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Home My WebLink About80-00687 No. 21.80 Estate of 6% 687 MARLIN c. ,ADAMS. JR. CARLISLE . PENNSYLVANIA RUBY D. WEEKS, ATTY. L ....... :\0. 21-80 6t,'{i PETITION FOR LETTERS OF ADMINISTRATION IN Tim ESTATE OF ....,JI<.\r.Un..I."..,MflInu....,Jr,.........,............ IlECI':AS~;Il, To ,.....,!1,~,r:-.Y.,'~~,~~~ ..." "."..""" .."",." """ .,." ",...'"",...... ".,..",...", ,.' .,.'",..,....,..".' Register of Wills fOl' the County of Cumherland, in I he Common\\'ealth of Pennsylvania, The Peti t ion of '.',.., !1!!,r:-J~!'!" ,9,:", ~~!!,m.~..", ~,r:, .'..,.."".",."""""""""..",.....".,......"',...,...."..,,..,.,",.....,...., ........ .........,....,..,.."..."...,..,....,.,.."..."....,'" respect fnlly sho\\'el h I ha I ".,~lar,lin..C.....^da1nuT ..J.t',....",.."",.,.."...,..,.. 'd t f Carlisle l''''''Mftit>- (' I' '\ let' Sl'lte of Penn.vl WRS a reSl en 0 ..........................................................BOI.ough . 11m IE.!I ntH .oun) ,e'" - vania, and a Citizen of United States, and departed Ihis life intestate in the County of ..,..9.l.l.I)JR~r:.1-.i'\n~.. ...... ,.......... ,.. ,........ ....,...." and St a te 0 f ",.., ,~~!'! !'!,~I ~ X!!!! ,~,'!:....".."...."".....",........,.."..", ....,........, ....,....,......, .... ....,... on ....,:1'l.\~~HlilY..,........,...... the ....\.Q,\1r.~fi,e,(\~h......,...... day of ,..,Q~J.(lllfi,J::..................,.........., A. D" 19,$,0....... at the age of ,....au......, years, That the said ,.......M.i!!:',Ho..,<;"...M,(l,rn;;...,.},J::,........,........,........, deceased, left su)'\'iving the following named widow or husband, heirs and next to kin, to wit: Name Relationship Residence ........,~!!!;!~,~..~,~.~,?:mLM!!!I:l,~,......,.,"',.. .........!1~:..~,~!:..g,:..,~~,~~....,~.r:,.'"..".."., ......,p.!!!-!r"l.:~~r.,."..".."..,",.. Father ..,..' ,~!!:.,~,~~~ ~,l.., ~~!),':l,~y. ~~,~,ry,~~....,.... Carlisle. Pennsylvania ............................................ ................................................................ .........lllll.Qr.IlS..,V,.,.. A~ams".........."""" "..,..NR,~,l;1,~r.,",...,.....,',..,"'" ....'" (;i1r:.1-. j, 1j~!i'"...P.~!).l!"n~~ :{,/1-,(l.j,i1,.. ...... ................................................................ ............................................ ................................................................ ................................................................ ............................................ n . ..................................(""t~~.........cJ:l........:ii::O c.r"! 0 1'l1r"1 :t~ C')g ,..................,....'.......'m;;..'....'~.......,~~ ~:o --. .qM ..................................~:~.......l"")..........119 z::: ..r::. . '0 o.~r ';"'t".1 .....................................~.......................:~I gvi '0 . .~ . (") :-...;. .." .................................."C..,.!.........!.:..........~.::.. ,..,.r:- N w~ ."~.) 0:. ................................................................ ............................................ ................................................................ ............................................ ................................................................ ............................................ ................................................................ ............................................ That those above named include all of the next of kin, so far as known, The sllid decedent was possessed of pel'sonal pl'oJlel't~' to the estimated vlllue of $.}SP../;'.'..\'.I:..,............ and of Real Estate, less incumbrance. to the estimated value of $......!l!?,(l.~..............,.... as near as can be ascertained, That the said Real I';state in so fal' as is knowu is located in none ................................................................ ........................................................................................................................................................................................ Therefore, your petitionel'!s) respectfully apply!ies) fol' Lcttel's of Administl'ation in the above named estate, , 1'1 \{). n of Petitionel'(:..;) ~gj,4,t.6...:.....U?&~,'~~.." ~l'(I~~N~,.. . ,"\::, "c::::,::.v 5) ,.1'-" f~ ,..(,("";,:.:;...-i-!L"J..\"if.!,'~U....~,~,:c;,~: ' ) 'f;'l'~'(~ , " ,:' "i~ ' , ~,:""" ........'....... ......... .~r;.... J.l,t.I.; i:'.L... ...;.~ ..j.:.~..~ :::. ....'::.::........... :............. . . I , ,.:" 'i- I '>\ '.' ".",.."",.,::..:,:,;::,:.,;.,.'..,\"'",,.,....,,:..',,'';.-:..,..""'..........:~ ~ Dated ....,..9.~,!:,:..J?............,............ A, 0,. l!l,~~.., Signature and Address , i i , ..i ! '.1 ;: ~/-ftJ-fo'?7 COMMONWEALTH OF PEl\:\SYI.V Al><IA COUNTY OF CUMBF.RI,AND 1 I liS: Marlin C, Adams, Sr, . named ........................................................................................................................................................................... in the above application beinl( dul~' ,..........1'i~!?r.n..............,.........., accordinl: to law, "ay that the facts set forth in the above application aI'<' true (0 (h,' beH! of ,..his....... know\edl(e and belief. 'b..e..f.o..r..e....m~!'Ie'~,'!:"l),..............,.......... ........, and "uh"crihed 1 "...', """,., '" ".,....',....,' "..", ,,'" "',, ,..'", ,......, ........."..,....,.. ........................................................................................ .........,~~'~.?,:.."~?..""'.....,~........, ,.... A, D., 1O,~,~.... ,....~:yZ........,....................~........,..:'..............,................ ......01t1&tff....c!...,.... ,d.;,!.,............,.. ,..,7).24,d-&L......,t?:U26:.?:::i:_...,. '''''''C- (j RegiHter Filed: ' ......,9.~.~,~)?,~E..n,~,..,~~,~.9..........,............, A ttorne~' : ) .' ",,/,.,;::,J!!!., ,/.():'::L:.:":,'.',(.jjf:,..",..,.., '7. ) /r ./1, A.C..., u Y (/~/(..f.'~'" J /~. ,;/.;/:1 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } ss: ,..........,.. .........................,.. ...... ..........~~:.,~,~,~..~,: ,..~~ ~.~, 1.., ~:.,:.... ....,..,.. ........ ........ ........ ....,.. ............, petitioner (s) being duly ..,......".~~:.!),..........,............,....,........, according to law do lj~l....,.., depose and say that as the ! ._~ . iidministra ,t.or.,........ of the estate of ....,t1iJ,r;',Un..,C.,..,!\ctaro.s"..,.lr."........,......,....................,.........,....,..........,..... ........................................................................................................................................................................................ deceased ..........B.e........., will well and truly adminh,ter the goods and chattels, rights and credits of said deceased, according to law, And also will diligently comply with the provisions of the law relating to Transfer Inheritances. ,....,......,........~,!'!Rr.))...............,..,........ and subscribed before me, October 23 80 ?ffi;~"d:~:;/'..... cPl I" rP d~ ":J7.1.zh;(,,..:!-........,";....,....~~~,.. ............................................................................................ DECREE Be it remembered that on the ..,....,..?,?,~,b....,......, day of ............,....9,S~9E.~,F...........,.. A. D., l!i!9...,.. Letters of Administration in the estate of ..,......klflr.Un..,G"..I\!;l,Q.I)J1j,...,.,T,r."......................,..,........,........,........... ....,...... ......".... ,.... ..,.... ,........' ....,..... ....', ..,.. ,.., ..,..,...., , late of .... ,Bor.o.ugl1".o.f., ,Car,li sle. ...., ,..,....,..,.......,..,...., ..,..' Cumberland County, Pennsylvania, deceased, were granted to .......,.t:1~:.,U~..~,:...Mi!!!l,",'...~:.,:........,..,....., ........................................................................................................................................................................................ Witness my hand and official seal the day and year aforesU ~ ........,......,....7lf4d-k/..,a.:" .. , ~d.. (" f' Register /3 ~5- REV-!l1Il EX+ (7-80) COMMONWEAL TN OF PENNSYL VANIA DEPARTMENT OF REVENUE TRANSFER INNERITANCE TAX RESIOENT DECEDENT //-/"/0 / INHERITANCE TAX RETURN FOR INSOLVENT ESTATES (Instructions on Reverse Side) Estate al Harlin C. Adams, Jr. Last addre.. 250 Franklin Street (STREET) I- % Carlisle Pennsylvania w 17013 Q w (CITY>> eSTATE) IZIP) u w Q October 14, 1980 Date al Death Social Security No. 179-54-9581 TYPE OF ASSET Personal Property " '" I- w '" '" ... " " " OFFICIAL USE ONLY DATE '" % 2 .. U ::l Q W Q Q % ... '" ?- m w " OFFICIAL USE ONLY DeSCRIPTION COUNTY NO. STATE NO. ( ) Exec. (Xl Adm. Other Name Harlin C. Adams. Sr. 250 Franklin Street (STREET) Pennsylvania Social Security No. ,.. '" ... U ::l Q ii: Addre.. Carlisle ~ I -S--(\~GS> 7 17013 (CITY) (STATEI (ZIPI Under penalties of perjury, I declare that I have examined this return and to th~ of my knowledge and belief It is true, correct and complete. "72.-;t;////z'.l-r #' ~ Slgrfa'ture of FldUI.'~ Date Central Life Insurance Company of Omaha - credit like insurance benefits in excess of loan balance with Beneficial Consumer Discount Company, Carlisle, Pennsylvania Federal Tax Refund - 1980 Final Salary Checks, Kinney Shoe Corporation Check 1F55132 Check /155967 CB Monitor Estate of Lisa Ann Adams TOTAL ESTIMA,'ED MAR~ET VALUE $ 957.03 859.00 <= ::J: ru, Pl -, ::U' r 0 ;:. , '" .::l DEPARTMENT VALUATION (OF. CIAL USE ONLY) :<Om ~n -.,0 '0:0 ,,'0 ~-'f"ll 'Q , , u:> ,.." v ,... "" .j, .zjJ.()7 '/J .::. 