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Home My WebLink About12-11-08ate, oc;y- .o~ FIRST AND FINAL ACCOUNT OF ANN E. BROADS, EXECIITRIX For ESTATE OF SARA I. HOFFSOMMER, Deceased, LATE OF HAMPDEN TONNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA NO. 2008 - 00200 Date of Death: February 6, 2008 Date of Executrix's Appointment: February 25, 2008 Dates of Advertisement of the Grant of Letters: The Patriot News - March 12, 19 ~ r'' and 2 6 , 2 0 0 8 ;_ . -~ r__~ ~.: , .- ; m~ - ~ t:,° Cumberlaad County Reporter - . r `-'~ ~ ', March 14, 21 and 28, 2008 ~~ r ,~--~ ~ ~ --~ ~' :~ ~ = _ - Accounting for the Period: -,, =+ `•~ ~-4 •~' February 25, 2008 to November 30 2008 ~ 7 , ~, , Purpose of Account: Ann E. Rhoads, Executrix, offers this Account to acquaint interested parties with the transactions that have occurred during her administration. This Account also indicates the proposed distribution of the Estate. It is important that the Account be carefully examined. Requests for additional information or objections can be discussed with: Ann E. Rhoads, Esquire CLECKNER AND FEAREN 119 Locust Street P. 0. Box 11847 Harrisburg, PA 17108-1847 (717)238-1731 SII~ARY OF ACCOUNT Proposed Distribution to Beneficiaries: Principal Receipts Less Disbursements: Debts of Decedent Funeral Expenses Administration Expenses Federal and State Taxes Fees and Commissions Balance Before Distributions Distributions to Beneficiaries Principal Balance on Hand Adjustment to Principal Balance Adjusted Principal Balance Income Receipts Less Disbursements Income Balance on Hand Combined Adjusted Balance on Hand $ 226.62 794.82 1,080.85 10,311.02 16.130.00 $ 2,579.80 - 0.00 RECEIPTS OF PRINCIPAL Assets Listed in Inventory (Valued as of Date of Death) Cash Country Meadows West Resident Acct. $19,050.63 Wachovia Bank Checking Acct. #1000643130022 14,098.84 Wachovia Bank Certificate of Deposit #247402043159464 10,183.45 Three (3) State Farm Bank Certificates of Deposit #1013964925, #1013964938, and #1013964983 75,128.19 $221,530.11 $247,424.29 28,.543.31 $218,880.98 -195,_500.00 $ 23,380.98 + _69.33 $ 23,450.31 $ 2,579.80 $ 26,030.11 Fiduciary Acquisition Value Wachovia Bank Certificate of Deposit #2427402062035918 25,000.00 Wachovia Bank Certificate of Deposit #242402092096020 30,000.00 Wachovia Bank Certificate of Deposit #247402082460703 20,010.60 Wachovia Bank Certificate of Deposit #247402052575644 30,011.36 Wachovia Bank Certificate of Deposit #247402112902903 10,713.31 Wachovia Bank Certificate of Deposit #247402112902991 11,506.42 2007 Pa. Income Tax Refund 83.00 2007 Federal Income Tax Refund 302.00 Federal Tax Rebate 538.00 Blue Cross Refund 209.46 Penn Treaty Network Premium Refund 47.94 Penn Treaty Hospital Ins. Claim 32.00 $246,915.20 Tangible Personal Property Household Goods $ 500.00 5500.00 TOTAL INVENTORY $247,415.20 Assets Not Listed in Inventory (Valued as of Date of Receipt) 5/19/08 Country Meadows Supplemental refund S 9.09 ~ 9.09 TOTAL RECEIPTS OF PRINCIPAL $247,424.29 Gains and Losses on Sales None DISBURSEMENTS OF PRINCIPAL Debts of_Decedent 02/21/2008 Pharmacy Charges (paid by Country Meadows West per 3/08 statement) 03/07/08 Verizon $191.59 35.03 $ 226.62 Funeral Expenses 02/27/2008 Repay John Hoffsommer who advanced funds for the following: Paxton Presbyterian Church (cemetery services; honorarium for paster and funeral reception) Auer Memorial Home & Cremation Services Auer Memorial Home & Cremation Services 04/17/2008 Romberger Memorials $390.00 227.82 67.00 110.00 $ 794.82 Administration Expenses 02/26/2008 Check order 02/27/2008 Register of Wills - probate fees 03/06/2008 Cumberland Law Journal - legal advertising 04/01/2008 Register of Wills - short certs. 