HomeMy WebLinkAbout01-0553
~ortt XUr8i
~~' ~
_~CY 9~
(j ?--
375 Claremont Drive
Carlisle, PA 17013-8805
main (717) 243-2031
fax (717) 240-1952
C/(ehabilitation Center
July 18,2001
Mr. Jim Flower, Jr.
26 W. High Street
Carlisle, P A 17013
RE: Bruce Hurst
DaB: 3/15/1951
Dear Mr. Flower:
This letter is in response to your telephone call on July 13, 2001, and my patient Bruce
Hurst. I have been caring for Mr. Hurst since January of this year. His current medical
problems include anoxic brain damage, functional quadriplegia, gastroesophageal reflux
disease, seizure disorder, and aphasia. His current medications include Phenobarbital,
Colace, Zantac, and Carafate. The patient is unable to be fed orally and is currently given
his nutritional needs through a gastrostomy tube.
The patient's medical condition is not expected to change, unfortunately. His anoxic
brain damage has left Mr. Hurst with the inability to communicate for himself. He
suffers as a result of this brain damage from contracture deformities of both his upper and
lower extremities. His prognosis is poor, and it is my professional opinion that his
current state will never improve.
It is my professional opinion that asking Mr. Hurst to be present for a court appearance
would be detrimental to his physical, as well as emotional, state and would not be in his
best interest.
If additional information is necessary regarding his medical condition, please feel free to
contact me.
Thank you for your attention in this matter.
Sincerely,
~ OC. u..)JlV..UA- ~
David R. Wenner, D.O.
DRW/asw
fi service agency of Cumberland County
SAIDIS
SHUFF, FLOWER
& LINDSAY
A1TORNEYSoAToLAW
26 W. High Street
Carlisle, PA
I
~
FOR THE BENEFIT OF
BRUCE ROBINSON HURST.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. S S :3 ORPHANS' COURT O"l oJ
CITATION WITH NOTICE
IMPORTANT NOTICE
TO: BRUCE ROBINSON HURST:
A PETITION HAS BEEN FILED WITH THIS COURT TO HAVE YOU
DECLARED AN INCAPACITATED PERSON. IF THE COURT FINDS YOU TO BE
AN INCAPACITATED PERSON, YOUR RIGHTS WILL BE AFFECTED, INCLUDING
YOUR RIGHT TO MANAGE MONEY AND PROPERTY AND TO MAKE DECISIONS.
A COPY OF THE PETITION WHICH HAS BEEN FILED BY ANNE K. HURST AND
GUY C. HURST IS ATTACHED.
YOU ARE HEREBY ORDERED TO APPEAR AT A HEARING TO BE
HELD ON THE cJ3/1i DAY OF n~ , 2001, AT
9 ",'3tJ O'CLOCK, ..ff:;M., IN COURTROOM NO..-3 , OF THE
,
CUMBERLAND COUNTY COURT HOUSE, IN CARLISLE, PENNSYLVANIA, to tell
the Court why it should not find you to be an Incapacitated Person and appoint a
Guardian to act on your behalf.
To be an Incapacitated Person means that you are not able to receive
an effectively evaluate information and communicate decisions and that you are
unable to manage your money and/or other property, or to make necessary decisions
about where you will live, what medical care you will get, or how your money will be
spent.
SAIDIS
SHUFF, FLOWER
& LINDSAY
ATIORNEYSoAToLAW
26 W. High Street
Carlisle, P A
At the hearing, you have the right to appear, to be represented by an
attorney, and to request a jury trial. If you do not have an attorney, you have the right
to request the Court to appoint an attorney to represent you and to have the attorney's
fees paid for you if you cannot afford to pay them yourself. You also have the right to
request that the Court order that an independent evaluation be conducted as to your
alleged incapacity.
If the Court decides that you are an Incapacitated Person, the Court
may appoint a Guardian for you, based on the nature of any condition or disability and
your capacity to make and communicate decisions. The Guardian will be of your
person and/or your money and other property and will have either limited or full powers
to act for yOU.
If the Court finds you are totally incapacitated, you legal rights will be
affected and you will not be able to make a contract or gift of your money or other
property. If the Court finds that you are partially incapacitated, your legal rights will
also be limited as directed by the Court.
If you do not appear at the hearing (either in person or by an attorney
representing you) the Court will still hold the hearing in your absence and may appoint
the Guardian requested.
By:
Clerk, Orphans' Court
SAIDIS
SHUFF, FLOWER
& LINDSAY
AITORNEYSoAToLAW
26 W. High Street
Carlisle, P A
FOR THE BENEFIT OF
BRUCE ROBINSON HURST.
L
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. ~S ~
ORPHANS' COURT,
~
ORDE~F COURT
AND NOW, this ~ day of
,2001,
based upon evidence received and the record, this C urt fin
, by clear and convincing
evidence, that BRUCE ROBINSON HURST is adjudged a totally incapacitated person.
The Court finds that BRUCE ROBINSON HURST suffers from diminished reasoning
powers and no longer has the cognitive skills necessary to make informed decisions
regarding his personal finances and that he no longer has the capacity to receive and
evaluate information effectively, nor to make or communicate decisions concerning his
management of financial matters.
ANNE K. HURST, his sister, and GUY C. HURST, his brother, are hereby
appointed plenary guardians of the person and of the estate of BRUCE ROBINSON
HURST. The guardians of the estate shall not be required to post a Court approved
Bond, but shall file a report within -100 days and annually thereafter, in
compliance with 20 Pa.Cons.Stat ~5521 (C). The aforementioned judicial determinations
have taken into consideration the matters required by 20 Pa.Cons.Stat. ~5512.1. The
Court's findings of fact and conclusions of law have been placed on the record at the
evidentiary hearing.
J.
SAlOIS
SHUFF, FLOWER
& LINDSAY
ATIORNEYSoAToLAW
26 W. High Street
Carlisle. PA
FOR THE BENEFIT OF
BRUCE ROBINSON HURST.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,PENNSYLVANIA
ORPHANS' COURT DIVISION
NO.
ORPHANS' COURT
PETITION FOR ADJUDICATION OF INCOMPETENCY
AND APPOINTMENT OF A GUARDIAN
IN AN ESTATE OF AN INCAPACITATED PERSON
1. Petitioners are GUY C. HURST, an adult individual, residing at
603 North West Street, Carlisle, Pennsylvania 17013, and ANNE K. HURST, an adult
individual, residing at 43 West Oakland Drive, Carlisle, Pennsylvania 17013.
2. The alleged incompetent is BRUCE ROBINSON HURST, an adult
individual, residing at Claremont Nursing and Rehabilitation Center, Room 219,
Claremont Drive, Carlisle, Pennsylvania 17013. The alleged incompetent is domiciled
in Cumberland County, Pennsylvania.
3. The alleged incompetent has no children, no surviving parents,
and no brothers and sisters other than Petitioners.
4. The alleged incompetent has made no Last Will and Testament to
the knowledge of Petitioners. Petitioners would be the individuals who would share
equally in the Estate of the alleged incompetent under the Intestate Laws of the
Commonwealth of Pennsylvania.
5. The alleged incompetent person has been in a coma-like state
since 1975. His brain functions to the extent that he responds to pain and touch and
his eyes are open. As a result of severe brain damage, he cannot communicate or
recognize individuals.
II
6. Petitioners believe the alleged incapacitated person is unable to
manage his money and/or property, and to make necessary decisions about where he
will live, what medical care he will receive, how his money will be spent, or in general,
to make necessary decisions with respect to his personal care.
