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DECEDENT'S ����;��, r• ;; ;,�,� ��.
COURT OF COMMON PLEA���F����B��I��l�l�+
COUNTY, PENNSYLVANIA �` �`�''
ORPHANS' COU�i����[IS�T ��� i ��
ESTATE OF DANIEL V. SCAMBI�;,DE,CEASED
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No. 2012-OOOQ3 ,:,.:, ,;,
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PETITION FOR ADJUDICATION/ � ' �s ;
STATEMENT OF PROPOSED DISTRIBUTION
PURSUANT TO Pa. O.C. Rule 6.9
Name of Counsel: Murrel R. Walters, III
Supreme Court I.D. No.: 24849
Name of Law Firm: Law Office of Murrel R. Walters, III
Address: 54 E. Main St., Mechanicsburg, PA 17055
Telephone: 717-697-4650
Fax: 717-697-9395
1. Name(s) and address(es) of Petitioner(s):
Name: Nicole L. Hook
Address: 301 Chestnut St. #513, Harrisburg, PA 17101
Identify any executors or administrators who have not joined in the Petition for
Adjudication and Statement of Proposed Distribution and state reason: None
Is this the first accounting by this fiduciary? Yes
If not, identify prior accountings, the accounting periods covered, and the date of
adjudication of the prior accounting.
2. Decedent died on January 18, 2012.
Letters of Administration C.T.A. were granted to Petitioner(s) on: January 30, 2012
Date of Will (if applicable): January 2, 1997
Date(s) of Codicil(s) (if applicable): N/A
Date of probate (if different from date Letters granted): N/A
Was a bond required? If yes, state amount: No
Are proofs of advertising of the grant of Letters attached? No
Dates of advertising of the grant of Letters:
The Patriot-News: April 20, Apri127, May 4, 2012
Cumberland Law Journal: Apri120, Apri127, May 4, 2012
3. Was decedent survived by a spouse? No
Page 1 of 8
If yes,name of the surviving spouse:
4. Has the surviving spouse filed to take an elective share? N/A
(See Section 2201 et s�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): N/A
6. Did decedent marry after execution of Will or Codicil(s)? No
Were any children born to decedent after execution of
Will or Codicil(s)? 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
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:
Page 2 of 8
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 Relationship & Comments, if anv Interest
l. ESTATE OF Cousin 9.83%
DONALD STISH, SR.
420 Krocks Rd., Apt. 248
Allentown, PA 18106
2. ROBERT STISH Cousin 9.83%
218 E. High St.,Apt. #2
Glassboro,NJ 08028
3. RICHARD STISH Cousin 9.83%
1084 S. Church St.
Hazleton, PA 18201
4. JACKIE STISH Cousin 9.83%
101 Howard Street
Enola, PA 17025
5. NANCY SCAMBIA Cousin 9.83%
n/k/a NANCY SCAMBIA TOOLE
124 Whistle Walk
Williamsburg, VA 23188
6. ESTATE OF Cousin 9.83%
JOANN M. SCHWEITZER
f/k/a JOANN SCAMBIA
c/o Joseph D. Ustynoski, Esquire
101 W. Broad St., Ste. 205
Hazleton, PA 18201
7. MARY JANE STANZIOLA HERR Cousin 9.83%
Glenaire Retirement Community
3 319 Glenhope Ct.
Cary,NC 27511
8. MARY SHULTZ KEMPER Friend 9.83%
n/k/a MARY BEILER
175 Bottom Rd.
Blain, PA 17006
9. VEBA JOHNSON Friend 6.4%
1113 N. 16th St.
Page 3 of 8
Harrisburg, PA 17103
10. THURSTON HENRY Friend 5.12%
261 N. Arlington Ave., Apt. C
Harrisburg, PA 17109-2308
11. ANGELA LaMONICA Friend 9.83%
n/k/a ANGELA MOORE
15 El Camino Rd.
Hazelton, PA 18201
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.
None.
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).
N/A
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.
Estate of Donald Stish Estate of Joann Schweitzer
Joan Stish, Surviving Spouse William E. Schweitzer, Executor
Date of Death: O1/26/2013 Date of Death: March 7, 2012
Estate will be opened before Letters Testamentary granted on
Distribution is made. March 23, 2012, in Luzerne
County, Pennsylvania
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.
None.
If the estate is insolvent, attach a schedule setting forth the order of preference under
20 Pa.C.S. § 3392 and the proposed payments.
Page 4 of 8
11. Was family exemption clairrled? No
Was family exemption allowed? No
Family exemption claimant's name and relationship:
Name:Relationship:
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
04/15/2012 $88,000.00 $0.00
10%26/2012 $13,193.98 $0.00
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?
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:
N/A
B. Has notice of the question requiring adjudication been given to the parties
identified in Paragraph 9 above?
N/A
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.