04/01/2008 ChartOne - Holy Spirit Hospital medical records 04/10/2008 The Patriot News - legal advertising 04/11/2008 Register of Wills - filing fee $ 8.00 310.00 75.00 8.00 110.75 155.10 15.00 07/08/2008 07/09/2008 07/15/2008 10/17/2008 RESERVE Register of Wills - filing fee $ 30.00 Register of Wills - filing fee (releases) 15.00 Register of Wills - additional probate fee 50.00 Register of Wills - short cert. 4.00 Register of Wills - filing fee (First and Final Acct.) 300.00 $ 1,080.85 Federal and State Taxes 04/11/2008 State Inheritance Tax $10,000.00 10/24/2008 State Inheritance Tax Refund - 188.98 $9,811.02 RESERVE State and Federal Income Taxes 500.00 10,311.02 Fees and Commissions 04/25/2008 Cleckner and Fearen - 1/2 legal fees $5,210.00 09/03/2008 Cleckner and Fearen - 1/4 legal fees 2,605.00 10/23/2008 Ann E. Rhoads - 3/4 executrix fee 3,907.52 RESERVE Cleckner and Fearen - balance of legal fee 2,605.00 RESERVE Ann E. Rhoads - balance of executrix fee 1,302.48 RESERVE Accountant to prepare income tax returns .500.00 516,130.00 TOTAL DISBURSEMENTS OF PRINCIPAL $28,543.31 DISTRIBUTIONS OF PRINCIPAL TO 8ffi~T]3FICIARIES T0: ROBERT D. HOFFSOMMER, JR., In satisfaction of gift under ITEM II of Will 1/3 Household Goodsl In partial satisfaction of gift under ITEM III of Will (1/3 Residue) 04/01/2008 Cash 07/11/2008 Cash T0: JON R. HOFFSOMMER, JR., In satisfaction of gift under ITEM II of Will 1/3 Household Goodsl In partial satisfaction of gift under ITEM III of Will (1/3 Residue) 04/01/2008 Cash 07/11/2008 Cash T0: BARBARA L. MARK, In satisfaction of gift under ITEM II of Will 1/3 Household Goodsl In partial satisfaction of gift under ITEM III of Will (1/3 Residue) 04/01/2008 Cash 07/11/2008 Cash $ 166.67 30,000.00 35.000.00 $ 166.67 30,000.00 35.000.00 $ 166.66 30,000.00 35,000.00 TOTAL DISTRIBUTIONS TO BENEFICIARIES $ 65,166.67 65,166.67 65.166.66 $195,500.00 1 The family members divided these items among themselves. PRINCIPAL BALANCE ON HAND Cash $23,380.98 Adjustment + 69.33 ADJUSTED PRINCIPAL BALANCE ON HAND $ 23,450.31 RECEIPTS OF INCOME Interest Wachovia Bank checking account #1000643130022 $ 205.18 Wachovia Bank C/D #247402043159465 38.20 Wachovia Bank C/D #247402062035918 426.53 Wachovia Bank C/D #247402092096020 518.51 Wachovia Bank C/D #247402082460703 431.45 Wachovia Bank C/D #24740205257564 582.82 Wachovia Bank C/D #247402112902991 195.29 Wachovia Bank C/D #247402112902903 181.82 52,579.80 TOTAL RECEIPTS OF INCOME $2,579.80 DISBURSEMENTS OF INCOME NONE INCOME BALANCE ON HAND $2,579.80 ADJUSTED COMBINED BALANCE ON HAND $26,030.11 PROPOSED DISTRIBUTIONS TO BENEFICIARIES TO: ROBERT D. HOFFSOMMER, JR., in satisfaction of gifts under ITEMS II and III of Will 1/3 Household Goodsl $ 166.67 04/11/2008 Cash 30,000.00 07/11/2008 Cash 35,000.00 PROPOSED Cash _ 8,676.70 $73,843.37 TO: JON R. HOFFSOMMER, in satisfaction of gifts under ITEMS II and III of Will 1/3 Household Goodsl $ 166.67 04/11/2008 Cash 30,000.00 07/11/2008 Cash 35,000.00 PROPOSED Cash 8,676.70 $73,843.37 TO: BARBARA L. MARK, in satisfaction of gifts under ITEMS II and III of Will 1/3 Household Goodsl $ 166.67 04/11/2008 Cash 30,000.00 07/11/2008 Cash 35,000.00 PROPOSED Cash 8,676.70 573,843.37 TOTAL DISTRIBUTIONS TO BENEFICIARIES $221,530.11 