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Home My WebLink About04-1109INRE: G. JANE HENRY Deceased IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. ., 2004 PETITION FOR SETTLEMENT OF A SMALL ESTATE UNDER SECTION 3102 OF THE PROBATE, ESTATES AND FIDUCIARY CODE 20 PA. C.S.A. SECTION 310~. AND NOW COMES Petitioner, D. Edward Henry, and submits this PETITION FOR SETTLEMENT OF A SMALL ESTATE, and in support thereof avers as follows: 1. Petitioner, D. Edward Henry, is an adult individual, living at 10308 Leona Avenue, Leona Valley, CA 93551. Petitioner is the son and only surviving heir of the Decedent. 2. Decedent, G. JANE HENRY, resided, at the date of her death, at 3609 Kohler Place, Apartment 12, Camp Hill, Hampden Township, Cumberland County, PA 17011. Decedent died June 1, 2004, having divorced her former husband, and the father of Petitioner, D. Edward Henry, their only child, on May 16, 1968,-Decree entered to # 1248 January Term, In the Court of Common Pleas of Dauphin County, PA. A tree and correct copy of her death certificate and the divorce decree are attached hereto and Marked Exhibits 1 and 2. 3. Decedent had limited business contacts, with which Petitioner has been familiar. 4. Petitioner believes atter investigation and therefore avers that Decedent managed her limited financial affairs, during her lifetime. 5. Afier investigation, Petitioner believes that the sole sources of income of the decedent were the followil~g: A. Interest on accounts identified below ' .~ ~ B. Direct deposit as annuitant from Pennsylvania Treasury Department, annartant ~dentd%atton number 1236003133 in the amount of $864.71 per month C. Social security. 6. At~er investigation, Petitioner believes that sole assets of the decedent, at the date of her death, were the following: A. Deposit account owned as joint tenants with the fight of survivorship with Petitioner, number 300002330 8113 with Wachovia Bank, available balance at June 2, 2004, per statement attached, $1003.12, paid to Petitioner; B. Account number 8701906540, Pennsylvania State Employees Credit Union, owned as joint tenants with the right of survivorship with Petitioner, per statement attached, $1690.33, paid to Petitioner. C. 1998 Ford sedan, title number 52190689001 with 7,500 Miles, and an estimated market value at the date of death of $3,000. D. Savings account at PSECU, with date of death balance of $5.01. See attached. $3,000. E. Limited tangible personal property and furnishings, in her apartment, valued at 7. After investigation, Petitioner believes that the only debts and liabilities of the decedent and the expenses incurred to date, are the funeral bill [from Parthemore Funeral Home and Cremation Services Inc. $1172.90, statement attached- paid in full], and Counsel fees for administration, based upon time involved. For information only, Decedent had a Visa Account, #8701906540, with PSECU, which has agreed with Petitioner not to collect same, and that the "estate" need not consider this balance to be a "debt." See correspondence attached, 8/24/04. 8. Under the Probate Estates and Fiduciaries' Code, the administrator, if so required to act, would be the Petitioner, named above, and he would be the sole heir of the Decedent. 9. Because of the limited assets of the estate, Petitioner seeks to administer and distribute the estate of the decedent as a Small Estate. 10. Petitioner believes, and therefore avers, that by virtue of the modest size of Decedent's estate, by virtue of the limited expenses and income of Decedent, no further notice of the administration and distribution of the estate is necessary or required. 