HomeMy WebLinkAbout01-17-08
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYL VANIA
REGISTER OF WILLS
IN RE: DALE M. HOERNER,
DECEASED
O.C. No. ~J-()f -OOul
PETITION FOR CITATION
TO GRANT LETTERS OF ADMINISTRATION
PURSUANT TO 20 Pa. C. S. & 3155
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TO THE REGISTER OF WILLS OF CUMBERLAND COUNTY:
The Petitioner, Church of God Home, Inc. ("Petitioner"), a principal creditor of
Dale M. Hoerner, respectfully represents that:
1. Dale M. Hoerner ("Decedent") died intestate on August 31, 2007. An
original Death Certificate is attached hereto as Exhibit" A."
2. Upon information and belief, Decedent was survived by a son, Larry
Hoerner, who resides at P.O. Box 1507, Hedgesville, West Virginia 25427.
3. At the time of his death, Decedent was a resident of Petitioner's nursing
facility located at 801 N. Hanover Street, Carlisle, Pennsylvania 17013, and Petitioner
was a principal creditor of Decedent.
4. Petitioner desires to have Shaun E. O'Toole, Esquire appointed by the
Court to administer the Estate of Dale M. Hoerner for the purpose of paying all debts
owed by Decedent, qualifying the Decedent for Medicaid benefits, and distributing the
balance of the estate pursuant to the intestate laws of the Commonwealth of
Pennsylvania.
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5. Shaun E. O'Toole, Esquire is a disinterested party who has no interest in
the outcome of any litigation, including medical assistance, involving the Decedent.
6. In furtherance of this matter, Petitioner also requests the appointment of a
Limited Administrator Pendente Lite, pursuant to 20 Pa.C.S.A 9 3160, solely for purposes
of appealing and preserving Decedent's eligibility for medical assistance benefits.
7. An application for medical assistance benefits was filed on behalf of
Decedent with the Cumberland County Assistance Office ("CAO"). That application
was denied on November 9, 2007, and a Notice of Appeal was filed with the CAO. The
appointment of a Limited Administrator Pendente Lite would allow Petitioner to
establish Decedent's eligibility for medical assistance benefits and secure benefits in a
timely manner.
8. Petitioner desires to have Shaun E. O'Toole, Esquire, appointed as
Administrator Pendente Lite, pursuant to 20 Pa.C.S.A. 9 3160, for the Estate of Dale M.
Hoerner for the limited and sole purpose of appealing and pursing medical assistance
benefits for the time period that he was a resident at Petitioner's nursing facility.
2
WHEREFORE, Petitioner, Church of God Home, Inc., respectfully requests that a
Citation be issued to Larry Hoerner to show cause, if any, why Letters of
Administration for the Estate of Dale M. Hoerner should not be issued to Shaun E.
O'Toole, Esquire, pursuant to 20 Pa. C. S. S 3155, and in the interim that Shaun E.
O'Toole, Esquire be appointed as Administrator Pendente Lite, pursuant to 20 Pa.C.S.A.
S 3160.
Respectfully submitted,
ScHUTJER BoGAR LLC
Date: J J }~ }~
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By ~1'~ ,&
Bradl A. Schutjer
Attorney I.D. No. 75954
(717) 909-5921
Mariclare L. Hayes
Attorney J.D. No. 201289
(717) 909-5922
417 Walnut Street, 4th Floor
Harrisburg, PA 17101
Counsel for Petitioner
3
VERIFICATION
The undersigned hereby verifies that the statements of fact in the
foregoing Petition for Citation to Grant Letters of Administration are true and
correct to the best of my knowledge, information and belief. I understand that
any false statements therein are subject to the penalties contained in 18 Pa. C.5.A.
9 4904, relating to unsworn falsification to authorities.
Dated: 1- /c-08
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Sharon Cramer
Church of God Home, Inc.
4
EXHIBIT II A"
H105.905 REV.(6/06)
Thi~ is to certifY that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records in accordance
with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
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No.
Cf~Yc lf~o~
Frank Yeropoli
State Registrar
Calvin B. Johnson, M.D., M.P.H.
