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HomeMy WebLinkAbout04-0338PETITION FOR GRANT OF LETTERS OF ADMINISTRATION Estate of GENEVIEVE E. ELICKER __ No. also known as To: Deceased. Social Security No. 1 8 5 - 5 2 - ? q 6 9 Register of Wills for the County of Cumberland Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(10, who is/0tr~xt 8 years of age or older, appl-/_' es ,d.~ b. n. (d.b.n.; pendente lite; durante absentia; durante minoritate) in the for letters of administration on the estate of the above decedent. Decendent at death owned property with estimated values as folllows: (If domiciled in Pa.) Ail personal property (If not domiciled in Pa.) Personal property in Pennsylvania (If not domiciled in Pa.) Personal property in County Value of real estate in Pennsylvania situated as follows: nono Decendent was domiciled at death in Cumberland County, Pennsylvania, with h er last family or principal residence at 1055 York Road, Dillsburg, PA17019 Monroe Twp. (list street, number and municipality) Decendent, then 32 ...................... years of age, di~xl March 13 ~ C: .,~ 2nc~ at. Sheaffer Road, Monroe Township, C~mberla~'"'~'~'~i'i~'~,~'"p'~'"i?: ............ ~, ~o. oo I Petitioner after a proper search ha s the following spouse (if any) and heirs: Name Charles Robert Elicker Phyllis Elaine Elicker Todd R. Elicker ascertained that decedent left no will and was survived by Relationship Father Mother Brother Residence 1055 York Road, Dillsburg, 1055 York Road, Dillsburg, 800 York Roa~d, Dover, PA THEREFORE, petitioner(~) respectfully request(s) the grant of letters of administration in the appropriate form to the undersigned. PA 17019 PA 17019 17315 PH~LLIS ELAINE ELICKER 1055 York Road Dillsburg, PA 17019 OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF ENNSYLVANIA SS COUNTY OF Cumberland The petitioner(~ above-named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(g) and that as personal representative(a) of the above decedent petitioner(~) will well and truly administer the estate according to law. Sworn Io or affirme~[., and subscribed b~ore ~e,th,!s t~r'3~ day of No...gt- oq-g3g Estate of GENEVIEVE E. ELICKER ?- ? ~ ~ ~,~ ~ , Deeease~? G~NT OF LETTERS OF ADMINIST~TION~ AND NOW ,4~Or-, ] 8 XI~.. 2004, in consideration o~he petitiO~ on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that Phyllis Elaine Elicker is/a~ entitled to Letters of Administration, and in accord with such finding, Letters of Administration d.b .n. are hereby granted to... Phyllis Elaine Elicker in the estate of Genevieve E. Elicker FEES Letters of Administration ..... $_.~. ~ ,OK) Short Certificates(~5) .......... Renunciation ................ $ - TOTAL $ Filed /-~- .~.'.~¢4 ................ A.D.~ ATT (Sup. Ct. I.D. No.) BRIAN C. LINSENBACH, ESQUIRE 87360 ADDRESS 124 West Harriburg St. P.O.Box 310 Dillsburg, PA 17019 PHONE 717-432-9733 RENUNCIATION - In Re Estate of GENEVIEVE E. ELICKER deceased. To the Register of Wills of CUMBERLAND County, Pennsylvania. The undersigned Charles R. Elicker, the father of the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters of Administration be issued to Phyllis Elaine Elicker WITNESS my hand this 6th day of April ,20.. 04 (Signature) 1055 York Road Dillsburg, PA 17019 (Address) (Signature) (Address) (Signature) (Address) his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent ~ling. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee t~ertlfi~ :~ertifi~:~te; $2.0~ APR -6 P1:29 10039924 ,,',~ t* 21-oq-33 5 L~)cal Registrar COMMONWEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH ti 29-234 (Coroner) ~UN~ OF DEaN C~,~ D~H FACILITY N~E [11 not inm,lulion, give ~r~l and n~) ~ CE~NT ~ Hl~lC ~IGIN? RACE Cumberland I Monroe I bneazfer Road, 1/2 mile north ,,. ~ ~o~t Elicker iNFORMANT'S NAME (Typ~Pr~n0 ~. C. Robert Elicker B~[] Cremal~m~ Remov,ltromSmmE] (MiX~lh.l~yYear} ~.,,~.E] ~(~ -- ~,,~3/15/2004 I". 