ANN E. RHOADS, Executrix under the Last Will and Testament of SARA I. HOFFSOMMER, deceased, being duly sworn accordingly to law, hereby declares and says that the foregoing account is just and true and that the grant of letters and first complete advertisement thereof occurred more than four months prior to filing of the account. ~a ANN E. RHOADS 1 Sworn to and subscribed before me this ~ day of December, 2008. ~~ ~ ' otary Public CRIMMONw~~-~YW~1~ PBNN~YLVANIA NOTARIAL SEAL JENNY A. TOBIAS, Notary Public City of tiamsburg, Dauphin County M Commission Expires Februa 15, 2(5109 PROOF OF PUBLICATION OF NOTICE IN CUMBERLAND LAW JOURNAL (Under Act No. 587, approved May 16, 1929), P. L.1784 COMMONWEALTH OF PENNSYLVANIA : COUNTY OF CUMBERLAND ss. 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, vlz: March 14 March 21 and March 28 2008 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. Marie Ho>~Yommer, Sara I. a/1t/a Sara Q. Iniram Hotllwmmer, deed. Late of Hampden Township. Executrix: Ann E. Rhoads c/o P.O. Box 11847, Harrisburg, PA 17108- 1847. Attorneys: Cleclmer and Fearen, P.O. Box 11847, Harrisburg, PA 17108-1847. Editor SWORI~f TO AND SUBSCRIBED before me this 28 day of March. 2008 F. !/ ~ ,~~~ ~~ Notary NOTARWL SEAL DE80RAN A COLLINS Notary public CARLISLE BORO, CUMBERLAND COUNTY My Commission Expires Apr 28, 2010 The Patriot-News Co. 812 Market St. Harrisburg, PA 17101 Inquiries - 717-255-8292 CLECKNER AND FEAREN ATTN: ANN E. RHOADS 119 LOCUST STREET P.O. BOX 11847 HARRISBURG c~he~llahiot News Now you know 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 since; 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 on the date(s) indicated below. 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 nwr a.~r. assaro amn ~.,.~ This ad # 0001822961 ran on the dates shown below: March 12, 2008 March 19, 2008 March 26, 2008 subscribed before(m~fhis ?~/d~of March, 2008 A.D. ry Public + COMMONWEALTH OF PENNSYLVANIA Notarial Seal { Shortie L. Kiener, Notary PubNc ~ city Of Hartisburg Dauphkr Courtly ^~ c ¢xpres Nov 28, Z01 ~ !vlember, Pennsylvania Assodatbn o/ Notarba BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 ANN E RHOADS CLECKNER & FEAREN PO BOX 11847 HARRISBURG PA 17108 DATE 11-10-2008 ESTATE OF HOFFSOMMER SARA I DATE OF DEATH 02-06-2008 FILE NUMBER 21 08-0200 COUNTY CUMBERLAND ACN 101 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~' --------------------------------------------------------------------------- REV-1607 EX AFP C03-05) *** INHERITANCE TAX STATEMENT OF ACCOUNT *~* ESTATE OF HOFFSOMMER SARA I FILE N0. 21 08-0200 ACN 101 DATE 11-10-2008 THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY DF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 09-22-2008 NCIPAL TAX DUE: PAYMENTS C CREDITS): 10,327.39 PAYMENT DATE ECEIPT N MBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID 04-11-2008 CD009556 516.37 10,000.00 10-24-2008 REFUND .00 188.98- TOTAL TAX CREDIT I, BALANCE OF TAX DUE INTEREST AND PEN. * IF PAID AFTER THIS DATE, SEE REVERSE I TOTAL DUE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. ) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT 10,327.39 .00 .00 .00 PAYMENT: Detach the tap portion of this Notice and submit with your payment made payable to the name and address printed on the reverse side. If payment if for a RESIDENT DECEDENT, make check or money order payable to: Register of Wills, Agent If payment if for a NON-RESIDENT DECEDENT, make check or money order payable