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HomeMy WebLinkAbout04-0139Register of Wills of York County, Pennsylvania PETITION FOR GRANT OF LETTERS Estate of C. 'I~'qEI~ ~ also known as ~ I(. (]RL]BB JAMES W. ~ and t~IqNIE S. No. 21-0 /° 13q , Deceased Social Security No. 204-01-9853 Petitioner(s) who is/are 18 years of age or older, apply(les) for: (COMPLETE "A" OR "B" BELOW:) [] A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the execute)rs named in the last Will of the decedent, dated July 23. 2001 and codicil(s) dated T~c~rnh~-r, .':l; 9.00,,] ( State relevant circumstances, e.g. renunciation, death of executor, etc.) Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents offered for probate; was not the victim of a killing and was never adjudicated incompetent: [] B. Grant of Letters of Administration (d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: Name Relationship Residence (COMPLb I b tN ALL CASES:) Attach additional sheets if necessary Decedent was dcmiciied at death in CLl'nber land County, Pennsylvania, with his/her last family or principal residence at 351 Nittanv. Messiah Villno'~.. M~c~hunlo~h,n-o'. ' - (list street, n~'ml~er, and municipality~ ...... Decedent, then g6 years of age, died January 30; 2004 20__ Decedent 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 , at M~.~.~iuh Vi 1 luo.o Mechanicsburg -(£o~ifio5~/ , $ 175,000.00. $ situated as follows: none Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of letters in the appropriate form to the undersigned: I ...-.--// -- '"',$,~tu~ ///' Typed or printed name and residence ""'"---~YLrr~m .~rD~'/23-- Bonnie ~. Sarmo, ltD 1. New Bloomfield. PA snaceNVills PetG rantLb'2001 REV- 1500 EX + (6-00) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT, 280601 HARRISBURG, PA 171Z8-0601 REV-1500 INHERITANCE TAX RETURN E C E D E N T RESIDENT DECEDENT CAPB HpRL EpIO caAC v~TK "-ES Co" C O M T I 0 OFFICIAL USE ONLY FILE NUMBER 21-04-00139 COUNTY CODE YEAR NUMBER DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) Grubb C. Kenneth DATE OF DEATH (MM-DD-YEAR) I DATE OF BIRTH (MM-DD-YEAR) 01/30/2004 I 06/17/1917 (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SOCIAL SECURITY NUMBER 204-01-9853 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER U (date.of death _, 3. Remainder Return priorto lZ-13-8/) 5. Federal Estate Tax Return Required i 8. Total Number of Safe Deposit Boxes r~ 11. Election to tax under Sec. 9113(A) (Attach Sch O) 1. OriglnaIReturn ~ 247! Supplemental Return 4. LimltedEstate · FuturelnterestCompromlse(dateofdeathafterlZ-1Z-8Z) 6. Decedent Died Testate Decedent Maintained a Living Trust (Attach copy of Will) (Attach copy of Trust) I I 9. Litigation Proceeds Received [] 10. Spousal Poverty Credit (date of death between 12-31-91 and 1 - 1-95) NAME Wm. D. Schrack III Esq. FI RM NAM E (if Applicable) Wm. D. Schrack, III Esquire COMPLETEMAILINGADDRESS 124 W. Harrisburg Street Post Office Box 310 Dillsburg, PA 17019-0310 TELEPHONE NUMBER 717./432- 9733 1. Real Estate (Schedule A) (1) 2. Stocks and Bonds (Schedule B) (2) 3. Closely Held Corporation, Partnership or (3) Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) (4) 5. Cash, Bank Deposits & Miscellaneous Personal Property (5) (Schedule E) 6. Jointly Owned Property (Schedule F) (6) [~] Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7) (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) (9) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. None None None None 99,416.75 None 479,723.88 48,369.72 6,313.75 Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) Net Value Subject to Tax (Line 12 minus Line 13) OFFICIAL ~.U~jE ONLY (8) 579,140.63 (11) 54,683.47 (12) 524,457.16 (13 (14) 524,457.16 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES 14. x .0 0 (15) 0.00 0.00 X .0 45 (16) 0.00 10,000.00 X .12 (17) 1,200.00 514,457.16 X .15 (16) 77,168.57 (19) 78,368.57 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116(aX1.2) 16. Amount of Line 14 taxable at lineal rate 17. Amount of Line 14 taxable at sibling rate 18. Amount of Line 14 taxable at collateral rate 19. Tax Due 20. Copyright (c) Z000 form software only The Lackner Group, Inc. Form REV- 1500 EX (Rev. 6-00) Decedent's Complete Address: STREET ADDRESS Nittany Buildin~ - Apt 4/351 Messiah Villase CITY Mechanicsbur~ STATE PA ZIP I 17055 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount 3. Interest/Penalty if applicable D. Interest E. Penalty 0.00 65,000.00 3,421.05 Total Credits ( A + B + C ) (2) (1) 78,368.57 Total Interest/Penalty ( 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) A. Enter the interest on the tax due. (SA) B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (SB} 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: Yes No a. retaintheuseorincomeofthepropertytransferred; ......................... b. retain the right to designate who shall use the property transferred or its income; ........... ¢. 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? ................................ [~ [~] 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? ................................ IXl L_.] IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. 68,421.05 0.00 0.00 9,947.52 0.00 9,947.52 Under penalties of perjury, I declare that I have examined this return, Including accompanying schedules and statements, and to the best of rny knowledge and belief, it Is true, correct and complete. Declaration of preparer other than the personal representative is based on all Information of which preparer has any knowledge. SIGNATURE.OFPERSON RESPON~FOP~FILING~R, ETURN James W. Grubb DATE ~ ~ ~>/ ////' ~ State Route 235 D A/,T~~/~// :- ......................... SI(~ATURE/~t3REPP)~r~'l~ER T'~IAN REPRESENTATIVE Wm. D. Schrack, III Esquire / .................... / ~~~~ Dillsburg, PA 17019-0310 ~ ~ ~ For dates of death on or a~er Ju{y 1, 1994 and before Janua~ 1, 1995, the tax rate ~mposed 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 a~er Janua~ 1, 1995, the tax rate imposed on the net va~ue of transfers to or for the use of the surv~vln~ spouse is 0% [72 P.S. 911~ (a) (1.1) (ii)]. The statute does not exempt a transfer to a survivin~ spouse from tax, and the statuto~ requirements for disclosure of assets and fili.~ a tax return are still applicable even if the survivin~ spouse is the only beneficial. For dates of death on or a~er July 1, 2000: The tax rate i~posed on the .et va{ue of tra.~ers fro~ a deceased child twen~-one years of a~e or youn~e~ at death to or for the use of a natural parent, an adoptive parent, or a stepparem of the child is 0% [72 P.S. 9116 (a) (1.~)]. The tax rate imposed on the net value of t~ansfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2) The tax rate i~posed o~ the net value of ~ansfers to or for the use of the decedent's siblim~s Js 12% [72 P.S. 911~(a)(1.3)]. A sibl~n~ is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by b~ood or adoption. copyright (c) Z000 form sof~ware onN The tackner Group, {nc. Fo~m R~V-~ 500 EX (Rev. 6-00) ADDITIONAL Personal Representatives Estate of C. Kenneth Grubb SS# 204-01-9853 01/30/2004 Under penalties of perjury, the undersigned declare that they have examined this return, including accompanying schedules and statements, and to the best of their knowledge and belief, it is true, correct and complete. Signature Marne Address Line 1 Address Line 2 City, State, Zip Date Bonnie Sanno R.D. #1, Box 364 New Bloomfield, PA 17068 SOLE CODICIL OF C. KENNETH GRUBB I, C. KENNETH GRUBB, of 351 Nittany, Messiah Village, Pennsylvania, declare this to be the sole Codicil to my Last Will and Testament dated July 23,2001. ITEM 1: I delete the bequest contained in Item 3(D) of my Will dated July 23, 2001. ITEM 2: In all other respects, I hereby ratiR..,, confirm, and republish my Last Will dated July 23, 2001, together with this sole Codicil, as and for my Last Will and Testament. )_<.7__..x lN WIINESS WHEREOF, I have hereunto set my hand this ~-~/5 day of 2003. --.~-' ~ 1///7f~7.~ i C. KENNETH GRUBB Signed, published, and declared on the date fl]ereofbv the above named C. KENNETH GRUBB as and for the sole Codicil to her Last \Vill daled July 23.2001. in the presence of us. who. at her request, in her presence, and in the presence of each off,er, have subscribed our names as wimesses hereto. 0 COMMONWEALTH OF PENNSYLVANIA, COUNTY OF YORK: We. C. KENNETH GRUBB, w/,~. :~. ...ec,,/,~,O¢~.-. z.~ and · ./~'/C ~ ¢. 7"Z't,,,:~ . the Testator and thewimesses herein, do herebv declare to the undersigned authority that the Testator siened and executed tlfis Codicil. that it was signed willingly a~ a free and voluntary act. and il~at e~ch of the witnesses, i~ the presence and hearing of tlie Testator signed the Codicil as witnesses. and that Io the best of their knowledge, the Teslator was at ~l~e time eighteen (18) years of age or older, of sound mind~ and under no constraint or undue ilffluence. ' SWORN TO AND SUBSCRIBED B_~ME THIS .~-.