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HomeMy WebLinkAbout79-00674 ;:j ~ ~ CI.l ~ CI.l 1'1 Il< I H ~ :x: CI.l 0 ~ p:; C' E-< Q ffi ~ . ~ ~ CI.l i ..:l :3C ~ '11 z: . is ' r-- H l" ..,.. '8 r--. , I S '- ,,~ ~ l!'\ d I r-i Z UI , . OATH OF SUBSCRIBING WITNESS COMMONWEALTH OF PENNSYLVANIA I ss: COUNTY OF CUMBERLAND \ This. ,."...........,..".......' 9~~",.."".."..""",..", ...""" day of",..", ,.....",.., .~~~~~~.~"'''''''"....,'''',... A, D., 1 f) ..?~'" Harold B. McLane, Deputy before me Rithrrrd-E:- AndCl'SlllT, Hegister for the Probate of Wills and granting letters of Administration in and for said County of Cumberland, in the Commonwealth of Pennsylvania, personully carne .............. ., '....... .......11a.l.,U..~<;~"', :;:r;J;o" , .,<;l.ng" ..J.R):m" .l?"",.f.9.Wl~x..,;I; .+J.. ."."", ,,', ,.""" """ '" ""'" ,. ,." ,... "",.' ,. ,..' ,.,.. the subscribing witnesses to the foregoing instrument of writing purporting to be the last Will und Testament of ".... ..,..." :L.. .J:i:i\tt.~X, ..~X.9.fL, "......"",.... ..,.. ,......', ",.""......" Dated .. ,~.~Y,~,1!!~,~,::,..~,!", .~.? ??.. late of ......,J:!tc,i,9)&?,~~.JR.I:ffi~h~p,.."....,',.........."..,........",....,',....',.,,,... Cumberland County Pa., deceased who being duly .s,wor,n................,............. according to law, depose and say, that ....1;O,li!Y...~~X,li!................ present, and saw and heard the testa,t;QX"...........""..,...." ............l,.....Wi\,l,,1;:,~L~I9.;I;J.......,......,.............. sign, seal, publish, pronounce and declare the said instrument of writing as and for hi.:L..,...... Testament and Last Will, and at the time of so doing ............)).,~.......................,........was of sound and disposing mind memory and understanding, to the best of ,.......thl':i1:.....,.....................knowledge, observation and belief. ................~~c:!~~........,.........., and subscribed before ,v.,...":~'/~"'.."..':.."~~z':?.....""......,.." l.,..,.~..-J:.,:-;;...,...,'..,.",....:.,',....,',.,."..,',....................'" '1fo,1.j,:~,4?~'7,~.c(zj.~,.:';;,s,.,.,.,.,"',.,',...,',.. Rlellltl"d-E:-:And~on, Register Harold B. McLane, Deputy L AFFIDAVIT OF DEATH COMMONWEALTH OF PENNSYLVANIA I ss: COUNTY OF CUMBERLAND \ ....... ................ ...... ....,.......9. :..,~;I;gMg;I?,.g,P1.."......,',.... ..,.,.. ,..', ,....... ,."".., .... ..,..,........,........... ....,. ..being duly ....................s.woxn,......,........ says that as nearly as can be ascertained the said decedent .......................... . ...... .....,..., ,......... .."..,,1.... .Wall:.er..,Gro,ff".,.,.,..."".."" """ "",... ..,.., ,......'" ".. "".,..,. ,..",..."........., ....'., .died on ..................S.unday................ the ......,.......2.S.t;O....,....day of ....,..,..Q,<;:,~R.1?,~);.........,..,.............. A.D., 19.n., at or about ....,.........six..................... o'clock, ~..M, .................."......"~9.*!:',,...,.,.......and subscribed this 8th November ...................................,............ day of .................""", 19, 7.~....., before , " ---, - {~ 0 / J r'__~:~S~,"',<. .I,;:..~V {tf:. ,_~~ .-................................................................................. "'- .;1 r ~~f' ,,' --J EK\?i\.... ., ..:? ..)l/. ,~l1.."H:".'\..,"~.:., """ ,....,.",.... Riehtli'tt E, l'ilOfl, Register Harold B. McLane, Deputy OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF ,Pl~NNSYLV ANIA} " COUNTY OF CUMBEHLAND SS: Before me, the He~ister fhr the Probate of Wills and ~l'Ilntin~ of Letters of Administration in and for the County of Cumberland, per'sonally came .............G.....Richar:d..Keim....,......................,......................... who. being duly ...I?WRJ.n...........,... do !'!.I?...... depose and say that as ..Exe.cutor............................,............... of the last Will and Testament of ...........l.....jlillt:.!'lJ...GJ,Q.H............,.........,......,.........................,....deceased .............h.e........ will well and truly administer the goods and chattels. rights and credits of said deceased according to law. And also will diligently comply with the provisions of the law relating to Transfer Inheritances, ..swD.rn.............. and subscribed before me. November 8 79 ......I................................................. A, D.. 19............ ,~J~.~.sil.~~..................,........".. RiebaTd -E: "1fuderson. Register Harold B. McLane, Deputy ;. 1;,..,.....:?...0:?:;~;;Q.Q..../~..................... .................................................................................. :.,,; 0\: :OJ 1'-: :00 :Ol a> :~ ....~ :OJ :0 ....: U. ra.: 00: *: .,: 0 ra.: ....: 0: lI"'~"\ 1>:: ,.,. 1"" .,i -I t!)i 0 ~ 0 i .' 1'-: -I 1>:: I!< ',,,. \D: Iiol: ~ I: E<: 0\: - ~: ~ .' tl: 1'-: S 0: >: I: E<: 0: !: ~ ..1: .~ Iioli N: .: '0 '0- ~ H: OJ ....: ....... '0 ... r--: . 0 1': - ~ <J N ~ =IF' '0 .2l OJ ~ '0 1>0 OJ 00 ro ~ !: ,~ ril Ol 0.. r:. DECREE Be it remembered that on the .........~~~~...... day of .................~.?~~~~.~............. A. D.. 19~~...... there was probated and recorded the last Will and Testament of ........~.~...!!.~~~.~~..9.~~.~~........,................,........ lateof.................~~~~~.~~~..~~.~.~~~...........,..... Cumberland County, Pennsylvania, Deceased. Letters ..............~.~!!~.~~.~~.~.~y....... ...... were granted to .............,.,.......~.~. ..~.~.~~.~~~...~~.~...,......,....................... Witness my hand and official seal the day and year aforesaidd I. "-.. ''N:: \.. , ',- "yJ.~~.~~I?~J?~~:i. . Register. 77.1 , . COMMONWEALTH OF PENNSYLVANIA CdUNTY OF CUMBERLAND 55: G. RICHARD KEIM being duly.. _ .iL~r.n .. according to law, deposes and says that he ..,___.is ...the..._.... ' _.___,____,.___Executor ,_,' of the Estate of I. Walter G:..~__,____ late of Middlesex Township ..