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4018887
No,
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COMMONweALTH 0' PINNIlYLl/~NIA' DBPARTMENT OF HIlALl"' YITAL AIDOADS
CllRTIFICATIl OF DEATH
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(f) to file any federal income tax return for. any year for
which I have not filed such return prior to my d~ath,
(g) to make distributions in cash or in kind, or in both, and
to determine the value of any such property,
(h) to employ any attorney, investment advisor, or other
agent deemed necessary by my Executori and to pay from my estate
reasonable compensation for all their services, and
(i) to conduct along with or with others, any business in
which I am engaged in, or have an interest in at the time of my
death.
Article V
I nominate, constitute, and appoint my son, STEPHEN GRUBE,
Executor of my Last will and Testament. In the event of the
renunciation, death, resignation, or inability to act, for any
reason whatsoever, of my Executor, I nominate, constitute and
appoint my brother, RICHARD O. PISCHKE, Executor of my Last Will
and Testament. In the event of the renunciation, death,
resignation, or inability to act, for any reason, of RICHARD O.
PISCHKE, I nominate, constitute and appoint my sister-in-law, JOAN
W. PISCHKE, Executrix of my Last will and Testament. In the event
of the renunciation, death, resignation, or inability to act, for
any reason, of JOAN W. PI SCHKE, I nominate, cons'ti tute and appoint
my nephew, RICHARD P. PISCHKE, of 115 Buffalo Run Road, Bellefonte,
Pennsylvania, Executor of my Last will and Testament. I hereby
relieve my Executor, whether original, substitute, or successor,
3
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fOR OATIS Of DEAnl AnER 12/31/91 CllECK IlERI
If A SPOUSAL
POVIRVY CRI.OIT IS CLAIMID [I
mE NUMBIR
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWeAl'" Of PfNNmVANIA (TO BE FILED IN DUPLICATE
""A'~I\'WJ,MVENur WITH REGISTER OF WILLS)
._ ~~~RI$8URO,!_A.- \7.~?o.~q~.~L.,"_______,_",,___. ". -.------ ," ,-.-. ,
.. otClOEN1'$ NAMl (IASl, 'IR'!>CM-TIl~;Hi(ilTmi(iAtl-.""----'"
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COUI'ITY COOl:
[;f({fif.r;i;~(:O;;irTfiT/J,{iR{~S-'--"-'-----~
~7 COLGATE DRIVE
CAMP HILL, PA 17011
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$OCIM HCUIlIlY NUMMR 1l....1f (If UUdH [IAIl (II IllR1l1
_ 1 98-1 2 35fL2~~-- --" -1.2.:-..12."-1-- ...Ji,-,ll",23 -,
1'1 ,..,'\tC....lll IU_Vl'NIO VllU\1 ~ ~IAIr\IIIA~! IIU! AlIll MI(lNI'~111tAlI ~OCIAl !>fCUPHY ~HJMBIR
~ __'___~ _._._~__________._-~.~.___ .~_ _ _ ___ n___~__
[1 I. OrigInal Roturn L] 2, Supplamentc11 Roturn
rJ 4. limited E,tUlo fl 40. Fuluro Intarclt Compromllo
llor dOllll 01 doath allor 12.12.02)
[J 6. Decodenl Diad Testala [] 7. Dccadonl Maintained n Llvlng Tn}11
(Alloch copy 01 Willi IAlloch copy oll,u"1
ALL CORRESPONDENCE AND CONfiDENTIAL TAX INfORMATION SHOULD BE DIRECTED TO. --
NAMI JO""'" "."'NO AO"'''--''
STEVE GRUBE__________________ 47 COLGATE DR!VE
IIL""ONINU"'" CAMP HILL PA 17011
L~LUl-8300 - --' '
.. __ __ .In~_"'_~~" --'- ~..
