HomeMy WebLinkAbout05-01-14 (2) DECEDENT'S ESTATE
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
ESTATE OF RICHARD F. GALLINA -, DECEASED
No. 21-13-0756
PETITION FOR ADJUDICATION/
STATEMENT OF PROPOSED DISTRIBUTION
PURSUANT TO Pa. O.C. Rule 6.9
This form maybe 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.
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INCL UDE ATTACHMENTS AT THE BACK OF THIS FORM. 'm
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Name of Counsel: Jennifer B. Hipp, Esquire oa E - 3 :* M
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Supreme Court I.D. No.: 86556 a '{ r [_ o
James D. Bo gar Law Offices `L
Name of Law Firm: g
Address: One West Main Street, Shiremanstown, PA 17011
Telephone: (717) 737-8761
Fax: (717) 737 2086
Form oc-01 rev. 10.13.06 Page I of 10
Estate of RICHARD F. GALLINA Deceased
1. Name(s) and address(es)of Petitioner(s):
Name_ Alice J.Gallina
Address: 430 Spring House Road
Camp Hill,PA 17011
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? . . . . . . . . . . . . . . . . . . . . . M Yes ® No
If not, identify prior accountings,the accounting periods covered, and the date of
adjudication of the prior accounting.
2. Decedent died on Mav 28, 2013
Letters Testamentary or MLetters of Administration were granted to Petitioner(s)on
Julv 9. 2013
Date of Will (if applicable): September 24, 2007
Date(s) ofCodicil(s) (:'applicable): N/A
Date of probate (if different from date Letters granted):
Was a bond required? Yes FA No If yes, state amount:
Are proofs of advertising of the grant of Letters attached? . . . . . . . . . 0 Yes 0 No
Dates of advertising of the grant of Letters:The Sentinel -7/9/13, 7/16/13, 7123/13
Cumberland Law Journal - 7/19/13, 7/26/13, 8/2/13
Form oC-oi rev.10.13.06 Page 2 of 10
Estate of RICHARD F. GALLINA Deceased
3. Was decedent survived by a spouse? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ®Yes 0 N
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):
N/A
6. Did decedent marry after execution of Will or Codicil(s)? . . . . . . . . . . . E]Yes R] No
Were any children born to decedent after execution of
Will or Codicil(s)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 Yes M 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MYes ® No
Form oC-01 rev. 10.13.06 Page 3 of 10
Estate of RICHARD F. GALLINA 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 acrd Address a Each Farly in Snterest Relationship and Comments,ifany Interest
Please see attached.
Farm oC-01 rev.10.13.06 Page 4 of 10
Estate of RICHARD F. GALLINA Deceased
Name and Address ofF.ach Party in Interest ( Retationshii,and Comments,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.
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.
Farm oC-01 rev, 10.13.06 Page 5 of 10
Estate of RICHARD F. GALLINA 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 Minim I Amoum afClaim Claim Will Claim
Admined? Be Paid In
Full?
None ElYes Yes
®No No
E]Yes OYes
ONo ONo
MY., MYes
nNo (3 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 1I✓ No
Was family exemption allowed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ®Yes E-1- No
Family exemption claimant's name and relationship:
Name: Relm+onship:
Form OC-01 rev. /0.13.06 Page 6 of 10
Estate of RICHARD F. GAUINA 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
8/27/13 24,228.01
11 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
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.
FormOC-n7 rev. IO.IJ.bb Page 7 of 10
Estate of RICHARD F. GALLINA Deceased
16. Had the decedent been adjudicated an incapacitated person? . . . . . . . . . . F-1, Yes ® No
If yes, attach a copy of the Order if available; otherwise state the Court, term, number,
date,and name of Hearing .fudge.
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 0 No
18. If a reserve is requested, state amount and purpose.
Amount: 1,250,00
P rp°e Costs to conclude administration of the Estate, including preparation and
filing of Court Accounting, Petition for Adjudication and preparation and
filing of Fiduciary Income Tax Returns.
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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [3Yes MNo
If so, attach a copy of the notice.
19. Is the Court being asked to direct
the filing of a Schedule of Distribution? . . . . . . . . . . . . . . . . . . . . . . . . . . Yes MNo
As to real estate only? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E3Yes M No
Form oC-oI rev, 10.13.06 Page 8 of 10
Estate of RICHARD F. GALLINA 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) AmoundPropordon
Please see attached.
