HomeMy WebLinkAbout10-23-09 (2)DECEDENT'S ESTATE
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
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ESTATE OF LILLIAN C. O'BRIEN ,DECEASED .., t, ~? r.,a ~ ~ ~=~
No. 21-07-0101 ` ~' '~' ~ ~~
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PETITION FOR ADJUDICATION /
STATEMENT OF PROPOSED DISTRIBUTION
PURSUANT TO Pa. O.C. Rule 6.9
This form may be used in all cases involving the Audit of the Account of a Decedent's Estate. If
space is insufficient, riders may be attached. Attach the spouse's election, if any; the papers
required under items 8-19 inclusive; and any instrument pertinent to the adjudication.
INCLUDE ATTACHMENTS AT THE BACK OF THIS FORM.
Name of Counsel: STEPHEN J. NOGG, ESQUIRE
Supreme Court I.D. No.: 36812
Name of Law Firm:
Address: 19 SOUTH HANOVER STREET, SUITE 101, CARLISLE PA 17013
Telephone: (717)245-2698
Fax:~717)245-0829
Form OC-01 rev. 10.13.06 Page 1 of 10
i
Estate of LILLIAN C. O'BRIEN _. _, Deceased
1. Name(s) and address(es) of Petitioner(s):
Name: Michael E. O'Brien
Address: 520 Reno Street, Apt. 7
New Cumberland, PA 17070
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 Q No
If not, identify prior accountings, the accounting periods covered, and the date of
adjudication of the prior accounting.
2. Decedent died on January 20, 2007
Letters Testamentary or ~ Letters of Administration were granted to Petitioner(s) on
Date of Will (if applicable):
Date(s) of Codicil(s) (f applicable):
Date of probate (f 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: February 9, 2007, February 16, 2007 and
February 23, 2007
Form OC-01 rev. 10.13.06
Page 2 of 10
I
Estate of LILLIAN C. O'BRIEN
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 (if 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? ..... 0 Yes ~ No
Form OC-01 rev. 10.13.06
Page 3 of 10
Estate of LILLIAN C. O'BRIEN
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 o Each Pa in Interest ~ Relationshiv and
Interest
Michael E. O'Brien Son 25%
520 Reno Street, Apt. 7
New Cumberland, PA 17070
Leilani J. Brandt Daughter 25%
832 Mountain Road
Newville, PA 17241
Form oc-Ol rev. 10.13.06 Page 4 of 10
Estate of LILLIAN C. O'BRIEN
Name and Address o Each Par in Interest ~ Relationship and Con
JODY L. GILBERT DAUGHTER
26 CHESTNUT STREET
NEWVILLE, PA 17241
RICHARD A. O'BRIEN SON
2501 PERTH DRIVE
EDMOND, OK 73013
Deceased
Interest
25%
25%
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 OC-01 rev. 10.13.06
Page 5 of 10
Estate of LILLIAN C. O'BRIEN
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
Fu/l ?
SPIRIT OF AMERICA $ 215.32 Wes ~ Yes
c/o Balough Becker LTC ~No ~ No
4150 Olsen Mem. Hwy. Suite 200
Minneapolis MN 55422
FIA Card Services, NA $ 1,455.88 Yes ~ Yes
Estate Unit DES-014-02-03 No ~ No
1000 Samoset Drive
Wilmington DE 19884
Discover Financial Services $ 14,791.70 Yes ~ Yes
c/o Balough Becker, LTD ~]No Q No
4150 Olson Mem. Hwy. Suite 200
Minneapolis, MN 55422
Estate Recoveries, Inc. $ 367.44 Yes Q Yes
P.O. Box 3542
No
No
Baltimore, MD 21214
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-Ol rev. 10.13.06
Page 6 of 10
Estate of LILLIAN C. O'BRIEN
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
January 16, 2008 680.13 (11.54)
March 3, 2009 179.59 (56.29)
August 17, 2009 15.13
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-OI rev. 10.13.06 Page 7 of 10
Estate of LILLIAN C. O'BRIEN
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 Q 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 ~ No
....................
As to real estate only? ............. ~ es ~ o
. ......................... Y N
Form OC-o~ rev. 10.13.06 Page 8 of 10
Estate of LILLIAN C. O'BRIEN ,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
(SEE ATTACHED)
B. Principal:
Proposed Distributee(s) Amount/Proportion
Submitted By:
(All petitioners ~:ust sign.
Add additional lines if necessary):
~ r /..
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Name of Petitioner: MICHAEL E. O'BRIEN
Name of Petitioner:
Form OC-01 rev. 10.13.06 Page 9 of 10
Estate of LILLIAN C. O'BRIEN Deceased
Verification of Petitioner
(Verification must be by at least one petitioner.)
The undersigned hereby verifies * [that he/she is rime
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. § 4904 (relating to unsworn
falsification to authorities).
t ~-~~~
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 fo a been made beyond the
responses herein. /~
of Counsel ,~dr Petitioner
Form OC-01 rev. 10.13.06
Page 10 of 10
ESTATE OF LILLIAN C. O'BRIEN
ATTACHMENT TO ITEM #9:
MAYNARD BAUM
27 WEST HIGH STREET
CARLISLE PA 17013
MADALINE FOLTZ
1910 STERRETTS GAP AVENUE
CARLISLE PA 17013
ATTACHMENT TO ITEM #10:
DCM Services/Citibank
P.O. Box 1568
Minneapolis, MN 55440-1568
Estate Recoveries, Inc.
P.O. Box 3542
Baltimore, MD 21214
Joyce Runback
Estate Recoveries, Inc.
P.O. Box 24566
Baltimore, MD 21214
Wells Fargo Financial
4830 Carlisle Pike, E3
Mechanicsburg, PA 17050
Walmart
P.O. Box 530927
Atlanta, GA 30353-0927
Weltman, Weinberg & Reis
P.O. Box 163428
Columbus, OH 43272
LOWES
P.O. Box 530914
Atlanta GA 30353
BROTHER
SISTER
$ 316.27
$ 1,459.38
$ 9,550.94
$ 1,292.00
$ 882.86
$ 10,342.00
$ 326.41
NONE
NONE
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY,
PENNSYLVANIA
ORPHAN'S COURT DIVISION
NO. 21 07-0101
ESTATE OF LILLIAN C. O'BRIEN
PROPOSED DISTRIBUTION OF $16,805.56
Michael E. O'Brien - 25% $ 4,201.39
Leilani J. Brandt - 25% $ 4,201.39
Jody L. Gilbert - 25% $ 4,201.39
Richard A. O'Brien - 25% $ 4,201.39
Total Estate Value $16,805.56