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HomeMy WebLinkAbout11-10-10DECEDENT'S ESTATE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF Marjorie M. Donovan ,DECEASED No. 21-07-1092 PETITION FOR ADNDICATION / STATEMENT OF PROPOSED DISTRIBUTION PURSUANT TO Pa. O.C. Rule 6.9 N O '~ O ~ 2 rn n o ~ ~ t ~~~ ~~a 3 ~~ ~ ~ TJ _~, (~fJ"f : ~ ~ ~; ~+~ r~- r-n c..- -.a '.._ r i T ~'~ a -TT This form may be used in all cases involving the Audit of the Account of a Decedent's Estate. If' space is insu~cient, 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: Richard C. Snelbaker Supreme Court LD. No.: 6355 Name of Law Firm: Snelbaker & Brenneman P.C. Address: ~ west Main Street, Mechanicsburg, PA 17055 Telephone: 717-697-8528 Fax:~17-697-7681 Form OC-ol rev. 10.13.06 Page 1 of 10 ~w Estate of Marjorie M. Donovan ,Deceased 1. Name(s) and address(es) of Petitioner(s): Name: Brenda J. Beecher address: 2250 Pine Road Newville, PA 17241 Identify any executors or administrators who have not joined in the Petition for Adjudication and Statement of Proposed Distribution and state reason: N/A Is this the first accounting by this fiduciary? ..................... ~ Yes ~ No If not, identify prior accountings, the accounting periods covered, and the date of adjudication of the prior accounting. 2. Decedent died on 11/23/2007 Letters Testamentary or Letters of Administration were granted to Petitioner(s) on 11/30/2007 Date of Will (if applicable): 07/20/2000 Date(s) of Codicil(s) (if applicable): N/A Date of probate (if different from date Letters granted): same as above Was a bond required? Wes ~ 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: Cumberland Law Journal ,December 14, 21, 28, 2007 & The Sentinel, December December 12, 19, 26, 2007 Farm oc-ol rev. 10.13.06 Page 2 of 10 Estate of Marjorie M. Donovan ,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 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)? ........... ~ Yes ®No Were any children born to decedent after execution of Will or Codicil(s)? ........................................... ~ Yes Q 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 Form OC-Ol .ev. lo.rs.o6 Page 3 of 10 Estate of Marjorie M. Donovan 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): For,,, oc-or rev. 10.13.06 Page 4 of 10 Estate of Marjorie M. Donovan ,Deceased Logan Donovan -Date of Birth: 6/3/1995 Brenda J. Beecher, Guardian of property which passes under the Will per Item IV Wade Donovan -Date of Birth: 5/6/1997 Brenda J. Beecher, Guazdian of property which passes under the Will per Item IV. C. State why a Petition for Guazdian/Trustee Ad Liaem has or has not been filed for this Audit (see Pa. O.C. Rule 12.4). D. If distribution is to be made to the personal representative of a deceased party, state date of death, date and place of grant of Letters and type of Letters granted. N/A Farm OC-O1 rev. 10.13.06 Page 5 of 10 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 Guazdian has been appointed, identify the next of kin of such party, giving the name, address and relationship of each. Estate of Marjorie M. Donovan ,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 Admittefi Be Paid In Full a Commonwealth of Pennsylvania $19,014.68 Yes Yes Department of Public Welfare ^No ~No Bureau of Financial Operations Division of Third Party Liability Estate Recovery Program Yes ~ Yes P.O. Box 8486 ONo ~No Harrisburg, PA 17105-8486 Yes ~ Yes ~No ~ No DYes 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. 11. Was family exemption claimed? ................................ Yes ~No Was family exemption allowed? ................................ Yes mNo Family exemption claimant's name and relationship: Name: Relationship: Farm oc-o/ rev. 10./3.06 Page 6 of 10 Estate of Marjorie M. Donovan Deceased 12. T'he 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 3/15/2010 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: N/A 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. 2,070.69 172.59 Farm oc-oI rev. !0.13.06 Page 7 of 10 Estate of MarJorie M. Donovan Deceased 16. Had the decedent been adjudicated an incapacitated person? .......... ~ Yes m 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. dmm.n~. 1,000. ~0 P'~FOSe~ Filing fees, accountant fees 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? ........................................ DYes ~No If so, attach a copy of the notice. 19. Is the Court being asked to direct the filing of a Schedule of Distribution? .......................... mYes ~No As to real estate only? ........................................ DI'es ~ No Form oc-ol rev. !0.13.06 Page 8 of 10 Estate of Marjorie M. Donovan 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) See Accounting B. Principal: Proposed Distributee(s) See Accounting Amount/Proportion Amount/Proportion Submitted By: (AU petitioners must sign. Add additional lines ifnecessary): ~ISC~ ~. ~5®P (~Lr c1~Pcufiti~o Name of Petite er: Brenda J. Beecher Name of Petitioner: Form oc-ol rev. 10.13.06 Page 9 Of 1 O Estate of Marjorie M. Donovan Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies * [that heishe she 1S title Executrix Deceased of the above-named name ofcorporation Estate of Mariorie M. Donovan 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). N ~ ~ 1 ~. r`-K~CI.~C~}C Signature of Pe ' ner "Corporate petitioners mast complete bracketed information. Certification of Counsel The undersigned counsel hereby certifies that the foregoing Petition for Adjudication/ Statement of Proposed Distribution is a true and accurate reproduction of the form Petition authorized by the Supreme Court, and that no changes to the form have been made beyond the responses herein. Signature of Counsel for Petitioner Form oc-o! rev. !0.13.06 Page 10 of 10 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, viz: December 14 December 21 and December 28 2007 Affiant further deposes that he is authorized to verify this statement by the Cumberland Law Journal, a legal periodical of general circulation, and that he is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statements as to time, place and character of publication are true. 4 Doaovan, Marjorie M., deed. Late of Penn Township. Executrix: Brenda J. Beecher, 2250 Pine Road, Newville, PA 17241. Attorneys: Saelbaker 8s Bren- neman, P.C., 44 West Main Street, P.O. Box 318, Mechanicsburg, PA 17055-0318. is arie Coyne, Editor SWORN TO AND SUBSCRIBED before me this 28 day of December, 2007 Notary ~~ NOTARIAL SEAL DEBORAH A COLLINS Notary public CARLISLE BORO, CUMBERLAND COUNTY My Commisalon Expires Apr 28, 2010 PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Tammy Shoemaker Classified Advertising Manager of The Sentinel, of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13,1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of THE SENTINEL on the following day(s) December 12, 19 26 2007 COPY OF NOTICE OF PUBLICATION Affiant further deposes that he/she is not interested in the subject matter of the aforesaid notice or advertisement, and that all allegations in the foregoing statement as to time, place and chazacter of publication are true. ~~ e~~~~ Swom to and subscribed before me this 27th. day of December 2007. '/ t' Notary Publi My commission expires: Q~~/c~' COMMONWEALTH OF PENNSYLVANIA Notary Seal Chrisir~ L. WaNe, Notary Pubic Carlisle Bono, Gnrrberlarb