HomeMy WebLinkAbout80-00614
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COURT OF CO/t!'ION PLEAS OF ClI'lBERLAND COUNTY
PENNSYLVANIA ORPIIANS' COIlRT DIVISION
NO. 21-80-614
ESTATE OF ETlllL ~~E GROVE, DECEASED
LATE OF TilE BOROUGII OF CARLISLJ:
STATEMENT OF PROPOSED DISTRIBUTION
Account proposes to distribute the combined balance remalnlng,
$31,924.33, in accordance with decedent's will as follows:
The First United Church of Christ $
Inez M. Arbegast
William Glenn Darr
Tury Grove
Lila Mae Schierff
Sara Grove
Minnie Wickard
Edna Lindsey
Mary Li11 ie
Louise Grove
Russell and Helen Grove (Russell died subsequent to decedent)
Harry Grove
Ray Grove
Arthur Grove
Robert Grove
Thelma M. Starner ~lcCullough
Mrs. G. Robert Martin
Alice E. Hackman, lapsed by death 10-20-78
Jack and Laura Burkholder
Kathryn F. Brougher
Leona Thumma
Inez Arbegast, trust for flowers for grave plot
George and Lillian 1.loffman
Elwood E. Lindsey
Inez Arbegast, 1/2 residue
William Glenn Darr, 1/2 residue
TOTAL DISTRIBUTION
SO 0.00
5,000.00
5,000.00
1,500.00
1,000.00
1,000.00
500.00
500. 00
SO 0.00
SO 0.00
1,000.00
500.00
500.00
500. 00
SO 0.00
500.00
200. 00
200. 00
200.00
100.00
500. 00
250.00
200. 00
5,387.16
5,387.17
$31,924.33
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PRINCIPAL RECEIPTS
Household furniture, appraised value
Carlisle Bldg. & Loan, Say. Ctf,
Interest to 9/15/80
Carlisle Bldg. & Loan, Say. Ctf.
Interest to 9/15/80
Carlisle Bldg. & Loan, Say, Ctf.
Interest to 9/15/80
Carlisle Bldg, & Loan, Say. etf,
Interest to 9/15/80
C.V.S.&L., Ctf.
Interest to 9/15/80
C.V.S.&L" Ctf.
Interest to 9/15/80
C.V.S.&L" Sav. Acct.
Interest to 9/15/80
Farmers Trust Co., Ck. Acct.
Farmers Trust Co., Christmas Savings
Refund, Cable TV
2,147.00
10,000.00
157.46
1,000,00
15.22
1,000.00
15.22
4,000,00
93,02
20,000,00
1,465.33
4,000.00
66.85
3,173.12
37,55
1,134.52
100.00
3.36
48,408.65
SUBSEQUENT RECEIPTS
Blue Shield payments
Medicare payments
Harleysvi11e Ins" refund
Com. of Pa., Rent rebate inflation dividend
85.20
340.80
7.00
70.00
503.00
48,911.65
TOTAL PRINCIPAL RECEIPTS
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No. 21-80 1;11
in the Estate of
PROBATE OF WILL
ETHEL tlAE
AND LETTERS
0iR. ov E.
TESTAMENTARY
PETITION FOR
, deceased.
/v1 M:!..Y C. L. E'WIS
To Richard~,~fldersen, Register of Wills for the County of Cumberland,
in the Commonwealth of Pennsylvania.
IS
Petitioner(s1--ore the execut R 1)< named in the Last Will and
Testament of ETI-IEL f-II-l E (7u~? liE: __ dated J,; 'V, B~ ''177,
Decedent was a citizen of the United States and a resident of
T~"",5"'ip
Borough, Cumberland County, Commonwealth
CA IC LISLE.-
af Pennsylvania,
Decedent died on 1'1 D N D II >' the
A. D, 19E-, in the County of C U /VI GE.R. I- 11 IV /)
P/;;fJN$.YLVAfJltl at the age of 73 years.
.ftes-. ~ her
Decedent has not been married and has not had children born to hi,m
since the execution of the above described Will.
Decedent was possessed of personal property to the value af
(),vEST't MATl::/) and of real estate to the value of
IS ti-
day of S:UT,
State of
N6NIO.
estate situated as follows
as near as con be ascertained; said real
~
Therefore, your petitioner(s) respectfully applies for the probate
of the said Last Will and Testament and for Letters Testamentary thereon.
Dated S~f'T, /0,/9'<:;'(,
Name and address
of Petitioner(s)
J)?Je.->, 711. ('iitfii;CC<.l,r
IN?Z (VI. ARB.' AS,
7-2.1 FoRC,E RO/IT)
C:Af2LJSLc., p/.. /761J
COMMONWEALTH OF PENNSYLVANIA}
ss
COUI'ITY OF CUMBERLAND
INEz... (\1. A I::;' f3 Ec;.A s-,
named in above application, being duly SIAJ 0/" I\J
say(s) that the statements set forth in this petition
best of H /;;' Ie. knowledge and belief.
Swo~rv To and subscribed before "YJ/:7/7)/
j .
according to law
are true to the
me Sept. 19 1980
'~. ai,~
~' ~~. Register
(/:i-(JII2t-'
/.5(}I.
Filed: September 25. 1980
~/-f()-(.,IY
Attorney: TAI"\/;,S R. HVMt::iZ.---:ff1
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OATH OF SUDSCRIIIING WITN.~~S
COMMONWEALTH OF PENNSYLVANIA I ss:
COUNTY OF CUMBERLAND
24th Sept. -AQ
This day of A,D..lr__.
before me. Register for Ihe Probate of Wills and granting letters of Adminislralion in and for said County of Cumberland. in
the Commonweallh of Pennsylvania, personally came
Jv1IZS, LEONA T HlJ MMfl AN!) I'1((S. II-IC:LfVlA f\I\. 5,Aa IV!:.!?
the subscribing witnesses to the foregoing instrumcnt of wrilillg purporting 10 be th<.lasl Will and T~slumenl of
ETHEL. I"IAE Gleave Dated JA'V[;A/~Y 25". /9'7'7
late of C. 4 f.?..1- IS L C Cumberland County Pa" deceased who being duly S'tVO!~1iJ
according to law. depose and say. that i J.4 E 7 ~" E. r- c
GT/-IEL. !vi. G,c.OVE.
prescnt. and saw and heard the testaIB I x
sign. seal. publish. pronounec and declare the said
instrument of writing as and for h E It Teslament and Last Will. and atlhe time of so doing
S ~/IS
was of sound and disposing mind memory and understanding, to thc best of
knowledge. observation and belief.
