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HomeMy WebLinkAbout02-0234IN RE: SAMUEL GRUIFF, an Incapacitated Person IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHAN'S COURT DIVISION NO. PETITION FOR ADJUDICATION OF CAPACITY IN ACCORDANCE WITH 20 Pa. C.S. §5517 TO THE HONORABLE, THE JUDGES OF SAID COURT: The Petition of SAMUEL GRUIFF and FRANK M. THURMAN represents that: 1. Petitioner, SAMUEL GRUIFF, was adjudged an incapacitated person by Decree of the Superior Court of the District of Columbia dated May 17, 2001. An exemplified copy of the record of said adjudication is attached hereto as Exhibit "A." 2. Petitioner, FRANK M. THURMAN, an adult individual, resides at 2000 Clarendon Street, Camp Hill, Pennsylvania and is the husband of SAMUEL GRUIFF's sister, Nell Thurman. 3. Petitioner, FRANK M. THURMAN, arranged for SAMUEL GRUIFF's moving from Washington, D.C. and is very familiar with his condition and his expressed desires. 4. Petitioner, SAMUEL GRUIFF, currently resides at ManorCare Health Services, 1700 Market Street, Camp Hill, Pennsylvania, in the assisted living quarters, where he has resided since June 30, 2001. 5. Petitioner, SAMUEL GRUIFF, resided at Northwest Health Care Center 3333 Wisconsin Avenue, NW, Washington, D.C. from June 27, 2000 until June 30, 2001 when he moved to ManorCare Health Services. 6. Petitioner SAMUEL GRUIFF's living next of kin are: Nell Thurman 2000 Clarendon Street Camp Hill, PA 17011 Marie Gruiff 311 South St. Mary's Street Apt. 11K San Antonio, Texas 78205 Adam Gruiff Lee Apartments No. 401 585 Winter Street, NE Salem, Oregon 97301 7. Petitioner SAMUEL GRUIFF's mental health has been restored and he is capable of managing his own property and his financial and personal affairs. 8. An Affidavit of his physician, Creston C. Herold, M.D. is attached hereto as Exhibit "B." WHEREFORE, Petitioner request that SAMUEL GRUIFF be adjudged capable of managing his own estate and that Myrna L. Fawcett, Conservator be directed to turn-over all his assets under her control to SAMUEL GRUIFF. SAMUEL GRUIFF FRANK M. THURMAN -2- DATE: By: Respectfully submitted, METTE, EVANS & WOODSIDE P. Daniel Altland, Esquire Sup. Ct. I.D. #25438 3401 North Front Street P.O. Box 5950 Harrisburg, PA 17110-0950 (717) 232-5000 -3- VERIFICATIONS I, SAMUEL GRUIFF, hereby verify and state that the facts set forth in the foregoing document are true and correct to the best of my information, knowledge and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A. §4904 relating to unsworn verification to authorities. DATE: SAMUEL GRUIFF I, FRANK M. THURMAN, hereby verify and state that the facts set forth in the foregoing document are true and correct to the best of my information, knowledge and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A. §4904 relating to unsworn verification to authorities. DATE: FRANK M. THURMAN 'L......-- :284096 I IN RE: Samuel Gruiff uperior (Eourt of the i tritt of (EoIumbia Fl L]E D PROBATE DIVISION NAY 1 8 2001 II-K [~OOiS/sr OI Wi~s (l~g~i[m Probate Division Intervention Proceeding No 82-01 An Adult FINDINGS OF FACT, CONCLUSIONS OF LAW, AND ORDER This matter came on for hearing on the 17th day of May, 2001 on the Petition of Northwest Health Care Center ~] Appointment individual; [~ Appointment individual; [~] Appointment of a permanent limited guardian of an incapacitated of a permanent general guardian of an incapacitated of a successor guardian: [-~ General [~] Limited; [~] Appointment of a permanent limited conservator of a protected individual; [] Appointment of a permanent general conservator of a protected individual; [] Appointment of a special conservator of a protected individual; ~] Entry of a protective order; [~] Other and A. the Court makes the following preliminary findings: The following were present at the hearing [check appropriate boxes]: Judge Jose M. Lopez (Name) Petitioner Northwest Healt Care Center (Name) Attorney for Petitioner Robert A. Gazzola (Name) Attorney for subject of proceeding Deborah D. Boddie (Name) Examiner Visitor Guardian ad litem (Name) (;Name) Form PD- 1895A/sep.89 1 ' (Name) Subject of proceeding was present Subject of proceeding was not present; good cause having been shown for his or her absence The following persons were also present who have been granted permission to participate in the proceeding after determination by the Court that the best interests of respondent would be served thereby: (Name) (Name) B. Subject of proceeding is an adult. C. The Court has jurisdiction over this proceeding because [Select appropriate box(es)]: the individual to be protected or who is incapacitated is domiciled in the District of Columbia. [--] the individual to be protected, while not domiciled in, nevertheless owns property located in the District of Columbia. property is coming, or has come into the ,control of a guardian or conservator who is subject to the laws of the District of Columbia. D. Subject of proceeding was personally served at least fourteen (14) days prior to the hearing date. E. All notices required by law have been given or have been waived by interested persons. Fo The hearing was [~ open subject of proceeding. closed at the request of counsel and/or After consideration of the Petition, the reports filed herein and the testimony and evidence adduced at the hearing, the Court makes the following findings of fact: Form PD-1895A/Sep.89 2 A. If a conservator is being appointed, select appropriate box(es): and/or and/or The incapacitated individual has property that will be wasted or dissipated unless property management is provided, money is needed for the support, care and welfare of the said individual and protection is necessary or desirable to obtain and provide money, money is needed for those entitled to said individual's support and protection is necessary or desirable to obtain and provide money. 13. The incapacity of the subject of this proceeding [5~ does not [--] does arise out of mental retardation. Co A current comprehensive evaluation or habilitation plan ~-] does exist and [~ is on file herein or [~ may be located at does not exisi Special Findings of Fact: The Subject is unable to independently manage his affairs or care for his person. E. [--] The subject of proceeding is not incapacitated. 3. The Court therefore makes the following: FINDINGS OF FACT [Select Appropriate Box(es)] Subject of proceeding is an adult whose ability to receive and evaluate information effectively or to communicate decisions is impaired to such an extent that he/she lacks the capacity to take actions necessary to: obtain, administer, and dispose of real and personal property, intangible property, business property, benefits and income. provide health care, food, shelter, clothing, personal hygiene, and other care without which serious physical injury or illness is more likely than not to occur; Form PD- 1895A/Sep.89 3 acquire and maintain those life skills that enable him or her to cope more effectively with the demands of his or her own person and of his or her own environment and to raise the level of his or her physical intellectual, social, emotional, and economic efficiency or meet all or some essential requirements for his or her therapeutic needs: (Select one:] [--] without court-ordered assistance or [~ without appointment of [Select appropriate box(es)]: a guardian as a means of providing continuing supervision of said incapacitated individual and/or care and conservator. 4. The Court therefore makes the following: CONCLUSIONS OF LAW [Select A or BI That Samuel Gruiff is an incapacitated individual whose best interests would be served by [Select appropriate box(es)]' and/or or or appointment of a guardian as a means of providing continuing care and supervision of said individual appointment of a conservator as a means of property management entry of a protective order B. ~] That the subject of proceeding is not incapacitated and the petition should be dismissed. o On consideration of the foregoing, the Court this 17tn day of May, 2001 makes the following order: Form PD-1895A/Sep.89 4 [Check appropriate boxes] ORDER A. [~ That (Name) (Address] (Telep~ne Nu~eO is appointed permanent ~] limited guardian FI successor guardian of CO--, [~ ~general guardian Samuel Gruiff (Name) 3333 Wisconsin Avenue NW', Washington, DC 20016 (Address) and letters shall issue upon acceptance of appointment and consent to jurisdiction. A copy of guardianship reports to be filed herein pursuant to SCR-PD 328 shall be served on all parties; upon any person who has filed an effective request for notice as provided in SCR-PD 304, and upon the following persons: Bo (Service of reports on ailditionaI persons may be required by subsequent order of Court or as determined by the Register of Wills) ','¥'i'tn.~u^ C. F A,.o (Name) (Address) ~'~ ("--- (Telephone Number) is appointed permanent [~ [~ special Gruiff limited conservator conservator (Name) and letters shah issue upon filing of appointment and consent to jurisdiction. [] general conservator of _Samuel bond, acceptance of Form PD-1895A/Sep.89 5 Co Do Bo~d Wii:h approved surety is set at forthwith. and sh~ll be'filed Special bonding provisions The guardian of the incapacitated individual is responsible for the care, custody and control of the Ward and shall be governed by the general powers and duties enumerated in D.C: Code §21-2047(a), (b), and (c), [--] subject to the following limitations which shall be endorsed on the guardian's letters: The conservator of the protected individual shall observe the standards of care applicable to trustees and shall account to the Court as provided by statute and rule of Court. Said conservator shall be governed by those powers in administration as enumerated in D.C. Code §21-2070 and those distributive duties and powers as enumerated in D.C. Code §21-2071 [-] subject to the iollowing enlargements and/or limitations which shall be endorsed on the Conservator's letters: F. [--] The Court makes the following protective order: G. [--] The petition be, and is hereby, dismisse // Copies mailed to: Parties to the above-captioned case, an/d persons granted permission to participate pursuant to SCR-PD 303, and persons who requested notice pursuant to SCR-PD 304. Samuel Gruiff North~nt~er Nell Thurman 3333 Wisconsin Avenue NW h3~~ 2000 Clarendon Street Washington, DC 20016 41/aiho~~C 20016 Camp Hill, Pennsylvania 17011 Form PD-1895A/Sep.89 ~,~ ~ /~ /)q/. ( . ~.~ c'~Uc~ ? 6 ,qopla,s mailed, postag~ prepaid, t~ SUPERIOR COURT OF THE DISTRICT ~i~ter PROBATE DIVISION iN RE: Samuel Gruiff ADULT INTERVENTIOI~. ~ 82-01 BOND OF CONSERVATOR Kr, ow all persons by +_hese presents, that whereas the Myrna Fawcett undersigned of 1763 R Street, N.W. Washington, D.C. 20009 [add~ess of conservator) Samuel Gruif f has been appointed conservator of by order of +_he Court dated May 17th 2001 ,~X~q~), A.D. and is required to give a bond, under seal, in the maximum amount of Seventy five thousand ($ 75,000.00) dollars, fixed by the Court, conditioned as by law and said order required: And whereas the condition of this undertaking is t-hat the said Myrna Fawcett , , shall faithfully d/scharge all duties of the trust according to law as such conservator and in all .things obey such order as the Court shall make in the pr~m4ses: .