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HomeMy WebLinkAbout02-14-13 IN THE COURT OF COMMON PLEAS IN c o OF CUMBERLAND COUNTY, ~ ~ ES1~T~ o ,d OC~JIAIMI ,~ VCVENNEY PENNSYLVANIA ~ c~ ~o ~ ° ~ ORPHANS' COURT DIVISION a~ • ~ ~ . w~ ,~ z w ~ . NO. ~-~3-v/~J~~ ~ ww ~ , c' ION FOR DISTRIBUTION OF SMALL ESTATE PETIT (Pursuant to 20 Pa C.S.A. §3102 ,~ TO THE HONORABLE, THE JUDGES OF THE SAID COURT: The Petition of Ruth M. Osborne, respectfully states as follows: 1. Mimi A. DeVenney, (Decedent) died on January 10, 2013, domiciled in Middlesex Township (1000 Claremont Drive, Carlisle, PA 17013), Cumberland County, Penns Ivania. A true and correct copy of her Death .Certificate is attached hereto as Y Exhibit "A." 2. Petitioner is Ruth M. Osborne, an adult individual of 9 E. Linden Drive, Carlisle, Pennsylvania 17015. 3. Petitioner, Ruth M. Osborne, is a cousin of the Decedent and held a Power of Attorney from the Decedent, during the Decedent's lifetime. 4. The undersigned counsel drafted a Last Will and Testament for Mimi A. Venne which was signed by her on January 24, 2008. A co of that Will, from De y, I's file is attached hereto as Exhibit "B." In that Will, your petitioner, Ruth M. counse , is named as Executrix. Your petitioner has been unable to locate the original Osborne, Will. The said Mimi A. DeVenney had become very disorganized in the of the management of her affairs. ecedent Page 1 of 4 h ~, f Petition for Distribution of Small Estate: Mimi A. DeVenney, D /' W ara ra h IV of said Will waives the posting of security for the Executrix. 5. P g p titioner does not intend to file for Letters of Administration as this is a 6. Pe small estate. onl known assets of the Decedent are an M & T Bank checking 7. The y 483 havin a balance of approximately $1,671.56 and an estimated account (No. 28300 ) 9 ecedent's ersonal needs account at Claremont Nursing Center in the balance in the D P amount of $427.30. the best of the knowledge, information and belief of your Petitioner, 8. To all re- aid as a result of family contributions to apre-payment funeral bills were p p the Decedent's passing. Decedent's medical bills should be paid by account, prior to dicaid. Decedent's known obligations are approximately $281.00 Medicare and Me Ruth M. Osborne for Post Office box rental, an administrator's fee to reimbursement to M. Osborne, attorney's fees to Stephen D. Tiley, Esquire, for be paid to Ruth in the small estate, and any balance payable to the Estate Recovery administrat g Program. edent was never married and never had any children. Decedent's g, A. Dec Decedent had two siblings, a brother Robert DeVenney of 100 parents predeceased 015 and a brother Samuel A. DeVenney of 3015 19tH Burnt House Road, Carlisle, PA 17 , Ave., N.E., Hickory, North Carolina 28601. O. Ct. R. 5.6 requires that a Notice of Beneficial Interest in Estate be B. Pa. state heirs of a Decedent within three months of the grant of letters, sent to the rote ' Petition is for distribution of a small estate without the grant of letters. however, this Pa. C.S.A. §3102, providing for settlement of small estates on C. 20 he Court may direct distribution "with such notice as the Court Petition, provides that t shall direct." Page 2 of 4 Petition for Distribution of Small Estate: Mimi A. DeVenney, Decedent D. Your Petitioner requests an Order for Distribution waiving notice to any Is or entities, (including waiving advertising), except for the mailing of a Rule individua the individuals listed at Paragraph Third of the Will attached as Exhibit "B" 5.6 Notice to and to Robert DeVenney identified in paragraph 9A of this Petition. 