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Home My WebLink About10-13-06 IN RE:ESTATE OF MILDRED A. BARTCH : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : ORPHAN'S COURT DIVISION : ESTATE NO. 2106-0099 LATE OF THE BOROUGH OF CARLISLE PETITION FOR SETTLEMENT OF A SMALL EST ATE PURSUANT TO 20 Pa.C.S.A. SECTION 3102 TO: THE HONORABLE JUDGES OF SAID COURT: The Petition of Mary A. Weir respectfully represents that: 1. Mildred A. Bartch died on July 2, 2005, a resident of the Borough of Carlisle, Cumberland County, Pennsylvania. 2. Petitioner, whose address is 7 Kerrs Avenue, Carlisle, Pennsylvania, 17013, is the Administratrix of Decedent's estate, having been issued Letters of Administration by the Register of Wills of Cumberland County Pennsylvania, on February 1, 2006. 3. Decedent's heirs pursuant to 20 Pa.C.S.A.s 2103(1) are: (a) John R. Weir 7 Kerrs Avenue Q r-...> <:::> <-:..~ Carlisle, P A 17013 ~ ."7;J a rl"i C) C) -; (~ (b) Debra L. Johnson ~-J W C:_~~J r, 2612 Keeler Run Court C:::J Travelers Rest, SC 29690 -0 ~::: S--? (c) Linda A. Weir a ,-,") :-:-:-;, Bungalow 0'\ ;-1 Bogend Farm Catrine, Maucline Ayrshire, KA5-JNJ 4. At the time of Decedent's death, the only assets of which she was seized were: if- (a) Commerce Bank Checking $ 7,773.22 Account No. 0513105890 (b) Unclaimed Property Claim with $ 2,297.06 Commonwealth of Pennsylvania (c) 2004 Rent Rebate payment $ 496.20 (d) Blue Cross Insurance $ 462.63 Reimbursement Total $11,029.11 5. Debts of the Decedent and funeral expenses and administrative costs of the estate are: (a) Administratrix Commission $ 436.60 to Mary A. Weir (b) Attorneys fees to $ 2,246.00 Griffie & Associates (c) Probate fees to $ 205.00 Register of Wills (d) Department of Public Welfare $ 6,486.14 Medicaid Lien - Estate Recovery (e) Final Nursing Home balance to $ 37.30 Forest Park Health Center (f) Medical bill to $ 16.00 Omega Labs (g) Medical bill to $ 323.00 Carlisle Regional Medical Center (h) Ambulance Service to $ 856.72 Goodwill Fire & Rescue (i) Medical bill to $ 8.73 Moffitt Heart & Vascular Group (j) Medical bill to $ 60.00 Graham Medial Clinic (k) Inheritance Tax to Commonwealth of Pennsylvania $ $15.85 Total $ 10,676.86 6. Petitioner has paid all known estate debts and expenses by her personal contribution to the estate. 7. The medicaid lien due and owing to the Department of Public Welfare has been satisfied to the satisfaction of the Department as set forth on Exhibit "B" which is attached hereto and incorporated herein by reference. 8. There are no additional claimants or creditors of whom Petitioner has knowledge who has not received full compensation. 9. A Pennsylvania Inheritance Tax Return has been filed previously in this estate, together with permitted discounts and exemptions and along with any interest and penalties. 10. The Inheritance Tax has been paid in full, as evidence by the Inheritance Tax statement of account is attached hereto incorporate as hereby reference as Exhibit "A." 11. The sum of $336.40 remains in the estate for disbursement to the heirs, who will share equally in this benefit. 12. Notice of the intention of filing the within Petition has been given to the named beneficiaries, as evidenced on the attached Certificate of Service. 13. In the correspondence to the named beneficiaries of the estate, notice was given that the within Petition would be filed on or after October 1, 2006. WHEREFORE, Petitioner requests your Honorable Court to approve settlement of this estate with no disbursements to the named heirs, as no assets or benefits exist for distribution. Respectfully submitted, riffie, Esquire om for Petitioner 200 North Hanover Street Carlisle, P A 17013 (717)243-5551 (800)347-5552 I verify that the statements made in the foregoing document are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unsworn falsification to authorities. DATE: 1 tJ'lt!; I t){p .1Jk auiuG trfR IN RE: ESTATE OF MILDRED