7. Petitioner is under the care of Dr. David Wenner, of 2140 Fisher
Road, Mechanicsburg, Pennsylvania 17055, and Petitioners allege that it would be
contrary to his best interest attend the hearing.
8. The alleged incompetent person's date of birth is March 15, 1951,
and he was admitted to Claremont Nursing and Rehabilitation Center on August 29,
1989.
9. Petitioners have no interest adverse to that of the alleged
incapacitated person.
10. The alleged incapacitated person receives Social Security
benefits in the amount of $1,351.00 per month, and Petitioner GUY C. HURST has
been appointed by the Social Security Administration as representative payee for him,
and currently manages his Social Security benefits.
11. In the course of managing his Social Security benefits, Petitioner
GUY C. HURST has acquired on behalf of the alleged incapacitated person, BRUCE
SAlOIS ROBINSON HURST, an approximately 40% interest in real estate located at 603
SHUFF, FLOWER
& LINDSAY North West Street, Carlisle, Pennsylvania, which is worth approximately $86,000.00
AITORNEYSoAToLAW
26 W. High Street
Carlisle, PA
12. In order to make certain decisions concerning the person care of
the alleged incapacitated person, and in order to more effectively manage his finances
and investments, it is necessary for Petitioners to be appointed Guardian of the
alleged incapacitated person's person and estate.
SAlOIS
SHUFF, FLOWER
& LINDSAY
AITORNEYSoAToLAW
26 W. High Street
Carlisle, P A
WHEREFORE, Petitioners request that this Honorable Court appoint
them as Guardians of the person and estate of BRUCE ROBINSON HURSTo
SAlOIS, SHUFF, FLOWER & LINDSAY
Attorneys for the Plaintiff
~ . \\
By \i~ V),~\I )
\/ parnes D. Flower, Jr. I .I
liD. #27742 V
26 West High Street
Carlisle, PA 17013
(717) 243-6222
VERI FICA TION
We, GUY C. HURST and ANNE K HURST, Petitioners herein, hereby
verify that the statements made in the within instrument are true and correct to the best of
our knowledge, information and belief. We understand that false statements herein are
made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unsworn
falsification to authorities.
(l
~Cr~
/ Guy C. Hurst
~~
Anne K. Hurst
Date: ~ '3,2001
"
FOR THE BENEFIT OF
BRUCE ROBINSON HURST.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,PENNSYL VANIA
ORPHANS' COURT DIVISION
NO. 553 ORPHANS' COURT, 2001
CERTIFICATE OF SERVICE
On the , l-th
day of July, 2001, I hereby certify that I met
personally with Bruce Robinson Hurst and provided him with a copy of the Petition
docketed to No. 553 Orphans'Court, 2001, and read to him the Citation With Notice in
its entirety.
Further, I met with Bruce Robinson Hurst on the 1./4"'''
day of July,
2001, and provided him with a copy of the Order of the Honorable George E. Hoffer,
J.P., rescheduling the hearing to August 17, 2001, at 10:30 a.m. in Courtroom No.3,
Cumberland County Courthouse.
SAlOIS, SHUFF, FLOWER & LINDSAY
By: ~~ /,J, ~ t.
David W. Warburton, Jr.~ aw Clerk
SAlOIS
SHUFF, FLOWER Sworn and subscribed to before me
& LINDSAY
ATIORNEYSoAToLAW
26 W. High Street
Carlisle, P A
this ~ -th day of July, 2001.
J
NOTARIAL SEAl..
MERlEHE J. MAAHEvKA. NOTARY PU8UC
CARUSlE, CUM8EALANo COUNTY. PA
.~ MY COMMISSION EXPIFIE8 JUNE 8.1002
SAIDIS
SHUFF, FLOWER
& LINDSAY
ATTORNEYS.AT.LAW
26 W. High Street
Carlisle. P A
. ...
, .
FOR THE BENEFIT OF
BRUCE ROBINSON HURST.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,PENNSYLVANIA
ORPHANS' COURT DIVISION
NO.
ORPHANS' COURT
ORDER
AND NOW, this
/3 flU
day of
2001,
n/
in response to the Petition for Adjudication of Incompetency and Appointment of
a Guardian in an Estate of an Incapacitated Person in this matter, it is hereby directed
that a hearing be held on this matter on the
/3~ dayof .A-v-~
#
2001 , at
/tJ:3d
o'clock, #:In., in Court Room No.
~
of the
Cumberland County Court House in Carlisle, Pennsylvania.
Service shall be made of the attached citation with notice as set forth in
Pa. Orphans' Court Rule 14.5 upon the alleged incapacitated person no less than 20
days in advance of the hearing.
Petitioner shall give notice of the date and place of the hearing by
certified mail at least
c:?o
days in advance of the hearing to all persons
residing within the Commonwealth who are sui juris and would be entitled to share in
the estate of the alleged incapacitated person if he died intestate at that time, and to
the Cumberland County Nursing Home, the institution providing residential services to
the alleged incapacitated person.
Petitioner shall further notify the Court at least seven days prior to the
hearing if Petitioner has no notice of counsel being retained by or on behalf of the
alleged incapacitated person.
BY THE COURT:
/II1MrJ
/? J.
.r>
"
IN RE:
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
553 ORPHANS' COURT 2001
BRUCE ROBINSON HURST:
IN RE: HEARING DATE
ORDER OF COURT
AND NOW, July 18, 2001, hearing in the above matter has been
continued from August 13, 2001, to August 17, 2001, at 10:30 a.m. in
Courtroom No.3; counsel for the petitioner to notify all interested parties.
By the Court,
P.J.
James D. Flower, Jr.
Said is, Shuff, Flower & Lindsay
26 West High Street
Carlisle, PA 17013
SAlOIS
SHUFF, FLOWER
& LINDSAY
AlTORNEYSoAToLAW
26 W. High Street
Carlisle, P A
FOR THE BENEFIT OF
BRUCE ROBINSON HURST.
AND NOW, this
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,PENNSYL VANIA
ORPHANS' COURT DIVISION
NO. 553 ORPHANS' COURT, 2001
CERTIFICATE OF SERVICE
/ 6 -14
day of August, 2001, I, JAMES D.
FLOWER, JR., Esquire, of the law firm of SAIDIS, SHUFF, FLOWER & LINDSAY,
Attorneys, hereby certify that in accordance with the Order of the Honorable George E.
Hoffer, P.J., dated July 18, 2001, I served notice of the hearing scheduled for August 17,
2001, at 10:30 a.m., by United States Mail, First Class, Postage Prepaid, in Carlisle,
Pennsylvania, addressed to:
Guy C. Hurst
43 West Oakwood Drive
Carlisle, PA 17013
Ann K. Hurst
603 North West Street
Carlisle, PA 17013
Ms. Julie Guistwite
Claremont Nursing & Rehabilitation Center
375 Claremont Drive
Carlisle, PA 17013
Administrator
Claremont Nursing & Rehabilitation Center
375 Claremont Drive
Carlisle, PA 17013
David R. Wenner, D.O.
Claremont Nursing & Rehabilitation Center
375 Claremont Drive
Carlisle, PA 17013
SAIDIS, SHUFF, FLOWER & LINDSAY
Attorneys for Petitioners
~~)I~'
James D. Flower, r.
26 West High Stre
Carlisle, PA 17013
(717) 243-6222
I.D. # 27742
. \ \
~
JAMES D. FLOWER
JOHN E. SLIKE
ROBERT C. SAlOIS
GEOFFREY S. SHUFF
JAMES D. FLOWER, JR.
