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HomeMy WebLinkAbout05-09-08-. 4~' 1 r FIRST AND FINAL ACCOUNT OF REBECCA F. AFROILAN, EXECUTRIX FOR THE ESTATE OF PHYLLIS F. FULLER, (AKA) PHYLLIS A. FULLER, DECEASED. CUMBERLAND COUNTY -CODE NO. 21-07-0311 DATE OF DEATH: MARCH 1, 2007 DATE OF EXECUTRIX'S APPOINTMENT: MARCH 30, 2007 THE ESTATE ADVERTISEMENTS WERE IN THE FOLLOWING PUBLICATIONS ON THE FOLLOWING DATES: A. THE SENTINAL 1. APRIL 19, 2007 2. APRIL 26, 2007 c~ `~"-' -~`~ ~ (~ _ ~ ' 3. MAY 3, 2007 a - B. THE PAXTON HERALD ~;>~;, '~'-" i -~' 1. APRIL 4, 2007 ~ ~ ,~ ~ f t 2. APRIL 11, 2007 ' -% '' ~~ =- - `-' 3. APRIL 18, 2007 ,,=~~ ~ ;_-, ~- _ .,..i ACCOUNTING FOR THE PERIOD: FROM MARCH 12, 2007 TO MAY 4, 2008 PURPOSE OF ACCOUNT: REBECCA F. AFROILAN, EXECUTRIX OFFERS THIS ACCOUNT TO ACQUAINT INTERESTED PARTIES WITH THE TRANSACTIONS THAT HAVE OCCURRED DURING THE ADMINISTRATION. THE ACCOUNT ALSO INDICATES THE PROPOSED DISTRIBUTION. IT IS IMPORTANT THAT THE ACCOUNT BE CAREFULLY EXAMINED. REQUESTS FOR ADDITIONAL INFORMATION OR QUESTIONS OR OBJECTIONS CAN BE DISCUSSED WITH: REBECCA F. AFROILAN, EXECUTRIX 1302 OLD WILMINGTON RD. COATESVILLE, PA 19320-1661 610-857-0065 1~Par E, /~ ~= SUMMARY OF ACCOUNT PROPOSED DISTRIBUTION PRINCIPAL RECEIPTS RECEIPTS DEBTS ADMINISTRATIVE EXPENSES FUNERAL EXPENSES FEES TOTAL DISBURSEMENTS CURRENT VALUE $ NONE $ 0.00 $ 387.45 $ 8,373.80 800.00 PRINCIPAL BALANCE ON HAND BEFORE DISTRIBUTION RESERVED FOR ADMINISTRATIVE EXPENSES AND FEES TO BE PAID BALANCE FOR PAYMENT OF UNRESERVED EXPENSES UNRESERVED PRO-RATED EXPENSES TO BE PAID NET BALANCE ON HAND FOR DISTRIBUTION FIDUCIARY ACCtUISITION VALUE $ NONE $15,142.36 -9 561.25 $ 5,581.11 -1501.56 $ 4,079.55 -4 079.55 0.00 2~P~~ge ~, RECEIPTS OF PRINCIPAL ASSETS LISTED IN INVENTORY. (VALUED AS OF DATE OF DEATH) COMMERCE BANK, N.A. ADD: OMMISION OF ASSET NOT LISTED IN INVENTORY. *ALLIANCE BANK/HAMILTON, N.Y.-TRUST ACCOUNT FOR FUNERAL EXPENSES -TRUSTEE, BURGESS & TEDESCO, FUNERAL HOME, INC. 31 CEDAR ST., MORRISVILLE, N.Y. CERTIFICATE OF DEPOSIT #90054649 RECIEPTS SUBSEQUENT TO INVENTORY (VALUE WHEN RECEIVED) MANOR CARE CARLISLE -PERSONAL CARE ACCT COMMERCE BANK, HARRISBURG, PA, N.A. TOTAL SUBSEQUENT RECEIPTS TOTAL RECEIPTS OF PRINCIPAL $ 7,042.42 $ 8,009.80 $ 90.02 0.12 90.14 $ 15. 142.36 31 P<~~;t, DISBURSEMENTS OF PRINCIPAL ADMINISTRATIVE EXPENSES: 5/12/07 E. A. COLUNGA -REIMBURSED FOR THE FOLLOWING EX PENSES: REGISTER OF WILLS -PROBATE WILL $96.00 PHOTO COPYING OF DOCUMENTS $ 2.50 PAXTON HERALD -ESTATE AD $ 38.00 THE SENTINAL -ESTATE AD 115.25 TOTAL REIMBURSEMENT TO E. A. COLUNGA 5/12/07 5/15/07 COMMERCE BANK- FEE, ESTATE CHECKING ACCT. 8/03/07 REGISTER OF WILLS -FILING FEE, INVENTORY 12/05/07 REGISTER OF WILLS -FILING FEE, TAX RETURN 12/19/07 REGISTER OF WILLS -ADDITIONAL PROBATE FEE TOTAL ADMINISTRATIVE EXPENSES PAID FEES: ESPIRIRRION A. COLUNGA, ACCOUNTANTS FEE ON ACCOUNT (PARTIAL) 3/31/08 FUNERAL EXPENSES: BURGESS & TEDESCO FUNERAL HOME, INC. 31 CEDAR ST.,. MORRISVILLE, N.Y. 13408 CERTIFICATE OF DEPOSIT # 90054649, (AT D.O.D.) (SEE PAGE 3)* TOTAL DISBURSEMENTS OF PRINCIPAL/ADMINISTRATIVE