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HomeMy WebLinkAbout12-04-12~j) C. i Cumberland DECEDENT'S ESTATE ~„~ ~o ~~ w -v COURT OF COMMON PLEAS OF ~ y. m COUNTY, PENNSYLVANIA tzi> ~ ORPHANS' COURT DIVISION ° n ~ c-s o ~, ~ c:: A~ ~¢ ESTATE OF John W. Halbert ,DECEASED No. 21-12-0043 PETITION FOR ADJUDICATION / STATEMENT OF PROPOSED DISTRIBUTION PURSUANT TO Pa. O.C. Rule 6.9 ..~ t_. . f,. ,. C.a f ~~ ~rn ~ c' c~> >~ ~.i ~yr~ "~1 ~: ~ :;~ ,,,~ ..,~ ._s,~ :.... r s ,:. ~:f7 tl"~ This form may be 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. INCL UDE ATTACHMENTS AT THE BACK OF THIS FORM. Name of Counsel: Melanie Walz Scaringi, Esq. Supreme Court I.D. No.: 88347 Name of Law Firm: Scaringi &Scaringi, PC Address: 2000 Linglestown Rd., Suite 106, Harrisburg, PA 17110 Telephone: (717) 657-7770 Fax: (7 1 71 657-7797 Fornv OC-O! rer. 10.13.06 Page 1 of ] 0 Estate of John W. Halbert l . Name(s) and address(es) of Petitioner(s): ,vome.• Diane L. Acri-Sheffer, Executrix Aaaress: 525 North Star Drive Harrisburg, PA 17112 Deceased 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 December 25, 2011 Letters Testamentary or ~ Letters of Administration were granted to Petitioner(s) on Januarv 11.2012 Date of Will (if applicable): October 13, 2011 Date(s) of Codicil(s) (f applicable): Uate of probate (rf 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? ......... Q Yes ~ No Dates of advertising of the grant of Letters: C„mherlanrl QPnr;nPl • ~~rar..h z i n ~ ~ 2012; Cumberland Law Journal: March 9, 16, 23, 2012 Form oc-nl rev. 10.13.06 Page 2 of 10 Estate of John W. Halbert Deceased 3. Was decedent survived by a spouse? ............................. Yes ®/ No [f yes, name of the surviving spouse: 4. Has the surviving spouse filed to take an elective share? ............. ^Yes ~ No (See Section 2201 et sic. 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 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 Form or-nl rev. 10.13.06 Page 3 of ] 0 Estate of John W. Halbert Deceased 8. Written notice ofthe 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 l0 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. [f 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): A'ame and Address oj'Each Par in /merest I Relationship and Patricia R. Stewart Girlfriend 10 Fieldcrest Drive Mechanicsburg, PA 17050 Interest Beneficiary Diane L. Acri-Sheffer Niece Executrix and 525 North Star Drive Beneficiary Harrisburg, PA 17112 Form OC-0/ rei•. J0. i3.06 Page 4 of 10 Estate of John W. Halbert Deceased ;Name and Address o/'Each Parry in /merest ~ Relationship and Comments, if any ~ /nterest Hospice of Central PA Charity Beneficiary 1320 Linglestown Rd. Harrisburg, PA 17110 St. Elizabeth Ann Seton Parish Charity Beneficiary 310 Hertzler Rd. Mechanicsburg, PA 17055 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 Ad 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. Fo,-m oc-ol rer. ln.r3.o6 Page 5 of 10 Estate of John W. Halbert Deceased 0. 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? Yes ~ Yes ~No ^ No Yes Yes ONo ^ No Yes ~ Yes No ~ No DYes ~ Yes ~No 0 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. 1 l . Was family exemption claimed? ................................ Yes ~/ No Was family exemption allowed? ................................ DYes ®/ No Family exemption claimant's name and relationship: Name.' Relationship. Form oc-nl rei-. /0.!3.06 Page 6 of 10 Estate of John W. Halbert ,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 /nterest March 16, 2012 34,000.00 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? .................. 