CAROLJ. LINDSAY
]OHNNA J. KOPECKY
KARL M. LEDEBOHM
JOSEPH L HITCHINGS
THOMAS E. FLOWER
1.;.\ W OFFI<;E5
SAIDIS, SHUFP, FLOWER & LINDSAY
A PROFESSIONAL CORPORATION
26 WEST HIGH STREET
CARLISLE, PENNSYLVANIA 17013
TELEPHONE: (717) 243-6222 - FACSIMILE: (717) 243-6486
EMAIL: attomey@ssfl-law.com
www.ssfl-law.com
-. ., j ..,- CO
. f :~:~. j
., 1.. ' i.' P Y
WEST SHORE OFFICE:
2109 MARKET STREET
CAMP HILL, PA 17011
TELEPHONE: (717)737-3405
FACSIMILE: (717)737-3407
REPLY TO CARLISLE
July 25,2001
Mr. Guy C. Hurst
603 North West Street
Carlisle, P A 17013
Ms. Anne K. Hurst
43 West Oakwood Drive
Carlisle, PA 17013
Dear Clients:
Re: Bruce Robinson Hurst
Enclosed please find the Court Orders and Citation in this case, along with our copy of the
Petition. In accordance with Pennsylvania statutes and the court's directive, we are formally
notifying you, as the individuals who would inherit from Mr. Hurst ifhe died in testate, of the
date and time of this hearing.
Please call if you have any questions. Otherwise, I will hope to see you both at Courtroom No.3
on the fourth floor of the Courthouse at 10:30 a.m. on August 17,2001. If only one of you is
able to attend, that would probably be sufficient.
(
Also, enclosed please find my letter to Dr. Wenner and to Claremont Nursing and Rehabilitation
Center.
JDFJ/pm
Enclosures
Very truly yours,
SAIDIS, SHUFF, FLOWER & LINDSAY
..
James D. Flower, Jr.
WEST SHORE OFFICE:
2109 MARKET STREET
CAMP HILL. P A 17011
TELEPHONE: (717)737-3405
FACSIMILE: (717)737-3407
REPLY TO CARLISLE
r-
I
I .1
i"/
f i
I
'-"
JAMES D. FLOWER
JOHN E. SUKE
ROBERT C. SAlOIS
GEOFFREY S. SHUFF
JAMES D. FLOWER. JR.
CAROL J. UNDSA Y
JOHNNA J. KOPECKY
KARL M. LEDEBOHM
JOSEPH L. HITCHINGS
THOMAS E. FLOWER
,
LAWOFFICFS
SAID IS, SHUFF, FLOWER & LINDSAY
A PROFESSIONAL CORPORATION
26 WEST HIGH STREET
CARLISLE. PENNSYLVANIA 17013
TELEPHONE: (717) 243-6222 - FACSIMILE: (717) 243-6486
EMAIL: attomey@ssfl-Iaw.com
www.ssfl-Iaw.com
July 25,2001
F Il E C G P -J~
Ms. Julie Guistwite
Claremont Nursing and Rehabilitation Center
375 Claremont Drive
Carlisle, PA 17013-8805
Re: Bruce Robinson Hurst
DOB: 3/15/51
Dear Ms. Guistwite:
We will probably have spoken on the phone by the time you receive this letter, but I wanted
to confirm that Mr. Hurst's hearing date has been changed to August 17,2001, at 10:30 a.m.
We would very much appreciate it if you would be able to take the time to attend that
hearing to give the Judge your observations of his condition. Enclosed, for your
convenience, is Dr. Wenner's letter, which he has provided to us.
I;
Very truly yours,
SAIDIS, SHUFF, FLOWER & LINDSAY
James D. Flower, Jr.
JDFJ/pm
Enclosure
cc: Guy C. Hurst
Anne K. Hurst
LAW OFFICES
SAID IS, SHUFF, FLOWER & LINDSAY
A PROFESSIONAL CORPORATION
26 WEST HIGH STREET
CARLISLE, PENNSYLVANIA 17013
TELEPHONE: (717) 243-6222 - FACSIMILE: (717) 243-6486
EMAIL: attorney@ssfl-Iaw.com
www.ssfl-Iaw.com
fll ~ rrp,v'
. E .~ c;~: .
JAMES D. FLOWER
JOHN E. SUKE
ROBERT C. SAlOIS
GEOFFREY S. SHUFF
JAMES D. FLOWER, JR.
CAROL J. UNDSA Y
JOHNNA J. KOPECKY
KARL M. LEDEBOHM
JOSEPH L. HITCHINGS
moMAS E. FLOWER
WEST SHORE OFFICE:
2109 MARKET STREET
CAMP HILL, PA 17011
TELEPHONE: (717)737-3405
FACSIMILE: (717)737-3407
July 25,2001
REPLY TO CARLISLE
Claremont Nursing and Rehabilitation Center
375 Claremont Drive
Carlisle, P A 17013-8805
Re: Bruce Robinson Hurst
DOB: 3/15/51
Dear Administrator:
~
As the institution providing residential services to Bruce Robinson Hurst, an alleged
incapacitated person, we are providing you with formal notice that there will be a hearing in
Courtroom No.3 at the Cumberland County Courthouse at 10:30 a.m. on August 17,2001
to determine whether Mr. Hurst should be declared to be an incapacitated person. Please
call if you have any questions. We have a statement from Dr. Wenner in support of this
Petition.
Very truly yours,
SAIDIS, SHUFF, FLOWER & LINDSAY
James D. Flower, Jr.
JDFJ/pm
cc: Guy C. Hurst
Anne K. Hurst
ff
/
,j .;
U
LAW OmCES
SAID IS, SHUFF, FLOWER & LINDSA Y
A PROFESSIONAL CORPORATION
26 WEST HIGH STREET
CARLISLE, PENNSYLVANIA 17013
TELEPHONE: (717) 243-6222 - FACSIMILE: (717) 243-6486
EMAIL: attomey@ssfl-Iaw.com
www.ssfl-Iaw.com
FI.I~E COpy
JAMES D. FLOWER
JOHN E. SLIKE
ROBERT C. SAlOIS
GEOFFREY S. SHUFF
JAMES D. FLOWER, JR.
CAROL J. LINDSAY
JOHNNA J. KOPECKY
KARL M. LEDEBOHM
JOSEPH 1. HITCHINGS
THOMAS E. FLOWER
July 25,2001
WEST SHORE OFFICE:
2109 MARKET STREET
CAMP HILL, P A 17011
TELEPHONE: (717)737-3405
FACSIMILE: (717)737-3407
REPLY TO CARLISLE
Dr. David R. Wenner, D.O.
Claremont Nursing and Rehabilitation Center
375 Claremont Drive
Carlisle, PAl 7013-8805
Re:
Bruce Robinson Hurst
DOB: 3/15/51
Dear Dr. Wenner:
~
You very kindly provided me with your letter of July 18,2001, relating to Mr. Hurst's
incapacity. Reviewing the rules, I find that I need to submit this in the form of a sworn
statement and would ask you to sign the enclosed Verification for me to attach to your letter
of July 18,2001, to submit to the Court.
Very truly yours,
..
SAIDIS, SHUFF, FLOWER & LINDSAY
James D. Flower, Jr.
JDFJ/pm
Enclosure
cc: Guy C. Hurst
Anne K. Hurst
~" '.
JAMES D. FLOWER
JOHN E. SLIKE
ROBERT C. SAIDIS
GEOFFREY S. SHUFF
JAMES D. FLOWER, JR.
