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HomeMy WebLinkAbout12-08-14 DECEDENT'S ESTATE r� COURT OF COMMON PLEAS OF c rn CUMBERLAND COUNTY, PENNSYLVANIA a M C ORPHANS' COURT DIVISION rnFri f.� C-) _d r iTt co f ESTATE OF Elizabeth I. Crum DECtA�,ED�A C� rrn g 1 G� C> No. 21-14-0145 y "T1 I PETITION FOR ADJUDICATION I STATEMENT OF PROPOSED DISTRIBUTION PURSUANT TO Pa. O.C. RULE 6.9 This form may be used in all cases involving the Audit of the Account of a Decedent's Estate. If space is insufficient, riders may be attached. Attach the spouse's election, if any; the papers required under items 8-19 inclusive; and any instrument pertinent to the adjudication. INCLUDE ATTACHMENTS AT THE BACK OF THIS FORM. Name of Counsel: Bradley L. Griffie Supreme Court I.D. No.: 34349 Name of Law Firm: Griffie&Associates, P.C. Address: 200 North Hanover Street Carlisle, PA 17013 Telephone: 717-243-5551 Fax: 717-243-5063 E-mail: bgriffie@griffielaw.com Form OC-01 Rev.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page I of 10 PETITION FOR ADJUDICATION Estate of Elizabeth 1. Crum Deceased 1. Name(s) and address(es) of Petitioner(s): Name. Abel T. Crum, Jr. Address: 181 Sunset Drive Carlisle, PA 17013 Identify any executors or administrators who have not joined in the Petition for Adjudication and Statement of Proposed Distribution and Account and state reason: Is this the first accounting by this fiduciary?......................................................................... ® Yes ❑ No If not, identify prior accountings, the accounting periods covered, and the date of adjudication of the prior accounting. 2. Decedent died on 01/30/2014 ® Letters Testamentary or ❑ Letters of Administration were granted to Petitioner(s) on 02/19/2014 Date of Will (if applicable): Date(s) of Codicil(s) (if applicable): Date of probate (if different from date Letters granted): Was a bond required? ❑ Yes ❑ No If yes, state amount: Are proofs of advertising of the grant of Letters attached? .......................................... ❑ Yes ® No Dates of advertising of the grant of Letters: 03/06/2014 03/13/2014 03/20/2014 03/07/2014 03/14/2014 03/21/2014 Form OC-01 Rev.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 2 of 10 PETITION FOR ADJUDICATION Estate of Elizabeth I. Crum Deceased 3. Was decedent survived by a spouse?....................................................................... ❑ Yes © No If yes, name of the surviving spouse: 4. Has the surviving spouse filed to take an elective share?......................................... ❑ Yes ❑ No (See Section 2201 et sem. of the Probate, Estates and Fiduciaries Code) If yes, date of election: 5. In the case of an intestacy, state the names of the decedent's surviving children or surviving issue of deceased children (if none, so state): 6. Did the decedent marry after execution of Will or Codicil(s)?.............................................. ❑ Yes © No Were any children born to decedent after execution of Will or Codicil(s)? ElYes © No If yes, give names and dates of birth: Name: Date of Birth: 7. If required by the Medical Assistance Estate Recovery Act, 62 P.S. §1412, was a request for a statement of claim sent to the Department of Public Welfare? ..................................................................................... © Yes ❑ No Form OC-01 Rev.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 3 of 10 PETITION FOR ADJUDICATION Estate of Elizabeth I. Crum 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 nterest(s):Name and Address of Each Party in Interest Relationship and Comments,if any Interest Deborah Stahl Daughter 1/3 609 West Pine Street Mount Holly Springs, PA 17065 Mary A. Fry Daughter 1/3 11 South Walnut Street Mount Holly Springs, PA 17065 Form OC-01 Re,10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 4 of 10 PETITION FOR ADJUDICATION Estate of Elizabeth I. Crum Deceased Name and Address of Each Party in Interest Relationship and Comments,if any Interest Abel T. Crum,Jr. Son 1/3 181 Sunset Drive Carlisle, PA 17013 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.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 5 of 10 PETITION FOR ADJUDICATION Estate of Elizabeth I. Crum 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? Pennsylvania Department of Public Welfare 282,581.56 ®Yes ❑Yes ❑ No ® No Above 282,581.56 Attachment Total 282,581.56 If the estate is insolvent, attach a schedule setting forth the order of preference under 20 Pa.C.S. § 3392 and the proposed payments. 