HomeMy WebLinkAbout08-10-11 (2)---~ REV-1500Ex`01-10) 1505610143
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Individual Taxes DEPARTMENT Of REVENUE
Po Box.2sosoi INHERITANCE TAX RETURN 21 1 1 0 5 6 6
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
09 03 2010 12 20 1937
Decedent's Last Name Suffix Decedent's First Name MI
GREGORY C E
(If Applicable) Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
GREGORY ARLENE F
Spouse's Social Security Number
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 ^ qa. Future Interest Compromise ^ 5. Federal Estate Tax Return Required
(date of death after 12-12-82)
® 8 Decedent Died Testate
(Attach Copy of WII) ^ ~ Decedent Maintained a Living Trust
(Attach Copy of Trust) 8. Total Number of Safe Deposit Boxes
^ 9. Litigation Proceeds Received ^ 1 °. Spousal Poverty Credit (date of death
^ 11, Election to tax under Sec. 9113(A)
between 12-31-91 and 1-1-95) (Attach Sch. O)
CORRESPONDENT -THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
PATRICIA C ZUCKER ESQ 717 724 9821
First line of address
1035 MUMMA RD STE 101
Second line of address
City or Post Office State ZIP Code
WORMLEYSBURG PA 17043
10~ormleysburg, PA 17043
Correspondent's a-mail address: pZUCkereU dZmmglaW.COm
-,-r
_;
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief,
it Is true, correct and complete. Declaration of preparer other than the personal representatroe Is based on all information of which preparer has anv knowledge.
Patricia C Zucker Esq
1035 Mumma Rd.,
REGISTER 0~1NILLS USE ONLY
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Side 1
1505610
143 J
2121 ~uglas Drive, Car~le~A 17013 i
1505610243
REV-1500 EX
Decedent's Social Security Number
oe~eaer,~'s Name: G R E G O R Y C E D W A R D
__ _
RECAPITULATION _ _ -
----
1. Real Estate (Schedule A) ................................................................................. .... 1. 2 5 3, 9 0 0 0 0
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. 1 , 0 4 9 9 9
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. 2 5 4, 9 4 9. 9 9
9. Funeral Expenses ~ Administrative Costs (Schedule H) ................................... ... 9. 9 . 8 8 7 0 0
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) ........................... .... 10.
11. Total Deductions (total Lines 9 & 10) ............................................................... ... 11. 9 , 8 8 7 0 0
12. Net Value of Estate (Line 8 minus Line 11) ....................................................... .... 12. 2 4 5 , 0 6 2 9 9
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. 2 4 5 , 0 6 2 9 9
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 .o0 2 4 4, 013.0 0 15. 0 0 0
16. Amount of Line 14 taxable
at lineal rate x .045 1, 0 4 9. 9 9 16. 4 7. 2 5
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. 4 7 2 5
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT.
Side 2
1505610243 1505610243
REV-1500 EX Page 3 File Number 21 - 1 1 - 0566
Decedent's Complete Address:
Gregory, C Edward
,STREET ADDRESS
2121 Douglas Drive
CITY
Carlisle
STATE ZIP
PA 17013
Tax Payments and Credits:
1. Tax Due (Page 2, Line 19)
2. Credits/Payments
A. Prior Payments
B. Discount
3. Interest
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is theOVERPAYMENT
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 theTAX DUE.
Total Credits (A + B)
(1) 47.25
(2> 0.00
(3) 0.26
(4)
(5) 47.51
Make Check Payable to: REGISTER OF WILLS, AGENT.
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred :............................................................................. i__ x
-~
b. retain the right to designate who shall use the property transferred or its income :................................ x
°-
-_
c. retain a reversionary interest; or ............................................................................................................ x
~~-
d. receive the promise for life of either payments, benefits or care? ..............................................._.......... x
L.
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without
receiving adequate consideration? ................................................................................................................. _ x ~i
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 )].
• 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 blood'or adoption.
SCHEDULE A
COMMONWEALTH OF PENNSYLVANIA REAL ESTATE
INHERITANCE TAX RETURN ~..
