HomeMy WebLinkAbout10-16-13 � l �� • �1�
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CUMBERLAND COUNTY, PENNSYL�t�1�IA �-�
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ORPHANS' COURT DIVISION ° " . ;
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ESTATE OF ROBERT E. SNELL , DECEASED
No. 2012-00732
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: Lisa Marie Coyne, Esq.
Supreme Court I.D. No.:53788
Name of Law Firm: Coyne & Coyne, PC
Address: 3901 Market Street, Camp Hill PA 17011
Telephone:�17-737-0464
Fax: 717-737-5161
Form OC-01 rev. 10.13.Oh Page 1 of 10
�
Estate of ROBERT E. SNELL , Deceased
l. Name(s) and address(es) of Petitioner(s):
Name: David Delbaugh
Addres�s: 34 Gale Road
Camp Hill PA 17011-2619
Identify any executors or administrators who have not joined in the Petition for
Adjudication and Statement of Proposed Distribution and state reason:
n/a
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 June 22, 2012
� Letters Testamentary or �Letters of Administration were granted to Petitioner(s) on
Julv 17. 2012
Date of Will (ifapplicable): May 11, 2009
Date(s) of Codicil(s) (if applicable): �a
Date of probate ('f different from date Letters granted): �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:Cumberland Law Journal and The Patriot
News: 8/17/2012, 8/24/2012 & 8/31/2012 (�x{,��;-�- ��
Form OG01 rev.10.13.06 Page 2 of 10
Estate of ROBERT E. SNELL , 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 0 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):
n/a
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 OG01 rev. 10.13.06 Page 3 of 10
Estate of ROBERT E. SNELL , 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):
Nume und Address of Each Purtv in Interest I Relationship und Comments,if uny I Interest
David L. Delbaugh Friend 100%Residual Heir
34 Gale Road
Camp Hill PA 17011-2619
Form OG01 rev.10.13.06 Page 4 of 10
Estate of ROBERT E. SNELL , Deceased
Nmne and Address of Each Party in lnterest 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.
n/a
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
Forin OGO/ rev. 10.13.06 Page 5 of 10
Estate of ROBERT E. SNELL , 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 Gaimant Amount of Claim Claim Will Claim
Admitted? Be Paid In
Full?
Department of Welfare $53,471.80 �✓ Yes 0 Yes
PO Box 8486 �No 0✓ No
Harrisburg PA 17105-8486
American Express $20,719.02 �Yes �Yes
c/o West Asset Management, Inc. �No �No
P.O. Box 956842
St. Louis, MO 63195
�Yes �Yes
❑No �No
�Yes �Yes
�No �No
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.• Relationship:
Form OG01 rev. 10.13.06 Page 6 of 10
Estate of ROBERT E. SNELL , 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
Insolvent Estate 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? . . . . . . . . . . . . . . . . . . . �Yes 0✓ 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? . . . . . . . . . . . . . . . . . . �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.
Forrn OC-O! rev. /0.13.06 Page 7 of 10
Estate of ROBERT E. SNELL , 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.
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.
Amaun�: 300.00
Pu.pose: Final Fiduciary Income Tax Return
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 OG01 rev.10.13.06 Page 8 of 10
Estate of ROBERT E. SNELL , 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 Distrifiutee(s) Amount/Proportion
See attached proposed schedule of distribution. �E��i•������)
B. Principal:
Proposed Distributee(s) Amount/Proportion
See attached proposed schedule of distribution. ���t�����`� ��
-T
Submitted By:
(All petitioners must sign.
Add additional lines if necessary):
������• ������ �-
Name of Petitioner:
Name of Petitioner:
Fonn OG01 rev. /0.13A6 Page 9 of 10
Estate of ROBERT E. SNELL , Deceased
Verification of Petitioner
(Verification must be by at least one petitioner.)
The undersigned hereby verifies * [that tieishe is rure
of the above-named name o/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).
� � Z�
Signature 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.