11. Petitioner believes, and therefore avers, that this abbreviated procedure will achieve a more just, equitable, efficient, appropriate, and inexpensive distribution of the Estate of Decedant than advertising the grant of letters, of administration, and filing court accountings and seeking court approval of the administration. WHEREFORE, Petitioner respectfully requests that the Court, under Section 3102 of the Probate, Estates and Fiduciaries Code, authorize and direct the Petitioner to receive from asset holders the assets of the Decedent, execute such automobile titles and documents of transfer, as required, pay from those funds the debts and expenses identified above, cause to be prepared, signed, and filed and paid a Pennsylvania Inheritance Tax Return, and Federal and State Income and local Tax returns, if required, and distribme the balance, if any, to Petitioner. Respectfully submitted, Date: /~ -2.-O q R~/~. SPITZER,~; ¢ 2401 North Front ff. g4et Post Office Box 12087 Harrisburg, PA 17108-2087 I. D. # 06264 Attorney for Petitioner VERIFICATION I verify that the statements made in this Petition are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C. S. A., Section 4904, relating to unswom falsification to authorities. ~ ~]~¥'~'~)(Petitioner)~l~0'~ v ~ Date: ~r_.D, ~t~- ~./~tg. his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as I-ocal Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 1032932S No. Local Registrar Date G. Jane Henry 80 Y~' Cumberland 3609 Kohler Place, Apt. 12 ~,~amp Hill, PA 17011 COMMOIh'WEALTH OF PENNSYLVANIA · DEPARTMENT OF HEALTH * VITAL RECORDS CERTIFICATE OF DEATH white SURVIVING SPOUSE Hampden Edward Henr7 ~. 10308 Leona Avenue~ Leona Valley. CA 93551 ~(s~ DIz~b June 3, 2004 ~ Yorkto~e Cre~tory York PA 17404 m~ ~ ~~ I~. ~D 013 340 L ~z~.~.O. Sox 431~ ~e~ Cumbe~[a~d~ PA'170~0-04~1 Commonwealth of Pennsylvania County of Dauphin, ss: DANIEL E. HENRY Plaintiff VS. Defendant In the Court of Common Pleas of Dauphin County, Pennsylvania Decree in Divorce AND NOW, to wit: lt~Y 16 .................................................................................... , 19..6...8- ...... , the Court having referred this cause to a master, who after taking the testimony and considering the same, has reported his findings of fact and conclusions of law thereon to the Court, the Court, upon due con- sideration thereof, hereby adopts the findings of facts and conclusions of law, as the findings and con- c]usions of the Court, and does accordingly grant the prayer of the plaintiff and hereby adjudges and decrees that DANIEL E. HENRY is hereby divorced and completely separated from the bonds of matrimony with ................ .G...~....~..~I.~..g..._,l.,....~.~..~ ................................ as fully as if the said defendant were naturally dead or as if the plaintiff had never been married; that every duty, right and claim heretofore accruing to either of the said parties by reason of said marriage does now cease and come to an end; and that each of the lmid parties is at liberty to marl~' a~ain as freely as if the marriage had never taken place, AND IT IS FURTI'IER ORDERED, That the costs of this proceeding be paid by the defendant. BY THE COURT, . .S.Z. g ... P. !..XO.~ .. ~ .l~a~. ................................... Judge Certified Certified WAC~HOVLA Deposit Account Close Confirmation (Debit) WACHOVIA BANK, N.A. Date 06/02/2004 Customer Name(s) and Address G JANE HENRY D EDWARD HENRY 3609 KOHLER PL. APT 12 CAMP HILL PA 17011 Taxpayer ID Number S187164455 ACCOUNT NUMBER: 3000023308113 Available Balance : $1,003.12 + Accrued Int: $0.00 - Fed W/Hd Due: $0.00 - Admin Fee: $0.00 - Outstanding Db: $0.00 - Closing Fee: $0.00 Paid To Customer: $1,003.12 11:42 PSECU PSEC the finenoial Ilnkwd P.02/04 July 6, 2O04 Robert C. Spltzet 407 N. Front S~reet H~risbu~g, PA 17101 RE: G. Jane Hem'y, Deceased Account # 8701906540 Dear Attorney Spirant: The following are the Date of Death B&lance's f'or G. ,lane Henry's accounts with PSECU: &econM Date or Death Balanees Am. Ned Interest Savtnss (SI) S5.01 $0,00 Check,s (,t4) $J.,6~o.33 So.oo Visa Loan 0.,9) S7,424.97 The account was opened April 21, 1983. The account was held jointly with D. Edwa,-d Henry. The account wus made joint Decemhe~ 23, I~1. Xf the Estate has suf~icicnt funds to payoff