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Home My WebLink About11-03-14 (2) 3C),4L-�4 RECORDED CFFiCE OF REGIS 'I"' ."ILLS 2014 NOU 3 801 1138 DECEDENT'S ESTATE CLE', ORPHAN:;' C U M B E i;i_,`,'' COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF LOUISE P. SOWERS -, DECEASED No. 21-14-0125 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: STEVEN J. SCHIFFMAN, ESQ. Supreme Court I.D. No.: 25488 Name of Law Firm: SERRATELLI, SCHIFFMAN & BROWN,PC Address: 2080 LINGLESTOWN ROAD, SUITE 201, HARRISBURG, PA 17110 Telephone: (717) 540-9170 Fax: (717) 540-5481 Form OC-01 rev. 10.13.06 Page 1 of 1.0 Estate of LOUISE P SOWERS , Deceased 1. Name(s) and address(es) of Petitioner(s): Name: STEPHANIE A. SOWERS-WAROS Address: 1093 COUNTRY HILL DRIVE HARRISBURG,PA 17111 Identify any executors or administrators who have not joined in the Petition for Adjudication and Statement of Proposed Distribution and state reason: Is this the first accounting by this fiduciary? . . . . . . . . . . . . . . . . . . . . . F7-1 Yes 0 No If not, identify prior accountings,the accounting periods covered, and the date of adjudication of the prior accounting. 2. Decedent died on NOVEMBER 2, 2013 Letters Testamentary or []Letters of Administration were granted to Petitioner(s) on FEBRUARY 10. 2014 Date of Will (if applicable): MARCH 24, 2005 Date(s) of Codicil(s) (if applicable): Date of probate (if different from date Letters granted): Was a bond required?F7Yes ®✓ 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: SENTINEL 2-27, 3-6, 3-1.3, 2014; CUMBERLAND LAW JOURNEL 2-28, 3-7, 3-14, 2014 Form OC-01 rev.10.13.06 Page 2 of 10 Estate of LOUISE P SOWERS , Deceased 3. Was decedent survived by a spouse? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MYes 0 No If yes, name of the surviving spouse: RAY K FORNEY (DECEASED 12/18/2013) 4. Has the surviving spouse filed to take an elective share? . . . . . . . . . . . . . ElYes ®No (See Section 2201 et sic. 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 decedent marry after execution of Will or Codicil(s)? . . . . . . . . . . . F7 Yes 0 No Were any children born to decedent after execution of Will or Codicil(s)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . El Yes R1 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? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F,�J' Yes 0 No Form OC-01 rev. 10.13.06 Page 3 of 10 Estate of LOUISE P SOWERS , 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 Party in Interest I Relationship and Comments,if any I Interest SEE ATTACHED Form OC-01 rev.10.13.06 Page 4 of 10 Attachment to Petition for Adoudication Page 4, No. 8 The attached Notice isbeing mailed to: StephanieSoxvers-VVaros 1D93Country Hill Drive Harrisburg, PA 17111 David L. Forney Executor ofthe Estate ofRay Forney and Individually 1601K.Street, NVV Washington, DC 20006'1600 Pamela K. Rad|e 120Wilson Court Harrisburg, P/\ 17112 Steven Forney 40West 22"pStreet, 7C New York, NY 10010 Susan Marie Forney POBox O437 Northfield, IL 60093-8437 Mary Stauffer 712Aspen Lane Lebanon, PA 17043 Peter Forney 12SHorseshoe Drive Williamsburg,VA 23185 Lynda Doane 99DProspect Road Columbia, PA 17512 Pau| Forney 3Locust Lane Leola, PA 17540 ADT Security Services 319OSouth Vaughn Way Aurora, CO 80014 Barclays Bank Delaware c/o Phillips&Cohen Associates, Ltd. IOO2JustisunStreet VVinoington, DE 19801 Elan Financial Services c/o Phillips&Cohen Associates, Ltd. 1OO2JustisonStreet Wilmington, DE 19801 Erie Insurance Company c/o Rceivab|eManagement Services Corp. 12SOE. Diehl Road, Suite 3OO POBox 3O99 Naperville, IL 60563 PPL Electric Utilities