HomeMy WebLinkAbout02-02-07
DECEDENT'S ESTATE
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYL VANIA
ORPHANS' COURT DMSION
ESTATE OF Jeannette M. Gottshall
, DECEASED
No. 21-06-0068
PETITION FOR ADJUDICATION I
STATEMENT OF PROPOSED DISTRIBUTION
PURSUANT TO Pa. O.C. Rule 6.9
This form may be used in all cases involving the Audit of the Account of a Decedent's Estate. If
space is insufficient, riders may be attached. Attach the spouse's election, if any; the papers
required under items 8-19 inclusive; and any instrument pertinent to the adjudication.
INCLUDE ATTACHMENTS AT THE BACK OF THIS FORM.
Name of Counsel: Stephen 1. Hogg
Supreme Court LD. No.: 36812
Name of Law Firm: Law Offices of Stephen J. Hogg
Address: 19 South Hanover Street, Suite 101, Carlisle, P A 17013
Telephone: (717) 245-2698
Fax: (717) 245-0829
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Farm OC-O J rev. J 0.13. 06
Page 1 ofl 0
Estate of Jeannette M. Gottshall
, Deceased
1. Name(s) and addressees) ofPetitioner(s):
Name:
Sandra B. Dean
Address:
2010 Manada Street
Harrisburg, PA 17104
Identify any executors or administrators who have not joined in the Petition for
Adjudication and Statement of Proposed Distribution and state reason:
Is this the first accounting by this fiduciary? . . . . . . . . . . . . . . . . . . . .. fl] Yes 0 No
If not, identify prior accountings, the accounting periods covered, and the date of
adjudication of the prior accounting.
2. Decedent died on October 31, 2005
fl] Letters Testamentary or DLetters of Administration were granted to Petitioner(s) on
January 24. 2006
Date of Will (ifapplicable): February 21,2005
Date(s) ofCodicil(s) (if applicable):
Date of probate (if differentfrom date Letters granted): September 12,2005
Was a bond required? oY es 0 No If yes, state amount:
Are proofs of advertising of the grant of Letters attached? ......... 0 Yes 0 No
Dates of advertising of the grant of Letters: 02/02/06, 02/09/06, 02/16/06, ()~/10/06
02/17/06, 02/24/06
Form OC-OI rev. 10.13.06
Page 2 of 10
Estate of Jeanette M. Gottshall
, Deceased
3. Was decedent survived by a spouse? ............................. DYes IZlNo
If yes, name of the surviving spouse:
4. Has the surviving spouse filed to take an elective share? ............ . DYes D No
(See Section 2201 et~. of the Probate, Estates and Fiduciaries Code)
If yes, date of election:
5. In the case of an intestacy, state the names of the decedent's surviving children or
surviving issue of deceased children (ifnone, so state):
6. Did decedent marry after execution of Will or Codicil(s)? . . . . . . . . . .. DYes IZl No
Were any children born to decedent after execution of
Will or Codicil(s)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DYes IZl No
If yes, give names and dates of birth:
Name:
Date of Birth:
7. If required by the Medical Assistance Estate Recovery Act,
62 P.S. ~ 1412, was a request for a statement of claim sent to
the Department of Public Welfare? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. IZlYes D No
Form DC-Ol rev. 10.13.06
Page 3 of! 0
Estate of Jeanette M. Gottshall
, Deceased
8. Written notice of the Audit as required by Pa. D.C. Rules 6.3, 6.7 and 6.8 has been or will be
given to all parties in interest listed in item 9 below, all unpaid creditors and all claimants
listed in item 10 below. In addition, notice of any questions requiring Adjudication as
discussed in item 14 below has been or will be given to all persons affected thereby.
A. If Notice has been given, attach a copy of the Notice as well as a list of the names
and addresses of the parties receiving such Notice.
B. If Notice is yet to be given, a copy of the Notice as well as a list of the names and
addresses of the parties receiving such Notice shall be submitted at the Audit
together with a statement executed by a Petitioner or counsel certifying that such
notice has been given.