RESIDENT DECEDENT
___ ___
FILE NUMBER
ESTATE OF Gregory, C Edward 21 - 11 - 0566
__ _ _ __
- -- _ - ---
All real property owned sole)y or as a tenant in common must be reported at fair market valu~air market value is defined as the price
at which property would be exchanged between a willing buyer and a willing seller, neither bein compelled to buy or sell, both having
reasonable knowledge of the relevant facts.Real property which is jointly-owned with right o~ 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 Real Estate located at 2121 Douglas Drive, Carlisle, North Middleton Township, Cumberland 253,900.00
County, Pennsylvania titled in decedant's name and transferred to spouse on May 11, 2011
(see copy of Deed transfer attached)
__.
TOTAL (Also enter on Line 1, Recapitulation) 253,900.00
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
COMMONWEALTH OF PENNSYLVANIA PCGG~ONA1 P~OPEpTv
INHERITANCE TAX RETURN GR~7 /1L R I
RESIDENT DECEDENT
FILE NUMBER
ESTATE OF Gregory, C Edward 21 - 11 - 0566
__ __,__
Include the proceeds of litigation and the date the proceeds were received by the estate411 property jointly-owned with the right of
survivorship must be disclosed on schedule F.
__
__ ----
ITEM DESCRIPTION VALUE AT DATE OF
NUMBER DEATH
_. ---
1 Hunting rifles and Taurus Judge handgun 1,049.99
TOTAL (Also enter on Line 5, Recapitulation) I 1,049.99
SCHEDULE H
COMMONWEALTH OF PENNSYLVANIA ~~~ /w ~..1 ~
INHERITANCE TAX RETURN A1'1A AIANC~Tp/~TI~/L ~nt+TC '..
RESIDENT DECEDENT F1LArll~rh7 ~ IW ~ ~YG \IW ~ ~7
_. _ __ __
ESTATE OF Gregory, C Edward FILE NUMBER
21 - 11 - 0566
__ _ _!
--
Debts of decedent must be reported on Schedule I.
ITEM __ __ __ __ _-
NUMBER ', FUNERAL EXPENSES: DESCRIPTION AMOUNT
- _ _ -_
A• 1 Cummings Funeral Service, Inc., 320 John Street, Clayton, NY 13624 8,130.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
Year(s) Commission paid
2. Attorney's Fees Daley Zucker Meilton Miner & Gingrich, LLC, legal
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 Register of Wills of Cumberland County
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
1 .The Paxton-Herald, advertise Estate Notice
1,257.50
376.50
48.00
- __
TOTAL (Also enter on line 9, Recapitulation) 9,887.00
Schedule H
Funeral E~er>ses &
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN /QC~11inIS'h'rtiVe Costs continued
RESIDENT DECEDENT
ESTATE OF Gregory, C Edward
- - _- - - _-
2 'Cumberland Law Journal, advertise Estate Notice
FILE NUMBER
21 - 11 - 0566
-- _ _-
75.00 ---
Page 2 of Schedule H
REV-1513 EX+ (11-08)
SCHEDULE J
COMMONWEALTH OF PENNSYLVANIA BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
__.
__
- _ _ _
ESTATE OF Gregory, C Edward FILE NUMBER
21 - 11 - 0566
i RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER NAME AND ADDRESS OF PERSON(S) DECEDENT I (Words) ($$$)
RECEIVING PROPERTY Do Not List Trustee(s)
j __ __ __ _ ___ _ - __ --_ __
___ _-
I, TAXABLE DISTRIBUTIONS[include outright spousal
distributions, and transfers
under Sec. 9116 (a) (1.2)]
1 Arlene F. Gregory Wife 100%
2121 Douglas Drive
Carlisle, PA 17013
2 Brian A. Gregory Son 1,049.99
149 Cedar Street
Carlisle, Pa 17013
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet, as appropriate.
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEEII 0.00
LAST WILL
OF
C. EDWARD GREGORY
I, C. Edward Gregory, now domiciled. in Cumberland County,
Pennsylvania, declare this to be my Last Will. I revoke all other
wills and codicils that I may have previously made.
Article I
My just debts and expenses of my last illness, funeral, and
administration of my estate shall be paid by my Executor from the
principal of my residuary estate as soon as practicable after my
death.
Article II
All inheritance, estate, and succession taxes (including
interest and penalties thereon, but not including any generation
skipping tax) payable by reason of my death shall be paid out of
and be charged generally against the principal of my residuary
estate without reimbursement from any person. This provision is
not a waiver of any right which my Executor has to claim
reimbursement for any such taxes which become payable as the result
of any property over which I have the power of appointment.