89.81 31.16 60.00 2,296.07 $4,293.07 I do hereby certify that the abave assets were appraised in accordance with Pennsylvania law. NAME OF PAYEE Hoffman-Roth Funeral Horne Jacee Leeann Adams, info dau Ruby D. l~eeks, Esquire Ruby D. Weeks, Esquire Ruby D. Weeks, Esquire Harlin C. Adams, Sr. Harlin C. Adams, Sr. Reserved to Finalize Estate Cumberland Valley Hem. Gard. Carlisle Hospital General Electric Credit Co. Marlin C. Adams, Sr. Frank Sherman Georges Flowers Carlisle Pediatric Center "vtJ- ER NATURE OF CLAIM Funeral expenses' Family exemption Reimburse for Evening Sent. Ad. Reimburse for Cumbo Law Journal Ad 5% - Counsel fees 5% - Fiduciary Commission Reimburse for Reg. of wills filing dministration Grave marker Bills outstanding for wife and dau Balance of loan Reimburse for April Reimburse for Preis Bill outstanding Bill outstanding for daughter rent of room Cons. Disc. Co debt s ~-J41 J~ d'EOUC.TIONS ALLOWED '~ ~ TOTAL {....- I) , '/7.1 :/ ~, /,,-rZ~ ~ISTER OF LLS f-,/,1-" / OATE AMOUNT CLAIMED $1,823,00 2,000.00 23.50 18.00 201.90 201. 90 16.00 50.00 477 .00 182.00 214.55 225.00 298.89 29.42 80.00 INSTRUCTIONS ASSETS: TYPE OF ASSET -Indicate whether the asset is real estate, personal property, tronsler or jointly.owned. DESCRIPTION _ List 011 assets owned solely by the decedent or owned jointly with another party or parties os tenonts !n common or as ioiot tenants with right of survivorship at the time of death. Include the decedent's percentage of ownership, the name (5) and relationship to the decedent of the surviving joint owners and the estimated market value of the decedent's interest os of the dote 01 death. Include intongible personal property titled in the nome 01 the decedent but payable ot deoth to another party or parties including but not limited to P.D.D. U.S. Savings Bonds and tentative trust accounts. list any property transferred by the decedent within two years of death for which he/she did not receive valuable and adequate consideration. Describe all real C5'ote locoted in Pennsylvania by lot and block number, street address, number of acres and include a generol description of the land and buildings. Also, include the book and page number in which the deed is recorded and the exact title as indicated on the deed. DEBTS & DEDUCTIONS _ Unsatisfied liabilities incurred by the decedent prior to hisfher death ore deductible against his/her taxable estate. In addition to debts incurred by the decedent, other items arc claimable including ,he c;ost of administration, attorney fees, fiduciary fees, funeral and burial expenses including the cost of 0 burial lot, tombstone or grave marker. List the date on which eac;h debt was incurred and/or paid and the names of each payee. Provide 0 brief explanation of the nature of each debt claimed and the amount being claimed, , Evidence to support the decedent's or the estate's liaIJility for the debts being claimed shauld be ottached to this return , A family e'lCemption may be claimed by a spouse of 0 decedent who died domiciled in Pennsylvania. If there is no spouse, or if the spouse has forfeited his/he, rights, then any child of the decedent who is 0 member of the some household con c10im the exemption. In the event there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of the same household as the decedent. .... >- z r- "U C n >- m >- ~ m n n c ~ z >- 0 0 C II' C r- ~ \l) C C'l n c: c .... !: r- m ~ ... ;0 m 0 m m "" :z ;0 >- :z :z r- " :z "U ..... m z :z m .... m --t ? ? :3: .... II' !:. ? --t -< '" m '" 0 t/) '" (; ? '" 0 .... :z ..... :z 0 ;0 " 3 ? "T1 ." m N >- " ..... .... :z ... I 0 ? '" (Xl .... '" 0 Z 'd Z ;; I n n N :;: '" " 0 'C c: \l) I.n ~ (Xl ~ " " ;; a ... 0 " .... .... " ... '" c" ..... ..... ..... ;;; t/) ". " " ...' '>j .... .... ~'< ;;; ~. ... t/) ... " ~ > ..... ~ :I: " ..... ..... \l) ~ < . ~ u:o '" " " () !!J \l) m" - " ... -< -< N " ~ 0 ".. "" ..... m m .... .... - < " 'd .... > >- w \l) " " > " '" ;0 >- I " '" " ;0 ..... 0 '" a N '" - ..... ... t/) '" ... ." .... " ..... .... " 0 " '" " " ..... " '-< (Xl ..... " "- w ... " 0 .... ... . ~ 0 n ~ ..... 0 w ~ INFORMATION PLACE FOR FILING _ The return is to be filed in duplicate with the Register of Wills of the county wherein the decedent resided. TIME FOR FILING _ The return is due nine months alter the decedent's death, unless on extension for liling has been opplied tor and granted by the Secretary of Revenue within the nine-month period. FAILURE TO FILE RETURN _ Section 791 of the 1961 Statute provides that" , . .ony pe,son who willfully foils to file 0 return or other report required of him shall be personolly liable _ . .to a penalty of 25% of the tax ultimately found to be due or Sl,OOO whichever is the less to be recovered by the Department of Revenue as debts of like amount are recoverable by law." NOTE: Fees paid to on estate representative: nomely, on executor or administrator, lor services performed in ad- ministering on estate is reportable for Pennsylvania Income Tax purposes, This taxable income item shoud be reported on form PA.40-lndividual Income Tax Return. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND \, J 55: ,______ _'_n__'_'__, ,_ __ ,_M,!~lin C'dAd'lms,_S,~_,_,__________,_,,____,____, being duly _ sworn __ ___ __ according to law, deposes and says that he ,,_,Narlin _C_._Adams ,- SR...,__ _,!\~IIl!.f1~~trat"E______..n__ H__ of the Estate of _tl.a.rJ,in C,,_Mams ,,,,J..;:., I.te of Borough of Carlisle __, Cumberl.nd County, Pa" dece.sed and that tho within is an inventory made by ,,' ,,__Harlin, C.,-Adams" Sr__ _ ,__,___, the said_Adminill.traJ:o!:--. of the entire estate of said decedent, consisting of all the person.1 prop..ty and re.1 estate, except real estate outside the Cemmonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the d.te of decedent's death. Sworn I j /,;J ~' ,:7/,//, ,./ ~/ ;L--;-L/--" / ./ {--- . ..... c>/ ZHiiDlblKo Administrator Marlin C. Adams, Sr. _____...150 Franklin Street /~ and subscribed before me, /(\ , 19 ~/ Carlisle, PA 17013 Addr.n ,K"S Date of Death October Month 1980 Yur Day INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of addition.1 a..ets, 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949, t-.... 1 00 I '-..P ~ '" I >- .... -0 0- W j III .. ~ 0 ~ '" 0- '" .. W ;:: .... .. 00 0.. " U 0 0 Vl '" .. .. w '" W 'd U C '" ... I J: 4 " .. I- 0.. 0.. c Z I- -' U. ..... ,,; ~ - , u. -' -< 0 0 0.. 0 ~ i w 0 -< w ~ ,.:. :I: > '" d .c <I: I z eo - II Z 0 c ." " c " .; Ii Vl z .... 0 0 '" ~ " U Z w -< 0 ... 0.. ~ '" -0 ! c .. I - -.: 0 .. .D -0 -" .. E - ..2 0 ! .. " 0 -' U u: '" ": ..~.:\:: .~~~..:'8~'H1J . .., . ,=:,,;) - 'ri>~'Jl: . ,() 0 I dJS 19 . . ::~~SJU3o ,,) J~J1!OJ3!1 Invenlory of Ihe reo I and personal e.lale of Marlin C. Adams, Jr. deceased. Central Life Insurance Company of Omaha - credit like insurance benefits in excess of loan balance with Beneficial Consumer Discount Company, Carlisle, Pennsylvania Federal Tax Refund - 1980 Final Salary Checks, Kinney Shoe Corporation: Check No. 55132 Check No. 55967 CB Monitor Estate of Lisa Ann Adams Total -l $ 957 03 859 00 89 81 31 16 60 00 II I 2,296 107 II I' I I I I I I I $4,293 07 ESTATE 01' l'IAIlLTN C, ADANS, JIl. 1J{~c('aHf'd Oetob(!r lil, Il)RO rormcrly of Lh" llol"OlIgh of Carli~l(!, Ctllnhcl-l~lnd County, PA IN TilE COUIlT 01' CONNON PLEAS Or cu~mEIlLAND COUNTY, PENNSYI.VANIA OIlPIIAN'S COUIn' DIVIS ION NO. CIVIl. ACTION 198] ~J -8'0 - (,,87 Q~S:IlE~I!l~T~:.J.:!!!:!:.~..()!__SNA.!..L ES]'^T~~~!:,lQ!01'E ES~~:I.:!'~....!-ND Y,!,D~!i.!ES cOIm 01' !22,2 AND NO\v, this /5'.;t..J- d"y of f)~ , 1<Jlll, the Est"te of ~1arlin C. ^dallls, Jr"" d('CP:IHCd, <.'OlnflCHil!d tiS set forth in the Petition attaclH!d, is ,lwarded Clnd distribution is as foJ Lows: Illlby D. Ivee"s. Esqllire - 57. S 201.90 Narlin C. Adams, Sr. - Fiducinry Commission $ 201.90 Ruby (). h'eeks t E:'HJII i re .~ n' imbu I"Hf'men t for payment of Cumberland Law JOlJrn..11 Estnte Advertifwment $ lR.OO Ruby D. 1-1eeks, Esquire - reimbllnil'!IlC'nt for pnyment of I~velling Sf'ntincd Estate Advertis(~rnent $ 23.50 ~kn-lin C. Adilms, Sr. - r('illlblJrsem(~nt for paymcmt of [1I ing "ith Ilegister o[ Hills Offiee $ ]6.00 Res('rved to finalize E~tatc Ad"lillistr~tion $ 50.00 Jaeee I..CP.:J1l1l Admns, fami ly ex('mpt i 011 (Exit ib i t flAil) $2,000.00 1I0ffm:1I1-lloth rlll1er,,1 1I0",e - funeral bill ($],823,00 leRR $2~5,on Soei"l Heellrity pay~emt) Sl,56R.OO CumbcrL1nd V~llley HClIlori.11 Gardens - grave marker, pnrtial paymC'nt $ 213.77 Total. GJ.oss Estate and Amount of D(~bts to be Paid $4,293.07 TI1CSC debts rornail1 t1npaid LJIld tll(! Estate is Insolv('11t: CUllIberl;:lI1d Valley ~lemori."Jl Gard('lls - grave marlu'r, unpo:Jid ba lance $ 263,23 Carlisle lIospital - hi.] Is olltst:lI1ding fnr deceased wife I.isa and infant diltlglltl!r J:.cee $ 182.00 ~~C,\ 108 PAGE '741 ESTATE OF ~lAIU,IN C. ADANS, JR. Deceased October 14, 1980 Formerly of the Boroogh of Carlis Ie, Cumberland County, PA IN TilE COURT OF CONNON PLEAS OF CUNBERLAND COUNTY, PENNSYI,VANIA ORPIIAN'S COURT DIVISION NO. CIVIL ACTION 1981 PETITION UNDER PROBATE, ESTATES. AND FIDUCIARIES CODE OF 1972 FOR SETTLENENT OF ESTATE OF NARLIN C. ADAfIS. JR. TO TilE HONORABLE JUDGES OF TillS COO RT: cmlES NO\~, Narlin C. Adams, Sr., Administrator of the Estate of Harlin C. Adams, Jr., by his attorney, Ruby D. IVeeks, Esquire, and avers: 1. Your Petitioner is Harlin C. Adams, Sr., 250 Franklin Street, Carlisle, Cumberland County, Pennsylvania 17013, natural father and Admin- istrator of the Estate of Harlin C. Adams, Jr., and an adult sui juris. 2. On October 14, 1980, ~Iarlin C. Adams, Jr., herein called "decedent" died in Pennsylvania, a resident of 250 Franklin Street, Carlisle, Cumberland County, pennsylvania, having separated from his "ife, Lisa Ann Adams, on October 1, 1980. 