c/m[B[S POBox Z724 Columbus,OH 43216'2724 PNC Bank c/o VVe|tnman,Weinberg Q' Reis Co, LPA 3J3VV. Lakeside Avenue Cleveland OH 44113'1009 PaAmerican Water P8Box 3714l2 Pittsburgh, PA 15250 RBS Citizens c/o DCK4Services, LLC 76U1Penn Avenue S, Suite AGD0 Minneapolis, MN 55423'5004 GE Capital Retail Bank c/o Ascension Point Recovery Services, LLC 2OOCoon Rapids 8|vd,Suite 2OO Coon Rapids, K4N S5433'5876 Book Services POBox 268Z2 Lehigh Valley, PA 18002 [omnenityCapita| Bank—HSN c/o Ascension Point Recovery Services, LLC 2ODCoon Rapids Bivd, Suite 2OO Coon Rapids, MN 55433'5876 K. l D SERRATELLI SCHIFFMAN & BROWN ,.C. TO: Interested Parties of the Estate of LoW* e . Sowers FROM: Steven J. Schiffman, Es --'`!�~ �F RE: Petition for Audi , ourt Accounti and Schedule of LORI K.SERRATELLIProposed Distribution STEVEN J.SCHIFFMAN MICHAEL F.BROWN DATE: November 3, 2014 JOHN D.SHERIDAN admitted in PA X NJThis is to advise you that Stephanie A. Sowers-Waros, Executrix of the CARA BOYANOWSKI Estate of Louise P. Sowers, has filed the Petition for Audit, Final Account and F.R.MARTSOLF Proposed Schedule of Distribution with the Clerk for Audit. Note that the DEBORAH A.HUGHEs Executrix is requesting a reserve of$2500.00 to pay additional attorney fees to MERRITT C.REiTzEL Steven J. Schiffman, Esquire in order to conclude the administration of the TRACY uPDIKE Estate. JENI S.MADDEN Please note that there are no funds available for distributions to the CAROL L.VERISH beneficiaries under the will. admitted in PA&FL ANDREW T.SCHIFFMANThe account will be presented for audit and confirmation at the Office admitted in PA&CA of the Register of Wills, Cumberland County Courthouse, Carlisle, NEIL E.HENDERSHOT Pennsylvania on January 13, 2015 at 9:00 a.m. Any objections to the Account of counsel GARTH A.STEPHENSON and Proposed Schedule of Distribution shall be filed no later than 9:00 a.m. on of counsel MD R DC onh, January 13, 2015. SPERO T.LAPPAS Thankou for our attention. of counsel Y Y 2080 LINGLESTOWN RD,STE 201 HARRISBURG,PA 17110-9670 rel 717.540.9170 jar 717.540.5481 W W W.SSBC-LAW.COM Attachment to Petition for Adjudication Page 4, No. 9 Name &Address of Interested Part v Relationship Interest Stephanie Sowers-Waros Granddaughter None-Insolvent 1093 Country Hill Drive Harrisburg, PA 17111 David L. Forney Deceased Spouse's None-Insolvent Executor of the Estate of Ray Forney and Estate & Individually Deceased Spouse's Son 1601 K.Street, NW Washington, DC 20006-1600 Pamela K. Radle Friend None-Insolvent 120 Wilson Court Harrisburg, PA 17112 Steven Forney Deceased Spouse's Son None-Insolvent 40 West 22nd Street, 7C New York, NY 10010 Susan Marie Forney Deceased Spouse's None-Insolvent PO Box 8437 Daughter Northfield, IL 60093-8437 Mary Stauffer Deceased Spouse's None-Insolvent 712 Aspen Lane Daughter Lebanon, PA 17043 Peter Forney Deceased Spouse's None-Insolvent 125 Horseshoe Drive Son Williamsburg,VA 23185 Lynda Doane Deceased Spouse's None-Insolvent 998 Prospect Road Daughter Columbia, PA 17512 Paul Forney Deceased Spouse's None-Insolvent 3 Locust Lane Son Leola, PA 17540 Estate of LOUISE P SOWERS , Deceased Name and Address of Each Party in Interest I Relationship and Comments,i 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. 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). 