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COURT OF COMMON PLEAS OF E_, ,..° �_� -,� . ., ;
CUMBERLAND � =� ':'
COUNTY, PENNSYLV���A , -,
ORPHANS' COURT DIVISION =��� `� ���- '�'
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' v
ESTATE OF Roy Scott Lauffer , DECEASED
No. 09-00980
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: Robert G. Frey
Supreme Court I.D. No.: 46397
Name of Law Firm: Frey & Tiley
Address: 5 South Hanover Street
Telephone: �17-243-5838
F�: 717-243-6441
Form OC-01 rev. 10.13.06 Page 1 of 10
Estate of Roy Scott Lauffer Deceased
,
1. Name(s) and address(es) of Petitioner(s):
Name:
Regina M.Lauffer
Address:
94 Rustic Drive
Shippensburg,PA 17257
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? . . . . . . . . . . . . . . . . . . . . . �Yes ❑ No
If not, identify prior accountings,the accounting periods covered, and the date of
adjudication of the prior accounting.
2. Decedent died on October 12, 2009
� Letters Testamentary or ❑Letters of Administration were granted to Petitioner(s) on
October 19, 2009
Date of Will ('f applicable): November 26, 2002
Date(s) of Codicil(s) (if applicable): N/A
Date of probate (if different from date Letters granted): N/A
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: Sentinel: Dec. 1, 8, 15, 2011
Cumberland Law Journal: Dec. 9, 16, 23, 2011
Fo.m oc-o� rev. 10.13.06 Page 2 of 10
Estate of Roy Scott Lauffer , 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? . . . . . . . . . . . . . ❑Yes �No
(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):
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-Ol rev. 10.13.06 Page 3 of 10
Estate of Roy Scott Lauffer , 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 ar
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 o Each Par in Interest Relationshr and Comments,i Interest
Regina M. Lauffer Spouse 100% of the
94 Rustic Drive remainder and family
Shippensburg, PA 17257 exemption
Fo.m oc-ol .�. Io.13.06 Page 4 of 10
Estate of Roy Scott Lauffer , Deceased
Name and Address of Each Party in Interest I Relationship and Comments,if arry 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.
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).
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.
Fo�oc-oi rev. 10.13.06 Page 5 of 10
Estate of Roy Scott Lauffer 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 C[aimant Amount of Claim Claim Will Claim
Admitted? Be Paid In
Full?
Citizens Automobile Finance $85,879.57 Dyes ❑Yes
%Richard J. Boudreau&Associates �No �No
5 Industrial Way
Salem,NH 03079
RBS Citizens,NA $6879.24 �yes ❑Yes
% Phillips & Cohen Associates, LLC ❑No ❑� No
480 Jefferson Blvd
Mail Stop RJE 110
Warwick, RI 02886
Thousand Trails $643.04 �yes ❑Yes
% Equity Lifestyle Properties, Inc. ❑No �No
2 North Riverside Plaza
Chicago, IL 60606
Discover Card $5922.14 �yes ❑Yes
%Weltman, Weinber& Reis �No ❑� No
175 South 3rd Street, Suite 900
Columbus, OH 43215
�-�,r�;r�.�� U c� +�d C..t` i F� �� v� � �P
If the estate is insolvent, attach a schedule setting forth the order of preference unde�
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:
Regina Lauffer Spouse
Name: Relationship:
Form OC-Ol rev. 10.13.06 Page 6 of 10
� I
� UV�� � t>�. 0
ESt�te�f Ray Scott Lauffer , Dereased
10. Other than the claim for the family etemption, Iist the names of ait known claimants and
the amount of their ctaims and state whether each claim is admitted.
Vmxe und.4ddrrss of Earh Clrumanr Amuunt of Clai� Claim lYill Claim
.4dmirled? Br Paid In
Fnf!?
Ciribank South Dakota $11,078.Ib (�i yes ❑Yes
DCM ServicesfCitzbank []No �No
P� Box 1�6$
Minneapolis,h1iV a54�0
ti�est Shore EhiS �l l i 2.62 �s "Y"es [�Yes
%Consolidated Collection Service L,]No �No
IIIC.
Po ao�6asso
Harrisburg,PA 17106 �
PNC Bank,NA �82i6.08 �Yes �Yes
�/o Weltman, Weinberg& Reis []No �+ Nfl
323 tiVest Lakeside Ave., Suite 200
Cl�veland,OH 44113
C�aseDCM ServicesJCitiban.k �9549.52 �Yes ❑Yes
Pt?Box 1473 [;��Jo �No
�iinneapolis,l�I�5�0
If the estate is insolvent, attach a schedule settin� farth the arder ofpreference under
20 Pa.G.S. § 3392 and the prnposed payments.
11. Was family exemption claimed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑Yes [�No
Was famiIy exemption allowed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �]'Yes [�No
Family exemptian ciaimant's nam�and relatianship:
.'�'+�me: Relatinnxirip:
Farm OC-�Jt rev.l�.13.Ob �ii`� �0���}
Estate of Roy Scott Lauffer , 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 �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:
None known.
