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HomeMy WebLinkAbout07-23-14 Le COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,PENNSYLVANIA ORPHANS' COURT DIVISION FILE NO. 21 -12 - 1247 FIRST AND FINAL ACCOUNT OF James D. Leggett and Jan L. Hawkes, Co-Executors of the ESTATE of ANN W. FERRAIOLO,Deceased Late of Silver Spring Township, Cumberland County,Pennsylvania Date of Death: November X0, 2012 Date of Grant of Letters Testamentary To Jan L. Hawkes and James D. Leggett December 3, 2012 Date of First Advertisement of Letters: Cumberland Law Journal December 14, 2012 The Patriot News Co. July 16,2013 Date of Accounting November 10,2012 to July 25, 2014 PURPOSE OF ACCOUNTING: Jan L. Hawkes and James D. Leggett, Co-Executors,offers this Account to acquaint interested parties with the transactions that have occurred during this administration. It is important that the Account be carefully reviewed. Requests for additional information or questions can be discussed with: Michael L. Bangs, Esquire �s Bangs Law Office, LLC Attorney Identification Number 41263 429 South 18a` Street, Camp Hill,PA 17011 rn S c', r— Er 730-7310 . r� 717 ' ) 32 _ i� SUMMARY OF ACCOUNT PAGE PRINCIPAL Receipts of Principal 3 $481,862.62 LESS DISBURSEMENTS Debts of Decedent 4, 5 $12,743.77 Administrative Expenses 5 $65,839.63 Attorney's Fees 5 $15,000.00 Administrator's Fee 6 $15,000.00 Accountant Fees 5 $810.00 INCOME Receeits of Income 7 COMBINED BALANCE ON HAND $372,469.22 PROPOSED SCHEDULE OF DISTRIBUTION Distribution of Specific Bequests to Grandchildren 8 $58,686.81 Distribution to Residuary Beneficiaries 8 $313,782.41 VERIFICATION 9 Page 2 RECEIPTS OF PRINCIPAL _ PRINCIPAL DATE � RECEIPTS _12/312012 Metro Bank yi _ -ii $16,207.96 12/3/2012 ING USA Annuity and Life Insurance Company $1,556.65 _12/312012 First Clearing, LLC i $93.36 _12/3/2012 Wells Fargo Home Mortgage _ $157.23 1/2/2013 Sale of automobile _ $15,000.00 1/18/2013 Refund from Comcast Cable i_ $115.76 1/2112013 Proceeds from ING USA Annuity $130,377.38 2/14/2013 Refund from Highmark (premium refimd) $133.37 _ 3/28/2013 Refund from Phillips Lifeline _ _ $35.07 4/1/2013 Payment from heirs(except Donald Leggett} for inheritance tax $8,751.71 i liability on trust proceeds 7/3/2013 Close of Wells Fargo account ___ $21,616.87 _ _7/16/2013 Proceeds from sale of Cumberland County real estate $196,296.20 7/24/2013 Refund from Erie Insurance(Policy Q561410923) _ $126.001i�_ _ 7/24/2013 Refund from Erie Insurance (Policy Q100305381) $17.00 8/22/2013 Refund from PNC Bank (overpayment of mortgage payoff)_____ $413.86 8/22/2013.Payment from Donald Leggett(reimburse estate amount due for PNC consumer loan) _ $62,710.27 _ 3/1012014 Refund of overpayment of inheritance tax $6,578.91 _ 6/27/2014 Distribution from Verizon Wireless _ $1.44 _ Payment from Donald Leggett for inheritance tax due on all specific bequests and trust proceeds and ING annuity ii $17,149.58 ($10,638.58 paid in; $6,511.00 still due) Payments from James Leggett, Ernest Leggett and Jan Hawkes for $4,524.00 inheritance tax liability for ING annuity ($1,508.00 er person x 3} _ (still due by all three) TOTAL PRINCIPAL RECEIPTS — $481,862.62 Page 3 DISBURSEMENTS OF PRINCIPAL DATE DEBTS OF DECEDENT 12/5/2012 Parthemore Funeral Home $1,804.88 _ 12/5/2012 An Olde Town Florist i _$90.10 12/5/2012 Jim Leggett(reimbursement for headstone expense) _$165.00 12/5/2012 Jan Haw kes(reimbursement for various funeral expenses) $1,526.98 12/13/2012 United