3. Decedent died intestate at 11:35 a.m. on October 14, 1980. lIis "ife predeceased him, having died at 11:20 a.m. on the same date. 4. Letters of Administration have been granted to the natural father, Harlin C. Adams, Sr., by the register of 1HUs on October 27,1980. 5. No taxes or debts are due by the Estate of decedent except as follo"s: Ruby D. l~eeks , Esquire - 5% $ 201.90 Harlin C. Adams, Sr. - Fiduciary Commission $ 201.90 Ruby D. l~eeks , Esquire - reimbursement for payment of Cumberland La" Journa 1 Estate Advertisement $ 18.00 Ruby D. l~eeks , Esquire - reimbursement for payment of Evening Sentinel Estate Advertisement $ 23.50 ~GC~ 1Q8 pm 731 ~Iarlin C. Adams, Sr. - reimbursement for payment of filing ..ith Register of tHlls Office Reserved to finalize Estate Administration - for Notary fees, costs of this Petition filed, and service of notices required Hoffman-Roth Funeral Home - funeral bill Jacee Leeann Adams - family exemption <Exhibit A) Cumberland Valley Nemorial Gardens - grave marker Carlisle Hospital - bills outstanding for deceased ..ife Lisa and infant daughter Jacce Narlin C. Adams, Sr. - reimbursement for 1 month rent for Locker Room, April 1980 General Electric Credit Company - balance of loan Georges Flo..ers - bill outstanding at death Frank Sherman - reimbursemen t for Preis Consumer Discount Company debt paid Carlisle Pediatric Center - for daughter Jacee Total Debts of Estate $ 16.00 $ 50.00 $1,568.00 $2,000.00 $ 477 . 00 $ 182.00 $ 225.00 $ 214.55 $ 29.42 $ 298.89 $ 80.00 $5,586.16 Petitioner has knOl.ledge. The above are all the names and claims of all unpaid claimants of ..ham of November 20, 1980, docketed to No. 3935 civil 1980. 6. The person entitled to receive the proceeds of the decedent I s net Estate is Jacee Leeann Adams, minor infant daughter of Lisa Ann Adams and Narlin C. Adams, Jr., date of birth November 8, 1979, "ho resides at R.D. 118, Regency l~ood, Carlisle, Pennsylvania, and is currently in the custody of Jack and Sharon Black, by Order of Cumberland County Court of Common Pleas 7. The child, ..ho resided ..ith her mother from October I, 1980 to October 14, 1980 Dt Carll"}'nne Nanor Apartments, Carlisle, Cumberland Gounty, pennsylvania, ~GGK 108 I'm 732 ., .-.-......~........- hereby c13ims the st3tutory f3mily exemption of $2,000.00 3g3inst the Est3te of her f3ther. Prior to October I, 1980, s3id minor child resided "ith both n3tur3l p3rents 3t 250 Pr3nklin Street, C3rlisle, Cumber13nd County, Pennsylv3nia. No other person is entitled to this f3mily exemption. (Exhibit "A") 8. The decedent's Estate 3t the time of his death consisted of the fo11o,,- ing items 3t the listed v31u3tions: (3) Central Life Insur3llee Comp3ny of Omah3 - credit like insurance benefits in excess of loan balance "ith Beneficial Consumer Discoun t Company, Carlis Ie , pennsylvania (b) Federal Tax Refund - 1980 (c) Final Salary Checks, Kinney Shoe Corporation Check No. 55132 Check No. 55967 (d) CIl Honitor (e) Estate of Lisa Ann Adams Total Assets $ 957.03 $ 859.00 $ 89.81 $ 31.16 $ 60.00 $2,296.07 $4,293.07 9. (a) The minor child, Jacee Leeann Ad3ms, has a Guardian, by 3 Petition for Appointment of Commom,ealth National Bank as Guardian of the assets of the minor filed in this Court. docketed to No. 292 Orphan's Court 1981 on April 28, 1981. HOI,ever, her custodi3ns, Jack and Sh3ron Black, l13ve also consented and join in this Petition. (b) Decedent l13d 3 group life insur3nce policy through his employer, Kinney Shoe Corporation, in the 3mount of $3,000.00, "hich proceeds are payable directly to the 3bove Guardi3n of minor child 3S benefici3ry under s3id policy and "hich do not consitute 3 part of the Est3te in this matter. See Exhibi.t "Il ". (c) All other parties 3re sui juris. ~G0~ 108 PAGE 733 ~-~.,;';';':f.;"';.,..-_.....-" 10. (a) All parties in interest in the proceeding as distributees, heirs, or creditors, \.,1110 arc sui juris, have consented to the filing of this Petition and join in its prayer, except Cumberland Valley Nemorial Gardens. The written consents of the parties in interest who consent are attached hereto as Exhibits lie 11 through II I II ~ (b) Jacee Leeann Adams, who lacks capacity as averred in paragraph 6 hereof, has not consented to the filing of this Petition except through her Guardian of her assets, Commonwealth National Bank, and her legal custodians, Jack and Sharon Black. (c) Ten (10) days written notice of the intention to present this Petition has been given to every unpaid beneficiary, heir, or claimant who has not consented and joined in this Petition. A copy of the notice is attached hereto as Exhibi t II J tI. 11. No one has received or retained any property of decedent as payment of wages or accrued pensions under S2 of the p.E.F.e. Code of June 3D, 1972, P.L. 508, as amended, 20 Pa. e.S.A. ~3101 or otherwise. 