERBERT DALLAS PETTIT
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY
: OF PENNSYLVANIA
an alleged incapacitated person
: ORPHANS' COURT DIVISION
: NO. 2001
PRELIMINARY ORDER
NOW, this
day of
, 2001, upon motion of Lindsay
Dare Baird, Esquire, and upon consideration of the attached petition, a rule is issued
upon Herbert Dallas Pettit to show just cause why a guardian of his person should not
be appointed. A hearing on this matter shall be held in Courtroom No. _ of the
Cumberland County Courthouse, on
,2000, at
o'clock .M.
Petitioner George H. Pettit is apointed temporary guardian of the person of
Herbert Dallas Pettit pending a final ruling by the Court following the hearing.
At least
days notice of the hearing shall be given to the next-of-kin
listed in the petition by personal service or by regular or certified mail.
By the Court,
J.
.ijP +131(1-911)
COMMONWEALTH OF PENNSYLVANIA
NOTIFICATION OF MENTAL HEALTH COMMITMENT
1M unifOrm RIMITT\S Ad. 18 PA. C.S. 8105 (e1{4) ~ lhat it BMlI be unlawM rot any pel10n adiudlc:ated iU an incrJmpetentor who h.\I, been il1V1;lkmtanly CQmmi~ to a mftnt81
ins1itution for InpatIent earo and halmenl unC!er SedJon 3(l~. !O~, or 304 or the Menial Health Ptoce<tucea/4d, of July ,. 1911J (P.l.6'1. No. 143) to poS3eU. u,e. manufacture.
conln:ll. selt 01' ransfer fireams. This WQUId Includ~ ad"JUd"lC3tiQn of lne3padty pUl'9uant \10 20 Pa.C.SA SSS01. PUnlUMt to tho f'ann&ylVanfo Mental Health P'~UItl9 h;t. ~
109, nollfi~tion sI'Iall be trBntmI1\ed ~ lne Penm;ytwnla S18to Police by the Judge. mental nltalth review omcer Clt county mental health and IMl'ltal mtafdation adminiwatarwithill
SEVEN days of the adJudication. oornmi1mM\ or treatment by tirat c1au mail to tM PenR$JlYanl. S~t. Pollee, AUlentSon: Arearm Unit. 1800 Elmertoh A\fenuo. Ha".f.$bt<lrg,
PA 11110. NOTE: The envelo~ .hllll bo Maf1(1Id wCONPID1!NT1Af.... n
INVOLUNTARY COM~;;;;~~el\MrlnVOlun..ry ~mrn~:~~~~;~: ;;~~=COMPETENT L
Date or Involuntary COmmltmel'\~ or Adjudicated tncompetent
INDIVIDUAL INFORMATION (INDIVIDUAL INVOLUNTARILY COMMITTED OR ADJUDICATeD INCOMPETENT)
LAST NAME -Perri t
FIRST gAr~rr.
MIODLE
nall~~
JR., ETC.
MAIOEN NAME
ALIAS
SEX Male
Q!?O/11
RACE White
SOCIAL SECURITY NUMBER 171 -01-fN81
DATE OF BIRTH
HEIGHT
WEIGHT
HAIR
EYES
AOD~ESS Manor Care, ~valnut Bottom Road, Carlisle, PA 17013
NOTIFICA TION BY (Please pnnt name. address, area code, and phone number of agency or county court.)
County Submitting Notification
County Mental He!llnh and Mental Retardation Adminigtrator
PhysJelan
County Mental Health Review Officer
Hospital I Facility Providing Treatment I Address
Judge
SIGNATURE OF NOTIFYING OFFICIAL
__ DAle
Court Cese Number
. Date of Court Order
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NOTIFICA TION OF PHYSJCIAN'S DETERMINATION lHA T NO SEVERE MENTAL DISABILITY EXISTS
Th. physician ~hll" provide signed wnftnnatlon (If the determln3!iOn t1I th~ lack of seVEre mental OiMbifity following the initial examination under Section 302.(b) of \.I'Ie Meflt31 Hei'.l!l'\
Procedures Act and pursuant to (he Unl(orm Firearms Act. Section S1".1 (g){3). Nl'ltiea t;rH.1I be lranllmitt!!d by Ihe physftia., to the PennsylllMia Stall! Police lhrough tl\e ecunty
menIal haallh and mental retardation administrdtcr or mental "~11ll rOIL/iaw officer.
"'4am9 Of Physician (Please print.)
~ignature of Physician
Dale
IN RE:
HERBERT DALLAS PETTIT
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY
: OF PENNSYLVANIA
an alleged incapacitated person
: ORPHANS' COURT DIVISION
: NO. 2001
FINAL DECREE
AND NOW, this
day of
, 2001, upon consideration of
the Petition to Adjudicate Incapacity and for the Appointment of Guardian of the Person
and Estate, and based upon the record and evidence received, this Court finds, by
clear and convincing evidence, that Herbert Dallas Pettit is adjudged a totally
incapacitated person.
The Court finds that Herbert Dallas Pettit suffers from a condition or
disability which totally impairs his capacity to receive and evaluate information
effectively and to make and communicate decisions concerning his management of
financial affairs and to meet essential requirements for his physical health and safety.
George H. Pettit is hereby appointed Plenary Permanent Guardian of the
PERSON and ESTATE of Herbert Dallas Pettit. The Guardian need not file a Report
as required by 20 Pa.C.S.A. S 5521 (c). Insofar as there are minimal liquid funds, the
Guardian need not post a Court approved bond.
As Guardian of the PERSON, George H. Pettit shall have the authority and
responsibility to decide where Herbert Dallas Pettit shall live and how meals, personal
care, transportation and recreation will be provided. The Guardian shall also have the
authority to authorize and consent to medical treatment and surgical procedures
necessary for the well being of Herbert Dallas Pettit.
As Guardian for the ESTATE, George H. Pettit shall have authority and
responsibility to manage and use Herbert Dallas Pettit's property primarily for
Herbert Dallas Pettit's benefit.
The aforementioned judicial determinations have taken into consideration the
matters required by Pa.C.S.A. 95512.1. The Court's findings of fact and conclusions of
law have been placed on the record at the evidentiary hearing.
BY THE COURT:
J.
cc: George H. Pettit
Herbert Dallas Pettit
Lindsay Dare Baird, Esquire
IN RE:
HERBERT DALLAS PETTIT
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
OF PENNSYLVANIA
an alleged incapacitated person
ORPHAN'S COURT DIVISION
NO. 2001
PETITION TO ADJUDICATE INCAPACITY PURSUANT TO 20 P.S. 5511 AND FOR
THE APPOINTMENT OF A GUARDIAN OF THE PERSON AND THE ESTATE
The petition of George H. Pettit, residing at 234 York Road, Carlisle,
Pennsylvania 17013, child of the alleged incapacitated person, respectfully states:
1. The alleged incapacitated person is HERBERT DALLAS PETTIT who is
87 years of age, (D.O.B. 9/20/13). He currently resides at Manor Care Nursing Home,
Walnut Bottom Road, Carlisle, PA 17013, with a permanent home address of 922 Nixon
Drive, Mechanicsburg, PA 17055, Monroe Township.
2. Mr. Pettit has no spouse. His wife Mae Arlene Good Pettit passed away
May 14,1974.
