The URL can be used to link to this page

Home My WebLink About05-17-11i COYNE & COYNE, P.C. _ _~ Lisa Marie Coyne, Esquire Pa. Supreme Ct. No. 53788 3901 Market Street Camp Hill, PA 17011-4227 _ '_' (717) 737-0464 Attorney for Petitioner IN THE MATTER OF: IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA RAYMOND R. LOGAN, DECEASED :ORPHANS' COURT DIVISION NO. ~l ~lI ' C.~~~(. PETITION FOR SETTLEMENT OF SMALL ESTATE IN ACCORDANCE WITH 20 PA C S A ~ 3102 TO THE HONORABLE, THE JUDGES OF THE SAID COURT: AND NOW COMES, Susan B. Logan, Petitioner, by and through her attorney, Lisa Marie Coyne, Esquire, and avers the following in support of the within Petition For Settlement of Small Estate in Accordance with 20 Pa.C.S.A. § 3102: Raymond R. Logan, deceased, died on April 10, 2011. (See Exhibit "A" -death certificate). 2. Decedent's last residence was 50 Circle Drive, Camp Hill, Township of East Pennsboro, Cumberland County, Pennsylvania. 3. Petitioner, Susan B. Logan, is the surviving spouse of the Decedent and resides at 50 Circle Drive, Camp Hill, Township of East Pennsboro, Cumberland County, Pennsylvania. -~ ~. ,.~. 4. Decedent died testate with a Last Will and Testament dated October 25, 1999. (See Exhibit "B" -Last Will and Testament). 5. Decedent's Last Will and Testament has not been probated and no Letters Testamentary have been granted by the Register of Wills. 6. The sole beneficiary under the Decedent's Last Will and Testament is the Petitioner, Susan B. Logan, the Decedent's wife. 7. The Petitioner has received the Decedent's last by payment of wages by the Commonwealth of Pennsylvania pursuant to 20 Pa.C.S.A. § 3101. 8. The Decedent died owning the following property valued at $25,1)00 or less: a State Employees' Retirement System (SERS) Deferred Contribution Account. 9. The Petitioner, as the sole beneficiary under the Decedent's Last Will and Testament, requests disbursement to her the Decedent's State Employees' Retirement System (SERS) Deferred Contribution Account. 10. There are no claims against the Decedent's estate. 11. There are no unpaid beneficiaries, heirs or claimants for the Decedent's estate. 12. No disbursements have been made prior to the filing of this Petition. 13. The Petitioner will pay any Inheritance Tax due, if any, on the property under this Petition. 2 14. All parties beneficially interested in the estate have been mailed notice of this Petition. (See Certificate of Service attached to Petition). WHEREFORE, Petitioner respectfully requests this Honorable Court to award disbursement of the Decedent's State Employees' Retirement System (SERS) Deferred Compensation Account to the Petitioner. Respectfully submitted: COYNE & COYNE, P.C. ~V. Dated: BY~ 2~'~-^ ~~`~ r isa 1 arie Coyne, Esquir ~'a. . Ct. No. 53788 31101 Market Street Camp Hill, PA 17011-4227 (717) 737-0464 Attorney for Petitioner .- .. _ , ,, ki"., _ ~~ I .,~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS ' ~:RINr," CERTIFICATE OF DEATH =~NCIaNENr _ Nx (See instructions and examples on reverse) srnrE FILE NuMe;eR z. Sex J JocW Secunh Numcer + Date d am ,Monet. far. ~,.w~ N alDaexnl,F,s: rmaw estsx. /HALE a ~ I - y ~ -749 ~~RI~ rD ao /> 'F2AYMoNtj ZI ~-0 R~1 S Age tLasl &nrgayl urger 1 tler Unwr'. ,fa -6. Dale of Bum IMcnm as 'earl 7 BIM. wce IC~rv an0 stale a rae coon ea sD' al of Daam ;Cnecx onl mnl Olner S~ Iknms Ders Haws 1Mnwes ~A K C ,a ~y I -l 1QIe~EI lI 1953 ~ e' "f e 5 ~ ~K ~~T. ^ Inpallenl ^ ER Duipaoent ^ DOA U 4 rsrg Fbme lp ReSbence r 04re, - Spe<rh YfS. ~ (-/I ?Me Ln@rxdn InOan. BtiLM. NTxla eY. ac "r for wC PI Daam BO facerry Name III not msututlm, give sueal arw numwrl 9 '.Jas Deceaent a HrspanK Cryan /°i .;.,~ ^ ytls so County a Ceam ~I Y in las. sPaory Cuoan. Ip ,SM-Ml ,SD C'iRC ~E ~ Rt~E MexKan. PuenD Rran e¢, W NirE ri(r1t8 ~qN E. PENS O la Manor star!!:: MarrreO ve.e Marred, is sun~.mg spo~sa ., w+o. gne nanen