HomeMy WebLinkAbout07-17-08
DECEDENT'S ESTATE
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COURT OF COMMON PLEAS OF r..
CUMBERLAND COUNTY, PENNSYLVANIN, --.J `
ORPHANS' COURT DIVISION
ESTATE OF MARY C. ZEIGLER -,DECEASED
No. 21-07-0299
PETITION FOR ADJUDICATION /
STATEMENT OF PROPOSED DISTRIBUTION
PURSUANT TO Pa. O.C. Rule 6.9
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: THOMAS J. AHRENS
Supreme Court I.D. No.: 80143
Name of Law Firm: AHRENS LAW FIRM, P. C.
Address: 52 Gettysburg Pike, Mechanicsburg, PA 17055
Telephone: 717-697-1800
Fax: 717-697-1866
Form OC-01 rev. 10. 13.06 Page 1 of 10
Estate of MARY C. ZEIGLER , Deceased
1. Name(s) and address(es) of Petitioner(s):
Name. Emily L. Reynolds
address. 1060 W. Limekiln Road
New Cumberland, PA 17070
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? M Yes M No
If not, identify prior accountings, the accounting periods covered, and the date of
adjudication of the prior accounting.
2. Decedent died on February 10, 2007
Letters Testamentary or [:]Letters of Administration were granted to Petitioner(s) on
March 28, 2007
Date of Will (if applicable): March 10, 2003
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: April 13, 20, 27, 2007
Form OC-01 rev. 10. 13.06 Page 2 of 10
Estate of MARY C. ZEIGLER , Deceased
3. Was decedent survived by a spouse? Yes No
If yes, name of the surviving spouse:
4. Has the surviving spouse filed to take an elective share? F-1 Yes E] No
(See Section 2201 et sue. 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 OC-01 rev. 10. 13.06 Page 3 of 10
Estate of MARY C. ZEIGLER , 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 Party in Interest I Relationship and Comments, if any I Interest
Emily L. Reynolds Daughter 100% of residue after
1060 W. Limekiln Road expenses
New Cumberland, PA 17070
Form OC-01 rev. 10. 13.06 Page 4 of 10
Estate of MARY C. ZEIGLER , Deceased
Name and Address of Each Party in Interest I Relationship and Comments, if any I Interest
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.
Form oC-01 rev. 10. 13.06 Page 5 of 10
Estate of MARY C. ZEIGLER , 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 Will Claim
Admitted? Be Paid In
Full?
Family/Internal Medicine Assoc., P.C. $133.05 Yes Yes
6 Market Plaza Way No No
Mechanicsburg, PA 17055
Pharmerica $532.06 Wes rl Yes
P.O. Box 6413 No No
Carol Stream, IL 60197-6413
Neighborcare - York $10,470.34 Wes Yes
3419 Concord Road No No
York, PA 17402
West Shore EMS - BLS $175.24 Yes El Yes
205 Grandview Avenue, Suite 211 r7No M No
Camp Hill, PA 17011
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? Yes No
Was family exemption allowed? Yes No
Family exemption claimant's name and relationship:
Name: Emily L. Reynolds Relationship: Daughter
Form oC-01 rev. 10. 13.06 Page 6 of 10
Estate of MARY C. ZEIGLER , 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
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 E] 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? F] 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-01 rev. 10. 13.06 Page 7 of 10
Estate of MARY C. ZEIGLER , 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? ri 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? MYes r7No
If so, attach a copy of the notice.
19. Is the Court being asked to direct
the filing of a Schedule of Distribution? Yes E]No
As to real estate only? DYes M No
Form oc-01 rev. 10. 13.06 Page 8 of 10
Estate of MARY C. ZEIGLER , 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) Amount/Proportion
B. Principal:
Proposed Distributee(s) Amount/Proportion
Submitted By:
(All petitioners must sign.
Add additional lines if necessary):
Name of Petiti er: Emily . keynolds
hitl L, o1J
Name of Petiti ner:
Form oc-01 rev. 10. 13.06 Page 9 of 10
Estate of MARY C. ZEIGLER , Deceased
Verification of Petitioner
(Verification must be by at least one petitioner.)
The undersigned hereby verifies * [that helshe is titre
of the above-named name of corporation 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 eo etitioner
* 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.
Signature of Counsel for Petitioner
Form OC-01 rev. 10. 13.06 Page 10 of 10
Estate of MARY C. ZEIGLER, Deceased
Item # 10 continued
Name and Address of Claimant Amount of Claim Admitted? Will Claim
Be paid in full?