__, Cumberland County, Pa., deceased and that the within is an inventory made by,.... ,G_...,RicharJi.K-eJm -__.. -..--, the said Executo.L-__ of the entire estate of said decedent, consisting of all the personal prop.rty and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of deceden!'s death. Sworn to and subscribed before me, ~~-~ IL Elfecutor.~kf)2ltJt( lit v' q 1980 f) ~\AavlN1v ,__~,,-JL.....1.,. Box 105 Carlisle, PA 17013 SANDRA S. ECKENRODE NOTARY PUIlUC CARUSLE. CUMBERLAND CO.. PA. MV COMMISSION EXPIRES OCT. 28. 1981 28 Date of Death __.._.u Address D.y October Month 1979 Yur INSTRUCTIONS I. An inventory must be filed within three months after appointment of personal representative. 2. A supplement inventory must be filed within thirty days of discovery of additional a"els. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. 1 .~I I I ..c:' u I '"I -u '" >- I ~, w 0- W 0 ~ '" 0- w ~ ~ w <( E-< w Z I'- a.. f- u 0 \0 0 0 Vl ~I :< . w Ul >- w w e '" I J: '" QJ '" i! 0\ I- a.. u. '" a.. 0- ..J w I'- Z U. ..J <( 0 P::, QJ a.. I I W 0 <( w c.!l, ..... ,;. \-'''<.. ..... ,i > z '" p::1 '1:l + '1 -( N Z 0 '1:l c " e 'M ~ ~ Vl ~. 0 (\1 0 Ii '" z E-<' ::;:: U Z w <( ~! .". ~ 11 0.. " C .. - w H 'I 0 ;: ~ " . .D II H 01 E " ... - .! 0 w ~ 0 ..J U u: '" Inventory of tho reol ond persono! estot. of I. WAL1'E_R_GRQEE:. deceased. REAL ESTATE: NONE . -c,-==-~c~=~=...=c,===c='=="=====-'-r NONE TOTAL REAL ESTATE NONE PERSONALTY: 1. Optional Payment Share Certificate No. 143573, Cumberland Valley Savings and Loan Association, registered in name of decedent. 2. Balance at date of death Accrued Interest I Checking Account No. 38-82-3764, Dauphin Deposit Bank and Trust Company, registered in name of decedent. Balance at date of death Savings Account No. 11-3-00450, Dauphin Deposit Bank and Trust Company, registered in name of decedent. Balance at date of death Accrued Interest I Statement Savings Account No. 06-6-02592, Dauphin Deposit Bank I and Trust Company, registered in name of decedent. I Balance at date of death Accrued Interest I Compound Investment Certificate No. 06-14-018001, Dauphin I Deposit Bank and Trust Company, registered in name of decedent;1 4 yrs., 7-1/4%, dated November 8, 1976. Balance at date of death I Accrued Interest Investment Income Certificate No. R-7768 (#4292007235), Lancaster County Farmers National Bank, since merged with National Central Bank of Lancaster, Pa.; 6 mos., 4-1/2% dated November 18, 1966, registered in name of decedent. Balance at date of death Accrued interest Weekly Premium Industrial Policy No. 522 712 812, The Prudenti I Insurance Company of America; date of issue, 7/7/52; Isaac W. Groff, insured; Leah Groff, wife, beneficiary, deceased; registered change of beneficiary on 10/21/59 to James W. Groff, brother, who died 9/13/76. Proceeds payable to the Estate. Proceeds Twenty-payment Life Policy No. 6942027, The Prudential Insuranc Company of America; date of issue, 6/2/30; Isaac W. Groff, insured; James W. Groff, brother, designated as beneficiary on date policy was issued; registered change of beneficiary on December 9, 1957, to Leah W. Groff, wife of the insured; re~tered change of beneficiary on 5/9/68, to James W. Groff, brother of the insured, who died 9/13/76. Proceeds payable to the Estate. Proceeds Promissory Note of $10,000.00; unpaid balance, $10,000.00; dated 12/60, A.K. Mann Tobacco Company, Lancaster, Pa., to I. Walter Groff; interest payable annually at 10% per annum. Date-of-death value Accrued Interest 3. 4. 5. 6. 7. 8. 9. TOTAL PERSONALTY RECAPITULATION TOTAL VALUE REAL ESTATE: TOTAL VALUE PERSONALTY: TOTAL APPRAISED VALUE: $ NONE $46,189.37 $46,189.37 4,415 66 80 56 I 1,085f07 I 325 40 25 40 12,922 30 48 99 10,665 71 2,567 36 2,000100 51 66 348 00 1,000 00 10,000 06 653 26 46,189 37 ~--- - --- -- ---- -.--- --- -.- -- - -.-- -- -- --... -- -- ~. - -.----..-.. -....- -- .--- ------- .. . . .~_....~__"""""'-_~........ EI:IL """'-__ :L:iL__IIIli-.:":>l .. --~tIQ ~~i~~'~'~}}W8)"';'~' COMMONWEALTH OF P"ENNSVLVANIA ti6:d063228 DEPARTMENT OF REVENUE i'y.,r'),,<, ('", , ,OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX II''':",,',,;,,, " e RECEIVED II a From, ~ ~'e" tl ~ --*TYF".,:;;':.,. ' ....::,.:.; .;..<; ____________________ZXOHT HtJYDIIRn DOT.J .AU____....-_______________ dollars representing Pennsylvania Inheritance or Estate Tax due from the following estate: a/o willi.. r. Mart.on, 10 .. Hi;h S~r8.~ f.C 27< Tax on s s carlill., 'a. 17013 6% Tax on $ $ Nome of Decedent I. WAL'l'Ba GROPP 7(> Tax on S Estate Tax, Act of May 7, 1927 $ S I s s 800.00 Date of Payment 21.7g.I!. .,. Dole of Death 1980 3111y 28. un I 5 ,/c;. Tax on S j File No, Counly c....tot.rl.n4 TOT AL TAX CREDIT less five percenlum of tax if paid within three months aher dole of death Plus interest 01 the rote of _fJ'cfrom to $ Remarks: -'AIl) Olf N:comrr" $ lJrn~[p[L~@&'iJ'~ 5 E A L TOTAL AMOUNT PAID $ 800.00 NOTE: Thi, Triplicatll Receipt to be retained for ludit purposes. -\ ~ / t:-' // / ' /;~.~~~~~ .;,: ' (Title) Received by NOTE: In occepllng the Iran.fer inherltontl IOK on fuluro eslotes, prior 10 the deolh 01 the life lenant or lenantlar years, os evidenced by this receipt, II is underslO.:ld Ihollhe Commonwealth shall not be precluded or prevented 'ram hereaUer aUlluing addiUonal Inherltonce IOJ( 01 the death ollhe Ill. tenant or tenant lor years whenever II appears that such additional tOJ( may be legally due and collectible for any reason wholsoevor. I ..---------------------.----------------.-- ---'---.--. , OEDUCTIONS AllDWEO IN REV.4!l~ 111.18) OFFICE OF THE REGISTER OF WILLS STATEMENT OF DEBTS AND DEDUCTIONS THE SUM OF / " "' , ..J- J" 'I / tj }(" DI.T". APPROVED.i '\.tt'5J)" _/.;J1" ,; 1 /.'" )~ ',,~' J _,_:-' :'Q1~R(''.r -~X0~T _-= OF Cumberland COUNTY AND AGENT OF THE COMMONWEAL TH / I ' , , (21-79-674) ESTATE OF 1. HALTER GROFF LATE OF Middles~~ Township OATE OF FILING APPRAISEMENT ( 1.4 , ') I 1 :rei DATE OF DEATH October 28. 