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HomeMy WebLinkAbout03-14-13O.C. Form 1 Petition for Settlement of Small Estate (Rev. 10/04) Cumberland In the Court of Common Pleas of xCounty, Pennsylvania Orphans' Court Division Estate of Laverne A. Yohe , also known as Laverne Yohe rlo, (~~ ' ~ ~ ~ ~' ~ 1 ,deceased Petition for Settlement of Small Estate Pursuant to section 3102 of the Probate, Estates and Fiduciaries Code, the undersigned petitioner respectfully represents that: 1. The name and address of the petitioner are: Michael L. Yohe 12 Pine Street Fredericksburg, PA 17026 2. The relationship of the petitioner to the decedent is: Son/Executor 3. The decedent died on: January 16, 2013 Cumberland 4. The decedent was domiciled at time of death in County, Pennsylvania, with a last famFly or principal residence at: 4529 Rolo Court Mechanicsburg, PA 17055 5. The decedent's social security number is: 193-12-967 ~? ``' 7ra 0 ~ ~ ~ ~ ~ 6. The death certificate is attached hereto. ~ ~ ~ ~ ~ s ~ 7. The decedent died: ~ ~ o ~ - ~ y -n `n ^ (a) intestate r, ~ ~~~ n o ~ ~ r- m ^x (b) testate :~ `~ crti ~ ~ a --~ If the decedent died testate: 1 ^ (i) the will has been probated, and a copy is attached hereto. Letters have been issued to: © (ii) the will has not been probated and the original will is attached hereto. [If not attached, explain.] The personal representative(s) named therein is (are): 8. The name(s), relationship(s), and interest(s) of all parties beneficially interested in the estate are: Sui Juris Name Relationship Interest es or no Karen Harbold Friend 100% y 9. A spouse's elective share: ^x (a) has not been claimed ^ (b) has been claimed. [Give details.] 10. If the decedent died testate, the decedent: ^x (a) was not married or divorced after the date of execution of the will ^ (b) was married or divorced after the date of execution of the will. [Give details.] 11. If the decedent died testate, the decedent: ^Q (a) did not have a child or children born or adopted after the date of execution of the will 2 ^ (b) had a child or children bom or adopted after the date of the execution of the will. [Give the name and date of birth or adoption of each such child.] Name Date of Birth or Adoption 12. The decedent died owning property (exclusive of real property and property payable under section 3101 of the Probate, Estates and Fiduciaries Code) of a gross value not exceeding $25,000, which is itemized below. [Include account numbers and registration numbers, etc. If a bequest is adeemed, explain.] xt ~ PNC Checking ac ount 2,77 SU. PNC Savings account 7,239.09 PNC Savings account 1,220.03 MetLife -insurance proceeds 9,537.27 VNA refund 14.19 Cumberland County -death benefit 100.00 Total 20,888.67 13. An itemized statement of all claims against the estate is set forth below: (a) The following person(s) claim(s) the family exemption under section 3121 of the Probate, Estates and Fiduciaries Code by virtue of being a member of the same household as the decedent: Amount or Name Relationship Items Claimed N/A 3 Total (b) The following persons claim reimbursement for debts, expenses, and other claims (including inheritance tax, if applicable) they have paid with their own funds: Nature of Person Claiming Date of Debt or Reimbursement Payment Payee Expense Amount N/A (c) The following claims remain unpaid: Claimant Nature of Claim See attached list of claims Total Amount Total 17,928.59 14. ^Q (a) All claims aze undisputed. ^ (b) The following claims are disputed: [Give details) 15. The petitioner has paid or will cause to be paid all Pennsylvania inheritance tax due on all property to be awazded under this petition. 16. All parties beneficially interested in the estate, other than the petitioner, including all holders of claims that aze denied, or, in the case of an insolvent estate, all holders of claims who will not be paid in full, have: ^ (a) signed the joinder in this petition which is hereto attached; or ^Q (b) been mailed at least ten (10) days written notice of the date, time, and place of the Orphans' Court audit session at which the petition will be ruled upon by the Court, a copy of which notice is attached hereto. 4 (b) The following persons claim reimbursement for debts, expenses, and other claims (including inheritance tax, if applicable) they have paid with their own funds: Person Claiming Date of Reimbursement Payment Payee Nature of Debt or Expense Amount N/A Total (c) The following claims remain unpaid: Claimant Nature of Claim See attached list of claims Amount Total 17,928.59 14. Q (a) All claims are undisputed. ^ (b) The following claims are disputed: [Give details) 15. The petitioner has paid or will cause to be paid all Pennsylvania inheritance tax due on all property to be awarded under this petition. 