�
gna re of Counsel for Petition
For„�oc-ol rev.10.13.06 Page 10 of 10
` z Patriot-News Co. •
. LOTechnology Pkwy e a rlo � ews
`� � � Suite 300
zchanicsburg, l�A 17050 Now you know
Inquir_ies - 717-255-8213
COYNE & CGYNE � ��
ATTENTION: LISA MARIE COYNE �J
3901 MARKET STREET � " ��
CAMP HILL S�P � ��1z
PA 17011 @y
THE PATRIOT NEWS
THE SUNDAY PATRIOT NEWS
Proof of Publication
Under Act No. 587, Approved May 16, 1929
Commonwealth of Pennsylvania, County of Dauphin} ss
Holly Blain, being duly sworn according fo law, deposes and says:
That she is a Staff Accountant of The Patriot News Co., a corporation organized and existing under the laws of the
Commonwealth of Pennsylvania, with its principal office and place of business at 2020 Technology Pkwy, Suite 300, in the
Township of Hampden, County of Cumberland, State of Pennsylvania, owner and publisher of The Patriot-News and The Sunday
Patriot-News newspapers of general circulation, printed and published at 1900 Patriot Drive, in the City, County and State
aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949,
respectively, and all have been continuously published ever since;
That the printed notice or publication which is securely attached hereto is exactly as printed and published in their regular
daily and/or Sunday/Community Weekly editions which appeared on the date(s) indicated below. That neither she nor said
Company is interested in the subject matter of said printed notice or advertising, and that all of the allegations of this statement as
to the time, place and character of publication are true; ancl
That she has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on
behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the
stockhalders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds
in and for said County of Dauphin in Miscellaneous Book"M", Volume 14, Page 317.
PUBLICATION COPY This ad # 0002224715 ran on the dates shown below:
August 17, 2012
, August 24, 2012
NOTICEISHEREBYGIventhat� ~ . � r.. /� August 31� 2��2
Letters�Testamentarvin;the�Esfataop,_.�� r (
Rabert Earl Snell lafe�ot'CamP HIIC;:, " , i ,,
Borauvh,Cumberland Caiiat�e ; �
PennsxlvaNa;,was3srantetliYathe :.' . . . . . . . . . . .
underslaned;and"all persons thdebtedTo �;�
Estate�arerequlred:tcrrmkefmroedlate ,,�, , .. '.
aarmentnndthose.havtnp<clalmsrvlll §� ! ,
prD�idme elha gh�ExY.,�ta - SW t0 nd ubs bed be e e th" 1 y of August, 2012 A.D.
c/o.LPsaMari'e.�oYne Hsqutra �
Cayne&4oyne P C , �s ,/�/
39p1 MarketStreeN ' ;�,� 1` ��y/�,�{ /
Camp HIII PA.17011-4227' ( ,��/
, ,
Notary Public
CQM^,,, MONWEAI.7H OF PENNSYLVANIA
Notarial Seal
- , Sherrie l.Qwens,Notary Public
Lawer Paxkon Twp.,Oauphin County
My Commission F�pires Nov.26,2015 / " «
MEMBER,pENNSYLVANIA A5SQCIAYSON OF NOTARIES �X�7/��� A
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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:
Aug,ust 17, August 24, and Au st 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.
� __�
is Marie Coyne, Edit
SWORN TO AND SUBSCRIBED before me this
31 dav of August, 2012
�
Snell,Robert Eari, dec'd. NOt�I.y
Late of Camp Hill Borough.
Executor: David L. Deibaugh c/o
Lisa Marie Coyne,Esquire,Coyne
& Coyne, P.C., 3901 Market
Street, Camp Hill, PA 17011- °
4227. tJ03ARiAL SEAL
Attorneys: Lisa Marie Coyne, Es- ' D�BpRAH A COLUNS
quire,Coyne&Coyne,P.C.,3901 Notary Public
Mazket Street, Camp Hill, PA ��RLISLE 90R011GH,CUMBERLANO COUNTY
17011-4227. ,yty Commfssion Expires Apr 28,2014 � �
�
FIRST AND FINAL ACCOUNTING
AND
PROPOSED SCHEDULE OF FINAL DISTRIBUTION
DAVID L. DELBAUGH, EXECUTOR
for
Estate of Robert E. Snell, Deceased
21-12-0732
Date of Death: 6/22/2012
Date of Executor Appointment: 7/17/2012
Date of First Complete Advertisement of Letter: 8/17/2012
Accounting for the Period: 7/17/2012 thru 9/30/2013
PURPOSE OF ACCOUNT:
David L. Delbaugh,Executor offers this account to acquaint interested parties with the
transcations that have occurred during the Administration.