CAROLJ. LINDSAY
JOHNNA J. KOPECKY
KARL M. LEDEBOHM
JOSEPH L. HITCHINGS
THOMAS E. FLOWER
LAW OFFICES
SAID IS, SHUFF, FLOWER & LINDSAY
A PROFESSIONAL CORPORATION
26 WEST HIGH STREET
CARLISLE, PENNSYLVANIA 17013
TELEPHONE: (717) 243-6222 - FACSIMILE: (717) 243-6486
EMAIL: altorney@ssfl-Iaw.com
www.ssfl-Iaw.com
WEST SHORE OFFICE:
2109 MARKET STREET
CAMP HILL, P A 17011
TELEPHONE: (717)737-3405
FACSIMILE: (717)737-3407
REPLY TO CARLISLE
July 25, 2001
Dear Judge Ho er:
Bruce Robinson Hurst
553 Orphans' Court 2001
'(L,
~
The Honorable Judge George E. Hoffer
Cumberland County Courthouse
1 Courthouse Square
Carlisle, P A 17013
We are required by 20 Pa.C.S.A.S5511 to advise the Court at least seven (7) days
prior to the hearing in the above-referenced matter, which is scheduled for August
17, 2001, at 10:30 a.m., if counsel has not been retained by the alleged incapacitated
person. Weare quite certain that Mr. Hurst will not have retained counsel. We were
also asked by the Court Administrator to submit a form for Notification of Mental
Health Commitment to the Court prior to the hearing, which form is enclosed.
Very truly yours,
SAIDIS, SHUFF, FLOWER & LINDSAY
~
. I
J~. Flower, Jr.
JDFJ/pm
Enclosure
cc: Guy C. Hurst
Anne K. Hurst
~ 06/08/01 FRI 09:53 FAX 2406462
CUMB/COUNTY COURTS
14; 002
o
SP 4-131(1-91)
CCMMCItlWIA/.TH OF PlNHSY1.VANIA
NOTIFICA liON OF MENTAL HEALTH COMMITMENT
'The UnIIam FII&am1I Act, , B ?A. C.S. 111 ~ (c)(4) spedt\IIs that It sllIlI .. UIlIIwlll tlf"lll~ IIIl'IlllIIl$xIlcat8d II an IlIC01t11l111lI1 cr w\"Q '- been lnvoU\t&riy ~ to I mer-ltal
Il1lilltllllon lei' InI8dent car. Ind 1IW~ under SeI#Jl302, *. or $~ oIlhe MolMI HcIl1ti Pro=dUIW hi. gf July 0, 18711 (p .u,1. No. 1.&3) tCI poMeSS. uae. 1'lWI\lf&iIn.
~ ... or ~ fiNam'lS. 1l\ia would lnd\JI:Ie ~ at incapdy pu'SUItt III 20 Pa..IlSA~. PInuanlIo till Pcn~WIi~ MelllIlIIWUth ~ ~ S4lcIlcn
.ClI. noIIIcdon aIllIII bIIIlrlWn'IiUId to t. PtrNylftnili .. PQlklc by the juclgc. IMfllII '-IIh re'llew gftfQer cr ggunty ~ I\eaIlh end mental retarcIatlon admlnlllll'alar whhiI
SevEN.ayt QI\t1e ~udlcatian, ClOI'M'ib\'leI't OJ' hllllmeftt by lilt! cl8a8ll'1111la I'Ie p~ S1IU Pol.., AtbIIltlOll: FhIrIn UBIt, 1ICO EIm,*n AvenU8, IQrriIburg,
PA 171 to. HOT1: The 111.'" .lI8n b8 mnn "CONPIDINTIAL..
Place an OX' on either Involuntary Commitment or Adjudicatecllnccmpetent
INVOLUNTARY COMMITMENT
ADJUDICATED INCOMPETENT ,X .
Date of Involuntary Commitment or Adjudicatsd Incompetent
INDIVIDUAL INFORMATION (INDIVIDUAL INVOLUNTARlL Y COMMllTED OR ADJUOICATeD INCOMPETENT)
lAST NAME -B IL.J1 ,J J:-- . FIRST J ,0 Cc.:_ MIDDLE R 0 bl~.( (ll-'t
JR.. ere. MAlCiN NANE ALIAS
DATE OF BIRTH :~; /5' - S - / SOCIAL SECURllY NUMBER )LJ 6 -- 3 t ..- 1 0 6 It
SEX f1.-1 RACE (J av ~ HEIGHT C (0 I( \'\/EIGHT I -9' 0 HAIR brOtP "1 I!Y!.S h rp W rl
AnDRUS ~ lar.L.~ tJ~'1J~ oJ- ReUa.t... C~) r~d/Ii.Ju~~) a:H-IJ:sl~
NOTIFICATION BY (pleClI8 print name, addrll8S.. area code, and phone number of ag.ncy or eounty cowt.)
COUnty Submitting NoUflcatJon (I V /;4. ~l-{ au ,,?
County Mental Health and Mental Retardation Administrator
County Mental Health Review Officer
Physician
Ho&pitall Facility Providins Treatment J Addnl$$
Judge
SIGNA ruM OF NOTIFYING OFF1CIAL.
DATE
Cclurt Cllse Number
Dale of Court Order
.l~-b4.Ull J.U HI1.J,.l,U.1l L .1 .11 .1R_........H~....'.w.UJ.J..I,,/,..J."".L..I.J.I..J.,l,UJ.J..LJ..lJ,J....~J.J.J.J, ,I..u...,l, HI 1 .l.1n .._"'_"R_~_ p~~p ....................~"'.,...,\...a 1.............
NOTIFICATION OF PHYSICIAN'S DETERMINATION THAT NO SEVERE MENTAL DISABILITY EXISTS
T'n8 phyliclol1 WIll prQVido ligned oonIirmlltian ,,, the delarmiNllioll OIlI\e lack 01_ menl8l d~~ fclewing the inIiaI ~ticn unde, S8clicn ~02(b) or the Mentlll Heattn
F'roclIdu.. PI:! end pUlll*\t Ie !he Unltorm FlAlanns "Cl, Sealion 8111.1 ClIl(3). Neb $Millie nl'lemllttd by tile phyllicDn ll:l1J\e PenngyluSI1ia S\$e Poles thteUgh \tie county
rntII'Itll r.alth and menial r.latda!io~ admini&ll'alol' or mental he-'Ih r8Vi_ QIIlClH'.
Name of Physician (Please print.)
Sign.Me of PhY$icl;lrl
Dale
,<
S,I<
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
ORPHANS' COURT DIVISION
IN RE: BRUCE ROBINSON HURST
NO. 21-01-0553
DATE OF APPOINTMENT: 08/17/2001
INVENTORY OF ASSETS
DATE: 10/01101
DESCRIPTION
$ AMOUNT
SOCIAL SECURITY (MONTHL Y) 1,399.00
CREDIT UNION/CHECKING & SAVINGS ACCOUNTS 204.34
TOTAL CERTIFICATE OF DEPOSIT (MEMBERS' 1ST FCU) 1,200.00
TOTAL MONEY MARKET ACCOUNT (EDWARD JONES) 2,436.37
Expenditures from the estate since July 1, 1997
DESCRIPTION
$ AMOUNT
GUARDIAN'S EXPENSES 7,200.00
INVESTMENT INTO 603 NORTH WEST STREET (Carlisle, PA) 48,908.00
TAXES 2,200.00
INSURANCE 500.00
GUARDIANSIDP ATIORNEY FEES 650.00
1. The needs of Bruce R. Hurst, the incompetent person, are room and board at the
Cumberland County Nursing and Rehabilitation Center. He occasionally needs socks to
protect his feet and hands. The expenses are taken care of by his Veteran's Disability
Total amount received to date from Social Security is $64,258.00
2. Guy Chadwick Hurst and Anne Kendall Hurst, brother and sister of Bruce Robinson
Hurst have been court-appointed as the guardians for the estate Bruce R. Hurst since
August 17, 2001.
