HomeMy WebLinkAbout04-0409ESTATE OF
BRIAN PETER KOSER
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
· NO. di-O¢-q'Oq
PETITION OF MABEL J. KOSER, AS ADMINIST,_,R~TOR · '~
OF THE ESTATE OF BRIAN PETER KOSER, FOR AI?ROvA~ OF ...... ~ ~
WRONGFUL DEATH/SURVIVAL ACTION SETT~MEN'~ -~', ~57 . (
AND NOW, comes Petitioner, Mabel J. Koser, as Administrator of the Estate of:B~rian Peter Kq~er,
seeking court approval of the settlement on behalf of the Estate of Brian Peter Koser, and~respectfully'~present
the following: ~
1. Petitioner, Mabel J. Koser, is the natural parent and guardian of decedent, and administrator of the
Estate of Brian Peter Koser, deceased, by virtue of Letters of Administration granted to them by the Register of
Wills of Cumberland County, Pennsylvania on December 2, 2003. (A true and correct copy of the Short
Certificate is attached hereto as Exhibit "A".)
2. The decedent, Brian Peter Koser, was 12 years old at the time of his death with a date of birth of
October 5, 1989, and was a resident of Newburg, Cumberland County, Pennsylvania.
3. Decedent died as a result of injuries sustained in a fatal motor vehicle accident on May 15, 2002,
when the vehicle in which the decedent was a passenger went out of control, and flipped over, ejecting decedent
from the vehicle. The accident occurred on Mongul Hill Road, South Hampton Township, Franklin County,
Pennsylvania. (A true and correct copy of the Pennsylvania State Police Report is attached hereto as Exhibit
4. At the time of the accident, the vehicle in which decedent was a passenger was being operated by
David J. Koser, the brother of the decedent.
5. By reason of the death of the decedent, Brian Peter Koser, a cause of action arose against the
tortfeasor, David J. Koser; however, no civil action has been filed to date.
6. At the time of the accident, the tortfeasor was covered by a policy of insurance through Allstate
Insurance Company that provided a liability limit of $100,000, as confirmed by the certified letter and
declarations page supplied by Allstate Insurance Company. (A true and correct copy of the certified letter and
declarations page printout is attached hereto as Exhibit "C").
7. Although not admitting liability on the part of the tortfeasor, Allstate Insurance Company on behalf
of the tortfeasor proposed a structured settlement, in full and final settlement of all claims against the tortfeasor
as follows:
a. A lump sum payment of $40,000 to be paid on or before 14 days from receipt of the executed
structured settlement release;
b. Lump sum guaranteed payments as follows:
(1) $7,500 guaranteed payment on March 1, 2007;
(2) $12,500 guaranteed payment on March 1, 2010;
(3) $20,000 guaranteed payment on March 1, 2013;
(4) $25,000 guaranteed payment on March 1, 2016; and
(5) $35,000 guaranteed payment on March 1, 2019.
(A true and correct copy of the release and settlement agreement is attached hereto as Exhibit D.)
8. Subject to the approval of this Honorable Court, Petitioner, Mabel J. Koser, as Administrator of the
Estate of Brian Peter Koser, has agreed to accept the aforementioned structured settlement proposal from
Allstate Insurance Company, representing satisfaction of the claims against the tortfeasor, in light of the fact
that there is no other available insurance or assets to satisfy Petitioner's claim.
9. The law provides for recovery of funeral expenses and loss contributions and services under the
wrongful death act and net lost earnings under the survival act.
10. In the instant case, the funeral expenses totaled $5,069.00, $2,500.00 of which has been paid by
Allstate pursuant to Petitioner's policy of insurance and the balance of which will be paid by Petitioner as
Administrator of the Estate of Brian Peter Koser out of the available life insurance proceeds.
11. At the time of his death, Petitioner's decedent was a 12 year old student and was not employed, and,
therefore, there is no claim for loss of earnings or earning capacity.
12. The evidence suggests that Petitioner's decedent was conscious, if at all, for only a very brief period
of time following the accident and became unconscious at the time of, or before, being placed on the helicopter
and before being flown to the hospital where he passed away.
13. In light of the foregoing, it is believed, and therefore averred, that any pain and suffering endured by
the decedent was brief and ended before being transported to the hospital.
14. In light of the above facts, Petitioner's believes and therefore avers that an allocation of $10,000 to
the survival action and the remainder being allocated to the wrongful death action is a fair and reasonable
allocation of the settlement proceeds.