thc above loan, please remit i check, mede payablc to PSECU, in tha ftmount ot'~7,424.97. If there are not sufficient ~d] to peyoft'the loan, please providc PSECU with i le~er stsfin$ this ~act. If'you have ny questions, please contact me at (717) 234-8484 or toll-f~e at (800) 23% 7328, then pi'els 6, ~ms~on 3120. Sincerely, Account Advisor PENNSYLVANIA STATE IMPLOYIEI 0RIDIT UNION Mllfl A4Mrlm8:1 Cro(iJt Union Pksne, Hl~liklrll, PA 17t10-299Q · (7t7) 234-6484 · (800) 237.73o8 M~liflg #dMroms: P.O. Ion e70'13. Himle)upll, PA 17100-7013 · (717) 777-2100 (TDD) · (800) 4?2.1SET (TOD) Kelley Blue Book - Private Party Pricing Report - Ford, Escort Page I of 2 BLUE BOOK PRIVATE PART BEPOIIT California * September 8, 2004 1998 Ford Escort LX Sedan 4D Engine: 4-Cyl. 2.0 Liter Trans: Automatic Drive: Front Wheel Drive Milsege: 7,200 Equipment Air Conditioning Power Steering Power Windows Search Listings_ for This Car List Your Car For Sale Online Buy a New Car Free Record Check Auto Loans from 3.75% APR [nsurance Ouote Print "For Sale" Sign Payment Calculator Tilt Wheel AM/FM Stereo Dual Front Air Bags ,! Consumer Rated Condition: Excellent "Excellent" condition means that the vehicle looks groat, is In excellent mechanical condition and needs no reconditioning. It should pass a smog inspection. The engine compartment should be clean, with no fluid leaks. The paint is glossy and the body and interior are free of any wear or visible defects. Thero is no rust. The tires are the proper size and match and aro new or nearly new. A clean title history is assumed. This is an exceptional vehicle. Private Party Value Search Local UsUnqs for This Car $3,94~ Private Party value represents what you might expect to pay for a used car when purchasing from a private party. It may also represent the value you might expect to receive when selling your own used car to another private party. rT - I Get Invoice & HSRP on New Cam Get a Person to Person Auto Loan http:~~www~kbb~~~m/kb/ki~d~~/kw~kc~ur?kbb~~A;53~~77;CA~37&9355~;+p&722;F~rd;~99~~~ 9/8/2004 9-5-04 Robert Spitzer 2401 North Front St. P.O. Box 12087 Ref: your letter to me dated 8-24-04 Dear Bob, Please pardon the delay in getting this information to you but here it finally is. 1. Copy of my mothers divorce papers. 2. Copy of Kelley's blue book car value taking from intemet. 3. Mother's tangible personal property consisted of furnished apartment. Total value approximately $3,000.00. Jewelry approximate value $1,500.00. Furniture was given to her friends and the church. A few jewelry items my daughter took. That's it! 4. Yes, my mother was getting social security. I notified them of her death. Hope this helps you with your task. Best wishes, ~d Henry A Family Tradition Of Caring PARTI-IEMORE Funeral Home & Cremation Services, Inc. Mr. Edward Henry 6/2/2004 10308 Loona Avanue I[~ona Valley, CA 93551 1303 Bridge Street We sinc~'~ly appreciate the confidenc~ you have plac~d in us and will continue to mist you in ev~-y way we can. Plens~ feel fre~ to contact us if you have any qu~dons in regard to this statement. The following P.O. Box 431 is an itemized statemant of thc services, facilities, automotive ~quipment and merchandi~ that you s~leeted New Cumberland, PA 17070 when making the funeral arrangements. (717) 774-772 l www,parthemore,com N~ 30 t 7/2/2004 2004042.1 Gilbert W. Parthemore, Founder Gilbert J. Parthemore, Supervisor Stephen K. Parthemore, CFSP Bruce R. Parthemore, Pre-Need Coordinator, CPC Professional Memberships: NFDA · PFDA DCFDA · CCFDA Description [ Amourtt Dir~t Creeaation for G. J~e H~ 1,070.~ To~ S~ ~d M~h~di~ 1,070.~ ~ Nofi~, H~sb~ P~ot 57.~ C~fi~ ~i~ of~ ~fic~ 20.~ Cm~l~d Co~ ~mn~ F~ C~on Au~on 25.~ To~ C~h A~ 102.~ To~l Shlm.~ Paymen~/Cmdi~ ~.