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DECEDENT'S ESTATE
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
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ESTATE OF DONNA JEAN KEPHART , DECEASED
a/k/ a OONNA J. KEPHART-HOOVER
No. 2007-00129
PETITION 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: R. Mark Thomas, Esquire
Supreme Court J.D. No.: 41301
Name of Law Firm: R. Mark Thomas, Attorney-at-Law
Address: 101 South Market Street, Mechanicsburg, PA 17055
Telephone: 717-796-2100
Fax: 717-796-3600
Form DC-OJ rev. 10.13.06
Page 1 of 10
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Estate of DONNA JEAN KEPHART
, Deceased
1. Name(s) and address(es) ofPetitioner(s):
Name:
Kimberly Ann Caudill
Fred A. Kephart, Sr.
Address:
15451 Sweetwater Court
7073 Carlisle Pike, Lot 69
Fort Myers, FL 33912
Carlisle, PA 17015
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? . . . . . . . . . . . . . . . . . . . " I2J Yes [] No
If not, identify prior accountings, the accounting periods covered, and the date of
adjudication of the prior accounting.
2. Decedent died on 12/29/2006
IZI Letters Testamentary or [] Letters of Administration were granted to Petitioner(s) on
02/09/2007
Date of Will (if applicable): 06/13/2003
Date(s) ofCodicil(s) (if applicable): N/A
Date of probate (if different from date Letters granted):
Was a bond required? DYes I2J No If yes, state amount:
Are proofs of advertising of the grant of Letters attached? ......... IZJ Yes [] No
Dates of advertising of the grant of Letters: Patriot News: 2/28/07, 3/7/07 & 3/14/07
Cumberland Law Journal: 3/2/07,3/9/07 & 3/16/07
Form OC-OJ rev. 10.13.06
Page 2 of 10
Estate of DONNA JEAN KEPHART
, Deceased
3. Was decedent survived by a spouse? ............................. IZ)Yes DNo
If yes, name of the surviving spouse: Fred A. Kephart, Sr.
4. Has the surviving spouse filed to take an elective share? ............. DYes IZI 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 of the decedent's surviving children or
surviving issue of deceased children (if none, so state):
6. Did decedent marry after execution of Will or Codicil(s)? ... . . . . . . .. DYes IZ) No
Were any children born to decedent after execution of
Will or Codicil(s)? " . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 Yes IZJ 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IZ]Yes 0 No
Form OC-OJ rev. 10.13.06
Page 3 of 10
Estate of DONNA JEAN KEPHART
, 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 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. 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) 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
Relationship and Comments, if any Interest
Bobbie L. Schwinabart
3925 NE 92nd Place
Anthony, FL 32617
sibling $20,000.00
Brenda S. Stinson
211 Sourwood Lakes Road
Tellico, TN 37385
step-daughter $20,000.00
Form DC-OJ rev. 10.13.06
Page 4 of 10
Estate of DONNA JEAN KEPHART
, Deceased
Name and Address of Each Party in Interest
Relationship and Comments, if any
Interest
(see attached)
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.
Brandon M. Gilsdorf - D/O/B: 12/29/1992
Next of Kin: Robyn Lea Smith (mother of minor)
2130 Bayford Court
Marietta, GA 30064
C. State why a Petition for Guardian/Trustee Ad Litem has or has not been filed for
this Audit (.see Pa. 0. C. Rule 12.4).
Brandon M. Gilsdorf is represented by his mother, with whom he lives. The
Estate has offered to pay for the services of an attorney for the benefit of the
minor and to review this Accounting.
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-OJ rev. JO.13.06
Page 5 of 10
-
Continued from page 5 of 10 - All Parties in Interest
1. Kimberly A. Caudill daughter Y2 of residue
15451 Sweetwater Court
Fort Myers, FL 33912
2. Dana M. Gilsdorf grandchild ~ of residue
3780 Towne Crossing (in trust)
Apartment #303
Kennesaw, GA 30144
3. Brandon M. Gilsdorf grandchild ~ of residue
2130 Bayford Court (in trust)
Marietta, GA 30064
4. Bobbie L. Schwinabart sibling $20,000.00
3925 NE 92nd Place
Anthony, FL 32617
5. Brenda S. Stinson step-daughter $20,000.00
211 Sourwood Lakes Road
Tellico, TN 37385
-
Estate of DONNA JEAN KEPHART
, 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?
(see attached) 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. ~ 3392 and the proposed payments.
11.
