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HomeMy WebLinkAbout07-14-10 _ __ , .,_- DECEDENT'S ESTATE n ~ ° ~ -~ COURT OF COMMON PLEAS OF r ~ -•r- C") r- << ~> .a.~ Cumberland COUNTY, PENN F- =-} ~ SYLVANIA 4 ~ - .~- . ~~- ~ r ~, =r~ ~ ORPHANS' COURT DIVISION ~ `~~c7 ~ ~rir ` c~ -r~ ~ . __ rt f..~ rY. (T'f r' ESTATE OF Erma I. Millard ,DECEASED No. 21-09-0698 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. INCLUDEATTACHMENTSATTHF BACK OF THIS FORM. Name of Counsel: Richard C. Snelbaker Supreme Court LD. No.: 6355 Name of Law Firm: Snelbaker & Brenneman P.C. Address: 44 West Main Street, Mechanicsburg, PA 17055 Telephone: 717-697-8528 Fax: 717-697-7681 Form OC-0! rev. 10.13.06 Page 1 of 10 / ~ Estate of Erma I. Millard Deceased 1. Name(s) and address(es) of Petitioner(s): Name: Ann M. Myers, Executrix Acidness: 302 N.E. 49th Street Oak Island, NC 28465 Identify any executors or administrators who have not joined in the Petition fob Adjudication and Statement of Proposed Distribution and state reason: N/A 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 March 4, 2009 ® Letters Testamentary or ®Letters of Administration were granted to Petitioner(s) on Julv 28.2009 Date of Will (fapplicable): 2/1/1989 Date(s) of Codicil(s) (if applicable): N/A Date of probate (f different from date Letters granted): same as above Was a bond required? [Yes ®No If yes, state amount: Are proofs of advertising of the grant of Letters attached? ......... ~ Y'es ~ No Dates of advertising of the grant of Letters: Cumberland Law Journal ,August 21,28, & September 4, 2009 & Patriot News August 21, 28 & September 4, 20p9 Form OC-OI rev. 10.13.06 ,Page 2 of 10 Estate of Erma I. Millard Deceased 3. Was decedent survived by a spouse? ............................. ®~es ®No If yes, name of the surviving spouse: 4. Has the surviving spouse filed to take an elective shaze? ............. ©1,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 (if none, so state): N/A 6. Did decedent marry after execution of Will or Codicil(s)? ........... ®Yles ®No Were any children born to decedent after execution of I'' Will or Codicil(s)? ........................................... ®Yles ®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 Welfaze? .............................. ®Yes ~ No Form oc-oi rev. 10.13.06 Page 3 of 10 Estate of Erma I. Millard 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 a~l 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 thbreby. A. If Notice has been given, attach a copy of the Notice as well as a list o$'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 dames 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 approprialte 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 i~ddition, the Attorney General's clearance certificate (or proof of service of Notice alnd 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 pajrty's interest(s): Form oc-oi rev. IoJ3.06 Rage 4 of 10 Estate of Erma I. Millard Deceased N/A C. State why a Petition for GuardiaNTrustee Ad Litem has or has not been filed for this Audit (see Pa. O.C. Rule 12.4). N/A 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-01 rev. 10.13.06 Page 5 of 10 B. Identify each party who is not sui juris (e.g., minors or incapacitated p rsons). 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 a next of kin of such party, giving the name, address and relationship of each. Estate of Erma I. Millard 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 Pard In Full? See Accounting Yes Yes ~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 lender 20 Pa.C.S. § 3392 and the proposed payments. ', 11. Was family exemption claimed? ................................ ~Yles mNo Was family exemption allowed? ................................ ~Y~es ~No Family exemption claimant's name and relationship: Name: Relationship: Form OG01 rev. 10.13.06 Page 6 of 10 Estate of Erma I. Millard 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 a~ follows: Date Payment Interest None -Insolvent Estate i 13. On the date of death, was the decedent a fiduciary (personal representative, trustee, guardian, agent under power of attorney) or surety on the bond of a fiduciary? ................... ~ I~es ~ 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 lthe 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 positio~ 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? .................. 0 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. N,'A Form OC-Ol rev. 10.13.06 Page 7 of 10 Estate of Erma I. Millard Deceased 16. Had the decedent been adjudicated an incapacitated person? .......... ~ ~l'es ®No If yes, attach a copy of the Order if available; otherwise state the Court, teircn, 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. Amovnt.~ $150.54 ru,pose: Filing fees, certified mail costs and other miscellaneous costs associated with the administration of the Decedent's estate. 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? ........................................ ®Ye~s ~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? ........................................ ~Ye~~ m No Form OC-01 rev. 10.13.06 Page 8 of 10 Estate of Erma I. Millard Deceased Wherefore, your Petitioner(s) ask(s) that distribution be awarded to the partied entitled and suggest(s) that the distributive shares of income and principal (residuary shares b~ing stated in proportions, not amounts) are as follows: A. Income: Proposed Distrrbutee(s) ~ AmoundProportion Ij None -Insolvent Estate B. Principal: Proposed Distributee(s) None -Insolvent Estate Amount/Proportion Submitted By: (All petitioners must sign. Add additional lines if necessary): Name of Petitioner: A~ M. Myers, Executrix Name of Petitioner: FormOC-O] rev. /0./3.06 P1ge 9 of 10 Estate of Erma I. Millard Deceased Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies * (that heishe she is title Executrix of the above-named name of corporation Estate of Erma I. Millard and] that the facts set forth in the foregoing Petition for Adjudication /Statement of Proposed Distribution ~{vhich 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 ujnsworn falsification to authorities). Signature of Petitioner * Corporate petitioners must complete bracketed information. .Certification of Counsel The undersigned counsel hereby certifies that the foregoing Petition for Adjud'~ ation/ Statement of Proposed Distribution is a true and accurate reproduction of the form Pet~tion authorized by the Supreme Court, and that no changes to the form have been made be}~ond the responses herein. Signature of Counsel for Petitionerr Form oc-oi rev. Io.13.06 Page 10 of 10 Th#riot-News Co. 812 Market St. Harrisburg, PA 17101 Inquiries - 717-255-8213 SNELBAKER, BRENNEMAN 8~ SPARE, P.G. 44 WEST MAIN STREET P.O. BOX 318 MECHANICSBURG PA 17055 c'~e~latriot 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 Leslie Kramer, being duly sworn according to law, deposes and says: That she is a Staff Accountant 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 Strut, in the City of Harrisburg, County of Dauphin, State of Pennsylvania, owner and publisher of The Patriot-News and Th Sunday Patriot-News newspapers of general circulation, printed and published at 812 to 818 Market Street, in the City, Countyland State aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th1, 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 ublished in their regular daily and/or Sunday/ Metro editions which appeared on the date(s) indicated below. That neither she no said Company is interested in the subject matter of said printed notice or advertising, and that all of the allegations of this tatement as to the time, place and character of publication are true; and That she has personal knowledge of the facts aforesaid and is duly authorized and empowered t 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 fo .the Recording of Deeds in and for said County of Dauphin in Miscellaneous Book °M", Volume 14, Page 317. PUBLICATION COPY This ad # 0002001449 ran on the dates shown below: ', August 21, 2009 August 28, 2009 ~X~;.,,*n / ~ September 04, 2009 Sworn to a~d'~ubs~cribed before me ~. Y~ras.