HomeMy WebLinkAbout08-15-14 IN RE: ESTATE OF CALANTHA T. : 1N THE COURT OF COMMON PLEAS OF
BIXLER, deceased : CUMBERLAND COUNTY, PENNSYLVANIA
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: ORPHANS COURT DIVISION c-> �_' :a-,
. ESTATE NO. 21-14- "�(�� ��-' �.. -;=' `=-'-'
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PETITION FOR SETTLEMENT OF SMALL ESTAT�� '�, �;, �r;`LY.�
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To the Honorable Judge of the said Court: '
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The Petition of Susan E. Cowley, Sally A. Bobb and William H. Bixler, Jr�'children�d ���
heirs of Calantha T. Bixler,respectfully represent:
l. The Petitioners are Susan E. Cowley, Sally A. Bobb and William H. Bixler,Jr. who
are the children and heirs of Calantha T. Bixler.
2. William H. Bixler, Sr., spouse of Calantha T. Bixler, died November 22, 2013, leaving
to survive him the aforesaid children.
3. Calantha T. Bixler died September 3, 2006, a resident of South Middleton Township,
Cumberland County, Pennsylvania. Since all assets were held jointly with her husband, William
H. Bixler, Sr., no estate was opened.
4. Recently,the heirs have been contacted by the Settlement Facility representing the
Dow Corning Trust regarding the award of money in connection with a medical class action suit.
A copy of the letter is attached hereto, incorporated herein and marked Exhibit"A"
5. The heirs have been advised that the settlement may be in the amount of$5,000.00,
however the amount has not been confirmed in writing. In order to issue a settlement check,the
Settlment Facility requires a Court Decree.
6. The names and addresses and relationships of all persons having an interest in the
estate of the decedent as heirs or next of kin are as follows:
Susan E. Cowley 216 Pintail Lake Drive, Gilbert, SC 29054 Daughter
Sally A. Bobb 275 High Mountain Road, Shippensburg, PA 17257 Daughter
William H. Bixler,Jr. 60 Lindsay Lane, Carlisle, PA 17015 Son
7. The decedent was not survived by any person entitled to claim the family exemption
under 20 Pa.C.S.A. Section 3121.
8. The total value of the decedent's personal estate is less than$10,000.00 and consists
solely of the proposed settlement from the Dow Corning Trust.
9. The expenses of the decedent's last illness and funeral have been paid and there are no
creditors of the decedent.
10. A Pennsylvania lnheritance Tax Return based on the projected amount is attached
hereto and marked Exhibit"B" and the tax due upon the decedent's estate will be paid upon
receipt of the settlement.
11. It is proposed that the following distribution of the decedent's personal estate be
made to the following creditors and heirs:
Cumberland County Register of Wills, filing fee $ 70.50
Register of Wills,Agent-Inheritance tax 499.33
Duncan&Hartman, P.C. - Legal fees 500.00
Susan E. Cowley 1409.99
Sally A. Bobb 1409.99
William H. Bixler, Jr. 1409.99
WHEREFORE, your Petitioners respectfully request your Honorable Court issue a decree
directing the distribution of the decedent's personal estate to the persons entitled thereto as set
forth in Paragraph 11 as set forth above.
Respectfully submitted,
Susan J. Hartm ire
Attorney for Petiti ers
1 Irvine Row, Carlisle, PA 17013
Attorney ID 65184
717-249-7780
susan @ duncanhartmanlaw.com
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VERIFICATION
The undersigned,having read the attached Petition,hereby verifies that the facts set forth
therein are true and correct to the best of his/her knowledge, information and belief.
This verification is made subject to the penalties of 18 Pa.C.S. section 4904 pertaining to
unsworn falsification to authorities.
, ,.
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S�lly A. Bo b
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VERIFICATION
The undersigned, having read the attached Petition, hereby verifies that the facts set forth
therein are true and correct to the best of his/her knowledge, information and belief.
This verification is made subject to the penalties of 18 Pa.C.S. section 4904 pertaining to
unsworn falsification to authorities.
�
iam H. ixler, Jr�
VERIFICATION
The undersigned,having read the attached Petition,hereby verifies that the facts set forth
therein are true and correct to the best of his/her knowledge, information and belief.
This verification is made subject to the penalties of 18 Pa.C.S. section 4904 pertaining to
unsworn falsification to authorities.
