HomeMy WebLinkAbout12-14-06
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21.06.0901
(')
:;=0
[_::5 ;g
: n""- (')
~:J :-'; r-
"i~~~
.:JcJo
,-) () -n
:~J~
--I
}i!
ESTATE OF GRACE M. GRIFFITH
PETITION UNDER SECTION 3102
OF THE PROBATE. ESTATES AND FIDUCIARIES
CODE FOR THE SETTLEMENT OF A SMALL ESTATE
TO THE HONORABLE JUDGES OF SAID COURT:
1. Your Petitioner, Joan M. Miller, 503 Gettysburg Pike, Mechanicsburg,
Cumberland County, Pennsylvania, 17055, is an adult individual and the one (1) and only
surviving child of Grace M. Griffith, deceased on September 4, 2006, Social Security Number
139-12-0701.
,......,
c:::::>
c:::;)
c;:r.
c:J
l"T1
(""')
2. The Decedent, Grace M. Griffith, was born on October 20, 1913 and was ninety-
two (92) years of age at the time of her death. Her residence was Claremont Nursing Home,
1000 Claremont Road, Carlisle, Cumberland County, Pennsylvania, 17013. She was a single
woman at the time of her death.
3. Her sole heir as set forth in her Last Will and Testament, a true and correct copy
.r:-
~TJ
h,
C")
C)
:::0
CJ
n,
CJ
(::>0
';"1 -'11
-n
r=)
11'1
';7~
-0
:x
Cf!
w
N
of which is attached hereto and incorporated as Exhibit "A", is her daughter, who has signed this
Petition. She is identified as follows: Joan M. Miller
4. Joan M. Miller was nominated in Decedent's Last Will and Testament as
executrix.
~
5. The Decedent's sole assets are as follows:
A. Stocks and Bonds: 119 SHS Common, CenterPoint Energy, Inc. @$14.59
per share, $1,736.00;
B. Fulton Bank Classic Checking Account No. 3622-32677, $4,565.00;
C. Resident Account at Claremont Nursing Home, $547.00;
6. Decedent had been receiving medical assistance from the Department of Public
Welfare in connection with her residing at a skilled nursing facility prior to her death. The
Department has agreed to accept the sum of $4,568.00 as payment in full. A letter of acceptance
from the Department of Public Welfare is attached hereto as Exhibit "B" and is incorporated by
reference.
7. It is requested that the assets of the Decedent be turned over to the Petitioner to
pay the administration expenses and make distribution as follows:
administrative expenses and balance to the Department Of Public Welfare
8. The Petitioner has filed a Pennsylvania Inheritance Tax Return and has received
acceptance of the return. A copy of the return and the response from the Department Of Revenue
are attached hereto Exhibits "c" and "D."
WHEREFORE, Your Petitioner prays that an Order be made authorizing distribution of
the accounts as set forth in the foregoing to Petitioner for him to apply against the expenses of
administration and debts.
O~;;2E
David A. Baric, Esquire
I.D.# 44853
19 West South Street
Carlisle, P A 17103
(717) 249-6873
Attorney for Petitioner
da b.dir/estates/griffith/smallesta te. pet
VERIFICATION
I verify that the statements made in the foregoing Petition are true and correct. I
understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section
4904 relating to unsworn falsification to authorities.
~-'-'~, 7JZlbA ---
Joan M. Mlller