/Jwt aw{(,~~1 lof6/0/
Guy Chadwick HurstlDate I
AtttuLKo~u ~~ lo/t~/D I
Anne Kendall HurstlDate
PETITION FOR GRANT OF LETTERS
OF ADMINISTRATION
In Re: Estate of Bruce Robinson Hurst, Deceased No..2/ - 0 I - S-S-..3
To: Register of
Wills for the
Social Security No.206- 36-9060 County of Cumberland in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioners, who are 18 years of age or older, apply for letters of administration on
the estate of the above decedent.
Decedent was domiciled at death in Cumberland County, Pennsylvania, with his last
principal residence at 1000 Claremont Road, Carlisle, P A 17013.
.
Decedent, 55 years of age, died May 6,2006, at Carlisle Regional MedicalQtr.
Decedent at death owned property with estimated values as follows:
r~\~~
Real Estate
All personal property
Total
-0-
$ 149,644.42
~.r;;:-
$149,644.42
Petitioners, Anne K. Hurst and Guy C. Hurst, after a proper search, have ascertained that
decedent left no will and was survived by the following heirs:
Name
Anne K. Hurst
Guy C. Hurst
RelationshiQ
Sister
Brother
Residence
43 W. Oakwood Drive, Carlisle, PA 17103
603 N. West Street, Carlisle, PA 17013
THEREFORE, petitioners respectfully request the grant of letters of administration in the
appropriate form to the undersigned.
~t f6M~
Signature of Petitioner
4~ W.6t1l::~h-. (hU~ i?4- (701S
Address
4~ ~ ;ka1-
~igna ure of Petitioner
f>63 IV. fVl='3r :>i!eMLlSLQ-l ;d,A; 170(3
Address
Register of Wills of Cumberland County
OATH OF PERSONAL REPRESENTATIVE
COMM:ONWEAL TH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
}
SS:
The petitioner(s) above-named swear(s) or affmn(s) that the statements in the foregoing petition are true and
correct to the best of the knowledge and belief ofpetitioner(s) and that as personal representative(s) of the above
decedent petitioner(s) will well and truly administer the estate according to law.
;X Auu-t:~
Sworn to or affIrmed ~ subscribed
Bef~..re me this /Q-+ _ day of
V~ . 20 c)lj)
Jiy-n~ ~d-1 n o~ l ..JfA ~(y-1J
~ *. ~ti Register
4
{
~~(l.tAwtf'
00
~.
~
(1)
-.
en
--
No. J lei. 0;--;-3
Estate of ~U.CSL (.L \~
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
Administration
in the estate of ~ ^-^ r J) e ~ J...:A""
FEES
Probate, Letters, Etc. ............. $ JltDO. 00
Will ................................. I $
Renunciation...... ............ ..... $
Short Certificates (t) ............ $ 32. LJ (~
J CP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ \ o. ~) l:.
Automation Fee................... $ S- . 6U
Bond........... ...................... $
Total $ 36'. Cl0
Filedlo, . ~ 20 01.0
L~lk~,j 1-hQA4~~ .
RegisterofWills --- (J-oa
-' l"rlf0~ h /Sz..,rd ')~d;:? r=ty
Attorney (Sup t. J.D. No.)
S~ 3-
Ad~. I
c~ '6tt
7/7
<<kV1~~ y
;) n- / /)&,)5
~??)11 - '-~ -~ :s -L
Rhone
/
~1:-1 .
~ ~ ',.~ 7!
......,r ~
~L
)~~ ~j
I
,j --" "'--
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
ORPHAN'S COURT DIVISION
IN RE: BRUCE ROBINSON HURST
NO. 21-0&-0553,'::
DATE OF APPOINTMENT: 08/17/2001
INVENTORY OF ASSETS
DATE: 06/09/2006
DESCRIPTION
$ AMOUNT
SOCIAL SECURITY (MONTHLY FOR 2002) 1401.-1500
CREDIT UNION/CHECKING & SAVINGS ACCOUNTS 1116.98
TOTAL CERTIFICATE OF DEPOSTIS (MEMBERS 1ST FCU) 38,685.76
TOT AL MONEY MARKET ACCOUNT (EDWARD JONES) 2,796.72
Expenditures from the estate since October 16, 2001
GUARDIAN'S EXPENSES 8,100.00
INVESTIMENT INTO 603 N. WEST ST (Carlisle, PAl -0-
TAXES (500/0 OF 603 Property Taxes) 3,500.00
INSURANCE (LIFE) 14,830.91
1. The needs of Bruce R. Hurst, the incompetent person, are room and board at the
Cumberland County Nursing and Rehabilitation Center (Claremont). He
occasionally needs socks to protect his feet and hands and an electric razor. The
expenses are taken care of by his Veteran's Disability. Total amount received from
the time period of October 2001 (last report) and this report upon death is
581,154.20.
2. Guy Chadwick Hurst and Anne Kendall Hurst, brother and sister of Bruce
Robinson Hurs~ have been court-appointed as the guardians for the estate of Bruce
R. Hurst since August 17, 2001
c H#~t 61/'2- ob
hadwick HurstJDate
At<<tL~~'li foll()/~
Anne Kendall HurstlDate
-36
6, 2006
, Cumberland Middleton Twp.
: 11. Oecedenfs Usual Occu ion Kind 01 worll done duri most 01 worll' ~. Do not s\ale retired.
Kind of Wot1< Kind 01 Business flndustry
Registered Nurse US Air Force
. 16. OecedenI's Mailing Address (Street. city flown. stale. ~ code)
17b. County
PA
CUmberland
Did Decedenl
LiYe in a
Township?
17c. f] Yes. Decedent Lived in
17d.O ~~wilhin
Middlesex
Twp.
Decedent's
Actual Residence 17a. Slale
Claremont Nursing & Rehab. Ctr.
1 Claremont Rd. Carlisle PA 17013
18. Falhel's Nane (FIrsl, middle. last. suflix)
Harry Kendall Hurst
2Oa. InIonnant's Nane (Type I Pml)
City I Bore
@
!3
~ . ~
CompIele Items 23lH: only when certifying
physician is not avaiable at time 01 death 10
certify cause of death.
Items 24-26 must be completed by plnOfl
oMlo pronounces dealh. -; : ~'O
CAUSE OF DEATH (SM lnstructlona and examplH)
llem 'E. PART I: Enler \he ~- diseases. injOOes. 01 cornphcalionS -lhal direcly caused \he death. DO NOT enter leIminallMlllls such as cardiac arrest.
resplraloly anesI. or _lricular libriIaIion wilIlout showilg Ihe etiology. List only one cause on each line.