2:00 A U' I~ March 13, 2004 ~ ...... ~"~ Closed Head - / *Tn4ur~es Motor Vehicle Crash ,,. Phyllis E. Gleixner I,..1055 York Road Dillsburgt PA 17019 Hollinger Cromator~ ~ Mt. Holly Springs, PA ~AMEANOADO~E~OFFA~IUT¥ 8 Market Plaza Way I~a~ll~zzi Funeral Hc~ne M~chanicsburg~ PA 17055 LICENSE NUMBER DUE TO (OR AS A CONSEOUE NCE OF): ~E I /(U°"lh' Da~ Y"0 I Aorx / I Unbelted passenger [..,.-, ~ ,o~,. Li[ Mar 13 200,.I ~prx. /Y- ~ noel vehicle left roadway al Road ~. Sheaffer Rd, Dfllsburg, PA .............................. *~~[ ' ~ Coroner ~m~m~k~W~d~h~u~d~a~d~n4~dde~h~c~{~)~dm~"~d ..................... [] }l~. 2 3,d.._March 15~ 2004 'M[OICACaXAM~COR~[R t~27)ry~mPrlnt Todd C. Eckenrode,Chf.Dep. Coroner On~e~Nlofex~l~orlnveMl~tlon, in my oplnlon, death~curr~atlhetlme date andplace Inddue/othecau~l)lnd 6375 Basehore Rd. , Suite ~,,.m~.,.~.t~ ............................................................. '....: ........ : ....................... ~ .. Mechanicsburg, Pa. ] 7050 Cumberland County - Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 07/01/2004 LINSENBACH BRIAN C 124 W HARRISBURG STREET PO BOX 310 DILLSBURG, PA 17019-0310 RE: Estate of ELICKER GENEVIEVE E File Number: 2004-00338 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 07/18/2004 Your prompt attention to this matter will be appreciated. Thank You. CC: File Personal Representative(s) Judge Sincerely, GLENDA ~A~ Clerk of the Orphans' Court Cumberland County Register Of Wills Hanover and High Street Carlisle, PA 17013 Phone: (717)240-6345 Date: 07/01/2004 ELICKER PHYLLIS ELAINE 1055 YORK RD DILLSBURG, PA 17019 RE: Estate of ELICKER GENEVIEVE E File Number: 2004-00338 Dear Sir/Madam: It has come to my attention that you have not filed the Certification of Notice Under Rule 5.7 (a) in the above captioned estate. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing will become delinquent on 07/18/2004 Your prompt attention to this matter will be appreciated. Thank You. CC: File Counsel Judge Sincerely, RNER STRASBAUGH~J Clerk of the Orphans' Court CERTIFICATiON OF NOTICE UNDER RULE 5.6 a Name of Decedent: Date of death: Estate No. To the Register: GENEVIEVE E. ELICKER March 13, 2004 2004-00338 I certify that Notice of Estate Administration required by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on July 13, 2004. Name Address Charles R. Elicker 1055 York Road Dillsburg, PA 17019 Phyllis Elaine Elicker 1055 York Road Dillsburg, PA 17019 Notice has now been given to all persons entitled thereto under Rule 5.6(a), except: NONE Dat e:-J-~!v 13~2004___~ Brian C. Linsen[~A~-'~~ Law Offices of Schrack & Linsenbach 124 West Harrisburg Street P.O. Box 310 Dillsburg, PA 17019 (717) 432-9733 Counsel for Personal Representative IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, CUMBERLAND COUNTY, PENNSYLVANIA In re: Estate of GENEVIEVE E. ELICKER Estate No. 2004-00338 TO: PHYLLIS ELAINE ELICKER 1055 YORK ROAD DILLSBURG, PA 17019 Please take notice of the death of decedent and the grant of Letters of Administration to the administrator of the estate named below. The Decedent, GENEVIEVE E. ELICKEI~ died on the 13t~ day of March, 2004, at Cumberland County, Pennsylvania. The Decedent died intestate (without a Will). The name, address and telephone number of the administrator of the estate follows: Phyllis Elaine Elicker 1055 York Road Dillsburg, PA 17019 A Petition for the Grant of Letters of Administration was filed with the Office of the Register of Wills of Cumberland County whose address and telephone number follows: Register of Wills of Cumberland County Cumberland County Courthouse 3 South Hanover Street Carlisle, Pennsylvania 17013 A copy of the Petition may be obtained by contacting either the undersigned or the Register of Wills and paying the charges for duplication. BRIAN C. LINSL~ACH, ESQUIRE SCHRACK & LINSENBACH LAW OFFICES 124 West Harrisburg Street P. O. Box 310 Dillsburg, PA 17019 717-432-9733 Counsel for Personal Representative IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS, CUMBERLAND COUNTY, PENNSYLVANIA In re: Estate of GENEVIEVE E. ELICKER Estate No. 2004-00338 TO: CRARLES IL ELICKER 1055 YORK ROAD DILLSBURG, PA 17019 Please take notice of the death of decedent and the grant of Letters