It is important that the Account be carefully examined Requests for additional
information, questions or objections can be discussed with :
COYNE & COYNE,PC
Lisa Marie Coyne,Attorney
Pa. Supreme Ct.No. 53788
3901 Market Street
Camp Hill,PA 17011-4227
717-737-0464
Attorney For Estate
f_x��� �� f,� �
A B C D E
1
2 ESTATE OF ROBERT E.SNELL,DECEASED
3 RECEIPTS OF PRINCIPAL
4
5 Fiduciary
6 Assets Listed in Inventory Ac uisition
7 Yalued as of Date of Death Value
8
9 Date Cash:
10 Date of Death Susquehanna Bank Checking Acct.No.XXXXX��8809 6 623.53 $ 6,623.53
11
12
13 Tan�ible Personal Pronertv and Receipts Subsequent to DOD:
14 Interest $ 0.27
15 Interest $ 0.20
16 Pension Payment $ 726.88
17 Refund of Headstone Engraving $ 32.00 $ 75935
18 $ 7,382.88
19 TOTAL RECEIPTS OF PRINCIPAL
20
2� DISBURSEMENTS OF PRINCIPAL
22
23 Debts and Expenses:
24 Date Check# Amount
25 9/7/2012 1001 Cumberland Law Journal(le al ad $ 75.00
26 9/11/2012 1002 Patriot News(legal ad) $ 109.52
27 9/19/2012 1003 David Delbau (reimbursement for funeral luncheon) $ 40.67
28 9/19/2012 1004 Barners Cemetery Association( ave care) $ 100.00
29 10/2/2012 1005 Register of Wills(filing fee for Inheritance Taac Return) $ 15.00
30 3/30/2013 Bank fee for Pa er Statement $ 3.00
31 4/30/2013 Bank fee for Pa er Statement $ 3.00
32 5/13/2013 1006 David Delbau robate fees-reimbursed to executor) $ 128.50
33 10/15/2013 1007 Register of Wills(Filing Fee for First and Final Accounting) $ 215.00 $ 689.69
34 TOTAL DISBURS�MENT OFPRINCIPAL: $ 689.69
35
36
A B C D E
37 Total Recei ts and Princi al $ 7,382.88
38 Total Distributions of Principal $ 689.69
39
40 TOTAL NET ESTATE $ 6,693.19
41
42 Proposed Schedule of Final Distributions To:
43
44 Final Administrative Costs:
45 Coyne&Coyne,PC-Attomey Fees $ 1,500.00
46 David Delbaugh Executor--Executor Commission $ 332.00
47 Reserves 300.00 $ 2,132.00
48
49 Creditors Claims:
50 Department of Welfare--Class 3 Claim Due($17,977.55) $ 4,561.19
51 Deparkment of Public Welfare--Class 5.1 Claim Due($35,494.25) $0.00
52 American Ex ress Claim(West Management)($20,719.02) 0.00 $ 4,561.19
53
54 Heirs:
55 David L.Delbauch,Residual Heir 0.00 0.00
56
57 Total Distribution: $ 6,693.19
58
59 David L.Delbaugh,Executor of the Estate of Robert E. Snell,deceased,hereby declares an oath
60 that he has fully and faithfully discharged the duties of his office;that the foregoing First and Final
61 Account and Proposed Schedule of Distribution is true and correct and full discloses all the
62 significant transactions occurring durin the accounting eriod;and that all lrnown claims against
63 the Estate have been aid in full;that to hisirnowledge,there are no claims now outstanding
64 against the Estate;and that all taxes presently duehave been aid.
65
66 '
67 David L. baugh,Ext
68 Sworn and subscribed before
69 me this day of
`?0 G 2013
71
72 �
73 �— ---_'�
74 N ary Public
75
76
COM ONWEltIfM Of PENN�S;YlyICMI
NOTARUt SEAL
Ltsa Marie Coyne, Notary Public
Mompden Township,Cumbsrland CouMy
MY Commis:ion Explre=June 10,201 b