3. The adult heirs of Mr. Pettit are:
George H. Pettit, Son
234 York Road
Carlisle, PA 17013
RuthAnn McGarry, Daughter
3006 Antietam Court
Marina, CA 93933-4900
Quillas Pettit, Brother
RR1, P.O. Box 655
Sugarloaf, PA 18249
Clara Mastellar, Sister
54 Martin Lane
Norwood, PA 19074
Ralph Pettit, Brother
1007 Washington Lane
Sellersville, PA 18960
4. Mr. Pettit's income is $1313.00/month from Social Security, $500.50 from
Coal Mine Disability Income and $383.00 from the International Operating Engineer's
Union pension.
5. Mr. Pettit was never a member of the armed services and is not receiving
any benefits from the U.S. Veterans' Administration.
6. Less restrictive alternatives are unavailable.
7. Guardianship is sought because Mr. Pettit is diagnosed with Alzheimer's
Disease and recently suffered a stroke and is non-responsive. He does not have the
mental capacity to enter into a Power of Attorney so a Guardian is necessary to protect
and prevent future harm to his person and property.
8. Mr. Pettit's mental status is a permanent condition and his incapacities will
not significantly change in the future.
9. Mr. Pettit's ability to receive and evaluate information effectively and
communicate decisions is impaired to such a significant extent that he is unable to
manage his financial resources or to meet essential requirements for his physical health
and safety.
10. The names and address of the proposed guardian of the person and
guardian of the estate of the alleged incapacitated person is:
George H. Pettit, Son
234 York Road
Carlisle, PA 17013
George H. Pettit is the natural son of the alleged incapacitated person. No consent of
the proposed guardian is attached to this document since the proposed guardian is the
petitioner in this matter.
11. The names and addresses of the proposed alternate co-guardians in the
event the proposed guardian is no longer able to perform his duties are:
RuthAnn McGarry
3006 Antietam Court
Marina, CA 93933-4900
Susan D. Petit
234 York Road
Carlisle, PA 17013
12. The proposed guardian has no interest adverse to the alleged
incapacitated person and is agreeable to serving as guardian of the person and
guardian of the estate.
13. No other Court has assumed jurisdiction in any proceeding to determine
the competency of Herbert Dallas Pettit.
14. No guardian has already been appointed.
WHEREFORE, your petitioner prays this Honorable Court to grant the following
relief:
A. That a citation be issued directed to Herbert Dallas Pettit, the alleged
incapacitated person, to show cause why he should not be adjudged an incapacitated
person; and
B. A guardian of Herbert Dallas Pettit's person and estate be appointed.
Respectfully submitted,
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~~DSAY DA~~/BAIRD, ESQUIRE
. /'Attorney for the Petitioner
10 # 72083
37 South Hanover Street
Carlisle, PA 17013
(717)243-5732
..--~
Date: ...-(_1.L/ C~l
VERI FICA liON
I verify that I am George H. Pettit, Son of Herbert Dallas Pettit, the petitioner herein,
and that the statements made in this Petition are true and correct. I understand that
false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904
relating to unsworn falsification to authorities.
Dated:
24 cqJ we; I
4....~~ JJ-~...::r)AI
GEORGE H. PETTll - Petitioner
IN RE:
HERBERT DALLAS PETTIT
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
OF PENNSYLVANIA
an alleged incapacitated person
ORPHAN'S COURT DIVISION
NO. 410- 2001
AMENDED PETITION TO ADJUDICATE INCAPACITY PURSUANT TO 20 P.S. 5511
AND FOR THE APPOINTMENT OF A GUARDIAN OF THE PERSON AND THE
ESTATE
The petition of George H. Pettit, residing at 234 York Road, Carlisle,
Pennsylvania 17013, and RuthAnn McGarry, residing at 3006 Antietam Court, Marina,
California 93933-4900, children of the alleged incapacitated person, respectfully states:
1. The alleged incapacitated person is HERBERT DALLAS PETTIT who is
87 years of age, (D.O.B. 9/20/13). He currently resides at Manor Care Nursing Home,
Walnut Bottom Road, Carlisle, PA 17013, with a permanent home address of 922 Nixon
Drive, Mechanicsburg, PA 17055, Monroe Township.
2. Mr. Pettit has no spouse. His wife Mae Arlene Good Pettit passed away
May 14, 1974.
3. The adult heirs of Mr. Pettit are:
George H. Pettit, Son
234 York Road
Carlisle, PA 17013
RuthAnn McGarry, Daughter
3006 Antietam Court
Marina, CA 93933-4900
Quillas Pettit, Brother
RR1, P.O. Box 655
Sugarloaf, PA 18249
Clara Mastellar, Sister
54 Martin Lane
Norwood, PA 19074
Ralph Pettit, Brother
1007 Washington Lane
Sellersville, PA 18960
4. Mr. Pettit's income is $1313.00/month from Social Security, $500.50 from
Coal Mine Disability Income and $383.00 from the International Operating Engineer's
Union pension.
5. Mr. Pettit was never a member of the armed services and is not receiving
any benefits from the U.S. Veterans' Administration.
6. Less restrictive alternatives are unavailable.
7. Guardianship is sought because Mr. Pettit is diagnosed with Alzheimer's
Disease and recently suffered a stroke and is non-responsive. He does not have the
mental capacity to enter into a Power of Attorney so a Guardian is necessary to protect
and prevent future harm to his person and property.
8. Mr. Pettit's mental status is a permanent condition and his incapacities will
not significantly change in the future.
9. Mr. Pettit's ability to receive and evaluate information effectively and
communicate decisions is impaired to such a significant extent that he is unable to
manage his financial resources or to meet essential requirements for his physical health
a nd safety.
10. The names and addresses of the proposed co-guardians of the person
and of the estate of the alleged incapacitated person are:
George H. Pettit, Son - Proposed Co-Guardian
234 York Road
Carlisle, PA 17013
RuthAnn McGarry, Daughter - Proposed Co-Guardian
3006 Antietam Court
Marina, CA 93933-4900
George H. Pettit is the natural son of the alleged incapacitated person. RuthAnn
McGarry is the natural daughter of the alleged incapacitated person. No consent of the
proposed guardians is attached to this document since the proposed guardians are the
petitioners in this matter.
11. The proposed guardians have no interest adverse to the alleged
incapacitated person and are agreeable to serving as co-guardians of the person and
co-guardians of the estate.
12. No other Court has assumed jurisdiction in any proceeding to determine
the competency of Herbert Dallas Pettit.
13. No guardian has already been appointed.
WHEREFORE, your petitioners pray this Honorable Court to grant the following
relief:
A. That a citation be issued directed to Herbert Dallas Pettit, the alleged
incapacitated person, to show cause why he should not be adjudged an incapacitated
person; and
S. Co-guardians of Herbert Dallas Pettit's person and estate be appointed.
Respectfully submitted,
/~v ~ .,~
_ {/t1 ,-t,/ 4 l
l)NDSAY DA E SAI D, ESQUIRE
/Attorney for the Petitioner
ID # 72083
37 South Hanover Street
Carlisle, PA 17013
(717)243-5732
,;
.-..---.-
JOHN J. ECKY, ESQUIRE
"-
Attorney for t' e Co-Petitioner
ID # 53147
26 West High Street
Carlisle, PA 17013
(717)243-6222
Date: :)'/ ,('. e'l
VERIFICA TION
I verify that I am George H. Pettit, Son of Herbert Dallas Pettit, the petitioner herein,
and that the statements made in this Petition are true and correct. I understand that
false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904
relating to unsworn falsification to authorities.
Dated:
,/) 0/
71 7-243-6485 5~ I D I S SHLFF MASLAt-1
?3B P05/06 MAY 10 '01 12:31
l VArlfy that' Am RuthAnn McGarry, Daught of Herbert DallBs p,,*t it , the co-p9tlUoner
herein, and that the sbttementa made in this Petition are true and correct. f understand
that false atAMmants herein lire made sub t to the penattl98 of 18 Pa.C.S Sectkln
4go4 relating to unsWOrn falalftcatton to auth rttles.
