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HomeMy WebLinkAbout03-26-15 RECORDED CF-FICE CF REOISTE% "- �,!ILLS- DECEDENT'S ESTATE ?015 MR9 26 AM IO ',7 GL Vii": : C'F op COURT OF COMMON PLEAS OF r U i;-L' ;. CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION ESTATE OF Carolyn MacAvoy DECEASED No. 21 -12 -00511 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: Debra K Wallet Supreme Court I.D. No.: 23989 Name of Law Firm: Law Offices of Debra K.Wallet Address: 24 North 32nd Street Camp Hill, PA 17011 Telephone: 7171737-1300 Fax: 7171761-5319 E-mail: walletdeb@aol.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 Carolyn MacAvoy Deceased 1. Name(s)and address(es) of Petitioner(s): Name: Joan Fitzwater Jackson Address. 625 Creekside Way,#3307 New Braunfels, TX 78130 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?.......................................................................... 0 Yes ❑ No If not, identify prior accountings, the accounting periods covered, and the date of adjudication of the prior accounting. 2. Decedent died on 3/22/2012 ❑ Letters Testamentary or 0 Letters of Administration were granted to Petitioner(s)on 6/5/2012 Date of Will (if applicable): 11/1/2001 Date(s) of Codicil(s) (if applicable): Date of probate (if different from date Letters granted): Was a bond required? ❑ Yes FX-1 No If yes, state amount: Are proofs of advertising of the grant of Letters attached? .......................................... [K Yes ❑ No Dates of advertising of the grant of Letters: 11/8/2014 11/14/2014 11/15/2014 11/21/2014 11/22/2014 11/28/2014 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 Carolyn MacAvoy Deceased 3. Was decedent survived by a spouse?........................................................................ D Yes Q No If yes, name of the surviving spouse: 4. Has the surviving spouse filed to take an elective share?......................................... El Yes Q No (See Section 2209 et seq. 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)?............................................... El Yes ❑X No Were any children born to decedent after execution of Will or Codicil(s)? ................................................................................................................ 1:1 Yes ❑X 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 R 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 Carolyn MacAvoy , 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 See attached schedule 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 Carolyn MacAvoy Deceased Name and Address of Each Party in Interest Relationship and Comments,if any Interest B. Identify each artYwho is not suiJuris(e.9�, minors or incapacitated persons). For each such party, give date of birth, the name of each Guardian and how each Guardian was appointed. If no Guardian has been appointed, identify the next of kin of such party, giving the name, address and relationship of each. N/A C. State why a Petition for Guardian/Trustee Ad Litem has or has not been filed for this Audit(see PA. 0.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 Form OC-01 Rev.