The URL can be used to link to this page

Home My WebLink About05-15-08 D - \ Do~'lS ,D~ G - \D3~1~ ,()\o o IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA. ORPHANS' COURT DIVISION FILE NO. 21-07-0248 FIRST AND FINAL ACCOUNT OF Sue H Clark David Harris Executors For ESTATE OF Esther I. Harris, Deceased Date of Executor's Appointment Date of First Complete Advertising: Accounting for the Period: March 09,2007 March 14,2007 March 28, 2007 March 09, 2007 April 17, 2008 to Date of Death: Purpose of Account: The Executor offers this Account to acquaint interested parties with the transactions that have occurred during the Administration. It is important that the Account be carefully examined. Requests for additional information, questions or objections can be discussed with: David H. Stone, Esquire 414 Bridge Street New Cumberland, P A 17070- (717) 774-7435 Supreme Court I.D. No. 39785 o c=;O ::u '-r1 ::to : ~r~ Sl u,,'...?.... 00 (:),1 C - ::D --I :E ", c:::,) ,C::';J c"!.:.) ---:-"1 :31: ;:p,. -< r^'~, f~~~ ('J') r:-.i ~;'l CJl ::t:Joo 3: ... en SUMMARY OF ACCOUNT PAGES PRINCIPAL Receipts 3 $ 130,987.21 Less Disbursements Administration Cost 5 921.61 Federal and State Taxes 5 4,871.34 Fees & Commissions 5 5,930.00 Funeral Expenses 5 12,000.00 Miscellaneous Expenses 5 1,117.71 Personal Expenses 5 36.00 Property Costs 5 410.74 Selling Costs 5 1,824.75 -$27,112.15 Balance before Distributions 103,875.06 Distribution to Beneficiaries 7 103,875.06 Principal Balance on Hand $0.00 For Information: Investments Made Changes in Holdings 8 INCOME Receipts 0.00 Less Disbursements 0.00 Balance Before Distributions 0.00 Distributions to Beneficiaries 0.00 Income Balance on Hand 10 0.00 COMBINED BALANCE ON HAND 0.00 Verification 10 2 PRINCIPAL RECEIPTS Assets Listed in inventory (Valued as of Date of Death) Cash and Cash Equivalents Blue Cross/Blue Shield-refund check Cash on hand Fulton Bank-Checking Acct. #3619-50365, David Harris and Sue H. Clark, Power of Attorney P A State-refund Peerless Insurance-car insurance refund Peerless Insurance-homeowners ins refund Peerless Insurance-insurance refund Railroad pension check received Readers Digest-refund Walmart-perscription refund Real Estate Property located at 422 4th St. New Cumberland, Cumberland County, P A sold to Michael R. Shuff and Barbara 1. Shuff, his wife on August 23, 2007 TOTAL INVENTORY 3 $ 96.80 12,000.00 954.06 250.00 97.00 121.74 14.78 413.36 15.98 23.49 $ 13,987.21 117,000.00 $ 130,987.21 PRINCIP AL GAINS OR LOSSES ON SALES OR OTHER DISPOSITIONS GAIN LOSS 08/23/2007 Property located at 422 4th St. New Cumberland Net Proceeds Fiduciary Acquisition Value $ 117,000.00 117,000.00 TOTALS $0.00 $0.00 NET GAIN TRANSFERRED TO SUMMARY $ 0.00 4 DISBURSEMENTS OF PRINCIPAL ADMINISTRA nON COST 04/05/2007 PPL-electric at residence 04/05/2007 UGl-gas service at residence 04/05/2007 P A WC-water service at residence 04/26/2007 UGl-gas service at residence 05/01/2007 PP&L-electric at residence 05/12/2007 PA WC-water service at residence OS/23/2007 UGl-gas service at residence 06/03/2007 PP&L-electric services at residence 06/13/2007 P A WC-water service at residence 06/23/2007 New Cumberland Bora-trash/sewer at residence 06/26/2007 UGl-gas service at residence 07/02/2007 PP&L-electric service at residence 07/12/2007 P A WC-water service at residence 07/24/2007 UGl-gas service at residence 08/01/2007 PP&L-electric service at residence 08/16/2007 PA WC-water service at residence 08/23/2007 UGl-gas service at residence 09/03/2007 PP&L-electric service at residence 09/03/2007 UGl-gas service at residence 09/03/2007 P A WC-water service at residence 10/02/2007 UGl-gas service at residence FEDERAL AND STATE TAXES 03/19/2007 Robin Gasperetti-taxes on property 12/07/2007 Register of Wills, Agent-inheritance tax due FEES & COMMISSIONS 12/07/2007 Stone LaFaver & Shekletski-Attomey's fee 04/17/2008 Stone LaFaver & Shekletski-bal due on Atty fee FUNERAL EXPENSES 03/12/2007 Don Allen, Inc.