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COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA
ORPHAN'S COURT DIVISION
Estate of Donald L. Hebei, )
Deceased )
No. 2010-01125
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Pa. No. 21-10-1125 co
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Small Estate Petition -a -n
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(Pursuant to Title 20 §3102)
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1. Your petitioners are Donna K. Walmer, who resides at 18 Sherks�ehurch Row,
Grantville, PA 17028, and Kenneth L. Hebei, who resides at 1067 Gravel Hill Road in
Grantville, PA 17028. (Hereafter designated the "Petitioners").
2. The decedent is Donald L. Hebei (hereafter designated the "Decedent") who died
on October 3, 2010, domiciled in Cumberland County, Pennsylvania.
3. The Decedent died testate on October 3, 2010, his Last Will and Testament
("Will"), dated August 11, 2003, having been admitted to probate on November 10, 2010.
Letters Testamentary were granted the Petitioners on November 10, 2010. The Petitioners
were not required to give bond. A true copy of the Decedent's Last Will and Testament is
attached hereto, marked Exhibit"A" and incorporated by reference herein.
4. The unpaid beneficiaries entitled to the estate of the Decedent under the Will, their
relationship to the Decedent and their interest in the estate are as follows:
Name Relationship Interest
Donna K. Walmer daughter 1/3 residue
Kenneth L. Hebei son 1/3 residue
Doris E. Gross daughter 1/3 residue
None of the aforesaid beneficiaries has received or retained any property of the
Decedent by payment of wages under Section 3101 of the PEF Code and none of the
beneficiaries is a minor, has been adjudicated incapacitated or is deceased.
5. No person is entitled to the Family Exemption.
6. The Decedent did not own any real estate. An inventory of the Decedent's
personal property follows:
a. Metro Bank, 50 Plus checking account#0536992746 5,085.00
b. VA pension —September, 2010 payment 90.00
c. Hershey Food Retirement—September, 2010 payment 284.64
d. Buse Funeral Home— refund 79.00
e. Cash found on Decedent 30.00
f. Conexis— refund of insurance premium 14.52
g. HCR Manor— refund of partial monthly charge 997.90
$6,545.06
7. A list of all unpaid claimants, all of whose claims are admitted, follows:
a. Manor Care— long-term care services (Class 6) 336.82
b. Commonwealth of PA, Dept. of Pub. Welfare—estate recovery
claim ($18,043.22, Class 3) —See attached Exhibit"E" 18,043.22
c. Commonwealth of PA, Dept. of Pub. Welfare—estate recovery
claim ($6,637.10, Class 5.1) - See attached Exhibit"E" 6.637.10
$25,017.14
8. Based on belief, and information received from the Decedent's nursing home
facility, Manor Care, where he was domiciled at the time of death, the Decedent appears to
have received benefits directly from the United States Veterans'Administration in excess of
the amount he was entitled to receive (as a result of the lowering of his benefit by$90.00
per month) in the aggregate amount of$1,064.00, which amount the Veteran's
Administration has failed to collect or claim despite Teceiving repeated notices>of the
apparent.overpayment. Based on the Veterans Administration's failure to seek
reimbursement or make a claim, your petitioner's denies such potential claim.
9. The unpaid.beneficiary, Doris E. Gross, joins in.this petition and consents to the.
relief requested herein.
1.0. The net distributable property and estate of the Decedent is set forth below:
Gross Estate: 6,545.06
Less expenses of administration and funeral (Exhibit"C"): 1,680.28
Net distributable estate: $4,864.78
11. The following exhibits are attached to this Petition:
a. ,Exhibit"A"— Copy,of Decedent's Will, as probated
b.,Exhibit"B" - Joinder to Petition.of Doris E. Gross
c. Exhibit"C" Itemized list of disbursements
d. Exhibit"D"— Notice of Inheritance Tax Appraisement, Allowance or
Disallowance of Deductions and Assessment of Tax.dated 7-2-12 (insolvent estate return).
e. Exhibit"E"-Notice of claim by the Commonwealth of Pennsylvania,
Department of Public Welfare dated March 14, 2011.
WHEREFORE, the Petitioners respectfully request that the Honorable Court:
(a) Award a Citation directed to the Secretary of the United States Veterans'
Administration to show cause why the Petitioners' prayer for relief under this Petition should
not be approved.