Water(10/1/12 to I1/1/12) $40.72 12/14/2012 PP&L Electric (11/2/12 to 12/4/12) _ _ $118.85 12/14/2012 UGI (10/22/12 to 11/20/12) $84.65 12/14/2012 Cardmember Services $1,071.31 12/14/2012 Hetrick Construction (work done at Cumberland County residence) $234.00 12/14/2012 Leggett, Inc. (work done at Cumberland County residence) $325.00 1/2/2013 Jim Leggett(reimbursement for costs to get automobile ready for sale) $84.39 1/15/2013 Erie Insurance(automobile policy} $290.00 1/15/2013 UGI (11/20/12 to 12/20/12) 1/18/2013 Verizon i i_ - $37.16 - 1/18/2013 JPP&L Electric(12/4/12 to 1/4/13) _ _ $42.49 1/18/2013 United Water i i $11.28 1/25/2013 Traditions of America(2 months of association dues) $370.00 1/25/2013 Erie Insurance(automobile policy) $290.00 1/25/2013 Silver Spring Township _ _ -���� $107.00 - - 2/13/2013 Traditions of America(association dues) _ _ _$185.00 2/13/2013 UGI _ _ _$136.18 2/13/2013 United Water _ _ $11.28 2/13/2013 Publishers Clearing House _ _ $81.90 2/14/2013 DCM Services (GE Capital Credit) _ $2,176.01 i 2/27/2013 Jennifer Stark(miscellaneous services) i" $225.00 2/27/2013 PP&L Electric(1/4/13 to 2/4/13) $55.30 w� 3/11/2013 UGI_ $142.36 3/11/2013 Publishers Clearing House _ $30.71 i 3/11/2013 United Water _ __ i $11.28 3/21/2013 H&R Block(preparation of 2012 income tax returns) ,„ $226.00 3/28/2013 PP&L Electric(2/4/13 to 3/4/13) _ _ $60.33 3/28/2013 Traditions of America(2 months of association dues) _ _ $394.00 3/28/2013 IRS (2012 income tax due) -��_- _- $398.00 ! _ 4/17/2013 UGI _ $115.88 4/17/2013 United Water $11.32 3__ 4/ $49.78 4/17/2013 PP&L Electric 4/6 4/17/2013 Silver S ring Township i$107.00 5/6/2013 UGI (3/22/13 to 4/23/13) _ $85.92 5/6/2013 Silver Spring Condominium Association $197.00�i„ 5/16/2013 1 United Water (4/1/13 to 5/1/13) $11.32 Page 4 DISBURSEMENTS OF PRINCIPAL 5/1612013 PP&L Electric(4/4/13 to 5/6/13) _ $38.93 6/6/2013 Silver Spring Condominium Association _ $197.00 6/6/2013 United Water $11.32 6/6/2013 UGl _ �i _ $14.19 6/6/2013 Shepherdstown Family Practice _ $216.00 7/1/2013 Traditions of America(balance due of tenant ledger) $24.00 7/1/2013 Leggett,Inc. (work done at Cumberland County residence) $455.00 7/1/2013 PP&L Electric (5/6/13 to 6/5/13) , $29.89 7/112013 Kim Leggett(reimbursement of amount paid to Todd Campbell,plumber _ for work done at Cumberland County residence) _ $150.00 7/24/2013 United Water $11.36 7/24/2013 UGI _ _ — �_-i— � i$11.51 7/24/2013 PP&L Electric _ _ _ $41.34 12/12/2013 Jan Hawkes(reimbursement for carpet cleanin at Cumberland County h $74.20 — TOTAL DEISTS OF DECEDENT: $12,743.77 DATE ADMINISTRATIVE EXPENSES i 12/5/2012 Cumberland Law Journal (advertising fee) $75.00 1218/2012 Register of Wills(probate fees) $388.50 .12/15/2012 Check to Alphagraphics (copies of Will and Codicil for heirs) $20.52 12/15/2012 Check to Postmaster(mailing of notices to all heirs) $29.85 12/17/2012 Check to Postmaster(mailing of notices to all heirs) _ _ $6.40 2/6/2013 Register of Wills(estimated inheritance tax payment made in discount) $50,000.00 _ 8/712013 Register of Wills (filing fee for inheritance tax return and inventory) $30.00 8/9/2013 The Patriot News Co. (advertising fee) ,„ $123.38 8/13/2013 Register of Wills (additional probate fee) $250.00 _ 2/4/2014 Check to Postmaster(mailing of fidicuary income tax returns) _ $8.98 2/4/2014 IRS (income tax due by estate for tax year 1 1/10/12 to 10/31/13) $14,320.00 2/4/2014 PA Department of Revenue (income due by estate 11/10/12 to 10/31/13) $38.00 _ Register of Wills (Accounting filing fee) $415.00�i "Postmaster(mailing of Accounting to heirs) _ $60.00 Capitol Copy Service (copyin of Accounting and Petition for Adjudicati _ $74.00 _ TOTAL ADMINISTRATIVE EXPENSES: $65,839.63 DATE FEES AND COMMISSIONS Michael L. Bangs, Esquire(attorney fees) (to be paid) $15,000.00 Boyer&Ritter (accountant fee) (fiduciary income tax returns 11/10/12-16 $405.00 Boyer&Ritter accountant fee (fiduciary income tax returns) i $405.00 Page 5 DISBURSEMENTS OF PRINCIPAL _ Jan L. Hawkes(Co-Executor fee) _ $7,500.00 James D. Leggett(Co-Executor fee) $7,500.00 TOTAL FEES: $30,810.00 TOTAL DISBURSEMENTS OF PRINCIPAL: i i $109;393.40 Page 6 RECEIPTS OF INCOME INCOME DATE RECEIPTS— —�-- -- TOTAL INCOME RECEIPTS i $0.00 Page 7 PROPOSED SCHEDULE OF DISTRIBUTION OF REMAINING PRINCIPAL AND INCOME SPECIFIC BEQUESTS _ _ _ DISTRIBUTION Donald B. Leggett: Item III of Will; net proceeds from slae of 1525 North Front Street,Harrisburg, PA Item IV of Will; 50% interest in 701 East Locust Street Associates,LLC — Grandchildren Item V of Will; I% of probate assets (not including inheritance tax reimbursements} as shown on Page 3 - $451,437.33) — — �.- Erica L. Ferraiolo _ _ — $4,514.37 Holly C. Ferraiolo _ i_ $4,514.37 Michael D. Ferraiolo $4,514.37 Vanessa M. Ferraiolo — _ _ _ $4,514.37 Lexy A. Hawkes $4,514.37 Anna M. Leggett _— _ $4,514.37 Ashley S. Leg ett _— _ $4,514.37 Brandon C. Leggett i — $4,514.37 Catherine E. Leggett — _ $4,514.37 Jessica S. etg t —_— — i — $4,514.37 Justin J. Leggett — $4,514.37 Matthew E. Leggett —�' _ $4,514.37 Michael C. Leggett — _ _ _ 11.514.37 $58,686.81 TOTAL AVAILABLE TO DISTRIBUTE TO RESIDUAL BENEFICIARIE — $313,782.41 James Leggett _ — _ $34,864.71 Jan Hawkes _ $34,864.71 Ernest Leggett _ — —_-- _ $34,864.71 Donald Leggett $34,864.71 Kenneth Ferraiolo __ _ $34,864.71 Joseph Ferraiolo, Jr. �i — $34,864.71 David Ferraiolo _ $34,864.71 Mark Ferraiolo i $34,864.72 Brian Ferraiolo i _34 864.72 $313,78141 NET DISTRIBUTION TO HEIRS WITH REMAINING UNPAID _ INHERITANCE TAX LIABILITY —_ — -__ James Leggett($34,864.71 - $1,508.00) _— $33,356.71 Jan Hawkes($34,864.71 - $1,508.00) — i $33,356.71 Ernest Leggett($34,864.71 - $1,508.00) $33,356.71 Donald Leggett($34,864.71 - $6,511.00) $28,353.71 Page 8 AFFIDAVIT JAN L. HAWKES and JAMES D. LEGGETT,Co-Executors of the.Estate of Ann W. Ferraiolo,deceased,hereby declare under oath that they have fully and faithfully discharged the duties of their 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 the best of their knowledge,there are no claims now outstanding against the estate; that all taxes presently due from the estate have been paid; and that more than four months have elapsed since the first complete advertisement of the granting of letters in this estate. This statement is made subject to penalties of 18 Pa. C.S.A. Section 4404 relating to unworn falsification to authorities. Jf L. HA $ JAM/S D. LEGGETT SUBSCRIBED AND SWORN TO BEFO THIS_ DAY OF — 2014. rT c r �artsrty � ay NOTARIAL SEAL Wendy K. Straub, Notary Publ4c Lower Allen Township,Cumberiand County My Cammks m Expires May 10. 2915 - - otary Public REQUEST FOR DISTRIBUTION Accountant requests that distribution be determined by the Court in accordance with the Schedule of Proposed Distribution filed as part of this account. JA 1. HAWKS J ES D. LEGGETT Page 9 Lek ,86a . DECEDENT'S ESTATE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF ANN W. FERRAIOLO —, DECEASED No. 21-12-1247 PETITION FOR ADJUDICATION/ STATEMENT OF PROPOSED DISTRIBUTION PURSUANT TO Pa.Q.