EXPENSES, FEES AND FUNERAL EXPENSES $251.75 $ 90.70 $ 15.00 $ 15.00 15.00 $387.45 $ 800.00 8 373.80 $ 9,561.25 4~ Par c- DISBURSEMENTS OF PRINCIPAL RESERVED ADMINISTRATIVE EXPENSES AND FEES TO BE PAID EXPENSES SUBJECT TO PRIORITY UNDER 20 PA. C.S.A. §3392 (1), 20 PA. C.S.A. §3392 (3) AND 20 PA. C.S.A. §3392 (6). ESPIRIRRION A. COLUNGA-ACCOUNTANTS FEE ON ACCOUNT, 20 PA. C.S.A. § 3392 (1) REGISTER OF WILLS -ESTIMATED COST OF FILING FEES FOR FIRST AND FINAL ACCOUNT AND PETITION FOR DISTRIBUTION & RELEASES, 20 PA. C.S.A. §3392 (1) KATHLEEN V17AGLIANO -FUNERAL FLOWERS REBECCA AFROILAN, EXECUTRIX -PERSONAL REPRESENTATIVE ESPIRIRRION A. COLUNGA & REBECCA AFROILAN FOR REIMBURSEMENT OF TRAVEL EXPENSES, POSTAGE, FAXING, TELEPHONE SERVICES & PHOTO COPYING OF ALL DOCUMENTS TOTAL DISBURSEMENTS $ 475.00 $150.00 $ 304.00 $ 356.62 215.94 1501.56 51P~~~Ji= PRORATED EXPENSES AS FOLLOWS: UNRESERVED NON-JUDGMENTAL EXPENSES ENTITLED TO PRO-RATA SHARE PURSUANT TO 23 PA. C.S.A. §3392 (3) AND (6) AT 100 PERCENT BALANCE OF CASH ON HAND 4 079.55 TOTAL OF UNPAID EXPENSE LESS -4 079.55 NET BALANCE 0.00 10/23/07 COMMONWEALTH OF PA. DEPT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DIVISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM P.O. BOX 8486 HARRISBURG, PA 17105-8486 EXPENSES UN-PRORATED AMOUNT 4 079.55 100% PRO-RATED AMOUNT 4 079.55 TOTAL TO BE PAID FOR PRO-RATED CLAIMS AGAINST THE ESTATE 23 PA. C.S.A. § 3392 (3) AND (6). 6~Pag- INSOLVENT ESTATE DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARY PRINCIPAL BALANCE ON HAND: CASH 04/04/2007 DISTRIBUTION OF INCOME TO BENEFICIARY NONE -ESTATE IS INSOLVENT PROPOSED DISTRIBUTION TO BENEFICIARY PER WILL: ALL REMAINDER TO: ALLEN H. FULLER, HUSBAND 71 Pa~~:- CURRENT VALUE 15 142.36 CURRENT VALUE NONE INSOLVENT ESTATE NONE FIDUCIARY ACQUISITION VALUE 15 142.36 FIDUCIARY ACQUISITION VALUE NONE iNSOIVENT ESTATE VERIFICATION Rebecca F. Afroilan, Executrix under the Last Will and Testament. of Phyllis F. Fuller, aka Phyllis A. Fuller, deceased, hereby declares under oath [penalties of perjury) that she has fully and faithfully discharged the duties of her office; that the foregoing First and Final Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the estate have been pro-rated for payment and are awaiting for Court adjudication; that, to her knowledge, there are no other claims now outstanding against the estate; and that all taxes presently due from the estate have been paid. Rebecca F. Afroilan, Executrix 1302 Old Wilmington Rd. Coatesville, PA 19320 610-857-0065 SWORN and subscribed to by ~ before me this day )~ ~ ~~'L COMMONWEHLTH OF PENNSYLVANIA Notarial Seal Nicole Marie Cody, Notary Public North Londonderry Twp., Lebanon County MY Commission Expires Oct. 1, 2008 Member, Pennsylvania Association Of Notaries ~~ STATE OF PENNSYLVANIA COUNTY OF CUMBERLAND SHORT CERTIFICATE I, GLENDA EARNER STRASBAUGH Register for the Probate of Wi11s and Granting Letters of Administration in and for CUMBERLAND County, do hereby certify that on the 30th day of March, Two Thousand and Seven, Letters TESTAMENTARY in common form were granted by the Register of said