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DECEDENT'S ESTATE
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
ESTATE OF JEAN FRALISH ,DECEASED
No. 21-06-0355 „_,
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PETITION FOR ADJUDICATION / ~u~ '" ~-~.''-
STATEMENT OF PROPOSED DISTRIBUTION C1' -7
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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 insuff dent, 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 ATTACHMENTS AT THE BACK OF THIS FORM.
Name of Counsel: Cory A. Leshner
Supreme Court I.D. No.: 310377
Name of Law Firm: Law Offices of Cory A. Leshner, LLC
Address: 2023 N. 2nd Street, Suite 201 Harrisburg, PA 17102
Telephone: (717) 909-9999
Fax:~7171909-9009
Form OC-Ol rev. 10.13.06 Page 1 Of I O
Estate of JEAN FRALISH
Deceased
Name and Address of Each Parry in /nterest ~ Relationship and Comments, if any ~ /nterest
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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.
N/A
C. State why a Petition for Guardian/Trustee 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-nl rev. 10.13.06 Page 5 of 10
Estate of JEAN FRALISH ,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 Paid In
Full?
NeighborCare 30,703.05 Q/ Yes ~ Yes
c/oRobert D. Kodak, Esquire ~No ~ No
407 N Front St
Harrisburg, PA 17101
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? .............................. .
Was family exemption allowed? .............................. .
Family exemption claimant's name and relationship:
Name: James Frahsh Relationship: SpOUSe
/®Yes ®No
DYes ~No
Form OG01 rev. 10.13.06 Page 6 0f 10
Estate of JEAN FRALISH
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
SQi~~l~a
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:
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. ff
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Form OC-01 rev. 10.13.06 Page 7 Of 1 ~
Estate of JEAN FRALISH
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.
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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:
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 A r '~
parties in interest? ...................................rv 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 OGOI rev. 10.13.06 Page $ Of ] Q
Estate of JEAN FRALISH
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 Drstributee(s)
NeighborCare
James Fralish
Christian Fralish
B. Principal:
Proposed Distributee(s)
Adam Fralish
Aaron Beidel
Leanne Sutton
Amount/Proportion
7675.76
1/2
1/8
Amount/Proportion
1/8
1/8
1/8
Submitted By:
(All petitioners must sign.
Add additional lines if necessary):
e of Petiti ner: James Fralish
Name of Petitioner:
Form oc-or rev. gyn. X3.06 Page 9 of 10
Estate of JEAN FRALISH
Verification of Petitioner
(Verification must be by at least one petitioner.)
The undersigned hereby verifies * [that tieishe is r~rre
Deceased
of the above-named name of~orpo.Qao~ 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).
Si ature 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. -- -
ror„1 oc~-oi rev. ~n.~3.o6 Page 10 of 10
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA.
ORPHANS COURT DIVISION
FILE NO. 21-06-0355
FIRST AND FINAL ACCOUNT OF
James Fralish, Administrator
For
Estate of Jean Fralish, Deceased
Date of Death: 06/13/06
Date of Incapacity, if any: None
Date of Administrator's Appointment: 06/20/06
Date of First Complete Advertisement: 09/16/06
Accounting for the period: 06/20/06 to
06/13/12
Purpose of Account: The 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, questions or objections can be discussed with
Cory A. Leshner
ID #310377
cal'r~;coryleshner.cem
Law Offices of Cory A. Leshner LLC
2023 N. 2"d Street, Suite 201
Harrisburg, PA 17102
(717) 909-9999
(717) 909-9009 FAX
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Summary of Account
Principal
Receipts from Litigation
Less Disbursements:
Debts of Decedent
Attorney Fees
Litigation Costs
Estate Tax
Balance before Distributions
Distributions to Beneficiaries
Principal Balance on Hand
72,675.76
61,719.76
1,940.24
1,272.04
$200 00__0.00
-137,607.80
62,392.20
-62,92.20
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Principal Receipts
Assets Listed in Inventory
(Valued as of Date of Death)
Gross Proceeds from Litigation/Cash
Total Principal Receipts
Disbursement of Principal
(Date) NeighborCare
(Date) Medicare
(Date) Attorney Fees
Law Office of Cory A. Leshner
(Date) Litigation Expenses
Law Offices of Cory A. Leshner
(Date) Estate Tax
Register of Wills
Total Disbursement of Principal
Distributions of Principal to Beneficiaries
(Date) James Fralish
(Date) Christian Fralish
(Date) Adam Fralish
(date) Aaron Beidel
(Date) Leanne Sutton
Total Distributions to Beneficiaries
Total Principal On Hand
$200,000.00
7,675.76
65,000.00
61,719.76
1,940.24
1,272.04
~1~ 5~7 $4
31,196.08
7,799.03
7,799.03
7.799.03
7,799.03
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James Fralish, Administrator of the
Estate of Jean Fralish
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VERIFICATION
James Fralish, Administrator of the Estate of Jean Fralish, hereby declares under oath that
he has fully and faithfully discharged the duties of his 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; that, to his
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 of Administration 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. §4904 relating to unsworn
falsification to authorities.
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Date Jame ralish, ~"
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA.
ORPHANS COURT DIVISION
FILE NO. 21-06-0355
CERTIFICATE OF SERVICE
I, C~ A._Leshner hereby certify that on the ~ ~~ of ~~~ ~ z 2012 I served one
(1) copy each of the First and Final Account, upon the person(s) indicated below, by United
States mail first-class,~osta~e pre_~aid, which satisfies the requirements of the Pennsylvania
Rules of Civil Procedure:
Robert D. Kodak, Esquire
4t}7 N I~4ront St
Harrisburg, PA 1.7101
(Attoi7rey f-or Neighboreare)
Christian Fralish,
75 John King Lane
Mechanicsburg, PA l 7050
Adam Fralish,
75 John King Lane
Mechanicsburg, PA 17050
Aaron Beidel,
13 Fisher Run Road
Dillsburg, PA 17019
Leanne Sutton,
55 Gasoline Alley
Carlisle, PA 17013
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'"~Co .Leshner, E~q'~
~ aw Offices of Cory A. Leshner
2023 N. 2"d Street, Suite 201
Harrisburg, PA 17102