B. Principal:
Proposed Distributee(s) AmountlProportion
Please see attached.
Submitted By:
(All petitioners must sign.
Add additional lines if necessary):
Name of Petit Alice J. Gallina
Name of Petitioner:
Rom oC-oI rev, f0./3.66 Page 9 of 10
Estate of RICHARD F. GALLINA Deceased
Verification of Petitioner
(Verification must be by at least one petitioner.)
The undersigned hereby verifies * [that neishe is titre
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).
Signaturet etitioner
*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.
d
ra
S4igtudre f Counsel for Petitioner
FormoC-01 rev. 10.13.06 Page 10 of 10
Petition for Adjudication (continued)
9 . A.
Name and Address Relationship Interest
Alice Jane Gallina Daughter 25% of rest,
430 Spring House Road residue and
Camp Hill, PA 17011 remainder
Joseph M. Gallina Grandson 12 . 5% of rest,
975 W. Matterstown Road residue and
Millersburg, PA 17061 remainder
Ann M. Gallina Granddaughter 12 . 5% of rest,
6191 Haymarket Way residue and
Mechanicsburg, PA 17050 remainder
Richard A. Gallina Son 25% of rest,
6156 East Preston residue and
Mesa, AZ 85215 remainder
Elizabeth A. Wroga Daughter 25% of rest,
9803 Autumn Lane residue and
Woodstock, IL 60098 remainder
Humane Society of Charity $1, 000 . 00
Harrisburg Area, Inc. Specific
7790 Grayson Road Bequest
Harrisburg, PA 17111
Proposed Distributions (Includes Principal and Income) :
Alice J. Gallina $ 757 . 76
Joseph M. Gallina $ 631. 39
Ann M. Gallina $ 631 . 39
Richard A. Gallina $1, 262 . 76
Elizabeth A. Wroga $1, 262 . 76
Humane Society of
Harrisburg Area, Inc . $1, 000 . 00
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587,approved May 16, 1929), R 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:
July 19, July 26, and August 2, 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.
sa Marie Coyne,Ed' or
SWORN TO AND SUBSCRIBED before me this
(( 2 day�gust,2013
Notary
Oallina,Richard F.,decd. `
late of Hampden Township.
Executrix: Alice Jane Gallind c/o
Jennifer B. Hipp, Esquire, One
West Main Street,Shiremanstown, NOTARIAL SEAL
PA 17011. DEBORAH A COLLINS
Attorney:Jennifer B.Hipp,Esquire, Notary Public
One West Main Street,Shiremans- CARLISLE BOROUGH,CUMBERLAND COUNTY
town,PA 17011. My Commission Expires Apr 28.2014
PROOF OF PUBLICATION
State of Pennsylvania,County of Cumberland
ackie Cox,Director of Sales of The Sentinel, of the County and State aforesaid,being
duly swom,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):
July 9,16,23 2013
COPY OF NOTICE OF PUBLICATION
� �- EXECUTOR'S NOTICE
Estate of RICHARD F.GALL/NA Affiant further deposes that he/she is not .
l Letters Testamentary on One Estate of Richard F.Gallina,Late of HamPdon Interested in the subject matter of the
Township,Cumberland County,Penn Name,have been granted tome
undersigned.All persons knowing themselves to be Indebted to said Estate aforesaid notice or advertisement,and that
are requested to make Immediate payment,and those having claims will
present them,without delay,for settlement to'- all allegations in the foregoing Statement as
Alice Jane Gaging,Executor to time,place and character of publication
do Jennifer S.Hipp,Esquire
One west Main Street re true. ,(�f'J�)
Shiremanstown,PA 17011 '
Sworn to and subscribed before me this
nA
Notary hublic
My commission expires:
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
BethaDy M.Ho{by,Notary Public
Cadiste Boro,Cumberland County
My Commis90n Expires Sept 26,2015
MEMBER,PENNSYLVANIA ASSOCIATION OF NOTARIES
In the Court of Common Pleas of Cumberland County, Pennsylvania
Orphans' Court Division
File No. 21-13-0756
Estate of Richard F.Galiina Deceased
Late of Hampden Township
FIRST AND FINAL ACCOUNT
AND STATEMENT OF PROPOSED DISTRIBUTION
Alice Jane Gallina, Executrix
Date of Death: 05/28/2013
Date of Executrix's Appointment: 07/0912013
Date Of First Complete Advertisement: The Sentinel 7/9113;7116/13;7123113 Cumberland Law Journal 7/19/13;7/26/13;812/13
Accounting for the period: 05/2812013 to 04/28/2014
Purpose of Account: Alice Jane Gallina, 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: C3 o
c M
o m
rn
Jennifer B.Hipp m �o o
Bogar and Hipp Law Offices a r c � v
1 West Main Street a can r—+ o
Shiremanstown, PA 17011 0 ? � m
ZE
717-737-8761 �CD co M
Supreme Court I.D. No.86556
*NOTE: This accounting .has been prepared in accordance with
information provided by the Executrix, particularly
with respect to reimbursements, expenses, distributions
and fund balances. All bank and investment accounts
were maintained and redeemed by Alice Jane Gallina,
Executrix.