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-I9 inclusive; and any instrument pertinent to the adjudication. - 'pc.-r.. INCLUDE ATTACHMENTS AT THE BACK OF THIS FORM. i rti n ,- C7r^,i--, 0 c,_ =, • co �= i-ri i Name of Counsel: Michael L. Bangs Supreme Court I.D. No.:42163 Name of Law Firm: Bangs Law Office, LLC Address: 429 South 18th Street, Camp Hill,'PA 17011 Telephone: 7 17-730-73 10 Fax: 717-730-7374 Foem aanr rev. 10.1.3.06 Page I of 10 Estate of ANN W.FERRAIOLO Deceased I. Name(s) and address(es)of Petitioner(s): Nwwe Jan L.Hawkes James D.Leggett Address: 95 Holly Lane 6411 Glenwood Street Etters,PA 17319 Mechanicsburg,PA 17450 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 F71 No If not, identify prior accountings,the accounting periods covered, and the date of adjudication of the prior accounting. 2. Decedent died on November 10,2012 0 Letters Testamentary or ®Letters of Administration were granted to Petitioner(s)on December 3. 2012 Date of Will (ifapplicable): March 23, 2011 Date(s) of Codicil(s) (if applicable): April 11, 2011 Date of probate (if different from date Letters granted): December 3,2012 Was a bond required?©Yes ©i No If yes, state amount: Are proofs of advertising of the grant of Letters attached? . . . . . . . . . 91 Yes F-1 No Dates of advertising of the grant of Letters:The Patriot News Co.: 7/16, 7/23 and 7/30/2013; Cumberland Law Journal: 12/14, 12/21 and 12/28/12. corm OG01 rev.10.13.06 Page 2 of 10 Estate of ANN W• PERRAIOLO Deceased 3. Was decedent survived by a spouse? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E]Yes 0 No If yes,name of the surviving spouse: 4. Has the surviving spouse filed to take an elective share? . . . . . . . . . . . . . ]Yes Ji 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 b. Did decedent marry after execution of Will or Codicil(s)? . . . . . . . . . . . O Yes M No Were any children born to decedent after execution of Will or Codicil(s)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 Yes 0 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. 10.13.06 Page 3 of 10 Estate of ANN W.FERRAIOLO Deceased 8. Written notice of the Audit as required by Pa. O.C.Rules 63, 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. & 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 a Each Part in Interesi Retationshi and Comments,ifany Interest *See attached sheet Farm oC-01 rev.!0.13.06 Page 4 of 10 Estate of ANN W. FERRAIOLO Deceased Name and Address o/Bach Parry in Interest Retatiamft and Comments,Tani, ( 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 Fled for this Audit(she 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 Pamt oC-01 rev. 10.13.06 Page 5 of 10 Estate of ANN W. FERRAIOLO 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 i Amount of Claim Claim I Will Claim yl Admitted? Be Paid In Full? Sallie Mae $16,580.25 ®Yes MYes Post Office Box 9500 7JNo ®No Wilkes-Barre,PA 18773-9500 ®Yes ®Yes ONo 0No MYes Yes FIN. 0 N ®Yes ®Yes []No F]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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E]Yes 0No Was family exemption allowed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ElYes ®No Family exemption claimant's name and relationship: Name: Retattoruhip. Form OC-67 rev.10.13.06 Page 6 of 10 Estate of ANN W.FERRAIOLO 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 2/6/2013 45,706.41 