~ Balance Duo $1,172.ffi LAW OFFICES OF ROBERT C. SPITZER, P.C. 2401 North Front Street Post Office Box 12087 Harrisburg, PA 17108-2087 TELEPHONE (717) 231-7600 FAX (717) 231-7602 emall: ~ August 24, 2004 PSECU P.O. Box 67013 Harrisburg, PA 17106-7013 Attn: Ms. Suzanne Farr In re: G. Jane Henry, deceased, account number 8701906540 Dear Ms. Fart: Mr. Edward Henry, at this point the informal representative of the "estate," has provided me with details of various communications between PSECU and him as to the above account. As I understand your letter of August 3, 2004, and your various telephone conversations with him, and after consultation with Mr. Henry, the position of PSECU as to collection of this account is that it will not seek to collect the balance owed PSECU. Accordingly, the estate does not consider PSECU to be a creditor, and does not consider the balance owed as a debt of the estate. We will proceed with the administration of the estate accordingly. If this understanding is incorrect, please advise immediately. R.C.S.: s cc: Mr. Edward Henry Law Office of Robert C. Spitzer, P.C. poat office Box 12087 INRE: G. JANE HENRY Deceased ) ) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DiVISION NO.-~ '- , 2004 ORDER OF COURT AND NOW, this { day of [~*"~- 5 , 2004, it appeanng to the Court that there is no need for further notice, and that the interests of justice warrant, it is hereby ordered and decreed as follows: 1. Petitioner shall have the authority to collect all assets of the estate of the decedent, execute such transfer documents, including but not limited to Motor Vehicle forms, as are necessary or desirable in connection with such assets, and otherwise administer the estate of the decedent 2. Petitioner shall pay the debts and expenses identified in the Petition, and as otherwise becoming known to Petitioner, administration expenses, including reasonable counsel fees, and, if necessary, sign, file and pay Pennsylvania inheritance taxes and federal and state and local income taxes. 3. Petitioner shall distribute the balance, if any, to Petitioner as sole heir. 4. Upon completion of the foregoing steps, Petitioner shall be free of any further duty or obligation in connection with the administration and distribution of the estate of decedent. BY THE COURT: COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV -1500 OFFICIAL USE ONLY REV";500E~ (6-00~ INHERITANCE TAX RETURN RESIDENT DECEDENT 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes 11. Election to tax under Sec. 9113(A) IAllllmSdlOl 6. Jointly Owned Property (Schedule F) . Separate Billing Requested 7. Inter-Vivos Transfers & Misc. Non-Probate Property (Schedule G or L) (6) $ O.OOi $ 0.00: $ 0.00\ , $ O.OO~ , $7,695.34! I ) $ 845.171 OFFICIAL USE ONLY Real Estate (Schedule A) (1) 2. StOCKS and Bonds (Schedule B) (2) 3. Closely Held Corporation. Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule 0) (4) 5. Cash, Bank Deposits & Misc. Personal Property (Schedule E) (5) " (7) $ 0.00! c:) I "'~'''7-'-'.''r I 10. Debts of Decedent, Mortgage Liabilities & Liens (Schedule I) (9) (10) (8) $2,'\94.90 $ 0.00 (11) (12) (13) $8,540.51 8, Tot3\ Gross A.ssets (total Lines 1-7) g, Funeral Expenses & Administrative Costs (Schedule H) 11. Total Deductions (total Lines 9 & 10) $2,194.90 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Govemmental Bequests/Sec 9113 Trusts for which an erection to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) $6,345.61 $ 6.00 (14) $6,339.61 15. Amount of Line 14 taxable at the spousal tax . rate, or transfers under Sec. 9116 (a)(1.2) x (15) 16. Amount of Lioe 14 taxable at lineal rate x (16) 17. Amount of Line 14 taxable at sibting rate x .12 (17) 18. Amount of Line 14 taxable at collateral rate x .15 (18) $ 0.00 $ 285.28 $ 0.00 $ 0.00 19. Tax Due 20. CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT (19) $ 285.28 Dell.'1dent's, Complete Address CITY CAAAIi ~t( Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount $ 285.28 Total Credits (A + B + C) (2) $ 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty 4. Total Interest/Penalty (0 + E) (3) If line 2 is oreater than line 1 + line 3. enter the difference. This is the