Loading...
HomeMy WebLinkAbout94-00802 No, To: Reglsler of Wills for the lHcrQJtd, CounlY of ( '\lIllI", " ! ,ll1cl in Ihe Soc/al Strum>, No, 1 '11 - 'J (, - 7 H ,\ 1I Commonweahh of Pennsylvania The pelilion of Ihe undersigned respeclfully represenls Ihal: Your pelilioner(s). who is/arc 18 )'ears of age or older an,(t?l\!~tcilf",,,;; dll" t'Y 1 1'(',lrrl"1 named In the lasl will of Ihe aboH decedenl. daled ~'f'pl' rl',l", " 'J 7 . 19...ll..6..- and eodicil(s) daled (No oxecutor nnMc'd; rcnldunry llcrlcf'.clnrlcs entitled to sorve nA ndrllinintrntors c.t.n.: fJ0P renUllcintiollr; ~ttncllcd) PETITION FOR PRODA TE Ind GRANT OF LETTERS r:;l.) - ql.{. -&O~ lIe'.cn B. G!"irrithn blalt oj also known QJ . {Ullt' rclr\anl cirCllmuancc,. (".. f('nunnallon. d('~lh of UtCUlor, tit.) Decendenl was domiciled at dealh in CIl",hpy 1 ,1 nc1 Coumy. Pennsylvania, with II n r lall famil)' or principal residence al .142 h'il \ 11 U t 130 t t o III HOild, Cil r 1 tfi ! e BOrOl1Clh Ih\llUf'C'l, number and munClr3hl~. Oeeendenl. thep B l) )'earl of a~e. died ~I,l rch 31 , J9l) 4 at 'I'hornwilld lIome, 442 \~illnllt Bottom HOilc1, Lilr!islc Borollqh hcepl "' followl. decedenl did nol manl'. w"' nol di\orced and did nol have a child born or adopted afler execulion of Ihe will offered for probale; wal nOllhe "iclim of a killing and wal never adjudicaled incompelelll: Oecendem al dealh owned propertl' wilh ellimaled valuel as follow" (If domiciled in Pa,) All perlonal property (If nol domiciled in Pa.) Personal property III I'ennlyh'ama (If nOl domiciled in I'll.) Personal property in County Value of real ellale in l'enMylvanill litualed "' follow" S unest ir.li1 ted S S S none WHEREFORE. pelilionerll) relpeclfully request(I) Ihe probale of the last will and codicil(s) pre'enled herel'llh and Ihe gram of leller> 0 f ildmi n i s t ril t ion c. t . il . 'C 6 ..,- l" '" t c ..,0 c:: . " _t ~~ . c ~ or. Ilt~lamtnliU~. .ulmlllnllallOn (,1,a.; admml\lratlOn d.b.n,t.1.a.1 ~~ ~" ~(( 0 --- .....:. l"lIA. ~" .JHr~'B DnvU] IIcndrv ~~u~o~:g\ ~l)~~ sgri~.T ...L:1.l.7l 7{;'\-1477 theron. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA }' l:lS COUNTY OF _LU~II3EIlI.^ND The pelilioner(l) a~o\'e'named Iwearll) or affirmll} thallhe Ilalemen:' In the foregoing pelition are true and mnecl 10 the bell of the knowledge and belier, of peli~ner(S) aJl'o'lhal as person~eprelen. latil'e(l) of Ihe ahole decedent pelilionerll) will well and trllly. ad~lillcl the <'11 ale aceorfing 10 law. . . "B&"<' ;(1 ! 5"orn 10 or affllmed and sublcnbed ., ('J'1M' .~, iX, (,' '" hdore '~<;',l~i~_~_l3IH-...,_ ~a.! o~ ~ ,Jilnics lJilVl lIel1dr..",....~ ~. 'ff!;' tl~ t~7197iTf" " ' !: .' -t_,. " _, ) ,) . ' t:' II'I! .:...~"i.'.. ,..,' . ,/ . 1.. (._~,I(I ~ J . I ' ~ 11(. ),~"" .;'I~l!lRY C, LEWIS R,'~i.I/,'r' ~' ~ N 21 - 94 - !l0;> o. Estate of . Dec:eued IIE'.FN B. GHlFFI'l'lI~ DECREE OF PRODA TE AND GRANT OF LETTERS ^NO NOW SEPTEMBER 20. 19..2.1.-, In consideralion of the petition on .he reverse side hereof. SllisflClory proof hlvinl been presented before me, :' IT IS DECREED Ihaltheinstrument(s) dlted t;cptl'II1!l,,;- 27, 1 'JIl(, described therein be admilled to probate and liIed of record as the last will of 11")"11 n. GriffilllB and Lellers or Adl11iniBt:riltiol1 c.l.ll. arc hereby Iranled to J,lll1l'B DilVi<1 ""11<11',/ Will Book' Pale /(.! '. /,1. fJ~ ( .:t. f.;/ . R.JiIl" of 110',111 ( 7/ MARY C. LEWIS . FEES 40.00 Probate, Leners. Elc. .....,... S ShOll Cellilicatel( 1) ........ "S 3.00 Renunciation . (~.l,..,.,."" s 20.00 JCP S 5.00 TOTAL _ S 6A.00 Filed ....,. ?~!"T.~~\\I~.R. ,~9,.. ,I, ~?~, , . , . , . . Htr"lf>h('ln f,. Bloom, EHl1ui rr~ A TIORN!:" CSur. Ct, 1.0. No., ~lAIl'I'SON. DEAHIlOHI'I' , \~ /1.1,1 MlSb O'J''I'O AOllRlSS 10 EM;t 1Ii,<]11 St.. Lllrlia1o, I'A 17013 (717) 241-1341 PilON I, ~) (j Ca 11 ed attOl'ney on 9-20-94. "'0" "~ IUV 1\ hI lHt Ion II,,~; C1RltFICAlllii)<;1 \,.r<lHH[/L,' II i!l; '"~ i,' ','1" I 1l'j nlJPllt/d HI' j'-ij"_'i(" j, i'il'- ," COMMONWEA\.l1t OJ I'ftlNSYI VANIA OEPAUTMU4T or HlAl lit VITAL fllconos LOCAL REGISTRAR'S CERTIFICATION OF DEATH CERT. NO. 2093780 ., {~h.' ). ,~,- (fIX...