Dated:
5/ j()(o I
I
RU HANN Mc~~etltlol1ef
IN THE MATTER OF
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 410-2001
HERBERT DALLAS PETTIT
IN RE: AMENDED PETITION TO ADJUDICATE INCAPACITY
PURSUANT TO 20 P.S. 5511 AND FOR THE APPOINTMENT OF A GUARDIAN OF
THE PERSON AND THE ESTATE
BEFORE OLER J.
FINAL DECREE
AND NOW, this 18th day of May, 2001, upon
consideration of the Amended Petition To Adjudicate Incapacity
Pursuant to 20 P.S. 5511 and for the Appointment of a Guardian of
the Person and the Estate, and following a hearing held on this
date, Herbert Dallas Pettit is adjudicated an incapacitated
person, and his children, George H. Pettit and RuthAnn McGarrYI
are appointed plenary co-guardians of his person and his estate.
The co-guardians are directed to file reports in accordance with
the provisions of 20 Pa. C.S. Section 5521(c) on each occasion
that a report is due by statute.
Pursuant to an agreement of counsel in the person of
Lindsay Dare Bairdl Esquire, on behalf of Petitioner George H.
Pettitl Johnna J. KopeckYI Esquire, on behalf of Petitioner
RuthAnn McGarry and Galen R. Waltzl Esquire, Court-Appointed
Counsel on behalf of Herbert Dallas Pettitl no bonds shall be
required of the co-guardians.
Pursuant to an agreement of counsell it is ordered
further that Co-guardian George H. Pettit shall have authority to
sign checks I alonel without the co-signature of Co-guardian
RuthAnn McGarrYI and the said George H. Pettit shall supply copies
of monthly statements from bank accounts maintained by or on
behalf of Herbert Dallas Pettit to the co-guardian and shall
supply quarterly information as to expenses and receipts related
to the guardianship to the co-guardian.
In addition, it is
authorized that Social Security payments to or on behalf of
Herbert Dallas Pettit may be directly deposited into the existing
account of Herbert Dallas Pettit as they have previously been
deposited, by the Social Security Administration.
NOTICE IS HEREBY PROVIDED to Herbert Dallas Pettit of
his right to appeal and to petition to modify or terminate the
guardianships created herein.
By the Court,
Lindsay Dare Baird, Esquire
For George H. Pettit
Johnna J. Kopecky, Esquire
For RuthAnn McGarry
Galen R. Waltz, Esquire
Court-Appointed Counsel
For Herbert Dallas Pettit
pcb
IN THE MATTER OF
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTYt PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 410-2001
HERBERT DALLAS PETTIT
IN RE: AMENDED PETITION TO ADJUDICATE INCAPACITY
PURSUANT TO 20 P.S. 5511 AND FOR THE APPOINTMENT OF A GUARDIAN OF
THE PERSON AND THE ESTATE
BEFORE OLER J.
OPINION and FINAL DECREE
OLERt J., May 18t 2001.
At issue in the present case is whether Herbert
Dallas Pettit should be adjudicated an incapacitated person, andt
if so, whether his children, George H. Pettit and RuthAnn McGarry,
should be appointed plenary co-guardians of his person and his
estate. A hearing was held on the matter on Friday, May 18t 2001,
before the undersigned judge.
Based upon the evidence presented at the hearing, the
following Findings of Fact, Discussion and Final Decree are made
and entered:
FINDINGS OF FACT
1. The allegedly incapacitated person is Herbert
Dallas Pettitt whose date of birth is September 20, 1913, and
whose present residences are the Manor Care Nursing Home, Walnut
Bottom Road, Carlisle, Pennsylvania, 17013, and 922 Nixon Drive,
Mechanicsburg (Monroe Township), Pennsylvaniat both in Cumberland
County, Pennsylvania.
2. Petitioners are George H. Pettitt who resides at
234 York Road, Carlisle, Cumberland County, Pennsylvania, 17013,
and RuthAnn McGarry, who resides at 3006 Antietam Court, Marina,
California, 93933-4900. Petitioners are the children of Herbert
Dallas Pettit.
3. The allegedly incapacitated person, Herbert
Dallas Pettit, suffered a stroke on or about April 27, 2001.
4. As a result of the stroke, Mr. Pettit has fallen
into a comatose condition, the duration of which is at the moment
uncertain.
5. As a result of the said condition, Herbert Dallas
Pettit is an adult whose ability to receive and evaluate
information effectively and communicate decisions is impaired to
such a significant extent that he is totally unable to manage his
financial resources and totally unable to meet essential
requirements for his physical health and safety.
6. At this point, it cannot be said that Mr.
Pettit's condition will be alleviated in the foreseeable future.
7. Based upon the aforesaid condition, the Court
finds that it is necessary to establish a plenary guardianship
with respect to the person and estate of Mr. Pettit.
8. In view of the absence of a more favorable
prognosis at this time, the duration of the guardianships required
must be said to be indefinite, pending further Order Of Court, and
possibly permanent.
9. The Petitioners are adult individuals who are
willing to serve as co-guardians of the person and the estate of
Mr. Pettit, with the understanding that Petitioner George H.
Pettit would have the authority to sign checks alone, without the
co-signature of the Co-petitioner RuthAnn McGarry, and with the
further understanding that Petitioner George H. Pettit would
provide to the co-guardian copies of monthly statements from banks
in which accounts are maintained on behalf of or by Herbert Dallas
Pettit and that he would supply information quarterly to the
co-guardian in the form of a report as to expenses and receipts of
Herbert Dallas Pettit.
10. Counsel in the case are in agreement and it will
be so authorized that Social Security checks in the name of
Herbert Dallas Pettit may be deposited directly into the account
of Herbert Dallas Pettit, as they have been in the past.
11. Based upon competent medical testimony, the
Court finds that the presence of Herbert Dallas Pettit at the
hearing held on today's date is excused pursuant to the Probate,
Estates and Fiduciary Code.
12. The foregoing Findings of Fact are made on the
basis of clear and convincing evidence.
DISCUSSION
The provisions respecting an adjudication of
incapacity have been relatively recently amended and are contained
in 20 Pa. C.S. Sections 5501 et sea. The Petitioners have
substantially complied with these provisions, and, based upon the
foregoing Findings of Fact, the following Final Decree will be
entered:
FINAL DECREE
AND NOW, this 18th day of May, 2001, upon
consideration of the Amended Petition To Adjudicate Incapacity
Pursuant to 20 P.S. 5511 and for the Appointment of a Guardian of
the Person and the Estate, and following a hearing held on this
date, Herbert Dallas Pettit is adjudicated an incapacitated
person, and his children, George H. Pettit and RuthAnn McGarry,
are appointed plenary co-guardians of his person and his estate.
The co-guardians are directed to file reports in accordance with
the provisions of 20 Pa. C.S. Section 5521(c) on each occasion
that a report is due by statute.
Pursuant to an agreement of counsel in the person of
Pettit, Johnna J. Kopecky, Esquire, on behalf of Petitioner
RuthAnn McGarry and Galen R. Waltz, Esquire, Court-Appointed
Counsel on behalf of Herbert Dallas Pettit, no bonds shall be
required of the co-guardians.
Pursuant to an agreement of counsel, it is ordered
further that Co-guardian George H. Pettit shall have authority to
sign checks, alone, without the co-signature of Co-guardian
RuthAnn McGarry, and the said George H. Pettit shall supply copies
of monthly statements from bank accounts maintained by or on
behalf of Herbert Dallas Pettit to the co-guardian and shall
supply quarterly information as to expenses and receipts related
to the guardianship to the co-guardian.
