HomeMy WebLinkAbout03-21-13 IN RE: ESTATE OF MARY E. MENTZER : ORPHANS' COURT DIVISION
LATE OF BOROUGH OF CARLISLE : COURT OF COMMON PLEAS
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21-12-0269
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Prior Judge: Chris lee Peck ' m
PETITION TO MAKE RULE ABSOLUTE WrrnM• J `
TO THE HONORABLE JUDGES OF SAID COURT:
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Petitioner, Bradley L. Griffie, Esquire, counsel of record for the 4ecrxtrix o f gie x b
within named estate, Petitions the Court as follows:
1. A Petition for Settlement of a Small Estate Pursuant to 20 Pa.C.S.A. Section 3102
was filed to the within estate on January 23, 2013 by Petitioner, Barbara A. Ickes,
the Executrix of the named estate.
2. A true and attested copy of the Petition and the resulting Order of Court and Rule
to Show Cause, a copy of which is attached hereto and incorporated herein as
Exhibit"A", was forwarded by certified mail to the following address:
Angela D. Carter
Claims Investigation Agent
DPW, Bureau of Program Integrity
Division of Third Party Liability
Estate Recovery Section
PO Box 8486
Harrisburg, PA 17105-8486
3. A copy of the certified mail receipt and the certified mail card are attached hereto
and incorporated herein by reference as Exhibit `B" evidencing receipt of the said
Petition by certified mail on January 31, 2013.
4. Said Rule gave Respondents thirty (30) days to respond to the Rule.
5. More than forty-five (45) days have passed since the Rule was served upon the
Pennsylvania Department of Public Welfare and they have failed to respond to the
Petition.
6. The heirs of the estate, being your Executrix, Barbara A. Ickes, Martha K. Stake,
and Robert L. Mentzer, as named in the Petition, have all been given notice of the
pending Petition and Rule by regular mail on approximately January 30, 2013.
7. Neither the Department of Public Welfare nor any named heirs have contacted the
Executrix or counsel of record, nor has an Answer to the Rule been filed despite
the fact more than forty-five (45) days have passed since service of the Rule.
WHEREFORE, Petitioner requests your Honorable Court to enter an Order making
the prior Rule absolute and, as such, Order that the distribution of the estate proceeds,
payment of debts and distribution of$2,412.32 to the Commonwealth of Pennsylvania to
satisfy the Department of Public Welfare claim, as well as no distribution to named heirs,
are hereby approved with prejudice.
Respectfully submitted,
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G
r' fie, Esquire
ey f Petitioner
prem Court ID No. 34349
200 North Hanover Street
Carlisle, PA 17013
(717) 243-5551
(800) 347-5552
IN RE: ESTATE OF MARY E. MENTZER : ORPHANS' COURT DIVISION
LATE OF BOROUGH OF CARLISLE : COURT OF COMMON PLEAS
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21-12-0269
Prior Judge: Christylee Peck
CERTIFICATE OF SERVICE
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I, Bradley L. Griffie, Esquire hereby certify that I did, the a I S�day of March,
2013, cause a copy of the within Petition to Make Rule Absolute to be served upon the
Respondents by regular mail,postage prepaid at the following addresses:
Angela D. Carter, Claims Investigation Agent
Department of Public Welfare
Bureau of Program Integrity Division
Estate Recovery Program
PO Box 8486
Harrisburg, PA 17105-8486
Martha K. Stake
18 Carter Place
Carlisle, PA 17013
Robert L. Mentzer
1884 Leafmore Road
Chambersburg, PA 17201
DATE: 3 1 1 3
Grif e, Esquire
ey for Petitioner
IN RE: ESTATE OF MARY E. MENTZER : ORPHANS' COURT DIVISION
LATE OF BOROUGH OF CARLISLE : COURT OF COMMON PLEAS
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21-12-0269
ORDER OF COURT
AND NOW, this ,Z75 W,, day of January, 2013, upon consideration of
Petitioner's Petition for Settlement of a Small Estate Pursuant to 20 Pa.C.S.A. §3102, a
Rule is hereby issued upon Angela D. Carter, Claims Investigation Agent, Department of
Public Welfare, Bureau of Program Integrity, Division of Third Party Liability Estate
Recovery.Section,;to show cause why the relief requested should not be granted.