A. BARTCH : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYL VANIA : ORPHAN'S COURT DIVISION : ESTATE NO. 21 06-0099 LATE OF THE BOROUGH OF CARLISLE CERTIFICATE OF SERVICE SI I, Bradley L. Griffie, Esquire, hereby certify that I did, the ;J I day of September, 2006, cause a copy of Petitioners Petition for Settlement of a Small Estate to be served upon the following by first-class mail, postage prepaid at the following addresses: John R. Weir 7 Kerrs Avenue Carlisle, P A 17013 Debra L. Johnson 2612 Keeler Run Court Travelers Rest, SC 29690 Linda A. Weir Bungalow Bogend Farm Catrine, Maucline Ayrshire, KA5-JNJ DATE: ~ I J";>-/'b fp rif , Esquire fo etitioner GRIFF &ASSOCIATES 200 North Hanover Street Carlisle, P A 17013 (717)243-5551 (800)347-5552 09-12-2006 BARTCH 07-02-2005 21 06-0099 CUMBERLAND 101 APPEAL DATE: 11-11-2006 ( See reverse side under Objections) Amount Remitted I I MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 PY!_~~9~~_!~~~-~~~~--____~___~~!~!~_~9~~~_~9~!!9~_E9~_Y9Y~_~~~9~~~__~____________________ REV-1547 EX AFP (03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX MILDRED A FILE NO. 21 06-0099 ACN 101 BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIYISION PO BOX 280601 HARRISBURG PA 17128-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT. ALLOWANCE DR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX BRADLEY L GRIFFIE GRIFFIE 8 ASSOCIATES 200 N HANOVER ST CARLISLE DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN PA 17013 ESTATE OF BARTCH REY-1547 EX AFP (06-05) MILDRED A TAX RETURN WAS: (X) ACCEPTED AS FILED ) CHANGED DATE 09-12-2006 I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will re~lect ~igures that include the total o~ ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rate 16. Amount of Line 14 taxable at Lineal/Class A rate 17. Amount of Line 14 at Sibling rate 18. Amount of Line 14 taxable at Collateral/Class B rate 19. Principal Tax Due RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. 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) (4) (5) (6) (7) .00 .00 .00 .00 11. 029 .11 .00 .00 (8) APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) 10. Debts/Mortgage Liabilities/Liens (Schedule I) 11. Total Deductions 12. Net Value of Tax Return 13. Charitable/Govern.ental Bequestsj Non-elected 9113 Trusts (Schedule J) 14. Net Value of Estate Subject to Tax (9) (10) 2.888.60 7.788.26 (11) (12) (13) (14) NOTE: (15) .00 X 00 = (16) 352.25 X 045 = (17) .00 X 12 = (18) .00 X 15 = (19)= NOTE: To insure proper credit to your account. submit the upper portion of this form with your tax payment. 11.029.11 10.676 86 352.25 .00 352.25 .00 15.85 .00 .00 15.85 TAX CREDITS: "'n~~. n;c,,"C.Lr l+J AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 08-01-2006 CD007035 .00 15.85 TOTAL TAX CREDIT 15.85 EXHIBIT BALANCE OF TAX DUE .00 I A INTEREST AND PEN. .37 TOTAL DUE .37 · IF PAID AFTER DATE INDICATED. SE FOR CALCULATION OF ADDITIONAL INTEREST. L DUE IS LESS THAN $1. NO PAYMENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDI~' (CR). YOU MAY BE DUE ; . *' n/A- c \ O;)e.!./ '7/0-'" (oltJ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DIVISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX 8486 HARRISBURG. PA 17105-8486 if , tv 1: 27 July 26, 2006 ~ i- L- ;- r:; "-..... GRIFFIE & ASSOCIATES BRADLEY L GRIFFIE ESQUIRE 200 NORTH HANOVER ST CARLISLE PA 17013 Re: MILDRED BARTCR CIS #: 910173827 SSN: 199-12-3306 Date of Death: 7/2/2005 Dear Attorney Griffie: This is to acknowledge receipt of payment in the amount of $1,943.69 regarding the above-referenced estate. Total paid to date is $6,486.14 and reflects payment up to the value of the estate. If any additional funds become available, please contact me. Your cooperation in resolving this matter is appreciated. Sincerely, ~ (J If.)iIi~1.~.n.,~ ~~J;.~>'t,{1-.. :.:/ . Barbara I. Aschenbrenner TPL Program Investigator 717-772-6617 717-772-6553 FAX EXHIBIT I A