(b)Award a Citation directed to the Commonwealth of Pennsylvania, Department of
Public Welfare, to show cause why the Petitioners'prayer for relief under this Petition
should not be approved;
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA
ORPHAN'S COURT DIVISION
Estate of Donald L. Hebel, )
Deceased )
No. 2010-01125
Pa. No. 21-10-1125
Verifications to Small Estate Petition
I verify that the statements made in this Small Estate Petition are true and correct. I
understand that false statements herein are made subject to the penalties of 18 Pa.C.S.
§4904 relating to unsworn falsification to authorities.
,0,,, -41.
J Donna K. Walmer
/�
Date: We-th beo' , 2014
I verify that the statements made in this Small Estate Petition are true and correct. I
understand that false statements herein are made subject to the penalties of 18 Pa.C.S.
§4904 relating to unsworn falsification to authorities.
Kenneth L. Hebel
Date: 4101feiwber ?X 020 , 2014
REGISTER OF WILLS CERTIFICATE OF
CUMBERLAND COUNTY GRANT OF LETTERS
PENNSYLVANIA
No. 2010- 01125 PA No. 21- 10- 1125
Es to to Of: DONALD L HEBEL
(First Middle,Last)
Late Of: CARLISLE BOROUGH
CUMBERLAND COUNTY
Deceased
Social Security No:
C)
WHEREAS, on the 10th day of November 2010 an instrument dated
August 11th 2003 was admitted to probate as the last will of
DONALD L HEBEL
(First,Middle,Lest
late of CARLISLE BOROUGH, CUMBERLAND County,
who died on the 3rd day of October 2010 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, GLENDA FARNER STRASBAUGH , Register of Wills in and
for CUMBERLAND County, in the Commonwealth of Pennsylvania, hereby
certify that I have this day granted Letters TESTAMENTARY to;
DONNA K WALMER and KENNETH L HEBEL
who have duly qualified as EXECUTOR(RIX)
and have agreed to administer the estate according to law, all of which
fully appears of record in my office at CUMBERLAND COUNTY COURTHOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my office on the 10th day of November 2010.
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Regrster of IIIs
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**NOTE** ALL NAMES ABOVE APPEAR (FIRST, MIDDLE, LAST)
LAST WILL AND TESTAMENTOF
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DONALD L. HEBEL '`0 Ca `3
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1, DONALD L. HEBEL, now domiciled in Cumberland County, Pennsylvania, declare
this to be my Last Will and Testament. I revoke all other wills and codicils that I may have
previously made.
Article I
My just debts and expenses of my last illness, funeral, and administration of my estate
shall be paid by my Executor from the principal of my residuary estate as soon as practicable
after my death.
Article II
All inheritance, estate, and succession taxes(including interest and penalties thereon, but
not including any generation skipping tax) payable by reason of my death shall be paid out of
and be charged generally against the principal of my residuary estate without reimbursement
from any person. This provision is not a waiver of any right which my Executor has to claim
reimbursement for any such taxes which become payable as the result of any property over
which I have the power of appointment.
Article III
I give, devise and bequeath my tangible personal property in accordance with any
memorandum which I have either handwritten or signed, located with my will or with my
valuable papers and found within 30 days of the probate of my will. Gifts may only be to
persons who survive me or to organizations which exist at my death, and if there is a conflict, the
memorandum having the latest date shall govern. To the extent no such memorandum is found,
or all of my tangible personal property is not disposed of pursuant thereto, my tangible personal
property shall be added to my residuary estate and pass under Article V hereof.
Article IV
I grant unto my son, KENNETH L. REBEL,the right of first refusal to purchase, at the
fair market value,the land that I own on the east side of Gravel Hill Road.
Article V
All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever
situate, I give, devise and bequeath IN EQUAL SHARES to my children: DORIS E. GROSS,
DONNA K. WALMER,and KENNETH L. REBEL.
However,if a beneficiary does not survive me by thirty (30)days, but leaves descendants
who survive me by thirty (30) days, those descendants shall receive, per stirpes, the share the
beneficiary would have received had he or she survived me by thirty(30)days.