~ie ,~ September, 2009 A. D. COMMOMNEALTH OF PENNSY VANIA NotarlN 13e~M Shsrtie L Iasner, No6ry PW~ c~cyara, rkuphlr, AM CamYMion E~ins Nov. Z6, 1 Member, PenMyNanie Auodetbn of -__r-i _. _. _ _ 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 ~ounty and State aforesaid, being duly sworn; according to law, deposes and says that the Cumb' land Law Journal, a legal periodical published in the Borough of Carlisle in the County and S to aforesaid, was established January 2, 1952, and designated by the local courts as the official le al periodical for the publication of all legal notices, and has, since January 2, 1952, bee regularly issued weekly in the said County, and that the printed notice or publication attached ereto is exactly the same as was printed in the regular editions and issues of the said Cumb and Law Journal on the following dates, ', Affiant further deposes that he is authorized to verify this statement by the C~lmberland 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 foregoi~lg statements as to time, place and character of publication are true. ', Coyne, )!!<i11aM,1~rma I., deed. Late of North Middleton Town- ship. Executrix: Ann M. Myers, 302 N.E. 49th Street, Oak Island, NC 28465. Attorneys: Snelbaker ~ Bren- neman, P.C., 44 West Main Street, P.O. Box 318, Mechanicsburg, PA 17055-0318. SWO1~T0 AND. SUBSCRIBl~D befor~ me this 4 day of September, 2009 it Notary (yy NOTARIAL SEA4 DEBORAH A COL4INS Notary Publicl CARLISLE 8080, CUMBERtJ~ND COUNTY My Commission Expires r 28, 2010 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANC4IL OPERATIONS DNISION OF THIRD PARTY LU-BILITY ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG, PA 17705-8486 August 10, 2009 SNELBAKER & BRENNEMAN PC RICHARD C SNELBAKER ESQUIRE 44 W MAIN ST MECHANICSBURG PA 17055 Re: ERMA MILLARD CIS #: 510165653 SSN: 170-30-3733 Date of Death: 03/04/2009 Dear Mr. Snelbaker: Please be advised that the Department of Public Welfare maintains a claim in the amount of $238,858.01 against the above-mentioned estate'. This claim is for restitution of medical assistance granted on behalf of t!he decedent for which the Probate Estate is now responsible to reimburs the Department according to Act 49, 62 P.S. 1412, effective August 15, 194, as amended by Act 20-95; effective June 30, 1995. Enclosed is the Depar~,tment's itemized statement of claim. A portion of this medical expense, namely $24,172.12, was incurred during the last six months of the decedent's life; therefore, it is a~~ Class 3 claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $214 6 5.89, is to be entered as a priority Class 5.1 claim against the estate. Please acknowledge receipt of this letter and advise whether the'. Commonwealth's claim is admitted and when payment may be expected. I'~f the estate accounting is complete, please provide a copy. If the estate contains real estate, please provide copies of the deed, the latest tax assessment, and a current appraisal, if available. Sincerely, Cu.~sU ~~ Jessica L. Strawbridge TPL Program Investigator 717-772-6238 717-772-6553 FAX Enclosure SNELBAKER F3 BRENNEMAN, P.C. A PROFESSIONAL CORPORATION ATTORNEYS AT LAW 44 WEST MAIN STREET MECHANICSBURG, PENNSYLVANIA 17055 RICHARD C. SNEIBAKER KEITH O. HREENNEMAN 717-697-8528 P. O. HOX 318 July 14 , 2 010 FACSIMILE (717) 697-7681 TO: Commonwealth of Pennsylvania Certified Mail Not Department of Public Welfare [ 7007 2680 0000 2363 1',522] Bureau of Financial Operations Division of Third Party Liability Estate Recovery Program Attention: Jessica Strawbridge P.O. Box 8486 Harrisburg, PA 17105-8486 I' Ann M. Myers 302 N.E. 49t'' Street Oak Island, NC 28465 Re: Estate of Erma I. Millard Estate No. 21-09-0698 NOTICE TO PARTIES IN INTEREST The undersigned, as Attorney for Ann M. Myers, the Executrix cif the Estate and under the Last Will and Testament of Erma I. Milla d, Deceased, hereby gives notice to each of the above named pers~ns pursuant to Rule 6.3 of the Pennsylvania Supreme Court Orphans' Court rules as follows: 1. She has filed this date in the office of the Clerklof Orphans' Court and Register of Wills of Cumberland County, Pennsylvania, at Carlisle, PA, the First and Final Account of her administration as such Executrix, together with an Inventory, It rue copies of which are enclosed herewith. 