__ .1'r'~1'"i'''''~''''''' /1; / ( .l ' I I 'r;" /(." Name 01 Decodenl '~(';~",.:-._-_...------- j-'-'''';!I'/d iU<'J. .L-<).__......_.~.Y..i r..-tl:/.J...------'--'-- r,," 1/,,<,.. ',. I ' Sox ,...y~,~..uL_...Social Security No._LZI....::..2;[,_~'-Z~':,,~d__.__,._Oalo of ooalh-21!.'L.'IL,tf~'J,lrLl2X~__._ Dalo of Birlh),j't,J ~; / '/<'.'L BlrthPlnCO___:.2'II.'L.-t.f~j~,c...;_';:'__.____...__ Placo of Oenttl _..Mc.w.:r:/?t. :~.L!J..!.,-,.___i!., JJli:.~J",,!c;_____.e~...&~~___._l'Jm!)!!YJ~fiDl"_ ,.~_ql f...... lu,,", ,,,'t IL.' "...)'-, t' l,,'''''''''1> ,>// ./- /) / ' ~), Raco __,_... LiL..l.:-___Occupalion ---:rv:t.t.c.u.:..;"'y.-"----,--,-...;C"t-IY~d Forcos? (Yes or No) ____J_<'___ 'J! ',1 _ _! Docedent's t. ..'1't";L"'t--;}U'lt.,t '_ /' _-~:;;:~r'~Jr ... _:,.- ---:7 Mnrllal SIal us ~~~"'(~h'$:(L.......- ~alling Addross ...~--i4.!c?"-~~4L}-k.(f.!..:iklll,::..?l7'-T~~':!:" I;. L---......!./"-_ Informanl"::'1;~4'a...~,(: /~.:....d.'4/;trt.v'.....__ Funeral Dlreclor ___~L':.c.4'~.,({C/,_X,LU:7.Jt/...:-.._____ Name and Addross of 1/' ff/, ,;., .,-~ Funornl Eslablishmonl ;jl1.fr<'.1J,j",-.7.mll.kLt.~ JIlL... .!j.Wd '.__V...J.!.~<J,...4_(Z;w.J:Jbc ','lo'l.-- ~ / ,/ t/,I': Intorval Botweon Pari I: Immodinle Causo : Onset and Doalh , , (a) _-'.y,".._....q..'J.,;.,~_;I;!/ t.xL/________ _m ___ __ ._.. ___ _ j_L42Jf~::?l.jh__ ".1/ I..--l ,J)' , (b) 'A'(...:.~r~I..<..L.,/l'.';:fWU."-W ~d.~_--------,---__~-- - 'I // I (c) " ,_,___....___,.____ .,_,____."__.___.____: , , (d). m_._____._.... u_._m_'.....'_.,____,________:__ Part II: Othor S.!'~f:C~~ Zf~~~a:Zt;"d_~d, ~/::r ..dO. .,.,._. __.m.---____________________'__ Manner of Death: Dosc:ribn how Injury occurrod: 0' Accident 0 o Nalurnl Homlcldo Cl o o Suicido Ponding Invostlgatlon Could nol bo Detormll1od 'j , io, 'I ,', Name and Title of COrllfior _&U~ &! d" 72:',._i;i . _______ , .' /} . " ........ (M.D" D,O" Coronor, M.E,) .. ., '1'1 ,r.;:.:,U . . , ""//"IA.,...- ,,' ili " F Addross ..'.':' I '1.a/~~_....L'{-'--~:~::--'7I. -ftj.z."""1#----:,...-~ , I' /' ! , ;', . I This is to certify that tho information horo givon is carroctly copied from an original certificate of dealh duly flied with me as Local Rogistrar. The original certificato will bo forwardod to the Stato Vital Rocords Office for perman en I filing, . .-' /~I : J:.'1,;..t. ...- ,/; - ! j~l.. ..u"".J ,,~, :,"L3' 11i"li\t'... U . . - -""" ~ l..o'l . /rh .-;/. --I",} .<</.......,,,: _......~":.:t---/JJ-.-r~...J_w..<_<.:.r......v_,,_....~_ay-- " \ u,,~, 11"J'\'rM ,~! '~l!,~lh.:'-"cI~ ,"',,"-! II,} , ......-;- I ," f'J /,',1 . II ,/"':7 ,.J.Sj:_(/.i/,.&_e...'t?-'-(~. ..-:.tt..:...!_0L/,j~ ~ '.t"." ,'-I'V"'~ ',"1, 1I<;""'H1>, l~""'~ / ./ / I 21 - 94 - 802 :i , 21 - 94 - 802 RENUNCIATION In Re EIlale of IIELEN B. GRIPFITIIS deceased. To the Register of Wills of Cumberland COlllllY. Pennsylvania, The undersigned residuary heir (grandson) of the above deeedenl. hereby renounce(s) the rlghl 10 admlnlller Ihe eslalC and respectfully ask(s) that Lelters of Administration c.t.a. be issued to James David lIendrv WITNESS mY hand this fl.l day of --A (/~ . ,192i-. . 'J) . S I( *~. .~C~ (SI,.DIII") Robin S. lIendry 3856 l\ Humphrey St. Louis, MO 63116 (Ad~r...) . (Slgllatute) (^~~",.) .<'l 00 (SlllnUltlfc) (^~~'m) 21 - 94 - B02 REGISTEI{ OF WILLS OF COUNTY OATH OF SUnSCRlUlNG WITNESS codicil (each) a lublcriblng witnels 10 Ihe will presented herewith. (each) being duly quallficd according 10 law, depOle(s) und lU)'(I) Ihal prclent und law the teSlal , lign Ihe lume und Ihal Ilgned us u willless allhe requesl of lel1al_ in h_ presence Gild (In Ihe prelence of each olher) (In thc presence of Ihe olher subleriblng wilness(elll. Sworn 10 or affirmed and subscribed before lIle Ihls day of 19_ (Name! (Address) Reg;slrr .- (Name) (Address) REGISTER 01<' WILLS OF cu~mrmr.