15. Petitioner has sought approval of the above-mentioned distribution from the Pennsylvania
Department of Revenue, and the allocation was approved by J. Paul Dibert, in a letter dated December 15, 2003.
(A true and correct copy of the letter from the Pennsylvania Department of Revenue approving the allocation of
the settlement proceeds, is attached hereto as Exhibit "E").
16. The decedent did not have any issue at the time of his death and Petitioner, as natural parent of the
decedent, is the only heir entitled to share in the estate of the decedent, pursuant to Pennsylvania Law of
Intestate Succession. 20 P.C.S. §2103 (2003). (See Exhibit "A").
17. The fees of the undersigned counsel for the Petitioner is being paid by Allstate Insurance Company
at no cost to Petitioner.
18. Petitioner believes, and therefore avers, that in light of the facts set forth in this Petition, the
allocation of $10,000 to the survival action claims with the remainder allocated to the wrongful death claim is
fair, just and equitable.
WHEREFORE, Petitioner respectfully requests that this Honorable Court enter an order approving the
settlement, directing the distribution of the proceeds thereof in accordance with the averments of this Petition,
and authorizing Petitioner, upon payment of the aforesaid sums to execute and deliver to Allstate's insured, a
good and sufficient general release discharging their liability in this matter.
\05_A\LIABXJPM\LLPG\I 38993~EMP\01199\00365
Respectfully submitted,
MARSHALL, DENNEHEY, WARNER,
COLEMAN & GOGGIN
~t~42 0~C F'rumMsuM~i ll~R~aS~d~l]ire
Suite B
Harrisburg, PA 17112
I.D. No. 78119
(717) 651-3509
VERIFICATION
The undersigned hereby verifies that the statements in the foregoing Petition are based
upon information which has been furnished to counsel by me and information which has been
gathered by counsel in the preparation of the defense of this lawsuit. The language of the
Petition is that of counsel and not my own. I have read the Petition, and to the extent that it is
based upon information which I have given to counsel, it is true and correct to the best of my
knowledge, information and belief. To the extent that the contents of the Petition are that of
counsel, I have relied upon my counsel in making this verification. The undersigned also
understands that the statements therein are made subject to the penalties of 18 Pa.C.S. Section
4904, relating to unsworn falsification to authorities.
BY:
Mal~$1 J. Ko~eO ' -
STATE OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SHORT CERTIFICATE
I, DONNA M. OTTO
Register for the Probate of Wills and Granting
Letters of Administration &c. in and for said
County of CUMBERLAND do hereby certify that on
the 2nd day of December A.D.,
- Two Thousand and Three,
Letters of ADMINISTRATION
in common form were granted by the Register of
said County, on the
estate of KOSER BRIAN PETER , late of HOPEWELL TOWNSHIP
(LA~'I', b'l~5'l', MIDDLE)
in said county, deceased, to
KOSER MABEL J
and that same has not since been revoked.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of said office at CARLISLE, PENNSYLVANIA, this 2nd day of December
A.D., Two Thousand and Three.
2003-00996
21-03-0996
5/15/2002
204-70-2422
File No.
PA File No.
Date of Death
s.s. #
NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL
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COMMONWEALIH OF PENNSYLVANIA
POLICE CRASH REPORTING FORM
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PENNDOTCOPY ~' ,~ : ..
. . _ .... . ~ - ~- , ~
National Support Center
Allstate Insurance Company
1819 Electric Road S.W.
Rbanoke, VA 24018-1618
Bus: (540) 989-2200
You re m good hands
To Whom It May Concern:
I, Linda Sisson, employee of Allstate Insurance Company, Roanoke, Virginia, do certify
that the enclosed is a copy of Policy Number
in the name of
showing the coverages that were on the policy at the time of loss of
State of Virginia, County of Roanoke
On this ! ~ day of ~ r~,/.~_.~"~.:~' ', 2003, before me
personally appeared Linda Sisson to me known to be the person who executed the
foregoing instrument and acknowledged that she executed the same as a free act and
deed.
My Commission Expires:
Notary Public
G L Fogelsonger Agy
66 E King Street
Shippensburg PA 17257
h,,llh,,h,hhh,llh,,hh,,,Ih,hh,,,llh,h,,hlh,hl
James R & Mabel Koser
1482 Three Sq Hollow
Newburg PA 17240-9351
vt Verify vehicles and drivers listed on the
Policy Declarations and ID cards.