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? . . . . . . . . . . . . . . . . . . . Q Yes rz 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 0 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. Farm OC-01 rev. 10.13.06 Page 7 of 10 Estate of ANN W. FERRAIOLO Deceased 16. Had the decedent been adjudicated an incapacitated person? . . . . . . . . . . Q Yes F,(1 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. N/A B. Has notice of the additional receipts and disbursements been given to the parties identified in Paragraph 9 above? . . . . . . . . . . . . . 0- Yes E]No 18. If a reserve is requested, state amount and purpose. Amount: Purpose: N/A 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E]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? . . . . . . . . . . . . . . . . . . . . . . . . . . DYes ONo As to real estate only? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dyes r7l No xnrm oe-oi .w.10.13.06 Page 8 of 10 Estate of ANN W.FERRAIOLO 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) Amoemttproportion **See attached sheet B. Principal: Proposed Distributee(s) AmountlProportios Submitted By: (All petitioners must sign. Add additional lines if necessary): ;Neof etitioner: Jan L. Hawkes of Petitioner: Ja Leggett Form OC-01 rev. 10.13.06 Page 9 of 10 Estate of ANN W. FERRACOLO Deceased Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies * (that he/she is title of the above-named name ofcorporation 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). S' ature 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 etitioner Form OC-01 rev. 10.13.06 Page 10 of 10 Estate of ANN W.FERRAIOLO Deceased Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies * (that helshe is ase of the above-named name ofcorporation 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 ol'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. § 4404 (relating to unswom falsification to authorities). Sig Aureof Petitioner i�o 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 f etitioner FormOC-ot rev. 10.13,06 Page 10 of 10 BENEFICIARIES OF THE ESTATE OF ANN W. FERRAIOLO Name and Address Relationship Distribution James D. Leggett Son $33,356.71 6411 Glenwood Street Mechanicsburg, PA 17050 Jan L. Hawkes Daughter $33,356.71 95 Holly Lane Esters, PA 17319 Ernest W. Lepett Son $33,356.71 243 North 27 Street Camp Hill, PA 17011 Donald B. Leggett Son $28,353.71 c/o 701 E. Locust Street Mechanicsburg,PA 17055 Kenneth Ferraiolo Stepson $34,864.71 711 North Warren Street Orwigsburg, PA 17961 Joseph Ferraiolo, Jr. Stepson $34,864.71 Post Office Box 436 Schuylkill Haven, PA 17972 David Ferraiolo Stepson $34,864.71 400 Malones Road Ashland, PA 17921 Mark Fermiolo Stepson $34,864.72 104 Quarry Drive Catawissa, PA 17820 Brian K. Ferraiolo Stepson $34,864.72 140 North Franklin Street Orwigsburg, PA 17961 Erica L. Ferraiolo Granddaughter $4,514.37 400 Malones Road Ashland,PA 17921 Holly C. Ferraiolo Granddaughter $4,514.37 104 Quarry Drive Catawissa, PA 17820 Michael D. Ferraiolo Grandson $4,514.37 104 Quarry Drive Catawissa, PA 17820 Vanessa M. Ferraiolo Granddaughter $4,514.37 400 Malones Road Ashland, PA 17921 Lexy A. Hawkes Granddaughter $4,514.37 95 Holly Lane Etters, PA 17319 Anna M. Leggett Granddaughter $4,514.37 2727 S. Rosegarden Blvd. Mechanicsburg, PA 17055 Ashley S. Leggett Granddaughter $4,514.37 243 North 27`h Street Camp Hill, PA 17011 Brandon C. Leggett Grandson $4,514.37 243 North 27`h Street Camp Hill, PA 17011 Catherine E. Leggett Granddaughter $4,514.37 