In addition, it is
authorized that Social Security payments to or on behalf of
Herbert Dallas Pettit may be directly deposited into the existing
account of Herbert Dallas Pettit as they have previously been
deposited, by the Social Security Administration.
NOTICE IS HEREBY PROVIDED to Herbert Dallas Pettit of
his right to appeal and to petition to modify or terminate the
guardianships created herein.
By the Court,
/s/ J. Wesley Oler, Jr.
J.
Lindsay Dare Baird, Esquire
For George H. Pettit
Johnna J. Kopecky, Esquire
For RuthAnn McGarry
Galen R. Waltz, Esquire
Court-Appointed Counsel
For Herbert Dallas Pettit
pcb
IN RE: HERBERT
DALLAS PETTIT
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYL VANIA
ORPHANS' COURT DIVISION
NO. 01-410
ORDER OF COURT
AND NOW, this 15th day of May, 2001, upon consideration of the Petition To
Adjudicate Incapacity Pursuant to 20 P.S. 5511 and for the Appointment of a Guardian of
the Person and the Estate, Galen R. Waltz, Esq., is hereby appointed to represent the
allegedly incapacitated person at the hearing scheduled for Friday, May 18, 2001, at 1:30
p.m., in Courtroom No.1, Cumberland County Courthouse, Carlisle, Pennsylvania.
BY THE COURT,
Lindsay Dare Baird, Esq.
37 South Hanover Street
Carlisle, P A 17013
Attorney for Petitioner
Galen R. Waltz, Esq.
28 S. Pitt Street
Carlisle, P A 17013
Attorney for Allegedly
Incapacitated Person
Court Administrator
:rc
".
Date: November 1,2001
Estate No.: 21-01-410
Date of Death: June 17, 2001
IN THE ESTATE OF HERBERT D. PETITT a/k/a HERBERT DALLAS PETTIT
RELEASE OF CLAIM AGAINST DECEDENT'S ESTATE
The Claimant filed a Claim Against Decedent's Estate with the Register of Wills on or
about August 2, 2001.
Claimant has been paid in full and hereby releases the claim filed.
On behalf of the Claimant, I do declare and affirm under the penalties of perjury that the
information and representations made herein are true and correct to the best of my knowledge,
information and belief.
~V~ L(,
David A. Baric, Esquire
for Claimant, HCR ManorCare, Inc.
17 West South 81.
Carlisle, P A 17013
(717) 249-6873
CERTIFICATE OF SERVICE
I hereby certify that on November 1,2001, I, David A. Baric, Esquire of O'Brien, Baric &
Scherer, did serve a copy of the Release of Claim Against Decedent's Estate, by first class mail,
postage prepaid, to the party listed below:
George Pettit {{
234 York Road
Carlisle, Pennsylvania 17013 ~ .
David A. Baric, Esquire
/1
L~
Date: August 2, 2001
Estate No.: 21-01-410
Date of Death: June 17, 2001
IN THE ESTATE OF HERBERT D. PETTIT a1k/a HERBERT DALLAS PETTIT
CLAIM AGAINST DECEDENT'S ESTATE
The Claimant certifies that there is due and owing by Herbert D. Pettit a1k/a Herbert
Dallas Pettit, deceased, the sum of $9,231.17, plus interest at the rate of $4.51 per diem from
August 2, 2001 to the date paid plus attorney fees, costs and expenses.
On behalf of the Claimant, I do declare and affirm under the penalties of perjury that the
information and representations made herein are true and correct to the best of my knowledge,
information and belief.
HCR ManorCare, Inc., Claimant
c/o O'Brien, Baric & Scherer
1 7 West South Street
Carlisle, Pennsylvania 17013
(71 7) 249-6873
David A. Baric, Esquire
for Claimant, HCR ManorCare, Inc.
17 West South Street
Carlisle, Pennsylvania 17013
(717) 249-6873
CERTIFICATE OF SERVICE
I hereby certify that on August 2,2001, I, David A. Baric, Esquire of O'Brien, Baric &
Scherer, did serve a copy of the Claim Against Decedent's Estate, by first class U.S. mail,
postage prepaid, to the party listed below:
George Pettit
234 York Road
Carlisle, pennsYlVM/ ~
David A. Baric, Esquire
IN RE:
HERBERT DALLAS PETTIT
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY
: OF PENNSYLVANIA
an alleged incapacitated person
: ORPHANS' COURT DIVISION
: NO.
AFFIDAVIT OF SERVICE
I, George H. Pettit, being duly sworn according to law do depose and state that an original
Citation and Notice in the above-captioned matter was personally served on Herbert Dallas
Pettit, at his home, by personal service. Said service being on Y - ~ (., 2001 at :J. '.3 5~
o'clock .12.tAM.
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George H. P+ttit - ~ '.
Petitioner
ct~h
J~ M l\ ~ rf'p,f
Sworn and Subscribed to
bef~~tis ~" day
of , 2001 .
Y\ ~~.)
Notary Public
-
Notarial Seal
Niven J. Baird, NO~...~~nty
Carlisle Boro, cumbeJlallU 2002
My Commission .-:~Dires Nov. 2. .
Member, Pennsv1v?n'l: \<:<;ociation ot Notanes
- PETITIONER'S
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DATE OF DEATH (MM-DD-YEAR)
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SOCIAL SECURITY NUMBER
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SOCIAL SECURITY NUMBER
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D 9. litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (date of death after ;2.12-82)
o 7. Decedent Maintained a Living Trust iAtlacn copy of TrJsll
D 10. Spousal Poverty Credit idaleofdsathbelween 12.31-91 ar.d 1-1.95)
D 3. Remainder Return (date of ~eath prior to 12-13-821
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8. Total Number of Safe Deposit Boxes
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THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL_ TAX INFORMATION SHOULD BE DIRECTED TO: .
NAME I COMPLETE MAILING ADDRESS
C. - . r V c?.!>~ I VOK,c;Q,J) .....-
FIRM NAME (IfAOP""b1,( C~::-LI ~/ ~~ p~ 1?(;)/3
TELEPHONE NUMBER r7 "'- J '- ,
7i7 ;;l. Sl!'
~t.J/'/IJ~c
(2) NA
(3) N A
(4) I N A
~ -if~ctJ.i.''''
,
!
I
,
!
l'O~ ,Oa,
I
I
I
OFFICIAL USE ONLY
1. Real Estate (Schedule A)
2, Stocks and Bonds (Schedule B)
. /., r.
z
o
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..J
::l
l-
e:
<(
u
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a:::
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
(6) Nf>
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter.Vivos Transfers & Miscellaneous Non.Probate Property
(Schedule G or L)
(7) j\i..,.
%. (Jes. 00
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
~'t
~
(8) HI'-
n, at! Co q is . <;0
~. )~~o~.3L ,
(11) J ~ ,-> C" ,;;)1.311.80
6 .. 7 -;l.3'........a, c;;:J'lf '7(. 7. t4i
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
(12)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (ScheduleJ)
30CO . OC)
7C- I. I
(13)
1'-1.4
14, Net Value Subject to Tax (Line 12 minus Line 13)
(14)
N/'r
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15, Amount of Line 14 taxable al the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
x.O~_(15) 1\1",
171/~ /, If-{ /'-{$ (16) ^-11 PI ,9Cf. 5 :3
'x .0 -.-..;
, '-
x .12 (17) NI.o,.