^ND COUNTY OATH OF NON.SUBSCRIBING WITNESS JAMES DAVID HENDRY and SANDRA S ECKENROOF (each) a lublerlber herelo, (each) being dull' qualined according 10 law, depOle(s) and say(s) that l1e/shc is familiar wilh the lignmure of l1e1en B. Griffiths. llIillltK will lellalri x or (Xlllll< X1t xlill! X'o\ll1>'(rlbiKlIOM'Ililll~oli.X y,lj the Ihnl h0/q,hC\ presentcd herewith and Xcoll~ll believes Ihe ,Ignnture un Ihe will II inlhc l1andwrltlng of lIe1en B. Griflfhl1s 10 Ihe bell of hi q /h('O y knowledge nnd belief. Sworn 10 or affirlll~J nnd lublcribed bcfore lIle Ihll 13TH SEPTE R 2~- ) Hi 11 '-':;:- ~Oll I ij. j '/// ",1/ /;,l . , ) 1/./;// 'b>O , r' ;0 - _,_, -:1 UO ,j ,I 21 - 94 - 802 RENUNCIATION In Re Estate of HELEn lL GHIFFITIIS.___ deceased. To the Resister of Wills of Cumberland County, Pennsylvania. The underslsned residuary heir (gran,lson) of the above decedent. hereby renounee(s) the rlsht to administer the estate and respectfully ask(s) that Lellers of Administration c.t.a. 'V. /--\ p~~[\~~1.1 / be Issued to jo. \/\/,es WITNESS mv hand this ~w'l- &....-nJ..eh11rC1 II end r y 6556 Odell St. Loui.s, HO 63139 (Addrml tSIBmnure) f)' (Addrml , . ~:J UL) (SlgnnlUr.) {Add,ml 21 - 94 - 802 RENUNCIATION In Re Estate of HELEN IJ, GRIFFITIIS deceased, To the Regis(er of Wills of Climber land County, I'ennsylvanla. The undersigned residuary heir (grandson) of (he above decedent, hereby renounce\S) the right to adminiSler the estate and respectfully ask(s) that Lellers ..9 f...11llin i n i s t r a, t iC'HL.5:.:J:. ....<;1 . -.-- ---_.._._~---~-_._- be issued to James David lIendry WITNESS mv hand this Cl' {, <:' 0' day of ::':lErlF-MF('I~191!..-, Brett Griff!.ths Box 665, Knockles Road, R. D. 1 Green Lane. PA 18054 (Addr.,,' (Signature I IAddrenl ;-) UU tShilRuturel IAddreul 21 - 94 - 802 RENUNCIATION In Re Estate of HELEN IJ, GRIFFITHS deceased. To the Register of Wills of Cumberland County, Pennsylvania, The undersigned residuary heir (grandson) of the above decedent. hereby renounce(s) the right to administer the estate and respectfully ask(s) that Lellers of Administration c.t.a. be issued to .T:"lmr-t~ 0:'1"; rl lIpnrl,.y WITNESS mv hand this II day of jep/~..dr.r. 1994 , , - (Slgnnl r Andrew Griffiths lJox 665, Knockles Road, R. D. 1 Green Lane, PA 18054 IAdd,ml (Signature) j-j ;.)(l (Addrc:u) ISlllllature) (I\lILlreul , . , I ,..~.L t _, ("1 . . , !. d ~ 'll~/ (, Clm'I'II~ICA'I'ION IW N()'I'ICI~ IINnlm JHlLI'; 1i,!i(II) Nllmo ofD\'c\,dolll: ImLl~N II, GHlFI.'J'I'IIH Dllto of Dellth: Mllrch :.II, 1!J94 I~ilo No, 21.114.802 'J'o tho HlIllislor: I cmiify thllt IIntlcll ofbelllllicilll interllst l'OllUil'Od by Hulo 1i.6!n) nftho Or(lhllns' Court Hulcs WIIS slIl'Vod nn nr mllilod 10 tho fnllowinll bmlClicilll'ios nf tho IIbOVO,clI(ltlnnod estlllo Oil or IIbout SO(ltomber 21, 19f14: ~ Addl'OSS Jllmes Dllvid Hondry Hnbin g, Hondry G, Hichllrd Hendry Brott Griffiths Anurew Griffiths Mllrthll Smith 22 South 29th Stroel, Cllmp Hill, PA 17011 3856 A Hum(lhrey, Sl. Louis, MO !i3116 651i6 Odell, St. Lnuis, 1\10 6313fl Box 665, Knockles Hnlld, H.D. I, Green Lillie, PA 18054 Box 661i, Knncldes HOlld, H. D, I, Gl'eell 1.11110, PA 18054 768 Burnt Houso HOlld, Cllrlislo, PA 1701:3 Notico hilS now been "riven to 1111 (lOI'lllIns ontitled therolo undOl' Rule 5,6(n) exce(lt: N/A Dnto: Septomber 21, 19f14 ~ _.;.. "''''';-5' --" ~ ....,,;., Sillnllture' - "'- ,J<.., ~- - "'......._ Nllme Ste(lhell I., Bloom MAR'I'SON, D1~ARDORFI~, WILLIAMS & O'I'TO Tell gllst H h:h Stroet Cllrlisle, PA 170t:l (717) 243.:3:341 Counsel fm' (lorsnnllll'l!(lI'l!Solltlltlvo '_)0 I fO. M.D.. AfES Of OIAfH AnlR 12131/91 CHICK HIRI INHERITANCE TAX RETURN ~tv:::'-,U~:~0IfI5CLAIMID n _ . RESIDENT DECEDENT Ifill NUMBIA (TO BE FILED IN DUPLICATE I 21 WITH REGISTER OF WILLS) _ I COUNlycoil'. __ ___. iOfClOItH !> (OMPUl( "'DOIl(~!I 'I:!~(~}-lm{': \{hll(~j'b'i: tOIll !load "'CartinIer P^ 17013 o1IV I !.too I). t11 "'t ... 15 i G!l I l'I'I'j'IIS , 1I,,1<'n ll, ~ i\OJ('(:7~c~'~~~:~:;;----r'.;7; ~l :~~~-'-r~~~:~';:::) 4 -'u:~u~--'I-r!..X~J!'4;-.