HomeMy WebLinkAbout03-06-06
IN RE: ESTATE OF GERALDINE
D. MCCLAIN, a/k/a JERALDINE D.
MCCLAIN, late of Mechanicsburg,
Cumberland County, Pennsylvania,
deceased.
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY,
PENNSYLVANIA
No. J-.' -<::J~- '0'\~-~
ORPHAN'S COURT DIVISION
PETITION UNDER SECTION 3102 OF THE PROBATE,
ESTATES AND FIDUCIARIES CODE
FOR SETTLEMENT OF SMALL ESTATES
AND NOW, comes James R. McDonald, Petitioner in the above
matter, by and through his attorney, Robert W. Lape, Jr.,
Esquire, who files this Petition for Settlement of Small Estate
under the provisions of Section 3102 of the Probate, Estates and
Fiduciaries Code, and in support thereof avers as follows:
1. Petitioner is James R. McDonald, who resides at R.R. 1,
Box 333, Saxton, PA 16678.
2. Geraldine D. McClain, also known as Jeraldine D.
McClain, deceased, died on January 20, 2006, at age 88, a
resident of Cumberland County, Pennsylvania, and who had a last
mailing address of 335 Wesley Drive, Apt. 311, Mechanicsburg,. PA
17055-3524. A death certificate is attached hereto as Exhibit A.
3. petitioner is both a creditor and the second cousin of
the decedent. There are no living first cousins, or any closer
relatives who have survived the decedent. Petitioner maintained
contact with the decedent until the time of decedent's death. It
is believed and therefore averred that no other next-of-kin
listed below maintained contact with the decedent. It is hoped
that additional addresses will be obtained and service will then
be affected upon the next-of-kin whose addresses are currently
unknown, with supplemental Affidavits of Service to follow.
4. Petitioner's mother, Martha Romane Dick, was the
decedent's only first cousin and her closest living relative
until she died on January 15, 2006. She had maintained personal
contact with decedent until her death.
5. To the best knowledge of Petitioner, the decedent died
intestate. Decedent had completed an Emergency Information .sheet
for her residence at Bethany Towers dated June 10, 2003, a copy
of which is attached hereto as Exhibit B which lists the
Petitioner as her "Executor". It is believed that upon her
death, the decedent intended for Petitioner to handle her
Rf.
affairs, but no will has been located.
6. The next of kin of the decedent and their mailing
addresses are as follows:
a. James R. McDonald, second cousin, of R.R. 1, Box 333,
Saxton, PA 16678 (Petitioner herein) .
b. Marilyn Godwin, second cousin, of 10653 Parliament
Place, Jacksonville, FL 32257.
c. Karen Tarleton, second COUSln, of 1712 Manchester Court
North, Jacksonville, FL 32259.
d. Robert Grandville, second cousin, address unknown.
e. Robert Diaz, second cousin, address unknown.
f. Kenneth Diaz, second cousin, address unknown.
g. John Thompson, second cousin, 1961 Frosty Hollow Road,
Roaring Spring, PA 16673.
h. Jerry Thompson, second cousin, Broad Top City, PA
16621, complete address unknown.
i. Ronald Thompson, second cousin, Defiance, PA 16633,
complete address unknown.
j. Vivian Reed, second cousin, 921 Main Street, Saxton, PA
16678.
k.
1.
Timothy Thompson, second cousin, address unknown.
Gerald Thompson, second cousin, address unknown.
Jay Thompson, second cousin, address unknown.
m.
7. All next of kin are of full legal age.
8. The exact extent of the probate assets of the decedent
is uncertain. It is believed and therefore averred that the
debts of the estate may exceed the assets. No current financial
documents were located in the decedent's apartment. The
decedent's known or anticipated assets are as follows:
a. Apartment contents--no value. The remaining contents
were removed by Petitioner at landlord's request to avoid further
rent charges. The apartment was in disarray and all contents of
value were removed by unknown persons prior to Petitioner's
arrival. The remaining contents were removed at the expense of
petitioner and have been or will be disposed of at his expense.
b. MetLife shares, 30 @ $40 per share for a total value of
approximately $1,200.00.
c. Bank account number 51-4003-9751 at PNC Bank with a
balance of $3,328.11 as of February 6, 2006 (this sum includes
certain post-death Social Security payments that must be
returned) .
d. Old documents found within the apartment disclose that
the decedent likely has a John Hancock annuity. It's value is
unknown, and the identity of the current designated beneficiary
is unknown.