~crm PD--1899A/Sept.89 We, therefore, the undersigned Myrna Fawcett St Paul Fire and Marine Insurance Company As principal_ ~nd As surety appearing and submitting to the jurisdiction of The Court, hereby undertake for ourselves and each of us, our and each of our heirs, personal representatives, successors, and assigns to abide by and perform ~he c-_2ar of the Court in the premises, and do further agree that upon default by the said principal in any conditions hereof the ~=~,ages, not exceeding the sum aforesaid, may be ascertained in such manner as the Court shall direct; that the Court may give judgement hereon in favor of any person thereby aggrieved against :_~ for ~=~..ages suffered or sustained by such aggrieved party and that. such judgement may be rendered in maid cause against all or any of us whose names are hereto signed: Signed. sealed and delivered in Surety approved this Form PD-1899B/Sept.89 ~fyrna Faw~t f / . (Seal) ~ul Fire. axed Ma~,%ns~rance Company ~/orney-~n-~a![ ' 21st' day of May ,20 01 REGISTER OF WTLLS CI.~RK OF TME PROBATE DIVISION BY: Deputy Clerk Superior Court of the District of Columbia OFFICE OF REGISTER OF WILLS PROBATE DIVISION IN RE: Estate of Samuel Gruiff INTVP NO. 82-01 LETTERS OF CONSERVATORSHIP (issued pursuant to original order of appointment under Guardianship and Protective Proceeding Act of 1986 -Effective September 30, 1989) To all persons interested in the Estate of Samuel Gruiff, a protected individual, permanent general conservatorship of the Estate of said protected individual has been granted to Myrna L. Fawcett, pursuant to order dated the 17th day of May, 2001, and said conservator having executed the Acceptance of'Appointment and Consent to Jurisdiction and having filed a duly approved undertaking in the maximum sum of seventy five thousand dollars ($75,000) with St. Paul Fire and Marine Insurance Company has the powers and duties set forth in D.C. Code Sec. § 21-2070 and the distributive duties and powers of conservator set forth in Sec. §21-2071, subject to the following enlargements, and/or limitations, and/or specification of assets set forth in the Order of Appointment. None The appointment is in full force and effect as of this date Date: May 22, 2001 WITNESS Register of Wills Clerk of the Probate Division DOCUMENT NOT VALID WITHOUT EMBOSSED SEAL Note: Letters of conservatorship are evidence of the transfer of all assets, or the part of the assets specified in the letters, of the protected individual to the conservator and the Letters of Conservatorship must be filed or recorded in the Office of the Recorder of deeds (515 D Street, N.W., Washington, DC 20001) to give record notice of title as between the conservator and the protected individual. "INFORMATiuN ON Superior Court of the District of Columbia OFFICE OF REGISTER OF WILLS PROBATE DIVISION INTVP NO. 82-01 LETTERS OF GUARDIANSHIP (issued pursuant to original order of appointment under Guardianship and Protective Proceeding Act of 1986 -Effective September 30, 1989) To all persons interested in the personal welfare of Samuel Gruiff, an incapacitated individual, permanent general co-guardianship of the person of said incapacitated individual has been granted to Myrna L. Fawcett and Nell Thurman pursuant to order dated the 17th day of May, 2001 and said co-guardians having executed the Acceptance of Appointment and Consent to Jurisdiction have the powers and duties set forth in D.C. Code Sec. § 21-2047 (A) and (b), subject to the following enlargements, and/or limitations, or other modifications as set forth in the Order of Appointment: None The appointment is in full force and effect as of this date WITNESS Date: May 18, 2001 Register of Wills Clerk of the Probate Division DOCUMENT NOT VALID WITHOUT EMBOSSED SEAL "!NFORM, : COPY ONLY" Superior Court of the District of Columbia PROBATE DIVISION DISTRICT OF COLUMBIA, to wit: I, Constance G. Evans, Register of Wills for the District of Columbia, Clerk of the Probate Division, do hereby certify that the foregoing is a true copy of the original Order dated May 17, 2001 appointing a permanent conservator and co-guardians, conservator's bond and letters of conservatorship and guardianship filed and recorded in the office of the Register of Wills for the District of Columbia in the matter of Samuel Gruiff, Intervention Proceeding Number INTVP 82-01. I Further Certify, that I have compared said copy with the original papers and original records, respectively, in said office and find them to be a full, true and correct transcript thereof. WITNESS, my hand and the seal of the said Superior Court of the District of Columbia, this 17th day of August, 2001. Register of Wills fo~/ffie District of Columbia Clerk of the Probate Division IN RE: SAMUEL GRUIFF, an Incapacitated Person IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHAN'S COURT DIVISION NO. AFFIDAVIT M.v name is Creston C. Hero!d, Jr. I-am licensed as a medical physician ar, d surgeon in the Commonwealth of Pennsylvania, License Number MD024004E. My professional office address is West Shore Family Medicine Center, 550 North 12tn Street, Lemoyne, Pennsylvania. I am the attending physician for Samuel Gruiff, who suffered a cerebrovascular accident in June 2000. Samuel Gruiff has regained his mental health and is able to care for his own personal needs, including his colostomy. He has no mental deficiency which impairs his ability to make and/or communicate responsible decisions concerning his personal property, benefits and income and his personal health care, food, clothing, and personal hygiene. I hereby verify that the facts set forth above are true and correct to the best of my knowledge, information and belief. I understand that false statements made herein are subject to the penalties of 18 Pa. C.S.A. §4204 relating to unsworn verification to authorities. Creston C. Herold, Jr.~/ :284102 1 IN RE: SAMUEL GRUIFF, an Incapacitated Person IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHAN'S COURT DIVISION PRELIMINARY DECREE AND NOW, '.~, ~ ?? ,2002, upon consideration of the petition, it is ordered and decreed that a hearing on the petition shall take place in Room ., Cumberland County Court House, Cumberland County, Pennsylvania, on .×~d~//4~]'' ~_]~ ,2002, at f ' ~ 5)/B~I. At least twenty days notice shall be given to the incapacitated person's living next-of-kin who are suijuris, personally or by registered mail. By the Court: IN RE: SAMUEL GRUIFF, an Incapacitated Person IN THE COURT OF COMMON PLEAS OF CUMBERL,a_ND COUNTY, PENNSYLVANIA ORPHAN'S COURT DIVISION NO. FINAL DECREE AND NOW ,2002, upon consideration of the petition of SAMUEL GRUIFF FRANK M. THURMAN and after a hearing held following notice as directed by the Court, it is hereby ordered and decreed that SAMUEL GRUIFF, who was adjudged an incapacitated person by Decree of Superior Court of the District of Columbia dated May 17, 2001, is no longer incapacitated, and it is ordered that his guardian/conservator shall file an account of his administration of the estate of SAMUEL GRUIFF, an incapacitated person, within ~ ~ days of the date of this decree. By the Court: :288494 PETITION FOR PROBATE AND GRANT OF LETTERS REGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of SAMUEL C. GRUIFF also known as File Number ~\ D'~ ()~~L{ , Deceased Social Security Number 204-03-5944 Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE 'A'or 'B' BELOW:) IZI A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is / are the EXECUTORS last Will of the Decedent dated APRIL 25, 2003 and codicil(s) dated NONE named in the (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 instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ;---~_:) O ~ .... B. Grant of Letters of Administration ( ') ~ (If applicable, enter: c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; €~ minorit~ \ =Tj. -,:f; " Petitioner(s) after a proper search has / have ascertained that Decedent left no Will and was survived by the following-s~'<if anwnd heir's:(If Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.} -::.;.C~;) \.D ' '~ ,..... Name Relationship R~i'iL,~ ; '-;i (COMPLETE IN ALL CASES:) Attach additional sheets ifnecessary. Decedent was domiciled at death in CUMBERLAND County, Pennsylvania with his / her last principal residence at 1700 MARKET STREET, BOROUGH OF CAMP HILL, PENNSYLVANIA (List street address, town/city, township, county, state, zip code) Decedent, then 85 years of age, died on JANUARY 15, 2007 at HOLY SPIRIT HOSPITAL, CAMP HILL, P A 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 P A) Personal property in County Value of real estate in Pennsylvania 4,500.00 $ $ $ $ situated as follows: 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: FRANK M. THURMAN 2000 CLARNEDON STREET, CAMP HULL, PA 17011 SUSAN J. THURMAN 493 SKYLINE ROAD, NEW CUMBERLAND, P A 17070 Form RW-02 rev. 10.13.06 Page 1 of2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are true and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitioner(s) will well and truly administer the estate according to law. before me the ,q day of Sworn to or affirmed and subscribed .= ~ Signature of Personal Representative .. /") -... - --~ C) . File Number: .~ \ D ~ (Y'd, ~L\ N Estate of SAMUEL C. GRUlFF , Deceased Social Security Number: 204-03-5944 Date of Death: JANUARY 15,2007 AND NOW, met rC h / Cj , :<00 l , in consideration of the foregoing Petition, satisfactory proof having been presented before me, IT IS DECREED that Letters TESTAMENTARY are hereby granted to FRANK M. THURMAN and SUSAN J. THURMAN in the above estate and that the instrument(s) dated APRIL 25,2003 described in the Petition be admitted to probate and filed of record as the last Will (and Codicil(s)) of Decedent. FEES AmdrA ~.ffia/Jf0~) r 1f.~/J 30.00 Register of Wills I Letters ............... $ ~a.. f!1 ~~::~~:::;,7(~) : : : :: : 16.00 :~:::: ::rure limDU CLOTFEL~R ~ WILL . . . $ 15.00 JCP . . . $ 10.00 AUTO . . . $ 5.00 . .. $ ...$ ... $ ...$ ...$ . .. $ TOTAL .... . . . . . . . . . . $ Supreme Court LD. No.: 72963 Address: 5021 E. TRINDLE ROAD, SUITE 100 MECHANICS BURG, PA 17050 Telephone: (717) 796-1930 76.00 Form RW-02 rev. 10.13.06 Page 2 of2 H105.905MS REV. 6/06 This is to certify that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records III accordance with Act 66, P.L. 304, approved by the qeneral Assembly, June 29, 1953. WARNING: It is illegal to duplicate this copy by photostat or photograph. /2 ~ .4 c-o ~ (!JJR~ lF10L H1OS.143REV.02I2006 TYPE I PRINT IN PERMANENT llACK ..K I. NameofOecedent(Firsl,~,lasl.sullix) ~ An1 U /c:..i!.- 5. Age(LastBir1hday) Calvin B. Johnson, M.D., M.P.H. Secretary of Health Frank Yeropoli State Registrar 1042239 FE8 0 1 2001 No. . VITAL RECORDS Date \ b'~ CJ96~ ~. gs Y~ Bb. CountvofDeath ?,/ 11. Decedenh Usual Occu tion KindofWCfttdone maslol'MlrXi Ife.Donotlltal8R1lin1d " _ Kind of woo. KndolBusi1ess/lnduslry ~blo--rE:uI.JUJAlJ t!"'rrJ,.,UNlcPTIO - 16. Deoedenl's MalfllgAddress (Sfreet, ctty I town, slale,Zipcode} 8;)."/ ,L./.:'>8ue,J ;eo~ C!,cVnP H/~. PA 1'0'1 Did Decedent Uveina Township? 17e. ta: Yes, Decedent lived in 17d.D~~iivedwilhin A~A.l Twp 17b. County City/Boo;. o ~ ~ . ~ 18. Father'SNiiITIe(Fil'sI.midcle,IIIst,sulfix) o 12... b>?\,J 208. Inform.,rs Name _ (Type I PmtJ c;'i2~N;L.. ;rl. 21a. Me..!,plofDlsposition "bit.... D--- D""". 213. Signlt1n &l2....LlU" ,:::: 19. Mother's Name (first, mi:ldle, maiden sumane) 7A;-(A - ~/oS-rIt..;:;1= 2Qb. InklrmClflrsMailingAddress(Slteet,cityJtown.slate,~oode) ,;)000 C!.t!-AI2L/VooN .:5-1.'" c:!4r>?PU/4.L, PA 17011 21c. Place 01 Dtsposilion (Na'l'le d cemetery. cremaklry Of olher place) 21d. LotaIioo (C~ floWn, slate, Zip code) -:Z::-"".h/""-'7C>W~ 6-AP 1JAPL.~. Easr r#I""''''&", PA 17"03 22c, N8melfldAcldressotFacilily //;1 ,J ~JZ..tIZA..:S~ ~~ t:. .:::rro.