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.10.13.06 Page 5 of 10 Estate of LOUISE P SOWERS , Deceased 10. Other than the claim for the family exemption, list the names of all known claimants and the amount of their claims and state whether each claim is admitted. Name and Address of Each Claimant Amount of Claim Claim Will Claim Admitted? Be Paid In Full? SEE ATTACHED nYes 0 Yes E]No [:]No E]Yes DYes ONo E]No E]Yes 1:1 Yes [:]No [:3 No ElYes El Yes F-INo Q 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 EJNo Was family exemption allowed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Yes E]No Family exemption claimant's name and relationship: Name:RAY K. FORNEY Relationship:SPOUSE Form OC-01 rev. 10.13.06 Page 6 of 10 Attachment to Petition for Adjudication Page 6, No. 10 Claimant—Name &Address Amount of Claim Admitted Paid in Full All Class I, II and III creditors have been admitted and have/will be paid pursuant to the attached Accounting and Proposed Schedule of Distribution. Class VI creditors are admitted and will be paid partially pursuant to the attached Proposed Schedule of Distribution. Class I—Costs of Administration Serratelli, Schiffman & Brown (Attorney Fees&Costs) 2080 Linglestown Road, Suite 201 Harrisburg, PA 17110 Amount Paid $6672.50 Amount to Be Paid (Reserve) $2500.00 Cumberland Law journal 32 S. Bedford Street Carlisle, PA 17013 Amount Paid: $75.00 The Sentinel 457 E North Street PO Box 130 Carlisle, PA 17013 Amount Paid: $84.34 Register of Wills (Probate Fees) Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Amount Paid: $189.50 Stephanie Sowers-Waros (Animal Expenses) 1093 Country Hill Drive Harrisburg, PA 17111 Amount to be Paid: $183.59 Stephanie Sowers-Waros (Costs Advanced—Attorney Fees) 1093 Country Hill Drive Harrisburg, PA 17111 Amount to be Paid: $240.00 SteohanieSovvers-Waros (Executrix Fee) l093Country Hill Drive Harrisburg, PA 17111 Amount to be Paid: $4000.00 Class 11—Family Exemption Ray K. Forney Ray K. Forney Estate c/o David Forney 16O1K. Street, NW Washington, DC 20006'1600 Amount Paid: $3500.00 Class III—Costs of Funeral and Burial; costs of medicines within six months of death; medical and nursing within six months of death and employee services Funeral Expenses Reimbursement toDavid Forney 16O1K.Street, NVV Washington, DC 20006'1600 Amount Paid:$4704.00 Harrisburg East Cemetery(Grave Opening and Disposition ofAshes) c/o Stephanie Sovvers'VVaros 1093Country Hill Drive Harrisburg, PA 17111 Amount tohePaid: $2400.00 Barbara Virgil Financial Services/Pharmacy—DOB 4-27'l931 3O8Student Health Center University Park, PA 16802 Amount tobePaid: $101.00 Class IV—Costs of Gravernarker Class V—Rents N/A Class 5.1—Commonwealth Claims N/A Class VI—All Other Claims ADT Security Services—Customer#19917791-$171.07 3190 South Vaughn Way Aurora, CO 80014 Amount to be Paid: $27.60 Barclays Bank Delaware—Acct Ending in 0836-$8595.67 c/o Phillips&Cohen Associates, Ltd. 1002 Justison Street Wimington, DE 19801 Amount to be Paid: $1386.92 Elan Financial Services—Acct Ending in 0716-$3451.28 c/o Phillips& Cohen Associates, Ltd. 1002 Justison Street Wilmington, DE 19801 Amount to be Paid: 556.87 Erie Insurance Company—Claim#446930596-EZ-$204.25 c/o Rceivable Management Services Corp. 1250 E. Diehl Road, Suite 300 PO Box 3099 Naperville, IL 60563 Amount to be Paid: $32.96 PPL Electric Utilities—Account#16970723-$205.93 c/o CBCS PO Box 2724 Columbus,OH 43216-2724 Amount to be Paid: $33.23 PNC Bank—Acct Ending in 3475-$15,346.01 c/o Weltman, Weinberg& Reis Co., LPA 323 W. Lakeside Avenue Cleveland, OH 44113-1009 Amount to be Paid: $2476.10 Pa American Water—Account#1024-210035070888-$120.95 PO Box 371412 Pittsburgh, PA 15250 Amount to be Paid: $19.52 RBS Citizens - Reference#10011333; Client ID RBSC42 -$3161.77 c/o DCM Services, LLC 7601 Penn Avenue S,Suite A600 Minneapolis, MN 55423-5004 Amount to be Paid: $510.16 GECapital Retail Bank—Acct Ending