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HomeMy WebLinkAbout03-14-14 9oL4 ,-Igq.c6 DECEDENT'S ESTATE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF Kenneth E. McClain II DECEASED No. 21-13-0376 PETITION FOR ADJUDICATION I 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. INCLUDE ATTACHMENTS AT THE BACK OF THIS FORM. Name of Counsel: Bradley L Griffie Supreme Court I.D. No.: 34349 Name of Law Firm: Griffie&Associates, P.C. Address: 200 North Hanover Street Carlisle, PA 17013 CD = T� Telephone: 717-243-5551 r°Ti'� �='cc�5 Fax 717-243-5063 �>> a j' c ; , E-mail: _- - :74 rifle @grifielaw.com - � r rl p L7 1.0 T Form OC-01 Rev 10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc Page 1 of 10 PETITION FOR ADJUDICATION Estate of Kenneth E. McClain II Deceased 1. Name(s) and address(es) of Petitioner(s): Name. Penny E.Zimmerman Address: 425 Steelstown Road Newville, PA 17241 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 03/25/2013 ® Letters Testamentary or ❑ Letters of Administration were granted to Petitioner(s) on 04/03/2013 Date of Will (if applicable): 03/06/2013 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 ❑ No Dates of advertising of the grant of Letters: 04/1912013 04126/2013 05/03/2013 04/1012013 04/17/2013 04/24/2013 Form OC-01 Rev.10.132006 Copyright(c)2006 torn SON am oNy no Lackner Group.Inc. Page 2 Or 10 Estate of Kenneth E. McClain II Deceased 3. Was decedent survived by a spouse?....................................................................... ❑ Yes ❑X 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 sue. 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 the decedent marry after execution of Will or Codicil(s)?.............................................. ❑ Yes ® No Were any children born to decedent after execution of Willor Codicil(s)? ............................................................................................................... ❑ Yes ❑X 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-01 Rev 10-13-2006 Copyright(c)2006 form software omy The Lackner Group,Inc. Page 3 of 10 PETITION FOR ADJUDICATION Estate of Kenneth E. McClain II 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 of Each Part in Interest, Relationship and Comments,if any Interest Penny E. Zimmerman None 100% of net 425 Steelstown Road distributable estate Newville, PA 17241 Form OC-01 Rev 10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc Page 4 of 10 Estate of Kenneth E. McClain II Deceased Name and Address of Each Party in Interest Relationship and Comments,1fany 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. C. State why a Petition for GuardianfTrustee Ad Litem has or has not been filed for this Audit (see PA. 0.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. Form OC-01 Rev 10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 5 of 10 PETITION FOR ADJUDICATION Estate of Kenneth E. McClain II 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 Amountof Claim Claim Will Claim AtlmRted? Be Paldm Full? Above Attachment Total 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 OC•01 Rev 10-13-2006 Copyright(c)2006 form software only The Lackner Group Inc. Page 6 of 10 I _�.14 Estate of Kenneth E. McClain II 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 06121/2013 28,372.83 06/2112013 -1,418.64 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: 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 Re,10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc Page 7 of 10 Estate of Kenneth E. McClain II Deceased 16. Had the decedent been adjudicated an incapacitated person?........................................... ❑ Yes ® No 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. Date Description 