N/A
16. Had the decedent been adjudicated an incapacitated person? 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. N/A
Page 5 of 8
B. Has notice of the additional receipts and disbursements been given to the parties
identified in Paragraph 9 above? N/A
18. If a reserve is requested, state amount and purpose.
Amount: $34,485.00
Purpose:
Register of Wills—Supplemental Return; First and Final Acct. $ 1,585.00
Alfred L. Whitcomb,personal income tax preparation and Form 1041 $ 2,000.00
Nicole L. Hook, Administratrix Commission $ 15,450.00
Murrel R. Walters, III, Executor Commission $ 15,450.00
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? If so, attach a copy of the notice.
See contemporaneously filed First&Final Account and Proposed Distribution. Both
documents will be served on all Beneficiaries providing notice of reserved amounts for counsel
fees.
19. Is the Court being asked to direct the filing of a Schedule of Distribution? Yes.
As to real estate only? No.
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&Principal:
Proposed Distributee(s): Amount/Proportion:
Estate of Donald Stish,per Item 3(1) of said Will 9.83%
Robert Stish,per Item 3(3) of said Will 9.83%
Richard Stish,per Item 3(4) of said Will 9.83%
Jackie Stish,per Item 3(5) of said Will 9.83%
Nancy Scambia, n/k/a Nancy Scambia Toole per Item 3(7) of said Will 9.83%
Estate of Joann Scambia,per Item 3(8) of said Will 9.83%
Mary Jane Stanziola Herr,per Item 3(11) of said Will 9.83%
Mary Shultz Kemper, n/k/a Mary Beiler,per Item 3(12) of said Will 9.83%
Veba Johnson,per Item 3(13)of said Will 6.4%
Thurston Henry,per Item 3(14) of said Will 5.12%
Angela L. LaMonica, n/k/a Angela Moore,per Item 3(15) of said Will 9.83%
Submitted By:
Page 6 of 8
Submitted By:
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Name of e tioner: Nic e L. Hook
Page 7 of 8 �
VERIFICATION
The undersigned hereby verifies 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).
� ` �� �
Dated: , �
� ' le L. Hook, Pe itioner
CERTIFICATION OF COUNSEL
The undersigned counsel hereby certifies that the foregoing Petition for Adjudication/
Statement of Pro osed Distribution is a true and accurate reproduction of e, form Petition
P
authorized by the Supreme Court, and that no changes to th h e b n made beyond the
responses herein.
Signature of ounsel for Petitioner
Page 8 of�
�1�1� �� .�7
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA ORPHANS' COURT DIVISION
ESTATE NO. 21-12-0093
ESTATE OF DANIEL V. SCAMBIA, Deceased
Late of East Pennsboro Township, Cumberland County, Pennsylvania
FIRST AND FINAL ACCOUNT OF NICOLE L. HOOK,AD_MINISTRATRIX
Date of Death: January 18, 2012
Date Letters Administration C.T.A. Issued: January 30, 2012
- Dates of Advertisement of Grant of Letters:
The Patriot-News: Apri120,April 27, May 4, 2012
Cumberland Law Journal: Apri120, Apri127, May 4, 2012
Account Stated to: July 25, 2013
NOTICE
PURPOSE OF ACCOUNT:
Nicole L. Hook, Administratrix, offers this account to acquaint interested parties
with the transactions that have occurred during this Administration. In addition,Nicole L.
Hook, would like to inform the interested parties of the proposed distribution of estat�
residue to the bene�ciaries in accordance with the decedent's Last Will& Testament.
It is important that the Account be carefully examined. Requests for additional
information, questions or objectioas can be discussed with:
Murrel R. Walters,Esquire
54 E. Main Street
Mechanicsburg,PA 17055
Supreme Court I.D. #24849 �, ::-�; ,�:s ��
(717) 697-4650 c � `�`' �;�,� �'
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�SUMMARY
PRINCIPAL:
Receipts $765,977.85
Disbursements (including amounts reserved)$191,147.04
Principal Balance Remaining: $574,830.81
INCOME:
Receipts $ 6,598.22
Disbursements $ 0.00
Income Balance Remaining $ 6,598.22
PARTIAL DISTRIBUTION TO BENEFICIARES: $ 0.00
COMBINED BALANCE REMAINING FOR DISTRIBUTION: $581,429.03
PRINCIPAL RECEIPTS
PNC Bank—Total Banking XX�:��XX5284 $383,587.33
Includes the following CD's:
PNC Bank—CD x:XX�;�KXX1021
PNC Bank—CD X��X�:�KXX1020
PNC Bank—CD X0223