County My Corrrrtission E Sept 1,2008 Hamper. PannsNvania Aesociatlon Of Notaries COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DIVISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX 3488 HARRISBURG, PA 17105-8488 February 14, 2008 RICHARD C SNELBAKER ATTY AT LA 44 WEST MAIN STREET MECHANICSBURG PA 17055 Re: MARJORIE DONOVAN CIS #: 220190441 SSN: 161-32-5312 Date of Death: 11/23/2007 Dear Attorney Snelbaker: Please be advised that the Department of Public Welfare maintains a claim in the amount of $19,014.68 against the above-mentioned estate. This claim is for restitution of medical assistance granted on behalf of the decedent for which the Probate Estate is now responsible to reimburse the Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as amended by Act 20-95, effective June 30, 1995. Enclosed is the Department's itemized statement of claim. A portion of this medical expense, namely $19,014.68, 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 $.00, is to be entered as a priority Class 6 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. If 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, ~ ~~~~~~J Linda J. Kauffman Claims Investigation Agent 717-772-6614. 717-772-6553 FAX Enclosure SNELBAKER F3 BRENNEMAN, P.C. A PROFESSIONAL CORPORATION ATTORNEYS AT LAW 44 WEST MAIN STREET MECFIANICSBURG. PENNSYLVANIA 17055 RICHARD C. SNELSAKER KEITH O. BRENNEMAN P. O. BOX 318 717-6~J7-8528 FACSIMILE (717) 6~J7.7681 November 10, 2010 TO: Tiffany N. Beecher Warner 93 Horse Killer Road Shippensburg, PA 17257 Matthew Beecher 20 Lebo Road Carlisle, PA 17015 Brenda J. Beecher, Logan Donovan and 2250 Pine Road Newville, PA 17241 Christina Beecher 2250 Pine Road Newville, PA 17241 guardian for Wade Donovan Commonwealth of Pennsylvania Department of Public Welfare Bureau of Financial Operations Division of Third Party Liability Estate Recovery Program Attention: Linda J. Kauffman P.O. Box 8486 Harrisburg, PA 17105-8486 Certified Mail No. [7007 2680 0000 2363 1904] Re: Estate of Marjorie M. Donovan, Deceased Estate No. 21-07-1092 NOTICE TO PARTIES IN INTEREST The undersigned, as Attorney for Brenda J. Beecher, Executrix of the Estate and under the Last Will and Testament of Marjorie M. Donovan, Deceased, hereby gives notice to each of the above named persons 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 Clerk of 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 and Statement of Proposed Distribution, true copies of which are enclosed herewith. SNELBAKER ~ BRENNEMAN, P.C. Estate of Marjorie M. Donovan November 10, 2010 Page 2 2. Said Account and Statement will be presented to a judge of the Orphans' Court Division of the Cumberland County Court of Common Pleas at the Cumberland County Court House, 1 Court House Square, Carlisle, PA 17013, on January 11, 2011 at 9:00 o'clock A.M., prevailing time, at which time said Account will be confirmed and distribution ordered in accordance with said Statement of Proposed Distribution unless written objections are filed prior thereto. 3. You have the right to file written objections to said Account and Statement prior to the confirmation as scheduled above. er y yours, Richard C. Snelbaker RCS: sks Enclosures ~-{~.5~ 3~ ~~° IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA. ORPHANS' COURT DIVISION FILE N0: 21-07-1092 FIRST AND FINAL ACCOUNT OF Brenda J. Beecher, Executrix For ESTATE OF MARJORIE M. DONOVAN LAW OFFICES SNELBAKER 8C BRENNEMAN, P.C. Social Security #: Tax ID #: Date of Death: Date of Incapacity, if any: Date of Executrix Appointment: Date of First Complete Advertisement: Accounting for the period: 161-32-5312 26-6125819 November 23, 2007 None November 30, 2007 December 7, 2007 November 23, 2007 to October 29, 2010 Purpose of Account: Brenda J. Beecher, 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: Richard C. Snelbaker Snelbaker & Brenneman, P.C. 44 West Main Street Mechanicsburg, PA 17055 Phone #: 717-697-8528 Supreme Court I.D. No: 06355 n ~O .