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 5 of 10 PETITION FOR ADJUDICATION Beneficiaries or Heirs (continuation of Question#9A) Estate of Carolyn MacAvoy Deceased Name and Address of Each Party in Interest Relationship and Comments,if any Interest Joan Fitzwater Jackson Sister 625 Creekside Way,#3307 New Braunfels,TX 78130 Kathleen Murphy Sister 871 E.Toledo St. Gilbert,AZ 85295 Charles W. Fitzwater Father 1001 Carpenters Way, C215 Lakeland, FL 33809 Theodora S. Fitzwater Mother 1001 Carpenters Way, C215 Lakeland, FL 33809 Jonathan C. MacAvoy Stepchild 2219 N. 2nd St. Harrisburg, PA 17111 Rachael MacAvoy Stepchild 1760 Pemberton Rd. Blue Bell, PA 19422 William F. MacAvoy Other c/o Jonathan C. MacAvoy 2219 N. 2nd St. Harrisburg, PA 17111 Form OC-01 Rev.10-13-06 PETITION FOR ADJUDICATION Estate of Carolyn MacAvoy 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? l See attached schedule Above Attachment 59,209.05 Total 59,209.05 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 0 No Was family exemption allowed?........................................................................................... E] Yes 0 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 Claims (continuation of Question#10) Estate of Carolyn MacAvoy , Deceased Name and Address of Each Claimant Amount of Claim Claim Will Claim Admitted? Be Paid in Full? Internal Revenue Service 3,581.33 ❑X Yes ❑Yes Fresno, CA 93888-0419 1:1 No FX] No Members 1st Federal Credit Union, 5000 Louise Dr., 12,358.60 ❑X Yes ❑Yes P.O. Box 40, Mechanicsburg, PA 17055(full amt.of ❑ No ❑X No claim-credit union took payment from checking & savinqs acct. at same institution -see acct.) Members 1st Federal Credit Union 4,460.78 ❑X Yes ❑Yes 5000 Louise Dr., P.O. Box 40 Mechanicsburg, PA 17055 ❑ No No DB Servicing Corporation (Discover Card) 7,002.04 ❑X Yes ❑Yes P.O. Box 1370 Reynoldsburg, OH 43068 ❑ No 1Z No Boscov's 488.22 Q Yes ❑Yes P.O. Box 5221 Carol Stream, IL 60197 ❑ No 1K No DCM Services (Target) 192.70 0 Yes ❑Yes P.O. Box 1334 Minneapolis, MN 55440 E] No No The Plum 824.85 ❑X Yes ❑Yes P.O. Box 1032 Harrisburg, PA 17108 E] No [Z No eciService 622.64 Yes ❑Yes 124 West Church St., P.O. Box 459 Dillsburg, PA 17019-0459 ❑ No RX No ADT Security Services 134.97 Yes ❑Yes P.O. Box 650485 No No Dallas,TX 75265-0485 ❑ Verizon 638.18 Yes ❑Yes P.O. Box 920041 Dallas,TX 75392 ❑ No No Q PPL Electric Utilities 174.96 0 Yes ❑Yes 2 North 9th Street No No Allentown, PA 18101 ❑ Claims (continuation of Question#10) Estate of Carolyn MacAvoy Deceased Name and Address of Each Claimant Amount of Claim claim Will Claim Admitted? Be Paid in Full? Erie Insurance Collection Department 129.25 0 Yes Ej yes 100 Erie Insurance Place No No Erie, PA 16530 ❑ Cumberland County (2011 tax) 137.17 [j]yes Ej yes 21 Waterford Drive,Suite 201 Mechanicsburg, PA 17050 E]No 0 No Elizabeth &Albert Schaffhauser(rent) 3,450.00 Yes Yes 240A North 36th Street No No Camp Hill, PA 17011 American InfoSource on Behalf of Bank of America 24,139.01 Yes Ej yes P.O. Box 248852 Ej No FXJ No Oklahoma City, OK 73124 DCM Services(Capital One N.A.) 874.35 Yes yes 7601 Penn Avenue S., Suite A600 No nX No Minneapolis, MN 55423-5004 The Estate is insolvent and there is no money to pay any of the claims listed above. Members V Federal Credit Union put a freeze on the checking and savings accounts at the bank, and made monthly payments on its $12,358.60 claim until the balance of the bank accounts were exhausted. (See final accounting). PETITION FOR ADJUDICATION Estate of Carolyn MacAvoy 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 ❑X No If yes, provide the name of the estate, indicate whether an account has been filed and confirmed absolutely and all awards performed, or, in the alternative, how the decedent's estate will be discharged for the decedent's fiduciary administration of the estate. 