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Home My WebLink About10-25-12IN RE: ESTATE OF STEVEN D. HERSHEY LATE OF BOROUGH OF CARLISLE ORPHANS' COURT DIVISION COURT OF COMMON PLEAS CUMBERLAND COUNTY PENNSYLVANIA NO.21-11-0954 PETITION FOR SETTLEMENT OF A SMALL ESTATE PURSUANT TO 20 Pa.C.S.A. SECTION 3102 TO: THE HONORABLE JUDGES OF SAID COURT: ~Q W -n . rn~c ~... ~;;, ~«'` fly-;; > c'~U ~ `_~; A _, r> rm ~ r~ c~ c-3 --t N CIl -o N N The Petition of Lucy J. Hayes and John L. Hershey, Jr. respectfully represent that: 1. Steven D. Hershey died on August 18, 2011, a resident of the Borough of Cazlisle, Cumberland County, Pennsylvania. 2. Petitioner, Lucy J. Hayes, whose address is 9451 Pinesville Road, Shippensburg, Pennsylvania, 17257, and Petitioner, John L. Hershey, Jr., whose address is 337 West Penn Street, Carlisle, Pennsylvania, 17013, aze the siblings of the Decedent, and the Co-Administrators of Decedent's Estate. 3. A Certificate of Grant of Letters of Administration was issued to Petitioners by the Register of Wills of Cumberland County Pennsylvania, on September 12, 2011. 4. Decedent died without a Last Will and Testament. 5. Decedent's sole intestate heir is his mother, Sonia L. Hershey, of 1 Longsdorf Way, Carlisle, Pennsylvania, 17013. 6. At the time of Decedent's death, the only assets of which he was seized, and assets received by the estate after decedent's passing, were the following: (A) 1997 Chevrolet Blazer $250.00 n;., r7 {-+C7 ~; ~;, _ci C7 _~~_~ ,. ~ -,~ T~ -.-_ ~; =_ ~n ~n p~n a (B) Members First Federal Credit Union Savings Account No. XXX736-00 (C) Members First Federal Credit Union Checking Account No. XXX736-11 (D) State Farm Auto Insurance Refund (E) 201 I Federal Income Tax Refund (Personal) (F) Cazlisle Syntec Incorporated final paycheck TOTAL 10.00 $107.45 $138.92 $1,493.00 1750.93 $3,750.30 7. Petitioners have paid from the limited estate assets, from their sepazate funds and from other funds contributed by Decedent's family, the following debts associated with administration of the estate: (A) Probate fees paid and anticipated $ 150.00 (B) Attorney's fees to Griffie and Associates $4,500.00 (C) Hoffman-Roth Funeral Home and Crematory Inc. $9,269.44 (D) Carlisle Memorial Service, Inc. $1,018.40 (E) Cohick & Associates (Tax Preparation) $ 225.00 (F) Cumberland Law Journal (Advertising) $ 75.00 (G) The Sentinel (Advertising) $ 189.54 TOTAL $19,439.88 8. As such, Petitioners have paid all known debts associated with the administration of the estate from the limited estate assets, from Petitioners' sepazate funds, and. from other funds contributed by Decedent's family. 9. Debts of the Decedent for which there aze no funds or assets of the Decedent or the estate to make payment aze as follows: (B) Cazlisle HMA Physician Management $ 35.87 (C) CitiFinancial - (Account ending 2669) $ 1,462.22 (D) Comcast Cable - (Eastern Account System of $ 268.35 Connecticut Inc.) (E) Discover Bank - (Account ending 8396) (DB $11,033.31 Servicing Corporation) (F) Fraternal Order of Eagles -Delinquent Rent $ 1,600.00 (G) Guistwite Family Practice $ 41.20 (H) Lung Asthma Sleep Associates $ 453.68 (I) Members First Visa- (Account ending in 9969) $ 3,942.04 (J) Moffitt Heart & Vascular Group $ 57.99 (K) PPL Electric Utilities $ 552.17 (L) Rodale - (Books) $ 53.96 (M) Per Capita Tax $ 5.50 (N) One Main Financial - (Auto loan -encumbrance $ 287.82 on 1997 Blazer) (O) Carlisle Regional Medical Center (Medical) $ 17.52 (P) Members 1 s` Federal Credit Union Personal Loan 4 964.84 TOTAL $25,777.02 10. There aze no assets of Decedent or the Decedent's estate from which any additional distributions can be made and, as the estate debts exceeded the estate assets, this is an insolvent estate. I1. There are no additional claimants or creditors of whom the Petitioners have knowledge who have not received full compensation other than those set forth in pazagraph 9 above. 12. As this is an insolvent estate, no Pennsylvania Inheritance Tax Return was due, but an Inheritance Tax Retum was filed and has been confirmed as per the Notice of Inheritance Tax Appraisement, Allowance or Disallowance of Deductions and Assessment of Tax which is attached hereto and incorporated herein as Exhibit .:A„ 13. Notice of the intent to file this Petition was given by regulaz mail, first class, postage prepaid, with a copy of this Petition, to all creditors named in paragraph 8 at least thirty (30) days prior to filing of the Petition. WHEREFORE, Petitioners request your Honorable Court to approve settlement of this estate with payment of debts associated with administration of the estate as noted in paragraph 6 and with no disbursements to the named heirs, and with no payment of the debts as described in paragraph 