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Home My WebLink About02-04-13IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHANS' COURT DIVISION Estate of Martha E. Black, Deceased FILE N0.2011-01119 PA N0.21-11-1119 PETITION FOR SETTLEMENT OF SMALL ESTATE IN ACCORDANCE WITH 20 Pa.C.S. §3531 The petition of Thomas A. Capper, Administrator, respectfully states: 1. Martha E. Black died on August 2$, 2010, having resided at 210 Big Spring Road, Newville, PA 17241. 2. Petitioner, Thomas A. Capper, is Administrator of the decedent's will dated August 2, 2000, which was admitted to probate by the Honorable Glenda Farner Strasbaugh, Register of Wills of Cumberland County, on November 22, 2011, and Letters of Administration C.T.A. were granted to Petitioner on November 22, 2011. A copy of the will is attached hereto as Exhibit A. 3. The first complete advertisement of the grant of letters was on December 30, 2011. 4. Petitioner's first and final account of the Estate of Martha E. Black, dated February 1, 2013, is attached hereto as Exhibit B. n ~=' n Q]~ 1'~l ~ ~ r Cx~ ~O c~ a7 y~ r - i ~.a 5. The decedent was not married on the date death. ~ c~n '-~~ -~ _ ` ~ ~ c~ ~'`~ ca c, -~ ~r -, s .=3 ,,,~ -~ ;,y h~ Cn C> 1 t?) -f'i 6. The gross personal estate of the decedent totals less than $25,000, as shown on page 2 of the account. The decedent did not own any real estate. 7. The remaining unpaid creditors of the estate are shown on page 4 of the account.. All of the claims are admitted. There are no other unpaid claimants of whom petitioner has notice or knowledge. 8. The Pennsylvania Inheritance Tax Return has been filed with the Register of Wills and there was no inheritance tax owed by petitioner. The inheritance tax Notice of Allowance from the Pennsylvania Department of Revenue is attached as Exhibit C. 9. The decedent was not a fiduciary in any other estate and was not a surety on the bond of a fiduciary. 10. The unpaid creditors listed in the account have been served with a copy of this petition and the attached account. 11. The following individuals with a beneficial interest in the decendent's estate (decedent's children) have also been served with a copy of this petition and the attached account: Sherry D. Wiest, Delores J. Garman, George M. Black, Jr., and Richard A. Black, Sr. 12. The entire distributable balance, as reflected in the attached account on page 4, should be awarded to the Pennsylvania Department of Public Welfare, the unpaid Class 3 Claim Creditor (20 Pa.C.S. §3392). 2 SALLY J. WINDER Attorney at Law 701 E. King Street- - Shippensburg, PA 17257 ~° ®®° % ~~~~~ u~c L~ J3~ac~ ~~~~ >~~~ . ~~ ~ ~~ ~7f7~ 532-.Af~l6 I, MARTHA E. BLACK, of 9443 Upper Strasburg Road, Upper Strasburg, Franklin County, Pennsylvania, being of sound mind and memory declare this to be my Last Will and Testament and revoke any will or codicil previously made by me. ITEM I: I direct that all my just debts and funeral expenses, including my gravemarker and all expenses of my last illness, shall be paid from my residuary estate as soon as practicable after my decease as a part of the administration of my estate. ITEM II: I give, devise and bequeath all of my estate of every nature and wheresoever situate to my husband, GEORGE M. BLACK, providing he shall survive me by thirty (30) days. ITEM III: Should my husband, GEORGE M. BLACK predecease me or die on or before the thirtieth day following my death, I give, devise and bequeath all of my estate of every nature and wheresoever situate to my issue per stirpes in shares of equal value, share and share alike. ITEM IV: I appoint my husband, GEORGE M. BLACK executor of this, my Last Will and Testament. Should he fail to qualify or cease to act as executor, I appoint my son, RICHARD ALLEN BLACK and my daughter, DECOKES JEAN GARMAN, co executors of this, my Last Will and Testament. f