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ESTATE OF Judy M. Evans , DECEASED
No. 21-12-00869
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 DecedenYs 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.
INCLUDE ATTACHMENTS AT THE BACK OF TH/S FORM.
Name of Counsel: Bruce J.Warshawsky
Supreme Court I.D. No.: 58799
Name of Law Firm: Cunningham &Chernicoff, P.C.
Address: 2320 North Second Street
Harrisburg, PA
Telephone: 717/238-6570
Fax: 717-238-4809
E-mail: bjw@cclawpc.com
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Estate of Judy M. Evans , Deceased
1. Name(s) and address(es) of Petitioner(s):
"ame: Michele Kennedy
Address: 'Z4,O W. Dauphin St.
Enola, PA 17025
Identify any executors or administrators who have not joined in the Petition for
Adjudication and Statement of Proposed Distribution and Account 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 06/27/2012
� Letters Testamentary or � Letters of Administration were granted to Petitioner(s) on
08/09/2012
Date of Will (if applicable):
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 � rvo
Dates of advertising of the grant of Letters:
08/17/2012 08/24/2012 08/31/2012 08/24/2012 08/31/2012 09/07/2012
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Estate of Judy M. Evans , Deceased
3. Was decedent survived by a spouse?....................................................................... � Yes ❑ No
If yes, name of the surviving spouse: Haydn T Evans
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 decedenYs surviving children or
surviving issue of deceased children (if none, so state):
Michele Kennedy
Shawn Kennedy
Brian Kerrigan
6. Did the decedent marry after execution of Will or Codicil(s)?.............................................. � Yes � ►vo
Were any children born to decedent after execution of
Wilior 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
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Estate of Judy M. Evans , 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 o/Each Part in Interest Relationship and Comments,if any Interest
See attached schedule
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Estate of Judy M. Evans , Deceased
Name and Address of Each Party in Inferest Relationship and Commenfs,if any 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).
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.
N/A
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Beneficiaries or Heirs
(continuation of Question#9A)
Estate of Judy M. Evans , Deceased
Name and Address of Each Party in Interest Relationship and Comments,if any Interest
Brian Kerrigan Son
48 Trudy Circle
Mechanicsburg, PA 17050
Shawn Kennedy Son
PO Box 99074
Seattle,WA 98139
Michele Kennedy Daughter
240 W. Dauphin St.
Enola, PA 17025
Haydn T Evans Spouse
221 Lee Ct.
Enola, PA 17025
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Estate of Judy M. Evans , 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?
See attached schedule
Above
,4ttachment 31,483.07
Tota� 31,483.07
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 claimanYs name and relationship:
Name: Relationship:
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Claims
(continuation of Question # 10)
Estate of Judy M. Evans , Deceased
Name and Address of Each C/aimant Amount of Claim C/aim Will C/aim
Admitted? Be Paid in
Fu111
Target 530.10 �Yes ❑Yes
c/o DCM Services, LLC � No � No
7601 Penn Ave. S
Suite A600
Chase 4,455.05 �Yes ❑Yes
c/o DCM Services, LLC � No � No
7601 Penn Ave. S
Suite A600
GE Capital Retail Bank-Qcard 676.14 �Yes ❑Yes
c/o Ascencion Point Recovery Services, LLC � No � No
200 Coon Rapids Blvd., Suite 200
Coon Ranids. MN 55433-5876
Chase 3,313.67 �Yes ❑Yes
c/o DCM Services, LLC � No � No
7601 Penn Ave. S
Suite A600
Capital One � Yes ❑Yes
PO Box 30285 � No � No
Salt Lake City, UT 84130-0285
HSBC/Bon Ton/Capital One 318.80 �Yes ❑Yes
PO Box 5226 � No � No
Carol Sream, IL 60197-5226
Citibank 20,603.42 � Yes ❑Yes
c/o Asset Acceptance LLC � No � No
PO Box 2036
Warren. MI 48090
Citibank NA 1,585.89 �Yes ❑Yes
PO Box 1370
� No � No
Reynoldsburg, OH 43068
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Estate of Judy M. Evans , Deceased
12. The amount of Pennsyivania 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
decedenYs estate will be discharged for the decedenYs 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
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.
