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Home My WebLink About05-26-06 ~ 15056041125 REV -1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes PO BOX 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death INHERITANCE TAX RETURN RESIDENT DECEDENT County Code Year .2.. 05 File Number /' (:) to '1 {c. Date of Birth 09138 054 7 o 5 1 1 2 0 0 4 03221917 Decedent's Last Name Suffix Decedent's First Name MI K R 0 L G R ACE (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 [XJ 1. Original Return D 4. Limited Estate D [XJ 2. Supplemental Return D D 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required 4a. Future Interest Compromise (date of death after 12-12-82) 7. Decedent Maintained a Living Trust (Attach Copy of Trust) 10. Spousal Poverty Credit (date of death D 11. Election to tax under Sec. 9113(A) between 12-31-91 and 1-1-95) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE plRECTED TO: Name Daytime Telephone Number 6. Decedent Died Testate (Attach Copy of Will) 9. Litigation Proceeds Received D D D D o 8. Total Number of Safe Deposit Boxes D 0 U G LAS L CAS S E L E S Q 232 -7661 Firm Name (If Applicable) REGISTER OF WILLS USE ONLY C A L D W ELL K EAR N S First line of address 363 1 NOR T H FRO N T S T R E E T ;-1 Second line of address i .J . j City or Post Office State ZIP Code DATE FILED H A R R I S BUR G P A 17110 Correspondent's e-mail address: Under penalties of perjury, 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 pre parer other than the personal representative is based on all information of which preparer has any knowledge. SI NATUR&OF PE~~~~ FO~I ING RETURN DATE 51l E>~06 ADDRESS 71 SHERWOOD CIRCLE ENOLA PA 17025 ESENTATIVE & KEARNS, N. FRONT ST. HARRISBURG PLEASE USE ORIGINAL FORM ONLY PA 17110 Side 1 L 15056041125 15056041125 ~ --.J 15056042126 REV-1500 EX Decedent's Social Security Number Decedent's Name GRACE KROL RECAPITULATION 091380547 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 & Notes Receivable (Schedule D) .......... . 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 5. 4 7 5 0 0 0 6 Jointly Owned Property (Schedule F) o Separate Billing Requested . . . . . 6. 1 1 9 0 2 6 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested. . . . 7. 0 0 0 8. Total Gross Assets (total Lines 1-7) 8. 5 9 4 0 2 6 ............. . 9. Funeral Expenses & Administrative Costs (Schedule H) 9. 1 0 9 1 8 3 5 ........ . 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10) 11. 1 0 9 1 8 3 5 ............ . 12. Net Value of Estate (Line 8 minus Line 11) 12. 4 9 7 8 0 9 . . 13. Charitable and Governmental Bequests/See 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 9 7 8 0 9 TAX COMPUTATION - 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.O _ 0 0 0 15. 0 0 0 16. Amount of Line 14 taxable at lineal rate X.O 0 0 0 16. 0 0 0 17 Amount of Line 14 taxable 0 0 0 at sibling rate X .12 17. 0 0 0 18. Amount of Line 14 taxable 0 0 0 at coliateral rate X .15 18 0 0 0 19. Tax Due 19 0 0 0 ............... . . . 20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT o Side 2 L 15056042126 15056042126 --.J REV-1500 EX Page 3 Decedent's Complete Address: DECEDENT'S NAME File Number GRACE KROL --- - -..- STREET ADDRESS 71 SHERWOOD CIRCLE CITY ENOLA STATE PA ZIP 17025 Tax Payments and Credits: 1 T ax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit 8. Prior Payments C. Discount (1) 0.00 Total Credits (A + 8 + C) (2) 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 TotallnterestlPenalty ( 0 + E ) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in oval on Page 2, Line 20 to request a refund. (4) 0.00 0.00 0.00 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5A) (58) A. Enter the interest on the tax due. 0.00 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; ...................................................................... D [Xl b. retain the right to designate who shall use the property