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Home My WebLink About08-22-12 DECEDENT'S ESTATE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF Jane O Warner No. 21-10-0358 PETITION FOR ADJUDICATION / STATEMENT OF PROPOSED DISTRIBUTION PURSUANT TO Pa. O.C. RULE 6.9 ~:, r-'~"'t v.i ~ L ~ : , ~":. ~ . . : ., - . ' D~--- ~--, -_- -z~, ~ :~' ~-; -c~ -- ~,~ y .~ DECEASED This form maybe used in all cases involving the Audit of the Account of a Decedent's Estate. If space is insufficient, riders maybe attached. Attach the spouse's election, if any; the papers required under items 8-79 inclusive; and any instrument pertinent to the adjudication. INCLUDE ATTACHMENTS AT THE BACK OF THIS FORM. Name of Counsel Supreme Court I.D. No Bradley L. Griffie 34349 Name of Law Firm: Griffie & Associates Address: 200 N Hanover Street Carlisle, PA 17013 Telephone: (717) 243-5551 Fax: (717) 243-5063 E-mail: bgriffie griffielaw.com Form OC-O~ Rev. 10-73-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 1 Of 10 Estate of Jane O Warner 1. Name(s) and address(es) of Petitioner(s): Name: Charlet Ann Warner .Deceased Address: 825 Burgners Road Carlisle, PA 17015 Identify any executors or administrators who have not joined in the Petition for Adjudication and Statement of Proposed Distribution and Account and state reason: Is this the first accounting by this fiduciary? ... If not, identify prior accountings, the accounting periods covered, and the date of adjudication of the prior accounting. ... ®Yes ^ No 2. Decedent died on 02/19/2010 ®Letters Testamentary or 04/06/201 ^ Letters of Administration were granted to Petitioner(s) on Date of Will (if applicable): 04/19/2005 Date(s) of Codicil(s) (if applicable): 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: 04/10/2010 04/17/2010 04/24/2010 04/16/2010 04/23/2010 04/30/2010 Form ~C-Q1 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 2 of 10 Estate of Jane O Warner 3. Was decedent survived by a spouse?.......... If yes, name of the surviving spouse: ,Deceased ^ Yes ® No 4. Has the surviving spouse filed to take an elective share? ......................................... (See Section 2201 et s,~c. 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 (if none, so state): 6. Did the 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 ® 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 ® Yes ^ No Form OC-O1 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 3 of 10 Estate of Jane O Warner 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. tf 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. Rute 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 Partv In Interest Charlet Ann Warner 825 Burgners Road Carlisle, PA 17015 and Comments, if Daughter Sole heir and Executrix Interest 100% Form OC-~~ Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 4 of 10 Estate of Jane O Warner ,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. O.C. Rule 12.4). None required 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. Not applicable Form OC-0~ Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, inc. Page 5 of 10 Estate of Jane O Warner . 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 Admitted? Will Claim Be Paid in Full? Above Attachment Total 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?........... ® Yes ~ No ® Yes ~ No Family exemption claimant's name and relationship: Name: Charlet Ann Warner Relationship: Daughter Form OC-0~ Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, inc. Page 6 of 10 Estate of Jane O Warner . 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 12/28/2011 06/15/2012 Payment 5,489.47 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? ............................................ 188.31 _.......,. ^ 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-~~ Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 7 of 10 Estate of Jane O Warner 16. Had the decedent been adjudicated an incapacitated person? . Deceased ^ Yes ® No If yes, attach a copy of the Order if available; otherwise state 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. Date Description Amount 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 parties in interest? ................................................................................. If so, attach a copy of the notice. 19. Is the Court being asked to direct the filing of a Schedule of Distribution? ............................................................... As to real estate only? ......................................................................................... ® Yes ^ No ^ Yes ® No ...... ^ Yes ^ No Form ~C-U1 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Page 8 of 10 Estate of Jane O Warner Deceased Wherefore, your Petitioner(s) ask(s) that distribution be awarded to the parties entitled and suggests} that the distributive shares of income and principal (residuary shares being stated in proportions, not amounts) are as follows: A. Income: Proposed Distributee(s) Charlet Ann Warner B. Principal: Proposed Distributee(s) Charlet Ann Warner Amount Proportion 100% Amount Proportion 26,622.74 100% Submitted By: (All petitioners must sign. Ad/d additional lines if necessary): (~ ~..i7V n r~ 1Y1 D ~4 Name of Petitioner: Charlet Ann Warner Name of Petitioner: Name of Petitioner: Form ~C-U1 Rev. >0-73-2006 Copyright (c) 2006 form software only The Lackner Group, inc. Page 9 of 10 Estate of Jane O Warner Verification of Petitioner (Verification must be by at least one petitioner.) Deceased The undersigned hereby verifies * [that nersne ~is rrne G~x«~~r'~ ~( of the above-named name ofcorporation ~ .~r~rt z. U . (~~ ~~ ~ ~ ~' 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 Charlet Ann Warner Signature of Petitioner 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. r~ Si r ounsel f Petitioner .~ y L. Griffie Form OC-O1 Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, -nc. PBge 10 Of 10 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): Apri110, 17, and 24, 2010 COPY OF NOTICE OF PUBLICATION - - EXECUTRIX'S NOTICE Letters Testamentary on-ttre~Estate of JANE O.INARNf R, late. of Lower - Frankford Township, Curnberiand County. Pennsylvania, deceased, have been granted tq-the undersigned_ _ All persons;knawing themselves to be indebted to aid Estate will make III .payment immediately, and hose fiaving'claims will present them for settlement toy I Chariot Ann: Warner, Executrix ~ c/o Bradley L.'Griffie, Esquire I GRIFFIE & ASSOCIATES 200 North Hanover Street '"' yr ~ Carlisle, PA i7Dt3' . -, , '(717) 243=5581 N. (800)347-5552. i 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 ~fh -~ Notary Public My commission expires: NOTARIAL SEAL BAMBI ANN HECKENDpRN Notary Public CARLISLE BOROUGH, GUMBERLANO CNTY My Commission Expires Jan 27, 2014 i~ Sworn to and subscribed before me this 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 Journal, of the County and State aforesaid, being duly sworn, according to law, deposes ar~d says that the Cumberland La:v 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, V1Z: April 16, April 23, and April 30, 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. ,.------ sa Marie Coyne ditor SWORN TO AND SUBSCRIBED before me this 30 da of Aril 2010 ` Warner, Jane O., deed. Notary Late of Lower Frankford Town- ship. Executrix; Chariot Ann Warner c/o Bradley L. Griffie, Esquire, N07ARIAL SEAL Griffie & Associates, 200 North DEBORAH A COLLINS Hanover Street, Carlisle, PA 17013. Notary Public Attorneys: Bradley L. Griffie, Es- CARLISLE BOROUGH, CUM$ERLAND COUNTY quire, Griffie & Associates, (717) My Commission Expires Apr 28, 2014 243-5551, (800) 347-5552. -- /~~ ~~~-~ In re: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of Jane O. Warner :ORPHAN'S COURT DIVISION Late of Lower Frankford Township NO. 2010-00358 Cumberland County, Pa., deceased PA NO. 21-10-03 5 8 FIRST AND FINAL ACCOUNT OF Charlet A. Warner, Executrix Estate of Jane O. Warner late of Lower Frankford Township, Cumberland County Pennsylvania, deceased CERTIFICATE OF CLERK The above Account was filed on , 2012, last advertised April 30, 2010, according to law, and is presented herewith to the Court of Common Pleas, Cumberland County, Pennsylvania, Orphans" Court Division for confirmation. Date Clerk ORDER OF COURT 2012, no exceptions or objections having been filed to the account or to the proposed schedule of distribution, the within account and schedule of distribution are confirmed and distribution is directed in accordance with the schedule of distribution. BY THE COURT, J. Date of Death: February 19, 2010 Gross value of estate: $138,682.54 Distribution amount of estate: $116,293.13 Last advertising: Apri130, 2010 1 In re: Estate of Jane O. Warner Late of Lower Frankford Township Cumberland County, Pa., deceased IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHAN'S COURT DIVISION NO. 2010-003 5 8 PA N0.21-10-03 5 8 DATE OF DEATH: February 19, 2010 LETTERS GRANTED: April 6, 2010 FIRST COMPLETE ADVERTISEMENT Apri124, 2010 OF GRANT OF LETTERS DISTRIBUTION OF ESTATE INCLUDED IN ACCOUNTING DISTRIBUTION AMOUNT IS $116,310.46 GROSS VALUE OF ESTATE IS: $138,682.54 ACCOUNTING FOR THE PERIOD April 6, 2010 through July 6, 2012 Purpose of the Account: Charlet A. Warner, Executrix, offers this accounting to acquaint interested parties with the transactions that have occurred during her administration. The Account also indicates the proposed distribution of the Estate. It is important that the Account be carefully examined. Requests for additional information, questions or objections can be discussed with: Bradley L. Griffie, Esquire Attorney for Petitioner 200 North Hanover Street Carlisle, PA 17013 (717) 243-5551 (800) 347-5552 n r- ,, r`,:. Y ti- Pte.... _ .