10. Petitioner files this Petition pursuant to 20 Pa. C.S.A. §3102. WHEREFORE, Petitioner requests your Honorable Court to enter a Decree hat the Estate of Mimi A. DeVenney, Deceased, be awarded to Robert ordering t and Samuel A. Devenney (to the extent any net estate may exist) without DeVenney , ; . and without notice to~ any additional party,- except for a Rule 5.6 Notice to advertising nne and the beneficiaries named in the Will, a copy of which is attached Robert DeVe y as Exhibit "B," and without appraisement, and with authority of the Petitioner, hereto borne to, without bond, receive, collect and distribute the Estate of Mimi A. Ruth M. Os , enne to creditors of the estate, or administrator's expenses, including her own DeV y or's fee with any net estate distributed to the intestate beneficiaries, and to administrat , make an and all necessary assignments and transfers. Y I~ ~~~ Dated: ~~"~ i Respectfully submitted, B, ~,~ St phen D. Tiley, Esquire 5 South Hanover Street Carlisle, PA 17013 (717) 243-5838 Supreme Court I.D. No.: 32318 Page 3 of 4 Petition for Distribution of Small Estate: Mimi A. DeVenney, Decedent VERIFICATION M. Osborne, depose and say that I am the Petitioner in the above matter; I, Ruth he facts set forth in the foregoing Petition for Distribution of Small Estate are and that t correct based partly upon personal knowledge and the remainder upon true and lief I understand that this Verification is made subject to penalties of information and be , 18 Pa. C.S.A. § 4904, relating to unsworn falsification to authorities. oaiea: //i ~{/~ ( 3 ~~' ~ Ruth .Osborne Page 4 of 4 Petition for Distribution of Small Estate: Mimi A. DeVenney, Decedent 105.805 REV (9/11) STRAR'S CERTIFICATION OF DEATH LOCAL REGI hotostat or photograph. WARNING: It is illegal to duplicate this copy by p ~~~,,,,,,,,,,,,,,,,, This is to certify that the information here given is gee for this certificate, $6.00 il,,l~l' p~tH OF pfd;-.__ correctly copied from an original Certificate of Death ~,,~~'~~~ _- hf~ _ duly filed with me as Local Registrar. The original Z° _ - y certificate will be forwarded to the State Vital o -- ~~ a Records Office for permanent filing. v ~-~ ~ *~ 0.J ~ ~ ~ ~ ~ -. ~ 'tlllllll .. __.. -99TMENT,~F''~~ al Re istrar Date Issued ,... Loc g Certification Number )i`~ COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS Type/Print In CERTIFICATE OF DEATH state Fite Number: Permanent 4. Date of Death (Mo`/Day/Yr) (Spelt Mo) Black Ink 2. Sex 3. Soclat Security Number ~ "\~ 2G{3 1. Decedent's Legal Name (First, Middle, Las[, Suffix) ~,-.ert~1 ~, N~> A - De\Ienne 6. Oahe of Birth (Mo/Day/Year) (Spell Month) 7a. Birthplace (City and State or Foreign Country) Sa. Age-Last Birthday (Yrs) 5 MoU thsr 1 Y Days ScHOUdrs r 1 Minutes Mar 28 , 1946 ~1 66 7b. Birthplace (COUn[y) Sc. Did Decedent Live in a TownMi~leseX ~p• 8a. Residence (State or Foreign Country) Sb. Residence (Street and Number -Include Apt No.) yes, decedent lived In PA 1000 Claremont Dr- dty/boro. Sd. Residence (County) Q No, decedent INed within limits of Cumberland Be. Residence (zip Code) 17 1 10. Marital Status at Time of Death Q Married Q Widowed il. Surviving Spouse's Name (If wife, give name prior to first marriage) 9. Ever in I.~Armed Forces? Never Married Q Unknown 13. Mother's Name Prior to First Marriage (First, Middle, Last) Q yes •~] No Q Unknown Q Divorced 12. Father's Name (First, Middle, Last, Suffix) Harlan ML1L'tOf f 14b. Relationship to Decedent 14ci Inf~ormB~t-1srnt~ngH~u~e trRa = d Number, City, State, Zip Code) Samuel DeVenney Carlisler PA 17013 '' ~4ao t~r~~nt's Name brother J- ....... ...... RR rJ@Vet'lrley 5 P ec on y one .... ..... .. ........ F fl ..•.••.... cedent s Home.• eat ._... _ .... -. ~ De -_.. ..._.. Hos ice -- -_.~ •• °Co 1 a. ace o ,_„•,,,, .._.. ac ____~ .............................. r.................... _.. .. .................................................... In atient ~ ;If Death Occurred Somewhere Other Than a Hospital: t~•-.