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"ii~~3~~3'7"3 COMMOND~P~~J~TO~ ~::~~VLVANIA
9t~~TIf0:R~~';"OFFIC'AL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
II ' ..U' d' .
~ _____________TWO HUNDRED EIGHTY-ElQUT
., RECEIVED - ~--^~
" '
= From, Eslote
~
~
l File No.
dress
(stella Richwine)
7 Ir"1ne Row
C'9rlisle, PerpQ
, 70' 3
21 60-100 Dote of Deolh12-1-J.979-
Dote of Payment
Fe'llruary 111> 1980
Nome of Decedent
QLIVER GRIFFIE
Counly
("umber' 9nn
Remarks:
"PAID ON ACCOUNTIl
'ITrna\?[La@&'TI'~ SEA l
NOTE: This Triplicate Receipt to be rotained for audit purposes.
_.._ ___0. ___ __ --
~
M.
oo-------------------~ II
aO on
lng Pennsylvania Inherllance or --
Tax due from the following estate:
2(lc. tax on
s
s
6'ic lox on
s
s
15'1, lox on
s
s
C;" Tox on S S
Estate To)(, Act of
Moy 7, 1927 S
TOTAL TAX CREDIT S 393.131
Less live parcenturn of tax if
paid within three months oller
dote 01 deoth S 1J.1B
Plus interest at ,t,c role of
_'klram
10 S
TOTAL AMOUNT PAID S ,,?\? .1\)
Received by
NotE: In acetlpllng the lransfer inherUance 101 on lulure e,loles, prior 10 Ihe dealh 01 lhe lile
lenonl or ltlnanl lor yeon, os evidenced by lhh receipl, it is undersTood Ihol the COffimonweallh ,hall
nol be prtlcluded or prevented hom htlreafter oueuing additional lnherilance 101 at the death 01 the
Illtl ltlnont or lenant lor yeon whenever II appeors Ihol ,uch odd,tional 101 may be legally due and
collectible far any reoson wholloeur.
~~j~# (\!. ,) '1+;'/ .
j I v (Signdw:te) I I G'i.N"f'
Harold B. McLane, Deputy
Regist~ntl.rf Wille
t
,.-- ---- - - - - -.- -- .-.. .-.. ---_.- --- - ---. .--.
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COMMONWEAL TII OF PENNSYLVANIA
DEPARTMENT or REVENUE
BUREAU OF COUNTY COLLECTIONS
*
RCC.:U 1"-731_
RESIDENT DECEDENT
COUNTY OF
CUMBERLAND
-
This return lIlust he completed in dClUillIlUll'iIetl in dllpliclttc.', with all nttnchcd. with till' Register nf Wills nf the
Count)' where decedent (csitlt..t1~ Return is due Willllll nine fIlll111hs after LIllie uf demit. unless un cxtCllsinn is grunted
by the SecretAry lIf I(C\lCIlUC. ISectiun 703 uf the InlU'ritancc "ud ESIiIIC Tu:( Act nf 111t,I,)
IMPORT ANT:
IN TIlE MATT Ell OF TilE ESTATE OF
} ;::: ':AUGHTER
~lll111'lJ~XR,l(1K1IX
OLIVER GRIFFIE
eSTATE FUI.l. NAME OF DECEDENTI
Late 01
Cumberland
Pennsylvania
Cumberland
stella
R. Richwine, d~ughter,
~
County
Stoto of
} ",
Coun'y of
DQXIlIIIl:~
of the estate of the oboveonoml:d decadent being duly sworn, depose
and soy
Decedent died
December
1
. 1t.)IL-.J toslate leaving Q lost will, copy of which is hereto attached. }
'YEAR' ~OOX Will not probated
(MONTHI
Name and ClddrelS of attorney or }
ather authorized reprcuntative 10 whom
011 correspandence should be mailed.
(CAyl
Bietsch & Morgenthal (Tom H. Bietschl
7 Irvine Row, Carlisle, PA.
17013
That as sueh Dauqhter depllnenl is familiar with the affairs of said esHttc and the property constituting
(EXECUTOR.ADMINIST Rt.. TO Rl
the assets therenf and their fair Ilmrkct value.
Thal at the time uf death there was no srlfc deposit hox registered in decedent's indi\'idualllilllle, or jointly with, ur
as agent or deputy of anuther, or in dccedent' s individuillulIlIlc, Wilh right uf access b)' another as agent or deputy, with the
exception of the following: -
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT RENTED A S_...FE DEPOSIT BOX
THIS SAFE DEPOSIT r:.-:lX RENTE.D
IN NAME OR Nf.Ml::S OF
..-.- -=
REl..,ATIONSH1P OF JOINT
HOl..,OERS TO DECEDENT
NONE
That the contents of said safe deposit hox or boxes are itemized under Schedules
wi th the exception'of the following, for the reasons hereinafter set forth:
of this return,
That Schedule A attached hereto and made pari hereof sets forth fully aod in detail all the real property
in the Commonwealth of Pennsylvania of which decedent died having an interest therein. It also sets forth the
mortgage encumbrances upon each parcel of real property al the date of death, giving the amount still due at
death, name of mortgagee, date, rate of interest, and book and page of record thereof. It also sets forth in the
columns provided thcrerorc the assessed valuation of each of said parcels, the estimated market value thereof
as of date of death of decedent.