~ DAY ?F -/-'~C~.,~'~'/~ .2003. F'~-" , ~OTA~V PfBLIC OF C. KENNETH GRUBB BE IT REMEMBERED, that I, C. KENNETH GRUBB, unremarried widower, of Messiah Village, Mechanicsburg, Upper Allen Township, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all Wills and Testaments and writings in the nature thereof by me at any time heretofore made. ITEM 1: I direct that my hereinat~er named Co-Executors pay all my just debts, my funeral expenses, and the expenses of the administration of my estate. With this direction, I authorize and empower my Co-Executors to expend for my funeral expenses and interment such amounts as they may consider necessary and proper, without regard to any limit that may be prescribed by a court of law. ITEM 2: I direct my Co-Executors to pay all inheritance, estate, succession, and legacy taxes of whatsoever nature and kind, to which my estate, or the transfer of any property passing hereunder or otherwise passing by reason of my demise, may be subject, and to charge such taxes against my residuary estate. It is my intention that none of the aforesaid taxes, either federal or state, on any property required to be included in my gross estate, under the provisions of any state or federal law now in force or hereafter enacted, shall be prorated among the persons interested in my estate to whom such property is or may be transferred or to whom any benefit accrues. ITEM 3: I give and bequeath the sum of FIVE THOUSAND DOLLARS ($5,000.00) to each of the individuals identified in this Item of my Will: A. My spouse's brother, ALLEN O. BAKER, of 727 West Locust Street, York, Pennsylvania; B. My spouse's sister, VERA REHRER, of 5012 Virginia Avenue, Harrisburg, Pennsylvania; C. My great nephew, ERIC GRUBB, of Liverpool, Pennsylvania; and D. My good neighbor and friend, HARRY L. I~LARSH, of 20 S. West Avenue, Shiremanstown, Pennsylvania ITEM 4: I give and bequeath unto my spouse's nephexv, BARRY BAKER, my Pennsylvania House Drop-Leaf Desk, believed to be cherry. ITEM 5: I give and bequeath unto my great nephew, ERIC GRUBB, my antique mantel clock. ITEM 6: I give and bequeath unto TLMOTHY MARSH, of Shermans Dale, Pennsylvania, the covered bridge painting and barn painting each of which was prepared by his mother. ITEM 7: I give and bequeath unto PETER MARSH the two paintings of barns in wooded settings, in round frames, which were painted by his mother. ITEM 8: All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, whether it be real, personal or mixed, including property over which I have a power of appointment, I give, devise and bequeath unto JAMES W. GRUBB, BONNIE S. SANNO, BARRY BAKER, and RICHARD GRUBB, in equal shares. 2 ITEM 9: In the event that any of the beneficiaries named in the foregoing section of this Will should predecease me, leaving issue surviving, I direct that the share of such deceased beneficiary shall pass to his or her issue, in equal shares. If any of the beneficiaries should predecease me without leaving issue surviving, I direct that the share of that deceased beneficiary lapse, and that the balance be divided among the surviving beneficiaries. ITEM 10: I nominate, constitute and appoint my nephew, JAMES W. GRUBB and my niece, BONNIE SANNO, or the survivor of them, to serve as Co-Executors of this my Last Will and Testament. ITEM 11: I direct that my hereinbefore named Co-Executors shall not be required to give bond for the faithful performance of their duties in this or any jurisdiction. 2TNESS WHEREOF, I have hereunto set my hand and seal this ,,-~/~/--day of _h'.,~2~,/.. ,,--~ ,2001. // / C. KENNETH GRUBB The preceding instrument, consisting of this and two (2) other typewritten pages, was on the day and date thereof signed, sealed, published, and declared by the Testator herein named, as and for his Last Will and Testament, in the presence of us, who, at his request, in his presence and in the presence of each other, have subscribed our names as witnesses hereto. COMMONWEALTH OF PENNSYLVANIA : COUNTY OF CUMBERLAND : ,~ We, C.~KENNETH G RUBB, ~~.~ ~.~/i ~~i~/~/-~ and ~ ~.~ ~ ~~~, ~h~ ~e~ta~o~ ~ ~h~wi~ne~e~, ~e~ve,y, who~ nam~ a~ signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament, and that he signed willingly, and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator signed the Will as witnesses, and that to the best of their knowledge, the Testator was at the time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. SWORN TO AND SUBSCRIBED BEFORE~ME THIS ~-~/_DAY I Notarial Seal I Judy,, N. Schrack, Notary Public DJIIsburg Boro, York County My Commission Expires June 13, 2003 Member, Penns.vlvanie Association c! Notaries C. KENNETH GRUBB DEPOSIT BOX COMMONWEALTH OF PENNSYLVANIA C EPARTMENT OF REVENUE I NVE NTORY · ..ER TA.CE D,WSIO. DEPT. 280601 HARRISBURG, PA 17128~601 Please Print or Type MUST BE COMPLETED BY REPRESENTATIVE OF FINANCIAL INSTITUTION WHERE SAFE DEPOSIT BOX IS LOCATED AND RETURNED TO ABOVE ADDRESS ~ FILE NU~IB~ER SOCIALSECURITY OR DEATH DECEDENT'S NAME (LAST, FIRST, MIDDLE) _ _ ~'~ DATE OF DEATH -- ADDR.~ESS OF DECEDENT (STREET) . (CITY) _ (STATE) /3 ,{ZIP CODE) NAME AND ADDRESS OF PERSON ~EQUESTING THE OPENING OF THE SAFE DEPOSIT BO~ NAME, ADDRESS AND RE~TIONSHIP (IF ANY) TO DECEDENT, OF PERSON(S) PRESENT AT THE BOX OPENING a. . (RE~TIONSHIP) (ZIP CODE) (NAM~---~ (ciTY) (RELATIONSHIP) (ZIP CODE) (STR%A~ ~) (NAME) '~ ' f ~r (ZIP CODE) (STREET NAME) (CITY) ~' NAME AND ADDRESS OF FINANCIAL INSTITUTION WHERE THE SAFE DEPOSIT BOX IS LOCATED (STATE) (ZIP CODE) (NAME) (STREET NAME) ~.~/~_~ ~..~ ~/~='~'/ i~ NAME OF PERSON MAKING LASrr ENTRY [[~ DATE OF CONTR/~T TO RENT BOX [1~ N'0'-MB~=~ OF ~bX ~1 NAME AND ADDRESS OF PERSON(S) HAVING ACCESS TO BOX / (CITY) (STATE) ~ [~ DATI~ AND TIME OF LAST ENTRY TITLE UNDER WHICH BOX IS~EQUESTED (ZiP CODE) (STREET ADDRESS) (CITY) (STATE) (ZIP CODE) b. (NAME) (STREETADDRESS) (CITY) (STATE) (ZIP CODE) NAME AND TITLE OF EMPLOYEE TAKING THE INVENTORY WAS A WILL IN THE BOX? [] YES ~ If yes, a. Date of will: b. Name and address of personal representative, if named in the will (NAME) (STREET NAME) (CITY) (STATE) (ZIP CODE) c. Name and address of attorney, if any (NAME) (STREET NAME) (CITY) (STATE) (ZIP CODE) SAFE DEPOSIT BOX INVENTORY ''Page'. [ '0r:J" '' INSTRUCTIONS " '- (1) Cash: Report total only. (2),.Stgcks:.,Lis,t in.~.e.tai! every common or preferred certificate, warrant or other rights found in box. Stocks are to be , ~ ::: ..:~ _--=. designated by name of company, certificate number, date of certificate, name in which stock is registered, and -.'; :' ~ number of shares and class of stock. ~ (3) ObligatiOns 6~ UiS. Government: Number of items, date of issue, face value, names in which registered and type of ownership, i.e., jointly held, payable on death, etc. (4) Bonds: Designate by name, amount, serial number, or other designation. (Bearer Bonds) (5) Bank and Savings and Loan Passbooks: State name of depositor, number of book, last date appearing in book, name of bank and branch, and balance. (6) Je~velry, Coins, Stamps, Manuscripts, etc: List and describe as fully as possible. (7) Deeds, Mortgages, Current Insurance Policies or other evidences of indebtedness: List and describe as fully as possible. (8) All other contents. ITEM NO. ITEM DESCRIPTION f I CERTIFY UNDER PENALTY OF ~E~JUR¥ THAT THE ABOVE RECO~D IS P~SON ~CEIVING COPY O~ CORRECT AND ~OMP/E]~E TO THE BEST OF MY KNOWLEDGE AND BELIEF. SA~ DEPOSIT 8OX INVENTORY: P~INT TTTLE DATE C~CK ~P~OP~SOX: J~ ~O~ d%~O~ ~ ~EstateRepresentativ. U Joint owner of safe deposit box NOTE: Attach additional 8%" x 11" sheet(s) if necessary or use duplicates of this page of form. REV- 1508 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF C. Kenneth Grubb SS~/ SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY 204-01-9853 01/30/2004 FILENUMBER 21-04-00139 Include the proceeds of litigation and the date the proceeds were received by the estate. All property jointly-owned with the right of survivorship must be disclosed on Schedule F. ITEM NUMBER DESCRIPTION #5001885069 1 2 3 4 5 6 7 8 9 PNC Bank, N.A. - checking account PNC Bank, N.A. - CD# 31700214485 Waypoint Bank - CD#505003107 Waypoint Bank - CD# 1855298256 Waypoint Bank - CD#1800010547 Waypoint Bank - CD#1800010413 Household contents (see appraisal) Ladies two-tone engagement ring (see appraisal) Miscellaneous coins/currency (as found in safety see attached appraisal deposit box) TOTAL (Also enter on line 5, Recapitulation) VALUE AT DATE OF DEATH 12,705.23 30,628.74 2,568.65 29,214.45 5 686.32 16,445.51 1 760.00 260.00 147.85 99,416.75 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-I$08 EX (Rev. 1-97) 0CT-24-2004 ~9:2~ PNC~RNK 4~2 768 S458 P.0~/0! 'PN CBA'N< October25, 2004 Schrack & Lmsenbach Attn: William D. Schrack 124 W Harrisburg St. P O Box 310 Dillsburg, PA 17019-0310 scp Estate of C Kenneth Cn'ubb (Deceased) SSN: 204-01-9853 DOD: 01-30-2004 Dear Mr. Schrack: In response to your request for Date of Death balances for the customer noted above, our records show the following: Certificate of Deposit Account #31700214485 C KENNETH GRUBB DOD balance: $29,899.69 + $729.05 accrued interest Established 07-23-2001 Checi~ng Aeeoun~ Account #5001885069 C KENNETH GRUBB DOD balance: $12,704.06 + $1.17 accrued interest Established 10-26-1998 Please note that this office only provides date of death balances for deposit accounts (IRAs, CDs, Checking and Savings accounts). We flo not process any Financial transactions or provide statements. If you need assistance with any of these items, plebe call 1-885-PNC-BANK (1-g88-762-2265) or stop by your local PNC Bank b~eh office. Sincerely, F_a-ica L Schlegel 1-800-762-1775 P7-PFSC-O4-F 500 Firs~ Ave. PJmburgh PA 15219 M~mber FDIC TOTRL P.01 LOOK FOR US. WE'LL 6ET YOU THERE. 