-~riOinal Return O[-~ 402. Suppl~:~-n~;~l~;;'- .... Limited hlete future '"'erenl Comp'omiu~ ~ 00 I 1'0' da.e. a' death alt., 12,12.B21 u~~ I fxj 6. Deudent Died TeUDle [J 7 Decedent Maintoined Q living Tru,' _ IAnech copy of WillI (Altach copy of 1 rUll) ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TOI "AM C M l M"W~ A I t:I!Z ..... ..0 o z u 0 ... 1. Real E.ta.e ISchedule AI I 1) _____ _.___.___...Jl...,..Q!!,,___ 2. Stac.. and Bond. (Schedule B) I 2).__...__________.Q.,Jl!L__ 3. Clo.ely Held S.ock/Partnenhlp In.e,..t ISchedule q I 31 ___._ (] . (] (] 4. Mortgage. and Note. Receiyable (Schedule DI I 41._.._.______~Q.~1__ 5. Co!h. Bon"- Cepo'ill & MilCelloneouI Personal Property( 51 ._____._._..__J.,2!J5...J.ii___ (Schedule EI 6. Jointly Owned Property (Schedule F) 7. T,aRlfe..IS,hedule G) ISchedulell 8. Tolol Gran Aneh (10101 line, 1.7) Q. Funeral Expense" Adminiuralive Co"'. Mllcelloneou, I 9) ___~-2,5 7 ~1 J~ Expen,e, (Schedule HI 10. Debt" Mortgage liobililie" lien, (Schedule 'I 11. Total Deduction, (10101 linen 9 & 10) 12. Nel Value of E,tate (line 8 minuI line 11) 13. Charitable and Governmental 6eque'" (Schedule Jl 14. Nel Value Subject 10 To... (line 12 minus Iillft 13) t. -') V ,.... ~.~~. ,,.. ,r: - COMMOt~wf AIIH 01 P(f~t4!o'fI'v'ANIA tllPAlIlMfNI 01 UVINUI DfP! ,IObOl IiUltt!olUllCt fA 11InObOI fOf.cJOflil !o '.A;';('llA'il'.Il~I:.A-t~l> ";';DOlll-t~'.il~-"- fltcophpn I.. Bloom, I;squi rc e. 1).1 YfAfl B()2 UUMB[R H~~I"T::';,,! t.t..:,,'!!r: UJ..:~ J 24]-]31,; Clllnbcl"! illHl ~~~-':~!----_.~~. ---- [j 3. Remainder Return (lor dole' 01 deolh prior 10 12.13.82) federal Ellote Tax Relurn Required T alai Number 0' Safe Depolit BouI z o 3 ::> ... ii: <( u ... .. 15. Amount of line 14 taxable at 6% role Ilnclude values 'rom ~chedule 1'\ or ~CMdui" M.I LJ 5. _B. NAWI'SON, '-'l'fl1) I:"st: Il"ll-' ',-' . . ~ ~.;- ~ :_'~.- (', IvlLLIMIS & 0'1"1'0 DCA!lDO!lI'I', lIiqh ~;trp("t l'f, 1 7(); 3 I 6) __.________0 I 7) (] 5,295.16 ( B) (101 () (11) (12) (13) (14) 5.574,12 -'>79 flC; (] -;170.% (] (15) _--_-___ (] )( .06 = (16)______ () ..)( .151:1 () z o ;:: <( ... ::> ... ~ o u )( <( ... 16. Amount of line 14 taxable 01 15% role (Include voluel from Schedule K or Schedule M.l 17. Principal lox due (Add tax from line 1 S and from line 16.1 18. Credi" Spoulal Pove,ty Credil Prior Poymcn" DilCount Inlorel' + +------- - ------ lQ. If line 18 i, greater Ihon line 17. enle, ,he difference on line 19. This is Ihe OVERPAYMENT. elD (171 o Chode hero if you Ofe roquCl$ling a refund of your overpayment, 1201 120AI 120BI 20. If line 1711 greoler Ihon line 18, enle, ,he difference on line 20. Thi' II the TAX DUE. A. Ente, the inlere" on Ihe balance due on line 20A. 8. En'er the 10101 of line 20 and 20A on line 206. Thil illhe BALANCE DUE. Mole. Ch.dc Payable to: Regl.t., of Will" Agent .. BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND TO RECHECK MATH...... Unde, penaltiel 01 p;,jury, I decla,e tho' I hove examined this r.lurn, induding Dccompanying schedulel and "alementl, and 10 the belt of my knowledge and beliol. i' is t,ue, correct Dnd (61hp1.,e. I declo,e 1~01 all ,eo I el'ote hUI been reporTed 01 t'ue mar'-el volu!!. Declaration 01 prepare' olher Ihon the ptltlonol reprelentative il baled on alllnlormallon of which pt. a~er hal any kl')owtedge ~IGHA'UR( Of P(R~O; II[ P N!l18!! 0 'I~ING RflURN( AO.-..RH~:2 2 ~~ou t h 2lJ t h ~; t :~ec' t D'&'I(.- . ' <oV1.c'k.::.,.J "~-V\.. / C,lnll II"', Pf, 17():' /ll";/';I/ ~NAlu~-rn:~lf'aO H II HA~ P N ATI'v'[ fOOIlEW-TO-I.:.lnt II~ c]h St r(~('t DATt -..-/f_ ,..-I ,._~ I d' -I I'^ 17()]3 {;/,/'-", ___. ,_~. -" . 1'-. Ldl I !_~, e._ ' () () PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING A CHECK MARK (~) IN THE APPROPRIATE BLOCKS, 1, Did decedent moke a tronsfer ond: 0, retain the use or income of the property transferred, ......,.............,.................. b, reloin Ihe righl to designate who sholl use Ihe property transferred or its income, I ' ,. I t c. ra oln a reversionary In eres or .................................................................... d, receive the promise for life of either poyments, benefits or core? ......,................ 