Vt Verify the vehicle identification number
(VIN) listed on these documents; its
accuracy could affect your premium.
Vt This is not a bill.
Confirming Your Policy Change
We've sent along this mailing to verify the changes to your policy that you recently
requested. The changes took effect on 02/14/02. Please look over all the information in this
mailing, and call us right away if you have any questions or if anything isn't exactly right.
The accompanying Amended Policy Declarations includes these changes:
A change in driver or use of your 88 Ford Truck Ranger.
The addition of one or more operators.
Your premium for this current period has been increased by a total of $386.00.
The coverages and limits you carry for your vehicles, and the costs of those coverages, are
listed in detail on the enclosed Amended Policy Declarations. By comparing this Amended
Policy Declarations with the Policy Declarations previously mailed to you, you can see any
changes in detail.
If You have any questions or concerns please contact me at (717) 532-4181--or call the
Allstate Customer Information Center at 1-800-ALLSTATE (1-800-255-7828).
G L Fogelsonger Agy
Your Allstate Agent
AUTO '510003702020703031830401' Inlorma~lon as ol Februa[y 7.2002
Illlll ! IIll Illl Il lll Ill IIII IlHIllllllllll Illl IIlll Illlllll
EA23
Allstate Insurance Company
Summary
NAMED INSURED(S)
James R & Mabel Koser
1482 Three Sq Hollow
Newburg PA 17240-9351
AMENDED
Auto Policy Declarations
YOUR ALLSTATE AGENT IS
G L Fogelsonger Agy
(717) 532-4181
66 E King Street
Shippensburg PA 17257
YOUR BILL
lists your payment options.
POLICY NUMBER POLICY PERIOD
0 77 051795 02/14 Feb. 14, 2002 to Aug. 14, 2002 at 12:01 a.m. standard time
DRIVER(S) LISTED DRIVER(S) EXCLUDED
James Mabel None
David
VEHICLES COVERED VEHICLE ID NUMBER LIENHOLDER
1. 88 Ford Truck Ranger 1FTBR10A3JUA88694 None
2. 88 Ford Taurus 1FABP5709JA128295 None
3. 83 Chew Blazer 1GSCT18B3D0136686 None
Total Premium
Premium for 88 Ford Truck Ranger $516,70
Premium for 88 Ford Taurus $356.80
Premium for 83 Chew Blazer $337~80
TOTAL $1,211.30
Your total premium reflects a combined discount of $498.00
VI Your total premium reflects a combined surcharge of $19.00
Your Policy Effective Date is Feb. 14, 2002
IN ACCORDANCE WITH SECTION 172§ OF THE MOTOR VEHICLE FINANCIAL RESPONSIBILITY LAW, THIS IS TO INFORM YOU THAT COLLISION DAMAGE TO
A RENTAL VEHICLE WILL BE COVERED IF: 1 ) THE RENTAL VEHICLE IS A FOUR WHEEL PRIVATE PASSENGER AUTOMOBILE OR A UTILITY AUTOMOBILE, AND
2) AT LEAST ONE PREMIUM FOR AUTO COLLISION COVERAGE APPEARS ON YOUR POLICY DECLARATIONS. COVERAGE WILL BE SUBJECT TO
DEDUCTIBLES AND TO POLICY TERMS AND CONDITIONS, INCLUDING ANY APPLICABLE ENDORSEMENTS.
AUTO *510003702020703031830402 *
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February 7. 2002 PAO10AMD
Allstate Insurance Company
Policy Number: 0 77 051795 02/14
Policy Effective Date: Fcb. 14, 2002
Your Agent: G L Fogelsonger Agy (717) 532-4181
COVERAGE FOR VEHICLE # 2
1988 Ford Taurus
COVERAGE LIMITS DEDUCTIBLE PREMIUM
Automobile Liability Insurance ~- Full Tort
· Bodily Injury $100,000 each person Not Applicable $72.00
$300,000 each occurrence
· Property Damage $100,000 each occurrence Not Applicable $60.00
Medical Expenses $25,000 each person Not Applicable $44.00
Funeral Expenses $2,500 each person Not Applicable $0.50
Income Loss
Each person up to $5,000 maximum benefit Not Applicable $5.00
Subject to $1,000 monthly maximum
Uninsured Motorists Insurance $100,000 each person Not Applicable $26.70
Full Tort / Stacked Limits $300,000 each accident
Underinsured Motorists Insurance $100,000 each person Not Applicable $24.60
Full Tort / Stacked Limits $300,000 each accident
Auto Collision Insurance Actual Cash Value $500 $90.00
Auto Comprehensive Insurance Actual Cash Value $50 $34.00
Total Premium for 88 Ford Taurus $356.80
DISCOUNTS Your premium for this vehicle reflects the following discounts:
Multiple Car $68.00 Premier Plus
$75.00
RATING INFORMATION
This vehicle is driven over 7,500 miles per year, over 20 miles to work/school, adult age 37, with no unmarried driver
under 25
AUTO '510003702020103031830403'
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Feb~aP/7, 2002 PAOIOAMD
Allstate Insurance Company
Policy Number: 0 77 051795 02/14
Policy Effeclive Date: Feb. 14, 2002
Your Agent: G L Fogelsonger Agy (717) 532-4181
Your Policy Documents
Your auto policy consists of this Policy Declarations and the documents listed below. Please keep these together.
