HomeMy WebLinkAbout10-24-08~yZ~Olcj . g'~
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SUMMARY OF ACCOUNT
PAGE FIDUCIARY ACQUISITION VALUE
PRINCIPAL
Receipts 1 $738,691.63
Net Gain/Loss on Sales or Other Dispositions 2 3 328.22
$742,019.85
Less Disbursements 1 -$639,115.97
Principal Balance on Hand 2 $102,903.88
Reserves/Pending 3 -$27,801.01
Principal Balance on Hand 3 $75,102.87
INCOME
Receipts 2
Less Disbursements 3 - 0.00
Income Balance on Hand 3 $37,253.04
Combined Balance on Hand for Distribution 3 $112,356.91
Schedule of Proposed Distribution 4-5 $112,356.91
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George Kaluger Estate #1260
PRINCIPAL RECEIPTS
10/24/2008
0 212 012 0 0 7 TRANSFER MONEY MARKET CASH BALANCE FROM GEORGE 8 MERIEM KALUGER ACCT # 0176 $48,919.40
02/26/2007 CONTRIBUTION RECEIVED -CHECK FROM FOGELSANGER-BRICKER FUNERAL HOME $226.71
03/02/2007 CONTRIBUTION RECEIVED -HIGHMARK BLUE SHIELD $14 39
03/02/2007 CONTRIBUTION RECEIVED -HIGHMARK BLUE SHIELD $5,278.23
03/02/2007 CONTRIBUTION RECEIVED -HIGHMARK BLUE SHIELD $4,121.17
03/08/2007 REFUND RECEIVED FROM READERS DIGEST $27 98
03!15/2007 CONTRIBUTION RECEIVED -TRANSFER CASH FROM TRUST ACCOUNT #0178 $138.36
03/19/2007 CONTRIBUTION RECEIVED -CHECK FROM HIGHMARK BLUESHIELD $24.80
03/23/2007 CONTRIBUTION RECEIVED -CHECK FROM TIME INC. SHARED SERVICES $14.44
03/26/2007 CONTRIBUTION RECEIVED -PRO-RATED FINAL PAYMENT FOR SHIPPENSBURG UNIVERSITY FOUNDATION $811.12
03/26/2007 REFUND RECEIVED FROM AT&T $2.65
04!02!2007 CONTRIBUTION RECEIVED - ANTIETAM HEALTH SERVICES $75.00
04/06/2007 CONTRIBUTION RECEIVED -PSECU CD PROCEEDS $54,501.25
04/23/2007 CONTRIBUTION RECEIVED -CHECK FROM BANK OF AMERICA FOR CD PROCEEDS $27,626.24
05/01/2007 CONTRIBUTION RECEIVED - PA ANNUITANT PA TREASURY $2,724.48
0 5/1 012 00 7 CONTRIBUTION RECEIVED - NAT'L GEOGRAPHIC SOCIETY $19.00
05/10!2007 CONTRIBUTION RECEIVED -TRANSFER FROM ORRSTOWN ACCOUNT #502448 $7,234.59
05/25/2007 CONTRIBUTION RECEIVED -CUMBERLAND COUNTY FROM VETERANS AFFAIRS OFFICE TOWARD BURIAL $100.00
06/04/2007 REFUND RECEIVED FROM READERS DIGEST $81 94
06/12/2007 REFUND RECEIVED FROM COMCAST CABLE $28 52
06/18/2007 CONTRIBUTION RECEIVED - US TREASURY TAX REFUND $6,255.31
06/25/2007 CONTRIBUTION RECEIVED -PROCEEDS FROM DAN HERSHEY AUCTION $17,928.48
07/24/2007 CONTRIBUTION RECEIVED -GOVERNMENT LIFE INSURANCE POLICY V 3372084 PROCEEDS $5,200.94