9. It is believed and therefore averred that all probate
assets of which the decedent died possessed will have a total
value of substantially less than $25,000.00, thereby allowing
it's disposition through a small estate petition under section
3102.
10. Petitioner, after collecting the estate assets, will
file a Pennsylvania Inheritance Tax Return, and will pay the
inheritance tax due, if any. Petitioner will pay all debts or
obligations of decedent in priority to the extent possible based
on the solvency of the Estate.
11. The known or anticipated debts of the estate are:
a. Court costs to the Register of wills of Cumberland
County for filing the instant Petition in the amount of $15.00
and JCP fee of $15.00 for a total of $30.00.
b. Filing fee to the Register of wills for the filing of
the Estate Inventory of $15.00 and Inheritance Tax return of
$15.00 for a total of $30.00.
c. Attorney's fees of $190.00 already paid by Petitioner
relative to the right of Petitioner to arrange for the
cremation/burial of the decedent, and liability for the payment
of such costs.
d. Attorney's fees of $500.00 relative to the instant
Petition and preparation of the Inheritance tax return
e. James R. McDonald, reimbursement expenses for clean:.ng
the decedent's apartment and disposing of contents (not yet
known) .
f. Cremation fee reimbursement due to James R. McDonald for
disposition of the decedent in the amount of $1,525.00.
g. Gravemarker fee (not yet determined)
h. Credit card balance due to Discover in the amount of
$1,336.32.
i. Any additional administrative fees or costs that may be
incurred, including but not limited to certified copies of the
Decree.
WHEREFORE, Petitioner prays that an Order be made
authorizing distribution of the assets of decedent's estate to
James R. McDonald, pursuant to Section 3102 of the Probate,
Estates and Fiduciaries Code.
Robert ~..; I ape(/ ~ :' Esquire
Attor~ey or Petl~loner
294 East Main Street
Roaring Spring, PA 16673
PA I.D. No. 32537
(814) 224-4533
FAX (814) 224-5506
I verify that the statements made in this Petition Under
Section 3102 Of The Probate, Estates and Fiduciaries Code For
Settlement of Small Estates are true and correct.
I understand
that false statements herein are made subject to the penalties of
18 Pa. C.S.A. ~ 4904 relating to unsworn falsification to
authorities.
~7'2m ~ ~a/,-L,
. ames R. McDonald
fl.
p
12212194
) ~J/ r
~~><IvUL- "-~ ~~~
~r OJ 7/A {Job
HlO:, 144 Hev ull(lb
TYPElPRINT IN
P:lA:AN,~~T 1130-166
I Name 0' Decadenl (FIIS1, nllOdle Iasl)
Geraldine
D
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH' VITAL RECORDS
CERTIFICATE OF DEATH (CORONER)
--_._--~- .
2. Sex 3 Social Seclll~ NUhilef
Female 199 - 07
B B'~lhplacil B and sIdle-;-~e9) COlllMY) 8J Place 01 Dealh (Check only one)
Hospital
o Inatil;nl
STATE FilE NUMBER
coalJoont LJ'A______
8d, faclj~Name(llnolirlstrtulioh.givestreetandnurrberJ
4 Dala 0' Daalh (Monlh. da~, ~eal)
McClain
1917
January 20, 2006
YfS
-8b.Counlyu~
88
7 DalaorBirlh Month,da ear
5 Age (laSlblfthday)
Cumberland
East Pennsboro
Holy Spirit Hospital
OUlel
o EHiOu alieni DOA 0 NUISlflg Home _ 0 AesidenCll 0 ClIner.
9 Was Decedenl 01 HlSpanl: Origin? 10 Race: Arnerran indian. &ck, Wh.ll, atc
H No 0 Yas (II yas. iOp9Cify Cuban, (Speci/)1
Mexican, Puerto AlCan, alC)
n
.
Dk:IDacedent
live ifi a
Townsh~?
