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HomeMy WebLinkAbout12-08-14 DECEDENT'S ESTATE M COURT OF COMMON PLEAS OF o rn cli CUMBERLAND COUNTY, PENNSYLVANIA } ORPHANS' COURT DIVISION - f rn m CC) zr t5 ESTATE OF Linda K. Kutz -D�CEASEQ rn ' No. 21-14-0058 . 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 1 Of 10 PETITION FOR ADJUDICATION Estate of Linda K. Kutz Deceased 1. Name(s) and address(es) of Petitioner(s): Name: Melissa A. Miller Address: 1005 Pheasant Drive North 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 12/01/2013 ❑ Letters Testamentary or ® Letters of Administration were granted to Petitioner(s) on 01/17/2014 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: 01121/2014 01/28/2014 02/04/2014 01/31/2014 02/07/2014 02/14/2014 Form OC-01 Rev.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 2 of 10 PETMON FOR ADJUDIC46MO Estate of Linda K. Kutz 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 sec. 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)? .............. ❑ 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 0 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 Linda K. Kutz 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 Relationship and Comments,if any Interest Melissa A. Miller Daughter 100% 1005 Pheasant Drive North Carlisle, PA 17013 Form OC-01 Rev.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 4 of 10 PETITION FOR ADJUDICATION Estate of Linda K. Kutz Deceased Name and Address of Each Party in Interest Relationship and Comments,if any Interest B. Identify each party who is not sui juris (e.g., minors or incapacitated persons). For each such party, give date of birth, the name of each Guardian and how each Guardian was appointed. If no Guardian has been appointed, identify the next of kin of such party, giving the name, address and relationship of each. C. State why a Petition for Guardian/Trustee Ad Litem has or has not been filed for this Audit(see PA. 0.C. Rule 12.4). D. If distribution is to be made to the personal representative of a deceased party, state date of death, date and place of grant of Letters and type of Letters granted. Form OC-01 Rev.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 5 of 10 PETITION FOR ADJUDICATION Estate of Linda K. Kutz 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 ClaimWill Claim Admitted? Be Paid in Full? Above Attachment Total If the estate is insolvent, attach a schedule setting forth the order of preference under 20 Pa.C.S. § 3392 and the proposed payments. 11. Was family exemption claimed?.......................................................................................... Yes ® No Wasfamily exemption allowed?.......................................................................................... Yes ® No Family exemption claimant's name and relationship: Name: Relationship: Form OC-01 Rev.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 6 of 10 PETITION FOR ADJUDICATION Estate of Linda K. Kutz 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: B. Has notice of the question requiring adjudication been given to the parties identified in Paragraph 9 above?............................................................ ❑ Yes ® No 15. If Petitioner(s) has/have knowledge that a share has been assigned, renounced, disclaimed or attached, provide a copy of the assignment, renunciation, disclaimer or attachment, together with any relevant supporting documentation. Form OC-01 Re,10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 7 of 10 PETITION FOR ADJUDICATION Estate of Linda K. Kutz 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 Rev.