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HomeMy WebLinkAbout95-00957 " ',-,.."..,', , 'j '-' ... " ~ ., 'P . " , ,,~ :,:', ,,' ". .J~,:, " <:>"':: \\'.:.:~ :~: --~'k: ~ !.;.;~\. \~~i!K;; , I , , ' I ," ',' ":"t'i: " . "/.'): ::'~:;L'>":":'" , ,', ,;",,';:" 'C,', ',' , '....."':>1,,:{' 'J, ~', : ',": ",'::', "''r:;\,,1;,>~:;"; , ',::~; " ,,," ;',: , ~') :~~rs&'~" ~,~~{J~~~),' ,..,..;:'::.'...'"',"'>:,:" ,:;. "::', :oO; ':,;:,';~< :,:,,"':': ,:.,' , ,', ::C\">"l':';:<:';f::;;'::':<J:i:i~~!~~!"; ,',' .. :' ',(,.;J\:,:',' " i:. ,"""': :"c', "'i:','" ; ,',: '", ", :~t{::I~fj~ ~ ' : ",.;{, :,~ ';:' :':',: ' ,.'< ":t: ,y;, ", :~/J '. "". ;'/ ': ,:'" ,: :, :' ,oj:>;; ,; ;,: :'.:;;, ,:i'>' ':~.':,:~" : '" ,::,:;::,~'\,~i;'.. ,;.' " ~:V;:',~~~' ~;.,,\ t ,~ ;;. ~. '....:. ;i ; '}f~'" , ' Yi:.~~:t~ ," " ;, ," ~',"':; 0~' ~, :\:; ,:( '::' :"~ ';:~::~ 'f'./ ',' ';' '; : . ":. ,",;",~c'.. \"" 'c':',',.': /'..' .,.." .,' ~:;: ;;:~, >U "';' ',~:'l ,,/''(:: ::: ',,:' .. .",' ", ,'," h{. 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"', '1') ,.:'.. ...... , .., "., ., ". ,..... ~ JO" .. " .,j <:;. , . " ...W ',:.. : .;", " ,_:, , <-f,y , "',:,' 'o' , " " .. " '/~:i~' 'ii' ' ",' ' ," a " '.':,.-',.., ;"";"".,,\":',', ',i~~';;' .. ., .'" "".' " 't' """,? . ".:';~Y:1 o 1;; ." . ....'...., z . ~ · ':, ~ : - )! '1.; .';,-!~ ~~~f~~.', 1, ' 1+1,;,'," ~",' l'__ """"" , };.~~Y: ;, - ~~ r::~(.': ~ , " ,~, '" , ." l'ETlTlON nm l'IWUATE nnd (;HANT OF LETTEHS ,c:2. I ~,q $=:J3 S:J 01' hl""'''/ Jesse II. Gray 1I/\fJ A. 110 wll 1'\ Nu. h,: Ill'~,,'e. III \\'llh 1m ,he CI1I1II1Y III CUlllb\'rliln\!-- III Ihe t'1l111I1H1I\W\.'1lIlh uf Pcnn...yh'uniu .. Sodlll .'iI'cII';'.\' So. _ ",.. ...... . Ikn'flwll. Jl!l~OI~,5924- Tin,' Ill'lili,," ul the und\.',,,,i)!Ul:d 1'-''''I'1l'~llul''' tL'I'IIl.'wnt... lhut: YI1I1' pelhilllle' ,,), "hl1 i" ;11" I~ yea" III al'" "' "'de, all III<' ew,'1I1 or~" ..,--,---..- n~'11eu / IlIlh,' h,,1 "ill I1llh,' al,,'''' l",e,..lelll. daled October,3,.... ....,-,.....-'--'--,.. . I'l~ i IInd wllidll)l.l UlIled ,_,september.-21" 1994,.. -,.-'" ,... ..."..,-."-'" .-~'-~"~ .-........_.--._'-~ ...._._-~_._--- ---- ,~-------.-_..-~.- ..-~.__._---- .,,~,~._-'-"" lqat'-t",,>\.llll 'lh'lllll'I,IIl~'\'\. ",.!. IlHIHh:lilllllll. ,killh III CW\'lII01. c:l~,) I Ile.elllklll ""' .,,"nidl,'d al ,Iealh in_..C,I!I!IIll!rJand,.._-_......... ..-- COllnly. I'cnll,ylvllllin. whh ILis-- la" 11I1I1i1\ I1.p,illdpIII.e,I.lell"e "' ,_2120J:hestnv:\:.,..s.tr.e..E1.t _...__ ........Camp, Hill,.. PI\ ._J 701L--,-..,-~' c.""''I.f'_.l\\ILJ~C'f<:''~' th~l '1lrel, nllIHI'~'1 ;llId 1I1l1lldp.llll}) ~ ./ Ik"emklll,'h"" ",_84,..-..1"11" 01 II~el lIiell _..November...Jl- .1'1 95 ," n Leader Nursing .Home,_campHI L~I\...JIQJ.L, . 1:\"<,\" 11,111110"" """"lkl1l ,Iill 110111""'), ...11' ""I.H\'lll"ell ,,"11 lIiu I1n\ hnve 11 ehilu borl1 or lIunplcu IIlIer e,"""liOI1 I111'e "III oHe",1I 10'1,,"hll"'; "'"' 11011h" \'lcllm 01 II killil1~ 111111 wn, ne\'er nuJlluicllleU i'I\.'llI1Ip\"Il'llt: _~n~~--._.- ~._.~._~_"_....._-_-._n ~--_.-~----------~-- ---- 1>....(\.'lh"'-'I\\ at dealh \l\\UL'll prnp\,'lty willt l"limntcd \'a'lIl'~ W, follnws: (If IInll1idk.' ill POI.) ,\II per'''''''' pr"pe"!' (If mil \h'mh:ikd in lIu,) IJcr,OIHlII1rol1erlY in Pcnn,yhania \11 not dnll1kil\,'.J in P.I,) Pcr~Ul1at properlY in Cou"t>, \'ahl\" \1' real ~"'lUl\" ill pCIIIllo,\'lnmin ,1\1",,<11 ", h,lIo"': "..2120_ClleS.tnu.t....st.r.!!Jtt.------ j .......... .._---- _,CampHUl._I'I\-J701l S 10,000.00 S S S 90.000.00 \\ IIEI{H(lI~E. pelilil1nerl') le\pe",llIlI) .e<lUNI') Ihe pl'\,hllle of Ih" "I'I will IIml coulciI(') 1,,,,'''"1,,,1 h"",,,"h 111111 I'''' gnl111 "I kller'-,Ie5tame_ntaJ:Y-----' tl~"lillllCllt;ll\: mhllilll,IIi\Ii\lll \,',1.".; "L1l1linl~lf;llll1n d.ll,n.c",n.) -~>--,.. ..~...._--_...._--_.__.__.._-_._.._.- 111\""\11. " .J: ~t =i;: ( \: r C_ ~., Rlchard-aray 'I 9ani/ ;li;i:t.o,'a Jime Sant6'L~ "".. .128 Nortl1 pr 1 nce_Str.eet,..J.-ilUCiI.1iter, PA _~_ '" ",_"...------'7602 . ~-_..._~.. ._-~_... .-,.-. --,. -. .. . ~~ =1z..~O~:i.Incofn~~;:.IVe.j;ampHillI7M 1 " ;: .._. .____ _TO' ".____..__L._.__.___".__.._.__~.._...__._,.__~._ ... __.' ____.. _....___._.T _._~_,.. p....---.. - .+--.-.-- OATH 01-' l'lmSONAL nEl'lmSENTATIVE CO:\IMO:-;WEAI.TII OF I'ENNS\'I.\' ANI'\ l ''; COl':\T\' 01' _ CUMBER,LANO..,.._,.._,____ J <i. 1 lie I','\ilioll""') III,",",":lIne<l ,,,e:III') ,n aflilllll\) IllUl Ihe \\(uemell" Illlhe foregoing pelilioll arc III'" .11"\ ."""" lolli" '''',' 0\ Ihe ~\Il",kdge allll hdld of pellliollerl,) alld 111111 a\ pe(\olllll repre,ell- 101\1,,'1'.' ,.1 IIIe "loll'" .I<',e<leIUl'e'i\II1I\1'I(,\ will ,~~~~<I \l1l1\ ,"~,l11illl,"Il'r lhcc~HItl' according tlllnw. S''''\I\ I,' "' ll1fill1ied ,,\Ill ,"h,ell'",d ~ ~, .......C.. '" hdll'" II'" Ihi, ,1TH. <I", 01 ~ (~-:\..-..,- '--"'-=n-"'~ ~. _-,ny,elI)9CEt4BERu (f 6 j/'h,9~,' rf<.id:J-<-.!....'-</.;;2-JL "t,/ ~ 1f1""1I .J'1ltc.~....., fLV 7<:::flJILtt:P-f-1! ...1-..__-,..---..-----..'-- ~ U MARY C. LEWIS Ikeil/l" ' .,.-.....----,--...--.....-- 12 /S-1t..( - L{ - .... ....-...' ..., No. 21 - 95 - 957 Estate of ,JESSE H GRAY I I>eceased DECREE OJ; 1)IWnATE ANI> GHANT OF LETTERS AND NOW DECEMBER 21, 19..1.L, in conslderallon of the pelltlon on Ihe reverse side hereof, slItisfuclory proof hllvlll!! heell prescllled hefore me, IT IS DECREEIlIIIllI Ihe IlIslrumelll(s) dllted OCTOB~ 1985 dcscrihed Ihcreln be ndmitled 10 probllle IIl1d filed of record ns Ihe IlIsl wlll of JESSE H GRAY IInd Lelters I ESTJlHENTARY nre hereby grnnlcd 10 J R I CHARD GRAY and JANE SANTOR [HI ~I) ",,/jl.