Page One of Five
Article III
I give, devise, and bequeath, all my property, real, personal,
and mixed, to my beloved wife, Arlene F. Gregory, provided she
survives me by thirty (30) days. If my wife fails to survive me by
thirty (30) days, I give, devise, and bequeath any real estate that
I may own to my two beloved children, Brian A. Gregory and M. Karen
Lickle. Any guns that I own at the time of death I give, devise,
and bequeath to my son, Brian A. Gregory.
All the rest, residue and remainder of my estate, real,
personal and mixed, I give, devise, and bequeath in equal shres to
Brian A. Gregory, M. Karen Lickle, Kimberly M. Dailey, Michele R.
Gibb and Melissa M. McCurdy, provided they survive me by thirty
(30) days.
In the event that any beneficiary fails to survive me by
thirty (30) days, his or her interest shall be paid to his or her
living children. In the event that any beneficiary who fails to
survive me by thirty ( 30 ) days does not have living children his or
her interest in my estate shall be paid to my remaining living
beneficiaries.
Article IV
In addition to the powers conferred by law, I authorize my
Executor, in his absolute discretion:
Page Two of Five
(a) to retain in the form received and to sell either at
public or private sale, any real estate or personal property except
that which I specifically bequeath herein,
(b) to manage real estate,
(c) to invest and reinvest in all forms of property without
being confined to legal investments, and without regard to the
principal of diversification,
(d) to exercise any option or right arising from the
ownership of investments,
(e) to compromise claims without court approval and without
consent of any beneficiary,
(f) to file any federal income tax return for any year for
which I have not filed such return prior to my death,
(g) to make distributions in cash or in kind, or in both, and
to determine the value of any such property,
(h) to employ any attorney, investment advisor, or other
agent deemed necessary by my Executor; and to pay from my estate
reasonable compensation for all their services, and
(i) to conduct along with or with others, any business in
which I am engaged in or have an interest in at the time of my
death.
Page Three of Five
Article V
I nominate, constitute, and appoint Arlene F. Gregory
Executrix of my Last Will and Testament. In the event of her
renunciation, death, resignation, or inability to act for any
reason whatsoever as my Executrix, I nominate, constitute, and
appoint M. Karen Lickle to act as my Executrix. I hereby relieve
my Executrix, whether original, substitute., or successor, from the
necessity of posting security in connection with her duties as such
in any jurisdiction in which she may be called upon to act so far
as I am able by law to do so. My Executrix shall receive
reasonable compensation for services rendered to my estate.
IN WITNESS WHEREOF, I, C. Edward Gregory, hereby set my hand
to this my Last Will, on this -~ 7 day of C~-r~~ 19 %_~
at Harrisburg, Pennsylvania.
C. Edward Gregory,; es ator
In our presence, the above-named Testator signed this and
declared this to be his Last Will and now at his request, in his
presence, and in the presence of each other, we sign as witnesses.
_cI
/fir
~e FouL ~~ r lve
I, C. Edward Gregory, Testator, who signed the foregoing
instrument, having been duly qualified according to law,
acknowledge that I signed and executed this instrument as my Will,
and that I signed it willingly as my free and voluntary act for the
purposes therein expressed.
Sworn to or affirmed and
acknowledged before me by
C. Edward Grego~y, the Testator,
this ~ day,
of _ 194).
NOTARIAL SEAL C . Edward Gregory, Te to r
PATRICIA A. PATTON. Notary Public
Lamer Pax~r~~,,Q., ~~~ ed witnesses who signed the foregoing
M omfnission x Tres une
instrument, being duly qualified according to law, depose and say
that we were present and saw the Testator sign and execute this
instrument as his Will; that he signed and executed it willingly as
his free and voluntary act for the purposes therein expressed; that
each of us in his sight and hearing signed the Will as witnesses,
and that to the best of our knowledge, that he was at that time
eighteen (18) years or more of age, of sound mind, and under no
constraint or undue influence.
Sworn to or affirmed and
subs r' e,~ t - befc e e
by ~~~~ ~ (. ~~~ ~~t. (la //~,.
and ~
witne ses t '.s ` ~/
da//y/'~~~of1 ~ - ,~ /19 ~f ) .
NOTARIAL SEAL
PATRICIA A. PATTON, Notary Public age Five of Five
Lower Paxton Twp., Dauphin Co.