1. R.ol E,'ol. (Sch.dul. AI ( II ____.-----9,O',JlO1l..-on,-,~
2, Slock. ond Bond. (Sch.dulo 81 (21 ---::.Q=------
3, ClolOly Hold SlocklPo,lnor.hlp Inl"OII (Sch.dulo Cj 131 -0-
4. Mo',gogOl ond Nolo. R".lvoblo (Schodul. DI 141 ___" -0-
5. Co.h, Bonk D.po.ln & MllCollonoou. Po"onol P,oporly 151 _-_ 44 . 28..9~SL-_-
(Sch.dul. EI
6. Jointly Ownod Proporly (Schodule Fj
7, l,onll." (Schodul. GI(Schodulo LI
8. T 0101 Groll Anotl (10101 line' 1.7)
Q. Funeral Expenun, AdmlnlUralivo Cosh, MI,celloMou,
EKpenses (Schedulo H)
10. Dcbh, Morlgage llobilillos, Lien' (Schedulo I)
1 L TOlol Deductions (Iolallloos 1:1 & 10)
12. Nel Value 01 Eslate (Une 0 minus Line 11)
13. Charitable and Govf}rnmonlal Bequosh ISchedule J)
14. No: Vulull Subject 10 Tax (Line 12 mInus UnEl13)
lS, Spousal Transfors (for dales of deolh after 6.30.1:141
See InstrvclloM for Appli<;oblu Percentage on Reverse (IS)
SIde, llnclune values !rom Sche-dulo K or Schedule M.l
16. Amounl of line 14 la.....able 01 6% ralo
(Include values from Schedule K or S~hodule M.)
17. Amount 01 line 14 ta.....ablc 01 15% role
(Include volues Irom Schedule K or S(hedulo M,l
la, Prlodpollox du~ (Add lOll: from lino~ 15, 16 and 17.)
11:1. Credih Spousal Povarly Crodil Prior p(lymar'\t~
__", ,~__H____' + =0""
--j
._____.~____________n__.~_.n_____.__~
[] 3,
[15,
Remalnd.,r Rltlurn
(for dCllet 01 dealh prior 10 12.13.82)
fodoral Eilolo Tax Rolurn Aoqulred
~ 0, Total Number of Sale Dopo,i1 901(111
( 6 I ,___,_Sl-r1-5 8
(7 I _...,."fi-
22
18)
14~.14'1'" 31
I q I
13.555.50
(101
?17.rlO
1 3.7". 'lrl
(111
(121
(13)
(14)
l?Q, F,:J.4Jl
__x,.:-.--=
1161 ~....J.2.!L-fi7.<1 _ R 1
717n.o.4Q
.X ,06..
117) _
_x ,15 ..
-_._----~
z
..
f1
!;
..
'"
..
w
(18)
Dhcounl
Inl(He1t
(lql
1201
_,0-__
+_ ___ 0--
--.-.._~--_.._-~-_._-_._-_.-
20. If Une 19 i~ graator II\0n lino 18, nnlllf lho difforanc6 on lino 20. Thilll the OVERPAVMENT,
m O__l!l:r:r.l!WiII<-lf,.la"'II.'U'."I.nlll.11111111..f'Irn":T:r:t""'III.'l:J,,]j!l!.lo'~liI'loI
21, If line 18 h groater lhon line 19, enler the differenco on Une 21. 'Thil i~ Iho TAX DUE.
^, ~nlor Iho inl/H.Ht on Iho hnlnnco dun on lin!) '11^
B. (111or llw 1010\ 01 Linu II (Jlld riA on litH' 711\, rhi\ i', II\!, nALANCE DUE,
...~_.~...._ .,'~.~~~ .C~o.~~.~~Y,Cl~.I_o to: R.l)J~j~t(Jr of Wilh,.~gunl
{211 ____~4_1ll.0__'_4.8_____
121 ^I----..,----..-,-..----
(71 fil
~
....
-.-.-~~"j;...'BF..SURE..TO--A:N.svir..R-.ALLQUESTIONS ON REVERSE SIDE AND T'O RECHEC-t<' Mi\TH' ...(__...___.___..n~__~.....
Undor penohla$ 01 periury, I d;J~ro th(~.-n~~~;-;;~'~i~cl!i;i~-~,~~";;:i~~~i~-(j'~~~-;;~~p~;~i~~'~~h'~-c~~--;'~~'~~~~;~ Cln(rl~lW-bo~t ~I my knowledge ond bollef,
II \, true, correcl (Ind 0 plcle. I doc\oro thoY{l1l runl oslnto 11m buon roporlod {lllrufJ mnfkOII/Clluo, ~11<laroliol1 01 preporor othor Ihon Ih(l porsonClI ropnuonlativo Is
~~:,~,n,~I~;~io' ,~-S;!i.!'i~~;1l;~hl~'NonLk'.O':;'~:~;~l ----.. --- / /1 ~'_ .....--"'---~.....-._--"--_... nAlE /
/ ".RERO' RlliA,rt0P(flfNi''';P ...'c.h4,/i, ::.lL_~,l/nr lull, LZc../L ,1.;';"/:/..112-----
UV.UIlIWI ('.4~1
hTATE Of
ITEM
NUMBBR
~I~:~~
......Sfllm-
COMMONWEALTH or PENNSYlVANIA
INtURITANCf YAM ReTURN
RUIDfNT Of.CIDINT
.-
ELINOR P. GRUBE
1.
