HomeMy WebLinkAbout02-0104PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
also known as r~, ~.t l (~. ~ ['~qt2.TZ ~r To:
Register of Wills for the
Deceased. County of in the
Social Security No. ~ ~ /'E) ~ 7 q / Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, app[
(d.b.n.; p~endente lite; durante absentia; durante minoritate)
the above decedent.
for letters of administration
on the estate of
Decendent was domiciled at death in
last family or principal residence at
Decendent, then ~ ~ years of age, died.
at
County, Pennsylvania, with
(list street, number and municipality)
Decendent at death owned property with estimated values as folllows:
(If domiciled in Pa.) All 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:
Petitioner___ after a proper search ha.__
the following spouse (if any) and heirs:
~_d~j~l~ame
ascertained that decedent left no will and was survived by
ice
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration in the
appropriate form to the undersigned.
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
The petitioner(s) 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(s) and that as personal
representative(s) of the above decedent petitioner(s) will well and
truly administer the estate according to law.
Sworn to or affirmed and subscribed
before me this 30th day of
~1~). 2002
_ ANUARY ,
No. 21-02-104
Estate of PAUL ROBERT SHARTLE , Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW JANUARY 30 1~ 200..~ in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that JOHN JOSEPH KNOLL
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to JOHN JOSEPH KNOLL
in the estate of
FEES
Letters of Administration ..... $.
Short Certificates( ) .......... $.
Renunciation ................ $
JCP $~
TOTAL ~ $.~
Filed ....J..Afl.....3.0. .........
18.00
15.00 ATTORNEY (Sup. Ct. I.D. No.)
5.00
5.O__0 ADDRESS
43.0~0
A.D. ~ 2002
PHONE
RENUNCIATION
In Re Estate of
Paul Robert Shartle
dece~ed.
To the Re~ister of Wills of ~rl~nd
County, Pennsylvania.
The undersigned Karen Zerger, daughter of
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
of Administraticn Pendenta Lite.
b~ issued to John Knoll of 348 Hillside Drive, New ~]~r]~m~r PA
WITNESS ~/~ f, ~~handthis oQ3cj dayof ~,/d/t-Q/.A/9~-,~)O~'''
4939 Buckhorn Drive
West Chester, OH 45069
(Addr~)
(Signature)
· (Addre~a)
(Si~ature)
(Address)
7174~0
JAN-~g-200~ 14:35
BRATIC PORTKO
Attorneys at Law
lOI OFFICE CENTEK SUITE A
1.Ol SOUTH U.S. ROUTE 15
DILI~BLIRG, PENNSYLVAlqlA 170.19..
(717) 432.9706
(717) 432~2538
~A.~ (717)
FAX 717 432-9220
FAX COVER
DATE:
TO: COMPANY
FAX NUMBER:
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NOTICE:
The information contained in this lacs*mile transmission is attorney
privileged and confidential ±nformation intended only for the use of the
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are hereby notified that any d£ss~m6-ntion, disrrfbutfon or copy of this
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in error, please notify us immediately by telephone and return the original
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is appreciated.
Coca,
.Assistant CommisSioner of
: I n n
Health
PT~milr¥ R~9 D~t NO VI[AL STATISTICS
,~.,,,,~. ~_~ CERTIFICATE OF DEATH ~..~
Paul Robert SHARTI. E ~Z~x --
4~ ~m~y~T ...... ~ Male
~ Cinci~ati
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CA San Bernardim) Rec lands
1.1 Wa~ ~m d ~ncO~n? Ct,
~Yel J~ NO
92374
Shartle
E] Don~t*o. tTj Otto, f'~,~ Crelllatiotl
September 20, 2001
22~. S~nalum d Funeral D~mco*' ~ Olher Per,,on
No While
Eleanor
Tuffs SchildrneT. er Cremation Sen'ices OH
Not embalmed
Tufts Schildmeyer Family Funeral Home
tM ..... 0,~, ~',,; 129 N Riverside Dr
SEP 2001 Loveland OH 45140
D~ake Cente~, inc., .......