•- p if Death Occurred in a Hospital: t~ -•P Other (Specify) . u Dead on Arrival _ Nursing Home/long-Term Care Facility 1Sd. County Death c Q Emergency Room/Outpatient Q 15cwClty~ n State, and Zip Code ~ ~ M . Y ~ SSb. Facility Nam~e (If~ n.yo~t in~ ~ ut. i?n, give s_ t~eet a^d ^ bei~ la FF!'I ""~~ (~V l {vj ` ~~ ^~~- ~ crematory, or other place) z VL gp(me & CretnzttOry LL Q Burial Cremation 16b. Date of Disposition 16c. Place of DispoHsitOio~~ arnEeuneral ' ' a 16a. Method of Disposition Donation Jan 14, 20]-3 HOffman- ~; m Q Removal from State Q -- y ~ Other (Specify) 17a. Sig ture of Funer erv" see or Person in Charge of Interment 17b. 138e5O4ber ~ 16d. Location of Disposition (City or Town, State, and Zip) Carlisle, PA 17013 PA 1 013 17c. Name and Complete Address of Funeral Facility 219 North Hanover Stree Ca ].Isle Hof fman--Roth Funeral Home & CrE'IL72Lt0 20. Decedent's Race -Check ONE OR MORE races to indicate what i ~ 1S. Decedent's Education -Check the box that best describes the 19. Decedent of Hispanic Origin -Check the Q Korean White Vietnamese ~°- highest degree or level of school completed at the time of death. Is Spanish/Hispanic/Latino.e Check hee'No'ent ~ Black or Afr can Ame icanself or hersQelf to be. '3 Q 8th grade or less box if decedent is not Spanish/Hispanic/Latino. Other Asian Q No diploma, 9th - 12th grade American Indian or Alaska Native a Native Hawaiian High school graduate or GED completed No, not Spanish/Hispanic/Latino Q Asian Indian ® Q Yes, Mexican, Mexican American, Chicano O Chinese Q Guamanian or Chamorro Q Some college credit, but no degree Q yes, Puerto Rican Q Filipino Q Samoan Q Associate degree (e.g• AA• ~) Q Yes, Cuban Q Other Pacific Islander Q Bachelor's degree (e.g. BA, AB, BS) Yes, other Spanish/Hispanic/Latino Q Japanese ~~ Q Master's degree (e.g. MA, M5, MEng, MEd, MSW, MBA) Q Q Other (Specify) Q Doctorate (e.g. PhD, Ed D) or Professional degree (Specify) done durin6 most of working Ilfe. 00 NOT USE RETIRED. 21. Decedent's Single Race Self-Designation -Check ONLY ONE to indicate wQhSamoa ecedent considered himself or herself to be. 22a• Oes'c~Cn~t.~~a~ycupation -Indicate type o wo e. . MD DDS OVM LLB JD White Q Japanese Q Korean Q Other Pacific Islander 22b. Kind of Business/In ustry Q Black or African American Vietnamese Q Don'i Know/Not Sure Q American Indian or Alaska Native ~ Other Asian Q Refused { ,~ Q Asian Indian Other (Specify) Manufacturing ~ Q Chinese Q Native Hawaiian 0 Q Filipino Q Guamanian or Chamorro ITEMS 23a - 2 MUST BE COMPLETED 23a. Date Pronounr~ dODead (MO DaY r) 23b. Signature of Perso~ onouncing Death Only w en applica le) 2~ice~unt of ,. BY PERSON WMO PRONOUNCES OR -.^GL~•J, 3 QJ-yt [~L?-/~-- CERTIFIES DEATH ~ ^1 ~ 24 Time~f eath Yes No ~ 23d. Date Signed (Mo/D.atyOr) LJV 25. Was Medical Examiner or Coroner Contacted? Q Approximate CAUSE OF DEATH a Interval: ` 26. Part 1. Enter the ~'~°'^ ^f events--diseases, Injuries, or complications--that directly caused the death. DO NOT enter terminal events such as cardiac arces . DO NOT ABBREVIATE. Enter only one cause on a line. Add additional tines if necessary ~ Onset to Death , respiratory arrest, or ventricular fibrillation without showing the etiol~~O ~~ -_ s Due to (or as a consequence of): IMMEDIATE CAUSE ---------~ a' _ (Final disease or condition ' ~- resulting in death) b s Due to (or as a consequence ot7: Sequentially list conditions, _ if any, leading to the cause e Due to (or as a consequence of): listed on line a. Enter the c. i UNDERLYING CAUSE _ (disease or injury that ~ Due to (or as a consequence of): Initiated the events resulting d• to death) LPST. 27. Was an autopsy perfo edT Q Yes 1a ''~O 26. Part 11. Enter