0 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. Norm oc-0/ rev. 10.13.06 Page 7 of 10 Estate of John W. Halbert 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. 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. dn,n..n.. 2,000.00 rt„pose: Plus the refund from PA Department of Revenue that is anticipated for overpayment and early payment of PA Inheritance Tax. Purpose is for payment of any misc. final expenses, and payment of any PA or Federal Income Tax due on Estate's PA41 or 1041 (Fiduciary Income Tax Returns) [f 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 1 f so, attach a copy of the notice. 19. Is the Court being asked to direct the filing ofa Schedule of Distribution? .......................... DYes ®/ No As to real estate only? ........................................ Yes ®/ No Form oc-nr ,-~. ro.13.o6 Page 8 of 10 Estate of John W. Halbert 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 Distribrdee(s) Amount%Proportion Patricia R. Stewart 35% Diane L. Acri-Sheffer 35% Hospice of Central PA 15% St. Elizabeth Ann Seton Parish 15~ B. Principal: Proposed Dish•iburee(s) ,9mo:rnt Proportion Patricia R. Stewart $1 1,278 auto + 35% of resid. Diane L. Acri-Sheffer 35% of resid. Hospice of Central PA I S% of resid. St. Elizabeth Ann Seton Parish 15$ of resid. Submitted By: (All petitioners must sign. Add a itional lines if necess/ar^y~): / / / _ A trix Name of Petitioner: Forrn oGnl rer. 10.13.06 Page 9 Of 1 ~ Estate of John W. Halbert Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies x [that l~e~she she is axle Executrix Deceased of the above-named name ofco~pora~ron Estate 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 * 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. Sig ture of Counsel for Petitioner FormOC-Ol rev. 10.13.0( Page 10 of 10 PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Tackie 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 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): March 3,10 & 17, 2012 COPY OF NOTICE OF PUBLICATION ~ `° ,,. Mr ~ ~ Affiant further deposes that he/she is not ~ ~~';°~`~~~'~~'~•1°+~"t1°e interested in the subject matter of the ~ rte, ~,,,,~„p*, ~~ aforesaid notice or advertisement, and that " ~ all allegations in the foregoing statement as °` ' ' w; rk~rr, ~'~°~"'""~R1°r to time, place and character of publication ~~ a true. ~i~a~ , Sworn to and subscribed before me this 1 ~ oZ. Notary Public My commission expires: NOTARIAL SEAL BAMBI ANN HECKENDORN Notary Public CARLISLE BOROUGH, CUMBERLAND CNTY illy Commiss~rtin Expires Jan 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, vlz: March 9 March 16, and March 23, 2012 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. r Li Marie Coyne, Edi r SWORN TO AND SUBSCRIBED before me this 23 of March, 2012 Notary Halbert, Joha W., deed. Late of Shiremanstown Borough. Executrix: Diane L. Acri-Sheffer, 525 North Star Drive, Harrisburg, PA 17112. ....~.~~ Attorneys: Melanie Walz Scaringi, NOTARIAL SEAL Esquire, Scaring[ ~ Scaringi, P.C., DEBORAH A COLLINS 2000 Linglestown Road, Suite Notary Public 106, Harrisburg, PA 17110. CARLISLE BOROUGH, CUMBERLAND COUNTY My Commission Expires Apr 28, 2014 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA ORPHANS' COURT DIVISION FILE N0.21-12-0043 FIRST AND FINAL ACCOUNT AND STATEMENT OF PROPOSED DISTRIBUTION OF Diane L. Acri-Sheffer, Eaecutriz FOR ESTATE OF JOHN W. HALBERT, Deceased Date of Death: Date of Executrix's Appointment: First Complete Advertisement of Grant of Letters: Accounting for the Period: Gross Estate: December 25, 2011 January 11, 2012 March 23, 2012 January 11, 2012 through November 7, 2012 $288,573.04 Purpose of Account: The Executrix offers this Account to acquaint