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HomeMy WebLinkAbout80-00403 No. 21.80 403 PETITION FOR PROBATE OF WILL AND LETTERS TESTAMENTARY in the Estate of JULIA F. GROENE , deceased. Mary C. Lewis To n;"l.uld c. AI,eler!l8j;1, Register of Wills for the County of Cumberland, in the Commonwealth of Pennsylvania. IS Petitioner(s) ata the executQr named in the Last Will and Testament of Julia V. Groene __.__ dated Nov. 20. 1979 Decedent was a citizen of the United States and 0 resident of ~ Borough, Cumberland County, Commonwealth Camo Hill of Pennsylvania. Decedent died on Tuesdav the "lrl day of June A. D. 19~, in the County of Dauphin State of Pennsylvania at the age of 72 years. hose has her Decedent has not been married and has not had children born to Mm since the execution of the above described Will. Decedent was possessed of personal property to the value of and of real estate to the value of l\'j'nnp os near os con be ascertained; said real estate situated os follows ~AAW Therefore, your petitioner(s) respectfully applies for the probate of the said Lost Will and Testament and for Letters Testamentary thereon. Doted June 11. 1980 vd-khrll!.te:,....;.. L Nome and address Elmer A. Groen" I Jr. of Petitioner(s) 4"lR I~mr Post I~ne Camp Hill, Pennsylvania 17011 COMMONWEALTH OF PEt'-lNSYLVANIA t COUNTY OF CUMBERLAND \ ss Elmer A. Groene. Jr. named in above application, being duly sworn according to low say(s) that the statements set forth in this petition ore true to the Sworn to knowledge and belief, i 0 c,-' d~ J /i),'-I c I and subscribed before X (IVn" ,(j/C/;L"t',,-, J, best of his me June 11 19 80 'i;~ .(! ~~ I '1 c. A, ~ ,Register toYo June 17, 1980 Attorney: Wm. J. Madden, Jr. .~ 240 N. 3d St., P. O. Box 877 ~ Harrisburg, Pennsylvania 17108 '" . . ' , . OATH OF SUBSCRIBING WITNESS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND } 85: This ,.............,.................l-1tl'I,................................... day of .............J.une............................................. A, D" 19...8.0. before me ...........~.a.;r;.Y...g.,....~~W.!!L....................................................................... Register for the Probate of Wills and granting letters of Administration in and for said County of Cumberland, in the Commonwealth of Pennsylvania. personally came ...... ..................?y.~Jy.!'!...!h. ..H.'?~.?...e!.!g... w.~ '!'J.~,e!!!....J.. .... Mi!-.g9.~.lh.. ;U;............ ....,.. ......... ............ .................................................................................................................................................................................................. the subscribing witnesses to the foregoing instrument of writing purporting to be the last Will and Testament of ,................................. ..................J.g;J,,;i!,...f..,...~*.9.!?.!'!!L.... .................................... Dated .N9.l!.'?!!l.RgL.;?Q.....12.?~... late of ...................................~mI?...I:I.:j,ll............................................................... Cumbe;land County. Pa.. deceased who being duly ................~~!?!;D...................... according to law, depose and say, that ......t.O!;lY...W-l'1.!::f:...................... present. and saw and heard the testa.:trix......................... ..........J.ulia...F.'......Gx:Q.ene..................................,.......... sign. seal. publish. pronounce and declare the said instrument of writing as and for h.e;r............ Testament and Last Will, and at the time of so doing .......................she................................... was of sound and disposing mind. memory and understanding, to the best of ....................theiI:.............................. knowledge, observation and belief, ....s.wo.rn...to.............................. and subsdbed before < " J, 2 . 7 / \ ........./..:?..L~~..;':: ,',..... ..:. ...~.. ' . ,~f":.1?:~-;:;/..I...................... q . .r~' ......................1 ....m.......................... ................................ , --0.{i(!'~ ....", AFFIDAVIT OF DEATH COMMONWEALTH OF PENNSYLVANIA 1 I "5' r 0.. COUNTY OF CUMBERLAND .............................................................Elmer...A....Graene.,...Jz:............................................................... being duly .................................................. says that as nearly as can be ascertained the said decedent ..J.uJ.i?,...f......~.J;:g.'?!J.~... .................. ....... ...... ....... .................... ................................. ...... ....... ...... ............ .................... ........................ ....... ...... died on .......:t!-!.'?~.g?y............ the ....~.g............................. day of ..........J.~!).~................................................... A, D., 19....~9, at or about ..................if.:..f?'-d.................... o'clock, A M. .......!?!!!?!:.I}...!9.............................., and subscribed this 'II " " j .(}/;~..L(l~h,:r:-:.~~.....,!:...,............m........................... ..................~.~t~.......................... day of ....:!.~.~~,......... 19,..~Q.. before ..........q;lLuy.....r2..,..1~(&.~. OATH OF PERSONAL REPRESENTATIVE COMMONWEALTH OF PENN5YLVANIA~ 55: COUNTY OF CUMBERLAND Before me. the Register for the Probate of Wills and gromting of Letters of Administration in and for the County of Cumberland. personally came .............~~~~.;:..!:!.~...9.;9.~X!~.,..J;.~............................................................. who. being duly ........!!~g.;!.l:.......... do es........ depose and say that as .............Exe.cuto!:.................,.........,............ of the last Will and Testament of .......................J.y.U.?>...f......G.);.Q.