in77gO $1338.25 c/o Ascension Point Recovery Services, LLC 2OOCoon Rapids Q|vd, Suite 2OO Coon Rapids, K4N 55433'5876 Amount to be Paid: $215.93 Book Services—Account#4012332S'$61.9G POBox J6O22 Lehigh Valley, PA 18002 Amount tohePaid:$9.99 ConmenbyCapital Bank—HSN—AcctEnding|n9O53'$3518.O5 c/o Ascension Point Recovery Services, LLC 20OCoon Rapids 8|vd.'Suite ZOO Coon Rapids, MN 55433-5876 Amount tmbePaid: $567.64 Estate of LOUISE P SOWERS , 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 NONE 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? . . . . . . . . . . . . . . . . . . . 0 Yes FA 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? . . . . . . . . . . . . . . . . . . E]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. Form OC-01 rev. 10.13.06 Page 7 of 10 Estate of LOUISE P SOWERS , Deceased 16. Had the decedent been adjudicated an incapacitated person? . . . . . . . . . . rl Yes R] 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. B. Has notice of the additional receipts and disbursements been given to the parties identified in Paragraph 9 above? . . . . . . . . . . . . . ElYes 0 No 18. If a reserve is requested, state amount and purpose. Amount: $2500.00 Purpose' ATTORNEY FEES AND COSTS PAYABLE TO STEVEN J. SCHIFFMAN IN ORDER TO COMPLETE THE ADMINISTRATION OF THE ESTATE. 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 E-71No If so, attach a copy of the notice. 19. Is the Court being asked to direct the filing of a Schedule of Distribution? ®✓- Yes ONo As to real estate only? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DYes RlNo Form OC-01 rev. 10.13.06 Page 8 of 10 Estate of LOUISE P SOWERS, , Deceased Wherefore, your Petitioner(s) as that distribution be awarded to the parties entitled of and suggest(s)that the distributive shares income and principal (residuary shares being stated in proportions, not amounts) ar 'e as follows rt A. Income: Proposed Distributee(s) Amount/Proportion N/A-ALL TO CREDITORS INSOLVENT B. Principal: Proposed Disiributee(s) Amount/Proportion N/A-ALL TO CREDITORS INSOLVENT Submitted By: ' (All petitioners must sign. Add additional lines if necessary): N me of P titi r: STEPHANIE A. S S-W.A&&.5, Name of Petitioner: Form OC-01 rev.10.13.06 Page 9 of 10 IN RE: ESTATE OF LOUISE P. SOWERS, : IN THE COURT OF COMMON PLEAS Deceased : CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-14-0125 RULE 6.3 CERTIFICATION I, Steven J. Schiffman, Esquire, do hereby certify that the requ' ements of Rule 6.3 regarding notice have been met in the above captioned matter. Dated: b _c % LO/ 6 S EVEN J. SCHIFF AN PROPOSED SCHEDULE OF DISTRIBUTION Amount Available for Distribution: $15,261.51 Unpaid Expenses: Class 1 Creditors - Costs of Administration a. Serratelli, Schiffman& Brown (Reserve) 2,500.00 b. Stephanie Sowers-Waros (Animal Expenses) 183.59 c. Stephanie Sowers-Waros (Executrix Fee) 4,000.00 d. Stephanie Sowers-Waros (Costs Advanced) 240.00 Class III Creditors—Funeral &Burial & Medicines a. Harrisburg East Cemetery 2,400.00 b. Penn State Pharmacy 101.00 5,836.92 Available for Class 6 Creditors—All Others 5,836.92 a. ADT (171.07) 171.07 36,175.19 x 5836.92 = 27.60 b. Barclays's Bank DE 8595.67 36,175.19 x 5836.92= 1386.92 c. Elan Financial Services 3451.28 36,175.19 x 5836.92= 556.87 d. Erie Insurance Company 204.25 36,175.19 x 5836.92= 32.96 e. PPL Electric 205.93 36,175.19 x 5836.92= 33.23 f. PNC Bank 15,346.01 36,175.19 x 5836.92= 2476.10 g. Pa. American Water 120.95 36,175.19 x 5836.92= 19.52 h. RBS Citizens 3161.77 36,175.19 x 5836.92= 510.16 i. GE Capital Retail Bank 1338.25 36,175.19 x 5836.92= 215.93 j. Book