Dreyfus Money Market 8933 $177,063.80
Dreyfus 1160 $ 42,599.19
E Trade Money Market �5���:xX0450 $ 88,712.58
PNC Investment Account x:XX�:��9826 $ 35,376.85
AE-Pennsylvania Place Associates, LP—Refund $ 223.89
Pinnacle Health—Overpayment $ 30.66
Fidelity �5:��:X:XX9083 $ 20,762.97
Federal Employees Group Life Insurance Death Benefit $ 13,605.87
2009 U.S. Income Tax Refund—Reissue $ 688.48
2010 U.S. Income Tax Refund $ 365.00
2010 PA Income Tax Refund $ 470.00
Civil Service Retirement&Disability Fund Death Benefit $ 1,221.06
2009 U.S. Federal Income Tax Refund—per Amended Filing (estimated) $ 258.00
2009 PA Income Tax Refund—per Amended Filing (estimated) $ 364.00
2008 U.S. Income Tax Refund—per Amended Filing (estimated) $ 473.00
PA Income Tax Refund—Reissue (expected) $ 175.17
TOTAL RECEIPTS: $765,977.85
PRINCIPAL DISBURSEMENTS
OZ/24/201�2 Register of Wills, Petition for Grant of Letters Testamentary,
Probate, Short Certificates $ 625.50
02/20/2012 Confidential Investigative—Locate Beneficiaries $ 350.00
04/13/2012 Myers-Buhrig Funeral Home $ 22,824.80
04/15/2012 Register of Wills—Inheritance Taxes—Prepayment $ 88,000.00
04/15/2012 Murrel R. Walters, III, Esquire—Attorney Fee $ 3,000.00
04/15/2012 Nicole L. Hook, Personal Representative $ 3,000.00
04/16/2012 3 Rental Fees—PNC Safe Deposit Boxes $ 275.00
04/18/2012 US Income Tax—payment $ 1,500.00
OS/03/2012 PNC Estate Checks—Fee $ 17.99
05/18/2012 Social Security—Overpayment $ 2,098.47
OS/18/2012 Confidential Investigative—Locate Beneficiaries $ 175.00
OS/29/2012 Cumberland County Law Journal—Publication $ 75.00
OS/29/2012 Associated Cardiologist- Medical $ 25.00
OS/29/2012 Hospital Telephone &Telcom $ 28.00
OS/29/2012 Golden Living- Medical $ 4,008.89
OS/29/2012 PharMercia -Medical $ 37.41
OS/29/2012 PRISM $ 3.58
OS/29/2012 Quantum Imaging - Medical $ 3.20
OS/29/2012 Commercial Acceptance Co. —Ambulance $ 450.90
OS/29/2012 Bureau of Account Management—Ambulance $ 634.25
06/08/2012 The Patriot-News—Publication $ 109.52
09/13/2012 Edward E. La Marque - Medical $ 460.55
10/16/2012 U.S. Income Tax—payment $ 31.00
10/25/2012 Cumberland County Register of Wills—PA Inheritance Tax $ 13,193.98
10/25/2012 Cumberland County Register of Wills -- Filing Fee Return $ 15.00
10/25/2012 Nicole L. Hook, Personal Representative - Fee $ 5,000.00
10/29/2012 Cumberland County Register of Wills—Additional Probate Fee $ 100.00
11/07/2012 Murrel R. Walters, III, Esquire—Attorney Fee $ 5,000.00
12/04/2012 Vital Statistics—Fee for Death Certificate $ 9.00
12/04/2012 Vennont Department of Health—Fee for Death Certificate $ 20.00
03/22/2013 Cumberland County Register of Wills—Short Certificate $ 5.00
04/16/2013 PA Dept of Revenue $ 29.00
04/17/2013 US Income Tax—payment $ 5,235.00
04/17/2013 PA Income Tax—payment $ 24.00
Multiple Insurance Premiums $ 297.00
Reserved Register of Wills—Supplemental Return; First and Final Acct. $ 1,585.00
: Reserved Albert L. Whitcomb,personal income tax preparation `10-12; $ 2,000.00
Amended Filings `08-09; and PA 1041. Reissue 2009 Refunds
Reserved Nicole L. Hook, Personal Representative $ 15,450.00
Reserved Murrel R. Walters, III, Esquire $ 15,450.00
TOTAL DISBURSEMENTS: $191,147.04
INCOME RECEIPTS
PNC Stock �:X��:X:���9826 $ 2,540.55
PNC Bank—Total Banking �:�K�:X��X5284 $ 4,057.67
Includes the following CDs:
FNC Bank—CD X��:X:����1021
PNC Bank—CD 1020
PNC Bank—CD �5���:XXX0223
TOTAL INCOME RECEIPTS: $ 6,598.22
INCOME DISBURSEMENTS
None $ 0.00
PARTIAL DISTRIBUTIONS TO BENEFICIARIES
None $ 0.00
VERIFICATION
Nicole L. Hook, verifies that she is the Administratrix of the Estate of Daniel V.
Scambia, deceased; and that she the Administratrix 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; that all known claims against the
Estate have been paid in full; that to her knowledge there are no claims now outstanding against
the Estate; and that all taxes presently due from the Estate have been paid.
I understand that false statements are subject to the penalties of 18 Pa. C.S. Section 4904
relating to unsworn falsification to authorities.
�
Dated: ' � �� �' v
icole L. Hook, dministratrix