11. Was family exemption claimed?.......................................................................................... ❑ Yes ® No Was family exemption allowed?.......................................................................................... ❑ Yes ® No Family exemption claimant's name and relationship: Name: Relationship: Form OC-01 Re,10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 6 of 10 PETITION FOR ADJUDICATION Estate of Elizabeth I. Crum 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 13. On the date of death, was the decedent a fiduciary (personal representative, trustee, guardian, agent under power of attorney) or surety on the bond of a fiduciary?................................................................ ❑ Yes ® No If yes, provide the name of the estate, indicate whether an account has been filed and confirmed absolutely and all awards performed, or, in the alternative, how the decedent's estate will be discharged for the decedent's fiduciary administration of the estate. 14. A. Describe in detail any questions requiring adjudication and state the position of the Petitioner(s) as to each question: The claim of the Deptartment of Public Welfare is $282,581.56. All other administrative expenses and claims of appropriate priority have been paid. Funds available for distribution to the Department of Public Welfare total $140,380.97 and a request has been made of the Department to accept this amount as payment in full (see attached correspondence of October 15, 2014), but no response has been received. B. Has notice of the question requiring adjudication been given to the parties identified in Paragraph 9 above?............................................................ ® Yes ❑ No 15. If Petitioner(s) has/have knowledge that a share has been assigned, renounced, disclaimed or attached, provide a copy of the assignment, renunciation, disclaimer or attachment, together with any relevant supporting documentation. Form OC-01 Rev.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 7 of 10 PETITION! FOR ADJUDICATION Estate of Elizabeth I. Crum Deceased 16. Had the decedent been adjudicated an incapacitated person?........................................... ❑ Yes ® No If yes, attach a copy of the Order if available; otherwise state Court, term, number, date, and name of Hearing Judge. 17. A. List or attach a separate list of additional receipts and disbursements since the closing date of the Account. Date Description Amount B. Has notice of the additional receipts and disbursements been given to the parties identified in Paragraph 9 above?................................................... ❑ Yes ® No 18. If a reserve is requested, state amount and purpose. Amount: Purpose: If a reserve is requested for counsel fees, has notice of the amount of fees to be paid from the reserve been given to the parties in interest?................................................................................................. ❑ Yes ® No If so, attach a copy of the notice. 19. Is the Court being asked to direct the filing of a Schedule of Distribution?................................................................................ ❑ Yes ® No As to real estate only?......................................................................................................... ❑ Yes ❑ No Form OC-01 Re,10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 8 of 10 PETITION FOR ADJUDICATION Estate of Elizabeth I. Crum 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) Amount Proportion Deborah Stahl 1/3 Mary A. Fry 1/3 Abel T. Crum, Jr. 1/3 B. Principal: Proposed Distributee(s) Amount Proportion Deborah Stahl 1/3 Mary A. Fry 1/3 Abel T. Crum, Jr. 1/3 Submitted By: (All petitioners must sign. Add additior4al lines if necess ry): - Name of Petitioner: Abel T. Crum,Jr. Name of Petitioner: Name of Petitioner: Form OC-01 Rev.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 9 of 10 PETITION FOR ADJUDICATION Estate of Elizabeth I. Crum 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 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). Signature of Petitioner Abel-f.