Susan E. Cowley
S F � c T
S E T T L E 1H E N Y F A C t L 1 T Y
�OW CORN[NG TRUST
P.O.Box 52429 Telephone 713.874.6099
Houston,Texas 77052 866.874.6099
July 08, 2014
I II I III�IIIV IIIIIIIIIIIIIIIIIIII IIII SI D: 6070812
CALANTHA BIXLER
60 LINSAY LANE
CARLISLE, PA 17013
UNITED STATES OF AMERICA
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Partial Premium Payment Award Letter
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CALANTHA BIXLER— Rupture-Premium - � ,��� : 00
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Dear CALANTHA BIXLER: `��,
The District Court has approved partial Premium Pa ��.s to Eligible ""Y�'nants who w aid a Base
Payment for Rupture or Disease. The ty. emiu �° :ment is list ove. On ;.. d letter will be
sent for each eligible Premium Paym ��� ' ill b ed in t y��ler in which B'ase payments
were issued.
Checks are nor r� ree we ' fter this letter. :�' cks wr1 �� :ayable to you and your attorney, if
you are repre
Receipt of . = e Payment for Rupture �_ � ase is guarantee of remium Payment. To be
eligible for . emium Payment, your clai , � � definition of an Eligible claim as set forth in
Article V o � ex A; all asserted lie st be d and the claim must meet an acceptable level of
reliability. I � r claim does not mee ibility criteria, your Premium Payment may be delayed or you
may not be e for a Premium Pay'
For more infor n how Premiu ments are calculated and when your check will be issued,
please visit our we . www.dcs�,�,�`e�„� nt.com or contact a Claims Assistance Representative toll free
at 866-874-6099.
Sincerely,
Payment Department
Settlement Facility-Dow Corning Trust
CC:
PT-9032
For assistance or questions call the Claims Assistance Program at 1.866.874.6099(toll free)
Or go to www.dcsettlement.com on the Internet
� 150561�140
REV-1500 EX (02-11)(FI)
OFFICIAL USE ONLY
PA Department of Revenue Coun Code Year File Number
Bureau of Individual Taxes INHERITANCE TAX RETURN ty
PO BOX 280601
Harrisburq,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
0 9 0 3 2 0 0 6 0 4 1 6 1 9 2 8
DecedenYs Last Name Suffix DecedenYs First Name MI
B I X L E R � A L A N T H A T
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
a 1.Original Return � 2. Supplemental Return � 3. Remainder Return(Date of Death
Prior to 12-13-82)
� 4. Limited Estate � 4a. Future Interest Compromise(date of � 5. Federal Estate Tax Return Required
death after 12-12-82)
� 6. Decedent Died Testate � 7. Decedent Maintained a Living Trust 8.Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust.)
� 9. Litigation Proceeds Received � 10.Spousal Poverty Credit(Date of Death � 11. Election to Tax under Sec.9113(A)
Between 12-31-91 and 1-1-95) (Attach Schedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAI TAX INFORMATION SHOULD BE DIRECTED T0:
Name Daytime Telephone Number
S U S A N J • H A R T M A N 7 1 7 2 4 9 7 7 8 0
REGISTER OF WILLS USE ONLY
First Line of Address
1 I R V I N E R 0 W
Second Line of Address
City or Post Office State ZIP Code DATE FILED
C A R L I S L E P A 1 7 � 1 3
CorrespondenYs e-mail address: SUS811@dU11C211haf'�CYlaf118W.COf11
Under penalties of pery'ury,I declare that I have examined this return,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 information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN DATE
ADDRESS
60 LINDSAY LANE CARLISLE PA 1707,5
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE DATE
ADDRESS
PLEASE USE ORIGINAL FORM ONLY
Side 1
� 1505610140 15D5610140 �
� 1505610240
REV-1500 EX(FI) DecedenYs Social Security Number
DecedenYsName: CALANTHA T • BIXLER 1 6 2 2 2 3 8 6 2
RECAPITULATION
1. Real Estate(Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. •
2. Stocks and Bonds(Schedule B) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. •
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C) . . . . . 3. •
4. Mortgages and Notes Receivable(Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . 4. •
5. Cash, Bank Deposits and Miscellaneous Personal Property(Schedule E). . . . . . . 5. 5 � � � • � �
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested . . . . . . . 6. •
7. Inter-Vivos Transfers&Miscellaneous N -Probate Property
(Schedule G) � Separate Billing Requested . . . . . . . 7. 0 , � �
8. Total Gross Assets(total Lines 1 through 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 5 � � � , � �
9. Funeral Expenses and Administrative Costs(Schedule H) . . . . . . . . . . . . . . . . . . 9. 5 7 0 . 5 ❑
10. Debts of Decedent,Mortgage Liabilities,and Liens(Schedule I) . . . . . . . . . . . . . 10. •
11. Total Deductions(total Lines 9 and 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 5 7 0 . 5 �
12. Net Value of Estate(Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. 4 4 2 9 . 5 �
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J) . . . . . . . . . . . . . . . . . . . . . . 13. .
