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HomeMy WebLinkAbout02-0660 BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ,/ October 8, 2002 IN YOUR REPLY PLEASE REFER TO: (717) 783-3836 MARY CLEWIS REGISTER OF WILLS CUMBERLAND CO COURTHOUSE 1 COURTHOUSE SQ CARLISLE PA 17013 Dear Ms. Lewis: Re, Estate of Marie L. Coplin File No., 21-02-0660 County, Cumberland Date of Death, January 6, 2002 The subject decedent at death legally resided outside the state of Pennsylvania; accordingly, you are authorized to close your records for inheritance tax purposes. All other inheritance tax documents filed under your resident inheritance tax number for the subject decedent (if any) should be forwarded to this office at the address shown above. Included should be photocopies of all receipts for collection of inheritance tax in the subject estate which have been issued by your office. It is not necessary to return Departmental documents forwarded to your office under the nonresident file number as we maintain a file of all documents forwarded for the estates. All matters concerning this estate will be maintained under the Pennsylvania Nonresident File Number 99-02-0756. Thank you for your cooperation in this matter. Sincerely, John Murphy, Chief Inheritance Tax Division S-IT, INH13 10,wd,028 Cumberland Register of Wills of ~ County, Pennsylvania PETITION FOR GRANT OF LETTERS No. 21-02-660 Estate of MARIE L. COPLIN also known as , Deceased Social Security No. 181-18-5000 l'c<jl><,,,e,M. who;slare lA ~e..'.ofaae '" ~de'. "pply!ieB) 100 (COMPLETE "A" OR "8" BELOW:) ~ A. Probate and Grant of Letters and aver that Petitioner(s) is/are the execut~ named In the Last Will of the Decedent, dated 2/3/88 and codicil Is I dated St~le ,elevBnt circumst/lfl"es. e.y., !enunciation, dealh of e""cut'". e'G Except as follows. Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicAted incompetent: Q B. Grant of Letters of Administration (C.'.<\.,d,b.n,G.l.".: pendmlle Ii.e, durante flbscfl'ia; ()u,m"em",,,n'B'el Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: I Name Relationship Residence I (CQMPLETF IN AI I ~A~lA1ta~tional sheets jf necessar y Decedent was domiciled at death in Pine lIas residence at 1100 S. Belcher Road South, #32, Florida County, )8e)QN:~~, with his/her last family or principal Largo, Florida 33771 Mariner Health of Clearwater, Florid1 ,20_, at (I,"' stoeel. ",,",be, aodlH"".cil'ahtvJ Decedent, then ~ years of age, died 1/6/2002 (Locat,,,,,1 Decedent at death owned property with estimated values as follows: Of domiciled in PAl All personal property (If not domiciled in PAl Personal property in Pennsylvania. (If not domiciled in PAl Personal property in County. . . . . . Value of real estate in Pennsylvania . . . . . . . . . . . . . . . . . . Real E"ate 'ituatedT::.;oli~w,i4. Donaid. Street; . MeC:hci.nlcshurg~. PA. . i 7055 $ $ $ $ $ -,/~,I;;)U~. utJ 7~j.D05.~ """ ....60 .,<'0 , Wherefore, Petitioner(s) respectfully request{s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: Typed or printed name and residence Jean M. Lehmer 221 Boas Street Harris urg, PA RW-7 /?-?b-/7'" Oath of Personal Representative Commonwealth of Pennsylvania County of ~ Cumberland The Petitioner(s) above-named swear(s) and affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. Sworn to and affirmed and subscribed before me this 22nd day of ~O"'- 'm. ~~'" JULY 20 02 ~., //~. / / ////II./I':' ~~./-' ,_ L2JII/ I /Q<u4~/ DECREE OF REGISTER Estate of MARIE L. COPLIN Deceased No. 21-02-660 also known as Social Security No. 181-18-5000 Date of Death 1/6/02 AND NOW, Q/// ./ '> J..