OVERPAYMENT Check box on Page 1 Line 20 to request a refund (4) $ 0.00 $ 0.00 5. If line 1 + line 3 is greater than line 2, enter the difference. This Is the TAX DUE. (5) $ 285.28 A. Enter the interest on the tax due. (SA) B. Enter tI1e total of Line 5 + 5A. This is the BALANCE DUE (5B) Make Check Payable to: REGISTER OF WILLS, AGENT $ 285.28 PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS Did decedent make a transfer and: Ves a. retain the use or income of the property transferred; I b. retain the right to designate who shall use the property transferred or its income; c. retain a revisionary interest; or . d. receive the promise for life of either payments, benefits or care? If death occurred after December 12, 1982, did decedent transfer property within on year of death without receiving adequate consideration? II Did decedent own an '1n trust for" or payable upon death bank account or seaJrity at his or her death? Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? _ _ IFTHE ANSWERTO fW'( OF TliE ABOVE QUESTlONSIS YES, YOU MUST COMPLETE SCHEDULE G AND RLE IT /IS PARTOFTliE RETURN. 1. No 2. I II 3. 4. Under penalties of pe~ury, I dedare that I have examined this retum, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer other than the personal representative Is based on all the information of which preparer has any knowledge. ADDRESS 2401 N. FRONT'ST~!*T:!j . ." . "i,_.,_,,",, -, '_.' 'I; -'lIl'B! . ,}Y<<.&/.t.-i';_jljd.j+~'f:;~(',j'" i i5i _ Uftii~.m\..~if:ll\9;liIl..4h~ ",(uA__~ 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 lax 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. REV-150BEX+(6-98) .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF HENRY, G. JANE FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jolntty.owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER 1. TOTAL Also enter on line 5, Reca (If more space is needed, insert additional sheets of the same size) $7,695.34 REV.1509EX+(6-9Bj .. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF FILE NUMBER If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT JOINTLY -OWNED PROPERTY: ITEM NUMBER DESCRIPTION OF PROPERTY Include name of finanCial insUtullon and bank. account nurrtJer or similar Identifying number. Attach deed for }ointly-held real estate. TOTAL (Also enter on line 6, Recapitulation) (If more space is needed, insert additional sheets of the same size) $ 845.17 REV.1511 EX+(12-99) .. SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF FILE NUMBER Debts of decedent must be reported on Schedule I. ITEM NUMBER A. B. 1. 2. 3. 4. Probate Fees 5. 6. TOTAL (Also enter on line 9, Recapitulation) $2,194.90 (If more space is needed, insert additional sheets of the same size) llU~ !to' REV qt8tJ. This is to certify that the infonnation here given is correctly copied from an original certificate of death duly filed with me as . Local Registrar. The original certificate will be forwarded to the State Vital Records Office for pennanent filing. WARNING: It Is lIIegsl to duplicate this copy by photostat or photograph. j'" t2nm- fJ?~ Local Registrar Fee for this certificate, $2.00 -- .-, \. '.' ., C^n.\ ...1...'" \.) 0 C..H.J"t No. Dale ,,!i143R.w2/el COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS CERTIFICATE OF DEATH .TATE 'U!NUMI!ft ~tate 11'. '"" 3609 Kohler Place, Apt. 12 .~Camp Hill, PA 17011 FATHER"SfWHlFlrIl........lal) .. Wilbur Loach ~TEOFDEATH(Monln,o.,. '1'-.) . . J;.,,., 1 20 4 NAME OF OECEOEHT (Finl MldlIe. l.Ul) t. G. Jane Henry .AGE(...It~1 .. Cumberland DECEDEH'rS USUAL oco...ATION ... ..--.., ;-.....- 0_ =0 WAS DECEDENT OF HISPANIC 0FtlGIN'? ttolll..,.n".,...1J*:iffcw.n. Md!In. ~Ran." . '" 80 Vtl. COlJHTV OF DEATH -0 -0 ::;:"'0 .~Incs.n,BlIc:II,"""'" ,- to. white SUfMIIING SPOUSE er.......__1 "0 Mana er Government I DECEOENT'S ACTUAL .......... ,,,,- onOlrlerU.1 MARITAL STATUS. UMlML --....,. ~(Spdy) divorced .. t~CoIrtv '" - Cumberland ~" 114.0 :;"'-=-':::01 MOTHER'S NAMe (FlnI. MidlIa...... ~ 11. Gertrude Cecelis Bartolet INFORMANTS MAIlING AOORUS (SnII. CllylTown. SIIIlilI. ZIp Coil) .. 