That Schedule B uUnched hereto and made part hereof sets forlh fully and in detail all personal property
whercsovcr situated owned by the decedent at the time uf death; all mlll1CY~ left by the decedent at the time of
death, whether in decedent's immediate possession, stllnding to decedent's credit in hanks of deposit, savings
banks, trust companies, or other institutions, whether individually, or ill trust for any other person or persons
giving also separately the accrued interest thereon, if any, dO\\'I1 tn the 1asI interest day prim to decedent's
death in tlte case of savings hanks, and to the date of decedent's dcuth in all other cases; all bonds, postal
savings, treasury certificatcs or notes and other e\'idence of indebtedncss of the Unitcd States to the de-
cedcnt; all obligations, whether hy statute or agrecmcnt they arc de:;ignated as lax free, of the United Slates,
or any state, or political subdivision thercof, or of :lilY foreign country. which lire owned at the time of death;
all wearing apparel, jewelry, silverware, pictures. honks, works of art, household furniture. horses, carriaHes,
automobiles, boats, and any and all other personal chattels of whatsocvcr. kind or nature, left hy dccedent,
together with the fairly estimated market value thereof: all bonds ill1d mortgages held by decedent ami of all
claims due and owing decedent at the time of death, and all promissory notes or other instruments in writing
for the payment of money of which decedent died Ilosscssed, of whatsocver nature, with interest thereon, if
any, giving the face vallie and estimated fair market mlue thereof, and if such cstimatcd fairmarkcI value he
less than the face value, it sets forth hriefly Ihe rcasons for such depreciation as to each itcm: all moncys
payable to the esliltc from life insurance policies carried by deccdcnt; 1111 annuity and endowmcnt contracts
the proceeds of which were payahlc upon the death of the decedent: all and the corporate stocks and dividends
due thereon and unpaid as of 111\ ,iah' of dcalh. honds and accrucd interest thereon to the dale of decedent's
death and other in\'cSII1H",j "'_' -" 1;...1 by the llcl:cdclIt ut lhe time of death, with the mllrket \'lIluc there-
of at such time.
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III thl' ,'us,' lit' sl'l~llrltl~~ of clOSt' or f'lllully l'III'JHIT'/It.lflllS. Ull' \'ulll"s r'-')lIlftefl nfl' liS ('Ul" ItS
l'osslhll! suh~tlln'tl't.l"fl h)' I'lnltllt.~11l1 sllll.I'nll'lllS lIt' till' 1:III"I'III'Iltl'"IS. shOl'itll.L!; lhl! IISSf!t.S I1Url lJ/lllll11 i(!s
thl'rcnl' ItS nl' tllf! tlnh.' of lit-nth. Till! Sl"hf'tlull' ulso splS {"firth till' Intf!rl'st lit' 11"(~l'lh'llt Ill. tI\l' t.lmf~ nf'
denth III lm~' cn-I'urtlwrshlp IIr hllShll'ss, lIud III SIIPJlfll't cd' till' \'u111l! HI' SII('II Intl'I'I'st Illerl! Is 1l1l1l1!Xf!fl t.o
sllhl S('hl'lllII,', t'lnnnctnl stlltl'm,'nts SIUHduJ..!.tlll'IlSs"ts IIlllt Illlhllll.ll-'S of' snlll ~ll-Jlllrllll!r'ihtp liT' hlls!llt'ss.
,\ l'llPY of t.ht' ~n-l1llrt.l1l~rshlp ttl!;rl'l'ml-'nt., (Ir nrlll, II slnt.Pflll'nt SI.t.t.IIlJ!. forlh thl' IlIltlll'f-' 01' thl' II~rf'f'I'II!Ill.)
logl~t.h('r ,\'llh a stnl.I'TllI'111 sl'l.l I Ill!. forth t.llll c:ltarHc'tl'r 01' t.h{' lIIISIIll'SS, Its I lit" It I. I 1111, tl1\lt SIIl~1l uther l'III~t.S
j't'rt'lllllll:!. 10 t)\I' hllsltlf'ss itS nlu:,' hI' IU'rt.IIlI'1J1 l.u II J'nlr 1I1II1 .lust 1l111lrnlsul lit' tlll~ iti!CI~"I!f1t.IS 11l11~rHst.
tlll'I".111 milS! 1,I'sllhmittf'lt. It. shcHltcl nlso Sl~t. forth In IIPmI7.1!i1 forni, to/!.I'l.hl~I' wit.h t"l~ ('nlr Il1l1rl(f~t. \'nllle
thilri'nf. Illl~ utllrr prnpl~l"t~' ClY,Iwcl Ill' hf'lllllllltlll'I' hy Ihl' 11"I~I'II(!Il! nl tIll' ttllll' of' Cll!1I111.
