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Home My WebLink About01-0099 .~. , ANCILLARY PETITION FOR PROBATE and GRANT O'F).LETTERS Estate 01 . DAVID F. KLINETOB No. also known as To: DAVID FRANKLIN KLINETOB Register of Wills for the Deceastd. County of CIJM'R}e!RLAND in the Social Securit)1 No. ~ 98 - 0 7 - 8 ~ 15 Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Y · .. th Co- our pentioner(s), who lS/are 18 years of age or older an e execut9~a in the last will of the above decedent, dated Ma V 10.. and codiC11(s) dated .Tl1n~ 1 R. 1995 21-01-99 named . 19 9 4 (state relevant circumstances, e.l. renunciation, death or executor, etc.) Decendent was domiciled at death in Anchoraae County, Ala~ka with b ; ~ last family or principal residence at 3316 La k~ Pa rk C i r~ 1 ~ nnt""f'\OT<=l'JC ('nnn+-y. ~';:ac:"';:a (Ust ~treet, number and munc:ipality) Decendent. then' 80' years of age. died November 28. " 2000 t at M~mn~;::II' ~n~r; .t-~' Except as follows, deced~nt did not marry t was not divorced and did not have a child born or adopted after ex~ution of the will offered for probate; was not the victim of a killing and was never adjudicated incompetent: . Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property S (If not domiciled in Pa.) Personal property in Pennsylvania S (If not domiciled in Pa.) Personal property in County S Value of real estate in Pennsylvania S 157 , 500 . 00+ situated as follows: 320 St. Johns Drive Hampden Township. Cumb~rland County, PA WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) pre.c;ented herewith and the grant of ; Ancillarv Letters (testamentary; administration c.t.a.; administration d.b.n.c.t.a.) theron. g ~ c: 'U "C - .- lit O~ a::'U c -g.g ..: _u ~Q. u ... ;0 &; c CQ rii '---Plevr- ;j'1~ ~ Max L_ Klinetob dh 1 ~lmmPrni 11 Rn Berwick, PA 18603 ~ p'~;1i~~e An~hnr~gp, Al~~k~ qq~17 lb.., c2CJ t.j - /3 OATH OF PERSONAL REPRESENTATIVE RICHARD A. JAMESON A L ALASKA } . 55 COUNTY OF - . ._ ~ C '! c~f(./ 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 t,he above decedent petitioner(s) will well an Iv admi~ t e estate according to law. nd subscribed day of { . ard :Jameson ~ '-n{' 0/ ~ :E: STATE OF .. .. . .. . ~.'" .~. 21-01-99 OATH OF PERSONAL REPRESENTATIVE MAX L. KLINETOB STATE OF PENNSYLVANIA ) ) SS COUNTY OF CUMBERLAND ) The petitioner above-named swears or affirms that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner and that as personal representative of the above decedent petitioner will well and truly administer the estate according to law. Sworn to or affinned a.f1d subscribed before me this 23rd day of ~ANUARY' 200t . . r.;/r(J"7":r:LLa-~ $( ./'o/"l-/:4-/ Reglster f '--Pl~ ;l y~ M~ Klinetob MARY C. LEWIS Register of Wills & Clerk of the Orphans' Court JERRY R. DUFFIE, ESQ. Solicitor One Courthouse Square Carlisle, Pa 17013 (717) 240-6345 FAX (717) 240-7797 OFFICES OF 3R2gist2r of mills ann <!.t12rh of t~2 <IDrp4ans' <!.tour! Q!ountv of Q!umherlanb January 4,2001 The Honorable John E.Duggan, Probate Master Superior Court for the State of Alaska Third Judi~ial Distri,;t at AnC:'horage 303 K street An~horage, AK. 99501 RE: Estate of David F . Klinetob Petition for Probate and Grant of Ancillary Letters We have been advised that Max L. Klinetob and Richard A. Jameson have petitioned your court for apIX>intment as ~o-personal representatives in the Estate of David F. Klinetob. We have further been advised that Max L. Klinetobcnd Richard A. Jameson also intend to file a petition in this office for the Grant of Ancillary Letters Testamentary to enable them to administer certain real property of the above named d~edent which is located in CUmberland County. An oath of personal representatives is required in conjunction with the submission of a Petition for Probate and Grant of Letters to this office. The pennsylvania Probate, Estates and Fiduciaries Code, at 20 P.s. 3154, permits a public officer of another jurisdiction having duties similar to those of a Pennsylvania Register of wills, who has been authorized to do so by the Register of the county where applic;ation of letters is tobe made, to administer the necessary oath. Accordingly, you are hereby deputized to take the oath of personal representative to be Given by Richard A. Jameson on Mr. Jameson's petition for Probate and Grant of Ancillary Letters in the Estate of Max L. Klinetob, to be filed with this offi~e. Very truly yours, ?L~,,~ Bat~ Deputy Register of Wills \ 21-01-99 IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF ALASKA AT ANCHORAGE AUTHENTICATION FORM FOR ALASKA COURT RECORDS A1TESTATION OF l'!r.RRK I, Charlene Dolphin, clerk of the Trial Courts (District and Superior Court) at Anchorage, Alaska, do hereby certify that the pa~r(8) aUached to tms certificate and listed below are true and correct copy(s) of the original doe-11nent(s) on file in my office: IN THE MA'ITER OF THE ESTATE OF DAVID F. KLINETOB, 3AN-oO-1568 PIE. LETTERS TESTAHENTARY, STATEMENT OF INFORMAL PROBATE OF WILL AND APPOIBTKENT OF PERSONAL REPRESENTATIVE, APPLICATION FOR INFORMAL PROBATE OF WILL AND APPOINTMENT OF CO-PERSONAL REPRESENTATIVES, LAST qILL AND TESTAMENT OF DAVID F. KLINETOB, Witness my hand and the seal of this court. 1/17/01 Date ~~~p&~~urt CERTIFICATE OF JUDGE I, Elaine M. AndrewsJudg~ of the Superior Court at Anchorage, Alaska, do hereby certify that Charlene Dol~hin is now, and was at the time of signing and sealing the above attestationhthe clerk of the Trial Courts (District and Superior) at Anchorage, Alaska, and that er attestation is in proper form. 1/17/01 Date lJ Elaine M. An~~rior Court Judge Admin. R. 9(e)(4) AS 09.30.200 28 USC ~ 1738 TF-315 ANCH (7/96)(cs) AUTHENTICATION FORM ~ -w ~ .S ~, ~ a ~ _~ .~ ~l 8:".t '"""1 ~ \~~~ ~ .l:-.- Qtr..O\ u ~ ~':UO\ l"C" _~ '5'~ 8; ;::: .....J 'J) ~ · C:l '--... _ ~ h.. ~ l;j ~ t(' t,,- ~~o:.l' '!) ~ Q t ~ 0\ ~!~ f ~ ~ 2 It''>;';: C) -\ Si ~ ~ 1::~ ~ ...... c; ~ ~ .