1972.- -- DATE NO. OF NAME OF PA YEE REMARKS AMOUNT VOUCHER !'; (9- . Nov. 8 Register of Hills Letters Testamentary ~ 33 00 ----- - N"" . 1 Cumberland Law Journal Advt. Executor's Notice 18 00 ~l^u 1 Rureau of Vital Statistic Death Certificate 2 ~ --1-"- Dec. 3 Bell Telephone of Pa. Account Payable 57 04 ~- - I)",,, 7 M~cl~nd Associates Medical Services 1.01l 00 Dec. 7 Hoffman-Roth Funeral Home Funeral Services 1,230 40 Dec. 7 Carlisle Corom. Ambulance Account Payable 35 00 Dec. 7 Frank S. Bryan, M.D. Medical Services 50 00 Dec. 8 Health Care Rental Co. Account Pavable 22 00 Dec. 8 Carlisle Radiology Account Pavable 183 00 n"" R D ~ , I); a"'"~ ,,- ,1, ('1 "h A~Cn1m!' P~YRh]" 7 7R --". Dec. 1 The Evening Sentinel Advt. Executor's Notice 16 65 Dec, 1 G. Richard Keirn KeurllJursement tor payment to PP&L ll/20/79 61 17 Dec. 1 PP&L Account Pavable to ll/28/79 75 62 I)",,, ?, Carlis Ie :~~, ,,. '" 17? Jl.L Dec. 2 Belvedere Medical Center Account Pavable 35 00 - 1980 _JRn 1 PP&L Account Pavable 106 06 Jan. 2 Register of Hills Short Certificate 1 00 Feb. 5 ~ister of Wills Short Certificate 1 00 -- _..------ Register of Hills Filin2: fee 9 00 G. Richard Keirn Executor's Commission 2,309 00 ---- .. Hilliam F. Martson, P.C. At torney's fee 1,500 00 --- .---.--.- jReserve for filing Acct, rei eases R~s~ry:~ I\cCOllFt _c~"..& ,mi.s.c: """~" ~oo nn - . __n__ . {u TOTAL '$'7,235.72 COMMDNWeALTH OF PEHNSYL VANtA I SS, COUNTY OF_Cum~~rland_ I I, _,_.._.Q.,..~lchard K~iE1__.____,_____,_ HEREBY CERTIFY, THAT TO THE BEST OF MY KNOWLEDCE :.IW BELIEF, THE FOREGOING IS A JUST AND TRUt: STATEMENT OF DEBTS, FUNERAL EXPENSES AND EXPENSES OF ADMIN'STRATIOH SUIIMITTEO TO THE ESTATE OF_ T I~R] !'PT' GT'off DECEASED, AS D;,QUCTIONS FOR INHERITANCE TAX PURPOSES. . ' '('I () 'J . .--~~ -:l ,,~.,b:_.,fi (I!<...-~~ '1'1, (L.S.) r; ~ G. R1.chard Ke1.m, Executor SWORN)~;2;U',BSCRIDED DEFORE ME THIS OAY OF '- Li!~--,fJ-I-- 19.Jill. _~+ l'U__'..J~'ll(J.'t/ __ SANDRA s. EcKENROD!! NOTARV PUlllJC CARLISLE, cur.,""" .'NO ro , ~^ MY COMf-.,.W:-;,.q ," .~:~.::'.=====--~-=._t-=.==.: -~=:=- ---..---.--.-.-.-----..----------.-------.---- 111:\1 llw ,'IHIl,'llls ul '.Hid ',,,ft' dl'!lll',it 111).\ III hCl.\C~ ale ill:lIliZl~d IlIIlh:r Sc..:hcdulcs \\llb Illl' 1.'\\'1"1'111'11 Iii llll' follll\\illg, i'lllllw l"l,,,...nlls hncinafll:r St:\ forlh: flf this return. rlhd Scllcdufc A ;ll1atltL'd hCI'l'LII .llld 111,l\ll: pari ht'rcnl' sets furth fully and ill dclltil all the real properly in the ('lll1lllllJlIWcalth of PClllls\'l\'illIia or which dCl'L'dl~1I1 dkd having an inlcn:st therein. It also sets forth the l1l()rtt:,I~'L' Clll'l1l1lhrann.'''' 1l[11l1l l'i1ch pan:cl of leal property al the date of death, giving the amount still due at death. llalll\~ Ill' I1Illrt);,q.!.l'L, Uillt.:, rale of interest, lllld honk and page of record thereof. It also sets forth in the.: columns pfClVidl:d tlil:rdnrr till: ass~:--scd valuation of each of s;lid parcels, the estimated market value thereof as of datt: or lkalh or dl:L'l'~Il:l1l. Thai Sdlf~dulc- B alladll:d herelo and made part hereof sets forth fully and in detail all personal property whcrc:-il1\'cr situalt.:d owned hy tlw deL:edcnt <11 tlw lime of lIeath; alll1loneys left by the decedenl at tlw time of death, \\helhcr in dccl:dcnt's immediate possession, standing to uecedent's cn:dil in banks of deposit, savings hanks, trust t.:nmp;lllil::-', Of other institutions, whcthcr individually, or in trust for any other person or persons gi\'ill~ aho separately tht.: accrued interl.:st tlwfCOll, if any, down to the Illst interest dny prior to decedent's delltll ill Illl: case or savings hanks, and to the date of decedent's death in all olher cases; all bonds, postal saving:--, treasury cl.:rLificates or notl.:S and nthl.:r evidence of indebtedness of the United St:ltes to the dc~ c:edl:nL all nhligations, whether hy statute or agreell1t.:llt they arc designatell as tax free, of the United States, or any stalt.:, or political sllblli\'isioll thereof, or of any foreign country, which arc owneu at the time of death; 'I:: "..."'lIle dllP'lll;l, l\';\Hit\, :-,ij\(;l\\ill\,;, pi<.,lun:s, hooks, works of art, household furniture, hOllies", carriages, 1I11tOlllObiles, hoats, ;I1HI a.;y and all other personal chattels of \\'hatsoever.iJ9~~?..~iAlt1~,t:f9.ft~rt}y deccucnt, togelher with the fairly e~limated market v,lIue thl.:reof: all hUllds and mortgages held by decedent aud of all daims dllt.: and owing dccedent at tIll.: time of death. and all promissory notes or other instruments in writing fur the paYlTlent (If mOllL')' or which decedenl died possessed, of whatsoever nature, with interest thereon, if lIny, giving. till' r,\l:l' valuc and t.:stimatl:d fair market valuc thereof, and if such estimated fair market value be less ,han till: facc value, it sets forlh hridly till.: reasons for such depreciation as to each item: all moneys payable to Ihe c"t,ll:: !'rilm lire ilisurance policies carried by decedent; all annuity and endowment contracts the pro~eL'ds lIf which \\'..~ ',aYilhle upon th;.: death of the decedent; all nnd the corporate stocks and dividends Jue thereon and unpaid 'I', II:' 1'" dall' Dr lkalll, bonus ,HId accrued interest thereon to the date of decedent's death and olht~r ill'".''''