- Pennsylvania Auto Insurance Policy form AU137-3 - Amendment of Policy Provisions form AU10600
- Amendment of Policy Provisions form AU1900-3
IN WITNESS WHEREOF, Allstate has caused this policy to be signed by its Secretary and its President at Northbrook,
Illinois, and if required by state law, this policy shall not be binding unless countersigned on the Policy Declarations by
an authorized agent of Allstate.
Secretary
President, Personal Lines
AUTO '510003102020703031830404'
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FebruaPJ 7, 2002PA010AMD
EXHIBIT
D
Settlement Aqreement and Release
This Settlement Agreement and Release (the "Settlement
Agreement") is made and entered into this day of
, 2004, by and between:
"Claimant" -
"Insureds" -
"Insurer" -
Mabel Koser as Executrix of the Estate of Brian
Koser
Mabel Koser and David Koser
Allstate Insurance Company
Recitals
A. On or about May 15, 2002, Brian Koser was fatally
injured in an accident occurring at or near Southampton Township,
Franklin County, Pennsylvania. Claimant has made a claim seeking
monetary damages on account of those injuries.
B. Insurer is the liability insurer of the Insureds, and as
such, would be obligated to pay any claim made or judgment
obtained against the Insureds which is covered by its policy with
the Insureds.
C. The parties desire to enter into this Settlement
Agreement in order to provide for certain payments in full
settlement and discharge of all claims which have, or might be
made, by reason of the incident described in Recital A above,
upon the terms and conditions set forth below.
Agreement
The parties agree as follows:
1.0 Release and Discharge
1.1 In consideration of the payments set forth in Section 2,
Claimant hereby completely releases and forever discharges the
Insureds and Insurer from any and all past, present, or future
claims, demands, obligations, actions, causes of action, wrongful
death claims, rights, damages, costs, losses of services,
expenses and compensation of any nature whatsoever, whether based
on a tort, contract or other theory of recovery, which the
Claimant now has, or which may hereafter accrue or otherwise be
acquired, on account of, or may in any way grow out of the
incident described in Recital A above, including, without
limitation, any and all known or unknown claims for bodily and
personal injuries to Claimant, or any future wrongful death claim
of Claimant's representatives or heirs, which have resulted or
may result from the alleged acts or omissions of the Insureds.
1.2 This release and discharge shall also apply to
Insureds' and Insurer's past, present and future officers,
directors, stockholders, attorneys, agents, servants,
representatives, employees, subsidiaries, affiliates, partners,
predecessors and successors in interest, and assigns and all
other persons, firms or corporations with whom any of the former
have been, are now, or may hereafter be affiliated.
1.3 This release, on the part of the Claimant, shall be a
fully binding and complete settlement among the Claimant, the
Insureds and the Insurer, and their heirs, assigns and
successors.
1.4 The Claimant acknowledges and agrees that the release
and discharge set forth above is a general release. Claimant
expressly waives and assumes the risk of any and all claims for
damages which exist as of this date, but of which the Claimant
does not know or suspect to exist, whether through ignorance,
oversight, error, negligence, or otherwise, and which, if known,
would materially affect Claimant's decision to enter into this
Settlement Agreement. The Claimant further agrees that Claimant
2
has accepted payment of the sums specified herein as a complete
compromise of matters involving disputed issues of law and fact.
Claimant assumes the risk that the facts or law may be other than
Claimant believes. It is understood and agreed to by the parties
that this settlement is a compromise of a doubtful and disputed
claim, and the payments are not to be construed as an admission
of liability on the part of the Insureds, by whom liability is
expressly denied.