07/24/2007 CONTRIBUTION RECEIVED -GOVERNMENT LIFE INSURANCE POLICY J 81025518 PROCEEDS $5,152.86
09/10/2007 DEATH BENEFIT RECEIVED FROM NATIONWIDE LIFE INSURANCE COMPANY $12,308.98
10/09/2007 CONTRIBUTION RECEIVED -CHECK FROM LNG LIFE INSURANCE AND ANNUITY COMPANY $4,929.26
04/18/2008 CONTRIBUTION RECEIVED -CHECK FROM COMMONWEALTH OF PA $3,217.76
08/11/2008 CONTRIBUTION RECEIVED US TREASURY TAX REFUND $758.00
08/19/2008 CONTRIBUTION RECEIVED ECONOMIC STIMULUS FOR 2007 TAX YEAR $300.00
SUBSEQUENT PRINCIPAL RECEIPTS
02/21/2007 DEPOSIT 25000 PAR VALUE MBNA CD 3.86 % 08/18/2007 $25,000.00
02/21/2007 DEPOSIT 69490.93 PAR VALUE PFCU CD 4.9% 10/04!2008 $69,490.93
02/21/2007 DEPOSIT 27317.31 SHARES PSECU CD 4.5 % 08/17/2009 $27,317.31
02/21/2007 DEPOSIT 1000 PAR VALUE PSECU CD 4.25% 09!28/2007 $1,000.00
02/21 /2007 DEPOSIT 10000 PAR VALUE PSECU CD 4.15% 10/05/2007 $10,000.00
02!2112007 DEPOSIT 10000 PAR VALUE FEDERAL HOME LOAN BKS DEB 4% 06!29/2007 $9,900.00
02/21/2007 DEPOSIT 15000 PAR VALUE FEDERAL HOME LOAN BKS DEB 5% 09/22/2010 $14,725.80
02!21/2007 DEPOSIT 30000 PAR VALUE FEDERAL HOME LOAN BKS 5.5 % 09/12/2013 $29,475.00
02/21!2007 DEPOSIT 25000 PAR VALUE FEDERAL HOME LOAN BKS 4 % 10/27/2008 $24,367.25
02/21/2007 DEPOSIT 15000 PAR VALUE FEDERAL HOME LOAN BKS 5 % 05/10/2011 $14,683.65
0 2 /2 112 00 7 DEPOSIT 20000 PAR VALUE FEDERAL HOME LOAN BKS 3.565 % 04/30/2008 $19,471.90
02!21/2007 DEPOSIT 10000 PAR VALUE FEDERAL FARM CR BKS 5.05% 12/27/2012 $9,721.90
02/21/2007 DEPOSIT 15000 PAR VALUE FEDERAL FARM CR BKS 3.06 % 05!11/2007 $14,798.47
02/21/2007 DEPOSIT 25000 PAR VALUE PENNSYLVANIA ST SECOND SER 5% 05/01/2020 $26,379.88
02/21/2007 DEPOSIT 15000 PAR VALUE WEST BRANCH S!D PA4.8% 03/15/2020 $15,336.68
02/21/2007 DEP 1 SHS 625 BRENTON ST SHBG PA $217,000.00
03/23/2007 DEP 100 SHS PERSONAL PROPERTY/CONTENTS $1.00
TOTAL PRINCIPAL RECEIPTS $738.691.63
DISBURSEMENTS OF PRINCIPAL
02/20/2007 REGISTER OF WILLS, CUMBERLAND COUNTY PROBATE FEE -$545.00
03/05/2007 LEFLER ENERGY MONTHLY BALANCE DUE FOR GEORGE KALUGER -$173.00
03/08/2007 MAGISTERIAL DISTRICT NO. 09-03-01 FAILURE TO REMOVE SNOW AND ICE ON -$86.00
03/13/2007 NANCY'S LOCK & KEY SERVICE BALANCE DUE FOR CHANGING LOCKS AT THE -$84.99
03/22/2007 PENELEC BALANCE DUE FOR THE KALUGER ESTATE -$207.25
04/06/2007 LEFLER ENERGY MONTHLY BALANCE DUE FOR THE KALUGER ESTATE -$173.00
04/16/2007 PENNSYLVANIA DEPARTMENT OF REVENUE PAYMENT ENCLOSED -$183.00