~ .~ ER ~ IN THE SUPERIOR COURT FOR THE STATE OF ALASKA i-ILED IN -, 'f= TIDRDJUDICIALDISTRlCT AT ANCHQ~~~COURI . '.. ---,,~ i tC 2../2UOO 8y~ . ---.~ D€A~C1erk In the Matter of the Estate of: ) ) ) ) ) ) ) DAVID F. KLINETOB, Deceased. 15be PIE Case No. 3AN-OO- LETTERS TEST AMENT ARY The will of David F. Klinetob having been admitted to probate, Richard A. Jameson and Max L. Klinetob are appointed as Co-Personal Representatives of the estate. . ;,-., --; ~'<. /", J/' ! I i ; .. . -I. "-t. \ ! -.- ! I I 1 Registr~lt/Superibr t=ourt Judge Date I I I I We, Richard A. Jameson and Max L. Klinetob, accept the duties and promise to perform . I the duties as required by law of the office of Co-Personal Representatives of the estate of David F. Klinetob. We acknowledge our duties as Co-Personal Representatives to: ACCEPTANCE (a) take possession and control of decedent's property as required by AS 13.16.380, determine the liabilities of the estate, and complete an inventory as required by AS 13.16.365; (b) provide notice to heirs and devisees as required by AS 13.16.360, except as provided by AS 13 .16.690~ Letters Testamentary and Acceptance Page 1 of 4 ~ 0') ti ~ . .... O"i ~ ~ ~ lJ) ~ ~ ~',t ~ ~ ~~~ ~ .l-.. ~ \i'i q-.. ~ ~ ~~ 0\ ~ ;:a:~~ · ~'-.. ~~ h. ~~~~ ~ ;:; ~ ..... ~ ". l::1 .~ '-') ~ ~ ~i8 ~ ~ ~ ~ \/', ~ ~ ~f5\ ~ ~ ! ~ ~ (c) provide notice to creditors as required by law, publish notice when required, and review and either accept or reject claims as required by AS 13.16.455-.515; (d) advise the court in writing of my address and telephone number as required by Probate Rule 8; (e) file returns for state estate taxes, if required by AS 43.31.121 and AS 43.31.250; (t) pay homestead, exempt property and family allowances as required by AS 13.11.125-.140, costs of administration and other claim as required by AS 13.16.470, and distribute the assets of the estate; and, (g) close the estate as soon as appropriate as required by AS 13.16.620-.670. We will file any required bond. I z/J r/ (!) CJ Date { ( ~~ 3345 Lake Park Circle Anchorage~ AK 995 I 7 (907) 248-5662 / _;). _/ ) - c (; Date '-"J/.}<I....~. . -:/ '--IX"'- ,/::.' . *,. / . / . ,.~. " ~.~~., .,~ / ~ I ~~ ,/. .~, .~ Max L. Klinetob 461 Summerhill Rd. Berwick, PA 18603 (570) 759-0209 Letters Testamentary and Acceptance Page 2 of 4 ~ ~ .~ ~ ~ ~ ~ II) 1:::l C\.l ~ ',t R:' ~ :::8~ .~ t C)\f\Q\ ~ e-.~O\ ~ ~ C) '5 ~ <.., ~ . \..J V) .] :... ~~~r:\ h. ~ ~ - ~ .9 'J) ~ ~ ~ '4 ~ ~ . ~8 i ~ ~~lr)~ % ~~ ~ ~ ~ ~ VERIFICATION OF RICHARD A. JAMESON I, Richard A. J arneson, say on oath or affirm that I have read the foregoing document and believe all statements made in the document to be true and correct. STATE OF ALASKA ) )ss. THIRD JUDICIAL DISTRICT ) SUBSCRIBED AND SWORN to or affirmed before me at Anchorage, Alaska, on this ~~ day of December, 2000. ..~~\~\';'c. ,'. ;i~;~/fi~.. ~ S) ..............-11.0 ~ ~~~... ~(1\\SSIC"ti..V~ ~ ~() ....eT' ~\~~ ~':i- $...~. ~ [NOTl\RY~ ~ %~\ PUBLIC/*i ~T" '. ~ .' ~ ~ ~ <.P';;'':-:Uly 25. zQ~..'~~ ~ ~ ~r. ......... ~J ~ ~ E OF ~\,: ~ . rJ/111111II1 m\\\\\~ Notary Public in 1[, r Ala~ki '2-)-[ 04 My Commission Expires:~ :::t ~ ~ S- ~ Letters Testamentary and Acceptance Page 3 of 4 ~ ~ ~ "'"1 .~ ~ ~ ... ~ V) - ~ ~.~ ~ ~ ~8~ ~ ~ C:l \r\ Q) u ~ f=:l... ~ 0"\ '" ~ .... <::t ~ ~ G '5'~ . ~ '-.. ~ J4 t--. ~ g~~ ~ ~ ,8 Vj ~ I ~.~ ~ ~ ~ . ~8 ~ ~ ~~Ir\~ ~ ""?::i rr ~ l-.::: -, ~ ~ i \.J ~ ~ VERIFICATION OF MAX L. KLINETOB I, Max L. Klinetob, say on oath or affirm that I have read the foregoing document and believe all statements made in the document to be true and correct. rYJ~ ,i-'-1~r Max L. Klinetel5' STATE OF PENNSYLVANIA ) )ss. COUNTY OF COLUMBIA ) SUBSCRIBED AND SWORN to or affirmed before me at :J5 r:."'_,--t..:.... c:.. !(- " '-f';'-" Pennsylvania, on this .:; , day of December, 2000. I I i )1 / -.r.. '-.t--' "c 1\.....<:-._ -i-- _ ~__ L \.LL .j ,>'- Notary Public in / for Pennsylvania My Commission Expires: NOT ARIAl SEAL flORENCE PETRUSA, NOTARY PUBLIC BERWICK BORO., COLUMBIA COUNT'( PA. MY COMMISSION EXPIRES OCT. 21. 2003 ._::R~~FY 'rHA T ON I")--)f 60 ~~";i;> U,~ THIS FORM WEi\-:;-,~-:-;-; ~~'":::;. "'='..:::::r"fioCII. ~ r . ~ C~I(' Letters Testamentary and Acceptance Page 4 of 4 <:::) <=:) c;:) C"I co - (.,) 1.&.1 Q ~ 0', ~ ~ ...... 0"\ ~ ~ ~ 'J} ~ C'-l ~'4:: ~ t:::' ~ E:8~ ~ -b ~\ri~ ~ e--.~~ 8; ;:: ~'5 ~ . ~ 2:~ ~ ~ t:::1 ~ ~ ~ t: g ~ ~ ~ t:t ..... V) ~ ~ ':::) ~ '-l ,~ ~ . ~ 8 t:J t:::' ~ 2 \" ~ a -) ~ t:\ ~ '1:~ ~ t:t ~ ~ ~ ~ ~ ,-ILEe iN}" . sr.HE ~t10b.4-"- .,...,.,~-. )\71[,9F= ~ t: (;OU- IN THE SUPERIOR COURT FOR THE STATE OF ALASKA '--"'''\/~ R D -~~~~- THIRD JUDICIAL DISTRICT AT ANCHORAGE .Fe 27 2000 . ,., By~ ______ --U /'. ------- vePtItv,-'" . J "\JtSn IN THE MATTER OF THE ESTATE OF DAVID F. KLINETOB, Deceased. ) ) Case No. 3AN-OO-/S~8p/E STATEMENT OF INFORMAL PROBATE OF WILL AND APPOINTMENT OF PERSONAL REPRESENTATIVE [A.S. ~ 13.16.1151 The Registrar makes the following findings based upon the application of Richard A. Jameson and Max L. Klinetob for informal probate of the last Will of David F. Klinetob and appointment of co-personal representatives: 1. The application appears to be complete and contains the applicanLs' oaths or affirmations that the statemen~s contained therein are true to the best of the applicants' knowledge and belief. 2. The applicants are interested persons. 3. Decedent died on No'/ember- 28, 2000, anc 3'::. :"'easc 120 ~C:~:-3 have ~_~~5ed since decede~c's death. 4 . Der::edent '/'Ias domi,:iled ~ 0- ct. i.... ~he Clm":: '"JI ~n P_nchor-ag,,=, .=-. ~;:z 5 ": a rjJ~a th. Venue is proper because decedent was rlcmici~ed in this judicial cEst.cict at the time of death. 6 . The time for appointment of a personal representative has not expired. 7. A personal representative has not been appointed in this or any ether judicial district of the state and neither t~is Will nor any other Wi 11 0 f ~ he de c e de Ii t has bee nth e sub j e c t 0 f a p r .:; 'J i 0 iJ S pro bat e c r de r . 