HomeMy WebLinkAbout03-25-11DECEDENT'S ESTATE
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
ESTATE OF EVELYN M. WELKER ,DECEASED
No. 2010-00426
PETITION FOR ADJUDICATION /
STATEMENT OF PROPOSED DISTRIBUTION
PURSUANT TO Pa. O.C. Rule 6.9
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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 A TTACHMENTS A T THE BACK OF THIS FORM.
Name of Counsel: THOMAS E. FLOWER
Supreme Court I.D. No.: $3993
Name of Law Firm: FLOWER LAW, LLC
Address: 10 W. HIGH ST.
Telephone: 717-243-5513
Fax: 717-241-4021
Form OC-01 rev. 10.13.06 Page 1 Of 10
Estate of EVELYN M. WELKER
1. Name(s) and address(es) of Petitioner(s):
Name: LARRY L. WELKER
Address: 5395 RIVENDALE BLVD.
MECHANICSBURG, PA 17050
Deceased
Identify any executors or administrators who have not joined in the Petition for
Adjudication and Statement of Proposed Distribution and state reason:
NONE
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 28, 2010
Letters Testamentary or Letters of Administration were granted to Petitioner(s) on
APRIL 22.2010
Date of Will (if applicable): N/A
Date(s) of Codicil(s) (if applicable): N/A
Date of probate (if different from date Letters granted): N/A
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: FiR~T C'(ZMPI .F.TF~ (1R/i ~/~~I ~
Form OGO/ rev. 10.13.06 Page 2 of 10
Estate of EVELYN M. WELKER
Deceased
3. Was decedent survived by a spouse? ............................. Yes No
If yes, name of the surviving spouse:
4. Has the surviving spouse filed to take an elective share? ............. Yes No
(See Section 2201 et sue. of the Probate, Estates and Fiduciaries Code)
If yes, date of election:
5. In the case of an intestacy, state the names of the decedent's surviving children or
surviving issue of deceased children (f none, so state):
NONE
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)? ........................................... ® es ®No
Y
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-01 rev. l0.13.06 Page 3 of l 0
Estate of EVELYN M. WELKER
Deceased
8. Written notice of the Audit as required by Pa. O.C. Rules 6.3, 6.7 and 6.8 has been or will be
given to all parties in interest listed in item 9 below, all unpaid creditors and all claimants
listed in item 10 below. In addition, notice of any questions requiring Adjudication as
discussed in item 14 below has been or will be given to all persons affected thereby.
A. If Notice has been given, attach a copy of the Notice as well as a list of the names
and addresses of the parties receiving such Notice.
B. If Notice is yet to be given, a copy of the Notice as well as a list of the names and
addresses of the parties receiving such Notice shall be submitted at the Audit
together with a statement executed by a Petitioner or counsel certifying that such
notice has been given.
C. If any person entitled to Notice is not sui juris (e.g., minors or incapacitated
persons), Notice of the Audit has been or will be given to the appropriate
representative on such party's behalf as required by Pa. O.C. Rule 5.2.
D. If any charitable interest is involved, Notice of the Audit has been or will also be
given to the Attorney General as required under Pa. O.C. Rule 5.5. In addition, the
Attorney General's clearance certificate (or proof of service of Notice and a copy
of such Notice) must be submitted herewith or at the Audit.
9. List all parties (charitable and non-charitable) of whom Petitioner(s) has/have notice or
knowledge, having or claiming any interest in the estate as beneficiaries under the Will or
Codicil(s) or as intestate heirs if there is a complete or partial intestacy:
A. State each party's relationship to the decedent and the nature of each party's
interest(s):
Name and Address of Each Party to Interest
and
lnterest
LARRY L. WELKER SON
5395 RIVENDALE BLVD
MECHANICSBUR , PA 17050
NONE-
INSOLVENT
ESTATE
Form OC-01 rev. 10.13.06 Page 4 of 10
Estate of EVELYN M. WELDER
Deceased
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.
NONE
C. State why a Petition for Guardian/Trustee Ad Litem has or has not been filed for
this Audit (see Pa. D.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 S Of I O
Estate of EVELYN M. WELKER
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 ojClaim Claim
Admitted? Will Claim
Be Paid In
Full?
ESTATE RECOVERY PROGRAM $ 58,930.74 Yes
No Yes
No
PA DEPT OF PUBLIC WELFARE
HARRISBURG, PA 17105-8486
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.
11. Was family exemption claimed? ................................ Yes ~No
Was family exemption allowed? ................................ Yes No
Family exemption claimant's name and relationship:
Name: Relationship.•
Form oc-o1 rev. 10.13.06 Page 6 of 10
Estate of EVELYN M. WELKER
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
~.~~
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:
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.