2, If death occurred on or before December 12, 1982, did decedent within two years preceding dealh transfer property without receiving adequate consideration? If death occurred after December 12, 1982, did decedent transfer property within one year of d h . h "d 'd' 2 eat wit out receiving 0 equate consl erahon, ........,........................................ 3, Did decedent own an 'in trust for' bank account 01 his or her death?..................... vn NO x x x I x x ! x ! IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. ~j. (OMIrIIONWlAl1" Of '.N...UIYANI" INH.'''.'''C. ,.. .nUIN .nIDIN1 DICIDIHI SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY Please P,inl a' Typ. fiLE NUMBER II. '\('11. ",' ESTATE Of G1HFFl'I'HS, Helen B. 21-94-002 fAil plOp.'" IOIIlIl,.O_II.a .,." Ih, .1I9M 01 SVhl.Oflt\,P mil" b. a,ntoUG 011 ~d''l.chM '1 ITEM I NUMBER I DESCRIPTION VALUE AT DATE OF DEATH 1 . Resident Fund Account, 'l'hornwald 1I0me, Cnrlisle, PA 5,295.16 TOTAL IAI\o enter on line 5. Recaplfulationl ! S 5,295.16 ... ",I1U. lit,"! ESTATE OF ITEM NUMBER 2 . 3 . 4 . 5 . 6 . ITEM NUMBER J6i;"9" _ .~~u.; [l)......OtH.. 1"\ II. nl ~f~jlj'"~".;"" INHllll"N(ll,,1 .I1U.N ."IPI~' DICICI!d SCHEDULE J BENEFICIARIES FILE NUMBER GHlI'FI'rIlS, lIelen IJ. 21-94- NAME AND ADDRESS OF BENEFICtARY RELATIONSHIP .. ......._ ,,_,_~_,,_,_,_,_____,____.,._,__' ..~__._~_____..______ u,_____ ___~___..~_' -_..~.~-------'_.- AMOUNT OR SHARE OF ESTATE __ ._.___..___~.._w._~~__..______.__._.~____ ~----- ---------~~ A. TOlloble Bequo\h: l. Hartha Smith 768 Burnt lIouse Hoad Carlisle, PA 17013 Robin S. lIendry 3856 A lIumphrey St. Louis, HO 63116 James David lIendry 22 South 29th Street Camp lIill, PA 17011 G. Richard lIendry 6556 Odell St. Louis, MO 63139 Andrew Griffiths lJox 665, Knockles Rd., R.D. 1 Green Lone, PA 18054 IJrett GriffithR , " 1J0x 665, Knockles Rd;, R.D. 1 Green Lone, PA 18054 I'riend Grandson Grandson Grandson Grandson Grandson NAME AND ADDRESS OF BENEFICIARY l. B. Chorlloblo ond Govornmental Bequo'''l None j TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS IAho o.lor on line 13. Re,opilulallon) (If more .poce I. n..ded, In..rl addlllonal .h..1I o. .am. .Iz.) $1,000.00 1/5 share state residue AMOUNT OR SHARE OF ESTATE one S None 'I . 1 /.,-. - /1. ,)3:;--/3 VREV-1547 EX AFP 112-941* ' COHHOHWrAllII Of rfNHSVPJAN(A I DII'AlnI1INI or RIVINUL L NOTICE OF INHERITANCE TAK 8URfAU Of IHlllVIDUAl tAXIS , . ~., I APPRAISEHENT, AllOWANCE OR DISALLOWANCE ~~:~is~~~ri~II'A H'la,oMI .,.,'..... j Of DEDUCTIONS AND ASSESSHENT OF TAX DATE 02-15-95 EsfATinjF=tjiffnf1'lTs~~~~'1rETEr-~-b~~~~'''''<'''' ..~.c. ""'~-"-'FILENO :.....'2j.94-:iiIfCif~.~~' DATE OF DEATH 03-31-94 COUNTY CUMBERLAND " (/ I' (. ACN 101 NOTE, TO INSURE PROPER CREOIT TO YOUR ACCOUNT, SUaMIT TIlE UPPER PORTION OF TltlS FORM WITH YOUR TAX PAYHENT TO THE REGISTER Of WILLS. HAteE CllECK PAYABLE TO "REGISTER OF WIllS, AGENT" REMIT PAYMENT TO: STEPHEN l BLOOM ESQ MARTSDtI ETAl 10 E HIGH ST CARLISLE PA 17013 REGISTER OF WillS CUMBERLAND CO COURT HOUSE CARLISLE. PA 17013 I==.,._=~nl R..HI.d =l CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .... REV: iS4i-EX-AFP-i iF94Y-NoYicniF-YNHEiiifANCE-YAx-iiPPRii iSEHENT-;-ALi:tiwANCE-oli----------- -- - --- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GRIFFITHS HElEtI B FILE NO. 21 94-0802 ACN 101 DATE 02-15-95 TAX RETURN WAS, I X I ACCEPTED AS FILED I CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL 1. R.d Estet. ISchedul. AJ IU 2. Stocks end Bonds (Schadula D) 12) 3. Closaly H.ld stock/Partnership Inter.st ISchadul. C) 131 4. Hortg.g../Notes Receivabl. (Schedul. 