12. On September 10 , 1981, a schedule of assets and deductions for inheritance tax purposes for an insolvent estate ,;as filed with the Register of Wills of Cumberland County. No inheritance tax assessment was made or due. A copy of the inventory and appraisement and of the tax voucher are attached hereto as Exhibi ts II K" and" L II. Dnd "Nil. Io/HEREFORE, the Petitioner requests the Court. pursuant to Section 2 of the Probate, Estates, and Fiduciaries Act of June 30, 1972, P.L. 508, as amended 20 Pa. e.S.A. S3l02, to award distribution of the Estate as fol101"s: Ruby D. IVeeks, Esquire - 5% $ 201. 90 $ 201. 90 Narlin C. Adams, Sr. - Fiduciary Commission ~CL~ 10S 'PAGE '734 . Ruby D. I,eeks, Esquire - reimbur,qement for payment of Evening Sentinel Estate Advertisement Ruby D. "eeks, Esquire - reimbursement for payment of Cumberland Law Journal Estate Advertisement Marlin C. Adams, Sr. - reimbursement for payment of filing with Register of "ills Office Reserved to finalize Estate Administration $ 23.50 $ 18.00 $ 16.00 $ 50.00 Jacee Leeann Adams, family exemption (gxhibit "A") $2,000.00 Hoffman-Roth Funeral Home - funeral bill ($1,823.00 less $255.00 Social Security payment) $1,568.00 Cumberland Valley Memorial Gardens - grave marker, partial payment Total Gross Estate and Amount of Debts to be Paid These debts remain unpaid and the Estate is Insolvent: Cumberland Valley Memorial Gardens - grave marker, unpaid balance Carlisle Hospital - bi lis outstanding for deceased wife Lisa and infant daughter Jacee Marlin C. Adams, Sr. - reimbursement for 1 month rent for Locker Room, April 1980 General Electric Credit Company - balance of loan Georges FIOl,ers - bill outstanding at death Frank Sherman - reimbursement for Preis Consumer Discount Company debt paid Carlisle Pediatric Center - for daughter Jacee Total Unpaid Debts of Estate Total Debts of Estate Respectfully Submitted, (j Ruby D.~t)~~~~ Attorney for Petitioner e~G~ 10.S PACE '735 $ 213.77 $4,293.07 $ 263.23 $ 182.00 $ 225.00 $ 214.55 $ 29.42 $ 298.89 $ 80.00 $1,293.09 $5,586.16 ,...111.." .' , ..... ....tj\\ ,.\,' 11:>'., .... \S\.........,~..:.('.\ .... : .....' "(,,,J'" .."\,.... f cJ ....\\0 i 1\ " , ' .... l' '. : \l ~.; ..... ., J "., ~ : '.~ :~;;:~'..to..- .:. ::. } \ ' ,;', (Ill "I \ C i- i '\,: ,:\.,. ::" :,:.:(\~~".... ""~ 1,' ,,",' \".' t1 ,,\. ,\ .,~' ':,..,.' ~ 'rt."J,!',\';' '(....:/i:l1ll"'\"'~.~ . ~.~-,.!J. ..,~. CO"~!'~O!!l,'!E^L TH OF PE:'n~SYL V it!.! I t\ ",,,,, ~u COU!JTY OF CU:.iBERLA!W PeI'son~lly appear'ed before lOe, a !!otal'y Public in ~nd 1'01' the Com:nonHeal th and Co"nty afol'e::-.aj d, the, Ilnder-si t;ned, beinG duly SHorn accordinr, to ] aH, deposes a"d says that the facts set forth in the fOl'egoinc; Petition al'e tl'ue and COl'rect. ~~ Marlin C. Adams, Sr. Sworn and subscd bed to J,J ~ t. before me this day of 14 ~~ 1911i Q, 777Mv-- Notary Publi.c SHARON A, MOSER, Notary Public Carlisle. r^. GL;,\!trrlJlld County My Commission E:.P::CS Jan, 14, 1985 L~C~ 108 rAGE 737 ......11..1,.. .. ..' () \,\ t\, /l'>,.., .' .,~ ,...,....,,'{; ", ..- .'l'.' ".~" "'. .: "';",.' ".\\"'. '.. f ,?:, \\OTM)l" '/',\ : l~ : e~."" . : "':. '\:<'\/)U~t \(',f,,' i .:.....~;;?~::;.... :....~. .... :'::~(~':.../ ".;.' ...~~: " "". ~ ,...... . ....::, ~':"':"'~" CO"I:.IO:~\o!SALTI1 OF l'E:H.:SYI.V Wl A .", ~., COU:!TY OF CUI.1BEHLM!IJ PCJ'sonal1y appcur.ed be:f'or'c 1'1(;1 a t!otar'y Pub] jc in and for the CO:lJlll0nHCal th cHId COlmLy nfur'p::;a id 1 t.he: under-si r,ned, beinr duly ~\.Jorn accordinG to 1 Ln.:, depose::> and 3ays that the facts set. fortl1 in the for'ecoint: Petition are tr'ue and correct. -~~-~~, J 8f'BlaCk SHorn and subscr'lbed t.o befope me thi~ /5 c/.. day of 1~ ,1981 ~.:u<m-o.-7V)~ ,..'ctary Publ ic SHARON A MO c.rlisle p~ CI~E~, Norary Puhllc- ~~, C"'-I.' .' '~.I~rl.1nd COllnty ."n,IS&IOO Exp' II.S J;;n, I~. 1~~5 ~GC~ 108 I'm '740 -.~.-.......'. ~ 1:.. l,; 1 f. ~ ,', ~'. .:' GrDUp Llll' Claim. OI__I,IDn o Metropolitan Life Insurance Company Onp Madl~on Avenue r,:('w Y()r~ NY 10010 .r':' ~._) }.;..~~ c: ..~.~... ..... ,,~::C~::: ,r'~ti::>~~:1C::P /.-: ~::..' ~-~':''j.' :;:..i:,'L:: :~~ ..,1::':': ;.;'~l.'C::-\... (:r ~::'::'~.:1c: ,;'. " -" ,--... '"-'.'{():-: Group No. CCrlil,e:tll' I~o N,lt1ll' ~llpplf'mrnIIIlY ConUatl No. rr~l, ...",'".;', =- 7~ :!::.;~,:.. ::::,:~'l:- !. Please refer to the paragraph(s) checked below: o 1, Payment of claim has been approved for the fOllowing applicable amounts: A, Life Insurance B. Accidental Means Oeath Benefit C, Refund of Annuity Contributions 0, Oelayed Settlement Interest E, Interest Accumulation $,~~~ ~_m__ ___n $-,_ - $----,-,----, $ ------- S o 2. The enclosed check represents the amount payable to date: o Lump Sum Payment o _ Periodic Payments plus Items "C" and "0" above, if applicable, Should it become necessary to write the Insurance Company regarding this Supplementary Contract, please furnish the Supplementary Contract number and name of payee, o 3, The enclosed check is in full settlement of claim, 04, i.p-;~cr t.;;(.: '0cneficiE.::,' ~""l'li:1 "~:-~:,,::~s ;::'o~n :'1::::'0 l:-:.:.; ~:l"G.