SUMMARY OF ACCOUNT
Estate of Richard F. Gallina, Deceased
For the period of May 28 9Q.j131hMIJ9hAP1iL2L.2QJA
Fiduciary
Current Acquisition
Proposed Distributions PAGES Value Value
to Beneficiaries 8 5,546.06
PRINCIPAL
Receipts: This Account 1-2 40,161.57
Net Gain (or Loss)on Sales
or Other Dispositions 3 113.56
Less Disbursements: 40,275.13
Debts of Decedent 0.00
Funeral Expenses 4 654.00
Administration Expenses 4 2,111.54
Federal, State& Local Taxes 4 24,228.01
Commissions 0.00
Fees 5 7,350.00
Family Exemption 0.00 34,343.55
Balance Before Distributions 5,931.58
Transfer to(from) Principal 0.00
Distributions to Beneficiaries 6 505.00
Principal Balance on Hand 5,426.58
For Information:
Investments Made
Changes in Holdings
INCOME
Receipts This Account 7 119.48
Net Gain (or Loss)on Sales 0.00
or Other Dispositions
119.48
Less Disbursements 0.00
Balance Before Distributions 119.48
Transfer to (from) Income - 0.00
Distributions to Beneficiaries 0.00
Income Balance on Hand 119.48
For Information:
Investments Made
Changes in Holdings
COMBINED BALANCE ON HAND 5,546.06
SCHEDULE A
RECEIPTS OF PRINCIPAL
Assets Listed in Inventory
(Valued as of Date of Death) Fiduciary
Acquisition
Value
SiSS�t
AARP-2 checks totaling$1.69-reimbursement for 1.69
medical expenses. The Decedent had these checks
in his possession,but had not yet cashed them.
M&T Sank-Checking Account No.491225. Principal 4,886.73
balance at date of death$4,886.71;accrued interest
$0.02.
NCFCU-Savings Account No.54720-St. Date of 4,224.13
death balance$4,224.13.
NCFCU-Checking Account No. 5472054. Date of 1,744.32
death balance$1,744.32.
NCFCU-Money Market Account No.54720-53. Date 1,246.00
of death balance$1,246.00.
Kinkora Pythian Home-Refund 740.00
Commonwealth of Pennsylvania-2012 Personal 187.00
Income Tax Refund
American General -monthly annuity payment 38.00
Members 1st Federal Credit Union-cash deposit to 5,00
open Estate savings account
Alice J. Gallina-contribution of personal funds to 24,228.01
pay Pennsylvania Inheritance Taxes
AARP/Medicare Refund 2.73
AARP/Modicare Refund 2.74
MetLife-Insurance policy payable to Estate 1,057.39
Commonwealth of Pennsylvania -Unclaimed 5.00
Property
Members 1st Federal Credit Union-additional funds 7,95
received re closeout of Decedent's personal savings
account
Senior Helpers-Refund 210.00
Total Cash 38,586.69
Personal Fre ert r
Personal Property/Household Contents -sold at 500.00
private sale
Total Personal Property 500.00
SCHEDULE A
RECEIPTS OF PRINCIPAL
Continued
Fiduciary
Acquisition
Value
to kc/I ic4ar�
25.00000 shares MetLife
1,074.88
Total Stocks/Listed
1,074.88
Total Receipts 40,161s7
Total Receipts of Principal 40,161.57
- 2 -
SCHEDULE B
GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS - PRINCIPAL
W LOSS
08/26/2013 MetLife
Net Proceeds 1,188.44
Fiduciary Acquisition Value -1,074.88 113.56
TOTAL GAINS AND LOSSES/PRINCIPAL 113.56
LESS LOSS
NET GAIN OR LOSS 56
- 3 -
SCHEDULE C
DISBURSEMENTS OF PRINCIPAL
F rn ral Expenses
06/2512013 Carraba's-funeral luncheon 277.00
06/25/2013 Myers-Harper Funeral Home-balance of funeral 377.00
expenses
Total Funeral Exoenses 664.00
Administration Expenses