Services 61.96 36,175.19 x 5836.92= 9.99 k. Comenity Capital Bank 3518.05 36,175.19 x 5836.92= 567.64 $5836.92 PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Patrick Doane,Production 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): February 27, March 6, 13, 2014. COPY OF NOTICE OF PUBLICATION ate.ICE Affiant further deposes that he/she is not ESTATE OF LOUISE P.SOWERS,late of Cumberland County,Pennsylvania interested in the subject matter of the (died November 2,2013).Stephanie A.Sowers-Waros,1093 Country Hill Drive,Harrisburg,PA 17111,Executrix.Stephen J.Schiffman,Esquire, aforesaid notice or advertisement, and that SERRATELLI,SCHIFFMAt4&BROWN,P.C.,2080 Linglestown Road, Suite 201,Harrisburg,PA 17110,Attorney. all allegations in the foregoing statement as to time,place and character of publication are true. Sworn to and subscribed before me this RIM dal! t U U N V 0kAy Public My commission expires: COMMONWEALTH OF PENNSYLVANIA Notarial Seat Bethany M.Holtry,Notary Public Carlisle Boro,Cumberland county MY commission Expires sept.26,2615 MEMBER,PENNSYLVANIA ASSOCIATION OF NOTARIES 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: February 28, March 7, and March 14, 2014 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. b1sa Marie Coyne, Edit SWORN TO AND SUBSCRIBED before me this 14 day of March, 2014 Sowers,Louise P.,decd. Notary Late of Cumberland County. Executrix: Stephanie A. Sowers- Waros, 1093 Country Hill Drive, Harrisburg, PA 17111. Attorneys: Steven J. Schiffman, Esquire, Serratelli, Schiffman & NOTARIAL SEAL Brown, P.C., 2080 Lingiestown Road, Suite 201, Harrisburg, PA FCARLISLE BORAH A COLLINS 17110. Notary Public OUGH,CUMBERLAND COUNTY ssion Expires Apr 28,2014 NOTICE OF INHERITANCE TAX Pennsylvania BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (08-13) PO BOX 280601 HARRISBURG PA 17129-0601 DATE 09-22-2014 ESTATE OF SOWERS LOUISE P DATE OF DEATH 11-02-2013 FILE NUMBER 21 14-0125 COUNTY CUMBERLAND SCHIFFMAN STEVEN i ACN 101 STE 201 APPEAL DATE: 11-21-2014 2080 LINGLESTOWN RD (See reverse side under Objections) HARRISBURG PA 17110-9670 Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE RETAIN LOWER PORTION FOR YOUR RECORDS 4-- ii-V---l--4-7-ii--A-F�--(-Oi---1-3-3--N-O-Tii-E--Oi--I-N;i-R-I-Ti-N-C-E-i-A-X--A-P-P-R-A-I-S-E-M-E-H-T-,--A-L-L-O-W-A-N-C-E--O-R--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: SOWERS LOUISE PFILE NO. :21 14-0125 ACN: 101 DATE: 09-22-2014 TAX RETURN WAS: ( X) ACCEPTED AS FILED C CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 00 NOTE: To ensure proper 2. Stocks and Bonds (Schedule B) (2) 11,545.00 credit to your account, 00 submit the upper portion 3. Closely Held Stock/Partnership Interest (Schedule C) (3) . of this form with your 4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 18,275.00 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total Assets (8) 29,820.00 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 20 ,667.00 10. Debts/Mortgage Liabilities/Liens (Schedule 1) C10) 55,156.00 11. Total Deductions (11) 75,823.00 12. Net Value of Tax Return (12) 46,003.00- 13. Charitable/Governmental Bequests; Non-elected 9115 Trusts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (14) 46,003.00- 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: 15. Amount of Line 14 at spousal rate (15) .00 X 00 = .00 16. Amount of Line 14 taxable at lineal rate (16) nn X 045 = .00 17, Amount of Line 14 at sibling rate (17) An x 12 = .00 18. Amount of Line 14 taxable at collateral rate (18) .00 x 15 = .00 19. Principal Tax Due (19)= .