PA Commission Expires June 20, 199II
13~~
DEED
THIS INDENTLRE made this J ~~'day of ~ p
IIBI~i~IN
Parcel No. 29-15-1249-007
201 ~
BETWEEN ARLENE F. GREGORY, Executrix of the ESTATE OF C. EDWARD
GREGORY, of Carlisle, Cumberland County, Pennsylvania,
(hereinafter called the Grantor), of the one part and
Pennsylvania,
ARLENE F. GREGORY, widow, of Carlisle, Cumberland County,
(hereinafter called the Grantee), of the other part,
WITNESSETH That in consideration of the sum of ONE DOLLAR and NO/ 100 ($1.00), in
hand paid, the receipt whereof is hereby acknowledged, the said Grantor does hereby grant and
convey unto the said Grantee, her heirs and assigns,
ALL THAT CERTAIN tract of land with the improvements thereon erected situate
in North Middleton Township, Cumberland County, Pennsylvania, bounded and
described as follows:
BEING Lot 14 on the Plan of Creek View Heights, as recorded in the office of the
Recorder of Deeds in and for Cumberland County in Plan Book 22, Page 152;
containing 90 feet along the West along Douglas Drive; containing 238.91 feet
along the North along Lot No. 15 on said Plan; containing 1=12.60 feet along the
East along the Conodoguinet Creek; and containing 28.59 feet along tree South
along Lot No. 13 on said Plan.
SUBJECT to a 20 foot sanitary sewer easement.
BEING improved with a two story residential dwelling and two car garage known
and numbered as 2121 Douglas Drive, Carlisle, Pennsylvania 17013.
SUBJECT, nevertheless, to the Building and Use Restrictions, as recorded in the
office aforesaid in Miscellaneous Record Book 197, Page 1050.
BEING the same premises which Loraine D. Gregory by her deed dated August 4,
1992 and recorded August 7, 1992 in the Office of the Recorder of Deeds in and
for Cumberland County in Deed Book U35, Page 1155, released any marital claim
that she may have had to the subject real estate.
WHEREAS, C. Edward Gregory departed this life on September 3, 2010, leaving a
Last Will dated October 27, 1995, which Last Will was probated in the Office of
the Register of Wills in and for Cumberland County, Pennsylvania on May 11,
2011, by which Arlene F. Gregory, widow of C. Edward Gregory, was appointed
Executrix.
14_N.J the said CTr~ntnr does .:;hereby. covenant tc? and with the said Grantee that she, the said
Grantor, SHALL AND WILL specially Warrant and forever Defend the herein above described
premises, with the hereditaments and appurtenances, unto the said Grantee and assigns, against
the said Grantor and against every other person lawfully claiming or who shall hereafter claim
the same or any part thereof, by, from or under or any of them.
IN WITNESS WHEREOF, the said Grantor has caused these presents to be duly executed, the
day and year first above written.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF DAiJPHIN
>< ~G ,
Arlene F. Gregory, Executrix of e
Estate of C. Edward Gregory
ss:
On this, the ll~'day of i'~ Q y , 201 I before me, Susan M. Hudson, the
undersigned officer, personally appeared Arlene F. Gregory, Executrix of the Estate of C.
Edward Gregory, known to me (or satisfactorily proven) to be the person whose name is
subscribed to the within instrument and acknowledged that she executed the same for the
purpose therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and seal.
N~TgR1Al SEAL ~~~ ,n ~ ~ - ~~~~,,~,,~~1 al~~ / % ; _
SUSkN M rUl)SON NOTARY PUBLIC --:~ ~ '~
Notary PuDhc _ f_
i.OWER PAXTON TWP, DAUPHIN CNTY - -~
INy Commission Expires Oct 12, 2014
,r..
4
.: ~-~, .
I hereby certify that the precise address of the Grantee herein is:
2121 Douglas Drive
Carlisle, P.A 17013
ROBERT P. ZIEGLER
RECORDER OF DEEDS
CUMBERLAND COUNTY
1 COURTHOUSE SQUARE
CARLISLE, PA 17013
717-240-6370
Instrument Number - 201113872
Recorded On 5/13/2011 At 10:56:02 AM
* Instrument Type -DEED
Invoice Number - 86854 User ID - MSW
* Grantor - GREGORY, C EDWARD
* Grantee -GREGORY, ARLENE F
* Customer - DALEY ZUCKER MEILTON
* FEES
STATE WRIT TAX $0.50
STATE JCS/ACCESS TO $23.50
JUSTICE
RECORDING FEES - $12.50
RECORDER OF DEEDS
PARCEL CERTIFICATION $10.00
FEES
AFFORDABLE HOUSING $11.50
COUNTY ARCHIVES FEE $2.00
ROD ARCHIVES FEE $3.00
CARLISLE AREA SCHOOL $0.00
DISTRICT
NORTH MIDDLETON TOWNSHIP $0.00
TOTAL PAID $63.00
* Total Pages - 5
Certification Page
DO NOT DETACH
This page is now part
of this legal document.