Tlll~ Scfieriulp C nt.tllchpll hf'rel.o IIn" 11l11l11' 11111'1. hPI'I'OI' SI!!.S l'orth II 1,I'Il~ tIlISWI~r t.o 1~III~h IllllUII')'
COllI. u IIlf">lt tl1...r('ln IIl1cllnt.hp. cnsl~ ot'trnnSf(~rslll'pl'(lIIl~I't:,', rl'Il1 or l,prsfI1J/1), \\'11.1IIn lvm ~'f~llrs 1II'lh~cl~ct~nl.'s
itenth. In I:ont.f'mplntlnn nl' ch'H~ed..~nt' S ilent.h, or 11\11~tl.I(,11 tll l.'ll,l! f!('I'f>ct III Jlnssl~ssloll or enl{l~'nu~lIt ul or
(if'ter Ilealh, slllll sclll~du)e sets fort.h t.he nut.ur.. 111111 \'111111' (If SlU~1l I'I'ol'('rt,~', to \\'hom t.ransl'f~rrl'c1, the
relatiollshlp of' the trllrlsl'er('C's to t.he .teccfl('nl., thn prlll't)rtlllnntt~ slJ/lrfl rnenl\,l'11 h~' f!HCh lrtlTlSrl~ree unci
IlIl otllf~r filets of II pertinent. nulllre rl~p;llrrllll~, sllll' I,rnnsl'l~rs. 111 t.hp ettS~ ot' trllllsfl~rs Inl.p.lIdp.d '"
take llt'fecl In possesslun or enjoyment. Ill. or aft.llf lli~lLl.h. t.llf!I'I! Is niSI) IIU,ndll~11 1.11 t.he sehnduln Il collY
of' thl~ ctnl~", trust llJ:;reement or otller Instrument crenttnJ; the trust.. Thl'r.~ Is nlso Sl"t l'ortll III said
scheclnlc II list of IlIl flr{lJ1f~rt.y, rent utld personlll, wlt.h Its \'ulllc. widell ]l1l~.S"S ul. dl~Cf!llentls dellt.h h~'
virtUl~ of' t.hl~ exercise hy decedent, either 11lIll\'illllully, or.tIJIIlt1~' with Ilnnt.h('r, III' /lilY po.....er of' IlI'Point.-
ment \'f~st(~d In decedent, either lnltlvldunll~' or .Jolnlly, hy thf.' \\'111, Ilnn!l, or Ilthpr InstruTllent IJI' Ilnn1.her,
with h. copy of the InstrlUl\ent crenltllJ!. such pO\\'l"r II t.ltlchect 1.11 UII" sdJ(~lllIlp.
That Scfoedule 0 /It.tllched hereto un II Illude purl hernol' Sllt.S l'urUJ thn nHIlIr>S IIwl IlfMresses of' /111
persons hl'lIef'lclall~' lnt.erested 1n thls estnle nt. the tlme of' ch.'cp.tll!llt.' s .lent.h, the 1Il1t.ure 01' their res-
peetlv.. IlIterests, their rel..Ullllshlp, II' allY, t.n t.h" .",e..d,,"t., tn~..t.her wlt.h the ",~es "I. 1.1", t.1"e 01'
clecedl'"t.'S ('enth of' nIl minors, nnnultnnts nlld htHlef'lel/lrll!s t'ur 111'1"' llIHlnr llcceilent's Will. It nlst)
contains n stntement showing which of Ule henertclllrles nlllnl"!d in l.hl~ fl,'ccllnnt's will, if' IIny, tllecl prior
to de~cilellt., the dates of their denth, their ISSlIP., IUld thl~ relnt.\llllshlp nl' stich iSSllP. to the hellf!flclary.
"hnt S.:fil'dule E nttllched hereto llnrl mllCh~ IL Jlflrt h,~reol' sr>ls forth /tll prnpert:\', reftl /Inti pf!r-
sonal, o.....ned b;y the decedent ,101nt.1'';,' with nnother or ot.hers, Inclwtlng Intan~thle, stnllf'\n~ in the 1l1l1l\1'!
01' the deccdellt "lid nthers, plus the d"te "",I pl"ce Ill' recnr.1 nl' I"st.r"",""t.s ..t'I'''ctlll~ th" ,est.ltllr.. 01'
renl estnt.e und the dute of' llClltlisit10n of' persnntllt.:,', plus t.he 1I11me, Illtcll'ess nnd rt~lnt.lonshlp, 1f' any,
or co-o\\ners to the deceden t.
Thllt Sc/ledule F nttncherl hereto /lnd mUlle Il part hereof' sets furt.h flllly 11I111 III c!c.t-nll nIl eleht.s
alld dedllctlons cllllmed I'or Ime! on hehllll' 01' this dec"denl.'s est"I..., Incl",lln~ "",,,r..1 expells"s Pllld;
l'amllyex.mpl.1on, wl",re "ppllcahl.; cost. 01' "dmlnl.l.rllt.1on 01' t.hl. ..stnte: ,:n""sel 1'..,,. ",,01 ""llcl"r)" s
comml.slons paid or to he 1'"ld; eo.t. cxpcnd",1 I'or bllr I III trll.t.., t.OInh.ton"s or ~rll"emllrker., ancl rd 1-
glous .ervlce., In eonse'lu.nc" nl' I.h. d,,"t.h nl' the clec"e!elll.; ""hI.' "ncl cllllms n"ln~ ancl 11111',,1,1 at tl"c ..1'
death; f.IIXC' llecrllccl chllrgellhle I'or Iwrlo,1 I'rlor t.o ,lec".I.llt'. clcath (cxe"l't. thnse "Uowecl 1Il"ler SeeLlnll
65101' the Inheritllnee ""d E.tate T"x ,\ct.); tn~ethor wit.h " st.at"ment nl' c"UaIN,,1 I'lcd~e,1 I'nr ohll",ll-
tlons, II' an)'. It I. IIgreed I.hllt. t.he l'lclnel"ry will I'r""!lIt I'rnnl' .". .al.1 cl"l",c,1 nhll:~at.ln'" "pon re-
'l"e.t. thllt. II' the IImonnt IICt.llaU)' "..1,1 In ."lllo"onl. nl' an)' I'ce, "nm"l.slnn nr cleht. Is less than t.he
estlmatecl amollnt dlllmlng llnd "Uowed, tI.llt. th,' sa"e will '", r.,,,nl.tecl to t.llc H..",lstcr nl' \\'111., 1I11c1 that
the amount of tnx assesseel CUll he r(>lIssesse(\ 111 t1ccnrltanr.P l.hl'rl~\d t.h.