2. Said Account will be presented to a judge of the Orphans' Court Division of the Cumberland County Court of Common Pleas lat the Cumberland County Court House, 1 Court House Square, Carlisle,'PA 17013, on August 24, 2010 at 9:00 o'clock A.M., prevailing time, at which time said Account will be confirmed unless written objecltions are filed prior thereto. 3. You have the right to file written objections to said Account and Statement prior to the confirmation as scheduled abbove. r trul yours, Richard C. Snelbaker RCS:sks Enclosures ?i' ~ n ~ ~ `~ Cr~an~rs arras Lrnsarrias of Esra~r~,s § 1b7:207 ~l Primary Authority 20 Pa. C.S. §§ 3381, 3392, 3532(b)(3) - A.L.R. Library - A.L.N,. Index, Decedents' Estates; Executors and Administrators; a Judgment Liens; Judgments, Orders, and Decrees; Liens and 1 Encumbrances; Preferences and Priorities; Tag Liens 1 West's A.L.R. Digest, Executors and Administrators X202 259 to - 261, 513(10). 513(11) i Legal Encyclopedias Am. Jur. 2d, Descent and Distribution § 141; Executors and Administrators §§ 649 to 676 ' C.J.S., Executors and Administrators §§ 503 to 532 § 157:207 Generally Research References West's Key Number Digest, Executors and Administrators c~219.6, 259 to 261 If the applicable assets of the decedent's estate are insuf- ficient to pay all proper charges and claims in full, the personal representative, subject to any preference given by law to claims due the United States, must pay them in the following order, without priority as between claims of the same class: (1) the costs of administration; (2) the family exemption; (3) the costs of the decedent's funeral and burial, and the costs of medicines furnished to the decedent within six months of his or her death, of medical or nursing services performed for the decedent within that time , of hospital services including maintenance provided the decedent within that time, of services provided under the medical assistance program provided within that time and of services performed for the decedent by any of his employees within that time; (4) the cost of a gravemarker; (5) rents for the occupancy of the decedent's residence for six months immediately prior to his or her death; (6) claims by the Commonwealth and the political subdi- visions of the Commonwealth; and 289 § 187:207 STANDARD PENNSYLVANIA PRACTICE 2D (?) all other claims.' The statutory order of priority applies only in determining the respective rights of unsecured creditors among them- selves, and does not apply to those who, during the decedent's lifetime, have obtained security for their claims by mortgage or by lien of judgment.2 Such secured creditors continue to have first priority with respect to the encumbered property of the decedent.9 The purpose of the rule fixing the order of priority among unsecured creditors and those who have incurred charges in connection with an estate is to favor certain classes of credi- tors; to this end, the law must be strictly construed, and is subject to the general rule of construction that parties claim- ing the benefit of class legislation must bring themselves within its provisions.4 Property which is subject to a valid option agreement made by the decedent while living, and which is subject to a decree of specific performance against his or her estate, takes prior- ity over the elective share of the decedent's surviving spouse.5 When a testator in his will gives specified property or a share of his estate in exact or substantial compliance with the terms of his obligations under an inter vivos