of Administration to the administrator of the estate named below. The Decedent, GENEVIEVE E. ELICKER, died on the 13m day of March, 2004, at Cumberland County, Pennsylvania. The Decedent died intestate (without a Will). The name, address and telephone number of the administrator of the estate follows: Phyllis Elaine Elicker 1055 York Road Dillsburg, PA 17019 A Petition for the Grant of Letters of Administration was filed with the Office of the Register of Wills of Cumberland County whose address and telephone number follows: Register of Wills of Cumberland County Cumberland County Courthouse 3 South Hanover Street Carlisle, Pennsylvania 17013 A copy of the Petition may be obtained by contacting either the undersigned or the Register of Wills and paying the charges for duplication. BRIAN C. L1Nb~'YqBACIrI, ESQUIRE SCHRACK & LINSENBACH LAW OFFICES 124 West Harrisburg Street P. O. Box 310 Dillsburg, PA 17019 717-432-9733 Counsel for Personal Representative U.S. POSTAL SERVICE CERTIFICATE OF MAILING MAY BE USED FOR DOMESTIC AND INTERNATIONAL MAIL, DOES NOT PROVIDE FOR INSURANCE -- POSTMASTER Rece~vedFrom: BRT~'~ C. LTNSENBACH~ ESq. SCHRACK & LINSENBACH Law Offices ............. b SL P.O. Box 310 Dillsburg, PA 17019-0310 One plea of ordinary mail addressed to: Charles R. Eltcker 1055 York Road Di!!sburg, PA 17019 PS Form 3817, Mar. 1989 of U.S. POSTAL SERVICE CERTIFICATE OF MAILING Afl' in § , MAY BE USED FOR DOMESTIC AND INTERNATIONAL MAIL, DOES NOT meter PROVIDE FOR INSURANCE- POSTMASTER ~i~ ~F~stma~gr fo~u[ Receiv~dFrom: BRIAN C. LINSENBACH, ESq. SCHRACK_ _ . & LINSENBACH Law Offices lzq West ~arrisburg Street P.O. Box 310 Dillsburg, PA 17019-0310~ Phyllis Elaine E]~F JUL 200 1055 York Road cz) PS Form 3817, Mar. 1989 . Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 N f D d t GENEVIEVE E. ELICKER ame 0 ece en : Date of Death: March 13,2004 Estate No.: 2004-00338 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes 0 No jgl 2. Ifthe answer is No, state when the personal representative reasonably believes that the administration will be complete: June 1, 2005 3. If the answer to No. I is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No 0 b. The separate Orphans' Court No. (if any) for the personal representative's account is: C. Did the personal representative state an account informally to the parties in interest? Yes 0 No 0 c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk ofthe Orphans' Court and may be attached to this report. Date: April 6, 2005 ~d! 4~M~~ SIgnature . r".',,"" BRIAN C. L1NSENBACH, ESQUIRE Name 124 West Harrisburg Street Dillsburg, PA 17019 Address (717) 432-9733 Telephone No. Capacity: 0 Personal Representative ~ Counsel for personal representative vA OFFICIAL USE ONLY REV-1500 EX + (6-00) CAPB HpRL EplO CRAC KOTK ES REV-1500 INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER o E C E o E N T COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ELICKER Genevieve E. DATE OF DEATH (MM-DD-YEAR) 185-52-7369 THIS RETURN MUST BE FILED IN DUI'UCATEWlTH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER 21-04-0338 COUNTY CODE YEAR NUMBER SOCIAL SECURITY NUMBER DATE OF BIRTH (MM-DD-YEAR) 1. Original Return 4. Limited Estate 6. Decedent Died Testate o 3. date pf death . Remainder Return prior 1012-13-82) 5. Federal Estate Tax Retur~ Required 8. Total N umber of Safe Deposit Boxes Supplemental Return Future Interest Compromise (date of death after 12-12-82) Decedent Maintained a Living Trust (Attach copy of Will) (Attach copy of Trust) o 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit o 11. Election to tax under secI9113(A) (Attach Sch 0) C P o 0 R N R 0 E E S N T C o M P T U A T X A T I o N Brian C. Linsenbach Es FIRM NAME (If Applicable) Schrack & Linsenbach TELEPHONE NUMBER 124 W. Harrisburg Street Post Office Box 310 Di11sburg, PA 17019-0310 R E C A P I T U L A T I o N 432-9 33 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (8) 16,267.09 (11 ) 120.241. 