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Estate of Judy M. Evans , Deceased
16. Had the decedent been adjudicated an incapacitated person?........................................... � Yes � rvo
If yes, attach a copy of the Order if available; otherwise state 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.
Dafe Descnption Amount
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.
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
Asto real estate only?......................................................................................................... � Yes ❑ No
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Estate of Judy M. Evans , Deceased
Wherefore, your Petitioner(s) ask(s) that distribution be awarded to the pa�ties 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 Distri6ufee(s) Amount Proportion
B. Principal:
Proposed Distributee(s) Amount P�oportion
Submitted By:
(All petitioners must sign.
Add additional lines if necessary):
�
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Name of Petitioner: Michele Kenne
Name of Petitioner:
Name of Petitioner:
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Estate of Judy M. Evans , Deceased
Verification of Petitioner
(Verification must be by at least one petitioner.)
The undersigned hereby verifies" [that n she is r;r�e
of the above-named name otcorPOratio�
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).
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Signature of Petitioner Michele Kenne y
Signature of Petitioner
Signature of Petitioner
*Corporate petifioners 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.
� at e Co el or Pe � ion
ruce J.Warshawsky
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THE eENTRAL PENN BUSINESS J(3URNAL
Proof of Publication
Under the Pennsylvania Newspaper Advertising Act
45 Pa.C.S. §101, et seq.
Commonwealth of Pennsyivania}
ss}
County of Dauphin }
Jerome Zary,�eing duly sworn according ta Iaw,deposes and says:
That he is the Controler pf and duly authorized agent for JOURNAL MLJLTIMEDIA,a corporation arganized and existing
under the laws of the Commonwealth of Pennsylvania,with its principal affice and place of business at 1 S00 P�ton Street,in the city
of Harrisburg,County of Dauphin, State of Pennsylvania;that the THE CENTRAL,PENN BUSINESS JOURNAL,a newspaper of
general circulation distributed and circulated in Dauphin,Curnberland,Lancaster, Lebanon and York caunties,is published by the
said JOURNAL MLTLTIMEDIA at 1500 Paxton Street, in the City,County and State aforesaid;and#hat THE CENTRAL PENN
BUSINESS JOURNAL was established Septernber 9th, 1984 and has been continually published ever since;
That the printed notice ar pubiicatian which is securely attached hereto is exactly as printed and published in the weekly
editions/issues of the CENTRAL PENN BUSINESS JOURNAL which appeared an the 24"'and 31St day(s)of August and the 7`�'
day(s)af September 2012. That neither he nor said Corporation is interested in the subject matter of said printed natice or advertising,
and that all of the allegations of this statement as to the time,place and character of pub(ication are true;and
This is a statement published by JOURNAL MiJLTIMEDIA.
PUBLICATION
COPY lerotne Z
NOTICE IS HEREBY GIVEN that Letters of
Administratian have been granted irr the t ,
following Estate. Aii persons Ifldebt�d Sworn to and subscribed before me thisc� � day ot' 2012 A.D,
to the said Estate are required to make
paymar�t and those having claims ar de- �
mands to present the same without delay
to the Administrator or attorney named
����'�� NOTARY P LIC
ESTATE OF Judy M.Evans,late nf Enola, COMM��',N�Al1'F�1 p�'pENNgYLVA1NlA
�umberland County, Pennsyivania {died N01'ARiAl.BEAL
June 27, 2012). Administrator — Mi- pONNA SCHANKWEIL�R,Nota
chele Kennedy.Attorney—Bruce J.War- ��ty cf���������������n�aun ublic
shawsky Esquire, Gunninghar�&Cher- � ty
nicoff, P.�C., 2320, North Secantl Street, I �Y�amsnissian�xpires Octob�r 03,20f 6
Harrisburg,PA 17110 '
Publisher's Receipt far Advertising Cost
JUURNAL MLTLTIMED[A,pubtisher of the CENTRAL.PENN BUSINESS JOURNAL,newspaper of generai circulatian,distribttted and
circulated in Dauphin,Cumberland, Lancaster,Lebanon and York cottnties,hereby acknowledges receipt af the aforesaid notice and
publication costs and certifies that the same have been duly paid.