2/26/2004 WM. D. SCHRACK III 124 W HARRISBURG ST PO BOX 310 DILLSBURG PA 17019-0310 The information which you requested on the account(s) of C KENNETH GRUBB (Social Security Number 204-01-9853) 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 SYLVA E Owner, if any GRUBB Date Ownership 091098 Was Established 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 1800010413 1800010547 1855298256 505003107 CERTIFICATE CERTIFICATE CERTIFICATE CHECKING 091098 062499 101796 011083 16407.58 5671.68 29139.21 2568.30 37.93 14.64 75.24 .25 16445.51 v 5686.32 ~ 29214.45 ~ 2568.65 JTO JTO JTO SYLVA E SYLVA E SYLVA E GRUBB GRUBB GRUBB 062499 101796 011083 2g?14o~5. Additional Information Requested SENIOR SERVICES REP. P.O. Box 171 I. HARRISBURG. PENNSYLVANIA 17105-1711 Toll Free 1-866-WAYPOINT (I-866-9;~9-7646) · IN YORK AREA 717/815-4500 · ~w. wagpointbank.com APPRAISAL Personal Property of ~_., ~Z..~/J/~'d-7-~ ~____m-~15/3 ,/"/6,s3/.,,~,ff' V'/c~dr,.~_~ Appraised by Chuck E. Bricker AU094-L Date oQ --//,~. -{,) ITEM VALUE ITEM VALUE INSURANCE APPRAISAL We herewith certify that we have this day carefully examined the following listed and described articles, at the request of.' NAME: Prepared for the Estate of C. Kenneth Grubb ADDRESS: DATE: FebrUary 25, 2004 In making this appraisal, we do not agree to purchase or replace the articles. This appraisal is intended for the function of insurance coverage only. /he values stated are a fair indication of the replacement costs for the items described in the report as of the date listed herein. It is understood that the items described in this report belong to the above, and that the manner of acquisition can be formally stated by the above named. The appraiser does not research ownership. The total retail replacement cost for the appraised items does not include sales tax or other charges which might be payable. The value conclusions may be subject to limiting conditions set forth in the body of the accompanying report. This appraisal report consists of 4 pages. It must be intact and in its entirety to be valid. These records are confidential. We will not permit access to them without your authorization. In order to avoid any misunderstanding this report must be used only in its entirety. It has been a pleasure serving you. We look forward to helping you with any of your future jewelry appraisal needs. Appraiser: Loraine Kline Myers, Graduate Gemologist (GIA) INSURANCE APPRAISAL The following appraisal report has been undertaken to determine the replacement cost of the items described below. Each item has been examined and researched to determine value for the function of insurance coverage only. The procedures, wording, and value would be different for any other function. The values expressed are based on current information on the date made and no opinion is hereby expressed either as to any future value or to the past value. The description, grading, and value of these articles are correct and/or estimated to be best of my knowledge and belief, and represent a subjective judgment; it being noted that others might describe, grade, and value them differently. This appraisal report was conducted in accordance with accepted appraisal practices and, in my opinion, is a fair representation of the market conditions, at the time the appraisal was performed, in the Harrisburg, Pennsylvania metropolitan area. The specific description of the items is for the sole purpose of identification in order to determine the parameters for valuation and is based only on the readily apparent identity of the items appraised. Possession of this report and any copy does not carry with it the right of publication, nor may the same be used without the previous written consent of the appraiser, and in any event, only in its entirety and with the proper qualifications, cover letter and transmittal letter. No change of any item in the appraisal report shall be made by anyone other than the appraiser, and the appraiser shall have no responsibility for any unauthorized change. Testimony or attendance in court or at any other hearing is not required by reason of rendering this report unless such arrangements are made a reasonable time in advance and commissioned at the customary per hour rate as of that date. Unless otherwise stated, the weights of all gemstones are estimated by formula. All measurements and weights are approximate. Although state of the art equipment is used, the actual weight of the gemstones may be different if analyzed out of the mounting. Photographs, if included, may not represent the true colors or actual size, and are used only to show the design of the items appraised. The grading nomenclature used for diamonds, colored stones, and pearls are those used in the systems developed by the Gemological Institute of America. Identification of gemstones, metals and methods of constructions are determined only to the extent that the item permits. Indications of metal fineness are based on reactions to an acid test (this is a limited but accepted test in the jewelry industry, but does not constitute an assay). No warranty of gold content or metal fineness can be made unless an actual fire assay is performed. Unless otherwise indicated, all diamonds and other gemstones are identified, measured and evaluated in their settings, and only to the extent that the mounting allows. Ordinary wear and tear common to these items is not noted. In the event that one of a pair (i.e. cuffiinks, earrings, etc.) requires replacement, to manufacture that one item would typically be about 75% of the estimated retail replacement value shown for the whole pair. INSURANCE APPRAISAL Unless specifically described otherwise, it is presumed that all colored stones described in this report have probably been subjected to a stable color enhancement process, which may be undetectable. The market values listed are based upon these universally practiced and accepted treatment processes. Unless otherwise stated, the final value estimates are based upon whole interest and possessory interest undiminished by any liens, fractional interests or any other form of encumbrance or alienation. This report is offered with no other contingent or limiting conditions which would affect the values stated. I also state that I have no present, nor contemplated future interest in the items described which would bias the report. Employment to make this report and compensation for it are not contingent upon the values found, but are based solely on time worked. MARKET ANALYSIS Basis for the determinations of value is for items of like kind and quality. The type of retail outlet that most commonly carries the items being appraised is considered the mode. The values given do not necessarily reflect the price at which the appraised items may be purchased from any one store. Replacement cost new is the cost necessary to replace with new materials of like kind, quality, and similarly utility, at current prices, to the item being appraised. For new items of personal property, custom designed pieces, signed or trademarked pieces by well know firms or designers, replacement cost equals reproduction cost. This definition assumes the item being appraised can be substituted new with an exact duplicate. Antique and per/od style jewelry is unique, and as such, reproduction costs are not applicable. Often it may be difficult to find an item comparable to the one being appraised. Even if the market does exist, it may be large enough to yield sufficient data for an accurate valuation. Therefore, the method used to appraise antique and period jewelry is replacement cost for comparable items. This is the cost necessary to replace with a comparable item of property of like kind, quality, and similar utility, at current prices, to the item being appraised. This definition assumes that the item being appraised can not be substituted new with an exact duplicate. QUALIFICATION The appraiser is a resident Graduate Gemologist of the Gemological Institute of America (GIA), and is the President of The Jewel Box in Newport, Inc., a retail jewelry business. INSURANCE APPRAISAL One ladies two tone engagement ring. Set in the center of the square white gold head is a Round Brilliant Cut diamond measuring 4.74 x 4.62 x 2.88 roms as measured with the Leveridge gauge and weighing approximately 0.38 cts. The diamond is out &round, the culet is large, the girdle is wavy, the table and culet are off center, there are numerous feathers which reach the surface of the crown and pavilion facets, there are numerous included crystals throughout the diamond. It grades GIA clarity h and color I to J to K. The diamond is set with eight prongs in an illusion head. The rounded shank measures 3 roms at the top and tapers to 1.5 mms at the back. Estate Value $260.00 4 HARDY'S AUCTION SERVICE 193 Orebank Rd Dillsburg, PA 17019 717-432-3779 Schrack & Linsenbach Law Offices 124 W. Harrisburg St. P.O. Box 310 Dillsburg, PA 17019-0310 March 6, 2004 Bill, Attached is the appraised value of coins/currency for the Estate of C. Kenneth Grub. The fee for this service is $25.00. Sincerely, Vickie Hardy AU-L-2795-L The Estate of C. Kenneth Grubb ITEM AMOUNT A. 1851 Liberty Head $1.00 Gold Piece 90.00 B 1857 Flying Eagle Penny 5.00 C 1865 Indian Head Penny 4.00 D 1964 Kennedy Halves 3 @ .75 each 2.25 -i~ 1966 Kennedy Half ----0.