HomeMy WebLinkAbout09-15-15 Pa. O.C. Rule X6.12 STATUS REPORT
REGISTER OF WILLS OF��w/v COUNTY, PENNSYLVANIA
Name of Decedent: /K //�/j
Date of Death: File Number:
Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of
the above-captioned estate:
1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . . . Yes ❑No
2. If the answer is No, state when the personal representative
reasonably believes that the administration will be complete:
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 formor informal accounts may be
filed with the Clerk of the Orphans' Court and may be ache to this report.
Date
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Form RW-/0`?ev. /0.13.06
YOU ARE HEREBY REQUIRED TO FILE A LAW OFFICES WE DO HEREBY CERTIFY THAT THE WITHIN
WRITTEN RESPONSE TO THE ENCLOSED �7 IS A TRUE AND CORRECT COPY OF THE
WITHIN TWENTY(20)DAYS FROM SERVICE H UME$ & DANIELS ORIGINAL FILED IN THIS ACTION.
HEREOF OR A JUDGMENT MAY BE `
ENTERED AGAINST YOU. 205 FARMERS TRUST BUILDING
BY ONE WEST HIGH STREET BY
ATTORNEY ATTORNEY
- riAR LISLE.PENNSYLVANIA 17013
In Re:
ESTATE OF No. 2109 04'3& "� rn '"`
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WILLIAM K. PEFFER II Deceased '
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RECEIPT, RELEASE, REFUNDING, AND INDEMNIFICATION AGUEl1aNT
The undersigned sole legatee and Executrix under the Last Will oitWILLIAM
K. PEFFER, II, Deceased, does hereby:
1. Acknowledge that she has examined and approved the statement of
the Pennsylvania Department of Revenue accepting the Inheritance Tax Return
for referenced administration of the Estate of William K. Peffer, II, Deceased, a
copy of which is attached hereto and incorporated by reference;
2. Waive the filing of a formal Account and Schedule of Distribution;
3. Acknowledge receipt of the entire proceeds of the said Estate;
4. Release herself the appointed Personal Representative and the sole
Beneficiary of the Estate of William K. Peffer, ll, and her heirs and Personal
Representatives, from all liabilities, whether due to her negligence or otherwise,
which may have arisen by reason of her administration of the Estate;
5. Agree to refund to the Estate any portion of the distribution to which
she is not properly entitled, and to the extent of said distribution, to indemnify
herself for claims made against her as Executrix, and to reimburse all expenses
and costs incurred in connection with any such claims; and
6. Declare that this instrument shall be legally binding upon herself as
Personal Representative and her heirs, successors and assigns.
IN WITNESS WHEREOF, I have hereunto with intent to be legally bound, set my
hand and seal this A7dday of
: W .....
Carol K. Wilcox
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA )
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} SS. i
COUNTY OF CUMBERLAND }
On . 2015 before a Notary Public in and
for said County and State, personally appeared CAROL K. WILCOX personally
known to me (or proved to me on the basis of satisfactory evidence) to be the
person whose name is subscribed to the within instrument and acknowledged to
me that she executed the same in her authorized capacity, and that by her
signature on the instrument the person, or the entity on behalf of which the
person acted, executed the instrument.
WITNESS my hand and official seal.
r 10-
Commonwealth of-Pennsylvania
NOTARIAL SEAL , Public in and for
voiliam S.Dantets, ry Public
gomqh of Carlisle,CumberlandCountY
My commission oxpiresNovemeef13,3017 Said County and State