to: Commogwealth of Peggsylvagia Failure to pay the tax, interest, and penalty due may result in the filing of a lien of record in the appropriate county, or the issuance of an Orphan's Court citation. REFUND (CR): A refund of a tax credit, which was not requested on the Tax Return, may be requested by completing an "Application for Refund of Pennsylvania Inheritance and Estate Tax" IREV-1313). Applications are available online at www revenue.state.pa.us, any Register of Wills or Revenue District Office, or from the Department's 24-hour answering service for forms orders: 1-800-362-2050; services for taxpayers with special hearing and/or speaking needs: 1-B00-447-3020 (TT only). REPLY T0: Questions regarding errors contained on this notice should be addressed to: PA Department of Revenue, Bureau of Individual Taxes, ATTN: Post Assessment Review Unit, P.O. Box 280601, Harrisburg, PA 17128-0601, phone (717) 787-6505. DISCOUNT: If any tax due is paid within three (3) calendar months after the decedent's death, a five percent C5%) discount of the tax paid is allowed. PENALTY: The 15% tax amnesty non-participation penalty is computed on the total of the tau and interest assessed, and not paid before January 18, 1996, the first day after the end of the tax amnesty period. INTEREST: Interest is charged beginning with first day of delinquency, or nine (9) months and one (1) day from the date of death, to the date of payment. Taxes which became delinquent before January 1, 1982 bear interest at the rate of six C6%) percent per annum calculated at a daily rate of .000164. All taxes which became delinquent on and after January 1, 1982 will bear interest at a rate which will vary from calendar year to calendar year with that rate announced by the PA Department of Revenue. Rates for years 1982 through 1999 can be found in the Pennsylvania Resident Instruction Booklet, CREV-1501), the Pennsylvania Non-resident Instruction Booklet (REV -1736) or on the Pennsylvania Dept. of Revenue web site www.revenue.state.pa.us. The applicable interest rates for 2000 through 2008 are: Interest Daily Interest Daily Interest Daily Year Rate Factor Year Rate Factor Y=ar Rate Factor 2000 8% .000219 2001 9% .000247 2002 6% .000164 2003 5% .000137 20D4 4% .000110 2005 5% .000137 2006 7% .000192 2007 8% .000219 2008 7% .000192 --Interest is calculated as follows: INTEREST = BALANCE OF TAX UNPAID X NUMBER OF DAYS DELINQUENT X DAILY INTEREST FACTOR --Any Notice issued after the tau becomes delinquent will reflect an interest calculation to fifteen (15) days beyond the date of the assessment. If payment is made after the interest computation date shown on the Notice, additional interest must be calculated. LAST WILL AND TESTAMENT OF SARA G. INGRAM HOFFSOMN.~R ~, ~. '.: ..-, I, SARA G. INGRAM HOFFSOMMER, of 728 South 28th Street, Harrisburg, Dauphin County, Pennsylvania, being of sound mind, memory and understanding, do hereby make, publish and declare this to be my Last Will and Testament, hereby revoking any and all former Wills and Codicils by me at any time theretofore made. ITEM I: I direct that all my funeral expenses and estate or inheritance taxes be paid by my hereinafter named Executrix as soon after my death as may be found convenient. ITEM II: I give all my tangible personal property, including but not limited to, any and all automobiles, furniture, furnishings, china, silverware, jewelry, ornaments, works of art, books, pictures and wearing apparel, but excluding cash on hand and tangible evidences of intangible personal property, to my children, ROBERT D. HOFFSOMMER, JR., JON R. HOFFSOMMER and BARBARA L. MARK, to be divided among them as they shall agree. ITEM III: All the rest, residue and remainder of my estate, both real and personal, wherever situate, I give, devise and bequeath as follows: A. One-third (1/3) to my son, ROBERT D. HOFFSOMMER, JR. In the event that my son, ROBERT D. HOFFSOMMER, JR., predeceases me, I give, devise and bequeath his one-third (1/3) - - .