transferred or its income; ............................... D [Xl c. retain a reversionary interest; or ................................................................................................ D [Xl d receive the promise for life of either payments, benefits or care? ....................................................... D [Xl 2. If death occurred after December 12,1982, did decedent transfer property within one year of death without receiving adequate consideration? ....................................................................................... D [Xl 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? ......... D [Xl 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? .................................................................................................. D [Xl 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 January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 PS ~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 zero (0) percent [72 PS ~9116 (a) (1.1) (ii)]. The statute does not exempt 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 tax 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 zero (0) percent [72 PS. ~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 four and one-half (4.5) percent, except as noted in 72 PS ~9116(1.2) [72 PS ~9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 PS ~9116(a)(1.3)I. 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-15G8 EX + (6-98) SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF GRACE KROL FILE NUMBER 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 NUMBER 1 DESCRIPTION Litigation proceeds from personal injury suit filed in the Dauphin County Court of Common Pleas under Docket No. 2005-CV-2356. (Six Thousand ($6,000.00) Dollar settlement less one-third contingency fee of Two Thousand ($2,000.00) Dollars). See attached documentation. VALUE AT DATE OF DEATH 4,000.00 2. Miscellaneous personal property, including clothing and minimal household goods 750.00 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 4,750.00 REV-1509 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF GRACE KROL 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 A. Annie A. Krol-Knight 71 Sherwood Circle Enola, PA 17025 Daughter B c JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY 'Io0F DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST 1. A 9/13/02 Savings Account at Members First Federal Credit Union, 197.53 50. 98.77 Account No. 222343-00 2. A. 6/28/00 Smith Barney Citigroup Mutual Fund Account No. 2,182.98 50. 1,091.49 724-02393-14-793 TOTAL (Also enter on line 6, Recapitulation) $ 1,190.26 (If more space is needed, insert additional sheets of the same size) REV-1510 EX + (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON.PROBA TE PROPERTY ESTATE OF GRACE KROL FILE NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY ITEM INCLUDE THE NAt,.1E OF THE TRANSFEREE THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH % OF DECD'S EXCLUSION TAXABLE NUMBER THE DATE OF TRANSFER ATTACH A COPY OF THE DEED FOR REAL ESTATE VALUE OF ASSET INTEREST VALUE (IF APPLICABLE) 1. Checking Account at Members First Federal Credit Union 0.00 50. 0.00 opened jointly with Annie A. Krol-Knight, daughter of decedent This Account was opened on July 12, 2003. However, this account was never funded. AccL #222343-11 . See attached documentation. TOTAL (Also enter on line 7 Recapitulation) $ 0.00 (If more space is needed, insert additional sheets of the same size) "",m>",. COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF GRACE KROL FILE NUMBER 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. Annie A. Krol-Knight Lineal 100% - 71 Sherwood Circle Enola, PA 17025 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET II. NON-T AXABLE DISTRIBUTIONS A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE 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, insert