-funeral expenses in West Virginia 03/12/2007 Parthemore Funeral Home-funeral expenses 03/15/2007 Travel, meals, & lodging expo from WV & NY to PA 5 $ 30.76 133.75 30.23 133.75 13.66 15.03 133.75 13.36 15.03 64.80 81.87 11.20 12.03 34.84 40.84 40.81 46.87 19.83 23.62 15.83 9.75 $ 921.61 9.80 4,861.54 4,871.34 3,000.00 2,930.00 5,930.00 4,287.05 5,240.64 2,472.31 12,000.00 DISBURSEMENTS OF PRINCIPAL (Continued) MISCELLANEOUS EXPENSES 03/15/2007 Checks written but not cleared until after death 03/19/2007 MCI-te1ephone service at property 03/19/2007 Bank of America- 04/17/2007 MCI-telephone service at residence 05/12/2007 MCI-telephone service at residence 06/13/2007 MCI-telephone service at residence 07/26/2007 MCI-te1ephone service at residence 08/19/2007 MCI-te1ephone service at residence 09/08/2007 MCI-te1ephone service at residence 12/07/2007 Stone LaFaver & Shek1etski-Reimb. on advertising 12/07/2007 Stone LaFaver & Shek1etski-Reimb. on tax cert 12/07/2007 Register of Wills- filing Inheritance Tax Ret & Inv 12107/2007 Stone LaFaver & Shek1etski-Reimb on 7 FEDEX 04/17/2008 Register of Wills-filing First and Final Acct 04/17/2008 Reserve for closing expenses PERSONAL EXPENSES 11/27/2007 Quantum Medical Imaging-services rendered PROPERTY COSTS OS/27/2007 Charlie Gethouas-Iawn care at residence 06/13/2007 Peerless Insurance-homeowners premium 07/12/2007 Peerless Insurance-homeowners insurance 07/21/2007 Charlie Gethouas-Iawn care at residence 08/19/2007 Peerless Insurance-premium SELLING COSTS 08/23/2007 Settlement charges ($2755.49) less reimb. (930.74) TOTAL DISBURSEMENTS OF PRINCIPAL FORWARD 148.55 33.90 16.50 34.30 34.12 35.16 35.31 35.99 14.42 209.46 5.00 30.00 105.00 180.00 200.00 36.00 100.00 109.80 50.47 100.00 50.47 1,824.75 6 $23,871.50 1,117.71 36.00 410.74 1,824.75 $ 27,112.15 08/28/2007 04/1 7/2008 08/28/2007 04/1 7/2008 08/28/2007 04/17/2008 DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES TO: Ann M Harris Trust Partial distribution Fulton Bank-Estate Checking Acct. #3622-92028 Distribute cash in the amount of$33,000.00 to Ann M Harris Trust TO: Ann M Harris Trust Residue Fulton Bank-Estate Checking Acct. #3622-92028 Distribute cash in the amount of$I,625.02 to Ann M Harris Trust TO: David Harris Partial distribution Fulton Bank-Estate Checking Acct. #3622-92028 Distribute cash in the amount of$33,000.00 to David Harris TO: David Harris Residue Fulton Bank-Estate Checking Acct. #3622-92028 Distribute cash in the amount of $1 ,625.02 to David Harris TO: Sue H Clark Partial distribution Fulton Bank-Estate Checking Acct. #3622-92028 Distribute cash in the amount of$33,000.00 to Sue H Clark TO: Sue H Clark Residue Fulton Bank-Estate Checking Acct. #3622-92028 Distribute cash in the amount of$I,625.02 to Sue H Clark TOTAL DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES 7 $ 33,000.00 1,625.02 33,000.00 1,625.02 33,000.00 1,625.02 $ 103,875.06 CHANGES IN PRINCIPAL HOLDINGS ACCOUNT VALUE Property located at 422 4th St. New Cumberland 03/09/2007 Inventoried Value 08/23/2007 Sold, carried at $117,000.00 No