10308 Leona Avenue Leona Valle CA 93551 PlACEOf' CllSPOSlTIOf4.""'" rIlc.n..,.. CterMIay lOCATION. Cilylfooon. 51-'-. ZlpCodl <<-- 21c. Yorktowne Crematory Itd. York. PA 17404 l'WIlEANDADOftESSOfFAClUTY ar emore ne. u.P.O. Box 431 New Cumberland 70-04 UCENSE NUMefR ~ 0.,. ~.-! U. ........."""""'"'" v.. No 0 PAIilTII: ""*IIgniIItInl:QOf\lIllclM~la-'1lUI f\CIlr-*ingin_~_giwMinPAATI. 17'- iI V...dIcelWIllwclin Hampden .... ..- .... Edward Henr DATE cw CllSPOStTtOM -0 ....0"""-6(1.--....0 0 -.....,-. 2004 11.. 0Iw~) 21b. June 3. OR PERSON ACT\Nl3 AS SUCH. . lICENSE MJM8ER .... PD 013 340 L =:"'t..~ dIflf\OCQItW.....~. dMe..pIIeI.... .... TIME OF DEATH DATE EDOEAD(Monlh.OlIJ.V-.) .. 1\:'-\0 P...... Onf' I 7-0 ' D.PAllTt ..............-...,..................................... D.__...........,..,.._..-....,..........,.--.~._....... UII...,___...._ o J (, J') .,,,,......... ,.'-..,1).....,..../ " t I( "'1./ ~~.I .,t;.l~~ E WANNER OF DEATH l),f,Te OF INJURY TIME Of IH./URY ~o.,.'I'''1 -- ~ - 0 _ 0 ......._ 0 .-ONoO O 0 0 CUlll1l1bedMrnll'lld 0 ilia. ... M. *" '(.. No ~ PlACEOFlNJUR'I'./lJIlOl'ne.......lIiClor'I.oIlca ........ ~....(tpMIr) ;.... . .. .. ~IC"_u"'_1 .... . ..,; . ." SlGNATURIANDTlTU!C;lFCOruru ~~~:="~~~'~'~'~'~'~"''''''''''''';;'~ ~-....'.))'\..-... ."".......,...........'"' ":..a=~CI~o..,"==~~~C::=::l~::=':'=-"WblL.....................Da1'- "",>Q"1j'.:.1)'-L 1d....-..- '\.. \._."''-1 HoWE AND AClORESS OF PERSON WtO CClMfI\fTED CAUSE OF DEATH .IlIIDICALDA..lVCOno.... (....Z7)TpOl'PmI')-..o A T' .....-, "'.,. :.=::::...~~~:~.~~~.~..~.~~.~.~.~.~.~.~.~~.~~.~~.~~.~..O J' "';{ ~J....J._ ..~...~........., J ".. J' I IlIOIITIWrI TUM AflO ,~~ DATE FUD IMcwlet. 0." '(lilt) _ /?? "d,..4._ff' J,.21/~ /VI .. (/ 1>-- 9 - 0 <.( OEe 0 6 2004 ff G.JANEHENRY ) IN THE COURT OF COMMON PLEAS ) OF CUMBERLAND COUNTY, PENNSYLVANIA ) ORPHANS' COURT DMSION ) ) NO. ~ I . 2004 - 1/ D'1 ) ) INRE: Deceased ORDER OF COURT AND NOW, this '7-tL day of 00 {'I _ . 2004, it appearing to the Court that there is no need for further notice, and that the interests of justice warrant, it is hereby ordered and decreed as follows: 1. Petitioner shall have the authority to collect all assets of the estate of the decedent, execute such transfer documents, including but not limited to Motor Vehicle forms, as are necessary or desirable in connection with such assets, and otherwise administer the estate of the decedent 2. Petitioner shall pay the debts and expenses identified in the Petition, and as otherwise becoming known to Petitioner, administration expenses' including reasonable counsel fees, and, if necessary, sign, file and pay Pennsylvania inheritance taxes and federal and state and local income taxes. 3. Petitioner shall distribute the balance, if any, to Petitioner as sole heir. 4. Upon completion of the foregoing steps, Petitioner shall be free of any further duty or obligation in connection with the ~ministration and distribution of the estate of decedent DYTHE COURT: l'5/.J1Rm~~f Htlt,1r ~J. . . ?-~.~ " ....:-.,..~. '.':"':-~'" -.- '!".~,:,"!,:,;"!,:".,.,.,, .._ ~ .~.. .' d. .ow" .. . A Family Tradition Of Caring PARTHEMORE Funeral Home & Cremation Services, Inc. Mr. Edward Henry 10308 Leona Avenue Leona Valley, CA 93551 61212004 1303 Bridge Street P.O. Box 431 New Cumberland, PA 17070 (717) 774-772\ (Fax) 774-5546 www.pafthemore.com We sincerely appreciate the confidence you have placed in us and will continue to assist you in every way we can. Please feel free to contact us jf you have any questions in regard to this statement The following is an itemized statement of the services, facilities, automotive equipment and merchandise that you selected when making the funeral arrangements. r== Tenns Due Date I Net 30 7/212004 Description Direct Cremation for G. Jane Henry Account # --1 2004042.1 Amount 1,070.00 Total Services and Merchandise 1,070.00 Gilbert W. Parthemore, Founder Death Notice, Harrisburg Patriot Certified Copies of Death Certificates Cumberland County Coroner Fee, Cremation Authorization 57.90 20.00 25.00 Gilbert J. Parthemore, Supervisor Total Cash Advances 102.90 Stephen K. Parthemore, CFSP Bruce R. Parthemore, Pre-Need Coordinator, CPC ~ ~Ato v.. '100, Professional Memberships: NFDA . PFDA DC FDA . CCFDA ~ ~ The Rule You Know, The People You Trust ~(!