31 (12) ,(3,974.22) (13) (14) 1(3,974.22) (1) (2) (3) None None None (4) (5) None 16,267.09 --:1 ~TJ (--) rTI , i (6) None None 10,214.97 10,026.34 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(a)( 1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. (15) (16) (17) (18) (19) .0 0 .0 45 .12 .15 0.00 0.00 0.00 0.00 0.00 (3,974.22) x X X X Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1S00 EX (Rev. 6-00) , .. Decedent's Complete Address: STREET ADDRESS 1055 York Road CITY I STATE I ZIP Dillsburg PA 17019 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 Total Credits ( A + B + C) (2) 0.00 3. interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty ( D + E) (3) 4. if Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) A. Enter the interest on the tax due. (SA) B. Enter the total of Line S + SA. This is the BALANCE DUE. (5B) Make Check Pa)'~b.leto: REGISTER. OF WILLS, AGENT . . . . . . . "''''':':'~;~~:~~;!~~~:W~:~.!1~~~::~:~~~~~I;~~I;;~b;~~~~~:~~,;~~;;~~~g111~1~1!~~ '!l,!~!" !~~!!'~!~!!~~~I~I~~!~!I~~~!~~~~~~mmm!m 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; . . . . . . . . . . . . . ~ ~x~x b. retain the right to designate who shall use the property transferred or its income; . c. retain a reversionary interest; or. . . . . . . . . . . . . . . . . . . . . . . . . . d. receive the promise for life of either payments, benefits or care? . . . . . . . . . 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. D 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ...... D 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 0.00 0.00 0.00 0.00 0.00 []]I []]I []] Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and bEllief, it is true, correct and complete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN Phy 11 is Elaine ELICKER DAtE p~ ~ ~~ ---~~I~\~~~-i~~~1~-li6i9-------------------------- ~ /g /60- SIGNATUREOFPREPAREROTHERTHANREP ESENTATIVE Schrack & Linsenbach - (Jrr.:,.. (.. Ll"-s",,\'.~l,u,.DAt~ ~~ <2- ~~~ -~1il;b~~C:~~ ~1~~i-~6r~-:6~i-6 - - - - - - - - - - - - - - - - - -- For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for surviving spouse is 3% [72 P.S. 9116 (a) (1.1) (il]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to ( [72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, al and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age' parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal benefic [72 P.S. 9116(a)(1)]. b......>.e_ rpd C: _ ,~,. ._..:,,;~,.., <::nnt.jse is 0% Ire of assets <",)\0 'IS c;;A (A:) natural The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 Section 9102, as an individual who has at least one parent in common with the decedent, whether by blooCl or ayVp.._... ~() d,s'-61'\) --- -).~~ 9116( 1.2) ined, under Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) II REV -1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Genevieve E. ELICKER SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY SS1ft 185-52-7369 03/13/2004 FILE N MBER 21-04-0338 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F ITEM NUMBER 1 DESCRIPTION Proceeds from personal injury lawsuit filed to York County, PA No. 2003-SU-4931-01 VAL E AT DATE o DEATH 750.00 2 Proceeds from under insured motorist claim - Progressive Insurance 15,000.00 3 PNC checking account #5003906193 91.60 4 United States Treasury - 2003 tax refund 25.49 5 1983 Toyota Camry - proceeds of sale 400.00 TOTAL (Also enter on line 5, Recapitulation) $ 16,267.09 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-15GB EX (Rev. 1-97) II ~ Morgan & Wilken, P.c. ATTORNEYS AT LAW 120 South Street Harrisburg, Pennsylvania 17101 (717) 236-7959 Fax (717) 231-7436 www.morganwilken.com Chambersburg Qffice Suite 309 14 N. Main Street Chambersburg, FA 17201 (717) 263-5607 " Scott W. Morgan* Thomas A. Wilken Gary Lysaght** Melissa Merritts Rivera** "BOARD CERTIFIED IN CIVIL TRIAL LAW BY TIlE NATIONAL BOARD OF TRIAL ADVOCACY "OF COUNSEL April 6, 2005 Brian C. Linsenbach, Esquire SCHRACK & LINSENBACH 124 W. Harrisburg Street P. O. Box 310 Dillsburg, P A 17019-0310 Re: Elicker v. W.R. Ramsey Property and Rentals York County, C.C.P., No. 2003-SU-4931-01 Dear Brian: I apologize for the delay in sending