additional sheets of the same size) SAVINGS ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established CHECKING ACCOUNT: Account Number/Suffix Date Account Established Principal Balance at Date of Death Accrued Interest to Date of Death Total Principal and Accrued Interest Name of Joint Owner Date Joint Ownership Established Estate of: GRACE KROHl Date of Death: 05/11/2004 Social Security Number: 091-38-0547 ,., 1st MEMBERS 1st FEDERAL CREDIT UNION 222343 -00 09/13/2002 $197.48 $.05 $197.53 Annie A. Krol-Knight 09/13/2002 222343 -11 07/12/2003 $.00 $.00 $.00 Annie A. Krol-Knight 07/12/2003 MfMBERS 1s:fEDERAL CREDIT UNION /i;/k:U t/I2'J~ Denise A. Wolfe Insurance Service Supervisor February 10, 2006 5000 Louise Drive . Po. Box 40 . Mechanicsburg, Pennsylvania 17055 . (717) 697-1161 . www.members1st.org SMITH BARNEY.... cltlgroupJ April 27, 2006 Caldwell & Kearns Attorneys at Law 3631 North Front Street Harrisburg, P A 17110-1533 RE: Estate of Grace Krol ACCT: 724-02393-14-793 Dear Mr. Cassel: I have sent the April 2004 statement for your records. The above account was opened on 06/28/2000. I have also sent you a copy of that statement for your records also. On May 11, 2004 there were 263.9634 shares of Smith Barney Multiple Disc FD-All Cap Growth and Value Cl A in the above account the price per share on that date was $8.27 per share which gave her a total value of $2182.98 in the account at the date of death. Sincerely, Y6;:;;.~ Customer Service Associate for Kimberly A. 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NY 13/91 (315)822-3111 Funeral Home Charges: For cOI?plete funeral services and care of; Grace' Krol, reference: Itemization #04058-D, which includes casket and outer interment receptacle... Cash Advanced: Cemetery Interment Fee Observer-Dispatch Patriot News Organist Clergy Honorarium National Mortuary Shipping D.S.Airways Vital Records, (death certificatesj TOTAL CASH ADVANCED... $535.00 $568.64 $524.96 $100.00 $150.00 $730.00 $267.75 $ 20.00 TOTAL FUNERAL CHARGES... $7,950.00 $2,896.35 $10,846.35 p. 1 Koerner-Dimbleby Funeral Home 79~1 Steuben SL //olum4 PRlent, NY 1 JJH (315)865-5411 GENERAL RELEASE For the consideration of Six TIlOusand Dollars ($6,0(XlOO), receipt of which is hereby acknowledged, I/we release and discharge, and for myself/ourselves and for my/our heirs, representatives, executors, administrators, successors and assigns, do hereby remise, release and forever discharge William and Evelyn Nauss hereinafter referred to as the releasee(s), his/her/their/its heirs, executors, administrators, insurers, successors and assigns, and any and all other persons, firms, corporations, associations, of and from any and all causes of action, suits, rights, judgments, claims and demands of whatsoever kind, in law or in equity, known and unknown, which I/we now have or may hereafter have, espc'Cially the claimed legal liability of releasee(s), arising from or by reason of any and all bodily or personal injuries and/or property damage known and unknown, foreseen and unforeseen which heretofore has/have been or which hereafter may be sustained by me/us arising out of the accident on or about August 11, 2003, at or near Route 81, near Progress A venue, Harrisburg, in the County of Dauphin, in the State of Pennsylvania, which liability releasee(s) expressly deny(ies). VWe agree that the consideration set forth above is specifically applicable to and paid to me/us with respect to any and all damage to any property, either real or personal, of mine/ours and with respect to any and all personal or bodily injury of mine/ours, whether presently known or unknown, foreseen or unforeseen or which may subsequently develop and the consequences thereof, all as arising out of the aforementioned accident. VWe further agree that the consideration set forth above is spc'Cifically applicable to and paid to me/us with respect to any right of