--;-I-IEI~
Su."OR..N 16
and subscribed before
1J~/'1- (J. of,rt;V
Register
AFFIDA VIT OF DEATH
COMMONWEALTH OF PENNSYLVANIA I ss:
COUNTY OF CUMBERLAND f
JIVe? (VI. A,z6t:c:,AST
being duly
S U)or.?./V
says that as nearly as can bc ascertainerlthe said decedent
E T4 E L.
c;,<2.o vE.
1'v1 .
) 51i
died on
)'1 bIvDA'j
s c: (',/2 fVI B r;: 1Z
the
&"6
A,O,,19_.
day of
at or about
SlJJoR.N
19th
'3: ,~-
I'" M,
o'clock, _ _
To
and subscribcd this
day of
Sept.
. Q )/t' :r )/;. ui:L'-;o'Jt:
, (j
80
19'-:9iie
afl
12 .o/~
Rcgister
27.
OATH m' Pt;RSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ss:
COUNTY OF CUMOERLAND
Before me, the Regisler for the Probate of Wills and granling of Letters of Administration in and for the County of
TN E L /'vt, A rV>,L,- (.; 4 0. T
Cumberland, personally came
who, being duly S" WOR/\J . do 10 ""
EYCCu7/:!./y
depose and say that as
of the last Will and Testament of
ETHEL-
;\-.\ ,
G~O\JE
deceased
SHe
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, S (;}O" N and subscribed before me,
(i - /',"
y u;, . ) efz (.I----c,_
/ 9
Sept. 19
80
A.,D" 19_
Register
:.,; 0:
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00
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Be it remembered that on the
25th day of
DECREE
September
,A.,D"Ig8~. there was probated and
recorded the last Will and Testament of
Ethel Mae Grove
late of
Carlisle
, Cumberland County. Pennsylvania,
Deceased. Letters Testamentary were granted to
Witness my hand and official seal the day and year aforesaid.
Inez M. Arbegast
Vl?((l~ (1
~oJ
Register
2:8
Ree. 3 11-60}
APPLICATION FOR CHARITABLE EXEMPTION
FROM PENNSYLVANIA TRANSFER INHERITANCE TAX
(Act of May 2B, 1956, P.L. 1757, and Ac' 01 June 15, 1961,
P.L. 373, a~ amended)
.i~-
~
COMMONWEAL TH DF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF COUNTY COLLECTIONS
Application is hereby Ii led I., the approval
of an exemption from Pennsylvania Transfer
Inharitanco Tax on the transfer of the property
d..cribed below:
1. lIu,eou File # -Z~ao~6J.A
2, Dote 01 Death Sept..eml.>e!:_.l 5.. !JIB!!
3, Date of Approval -,2k;.<L~ 3, / f.r i
4, Home 01 Decedent n4e1 ;.lae Grove
S, The Commonwealth's app,oised value of the property far which an e.emption is claimed is $ 500.00
(Hate: Whe.. tho property is other than 0 specified amount 01 cash, the exemption cannot be appreved until the value 01
the property has been established by appraisal by the Commonwealth, except in those cases where the amount 01 the gilt
or bequest represents 0 stated Iractional or percentage portion of the entire estate or the entire residue, In those co..s
enter such fractional Dr percentage amount above).
6, Check the manner in which the tronsler was ellected and submit a copy of the document authorixing the tronsler, unl..s
such material has been previously filed,
WILL 8.;
DEED 0;
TRUST IHOEtlTURE 0;
SURVIVORSHIP 0;
OTHER 0;
(II other, explain)
7. Correct Business Nome and Address of Charitable Organization receiving property:
NAME The First United Church of Christ
ADDRESS 30 N. Pitt St.. Carlisle. PA 17013
8, I certily that the inlarmatian contained herein is, to the best of my knowledge and beliel, true and correct,
Signature "I Applicant ~J <-~.'--. -'v( ."f]-- "'-""
AddressolAPPlican/1 W. Hh:h St.. Carlisle. PA 17013
Thi. form must be complotod in .dplicote and oll.h.ee caple. delive.od '0 the Reg;.te. of Wills '0. .he Coun'y In which .he decedent
resided, a. In which lotters wo.e Issuod for 0 neo..esld.n. decodent's esto'e, If ,he decedent was 0 non..eslden' of Penn.ylvonlo and
lette.. wer. no' issued by 0 Pennsylvon;o Reg;s'., 01 Wills, dollve. oll.h... caple. '0 'h. Ol..c.or, Bu,eau of Ceunty Collections,
Penna. Department of Revenuo, 26 S. 4th Street, Harrisburg, Po.
Olliciol Title Attorney for Estate
Date
4.3- 81
Do not write below this line' For Official Use Only
For the Secretary of Revenue
Referred to Bureau Headquarters
Approved 0
For Secretary of Revenue
Denied' 0
(Initials 01 Register 01 Wills)
(Authorized Signature)
(County)
(Title)
(Date 01 Rulorral)
(Date 01 Action)
* 506 reverse side for reasons
MUST BE FILED IN TRIPLICATE
REY-485 la-78'
DEDUCTIONS ALLOWED IN
OFF ICE OF THE
REGISTER OF WILLS
OF Cumberland COUNTY
AND AGENT OF THE COMMONWEALTH
STATEMENT OF DEBTS
AND DEDUCTIONS
21-80-614
THE SUM OF
ESTATE OF Ethel ~Iae Grove
LA TE OF
Borough of Carlisle
DATE OF FILING APPRAISEMENT
1-~~-t(
DATE OF DEATH
September 15, 1980
DATE NO, OF NAME OF PAYEE REMARKS AMOUHT
VOUCHER
Rerrister of Wills Let tel'S & Sh. Ctfs. 42 00
The Sentinel Adv. Letters 18 00
Cumberland Law Journal Adv. Le tters 18 00
Samuel A. Miller , Annraisal of household <Toods 25 00
Hoffman-Roth Funeral Home Services 2.866 50
Ebv Granite Works ~Iemorial 235 00
Carli~le Radiology Assoc. X-rays 65 00
Leland F. Patterson, ~!.D, Last illness 130 00
Gary L. Blacksmi th , Jr.M. . Last illness 412 00
Carlisle Hosnital Last illness 12 50
Masland Associates Last illness 60 00
Richard E. Barrett Ant, rent - October 160 00
PP&L Electric Service 21 16
Melvin E. Spahr Ins urance premi urn 20 00
ITn i ted Tel. Co. Service 15 07
C.V.S.&L. Lock box rent 3 00
William Glenn Darr Loan 2 500 00
ReI' is tel' of Will s Filing Inventory & Deduction 6 00
Pa. Dept. of Revenue 1980 Income Tax 74 41
Inez M. Arbegast FlO1,ers, Wreaths for GraveP t 508 88
Inez M. Arbeiiast Executrlx Commlssion 2,42
T"~~ ~ R Humer Attornev Fee 2 420 00
Reserved for fil ing final account and closing expenses 150 00
TOTAL 12 173 64
COMMONWEALTH OF PENNSYLVANIA}
COUNTY OF Cumberland SS.