-)n E/;t; ([) -I.,. R,ghr,r Ilr will, r<=~ MARY CLEWIS FEES Probnle, Lelters, Ere. ......... $ 200.00 Short Cerllflenles( 5) .. .. . .. ." $ 15 .OQ ~eciWf~lr\lolI ................ $_f1f:5O X-Pages S~'r.OD JCP TOT/\L - $-5.00 Filed .... ..Q~~,E.t1~~R on.. om? .2A2..50 Charles F. Herr Esq. 10R31 "rroRNI!Y (Sup. C1. 1.1>. Nil.) 53 N Duke St. Suite 420' ,\llllRI!SS Lancaster Pa. 17602 PIIONE ef)dd;;t....tJ.,~.O ~bl.:~ ~ (717) 299-7374 /'fl.96"': /'C). ~d . l:Ja.t.t11 ~)~ ~ 1 ~ " . i Mailed letters and order to attorney on 12-21-95. 21 - 95 - 957 :~j ,._\ i~ .;...~ " '-... l.-) ,"'1' ...7 ~:.--:' ~'C :H\., , . j"~ . (:" r; -:-'" ~ ,J I" '-J."..-; - . fl.. .;j...... - >:~: I;" e..::J.., "'oJ' , ,;!;! rj8 <~\ ;.} 'i~l, fila: a: 151 >< < e>: Cl ~ : g ~ a ~ ~,~ E ~ ei~~t!i 9 ~ ~ ~ ffi o " ~ Ii Do ~ ~ ~ ~ll! :l " Ill, . i ~ j o ~ ..1 ..1 H ~ , :c w III III W ,., .. r:l W Eo< < r:l , :P4l4- . WINDOLPH, BURKHOLDER. 6TAINTON AND GRAY ATTORNlva AT LAW aUITIl <11.0 II NORTH DUKE .Tft.IT LANCASTER, PENNSYI.VANIA 17ll0Z ........ J>' .' .. . " " . W!l.I. UP JESSE II. GRAY I. JESSI! II. GIlAY. IlI'eHlIlltly of Coml> lillI, l'ennsYlvonlo make the following os my Will ond revoke ony other WJIls which I previonsly hove mude. ARTICI.E I give my entire estote in equol shores to my two children, JANE SANTOR ond J. RICIIARD GIlAY. 10 the event thot my donghter hos predeceased me, her children, Steven, Susan ond Kimberly, or the survivor of them, sholl toke her shore equally. In the event that my son has predeceosed me, hJs son, Josse II. Gray, sholl toke his fother's share. ARTICLE I I In the event thot 0 shore ef my estote under the provisions of Article I Is poyoble to 0 grondchJld who Is under the oge of twenty-ono, thot Hhore sholl be held In trust by my surviving Hon or daughter os the eOHe muy be to use, opply ond oxpend both prineil>ul nnd income fol' tho honufJt of the minor child and fOl' the child's oducotion until the chJld reoehes the uge of twullty-uno yours when tho Ll'ust s/1I111 termJnote olld the bolonce dlstl'lbuted. (c) Tn hnrrow mOlluy I\l\d 1I0tes thel'cfor, nlld to SOCUI'C mortgnga or IJlctduu. In oxucute pl'umlssory such ohllglltlolls by (d) Tn omllloy such hrokors, hllllks, cII8todll\ns, Investmellt cnullsol, IIttorlluys IInd othcr IIgollts, nlld to deJe"oto \.0 thum such of till! dutlos, rlllhts ood powers of the Trus\.eo (1lIcludlng, omong others, rights to voto shul'os of stur:k) for such periods I\S It thlllks fit. olld to keell ossuts In the ullme of n nomilleu wIthout mClltloll of the estutu or Trust In ony Instrument of ownershIp. (c) To pnrtlclpllte In or consolldntlon nnd In exchonge uny propcrty heid nny mnrgor, I'uorunnlzntlon connectIon therewIth to for othor proporty. If) To dotermine, os to oJI sums of ,"ouey ond other things of vnluc I'ecelved, whether und to whllt extent the some sholl he deemod to be prlnclpnl or to be Income, incJudill1l tho pruceeds from the soJo of non-productIve ossets, nlld os to 011 chul'ges or expellsos pold, whothcr IInd to whllt ext"nt the sumo shojI be charged ogolnst prlnclpol or ognlnst Income, Including, without h"roby IJmltlnll tho Hellernllty of the fOl'egolng InlllIuoge, powel' to Ilppol'tlon nny receIpt or expons" betwoon prlnc.!pllJ IInd Income 811d to determlno whot port, If ony, of the octulIl income recoived upon ony wost.!1I1l ossot or upon OilY socurlty purchosed 01' ncquired ot n premIum shnll hc retoilled ond lidded to pl'lnclplIl to provellt II dimlnlltlon of prlnclpol upon the exhoustlon or the moturlty of the IlIvustmellt. (H) III dlvldlllll IIssutS hel'ulllldel' Into shores 01' III dlstl'lbutlllg tho sume, to dIvIde 01' dlstl'lhute In cosh, 111 kll1d, 01' PlIl't.Jy III cuuh ond plll'tly III kllld, ns It thinks fit. For purpose8 of dIvIsIon or dIstrIbution, to vnlue pl'nporty l'en801l0hly olld III good folth, olld such volulltlou shllll he conclusIve upon oil plIrtles. To whlltevor oxtOllt divIsIon or dlstrlbutloll Is mnde ill kInd, It Shllll, liS fill' os proctlcoblo, ollocllto IIppl'oxlmlltoly pl'opurtlonoto nmouots of ench kInd uf socurlty 01' other property. (h) Tn tllke ovor 11 'HI Trustee moy deum npproprlote In ouy corporllte fJdllcllll'Y. l'ctll.!n /lUY 11rOIll!rty tho Includlull OilY Investment AIlTICI.1\ V nOlle my son nnd dough tor', oJ. RICIlARD GRAY ond JANE SANTOIl, or tho 8nrvJvor of tholl, OXtlcutors of lilY wJIl. My Ilersonol repre8ontotlves sholl not he requJred to fJle 0 bond for ony purpose In ony jurJsdJctJon. IN WITNESS WHEREOF, I hereunto set my hand ond sool thIs ~rtL ~ doy of October, 1985. \. ( S E H. GRAV SIgned, sonled, publIshed nnd'declnred by tbe bove nomed testotor, JESSE H. GRAY, oS ond for bis lest wlll In tbe presence of us wbo, ot hIs request, In hIs presence nnd in the presence of eoch otber, bove subscrIbed onr names os wJtnesses hereto. (111~' _ f/? f-I /J1/'..h~:" 4J. /J1;J(J~ ;' , , COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF LANCASTER WE, JESSE H. GRAY, CHARLES FOLTZ HERR nnd GLORIA M. MYERS, the testntor ond the witnesses respectively, whose nnmes nre sIgned to thu nttnchud or foregoIng Instrument, beIng fIrst duly sworn, do hereby declnre to the undersIgned nuthorlty thnt the testntor signed nnd executed the Instrument ns his lost wIll nnd thnt he sIgned wIllIngly (or wIllIngly directed nnother to sign for him) nnd thllt he executed it ns his free nlld voluntnry oct for the purposes therein expressed, nnd thot ench of the wi tnesses, In the presence nnd heol'ing of the testotor sIgned the wIll os wItnesses. ond thot to the best of their knowledge the testlltor wns nt thnt time eighteen (18) yeors of oge or older, of sound mInd ond under no constrolnt or undue influence. '~Miqf. 1!Jc~ CLr/~ A r /4 -'t'->/ gL;A,/JJ.I)J~~./ J_)SE H. GRAY (j (Witness) , (Wltn'ess)' d Subscri bed, sworn to nnd ncknowledged hefore me by JESSE H. GRAY, the testotor, ond subscrIbed ond sworn to before me by CHARLES FOLTZ HERR ond GLORIA M. MYERS, wItnesses, this ,rt-L. dny of October, 1985. MY COMMISSION C~cc-C ~t(N~~X EXPIRES: X~lo:.llJIllllt~j{1X1l1:111XO<ImX ~) t--.' . U IC--<-_.o__a.