HomeMy WebLinkAbout01-27-06
LAW OFFICES
UNRUH, TURNER, BURKE & FREES
A PROFESSIONAL CORPORATION
P.O. BOX 289
120 GAY STREET
PHOENIXVILLE, PA. 19460-0289
Ross A. UNRUH
DONALD C. TURNER
WILLIAM J. BURKE, III
DAVID M. FREES, III'
STEPHEN P. LAGOY
JOHN K. FIORILLO'
JOHN L. HALL
KEVIN E. MCLAUGHLIN
DOUGLAS L. KAUNE'
KEITH N. RENALDO
BRIAN D. BOREMAN
THEODORE F. CLAYPOOLE
JOHN P CONNORS
DANIEL P DWYER
(610) 933-8069
FAX 1610) 240-9323
MALVERN OFFICE:
346 E. KING STREET
MALVERN, PA 19355
(610) 240-0750
WEST CHESTER OFFICE:
P.O. Box 515
WEST CHESTER, PA 19381-0515
16101692-1371
OF COUNSEL
ANDREW D.H. RAU
· ALSO MEMBER, NEW JERSEY BAR
January 25,2006
CERTIFIED MAIL
Cumberland County Register of Wills
Attn: Colleen
One Courthouse Square
Carlisle, PA 17013
Re: Estate of James D. Hansen
Dear Colleen:
Pursuant to our telephone conversation, I am enclosing a check payable to your order in
the amount of$14,500.00 which constitutes a prepayment of inheritance taxes. I am also
enclosing a death certificate for Mr. Hansen. Please provide me with a receipt. Thank you for
your time and consideration in this matter.
Very truly yours,
\~!Itl 111 !1AritIG
Tara M. Walters
Paralegal
tmw
Enclosure
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX! 11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HANSEN BRUCE J
814NARCHST
MECHANICSBURG, PA 17055
_uun_ fold
ESTATE INFORMATION: SSN: 391-30-6570
FILE NUMBER: 2106-0083
DECEDENT NAME: HANSEN JAMES DONALD
DATE OF PAYMENT: 01/27/2006
POSTMARK DATE: 01/27/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 10/26/2005
NO. CD 006249
ACN
ASSESSM ENT
CONTROL
NUMBER
AMOUNT
101 I $14,500.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: EST OF JAMES 0 HANSEN
BRUCE J HANSEN
CHECK# 731
SEAL
INITIALS: CM
RECEIVED BY:
REGISTER OF WILLS
$14,500.00
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
This is to certify that the information 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 permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No.
, ,'II.{~c1"'Orpl;'---_",_
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-.,.,--- /MENl ~\ "",..,
''''''''',hI.nnIlIJIIIII'
~C!~
( Local Reg;"m'
Fee for this certificate. $6.00
P 12059904
OCT 2 8 2005
Date
;
C;l
Ci-\
)5.143 Rev. 2/87
COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
STATE FILE NUMBER
NAME OF DECEDENT (First. Middle, Last)
SEX
BIRTHPLACE (City and
State or Foreign CountJy)
MARITAL STATUS - Married,
Never Married, Widowed,
Divorced (Specify;
14. Widower
~~:~ify) 0
RACE - American Indian, Black. White, et .
(Specify)
White
SURVIVING SPOUSE
(If wife, give maiden name)
8b.
17a. State
PA
i7e, 0 Yes, decedent liveci in
twp
16. Mechanicsburg, PA 19143
FATHER'S NAME (First, Middle, Last)
18. e H. Hansen
INFORMANTS AME (Type/Print)
20a.
Did
decedent
live in a
17b. County Cumberl and township?
MOTHER'S NAME (First, Middle, Maiden Surname)
19. Clara N. Hnilicka
17d. iii ~ijh~ei~t~~?~i~ii~ of
MechanincsburQ:
city/boro.
PA 19143
of Prussia PA 1 406
Y~~ri~~f & PAeT718gvs.