interested parties with the transactions that have occurred during the Administration of the Estate. It is important that the Account be carefully examined. Requests for additional information, questions or objections can be discussed with: Melanie Walz Scaringi, Esq. Attorney ID# 88347 Scaringi & Scaringi, PC 2000 Linglestown Road, Suite 106 Harrisburg, PA 17110 Phone (717) 657-7770 ''~' Fax (717) 657-7797 ~ o ~ rn m melanie@scaringilaw.com ~ ~ ~ ~ p -a ~~ c-~ to ~ ~ n `° r i r~~t n~~ -~ z . ~ v~~ ~ cy ~-a -~,..,~ ~„ c.,~ va ca 1 SUMMARY OF ACCOUNT PRINCIPAL Receipts Cash and items converted to cash In-kind asset (automobile) Total Receipts Less Disbursements Debts of Decedent Funeral Expenses Administration Expenses Federal, State & Local Taxes Fees and Commissions Total Disbursements Balance of Cash on Hand before Distributions and Reserves Distributions of Principal to Beneficiaries - In-kind distribution of automobile Principal Balance on Hand INCOME Receipts of Income, interest in bank Less Disbursements Distributions of Income to Beneficiaries Income Balance on Hand COMBINED PRINCIPAL & INCOME BALANCE ON HAND ANTICIPATED REFUND AND RESERVES Anticipated refund from PA Department of Revenue Reserve requested for estate finalization and payment of Income Taxes TOTAL ANTICPATED RESERVE Page 3 3 4 4 4-5 6 6 6 6 6 Paee 7 7 7 7 Page 8 8 $277,295.04 $11,278.00 $288,573.04 $ 2,443.80 349.07 23,114.43 34,023.00 28,193.65 $88,123.93 200,449.1 1 11,278.00 189,171.11 $368.06 0 0 $368.06 $189,539.17 $]0,131.56 $2000.00 $]2,131.56 2 PRINCIPAL RECEIPTS ASSETS LISTED IN INVENTORY Real Estate Residence 9 South Rupp Avenue, Shiremanstown, PA 17011 (Gross Sale Price) Tangible Personal Property Automobile: Ford Escape, 2008 (KBB trade-in value on 3/5/12). Kept in kind per Will Cash Members 1 S` Savings Account No. l 73833-0, date of death value Members 1 S` Money Management Account No. 173833-5, date of death value Metro Bank Checking Account No. 32002925, date of death value SUBSEQUENT RECEIPTS (CASH Refund of Policy Premium, State Farm Insurance Reimbursement for Ambulance Services from Highmark Blueshield Refund from U. S. Treasury -IRS Reimbursement of county real estate taxes from Real Estate Purchaser Reimbursement of school real estate taxes from Real Estate Purchaser Reimbursement of sewer from Real Estate Purchaser Refund of Policy Premium, Erie Insurance (Homeowner's insurance) TOTAL PRINCIPAL RECEIPTS $141,500.00 $11,278.00 $ ] 5.09 $121,297.91 $8,492.95 $223.09 $720.00 $3,179.00 $223.19 $1,604.95 $13.86 $25.00 $288,573.04 3 PRINCHAL GAINS OR LOSSES ON SALES OR OTHER DISPOSITIONS None DISBURSEMENTS OF PRINCIPAL DEBTS OF DECEDENT Verizon Reimbursement to Diane Acri-Sheffer for AAA fees paid on Decedent's behalf Quantum Imaging & Therapeutic Associates Quest Diagnostics Andrews & Patel Associates Holy Spirit Hospital Hope Medical Services Silver Spring Ambulance Association TOTAL DEBTS OF DECEDENT FUNERAL EXPENSES Malpezzi Funeral Home -Funeral Services Reimbursement to Diane Acri-Sheffer for Hoss's Steak & Sea House -Funeral Meal TOTAL FUNERAL EXPENSES ADMINISTRATION EXPENSES Cumberland County Register of Wills -Probate fee PP&L Electric Bills for Decedent's Residence PA American Water for Decedent's Residence Lower Allen Township, Sewer, for Decedent's Residence Interstate Waste Services, trash removal, for Decedent's Residence Leffler Energy, heating oil for Decedent's Residence $ 32.08 41.50 23.87 15.59 117.19 1,3 74.21 19.3 6 820.00 $2,443.80 109.85 239.22 349.07 423.50 135.55 126.59 181.50 111.06 2,109.46 4 Ed Michael for Snow Removal 50.00 Dugan Appraisal Services for Decedent's Residence 350.00 Commonwealth of PA fee