~.U!;!......................................................... deceased .................!:\~...............,.... 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. ..~x{9.nl....1;g.......... and subscribed .........,.....J.w1f~...ll.............................. A, D,. l~JL.. @1~JL~------- ....d/~J..(ut...q!?~.J.:.,..,.................".......,...',.. before me. ............................................................................................ "ti 01 to: " 0\ ~ ... " u " Q I.L 0 ra: ...i al: fill =ll:j C'l ....I l5!! -" 0 el: 0 ~ ., ....I s 0 I .: . 0 ra.! - u r-i .'di to - l(i ~ tl 0-4j I ~ 0-4 Hi .5 all N ~\ c:li 0 "'" III ~\ 00 " C'l ~ ." ... I ~ - 0 =II: N u " ~ ~ "'" " ci '" ." "" ~ ~ Z J!l c: ~ ii: '" DECREE Be it remembered that on the ..........1.7.~~...... day of ......................g:~~!!........................... A, D,. 19.~9.... there was probated and recorded the last Will and Testament of ..........~~.1.~.~...~.~....~.r:::~~~~............................................ late of ..........~.~~...~~.1.~............................................................ Cumberland County. Pennsylvania. Deceased, Letters ..,.....................~~~.~~~~.~~ry........... were granted to .................E..~.e.~..~~....~.!:~.~~.!....~.r:::.~................,.............. Witness my hand 3nd official seal the day and year aforesaid... ~ ./..) I '.J .........~J2({Lr.....e....... .. ..e.-0.::....R~~;;;~~:..... , . . , . . , OATH OF SUBSCRIBING WITNESS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND 1 sa: This ....,.......,..............,....1.1:t.h......h..m..m.................. day of .............J.uoe..h......................................... A, D" 19...aO, before me ...........~.~!'y...g....h~~W.~~.....h....h....h............................................h........' Register for the Probate of Wills and granting letters of Administration in and for said County of Cumberland, in the Commonwealth of Pennsylvania, personally came ....m .................!;:v.~Jy.n...ij.'....I:J!?~.!?...~D.9.. .w.P,J.:!-.~m....l..!...M~.gg~D.J...J.E,...................................... .................................................................................................................................................................................................. the subscribing witnesses to the foregoing instrument of writing purporting to be the last Will and Testament of ...........................................h.......J~;J)A..f..,...G.F.Q~.n!?h......................m........h...... Dated .N!?Y!?ID.R!?L?Q......!9.,7.j?.... late of '...h..................h...h....c.?,mp....Hp.J......~.....m...............m..mh..........h.......h... Curnbe;land County, Pa., deceased who being duly ................~~Q.;!?.................h... according to law, depose and say, that ......t.ll~Y...w.e.+:e...................... present, and saw and heard the testa.:trix..........h.......h..., ..........J.uli....hF.......Gx:Q.ene......h..............................h..... sign, seal, publish, pronounce and declare the said instrument of writing as and for h.a;r..m....... Testament and Last Will, and at the time of so doing ............h.........She....................h.....m..... was of sound and disposing mind, memory and understanding, to the best of ..................,:thei..I:............m............... knowledge, observation and belief, ....SWD.rn...tD.......h.............h...... and subscribed before ___q;{lll,4~m Ro,"" AFFIDAVIT OF DEATH COMMONWEALTH OF PENNSYLVANIA I COUNTY OF CUMBERLAND I ss: . .................. ......." ................ .............. ...ElmermA ....G.raene.,...JI: .....m..... ...... ............................. .....,......... being duly I I .I h...........h................................... says that as nearly as can be ascertained the said decedent ..J.u.U.?...f......~};.Qgp..~... h................ h.m................................. .................. .....m.. ............... ...hm..... ......... ...........h. ..m...h............... .................. died on /. .......:+.~.'?~.g!!-.Y............ the ....;?9............................. day of m...m.J~!!!~.......h........................m............... A, D" 19....~9, at or about ..................if..:..~y.................... o'clock, A M, ......h....h....~.~.:1:!'!.......................... day of ....:!.~~~.......... 19,..~9., before ..........ql--1LUf..lL..~ad... 1jJ ;:t;' j C:..~!J1!i lit X'Ci'J... t. ........................................................................................... .......!?V!2F.!.!...!:2.............................. and subscribed this RECAPITULATION Appraised value of Personal Property................................................................,.... $ (\1.,2,al~D.4 Appraised value of real estate .................................,............................................. $ .........,.......,.. Total appraised value ..""...........,........................... ...,. ..,.................. .......... ..,..,.., $ 84y2P..l,.C).1 AFFIDAVIT OF PERSONAL REPRESENTATIVE County of Dauphin ss: ...,.., .",.."..,. ,...",. ,.,.." ,.EllOex...A.... GJ;Q~n.~",. ..lx". ".. "". "" " ,.., """.' ,."., .".", ....... ",.... ".,., ,. Execut or lIJltniu)s:b:llk of the Estate oL..,..........J.\J.J.;i.il...Y.......GX;Q.f,.u~..........................................,.......,.. deceased, being duly................~.w.9.r.r..................................,.... according to law, depose and say that the items appearing in the Inventory inclnde all of the personal assets wherever situate and all of the real estate in the Commonwealth of Pennsylvania of said decedent: that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the decedent's death: and that decedent owned no real estate outside the Commonwealth of Pennsylvania except that which appears iU.,~$:;.~;:~:~~~~:..~.t,,::,;:.