8. Decedent left a valid, unrevoked .Will dated May 10, 1994. The original or this Will is in the Registrar's possessio~. 9 . The per son s w h c sea p poi n t men tis so 'J 'j r. t h d 'I e ~ r i 0 r i t Y for app.:)intm::=:r-!t as co-personal representati ves. 10. No bond is required because decedent's Will waives any bond. ~ ~ t::t ...... \J ~ ~ V) .8 ~ ~ '-1 ~ ~ ~ ~ ~ C) \.f\ Ql ~ ~":oJ O'i :s .~ Q ~ \..) ';S ~ ~.......... ,-...::: ~ l:it;~ ~ ~ ' ~.8 ~ ~ - l..r, t::l ~~'-l h. . '~8 i ~ ~ \i', l;\ ~r:\ ~ \J ~ O'l ~ ~ q r:::: ~ :..! ~ . /,,, r-... ~ ~ C\l --- 1,- CJ .~ ~ ~ ~ ~ 11. Any notice required by the laws of this state has been given. THEREFORE, it is ordered that the Will is admi t ted to informal probate. It is also ordered that Richard A. Jameson and Max L. Klinetob are appointed as co-personal representati ves of decedent r s estate. Letters of testamentary will be issued upon qualification. Date: I t / L l/c;?' . . ... I' /'/{I' " . ij'l,L,~ Rei~is'trar . I I I, CERT;F'. . . / ~ " .J>: (.'-tAT ON ~ - dO~' 00 COP~E8 ;-;.{_: Ti-Iv" c{-.,...... ---...- ~ _.~. - ."l;')~ ....JH~A'Nr=R~-.:..:.:.. . iU ~ - "ii, --~----- {,~,_:~:~~, _. ~ CJ) .~ ...... ~ ~ ~~ ~ ;:: h.. ~ ~.~ ~ t:::' ~8~ ~ -b C Ii) Q\ >.::J e-.~O\ 8; ~ c':; ~ \.JVj.] . <:;:)......... ... ...... ~ i! t: ~ t.... fl ... ~ .9 'J) ~ ~ ~~'--l~ C'~ . ~8i t:::' ~ 10.::: \1) Q ~ ~ ~ ~l;\ ~ ~ J! .~ .~ ~ ~ ~ IN THE SUPERIOR COURT FOR THE STATE OF ALASKA THIRD JUDICIAL DISTRICT AT ANCHORAGE In the Matter of the Estate of: ) ) ) ) ) ) PIE DAVID F. KLINETOB, /i Deceased. Case No. 3AN-00- /5t1 APPLICATION FOR INFORMAL PROBATE OF WILL AND APPOINTMENT OF CO-PERSONAL REPRESENT A TIVES We, RICHARD A. JAMESON and MAX.L. KLINETOB, co-applicants, state that: 1. I, Richard A. Jameson, am an interested person because I have been named Co- Personal Representative in the decedent's will and because I am a surviving stepson of the decedent. 2. L Max L. Klinetob, am an interested person because I have been named Co- Personal Representative in the decedent's will and because I am surviving son of the decedent. 3. Decedent David Franklin Klinetob died on November 28, 2000, at the age of 80. IA! least 120 hours have passed since decedent's death. 4. Upon reasonable diligence, the following is a list of the names and addresses 0 f the decedent's spouse, children, heirs, and devisees: Richard A. Jameson 3345 Lake Park Circle Anchorage, AK 9951 7 Stepson and Co-Personal Representative Max L. Klinetob 461 Summerhill Rd. Berwick, PA 18603 Son and Co-Personal Representati ve Christy A. Klinetob 706 16th Street Berwick, P A 18603 Granddaughter Application for Informal Probate of Will and Appointment of Co-Personal Representatives Page 1 of 5 ~ 0\ """'l .;:t ~ ~ ;:: ~ V') c. C\l ~',t ...... t::' ~ ~8~ ~ -t c. \i) 0\ ~ e-.~O\ ~ ;:: a ";;.J2 . <::) '-- ~ Jl t--. ~ l::1 ~ ~ h.. ~~~~ ;;: t:i .~ VJ ~ ~ ~~8 ~ ~ ~ 2li) t: C) '-'\ e..t (\ ~ ~r:\ ~ ~ i ~ ~ Matthew L. Klinetob 461 Summerhill Rd. Berwick, PA 18603 Grandson Michael L. Klinetob 4204 Market Street Berwick, P A 18603 Grandson Kelly Jameson 750 North Dearborn Street, Apt. 408 Chicago,IL 60610 Step-Granddaughter John Jameson 339 Race Street E. Stroudsberg, P A 18301 Step-Grandson Isabella K. Jameson c/o Richard A. Jameson 3345 Lake Park Circle Anchorage, AK 99517 Step-Granddaughter Minor: Age 6 months 5. Decedent was domiciled in Anchorage, Alaska, at the time of his death. 6. Venue is proper because decedent was domiciled in the Third Judicial District. Alaska, at the time of his death. 7. No personal representative of the decedent's estate has been appointed in this state or elsewhere. 8. I have not received demand for notice of probate or appointment proceedings concerning the decedent and am not aware of any demand for notice that may have been filed in this state or elsewhere. 9. The time for informal probate as provided in AS 13.16.080-13.16.130 has not expired. 10. The original of the decedent's last will and testament accompanies this application. Application for Informal Probate of Will and Appointment of Co-Personal Representatives Page 2 of5 ~ ~ '""1 ~ ~ ';:S ~ ~ ~ V:l ~ ~ ~ '.t i':' ~ ~8~ ~ b ~~ ~ ~ ~-Wl:1 ~ +::: G ':; ~ · ~ '-.:Ji h.. ~l:i~~ h.. ~ ~ ' ~ ;:: .9 r~J ~ I ~~'-4~ ~ . ~8 i ~ ~~tr\t\ ~ ~ ~ ~ ~ 1 ~ ~ 11. To the best of my knowledge and belief, the attached original last will and 4 estament was validly executed by decedent. 12. After the exercise of reasonable diligence, I am unaware of any instrument evoking the attached will, and I believe that the attached will is the decedent's last will. 13. We are entitled to be appointed as Co-Personal Representatives of decedent's estate because we have been so named in decedent's will and no other persons have a prior or equal right to appointment under AS 13.16.065. 14. No bond should be required because such bond has been waived in decedent's will at Item VI, which states: ITEM VI: No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction. Therefore, we hereby request an order admitting decedent's will to informal probate and an order appointing us as Co-Personal Representatives of decedent's estate and that letters testamentary be issued. (3./t)~/oo Date I { ~~\ 3345 Lake Park Circle Anchorage, AK 9951 7 ~- / ~:J ' /}- ~ c 6 Date -}11 ~~'T .~-;!. 7~~~~.~.~/~ Max L. KlinetOb 461 Summerhill Rd. Berwick, P A 18603 Application for Informal Probate of Will and Appointment of Co-Personal Representatives Page 3 of5 ~ 0) ~ ""'1 .~ ~ ti I ~ ~ ~ ~ C) t'l ~.~ '""1 ~ C\ ~~S? ~ -b C) \;\ Q-: ~ e-.~O) ~ ~ C) '5'~ . ~~:J4 ~ ~ gE~ ~ !:: .9 .~ ~ ~ ~.~ ~ ~ ~ . ~8 i ~ ~~'r)~ ~ ~r.\ ~ ~ .~ u S ~ ~ VERIFICATION OF RICHARD A. JAMESON "f I, Richard A. Jameson, say on oath or affirm that I have read the foregoing document and believe all statements made in the document to be true and correct. ~~~ STATE OF ALASKA ) )ss. THIRD JUDICIAL DISTRICT ) SUBSCRIBED AND SWORN to or affirmed before me at Anchorage, Alaska, on this ~~ day of December, 2000. ~~\\\\\\ III iJIi/!i///fh. ~ ~ ~ :..tI..c.1/~ ~~ i$ ')..