B. Has notice of the question requiring adjudication been given
to the parties identified in Paragraph 9 above? . . . . . . . . . . . . . . . . . . �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 Roy Scott Lauffer , Deceased
16. Had the decedent been adjudicated an incapacitated person? . . . . . . . . . . ❑ Yes �i 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.
None.
B. Has notice of the additional receipts and disbursements been
given to the parties identified in Paragraph 9 above? . . . . . . . . . . . . . ❑Yes ❑No
18. If a reserve is requested, state amount and purpose.
$--0.00--
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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑Yes ❑No
If so, attach a copy of the notice.
19. Is the Court being asked to direct
the filing of a Schedule of Distribution? . . . . . . . . . . . . . . . . . . . . . . . . . . ❑Yes ❑� No
As to real estate only? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ❑Yes �No
Form OGOI rev.10.13.06 Page 8 of 10
Estate of Roy Scott Lauffer , 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):
b
Nam of Petitione : egina
Name of Petitioner:
Form OC-01 rev. 10.13.06 Page 9 of 10
Estate of Roy Scott Lauffer Deceased
,
Verification of Petitioner
(Verification must be by at least one petitioner.)
The undersigned hereby verifies * [that�isr� is r;rte
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).
,
Sign e of Petitioner
*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 Pet' ner
Form OC-Ol rev. 10.13.06 Page 10 of 10
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First and Final Account of � �a �y -� ' '. Y
Regina M.Lauffer � G`� . . __r, �:�
Executor of the Last Will and Testament of`'� '�' �� �" �
_ �_y ��
��.�, _
Roy Scott Lauffer c:.i � � �
Late of South Newton Township,Cumberland County�ri�sylvarua `�`
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DATE OF DEATH: LETTERS TESTAMENTARY ADVERTISED:
October 12,2009 CUMBERLAND LAW JOURNAL
December 9, 16,23,2011
THE SENTINEL
December 1,8, 15,2011
ACCOUNTANT IS CHARGED WITH THE AMOUNTS OF PRINCIPALAND INTEREST
RECENED AND CLAIMS CREDIT FOR THE DISBURSEMENTS MADE AS STATED BELOW:
PRINCIPAL RECEIVED
70 shares,Comcast Class A common stock 1,076.00
22 shares,AT&T common stock 565.00
4 motorcycles and 1 Lark trailer sold at Gateway Auction 6,076.�2
McGregor boat and trailer 975.86
Stingray boat and trailer 1,360.00
1995 Ford Econoline Van and 2002 Jeep,sold together 5,575.00
Motor Home. Repossessed and sold by secured creditor o.00
Z-3 automobile 4,045.00
Miscellaneous personal property 1,982.14
6,435.20
TOTAL PRINCIPAL RECEIVED 28,090.92
INCOME RECEIVED
Dividends received 31.72
TOTAL INCOME RECEIVED 31.�2
�
DISBURSEMENTS
Priority expenses paid:
Ewing Brothers Funeral Home 9,281.80
Family exemption to Regina Lauffer 3��•�
Executrix fee to Regina Lauffer 1.�•�
Attorney's fee to Frey &Tiley 1>�•�
Probate fee to Register of Wills 132.00
Advertising fee to Cumberland Law Journal 75.00
Advertising fee to the Sentinel 178.92
Inheritance tax return filing fee 15.00
Filing fee for final account and petition for adjudication 243.50
Auctioneer fees for sale of motor vehicles 375.00
Title fee for trailer 39.50
Replacement battery for Ford van 86.92
Total priortity expenses to be paid 15,927.64
Total Assests 2g,o9o.92
Less,Total Priority Expenses (15,927.64)
Net assets to be paid to creditors prorata 12,163.28
Debts praposed to be paid prorata.
Total Debt Teditoi' Debt ta be Paid
85,879.57 Citizens Automabile Finance {net of praceeds of sale of 7,217.56
repossed motarhome)
6,8'79.24 RBS Citizens,NA acct.ending 1687 S'78.15
15,426.82 Chase acct.ending 4672 1,296.51
11,0'78.16 Citibank(South Dakota} NA,acct.ending 6051� 93i.Oq.
6�3.04 Thausand Trails acct.734-298-094730 54.04
1,112.62 West Shore EMS acct C09009109 43.51
s,z36.o8 PNC Bank acct.�311 9675 2�58 257A� 692.18
9,54952 Chase accaunt ending 1144 gp2.57
5,922.14 Discc�ver Bank Account 60110022758810'� 497.71
144,727.19 Total
TOTAL DISBURSEMENTS 12,163.27
Ct7MMOl�TWE:ALTH OF PENNSYLVANIA
. SS..
COUN'T"Y OF CUMBERALND
I,Regina Lauffer,Executrix of the Last Wilt and Testatrnent of R.Scott I.auffer, does hereby declare under
oath that I have fuIiy and faithfully discharged the duties af the affice;that foregoingAccount is true and correct and
fully discloses all significant transations occuring during the accounting period;that all known claims against the estate have been
included in this Account;that there are no knacvn claims againsi the estate and that na taaces are presently due .
.
Regina er
Scvorn to and subscribed before me
r
this ,��� day flf Juty,2013.
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