A. Funeral EMpeNIIsl
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATlVG COSTS AND
MISCEllANEOUS EXPENSES
.------..--..
__0__'-'
Plea.. Print or TVp.'
DESCRIPTION
,
FUNERAL -NEILL FUNERAL HOME
MINISTER
1.
B. Admlnl.tratlve Colll1
2.
3.
4,
C.
1.
~,
3,
4.
5,
6.
7,
8.
Perianal Representallve Commlulonl
Social Securlly Number of Personal Represenlallvel
Vear Commlulonl paid
Allorney Feel
JAN L. BROWN, ESQ.
Family Exempllon
Clolmanl STEVE GRUBE Relationship
Address of Claimont at decedenl's dealh
Slreet Addre"
Clly _ CAMP HILL
'Prabato FOOl
MI.cellaneoul ExpenlOlI
~mJ
47 COLGATE DRTVE
Slalo P A
Zip Code 1 7 n, 1
SENTINEL-LEGAL ADVERTISING
CUMBERLAND LAW JOURNAL
(If moro .paco I. needod, Inlort additional .hoots of same size,)
TOTAL (AI.a onlor on line 9, Recapitulation)
AMOUNT
$ 3,360.00
200.00
-0-
$ 6,089.00
$ 3,500.00
$
270.00
$
76.50
60.00
$ 13
L
SUMMARY OF SALIENT FEATURES
Slibll)(;l AlkIIo5~ 4'1 colq.to o~iVa
l'lJ<llO""~~n ROQord Dook 19k P.gOl 460
CIy CAmP iliJ,l
County ~urnb8rlQnd
51" "^
Z~l CO\Io 1'1011
Censuslri~l 0111
MilpnotclO!'l::C 1'-2'-0545-394
SaloPrk:e I.NI^
Oalool~ NI^
8oIrowor/CIlcnt Est_to of Orubo
lerOOl Estato of Grube
Slzo(SqtlilJoFectl 1,204
PrlcflporSlluaJofool
localx,n 1'\vg SUb1.trba
^'1' 40 hs Est.
Condhm Average
ToldJRooms 6
DedroQms 3
a,,,,, 1,5
Appraiser LinaA S, GrAdy
Oalool^pprd/$cdVil/uc 05/30197'
fIoolE,lrn..oIV'"
$ 90,000
II'
form SSO ~- 'lOTAl2LW lor W~)lklI'/5' apllIills.11 soflwJlQ by d ~I nlQ(!Il, loco - 1.800.Al.lIMOOE
i:ilo'JI'J,.!ljl)./I!IUJ',11l1i 1(,1)
COMMONWEAI.TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
/S'- / f II. P
BUREAU OF INPIVloU^L TAMF.S
INtfERJTANCE fA)! 1I1VrstoN
DUll. l80601
HAFfR1SBUMD, I'" 11128-0601
NOnCF. OF INIIERITANCE TAM
APPRAISEMENT, AllOWANCE OR OISALLOWANCE
OF OEDUCTIONS AND ASSESSMENT OF TAM
11-24-97
GRUBE
12-12-96
21 97 - 0496
CUMBERLAND
101
E-~__ A.~~!-~.'!ltt.d - J
MAKE CHECK PAYABLE AND REMIT PAYMENT TOI
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ... RETAIN LOWER PORTION FOR YOUR RECORDS ....
R i!V; is4''i- EY"AFi;" (il'9'; 97"1" "Hili'i c nip" YNHEii i f ANc E - TAX -iI P PRiI"fSEifENT",- -A [rciwAifcE - (jli- -"" -- - -- -- - - -. -.
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ELINOR P FILE NO. 21 97-0496 ACN 101
DATE
ESTATE OF
DA TE OF DEATH
FILE NUMBER
COUNTY
ACN
STEVE GRUBE
47 COLGATE DR
CAMP HILL
PA 17011
ESTATE OF GRUBE
TAM RETURN WAS, (X) ACCEPTED AS FILED
RE5IERVATION CONCERNING FUTURE INTEREST " SEE REVERSE
APPRAISED VALUE OF RETURN iAS~ON: ORIGINAL RETURN
1. R..l E.t.tc (Svhadul. A)
2. stock. bnd Bond. (Soh.dule 8)
3. Clo,.ly held StCl(:k/p"rtn.r~hlp Inhrest (Sc:h.dul. C)
4. Hortgag.,/Notas Rao.lvable (Sch.dulft D)
5. C..h/S.nk Depa,tta/Hisa, Personal Property (Schadule E)
6. ,Jointly Owned Property (Schedule f)