Article VI
I nominate, constitute and appoint my children, DORIS E. GROSS, DONNA K.
WALMER, and KENNETH L. REBEL, as Co-Executors of my Last Will and Testament. I
direct that my Co-Executors be permitted to serve without bond and in addition to those powers
2
granted by lave, I grant them power to distribute in cash or in kind, in like or in unlike shares, and
to file any qualified disclaimer I could have filed if living. My Co-Executors shall receive
reasonable compensation for services rendered to my estate.
Article VII
In addition to the powers conferred by law, I authorize my Co-Executors, in his/her
absolute discretion:
(a) to retain in the form received and to sell either at public or private sale, any real
estate or personal property except that which I specifically bequeath herein,
(b) to manage real estate,
(c) to invest and reinvest in all forms of property without being confined to legal
investments, and without regard to the principal of diversification,
(d) to exercise any option or right arising from the ownership of investments,
(e) to compromise claims without court approval and without consent of any
beneficiary,
(f) to file any federal income tax return for any year for which I have not filed such
return prior to my death,
(g) to make distributions in cash or in kind, or in both, and to determine the value of
any such property,
(h) to employ any attorney, investment advisor, or other agent deemed necessary by
my Executor; and to pay from my estate reasonable compensation for all their services,
(i) to conduct alone or with others, any business in which I am engaged in, or have
an interest in at time of my death, and
3
�) to receive reasonable compensation in accordance with their standard schedule of
fees in effect while their services are performed.
IN WITNESS WHEREOF,1,DONALD L. HEBEL,hereby set my hand to this my Last
Will and Testament, on , 2003,at Harrisburg, Pennsylvania.
DONALD L. HEBEL
In our presence,the above-named DONALD L. HEBEL signed this and declared this to
be his Last Will and Testament and now at his request, in his presence, and in the presence of
each other, we sign as witnesses.
Name Address
741" bV 17/11'
4
I, DONALD L. HEBEL, Testator, who signed the foregoing instrument, having been
duly qualified according to law, acknowledge that I signed and executed this instrument as my
Will, and that I signed it willingly as my free and voluntary act for the purposes therein
expressed.
Sworn to or affirmed and
Acknowledged before me by
DONALD L. HEBEL,the Testator
on /'- ,2003.
Notary Pub is IDONALD L.HEBEL
Notarial Seal
Marielle F. Hazen. Notary Public
City of Harrisburg, Dauphin County
My Commission Expires Sept.23, 2006
We,the undersigned witnesses who signed the foregoing instrument, being duly qualified
according to law,depose and say that we were present and saw the Testator sign and execute this
instrument as his Will; that he signed and executed it willingly as his free and voluntary act for
the purposes therein expressed; that each of us in his sight and hearing signed the Will as
witnesses, and that to the best of our knowledge, that he was at that time eighteen (18) years or
more of age,of sound mind;and under no constraint or undue influence.
Sworn to or affirmed and
Subscribed to beforepie
by i M
and9,2.; tan
s
witnesses, on 19, t4 e ,2003. _
.S
No ublic
Notarial Seal
Marielle F. Hazen. Notary Public
City of Harrisburg, Dauphin County
My Commission Expires Sept. 23, 2006
5
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA
ORPHAN'S COURT DIVISION
Estate of Donald L. Hebel, )
Deceased )
No. 2010-01125
Pa. No. 21-10-1125
Joinder to Small Estate Petition
(Pursuant to Title 20 §3102)
The undersigned, Doris E. Gross, a daughter of the Decedent and entitled to a
distribution from the estate of Donald L. Hebel under the residuary clause of the
Decedent's Last Will and Testament, hereby joins in the Small Estate Petition to which
this joinder is attached and consents to the prayer of relief set forth therein.