contribution that I/we may have against the reieasee(s), his/l1erltl1eir/its hci,s, executors, ac!minist::c,to::s, insurers, successors and assigns relative to claims of others that may be brought against me/us by reason of said accident. I/We further agree that the consideration set forth above is specifically applicable to my/our agreement that I/we will not join nor attempt to join the releasee(s), his/her/theirlits executors, administrators, insurers, successors and assigns in any capacity, in any action that may be brought against me/us arising out of said accident. I/We warrant for myself/ourselves and my/our heirs, representatives, executors, administrators, successors and assigns that I/we have received no money or other valuable consideration from any other person or persons by reason of any causes of action, suits, covenants, agreements, judgments, claims and demands of whatsoever kind, which I/we now have or may hereafter have, for injuries to my/our person or property or for the other matters for which this release is given. I/we further understand and agree that this Release is inclusive of any and all present and future liens or claim.'> for subrogation against the payments to be made in accordance with this Release. IIwe understand and agree that IIwe are responsible for the payment of any liens or charges against the payments to be made hereunder should any such liens, subrogation, claim.'> or claims for expenses and charges be asserted. This includes, hut is not limited to, medical expense liens, workers' compensation liens, ERISA liens, liens asserted by any federal, state or local governmental entity or agency or any medical expense claim. Should any person or entity make claim for payment of any liens or charges against 'Ille ERIE or their counsel, I/we agree to indenmify and hold harmless TIle ERIE and their counsel from any and all such liens, charges, fees, claim.'> , attorney fees, costs, interests and any other sum. I/we understand that this settlement is the compromise of a disputed claim, a.nd that the payment is not to be construed as an admission of liability on the part of the persons, firms and corporations hereby released by whom liability is expressly denied. J l/ -/"'- Intending to be legallv bound thereby, :)1' it:.- k.-r 90 05" WITNESS my/our hand(s) and seal(s) thi'> day of Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim cont:lining any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects the person to crinlinal and civil penalties. " NOTE: This ReleaSe? is intended to release the claims Grace Kr,) 1 l.II' U12 Estate of W)ryE'; Grace KrOl~:l~. _, ( ! . \ L /7 ,""-j un u_ AI\I\~~ 1lC'0~l0~\!~l~__ (M""(~~~"') NOTICE: I (Seal) Claim #010170697054 D. Wallace:nac REL2 12/04 Page 1 1173547 1 DOC CALDWELL & KEARNS A PROFESSIONAL CORPORATION JAMES R. CLIPPINGER CHARLES J. DEHART. III JAMES D. CAMPBELL. JR JAMES L. GOLDSMITH P. DANIEL ALTLAND JEFFREY T. MCGUIRE. STANLEY J. A. LASKOWSKI DOUGLAS K. MARSICO BRETT M. WOODBURN RAY J MICHALOWSKI DOUGLAS L CASSEL ATTORNEYS AT LAW OF COUNSEL RICHARD L KEARNS CARL G. WASS 3631 NORTH FRONT STREET HARRISBURG. PENNSYLVANIA 17110-1533 THOMAS D. CALDWELL. JR. 11928- 2001) September 20, 2005 717-232-7661 FAX: 717-232-2766 thefirm@caldwellkearns.com -ALSO A MEMBER OF NJ BAR Settlement Distribution Statement Insured: Claim Number: Date of Loss: Estate of Grace Krohl 010170697054 8/11/2003 Settlement amount $6,000.00 Costs advanced None Caldwell & Kearns (1/3 of$6,000.00) $2,000.00 Total Expenses $2,000.00 Net to Estate of Grace Krohl 04.86/92907 $4,000.00 ESTATE OF GRACE KROL by and through the Administratrix, Annie A. Krol-Knight and ANNIE A KROL-KNIGHT in her own right, IN THE COURT OF COMMON PLEAS DAUPHIN COUNTY, PENNSYLVANIA NO. d005 tv 3~5Lo CV Plaintiffs r:~) T-) C~:-:l ~~ CIi CIVIL ACTION - LAW - C -1 , ( .