04/19/2007 HAWKIN'S CONSTRUCTION COMPANY SNOW REMOVAL FOR FEBRUARY AND MARCH 2007 -$315.00
04/24/2007 COLLEGE TOWN, INC. VALLEY HEATING AND COOLING, LLC -$665.56
04/24/2007 CUMBERLAND LAW JOURNAL ADVERTISEMENT MARCH 9, 16, & 23, 2007 -$75.00
04/26/2007 TRACY MCMICHAEL AMOUNT OWED TO TRACY FOR 14 HOURS OF -$196.00
04/26/2007 AMY YEAGY AMOUNT OWED TO AMY FOR 2 DAYS OF -$250.00
05/04/2007 GLENN NAVE FOR MOWING GRASS -$25.00
05/04/2007 S.W. BARRETT REAL ESTATE & APPRAISAL APPRAISAL FEE FOR 625 BRENTON STREET -$325.00
05!07/2007 REGISTER OF WILLS, CUMBERLAND COUNTY GEORGE KALUGER ESTATE -$37,601.81
05/09/2007 EQUIPPED FOR LIFE BALANCE DUE FOR GEORGE KALUGER -$35.00
05/09/2007 SHIPPEN CLEANERS BALANCE DUE FOR GEORGE KALUGER -$14.10
05/10/2007 COMCAST CABLE OUTSTANDING BALANCE DUE FOR THE -$28.52
05/16/2007 EMBARQ GEORGE KALUGER 717-532-5430-904 -$42.96
05/16/2007 FAYETTEVILLE VOLUNTEER FIRE DEPT. GEORGE KALUGER / RUN #06-71307 -$470.00
0 5/1 712 00 7 AT&T GEORGE KALUGER _$6.11
05/17!2007 COMCAST CABLE GEORGE KALUGER _$28.52
05/17/2007 BOROUGH OF SHIPPENSBURG GEORGE KALUGER -$94.85
05/17/2007 GLENN NAVE FOR MOWING THE LAWN -$25.00
05/18/2007 PENELEC GEORGE KALUGER -$65.71
05/29/2007 COMMONWEALTH OF PENNSYLVANIA STATE EMPLOYEES' RETIREMENT SYSTEM -$7,356.10
~ George Kaluger Estate #1260
05/29/zoo7
05/31/2007
0 6/1 412 0 0 7
06/19/2007
06/20/2007
06!21/2007
06!25!2007
06/25!2007
07/18/2007
07!18/2007
07!20/2007
0720/2007
07/24/2007
07/26/2007
07126!2007
08/07/2007
08/10/2007
08120!2007
08/20!2007
08/20!2007
10/04!2007
11/08/2007
11/14/2007
11/28/2007
04/24/2008
05/23/2008
05/27/2008
05/27/2008
7!23/2008
08/19/2008
08/19!2008
08/20/2008
08/20/2008
08/20/2006
o8/zo/zoos
08/21/2008
08/21/2008
08/27/2008
08/27/2008
08/27/2008
08/27!2008
08/28/2008
09/29/2008
GLENN NAVE
ORRSTOWN BANK
FRANKLIN COUNTY MEDICAL ASSOC.
PENELEC
THE NEWS-CHRONICLE CO.
GLENN NAVE
WSEMS -CHAMBERSBURG ALS/BLS
WSEMS -CHAMBERSBURG ALS/BLS
REVERSE SOCIAL SECURITY BENEFITS RECEIVED
PENELEC
U.S. DEPARTMENT OF THE TREASURY
DEL 100 REAL ESTATE, 625 BRENTON ST SHBG PA
BOROUGH OF SHIPPENSBURG
VOID CHECK #30237 DATED 07/27/07 TO BOROUGH
IEFFLER ENERGY
PENELEC
DAN HERSHEY AUCTIONEERING SERVICE
DEL 25000 SHS, MBNA CD 3.86 % 08/18/2007
DEL 1000 SHS, PSECU CD 4.25 % 09/28/2007
DEL 10000 SHS, PSECU CD 4.15% 10/05/07
CAPITAL RECOVERY
REGISTER OF WILLS, CUMBERLAND COUNTY
AR RESOURCES, INC.