I Certify this to be recorded
in Cumberland County PA
~ c~ C°'~e
.~ F ,D
o= 9~z
° ~ ° RECORDER O
r~so
* -Information denoted by an asterisk may change during
the veriTication process and may not be reflected on this page.
umii~n~~uum
REV-183 EX (oq-io)
~ - pennsylvania
c~'~. DEPARTMENT OF REVENUE
Bureau of Individual Taxes
PO BOX z8o6o3
Harrisburg, PA 1~iz8-o6o3
REALTY TRANSFER TAX RECI
State Tax Paid
STATEMENT OF VALUE Book Number
See reverse for instructions.
Nage Number
uaTe rcecoroed
Complete each section and file in duplicate with Recorder of Deeds when (1) the full value/consideration is not set forth in the deed, (2) the
deed is without consideration or by gift, or (3) a tax exemption is claimed. A Statement of Value is not required if the transfer is wholly exempt
from tax based on family relationship or public utility easement. If more space is needed, attach additional sheets.
A. CORRESPONDENT -All inquiries may be directed to the following person•
Name Telephone Number:
Patricia Carey Zucker, Esq. 717-724-9821
Mailing Address City State ZIP Code
1035 Mumma Road, Suite 101 Wormleysburg PA 17043
B. TRANSFER DATA C. Date of Acceptance of Document
~rancorls~/~essorlsl Arlene F . Gregory, Exec . Grantee(s)/Lessee(s)
of the Est. ofd C. Edward Gregory Arlene F. Gregory
Mailing Address Mailing Address
2121 Douglas Drive 2121 Dou las Drive
City
Carlisle
State
PA
ZIP Code
17013 _
City
Carlisle _
State ZIP Code
~ PA 17043
D. REAL ESTATE LOCATION -
Street Address City, Township, Borough
2121 Douglas Drive Carlisle, North Middleton Township
County School District Tax Parcel Number
Cumberland Carlisle Area School 29-15-1249-007
E. VALUATION DATA -WAS TRANSACTION PART OF AN ASSIGNMENT OR RELOCATION? ^ Y ^ N
1. Actual Cash Consideration 2. Other Consideration 3. Total Consideration
$1.00 -{- $0 - $1.00
4. County Assessed Value 5. Common Level Ratio Factor 6, Fair Market Value
$253,900 X 1.00 = 253 900
F. EXEMPTION DATA
la. Amount of Exem lion Claimed lb. Percents e of Grantor's Interest in Real Estate lc. Percentage of Grantor's Interest Conveyed
p 9
1008 1000 ~nn~
Check Appropriate Box Below for Exemption Claimed.
® Will or intestate succession. C _ Edward ,r ~r 2 01 1 -0 0 5 6 6
(Name of ecedent) (Estate'File Number)
^ Transfer to a trust. (Attach complete copy of trust agreement identifying all beneficiaries,)
^ Transfer from a trust. Date of transfer into the trust
If trust was amended attach a copy of original and amen e trust. - ------ -------
^ Transfer between principal and agent/straw party. (Attach complete copy of agency/straw party agreement.)
^ Transfers to the commonwealth, the U,S, and instrumentalities by gift, dedication, condemnation or in lieu of con-
demnation. (If condemnation or in lieu of condemnation, attach copy of resolution.)
^ Transfer from mortgagor to a holder of a mortgage in default. (Attach copy of mortgage and note/assignment.)
^ Corrective or confirmatory deed. (Attach complete copy of the deed to be corrected or confirmed.)
^ Statutory corporate consolidation, merger or division. (Attach copy of articles.)
^ Other (Please explain exemption claimed.)
Under penalties of law, I declare that I have examined this statement, including accompanying information, and to
the best knowledge and belief, it is true, correct and complete.
Si ure of C on nt e Party i Date
~~~ ~~
URE TO COMPLET H S FORM PROPERLY OR ATTACH REQUESTED DOCUMENTATION MAY R ULT IN
THE RECORDER'S REF S TO RECORD THE DEED.