2.0 Payments
In consideration of the release set forth above, the Insurer on
behalf of the Insureds agrees to pay to the individual(s) named
below ("Payee(s)") the sums outlined in this Section 2 below:
2.1 Payments due at the time of settlement to the Claimant:
The sum of Forty Thousand Dollars
($40,000.00) on or before fourteen days
from receipt of this fully and properly
executed document.
2.2 Periodic Payments. Insurer agrees to make payment to
Mabel Koser and James Koser "Payees,, in the following manner:
(i) Lump sum guaranteed payments:
On March 1, 2007, guaranteed payment of
Seven Thousand Five Hundred Dollars
($7,500.00);
On March 1, 2010, guaranteed payment of
Twelve Thousand Five Hundred Dollars
($12,500.00);
On March 1, 2013, guaranteed payment of
Twenty Thousand Dollars ($20,000.00);
On March 1, 2016, guaranteed payment of
Twenty-Five Thousand Dollars ($25,000.00);
3
On March 1, 2019, guaranteed payment of
Thirty-Five Thousand Dollars ($35,000.00).
Ail sums set forth herein constitute damages on account of
personal injuries and sickness, within the meaning of Section
104(a)(2) of the Internal Revenue Code of 1986, as amended.
3.0 Payees, Rights to Payments
Claimant acknowledges that the Periodic Payments cannot be
accelerated, deferred, increased or decreased by the Claimant or
any Payee; nor shall the Claimant or any Payee have the right or
power to sell, mortgage, encumber, or anticipate the Periodic
Payments, or any part thereof, by assignment or otherwise.
4.0 Payees'Beneficiary
Any payments to be made after the death of any Payee,
pursuant to the terms of this Settlement Agreement, shall be made
to their named beneficiary. If no person or entity is so
designated by Payee, or if the person designated is not living at
time of the Payee's death, such payments shall be made to the
estate of Payee. Payee may request in writing that Assignee
change the beneficiary designation under this Agreement.
Assignee will do so but will not be liable, however, for any
payment made prior to receipt of the request or so soon
thereafter that payment could not reasonably be stopped.
5.0 Consent to Qualified Assignment
5.1 Claimant acknowledges and agrees that the Insurer will
make a "qualified assignment", within the meaning of Section
130(c) of the Internal Revenue Code of 1986, as amended, of the
Insurer's liability to make the Periodic Payments set forth in
Section 2.2 to Allstate Assignment Company ("the Assignee"). The
Assignee's obligation for payment of the Periodic Payments shall
4
be no greater than that of Insurer (whether by judgment or
agreement) immediately preceding the assignment of the Periodic
Payments obligation.
5.2 Such assignment shall be accepted by the Claimant
without right of rejection and shall completely release and
discharge the Insureds and the Insurer from the Periodic Payments
obligation assigned to the Assignee. The Claimant recognizes
that the Assignee shall be the sole obligor with respect to the
Periodic Payments obligation, and that all other releases with
respect to the Periodic Payments obligation that pertain to the
liability of the Insurer shall thereupon become final,
irrevocable and absolute.
6.0 Right to Purchase an Annuity
The Insurer, itself or through its Assignee, will fund the
liability to make the Periodic Payments through the purchase of
an annuity policy from Allstate Life Insurance Company. The
Insurer or the Assignee shall be the sole owner of the annuity
policy and shall have all rights of ownership. The Insurer or
the Assignee may have Allstate Life Insurance Company mail
payments directly to the Payee(s). The Claimant shall be
responsible for maintaining a current mailing address for
Payee(s) with Allstate Life Insurance Company.
7.0 Discharge of Obligation
The obligation of the Insurer and/or Assignee to make each
Periodic Payment shall be discharged upon the mailing of a valid
check in the amount of such payment to the designated address of
the Payee(s) named in Section 2 of this Settlement Agreement.
5
8.0 Representation of Comprehension of Document
In entering into this Settlement Agreement the Claimant
represents that the terms of this Settlement Agreement have been
completely read and are fully understood and voluntarily accepted
by Claimant.
9.0 Warranty of Capacity to Execute Agreement
Claimant represents and warrants that no other person or
entity has, or has had, any interest in the claims, demands,
obligations, or causes of action referred to in this Settlement
Agreement, except as otherwise set forth herein; that Claimant
has the sole right and exclusive authority to execute this
Settlement Agreement and receive the sums specified in it; and
that Claimant has not sold, assigned, transferred, conveyed or
otherwise disposed of any of the claims, demands, obligations or
causes of action referred to in this Settlement Agreement.