-'/, , 20~, In consideration of the Petition on the reverse side ereon, ,latl~eL'l\:R:",OOf having been presented before me, IT IS DECREED that Letters ~ Testamentary 0 of Administration {c.t.~.. d.b ,..",; p""d~Clte I"e, uu,aBW 3l'"~tHi,,; (hJF~nt" mill,,"''''") are hereby granted to JEAN M. LEHMER in the above estate and that the instrument(s), if any, dated described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters........................... $ 115.00 >-Y//.-/N-/ (/ / ,~d-GJ~..J 4.(j J:1" u2j/ / / Registe of Wills Short Certificate(s).......... $ Renunciation.................. $ Affidavit ( )................. $ Extra Pages ( )............ $ 3.00 12.00 CodiciL........... .............. $ JCP Fee........................ $ 5.00 Inventory & Tax Forms... $ Other..................:fl..r...&? $ JQ 00 Attorney: 1.0. No: Address: William T. Smith, Esquire 06887 3747 Derry Street TOTAL.............. $ 135.00 H~rriQhllr8J ~A 17111 :e~~;:~~~D:~)~~:;~~. ~6;:J ) c ~c.~-/ ~ J,-y' L.G.~-<4....c / RW-7. McDERMOTT . 4SS0CrATES "'TTO~I\lEYI"'T""'W IOIN.CLEAIlW...n:M.AIlGOIID tAIIGa.fLOll'043~~ \tU.....M.Z4 .-- . , i~ <=> '" ']:' <..0- ,0 .. ~ : n~:!.. :z: .. p8C4:' '" . ~ Ul r,-. ~:o'l_'- ~'iI~-" -0 .,G ~ ::;: ~i ,'. <!: " '.l. ~ ~ '" LAST WILL AND TESTAMENT Od-IO?J E-53 OF MARIE L. COPLIN I, MARIE L. COPLIN, a resident of Pinellas County, State of Florida, being of sound and disposing mind and memory, do he-reby make and decla-re this to be my Last Will and Testament, hereby revoking and annulling all Wills and Codicils by me heretofore made. 02-081675 MAR- 1-2002 9: 18PM PINELLAS CO 8K 1186S PG 688 I 111111 11III III UIII II 01 III IIlI UI III I. I desire and direct that all my just debts and funeral expenses be paid without delay by the Personal Representative of my estate, hereinafter named and appointed. II. I desire and direct that my body be cremated as soon as practical following my death and disposed of in a manner suitable to my position in life. III. '. j [ J(: hel:!hj'!ubn-d'_ that! may p"f'()v,cie in .9 .<::ei-'J3.rai.::: ~'.'l:_' ::-:.g for tho:' cJisposii.;ion or c-:,;,.: ::.-. items of personal property ownt=:d by me at the time of my death. In the event that my Personal Representative is unable to locate such written signed statement wi thin 30 days after the Probate of my Will, it shall be conclusively presumed that such written statement does not exist, irrespective of whetber such statement is later found. IV. I hereby give, devise and bequeath all the rest, residue and remainder of my estate, whether teal, personal or mixed and ~1tt.~c~~;L McDERMOTT " ASSOCIATES "noIlHM....'I..4W lO(...~TliI........RGOIIO 1..4IIGO.1'I..Ol'l1O.ll,.....O ,,1:JJ&q4.IU4 .-- . , wheresoever the same may be situate to the following named beneficiaries, to-wit: A. SEVENTY-FIVE PERCENT (75%) of my estate to my niece, JEAN M. LEHMER, if living, however, if deceased to her lineal descendants pet" stit"pes Bnd not pet" capita. B. TWENTY-FIVE PERCENT (25%) of my estate to my nephew, CHARLES A. LINDLE, JR., if living, however, if deceased to his lineal descendants per stirpes and not per capita. V. ~INELLAS COUNTY FLA. OFF .REC.BK 11866 PG S69 If. at the time of my death, I am joint owner, co-owner or owner of any real estate, bank account or savings account or savings share account in any commercial bank or savings institution, stock, bond, security or instrument of indebted- ness, which is registered or issued in my name and that of anothe[" person or persons as joint tenants with right of surVivorship, of which is payable to either