HomeMy WebLinkAbout08-17-15 �19ti -38
RECORDED OFFICE OF-
REGISTER OF WILLS
?015 8UG 17 F EC�F7DENT'S ESTATE
- CLERK O
0 R P HAN''S' C`COURT OF COMMON PLEAS OF
.0 U 14 E E R 1_fQ MBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
ESTATE OF DOROTHY M DEAVEN , DECEASED
No. 21 -14-0446
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: LISA MARIE COYNE
Supreme Court I.D. No.: 53788
Name of Law Firm: Coyne&Coyne, P.C.
Address: 3901 Market Street
Camp Hill, PA 170114227
Telephone: 7171737-0464
Fax: 7171737-5161
E-mail: lisa@coyneandcoyne.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 DOROTHY M DEAVEN Deceased
1. Name(s)and address(es)of Petitioner(s):
Name: LISA MARIE COYNE
Address: 3901 MARKET STREET
CAMP HILL, PA 17011
Identify any executors or administrators who have not joined in the Petition for
Adjudication and Statement of Proposed Distribution and Account and state reason:
NONE.
Is this the first accounting by this fiduciary?.......................................................................... 0 Yes n No
If not, identify prior accountings, the accounting periods covered, and the date of
adjudication of the prior accounting.
2. Decedent died on 12/18/2012
❑Letters Testamentary or Q Letters of Administration were granted to Petitioner(i)on
5/13/2014
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? n Yes 0 No If yes, state amount:
Are proofs of advertising of the grant of Letters attached? .......................................... n Yes n No
,P)ck,b f 4-'p h
Dates of advertising of the grant of Letters:
5/27/2014 6/3/2014 6/10/2014 5/30/2014 6/6/2014 6/13/2014
For,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 DOROTHY M DEAVEN , Deceased
3. Was decedent survived by a spouse?........................................................................ Yes 0 No
If yes, name of the surviving spouse:
4. Has the surviving spouse filed to take an elective share?......................................... Yes Q 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):
Donna Deavan
145 East Main Street
Mechanicsburg, PA 17055
6. Did the decedent marry after execution of Will or Codicil(s)?............................................... Yes 0 No
Were any children born to decedent after execution of
Willor Codicil(s)? ................................................................................................................ 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? ..................................................................................... Q 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 DOROTHY M DEAVEN , 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
DONNA DEAVEN Daughter 100%RESIDUAL
145 EAST MAIN STREET
MECHANICSBURG, PA 17055
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 DOROTHY M DEAVEN Deceased
Name and Address of Each Party In Interest Relationship and Comments,it 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.
NONE.
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-OT Rev.10-13-2006 Copyright(c)2006 form software only The Latimer Group,tnc. Page 5 of 10
PETITION FOR ADJUDICATION
Estate of DOROTHY M DEAVEN , 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?
Department of Human Services--Estate Recovery 45,415.34 ❑X Yes Ej Yes
P.O. Box 8486 No Q No
Harrisburg, PA 17105-8486
Parthemore Funeral Home 544.11 a Yes Yes
P.O. Box 431 No ❑No
New Cumberland, PA 17070
West Shore EMS 977.90 ❑X Yes ❑X Yes
205 Grandview Ave., Suite 211 No No
Camp Hill, PA 17011-1708
Above 46,937.35
Attachment
Total 46,937.35
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 Q No
Was family exemption allowed?........................................................................................... Yes 0 No
Family exemption claimant's name and relationship:
Name: Relationship:
Form 0C-01 Rev.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 6 of 10
PETITION FOR ADJUDICATION
Estate of DOROTHY M DEAVEN , 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
0.00
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 0 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?............................................................. 0 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 forth software only The Lackner Group,Inc. Page 7 of 10
PETITION FOR ADJUDICATION
Estate of DOROTHY M DEAVEN , Deceased
16. Had the decedent been adjudicated an incapacitated person?............................................ n Yes ❑X 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?.................................................... Yes Q No
18. If a reserve is requested, state amount and purpose.
Amount: 0.00
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
partiesin interest?.................................................................................................. Yes No
1.
If so, attach a copy of the notice.
19. Is the Court being asked to direct
the filing of a Schedule of Distribution? Yes 0 No
................................................................................
Asto real estate only?.......................................................................................................... Yes ❑X 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 DOROTHY M DEAVEN , 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 Distributees) Amount Proportion
See attached schedule
B. Principal:
Proposed DistAbutee(s) Amount Proportion
See attached schedule
Submitted By:
(All petitioners must sign.