4 ~~Lf ..... ..' OIJO, 00
x .15 / (18) "IA
t
-- ~3-~ 7 ,5-:3 /37'Cf,S3
- (19)
.
16. Amount of Line 14 taxable allineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS !:iN REVERSE'$IDE'AND RECHECK MATH<< '>' "1":' "":i-"~,..;'!:i(~_i'
Decedent's Complete Address:
STREET ADDRESS
.
CITY
fl'\l3'c./+'A
Ie
A-
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
~! =3 ;;2/.5"3
N".
N .4
N.4
Total Credits ( A + B + C ) (2)
t'/A
3. InteresUPenalty If applicable
O. Interest
E. Penalty
hi t'1-
NA
(3) /\1 A-
(4) Nf'r
(5) N(~
(SA) N~
(5B) N~
TotallnteresUPenalty ( D + E )
4 If Une 2 is greater than Une 1 + Une 3, enter the difference. This IS the OVERPAYMENT.
Check box on Page 1 Une 20 to request a refund
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the lax due.
B. Enter the total of Une 5 + SA. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
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;.. ..................... ............................... D ~
b. retain the right to designate who shall use the property transferred or its income; ... ............................ 0 ~
c. retain a reversionary interest; or. ........... .. ............................ .............................................. ............ 0 ~
d. receive the promise for life of either payments, benefits or care? ....... . .. .... ............. 0 ~
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 r&1
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ........................... ................... ................. ........ 0 [XJ
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 penalties of perjury, I declare thai 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 a/which preparer has any knowledge.
SIGNATUR OF PERSON RESPONSI
DATE
cr :l.? ~CX"
,D C. 4 '-i
PARER OTHER THAN REPRESENTATIVE
d_+ t7 0 I
DATE
ADDRESS
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3%
[72 PS. 39116 (a) (1.1) (ill.
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. 99116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even 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. 39116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's iineal beneflcianes is 4.5%, except as noted in 72 P.S. 39116(1.2) [72 P.S. 39116(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. 99116(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.
RE:V-1~2EX.{1-971
SCHEDULE A
REAL ESTATE
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENl
ESTATE OF FILE NUMBER
)+t?ii'f?~ei 0 PI:cJT77 ~CC' / Do 4 775
All real property owned solely or as a tenant in common must be reported at fair market value, Fair market value is defined as the price at which property would be exchanged
between a willing buyer and a willing seUer, neither being compelled to buy or sell, both having reasonable knowledge of the relevant facts. Real property which is jointty.owned with
right of
survivorshio must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
iSx :;1..)0" w :213A't
/"no f) ic..~ J..J..t>..,..,l;y-
(J.Atl.AC~/W 14 )('10
0,"" 0"" t,::: UJJ {),,--
I./t:'j OO".cJO
TOTAL (Also enter on line 1, Recapitulation) $ i-l 0 I 0 () 0 , c' 0
(If more space is needed, insert additional sheets of the same size)
<"'~m,"'~>.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
I-U: iN;) ,:" T f7 P i:7T, r
FILE NUMBER
:2. 00
o 041()
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
VALUE AT DATE
OF DEATH
'''/<t7Geo il,..,2/,-n
If~=r,' Dfi, Cn.,-l-T"t;: IL.
WlUH-<--/Z.
D Il'i "-,,
C0'l.Ic.:.j.-t "",CHPu;1..
floc-liFe. i:{Ii"Ci..N",12.
.5Wd! cl- "R b c.:' r:b" 1:..-
fHO,;"o TR;>.c:.-r" 't
P.~I,a- 71u.tFtl...
l- At.&..' N ;v'td I4.l cr'~
~Ncw "l..~ l..\r~f(
P R .:SS " /"-
d 13 ;,,:P6
3 L'N 0 TH-I3L-.;-';
I IV
.I"t'\ ~ S C P I oS ;4-=.So ..,... 1;Tc .,
I Q ':5 i1
I B ~" If CC\ s "
3)l,../ ()O. 0 0
25d,<o
lI,dldcJ
IL.O."iJ
35"t'll..'{)
j 30. do
ie)," t:'
'iP/J,oc"i
30 ,oa
56' ,t!"
~SO,()O
,',o()
~ ;:), (It.''
~ 0, [.'0
<-/.::>-, ~,~
q (J,() iJ
YO> a I>
I !>-,v 0
j {, (jg5 .OC
/ \- <-
.\~<.-e. y~-
't 0'"
f~ ( \ t... .~
C....l, Jit:"
{,c~
l'iC, , I I"
QOY ; .-'1'
( "
C ~l~.'
\Y
l, .'. "
C'. -.~, -.,'
. ,,/,.
,
TOTAl (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
REV-1511 EX+ (12-99)
~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
I..j- t.:: ~ (',,9 IU
D
P~-rT'iT
Debts of decedent must be reported on Schedule I.
FILE NUMBER
'- 00 1 0 {) '-I f D
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. i=/JI2AJ ,,'- /-/-" "'... c ':Cm.a noif 3,:;2.77, LlO
!Yl 'I ,;~s
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s) r:. €fJ'~c.~ H- PP7'Ii-r
--
Social Security Number{s)/EIN Number of Personal Representative(s)
Street Address 1.. ,3 '1 YtJl1.l-( Qo
City C ..".121...1 S L& State J7A- Zip [70 1.3
Year(s) Commission Paid: .3 'l6 <.' 3'-1 " C.Ot
, ,
2. Attorney Fees
3. 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
4. Probate Fees ).3 S,5o
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ -< '1/:f, S-V
(II more space is needed, insert additional sheets of the same size)
RE"'_l~l1E:<:'llg,\ .;..~
. ..~.~<>:,
h ~'>'...."
-.: ~-'
- ~(~".":~
COMMON\NEAlTHOF PENNSYlVANI^
INHEHITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
ESTATE OF
1-i1?R.""~n+
J')
PGTTI-r
FILE NUMBER
:Jo"/60YID
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
t 3 .;L 3 'J. () 'I
fV\'.FfJ/ C~'- G;I.. PcF"L5~-S
~ &L..c"-TYtIC.
a i>~4);..j~
l./ "",j- 1'': f2..
" S' G'U.J ,.:.'tL
, IAlIt?S
7 P/Zo-f'A"'';-
((,3''''11
10....:31
It; .5f
4 ,..ci,j r
Y5'" /'1
if,> 'i
TOTAL (Also enter on line 10, Recapitulation) 01-/ t.I" :I.. 310
(If more spacE: is needed, insert additional sheets of the same size)
REV-16:3 EX. 19-00*
COMMONWEALTI,j OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
'-4 E rz n ~((:r
NUMBER
I
>
D P 1::''''717'
I.
NAME AND ADDRESS OF PERSONIS) RECEIVING PRDPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
u, E D R Go t2 1-+ Pe rn',
'--J'-I '/"'i.1t n.o CAItl.-ISl-C: pp,.
l~ iJTH t:\J./;" me c; .4-tz/l"/ C. P~"T77t]
"Idc, :13-
3"01. /'tj.J'rlL:rt:>/fI w>ul2:+ I11M/"iIAe A L.-
FILE NUMBER
"l n", / - () ("J Li I /l
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Truslee(s) OF ESTATE
5,)tJ
O.4WCH7trL
n-=l7bt J.I J)
i
I
IF t? I? /J-li)
- - t::.:.J.kJ 12. oH
C; rLfr-/'i () :5.0.V
(, ODO. <, {}
/ ""0 . " {)
-:)O(XJ. " "
adOO.",?>
}CJoC>. tn>
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH I B. AS APPROPRIATE. ON REV-15GG COVER SHEET
II NON.TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
:l
3
5
N,4Aic-y c.(?<2I1)CR /at.4 A.lt..rlD~;- ~O
mtFC/..OINlcstJ;)/fC 1'4 /7':>S'S
1..11 T.4I..IH.4 CL4U ViCJ
VN If:NDl.VA/
-- rR iN /ryu;:'--;"'TH-;" I'-}'/ c..l+u 2.CH
~ 0<'" C H~s-' J-./.....7;jT C A-1l1 P H. t /..L- P-'fI
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-15GG COVER SHEET $
~' r
/ ;\J
,\'l '
'7
"
C"-o RGi? :5 PE--rt'7T /I 7,3 '3 S€)../(J,{l..:
).f'U,"''' RD Nt?-IV1]UII.~ pI!"' 1711-.l-Io
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
I.