19. Molher's Nane (First. middle, IlI8iden surname)
Anne Chadwick
2lXl. Inlormanfs MaI1i1g Address (SIrget. city I town. slate, zip code)
43 W. Oakwood Dr., Carlisle, pa 17013
21c. Place 01 Dispo5iIion (Nane 01 cemetery. cremalDry or olher place) 21d. Locallon (City llown, stale. zip code)
York, Pa 17404
23c. Date Signed (Month. day. year)
26. Was Case ReIemld to Medical Examiner I Coroner for a Reason Other thai Cremation or Donation?
~ONo
~.
j
SequenIiaIy list conditions. Wany,
=:=:.~~~~
(disease or injury lhal initialed the
_Is resulting in death ) LAST.
se.f..s /5
Due 1D ( .,.. con_,,",," 01)'
c.ellc,.,I/1 :5
Due to (or .. . consequence 01)'
:z w~f..f
II- 1tDk.:.c- b*,tI. :~ ,'oA. j- ~""Y
28. Did Tobacco Use Contribute to Deatl?
o yes 0 ProbabI~
o No [31lOknown
29. W Female:
o Not pregnant within past year
o Pregnant al time of death
o Not pregnan~ but pregnant within 42 days
of dealh
o Not pregnant bul pregnant 43 days to 1 year
of dealh
o Unknown W pr8gIlanl within Ihe past year
32c. Place 01 Injury: Home. Farm. SlnIel. Factory,
Office Building, etc. (Specify)
AjlprOllimate inleMll:
Onset to Dealh
P8II1I: Enlllr o4IIer s9llficant mntitirlns mnlributino 10 deatI
but not resulting in \he undellying cause ~ in PlI1l.
:=~~US:J:~)dise~
J
I~I t /'O~l/" e)--fr~, "f7
Due to (or as . consequence 01)
o yes ~
o yes 0 No
31. Manner.JlHlealh
a(atural 0 Homicide
o Acddent 0 Pending Invesllgab 32d. Time of Injury
o Suicide 0 Could Not be Delermined
32g. Location of Injury (S_1. city floWn, slate)
3Oa. WIllS an Autopsy
Performed?
3/)). Weill Autopsy Fmdngs
Available Prior III Completion
of Cause of Death?
M.
33a. Certiller (check only one)
CertIIylng physlclen (Physician certiIytng cause 01 dealh when anothef physician has pronounced death and compleled lIem 23)
To lhe best 01 my ~...., deeth oc:cumd due to the ceWe(I).nd....- '''IIIe9_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - - - - - - - - _..D
. Pronouncing Ind certIIylng physlcllll (Phys1clan bolh pronouncing death and cenifying to cause of death)
To the besl 01 my knowtedge, deelh occumtcl . the tiM, dele, Illd piece, Ind due to the ceUH(a) Illd ....nner n a\al1d_ - - - - - - - - - - - - - - - - -
" = =n:~= and I or Il1Ynllgllllon. In my opinion, deMh occumd at thaliM, date, Ind place, and dUI to thl ceUH(I' and ......- .1 IIIIfcl.. - ..D
~
~
~
o
I
35. RegiS s'
~
u I a I \ I d-..I \ 10 1
CERTIFICATION OF NOTICE UNDER RULE 5.6(A)
Name of Decedent: Bruce Robinson Hurst
Date of Death: May 6,2006
Estate Number:
2001-0553
21-01-0553
To the Register:
I certify that notice of (beneficial interest) estate administration required
by Rule 5.6(a) of the Orphans' Court Rules was served on or mailed to the
following beneficiaries of the above-captioned estate on June 12, 2006:
Anne K. Hurst
Guy C. Hurst
43 West Oakwood Drive, Carlisle, PA 17013
603 North West Street, Carlisle, PA 17013
Notice has now been given to all persons entitled except: None
Date: t..e I /4' cl&
Lindsay D. Baird
Name
37 South Hanover Street
Carlisle. PA 17013
Add ress
c::>
L:J
(717) 243-5732
Telephone
Personal Representative
1-:)
lL Counsel for above
r
(
(
......",
c:..::.::
,-'~ -
~OMMOI, NEAL TH OF PENNSYL IJ ANIA
DEPARTMENT OF REVENUE
BUREA.U OF II"DIIJIDUAL TAXES
DEPT 2806(1
HARRISBURG, e~. 17128.0601
REV.1162 EX,II'96)
RECEIVED FROM:
PENNSYLV ANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
HURST ANNE 1<
43 WEST OAI<WOOD DRIVE
CARLISLE, PA 17013
-~ .un_ fold
I ESTATE INFORMATION: SSN: 206.36-9060
FILE NUMBER: 2101-0553
DECEDENT NAME: HURST BRUCE R
DA TE OF PAYMENT: 07/18/2006
POSTMARK DATE: 07/18/2006
COUNTY: CUMBERLAND
DA TE OF DEATH: 05/06/2006
!NO. CD 006989
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $10,661.83
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$10,661.83
REMARI<S:
CHECI<# 3755
INITIALS: JA
SEAL
RECEIVED BY:
REGISTER OF WILLS
GLENDA FAI~NER STRASBAUGH
REGISTER OF WILLS
_J
15056051058
REV-1500 EX (06-05)
PA Department of Revenue '*
Bureau of Individual Taxes
PO BOX 280601
Harrisburg, PA 17128-0601
ENTlER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
INHERITANCE TAX RETURN
RESIDENT DECEDENT
OFFICIAL USE ONLY
County Code Year
File Number
21 01
0553
Date of Birth
206-36-9060
05/06/2006
03/15/1951
Decedent's last Name
Suffix
Decedent's First Name
MI
HURST
BRUCE
R
(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
. 1. Onginal Return
2. Supplemental Return
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 11 Ejection 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 DIRECTED TO:
Name Daytime Telephone Number
4. limited Estate
6 Decedent Died Testate
(Attach Copy of Will)
9 litigation Proceeds Received
8 Total Number of Safe Deposit Boxes
JEFFREY S COHICK, EA
(717) 249-5321
Firm Name (If Applicable)
REGISTER OF WILLS USE ONLY.,
COHICK & ASSOCIATES
First line of address
390 ALEXANDER SPRING RD
Second line of address
City or Post Office
State
ZIP Code
DATE FILED
CARLISLE
PA
17015-9129
Correspondent's e-mail address:jcohick@cohickassoc.com
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 preparer other than the personal representative is based on all Information of which preparer has any knowledge
SIGNAT~E OF PER,SONRESPON~IBLE FOR FILING RETURN
n t 1i t.L K -I-ttU':"l
ADDRESS
43 W OAKWOOD DRIVE, CARLISLE, PA 17015
/~dZPARE V
c:: ADDR~'f;I;V
390 ALEXAN6ER SPRING ROAD, CARLISLE, PA 17015-9129
PLEASE USE ORIGINAL FORM ONLY
DATE,
'lIllie*"
f.ATE/
>7/'7 0 h
Side 1
L_
15056051058
15056051058
.-J
_J
15056052059
REV-1500 EX
Decedent's Name.
BRUCE
R HURST
FtECAPITULATION
1. Real estate (Schedule A),
2 Stocks and Bonds (Schedule B) ,
3, Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) , 3
4 Mortgages & Notes Receivable (Schedule D) .
5 Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ,
6 Jointly Owned Property (Schedule F) Separate Billing Requested . ,
7 Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) Separate Billing Requested"
8 Total Gross Assets (total Lines 1-7),
9, Funeral Expenses & Administrative Costs (Schedule H), '
1 0, Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) .
11. Total Deductions (total Lines 9 & 10).
12 Net Value of Estate (Line 8 minus Line 11)
13 Charitable and Governmental Bequests/See 9113 Trusts for which
an election to tax has not been made (Schedule J)
14 Net Value Subject to Tax (Line 12 minus Line 13)
TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(12) X ,0_
16. Amount of Line 14 taxable
at lineal rate X.O_
17, Amount of Line 14 taxable
at sibling rate X ,12 93,524,87
18 Amount of Line 14 taxable
at collateral rate X 15
19 TAX DUE
, 10.