2727 S. Rosegarden Blvd. Mechanicsburg, PA 17055 Jessica S. Leggett Granddaughter $4,514.37 330 Bain Bridge Street, Apt. 18 Philadelphia, PA 19147 Justin J. Leggett Grandson $4,514.37 6411 Glenwood Street Mechanicsburg, PA 17050 Matthew E. Leggett Grandson $4,514.37 243 North 27h Street Camp Hill, PA 17011 Michael C. Leggett Grandson $4,514.37 6411 Glenwood Street Mechanicsburg, PA 17050 The Patriot-News Co. 2020 Technology Pkwy �e aft*1otwNew Suite 300 Mechanicsburg, PA 17050 Now you know Inquiries - 717-255-8213 BRINGS LAW OFFICE ATTN: MICHAEL L. BANGS 429 SOUTH 18TH STREET CAMP HILL PA 17011 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 Marianne Miller, being duly sworn according to 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; and 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 stockholders 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# 0002266789 ran on the dates shown below: July 16,2013 V/ July 23, 2013 July 30,2013 Sworn to and subscribed b ore tNs 31 day of July, 2013 A.D. LAP1w -Notary Public COMMONWEALTH OF PENNSYLVANIA Notanal Seal Holly Lynn Warfel,Nolan Pubfic washington Twp.,DauPlnn G�unty Commiso res D ON OF2NOTARIFS MEMBER,pENNS'WANIA ASa04n ESTATE NOTICE LETTERS TESTAMENTARY on the Estate of ANN W.FERRAIOLO,late of Sliver Spring Township,County of Cumberland,Pennsvlvanlo,deceased, were granted to Jan L.Hawkes and James D.Leggett on December 3,2012. All persons knowing themselves to be indebted to sold Estate are requested to make Immediate payment and those having claims will present them,without delay,to the undersigned. Michael L.Bangs,ESquIre - - - — - Bangs Law Office,LLC 499 South 18th Street Camp Hill PA 17011 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: December 14 December 21 and December 28 2012 Affrant 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. 4rie Coyne, Editor SWORN TO AND SUBSCRIBED before me this 28 day of December,2012 Notary Ferrallolo,Ann W.,deed. Late of Silver Spring fiownship, Executors: Jan L. Hawker and m Jaes ID, Leggett. NOTARIAL SEAL Attorneys; Michael L. Bangs, Es- DEBORAH A COLLINS quire,Bangs Law Mce,LLC, 17011. 429 Notary Public South SSth Street,Camp Hill,PA CARLISLE BOROUGH,CUMBERLAND COUNTY My commission Expires Apr 28,2014 1 1 pennsytvania DEPARTMENT OF PUBLIC WELFARE December 8, 201.2 MICHAEL L BANGS ESQUIRE 429 S 18TH ST CAMP HILL PA 17011 Re: Ann W. Ferraiolo SSN. ####-##-1755 Dear Attorney Bangs: Pursuant to your letter dated December 05, 2012, the Department's, Estate Recovery Program, has reviewed the information you provided regarding the above-referenced individual. It has been determined that this individual did not receive any type of assistance during the questioned period. Therefore, according to the information you provided, the Department's Estate Recovery Program will not seek any recovery from this estate. If your client applied for Medical Assistance and had an application and/or hearing pending at the time of death, please advise us and provide any additional information that may affect a recovery by our Department. Thank you for your cooperation in this matter. If you have any questions, please contact me. Sincerely i� we Vince A. Porter Recovery Section Manager (717)772-6604 Bur_au of Program Integr;ty i Division of Third Party Liability I ReLove:y Secion 90 Box 8486 1 Fian isbw% Pennsylvania 171 05-148E s pennsytvania DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX REV-1607 EX AFP C12-13) INHERITANCE TAX DIVISION .STATEMENT !