14. A. Describe in detail any questions requiring adjudication and state the position of the Petitioner(s)as to each question: None B. Has notice of the question requiring adjudication been given to the parties identified in Paragraph 9 above?............................................................. Yes ❑X 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 Carolyn MacAvoy Deceased 16. Had the decedent been adjudicated an incapacitated person?............................................ 1:1 Yes 0 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 None B. Has notice of the additional receipts and disbursements been given to the parties identified in Paragraph 9 above?.................................................... E] Yes [g] No 18. If a reserve is requested, state amount and purpose. Amount: 976.04 Purpose: Debra K.Wallet, Esq. -reduced attorney fees-$641.04 Attorney postage, mileage, photocopies, advertising costs -$115.00 Final acct.filing fees-$220.00 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?.................................................................................................. 0 Yes F-1 No If so, attach a copy of the notice. (See First and Final Account) 19. Is the Court being asked to direct the filing of a Schedule of Distribution?................................................................................ Yes 0 No Asto real estate only?.......................................................................................................... Yes 0 No Form OC-01 Rev.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 8 of 10 PETITION FOR ADJUDICATION Estate of Carolyn MacAvoy , 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: poposedDe M08(s) Amount popftw None B. Principal: poposedtee(a) Amounf Piopatsn None Submitted By: (All petitioners must sign. Add additional lines if necessary): L A W4 PA"0�� Name of Pel:406r_ Joan F ter Jackson Name of Petitioner. Name of Petitioner. Fom,OC-01 Rev 1&13-2W6 (c)2006 form software only The Lackner Group,lras. Page 9 of 10 PETITION FOR ADJUDICATION Estate of Carolyn MacAvoy , Deceased Verification of Petitioner (Verification must be by at least one petitioner.) The undersigned hereby verifies* [thathwo is we of the above-named mm of mmmum 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). /V� Signatu of Petitioner an Fitzwater ackson Signature of Petitioner Signature of Petitioner 'Corporate peffionem must complete bucketed fnformadon. 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 Petitioner Debra K Wallet roan OC-M RM 10-13-2M to �,,,,sonwee«h T►re�aca�ar Group.gyne Page 10 of 10 PROOF OF PUBLICATION State of Pennsylvania, County of Cumberland Cathy Clark,Advertising 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 November 8,2014 and November 15,2014 and November 22, 2014. COPY OF NOTICE OF PUBLICATION - NO-fICE -- NOTICE IS HEREBY GIVEN that Letters of Administration have been granted Affiant further deposes that he/she 1S not in the following estate.All persons indebted to the estate are required to make payment,and those having claims or demands to present the same interested in the subject matter of the without delay to the Executrix or her attorney. ESTATE OF CAROLYN'MACAVOY,late of Cumberiand.County, aforesaid notice or advertisement, and that Pennsylvania,died March 22,2012.Joan Fitzwater Jackson,Administratrix. all allegations in the foregoing