The URL can be used to link to this page

Home My WebLink About04-30-14 IN RE: COURT OF COMMON PLEAS OF ESTATE OF THOMAS G. MULDER, CUMBERLAND COUNTY PENNSYLVANIA LATE OF CARLISLE BOROUGH ORPHANS COURT DIVISION NO. 2013-01024 PETITION FOR SETTLEMENT OF A SMALL ESTATE AND NOW, comes Petitioner, Paul C. Mulder, by and through his counsel, Bradley L. Griffie, Esquire, and the law firm of Griffie & Associates, P.C., and petitions the Court as follows: 1. Your Petitioner is Paul C. Mulder, an adult individual currently residing at 55 East Penn Street, Carlisle, Cumberland County, Pennsylvania. 2. Your Petitioner is the Executor of the estate of his brother, Thomas G. Mulder„ who passed away on December 5, 2012. 3. Your Petitioner was appointed as Executor of the estate of Thomas G. Mulder on z September 24,2013. 4. Petitioner is the natural brother of the decedent, Thomas G. Mulder, and decedent was also survived by another brother, Richard P. Mulder, of 4798 Birch Drive, Preston, Maryland, 21655. 5. The assets in decedent's possession at the time of his death was limited to the following: (A) PNC Bank $ 550.00 Checking Account No. XXXXXX7362 N (B) PNC Bank 21151.62 c rn Checking Account No. XXXXXX3648 ° C>> O - n (C) PNC Bank .60 ;, wo . Checking Account No. XXXXXX3965 = (0 o Z3 o ~ m 'off (D) Metro Bank 97.40 Checking Account No.,XXXXX6867 (E) 2004 Toyota Camry 4,188.00 (F) 2013 Personal Income Tax Refund 584.00 (Estimated) TOTAL $ 6,987.62 6. The only asset received by the estate after decedent's death was a 2012 personal income tax refund of$594.00 7. The estate incurred the following expenses that were costs of administration of the estate: (A) Family Exemption $3,500.00 . (B) Probate Fees 163.50 (C) Advertising to the Sentinel 168.30 (D) Advertising to the Cumberland Law Journal 75.00 (E) Accountant fees (Tax preparation) 250.00 (F) Attorney's fees 2,000.00 TOTAL $6,156.80 8. In addition, the decedent, at the time of his death, had the following indebtedness due and owing to the named parties: (A) Convergent Healthcare Recoveries, Inc. $ 175.00 124 SW Adams Street Suite 215 Peoria, IL 61602 (B) CBCS 574.62 PO Box 165025 Columbus, OH 43216-5025 (C) Apex Asset Management, LLC 20.05 2501 Oregon Pike, Suite 102 Lancaster, PA 17601-4890 (D) Capio Partners 324.92 2222 Texoma Pkwy, Suite 150 Sherman, TX 75090 (E) Associated Otolaryngologists of PA, Inc. 13.54 875 Poplar Church Road, Suite 320 Camp Hill, PA 17011 (F) Hospitalists of Central Pennsylvania 13.60 PO Box 62722 Baltimore, MD 21264-2722 (G) Chase 165.00 Cardmember Service PO Box 15298 Wilmington, DE 19885-5298 (I) HSBC Card Services 569.86 PO Box 80084 Salinas, CA 93912-0084 (J) Mid America Bank & Trust Company 2,015.62 PO Box 5217 Sioux Falls, SD 57117-5217 (K) Paragon Revenue Group 65.21 216 Le Phillip Court Concord,NC 28025-2954 (L) Phillips & Cohen Associates, Ltd. Unknown Mail Stop: 9500 1002 Justison Street Wilmington, DE 19801-5148 (M) Critical Care Systems, Inc. 83.88 PO Box 52741 Phoenix, AZ 85072 (N) Allied Interstate 200.00 Healthcare Division PO Box 361596 Columbus, OH 43236-1596 (0) University of Rochester Medical Center 263.06 Strong Memorial Hospital Patient Accounts Office 601 Elmwood Avenue Rochester,NY 14642 (P) Card Services 229.56 PO Box 13337 Philadelphia, PA 19101-3337 (Q) Tristate Infectious Diseases 15.00 Office of Sheikh Parviz PO Box 387 Hagerstown, MD 21741-0387 TOTAL $ 8,187.08 9. To date, all costs and fees paid associated with administration of the estate as previously identified have been paid from the probate assets. 10.. A Pennsylvania Inheritance Tax Return was filed and approved as an insolvent estate, a copy of said Notice of Inheritance Tax Appraisement, Allowance or Disallowance of Deductions and Assessment of Tax being attached hereto and incorporated herein by reference as Exhibit "A". 