HomeMy WebLinkAbout09-14-10-I REV-1500Ex(01-10) 1505610143
PA De artment of Revenue OFFICIAL USE ONLY
p Pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENT OF REVENUE
Po Box.2sosol INHERITANCE TAX RETURN 21 10 0 0 714
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death
195 16 5390 05 24 2010
Decedent's Last Name
GRISCAVAGE
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name
Spouse's Social Security Number
Date of Birth
07 30 1922
Suffix Decedent's First Name MI
HELEN R
Suffix Spouse's First Name MI
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
® 1. Original Return ^ 2. Supplemental Return ^ 3. Remainder Return (date of death
prior to 12-13-82)
^ 4. Limited Estate ^ 4a. Future Interest Compromise ^ 5. Federal Estate Tax Return Required
(dale of death after 12-12-82)
® g Decedent Died Testate
(Attach Copy of Will) ^ ~ Decedent Maintained a Living Trust
(Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes
^ 9. Litigation Proceeds Received ^ 10. Spousal Poverty Credit (date of death
between 12-31-91 and 1-1-95)
^ 11. Election to tax under Sec. 9113(A)
(Attach SCh. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
ROBERT P KLINE 717 770 2540
r-a
First line of address
714 BRIDGE STREET
Second line of address
PO BOX 461
City or Post Office
NEW CUMBERLAND
State ZIP Code
PA 17070
REGISTER t~~LS US~
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DATE FILED CIt .~
Correspondent's a-mail address:
Un enalties of perjury, I decl re that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it correct and complete~cl~at~ of preparer other than the personal representative Is based on all information of which preparer has any knowledge.
Charlene Griffiths (~~~~-
10425 West BrookslHe Drive, Sun City, AZ 85351
SIGNPQURE OF P EPA~OTHE`1 R THAN REPRESENTATIVE DATE
~~/LC/"/„ _ Robert P Kline ~~ ~~ ~l~
ADDRESS ~ ~
714 Bridge Street, New Cumberland, PA 17070
Side 1
L 1505610143 1505610143
REV-1500 EX
1505610243
~eceeenc~sName: GRISCAVAGE, HELEN R.
RECAPITULATION
1. Real Estate (Schedule A) .......................................................................................... 1.
2. Stocks and Bonds (Schedule B) ............................................................................... 2.
3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C).......... 3.
4. Mortgages & Notes Receivable (Schedule D) .......................................................... 4.
5• Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ................ 5
6. Jointly Owned Property (Schedule F) ^ Separate Billing Requested ............. 6.
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G) ^ Separate Billing Requested ............. 7,
8. Total Gross Assets (total Lines 1-7) ....................................................................... g.
9. Funeral Expenses & Administrative Costs (Schedule H) ......................................... 9.
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ................................ 10.
11. Total Deductions (total Lines 9 & 10) ......................................................................11.
12. Net Value of Estate (Line 8 minus Line 11) .............................................................12,
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made (Schedule J) ................................................. 13.
14. Net Value Subject to Tax (Line 12 minus Line 13) ............................................ ..... 14.
TAX COMPUTATION -SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate, or
transfers under Sec. 9116
(a)(1.2) X .00 15.
16. Amount of Line 14 taxable
at lineal rate X .045 13 4, 1 3 9. 9 0 16.
17. Amount of Line 14 taxable
at sibling rate X .12 17.
18. Amount of Line 14 taxable
at collateral rate X .15 18.
19. Tax Due ...................................................................................................................19.
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Decedent's Social Security Number
195 16 5390
136,395.00
136,395.00
1,884.00
371.10
2,255.10
134,139.90
134,139.90
6,036.30
6,036.30
Side 2
1505610243 1505610243
REV-1500 EX Page 3 File Number 21 - 1 O - 00714
Decedent's Complete Address:
Griscavage, Helen R.
STREET ADDRESS
10425 West Brookside Drive
CITY
Sun City
~ STATE
AZ
ZIP
85351
(1) 6,036.30
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments 5,250.00
B. Discount 276.32
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 2 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.
Make Check Payable to: REGISTER OF WILLS, AGENT.