DATE SIGNED
(Month. Day, Year)
a K
27, PART I: Entllr the di......, inJuri.. or complications which caused thu d9ath. 00 not enter the mode of dying. such as cardiac or respiratory .rrellt, shock or h".rt fenure. . Approximate
Lillt only on" elus" on each line. : interval bet\Veen
: onset and death
Sequentially list conditions
if any, leading to immediate
.. cause. Enter UNDERLYING
CAUSE (Disease or injury
... that initiated events
resulting on death) LAST
WAS AN AUTOPSY WERE AUTOPSY FIND!NGS
PERFORMED? AVAILABLE F'RIOR TO
COMPLETION OF CAUSE
OF DEATH?
!:
DUE TO (OR AS A CONSEQUENCE OF)
DUE TO (OR AS A CONSeQUENCE OF)
MANNER OF DEATH
Natural
\f1'
o
o
Homicide
DATE OF INJURY
(Month. Day, Year)
o
o
o
TIME OF INJURY
INJURY AT WORK? DESCRIBE HOW INJURY OCCURRED.
Accidenl
Pending Investigation
Could not be determined
Yes 0 No 0
30a. 30b. M 30e.
PlJ\CE OF INJURY - At home, farm, street, factory, office
tHlilding, etc. (Soecify)
30e.
(.,c
(l,.
~
.~
~
'~
~
~
Yes D No
Yes 0
N~
Suicide
28a. 28b
CERTIFIER (Check only one)
*~~~~~F~~tGor~~\I~~e,~e~~l.'~~:~ c~g~~~~ddUuS: trg g,e:~a~~:~(:r~~d~~X~i~~a~s h:t~re~,~~~~::,~ .~~~~~. .~~~ .:~.~~~~~:.~ .I.t~.~ .~~~.,
29.
*PRONOUNCING AND CERTIFYING PHYSICIAN (Physician both pronouncing death and certifying to cause of death)
To tho bost of my knowledge. death occurred at the time, date, and place, and due to the eauses(s) and manner as stated,
*MEDICAL EXAMINER/CORONER
~:~~:rb::i:::e~~~~I.~~~I~~. ~~.~~~~~~~~~~~~.~~~~~: .i~ .~:. ~:.l~~~.~:.~~,~th occurred at the ti.~~:. ~~t~:.~.~~.~~~,~~: ~~~.~~~.~~.~~~.,~~~~,~~,:~~ .~~~. 0
318.
REGISTRAR'S SIGNATURE AND NUMBER
;)U'iM:.. c"''JfL'1~'<:- ~ t.,;f /~vl
,_/
34.
OCT 2 8 2005
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
NO. CD 006249
DUPLICA TE
HANSEN BRUCE J
814 N ARCH ST
MECHANICSBURG, PA 17055
__nun fold
ESTATE INFORMATION: SSN: 391-30-6570
FILE NUMBER: 2106-0083
DECEDENT NAME: HANSEN JAMES DONALD
DATE OF PAYMENT: 01/27/2006
POSTMARK DATE: 01/25/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 10/26/2005
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $14,500.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: EST OF JAMES D HANSEN
BRUCE J HANSEN
CHECK# 731
SEAL
INITIALS: CM
RECEIVED BY:
TAXPAYER
$14,500.00
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BU5f.AU OF INDIVIDUAL TAXES
/"DEPT,280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROlV1:
PENNSYLVANIA
INHERITANCE AND ESTATe TAX
OFFICIAL RECEIPT
HANSEN BRUCE J
814 N ARCH ST
MECHANICSBURG, PA 17055
_._nn. fold
ESTATE INFORMATION: SSN: 391-3,0-6570
FILE NUMBER: 2106-0083
DECEDENT NAME: HANSEN JAMES DONALD
DATE OF PAYMENT: 01/27/2006
POSTMARK DATE: 01/27/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 10/26/2005
NO. CD 006249
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $14,500.00
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$14,500.00
REMARKS: EST OF JAMES 0 HANSEN
BRUCE J HANSEN
CHECK# 731
SEAL
INITIALS: CM
RECEIVED BY:
',vrO(lt", i,lOnY1c,v k
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REGiSTER OF WILLS
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GLENDA FARNER STRASBAUGH
REG!STER OF VV!U_S
TRANSMISSION VERIFICATION REPORT
TIME 01/30/2006 14:01
NAME
FAX
TEL
DATE,TIME
FAX NO./NAME
DURATION
PAGE(S)
RESULT
MODE
01130 14: 00
916102409323
00:00:17
01
OK
STANDARD
ECM