property settle- ment or antenuptial agreement made with his wife, the wife is a creditor of his estate and not a legatee under the will, and consequently, the wife's claim is superior to the claims of other legatees and devisees.e Where a surety pays money to the government on behalf of his or her principal for taxes assessed as due, the surety is entitled to be subrogated to the rights of the government, including any priority which the government may have.' [Section 167:207] '20 Pa. C.S. § 3392. As to the preference for claims due the United States, see §§ 157:215, 167:216. For further discussion of pri- ority of claims, see 10 Sum. Pa. Jur. 2d, Probate, Estates, and Trusts §§ 12:51 to 12:52. 2§ 157:208. 3§ 157:208. 4In re Gilbert's Estate, 5 Pa. 290 D. & C.2d 646, 1956 WL 6522 (Orphans' Ct. 1956). gIn re Brown's Estate, 446 Pa. 401, 289 A.2d 77 (1972). As to specific performance of such agreements, see 20 Pa. C.S. § 3390, discussed in § 164:33. BIn re Estate of Blumenthal, 2002 PA Super 382, 812 A.2d 1279 (2002). . ~In re Sheaffer's Estate, 281 Pa. 138, 126 A. 205 (1924). IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY] PA. ORPHANS' COURT DIVISION FILE NO: 21-09-0698 FIRST AND FINAL ACCOUNT OF Ann M. Myers For ESTATE OF ERMA I. MILLARD LAW OFFICES SNELBAKER 8f BRENNEMAN, P.C. Purpose of Account: Ann M. Myers, Executrix offers this Account to acquaint interested parties with the transactions that have occurred during her Administration. It is important that the Account be carefully examined. Requests for additional information, questions or objections can be discussed with: Social Security #: 170-30-3733 Tax ID #: N/A Date of Death: March 4 2009 Date of Incapacity, if any: , None Date of Executor Appointment: July 28, 2009 Date of First Complete Advertisement: August 21 2009 Accounting for the period: , March 4, 2009 to May 19 2010 Richard C. Snelbaker Snelbaker & Brenneman, P.C. 44 West Main Street Mechanicsburg, PA 17055 Phone #: 717-697-8528 Supreme Court LD. No: 06355 >. C, 7 _ ~i n I"- p ~ 1'^ _ _ , .t"7 , ~ t f, r ' r } '--~ i 3 ~ ~`t Y '~l ~ ~•7 ~ .~ Page 1 __ __ - _ i I i SUMMARY OF ACCOUNT PRINCIPAL PAGE Receipts 3 $6,929.08 $6,929.08 Less Disbursements/Claims to be paid upon confirmation of account: Class (1) Claims: 3 $2,895.618 Class (2) Claims 3 $O.O~p Class (3) Claims 3 $4,033.4p Class (4) Claims 4 $O.Op Class (5) Claims 4 $O.Ob Class (6) Claims 4 $0.0~ $6 929 08 Balance before Distributions , . $0 00 Distributions to Beneficiaries 4 . $0 00 Principal Balance on Hand 4 . $0.00 For Information: Investments Made 5 Changes in Holdings 5 INCOME Receipts 5 $0 00 Less Disbursements 5 . $0 00 Balance before Distributions . $0 00 Distributions to Beneficiaries 5 . $0 00 Income Balance on Hand . $0.00 COMBINED BALANCE ON HAND $0.00 Listing of Unpaid Creditors g Listing of Persons Interested in Distribution g Estate Affidavit Page 7 uw o~icEs SNELBAKER 8C BRENNEMAN, F.C. Page 2 __ ', i PRINCIPAL RECEIPTS Assets Listed on Inventory per copy of attached: (Valued as of Date of Death) ADJUSTMENTS TO INVENTORY SUBSEQUENT RECEIPTS TOTAL PRINCIPAL RECEIPTS DISBURSEMENTS OF PRINCIPAL uw or~icEs SNELBAKER & BRENNEMAN, P.C. CLASS {1) CLAIMS -COSTS OF ADMINISTRATION The following items are to be paid upon confirmation of accounting: 8/14/2009 State Employees Retirement System, repay pension paid in error 9/25/2009 Register of Wills, filing fee for Inheritance Tax Retum '`" Snelbaker & Brenneman, P.C., costs advanced a. Register of Wills, probate fee b. Patriot-News, advertising Executrix Notice c. Cumberland Law Journal, advertising Executrix Notice '" Snelbaker 8~ Brenneman, P.C., attorney fees "" Ann M. Myers, claim for travel expenses required for the administration of Decedent's estate Ann M. Myers, Executrix Commission "` Reserve for filing fees for Final Accounting, Inventory and certified mail costs TOTAL CLASS I CLAIMS TO BE PAID: CLASS (2) CLAIMS -FAMILY EXEMPTION NONE $6,929.08 $0.00 $0.00 $6,929.08 $232.61 15.00 324.03 1,250.00 577.50 