(3) 0.00
(4)
(5) 509.98
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 :.................................................................................'~ 1, '~~,
- ,
b. retain the right to designate who shall use the property transferred or its income :.................................... ~, j x
c. retain a reversionary interest; or ................................................................................................................. ~I [I
d. receive the promise for life of either payments, benefits or care? ............................................................. ~', rx
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? .....................................................................................................................•-_' x
3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death?......... ' x_
4. Did decedent own an Individual Retirement Account, annuity, or other non-probate property which
contains a beneficiary designation? ...................................................................................................................:.. ~ X .,
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETUR
For dates of death on or after July 1, 1994 and before Jan. 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving
spouse is 3 percent [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 percent
(72 P.S. §9116 (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 21 ears 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 percent [72 P.S. §9116 (a) (y.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 percent, except as noted in
72 P.S. §9116 1.2) [72 P.S. §9116 (a) (1)].
Total Credits (A + B) (2) 5,526.32
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent [72 P.S. §9116 (a) (1.3) . A
sibling is defined under Section 9102, as an individual who has at least one parent in common with the decedent, whether by bloo~ or adoption.
SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Griscava e, HeIe11 R. FILE NUMBER
9 21 - 10 - 00714
All real property owned sole)y or as a tenant in common must be reported at fair market value. Fair market value is defined as the price
at which property would be exchanged between a willing buyer and a willing seller, neither being compelled to buy or sell, both having
reasonable knowledge of the relevant facts. Real property which is jointly-owned with right of survivorship must be disclosed on
schedule F.
Attach a copy of the settlement sheet if the property has been sold.
Include a copy of the deed showing decedent's interest if owned as tenant in common.
-- - _ __
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
1 1712 Sherwood Road, New Cumberland, Cumberland County, PA Parcel # 26-23-0543-186 136,395.00
(Assmnt 108250.00 x CLR 1.26)
-- _ - - -
TOTAL (Also enter on Line 1, Recapitulation) 136,395.00
S(~DULE H
FUI~RAL EXf~E7VSES &
COMMONWEALTH OF PENNSYLVANIA A~~ ~~~'-''~'p~
INHERITANCE TAX RETURN F11./IrR1~ 1 IW~ ('~('1~TQ
RESIDENT DECEDENT . w' , v-~, , - ` vvww ~~ vv
ESTATE OF Griscavage, Helen R.
Debts of decedent must be reported on Schedule I.
- --
ITEM
NUMBER !, FUNERAL EXPENSES: DESCRIPTION
A.
B.
1
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
2
3
City State Zip
Year(s) Commission paid
Attorney's Fees Kline Law Office
Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
4.
5.
6.
7.
1
Street Address
City State Zip
Relationship of Claimant to Decedent
Probate Fees Register of Wllls
Accountant's Fees
Tax Return Preparer's Fees
Other Administrative Costs ~',
Recorder Of Deeds
TOTAL (Also enter on line 9, Recapitulation)
1,500.00
318.50
65.50
1,884.00
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF Griscavage, Helen R.
SCHEDULEI
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
FILE NUMBER
21 -10-00714
Report debts incurred by the decedent prior to death that remained unpaid at the date of death, including unreimbursed medical expenses.
ITEM
NUMBER
1 HARP Health Care
DESCRIPTION
AMOUNT
371.10
- _ --- -
TOTAL (Also enter on Line 10, Recapitulation) 371.10
REV-1513 EX+111-08)
' SCHEDULE)
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Griscavage, Helen R.
NUMBER ~ NAME AND ADDRESS OF PERSON(S)
RECEIVING PROPERTY
I~ TAXABLE DISTRIBUTIONS(include outright spousal
distributions, and transfers
under Sec. 9116 (a) (1.2)]
FILE NUMBER
21 - 10 - 00714
RELATIONSHIP TO !~ SHARE OF ESTATE i AMOUNT OF ESTATE
DECEDENT (Words) ($$$)
Do Not List Trusteels)
I
1 Charlene Griffiths
10425 West Brookside Drive
~i Sun City, AZ 85351
Daughter
real estate
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet, as appropriate.
II. NON-TAXABLE DISTRIBUTIONS:
CIA. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
'I
~~
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 0.00
l - lG~ - ~~7i ~f
LAST WII.,L AND TESTAMENT
OF
HELEN R. GRISCAVAGE
I, HELEN R GRISCAVAGE of CUMBERLAND COUNTY, PENNSYLVANIA, being
of sound and disposing mind, memory and understanding, do make, publish and declare this to be
my Last Will and Testament, hereby revoking and making void all previous Wills and Codicils
heretofore made by me.