!'nt:;~\ ';V': ')\\lll'U hy the dl.:cedent at the time of death, with the market value there- or at such I il1ll'. ", " In the case of securities of close or rl1mll~' carporllUOIIS, tile vllluns reported nre liS f'/lr 11fl possible suhstantiaterl by financial statements of the corporntions, showillj.!; t.ILe I1S~WtS 11IHt lluhl11 t.1es thereof as of the dt\le of' death. The schedule /lIRO sets f'ort.1l the Int.erest of' (ICCf!llent Ht tll(> t.lme or death In uny co-pl\rtnership or business, nnll in support of the vnllw of' slll~h interest there Is lllUlp.xed to said schedule, flnnnc1al statements showing theassllts Il!lll I 11lhl1 Ittf!S 01' snlel CO-IHlrt.lwrshlp or \Hlsllless. A cOPJ' of thl' co-partnership ngreement, (if ofal, El stlll.ement .'ietttll~ f'of't.h thr:! nlltllff> Ill' tlil'! Ilgrer>wmt) together with l:l. statement settin}!; forth the chll.rnct.er of t.lle hllSllll'SS, Its 101'11 U 011, /llld sllr.h ot.her filets ~lertatntng to tile business as may he IJertj,lIfHlt to a fllir IIn(1 .lmit IIpprlllsnl of' tile (\f!et!dellt's luI.C!rl!st therein mllst bes\lllmlttf!d. It slLould also set forth In !tI111l1/.I!d fOl'Ill, I.O~I't.Il~'I' wllh tltl' f'IlII' mll.l'kel. valli/! thereof, an)' other property ownerl or bequentllfHI by the de<ll'delll Ill. tho I tme of' dl!lltll. The Sc/1edule C attnched hereto Ilncl mllcic purl. herl~Or set.s fortll It I,rlle Ill\sw('r to clleh inquiry contatned therein and in the case of transfers ofproJlert~', rent or persnnnl, wi thin t.wo years or llecednnt' s death, in contemplation of decedent's death, or Intendnd to l.~,ke of'f'ect In possession or en.luymrmt at or after death, sairl schedule sets forth the nature nnd vnlup. of such JlI'olH1rty, 1.0 whom trnllsfl!rred, the relationship of the trans ferees to the deceden t, the pro port I Ol1fl te slHlrc recel VIlrl hy cnch trlLlIsf'cree nnd all other facts of a pertinent nature regarding sntrl transfers. In the cnsr~ of tl'IUlsf'l~rs intendel\ to take effect in possession or en,10yment at or Ilfter oenth, there Is 111S0 nttncherl to the scherlule Il cony of the deed, trust agreement or other instrument creating the trust. Ther.~ is nl50 set forth in saitl schedule a list of nIl property, real and personal, with its vIllue, which plu"ses III decedent's death hy virtue of the exercise by decedent, either individually, or jointly with another, 01' Imy power of 1l1l}lolnt.- ment vested1n decedent, either individually or jointly, by the w1ll, deen, or other instrument of' another, with a copy of the instrument creating such power attached to the schedule. That Schedule 0 attached hereto and made part hereof sets forth t.he ntlmes fiwl adnresses of nIl persons beneficially interested in this estate at the time of decedent' 5 rlenth, the lHlture of their res- pective interests, their relationship, if any, to the decedent, together w:l.th the ages at the time of decedent's death of all minors, annuitants and beneficiartes for life Hnrler decedent's Will. It also contains a statement showing which of the beneficiaries named in the rlecerlent's wtll, t f nny, died prior to decedent, the dates of their death, their :Issue, ancI thp. relationship of such issue to thp. beneficiary. That S.:/1edu/e E attached hereto and made 11 part hereof sets fort.h nIl property, relll and per- sonal, owned by the decedent ,jointly with another or others, including intl1.n~tble, stnndtnp; in the nnme of the decedent And others, plus the rlllte and place of recorrl of instruments ef'rectin~ the vcstitllre of real estate nnd the date of' llcl]uisition of Jlersnnlllt,y~ pIllS the nllme, Ildrlrcss Ilncl rl~llltionshiJ1, if nny, of co-owners to the deceden t. That Sc/1edule F attached hereto and made a pnrt hereof sets forth full:,' find in detllil 11.11 debts and deductions claimed for and on behalf of this decedent's estate, InclllfHn,c; funeral expenses paidj family exemption, where applicable; costs of administration of this estnt.ej counsel fees nnd fmHcinry's conunissions paid or to be paid; cost expended for burilll trusts, tombstones or gravemnrkers, and reli- gious services, in consequence of the death of the decedent; debts and claims owing: nnd llnpairt Ilt time of death; taxes accrued chargeable for period prior to decedent's death (except those allowed under Section 651 of the Inheritance and Estate Tax Act); together with Il statement of collaternl pledgert for oblign- tions, if any. It is agreed that the fiduciary will present proof of suirt clnlm(~d ohlt:;utions upon re- quest, that if the nmount actually paid in settlement of any fee, commission or deht is less than the estima.ted amount clnlming and allowed, that the same will he reported tn the I\egtst.er of W111s, Rnd thllt the Rmount of tax assessed can be reassessed In accordllOce therewi tho That the totals of the appropriate columns in Scher1ules "A", "B", "e", "E", Imll "F" fiS dt.rccted therein, have been carried forward and properly regist.ered in the Summary. Subscribed and sworn to before me thiB ..........'.....''?r ",'" ",., d? of i~9,L\.{, "',' ,....,.;UlJJ.idLi(,; /)(Cg,lUfC:!- ..9~~""",., "",,19,..?Q ~u~jJ=f."..",li..~.."....,..,...,.. ( E.reC1Ltor.Jl.ll>H~Itl!) R. D "l"""",!3.2,~"J.9,,?..,' ..,...................., (Street Numb...) Carlisle, PA 17013 ............... ,..'......."..."...'.,.........'......... (City or Town and State) SANDRA S. ECKENRODE NOTARV PUBLIC CAPlI~1 r. .." '0_0, ^,'DEo"rA SOrE: Dp'f'orc, signln~ llrfida,v:~I,;.lll}tf.'1'd~Vre 11.11 hllmk Sll1lel!S in the Ilf'fidll\'it. .'1II11 schedull's annexed 11re filleri ill wlth flctaUs or the worrl "None", 1l1lr1 in Cllse t1lt~ Ils!'