-~ ~~~ '~~ Page 1 N c7 `J7 O -Z. ,1 Z' f/Ti J Yl ~ r +~ aP„ G^ i.".7 f~-~, ,_ ~ Q YC°: r._..J C.' ", A -i-1 3 :.^~ ~~, ~ •~_~ .~ :r~C; ~ --i LAW OFFICES SNELBAKER 8C BRENNEMAN. F.C. SUMMARY OF ACCOUNT PRINCIPAL Receipts Net Gain on Sales or Disposition Less Disbursements: Debts of Decedent Funeral Expenses Administration Expenses Family Exemption Federal, State & Local Taxes Fees and Commissions Balance before Distributions Distributions to Beneficiaries Principal Balance on Hand For Information: Investments Made Changes in Holdings INCOME Receipts Less Disbursements Balance before Distributions Distributions to Beneficiaries Income Balance on Hand COMBINED BALANCE ON HAND Listing of persons interested in the Estate Statement of Proposed Distribution Affidavit /verification page PAGE 3 $46,433.51 3 -139.25 $ 46,294.26 3 $ 19,014.68 3 9, 920.58 3 & 4 2,006.62 4 0.00 4 2,243.28 4 2,115.95 35,301.11 $ 10,993.15 4 0.00 $ 10,993.15 4 4 5 $ 49.65 5 $0.00 $ 49.65 5 $0.00 $ 49.65 $ 11,042.80 6 7 8 Page 2 PRINCIPAL RECEIPTS Assets Listed on Inventory per copy of attached: $46,101.36 (Valued as of Date of Death) ADJUSTMENTS TO INVENTORY 0.00 SUBSEQUENT RECEIPTS 12/3/2007 PR Hoffman, pension payment 206.04 6/11/2010 Final distributive share from Estate of Helen Arlene Donovan 126.11 TOTAL PRINCIPAL RECEIPTS $46,433.51 PRINCIPAL GAINS OR LOSSES ON SALES OR OTHER DISPOSITIONS GAIN LOSS 1/22/2008 MetLife, 92 shares of common stock $ - $ 139.25 TOTAL GAINS AND LOSSES $ - $ 139.25 NET GAIN/LOSS TRANSFERRED TO SUMMARY $ (139.25) DISBURSEMENTS OF PRINCIPAL DEBTS OF DECEDENT The following item will be paid upon confirmation of the Accounting *** Commonwealth of Pennsylvania, Department of Public $ 19,014.68 Welfare, Class 3 claim for medical expenses incurred during the last six months of the decedent's life $ 19,014.68 FUNERAL EXPENSES 1/18/2008 Fogelsanger-Bricker, funeral services $ 5,000.00 1/28/2008 Fogelsanger-Bricker, funeral services 4,920.58 $ 9,920.58 ADMINISTRATION EXPENSES 2/15/2008 PR Hoffman, return pension payment paid in error $ 206.04 2/29/2008 Dan Hershey Auction Service, LLC, appraisal fee 75.00 6/2/2008 Greenawalt 8~ Company, P.C., preparation of Final 300.00 Individual Income Taxes 2/28/2010 Adams County National Bank, service charges 40.00 3/15/2010 Register of Wills, filing fee for Supplemental Inheritance 15.00 Tax Return The following item will be paid upon confirmation of the Accounting *** Snelbaker & Brenneman, P.C., costs advanced: 370.58 a. The Sentinel, advertising Executrix 174.58 Notice b. Cumberland Law Journal, advertising 75.00 Executrix Notice c. Register of Wills, short certificate 4.00 d. Register of Wills, filing fee for 15.00 Inheritance Tax Return e. Register of Wills, additional probate 15.00 LAW OFFICES fee SNELBAKER & f. Register of Wills, probate fees 87.00 BRENNEMAN. P.C Page 3 DISBURSEMENTS OF PRINCIPAL -CONTINUED ADMINISTRATION EXPENSES -CONTINUED *** Reserve for filing fees, accountant fees and other miscellaneous costs associated with the administration of the decedent's estate FAMILY EXEMPTION FEDERAL. STATE & LOCAL TAXES 3/15/2010 Register of Wills, Agent, PA Inheritance Tax FEES AND COMMISSIONS 1,000.00 $ 2,006.62 0.00 2,243.28 2,243.28 7/18/2008 Dan Hershey Auction Service, LLC, commission $ 40.95 on household goods sold at auction The following item will be paid upon confirmation of the Accounting *** Snelbaker & Brenneman, P.C., attorney services 2,075.00 2,115.95 TOTAL DISBURSEMENTS OF PRINCIPAL $ 35,301.11 DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES NONE $0.00 TOTAL DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES $0.00 PRINCIPAL BALANCE ON HAND FIDUCIARY VALUE AT ACQUISITION 10/29/10 VALUE Common Stocks Household goods retained In-Kind Cash *** Less items to be paid upon confirmation of Accounting as listed on page three and four TOTAL PRINCIPAL BALANCE ON HAND INFORMATION SCHEDULES PRINCIPAL INVESTMENTS MADE NONE $0.00 $ 5,669.96 $0.00 $ 346.00 $ 33,503.06 $ 40,085.40 $ (22,460.26) $ 11,042.80 $ 46,101.36 CHANGES IN PRINCIPAL HOLDINGS LAW OFFICES SNELBAKER & BRENNEMAN, P.C. NONE Page 4 RECEIPTS OF INCOME 1/28/2008 MetLife, dividend 12/12/2007 Adams County National Bank, checking account interest from 11/23/07 to 12/12/07 TOTAL RECEIPTS OF INCOME DISBURSEMENTS OF INCOME NONE TOTAL DISBURSEMENTS OF INCOME DISBURSEMENTS OF INCOME TO BENEFICIARIES LAW OFFICES SNEL6AKER SC BRENNEMAN, P.C. NONE TOTAL DISBURSEMENTS OF INCOME TO BENEFICIARIES $ 49.02 0.63 $ 49.65 $0.00 $0.00 $0.00 $0.00 Page 5 " UNPAID CREDITORS: NONE *" PERSONS INTERESTED IN DISTRIBUTION OF ESTATE: Tiffany N. Beecher Warner 93 Horse Killer Road Shippensburg, PA 17257. 2. Matthew Beecher 20 Lebo Road Carlisle, PA 17015 3• Brenda J. Beecher, guardian for Logan Donovan 2250 Pine Road Newville, PA 17241 4• Brenda J. Beecher, guardian for Wade Donovan 2250 Pine Road Newville, PA 17241 5. Christina Beecher 2250 Pine Road Newville, PA 17241 6• Commonwealth of Pennsylvania Department of Public Welfare Bureau of Financial Operations Division of Third Party Liability Estate Recovery Program Attention: Linda J. Kauffman P.O. Box 8486 Harrisburg, PA 17105-8486 LAW OFFICES SNELBAKER & BRENNEMAN, P.C. Page 6 PROPOSED DISTRIBUTION TO BENEFICIARIES LAW OFFICES SNELBAKER 8C BRENNEMAN, F.C. Brenda J. Beecher, Executrix and Accountant herein, proposes to distribute the balance of the Estate of Marjorie M. Donovan, Deceased, to wit: $11,042.80 in accordance with the Last Will and Testament of said Decedent as follows: 1. Tiffany N. Beecher Wamer 115 of residue as per Item III of Will 2~ Matthew Beecher 1/5 of residue as per Item III of Will 3. Brenda J. Beecher, guardian for Logan Donovan 1/5 of residue as per Item III of Will 4. Brenda J. Beecher, guardian for Wade Donovan 1/5 of residue as per Item III of Will 5• Christina Beecher 1/5 of residue as per Item III of Will ~ TOTAL DISTRIBUTION: $ 2,208.56 $ 2,208.56 $ 2,208.56 $ 2,208.56 $ 2,208.56 $ 11,042.80 Page 7 AFFIDAVIT /VERIFICATION BRENDA J. BEECHER, Executrix under the Last Will and Testament of MARJORIE M. DONOVAN, Deceased hereby declares under oath that she has fully and faithfully discharged the duties of her office; that the foregoing First and Final Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the Estate have been paid in full; to her knowledge, there are no claims outstanding against the Estate; that all taxes presently due from the Estate have been paid; and that the grant of Letters Testamentary and the first complete advertisement thereof occurred more than four months before the filing of the foregoing First and Final Account. This statement is made subject to penalties of 18 pa. C.S.A. Section 4904 relating to unsworn falsification to authorities. ~t ~ ..~ ~ n ~r it ti ~p,r .,firs B da J. Beecher, Executrix Dated: 1 ~ ~ [~ Subscribed and sworn to by BRENDA J. BEECHER before me this ~ `~'~ day offJol~R~~~ , 2010 of Pu COMMONWEALTH OF PE ~N9YLVANIA N07ARIAL SEAL JODY L. GILBERT, Notary Publ'~c Newvilla Boro., Cumberland Coun ,.._w_:.~, ._ _ ~.nw oFFicEs SNELBAKER 8C BRENNEMAN, P.C. Page 8