16. All parties beneficially interested in the estate, other than the petitioner, including all holders of claims that are denied, or, in the case of an insolvent estate, all holders of claims who will not be paid in full, have: ^ (a) signed the joinder in this petition which is hereto attached; or ^Q (b) been mailed at least ten (10) days written notice of the date, time, and place of the Orphans' Court audit session at which the petition will be ruled upon by the Court, a copy of which notice is attached hereto. 4 Estate of Laverne A. Yohe 13(c) The following claims remain unpaid: Concklin Funeral Home Funeral (class 3) 12,720.38 Swope and Sipe Atty's fees/costs (class 1) 875.77 Pinnacle Health Medical (class 3) 10.00 Discover Card Credit card (class 6) 1,948.99 Pinnacle Health Cardio Medical (class 3) 25.00 PNC Bank Credit card (class 6) 1,669.87 WalMart/GE Capital Credit card (class 6) 14.99 Holy Spirit Hospital Medical (class 3) 65.00 GE Pension pension overpayment (class 6) 166.45 PP&L Utility (class 6) 350.85 AT&T Utility (class 6) 81.29 Total $17,928.59 17. Your petitioner proposes: (a) that the family exemption, if any, be paid or satisfied as follows: N/A (b) that the following claims be paid: [Refer to section 3392 of the Probate, Estates and Fiduciaries Code to establish priority among claims, if necessary.] Claimant Nature of Claim Amount See attached Total 17,928.59 (c) the balance, if any, be distributed as follows: tem Amount Karen Harbold 2,960.08 Total $20,888.67 ~-~ Signature of Petitioner Typed N~~ r //~ Signature of Attorney for Petitioner Typed Name: Alexis K. Sipe, Esquire Supreme Court I.D. No.: 312553 Office Address: 50 East Market Street Hellam, PA 17406 Telephone Number: 717-840-0110 5 Estate of Laverne A. Yohe Your Petitioner proposes: 17 (b) that the following claims be paid: Concklin Funeral Home Funeral (class 3) 12,720.38 Swope and Sipe Atty's fees/costs (class 1) 875.77 Pinnacle Health Medical (class 3) 10.00 Discover Card Credit card (class 6) 1,948.99 Pinnacle Health Cardio Medical (class 3) 25.00 PNC Bank Credit card (class 6) 1,669.87 WalMart/GE Capital Credit card (class 6) 14.99 Holy Spirit Hospital Medical (class 3) 65.00 GE Pension pension overpayment (class 6) 166.45 PP&L Utility (class 6) 350.85 AT&T Utility (class 6) 81.29 Total $17,928.59 Verification The undersigned petitioner hereby verifies, subject to the penalties of 18 Pa. C.S.A. §4904 (relating to unsworn falsification to authorities), that the facts set forth in the foregoing petition which are within his (her) knowledge are true, and, as to the facts based on information received, after diligent inquiry, he (she) believes them to be true. Date: ~/~ 3/~ ?~ Signature of Petitioner oinder I (we), the undersigned, being parties other than the petitioner beneficially interested in the estate of the foregoing decedent, do hereby certify that I (we) have read the foregoing petition and join in the prayer thereof. 6 IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OF OTHERWISE BEFORE THE REGISTER OF WILLS, COUNTY OF CUMBERLAND, PENNSYLVANIA In Re: Laverne A. Yohe, deceased No. To: Karen Harbold 4529 Rolo Court Mechanicsburg, PA 17055 Please take notice of the death of decedent and to the proposed actions described below: The decedent, Laverne A. Yohe, died on the 16th day of January, 2013, at Mechanicsburg, Pennsylvania. The decedent died testate (with Will). The persons seeking an order from the court are: Michael L. Yohe; 12 Pine Street, Fredericksburg, PA 17026 A petition for the settlement of small estate was filed on or about March 13, 2013, in the Court of Common Pleas, Orphans' Court Division, Cumberland County Court House, One Courthouse Square, Courtroom 1, Carlisle, Pennsylvania. If you have any objections to the relief requested you should file them in writing with the Register of Wills within ten (10) days of date of this notice. Date: 3' 13 "j Alexis K. Sipe, Esquire 50 E. Market St., Hellam, PA 17406 717-840-0110 Counsel Representative IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: No. ESTATE OF LAVERNE A. YOHE CERTIFICATE OF SERVICE I, Alexis K. Sipe, Esquire, attorney for the Estate of Laverne A. Yohe do hereby certify that on this date I served the Notice of Estate Administration to the following by depositing same in the United States mail, postage prepaid, addressed to: Karen Harbold 4529 Rolo Court Mechanicsburg, PA 17055 r DATED: Alexis K. Sipe, Esquire " Attorney for the Estate of Laverne A. Yohe Supreme Court I. D. 312553 50 East Market Street Hellam, PA 17406 (717)840-0110 "O~.PpS RFV r4/; I? LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It Is Illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 19204956 Certification Number This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar. 