.ets include 1'111'(> Il1l1t llnl iSI.I~(t ~;(~ctlrities, securities of' close or fnmily corpornt1olui or 1111 int.erest in IUl~' r:n-l"lrtllersllip or !Jusiness, tllIlt the f1lltn anll stlltf'm('nts required ulllh~I' the pr1rnp;raph 1l1jO\'I~ relating; to ScllI'rhlle "U" lire IlttflclH?lI. Also mlik(' certnin t.h:lt column #1 in the "Summary" hits heen prollerl~' cllmpll.tell liS 11!lo\.'p-dirl'ct.ed. .' RC C.I" (....711 COMMONWE....L TH OF PENNSYLV....NIA DEP....RTMENT OF REVENUE BUREAU OF COUNTY COLLECTIONS TR....NSFER INHERIT....NCE TAX RESIDENT DECEOENT SCHEDULE "A" REAL PROPERTY - Real property in Pennsylvania, with statement of mortgage encumbrances upon each parcel at deoth of dece. dent. Property held by the decedent os tenant in common with onother or other, should be identified os to quantum of interest and the estimated value should be that of the decedent's interest only. (Property held os joint tenonts with right of surviorship or tenancy by entireties should be reported on Schedule "E.") The r.al property loc:ated In the Commonwealth of Ponh.ylvanla should be (1) (2) 131 de.crlbed by lot and black numbor, .traat and .troct number, tagether with DEPARTMENT a general dllcrlptlon of the praperty, with a ref.rence to tho record of tho ASSESSED VALUE VALUATION conveyance by which tho decedent took title: If a farm .tat. numb., of a. FOR VEAR OF ESTIMATED CAUTION er..; olao .tat.ment of mortgage encumbrancn upon oach parcel at death DECEOENT'S MARKET VALUE (Do not writ. of decedent. TOXII, a..e..mont., accrued Int.,..t on mortgage., ,'e./ar. DEA TH In 'hi. .pac.) to be lI.ted on Schadule "F" and mu.1 not b. deducted from this Ichedul.. None None I None - Insert this total opposite "real property", Schedule "A" in the X X X X X "As Reported" column on the lost page of this return. Nnu.- -UJfI? " RC'C -~F 'n)~I,\I(JNW"\LTII C"" J>I':NN,YI.V\!,I,\ TIl,\NSFI':1l INIII.;IlIT,\NCI': 'L\~ IlFSIIlJo:.~T 1l1.:n:IlI.:n ~;CIII"I II' 1.Jo: "It" PI':II~ll~; ..\1. 11!{llllj':IITY , I'" ~' ~~\t f ,,~0';i:, t\ J~~,Iv"~";.42: I:\S1'H1!{;TIOSS: Tills SI'II(!fhlll' nllls!. dlsl'I(ISl' 111\ 'lll1~II.II';lIldJlltlll1l~ll)lj' I'I'I'SIIIIIII 1II'lIPPI'!..\' OWlll'l1 IlllllvlillllLlly h~' the Ileet~t1elltt al 111I' tillu' 01' Ills dl'ltt.ll. Ilf'oiH'I'ty oWllI'd !l,\' 1111' dI'I'('dl'lI1. .lllilll,ly wltll Illlflt,lu!l" 01' flt.h.!rs rllllsL hI' 1Istt.c1 unlll'/' St~h"IIIlJI' 111.;'1, In\./llll!,lhll' Pt'I'son:l] lll'(.)]ll~l't.~., 1.I111'd III tILl' llllm" or tilL' dl'f'(;dIJUt., !Jut JlIlj'llhlf! Ill, c1l!lIt.1l t.o Hnllthc'" 01' Ot.ll'~I'S, ItIC~I\lCllllJ!. hIll. llot, Ilmit.I'" t,(l 11.(I.IJ. I;', S. SuvJrlgs llolHls IUlll !.t!lILIl- t.lvl~ l,rllslneeoun1.s, mllst. Ill' Ilst.I'tl, df.'spitp L1lf~ I'n..'/. I,!llll t.Ill'~' I:rl' !loL 0(' 1.11" Ilr!mlllls!.t>\'/'d ('sllltl'. 1'nTl,l!;Lhlp pl'rsollul I"'opt!rl.y slll)1I111!it> lIs!.!'!! i'll')i\, (1"1!,' .I"wplt'y, 1I'1'1I1'illg jIPJlllrl~l, Imusllllold 1~1l(llls, /tIul 1'III'nlshll1~S, hool{s, puITlt.llIl;s, IIlll.nl1lo11llps, hOIlUi, ct.e.) lulnnglhll' Ill!rsonnl propprtj', snell liS honds. l.rl!/lslIl'Y el~r.t,ll'Jc1l1Ys, ellsh 011 Ilund HluJ III hllnk, stocks, mot' t.gll~es, noll!s, l,o,L!;(! tiler' wi ill Ilcel'lIed IlItel'cst or ell \' Iclends, sill lit' I Ps or WIl~f~S, 1 nsuruflce poy- Ilhle to t.he estate ot' f'lcllll:llll'Y 1n snll\ '~1I1H1Clt.j', }1llrtnerr.lllp IIlU~rl!sts, InLt~r('st 1n IlnYllfHlist.rlhllt.~d estllt.e of' 01' Incnl1ln l'rom 1111)' pl'fllll~rl.~' lIP-Ill In I.I'IIS(. Unlll!I' tllll will or 1lp;I'tlCmCIIl. of' another, CV\!Tl though Jncntell ollt!"ildc nj' t.Iw SUtt.f!~ Ill. the time 01' d/~llth, ShOuJfIIJl~ 1.ist."d in this sellf'!dulo. -- Item No. ITE,\I Lis\' IlIltt lleserthe {'\Illy J!N IT ES'l'I,If,~'f1m V AWE MAIlK!':l' V A"tn, DEPAlITMEN'J' YAJJ)ATION (Do not write in th:ls space) 1. Optional Payment Share Certificate No. 143573, Cumberland Valley Savings and Loan Association, registered in name of decedent. Balance at date of death Accrued Interest 2. Checking Account No. 38-82-3764, Dauphin Deposit Bank and Trust Company, registere in name of decedent. Baanee at date of death Account No. 11-3-00450, Dauphin Bank and Trust Company, registere of decedent, Balance at date of death Accrued Interest 4. Statement Savings Account No. 06-6-02592, Dauphin Deposit Bank and Trust Company, registered in name of decedent. Balance at date of death Accrued Interest 5. Compound Investment Certificate No. 06-14-018001, Dauphin Deposit Bank and Trust Company, registered in name of decedent; 4 yrs., 7-1/4%, dated 11/8/76. Balance at date of death Accrued Interest 6. Investment Income Certificate No. R-7768, Lancaster County Farmers National Bank, since merged with National Central Bank of Lancaster, Pa.; Certificate now registered as No. 4292007235; 6 mos., 4-1/2%. dated November 18, 1966. Balance at date of death Accrued Interest 7. Weekly Premium Industrial Policy No. 522 712 812, The Prudential Insurance Company of America; date of issue, July 7, 1952; Isaac W. Groff, insured; Leah Groff, wife, beneficiary, deceased; ~. registered change of beneficiary on . October 21, 1959, to James W. Groff, brot er, who died September 13, 1976. Proceeds 'I payable to the Estate. Face amount I 8. Twenty-payment Life Policy No. 6942027, I The Prudential Insurance Company of Ameri~a; date of issue, June 2, 1930; Isaac W. Groff, insured; James W. Groff , brother designatid tnsert t~HPt!'J~]~ls\~;QS1q~ "~er~JlllIl prOpl1l.ty", Sdlt~(ll1ll~ "'B" III till' "As Hl!jlortelt" r.nlUlllll 011 the lust Ilas.:;ll of thl~ rf't.llrn. 3. Savings Deposit in name 1$ 4,415.66 80.56 I 1,085.07 325.40 25.40 12,922.30 48.99 10,665.71 2,567.36 2,000.00 51. 66 348.00 :\ :\ . . . .' LAW OJ I lC[.':l '1//14(11I1 .'J~ /J,I'I!()I/. .f!(/ H[NDJ;R~ot,J 1I1.0CK Tf:N EAST HIGH STRUT CARLISLE, PENNsYLVANIA 17013 ARE", CODE 717 2113-33<11 WilliAM F, MARTSON DANIEL K, DEARDORFF THOMAS J, WilLIAMS IVO V, OTTO, In November 13, 1979 RE: Estate of 1. Yj~~~'N . ,::2~ l,.lq,~ C ~ I-J. ":Z r1) ~ ~'L\cZ~ ~ Walter Groff. Deceased r I \J,\. Branch ~~ Farmers First Bank 1635 Lititz Pike Lancaster Shopping Center Lancaster, PA 17601 I} (0 I Gentlemen: Please be advised that we represent the Estate of I. Walter Groff, late of R. D. 8, Carlisle, Pennsylvania, and formerly of 417 North Prince Street, Lancaster, Pennsylvania, who died October 28, 1979. Letters Testamentary on said Estate have been granted to G. Richard Keirn, Executor, and a Short Certificate attesting to the issuance of same is enclosed. Included with the personal effects of ~!r. Groff was an Investment Income Certificate in the amount of $2,000.00, issued by the Lancaster County Farmers National Bank. I have been unable to find a listing for that bank in the Bank Directory; therefore, I am seeking help from you. If this certificate was not issued by your bank, we would appreciate your forwarding our request for information to the proper location. If Mr. Groff maintained any accounts with your bank, would you please advise us of the balances as of date of death, accrued interest to date of death, and the manner in which the accounts were held. We appreciate any information that you may be able to give us. Very truly yours, WILLIAM F. MARTSON, P.C. ~j'~<Vf William L. Earp Estates Administrator WLE/sg Enclosures REV-4~3 (8-70) .COI\L\tUNWEALTII OF PI':NNSYl.