Secretary of Health
4204237
DEe 26 Zoo7
Date
H105-143 REV 1112006
TYPE I PRINT IN
PERMANENT
BlACK INK
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
(See Instructions snd exsmples on reverse)
083732
,. Name of Decedent (Flrsl. middle, last, suIIix)
Dale M. Hoerner
5."'" (laslBinMay)
6. Date of BitttI Month,
7.
{ andstateor
STATE FilE NUMBER
89 Vrs
4. Da1e 01 Dealt1 (Mon1h. day. year)
August 31, 2007
~
Cumberland
23, 1918 Harrisburg, PA
Sd. Facility Name (" not insIitulion, ~ streeIend number)
Church of God Home
8b. County of Death
11. Oecedent'sUslJ81
Kind of Worll
Cleaner
16. Oacedenr, """'"11_ (SIRe, 01y/_, ala... zip_)
801 N. Hanover Street
Carlisle, PA 17013
12. Was Decedent ever in the
U.S. Armed Forces?
:KJv" ONo
13. _', Eduadicn (SpacIfy on~ h9\Ul grada oomplaIad)
Elementary 11~ry (0-12) CoOege (,-4 Of 5+)
14. Marital SIatus: Married, Never Married,
W_, llM>roed (Spodf)j
Widowed
17b. County
PA
Cumberland
l>d_
Liveins
Township?
17e. Dyes, Decedenl LiYed in
17d,:f] No, -.. Uved_
AcluaJUmI1aol
Twp,
Carlisle
City/Boro
18. Father's Name (First mickle, last, st1fixl
Harry M. Hoerner
19~yE~'~a~nmama)
~'n'r~ni'J~01yL'art'"~';1fedgesville, WV 25427
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21c. Place of 0isp0slIi0n (Name 01 cemetery, crematory or other place)
RI
23b. Uoense NooIber
tl\J S ;7.1;. 3 if a L
230, Da1e Signad (Monll1, day, year)
26. Was Case Referred to Medical ExamIner I Coroner for a ReaIOO Other than Cremation or 00na1l0n?
Ov..
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Onset to Dealtl
Parttl: Enter other
butnol reIlJting inlhe underlyingcauaegr.,en in Parl!.
29. Did Tobacco Usa Con1rIlUta to 0aaJh7
OV.. OProballly
I2'NoO"""""'"
29,HF_:
o Nol,..gMnt_postyaar
o P~ntllltime~_
o Nol,..gMnt,bul_ant_42day&
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o Not P"9\llnt, but p,.anl43 days to 1 year
beIoIe_
o Unknown. _ _n'" post year
32c.=~~::t~)Slreel. Factory,
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a.
IlaJe"k
1,,-.
eially islcondltion&. 'any,
to the cause listed on Mne a.
Enter UNDERLYWG CAUSE
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Due 10 (or as a consequenoe 01)'
d.
32d. Time of InJury
32g.l0catt0n~InjuryISlreet,01y/_._)
3Oa. Was an Autopsy
Performed?
Ov" JZl No
3Ob.Wa..Autopoy~ 31MamorolOaath
~=:<;;- Jll- D-
O- Of'ent1;"9lnvaa11gation
o S"'"'" 0 C<><.OI No! be DelannOed
Ov" ONo
M.
338. CertIIIeI" (check. only one)
CaI1ItyIng phyalc:1an (_ COItiIy;"9 cause of daa~ when anoIher ~ has pmnouncad _ and oompIaIed hern 23)
To.. baa! of my "'-Iadgt. _ _... to.. _a)'" _.. __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
==~:=~~~~==:c.~~~:ro:~=manner.~..__.... ........___....___ 0
=- =~lftd/otlnveltigltkln, In my opinion, dIIth occutTIclllthe time,dIIe,lftCl pilei, andduttOtheClUH(a)lIlcIlMIlntr.1tIIecL 0
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35. RegIstrar's
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I Aj /1 ~ /1 /1 '..3/ t!>da'7'i
Oi_Penn'No OII~'7'S
3311. Date Signed (MonIh. day, vear)
o ~ - s I - cOO "7
34. Name and Address 01 Person Who Completed Cause of Deeth (Item 27) Type f Print
D..u,J L - W..""f'..... M.i>.
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