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STATUS REPORT UNDER RULE 6.12
Name of Decedent: Itnne C-
Date of Death: {-lg"'05
Will No. al-05 -00/7
erecKels
Admin. No. aOO5-roo77
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 f>( 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 K 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 report.
Date: 5.2(-D5
~OMl_ <; ~~MO. ~
Signature
-hooe s - EA12fu,4-
Name (Please type or print)
5as ~rea9J1\I ec1
Address ectr1\s>\e ,pit- r-w13
( ) JI'1-24.Q -l41 50
Te 1. No.
Capacity: ~personal Representative
Counsel for personal oJ)
representati ve if"
C>
1_'...";
;
(MAH:rmf/AM3)
~eA#f+ChQd
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
-
REV-1547 EX AFP (03-05)
DIANE S BARNA
525 GREASON RD
CARLISLE
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
05-16-2005
BRECKElS
01-18-2005
21 05-0077
CUMBERLAND
101
ANNE
S
PA 17013
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 ~
1t1~~l:"Yf.m.ra;Br'lmtm.M!"~!_lrr~M.Y.m.A"'AmMMf~~YCtJM~M.'IrOft'.............. ...
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX .
ESTATE OF BRECKElS ANNE S FILE NO. 21 05-0077 ACN 101 DATE 05-16-2005
TAX RETURN WAS: (X J ACCEPTED AS FILED
J CHANGED
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 CJ
4. Mortgages/Notes Receivable (Schedule DJ
S. Cash/Bank Deposits/Misc. Personal Property (Schedule EJ
6. Jointly Owned Property (Schedule FJ
7. Transfers (Schedule G)
S. Total Assets
ClJ
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
82.08
10,095.68
5,095.53
(S)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governmental 8equestSj Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
15,273.29
(9)
UO}
1,855.84
NOTEL. ..I'f.....iIn-as~t~lfaL-1.$.s.ue.d....R~'l.iAu.s1Y.,li~.$ l.~, J.Sand"-'~J" .1J~J.I'lL-1..8.. and
reflect ~1gureS that include the total o~ ALL returns assessed todate~ .
ASSESSMENT OF TAX:
15. AlIIOUnt of Line 14 at Spousal rate US}
16. AIIIOUnt of Line 14 taxable at Lineal/Class A rate (16)
17. AROUnt of Line 14 at Sibling rate (17J
IS. Amount of Line 14 taxable at Collateral/Class B rate (IS)
19. Principal Tax Due
X CREDITS:
.00
Ul)
U2}
(3)
U4}
1.85'5 84
13,417.45
.00
13,417.45
19.wil1..
.00
.00
.00
13,417.45
x 00 =
X 045 =
X 12 =
X 15 =
DATE
02-22-2005
(9)=
.00
.00
.00
2,012.62
2,012.62
NUMBER
CD004971
+
INTEREST/PEN PAID (-J
100.63
AMOUNT PAID
2,012.62
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
2,113.25
100.63CR
.00
100.63CR
· IF PAID AFTER DATE INDICATED, SEE REVERSE
..- ------ -- ~-----_...-.. --------
( IF TOTAL DUE IS LESS THAN $1, NO PAVMENT IS REQUIRED.
"Pr- -_"AI hur TiC!" DI:e'll:'rTCn A~ A nrDl:nTTft IrDl_ vnll MAY AF nul!