statement as Attorney;Debra K.Wallet,Esquire,24 North 32nd Street,Camp Hill, g g g Pennsylvania 17011. to time,place and character of publication are true. Sworn to and subscribed before me this 41, &W moLm1w 101/T-- Notary Public My commission expires: t=nay sras �g K camas 001101 cvmbedaw courly Ni-2RE! on Sept Z5e 2013 ME?IBEk I)EVI&YLVPKh Aqq-'L,;;A9m OF WTARIES 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: November 14, November 21, and November 28, 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. ULisa Marie Coyne, 1 ditor SWORN TO AND SUBSCRIBED before me this 28 day of November, 2014 Notary Macavoy, Carolyn, dec'd. Late of Cumberland County. COMMONVVEALiH OF PENNSYLVANIA Administratrix: Joan Fitzwater NOTARIAL SEAL Jackson. DEBORAH A COLLINS Attorney:Debra K.Wallet,Esquire, Notary Public 24 North 32nd Street, Camp Hill, ECARLISLE KORO.,CUMBERLAND CNTY PA 17011. mmission Expires Apr 28.201 B BEFORE THE REGISTER OF WILLS, CUMBERLAND COUNTY, PENNSYLVANIA',r No. 2012-00511 FIRST AND FINAL ACCOUNT OF Joan Fitzwater Jackson,Administratrix ',-� ------ For ESTATE OF CAROLYN MACAVOY, Deceased t' Date of Death: March 22, 2012 Date of Administratrix's Appointment: June 5, 2012 Date of Last Advertisement: November 28, 2014 Accounting for the Period: June 5, 2012 to March 5, 2015 PURPOSE OF ACCOUNT: Joan Fitzwater Jackson, Administratrix, offers this Account to acquaint interested parties with the transactions that have occurred during her administration. The Account also indicates the proposed distribution of the Estate. It is important that the Account be carefully examined. Requests for additional information or questions or objections can be discussed with: Debra K. Wallet, Esquire 24 N. 32nd Street Camp Hill, PA 17011 I.D. #23989 (717) 737-1300 SUMMARY OF ACCOUNT Fiduciary Current Acquisition Paste Value Value Proposed Distribution 8 $0.00 to Beneficiaries PRINCIPAL Receipts 2-3 $ 16,948.82 Less Disbursements Debts of Decedent 4 $ 5,563.00 Funeral Expenses 4 6,152.27 Administration Expenses 5 2,390.82 Fees and Commissions 5 1,875.00 Reserves 6 976.04 $ 16,957.13 Principal Balance on Hand $ (8.31) INCOME Receipts 7 $ 8.31 Income Balance on Hand 8.31 Combined Balance on Hand $ 0.00 Page 1 RECEIPTS OF PRINCIPAL Assets Listed in Inventory: (Value as of Date of Death) Cash and Bank Deposits: Member 1 st Savings $ 5.00 Acct. #441481 Members 1st Checking 335.35 Acct.#73609 Members 1st Savings 2,746.98 Acct. #73609 Members 1st Savings 1,369.47 Acct. #378726 Members 1st Checking 994.98 Acct. #378726 Cash in safe deposit box 150.00 Cash in possession of Decedent 61.00 $ 5,662.78 Tangible Personal Property: 2001 Chrysler Sebring convertible $ 5,000.00 Furniture and household items 2,568.44 Jewelry 1,850.87 Scrap gold 1,394.14 $ 10,813.45 Refunds: Blue Cross/Blue Shield refund $ 65.00 Erie Insurance refund 18.00 Verizon refund 3.60 Unum refund 19.06 Toluna refund 40.00 $ 145.66 TOTAL ASSETS LISTED IN INVENTORY: $ 16,621.89 Page 2 Receipts Subsequent to Inventory (Valued When Received) Bank of America Refund 326.93 $ 326.93 TOTAL RECEIPTS OF PRINCIPAL: $ 16,948.82 Page 3 DISBURSEMENTS OF PRINCIPAL Debts of Decedent: Date: Members 1st Federal Credit Union 4/2/2012 $ 281.95 unsecured loan (freeze put on 6/20/12 621.30 Members 1 st account by bank and 7/2/12 310.65 monthly payments automatically 8/25/12 310.65 deducted) 9/4/12 310.65 10/1/12 310.65 11/2/12 310.65 12/3/12 310.65 1/2/13 310.65 2/1/13 284.31 3/8/13 336.99 4/2/13 310.65 5/1/13 310.65 6/1/13 310.65 7/12/13 310.65 8/2/13 310.65 9/5/13 310.65 $ 5,563.00 Funeral Expenses: Parthemore Funeral Home 7/13/12 $ 4,048.75 Theodora Fitzwater(reimbursement 7/13/12 778.52 for 5/2/12 funeral deposit) Charles&Theodora Fitzwater for reimb. 