(If more space is needed, insert additional sheets of the same size)
REV"~13 EX+ 19'00.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
l+i-- ,J rh~IZ"'"
f) Pi-77"/1
FILE NUMBER
., t<);o I _ 0 0 (~ / tl
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
b
NAME AND ADDRESS OF PERSONIS) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) 11.2))
(Jfl.IAi-/;j PL""I"iiT "2.1/YIO~/N'A"N
'riUW-4cr; N/?uJviUg p~ 17;1.'-11
Tl/nclitLj J PeTTI'
c t=c. AI 8 flJ+'-'v c.o N M Cd r,,,e <!N/r
2'J'/'-( FPCJ AP Cl"ol-il'i"1
G R ;:v_/ 0 :,).> N
/o<XJ.('O
NUMBER
I
y
C- R.JJo.uP saN
I ~"{,,do
q
/'(1/ c.1i 1TI..I.i: H \I m P JlA I ~s 3"'"1'1 <;;0" Dw (U
CO<llrr 5imlA VAU.G'y c.qz-. ".I:Jo'~
(.rU"N f) fll/G H-~Jt.. I DCl>. 0-0
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
,.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART 11- 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)
-n ~
..~...~
:.-" ',-'. -"':~
~ , :';~,",. ~,...,": ~'H' ~ ~itl\>~:';";' ,,' ~ ' .'
~,."'~\:~
~~'~~{ .
.,'~ .:~C<.; C.~':'~.~-: ,-,_,;-,_'~<' :: " ' _:_"':;;:-",
~...~-t)~ ;,'
.r' ."'~",;.
,"-'-'
,"<-"
.~E'.'-1;';J eX "i.~'O' "-"
*. '1':' COMMONWEALTH OF
" PENNSYLVANIA
~. . DEW RTMENT OF REVENUE
, DEPT 280601
e:' .' , HARRISBURG. PA 17128-0601
~~~
REV-1500
S:;-\5- D~
'::C:,\;" U3E CNL'f
01185609
FILii NUMBER
02 1_ - _iLl _ -'L ...!:j -1 .J:i.
COUNTY CODE YEAR NUMBER
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I-
Z
W
C
W
U
W
C
OECEDENTS NAME (LAST, fiRST, AND MIDDLE INITIAL)
P<:,"fTlr I~ =-'.. 04L \/
DATE Of DEATH (MM.DD-YEAR) DATE Of BIRTH (MM-DD-YEAR)
~)7 /))0 <'1).0) 13
(If APPLICABLE) SURVIVING SPOUSES NAME (LAST, fiRST. AND MIDDLE INITIAL)
SOCIAL SECURITY NUMBER
17/ - 0'
v
6963
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
w
e-
::.::::!(fJ
'" ,""
w"-'"
",00
",0:--'
,,-'"
"-
'"
~ 1. Original Return
04. Limited Estate
o 6. Decedent Died Testate (Attacn copy 01 Will)
o 9. Litigation Proceeds Received
03. Remainder Relum !daleofdeath prior to 12-13-82)
o 5. Federal Estate Tax Return Required
8, Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (AttachSchOI
o 2. Supplemental Return
o 403. Future Interest Comprom'lse Idale 0/ death Jfter 12-12.82)
o 7. Decedent Maintained a Living Trust (Atlach copy of Trust)
D 10. Spousal Poverty Credit (date of death belwaen 12-31-913nd 1-1-95)
e-
Z
w
o
z
o
"-
'"
w
0:
0:
o
'"
THIS SECTION_MUST BE COMPLETED, ALL CORRESPONDENCE AND CONFlDENTIALTAXJNFQRMATIONS OULDBE DIRECTED TO: .
NAME COMPLETE MAILING AODRESS
Co -. . r J c?~il VO~~.t<L) ,/
fiRM NAME (IfApp"~b'" C~::, ,.~ e ~ P.4 I? Q 1..5
TELEPHONE NUMBER r7 "... ..;0 '- ,
71'7 ;::l Slf
1, Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
:7-t..I'i',,./~~1:2 Ij~
(2) NA-
(3) I\J A
(4) _ N A
~..; f '-I CO.<,~,
I
I
I
I
I
I
[,08::J IOd)
I
OFFICIAL USE ONLY
z
o
~
..J
::::l
l-
e:::
<C
u
W
0::
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule OJ
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Nair-Probate Property
(Schedule G or l)
~0. oB5. 00
(6)
Nf>
Nft
(7)
(8) '" II-
~"i 77,oe (oCjI~'<;f
;m( liI..!>) 4) LtO~. 3G ,
J ~n'" Q^ dJl, 311. (5(,
.., I 7').?~e;icr\7L7. 1.41
rJ ,4 .30<:(:> , OCY
7(.. I. I
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs {Schedule H)
10. Debts of Decedent. Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
(11)
12. Net Value of Estate (Line 8 minus Line 11)
(12)
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
(13)
14 Net Value Subject to Tax (Line 12 minus Line 13)
(14)
N/l'
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
z
o
~
I-
::l
0-
:z
o
u
><
~
15. Amount of Une 14 taxable at the spousal tax
rale, or transfers under Sec. 9116 (a)(1.2)
19. Tax Due
x .0 ",--, (15) I\J...
//I,l, (./1;-{ /'-\5 (16) N/f'l jqq, 5"3
.0 ---'
x .12 (17) NIp,
~ __GC I '- .,' boo oD
x .15 (18) ,,(~
/ ~Y~7 ,,-:3 /31''t,-S3
--- (19)
16. Amount of Une 14 taxable at lineal rate
17, Amount of Line 14 taxable at sibling rate
i8, Amount of Une 14 taxable at collateral rate
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
,> >BE SURE TO ANSWER ALL QUESTIONS OI(REvERSE:.SIDE AND. RECHECK MATH"<''',''--'f~;;i;:rt':.''~~~::~;i;i-
""~'E>,:""'~
1~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENl
SCHEDULE A
REAL ESTATE
DESCRIPTION
VALUE AT DATE
OF DEATH
~Sl( :J,.)O" w :2I3A'i
rnOOiLCf I~."\'IU:-
r.:.Aft."'C:~/W "l4X,,/d
O,'.:J'O""t?(.A..IJOi..--
/..("1 (.l<"._,JO
TOTAL (Also enter on line 1, Recapitulation) $ H () / 0 0 0 , c' 0
(If more space is needed, insert additional sheets of the same size)
'~'~m.,"".
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
/..) ere r.~l:FT D Pi...oT/,T
FILE NUMBER
.2. (J 0
004/0
Include the proceeds of litigation and the dale 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
VALUE AT DATE
OF DEATH
3,Yoo.<Jo
250. . 0
i (,4. 0 0
(lV.cd
l"fq7 Gi?a if/,\12"."