That t.he Lnt.III' of t.he apl'rol,,,I,,t.e eol""'" In Sehe,I"le. ",\", "1\", "CO, "E", anct "F" as .lIr"cto.1 therolll,
have heen cnrrlerl f'orwnrrl Rnn properly re~lsl.e!"cd hi till" SllnUIlHr~'.
Subscribed and sworn to beforc me this .............................
.............."...I.,,~::~ day of ~~\cNJ...~ . . 19..11.0..
--c-,,> \"\ _~
C~ \.)..,_~. C. \.l.D.-y' ~-~
""""""JJ@rcT:I:.1-I"'P."'''71 H' ~"('JT^R, ,>tlr,Ui:
/; -'- ,.. 'j);j) //;
.....)d..:4t.e..t.:4.<./.)..,....L)....::t,c:8..!:~:.t...;u:.......- ..
(~~~~~~ Daughter
.R...... D.......?.,..!:lQ~...".l.AJL............ ............."...--"..
(Strcet Number)
Gardi1e.J:9 L.. P A.........1: 7 ~?4
(City or Town and State)
(1;:",",1 ;'~i I,.:~...l ,- ;' :~,I" ("r.~-\;~!:.., ~,\
My Cc,'w,I;,,';i,-,n F:~pjrcs JCJnucry 27, 1983
SOTE; I\el'oro sl~nln~ IlI'!'IdllVIt. ,""ke .lIro "II hlll"k SI'''''''S I" tI.., "I'!'Ic1"" I I "",I sch",I"les alll.,,,,,,1 lire
l'l1led In with clctalls or f.he wor,1 "Snn"", 111111 In ""s,> 1.1,,' """" In..ln,le r"re "no! "nll.le,t .oellrll.los,
scc"rltle. nl' clnse or I'lImll)' ""r"orlltlnns "r "" It,t,'r"st III ''")' "..-"",.tll,'rslll" nr 1""lncss, I.IIal. tI",
cI"t" "n,1 .t.lltem""ts re'I,,1 rocl 11ll.lor th.. 1"""~I'''i'h "ho\'" r..1 "tlng In Sel,..""lc "1\" "r.' aU"eh",I. .\\ sn mak"
eerUlln that column #1 In till'! "Sunlllllry" hns he ell l'rnp'~l"ly cnmpl"tr>1l as Illln\'I~-'llrl'ct'~II.
. .
HCC.U ("-711
COM/olOllllRALTIt Of I'ENNSYLVANh\
. DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
TRANSFER INHERITANCE TAX
RESIDENT oeCI!DENT
SCHEDULE "A"
REAL PROPERTY
*
Real property in Pennsylvania, with statement 01 mortgage encumbrances upon each parcel at death 01 dece.
dent. Property held by the decedent os tenant in common with onother or other, should be identilied
os to quantum 01 interest and the estimated value should be that 01 the decedent's interest only. (Property
held as joinltenants with right 01 surviorship or tenancy by entireties should be reporled on Schedule "E.")
The real property located In the Commonwealth of Pennlylvanla should b. (1) (2) (31
daacrlbod by tot and bloc!,c numb.r, .tr..' and .tr..' number. togothor with D.PARTMENT
o genoral ducrlptlon of the properly, with 0 r.f.ronco to tho record of tho ASSESSED VALUE VALUA TlaN
cony.yance by which tho dacedent took title; If Q form .tot. numb.r of o. FOR YEAR OF ESTIMATED CAUTION
erol; also Ita'amont of mortgago oncumbrance. upon C10ch porcol at doath DECEDENT'S MARKET VALUE (Do not writ.
of decedent. Tax.., a.....m.nt., accrued Int.,... on mortgag.s, .tc.,or. DEATH In ,hi. spau)
to b. lI.ted on Schedulo uF" and must not b. deducted from this schedul..
NONE
-
Insert this tolal opposite "real property", Schedule" A" in the X X X X X
II As Reported" column on the lost page 01 this return.
NONE
N",t.U
-9'Pf.
. .
REY-4St (8-,1)
.
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
INSTRUCTIONS: This Schedule must t1isclnsc 1l11IUJ1gihlc UTld inlllllgihlc person..1 pWI'erl)' nwncd indi\'itllllllly by the
dcccdcnl, at the time of his oCllth. PWllert)' nwnctJ by Ihe decedent juinll)' wilh another tlr uthers IIII1St he listed
under Schedule "E". Intangible persolla1llwl,crly, titled ill lhe nl1l11e (If the cJCCCdCllI, hUI I'ilyuhlc ill dealh 1lll1l1lJlhcr
or uthers, including hut Ilollimited In p.o.n. U.S. SIl\'ini;s Bonds ilnd lentative trust ill'eulInls, mllst he listed, despite
the facllhlll they llrc not of the administered estate.
Tangihle I,crsullnl pruperly shuuld be listed first (c.g. jewelry. \\'curing 1'111111fCI, household f:!lImls, lI11d
furnishings, bonks, puintings, lIutnnwhilcs, hllll IS, etc.)
Intangible persul1ul prnf1ert)', such us bonds, Irellsury certiCiclIlcs, cash IIn hand nnd in hank, slocks,
mortgages, notes, tugethcr wilh accrued interest or di\'illeI1lJs, sulnrics or wagcs, insurullcc puyahlc to thc estate or
fiduciary in said capllcity, partncrship interests, interest in any undistributed estate of or illCftlllC fwm IIn)' l,wpeny
held in trust under the will or lIg1"cemclll uf lU\u,ht:r, cvcn thuugh localed (lutside uf the Stille, at the limc of dCllth,
shuuld be lislcd in this sdlCt.lulc.