Longer Held $ 117,000.00 -$117,000.00 $0.00 8 Proposed Distribution for the Estate of Esther I. Harris Distribution of Estate David Harris Cash Dist. made Balance to distribute Total Distribution Sue H. Clark Cash Dist. made Balance to distribute Total Distribution Ann M. Harris Trust Cash Dist. made Balance to distribute Total Distribution Total Distribution Balance in account $33,000.00 1,625.02 $34,625.02 $33,000.00 1,625.02 $34,625.02 $33,000.00 1,625.02 $34,625.02 $103,875.06 $103,875.06 $ .00 STATE OF NEW YORK SS: COUNTY OF ()/lOl\. David Harris, Co-Executor under the Last Will and Testament of Esther I. Harris, deceased, hereby declares under oath (penalties of perjury) that he has fully and faithfully discharged the duties of his 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 paid in full; that, to his knowledge, there are no claims now outstanding against the estate; and that all taxes presently due from the estate have been paid. -Executor Sworn to and subscribed before me this ,~- day of ~, 20.08. ~o 'J ~ .. pL~,-__ .4'. [1r~ . otary Publlc DEBRA A. DIXON Notary Public in the State of New York Qualified In Onon. Co. No. 4683629 My Commission expires December 31, dol c) 9 STATE OF WEST VIRIGINA SS: COUNTY OF Sue H. Clark, Co-Executor under the Last Will and Testament of Esther I. Harris, 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 paid in full; that, to her knowledge, there are no claims now outstanding against the estate; and that all taxes presently due from the estate have been paid. '-L~i 1 ) 1'/. (!~l. c~fLJu Sue H. Clark, Co-Executor Sworn to and submcribed befor~t1 this ~ day of C; ,2008. ~~. 10 PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 COMMONWEALTH OF PENNSYLVANIA ss. COUNTY OF CUMBERLAND Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid, was established January 2, 1952, and designated by the local courts as the official legal periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly issued weekly in the said County, and that the printed notice or publication attached hereto is exactly the same as was printed in the regular editions and issues of the said Cumberland Law Journal on the following dates, VIZ: March 30, April 6, and April 13, 2007 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. Hanis. Esther I.. dec'd. Late of the Borough of New Cumberland. Executors: Sue H. Clark. 5005 Northwest Way, Hurricane, WV 25526 and David Harris. 4658 Glencliffe Road. Manlius, NY 13104. Attorneys: David H. Stone, Es- quire. Stone LaFaver & Shek- letski. P.O. Box E, New Cum- berland, PA 17070. SWORN TO AND SUBSCRIBED before me this 13 day of April. 2007 NOTARIAL SEAL LOIS E. SNYDER, Notary Public Carlisle Boro, Cumberland County My Commission Expires March 5, 2009 THE PATRIOT NEWS THE SUNDAY PATRIOT NEWS Proof of Publication Under Act No. 587, Approved May 16,1929 Commonwealth of Pennsylvania, County of Dauphin} ss Joseph A. Dennison, being duly sworn according to law, deposes and says: That he is the Assistant Controller of The Patriot News Co., a corporation organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal office and place of business at 812 to 818 Market Street, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot- News and The Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, County and State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever Slllce; That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular daily and/or Sunday/ Metro editions which appeared in 28th day(s) of March and the 4th and 