White
,.,- 0",,,,,,, "",,' Dco",,""o "00" ol.,ok j "m", """ 01''''00 "", 00 .001 ".., ",,,'"
Kind 01 WOIk Kind 01 BuslfleSsllnduslly
Secretary __ Secretarial
16 Decedenl's Mailog At:kliess (Slleet, clyllown. slale, ZIjl code)
335 Wesley Drive
Mechanicsburg, PA 17055
12 Was Decedenl ever I/l-ihelis-
AmoudFofces1
DYes JCI No
Decedent's
Ac!ualAesiUence 17a Slale
hi heSI ladeeo leted
CoHege(14015t)
15 SUrYlV1IIg Spoljse (II WIle, givi maiden namel
17cH
Yes,Dec:edenllivedirl
UPW!" Allen
. T."
17b COLlnly__
~!"!al1(j
17d 0
No, DecedenlllVad wlthlfl
AcluallirW 01
C.y,'Boro
t8 Falhe/'s Name (hSI,rr;jdle.Ia~-
19 Molhel's Nafl'ltl (fIfSI, middle, maiden surname)
Charles McClain
Elizabeth Thanpson
20tl lnlormanl's Mailing /lJdfass (Slreet, cily!lown, s\ale, lip code)
lOa IfIlormanl's Name (T ype;print)
o
w
<n
::>
<n
..,
~
James R. McDonald
RR 1 Box 333 Saxton PA
o RefOOvallromSlale
o DonaliOn
2006
22b licenseNurrilel
26
21b Dale 01 DlSposdlOn (Monlh, day. year)
FD - 014889
To Ihe besl 01 my knowledge. dlld!h OCCUlled allbe lime, dale i100 place slated (Sign<1IUre and ldlii)
. li;ITi5i4 26 must be cofll)leled by pe'lsoo- 24
IfftlOpfoflOUllCesdedlh
Time or Dealh
2:40
P. "
25 DalePronoljncedDead(Monlh,day.y~-~-'---~-
January 20, 2006
JlI. ,,, 0 No
CAUSE OF DEATH (See InstrYCtlo11l and .umplell
: Applollmai611;ieivat Parl II. Enler othel n f
: onsel10 dtH:llh bul not lesulhng in Iheundellyingcausegi'lenin arll
o V" JIl No
"
JOb Welfl Aulopsy hidings
Available Prior \0 Co~lellOn
01 Cause 01 Dealh?
o Ves 0 No
31 MdnnerolDeath
32a Dale OII~1JUry (Monlh, day, year)
32b. DeSClibe how-Injury Occuned:
Old Tobacco Use ConlIlbul. 10 Oeeth'!
DYes 0 Pfobabty
o No 0 Unknown
29 Ithmale
o Not fH'egnanl w.run past yeal
o Plegoant al time 01 death
o Not plegoanl, but pregnanl WIthin 42 d.ays
01 death
ONolpr~n1,btApr~nt43dayslolyear
bekMedlililllh
o Uoknown d pregnal1l rihin Ihe pasl year
32c. Piau of Injury: Home, FIIR\, Street, Fac\Ol'y.OI:ic.
-,"","'(-
l18m 21 Pari I Enhlf the ~ - Oiseues, in,..lllls 01 complications - that dR8Clly caused the deollh DO NOT enler lemMllillevenls such as uudlaC atlasl
resplfalory elles\. 01 Yenlliculallibr~lalion withoul showl1g Iha etiology DO NOT abbreviale Enler only one cause on a line
IMMEDLATE CAUSE (F~al df;;ease or
condilionleSl.lling ifIdealh) ----7 a
Chronic Obs truc ti ve . !,.~lmoIl_~J:"y[)i~e<i!l~
-O;;;;-(~;-;s-ico~equ~ oQ-- -'-.----
SequanhaltyllSlcoodilions.llany,
leadinglOlhecauselisle<lonlmea
- Enler the UHDERl YANG CAUSE:
. (dlSe.aseOfinjUrythalinlllaledlne
evenls'6SUIll\lllfldealhILAST
Due \0 (Of as a cOlISequerlCeoQ
Due 10 lor as a eonsequenceofJ
JOa WasanAulopsy
Pe,b'med?