-lIL 1="IJt.eAc..... ~C- ..:SrL€.....rc.J P4 '''is 23b. license Number 23c. Dale Signed (Month, day. year) 24. TmeotDeath : ~ximate inlefval: : Onset tl Dealh 25. WaC.. Referrgd to Medical Exarooer fCoronerfor a Rea!JOl'l Other Ihil'l Cremation or Donation? D Yeo aNo Part II: Emerother!liMi!icanlmndllionscmtribulmlodealh 28. Did Tobacco Use ContrlbuWi 10 Death? butnolresultioginlhe..nderlyingC8USe!jYeninPMI DVes DProbabI)' D No ~"known 29, If Female: o Not pregnil'llwilhinpast 'j'Hr d. Pregnant al time of death o Notpregnanl, bul pregnant wilhin 42 days ddealh o Not pr&gnant, but pregnanl43 days ID 1 'f8ar oId_ o Unknown if pregnanl 'Nithin Ih. past year 32c. Plea aflnjwy: Home, Farm, Slreet. Factory. Office Buicling. etc. (SpecifyJ (5~;;l.. CAUSE OF DEATH ,See inatructtona and exampte.) Item LT. PARTI: Entfl"lhe~.Oseases, injuries, orcom~ -1hal,di'ecIly caused lhedealh. 00 NOT enlerlenninal events such as cardia::.rest, ~.-res!, <<venlricularlibfjlaliOnwilhoulshowVlg thBellology.lis1onlyonecauseon each line. =:=~~=dise~ \?"'e.u..~\'C I \),,~\~ 0uII to (or. a consequenc;'of)" <.\ " . .~. ~listcondilions,if"'''', klC8UEHled on Ir1e a. Enler UNDERLYING CAUSE (diHase01 injll'YIhatntiatedthe events resuIing II de8lh ) LAST. Due kller... . c:onMquance of) Due tg (or as. c:onMquenc;;e of) loJ / 1 cVI / I /1 32d. Tlme d IrVY 3211. Location of !IVY (Street. ~ I town, state) D Yeo ~No D Yeo fSI&<o 31. MannerofOllath ~,. D- O- De"",...,-_ o SUicide 0 CauldNclbeDetermined M. 308. WasanAulopsy -, n. Were Auklpsy Ftndings A'JaiIabIe Prior 10 Completion of Cause of Death? \;' I ~ 33a. Certifier (check cl"dy one) c.rtIfying phyaidlln (Physician cerlifying caM of death when another physician has pronounced dealh and COl'll*ted Item 23) To the best 01 myknowtedge,dHth oc:curNd due to the caUle(l,.nd mIInnerustM19_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _..D Pronourteing and cwtlfytng phyU:iIIn (Physician both pronouncing death and certifying to cause 01 death) To the best 01 my knowledge. dnth occurred It the time, dmI, and pI___, and due to 1M RUM(.) snd mann<<.. .talJCl_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ==n:=sndlorlnlJfttigalion. Inmyoplnlon,cMIth occurred It tfIe tllM,dIIte, sndplKe, .nddUlto....c.U..(.)sndm.sntllr...tltfd__..D ~ .....) !'7b 1fTa.-, .. . 17~" :;;0 o / ;; .5-56- h \.D :I:-'" 3: CO N LAST WILL AND TESTAMENT n r---',~ ~~1 >J OF SAMUEL C. GRUIFF w ('J P,) I, SAMUEL C. GRUIFF, now of Woods of Cedar Run, 824 Lisburn Road, Camp Hill, Cumberland County, Pennsylvania 17011, do publish and declare this to be my Last Will and Testament, hereby revoking all other prior wills and codicils made by me. FIRST: Familv Back2round and Appointment of Executor. I was married to (B) Appointment of Executor. I appoint as my Co-Executor and Co-Executrix (all hereinafter referred to as Executor or Executor(s) under this Will), the following named persons or corporations to serve without bond and without being required to account to any Court: Co-Executor and Co-Executrix: My brother-in-law, FRANK M. THURMAN and my niece, SUSAN J. THURMAN, to act jointly and individually. SECOND: Funeral and Last Illness Expenses; Taxes. (A) Illness. I direct my Executor to pay my funeral expenses and the expenses of my last illness from my estate. (B) ~. I direct my Executor to pay any and all estate, inheritance, succession, legacy, transfer and other death taxes or duties, by whatever name called, including any and all interest and penalties thereon, imposed under the laws of any jurisdiction by reason of my death upon or with respect to any and all property included in my gross estate for the purpose of such taxes, whether such property passes under or outside of this Will. Without any apportionment otherwise required by law and without being prorated or apportioned among or charged against the respective devises, legatees, beneficiaries, transferees, or other recipients of any such property or charged against any property passing or which may have passed to any of them, I direct that any taxes so paid shall be charged against my residuary estate. My Executor shall not be entitled to reimbursement for any portion of any such taxes from any such person. ~. ~ tJ1W LAST_WILL AND TESTAMENT OF SAMUEL C. GRUIFF PAGE 2 THIRD: Tane:ible Personal Property. Except for those items excluded below and those items enumerated in the Letter of Instruction, I bequeath all my tangible personal property, including but not limited to clothing, jewelry, heirlooms, furniture, household furnishings, personal effects, and all other similar articles, which I own, and the insurance thereon, to be equally divided between my brother-in-law, FRANK M. THURMAN, and my niece, SUSAN J. THURMAN. Tangible personal property shall not include: (1) any and all property used by me in any business, (2) cash on hand or on deposit in banks, (3) stock or securities, (4) any type of evidence of indebtedness, and (5) any life, health or accident insurance policies. If my either my brother-in-law or my niece do not survive me, I leave such tangible personal property to the survivor of them. If neither my brother-in-law nor my niece survive me, I leave such tangible personal property to their then living issue, as they should request. If there is any disagreement as to distribution, I direct my Executor to make such distribution. The decision of my Executor shall be final and binding. Any items not selected or any items which my Executor considers unsuitable for a minor child shall be sold in the sole discretion of my Executor and, if sold, the net proceeds therefrom shall be added to the residue of my estate. Any such article allocated to a minor may, as my Executor deems advisable, either be delivered to the minor or to any person to safeguard on behalf of the minor. Notwithstanding any other provisions in this Article THIRD, I may leave a separate, dated and unsigned Letter of Instruction, which I shall place with my Will, containing directions as to the ultimate disposition of certain of the property bequeathed under this Article THIRD, and such Letter of Instruction shall determine the distribution of such items. FOURTH: Residuary Estate. I devise and bequeath all of the rest, residue and remainder of my estate, real, personal and mixed, of whatever nature and wherever situated to which I am legally or equitably entitled, to be divided equally between my brother-in-law, FRANK M. THURMAN, and my niece, SUSAN J. THURMAN. Should either my brother-in- law or my niece predecease me, I direct that individual's share of my estate to go to the survivor of them. Should both my brother-in-law and my niece predecease me, I direct my entire residuary estate go to SUSAN J. THURMAN'S then living children. Should my niece, SUSAN ~ ?<1C--. wrrzJ LAST WILL AND TESTAMENT OF SAMUEL C. GRUIFF PAGE 3 J. THURMAN, die without issue, I direct my entire estate shall go to my nephew, FRANK D. THURMAN. FIFTH: Powers of Executor. In addition to the powers and duties as may have been granted elsewhere in this Will, but subject to any limitations stated elsewhere in this Will, the Executor shall have and exercise exclusive management and control of the Estate and shall be vested with the following specific powers and discretion, in addition to the powers as may be generall y conferred from time to time upon the Executor by law: (A) In the management, care and disposition of the Estate, the Executor shall have the power to do all things and to execute such instruments, deeds, or other documents as may be deemed necessary or proper, including the following powers, all of which may be exercised without order of or report to any Court: (1) To sell, exchange or otherwise dispose of any property at any time held or acquired hereunder, at public or private sale, for cash or on terms, without advertisement, including the right to lease for any term notwithstanding the period of the Estate, and to grant options, including any option for a period beyond the duration of the Estate. (2) To invest all monies in such stocks, bonds, securities, mortgages, notes, choses in action, real estate or improvements thereon, and any other property as the Executor may deem best, without regard to any law now or hereafter enforced limiting investments of fiduciaries or issued by a parent or affiliate company of such Executor. (3) To retain for investment any property deposited with the Executor hereunder. (4) To vote in person or by proxy any corporate stock or other security and to agree to or take any other action in regard to any reorganization, merger, consolidation, liquidation, bankruptcy or other procedure or proceedings affecting any stock, bond, note or other security. (5) To use attorneys, real estate brokers, accountants and other agents, if such employment is deemed necessary or desirable, and to pay reasonable compensation for their services. M ~c -~ t< AJJ ) LAST WILL AND TESTAMENT OF SAMUEL Co GRUIFF PAGE 4 (6) To compromise, settle or adjust any claim or demand by or against the Estate and to agree to any rescission or modification of any contract or agreement affecting the Estate. (7) To renew any indebtedness, as well as to borrow money, and to secure the same by mortgaging, pledging or conveying any property of the Estate. (8) To retain and carryon any business in which the Estate may acquire an interest, to acquire additional interest in any such business, to agree to the liquidation in kind of any corporation in which the Estate may have an interest and to carryon the business thereof, to join with other owners in adopting any form of management for any business or property in which the Estate may have an interest, to become or remain a partner, general or limited, in regard to any such business or property and to hold the stock or other securities as an investment, and to employ agents and confer on them authority to manage and operate the business, property or corporation, without liability for the acts of such agent or for any loss, liability or indebtedness of such business if the management is selected or retained with reasonable care. (9) To register any stock, bond or other security in the name of a nominee, without the addition of words indicating that such security is held in a fiduciary capacity, but accurate records shall be maintained showing that such security is a Estate asset and the Executor shall be responsible for the acts of such nominee. (B) Whenever the Executors are directed to distribute any Estate assets in fee simple to a person who is then under twenty-one (21) years of age, the Executor shall be authorized to hold such property in Trust for such person until he/she becomes twenty-one (21) years of age, and in the meantime shall use such part of the income and the principal of the Estate as the Executor may deem necessary to provide for the proper support and education of such person. If such person should die before becoming twenty-one (21) years of age, the property then remaining in trust shall be distributed to the personal representative of such person's estate. (C) In making distributions from the Estate to or for the benefit of any minor or other person under a legal disability, the Executor need not require the appointment of a guardian, but shall be authorized to payor deliver the same to the custodian of such person, to payor deliver the same to such person without the intervention of a guardian, to payor deliver the same to a ~ ~cC tvr[1J .' . LAST WILL AND TESTAMENT OF SAMUEL C. GRUIFF PAGE 5 legal guardian of such person if one has already been appointed, or to use the same for the benefit of such person. (D) In the disbursement of the Estate and any division into separate trusts or shares, the Executor shall be authorized to make the