Add nal line, if cessary):
r
Name CVoner LISA MARIE C NE
Name of Petitioner:
Name of Petitioner:
Form OC-01 Rev.10.13-2006 Copyright(c)20D6 form software only The Lackner Group,Inc. Page 9 of 10
Final Costs:
Coyne &Coyne, P.C.--Postage $20.00, $20.00
Claims Submitted:
West Shore EMS -ALS-- Schedule H(Services Rendered on 12/17/2012) $977.90
Parthemore Funeral Home-- Balance of Funeral Bill $544.11
Department of Human Services-- (Class 5.1 or 6 claim of$45,715.04) Sla22.09 $6A314.10
Residual Heirs:
Donna Deaven-- Surviving Daughter $0.00 0.00
Total Proposed Final Distrubtions: $6,334.10
PETITION FOR ADJUDICATION
Estate of DOROTHY M DEAVEN , Deceased
Verification of Petitioner
(Verification must be by at least one petitioner.)
The undersigned hereby verifies* [that hexane is true
of the above-named nameofcorporation
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).
Signatu Petitiondr LISA ARIE COYNE
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.
'A,X'r
r----
_SidnjAre of Counsel for Vetitioner
LISA MARIE COYNE
Form OC-01 Rev.10-13-2006 Copyright(c)2006 form software only The Lackner Group,Inc. Page 10 of 10
The Patriot-News Co.
2020 U Finology Pkwy a tlo Aw ews
Suite 300Z4(
Mechanicsburg, PA 17050 NOW you, know
Inquiries - 717-255-821.3
COYNE & COYNE
ATTENTION: LISA MARIE COYNE
3901 MARKET STREET
CAMP HILL PA 17011
THE PATRIOT NEWS
THE SUNDAY PATRIOT NEWS
Proof of Publication ,
Under Act No. 587, Approved May 16, 1929
Commonwealth of Pennsylvania, County of Dauphin} ss
Marianne Miller, being duly sworn according to law, deposes and says:
That she is a Staff Accountant of The Patriot News Co., a corporation organized and existing under the'laws of the
Commonwealth of Pennsylvania, with its principal office and place of business at 2020 Technology Pkwy, Suite 300, in the
Township of Hampden, County of Cumberland, State of Pennsylvania, owner and publisher of The Patriot-News-and The Sunday
Patriot-News newspapers of general circulation, printed and published at 1900 Patriot Drive, in the City, County and State
aforesaid; that The Patriot-News and The Sunday Patriot-News were established March 4th, 1854, and September 18th, 1949,
respectively, and all have been continuously published ever since;
That the printed notice or publication"which is securely attached hereto is exactly as printed and published in their regular
daily and/or Sunday/Community Weekly editions which appeared on the date(s) indicated below. That neither she nor said
Company is interested in the subject matter of said printed notice or advertising, and that all of the allegations of this statement as
to the time, place and character of publication are true; and
That she has personal knowledge of the facts aforesaid and is duly authorized and empowered to verify this statement on
behalf of The Patriot-News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and adopted severally by the
stockholders and board of directors of the said Company and subsequently duly recorded in the office for the Recording of Deeds
in and-for said County of Dauphin in Miscellaneous Book"M", Volume 14, Page 317.
PUBLICATION COPY This ad# 0002301390 ran on the dates shown below:
May 27, 2014
June 03, 2014
EsrASE NOTICE i June 10,2014
LeNers Ad rriirilstrotioh In the Est6fe of"
Dorothy M.Deaven,late of East .
Pennsboro-Townshlp,Cumberland
County;Pennsylvania;deceased,were . . . . . . . . . . .
granted to the undersigned,ond.all
Persons indebted to said Estate.(ire
required to.4nake immediate Payment.-
and those
ayment.,and?hose hovfnosettlement
claims will present ' S,wor to and subscribed b me this 12 day,of June 2014 A.D.
them torsetttement to,::�" '� t : '
.i Lisa Esquire"
COYNE&COYNE,P.C.
3901,Morket'Street '
Camp Hill,PA 17011:-4227
otary ublic
CQ1M eQkJ1iw31!r}t OF I'a %fi.Nr1-tJAf/f7h
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t°iDlty Lynn vv,;.t.,_v,A dory. "1,':,•+_
• Ulla{}liilt�hGn;wp.,�i ,xE~hltt�f?Vf''�
MEMBER.DFNNrYtVANtA Afi90 i a' ,%,rir
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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, depo.-q 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:
ME 3 0, June 6, and June 13, 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.
r
lsa Marie Coyne, Ed
ito
SWORN TO AND SUBSCRIBED before me this
13 day of June, 2014
Notary
Deaven,Dorothy M.,dec'd.
Late of East Pennsboro Township. COMMONWEALTH I PENNS�VANU1
Admuustcatrix:Lisa Marie Coyne, NOTARIAL SEAL
Esquire, Coyne & Coyne, P.C., DEBORAH A COLLINS
3901 Market Street, Camp Hill, Notary Public �
PA 17011-4227. CARLISLE BORO..'CUMBERLAND CNTY k
Attorneys: Lisa Marie Coyne, Es- My Commission Expires Apr 28,2018
quire,Coyne&Coyne,P.C.,3901
Market Street, Camp fiill, pA
17011-4227. 2 Z
FIRST AND FINAL ACCOUNTING
and PROPOSED SCHEDULE OF FINAL DISTRIBUTION
LISA MARIE COYNE,ADMINISTRATRIX
for
Estate of Dorothy M. Deaven,Deceased
21-14-0446
Date of Death: 12/18/2012
Date of Administratrix Appointment: 5/13/2014
Date of First Complete Advertisement of Letter: 05/27/14
Accounting for the Period: 5/13/14 to 8/14/15
PURPOSE OF ACCOUNT:
Lisa Marie Coyne,Administratrix offers this account to acquaint interested parties with the
transcations that have occurred during the Administration and seek Court confirmation of the Account
and proposed Schedule of Final Distribution.