11th day(s) of April 2007. That neither he nor said Company is interested in the subject matter of said printed notice or advertising, and that all of the allegations of this statement as to the time, place and character of publication are true; and That he has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the stockholders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds in and for said County of Dauphin in Miscellaneous Book "M", Volume 14, Page 317. PUBLICATION COPY Sworn to and subscr' d .' . EXIiCUTOR'S NOTICE lAINtll T~ on the Es1aIeor ~t. ~ Iaht or the BOI1IUlIII of ~~ CUmberland County .~. "JlIIItI or PennsYlvania, ~~beenlll"CllltlldJotheun . ~',.'" AD ~Itldebhtd to the said Estate a"~;,,, make ImllHldlaht pay . ' mentOlllltllill!ilitillaYl.. dOImswm... . tIIII'....~delayto: -"-'QiIn .....T ~., ~t.:.. ~l'~ &-....... .....1l ......... PA 1JIJt STONE, LAF AVER & SHEKLETSKI 414 BRIDGE STREET P.O. BOX E NEW CUMBERLAND, PA. 17070 INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYL VANIA COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } SS File Number 21 07 0248 Personal Representative(s) of the Estate of Esther I. Harris deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this inventory. I verify that the statements made in this Inven- tory are true and correct. I understand that false state- ments herein are made subject to the penalties of 18 Pa. c.s. S 4904 relating to unsworn falsification to authorities. } )d(/YJ ;/. ~_/-0 Sue H. Clark, Co-Executrix David Harris, Co-Executor Attorney -- (Name) David H. Stone, Esquire (Address) 414 Bridge Street (Telephone) (717) 774-7435 (Supreme Court I.D. No.) 39785 New Cumberland PA 17070- DATE OF DEATH LAST RESIDENCE 5005 NW Way Hurricane DECEDENT'S SOC. SEC. NO. 3/9/2007 WV 25526 183-18-7122 FIGURES MUST BE TOTALED Fulton Bank-Checking Accl. #3619-50365 Etonatd P. Harris and Sue H. Clark, Power of Attorney JU\lId Property located at 422 4th Sl. New Cumberland Cumberland County, PA sold to Michael R. Shuff and Barbara J. Shuff, his wife on August 23,2007 954.06 117,000.00 Peerless Insurance CO.-refunds on homeowners and car insurance 233.52 Railroad pension check received "-> '= = ----- o /"T1 C"') o ~J ;..r--1 i,~~~~;! I~"~':': 41.3.36 Cash on hand ~12,ddo.oo ;; 1-1 . r't -u ::It - .. ~ W (Attach additiollal sheets as Ileeded) TOT AL: 130,600.94 ",OTE: The Memorandum orreal estate outside the Commonwealth or Pennsylvania may, at the election of the personal representative include the value of each Item. but such tlgures should 110t be extended into the total oflhe Inventory. ISet'::1J I'll. c.s. J 331J/lh)) Form RIV-1J9 rt'\'. /1!./3,lJn 7143869 10:42:17 a.m. 12-06-2007 5/18 INVENTORY REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYL V ANlA COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } 55 File Number 21 01 0248 Personal Representative(s) of the Estate of Esther I. Harris deceased, depose(s) and say(s) that the items appearing in the following inventory include all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said inventory represents its fair value as of the date of the decedent's death, and that Decedent owned no real estate outside of the Commonwealth ofPennsyJvania except that which appears in a memorandum at the end of this inventory. I verify that the statements made in this Inven- tory are true and correct. I understand that false state- ments herein are made subject to the penalties of 18 Pa. e.s. ~ 4904 relating to unsworn falsification to authorities. } ~~~Ct;? X