distribution and division in money or in kind, or both, regardless of the basis for income tax purposes of any property distributed or divided in kind, and the distribution and division made and the values established by the Executor shall be binding and conclusive on all persons taking hereunder. The Executor may in making such distribution or division allot undivided interests in the same property to several trusts or shares. (E) The Executor shall be authorized to lend or borrow, including the right to lend to or borrow from any trusts which I or my spouse may have established during life or by will at an adequate rate of interest and with adequate security, and upon such terms and conditions as the Executor shall deem fair and equitable. (F) The Executor shall be authorized to sell or purchase at the fair market value as determined by the Executor, any property to or from any trust created by me or my spouse during life or by Will, even though the same person or corporation may be acting as Executor of my estate or as Trustee of any of my other trusts. (G) The Executor shall have discretion to determine whether items should be charged or credited to income or principal or allocated between income and principal as the Executor may deem equitable and fair under all the circumstances, including the power to amortize or fail to amortize any part or all of any premium or discount, to treat any part or all of the profit resulting from the maturity or sale of any asset, whether purchased at a premium or at a discount, as income or principal or apportion the same between income and principal, to apportion the sales price of any asset between income and principal, to treat any dividend or other distribution of any investment as income or principal, or apportion the same between income and principal, to charge any expense against income or principal or apportion the same, and to provide or fail to provide a reasonable reserve against depreciation or obsolescence on any assets subject to depreciation or obsolescence, all as the Executor may reasonably deem equitable and just under all the circumstances. If the Executor does not exercise the above discretionary power, the cash or accrual allocation shall be in accordance with Chapter 81 of Title 20 of the Pennsylvania Consolidated Statutes, or the corresponding provisions of subsequent state law. ~ dtC- V/~ LAST WILL AND TESTAMENT OF SAMUEL C. GRUIFF PAGE 7 exercise of a power of appointment. No part of the estate shall be liable for or charged with any debts, contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a beneficiary. EIGHTH: Tax Elections. (A) In determining the estate, inheritance and income tax liability relating to my Estate, the Executor's decision as to all available tax elections shall be conclusive on all concerned. If the Executor joins with my spouse in filing income tax returns, or consenting for gift tax purposes to having gifts made by either of us during my life considered as having been made one-half by each of us, any resulting liability shall be borne by my Estate and my spouse in such proportions as they may agree. In accordance with IRe Section 2632(a) and without regard to whether a Federal estate tax return is actually filed, my Executor shall allocate so much of the Federal Generation Skipping Transfer (GST) exemption amount as will fully exempt any generation skipping transfer which may occur under this Will. The Executors may, in their discretion, determine the date as of which my gross estate shall be valued for the purpose of determining the applicable tax payable by reason of my death. (B) The Executors may, in their discretion, decide whether all or any part of certain deductions shall be taken as income tax deductions (even though they may equal or exceed the taxable income of my estate and whether or not claimed or of benefit on my estate's income tax return) or as estate tax deductions when a choice is available; and in the event that all or any part of such deductions are taken as income tax deductions, no adjustment of income and principal accounts in my estate shall be made as a result of such decisions. NINTH: Definitions and General Provisions. (A) Survival. Any beneficiary who dies within sixty (60) days after my death shall be considered not to have survived me. (B) Captions. The captions set forth in this Will at the beginning of the various articles hereof are for convenience of reference only and shall not be deemed to define or limit the provisions hereof or to affect in any way their construction and application. (C) Children. As used in this Will, the words "child" and "children" shall include persons who are legally adopted and the issue of said persons, whether born in or out of wedlock, ~ 6.LC- /JJZJ LAST WILL AND TESTAMENT OF SAMUEL C. GRUIFF PAGE 8 so long as any person born out of wedlock is acknowledged in a written instrument executed by the one of their natural parents who is a descendant of mine to be the child of said descendant. The word "issue" shall include descendants of all generations including adopted persons. A posthumous child shall be considered as living at the death of his parent. The birth to me or the adoption by me of a child or children subsequent to the execution of this Will shall not operate to revoke this Will. Except for discretionary distributions which may be made unequally among a group of persons and distributions pursuant to a valid exercise of a power of appointment, in making a distribution to the children of any person, the property to be distributed shall be divided into as many shares as there are living children of the person and deceased children of the person who left children who are then living. Each living child shall take one share and the share of each deceased child shall be divided among his then-living descendants in the same manner. (D) Code. Unless otherwise stated, all references in my Will to section and chapter numbers are to those of the Internal Revenue Code of 1986, as amended, or the corresponding provisions of any subsequent federal tax laws applicable to my estate. (E) Other terms. The use of any gender includes the other genders, and the use of either the singular or the plural includes the other. (F) Powers of Appointment are Exercised. By this Will I exercise any and all Powers of Appointment which I possess at the time of my death. IN WITNESS WHEREOF, I, SAMUEL C. GRUIFF, the Testator, have to this my Last Will and Testament, typewritten on ten (10) pages, including the Acknowledgment and Mfidavit, set my hand and seal this ~b day of April, 2002. _ ~~~ SAMUEL C. G IFF [This space is intentionally left blank.] AKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND The Testator and the witnesses whose names are signed and subscribed to the attached or foregoing instrument, being first duly sworn and qualified according to law, do hereby acknowledge, depose and say to the undersigned authority, that the Testator signed and executed the instrument as his Last Will in the presence of the witnesses; that he signed it willingly or willingly directed another to sign it for him; that he executed it as his free and voluntary act for the purposes therein expressed; that each of the witnesses were present and saw the Testator sign and execute the instrument as his Last Will; that each subscribing witness in the hearing and sight of the Testator signed the will as witnesses; and that to the best of their knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. (~b-h Testator Witness COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND On this, the ~ day of April, 2003, before me, a Notary Public for the Commonwealth of Pennsylvania, the undersigned officer, personally appeared SAMUEL C. GRUIFF, and the above witnesses, known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and acknowledged that they executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have set my hand and notarial seal. ~ fQ,~~ Notary Public ~ . My Commission Expires: ~\..J)NX)JD~ ~~I~S Notarial Seal Kimberly R. Hanford, Notary Public Mechanicsburg Boro, Cumberland County My Commission Expires Apr. 4, 2005 '. , ( CERTIFICATION OF NOTICE UNDER RULE 5.6(a) Name of Decedent: Samuel C. Gruiff, deceased Date of Death: January 15, 2007 Will No. 2002-00234 PA No. No. 21-02-00234 To the Register: I certify that notice of estate administration 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 May 21, 2007. (See copies attached). Name Address Frank M. Thurman Susan J. Thurman 2000 Clarendon Street, Camp Hill, P A 17011 493 Skyline Road, New Cumberland, PA 17070 Notice has now been given to all persons entitled thereto under Rule 5.6(a). Date: 5/ A I J 07 inda . Clotfelter, Esquire 021 E. Trindle Road, Suite 100 echanicsburg, P A 17050 (717) 796-1930 Counsel for Personal Representatives _J r',,) (",) ~ ::'::i f'-) ( ) r'v v-. 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 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, CUMBERLAND COUNTY, PENNSYL VANIA In re Estate of Samuel C Gruiff, deceased, Late of Camp Hill Borough, Cumberland County No. 21-02-00234 TO: FRANK M. THURMAN 2000 CLARENDON STREET CAMP HILL, P A 17011 Please take notice of the death of decedent and the grant of letters to the personal representative named below. The Decedent, Samuel C. Guiff, died on the 15th day of January, 2007, at Cumberland County, Pennsylvania. The Decedent died testate (with a Will). The personal representatives of the Decedent are: Frank M. Thurman Susan J. Thurman 2000 Clarendon Street 439 Skyline Road Camp Hill, P A 17011 New Cumberland, P A 17070 (717) 737-7451 (717) 576-0065 If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, Cumberland County Courthouse, One Courthouse Square, Carlisle, Pennsylvania 17013, (717) 240-6345. If the Decedent died intestate, a Petition for the grant of Letters of Administration was filed with the Office of the Register of Wills of Cumberland County, Cumberland County Courthouse, One Courthouse Square, Carlisle, Pennsylvania 17013, (717) 240-6345. A copy of the Will or Petition may be obtained by contacting the Register of Wills and paying the charges for duplication. L da A. Clotfelter, Esquire 5 21 E. Trindle Road, Suite 100 Mechanicsburg, P A 17050 (717) 796-1930 Counsel for Personal Representatives Date: 5/2,.,-1 J 07 I v- IMPORTANT NOTICE NOTICE OF ESTATE ADMINISTRATION THIS NOTICE DOES NOT MEAN THAT YOU WILL RECENE ANY MONEY OR PROPERTY FROM THIS ESTATE OR OTHERWISE. Whether you 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, CUMBERLAND COUNTY, PENNSYLVANIA In re Estate of Samuel C Gruiff, deceased, Late of Camp Hill Borough, Cumberland County No. 21-02-00234 TO: SUSAN J. THURMAN 439 SKYLINE ROAD NEW CUMBERLAND, PA 17070 Please take notice of the death of decedent and the grant of letters to the personal representative named below. The Decedent, Samuel C. Gruiff, died on the 15th day of January, 2007, at Cumberland County, Pennsylvania. The Decedent died testate (with a Will). The personal representatives of the Decedent are: Frank M. Thurman Susan J. Thurman 2000 Clarendon Street 439 Skyline Road Camp Hill, P A 17011 New Cumberland, P A 17070 (717) 737-7451 (717) 575-0065 If the Decedent died testate, the will has been filed with the Office of the Register of Wills of Cumberland County, Cumberland County Courthouse, One Courthouse Square, Carlisle, Pennsylvania 17013, (717) 240-6345. If the Decedent died intestate, a Petition for the grant of Letters of Administration was filed with the Office of the Register of Wills of Cumberland County, Cumberland County Courthouse, One Courthouse Square, Carlisle, Pennsylvania 17013, (717) 240-6345. A copy of the Will or Petition may be obtained by contacting the Register of Wills and paying the charges for duplication. inda A. Clotfelter, Esquire 021 E. Trindle Road, Suite 100 echanicsburg, P A 17050 (717) 796-1930 Counsel for Personal Representatives Date: S I~, I 01 , v-- Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717) 240 -6345 \",,-,~) o ~:;: 0 '- -~ 1 L_ " ~..,..... CLOTFELTER LINDA A 5021 E TRINDLE RD SUITE 100 ...;....