James R. Harty MD $20.30 Yes No
P.O. Box 168
Hummelstown, PA 17036-0168
Golden Ventures $1,835.37 Yes No
P.O. Box 180970
Ft. Smith, AR 72918
r
PROOF OF PUBLICATI ON 01-. NO'
IN CUMBERLAND L: X J 1ZN i"
(Under Act No. 587, approved 1\4hiy 16, ~)29> P. 1784
COMMONWEALTH OF PENNSYLVANIA :
SS.
COUNTY OF CUMBERLAND
Lisa Marie Coyne, Esquire, Editor of the Cumbcrl~ nd I W "Moral, of the County and
State aforesaid, being duly sworn, according to law, dchosc: acid that the Cumberland Law
Journal, a legal periodical published in the Borough of Carl!,- C il, t ounty and State aforesaid,
was established January 2, 1952, and designated by the loci .-tirts as the official legal
periodical for the publication of all legal notices, and has, si!ce 2, 1952, been regularly
issued weekly in the said County, and that the printed motif- c of )uhiication attached hereto is
exactly the same as was printed in the regular editions and ssuc o i- the said Cumberland Law
Journal on the following dates,
viz:
April 13, 20, 27, 2007
Affiant further deposes that he is authorized ?o vcr l tl,,i ~,incnt by the Cumberland
Law Journal, a legal periodical of general circulation. anc( 1!~.it h~ , ~ )t interested in the subject
matter of the aforesaid notice or advertisement, iii:<i th.: aii :d!,,ptions in the foregoing
statements as to time, place and character of publication arc ic.
Lis \J i c C. i ditor
Zeigler, Mary c., decd. SWO 7,0 A S! :Z I BED before me this
Late of East Pennsboro Town- 27 di iv o; ri - ',O7
ship.
Executrix: Emily L. Reynolds
c/o Ahrens Law Firm, P.C., 52
Gettysburg Pike, Mechanics-
burg, PA 17055.
Attorney: Thomas J. Ahrens, mss, _=v
Counselor at Law.'
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PROOF OF PUBLICATION
State of Pennsylvania, County of Cumberland
Tammy Shoemaker, Classified Advertising Manager, 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 13th, 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)
April 13, 20, 27, 2007
COPY OF NOTICE OF PUBLICATION
Affiant further deposes that he/she is not
- - f interested in the subject matter of the
aforesaid notice or advertisement, and that
EXECUTRIX'S NOTICE all allegations in the foregoing statement
Letters Testamentary on the Estate of MARY C. as to time, place and character of
ZEIGLER, late of East Pennsboro Township, l
Cumberland County, Pennsylvania, deceased, publication are true.
have been granted to the undersigned.
All persons knowing themselves to be indebted to the
Estate will make payment immediately, and those YY
having claims will present them for settlement to:
Emily L. Reynolds \
c/o Ahrens Law Firm, P.C.
52 Gettysburg Pike
Mechanicsburg, PA 17055
Thomas J. Ahrens, Counselor at Law Sworn to and subscribed before me this
01st day of May 2007.
/
/ / 1o~
Notary l'ubliMy commission expires: ( ~ ( 10~
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Chnstim L. Wolfe, Notary Pubbc
Carlisle Boro, Cumberland County
My Commisslw Expires Sept 1.2008
Member, Pennsylvania Association of Notaries
Order of Payments - Mary Zeigler, file # 21-07-0299
Due Paid
United States Government
IRS - Income tax due $190.00
$190.00
Funeral - paid from Burial Reserve account $3,948.35
$3,948.35
Costs of Administration
Probate fees $106.00
Estate notices $204.77
Inventory filing fee $10.00
Inheritance Tax filing fee $15.00
Estate accounting $130.00
$465.77
Family exemption
$0.00
Funeral & final medical (within 6 months)
Proposed distributions at 47.04%
Family/Internal Medicine Assoc., P.C. $133.05 $62.59
Pharmarica $532.06 $250.29
Neighborcare $7,515.28 $3,535.30
West Shore EMS $175.24 $82.44
James R. Harty MD $20.30 $9.55
Golden Ventures $1,835.37 $863.39
$4,803.56
All other claims
Neighborcare - over 6 months $2,955.06 $0.00
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS COURT DIVISION
FILE NO. 07-0299
CERTIFICATION OF NOTICE
To the Clerk of Court:
I certify that Notice of Filing of Account and Call for Audit was served on or mailed to
the following beneficiaries and creditors of the above-captioned estate on July 16, 2008:
Name: Address:
Family/Internal Medicine Assoc. 6 Market Plaza Way
Mechanicsburg, PA 17055
Pharmerica 491-A Blue Eagle Ave.