~. F. share to his wife, if she survives me. If his wife does not survive me, then his one-third (1/3) share shall be divided equally among his children surviving at the time of my death. B. One-third (1/3) to my son, JON R. HOFFSOMMER. In the event that my son, JON R. HOFFSOMMER, predeceases me, I give, devise and bequeath his one-third (1/3) share to his wife, if she survives me. If his wife does not survive me, then his one-third (1/3) share shall be divided equally among his children surviving at the time of my death. C. One-third (1/3) to my daughter, BARBARA L. MARK. In the event that my daughter, BARBARA L. MARK, predeceases me, I give, devise and bequeath her one-third (1/3) share to her son, MICHAEL D. KAUFFMAN. ITEM IV: I nominate, constitute and appoint ANN E. RHOADS, as Executrix of this my Last Will and Testament. ITEM V: I direct that no personal representative hereunder shall be required to provide security, surety or bond in any jurisdiction for the faithful performance of any duty under this Will. This clause is applicable only to such personal representatives as are specifically named in this Will. ITEM VI: Any word in the test of this Will shall be read as the singular or the plural and as the masculine, feminine or neuter gender as may be appropriate under the circumstances then existing. 2 IN WITNESS WHEREOF, I, SARA G. INGRAM HOFFSOMMER, have set my hand and seal to this, my Last Will and Testament, this~~ day of ti~J _~ SARA G . INGRP,i`NI HOFFSOM~'!ER * ~ * ~ * * * ~ Signed, sealed, published and declared by SARA G. INGRAM HOFFSOMMER, the Testatrix, as and for her Will, in the presence of us, who, at her request, in her presence and in the presence of each other, we believing her to be of sound mind, memory and understanding, have hereunto subscribed our names as witnesses. ,- ire ,' ~i ~ j`r ~= f ,.,~ ,. OF Grr~/~a~ /~~ ~ /'~~ci 3 ---- -_,.. ~% COMMONWEALTH OF PENNSYLVANIA COUNTY OF DAUPHIN . SS: We, SARA G. INGRAM HOFFSOMMER, Testatrix, ;=~,;-,n C.-; ~?.Gi~l~~~s and ~„-~c% r~~/,~~ ,witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testatrix signed and executed the instrument as her Last Will and Testament and that she had signed willingly, and that she executed it as her free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testatrix, signed the Will as witnesses and that to the best of their knowledge, the Testatrix was at that time eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. SARA G. ING HOF~`SO ER - Testatrix Subscribed, sworn to and acknowledged before me by SARA G. INGRAM HOFFSOMMER, the Testatrix, and subscribed and sworn to before me by _ ~n E~ ~~~c~S and ~i;,~ c~CL. ~~~d~G witnesses, this /7~ day of 2001. ~~~ ~ ~~ NOTARY ~'UBLIC Jenny A. Tobias,i Notary M Harrisburg, Dauphin Co~~~;o y Commission Expires Feb.15, 2005 -- ro ~ ~ ~ v 0 yµL! ~,7.1 ~ ! J ~` ~ W ~ 0 / ~ '+j ~ H ~'* o ~ i w i o ~ ~ o -d ~ IN RE: ESTATE OF IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA SARA