14. Net Value Subject to Tax(Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . . 14. 4 4 2 9 . 5 0
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.0 _ � . � O 15. O . � �
16. Amount of Line 14 taxable
at�inea�rate X.045 4 4 2 9 . 5 0 �s. 1 9 9 . 3 3
17. Amount of Line 14 taxable
at sibling rate X.12 � . � � 17. 0 . � 0
18. Amount of Line 14 taxable
at collateral rate X.15 � • 0 � 18. � . � �
19. TAX DUE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19. 1 9 9 . 3 3
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT �
Side 2
� 1505610240 1505610240 J
REV-1500 EX(FI) Page 3 File Number
�Decedent's Complete Address: o 0
DECEDENT'S NAME
CALANTHA T. BIXLER
STREET ADDRESS
29 FAIRFIELD STREET
CITY STATE ZIP
CARLISLE PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 199.33
2. Credits/Payments
A.Prior Payments
B.Discount
Total Credits(A+g) �2� 0.00
3. Interest
4. If Line 2 is greater than Line 1 +Line 3,enter the difference.This is the OVERPAYMENT. (3)
Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00
5. If Line 1 +Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 199.33
Make check payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred ...................................................................... ❑ X❑
b. retain the right to designate who shall use the property transferred or its income ............................... ❑ ❑X
c. retain a reversionary interest ..................................................................................................... ❑ ❑X
d. receive the promise for life of either payments,benefits or care? ....................................................... ❑ 0
2. If death occurred after December 12,1982,did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... ❑ QX
3. Did decedent own an"in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ X❑
4. Did decedent own an individual retirement account,annuity or other non-probate property,which
contains a beneficiary designation?.................................................................................................. ❑ X❑
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
For dates of death on or after July 1, 1994,and before Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse
is 3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 1, 1995,the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0 percent
[72 P.S.§9116(a)(1.1)(ii)].The statute does not exempt a transfer to a surviving spouse from tax,and the statutory requirements for disciosure 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 tax rate imposed on the net value of transfers from a deceased child 21 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 percent[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 percent,except as noted in�2 P.s.§s��s(a)(�)�.
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[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 atloption.
REV-1508 EX+(OS-12)
� � pennsylvania SCHEDULE E
DEPARTMENTOFREVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN
RESIDENTDECEDENT PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
CALANTHA T. BIXLER 0 0
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. DOW CORNING TRUST 5,000.00
[DATE RECEIVED: ]
TOTAL(Also enter on Line 5,Recapitulation) $ 5 000.00
If more space is needed, use additional sheets of paper of the same size.
REV-1511 EX+(08-13)
� � pennsylvania SCHEDULE H
DEPARTMENTOF REVENUE FUNERAL EXPENSES AND
INHERITANCETAXRETURN ADMINISTRATIVE COSTS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
CALANTHA T. BIXLER 0 0
DecedenYs debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State Z�P
Year(s)Commission Paid:
2, AttorneyFees: DUNCAN & HARTMAN, PC 500.00
3. Family Exemption:(If decedenYs address is not the same as claimanYs,attach explanation.)
Claimant
Street Address
City State ZIP
Relationship of Claimant to Decedent
4• Probate Fees:
5 Accountant Fees:
6. Tax Retum Preparer Fees:
7. FILE PETITION 70.50
TOTAL(Also enter on Line 9,Recapitulation) $ 570.50
If more space is needed,use additional sheets of paper of the same size.
REV-1513 EX+(01-10)
� � pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
CALANTHA T. BIXLER 0 0
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS [Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
1. SUSAN E. COWLEY Lineal
216 PINTAIL LAKE DRIVE 1/3 SHARE
GILBERT, SC 29054
2. SALLY BOBB Lineal
275 HIGH MOUNTAIN ROAD 1/3 SHARE
SHIPPENSBURG, PA 17257
3. WILLIAM H. BIXLER, JR. Lineal
60 LINDSAY LANE 1/3 SHARE
CARLISLE, PA 17015
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF REV-1500 COVER SHEET,AS APPROPRIATE.
II. NON-TAXABLE DISTRIBUTIONS:
A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN:
1.
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size.