Item I1ml UNIT ESTI~IATE\) UEI'AllTMENT
No. Li sllllld describe fully VALUE MA.RKET VALUATION
VALUE ([)o not write in
Ihis spaec)
NONE
-
Insert this total opposile "Personal PropCrly", Schedule uBtI b XX NONE r&....v
the UAs Reported" column on the last page of this return. - -<l9~
i
I
I
I
,
I
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I
I
I
REV.-52 (8.78)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
SCHEDULE "C"
ThANS!:E"S
','
~ /"~
M~'f(:i. ~_ :\
... r]!,....,
"/: '"",,,.., ,~
-;:',": ;'~';1!:'.\"::~"
RESII>ENT DECEDENT
------._-~-_._--~_. .------.----.
(1) Old decedent, within twu ycau of dftotth, milku ,Illy trJllSfer uf ,tiIy w;llai.-:1 p"H: of hi:; I.Slilte, ....ithout rer.civillY II valuable and
bdoquate considerc.tlon therefor? {Amwcr Yi!:i Of rial -No__
(2) Did decedent, within two year:. of dCJlh, Hdnr.{cr prol1clly frum hilmdf to himself ,lIid ,motht;r or others (including a spouse)
I in joint ownership? (answer yes or no) -":'_N...9_'
(3) If the 8nSWi!r to (1) or (2) above is in the otffirmtltivl: st\Jtu:
(a) Ago of decedent at time of tramfcr _'_
(bJ Stato of decedent's health at tim..: of I11tiking tho tr~nsfcr. (Note 1~.
Ie) Cause of decedent's death. (Note 11.
(4) Did decedent, in his lifetime, make any tr&l1sfer of prol)Crty without receiving a valuable or adequate considflration therefor
which was to take effect in possession or onjoyment at or after his dunlh? IAnswer yes or no) Nn
(a) Was there any possilJility that the property tr,lOs(crrcd might return to trnnsfcrcr or his cstatl! or be subject to his
power of disp03ition7 (Answer yps or no) .
(b) What WJS thl! transferee's ijgc ill limo of decedent':. deilth? ___
(5) Did decedent in his lifetime mako any trandt!r wilhout rllcciving a valuable and adequate consideration therefor under which
transferor expressly or impliedly reserves for his life or any periOd which docs not in fact end before his death:
(81 The possession or enjoyment of or tho right to income from the property trilnsfcrrcd? (Answer yes or no) No
(b) rhe right to designate the persons who shall pO!tse:>s or enjoy the pmperty transferred or income therefrom?
IAn~'eryesorno)~_______
(6) If the answer to (5) (b) above is in the at"tirmativo,llotdtO whether the right \Vas reselved in decedent olom: or others
(7)
(8)
Did decedent in his lifetime make a transfer, the consideration for which was transferec's promise to pay income to or for the
benefit of care of nansferor? (Anl~Yer ya, or no) N'n
Did decedent, at any time, transfer property, the beneficiJI enjoyment of which was subjec:t to change, because of a reserved
power to alter, amend, or revoke, or which could rC\lert to decedent under terms cf transfer or by opcration of law?
(Answer yes or no) No
(9) If the answer to (8) above is in the affirmJtive, was the power to ulter, amend, or revoke the interest of the beneficiary reserved
in the decedent alone or the decedent and others? (Answer yes or noJ
NOTE 1: The answers to these questions should be supported by affidavit by the attending physician as well as a copy of the de8th
certificate.
NOTE 2: If answer to any of the abo~e que:;tians is yes, set forth below a description of the property transferred, it's fair market
value at date of death, dates of transfers imd to whom trllnsferred, with relationship of transferees to decedent, if any. Submit
copy of any trust deed or instrument, if tnmsfers lIrc claimed to be non.taxalJlc, also submit detailecl statement of fnets on which
said claim is based.
NOTE 3: List 8~plicable property below in manner in which provided in Schedule, A, B, or E.
MARKET VALUE
(Estimoted)
ITEM
DESCRI PTI ON
DEPT. VALUATION
(Dept. Only)
NONE
Insert this torol opposite "Transfers", Schedule "C" in the
"As Reported" column on the last page of this return,
NONE
N..-nu
--Y$fC
, .
RCC-37 (12-63)
t'mIMO:l:\\"I':Al.l'lI (iF" i'f:~;~!'YYl..\~I"
TIlANSFt:H INm:IlI'l'AJI;t'E TAX
Rt:Smt:NT IJEL'EIJt:NT
\"-
lI': -I ~\.,,\l
'S4l{,~'~.lr~t.
"rrl:,,::,;,,~\,
,,'. .;..... .
~;<:IIEJJII.J.: "I)'
IIL';U'lt:!..\HIi':S
11L'''VL'ICI \1111'5 ANI) AI))))"'SSJ'S' '1-- H1.:i~ATI(i;~";liIP" ;--;:t"I\-\"-I\~-I:I--:---'- -. I .
, '~IH.J'". I ',. , .... " , or stc'IH'llIldn'n IIr ' ''':., .' .J, I JHT!: INTEHFST OF
\~tlll~ lull nnr:Il's and :lllltr('sHI'~; of nIl \\hOI iJlI'J..:itllnah.' ('hlilrcn: ~::.t.l}JI..;".J. : In: J1J:~EI.I('JABY
h:l\'(' no jnt(,I'L.~t. "m~tt>fl. ('(llltilll:I'/lt OIoOt!\t'I''''! ;m' l,\\'ulvl'd, sl't I SI,\I....,l:..~ j , ., J'\ l:ST\TE
NOT ~~;~~~~~~~:~o' '-:-~~~-!:~~~i-(~~~_~I-~l!I-....+----_-
.-I----~ .------j---
ESTATE TO DISTRIBUTE. i-: I
I I I
i C-
t=. .1
I '
I l
-.----r---r
=1=-----~.--t=-=I----l=
I .