Was family exemption claimed?
... . ... . ... . ... . . ...... .. .... ...
DYes IZlNo
DYes DNo
Was family exemption allowed?
. ... . . .. .. ..... . ... . ... .. .... ...
Family exemption claimant's name and relationship:
Name:
Relationship:
Form DC-OI rev. 10./3.06
Page 6 of 10
-
Estate of DONNA JEAN KEPHART
, 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
3/29/2007
$16,000.00
All Beneficiaries
9/26/2007
$3,575.10
All Beneficiaries
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:
None
B. Has notice of the question requiring adjudication been given
to the parties identified in Paragraph 9 above? .................. 0 Yes I&J 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-OJ rev. 10.13.06
Page 7 of 10
-
Estate of DONNA JEAN KEPHART
, Deceased
16. Had the decedent been adjudicated an incapacitated person? . . . . . . . . . .0 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 IZI No
18.
If a reserve is requested, state amount and purpose.
N/A
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 IZJ No
If so, attach a copy of the notice.
19.
Is the Court being asked to direct
the filing of a Schedule of Distribution?
. .. ........ ........ .. .. .... .. .. ...... .. .. .... .. .. ..
IZJYes DNo
As to real estate only? ........................................ DYes IZINo
Form OC-Ol rev. 10.13.06
Page 8 of 10
Estate of DONNA JEAN KEPHART
, 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: (6s?e al/c;dct/)
Proposed Distributee(s) Amount/Proportion
B. Principal:
Proposed Distributee(s)
Amount/Proportion
Submitted By:
(All petitioners must sign.
Add additional lines ifnecessary):
~~
Name of Petitioner: POA for Kimberly Ann Caudill
Name of Petitioner:
Form OC-01 rev. 10.13.06
Page 9 of 10
Estate of DONNA JEAN KEPHART, Deceased
VERIFICATION
The Undersigned hereby verifies that he is the attorney for the Estate of Donna
Jean Kephart, that the Executrix/Petitioner, Kimberly Ann Caudill, is unavailable due to
being out of state, to sign this Petition for Adjudication/Statement of Proposed
Distribution, but after having reviewed same, including the Final Account, hereby
authorizes the undersigned to sign this Petition and hereby declares that based upon her
personal knowledge that the facts set forth herein are true, and as to facts based on the
information of others, the Petitioner, after diligent inquiry, believes it to be true; and that
any false statements herein are made subject to the penalties of 18 Pa. C. S. ~ 4904
(relating to unworn falsification to authorities).
~~~
R. Mark Thomas, Esquire
Attorney for the Estate
101 South Market Street
Mechanicsburg, P A 17055
Attorney No. 41301
(717) 796-2100
CERTIFICATION OF COUNSEL
The undersigned counsel hereby certifies that the foregoing Petition for
Adjudication/Statement of Proposed Distribution, except for the above Verification, 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.
s~~~
FIRST AND FINAL ACCOUNT OF : IN THE COURT OF COMMON PLEAS
KIMBERLY A. CAUDILL, EXECUTOR : CUMBERLAND COUNTY, PENNSYL VANIA
OF THE LAST WILL AND TESTAMENT :
OF DONNA JEAN KEPHART : ORPHANS' COURT DIVISION
AlK/A DONNA J. KEPHART-HOOVER
: ESTATE NO. 2007-00129
Date of Death: December 29,2006
Employee's Identification No.: 13-7557890
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CUMBERLAND COUNTY, PA
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The Accountant Charges herself as follows:
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PRINCIPAL ACCOUNT
REAL ESTATE
2B & 2C West Springville Road
Boiling Springs