:~ Blunt-
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CAUSE IO~$~;~';e or ml~:W ~ ~,
JRD/June 30, 1992/17858
JUN 1 3 ~DO~ ~'
In Re: Estate of PAUL ROBERT SHARTLE
Late of REDLANDS, CA
Estate No.: 21-2002-104
ORPHANS' COURT DIVISION
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
PENNSYLVANIA
· NO.
NOTICE OF FAILURE TO FILE CERTIFICATION AND REQUEST TO CONDUCT A
HEARING PURSUANT TO RULE 5.6(e), SUPREME COURT
ORPHANS' COURT RULE
Personal Representative: JOHN KNOLL
Counsel for Personal Representative: DUSAN BRATIC
Date of Grant of Original Letters: JANUARY-30-2002
Date of Delinquency Notice: MAY-10-2002
The undersigned, Mary C. Lewis, Register of Wills, in accordance with Rule 5.6,
Supreme Court Orphans' Court Rules, hereby notifies the Orphans' Court Division, Court of
Common Pleas of Cumberland County, that neither the above named personal representative nor
the above named counsel for the personal representative have filed with the Register of Wills or
Clerk of the Orphans' Court his, her or its certification required by Rule 5.6(e), Supreme Court
Orphans' Court Rule and that the requisite notice, pursuant to Rule 5.6(e), Supreme Court
Orphans' Court Rules, was given by the Register of Wills on 05-10, 2002, and that the ten (10)
day notice to file the certification has expired. Accordingly, in accordance with Rule 5.6(e) the
Court is hereby notified of such delinquency and the undersigned requests that a Court conduct a
hearing to determine whether sanctions should be imposed upon the delinquent personal
representative or counsel for the delinquent personal representative.
Date: 06-12-2002
Distribution:
lV~ry ~. Lewis, 'Register of Wills
Personal Representative
Counsel for Personal Representative
Estate File
A hearing is scheduled for ./J.-6(~4 ,,O~.-- at q ;..3o ,~,~,in Courtroom No. 3. If the
Certification of Notice is filed prior to the hearing date, the hearing will automatically be
cancelled.
Geor~
Name of Decedent:
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Pan1 Rc~l~.r-h Shat-t-.lo
Date of Death:. q/1 q./2O01
Will No. Admin. No. 2002-00104
To the Register:
I certify that notice of (beneficial interest) 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 6/26/02 :
Name Address
Karen Zerqer 4939 Buckhorn Drive, West Chester, OH 45069
Carol Ellie Shartle as Parent
& Natural Guardian of 19765 Derby Street, Wist Linn, OR 97068
Andrew Shartle & Emily Shartle
Notice has now been given to all persons entitled thereto under Rule 5.6(a) except
Signature
Date: ~/2~/02
Name Dusan Bratic
Address 101 South U.S. Route 15
Dillsburg, PA 17019
Telephone {717) 432-9706
Capacity: ~ Personal Representative
X Counsel for personal representative
JOHN KNOLL,
Administrator of the Estate of
PAUL ROBERT SHARTLE
Ve
CAROL WIKE
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS COURT DIVISION
REGISTER OF WILLS
ESTATE NO. 2002-00104
PAUL ROBERT SHARTLE, Deceased
AND NOW, thi~ day upon consideration of the within Motion, it is
hereby ORDERED and DECREED that Petitioner, JOHN KNOLL, Administrator of the Estate
me
of Paul Robert Shartle, upon presentation of the within Petition presented The Court and The Court
is satisfied that the proposed settlement is in the best interest of all parties concerned and that the
Administrator, JOHN KNOLL, is hereby authorized to sign a Release to ERI]E INSURANCE
COMPANY in settlement of all claims against CAROL WIKE as indicated within the said Release
and that Administrator, JOHN KNOLL, is hereby authorized to settle claims for Wrongful Death
and Survival Actions which KAREN ZERGER, ANDREW SHARTLE AND EMILY SHARTLE
may have and that a Release with ERIE INSURANCE COMPANY shall incorporate the settlement
of the above claims under the terms contained therein.