REGISTER OF WILLS, CUMBERLAND COUNTY
DEL 1 SHS, PERSONAL PROPERTY/CONTENTS
ORRSTOWN BANK
UNITED STATES TREASURY
PA DEPARTMENT OF REVENUEffAX DUE
INTERNAL REVENUE SERVICE
DISTRIBUTION TO BENEFICIARY
DISTRIBUTION TO BENEFICIARY
DISTRIBUTION TO BENEFICIARY
DISTRIBUTION TO BENEFICIARY
DISTRIBUTION TO BENEFICIARY
DISTRIBUTION TO BENEFICIARY
DISTRIBUTION TO BENEFICIARY
DISTRIBUTION TO BENEFICIARY
DISTRIBUTION TO BENEFICIARY
DISTRIBUTION TO BENEFICIARY
DISTRIBUTION TO BENEFICIARY
DISTRIBUTION TO BENEFICIARY
DISTRIBUTION TO BENEFICIARY
PARTIAL EXECUTOR FEE
TOTAL DISBURSEMENTS OF PRINCIPAL
PRINCIPAL GAINS AND LOSSES ON SALES_OR OTHER DISPOSITIONS
FOR MOWING GRASS
2006 TAX PREP FEE
GEORGE KALUGER
GEORGEKALUGER
KALUGER ESTATE ADVERTISEMENT
FOR GRASS MOWING
GEORGE KALUGER ! 26083
GEORGE KALUGER / 26083
AFTER DATE OF DEATH
ESTATE OF GEORGE KALUGER
FINANCIAL MANAGEMENT SERVICE
BEQUEATHED TO SU FOUNDATION, PER LAST WILL
ESTATE OF GEORGE KALUGER
OF SHIPPENSBURG /PAID IN ERROR
FINAL BALANCE DUE FOR THE KALUGER ESTATE
GEORGE KALUGERlACCT #10 00 11 5177 19 FINAL BILL
FEE FOR APPRAISAL OF TRAVEL MEMORABILIA
PROCEEDS RECEIVED 04!23/2007
PROCEEDS RECEIVED 04/06/2007
PROCEEDS RECEIVED 04!06/2007
BALANCE DUE FOR GEORGE KALUGER
CHECK NUMBER 31299
GEORGE KALUGER/ACCT #0671307/RE: 629772
ADDITIONAL PROBATE FEE FOR THE
PROCEEDS DELIVERED TO SU PER REQUEST
2007 TAX PREP FEE
INTERNAL REVENUE SERVICE CENTER
BUREAU OF IMAGING & DOCUMENT MGMT
ADDITIONAL TAX DUE 2007 FORM 1041
SHIPPENSBURG HISTORICAL SOCIETY
SHIPPENSBURG UNIVERSITY FOUNDATION
SHIPPENSBURG CIVIC CLUB
SALLY LEITH BEALS
CAROL ANN DROGUS
DANIEL WEITZEL
GRACE UNITED CHURCH OF CHRIST
ST. ELIE ROMANIAN ORTHODOX CHURCH
JHAN MASON
SLIPPERY ROCK UNIVERSITY
VALERIE M. ROACH
JOHN RODDICK
ROTARY CLUB OF SHIPPENSBURG
ORRSTOWN BANK
PRINCIPAL PROCEEDSlACQUISITION VALUE
03/26/2007 SOLD 30000 (4198.375 FED HOME LOAN BKS 5.5 % 09/12/201 3 $29,512.501$29,475.00
03/26/2007 SOLD 15000 ~ 98.0625 FED HOME LOAN BKS 5% 05/10/2011 $14,709.38/$14,683.65
0 3/2 612 0 0 7 SOLD 25000 ~ 97.31 FED HOME LOAN BKS 4 % 10/27/2008 $24,327.50/$24,367.25
03/26/2007 SOLD 15000 (ti) 97.40 FED HOME LOAN BKS DEB 5% 09122/201 ($14,610.00/$14,725.80
03/26/2007 SOLD 10000 ~ 97 FED FARM CR BKS 5.05 % 12/27/2012 $9,700.00/$9,721.90
03/27/2007 SOLD 20000 ~ 97.20 FED HOME LOAN BKS 3.565°k 04/30!2008 $19,440.00/$19,471.90
03/27/2007 SOLD 15000 ~ 99.05 FED FARM CR BKS 3.06%05!11/2007 $14,857.501$14,798.47
03/27/2007 SOLD 10000 (~D 98.80 FED HOME LOAN BKS DEB 4 % 06/29/200' $9,880.00/$9/900.00
03/28/2007 SOLD 25000 (d1 105.186 PA ST SECOND SER 5 % 05/01/2020 $26,296.50/$26,379.88
03/28/2007 SOLD 15000 ~ 101.504 WEST BRANCH S/D PA 4.8 % 03/15/2021$15,225.60/$15,328.07
07/12!2007 SOLD 69490.93 SHRS PFCU CD 4.9 % 10!04/2008 $73,112.09/$69,490.93
TOTAL GAIN
PRINCIPAL BALANCE ON HAND
INCOME RECEIPTS
03/02/2007 - 06/02/2008 DIVIDENDS RECEIVED FEDERATED MONEY MARKET FUND
02/26/2007 ANNUITY PAYMENT ING