C. If any person entitled to Notice is not sui juris (e.g., minors or incapacitated
persons), Notice of the Audit has been or will be given to the appropriate
representative on such party's behalf as required by Pa. D.C. Rule 5.2.
D. If any charitable interest is involved, Notice of the Audit has been or will also be
given to the Attorney General as required under Pa. D.C. Rule 5.5. In addition, the
Attorney General's clearance certificate (or proof of service of Notice and a copy
of such Notice) must be submitted herewith or at the Audit.
9. List all parties (charitable and non-charitable) of whom Petitioner(s) has/have notice or
knowledge, having or claiming any interest in the estate as beneficiaries under the Will or
Codicil(s) or as intestate heirs if there is a complete or partial intestacy:
A. State each party's relationship to the decedent and the nature of each party's
interest( s ):
Name and Address of Each Party in Interest
ReJationshiTJ and Comments, if any Interest
Sandra B. Dean
2010 Manada Street
Harrisburg, P A 17104
Daughter $4046.07
(20% less advance
pmt. of$I,842.45)
Barry Siple
178 Jo-Lee Drive
Middletown, P A 17057
Son $3088.52
(20% less advance
pmt. of($2800.00)
Form OC-OJ rev. 10./3.06
Page 4 of 10
Estate of Jeannette M. Gottshall
, Deceased
Name and Address of Each Partv in Interest
Re/ationshiD and Comments. if arry Interest
Penny MacDonald
1035 SchwangerRoad, Apt. 13
Elizabethtown, P A 17022
Daughter $4,944.38
(20% less advance
pmt. of$944.14)
Wayne Gotshall
Lot 94, Leiby's Parkway
7073 Carlisle Pike
Carlisle, P A 17013
Son $5,888.52
(20%)
B. Identify each party who is not sui juris (e.g., minors or incapacitated persons).
For each such party, give date of birth, the name of each Guardian and how each
Guardian was appointed. If no Guardian has been appointed, identify the next of
kin of such party, giving the name, address and relationship of each.
C. State why a Petition for Guardian/Trustee Ad Litem has or has not been filed for
this Audit (~ee Pa. o.c. Rule 12.4).
No minors or incapacitated persons.
D. If distribution is to be made to the personal representative of a deceased party,
state date of death, date and place of grant of Letters and type of Letters granted.
Form OC-OI rev. 10.13.06
Page 5 ofl 0
Estate of Jeannette M. Gottshall
, Deceased
10. Other than the claim for the family exemption, list the names of all known claimants and
the amount of their claims and state whether,each claim is admitted.
Name and Address of Each Claimant Amount of Claim Claim Will Claim
Admitted? Be Paid In
Full?
DYes DYes
DNo DNo
DYes DYes
DNo DNo
DYes DYes
DNo DNo
DYes DYes
DNo DNo
If the estate is insolvent, attach a schedule setting forth the order of preference under
20 Pa.C.S. S 3392 and the proposed payments.
11.
Was family exemption claimed?
..................... . . ..... . ...
DYes IZINo
DYes DNo
Was family exemption allowed?
........ ... .......... .. ..... . .. .
Family exemption claimant's name and relationship:
Name:
Relationship:
Form OC-Ol rev. 10.13.06
Page 6 of 10
Estate of Jeannette M. Gottshall
, Deceased
12. The amount of Pennsylvania Transfer Inheritance Tax and additional Pennsylvania Estate
Tax paid, the date(s) ofpayment(s), and the interest(s) upon which paid, are as follows:
,
Date
Payment
Interest
09115/2006
1,124.66
9.72
13. On the date of death, was the decedent a fiduciary
(personal representative, trustee, guardian, agent under power
of attorney) or surety on the bond ofa fiduciary? . . '" . . . . " . . . . . . . . DYes 1ZI No
If yes, provide the name of the estate, indicate whether an account has been filed and
confirmed absolutely and all awards performed, or, in the alternative, how the
decedent's estate will be discharged for the decedent's fiduciary administration of the
estate.