I
I
L.
-L
i
L_~
IJeponcnt. f\lrthnr sU,ys t1IllL 1111 the nho\'('-IHlnwl1 Ilf'lH~n<'1llrJ(~s Are 1 fvlTl~ nt. t.his time except helow:
NAME T DAn; OF DEATH l HESIDENCE
I
, I
L
I
I I
I
. .
(1) (2 i
~ SIJ~I~IAI\Y ( As II.'porh.e1) (As J)/'I/'nllill,.e1)
c
- ...-
~ ,.... IIl'al Pro[>crt)' (Seh. "A") S none S
~<
ow;: c:
'c c:,I E "ersollal Properl)' (Seh. "n") S none S
.-.... :::
E"-
"Cc.8 Trunsfers (Seh. "C") S none S
<( E.
.:. o. Jointly~ed P1:tl~y (Sch~ .u~~'L .7,.523.60 i
ofJ'E S S
. . 5~t:
t " ~ S S
~Ef'
_ c:: Gross Taxahle Eslate S 7,~.23.60 S
"
t- o.
z '" '.-l
.. .r:
~ til ~
~ ." Ill' ,
;;:: .. -
;... ." 1::' 00(
til .. :3' III
III Q 0 -
- 00(
..-. 8: " a:
~ It, I:: '(j 'c c..
~ 0 " c..
'" ..-. ~ 0 s:: ..:: <
1: w .jJ. ttJ '".
til ... f-o til. OJ. o-l 5 Q
~ - .. of, H. .--I l-; Z
c 1= 0 f-o Ii< 'tl <1l ::;
Z '" Ii< 'tl ~ c.. <
t.. W H. -.-I ~ I-
---- 0 a: ::;: ::l c a:
" c: t.!l () 0
.S: . ::..
<; W t>:: CIl " :.;
~ til ~ ~ a:
.: :> 0
"2 ;:; H 'C 1::;.
a] ..... ~ .;:
0 ~
..~ - j u u
......-.
REV-4'3 l....?9)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BANK NO.
\.,' ~.... j
Submit in triplicote within 10 doys ofter knowledge of
the deoth.
NOTICE OF DECEDENT ACCOUNT STATUS
DATE FILED
RETURN COMPLETED
FORMS TO LOCAL COUNTY
INHERITANCE TAX OFFICE
SURVIVING DEPOSITOR (Boneflcta INFORMATION
NAME
Stella RichlTine
RELATIONSHIP
TO OEC"U'~OIlIl
ADDRESS
Unknown
BANK/INSTITUTION ADDRESS
CCNB Bank, N.A.
331 Bridge Street
NelT Cumberland, PA 17070
"
July 10, 1980
STATUS OF ACCOUNT NOI (JOINT. TRUST. 0 R INVESTMENT)
Joint Checldn Account #733-9200-3
ESTABLISHED DATE
4/63
NAMES ON ACCOUNT
SOCIAL SECURITY HUMBER(S)
174-05-1094
Oliver Oriffie
Stella Richwine
DECEDENT INFORMATION
NAME
Oliver Griffie
ADDR ESS
R. D. #2
CITY
Gardners
BALANCE OF ACCOUN TAT 000
INTEREST ACCRUED AND COLLECTIBLE AT 000
TOTAL.
BANK AUTHORIZATION
CATE OF DEATH
12/1/79
COUNTY Cumbo
ZIP COD"17324
, 1, 5 .25
'-:: 0 -
,
I HEREBY CERTIFY THAT THE INFO~ATlON CONTAINED HEREIN IS A
CORRECT REPRESENTATION OF INFORMATION IN OUR FILES IN ACCORD
WITH SECTION 742P I a. E TAX ACTOFI9al.
SIGNATURE OF FINA~ L .. A~::>
1/ q q. '- .-
. ... '. t~1'Il::ms/
I DATE
July 10,
1980
,-- I..
~
_.
REY-,n3("'7lI1.
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
J ~L J
BANK NO.
DATE l"'ILEO
Submit in triplicote within 10 doys oft~r knowledge of
the deoth.
NOTICE OF DECEDENT ACCOUNT STATUS July 10
STATUS OF ACCOUNT NOI (JOINT, TRUST, OR INVESTMENTJ
J~int Savings Account #071-115637-2
RETURN COMPLETED
FORMS TO LOCAL COUNTY
INHERITANCE TAX OFFICE
SURVIVING DEPOSITOR B.neflcla INFORMA.TION
NAME
Stelle Richwine
RELATIONSHIP
TO OE'tflB'ibwn
ADDRESS
Unlwown
BANK/INSTITUTION ADDRESS
ccun Banl~, ii.A.
331 Bridgc Street
Ney Cwnberlc.nC:, PA 17070
"
ESTABLISHED CATE
9/28178
NAMES ON ACCOUNT
SOCIAL SECURITY NUMBER(S)
Ol1v,)r Griffie
Stell'-1 :Uchwine
174-05-1094
DECEDENT INFORMATION
NAME
Oliver Grif1'ie
OATEOF DEATH
12/1/79
ADDRESS
R. D. 1/2
CITY
Gnr<1nnrs
ZIP COOE17324
$ 10.2QO. Q8
$ ~6. 21
$ 10.37.19
BALANCE OF AceOUN TAT 000
INTEREST ACCRUED AND COLLECTIBLE AT 000
TOTAL
BANK AUTHORIZATION
I HEREBY CERTIFY THAT THE INFORMATION CONTAINED HEREIN IS A
CORRECT REPRESENTATION OF INFORMATION IN OUR FILES IN ACCORD
WITH SECTION HZ P I a E TAX ACT OF IUt.