RULE RETURNABLE within thirty (30) days of service.
BY THE COURT,
J.
Bradley L. Griffie,Esquire
200 N. Hanover Street
c;. r
Carlisle,PA 17013 all -
Attorney for Petitioner
Angela D. Carter
Claims Investigation Agent
Department of Public Welfare
Bureau of Program Integrity `
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Division of Third Party Liability ,,,
Estate Recovery Section A TRI IF C,O Y FROM RECORD
PO Box 8486. Ir•f`f t,iilgn,onywh®rof, I hereunto
Harrisburg,PA 17105-8486 vi my hand and the seal
of said Court t Carlisle, RA
hisrv: 'ddy Q
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Exhibit "A" eriand County
IN RE: ESTATE OF MARY E. MENTZER : ORPHANS' COURT DIVISION
LATE OF BOROUGH OF CARLISLE : COURT OF COMMON PLEAS
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21-12-0269 c ,
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PETITION FOR SETTLEMENT OF A SMALL ESTATE m W
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PURSUANT TO 20 Pa.C.S.A. SECTION 3102 �� `;,' `+
TO: THE HONORABLE JUDGES OF SAID COURT: 3
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The Petition of Barbara A. Ickes respectfully represents that:
1. Mary E. Mentzer died on January.31, 2012, a resident of the Borough of Carlisle,
Cumberland County,Pennsylvania.
2. Petitioner, Barbara A. Ickes, whose address is 704 West Penn Street, Carlisle,
Pennsylvania, 17013,is the Executrix of Decedent's Estate.
3. A Certificate of Grant of Letters Testamentary was issued to Petitioner by the
Register of Wills of Cumberland County Pennsylvania, on March 1,2012.
4. Decedent died with a Last Will and Testament dated May 24,2007.
5. Decedent's Last Will and Testament provides that Petitioner, along with her .
siblings, Robert L. Mentzer and Martha K. Stake, are the sole heirs of Decedent's
estate, with the Decedent's Last Will and Testament intending to have the residue
of the Estate divided equally among the three of them.
6. At the time of Decedent's death, the only assets of which she was seized, and
assets received by the estate after decedent's passing,were the following:
(A) F&M Trust $7,367.17
Checking Account No. XXX5438
__ —_------ ___(B)–F&M-Trust Irrevocable-burial-account---- _____.$8,47937--
Certificate of Deposit No. XXXX9080
(C) Everence Financial $ 95.83
Health insurance premium refund
TOTAL $15,942.76
7. The F&M Trust Irrevocable Burial Account referenced above was paid directly to
the Thomas L. Geisel Funeral Home, Inc.,the funeral home handling the services
for the Decedent.
8. The assets or funds available to the Petitioner in the Decedent's Estate for use for
payment of fees and expenses,therefore,totaled $7,462.99.
9. Petitioner has paid from the limited estate assets, the following debts associated
with administration of the estate:
(A) Probate fees paid and anticipated $ 141.50
(B) Attorney's fees to Griffie and Associates $2,000.00
(C) Personal Representative's Commission to
Barbara A. Ickes $1,500.00
(D) Thomas L. Geisel Funeral Home $ 519.63
(Balance of funeral home expenses)
(E) Salem Cemetery Association(grave opening) $ 500.00
(F) Pastor's fee $ 125.00
(G) Cumberland Law Journal (Advertising) $ 75.00
(H) The Sentinel (Advertising) $ 189.54
TOTAL $5,050.67
10. As such, Petitioner has paid all known debts associated with the administration of
the estate from the limited estate assets.
11. After payment of all debts associated with the administration of the estate,
Petitioner has $2,412.32 remaining from the estate assets.
12. The Commonwealth of Pennsylvania, Department of Public Welfare, has a claim
against the estate for medical expenses and Medicaid expenses in the amount of
$27,688.25, as evidenced by Exhibit "A", which is attached hereto and
incorporated herein by reference.
13. Petitioner, after proper advertising of the Estate, and after serving as Power of
Attorney for Decedent before Decedent's death, is not aware of any additional
indebtedness of the Decedent.
14. Petitioner has proposed to the Department of Public Welfare that the remaining
estate asset of$2,412.32 be distributed to the Commonwealth of Pennsylvania to
satisfy the claim set forth in paragraph 12.