An,). o . Harris, Co- utor ~ Attorney -- (Name) David H. Stone, ESQuire (Address) 414 Bridge Street (Telephone) (717) 774-7435 (Supreme Court J.D. No.) 39785 New Cumberland PA 17070- DATE OF DEATH LAST RESIOENCE 5005 NW Way Hurricane WV 25526 I FIGURES MUST BE TOTALED I DECEDENTS SOC. SEC. NO. 3/9/2007 183-18-7122 Fulton Bank-Checking Acct. #3619-50365 Donald P. Harris and Sue H. Claric:, Power of Attorney (Should be David Harr~s~ Property located at 422 4th S1. New Cumberland Cumberland County, PA sold to Michael R. Shuff and Barbara J. Shuff, his wife on August 23,2007 954.06 117,000.00 Peerless Insurance CO.-refunds on homeowners and car insurance 233.52 Railroad pension check received 413.36 Cash on hand 12,000.00 (Antlc" tldditionill slreetJ tlS needed) TOTAL: 130,600.94 '0 fE fhe \knlOrJnJum ot' r~JI (~'at~ ,lU(SIJe the (\muTl<>n\\ (Jlth oJ' P~nnsy I, an;a may. Jtthe de~llon ot' thc persunal reprc5<nt.lI"'c lOdllllc Ihe 'allle ", e;!Co '!(IT'. hut >11.:0 figures .h,'uIJ iWI ~ nl(nJ(J IIlfU the I,)(al Mlhe In\~ntol") ,'i..,. _'01'.,. C S .13)11/1"11 F,}/"III RW.IiY r",' ili 1.11'1> , DECEASED o :;:;0 '-:0 ')'-a 1-;"0 ~r- ,2rT1 , r; ::n r 11.....~/, . '-J ~~ :::2--1 DECEDENT'S ESTATE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA ORPHANS' COURT DIVISION ESTATE OF ESTHER I. HARRIS No. 21-07-0248 PETITION FOR ADJUDICATION / ST A TEMENT OF PROPOSED DISTRIBUTION PURSUANT TO Pa. O.c. Rule 6.9 Ul :no. :.t:: - - .. .c- O) 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: David H. Stone, Esquire Supreme Court I.D. No.: 39785 Name of Law Firm: Stone LaFaver & Shekletski Address: 414 Bridge Street Telephone: 717-774-7435 Fax: 717-774-3869 Form DC-Ol rev. 10.13.06 Page 1 of 10 "'-, = Co.",::> Ol.:> :'""ll" i:;; -< o :X"J !1i fTl C) rQ '::; c-J f(-l c:; ~;..') :,{J ~~,-) _. , rl '--::> '. ') Estate of ESTHER 1. HARRIS , Deceased 1. Name(s) and addressees) ofPetitioner(s): Name: David Harris Sue H . Clark Address: 4658 Glencliffe Rd 5005 NW Way Manlius, NY 13104 Hurricane, WV 25526 Identify any executors or administrators who have not joined in the Petition for Adjudication and Statement of Proposed Distribution and state reason: N/A Is this the first accounting by this fiduciary? . . . . . . . . . . . . . . . . . . . .. [Z] Yes 0 No If not, identify prior accountings, the accounting periods covered, and the date of adjudication of the prior accounting. 2. Decedent died on March 9, 2007 [Z] Letters Testamentary or o Letters of Administration were granted to Petitioner(s) on March 14. 2007 Date of Will (ifapplicable): July 26,1983 Date(s) ofCodicil(s) (ifapplicable): N/A Date of probate (if different from date Letters granted): N/ A Was a bond required? oYes [Z] No If yes, state amount: Are proofs of advertising of the grant of Letters attached? ......... [Z] Yes 0 No Dates of advertising of the grant of Letters: Cumberland Law Journal March 30 , April 6 & 13,2007 and The Patriot News Co. March 28, April 4 & 11,2007 Form DC-OJ rev. JO.13.06 Page 2 of 10 Estate of ESTHER I. HARRIS , Deceased 3. Was decedent survived by a spouse? . . . . . . . . . . . . . . . . . . . . . . . . . . . .. DYes ({] No If yes, name of the surviving spouse: 4. Has the surviving spouse filed to take an elective share? ............. DYes ({]No (See Section 2201 et~. of the Probate, Estates and Fiduciaries Code) If yes, date of election: 5. In the case of an intestacy, state the names of the decedent's surviving children or surviving issue of deceased children (if none, so state): N/A 6. Did decedent marry after execution of Will orCodicil(s)? ........... DYes ({] No Were any children born to decedent after execution of Will or Codicil(s)? .. . .. . .. . . . . . . . . .. .. . . . . .. .. . . . .. . . .. . . . . .. DYes ({] 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. 