ER'S USE ONLY
RECEIPT FOR PAYMENT
GLENDA FARNER STRASBAUGH
Cumberland County - Register Of Wills
One Courthouse Square
Carlisle, PA 17613
GREGORY C EDWARD
* DUPLICATE
Receipt Date: 5/11/2011
Receipt Time: 12:28:50
Receipt No.: 1065581
Estate File Nc.: 2011-00566
Paid By Remarks: ARLENE GREGORY
CJ
------------------- ----- Receipt Distribution ----- -------
Fee/Tax Descripl=ion Payment Amount Payee Name
FETITION LTRS TEST 260.00 CUMBERLAND COUNTY GENERAL FU
WILL
SHORT CERTIFICATE x.5.00
3.00 CUMBERLAND
CUMBERLAND COUNTY
COUNTY GENERAL
GENERAL FU
FU
JCS FEE
AUTOMATION FEE 23.50
5
00 BUREAU OF RECEIPTS & CNTR M.
.
----- CUMBERLAND COUNTY GENERAL FU
Check## 2504 -----------
$311.50
Total Received..... .... $311.50
THE P~XT~N HERALD
rn. onno~ H.~b • ~oia ~.i o.:.., wa.~,w~ a. rn is • smash
Fax
(717) 657-3523 East Shore
Office & Plant - (PO Box 6310) 101 Lincoln Street (717) 545-9540
Harrisburg, PA 17112 (717) 545-8762
PROOF OF P BLI ATION
STATE OF PENNSYLVANIA
COUNTY OF DAUPHIN
Before me, the subscriber, a Notary Public in and for the said County,
personally came Lisa M. Carnes who, being duly sworn, doth depose
and say that she is CLERK of THE PAXTON HERALD, a
newspaper of general circulation published in Harrisburg, Pennsylvania;
That THE PAXTON HERALD was established on the 28th day of
June, 1960, and has been published continuously since that date;
That the advertisement, of which a copy is attached hereto, was
published in the advertising columns of THE PAXTON HERALD in
all respects as ordered in the issue(s) of ~j-/ ~, ~J'~S ~,T- f ,~ ()(~ ,
Affiant finrther deposes that she is not interested in the subject matter of
the aforesaid notice or advertisement, and that the allegations in the
foregoing statement as to the time, place and character of publication
are true.
f J--
( ature of the Affiant)
Sworn and subscribed before me this day of
~~ / ~ /
A.D.
ESTATE NOTICE-
NOTICE IS HEREBY. GIVEN
that letters testamentary or of
administration have been
granted in the following Es-
tate. All persons indebted to
the said Estate are.required to
make payment, and those hav
ing cal ims ,or -demands to
present the-same without.
delay to the administrators, ex-
ecutors,-or their attorneys
named below...... ;
ESTATE OF C. Edward
Gregory, late of North Middle-
ton'TTownship, Cumberland
County, PA. Died: September
3, 2010.- Executrix: rlene_ F:
Gregory. Attorney
Patricia Ca Zucker, Esquire
DALEY ZUCKER MEILTON
MINER & GINGRICH, LLC
1035 Mumma Road, Suite 10T
Wormleysburg, Pennsylvania
17043
5-18, 5-25, 6-1
NOTARIAL SEA±
DAVID ~.1. GOLDSTEIIV, Natarr Pu~fic
City of Harrisburg, Dsuph;n County
My Commission Expires May 26, 2014
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16, 1929), P. L.1784
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ss.
Lisa Marie Coyne, Esquire, Editor of the Cumberland Law Journal, of the County and
State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland Law
Journal, a legal periodical published in the Borough of Carlisle in the County and State aforesaid,
was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Journal on the following dates,
May 27 June 3 and June 10 2011
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time, place and character of publication are true.
\ ~~
vt- ~--_
Li~a M rie Coyne, Editor
SWORN TO AND SUBSCRIBED before me this
10_ of June. 2011
Notary
Gregory, C. Edward, deed.
Late of North Middleton Town-
ship.
Executrix: Arlene F. Gregory.
Attorneys: Patricia Carey Zucker,
Esquire, Daley Zucker Meilton
Miner ~ Gingrich, LLC, 1035
Mumma Road, Suite 101, Worm-
leysburg, PA 17043.
DEBORAH A COLLINS
Notary Public
CARLISLE BOROUGH, CUMBERLAND COUNTY
My Commission Expires Apr 28, 2014