7. Tranltaru (Sch.dul. Gl
8. Tot.l A....t.
APPROVED DEDUCTIONS AND EXEMPUONS:
9. Funaral Exp.n..~/^dm. Costs/Hisc. Expenses ISchedule H)
10. Debts/Hortgage Liabilities/Lians (Schedula I)
11. Tntal DaduoUona
12. Nat Valua of Tax Raturn
15. Chad table/GovarnMental a.quashi Non~alac'lad 9113 Trustll
14. Nat Valu.. of elt'Ate Subj.ci: to Tax
(9)
UOl
) CHANGED
U)
(2)
(3)
(4)
(5)
(6)
(7j
90,000.00
.00
.00
.O.Q.
44,289,09
9,158,22
,00
(81
{I/
*'
13.555,50
217.00
(11 )
(12)
(13)
(14)
(Soh.dub Jl
UV.IUI U." tit..,.
ELINOR
P
DATE
11-24-97
NOTEI To in sur. propar
cradit to your account,
sub.it the uppar portion
of this forn with your
tal( pay..nt.
143.447,31
n,77? GO
129.61i:.!!,
,00
129.674,81
If an assessment was issued previOUSly, lines 14, lS and/or 16, 17 and 18 will
reflect figures that include the total of Abh returns assessed to date.
ASSESSMENT OF TAXI
IS. Allount of Line 14 ..t Spousal rata US)
lb. Anount of Lina 14 taxable at LJn'.l/Cla.s A rat. (16)
17. AMount of Lin. 14 t*xabl. .t Collat.ral/Cl... Brat. (17)
la. Principal Tax Due
NOTE:
TAX CREDITS I
PAYHENT
DATE
08-22-97
RECEIPT
NUMBER
AA211682
DISCOUNT (+1
INTEREST/PEN PAID (-I
.00
.00
129,674,81
.00
M ,00,
X .06,
X ,15,_
(18)
AMOUNT PAID
7.780,48
TOTAL TAX CREDIT
BALANCE OF TAX DUE
INTEREST AND PEN.
-----
TOTAL DUE
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIDNAL INTEREST.
.00
7.780.48
,00
7,780,48
7.780.48
,00
,00
.00
IF TOTAL DUE IS LESS TMAN .1. NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CRI. YOU MAY BE DUE
A REFUND, SEE REVERSE SIDE DF THIS FORM FOR INSTRUCTIONS.)
\,~l
:! ~ :3
()C)
RfI[RIJATJOHI eltlte. of dloedlntl dvl". DO or be'Dre Declublr 12, 191' ... If InV futu,.e Int.,ltt In thl Ittllt_ 11 tr-,\.flrred
In polII..lon Cfr enJoYHnt to el... I (ool1lit.rl1) bltMlf'tollrl.. of thw dlOlcMnt Ifter tht IMP!"U"" of env utltl for
lIfl IU' for y..r., tht Co.onwtl1th herebY eMprltdY r..e,.veI the tight to ",rllll end e.,I.. trlntf.,. lnhltr.!t1nCl1 TIM"
It thl l.flJI CI... . (~ol1.tlr.U r.t. on eny .uoh future Intlr..t.
_Of
NOueE, Tn f"Ulll thtl rlqulrlMntl of BllOtto" Z1~O of thtl .tnherit.noe Ind s.tltl TaM Aot, Aot 21 of 19'1. (72 P,I.
seuUon 9UO),
PAVHE:Nl', Dlt.oh the top portion of thl. NoUo. llI'Id lub_it with your PIy..nt to thl R,ght,r u, Willi prlntlld on the r.v,,,,, II..
u.... c:tMtCk or 1IOMI!f order pIyabl1 tOI REGISTER OF' MILLS, AGENT
REfUND (tA)1 A rlfund of , tlM erlcHt, which wa. not r.qulltld on thcl TIM Rlturn, I.Y bQ r.qutllbd by ~OIpletlne In "Appll~t1on
for Refund of Penn.ylYlnll lnh.rJttnCll Ind Eltlt, TIM" (REV"U\3l. Appllcltlon. are ,valllbl. .t th.Offlc,
of thlt Rqllter of Will., any of th. U Revlnu. Dlttrlot Offle", or by oll111na the 'PMI.I 24-hour
"'....rlng ..rvioe ~r. for forll.ordll'JnSIl In PI"n.ylvlnll 1-800-362"2050, ouhld. P.nn.vlvlW'd. and
within 10011 tlarrhburu Irll' (111) 111-8094, TOO' (717) 772-U52 ("e.rI". IlIpa.lrtd OnlY).