}F ACCOUNT PO BOX 280601 HARRISBURG PA 17128-0601 DATE 03-03-2014 ESTATE OF FERRAIOLO ANN W DATE OF DEATH 11-10-2012 FILE NUMBER 21 12-1247 COUNTY CUMBERLAND BANGS MICHAEL L ACN 101 429 S 18TH ST CAMP HILL PA 17011-5902 Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS I COURTHOUSE SQUARE CARLISLE PA 17013 NOTE: To ensure proper credit to your account, submit the upper portion of this form with your tax payment. CUT .ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS - 4 REV-1607 EX AFP (12-13) xiE* INHERITANCE TAX STATEMENT OF ACCOUNT ESTATE OF:FERRAIOLO ANN W FILE NO. : 21 12-2247 ACN: 101 DATE: 03-03-2014 THIS STATEMENT PROVIDES CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE, BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 01-21-2014 PRINCIPAL TAX DUE: 45,706.41 PAYMENTS (TAX CREDITS) : PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) 02-06-2013 C0017149 2,285.32 50 ,000.00 02-10-2014 REFUND .00 6,578.91- TOTAL TAX PAYMENT 45,706.41 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 IF PAID AFTER THIS DATE, SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. NOTICE OF INHERITANCE TAX pennsylvania APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES OF DEDUCTIONS AND ASSESSMENT OF TAX INHERITANCE TAX DIVISION REV-1547 EX AFP (88.13) PO BOX 288601 HARRISBURG PA 17128-0601 DATE 01-30-2014 ESTATE OF FERRAIOLO ANN W DATE OF DEATH 11-10-2012 FILE NUMBER 21 12-1247 COUNTY CUMBERLAND BANGS MICHAEL L ACN 101 429 S 18TH ST APPEAL DATE: 03-31-2014 CAMP HILL PA 17011-5902 (See reverse side under Objections) Amount Remitted{------ � I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE —�1 RETAIN LOWER PORTION FOR YOUR RECORDS t— REY-1547 EX AFP COB-133 NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE qR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: FERRAIOLO ANN WFILE NO. :21 12-1247 ACN: 101 DATE: 01-30-2014 TAX RETURN WAS: ( X) ACCEPTED AS FILED C ) CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 325,464.20 NOTE: To ensure Proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account, 00 submit the upper portior 350. 3. Closely Hold Stock/Partnership Interest (Schedule C) (3) 232, of this form with your 4. Mortgages/Notes Receivable (Schedule D) (4) •00 tax payment. S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 183,165.87 6. Jointly Owned Property (Schedule F) (6) . 00 T. Transfers (Schedule G) (7) 410,757.79 S. Total Assets (aJ 1 ..151,.737.86 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 27,465.23 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 108.574.65 11. Total Deductions (11) 136,639.88 12. Not Value of Tax Return (12) 1 ,015,697.98 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (14) 1 ,015,697.98 NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, 18 and/or 19 will reflect figures that include the total of all returns assessed to date. ASSESSMENT OF TAX: 16. Amount of Line 14 taxable at lineal rate (16) ) ,I119.697_9A X 045 = 45,706.41 17. Amount of Line 14 at sibling rate (17) -6n X 12 .DO 18. Amount of Line 14 taxable at collateral rate (la) .00 X 15 = .00 19. Principal Tax Due (19)= 45,706.41 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) 02-06-20 3 CDO17149 2,285.32 50,000.00 TOTAL TAX PAYMENT 52,285.32 BALANCE OF TAX DU£ 6,578.91CR INTEREST AND PEN. .00 TOTAL DUE 6,578.91CR + IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR). YOU MAY BE DUE ��o rA, rm ATTnN OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS.