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Home My WebLink About04-0023JAN 1 3 In Re: : ESTATE OF : MAMIE ELIZABETH TATUM SCOTT,: Deceased : _~~da }RDER AND NOW, this y IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION No. "Petition Under Section 3102 of the Probate, Estates & Fiduciaries Code for Settlement of Small Estate", it is hereby ORDERED AND DECREED that the funds held by the Social Security Administration on behalf of Mamie Elizabeth Tatum Scott shall be payable to the Estate of Mamie Elizabeth Tatum Scott and deposited into the client escrow account at the law offices of Goldberg, Katzman & Shipman, P.C. and a check shall be issued from those funds to Beverly Healthcare t/d/b/a West Shore Health and Rehabilitation in the amount of Five Thousand Forty-seven Dollars ($5,047.00), with the balance of the funds payable to Goldberg, Katzman & Shipman, P.C. for attorney fees and estate administration expenses. AND, John DeLorenzo, Esquire, of Goldberg, Katzman & Shipman, P.C., is authorized to execute the necessary documents on behalf of the Estate. ~, ~nO~hans' Court Division ,2004, upon consideration of a In Re: : ESTATE OF : MAMIE ELIZABETH TATUM SCOTT,: : Deceased : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. PETITION UNDER SECTION 3102 OF THE PROBATE, ESTATES AND FIDUCIARIES CODE FOR SETTLEMENT OF SMALL ESTATE TO THE HONORABLE JUDGES OF SAD COURT: AND NOW, comes Beverly Healthcare trading and doing business as West Shore Health and Rehabilitation, Petitioner (the "Petitioner") by and through its attorneys Goldberg, Katzman & Shipman, P.C., respectfully files this Petition for Settlement of a Small Estate under the provisions of Section 3102 of the Probate, Estates and Fiduciaries Code (the "P.E.F. Code") and in support thereof states as follows: Mamie Elizabeth Tatum Scott died on August 17, 2003 (the "Decedent"). A death certificate is attached hereto as Exhibit "A". The Decedent was a widow and died without a Will and no letters of administration have been issued. Prior to Decedent's death, Decedent was receiving Medicaid from the Pennsylvania Department of Public Welfare (the "Department") commencing January 16, 2003. The Department determined that the income from Social Security would be paid to Petitioner as private pay portion of costs for payment toward Decedent's nursing home care. o Since February 2003, Petitioner has been in contact with the Social Security Administration regarding the changes in bank account information for direct deposit of the monthly benefits. o On Decedent's date of death, the Social Security Administration was not forwarding the monthly benefits to Petitioner. Therefore, the Social Security benefits, which are still payable to the Petitioner, become part of the Decedent's Estate. ° The Social Security Administration is holding approximately Six Thousand Eight Hundred Dollars ($6,800.00). The exact amount of Social Security benefits held is unknown as the Social Security Administration will not release such figures without court intervention. However, such estimate is fairly accurate as Petitioner is aware of the Decedent's monthly Social Security benefits and how many months of payments had accrued. o Decedent owed Petitioner Five Thousand Forty-seven Dollars ($5,047.00). A copy of the Petitioner's bill is attached hereto as Exhibit "B". ° The remaining balance of the Social Security benefits will pay Goldberg, Katzman & Shipman, P.C. for attorney fees and estate administration expenses. 10. There being no will, Section 2102 of the P.E.F. Code (intestate succession law) is followed. The only know heir is the Decedent's granddaughter, Marcia Reeves. 11. The Decedent' s granddaughter, Marcia Reeves, will not open the Estate since the Petitioner's bill and estate administration expenses clearly outweigh the Social Security benefits. 12. There are no other known assets or expenses of this Estate 13. Since Petitioner is a creditor of the Estate, Petitioner has an interest in settling the affairs of the Estate. 14. A Small Estates Petition is the most efficient and reasonable means to finalize this Estate. WHEREFORE, the Petitioner respectfully requests that this Court issue an Order authorizing the distribution of the total funds from the Social Security Administration via check made payable to the "Estate of Mamie Elizabeth Tatum Scott"; directing the Social Security proceeds be deposited into the client escrow account at the law offices of Goldberg, Katzman & Shipman, P.C.; directing that payment shall be issued to Beverly Healthcare t/d/b/a West Shore Health and Rehabilitation in the amount of Five Thousand Forty-seven Dollars ($5,047.00); and that the balance of the proceeds are payable to Goldberg, Katzman & Shipman, P.C. for attorney fees and estate administration expenses; and, John DeLorenzo, Esquire of Goldberg, Katzman & Shipman, P.C., is authorized to execute the necessary documents on behalf of the Estate pursuant to Section 3102 of the Probate, Estates and Fiduciaries Code. Date: Respectfully submitted, GOLDBER~]] KATZMAN & SHIPMAN, P.C. By: ~!~/eeLOr/~enz// J~Att~mey I.D. #~uire P.O. Box 1268 Harrisburg, PA 17108-1268 (717) 234-4161 Attorney for Petitioner VERIFICATION I, Chris Miller, Business Office Manager for Beverly Healthcare t/d/b/a West Shore Health and Rehabilitation, verify that the statements made in the foregoing "Petition Under Section 3102 of the Probate, Estates and Fiduciaries Codes for Settlement of Small Estate" are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A. {}4904 relating to. unsw~rn falsification to authorities. Date: Chris Miller, Business Office Manager EXHIBIT A EXHIBIT B BEVERLY ~H E A L r H C A R E ITEMIZED STATEMENT Date: October 1, 2003 Facility: West Shore Health & Rehab Fac. #: 285 Resident Name: MAMIE SCOTT Acct. #: 99724 DATES OF SERVICE DESCRIPTION DAYS CHARGES CREDITS 02/01-02/28/03 PRIVATE PORTION $ 721.00 3/1-3/31/03 !PRIVATE PORTION $ 721.00 4/1-4/30/03 PRIVATE PORTION $ 721.00 5/1-5/31/03 PRIVATE PORTION $ 721.00 6/1-6/30/03 PRIVATE PORTION $ 721.00 7/1-7/31/03 PRIVATE PORTION $ 721.00 8/1-8/13/03 PRIVATE PORTION $ 721.00 Balance Forward Charges Credits Balance Due $ $ 5,047.00 $ $ 5,047.00 770 Poplar Church Road Camp Hill, PA 17011 (717) 763-7070 · FAX (717) 763-7850 CERTIFICATE OF SERVICE I, John DeLorenzo, hereby certify that on this 6th day of January, 2004, I served the foregoing "Petition Under Section 3102 of the Probate, Estates and Fiduciaries Codes for via U. S. Mail, postage prepaid, on the persons set forth below, Settlement of Small Estate", namely: Marcia Reeves 131 Hoerner Street Harrisburg, PA 17103 GOLDB/E/I~G, KATZMAN & SHIPMAN, P.C. (//,/~hn DeLorenzo, Esquire 103717.1 In Re: : ESTATE OF : MAMIE ELIZABETH TATUM : SCOTT, : Deceased : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION No. 21-04-23 CERTIFICATE OF SERVICE I, John DeLorenzo, hereby certify that on this 20th day of January, 2004, I served the foregoing "Order" dated January 14, 2004 and accompanying Petition, via U. S. Mail, postage prepaid, on the person set forth below, namely: Marcia Reeves 131 Hoerner Street Harrisburg, PA 17103 105416.1 By: ~~ /J o ~ ~IAN &~HIPMAN, P.C. Esquire