other i niflcant conditions contributing to death but not resulting in the underlying cause given in Part I 2B Were autopsy findings available to complete the cause of death? c Q Yes No g m 31. Ma ner of Oeath -4 30. Did Tobacco Use Contribute to Death? [Natural Q Homicide ~ 29. If Fe le: Q Yes Q P bably Q Accident Q Pending Investigation E ~ot pregnant within past year Q No Unknown Q Suicide Q Could not be determined ~ Q Pregnant at time of death r 5 ell Month) ~ Q Not pregnant, but pregnant within 42 days of death 32. Date of Injury (Mo/Day/Y) ( P 33. Time of Injury F F 0 Not pregnant, but pregnant 43 days to 1 year before deatF Q Unknown if pregnant within the past year Street and Number, City, State, Zip Code) . 35. Location of Injury a e. home; construction site; farm; school) 34. Place of Injury ( B• - 38. Describe How In1urY Occurred: 36. Injury at Work 37. If Transportation Injury, Specify: Q Yes Q Driver/Operator Q Pedestrian Q No Q Passenger Q Other (Specify) 39a. C ifler (check only one): death occurred due to the cause(s) and manner stated lace, and due to the cause(s) and manner stated Certifying physician - To the best of my knowledge, or investigation, In my opinion, death occ rred at the time, date, and place, and due to the cause(s) and manner sta e { [] Pronouncing A Certifying physician - To the best of my knowledge, death occurred at the time, date, and p r7O . ~ ~ZG '~'y' L'- _ Q Medical Examiner/Coroner - On the basis ~jj'Yjr/~i //f~/ Lleense Number: Title of certifier. 39c. Oahe Signed (Mo/Day/Yr) Signature of certifier: ~/~_! ~, ~~ Address and Zi Code of P on Com leting use of Death (Ite~ 2~6 •+ ~~'Q ~ D~ ~~ ~~_~'~ ~t . 42. Regi{stray Fi a Date Mo aY r .1 39b. Name, p lye ~ f j ~ 41. Registrar's Si'~~uyr.C~~~ /'~ . 1 ~~ ` r~ a ~ ~~ 40. Registrar's District Num ¢r ~...-~i"~~C V e ~,t-atio c 43. Amendments _ ~_ '~ f j ~' ~`? HSOS-143 O SS' ~ 3 O ~~ - ~ " ° `=' ~ ~ `~~~ REV 07/21711 Disposition Permit No. - - LAST WILL AND TESTAMENT OF MIMI A. DeVENNEY I, Mimi A. DeV~nney, of 226 North Bedford Street, Carlisle, a d u derstand'ng, Pennsylvania 17013, being of sound and disposing mind, memory do hereby make, publish and declare this as and foa Cod cils'Iheretofore made. hereby revoking and making void any and all Wills FIRST I direct the payment of my just debts and fun belcremateds and that myeashes be death as may be convenient. I desire that my body distributed at the discretion of my hereinafter named Executrix. I direct that all federal and Pennsylvania estat sta res~ut of myl death, not lim'ted taxes, and generation-skipping transfer tax payable a to taxes attributable to property passing under this Will, shall be allocated to and paid by the beneficiary of the property whose transfer is subject to the tax. Each beneficiary shall a their share of the inheritance tax (or have it deducted from their share) based p y licable to them. upon the inheritance tax rate app I declare that I am unmarried and that I have no children. ,. SECOND I make the following specific bequest: If at the time of my me friend, Doris Do possession of my cat "Lucy", I give and bequeath my said cat to y Strock, of 714 Williams Grove Road, Mechanicsburg, Pennsylvania 17055. THIRD residue and remainder of my estate, real, personal an ee a eualand All the rest, wheresoever the same may be situate, I give, devise and bequeath in t r q shares, one each to: a~ a M brother, Samuel A. DeVenney, of 3015 19~' Avenue, NE, Hickory, North Carolina 28601, his heirs and assigns; b My friend, Doris Do Strock, of 714 Williams Grove Road, Mechanics urg, ~~ () ~` Pennsylvania 17055, her heirs and assigns; and .Osborne, of 9 East Linden Drive, Carlisle, (C) My cousin, Ruth M Pennsylvania 17015, her heirs and assigns; °-= 90 da s In the event