~~cc or 'I'~C.;~).CU :~: ;:--'_:.pc.-:Jl..C r:.'ovicion of the Group CO:1t.~::;et. ::~i~~ p:.'o',':: (lc:~ th;::,~':.: 2r~:::,:c::"t ~)02 sc::"€ to "'::1),0 fi!,:J.: ::-t::....:::.-::_:-:.:; Q:'~ .J.:1~c: i--,- ~_::".:~,:~~'..J i.~:~ .;':'C'.; 1;; c~.J..;:.J.:.c. ::<: t.:...c._....::;::....')~'C: "':'.::~:: "::':"." .....~::I~.,:~L'; C~l::.~_;-::.c:. :-:::,:'c:-:.t:3 ::c t::!: ,_ : ~:'C';'...\~. ",:::'~':':-, ~, C::'I~::""':' cCl~-~~i:::'ic.:r:J..:c :1;:.::':"~/';:";:= r. :;~1: :.....::.::--.:: f:.':.' '~:':i.' ;~~.c ':':::';~.- '. ~i._ ::'_C: ~.~ -: ,..:-. .~,::.;",:- L.-.:'.:,~-; ~l'":l'.:l) ':"i::\~ :',:'L: ~cc:;',:e:1~':':-::. l-IC::t:. -:.;::-.,:~':"~ ;:':-::'~'_:::.:::":L' :::,~' '-,' :C~'~'."(' i:-. ~',:.j'~....:c: .~o 1'.::::: G::to.~~ ',:C t:.c:~c:'o~'(' :~"r-:':.: ..1: ":~c~:.:.':~,.:. ~ C~':_~.~\: r.c:.t:.~:~'.:'--::,(' r~~"):lin':~i~1: a:1 c::c~:;~:J:;" J;' ::..' :,:::':~~.:~_.~:J..:'J:' , , ~..(':: ~::.::, _L. Group Life_Claims Division ./--, ) ~./, ' /;'~,-r-:;~/ " ,," ./' -'! ,.." """'-"":t -' :/ --' , , . /,':"" ..... --- ~--- ....J.. Enclosure' 0 Check o Supplementary Contract G, 10381 r3.73} Printod in USA Exhibit ttB" CON:jENT 'J'O l'E'rJ'l'ION I, Robert Reitz,el, Trust Of1'icer of COImlollwealth lJational Bank, as GUardian of Jacee Leeann Adams, heir of the Estate of r''larlin C. Adams, Jr., deceased, hereby consent to the filing by Marlin C. Adwns, Sr. of a Petition for Settlement of the Estate of r,iarlin C. Adams, Jr., and join in the request tlmt the Court grant the Petitioner the relief requested by him therein. Date: ':--,,, ,,~ '). '1 \ C{ '<; I , Exhibit "ell COli: :J.J!T 'ID I'I';T I 'J' roil I, William E, Hoffman , lduly ::lUthOl'ized l'c)1l'cscntatJve)- President (title) , of 1I0ff'rnun - Roth F'unel'al 1I01J:C, as cl'ecUtoJ" of' the Estate of fiElt'l1n C. Adams, Jr., deceased, hereby consent to thr. nUng b,y f.JaY'lln C. ^dilInS, Sr. of a Petition for ~;ettJ.ement of' the Estatc 01' f.1ar'J.in C. ^D2I~s, ,Jr., illld Join in the rcquest th'lt the Cour't ['nmt, the Pr.tItianer' the relief requested by him therein. Date: September 10, 1981 Exbibit "D" CtXJ: :1-lJ'I' 'r~J PJ,:r I 'r [(); l I, ,James 1\. l,lcN;1I1)' . , (duly authopized pepI'esentatl V']) Bnlllch 11sL, ( tIt;le) , of General ElectI'ic Credit Company, as cpedlLOl' of the Estate of H1p]j n C. Adams, Jr., deceased, hopeby consont to the nJing by r,1aplin C. Adams, Sr. of a Petition fop 8ettlement of the Estate of [.1aplin C. Adams, Jr., and ,Join in the request that the COUI't gt>o.nt the Petitionep the J'Clief requested by hlJTI therein. Date: 9/21/81 r, ~ ) kL ?-1Vd , C fl~ (ti{{y-- Duly iluthoI'ized 1'"presentaUve' IJ /,' [. I~xhibi.t "F" , ~~ .l:'; .~ .'4. '.. .,- >:-\',~,;-.;{ I :,; If',"" J , (duly authol'l.:ced COli: \1-11']' 'j\) 1'1':1' 1 'I' I Iii J },',Ix, )1.' i,; " I'Cf;J'esentClUve} p~') /ll'" ( \J tIe) I of' Carlisle PccUatr'ic Contc!', as cl'ccLLto!' 01' the J':stnte of r'~1J'lin C. Adnms, ,Jr'" dcceased, l1el"cb,yeonscnt to the rUing by r'~!l'Un C. ^,';J/,!s, ::1'. of' a PetJtion for :;etUement of' thc [':state of' r.1;-wEn C. Adams, ,Jr., and ,join in the request that the COUl't fc1'cmt the l'eUt:ton01' the pellef' re'lucsted by h1m therein. Date: ,.rll'~ /2,/ I Duly Exhibi t "/J" 1 CON~;Eil'r 'ID 1'1,;1' I 'J' I OIl I ',:,.._ )?(t-?lLi-{ (title) ! l " I I ' , .. ] \:!' I " " / 'e" <....(....[~ - , ~ / , ' _y.... ./ ..r. _ y - , / ~lL 1. authop12ed T'eppesent3tl ve (/ /. /" / / ..::....-.,/ "-'--.-/ Georges' Floweps, as credltop or the I::state .~/ or of' l,lupJln C. ^dnnrs, Jp. deceased, hereby consent to the rHine: by /,t':u'Un C. Admrr;, SP. of' n Petition for Settlement of the Estate of' /,1arlin C. Adams, Jp., and join in the request that the Coupt f,'rant the PetitIoner the peller pequested by him therein. 'I , I d I- 'I A'-7Ir--'l77u(.,~~-d7d-~ ,~ ,Duly authorized representatiy~ , / ~ ,--" Date: ' Exhibit "r" COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 55: being duly __" SWOJ:~__.__ __ __ ._ _ .lccording to law, dcpo~c~ clnd s,'ys that he H:ll~lin _c.. ..Ad:lln~t SR., Administrator '....,_, _________.. 01 the Estate 01 ,_...._~1:"!:JilLJ:-,_M,,-m-';_L'!..1~.,__ ...,....-, late of Borough of Carlisle , Cumberland County, Pa., deceased and that tho within is an inventory made by ..,,_,__,..Harlin, C._Adams, Sr .._'_ ..,.. ,,__, the said n,_AdOlinistr:ltc":___ 01 the enlire estale 01 said decedent, consisting 01 all the personal proporly and real estate, except real ellale ouhide Ihe Commonwealth 01 Pennsylvania, and thaI the ligures opposite each itom 01 the Inventory represent it's lair value as 01 the dale 01 decedent's death, Harlin C. Adams, _Sr. ___ _ Sworn ~~~~e c..