~ CM""'I ~. ~~t.p ~'n'rr1f f'>!lhnc " L' . ' . ...,.".........1 .\;..ill"'"lI~.A4,1!..'l..1 21 - 95 - 957 REGISTER 0... WILl.S (lI<' COUNT\' OATU 0... SUIJSCIUIJING WITNESS // " " , cmllcil (each) a subscribing wllness III the will presenled herewilh, (each) being law, depose(s) and say(s) Ih~t', '" the lestat , sign Ihe same and'lhKl...._ reQuesl of leslat_ In h_ presenc?-a d (in Ihe other subscribing wilness(es)). y qualified according to presenl and saw signed 115 a wilness allhe sellce of ellch olher) (In Ihe presence of Ihe Sworn 10 or affirmed and subscribed before me Ihls day 19 (Name) RClllsler (Ada~ (Name) ~ (Address) '- / .' REGISTER OF WILLS OF t:U~l[\r.!:L~~Ir. COUNTY OATH OF NON-SUBSCRIBING WITNESS ChRrl~s P. Perr ~nd [\orneice L. Burkholder (each) a subscriber hcrelo, (ellch) being duly qUlllifled IIccordlng 10 IIIW, dcpose(s) and say(s) that they are rlllllllillr with Ihe slgnUlure lIr Jesse II. Gray clldlcll ",:lIk Ihal they presented herewilh and codicil belicves Ihe slgnalure on Ihe will is in the handwriting of testal~ of (Ol1Excxfxmcxxublloribin&xll'iU13:ol~'041l) the Jesse H. Gray 10 Ihe beSI of the i r knowledge and belief. Sworn to or IIffirme~ subscribed before me this /.r day of ~~-<!",- '? j RI!/.:;ster a~,{ ~,v fJ ILr A-r -- I (Nall/c) 53 N. Duke St., Suite 420, Lane. PA (Addrcss) ,L:.")'}~1 "";,,C) tY /(~'''~~/'o1'''Y/d~J (Namc) 53 N. Duke St., Suite 420, Lane. PA (Address) E- ~ CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Jesse Ii. Gray Date of Death: November 11, 1995 Will No. 21-0957-1995 Admin. No. To the Regisler: I certify that notice of beneficial interest required by Rule 5.6(a) of the Orphans' Court :Ru1es was served on or mailed to the following beneficiaries of the above-captioned estate on II March 1996 : Name Address Tressler Lutheran Services, 960 Century Drive, Mechanicsburg, PA 17055 Trinity Lutheran Church, 2000 Chestnut Street, Camp Hill, PA 17011 Jesse Higgins Gray, c/o J. Richard Gray, 128 North Prince Street, Lancaster, PA 17603 Evan Kashar, 563 West Lemon Street, Lancaster, PA 17603 *See below Notice has now been given to all persons entitled thereto under Rule 5.6(a) except Date: ,3/1114t- I , (j~L/ f ~ Signature Name Charles Foltz Herr, Esquire Address 53 N. Duke Street, Suite 420 Lancaster, PA 17602 Telephone(711 299-7374 Capacity:_____ Personal Representative X. Counsel for personal representative *Summer1ea Kashar, c/o Law Offices of l~i11iam L. Veen, 711 Van Ness Avenue, Suite 220, San Francisco, CA 94102 Stephen Santor, 9 Dish1ey Drive, Mechanicsburg, PA 17055 Susan Santor Seidenberger, 19 C1aravista Drive, lIo11idaysburg, PA 16648 Kimberly Santor, 513 Susan Road, Camp fUll, PA 17011 '/<1 - ,/ INHERITANCE TAX RETURN RESIDENT DECEDENT COMMO"W[Al!Il Of ,.,.""'..,,,. (TO BE FILED IN DUPLICATE O(PAII'M(Ul Of R(VENU( H..",fJ:~,~~l'JllOO"" WITH REGISTER OF WILLS) COU,m~OD! ---- OICIPaW', t4AMI I.'" ,'I.,T. ...up ,",'DDU IUl 'AU LJI<lOltlI1o (OlolPI(l1 AO(lIHS Gt-ny, .Tesse II. 7.17.0 Clwslnut SOCIA' SlCUlllf tllJMII' ~ ----IOAlIO' OlA1H ]tlA11-OI .I~lt+ C i1mp 1111 I, "^ 178-01-5n6 ll/ll/~5 11/7.1/1 0 c..'" Cumlwr1.1nd " ..".""" "...",," """If' "., '"=''' ;-"., "~~~]:('~" \I(U'~,,"'M'" ].MO~,,':"(,," o "If ';;\I~"(' u"" " @ 1. Original R.lurn LJ 2. Suppl'lT'I.n1ol R.lu,n i J Remllind., hlu'" 1'0' dIJ'" of death ,lIiu. In 11 I J 871 o ..t. limit.d E,loIII [J 40 fUlur.lnt,r,,' (ompromi..l' 1:1 s red.fIIl hlot' "11 Rlll,I'" R.qulred If 01 dOhli 01 deoth afte, 1'.12.821 06. Dec..d.nt Died TIltot. IJ 7. Dec.dent Maintained a living T,uu __ e 10101 Numl"" nl ftnl" U'flo'll 80'" (Atlach copy 0' Wilt) (Attach copy of rU.Iltl _____ _~_.__..,___ ______. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO~_______':"""""____ ," R(V.UOO (1+ 1'.Q,! w ... ...... uiE~ wag Qg:~ .. .. 1<" r,... ~:J~ ~~ ... is r;J u w co ...... wiS "co ..z COco u.. NAM( Chnr1es Foltz lIerr, Esquire HU'HON( NUMIU ('- FOR DAlES OF DEATH A"n 12/31191 CHECK ItlRI IF A SPOUSAL ' POVERIY_~~IDITJ~gAIM!!>_!J, ' FILE NUMBER 21 J~95 11,)1)'; ":[AR tlllMAI N 717 l-"zj~-7374 z co ;:: 5 :> t: .. .. u w .. 1. Real E.lale 15ch.dule A) 2. Slack. and Bond. ISchedule B) 3. Clolely Held Slock/Porlner.hip Inl.r." (Sch.dule q 4. Morlgage. and NoI.. R.ceh.abl. (Schedule OJ 5. Ca,h, Bank Depa.it. & Mileel1oneou. Porsonal Prop.rty IS,h.dul. E) 6. Jointly Owned Property (Schedul. FI 7. Tron,'ers (Sch.dule GJ 1Schedule l) 8. Total Gran Anels (Iotollln.. 1.71 9. Fun.rol E...p.n.... Administrolive COlli. Milcelloneou. hpens.. ISchedul. HI 10. Debh, Mortgage liabilities. lien. (Schedule II '1. Tolol Deduction. (10101 Un.. 9 & 10) 12. Net Value 0' hlate (line 8 minus line 11) 13. Chariloble and Goyernmenlol Beque," (Schedule JI 14. Nel Value Subjeclto Tall (Line 12 minus line 13) 15. Spousal Tronslers lIar dOl" of death oller 0.30.94) See Instruction. for Ar,pllcoble Percentaoe on Reverie Side. (Include yolu., ram Schedule K or Schedule M.I 16. Amounl of line 14 lo...oble at 6% ralo (Include voluO$ from Schedule K or Sch.dule M_I 17. Amount 01 line 14 huable at 15% role (Include values Itom Schedule K or Schedule M.I 18. P,incipalto.. duelAdd to... from Linlll 1.5. 