01 (4) 5. C.sh/Dank Daposits/Hisc. Parsonal Proparty ISchedul. E) 151 b. Jointly Owned Proparty CSchedule F) Ibl 7. Transf.rs (Schedul. G) (7) 8. Total Asset. ,00 .00 ,00 .00 5.295,16 .00 ,00 181 5,295,16 APPROVED DEDUCTIONS AND EXEMPTIONS: IJ. Funeral E.panses/Adll'l. Costs/Hisc. E.panses CSchedule H) IIJ) 10. Debts/Hortgag. Liabilities/Liens (Schadul. II 1101 11. Total Deductions 12. Nat Valua of Tax Return 13. Charitabl./Gov.rn~ant.l aequa.ts (Schedule J) 14. N.t Valu. of Est.t. Subject to Tax 5.574,12 ,00 1111 1121 1131 1141 ~. ~74 1:? 278,96- ,00 278,96- If an assessment was issued previouslY, lines reflect figures that include the total of ahh ASSESSMENT OF TAX: 15. Amount of line 14 at Spousal 1&. Amount of Lina 14 taxable at 17. Amount of Line 14 taxable at 18. Principal Tax Dua 14, 15 and/or 1&, 17 and IB will returns assessed to date, NOTE: rat. Line.l/Cla.s A rat. Collateral/Cl... 8 rat. IIS1 libl 1171 ,00 X ,00. ,00 X ,06. ,00 X ,15. 1181 ,00 ,00 ,00 ,00 TAX CREDITS: PAYMENT DATE DISCOUNT 1'1 INTEREST I-I RECEIPT NUM8ER AHOUNT PAID TOTAL TAX CREDIT I BALANCE OF TAX DUEl INTEREST TOTAL DUE ,00 ,00 ,00 ,00 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF AOalTIONAL INTEREST, ( IF TOTAL DUE IS LESS THAN $1. NO PAVMENT IS REQUIRED, If TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU HAY DE DUE A REFUND. SEE REVERSE SIDE OF nns rORH fOR INSTRUCTIONS.) {r ,. S:;l- c.r ItHilSTEll OF WILLS OF CUl\lIlEIU.ANII COUNTY STATUS IlEl'OIlT lINIlEllIUJU: (,.12 (For Ileslllelltlleeellellts 11)'1111\ After .1111)' 1,11)1)2) C)( " I Nome of Decedent: IIELEN B, GRIFFITIIS Dale nf Denlh: MlIrch31,IlJlJ4 r1 " FileNo,: 21.1)4-802 Socilll Sccurity No,: 191-2(,.7840 " Ul Pursuant to (tule 6,12 orthe Suprcme Court Orphlllls' Court Ilules, I report Ihe lbllowing with respecl to complelion oflhe IIdministrntion of the nbul'e.clIptiollell eSlllte: I. Stllte whether IIl1mlnistrntiun of the estllte is cumplete: Yes~ No_ 2, (f the answcr is No, stille when the persunal representalil'e rellsonllbly believes that the IIdministrlltlonwill be complete: 3, lI"the IInswer 10 No, I is Yes, stnte the Illlluwlng: II, Dillthc personal representntive liIe II Iinlll IIccount with the Court? Yes_ No , b, The sepnrntc Orphans' Court No, (il"any) Ill[ the personlll represcntntil'e's lIeCollnt Is: c, Dill the personal representlltil'e stllte IInllCcollnt infonlll1l1)' to the Pllrties in interest? Yes , No_ II, Copies 01" receipts, releases, joinders nnd npprol'lIls 01" lilflllnlor Informlll accollnts ma)' be liIellwith Ihe Clerk 01" the Orphllns' Court lIud mllY be 1I11l1ched to this report, Dille: Seplemher 26, 11)95 Signllture NlIme Address . ./::-~ ,; ,..,-.-~.. v '~. ~_____: .~- '-.._.._ n.,.- -Stepheul.. Bloom MARTSON, DEARDORFF, WILLIAMS & ana Ten ElIst lligh Street Cnrlisle,('A 17013 (717) 243-3341 Couusel fi.lr personnl representlltil'e L-- l RELEASE KNOW ALL MEN BY THESE PRESENTS that I. MARTHA SMITH, one of the legatees onderthe Last Will and Testament of HELEN B, GRIFFITHS. late of Carlisle. Comberland County. Pennsylvania, deceased, do hereby acknowledge that I have this day had and received of and from James David Hendry, Administrator c.t.a.. the sum of One Thousand Dollars ($\,000.00), in full satisfaction and payment of my legacy undcr the terms of said Last Willnnd Testament. AND, THEREFORE, I. the said MARTHA SMITH. do by thcse prcsents remise. release, quit- claim. nnd forever discharge the said James David Hendry. Administrator c.I.a. aforesaid, his heirs. executors and administrators, of and from the aforesaid legacy, and of and from all actions, suits, payments, accounts. reckonings, claims and demands whatever. from the beginning of the world to the day of the date of these presents. AND. THEREFORE. I, the said MARTI-IA SMITH. agree to refund to James David Hendry, Administrator c.t.a.aforcsaid, any portion of the distribution to which lam not properly entitled, and to the extent of said distribution. to indemnify said Administrator c.t.a. for claims made against him as Administrator c.t.a.. and to reimburse to said Administrator c.t.a. all expenses and costs incurred in connection with any soch claims. AND I hereby consent and agree that the Orphans' Court of Cumberland County may discharge the said James David Hendry, Administrator c.t.a. upon application. without further notice to me. IN WITNESS WHEREOF. I have hereunto set my hand and seal this /fd day of GfU(1" .199~ . Witness: '/1~ud/.( ,-,-j~/lf~ /, _ . '--_ A Martha Smith lfp~_;AA.cX? / Y1r./ COMMONWEALTH OF PENNSYLVANIA ) : SS. COUNTY OF CUMBERLAND ) On this. the tfofhuay of ~~-f ,199S:'before me. a Notary Public, personally appeared Martha Smith, known to me to be the person whose name is subscribed to the within instrument and acknowledged that she executed same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. (!~bZ_L" ~/? frj'/" -, Notary Public NOlarlO1 Seal Corrino L. Myers, Notary Public Cmllsle Bora, Cumborland Count,! My CommiSSIon Expires May 27.1999 \ '. RElEASE KNOW ALL MEN BY THESE PRESENTS that I. G, RICHARD HENDRY. one oflhe residuary legatees under the Last Will and Testament ofl-lELEN B. GRIFFITHS. late of Carlisle. Cumberland County, Pennsylvania. dcceased. do hereby acknowledge that I have reviewed the Stalemcnt of Account of Administration of James David Hendry, Administrator c.I.a. of the Estate of Helen B, Griffiths, allachcd hereto. and that I acknowlcdgc the ti1ctthat atler the payment of the debts of the estate and the specific bcquest as set fonh in the tirst paragraph of said Last Will and Testament of Hclcn B. Grilliths. there remain no funds to be distributed to the residuary legatees thercunder, AND. THEREFORE. I. the said G. RICHARD HENDRY. do by these presents remise. release. quit-claim. and forever discharge the said James David Hendry, Administrator C.T.A. aforesaid. his heirs. executors and administrators. of and from the aforesaid legacy. and of and from all actions, suits. payments. accounts. reckonings, claims and demands whatever. from the beginning of the world to the day of the date of these presents. AND I hereby consent and agree that the Orphans' Coun of Cumberland County may discharge the said James David Hendry. Administrator c,t.a. upon application. without funher notice to me, IN WITNESS WHEREOF. I have hereunto set mv hand and scal this -'1-11 day of \Vh~~1U' r. 1995 ~I}!;f ~ J L~ /j[.L((.f-~ G, ~ha~enjry--- (/ '(1 RFLE,~ KNOW ALL 1\IEN BY THESE PRESENTS that I, JA1\IES DA VID HENDRY. one ol'the residuary legatees undcr the Last Will and Tcstament ol'HELEN B. GRIFFITHS. late of Carli sic. Cumberland County. Pennsylvania, dcccased. do hereby acknowledge that I have reviewed the Slatemcnt of Account of Administration 01' James David Hendry. Administrator c.t,a. of the Estate ofUelen B. Griflilhs. auached hcreto. and that I acknowlcdge the fact that aner the payment of the debts of the estate and the spccitic bcquesl as set tonh in the tirst paragraph of said Lasl Will and Testament of Helen B. Grilliths, there remain no funds 10 be distributcd to the residuary legatees thereunder. AND. THEREFORE, I. the said JAMES DAVID HENDRY. do by these presents rcmise. release. quit-claim. and forever discharge the said James David Hendry, Administrator C.TA aforesaid. his heirs, exccutorS and administrators, of and from the atoresaid legacy, and of and from all actions, suits. paymcnts, accounts, rcckonings, claims and demands whatever. from the beginning of the world to the day ofthc date of these presents, AND I hereby consent and agree that the Orphans' Coun of Cumberland County may discharge the said James Da\id Hendr)'. Administrator c.t.a. upon application. without lunher notice 10 me. IN WITNESS WHEREOF, I have hereunto set my hand and scal this do<; .Y, 1995, ,'< ;!",.f/ Witness: I f ..U O' .- day of --. 