County, on the estate of PHYLLIS F FULLER 1 a to of NEWVILLE BOROUGH (FiisG Middle, Last) a/k/a PHYLLIS A FULLER in said county, deceased, to REBECCA FAFROILAN (First, Middle, Last) and that same has not since been revoked. IN TESTINTONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 30th day of March Two Thousand and Seven . File No. PA File No. Date of Death S.S. # 2007- 0031 1 21- 07- 0311 3/01/2007 069-24-4567 ~~t NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Tammy Shoemaker, Classified Advertising Manager , of The Sentinel, of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th, 1881, since 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 oil THE SENTINEL on the following day(s) Apri119, 26, May 03, 2007 COPY OF NOTICE OF PUBLICATION ' _ EXECUTRIX N TI Letters Testamentary on the Estate of PHYLLIS F. FULLER, late of the Borough of Newville, Cumberland County, Pennsylvania, deceased, have been granted to the undersigned. ~AII person knowing themselves to be indebted to said Estate will make payment immediately, and those having claims will present them for settlement. . Rebecca F. Afroilan Executrix 1302 Old Wilmington Road Coatsville, PA 1 9320-1 66 1 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 publication are true,...,, Sworn to and subscribed before me this 3ra. day of May, 2007. Notary Publi My commission expires: l ~ r r D~ COMMONWEALTH OF PENNSYLVANIA Notarial SCI Christina L Wcafe, Notary Public ~U L 1, 2008 Member, Pennsylvania Association f?f Notaries THE PAXT~N HERALD TI. Pn.lon W cold •0910 Eorl Drio~, Hrria~rg, PA 17112 •806-0800 Fax Easi Shore (717) 657-3523 Office & Plant - (PO Box 6310) 101 Lincoln Street (717) 545-9540 Harrisburg, PA 17112 (717) 545-8762 PROOF OF PU~I TCA~ION STATE OF PENNSYLVANIA COUNTY OF DAUPHIN Before me, the subscriber, a Notary Public in and for the said County, personally came ~.isa M. Carnes who, being duly sworn, doth depose and say that she is LE of THE PAXTON HERALD, a newspaper of general circulation published in Harrisburg, Pennsylvania; That THE PAXTON HERALD was established on the 28th day of June, 1960, and has been published continuously since that date; That the advertisement, of which a copy is attached hereto, was published in the advertising columns of THE PAXTON HERALD in all respects as ordered in the issue(s) of ~~ /~~/, ~ /~ a?j,~7 Affiant further deposes that she is not inter din the subject matter of the aforesaid notice or advertisement, and that the allegations in the foregoing statement as to the time, place and character of publication are true. vim. . ignatur the .Affiant) Sworn and subscribed before me this day of ~ `~ A.D. ~_ ~~.. N [a blic NOTAFtEAL SEAL CAFrRIE JE,~A; Sl;~,!(3~Fg, F70 TAFiY PUBLIC _.+.3i"!E'i F'^J(~'C;P~ l'~1', ~~'-,UF'PilN COUNTY ~...~'.. .,~. l [ ,n G ScPI. /, 2010 ESTATE IVm'ICE L.E7'iEFIS TESGY~f [MY on tfie Est~M of Phyflfs F. Fuller, late of the Newville Borough of Cumberland County, March 1, 2007 de- ceased, havingg been granted to the undersigned, all per- sons irxiebted to make imme- diate and those hav- ing calms will present them for settlement to: 1 ~~~ DECEDENT'S ESTATE COURT OF COMMON PLEAS OF un-~QERti/rv'D COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION , DFCE ESTATE OF N LL:Z5 ,~ I,~ LL£~ ASET~ ~; ~-; _ ~~ c~ p ,~, ~ No. ~` l- O'1-031 ~ ~-~ ~ ~ t ~ "~ .. _ __. - ~ `-` ~ . . Ln - - .. , _ _. ..