' FIRST
~`=~ I order and direct my personal representative hereinafter named to pay all of my just debts,
funeral expenses and expenses involved or connected with the administration of my estate as soon
_ after my death as is reasonably possible. However, my personal representative need not accelerate
and pay those unmatured obligations which, in his, her or its opinion, it might be proper and more
advantageous to retain or renew and pay as they become due and payable. If I do not own a burial
~. _.
plot or a grave marker at the time of my death, I authorize my personal representative, in his, her, or
its sole discretion, to purchase a burial plot and to erect a suitable mazker at my grave, and to
expend sums from my estate for this purpose.
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Page 1 of 5 ~ ~ ~ rn
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SECOND
I give, devise, and bequeath, the real property that I own at 1712 Sherwood Road, Borough
of New Cumberland, Cumberland County, Pennsylvania, together with all furnishings contained
therein at the time of my death, to my daughter, CHARLENE GRIFFITHS, providing that she
survives me by 60 (sixty) day. Should CHARLENE GRIFFITHS predecease me or die on or
before the sixtieth (60th) day following my death, then I give, devise, and bequeath the above
referenced real properly and furnishings to my granddaughter, MARY ANN THATCHER,
provided that she survive me by sixty (60) days.
THIRD
;~ I give, devise, and bequeath the rest, residue and remainder of my entire estate together
with all insurance proceeds hereon of whatever nature and wheresoever situate in equal shares to
my children, CHARLENE GRIFFITHS, EDWARD G. GRISCAVAGE, and MARY ELLEN
WENTWORTH, or their surviving issue, who survive me by sixty (60) days, per stirpes.
FOURTH
My Executor is authorized and empowered to exercise from time to time in his, her or its
sole discretion and without prior authority from any court, in respect of any property forming part of
my estate or otherwise in its possession hereunder all powers conferred bylaw upon executors and
the Testatrix intends that such powers can be construed in the broadest possible manner.
Page 2 of 5
FIFTH
I nominate, constitute and appoint, CHARLENE GRIFFITHS, Executrix of this my Last
Will and Testament. In the event CHARLENE GRIFFITHS is deceased, unable or unwilling to
serve or shall cease to serve for any reason whatsoever, then I nominate, constitute and appoint
EDWARD G. GRISCAVAGE, to serve instead. I direct that my personal representatives shall not
be required to give or post bond for the faithful performance of his, her or its duties in this or any
other jurisdiction.
IN WITNESS WHEREOF, I have
Testament this ~ Ga ~' day of _
rtness
fitness
set my hand to this my Last Will and
2000.
R. GRISCAVAGE
Page 3 of 5
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS
I, HELEN R GRISCAVAGE, the Testatrix whose name is signed to the attached or
foregoing instrument, having been duly qualified according to the law, do hereby acknowledge that
I signed and executed the instrument as my Last Will and Testament; that I signed it willingly, and
that I signed it as my free and voluntary act for the purposes therein expressed.
1
~r
..,
LEN R GRIS AGE
Sworn or affirmed and acknowledged before me by HELEN R GRISCAVAGE, the
Testatrix, this _ day of _ ~~a~, ~ , 2000.
NOTARY PUBLIC
NOTARIAL SEAL
ROBERT PETER KLINE, Notary Rublic
My Commis on Expires June 212004
Page 4 of 5
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS
We,~ -thiG~ ;~ p and ~~r2~~_ ~~ !4/iy-~ ,the
witnesses whose names are attached to the foregoing document, being duly qualified according to
the law, do depose and say that we were present and saw Testatrix sign and execute the instrument
as her Last Will and Testament; that she signed willingly and that she executed it as his free and
voluntary act for the purposes therein expressed; that each subscribing witness in the hearing and
sight of the testator signed the Last Will and Testament as witnesses and that to the best of our
knowledge the Testatrix was at the time 18 or more years of age, of sound mind and under no
constraint or undue influence.
l~~_ K .~-
-~-~' ~'~
woiiivr a 11 u73icd acid Jll'C7$(:I1bCd beIOre me by (! v w'~"h,%(/~ ~ ~ p~f~,~ and
f _- /~-~; r~~ this ~-}-~ day of ~P,~~b~, , 2000.
NOTARY PUBLIC
Page 5 of 5 NOTARIAL SEAL
ROBERT PETER KLINE, Notary Public
New Cumberland Boro., Cumberland Co.
My Commission Expires June 21, 2004
. R. ~
_l
10. 2'8888 ~ PENNA ~G15TERED sY'THB TH 15 INDENTURE, I
)EED $120.00 @QRDUGH Of NFW CUII$ERlAR9 MADE TIRE 26TH' DAY '
NPN INt~_ SE PT 26 .. 195.