= I d'.) v. -\"-i' EVELYN NAUSS, r" c.:'-j Defendant JURY TRIAL DEMANDED J>.,.' r ,. (" ': -( '. r " ~-' NOTICE YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice are served, by entering a written appearance personally or by attorney and filing in writing with the Court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and 3 judgment may be entered against YOll by the Court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LA WYER AT ONCE. IF YOU DO NOT I-IA VE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFfICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LA WYER. IF YOU CANNOT AFFORD TO HIRE A LA WYER, THIS OFFICE MAYBE ABLE TO PROVIDE YOU WIT] I INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. DAUPHIN COUNTY LA WYER REFERRAL SERVICE 2 I 3 North Front Street Harrisburg, PAl 71 0 I (717) 232-7536 ESTATE OF GRACE KROL by and through the Administratrix, Annie A Krol-Knight and ANNIE A. KROL-KNIGHT in her own right. IN Tl1E COURT OF COrvlMON PLEAS DAUPHfN COUNTY, PENNSYLVANIA NO aco5 CV 3~5LO W Plainti tIs c: ):> c ~ = c:::::.J ,":-,-~ \. ...., CIVIL ACTION - LAW -0:: Jli= 'e' .; EVELYN NAUSS, Defendant JURY TRIAL DEMANDED J::-"" ::~: r- -. -' r-. o~ I< '., -( '-.,~ CJ AVISO USTED HA SIOO DEMANDADO/A EN CORTE. Si usted desea defenderse de las demandas que se presentan mas adelante en las siguientes paginas, debe tomar accion dentro de los proximos veinte (20) dias despues de la notificacion de est a Demanda y A viso radicamlo personal mente 0 por medio de un abogado una comparecencia escrita y radicando en la Corte por escrito sus defensas de, y objecciones a, las c1emandas presentadas aqui en contra suya. Se Ie advierte de que si usted falla de tomar accion como se describe anterionnente, el casu puede proceder sin usted y un fallo por cualquier suma de dinero reclamada en la demanda 0 cualquier otra reclamacion 0 remedio solicitado por el demandante puede ser dictado en contra suya por la Corte sin mas ,1\.iso adicional Usted puede perder dinero 0 propiedad U otros derechos importantes para usted. USTED DEBE LLEVAR ESTE OOCUMENTO A SU ABOGADO INMEDIA T AMENTE. SI USTED NO TIENE UN ABOCJADO, LLAME 0 V A Y A A LA SIGUIENTE OFICfNA. ESTA OFICINA PUEDE PROVEERLE INFORMACION A CERCA DE COMO CONSEGUIR UN ABOGADO. SI USTED NO PUEDE PAGAR POR LOS SERVICIOS DE UN ABOGADO, ES POSIBLE QUE ESTA OFICINA LE PUEDA PROVEER INFORMACION SOBRE AGENCIAS QUE OFREZCAN SERVICIOS LEGALES SIN CARGO 0 BAJO COSTO A PERSONA.S QUE CUALIFICAN. DAUPHIN COUNTY LAWYER REFERRAL SERVICE 213 North Front Street Harrisburg,PA 17101 (717) 232-7536 2 EST/\TE OF CJRACE KROL by and through the l~dlllinistratrix, Annie /\. KroJ~Knight amI ANNIE A KROL~KNIGHT in her own righL IN THE COURT OF COMMON PLEAS DAUPHIN COUNTY. PENNSYLVANIA NO. eJ005 CV 3~5UJ QV CIVIL ACTION ~ LA W r--.) c.~' = = -.,....-. ~J1 . . r C "':'_,. -. c: ,J - .~ ) ., r<l .. ~ I - oOIci_ . <.11 -~ ~.c,_ > (:- -0 ,"-- ...; '0 ~. n .. 1'..) -( '.' C;) Plaintiffs v. EVELYN NAUSS. Defendant JURY TRIAL DEMANDED COMPLAINT AND NOW. come the Plainti ffs, the Estate of Crace KroI by and through the Administratrix Annie A. Krol~Knight and Annie A. Krol-Knight, individually in her own right, by and through their attomeys. CalclwcJJ & Kearns; and file this Complaint and state in support thereof. as follows: I. Plaintiff, Annie A. Krol-Knight ("Plaintiff Krol-Knight"), as the Administratrix of the Estate of Plaintiff Grace Krol ("Plaintiff Krol"). and Individually in her own right, is an adult individual residing at 71 Sherwood Circle, Enola. P A 17025~ 1838. 2. Defendant Evelyn Nauss ("Defendant Nauss"), is an adult individual with a last known address of 4 W1tming Hill Drive, Mechanicsburg, P A 17055. 3. The facts and occurrences herein related took place on or about August 11, 2003, at approximately 4:00 p.m., while Plaintiff Krol~Knight was operating her vehicle on the Progress A venue on-ramp to 1-81 South in Susquehanna Township, Dauphin County, Pennsylvania. 