you the Elicker settlement check. The depdsit was made but it appears I just forgot to mail you the Estate's payment. Enclosed is the Estate's settlement proceeds in the amount of$190.85. The tq~al settlement was $750.00 less one third attorney's fee of$250.00 and reimbursement oflitigatiqn expenses (attached) of $309.15. The balance available to the Estate is, therefore, $190.85. I Again, my apologies for the delay. Should you have any questions concerning.the case or its settlement, do not hesitate to call me. ' Very truly yours, MORGAN & WILKEN, P.C. SWM/men II PROGRE.f.fIVE ~ JUNE 1, 2004 4000 Crums Mill Road, Suite 201 Harrisburg, PA 17112 Telephone. 717540-2500 717540-2600 Facsimile: 71767t-6458 SCHRACK & L1NSENBACH P.O. BOX 310 DILLSBURG, PA 17019-0310 progressive. com Our Insured Policy Number Our Claim Number Date of Loss Your Client : GENEVIEVE ELICKER : 58052923-4 : 042517225 : 3/13/04 : ESTATE OF GENEVIEVE ELICKER Dear Mr. Linsenbach: Please find enclosed our draft and release in the amount of $15,000.00, for full and final settlement of your client's Uninsured Motorist claim, against the above policy, against Progressive. As you ar~ aware we do have an additional Uninsured Motorist claim open for your client under policy numb~r, 55351389-5, policy issued to Charles Elicker. Please be advised that a copy of this correspondence is being forwarded to Mrs. Phyllis Elicker. ! Please hold this draft in escrow until I have received the completed general release back in the rllail after it has been properly executed. Thank you for your cooperation throughout the handling of this file. Sincerely, p~ir~~~~IVE1N~:TH!\~ I,~SURANCE J. \ ,iv vlJ)'\; l/~/HV f' ) {"V ~ Il-/ VERO'NICA SHIRK j ~ Casualty Representative Enclosures: DRAFT & RELEASE Cc: MRS. PHYLLIS ELICKER , 1 , . r BELCO COMMUNITY CREDIT UNION BELeo MAIN OFFICE C.mm""'f~ Credit Union 403 N. 2nd Street. P.O. Box 82 . Harrisburg, PA 17108 Lr- BRANCH OFFICES 354 N. Prince Street. Suite 120 . P.O. Box 1026 . Lancaster, PA 17606 3500 Trindle Road . Camp Hill, PA 17011 205 S. Front Street. P.O. Box 8700 . Harrisburg, PA 17105 "Getting You There" 5785 Allentown Boulevard. Harrisburg, PA 17112 39 North Washington Street . Gettysburg, PA 17325 201 Good Drive. Lancaster, PA 17603 HARRISBURG SERVICE TELEPHONE NO:... . .. '-717-23-BELCO LANCASTER SERVICE TELEPHONE NO:.... .. .1-717-393-1116 CAMP HILL SERVICE TELEPHONE NO: . . . . . . . . 1-717-720-6290 PINNACLE HEALTH SERVICE TELEPHONE NO:. '-717-231-8301 GETTYSBURG SERVICE TELEPHONE NO:. . ... 1-717-337-3474 TOLL FREE TELEPHONE NUMBERS: I Toll Free. . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . .~-8oo-642-4482 Belle Automated Services. . . . . . . . . . . . . . . . . . . . . ~ -8oo-75-BELLE Web Site. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 www.belco.org x THE ESTATE OF G E ELICKER PHYLLIS E ELICKER 1055 YORK RD DILLSBURG PA 17019 I DEPOSIT/PAYMENT I FOR ,o.MOUNT OF $***"""'''''191.60 ON 041604 EFFECTIVE 041/604 TLR:3~41 REBEKAH- 12:33:12 llCCOlJNT NUt~BER 844395 i CHECKS RECEIVED:$ 91. 60 CfiSH: $ 0,00 ACCT S 4 DEscrnPTION S4--CHECKING TRAN-AMOUNT 91.60 NE~I--BALANCE 91.60 FEE 0.00 INT-PA D NXT DUE ./ SHARE ID LEGEND S1 - SAVINGS 54 - CHECKING S2 - CHRISTMAS CLUB S5-IRA S3 - WHATEVER CLUB, SAFARI CLUB, TEEN CLUB 86 - MONEY MARKET GROWTH FUND I'NaiAI _c.........__. '11'_-" - - -~ --~----- - -- -~----- - -"----- - - - ---- ~---- - --- ---~ - --- -- --- MV-3 (07-03) MOTOR VEHICLE VERIFICATION OF FAIR MARKET VALUE BY THE ISSUING AGENT Commonwealth of Pennsylvania Department of Transportation Bureau of Motor Vehicles Harrisburg, PA 17104-2516 This form is used in conjunction with Forms MV-1, MV-4ST, MV-217A and an on-line rocessing A plicant Summa Statement. TYPE OR PRINT ALL INFORMATION AS REQUESTED FOR DEPARTMENT USE ONLY PURCHASE - PRICE s~~at,ure of Authorized Agent - "/f , "Lj LiV0LJLL-l 0(r; C~1 r C PURCHASER INFORMATION Last Namn'~71s ~ame~ Co-Purchaser D PURCHASER/SELLER EXPLANATION Explain in detail why the purchase price listed on Form MV-1, MV-4ST or MV-217 is less than 80% of the average