N. p~ NINNEMAN,' INCORPORATED ~. TAX •~-~"'-"'~"' "" ""~"M• • OF SEPTEMBER IN THE i
TO I ~ ~ ~ ~ 9~T1~~3 B. P,~~L'~"R'AE' ~~;ry "" YEAR OF OUR.LORD ONE
t1NITED SATES THOUSAND NINE
EDWAf~O L. GR I SCAVAGE ET UX _ $13.20
~ INTERNA~,:IIEMENUE HUNDRED AND F 1 FTY-THREE `
CONS,•~11,990.00 NPN IMC
LOC. NEW CUMBEF~LAND ~ ~ D D PITARY ~ BETWEEN N. p. NI NNEMAN, INCORPORATED' i
~ 28 ~"" A CORPORATION URGANI'lED AND EXISTING UNDER ~
DATED-SEPTEMBER 26, 1953
ENTD. SEPT. 28, 1953 THE LAWS OF PENNSYLVMIIA, HAVING ITS PLACE OF BU51NE15~
TIME 3;20 PM SIN THE TOWNSNIP OF LOWER ALLEN, COUNTY OF CUM ['ERLAND ANO
_ 17~ STATE OF PENN'SYLVAN 1 A, PARTY OF THE F i RST PART, AND ~
-- ___ ____ _.__ _._ ____l______._.
,: .., i
' EDWARD L. GRISCAVAGE AND HELEN R. GRISCAVAGE,'HIS WIFE, OF THE BOROUGH OF NEW ~ I
CUMBERLAND, CUMBERLAND COUNTY, PENNSYLVANIA, PARTIES. OF THE SECOND PART,
WI'I'FIESSETH, THAT THE SAID PARTY bF THE FIRST PART FOR AND IN CONSIDERATION OF THE SUM
~dF ELEVEN THOUSANO'NINE HUNDRED NINETY DOLLARS >~11 990.00) LAWFUL MONEY OF THE UNITED
STATES ~F AMERICA, UNTO IT~WELL ANb TRULY PAID BY THE'SAID PARTIES OF•THE B~ECOND PART AT +~~
ANDS ~~fORE THE SEALING ANb DELIVERY OF THESE PRESENTS, THE ~REC~~I PT WHEREOF t15 HEREBY
~ACKNO~ILEDGEO, HA§ GRANTED, BARGAINED, SOLD, ALIENED, ENFEOFFEO, RELEASED AND 'CONFIRMEb,
MID BY THESE PRESENTS DOES GRANT, BARGAIN, SELL, ALIEN, ENFEOFF, RELEASE ANO CONFIRM UNTO
i L 1 ,
~THE~ SAID~PARTIES OF THE SECOND PART, THEIR HEIRS ANO A#351GN5, -
~ ~
~ ALL THAT CERTAIN LOT OF LAND SITUATE IN THE BOROUGH OF NEW CUMBERLAND, COUNTY OF
CUMBERLAND ANO STATE OF PENNSYLVANIA, BOUNDED AND DESCRIBED A5 FOLLOWS;
BEGINNING AT A POINT ON THE WESTERLY LINE OF SHERWOOD ROAD 5.EVEN HUNDRED 5;IXTY-FOUR
ANO SIXTY-ONE ONE-HUNDREDTHS (>~"~'64.61) FEET MEASURED WESTMIAROLY AND NORTH~-ARDLY ALONG
SHERJr00D ROAD FROM THE SOUTHWEST CORNER OFI THE SOUTHERLY t~ITER5ECT{O.N.OF SH~RW000 ROAD AND
}
LOCUST STREET; THENCE S~;UTHWESTWARDLY'ALONG THE NORTHERLY LINE OF .LOT NO, 14,. BLOCK "A" -0NE
UNORED T1rENTY (120) FEET TO A POINT ON THE MIGHT-OF-WAY LINE OF THE STATE HIGHWAY FOCALLY
NOWN AS THE YORK BALTIMORE EXPRESSWAY; THENCE ALONG SAID HIGHWAY NORTHWESTWARDLY,THIRTY-
I NE AND 5EVE1+tTY-TWO ONE -HUNDREDTHS (3 9,72) FEET TO A PO I NT', THE NCE CONTINUING ALONG SA I D
IGHWAY IN A NORTHERLY DIRECTION FIFTY-ONE AND NINErTENTHS (51.9) FEET TO A~POINT; THENCE
ORTHEASTWARDLY ALONG THE SOUTHERLY LINE OF LOT N0~ 16, BLOCK "A" ONE HUNDRED TWENTY (120)
EET TO A POINT; THENCE ALONG THE WESTERLY LINE OF 5HERYYOOD~ROAD'SOUTHEASTWARDLY AT RIGHT
NGLES THIRTY-TWO AND FIFTY-NINE ONE-HUNDREDTHS (32.59) FEET TO A POINT; THENCE SOUTH- ~~.