-55 .~ __ --, ~1_9_§ 8_D_ _K e n__ned y_ __FI a I_~f ........................................ .0_- 5 5 G ....... ! a~9_M_ o?_g_a_n_..D°J!a r__ 11.00 ! ..... l_~._0p_s M org a__n__Dp II__a_r_ ........................................................... 9..00 J 1925 Peace Dollar 6.00 K $2.00 bills 5 @ 2.10 each 10.50 L Red Seal $2.00 bill 3.00 TOTAL 147.85 REV- 1510 EX + (1-97) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF C. Kenneth Grubb SS~/ 204- 01- 9853 01/30/2004 FILE NUMBER 21-04-00139 This schedule must be completed and filed if the answer to any of questions 1 through 4 on page 2 is yes, DESCRIPTION OF PROPERTY % OF ITEM INCLUDE THE NAME OF THE TRANSFEREE, THEIR DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE RELATIONSHIP TO DECEDENT AND THE DATE OF TRANSFER NUMBEF ATTACH A COPY OF THE DEED FOR REAL ESTATE. ' VALUE OF ASSET INTEREST (~F APPLICABLE) 1 lNG - Account ~/90117246 61,133.66 61,133.66 2 ING - Account ~/90116351 104,202.12 104,202.12 3 ING Account ~/90129251 110,849.05 110,849.05 4 ING - Account f/90129252 90,383.32 90,383.32 5 MetLife Annuity - Policy 113,155.73 113,155.73 ~/A2070338 TOTAL (Also enter on line 7, Recapitulation) $ 479,723.88 (If more space ~s needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1510 EX (Rev. 1-97) FINANCIAL GROUP William Schrack, Esq. 124 W. Harrisburg St. Dillsburg, PA 17019 April 26, 2004 Re: C. Kenneth Grubb Date of Death Balances Dear Mr. Schrack: This letter is in response to your request for the original purchase premium and date of death balances for C. Kenneth Grubb's fixed am~uity policies of which I am the agent of record. The following table gives the company name, policy number, purchase premium and values as of 1/30/04 for the policies he had with ING and Met Life. Policy Number Purchase Premium Date of Death Balance ING 90117246 $57,500.00 $61,133.66 ING 90116351 $104,000.00 $104,202.12 ING 90129251 $109,108.00 $110,849.05 ING 90129252 $88,988.84 $90,383.32 Met Li~ A2070338 $100,362.05 $113,155.73 Please feel free to contact me with any questions you may have. Sincerely, Eric W. Grub~ 801 East Park Drive, Suite 103 t Harrisburg, PA 17111 (717) 657-8878 t FAX (717) 657-8839 Securities offered t3hrough Walnut Street Securities, Inc. Member NASD, SIPC 270 Walker Drive, State College, PA 16801 I (814) 238-0544 Advisory Sm'ices through PFG Financial Advisors /' PNCINVESTMENTS 't~mb~r NASD and S1PC March 15, 2004 Schrack & Linsenbach Attoneys-at-Law 124 West Harrisburg Street P. O. Box 310 Dillsburg, PA 17019-1053 Attn: William D. Schrack III RE: C. Kenneth Grubb Date of Death - January 30, 2004 Dear Sir: Mr. Grubb owned a MetLife Annuity, Policy # A2070338. This annuity was opened August 30,2001 with $76,562.93. An addition of $23,799.12 was made to the annuity on September 22, 2001. The Date of Death Valuation for the annuity is $113,155.72. *Fine value of the annuity today, March 15, 2004 is $113,602.79. There are four beneficiaries as listed: James W Grubb, Nephew iBonnie S Sanno, Niece Barry Baker, Nephew Richard Grubb, Nephew Enclosed is a claim form for MetLife. Sincerely, Chuck Little, cFp A member oflhe PNC Financial Services Group 2 East Main Street Mechanicsburg Pennsylvania 17055 www.pncinvestments.com Important Investor Information: Securities and brokerage services are provided by PNC Investments LLC, member NASD and SIPC. Annuities and other insurance products are offered by PNC Insurance Services, Inc. a licensed insurance agency. MK1007 M~1UO! REV- 1511 EX + (1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF C. Kenneth Grubb SS~/ 204-01-9853 01/30/2004 Debts of decedent must be reported on Schedule I. ITEM NUMBER Bo SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS FILE NUMBER 21-04-00139 1 2 3 4 5 6 DESCRIPTION FUNERAL EXPENSES: Neil Funeral Home Rice Memorial Works - marker engraving ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) James W. Grubb Social Security Number(s) / EIN Number of Personal Representative(s) Street Address 60 State Route 235 City Liverpool State PA ~Zip 17045 Year(s) Commission Paid: Attorney's Fees Wm. D. Schrack, III Esquire Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State Zip Relationship of Claimant to Decedent Probate Fees Register of Wills Accountant's Fees Tax Return Preparer's Fees Other Administrative Costs Bureau of Vital Statistics - death certs Clerk of Orphans' Court - Release fee Cumberland Law Journal - estate advertisement Hardy' s Auction Service (coin/currency appraisal) Miscellaneous expense - postage, Notary fees, photocopies, etc. Patriot News estate advertisement for Sylva Grubb Total of Continuation Schedule(s) TOTAL (Also enter on line 9, Recapitulation) (If more space is needed, insert additional sheets of the same size) AMOUNT 8,654.53 145.00 28,170.00 10,500.00 282.50 16.00 28.00 75.00 25.00 25.00 103.15 345.54 48,369.72 Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1511 EX (Rev. 1-97) Estate of: C. Kenneth Grubb Soc Sec #: 204-01-9853 Date of Death: 01/30/2004 Item Description Continuation of Schedule H-B7 (Other Administrative Costs) Amount 7 Register of Wills filing fee 8 Register of Wills - additional Short Certificates 9 Reserve for future administrative expense 10 The Jewel Box (ring appraisal) 15.00 18.00 250.00 62.54 345.54 REV-1511 EX+ (12-99) ~,..~ [ (Cont inuat ion) I SCHEDULE H COMMONWEALTH OF PENNSYLVANIA ~ FUNERAL EXPENSES & INHERITANCE TAX RETURN / ADMINISTRATIVE COSTS ESTATE OF FILE NUMBER C. KENNETH GRUBB ss# 204-01-9853 01/30/2004 2104-00139 Debts of decedent must be reported on Schedule L ITEM NUMBER DESCRIPTION A. FUNERAL EXPENSES: 1. 5. 6. 7. ADMINISTRATIVE COSTS: Personal Representative's Commissions Name of Personal Representative(s) Bonnie S. Sanno Social Security Number(s)/EIN Number of personal Representative(s) 175-40-5158 Street Address R. D. #2, Box 364 city New Bloomfield . State PA Year(s) Commission Paid: 2004 Attomey Fees Family Exemption: (If decedenrs address is not the same as claimant's, attach explanation) Claimant Street Address City State Relationship of Claimant to Decedent Probate Fees Accountant's Fees Tax Return Preparer's Fees Zip 17068 .Zip TOTAL (Aisc enter on line 9, Recapitulation) (If more space is needed, insert addiiional sheets of the same size) AMOUNT $ 0.00 Estate of: C. Kenneth Grubb Soc Sec #: 204-01-9853 Date of Death: 01/30/2004 Continuation of Schedule H-Bi (Personal Representative's Commissions) Item Description Amount Bonnie S. Sanno James W. Grubb 14,085.00 14,085.00 28,170.00 REV- 151Z EX + {1-97) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF C. Kenneth Grubb SS~/ SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, AND LIENS 204-01-9853 01/30/2004 FILENUMBER 21-04-00139 Include unreimbursed medical expenses. ITEM NUMBER DESCRIPTION AMOUNT 1 2 3 4 Alert Pharmacy Services last illness expense Bankcard Services debt of dececent Elite Staffing Services last illness expense Messiah Village - debt of decedent 91.90 134.39 204.00 5,883.46 TOTAL (Also enter on line 10, Recapitulation) $ 6,313.75 (If more space is needed, insert additional sheets of the same size) Copyright (c) 1996 form software only CPSystems, Inc. Form REV-1512 EX (Rev. 1-97) REV- 1513 EX + (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN R£SIDENT DECEDENT ESTATE OF C. Kenneth Grubb SS# 204-01-9853 SCHEDULE J BENEFICIARIES 01/30/2004 FILENUMBER 21-04-00139 NUMBER I. 2 II. NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spou~l distributions, and transfem under Sec. 9116~(1.9] Allen O. Ba~er 727 W. Locust Street York, PA 17404 Barry Baker 1748 Crescent Road York, PA 17403 Eric Grubb 203 South Market Street Liverpool, PA 17045 James W. Grubb 60 State Route 235 Liverpool, PA 17045 Richard Grubb RELATIONSHIP TO DECEDENT Do Net List Trustee(s) Brother-in-Law Nephew Grand Nephew Nephew AMOUNT OR SHARE OF ESTATE 5,000.00 1/4 of residue; PA House drop leaf desk 5,000.00 1/4 of residue TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0o 00 (If more space is needed, insert additional sheets of the same size/ Copyright {c) :~000 form software only The Lackner Group, Inc. Form REV-1513 EX (Rev. 9-00) B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS Nephew 1/4 of residue ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18, AS APPROPRIATE, ON REV 1500 COVER SHEET NON-TAXABLE DISTRIBUTIONS: A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE ' Estate of: C. Kenneth Grubb Soc Sec #: 204-01-9853 Date of Death: 01/30/2004 Continuation of Schedule J, Part I (Taxable Bequests) Item Name and Address of Beneficiary # Relationship Amount or Share of Estate 7 11284 SW 75th Terrace Ocala, FL 32676 Peter Marsh 200 South Pine Street Lewistown, PA 17044 Timothy Marsh 75 Klinger Drive Shermans Dale, PA 17090 Vera Rehrer 5012 Virginia Avenue Harrisburg, PA 17109 Bonnie S. Sanno R.D. #1, Box 364 New Bloomfield, PA 17068 Friend Friend Sister-in-Law Niece two paintings of barns in wooded setting covered bridge painting and barn painting 5,000.00 1/4 of residue COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD REV-1162 EX(11-96) 004547 SANNO BONNIE R.D. #1 BOX 364 NEW BLOOMFIELD, PA 17O68 ........ fold ESTATE INFORMATION: SSN: 204-01-9853 FILE NUMBER: 2104-01 39 DECEDENT NAME: GRUBB C. KENNETH DATE OF PAYMENT: 10/26/2004 POSTMARK DATE: 10/26/2004 COUNTY: CUM BERLAN D DATE OF DEATH: 01/30/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $9,947.52 REMARKS: GRUBB TOTAL AMOUNT PAID: $9,947.52 SEAL CHECK# 511 INITIALS: CCP RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS Oath of Personal Representative Commonwealth of Pennsylvania County of York 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 or Petitioner(s) and that, as personal representative(s) of the Decedent, Petition(s) will well and truly administer the e,,?tate accor, d, ing.,.to law. / Sworn to or affirmed and subscribed before me this ] _~ ~ ~ day of ~ ~o the egister No. 2.1-oq- 5 Estate of C. ~ Deceasec Social Security No.: 204 01 9853 Date of Death: January 30, 2004 AND NOW, ,20 04 , in consideratior of the Petition on the reverse side hereon, satisfactory proof having been presented before me, IT tS DECREED that Letters [~ Testamentary ~ Of Administration are hereby granted to J.,NVJES W. (]RUB~ nad BC[~IE S. d.~pendente lite; durante absentia; durante minoritate in the above estate and that the instrument(s) dated Jul_v 23. 2001 and ~eeemher 3 described in the Petition be admitted to probate and filed of record as the last Will of Decedent. FEES Letters ............ $ Short Certificate(s). Renunciation ....... $ Affidavits ( ) ....... $ Extra Pages ( ) ..... $ Codicil ............ $ JCP Fee ........... $ Inventory ........... $ Automation Fee ..... $ Other .............. $ TOTAL ........ $ snace/WillsPetGrantLt/2001 Register of ~11~''~- ~ ~ Attorney: I~hl. D. Schrack, I I I I.D. No: 15893 Address: P. O. Box 310, Dillsburg, AP 17019 Telephone: 717-432-9733 Vel "o0 puep,gquirl,O 00: EI EtB3J his is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as Local Re, gistrar. The original certificate will be forwarded to the State Vital Records Office for permanent tiiling. WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $2.00 P 9825814 No. COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF HEALTH · VITAL RECORDS CERTIFICATE OF DEATH SOLE CODICIL OF C. KENNETH GRUBB I, C. KENNETH GRUBB, of 351 Nittany, Messiah Village, Pennsylvania, declare this to be the sole Codicil to my Last Will and Testament dated July 23, 2001. ITEM 1: I delete the bequest contained in Item 3(D) of my Will dated July 23, 2001. ITEM 2: In all other respects, I hereby ratify, confirm, and republish my Last Will dated July 23, 2001, together with this sole Codicil, as and for my Last Will and Testament. .___..WITNESS WHEREOF, I have hereunto set my hand this ~}) 2003. day of C. KENNETH GRUBB Signed, published, and declared on the date thereof by the above named C. KENNETH GRUBB as and for the sole Codicil to her Last Will dated Jul3, 23. 2001. in the presence of us, who, at her request, in her presence, and in the presence of each other, have subscribed our names as witnesses hereto. COMMONWEALTH OF PENNSYLVANIA, COUNTY OF YORK: We. C. KENNETH GRUBB, ada4. ::z,. 3'cnt~,,Oc.t~'' ~ and ,.6q,td/C ~' ¢. 7-~0,t4,o . the Testator and the witnesses herein, do hereby declare to the undersigned authori .ty that the Testator signed and executed this Codicil, that it was signed willingly as a free and voluntary act, and that each of the wituesses, in the presence and hearing of tlie Testator signed the Codicil as witnesses, and that to the best of their knowledge, the Testator was at the time eighteen (18) years of age or older, of sound min& and under no constraint or undue influence. SWORN TO AND SUBSCRIBED B_~Ct~;~ME THIS _~-~ DAY ~,* ,-~-~' ,2003. OF C. KENNETH GRUBB BE IT REMEMBERED, that I, C. KENNETH GRUBB, unremarried widower, of Messiah Village, Mechanicsburg, Upper ~Sdlen Township, Cumberland County, Pennsylvania, being of sound mind, memory and understanding, do make, publish and declare this as and for my Last Will and Testament, hereby revoking and making null and void any and all Wills and Testaments and writings in the nature thereof by me at any time heretofore made. ITEM 1: I direct that my hereinafter named Co-Executors pay all my just debts, my funeral expenses, and the expenses of the administration of my estate. With this direction, I authorize and empower my Co-Executors to expend for my funeral expenses and interment such amounts as they may consider necessary and proper, without regard to any limit that may be prescribed by a court of law. ITEM 2: I direct my Co-Executors to pay all inheritance, estate, succession, and legacy taxes of whatsoever nature and kind, to which my estate, or the transfer of any property passing hereunder or otherwise passing by reason of my demise, may be subject, and to charge such taxes against my residuary estate. It is my intention that none of the aforesaid taxes, either federal or state, on any property required to be included in my gross estate, under the provisions of any state or federal law now in force or hereafter enacted, shall be prorated among the persons interested in my estate to whom such property is or may be transferred or to whom any benefit accrues. ITEM 3: I give and bequeath the sum of FiVE THOUSAND DOLLARS ($5,000.00) to each of the individuals identified in this Item of my Will: A. My spouse's brother, ALLEN O. BAKER, of 727 West Locust Street, York, Pennsylvania; B. My spouse's sister, VERA REHRER, of 50t2 Virginia Avenue, Harrisburg, Pennsylvania; C. My great nephew, ERIC GRUBB, of Liverpool, Pennsylvania; and D. My good neighbor and friend, HARRY L. MARSH, of 20 S. West Avenue, Shiremanstown, Pennsylvania ITEM 4: I give and bequeath unto my spouse' s nephew, BARRY BAKER, my Pennsylvania House Drop-Leaf Desk, believed to be cherry. ITEM 5: I give and bequeath unto my great nephew, ERIC GRUBB, my antique mantel clock. ITEM 6: I give and bequeath unto TIMOTHY MARSH, of Shermans Dale, Pennsylvania, the covered bridge painting and barn painting each of which was prepared by his mother. ITEM 7: I give and bequeath unto PETER MARSH the two paintings of barns in wooded settings, in round frames, which were painted by his mother. ITEM 8: All the rest, residue and remainder of my estate, of whatsoever nature and wheresoever situate, whether it be real, personal or mixed, including property over which I have a power of appointment, I give, devise and bequeath unto JAMES W. GRUBB, BONNIE S. SANNO, BARRY BAKER, and RICHARD GRUBB, in equal shares. ITEM 9: In the event that any of the beneficiaries named in the foregoing section of this Will should predecease me, leaving issue surviving, I direct that the share of such deceased beneficiary shall pass to his or her issue, in equal shares. If any of the beneficiaries should predecease me without leaving issue surviving, I direct that the share of that deceased beneficiary lapse, and that the balance be divided among the surviving beneficiaries. ITEM 10: I nominate, constitute and appoint my nephew, JAMES W. GRUBB and my niece, BONNIE SANNO, or the survivor of them, to serve as Co-Executors of this my Last Will and Testament. ITEM 11: I direct that my hereinbefore named Co-Executors shall not be required to give bond for the faithful performance of their duties in this or any jurisdiction.  ,H~:ITNESS WHEREOF, I have hereunto set my hand and seal this c2~ ,~/_.