/ c-<<~~ ~ it=- ";),.~ 5"t- '-"-- Total Payments/Credits Balance Due $1,172.90 $0.00 ~ $1,172.90 9-5-04 Robert Spitzer 2401 North Front St. P.O. Box 12087 Ref: your letter to me dated 8-24-04 eff 1 3 2004 Dear Bob, Please pardon the delay in getting this information to you but here it finally is. I. Copy of my mothers divorce papers. 2. Copy ofKeUey's blue book car value taking from internet. 3. Mother's tangible personal property consisted of furnished apartment. Total value approximately $3,000.00. Jewelry approximate value $1,500.00. Furniture was given to her friends and the church. A few jewelry items my daughter took. That's it! 4. Yes, my mother was getting social security. I notified them of her death. Hope this helps you with your task. Best wishes, a G ~ Henry Kelley Blue Book - Private Party Pricing Report - Ford, Escort Page 1 of2 _!!!-...= 'f' (~' \",' - _...-~..-. ... ,1;., ,t ~;. 1'''- ,;0-" - - ,-~.' /.... .)' l' ' . .1 ,'\ I 'j ~ .,~ . -,_......,... !.:....._~ -.Jl:.:.~l 'I~, ~_ . )1, ',Y1\ '- -.A } UUDCAIl8 ~E" E,'IS IIr. ii/"T ~G" tlS',I:E '1~;'~~:I"'::":o;, """,u"'fJo,, E 0,.,.. D.~rPiIii~..' O......UMd ca...... I BLUE BOOK PRIVATE PARTY mORT California. September 8, 2004 A, SPECIAL OFFE 1998 Ford Escort LX Sedan 40 , , ~ J.. >- ~ 'II~- ._., -~- ... , '. , . 1....- ___ I ..- -" S~~.r:.ch_Ljstings fOJ This Car List Your Car For Sale Online Buv a New Car Free Record Check Auto Loans from 3.75% APR Insurance Ouote Print "For Sale" Sian Pavment Calculator iF . FJ~,tcst W;:>b browsin yet with AOL' TopS.pet'-d'. Technolo . [, ni;Jil Viru~ Protectio Inc!udeJ . B!CCK Web POPlJP5 Engine: 4-Cyl. 2.0 Liter Trans: Automatic Drive: Front Wheel Drive Mileage: 7,200 Equipment Air Conditioning Power Steering Power Windows Tilt Wheel AM/FM Stereo Dual Front Air Bags Consumer Rated Condition: Excellent "Excellent" condition means that the vehicle looks great, is in excellent mechanical condition and needs no reconditioning. It should pass a smog Inspection. The engine compartment should be clean, with no fluid leaks. The paint Is glossy and the body and interior are free of any wear or visible defects. There is no rust. The tires are the proper size and match and are new or nearly new. A clean title history is assumed. This is an exceptional vehicle. Private Party Value Search Local Listinas for This Car $3,945 Private Party value represents what you might expect to pay for a used car when purchasing from a private party. It may also represent the value you might expect to receive when selling your own used car to another private party . Get a Used Car Trade-In Value Get Invoice 8t. MSRP on New Cars Get a Person to Person Auto Loan http://www.kbb.comlkblki.d11/kw.kc.ur?kbb.CA;531 077;CA037&93551 ;+p&722;Ford; 199... 9/8/2004 JU.. -06-2004 11 : 42 PSECU P.02/B4 PSEC4; the flnanolalllnk", July 6, 2004 Robert C. Spitzer 407 N. Front Stmlt HanisblD'g,PA 17101 RE: G. Jane Henry, Deceased Account # 8701906540 Dear Attorney Spitzer: The following are the Date of Death Balance's for a.lane Henry's accounts with PSEClJ: A_D.t Date 01 OtIat. BalaaUl Aeeraed I.terest Savings Checking Visa Loan (81) (54) (L9) 55.01 SI,690.33 S7,424.97 SO.OO SO.OO The account was opened AprIl 21, 1983. The account was held jointly with D. Edward Henry. The acCOWlt was made joint Dcc:embcr 23,1991. If the Estate has sufficient funds to payoff the above loan, please remit a check, made payable to PSEClJ, in the amount of 57,424.97. If there are not sufficient fIInds to payofflhc loan, please provide PSEClJ with a letter stating this fact. If you have any questiOOl, please contact me at (717) 234-8484 or toll-free at (800) 237- 7328, then preIS 6, extension 3120. Sincerely, ~1.