14. A. Describe in detail any questions requiring adjudication and state the position of the
Petitioner(s) as to each question:
B. Has notice of the question requiring adjudication been given
to the parties identified in Paragraph 9 above? .................. 0 Yes 0 No
15. IfPetitioner(s) has/have knowledge that a share has been assigned, renounced, disclaimed
or attached, provide a copy of the assignment, renunciation, disclaimer or attachment,
together with any relevant supporting documentation.
Form OC-OI rev. 10.13.06
Page 7 of 10
Estate of Jeannette M Gottshall
. Deceased
16. Had the decedent been adjudicated an incapacitated person? .... . . . . . . 0 Yes IZ'! No
If yes, attach a copy of the Order if available; otherwise state the Court, term, number,
date, and name of Hearing Judge.
17. A. List or attach a separate list of additional receipts and disbursements since the closing
date of the Account.
B. Has notice of the additional receipts and disbursements been
given to the parties identified in Paragraph 9 above? ............. DYes 0 No
18. If a reserve is requested, state amount and purpose.
Amount:
Purpose:
If a reserve is requested for counsel fees, has notice of the
amount of fees to be paid from the reserve been given to the
parties in interest? ........................................ DYes IZINo
If so, attach a copy of the notice.
19.
Is the Court being asked to direct
the filing ofa Schedule of Distribution?
.......... ................
IZ'!Yes DNo
As to real estate only? ................................
DYes IZINo
Form OC-OJ rev. JO.13.06
Page 8 of 10
Estate of Jeannette M. Gottshall
, Deceased
Wherefore, your Petitioner(s) ask(s) that distribution be awarded to the parties entitled
and suggest(s) that the distributive shares of income and principal (residuary shares being stated
in proportions, not amounts) are as follows:
A. Income:
Proposed Distributee(s)
Sandra B. Dean
Barry Siple
Penny McDonald
B. Principal:
Proposed Distributee(s)
Amount/Proportion
20%
20%
20%
Amount/Proportion
Submitted By:
(All petitioners must sign.
Add additional lines ifnecessary):
~&Q.. ~ ~
Name of Petitioner: Sandra B. Dean
Name of Petitioner:
Form OC-OJ rev. JO.13.06
Page 9 of 10
Estate of Jeannette M. Gottshall
, Deceased
Verification of Petitioner
(Verification must be by at least one petitioner.)
The undersigned hereby verifies * [that he/she she
of the above-named name of corporation Estate
is title Executrix
and] that the facts set
forth in the foregoing Petition for Adjudication / Statement of Proposed Distribution which are
within the personal knowledge of the Petitioner are true, and as to facts based on the information
of others, the Petitioner, after diligent inquiry, believes them to be true; and that any false
statements herein are made subject to the penalties of 18 Pa. C.S. g 4904 (relating to unsworn
falsification to authorities).
~~~~
Signature of Petitioner
* Corporate petitioners must complete bracketed information.
Certification of Counsel
The undersigned counsel hereby certifies that the foregoing Petition for Adjudication!
Statement of Proposed Distribution is a true and accurate reproduction of the form Petition
authorized by the Supreme Court, and that no changes to the form hav been made beyond the
responses herein.
Form DC-OI rev. 10.13.06
Page 10 of 10
Attachment to Pae:e 9
Wayne Gottshall
Bonnie Basom
20%
20%
... .......
Attachment to Item #9
Bonnie Basom
479 2nd Avenue
Highspire, P A 17034
Daughter
$5,888.52
(20%)
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No.5 87, approved May 16, 1929), P. L.1784
COMMONWEALTH OF PENNSYL VANIA
55.
COUNTY OF CUMBERLAND
Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and
State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law
Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid,
was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Journal on the following dates,
V1Z:
February 10,17,24,2006
Affiant further deposes that he is authorized to verify this statement b:' the Cum~ ....lld
Law Journal, a legal periodical of general circulation, ;:-u.l '~at he is nOt inte':" ~he .:>..
matter of the aforesaid notice or advertisement, and that all allegation~ a l".~ i':J1\;:got.'6
statements as to time, place and character of publication are true.