~ay of  H-'~-~_~,'''- ,2001. C. KENNETIt GRIJBB The preceding instrument, consisting of this and two (2) other typewritten pages, was on the day and date thereof signed, sealed, published, and declared by the Testator herein named, as and for his Last Will and Testament, in the presence of us, who, at his request, in his presence and in the presence of each other, have subscribed our names as witnesses hereto. OF COMMONWEALTH OF PENNSYLVANIA : COUNTY OF CUMBERLAND : ~'~~/~Yx~/ ~' ~/~~/, the Testator and the witnesses, respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator signed and executed the instrument as his Last Will and Testament, and that he signed willingly, and that he executed it as his free and voluntary act for the purposes therein expressed, and that each of the witnesses, in the presence and hearing of the Testator signed the Will as witnesses, and that to the best of their knowledge, the Testator was at the time eighteen (18) years of age or older, of sound mind, and under no constraint or undue influence. C. KENNETH GRUBB SWORN TO AND SUBSCRIBED BEFORE ME THIS ~ ~AY Notarial Seal Judy.. N. Schrack, Notary Public DiIIsburg Boro, York County My Commission Expires June 13, 2003 Member, Pennsylvania Association of Notaries CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Date of Death: Estate No. C. KENNTH GRUBB sdka/CLARENCE IC GRUBB JANUARY 30, 2004 2104-0139 To the Register: I certify that Notice of Estate Administration required by Rule 5.6(a) of the Orphan's Court Rules was served on or mailed to the following beneficiaries of the above-captioned estate on February 17, 2004 Name Allen O. Baker Address 727 W. Locust Street York, PA 17404 Vera Rehrer 5012 Virginia Avenue Harrisburg, PA 17109 Eric Gmbb 203 Market Street Liverpool, PA 17045 Barry A. Baker 1748 Crescent Road York, PA 17403 Timothy Marsh 75 Klinger Drive Shermans Dale, PA 17090 Peter Marsh 200 S Pine Street Lewistown, PA 17055 Richard Gmbb James W Grubb Bonnie S. Sanno 11284 SW 75t~ Terrace Ocala, FL 32676 60 St Rt 235 Liverpool, PA 17045 R.D. #1, Box 364 New Bloomfield, PA 17068 Notice has now been giyen ~l]'~t~'~s~;~fi~ ~lLJ~,.,f~ereto kmde~Ru.l~S.~(a),ejx~ept none Date: ~//~/aO~ ( ~~... ~: Z~ ~ t ~31 ~. ~C~CK, m~SQ~ 124 West H~sb~g S~eet P.O. Box 310 S!~tVl~-. ~''~ ~'~;~r:billsburg, PA 17019-0310 Counsel for the personal representative IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECEIVE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you will receive any money or property will be determined wholly or partly by the decedent's Will. If the decedent died without a Will, whether you will receive any money or property will be determined by the intestacy laws of Pennsylvania. BEFORE THE REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA In re' THE ESTATE OF: C. KENNETH GRUBB a/k/a CLARENCE K. GRUBB ESTATE NO. 2104-0139 To: ALLEN O. BAKER, VERA REHRER, ERIC GRUBB, BARRY A. BAKER, TIMOTHY MARSH, PETER MARSH, RICHARD GRUBB, JAMES W. GRUBB, and BONNIE S. SANNO Please take note: The Decedent, C. KENNETH GRUBB a/k/a Clarence K. Grubb, died on the 30th day of January, 2004, at Messiah Village, Upper Allen Township, Cumberland County, Pennsylvania. The personal representatives of the Decedent are: James W.Grubb Bonnie S. Sanno 60 St Rt 235 R.D. #1, Box 364 Liverpool, PA 17045 New Bloomfield, PA 17068 (717) 444-7284 (717) 582-4647 The Decedent died testate (with a Will)and the Will was filed with the office of the Register of Wills of Cumberland County. Register of Wills of Cumberland County 1 Courthouse Square Carlisle, Pennsylvania 17013 (717) 697-0371 Vd "~pL~!~qU~;~0 An additional copy o~.=~t~ne Will may be ~a~ by contacting the Register of Wills and paying the cha~ges/ f~-~/~upli~tion. Jo gc~~, ~?/ 124 West Harrisburg Street ~ P.O. Box 310 Dillsbur~, PA 17019 (717) 432-9733 Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. REV-1162 EX(I 1-96) CD 003883 SCHRACK WM D III ESQ 124 W HARRISBURG ST P O BOX 310 DILLSBURG, PA 17019 ........ fold ESTATE INFORMATION: SSN: 204-01-9853 FILE NUMBER: 2104-01 39 DECEDENT NAME: GRUBB C. KENNETH DATE OF PAYMENT: 04/30/2004 POSTMARK DATE: 04/26/2004 COUNTY: CUMBERLAND DATE OF DEATH: 01/30/2004 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 $65,000.00 REMARKS: TOTAL AMOUNT PAID: $65,000.00 SEAL CHECK# 507 INITIALS: JA RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS [] Please call to make an appointment [] Please sign and return [] Please sign, have your signature notarized and return. [- Rt~ISWER OF WILLS Cunberland County Court House TO CARLISLE, PA 17013 [#CLOS[O Fee ¥oue AcTie# Date April 26, 2004 FileNo. 2104-00139 Re: Estate of C. I<ENNEI~ Eno,o~s~ed.y~o_u wi,!_~n~d?~,e.c.t.or's eheok #S07. payabXe to' thff~,ut~ff, ister of Wills-Agent", for the san u~ ~/6~,UU0.uu. which repersents a payment of accoUnt':~Of Pa Inheritance Tax liability [] Please review and call with any questions or changes - - ~ Please retmm receipt to me /_ t: L \:' 0~ Hd~t !70. SOIRACK & LINS£NBACIt LAW OFFICES 124 WESt HARRISBURG STREET POST OFFICE BOX 310 D~[SSUR~, PA 17019-0310 (717) 432-9733 · [^x (717) 432-1053 SCHRACK & LINSENBACH LAW OFFICES 124 WEST HARRISBURG STREET POST OFFICE BOX 310 D]LLSBURG, PA 17019-0310 5426176 :37: PLEASE FILE THIS REPORT WITHIN TWO YEARS OF DATE OF DEATH REGARDLESS OF THE STATUS OF THE ESTATE. IF ESTATE IS NOT COMPLETED, FILE a 6.'I2 FORM YEARLY UNTIL COMPLETION " ' Name of Decedent: STATUS REPORT UNDER RULE 6.12 Date of Death: Estate No.: January 30, 2004 21-04-00139 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: State whether administration of the estate is complete: Yes X No Date: 10/26/2004 If the answer is No, state when the personal representative reasonably believes that the administration will be complete: (date) 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 the personal representative's account is: (Not Applicable in Dauphin County) 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 the Clerk of the Orphans' Court and may be attached to this report. James W. Grubb Bonnie Sanno Name (Please type or print) 60 State Route 235 Liverpool, PA 17045 R.D.#1, Box 364 NewBloomfield, PA 17068 Address (MAH:rmt/AM3) c/o 717-432-9733 Telephone No. g.W. - 5~ Capacity: X Personal Representative Counsel for Personal Representative COMMONWEALTH OF PENNSYLVANZA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEHENT, ALLO#ANCE OR DISALLO#ANCE OF DEDUCTIONS AND ASSESSHENT OF TAX REV-IB~7 EX AFP C09-D~) ZDDqDEC29 AH9:09 DATE 12-27-2004 ESTATE OF GRUBB DATE OF DEATH 01-30-2004 FXLE NUMBER 21 04-0139 COUNTY CUMBERLAND ACN 101 I Amount RamA~ad C K HAKE CHECK PAYABLE AND REHZT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 1701:3 CUT ALONG THZS LINE ~ RETAZN LOWER PORTZON FOR YOUR RECORDS ~ REV-Z547 EX AFP (01-03) NOTICE OF ZNHERZTANCE TAX APPRAZSEHENT, ALLOWANCE OR DZSALLOWANCE OF DEDUCTZONS AND ASSESSMENT OF TAX ESTATE OF GRUBB C K FZLE NO. 21 04-01:39 ACN 101 DATE 12-27-2004 TAX RETURN HAS: [ ) ACCEPTED AS FZLED [ X) CHANGED SEE ATTACHED NOTICE RESERVATZON COHCERNZNG FUTURE ZNTEREST- SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Es~a~e (Schedule A) (1) 2. S*ocks and Bonds [Schedule B) [2) 3. Closely Held S:tock/Par:knarshAp In~oras~ [Schedule C) [$) r*. Nor*gagas/No~as RocaAvable (Schedule D) (r*) 5. Cash/Bank Doposi:~s/HAsc. Personal Proper~y (Schedule E) ($) 6. JoAn'l:ly Owned Proper'l:y (Schedule F) [6) 7. Transfers [Schedule G) [7) 8. To*al Asse~s APPROVED DEDUCT]:ONS AND EXEMPTIONS: 9. Funeral Expenses/Ado. Costs/MAsc. Expenses (Schedule H} (9) 10. Deb*s/Nor*gage LAabAIA~Aes/Liens (Schedule I) (10) 11. To'al Deduc~:Aons 12. Ne~ Value of Tax Re~urn .00 .00 .00 .0O 99t416.75 .00 NOTE: To Ansure proper credA~ ~o your account, submA~ ~ha upper por*lon of *hAs fore wi~h your ~ex payment. 479~72:3.88 (8) 579,140.6:3 48,:369.7Z 6~:31:3.75 (11) (ia) 524,457.16 15. Ir,. NOTE: CherA*abla/govarneon~al Bequests; Non-elected 9115 Trus*s (Schedule J) (13) . O0 Ne~; Value of Es~:e~:a Subject: ~o Tax (lq) 524,457.16 Zf an assess.ant ~as issued previously, lines 1~, 15 and/or :16, 17, 18 and 19 .ill reflect flgures that include the total of ALL returns assessed to date. 10-26-2004 TAX CREDZTS: PAYHENT DATE 04-26-2004 .00 x O0 = .00 .00 x 045= .00 .00 x 12 = .00 524,457.16 x 15 = 78,668.57 (19)= 78,668.57 R~CEZPT NUMBER CD00:388:3 CD004547 INTEREST/PEN PAID (-) :3,421.05 .00 INTEREST IS CHARGED THROUGH 01-11-2005 AT THE RATES APPLICABLE AS OUTLINED ON THE REVERSE SIDE OF THIS FORM AMOUNT PAID 65,000.00 9,947.5Z TOTAL TAX CREDZT BALANCE OF TAX DUEI ZNTEREST AND PEN. TOTAL DUE IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST. 78,:368.57 I :300.00 2.86 :302.86 ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT ZS REOUZRED. ZF TOTAL DUE TS REFLECTED AS A "CREDIT' (CR), YOU NAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.) ~-- ASSESSMENT OF TAX: 15. Amoun~ of Line lr* a~ Spousal ra~a (15) 16. Amoun~ of LAne lr* *axable a~ LAnaal/Class A re~a (16) 17. Amoun~ of LAne lr* a~ SiblAng ra~o (17) 18. Amoun~ of Line lr* ~axable a~ Collateral/Class B ra~e (18) 19. Principal Tax Due REV-1470 EX (6-88) ~  INHERITANCE TAX EXPLANATION COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE OF CHANGES BUREAU OF INDIVIDUAL TAXES PO Box 280601 HARRISBURG, PA 17128-0601 DECEDENTS NAME FILE NUMBER Kenneth C. Grubb 2104-0139 REVIEWED BY ACN Destiny S.R. Brown 101 ITEM SCHEDULE NO. EXPLANATION OF CHANGES Changed tax rate from 12 percent to 15 percent since a brother and sister in law is a collateral beneficiary. ROW Page 1 SCHRACK & LINSENBACH LAW OFFICES 124 W. HARRlSBURG ST. P.O. BOX 310 DlLLSBURG, P A 17019-0310 PHONE (717) 432-9733 FAX (717) 432-1053 Attorneys WM. D. SCHRACK III BRIAN C. LINSENBACH July 12, 2005 Register of Wills Cumberland County Court House One Court House Square Carlisle, PA 17013 a ~~ UJ'"Oo m.:n~r- --~93 'iE ct5~ .