11
12.
, 13.
14.
15
16
17,
18.
, 19
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
15056052059
Side 2
L_
Decedent's Social Security Number
206-36-9060
1,
2
2,791,53
4,
5,
48,584,72
47,587,05
6,
7,
8,
98,963.30
5,438.43
9,
5,438.43
93,52487
93,524.87
11,22298
11,222.98
15056052059
...J
REV-1500 EX Page 3
Decedent's Complete Address: 21
DECEDENT'S NAME
BRUCE R HURST
_~.u__.___~___._ _,'_.'___ _ ______ ___ _ ____ ____.__.._.__ __~.,. _______ ___
STREET ADDRESS
cia ANNE HURST
File Number
01 0553
DECEDENT'S SOCIAL SECURITY NUMBER
206-36-9060
43 W OAKWOOD DRIVE
CITY
CARLISLE
STATE
PA
ZIP
17015
Tax Payments and Credits:
1 Tax Due (page 2 line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
11,22298
561.15
Total Credits ( A + B + C ) (2)
561 .15
3. InteresVPenalty if applicable
D. Interest
E. Penalty
TotallnteresVPenalty ( 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)
5 If line 1 ;. line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
(5)
(5A)
(58)
10,66183
A Enter the IIlterest on the tax due.
10,661.83
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Did decedent make a transfer and: Yes No
a retain the use or I/1come of the property transferred; ............. ....... . ... .... .. .. ........ 0 ~
b retain the rrght to deSignate who shall use the property transferred or Its IIlcome;.. . .... . ...... 0 ~
c retain a reverSionary interest; or... . .. . .......... ..... ....... 0 GJ
d. receive the promise for life of either payments, benefits or care?.. ... .............. 0 [i]
2. If death occurred after December 12,1982, did decedent transfer property within one year of death
without receiving adequate consideration? ... . . .. ............... .............. .. .. .... 0 [i]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? " 0 [i]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ............................................................... ... ......... 0 ~
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 P.S, ~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 99116 (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 lax 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 99116(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. 991'16(1.2) [72 PS. 99116(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 P.S. S9116( 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 adoption.
REV-1503 EX+ (6.98*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
BRUCE R HURST
FILE NUMBER
21-01-0553
All property joinlly-owned with right of survivorship must be disclosed on Schedule F_
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
EDWARD JONES ACCOUNT #851.09760-1-5
2.79153
TOTAL (Aiso enter on line 2, Recapitulation) $
(If more space IS needed. Insert additional sheets of the same size)
2.791 53
REV-1508 EX+ (6-98)
SCHEDULE E
CASH, BANK DEPOSITS, & MISe.
PERSONAL PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BRUCE R HURST
FILE NUMBER
21-01-0553
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with right of survivol'1ihip must be disclosed on Schedule F.
ITEM
NUMBEH
DESCRIPTION
VALUE AT DATE
OF DEATH
MEMBERS FIRST FEDERAL CREDIT UNION
REGULAR SAVINGS ACCOUNT #223841-00
27.88
2 MONEY MANAGEMENT ACCOUNT #223841-05
16,89213
3 CERTIFICATE OF DEPOSIT ACCOUNT #223841-40
4 CERTIFICA TE OF DEPOSIT ACCOUNT #223841-45
o
11,69998
18,84775
5 REGULAR SAVINGS ACCOUNT #172644-00
1,11698
__1
TOTAL (Also enter on line 5. Recapitulation) $
48.584.72
(If more space IS needed. Insert additional sheets of the same size)
REV.1509 E:X+ (6-98.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
BRUCE H HURST
FILE NUMBER
21-01-0553
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. ANNE HURST
43 W OAKWOOD DRIVE
CARLISLE, PA 17015
SISTER
B. GUY C HURST
603 N WEST STREET
CARLISLE, PA 17013
BROTHER
c.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECOS VALUE OF
NUMBE R TENANT JOINT IDENTIFYING NUMBER ATTACH DEED FOR JOINTLY.HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENTS INTEREST
1. A. 02102103 MEMBERS FIRST CREDIT UNION CERT OF DEPOSIT #223841-42 11 ,444.44 50. 5,72222
2 A 02/24105 MEMBERS FIRST CREDIT UNION CERT OF DEPOSIT #223841-43 31.60062 50 15,80031
3 A 05/03/05 MEMBERS FIRST CREDIT UNION CERT OF DEPOSIT #223841.44 15,54134 50 7,77067
4 B. 07/14/02 MEMBERS FIRST CREDIT UNION CERT OF DEPOSIT #172644-40 36,587 69 50 18.293 85
I
I
TOTAL (Also enter on line 6 Recapitulation) $ 47.58705
!If more space IS needed. Insert additional sheets of the same size)
REV.1511 EX+ (12'99)*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
BRUCE R HURST
FILE NUMBER
21-01-0553
ITEM
NUMBER
A.
Debts 01 decedent must be reported on Schedule 1.
DESCRIPTION
AMOUNT
1.
FUNERAL EXPENSES:
FUNERAL
CEMETARY
FLOWERS
ORGANIST FOR SERVICE
FOOD AFTER SERVICE
2,09560
705.00
37.10
45.00
200.40
2
3.
4.
5.
B. ADMINISTRATIVE COSTS
Personal Representatives Commissions
Name of Personal Representative( s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City
State
Zip
Year(s) Commission Paid:
2.
Attorney Fees
1,05000
3. Family Exemption (If decedents address is not the same as claimants. attach explanation)
Claimant
Street Address
City
State
Zip
Relationship of Claimant to Decedent
4
Probate Fees
307.00
5. Accountant's Fees
6.
Tax Return Preparer's Fees
750.00
7
LEGAL ADVERTISING- THE SENTINEL & CUMBERLAND LAW JOURNAL
248.33
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, Insert additional sheets of the same size)
5.438.43
REV.I513 EX t (9-00)
'*'
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
BRUCE R HURST
NUMBER
I
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under
See 9116 (a) (1.2)]
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
1.
43 W OAKWOOD DRIVE, CARLISLE, PA 17015 SISTER
ANNE HURST,
2.
603 W NORTH STREET, CARLISLE, PA 17013 BROTHER
GUY C HURST.
FILE NUMBER
21-01-0553
AMOUNT OR SHARE
OF ESTATE
50%
50%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-1500 COVER SHEET
II NON-TAXABLE DISTRIBUTIONS:
A SPOUSAL DiSTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART" - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $
(if more space is needed, insert addilional sheets of the same size)
STATUS REPORT UNDER RULE 6.12
Name of Decedent: Bruce Robinson Hurst
Date of Death: 05-06-2006
Will No. 21-01-0553
Admin No. 2001-0553
Pursuant to Rule 6.12 of the Supreme Court Orphans' Rules, I report the following with
respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete:
Yes X No
2. If the answer is No, state when the personal representatives reasonably believe that the
administration will be complete:
3. If the answer to No.1 is Yes, state the following:
Date:
a. Did the personal representatives file a final account with the Court?
Yes No X
b. The separate Orphans' Court No. (if any) for the personal representatives'
account is:
c. Did the personal representatives state an account informally to the parties in
interest? Yes X No
d. Copies of receipts, releases, joiners and approvals of formal or informal
accounts may be filed with the Clerk of the Orphans' Court and may be attached
to this report.
September 9, 2006
! /
\, ,/
i/ ( \. f. 1.( j~ \ ,~/ /Ot . ,. ,~, /' ~_ <. l
/
Signature /
/ Lindsay Dare Baird, Esg.