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 8 of 10 PETMON ON FOR ADJU MCLQ'iTi M Estate of Linda K. Kutz 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 ncome:Proposed Distributee(s) Amount Proportion Melissa A. Miller 100% B. Principal: Proposed Distributee(s) Amount Proportion Melissa A. Miller 100% Submitted By: (All petitioners must sign. Add additional limes if necessary): z a _VXVI., Name of Petitioner: Melissa A. Miller 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 Linda K. Kutz Deceased Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies * [that helshe 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). Jq� 0 Signature of Petitioner Melissa A. Miller 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. n ou el for Petitioner L. iffie Form OC-01 Rev.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): January 21,28,February 4, 2014. COPY OF NOTICE OF PUBLICATION ADMINISTRATRIX NOTICE Affiant further deposes that he/she is not •Letters of Administration on the Estate of LINDA K.KUTZ,late of Lower. interested in the subject matter of the Frankford Township,Cumberland County,Pennsylvania,deceased,nave 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 to time,place and character of publication settlement to: .. are true. Melissa A.Miller,AdminNtratrix c/o Bradley L.Griffie,Esquire GRIFFIE&ASSOCIATES f 200 North Hanover Street ._ .._ ..._.. _. Carlisle,PA 17013.. t , Sworn to and subscribed before me this 1 n Not -y Public My commission expires: COMMONWEALTH OF PENNSYLVANIA Notarial Seal Bethany M.Floltry,Notary Public Carlisle Boro,Cumberland County My Commission Expires Sept.26,2015 MSMOER,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: January 31, February 7, and February 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. Lisa Marie Coyne, Edi r SWORN TO AND SUBSCRIBED before me this 14 day of February, 2014 Rutz,Linda R.,dec'd. Notary Late of Lower Franword Town- ship. Administratrix: Melissa A. Miller C/o Bradley L. Griffie, Esquire, Griffie & Associates, 200 North �*ivOTARiAL SEAL sn Hanover Street, Carlisle, PA, DEBORAH P,COLLI 17013. i? Attorneys: Bradley L. Griflie, Es- fttary Public (( quire, Griffie&Associates. CARLISLE BOROUGH,CUMBERLAND COUNTIl My Commission Expires Apr 23,2014 In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division File No. 21-14-0058 Estate of Linda K. Kutz, Deceased Late of Township of Lower Frankford Account Melissa A. Miller, Administratrix Date of Death: 12/01/2013 Date of Incapacity, if any: None Date of Administratrix's Appointment: 01/17/2014 Date of First Complete Advertisement: 01/31/2014 Accounting for the period: 01/17/2014 to 12101/2014 Purpose of Account: Melissa A. Miller, Administratrix, 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 r.s Carlisle, PA 17013 rri c Co rn Q 717-243-5551 cl*:) Supreme Court I.D. No. 34349 Mm rrnn co X C Q Co r-> o -n ..n -n c cl ; c,w M �n W C � 1 , . i SUMMARY OF ACCOUNT Estate of Linda K. Kutz, Deceased For the period of December 1, 2013 through December 1. 2014 PAGES PRINCIPAL Receipts: This Account A 25,274.18 Net Gain (or Loss) on Sales or Other Dispositions 0.00 25,274.18 Less Disbursements: C Debts of Decedent 8,717.61 Funeral Expenses 3,507.78 Administration Expenses 549.55 Federal, State& Local Taxes 0.00 Commissions 0.00 Fees 3,731.00 Family Exemption 0.00 16,505.94 Balance Before Distributions 8,768.24 Transfer to (from) Principal TP 0.00 Distributions to Beneficiaries 0.00 Principal Balance on Hand PBOH 8,768.24 For Information: Investments Made Changes in Holdings F INCOME Receipts This Account 0.00 Net Gain (or Loss) on Sales 0.00 or Other Dispositions 0.00 Less Disbursements 0.00 Balance Before Distributions 0.00 Transfer to (from) Income TI 0.00 Distributions to Beneficiaries 0.00 Income Balance on Hand 0.00 For Information: Investments Made Changes in Holdings COMBINED BALANCE ON HAND CBOH 8,768.24 Signature Verification SCHEDULE A RECEIPTS OF PRINCIPAL Assets Listed in Inventory Fiduciary (Valued as of Date of Death) Acquisition Value Cash 2013 State Tax Refund 94.00 Erie Insurance- 73.00 Automobile Insurance Refund M&T Bank Checking Account- 7,472.22 Account No.XXX662 M&T Bank Savings Account- 120.00 Account No. XXXXXXXXXX9082 Orrstown Financial Advisors - 17,377.10 DWS Balanced Fund A Account No.XXXXXXX5995 Refund of overpayment from Carlisle Medical 137.86 Pathology, P.C. Total Cash 25,274.18 Total Receipts 25,274.18 Total Receipts of Principal 25,274.18 A-1 SCHEDULE C DISBURSEMENTS OF PRINCIPAL Debts of Decedent AT&T Mobility (Final bill) 05/13/2014 30.82 30.82 Carlisle Regional Medical Center(Medical) 04/23/2014 117.86 117.86 Forest Park Health Center(Medical) 04/23/2014 950.00 950.00 James D. Bogar. Esquire 04/23/2014 175.00 (Pre-death legal services) 175.00 The Johns Hopkins Hospital 05/13/2014 7,443.93 7,443.93 Total Debts of Decedent 8,717.61 Funeral Expenses Hoffman-Roth Funeral Expenses 02/26/2014 3,507.78 3,507.78 C-1 SCHEDULE C DISBURSEMENTS OF PRINCIPAL Continued Total Funeral Expenses 3,507.78 Administration Expenses Cumberland Law Journal (Advertising) 12/01/2013 75.00 75.00 Orrstown Bank(Bank fees) 04/2312014 16.75 16.75 Probate Fee 12101/2013 288.50 288.50 The Sentinel (Advertising) 02/24/2014 169.30 169.30 Total Miscellaneous Administrative Exoenses 549.55 Fees Cohick&Associates 04123/2014 231.00 (2013 Personal Income Tax Return) 231.00 Griffie &Associates, P.C. 12101/2014 3,500.00 C-2 SCHEDULE C DISBURSEMENTS OF PRINCIPAL Continued 3,500.00 Total Fees 3,731.00 TOTAL DISBURSEMENTS OF PRINCIPAL 16,505.94 C-3 PRINCIPAL BALANCE ON HAND Current Value Fiduciary 12/01/2014 Acquisition #Units Description or as Noted Value cash Orrstown Bank -16,505.94 -16,505.94 Total Cash -16,505.94 -16,505.94 Assets 2013 State Tax Refund 94.00 Erie Insurance 73.00 M&T Bank Checking Account 7,472.22 M&T Bank Savings Account 120.00 Orrstown Financial Advisors 17,377.10 Refund of overpayment from Carlisle Medical Pathology, P.C. 137.86 Total Assets 25,274.18 -16,505.94 8,768.24 PBOH-1 COMBINED BALANCE ON HAND Current Value Fiduciary 12/01/2014 Acquisition #Units Description or as Noted Value Cash Orrstown Bank -16,505.94 -16,505.94 Total Cash -16,505.94 -16,505.94 Assets 2013 State Tax Refund 94.00 Erie Insurance 73.00 M&T Bank Checking Account 7,472.22 M&T Bank Savings Account 120.00 Orrstown Financial Advisors 17,377.10 Refund of overpayment from Carlisle Medical Pathology, P.C. 137.86 Total Assets 25,274.18 -16,505.94 8,768.24 CBOH-1 SCHEDULE J DISTRIBUTIONS - INCOME 12/01/2014 Melissa A. Miller 8,768.24 8,768.24 TOTAL DISTRIBUTIONS TO BENEFICIARIES 8,768.24 J-1 In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division File No. 21-14-0058 Estate of Linda K. Kutz, Deceased Signature Melissa A. Miller, Administratrix In the Court of Common Pleas of Cumberland County, Pennsylvania Orphans' Court Division File No: 21-14-0058 Estate of Linda K. Kutz, Deceased Verification Melissa A. Miller,Administratrix under the Last Will and Testament of Linda K. Kutz, 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: Melissa A. Miller,Administratrix I hereby certify that written notice of the filing of this Account, and of the date, time and place when the same will be presented to the Court for confirmation and of the last day to file written objections to said Account, has been given to every unpaid claimant and to every other person known to the accountant to have or claim an interest in the estate as creditor, beneficiary, heir, or next of kin. dl r . e, Esquire