Rt.=F'()~ Ccn,4rC:IL
W4sI+<--1l.
o Il'i ,,-rZ.
CLtuc.:.j.\. ""'CHA/;2..
MOC/1?1<.. r?t?CL"""~
bw"u.:L- R" c.: kr; A:.-
RiD';".. TRAC-r" it
p,c-r~ /1U.t:tl-
L. Aw 10/ ,vld..., C-'?'
~Ncw 13l.< welt.
PRt.f'Ss c 12-
'& (3 L'if)6
3 LCN 0 r(~13L-~l;
i IV
.I'r\ (S C P j oS i.j.'" S ... ","c r
I C)E"'i>K
I Gb6 trc.c,s.:
3S""f) IlJ ()
i 30. tJd
to, (J"
yPd,OO
.3<,. (JO
56,ao
::l.SO.C:) 0
".0'-'
i ? ,-' , ~,,,
L:- 0 '- t'o
'"".>-. t.' C'
'1iJ.,;) iJ
'-l o. 0 '"
I t;>-,Vo
-i {, OeS .oC
.; \- .c
+k..t. 0"'v'-
f~( f ::.-
l\ I ".il
CQ<.. ,c;;,'
QOvl'Jl:- I..H c..
~ I C ~1U'1 (~
~IOS~'; ,<10
TOTAL (Also enter on line 5, Recapitulation) $
(If more space IS needed, Insert additional sheets of the same size)
REV-1S'11 EX+- (12-99) .
~&
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
I..}e R [',L?l2.:T
D
vi7/T'i'T
Debts of decedent must be reported on Schedule 1.
FILE NUMBER
:< 00' 0 0 Lf , D
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. .'l1'{~IlS P'otzAJ ,,'- 1+" (}7t: C ~G,rtJtJ rioi'( 3,;2. 77, "0
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representalive(s) t:e/:)fl.c.~ f-+ P~/-r
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address "'-;.'-f YOa.11. Qf')
Cily CP,t11.../SLb Slate e... lip /701.3
Year{s) Commission Paid: .3 'i6 0 3,,40 O.O~
,
2. Attorney Fees
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Str~\ Address .
City State _ Zip
Relationship of Claimant to Decedent
4. Probate Fees ?,.3S,So
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ -< '1 J.:f, 6'0
(If more space is needed, insert additional sheets of the same size)
Rt:'J_\~\1E)( '\1'~r\
. .
_.~
'H -'
~"'e' - "
-,
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMOn NEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Ilf::RI">Gn-+-
D
p;;rr,-t-
FILE NUMBER
:J""/60Y/O
Include un reimbursed medical expenses.
ITEM
NUMBER
1. tytC:OI C~<- t: A Pl:::-I'l~tc-S
DESCRIPTION
AMOUNT
t.3..t.3~. 07
,;l.. i?1..t:C.'T"Tt1~
a "u.~;,J -.:
'-I "". ,+ rr: f7...
:) S'CI.).J~,"tL
, rA;< ",-.s
7 pa,)'f''''''';-
1(.3..../1
1/)"/,31
Jq .sf
4~';'lr
435". 1'1
tj,5'"'-j
TOTAL (Also enter on line 10, Recapitulation) ~ l.j lj 0 .2. 310
(If more space is needed, insert additional sheets of the same Slle)
. REV-15l3 EX+ (9-001C}.,,3..Q
'. ~
COMMONWEALT\rI OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
'. E r<. n z: f{'
NUMBER
I
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions. and transfers under
Sec. 9116 (a) (1.2)]
CD 2 D 8 Go e 1-+ Pe in'..
:;L"J'-{ '/"'f.k. (l.O CAR-I.I';../:? PA-
I~ urn ~J.i)" me (;412/1", c. P~=-mT J
'1J4 if3-
3,'''1. ftj.Jr/l:r~m WJIJIl.-+ mMlIH/ACA"-
1.
::z
3
N ANC-'t cRell);:/? 1 ot,q A./.t.ND~~ It 0
>J1~CI..HINICS8;)/l~ 1'4 /?.>s:>
VITt4l.-iH.4 CL4uviO
/) N tt"N 0 "" '"'
~" r
/ -\I
, \
\"J '
I-J
5
---"..--..-----
rill'" /ry t...I.JTI-I r;'f1-/O-/ c../-f" tZ.cH
tlo,'o cHeSTNI.,/;-:;T C",,"I11P I.J.Lt.L-P~
C. ~ORGd' 5' pe1""hr //1.3 "3 ;5D.1~I2.:
/.+."'..'" IW Nt?"-J[]Ue.&; plY J 7:Lt.(o
"
FILE NUMBER
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
s " J.J
O.4I.JCH7trL
r-fl..., J.i J)
,
lJ::"t?I?/ND
-e:;~ t1.oH
G rlfr-I'i I? :;.o,t.J
AMOUNT OR SHARE
OF ESTATE
(,O()(I.<'O
I 000 . (J v
':)OCJO. D D
3<100." f)
3ClOCl ..'"
JOo6. d7>
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
,.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART ll- 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)
REV-'~'3 EX. 19-00*
COMfviONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RI:SfO!:;:NT DECEDENT
SCHEDULE J
BENEFICIARIES
ESTATE OF
l+"'--Il 12 -~,-t 'T
f) PEf-r"/1
FILE NUMBER
'- r>t' f - Ci 0 C'/ I ()
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
Do Not List Trustee(s) OF ESTATE
b
NAME AND ADDRESS DF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2))
(3fl.IA/./ ;y Pi..---rr1r ~ I /YIOON,A"f./
-r.;Rn4G~ NG''')ViUo; p~ 17;).'-1/
TI/1Ic71t'i .J peTT,'
CGc. N i?JII/tuo Co "'MCa rl/I/: (/N',
2 ;H<-( FPCl AP Q',o/-#'i"f
GRI'IMO ,...<.J
I CJc::J() - (j ()
NUMBER
[
y
C; R.c...O J'" N
l ..ec"c.Jc
Cj
i>ll c.H "I..i.i: 14 f/ (Y\ "IiRI~.s .3 q 7'j <;o"Dw,).[
CO<lIlT 5imlA VAU..li'y c.q.... '1:JO'3>
(,f1.A-1-I P) nVG HTifJt. I DO". 000
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
,.
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)
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 mailpiece,
or on the front if space permits.
1. Article Addressed to:
~s Clam (V\Qs+cllav
f~ ~()[t1 () Wnl--
NOrWoW/ PA Iqo1~
J
3. ~':liSTcR!CstaE '.,
~egister.. A'tEfl!! R\I for Merc~andise
o 'Insured I IJ;J<\I)I:. I. .
4. R~trictEifil:Oeliv~}~~t~-fee), .,. as
2. Article Number (Copy from service label)
10C1q 32'20 OODLI~(P 1 ,1)g'32
Domestic Return Receipt 102595-00-M-0952
PS Form 3811 , July 1999
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 mailpiece,
or on the front if space permits.
1. Article Addressed to:
D. Is delivery address different fro ite
If YES, enter delivery address be
~'7 Kl!+t1. w~n. M (Gary\}
100lo Av1tlttrm1 Wi'
MW!;1lA CPr q3q33-~400
. (
Domestic Return Receipt
2. Article Number (Copy from service label)
PS Form 3811 , July 1999
EXHIBIT "B"
,.;
i
..
..
~
I ,j'I)"O/
PETITIONER'S
EXHIBIT
If;)
z
) .' 'I
r('D I
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 mailp;ece,
or on the front if space permits.
