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HomeMy WebLinkAbout05-18-07 . - DECEDENT'S ESTATE COURT OF COMMON PLEAS OF Cumberland COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF Eugene Lawrence Keefe , DECEASED No. 21-05-0169 PETmON FOR ADJUDICATION / 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: Mark A. Mateya Supreme Court I.D. No.: 78931 Name of Law Firm: Mateya Law Firm Address: P.O. Box 127, Boiling Springs, FA 17007 Telephone: 241-6500 Fax: 241-3099 Q. ::-;:0 :0 ~~0 ~;;;~ ~' --, >i':; w s:- Cn Form OC-OI rev. 10./3.06 Page 1 of 10 r"., .;.:'~) c.~ _J ~~ -< co -0 "'-,".iiO -~ ~~ 1:-,------,-:-- Estate of Eugene Lawrence Keefe ,. , Deceased 1. Name(s) and addressees) ofPetitioner(s): Name: Mary Anne Beattie Address: 114 Patricia Road Newark DE 19713 Identify any executors or administrators who have not joined in the Petition for Adjudication and Statement of Proposed Distribution and state reason: None Is this the first accounting by this fiduciary? . . . . . . . . . . . . . . . . . . . . . IZI Ves [J No If not, identify prior accountings, the accounting periods covered, and the date of adjudication of the prior accounting. 2. Decedent died on November 20, 2004 D Letters Testamentary or IZILetters of Administration were granted to Petitioner(s) on Februarv 23. 2005 Date of Will (if applicable): Date(s) ofCodicil(s) (if applicable): Date of probate (if diffirent from date Letters granted): Was a bond required? e{Yes r']No If yes, state amount:" 10)000.00 ". Are proofs of advertising of the grant of Letters attached? ......... IZIVes D No Dates of advertising of the grant of Letters: September 14,21,28,2005 Form DC-OJ rev. JO.13.06 Page 2 oft 0 Estate of Eugene Lawrence Keefe . Deceased 3. Was decedent survived by a spouse? . . . . . . . . . . . . . . . . . . . . . .. . . . . .. DYes IZINo 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 seq. of the Probate, Estates and Fiduciaries Code) If yes, date of election: 5. In the case of an intestacy, state the names ofthe decedent's surviving children or surviving issue of deceased children (ifnone, so state): None 6. Did decedent marry after execution of Will or Codicil(s)? . . . . . . . . . .. DYes IZI No Were any children born to decedent after execution of Will or Codicil( s)? .. .. . . . .. . . . . .. . . . .. . . .. . .. . .. . .. . . .. . .. . .. DYes IZI No If yes, give names and dates of birth: Name: Date of Birth: 7. Ifrequired 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. DYes IZI No Form DC-OJ rev. 10.13.06 Page 3 ofl0 Estate of Eugene Lawrence Keefe . Deceased . 8. Written notice of the Audit as required by Pa. O.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 ofthe 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. Ifany person entitled to Notice is not suijuris (e.g., minors or incapacitated persons), Notice ofthe Audit has been or will be given to the appropriate representative on such party's behalfas required by Pa. O.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. O.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) ofwhomPetitioner(s) haslhave 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'srelationship to the decedent and the nature of each party's interest(s): Name and Address of Each Party in Interest R61alionshiD and Comments. if any Interest Emelia C. Keefe 114 Patricia Drive Newark, DE 19713 Mother Lineal Thomas F. Keefe 2236 Laurel Hill Drive Eugene, OR 97403 Brother Sibling . Form OC-Ol rev. 10.13.06 Page 4 of 10 Estate of Eugene Lawrence Keefe . Deceased Name and Address of Each Party in Interest Relationship and Comments. if anv Interest Mary Anne Beattie 114 Patricia Road Newark, DE 19713 Sister 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 Guardianlfrustee Ad Litem has or has not been filed for this Audit (~ee Pa. o.c. Rule J 2.4). 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./3.06 Page 5 of 10 Estate of Eugene Lawrence Keefe . 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 AmOlUll of Claim Claim Will Claim Admitted? Be Paid In Full? Citicorp Credit Services, Inc. 8047.88 IZIVes DVes C/O Balogh Becker L TD DNo IZI No 41500lson Memorial Hwy #200 Minneapolis, MN 55422 Citibank (South Dakota) NA 6869.03 IZIVes DVes 7930 NW 11 Oth Street DNo IZINo Kansas City, MO 64153 GMAC 6796.84 IZIVes D Ves PO Box 7041 DNo IZINo Troy, MI 48807 DVes DVes DNo DNo If the estate is insolvent, attach a schedule setting forth the order of preference under 20 Pa.C.S. ~ 3392 and the proposed payments. 11. Was family exemption claimed? ......................................... . DVes IZINo DVes IZINo Was family exemption allowed? ............................................................ .. Family exemption claimant's name and relationship: Name: Relationsllip: Form OC-Ol rev. 10.13.06 Page 6 oft 0 Estate of Eugene Lawrence Keefe . 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 Paymenl Inlerest 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 of a fiduciary? . . . . . . . . . . . . . . . . . . .0 Yes IZJ 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 IZJ 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 DC-OJ rev. JO./3.06 Page 7 of 10 Estate of Eugene Lawrence Keefe .. Deceased 16. Had the decedent been adjudicated an incapacitated person? . . . . . . . . . . D Yes IZI No If yes, attach a copy of the Order if available; otherwise state the Court, tenn, 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. . None B. Has notice of the additional receipts and disbursements been given to the parties identified in Paragraph 9 above? ............. DYes D 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 DNo If so, attach a copy of the notice. 19. Is the Court being asked to direct the filing of a Schedule of Distribution? ......................... . IZIYes DNo As to real estate only? ........................................ [JY es IZI No Form DC-OJ rev. 10.13.06 Page 8 oft 0 Estate of Eugene Lawrence Keefe , 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) Amount/Proportion B. Principal: Proposed Distributee(s) Amount/Proportion Citicorp Credit Services Citibank GMAC Submitted By: (All petitioners must sign. Add additional lines ifnecessary): Name of Petitioner: Mary Anne Beattie Name of Petitioner: Form OC-Ol rev. 10.13.06 Page 9 of 10 Estate of Eugene Lawrence Keefe . Deceased Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies * [that he/she She is title Administratrix of the above-named name of corporation Estate of Eu~ene Lawrence Keefe 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. ~ 4904 (relating to unsworn falsification to authorities). ~~~Ul~'P' Sign tur f etitioner . · Corporate petitioners must complete bracketed in/ormotlo". 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 have been made beyond the responses herein. W . Form OC-OJ rev. 10.13.06 Page 10 of 10