16 ond 17,) 19. C"dil' Spousal Poyerty Credil Prior Poymel'lh + J?"J_Cl.L. :itrl!ct 17011 COM.un M"'ILlflG AODI(U 53 N. Duke Slreet. ,1111" 47.11 Lancaster, O^ if,O;> ~3 97~ 111 -,__,____,_, (2).-~ 178 (3) - 14).._______ (5) _--'.12.. .2.iUL_ (6)_ 17) 191 110) 1,690 I B) 2V. JIlS I, IdA no. .1117 ;> ,noo 7.lll, .111, 1:1,10') 1 3 , 1 (0) "," ""0----" ~.. . ^ _ _.__.___._._.".H" ~ ~ BE SURE TO ANSWER ALL QUESTIONS ONIIEV-EiisE~siiifi"Nii'TORi'CtiICi(MATH -<-< Under penaltie. of perjury. I declare thaI I hon e...omined this relurn. indudin;p ouompunyinu \Ch.ltvl.s tint.! ,'lvl.'n."", 111'11110 the hili 01 my Io.nowl.dg. and b.el;,,!. it Is true, correct and complete. I declare thai 011 reol."lale has bun repOrle 01 I'UG mmknt yul",a. Oo(llI,nllon 01 !"'pm" olher thon th. p.rsonal rep,osontallyell bosed on 011 informal ion 01 which preporer has any Io.nawledgo. "". ,,"ON'COI""NG'"U,''' 'D~~' N. Dllkl:,-,~~I~,',,-:~;-~.-. 'l';,;,-~'-'~I1C''''I>^'1_7~''O~1it?l-Uq~,..__ u THAU ~ . uwr I AOOIU!! CAli /~53 N. Duk.. St.. St.. 420, 1.0011e. I'^ 1,(,07. z co ;:: .. ... :> .. '" co u >< .. ... 208 liS) ,. 116} 1171 __ III) 1111 Illl ,,('" . . liC 06. . II . IIBI 119) 11DI 1111 111^1 111BI 7.16,467 DiHount l"hHe" +, . 20, If lino 19 is 9reoler than line 18. enler the dillerence on Line 20. 111l, is th_ OVERPAYMENT, aD 21. Chock horo If you ore requestlng a r.fund of you, ovarpaym.nt. II line 181s greater than line 19, enler the difference on Line 71. lhl, II ,h.. TAX DUE, A. Enle, the inlltos' an Ihe balance due on Linn 21 A 8. Enler Ihelolal of line 21 and 21A on Line 216 1hil is Ih. BALANCE OUt. Molt. Ch.ck Povabl. tOI Ragl.,., of Will., Au!.n! Ln ~,:C - N ~o.: oEl - !) ;.~l~ e: 0' co ':. -~ .,..0 .- Ln ,- oJ. I " r'~ .. (~ , " ~ it , c, ";,-; c '.) 6Til .......:.1 . ul1l fR """E wa:: Q) a:: u8 -~----~,,"~.,..~'~ ,,>~ .', ;" " , t.' REV.l502 IX. 112.1$1 ~j. CQMMONWfA\TH 0' P(NN~'f'lVANIA INHUltANCf tAll R(TURN ___,__Jl!S!l!f~l,l;)(q~!~! E5TATnfF---------- -,.- -- .., ",,-- .,..- ,., FI(ENUI;(BEil"=~""'..~~". Jesse H-,_.~r_ax,._.______,...., __..____ _______._..__..._3..l:.:~~~S-O~5 7._____.. IProp.rly lolnlly.own.d with Right 01 Survlvanhlp mUlt b. dl"lol.d an Sch.dul. FI All ,.al"lat. Ihould b. r.pa,t.d at '01, mark.t valu. which II dlfln,d a. the price at whIch property would b, ..changld b,tw,.n a willing buy., and a willing ..II.r, n,lther b.lng comp,lI.d !.-O bu'y or ..II,. both ha~~~g.!.!.~~.~~.~~!e kno~J~!~I;I_!_~.f__I~~__r.!~e~~~~.!~.~!..._, ~_.______~__,..~.__~"U_" _~__ _._" NUITMEMBER DESCRIPTION VALUE AT DATE OF DEATH SCHEDULE A REAL ESTATE -_._.._--....._.-._._,..~---_.._..._~--~.~ ""-'-"'-~'---""-'---------.--._~'-~'-- ----.._-.-- I. 2l2~ Chestnut Street Camp Hill, PA 17011 Cumberland County Deed Book A. Volume 21, Page 852 Net selling price Copy of closing statement attached ~3,~H TOTAL (Aho enter on line I, Reca Ilulallan {If more 'pac. is' n.,a.a, in,,,' oaailiano' ,heels 0' ,om. size.' s ~ 3,97~ ... _,.,... -,_,~_~_..;,',,';""$"""';~"',_'eih 'r'_ .~,'''__ .......'.._ 11. . SE'l"l'I.EHENT STlITEHENT u.s. DEPARTMENT or llooSING AND UROAN DEV[lOPMENT lJ40 NU. 25D2'0265 ~ ,r , O. TYPE Of lDAN 1. I I filA 2. I I fn'IA 3. I I Cony. un16'16. filE NUMDER 17. lOAN NUMDER 18. MORTGAGE INS CASE NUMOER 4. I I VA 5. t J Conv. Ins. REIClltL SKS c. HOIEllhl, form I, furnilohc:d to give you .. ItotfftlCnt of actuol iettlcmcnt cosU. Aroounta paid to o,d by th~ settlement agent are Iihown. I tL'fIlS rnarhd II tPOCl II were paid outside the Closing; they orc Iihown here for Informat lanai purposei ond are not Included In th... touls. 4.2 05'95 (3fREICNEL) O. NAME AND ADDRESS or BORROUER E. NAME AND ADDRESS of SELLER f. NAME AND ADDRESS Of lENDER ~AINE E. RE I CN[l on<!' ESIATE Of JESSE R. GRAI N[lEN E. REICIl[l G. PROPERlY lOCAtlUN II. SEtllEMENI AGENI I. SEI1LEMENI DAlE 2T20 CIlESINUI StREEt MIDST ATE ABSTRACT COHI'ANl CAMP HILL, PA 17011 Hay 1. 1996 CUHOERLAND County, PA PLACE Of SElllEMENT 233T HARKET StREET CAMP HILL, PA 17011 J. SUMMARI or OORROVER'S TRANSACTION K. SUMMARI Of SELLER'S tRANSACT lOR 100. GROSS AHOUHI DUE fAOM bURROWER 400. GROSS AHOUNT DUE 10 tELLER 101. Controct Soles Price 95,000.00 40T. Controct soles Price 95,000.00 102. Personal Property 402. Personal Proporty 103. Settl~nt Chargeli to Borrower line 1400 4,241.50 403. 104. 404. 105. 405. Adjustmentll for Itern$ paid by Se'ler In advance Adjustments for items paid by sltller In advonce 106. City/town toxes to 406. City/town taxes To 107. County taxes 05.01.96 to OT'01-97 279.21 407. County tons 05.01.96 to Ol.OT.97 279.21 100. School Taxes 05'01'96 \0 07'01-96 176.90 406. School Tau. 05.0T-9b \0 07.0T-96 176.90 T09. SEUER PRORATION 05.01.9b \0 07-01-96 20.'T 409. SE~ER PRORATION 05-01'96 to 07'01'96 20.'1 110. 410. '1,. 411. 112. 412. 120. GROSS AMOUNT OUE fROM BORROVCR 99,717.72 420. CROSS AMOUNT DUE TO SELLER 95,476.22 200. AMOUNTS PAID 01 OR IN OEIlALf or OORRO~ER 500. REOUCIIONS IN AMOUNT DUE 10 SELLER 201. Deposit or earnest money 3,000.00 SOT. ExceSS Deposit (see Instructions) 202. Principal Amount of New Loon(s) 502. SoU lcmcnt Charges to Seller line 1400 1.497.TO 203. Existing Loon(s) TDk~n Subject to 503. Existing Loona Token Subject to 204. 504. Poyoff of first mortgage loon 205. 505. Payoff of second mortgage loon 206. 506. 207. 507. (Deposit disbursed os proceeds) 200. 506. 209. 