Fair Market Value, or ifthe vehicle i over 15 years old and the purchase price is less than $500, explain how the purchase price was determined, or if the vehicle is not listed in a PENN DOT approved publi ation, explain how the purchase price as listed in Section A was determined. Please use additional paper if more space is required_ NOTE TO PURCHASER: h' e sale bv the DeDartment of Revenue mav occur, Please retain copies of this form, your cancelled check or original cash receipt, and your rEI Ipt from the seller of this vehicle, along with either your copy of the Application for Certificate of Title (MV-1), the Vehicle Sales and Use Tax ReturnlApplication for eglstration (MV-4ST) or the Application by Financial Institutions for Certificate of Title After Default by Owner (MV-217 A). 6/14 V~H:fepf!Jr l)~~~, E SEAL AND SIGNATURE OF SELLER - NOT REQUIRED FOR VEHICLES PURCHASED OUT.OF.STATE I/We state that I/we have read and signed this form after its completion, and I/we swear or affirm that the statements made herein are true an~ correct, and that any statement made on or pursuant to this form is subject to the enalties of 18 PA C.S. Section 4903(a)(2)(relating to false swearing), which shall in lude punishment of a frne not exceeding $5,000, or to a term or imprisonment of no. more than two years, iJr-both. I ; . na ure of Seller i.~R~ Signature of Co-Seller E A L F SEAL AND SIGNATURE OF PURCHASER SUBSCRIBED AND SWOR TO BEFORE ME: Telephone Number ( E A L 1- 'OJ. ,~.~ .." i Chris~~~~~tft~W~~~::YI,~~ESS I, ~8:~"l"~~~'%l.!,~~;,:jlJ.;6~;t"iASER IN I ~I!Y ;/o,;.rr.lsf,lB~~NCE;Q~~_~~~,RY I/We state that I/we have read and signed this arm after it completion, and IIwe swear or affirm that the statements made herein are true an~ correct, and that any statement made on or pursuant to this form is subject to the enalties of 18 PA C.S_ Section 4903(a)(2)(relating to false swearing), which shall in lude punishment of a ,ne not exceeding $5,000, or to a term or imprisonment of no more than two years, or b tho 5i ature of Purchaser I ,U I Telephone Number ( I THIS FORM MAY BE PHOTOCOPIED Messenger No. REV-1511 EX +(1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF Genevieve E. ELICKER SSiI 185-52-7369 03/13/2004 FILE NUMBER 21-04-0338 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION A~OUNT i 1 FUNERAL EXPENSES: Malpezzi Funeral Home 3,592.98 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s) / EIN Number of Personal Representative(s) Street Address B. State Zip City Year(s) Commission Paid: 2. 3. Attorney's Fees Schrack & Linsenbach Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Phyllis E. Elicker Street Address 1055 York Road City Dillsburg State PA Zip 17019 Relationship of Claimant to Decedent mother 1,850.00 3,500.00 4. Probate Fees Register of Wills 55.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 7. Other Administrative Costs 1 BELCO - fee to transfer checking account Total of Continuation Schedule(s) 5.00 25.00 75.00 83.34 50.00 25.00 i 953.65 10,214.97 2 Clerk of Orphans' Court - filing fee/Family Settlement Agreement 3 Cumberland Law Journal - estate advertisement 4 Dillsburg Banner - estate advertisement 5 Jones Accounting - 2003 tax return preparation 6 Miscellaneous expenses (postage, photocopying, etc.) TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-t511 EX (Rev. 1-97) Estate of: Genevieve E. ELICKER Sac Sec #: 185-52-7369 Date of Death: 03/13/2004 Continuation of Schedule H-B7 (Other Administrative Costs) Item # Description Amount 7 Morgan & Wilkins, P.C. - expense of personal lnJury lawsuit filed to York County, PA Court of Common Pleas No. 2003-SU-4931-01 559.15 8 PennDOT - title transfer 29.50 9 Register of Wills - filing fee 15.00 10 Reserve for future administrative expense 350.00 953.65 " II --------= Morgan & Wilken, P.c. ATTORNEYS AT LAW . Scott W. Morgan* Thomas A. Wilken Gary Lysaght** Melissa Merritts Rivera** 120 South Street Harrisburg, Pennsylvania 17101 (717) 236-7959 Fax (717) 231-7436 www.morganwilken.com Chambersburg Office Suite 309 14 N. Main Street