~ - ,~ ~ - ' PETITION FOR ADJUDICATION / -~ ,- ~ . `` STATEMENT OF PROPOSED DISTRIBUTION j~ . , a ~~'' PURSUANT TO Pa. O.C. Rule 6.9 This form may he used in all cases involving the Audit of the Account oha Decedent's Instate. 1l space is insuffrcient, riders may be attached. Attach the spouse's election. if any; the pcrper.~ required under items 8-19 inclusive; and any instrument pertinent to the adjudicati~~n. INCL UDE A TTACHMENTS A T THE BACK OF THIS FORM. Name of Counsel: /t~'lJ//~ Supreme Court I.D. No.: Name of Law Firm: Address: Telephone: Fax: Fonrr OC-01 rev. t 0.13.06 Page I of 1 Cr Estate of ~ f ~ 4J~C~'S F ~u ~ L I;1Q, ~AKA,~ ~i N +~l LIS A ~u LL ~R ,Deceased 1. Name(s) and address(es) of Petitioner(s): Name: aE8 . ~~CA ~ A ~'/CQ ~~~ EJ'l~'L-?Pk~' .address: /:3d ~ C~L© LL12 L f'ttZ nI G ~oN ~i Q ~DATESYrLC~y pA 193 ~Q Identify any executors or administrators who have not oined in the Petition for Adjudication and Statement of Proposed Distribution and state reason: ~1 ~.(.~~ ~ ~ctLL~R ~-J~cSsRN,t7--~~Nun/G?A"~1CJn/, ~~~~ .3~~1187 Is this the first accounting by this fiduciary? ..................... (Yes ^ No If not, identify prior accountings, the accounting periods covered, and the date of adjudication of the prior accounting. 2. Dec;edent died on ~ ~~ `~ _ ~f Letters Testa entary or ~ Letters of Administration were granted to Petitioner(s) on GYM '7 ____ Date of Will (if applicablej: .~fA~u~~ y 9. ~ 99~ Date(s) of Codicil(sj (if applicable): NoN~ Date of probate (if'different from date Letters grantedj: Was a bond required? [CYes ~ No if yes, state amount: Are proofs of advertising of the grant of Letters attached? ......... ~ Yes ~ No Dates of advertising of the grant of Letters:L~E SEN%.LNA ~9i~~.~o ~5~03JdG0'f ~ / %fl~ PAx%aN f1~iQA~..,o o~,.._'~i/ ~ '~/~/S,,C~©O `~ Form OC-0! rev. 10. i 3.06 Page 2 o f 10 Estate of ~f Nl~L~..~. S H }-tl LL~R AKA) ~N+([.4~5 fl. HG( LL~~ ,Deceased 3. Z~/as decedent survived by a spouse? ............................. Yes ^'.``o If yes, name of the surviving spouse: 4. Has the surviving spouse tiled to take an elective share? ............. ^Yes ~No (5'ee Section ?2U1 et sue. of~the Probate, Estates anti Fiduciaries Coc}e) If yes, date of election:- _.. 5. Ir- the case of an intestacy, state the names of the decedent's surviving children or surviving issue of deceased children (if none, so state): NOiv~ 6. Did decedent marry after execution of Will or Codicil(s)? ........... ^Yes ~(No Were any children born to decedent after execution of Will or Codicil(s)'? ........................................... ^Yes ~ No If yes, give names and dates of birth: Name: Date of'Birth: 7. If required by the Medics] Assistance Estate Recovery Act, b2, P.S. § 1412, was a request for a statement of claim sent to the Department of Public Welfare? .............................. Yes ^ No form O('-CJ1 rer 1+3 1 ? r~~i Page ~ Of 1 Estate of ~1 NyLL15 ~ ~~,(LL~R~~AI~~,T~f l~~L.L1S~ ~. ~i.