~-c. 1i~;:~~,.:-:. Admini,trtdCI ~~ilr]itl C. ~dam~. Sr. _____,;!_50 Franklin Stree_t and subscribed before me, ._______'__n_.____, 19_ r i , , ! Carlisle, PA 17013 AddrflU J Date 01 Death _,__,_ 14 1980 ..__,____,_,__,_O..E..tQb~L__._,_ Month Year D.y INSTRUCTIONS I. An inv~ntory must be filed within three months after appointment of pNsonal representative. 2. A supplement inventory must be filed within thirty days of d~sco\'cr)' cf additionn! a~sch. 3. Addilional sheels may be attached a,s to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. I I , J .:j "I >- -I -ci ,~ f- UJ 1 ~I ~ :l ~ >- '" f- ~ q- UJ <: '" ~ '" ~ 0- f- a ... u "L.. a 0 VI " " ~ ~ I w UJ ." U Cl '" :r: '" <: ~ ~j I- 0- 0- Z f- -' U. , "" ~ , u. -' <: 0 ~I 0- n w 0 <: UJ u ,;. > '" =4<: :t z c: ~I - z 0 '", c I; Cl ~ ~ .; I' VI z ..... 0 '" ~ U z II w <: .... 0- :;; "'I -0 ~ I c ::I ~ I : - " l 0 ~ .n -0 oJ< ~ E ~ 0 , ~ ~ 0 -' U u: c> 11)111 .LIHIIlX3 Inventory of the reol one! per!:.olloi estate of Harlin C, i\.9,a:n,~~. J:~.. ._.._'__ _,__,decoo.ed, ._-~---: ~=~-:~--=--_..::::;;:==.=_---::::..~::=-:::-=---- --~-''=:~::._--::;::::'' -=--::=.::;.~----_._----=-- 'C~-=lr II Central Life Insurance Company of Omaha - crcdi t like insurance benefits in excess o[ loan bal:lIlce ,...ith Bene[icial Consumer Discount Company, Carlisle, Pcntlsylvania $ 957 03 Federal Tax Re[und - 1980 859 00 Final Salary Checks. Kinney Shoe Corporation: Chec1< No. 55132 Check No. 55967 , 89 81 , il 31 16 I, I: 60 ~OO ii 2,296 107 !! P " , II iI :: ., I: , Ii " !i It :i Ii " II I CB Nonitor Estate of Lisa Ann Adams Ii I I I Total $4,293 07 EXHIBIT "K" REV-!.lIl t:.~+ ("'-~'J' COMMONW[AL TH or- flltwHL ':M,lI. DEPARTMENl or RlVEt.~!E TRANSFER ItmERI1AUCE 1/0.)', RESIDENT DECEDENT ItlHERIT AIKE TAX RETur:t~ FOR INSOLVEIH ESHTES (Insiructions on Rove"" Side) Estate of flnrlin C. Adu,,,,;, Jr. Lost address 250 Frnnld in Street ISTHt:.ET) Carlis Ie (CITV) Pennsvlvnnia (S7I<.TI:I 17013 lZIPI 'Date of Death Oc tober 14, 1980 Social Security Ho. 179-54-9581 TyPE OF ASSET DESCRIPTION ( ) b.cc, (X) Adm. COUt. TY r.G. STATE NO. l'i:!rlin C. Ad.1lns. Sr. Other NcmC' Social 5ccurity No. >- '" < U ::> o u: Addre.. 250 Franklin Street (~THE["T1 f -/o..fI . ~ C.rli.!e Penn.ylvania 17013 (CITY) tSTJ.TEI (ZIPI Until" 11I'n.:'lt~~ (lll"~rjurv. I declare that I ha'or'C examined this feturn Dnd to /2t:'~-'" ,..~ . ,>o..'"~~"nd be".!.t ""ue, CO,,"Ct and com"I..., ~-~~/ " ~?1~ .11t1fl,O< UCI:tI\ I !:3TIM;'1EI) M;"R~:ET DePARTMENT VJ.LUATIOt~ ! '!.'.L"= lOF!"I{"'II,t U$F rH~LY) Personal Property Central Life Insurance Company of Omolw - credit like insurance benefits iIl 0XCCSS of loan balance \.,ith BenefieL,l CClJl:.IJl:l(:1" Discount Compnny, Carlisle, .lJc;w;-:) i'..:..;,.~:~ 11 Fed~ral Tax Refund - 1980 11 11 11 OFFICIAL USE ONLY T01/,L :; ~'5", .l):i 859.00 89.81 31.16 60.00 2,296.07 $" ,293.07 do hereby certify that the above assets were apprcised in accordance with Pennsylvania law. Final Salary Ch(>c~:s, Kinney Shoe Corpcn-.3tion Check #55132 Check 1155967 CB Hon i tot' Estate of Lisa Ann Adams DATE NAME OF PAyeE Hoffman-Roth Funet'al Home Jacee Leeann Adams, info dau Ruby D. Heeks, Esquire Ruby D. \leeks, Esquire Ruby D. I'leeks, Esquire Narlin C. Adams, Sr. Narlin C. Adams, Sr. Reserved to Finalize Estate Cumberland Valley Hem. Gat'd. Carlisle Hospital General Electt'ic Credit Co. Harlin C. Adams, Sr. Frank Shennan Georges Flowers Carlisle Pediatric Center APPRAISER NATURE OF CLAIM Funeral expenses- Family exemption Reimbur.e for Evening Scnt. Ad. Reimburse fot' Cumbo Law Journal Ad 5~~ - Counsel fees 5% - Fiduciary Commis,ion Rei,"bur.e for Reg. of l<ills filing \dministration Grave marker Bills outstanding for wife and dau Balance of loan Reimbur.e for April Reimburse for Preis Bill outstanding Bill out. tanding for daughter rent of room Cons. Disc. Co debt TOTAL DJ.TE AMOUNT CLAIMED '. $1,823.00 2,000.00 23.50 18.00 201. 90 201. 90 16.00 50.00 477 .00 132.00 214.55 225.00 298.89 29.42 80.00 $5,586.16 DATE 'UJO~u~ X01 uWOJUI jonp'^!pul'O$'.Vd lUJOf uo papOc.lDJ aq pno4'5 UJa~! <3lUOJU! iJlqOJl(Ol 5!41 'c;asod..nd xo1 vUJO)UI O!uO^IASllUOd JOf vlqopodo, Ii! iHOI'iil UO 6UpillSlUllll .pO u! pawJofJild '5uJ!^Ju'5 10f 'lOIOJl'l!ll!WPO 10 JOIO);)X;) uO ^laWOU :iM!lD1UQ<;;JldiJJ alDISu UD 0, plod '5u.l;j :310N 11'."'01 "<'1 O)!qOJO)^O:l.1J .1JO lunowo ,J~!I JO "ilq,Jp 'i0 .1nu.'l^.1~ fa IUaWIJod.1Q .1'i1 '<''1 p.1HJ^O:l,JJ aq 01 'i'ial a'i' 'i! Ja^OJ'i:l!'i"" OOQ'l S JO .'lOp aq 01 punDf ^1.110W!IIO XOI .1111 fO ~"SZ fO '<'llou.1d 0 01. . . ,)lqO!1 ^1I0UO..J3d 3'1 I10liS W!'i fa p3J!ob.u UOd3J J,)'i'o 10 UJOl3J D 'Ill 0; 'I!'I ~1I"1I1!'" 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