ITEM V: I direct that my executor or his successor shall not be required to give bond for __ __ ~ the faithful performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I hereunto set my hand and seal to this mGcyS~ast Will and Testament, written on two (02) sheets of paper, dated this ZnD~ day of A~~~~, 2000. (SEAL} RTHA E. BLACK The preceding instrument, consisting of this and one (O1) other typewritten page, each identified by the signature of the testatrix, MARTHA E. BLACK, was on the day and date thereof signed, published and declared by MARTHA E. BLACK, the testatrix herein named, as and for her Last Will, in the presence of us, who, at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. residing at ~G residing at , 2 _ ~_ COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND We, MARTHA E. BLACK, the testatrix in, and the undersigned witnesses to, the will, the attached or foregoing instrument, who have signed the instrument, having been qualified according to law do depose and say: _(al_tl~at T ,_tJ~eaoBtatriK,.-do_hereby., acknowledge that I signed the instrument as my will, that I signed it willingly and as my free and voluntary act for the purposes therein expressed; and (b) that we, the witnesses, were present and saw the testatrix sign and execute the instrument as her will, that she signed it willingly and executed it as her free and voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the testatrix signed the will as a witness and that to the best of our knowledge the testatrix was at that time 18 or more years of age, of sound mind and under no constraint or undue influence. THA E. BLACK Witness Witness Subscribed to and subscribed or affirmed and acknowledged before me by MARTHA E. BLACK, the testatrix and the witnesses whose names are signed above this ~ day of /~~5 X00. U- \/ J(~ Notary Public Sally J. Notarial Sggl ShIPPensburg ruder, Notary Pe-bitC MY Commission Ex~e~eb~ 3~ 2~ty IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ORPHANS' COURT DIVISION FILE N0.2011-01119 PA N0.21-11-1119 FIRST AND FINAL ACCOUNT OF Thomas A. Capper, Administrator For ESTATE OF MARTHA E. BLACK, DECEASED Date of Death: Date of Incapacity, if any: Date of Administrator's Appointment: Date of First Complete Advertisement Accounting for the period: 8/28/2010 None 11 /22/2011 12/30/2011 11 /22/2011 to 2/1/2013 Thomas A. Capper Ball, Murren & Connell 2303 Market Street Camp Hill, PA 17011 (717) 232-8731 Supreme Court I.D. No. 75020 1 PRINCIPAL RECEIPTS Personal Effects (Valued as of Date of Death 8/28/2010) Orrstown Bank -checking account 8,529.48 $ 8,529.48 Subse uent Recei is 8/28/2010 to 11/21/2011 9/1/2010 Automated Credit - U.S. Treasury (Civil Service) $957.92 9/3/2010 Automated Credit - U.S. Treasury (Social Security) 359.00 9/7/2010 Automated Debit - U.S. Treasury (395.00) 10/12/2010 Automated Debit - U.S. Treasury (957.92) 8/28/2010 to 1 1/21/2011 Interest 1.11 $l.l l Personal Effects (Valued as of Date of Administration Appointment 11 /22/2011) Orrstawn Bank -checking account $ 8,530.59 TOTAL PRINCIPAL RECEIPTS $ 8,530.59 2 DISBURSEMENTS OF PRINCIPAL ADMINISTRATION EXPENSES (Class 1 Claims - 20 Pa C S §3392 12/2/2011 Cumberland Law Journal Legal Advertisements 75.00 12/13/2011 Register of Wills -Cumberland County Filing Fees 30.00 1/9/2012 Barbush & Hoffinan, CPAs Preparation of federal and state income tax returns 75.00 1 /31 /2012 Ball, Marren & Connell Probate fees, Legal Advertising (Sentinel), photocopies, postage, and telecopier expenses 298.57 1 /29/2013 Ball, Marren & Connell Probate fees (Renunciation filings) and Photocopies 21.20 $499.77 ADMINISTRATION EXPENSES -FEES (Class 1 Claims - 20 Pa C S §3392) 1 /31 /2012 Ball, Marren & Connell $ 1,000.00 $1,000.00 Attorney's fees TOTAL DISBURSEMENTS OF' PRINCIPAL $1,499.77 NET AVAILABLE FOR DISTRIBUTION TOTAL PRINCIPAL RECEIPTS $ 8,530.59 TOTAL DISBURSEMENTS OF PRINCIPAL FOR ACCOUNT PERIOD 1 499.77 $ 7,030.82 Reserve for filing fees and final costs (photocopying and postage) (30 82) Net Available for Distribution to Unpaid Creditors $7,000.00 3 UNPAID CREDITORS' CLAIMS - (Class 3 Claims - 20 Pa.C.S. X3392) Amount Claimed Proposed Distribution 1) Pa. Dept. of Public Welfare Bureau of Program Integrity Division of Third Party Liability Recovery Section P.O. Box 8486 Harrisburg, PA 17105-8486 (CIS # 920194365) $22,175.14 UNPAID CREDITORS' CLAIMS - (Class 5 1 Claims - 20 Pa C S §3392) Amount Claimed Proposed Distributian 2} Pa. Dept. of Public Welfare Bureau of Program Integrity Division of Third Party Liability Recovery Section P.O. Box 8486 (CIS # 920194365) Dated: $54,770.97 $7,000.00 $0 // Thomas A. Capper, A mstrator Estate of Martha E. Black, Deceased 4 VERIFICATION THOMAS A. CAPPER, Administrator of the Estate of Martha E. Black, Deceased, hereby declares under oath that he has fully and faithfully discharged the duties of his office; that the foregoing First and Final Account is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the Estate have either been paid in full or that all known unpaid creditors have been identified as set forth in the Account; that all taxes presently due from the Estate have been paid; and that the grant of Letters of Administration and the first complete advertisement thereof occurred more than one year before the filing of the foregoing First and Final Account. This statement is made subject to penalties of 18 Pa.C.S. §4904, relating to unsworn falsification to authorities. Dated: °~ ~ ~~ ~~ THOMAS A. CAPPER 5 EXHIBIT C NOTICE OF INHERITANCE TAX pEnnSy~Vanla ~ BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX DEPARTMENT OF REVENUE PO BOX 280601 REV-1!i47 EX AFP C12-11) HARRISBURG PA 17128-0601 DATE 06-05-2012 ESTATE OF BLACK MARTHA E DATE OF DEATH 08-28-2010 FILE NUMBER 21 11-1119 THOMAS A CAPPER COUNTY CUMBERLAND 2303 MARKET ST ACN 1D1 APPEAL DATE: 08-04-2012 CAMP H I L L PA 17011-4627 (See reverse side under Objections) Amount Remitted MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS 1 COURTHOUSE SQUARE CARLISLE PA 17013 CUT ALONG THIS LINE --1 RETAIN LOWER PORTION FOR YOUR RECORDS 4- _ -------------------------------------------------- REV-1547 EX AFP C12-11~ NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF: BLACK MARTWA` EFICE N0.:21 11-1119 ACNc 101 DATEi 06=05-2012 TAX RETURN WAS: C X ) ACCEPTED AS FILED C ) CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) .0 0 2. Stocks and Bnnds (Schedule B) NOTE: To ensure proper C2) .00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portio 4. Mortgages/Notes Receivable (Schedule D) of this form with your C4) .00 tax payment. 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) C5) 8,5 2 9.4 8 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) C7) _ .0 0 8. Total Assets APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liehs (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 cll) 78, 141.61 c12) 69, 612. 13- (13) .OD c14) 69 612 13 NOTE: If an assessment was issued previously, lines 14 15 ' reflec t figures that include the tot l , and/or 16, 17, o and 19 will ASSESSMENT OF TAX: a of ALL returns asses sed to d t 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate (15) (16) .00 X - 0 0 - .D 0 17. Amount of Line 14 at Sibling rate nn x 045 = . 00 18. Amount of Lima 14 tax bl . c17) _ nn x 12 = .00 a e at Collateral/Class B ra te (18) 0 0 19. Principal Tax Due . X 15 = .00 TAX CREDITS: (19) .0'0 PAYMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMDUNT PAID TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .DO INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A "CREDIT" CCR:), YOU MAY BE DUE FOR CALCULATION OF A.DDITIDNAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. cs) - 8 , 529 48 C9) - 1 1 9 0 (lo) 76,946.11