\'A~IA TllANSFEll INIIEIUTANI'E T,\X RFBII'ENT IlEI'I'IlE~T 1 '\\: f"~ctS " ~ \~"", '(,.,.."" " .I', I ;:.:~.t . ~" "'.I J, \111';,.:.: i) '(l.:~::~:\~~i<;.':;:) :\ SCIII':lllI\.l "Ii" IlI'NI;I:I('I:\IlIl':S --------- -.---.--.- --- .,-- ' ~ .-----.- . - .-._-~-------,_.__._._"---- .---.... --,--.------------..-- ...------.1 I IlENEFll'IARII'S ,\NIl AllImFSSES REI.ATIONSIIII' (SUltC fullll:lmCH lllld lltldr<~fises of ull who (If luep-cilildH'll or SUR\'lVI'.I> 11"'l\-. INTl'IlEST 01' havc un intercst, vested. contingent or other" illegitinllltc children IlECI,IlENT 01' nl~NEFICi/\lty wise, ill CSlUlc) arc il1\'ol\'l~d. set STATE YES 1I!llTlI IN ESTATE forth thi:~ fuel,) OR NO , John W. Keirn Nephew Yes One-third of residue -- f--'-'- ----.---. 567 "E" Street per item II of Last - ----- ----..--.-. Carlisle, PA 17013 Will and Testament ,- ~- - G. Richard Keirn Nephew Yes One-third of residue R. D. 1. Box 105 per Item II of Last Carlisle. PA 17013 Will and Testament Elizabeth K. Clepper Niece Yes One-third of residue 919 North College Street - Iner Item II of Last Carlisle. PA 17013 \will and Testament NOTE: JOHN W. KEIM and E' IZABETH K. CLl PPER have each sig,ed a Disclaimer and Renunciation 0 Bequest -, .. r-~~~ I ----1 ...-'--- ,. - -.-----...-.. ..~~_.,_.----_..-. ._..._.._----~-_.._--_._--_.._- Deponent further ~ays that al!...!.~bovc..namcd bcnc~icicric5 arc I~i~g at this time except below: NAME DATE OF DEATH RESIDENCE ---- - EVl...... ~...: ~ ~. :n: ~. " 'c ~ e ,... u :;) B- "0 oijo.u '1 g. - u. .9.... "3 " ~ ~ u " - u e 0 >< 0. oJ U ~ cr: Renl Property PcrsclI1l1l Property Trunsfers SUMMAR Y (Seh. IIN') $ (Seh. UB") 11 (Sch, "C") $ ,~ $ ,\ fJfOSS Taxable Estntc I- '0 .. Z u '" tJ,J ~ <:.> ::;; ~ :>- u tJ,J u '" u ..J - Q <l: < VI 0:: u.. ~ :< c.. 0 e "" c.. ~ "" <:.> < <:.>tJ,J ~ "" "'" tJ,J ""'I- ~. <l: 0 I- 1-< ~ :: " 0 Z c: I- '-l- e % 0", u <l: u.. tJ,J "" 0 ~ l- .. 0 "" .S 0:: -= 0 - tJ,J "" " ~ w .. I- - " "" <Il l- e ~ 'c < ~ " 0 t- o _os ::;; e " " ::='"0 ;;; " e ;::< 0 0 ..J U U (1) (As I(epurled) (2) (As Determined) $ $ $ $ $ $ RCC.3!l,(8.77J County, Numbe' and Nome~CumEe_r.lan~n_ File Number 21-79-674 Dote of Deoth___~~t:.9'p..er 28_0..121.2.______________ Estate Name ...QROFL..,____._,.,____._J,.,____ Walter {L,\r,T IjM.III {Hl'<;"[ tIAI.1f I liNt rlM.l SUMMARY COMMOfIWE^LTH OF PENNSYLVANIA TRANSFER INHERITANCE TAX RESIDEIIT OECEoENT REPORT OF INHERIl ANCE T AX APPRAISER I, the undcr~igncd duly oppoint~d InhcritClncc Tux Appraiser in and for the County of Cumberland Pennsylvania, do r~5pcctfully r~port that I havc appraised the reol and pero;,onol property Of> rcport~d in the foregoing return at the values set forth opposite each item in the last column to the right in Sch~dlJlcs IIA", liB", lie',. and liE". Dated: Aup:ust 5. 1980 , , , ~"'I J ,. ~. I -f/,' (' /. .J 'f I ) INHEI/ITMIC;E TAX APPHAISER I i I I I . I , I i , I i i I i I \ i I I I i I I I i I I I I I REPORT OF THE REGISTER OF WILLS I, the undersig,1ed duly elected Register of Wills in and for County, Pennsylvania, do respect- fully report that 1 have allowed deductions in the amounts claimed by deponcnt, except as to those items where a greater or lesser amount is set forth in the last column to the right in Schedule !IF", which greater or lesser amount represents the sum allowed as a deduction. Dated: REGISTER OF WILLS ADJUSTMENTS ODE (HARRISBURG USE ONL YI I REMAINDER APPRAISEMENT CODE V ALUE AS APPRAISED S None 46 1 None None 46 18 INVENTORV Real Property (Schedule A) Personal Property (Schedule Bl Joint.Held Property (Schedule El Transfers (Schedulo Cl TOTAL GROSS ASSETS Less Oebt$ and Deductions (SCHEDULE FI CLEAR VALUE OF ESTATE 00+ 10+ 20+ 30+ 92+ 93- 40- FACTOR VALUE \~ PRINCIPLE ,.. " annuities.................. ...== S Valuation of life estatos at t= ~ ESTATE TAX ASSESSMENTS - $ COMPUTATION OF TAX CODE FOR USE OF REGISTER ONLY Tax on S Tax on S Tax on $ Tax on $ Tax on $ Exemptions Total Estate t== \=(.) 1- As evidenced by Chnrltable Exemption ClJrllficntes Issued by the Secretary of Revenue. $ S $ $ $ ~" 1~~ I TOTAL TAX 5 Less tax previously paid $ BALANCE $ Less 5% of fax if pold within 3 months after death S ~ S t"-- S I -1= r- 5 5 TOT AL T AX BALANCE S L_ PAil" \ BALANCE OF INHERITANCE TAX DUE Add Interest at rate of 6% fraln 10 AMOUNT OF ESTATE TAX ASSESSED $ Estate tax paid S BALANCE DUE Add interest ot rate of 6% from 10 Supplemental Codes: (FOR USE IN HARRISBURG ONL YI 48-Adjustment 49+Adju5tment 56-Annuity 60-Lifc E"tnte 921-Rcnoindcl' Appraisal 9'~.~kc!r,fljr,dL't Dc..ouction 93C-Chnrity 94_Rcmoinder Residue 96.-Suc:ccssi....\! Life Estotc FOR USE OF '[C,I,HR m'u ADJUSTMENTS --_.-._~ ------- N.OTE: Whct" wb." ,;,;Cll~ ,,:'1]'.111"',11, ,:,t: mod.., ,0 th-c abo....e compu\'Jtion of tox by the Rcgh.ter of Wills, for proper reason, some "he;;I.' 'I ( J lH lu,i. wi:h . hort cxplo...ation. ,.. -l Z ., <I: ~ UJ 0 :!l ~ ~ " :;; " -.: ... UJ 0 Ct: ~ 0 0.. Cl -<: 0.. c;: " <I: c.. ~ ';: 0 c.. " 0 :> Z l::! -<: l::! LLJ ;;, -.: 1= UJ 1= ,.. In ,.. 0 ~ ;l: .. -<: " Ct: Z ,.. 0 ,.. " 0 ~ Ul 0.. 0.. 0 tJJ ~ LLJ r"? 0 c;: c;: ~ .2 UJ - .... " " i-o " ~ ~ ,. - ..: 0 ~ ~ c '" :;; 0 ::- 0 .~ .:1 c E =E " E .~"O " C 0 0:..: ..J '.) U ~ '1Il ~ ~ ~ M \.'