Harrisburg, PA 17112
Neighborcare - York 3419 Concord Road
York, PA 17402
West Shore EMS - BLS 205 Grandview Avenue, Suite 211
Camp Hill, PA 17011
James R. Harty MD P.O. Box 168
Hummelstown, PA 17036-0168
Golden Ventures P.O. Box 180970
Ft. Smith, AR 72918
Date:
homas Y Ahrens, Counsel for the
Estate of Mary C. Zeigler
52 Gettysburg Pike
Mechanicsburg, PA 17055
717-697-1800
• COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
INHERITANCE TAX DIVISION 46
PO BOX 280601 OF DEDUCTIONS AND ASSESSMENT OF TAX
HARRISBURG PA 17128-0601 REV-1547 EX AFP (06-05)
DATE 02-26-2008
ESTATE OF ZEIGLER MARY C
cop*4 DATE OF DEATH 02-10-2007
FILE NUMBER 21 07-0299
COUNTY CUMBERLAND
THOMAS J AHRENS ACN 101
AHRENS LAW FIRM APPEAL DATE: 04-26-2008
52 GETTYSBURG PIKE (See reverse side under Objections)
MECHANICSBURG PA 17055 Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS_LINE RETAIN LOWER PORTION FOR YOUR RECORDS _
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF ZEIGLER MARY C FILE NO. 21 07-0299 ACN 101 DATE 02-26-2008
TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1) .00 NOTE: To insure proper
2. Stocks and Bonds (Schedule B) C2) 2,4 72.12 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion
of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment.
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 10,379.64
6. Jointly Owned Property (Schedule F) (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets (8) 12,851.76
APPROVED DEDUCTIONS AND EXEMPTIONS: 8,094.12
9. Funeral Expenses/Adm. Costs/Misc. Expenses CSchedule H) C9)
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 13,14 6.06
11. Total Deductions C11) 21 .240.18
12. Net Value of Tax Return C12) 8,388.42-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 8,388.42-
NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate (15) •00 X 00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) .00 X 045 = .00
17. Amount of Line 14 at Sibling rate (17) .00 X 12 = .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) •00 X 15 = .00
19. Principal Tax Due (19)= .00
AX CREDITS:
PAYMENT RECEIPT DISCOUNT C+)
DATE NUMBER INTEREST/PEN PAID C-) AMOUNT PAID
TOTAL TAX CREDIT .00
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
* IF PAID AFTER DATE INDICATED, SEE REVERSE C IF TOTAL DUE IS LESS THAN 41, NO PAYMENT IS REQUIRED.
FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS COURT DIVISION
FILE NO. 07-0299
FIRST AND FINAL ACCOUNT OF
Emily L. Reynolds, Executrix
For
ESTATE OF Mary C. Zeigler, Deceased
E-
Date of Death February 10, 2007 c .
Date of Executor's Appointment: March 28, 2007 T
^f77~~ _
3
Date of First advertisement of -T I
the grant of letters: April 13, 2007
cn
Accounting for the Period: February 10, 2007 to r..
July 14, 2008
Purpose of Account: Emily L. Reynolds, Executrix, offers this account 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 or questions or objections can be discussed with:
Ahrens Law Firm, P.C.
Thomas J. Ahrens, Esq.