Print Name
N
("')
N
({:
I--
0: C"
J :'
LLr.....( ';
OU(-.,
:-L: U) :;:-,
ffi z ~j
---' :$ 0-
U --- Lc
8:!;!.~
0;5
'-.)
(717 ) 243-5732
Tel. No.
.......
~.....
0-
37 S. Hanover Street, Carlisle, PA 17013
Address
r-
I
0-
W
(/)
v-c:>
=
=
~
Capacity: _ Personal Representative
~ Counsel for personal
representati ves
<~
'.J
F AMTLV SETTLEMENT AND FINAL RELEASE
ESTATE OF BRUCE R. HURST, DECEASED
KNOW ALL MEN BY THESE PRESENTS, that WHEREAS, Bruce R. Hurst, late of 1000
Claremont Road, Carlisle, Cumberland County, P A, deceased, died intestate on May 6, 2006;
WHEREAS, letters of administration on the estate ofthe said decedent were duly issued by
the Register of Wills of Cumberland County, Pennsylvania, to the Executors, hearinafter called
personal representatives;
WHEREAS, the said personal representatives have gathered the assets of the estate of the
said decedent and the assets consist of personal property to a total value of $160,801.82, as set forth
in Exhibit A, which is a statement of account of the said personal representative, and which is
attached hereto and made a part hereof, and marked Exhibit A;
WHEREAS, the debts and the deductions, including the payment of inheritance tax in the
said estate. amount to $13,240.61, leaving a balance for distribution of$14 7 ,561.21. also as set forth
in the statement of the said personal representatives, Exhibit A;
WHEREAS, the balance for distribution as shown in the said statement marked Exhibit A
has been reduced to cash and has been distributed as follows:
Guy C. Hurst - $29,379.69, and
Anne K. Hurst - $118,181.52.
NOW, THEREFORE, KNOW YE, that we, Guy C. Hurst and Anne K. Hurst, being all of
the siblings of the said decedent and his heirs, do hereby, each of us, acknowledge that we have this
day had and received from the aforesaid personal representatives, in full satisfaction and payment
of all sum or sums of money, which amounts we have received this day, and which amounts are in
the amount set opposite our respective names in the table and schedule of distribution in said
statement attached hereto and marked Exhibit A;
AND, each of us does hereby stipulate that in order to avoid the expense and time involved
in the filing of a formal account and schedule of distribution, we each agree that no account is
necessary and we do hereby agree that we do consent to distribution being made without the filing
of an account and schedule of distribution, the same to be with the same force and effort as if they
had been filed and confirmed by the Orphans Court Division of the Court of Common Pleas,
Cumberland County Branch.
THEREFORE, we and each of us do hereby remise, release, quitclaim and forever discharge
the said personal representatives, two heirs, executors, and administrators and assigns, of and from
the said estate and from all actions. suits, payments, accounts, reckonings, claims, and demands
whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever touching
upon the estate ofthe said decedent, and each of us do further hereby covenant and agree that should
any liability come due to the estate of the said decedent after the signing of this agreement, we and
each of us do hereby covenant and agree with each other and the aforesaid personal reprcscntatiycs
that we will contribute pro rata our share of the estate to satisfy any and all claims, demands, suits,
or causes of action which may be successfully prosecuted against the said estate or the aforesaid
personal representative after the signing, sealing and delivery of this family settlement agreement
and final release.
IN WITNESS WHEREOF, we have hereunto set our hands and seals this r..
:Y. ! (ld\,':' ,2006.
day of
Witness:
><;/
;.
/~, . ( I
--:>
\ '; ':,' " / t.).f. ',' ," --
t \~ "ilL'- k ,1c.U -:;t.
(SEAL)
)
i /:
//~ltz. ,/ ( lL< 1 i . f-
(SEAL)
/ /
? -
COMMONWEAL TH OF PENNSYLVANIA
SS
COUNTY OF CUMBERLAND
On this, the-:; / day of 1/, 2006, before me, a Notary Public, the
undersigned officer, personally appeared Guy C. Hurst and Anne K. Hurst, (known to
me/satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and
acknowledged that they executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
t ( ";1"";./::"1,, C'. > /.
Notary Public
My commission expires:
Notarial Seal
Lindsay D. Baird. Notary Public
Carlisle Bora, Cumberland County
My Commission Expires Oct. 21. 2006
Member, pennsylvania Association ot Notanos
STATEMENT OF THE PERSONAL REPRESENTATIVES
Estate of Bruce R. Hurst
Total assets:
$160,801.82
T otal debts:
13,240.61
Assets available for distribution:
147,561.21
Schedule of distribution:
Guy C. Hurst - $ 29,379.69
Anne K. Hurst - $118,181.52
09-04-2006
HURST
05-06-2006
21 01-0553
CUMBERLAND
101
APPEAL DATE: 11-03-2006
( See reverse side under Objections)
Amount R-.ittedJ r
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE1 PA 17013
~~I_~~9~~_I~~~_~~~~------~--_!~!!!~_~9~~!_~9!!!9~_E9!_Y9Y!_!~P9!~!__~____________________
REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
BRUCE R FILE NO. 21 01-0553 ACN 101
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
PO BOX 2110601
HARRISBURG PA 171211-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
p.or.rl~~SEMENT 1 ALLOWANCE OR DISALLOWANCE
"._~,j,'iotL9~c-AND ASSESSMENT OF TAX
Ht.'''iC'Trq "roo VL ,~!,:-
, .\.1;, ,'I""f f ".
...- ..........c j \....)/
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
2006 SEP -8 AH ff: 13
~~~~~&SA~~~~~ cu~~~~
390 ALEXANDER SPG RD '
CARLISLE PA 17015
ESTATE OF HURST
*'
REV-1547 EX AFP (06-05)
BRUCE
.I
R
TAX RETURN WAS: (X) ACCEPTED AS FILED
( ) CHANGED
NOTE: To insure proper
credit to your eccountl
sublli t the upper portion
of this for. with your
tex paYllent.
I~ an asses..ent was issued previously, lines 14, 15 and/or 16, 17, 18 and
r~lect ~igures that include the total ~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Mount of Line lilt et Spousel rete (15)
16. ADount of Line lilt texable at Lineal/Cless A rate (16)
17. Allount of Line lilt at Sibling rate (17)
18. Mount of Line lilt taxable at Colleteral/Cless B rete (18)
19. Principel Tax Due
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Reel Estete (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
Ilt. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. .Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(Ilt)
(5)
(6)
(7)
.00
2.791.53
.00
.00
48.584.72
47.587.05
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/AdM. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgege Liabilities/Liens (Schedule I)
11. Totel Deductions I
12. Net Velue of Tax Return
13. Charltable/80vern.ent.l Bequestsi Non-elected 9113 Trusts
lilt. Net Velue of Estate Subject to Tax
51438.43
(9)
1l0)
00
(11)
(12)
(13)
llllt)
(Schedule .n
NOTE:
.00 X
.00 X
931524.87 X
.00 X
00 =
045 =
12 =
15 =
(19)=
DATE
07-18-2006
NUMBER
CD006989
INTEREST/PEN PAID (-)
561.15
AMOUNT PAID
101661.83
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
TOTAL DUE
· IF PAID AFTER DATE INDICATED 1 SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
DATE 09-04-2006
981963.30
1i.43A 43
931524.87
.00
931524.87
19 will
.00
.00
lL222.98
.00
111222.98
111222.98
.00
.00
.00
( IF TOTAL DUE IS LESS THAN $11 NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR)I YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)