-Crum, Jr. Signature of Petitioner Signature of Petitioner *Corporate petitioners must complete bracketed information. Certification of Counsel The undersigned counsel hereby certifies that the foregoing Petition for Adjudication/ Statement of Proposed Distribution is a true and accurate reproduction of the form Petition authorized by the Supreme Court, and that no changes to the form have been made beyond the responses herein. SiPGriff" nse or Petitioner Form OC-01 Re,10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 10 of 10 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): March 6, 13,20,2014. COPY OF NOTICE OF PUBLICATION ADMINISTRATOR'S NOTICE Affiant further deposes that he/she is not Letters of Administration on the Estate of ELIZABETH L CRUM,late of interested in the subject matter of the Carlisle Borough,Cumberland County;Pennsylvania,deceased;have aforesaid notice or advertisement and that .been granted to the undersigned. , All persons knowing themselves to be indebted to said Estate will make all allegations in the foregoing statement as payment immediately,and-those having claims will present them for settlement to: to time,place and character of publication Abel T.Crum G Administrator are tTue. GBradley Bradle GSOC Esquire GRIFF.IE&.ASSOCIATES f 200 North Hanover Street Carlisle,PA 17013, s Sworn to and subscribed before me this iC G otary Public My commission expires: Lcadisle NVVEANotarrO SeaINNSYLVANIA any M.Holtry,Notary Public Baro,Cumberland ot. 2015 mmtsslon Expires.SeP MEMBER,PENNSYLVANIA ASSocL"''RON-- 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: March 7, March 14 and March 21, 2014 Affiant filrther 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. r� Lisa Marie Coyne Editor SWORN TO AND SUBSCRIBED before me this 21 day of March, 2014 Notary Crum,Elizabeth I.,deed. Late of the Borough of Carlisle. Administrator: Abel T. Crum,Jr. c/o Bradley L. Griffie, Esquire, Griffie & Associates, 200 North _ Hanover Street, Carlisle, PA <Ys� 17013. hl�iAIiIAL S,AL Attorneys: Bradley L. Griffie, Es- DEAOnAl1 A COLLI\S quire,Griffie&Associates. ! idotary I'ub!ic CARLISLE BOROUGH,Mf.,?,BERLAND COUNiT Y� My Commission Expires Apr 28,20114 PETITION FOR ADJUDICATION ESTATE OF ELIZABETH I. CRUM Attachment to No. 8A. Deborah Stahl 609 West Pine Street Mt. Holly Springs, PA 17065 Mary A. Fry 11 South Walnut Street Mt. Holly Springs, PA 17065 Abel T. Crum, Jr. 181 Sunset Drive Carlisle, PA 17013 Department of Public Welfare Attn: Elvetta E. Knox Bureau of Program Integrity Division of Third Party Liability PO Box 8486 Harrisburg, PA 17105-8486 COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHANS'COURT DIVISION IN THE MATTER OF ELIZABETH 1. CRUM FIRST ACCOUNT OF ABEL T. CRUM, JR. EXECUTOR UNDER THE WILL OF ELIZABETH I. CRUM NUMBER 21-14-0145 NOTICE TO PARTIES IN INTEREST Notice is hereby given that the Executor of the above captioned Estate has filed a First Account and Statement of Proposed Distribution with the Clerk of the Orphans' Court of Cumberland County, Pennsylvania, and the Audit thereon shall be before the Court on the 13`" day of January, 2015, at 9:30 a.m., in Courtroom No. 1, Cumberland County Courthouse, One Courthouse Square, Carlisle, Pennsylvania, 17013. If you have any objection to any transaction or matter involving the Estate, you must file with the Clerk of the Orphans' Court objections thereto in writing prior to Audit, or appear in person or by legal counsel and present your objections to the Court at Audit. If you fail to present objections, the Court may assume you have no objection to the Account and Statement of Proposed Distribution. You are not required to appear if you have no objections. A copy of the Account and Statement of Proposed Distribution is attached hereto; and if not attached, it is available for your examination at the Register of Wills Office, Cumberland County Courthouse. Respectfully submitted, DATE: ri£fa , Esquire Attorney for Petitioner Supreme Court ID No. 34349 200 North Hanover Street Carlisle, PA 17013 (717) 243-5551 (800) 347-5552 Gr`rFF-TE & AssoC�. 