for vehicle transfer 58.50 Carlisle Sentinel -Publication of Legal Notice 168.30 Cumberland County Law Journal -Publication of Legal Notice 75.00 Administrative expenses such as photocopy, postage, fax expenses 92.95 incurred by Scaringi &Scaringi, P.C. (detail on invoices) Cumberland County Register of Wills -Short Certificates 8.00 PA Department of Health -Death Certificates for Rose Halbert (needed to close 37.00 Joint bank account and sell real estate Ed Michael for Lawn Mowing and related services 820.00 Joy Daniels Group Real Estate Broker Fee for selling Decedent's Residence 395.00 School Real Estate Taxes for Decedent's Residence 1,939.50 County Real Estate Taxes for Decedent's Residence 779 22 The Virtus Group, home inspection for Decedent's Residence 275.00 Seller's Assistance for selling Decedent's Residence 4,245.00 Real Estate Broker Commission for selling Decedent's Residence 8 235.30 Notary Fees for selling Decedent's Residence 10.00 Tax cert. fee to Abstract Land Associates, Inc. for selling Decedent's Residence 5.00 Realty Transfer Tax for selling Decedent's Residence 1,415.00 Radon Mitigation to Central Penn Radon, Inc. for selling Decedent's Residence 820.00 Postage expense incurred by Executrix 18.00 Filing Fee for Account and Petition for Adjudication 150.00 Advertisement fee for Account and Petition for Adjudication 80.00 TOTAL ADMINISTRATION EXPENSES $23,114.43 5 FEDERAL, STATE & LOCAL TAXES Pennsylvania Inheritance Tax Deposit (actual amount believed to be due is $25,124.67. $34,000.00 (Refund of $10,131.56 is anticipated (which includes a credit for early payment in the amount of $1,256.23) -see "ANTICIPATED REFUND, RESERVES ..." below) 20] 1 Pennsylvania Income Tax (for Decedent's final return) 23.00 TOTAL FEDERAL, STATE & LOCAL TAXES 34,023.00 FEES & COMMISSIONS Diane L. Acri-Sheffer, Executrix 5% commission per Last Will and Testament $14,428.65 Scaringi &Scaringi, PC, invoices (see attached copies of invoices with 13 765.00 complete itemization to include fees earned and administrative disbursements advanced by Scaringi &Scaringi, PC): TOTAL FEES & COMMISSIONS $28,193.65 TOTAL DISBURSEMENTS OF PRINCIPAL $87,344.71 DISTRIBUTIONS OF PRINCIPAL TO BENEFICIARIES Beneficiary Distribution Patricia R. Stewart, 10 Fieldcrest Dr., Mechanicsburg, PA- In kind Automobile $1 1,278.00 distribution of automobile per Last Will and Testament TOTAL DISTRIBUTIONS OF PRINCIPAL TO $11,278.00 BENEFICIARIES PRINCIPAL BALANCE ON HAND Cash Principal in Estate Checking Account TOTAL PRINCIPAL BALANCE ON HAND OUTSTANDING CLAIMS REMAINING TO BE PAID None. $189,171.11 $189,171.11 6 RECEIPTS OF INCOME Members 1'` Money Management Account -Dividends Dec. 26-Dec. 31, 201 1 $12.79 Members 1 S' Money Management -Dividends January 2012 to account closure $1 14.12 Metro Bank -Decedent's 50+ Checking -Interest Dec. 20l 1 $.30 Metro Bank -Decedent's 50+ Checking -Interest Jan. 2012 to account closure $5.63 Metro Bank Estate Money Market -Interest during accounting period 235.22 TOTAL INCOME $368.06 PROPOSED DISBURSEMENTS OF INCOME Diane L. Acri-Sheffer, Executrix 5% commission on Income $18.40 TOTAL REMAINING INCOME TO BE DISTRIBUTED $349.66 PROPOSED DISTRIBUTIONS OF INCOME TO BENEFICIARIES Pursuant to Paragraph Seventh of Will: (a) To: Hospice of Central PA, 1320 Linglestown Rd, Harrisburg, PA, (15%) $52.45 (b) To: St. Elizabeth Ann Seton Parish, 310 Hertzler Rd, Harrisburg, PA, (15%) $52.45 (c) To: Patricia R. Stewart, (35%) $ l22 38 (d) To: Diane L. Acri-Sheffer, (35%) $122 38 TOTAL REMAINING INCOME AFTER ABOVE DISTRIBUTIONS $0.00 7 PROPOSED DISTRIBUTIONS TO BENEFICIARIES OF PRINCIPAL BALANCE ON HAND NET PRINCIPAL BALANCE ON HAND (AFTER