pro-rated taxes
108 Juniper Drive, Mechanicsburg
pro-rated taxes
$195,000.00
278.11
$185,000.00
669.40
TOTAL
$380,947.51
PERSONAL ESTATE
12/29/2006 Jewelry $10,000.00
12/29/2006 Sovereign Bank Account $15,684.49
Account No. 1681716054
12/29/2006 Sovereign Bank Account $ 860.12
Account No. 1684006131
12/29/2006 Sovereign Bank Account $ 120.02
Account No. 1684010067
12/29/2006 Citizens Bank $ 7,354.14
12/29/2006 Household Furnishings $ 3,115.00
12/29/2006 1995 Cadillac DeVille Sedan $ 3,390.00
12/29/2006 Rolling Green Cemetery Plots $ 500.00
12/29/2006 Cash $ 49.72
12/29/2006 Southern Co. $ 4,081.04
110.50763 shares @ $36.93/share
12/29/2006 Vectren Corp. $ 3,970.13
139.99035 shares @ $28.36/share
~
12/29/2006 Washington Mutual $ 10,040.31
288.018 shares @ $34.86/share
12/29/2006 Growth Fund of America $ 13,063.92
397.442 shares @ $32.87/share
12/29/2006 Amer. Tax Exempt Fund ofMD $ 10,529.98
655.257 shares @ $ 16.07/share
12/29/2006 Bank of America $ 4,347.83
81.24514 shares @ $53.52/share
12/29/2006 Chevron Texaco $ 5,131.52
69.53283 shares @ $73.80/share
12/29/2006 Cap. Income Fund $ 27,923.11
456.932 shares @ $61.11/share
01/03/2007 Final Pension Payment - NEBF $ 77.94
OS/22/2007 IBEW $ 336.00
TOTAL $120,575.27
INCOME ACCOUNT
02/13/2007 Rent 2B & 2C Springville $ 3,000.00
02/13/2007 Rent 2C Springville $ 600.00
03/22/2007 Rent 2C Springville $ 600.00
03/26/2007 Southern Co. $ 9.31
111 shares @ $36.85/share
03/26/2007 Vectren Corp. $ (3.09)
141 shares @ $28. 135/share
03/26/2007 Washington Mutual $ 210.27
289.401 shares @ $35.42/share
03/26/2007 Growth Fund of America $ 294.05
397.442 shares @ $33.61/share
03/26/2007 Amer. Tax Exempt Fund ofMD $ 73.39
660.235 shares @ $16.06/share
03/26/2007 Bank of America $ (196.58)
81 shares @ $51.25/share
03/26/2007 Chevron Texaco Corp. $ 56.88
70 shares @ $74. 12/share
03/26/2007 Cap. Income Fund $ 699.38
460.613 shares @ $62. 14/share
04/30/2007 Rent 2B & 2C Springville $ 1,175.00
05/11/2007 Rent 2C Springville $ 575.00
08/01/2007 Sale of Cadillac to Fred $ (2,890.00)
11/05/2007 Sale of Juniper Drive contents $ 1,309.47
11/3012007
01/31/2008
Insurance Claim (flood damage)
Inheritance Tax Refund
CREDITS
The Accountant claims the following credits:
DEBTS
04/02/2007
04/02/2007
04/03/2007
04/1 7/2007
04/17/2007
10/05/2007
10/05/2007
Bonton Retail Services
Bellefonte Emergency Medical
Sears Credit Cards
Boscov's
GEMB - JC Penney
2006 Federal Income Tax
2006 P A Income Tax
ADMINISTRATION EXPENSES
Neil Funeral Home, Inc.
Funeral Dinner
Rolling Green Cemetery (internment of remains)
Rolling Green Cemetery (memorial marker)
Executrix fee (Kimberly A. Caudill)
Attorney fees (R. Mark Thomas, Esquire)
Probate fees
Tax Return Preparer's fees (Doug Mangle)
Publication - Cumberland Coun~y Law Journal
Publication - The Patriot News
Appraisal of personal property - Bricker Auc.
Appraisal of jewelry - Joseph James Jewelers
Repairs to automobile
Reimburse Executrix travel expenses of 2/2007
Wire fees from Edward Jones
U-Haul (transport household fum. from estate)
Reimburse Executrix travel expenses of 812007
Fulton Bank - estate checking account fee
UPS - ship financial records to Florida
$
$
747.85
42.11
TOTAL
TOTAL DEBITS
$ 148.64
$ 32.06
$ 58.33
$ 131.92
$ 38.03
$ 1,782.10
$ 2,729.00
TOTAL
$ 7,115.21
$ 184.63
$ 1,175.00
$ 1,626.00
$18,000.00
$17,000.00
$ 495.00
$ 175.00
$ 75.00
$ 141.18
$ 100.00
$ 42.40
$ 30.20
$ 860.46
$ 11. 00
$ 1,008.68
$ 1,026.01
$ 64.20
$ 36.48
$6,303.04
$507,825.82
$4,920.08
Staples - purchase office supplies, boxes, etc.