346.00 150.54 '~ $2,895.68 CLASS (3) CLAIMS -COST OF FUNERAL AND BURIAL AND THE COSTS OF MEbICINES FURNISHED WITHIN SIX MONTHS OF DEATH 5/5/2009 Cocklin Funeral Home f I $0.00 unera services $461.02 '"` Ann M. Myers, claim for funeral luncheon and flowers ' 467.00 "" Partial payment to Commonwealth of Pennsylvania for reimbursement 3,105.38 for medical expenses incurred during last six months of decedent's life TOTAL CLASS III CLAIMS TO BE PAID: ~ $4,033.40 Page 3 I 91.0 158.031 75.Oa II CLASS l4) CLAIMS -COSTS OF GRAVE MARKER NONE $0.00 CLASS l5) CLAIMS -RENTS FOR OCCUPANCY OF THE DECEDENT'S RESIDENCE NONE $0.00 CLASS /6) CLAIMS -ALL OTHER CLAIMS UNPAID CREDITOR -Commonwealth of Pennsylvania for $0.00 reimbursement of Class VI Claim in the amount of $214,685.89 DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES NONE $0.00 PRINCIPAL BALANCE ON HAND FIDUCIARY VALUE AT ,ACQUISITION 5/19/2010 VALUE Law o~icEs SNELBAKER & BRENNEMAN, P.C. I Cash '* Less expenses to be paid subsequent to confirmation of First and Final Account as listed on page 3 of accounting TOTAL PRINCIPAL BALANCE ON HAND $ 6,220.45' $ 6;929.08 $ (6,220.45 $0.00 $ 6,929.08 Page 4 INFORMATION SCHEDULES ~ ' PRINCIPAL INVESTMENTS MADE NONE $0.00 CHANGES IN PRINCIPAL HOLDINGS NONE $0.00 RECEIPTS OF INCOME NONE $0.00 DISBURSEMENTS OF INCOME NONE $0.00 DISBURSEMENTS OF INCOME TO BENEFICIARIES NONE $0.00 LAw o~icES II SNELBAKER & BRENNEMAN, P.C. Page 5 * UNPAID CREDITORS: 1 • Commonwealth of Pennsylvania Department of Public Welfare Bureau of Financial Operations Division of Third Party Liability Estate Recovery Program Attention: Jessica Strawbridge P.O. Box 8486, Harrisburg, PA 17105-8486 Class 3 Claim for remainder of unpaid medical expenses $ 21,066.74 within the last six months of Decedents life Class 6 Claim for balance of medical expenses $ 214,685.89 ** PERSONS INTERESTED IN DISTRIBUTION OF ESTATE: 1. Ann M. Myers $0.00 302 N.E. 49th Street Oak Island, NC 28465 LAW OFFICES SNELBAKER EC BRENNEMAN, P.C. Page 6 STATE OF NORTH CAROLINA ~ SS. COUNTY OF ~ nU -~- S l~ ~ c ~ ~ ] Ann M. Myers, being duly sworn according to law deposes and says: that she is the Executrix of the Estate and under the Last Will and Testament of Erma I. Millard, Deceased; that she is the Accountant herein; that the foregoing is a true and complete accounting of her administration of said Estate; that the attached list or schedule [*] contains the names, addresses and amounts due unpaid creditors who have given proper notice of their claims; that the attached fist or schedule (**) contains the names and addresses of all perso!~s interested in the distribution of said Estate; and that the facts set forth herein are true and correct to the best of her knowledge, information and belief. Ann M. Myers, Executri Swom to and subscribed before me thisr,~ 5 day of 1,A.wc.l 2010 ~"`1 c.-o~.K., pxp. 1- at-ao ~ 3 ~aNpVA ~s44 0 cv H®I,y~, `~Z= pv Y Z e4~ _ C Ck e• ''o,'ii ~OUN~:~,,. Lnw o~~cEs SNELBAKER & BRENNEMAN, P.C. Page 7 __ __ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTI", Pq, ORPHANS' COURT DIVISION FILE NO: 21-09-0698 FIRST AND FINAL ACCOUNT OF Ann M. Myers For ESTATE OF ERMA I. MILLARD Purpose of Account: Ann M. Myers, Executrix-offers this Account 10 to acquaint interested parties with the transactions that have occurred during her Administration It is important that the Account be carefully examined. Requests for information, questions or objections can be discussed with: additional Social Security #: Tax ID #: 170-30-3733 Date of Death: N/A Date of Incapacity, if any: March 4, 2009 Date of Executor Appointment: None Date of First Complete Advertisement: July 28, 2009 Accounting for the period: August 21, 2009 March 4, 2009 to May 19 20 Richard C. Snelbaker Snelbaker & Brenneman, P.C. 44 West Main Street Mechanicsburg, PA 17055 Phone #: 717-6g7_g52g Supreme Court LD. No: 0_ LAw ~icEs ~NELBAKER & `NNEMAN. P.C. c7 ~~' N a '7 •Z = ~ ~ ~`1 C'~ • ~C7 ~ ~ ~ rx a r`1 ~~ ~' ~ ~ { .~ ~.._ a ~ car a `~' ~- ~ Page 1