15. Despite corresponding with the Department of Public Welfare, Third Party
Liability Recovery Section, on July 9, 2012, making this proposal, and no
response was received from the Department.
16. Despite corresponding with the Department of Public Welfare, Third Party
Liability Recovery Section, by correspondence dated October 17, 2012, which
was forwarded by certified mail and received by the Department on October 22,
2012, the Department has failed and refused to respond to Petitioner's offer of
settlement.
17. By correspondence dated December 4, 2012, Petitioner, through counsel, has
provided a copy of the within Petition to the Department of Public Welfare, Third
- - ---- - --- --Party--Liability--Section,-indicating that-upon-notification-of-the-date-of-receipt of------------ - --- --
that correspondence which includes a copy of this Petition, which documents
were sent by certified mail, Petitioner will wait an additional thirty (30) days and
then file the within Petition.
18. A copy of the original certified mail sent on October 17, 2012, which. was
received by the Department on October 22, 2012, it attached hereto and
incorporated herein by reference as Exhibit`B," along with the certified mail card
evidencing receipt.
19. A copy of the certified mail card evidencing receipt of the correspondence dated
December 4, 2012 and a copy of this letter were forwarded by counsel for
Petitioner evidencing receipt of documents on December 5, 2012 by the
Department of Revenue is attached hereto and incorporated herein by reference as
Exhibit"C."
20. As the Department of Public Welfare has refused to respond to the
correspondence of counsel requesting cooperation in settling the Department's
claim, it is appropriate under the Pennsylvania law for the court to approve the
request of the Petition herein requiring the Department of Public Welfare to
accept disbursement of the sum of$2,412.32 as payment in full satisfaction of the
Department's claim,pursuant to 55 Pa. Code §258.8.
21. There are no assets of Decedent nor of 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.
22. There are no additional claimants or creditors of whom the Petitioner has
knowledge who have not received full compensation other than the
Commonwealth of Pennsylvania, Department of Public Welfare, as hereinbefore
described.
23. As this is an insolvent estate, no Pennsylvania Inheritance Tax Return was due,
but an Inheritance Tax Return 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
«D»
24.Notice of the intent to file this Petition was given by certified mail, return receipt
requested, with a copy of this Petition, to the Commonwealth of Pennsylvania,
Department of Public Welfare, Third Party Liability Recovery Section, more than
forty-five(45)days prior to filing of the Petition.
WHEREFORE, Petitioner requests your Honorable Court to approve settlement
of this estate with payment of debts associated with administration of the estate as noted
in paragraph 9, with payment of $2,412.32 to the Commonwealth of Pennsylvania,
Department of Public Welfare, in full satisfaction of its claim as described in paragraph
13 and with no disbursements to the named heirs.
Respectfully submitted,
r Grf , Esquire
ey for etitioner
ney
ID#34349
GRIFFIE&ASSOCIATES,P.C.
200 North Hanover Street
Carlisle,PA 17013
(717)243-5551
Pennsylvania
DEPARTMENT OF PUBLIC WELFARE
April 17, 2012
GRIFFIE & ASSOCIATES
BRADLEY L GRIFFIE ESQUIRE
200 N HANOVER ST
CARLISLE PA 17013
Re: Mary Mentzer
CIS #: 820311071
SSN: ###-##-2084
Date of Death: 01/31/2012
Dear Attorney Griffie:
Please be advised that the Department of Public Welfare maintains a claim in the
amount of$27.688.25 against the above-mentioned estate. This claim is for restitution of
medical assistance granted on behalf of the decedent for which the Probate Estate is now
responsible to reimburse the Department according to Act 49, 62 P.S. 1412, effective
August 15, 1994, as amended by Act 20-95, effective June 30, 1995. Enclosed is the
Department's itemized statement of claim.
A portion of this medical expense, namely $27,688.25, was incurred during the last
six months of the decedent's life; therefore, it is a Class 3 claim pursuant to Section 3392 of
the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A. 3392(3). The balance of the
claim, namely .00, is to be entered as a priority Class 5.1 claim against the estate.
Please acknowledge receipt of this letter and advise whether the Commonwealth's
claim is admitted and when payment may be expected. If the estate accounting is
complete, please provide a copy. If the estate contains real estate, please provide
copies of the deed, the latest tax assessment, and a current appraisal, if available.