I. Inez ~1. Arbegast HEREBY CERTIFY, THAT TO THE BEST OF
MY KNOWLEDGE AND BELIEF, THE FOREGOING IS A JUST AND TRUE STATEMENT OF DEBTS, FUNERAL EXPENSES AND
EXPENSES OF ADMINISTRATION SUBMITTED TO THE ESTATE OF Ethel MIll" r,rm,,,
DECEASED, AS DEDUCTIONS FOR INHERITANCE TAX PURPOSES. ,
L\--.:(:~lL'.--' >/1,(?;~/..~_'~, ~'fl.(-
:) if
(L.S.)
SWORN AND SUBSCRIBED BEFORE ME THIS
, Apri 1 .. 19....B.l...
x"/rt.(.$)'/> / '/ //& ,".' ~,,1- /, ',.,.~/
N01 AR'{ PUBt.l~ t981
. E ..,~ !J\~ I...
Mv (o~f'li~\~C:'l <"1,- bd'nd CoUnty
'Olr\i~:c. fA U~ ,~
,
''-.
DAY OF
'" :!...
,- tr cL.:
L
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,-, 0.. ""
;0<..;.
" Zo
h.... C""'\ .~z.
O!:. ~"'"3~
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W~J ~ e::--I
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C~ C- ,W
",er, e: ~C:~
0-
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,
"
"
REV..49 (5.75)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF FIELD OPERATiONS
2 I -- ~f ('- (. III
~
RESIDENT DECEDeNT
COUNTY OF CUMBERLAND
-
IMPORTANT:
- _.
This feturn must he comjllcl~d in detail and filed in duplic:Il~. with uIl attuched, with the Register of Wills of the
County where decedent ICSilkd; Return is due within nine months "her d'lle of death. unless un cltlcnsiun is grunted
by the Secretlu}' of Rnt"nuc. (Section 703 Hf the Inhcrillincc and Eslale TIIX Act uf 1961.)
Lcto of
Cumberland
Pennsylvania
Cumberland
Inez
} AFrm. A VIT OF
EXECUTOR
,NI\~=XNR
IN TilE lIATTER or TilE ESTATE OF
ETHEL MAE GROVE
(STATE FULL NAME OF DECEDENT!
County
S'are III
} u,
County of
~
~1. Arbegast
E'(ccutor
of tho estate of ,hlCl above-named dotedont being duly sworn, deposoS
and soy S
Decedent died Seotember
IMONTHI
Nam. Clnd oddrn. of attornoy or }
oth.r outhodzwd ,.pr..lnlotlve ta whom
all corr..pondenctl ,hould be mollod.
l5
(DAY)
. 19~ tOltate leaving (J 1011 will, copy of which Is heleto allached. }
~~!Jt~~
James R, Humer. Atty,
1 W. High St,. Carlisle, PA 170n
That as such Execu tr ix deponent is familiar with the arfairs of said estate and the properly constituting
I EX ECU TOR.ACMINISTRA TORI
the assets thereof and their fnir markct \lalue.
That at the: time of death there was no safe deposit box registered in decedent's individual name, or jointly with, or
as agent or deputy of another, or in decedent's individual name, with risht of access by another as agent or deputy, with th~
exception of Ihe following: -
NAME AND ADDRESS OF BANK OR OTHER INSTITUTION
IN WHICH DECEDENT RENTED A. SAFE DEPOSIT BOX
THIS SAFE DEPOSIT BOX RENTED
IN NAME OR NAMES OF
RELATIONSHIP OF JOINT
HOt...i)EAS TO DECEDENT
CVS&J.,
11i W
High St
r~,..lic:l~ Pl\.
. 17013
That the contents of said safe deposit box or boxes are itemized under Schedules B
with the exception of the following, for the reasons hereinafler set forth:
of this return,
That Schedule A attached hereto and made part hereof sets forth fully and in detail all the real property
in the Commonwealth of Pennsylvania of which decedent died having an interrst therein. It also sets forth the
mortgage encumbrances upon euch parcel of real property at 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 therefore the asscssed valuation of each of said parcels, the estimated market value thereof
as of date of death of decedent,
ThaI Schedule B attached hereto and made patt hereof sets forth fully and in detail all personal property
whcresovcr situated owned by the decedent at the lime of death; all moneys left by the decedent at the time of
death, whether in decedent's immediate posse~sion, standing to decedent's credit in banks of deposit, savings
banks, trust companies, or other institutions, whelher individually, or in trust for any other person or persons
giving 2.1so separately the accru~r1 inlerest thereon. if any, down to the last interest day prior to decedent's
death in the case of savings banks, and to the date of decedent's death in all othe( cases; all bonds, postal
sav ings, tft:asury certificates or notes and other evidence of indebtedness of the United State s to the de.
cedent; all obligations, whcthcr by statute or agreement they arc desig.nated as tax free, of the United Slates,
or any state, or political subdivision thereof, or of any foreign country. which ar~ owned at the time of death;
all wcaring apparel, jewelry, silverware, pictures. books, works of art, household furniture, horses, carriages,
automobiles, boals. and any and all other personal lo:!:J.ttcls of whatsoever kind or nature, left by decedenl,
together with the fairly estimated market v,lue thereor; all bonds and mnrtgages held by decedent and 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 possessed, of whatsoever nature, with interest thereon, if
any, giving the face value and estimated fair market value thereof, and if such estimated fair market value be
less than the face value, it sets forth brir.f1y the reasons for such depreciation as to each item; all moneys
payable to the estate from life insurance policit~s carried by decedent; all annuity and endowment contracts
Ihe proceeds of which were payable upon the dealh of the. decedent; all and the corporate stocks and dividends
due thereon and unpaid as of the datc of death. bonds and accrued interest thereon to Ihe dale or deccdent' s
death and other investment securities owned by the decedent at the time of death, with the market value there-
of al soeh time.
'.
.