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT AMOUNT PAID DATE NUMBER INTEREST/PEN PAID C-) TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE . 00 IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE FOR INSTRUCTIONS. pennsylvania DEPARTMENT OF PUBLIC WELFARE February 24, 2014 SERRATELLI SCHIFFMAN BROWN & CALHOON PC STEVEN J SCHIFFMAN ESQUIRE STE 201 2080 LINGLESTOWN RD HARRISBURG PA 17110-9445 Re: Louise Sower SSN: ###-##- Dear Attorney Schiffman: Pursuant to your letter dated February 22, 2014, 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 Zne-x— CL T-; Vince A. Porter Recovery Section Manager (717)772-6604 Bureau of Program Integrity Division of Third Party Liability Recovery Section PO Box 8486 1 Harrisburg, Pennsylvania 17105-8486 COURT OF COMMON PLEAS OF CUMBERLAND,PA ORPHANS' COURT DIVISION File No. 21-14-0125 FIRST AND FINAL ACCOUNTING OF STEPHANIE A. SOWERS-WAROS, Executor For LOUISE P. SOWERS ESTATE Date of Death: November 02, 2013 Date of Incapacity, if any None Date of Appointment: February 10, 2014 Date of First Complete Advertisement March 13, 2014 Accounting for the Period: November 02, 2013 to October 09, 2014 Purpose of Account: The above fiduciary offers this account to acquaint interested parties with the transactions that have occurred during his/her administration. It is important that the account be carefully examined. Requests for additional information, or questions, or objections, can be discussed with: SERRATELLI, SCHIFFMAN & BROWN, PC 2080 LINGLESTOWN ROAD, SUITE 201 HARRISBURG, PA 17110 STEVEN J SCHIFFMAN ESQ (717)540-9170 Signatures: Supreme Court I.D. No. 25488 e C7 � co Ca C;r C-0 cn o CXR `ts LOUISE P SOWERS ESTATE Summary of Account Principal Page Receipts 2 $ 30,460.30 Net Loss on Sales or Other Dispositions 3 (55.54) $ 30,404.76 Less Disbursements: 5 Funeral Expenses $ 4,704.00 Administrative Expenses 159.34 Family Exemptions 3,500.00 Fees & Commissions 6,862.00 15,225.34 Balance Before Distributions $ 15,179.42 Less Distributions to Beneficiaries 7 $ 0.00 Total $ 0.00 Principal Balance On Hand 8 $ 15,179.42 For Information: Investments Made 9 Unpaid Expenses 10 Unrealized Gains and Losses 14 Income Receipts 15 $ 82.09 Net Gain on Sales or Other Dispositions 16 0.00 $ 82.09 Less Disbursements: 17 0.00 Balance Before Distributions $ 82.09 Less Distributions to Beneficiaries 18 0.00 Total $ 0.00 Income Balance on Hand 19 $ 82.09 For Information: Investments Made 20 Unpaid Expenses Unrealized Gains and Losses 21 Verification 22 Combined Balance on Hand 15,261.51 LOUISE P SOWERS ESTATE Receipts of Principal Inventory Value Cash and Cash Equivalents 11/02/2013 LOOSE CHANGE/COINS $ 188.24 MEREDITH BOOK CUSTOMER SERVICE 38.06 PA TURNPIKE COMMISSION (E-Z PASS CREDIT BALANCE) 43.89 PENN STATE FEDERAL CREDIT UNION REGULAR SHARES ACCOUNT 5.00 Total Cash and Cash Equivalents $ 275.19 No. of Shares Stocks 90 MET LIFE TRUST INTERESTS $ 4,860.90 208.15057 PFIZER 6,683.71 Total Stocks 11,544.61 Miscellaneous MET LIFE INSURANCE $ 13,321.23 PRUDENTIAL LIFE INSURANCE 5,319.27 Total Miscellaneous 18,640.50 Total Inventory $ 30,460.30 Total Receipts of Principal $ 30,460.30 Page 1 (2) LOUISE P SOWERS ESTATE Gains and Losses on Sales or Other Dispositions of Principal Net Gain Net Loss 02/12/2014 Collection MEREDITH BOOK CUSTOMER SERVICE Net Proceeds $ 38.06 Inventory Value $ 38.06 03/12/2014 Sale 90 Shares MET LIFE TRUST INTERESTS Inventory Value $ 4,860.90 Net Proceeds $ 4,812.03 $ 48.87 03/12/2014 Sale 208.15057 Shares PFIZER Inventory Value $ 6,683.71 Net Proceeds $ 6,677.04 6.67 03/13/2014 Collection MET LIFE INSURANCE Net Proceeds $ 13,321.23 Inventory Value $ 13,321.23 04/04/2014 Sale PRUDENTIAL