Sincerely,
Angela D. Carter
Claims Investigation Agent
717-772-6612
717-772-6553 FAX
Enclosure
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Bureau of Program Integrity i Division of Third Party Liability i Recovery Section
PO Box 8486 1 Harrisburg,Pennsylvania 17105-8486
7007 0,220 1,90112 :252616445
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7007 0220 0002 2522 8603
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NOTICE OF INHERITANCE TAX pennsytvahia
BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE
INHERITANCE TAX DIVISION OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (12-11)
PO BOX 280601
HARRISBURG PA 17128-0601
DATE 10-08-2012
ESTATE OF MENTZER MARY
DATE OF DEATH 01-31-2012
FILE NUMBER 21 12-0269
COUNTY CUMBERLAND
BRADLEY L GRIFFIE ACN 1Q1
200 N HANOVER ST APPEAL DATA: . 12-07-2012
CARLISLE PA 17013-2423 (Seereverse•sid !underO,biections)
Amount Remitted
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
1 COURTHOUSE SQUARE
CARLISLE PA 17013
CUT ALONG THIS _LINE _ � RETAIN LOWER PORTION_ FOR YOUR RECORDS � _ ____ __________
REV-1547 EX AFP C12-11) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE- OF: MENTZER MARY - FILE NO. :21 12-'0269 ACN. 101 DATE: 10=08-2012
TAX RETURN WAS: ( X) ACCEPTED AS FILED C ) CHANGED
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate CSchedule A) Cl)-- 00 NOTE: To ensure proper
2. Stocks and Bonds CSchedule B) C2) 00 credit to your account,
submit the upper portion
S. Closely Held Stock/Partnership Interest CSchedule C) C3) 00 of this form with your
4. Mortgages/Notes Receivable CSchedule D) C4) 00 tax payment.
S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 7,462.99
6. Jointly Owned Property CSchedule F) (6) DO
7. Transfers (Schedule G) C7) 0 0
8. Total Assets (8) 7,462.99
APPROVED .DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses CSchedule H) Cot, 5.550 .67
10. De bts/Mortgage Liabilities/Liens '(Schedule I) C10) 27,688.25
11: Total Deductions C11)
33,238.92
12. Net Value of Tax Return C12) 93-
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts CSchedule J) C13) .0.0
14. Net Value of Estate Subject to Tax C14) 25,775.93-
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 C15) .00 X 00 = .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) nn X 045 = .00
17. Amount of Line 14 at Sibling rate (17) _011 X -12 = . 00
18. Amount .of Line 14 taxable at Collateral/Class B rate C18) .00 X 15 = . 00
19. Principal Tax Due (19)= .00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+)
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
_ _._- __-- --TOTAL TAX-PAYMENT---- -- - — -
BALANCE OF TAX DUE .00
a 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 ADDITIONAL INTEREST. A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
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 unworn falsification to authorities.
DATE: ; -.� — 02 D `2 i Q
BARBARA A. ICKES
IN RE: ESTATE OF MARY E. MENTZER : ORPHANS' COURT DIVISION
LATE OF BOROUGH OF CARLISLE : COURT OF COMMON PLEAS
CUMBERLAND COUNTY
PENNSYLVANIA
NO. 21-12-0269
CERTIFICATE OF SERVICE
I, Bradley L. Griffie, Esquire hereby certify that I did, the ZL day of December,
2012, cause a copy of the within Petition for Settlement of Small Estate to be served upon
the Department of Public Welfare, Estate Recovery Program by certified mail, return
receipt requested, at the following address:
Angela D. Carter, Claims Investigation Agent
Department of Public Welfare
Bureau of Program Integrity Division
Estate Recovery Program
PO Box 8486
Harrisburg,PA 17105-8486
And by regular mail to the named heirs of the estate at the following addresses:
Martha K. Stake Robert L. Mentzer
18 Carter Place 1884 Leafinore Road
Carlisle,PA 17013 Chambersburg, PA 17202
DATE: I x l` la�
e, Esquire
e Petitioner
Attorney ID#34349
GRIFFIE &ASSOCIATES,P.C.
200 North Hanover Street
Carlisle,PA 17013
(717)243-5551
(800)347-5552
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