In till' ellSt! uf Sl!ellrtt.les (II- cl()St~ or !'lUlIlly corllf,rnl.lons, the 1I1t1111!S rl!)lorted nrc us ('or AS
poss1hl(! foOllhst""t.llttl~.1 by rtlllll1ctnl stllU'ml!flts 1)(' lhe l1orl'urutlnns, sh(Jwll1~ the IISSI~I.S Ilnd l1ahI1Jt.Jor;
thl'reot' liS n1' "1(' dlllO cf' Ih'-lIth. TIIl~ sehertllle nIso sets f'orth the Interest. of rloccllent nt. the time or
ch~t1th In tlll~' cO-l'lLrtnt'rshtp or huslness. luul In sUllflurt 01' tho vllluH of such Inlerest. Utero Is tlnm:xed to
sulci licht'dllle, fJnnnclu! slRlemlmts shovdnE;thP-ossets nne! I1nhlltlles of slttd co-pllrtnershlp or huslnass.
A copr or th(\ cn-pnrtnerslllp ll,.;rl!l'ml'nt, (if orral, R st.llt-emen\. set.t.1n~ forth thn J1nture of thl: dgrcemcnt)
L()~I.th~I' with R stRLelllonl sef.l1n~ I'ort.h the charncler of UII~ hllslru'ss, Its locntlun, und such other fn,cts
rH~rtlllnlllj:!; to t1ll~ huslnC!ss us mu~' hI! pertlruwt t.o tl fnlr Ilnl1 .1I1st. 111111rfl15<<1 of tJw decmlentls intorcst
therl~ln nHl'ithesuhmltlNI. [t sltctuld nlsfl set r'urth In Itf!mtzed form, toget.her with the fair market VIl}lIe
thereof, nny otlu~r pro[lp.rt)' llWIlPll or hCC]UfHlthf!f1 by the decedent. at the time or ,Ienth.
The Schpdvlp C nt-tllehel! her(~I.C1 111111 mude pnrf. Iwreof set.s forth n trne ""swcr t.o each Influiry
contnlned therein find In the clL....e 01' trnnsf'ers ofpro!,p.rt.y, rcnl or personal, within two yenrs of decedent's
death, In contemplation of llecf~dcntt s dCllth, or lnt.enrleti to t'l.ke ef'fect 111 possession or enjoyment at or
after death, suld schedule sets forth the nnture I1l1d valll~ of such property, t.o whom transf'erred, the
relatfonshlp of' the transferees to the tlP.c~(rent., tlm proporUonnte shure rp.cp.lvp.n by each transfer-ee and
all other facts of n perttnent nnture r('~nrdlnJ!; sflllt transfers. In the case ot' tl'nnsfcrs intended to
take ei'fcct in possession or enjoyment Ilt or ILf'ter llenth, there is also nttnchert to the schedule a cony
of the deed, trust agreement or other instrument crcuting the trust.. Thor.' Is also set forth in said
schedule II list of <<11 property, real llnti l'crsonal, with its value, which pa~;ses at decedent' 5 death by
virtue of the exercise b)' decedent., either tndlvlrlulLll~', or Jointly with another, or MY {lower of appoint-
ment vested in decedent, either individually or joinl1~', by the will, deecl, or other instrument of another,
with IL cop~' of the instrllr.umt creating such power nttftched to the schedule.
That Sch~du/~ 0 attached hereto nnd made part hereof sets forth the nRmeS nnr! addresses of all
p(!rsol1s beneficially interested in this estate at the time of decedent.' 5 .leath, the nuture of their res-
pective interests, their relationship, if nn)', to the rll':ce.tent, to:;ether with the ages at the time of'
decedent's death of' nIl minors, annuitants anel henefJclnrles f'or 11fe un(\er rlecedent's Will. It also
contains a statement showing which of the beneficiaries nnmed in the rlecellcnt's wHI, if' any, died prior
to decedent, the dates of their dcnth, their issue, I1ml the relntfonshtp of such issue to the beneficiary.
That S.:/ledule E attached hereto and made n pnrt hereof sets forth nIl property, rea.l Rnd per-
sonal, ol'med by the decedent .Jointly wi th nnot.her or others, including intangible, standing 1n the name
of the decedent and others, plus the dat.e nnd place of' record of lnstruments effecting the \oestiture of'
real estate Imd the date of acquisition of' personalty, plus the name, adr1ress fLnd relationship, if any,
of co-o'mers to the decedent.
That SChedulE' F attached hereto and made a part hereof sets forth fully and in detail all debts
and deductions claimed for anrt on uehalf of' this decedent's estate, including funeral expenses paid;
family exem[ltion, where llppl tcnule; costs of nrlminlstraUon of this estate; counsel fees and f'udiclnry's
commissions paid or to be paid; cost eXJlended for bur ial trusts, tombstones or gravemarkers, and reli-
gious services, in consc1luence of the death 01' the decedent; debts and claims owing nnci llnpairl at time of
death; taxes accrued chargeahle for perior! prior to decedent's deuth (except those allowed under Section
651 of' the Inheritance and Estate Tax Act.) j together .....ith n statement of collateral pledged f'or obliga-
tions, if nny. It Is agreed that the fiduciary will present proof of suld cllllm,!d obl1glttions upon re-
quest, that if the amount actually pnid in settlement of any fee, commissfon or debt is less than the
estimated nmount claiming nnd allowed, that the sUme will he reported to the Register of' WHIs, and that
the umoun t of tax assessed can he reassessell in oc('orrltulCe therev.'f tho
That the tolnls of the IlPllro}lrlatc columns in Scheftules "A", "B", "e", "E", Rnd "F" as directed therein,
have been carried rorwnrd Rnd properl)' registered in the Summary.
Subscribed and sworn to before me this ......;c.~..Y.li......
.....\...9.J.}ifJ2~;:1dt11d~jJ...rL.z.:.t:...._-
..4 f.l......f..QXg.e.....RQa.d..............................................._'__'
(Street Number)
. C.<l :r.JJ.s.l.e.... .PA...1.2 013..............................................
(City C>r Town and St4te)
............... ...... ...... day of ..... ......Oct.o.ber. ........ 19.8.0....
............. )!c-~J;t.. --;./ /. I.~., .
............A"'f;".c . ~~--:; '-"'..J......J...(.,..:"'t>c. ,:::-:..:::..............
j' . ~ '. ~!::" ~ ....