I. HOFFSOMMER, . ORPHANS' COURT DIVISION Deceased . NO. 00200 YEAR OF 2008 CERTIFICATION OF NOTICE OF ACCOIINT I, Ann E. Rhoads, Esquire, attorney for the Estate of Sara I Hoffsommer, deceased, certify that the requirements of Local Rules 6.3 for notice of the filing of a first and final account for said estate have been met. ~~~~~ Ann E. Rhoads, Esquire Sworn to and subscribed before me this ~~~ day of December, 2008 ~~~~ /~ Nota y Public COMMONWJ;:AI.TH KtF ~'ENNSYLVANIA NOTARIAL SEAL JENNY A. TOBIAS, Notary Public City of Hamsburg, Dauphin County M Commission Expires February 15, 2Q09 r-.v, 4:J ::.~ l.. ('~ ~ I- _: Y ~ `_~ >r- i ~"t .: j _'.~ _" - ,._, { -> -~ ~..- sA _ -, -~ ~ _ -~ --^~ --~ c~ .. _ ? ~ r"i ~ W i -J DECEDENT'S ESTATE COURT OF COMMON PLEAS OF C[7N>B>;RLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF SARA I. HOFFSONIlKER DECEASED No. 2008-00200 ~ >> ~ :~ y, -~ 17 ~ ?t ~ dTH l 7 ~ ~ ;, ~ ,. ~:.:.~ PETITION FOR ADJUDICATION / ~ ~ ~ ~ t STATEMENT OF PROPOSED DISTRIBUTION ~ ' ` ~ `-- - ~ ~~ PURSUANT TO Pa. O.C. Rule 6 9 ~ ~ ~=~ ~= :-~. ~`' ,, -~~` . ~..._ D {~J c:s': C~ .,r _~: V 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: `~ E• Rh°ads, Esquire Supreme Court I.D. No.: 49631 Name of Law Firm: Cleckner and Fearen Address: 119 Locust St., P. O. Box 11847, Harrisbur , PA 17108-1847 Telephone: (717)238-1731 Fax: (717)238-8481 Farm oc-ol rev. 10.13.06 Page 1 of 10 Estate of SARA I. HOFFSOMMER I . Name(s) and address(es) of Petitioner(s): Name: Ann E. Rhoads 119 Locust Street Address: Harrisburg, PA 17101 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 February 6, 2008 ® Letters Testamentary or ^Letters of Administration were granted to Petitioner(s) on Februarv 25, 2008 Date of Will (if applicable): May 17, 2001 Date(s) of Codicil(s) (f applicable): None Date of probate (f different from date Letters granted): S~ Was a bond required? ^Yes ~'J 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: The Patriot News -March 12, 19 and 26, 2008; Arland County Reporter -March 14, 21 and 28, 2008 Form oc-ol rev. IOJ3.06 Page 2 of 10 SARA I. HOFFSONII~R Estate of 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 s„~. 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 (rf 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 [f 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 FormOC-01 rev. /0.!3.06 Page 3 of 10 Estate of SARA I. HOFFSON'Il"!IIZ 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. 1f 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 I Relationship and Comments i any I Interest Robert D. Hbffsommer, Jr. Son 1/3 Residuary Estate 68 Eggert Avenue Metuchen, NJ 08840 Jon R. Hoffsommer 1802 Brandt Avenue New Cumberland, PA 17070 1/3 Residuary Estate Form OC-0/ rev. 10.13.06 Page 4 of 10 SARA I. HOFFSONIlMQt Estate of ,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? All known claimants have ^Yes ^Yes been paid in full . ^No ^ No ^Yes ^Yes ^No ^ No ^Yes ^Yes ^No ^ No ^Yes ^Yes ^No ^ 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. l 1. Was family exemption claimed? ................................ ^Yes ~No Was family exemption allowed? ................................ ^Yes ®No Family exemption claimant's name and relationship: Name: Relationship: Form OC-Ol rev. !0. /3.06 Page 6 of 10 Estate of SARA I • HOFFSONIl~~[t 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 04/11/2008 $10,000.00 ($188.98 refunded 10/24/2008) l 3. 