-.. z ~ ~ ~ 0 :>< ~ I CIl .,; ~ :;J .: 11I l:'-.. ...:i M <: r.. - " I U z l 0 00 ........ - M '" 0 C\J '" - 0 ~ ~ '" c5 '" ~ 0 CIl 0 Z CIl CIl :>< ~ c5 c5 ~ ~ z ~ ~ f-< ~ Z Z ...:i c5 ~ c5 ~ z ~ ::s ~ ...:i Z Z f-< c:l :;J U t.:: ~ ~ ~ CIl ~ 8 0 ~ z - ~ 0 ...:i IN'; fH11r: 1 !(l.~;'; ]" i",UII' i :.'\11" I;d (,11 11~. ht:::',.( 1l'{,nJ , d ' ",r 1-,,1 :,' '" ,,1,- pf.!\! :'1', ,.,,10'1'; I', .,t:, i,', . I' ~ '<1.: ",:,':" ,!',,j I -":,, I,", !,f'1 1;1 186J \.''' } '1 ,~! i J'o II!!' "'!"';! !!';i! ,::,,: I, '1.,,',I"ld ,'j 'JI:;;C(lUfl( ot /IV{' (~i) PI ,'-\.'n: i', <111 ,..'JI'd ~J,' ;" '" Inh(:(lldrlCC: 1"<1,. ,.thb iI,,1I1 r,J"{ , ,', .,." l!d" ,i ",,, (j~~,.' J'nl"; {ii'd~h ;q:d !J,:I'(I:l""; c1plinq'.!I'Jlt dl np~ l'.~'i!;q'()ll oIf II!!I" i~lj 11"',,1'1'.. ,il!,'f :'IC' 1\"':('(1' I\!'S (1"dd1 II) ~;_S :J'1H5, /11! Ir,lit'rll:HlC!~ Tax on il !lJllJrf~ In!prp::;l IS payiJblf' ......ithl!l 11:(1:1' enjo','Jlj,:111 drld I:. 'klll\qll'lll li\I)fC',J!II.'i' (/:' P:; OI1I;H' :iJt:e ot il.:5 IUIUl!O 111C (Iiltl' d ,j',"J!!; ;id1I'" :i\ rllIJll!;,', ,':1'>( 11\!! LI:lt\',I'!f 1if~:",; ('fj(:ct 11\ po~',se-:;slon ,Hid >"-' I I ~'; la..o.I',,' II"!:;, .1 ':;,1,' ~~;~: d~~I:r,q\,t'r\t d",,~ ~JIi()\....n 1<1 ',j:,I:o~J :: 'I' iu( i "v" :I~) ,I :\'-'1 ..';t (d1/:U --------. .. -- .-- .-- -- ----, 1 month OOS " liKJII1h::; (\','0 I II1(m::~s ()~F; lu I' ; \.l r 1 111~; OGO 2 months 010 ~; 1r10n!W; 0/ ~) :f" .;1,,; ..;,1;) \ 1 lW'fltl15 ,Ori5 3 months ,01" U 1~\0rJlll~; ln~J 'J II;; ," I).: ~~ 12 n.c:l1!\,; 000 1 days ,(YX117 , 1 dc,', :)lil::_i", :'.1 (hlVs .00352 2 days ,C}<}{J34 1/ 'J,l,':; (YJ;.':r! i! diPi'; 003G~~ 3 days .00051 1:J '_:'-''l:' .C:)~".)I) ~] JdYS ,00386 4 days ,00068 1,1 (j dl ~> C,)2:,'1 '" d~l\'~ 0(10103 ~" 5 days ()()()85 h (1'1,', (l(J::bU "" d:IYS ,00420 -" 6 clays 08101 1l; d,jY~ (:,'ihl 20 ,'Ll'(5 00437 7 doY~ 00118 11 d,l'.,. ~, U'J}f;.~ 27 diiY~-' ,00454 8 dnys .00135 18 dc''!:; ocrWl 28 ~Jaf:;; ,00471 9 daV$ ,00152 19 (i,j','~' ()U3IB 29 day~~ 00488 10 d,JYs .00169 .10 "~ ;: \' c; ( \:, \:-U ~) 30 dnys ,00500 /"'':iY parl', III li'\tPH",t, inciudi:lg the Cor'l: lurh"JI'dllll "wi n,(' Pl,i:;ur:jl (.~;!llc.S~;'\liJIIVe, Ihii StHi::died with the t1S$cs:>rnent flUI' {j!iJ,~Li l~l;_'rl!\(j willlln ~;i\'~Y (G',:i (:i,\,:;~ ,j!;vr r..:Chp! uf !~115 Nr..!lct: tiS provided iJY Section 1001 of the Inhcil!;JnCt! ,111U L~,L;\I; LIX !;u (I( 1 <;;;tj'l ("-:~ r-.-, "",p;~ lUI)1 fl/i(,kt, c!lPr;!i. ','I " ,!fil'y ~)I:i(; i':'V,-lid'.: to "fie;;" ',..'r .,j '.Vllls. "",;i~r:t' t/in,lc>th' '),11',' '~:" d L " ," STATEMENT OF PROPOSED DISTRIBUTION BY G, RICHARD KEIM, EXECUTOR UNDER THE LAST HILL AND TESTAMENT OF I. HALTER GROFF, LATE OF MIDDLESEX TOHNSHIP, Cill1BERLAND COUNTY, PENNSYLVANIA, DECEASED. G. RICHARD KEIM, Executor of the Last Hill and Testament of I. Halter Groff, Deceased, proposes to distribute the balance in his hands, to wit: $33,360.27, in accordance with the said Last Hill and Testament as heretofore filed in the Office of the Register of Hills of Cumberland County, Pennsylvania, as follows: 1. TO: G. RICl~RD KEIM, pursuant to Item II of said HilI and the Disclaimers and Renunciations of Bequests executed by John H. Keirn and Elizabeth K. Clepper, copies of which are attached hereto. A. CASH TOTAL DISTRIBUTION $33,360.27 $33,360.27 \oIHEREFORE, the said G. respectfully proposes to Estate as stated above. RICHARD KEIM, Executor as aforesaid, distribute the net balance of said ~"''r(3V-L-j2.J I L G. Richard Keirn, Executor COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CU}IBERLAND ) G. RICHARD KEIM, being duly sworn according to law, deposes and says: that he is the Executor of the Last Will and Testament of I. WALTER GROFF, Deceased; that the facts set forth in the foregoing Statement of Proposed Distribution are true and correct to the best of his knowledge, information and belief. . ~~-c)J~Jl.J / J ,- G. Richard Keirn SS. ,.,'0 ,,' "\"~>,, ,.,~~(l.arn to and subscribed before me :...~ ..:,Io!"..;.:~, "';"', j "~"~,, ,thi~,\2.l\t.!! day of DC.TOeM. , 1980. LAW~I'~ICEi 0 ~ . . \~: WILUAM F. ~NlTio~:\P. c. ' .:."":: ( : ~~ ',.. '.,"'. \,,'\'j,:\i. ~ ~ <~'" '\;'...'., "..,tJ. Q \l E.r:' ... d. I d _J '" ' r., ,_."'l._,,_ " _~ - ~ "',""," "Notary Pu ic ' WILLIAM L [P,~P, Nolory P"bilc Carllsle, CumberLmd Co., Pd, My Commission Expire~ Aug. 13, 1984 !."... ......:4 97 ' ~.:'19 LAST WILL AND TESTAMI';NT OF 1. W ^ LT 1'; H C: H () J.' F -- -----~-~-- '" . - -----.----. -.-' . --_.-~._.-.-. I, I. Walter Groff, of R. D. 8, Cal'Ji~]e, Cumberland Count.y. Pennsylvania. declare this to be my Last Will and Testament andl'evol,e all Wills and Codicils previously made by me. ITEM I: I direct my Executor hereinafter named to pay my just debts and funeral expenses and the costs of administration of my estate as soon as may conveniently be done after my death. ITEM II: All the rest, residue and remainder of my estate and wherever situate I give in equal shares to my nephews. John W. I<eim. Carlisle, pa.. G. Richard Keirn. Carlisle. pa.. and my niece, Elizabeth K. Clepper, Carlisle, pa.. or their issue per stirpes. ITEM HI: I name, constitute and appoint my nephew, G. Richard Keim. of Carlisle. Pennsylvania, to be the Executor of my Last W ill and Testament. IN Wl'fNESS WHEREOF. I have hereunto set my hand and seal. this Bth day of November. 1976. { 'I ///Cf.':;'l'l~ 7~r - / c.