3 4 At that time and place, Plaintiff Krol-Knight was proceeding slowly on the ramp, awaiting an opportunity to merge into traffic. when her 1987 Mazda Rx7 was rear-ended by a 1995 Chrysler being operated on the on-ramp by Defendant Nauss. 5 At that time and place, Plaintiff Krol-Knight 's mother, Plaintifl Krol, was a passenger in PlaintiffKrol-Knight's 1987 Iv1azda Rx7. 6. At that time and place, Plaintiff Krol-Knight and PlaintiffKrol were properly restrained wearing seatbelts. 7. At that time and place, PlaintiffKrol-Knight and PlaintiffKrol were both insured and maintained Full Tort option. COUNT I - NEGLIGENCE Annie A. Krol-Knight v. Nauss 8 Averments 1 through 7 are incorporated herein as though they were set forth at length. 9. The foregoing accident and all of the injuries and damages set forth hereinafter sustained by PlaintiffKrol-Knight and Plaintiff Krol are the direct and proximate result of the negligence, carelessness and recklessness in which Defendant Nauss operated her motor vehicle. 10. The negligence, carelessness and recklessness of Defendant Nauss consisted of, but is not limited to, the following: (a) failing to keep a lookout and maintain a proper watch for slowed or stopped vehicles merging on to the highway and failure to exercise a reasonable standard of care under the circumstance while merging her vehicle; 4 (b) f~liling to keep alert and maintain a proper watch for the presence of slowed or stopped cars which she knew or should have known were merging on to the highway. (c) Lliling to operate her vehicle safely; (d) f~li1ing to drive her vehicle with due regard to conditions which were existing and of which she was or should have been aware: (e) failing to keep proper and adequate control over her vehicle; (f) failing to stop before striking the Plaintiffs' vehicle; (g) failing to stop her vehicle within the assured clear distance ahead in violation of 75 Pa CS.A. ~336l; (h) operating her vellicle in a careless manner, in violation of the Pennsylvania Motor Vehicle Code, specifically 75 Pa.CSA. ~3714; and (i) operating her vehicle in a reckless manner, in violation of the Pennsylvania Motor Vehicle Code, specifically 75 Pa.CSA. ~373(J. 1 I. As a direct and proximate result of the negligence of Defendant Nauss, Plaintiff Krol-Knight sustained serious and pennanent injuries in and about her head, body and limbs, including but not limited to injuries of her back and neck, \vhipJash, right should problems which may require surgery, occipital headaches, sleep problems, emotional distress, anguish, and aggravation of pre-existing injuries. 12. As a direct and proximate result of the negligence of Defendant Nauss, Plaintiff Krol-Knight has undergone, and continues to undergo medical treatment. 5 13 As a direct and proximate result of the negligence of Defendant Nauss. Plainti ff Krol-Knight has been and continues to be obligated to expcnd various sums of money for the medicine and medica] treatment for her injuries ] 4 As a direct and proximate result of the negligence of Defendant Nauss. Plainti If Krol-Knight has suffered, still suffers and will continue to suffer great pain and anguish for an indefinite time into the future. WHEREfORE, Plaintiff demands judgment against Defendant for an amount in excess of Thirty-Five Thousand Dollars ($35,000.00) plus interest, costs, attomeys fees, and delay damages. COUNT II - NEGLIGENCE Estate of Grace Krol bv and through the Administratrix Annie A. Krol-Knight v. Nauss J 5. ;\ vennents 1 through 14 are incorporated herein as though thcy were sct forth at length. J 6. As a direct and proximate result of the negligence of Defendant Nauss. Plaintiff Kro] sustained serious and pem1anent injuries in and about her head, body ancllimbs, including but not limited to neck and back injuries, aggravation of pre-existing osteoporosis, headaches, emotional distress, and anguish. ] 7. As a direct and proximate result of the negligence of Defendant Nauss. Plaintiff Krol had undergone medica] treatment up until the time of her death. ]8. As a direct and proximate result of the negligence of Defendant Nauss, Plaintiff KIo] had been obligated to expend various sums of money for the medicine and medical treatment for her injuries. 