co-owner or the survivor of them, I give and bequeath all my right, title and interest in any such property to the surviving joint owner thereof. It is my understanding all right, title and interest in any such property will pass to such surviving joint owner upon my death by operation of law, but I do nevertheless make these pr0visi'0,~'.iS in order to I;;:l.l~inb:'';: ,'iny qUef1tinns "<::: to t\..o:; ownersh ip of such property upon my death and to prov ide for the possibility that a true joint tenancy with right of survivorship was not created during lIly lifetime. If, at the time of my death, I am the owner as Trustee for another of any bank account or savings account or savings share account in any commercial bank or savings institution, or any stock or bond which form of ownership is more popularly referred to as a "Totten Trust", I give and bequeath all my right, title and interest in and to any such bank account, savings account or stock or bond to the named beneficiary for whose benefit I was named as Trustee. -2- Mf:DERMOTT k ASSOCIATES ATTOIIlIlYSAT Ll,W 10' ..,C\.IAAW...TlR.....FIGORC, I.UIGo.I'LOIllOo\l41M1) !l13)5"."14 --.- . .. VI. I hereby nominate, constitute and appoint my niece, JEAN M. LEHMER, as Personal Representative of this my Last Will and Testament, excusing her from being bonded as such. If she be unable or unwilling to so act, then and in that event, nominate, constitute and appoint my great-niece, DENISE ROATH, as Personal Representative, in her stead? excusing her from being bonded as such. PINELLAS COUNTY rLA. 0" .REC .BK 11866 PG 670 VII. In the administration of my estate, I hereby authorize and empower my said Personal Representative, at any time acting hereunder, to sell at public or private sale, with or without notice, the whole or any part of the real or personal property of which r die seized or possessed, and I do further hereby authorize and empower my said Personal Representative to execute and deliver good and sufficient deeds or other instruments of transfer without the order, approval or prior authorization of any Court being required, and no purchaser at any such sale or sales shall be bound to see to the appl ication of the proceeds thereof. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last. Will ~nd Testament; t-.,~~ !-'!"rt d;iy of February, A. D. t 1988. ~~..",," i:{jtJL~ "_(SEAL) . L. t; ! The foregoing instrument was signed, sealed, published and declared by MARIE L. COPLIN as her Last Will and Testament, in the presence of us? tbe undersigned, who, at her special instance and request, do attest as witnesses after said Testatrix signed her name hereto, in her presence and in the presence of each other, the day and year last above written. ./r2~_ .....O"..<..~.s:- OF {!jJ,~~~ , Florida. OF --E ""'" . :.. ...f' cV , Flor ida. -3- . . .. STATE OF FLORIDA COUNTY OF PINELLAS PINELLAS COUNTY FLA. OFF.R~C.BK 11888 ~G 871 WE, MARIE L. COPLIN, ROBERT J. McDERMOTT and TERESA A. STALHEIM , the Testatrix and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned officer that the Testatrix signed the instrument as her Last Will and Testament and that she signed voluntarily and tbat each of the witnesses in the presence of the Testatr ix, at her request, and in the presence of each other signed the Will as a witness and that to the best knowledge of each witness the TestatI' ix was at that time 18 or more years of age J of sound mind and under no constraint or undue influence. ~nt-~ e?: ~...LAJ E L. ]:I a.l~.,-O :Pn.,- 8~ Wl tnes8 - --/ ''--'_.1 tt:~.A._. J ~ Subscribed and acknowledged before me by MARIE L. COPLIN, the Testatrix, and subscribed and sworn before me by ROBERT J. McDERMOTT TERESA A. STALHEIM and , the witnesses, on the 3rd day of February, 1988. ~;~~ .....,> t. ~ -ojF' - !'