LIFE INSURANCE Net Proceeds $ 5,319.27 Inventory Value $ 5,319.27 05/01/2014 Sale PA TURNPIKE COMMISSION (E-Z PASS CREDIT BALANCE) Net Proceeds $ 43.89 Inventory Value $ 43.89 05/23/2014 Sale PENN STATE FEDERAL CREDIT UNION REGULAR SHARES ACCOUNT Net Proceeds $ 5.00 Inventory Value $ 5.00 Total Gains and Losses $ 0.00 $ 55.54 Page 1 (3) LOUISE P SOWERS ESTATE Disbursements of Principal Date Paid Amount Paid Funeral Expenses FUNERAL EXPENSES (REIMBURSEMENT TO DAVID FORNEY) 06/26/2014 $ 4,704.00 Check Number 30907 Total FUNERAL EXPENSES (REIMBURSEMENT TO DAVID FORNEY) $ 4,704.00 Total Funeral Expenses $ 4,704.00 Administration Expenses CUMBERLAND LAW JOURNAL (ESTATE ADVERTISEMENT) 02/11/2014 $ 75.00 Check Number 55645 Total CUMBERLAND LAW JOURNAL (ESTATE ADVERTISEMENT) $ 75.00 THE SENTINEL (ESTATE ADVERTISEMENT) 04/03/2014 $ 84.34 Check Number 55796 Total THE SENTINEL (ESTATE ADVERTISEMENT) $ 84.34 Total Administration Expenses $ 159.34 Family Exemptions RAY K.FORNEY C/O RAY K. FORNEY ESTATE DAVID L. FORNEY,EXEC. 06/26/2014 $ 3,500.00 Check Number 30908 Total RAY K. FORNEY C/O RAY K. FORNEY ESTATE $ 3,500.00 Page 1 (5) Disbursements of Principal (Continued) Date Paid Amount Paid Family Exemptions RAY K. FORNEY C/O RAY K. FORNEY ESTATE DAVID L. FORNEY, EXEC. DAVID L. FORNEY, EXEC. Total Family Exemptions $ 3,500.00 Fees and Commissions REGISTER OF WILLS (PROBATE FEES) 02/10/2014 $ 119.50 Check Number 55643 05/28/2014 70.00 Check Number 30900 Total REGISTER OF WILLS (PROBATE FEES) $ 189.50 SERRATELLI, SCHIFFMAN & BROWN 10/09/2014 $ 6,672.50 Total SERRATELLI, SCHIFFMAN & BROWN $ 6,672.50 Total Fees and Commissions $ 6,862.00 Total Disbursements of Principal $ 15,225.34 Page 2 (6) LOUISE P SOWERS ESTATE Distributions of Principal to Beneficiaries Distribution Value Total Distributions of Principal $ 0.00 Page 1 (7) LOUISE P SOWERS ESTATE Principal Balance On Hand Inventory Value Cash and Cash Equivalents LOOSE CHANGE/COINS $ 188.24 Pass Thru Account 14,991.18 Total Cash and Cash Equivalents $ 15,179.42 Total Balance on Hand $ 15,179.42 Page 1 (8) LOUISE P SOWERS ESTATE Information Schedules -Principal Inventory Value Exchanges and Stock Distributions MET LIFE INSURANCE 11/02/2013 Received 13,321.23 03/13/2014 Collected (13,321.23) MET LIFE TRUST INTERESTS 11/02/2013 90 Shs. Received 4,860.90 03/12/2014 (90) Shs. Sold (4,860.90) PFIZER 11/02/2013 208.15057 Shs. Received 6,683.71 03/12/2014 (208.15057) Shs. Sold (6,683.71) PRUDENTIAL LIFE INSURANCE 11/02/2013 Received 5,319.27 04/04/2014 Sold (5,319.27) Page 1 (9) LOUISE P SOWERS ESTATE Unpaid Principal Expenses STEPHANIE SOWERS-WAROS (Refund of Costs Advanced-Attorney Fee) $ 240.00 Total STEPHANIE $ 240.00 SOWERS-WAROS (Refund of Costs Advanced-Attorney Fee) ADT SECURITY SERVICES $ 171.07 Total ADT SECURITY $ 171.07 SERVICES ANIMAL EXPENSES (PAYABLE TO STEPHANIE SOWERS-WAROS) $ 183.59 Total ANIMAL EXPENSES $ 183.59 (PAYABLE TO STEPHANIE SOWERS-WAROS) BARCLAY'S BANK DE (LL BEAN) C/O PHILLIPS & COHEN ASSOCIATES, LTD. $ 8,595.67 Total BARCLAY'S BANK DE $ 8,595.67 (LL BEAN) C/O PHILLIPS & COHEN ASSOCIATES, LTD. COMENITY CAPITAL BANK-HSN $ 3,518.05 Total COMENITY CAPITAL $ 3,518.05 BANK-HSN Page 1 (10) Unpaid Principal Expenses (Continued) EAST HARRISBURG CEMETERY (FEE ASSOCIATED WITH GRAVE OPENING FOR DISPOSITION OF ASHES AND GRAVEMARKER) $ 2,400.00 Total EAST HARRISBURG $ 2,400.00 CEMETERY (FEE ASSOCIATED WITH GRAVE OPENING FOR DISPOSITION OF ASHES AND GRAVEMARKER) ERIE INSURANCE GROUP C/O RMS COLLECTIONS (Auto Insurance Balance) $ 204.25 Total ERIE INSURANCE $ 204.25 GROUP C/O RMS COLLECTIONS (Auto Insurance Balance) FULTON BANK