~~ ~''~'~ ~ ~ r ~ -, .,.A _ ~ M ~~. J ~y ^w ~ .~ ~T7 2 PRINCIPAL ASSETS RECEIVED REAL ESTATE None STOCKS AND BONDS: 1. Cumberland Valley Cooperative Assn. $ 120.00 12 shares, Certificate No. 6749 2. United States Savings Bonds 2,941.20 Series E Bond D21158385E, issued 03/1950, Face amount $500.00 3. United States Savings Bonds 2,941.20 Series E Bond D21158386E, issued 03/1950 Face amount $500.00 4. United States Savings Bonds 5,882.40 Series E Bond M20995456E, issued O1/19~0 Face amount $1,000.00 5. Unites States Savings Bonds 9,110.80 Series E Bond M84238263E, issued 04/1964 Face amount $1,000.00 6. Adams Electric Cooperative, Inc. 480.20 Patronage Capital #4150 Subtotal $ 21,475.80 -, J CASH AND BANK DEPOSITS: 1. Cash found in safe deposit box $ 4,543.00 2. Coins found in safe deposit box 2.45 3. M&T Bank -Checking Account No. 9849247201 25,124.41 4. Citizens Bank -Checking Account No. 6100730468 731.33 5. Commonwealth of PA -Real Estate Tax Rebate 500.00 Subtotal JOINTLY HELD PROPERTY None PERSONAL PROPERTY AND VEHICLES: 1. 1990 Jeep $ 500.00 Subtotal INTER-VIVOS TRANSFERS: None ADDITIONAL RECEIPTS: 1. Prudential Stock Dividend payment 46.40 Subtotal NON-PROBATE ASSETS 1. Prudential Insurance Company of America $ 9,521.39 Annuity Policy No. 73061278 2. Midland National Life Insurance Company 76,284.16 Annuity No. 8500380970 Subtotal $ 30,901.19 $ 500.00 $ 46.40 $ 85,805.55 4 GAINS AND LOSSES ON LIQUIDATIONS AND OTHER DISPOSITIONS: LOSSES/COSTS: 1. M&T Bank checking $(-) 299.69 Checks processed post-death 2. Citizens Bank checking (-) 167.54 Checks processed post-death $(-) 467.23 GAINS None Subtotal .00 NET GAINS OR LOSSES ON LIQUIDATIONS INTEREST ACCRUED ON ESTATE CHECKING ACCOUNT: None Subtotal Total Principal of Estate with Adjustments $ (-) 467.23 $ 0.00 $ 138,261.71 5 DISBURSEMENTS OF PRINCIPAL DEBTS OF DECEDENT: 1. Adams Electric Cooperative $ 43.00 2. Paula Burkholder, Tax Collector (2009 Personal taxes) 9.80 3. CenturyLink 96.14 4. Citizens Bank (bank fees) 20.00 5. Health Insurance (automatic withdrawal) 7.95 Subtotal $ 176.89 FUNERAL EXPENSES: 1. Ewing Brothers, Inc. $ 5,097.37 Subtotal $ 5,097.37 ADMINISTRATIVE EXPENSES AND COSTS: 1. Attorney's fees to Griffie & Associates $ 6,300.00 2. Probate fees 621. ~ 0 3. Advertising-Cumberland Law Journal 75.00 4. Advertising-The Sentinel 187.54 5. Family Exemption 3,500.00 6. Accountant fees 100.00 7. Ibis Appraisal Services (coins/cash) 30.00 8. Citizens Bank (bank fees) 31.00 9. Citizens Bank fee for safe deposit box 1 X0.00 10 . Orrstown Bank (bank fees) 21.50 Subtotal $ 11,016.54 6 TAXES Pennsylvania Inheritance Tax $ 5,489.47 Interest 1 R R _ 31 Subtotal Total Disbursement of Principal $5,677.78 $21,968.58 PRIOR_IN KIND DISTRIBUTIONS AND NON-PROBATE ASSETS DISTRIBUTED 1. Non-Probate Asset distributed to named beneficiary (A) Prudential Insurance Annuity $ 9,521.39 (B) Midland National Life Annuity 76,284.16 2. Cash and coins in Citizens Bank safe deposit box 4,545.45 3. United States Savings Bonds retained 20,875.60 4. 1990 Jeep 500.00 5. Advanced distribution to sole heir 3,864.84 Subtotal $ 115,591.44 Total Principal of Estate with Adjustments $13 8,261.71 Less Disbursements of Principal - $ 21,968.58 Less Non-Probate and in Kind Distributions - $115,591.44 TOTAL $ 701.69 NET ASSETS/PROCEEDS AVAILABLE FOR DISTRIBUTION TOTAL $ 701.69 PROPOSED DISTRIBUTIONS TO TESTAMENTARY BENEFICIARIES AFTER ACCOUNT CONFIRMATION Charlet A. Warner $ 701.69 Total Share of Distribution 100% TOTAL PROPOSED DISTRIBUTION OF PRINCIPAL AND INCOME: $ 701.69 7 I hereby certify that written notice of the filing of this Account, and of the date, time and place when the same will be presented to the Court for confirmation and of the last day to file written objections to said Account, has been given to every unpaid claimant and. to every other person known to the accountant to have or claim an interest in the estate as creditor, beneficiary, heir, or next of kin. Br riffie squire 8 Charlet Ann Warner, Executrix of the Estate of Jane O. Warner, deceased, hereby declares under oath that she has fully and faithfully discharged the duties of her office; that the foregoing First and Final Account and Schedule of Distribution 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 her knowledge, there are no claims now outstanding against the Estate; and that all taxes presently due from the Estate have been paid. Charlet Ann Warner Sworn and subscribed to before me, this ,,,? 1 s ~ day f of , 2012. Notary Pu is NOTARIAL SEAL ROBIN ,~. f3ASSETT, Notary Public CARLISLE BOROUGH, CUMBERLAND CO. Commission Expires Apr.17, 2015