~~~tJ~:::dc:~~:dnfl \"ry, ~~..ik},/11t.f:~....J..........,..,............................ hefore me tll1S.."....".....~.~........". ay 0 Executor. AdmMd."MW ::~iI.:~".~-'~:~~ ~i;'...\&."R.Eg,.L~..S.."e.,!'.!.!,....~;. !...\ INSTRUCTIONS ~:~l;:\~';''', 1,' ~'_. / "n ~~;:.;:I 17011 1. An inventory must be filed within three montbs after appointment of panooa1 repreBenta.tlv8. 2. A Bupplemento.l Inventory must be filed wllhln thirty da)'8 ot discovery ot additional assets. a. Additional sheets may be aUached 0.8 to persona.lty or realty. 4. See Article IV. Flduclo.rle8 Act ot 1949. .-:...1 ,.. :: .~. l :;.1:" ~~.. - ~ Ci: ::r :;., .E " t G:\... ~ '" '" ~ .,- , ~ - ~ e 9~~ '" ~ c:i ~ CJ'.- I -~ i .!l m Cl ~ lJ.'.., ~ j III < 0;- c:. ~ < 0::..... ~ Q ~ 0 0-' "" M' c.>'" \1<: rl ~ v ....w ?f~ oS ~ ..c ~ u ",'" ~ w .-E :z: iE !Xl ..J " \Y) c.> ~ .,., ~ ~ ~ 0 ... q .c; ::q 0 " 0> u ~ ~ .. ; ;:Ii Ii " OM :1! '" t<i 0.: '" ~ ~ " ."j H: n;, ~ Q ~ I :e a: q ~ 'r. cl ~\ :z: u ~. :-; < ~ .~ oS ~ ~ ~ u >-i ~ ,: 0 .r. :::--.J .s v u ~ .r. 1 ~ 'O.g .S '- ~l >, 0 I:.. ~ .li to .., " % v 0 ~ ~ 8 '0 ~ ~ i;: 0 ~ ..:! 0 HI2 u Pl ~ <ll .D ! !3 / U / RW..8 -. -. - ~- INVENTORY OF REAL AND PERSONAL ESTATE 3Jn tllr :SIuttrr of l~r flltatr Pf.....,....lUI.IJ\..F....GJLOl':N1.L..,....,............,........,.... . Cumberland . late of ....,J;i}!~J?...I:\JJ;I..............,....,......,..........in the County of Inullhilt, State of Penna., deceased, JUUflltOfU of the real and personal estate which were of the above-named ..,.... ....,..,...............,....... .....,..,. ..,..,......"..,...,......,......,...,.,',..., deceased. Taken and appraised the .................. day of .......................,....19 (Date of death J.W~'i'...2....J,?,?Q,) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. ~~: 75 Shs. U. S. Steel Corp. @ lB.125 45 Shs. Norfolk & \vestern Railway @ 30.6375 4150 5hs. Penn Appliance Dist. @ 17.50 5 Shs. American Hetal Climax, Inc. (now Amax Inc.) @. 45.0625 CCNB Savings Acct. #006-105510-9 Interest to date of death Cash on hand , ~CNB Checking Account #~41_596_5(Reduced to. Household furnishings: ~~~~rOaeR~h1ks.cleanng (a) Living room - 2 sofas, 4 chairs, 2 coffee tables, 2 floor lamps, television set, 4 framed pictures (copies) 650.0 (b) Master bedroom - Icing-sized bed, dressing table, 2 chairs, bureau, 2 night tables 300. O( (c) Second bedroom - 1 bed, 2 chairs, 1 night table, floor lamp, d:esser 200.0 (d) Dinette - 1 dinette table 25.0 (e) Kitchen _ cooking utensils, 1 elec- tric toaster, tableware 100.0 2 German Bibles 1909-1912 1 First Continental Congress Corom. Mcdal postal Service Commemorative medal .5 Silver dollars Following jewelry in safe deposit box, badly tarnished and for most part unserviceable: 1 ladies' gold pocket watch 2 open-face silver watches B small children's rings 1 pair silver rings with 2 blue stones 1 tin soldier 1 Hampden Gold watch and cbain 1 box miscellaneous pins (9) I engraved bracelet I wide gold band 3 sticl, pins 1 pin (red stone) 1 chilin 2 necklaces (costume jewelry) 1 pair earrings 1 silver chain 2 ladies' pins 1 gold ring 3 strings pearls 1 used mink coat '1~s<s'2~btJ1b'1'1"l;'y~(pal clothi.ng 1,359 37 1,380 93 72,625 00 270 37 4,345 92 35 06 30 00 2,003 39 1,275 00 1 00 20 00 20 00 65 00 40 00 40 00 40 00 50 00 1 00 75 00 50 00 30 00 75 00 3 00 00 00 00 00 00 00 00 00 00 ~,\t RR " GENERAL INHERITANCE TAX INFORMATION , Unsatisfied liabilities incurred by the decedent prior to his/her death are deductible against his/her taxable estate. In addition to debts incurred by the decedent or estate, other items are claimable including the cast of administratian, a"arney fees, liduciory fees, funeral and burial expenses including the cost of a buriollot, tombstone or grave marker and ather related burial expenses. All debts being c10imed against an estate Ole subject to the approval of the Register of Wills with whom the Inheritance Tax Return is filed. Evidence.lo support the decedent's or the estate's liobility for the debts being claimed should be a"ached to this schedule. A family exemption may be claimed by a spouse of a decedent who died domiciled in Pennsylvania. If there is no spouse, or if the spouse hos forfeited his/her rights, then any child of the decedent who is a member of the same household can claim the exemption. In the event there is no such spouse or child, the exemption can be claimed by a parent or parents who are members of the same household as the decedent. The family exemption is allowable only against assets which pass by a will or by the Pennsylvania Intestate Laws. NOTE: Campensation paid to an estate representative; nomely, an executor or administrator, for services performed in administering an estate is reportable for Pennsylvania Income Tax purposes. This taxable income item should be reported on farm PA-40-lndividuallncome Tax Return. t"" "C ti n E; t>1 ~ !l - ~ 0 0 tr> Z Cl n ~ I:) ~ z :: z b t>1 t'1 :>:: ::z;I 9 - 9 z Z t>1 ..., t'1 Z 9 ..., -< Vl t'1 - P tr> Z 0 Vl 0 ..., P ." ." ~ ~ - 0 Z -< -< t'1 t'1 ~ ~ ::z;I ;>:l INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1 U +1..... t..._:I.. _..