.. -~ .. _- - t~n'cl~.\1 STATE OF FLORIDA. PINELLAS COUN.ji~;~~ .ql"id~ .: O~.... ....~.~..... I, I hateby certify thot tile foregoing IsidW~~"P8~F 18. 1990 ::" "'j ". I photostotlc copy as the some ap~' ~:i~'" ~'~r-'- .: \ * ~ am07~a files and records OfthiS:G~9..iA:.~:i~f I -::l- <.. ..., : f.' : -<(.. ..., -e- '.fZ',,;.; Q, ;/~/ C C) DL v- ~ : t i ~,. This day of .........,.:;,i ....."'.... , ,.~ ... 0.,#1 , ~ ,'{;(J(:"ff':. -..,.:-" ,/<. " ,,' ~ : Cia f C'ID KER "t' '11"",,,,\\'\1 ,41/.1\.... ....L"Y..:. 0 Court ,~1-"'J,? ,:Vi: ~''-' I "-c''':'~ ,. - -0' e''''. "\,011.... .:.,...- BY: \"........' ':STATE,OF FLORIDA COUNTY OF PINELLAS . I, JUDGE GEORGE W. GREER , one of the presiding Judges of the Circuit Court of the Sixth Judicial Circuit of Florida, in and for Pineilas County, duly elected, qualified and acting, hereby certify that KARLEEN F. De BLAKER, whose name is signed to the foregoing certificate, is now and was on the date stated in the said certificate, Clerk of the Circuit Court in and for Pinellas County, Fiorida, duiy elected, qualified, commissioned and acting, and that she is the custodian and the Officer having charge of all of the records, files and judicial proceedings in said County and that the above and foregoing certificate of the said KARLEEN F. De BLAKER, as Clerk of the Circuit Court, certifying to the transcription of certain instruments, recorded in the public records of Pinelias County, Florida, is duly signed by KARLEEN F, De BLAKER, as said Clerk, and that the seal affixed to said certificate is the seal of said Circuit Court for said County, and that the attestation of said Clerk to said transcription of the record is in due form, WITNESS my hand in the State and County aforesaid, this 17 th day of JULY A, 0,20 02 .J "- c' ' '. ',\ ~ : . . " .. . It " ,-' -.,"-'-, ;j (SEAL) 'I : E CIRCUIT COURT SIXTH JU IAL CIRCUIT OF THE STATE OF FLORIDA ) : -- . ........ STATE OF FLORIDA COUNTY OF PINELLAS I, KARLEEN F, De BLAKER, hereby certify that I am the Clerk of the Circuit Court of the Sixth Judicial Circuit of the State of Fiorida, in and for Pinellas County, duly elected, qualified, commissioned and acting, and that the foregoinjl certificate"purporting to be signed by the Honorable JUDGE GEORGE W, GKEER , Circuit Judge is in fact signed by him, and that he was on the date stated in said certificate and stiil is one of the presiding Judges of said Circuit, duly elected, qualified, commissioned and acting in and for said Circuit WITNESS my hand and the seal of said County, this 17th day of JULY A,D, 20 02 ''''. ~~-' (. ......... (SEAL) . - ) . -:;: ." " 1I':A~'r j}, ~~ KARLEE' foe BLAKER . CLERK OF THE CIRCUIT COURT PINELLAS COUNTY .') .~ , . . " ." ...... " fi ,\ P-54 (7-90) WD2/D21/P-54 4100 X'7-?b- Fy COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPARTMENT 280601 HARRISBURG, PA 17128-0601 September 19,2002 Telephone (717) 787-3930 FAX (717) 772-0412 John M. Moser,CPA. 1300 Market St.