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 Form OC-01 Rev 10-13-2006 Copyright(c)2006 form sofhaare only The Lackner Group,Inc. Page 8 of 10 PETITION FOR ADJUOICATION Estate of Kenneth E. McClain II , 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: Prmposed Oistnbutee(s) Amount Proportion Penny E.Zimmerman 100% B. Principal: Pmeosed Oistnbutee(s) Amount Proportion Penny E. Zimmerman 100% Submitted By: (All petitioners must sign. Add additional lines if necessary): Nam�titioner: P nny E.Zimmerman Name of Petitioner: Name of Petitioner: Form OC-01 Rev 10-13-2006 Copyright(c)2005 farm software only The Lackner Group,Inc. Page 9 of 10 PETITION FOR ADJUDICATION Estate of Kenneth E. McClain II Deceased Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies * [that neisne _is tine 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). Signatur f Petitioner 0 enny E.Zimmerman Signature of Petitioner 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. ign ou el for etitioner a ie/ Form OC-01 Rev 10-13-2006 Copyright(q 2006 form software only The Lackner Group,Inc. Page 10 of 10 PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Jackie Cox,Sales Director, of The Sentinel, of the County and State aforesaid,being duly sworn, deposes and says that THE SENTINEL, a newspaper of general circulation in the Borough of Carlisle, County and State aforesaid,was established December 13th, 1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice or publication attached hereto is exactly the same as was printed and published in the regular editions and issues of THE SENTINEL on the following day(s): April 10, 17&24, 2013 COPY OF NOTICE OF PUBLICATION w X•ECU NG'pIS3E i i4et tern:Teatamenra%ch the JEtatate�of'NBNNE'ARE.UNnCLAINi.tl,late 01 5over Spdne'UawnaJl Cutubarim ul:0ouruy,:Pennsylvania,deceased, i Affiant further deposes that he/she is not trava�neen.g�gntedaatne UruYarslgnad. interested in the subject matter of the AU,perannsknowiileftliemaehiestene mdanted.teealG Estate w7R make paymettlimmealataty,..andltliosemavnagrciatma wtnprese"tahem,w� aforesaid notice or advertisement, and that �ae8lenl all allegations in the foregoing statement as Peony as byL,Bwlm Eagau'e to time,place and character of publication •GRtimir&AasoWi ARs 200,NOM+Hanover BiFeeR - I u . 'Cad als�PA 17,09:3 I Sworn to d WI DO. ed bee this I�J � /� 1111 1 ��II u✓' r lX��/WOVJ� No Public My commission expires: NOTARIAL SEAL BAMBI ANN HECKENDORN Notary Public CARLISLE BOROUGH,CUMBERLAND CNTY My Commission Expires Jan 27,2014 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: April 19 Apri126 and May 3 2013 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. Lis Marie Coyne; ditor SWORN TO AND SUBSCRIBED before me this 3 day of May, 2013 Notary McClain,Kenneth E.,II,deed. Late of Silver Spring Township. Executrix: Penny E. zinunennan c/o Bradley L. Griffie, Esquire, Griffie & Associates, 200 North NOTARIAL SEAL Hanover Street,Carlisle;PA 17013. DEBORAH A COLLINS Attorneys: Bradley L. Griffie, Es- Notary Public quire,Griffre&Associates. CARLISLE BOROUGH,CUMBERLAND COUNTY My Commission Expires Apr 28,2014 In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division File No. 21-13-0376 Estate of Kenneth E. McClain II, Deceased Late of Township of Silver Spring First and Final Account Penny E. Zimmerman, Executrix Date of Death: 03/2512013 Date of Incapacity, if any: None Date of Executrix's Appointment: 04/03/2013 Date of First Complete Advertisement: Accounting for the period: 03125/2013 to 03/0112014 Purpose of Account: Penny E.Zimmerman, Executrix, 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: Bradley L Griffie Griffie&Associates, P.C. 200 North Hanover Street Carlisle, PA 17013 717-243-5551 C--O 7 Supreme Court I.D. `5 D. No. 34349 m� . r :V -� y C) 4J� SUMMARY OF ACCOUNT Estate of Kenneth E. McClain 11, Deceased For the neriod of March 25 2013 through March 1. 