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Home My WebLink About02-0568PETITION FOR PROBATE and GRANT OF LETTERS Esrare of Rboert R. Gross, Jr. also known as Deceased. Social Security No. 179-1f3-9905 No.2t-oz-5b~ To: Register of Wills for the County of Cumberland in the Commonwealth of Pennsylvania The petition of the undersigned respectfully represents that: Your petitioner(s), who is/are 18 years of age or older an the execut ~r named in the last will of the above decedent, dated March 18 , 19_9.2. and codicil(s) dated IV(1NF (state relevant circumstances, e.g. renunciation, death of executor, etc.) Decendent was domiciled at death in Cumberland Count}, Pennsylvania, with hl S last famil or principal residence at 232 W1 ndl ng_ Way, Camp Hi I 1 , PA 17011 Lower Ayllen Township (list street, number and muncipality) Decendent, then 78 years of age, died March 4, 2002 , 19 , at . Except as follows, decedent did not marry, was not divorced and did not have a child born or adopted after execg~lpp o~(l~elv~ilP~ffer~d for probate; was not the victim of a killing and was never adjudicated incompetent: Surveyed by spouse . Louise S. Gross , the Petitioner herein . Decendent at death owned property with estimated values as follows: (If domiciled in Pa.) All personal property $ _ ~ ~ ~ ~ ~ " ~ (If not domiciled in Pa.) Personal property in Pennsylvania $ _ (If not domiciled in Pa.) Personal property in County $_ Value of real estate in Pennsylvania $_ situated as follows: WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s) presented herewith and the grant of letters (testamentary; administration c.t.a.;; administration d.b.n.c.t.a.) theron. .~~ ~-~~~~ ~ _ ~,~~ 232 Winding Way, Camp Hi 11 , PA 17011 ~~ ~` C C eE '« h 4 N r.. ~ O id C 00 OATH OF-PERSONAL REPRESENTATIVE COMMONWEALTH OF PENNSYLVANIA l ss COUNTY OF CUMBERLAND The petitioner(s) above•~named swear(s) or affirm(s) that the statements in the foregoing petition are true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen- tative(s) of the above decedent petitioner(s) will well truly administer he est to according to law. _ ~' Sworn to or affirmed and subscribed - rn before me this 17th .day of ~~ J 002 ~~~ r y LEW Register A .+ No. 21-OZ -5t~A Estate of Robert R. Gross, Jr. ,Deceased DECREE OF PROBATE AND GRANT OF LETTERS AND NOW JUNE 18, ~~2002 in consideration of the petition on the reverse side hereof, satisfactory proof having been presented before me, IT IS DECREED that the instrument(s) dated March 18, 1992 described therein be admitted to probate and filed of record as the last will of Robert R Gross Jr and Letters are hereby granted to LOU i se S . Gross FEES Probate, l.,etters, Etc.......... ~ 25.00 Short Certificates( ) .......... ~ 12.00 #~~{~~x , extra , ~g@~ . ~ 9.00 jcp ~ 5.00 TOTAL ~ 51.00 Filed .. 6-18-2002 ........................... mailed to atty 6-18-2002 ~~;~~~ 6~7 '. ,~ ~7 ~. MARY LEv17 kegister of Wills William I__ Gruhhh 72661 ATTORNEY (Sup. Lt. LD. No.) 3105 Old Gettysburg Rd., Camp Hill ADDRESS pA 17011 763-5580 FAX 763-6848 PHONE ~.'{ ~i1 -1, n5.9054fS REV.!09/Ol! This is to certify that this is a true copy of the record which is on file in the` Pennsylvania Division of Vital Records in accordance with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953. WARNING: It is illegal to duplicate this copy by photostat or photograph. Robert S. ~.~.~rman, Jr., MPH Secretary of Health Military status 015 7 2 7 8 No. M105. iaJ Rev. ?/B7 TrPlJraINT xN PEAYANENT TRACK BN( ~/ 2 U O O I 2 Charles Hardester State Registrar IMAY 0 6 2002 Date COMMONWEALTH OF PENNSYLVANIA • OEPARTMEN'f Of HEALTH • VITAL RECORDS 0 3 0 0 5 b CERTIFICATE OF DEATH NAME OF DECEDENT IFag. MioW.LaN) SE% SOCIAL SECURITY NUMSER DATE OF DEATN,MCrM. Day. ~bul ,- Robert R. Gross, Jr. ,male ,,179 - 18 - 9905 .-r 0.rcK Y ac~~. AGEILag SirRmy) UNDERI YEAR UMDERI DAY ORE aF BIRTN BUTFHPIACE ,C.ry ant PLACE dF OERNICnecM aW nro--xe+raruclpnon Ge,e eoY1 MMIU r Daya Hone Mewlaa !MGnm. Day.'~Yerl iteMaFaegn Counayl 78 OTHER HOSPITALy: Y~ 12 / 26 /2 Hazelton,PA - s. a 7. ~ Irwli.rN[RI ERIQApelisN ^ DaA^ N"aM° ^ ^ ,°"~,,.1^ !~ COUNTY OF DERM CRY. BORO. TM/P OF DERH FACK.T' NAME m rbl ngnlnpn, give grM ano nunbwi VMS DECEDENT OF HISPANIC ORIGNNT RACE -Amea:an N10iNr4 Bbca, While. ab. Cumberland E. Pennsboro Twp. t I ~ 5 ~, 11 S ~ l~l G 1 ~ , 1dn 1 I+X~C7 ~~ ~~• 'sD"'ytwhite !a «. w. f. ,o. DECEDENT'S USUAL OCCUPRION KIND OF BUSINESSIINDUSTRY YM$DECEDENT EVER IN DECEDENT'S EDUCRION MARRAL STRUS-Menial SURVIVNeG SPOUSE IGiaeNMdeuarlar OUrngrmY n ge ~" ~ ~ " ~ b d U.S.ARMED F011CE37 Y'•l~ "^^ c 1.3 `~ m"+ NevM MrriM.WWavW, i d~M IN'Ma. grw mabanrwMl L i S a r g it I a ,T. 1 eryar Ta Lum ~_ T~ n~ ~marr e ou se cott DECEDENT'S MAILRIG ADORESSISYM.CiIWban, 5ls.zveoael DECEDENTS I.nwar A17Rn n. WC.Wre NN.e.r Pennsylvania oM +Ta®n. cr T S A 232 Winding Way . . p. A e. l.b u L , RESIDENCE Wc.WM ~~ Camp Hill, PA 17011 ~ Win"" ~~ Cumberland °"rrnp9 ,y`^.Nl.n~rowa cavAO,e. FRMER'S NAPE (Frg. MiOds. Lesq MOTHER'S NAME (Fag. Mdse. MadM Suname) „ Robert R. Gross, Sr. „• Margaret Weir WFORYNTT'SNAME (TypeProat N +FDRMANrs MAIwG AODRESSISaea. cAyir .slr.. zv coos) Louise S. Gross „232 Winding Way, Camp Hill, PA 17011 METNOOaFasPOSTraN DREGFDISPOSIraN PLACEDFDISPOSrr1DN-NMMae.ma«y.cr.m.wr LocRIDN-cgYTpen,sw.,zviceW ^ °inu11pA~ ~"an151Ye^ r h 6 ~o ~ p D„rp„^ o~ Ma c , 2002 k o wne Cremation Service York, PA 17404 ,. :,.. 2 1e. 216 SIWRU OP sER ICENSEE OR PERSON ACTING AS SUCNI LICENSE NUMSER NAME AnD ADORESSOFF"c'LI^'Pa7'theplor2 Fllne~$1 µ07Q@ Inc. 0 CFSP ,,,- FD 013340-L Tx.PO BOX 431, New um er an A 1 / U I CarlpNe ewns7lee arny cerlKyxq btlw MN amYLrowlNGge, Watlr accurrW glM lime. Oge and place galM. LICENSE NUMSER oRESIGNED plryeiden~rloN avaaeeleYlmed Wellrb Bard TYq (Magl. DaN YMrI c«a, ralrr a G.wr. tea Nx. Nx. NwM 2a-NO nrlINlMrorrlplelaG eY Parson Nlo ProlloraKM GeYII NAE OF DERN ORE PRONOUNCE DEADIMmN. Day. ~1 I /, ~ VMS CASE REFERRED TO MEDICAL E%AS4NERICONONERT ^ . 1 ' ,^ YM ~y No tT. PART 1: ENerNH 6weMS, injuriesawmacalverreice oases lM Wale. Op nd aMerlM nbW OI Gyeq, auto as CarOiaCaraspGalOry arras, gbcaa Marl laawa. rAppmaimMa PART N: OlMrsgrvNCaM COrlWiar wrViOairgb Wale, eul Lis adYOne pelua pn MCJIYr. ~IMervM MlNraan orwlaMAMle nolnWilq ntlN laleMYalgcelM giaanb PARE 1. I NIYIEdATl CAVaE1F+W 1 GrNeetaa Cad4en ~ ra.rgbnrnl-- e. A -WehCE I SapNrrYNy Ng oadNaa s Nany, MedngbeMbOieM . 7p10R ASA ONSEOUENCE OFl: I Erner UMDENLYNq CMIlE IOewrq aMIKY ~ c NlalYleOaveae MNE TO IDR ASACONSEOUENCE OFT: ~.. rasuNnp n GaM10 LAST ' 0. WAS AN AUTOPSY WERE AUTOPSY FINDINGS MANNER OF DERV GATE OF INJURY TIME OF INJURY MMURV R WORKS DESCRIBE 110W INAIRYOCCURRED. PERFORMEOT AMIABLE PRIOR TO IMOnm, DeY• warl COLiIEiIOIN OF CAl13E rg NM L H vo ^ ~ U J X om a We ^ No ^ Alxidne ^ Pandrg bveMigMbn ^ Ye ^ NOT' 1 'M ^ No ^ ~~• ^ Cares MI M Wlermbao ^ PLACE OF NNJURY - A sent Mn grM la Yp dNCe M LOCRgN (SY CMf n N e , . y, wv . . orri16rr0. eb. ISpecMl 2Ne. M. ]ee. 701. CEITTIPIER ICnaaradY CnN SIGNRUIIE ANOM C I R •CE/ITNYNK: PNYSKlA11 rPnyecwnceMynrg Tame a team when shahs pnysa:an has aawrlceG Wee. am canaeleG hen zal ^ TO NNe Maol my erloNalWge, Wale eceurreg elreblM eauselsl and lrranMlNalaleG ..................................................... Ito. LICENSE NUMBER SIG Magr, -1br1 •MONOUNCING AND CERTIFYING M/YSICIANIPnyscnn can aaro„nong Wan and ceNWgbcausad GeaVO To gra Mal a my aneMaggw. team eNar.raG r ba sera, Gab. ant PMCa, and Gw b IM eaeaNal and manrwr x alalM .......................... ~ ---I O~~rU"~q 1 I `~ s /n7 ,le. 1 ]16 V NAME AND ADDRESS OF PERSON WHO COMPLETEDCAUSE OF N 'YEDNCAL EXAYINER/COITONER in my opinion On tlr Ouis d eNaminnlon ardla Ineeetfga[ion dente oecunW el the Nme Ged and pMCe ang due to the oase(s) and (Nam 277 Type or Print ~~;~ O~`r ~ O j ,~lr yy qq \ , , , , , mrlmr u Melatl .................................................................................................. ^ J,a. . G y ~,~L V1~.112~N 1"'~ V 77. (~ ~~ REGISTRAR'S SIGNRURE ANO NUMBE~~ GATE FILED (Haan. Day, lbel V FAST WILL AND TESTAISENT OF ROBERT R. GROSS, JR. 2~- 02-5~8 I, Robert R. Gross, Jr., a resident of and domiciled in Lee County, Florida, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament and hereby revoke all Wills or Codicils heretofore made by me. FIRST: I direct that all my just debts and funeral expenses be paid as soon after my decease as practicable, and to that end I hereby charge all my estate, real, personal and mixed. SECOND: I devise all of my estate, real, personal and mixed, and wheresoever situated and whether now owned or hereafter acquired by me to my wife, Louise S. Gross, if she survives me. THIRD: In the event that my said wife does not survive me, I devise all of my estate, real, personal and mixed, and wheresoever situated and whether now owned or hereafter acquired ~y me to my son, Robert R. Gross, III, if he survives me. FOURTH: In the event that both my said wife and my said aon predecease me, I devise my estate as follows, to-wit: A. The sum of Ten Thousand Dollars ($10,000.00) to my daughter-in-law, Maryann S. Gross, if she survives me; and B. The residue of my estate, real, personal and mixed, and wheresoever situated and whether now owned or hereafter DYE & SCOTT, P.A. - Attorneys at Law - Bradenton, Florida acquired by me to my Trustee hereinafter named in trust for the following uses and purposes: 1. To distribute from time-to-time, to or for the benefit of my grandchildren, so much of the income as my Trustee shall deem necessary to provide for the proper housing, support, maintenance, health care and education of my grandchildren, and to the extent income is not adequate to so provide, my Trustee may, in his or her sole discretion, distribute principal, as needed, for such purposes. 2. At such time as my youngest grandchild living at any time attains the age of twenty-one years, this trust shall terminate and shall be divided equally among my then living grandchildren. 3. At the present time my grandchildren are Katrina L. Gross and Kyle R. Gross. 4. I nominate and appoint Margaret A. Miller as Trustee of the trust hereunder and in the event that she fails to serve or complete the administration, I nominate and appoint David Weller as Trustee. The Trustees named herein shall serve without bond and shall have all powers given trustees by the State of Florida. FIFTH: I nominate, constitute and appoint my wife, Louise S. Gross, as the Personal Representative of this my Last Will and Testament. If she fails to qualify or complete her Page 2 DYE & SCOTT, P.A. - Attorneys at Law - Bradenton, Florida administration, I nominate, constitute and appoint my son, Robert R. Gross, III, as the Personal Representative. I direct that no bond shall be required of any Personal Representative nominated in this paragraph. SIXTH: I give and grant to any Personal Representative nominated herein, all powers granted by law together with full power and authority to sell, transfer and convey any property, real or personal, which I may own at the time of my death, at such time and price and upon such terms and conditions as my Personal Representative may determine and to do every other act and thing necessary or appropriate to the complete administration of this Will. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this ~ g day of M at~c~, , 1992. '~'~ (SEAL) Ro ert R. Gross, The foregoing instrument was subscribed, sealed, published and declared by Robert R. Gross, Jr. as and for his Last Will and Testament in our presence, and in the presence of each of us, and we, at the same time at his request, in his presence and in the presence of each other, hereunto subscribed our me as to ng itnes s. Z - f Florida. ` of ~ , Florida. Page 3 DYE & SCOTT, P.A. - Attorneys at Law - Bradenton, Florida STATE OF FLORIDA COUNTY OF i~'f.~ll/f} ~/= E We, the undersigned, the Testator and the witnesses respectively, whose names are signed to the attached or foregoing instrument, having been sworn, declared to the undersigned officer that the Testator, in the presence of the witnesses, signed the instrument as his Last Will, that he signed and that each of the witnesses, in the presence of the Testator and in the presence of each other, signed the Will as a witness. ~/ _ T stator f Witness ~ R ~r W1~ Witness Subscribed and sworn to before me by t/he Testator, and by the attesting witnesses, on , 1992. ~- ! ~~ Testator Identification: Notary Public _ Name • ~ ,~} My Commission Expires: _~,: Page 4 DYE & SCOTT, P.A. - Attorneys at Law - Bradenton, Florida ~uL~ ~' E IN RE: : IN THE COURT OF COMMON PLEAS OF :CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ROBERT R. GROSS, JR. :ORPHANS COURT DIVISION DECEASED No. 2002 - 00568 ORDER AND DECREE UNDER SECTION 3102 OF THE PROBATE ESTATES A FIDUCIARIES CODE AND NOW this ~~ da of 2 02 y _ 0 ,upon consideration of the annexed Petition, IT IS HEREBY OR ;D AND DECREED pursuant to Section 3102 of the Probate, Estates and Fiduciaries Code, that all funds held in account of Robert R. Gross, Jr., in account 10968 at Susquehanna Valley Credit Union be distributed to Louise S. Gross, and further that a certified copy of this Order shall serve as authority to Susquehanna Valley Credit Union to make the distribution directed hereby. BY THE COURT: J. -- -- ,= ,_ ~, ~~ ~., IN RE: : IN THE COURT OF COMMON PLEAS OF :CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ROBERT R. GROSS, JR. :ORPHANS COURT DIVISION DECEASED No. 2002 - 00568 PETITION UNDER SECTION 3102 OF T:HE PROBATE, ESTATES AND FIDUCIARIES CODE FOR SETTLEMENT OF SMALL ESTATE TO THE HONORABLE, THE JUDGE OF SAID COURT: Your Petitioner, Louise S. Gross, by and through her attorney, William L. Grubb, Esquire, files this Petition for Settlement of a Small Estate under the provisions of Section 3102 of the Probate, Estates and Fiduciaries Code and in support avers that: 1. Your Petitioner, Louise S. Gross, is an adult individual, sui juris, residing at 232 Winding Way, Camp Hill, Pennsylvania, and is the wife of above-named decedent. 2. Robert R. Gross, Jr., husband of your Petitioner, died on March 4, 2002, at the age of 78 years, and prior thereto lived and was domiciled at 232 Winding Way, Camp Hill, Pennsylvania. 3. At the time of his death, the decedent formed a part of the household of your Petitioner, Louise S. Gross. 4. The decedent died testate and Letters testamentary have been granted by the Register of Wills of Cumberland County to your Petitioner, Louise S. Gross A true and correct copy of the decedent's Last Will and Testament is attached hereto, made a part hereof, incorporated herein by referencf; and marked Exhibit «A„ 5. The decedent had no probate estate when he died other than the following: (a) Bank account at Susquehanna Valley Credit I?Tnion, #10968, with a balance at date of death of $1,029.96, plus interest and deposits. 6. All other assets of the decedent were owned as joint tenants with right of survivorship with your Petitioner, Louise S. Gross. 7. The decedents Estate is not subject to Pennsylvania Transfer Inheritance Tax as indicated by a true and correct copy of the Inheritance Tax Return for a resident Decedent attached hereto, incorporated by reference thereto, made a part hereof and marked Exhibit "B". 8. The sole person entitled to receive the decedent's property under the terms of decedent's Last Will and Testament is your Petitioner. 9. There are no creditors of the decedent and no claims unpaid known to your Petitioner. 10. Your Petitioner desires to receive the Decedent's property held in Susquehanna Valley Credit Union account #10968, and that all funds now in the account be paid to her. WHEREFORE, your Petitioner prays your Honorable Court that an Order be made directing that Susquehanna Valley Credit Union distribute all funds in the above mentioned account over to her, and further that a certified copy of said Order shall serve as authority to Susquehanna Valley Credit union, and that Petitioner, Louise S. Gross, be authorized to execute any and all documents required by Susquehanna Valley Credit Union, to carry out the Order of the Court. Date: ~~'t ~~: --~ William L. Grubb, Esquire ID 72661 3105 Old Gettysburg Road Camp Hill, PA 17011 Attorney for the Petitioner VERIFICATION I, Louise S. Gross, verify that the facts set forth within the foregoing Petition are true and correct, to the best of my knowledge, information and belief. I understand that false statements herein are subject to the penalties of 18 Pa. C.S.A. §4904, relating to unsworn falsifications to authorities. Date: ~ ^ / O - p,Z,, Louise .Gross 'r ~ ~~ r C ,t ~ ~ .: ' . -. ~ - ~ _ .. ~ ~ r f ..+ 1 LAST WILL AND TESTAI~sENT OF ROBERT R. GROSS, JR. 2i- 02-5+~$ I, Robert R. Gross, Jr., a resident of and domiciled in Lee County, Florida, being of sound and disposing mind and memory, do hereby make, publish and declare this to be my Last Will and Testament and hereby revoke all Wills or Codicils heretofore made by me. FIRST: I direct that all my just debts and funeral expenses be paid as soon after my decease as practicable, and to that end I hereby charge all my estate, real, personal and mixed. SECOND: I devise all of my estate, real, personal and and wheresoever situated and whether now owned or hereafter acquired by me to my wife, Louise S. Gross, if she survives me. THIRD: In the event that my said wife does not survive me, I devise all of my estate, real, personal and mixed, and wheresoever situated and whether now owned or hereafter acquired by me to my son, Robert R. Gross, III, if he survives me. FOURTH: In the event that both my said wife and my said son predecease me, I devise my estate as follows, to-wit: A. The sum of Ten Thousand Dollars ($10,000.00) to my daughter-in-law, Maryann S. Gross, if she survives me; and B. The residue of my estate, real, personal and mixed, and wheresoever situated and whether now owned or hereafter DYE & SCOTT, P.A. - Attorneys at Law - Bradenton, Florida acquired by me to my Trustee hereinafter named in trust for the following uses and purposes: 1. To distribute from time-to-time, to or for the benefit of my grandchildren, so much of the income as my Trustee shall deem necessary to provide for the proper housing, support, maintenance, health care and education of my grandchildren, and to the extent income is not adequate to so provide, my Trustee may, in his or her sole discretion, distribute principal, as needed, for such purposes. 2. At such time as my youngest grandchild living at any time attains the age of twenty-one years, this trust shall terminate and shall be divided equally among my then living grandchildren. 3. At the present time my grandchildren are Katrina L. Gross and Kyle R. Gross. 4. I nominate and appoint Margaret A. Miller as Trustee of the trust hereunder and in the event that._she fails to serve or complete the administration, I nominate and appoint David Weller as Trustee. The Trustees named herein shall serve without bond and shall have all powers given trustees by the State of Florida. FIFTH: I nominate, constitute and appoint my wife, Louise S. Gross, as the Personal Representative of this my Last Will and Testament. If she fails to qualify or complete her Page 2 DYE & SCOTT, P.A. - Attorneys at Law - Bradenton, Florida :~... .. Yiit:4.ga taY'b''.,~:r,.S.~.il3.'.i.M^4s+'tw._~....w.iYi'iMW~Cau:4„'.cs.:._. _.. ,. .... ~.. .. ....- administration, I nominate, constitute and appoint my son, 'Robert R. Gross, III, as the Personal Representative. I direct that no bond shall be required of any Personal Representative nominated in this paragraph. SIXTH: I give and grant to any Personal Representative nominated herein, all powers granted by law together with full power and authority to sell, transfer and convey any property, real or personal, which I may own at the time of my death, at isuch time and price and upon such terms and condit:.ons as my Personal Representative may determine and to do every other act and thing necessary or appropriate to the complete administration ~of this Will. IN WITNESS WHEREOF, I have hereunto set my hand and seal to this, my Last Will and Testament, this 18 day of M ahc~... , 11992 . / :~ (SEAL) Ro ert R. Gross, The foregoing instrument was subscribed, sealed, ~published_and declared by Robert R. Gross, Jr. as and for his Last Will and Testament in our presence, and in the presence of beach of us, and we, at the same time at his request, in his presence and in the presence of each other, hereunto subscribed Page 3 our me as to ng itnes s. Z - f , Florida.` `~. of ~ , Florida. DYE & SCOTT, P.A. - Attorneys at Law - Bradenton, Florida STATE OF FLORIDA COUNTY OF iyll~/I/f} 1~/= E We, the undersigned, the Testator and the witnesses respectively, whose names are signed to the attached or foregoing instrument, having been sworn, declared to the undersigned officer that the Testator, in the presence of the witnesses, signed the instrument as his Last Will, that he signed and that each of the witnesses, in the presence of the Testator and in the presence of each other, signed the Will as a wi~~ness. y T stator f Witness l~Jl~. Witness Subscribed and sworn to before me by t/he Testator, and by the attesting witnesses, on ~ ` ~ , 1992. Testator Identification: FL D/L_~6~D-7~d-~3-T~i~'°Z Notary Public Name: My Commission Expires• - ~~ Page 4 DYE & SCOTT, P.A. - Attorneys at Law - Bradenton, Florida aEVSOOex,nmt COMMONWEALTH OF REV -15 0 0 OFFICIAL USE ONLY PENNSYLVANIA °"""' "' • DEPARTMENT OF REVENUE INHERITANCE TAX RETURN FILE NUMBER DEPT. 280601 ~, HARRISBURG, PA 17128-0601 RESIDENT DECEDENT COUNTYCDDE YEAR NUMBER -~ - - - - - - - DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER ~ Z Gross Robert R. Jr. 179-18-9905 W - --- -- DATE OF DEATH (MM-DD-YEAR) -- -- - - ----- --- --- . --- - ---- DATE OF BIRTH (MM-DD-YEAR) - ----- ------------- ------ THIS RETURN MUST BE FILED IN DUPLICATE WITH THE U 03/04/02 12/26/23 REGISTER OF WILLS Q (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER Gross Louise S. 157-18-2757 ~ ~ 1. Original Return ~ 2. Supplemental Return ~] 3. Remainder Return (date ordeatn pd« to ~z-i3-sz) w a ~ ~ 4. Limited Estate ~ 4a. Future Interest Compromise (date ordeadt aver ~z-~z-sz) ~~ 5. Federal Estate Tax Retum Required ~ a m X^ 6. Decedent Died Testate lattacn copy of waq ~ 7. Decedent Maintained a Living Trust IAUav, copy of TNSt) 8. Total Number of Safe Deposit Boxes a a ~ 9. Litigation Proceeds Received ~ 10. SpoUSal POVerty Credlt (dale of death behveen 1231-91 and 1-1-95) ~] 11. Election to tax under Sec. 9113(A) tauacn sch o) ~ THIS SECTICIN MUST BE GOMPLET~D.ALL"GORRESPQNDENCE A ND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: z w o NAME William L. Grubb, Esq. COMPLETE MAILING ADDRESS ti W FIRM NAME (~tAppYnde) 3105 Old Gettysburg Road o TELEPHONE NUMBER - -- - Camp HIII, PA 1701'1 ~ (717) 763-5580 1. Real Estate (Schedule A) (1) OFFICIAL USE ONLY , 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or Sole-Proprietorship (3) 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) 1,029.96 Z (Schedule E) ~ 6. Jointly Owned Property (Schedule F) (6) Q ~ Separate Billing Requested J ~ 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) F_ (Schedule G or L) Q 8. Total Gross Assets (total Lines 1-7) (8) 1,029.96 W 9. Funeral Expenses & AdminisUafive Costs (Schedule H) (9) ~ 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) (11) 12. Net Value of Estate (Line 8 minus Line 11) (12) 1,029.96 13. Charitable and Governmental BequestslSec 9113 Trusts for which an election to tax has not been (13) made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 1,029.96 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES Z ~ 15. Amount of Line 14 taxable at the spousal tax 1,029.96 t t f d S 9116 2 x 0 0 0.00 (15) a ) --- ____ ra e, or rans ers un er ec. (a)(1. , _ H 16. Amount of Line 14 taxable at lineal rate - ---------------.--- - x .0 _.. _. (16) _ n' 17. Amount of Line 14 taxable at sibling rate -----------------____-_ __-____ ___.... x .12 (17) _ ~ 18. Amount of Line 141axable at collateral rate ------- --- -- -.- - - ---. _- ___ x J5 (18) Q 19. Tax Due (19) 0.00 H > > BE SURE TO ANSWER ALL gUEST1ONS ON REVERSE SIDE ANI~ REGH6CK MATH: < < Decedent's Complete Address: STREETADDRESS _ 232 Winding Way I vCamp Hill -1 §rArEPA _ f zia17011_ Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) (1) 0.00 2. CreditslPayments A. Spousal Poverty Credit _ _ __ _ _____ .__-_______ ___ B. Prior Payments __ C. Discount Total Credits (A + B + C) (2) 0.00 3. InteresUPenalty if applicable D. Interest _ ___ _____ E. Penalty Total InteresUPenalty (D + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0.00 A. Enter the interest on the tax due. (5A) B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) 0.00 Make Check Payable fo: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred :......................................................................................... ^ b. retain the right to designate who shall use the property transferred or its income :........................................... ^ ^x c. retain a reversionary interest; or ......................................................................................................................... ^ d. receive the promise for life of either payments, benefits or care? ...................................................................... ^ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................. ^ ^x ................................................ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. ^ ^X 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ ^ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and fo the Desl of my knowledge and belief, it is Irue, correct and complete. Dedaration of preparer other than the personal representative is based on all iniormaGon of which preparer has any knowledge. SIGNATUR OF PERSON RESPONSIBLE R FILING TURN DATE _-. ~-- ~ o_- o_,'Z, - - ------ ADDR S _-- ---- - 232 Winding Way, Camp Hill, PA 17011 I NA UR ~JF REPARER OTH TH REPR TATIVE DATE ADDRESS - r - CJ ,'..__ ---- _- -~ ~-- 3105 Old Gettysburg Road, Camp Hill, PA 17011 For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. §9116 (a) (1.1) (i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. §9116 (a) (1.1) (ii)]. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. §9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as nosed in 72 P.S. §9116(1.2) [72 P.S. §9116(a)(1)j. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. §9116(a)(1.3)]. Asibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508 EX+ (6-98) Y COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF FILE NUMBER Robert R. Gross, Jr. Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of surv(vorshia must be disclosed on Schedule F (Ir more space is needed, insert additional sheets of the same size) /~ - %P' - BUREAU OF INDIVIDUAL TAXES V INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 .~. WILLIAM L GRUBB ESQ 3105 OLD GETTYSBURG CAMP HILL °-PA COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX REY-1547 ER ~FP (01-027 DATE 08-26-2002 ESTATE OF GROSS JR ROBERT R DATE OF DEATH 03-04-2002 FILE NUMBER 21 02-0568 - - ~-' COUNTY CUMBERLAND ACN 101 RD Amount Remitted 17011 MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE - RETAIN LOWER PORTION FOR YOUR RECORDS ~ ---------------------------------------------------------------------------------------------------------------- REV-1547 EX AFP (01-02) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GROSS JR ROBERT R FILE N0. 21 02-0568 ACN 101 DATE 08-26-2002 TAX RETURN NAB: (X) ACCEPTED AS FILED ( )CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Reel Estate (Schedule A) (1) .00 NOTE: To insure proper 2. Stocks and Bonds (Schedule B) (2) .00 credit to your account, 3. Closely Held Stock/Partnership Interest (Schedule C) (3) .00 submit the upper portion 4. Mortgages/Notes Receivsble (Schedule D) (4) .00 of this form with your 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (5) 1,029.96 tax payment. 6. Jointly Owned Property (Schedule F) (6) .00 7. Transfers (Schedule G) (7) .00 8. Total Assets (g) 1,029.96 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) .00 10. Debts/Mortgage Liabilities/Liens [Schedule I) (10) .00 11. Total Deductions (11) _00 12. Net Value of Tax Return (12) 1,029.96 13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) (13) .00 14. Net Value of Estate Subject to Tax (14) 1,029.96 NOTE: if an assessment was issued previously, lines 14, 15 andior 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assessed to date. ASSESSMENT OF TAX: 15. Amount of Line 14 at Spousal rata (15) 1,029.96 X 00 _ .00 16. Amount of Line 14 taxable at Lineal/Class A rate (16) .00 X 045 . .00 17. Amount of Lina 14 at Sibling rate (17) •00 X 1 2 - .00 18. Amount of Line 14 taxable at Collateral/Class B rate (18) .00 X 15 - .00 19. Principal Tax Due (19)= .00 DATE ~ NUMBER ~ INTEREST/PEN PAID (-) I AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .DO TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A ''CREDIT" (CR), YOU MAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) V y .. IN RE: : IN THE COURT OF COMMON PLEAS OF :CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ROBERT R. GROSS, JR. :ORPHANS COURT DIVISION DECEASED No. 2002 - 00568 STATUS REPORT UNDER RULE 6.12 Name of Decedent: Robert R. Cross, Jr. Date of Death: March 4, 2002 Will No. Admin. No. 21-02~ 0568 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes XX No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? Y~~,.. No XX ~ b. The separate Orphans' Court No. (if any) for the personal =j ~ representative's account is: N ut c. Did the personal representative state an account informally to the ~ J parties in interest? Yes XX No. ~ d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' -- Court and may be attached to this report. Date: ZS ZJ-o ' Signature William L. Grubb, Esquire 3803 Gettysburg Road Camp Hill, PA 17011 (717) 763-5580 Capacity: Personal Representative XX Counsel for personal representative REV_1500EX (6.oaj REV-1500 '* COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT 280601 _. HARRISBURG, PA 17128-0601 INHERITANCE TAX RETURN RESIDENT DECEDENT to- Z W C W U W C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Gross Robert R. Jr. DATE OF DEATH (MM-DD-YEAR) j DATE OF BIRTH (MM...-DD-YEAR) 03/04/02 12/26/23 - ---- -.--- --- - (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST. FIRST, AND MIDDLE INITIAL) Gross Louise S. C- OFFICIAL USE ONLY 17- 70-- 5 oo$;g ----- FILE NUMBER iSLl -C~ COUNTYCOOE YEAR NUMBER w " x::g;1/) ,,"'''' w"" ,,00 "",," ..CD .. '" [!] 1. Original Return D4,LimitedEstate o 6, Decedent Died Testate lAlIach copy of Will) D 9. LitigaUon Proceeds Received D2,SupplementalReturn D4a.FuturelnterestCompromiseldaleOfdeathaftert2-12-1l2) D 7. Decedent Maintained a Living Trust (Attach copy of Trusl) D 10. Spousal Poverty Credit (date ofdeall1 between 12-31-91 arid 1-1-95) SOCIAL SECURITY NUMBER 179-18-9905 I THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER D 3. Remainder Return ldale ofdeatll prior 10 12.1)..82) o 5. Federal Est<lle Tax Retum Required 8. Total Number of Safe Deposit Boxes D 11 Election to tax under Sec. 9113(A) (Attacl1 Sch 0) 3105 Old Gettysburg RQ8d Camp Hill, PA 17011' " z w o z o .. '" w '" '" o " NAME __ William L. G!ui:Jb,-,=s.g. FIRM NAME (If Applicable) COMPLETE MAILING ADDRESS : OFFICIAL USE ONLY -- 1,029.96 (8) 1,029.96 TELEPHONE NUMBER (717) 763-5580 (11) (12) (13) 1,029.96 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) (14) 1,029.96 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule 0) z o ~ ...J :J !:: a. el: u w c:: 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) D Separate Bil ted 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G orL) 8 Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Admiristrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12 Net Value of Estate (Line 8 minus Line 11) (9) (10) 0.00 (19) 0.00 (61 (7) 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Line 13) SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ I-' :J a. ::E o U g 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a}{1.2) u___l,029.96 ,.0 0 (15) 16 Amount of Une 14 taxable at lineal rate , .0 (16) 17 Amount of Line 14 taxable at sibling rate , .12 (17) 18. Amount of Line 14 taxable atcollateraJ rate ,.15 (181 19. Tax Due 20.0 CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Decedent's Complete Address: STREET ADDRESS ~2 Windin9~ Clrv Camp Hill STATE PA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 1 g) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 3. InteresUPenalty if applicable D.lnlerest E. Penalty Tofal Credits (A + 8 + C ) (2) 0.00 TolallnleresUPenal1y ( D + E ) (3) 4. If Line 2 is greater than Une 1 + line 3, enter the difference. This is the OVERPAYMENT. Check box on Page 1 Line 20 to request a refund (4) 5. If Line 1 + Line 3 is greater than line 2, enter the difference. This is the TAX DUE. 8. Enter the total of line 5 + SA. This is the BALANCE DUE. (5) (SA) (5B) 0.00 A Enter the interest on the tax due. 0.00 Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: a. retain the use or income of the property transferred:.. b. retain the right 10 designate who shall use the property transferred or its income;.. .................. c. retain a reversionary interest; or.. d. receive the promise for life of either payments, benefits or care?.. nom................ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration?.. ................. 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? . .......... D [KI IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Yes .........0 ...................0 o o ......0 .............0 No ~ ~ ~ ~ ~ ~ Under penatties of pe~ury, I declare thai I have examined this return. including accompanying schedules and statements. and to the best of my krlOwfedge and belief. it is true, correct and complete Declaration of preparer olher Ihan the personal represenlative is based on all information of which preparerhas any knowtedge. SIGNATUR OF PERSON ~ESPON:;r:~;N~, ADDR S 23~ Windinf!Way,Camp ~PA17011_ . SIGNAtR~~OT'!:Ej[:TIVE~ r- ADDRESS fC '~CJ 3_105()Ic1Gettysbur(L~()ad, Camp Hill, PA Y011 DATE ?-liI-O& DATE .-") -I 0 -0],.,- For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P5. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. S9116 (a) (1.1) (ii)l. The statute does not exemot a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent, an adoptfve parent, or a stepparent of the child is 0% [72 P.S. ~9116(a)(1.2)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. S9116(1.2) [72 P.S. s9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. g9116(a}(1.3)J. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508EX+(6-98) *' COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY ESTATE OF Robert R. Gross, Jr. FILE NUMBER Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION Account at Susquehana Valley Credit Union, #10968 VALUE AT DATE OF DEATH 1,029.96 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 1,029_96 IN RE~ ESTATE OF ROBERT R. GROSS, JR. DECEASED · IN THE COURT OF COMMON PLEAS OF · CUMBERLAND COUNTY, PENNSYLVANIA · ORPHANS COURT DIVISION No. 2002-00568 STATUS REPORT UNDER RULE 6.12 Name of Decedent: Robert R. Gross, Jr. Date of Death: March 4, 2002 WillNo. Admin. No. 21-02, 0568 Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete: Yes XX No 2. If the answer is No, state when the personal representative reasonably believes that the administration will be complete: 3. If the answer to No. 1 is Yes, state the following: a. Did the personal representative file a final account with the Court? ~4~? No XX ~ b. The separate Orphans' Court No. (if any) for the personal [:' '.::. "'"-~: representative's account is: c. Did the personal representative state an account informally to the XX parties in interest? Yes No. d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court and may be attached to this report. Date:~_ Signature William L. Grubb, Esquire 3803 Gettysburg Road Camp Hill, PA 17011 (717) 763-5580 Capacity: XX Personal Representative Counsel for personal representative