~L.L-~/~ ,Deceased 8. 'Written notice of the Audit as required by Pa. O.C. Rules 6.3, 6.7 and b.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 belaw has been ar 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 I~oti:;e 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 Natice) 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 gQp 'REEK ~o A D C'ARLi.SL~ PA 174/5' fju5~3AA1l~ ~ NONE- ,ESi~TE 1S i~so~v~ ni i Form OC-0! rev. 10.13.(16 Page 4 of 10 May S, 2008 To: AUen Ft. Falter 800 Creek Road Carlisle, PA 17013 Hand Carried RE: Estate of Phyllis F. Fuller, (AKA} Phyllis A. Fuller County code: 21-07-0311 Dear Mr. Fuller, Please be advised that the First and Final Account of Rebecca F. Afroilan, Executrix of the Estate of Phyllis F. Fuller also known as Phyllis A. Futter, No. 21-07-0311 of the year of 2007, was filed with the Orphans' Court Division of the Cumberland County Courthouse by Rebecca f, Afroilan, Executrix of the Estate on ~ Q _ A Petition for Distribution was fated at the same time. Copies of the above ment' ed ocuments are enclosed for your review and for your records. An audit will be held by the Judge of the Cumberland County Orphans' Court Division on June 17, 2008 at 9:00 a.m. If you should have any objections to this accounting, you or your attorney must file your objections in writing on or before 9:00 a.m. June 10, 2008, with the Clerk of Orphans' Court, Cumberland County, Pennsylvania. Sincerely, ~ ~Gvyt/ Rebecca F. Afroilan, Executri May 5, 2008 TO: Commonwealth of PA Dept of Public Welfare Bureau of Financial Operations Certified Mail Division of Third Party Liability Estate Recovery Program P. O. Box 8486 Harrisburg, PA 17105-8486 RE: Estate of Phyllis F. Fuller, (AKA) Phyllis A. Fuller County Code: 21-07-0311 Dear Ms. Wilson, Please be advised that the First and Final Account of Rebecca F. Afroilan, Executrix of the Estate of Phyllis F. Fuller also known as Phyllis A. Fuller, No. 21-07-0311 of the year of 2007, was filed with the Orphans' Court Division of the Cumberland County Courthouse by Rebecca F. Afroilan, Executrix of the estate on ~ ~ a~g A Petition for Distribution was filed at the same time. Copies of the above mentio d documents are encbsed for your review and for your records. An audit will be held by the Judge of the Cumberland County Orphans' Court Division on June 17, 2008 at 9:00 a.m. If you should have any objections to this accounting, you or your attorney must file your objections in writing on or before 9:00 a.m. June 10, 2008, with the Clerk of Orphans' Court, Cumberland (:ounty, Pennsylvania. Sincerely, ,_ ~CC~~ J Rebecca F. Afroilan, Executr' IN RE: FIRST AND FINAL IN THE COURT OF COMMON PLEAS ACCOUNT OF THE ESTATE :CUMBERLAND COUNTY PENNSYLVANIA OF PHYLLIS F. FULLER, (AKA) :ORPHANS' COURT DIVISION PHYLLNS A. FULLER NO. 21-07-0311 CERTIFICATION PURSUANT TO RULE 6.3.1 1, the undersigned, do hereby certify that written notice of the date, time and place of presentation in the account for Audit and Proposed Statement