SIONA)URE OF FINAN~AR
R. ". S~ephena n _ _
DATE
Ju.1.y .1.0,
. .
RCC.38
.. ..o .
COMMONWEALTH OF I'ENNSYLYANIA
TRANSFER INHERITANCE T,\X
*
RESlllENT DECEDENT
SCHEDlILE "10"
JOINTLY OWNED I'IWI'ERT\'
INSl'RtlCTIONS: TIl t S Sdll'dllll' IllIIS t. fll sc I u~w III J prup"r t~.. rl!lIJ IUlll 'U~I'SlJlHl J, ulOII'd hy till.' Ih~I~I!,h!tlL .I nJH LJ y
With Illlutlwr lIr uthnrs. 1lll.'l\Illlfl~ 11l11I1I,~lhl,!s, stlilullllA III Ihl' !ltlm" 01' tlu! Ch'CI'CJ,HII. /llIcI olhnrs. l.h.l
rl'a] I'!"Ittt.1I' first. liS 1.'lltlrl.tl,'s, nt' .IUI11{. !.I'unnts, j.!;1\'IJlJ; brief' Ilf~sc~rJ(I1.I(lIl, IlS IlIcllcl1t.'-~lt IlJllh!r Schedule
"A", phiS tile llntl' 111111 plllel! fit' rneord nl' IlIs!.l"Unll'lIt ,!I'l'l!t:tlll~ \'1!sl.ltllrp, hut. do Hot Illclucle entireties
or nut of' Stall' r,'nl l~stllll' \'Hllll~ III cst.lIle \'11111111.1011 c:ll)umll. Persunll} prnpnrl.)' sllollJ.1 he listed 1t5 In
Schedule "H", pillS llltle III' IIt'IIUlsi t 11111, utili till! IHUIIH. Illltlrl1SS II iii I r'!llltJunshlp (II' nllY) of' co-owners to
the ileC'!llt'lnt.
Ot'scrlptlon nl' Prllp('rt~., !Jilt'. uf' ,\cqulsJtlnn, Snml~ 1111tt perct-'llt.nge
Achlress lUut Ilclllt.tonshlp 01' Cn-Ovmnrs, nud PJllee VuIue :-ihnrt.
or I\ecord of' lnstrllnltmt, v.'llerl' Ih'nl Estnle.
r;stnl.n
VllluntlulI
DfJ'A1lTm;ST VAI.UATIOS
CAUTION-Do not IVrll.
In Thls SpIlCf~.
Vnluo or VuJue of
l!.'ntlro Deccdent's
propert.y Interest.
00<
~ 00 :xx
~'X> 00 06
ON Zl< :><
x/, '>:;-.?2 W.' :xYV .'Y.'/.^ : eX' ,-" .
~x x 2/> Y~X' '>>)' .!/;OX;/,' '" ,
'" ,.'K" ',~
e:r~:x.> ,%?) WM4'X x00, ',' ex
:xx:
:'x CX.>:::
1. Checking Account No.
733-9200-3, CCNB Bank, N.A.,
Mount Holly Springs, PA.,
having a balance of $1,654.25.
2. Savings Account No. 071-115637- ,
CCNB Bank, N.A., Mount Holly
Springs, PA., having a balance
of $10,290.98 with accrued
interest of $96.20.
50%
827.13
50%
5,193.59
3. Certificate of Deposit No.
21131, CCNB Bank, N.A., Mount
Holly Springs, PA., in the
amount of $3,000.00 with
accrued interest of $5.76.
50%
1,502.88
The above three items were
registered in the joint names
of decedent and Stella R.
Richwine, his surviving
daughter.
Insert. this totn) ullposlt(! ".Joilltlj' Owned Propcrt.j.Il, Schedule "E" 7,523.6t
In the "As HI!t1orl.cd" co 1 1Il:If1 on t.he )nst pngc or this return.
Tb-.:..J.,O
-tt',9tr
REV-484 EX+ (3-80)
INHERITANCE TAX SUMI.!I\RY SHEET
(BUREAU US~Q~L Xl
21-80-0100
File Number
Estate Name
GRIFrIE.'..~liver
Dote 0 f Dca th
12/01/79
Social Security Number
-------..-------------...---
REPORT OF INHERITANCE TAX APPRAISER
I, the unde"igned duly appointed Inheritance Tax Apprai.er in and far the Caunty of Cumberland
Pennsylvania, do respectfully report thot I have appraised the real and personal property as reparted in the laregoing
retum at the values set forth opposite each item in the fast column to the right in Schedules "A", "8", "C", and HE"
Dated:
April 3. 1980
.ft/~,J.a..J-!1/F'J"HJ )
INIiERITANCL: TA . APPRAI~LH
INVENTORY
VALUE AS APPRAISED
ADJUSTMENTS
CODE (HARRISBURG USE ONLY) REMAINDER APPRAISEMENT CODE
Real Propert)' (Schedule A)
Personal Property (Schedule 8)
Jolnt.Held Property (Schedule E)
Tran.fers (Schedule C)
$
None
None
ao+
10+
7,523 60 20+
None 3a+
7,52360 r-
-- - -.:~r-
--:-
---I
I
TOT AL GROSS ASSETS
leu D.bt. and Deductions
(SCHEDULE F)
CLEAR VALUE OF ESTATE
Valuation of life estates or
annultl.s. . . . . . . . I I . I I .