52 Gettysburg Pike
Mechanicsburg, PA 17055
(717) 697-1800
Supreme Court I.D. No. 80143
Page 1
Summary of Account
Page Current Value Fiduciary
07114108 Acquisition
Value
Proposed Distribution to creditors 8 $ 4,802.35 $ 4,747.64
Principal
Receipts 3 $ 12,851.76
Net Gain on Sales or Other Dispositions 4 38.79
$ 12,890.55
Less Disbursements
Debts of Decedent 5 $ 190.00
Funeral Expenses 5 3,948.35
Administration Expenses 5 465.77
Fees and Commissions 5 3,500.00 $ 8,104.12
Principal Balance on Hand 6 $ 4,786.43
Income
Receipts 7 $ 17.13
Income Balance on Hand $ 17.13
Combined Balance on Hand $ 4,803.56
Page 2
Receipt of Principal
Assets Listed in Inventory Fiduciary
(Valued as of Date of Death) Acquisition
Value
Cash:
Wachovia Bank - Checking Account $ 2,443.11
Wachovia Bank - Burial Reserve Account 7,745.38
Wachovia Bank - Money Market Account 33.93 $ 10,222.42
Stocks:
27 shs. Prudential Financial, common $ 2,472.12 $ 2,472.12
Total Inventory $ 12,694.54
Receipts Subsequent to Inventory
(Valued When Received)
6/04/07 Refund of Continental Life
Insurance premium $ 157.22
Total Principal Receipts $ 12,851.76
Page 3
Gains and Losses on Sales or Other Dispositions
Gain Loss
1/25/08 27 shs. Prudential
Financial, common
Net Proceeds $ 2,510.91
Fiduciary Acquisition Value $ 2,472.12 $ 38.79
Total Gains and Losses $ 38.79
Net Gain $ 38.79
Page 4
Disbursements of Principal
Debts of Decedent
03/05/07 IRS - 2006 income tax due $ 190.00 $ 190.00
Funeral Expenses Paid from the Burial Reserve Account
06/07/07 Michael J. Shalonis Funeral Home $ 3,948.35 $ 3,948.35
Administration Expenses
03/28/07 Clerk of Court - probate fee $ 98.00
04/27/07 Estate publication fees 204.77
07/16/07 Clerk of Court - Short Certificate 8.00
11/09/07 Clerk of Court - Inheritance Tax filing fee 15.00
06/28/08 Register of Wills - Inventory 10.00
06/28/08 Clerk of Court - Accounting fee 130.00 $ 465.77
Fees and Commissions
02/20/07 Ahrens Law Firm, P.C., attorney's fee $ 3,500.00 $ 3,500.00
$ 8,104.12
Page 5
Principal Balance on Hand
Current Value Fiduciary
07114108 Acquisition
Value
Cash $ 4,786.43 $ 4,747.64
Page 6
Receipts of Income
Interest
Wachovia Bank
2/10/07 to 3/29/07 $ 1.94
Members 1" FCU
3/29/07 to 6/24/08 15.19
Total $ 17.13
Page 7
Proposed Distributions to Creditors
Current Value Fiduciary
07114108 Acquisition
Value
TO: Family/Internal Medicine Assoc. $ 62.59 $ 61.86
Pharmerica 250.29 247.38
Neighborcare 3,535.30 3,494.15
West Shore EMS 82.44 81.48
James R. Harty MD 9.55 9.44
Golden Ventures 863.39 853.34
Page 8
VERIFICATION
Emily L. Reynolds, Executrix under the Last Will and Testament of Mary C.
Zeigler, deceased, hereby declares under oath that she has fully and faithfully discharged
the duties of her office; that the foregoing First and Final Account is true and correct and
fully discloses all significant transactions occurring during the accounting period; and
that all taxes presently due from the estate have been paid; and that the grant of Letters
Testamentary and the first complete advertisement thereof occurred more than four
months before the filing of the foregoing First and Final Account.
Emil :4. Reynol ,
Ex rix
Subscribed and sworn to
by Emily L. Reynolds before
me this / S 6'6 day of , 2008
Notary Public
COMMONWALTH O PENNSYLVANIA
NL SEAL Public
JUDD S, Notary
MechanicsbCumberland County
M Commpires May 23,2009
Page 9
Order of Payments - Mary Zeigler, file # 21-07-0299
Due Paid
United States Government
IRS - Income tax due $190.00
$190.00
Funeral - paid from Burial Reserve account $3,948.35
$3,948.35
Costs of Administration
Probate fees $106.00
Estate notices $204.77
Inventory filing fee $10.00
Inheritance Tax filing fee $15.00
Estate accounting $130.00
$465.77
Family exemption
$0.00
Funeral & final medical (within 6 months)
Proposed distributions at 47.04%
Family/Internal Medicine Assoc., P.C. $133.05 $62.59
Pharmarica $532.06 $250.29
Neighborcare $7,515.28 $3,535.30
West Shore EMS $175.24 $82.44
James R. Harty MD $20.30 $9.55
Golden Ventures $1,835.37 $863.39
$4,803.56
All other claims
Neighborcare - over 6 months $2,955.06 $0.00