-- Date: 06/14/2007 -,.., ---I .:..,) MECHANICBURG, PA 17050 RE: Estate of GRUIFF SAMUEL C File Number: 2002-00234 Dear Sir/Madam: This notice is to serve as a reminder that the Certificate of Notice under Rule 5.6(a) is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July I, 1992, the personal representative or his councel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing is due by: 06/29/2007 Please feel free to contact this office with any questions you may have. If you have already filed your certificate, please disregard this notice. Sincerely, ~~~~ Glenda Farner StrasbaUg~ Clerk of the Orphans' Court cc: File Personal Representative(s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717)240-6345 o ~.,;O -:0 "--,.--, :'-',.J c '. c_ "- Date: 06/14/2007 -.J (0 THURMAN FRANK M 2000 CLARENDON STREET CAMP HILL, PA 17011 RE: Estate of GRUIFF SAMUEL C File Number: 2002-00234 Dear Sir/Madam: This notice is to serve as a reminder that the Certificate of Notice under Rule 5.6(a) is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July I, 1992, the personal representative or his councel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing is due by: 06/29/2007 Please feel free to contact this office with any questions you may have. If you have already filed your certificate, please disregard this notice. Sincerely, Gl~n~~1::r Clerk of the Orphans' Court cc: File Counsel Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (717)240-6345 Date: 06/14/2007 o c;o .~~ -i~ I' ") '-_;J c..:...~) -.. .: . THURMAN SUSAN J 493 SKYLINE ROAD ;, .... .", NEW CUMBERLAND, PA 17070 (t) '-.-f RE: Estate of GRUIFF SAMUEL C File Number: 2002-00234 Dear Sir/Madam: This notice is to serve as a reminder that the Certificate of Notice under Rule 5.6(a) is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, NO. 103 SUPREME COURT RULES DOCKET NO.1, for decedents dying on or after July 1, 1992, the personal representative or his councel, within ten (10) days after giving proper notice to the beneficiaries and intestate heirs as required by subdivision (a) of Rule 5.7, shall file with the Register of Wills or Clerk of the Orphans' Court his/her Certification of Notice. This filing is due by: 06/29/2007 Please feel free to contact this office with any questions you may have. ' If you have already filed your certificate, please disregard this notice. Sincerely, 4~/,,_ ',~<4J ~ Glenda Farner Strasbaugh Clerk of the Orphans' Court cc: File Counsel REV-\500 EX 1,,(0) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1500 w '"" x:~Ul (Jr:t:X: wn.(J :1:00 (Jr:t:....I n.1XI n. c( FILE NUMBER 21 02 INHERITANCE TAX RETURN RESIDENT DECEDENT NUMBER 00234 COUNTY CODE YEAR t- Z W C W o W C DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) SAMUEL C. GRUIFF SOCIAL SECURITY NUMBER 204-03-5944 DATE OF BIRTH (MM-DD-YEAR) 10/29/1921 DATE OF DEATH (MM-DD-YEAR) 01/15/2007 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER (IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL) ~ 1. Original Return o 4. Limited Estate o 6. Decedent Died Testate (Attach copy ofW;lI) o 9. Litigation Proceeds Received o 2. Supplemental Return o 4a. Future Interest Compromise Idate of death after 12-12-82) o 7. Decedent Maintained a Living Trust (Attach copy ofTrust) o 10. Spousal Poverty Credit (dale of death between 12-31-91 and 1-1-95) o 3. Remainder Return (dale of death pnor to 12-13-82) o 5. Federal Estate Tax Return Required 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (AttachSch 0) I- Z W C Z o n. Ul w r:t: r:t: o (J THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX tNFORMAnON SHOULD BE DIRECTED TO: NAME COMPLETE MAILING ADDRESS LINDA A. CLOTFELTER, ESQUIRE FIRM NAME (If Applicable) LAW FIRM OF LINDA A. CLOTFELTER TELEPHONE NUMBER (717) 796-1930 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) (1) (2) (3) (4) (5) 0.00 0.00 0.00 0.00 5,972.75 z o ~ ..J :J t- o:: ~ o w 0:: 3. Closely Held Corporation, Partnership or Sole-Proprietorship 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) 11. Total Deductions (total Lines 9 & 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been made (Schedule J) 5,972.55 0.00 0.00 .1 0.00 f'...) (6) . I , I (7) 0.00 (~: Cd 5,972.55 (9) (8) 2,402.72 3,569.83 (11) (12) (13) (10) 14. Net Value Subject to Tax (Line 12 minus Line 13) (14) 0.00 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES z o ~ ~ :J C. :i o o ~ 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) ________ X .0.__._ (15) 0.00 0.00 0.00 0.00 0.00 16. Amount of Line 14 taxable at lineal rate x .0_ (16) 17. Amount of Line 14 taxable at sibling rate x .12 (17) x .15 (18) (19) 18. Amount of Line 14 taxable at collateral rate 19. Tax Due CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 20.0 Decedent's Complete Address: STREET ADDRESS 1700 MARKET STREET CITY CAMP HILL -----~-_.,-~~ STATEpA ZIP 17011 Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 0.00 Total Credits ( A + B + C ) (2) 0.00 3. Interest/Penalty if applicable D. Interest E. Penalty ---~-_..-~~ TotallnteresVPenalty (D + E) 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (3) (4) (5) (5A) 0.00 0.00 0.00 0.00 4. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5B) Make Check Payable to: REGISTER OF WILLS, AGENT 0.00 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 ~ b. retain the right to designate who shall use the property transferred or its income; ........................................... D ~ c. retain a reversionary interest; or.......................................................................................................................... D [i] d. receive the promise for life of either payments, benefits or care? ...................................................................... 0 [iJ 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? .............................................................................................................. 0 ~ 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? .............. 0 00 4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which contains a beneficiary designation? ........................................................................................................................ D ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. Under penalties of perjury, I declare ll1at I have examined ll1is return, including accompanying schedules and statements, and to ll1e best of my knowiedge and belief, it is true, correct and complete. Declaration of preparer oll1er than the personal representative is based on all information of which preparer has any knowledge. SIGNATURE OF RSON RE~IBLE FOR FILING RETURN J!,.. ./:1f2.~~_...__._.__._....._-_........_..__.....__.... ADDRESS 2000 CLARENDON STREET, CAMP HILL, PA 17011 --.. ....-.....-.-~..--- ------.--...---...---.--......------....-..--..-....- ......------. ..............--.....-.... .......-.--.....---.. s~crA~AN RCPRCSENTATIVE 'AD6RESS . m mm....-Q-mmm.. .. .m~m__..mmmmm 493 SKYLlNJr}OAD. NEW CUMBERLAND, PA 17070 DATE f!~<t:- ...m..mmmmmmm...........m................~m....m...;m._mmmn P'/f)/l-Yu: ~ . . .SQM...e.,r~ DATE 'Ie? €J!I?8 111>f110\'> ~.M'l,l.~Ja o.Atq.i!A I'O.~.O For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 3% [72 P.S. ~9116 (a) (1.1) (i)]. For dates of death on or after January 1,1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parent. an adoptive parent, or a stepparent of the child is 0% [72 P.S. 99116(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. ~9116(1.2) [72 P.S. 99116(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. 99116(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. REV-1511 EX+ (12-99)W COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS ESTATE OF SAMUEL C. GRUIFF FILE NUMBER 2002-00234 Debts of decedent must be reported on Schedule I. ITEM NUMBER A. DESCRIPTION AMOUNT 1. FUNERAL EXPENSES: James F. Stone Funeral Home, Inc. - Funeral Expenses 790.00 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions Name of Personal Representative(s) Social Security Number(s)/EIN Number of Personal Representative(s) Street Address City State Zip Year(s) Commission Paid: 2. Attorney Fees 1,226.74 3. 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 4. Probate Fees 76.00 5. Accountant's Fees 6. Tax Return Preparer's Fees 8. Cumberland Law Journal - Estate Advertisement The Patriot News - Estate Advertisement Register of Wills, Cumberland County - Filing Fee for PA Inheritance Tax Retum Orphan's Court, Cumberland County - Filing Fee for Family Settlement Agreement 75.00 199.98 15.00 20.00 7. 9. 10. 11. 12. TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 2,402.72 REV-1512 EX+ (12-03) '* COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS ESTATE OF SAMUEL C. GRUIFF FILE NUMBER 21-02- Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses. ITEM VALUE AT DATE NUMBER DESCRIPTION OF DEATH 1. East Pennsboro Ambulance Service, Inc. - Medical Bill 60.00 2. Department of Veterans Affairs - Lebanon VA Medical Center - Medical Bill 30.00 3. Commonwealth of Pennsylvania, Department of Public Welfare - Claim for medical assistance Medical expense of $7,419.91 incurred during last six (6) months. Priority Class 6 claim $0.00 3,479.83 Probate assets available to pay Commonwealth lien: $3,479.83. TOTAL (Also enter on line 10, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 3,569.83 . COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE BUREAU OF FINANCIAL OPERATIONS DIVISION OF THIRD PARTY LIABILITY ESTATE RECOVERY PROGRAM PO BOX 64B6 HARRISBURG, PA 17105-6486 May 24, 2007 LINDA A CLOTFELTER LINDA A CLOTFELTER SUITE 100 5021 EAST TRINDLE MECHANICSBURG PA LAW FIRM ESQUIRE ROAD 17050 Re: SAMUEL GRUIFF CIS #: 910183255 SSN: 204-03-5944 Date of Death: 01/15/2007 Dear Attorney Clotfelter: Please be advised that the Department of Public Welfare maintains a claim in the amount of $7,419.91 against the above-mentioned estate. This claim is for restitution of medical assistance granted on behalf of the decedent for which the Probate Estate is now responsible to reimburse the Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as amended by Act 20-95, effective June 30, 1995. Enclosed is the Department's itemized statement of claim. A portion of this medical expense, namely $7,419.91, was incurred during the last six months of the decedent's life; therefore, it is a Class 3 claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $.00, is to be entered as a priority Class 6 claim against the estate. ---- Please acknowledge receipt of this letter and advise whether the Commonwealth's claim is admitted and when payment may be expected. If the estate accounting is complete, please provide a copy. If the estate contains real estate, please provide copies of the deed, the latest tax assessment, and a current appraisal, if available. Sincerely, .4 J I ".l:[n/,;'- _,/"....~J,,1 J.,./ Snober V. Ketty Claims Investigation Agent 717-772-6608 717-772-6553 FAX Enclosure r- ESTATE OF SAMUEL C. GRUIFF FRANK M. THURMAN, EXEC. 2000 CLARENDON ST. CAMP HILL, PA 17011-3827 110 ::::. F__ DetIIil&onB.ad<. ...,~-=~~~ ~~~--"' I: 2 ~ . ~ 7 2 b ~ .1: .0 5 . . ~ B b . 