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Home My WebLink About01-19-12~; ~. ~~~-i?~-`'fC F:\F[LES\Clients\13768 Morones\13768, Lpeti[ion.adjudicate DECEDENT'S ESTATE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF MITZI WINTERS MORONES, DECEASED No. 21-10-0650 PETITION FOR ADJUDICATION / STATEMENT OF PROPOSED DISTRIBUTION PURSUANT TO Pa. O.C. Rule 6.9 _~~ _ ~, -, ,t. This form maybe used in all cases involving the Audit of the Account of a Decedent's Estate. If space is insufficient, riders may be attached. Attach the spouse's election, if any; the papers required under items 8-19 inclusive; and any instrument pertinent to the adjudication. INCLUDE ATTACHMENTS AT THE BACK OF THIS FORM. Name of Counsel: Supreme Court I.D. No. Name of Law Firm: Address: Telephone: Fax: Seth T. Mosebey 203046 MARTSON LAW OFFICES 10 East High Street, Carlisle, PA 17013 (717)243-3341 (717)243-1850 Form OC-O1 rev. /0. 13.06 Page 1 of 8 Estate of Mitzi Winters Morones, Deceased 1. Name(s) and address(es) of Petitioner(s): Michelle Winters 622 Wood lawn Avenue Mt. Holly Springs, PA 17065 Identify any executors or administrators who have not joined in the Petition for Adjudication and Statement of Proposed Distribution and state reason: Is this the first accounting by this fiduciary? .................................... ®Yes ^ No If not, identify prior accountings, the accounting periods covered, and the date of adjudication of the prior accounting. 2. Decedent died on March 3, 2010. ^ Letters Testamentary or ®Letters of Administration were granted to Petitioner(s) on June 25, 2010 Date of Will (if applicable): N/A Date(s) of Codicil(s) (f applicable): N/A Date of probate (if different from date Letters granted): Was a bond required? ^Yes ®No If yes, state amount: Are proofs of advertising of the grant of Letters attached? ..................... ®Yes ^ No Dates of advertising of the grant of Letters: The Sentinel: August 25, September 5 & 12, 2011 Cumberland Law Journal: August 26, September 2 & 9, 2011 3. Was decedent survived by a spouse? ...................................... ^Yes ®No If yes, name of the surviving spouse: Fomr OC-Ol rev. /0. 13.06 Page 2 of 8 Estate of Mitzi Winters Morones, Deceased 4. Has the surviving spouse filed to take an elective share? ...................... ^ Yes ®No (See Secriorc 2201 e~ 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: Michelle Winters Sheila Winters 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)? ........ oyes ®No If yes, give names and dates of birth: Name: Date of Birds: 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 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 sus 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. Form OC-07 rev. /0. 13.06 Page 3 of 8 Estate of Mitzi Winters Morones, Deceased 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 Partv in Interest Relationship and Comments ifanv Interest Michelle Winters Daughter None: Estate insolvent 622 Woodlawn Avenue Mt. Holly Springs, PA 17065 Sheila Winters Daughter None: Estate insolvent 473 Wayne Avenue Chambersburg, PA 17065 B. Identify each party who is not sui juris (e.g., minors or incapacitated persons). For each such party, give date of birth, the name of each Guardian and how each Guardian was appointed. If no Guardian has been appointed, identify the next of kin of such party, giving the name, address and relationship of each. C. State why a Petition for Guardian/Trustee Act Litem has or has not been filed for this Audit (see Pa. O. C. Rule 12.4). D. If distribution is to be made to the personal representative of a deceased party, state date of death, date and place of grant of Letters and type of Letters granted. 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. Form OC-Ol rev. /0. 13.06 Page 4 of 8 Estate of Mitzi Winters Morones, Deceased Narne and Address of Each Claimant Amnuru gFClaim Claim Admitted ~ Will Claim Be Paid in Full Carlisle Regional Medical Center 550.00 ®Yes ^Yes P.O. Box 281442 ^ No ®No Atlanta, GA 30384-1442 Robert J. Beaudry, Jr. DMD 74.00 ®Yes ^Yes 3600 Old Gettysburg Road ^ No ®No Camp Hill, PA 17011 Department of Veterans Affairs 2180.61 ®Yes ^Yes VA Medical Center ^ No ®No 3900 Woodland Avenue Philadelphia, PA 19104 Holy Spirit Hospital 250.00 ®Yes ^ yes P.O. Box 822183 ^ No ®No Philadelphia, PA 19182 Carlisle HMA Physical Management 40.00 ®Yes ^Yes P.O. Box 21629 ^ No ®No Atlanta, GA 30384 Consumer Portfolio Services, Inc. 2,718.24 ®Yes ^Yes Asset Recovery Department ^ No ®No P.O. Box 57071 Irvine, CA 92619 Merrick & Fair, Inc. 114.47 ®Yes ^Yes 901 Walnut Bottom Road ^ No ®No Carlisle, PA 17015 RMBC Collection Agency 318.00 ®Yes ^Yes 2269 S. Saw River Road, Bldg. 3 ^ No ®No Elmsford, NY 10523 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: Form OC-Ol rev. /0. 13.06 Page 5 of 8 Estate of Mitzi Winters Morones, Deceased Name: Relatlon.chip: 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: None Paid. Estate Insolvent 13. On the date of death, was the decedent a fiduciary (personal representative, trustee, guardian, agent under power of attorney) or surety on the bond of a fiduciary? ............................ ^ Yes ®No If yes, provide the name of the estate, indicate whether an account has been filed and confirmed absolutely and all awards performed, or, in the alternative, how the decedent's estate will be discharged for the decedent's fiduciary administration of the estate. 14. A. Describe in detail any questions requiring adjudication and state the position of the Petitioner(s) as to each question: B. Has notice of the question requiring adjudication been given to the parties identified in Paragraph 9 above? ........................ ^ Yes ^ No 15. If Petitioner(s) has/have knowledge that a share has been assigned, renounced, disclaimed or attached, provide a copy of the assignment, renunciation, disclaimer or attachment, together with any relevant supporting documentation. 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 made. 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: $ 400.00: Michelle Winters, Executrix Commission Form OC-01 rev. /0. 13.06 Page 6 of 8 Estate of Mitzi Winters Morones, Deceased $ 1,~ l9.~$: Martson Law Offices, balance of attorneys' fees (discounted) $ 130.00: Martson Law Offices, account filing fee 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 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 No Distribution B. Principal: Proposed Distributee(s) Amount/Proportion No Distribution Submitted By: (All petitioners must sign. Add additional lines if necessary): ~r 1 Mich Winters ~ `~ Form OC-Ol rev. /0. 13.06 Page 7 of 8 Estate of Mitzi Winters Morones, Deceased Verification of Petitioner The undersigned hereby verifies that she, Michelle Winters, is Administrator of the Estate of Mitzi Winters Morones 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). ~~ ~--~~ Michell inters 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. ~, Seth T. Mosebey Form OC-O1 rev. /0. 13.06 Page 8 of 8 PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Tackle Cox, Sales Director 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 SENTIlVEL 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): AuQtzst 29, September 5 and September 12 2011 COPY OF NOTICE OF PUBLICATION -~•+ar~ ESTATE NOTICE Letters of Administration on he Estate'ot AAITZI WINTERS INORONES, late of thel3orough of GarNalA, Cumbedand'County, Pennsylvania, deceased, have been granted to the'undersigned: All persona knowing,themedlves to be Indebted to said Estate will make payment imm^ed18t81y, and those having claims wiltpre8ent them for settlement to: Michelle Winters; Adminiatratrix c!o MARTSON LAW OFFICES 10 East High Street - ~' - Carlisle, PA 17013 Seth T. Mosebey; Esquire MARTSON LAW OFFICES Attorneys. -- 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 tie, place and character of publication ~` Sworn t and ~~d .~ me this Notary Public My commission expires: NOTARIAL SEAL BAMBI ANN HECKENDORN Notary Public CARLISLE BOROUGH, CUMBERLAND CNTY (dy Commission Expires Jar, 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 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: August 26, September 2, and September 9 2011 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. Coyne, Editor SWOR1tT"TO AND SUBSCRIBED before me this 9 of September, 2011 Notary Moroaes, Mitai Winters, deed. Late of the borough of Carlisle. Administratrix: Michelle Winters c/o Martson Law Offices, 10 East ~,~ High Street, Carlisle, PA 17013. NOTARIAL SEAL Attorneys: Seth T. Moseby, Es- DEBORAH A COLLIPJS quire, Martson Law Offices. Notary Public CARLISLE BOROUGH, CUMBERLAND COUNTY My Commission Expires Apr 28, 2014 IN RE: IN THE COURT OF COMMON PLEAS OF ESTATE OF MITZI WINTERS MORONES, . DECEASED :CUMBERLAND COUNTY, PENNSYLVANIA LATE OF NORTH MIDDLETON TOWNSHIP, CUMBERLAND COUNTY, :ORPHANS' COURT DNISION PENNSYLVANIA N0.21-10-0650 NOTICE OF FILING FIRST AND FINAL ACCOUNT AND PETITION FOR ADJUDICATION/SCHEDULE OF PROPOSED DISTRIBUTION AND CALL FOR AUDIT OR CONFIRMATION NOTICE IS HEREBY GNEN that Michelle Winters, Administrator of the Estate of Mitzi Winters Morones, deceased, has this date filed the First and Final Account and Petition for Adjudication/Schedule of Proposed Distribution in the above-captioned Estate in the Office of the Clerk of the Orphans' Court in and for Cumberland County, Pennsylvania, where the same is filed as public record and may be inspected. Copies of the Account and Petition are enclosed for your information. YOU ARE FURTHER NOTIFIED that any exceptions or objections to said Account or Petition must be filed in writing at the office ofthe Clerk ofthe Orphans' Court, Cumberland County Courthouse, Carlisle, PA 17013, aforesaid prior to the confirmation of said Account and Schedule of Proposed Distribution scheduled as set forth below. UNLESS written exceptions or objections are filed prior thereto, said Account will be presented by the Clerk of the Orphans' Court to the above-captioned Court in Court Room No. 1 of the Cumberland County Courthouse, Carlisle, Pennsylvania, at 9:30 a.m. prevailing time, on Tuesday, March 6, 2012, at which time said Account will be confirmed and distribution ordered in accordance with the Petition for Adjudication/Schedule of Proposed Distribution. MARTSON LAW OFFICES By: J ~ ~~~~ n Date of Notice: :.c~y~ /~~ ~O ~Z NOTICES TO: Carlisle Regional Medical Center P.O. Box 281442 Atlanta, GA 30384-1442 Robert J. Beaudry, Jr. DMD 3600 Old Gettysburg Road Camp Hill, PA 17011 Department of Veterans Affairs VA Medical Center 3900 Woodland Avenue Philadelphia, PA 19104 Seth T. Mosebey, Esquire / / 10 East High Street (~ Carlisle, PA 17013 (717) 243-3341 Attorney for Estate of Mitzi Winters Morones Holy Spirit Hospital P.O. Box 822183 Philadelphia, PA 19182 Carlisle HMA Physical Management P.O. Box 21629 Atlanta, GA 30384 Consumer Portfolio Services, Inc. Asset Recovery Department P.O. Box 57071 Irvine, CA 92619 Merrick & Fair, Inc. 901 Walnut Bottom Road Carlisle, PA 17015 RMBC Collection Agency 2269 S. Saw River Road, Bldg. 3 Elmsford, NY 10523 Ms. Michelle Winters 622 Woodlawn Avenue Mt.Holly Springs, PA 17065 Ms. Sheila Winters 473 Wayne Avenue Chambersburg, PA 17201 s , F:\FILES\Clients\13768 Morones\13768.1.accoutu2 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA ORPHANS' COURT DIVISION FILE NO. 21-10-0650 FIRST AND FINAL ACCOUNT OF MICHELLE WINTERS, ADMINISTRATOR OF THE ESTATE OF MITZI WINTERS MORONES, LATE OF NORTH MIDDLETON TOWNSHIP CUMBERLAND COUNTY, PENNSYLVANIA Social Security Number: Tax ID Number: Date of Death: Date of Incapacity, if any Date of Executor's Appointment: Letters Advertised: Sentinel - Cumberland Law .Tournal - Accounting for the period: 191-46-0330 27-6648990 March 3, 2010 None June 25, 2010 August 29, September 5 & 12, 2011 August 26, September 2 & 9, 2011 March 3, 2010 -January 6, 2012 Purpose of the Account: Michelle Winters, Administrator, offers this account to acquaint interested parties with the transactions that have occurred during the administration. It is important that the Account be carefully examined. Requests for additional information or questions or objections can be discussed with: Seth T. Mosebey, Esquire MARTSON LAW OFFICES 10 East High Street Carlisle, PA 17013 (717) 243-3341 Supreme Court No. 203046 . SUMMARY OF ACCOUNT Page No. PRINCIPAL Receipts Less Disbursements Debts of Decedent (Unpaid) Funeral Expenses Administration Expenses Family Exemption Federal, State & Local Taxes Fees and Commissions Balance Before Distributions Distributions to Beneficiaries Principal Balance on Hand INCOME Receipts Less Disbursements Balance Before Distributions Distributions to Beneficiaries Income Balance on Hand COMBINED BALANCE ON HAND 3 5 3 6,835.56 3 397.66 0.00 0.00 4 4.110.18 Fiduciary Acquisition Value 11,343.40 -11.343.30 0.00 0.00 0.00 0.21 -0.21 0.00 0.00 0.00 0.00 -2- PRINCIPAL RECEIPTS Assets Listed in Inventory (or Inheritance Tax Return) (Valued as of Date of Death) Metro Bank checking HM Life Insurance, refund of premium State Farm, refund of premium Trademark, Inc., refund of premium Ahold Financial, vacation pay due on date of death Ahold Financial, 401k benefit paid to estate Hoffman-Roth, overpayment of funeral bill American General Life Insurance Co., 8460814001, beneficiary estate Pinnacle Health, refund Income transferred to principal TOTAL PRINCIPAL RECEIPTS PRINCIPAL DISBURSEMENTS DEBTS OF DECEDENT See list of unpaid creditors (page 5) FUNERAL EXPENSES Hoffman-Roth Funeral Home Michelle Winters, reimbursement for grave marker ($833.00) and balance of burial plot payment ($156.73) Total Funeral Expenses ADMINISTRATION EXPENSES Martson Law Offices, disbursements: Probate Fee 53.50 Filing fee-Inheritance Tax return 15.00 Additional probate fee 50.00 Legal Advertising-Cumberland Law Journal 75.00 Legal Advertising-The Sentinel 200.16 Metro Bank, fees Total Administration Expenses 351.43 57.60 37.15 58.44 136.59 581.98 100.00 10,000.00 20.00 0.21 11,343.40 5,845.83 989.73 6,835.56 393.66 4.00 397.66 -3- TOTAL DISBURSEMENTS OF INCOME TO BENEFICIARIES 0.00 UNPAID CREDITORS Medical services: Carlisle Regional Medical Center, accounts 9455560; 9454685; 9454452; 550.00 9455535 Robert J. Beaudry, Jr., DMD, account 9383 74.00 Department of Veterans Affairs, claim for co-payments 2,180.61 Holy Spirit Hospital, account 36576551 250.00 Carlisle HMA Physical Management, account 688975 40.00 All other claims: Consumer Portfolio Services, Inc., loan #00112245817, 2003 Jeep Liberty, total balance due on date of death $9,840.74, vehicle repossessed and sold 2,718.24 for $7,600.00. Remaining balance due + expenses $2,718.24 Merrick & Fair, balance due for auto repair, invoice 658730 114.47 The History Channel Club, account #80072757 318.00 TOTAL DUE UNPAID CREDITORS: 6,245.32 VERIFICATION Michelle Winters, Administrator of the Estate of Mitzi Winters Morones, 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 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. ~. ~ Mich e Winters Dated: l l ~ ~ ~ ~ -5- IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA ORPHANS' COURT DIVISION FILE NO. 21-10-0650 FIRST AND FINAL ACCOUNT OF MICHELLE WINTERS, ADMINISTRATOR OF THE ESTATE OF MITZI WINTERS MORONES, LATE OF NORTH MIDDLETON TOWNSHIP CUMBERLAND COUNTY, PENNSYLVANIA PROPOSED DISTRIBUTION TO BENEFICIARIES Michelle Winters, Administrator of the Estate of Mitzi Winters Morones, deceased, states that no payment will be made to the Unpaid Creditors listed in the First and Final Account, nor will any distribution be made to any heirs due to the insufficient funds in the Estate. W~~ Mich e Winters, Administrator Estate of Mitzi Winters Morones Sworn and subscri~d to before me this ~~ `~ o -=~~utcc,. , 2012. ~~ i _ / ~ 1 lc ~ ~~„ C Notary Public COMMONWEALTH OF PENNSYLVANIA NOTARIAL, SEAL ~%ictoria L. Otto, tJcr~y Public ~'arlisle Boro, Cur~~i,~:;i.z~,~ ^ounty z `~'• ~ commission expires ~~i• ,.; ~;, i~ 014 -6-