11. The automobile loan due and owing to Wells Fargo, with the balance of $1,361.06, served as a lien on the decedent's automobile, which automobile was the largest valued asset of the decedent, and, as such, said loan was obligated to be paid in full in order to release the lien and make the vehicle available as an asset to the estate. 12. After payment of costs of administration of the estate and the automobile loan that serves as a lien, the funds remaining available in the estate totals $63.76. 13. Of the remaining debts of decedent previously referenced, there are multiple, nominal medical bills for services provided to decedent within six (6) months of death, thereby being class (3) priority claims, including the following: (A) Critical Care Systems (7/5 to 7/30/12) $ 83.88 (B) TriState Infectious Disease (7/26/12) 15.00 (C) Carlisle Regional Medical Center Unknown (D) Walnut Bottom Radiology LLC (6/27/12) 20.00 (E) Carlisle Medical Group LLC (8/2/12) 25.00 (F) Pinnacle Health Hospitals (7/23/12) 20.00 (G) Boiling Springs Medicine(10/4/12) 20.05 (H) Carlisle RMC (8/14/12) 200.00 (1) Carlisle RMC (6/24/12) 65.00 (J) Carlisle RMC (7/5/12) 200.00 (K) Associated Otolaryngologists of PA (10/16/12) 13.54 (L) Hospitalists of Central PA (8/14/12) 13.60 14. In addition, Carlisle Regional Medical Center provided class (3) priority services to decedent in a sum greater than $2,250.00. 15. Petitioner proposes to release the sum of$63.76 to the Carlisle Regional Medical Center as a contribution toward its priority (3) claim, and that all other claimants listed in paragraph 8 above have their claims extinguished. 16. There are no assets to provide any distribution to any heirs of decedent's estate. WHEREFORE, Petitioner requests your Honorable Court to enter an Order of Court and Rule to Show Cause upon the hereinafter named creditors or collection agencies, to show cause, if any they have, as to why their claims should not be discharged and extinguished due to the insolvency of this estate with the exception of distribution of $63.76 to Carlisle Regional Medical Center, with no distribution to heirs, and why this estate should not be settled as so proposed: (A) Convergent Healthcare Recoveries, Inc. 124 SW Adams Street Suite 215 Peoria, IL 61602 (B) CBCS PO Box 165025 Columbus, OH 43216-5025 (C) Apex Asset Management, LLC 2501 Oregon Pike, Suite.102 Lancaster, PA 17601-4890 (D) Capio Partners 2222 Texoma Pkwy, Suite 150 Sherman, TX 75090 (E) Associated Otolaryngologists of PA, Inc. 875 Poplar Church Road, Suite 320 Camp Hill, PA 17011 (F) Hospitalists of Central Pennsylvania PO Box 62722 Baltimore, MD 21264-2722 (G) Chase Cardmember Service PO Box 15298 Wilmington, DE 19885-5298 (I) HSBC Card Services PO Box 80084 Salinas, CA 93912-0084 (J) Mid America Bank & Trust Company PO Box 5217 Sioux Falls, SD 57117-5217 (K) Paragon Revenue Group 216 Le Phillip Court Concord,NC 28025-2954 (L) Phillips & Cohen Associates, Ltd. Mail Stop: 9500 1002 Justison Street Wilmington, DE 19801-5148 (M) Critical Care Systems, Inc. PO Box 52741 Phoenix, AZ 85072 (N) Allied Interstate Healthcare Division PO Box 361596 Columbus, OH 43236-1596 (0) University of Rochester Medical Center Strong Memorial Hospital Patient Accounts.Office. 601 Elmwood Avenue Rochester, NY 14642 (P) Card Services PO Box 13337 Philadelphia, PA 19101-3337 (Q) Tristate Infectious Diseases Office of Sheikh Parviz PO Box 387 Hagerstown, MD 21741-0387 Respectfully submitted, 1 f B G ' fie,Esquire ney forpet'itioner upreme Court ID No. 34349 200 North Hanover Street Carlisle, PA 17013 (717) 243-5551 (800) 347-5552 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: 11 2 t l/ Paul 4uer IN RE: COURT OF COMMON PLEAS OF ESTATE OF THOMAS G. MULDER, CUMBERLAND COUNTY PENNSYLVANIA LATE OF CARLISLE BOROUGH ORPHANS COURT DIVISION NO. 2013-01024 CERTIFICATE OF SERVICE I, Bradley L. Griffie, Esquire hereby certify that I did, the K day of April, 2014, cause a copy of the within Petition for