- Suite 204 Lemoyne, Pa.17043 Re: Estate of Marie L. Coplin File Number 2102-0660 Dear Mr Moser: This is in response to your request for an extension of time to file the Inheritance Tax Return for the above estate. In accordance with Section 2136 (d) of the Inheritance and Estate Tax Act of 1995, the time for filing the return is extended for an additional period of six months. This extension will avoid the imposition of a penalty for failure to make a timely return. However, it does not prevent interest from accruing on any tax remaining unpaid after the delinquent date. The return must be filed with the Register of Wills on or before April 6,2003. Because Section 2136 (d) of the 1995 Act allows for only one extra period of six (6) months, no additional extension(s) will be granted that would exceed the maximum time permitted. ~ f~ "fITe, HoIOo"",h, S'peNiwc Document Processing Unit Inheritance Tax Division Qv DATE: COMMONWEALTBOFPENNSYLVANIA SUBJEcr: DOCKETING NONRESIDENT DECEDENT ~/ _ a) ~6 Go Fn.E INFORMATION \""\.: . ~'<\()w;::r. C - \. !t.:"": s ",,'''' ,,-v\<>. "^ COUNTY REGISTER OFWILLS FROM: .JoIm Riedman Specialty TulNoaresideat Ullit IDberitaDce Tu DivisioD Bureau of Individual Taxes Department of Revmue TO: {! AttadIed is DOBresideut deeedeat file iDformatioD COIICeruiDg taxable property located in your COIIJIty. PIeue doeket and file the ptt~ched iDformaticm so it may be aV8ilabJe for future nfereace. Thllllk you. Attaduneut MAKE CHECK PAYABLE AND REMIT PAYMENT TO: PA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 CUT ALONG THIS LINE __ RETAIN LOWER PORTION FOR YOUR RECORDS ... RE-lj=S3Y-Ei(AFP-Ti2:'-OO,)--N"OYYCE-ifF-NCfN"RESiiiEiif-I'N-1iERI-fANCE"-yiri-iip-PRAI-SEH'rN"i':-ALLCfwANCE"-OR---- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF COPLIN MARIE L FILE NO. 99 02-0756 ACN 101 DATE 11-04-2002 TAX COMPUTATION METHOD ELECTED: I I FLAT RATE (XI PROPORTIONATE TAX RETURN WAS: I XI ACCEPTED AS FILED I I CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. stocks and Bonds (Schedule B) (2) 3. Closely Held stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable {Schedule OJ (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule FJ (6) 7. Transfers (Schedule G) (7) 8. Total Assets /7-7fP-N COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF NONRESIDENT INHERITANCE ;2/ -Q;).. {;(P () TAX APPRAISEMENT, ALLOWANCE OR DISALLOMANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG. PA 17128-0601 JOHN M MOSER STE 204 1300 MARKET ST LEMOVNE 11-04-2002 COPLIN 01-06-2002 99 02-0756 NON-RESIDENT t'f~ 101 Allount Remitted PA 17043 112,000.00 77,795.40 .00 .00 43,803.46 .00 26,331. 27 181 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests (Schedule J) 14. Net Value of Estate Subject to Tax 191 1101 28.945.68 1.028.00 1111 1121 1131 11~1 _~v REV-5J7EXAFPnZ-OOl MARIE L NOTE: To insure proper credit to your account~ submit the upper portion of this form with your tax payment. 259,930.13 29.973.68 229.956.45 .00 229.956.45 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: TAX -rDEDITS: PAYMENT RECEIPT D>SCOUNT 101 AMOUNT PAID DATE NUMBER INTEREST/PEN PAID I I 09-13-2002 NR003925 .00 9,952.71 TOTAL TAX CREDIT 9,952.71 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 Line 14 at Spousal rate 1151 .00 X 00 = Line 14 taxable at Lineal/Class A rate 1161 .00 X 045 Line 14 at Sibling rate 1171 .00 X 12 = Line 14 taxable at Collateral/Class B rate 1181 66,351. 40 X 15 15. Amount of 16. Allount of 17. Allount of 18. Allount of 19 Principal Tax Due 1191 . IF PAID AFTER DATE INDICATED~ SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 .00 .00 9,952.71 9,952.71 IF TOTAL DUE IS LESS THAN $1, ND PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. I "tV~'n7~2EX 'I'H~ ~ C!JMMONWEALTH OF PENNSYLVANIA , INHERITANCE TAX RETURN NONRESIDENT DECEDENT ESTATE OF SCHEDULE A, PART 1 REAL ESTATE IN PENNSYLVANIA MARIE L. COPLIN FILE NUMBER 21-02-6600 Part 1 must include all real property owned by the decedent individually or as a tenant in common