REMOVAL OF $2000 FOR $187,171.11 RESERVE -SEE BELOW) - To be distributed pursuant to paragraph Seventh of Decedent's Last Will and Testament: To: Hospice of Central PA, 1320 Linglestown Rd, Harrisburg, PA, cash (15%) To: St. Elizabeth Ann Seton Parish, 310 Hertzler Rd, Harrisburg, PA, cash (15% To: Patricia R. Stewart, cash (35%) To: Diane L. Acri-Sheffer, cash (35%) TOTAL PROPOSED DISTRIBUTIONS TO BENEFICIARIES OF NET PRINCIPAL BALANCE ON HAND $28,075.67 $28,075.67 $65,509.89 $65,509.88 $187,171.11 ANTICIPATED REFUND, RESERVES AND FINAL DISTRIBUTION TO BENEFICIARIES Refund anticipated from PA Department of Revenue for overpayment of Inheritance $10,131.56 Tax, and for having paid Inheritance Tax in discount period. -Amount is uncertain because appraisement has not been received yet -but amount is believed to be $10,131.56. Reserve requested from Principal Balance on Hand to pay for any final expenses $2000.00 including the PA and Federal Fiduciary Income Tax Liability (if any) for the Estate's Income Tax Returns for the year ending Dec. 31, 2012 (due by April 15, 2013). This additional reserve is being requested because it is not believed that the refund from the PA Department of Revenue for overpayment of lnheritance Tax will have been received yet at the time the Income Tax is due. *Note that actual final expenses are anticipated to be less than $2000 but because the amount the Estate will receive from Revenue as a refund is unknown, it is easier to disburse that at the end of the estate administration in the same manner as a regular reserve. That way we can move forward with the adjudication before that final piece of information is known. TOTAL ANTICIPATED RESERVE $12,131.56 * Balance of Reserve (once figure is certain, and once all Estate expenses are paid) shall be distributed in the shares set forth in Paragraph Seventh of Decedent's Will To: Hospice of Central PA, 1320 Linglestown Rd, Harrisburg, PA 15% To: St. Elizabeth Ann Seton Parish, 310 Hertzler Rd, Harrisburg, PA 15% 8 To: Patricia R. Stewart To: Diane L. Acri-Sheffer TOTAL DISBURSEMENTS OF RESERVE ONCE ESTATE IS COMPLETELY FINALIZED Date: ~~ ~y ~~~ R spec ully sub , Diane L. Acri- heffer, Executrix Estate of John W. Halbert 35% 35% 1Q0% 9 VERIFICATION I, DIANE L. ACRI-SHEFFER, EXECUTRIX OF THE ESTATE OF JOHN W. HALBERT, deceased, hereby declare under oath that 1 have fully and faithfully discharged the duties of my office; that the foregoing First and Final Account of the ESTATE OF JOHN W. HALBERT contains, according to the best of my knowledge and belief, a true state of all of my receipts and disbursements on account of the Estate to November 7, 2012, and of all moneys or other property belonging to the Estate which have come into my hands or been received by any other person by my order or authority for my use, and that I do not know of any error or omission in the account to the prejudice of any creditor or other person interested in the Estate. This statement is made subject to penalties of 18 Pa.C.S.A. §4904 relating to falsification to authorities. Date: ~~'~~P COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF DAUPHIN On this the ~ day of !V~ 1Tl ~ (' , 2012, before me, a Notary Public, the undersigned officer, personally appeared DIANE L. ACRI-SHEFFER, EXECUTRIX OF THE ESTATE OF JOHN W. HALBERT, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purpose set forth within. IN WITNESS WHEREOF, I hereunto set my hand and official seal. m. N ary Public My commission expires: NOTARfAL SEAL JULIE M G000 Notary Public i111011EPMN1IA TWP., DAUPHIN COUNTY N/ CMIIIMpiOn ExpMra Jan 11, 2016 10 ~y'~Ill~: '!`iY ANi~~~H`:id2u2 -:, 2!1(!x: tl4~:diNl'ltitQ~