Chambersburg, FA 17201 (717) 263-5607 'BOARD CERTIFIED IN CIVIL TRIAL LAW BY THE NATIONAL BOARD OF TRIAL ADVOCACY "OF COUNSEL April 6, 2005 Brian C. Linsenbach, Esquire SCHRACK & LINSENBACH 124 W. Harrisburg Street P.O. Box 310 Dillsburg, P A 17019-0310 Re: Elicker v. W.R. Ramsey Property and Rentals York County, c.c.P., No. 2003-SU-4931-01 Dear Brian: I apologize for the delay in sending you the Elicker settlement check. The depqsit was made but it appears I just forgot to mail you the Estate's payment. Enclosed is the Estate's settlement proceeds in the amount of$190.85. The to~al settlement was $750.00 less one third attorney's fee of$250.00 and reimbursement oflitigati9n expenses (attached) of $309.15. The balance available to the Estate is, therefore, $190.85. ' Again, my apologies for the delay. Should you have any questions concerning the case or its settlement, do not hesitate to call me. : Very truly yours, MORGAN & WILKEN, P.C. SWMlmen REV -1512 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Genevieve E. ELICKER SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS SSfI 185-52-7369 03/13/2004 Include unreimbursed medical expenses. ITEM NUMBER 1 10 DESCRIPTION American Education Services - account fl185-52-7369 - student loan balances 2 AT&T - account flA0703089576701 3 BankOne - account fl626202 - balance due 4 Citibank - account fl4128003579362537 - balance due 5 MCI - account fl2FK91741 - balance due 6 Pennsylvania Department of Revenue - amount due 2003 taxes 7 Progressive Insurance - premium due 8 Sherman Financial Services - account fl4417129274105572 - balance due 9 Shumaker Garage - balance due on car repairs West Shore Tax Bureau - amount due 2003 taxes (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. TOTAL (Also enter on line 10, Recapitulation) $ II FILE NlIMBER 2l-0~-0338 AMOUNT 4,412.96 70.85 2,081. 82 895.20 46.06 9.00 49.00 I 2,135.37 321.99 4.09 ! 10,026.34 Form REV...1512 EX (Rev. 1-97) II REV -1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF Genevieve E. ELICKER SCHEDULE J BENEFICIAR IES 55f! 185-52-7369 03/13/2004 FILE N MBER 21-04-0338 RELATIONSHIP TO DECEDENT AMOUNT OR SHARE Do Not List Trustee(s) OF ESTATE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] 1 Charles Robert Elicker 1055 York Road Dil1sburg, PA 17019 Father resid~ary estatb i I 2 Phyllis Elaine Elicker 1055 York Road Di11sburg, PA 17019 Mother I resi~ary estatJe ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET II. NON- TAXABLE DISTRIBUTIONS, A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0.00 (If more space is needed, insert additional sheets of the same size) Copyright (c) 2000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) 11-21-2005 ELlCHER 03-13-2004 21 04-0338 CUMBERLAND 101 APPEAL DATE: 01-20-2006 ( See reverse side under Objections) A.ount Remittedl I MAKE CHECK PAYABLE AND REMIT PAYMENT REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 ;"'~(v"'.n;"c,",. ,"CC','"'[ ~ICE OF INHERITANCE TAX ri::"t..Al["'.<U APPRMSEf;jENT, ALLOWANCE OR DISALLOWANCE - -Ol=":tlED:,JCTIONS AND ASSESSMENT OF TAX .- ') {~ C Pl1 3: 04 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN c: BRIAN C LlNSENBAIOt ESQ SCHRACK & LINSENBACH PO BOX 310 DILLSBURG PA 17019 REV-1547 EX AFP (06-05J GENEVIEVE E TO: CUT ALONG THIS LINE --+ RETAIN LOWER PORTION FOR YOUR RECORDS +-- ------------------------------------------------------------------------------------------- REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF ELlCHER GENEVIEVE E FILE NO. 21 04-0338 ACN 101 DATE 11-21-2005 TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Stock/Partnership Interest (Schedule C) (3) 4. Mortgages/Notes Receivable (Schedule DJ (4) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6. Jointly Owned Property (Schedule F) (6) 7. Transfers (Schedule G) (7) .00 .00 .00 .00 16.267.09 .00 .00 (8) 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 10,214.97 10,026.34 NOTE: To insure proper credit to your account. submit the upper portion of this form with your tax payment. 