21110 . .0 REV-1513 EJ(+ (9-00) ... COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE , BENEFICIARIES ESTATE OF SAMUEL C. GRUIFF NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116 (a) (1.2)] Frank Thurman 2000 Clarendon Avenue, Camp Hill, PA 17011 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) brother-in-law 1. fifty percent (50%) but no assets to distribute - estate insolvent 2. Susan J. Thurman 493 Skyline Road, New Cumberland, PA 17070 fifty percent (50%) but no assets to distribute - estate insolvent FILE NUMBER 21-02-0234 AMOUNT OR SHARE OF ESTATE 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 B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REY-1500 COYER SHEET (If more space is needed, insert additional sheets of the same size) LAST WILL AND TESTAMENT OF SAMUEL C. GRUIFF I, SAMUEL C. GRUIFF, now of Woods of Cedar Run, 824 Lisburn Road, Camp Hill, Cumberland County, Pennsylvania 17011, do publish and declare this to be my Last Will and Testament, hereby revoking all other prior wills and codicils made by me. FIRST: Family Baclmround and Appointment of Executor. m I was married to (B) Appointment of Executor. I appoint as my Co-Executor and Co-Executrix (all hereinafter referred to as Executor or Executor(s) under this Will), the following named persons or corporations to serve without bond and without being required to account to any Court: Co-Executor and Co-Executrix: My brother-in-law, FRANK M. THURMAN and my niece, SUSAN J. THURMAN, to act jointly and individually. SECOND: Funeral and Last Illness Expenses: Taxes. (A) Illness. I direct my Executor to pay my funeral expenses and the expenses of my last illness from my estate. (B) Taxes. I direct my Executor to pay any and all estate, inheritance, succession, legacy, transfer and other death taxes or duties, by whatever name called, including any and all interest and penalties thereon, imposed under the laws of any jurisdiction by reason of my death upon or with respect to any and all property included in my gross estate for the purpose of such taxes, whether such property passes under or outside of this Will. Without any apportionment otherwise required by law and without being prorated or apportioned among or charged against the respective devises, legatees, beneficiaries, transferees, or other recipients of any such property or charged against any property passing or which may have passed to any of them, I direct that any taxes so paid shall be charged against my residuary estate. My Executor shall not be entitled to reimbursement for any portion of any such taxes from any such person. Lr<&. ,...kr~. ~ {J7W LAST WILL AND TESTAMENT ill: SAMUEL C. GRUIFF PAGE 2 THIRD: Tan~!ible Personal Property. Except for those items excluded below and those items enumerated in the Letter of Instruction, I bequeath all my tangible personal property, including but not limited to clothing, jewelry, heirlooms, furniture, household furnishings, personal effects, and all other similar articles, which I own, and the insurance thereon, to be equally divided between my brother-in-law, FRANK M. THURMAN, and my niece, SUSAN J. THURMAN. Tangible personal property shall not include: (1) any and all property used by me in any business, (2) cash on hand or on deposit in banks, (3) stock or securities, (4) any type of evidence of indebtedness, and (5) any life, health or accident insurance policies. If my either my brother-in-law or my niece do not survive me, I leave such tangible personal property to the survivor of them. If neither my brother-in-law nor my niece survive me, I leave such tangible personal property to their then living issue, as they should request. If there is any disagreement as to distribution, I direct my Executor to make such distribution. The decision of my Executor shall be final and binding. Any items not selected or any items which my Executor considers unsuitable for a minor child shall be sold in the sole discretion of my Executor and, if sold, the net proceeds therefrom shall be added to the residue of my estate. Any such article allocated to a minor may, as my Executor deems advisable, either be delivered to the minor or to any person to safeguard on behalf of the minor. Notwithstanding any other provisions in this Article THIRD, I may leave a separate, dated and unsigned Letter of Instruction, which I shall place with my Will, containing directions as to the ultimate disposition of certain of the property bequeathed under this Article THIRD, and such Letter of Instruction shall determine the distribution of such items. FOURTH: Residuary Estate. I devise and bequeath all of the rest, residue and remainder of my estate, real, personal and mixed, of whatever nature and wherever situated to which I am legally or equitably entitled, to be divided equally between my brother-in-law, FRANK M. THURMAN, and my niece, SUSAN J. THURMAN. Should either my brother-in- law or my niece predecease me, I direct that individual's share of my estate to go to the survivor of them. Should both my brother-in-law and my niece predecease me, I direct my entire residuary estate go to SUSAN J. THURMAN'S then living children. Should my niece, SUSAN ~ ~ vnzJ LAST WILL AND TESTAMENT OF SAMUEL C. GRUIFF PAGE 3 J. THURMAN, die without issue, I direct my entire estate shall go to my nephew, FRANK D. THURMAN. FIFTH: Powers of Executor. In addition to the powers and duties as may have been granted elsewhere in this Will, but subject to any limitations stated elsewhere in this Will, the Executor shall have and exercise exclusive management and control of the Estate and shall be vested with the following specific powers and discretion, in addition to the powers as may be generally conferred from time to time upon the Executor by law: (A) In the management, care and disposition of the Estate, the Executor shall have the power to do all things and to execute such instruments, deeds, or other documents as may be deemed necessary or proper, including the following powers, all of which may be exercised without order of or report to any Court: (1) To sell, exchange or otherwise dispose of any property at any time held or acquired hereunder, at public or private sale, for cash or on terms, without advertisement, including the right to lease for any term notwithstanding the period of the Estate, and to grant options, including any option for a period beyond the duration of the Estate. (2) To invest all monies in such stocks, bonds, securities, mortgages, notes, chases in action, real estate or improvements thereon, and any other property as the Executor may deem best, without regard to any law now or hereafter enforced limiting investments of fiduciaries or issued by a parent or affiliate company of such Executor. (3) To retain for investment any property deposited with the Executor hereunder. (4) To vote in person or by proxy any corporate stock or other security and to agree to or take any other action in regard to any reorganization, merger, consolidation, liquidation, bankruptcy or other procedure or proceedings affecting any stock, bond, note or other security. (5) To use attorneys, real estate brokers, accountants and other agents, if such employment is deemed necessary or desirable, and to pay reasonable compensation for their services. J~ ~c _. 'j u/'fltJ LAST WILL AND TESTAMENT OF SAMUEL C. GRUIFF PAGE 4 (6) To compromise, settle or adjust any claim or demand by or against the Estate and to agree to any rescission or modification of any contract or agreement affecting the Estate. (7) To renew any indebtedness, as well as to borrow money, and to secure the same by mortgaging, pledging or conveying any property of the Estate. (8) To retain and carryon any business in which the Estate may acquire an interest, to acquire additional interest in any such business, to agree to the liquidation in kind of any corporation in which the Estate may have an interest and to carryon the business thereof, to join with other owners in adopting any form of management for any business or property in which the Estate may have an interest, to become or remain a partner, general or limited, in regard to any such business or property and to hold the stock or other securities as an investment, and to employ agents and confer on them authority to manage and operate the business, property or corporation, without liability for the acts of such agent or for any loss, liability or indebtedness of such business if the management is selected or retained with reasonable care. (9) To register any stock, bond or other security in the name of a nominee, without the addition of words indicating that such security is held in a fiduciary capacity, but accurate records shall be maintained showing that such security is a Estate asset and the Executor shall be responsible for the acts of such nominee. (B) Whenever the Executors are directed to distribute any Estate assets in fee simple to a person who is then under twenty-one (21) years of age, the Executor shall be authorized to hold such property in Trust for such person until he/she becomes twenty-one (21) years of age, and in the meantime shall use such part of the income and the principal of the Estate as the Executor may deem necessary to provide for the proper support and education of such person. If such person should die before becoming twenty-one (21) years of age, the property then remaining in trust shall be distributed to the personal representative of such person's estate. (C) In making distributions from the Estate to or for the benefit of any minor or other person under a legal disability, the Executor need not require the appointment of a guardian, but shall be authorized to payor deliver the same to the custodian of such person, to payor deliver the same to such person without the intervention of a guardian, to payor deliver the same to a ~ ~cC w([k/ , LAST WILL AND TESTAMENT OF SAMUEL C. GRUIFF PAGE 5 legal guardian of such person if one has already been appointed, or to use the same for the benefit of such person. (D) In the disbursement of the Estate and any division into separate trusts or shares, the Executor shall be authorized to make the distribution and division in money or in kind, or both, regardless of the basis for income tax purposes of any property distributed or divided in kind, and the distribution and division made and the values established by the Executor shall be binding and conclusive on all persons taking hereunder. The Executor may in making such distribution or division allot undivided interests in the same property to several trusts or shares. (E) The Executor shall be authorized to lend or borrow, including the right to lend to or borrow from any trusts which I or my spouse may have established during life or by will at an adequate rate of interest and with adequate security, and upon such terms and conditions as the Executor shall deem fair and equitable. (F) The Executor shall be authorized to sell or purchase at the fair market value as determined by the Executor, any property to or from any trust created by me or my spouse during life or by Will, even though the same person or corporation may be acting as Executor of my estate or as Trustee of any of my other trusts. (G) The Executor shall have discretion to determine whether items should be charged or credited to income or principal or allocated between income and principal as the Executor may deem equitable and fair under all the circumstances, including the power to amortize or fail to amortize any part or all of any premium or discount, to treat any part or all of the profit resulting