9. Respectfully submitted, L. iffie, Esquire orney or Petitioners Attorney ID#34349 GRIFFIE & ASSOCIATES, P.C. 200 North Hanover Street Cazlisle, PA 17013 (717)243-5551 VERIFICATION I verify that the statements made in the foregoing document aze true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unsworn falsification to authorities. DATE:~o? / LUCY AYS VERIFICATION I verify that the statements made in the foregoing document are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unsworn falsification to authorities. DATE: ~/ / L. HERSHEY, JR. IN RE: ESTATE OF STEVEN D. HERSHEY LATE OF BOROUGH OF CARLISLE ORPHANS' COURT DIVISION COURT OF COMMON PLEAS CUMBERLAND COUNTY PENNSYLVANIA NO. 21-11-0954 CERTIFICATE OF SERVICE sf I, Bradley L. Griffie, Esquire hereby certify that I did, the .2 ~_ day of September, 2012, cause a copy of the within Petition for Settlement of Small Estate to be served upon all creditors by first class mail, postage prepaid, at the following addresses: AmeriCaze/Care Plus Oxygen 2233 East Main Street Montrose, CO 81401 Carlisle HMA Physician Management P.O. Box 281629 Atlanta, GA 30384-1629 CitiFinancial Box 6500 Sioux Falls, SD 57117 Comcast Cable (Eastern Acct System of Connecticut Inc.) P.O. Box 837 Newton, CT 06470 Discover Bank (DB Servicing Corp) Fraternal Order of Eagles c/o William T. Molczan 26 East High Street Weltman, Weinberg & Reis Co., LPA Cazlisle, PA 17013 436 Seventh Avenue, Suite 1400 Pittsburgh, PA 15219 Guistwite Family Practice 522 South Pitt Street Cazlisle, PA 17013 Lung Asthma Sleep Associates 1497 South Queen Street York, PA 17403-3852 Members First Federal Credit Union 5000 Louisa Drive Mechanicsburg, PA 17055-4899 PPL Electric Utilities 2 North 9~h Street RPC-GENN1 Allentown, PA 18101-1175 Moffitt Heart & Vascular Group 1000 North Front Street Wormleysburg, PA 17043 Rodale P.O. Box 6001 Emmaus, PA 18098-0601 Borough of Carlisle (Per Capita Tax) 53 West South Street Cazlisle, PA 17013 Pazagon Revenue Group (for Carlisle Regional Medical Center) P.O. Box 127 Concord, NC 28026 DATE: °~ (li' l 1 -~T One Main Financial P.O. Box 183172 Columbus, OH 43218-3172 B riffie, Esquire ey r Petitioners ttorney ID# 34349 GRIFFIE & ASSOCIATES, P.C. 200 North Hanover Street Carlisle, PA 17013 (717)243-5551 (800)347-5552 BUREAU OF INDIVIDUAL TAXES INHERITANCE TA% DIVISION PO BOX 280601 HARRISBURG PA 1]128-0601 BRADLEY L GRIFFIE 200 N HANOVER ST CARLISLE NOTICE OF INHERITANCE TAX pennsylvania ~ ' APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVEN UE OF DEDUCTIONS AND ASSESSMENT OF ?AX REV a54] IX AFP (12 -11) DATE OB-27-2012 ESTATE OF HERSHEY STEVEN D DATE OF DEATH 08-18-2011 FILE NUMBER 21 11-0954 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 10-26-201.2 PA 17013-2423 (See reverse side under-0bjections) Amount Remitted r MAKE CHECK PAYABLE AND REMIT PAYMENT TD: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE '~- RETAIN LOWER PORTION_FOR_YOUR_RECORDS_ F ___________________ REV-1547 EX AFP C12-11)DISALLOWANCENDFRDEDUCTIONS ANDRASSESSMENTAOFOWAAXCE OR ESTATE OF: HERSHEY STEVEN DFILE N0.:21 11-0954 ACN: 101 DATE: 08-27-2012 TAX RETURN WAS: (X7 ACCEPTED AS FILED ( ) CHANGED ASED ON• ORIGINAL RETURN APPRAISED VALUE OF RETURN B 00 (1) . NOTE: To ensure proper 1. Real Estate (Schedule A) Op credit to your account, 2. Stocks and Bontls (S<he tlule B7 C2) , submit the upper portion t (Schetlule C) t (3) '00 of this form with your 3. eres Closely Heltl Stock/Partnership In 4. Mortgages/Notes Receivable (Schetlule D) (4) .00 tax payment. 5 Lash/Bank Deposits/Misc. Perso nal Pro pe rty (SChedula E) (5) 3,750.30 . 6. Jgintly Ownetl Property (SChetluleF) (6) .00 (7) .00 7. Transfers (Schetlule G) -(g) 3,750.30 8. Total Assets APPROVED DEDUCTIONS AND .EXEMPTIONS: ~ - 9. Funeral Expenses/Atlm. Costs/Misc.Expenses (Schedule H) (9) 19.939.88 hetlule I) (S (10) 25,777.02 10. c Debts/Mortgage Liabilities/Liens u17 45,716.90 I3. Total Deductions 41,966.60- 12. Net Value of Tax Return (12) 00 13. Charitable/Governmental Bequests; Nonelected 9113 Trusts (Schetlule J) (13) . (14) 41,966.60- 14. Net Value of Estate Subja ct to Tax NOTE: If an assessment was issued previously, lines 14, 15 and/or 16, 17 , 18 and 19 will reflect figures that include the total of ALL 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 SiblSng rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due nTTC. a5) .00 x 00 = .00 0167. . DD z 045 ~° : 00 nn nn x 12 = .00 c i s) .00 x 15 = .00 _ (197= .00 ^" PAYMENT DATE RECEIPT NUMBER DISCOUNT INTEREST/PEN C+) PAID (-) AMDU NT PAID TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 x IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YDU NAV BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE DF THIS FDRM FOR INSTRUCTIONS. Ekhibit "A"