03/01/2007 CONTRIBUTION RECEIVED AMERIPRISE FINANCIAL
03!01/2007 CONTRIBUTION RECEIVED ANNUITANT PA TREASURY
03/12/2007 INTEREST ON 30000 PAR VALUE FED HOME LOAN BKS 5.5% 09/12/2013
03/15/2007 INTEREST ON 15000 PAR VALUE WEST BRANCH S/D PA 4.8°h 03/1 512 02 0
03/22/2007 INTEREST ON 15000 PAR VALUE FED HOME LOAN BKS DEB 5%09/22/2010
03/26!2007 INTEREST ON 30000 PAR VALUE FED HOME LOAN BKS 5.5 % 09/12/2013
03/26/2007 INTEREST ON 25000 PAR VALUE FED HOME LOAN BKS 4 % 10/27/2008
0 3/2 612 00 7 INTEREST ON 15000 PAR VALUE FED HOME LOAN BKS 5 % 05/10/2011
03/26/2007 INTEREST ON 10000 PAR VALUE FED FARM CR BKS 5.05 % 12/27/2012
03/26/2007 INTEREST ON 15000 PAR VALUE FED HOME LOAN BKS DEB 5% 09/22/2010
03/26/2007 ANNUITY PAYMENT ING
03/27/2007 INTEREST ON 20000 PAR VALUE FED HOME LOAN BKS 3.565% 04/30/2006
03/27/2007 INTEREST ON 10000 PAR VALUE FED HOME LOAN BKS DEB 5% 06/29/2007
1 o/2anoos
-$25.00
-$250.00
-$61.94
-$29.05
-$17.00
-$25.00
-$150.39
-$135.63
-$781.00
-$44.08
-$1,562.00
-$217,000.00
-$132.27
$132.27
-$1,020.47
-$81.03
-$150.00
-$25,000.00
-$1,000.00
-$10,000.00
-$3,210.64
-$15.00
-$470.00
-$150.00
-$1.00
-$250.00
-$195.00
-$102.00
-$10.32
-$15,286.60
-$110,063.49
-$3,057.32
-$7,643.30
-$53,503.09
-$7,643.30
-$24,458.55
-$3,057.32
-$10,700.62
-$9,171.96
-$53,503.09
-$4,585.98
-$3,057.32
-$22,575.00
-E639.115.97
GAIN/LOSS
$37.50
$25.73
-$39.75
-$115.80
-$21.90
-$31.90
$59.03
-$20.00
-$83.38
-$102.47
$3,621.16
3 328.22
$102.903.88
$25,644.71
$244.50
$183.55
$2,724.48
$825.00
$351.39
$375.00
$64.17
$413.89
$283.33
$124.85
$8.33
$244.50
$291.14
$197.78
George KalUger Estate #1260
03/27/2007 INTEREST ON 15000 PAR VALUE FED FARM CR BKS 3.06% 05/11/2007
03/28/2007 INTEREST ON 25000 PAR VALUE PA ST SECOND SER 5% 05/10/2020
03/28/2007 INTEREST ON 15000 PAR VALUE WEST BRANCH S/D PA 4.8 % 03!15!2020
04/02/2007 CONTRIBUTION RECEIVED AMERIPRISE FINANCIAL
04/02/2007 CONTRIBUTION RECEIVED ANNUITANT PA TREASURY
04/24/2007 RECEIVED INTEREST PSECU DC 4.5% 08/17!2009
01!03!2008 POLICY DIVIDEND RECEIVED PRUDENTIAL FINANCIAL
10/03/2008 INTEREST RECEIVED ORRSTOWN BANK DAILY DEPOSIT FDIC ACCOUNT
TOTAL INCOME RECEIPTS
INCOME BALANCE ON HAND
COMBINED BALANCE ON HAND
RESERVED:
ORRSTOWN BANK, REMAINING EXECUTOR FEE
JOEL R. ZULLINGER, ATTORNEY FEE
FILING FEES
PENDING:
PENNSYLVANIA DEPT. OF REVENUE, ADDITIONAL REFUND
COMBINED BALANCE ON HAND FOR DISTRIBUTION
10/24/2008
$173.40
$510.42
$2s.oo
$183.55
$2,724.48
$1,535.92
$82.47
$40.18
37 253.04
37 253.04
5140.156.92
-$7,525.00
-$27,500.00
-$500.00
$7,724.99
5112.356.91
3
George Kaluger Estate #1260
PROPOSED SCHEDULE OF DISTRIBUTION
Shippensburg University Foundation $40,448.48
Old Main Road
Shippensburg, PA 172
Slippery Rock University $3,370.70
1 Morrow Way, 100 Old Main
Slippery Rock, PA 16057
Grace United Church of Christ $8,988.55
121 E. Orange Street
Shippensburg, PA 17257
St. Elie Romanian Orthodox Church $1,123.56
425 Cherry Way
Ellwood City, PA 16117
Shippensburg Historical Society $5,617.84