-/F' ( ;; (SEAL) " { The preceding instrument. identified by the sign,:ture of the Testator, was on the day and date thereof signed. published and declared by 1. WALTER GROFF, the Testator therein named. as and for his Last Will and Testament, in the presence of us, who, at his request. in his presence and in the presence of each other, have "" ." I: ::::J " .. IN RE: ESTATE OF I. WALTER GROFF, DECEASED, LATE OF HIDDLESEX TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COM}10N PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-79-674 DISCLAU1ER AND RENUNCIATION OF BEQUEST I, JOHN W. KEIH, residing at 567 "E" Street, Borough of Carlisle, Cumberland County, Pennsylvania, as beneficiary under Item II of the Last Will and Testament of I. WALTER GROFF who died October 28, 1979, said Will being dated November 8, 1976, a resident of Middlesex T0W11Ship, Cumberland County, Pennsylvania, declare as follows: I hereby disclaim and renounce my residual share and disclaim all right to take any interest in said residue and remainder under Item II of the Last Will and Testament of I. WALTER GROFF, Deceased. I further disclaim and renO\lnCe all right, title and interest which I may have in the property comprising the Estate of I. WALTER GROFF, whether rea.l or personal, whether such interes t should arise under or irrespective of the Last Will and Testament of said I. WALTER GROFF. It is my intention to be legally bound hereby. In witness whereof I have hereunto set my hand and seal, this &.3 M-.day of 9cv:>u<..~ ' 19J'O. ~~~~-f/t (SEAL) COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUMBERLAND ) SS. On this, the v;JJM- day of 9a.~'l..r ' 19.fO, before a Notary Public, the undersigned officer, personally appeared JOHN W. KEIM, known to me to be the person whose name is subscribed to this instrument, and he acknowledged that he executed the same for the purpose therein contained. In witness whereof, I hereunto set my hand and notarial seal. me, t}1 ' I~J /,'~ \~ S;!i~, V!lt,,1v1!/ "." ~. . . '. .' ",'. ,-. .} . ..J~{&.,::(Ji;, ,'.. ,'.. ,..' .../)" ....:.: .~.~. ~ ~.~. '~:'~~:~\ ::,':~ ~~ : '~ ~ , ,::';. )J~ r~ Notar~public LAW 0l'l'1CE6 WILLIAM F. MART.ON. P. C. l:.... ','r' :_! '- ' ,", l,". ['t" 9'i" ""lj .-. A. _ LAW Ol'l'lCtG WILLIAM F. MART'ON. P. C. 12/11/79 12/29/79 12/29/79 01/19/80 01/24/80 P.P.& L.: Account payahle to 11/28/79 $ Carlisle Hospital: Account Payable Belvedere Medical Center: Account Payable P.P.& L.: Account Payable Register of Wills: Payment on Account of Pennsylvania Transfer Inheritance Tax (NOTE: Payment of this sum at early date entitled Executor to a credit or discount of $250.00.) Register of Wills: Payment on Account of Pennsylvania Transfer Inheritance Tax Register of Wills: Balance due, Pennsylvania Transfer Inheritance Tax: $43.05, plus interest at 6%, from 7/28/80 to 9/11/80, in the amount of $.33. 07/28/80 09/11/80 The Accountant reserves the following sums to be paid subsequent to the filing hereof: 1. WILLIAM F. MARTSON, P.C. - Reimbursement for Costs Advanced 2. WILLIAM F. MARTSON, P.C. - Attorney's Fee 3. G. RICHARD KEIM: Executor's Commission 4. Reserve for filing account, releases, disclaimers, and closing and miscellaneous costs TOTAL, PERSONALTY, PRINCIPAL ACCOUNT, CREDITS: PERSONALTY - INCOME ACCOUNT DEBITS The Accountant charges himself with receipt of the following items of income from personalty: TOTAL, PERSONALTY, INCOI1E ACCOUNT, DEBITS: PERSONALTY - INCOME ACCOUNT CREDITS The Accountant claims credit for the payment of the following items from personalty-income: TOTAL, PERSONALTY, INCOME ACCOUNT, CREDITS: -2- , '~!. I-~ ~JI . '.:'15 75.62 172.00 35.00 106.06 4,750.00 800.00 43.38 80.65 1,500.00 2,309.00 300.00 $12,829.10 $ NONE $ NONE $ NONE $ NONE LAW OF'ICES WIWAM F. MART.ON, P. C. RECAPITULATION I. PERSONALTY A. Principal Account: Debits: $46,189.37 Credits: 12,829.10 Balance $33,360.27 B. Income Account: Debits: $ NONE Credits: NONE Balance $ NONE C. NET BALANCE OF PERSONALTY: $33,360.27 II. REAL ESTATE A. Principal Account: Debits: $ NONE Credits: NONE Balance $ NONE B. Income Account Debits: $ NONE Credits: NONE Balance $ NONE C. Net Balance of Real Estate: NONE III. NET BALANCE OF ESTATE FOR DISTRIBUTION: $33,360.27 -4- I''': &7 ' 'i ., .... ~. . LAW OFFlCE6 WILLIAM F. MART.ON. P. C. - '. . . . IN RE: ESTATE OF I. HALTER: GROFF, DECEASED, LATE OF MIDDLESEX TOWNSHIP, CUMBERLAND COUNTY, PENNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBEPLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-79-674 DISCLAU1ER AND RENUNCIATION OF BEQUEST I, ELIZABETH K. CLEPPER, residing at 919 North College Street, Borough of Carlisle, Cumberland County, Pennsylvania, as beneficia y under Item II of the Last Will and Testament of I. WALTER GROFF who died October 28, 1979, said Will being dated November 8, 1976, a resident of Middlesex Township, Cumberland County, Penusylvania, declare as follows: I hereby disclaim and renounce my residual share and disclaim all right to take any interest in said residue and remainder under Item II of the Last Will and Testament of I. WALTER GROFF, Deceased. I further disclaim and renounce all right, title and interes which I may have in the property comprising the Estate of I. WALTER GROFF, whether real or personal, whether such interest should arise under or irrespective of the Last Will and Testament of said I. WALTER GROFF It is my intention to be legally bound In witness whereof I have hereunto set Cf'7'UA-<lA.t ,19110. r:l A"ktJ E~Abeth K. COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF CUNBERLAND ) On this, the dJ,M.- day of 0.""7'-<-<'<''1-' ,19S!>, before me a Notary Public, the undersigned officer, personally appeared ELIZABETH K. CLEPPER, known to me to be the person whose name is subscribed to this instrument, and she acknowledged that she executed the same for the purpose therein contained. In witness whereof, I hereunto set my hand and notarial hereby. my hand and seal, this d;:3/ld.. day of It?, ~ ~ Clepper (SEAL) 55. seal. ~. ..,P /It~ ,-y..Jl..t.- Notarl Public " ..,:~:.'~ :;'<:.r '\,,'/' ..... ",'l' , J.;,," .', .' ~ ' ~'.' . ~ r: :' I ..,,; ...~. :1...:.:..... .~'-~ . 0::': ';':(J': ....' :::: \' .:~..<.:?..>~~;<:/,: '.. -- ....,. ,. M"',P"V Ltt, ~,HrNK, t'~'.!~ry PU:llic Corli'ilc, Curr!L~'!lond CJ., PA My C(mln'li~>..i.:m t>.:pIH.'~ Feb. 27, 19a1 ".r - ,":. .J7 .....,1", ".'..-