name) t I pece0errrs Lsual Jcc Ipn IGM of wurx aarw Ourvl rtwsl a worn we Do no, surf rowed 12. Wu Decewm ever n Ina 13 Decedents Eoucaoon tSpeclry mry ngnest grace ,:anpreledl W~,a,~, Drvacea Ivry K/x1 d was xaq a auvness I Inwstry U S. Armes Foces? Elemeneary % Secmdary 1412) S fi loge 11 _s a 5.1 ~~ S~S+9N $• ,ST/Q ~} ~E Q ~M~ f}N L 5~ f}i LA9e ~' eJDtlfta Yea ^ ~ IED /• Decewnts rJ^ Dlrl Deceaenl e PEAI/~s BO RO rwD tB Decewds Mauutg AoOress lSVeet. ury. town. slate. np cooe) A.cbal Resderce Va. $idie TrT Llve m a 77c. ®Yes, DeceOent lweo ~n 5'o G,eer..E ~a2ivE ~'s.MSE~eS.Ati19 Townsnrp~ t7d ^NO Decadem Llved wtmin ~ ik M~ ti 1 ~L ~ . I Z ~ 11 1D c°°n" Aawl Lmrla a cxy eorD i 8 FaVwr s IFlrst mode. last wmx) 19. Hamer a Name IFrst. mdde, rvwen wmartw~ £oRGE W. LG~q~ ~pLORES CAµa 20a Inlormants Wnta ITyye ' Pmtl 2W InbrtMnl MaIMg AOdeaa ISuwt, city !u n, stale, np caeel SKSRn! B. ~GA^) So C/;acct: ~l2WE yr},x{ J}it~ ~a. I'7O11 ?ta Meltwa of Dywsnan ~ Cremallm ^ Dmatron 21D Dace of Dlsposnwn IMOnm, day. Year! 21 c. Place a Dlsposrllm IName of cemelery..rematory aOmer pace! 2ta toaoon rCrry 'own. sa~.a :rp .woe, _ ^ aura, ~^ Ramovallmmsute ~w.aGemNiondoonaeonAuUnruw e'L /~ ~O!/ E/ANS ~R6MIAT~D~J SE2JICE SCNAEfFFRSTb~"~'Q+•Ij°pp ^ Omer ~ ' M AMdical Examine lDawe? ®Yas^ No /N 22a Sgnawra of Serve Lxersee la per ac as 22D. L¢ertse Numwr 22c Name and Ao0 ass al FaWrry ~ 70 ~ ` a ~ D/o?/a~ L /~£Ill ~~IERRt_ ~tc, 3`W~ IN/4 FrST: ~ic~. ~A. ' 23o L.cense NumAer 27c Dare S,ptec Monet vY Man ConVrew cams : afY ardyug 23a. rD 7.e cev a my uwwMdge seam oauned at ate urw. dat and place sated. I ~ e arc _Ital yrysran a rw a.a+aore d are a wam to ~ /-I// /J ~ S sS L f }P`, ~~ ! O ~~ I l ~ Iry ~a~sa a w.m -.ar,,,net 25. Dew PrauxxKed Deno IMmm, OaY. /earl 26 Wu Casa Rtlwr+ed m Mental ~ Corawr la a Realm Cver man Germuon a Doraoon° za rime ar Deam No '~tems 2a.2e muu w car~aered Dv xrsm 3a P. a,l. A ~ o ^ f 85 ~ wnD pDrwurx ea seam r r l ~ o I l CAUSE OF DEATH (See fnslruetlone end examples) , Apprcxraw .menat. Pan ~,i Emer amen ~ t- i - ^mon Ja 0.ma'o deem 28 ~a Txaao-..se Convouw :o Deav~T n01 resullln ~~'.~ unJenyng U Se given n Pan I. L~ .-. ~oQaply nom 27 Pan i ?wr Ina s1 ^L3L iY9nJ5 - asaases, shires. a cortpl¢auons -mat dreary caused Ina seam. DO N07 enter lerminal aver:ls wcn as :arroac arrest. Onsai !o Deam Sul 9 G s~ ~ u~p~ -eePudlay dne5r. a venlncuar nonlauon wimwul snowlrg me BwbgY. Uat fay ate cause w BaUt ImO. r ....~ 29 1 Fertwe wIMEDUTECAUSE,FaWatease~~Ca~G•h~GtnQ ~C J~tnclYr»/ I;v.2~ Wlef~4~P~ nna,re~anl.a.toaxr•+r ca,droal resamr 7 ~n maml ^ Pregnant a! ana a Dean a Due m la ss a conaeguenw dr. ^ vat aev~an. DN preyam wratx, az daYa Wy at axtdoons. A arty, p .eaSepN aio the use :rslea a, lure a. D,e to la as a corueauerce aq' ai xam Emer Ilx UNDERLYY/G LOUSE lOcsease a ryury 'nal inlWted Vte c ^ 40l p'-4~!~ JN Pra7WR 47 diya U I Yaar --r events resWrag ~n deaml LAST. Oepre facet e Du• to la as a cortseguerra al. ^ JnMllOwn J Yegwa wane eM peG Mar `^ a ~ 12a. Date a In nwnm, dav..e J2D Dexratl Now Inwrv Ocaned J2c. Puce >. ~.~-. bane Fans. saw. Factory 70a Nay an AatcosY 30o were AuwpaY frnaugs 7f. Manner DI Deem lury I Olhce Buaivg, etc. rSPeah! ~( 7anamean Avaaaaw Rne to CanPweon ~ Natural ^ Momlutle or Corse a Deem! 720. Tmte d I 32a_ byury at WmP 721 ll Tranapauam w,ury fSnerrbl 32g Loreum d uyury ISaeat. cxy -town. swwl ves ^ AcciOent ^ PeMing lnvesagaeon Mury ^ Drnerr Operate ^ Passenger ^ Pedesalan Z ^ res C~ ~ ^ ^ ND ^ y,,,~,w ^ ca,u Nol w Dtltermmaa M ^ Ve5 ^ "° Dma ioec N 0 33o Sgnawre a T ne of Comb r /~ I Aa. Ctlmtrencnea mry anal - (1~/; ~ / C ~ ,~ /~ ('~ '~ eenrtying pnyvuan IPnrswan ceror,.ny cause .,r team ..nan anomar pnyskarl nas yona,r,ctld deem and complelwa Item 271 ~ QJ t,l w~ l../~~ r. io tw wet DI my xrawkaga, death occumd due tD me cauaNal arW manner as eala0 - - - - - - - - - - - - - - - - - - - - - - - - - - - -' - - - - lJC lcen~e Numoer 3:70 Date ~~yne0 AIM-.