~ ..' :';'~~\ISSiOf) ;;:"c..9 ~ ~ ~O'/(F ~~""~~ ~.~ ~. ~ ~ [' NOTARy'E ~: '%... \. PUBLIC./ lIt~' .~ '. !l. .' ""- ~, ~ d?;..'..::lJ!y 25.l~?"~::.~..,-$'" .~ ~/i"'''''' ~.) .~.:~ ,~~ . {.' 0 F ~ \<\.~,~~", flll11/i;im \!i',:\."" ~. otary Public in I or Alaska \ My Commission Expires: ~ \ 1.'; 0'-1 1 \ Application for Informal Probate of Will and Appointment of Co-Personal Representatives Page4of5 ~ 0) ~ ~ ....... 0\ ~ ~ ~ V) C) ~ ~ ".c i':' ~ ~8~ ~ ,t--. C) \i\ Q'\ u ~ ~"UO\ '"'" 6 '5~ ~ ;::: U 'J) ~ · C;)~ ,~ I'". ~~~t:\ I'". ~~~~~ l::i "~ VJ ~ ~ ~~8 ~ ~ ~ 2 \i\'" c::J '-~ ~ r:\ ~ ~~ ~ ~ ~ ~ ~ Er< ~ VERIFICATION OF MAX L. KLINETOB I, Max L. Klinetob, sayan oath or affirm that I have read the foregoing document and believe all statements made in the document to be true and correct. /1Jc~ ;;i ~~~~.t-- Max L. Kline ob STATE OF PENNSYLVANIA ) )ss. COUNTY OF COLUMBIA ) SUBSCRIBED AND SWORN to or affirmed before me at_6e ,"'--w!f 'c/<- \'~-h Pennsylvania, on this /.J. I day of December, 2000. ;/ !__.~_"" f. "1. ~'- .}" i._ ~ t(:~ ~'__,. ~'__ ; '~.~ L_~_ Notary Public in / for Pennsylvania My Commission Expires: NOTARIAL SEAL nORENCE PETRUSA, NOTARY PUBUC BERWICK BORo., COLUMBIA COUNT'(, PA. MY COMMISSION EXPIRES OCT. 21, 2003 Application for Informal Probate of Win and Appointment of Co-Personal Representatives Page 5 of 5 . . }-ILEO iN THE PH' 'OLlA St UJ"\ I t: CO' --,.-- A~9f~ VA, , r ;j'STR,CT t""'" - "'~ LAST WILL AND ~ - ~. 2 ~ 2000 T EST A MEN T ~y - DePtJtyClerk o F D A V I D F. K L I NET 0 B I, DAVID F. KLINETOB, of Camp Hill, Cumberland' County, 'i Pennsylvania, being of sound and disposing mind, memory and I I ;. understanding, do hereby make, publish and declare this as and for my Last Will and Testament, hereby revoking any and all prior Wil~3 and any and all Codicils thereto, by me at anytime he=a~ofora~adE. ITEM I: I direct the payment of my debts and expenses of my last illness and funeral from my estate as soon after my death as conveniently may be done. If there be no cemetery lot available for my interment owned by me at the time of my death! _ a~thoriz2 my personal representative to purchase such ~2~e~e~ lo~ wi~~ 3 contract for perpetual care using therefor-e f unes f::--om ::.Y~3-:'~-:'c:: .:...:~ such amount as he shall consider necessary and desirable, and = authorize my personal representative to cause title to or ownership of such lot so purchased to be vested in such person as my personal representati~e shall designate. Further, in this connection, I al.4.thcrize m~,. pE:rscn~-: representative to spend funds from my eST.a'~e ir... Sll~~ ~nG~:l:: c.:: ~'.:.';/ personal representative shall consider necessary and desirable io~ the purchase, erection and inscription of a suitable marker for my grave. ITEM II: I give, devise, and bequeath all the rest, residue # ".. - . .~ I . ,t. .~.'''_ '~''''_ ,_. "J"t..-"-... '. ..-~' DAVID F. KLINETOB Page 1 and remainder of my estate, whether real, personal, or mixed, and of any nature whatsoever and wherever situated unto MAX L. KLINETOB and RICHARD A. JAMESON in equal shares, per stirpes. j j ! 1 f I ITEM III: Any and all payment or payments of any sum or sums, Ii whether in cash or in kind and whether for principa~ cr payable to the said beneficiaries, or any of them, shall incone, "be :n=.de upon the sole receipt of the respective individual t~ whom ~h€ payment is made, and free from anticipation, alienqtion, assignment, attachment, and pledge, and free from control by the creditors of any such beneficiary. All shares of principal and income herein given shall be free from anticipa~ia~1 assig~~e~t; pledge, or obligations of any beneficiary: and sha:: ::.:.-::. ~..; S~~ j 22-:' to any execution or attachment. ITEM IV: In addition to the powers conferred by lattl / I authorize my Co-executors in their absolute discretion: A. To retain in the form received, and to sell either at public or private sale, any real or personal p~cpEr~y; B. To manage real estate; c. To invest and reinvest in all forms of property withoat being confined to legal investments I and without regard to the principal of diversification; D. To exercise any option or rights arising f=om ownership of investments; E. To distribute in cash or kind or both at su~~ va~uaL~c~s DAVID F. KLINETOB . . . ~ ..... .... , - - -. .. : . .." - ," .....- __l... . -~.. Page 2 ~ as they both may agree upon. : ~ ITEM V: I direct that any and all inheritance, estate and transfer taxes imposed upon my estate passi~g under my Will or otherwise, shall be paid out of the principal of my rasiduarv I i estate. ITEM VI: No fiduciary acting hereunder shall be required to post bond or enter security in any jurisdiction. ITEM VII: Finally, I nominate, constitute and appoint ~x L. KLINETOB and RICHARD A. JAMESON, Co-executors of this, my ~ast Wi:l and Testament. IN WITNESS WHEREOF, I set my hand and seal tc t_""'..l.S :"1~/ L=.E-:' will and Testament consisting of four (4) pages this ~ day of I j -- .z_- ....-.- , 1994. - ~ .!,.,-~... -....1. _: .'. '-. .. - ."- :.- .... DAVID F. KLINETOE WITNESS: 7",' '} ./~ ~~ ----;-.' '.<':: ...'-... ,'. :.....~/.. "\_'~'~'..J'~ N afue : ,,2..:.,.. Y _.";' "h~.,;.,-::..:';~~. 1--"'" Address: '" /F .: (/1. J /-.. _ .,"-:'" Ju./~-'<l.--<.~- ; ~ s._. . / 7C/i~] / .~, 'l - .' .'] .,. ... I j.;,:' ~ - - '_~ -L "!'.. ," __ ..,/ .-..... t .. -c. __",-:'I,.i. c.1-~{'I_~~/~ - Name: .' -~~, ; ~.... '\ I -,' ,," ,"? ...:-..... ",. .-.",_:.....~ Address: , ::~-L/ -, ~ ._'-.. " j---, '., I lit.. ,-- ...- I . - . ,1 --. .-.... ..-...... ....... .........--. . -.- ~ :...i. !., 1.-"'""::~ : ,'\ .;.... _.