-. .,,' , , . , . I. ,. , " ~ . " GENERAL INHERITANCE TAX INFDRMATION . Unsatislied liabilities incurred by the decedent prior to his/her death ore deductible against his/her taxable estate. In addition 10 debts incurred by the decedent or estate, other items are claimable including the cost 01 administration, attorney lees, liduciary lees, luneral and burial expenses including the cost 01 a burial lot, tombstone or grove marker and other related burial expenses. All debts being claimed against an estate ale subject to the approval of the Register of Wills with whom the Inheritance Tax Return is liled. Evidenceto support the decedent's or the estate's liability lor the debts being claimed should be attached to this schedule. A lamily exemption may be claimed by 0 spouse 01 0 decedent who died domiciled in Pennsylvania. If there is no spouse, or if the spouse has lorleited his/her lights, then ony child 01 the decedent who is a member of the same household con claim the exemption. In the event there is no such spouse or child, the exemption can be claimed by o parent or parents who ore members 01 the same household as the decedent. The lamily exemption is allowable only against assets which poss by 0 will or by the Pennsylvania Intestate Lows. NOTE: Compensation paid to an estate representative; namely, an executor or administrator, lor services perlormed in administering on estate is reportable lor Pennsylvania Income Tax purposes. This taxable income item should be reported on lorm PA.40.lndividuallncome Tax Return. r"' "" 0 (") ~ tr1 ~ ;S - ;l> 0 0 en Z C) (") C 0 ~ z ::: z ~ tr1 !=l !=l tr1 ~ Z ~ ..., ~ Z Z tr1 ..., ttl Z !=l ..., -< tr1 ~ !=l en en Z 0 en 0 ..., 0 "r1 ()f-' "r1 ~ III 0 -' S III ~ '0 0 ,:'t 0 Z ~ : -' ~. ::'.' :J:n '.' :a: .' ;:;.u. 'il 1-" rt . . I. . :.~ I:'. () f-'O l. ~ . c' ~~ ~ f-'o' C":-~ I . f1) ull.d (~l. 0' Ii o. C::(i;: t::tt-- O. OlJ (0 '1:1 1)';''-"'; "'" ~Q~ Ii f1) tI O~-. u'" .~.,~ f-' ::l Ii ","J 0":- \lI ::l 1-" ~ L~18 ",'" fO -' ::l III < -< -< u 0- . f1) t'] ttl ~ ;l> f-';J> ~ -.l Ort f-'. f-' W INSTRUCTIONS FOR COMPLETING SCHEDULE "F" 1. If the lamily exemption is being claimed, indicate the claimant's nome, address and his/her relationship to the decedent. Enter "Iamily exemption" in the remarks column and the amount claimed in the amount column. 2. Assign consecutive numhers to each item listed. 3. Enter the dote on which each debt was incurred and/or paid. 4. Enter the names 01 each payee. 5. Provide 0 brief explanation i" the ren,arks column lor each debt claimed. 6. Enter the amount 01 each debt being claimed. 7. The lorm must be signed by the person who has assumed the responsibility lor paying the debts. IF ADDITIONAL SPACE IS NECESSARY USE 8Yz" x 11" SHEETS. -- ,-I' I .1' _;:~ -- ~~ - -~ ~ - - -- ,....,. - . ~- I ~I' IIBUK ...,' '.' . \ I ):~,qi\:',<:\/" . COMMONWEALTH OF PENNSYLVANIA 4 '&KO'O'< '059'. ' DEPARTMENT OF REVENUE . I 6,:/ . ..; , "'OFFICIAL RECEIPT' PENNSYLVANIA INHERITANCE AND ESTATE TAX \ I ' , ;II , " I " I It i = U tl~.'RFREOCEMIVEO w11lillm J. IIIldden, Jr., Blq. " .llllilr A. TAXAT_% ADDRESS ,. O. lOx 877 TAX AT 6% TAXAT1S% ESTATE TAX aarrilbur PA 17108 TOTAL TAX CREDIT '7.500.00 '--ESTATEINFORMAT~iI:-------------------------- DATE OF DEATH FILE NUMBER - LESS DISCOUNT - PLUS__ % INTEREST (FROM TO_I DATE OF PAYMENT 11 2 1981 m m TOTAL AMOUNT PAID *7.SOll.00 NAME OF DECEDENT COUNTY cumberland ..------------------------------------..------ POSTMARK DATE REMARKS: .PAll) ON ACCOUNT" RECEIVED BY / SEAL I I',. I REGISTER OF WILLS \ L____---------------------------.- r-.-.--.----.--------.------------------ , I L .__w."I& __ .,......._- -- ""-"'- -- ..........------ ,..."....,.. .......... _:IIi If 11. REV.,'{02P< ,,::~ , '.' .~H1t;if'~..,:~;;,:t;,::>:' , ., . COMMONWEALTH OF PENNSYLVANIA . 4 ''No,II)1;<:SI803i,'" DEPARTMENT OF REVENUE , '<}~.,.:.".\l' . .', OF'FICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX I"."'Y.. . " .. , 'II " II i a. .1 ~ I; ~. RECEIVED . ,j FROM .r. ,-,\ADDRESS Harrisburq, Pa. 17108 - TAX AT 6% Elmer A. Groene, Jr. 010 William J. Madden Jr. TAX AT 15% TAXAT_% 248 N. 3rd St. P.O. Box 877 ESTATE TAX TOTAL TAX CREDIT 391.48 F!L~.N!JMBER NAME OF DECEDENT Julia F. Groene m - -------- m LESS DISCOUNT PLUS % INT!;REST (FROM 4-2-82 Tlf2-:nj81 (.0451 - 17.98 DATE OF PAYMENT DeoeMber 22, 19B1 COUNTY Cumberland TOTAL AMOUNT PAID 409.46 POSTMARY. OA TE REMARKS: ~ PAID IN FULL SEAL RECEIVED BY t REGISTER OF WILLS :1 L...... - ~- -- '---- - - ---'- - ---- -----------".- 1 , 1 I .( j I I 'i I , I I I I J " ., j I COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF EXAMINATION ..-/ OFFICIAL NOTICE OF INHERITANCE TAX ASSESSMENT * COUNTY FILE NO: ~. ..;/1 ':;/J _ 4~1 ;;) (-1/ _ ( /) I I '" DATE . "." .e-' "I>?/ ~~ - ,.'~-' , '-" ---c_ / i ,~ I ~ ESTATE I ,:' I;;: A ~ 11; j:..--t; .-1-':' "LIZ-- /t"'r......... V .'/ ,;'1, ..--... FILE NO. /' -/ 1_ ..,j _ .II/1~ :/ I. / '__ TO: .~~ ~/;;f/b e:;,~" ~:/'~./:! ~ ::!1,;;d({.~.#I>:~/ ;'~17' J .-.. ""'.:" / J /'6' L ',< 'n.,' - ',/./' ~. il' 1 ';j;~'.'. I,. --..., .... ,. . :01.. '1/1' ,ro', /"'//....1::.7 . . t.. "VI ~,.- 'U~.. COUNTY .(;>( ~ ;'J" ,J!.~ -~ t.~ ~ .,' ~f Appraised Value of Estate; Real Estate DATE OF DEATH '" . L -;"-- , ~ - q /4 ({I -./ I I; Personal Property $ + '/1/3// tf .. . I + ,~- ;// ,,)/)/ '1'1 I . "w . $ /,;;.:? ,j-;:'/} ':/ / _.- / . Jointly Held PropertylTransfers Total Gross Estate Total Approved Deductions '-/ '> 1,( {I 2" ~ _ . . , w $ .I -;.{A .??117 ~13 " Clear Value of Estate Less: Approved Charitable Exemptions Clear Value of Estate Subject to Tax $ IX. -;>,<" //'5 / Amount Taxablo @ 6% Rate 'j'. $.<./) "'/,',// /~../':I /. ,f ", ._ tax due $, '/ -;"'~I.-;- ~) .2':; ---r'/.., _ Amount Taxable @ 15% Rate tax due ,~~..., . l-7h." ****** TOTAL PENNSYLVANIA INHERITANCE TAX DUE y}~',j;;:~d':: ;)}<rm ',//)vcc:/... '31 /)?I A five percent discount totaling $;:; Inheritance Tax is paid by 7':1., td!.j /!!j . , I $ '7x' Ie;- ';J '.. -~ / ~:2 // '} -ii' / "..... . AMOUNT PAID OISCOUNT INTEREST TAX CREDIT $ '7/;(.'iJ ,i,1i + $ $ = $ ~?J~,11. ,....-11 1 I + = + = I) ,/6/' ,/ (., 7 / 3?-;2(,. jig' will be granted if the Less Credits: DATE OF PAYMENT Interest accrues at the rate of six (6) percent per annum on the unpaid balance of Inheritance Tax from to date of payment. Interest due if paid bV is BALANCE OF PENNSYLVANIA INHERITANCE TAX DUE $ :;:;,Jlj,y INFORMATION To insure proper credit to your account, tho name of the estate and file number should be clearly print- od on the check or money order, This assessment is made in accordance with Section 708 of tho Inheritance and Estate Tox Act of 1961 (72 P.S. S 2485.7081. To the extent that inheritance tax is paid within three (31 months after the death of the decedent. a discount of five (5) percent is ollowed 172 P.S. S 2485- 716). Inheritance Tax. other than tax on a future interest, is due at the date of the decedent's death end becomes delinquent at tho expiration of nine 191 months after the decedent's death (72 P.S. S 2485.711). Inhoritance Tax on a future interest is payable within three (3) months after the transfer takes effect in possession and enjoyment and is delinquent there alter 172 P.S. S 2485.712). Colculato interest from tho dolinquent doto shown on the face of this form to the date of actual payment using the fOllowing interest table: -------..---- --------- ---------- -- - ------------- - - --- - --- -------- -- -- -- - -- -- , month .005 4 months .020 7 months .035 10 months .050 2 months .010 5 months .025 8 months .040 11 months .055 3 months .015 6 months .030 9 months .045 12 months .060 1 days .00017 11 days .00186 21 days .00352 2 days .00034 12 days .00203 22 days .00369 3 deys .00051 13 days .oono 23 days .00386 4 days .00068 14 days .00237 24 days .00403 5 days .00085 15 days .00250 25 days .00420 6 days .00101 16 days .00267 26 days .00437 7 days .00118 17 days .00284 27 days .00454 8 days .00135 18 days .00301 28 days .00471 9 days .00152 19 days .00318 29 days .00488 10 doys .00169 20 days .00335 30 days .00500 -------------------- - ---- - - - - ---- -- - - ---- --- --_._---- --- --------- -----.. Any party in interest. including the Commonwealth and the personal representative, not satisfied with the assessment may object thereto within sixty (601 days after receipt of this Notice as provided by Section 1001 of the Inheritanco and Estaw T3x Act of 1961 (72 P.S. S 2485-100 t). Make check or money order payable to: "Register of Wills, Agent" Mail to the address listed below: INFORMATION To insui6 prOpGi credit to your account, the namo of Iho estate nnd file number should be clearly print. ed on the check or money order. This assessment is made in accordance with Section 70B of the Inheritance and Estate Tax Act of 1961 172 P.S. 9 24B5-70BI. To the extent that inheritance tax is paid within three (3) months alter the death of the decedent, a discount of five (51 percent is olloVlod (72 P.S. 9 24B5-716). Inheritance Tax. other than tax on a future interest, is due at the date of the decedent's death and becomes delinquent al the expiration of nine (9) months after the decedent's death (72 P.S. S 2485.711). Inheritance Tax on a future interest is payable within three (3) months after the transfer takes effect in possession and enjoyment and is delinquent thereafter (72 P.S. 9 2485.712), Calculate interest from the delinquent date shown on the face of this form to the date of actual payment using the following interest table: ------------------------------- ---------------- - - .~------ -------- -- -- -- - ---- 1 month .005 4 months .Q20 7 months .035 10 months .050 2 months .Q10 5 months .025 B months .040 11 months .055 3 months .015 6 months .030 9 months .045 12 months .060 1 days .00017 11 days .00186 21 days .00352 2 deys .00034 12 days .00203 22 days .00369 3 deys .00051 13 days .00220 23 days .00386 4 days .0006B 14 days .00237 24 deys .00403 5 days .00085 15 days .00250 25 days .00420 6 days .00101 16 days .00267 26 days .00437 7 days .00118 1 7 days .002B4 27 days .00454 B days .00135 18 days .00301 28 days .00471 9 days .00152 19 days .00318 29 days .00488 10 days .00169 20 days .00335 30 days .00500 -- - ------------------ --- - -- - -- --- --- -- --- -- - --- ----- - - - --------- --- --- Any party in interest, including the Commonwealth and the personal representative, not satisfied with the assessment may object thereto within sixty (60l days after receipt of this Notice as provided by Section 1001 of the Inheritance and Estate Tax Act of 1961 (72 P.S. S 2465.1(01). Make check or money order payable to: "Register of Wills. Agent" Mail to the address listed below: PENNSYLVA.NIA INHERITANCE TAX GENERAL INFORMATION L PERSONS RESPONSIBLE FOR RETURN Section 701 of the Inheritance and Estate Tax Act of 1961 provides that tile following persons shall prepare and file a return: > ' a. The personal representative of the estate of the decedent as to property of the decedent administered by him and such additional property which is Dr may be subject to Inheritance Tax of which he/she shall have or acqui re knDwledge; b. The transferee of property upon the transfer of which Inheritance Tax is or may be imposed by the 1961 Statute, including a trustee of property transferred in trtlst, provided that no separate return need be made by the transferee of property included in the return of a personal representative. 2. PLACE FOR FILING The return is to be filed in duplicate with the Register of Wills of the county wherein the decedent resided, 3. TIME FOR FILING The return is due nine months after the decedent's death, unless an extension for filing has been applied for and granteu by the Secretary of Revenue within the nine-month period. 4, FAILURE TO FILE RETURN S~ction 791:of the 1961 Statute provides that" . . .any person who willfully fails to file a return or other report required of him. . .shall be personally liable, , ,to a penalty of 25% of the tax ultimately found to be due or $1,000 whichever is the lesser to be recovered by the Department of Revenue as debts of like amount are recoverable by law." 5. TAX RATES Inheritance Tax is payable at the late of 6% on transfers to lineal descendants, such as father, mDther, husband, wife, son, daughter, grandchildren, grandparent, son-in-law and daughter-in-law and at the rate of 15% as to all others, G..PAYMENT OF TAX The tax assessed on the transfer of property reported in the return is due 9 months after the decedent's death. Interest at the rate of G% per annum accrues thereafter until payment is made. All payments received are first applied to any interest which may be due with any remainder applied to the tax, IF TAX IS PAtD WITHIN 3 MONTHS A.FTER THE DECEDENT'S DEATH, A. DISCOUNT OF 5% OF THE TAX PA.YMENT IS ALLOWED. All checks should be made payable to the Register Df Wills of the county wherein the decedent resided and are received subject to the final determination of the Department of Revenue, 7. FAILURE TO PAY The taxes imposed, together with any interest thereon, are a lien upon real property, which lien remains in effect until the taxes and interest have been paid in full. The taxes may be sued for against any real property in the decedent's estate or against any property belonging tD a transferee liable fOI the tax. a. FILlNGOF FALSE RETURN Any person who willfully makes a false return or report required of him shall, in accordance with Section 793 of the 1961 Statute, be guilty of a misdemeanor and, on conviction thereof, shall be sentenced to pay a fine not exceeding $1,000 or undergo imprisnnment not exceeding one year or both. SCHEDULE "B" PERSONAL PROPERTY RFY."!JII.^1{~.~'(')' COMMONWEAL TH OF PENNSYLVANIA . DEPARTMENT OF REVENUE TRANSFER INHERITANCE TAX RESIDENT DECEDENT 75 Shs. U. S. Steel Corp. r1 lfl.12S 45 Shs. Norfolk & Western Railway i1 30.6[\ 5 4150 Shs. Penn i\ppliance Dist. Ii 17.50 6 Shs. American N<~tal Climax, Inc. (noVl Amax Inc.) t2 45.0625 CCNB Savings Acct. #006-105510-9 Interest to date of death Cash on hand CCNB Checking l\ccount #~141-596-5 Household furnishings: (a) Living room - 2 sofas, 4 chairs, 2 coffee tables, 2 floor lamps, tele- vision set, 4 framed pictures (copie )650.00 (b) Master bedroom - king-sized bed, dressing table, 2 chairs, bureau, 2 night tables (c) Second bedroom - 1 bed, 2 chairs, 1 night table, floor lamp, dresser (d) Dinette - 1 dinette table (e) Kitchen - cooking utensils, 1 elec- tric toaster, tableware 2 German Bibles 1909-1912 1 "irs'~ continental Congress Comm. Ivledal postal Service Commemorative medal 5 Silver Dollars Following newelry in safe deposit box, bac- ly tarnished and for most part unservice able: 1 ladies' gold pocket watch 2 open-fa.ce silver watches 8 small children's rings 1 pair silver rings with 2 blue stones 1 tin soldier 1 Hampden Gold watch and chain 1 box miscellaneous pins (9) 1 engraved bracelet 1 wide gold ba.nd 3 stick pins 1 pin (red stone) 1 chain 2 necklaces (costume jewelry) 1 pair earrings 1 silver chain 2 ladies I pins 1 gold ring 3 strings pea.l:ls Estate of ITEM NO. 1. 2. ., .-" 4. 5. 6. 7. 8. 13. 14. 15. 16. 17. 18. 119. ; \ 20. '\ 21. 1 22. 1 23. I 24. , 1 25. I' 26. 27. I( 28. I I 29. 30. (Instructions on Reverso Sido) .JuliC\ Ii'. Gror'np DESCRIPTIOH If odditiona\ spoce is necessary. use 8'2" x 11" sheets. UNIT YALUE 300.00 200.00 25.00 100.00 TOTAL *, .- ESTIMATED MARK ET YALUE DEPARTMENT VALUATIOH [OFFICIAL USE ONL YI 1,359.37 1,380.93 72,625.00 270.37 4,345.92 35.06 30.00 2,003.39 1,275.00 1.00 20.00 20.00 65.00 40.00 40.00 40.00 50.00 l.00 75.00 50.00 30.00 75.00 3.00 10.00 10.00 l.00 5.00 10.00 10.00 40.00 10.00 QUESTIONS CONCERNING PROPERTY TRANSFERS L Did decedent, within two years of death, make any transfer of any material part of his estate without receiving valuable and adequate consideration? (Answer "Ves" or "No",) 2, Did decedent, within two years of death, transfer property from himself/ herself to himself/herself and another party or parties (including a spouse) in joint ownership? (Answer "Ves" or "No",) _ 3. If the answer to one or two above is "Ves" and the transfers are claimed to be nontaxable, provide the following information: a. Age of decedent at time of transfer, b. Copy of death certificate, c. Affidavit by the attending physician indicating the state of decedent's health at time of transfer. d. All oUler information supporting nontaxability of transfer. 4. Did decedent, in his/her lifetime, make any transfer of property without receiving a valuable or adequate consideration therefor which was to take effect in possession or enjoyment at or after his/her death? (Answer "Ves" or "No".) a. Was there any possibility that the property transferred might return to transferor or his/her estate or be subject to his/her power of disposition? (Answer "Ves" or "No".) b. What was the transferee's age at time of decedent's death? 5. Di~ decedent in his/her lifetime make any transfer without receiving a valuable and adequate consideration therefor under which transferor expressly or impliedly reserves for his/her life or any period which does in fact end before his/her death: a. The possession or enjoyment of or the right to income from the property transferred? (Answer "Ves" or "No".) - . b. The right to designate the persons who shall possess or enjoy the property transferred or income therefrom? (Answer "Ves" or "No".) 6. If the answer to five b, above is "Ves," was the right reserved in decedent alone ( ) or decedent and others ( ), 7. Did decedent in his/her lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the benefit or care of transferor? (Answer "Ves" or "No".) 8. Did decedent, at any time, transfer property, the b61eficial enjoyment of which was subject to change, because of a reserved power to alter, amend, or revoke, or which could revert to decedent under terms of transfer or by operation of law? (Answer "Yes" or "No".) 9. If the answer to eight above is "Ves," was the power to alter, amend or revoke the interest of the beneficiary reserved in the decedent alone ( ) or decedent and others ( ), INSTRUCTIONS FOR SCHEDULE "D" 1. List full names and addresses of all who have ail interest in the estate either vested, contingant or other interest, 2. Indicate the beneficiary's relationship to the decedent, Specify if stepchildren or illegitimate children are involved. 3. Indicate "Yes" or "No" if the beneficiary survived the decedent. 4. Indicate the date of birth of the beneficiary if the interest is a life interest, term certain interest or a future interest, 5. Indicate the interest of the beneficiary in the decedent's estate. For example: Specific bequests of a diamond ring, savings bonds or cash of $5,000; bequest of 25% of residue; remainder interest; etc. 6. At the bottom of Schedule "D" state those beneficiaries who are not living at the time the return is being filed and include date of death, INSTRUCTIONS FOR COMPLETING SCHEDULE "E" Schedule "E" must include all property, real and personal, owned by the decedent jointly with another party or parties as joint tenants with right of survivorship. 80th tangible and intangible property are to be included. List real estate first. 1. Describe all real property as indicated in the instructions for Schedule "A," Describe all personal property as indicated in the instructions for Schedule "8," Include the name, address and relationship to the decedent of the co.owner[s] and the date the joint ownership was established, 2, Indicate the total market value of the jointly owned property. 3, I ndicate the percentage of the decedent's interest. 4, Indicate the market value of the decedent's interest. t"' "tl tl n l; t'l > :;; Z >- 0 0 Vl tl - C1 n e tl >-l Z s:: Z t"' t'l m > ~ ~ t'" ~ Z :>:l - Z Z t'l >-l m >-l Z ~ ~ >-l ><: Vl t'l - Vl Z 0 Vl 0 >-l 0 ." ." ~ ~ - 0 Z ><: -< m trl ~ ~ INSTRUCTIONS FOR COMPLETING SCHEDULE "E" Schedule "E" must include 01\ property, real and personal, owned by the decedent jointly with another party or parties as joint tenants with right of survivorship, Botil tangible and intangible property are to be included, List real estate first. 1. Describe al\ real proper tv as indicated in tile instructions for Schedule "A." Describe al\ personal property as indicated in the instructions for Schedule "B," Include the name, address and relationship to the decedent of the co.owner[sl and the date tile joint ownership was established, 2, Indicate the total market value of the jointly owned property, 3. 1 ndicate the percentage of the decedent's interest. 4. Indicate the market value of the decedent's interest, .- '" tl (") ~ t'1 ~ :;; Z :>- 0 0 en - C'l (") c: 0 ..., z 3: z ~ t'1 t'1 ~ Z ;xl :>- 9 ~ 9 z Z t'1 ..., t'1 ..., z 9 9 ..., -< en t'1 - Z 0 en 0 ~ 9 'T1 'T1 ;xl ~ - 0 Z ><: t'1 :>- ;xl -< t'1 ~ ACCRUED INT $349.46 CCNB. Acct. No. 128930, decedent or Elmer A. Groene or $25,342.63 sidney L. Groene $349.46 " Acct. 128929. decedent. or Roc",ld \~. Groene 25,342.63 $ 2;B2 " Acct. 15220, Decedent or Karen L. Groene 2,000.00 $ 2.B2 " 11 15221, " " Julia Kate Groene 2,000.00. $ 2.B2 " 11 15222 II 11 susan Ann Groene 2,000.00 $ 1.41 11 11 15223 II " Louis Hagee Groene 1,000.00 $ 2.B2 11 " 15226 " 11 Debra Lynn Groene 2,000.00 $ 2.B2 " 11 15225 " 11 Jeffrey S. Groene . 2,000.00 $ 1.41 11 11 15224 " " Steve Hagee Groene 1,000.00 $ 2.B2. 11 " 15218 " " Ronald William Groene 2,000.00 ! $ 2.B2 " 11 15219 " " Dennis Groene Lavercomber 2,000.00 AS. OF JUNE 3,1980 Acct. NO DT OP Related Party Balance Int. CD6199304907 8-27-76 Ronald W Croene (Son) $6,500.00 $9.16 CD6199203418 8-30-74 Ronald W Groene (Son) 2,000.00 $1. 66 CD6199203302 8-30-74 Ronald W Groene (Son) $10,000.00 $8.32 CD6199203507 8-30-74 Ronald W Groene (Son) $1,500.00 $1. 25 CD6199203604 8-30-74 Elmer A Groene Jr. (Son) $1,500.00 $1. 25 CD61.99098908 8-5-74 Elmer A Groene Jr. (Son) $10,000.00 $58.56 CD6199099009 8-5-74 Elmer A Groene Jr. (Son) $1,000.00 $4.83 CD6199099l06 8-5-74 Elmer A Groene Jr. (Son) $1,000.00 $51.79 'tl Q) " g ,... ..... 8- " " " '" '" 0 ,... ,... ,... ,... ,... " " " <'l ..... ..... ..... ..... ..... ,... ,... ,... ..... Q) 0 0 0 ,... ,... ..... ..... ..... CO ., <'l <'l <'l N N lI'l lI'l lI'l '" ..... ..... ..... ..... ..... ..... ..... ..... 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BnCKI,EY Be MAJ)D]~N ATTOIfNBVH AT LAW PAYNR SIIOnMAKIIH !JIIJI.nINu ~40 NORTJ! TIIIHU STROUT PONT OPI"Jell nox UT' lIARRIRDUHO. P"NNRYINANIA 17106 AUDA CODti 717 TBLHPUONB 800-1601 PILU NO. January 25, 1982 Re; Estate of Julia F. Groene " cC t-~::~ ;offl C"__p N :--:.';;,; :.~n \~ " '- -'_0 r, '(') ~~ '.";.0 .... -. -:":J ~''':1 "", " N .., ,:;j !., 0, , '-'1 'C , ~ Mrs. Mary C. Lewis, Register of Wills, Cumberland county, Cumberland County Court House, Carlisle, PA 17013 Dear Mrs. Lewis; I am attaching a copy of a letter which I received from the Internal Revenue Service requiring proof of the pay- ment by the Estate of Julia F. Groene of the Pennsylvania in- heritance tax. I am also enclosing a copy of your official receipts. I would appreciate your indicating thereon, over your seal, that the information thereon is correct and re- turning them to me. Thank you for your cooperation. WJM;EH Yours very truiy, ,-' ) X ~.c.-,,- r' ."-' {(/ "'j' C~'t>'(-'...?~ ,/ Willi~~d. Madden, Jr. '" ./ I',. ....' Internal Revenue Service District Director Department of the Treasury l> 18b~24~9572V2352b824 JULIA F GROENE ESTATE ELMER A GROENE JR 8117 438 LA~'P POST LANE' CAMP HILL. PA 17011 800b Estato of: Julia F. Groene Date 0' Oe.th: June 3, 1980 Parson to Contact: CSB:R&C Contact relephone Number: '" ,- ("j,,, S:IJ ~t;~': ;rl,_.., (:'.~i cC N ",'" ","" ",'" ...0 ,~" :.IJ 1:2 ..' , ....... ," Oato: January 13, 1982 '-- ~F ;... , ;';:.:;: ;::1::. ("") '; ',J," N 0\ 1: -: ,.) 'At the end of this letter we have shown the amount of gross Federal tax for the estate named above, 'Seotions 2011 and 2014 of the Internal Revenue Code allow credit against the Federal. estate tax for certain state and foreign death taxes if the Internal Revenue Service has evidence that these taxes have been paid. Before we can allow the amount of the credit shown, we will need the information identified opposite the boxes checked: ~A certificate from the proper officer of the taxing State, territory, possession of the United States, or the District of Columbia showing the total amount of tax imposed (before adding interest and penal ties and before allowing discount); the amount of any discount allowed; the amount of any penalties and interest imposed or charged; the total amount actually paid in cash, and the date or dates of payment. If the amount of such taxes has been redetermined, the amount finally determined should be stated. OR ~XXCopies of receipts or canceled checks showing payment, by reason of the above decedent's death, of State death taxes equal to or in excess of the allowable credit shown at the end of this letter. o A completed Form 706CE, Certification of Payment of Foreign Death Tax, certified for you by the applicable foreign tax authority or, if the authority will not certify the form, please furnish us a completed Form 706CE with the documents listed in its instructions, o 600 Arch 51.. Philadelphia, Pa, 19106 Letter 628 (DOl (7.77) :~~~~~jfl~G~i~~~i~;~~~\llllt\~l:~~!~;~1~::~~~7~~~~;~::\;\qf~:~~;\~]:\::.~:I~;::;:i,~N:r1lli~i:~;;;;:~;~ij;~\;j;';":~~~tl~.1~\ill~\~;g~~;~:r:.\~W~1~\\\;\. ., ., . .. Itrill. , '..." .~I '.'~' ~!r. . .~: : ~ Please sond this within the next few days or. if that is not possible. let us know when we can expeot it. We will mail you the closing letter for the estate after we receive this credit evidence. If you have any questions. please contact the person whose name and telephone number are shown on the front of this letter. Thank yoU for your cooperation, ,~ . Sincerely yours. .:. ;t:' ~;: District Director n r' "r1 ~::::) iT: ::;~ .~.: ':.~' I"::":: cC ",,"" N r~r>1 m""' '- '~MO VI:;:) :~ ~..la ::!' " J.I"\ N ~ ":;J .;]\ .,~ .;. .~ _.~. ~~"!:">- ..-..;:..... :..~'. :j . ,.,,;' .,. .' :- ::'1"- 'u __ '1 $.,$6 ,547 _ OCL S ~.J..,.19l3..;JlCL S _..:.0,,-- S --1..-79a.,OJl.. s . ':~ Gross estate tax, Credit allowable. Credit substantiated. State death tax credit to be substantiated. Foreign death tax credit to be substantiated. \ \ II! H ... I " I 'II \ , I , I I \, I I I , I ..' ., .' , .1 :~..l ; .~ ., !l Letter G28 (001 (7.771 :....~...,..!,.:~..~-:".::',.;..~:.i'.wr.',.~...~.;'.:.'.::.:._:.::..".'~~'."'.:.'::',~,,-~',,"'::"~~.,'..,;'..,:.:....~...~:,~..,.:..,..~,4.:::;.,:-..',..'~:....~~.::';....::..,....:::.,',.,~.:',...:,..~.,.._.,;~:'.:..~......:.~..:...I.'::_...:....,~.,..:.~.'.,:,:~....,.~..'.....~:..i.:.....;:".~L..:...;..,..'.._:,:;..:,.....:..,.:....,..:..:.::,:.,:.,.:,.'.. ." 110. ~.. -.' I ,... I' t. 1 ./.1 ..1.... .tt .1' .. c. ...I.....i . ....~.... .. , . .. ',_ .:>,;V;::;i:;;;';c~.;: ';i::l~t:~~!'i,}~,tl::;~:::~~~t::!'tf;;~;::' or' ,....'. MARY C. LEWIS Register 01 Will, & Clerk of tho Orphsn,' Cou,1 JERRY R. DUFFIE, ESQ. Solicitor OFFICES OF lRegister uf lliUs anll (!tltrk of tlte Ql)rp~ans' aruurt ClLountv of ClLumberlunll COURTHOUSE. CARLISLE. PA 17013 Date: January 26. 1982 MEMO TO: william J. Madden. Jr.. Esq" I am writing in responae to your letter dated Janpary 25, 1982. I am enclosing copies of the bank deposit slips and copies of the monthly report sent to the state. They both verify the payments of $7.500.00 and ~409.46 for the estate of Julia F. Groene. The seal is on the Tax Receipt and a typewritten note verifying proof of payment. I am sorry you have been inconvenienced. 5 incerely. C/J1~r{2,~ Mary C. Lewis ' Register Of wills .' --- .;-.-:,r~~......-mr~_.~~:' I , f 0 0 i 0 0 , . . I ~I 0 . 0 I III ~ . I " ~ I' , x >- l- I- a <( 6 Z CI) <i: w ::J ~ t ~ I- 0: W a.. u 0 a: I w x I- .jJ ,I- '" U W 0 z ! '<( >- CI) I- ,- I- -' Z ::J en ~ 0 0 ri w 0 V> o~ :;:: f <I: Cl >- V> II w <( 2 z -' ~ <( -l 0 <I: ~ 'tl U > w ~ ~ (1) Q) ...I (,) 0 'tl ~ ! >- 2, -'0 ~ (1) 0.. 0: I- O'tl~ J CIlUJ ~ ~ U c:: 2" (1) III III 2ffi a: ;/I o' J< x ~ 0. w '" "' I ~ U1~.jJ w> :r: ~ >- a..~ z ~ >- ~ w ~IllU~ CD w~ '" >- 0 >-, u.... x x ~ ~ .a ~~ w <( I 00 ~ G rn > 0., '" ~ V> .jJ.jJ ~ , ill x l- I- I- W <(' ::t:ffi Z C::fdO~ u 1-< <( w ul'!; 0: ,( 1-:;; > . 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J COMMONWEALTH OF PENNSYLVANIA OEPARTMENT OF nEVENUE BUREAU OF EXAMINATION p, 0, BOX B327 HARRISBURG, PA 17105 NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN ACN 201 DATE05-19-86 ESTATE OF GROENE JULIA f FILE NUMBER 21 80-0403 DATE OF DEATH 06-03-80 COUNTY CUMBERLAND NOTE: TO INSURE PROPER CREDIT TO YDUR ACCOUNT.SUBMIT THE UPPER PORTION OF THIS NOTICE WITH YOUR TAX PAYMENT TD THE REGISTER OF WILLS OF THE ABOVE COUNTY, MAKE CHECKS PAYABLE TO "REGISTER OF WILLS, AGENT," II lLLlA/4 J MADDEN JI\ PLEASE RETURN THIS 240 N 3RO ST ~~rm~~Mit~m~s~ PO BOX 877 AMOUNT REMITTEa HARRISBURG 17108 S ~~!~~~~y~!~~~~______!~~T~~~E~~!~~~~!2R-~~~~~~~~~---------------------- :;.< NOTICE OF DETERMINATION AND ASSESSMENT OF PENNSYLVANIA ESTATE TAX BASED ON FEDERAL ESTATE TAX RETURN ESTATE OF GROENE JU1.IA F FILE 21 80-0403 ACN201 DATE05-19-86 NUMBER ESTATE TAX DETERMINATION AND ASSESSMENT 1, Credit For State Death Taxes as Verified 1, 1.798.00 2. Pennsylvania Inheritance Tax Asses!:ed 2, 7.852.22 (Excluding Discount and/or Interest) 3, Inheritance Tax Assessed by Other States or Territories of the United States 3, .00 (Excluding Discount and/or Interest) 4, Total Inheritance Tax Assessed 4, 7.852.22 (Line 2 plus Line 3) 5. Pennsylvania Estate Tax Due 5, .00 (Line 1 minus Line 41 TAX CREDITS: Payment Date Receipt Number Interest l-J Amount Paid . IF PAID AFTER THIS DATE SEE REVERSE SIDE FOR CALCULATION OF ADDITIONAL INTEREST Totu! Tax Credit _ 00 Balance of Tax DUll . 00 Interest .00 Total Due _ 00 (If Balance Due is less than $1. no payment is required)