~^. :a. .eel • Prorrourrclnq arN wmlYUrg pDyfrcun IPnysxan axn Drorwr.rtonq Daam arts <amtyinq to cause cal daamr u ~ I ~ 'J ~ /, ~ /' - / r, / / 'y ~ I I _ To lw Dee d my W/Nega, Daam ouurtad al 1M Iim•, ww, and p4ca, arM dw Io ma GuaNfl and mama as aleled _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ 1 ' S 'Y o ` T G I _ _ _ j YedIW EaamrwlCOrowr at t11a wNa d eiamYaallel and I W rnW W gau mY opln10r1, MeM occurred it Iw ama, Oaq. and plxe. and d1M 10 tM Ciufilf) and manwr of 4We~ ^ 3A Ndma 0 A0ne5a "r Persm Wtp l,anaelw (.d~5e a Deam ~ Item 211 rYpe' nnr ~~ D5 Rego r rata 36 Dale Fded m, daY !earl F , I~lala.lal~- ~- ~/ 3~,2 ~TR~~~C~ ~o,a~ Ca H' i~rc~.Pa 17a1i Dr5p0yilon PBrmri No. ~~s~~ . i~Z ~~ ~ C~e,~~ ~cm exit I, Raymond R. i,ogan, a resident of Allegheny County, Co~~nmenwealth of Pennsylvania, declare this to be my Last Will And Testament. I hereby revoke any and all other Wills and Codicils that I previously made and affirm that the following paragraphs express my intent as to powers conveyed to my Executor, the distribution of my assets and payment of my liabilities after my death. ARTICLE 1. PAYMENT OF F,XI'ENSES AND DEBTS 1.01. I authorize my Executor to pay all of the following expenses which relate to: (1) a funeral or memorial service; (2) the interment of my remains, including the costs of a grave site, if necessary; and (3) the installation of a suitable marker at, or the perpetual care of, my grave site. I further authorize my Executor to pay all of my debts that my Executor, in his or her sole discretion, may allow as being valid, claims against my estate. ARTICLE 2. DISPOSITION OF TANGIBLE PERSONAL PROPERTY Dis osition in Accordance with Memorandum 2.01. I direct that my tangible personal property be distributed in accordance with a written r:~emorandum dated and signed by me, to be found with ±1',is Will or m co important papers. In the event of a conflict, the latest memorandum~orhprovlision inthhe 1 test memorandum, shall control the distribution of my tangible personal property. If any- person receiving tangible personal property in the memorandum does not survive me, that gift shall lapse. Disposition to Familv 2.02. To the extent that any of my tangible personal property does not pass pursuant to the provisions of Paragraph 2.01 of this Will, I give that tangible personal property to my spouse, if she shall survive me. If my spouse does not survive me I give that tangible personal property to Danielle L. Logan and Kenneth R. Logan in substantially equal shares, to be divided among them as they shall agree. If no agreement is reached within ninety (90) days of my death, my tangible personal property shall be distributed substantially equally among Danielle L. Logan and Kenneth R. Logan as my Executor shall direct. The decision of my Executor shall be conclusive and binding on all persons interested in my estate. Alternative Disposition to Residuary Estate 2.03. To the extent any of my tangible personal property does not pass pursuant to the provisions of Paragraphs 2.01 and 2.02 of this Will, said property shall be added to my residuary estate. ARTICLE 3. DISPOSITION OF RESIDUARY ESTATE Disposition to Familv 3.01. I give the rest, residue, and remainder of the property that I own at my death, real and personal, of every kind and description, to which I may be legally or equitably titled at the time of my death ("my residuary estate"), to my spouse, if my spouse shall survive me. If my spouse does not survive me, I give my residuary estate to Danielle L. Logan and Kenneth R. Logan, in equal shares. ~~xly~~~}-~ '~r~j ~. Alternative Disposition Under Intestacy 3.02. If any part of my residuary estate is not completely disposed of by the provisions of Paragraphs 3.01 of this Will, I give that part of my residuary estate to the persons who would be entitled to it under the intestacy provisions of the statutes of the Commonwealth of Pennsylvania in effect at the time of my death. ARTICLE 4. APPOI!`~i`I'MEri7' OF' 1.XECU'I~OR 4.01. My spouse shall be Executor of my estate. If for any reason my spouse is unable or unwilling to serve or ceases to serve after having been appointed, Danielle L. Logan shall be Executor. If same for any reason is unable or unwilling to serve or ceases to serve after being appointed, Kenneth R. Logan shall serve as Executor. My Executor shall have the powers set forth in Article 5. ARTICLE 5. POWERS OF ADMINISTRATION Grant of Powers 5.1?1. T~I;r E;re_,,~tor, hereinafter referr'e~l to ~s "mv .fiduciaries". shall have the powers and authorities set forth in this Article 5. These powers may be exercised by my fiduciaries in their sole and absolute discretion, without the permission or order of any Court. These powers shall be supplementary to the powers conferred by law, including but not limited to those set forth in Title 20, Chapter 33, of the Pennsylvania Consolidated Statutes. Resignation of Fiduciarv 5.02. Any individual may resign from their fiduciary position by executing a written resignation and delivering it ±c~ ±he successor Executor. The date of delivery of the resignation to the successor Executor shall be the effective date of the resignation. No court action or other proceeding shall be necessary for the resignation of any individual Executor. Every title, estate, right, power and discretion conferred on the initial Executor under this Will shall be conferred on any successor Executor. No Bond Re uired 5.03. No bond shall be required of any Executor or successor Executor named in this Will. Retention of Assets 5.04. My fiduciaries shall have the power to retain any or all property of my estate, however received or acquired, for so long as they deem appropriate. This power maybe exercised even though the property may not be of the type authorized by law for investment, and even though retention may leave a disproportionate amount of the value of my estate invested in one type of property. Transfer of Assets 5.05. My fiduciaries shall have the power to sell, transfer, and convey any property, of whatever nature, including real property, and wherever situated, that I may own at the time of my death, or that may come into ~vny .estate £it or aft~;r iiry death. Tire sai~, %'ailSfer, or ctsnveyaiice may be by public or private sale, at such time, on such terms and conditions, including selling price and credit, in such manner, and for any reason that my fiduciaries deem appropriate, including but not limited to the purpose of obtaining net proceeds to be distributed to my residuary beneficiaries. Investment 5.06. My fiduciaries shall have the power to invest and reinvest any property in my estate in preferred and common stocks, bonds, notes, common trust funds (including any managed by any comorate fiduciary), interests in investments, trusts, mutual funds, leases, mortgages on property and in proportions of such property as my fiduciaries deem advisable, even though such investments are not the character or proportions authorized by applicable law for the investment of such funds. Power to Borrow 5.07. My fiduciaries shall have the power to borrow money for any purpose for any periods of time and on any terms and conditions as they deem advisable (including the power to borrow from any corporate fiduciary), and to pledge, mortgage, or otherwise encumber any property in my estate to secure repayment of any loan, as well as the power to renew existing loans either as maker or endorser. Distribution in Lash or bind 5.08. My fiduciaries shall have the power to make distributions in cash or in kind, or partly in each, in divided or undivided interests, and the power to determine which assets shall be sold and which shall be distributed in kind, without