THE CENTRAL PENN BLISINESS JOURNAL
Re: Estate of Judy M.Evans By......... ..... . .. . ............... .. .......... ......
CLTNNINGHAM&CHERNICOFF,P.C.
2320,North Second Street
Harrisburg PA 171 t4
Attention:Bruce J.Warshawsky,Esquire
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16, 1929), P. L.1784
COMMONWEALTH OF PENNSYLVANIA :
. ss.
COUNTY OF CUMBERLAND .
Lisa Marie Coyne,Esquire, Editor of the Cumberland Law Journal, of the County and
State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law
Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid,
was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Journal on the following dates,
viz:
August 17, August 24, and Au ust 31, 2012
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time,place and character of publication are true.
.
r
���
Li a Marie Coyne, E tor
SWORN TO AND SUBSCRIBED before me this
31 day of August, 2012
Notary
Evatta,Judy M.,dec'd.
Late of Enola.
Administratrix: Michele Kennedy.
Attorneys:Bruce J.Warshawsky, ,�.
Esquire, Cunningham & Cher- NOTARIAL SEAL
nicoff, P.C., 2320 North Second DEBORAH A COLLINS
Street, Harrisburg, PA 17110. Notary Public
CARIISIE BOROUGN,CUMBERLAND COUNTY
My Commission Expires Rpr 28,2014
ESTATE OF JUDY M. EVANS
PROPOSED SCHEDULE OF PAYMENTS—INSOLVENT ESTATE
Available Assets $45.00
Expenses
a. Administrative Expenses $2,344.50*
b. Funeral Expenses $7,930.00*
(*these Expenses will be paid from the proceeds of the Estate
set forth above and by other family members)
c. Debts per Claim and Schedule $31,483.07 (not paid)
F:U-Iome�BJVV�DOCS\EVANS.JUDY�FINAL ACCOIINTING�Proposed Schedule of Payment.wpd
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In the Court of Common Pleas of Cumberland County, Pennsylvania
Orphans' Court Division
File No. 21-12-00869
--------- --
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i_________ ___ _ __� Estate of Jud�M. Evans, Deceased �=� �., �
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East Pennsboro � �' �,�� ;." '�
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First and Final Account `�� �= `�.`� -�
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Michele Kennedy � ` � �
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. �
Date of Death: 06/27/2012
Date of Incapacity, if any: None
Date of Appointment: 08/09/2012
Date of First Complete Advertisement: 08/31/2012 in Cumberland Law Journal and 09/07/12 in
Central Penn Business Journal
Accounting for the period: 06/27/2012 to 09/03/2013
Purpose of Account: Michele Kennedy,offers this Account to acquaint interested parties with the
transactions that have occurred during the Administration.
It is important that the Account be carefully examined. Requests for additional information or questions
or objections can be discussed with:
Bruce J.Warshawsky, Esquire
Cunningham 8 Chernicoff, P.C.
2320 North Second Street
Harrisburg, PA
717/238-6570
Supreme Court I.D. No. 58799
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SUMMARY OF ACCC7UNT . -
Estate of Judy M. Evans, Deceased
Far the neried of I�ne 27, 2012 thro����pntember�, 01'�
�.��
PR��c�Pa�
Receipts; This Account 3 45.00
Net Gain(or�ass)on Sales
or Qther D�spositions 0.00
45.04
�ess Disbursements:
Debts of Decedent 4 31,483.07
Funeral Expenses 3 7,ssa.aa
Administration Expenses 3 344.50
Federal, S#ate& local Taxes 8.00
Commissions 0.00
Fees 3 2,00a.ao
�amily Exemptian 3 0.40 41,75T.5T
Balance Before Distributians -41,712.57
Transfer to(from}Principal p,pp
Dlstributions to Beneficiaries 0.00
Principal Balance an Hand , -41,712.57
For lnfarmation:
Investments Made
Changes in Hotdings 6
�r.�E
Receip#s This Accaunt 0.00