It is important that the Account and Proposed Schedule of Distributrion must be carefully
examined Requests for additional information, questions or objections can be discussed with
COYNE&COYNE,P.C.
CD C Lisa Marie Coyne,Attorney
-' r-L Pa. Supreme Ct.No. 53788
U ` 3901 Market Street
, �' Camp Hill,PA 17011-4227
- - 717-737-0464
UJ UJ Attorney For Estate
V CL: C
W �
0
Page 1
A g
1 C
2 RECEIPTS OF PRINCIPAL D E
3 p
— - —.
4
5 Assets Listed in lnvento
Lp Valued as o Date o Death Fiducia
6 Ac uisitian
7 Cash: Value
8
9 Metro Bank Checkin Account
I TOTAL RECEIPTS OFpRINGIpAL 7 11.38
1
12 $7,911.38
13 DISBURSEMENTS OF PRINCIPAL
14
15 _DATE CHECK# Debts and____ xnen_cP�
16 5!2112014 99 - The Patriot News-
17 6/17/2 14 501 Legal Advertisement Amount
Cumberland Coun Law Journal Le
18 8/7/2014 100 al Advertisement $I73.78
19 9/26/2014 502 Co e&Co e,P.C. reimbursement of robate fee&at .Fees) $75.00
20 8/12/2015 Re aster of Wilis-Cumberland Cour Additional Probate $1,098.50
503 Filin Fee for Confirmation of First and Final Accountin
21 $15.00
22 TOTAL DEBT AND EXPENSES 215.00
23
24 $1,577.28
25 Total Receipts and Princi al
26 Total Distributions of Princi aI
27 TOTAL NET ESTATE $7911.38
28 - 1 577.28
29 $6,334.10
30 Pro osed Final Distributions To:
31 Final Casts:
32
33 Co e&Coyne,P.C.—Posta e
34 Claims Submitted: 20.00 $20,00
35 West Shore EMS-
36 ALS--Schedule H Services Rendered on 12117!2012
37 Parthemore Funeral Home--Balance of Funeral Bill $97790
38 De artrnent ofNuman Services-- Class 5.1 or 6 claim of$45,715.04 $544.11
39 Residual Heirs: 4792.09 $6,314.10
40
41 Donna Deaven—Survivin Dau to
42 0,00 0.00
43 Total Proposed Final Distrubtions:
44 $6,334.10
45 Lisa Mane Co e,Adminitrator of the Estate of Dorothy M.Dcaven,deceased hereb declare
46 that she has full and faithfuls dischar ed the duties of her office,that the fore ,h First and an
47 Account is true and correct and Eula discloses a1!the si ificant transactions occ oath
48 account' eriod;and that ail known claims against the Estate have been aid in full;that to h Final
49 knowled e,there are no claims now outstandin a ainst the Estate;and that all taxes reseno the
50 have been aid. her
5i due
52
53
54
55Sworn Ll Marie Come,Admin! trator
56 a this
and subscribed before
57 me this a of
58
59 -
60 _
61 Notary public -
62
C6MMQNW.FA+LTl.bF 0ENN$yli►A'N1A'
NOTARIAL SEAL , 11t
II F. Coy"- NOtory Public
+miadtn Township,CuMb-Ottond County
;My Corntitission Expires j".. ;I f,.gpjly ;
y 1
CERTIFICATE OF SERVICE
I, Lisa Marie Coyne, Esquire, of Coyne & Coyne, P.C., hereby certify that true copy of the
foregoing Notice of Confirmation of Account and First and Final Account and Proposed Schedule of
Distribution was served this date upon the below-referenced creditors or individuals at the below listed
address by way of first class mail,postage pre-paid:
Ms. Donna Deaven
145 East Main Stree
Mechanicsburg, PA 17055
Parthemore Funeral Home
P.O. Box 431
New Cumberland,PA 17070
West Shore EMS
205 Grandview Ave., Suite 211
Camp Hill, PA 17011-1708
Department of Human Services—Estate Recovery
ATTN.- Gary Neubaum
P. O. Box 8486
Harrisburg,PA 17105-8486
COYNE&COYNE,P.C.
Dated: �'=�y ZO/5� By;
isa Marie Coyne squire
Pa. Supreme Ct.No 53788
3901 Market Street
Camp Hill,PA 17011-4227
(717)737-0464