52 West King Street
Shippensburg, PA 17257
Shippensburg Civic Club $1,123.56
P.O. Box 593
Shippensburg, PA 17257
Shippensburg Rotary Club $1,123.56
P.O. Box 572
Shippensburg, PA 17257
Carol Ann Drogus $19,662.46
14 Marvin Street
Clinton, NY 13323
Sally Leith Beals $2,808.92
1651 Coral Terrace
North Lauderdale, FL 33068
Daniel Weitzel $2,808.92
653 Wyndham Court
Orange Park, FL 32073
Jhan Mason $3,932.49
23 River Oaks Drive
Chico, CA 95973
'~"
George Kaluger Estate #1260
John Roddick
601 Baltimore Road
Shippensburg, PA 17257
Valerie M. Roach
660 Nobel Drive #1 C
Santa Cruz, CA 95060
Total Proposed Distributions
PROPOSED SCHEDULE OF DISTRIBUTION
$ 1,685.42
$ 19,662.45
$112.356.91
i
DECEDENT'S ESTATE
RECORDED OFFICE OF
REGISTER OF WILLS
2008 OCTOBER 24 4:33 PM
CLERK OF
ORPI-L~1NS' COURT
CUMBERL~IND CO., PA
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
ESTATE OF GEORGE KALUGER
No. 21-07-0165
DECEASED
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.
INCL UDE ATTACHMENTS AT THE BACK OF THIS FORM.
Name of Counsel: JOEL R. ZULLINGER
Supreme Court I.D. No.:
Name of Law Firm: ZULLINGER/DAVIS
Address: 14 N. MAIN STREET, SUITE 200
Telephone: 717-264-6029
Fax: 717-264-1884
Fo.,,, oc-oi rte. ro.~s.o~ Page 1 of 10
Estate of GEORGE KALUGER
1. Name(s) and address(es) of Petitioner(s):
Name: ORRSTOWN BANK, EXECUTOR
Address: 77 EAST KING STREET
SHIPPENSBURG, PA 17257
Deceased
Identify any executors or administrators who have not joined in the Petition for
Adjudication and Statement of Proposed Distribution and state reason:
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. Decedent died on 2/8/2007
Letters Testamentary or Letters of Administration were granted to Petitioner(s) on
Date of Will (if applicable): 1/7/07
Date(s) of Codicil(s) (if applicable):
Date of probate (different from date Letters granted):
Was a bond required? Yes ~ 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: Ma,-~h 9 1 ~ ~~t ~nm
Form oc-or rev. Io.13.06 Page 2 of 10
Estate of GEORGE KALUGER
Deceased
3. Was decedent survived by a spouse? ............................. Yes ~ No
If yes, name of the surviving spouse:
4. Has the surviving spouse filed to take an elective share? ............. ®Yes ~ No
(See Section 2201 et sue. 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 (f none, so state):
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 Medical Assistance Estate Recovery Act,
62 P.S. § 1412, was a request for a statement of claim sent to
the Department of Public Welfare? .............................. ~ Yes ~ No
Farm oc-o~ rev. 10.13.06 Page 3 of 10
Estate of GEORGE KALUGER
Name and Address of Each Party in Interest ~ Relationshi
Grace United Church of Christ charity
121 E. Orange Street
Shippensburg, PA 17257
Deceased
8%
St. Elie Romanian Church charity 1
425 Cherry Way
Ellwood City, PA 16117
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 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.
