Page 1 of 6 IN THE COURT OF COMMON PLEAS OF ALLEGHENY COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION FORM NO. 46 IN RE ESTATE OF _______________________________ _______________________________ _______________________________ _______________________________ Deceased No. _______ of ______ TESTACY PETITION FOR DISTRIBUTION To the Honorable, the Judges of said Court: The petition of _______________________________________________ respectfully represents that: 1. The decedent died _____________________, ____, testate, and at that time was domiciled in ____________________________________ and resided in State or Foreign Nation __________________________________________________________________ City County State Letters Testamentary on h ___estate were granted on the __________ day of ______________, ____, and on the __________ day of _____________, ____, bond in the sum of $___________, with _________________________________ as surety, was approved. A copy of the will and codicil, if any, is hereto attached and marked Exhibit "A". [testacy] American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 6 Complete advertisement of letters was made in the __________________ _______________________ and the daily edition of the Pittsburgh Legal Journal, the first publication having been made on the ________ day of __________, ___, and on the _________ day of ____________, ____, respectively, more than four months before the filing of the account. Proofs of publication marked Exhibit "B" are attached. An inventory, a copy of which (certified by counsel or by the Director) is hereto attached and marked Exhibit "C", was filed on the ______________ day of _________________________, _____. Since filing the account, (a) the following assets have been discovered: (b) the following income has been received: (c) the following disbursements have been made: See secs. 31213126 of P.E.F. Code 2. The family exemption of $__________was_______ claimed by ________ Personalty or Realty _________________________ out of ___________________________________ [testacy] American LegalNet, Inc. www.FormsWorkFlow.com Page 3 of 6 3. Accountant has given written notice of the filing of the account and of the call thereof for audit or confirmation to every unpaid creditor who has givenwritten notice of his claim to the accountant or his attorney of record. The following is a list of all creditors, together with the amounts of their claims and to what extent their claims are admitted: Give preferred claims first and mark "P". If balance includes proceeds of judicial sale, attach List of Liens Marked Exhibit "D". NAME Amount NAME Amount If decedent was an inmate of a public institution. 4. (a) A copy of the account, certified by counsel, has been filed with the Department of Revenue of the State of Pennsylvania in accordance with Section 7, Rule 6 of the Orphans' Court Rules of the Supreme Court of Pennsylvania. (b) Within three months after the grant of letters notice was given to ____ ________________________________ by which the decedent was maintained in an institution. (c) Is a charitable interest involved?______________________________ If so, has notice been given to the Attorney General?_______________________ See sec. 3393 P.E.F. Code. See Supreme Court O.C. Rules, Sec. 5, Rule 5, and Local Rule 41. If decedent was a veteran or the child of a veteran entitled to benefits. Indicate any exceptions 5. A copy of the account, certified by counsel, has been filed with the United States Veterans Administration in accordance with Section 6, Rule 8 of the Orphans' Court Rules of the Supreme Court of Pennsylvania. 6. All parties, other than creditors, known to the accountant to have an interest in the estate as heirs or next of kin, have had written notice of the filing of the account and of its call for audit. [testacy] American LegalNet, Inc. www.FormsWorkFlow.com Page 4 of 6 7. (a) The following parties are not sui juris and are not represented: (b) The following parties are enemy aliens or residents of enemy occupied territory: Explain. (c) The following parties are in the military service of the United States: (d) Accountant is ____________ acting in a dual fiduciary capacity. Taxes 8. (a) The estate is ____________ subject to the payment of a transfer inheritance tax to the State of Pennsylvania and the tax has _____________been paid. (b) The estate is _____________subject to the payment of a federal estate tax and the tax has _____been paid. A petition for proration of taxes under Chapter 37 of the Probate, Estates and Fiduciaries Code of 1972 or its successor will ____________ be filed. (c) The estate is _____________subject to the payment of a Pennsylvania estate tax and the tax has ________ been paid See sec. 3330 P.E.F. Code 9. Within three months after the grant of letters, written notice was ________ sent to each corporation and association named as a beneficiary in the decedent's will. Marital status on date of death 10. (a) Decedent was ________ married. (b) The spouse did _______ survive. Attach copy of elections marked Exhibit "E" (c) There is ________ election by surviving spouse. (d) There was _________ marriage settlement. (e) The family relationship was ________ maintained. Name and dates of birth 11. (a) There were _______ children born after the execution of the will or codicil: [testacy] American LegalNet, Inc. www.FormsWorkFlow.com Page 5 of 6 Names and dates of adoption (b) There were _________ children adopted after the execution of the will or codicil: Partial intestacy. Give facts. 12. There is __________ intestacy as to part of the estate. Give caption, number, and present status. 13. At the time of h____ death the decedent was known to be a fiduciary of the following estates: 14. The names of all persons having interests as legatees, next of kin, devisees, or heirs, including adopted children, with names of parents of all children if necessary to show relationship, are as follows: Name Legatees, next of kin, devisees or heirs Sui Juris (Yes or No) Guardian Bond Give names, dates of death, fiduciaries, issue, adopted children, spouse 15. All parties in interest are living except: See Rule 3. Sec 19 (c) Attach elections, if any, marked Exhibit "F". See sec.3534 P.E.F. Code [testacy] 16. The balance for distribution is personalty _____________ realty. Proposed Schedule B of the decree of distribution is submitted herewith separately. 17. Elections to take in kind, if any: American LegalNet, Inc. www