~-'oo ,:)Om .:,:)c . Xl -'o-t ~~-> Re: File #: Estate of C. Kenneth Grubb 21-04-0139 ...., = = c.n ~ r ~ ." :ll: ':'? Ul N = -'-J rrl nte:> (";")0 ~;/?l e3 1"'-liTl '-::'00 (~C) -'-1" <: ::D :cc, C) ::: rn ~/) C~ -n To Whom It May Concern: You will find enclosed herewith Executor's check #703, in the amount of $310.06, which constitutes the balance of tax and interest owed on the above-noted account. Kindly accept the payment, as remitted, and return a receipt to me in the self- addressed, stamped envelope that is provided. Thank you for your assistance. m. D. Schrack III SCHRACK & LINSENBACH WDS/jsg enc. .)-- COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG. PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SCHRACK WM 0 III ESQ 124 W HARRISBURG ST POBOX310 DlllSBURG, PA 17019 -------- fold ESTATE INFORMATION: SSN: 204-01-9853 FILE NUMBER: 2104-0139 DECEDENT NAME: GRUBB C. KENNETH DATE OF PAYMENT: 07/14/2005 POSTMARK DATE: 07/13/2005 COUNTY: CUMBERLAND DATE OF DEATH: 01/30/2004 NO. CD 005564 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $310.06 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CHECK# 703 SEAL INITIALS: JA RECEIVED BY: REGISTER OF WILLS $310.06 GLENDA FARNER STRASBAUGH REGISTER OF WillS BUREAU OF INDIVI~ro~ OFF\CE OF INHERITANCE TAX DIVISIQIi....(':itrC.1 /".\'- Ull!. I (\ PO BOX Z806Dl I\t0~v ~..!I "t. 'i 'j 1'. L...J HARRISBURG PA 171Z8-D601 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX RECORD ADJUSTMENT *' REV-1593 EX AFP (03-05) 2005 JUL 15 PH 12: 24 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN 06-29-2005 GRUBB 01-30-2004 21 04-0139 CUMBERLAND 101 C K CLERK OF ORPHAN'S COURT WILLIAIWM~~ a:UF~SQ 124 W HARRISBURG ST PO BOX 310 DILLSBURG PA 17019-0310 Allount Re..itt.d MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 NOTE: To insure proper credit to your account, sub.it the upper portion of this form with your tax payment. CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~ UV-"UW.U.W,..Tl'lr-""'......W.IFIMl!mtt'.tly.ltWl'lltb".It!l:tIMtwm............................... ... ESTATE OF GRUBB C K FILE NO. 21 04-0139 ACN 101 DATE 06-29-2005 ADJUSTIlENT BASED ON: VALUE OF ESTATE: 1. R..1 Estate (Schedule A) 2. stocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. Cash/Bank Deposits/Misc. Personal Property (Schedule El 6. Jointly Owned Property (Schedule Fl 7. Transfers (Schedule G) 8. Total Assets DEDUCTIONS AND EXEMPTIONS: PROTEST BOARD DECISION (1) (2) (3) (4) IS) (6) 171 .00 .00 .00 .00 99,416.75 .00 479.723.88 (8) 579,140.63 10. 11. 12. 13. 14. TAX: 15. Amount of Line 14 at Spousal rate 16. A.aunt of Line 14 taxable at Lineal/Class A rat. 17. Amount of Line 14 at Sibling rat. 18. Amount of Line 14 taxable at Collateral/Class Brat. 19. Principal Tax Due TAX CREDITS' 9. Funeral ExPBnses/AdBlnistrative Costs/ Miscellaneous Expenses (Schedule H) Debts/Mortgage Liabilities/Liens (Schedule Il Total Deductions Net Value of Tax Return Charitable/Governmental Bequests; Non-elected 9113 Trusts Net Value of Estate Subject to Tax (9) (10) 48,369.72 6,313.75 Ill) (12) (13) (14) 54.683.47 524.457.16 .00 524,457.16 (Schedule J) .OOX 00 = .00X045= .OOX 12 = 524.457.16 X 15 = (19) .00 .00 .00 78.668.57 78.668.57 (15) (16) 1171 I1B) INT AT REV . Ktl,;Ur. " '.J AIlOUNT PAID DATE NUIlBER INTEREST/PEN PAID 1-) 04-26-2004 CD003883 3,421.05 65,000.00 10-26-2004 CD004547 .00 9,947.52 EREST IS CHARGED THROUGH 07-14-2005 TOTAL TAX CREDIT 78,368.57 THE RATES APPLICABLE AS OUTLINED ON THE BALANCE OF TAX DUE 300.00 ERSE SIDE OF THIS FORM INTEREST AND PEN. 10.06 TOTAL DUE 310.06 . IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION DF ADDITIONAL INTEREST. IF TOTAL DUE IS LESS THAN $1, NO PAYIlENT IS REQUIRED. IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU IlAY BE DUE I.- A REFUND. SEE REVERSE SIDE OF THIS FDRIl FOR INSTRUCTIONS.) ~~ BOARD OF APPEALS DEPT.2810Z'1 . HARRISBURG, PA 17128-1021 COMMONWEALl:H OF PENNSYLVANIA DEPARTMENT OF REVENUE WILLIAM D SCHRACK III ESO SCHRACK & L1NSENBACH PO BOX 310 DILLSBURG PA 17019-0310 IN RE ESTATE OF: GRUBB C K DOCKET NO.: TAX TYPE: APPEAL TYPE FILE NUMBER: ACN: APPRAISEMENT: PETITION FILED: EXAMINER: MAILING DATE: DECISION AND ORDER 0500947 Inheritance Protest 2104-0139 101 12/27/2004 1/7/2005 WilLIAM J ZDRADZINSKI Direct Dial: (717) 787-5761 Fax: (717) 787-7270 Email: wzdradzins@state.pa.us June 27, 2005 On December 27,2004, the Department issued an appraisement and assessment that imposed tax at the 15% collateral rate on a $5,000.00 bequest to decedent's sister-in-law and a $5,000.00 bequest to decedent's brother-in-law. Petitioner argues those bequests are properly taxable at the 12% sibling rate as "Brother and sister, or sister-in-law, are siblings." Section 2116(a)(1.3) of the Inheritance and Estate Tax Act of 1991, 72 P.S. 9 9116(a)(1.3), as amended by Act 23 of 2000, effective for estates of decedents dying after June 30, 2000, provides for the imposition of tax at the 12% rate on the net value of transfers to or for the use of a decedent's siblings. Section 2102 of the Statute as amended defines "sibling" as "An individual who has at least one parent in common with the decedent, whether by blood or adoption." As neither a sister-in-law nor brother-in-law have at least one parent in common with the decedent, the bequests are taxable at the 15% rate as assessed. GRUBBC K" BOARD DOCKET NO. 0500947 Page 2 of 2 Accordingly, it is hereby, Ordered that the protest is denied. The Department's appraisement and assessment shall stand as filed. FOR THE BOARD OF APPEALS JOSEPH R. SLEEK, MEMBER A STATEMENT OF ACCOUNT WILL BE MAILED TO YOU BY THE BUREAU OF INDIVIDUAL TAXES. ANY APPEAL FROM THIS DECISION MUST BE FILED WITH THE ORPHANS' COURT WITHIN SIXTY (60) DAYS OF RECEIPT OF THIS DECISION. IF YOU REQUIRE THIS INFORMATION IN AN ALTERNATE FORMAT UNDER THE PROVISIONS OF AMERICANS WITH DISABILITIES ACT OF 1990, PLEASE CALL (717) 783-3664, OR FOR SERVICES FOR TAXPAYERS WITH SPECIAL HEARING AND SPEAKING NEEDS: 1-800-447-3020 (TT ONLY). ~~:~~~AN~~ iA~:~y~=~!j OF;[,iCE or~ PD BQX 280601 -" /T-'-~- C HARRISBURG PA 17128-0601': COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE INHERITANCE TAX STATEMENT OF ACCOUNT 2005 J'UG 12 Pi; !: 07 DATE ESTATE OF DATE OF DEATH FILE NUMBER COUNTY ACN !",: WILLIA",,~-;CHRAtK Ui'_ESQ 124 W HARRISBURG ST PO BOX 310 DILLSBURG PA 17019-0310 '*' REY-1607 EX AFP (03-05) 08-08-2005 GRUBB 01-30-2004 21 04-0139 CUMBERLAND 101 Allount RMitted C K MAKE CHECK PAYABLE AND REMIT PAYMENT TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE NOTE: To insure proper credit to your account I sub.it the upper portion of this for. with your tax payment. - REV-1607 EX AFP (03-05) --+ RETAIN LOWER PORTION FOR YOUR RECORDS --------------------------------------------------------------------------- ~~~ INHERITANCE TAX STATEMENT OF ACCOUNT KKK ESTATE OF GRUBB C K FILE NO.21 04-0139 ACN 101 DATE 08-08-2005 THIS STATEMENT IS PROVIDED TD ADVISE OF THE CURRENT STATUS OF THE STATEO ACN IN THE NAMED ESTATE. SHOWN BELOW IS A SUMMARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYMENTS, THE CURRENT BALANCE, AND, IF APPLICABLE, A PROJECTED INTEREST FIGURE. DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 06-28-2005 PRINCIPAL TAX DUE: 78,668.57 PAYMENTS (TAX CREDITS): PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID DATE NUMBER INTEREST/PEN PAID (-) 04-26-2004 CD003883 3,421. 05 65,000.00 10-26-2004 CD004547 .00 9,947.52 07-13-2005 CD005564 10.02- 310.06 TOTAL TAX CREDIT 78,668.61 BALANCE OF TAX DUE .04CR INTEREST AND PEN. .00 IF PAID AFTER THIS OATE, SEE REVERSE TOTAL DUE .04CR . SlOE FOR CALCULATION OF ADDITIONAL INTEREST. ( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED. IF TOTAL OUE IS REFLECTED AS A "CREOIT" (CRl, YOU HAY BE OUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. l ,L ~ INRE: THE ESTATE OF C. KENNETH GRUBB THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYL VANIA ORPHANS' COURT DIVISION NO. 21-04-0139 LATE OF Cumberland County PENNSYL VANIA RECEIPT AND RELEASE KNOW ALL MEN BY THESE PRESENTS, that I as beneficiary and heir of C. KENNETH GRUBB, late ofY ork County, Pennsylvania, deceased, do hereby acknowledge that I am about to receive from the Executor of the decedent, a distribution, representing the current balance of my share of distribution under said Will, in full, as total satisfaction and payment of such sum of the Estate of the decedent. I desire that the shares ofthe Estate be distributed without the formality of a court adjudication and final accounting, in order to save expense, publicity, and delays incident to such court proceeding, and authorize the said Executor to make such distribution upon return of the Receipt and Release. AND, THEREFORE, I, by these presents, remise, release, quitclaim, and absolutely discharge, indemnify and hold harmless the Executor, his executors, heirs, and administrators, of, and from said legacy, and of and from all action, whatsoever, for or by reason thereof or relating in any way to his administration ofthe Estate or of any other act, matter, cause, or thing whatsoever from the beginning ofthe world to the date of these presents. '. {$ ~egallY bound hereby, we have hereunto set our hands and seals this ~ day of , 2004. ~~J.