07/0812013 Cumberland Law Journal-Executrix's Notice 75.00
07/08/2013 Register of Wills-probate fees 138.50
0711612013 Register of Wills-2 Short.Certificates 10.00
07/2912013 Members 1st Federal Credit Union-fee for temporary 4.00
checks
08/01/2013 American General -reclamation of monthly annuity 48.00
payment,plus stop payment fee
08/0112013 The Sentinel-Executrix's Notice 157.68
08/0812013 Register of Wills-3 Short Certificates 15.00
08127/2013 Register of Wills-Additional probate 15.00
09/18/2013 MetLife-return of overpayment 105.36
03/14/2014 Commonwealth of PA-2013 Personal Income Tax 168.00
payment
03/14/2014 Duane E.Herman,CPA-fee to prepare 2013 Personal 125.00
Income Tax Returns -
RESERVES:-Costs to conclude administration of 1,250.06
Estate,including filing PA Inheritance Tax Return and
Inventory, preparation and filing of final Personal
Income Tax Returns and Fiduciary Income Tax
Returns
Total Miscellaneous Administrative Exoenses 2,111.54
Federal, State. and Local Taxes
0 812 712 01 3 Register of Wills,Agent-Pennsylvania Inheritance 24,228.01
Taxes paid at 5%discount
-4 -
SCHEDULE C
DISBURSEMENTS OF PRINCIPAL
Continued
Total Taxes 24,228.01
Fees
08/27/2013 Jennifer B. Hipp, Esquire-fees for representation of 4,900.00
Estate per agreement
Jennifer B. Hipp, Esquire-fees for representation of 2,450.00
Estate per agreement _
Total Fees 7,350.00
TOTAL DISBURSEMENTS OF PRINCIPAL 34,343.55
- 5 -
SCHEDULE D
DISTRIBUTIONS OF PRINCIPAL
05/29/2013 Alice J.Gallina-"In kind"distribution of personal 500.00
property
10/2412013 Alice J. Gallina-Distribution of Unclaimed Property 5.00
Refund
505.00
TOTAL DISTRIBUTIONS TO BENEFICIARIES 505.00
SCHEDULE G
RECEIPTS OF INCOME
Dividend
0712912013 MetLife-dividend 6.88
TOTAL DIVIDEND INCOME
Interest/Bank
07/29/2013 M&T Bank-Checking Account No.491225. Interest 105.44
earned in personal account from date of death
through closeout.
07/29/2013 NCFCU-Interest earned in personal accounts from 2.19
date of death through closeout
03/31/2014 Members 1st Federal Credit Union-Interest earned in 4.97
Estate accounts through March 31,2104
TOTAL BANK INTEREST 112.60
TOTAL RECEIPTS OF INCOME
_ 7 _
PROPOSED DISTRIBUTIONS TO BENEFICIARIES
Current Value Fiduciary
04/28/2014 Acquisition
or as noted Value
TO:
Alice J.Gallina-Proposed Distribution
Ann M. Gallina -Proposed Distribution 757.76
631.39
Elizabeth A.Wroga-Proposed Distribution 1,262.76
Joseph M.Gallina-Proposed Distribution 631.39
Richard A, Gallina-Proposed Distribution 1,262.76
4,546.06
TO: Humane- o i tv of Harrisb rg Ar - In
Humane Society of Harrisburg Area, Inc.-Specific Bequest 1,000.00
1,000.00
Total 5,546.06
_ g _
In the Court of Common Pleas of Cumberland County, Pennsylvania
Orphans' Court Division
File No. 21-13-0756
Estate of Richard F. Gallina,Deceased
Verification
Alice Jane Gallina,Executrix under the Last Will and Testament of Richard F.Gallina,Deceased,
hereby declares under oath that he/she has fully and faithfully discharged the duties of hither
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 1S Pa.C.S.A.Section 4904 relating to unsworn
falsification to authorities.
Dated: y� �! zf %✓.Cx� r��Y X C'
Alice Jane G°na,Executrix