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: None 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. None known. Form OC-01 rev. 10.13.06 Page 7 of 10 Estate of ~~ I • HOFFSONIl~fEf2 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. None 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: $5, 207.48 Purpose: Filing Fee, Account $300.00 State and Federal Income Taxes $500.00 Tax Return Prep. Fee $500.00 Balance Legal Fees $2,605.00 Balance Executrix Fee $1,302.48 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. See Notice att~ah~d°- }~' ~#8'a~iave. l 9. Is the Court being asked to direct the filing of a Schedule of Distribution? .......................... ^Yes ®No As to real estate only? ........................................ ^Yes Q No Form OC-0/ rev. 10.13.06 Page 8 of 10 Estate of SARA I • HOFFSONA'!ER 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(sJ AmoundProportion Robert D. Hoffsommer, Jr. 1/3 Jon R. Hoffsommer 1/3 Barbara L. Mark 1/3 B. Principal: Proposed Distributee(sJ Amount/Proportion Robert D. Hoffsommer, Jr. 1/3 Jon R. HoffsotY¢ner 1 /3 Barbara L. Mark 1/3 Submitted By: (All petitioners must sign. Add additional lines if necessary): . ~~ Name of Petitioner: ANN E. BROADS Name of Petitioner: Form OC-0/ rev. 10.13.06 Page 9 of 10 SARA I. HOFFSONJNID.2 Estate of Verification of Petitioner (Verification must be by at least one petitioner.) Deceased The undersigned hereby verifies * [that heishe SHE 1S title Executrix of the above-named name o ~o n Estate 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). Signature of Petitioner ANN E. BROADS * 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. ~ t~~c ~ Signature of Counsel for Petitioner ANN E. BROADS, ESQUIRE Form OC-0/ rev. /0.13.06 Page 10 of 10 • • <. COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DIVISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG, PA 17105-8486 March 27, 2008 CLECKNER AND FEAREN ANN E RHOADS ESQUIRE 111 LOCUST STREET P 0 BOX 11847 HARRISBURG PA 17108-1847 Re: SARA I HOFFSOMMER SSN: 164-50-2169 Dear Attorney Rhoads: Pursuant to your letter dated February 22, 2008, the Department of Public Welfare (DPW), Estate Recovery Program, has reviewed the information you provided regarding the above-referenced individual. It has been determined that this individual did not receive any type of assistance during the questioned period. Therefore, according to the information you provided, the Department's Estate Recovery Program will not seek any recovery from this estate. If your client applied for Medical Assistance and had an application and/or hearing pending at the time of death, please advise us and provide any additional information that may affect a recovery by our Department. If you have any questions, please feel free to contact me. Sincerely, .~ ,~ ~~~ Carole A. Procope Recovery Section Manager (717)772-6604 CLECKNER AIVU FEAREN ATTORNEYS AT LAW 119 LOCUST STREET P.O. BOX 11847 HARRISBURG, PENNSYLVANIA 1 71 08-1 847 RICHARD W. CLECKNER TELEPHONE: (717) 238-1731 (1926 - 20041 FAX: 1717) 238-8481 ROBERT D. HANSON DENNIS J. SHATTO (1916 - 20061 ANN E. RHOADS RETIRED: WILLIAM FEAREN December 11, 2008 CERTIFIED MAIL - RETURN RECEIPT REQUESTED Mr. Robert D. Hoffsommer, Jr. 68 Eggert Avenue Metuchen, NJ 08840 RE: Estate of Sara I. Hoffsommer, Deceased No. 00200 of 2008 Cumberland County, Pennsylvania Dear Mr. Hoffsommer: The first and Final Account of Ann E. Rhoads, Executrix of the Estate of Sara I. Hoffsommer, Deceased, will be presented by the Clerk to the Orphans' Court