Dated:
BY THE COURT
JOHN KNOLL,
Administrator of the Estate of
PAUL ROBERT SHARTLE
Vo
CAROL WIKE
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS COURT DIVISION
REGISTER OF WILLS
ESTATE NO. 2002-00104
PAUL ROBERT SHARTLE, Deceased
AND NOW COMES, JOHN KNOLL, Administrator of the Estate of Paul Robert Shartle,
by and through bis Attorney, DUSAN BRATIC, ESQUIRE of BRATIC & PORTKO and hereby
requests Petition of Approval For Settlement and states the following in support thereof.
1. Your Petitioner, JOHN KNOLL was named Administrator on the 30th day of
January, 2002 to Docket No. 21-02-00104 at the Register of Wills, Cumberland County,
Pennsylvania.
2. Your Petitioner, JOHN KNOLL is the Nephew of the Decedent, PAUL ROBERT
SHARTLE, and your Petitioner resides at 348 Hillside Drive, New Cumberland, PA 17070.
3. The Decedent, PAUL ROBERT SHARTLE was 79 years of age at the time of his
death, which occurred on the 19th day of September 2001.
4. The matter arises out of the death of PAUL ROBERT SHARTLE on the 19th day of
September 2001. The decedent died approximately three months following an automobile accident
in which he was a passenger in a vehicle operated by CAROL WIKE when, inter alia, her vehicle
rolled over while traveling on State Route 78 in Berks County, Pennsylvania.
5. The Decedent PAUL ROBERT SHARTLE is survived by his daughter, KAREN
ZERGER, who is a cousin to your Petitioner. Johll Knoll, and she resides at 4939 Buckhorn Drive,
West Chester, OH 45069. The Decedent is also survived by two grandchildren ANDREW
SHARTLE and EMII,Y SHARTLE, who are the children of Keith Shartle, the son of Paul Robert
Shartle, who predeceased him 'on September 1, 2000. They reside at 19765 Derby Street, West
Linn, OR 97068. These three are his only heirs.
6. At the time of the accident CAROL WIKE was insured through an automobile
insurance policy through ERIE INSURANCE COMPANY under Policy # Q052301503H.
7. Under the terms of the policy there was $100,000 per person and $300,000 per
occurrence in liability coverages for the vehicle in question.
8. Your Petitioner, JOHN KNOLL, Administrator of the Estate of Paul Robert Shartle,
and the ERIE INSURANCE COMPANY have reached a settlement agreement whereby ERI~E
INSURANCE COMPANY has agreed, on behalf of CAROL WIKE, to pay the sum of SEVENTY
FOUR THOUSAND THIRTY-FOUR DOLLARS ($74,034), which is the remaining balance of
coverages in the policy, in full settlement of all claims.
9. At no time has the Defendant admitted liability in this case therefore, the settlement
is a settlement of a disputed claim.
I 0. The settlement is in full satisfaction of any Wrongful Death and Survival Actions
against Carol Wike.
11. Your Petitioner, JOHN KNOLL, Administrator of the Estate of Paul Robert Shartle,
requests that the Court approve the SEVENTY FOUR THOUSAND THIRTY FOUR DOLLARS
($74.034) settlement.
12. Your Petitioner, JOHN KNOLL, Administrator of the Estate of Paul Robert Shartle,
requests that this Court approve the proposed settlement and that he be authorized to sign a Release
to ERIE INSURANCE COMPANY in settlement of claims as set forth therein including any
Wrongful Death and Survival Actions which could be brought against CAROL WIKE.
! 3. The Decedent, PAUL ROBERT SHARTLE had no debts or assets in his own right
and all expenses associated with his demise have now been paid or will be paid in accordance with
the law as well as the payment of inheritance taxes, which the Administrator will proceed to pay in
accordance with the law.
WHEREFORE, Petitioner, JOHN' I<2NOLL, Administrator of the Estate of Paul Robert
Shartle prays this Honorable Court to approve the proposed settlement as set forth herein and to
authorize him to sign a Release for any claims against CAROL
COMPANY for the sum of SEVENTY-FOUR THOUSAND
($74,034) under the terms and conditions of said Release.
Dated:
W/KE, ERIE INSURANCE
THIRTY~FOUR DOLLARS
Dusan Bratic
Attorney I.D. No. 19249
101 Office Center, Suite A
101 U.S. Route 15 South
Dillsburg, PA 17019
(717) 432-9706
Attorney for Petitioner
~o ~~~ 11, Administrator
YERIFICATION
I, _ ,Tnhn Enn11
the _ A~m~n~er~r
of
hereby acknowledge that I am
that I have read the foregoing _ Pef~f4nn and -'
that the facts stated therein are true and correct to the best
of my knowledge, information and belief.
I understand that any false statements herein are made subject
to penalties of 18 Pa.C.S. Section 4904, relating to unsworn
falsification to authorities.
Dated :_ 8/16/02
STATUS REPORT UNDER RULE 6.12
Name of Decedent: PAUL ROBERT SItARTLE, Deceased
Date of Death:
9/19/2001
Estate File No.'
2002-00104
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:
State whether administration of the estate is complete:
Yes No X
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete: The Estate was opened
for litigation purposes. That litigation is still ongoing.
3. If the answer to No. 1 is Yes, state the following:
ao
Yes
Did the personal representative file a final account with the Court?
No
b. Did the personal representative state an account informally to the
parties in interest? Yes
Copies of receipts, releases, joind_e, rs and p/,provalNs°of formal or informal accounts
may be filed with the Clerk of the Orphan s Cou~'and may be attached to this report.
Date: ('c; --//-~ gn ure~/~~'~
Si
Dusan Bratic, Esq.
Name (Please type or Print)
101 South U.S. Route 15, Dillsburg, PA 17019
Address
Capacity:
717-432-9706
Tel. No.
~Personal Representative
X Counsel for Personal Representative
April 29, 2004
DUSAN BRATIC
101 US RT 15 SOUTH
DILLSBURG, PA. 17019
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
;:':' DEPARTMENT:280601
HARRISBURG, PA 17128-0601
'04 i'i/¥¥ -7 P3
,,!,
Telephone
717-787-6677
Dear MR. BRATIC:
Re:
Estate of PAUL R. SHARTLE
File Number 2102-0104
The Department has been advised that the above-referenced estate is
presently involved in litigation. The Department will suspend further activity on this estate until
APRIL 29, 2005. You are required to notify the Department when the status changes or the
extension date expires.
If you have any questions, please contact me at (717-787-6677).
Sincerely,
EMERSON LUCIANO
Inheritance Tax Division
FAX 717-772-0412
Cumberland County - Register of Wills
Hanover and High Streets
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 8/03/2004
JOHN KNOLL
Estate of SHARTLE PAUL ROBERT
File Number: 2002-00104
Dear sir/Madam:
It has come to my attention that you have not filed the Status Report by Personal
Representative (Rule 6.12) in the above captioned estate.
As per the AMMENDMENTS 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 will become delinquent on: 09/19/2004
Your prompt attention to this matter will be appreciated.
Thank you.
Sincerely,
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
CC:
File
Personal Representative (s)
Counsel
Judge
STATUS REPORT UNDER RULE 6.12
Name of Decedent:
Date of Death:
Estate of Paul Robert Shartle, Deceased
9/19/2001
Estate File No.:
2002-00104
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:
State whether administration of the estate is complete:
Yes No X
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete: The Estate was opened
for litigation purposes. That litigation is still ongoing.
3. If the answer to No. 1 is Yes, state the following:
ao
Yes
Did the personal representative file a final account with the Court?
No
b. Did the personal representative state an account informally to the
parties in interest? Yes No
Copies of receipts, releases, joinders a~ad approvals of formal or informal accounts
may be filed with the Clerk of the Orphan's C ~urt and may be attached to this report.
Date: August 5, 2004
Dusan Bratic, Esq.
Name (Please type or Print)
101 South U.S. Route 15, Dillsburg, PA 17019
Address
717-432-9706
Tel. No.
Capacity:
__Personal Representative
X Counsel for Personal Representative
r
SEP 06 2005 10:27
7174329220
7174329220
P.03/03
STA111S REPORT UNDER RULE 6.12
Name of Decedent: PAUL ROBERT SHARTLE~ Deceased
Date of Death: 9/1912001
Estate File No.: 1001-00104
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 No X
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete: The Estate was opened
for litigation purposes. That litigation is still ongoing.
3. If the answer to No.1 is Yes, state the following:
a.
Yes
Did the personal representative fIle a final account with the Court?
No 'X
.
b. Did the personal representative state an account informally to the
parties in interest? Yes No X
Copies of receipts. releases, joinders and approvals of formal or informal accounts
may be filed with the Clerk of the Orphan' s ~urt and may be attached to this report.
i
Date: ,~ 1 '3 J r:;;
"",,'
Si~ture
.
I
Dusan Bratic. Esquire
Name (please type or Print)
C"J
101 South U.S. Route 15. DiIlsburg. PA 17019
Address
I.
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J
717-432-9706w
Tel. No.
t.r,,:
'-
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Personal Representative
Capacity:
~
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X Counsel for Personal Representative
&-
TOTAL P.03
-
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 8/30/2005
BRATIC DUSAN
101 SOUTH U.S. ROUTE 15
DILLSBURG, PA 17019
RE: Estate of SHARTLE PAUL ROBERT
File Number: 2002-00104
Dear Sir/Madam:
It has come to my attention that you have not filed the Status
Report by Personal Representative (Rule 6.12) in the above captioned
estate.
As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO.
103 SUPREME COURT RULES DOCKET NO. 11 for decedents dying on or after
July 11 19921 the personal representative or his counsel, within two
(2) years of the decedent's deathl shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
9/19/2005
Your prompt attention to this matter will be appreciated.
Thank You.
Sincerely,
~.~
GLENDA F]I~R..T\JER STRAS
REGISTER OF WILLS
cc: File
Personal Representative(s)
Judge
eP
STATUS REPORT UNUERRULE 6.12
Name of Decedent: PAUL ROBERT SHARTLE, Deceased
Date of Death: 9/19/2001
Estate File No.: 2002-00104
Pursuant to Rule 6.12 ofthe 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 No X
2. If the answer is No, state when the personal representative reasonably
believes that the administration will be complete: The Estate was opened
for litigation purposes. That litigation is still ongoing.
3. If the answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No
b. Did the personal representative state an account informally to the
parties in interest? Yes No
Copies of receipts, releases, joinders and a provals of formal or informal accounts
may be filed with the Clerk of the Orphan's Cou and may be attached to this report.
~ _ r
Date: j (c, i oc:,
Signat e
Dusan Bratic, Esquire
Name (Please type or Print)
101 South U.S. Route 15, Dillsburg, PA 17019
Address
717-432-9706
Tel. No.
~Capacity:
Personal Representative
g-:'l :: .,
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Counsel for Personal Representative
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COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
DECEDENrs NAME (LAST, FIRST, AND MIDDLE INITIAL)
Shartle Paul R.
DATE OF DEATH (MM-DD-Year)
OFFICIAL USE ONLY
REV -1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
2 1 -0 2 0 1 04
""COuNTYCODE -YEAR- - - 'NUiiBER- -
SOCIAL SECURITY NUMBER
DATE OF BIRTH (MM-DD-Year)
2 03- 1 0 - 6 7 9 1
THIS RETURN MUST BE FilED IN DUPLICATE WITH THE
REGISTER OF WILLS
09/19/2001 06/30/1922
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
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[R] 1. Original Return
o 4. Limited Estate
o 6. Decedent Died Testate (Attach copy of Will)
o 9. litigation Proceeds Received
SOCIAL SECURITY NUMBER
D 2. Supplemental Return
o 4a. Future Interest Compromise (date of death after 12.12.82)
o 7. Decedent Maintained a living Trust (Attach copy olTrusQ
o 10. Spousal Poverty Credit (date of death between 12-31.91 and 1-1.95)
o 3. Remainder Return (date of death prior to 12.13.82)
D 5. Federal Estate Tax Return Required
_ 8. Total Number of Safe Deposit Boxes
o 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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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
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent Mortgage liabilities, & Liens (Schedule I)
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)
NAME
Dusan Bratic Es .
FIRM NAME (If Applicable)
Bratic & Portko
TELEPHONE NUMBER
717-432.9706
COMPLETE MAILING ADDRESS
101 South US Route 15
DiIIsburg, PA 17019
OFFICIAL USE ONLY
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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133,259.67
7 ,995.00
4,438.14
(11)
(12)
(13)
12,433.14
120,826.53
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
(14)
120,826.53
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
X _(15)
120,826.53 X .045 (16)
X .12 (17)
X .15 (18)
(19)
5,437.19
5,437.19
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
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I t Add
eee en s omple e ress:
STREET ADDRE!3S
624 Juniper Ct.
CITY I STATE I ZIP
Redlands CA 92373
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
5,437.19
Total Credits (A + B + C) (2)
3.
Interest/Penalty if applicable
D. Interest
E. Penalty
1,269.57
4.
Total Interest/Penalty ( 0 + E)
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
(3)
1,269.57
(4)
(5)
(5A)
(5B)
AGENT
5.
If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check
6,706.76
6,706.76
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred; ........................................................................... 0 lXI
b. retain the right to designate who shall use the property transferred or its income; ........................................ 0 lXI
c. retain a reversionary interest; or ...................................................................................................... 0 lXI
d. receive the promise for life of either payments, benefits or care? ............................................................. 0 lXI
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?............................................................................................... 0 lXI
3. Did decedent own an 'in trust for' or payable upon death bank account or security at his or her death? ................. 0 lXI
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ....................................................................................................... 0 lXI
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
ADDRESS
PA 17070
DATE
1- /7-0'
ADDRESS
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 the use of the surviving spouse is 3%
[72 P.S. ~9116 (a) (1.1) (i)).
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. ~9116 (a) (1.1) (ii)].
The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets 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 or younger at death to or for the use of a natural 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 beneficiaries is 4.5%, except as noted in 72 P.S. ~9116(1.2) [72 P.S. ~9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. ~9116(a)(1.3)]. A sibling is defined, under Section 9102, as an
individual who has at least one parent in common with the decedent, whether by blood or adoption.
""'~m.".,,, .
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Shartle. Paul R.
FILE NUMBER
21 02
0104
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
Litigation v. Nationwide Insurance - underinsured motorist benefits
$10,000 less Attorney fees to Dusan Bratic of $3,333.33
VALUE AT DATE
OF DEATH
6,666.67
2.
Litigation v. Nationwide Insurance
$50,000 less Attorney fees of $16500, less Medicare lien of $30690.80,
Less costs of litigation to law office $2809.20
Litigation v. Carol Wike/Erie Insurance
$74,304 less Attorney fees of $24,997
0.00
3.
49,307.00
4.
Litigation v. Ford Motor Company
Federal Court per court order net
77,286.00
TOTAL (Also enter on line 5, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
133 259.67
REV-151\EX+(1.s7} _~_
. .~
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of PeIsonaI R8pI8S8IItative (s) John Knoll. Nephew
Social Security NumbeI(s) J EIN Number of Personal Represenlalive(s) 167404265
Street Address 348 Hillside Drive
City New Cumberland Slate PA Zip 17070
Year(s) CommIssion Paid: 2006
AttomeyFees Dusan Bratic, Esq.
Family Exemption: (If decedenfs address is not the same as claimant's. attach explanation)
Claimant None
street Address
ESTATE OF
Shartle. Paul R.
Debts of decedent must be reported on Schedule L
ITEM
NUMBER
A.
DESCRIPTION
FUNERAL EXPENSES:
1.
B.
1.
2.
3.
City
Relationship of Claimant to Decedent
Slate
4.
Probate Fees
5.
6.
Accountanfs Fees
Tax Return Prepal'8l's Fees
7.
FILE NUMBER
21 02
Zip
0104
AMOUNT
0.00
7,995.00
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert addItional sheets of the same size)
7.995.00
~EV.'512EX+(1~7) '_~_
~
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Shartle. Paul R.
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
FILE NUMBER
21 02
0104
Include unreimbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
1.
Central Penn Auto Salvage - Auto storage
649.00
2.
Central Penn Auto Salvage - Auto storage
726.00
3.
Dusan Bratic Esq. - Reimburse litigation expenses
1,100.00
4.
Central Penn Auto Salvage - Auto storage
209.20
5.
Dr. Charles Hash - Medical Records Review
500.00
6.
Central Penn Auto Salvage - Auto storage
1,000.00
7.
Rawlings Company, LLC - Doctor's bill
253.94
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
4438.14
,:,v-/", "I. W
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE J
BENEFICIARIES
FILE NUMBER
~h~rtl"" Paul R. ?1 O? 0104
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I. TAXABLE 01 STRIBUTIONS pnclude outright spousal distributions, and transfers under
Sec. 9116 (a) (1.2)]
1. Karen Zerger Daughter 50%
6 Kober Drive
Havre, MT 59501
2. Andrew B. Shartle Grandson 25%
P.O. Box 82
West Linn, OR 97068
3. Emily M. Shartle, date of birth 1/30/1991 Granddaughter 25%
P.O. Box 82
West Linn, OR 97068
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(If more space is needed, insert additional sheets of the same size)
----~
I.r'l
~-
;30
o~
o~~
~cn<
00 ad
---
..
"
Glenda Farner Strasbaugh
Register of Wills
and
Clerk of Orphans' Court
Marjorie A. Wevodau
First Deputy
Kirk S. Sohonage, Esq
Solicitor
Register of Wills and Clerk of the Orphans' Court
County of Cumberland
One Courthouse Square
Carlisle, PA 17013
(717) 240-6345
FAX (717)240-7797
INVOICE
Bill To:
InvoiceNo:
Invoice Date:
Estate of:
Estate No:
1166
11/21/2006
Paul R Shartle
21-06-0104
BRACTIe & POR1KO
101 OFFICE CENTER SUITE A
101 sournus ROUTE 15
DILLSBURG, PA 17019
cj
Qty
1
Fee Description
Additional Probate
Fee Total
242.00 $242.00
Total:
$242.00
Checks should be made payable to the Register of Wills. Terms: Net 30.
Please return one copy of this invoice with your payment. Thank you.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
KNOLL JOHN
348 HILLSIDE DRIVE
NEW CUMBERLAND, PA 17070
__nun fold
ESTATE INFORMATION: SSN: 203-10-6791
FILE NUMBER: 2102-0104
DECEDENT NAME: SHARTLE PAUL ROBERT
DA TE OF PAYMENT: 11/21/2006
POSTMARK DATE: 11/20/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 09/19/2001
NO. CD 007466
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $6,706.76
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK# 76
SEAL
INITIALS: CJ
RECEIVED BY:
REGISTER OF WILLS
$6,706.76
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
A~P~~I~~'!fE~Tli ALLOWANCE OR DISALLOWANCE
'OFDEDliCTIONS AND ASSESSMENT OF TAX
*
DATE 02-27-2007
ESTATE OF SHARTLE PAUL R
DATE OF DEATH 09-19-2001
FILE NUMBER 21 02-0104
COUNTY CUMBERLAND
ACN 101
APPEAL DATE: 04-28-2007
( See reverse side under Objections)
A.ount Re.ittedl I
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
~~!_~~~~~_!~!~_~!~~______~___!~!~!~_~~~~!_e~!!!~~_~~!_!~~!_!~~~!~!__~____________________
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF SHARTLE PAUL R FILE NO. 21 02-0104 ACN 101 DATE 02-27-2007
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17128-0601
4"lonl Hr\R ;-
L' Ii f:' n. - .'"'1
... 01' 4 I Ii ~ j. ~ ...,
Pfl I: I 9
DUSAN BRATIC ESQ
BRATIC & PORTKO
101 S US RTE 15
DILLSBURG PA 17019
REV-1547 EX AFP (06-05)
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)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
.00
.00
.00
.00
133.259.67
.00
.00
(8)
(1)
(2)
(3)
(4)
(5)
(6)
(7)
NOTE: To insure proper
credit to your account,
submit the upper portion
of this form with your
tax payment.
133,259.67
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
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 ~ returns assessed to date.
ASSESSMENT OF TAX:
15. Amount of Line 14 at Spousal rate
16. Amount of Line 14 taxable at Lineal/Class A rate
17. Amount of Line 14 at Sibling rate
18. Amount of Line 14 taxable at Collateral/Class B rate
19. Principal Tax Due
CR D T :
A
DATE
11-20-2006
NOTE:
(9)
(10)
7,995.00
4.438.14
(11)
(12)
(13)
(14)
1~.4~~ 14
120,826.53
.00
120,826.53
(15) .00 X 00 .00
(16) 120,826.53 X 045 = 5,437.19
(17) .00 X 12 = .00
(8) .00 X 15 = .00
(19) = 5,437.19
AMOUNT PAID
6,706.76
SCO +)
INTEREST/PEN PAID (-)
1,269.57-
BALANCE OF UNPAID INTEREST/PENALTY AS OF 11-21-2006 TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
5,437.19
.00
5.22
5.22
* IF PAID AFTER DATE INDICATED. SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. ~O~
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE" (
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 2B0601
HARRISBURG PA 1712B-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
REV-1607 EX AFP (03-05)
JL _ 20
D:.
I ! ~
f~: 00
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
07-16-2007
SHARTLE
09-19-2001
21 02-0104
CUMBERLAND
101
PAUL
R
DUSAN BRATIC ESQ
BRATIC & PORTKO
101 S US RTE 15
DILLSBURG
Amount Remitted
PA 17019
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this form with your tax payment.
CUT ALONG THIS LINE
-+
RETAIN LOWER PORTION FOR YOUR RECORDS
+-
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
REV-1607 EX AFP (03-05)
*** INHERITANCE TAX STATEMENT OF ACCOUNT ***
ESTATE OF SHARTLE
PAUL
R FILE NO. 21 02-0104
ACN 101
DATE 07 -16 -2007
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 02-20-2007
PRINCIPAL TAX DUE: 5,437.19
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
11-20-2006 CD007466 1,269.57- 6,706.76
06-15-2007 CD008297 5.22- 5.22
TOTAL TAX CREDIT 5,437.19
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
" IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
(!,f<\
Cumberland County - Register Of Wills
One Courthouse Square
Carlislel PA 17013
Phone: (717) 240-6345
Date: 9/07/2007
BRATIC DUSAN
101 SOUTH U.S. ROUTE 15
DILLSBURGI PA 17019
RE: Estate of SHARTLE PAUL ROBERT
File Number: 2002-00104
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 I NO. 103
SUPREME COURT RULES DOCKET NO. 11 for decedents dying on or after
July 11 19921 the personal representative or his counsell within two
(2) years of the decedent's deathl shall file with the Register of
Wills a Status Report of completed or uncompleted administration.
This filing is due by:
9/19/2007
Please feel free to contact this office with any questions you may
have. If you have already filed your Status Report I please disregard
this notice.
SincerelYI
~~~
Glenda Farner Strasbaugh
Clerk of the Orphans' Court
cc: File
Personal Representative(s)
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17013
Phone: (717) 240-6345
Date: 9/07/2007
KNOLL JOHN
348 HILLSIDE DRIVE
NEW CUMBERLAND, PA 17070
RE: Estate of SHARTLE PAUL ROBERT
File Number: 2002-00104
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:
9/19/2007
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
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Paul R. Shartle
Date of Death: 09/19/2001
Estate File No.: 21-02-0104
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the
following with respect to completion of the administration ofthe above captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2. lfthe answer is No, state when the personal representative reasonably
believes that the administration will be complete:
3. lfthe answer to No.1 is Yes, state the following:
a. Did the personal representative file a final account with the Court?
Yes No X
b. Did the personal representative state an account informally to the
parties in interest? Yes X No
Copies of receipts, releases, joinders and approvals of formal or informal accounts
may be filed with the Clerk of the Orphan's Court and may be attached to this report.
Date: "1-/3 .0L-
Signatur
Dusan ratic, Esq.
101 South US Route 15
Dillsburg, PA 17019
(717) 432-9706
Capacity:
Personal Representative
1,_.....,..
ItJr~DJ
~rl >l;,..r~~fl
..1\.,::1_, ,J
X Counsel for Personal Representative
2+J :21 Hd L I d3S LlJOZ
,...~. ,~
,~~ .. .~: \i
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