509. Adjustments for tt~s unpaid by Seller Adjustments for t tClns unpaid by Set ter 210. C1 ty/town taxes to 510. City/town tOMes \0, 211. County tuei \0 511. County taxes \0 212. School Taxes to 512. School Toxes \0 213. 513. 214. 514. 215. 5T5. 216. 516. 217. 517. 210. 516. 219. 519. 220. lOTAl PAID OI/fOR DORROUER 3,000.00 520. lOtAl REOUCtloR AMOUNI DUE SEtlER 1,497.10 300. CASH At SCTTlEMERl fROH/tO OORROVER 600. CASN AT SEHUMENT TO,fROM SELLER 301. Gross Amt Due from Borrower (llno 120) 99,717.72 601. Cross A"~unt Due to Seller (lIno 420) 95.476.22 302. Less Amt Paid br/for Borrower (llno 220) ( 3,000.00) b02. Less Reduct Ions Due Seller (line 520) ( 1,497.10) 303. CASH I" fROH I J TO DOAROVCR 96,717.72 603. CASH [X] TO E ] fROM SELLER 93,979.12 The unlh:rsigllcd hereby .9l.}nowtI.'1l!J1! tl'CCIlJt of 1I ClIlllfJlcted copt uf /,~ '::""~ "7 '1 1) OORRO\I[R ~_ :~~~ '''IL 0, < I. , "'A'T~[ . [ICltn J" 'l/ , ?' .' /' . OORRO~[R ~(/(. . ~ r _ y(,.,. ("" t. { IlClEN E. NCICIl[l llntlc:. U,2 or t!llb lOtat';'ll."Jj" nny attochmunts fC!l~rretJ '0 herein. SElLCR. (/~U'-..l6J'.f Ii ~- [SIAl( Dr J[SS( 1l....GifA.., A' Ily ~/! c:h, r.. snUR HUO'1 (3-86) RESPA, HO 4305.2 L. SE11\EHENT tllARtES 700. Toto\ soles/Brokers Comnil.slans Dnsed on Price" ,---r.6iiO:oD ---pAID rROH PAID 'ROH Division of COII'Ol56loo (\ Inl1 100) os follow~1 OORROUtR I 5 5nl[A I 5 701. , 2,600.00 to COlDU[ll OANK[R/MGH REALTY rUNOS AT rUNOS AT 702. , 10 SETTLEHERT SET1\EHENI 70l. COlflntllion Paid at Settlement Z,bOO.OO 704. BOD. IllHS PAYABLE IN CONNLtllON NI1II tOAN BOlo loa" original ion fee .. 'l, 10 BOZ. lo,m D t ,"count 'l, 10 BDl. Apprniul fee 10 B04. credit Report 10 Lender" ~'on '!C -- .. BO). 10 BOb. Hortgage Ins. App. Fco 10 B07. AUUTopt Ion Tu 10 - 608. B09. BID. Bll. 900. ITEHS REOUIREO BY LENDER 10 BE PAID IN ADVANCE 901. Interest from to QS Idny( d.ys 'l,) 90Z. Mortgage Insurance Premium for monthl to 903. Hazard Insurance Premium for , years 10 904. to 90). 1000. RESERVES DEPOSITED NllH tENDER IDOl. Hotard Insurance ItIOnths Q' por monlh 100Z. Mortgoge Insurance months Q S par month T003. City/town taxes months Q S per month 1004. County taite' months Q S per month T005. School T 8XU months Q S petr month 100b. months Q S per month T007. months Q S por monlh 100B. TTOO. TTILE CHARGES 1101. Settlement or Closing fee 10 HIOSTATE ABSTRACT COHPANY 35.00 110Z. Abstract or Title ~eQrch 10 1103. Title E~Qminot'on 10 1104. Title Insurance Binder 10 1105. Doc~nt Preparation to 110b. Notary Fees 10 1107. Attorney's fees to ( 'nct udes above I tern nwillers: ) TTOB. Title Insurance to HIOS1ATE ABSTRACT COMPANl b7Z.50 ('ncludes above i tern nll1ben.: IIOZ T101 AND 1104 1 1109. lender'S Coverage S 1110. Owner's Coverago S 95,000.00 1111. l11Z. NOTARl lEE to CMH ).00 1113. NOTARY lEE to CASH 5.00 IZOO. COVERNHEHl RECORDING AND TRANSIER tHARGES IZOI. Recording FeeS: Deed S T4.00 ;Hortgage S ;ReleDlies S 14.00 IZOZ. city/County lax/StDn~s: Deed S 950.00 iHortgoge S 950.00 1203. Stote lox/StOmps: Deed S 950.00 iHortgoge S 950.00 IZ04. IZ05. 1300. ADDITIONAL SETILEHENT CHARGES 1301. Survey 10 130Z. Pelt Inspection 10 PENN PEST 30.00 1303. 199b COUNlY/BOROUGIl TAXES 10 ANH H. HARKLEl. TAX COLLECTOR 01-ZI-OZ71-4)5 417.10 1304. sewer 1/1j96 . 6/30/96 10 CAHP IIILL OOROUGIl bO.OO 1305. 1400. lOTAl SETTLCHENl CllARCU ([ntur On Linea 103, Section J and 502, section K) 4,241.50 1,497.10 SETTLEHENl SlATEHENT PAGE 2 By .10nlng p.go T of Ihl. .loloOlonl, tho slgn.,orlo. .cknow'cd~o rocolpt of 0 cOl'l"olod'coPY of pogo Z of Ihls 2 pogo sl.l....nl. / !tift/If {~~tJf (3,REICIIEL) Certified to be D true copy Settlement Agent "",1)04111_1'11) ESTATE OF " * COMMONW(AtlH or '(NN'YIVANIA INHUnANCI TAX .nUIN IUID(NT DlelDINT SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY L _~I.D'O P,lnl 0' Typo FILE NUMBER 7.l-1 H5-0~5 7 Jesse II. Gray IAlI prop.rty Jolntly.owned with the RI,ht .f Surwlwonhlp mu.t he dlnt...d on Schedul. FJ ITEM NUMBER 1 2 3 4 5 6 DESCRIPTION , VALUE AT DATE OF DEATH 2,264 2 PNC Bank Account No. 51-3006-6150 Accl'ued Interest Merrill Lynch Account No. 072-45~01 1,000 Pennsylvania Dlue Shield 16 Bell Atlantic, reimbursement 90 20 2 Citicorp Travelers Check Bell Atlantic refund 7 Belco Federal Credit Union Account No. 16670 Savings Account Accrued Interest Money Management Account Accrued Interest Checking Account Accrued Interest 6,032 16 20,289 53 10,227 16 8 Belco Federal Credi t Union CD # 16481 Accrued Interest CD " 16699 " Accrued Interest CD # 16905 Accrued Interest CD # 17038 Accrued Intel'est CD # 17147 Accrued Interest 1,000 49 1,000 45 1,000 41 1,000 35 1,000 31 TOTAL AI.o onlo, on lino 5, Roco S 45,228 (Allach addillol'lal oyt.. )( II" .h..h if more .pac. " needed.1 II~Ull'" 1'''1 1 SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELL,ANEOUS EXPENSES ~(~~ '1-':~~'u.!' (OMMONWIAUH or PlNNlnVANIA INHlIlU.'~CI 1M UhJIN .!'I~INf DfC!.OlNf UTATE OF Jesse II. GrilY ITEM NUMBER AMOUNT DESCRIPTION A. Funeral Expens," puncrnl Dills 517 1. B. Admlnlstrallv. CDS'" P.rsonol R.pr.s.nlall.. Comml..lons Social S.curily Numb.r of P.rsonol R'pr.,.nlollv.: Y.ar Comml..lons paId 1. 2. Allorn.y Fe.. 3. Family Ex.mplion ClaIm anI Add,... a' Clolmonl 01 d.c.d.nl's d.alh Slr..1 Add,... R.lolionship City 4. Probol. F..s C. Mlscollon.ous Expons," 1. Real Estate Appraisill 2. \~a ter bills 3. PP&L Electric 4. Puel Oil 5. Dell Atlilntic, Phone 6. Lawn Care 7. \~aste Hanagement, trash B. Sewer 5101. Zip Cod. 255 250 34 68 350 44 40 72 60 TOTAL (Also .nl.r on Iin. 9, R.copllulalion) (II more spac. Is n.od.d, Ins.rt addlllonalsh.... of soma sh..) S 1,690 .."'''''''''''