of Distribution has been given at least twenty (20) days prior to the date fixed for presentation and to every other person known to the accountants to have claim and interest as beneficiary, creditor, heir or next of kin. The notice states that a copy of the First and Final Account and the proposed schedule of distribution is attached and contains the date of audit of June 17, 2008 and the date by which to file objections of June 10, 2008. Said notices were sent by Certified Mail, on n'lay ~~ ~j~ This verification is given pursuant to Local Rule 6. 3. 1 of the Orphans' Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania. Executrix for the Estate of Phyllis F. Fuller, (AKA) Phyllis A. Fuller By: Rebecca F. Afroilan, Execut 1302 Old Wilmington Rd. Coatesville, PA 19320-1661 610-857-0065 Estate of_~k4~LL1$ ~ ~t(tL£tPr1 AIIA~., ~j N~GLI$ /~,~i(LL~IQ ,Deceased 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. NO~/~ fIPP.c.s'~A6LF C'. State why a Petition for GuardianlTrustee Ad Litem has or has not been filed for this Audit (see Pa. O.C. Rule 12.4). D. If distribution is to he 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. ~/o.r~ ~P~~ 1 ~~at ~ Forts oc-ot rev. 1P.13.06 Page 5 of 10 Estate of ~j-fI f~lLlS F LGl[L~R ~,QkA~~r t~S~L[35 {~: t~LL~/2 ,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. ~ti`ume and Address of Each Claimant Amount of Clnim Claim .9dmitted:' Will Claim Be Paid In full'' ~DmmO NuJEA~7N D-= +~ai.' O~ t~ilB~~C /,fI~G~l9RE ~li/ ~ `79. /r' S i Yes ^Yes (3u,PFaK oc' F~,/ptyt'1AL OP~,PATOn! No ~No ~s V TS.e.t?'N p~ 7Fl~R~D~+?~!j („I~l{Ql'L 1 }I Es7r'~ ~ ~ ~i FCD/gRl~ ^~'b~RA~ R . a~x ~~18~o J A QYes []Yes ^No ^ No ^Yes ^Yes []No ^No ©Yes ^Yes ^No ^ No 1_f the estate is insolvent, attach a schedule setting forth the order of preference under 2(1 Pa.C.S. § 3392 and the proposed paym nts. l S~'E EXfi<1 i81"'7 'A ~~ 1 1. Was family exemption claimed? ................................ ^Yes ~No Was family exemption allowed? .............. . ................. ^Yes ^No Family exemption claimant's name and relationship: Name Relationship: FormOC-01 rer. l(1.13.1t6 Page 6 of 10 EX N [ g IT ,~ f~" PRORATED EXPENSES AS FOLLOWS: UNRESERVED NON-.IUDGMENTAL EXPENSES ENTITLED TO PRO-RATA SHARE PURSUANT TO 23 PA. C.S.A. §3392 (3) AND (6) AT 100 PERCENT BALANCE OF CASH ON HAND TOTAL OF UNPAID EXPENSE NET BALANCE 4 079.55 10/23/07 COMMONWEALTH OF PA. DEPT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DIVISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM P.O. BOX 8486 HARRISBURG, PA 17'105-8486 LESS -4 079.55 EXPENSES UN-PRORATED AMOUNT 4 079.55 0.00 ~. 1009b PRO-RATED AMOUNT 4 079.55 TOTAL TO BE PAID FOR PRO-RATED CLAIMS AGAINST THE ESTATE 23 PA. C.S.A. § 3392 (3) AND (6). 6~ Estate of _ ~~l-~~LL1 S % ~bt LLf.R ~A11~~ f~N ~L LT 5 A• {-r,I LL ~iQ ,Deceased l2. The amount of Pennsylvania Transfer Inheritance Tax and additional Pennsylvania Estate Tax paid, the dates} of payment(s), and the interest(s) upon which paid, are as follows: Date Payment Interest ~ ~C• ~. BOO NoN~" NDn~~ '7brR+. ~o,~crzaya=~V/5,/7a.d~/ NSOL'1/Ent% ES.