Net Gain {or Lass)an Sales 0.00
ar Cither Dispositions 0.00
Less D�sbursemen#s 0.00
Balance Before Distributians p,pp
Transfer to(fram) Income O.00
Distributians to Bene�ciaries p.pp
Income Balance on Hand p,p�
For Informatian:
tnves#men#s Made
Changes in Holdings
CQMBINED BAIr4NCE ON HAND 7 ��,���,g7
Signature g
Verifrcation 1p
- 2 -
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SCHEDULE A
RECEIPTS OF PRINCIPAL
Assets Listed in Inventory Fiduciary
(Valued as of Date of Death) Acquisition
Value
Personal PronertT
Jewelry Chest 45.00
Total Personal Property 45.00
Total Receipts 45.00
Total Receipts of Principal 45.00
- 3 -
SCHEDULE C
DISBURSEMENTS OF PRINCIPAL
Debts of Decedent
Catzital One(balance unknownl
06/27/2012
Chase 0547
06/27/2012 4,455.05
4,455.05
Chase 1525
06/27/2012 3,313.67
3,313.67
Citibank 3938
06/27/2012 20,603.42
20,603.42
Citibank Sunoco
06/27/2012 1,585.89
1,585.89
GE Bank-QCARD
06/27/2012 676.14
676.14
HSBC Bonton
06/27/2012 318.80
318.80
-4 -
SCHEDULE C
DISBURSEMENTS OF PRINCIPAL
Continued
Taraet
06/27/2012 530.10
530.10
Total Debts of Decedent 31,483.07
Funeral Ex e° nses
Sullivan Funeral Home
06/27/Z012 7,930.00
7,930.00
Total Funeral Exnenses 7,930.00
Administration Ex eq nses
Cumberland Countv
08/09/2012 119.50
119.50
Legal Advertisina
06/27/2012 225.00
225.00
Total Miscellaneous Administrative Ex�enses 344.50
Fees
Cunningham 8 Chernicoff. PC
06/27/2012 2,000.00
- 5 -
SCHEDULE C
DISBURSEMENTS OF PRINCIPAL
Continued
2,000.00
Total Fees 2.000.00
Family Exem t{� ion
H�vdn T. Evans-Husband (insufficient assets to nav►
06/27/2012 0.00
0.00
Total Familv Exemntion 0.00
TOTAL DISBURSEMENTS OF PRINCIPAL 41.757.57
- 6 -
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PRINClPAL BALANCE ON NAND
Current Value F9duciary
09103/2013 Acquisition
#Units Descriptian or as Nated Vatus
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[BankOut Name] -41,757.57 -41,757.57
Tatal Cash �1,757.57 -41,757.57
AsSSts
Jewelry Chest 45.00
Total Assets 45.00
-41,757.5T -41,712.57
- � -
SCHEDULE F
CHANGES IN PRINCIPAL HOLDINGS
#units �
Jewelrv Chest
06/27/2012 Inventoried 45.00
45.00
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COMBINED BALANCE ON HAND
Current Value Fiduciary
09/0312013 Acquisition
#Units Description or as Noted Value
s3sb
[BankOut Name] -41,757.57 -41,757.57
Total Cash -41,757.57 -41,757.57
ASSP�S
Jewelry Chest 45.00
Total Assets 45.00
-41.757.57 -41.712.57
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in the Court of Common Pleas of Cumberland County, Pennsylvania
Orphans' Court Division
File No. 21-12-00869
Estate of Judy M. Evans, Deceased
Signature
\ \ � ��-�-
Michele Kennedy
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In the Court of Common Pleas of Cumberland County, Pennsylvania
Orphans' Court Division
File No. 21-12-00869
Estate of Judy M. Evans, Deceased
��
�✓1�/��S ���f� Verification
Michele Kennedy� f Judy M. Evans, Deceased, hereby declares
under oath that he/she has fully and faithfully discharged the duties of hislher office; that the
foregoing 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 hislher knowledge,there are no claims now outstanding against the Estate; that ali taxes
presently due from the Estate have been paid; and that the grant of Letters 'F�t�a nd the
first complete advertisement thereof occurred more than four months before the foregoing �,,�
Account.
�,
'�i
This statement is made subject to penalties of 18 Pa.C.S.A. Section 4904 relating to unsworn '��1�
falsification to authorities. � J
� l�
Dated: �'�j '�j \-" " �-z�
Michele Kennedy
�
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