UPS - overnight delivery of death certificate
Reimburse Executrix and sister for
travel expenses of 6/2007
Federal Express - overnight delivery and return $
Hazard insurance - Boiling Springs property $
Repairs - Boiling Springs property $
Final water & sewer bill - Boiling Springs property $
Storm tree removal- Boiling Springs property $
Reimburse Executrix travel expenses of 1012007 $
Rolling Green Cemetery - memorial tree $
2007 real property taxes - Boiling Springs property $
Hazard insurance - Mechanicsburg property $
2007 real property taxes - Mechanicsburg property $
2007 school taxes - Mechanicsburg property $
PPL Electric - Mechanicsburg property $
United Water - Mechanicsburg property $
York Waste Disposal - Mechanicsburg property $
Interior & exterior cleaning - Mechbg property $
Secco Home Services - Mechanicsburg property $
Zimmerman Plumbing, Heating and AlC - $
Mechanicsburg property
Puroclean of Susquehanna Valley-
Mechanicsburg property
Michael Vandrew - Mechanicsburg property
(routine property maintenance)
Pennsylvania Inheritance Tax
Account filing fee
Publication fee of notice
Wayne Myers - Auctioneer
Sewer bill- Mechanicsburg property
COSTS OF SELLING REAL ESTATE
(2B & 2C West Springyille)
ERA - NRT, Inc. (realtor)
Kimberly Realty (realtor)
Wire fees
Transfer tax
Tax certification
Final sewer and water bill
Pro-rated rents
$ 16.96
$ 13.58
$ 1,529.42
80.00
445.00
364.41
198.00
350.00
696.82
82.00
412.18
743.00
539.68
1,920.57
478.20
75.04
43.50
970.00
69.95
1,575.00
$ 3,275.54
$
1,460.00
$ 19,575.10
$ 300.00
$ 80.00
$ 739.78
$ 300.00
TOTAL
$ 6,040.00
$ 5,825.00
$ 31. 00
$ 1,950.00
$ 5.00
$ 168.72
$ 459.96
($14,479.68)
$85,500.18
(108 Juniper Drive)
Realtor commission
Seller's assistance at closing
Transfer tax
Wire fees
Tax certification
Final sewer and water bill
REAL ESTATE
PERSONAL ESTATE
TOTAL
TOTAL CREDITS
RECAPITULATION
$11,265.00
$ 3, 000.00
$ 1,850.00
$ 30.00
$ 10.00
$ 55.00
($16,210.00)
PRINCIP AL ACCOUNT
$380,947.51
$120,575.27
TOTAL
INCOME ACCOUNT
TOTAL
GROSS ESTATE
DEDUCTIONS
DEBTS
ADMINISTRATIVE EXPENSES
COST OF SELLING REAL ESTATE
TOTAL
BALANCE FOR DISTRIBUTION
IN KIND
Household Furnishings
Jewelry
TOTAL
CASH FOR DISTRIBUTION
$ 4,920.08
$85,500.18
$30,689.68
$ 1,065.75
$10.000.00
$30,689.68
$121,109.94
$501,522.78
$ 6,303.04
$507,825.82
$121,109.94
$386,715.88
$ 11,065.75
$375,650.13
PROPOSED SCHEDULE OF DISTRIBUTION
1.
2.
3.
4.
Bobbie L. Schwinibart
Brenda S. Stinson
Kimberly A. Caudill
Glenn Caudill, in trust for
Dana M. Gilsdorf
Glenn Caudill, in trust for
Brandon M. Gilsdorf
5.
Dated: February 1,2008
$20,000.00
$20,000.00
$167,825.06
$83,912.53
$83,912.53
Respectfully submitted,
~J~
R. Mark Thomas, Esquire
AttomeyNo.41301
101 South Market Street
Mechanicsburg, P A 17055
Telephone: (717) 796-2100
CERTIFICATE OF SERVICE
I, R. Mark Thomas, Esquire, hereby certify that I have served a true and correct copy of
the within document on the following persons by depositing a true and correct copy of the same
in the U.S. Mail at Mechanicsburg, Pennsylvania, First Class Postage pre-paid, addressed to:
Kimberly A. Caudill
15451 Sweetwater Court
Fort Myers, FL 33912
Dana M. Gilsdorf
3780 Towne Crossing
Apartment #303
Kennesaw, GA 30144
Brandon M. Gilsdorf
2130 Bayford Court
Marietta,GA 30064
Bobbie L. Schwinabart
3925 NE 92nd Place
Anthony, FL 32617
Brenda S. Stinson
211 Sourwood Lakes Road
Tellico, TN 37385
Date: February 1, 2008
~J~
R. Mark Thomas, Esq.