~i ~ 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? ................... Q Yes ~ 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 sta±e the position of +.l:e Petitioner(s) as to each question: No~/,~ B. Has notice of the question requiring adjudication been given to the parties identified in Paragraph 9 above? .................. Yes ^ No 15. If Petitioner(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 ,-e,~. ro ~ x.06 Page 7 of 10 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIYISION Po sox 2ao6o1 WIRRISBURG PA 17128-86D1 REBECCA F AFROILAN 1302 OLD WILMINTON RD COATESVILLE PA 19320 DATE 03-10-2008 ESTATE OF FULLER PHYLLIS A DATE OF DEATH 03-01-2007 FILE NUMBER 21 07-0311 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 05-09-2008 (See reverse side under Objections ) Aaount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~1 RETAIN LOWER PORTION FOR YOUR RECORDS E~ REV-1547 EX AFP C03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF FULLER PHYLLIS A FILE N0. 21 07-0311 ACN 101 DATE 03-10-2008 TAX RETURN WAS: (X) ACCEPTED AS FILED C ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) 7. Transfers (Schedule G) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Nai Value of Estate Subiect to Tax C13) . 00 c14) 30.00 - NOTE: If an assesssent 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 Lirle 14 taxable at Lineal/Class A rate 17. Aaount of Line 14 at Sidling rate 18. Amount of Lirie 14 taxable at Collateral/Class B rate 19. Principal Tai; Due T6Y f DCTTTC. (15) 00 X c16) . oo x (1n • 00 x (18) .00 X 00 _ .00 045 = .00 12 = .DO 15 _ .00 c19)= . 00 C COON C+ AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (06-05) TOTAL TAX CREDIT .OD BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 (1) .00 NOTE: To insure proper (2) .00 credit to Your account, 00 submit the upper portio (3) . of this form with your (4) .00 tax payment. c5) 15, 142.24 c6) .00 c7) .00 (g) 15, 142.24 11,045.31 C9) (1D) 4.126, 93 (11) 1F.172.24 clz) 30.00- ^ IF PAID AFTER DATE INDICATED, SEE REVERSE C IF TOTAL DUE IS LESS THAN il, NO PAYMENT IS REQUIRED. ---~~ •- -------•••• -••~---..~ er Tn•'u nnr •o nrr, crTC,~ •c A ,.1'DCTTT„ Irpl. Vnll MAV AF nUF Estate of_ ~~H~LLIS ~ FuzeER ~RKA~ '~i N~?~L7's {~ FU ~ ~~ ,Deceased lb. Had the decedent been adjudicated an incapacitated person? .......... [~ Yes ~ 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. ~On/~ B. Has notice of the additional receipts and disbursements been given to the parties identified in Paragraph 9 above? ............. ^ Yes ~ No 18. If a reserve is requested, state amount and purpose. amount: ~~~, 5QI Purpose: /Q ~ ~ ,BALANCE O F R,OmIN?'STIC~A 71 v~ ~'kP~1/sFS, ~3gLAIrCF Dui FOR /~CC4~lNT~t? F6ESj ?r E.ZmBcLRS~rnEU~ FOR ~u of ERAG r~pu/ERs. Anp ~oR o ~NFR /y! ~s~~tc ft ntFDUS Z U~ ~XpE~I'S~S~ I P~ ~1 L1 NG f-FE-s~ l 1pAV~L<~ R Om3nlS~RA 'CGS , AGF' ¢ E?C . 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? ........................................ ©Yes [JNo If so, attach a copy of the notice. 