Settlement of a Small Estate to be served upon all creditors and collection agencies, and upon the heir, Richard P. Mulder, by first class mail, postage prepaid, at the following addresses: (A) Convergent Healthcare Recoveries, Inc. 124 SW Adams Street Suite 215 Peoria, IL 61602 (B) CBCS PO Box 165025 Columbus, OH 43216-5025 (C) Apex Asset Management, LLC 2501 Oregon Pike, Suite 102 Lancaster, PA 17601-4890 (D) Capio Partners 2222 Texoma Pkwy, Suite 150 Sherman, TX 75090 (E) Associated Otolaryngologists of PA, Inc. 875 Poplar Church Road, Suite 320 Camp Hill,PA 17011 (F) Hospitalists of Central Pennsylvania PO Box 62722 Baltimore, MD 21264-2722 (G) Chase Cardmember Service PO Box 15298 Wilmington, DE 19885-5298 (I) HSBC Card Services PO Box 80084 Salinas, CA 93912-0084 (J) Mid America Bank & Trust Company PO Box 5217 Sioux Falls, SD 57117-5217 (K) Paragon Revenue Group 216 Le Phillip Court Concord,NC 28025-2954 (L) Phillips & Cohen Associates, Ltd. Mail Stop: 9500 1002 Justison Street Wilmington, DE 19801-5148 (M) Critical Care Systems, Inc. PO Box 52741 Phoenix, AZ 85072 (I) Allied Interstate Healthcare Division PO Box 361596 Columbus, OH 43236-1596 (0) University of Rochester Medical Center Strong Memorial Hospital Patient Accounts Office 601 Elmwood Avenue Rochester,NY 14642 (P) Card Services PO Box 13337 Philadelphia, PA 19101-3337 (Q) Tristate Infectious Diseases Office of Sheikh Parviz PO Box 387 Hagerstown, MD 21741-0387 (R) Richard P. Mulder 4798 Birch Drive Preston, MD 21655 DATE: Griffie,Esquire orn y for Petitioner NOTICE OF INHERITANCE TAX T pennsylvania BUREAU OF INDIVIDUAL TAXES APPRAISEMENT, ALLOWANCE OR DISALLOWANCE DEPARTMENT OF REVENUE INHERITANCE TAX IVIDUA OF DEDUCTIONS AND ASSESSMENT OF TAX REV-1547 EX AFP (06-13) PO BOX 260691 - HARRISBURG PA 17126-6601 DATE 03-17-2014 ESTATE OF MULDER THOMAS G DATE OF DEATH 12-05-2012 FILE NUMBER 21 13-1024 COUNTY CUMBERLAND GRIFFIE BRADLEY L ACN 101 200 N HANOVER ST APPEAL DATE: 05-16-2014 CARLISLE PA 17013-2423 (See reverse side under Objections) 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--4- ------------------- REV-1547 EX AFP (08-133 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR -- - DISALLOWANCE OF DEDUCTIONS AND .ASSESSMENT OF TAX . - - - -- -- - ESTATE OF: MULDER THOMAS GFILE NO. :21 13-1024 ACN: 101 DATE: 03-17-2014 TAX RETURN WAS: (X) ACCEPTED AS FILED ( ) CHANGED APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) .00 NOTE: To ensure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C3 (3) .00 submit the upper Portion of this form with your 4. Mortgages/Notes Receivable (Schedule D) (4) .00 tax payment. S. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 7,581 .62 6. Jointly Owned Property (Schedule F) C6) .DO 7. Transfers (Schedule G) t7) .00 B. Total Assets (B) 7.581 .62 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule N) (g) 6.156.80 10. Debts/Mortgage Liabilities/Liens CSchedule I) (10) 8,167.08 11. Total Deductions C1I) 14,343.88 12. Net Value of Tax Return (12) 6,762.26- 13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule J) (13) 100 14. Net Value of Estate Subject to Tax (14) 6,762.26- NOTE: If an assessment was issued previously, Lines 14, 15, 16, 17, 18 and/or 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 ..___ ... ,.. . .,__S 15? .00 X,,,00,. = .00 _ ..._ .. 16. Amount of Line 14 taxable at lineal rate (16). -nn X 045 = .00 17. Amount of Line 14 at sibling rate (17) .n0 X 12 = .00 18. Amount of Line 14 taxable at collateral rate (18) .00 X 15 = .00 19. Principal Tax Due {34}= .00 TAX CREDITS: PAYMENT RECEIPT DISCOUNT C+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) TOTAL TAX PAYMENT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 IF PAID AFTER DATE INDICATED, SEE REVERSE IF TOTAL DUE IS REFLECTED AS A CREDIT (CR), YOU MAY BE DUE FOR CALCULATION OF ADDITIONAL INTEREST. A EfUyq. REEF, REVERSE SIDE FOR INSTRUCTIONS. 1