7/26/12 1,325.00 $ 6,152.27 for payment to St. Matthew Catholic Church (columbarium burial unit) Page 4 Administration Expenses: Probate Fees 12/19/12 $ 146.50 Adminstratrix mileage(including 12/5/12 532.80 several round trips from Garnet Valley, PA to Harrisburg, PA) Adminstratrix expenses 12/5/12 375.33 (hotel for 2 nights, meals, postage, turnpike tolls) Administratrix expenses (for filing 3/30/13 259.04 inheritance tax return 12/19/2012 in Camp Hill) Towing for auto to prepare for sale* 6/22/12 537.35 *These auto-related Commonwealth of PA(title/registration)* 6/22/12 58.50 bills were paid Jones BP (auto repair)* 6/26/12 139.07 by Administratrix Auto Traders (listing fee for car)* 6/26/12 55.00 & reimbursed in State Farm (to insure car from 6/20/12 to 6/26/12 38.71 one check 7/11/12)* Gasoline for car 6/26/12 10.00 Jones BP (inspection and emissions) 6/26/12 96.70 The Sentinel (advertisement of Grant 12/14/14 126.82 of Letters) Bank Service Charges: 1/5/14 1.00 2/5/14 1.00 3/5/14 1.00 4/4/15 1.00 5/5/14 1.00 6/5/14 1.00 7/5/14 1.00 8/5/14 1.00 9/5/14 1.00 10/3/14 1.00 11/5/14 1.00 12/5/14 1.00 1/5/15 1.00 2/5/15 1.00 3/5/15 1.00 $ 2,390.82 Fees and Commissions: Debra K. Wallet, Esq.--Attorney Fees 12/19/12 $ 1,750.00 LA Long &Assoc. (2012 Income Tax 2/28/13 125.00 $ 1,875.00 Returns) Page 5 Debra K. Wallet, Eso —Attorney Fees 641.04 (fee reduced due tplack offunds) Attorney's postage, copies, mileage, etc. 40.00 Cumberland Law Journal(reimbursement for 75.00 advertisement ofgrant ufletters paid byattorney) Reserve for filing ofAccount 220.00 $ 976.04 / Page 6 � ! � ` RECEIPTS OF INCOME Interest: Members 1st Estate Savings Acct. 378726 dividends 3/25/12 - 11/30/12 $ 2.61 dividends 12/1/12 -2/28/12 0.21 dividends 1/1/13-9/24/13 1.52 Members 1 st Estate Savings Acct. 73609 dividends 3/25/12 - 11/30/12 3.26 dividends 12/1/12 - 1/31/13 0.05 Members 1 st Estate Savings Acct. 441481 dividends through 6/24/12 0.66 TOTAL RECEIPTS OF INCOME: $ 8.31 Page 7 PROPOSED DISTRIBUTION TO BENEFICIARIES TO: William F. MacAvoy c/o Jonathan C. MacAvoy 2219 N. 2nd Street Harrisburg, PA 17111 $0.00 Rachael MacAvoy 1760 Pemberton Road Blue Bell, PA 19422 0.00 Jonathan C. MacAvoy 2219 N. 2nd Street Harrisburg, PA 17111 0.00 Theodora S. Fitzwater 1001 Carpenters Way, C215 Lakeland, FL 33809 0.00 Charles W. Fitzwater 1001 Carpenters Way, C215 Lakeland, FL 33809 0.00 Kathleen Murphy 871 E. Toledo Street Gilbert, AZ 85295 0.00 Joan Fitzwater Jackson 625 Creekside Way, #3307 New Braunfels, TX 78130 0.00 TOTAL PROPOSED DISTRIBUTION TO BENEFICIARIES: $0.00 Page 8 IN RE: CAROLYN MACAVOY IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA LATE OF CAMP HILL, PENNSYLVANIA ORPHANS' COURT DIVISION DECEASED #2012-00511 VERIFICATION JOAN FITZWATER JACKSON, ADMINISTRATRIX FOR THE ESTATE OF CAROLYN MACAVOY, DECEASED, hereby declares under oath that she has fully and faithfully discharged the duties of her 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 recognized; that all inheritance taxes presently due from the Estate have been paid; and that the grant of Letters of Administration 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. Date: `(n AFS�+ 21r, o t S� JOA ITZWATER J KSON, AD STRATRIX