-;;...: .f-d.:;" ~ DAVID F. KLINETOB - Page 3 # COMMONWEALTH OF PENNSYLVANIA ss: THIRD JUDICIAL DISTRICT We , DAVID F . KLINETOB, , anc. , the Testator and the Witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare" to the Ii undersigned authority that the Testator signed and executed the . I instrument as his Last will and Testament and that he had signed willingly, and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Last Will and Testament as Witness. arid that to the best of their knowledge I the Testator was at that time eighteen (18) years of a~e O~ oldE~ of sound mind and under no c~nstraint or u~d~a ~~z~~~~=~. ~-2~.~2 !. ~".::t :;-.<.. 2~~.'1 ~:~~i.. DAVID F. KLINETOB Testator "7G.~-r-Y~-~/L-(" '. . J /L-&:/~~ Witness / -) ." ~ -,..- ....~- Wi~ncss / i , ~"'<~'--' ':'>-;;'<.:..{'- Subscribed, sworn to and acknowledged before me by DAVID F. KLINETOB, the "~estator, and subscribed and sworn to before me by . ,". ~: I ; _.; n /l I th (. " ',~ _-f'; 'jJ"1 ::.-' an"'l ,~~i.--/~lc...:--~.;:';--'l~~ e witnesses, this " " day of I',;:', _ ~ I 1994. --. .....,-.... I '..:LJI., ,;(. l~ . '; ,).---- .:': Notary Public / ~.'~ .>>.....-,. \ I . Ji>". , My commiSSio~\:;t;~J~~1 ~? '- . _ ~ ~ '~I~:". r : ... .. .-'~ \.......__.J.~ . . DAVID F. KLINETC3 Page 4 j i HI05.805 REV 9/H(, This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 p 6891114 No. 21-01-99 ~~~~ ~~)4d-,;f dtfd Date '.1/11 COMMONWEALTH OF PENNSYLVANIA · OEPARTMENT OF HEALTH · VITAL RECOROS CERTIFICATE OF DEATH (Coroner) Old dec:edenI live In a lDWnIhlp? 17d.Kl ~:='.=Ol MOTHER'S NAME (First. Mi<ldIe. Maiden Surname) 1t. Catherine R. Creveling INFORMANT'S MAILING ADDRESS (Street. CityfTown. State. Zip Code) 461 Summerhill Road Berwick PA 18603 PLACE OF DISPOSITION. Nam. 01 Cem.t.ry, Cr.matory LOC,(f'ON . CityfTown. Stal., Zip Code or OIher Place Grove Walnut St. Ceme !y, Berwick, PA 18603 NAME AND ADORESS OF FACIlITY ~elchner-McMichael F.H. Inc. 119-121 E. 3rd St., LICENSE NUMBER OATE SIGNED Berwick, PA 1860 (MonIh.OeV, 'lUr) 23b. 23C. WAS CASE REFERREO TO MEOICAL EXAMINER/CORONER? Yes~ aka: David Franklin Klinetob ,NAME ~ DECEDENT (FlfSl. Middle. Last) David F. Klinetob SEX 2.Male UNDER 1 YEAR Months Days UNDER 1 DAY Hourt Mlnut.. BIRTHPLACE (City and Stal. or Foreign Country) Bf'~dford ~. Towanda ~.Memotial Hospital KINO OF BUSINESS/INDUSTRY WAS DECEOENT EVER IN U.S. ARMED FORCES? Yes 0 NoKJ 12. 17a.S1at. Alaska DECEDENTS USUAL OCCUPATION (G!ve klnd 01 worl< done du~,~ ~"t;~~Iileering 11 11b AMP, Inc. DECEDENTS MAlLING A ESS (Street. CityfTown. State. Zip Code) DECEDENT'S 33 J 6 Lake Park Circle ~~~~'tNCE Anchorage, AK 99517 ~~~~ 11- FATHER'S NAME (F1ftl. Middle, Laal) 11. Walter B. Kl inetob INFORMANT'S NAME (TypelPrinl) Mr. Max L. Klinetob METHOD OF DISPOSITION BurIal e9 Cremation 0 R.moval Olhar (Specify 1Th. Cou Anchora~e 21l in e 607-L IMMI!DfATI CAUll (FIMI ~ orcondlllon r8tUlllng In d881h)- ~1Il~ lIany.lHdng 10 Immadlate ca.-. ErRr UNDERLYING CAlISl (o..a at injury lh8I~__ r-..,g In MIll) LAST b. DUE TO (OR AS A CONSEOUENCE OF): DUE TO (OR AS A CONSEOUENCE OF): WAS AN AUlOPSV PERFORMED? d WERE AUTOPSY FINDINGS A\IlI\.ILABLE PRIOR TO COMPLETION OF CAUSE OF DEATH? Natural Homicide o o 3 O PLACE OF INJURY. At horne, IIlrrn. 8lraet. lactory, office building. etc. (Specify) \ 308. MANNER OF OE,(fH DATE OF INJURY (Month, Oey, '1&er) ~ o ;~*';.. , "'- '.]j~",No ~ 21&. "'i!l;"':,'" Pencllng InVHligstion Could not be determined 'Y\IeO NoD Acddent Suicide 29. JIb. CERTII'IER (Check rnt one) 'c:&mf'YINQ PHYSICIAN (Phytician certiIyIng C8U1B Of deeth when another phy$cisn h8s pronounced death and completed hem 23) To.......ofmy knowtad1Je, deetll oc:cwrad due to the caua-<<a) and manner.. 8tlltad. ...................,.....................,.......... 'PRONOUNCING AND ClRTll'YlNG PHYSICIAN (Physician both pronouncing death and certifying 10 cause of death) To..1IMt of my knowIadoe. deetll occurred at the tlma. d.... and place, and due 10 the cauM(a) and menner.. atated.. . . . . . . . . . . . . . . . . . . . . . . . . ~DAMINERlCORONEA on IIIe ..... of examination andlor InvestIgation, In my opinion, death occurred It the time, dste, Ind place, and due to the cauH(l) and menReI' _ ....ed.. . . . . . , . , . . . . . . . . . . . . . . , . . . . . . . . . . . . . , . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.. REG ~ Ij't 7f/,f,~ u. VJ. STm FILE NUMBER SOCIAL SECURITY NUMBER DATE OF DEATH (Monlh. Oev. 'Year) 4. Nov. 28, 2000 3. 198-07-8715 ~=Ity) 0 MARITAL STATUS. Marriell N_ Marriell, WIdowad. ONorced lSPtlcify) Widowed RACE. American Indian, Black. Whrt.. .tc (Specifv) 10. White SURVIVING SPOUSE (11 wife, give maiden name) 17C.O Yes, dacedanllNed In rwp. Anchorage cily NoD 2.. . Approximat. : Int.rval be\WMft i oneet and death PARllI: Other slgnificant conditions contr;buling to cleat". bot not resulting In the underlying ce.... giYen in PART I. TIME OF INJURY INJURY AT WORK? 'Ills 34. p- .:b " tYt7 O.(J. JERRY R. DUFFIE RICHARD W STEWART C. ROY WEIDNER, JR. EDMUND G. MYERS DAVID W DELUCE RALPH H. WRIGHT, JR. DAVID J. LANZA MARK C. DUFFIE MELISSA PEEL GREEVY MICHAEL J. CASSIDY ROBERT M. WALKER LAW OFFICES JOHNSON, DUFFIE, STEWART & WEIDNER A Professional Corporation 301 MARKET STREET P. O. BOX 109 LEMOYNE, PENNSYLVANIA 17043..0109 WEBSITE: www.jdsw.com HORACE A. JOHNSON COUNSEL TO lHE FIRM KEIRSTEN WALSH DAVIDSON OF COUNSEL TELEPHONE 717- 761,4540 FACSIMILE 717,761,3015 E,MAIL mail@jdsw.com E-MAIL rws@jdsw.com January 16, 2003 Register of Wills Cumberland County 1 Courthouse Square Carlisle, PAl 7013 RE: David F. Klinetob Estate No. 21-2001-0099 Dear Ladies: Please be advised that we no longer represent the Personal Representative in the above captioned estate. We were engaged for limited purposes and those purposes have been fulfilled. Very truly yours, JOHNSON, DUFFIE, STEW ART & WEIDNER ?f~~~ Richard W. Stewart RWS:klt: 167048 .. ~ ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: David F. Klinetob Date of Death: November 28, 2000 Will No. Admin. No. 2001-00099 To the