1\. t r. , I' r: ' 1:-:1 U-et :.' ~.l ,AOt rtl J / c: d" n jJ. 1)( /(' " ; l~tl.cu1,( U"'~fl - . Janre's David Hendrv ! / ' '- r- ------~.. RELEASE KNOW ALL MEN BY TIIESE PRESENTS that I, ANDREW GRIFFITIIS, one of the residuary legatees under the Last Will and Testament of HELEN B, GRIFFITHS. hue of Carlisle, Cumberland Coumy, Pennsylvania, deceased, do hercby acknowlcdge that I have reviewed the Statement of Account of Administration of James David Hendry, Administrator C,l.a, of the Estate of Helen B, Griffiths, a!lached herelo, and that I acknowledge the fact that after the payment of the debts of the estate and Ihe specilic bequest as set forth in the lim pdrugr::rh of said Last Will and Testament of Helen 11, Griffiths, there remain no funds to be distributed to tile residuary legatces thereunder, AND. THEREFORE. I. the said ANDREW GRIFFITHS. do by these presems remise. release, quit-claim. and forever discharge the said James David Hendry, Administrator C,T,A, aforesaid, his heirs. executors and administrators, of and from the aforesaid legacy, and of and from all actions, SUilS, payments. llccounts, reckonings, claims and demands whatever. from the beginning of the world to the dllY of the date of these presents, AND I hereby consent and llgree that the Orphans' Court of Cumberlllnd County may discharge the said James David Hendry, Administrator c,l.a, upon appliclltion. without lurther notice to me, IN WITNESS WHEREOF, I hllve hereunto set my hllnd and seal this I, ',!u:,-= , 1995, _ ri\. !" day of ,'I Ut'll,~t. I , / ~/ .f , ' . ..."" /', ~ ;: ...., /' -,. ..... . / I ._r~-'::.(.I~/ .;.:;:;.:;..'. ,- Andrew Grifliths' . . /-1:;"15 Witness: " RELEASE KNOW ALL ~IEN BY THESE PRESENTS that I. ROBIN S. HENDRY. one of the rcsiduary legatees under the Last Will and Testament of HELEN B. GRIFFITHS. late of Carli sIc, Cumberland County, Pennsylvania. deceased. do hcrcby acknowledge that I have reviewcd the Statement of Account of Administration of James David Hendry. Administrator C.La, of the Estate of Helen B, Griffiths. allachcd hereto, and that I acknowledge the fact that after the payment of the debts of the estate and the spccilic bequcst as set tanh in Ihe first paragraph of said Last Will and Testamcnt of Helen B, Griffiths. Ihcre remain no funds to be distributcd to the residuary Icgatecs thereunder, AND. THEREFORE. I. the said ROBIN S. HENDRY. do by thcse presents remise. release. quit-claim. and larever discharge Ihe said James David Hendry. Administrator C.T.A. ataresaid, his heirs. executors and administrators, of and Irom the ataresaid legacy. and of and from all actions. suits. payments. accounts. reckonings, claims and demands whatever. trom the beginning of the world 10 the day of the date of these presents. AND I hereby consent and agree that the Orphans' Coun of Cumberland County may discharge the said James David Hendry. Administrator c.I.a. upon application, withouttunher notice to me, o IN WITNESS WHEREOF. I have hereunto set my hand and seal this :~if':-i.- . 1995. :..'t-U day of 1,~. ",:-.r . 4/' / /' ,. ..........,..""; '-......~ ~'.--.;." .0"') I ~:l~,::\ ') -/+,., l Robin S. Hendry Witness: .,,/ / 111lISIl"'AllllllilA1IS,\nllAI'. ESTATE OF IIELEN B GRIFFITIIS Statcmcntof Accoulll of Administration of James David Ilendty Administrator eta us of July 31. 1995 Principal Rcceipts: Resident's Fund, Thornwuld Home. uccount hlllance $5 29~ 16 TOTAL RECEIPTS: $5.295.16 I'rincipul Distributions: Marthu Smith, pursuant to first parugrnph of Will $100000 TOTAL PRINCIPAL DISTRIBUTIONS: $1.000.00 Principal Disbursements: Holcombe Funeral (-(orne, balunce due on account Phoenixville Memorial Works. monument Richard H, Grimths, reimbursement for funeral nowers Social Security Administrntion. return of overpayment J. David Hendry. Administrator's commission MARTSON. DEARDORFF. WILLIAMS & OTTO. disbursements: Probate fee $68.00 Filing fee. Inheritance Tax Return .li2.llJl MARTSON, DEARDORFF. WILLIAMS & OTTO. attorney's fces: Actual fee pursuanl to billablc hours S 1.568,00 Discount credit due to lack of estate asscts 641) 1)4 Net fee $ 979,98 1.300,00 16\.12 593,00 265,00 78,00 1)1806 TOTAL DISBURSEMENTS: $4.295.16 SUMMARY OF A('('OtINT Total Principal Receipts Total Principal Distributions $5.295,16 -100000 Total Principal Disbursemcnls 4.295.16 -4 29~ 16 Balance for Distribution 0,00