from the maturity or sale of any asset, whether purchased at a premium or at a discount, as income or principal or apportion the same between income and principal, to apportion the sales price of any asset between income and principal, to treat any dividend or other distribution of any investment as income or principal, or apportion the same between income and principal, to charge any expense against income or principal or apportion the same, and to provide or fail to provide a reasonable reserve against depreciation or obsolescence on any assets subject to depreciation or obsolescence, all as the Executor may reasonably deem equitable and just under all the circumstances. If the Executor does not exercise the above discretionary power, the cash or accrual allocation shall be in accordance with Chapter 81 of Title 20 of the Pennsylvania Consolidated Statutes, or the corresponding provisions of subsequent state law. ~y ~ ~/~ LAST WILL AND TESTAMENT OF SAMUEL C. GRUIFF PAGE 6 (H) If at any time the total fair market value of the assets of any trust established or to be established hereunder is so small that the corporate Trustee's annual fee for administering the trust would be the minimum annual fee set forth in the Trustee's regularly published fee schedule then, in effect, the Trustee in its discretion shall be authorized to terminate such trust or to decide not to establish such trust, and in such event the property then held in or to be distributed to such trust shall be distributed to the persons who are then or would be entitled to the income of such trust. If the amount of income to be received by such persons is to be determined in the discretion of the Trustee, then the Trustee shall distribute the property among such of the persons to whom the Trustee is authorized to distribute income, and in such proportions, as the Trustee in its discretion shall determine. (I) Except as otherwise provided in this Will, when the authority and power under this Will is vested in two (2) or more Executors or Trustees, the authority and powers are to be held jointly by the Executors or Trustees, respectively. A majority of the Executors or Trustees may exercise any authority or power granted under this Will or granted by law, and may act under this Will. Any attempt by one such Executor or Trustee to act under this Will on other than ministerial acts shall be void. The action of one such Executor or Trustee under this Will may be validated by a subsequent ratification of the act by a majority of the Executors or Trustees. SIXTH: Riehts and Liabilities of Executor. (A) No bond or other security shall be required of any Executor. (B) This instrument always shall be construed in favor of the validity of any act or omission by any Executor, and any Executor shall not be liable for any act or omission except in the case of gross negligence, bad faith or fraud. Specifically, in assessing the propriety of any investment, the overall performance of the entire Estate shall be taken into account. (C) Each Executor shall be entitled to receive reasonable compensation for services actually rendered to my estate, in an amount the Executor normally and customarily charges for performing similar services during the time which he/she performs the services. SEVENTH: Spendthrift Provision. No beneficiary shall have the power to anticipate, encumber or transfer his or her interest in the estate in any manner other than by the valid ~ -..\?~'C' ~ wruJ LAST WILL AND TESTAMENT OF SAMUEL C. GRUIFF PAGE 7 exercise of a power of appointment. No part of the estate shall be liable for or charged with any debts, contracts, liabilities or torts of a beneficiary or subject to seizure or other process by any creditor of a beneficiary. EIGHTH: Tax Elections. (A) In determining the estate, inheritance and income tax liability relating to my Estate, the Executor's decision as to all available tax elections shall be conclusive on all concerned. If the Executor joins with my spouse in filing income tax returns, or consenting for gift tax purposes to having gifts made by either of us during my life considered as having been made one-half by each of us, any resulting liability shall be borne by my Estate and my spouse in such proportions as they may agree. In accordance with IRe Section 2632(a) and without regard to whether a Federal estate tax return is actually filed, my Executor shall allocate so much of the Federal Generation Skipping Transfer (GST) exemption amount as will fully exempt any generation skipping transfer which may occur under this Will. The Executors may, in their discretion, determine the date as of which my gross estate shall be valued for the purpose of determining the applicable tax payable by reason of my death. (B) The Executors may, in their discretion, decide whether all or any part of certain deductions shall be taken as income tax deductions (even though they may equal or exceed the taxable income of my estate and whether or not claimed or of benefit on my estate's income tax return) or as estate tax deductions when a choice is available; and in the event that all or any part of such deductions are taken as income tax deductions, no adjustment of income and principal accounts in my estate shall be made as a result of such decisions. NINTH: Definitions and General Provisions. (A) Survival. Any beneficiary who dies within sixty (60) days after my death shall be considered not to have survived me. (B) Captions. The captions set forth in this Will at the beginning of the various articles hereof are for convenience of reference only and shall not be deemed to define or limit the provisions hereof or to affect in any way their construction and application. (C) Children. As used in this Will, the words "child" and "children" shall include persons who are legally adopted and the issue of said persons, whether born in or out of wedlock, ~~ 6.LC- ~ LAST WILL AND TESTAMENT OF SAMUEL C. GRUIFF PAGE 8 so long as any person born out of wedlock is acknowledged in a written instrument executed by the one of their natural parents who is a descendant of mine to be the child of said descendant. The word "issue" shall include descendants of all generations including adopted persons. A posthumous child shall be considered as living at the death of his parent. The birth to me or the adoption by me of a child or children subsequent to the execution of this Will shall not operate to revoke this Will. Except for discretionary distributions which may be made unequally among a group of persons and distributions pursuant to a valid exercise of a power of appointment, in making a distribution to the children of any person, the property to be distributed shall be divided into as many shares as there are living children of the person and deceased children of the person who left children who are then living. Each living child shall take one share and the share of each deceased child shall be divided among his then-living descendants in the same manner. (D) Code. Unless otherwise stated, all references in my Will to section and chapter numbers are to those of the Internal Revenue Code of 1986, as amended, or the corresponding provisions of any subsequent federal tax laws applicable to my estate. (E) Other terms. The use of any gender includes the other genders, and the use of either the singular or the plural includes the other. (F) Powers of Appointment are Exercised. By this Will I exercise any and all Powers of Appointment which I possess at the time of my death. IN WITNESS WHEREOF, I, SAMUEL C. GRUIFF, the Testator, have to this my Last Will and Testament, typewritten on ten (10) pages, including the Acknowledgment and - Affidavit, set my hand and seal this ~b day of April, 2002. ~<'~ SAMUEL C. G FF [This space is intentionally left blank.] Signed, sealed, published and declared by the above-named Testator, as and for his Last Will and Testament, in the presence of us, who have hereunto subscribed our names at his request, as witnesses hereto, in the presence of the said Testator, and in the presence of each other. Each of us further declares that he or she believes the Testator to be of sound mind and memory. The preceding instrument consists of this and nine (9) other consecutively numbered typewritten pages including the Acknowledgment and Affidavit. ~ nil residing atarA"~i.YYLeA J H "\ ~-.7i ft/;:tL .1 k~-1-. f;; IfPI r tJ~AJ print name) residing at A ;:'Ch4rJ I'C <;1 fA'5 fA- I ' [This space is intentionally left blank.] AKNOWLEDGMENT AND AFFIDA VIT COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND The Testator and the witnesses whose names are signed and subscribed to the attached or foregoing instrument, being first duly sworn and qualified according to law, do hereby acknowledge, depose and say to the undersigned authority, that the Testator signed and executed the instrument as his Last Will in the presence of the witnesses; that he signed it willingly or willingly directed another to sign it for him; that he executed it as his free and voluntary act for the purposes therein expressed; that each of the witnesses were present and saw the Testator sign and execute the instrument as his Last Will; that each subscribing witness in the hearing and sight of the Testator signed the will as witnesses; and that to the best of their knowledge the Testator was at that time eighteen years of age or older, of sound mind and under no constraint or undue influence. ~~ ~ r .\2- -&1 "'-" x~\r . <J Testator COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND On this, the ~ day of April, 2003, before me, a Notary Public for the Commonwealth of Pennsylvania, the undersigned officer, personally appeared SAMUEL C. GRUIFF, and the above witnesses, known to me (or satisfactorily proven) to be the persons whose names are subscribed to the within instrument, and acknowledged that they executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have set my hand and notarial seal. ~~ ~,~t'-~Ld Notary Public ~ " . My Commission Expires: ~W).~ Xj':)}~ ~_~.,.