Register: I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on .J an 1] a ry 1 6 , 2001 Name Address See attachment hereto Notice has now been given to all persons entitled thereto under Rule 5.6(a) except None Date: .;- P-10( Signature ~~ Name Richard A. Jameson Address 500 L Street, Suite 502 Anchorag~~ AK 99501 Telephone ( ) (9 0 7) 2 72- 9 3 7 7 Capacity: ~ Personal Representative _Counsel for personal representative .. ATTACHMENT TO CERTIFICATION OF NOTICE UNDER RULE 5.6(a) NAMES AND ADDRESSES OF BENEFICIARIES Richard A. Jameson 3345 Lake Park Circle Anchorage, AK 99517 Max L. Klinetob 461 Summerhill Rd. Berwick, P A 18603 Christy A. Klinetob 706 16th Street Berwick, PA 18603 Matthew L. Klinetob 461 Summerhill Rd. Berwick, P A 18603 Michael L. Klinetob 4204 Market Street Berwick, P A 18603 Kelly Jameson 750 North Dearborn Street, Apt. 408 Chicago,IL 60610 John Jameson 339 Race Street E. Stroudsberg, PA 18301 Isabella K. Jameson c/o Richard A. Jameson 3345 Lake Park Circle Anchorage, AK 99517 Stepson and Co-Personal Representative Son and Co-Personal Representati ve Granddaughter Grandson Grandson Step-Granddaughter Step-Grandson Step-Granddaughter Minor: Age 6 months ..., .. Gv" oK Ii .1 , 11 V.u J'/ i' l'~ /Itl(}~~ ' -' ~ v i -)3'123 Name of Decedent: iJqf/11/ ~ fl~/,Mcfot3 (/ut>fV- J<t:f'S/i?L~JVr j)d:<:LCr-r-~ Date of Death: jlJoV; ~7 c7000 Will No. ~/- ~oo/- 00 97 Admin. No. ~/,,~oOJ-0097 STATUS REPORT UNDER RULE 6.12 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 X 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 reR;esentative file a final account with the Court? Yes No ~ . b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes ~ No d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. Date: /-cJ';7- 03 '--y?1~ ;7'/~- Signat.ure -- /Yl4 X ~ /~/ /V ,-::-or 0 B Name (Please type or print)~. ? . c:;;:" '7 /JERt:u/ck" I (4 ~6/ Jc, f1'1P?C:-Z M~L F-p IY~:5 Address p/B) ~S.-7 - o~o/ Te 1. No. )( Personal Representative Capacity: Counsel for personal representative (MAH:rmf/AM3) .~ .. Richard A. Jameson, Esq. RlCIL~RD A. JAMESON & ASSOCIA YES 500 L Street, Suite 502 Anchorage, Alaska 99501 (907) 272..9377 (907) 272.9319 Facsimile i~fNTHe ~,Ot~~~"t~ ~ COurrr , "",I.~.t J"'lOo"'''''' ( ....., , rrlCr f~;AR '4 2002 ay - f)..,;fJt.,I,y Ll$1t( IN THE SUPERIOR COITRT FOR THE STAlE OF ALASKA THDlD WDICIAL DISTRICT AT ANCHORAGE In the Matter of the Estate of DAVID F. KLlNETOB;l ) ) ) ) ) ) ) Case No. 3AN-OO-1568 PIE Deceased. PERSONAL REPRESENTATIVES' SWORN STATEMENT TO CLOSE ESTATE (AS 13.16.630) nIL 11,.-.'-. AND NOW) This .!:/!:)ay off.amary, 2002, comes the undersigned personal representatives Qfthe Estate of David F. Klinetob who, being duly sworn, state that: 1. We .are the co-personal representatives of the above-na.med estate. 2, We have published notice to creditors as provided by AS 13.16.450. The first publication occulTed more than six months ago~ more particularly the initial publication took place on January 21, 2001 as evidenced by the attached Affidavit at Exhibit A. 3. We have fully administered the Estate of David F. KIinetob by making" payment, settlement, or other disposition of all claims which were presented~ expenses of administration and estate, inheritance and othcr death taxes. Ther~ are no kno\\'Il undischarged clain1s or any known outstanding tia.bllitics. cd W~S~:90 [002 cc 'uer 6tE6cLcL06 'ON 3NOHd L~O?::f..:f 4. We have distnouted the assets of the estate to the persons entitled to Loe assets in the amount and manner to which they arc entitled . 5. We have sent a copy of this statement to all distributees of the estate and to all creditors or other claimants of whom "ve are aware whose claims ate neither paid nor barred. 6. We have furnished a full account in writing of our administration of the estate to the distributec:s whose interests are affected by it. 7. This statement closes this estate and terminates the appointment of the co- personal representatives within one year if no proceedings involving the co- personal representatives are pending in the court. IN WITNESS WHEREOF, the personal representatives of the Estate of David F. Klinetob have hereunder set their hands and seals the day and year tirst above written. ~--~ Richard A. e$Qn Co-Personal Representative ( ~e;u;) '"fJ1~ i! 7'~~-rsEAL) rv1ax L. Ktmetob Co.-Personal Representative STATE OF ALASKA ss THIRD JlTOICAL DISTRlCT : J-1 AY~I\. On this the Mday of Fcbraary, 2002, before me, a Notary Public, the ~tndersigned officer. perwnally appeared Richard A. Jameson. Cl)-Pet'sonal Representative of the Estate of David F. Klinetc)b, deceased. known TO me, (or satisfactorily proven) to be the pcrcson des-:ribed in the foregOing il"strument, f:d ~!tfS~: 9a (002 cc 'U'l?f 6t~6cL2L06 'ON 3Na-ld WOtL:l .~ and acknowledged that he executed the same in the capl~ity therein stated and for the purposes therein contained. In Witness Wbereof; I hreunto set my nand and official $ell!. My oornmlssion e>:plres &/21/ Or' ~Aiy~'@(~J- COMM"ONWEAL TH OF PENNSYLVANIA ss COUNTY OF CQLtlMBIA ~ : On this the 4t;p. daylj:;~nMI?f, 2001 before me, a Notary Public, the ulKlersigned officer, personally appeated ~{ax L. KlinetQb, Co-Personal Representative o(the Estate of David F. KHnetob~ deceased, known to me. (or ztisfactorily proven) to be the pefC$Qn d~ribed ill tM foregoing instrument, and acknowledged tbat he executed the same in. the capacity there:l1'l stated and for the purposes therein contained. In Witness Whereof. 1 h~ set my band and official seal. ,--J-~ {J~O-- My commission eKpires NOTMY PUBUC NOTARIAL SEAL FLORENCE PETRUSA, NOTARY PUBUC BERWICK BORO., COLUMBIA COUNTY, PA. MY COMMISSION EXPIRES OCT. 21, 2003 t'd l--II;;S~: 9a Z~30G 22: .U'E'f 6rE6c.