Form OC-01 rev. 1 D.13.06 Page ~ Of 1 Q
Estate of EVELYN M. WELKER
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.'
Purpose: NONE
If a reserve is requested for counsel fees, has notice of the
amount of fees to be paid from the reserve been given to the
parties in interest? ........................................ Yes No
If so, attach a copy of the notice.
19. Is the Court being asked to direct
the filing of a Schedule of Distribution? .......................... Yes No
As to real estate only? ........................................ Yes ~ No
Form OC-01 rev. l 0.13.06
Page 8 of 10
Estate of EVELYN M. WELKER ,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
NONE
B. Principal:
Proposed Distributee(s)
NONE
Amount/Proportion
Submitted By:
(All petitioners must sign.
Add additional lines if necessary):
Name of Petitioner: LARRY L. WELKER
Name of Petitioner:
Form OC-01 re>>. 10.13.06 Page 9 of 10
Estate of EVELYN M. WELKER
Verification of Petitioner
(Verification must be by at least one petitioner.)
Deceased
The undersigned hereby verifies * [that heishe is r;rle
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).
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 form have been made beyond the
responses herein.
Signature of Counsel for Petitioner
Form OC-o/ rev. 10.13.06 Page 10 of 10
FLOWER LAW, LLC
10 W. HIGH STREET
CARLISLE, PA 17013
James D. Flower, Jr.
Thomas E. Flower
PHONE: (717) 243-5513
FACSIMILE: (717) 241-4021
March 23, 2011
Ms. Barbara E. Witmer
Claims Investigation Agent
Pa. Dept. of Public Welfare
Estate Recovery Program
P.O. Box 8486
Harrisburg, PA 17105-8486
Re: Evelyn M. Welker Estate
CIS # X20212071
Cumberland County Estate No. 2010-00426
Dear Ms. Witmer:
The First and Final Account of Larry L. Welker, Administrator of the above-mentioned
estate will be filed for Audit with the Orphans' Court Division of Cumberland County Court of
Common Pleas, no later than March 25, 2011. The Account will be presented for audit and
confirmation on Apri126, 2011, at 9:30 a.m. If no objection is raised at the time of audit, the
Court will confirm the account.
A copy of the account and petition for adjudication is enclosed.
In addition, you will find enclosed the estate's check in payment of a portion of the
DPW's claim, in the amount of $4,525.48.
Very truly yours,
FLOWER LAW, LLC
~~
Thomas E. Flower
PROOF OF PUBLICATION
State of Pennsylvania, County of Cumberland
Tames Kleinklaus, Director of Sales and Marketing, 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):
May 7, May 14 and May 21, 2010
COPY OF NOTICE OF PUBLICATION
E TATE N TI E
Letters of Administration in the Estate of EVELYN WELKER, late of
Cumberland County, Pennsylvania, deceased, have been granted to the
undersigned.
All persons knowing themselves to be indebted to said Estate will make
payment immediately and those having claims will present them for
settlement to:
Larry Welker, Administrator
c/o Thomas E. Flower, Esquire
SAIDIS, FLOWER & LINDSAY
2109 Market Street
Camp Hill, PA 17011
(717)737-3405
Thomas E. Flower, Esquire
SAIDIS, FLOWER & LINDSAY
2109 Market Street
Camp Hill, PA 17011
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 character of publication
are true.
Sworn to and subscribed before me this
th ~ I
Notary Public
My commission expires:
NOTARIAL SEAL
8AMg1 ANN HECKENOOAN
Notary Public
CARLISLE BOROUGH, CUMBERLAND CNTY
My Commission Expires Jan 27, 2014
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 .Iournal, of the County and
State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland L_aw
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:
August 13, August 20 and August 27 , 2010
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.
L s Marie Coyne, Edit
SWORN TO AND SUBSCRIBED before me this
27 day of August, 2010
Notary
Welker, Evelyn, deed.
Late of Cumberland County.
Administrator: Larry Welker c/o
Thomas E. Flower, Esquire, Flow-
er Law, LLC, 10 W. High Street,
Carlisle, PA 17013.
Attorneys: Thomas E. Flower,
Esquire, Flower Law, LLC, 10 W.
High Street, Carlisle, PA 17013,
(717) 243-5513.
NOTARIAL SEAL
DEBORAH A COLLINS
Notary Public
CAR!{S!E BOROUGH, CUMBERLAND COUNTY
My Commission Expires Apr 28, 2014