)(Natufal
o Accident
o Suicide
o Ho!Ticide
o Peodirlglnvesligation
o Could No! Be Oe!emlined
32d Tlmeo!lnjury
32g localion IStleel,Clfy.1own, sLalel
"
I-
Z
W
o
w
'-'
w
o
'L
o
W
::;;
..,
Z
33a Certifief (clleck 0I11y ona)
CenitylnQ physkiln (Pt1ysiclil/'l certilylflg ca..se 01 death when anothel physician has prDrlOullCed death and oo~leled Ilem 23)
To Ihe_1 01 my knowledge, de.athoccurred due 10 the cause(sl and 1J}jnnet' as wled
Pronouncing and ce"ifying physk1an (PhysICian both plonouncing dealh and cerlllyinglo cause 01 death)
10 the bell 01 my knowledge, de.athoccurred at lhe lime, dale, and place, and due to the uuse(s) and mannel as .tated ...,.. ...... ...... ...... ............... ..... .... ....... ...0
Medbl.umlnerkoronef
On the basis 01 exari\atioll anlS/or invesligation, III my opinion, death occurred al ItwI lime, dale, and place, and due to lhe c.ause(sl and IJ}jnl'ler as staled...
fal'S S9nawle and Distnct Nunibel
Coroner
33d, Daltl Signed (Month, day, year)
January 25. 2006
~.......
ldll I~ I I I~J .).7 ~O"b
(See instructions and examples on reverse)
34 Name and Add,ess 01 PllISOll Who Conl;Ilelad Cause of Death (hem 21) Type/Priol
Michael L. Norris, Coroner
6375 Basehore Road, Suite III
Mechanicsburg, PA 17050
35
. ' ~,,~{it~~ :.:l1i:l/21i:11i:16 - _15~?1i:I_~ .._63~;.'i5.6Z..ant\t.. IWJ:il~ J~96~~LD
~~~~t::~:'1 .:Bethany Towers - EMERGENCY L'lFORMATION
~"r .
PI.._ ntllm ro fraDt .. ill OM 1ft..
Name 9.. PIUJ!cIw~ .n /}Jr IfJl1N. Apt.i1 "II
Ph....~ 7/'Tdl '11/'Jb/J'1 Oat. OfBirth~~-? , ,C Aac ~I.i.-
~ ('r~~/ -
Primary Physician ~4u. B ~ /It Jj- Phone # '1.I{~:" ~~=3
~/~
Spocialty Physician'r!.lcLzLd IIJ: 4L//flr, .IA/ jj- Phone II 10/- ~4'a
-;; JJ /'1/- ___
Pre(crrod Hospital .- 'l
PAGE Ii:Il
1-482 P0Z V-i.52.
- Date '~-;Y(7 ~ ~
(~/Jj' ~9.f:. b~
phone number
N 0 It. TIN MERCENCY: (List two (2) in separate households)
I. Jr..q(" k&4JI (!/XdfJ1/. ('ilLI/.)"-'1'?~JI~- MMI.
~ n8IJlC relationship home phone work phone
2. 4~j ~1J41/dIiL ~=t:
:a1t::ff!7:n J?~
stre~ t;y
EXEcUTOR OF YOUR ESTATE: .1 d.JJVM )?ft%t!~,lj
I.. Dame
p. r7 J;j ~~-:1 ~A17~~
sUeet City
'J
~OWER OF ATroRNEY:
011f) 1~/... 03~
phone number
work phone
~"
f?~<< relationship
state zip code
HEAI.TR INSURANCE INFORMATION:
Mcdicare#~'~,,[}JY- j vr'-lfi
BilK C.~....JB",t Sh;",Jd"# ,9/;1( /J
c!~OJJ1I(
/Jet relationship
stare zip code
Social Security;# p.rttl.. tJ '7.. i' a 0:1'/
(if different ti'om Medicare number)
Other #'s -
--
DO YOU USE. HAVE. OR EVER HAD ~w OF THE FOLLOWING:
Wheelchair .....Jt!...-. Stroke Heart Attack: Oxygen
Arthritil~ JZlkcr _ Legally Blind__ Quad Cane _
Are you diHbled? If yel, describe
Do you own a pet? & [f yes, describe
Do you own a vehicle? ~ It yes, - -
~ make model
Do you have a handicap plate or placard _ .,
Preferred tlmeraJ home ({I ~_'(;I, t<.v.{~.1 ~.It1:U..
over ff~
Diabetic Seizure
Insulin D~t Diabetic _
--
:......
-
-
year color Ikcnse number
Parking Lot II --
Phon. . ffrTC2 'i ,.;t~;i. €
{1.~.~~~-