7�,S� P.C. Attorneys and Counselors at Law 200 North Hanover Street Bradley L. Griffie, Esquire Carlisle,PA 17013 Hannah Herman-Snyder,Esquire (717)243-5551 100 Lincoln Allay East,Suite Robin J.Bassett Chambersburg,PA 17201 Office Manager (717)267-1350 Kelly L.Perez. (800)347-5552 Legal Assistant Fax(717)243-5063 Reply to:Cal-lisle October 15, 2014 Department of Public Welfare Attn: Elvetta E. Knox Bureau of Program Integrity Division of Third Party Liability PO Box 8486 Harrisburg, PA 17105-8486 RE: Elizabeth Crum CIS#: 260219608 SSN: #0-0-1131 Date of Death: 1/30/2014 Dear Ms. Knox: Enclosed herein please find correspondence fiom you dated March 31, 2014 that was forwarded to me in my capacity as attorney for the estate of Elizabeth Crum. Please be advised that this estate included the following assets: Real estate $173,000.00 1 West Countryside Dr. Boiling Springs, Cumberland County Hartzell Eye Specialists refund $43.55 United Healthcare Systems, Inc. refunds $240.20 Social Security benefit from pre-deceased $255.00 husband's passing Real Estate tax proration from settlement $299.30 TOTAL $173,83.8.05 In addition there were two jointly held accounts with the decedent and her daughter, Deborah E. Stahl, which totaled $3,789.64, but are non-probate assets. At the time of her passing, the decedent held the following indebtedness: Three Springs Family Practice (medical) $134.58 Sarah Todd Nursing Home(final billing) $53.65 TOTAL $188.23 The following indebtedness was incurred by the estate in administering the estate: The Sentinel (Advertising) $ 135.44 Cumberland Law Journal (Advertising) 75.00 Orrstown Bank Check Fees 16.25 Real Estate repairs prior to sale 700.00 Real Estate maintenance 475.00 (lawn maintenance and snow removal) Met-Ed (Utilities) 537.37 Real Estate Water/Sewer 135.22 Real Estate sale fees/costs 17.639.07 TOTAL $19,697.10 Based upon the assets of the estate, the decedent's expenses and the estate administration expenses, the balance that we have available to contribute toward the Department's claim is $140,380.97. I would appreciate if you could review this matter and advise us as to whether the Department will accept this distribution as payment in full on the claim. Your prompt attention in is matter would be appreciated. V truly yours, y L. Griffie BLG/rjb Enclosure Cc: A. Thomas Crum, Executor . 03,70'�F 05 In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division File No. 21-14-0145 Estate of Elizabeth I. Crum, Deceased Late of Borough of Carlisle First and Final Account Abel T. Crum, Jr., Administrator Date of Death: 01/30/2014 Date of Incapacity, if any: None Date of Administrator's Appointment: 02/19/2014 Date of First Complete Advertisement: Accounting for the period: 01/30/2014 to 11/15/2014 Purpose of Account: Abel T. Crum,Jr.,Administrator, offers this Account to acquaint interested parties with the transactions that have occurred during the Administration. It is important that the Account be carefully examined. Requests for additional information or questions or objections can be discussed with: Bradley L. Griffie Griffie&Associates, P.C. 200 North Hanover Street Carlisle, PA 17013 717-243-5551 Supreme Court I.D. No.34349 N C) C Q :;0 Co G-) a �7 C'7 70 I r- co Cr7 1T1 ` C) C::> M --� r— CJ1 N J SUMMARY OF ACCOUNT Estate of Elizabeth I. Crum, Deceased For the period of Januar 30- 2014 through November 15, 2014 PAGES PRINCIPAL Receipts: This Account 3 173,838.05 Net Gain (or Loss) on Sales or Other Dispositions 0.00 173,838.05 Less Disbursements: Debts of Decedent 4 255,275.17 Funeral Expenses 3 175.00 Administration Expenses 3 20,213.85 Federal, State & Local Taxes 0.00 Commissions 3 8,880.00 Fees 3 4,000.00 Family Exemption 0.00 288,544.02 Balance Before Distributions -114,705.97 Transfer to (from) Principal 0.00 Distributions to Beneficiaries 0.00 Principal Balance on Hand 5 -114,705.97 For Information: Investments Made Changes in Holdings 6 INCOME Receipts This Account 0.00 Net Gain (or Loss) on Sales 0.00 or Other Dispositions 0.00 Less Disbursements 0.00 Balance Before Distributions 0.00 Transfer to (from) Income 0.00 Distributions to Beneficiaries 0.00 Income Balance on Hand 0.00 For Information: Investments Made Changes in Holdings COMBINED BALANCE ON HAND 7 -114,705.97 Signature 8 Verification 9 - 2 - SCHEDULE A RECEIPTS OF PRINCIPAL Assets Listed in Inventory Fiduciary (Valued as of Date of Death) Acquisition Value Cash Hartzell Eye Specialists Refund 43.55 Real Estate tax prorations at settlement 299.30 Social