~ Suannc: E. Fal1r AecountAdvlsor ".IlIlDYLVAIIIA STAT. .MOILOy.e. CIl.OIT UNION Main Add'..., 1 Crwdll UnIOn _. H._'ll. PA 17110.Z980. (7171234........ (1001231.7U. MoIli"V Add,...: ~.O. 1Jo" 87D13, H.rrlelMII't, PI" 171oe-7013 . (717) 717.2100 ("1"00) . (BOO) .72.'"7 (TOO) Web Adc:INII.: www'Eiaam .............., I...... .. .. .1..... .. ... aMIt U.I... AHlIftI.......... RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Orphans Court One Courthouse Square Carlisle, PA 17G13-3387 Receipt Date: Receipt Time: Receipt No.: 12/03/2004 14:34:39 1025930 HENRY G JANE File Number: Paid By Remarks: 2004-01109 ROBERT SPITZER JA ------------------------ Receipt Distribution ------------------------ Fee/Tax Description Payment Amount Payee Name PET SETTL SM ESTAT ORDER JCP FEE Cash Total Received......... 9.00 3.00 10.00 ---------------- $22.00 $22.00 CUMBERLAND COUNTY GENERAL FUN CUMBERLAND COUNTY GENERAL FUN BUREAU OF RECEIPTS & CNTR M.D COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT.2B0601 HARRISBURG, PA 17128-0601 REV-"62 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SPITZER ROBERT C 2401 N FRONT ST BOX 12087 HARRISBURG, PA 17108 uuuu lold ESTATE INFORMATION: SSN: 187-16-4455 FILE NUMBER: 21QO 0000 OL\ - \l09 DECEDENT NAME: HENRY G JANE DATE OF PAYMENT: 03/24/2005 POSTMARK DATE: 03/24/2005 COUNTY: CUMBERLAND DATE OF DEATH: 06/01/2004 NO. CD 005118 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $285.28 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 2661 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $285.28 GLENDA FARNER STRASBAUGH REGISTER OF WillS 06-20-2005 HENRY 06-01-2004 21 04-1109 CUMBERLAND 101 APPEAL DATE: 08-19-2005 ( See reverse side under Objections) Amoun1: Rni1:1:edl I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE _ RETAIN LOWER PORTION FOR YOUR RECORDS - REY:is47-Ex-AFP-io3:os3-NOTICE-OF-INHERITANCE-TAX-APPRAISEMENT:-ALLONANCE-OR--------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX G J FILE NO. 21 04-1109 ACN 101 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAK DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLOWANCE DR DISALLOWANCE OF DEDUCTIONS AND ASSESSHENT OF TAX = JU:: ; 7 I C:(". l: ..;J DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN t"i t ROBERT c=si>'ifzER BOX 12087 2401 N FRONT ST HBG PA 17108 ESTATE OF HENRY *' REV-1547 EX AFP (06-05) G J TAX RETURN WAS: (X) ACCEPTED AS FILED ) CNAIl6ED DATE 06-20-2005 I~ an asseSSMen'!: was issued previously, lines 14, IS and'or 1&, 17, 18 and 19 will re~lec1: ~igures 1:ha1: include 1:he 1:01:a1 o~ ALL re1:urns assessed 1:0 da1:e. ASSESSMENT OF TAX: 15. Anount of Line l~ at Spousal rate 16. A.aunt of Line 14 taxable at Lineal/Class A rat. 17. A.aunt of Line 14 at Sibling rat. 18. AMount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due X C IT. 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/Hisc. Personal Property (Schedule EJ 6. .Jointly Owned Property (Schedule f) 7. Transfers (Schedule G) 8. Total Assets (1) (2) (3) (4) IS) (6) (7) .00 .00 .00 .00 7.695.34 845.17 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. funeral Expenses/A~. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Govern.ental Bequests; Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 2,194.90 .00 Ill) (12) (13) (14) NOTE: + (15) .00 X 00 = (16) 6,339.61 X 045 = (17) .00 X 12 = (18) .00 X 15 = (19)= AHOUNT PAID 285.28 DATE 03-24-2005 NUHBER CD005118 INTEREST/PEN PAID (-) .00 ~ TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE NOTE: To insure proper credit to your account, submit the upper portion of this for. with your tax paYllent. 8,540.51 2 lQG. QO 6,345 . 61 6.00 6,339.61 .00 285.28 .00 .00 285.28 285.28 .00 .90 .90 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. I IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FOHN FOR INSTRUCTIONS.)