VERIFICATION
I verify that the statements made in this Joinder to Small Estate Petition are true and
correct. I understand that false statements herein are made subject to the penalties of
18 Pa.C.S. §4904 relating to unsworn falsification to authorities.
Doris E. Gross
Date: "'14Ak , 2014
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COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA
ORPHAN'S COURT DIVISION
Estate of Donald L. Hebei, )
Deceased )
No. 2010-01125
Pa. No. 21-10-1125
Small Estate Petition
Itemized List of Disbursements
Date Description §3392 Class Amount
10-9-10 Market Place —funeral luncheon Class 3 438.28
10-14-10 St. John's UNC — officiating fee Class 3 75.00
12-1-10 Register of Wills — probate fees Class 1 86.50
12-4-10 Keiter &Walmer—attorney fees Class 1 400.00
11-18-14 Jeffrey A. Keiter— attorney fees Class 1 625.00
11-18-14 Clerk of the Orphan's Court—fee Class 1
To file Small Estates Petition 55.50
$1,680.28
Ilk
NOTICE OF INHERITANCE TAX pennsylvania
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 1.7128-0601
DATE 07-02-2012
ESTATE OF HEBEL DONALD L
DATE OF DEATH 10-03-2010
FILE NUMBER 21 10-1125
COUNTY CUMBERLAND
DOUGLAS L WALMER ESQ ACN 101
226 W CHOCOLATE AVE APPEAL DATE: 08-31-2012
HERSHEY PA 17033-1570 (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 (12-117 NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE Of: HEj1EL- - DONAtD----LFILE---NO-. :2i- 10 -125--- ACii:- -i pi --DATE:-07=02-'2612-`- ---
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) C2)
00 credit to your account,
3. Closely Held Stock/Partnership Interest (Schedule 00 submit the upper portion C) (3) of this form with your
4. Mortgages/Notes Receivable (Schedule D) (4) •00 tax payment.
5. Gash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 6o545.06
6. Jointly Owned Property (Schedule F) • (6) .00
7. Transfers (Schedule G) (7) .00
8. Total Assets CS) 6,545.06
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9)- 1 ,9 9 9.78
10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 25,017.14
11. Total Deductions (11) 27416.92
12. Net Value of Tax Return (12) 20,471.86-
13. Charitable/Governmental Bequests: Non-elected 9113 Trusts (Schedule J) (13) .00
14. Net Value of Estate Subject to Tax (14) 20,471.86-
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 (15) .00 X 00 .00
16. Amount of Line 14 taxable at Lineal/Class A rate (16) -On X 0445 = .00
17. ,Amount of Line 14 at Sibling rate (17) _. =nn "X`12 C v .00
18. Amount of Line 14 taxable at Collateral/Class B rate (18) 00 X 15 - ._00
19. Principal Tax Due (19)= .00
TAX CREDITS:
PAYMENT RECEIPT DISCOUNT (+)
AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID C-)
TOTAL TAX PAYMENT Q0
t1 �/ 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 REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF PUBLIC WELFARE
BUREAU OF PROGRAM INTEGRITY
DIVISION OF THIRD PARTY LIABILITY
ESTATE RECOVERY PROGRAM
PO BOX 84W
HARRISBURG,PA 17105$486
March 14, 2011
KEITER & WALMER LLC
DOUGLAS L WALMER ESQUIRE
226 WEST CHOCOLATE AVE
HERSHEY PA 17033
Re: Donald Hebel
CIS #: 900245297
SSN: ###-##-4973
Date of Death: 10/03/2010
Dear Attorney Walmer:
Please be advised that the Department of Public Welfare maintains a
claim in the amount of $24,680.32 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 $18,043.22, 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 $6,637.10, 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,
Elizabeth M. Wilson
TPL Program Investigator
717-214-1868
717-772-6553 FAX
Enclosure
cc: Donna Walmer
18 Sherks Church Rd-
Grantville PA 17028
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E
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF PUBLIC WELFARE
BUREAU OF FINANCIAL OPERATIONS
TPL SECTION-CASUALTY UNIT
PO BOX B486
HARRISBURG PA 17105.8486
March 10,2011
STATEMENT OF CLAIM SUMMARY
-NAME Estate of HEBEL,DONALD
ID 900 245 297
MEDICAL CLASS.3> CLASS 5.1 TOTAL
INPATIENT .00 .00 .00
OUTPATIENT .00 .00 .00
LONG TERM CARE 18,043.22 6,631.34 24,674.56
DRUG .00 6.76 5.76
REIMBURSEMENT TO DPW 18,043.22 6,637.10 24,680.32
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF PUBLIC WELFARE
EIN- 23-6003113