Security death benefit from pre-deceased 255.00 husband's passing United Healthcare Systems, Inc. Premium Refund 234.00 United Healthcare Systems, Inc. Premium Refund 6.20 Total Cash 838.05 Real Estate 1 West Countryside Drive, Boiling Springs,South 173,000.00 Middleton Township,Cumberland County- Single Family Residence (See attached HUD-1 Settlement Statement) Total Real Estate 173,000.00 Total Receipts 173,838.05 Total Receipts of Principal 173.838.05 - 3 - SCHEDULE C DISBURSEMENTS OF PRINCIPAL Debts of Decedent Department of Public Welfare 01/30/2014 255,086.94 Division of Third Party Liability Medicaid Claim 255,086.94 Sarah Todd Nursing Home(final billing} 01/30/2014 53.65 53.65 Three Springs Family Practice(Medical) 04/0812014 134.58 134.58 Total Debts of Decedent 255,275.17 Funeral Expenses Hollinger Funeral Home & Crematory, Inc. 03/05/2014 175.00 (Stone etching and grave marker) 175.00 Total Funeral Exaenses 175.00 Administration Expenses - 4 - SCHEDULE C DISBURSEMENTS OF PRINCIPAL Continued Butterworth Electric Service 03/17/2014 700.00 (Real estate repairs prior to sale) 700.00 Cumberland Law Journal (Advertising) 02125/2014 75.00 75.00 Med-Ed 03/2112014 173.72 173.72 Met-Ed 02/24/2014 248.76 04/25/2014 114.89 363.65 Orrstown Bank Check Fees 01/30/2014 16.25 16.25 Probate Fees 01130/2014 500.50 500.50 Real Estate Expense- Law Maintenance to Tom Crum 05/06/2014 300.00 300.00 Real Estate Expense -Snow Removal to Fred Stahl 05/06/2014 175.00 - 5 - SCHEDULE C DISBURSEMENTS OF PRINCIPAL Continued 175.00 Real Estate Settlement Fees 01130/2014 17,639.07 (See attached HUD-1 Settlement Sheet) Realtor's Commission 10,380.00 Title Insurance letter 40.00 Realty Transfer tax 1,730.00 2014 County/Twp.taxes 444.67 Pest Treatment 265.00 Water/Sewer final bill 44.40 "Seller Help"to Buyers 4,735.00 17,639.07 South Middleton Municipal Authority(Water& Sewer) 01/30/2014 135.22 135.22 The Sentinel (Advertising) 03/17/2014 135.44 135.44 Total Miscellaneous Administrative Expenses 20,213.85 Commissions Abel T. Crum,Jr. 01/3012014 8,880.00 8,880.00 Total Commissions 8,880.00 - 6 - SCHEDULE C DISBURSEMENTS OF PRINCIPAL Continued Fees Griffie&Associates. P.C. 01/30/2014 4,000.00 4,000.00 Total Fees 4,000.00 TOTAL DISBURSEMENTS OF PRINCIPAL 288.544.02 - 7 - PRINCIPAL BALANCE ON HAND Current Value Fiduciary 11/15/2014 Acquisition #Units Description or as Noted Value Cash -75.00 -75.00 Orrstown Bank -288,469.02 -288,469.02 Total Cash -288,544.02 -288,544.02 ACS 1 West Countryside Drive, Boiling Springs,South Middleton 173,000.00 Township,Cumberland County Hartzell Eye Specialists Refund 43.55 Real Estate tax prorations at settlement 299.30 Social Security death benefit from pre-deceased husband's 255.00 passing United Healthcare Systems, Inc. Premium Refund 240.20 Total Assets 173,838.05 -288,544.02 -114,705.97 - 5 - In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division File No. 21-14-0145 Estate of Elizabeth I. Crum, Deceased Signature Abel T. Crum,Jr.,Administr r - 8 - In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division File No. 21-14-0145 Estate of Elizabeth I. Crum, Deceased Verification Abel T. Crum, Jr.,Administrator under the Last Will and Testament of Elizabeth I. Crum, Deceased, hereby declares under oath that he/she has fully and faithfully discharged the duties of his/her office; that the foregoing Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the Estate have been paid in full; that,to his/her knowledge, there are no claims now outstanding against the Estate; that all taxes presently due from the Estate have been paid; and that the grant of Letters Testamentary and the first complete advertisement thereof occurred more than four months before the foregoing Account. This statement is made subject to penalties of 18 Pa. C.S.A. Section 4904 relating to unsworn falsification to authorities. Dated: Abel T. Crum,Jr.,Adminis for - 9 - I hereby certify that written notice of the filing of this Account, and of the date, time and place when the same will be presented to the Court for confirmation and of the last day to file written objections to said Account, has been given to every unpaid claimant and to every other person known to the accountant to have or claim an interest in the estate as c 'tor, beneficiary, heir, or next of kin. r Tie, Esquire