9 1412, was a request for a statement of claim sent to the Department of Public Welfare? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ({]Yes D No Form DC-OI rev. 10.13.06 Page 3 of 10 Estate of ESTHER I. HARRIS , 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 Relationshin and Comments, if any Interest David Harris 4658 Glencliffe Rd. Manlius, NY 13104 son 1/3 Sue H. Clark 5005 NW Way Hurricane, WV 25526 daughter 1/3 Form OC-OI rev. 10.13.06 Page 4 of 10 Estate of ESTHER 1. HARRIS , Deceased Name alld Address of Each Party in Illterest Relationshio and Comments, if any Interest Ann M. Harris Trust Sue H. Clark, Co-Trustee 5005 NW Way Hurricane, WV 25526 daughter 1/3 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. N/A C. State why a Petition for Guardian/Trustee Ad Litem has or has not been filed for this Audit (see Pa. O.c. Rule 12.4). 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. N/A Form OC-OI rev. 10.13.06 Page 5 ofl 0 Estate of ESTHER 1. HARRIS , 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? N/A 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. 9 3392 and the proposed payments. 11. Was family exemption claimed? DYes IZINo IZINo Was family exemption allowed? DYes Family exemption claimant's name and relationship: Name: Relationship: Form OC-OI rev. 10.13.06 Page 6 of 10 Estate of ESTHER 1. HARRIS , 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: Dale Payment Interest 12-07-07 4,861.54 .00 13. On the date 0 f death, was the decedent a fiduciary (personal representative, trustee, guardian, agent under power of attorney) or surety on the bond ofa fiduciary? .., .. .. .. . . . . . .. . .. DYes 0 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: N/A B. Has notice of the question requiring adjudication been given to the parties identified in Paragraph 9 above? .................. DYes 0 No 15. 1 f 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-OJ rev. JO.J3'()6 Page 7 of 10 Estate of ESTHER I. HARRIS , Deceased 16. Had the decedent been adjudicated an incapacitated person? . . . . . . . . . . D Yes [l] No I f 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. N/A B. Has notice of the additional receipts and disbursements been given to the parties identified in Paragraph 9 above? ............. DYes [l] No 18. If a reserve is requested, state amount and purpose. 200.00 Amount: I'll/pose: closing expenses 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? [l]Yes DNo As to real estate only? ....................................... . DYes [l] No Form DC-O/ rev. 10./3.06 Page 8 of 10 Estate of ESTHER 1. HARRIS , 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 N/A B. Principal: Proposed Distributee(s) Amount/Proportion David Harris 1/3 residue Sue H. Clark 1/3 residue Ann M. Harris Trust 1/3 residue Submitted By: (All petitioners must sign. Add additional lines ifnecessary): r I~ N Name of Petitioner: Sue H . Clark Form OC-OJ rev. JO.13.06 Page 9 of 10 Estate of ESTHER 1. HARRIS , 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 N/A B. Principal: Proposed Distributee(s) Amount/Proportioll David Harris 1/3 residue Sue H. Clark 1/3 residue Ann M. Harris Trust 1/3 residue Submitted By: (All petitioners must sign. Add additional lines ifnecessary): Name of Petitioner: David Harris xiu.J #. (!L O-/L.'- Name of Petitioner: Sue H . Clark Form OC-O/ /"(T /1i./3.()(j Page 9 of 10 Estate of ESTHER I. HARRIS , Deceased Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies * [that he/she Iu..... IS title to t~~ of the above-named name of corporation ~ 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. S 4904 (relating to unsworn falsification to authorities). JMn~t{j~ Signature of Petitioner * Corporate petitioners must complete bracketed information. Certification of Counsel The undersigned counsel hereby certifies that the foregoing Petition for Adjudication! Statement of Proposed Distribution is a true and accurate reproduction of the form Petition authorized by the Supreme Court, and that no changes to the form have been made beyond the responses herein. Form OC-OJ rev. JO.13.06 Page 10 of 10 Estate of ESTHER I. HARRIS , Deceased Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies * [that he/she ~ IS title Co '-" ~"x:c~~ of the above-named name of corporation Jl~ri.li::. 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. S 4904 (relating to unsworn falsification to authorities). du-<-) 'Iy, "Signature of Petitioner (?( cd. .t' - * Corporate petitioners must complete bracketed information. Certification of Counsel The undersigned counsel hereby certifies that the foregoing Petition for Adjudication! Statement of Proposed Distribution is a true and accurate reproduction of the form Petition authorized by the Supreme Court, and that no changes to the form have been made beyond the responses herein. Signature of Counsel for Petitioner Form OC-O I rei'. / () / J. 06 Page 10 of 10 est\ffa\HARRISesthernot IN RE: ESTATE OF ESTHER I. HARRIS LATE OF THE BOROUGH OF NEW CUMBERLAND, CUMBERLAND COUNTY, PENNSYLVANIA, DECEASED IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-07-0248 NOTICE OF FILING ACCOUNT AND STATEMENT OF PROPOSED DISTRIBUTION NOTICE IS HEREBY GIVEN THAT David Harris and Sue H. Clark, Co- Executors of the Last Will and Testament of Esther I. Harris, deceased, has this date filed their First and Final Account and State- ment of Proposed Distribution in the above captioned Estate in the Office of the Register of Wills in and for Cumberland County, Pennsyl- vania, at Carlisle, PA 17013, where the same are filed as public records and may be inspected. Enclosed herewith are copies of the Inventory, First and Final Account and Statement of Proposed Distribution as filed, together with copies of the will. YOU are further notified that any exceptions or objections to said account or statement must be filed in writing at the Office of the Register of Wills aforesaid prior to the confirmation of said account scheduled as set forth below. UNLESS written exceptions or objections are filed prlor thereto, said account and statement will be presented to the above captioned Court in Court Room No. 1 of the Cumberland County Courthouse, Carlisle, Pennsylvania, at 9:30 A.M., prevailing time on Tuesday, June 17, 2008, at which time said account will be confirmed and distribution ordered in accordance with the Statement of Proposed Distribution. David o ::0 '=' J:C) _Do 1- -: ~ ;fJ . ~, ('~.) ~ )C)~l -)C :::0 :2-; 13104 ,....., = = co .:::z :bo -< DATE OF NOTICE: ,r;-\\l.v~ CJ1 NOTICES TO: :boo :r ~ ". , - - .. ~! . ('"'; f-' ;-ri 0" '";: ;~~~) 1. David Harris, 4658 Glencliffe Rd., Manlius, NY .:e- 0'\ 2. Sue H. Clark, 5005 NW Way, Hurricane, WV 12526 3. Ann M. Harris, 5005 NW Way, Hurricane, WV 12526