notice to or consent by any beneficiary. Distribution to Minors and Persons Under Disability 5.09. My fiduciaries shall have the power to make distributions or payments to or for the benefit of any beneficiary who is a minor, an incompetent, or who, in the fiduciaries' judgment, is incapacitated. The distributions or payments shall be made in any one or more of the following ways: (1) directly to the beneficiary; (2) directly to the creditor in payment of the debts or expenses of the beneficiary; (3) to the guardian of the person or the estate of the beneficiary; (4) to any custodial parent of a minor beneficiary; (5) to a custodian for the beneficiary under any law related to the gifts to minors, including to my fiduciaries in that capacity; or (6) to any other person who shall have the care and custody of the person of the beneficiary. There shall be no duty to see to the application of funds so paid, provided due care was exercised in the selection of the person to whom the funds were paid, and the receipt of the person shall be full acquittance of the fiduciaries. For purposes of this Article 5, "minor" is defined to mean any person under the age oftwenty-one. Employment of A ents 5.10. My fiduciaries shall have the power to employ and pay for the compensation of any and all attorneys, agents, custodians, attorneys-in-fact, experts, investment counsel, accountants, bookkeepers, or other agents or providers of services as my fiduciaries deem advisable in the administration of my estate. Commissions 5.11. My fiduciaries shall have the power to take reasonable commissions on account at any time during the administration of my estate without the approval of any beneficiary or of the court, but subject to allowance or disallowance on the settlement of the final accounts of my fiduciaries. Third Party Reliance 5.12. No person or corporation dealing with my fiduciaries shall be required to see to the application of aiiy property Paid and delivered io tl: j~ f1UliC;lai'1~5, i7t i0 iiiiii.lit~ 1nlU l;i~lieP ii'cc^ atiiiiUriy C;i my fiduciaries to enter into any transaction or the expediency and propriety of any transaction entered into by my fiduciaries. ARTICLE fi. PAY1VTk;:ZT'r QF L~E.A.T~ TAXES 6.01. All estate, inheritance, and succession taxes, together with any interest and penalties thereon, payable as a result of my death and imposed with respect to any property, whether or not disposed of by this Will, shall be paid out of my residuary estate and shall not be deducted or collected from any beneficiary under this Will or other transferee. ARTICLE 7. LIMITED LIABILITY OF FIDUCIARIES 7.01. My fiduciaries shall not at any time be liable for mistakes of law or fact or both, for errors of judgment, or for any loss coming to any beneficiary under this Will, or to any other person, unless the loss is the result of actual fraud or willful misconduct on the part of the fiduciary. My fiduciaries may, from time to time, consult with counsel with respect to the meaning, construction, and operation of this Will, particularly with respect to the apportionments, allocations, and disbursements, and may act on the ad~Tice of counsel in all matters without incurring liability on account of their actions. ARTICLE 8. INTERPRETATION Meaning of "Survive" 8.01. For the purposes of this Will, in determining whether a person has survived me or survived another person, the person shall not be deemed to have survived if he or she dies within thirty (30) days of my death or of the death of the other person. Successors of Fiduciaries 8.02. All pronouns referring to an Executor, and the term "Executor", shall be construed to mean any person acting as my Executor or administrator, as the case may be. Number and Gender 8.03. If required by the context of this Will, singular language shall be construed as plural, plural language shall be construed as singular, and