16,267.09 (11) (12) (13) (14) ?D . ?41 .31 3,974.22- .00 3,974.22- NOTE: If an assess.ent was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of !ll. returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate (15) .00 X 00 .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) .00 X 045 = .00 17. Amount of Line 14 at Sibling rate (17) .00 X 12 = .00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 = .00 19. Principal Tax Due (19)= .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ~t IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) SCHRACK & LINSENBACH LA W OFFICES 124 W. HARRISBURG ST. P.O. BOX 310 DILLSBURG, PA 17019-0310 PHONE (717) 432-9733 FAX (717) 432-1053 Attorneys WM. D. SCHRACK III BRIAN C. LINSENBACH December 22, 2005 Register of Wills Cumberland County Court House 1 Court House Square Carlisle, Pennsylvania, 17013 Re: Genevieve E. Elicker Estate No. 2004-00338 Dear Prothonotary: Please accept the enclosed document for recording and return the time stamped copy to me in the envelope enclosed. Thank you. Very truly yours, ~~~ Brian C. Linsenbach, Esq. SCHRACK & LINSENBACH BCL/jct Enclosures "," ) - -J c' . Register of Wills of Cumberland County STATUS REPORT UNDER RULE 6.12 Name of Decedent: GENEVIEVE E. ELICKER Date of Death: MARCH 13, 2004 Estate No.: 2004-00338 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: I. State whether administration of the estate is complete: Yes 0 No I8l 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. I is Yes, state the following: a. Did the personal representative file a final account with the Court? Yes 0 No.l8l b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? Yes J8l No D c. Copies of receipts, releases, joinders and approval of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date: 12/22/2005 ~ Signature - ('-) BRIAN C. L1NSENBACH, ESQUIRE Name 124 West Harrisburg Street Dillsburg, PA 17019-0310 '" r Address (717) 432-9733 ,- - Telephone No. Capacity: 0 Personal Representative ~ Counsel for personal representative \f1r Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 2/20/2007 LINSENBACH BRIAN C 124 W HARRISBURG STREET PO BOX 310 DILLSBURG, PA 17019-0310 RE: Estate of ELICKER GENEVIEVE E File Number: 2004-00338 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO. I, for decedents dying on or after July I, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of Wills a Status Report of completed or uncompleted administration. This filing is due by: 3/13/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Personal Representative(s) eN Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240-6345 Date: 2/20/2007 ELICKER PHYLLIS ELAINE 1055 YORK RD DILLSBURG, PA 17019 RE: Estate of ELICKER GENEVIEVE E File Number: 2004-00338 Dear Sir/Madam: This notice is to serve as a reminder that the Status Report by Personal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of wills a Status Report of completed or uncompleted administration. This filing is due by: 3/13/2007 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~~~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel ~ Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF Cumberland COUNTY, PENNSYLVANIA Name of Decedent: Genevieve E. Elicker Date of Death: March 13, 2004 File Number: 2004~00338 Pursuant to Pa.O.c. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: . . . . . . . . . . . . . . . . . . . . ~ Ves 0 No 2. Ifthe answer-is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No.1 is YES, state the following: a. Did the personal representative file a final account with the Court? . . . . . .. Dv es ~No b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? . . . . . .. .. . . . . .. . . . . . . . . . . . . .. . -pres DNa d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. ~ Date March 5, 2007 ""-,, Signature of Person Filing this 0 Capacity: DPersonal Representative ;rJ Counsel Brian C. Linsenbach. ERql1ire Name of ferson Filing this Form 124 't1fest Harrisburg St., P. O. Box 3~0 Add,.;ss ' .~ Dillsburg, PA 17019 l"" 7 "I ! (~:I (, (.",. ,(.1 717-432-9733 ,; I. Telephone Form RW-IO rev. 10.13.06