~ASTWARDLY ALONG SA10 LINE OF SHERWOOD ROAD TWENTY AND FORTY-ONE ~ONE~FIUNDREOTHS (20.41) I
~EET TO A POINT, THE PLACE OF BEGINNING.
BEING LOT N0. 15, BLOCK "A" ON THE PLAN OF LOTS OF HIGHLAND PARK EXTENSION; SAID '
PLAN BEING RECORDED IN THE CUMBERLAND COUNTY RECORDER'S OFFICE IN PLAN BOOK 9, PAGE 59.
HAVING THEREON ERECTED A SINGLE DWELLING HOUSE N0. 1712 SHERWOOD ROAD, NEW' CUMBERLAND,
NNSYLVANIA, i ;
BEING A PORTION OF' THE PReMISES WHICH ELMER E. ZIMMERMAN BY GEED DATED APR1~ 1, 1953.,: i
D RECORDED IN THE CUMBERLAND COUNTY RECORDER'S OFFICE IN DEED BOOK "F", VOL. 15, PAGE
25, GRANTED AND CONVEYED UNTO N, P. NINNEMAN, INC., GRANTOR HEREIN..,- i ~' 1
UNDER AND SUBJECT TO EASEMENT FOR HIGHWAY SLOPE PURPOSES ALONG THE REAR BOUNDARY ,OF j
_,.
HE LOT HEREIN DESCRIBED A5 SHOWN ON 5A1D PLAN ~ ~-- ' -'
TOGETHER WITH ALL AND"SINGULAR THE WAYS, WATERS, WATER-COURSES ~ ~ "'~
RIVILEGES, HEREOITAMENTS ANO APP~IRTENANCES MHATSOEVER THEREUNTO BELONGIHTS, LIBERTIES,
PPERTAINING, AND THE REVERSIONS AND ~• OR-IN ANY WISE
REMAINDERS, RENTS, ISSUES ANp pRpFITS THEREOF; ANO_ALL
HE ESTATE, RIGHT, T'`ITLE,'INT~REST, PROPERTY, CIA IM AND OEIIAANO WHATSOEVER, OF PARTY OF THE
IRST PART IN LAW, EQUITY OR IdTHERINISE HOWSOEVER OF rIN ~ j ~`
s , ANO TO THE ' ~ . ; a ,.~~ I
HEREOF, _ ~ii11E AND EVER1i pA
,i:~
TO WAVE ANO TO HOi,D THE' SAID HEREIN DESCRIBED HE REDITAWENtb ANO PREMISES H
!GRANTED OR AiENT10NE0 AND INTENDED 50 TO BE., WITH THE. APPURTENAN.CES_, UNTOe,THE $AED PARTaE$'--'
~OF, TI$ SECpNp pp~ ~ TI{ I R HEIRS AND ASSIGNS, TO AND FOR THE ONLY PROPER USE AND 00
THE RAID; PARTLES OF 'THE secoruo PARE, THEIR HEIRS AND ASSIGNS p ~~ , F OF~;~,
~ F REVER.