OIJECTIONSI Any port~ In Int.r..t not ..tl.f.lw.l with tha eppral....nt, allowance or dl..llowanel of dlductlonl, or ......Ment
of t.x (Including dheount or Inhrtltl a. .hown on this Notice IN.t obJlct within ..lMb 16n) da~. of r~.lpt of
thh Not 101 by.
~-wrlttln protut to t~ PA D.p.rtlllllt of Alv.nul, Baird of Appuh, Dlpt. 2&10i!1, H.rrlsburg, PA l1U8-1021, OR
--IIIClUon to havI the hlUer dltlrllln'd at audit 0' the account of thl p.r.onlll rlprl.tmtIUvl, OR
~~appl.l to th. Orph.n.' Court.
AOtIIN
ISTRAllYE
CORRECTlotfti.
FaotuII .rror. dhClOVlrld on thh ''''Ulllnt .hould b. eddr....d In writing tal PA Dlpart.."t of RIVInIJI,
Burn" of Individual TaXIIiI, AnNz POlt A.......nt Rlvbw Unit, Dapt. 280601, Harrhburo, PA 17128-0601
Phona (1H) 787-65(15. S.. p.ge 5 of thl bDcHc:1at ''In.trucUon. fer Inh.r.ltlncl Tax Return for I A.aJdlnt
Ikcldlnt.. lREV-1501l far an Ixplanllltlon of adlllnhtraUv'h corrlctlbll .rrort.
DISCOUNT I
If 1f'IV t.M dull h Pllid within thr.. IS) cal.ndar IIOnth. aftlr th. d.eld,,"t.. dleth, . flv. percent (5:0 dl.e~t of
thtl tex p.ld 11 allowed,
PENAL TV I
The 15;( tllM ..,uty non~p"rtJclp.Uon panalty I. cOllfl'uted on th. total o~ the hM and tnterut ......act, Ilftd not
paid btlforl Januflry 18, 1996, tha tlr.t day flfhr the Ind (If thl tax ","uty p.r1od, Thll t1on~part1clpltlon
p.nlit~ h appuhbl. In th. ..... .anOlr and In thl tI,. .... U.. p.r1od II YOU would llflPI.l the t.M If~ Intlrllt
thet h.. bun .u..Md II indicated on thh ntltle..
INTEREST I
Inter..t h eh.rgld bllilnninu with flrlt day of d.lInqu.nc~, or nln. (9) .onth_ and OM (I) day frOll thl dat. of
d..th, to th. dati of ply..nt. Tlxu uh1ch bac... dlllnquant bafor. Januarv I, 1'182 blar Intar..t at th.rlt. of
.1M (6:<) plrcant p8r IInt'IOI CI!lltlulahd lit a daUv rah of .000164. All taMU which ble... dlUnquw,t on and aft.r
Janulry I, 1982 will bllr tnt.rut lit II r.ta Which will vlry fro. c.l~ar y.ar to c.hlndlr y..r .,lth ttllt ret.
ltMounc..d by th. PA nlPlrtltGnt of Rav.ou.. Th. nppllcabh 1ntarut rat.. fOI' 1982 through 1997 arel
'!.!!r !.nt.raNt Ra!! Ualh Inter..t rector !!!! Intlr..\; Rat. O"lly Inttlrut factor
I'll 20:< .000548 1987 ,~ .000241
19a1 16% .00003 1983-1991 tIi: .000101
1914 11% .000301 L992 9% .000241
1985 u:< .oaOlS6 1995-1994 ]X .000192
198' lOX .000274 1995~ 1991 9~ .000247
~~Int.tut I. cllloul.ttd I' follot.l..
INTEREST. BALANCE OF TAX UNPAID X NUNBEII OF DAYB DELlNQUENT X DAlLY lNTEREST FACTOR
w-Anv Notlo. I..~ Ift.r tho taM blOOll' deUnquMlt .,111 rlr'het an 'nter..t calculation to flft..,., (15) nYI
beVQnd th. d.t. of thl ........nt. If p.y..nt is .ad, aUar tha Inhrut cOIlPlJtatlon data lhown on tha
Notlc., ftddlUonal Int.r..t .Ult b, calcuhtacl.
\