with another party(ies), having its situs in Pennsylvania, Property which is jointly-owned with right of survivorship should be disclosed on Schedule E All real estate must be reported at fair market vatue which is defined as the price at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knowledge of the retevant facts ITEM NUMBER DESCRIPTION VALUE AT DATE DF DEATH 1. RANCH HOUSE - 14 DONALD STREET 75,000.00 HAMPDEN TOWNSHIP MECHANICSBURG PA C,-,~b,""",J.. <:::.. <J\J 'I" I . PART 1 TOTAL $ 75.000.00 PART 2 TOTAL Proportionate Method Only from reverse side $ 37,000.00 TOTAL (Also enter on line 1, Recapitulation) $ 112,000.00 (If more space is needed, insert additional sheets of the same size) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT No. NR003925 RECEIVED FROM: ACN ASSESSMENT JOHN M MOSER PC CONTROL AMOUNT 1300 MARKET ST STE 204 NUMBER LEMOYNE PA 17043-1420 101 9,952.71 ESTATE INFORMATION I FILE NUMBER 99 02-0756 NAME OF DECEDENT (LAST) (FIRST) (MI) COPLIN MARIE L DATE OF PAYMENT 911612002 POSTMARK DATE 9113/2002 COUNTY Non-Resident DATE OF DEATH 1/6/2002 TOTAL AMOUNT PAID $9.952.71 REMARKS FL RECEIVED BY John M. Riedman SEAL COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE Register ,.... :.~ 'ri !ll ~n .' ..... (.11 ~~~~~ t<OlllH~ H~t<:Ioo~ gll-ji~>< t<:I:xl ~ o 0 ~c:OO .....00 ":It< t<:IO t<:I 0:;::;: ......00 HH -JiOOt<oo o ot< t;; ~oo I-j :xl 8 00 t<:I I'.' ".j () l.... (,,! -='~. . ......~ .......-."" ~ = Q.. <:y " 6" fI> 0' :r: ,':"- t"<l ~ il' p: fJ 'i j 'i (:. :.2 ,... .. ~ u. ,"- cr !'~ " D ,., i'.i, ~~ '" ~"I ",' ~~'{~?f( t'..~ ~..l "~ ;1 U' i", .~ I" ~~~ Cl i::) ,... ...::! 0" X (t'l t,; '~ ([) "' ..... "'1 r'~ ~ ~ .,:.. l-" ~ ,<; i;, " -, " ,~ I " .--------- . . . ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Yv\. u..J__Q.. L _ Q()~ \, A Date of Death: \ - c.. - 0'1- Name of Decedent: ~'0o, L,\-b1..-0CC,\j Ad N rl.;:y<~ '7 - ^ b I" " (9 min. o. L !..,. Will No. ... L(' ,~-L ..; () () G-C.".D To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the O~ans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on '1. ~ "L _ 6L-.. : . Name Address c\-.<>-('\~ '11;1 ~,..\. \""-' \.C..A "- \-\,,~-\~\" 1'10'10 41\ 004.~~\'' \-\~Q.~\\IO<' ~e.<>-V"o M.lc\--""""" Notice has now been given to all persons entitled thereto under Rule 5.6(a) except "",",0 ""'<.... Date ---1/- l - 0 L Signature ~ S..... :9 J1 w~\'-"'-~. ~~'-~ ,'\ "'~"c,~.('~ \\\,~ ~ t\, ,,\ Telephone ~ n be - 2 C 1 '1 Name Address Capacity: _ Personal Representative ~el for personal representative STATUS REPORT UNDER RULE 6.12 Name of Decedent: \rY\a....,-<:... '-.. CO"(S\.'-"", i\ '/ ,I ~ I VOl'--, Date of Death: \_<.._(:)L- Will No.: 2.. \ - (> '2. _ (; c..c. 0 Admin. No.: 10D:L. - 60\.(" 0 , 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: I. State ~e~dministration of the estate is complete: Yes ~ No 0 2. If the answer is No, state when the personal representativ.)e r~asonably believes that the administration will be complete: 0 I ).+ 3. If the answer to No. I is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes No a-.....- b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal ~re~ative state an account informally to the parties in interest? Yes ~ No 0 Date: c. Copies of receipts, releases, joinders and approval oHormal or informal accounts may be filed with the Clerk of the. Orphans' Court and may be attached to tills report. f1\\,~~) [) I-L-OY D~,,-~ Signature W,\ \~a~~. SVv-.--\~ Name Sl'-'-'l~Q'~ S\.l-\~~Aq\\~ Address - ~ l ('[ S:C, \- 2(. \. \. Telephone No. Capacity: 0 Personal Representative ~ for personal representative