6 19. As a direct and proximate result of the negligence of Defendant Nauss. Plaintiff Krol had suffered great pain and anguish up until the time of her death WHEREFORE. Plaintiff demands judgment against Defendant for an amount not in excess of Thirty-Five Thousand Dollars ($35,000.00) plus interest, costs, attorneys fees, amI delay damages. Respectfully submitted, Dated: 9 /y:- ~~ ~--I-<tJ--~-- By: CAlI. WEL~~_ jU '-. ~l~~McC.;uire, Esq~;T~e---. ttorney LD. No. 73617 3631 North Front Street Harrisburg. P A 17110 (717) 232-7661 Attorney for Plaintiffs 04-:-\6/9] 002 7 VERIFICATION The undersigned. ANNIE A. KROL-KNIGHT. hereby verifies that the facts set forth in the Complaint arc truc and cOITect to the best of her knowledge, infonnation and belief and further states that f:l]se statements herein arc made subject to the penalties of 18 Pa.CS. Section 4()()4 relating to unswoll1 falsi fication to authorities. A/Y\J~A~-~'k ~ -- ------~-_._~--------------- -- ANNIE A. KROL-KNIGH . CALDWELL & KEARNS A PROFESSIONAL CORPORATION JAMES R. CLIPPINGER CHARLES J. DEHART, III JAMES D CAMPBELL, JR. JAMES L. GOLDSMITH P. DANIEL ALTLAND JEFFREY T. McGUIRE" STANLEY J. A. LASKOWSKI DOUGLAS K. MARSICO BRETT M. WOODBURN RAY J. MICHALOWSKI DOUGLAS L. CASSEL ATTORNEYS AT LAW OF COUNSEL RICHARD L. KEARNS CARL G. WASS 3631 NORTH FRONT STREET HARRISBURG, PENNSYLVANIA 17110-1533 THOMAS D. CALDWELL, JR. 11928 - 2001) May 22,2006 -BOARD CERTIFIED CIVIL TRIAL ADVOCATE 717-232-7661 FAX, 717-232-2766 thefirm@caldwellkearns.com Glenda Farner Strasbaugh Register of Wills, Cumberland County Cumberland County Court House 1 Court House Square Carlisle, PA 17013 RE: Estate of Grace Krol Docket No. 2005-00696 Dear Register Of Wills Strasbaugh: Enclosed herewith for filling, you will find the original and two copies of the inheritance tax return with regard to the above - captioned estate. The estate is insolvent and no tax is due and as a result, payment is not included. We respectfully request that you accept for filling the original and two copies of the enclosed inheritance tax return. Please return a time stamped copy of the inheritance tax return to the undersigned in the enclosed self-addressed, stamped envelope. Thank you for your cooperation. Please feel free to contact me with any questions. Very truly yours, D0as CALDWELL & Enclosure 04-86/1 021 50 CALDWELL & KEARNS A PROFESSIONAL CORPORATION ..JAMES R. CLIPPINGER CHARLES ..J. DEHART. III ..JAMES D. CAMPBELL. ..JR. ..JAMES L. GOLDSMITH P. DANIEL ALTLAND ..JEFFREY T. McGUIRE. STANLEY ..J. A. LASKOWSKI DOUGLAS K. MARSICO BRETT M. WOODBURN RAY ..J. MICHALOWSKI DOUGLAS L. CASSEL ATTORNEYS AT LAW OF COUNSEL RICHARD L. KEARNS CARL G. WASS 3631 NORTH FRONT STREET HARRISBURG, PENNSYLVANIA 17110-1533 THOMAS D. CALDWELL. ..JR. 11928 - 20011 -BOARD CERTIFIED CIVIL TRIAL AOVOCATE May 25,2006 717-232-7661 FAX: 717-232-2766 thefirm@caldwellkearns.com Glenda Farner Strasbaugh Register of Wills, Cumberland County Cumberland County Court House 1 C0Urt HOt'S~ Sq'1me Carhsle, P A 17013 Re: Estate of Grace Krol Docket No. 2005-00696 Dear Register of Wills Strasbaugh: Enclosed please find a check 111 the amount of Fifteen ($15.00) Dollars for the filing fee of the Inheritance Tax Return for the above-referenced estate. 1 apologize that it was inadvertently not included along with the Return. As per my conversation with your office, the Return remains there pending receipt of this check. Please accept this filing fee in order to properly file the Inheritance Tax Return. Please feel free to contact me with any other questions or concerns. Thank you in advance. 04-86/102337 Enclosure