the gender of personal pronouns shall be construed as either masculine, feminine, or neuter. Headings 8.04. All headings used in this Will to describe the contents of each article, paragraph, or other division are provided for convenience only and shall not be construed to be a part of this Will. Governing Law 8.05. This Will shall be construed in conformity with the laws of the Commonwealth Pennsylvania. T!1 WITNESS my hand this 2.5 day of O~"'CG$~E(~ 19q,~ and R. Log Signed, published and declared by the above named individual, as the above person's Last Will And Testament in the presence of us who by request, in the aforementioned's presence and in the presence of each other have hereunto subscribed our names as witnesses. Witness ~/y Address 1(PLI ~-a~rc ~/,A V, ~ ~~cr wr~+t PA fitness Address ~ Commonwealth of Pennsylvania County of Allegheny AFFIDAVIT We, T~1t`1t~lE R• ~w`a2~l~and ~~c3~~! K21/PP-S ,the witnesses whose names are signed to the attached foregoing instrument, being duly qualified according to law, do depose and say that we were present and saw such individual sign and execute the instrument as his Last Will; that he signed willingly and that he executed it as his free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the individual signed the Will as witnesses; and that to the best of our knowledge such individual was at the time 18 or more years of age, of sound mind and under no constraint or undue influence. ~~~- ~ d~Z~c~l-lfz~ [Witness #1] l _ [Witness #2] Subscribed and sworn to before me by~~.v=-1ttt„ ~- c _ `L ~ tia r3 ~ ,Witnesses, this ~ _`-s'"~ day of ~~ ~~-~~w~ r' 19~. ~ ~,i~~t -~ ~j ~ .~. ~,~C. , ' ~` My commission expires: Carolyn J Peters, Nota Public Pittsburgh, Allegheny ~ounty My Commission Expires Feb. 26, 299t Member, Pennsylvania Association of INc~t.~ri,~,~ ACKNOWLEDGMENT Commonwealth of Pennsylvania County of Allegheny and I I, Raymond R. Logan, whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, hereby acknowledge that I signed and executed the instrument as my Last Will; that I signed it willingly; and that I signed it as my free and voluntary act for the purposes expressed. / ~~ Ra mond R. Lrol S~ orn or affirmed to and acknowledged before me, by Raymond R. Logan, this ~`f ~"4day of ~~ !mil '~ -C~+ ' zes s,, _ ~.. Notarial Seal Carolyn J. Peters, Notar Public Pittsburgh, Allegheny County My Commission Expires Feb. 26, 2001 My commission expires: Member, Pennsylvania Association of Nrtaries VERIFICATION The facts set forth in the foregoing are true and correct to the best of the undersigned's knowledge, information and belief and are verified subject to the penalties for unsworn falsification to authorities under 18 Pa. C.S.A. § 4904. Dated: ~ ~~ ~'' ~ ~ • ~ ~ ~- 2ae.-~ . Susan B. Logan .~ CERTIFICATE OF SERVICE I, Lisa Marie Coyne, Esquire, of Coyne & Coyne, P.C., hereby certify that true copy of the foregoing Petition for Settlement of Small Estate in Accordance with 20 Pa.C.S.A. ~ 3102 was served this date upon the below-referenced individual at the below listed address by way of first class mail, postage pre-paid: Commonwealth of Pennsylvania State Employees' Retirement System Harrisburg Regional Counseling Center 30 N. Third Street, Room 319 Harrisburg, PA 17101 v Dated: [ '~ 'ti~`- Li a arie Coyne, Esquire Attorney for Petitioner 4 RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Orphans Court One Courthouse Square Carlisle, PA 17613-3387 LOGAN RAYMOND R File Number: 2011-00580 Paid By Remarks: COYNE & COYNE CJ Fee/Tax Description PETITION JCS FEE AUTOMATION FEE Check# 1409 Total Received......... Receipt Distr Payment Amount 15.00 23.50 5.00 -------------- $43.50 $43.50 Receipt Date: 5/17/2011 Receipt Time: 08:55:20 Receipt No.: 1045463 ibution ------------------------ Payee Name CUMBERLAND COUNTY GENERAL FUN BUREAU OF RECEIPTS & CNTR M.D CUMBERLAND COUNTY GENERAL FUN