.. (...l.. c'" .
t. ;~:l.C. ".\" .., t ,~~, '.:~d c".:.'~:'r,
NOTE: Uefore signing affidavit make sure nll blnnk spaces in the IIffidll,,'it nnli schedules annexed ore
rllled In with details or t.he word "None", allll in cuse the nssets include rltre and unlisted sccur1t1~s,
sCI:url tics of close or f'nmlly corporntl11ns or nn Interest in Iln~' co-pnrtnf!rship or busIness, that the
rtlltU luul st./t.tements reqlli rl!fl uucler the parllp;raph allo\'e rellttfn~ t.o Schedule "U" nre attached. ,\150 make
cf!rtnlll t.hnt column #1 In the "Sunmnry" hus heen properly completed ElS R.bove-cl1rcctell.
REv..,lle-781
~
.
COMMONWEAL TH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
RESIDENT DECEDENT
SCHEDULE "B"
PERSONAL PROPERTY
INSTltUCTIONS: This Sdlct.lulc musl Jisclnse lllllangihlc and inlangihle tlersllllill property owneu inuividually by the
decedent, :11 the time Clf his dealh. I'rllperly owned by the dcccdl~111 jClinlly wilh :lIIuther ur Hlhers must he listed
limier Schedule liEu. Intangihle pcrsollalprnpcrty, titlcll ill the nalllc Ill' the decedent, hut payable lit death 10 another
e1r tllhers, including hut nllt limited tll p.n.u. U.S. Savings Blinds .uHllcnlati\'c trust accounts, must he listeu, despite
the fact thill they arc not of (he administereu estate.
Tungible personal prnpl~rt)' should he listed first (e.g. jewelry. wcaring ill'l,arel, household gumls, lInd
rurnishings, hOllks, paintings, lIUlllIlluhiles, hOilts, etc.)
Intangible persunal property, such tiS bunds, trcilsury ccrtificates, cash 011 Iwnl! ilnt..! in bank, !-ltncks,
mortgages, notes, together \\ilh accruell interest or dividcnds, sal.uies ur WilgCS, insunnee payahle to the estate ur
fiduei.uy in said capacity, partnership interests, interest in any undistrihuted estate of or incume frum .my property
held in trust undcr the will or agrce11lcnl of another, e\'en thuug,h IClcatctluutside uf the Slntc, :II the tinw uf death,
should be listed in this sl:hedulc.
Item
No.
l1liM
List and describe fully
UNIT ESTIMATED
VALUE MARKET
VALUE
DEPARTMENT
VALUATION
(Do nnt write in
this space)
1.
Household furniture as per appraisal by
Samuel A. Miller, Auctioneer, attached
Carlisle B & L, Suv, Ctf. #11-00-2098
dtd 1/7/77 for 4 yrs. @ 7.50%
Accrued earnings to 9/15/80
Carlisle B & L, Say. Ctf. #09-00-0985
dtd 1/2/74 for 4 yrs. @ 7,25%
Accrued earnings to 9/15/80
Carlisle B & L, Say. Ctf. #09-00-1254
dtd 7/1/74 for 4 yrs. @ 7.25%
Accrued earnings to 9/15/80
CVS&L, Ctf. #6705826 dtd 3/31/80 for 6 mo.
@ 15.700%
Accrued earnings 3/31/80 to 9/15/80
CVS&L, Ctf. #6693707 dtd 6/13/77 for
6 yr s. @ 7. 7 5 %
Accrued interest 7/1/80-9/15/80
Farmers Trust Co., Ck. Acct. #4-15944
Farmers Trust Co., Christmas Say. Club
No. 1206603
Refund Cable TV of Carlisle
CVS&L, Say. Acct. #120086, Balance
Accrued earnings to 9/15/80 from 7/1/80
Carlisle B & L, Say. Ctf. # 17-00-0622
dated 5/23/80 for 2 1/2 yrs. @ 10.75%
Accrued earnings to 9/15/80
4,000,00
93.02
2.
2,147.00
10,000.00
157.46
3.
1,000.00
15.22
4.
1,000.00
15.22
20,000.00
1,465.33
4,000.00
66.85
1,134,52
10 0.00
3,36
3,173.12
37.55
5.
6.
7.
8.
9.
10.
11.
Insert this total opposite "Personal ProJlcrty", Schct..!ule UB" in
the "As Reported" column on the last page of this return.
xx
f~ foi/ft,S'
.
48,408.65
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CARLISLE 8UIUlI"':.
AND LOAII ASSOCI~l'Ol
Phon. - A.... Cod. .17171713.2915
OFFICES. N. MIDDLETON' MECHANICSBURG
{D.,.,.. .
. .
~... \
@
;,~:
17 WtST HIGH STREET. CARLlSL&. PENNA. 1701'
Octo'.:>er 9, 1')30
James R. Buner
Attorney at La,'!
FarmerB Trust 3uildinb
One ;'lest Hig!1 St~"eet
Carlisle, Fa. 17013
Reference: Estate of :Ethel E. Grove
Letter dated October 3, 1930
Dear j.!r. RuneI':
As of September 15, 1<;380, the date of death of Ethel I':. Grove, ..
the follOl'ling information applies to the sav5_nGs certifj_cates Olmed
by Ethel !1. Grove:
Acct. No.
3alance
+
Acc~ued EarninGS
=
Total
11-00-28<;3E
09-00-0985
0<;3-00-1254
';10,000.00
~f1 ,000.00
';\1,000.00
";1 <;7 4-6
'.i ..,. .
:;.1;.22
':i15.22
"110 1t;7 ll.r:.o
or './.'
~t1 ,015.22
S1, 015 .22
If there are any ~urther questions, please feel free to contact me.
Sincerely,
/ I'lL.!/) /
ili~n: k II. l):--y{{.t;
\':anda A. Borden
Sn:.;inss Dep2.rtlr.ent r-':anae;er
16 Wesl High Shee!. Carlisle, Pennsylvania 17013 249-2525
. CUMBERlAND
W4LLEY ~1NC:15
AND L04N ASSOCIf:>...TION
James R. HI!T.er
Attorney at law
Famers Trust Building
One \'lest High Slreet
Carlisle, Pa. 17013
October 25, 1980
RE: Eslate of Elhel M. Grove
Date of Death: 9/15/80
Dear Mr. Humer:
lisled below is the account you referred to in your letter af
October 24, 1980 far the above captianed estate of Ethel I~. Grove.
1/120086
Principal Balance
$ 3,173,12
Accrued Interest from
7/1/80 to 9/15/80 37.55
$ 3,210.67
If you are in need of any additional information please cant act
this affice.
'~~?4--
Richard l. Kuntz
Accaunting Department
RlK:ymr
REV-4~2 (8,78)
COMMONWEALTH OF PENNSYLVANIA
TRANSFER INHERITANCE TAX
SCHEDULE "C"
TRANS!' E .1S
"'1"
'S ,~i}~
,~~. rg
(.' ~~l<'; :q;
r:..~..-~.j1'r~..~.."
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RESIDENT DECEDENl'
..------.--.------. --'-'-"'-'-'---.---
l1i
(2)
i
(3)
Did decedent, within tWo ye.IU of dt~ath. make any tr.lIlsfct.,ut .IllY lI1iltainl put of hi~ ..;~tUft!. without receiving a valuablo and
lldequa~e considcrEtlon therefor? 'Answer y~,; or hoJ ~~
Did decedent, within two yeilr) of death, trtUlster property from him~clf to hjlil~clf anu ~ll1a~hl:r or others (including 8 spouse)
in joint ownership? (answ!!r yes or nul _~
If the answor to (1) cr (2) above is in the affirmiltivc st,lt-.::
{al Age of decedeot at time of transfer _llJ'.L
(b) State of decedent's health at time of milking the transfer. (Not~ 1).
{cl Cause of decedent's death, (Note 11,
Did decedent, in his lifetime, mako any trhn:.fer of property without receiving n vnlunblc or adequate consideration therefor
which was to take effect in possession or onjoyment at or after his death? (Answer yes or no) No
(a) Was thero any po~sil.Jility that the property triJmflJrrcd mi!Jht return to transferer or his c5tnt~ or be $lJbject to his
pOWllr of dispo3ition7 (Amwcr YI'S or lIO) __No
(b) What was the trensrerec's ege at lin.e 01 decedent', dealh? --.1l/..!l.-
Did decedent in his lifetime make any uansfcr without receiving a vnlunble and adequate consideration therefor under which
transferor expressly or impliedly reserves for hi:; life or Jny period which docs not in f.let end before his dC:lth:
(a) The possession or enjoyment of or the right to income from the plOpcrty trmlsferred? (Answer yes or no) Nn
(b) The right to designate thllPcrsons who shall POSSC$S or enjoy \he property transferred or income therefrom?
(Aoswer yes or 00) NO
Ifthe answer to (5) (b) above is in the affin ative, :.tate whdther the right wus rcserveLl in decedent alone or others
(4)
(5)
(61
(7)
(8)
Did decedent in his lifetime make a transfer, the consideration for which was transferee's promise to pay income to or for the
beoefit of care of traosferor? (An'N.r yes or no) No
Old decedent, at any time, transfer property, the beneficial enjoyment of which was subjer.t to change, because of a reserved
pOWllr to alter, amend, or revoke, or which could revllrt to decedent under terms of transfer or by operation of law?
(Answer yes or 00) No
(9) If the answer to (8) above is in the affirmJtive, wa:. the pO\NCr to ultt::r, &mend, or revoke the interest of the beneficiary reserved
in the decedent alone or the decedent and others? (Answer yes or nol Nn
NOTE 1: The answers to these questioos should be supported by affidavit by the atteoding physiciao as well as a copy of the death
certificate..
NOTE 2: If answer to any of the abolJe questions is yes, set forth below a description of tho property transferred, it's fair market
value at date of death, dates of transfl1rs and to whom transferred, with relationship of transferees to decedent, if any. Submit
copy of any trust deed or instrument, ij trdnsfers arc claimed to be non..taxable, also submit detailecl statement of facts on which
said claim is based.
NOTE 3: List applicable property below in ,"an ocr in which provided io Schedules A, 13, or E.
ITEM
MARKET VALUE
(Estim;;tecll
DEPT, VALUATION
(Dept, Oolyl
DESCRIPTION
None
Insert this total opposite "Traosfers", Schedule "C" in the
"As Reported" column on tho last page of this roturn.
N $-1'LV -Ufj1f.
.' "
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REV-4~3 te"781
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CO:\I.\IONWb\LTII UF PENl'\'SYI,\'A:'\lA
TRANSI'ER INIIEIUT^Nl"E TAX
RI'.5I1lENT IlECEUENT
SCIIEIlUI.I: "Il"
\lFNEI;WI.\I:II;S
RENEFIl"I,\RII'.S AND ,\llIlRESSES
(Slule rUllnmll'!i und al1JrC~!'Il'!'i 01 nil \\hn
hllVC un intcrc~t. ,'cstcd, continJ.:cnt or OIhcr-
wise, ill cstUI")
REI.ATlU;'IiSIIIP
(If sU':p.dlihlrcn ur
illt.'g.itim:ltt' chiltlu'f1
an' ill\'tlIH~t1, set
ftlfth this f"ct.)
~--l
I
~.~-- -'-- ------- ._-~._---------------
.-- _._.._~.-_._..__.._-------
St:H.\'IVFIl
1I1.:CEIlI..NT
STATE ITS
Oil :\()
\
1)\11 l 1-"'; IFill STili,
01- IlI'NEi'l('I,\l{\'
_~:~-- ___~.sr'\TE _
--- - 1:::0 - .1"' 1/2
residue of estate
The F~rst Unit~ Chu~~~f-
30 N. Pitt St., Car1isle,PA 17013
Inez M, (Darr) Arbegart Sister
421 For e Rd., Carlisle, PA 17013
William Glenn Darr Brother
26277 Vista Pl. Hemet, CA 9 343
Yes
Yes
1=
1____
5000.00 __-=--_nlllJL-.ll..L-
residue of estate
Yes
1500.00
-~
_j1000.00
I
I
....l
1000.00
Tur Grove
50 W, Rid e St. Carlisle PA
Lila Mae Schierff
6910 Lawnton St. Roxborou h
philadelphia, PA 19128
Sara Grove Sister-in-law
146 S. West St.,Car1isle, P~ 17013
Minnie Wickard
235 Arch St. Carlisle PA 1
Edna Lindse
620 Yorkshire Dr. Carlisle
Mary Lillie
146 S. West St.,Carlisle, P
Sister-in-law
Yes
17013
Sister-in-lawl
Yes
Louise Grove
146 S.West St. Carlisle PA
Russell & Helen Grove
32 S. Hanover St. Carlisle
Grove Church of God
801 N, Hanover St. I
PA 17013 \
I
Ra S. A t. G-449 Brother-in-la Yes 1500.00
3.401 S Trail, Delra' __-1
Be", Flodd. 33444 . ---I
...LlGONT'D ON EXT~ ?llggT)1___ _.______c===L-..=o.=-==-c:o:.::c::c::::....-==-J--
Sister-in-law Yes 500.00
013
Sister- in-la\~ Yes I ,500.00
A 17013 ~ =t
Sister-in-law Yes 500.00
17013
Sister-in-law Yes 1500.00
7013 .L-
BTother-inlaw Yes I 1000.00
PA 17013
JlJLJl.O
Deponent further says that 011 the above-named beneficiaries orc living at thi s time Cl(ccpt below:
NAME
DATE OF CEATii
RESIDENCE
~
g\fl~
.... -
.=..- :tt
",. C
'c ~ E
.- u =
~-o
-00."
--t 5"
i!.u:o
E _ U
:1:11 -
U = E
u e 0.
" u
:!! et:
SlIMMARY
({enl Property
Pcr:Hll1rtl Property
Trnnsrcrs
(Seh. "AU)
(Sell. liB")
(Seh, tiC")
Gruss Taxable Estute
,.... "0
~ Z u
'" ILl ~
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ILl u
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:;: Q ...:
'"
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:::~ ;; 5 E
0 0
:::< ..l u U
(1)
(As Reponed)
~
$
$
$
$
~_..-
(2)
(,\s Determined)
$
$
$
$
$
$
.
REV...,) (8-781
~. ~~. 111
~~' ~
fl' ~t:~~~i'i\
......":-~~..;"~
.~,,:..,'t;"\~~''''I~
COlNONWI!AI.TII OF I'I!NNS\'I.\'ANIA
TRANSFER INIIERITANCE TAX
RI!SIIlI!NT OI!CI!UENT
SCIIEIlULl~ "Il"
IlE1'\EFICI.-\RIES
5
- ----- .- "---- ---_...----"--- --. ..
- -- _._-- - T-
81!NEFICIAllIES AND AlJIIRI:l;SES REI.ATIONSIIII'
(Slate fullllanws Illld ;lddrc~~cs of 1111 whn (II 5u~(l.d1ildren ur SllRVI\'I':O 11 \'11'. INTFIlFST OF
have an interest. \'CMI:LI, cOlltingent or othl't'- illl.'gitirnatl" Cllildf('ll IIECI.m'NT "'1 IlENEl-ICL\1l \.
wise. in Cl'lIlle) me invulved, sel STATE Y I,S -=~ IN EST,\TE
forth tllb filet,) (Jltj'\O
ArthJU:. Grove ~. , - ; n -1 ", Yes ~nn J)J)
157 Marbeth Ave. , Carlisle, PA 17013
Robert Grove Brother-in-lal' Yes 500.00
R.n.7 Carlisle. PA 17013 I
-
Thelma M. McCuUouo-h F,. ..i.e.nd Yes 500.00
3 W.Pomfret St. ,Carlisle,PA 17013
A 1 ;rp P Hackman Friend No 200.00
Mrs. G. Robert Martin Friend Yes 1200.00
---
726 W. South St. .Carlisle,P i 17013
Jack and Laura Burkholder Friend Yes I I~oo
217 N. Hanover St. ,Carlisle PA 17013 I !
Kathryn F. Brougher Friend Yes 200.00
304 S. West St. .Carlisle, P 17013
Leona Thumma Friend Yes 100.00
60 Union Hall Rd. ,Carlisle, A 17013
George Ii Lillian Hoffman Nenhew & Wife Yes =l250'00
727 W. Louther St. Carlisle PA 17013
Elwood E, Lindsey 1>Jenhew Yes
200.00
1004 Dale Place. Carlisle. A 17013
I
I
. . _.U_'__ -. - - .
-
Deponent further says that 011 the above-named beneficiaries arc 1 iving at thi s time except below:
NAME
DATE Of DEATii
RESIDENCE
A 1; ce E, Hackma
ct. 20 1978
W. South St, Carlisle
PA
~
Cl ~ """:
';j~U
=:
~ c
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.- t) =
Eo.c
-; e U
.t 8 :
s...~
:2 'I. t:
u = "
.. E Co
K ~
!!:. 0:
SllM~l'\R Y
Real PWllcrly
Pcrsnnal Pruperty
Transfers
(Sdl. H.\")
(Seh.lln")
(Seh, "C")
Gross Taxable EslulC
!- ""
.. Z u
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0)
CAs Reported)
$
$
$
$
$
$----
.
(2)
(As Ilelermined)
$
$
$
$
$
$
REV-"!4 ,..79)
COMMONWEAL TN OF PENNSYLVANIA
BUREAU OF EXAMINATION
INNERITANCE TAX SECTION
."
"
" x .
SCIIEIlULE "E"
JOINTL Y OWNEI> PRO"ER I'y
INSTRUCTIONS: This schedule must disclose all properlY. real alld l,ers",,,L1. oWlled hv the decedellt illintlv with
another or others, including inlangibles, slandillg ill Ihe nallle ..f Ihe deeedl'nl alld ..thers. I,isl real eslate f1rsl. ns
entireties, or joint lenanls, giving brief description, as illdieated under Schedule ""." plus the date und pi nee of
record of instrumenl .ffecling vesliture. hut dllllol include elllirelies or ..nl ..f stale real eslale value in eslate
v.lu.tion colu!"n. P.rslln.lllfoperly shlluld be Iisled as ill Schedule "\l." plus lla",..f aelluisitillll. alld Ihe n.me.
address and relationship (ir uny) or coootlWners tn the deccJent.
Description of Property, D;lle or Acquisitiun, Name
Ad1ress and Relationship or Co..Owners, and Place
of Record of Instrument, where Real Estate.
Unit
Value
Perl.....:ntagc
Share
Estate
Valuation
IlEI'Al\TMENT VALUATION
(OFFICIAL USE ONLY)
Value or
Entire
I)ro[lcrt)'
\'utlle or
Decedent's
Interest
None
Insert this total opposite "J()intly Owned Property," Schedule "E"
in the liAs Reported" column on the last page of this return.
NnuJ
~
..
REV-4U EX+ tHO)
INHERITANCE TAX SUMMARY SHEET
(BUREAU USE ONLY)
m Original
o Supplemental
o Remainder
File Number
21-80-0614
Estate Name
Ethel Mae Grove
Date of Death
September 15, 1980
Social Security Number
REPORT OF INHERITANCE TAX APPRAISER
I. the und.rslgned duly appointed Inh.ritance Tax Appraiser In and for the County of Cumberland
Pennsylvania, do respecffully report that I "ave appraised the real and personal property as reported In the faregaing
r.tum at the value. ~.t forth opposite each item in the last column to the right in Schedules "Aft, liB", "CIf, and HE"
Dated: April 20, 1981 _pll~ 7/ J ,-//'t,.;",,,j)
INHERITANCE TAX APPRAISER
ADJUSTMENTS REMAINDER APPRAISEMENT CODE
INVENTORY VALUE AS APPRAISED CODE (HARRISBURG USE ONLY)
Real Pr.perty (Schedule A) $ None 00+ 92+
Personal Property (Schedul. B) 48 408 65 '0+
Jolnt.Held Property (Schedul. E) None 20+
Trauf.r. (Schodule C) None 30+
TOTAL GROSS ASSETS 48...!t.O_a. 65
LOll D.bts and Deductions 40- 93-
(SCHEDULE F)
CLEAR VALUE OF ESTATE
o Life Estate RATE FACTOR PRINCIPLE VALUE CODE
o Annuity
FOR USE OF REGISTER ONLY
Tall: on $
s;QQS.
COMPUT ATION OF TAX
$
$
$
$
$
6'.
"
T OK on S
lS!c
Tax on $
Tax on $
TaxonS
Exemptions
Total Estate
$
$
$
TOTAL TAX
INTEREST FROM
BALANCE
TO
L.eu Credits
DATE OF PAYMENT
INTEREST
DISCOUNT
TAX CREDIT
AMOUNT PAID
S
+ S
S
=
$
+
=
INTEREST FROM
BALANCE DUE
BALANCE
TO
S
S
REV,S18 Fa 17,801
I~~
.... ........., ~ .,0
NOTICE OF FILING OF APPRAISEMENT
COMMONWEALTH OF PENNSVLVANIA
DEPARiMEN'" OF REVENUE
BUREAU OF FIELD OPERATIONS
Ms. Inez M, Arbegast
421 Forge Road
Carlisle, PA 17013
RE: Estate of
County of
FileNo.
Ethel Mae Grove
Cumberland
21-80-0614
Dear Ms. Arbegast:
You are hereby notified that the original
appraisement in the estate of Ethp.l Mfle Grove
has been filed in the office of the Register of Wjlls of Cumberland
County on April 20 , 19 81 . Said appraisement reflects the following valuations:
Real Estate
Personal Property
Jointly Owned
Transfers
Total
l,one
$48,408.65
None
None
$48,408.65
As to such tax that is paid within three months from date of death, a five (5%) percent
discount is allowable. As to any tax that remains unpaid alter nine (9) months (fjfteen months
when death occurred from December 22, 1965 to June 16,1971, inclusive; and twelve months when
death occurred prior to December 22, 1965) from dote of death, interest at the rote of six (6%) percent
per annum is charged.
Any party in interest who is aggrieved by this notice may object thereto within sixty days
after receipt of said notice os provided by Section 1001 of the Inheritance and Estate Tax Act of
1961,72 P.S. 2485-1001, P.L. 373.
Dote
April 20, 1981
Nil .,,' " .f? I" fJl1.. d.)
Chief Appraiser
Si gned
Title
NOTE: This is not 0 bill.
REV<<4!57 (1.80)
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
TRANSFER INHERITANCE TAX
RESIDENT DECEOENT
INHERITANCE TAX
APPRAISEMENT
'*
Estate of
Ethel Mae Grove
File No,
21-80-0614
County
Cumberland
Date of Death September 15. 1 980
In the event that any utur. Interest in this .ltate i. transf.rred In possnsion or enjoyment to coUateral holrs 0 the Deed.Me tllr t .e OItP rat on 0 any
estat. for life or for years, the Commonw83lth hereby expressly reserves the right to appraise and assoss transf.r inheritance taxes at the lawful cotlateral rata
on any such futurelnt.r8l1.
PROPERTY REPORTED BY THE ESTATE
DEPARTMENT'S
APPRAISED VALUE
1. TOTAL REAL PROPERTY - SCHEDULE "A" , ,
2, TOTAL PERSONAL PROPERTY - SCHEDULE "B"
3, TOTAL TRANSFERS - SCHEDULE "C" , , , .
4, TOTALJOINTL Y OWNED PROPERTY - SCHEDULE "E"
None
$48 408.65
No
TOTAL REPORTED PROPERTY
PROPERTY NOT INCLUDED IN RETURN BUT APPRAISED BY THE COMMONWEALTH
48 408.65
TOTAL UNREPORTED PROPERTY
TOTAL GROSS ASSETS
$48 408.65
LIFE ESTATE OR ANNUITY CALCULATION
I do hereby certify that the above appraisement is made in conformity with Pennsylvania law and has been filed this day
with the Register of Wills,
( " I)
..U/(.. ,:" .:'-// f~ljft} 'r,'
APPRAISER
,
I
\ '*
"'
i ~
~ ~
~ ~ Q)
;z: l>l r.:i >
0 :>- :>< 0
" <1l
r.:i " .....
Vl ~ '0
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~ nl ~ > <1l
:;: ,..., ,...,
" :>, to ~ <-- M
- .... ..... OJ OJ ~ C\I
U ;z: " .... " ~ ~
- 0 .a " "
'" ..., nl OJ
'" - tiI U 0.. U
0 ~
~ ~ ci
~
1n 0 Vl 0 ;z: ci
- r.:i Vl :>< !-< ci
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:J ci ci i>:: ;z: ::<: r.:i l>l
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~ ~ Vl ~ 8 0 Z
r.:i 0 :l
.
--- - - -- ----- -- -- --- - --.,--- ----- -------- ----- -- ----,
.~-..... __ J .
" ft[V.1162EX
a . COMMONWEALTf/ OF PENNSYLVANIA
4 No,K 29405 DEPARTMENT OF REVENUE
. OFFICIAL RECEIPT. PENNSYLVANIA INHERITANCE AND ESTATE TAX
I
t\
.
.
II
=
~ RECEIVED
, FROM
-~
~~
--..... ----
~..
~
, ADDRESS
TAX AT 6%
TAX AT 15%
TAXAT_%
1 "..t 81 h st.
Carli.l. PA 17013
ESTATE TAX
.--f5TATEINFORMATION7--------------____________
Ok TE OF DEATH 8e telllber 15 1980
TOTAL TAX CREDIT
'5.360.25
FilE NUMBER
21-80-614
A 11 6. 1981
lESS DISCOUNT
PLUS % INTEREST
(FROM TO_I
DATE OF PAYMENT
NAME OF DECEDENT
8th.1 Ma. Grov.
m
m
TOTAL AMOUNT PAID
COUNTY
C Ulllberllnd
-----------------------------------------
'OSTMARK DATE
REMARKS:
85.360.25
"PAID OR ACCOUNT"
SEAL
., ~'-r /
-// /e.' II ~. Afi/.~ '1 a
( . SIGNATURE
RECEIVED BY
I
REGISTER OF WillS
-.-----
---------------- ------.----