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09-10-12
DECEDENT'S ESTATE {~'~l ~: " .` COURT OF COMMON PLEAS OF a =~=~" CUMBERLAND ~ ` COUNTY, PENNSYLVANIA ~`:~f ORPHANS' COURT DIVISION ~" ; -'~ ESTATE OF ROBERT C. FALCO ,DECEASED No. 21-10-0177 PETITION FOR ADJUDICATION / STATEMENT OF PROPOSED DISTRIBUTION PURSUANT TO Pa. O.C. Rule 6.9 ~, -.., - ~-, fly r-j-'a o - ~ `- { - -tr : f - - _ ~ ~ rT=,' r~: ~'~ Q .~- This form may be used in all cases involving the Audit of the Account of a Decedent's Estate. If space i.s 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 ATTACHMENTS AT THE BACK OF THIS FORM. Name of Counsel: Joseph D. Buckley, Esquire Supreme Court LD. No.: 38444 Name of Law Firm: Law Offices of Joseph D. Buckley Address: 1237 Holly Pike, Carlisle, PA 17013-4435 Telephone: 717-249-2448 Fax: 717-249-41 n~ Form OC-0l rev. 10.13.06 Page 1 of 10 `t Estate of ROBERT C. FALCO Deceased 1 • Name(s) and address(es) of Petitioner(s): Nome: Barbara J. Boyer Address: 25 Bentley Place Carlisle, Pa 17013 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 o adjudication of the prior accounting, f 2. Decedent died on November 12, 2009 Letters Testamentary or 0/ Letters of Administration were granted to Pe ' ' March 12.2010 tthoner(s) on Date of Will (fapplicable): No Date (Holigraphic) Date(s) of Codicil(s) (if applicable): None Date of probate (if different from date Letters granted: Was a bond required? Dyes ~ 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: 04-02-10, 04-09-10 & 0 - _ --__ 4 16 10 (CCLJ) 03-27-10, 04-03-10 & 04-10-10 (The Sentinel) Form OC-0I rev. 10.13,06 Page 2 of 10 Estate of ROBERT C. FALCO Deceased 3 • Was decedent survived by a spouse? ....... . ..................... ~]/ Yes [] No If yes, name of the surviving spouse: Barbara J. Boyer 4. Has the surviving spouse filed to take an elective share? .. . (See Section 2201 et sue. of the Probate, Estates and Fiduciaries Code) ~ Yes ©No If yes, date of election: See Order of 06-09-10 (The Honorable J. Wesley Oler) 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 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 0/ 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 Form OC-0/ rev. 10.13.06 Page 3 of 10 Estate of ROBERT C. FALCO 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 in Interest ~ Relationship and Destiny Daniels c/o Amanda A Falco 213 Lehman Street Ft. Bragg, NC 28307 Barbara J. Boyer 25 Bentley Place Carlisle, Pa 17013 Form OC-01 rev. 10.13.06 granddaughter residing with her guardian and mother, Amanda Falco (daughter of decedent) surviving spouse Interest 2/3 of residuary as per Order dated June 9, 2010 by Judge J. Wesley Oler 1/3 of residuary as per Order dated June 9, 2010 by Judge J. Wesley Oler Page 4 of 10 Estate of ROBERT C. FALCO Deceased Destiny Daniels (granddaughter) age 9 years. Daughter of Amanda A. Falco, mother and legal guardian, both residing at 213 Lehaman Street, Ft. Bragg, NC 28307. 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). The minor child has been represented throughout the Estate proceedings and administration by her mother and legal guardian Amanda A. Falco. The Court has formerly accepted mother as guardian in this Estate ,see Petition filed May 2010 and Order following hearing dated June 9, 2010. 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. Form OG01 rev. 10.13.06 Page 5 of 10 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. Estate of ROBERT C. FALCO Deceased 10. Other than the claim for the family exemption, list t the amount of their claims and state whether each claim i he names of all known claimants and s admitted. Name and Address of Each Claimant Amount ofC[aim Claim Admitted. Wlll Claim Be Paid /n Full. ]Yes ~ Yes ONo Q No DYes ~ Yes ^No ^ No 0 Yes ~No ^ Yes ~] No Yes ~No 0 Yes No If the estate is insolvent, attach a schedule setting forth the 20 Pa.C.S. § 3392 and the proposed a order of preference under p yments. 11. Was family exemption claimed? . , , . . Was familyexem ••~~~~~~~•"""• DYes ©/No ption allowed? . Famil ex P • clai • ........................... 0 es ONo Y Y em hon mant's name and relationship: ,Name: Relationship; Estatt ROBERT C. FALCO 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 08-25-2010 06-19-2012 3,000.00 1,420.23 90.37 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? ...... . ..... . Q 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 OG0/ rev. 10.13.06 Page 7 of 10 Estate of ROBERT C. FALCO Deceased 16. Had the decedent been adjudicated an incapacitated person? .......... ^ Yes 0/ 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 Q 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? ........................................ Yes Q 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 0/ No As to real estate only? ........................................ DYes ®/ No Form oc-oi rev. 10.13.06 Page 8 of 10 Estate of ROBERT C. FALCO 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) B. Principal: Proposed Distributee(sJ Barbara J. Boyer Destiney Daniels c/o Amanda A. Falco Amount/Proportion Amount/Proportion 1 /3 2/3 Submitted By: (All petitioners must sign. Add additional lines if necessary): Name of Petitioner: Barbara J. Boyer Name of Petitioner: Form oc-ol rev. !0.13.06 Page 9 of 10 Estate of ROBERT C. FALCO Verification of Petitioner (Verification must be by at least one petitioner.) Deceased The undersigned hereby verifies ~r:e,~~~~ __ of t1~l3e~ote-wed-„~~Ze o,°~~~xL,~~~ 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 nature of Petitio r 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. Form oc-nl rev. 10.13.06 Page 10 of 10