~cL06 .ON 3NGld wo~ COMMONWEALTH OF PENNSYLVANIA DEPARTMDlT OF REVENUE *' ... alJREAu OF I:MDIVXDUAl 'TAXeS INHERITANCE TAX DIVISION DEPT - ?Hill HARRlSlBURG, PA 1'U&-Ol.Cll JOHN K SROr.;ONCIK DEVANEY a co ZZZ S MARKET ST 202 ELlZAIETHTOWN PA 17022 NOTICE Of' NQNIlU1:DENT :INllDITAHCE TAX ArPRAI8D1EJa I ALLOMANCS OR DIGALLDMANCE OF DBDUCIIO"S, MP ASSSSSIIINf OF TAX DA11 ESTATI OF DA TE OF DI!A TH FILE NUnaER COUNTY ACN ItIV-Dr II ~'I" (11-~8~ 08-06-2001 KLINETOB 11-28-2000 99 01-0397 NON-RESIDENTf\V~~~, 101 ~t rt..ltted DAVID F j MAKE CHECK PAYABLE AND REHIT PAYMENT TOt PA DEPARTMENT OF REYEHUE DEPT. 280601 HARRISBURG, PA 17128-0601 euT ALONG THIS LIN. . RETAIN LOWER P,ORTION 'OR YOUR RECORDS ~ --UV;SS7':U-Mfi-Tii--iil--iifii"ci-aY~NiiiiiY66ir-lr;wiuTiic~ ~TAi-iirpRlYsiitE~DiAt('ci-OR---- DISALLOWANCE Of DEDUCTIONS AND ASSESSMENT a TAX" J____~~___u'" ESTATE OF I(lINETOB DAVID F FIL! NO.. 99 01-0397 ACN 101 DATE OB-06-Z001 TAX COMPUTATIDN METHOD !LECTED: [ ) FLAT RAT! ( Xl ~TIONATI TAX RETlIRH WAS: ( Xl ACCEPTED AS FILED () CHAN8l!lJ RESERVATION CONCERNING FUTURI JNTEREST · SEE REVERSE APPRAISED VALUE OF RETURN BASEm ON: ORI6INAL RETURN 1. Real !st.te (Schedule A) 2. St:ock~ end Bonds ($ehadule I) 3. Clo_1y "_lei stock.l..~u..tner"ah1P Interest ($C;hedule C) 4. Mbr-taase s/Motn Rece i vable (Schedule D) S. Ca$hl8ank DepOsltslHiso. P~al P~opArt~ (Schedule t.) 6. ~~tl~ own.d Praper~~ (Sc~le Fl 7. T,.....fl." B (SCnecklle G) a. Total Assets (1) (~) fl) (4) (Ii) Ul) (7) 5781300.00 .00 .00 90..000.00 911124.00 .00 .00 ee> NOTE: To insure ~~QDer crltCllt to you.~ ~i:, subII i t the upPer- por~ ion of t~i~ for. with ~r tax ~a)l'llllmt. 759,424.00 APPROVED DEDUCTIONS AND EXEMPTIONS: ,. FlI1Bral ExPen$e:s/AdII. CorlalHi$C. E~se!l CSoNwIula HJ (,)_ 39.818.00 10. Dllbts/nortgage;; lieb11itiesllioft4 {Schadule I,} (10) 71 ~ OS9. 00 11. To-tal DeClUC:tion& (11) 110 ,877 . 00 1:. Net Val\IIJ of Tax Ret"""", flZ) 648 j SCi7 .00 13. ChBr1tab1e.fGover-nnental 8e4ue,gt:s (Schedule J) (l~U' 00 14. Nei V.l.... of E$tat. ~J.c:i to Tax (14) 648. 547.00 __'_ NO!! ~"._~f':e:S;:'S::~~=i=~~~~=i=;r I Ji~~ ::f..::e a~~~~=, J:~ '~ ~a~_d"~9.!~~.~ _ .. ASSESSMENT OF TAX: ~. , IE. AMount of Line 14 At Spousal rete CUi) 16. &IIouht of L1.,. 14 taxable .~ l i,..~/CIBG8 A rate (16) 17. A.OUht o~ Line 14 .t Sibli~ rat. (11) la. Allount en Line 14 taXBbl@ Ai: Collaterlll/Cltt$$ 8 rl!lte [is) 19 . Pr-i~ipal lAV Due ;tAX ,.A · I T! p) 06-08-2001 .00 )f 00 ;; 267 1 S~8. OLx 045.. . 0 0-..-)( 12 II: .00 X 15 = ( 19 ). .00 12,040.00 .00 .00 12,040.00 AfItCUfT PAID 12..040.00 TOTAL TAX CREDIT BAL.ANCE OF TAX DUE ~NT~EST AND PEH. TOTAL DU~ 12~04().OO .00 .00 -.:.,00 Sd lrli:BS:: ~ :2002: C:c 'U"€, f ( IF TOTAL DUE IS LESS THAN .1~ NO rAy"eMT IS RtQUIRED~ IF TOTAL DOE IS REFLECT!IJ AI! A ..CREJ)rT~' (eft) J yOU H,AV 8E DUt! A REFUND. SEE REVERSE SIDE OF tHIS F~ FOR tNSTRUCTIONS.) 6t~6cLcLe6 : 'ON 3NOHd : l~Od.:l . IF PAUl AFTER DATe INDICATED.. SI!! REVERSE FOR CALC:ULATXO'" OF ADDITIONAL l:NT!ltfST. NatJolJal BalJJ(V'Alasq 1.043 BrA'" -:.. aallBOl :III =--....= ,. .M"~ I=-_~. .., .r."A;~~ . I S-i.,.NG:'" I ~'f"- Tl.....~~ ~. eM! ~~ ..;;..... 8 E:: I_q~ . t;~l5ZDOOlt~&..-- Mll.. 104 10"'~ ." .-un ~=u..KUIIIPa =- :I::F.;.-.= .... ~f' I !~~L:~[~7;: 1_~~1V : ~~ .~ .: l ~s ZODOt ,.n .cu ~..r.""'" 1.0.... ~.."g..~...,. 1044 6/2 04 . 19 .... a-.... II.IYmm =- 1048 -~:tt&'-= - &'\111\ l~::~t:.;. ~~~~~~ I ~.' ~~;';~:;;U"""~;""i~ 10 416.00 BtAW.~'-""'" ~ 1010 .........., ,. ~iul.an.... _ C1~"\o. i~~-.- ~ ~ .... ~" ~L." I S "t..~~.~' tr-...:a sa ~_'a. -. ...~ ~ ~~ II:" & ! - ~ ~/f:P' .;;:::;;~I~~.~~;;~~~""- ~Z_~~WM);:~ 10 0 5 J 311 1 , , 80,0 ..,.,. ... __ "........ == "0." ~....,.. _cta.~lll.L." I=:.-" - L..... ~ ~. ~ 1: 's."~,~ r~' - ~,~--*-.-. ~~-I-= I. ~._~;. -'"~~ "';"~i ~ - ......iI'I__~, --:r e~15tQdCS"JC~loCn~~J.--- ~51 IU n r-ooat.; .-naallGfoloaao.r 1051 8/15/01 12.04 .00 9d ~~1;::f9~: 90 t:80c 2c .U,€,[ 6JE6cJ..2L06 ttilA'C vr VAVIU r nLI"~'VU Aceoun t No.: 1102296988 'a.. 3 < ~ (,4 'ON 3NOHd --:- ]df.es WO~.:l JRD/June 30, 1992/17858 DEe 1 2 2002 r . Estate No.: 21-2001-0099 ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA In Re: Estate of David F. Klinetob Late of Anchorage Alaska NO. 21-2001-0099 NOTICE OF FAILURE TO FILE STATUS REPORT AND REQUEST TO CONDUCT A HEARING PURSUANT TO RULE 6.12, SUPREME COURT ORPHANS' COURT RULE Personal Representative: Counsel for Personal Representative: Richard W. Stewart, Esquire Date of Decedent's Death: 11-28-2000 Date of Delinquency Notice: 10-08-2002 The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 6.12, Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of Common Pleas of Cumberland County, that neither the above named personal representative nor the above named counsel for the personal representative have filed with the Register of Wills or Clerk of the Orphans' Court his, her or its Status Report required by Rule 6.12, Supreme Court Orphans' Court Rule and that the requisite notice, pursuant to Rule 6.12, Supreme Court Orphans' Court Rules, was given by the Register of Wills on 10-08, 2002, and that the ten (10) day notice to file the Status Report has expired. Accordingly, in accordance with Rule 6.12 the Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a hearing to determine whether sanctions should be imposed upon the delinquent personal representative or counsel for the delinquent personal representative. Date: 12-09-2002 I~ Distribution: Personal Representative Counsel for Personal Representative Estate File () ~OJi "\ , j.Y 'ifo'? . " } . \/ I () r- r:J /1t//tJ .} 9: 3~ /;.PI, A hearing is scheduled for at in Courtroom No.3. If the Status Report is filed prior to the hearing date, the hearing will automatically be canc~~i IfH Georg E. 0 fe , P. . .. -, Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717) 240-6345 . Date: 10/08/2002 RICHARD A JAMESON 3345 LAKE PARK CIRCLE ANCHORAGE, AK 99517 RE: Estate of KLINETOB DAVID F File Number: 2001-00099 Dear Sir/Madam: It has corne to my attention that you have not filed the Status Report by Personal Representative (Rule 6.12) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing will become delinquent on: 11/28/2002 Your prompt attention to this matter will be appreciated. Thank You. Sincerely, ~m&W~~ MARY C. LEWIS ~ REGISTER OF WILLS cc: JFile Counsel Judge ~ ~ , ~ ~ ~ ~ 9 --- ~ i11li ~ WAg \ \ ;l \1 S' ~ ~ ~\ l- I ::I. ! , ~} i~ ~ ~ ~ I ~ RG- n ii'i' \ ~ P ~ i; a. l a.!e I ~~ i~ "- i. ~i ~ 0 d\ ~ ;. ~~~i ~ a a e..1: a c' Q CJ ~ ..... 