AMO 'THE SAID (?ARTY OF ,THE F I R3T PART' DOES BY THESE PRESENTS, COVENANT, GRANT- ANO :',, J '
AGREE TO AND WITH THE SAID p~(RTIES OF THE SECOND PART, THEIR HEIRS ANO ASSIGNS, THAT IT :•
THE-8AIO PARTY OF ThE FIRST PART ALL ANO SINGULAR~THE HEREDITAMENT5 AND PREMISES..HE.REIN.r
ABOVE DESCRIBED ANO GRANTED, FOR AE,NTIONEQ AND INTENDEt~ SO TO BE, WITH THE. APPURTENANC 5,~,`,
,TO THE 8AID~PART1£S OF THE,$ECONO PART T1•IEIR HEIRS AND ASSIGNS ~ ,~ ~~•
,AGAINST IT THE SAID _
ARTY OF THE (FIRST PARTigNp AGAINST ALL AND EVERY PERSON OR PERSONS, WHOMSOEVER (AWFULLY, -'
CALMING. OR TO CLAIM THE ,trAME pR pNy pq~ THEREOF, SHALL NANO WILL WARRANT ANO FOREVER
EFEND~
.: ~ I ~
AND THE SAID PARTY OF THE FIRST PART DOTH HEREBY CON5T~~yjTE AND_APPOINT N. p - t i~
. _....__..__ I
4~i)
NINNEMAN~ TO BE' iT8 ATTORNEY,' FOR IT"AND IN ITS NAME, AND AS AND FOR ITS CORPORATE::ACT ~~'I
•AND OEEO TO ACKNOWLEDGE TH 15' 1 NDENTURE BEFORE ANY PER';ON HAV I NG ~ AUTHOR I TY °BY > THE L,/N3 OF
COMMONWEALTH OF~PENNSYLVANIA TO~T~ICE•SUCH ACKNOWLEDGMENT, TO THE INTENT THAT THE ~8AME~MAY
BE DUIsY ~ REC~OROED, l ~ ~ I ~ i : ,
•~_~N,•1MITNESS WHEREOF, TF1E SAID N.: P,.•NINMEMAN~ INCORPORATED HAS_HEREUNTO, C.AUSEO ITS
CORPARATE;`SEAL•TO.BE AFFIXED AND.ATTEST~D THIS 26TH, QAY OF SEPTEMBER A, p. ONE THOUS~IWO,.
NINE HONORED AND FIFTY-THREE N. P. NINNE~IAN', INCORPORATED '
9ft AlE!? AND b~ L I VE RED ~ i _ •
IN THE PRESENCE OF U5: BY N. P, NINNEMAN ~ PRESIDENT' I
• CO~p9AATI0N' ATTE$T: ~ ' I
• .SERE NAOMI 5 . N I NNEMAN SECRETARY
STATE OF PENNSYLVANIA, ~g;
C01'JNTX r dF' DAUPHIN G ~ ~ , ,
• 1 NEkE~`F CERTIFY, TI•IAT ON Tw15 6TH DAY OF SEPTEMBER IN THE YEAR OF OUR CO#iD'ONE `' ~''
THOUSAND NINE HUNDREO• AND FIFTY -THREE• ~FbRE ME , THE t3UBSCR~ BER, A • NOTARY PUBLIC, '
RE$IDIN6 IN THE 000NTY OF DAUF~iIN PERSONALLY APPEARED N.'•p~ NItINEMANTME"ATTORNEY NAMED
THE FOREGOING INDENTURE, ,AND BY'VIRTUE AND SIN PURSUANCE OF THE AUTHORITY THERELN'CONFERRE
UPON-HiM~ ACKNOWLEDGED THE SAID INDENTURE TO BE THE-ACT AND DEED•OF'THE S'A"IO N; P~
N.I NNEMAN ,. INCORPORATED ~ ~ ~ ~ ,
WITNESS MY HAND AND NOTARIAL SEAL THE OAY AND YE~AR~ AFORESAID.' +,
' +
' ` ° ' ' HARRY L. BOWERS I
~~~!'~` NOTARY PUBLIC ~ •
~•~ ~ IS510N"EXPIRES MARCH 15, i957= r < <!'`
THE AnDRESS tOF-tiFiE WITHIN-NAMED GRANTEE IS' 1712 3HERWOOD ROAD, NEW°CUMBERLANO,'rpA,''+"
I THOMAS I . MYER5' ~
ON BEHALF; OF THE GRANTEE;.; - ,: ,; . ~ ; "
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ROBERT P. KLINE, ESQ.
Glenda Farner Strasbaugh, Register of Wills
Cumberland County Courthouse
One Courthouse Square, Room 102
Carlisle, PA 17013
Dear Glenda:
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September 13, 2010 ~O O i3.?'-~
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Re: Estate of Helen R. Griscavage
No. 2010-00714
Enclosed with this letter you will find an original and two copies of an Inheritance
Tax Return in regard to the above referenced estate, together with a check in the amount
of $15.00 for the filing fee and a check payable to you as Agent for the Department of
Revenue in the amount of $509.98, representing the balance of the tax due. Kindly file
the original document and return atime-stamped copy, as well as a receipt, to my office
in the enclosed postage paid envelope at your earliest opportunity.
Thank you for your assistance in this matter.
RPK/srf
Enclosures
cc: Charlene Griffiths
ery trul yours,
.._-
Robert P. Kline, Esquire
714 Bridge Street
P.O. Box 461
New Cumberland, PA 17070
(717) 770-2540
(717) 243-5940
Fax (717) 770-2553
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