(J/
1. Article Addressed to:
j' Mr. (2Mp~ PeHi f
..1007 vJa~nq~ lar1L-
Q IIf ~ vi ntf f f1 I gq /PO
o Agent
o Addressee
DYes
o No
2. Article Number (Copy from service label)
3. ~::i':~m'Eel<RICTED ..
o Registere~ \ ~et i yerchand~e
o Insuroo Mail O. .
4. RestricteCtDellve xtra-Fee)-- ~~s~,
PS Form 3811 , July 1999
Domestic Return Receipt
~'61/
102595-00-M-0952
SENDER: COMPLETE THIS SECTION
Com lete items 1, 2, and 3. .Also ~omplete
· 't m ~ if Restricted Delivery IS desired.
I e. e and address on the reverse
. Print your nam
n return the card to you.
so that w.e ca d t the back of the mailpiece,
. Attach thiS car 0 .
or on the front if space permIts.
1. Article Addressed to:
1}Ar. OJAnCls peHi~
~~ l r Df;oj ~~~
)u~1 rPA I ~~~~
C. Si atur~
X
D Is delivery address different from item 1?
. If YES, enter delivery address below:
o Agent
o Addressee
DYes
o No
j
2. Article Number (Copy from service label) .,/
3. Service Typ,e / . :..,t:. "'. .:~. .' :.,>;'" . "'~~'.,~\ 'i.:..
.Jt~ert.ifie1 ~'ail ~rB1CtitOise j
o Registered f
o Insured'Mail
4. Restricted, Delivery?
PS Form 3811 , July 1999
EXHIBIT "e"
-
r-- ~ PETITIONER'S
I EXHIBIT
#3 - I
~ - )-(1'13
l~ ____'5 /<:; c:r
!
///- //.) ~ /-
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHfJITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
Of DEDUCTIONS AND ASSESSMENT OF TAX
RecoraeCl' of
Rer,','.I'..,to> n \;.,it'US
U ~~t"J! ~" !f'1i fl.
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
.01 NOV 26 All:51
GEORGE H PETTIT
234 YORK RD
CARLISLE
11-20-2001
PETTIT
06-17-2001
21 01-0410
CUMBERLAND
101
*
REV-1547 E~ AFP (12-00)
HERBERT
D
PA 1 ~,ft~_:-- Court
Curnbenand Co., PA
Amount Remitted
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 = i54-j-E3f-AFP--fi2-:oo-f-No~"-icE--oF-YNHEififAifcE-"-AX-,,-PPR"-isEi-fENT-:--AiroWAN-CE-cfi----------- - - - - --
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF PETTIT HERBERT D FILE NO. 21 01-0410 ACN 101 DATE 11-20-2001
TAX RETURN WAS:
J ACCEPTED AS FILED
SEE ATTACHED NOTICE
( XJ CHANGED
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15J
16. Amount of Line 14 taxable at Lineal/Class A rate (16J
17. Amount of Line 14 at Sibling rate (17J
18. Amount of Line 14 taxable at Collateral/Class B rate (18J
19. Principal Tax Due
TAX CREDITS:
.00 X 00 = .00
17,767.14 X 045 = 799.53
.00 X 12 = .00
4,000.00 X 15 = 600.00
1I9J= 1,399.53
J
J RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
~ APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule AJ
2. Stocks and Bonds (Schedule BJ
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule DJ
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule GJ
8. Total Assets
lIJ
(2J
(3)
(4J
(5J
(6)
(7)
o
O.
\)
----...
-'
i
.~
'V
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule HJ
10. Debts/Mortgage Liabilities/Liens (Schedule IJ
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule JJ
14. Net Value of Estate Subject to Tax
(9J
1I0J
40,000.00
.00
.00
.00
6,085.00
.00
.00
(8J
6,915.50
14.402.36
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
46,085.00
lIlJ
1I2J
1I3J
(14)
1>>1.31786
24,767.14
3,000.00
21,767.14
PAYMENT RECEIPT DISCOUNT (+J AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
PAYMENT MUST BE MADE BY 03-17-2002*. TOTAL TAX CREDIT .00
BALANCE OF TAX DUE 1,399.53
INTEREST AND PEN. .00
TOTAL DUE 1,399.53
. 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.J
REV-1470 EX (6-88)
~ '
, COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG PA 17128-0601
DECEDENT'S NAME
INHERITANCE TAX
EXPLANA TION
OF CHANGES
Herbert Dallas Pettit
FILE NUMBER
ANITA MCCULLY
ACN
2101-0410
101
REVIEWED BY
ITEM
SCHEDULE NO.
EXPLANATION OF CHANGES
The value of the estate has been adjusted as the result of the correction of an error in
arithmetic.
ROW
Page 1
\. //_./g-/.:v
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
*'
REY-U07 EX AFP 112-00>
'01
GEORGE H PETTIT
234 YORK RD
CARLISLE
Ole 27 ~10 :07
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
12-17-2001
PETTIT
06-17-2001
21 01-0410
CUMBERLAND
101
HERBERT
D
Recur: .
RE'.~'...c~
Amount Remitted
C:arA 17013
Cl un be. ...., ..".:
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
RE-Y- =i r;ifj-i3f-AFP--fi"2-:offf------i..--fNifERiYANc"E--YA3f-STAfEMENY-ifF"-AC-couiff--.-.i---- ----------- - - - - --
ESTATE OF PETTIT HERBERT D FILE NO.21 01-0410 ACN 101 DATE 12-17-2001
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-20-2001
P R I NC I PAL TAX DUE: ...........................................................................................................................................................................................................................
1,399.53
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
11-09-2001 CDOO0507 .00 1,399.53
TOTAL TAX CREDIT 1,399.53
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
., IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE 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. )
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
PETTIT GEORGE H
234 YORK ROAD
CARLISLE, PA 17013
_____u_ fold
ESTATE INFORMATION: SSN: 171-01-8983
FILE NUMBER: 21-2001- 0410
DECEDENT NAME: PETTIT HERBERT DALLAS
DATE OF PAYMENT: 11/09/2001
POSTMARK DATE: 00/00/0000
COUNTY: CUMBERLAND
DATE OF DEATH: 06/17/2001
NO. CD 000507
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $1,399.53
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$1,399.53
REMARKS: GEORGE H PETTIT
CHECK# 237
SEAL
INITIALS: PB
RECEIVED BY:
MARY C. LEWIS
REGISTER OF WILLS
REGIS1~R OF WILLS
-
.,/". ..
..
STATUS REPORT UNDER RULE 6.12
(~ ) .'\
vc/~
lr/'
Name of Decedent: J-JER 6E /(117 PFrri' I
Date of Death: , J 7 2.. Do J
Will No.:
~:;;.~ 0;' - J!/(J
Admin. 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 administration of the estate is complete:
Yes (Zl No 0
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?
Yes No CJ
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.
Date: 1.....lLD-3 Q-<j.tl iJ.-B.p 7Z:l
Signature
C Eu IZ C;; 1.+ {? F TT )7
Name
. ~
J 6 '5 J A 51-1 'TO /.,/ J] f:.
I
Address
~ H J P P 6' N s {j U Il C' P A 17:2 5 7
7 /7 53'.2 I I l3--k
Telephone No.
t';
f.- 1.
Capacity: f2jPersonal Representative
o Counsel for personal representative
Cumberland County - Register Of Wills
Hanover and High Street
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 5/07/2003
PETTIT GEORGE
234 YORK ROAD
CARLISLE, PA 17013
RE: Estate of PETTIT HERBERT DALLAS
File Number: 2001-00410
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: 6/17/2003
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
cc:
) File
Counsel
Judge