CARDMEMBER SERVICES ELAN FINANCIAL SERVICES C/O PHILLIPS & COHEN ASSOCIATES,LTD. $ 3,451.28 Total FULTON BANK $ 3,451.28 CARDMEMBER SERVICES ELAN FINANCIAL SERVICES C/O PHILLIPS & COHEN ASSOCIATES, LTD. GE CAPITAL RETAIL BANK $ 1,338.25 Total GE CAPITAL RETAIL $ 1,338.25 BANK Page 2 (11) Unpaid Principal Expenses (Continued) PENNSYLVANIA AMERICAN WATER $ 120.95 Total PENNSYLVANIA $ 120.95 AMERICAN WATER PNC BANK ACCOUNT ENDING IN 3475 $ 15,346.01 Total PNC BANK ACCOUNT $ 15,346.01 ENDING IN 3475 PPL ELECTRIC $ 205.93 Total PPL ELECTRIC $ 205.93 RBS CITIZENS,N.A (Vehicle Deficiency Debt) c/o DCM SERVICES, LLC The decedent's vehicle (2013 Toyota Rav 4) was encumbered by a loan in the amount of$21,161.77). The lender(RBS Citizens) agreed to accept $18,000 from the Executor as a short payoff. A deficiency balance claim was made against the Estate. $ 3,161.77 Total RBS CITIZENS, N.A $ 3,161.77 (Vehicle Deficiency Debt) c/o DCM SERVICES, LLC SERRATELLI, SCHIFFMAN & BROWN $ 2,500.00 Total SERRATELLI, $ 2,500.00 SCHIFFMAN & BROWN STEPHANIE SOWERS-WARDS $ 4,000.00 Page 3 (12) Unpaid Principal Expenses (Continued) STEPHANIE SOWERS-WAROS Total STEPHANIE $ 4,000.00 SOWERS-WARDS TASTE OF HOME BOOKS c/o BOOK SERVICES $ 61.96 Total TASTE OF HOME BOOKS $ 61.96 c/o BOOK SERVICES UHS PHARMACY $ 101.00 Total UHS PHARMACY $ 101.00 Total $ 45,599.78 Total Unpaid Expenses $ 45,599.78 Page 4 (13) LOUISE P SOWERS ESTATE Principal Unrealized Gains and Losses Market Value Inventory Value Gain or(Loss) Total $ 0.00 $ 0.00 $ 0.00 Page 1 (14) LOUISE P SOWERS ESTATE Receipts of Income Income Collected MET LIFE TRUST INTERESTS 02/12/2014 Dividend on 90 Shares $ 4.13 02/12/2014 Dividend on 90 Shares 20.63 03/13/2014 Dividend on 0 Shares 4.13 04/01/2014 Dividend on 0 Shares 20.63 $ 49.52 PFIZER 06/17/2014 Dividend on 0 Shares $ 0.41 08/15/2014 Dividend on 0 Shares 32.16 32.57 Total Income Collected $ 82.09 Total Income Received $ 82.09 Page 1 (15) LOUISE P SOWERS ESTATE Gains and Losses on Sales or Other Dispositions of Income Net Gain Net Loss None No Gain or Loss $ 0.00 Page 1 (16) LOUISE P SOWERS ESTATE Disbursements of Income Date Paid Amount Paid Total Disbursements of Income $ 0.00 Page 1 (17) LOUISE P SOWERS ESTATE Distributions of Income to Beneficiaries Distribution Value Total Distributions of Income $ 0.00 Page 1 (18) . LOUISE P. SOWERS ESTATE Income Balance On Hand Inventory Value Cash and Cash Equivalents Pass Thru Account $ 82.09 Total Cash and Cash Equivalents $ 82.09 Total Balance on Hand $ 82.09 eS cd* PHAN A. SOWERS-WA OS, Executor of LOUISE P. SOWERS ESTATE. Page 1 (19) LOUISE P SOWERS ESTATE Information Schedules- Income Inventory Value Exchanges and Stock Distributions Page 1 (20) LOUISE P SOWERS ESTATE Income Unrealized Gains and Losses Market Value Inventory Value Gain or(Loss) Total $ 0.00 $ 0.00 $ 0.00 Page 1 (21) M LOUISE P. SOWERS ESTATE VERIFICATION STEPHANIE A. SOWERS-WARDS, Executor of LOUISEP SOWERS ESTATE, hereby declares under oath that said executor has fully and faithfully discharged the duties of their office; that the foregoing First and Final 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 their knowledge there are no claims now outstanding against the Estate; and that all taxes presently due from the Estate have been paid; and that the grant of Letters Testamentary and the first complete advertisement thereof occured more than four months before the filing of the foregoing First and Final Account. This statement is made subject to the penalties of 18 Pa. C.S.A. Section 4904 relating to unsworn falsification to authorities. �cc. r�X d�STEP AN A. SOWERS-WAROS Dated: I L ��'