Division for audit, confirmation and distribution at the Cumberland County Courthouse, One Courthouse Square, Carlisle, Pennsylvania, 17113, on January 13, 2009. I enclose a copy of the First and Final Account and the Petition and Proposed Schedule of Distribution. You will note that the Account includes a reserve for the balance of legal fees to be paid to Cleckner and Fearen. If you wish to object to the Account, you must file a written objection no later than 9:00 a.m. on January 13, 2009. Otherwise, any objections will be deed to have been waived. Please contact me if you need further information or have any questions regarding the Account. Very truly yours, CLECKNER AND FEAREN Ann E. Rhoads AER : j at Enclosures CLECKNER ANU FEAREN ATTORNEYS AT LAW 119 LOCUST STREET P.O. BOX 11847 HARRISBURG, PENNSYLVANIA 17108-1847 TELEPHONE: (717) 238-1731 FAX: (717) 238-8481 DENNIS J. SHATTO ANN E. RHOADS December 11, 2008 CERTIFIED MAIL - RETURN RECEIPT REQUESTED Ms. Barbara L. Mark 410 Nottingham Place Harrisburg, PA 17109 RE: Estate of Sara I. Hoffsommer, Deceased No. 00200 of 2008 Cumberland County, Pennsylvania Dear Barbara: RICHARD W. CLECKNER (1926 - 20041 ROBERT D. HANSON f191s - 2oosl RETIRED: WILLIAM FEAREN The first and Final Account of Ann E. Rhoads, Executrix of the Estate of Sara I. Hoffsommer, Deceased, will be presented by the Clerk to the Orphans' Court Division for audit, confirmation and distribution at the Cumberland County Courthouse, One Courthouse Square, Carlisle, Pennsylvania, 17113, on January 13, 2009. I enclose a copy of the First and Final Account and the Petition and Proposed Schedule of Distribution. You will note that the Account includes a reserve for the balance of legal fees to be paid to Cleckner and Fearen. If you wish to object to the Account, you must file a written objection no later than 9:00 a.m. on January 13, 2009. Otherwise, any objections will be deed to have been waived. Please contact me if you need further information or have any questions regarding the Account. Very truly yours, CLECKNER AND FEAREN Ann E. Rhoads AER : j at Enclosures CLECKNER ANU FEAREN ATTORNEYS AT LAW 119 LOCUST STREET P.O. BOX 11847 HARRISBURG, PENNSYLVANIA 1 71 08-1 847 RICHARD W. CLECKNER TELEPHONE: (717) 238-1731 (1926 - 20o4J FAX: (717) 238-8481 ROBERT D. HANSON DENNIS J. SHATTO (1916 - 20061 ANN E. RHOADS RETIRED: WILLIAM FEAREN December 11, 2008 CERTIFIED MAIL - RETURN RECEIPT REQUESTED Mr. Jon R. Hoffsommer 1802 Brandt Avenue New Cumberland, PA 17070 RE: Estate of Sara I. Hoffsommer, Deceased No. 00200 of 2008 Cumberland County, Pennsylvania Dear Mr. Hoffsommer: The first and Final Account of Ann E. Rhoads, Executrix of the Estate of Sara I. Hoffsommer, Deceased, will be presented by the Clerk to the Orphans' Court Division for audit, confirmation and distribution at the Cumberland County Courthouse, One Courthouse Square, Carlisle, Pennsylvania, 17113, on January 13, 2009. I enclose a copy of the First and Final Account and the Petition and Proposed Schedule of Distribution. You will note that the Account includes a reserve for the balance of legal fees to be paid to Cleckner and Fearen. If you wish to object to the Account, you must file a written objection no later than 9:00 a.m. on January 13, 2009. Otherwise, any objections will be deed to have been waived. Please contact me if you need further information or have any questions regarding the Account. Very truly yours, CLECKNER AND FEAREN Ann E. Rhoads AER : j at Enclosures