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Pa. O.C. Rule 6.12 STATUS REPORT
REGISTER OF WILLS OF i CUMBERLAND COUNTY, PENNSYLVANIA
Name of Decedent: Arthur F Ed in
Date of Death: 12/2312010 File Number: 21-11-0039 t
Pursuant to Pa. O.C. Rule 6.12, 1 report the following with respect to completion of the administration of
the above-captioned estate:
1- State whether administration of the estate is complete: ® Yes ❑ No
2. If the answer is No, state when the personal representative
reasonably believes that the administration will be complete: .- - -
3. If the answer to No. 1 is YES, state the following:
a. Did the personal representative file a final account with the Court? ❑ Yes ® No
b. The separate Orphans'Court No. (if any)for the personal
representative's account is:
c. Did the personal representative state an account
informally to the parties in interest? ® Yes ❑ No
Cl. Copies of receipts, releases,joinders and approvals of formal or informal accounts may be
filed with the Clerk of Orphans' Court and may be attached to this report.
I A copy of the Family Settlement Agreement is attached to this report.
Date
Signature of Person Filing this Form
Capacity: ❑ Personal Representative ® Counsel
.t
- Marielle F. Hazen Esq. #68003
,;z Name of Person Filing this Form
>r o LU 2000 Linglestown Road
c:5 c> s w Suite 202
� m Address
w _Harrisburg, PA 17110
� �' o V cr7 shers.zip
" 717-540-4332
Telephone
Form RW f0 Rev.1043-2006 Copyright(c)2006 form software only The Lackner Group,Inc n./,
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FAMILY SETTLEMENT AGREEMENT AND FINAL RELEASE
IN THE
ESTATE OF ARTHUR F. EDGIN, DECEASED
KNOW ALL MEN BY THESE PRESENTS, that WHEREAS ARTHUR F. EDGIN, late
of North Middleton Township, Cumberland County, Pennsylvania, deceased, died testate on
December 23, 2010, having first made his Last Will and Testament, which was duly executed on
November 30, 2010 and is duly recorded in.Cumberland County Courthouse, Register of Wills,
File No. 21-11-0039;
WHEREAS, ARTHUR F. EDGIN, by the aforesaid Last Will and Testament, named
CURTIS A. EDGIN and DIANE L. MILLER as Co-Executors of his Last Will and Testament;
WHEREAS, Letters Testamentary on the estate of decedent were duly issued by the
Register of Wills of Cumberland County and were granted to CURTIS A. EDGIN and DIANE
L. MILLER on January 10, 2011, hereinafter called Personal Representatives;
WHEREAS, the Personal Representatives have gathered the assets of the estate of the
decedent, and the assets consist of real and personal property to a total value of$366,607.72 as
set forth in Exhibit A, which is a statement of account of the said Personal Representatives, and
which is attached hereto and made a part hereof and marked Exhibit A;
WHEREAS, the balance for distribution as shown in the statement marked Exhibit A has
been distributed as herein indicated in accordance with the terms of the Last Will and Testament
of the decedent;
NOW,THEREFORE,KNOW YE, that 1, CURTIS A EDGIN,Trustee, being the Trustee
of the Testamentary Trust for the Benefit of Julia R. Edgin and the Testamentary Third Party
Special Needs Trust for the benefit of Julia R. Edgin, both created pursuant to the terms of the
Last Will and Testament of Curtis A. Edgin, and being the sole beneficiaries of the estate of
Curtis A. Edgin, do hereby acknowledge that I have this day received from the Personal
Representatives, in full satisfaction and payment, all sum or sums of money, legacies, bequests
and devices as are given, devised and bequeathed to the trusts, which amounts I have received
this day, and which amounts are set opposite the trusts in the table and schedule of distribution in
the statement attached hereto and marked Exhibit A;
AND, I do hereby stipulate that in order to avoid th-° expense and time involved in the
filing of a formal account and schedule of distribution, I agree that no account is necessary; and I
do hereby consent to distribution being made without the filing of an account and schedule of
distribution, the same to be with the same force and effect as if it had been filed and confirmed
by the Orphans' Court Division of the Court of Common Pleas, Cumberland County.
THEREFORE, I do hereby remise, release, quit claim and forever discharge the Personal
Representatives, Curtis A. Edgin and Diane L. Miller, their heirs, executors, administrators and
assigns, of and from the estate and from all actions, suits, payment, accounts, reckoning, claims
and demands whatsoever for or by reason thereof, or for any other use, matter, cause or thing
whatsoever touching upon the estate of the decedent; and I do further hereby covenant and agree
that should any liability come due to the estate of the decedent after the signing of this
agreement, I do hereby covenant and agree with the Personal Representatives that I will
contribute pro rata the trusts' share of the estate to satisfy any and all claims, demands, suits or
causes of action which may be successfully prosecuted against the estate or the Personal
Representatives after the signing, sealing and delivery of this Family Settlement Agreement and
Final Release.
i
IN WITNESS WHEREOF, we have hereunto set our hands and seals this 1' day of
2012.
( _
WitnesU — Q CURTIS A. 1315GINN —
Estate of Arthur F. Edgin
COMMONWEALTH OF MASSACHUSETTS }
County of Nam eh / s$'
On this the 1St day of 2012, before me, a Notary
Public, the undersigned officer, personally appeared Curtis A. Edgin, known to me or
satisfactorily proven to be the person whose name is subscribed to the within instrument, and
acknowledged that he executed the same for the purposes therein contained.
IN WITNESS WHEREOF,I hereunto set my hand and official seal.
Notary IWblic
DOD 12!23 2q STATE OF ARTHUR
F•EOO1N STATEMENT OF ACCOUNT-"HiSIT
Mid Penn Revised 72/7/2672
Mrd PenPe„" nCkin Act#9079079 smote sets
Mb� k Cb#309002187
Mid Penn Bank CD#3090, D aloe
Bank CU� #00_ aloe
Mid $ _ 5G,677.65
Mid Penn Bank C �"`- E - 6_ 84289
4
Sus ueha Cnan Orin Bank Reserve ��' E �65�,777,24
Chasa Cato' ,ery t �0�199� $
De osit 5/3/1, -- 51,27,2 g
2-US 7reasu $ 9000,00
Tot' E -_ 114.766,10
Estate Assets $ 7,24677
E 9.'0
367,067.72
MO -annuit�7 Assets h¢1d Jointl with
Mid Penn Bank Ckln'q-��_"" SP°us¢
Mar an Stank SIX.#1057788 Total- - D�D yalo
Oust -«zAAct #604 0' p Q Al $29,000.00 e
ank Ckiri Aci '. 42-Od5-dT ----�7ot�a1-$27002,56 $ 74.500.00
O rsllyBa„k CD R, k`I0p00270793-JT ioiai.$3 --� 13,507 29
OWn Bank COA, 913-J7 -- 7otaal-$,1,867.60 = 17,500.00
udenn f Sink CD AC1"00002�360-JT ----- l$15,000.00 $ 5.943_82
Sawn s Bonds JT ~- J-T"----- �`'`$7-'0 030 06 7.500 00_
J7 �TOtai-$'S 158.48 $ 5 000
f
Total
-- $ 3 60600
la $45,02 2.90,00
Total Joint Assts Tol- @00 $ 1,300.00
Total Assess $ 22,512.50
90,936.84
458,004.56
CIIIienS
Citizens Bank Estate ACCT.#62 income
Bank Estate A'�9`-,114-1nI rest 8
Citizens Bank cct#6222402074-into 2111'-- _ $ Received
Cin'zens Estate ACCT #62224
Gina..Bank Estate Acci'"'- Interest 317 t 001
Estate AC '#62224920?4-fniere� si- d-' f--"' $
Citizens c1.#622249209 -1 !'-' -- $ 0.05
Citizens Bank Estee Aoct #6222492014 Interest 5fl -�� � 0,05
Citizens Bank EStatee Ac,, 92014-Interest
CIlizens Bank Estate qCd #6222492014:interest 711
Citizens paokEst"-aie?�t#8222492pi4-int, erect 8`tt
Cifkens Bank EsA�-K6?22492ota-Interest 9171"'-^
Clliz¢ns Bank Esata qqy,{ 222492014 ni¢rwt 4 a'16
CitiZeryS yank Estate A¢4Y.#6 Interest1 if11``- $
erect _ 0.16
Cifizans gam nk Es�at q tt #6222492- py4-interest 7 121 $
Citizens Bank Estai_ e� ct22452014. $
Cil¢ens yank Estate Acet.#622249201 �t1s- 3112
0.16
e
Citizens Bank Estatepcct 2-_._492pi;Linf¢�reest 4112---_____'''--- $ 016
Cdizens Sank''-'#62224'92014- g U 78
Citizens Bank #6222492014_Interest 5112 $ 0.76 Irt
Citizens Bank=eAA F'_�2 24920 i4.t 6112 $ 1.13
Citizens Bank Esiateq 222402014-Interesf`efi2' - $
Citizens Ban ateA�t #6222492014-Interesl'gfi2 _, g"' 1.10
Cdizens Bank E cd.#6222492014- X10/,2 _� S 1.14
Cdizens Bank ESiatIe ASCt.#623 .4132623 -4132 X4-6 interest l0/t2 $ -_114
Citizens Bank Estate Acq.#623231-404- Interest 4717 $ i..0
Citize"S Bank-Bank -ate-A,CCt.#823231_404-6-Intere�l Sfi t $ 0.16
Citizens Bank Estlate Acpt,#623231-40-64 -Intt�� �`-'- $ 231.18
Ci/hens Sank Es ACIX.#62328_-___""'----- $ 272.42
Citizens iafa Acct.#8232---8 Interest 8/11 214.94
Bank Estate Rctt #623 31`04-'6--inioieres(9j17 -' $ 236.64
ifiz"Cit¢ensg EZe---�_23t-God-6-intere- sjj-!-'-. $ 17222
C&liens Ban -Accf.#623237-484.6 Blot-gr¢st-1-/t i'."�-- $ 162.73
CJtiZens Ba to #823123T-`6'loterest 121j $ 123,
-_�k Estate A`-- 404-
Cdizens Bank Est 4 #623237-404- Interest 1112 $ 173 32
Citizens ate Acci #6 6-Illterest 271 -�
Bank Estate A�3231-404-66-M-I 3/12 1
Citizens #623237 20842
Citizens Bank Estate ACCT #623231-404-6-jeterest 412 ----_�,� $ 117.76
Citizens Bank Estate qCq #623231.4 6'Interest'- -- 5,,2 $ 16533 Interest $Citizen k Estate AA f #'_231-gQ,`lnte es 7/12""----' $!149 56
Bank Estate
CGaens Bank2state #6232'3t-qpq- $
Citizens Bank Acct1#623237 6'Interest 8112 --._� 117.77
Mb Penq 8 Es;a-e &23 31.404.8_iniereS19112 $ 90.62
Mid Penn Bank CD Act'#90 014404-5 erest 1012 $ 81.63
CD#309 79 income $ 82.90
MfR peon Ban tom' e' ?9o�a�llac g
Mrd Penn Bank CD 309002646_ $ 80.47
Sus vehanna CD #309002964-into`-e at W=se otaccl 207.39
Svs uehanna`-0-72000019yg- me at dose o/day $ 565.21
CD#401240007998 erest tl.at cbsin $ 385.32
To $
Interest d.atier GOSln��- 229,99
tal 558.38
$ 4,44
$ 4,862.38
Expenses
Fare!) To Be Paid
Cumbedatl L J estate notice An
FaFare!) n aw ournal- mou [il Home Medical-medical a ui merit rental lee S 75.00 S 75.00
Funeral meal- aid b Cunis $ 50.85 S 50.85
Funeral service- actor ianist r ram
$ 822.00 5 922.00
Heath Funeral Home $ 170.00 S 170.00
Heath Funeral Home-remainin balance $ 9000.00 S 9000.00
Hazen Elder Law-fees $ 71.02 5 71.02
Hazen Elder Law-disbursements $ t4 300.00 S 14 300.00
He S iril Has ttal-medical $ 22.62 S 20.22 S 2.40
PA De t.of Revenue-2011 Pq Fid.laz $ 188.19 5 188.19
PA De t,of Revenue-2012 PA Fid.tax $ 131.00 S 131.00
Pinnacle Health Med Svcs-Harrisbur Hospital stay $ 44.00 S 44.00
Pinnacle Health Eme en S 53.86 $ 53.86
Quantum Ima in -medical 573.32 check retumetl as aitl account
23.71 S 23.71
Re isterof iNS-Probate Fees
Re islet of WJls-Adtldional Probate Fees S 381.50 S 381.50
R ister of Wills- ,in fees for inher8ance taxlinvento S 50.00 $ 50.00
Richard P.Pa nski MD-hoc Nal care S 30.00 $ 30.00
Sentinel
-e notice S 33.98 $ 33.98
Reserve for at e S 276.02 5 276.02
Total S 25,837 075 $ 24 729.35 S 1,10x.40
Estate Assets
Jo(nt Assets S 367067.72
Total Income S 90 936.84
TOTAL ASSETS S a 862.38
Less Total Ex arises f a62,866.9a
Less Inhedtance Taz 5 25 813.75
TOTAL 5 (4.169,92)
S 432,843.27
Distribution a is
Jdnt Assets distributed out' ht to S use Distribution
Distribution to Testaments Su n Trust $ 9D 936.84
Distribution to Testaments 310 Party SNT $ 53 344.25
TOTAL
$ 288,562.18
$ 432,843.27
Adual cash disinbution mayincresse ordeaease based on receipt of additional assets orincome,presentation of an
obtaa'on,and brpayment of edditional expenses,