~~ 'i /,;t:)OS Notarial Seal i Kimberly R. Hanford, Notary Public I Machanicsburg Boro. Cumberland County I My Commission Expires Apr. 4, 2005 ~ " " FAMILY SETTLEMENT AND FINAL RELEASE IN THE ESTATE OF SAMUEL C. GRUIFF r:-J """":~... ,~;~ ;:.u ,'Ii -~-.., -',.) ". ~.J -::J KNOW ALL MEN BY THESE PRESENTS, THAT WHEREAS, Samuel C. <J.tOiff, late of the Camp Hill Borough, Cumberland County, Pennsylvania, deceased, aled on J~ary 15, 2007, testate. WHEREAS, Letters Testamentary were granted to Frank M. Thurman and Susan J. Thurman, on March 19, 2007, with same having been filed in Cumberland County, Pennsylvania, to Estate No. 21-02-00234; WHEREAS, the said personal representative has gathered the assets of the estate of the said decedent and the assets consist of personal property to a total value of $5,972.55, as set forth in Exhibit "A", which is a statement of account of the said personal representatives, and which is attached hereto and made a part hereof, and marked Exhibit "A"; WHEREAS, the debts and deductions amount to $5,972.55, leaving a balance for distribution of $0.00, also as set forth in the statement of the said personal representatives, which is attached hereto and made a part hereof, and marked Exhibit "B"; NOW THEREFORE, KNOW YE, that we, Frank M. Thurman and Susan J. Thurman, being the heirs of the said decedent, and being the individuals entitled to inherit under the Last Will and Testament, do hereby acknowledge that we have this day had and received from the aforesaid personal representative, in full satisfaction and payment of all sum or sums of money, legacies, bequests, and devises as are given, devised and bequeathed to us by the said Last Will and Testament, which amount we have received this day, and which is the amount set opposite our names in the table and schedule of distribution in said statement attached hereto and marked Exhibit "C"; AND, we do hereby stipulate that in order to avoid the expense and time involved in the filing of a formal account and schedule of distribution, we agree that no account is necessary and we hereby agree and consent to distribution being made without the filing of an account and schedule of distribution, the same to be with the same force and effect as if it had been filed and confirmed by the Orphan's Court Division of the Court of Common Pleas of Cumberland County. THEREFORE, we do hereby remise, release, quitclaim and forever discharge the said personal representatives, their heirs, executors, administrators and assigns, of and from the said estate and from all actions, suits, payments, accounts, reckonings, claims and demands whatsoever, touching upon the estate of said decedent, and we do further hereby covenant and agree that we will contribute my share of the estate to satisfy any and all claims, demands, suits, or causes of action which may be successfully prosecuted against the said estate or the aforesaid personal representatives after the signing, sealing and delivery of this family settlement agreement and final release. tl1 IN WITNESS WHEREOF, we have hereunto set my hand and seal this ~ day of January, 2008. WITNESSES: r ~,.r\ ~~;~^-- - - i ~~~ FRANK M. THURMAN )\ ~ V'-~.- - - ~~~ COMMONWEALTH OF PENNSYLVANIA SS COUNTY OF CUMBERLAND On this zg"'1- day of -J/Lrl u..M iJH ' 2008, before me, the undersigned officer, personally appeared FRANK M.' URMAN and SUSAN J. THURMAN, known to me (or satisfactorily proven) to be the individuals whose names are subscribed to the foregoing instrument, and acknowledged that they executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. My Commission Expires: NOTARIAL .. I.JO\ A CL01fB,1II NotarY ~, CNIt tWMUN 1WP. CUI... ~ My eommJIIIon..... Jun 21. 2010 LAST AND FINAL ACCOUNT OF THE ESTATE OF SAMUEL C. GRUIFF LATE OF THE CAMP HILL BOROUGH, FRANKLIN COUNTY, PENNSYLVANIA DATE OF DEATH: JANUARY 15,2007 PRINCIPAL ACCOUNT DEBITS: Your Accountants charge themselves with the following: Personal Property 1 Checking Account No. 1051065453 with Sovereign Bank $ Date of death value $2,666.00 Interest accrued $0.00 2 Retirement check from International Brotherhood (IBEW) $ 3 Unclaimed property retrieved by estate due to deneutralization $ of insurance policy. Date of death value $1,459.19 4 Refund from Manorcare Nursing Home $ 5 Interest earned by estate $ TOTAL PRINCIPAL DEBITS: $ E X H I BIT "A" 2,666.65 74.00 1,459.19 1,772.26 0.45 5,972.55 CREDITS Your Accountants ask credit for payments made from Principal Account as follows: Description 1. James F. Stone Funeral Home, Inc. - funeral expenses 2. Law Firm of Linda A. Clotfelter - professional fees for estate administration 3. Law Firm of Linda A. Clotfelter - reimbursement of estate advertisement fees to Cumberland Law Journal 4. Law Firm of Linda A. Clotfelter - reimbursement of estate advertisement fees to The Patriot News 5. Frank Thurman - reimbursement for administrative expenses of estate 6. East Pennsboro Ambulance Service, Inc. - medical bill 7. Department of Veterans Affairs, Lebanon VA Medical Center - medical bill 8. Commonwealth of Pennsylvania, Department of Health and Welfare - medical assistance lien. Medical expense lien: $7,419.91 Priority Class 6 lien: $0.00. Sum to be paid to Commonwealth of Pennsylvania $3,479.83. 9. Register of Wills, Cumberland County - filing fee for Pennsylvania Inheritance Tax Return 10. Orphan's Court, Cumberland County - filing fee for Family Settlement Agreement TOTAL: E X H I BIT "B" Amount $ 790.00 $ 1,226.74 $ 75.00 $ 199.98 $ 76.00 $ 60.00 $ 30.00 $ 3,479.83 $ 15.00 $ 20.00 $ 5,972.55 RECAPITULATION Principal Debits Minus: (A) (B) Administrative Expenses & taxes paid Last Debts of Decedent SUBTOTAL: TOTAL BALANCE OF ESTATE ASSETS AVAILABLE FOR DISTRIBUTION PROPOSED DISTRIBUTION $ $ $ $ $ 5,016.55 2,402.72 3,569.83 5,972.55 0.00 The Personal Representative proposes distribution of the Total Balance for Distribution to the following heir as described: FRANK M. THURMAN 2000 Clarendon Street Camp Hill, PA 17011 50% of residual estate estate insolvent SUSAN J. THURMAN 493 Skyline Road New Cumberland, PA 17070 50% of residual estate estate insolvent EXHIBIT C $ 0.00 $ 0.00 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION PO BOX 280601 HARRISBURG PA 17128-0601 +-; ~ - - ".MO-T ICE OF INHERITANCE TAX _AAP'"~ -'' ~' RAISE.~IENT, ALLOWANCE OR DISALLOWANCE -L,."_ .;Q'F. DEDUCTIONS AND ASSESSMENT OF TAX ~~~~ ,~`~ ~~ ~~ ~~~ J3 t'a ~Ci :! rig v~,.,l :f~k ~,., a' ~~~ LINDA A CLOTFELTER~~3xQ~`l - `~"" .. ~;~; L A CLOTFELTER LAW FRM 5021 E TRINDLE RD 100 MECHANICSBURG PA 17050 REV-1547 EX AFP (06-05) DATE 05-26-2008 ESTATE OF GRUIFF SAMUEL C DATE OF DEATH 01-15-2007 FILE NUMBER 21 02-0234 COUNTY CUMBERLAND ACN 101 APPEAL DATE: 07-25-2008 (See reverse side under Objections) Amount Remitted~- MAKE CHECK PAYABLE AND REMIT PAYMENT T0: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS E- REV-1547 EX AFP C03-05) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GRUIFF SAMUEL C FILE N0. 21 02-0234 ACN 101 DATE 05-26-2008 TAX RETURN WAS: C X) ACCEPTED AS FILED C ) CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. 12ea1 Estate (Schedule A) (1) .00 NOTE• To insure proper 2. 'itocks and Bonds (Schedule B) 3. Closely Held Stock/Partnership Interest (Schedule C) 4. Mortgages/Notes Receivable (Schedule D) 5. f:ash/Bank Deposits/Misc. Personal Property (Schedule E) 6. .Jointly Owned Property (Schedule F) 7. "transfers (Schedule G) 8. Total Assets C2) .00 C3) .00 c4) .00 c5) 5,972.75 C6) .00 c7) .00 (8) credit to your account, submit the upper portion of this form with your tax payment. 5,972.55 APPROVED DEDUCTIONS AND EXEMPTIONS: 2,402 .72 9. 1=uneral Expenses/Adm. Costs/Misc. Expenses (Schedule H) (9) 10. Debts/Mortgage Liabilities/Liens (Schedule I) (10) 3,569 .8 3 11. Total Deductions (11) 5 • 9 7 • ~~ 12. Net Value of Tax Return (12) .0 0 13. Charitable/Governmental Bequests; Non-elected 9113 Trus ts (Schedule J) C13) .00 14. Net Value of Estate Subject to Tax (14) .00 NOTE: If an assessment was issued previously, l ines 14, 15 and/or 16, 17, 18 and 19 will reflect figures that include the total of ALL returns assess ed to date. ASSESSMENT OF TAX: 15. ~4mount of Line 14 at Spousal rate (15) • 00 X 00 = . 00 16. ~4mount of Line 14 taxable at Lineal/Class A rate C16) • 00 X 045 = . 00 17. Amount of Lfne 14 at Sibling rate (17) .00 X 12 = .00 18. ,4mount of Line 14 taxable at Collateral/Class B rate (18) • 00 X 15 _ . 00 19. Principal Tax Due C19)= .0 0 TAY PDCTTTC. PAYMENT DATIE RECEIPT NUMBER DISCOUNT C+) INTEREST/PEN PAID C-) AMOUNT PAID TOTAL TAX CREDIT .00 BALANCE OF TAX DUE .00 INTEREST AND PEN. .00 TOTAL DUE .00 * IF PAID AFTER DATE INDICATED, SEE REVERSE C IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. FOR CALCULATION OF ADDITIONAL INTEREST. IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU MAY BE DUE O RFFIINn- CFF RGVCRCC CTnC nG TNT( FnRM CAD TNCTDIIrTTnNC \ Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone:(717) 240-6345 Date: 12f22J2008 ~.r CLOTFELTER LINDA A ~-> 5021 E TRINDLE RD SUITE 100 - _~ `;~' r; _ -~ T~FCHANICBURG, PA 17050 ~ !~ ` r. - rv ,-,> --; :. rJ RE: ;state of GRUIFr SAMUEL C ~' rile Number: 2002-00234 Dear SirjMadam: This notice is to serve as a reminder that the Status Report by Pe__sonal Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPREME COURT RULES DOCKET NO. 1, for decedents dying on or after ~7uly 1, 1992, the personal representative or his counsel, within two (2) years of the decedent's death, shall file with the Register of wlills a Status Report of completed or uncompleted administration. This ` fling is due by: 1/15/2009 Please feel free to contact this office with any questions you may have. If you have already filed your Status Report, please disregard this notice. Sin erely, /~ Glenda Fanner Strasbaugh Clerk of the Orphans' Court ~c: F~l_ rersor.ay Rerresertat~ve~s) Cumberland County - Register Of Wills One Courthouse Square Carlisle, PA 17013 Phone: (`717) 240-6345 Date: 12j22j2008 TNURMAN FRANK M 2000 CLARENDON STREET CAMP HILL, PA 17011 RE: Estate of GRUIFF SAMUEL C File Number: 2002-00234 Dear SirjMadam: >_ ~ t, _~ - .. t.:-: ~. r.; ~,„ -:: ^..3 lSJ This notice is to serve as a reminder that the Status Report by Pe_~sonal Renresentative under Rule 5.12 is due on the belo~s~~ listed date. As per the P.MENDMENTS TO SUPREME COURT ORPHANS` COURT RULES, NO. 103 SUPRE/~E COURT RULES DOCKET NO. 1, for decedents dying on or after July 1, 1902, the personal representative or his counsel, within tiro (2) years of the decedent's death, shall file with the Register of ~~il,s a Status Report of completed or uncompleted administration. This filing is due by: 1j15j2009 Please reel free to contact this office with any questions -you may ha-~~e. If you have already filed your Status Report, please disregard this r_otice. Sincerely, Glenda Farner Strasbau_Jh~~ Clerk of the Orphans' Court Cumberland County - Register Of Wills One Courthouse Square ~~arlisle, PA 17013 Phone: (717) 240-6345 Date: 12j22j2008 `- .. ,_, ,, THUFcI~1AN SUSAN J ~r-~, 493 SKYLINE ROAD ~ ,,, j..,J Nl~W CUr~IBERLAND , PA 17 0 7 0 _._ _._; rte RE,: Estate of ~=RUIFF SAMUEL C ?~ile Number: 2002-00234 Dear Sir/Madam: 'ibis notice is to serve as a reminder that the Status Rex~ort by Perscr_al Representative under Rule 6.12 is due on the below listed date. As per the AMENDMENTS TO SUPREME COURT ORPHANS' COURT RULES, N0. 103 SUPRE7IE COURT RULES DOCKET N0. 1, for decedents ying on or after Ju__y 1, 1992, the personal representative or his counsel, within t~~,~o !21 •,~~_ars of the decedent's death, shall file with the Register of ~~1il.~s a Status Report of completed or uncompleted administration. phis fi'~ing is due by: 1j15j2009 Please feel free to contact this office with any questic~ls you may have. If you have already filed your Status Report, please disregard this notice. Sincerely, ~^') u ,. ~~~~ Glenda Farner Stras'~~augh Clerk of the Orphans' Court cc. ~'i~ C:~~_:r.sel Pa. O.C. Rule 6.12 STATUS REPORT REGISTER OF WILLS OF CUMBERLAND Name of Decedent: Samuel C. Gruiff COUNTY, PENNSYLVANIA Date of Death: January 15, 2007 File Number: 2002-00234 Pursuant to Pa. O.C. Rule 6.12, I report the following with respect to completion of the administration of the above-captioned estate: 1. State whether administration of the estate is complete :.................... ^Yes ^ 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 b. The separate Orphans' Court No. (if any) for the personal representative's account is: c. Did the personal representative state an account informally to the parties in interest? ...... .. ........... ..... ©Yes ^No Fa.r~-~ ~ I y 3.e t t lc .run t- /~ j~u.,~,,~.:t.- tj~ t~a~ d. Copies of receipts, releases, joinders and approvals of formal or informal accounts may be filed with the Clerk of the Orphans' Court ~ may be attached to this report. Date , ! ~' ~ ~ ~ Si uUnre o erson Filing this Form Ca acity: ®Personal Representati~~Counsel mda A. Clotfelter, Esquire 1Vame of Person Filing this Form 5021 E. Trindle Road, Suite 100 Address ~~ ~ ~~ ~ . ~~ ~~ Mechanicsburg, PA 17050 ,r _, _ >w _~~ ~w1 ,_;~~- ~L. ,~~~ ,`~ I 717-796-1930 Telephone 9 d ~ f 'd Z ~ ~m ~~ ~~~1 FormRWl(j I~ev.1013.ptS ~ ~ Y', ~~. _ ~.~ <<i