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WMDYpN TrilO er artlw•n A'l JJ l1a•M•NU,wM /A.D~I.B /`Y!F wti n uN te.. - T.., a M 41p ~ G ~ P A a... ... - ..i.tl... fJ ilea :~~- a~ i~ t~is 1n..,N 1'7 Dbee.RNn P.rmb NO_. n~ e!~_~,"J ~ N[i•1eP wtlY o[Jaou ,~ LAST' WiLLANll TE~~iAMENT VF LAVERNE YUHE I, LAVERNE YOHE, of 4529 Rolo Court, Mechanicsburg, Cumberland County, Pemisylvania 17055, being of sound and dispn;,iig mind, memory and understanding, do hereby make, publish and declare the following as and for my Last Will and Testament, hereby revoking and making void any and all Wills and Codicils by me at any time heretofore made. FIRST: I direct that all my just debts and funeral expenses be fully paid as soon after my demise as may be found convenient. SF,COND: I hereby give, devise and bequeath all of the rest, residue and remainder of my estate, whether real, persona] or mixed, of whatsoever nature or kind and wheresoever situate, to my companion, KAREN K. HARBOLD, to be hers absolutely. THIRD: It is my specific intention to exclude my children from-any bequest or share to which they may otherwise be entitled from my estate because I feel that I have adequately provided for them during my lifetime. FOURTH: I hereby nominate, con..=,titute and appoint my son, MICHAEL L. YORE, as Executor of this, my Last Will and Testament. My Executor named herein shall have full power to do any and all things necessary liar the C(}11~I)irs+= ad!ninistration of my Estate, including the Nag... of 3 Pages power to sell, at public or private sale and without order of Court, and without the necessity of filing a bond, any real or personal property (except as otherwise provided herein) belonging to me, and to compound, compromise or otherwise to settle and adjust any and all claims against or in favor of my estate, as fully as I could do if living. My Executor shall have the right, but not the obligation, to distribute property in kind at then current values and on a non-pro rata basis. FIFTH: I hereby direct my Executor to appoint the Law Offices of Swope and Sipe as attorney for my estate in the event his services aze available. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this my Last Will and Testament this ~~~ day of January, 2012. o~ ~~ ~ ~ ~14 °~V~ (SEAL) LAVERNE YOHE This instrument, with each page bearing the signature of the above-named Testator, was by him on the date hereof signed, sealed, published and declazed by him to be his Last Will and Testament, at his request and in his presence and in the presence of each other, have hereunto residing at 620 S. Front St., Wrightsville, PA 17370 ~~~ i l) ~~ : ;_ residing at 330 Popps Ford Road, York Haven, PA 17370 Page 2 of 3 Pages a COMMONWEALTH OF PENNSYLVANIA COUNTY OF YORK SS: We, LAVERNE YORE, Alexis K. Sipe and Michele M. Duncan, the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly affumed, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament and that he had signed the instrument willingly, and that he executed it as his free and voluntary act for-the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator, signed the Will as witnesses and that to the best of our knowledge, the Testator was at the time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. .~ Subscribed, affirmed to and acknowledged before me by the aforesaid Testator and witnesses respectively, the ~~aay of January, 2012. Notary Public QOI~ASONWEALTHOF PENNSYLVANIA AL SF.AI. Sbamu L. Swope, Notary Public Hallam 13orou~, Yark Qouoty oom^iuioa fled~berh,lN4 Page 3 of 3 Paces ~, Witne s ; ~l pennsylvania 6EPAR7MENT 0'F PUBLIC IW~LFARB January 30, 2013 ALEXIS K SIDE ESQUIRE 50 E MARKET ST HELLAM PA 17406 Re: Laverne Yohe SSN: ###-##-9767 Dear Attorney Sipe: Pursuant to your letter dated January 29, 2013, the Department's, Estate Recovery Program, has reviewed the information you provided regarding the above-referenced individual. It has been determined that this individual did not receive any type of assistance during the questioned period. Therefore, according to the information you provided, the Department's Estate Recovery Program will not seek any recovery from this estate. If your client applied for Medical Assistance and had an application and/or hearing pending at the time of death, please advise us and provide any additional information that may affect a recovery by our Department. Thank you for your cooperation in this matter. If you have any questions, please contact me. Sincerely Vince A. Porter Recovery Section Manager (717)772-6604 Bureau of Program Integrity i Division of Third Party Liability i Recovery Section PO Box 8486 i Harrisburg, Pennsylvania 17105-8486