2014 PAGES PRINCIPAL Receipts: This Account A 204,744.05 Net Gain (or Loss) on Sales or Other Dispositions 0.00 204,744.05 Less Disbursements: C Debts of Decedent 4,140.63 Funeral Expenses 0.00 Administration Expenses 1,638.85 Federal, State& Local Taxes 26,954.19 Commissions 0.00 Fees 8,165.00 Family Exemption 0.00 40,898.67 Balance Before Distributions 163,845.38 Transfer to (from) Principal TP 0.00 Distributions to Beneficiaries D 161,941.00 Principal Balance on Hand PBOH 1,904.38 For Information: Investments Made Changes in Holdings F INCOME Receipts This Account 0.00 Net Gain (or Loss) on Sales 0.00 or Other Dispositions 0.00 Less Disbursements 0.00 Balance Before Distributions 0.00 Transfer to (from) Income TI 0.00 Distributions to Beneficiaries 0.00 Income Balance on Hand 0.00 For Information: Investments Made Changes in Holdings COMBINED BALANCE ON HAND CBOH 1,904.38 Signature Verification SCHEDULE A RECEIPTS OF PRINCIPAL Assets Listed in Inventory Fiduciary (Valued as of Date of Death) Acquisition Value Cash 2012 Personal Income Tax Refund(IRS) 1,027.00 Andrews& Patel Assoc. (Medical bill payment refund) 60.00 Comcast Refund 47.65 Guardian LTC Pharmacy, refund of overpayment 12.05 Progressive Insurance Premium Refund 11.00 PSECU (Checking Account No.XXXXXXXXX431) 725.72 PSECU (Money Handler Account No. 3,459.04 XXXXXXXXXX431) PSECU (Money Market Account No. 46,145.97 XXXXXXXXXX431) QLT Consumer Lease Services-Refund 5.62 Refund for Adoption costs 10.00 Veterans Affairs benefit distribution 100.00 Westfield Insurance Refund 111.00 Westfield Insurance Refund 88.00 Total Cash 51,803.05 Personal PropatU 1967 Triumph Motorcycle T1 20R 800.00 1977 Kawasaki KZ1000A 1,000.00 1992 Chevrolet K1500(VIN#GCEK14K1 NE158827) 250.00 1997 Chevrolet Tahoe(VIN#1GNEK13RXVJ411138) 196.00 2011 Chevrolet Van 16,000.00 Household Furnishings(Appraised) 4,695.00 Total Personal Property 22,941.00 Real Estate 213 Ridge Hill Road-Mechanicsburg, PA 17050 130,000.00 (Residential) Total Real Estate 130,000.00 Total Receipts 204,744.05 Total Receipts of Principal 204,744.05 A-1 SCHEDULE C DISBURSEMENTS OF PRINCIPAL Debts of Decedent Forest Park Health Center 04/26/2013 1,704.00 1,704.00 Graham Medical Clinic. PC (Medical! 0412612013 10.00 10.00 Griffle&Associates (Pre-death Adoption proceedings) 04/26/2013 748.50 748.50 Griffie &Associates (Pre-death Estate Planning Docs) 04/26/2013 419.50 419.50 Guardian LongTermCare Pharmacy (Medical) 04/26/2013 12.05 12.05 Holy Spirit Hosoital 04/26/2013 42.50 42.50 PA American Water 04/26/2013 - 14.21 14.21 C-1 SCHEDULE C DISBURSEMENTS OF PRINCIPAL Continued PPL Electric Utilities 04/26/2013 52.18 52.18 Silver Spring Two. Authority (Sewer) 04/26/2013 166.10 166.10 State Employees Retirement System (SERS) 07/15/2013 647.37 Refund of overpayment 647.37 Sterling Medical Services. LLC (Medical) 04/2612013 147.00 147.00 West Shore EMS-BLS 04/26/2013 177.22 177.22 Total Debts of Decedent 4.140.63 Administration Expenses Advertisina to Sentinel 05/07/2013 168.30 168.30 Bank fees to Orrstown Bank 05/07/2013 12.50 C-2 SCHEDULE C DISBURSEMENTS OF PRINCIPAL Continued 12.50 Barrett's Real Estate - Real estate aporaisal costs 04/26/2013 375.00 375.00 Cumberland Law Journal 04/26/2013 (Advertising) 75.00 75.00 Erie Insurance Group (Homeowner's) 05/13/2013 55.00 55.00 Linden Hall Antiaues - Personal property appraisal costs 04/26/2013 95.00 95.00 PA American Water 06/10/2013 29.71 29.71 PPL Electric Utilities 05107/2013 78.94 78.94 Probate fees 03/01/2014 613.50 613.50 C-3 SCHEDULE C DISBURSEMENTS OF PRINCIPAL Continued Silver Spring Township Authority (Sewer) 07/15/2013 135.90 135.90 Total Miscellaneous Administrative Exoenses 1,638.85 Federal. State. and Local Taxes scount 0612012013 -1,418.64 -1,418.64 PA Department of Revenue 06/20/2013 28,372.83 28,372.83 Total Taxes 26,954.19 Fees Griffie &Associates 03/01/2014 8,000.00 8.000.00 Howard's Accountina (2012 Personal Return Preparation) 04/26/2013 165.00 165.00 Total Fees 8,165.00 TOTAL DISBURSEMENTS OF PRINCIPAL 40,898.67 C-4 SCHEDULE D DISTRIBUTIONS OF PRINCIPAL 06/20/2013 Interim Distribution to Penny E.Zimmerman 15,000.00 06/2012013 Transfer of four vehicles to Penny E. Zimmerman 2,246.00 06/2012013 Transfer of personal property to Penny E.Zimmerman 4,695.00 06/21/2013 Transfer of Real Estate to Penny E. Zimmerman 130,000.00 09/11/2013 Interim Distribution to Penny E. Zimmerman 10,000.00 161,941.00 TOTAL DISTRIBUTIONS TO BENEFICIARIES 161,941.00 D-1 PRINCIPAL BALANCE ON HAND Current Value Fiduciary 03/0112014 Acquisition # Units Description or as Noted Value Cash [BankOut Name] -26,954.19 -26,954.19 Orrstown Bank -13,944.48 -13,944.48 Total Cash -40,898.67 -40,898.67 ACCP}C 1967 Triumph Motorcycle T120R 800.00 1977 Kawasaki KZ1000A 1,000.00 1992 Chevrolet K1500(VIN#GCEK14K1 NE158827) 250.00 1997 Chevrolet Tahoe(VIN#1GNEK13RXVJ411138) 196.00 2011 Chevrolet Van 16,000.00 2012 Personal Income Tax Refund (IRS) 1,027.00 213 Ridge Hill Road 130,000.00 Andrews&Patel Assoc. (Medical bill payment refund) 60.00 Comcast Refund 47.65 Guardian LTC Pharmacy, refund of overpayment 12.05 Household Furnishings(Appraised) 4,695.00 Interim Distribution to Penny E.Zimmerman -25,000.00 Progressive Insurance Premium Refund 11.00 PSECU (Checking Account No.XXXXXXXXX431) 725.72 PSECU (Money Handler Account No.XXXXXXXXXX431) 3,459.04 PSECU (Money Market Account No. XXXXXXXXXX431) 46,145.97 QLT Consumer Lease Services -Refund 5.62 Refund for Adoption costs 10.00 Transfer of four vehicles to Penny E.Zimmerman -2,246.00 Transfer of personal property to Penny E.Zimmerman -4,695.00 Transfer of Real Estate to Penny E.Zimmerman -130,000.00 Veterans Affairs benefit distribution 100.00 Westfield Insurance Refund 199.00 Total Assets 42,803.05 -40,898.67 1,904.38 PBOH-1 PROPOSED DISTRIBUTIONS TO BENEFICIARIES Current Value Fiduciary 03/0112014 Acquisition or as noted Value TO: Penny E.Zimmerman 1,904.38 1,904.38 Total 1,904.38 PD-1 In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division File No. 21-13-0376 Estate of Kenneth E. McClain II, Deceased Signature Penny E.Z erman, xe utrix In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division File No. 21-13-0376 Estate of Kenneth E. McClain II, Deceased Verification Penny E.Zimmerman, Executrix under the Last Will and Testament of Kenneth E. McClain II, Deceased, hereby declares under oath that he/she has fully and faithfully discharged the duties of his/her 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 his/her knowledge, there are no claims now outstanding against the Estate; that all taxes presently due from the Estate have been paid; and that the grant of Letters Testamentary and the first complete advertisement thereof occurred more than four months before the foregoing Account. This statement is made subject to penalties of 18 Pa. C.S.A. Section 4904 relating to unsworn falsification to authorities. Dated: �s i D- �� �RMivwY Penny E.Zi merman, E'a 4itrix I hereby certify that written notice of the filing of this Account, and of the date,time and place when the same will be presented to the Court for confirmation and of the last day to file written objections to said Account, has been given to every unpaid claimant and to every other person known to the accountant to have or claim an interest in the estate as creditor, beneficiary, heir, or next of kin_ riff