. COlollolONiIlIUUH 0' 'um"'"......',. ltltttlltUI(lIUtllU'''l 'UtllINtDIUOI'jl JeBse II. Gray SCHEDULE I ~ DEBTS OF DECEDENT, MOR!GAGE ,~I~BI~!T1~S~N~_LIENS Ploa.e P,lnt 0' Tvpe FILE NUMBER 21-1~~5-0~5; ESTATE OF ITEM NUMBER DESCRIPTION AMOUNT 1. Uell Atlantic 5; 2 Iloly Spirit lIoapital ~O 3 Ambulance S~rvice 61 TOTAL (Aha anler on line 10, Recapllulatlon) S (II more space i. ne.cloa, ins,,' additional she." or same sin.' _hIlIJlI. Ut'l ESTATE OF ITEM NUMBER ITEM NUMBER * 1. * 2 3 4 5 6 ,e,~ (O......Ol-ilolof..'.H()I"',.j\>"I...'j,.. IHHunAttCI ,,,. _"U_1i "~Il~f~! ,tlftl~IH~_.. SCHEDULE J BENEFICIARIES .le,;,;e II. Gray FILE NUMBER 2l-1~~5-0~5i --,~-- ----- ----+--_..._-- -~-+--,.__. ,_.._._~. +---- NAME AllO ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTAlE RELAlIONSHIP ------~------"_.. .---. '".. -----~._._---~-_.+-- --"-"-.--,-.-.-..-..--,",-- --,--------- 1. A. To..oble Bequolh: Jesse IIiggil1/1 Gl'ay, c/o J. Hich.1rcJ Gray 53 N. Duke SL., Suite> 420, l.al1caslc'r, Gl'ilOdson PA 1 i602 100 shares AT&T Rtock $2,500 cash Ix.Cju(', 2 Evan Kashar, 563 W. Lemon Street, Lancaster, PA li603 Step- Grandson 50 shares AT&T stock Summerlea Kashar, c/o Law Office of William L. Veen, ill Van Ness Ave., suite 220, San Francisco, CA ~4012 S tep- Gr<.nddaughter 50 shares "1'&1' steck Stephen Santor, ~ Dishley Drive, Mechanicsburg, PA li055 Grandson $2,500 cash bequest Susan Seidenberger, l~ Claravista Drive Hollidaysburg, PA 16648 Granddaughter $2,500 cash beGuest Kimberly Santor. 513 Susan Road, Camp Hill, PA liOll Gr anddaughter $2,500 cash bequest * See continued Beneficiaries attached NOTE: Items 1-6 all in decedent's codi il NAME AND ADDRESS OF BENEFICIARY AMOUNT OR SHARE OF ESTATE B. Charitable and Governmental Bequo,": Trinity Lutheran Church 2000 Chestnut Street, Camp IIi 11 , PA 1 iOll $1,000 Tressler Lutheran Services ~60 Century Drive, P.O. Box 2001, Mechanicsburg, PA li055 $1,000 *Bequests in codicil TOTAL CHARITABLE AND GOVERNMENTAL BEQUES1S (Aho en' or on line 13. Recopi.ulo'ion) (lr more 'pac. I, ne.ded, 'n,e,' additional ,h.." of ,om. .Iul S 2,000 , COMMONWI!AI.TIIOI'I'I!.NNSYLVANlA INIII!RITANCn TAX RIITIIRN IU'.SlUrm Ur.clUlrm SCHEDULE J BENEFICIARIES CONTINUED = U.\'TATUOI' Jesse H. Gray I'II.IlNIIMIII!R 21-1995-0957 Item Name and Address Df Beneficiary No. RelatiDnehip AmDunt or Share Df Estate 7 J. Richard Gray, 53 North Duke street, suite 420, Lancaster, PA 17602 Son 1/2 residue B Jayne Santor, 1710 Lincoln Drive camp Hill, PA 17011 Daughter 1/2 residue Ai t."T ~-lo cl( (100) \ DO o5L......... -l ":fie" 1.\, '1"'" IC. (e~ J\st....b~n q€' o,'tJ(\ .!.Lf'.L.,)J,~--, ...SC-p./g, ~_'i.rc.t. - '-"-'-' ~ !ill. +.. EY~1'l K~J.hoz.~ So" f.. ~ I.J l1\.m.ey~..JJaJ-I:.er.: -' __._._"1J:C5$)~1-' tr..dh(_r~n SeXYI':'.>--- .__~-'-OPd,:.!().. l.-~$l.., ,.,,- ,.-....' ' ~t"o__~~ut'f'J))'\"lL __,_____,.______. ,,___ - ,_,.-.---------.d f"JQ.~..)oOJ---------------.---------.----- --, .- .---.-- ._____NG-4 ~n,:C5_htj-7tl- ~'lof.f:_qq,L----,-- --..-..-~.-.-'- --- -.'--' ' ---+----"-"-_._--~_.._~-,._._---~'".--- ..---~.- .----~ .. --.. - ._" --_.---~......._-~ ..---.. <I I 000 . 00 t.'t dL---. --------- I rlJ:lJ:ty_LyjJ:.lt~1!...- C h ~ rel1 ~.joo C ~( -'.W y-/ n. C-aIl1Il!-ld1,l'A /"0/1 , -_...--- ----- - --- --- ----- ----.- _~Klm ~ 10 0 \'j\ ~ 1,1/ 1 Ccr: , (5-0!.r 'Se._tM.:P~4'1U'f _~UoP....P 0 \~.r11'~l.l+_t ~f!1I;t"$ ... --........-- ---.-- .-..---...-- ~---------_.. -_. .----- .-.---~."'~\I--CbK .-.-----.,-,------.-~ -------...----.'---" ,------- ,."'" __._ __ ..'J ~ b k ~ le.:<,:r'.(.~ .:.:"__ "" LI_t1!Y.f.) __..d~_1"o{~p-bl" ( .~ '(;':'!l ~d_fhv L. ' ----- --. _.._~---,.---~.--. - --~._._-. .-",-,. ~._-----~-- '7-,~_~" -r c.._~.h$...LhlL~nh_13H'\h~l"hl>>cLftnn vd,_{S,!f.t!l!J') --- -..-' -- _f-h~,r,J~-1J.Y." ~ '-. CD Q C.!,J'.h_03h~-'- . ----- _---:CU:CI'-\u,\LS,).I'1f.VX---- ..--------- ___-~y-JJo.\,d;~J:J..(.r.'J1.~t# e r- , K"\"~ &a.,.ol-' -'-- .:r c.~ I ~ l'\ ~5 "i5 6 "!r L~ '" dn ~lt r /I;fI.-!.f.i!~1( (1!2r-) -----{q-;;;:-~:-fI --~~ ~ ~- J-I-9 q---- ~_._--- - (c) To borrow money notes therefor, nnd to mortgnge or pledge. n nd to secure execute Ilfo.lssory such obllgotlons by iI !1 I (d) To employ such brokers, bnnks, custodlnns, Investment counsel, ottorneys nnd other ngents, ond to delegote to them such of the duties, rights nnd powers of the Trustee (Including, o.ong others, rlghto to vote shores of stock) for such periods os it thinks fit and to keep assets In the nnse of a nominee without mention of the estate or Trust In ony Instrument of ownership, (e) To participate In or consolidation and In exchange ony property held any merger, reorgnnlzotion connection therewith to for other property, (f) To determine. os to 011 sums of money and other things of volue received, whether and to what extent the some sholl be deemed to be principal or to be Income, Including the proceeds from the sole of non-productive ossets, ond os to 011 charges or expenses paid, whether and to what extent lhe salle sholl be charged agolnst principal or agalnsl Income, including, without hereby Umiting the gencrulity of the foregoing language, power to apportion any receipt or expense between prlnclpol and Incose ond to deterlline what port, If ony. of the actuol Income received upon any wasting asset or upon any security purchased or acquired at a premium sholl be retained and added to principal to prevent a dhlnutlon of principal upon the exhaustion or the 1I0turity