10.0 Governing Law
This Settlement Agreement shall be construed and interpreted
in accordance with the laws of the Commonwealth of Pennsylvania.
11.0 Additional Documents
Ail parties agree to cooperate fully and execute any and all
supplementary documents and to take all additional actions which
may be necessary or appropriate to give full force and effect to
the basic terms and intent of this Settlement Agreement.
12.0 Entire Agreement and Successors in Interest
This Settlement Agreement contains the entire agreement
between the Claimant, the Insureds and the Insurer with regard to
the matters set forth in it and shall be binding upon and inure
6
to the benefit of the executors, administrators, personal
representatives, heirs, successors and assigns of each.
7
13.0 Effectiveness
This Settlement Agreement shall become effective immediately
following execution by each of the parties.
Claimant
Mabel Koser as Executrix of the Estate
of Brian Koser
By:
Date:
Mabel Koser
By:
Date:
James Koser
By:
Date:
Insurer
Allstate Insurance Company
By:
Title:
Date:
8
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPARTMENT 280601
HARRISBURG, PA 17128-0601
Telephone
12/15/2003
717-783-0972
Joseph F Murphy, Esquire
Marshall et al
4200 Crums Mill Road, Suite B
Harrisburg, PA 17112
Re:
Estate of Brian P Koser
File Number: 2103-0996
Date of Death: May 15, 2002
Court Number: Cumberland
Dear Mr. Murphy:
The Department of Revenue received the Petition for Approval of Settlement Claim to be filed on
behalf of the above-referenced Estate in regard to a wrongful death and survival action. It was forwarded
to this Bureau for the Commonwealth's approval of the allocation of the proceeds paid to settle the
actions.
Pursuant to the Petition, the 12-year-old-decedent died as a result of motor vehicle accident. The
heirs to the decedent's estate are his parents. Therefore, any proceeds paid to settle the survival action
would pass to decedent's parents and would be subject to a zero percent inheritance tax rate. 72 P.S.
§9116(a)(1.2). Accordingly, regardless of the allocation of the subject proceeds, there would be no
inheritance tax consequences.
Please be advised that based upon these facts and for inheritance tax purposes only, this
Department has no objection to the proposed allocation of the gross proceeds of this action, $ 90,000.00
to the wrongful death claim and $10,000.00 to the survival claim. Proceeds of a survival action are an
asset included in the decedent's estate and, although subject to the imposition of a zero percent
inheritance tax rate in this instance, they must be reported on decedent's Pennsylvania inheritance tax
return. 42 Pa.C.S.A. §8302; 72 P.S. §§9106, 9107. Costs and fees must be deducted in the same
percentages as the proceeds are allocated. In re Estate of Merryman, 669 A.2d 1059 (Pa. Cmwlth. 1995).
I trust that this letter is a sufficient representation of the Department's position on this matter. As
the Department has no objections to the Petition, an attorney from the Department of Revenue will not be
attending the hearing regarding it. Please contact me if you or the Court has any questions or requires
anything additional from this Bureau. Finally, the approval of this allocation is limited to this estate and
does not reflect the position that the Department may take in any other proposed distribution of proceeds
of a wrongful death / survival action.
cc: Cumberland County Clerk of Orphans Courts
Trust Valuation Manager
Inheritance Tax Division
Bureau of Individual Taxes
ESTATE OF
BRIAN PETER KOSER
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
· NO. ZI- O't-q0q
AND NOW, this
Koser, as Administrator of the Estate of Brian i
~d ORDER
ay of/~/__~_~~, 2004, upon consideration of the Petition of Mabel
J.
Koscr, it is hereby ordered that said Petition is approved
with the following allocation of the settlement funds:
1. $10,000 allocated to the survival action;
2. $30,000 lump sum paid to the beneficiaries on or before 14 days from receipt by Ringler
Associates of the executed release and settlement agreement;
3. The following periodic payments to be made to the benefimane~
a. $7,500 guaranteed payment on March 1, 2007;
b. $12,500 guaranteed payment on March 1, 2010;
c. $20,000 guaranteed payment on March 1, 2013;
d. $25,000 guaranteed payment on March 1, 2016; and
e. $35,000 guaranteed payment on March 1, 2019.
BY THE COURT: