HomeMy WebLinkAbout02-0898
Blare 01 Elizabeth Jane Gray
also known as
PETITION FOR PROBATE and GRANT OF LJH.lJiliS
.:LI~"Z. ~'r'
No.
To:
Register of Wills for the
Decerued. County of Cumberland in the
Social Security No. 180-38-8020 Commonwea!lh of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), whoJDtare 18 years of age or older an the exeCUt or
in the last will of the above decedent, dated /lnril 21
and codicil(s) dated
named
,19 86
(Slale relevant circumstances. e.g. rmvrroisriou, dalh of CUCIIIOI', etc.)
Decendent was domiciled at death in Cumberland County, Pennsylv\ll\ia, with
b er last family or principal residence at 70 Drexel Place, Lower Allen ToWnship,
Cumber land County, pennsy 1. vam.a
(\is, su.... number lIlICIllllUlCipaijty)
Decendem, chen 54 years of a~. died September 13, 2002 ~
at 70 Drexel Place, Lower Allen 'lwp., Cumberland County, t'A .
Except as follows. decedent did not marry. was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendem at death owned properry 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: 70 Drexel Place, Lower Allen Two.,
Curol-Pr land County, PA
S 50,000.00
,
S
S
S
70rOnO_OO
WHEREFORE, petltioner(s) respectfully request(s) lhe probate of lhe last will and codicil(s)
presented herewith and the grant of letters test""",nt-"rv
(ICSWUematY: adminisuation "-La.; adminisuation d.b.n.t.'...)
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600 Potzman Street
Morqantown, w<l 26505
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } sa
COUNTY OF CUMBERLAND
The petitioner(s) above-named sWear(s) or affirm(s) that the statements in lhe foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
ta!ive(s) of the above decedent petitioner(s) will well and truly arlminioner the estate according to law.
Sworn to or affirmed and subscribed {
before ~ t~ := day of
4kmJtIY?J. g~, .~~
(}_q?_ q ReglSte
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No. 21-02-0898
Estate of Elizabeth Jane Gray
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW OCTOBER 7th ~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 April 21, 1986
described therein be admitted to probate and filed of record as the last will of Elizabeth Jane
Gray
and Letters Testamentarv
are hereby granted to Ralph W. Plurrmer
4):;,.".,,.) '/IJ.t!J/;/;, /;?J4 r t?tJ. -u{'~~.L)t4-
Il.egislcr of Wills
FEES
Probate. Letters. Etc. ......... S 235.00
Short Certificates( 3) . . . . . . . . .. S 9.00
~.F;4T~..E:Gf!..;J.. S 9.00
JCP S 5.00
TOTAL _ S 258.00
Filed . O~.'l;Ql}~!l-. .7.~~! . ?9P.~ . . . . .. . .. . . . . .
Gerald J. Shekletski #40486
ATTORNEY (Sup. Ct. 1.0. No.)
414 Bridqe st., New Cumberland, PA 17070
ADDRESS
(717) 774-7435
PHONE
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70.
Hl05.805 REV ')186
This is to certifY that the information here given is correctly copi~d ffom an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the Srate Vltal Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
P 8387784
No.
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fee for this certificare, $2.00
SEP 1 4 2002
Date
.1';.;,fJA",.2i81
CO'UMOHWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
HNoIlE OF OfCEDEN1Cf..., M..,....l_
I. Elizabeth Jane Gray
.loGE It;lll 8orlt>da11 UNDEA I YeAR
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lL Warren Edward Gray
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STONE,SAJER
8: STEWART
Attorneys at L.aw
414 Bridge Street
New Cumberland, Pa.
17070
()
21-02-0898
LAST WILL AND TESTAMENT
OF
ELIZABETH JANE GRAY
I, ELIZABETH JANE GRAY, of the Township of Lower Allen, County of
Cumberland, and Commonwealth of Pennsylvania, declare this to be my last will
and revoke any will previously made by me.
ITEM I: I devise and bequeath all of my estate of every nature and
wherever situate to my mother, MARY BIEBER GRAY, if she survives me by thirty
(30) days.
ITEM II: Should my mother, MARY BIEBER GRAY, fail to survive me by
thirty (30) days, I devise and bequeath my estate as follows:
A. The automobile that I own at the time of my death, together
with any insurance thereon, to my sister, CAROL LYNN HESS, of Oak Hill Road,
Waynesboro, Pennsylvania.
B. The residue of my estate of every nature and wherever
situate to my sister, MARGARET JOY GRAY, of 70 Drexel Place, New Cumberland,
Pennsylvania, or to her issue, per stirpes.
ITEM III:
I appoint my Executor and his successors guardian of any
property which passes either under this will or otherwise, to a minor and with
respect to which I am authorized to appoint a guardian and have not otherwise
specifically done so, provided that this appointment of a guardian shall not
supersede the right of any fiduciary in its discretion to distribute a share
where possible to the minor or to another for the minor's benefit. Such guar-
dian shall have the power to use principal as well as income from time to time
Page 1 of 4 pages
STONE, SAJER
8: STEWART
Attorneys at Law
414 Bridge Street
New Cumberland, Pa.
17070
for the minor's support and education (including college education, both gra-
duate and undergraduate) without regard to his or her parent's ability to pro-
vide for such support and education, or to make payment for these purposes,
without further responsibility, to the minor or to the minor's parent or to
any person taking care of the minor.
ITEM IV: I direct that all taxes that may be assessed in consequence
of my death, of whatever nature and by whatever jurisdiction imposed, shall be
paid from my residuary estate as a part of the expense of the administration
of my estate.
ITEM V: I appoint my brother-in-law, RALPH W. PLUMMER, of 600
Potzman Street, Morgantown, West Virginia, 26505, Executor of this my last
will.
ITEM VI: I direct that my Executor or guardian or their successors
shall not be required to give bond for the faithful performance of their
duties in any jurisdiction.
IN WITNESS WHEREOF, I, ELIZABETH JANE GRAY, Testatrix,
r,~ ~
ell day of
have hereunto
, 1986.
set my hand and seal this
l
A1tk<-
(SEAL)
Page 2 of 4 pages
SIGNED, SEALED, PUBLISHED and DECLARED by ELIZABETH JANE GRAY, the
Testatrix above named, as and for her Last Will and Testament, and in the pre-
sence of us, who at her request, in her presence and in the presence of each
other, have subscribed our names as witnesses.
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tness
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Address J
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Address
COMMONWEALTH OF PENNSYLVANIA:
:SS:
COUNTY OF CUMBERLAND
I, ELIZABETH JANE GRAY, the Testatrix whose name is signed to the
attached or foregoing instrument, having been duly qualified according to law
do hereby acknowledge that I signed and executed this instrument as my last
will; that I signed it willingly and that I signed it as my free and voluntary
act for the purposes therein contained.
f ~atd ,t"lLL ~W;
ELI TH JANE GRAY
Sworn to or affirmed to and acknowledged before me by ELIZABETH JANE
GRAY, the Testatrix, this C7/~ay of ~_ 1986.
STONE, SAJER
a STEWART
~~~~~
Notary Public
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Nil I
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STONE:, SAJER
&: STEWART
Attorneys at L.aw
414 Bridge Street
New Cumberland, Pa.
17070
COMMONWEALTH OF PENNSYLVANIA
:SS:
COUNTY OF CUMBERLAND
We, ~lJi 1\ ~ -ffnne.
and ~-R '-12_ ~--<J' 1, 'cr
the attached or foregoing instrument,
the witnesses whose names are signed to
being duly qualified according to law, depose and say that we were present and
saw Testatrix sign and execute the instrument as her last will; that Testatrix
signed willingly and that she executed it as her free and voluntary act for
the purposes therein expressed; that each of us in the hearing and sight of
the Testatrix signed the will as witnesses; that to the best of our knowledge,
the Testatrix was at that time eighteen or more years of age, of sound mind
and under no constraint or undue influence.
()rt"Sh-
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Sworn to or affirmed to and acknowledged before me by
/j~ ~ ~J and
this ';;1 ~day of ~
ff? ;? ~JJ
, 1986.
, witnesses,
~d~~,
Notary Public
BETH ANN HECKMAN, Not..., Public
New Cumberland, Cumberland Co., Pa
~~laio!'flqli~$ fe~. 6/ 19\1\1
Page 4 of 4 pages
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
Name of Decedent: Elizabeth Jane Gray
Date of Death:
September 13, 2002
Will No. 2002-00898
To the Register:
I certify that notice of beneficial interest required by
Rule 5.6(a) of the Orphans' Court rules was served on or mailed
to the following beneficiaries of the above captioned estate on
October 4, 2002:
Mary Beiber Gray
70 Drexel Place
New Cumberland, PA 17070
Notice has now been given to all persons entitled thereto under
Rule 5.6(a).
Date: a/Y~J- ~ ~
Gerald {/s~e~qu'ire
414 Bridge Street
New Cumberland, PA 17070
717-774-7435
Capacity: Personal Representative
X Counsel for Personal
Representative
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDMDUAl TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-l 162 EX(1 1-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
SHEKLETSKI GERALD J ESQ
POBOX E
NEW CUMBERLAND, PA 17070
n_~n__ fOld
ESTATE INFORMATION: SSN: 180-38-8020
FILE NUMBER: 2102-0898
DECEDENT NAME: GRAY ELIZABETH JANE
DATE OF PAYMENT: 12/1 0/2002
POSTMARK DATE: 0010010000
COUNTY: CUMBERLAND
DATE OF DEATH: 09/13/2002
NO. CD 001934
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $9,251.39
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS:
CHECK#101
SEAL
INITIALS: AC
RECEIVED BY:
REGISTER OF WILLS
$9,251.39
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
REV. 1500 EX (6_00)
OFFICIAL USE ONLY
~
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128.0601
REV.1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
/'/-902
9
FilE NUMBER
21
COUNTY CODE
2002
yEAR
-.989fL --
NUMBER
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
GRAY, ELIZABETH JANE
DAlE OF DEATH (MM-DO-YEAR)
09/13/2002
SOCIAL SECURITY NUMBER
180-38-8020
DATE OF BIRTH (MM-DD-YEAR)
2/6/1948
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
Original Return
o 2. Supplemental Return D 3. Remainder Return (date of death prior to 12-13.82\
o 4a. Future Interest Compromise (dale of dealh after 12-12-82) D 5. Federal Estate Tax Retum Required
D 7. Decedent Maintained a Living Trust (Allach copy of Trust) ....!... 8. Total Number of Safe Deposit Boxes
o 10. Spousal Poverty Credit (dale of death between 12-31-91 ard 1-1-95) D 11. Election to tax under Sec, 9113(A)(,I.ttact\Sct\Ol
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limited Estate
Decedent Died Testate (Altach copy 01 Will)
Litigation Proceeds Received
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THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
NAME COMPLETE MAILING ADDRESS
Gerald J. Shek1etski, Esq.
FIRM NAME (If Applicable)
Stone, Lafaver & Shekletski
lElEPHONE. NUMBER
414 Bridge St.
P,O, Box E
New Cumberland, PA 17070
717-774-7435
3. Closely Held Corporation. Partnership or Sole-Proprietorship (3)
4 Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E) (5)
Z 6. Jointly Owned Property (Schedule F} (6)
0 o Separate Billing Requested
;::
:5 7 Inler-Vivos Transfers & Miscellaneous Non-Probate Property (1)
=> (Schedule G or L)
l-
e: 8. Total Gross Assets (total Lines 1-7)
<t
U
W 9. Funerol Expenses & Administrative Costs (Schedule H) (9)
0::
10. Debts of Decedent Mortgage Liabilities, & Liens (Sd1edule (I (10)
11. Total Deductions (total Lines 9 & 10)
72,053.'40
2,169,72
0,00
0.00
193,003,00
7,400,50
OFFIClAt. USE ONLY
1. Real Estate (Schedule A)
(1)
2 Stocks and Sands (Schedule B)
12)
0.00
274,626,63
(8)
20,300,81
37,918,83
(13)
58,219,64
216,406,99
0,00
(11)
12. Net Value of Estate (Line 8 minus line 11)
13 Charitable and Governmental Bequests/Sec 9113 Trusts for which an election 10 lax has not been
made (Schedule J)
(12)
14 Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15 Amou(lt of Une 14 taxable at the spousal tax 0,00
Z rate, or transfers under Sec. 9116 (a)(1 .2)
0
i= 16 Amount of line 14 taxable at lineal rate 216,406,99
"
>-
::> 0,00
"- 17. Amounl of Line 14 taxable at sibllng rate
::;
0 0.00
" 18 Amount of Line 14 taxable at collateral rate
x
" Tax Due
>- 19.
(14)
216,406,99
x.OO_(15)
0,00
(19)
9,738.31
0.00
0,00
9,738,31
x.04L-(16)
x .12
(17)
x .15
(18)
20.0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMEN
,.,. BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
2W46451000
Decedent's Complete Address;
STREET ADDRESS
70 DREXEL PLACE
CITY I STATE ( ZIP
NEW CUMBERLAND PA 17070
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)
9,738.31
0.00
486.92
0.00
Total Credits (A + B + C) (2)
486.92
3. Interest/Penalty if applicable
D. Interest
E. Penally
0.00
0.00
Total Interest/Penalty (0 + E) (3)
0.00
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)
9,251.39
A. Enter the interest on the tax due.
(5A)
0.00
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
Make Check Payable to: REGISTER OF WILLS, AGENT
(5B)
9,251.39
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;. . . . . . . . . . . . . . . D (XJ
b. retain the right to designate who shall use the property transferred or its income, D [X]
c. retain a reversionary interest; or . . . . . . . . . . . . . . . . . . . . . . . . D [z]
d. receive the promise for life of either payments, benefits or care? , . . . . . . . D [X]
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration? , . . . . . . . . . . . . . . . . . . . . . . . . . .. D [X]
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?D [X]
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation?, , . . . . , , , , . . . , . . , . . . , , . . . . . . , , .. D [Xl
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 pen allies of perjury. I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief. it is true, correct
and complete
Deciarallo(l of preparer other than the personal represe(ltative is based 0(1 all information 01 which preparerhas any knowledge
/2 t? '--
DATE.
SIGNATURE O~
ADDRESS
Morgan
SIGNATURE OF P
ADORE
New
PA 17070
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 forthe use of the surviving spouse is 3%
(72 P.S. 99916 (a) (1.1) (i)]
For dales of death on or after Janusry 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% 172 P.S. !3 9116 (a) (1.1) (ii)]
The statute does not exemot a transfer to a survil/ing spouse from ta):, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even jf
the surviving spouse is the only beneficiary.
F or dates of dea-th 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 noted in 72 P.S. !3 9116(1 .2) [72 P.S. ~ 9116(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. ~ 9116(a}(1.3)]. 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,
W46461000
.._--~.~
LAST WILL AND TESTAHENT
OF
ELIZABETH JANE GRAY
1, ELIZABETH JANE GRAY, of the Township of Lower Allen, County of
Cumberland, and Commonwealth of Pennsylvania, declare this to be mv last will
and revoke any will previously made by me.
ITEM 1: 1 devise and bequeath all of my estate of every nature and
wherever situate to my mother, MARY BIEBER GRAY, if she survives me bv thirty
(30) days.
ITEM 11: Should my mother, MARY BIEBER GRAY, fail to survive me by
thirty (30) days, 1 devise and bequeath my estate as follows:
A. The automobile that 1 own at the time of my death, together
with any insurance thereon, to my sister, CAROL LYNN HESS, of Oak I!ill Road,
Waynesboro, Pennsylvania.
B. The residue of my estate of every nature and wherever
situate to my sister, MARGARET JOY GRAY, of 70 Drexel Place, New Cumberland,
Pennsylvania, or to her issue, per stirpes.
ITEM III:
I appoint my Executor and his successors guardian of any
property which passes either under this will or otherwise, to a minor and with
respect to which 1 am authorized to appoint a guardian and have not othendse
specifically done so, provided that this appointment of a guardian shall not
supersede the right of any fiduciary in its discretion to distribute a share
where possible to the minor or to another for the minor's benefit. Such gl:<.:!r-
STONE, SAJER
dian shall have the power to use principal as well as income from time to time
6: STEWART
,
Attorneys at uw
414 Bridge Street
New Cumberland, Pa.
Page 1 of 4 pages
,
17070
~ .~
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'.'
. //
STONE, SA.lER
B: STEWART
Attorneys at Law
414 Bridge Street
New Cumberland, Pa.
17070
for the minor's support and education (including college educatioL, both g:r~-
duate and undergraduate) without regard to his or her parent's ability to pro-
vide for such support and education, or to make payment for these Vlrposes,
vdthout further responsibility, to the minor or to the minor's DarC"Lt c':" to
any person taking care of the minor.
ITEM IV: I direct that all taxes that may be assessed in consequence.
of my death, of whatever nature and by whatever jurisdictlon iwposec, shalJ be
paid from my residuary estate as a nart of the expense of the admi~.istrat'on
of my estate.
ITEM V: I appoint my brother-in-law, RALPH W. PLUHHER, of 600
Potzman Street, Morgantown, West Virginia, 26505, Execntor of this my last
wilL
ITE~l VI: I direct that my Executor or guardian or their successors
shall not be required to give bond for the faithful performance of their
duties in any jurisdiction.
IN WITNESS WHEREOF, I, ELIZABETH
r;r
set my hand and seal this d I ,. day of
JANE GRAY, Testatrix,
/7
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. I
havE' hereonto
, ~ 9K6.
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f~~-_{,' '".'{ ,{.j'\,
ELIZABETH JANE
:.;
(SEAL)
. ~. - ....
GRAY
Page 2 of 4 pages
STONE. SA.lER
8: STEWART
Attorneys at Law
414 Bridge Street
New Cumberland, Pa.
17070
SIGNED, SEALED, PUBLISHED and DECLARED by ELIZABETH Jfu~E GRAY, the
Testatrix above named, as and for her Last Will and Testament, and in the pre-
sence of us, who at her request, in her presence and in the presence of each
other, have subscribed our names as witnesses.
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Address
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Address
COMMONWEALTH OF PENNSYLVANIA:
:55:
COUNTY OF CUMBERLAND
I, ELIZABETH JANE GRAY, the Testatrix whose name is signed to the
attached or foregoing instrument, having been duly qualified according to law
do hereby acknowledge that I signed and executed this instrument as my last
will; that I signed it willingly and that I signed it as my free and voluntary
act for the purposes therein contained.
.1
I J 7
ELIZABETH JANE GRAY
Sworn to or affirmed to and acknowledged
"iT'
GRAY, the Testatrix, this C]/ day of
before me by ELIZABETH JA;;[
/1 '")
'--.J.-lY1,( --/
i
1986.
/
~,~~7:1,-- .. .' /._,>~ ~
Notary Publi c
BETH ANN HECKMAN. Notary Public
New Cum~er.Jand. Cumberland Co.. PI
My .Commlll,onl<pi'.. feb. a, 1966
Pag~ 3 of 4 pages
STONE. SAJER
8< STEWART
Attorneys at L.aw
414 Bridge Street
New Cumberland, Pa.
17D7D
COMMONWEALTH OF PENNSYLVANIA
:55:
COUNTY OF CUMBERLAND
We,
~'il') W:;.\:(;rs{,lt:..
\/,--;' (/.
-/
and
the witnesses whose names are signed to the attached or foregoing instrument,
being duly qualified according to law, depose and say that we were present and
saw Testatrix sign and execute the instrument as her last will; that Testatrix
signed willingly and that she executed it as her free and voluntary act for
the purposes therein expressed; that each of us in the hearing and sight of
the Testatrix signed the will as witnesses; that to the best of our knowledge,
the Testatrix was at that time eighteen or more years of age, of sound mind
and under no constraint or undue influence.
;J Ji'
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Sworn to or affirmed to and acknowledged before me hv
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and
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witnesses,
, ,
this ,)/ :r'f day of
-,
'>.f]".~-
/
, 1986.
_:;.:;:' -;--1'
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, /;~/l':.
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/'. )"-'-:-:"";,r-'iJ:/l, "___ ____
Notary Publi c
BETH ANN HECKMAN, Nolary Public
New Cumberland, Cumberland Cc., Pa
MoY _~mmi..ionExeires feb. 6, 1966
Page 4 of 4 pages
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REV.jS02EX +(1.97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE A
REAL ESTATE
ESTATE OF
GRAY, ELIZABETH JANE
FILE NUMBER
21-2002-0898
All real property owned solely or as CI tenant in common must be reported at fair market value. Fair market value is defined as the price at which property would be exchanged
between a willing buyer and a willing seller, neither being compelled to buy or sell, both having reasonable knOwledge of the relevant facts. Real property which is jointly-owned with
right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
72,053.40
70 Drexel Place, New Cumberland,
Cumberland County, Pennsylvania 17070
Real Estate Tax assessed value = 71340 x
1.01 common level ratio = $72,053.40
2W46952.000
TOTAL (Also enter on line 1, Recapitulation)
(If more space is needed, insert additional sheets of the same size)
$
72 053.40
Form View - public tax tile 10-01-02.tj:J5
Page I of I
Form View
public tax file lO-QI-02.fp5
1::f~)I'I1~
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Tab.!eJljg~
Viewing: 1 of 1
District_Number 13
ParceUdentifier 13-25-000B-002A
Map_Suffix_Number UK-70-1
House_Number 70
S'..e' DREXEL PLACE
Owne'_Name_' GRAY, ELIZABETH J
Owner_Name_2
Land_Us8_Code R
Property_Description
Living_Area 1400
Current_land_Value 0
CurrenUmprovemenCValue 71340
Current_TotaLValue 71340
Curre nt_Prete rred_ Val ue
Acreage .00
Clean Green_Status
Taxable_of_Exempt 1
Sale_Amount 36900
Sale_Month 12
Sale_Day 28
Sale_Century 19
Sale_Year 78
Deed_Book_and_Page 0028F-Q0422
Year_Built 1978
http://205.247.227.59:591/FMRes/FMPro?-db=public%20tax%20file%2010_01_02.tp5&_o. .. 10/2/2002
UJ4is irrb,made this
~;-:'UI
dayof
r"'Cf' '11.,.}'
197:"
ilrtwttn. OXFORD VILLAGE, INC.
, . corporation organized and existing under and by
virtue of the laws of Pennsylvania (hereinafter called "Grantor"), of the one part, and
Eliz;abeth tT. Gray
(hereinafter called the"Grantee"), of the other part,
.ttnr1111ttlJ. That in consideration of Thirty six thous"mi nine llUndr8C' ,'nrl no cents
r~1(, on,')", Dollars
"J ,/. -.- I ,
in hand paid, the receipt whereof is hereby acknowledged, the said Grantor do hereby grant and convey unto the said
, Grantee
and assigns,
ALL THAT CERTAIN lot or piece of land. situate in the Township of Lower Allen, County of
Cumberland and Commonwealth of Pennsylvania. bounded and described in a~rdance with Plan
showing Foxlea Residential Community Village Un'", Phasern', . Section A , made by Gerrit J. Betz
Associates, Inc., dated .T :Q!I.1.::>r'J ':!7, lr;17f and last revised n8cembr~r ~-~, 197;:.\
as recorded in the Office of the Recorder of Deeds of Cumberland County, Pa. on f1ec"f"kr )" I 1 ?7f'in
Plan Book r:,' ,Page en ,which Plan is herein incorporated by reference as if hereto attached, as unit
number 7 1 in Building "1:" consisting of 'J';, (, square feet and described on said As
Built Plan by metes and bounds which description is likewise herein incorporated by reference.
BEING a part of the same premises which Leafox Corp, a Pa. Corp, by deed dated
'j '" "", ," '" 1 ':'7" and recorded in the Office of the Recorder of Deeds in and for the
County of Cumberland in Deed Book ;:, Vol. rf] ,Page C"; granted and conveyed unto Oxford
Village, Inc"
TOGETHER with all the benefits and rights of easement and enjoyment as excepted and reserved by Foxlea Nominee
Corp. and Foxle. Enterprises, Inc. in its Deed to Cumberland County National Bank and Trost Company dated April
21. 1975 and duly recorded in the Office of the Recorder of Deeds in and for the County of Cumberland in Deed Book
A-26 page 303.
UNDER AND SUBJECT to the covenants, restrictions, easements, charges,liens, terms, rights, agreements, conditions,
exceptions, reservations and exclusions as contained and mOTe fully set forth in Trust Deed between Foxlea Nominee
Corp. and Cumberland County National Bank and Trust Comapny dated November 21, 1973 and recorded in the Office
of the Recorder of Deeds in and for the County of Cumberland in Deed Book K-25 page 912, as amended by Amend.
ment thereto dated August 26, 1974 and duly recorded in the Office aforesaid in Deed Book T -25 page 470, and by
Amendment thereto dated April 21, 1975 and duly recorded in the Office aforesaid in Deed Book A-26 page 303,
and any amendments to the foregoing as may be made from time to time.
UNDER AND SUBJECT to easements, rights granted to public utilities and other rights, covenants and restrictions of
record.
TOGETHER with all and singular the improvements, ways, streets, alleys, driveways, passages, waters, water-courses,
rights, liberties, privileges, hereditaments and appurtenances, whatsoever unto the hereby granted premises belonging,
or in any wise appertaining and the reversions and remainders, rents, issues, and profits thereof; and an the estate, right,
title, interest, property. claim and demand whatsoever of the sairl. g~~ntnr. as '.vd.1 ;J,{ '~",If as in 'equity. cr, i.L:mJ to the
same.
TO HAVE AND TO HOLD the said lots and the hereditaments and premises hereby granted, or mentioned and intend-
ed so to be with the appurtenances, unto the said grantees, their heirs, personal representatives, successors and assigns,
to and for the only proper use and behoof of the said Grantees, their heirs, personal representatives, successors and
assigns forever. Subject as aforesaid.
THE Grantees, for and on behalf of the Grantees, their heirs. personal representatives, successors and assigns. by
acceptance and recordation of this Deed, acknowledge that this conveyance is subject in every respect to the aforesaid
Trust Deed by Foxlea Nominee Corp. to Cumberland County National Bank and Trost Company dated November 21,
1973 and recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, in Deed Book
K- 25 page 912, as ame~ded by Amendment thereto dated August 26, 1974 and duly recorded in the Office aforesaid in
Deed Book T -25 page 470, and by Amendment thereto dated April 21, 1975 and duly recorded in the Office aforesaid
in Deed Book A-26 page 303, and any Amendments to the foregoing as may be made from time to time, and all
Amendments thereto; acknowledge that each and every provision thereof is essential to the successful operation and
management of Foxlea Residential Community, and in the best interests and for the benefit of all Lot Owners therein;
and covenant and agree, as a covenant running with the land, to abide by each and every provision of the aforesaid
documents. ~__
."
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School Dist. Cumbo Co., P.
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.AM the said Grantor doth hereby covenant to and with the said Grantor that, it, the said Grantor, its
successors, and assigns, SHALL and WILL by these presents, Warrant and forever defend the herein above described
premises, with the hereditaments and appurtenances, unto the said Grantee,
and assigns, against the said Grantor and against every other person lawfully claiming or who shall hereafter claim the
same or any part thereof, generally.
IN WITNESS WHEREOF, the said Grantor has caused these present to be duly executed, the day and year first above
written. - .
r.J. ;J..
\.0.1.>;.
OXFORD VILLAGE, INC.
By:
:..;-' :.- ~:)-_.
:?' i A:U...~~r,,:,;.'.
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Secretary
tF
J,.J<< rL
State of 1'<:nll~~..:1 vilrli.i
County of
,1:1.:1;1
On this
..:.'UJ
1}';1.: !ll"<::'
,A,D.197:'
, before me, the undersigned
day of
~.-
Presiden t
officer, personally appeared
..!i' :lj,;~ ',I~!!;U
, who acknowledged himself to be the
President of the said Grantor corporation, and that he, as such President, being
authorized to do so, executed the foregoing instrument, for the purpose therein contained, by signing the
name of the corporation by himself as
President
IN WITNESS WIfEREOF, I hereunto set my hand and official seal.
, .
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REV-1:,c3EX+ (1.971
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE B
STOCKS & BONDS
ESTATE OF
GRAY, ELIZABETH JANE
FILE NUMBER
21-2002-0898
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1. 8 Shares Waypoint Financial
Corp. Common Steck
$17.64 per share x 8 =
$141.12
DESCRIPTION
VALUE AT DATE
OF DEATH
141.12
2 115 Shares Waypoint
Financial Corp. Common
Stock. $17.64 per share x
115 = $2,028.60
2,028.60
2W46963.000
TOTAL (Also enter on line 2. Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
2,169.72
Historical p,.,cc,s
Page I of 1
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COMMONWEAL TH OF PENNSYlVANIA
INHERIT/">J\ICE TAX RETURN
RESIDENT OECECENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
Include the proceeds of litigation and the date the proceeds were received by the estate. .oJ1 property jointly-owned with the right of survivorship must be disclosed on Schedule F.
ESTATE OF
GRAY, ELIZABETH JANE
FILE NUMBER
21-2002-0898
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
179,918.00
1. Mack Trucks, Inc. Retitrement Income Plan
2 2001 Dodge Caravan SE Minivan 4D
Blue Book Value - $13,085.00
13,085.00
2W46AO 2.000
TOTAL (Also enter on line 5. Recaoitulation) $
(If more space is needed. insert additional sheets of the same size)
193,003.00
Mack Trucks, Inc.
Benefit Calculation
Data
Name:
SSN:
Date of Birth:
Beneficiary Birth Date:
Date of Hire:
Date of Death:
Payment Date:
Elizabeth Gray
180-38-8020
02/06/1948
N/A
09108/1969
09/1312002
11101/2002
01/01/2002 Pay: $ 40,244.00
Core Cash Balance
Account at 07101/2002: $ 175,698
Minimum Account
Value at 07/01/2002: $ 96,781
A. Core Cash Balance as of October 1, 2002
,. Core cash balance account at 07/01/2002
2.lnteresll(1)x5.12%x3/12]
3. Basic credits [01/01/2002 Pay x 8.00% x 3/12]
4. Transition credits [01/01/2002 Pay x 4.00% x 3/12 ]
5. Core cash balance account at 10/01/2002 ((1) + (2) + (3) + (4)]
$ 175,698
2,249
805
402
$ 179,154
B. Minimum Account Value as of October 1,2002
,. Minimum account value at 07101/2002
2. Interest [ (1) x 5.12% x 3/12]
3. Minimum account value at 10/0112002 [(1) + (2)]
$
96,781
1,239
98,020
$
C. Cash Balance Account as of October 1, 2002
,. Maximum of A. and B.
$ 179,154
D. Lump Sum Payable as of November 1,2002
,. Cash balance account at 10/0112002
2. Vested Percentage
3. Lump sum payable at 10101/2002 [(1) x (2)]
4. Interest [(3) x 5.12% x 1/12]
5. Lump sum payable at 11/01/2002 [(3) + (4)]
$ 179,154
100%
$ 179,154
764
$ 179,918
G:\vwcO 1 h\cafc2002\Mack\Retirement\[Gray1 01 O.xls)Calc
REV-1509E,X+ (1-91)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
EST ATE OF
GRAY, ELIZABETH JANE
SCHEDULE F
JOINTLY-OWNED PROPERTY
FILE NUMBER
21-2002-0898
If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
ADDRESS
RELA TlONSHIP TO DECEDENT
A
MARY B. GRAY
70 DREXEL PLACE
NEW CUMBERLAND, PA 17070
MOTHER
B.
G
JOINTLY-OWNED PROPERTY:
>EmR DATE DESCRIPTlON OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of finanCial instiluhon and banKaCCQunl numtleror DATE OF DEATH DECO'S VALUE OF
NUMBER TENANT JOINT similar identifying number, Attach cleedforjointly.heldrealeslale. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A 05/06/1993 Waypoint Bank savings 9,452.13 50.00 4,726.06
account #702127797
2 A 12/31/1985 Waypoint Bank checking 5,348.88 50.00 2,674.44
account #500011295
TOTAL (Also enter on line 6, Recapitulation) $ 7,400.50
2W46AE2,OOO
(If mdfe space is needed, insert additional sheets of same size)
10/09/2002
STONE LAF AVER & SHEKLETSKI
414 BRIDGE ST
NEW CUMBERLAND PA 17070
. Way~ql!1Kt
The information which you requested on the account(s) of ELIZABETH GRAY
(Social Security Number 180-38-8020) is/are as follows:
Account Number
Class of Account
Date Opened
Principal Balance
Accrued Interest
Balance at Date of
Death
Account Ownership JTO
Name of Joint MARY GRAY
Owner, if any
Date Ownership 12/31/85
Was Established
500011295
CHECKING
12/31/85
5348.40
.48
5348.88
Account Number
Class of Account
Date Opened
Principal Balance
Accrued Interest
Balance at Date of
Death
Account Ownership
Name of Joint
Owner, if any
Date Ownership
Was Established
Additional
Information
Requested
702127797
SAVINGS
05/06/93
9452.13
2.42
9454.55
JTO
MARY GRAY
05/06/93
Sincerely, .
/1ttti.j l)l1l"}
KATHnOl&\JG
SENIOR SERVICES REP.
P.O. Box 1711. HARRISBURG. PeNNSYl.VANIA 17105-1711
Toll Free 1-866-WAYPOINT (1-866-929-7646) . IN YORK AREA 717/815-4500 . www.waypointbank.com
",EV-'S' ~ E\ ., '-87)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
GRAY, ELIZABETH JANE
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-2002-0898
Debts of decedent must be renorted on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1 Parthemore Funeral Home & Cremation Services, Inc. 3,505.00
1303 Bridge St.
New Cumberland, PA 17070
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions 0.00
Name of Personal Representative(s)
Social Security Number(s) I E1N Number of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission Paid:
2 Attorney Fees Name: Gerald J. Shekletski, Esq. 13,731. 00
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) 0.00
Clai mant
Street Address
City State Zip
Relationship of Claimant to Decedent
4. Probate Fees 12.00
5. Accountant's Fees 0.00
6. Tax Return Preparec's Fees 0.00
7. Letters Testamentary 258.00
8 Cedar Hill Cemetery Assn. 1,200.00
9 Memorial Service and Luncheon 190.00
10 Legal Advertising - Cumberland Law Journal 75.00
11 Legal Advertising - Patriot-News 102.67
12 Lower Allen EMS 407.50
,.otaL from cont~nuat~on pages.... \n~.bQ
TOTAL (Also enter on line 9, Recapitulation) $ 20,300.81
2W46AG2,OOO
(If more space is needed, insert additional sheets of same size)
Estate of: GRAY, ELIZABETH JANE
Schedule H, Part B -- Administrative Costs
Item
No. Description
13
Fox Lea Homeowners Assoc.
14
Verizon
15
Pennsylvania American Water Co.
16
Patriot News
17
AT&T Wireless
18
PPL
19
UGI
20
Comcast
21
Filing Fees - PA Inheritance Tax Return ($15.0Q) and
Personal Inventory ($10.00)
22 Reserve for Closing Expenses
TOTAL. (Carry forward to main schedule)
Page 2
21-2002-0898
Amount
85.00
59.21
54.11
43.00
34.03
163.79
18.56
36.94
25.00
300.00
819.64
REV-1512E.>(+(Hi7l
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
GRAY, ELIZABETH JANE
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES. & LIENS
FilE NUMBER
21-2002-0898
Include un reimbursed medical eXllenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
8,676.54
1. Waypoint Bank Mortgage Loan Account
#5000 0050 0071018974
2 Chrysler Financial Auto Loan Account
#1011128293
15,587.36
3 Fleet Platinum Credit Card Account
#5491 0008 4816 4740
9,146.18
4 First Usa Visa Account #4266 5012
0114 3242
1,397.34
5 JC Penney Credit Card Account
#013-374-60204
568.51
6 Hecht's Credit Card Account
#316-442-01
291.68
7 Boscov's Credit Card Account #003 90
9360
1,555.34
8 Sears Credit Card Account #5484 041 239675
232.54
9 Lane Bryant Credit Card #601-173-669
463.34
2W46AH2,OOO
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additiDnal sheets of the same size)
37,918.83
REV-1511 EX. (9-00)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
GRAY ELIZABETH J"NR
SCHEDULE J
BENEFICIARIES
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
I. TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfer
under Sec. 9116 (a) (1.2)J
1. GRAY, MARY B
70 DREXEL PLACE
NEW CUMBERLAND, PA 17070
FILE NUMBER
21-2002-0898
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
MOTHER
AMOUNT OR SHARE
OF ESTATE
216,406.99
ENTER DOLlAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18. AS APPROPRIATE, ON REV-1500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAl DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
2W46Al 1 000
TOTAL OF PART 11- ENTER TOTAl NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
(If more space IS needed, Insert additional sheets of the same size)
$
0.00
Inventory of the real and personal estate of
Elizabeth Jane Gray
deceased
REAL ESTATE
1. 70 Drexel Place, New Cumberland, PA 17070
PERSONAL PROPERTY
1. 123 Shares Waypoint Financial Corp. Common Stock
2. Mack Trucks, Inc. Retirement Income Plan
3. 2001 Dodge caravan SE Minivan
TOTAL REAL ESTATE
TOTAL PERSONAL PROPERTY
TOTAL REAL ESTATE AND
PERSONAL PROPERTY
T
I
Ir
I
I
I
,
I'
I:
Ii
I,
Ii
Ii
ii
Ii
II
!I
II
,
I
I
i
I
I
!;
$ 72,053.40
2,169.72
179,918.00
13,085.00
$ 72,053.40
195,172 .72
I
$267,226.12
COMMONWEALjH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
55:
Ralph W. Plummer
being duly 3Wefil according to law, deposes and says that he is the
Executor of the Estate of ElizO'ln.>t Jane Grav
late 01 _~~:r: Allen~wnship._.___.__. , Cumberland County, Pa., deceased and that the
within is an inventory made by Ralph W. Plunmer ._ _ ., the sai~ecutor
01 the entire estate 01 said decedent, consisting 01 all the personal property and real estate, except real estate outside
the Commonwealth or Pennsylvania. and that the ligures opposite each item 01 the Inventory represent it's lair value
as 01 the date 01 decedent's death.
muvv?r l'
~ 2002
~J)~
Encutor . Administrator
dnd subscribed before me,
J
Ralph W. Phunmer
600 Potzman Street
Mor'),:::mf-nt.m W\1 ?f\SOS
Ad/r."
Clate 01 Death _
13
September
Month
2002
Doy
Y..r
INSTRUCTIONS
I. An inventory must be filed within three months dfter appointment of personal repreJ",rilative.
2. A suppiemed inventory must be filed within thirty days of discovery of additional a~'~eh.
). Additional ,,,eets may b. attached as to personalty or realty
.; See Article IV Fiduciaries Act 01 /949.
.
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\, BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG~ PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
i
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
GERALD J SHEKLETSKI ESQ
STONE ETAL
PO BOX E
NEW CUMBERLAND PA 17070
02-10-2003
GRAY
09-13-2002
21 02-0898
CUMBERLAND
101
AlIOunt R...1 tted
'*
REV-lSUEKAFPUl-05l
ELIZABETH J
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS .....
RW:is'4-j-EiCAFP-foFii3rNOYiCE--OF-iiiHERii'ANCE-YA'in,PPRAYSEMEN1:~--ALL-OWANCE-OR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF GRAY ELIZABETH J FILE NO. 21 02-0898 ACN 101 DATE 02-10-2003
TAX RETURN WAS: I X I ACCEPTED AS FILED
I CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. 1..1 Estat. (Schedule AJ
2. Stocks ond Bonds (Schodu1e BI
3. Closely Held stock/Partnership Interest (Schedule C)
4. "ortgages/Notes Receivable (Schedule D)
5. C.sh/B.nk Deposlts~isc. Personal Property (Schedule EJ
6. .Jointly Owned Pro...rty ISchodu1e FI
7. Transfers (Schedule G)
a. Total Assets
(11
121
131
141
151
161
171
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Fun.rel Expenses/A~. Costs/Misc. Expenses (Schedule H)
10. Debts/Mortgage Liabilities/Liens (Schadule I)
11. Total Deductions
12. Net Value of Tax R.turn
13. Charitable/Governmental Bequests; Non-elected 9113 Trusts (Schedule ~)
1~. Net Value of Estate Subject to Tax
191
1101
72.053.40
2.169.72
.00
.00
193.003.00
7.400.50
.00
181
20,300.81
NOTE: I~ an asses~ent was issued previously. lines
reflect ~igures that include the total o~ ALL
ASSESSMENT OF TAX:
IS. AlIOunt of Line 14 at Spousal rate (IS)
16. A~unt of Line 14 taxable at Lineal/Class A rate (16)
17. A~unt of Line 14 .t Sibling rate (17)
18. AlIOunt of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS.
37.918.83
1111
1121
1131
1141
NOTE: To insure proper
credit to your account I
submit the upper portion
of this form with your
tax pay.ent.
274,626.63
58.:>19 64
216,406.99
.00
216,406.99
14. lS and/or 16. 17. 18 and 19 will
returns assessed to date.
.00 X 00 =
216,406.99 X 045 =
.00 X 12 =
.00 X 15 =
1191=
.00
9,738.31
.00
.00
9,738.31
.
... AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-I
12-10-2002 CDOO1934 486.92 9,251.39
TOTAL TAX CREDIT 9,738.31
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A nCREDIr' (CRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FDR INSTRUCTIONS. I
STATUS REPORT UNDER RU~.E 6.12
Name of Decedent:
Date of Death:
Will No.
Elizabeth Jane Gray
September 13, 2002
2002-00898
To the Register:
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:
Yes
1. State whether administration of the estate is complete:
X 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? Yes No X
(b) The separate Orphans' Court No. (if any) for
personal representative's account is: N/A
the
Date:
the Clerk of the Orphans'
report.
(c) Did the personal representative state an account
informally to the parties in interest? Yes X No
(d) Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with
Court a~e attached to !.~.{i~.
Ger~
414 Bridge Street
New Cumberland, PA 17070
717-774-7435
C~%-~acity: Personal Representative
X
Counsel for Personal
Representative
est~rel\,lform.rel
IN RE:
ESTATE OF
ELIZABETH JANE GRAY
LATE OF LOWER ALLEN
TOWNSHIP, CUMBERLAND
COUNTY, PENNSYLVANIA
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 2002-00898
RECEIPT, RELRASE AND WAIVER OF ACCOUNTINC
KNOW ALL MEN BY THESE PRESENTS, that I, MARY BEIBER GRAY, being f
the beneficiary under the will of ELIZABETH JANE GRAY, do hereby
acknowledge that I have received all sums of money and property due me
by virtue of the death of ELIZABETH JANE GRAY, in full satisfaction
and settlement of all of my rights and claims under her estate.
I further declare, intending to be legally bound, that I hereby
waive my right to require the filing of a First and Final Account and
Proposed Schedule of Distribution in any Court of Common Pleas having
jurisdiction over the same, and I acknowledge that I have had an
opportunity to examine copies of the books and records of the said
estate, and I agree to the final distribution of the estate without
further formalities, and with the same force and effect as if a First
and Final Account and Proposed Distribution had been filed in a Court
of Common Pleas of Pennsylvania having jurisdiction over the same and
duly audited and confirmed.
AND THEREFORE, I, MARY BEIBER GRAY, do by these presents, remise,
release, quitclaim and forever discharge the Executor, his heirs,
successors and assigns, from the acts of the Executor as aforesaid,
and of and from all actions, suits, payments, accounts, reckonings,
claims, and demands whatsoever, for or by reason thereof, or any other
act, matter, cause or thing whatsoever, and I do hereby consent to the
discharge of the said Executor.
IN WI~EREOF, I have hereunto set my hand and seal the /~2~
day of 2004
Witness
COMHONWEALTH OF PENNSYLVANIA:
:
COUNTY OF CUMBERLAND :
On this, the /~ day of
SS:
, 2004, before
me a Notary Public, the u~dersigned-?B~cer, personally appeared MARY
BIEBER. GRAY, known to me (or satisfaC~.~ly proven) to be the person
whose name is subscribed to the within instrument and acknowledged
that she executed the sam~%.fgr 6~%~u~oses therein contained
, IN WITNESS WHEREOF,~?'~%e~unt% s~e ......... · ~
~ 2LL~ ll~n~ ano s oay
ano year first above written. ~~/~.~no ~
~ N~ Cum~rland ~[o. Cum~rland Go. I
~ My Comm1~i~ ~pir~ Nov. 9, 2006 I