of the investment. '. (g) In dividing assets hereunder Into shores or in distributing the some, to divide or distribute in cosh, in kind, or portly in cnsh nnd pnrtly In kind. os It thinks fit. For purposes of division or distribution, to value property rensonobly and In good foi th, ond such vnluatlon sholl be conclusive upon all parties. To whatever extent division or distribution is mode In kind, it sholl, os for os practicnble, allocate approximately proportionate amounts of each kind of security or other property, (h) To take over and Trustee may deem nppropriote in any corporate fiduciary. retain any property the Including any investment 'Ii Ii " \' " ;, I, " I: I I' ! !, i I' Ii II " . . COMMONWEALTH OP PENNSYLVANIA ) ) SS 1 ) COUNTY OP LANCASTER WE, JESSE H. GRAY, CHARLES POLTZ HERR and GLORIA M, MYERS, the testator and the witnesses respectlvely, whose nalles are signed to the ettached or foregoing instruaent, being first duly sworn, do hereby declare to the undersigned authority that the testator signed and executed the instruaent as his last will and that he signed willingly (or willingly directed another to sign for him) and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the wi tnesses, in the presence and hearing of the testator signed the will as witnesses, and that to the best of their knowledge the testator was at that the eighteen (18) years of age or older, of sound mind and under no constraint or undue influence. ~q,{. ~ CLrt.. (/k4'?',gA".~./JJ.~"~ . SE H. GRAY (Witness) . (witness) . I: " Subscribed, sworn to and acknowledged before lie by JESSE H. GRAY, the testator, and subscribed and sworn to before ae by CHARLES POLTZ HERR and GLORIA M. MYERS, wi tnesses, this J~ day of October, 1985. :: C~O.~ >N'I\1O~']( MY COMMISSION EXPIRES1~~~~~~~~ I " ! ClMl ~.. PIllS!;'!, I'!o!nry Putlllc ;1"":1',"," ',1'...1:.. l:l t.-. .._01..,;:......\ l:A;.lII'/l:t AupJ6t 4, lse3 .- ...."- -'," ------' .. -....,.-" ..,-.. .- , .-.,_...~..._-_.-- ,. , I .' _ ", .... "._.,;."._'....___.- 14~. , 1 :"..:,' ":,'/"1' :'.1;'2' :gO'1""COMMONWEALTH OF PENNSYLVANIA Mo.AA ,,' ' ,,' " : ,,' ,"..:,; ".,,', ;;':', DlPAR1MINT o'JlIYIHUI 'm,;iU ~~:~': ~\~>,YO'''CIAL RlCIIPI' . PIMMSYLVA' ~iA INHERITANCE AND ESTATE TAX AMOUNT D ACN ASSESSMENT P:I CONTROL I,;i NUMBER RECEIVED FROM: \ 101 .. I ." 1 017 . 00 HERR CHARLES F ESQ 53 N DUKE Sf SUITE 420 LANCASTER, PA 17602 . ESTATE INFORMATIONI m FilE NUMBER \ III _, 21-1995-0957 / . E OF DECEDENT (lAST) GRAY JESSE H II DATE OF 'AYMENT m POSTMARK DATE COUNTY SSN 178-01-5924 (FIRST) IMI) ... 'r~"-."t" CUMBERLAND DATE OF DEATH .IS, 109.00 PB m TOTAL AMOUNT PAID REGISTER OF WILLS RECEIVED B~) J (r..k/ iJ MARY C. LEWIS REGISTER OF WILLS I" f -t l .. 1,1,.1 I,Y ~ONA10Rt ' ./ ',/ /' .,/1"; REMARKS J RICHARD GRAY C/O CHARLES F HERR ESQ CHECK" 10S3 SEAL ~ - --~ --~. ---- _._- -- - - - -~- - - --- -'~ .-..- -..'- --- -'"' .._~ ___ -' - - - - -,- -~l--'~---- -~-- '11 ... ',\ , r <~ . . ; ," <>;' ...~ "-' -, . " ,,-_., ~ ~ "7~-,---~:--.".~.:.Jldlf _ ..IJ'I:" \ , " ;_1(,;./ I ! l /1 I ~. t "f:~ i i:J ) 'I . ;, BUREAU OF INDIVIDUAL TARES INUITAHCt tAX DIVIIION OCPt. llD60. IIARAIUu:tG, Pi I1UI-0601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE (,1, NOTICE OF INHERITANCE TAR APPRAISEHENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AHO ASSESSHENT OF TAR DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 10-22-96 GRAY 11-1l-95 21 95-0957 CUMBERLAND 101 AMount R..tlt.d CHARLES FOLTZ STE 420 53 N DUKE ST LANCASTER HERR ESQ PA 17602 - ..,.tl4'" '" III.". JESSE H MAKE CHECK PAYABLE AND REMIT PAYMENT TOI REGISTER OF WILLS CUMBERLAND CO CDURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ REy:is'4-j-iix-AFP-riii-':96Y-iiil'ficii--ciF-YNHiiiiifANci-YAx-APiiiiA'isiiifiii'r;-,U.i."ciiiANCi-oli----------------- DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GRAY JESSE H FILE NO. 21 95-0957 ACN 101 DATE 10-22-96 TAX RETURN WAS, C X I ACCEPTED AS FILED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ONI ORIGINAL RETURN 1. R..I E.t.t. (Schedule AJ 2. stock. end Bond, (Schedule 8) 5. Cloa.ly Hald stock/Partnership Int.r..t (Schedul. C) 4. "ortgag"/Not.. Rec.habl. (Schedul. DJ S. Cash/Bank Dapallt./Hllc. p.rson.l Property (Sch.dule E) 6. Jointly Owned Property ISchadul. Fl 7. Tranlf.... (Schedule OJ 8. Tot.l A...t. I CHANGED III 121 131 141 151 161 171 93,979.00 83,178.00 .00 .00 45.228.00 .00 .00 IBI NOTEI To Inlur. prop.r credit to your account, lub.lt the upp.r portion of thla for. with your tl. Ply.ent. 222,385.00 APPROVED DEDUCTIONS AND EXEMPTIONS I 1,690.00 9. fun.r.l EKpen.../Ad.. Co.t./HI.o. Expen... ISchedula H) (9) 10. D.bh/Hort.... LI.tJllItI../Lhn. ISch.dul. II 1101 208.00 11. Total Daduction. Ill) 12. Net Value of ralC Raturn IlZ) 15. Charltabla/Govern..nt.l O.qu..t. (Sch.dul. J) (15) 14. H.t Value of E.tat. Subj.ct to Tax (14) NOTEI If an assassmant was issued previouslY, lines 14, 15 and/or 16, 17 and 18 will reflect figures thBt include the total of ahh returns assessed to date. ASSESSMENT OF TAXI 1&. A~t of LIn. 14 at Spou..l rata (15) 1'. ~t of LIn. 14 taxable .t Lln..l/Cl... A r.t. (16) 17. Aaount of Lln. 14 taxable at Collataral/Cla.. 8 rat. (17) 18. Principal Tax Due TAX CREDITS I PAYHENT DATE 06-04-96 RECEIPT NUHBER AA1l2901 DISCOUNT C>I INTEREST I-I .00 INTEREST IS CHARGED FROM 08-12-96 TO 10-30-96 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. .00 X .00, 218.487.00 X.06, .00 X .15, IIBI AHOUNT PAID 13,109.00 TOTAL TAX CREDIT BALANCE OF TAX DUE INTEREST AND PEN. TOTAL DUE I,AgA nn 220,487.00 2,000.00 218,487.00 .00 13.109.00 .00 13.109.22 13,109.00 .22 .00 .22 IF TOTAL DUE IS LESS THAN fl, NO PAYHENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU KAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORK FOR INSTRUCTIONS.) ()(', . . '. f'_1 RESERVAJIDHI [,t,t.. of ct.c.cMnh dying an Dr "fon DecMber a, ..Ir ... 