'ZtI). i .... ~tlgt t t1 i'+ ~ ~ , d 9 /'\ ~ t , ~ i I .... , <!0 i: ~ i i i: ----- i a S , !. ~ 8 !. i ----.. ! g ~ g " i i \ ;; r--... e ~ ," \S ~ a i ~ i' S* ~ (fa ~ \ ~. I: a ~ 8' a' -d ... i ~ t a,. ~ z ~! ~ '(IJ i ~ ~ "- ~ \" 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-Y-=S3;--i5tAFP--Ci2:'-6oj--NOy'rci-irF"-NONRESiuENf-iNHiRITANc€-YAX-APPRAIsiME-NT;--ALLOWANc€-oit--- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF KLINETOB DAVID F FILE NO. 99 01-0397 ACN 101 DATE 08-06-2001 TAX COMPUTATION METHOD ELECTED: ( ) FLAT RATE (X) PROPORTIONATE TAX RETURN WAS: ( X) ACCEPTED AS FILED () 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 D) (4) S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) 8. Total Assets /b -2Js/~-/8 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE ",- BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 NOTICE OF NONRESIDENT INHERITANCE TAX APPRAISEKENT~ ALLONANCE OR DISALLOHANCE OF DEDUCTIONS, AND ASSESSMENT OF TAX JOHN R 5ROGONCIK DEVANEY & CO 222 5 MARKET 5T 202 ELIZABETHTOWN PA 17022 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests (Schedule J) 14. Net Value of Estate Subject to Tax -. C' <....--' :2/--01--00 1 7 REV-liS7 EX lFP el2-00) 08-06-2001 KLINETOB DAVID 11-28-2000 99 01-0397 NON-RE5IDENT~\~~~ 101 F Amount Remitted 578,300.00 .00 .00 90~000.OO 91,124.00 .00 .00 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. (8) 759,424.00 39,818.00 71,059.00 (11) (12) (13) (14) 110,877.00 648,547.00 .00 648,547.00 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 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due TAX CREDITS: (15) .00 X 00 = .00 (16) 267,558.00 X 045 = 12,040.00 (17) .00 X 12 = .00 (18) .00 X 15 = .00 (19) 12,040.00 PAY"ENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NU"BER INTEREST/PEN PAID (-) 06-08-2001 NR002343 .00 12,040.00 TOTAL TAX CREDIT 12,040.00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1~ NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A ..CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT No. NR002343 RECEIVED FROM: ACN ASSESSMENT JOHN R. SROGONCIK CPA CONTROL AMOUNT DEVANEY & COMPANY PC. NUMBER 222 SOUTH MARKET STREET, STE 202 101 12,040.00 ELIZABETHTOWN, PA 17022 ESTATE INFORMATION J FILE NUMBER I 9901-0397 NAME OF DECEDENT (LAST) (FIRST) (MI) KLINETOB DAVID F DATE OF PAYMENT 6/8/2001 POSTMARK DATE 5/23/2001 COUNTY Non-Resident DATE OF DEATH 11/28/2000 TOTAL AMOUNT PAID $12.040.00 REMARKS AK RECEIVED BY John M. Riedman SEAL COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE Register REV-1737-2 EX + (11-99) (I) II '. II COtJMONWEAL TH OF PENNSYLVANIA INHERITANCE TAX RETURN NONRESIDENT DECEDENT ESTATE OF SCHEDULE A, PART 1 REAL ESTATE IN PENNSYLVANIA FILE NUMBER DAVID F. KLINETOB 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 F. All real estate must be reported at fair market value 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 relevant facts. ITEM NUMBER DESCRIPTION 1. RESIDENTIAL REAL ESTATE - 320 ST. JOHN'S DRIVE, CAMP HILL, PA 17011 - HAMPDEN TWP., CUMBERLAND COUNTY - SINGLE DWELLING UNIT. SEE SETTLEMENT SHEET AND AGREEMENT OF SALE MARKED "EXHIBIT B" ATTACHED. VALUE AT DATE OF DEATH 157,500 2. LAND - 41.44 ACRES - RTE. 93 NORTH CENTRE TWP, BERWICK, PA 18603 - COLUMBIA COUNTY - DEED BOOK 330, PAGE 172 SEE ATTACHED APPRAISAL REPORT MARKED "EXHIBIT C" 96,000 3 . LAND - 2 3 . 8 6 7 ACRES - SUMMERHI LL, BRIAR CREEK TWP, BERWICK, PA 18603 - COLUMBIA COUNTY - DEED BOOK 330, PAGE 168 SEE ATTACHED APPRAISAL REPORT MARKED "EXHIBIT D". 59,800 . ~ I "'!!"! - j~ J~ . PART 1 TOTAL $ 313,30C PART 2 TOTAL Proportionate Method Only from reverse side $ 265,OOC 'I STFPA42025F.5 "I TOTAL (Also enter on Line 1, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 578,30C I:, i: ".,. ..:.. .'n '.ft ()l-'n~X ~t)SG)t.Q I:"'OSH!:: ~~~tQ~ ~~~~~ o n ~ C 0 ~e,g "11:'" t'Jn J:1j O~I: l-'U1 HH -1cnt""r..G o 01:""' l-' -tQ U.) ~ ~ g UI t":I t-... ...j ,-' ..,l r-- (1,\ - - - - - - - - .,. - - - - - .. - - - .. - ... - ... .,. .. - - ... - - - - tr:2 ~ b" ~. ~ ~ ~. ~~g to ~ ~ :( cr ~ro c::~o~~ ~~Hl8~ .. rt H~ 0- ~. &. ("1' 0 >N",,"'O I-h ~ ~. M'I ~ .-~~~(TJ ;::~5~5 ~ ~ro~ ~::s~ ~ c: < ~ (\) Q) \. ro ::3 ..... (fJ 1--1' Q) (' K:J ---.... \ \'\ ~: I ~ K ,-) "'-C) ~) (---e ',- ,~} 2 ~.. .' ~ :' rH" " : '" R-~';~;"'~' . 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KLINETOB STATE OF PENNSYLVANIA ) ) SS COUNTY OF CUMBERLAND ) The petitioner above-named swears or affirms that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner and that as personal representative of the above decedent petitioner will well and truly administer the estate according to law. Sworn to or affirmed !l..Tld subscribed before me this 23rd day of \ JANUARY, 200J . 7LY(? ~LL<b:/,jJi! )~L<'</ RegIster f ~~- cl y~ M~ Klinetob ,~.', .J'<' \;.,\" BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRlSBURG, PA 17128-0601 /fP-t2of-12 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE June 14, 2001 IN YOUR REPLY PLEASE REFER TO: (717) 783-3836 MS MARY CLEWIS REGISTER OF WILLS CUMBERLAND CO COURTHOUSE 1 COURTHOUSE SQ CARLISLE PA 17013 Dear Ms. Lewis: Re: Estate of David F. Klinetob File No.: 21-01-0099 County: Cumberland Date of Death: 11-28-2000 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 bave 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 :?ennsylvania Nonresident File Number 99-01-0397. Thank you for your cooperation in this matter. Sincerely, John Murphy, Chief Inberitance Tax Division S-IT: INH13 PC6:017(tg)