14. Is the Court being asked to direct the filing of a Schedule of Distribution? .......................... Yes No As to real estate only? • ... • • • • • • • • • • • • ~~ es ~No Form c~c-al rer. ID.13 06 Page 8 of 10 Estate of_~},lytLZ$ F. F~(LLf~ (/~~A, ~{~4~LLIS A. fc(L~~R ,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) B. Principal: Proposed Distributee(s) _A~L EN H. f~r~c~R. tlc%Str~NO Amount/Proportion iNE E57/~Tf ..t.5 ?~/SvL UE'~T' Amount/Proportion ~~ 7NF ~sTffT~ S5 SNSot- U~/V~ Submitted By: (A[l petitioners must sign. Add additional lines if necessary): .~ ~~ Nam f Petitioner:~i ErQE F AG~f'01Lf1 J ,~ylF"C~f7~P-~.X Name of Petitioner: Form OG01 rev. IOJ3A6 Page 9 of 10 4 Estate of P~i~LL1 S f ~/~(L C £lQ l,,~f1 f(fl~, ~j l-~ SELL 1.5 {~. ~i{LL ~'~ ,Deceased Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies * jthat lie%he SNP is title 7~~ ~XE'Cl(7R~~_ of the above-named ~»~~t;~- ,~STA ~ E 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). ~GL- Sign tore of Petitioner FBEeCi9 ~ AFROZ L A~ ~XE~ tl,-rRi-x * 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 farm Petition authori:red by the Supreme Court, and that no changes to the form have been made beyond the responses herein. Signature of Counsel for Petitioner S'u Bins T r~0 t,.L-'Tyo~ ~DUNS~L Form OC-01 rev. 10.13.06 Page ]0 of (0 IN RE: FIRST AND FINAL IN THE COURT OF COMMON PLEAS ACCOUNT OF THE ESTATE :CUMBERLAND COUNTY PENNSYLVANIA OF PHYLLIS F. FULLER, (AKA) :ORPHANS' COURT DIVISION PHYLLIS A. FULLER NO. 21-07-0311 CERTIFICATION PURSUANT TO RULE 6.3. 1 I, the undersigned, do hereby certify that written notice of the date, time and place of presentation in the account for Audit and Proposed Statement of Distribution has been given at least twenty (20) days prior to the date fixed for presentation and to every other person known to the accountants to have claim and interest as beneficiary, creditor, heir or next of kin. The notice states that a copy of the First and Final Account and the proposed schedule of distribution is attached and contains the date of audit of June 17, 2008 and the date by which to file objections of June 10, 2008. Said notices were sent by Certified Mail, on This verification is given pursuant to Local Rule 6. 3. 1 of the Orphans' Court Division of the Court of Common Pleas of Cumberland County, Pennsylvania. Executrix for the Estate of Phyllis F. Fuller, (AKA) Phyllis A. Fuller ~~ By: Rebecca F. Afroilan, Executr 1302 Old Wilmington Rd. Coatesville, PA 19320-1661 610-857-0065 IN RE: ESTATE OF PHYLLIS F. FULLER (AKA) PHYLLIS A. FULLER, DECEASED IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-07-0311 ORDER AND NOW, this day of proper notice having been given of the filing of the First and Final Account in the above-captioned matter and of the call thereof for audit and no objections having been filed, the account is hereby confirmed and distribution decreed in accordance with the proposed Schedule of Distribution. This is a nisi order which shall become absolute as of course unless written exceptions are filed within ten (10} days after the date of the filing hereof. Judge of the Orphans' Court Division Certified from the record As Absolute Clerk of the Orphans' Court Division