11 MY future Int.r..t In tn. ..t.t. II trMIf.rred In pa.....lan or enJo~t to Cl... I (coll,tl"tl) ben.flcl.rl.. of ~ dec~t .,t,,. the tWPlr.tlon of eny ..t.t. for Ilf'Dr 'or Y""" the C~.lth hereby IKPr...ly r...rVI, the rlDht to apprtl'l end ...... tr....'.,. Inn.rlt~. T.... .t ~ l.wful CI... . (coll.tt,.tl) t.t. an any ~ lutu... lnt.r..t. PURPOSE Of HaTlCE, To fulfill the '....1'....,'. of Section ZIU 0' the JntMrHMCI end Elt,t, '11iI Act, Act ZZ of 1991. 12 P.S. Section 11~a. PA\1IJfT, IktKh thl top portion of this holle. Dnd tubli1t ..Ith your ply.."t to 1M R-ahtlr of Willi printed on the nv.,... .lde. uK8kt check or HlMJ' orlMr parabl. tal REGISTER OF MILLS, AGENT All plYHl\t, t.ul,,~ ,hell first be applied to any Int.r..' Which "11' bt due with any r...lndtlr IIPplJlKt to the tl.. REfUr(D ttAh A nfund 0' . talC crlldlt. which .... not r..,..ted on the ,.. Rthlrn, "V be reqlM.t~ bV CHPlat1~ en "Application for Rafund of P-nn.vlv~la Inn.rltlnCa ~ E.tata T.... (REV.15l5). Appllc.tlon. .... .v.llabl. .t the Offlc. of tt. Rqhhr af WU1., Mvof the Z3 R.VWlUe Dhtrlct Offlc.., or by calling the 'f*CI.l Z~.hour lW1.",.rlng ..rvlu r\l.IIIbe,.. fa" for.. orcM..I~1 In P.....vlvanl. l.aOO"UZ-zno, DUblde P.......vlv....l. and within loc.l H.r..hburg .r.a (717) 787.809<\, TDDI (717) 77Z.2252 ClI..rlng Illpalr~ Only). OBJECTlONSI Anv p...ty In Int.r..t not nthfl-.:i with ttM app..ah..."t, allowanu 0" dl..l1owanc:a of deduction.. or a....A8ftt af t.. (Including dhcDl.,t or Inh....t) a. .hown on thh HoUc. au.t obJ.ct within .bty (60) daVl of ..ac.lpt of thh Notlc. bv. "wrltts" p..ot..t to the PA Dap...tMnt af R.vlf'llM, Board of ",,"ah, Dept. Z810ZI. ........aburg. PA 17lZl.IOZI, OR .-slactlon to hev. tNi _U.r dehr.lned .t audit of the ItCCDlllt of the par.onel ..lPr........Uv., OR -.eppe.1 to the Orphana' Court, ADtUN lSTAATlVE CORRECTlOHSI Factual .....or. dlscov.r.d on thl. ......-.ot .nould be addr....d In writing tOJ PA D,part_ent of R.VWlUe, au...., of Indlvldutll rIM", ATTNI Po.t A.......,..t Rnl... Unit. Dept. 280601. tt...rhburg, PA 17128.0601 Phone (117) 787.6505. Sea pegs 5 of the booklet "In.tructlon. for Inherltanc. TIM R.turn fo.. . R..ldent Decedent" (R[V.1501) for en ..plen.tlon of 8dalnl.tratlv.lv correctable error.. DlSCDllfTI If anv talC due I. paid within thr.. (5) calendar .unth. afhr the dec:~'"t.. d'ath, . flv. parc....t (5:(1 dhcOWtt of the tu: paid II allowed. The lU tIJC __.ty non.part1clp.tJon penalty II COlPUt~ on the tohl of tNi taM Md Int.r..t ......-.:i, and not p.ld tMfor. J.--..rv 18, 1996, the fl...t d.v .ft.,. the and of the t.. _"..tv p.rlod, Thh non-p.rtJclp.tlon pen_Ity II fIPPIsllllbls In ttM .... .lIlrW1Ir end In thl the .1tH tI.. p.rlod III you would IIppIII tt. t.. and Int.rut that has b..... ......~ .. IrMtlclt~ on thh notlc.. PEHALTVI IHTERESTI Intlr..t II chllrgtlCt beginning with flnt day of dellnquww:y, or nine (" IIOnth. and or-.. (11 day frOll the det. of dMth, to the d.t. of P'YHnt. T.... which ~ dall~t before Janu.ry I, I'az Ner Int.r..t .t the rete of .h C6%) p.rcant ~r ~ c.lculated .t . dally rata af .000164. All t.... which bK... delinquent on and aft.r Janu.ry I, I'IZ will be.r Int.r..t at . r.t. which ~III very fr~ c.lendar y.er to cllandsr y.... with th.t r.t. announced by the PA Dap.rt-.nt of R.vanu.. The appllcabl. Int.r.st ret.. for l,az through 1996 .r~1 '!!!! Int.r..t R.h D.lly Int.r..t Factor !!!r Int.r..t Rllt. D.lllll Int.r..t Factor I'll ZU .000Slt8 1987 'X ,OOOZ47 IUS IU .ODDU8 19a~H991 11% .00nOl .... IIZ .0DDSOl I'" .. .aaOZ~7 19.5 U. .00nS6 1"5-1994 7> .ooonz ..16 IU .000Z74 1"5-1996 .. .00DZ47 --lnt.....t II nlcuhted .. follow.1 INTEREST . BALANCE OF TAX UNPAID X NUNBER OF DAYB DELINQUENT X DAILY INTEREST FACTOR --Anv Notlc. I..ued .ft... the tlllll bK~. dlllInqu.nt will r.fleet en Int.r..t celcul.t1on to flft..... (15) dau beyond the d.t. of the ......Mnt. If p.~t II sade eft.r the Inhr..t cQIIfMJhtlon det. shown on the Hotlc.. addltlon.l Int.r..t .u.t be c.lcul.ted. , STATUS REPORT UNDER RULE 6.12 Name of Decedent I Jesse If. Gr'llY Date of Deathl November' 11. 1995 Will No. 1995-00957 AdmIn. No. Pursuant to Rule 6.12 of the Supr'eme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estatel 1. State whether administration of the estate is complete I Yes-x- No 2. If the answer is No, state when the per'sonal representative reasonably believes that the administration will be complete I 3. If the answer to No.1 is Yes, state the followingl a. Did the personal representative file a final account with the Court? Yes No x b. The separ'a te Orphans' COUr't No. (if any) for the personal representative's account iSI c. Did the personal r'epresentative state an account informally to the parties in interest? Yes x No d. Copies of receipts, releases, joinders and approvals of formdl or informal accounts may be filed with the Cerk of the Orphans' Court and may be attached to this report. DateI10/7/99 (fI ~A,.,.-f /i",.,....., Signat.ure I . Charles Foltz Her'r' Name (Please type or print) 53 N. Duke St., Suite 420, Lancaster, PA Address 17602 (717 ) 299-7374 Te 1. No. Capacity: Personal Representative x Counsel for personal r'epresentative (MAH I rmf/ AM3)