Gottshall, Jeannette M., dec'd.
Late of Carlisle.
Administratrix: Sandra B. Dean.
2010 Manada Street, Hanisburg,
PA 17104.
Attorney: Stephen J. Hogg, Es-
quire, 19 S. Hanover Street, Suite
101, Carlisle, PA 17013.
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Lisa Marie Coyne Ed: ~vr
I .
SW~TO AND SUBSCRIBED before me this
24 day of February. 2006
~~~)~. _J//J~PA/
Notary
, ,
PROOF OF PUBLICATION
State of Pennsylvania, County of Cumberland
Tanunv Shoemaker, Classified Advertising Manager, of The Sentinel, of the County
and State aforesaid, being duly sworn, deposes and says that TIlE SENTINEL, a
newspaper of general circulation in the Borough of Carlisle, County and State
aforesaid, was established Deceplber 13th, 1881, sll1ce which date THE SENTINEL has
been regularly issued in said County, and that the printed notice or publication
attached hereto is exactly the Same as was printed and published in the regular editions
and issues of THE SENTINEL on the following day(s)
February 02,09,16,2006
COpy OF NOTICE OF PUBLICATION
Sandra B. Dean
2010 Manada Street
Harrisburg, PA 17104
Affiant further deposes that he/ she is not
interested in the subject matter of the
aforesaid notice or advertisement, and that
all allegations in the foregoing statement
as to time, place and character of
~~jz~~(
NOTICE OF ADMINISTRATION
. Letters of Administration on the Estate of JEANNETTE
M. GOTTSHALL, late of Cumberland County, Carlisle,
PA, deceased. have been granted to the undersigned.
All persons knowing themselves to be indebted to said
Estate will make payment immediately, and those
having claims will present them for settlement to:
Orto:
Stephen J. Hogg, Esquire
19 South Hanover Street Suite 101
Carlisle, PA 17013 '
Sworn to and subscribed before me ~l-,;,;:
22nd day of February 2006.
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My con, ission eXF::"~s: q!, /(/r
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Chnslina L Wdfe. Notary Publ"1C
D>riic;!e Bero. Cumber1and County
My G...."mmisSlOO Expires 5er". 1, 2008
Member. r'ennsylvania Association Of Notaries
.' ,
-~---_. .---.
REGISTER OF WILLS
CUMBERLAND County, Pennsylvania
CERTIFICATE OF GRANT OF LETTERS
No. 2006-00068 PA No. 21-06-0068
Esta te Of: JEANNETTE M GOTTSHALL
(First. Middle.' Lastl
Late Of:
SIL VERSPRING TOWNSHIP
CUMBERLAND COUNTY
Deceased
Social Security No: 196-14-0190
WHEREAS, on the 24th day of January 2006 an instrument dated
February 21st 2005 was admitted to probate as the last will of
JEANNETTE M GOTTSHALL
(First. Middle. Lastl
late of SIL VER SPRING TOWNSHIP, CUMBERLAND County,
who died on the 31st day of October 2005 and,
WHEREAS, a true copy of the will as probated is ~nnexed hereto.
THEREFORE, I, GLENDA FARNER STRASBAUGH Register of Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to:
SANDRA B DEAN
who has duly qualified as EXECUTOR(RIX)
and has agreed to administer the estate ac,-.rdin;;j cc law, all :n which
fully appears of record in my office a t CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYL VANIA.
IN TESTIMONY ~~EREOF, I have hereunto set my hand and affixed the seal
of my office on the 24th day of January 2006.
Jjttn it'--.ft;t/l/UU h-ik2-t'4l'J I
Register of Wills t...-
~ e,t&~ ~11 '/JfJc/( j
/ Deputy i
**NOT'* /, _::'_~L NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)