~
FACTOR
PRINCIPLE
FOR USE OF REGISTER ONLY
Tax on $
~
6'.
"
15%
Tax on $
Tax on $
Tax on $
Tax on $
Exemptions
Total Estato
TOTAL TAX
INTEREST FROM
BALANCE
TO
Less Crodlls
DATE OF PAYMENT AMOUNT PAID DISCOUNT INTEREST
5 + 5 S =
+ =
BALANCE S
INTEREST FROM TO __ S
BALANCE DUE S
VALUE
COMPUTATION OF TAX
S
5
5
S
I
5
S
S
TAX CREDIT
s
92+
93-
CODE
I
.
REV.457 \1-80)
COMMONWEALTH OF PENNSVLVANIA
. OEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
*
"
,r \ '
, ,
.' .
INHERITANCE TAX
APPRAISEMENT
- -- -
Estate D f
GRIFFIE, Oliver
File No. 21-80-0100
CountY
Cumberland
D~te 01 Death 12/01/79
t" the event that any future int<<61t in this eState it transferred in pOSSOJsion or enjoyO'ont to cullatcral hnin 0 t 9 decedent a tor tho expiration 0 any
estate for life or for years. the Commonwealth hereby u:pressl'( resu{lIP.f the right to appraise and assess transfer inheritance \altOS at tho lawful collettlr.' r.to
on any lOch futuralnterMt.
PROPERTY REPORTED BY THE ESTATE
DEPARTMENT'S
APPRAISED VALUE
None
1. TOTAL REAL PROPERTY - SCHEDULE "A" . .
2. TOTAL PERSONAL PROPERTY - SCHEDULE "6"
3. TOTAL TRANSFERS - SCHEDULE "C" . . . .
4. TOTAL JOINTLY OWNED PROPERTY - SCHEDULE "E"
None
None
7,523.60
TOTAL REPORTED PROPERTY
7,523.60
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
TOTAL UNREPORTED PROPERTY
None
TOTAL GROSS ASSETS
7,523.60
LIFE ESTATE OR ANNUITY CALCULATION
I do hereby certily that the above appraisement is made in conformity with Pennsylvania law and has been filed this day
with the Register of Wills.
.ii" , &:,., I J
.PrOfIt)), ttfl1Jt.
APPRAISER
P-
....
'"
1Il
~
0
Eo<
~ -. P::: ~ H <:
~ .. 0
<: > ...
Z l'l ~ .... .. dP
.-/ .-/ to
0 :>- 0 'tl 'tl
'tl <:
I l'l . .... III
'" '" :l':: .-/
~ ::l H H
...l '" '" ..
'" j:j ~
<: Ii! en
- 0 0 en
, U Z <.!l en () .-/ '" III
'- - 0
~
~ -
~ 0 ~ ~ 0
~
~ 0 Z
!-o 0 '" 0
'" l'l en :>- !-o 0
- l'l !-o l'l Z Z
0 Z 0 !-o P::: Z :.: l'l
...l - ~ l'l
...l Z ;:g Z Cl ::l U ~ Z
~ ~ '" ~ 8 0 ~ -
l'l Cl ...l
REY-4'" le-7e)
OFF ICE OF THE
REGISTER OF WILLS
STATEMENT OF DEBTS
AND DEDUCTIONS
DEDUCTIOHS ALLOWED IN
",1/0 lj..O
THE SUM OF S !J\'i"'-:5 ____
D~;~ A\PR,~VE~ (\'(f"'-- J J-/ CJ f11
"--'i,!{f"~l-t<; ~d -j"V<0..
'-.........JREGISTER OF'WILLS, AGENT
'? \J~_
IJ
LATEOF South Middleton Township
OF CUMBp.1H,IINn COUNTY
AND AGENT OF THE COMMONWEAL TH
ESTATE OF OLIVER GRIFFIE
,'1'\
DATE OF FILING APPRAISEMENT \ f'II;' '", ') '4 DATE OF DEATH December 1 1979
, .- . . ,
DATE NO, OF NAME OF PA YEE REMARKS AMOUNT
VOUCHER
R. L. Pittenturf F'uneral Expenses 2,026 20
Belvedere Medical Corn. Statement 9 00
Carlisle Memorials Reserve for Letterina 30 00
Monument
Mt. Victory Cemetery Lot Care 50 00
Adams Electric Statement 65 14
Co-Operative, Inc.
Aero Oil Company Statement 124 06
Reaister of wills F il inq RCC 3 00
Register of Wills Filing Debts & Deductions 3 00
Janice E. Hertzler Notary Public 3 00
Bietsch & Morgenthal Attorney Fee 150 00
TOTAL 2,463 40
COMMONWEAL TH OF PENNSYLVANIA I
COUNTY OF CUMBERLAND 55:
f, Stella R, Richwine, daughter, HEREBY CERTfFY, THAT TO THE BEST OF
MY KNOWLEDGE AND BELfEF, THE FOREGOING IS A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND
EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF Oliver Griffie
DECEASED, AS DEDUCTIONS FOR INHERITANCE TAX FURPOSES.
J' .~ /}
'1:;-" ./ ~
/",///1 ..1. /r.tc4u'--t~u
Stella R. Richw~ne
DAY OF
(L,S.)
SWORN AND SUBSCRIBED BEFORE ME THIS 14th
February ) 19 80.
C7l~ r:. \-4 ~.lu ~ -;-
,I'Jlr" E. HFRT71."R. !':. TI-.:"'Y [1\ 1'-lUC
. C ..-j':i" r).\
rl,.--.hpr!rp"1G r("'nl-v (', ,1,.._, I"
. M,/ Commission Expires January 27, 1933