that a eriod of ninety ( ) y provided that each shall survive me by p the aforesaid period any said individual should predecease mn °ned find v dual would have received shall c '~' da s, then the share such of ninety (90) Y share or shares. lapse and be added to the remaining FOURTH 'Hate constitute and appoint my cousin Ruth MLOsb~ill a, ~ 9 East I hereby norm Ivania 17015 as Executrix of this my Linden Drive, Carlisle, Pennsy e event of the renunciation, death, resignationinate aconst tute and any Testament. In th grin s, said cousin, Ruth M. Osborne, I nom reason whatsoever of my m cousin, Anne L. Hawbaker, of 403 Pine Ri andlTest ment I further direct appoint y Last W ointed Pennsylvania 17065 f secur ty shall behrequ red of any Executor or Executrix app that no bond or othe page 1 of 3 Last Will and Testament of Mimi A. DeVenney {~~~ ~~ urisdiction in which he, she in this Wili for the performance of his, her or its duties in any j be used or it may be called upon to act. The terms Executor or Executrix may ointed in this interchangeably in this Will and shall refer to an ourt ofucompeEent jur sd cp on. will, or any other Administrator appointed by a c FIFTH to and not in limitation of, the powers conferred by law or by -other In addition owers, each of which may provisions of this Will, my Executrix shall have the following P exercised from time to time by my Executrix in [hislher] sole discretion: be _ a To retain in the form received, and to sell eitonal t roperty r private () sale, or to distribute in kind, any real or pers p (b) To manage both real and personal property. e ,notwithstanding the (c) To invest and reinves he investme t pmade acre of a character or size fact that any or all oft would not be considered which but for this expressed authority proper for an Executrix. cise an option or rights arising from the ownership of (d) To exec Y investments. e To compromise claims without court approval and without the () consent of any beneficiary. hand and seal to this my Las ~, IN WITNESS WHEREOF, r ea 3 hages (nclud ng notary page), this Will and Testament, written on th () P day of January, 2008. ~ ~ % ,, r ~ i ) (SEAL Mi i A. DeVenney Mimi A. DeVenney the Testatrix Signed, sealed, published, and declared by nd for her Last Will and Testament, in ourhave hereunt osubscribed above named, as a resence, at her request, and in the presence of each of er, p witnesses. our names as attesting ~ ,- ~~ Page 2 of 3 ~~~°t' t;~ Last Will and Testament of Mimi A. DeVenney COUNTY OF. GUNEB~RLAND ~ . We, Mimi A. DeVenney,. the Testatrix in, and. seshto the ast Will -and the witnes , and Robert. G. Frey Testament, the attached or foregoing instrument, who h nd sa ned the instrument, having been duly qualified according to law do depose a Y . that t, the Testatrix, do hereby acknowledge that I signed and executed a' Last Will and Testament, that I signed it willingly and the instrument as my as my free and voluntary act for the purposes therein expressed; an p. that we, the witnesses, were present and saTestament, that she s gned it execute the instrument as her Last Will and act for the purposes willingly and executed it as her free and volunta and si ht of the Testatrix therein expressed; that Testament asha wi Hess and that to the best of signed the Last Will and 18 or more years our knowledge the Testatrix was aotconstrai t ortundue .influence. of age, of sound mind and under n ~. ., ~- J~~-a cribed, sworn to and acknow edged before me by the Testatrix and the SuMs ay of January, 2008. witnesses above-named, this llpTpRIALSEAI ~' Notary Pu lic TRISHA A. UESS, Not~Y Pt~lic Borough of Carlisle, Comb. County, PA ~,ly ~,m;~ion EscRires. AA~y 20, 2010 page 3 of 3 Last Will and Testament of NLimi A. DeVenney ~~;-j~~ri~ i~ ~6d~~