~ BONNIE S. SANNO t::J G-:l o U'l ~ V'~ INRE: THE ESTATE OF C. KENNETH GRUBB THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYL VANIA ORPHANS' COURT DIVISION NO. 21-04-0139 LATE OF Cumberland County PENNSYLVANIA RECEIPT AND RELEASE KNOW ALL MEN BY THESE PRESENTS, that I as beneficiary and heir of C. KENNETH GRUBB, late ofY ork County, Pennsylvania, deceased, do hereby acknowledge that I am about to receive from the Executor of the decedent, a distribution, representing the current balance of my share of distribution under said Will, in full, as total satisfaction and payment of such sum of the Estate of the decedent. I desire that the shares ofthe Estate be distributed without the formality of a court adjudication and final accounting, in order to save expense, publicity, and delays incident to such court proceeding, and authorize the said Executor to make such distribution upon return of the Receipt and Release. AND, THEREFORE, I, by these presents, remise, release, quitclaim, and absolutely discharge, indemnify and hold harmless the Executor, his executors, heirs, and administrators, of, and from said legacy, and of and from all action, whatsoever, for or by reason thereof or relating in any way to his administration ofthe Estate or of any other act, matter, cause, or thing whatsoever from the beginning of the world to the date of these presents. /~~ INTf<.NDING to be legally bound hereby, we have hereunto set our hands and seals this L.S.L::- day of r.J..,.- ~ ' 2004. M~f~ ~~w J~ ES W.~RUB ~" (..--j :...:.....-, ~~ . J -_J :-"-'.:J c::) (:) Uj ~ INRE: THE ESTATE OF C. KENNETH GRUBB THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION NO. 21-04-0139 LATE OF Cumberland County, PENNSYL VANIA RECEIPT AND RELEASE KNOW ALL MEN BY THESE PRESENTS, that I as beneficiary and heir of C. KENNETH GRUBB, late of Cumberland County, Pennsylvania, deceased, do hereby acknowledge that I am about to receive from the Executor of the decedent, a distribution, representing the current balance of my share of distribution under said Will, in full, as total satisfaction and payment of such sum of the Estate of the decedent. I desire that the shares of the Estate be distributed without the formality of a court adjudication and final accounting, in order to save expense, publicity, and delays incident to such court proceeding, and authorize the said Executor to make such distribution upon return of the Receipt and Release. AND, THEREFORE, I, by these presents, remise, release, quitclaim, and absolutely discharge, indemnify and hold harmless the Executor, his executors, heirs, and administrators, of, and from said legacy, and of and from all action, whatsoever, for or by reason thereof or relating in any way to his administration of the Estate or of any other act, matter, cause, or thing whatsoever from the beginning of the world to the date of these presents. INTENDING to e legally bound hereby, we have hereunto set our hands and seals this .~ day of / ~ ,2004. WITNESS; /=~~1 ,/ / . /l~~ {"~6i7~ Allen O. Baker C"c') -,..-! {~ Ui \ ~\ \ INRE: THE ESTATE OF C. KENNETH GRUBB THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYL VANIA ORPHANS' COURT DIVISION NO. 21-04-0139 LATE OF Cumberland County PENNSYL VANIA RECEIPT AND RELEASE KNOW ALL MEN BY THESE PRESENTS, that I as beneficiary and heir of C. KENNETH GRUBB, late ofY ork County, Pennsylvania, deceased, do hereby acknowledge that I am about to receive from the Executor of the decedent, a distribution, representing the current balance of my share of distribution under said Will, in full, as total satisfaction and payment of such sum of the Estate of the decedent. I desire that the shares ofthe Estate be distributed without the formality of a court adjudication and final accounting, in order to save expense, publicity, and delays incident to such court proceeding, and authorize the said Executor to make such distribution upon return of the Receipt and Release. AND, THEREFORE, I, by these presents, remise, release, quitclaim, and absolutely discharge, indemnify and hold harmless the Executor, his executors, heirs, and administrators, of, and from said legacy, and of and from all action, whatsoever, for or by reason thereof or relating in any way to his administration ofthe Estate or of any other act, matter, cause, or thing whatsoever from the beginning ofthe world to the date of these presents. INTENDING to be legally bound hereby, we have hereunto set our hands and seals this day of lloc 0"" ko r , 2004. I yrH WITNESS: ~o_ f) ~ I i I " l/ r ~ ).t Jv..vA VERA REHRER :...:....-. '~~ -.,,,..1 C) ,=) 'Jl v~ INRE: THE ESTATE OF C. KENNETH GRUBB THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYL VANIA ORPHANS' COURT DIVISION NO. 21-04-0139 LATE OF Cumberland County PENNSYL VANIA RECEIPT AND RELEASE KNOW ALL MEN BY THESE PRESENTS, that I as beneficiary and heir of C. KENNETH GRUBB, late ofY ork County, Pennsylvania, deceased, do hereby acknowledge that I am about to receive from the Executor ofthe decedent, a distribution, representing the current balance of my share of distribution under said Will, in full, as total satisfaction and payment of such sum of the Estate of the decedent. I desire that the shares ofthe Estate be distributed without the formality of a court adjudication and final accounting, in order to save expense, publicity, and delays incident to such court proceeding, and authorize the said Executor to make such distribution upon return of the Receipt and Release. AND, THEREFORE, I, by these presents, remise, release, quitclaim, and absolutely discharge, indemnify and hold harmless the Executor, his executors, heirs, and administrators, of, and from said legacy, and of and from all action, whatsoever, for or by reason thereof or relating in any way to his administration ofthe Estate or of any other act, matter, cause, or thing whatsoever from the beginning ofthe world to the date of these presents. ~NDING to be legally bound hereby, we have hereunto set our hands and seals this day of L c....-e t<-f ~_ ,2004. ,/ f 7L WITNESS: ~il~~ - ~..=:;:..> U ~". ;=-::-) '.a__J C) (..II ~\ " I INRE: THE ESTATE OF C. KENNETH GRUBB THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYL VANIA ORPHANS' COURT DIVISION NO. 21-04-0139 LATE OF Cumberland County PENNSYL VANIA RECEIPT AND RELEASE KNOW ALL MEN BY THESE PRESENTS, that I as beneficiary and heir of C. KENNETH GRUBB, late ofY ork County, Pennsylvania, deceased, do hereby acknowledge that I am about to receive from the Executor of the decedent, a distribution, representing the current balance of my share of distribution under said Will, in full, as total satisfaction and payment of such sum of the Estate of the decedent. I desire that the shares ofthe Estate be distributed without the formality of a court adjudication and final accounting, in order to save expense, publicity, and delays incident to such court proceeding, and authorize the said Executor to make such distribution upon return of the Receipt and Release. AND, THEREFORE, I, by these presents, remise, release, quitclaim, and absolutely discharge, indemnify and hold harmless the Executor, his executors, heirs, and administrators, of, and from said legacy, and of and from all action, whatsoever, for or by reason thereof or relating in any way to his administration of the Estate or of any other act, matter, cause, or thing whatsoever from the beginning of the world to the date of these presents. INTE~JlG to be legally bound hereby, we have hereunto set our hands and seals this day of / ~ j , 2004. WITNESS: ~a~~y:~g~ ~-t1(;/;b~^ '~ --....:: ,c. ) o (Jl ~ INRE: THE ESTATE OF C. KENNETH GRUBB THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYL VANIA ORPHANS' COURT DIVISION NO. 21-04-0139 LATE OF Cumberland County PENNSYL VANIA RECEIPT AND RELEASE KNOW ALL MEN BY THESE PRESENTS, that I as beneficiary and heir of C. KENNETH GRUBB, late ofY ork County, Pennsylvania, deceased, do hereby acknowledge that I am about to receive from the Executor of the decedent, a distribution, representing the current balance of my share of distribution under said Will, in full, as total satisfaction and payment of such sum of the Estate of the decedent. I desire that the shares ofthe Estate be distributed without the formality of a court adjudication and final accounting, in order to save expense, publicity, and delays incident to such court proceeding, and authorize the said Executor to make such distribution upon return of the Receipt and Release. AND, THEREFORE, I, by these presents, remise, release, quitclaim, and absolutely discharge, indemnify and hold harmless the Executor, his executors, heirs, and administrators, of, and from said legacy, and of and from all action, whatsoever, for or by reason thereof or relating in any way to his administration of the Estate or of any other act, matter, cause, or thing whatsoever from the beginning of the world to the date of these presents. ~/io be legally bound hereby, we have hereunto set our hands and seals this _"7-<1+ day of et-, 2004. WITNESS: .. ~~~~ ~ ~~~ ERIC W. GRUBB t-....,) -...-J C) (./1 ~ '\~"\