Form OG01 rev. 10.!3.06 Page 5 of 10
Estate of GEORGE KALUGER
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):
Address of Each Party in Interest
/nterest
Shippensburg Historical Soc. charity 5%
52 West King St.
Shippensburg, PA 17257
Carol Ann Drogus collateral 17.5%
14 Marvin St.
Clinton, NY 13323
Form OG01 rev. 10.13.06 Page 4 of 10
Estate of GEORGE KALUGER
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 Parry in Interest ~ Relationshio and
Shippensburg Civic Club charity 1
P.O. Box 593
Shippensburg, PA 17257
Shippensburg Rotary charity 1
P.O. Box 572
Shippensburg, PA 17257
Form OC-0/ rev. 10.13.06
Page 4 of 10
Estate of GEORGE KALUGER
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 olEach Partv in
Shippensburg University Found charity 36%
Old Main Road
Shippensburg, PA 17257
Slippery Rock University charity 3%
1 Morrow Way, 100 Old Main
Slippery Rock, PA 16057
Form oc-o~ rev. 10.13.06 Page 4 of 10
Estate of GEORGE KALUGER
Deceased
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):
Address of Each
Interest
Sally Leith Beals collateral 2.5%
1651 Coral Terrace
North Lauderdale, FL 33068
Daniel Weitzel collateral 2.5%
653 Wyndham Court
Orange Park, FL 32073
Form OC-01 rev. 10.13.06 Page 4 of 10
Estate of GEORGE KALUGER _ ,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):
and Address
Jhan Mason
23 River Oaks Drive
Chico, CA 95973
collateral
3.5%
in Interest ~ Relationship and
John Roddick
601 Baltimore Road
Shippensburg, PA 17257
collateral
Form OC-Ol rev. 10. /3.06
1.5%
Page 4 of 10
Estate of GEORGE KALUGER
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):
Address
Valerie Roach
660 Nobel Drive # 1 C
Santa Cruz, CA 95060
Interest ~ Relationship and
collateral
17.5%
Form OC-01 rev. lOJ3.06 Page 4 of 10
Estate of GEORGE KALUGER
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.
Nome and Address of Each Claimant Amount of Claim Claim Will Claim
Admitted? Be Paid In
Full?
Yes ~ Yes
~No ®No
Yes ®Yes
®No ®No
®Yes ®Yes
~No ®No
Yes ®Yes
~No Q No
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? ................................ Yes ®No
Was family exemption allowed? ................................ ®Yes ~No
Family exemption claimant's name and relationship:
Name: Relationship:
Form OC-01 rev. 10.13.06 Page 6 of 10
Estate of GEORGE KALUGER
Deceased
12. The amount of Pennsylvania Transfer Inheritance Tax and additional Pennsylvania Estate
Tax paid, the date(s) of payment(s), and the interest(s) upon which paid, are as follows:
Date Payment Interest
5/7/07 37,601.81
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? ................... ®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 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? .................. ®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-ol rev. Jo.13.06 Page 7 of 10
Estate of GEORGE KALUGER
Deceased
16. 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.
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.•
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? ........................................ ®Yes ®No
If so, attach a copy of the notice.
19. Is the Court being asked to direct
the filing of a Schedule of Distribution? .......................... ®Yes ~o
As to real estate only? ........................................ ®Yes ~ No
Form oc-oi rev. l0.13.06 Page 8 of 10
Estate of GEORGE KALUGER
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 Distrtbutee(s)
B. Principal:
Proposed Distributee(s)
Amount/Proportion
Amount/Proportion
Submitted By:
(All petitioners m t sign.
A itional a necessary):
~~~ ~ ~ ~~~
N e of Petitioner: O STOWN BANK, EXECU~
~ !~ ~~
ame of Petitioner:
Form oc-o] rev. 10.13.06 Page 9 of 10
Estate of GEORGE KALUGER ,Deceased
Verification of Petitioner
(Verification must be by at least one petitioner.)
The undersi ed hereb ver' es * [that tieistiev is rir~ l Wu-~ ~~~~
~ y -'~ ~~ and) t at the facts set
of the above-named name of corporatio
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).
* 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.
Si tore of Counsel r titioner
Form OC-Ol rev. !0.!3.06 Page 10 of 10