The URL can be used to link to this page

Home My WebLink About95-0322I~ This is to certify that the certificate hereunto attached is a true and accurate copy of the original death record on file with the Division of Vital Records, and that Frank Yeropoli, whose name is subscribed thereto, was at the time of subscribing the same and now is Director, Division of Vital Records of the Department of Health, for the Commonwealth of Pennsylvania, duly appointed and commissioned as directed by Act 66 of the General Assembly, approved 29 June 1953, P.L. 304. Auc 1 s- 200 Date H,OS.ta3 Rw.?IB7 7YIaElrRNrT N PERIIAMEIIT euac.xc O ,~ p Fran eropoli, ' ect Division of Vital Records P.O. Box 1528 New Castle, PA 16103 COMMONWEALTH OF PENNSYLIMNIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH u3fi$8 NAME OF DECEDENT IF+eL Mldsa, uq SDB[RIE NIIMaFR - _ _ ,. Wayne Harold Green ~" soclAL SECURrtr "w DATE OF DERNIMOAh, yr, =male ~ 181 _ 6587 ,April 22,995 M]E(Lap t]Hnd.y, uN0B11 YEM UIIDEA,ox DREGFawrIl er,rIlF,AC'a pQyarr vuc[a DERNPLYwAONIans-ew+aareau•aeeaw eron X41 Ma.rN Dn. Igor. ~ MYrMaa lMmn.t3~,y.q SYarFOraglCpnayl _ YR ~ ept .27,195 T Carlisle, Pa. Inp.drA ^ ERg1I~MMr ^ DGA ^ ,~ ^ ~, , ^ ~rroFOERII DIn:BORarwraFDERN NAMEdnr:ewNOn.waor.ramr.Aneen VNBDECEOENTOFHSMNICDRgW7 RACE•Amrba t~ Wa ^ rw..wwae.n. Isp.o~~~ ~. aMdc wlw..Ie Cumberland Nex Cumberland 1019 Drexel Hills Blvd. MtwivgP•eR•Rkarr,ra. White a~ gqlal~apIOn~ ~~~S~~g~ K wD,.ES ~FORCES7~ OECFDENf'S EDUCRION MNRPLSWUI.Mrh! t4 9UMNNID SPDWE dertq]Nr aonqur naiad.) Na.rMrdad. wtao..a, B•M V.•mndann.nlN Realtor , Real E=state 1z "'^ "°® ,~~ c,~, ~ ne~YjO~°ried D[emENraMAU~oADOREasas-«.c.~,+*onn.sr..mcaex DEC~oENrs +a wa ,x.^ w.a.c.dNaialr~ 1019 Drexel Hills Blvd, nESloe+cE 'T`g` a. ,,.,,.,^ +•o. New Cumberland Pa. ~~ """' w . °"ia°" Cumberland DoT ~~«~•~ ~~ ,>7. „~ „],,,,,,,a,,,~r New Cumberland aymon~:"~reen ev"~erl~y`~'.'"ran ing ",F°~:~`~e `nnf~~G~een "~~'~"`~~$°~165~$';~';"`~f~ington D.C. 20007 . METHDDOFDMFOMION yy oFasFOSInON IaACEDFDISP061TgN-Nrn.dC.rngr%CIrIrNY LOCRIDN.CMWbw431rwLOCaO. rlrlfa•~S Ranr D•n N•0 11 ^ .a 1m91aM • roar FNw Derlelbn^ OYrI~Yp ^ ]~wpril 24, 1995 rcon-o-late Crematory 4chaefferstoxn, Pa. 17088 ~ ~~~~~ L u s~~an`~unral Home Inc.324Hummel Ave Lemoyne . , BaaNZlra aryMwtorr,aq Ilrerr aa' ply.r~r,rrw aellWNrirwaeaw„o aw r~atroa+.ep.,a.rn oonnadr nairn.dra.nagaw ala,.LL LICENSE NUMBER DRESIGNED erer,tyu.aaa.a. (MO~n.Dev.,aen Baar~nartwmrrplrw p, OFOEaN REFERRED Ip MEDICAL ENMSNER/CDRONEp, paraangW paroanna e.re. DOE DEAD SearAh•Dry, ~darl wASCABE A TART I E a ~ . : rr rdWraa,i{IeN.r oampkAenr WatA UUad tlw darh. DO rrol annrlM modad rrlt laataor liel orYrracalramaadt Ina. nrOM+bYanw.al for M•n hilwa IApplm'~Y M1Rf ~: WwY7YIk+MaanrhlrmnMMYgtldrY40u1 B]Y®IATECADSE (F.r jarr•I ar,a d.rh ed r••~Wletlr ~IB•r/•Y.a•bRNTI. 6rearcerwYkn I A1rYlp n fl.~r) -y i DUE (ORASA OUENCE GFY Yarr„NadlnpbYraadir. o t TO (DR ASACONSEDUENCE OFk I raaw. Efer UMDeLLYBq ~ CAIIEI IDiaaaear+yvy ~ i --! r ,~J,rgmdegrl LAfT DVE Ipi ASACCNSEDUENCE OFk I n PINS AN AUIDPSY WERE MfIDISy FMIDSKiS MANNER OF DERV DATE OF WARY TIME OF WURY WURYRWORKT DEBCWBE IIOWINAWYOCCURRED. F'ERPoRMED7 AMEABLE PII1011 W (Lb.n. D•Y,,aarl COI/LETpN OFCAUSE Nallar ® ^ Ilorrlicida ACEMra ^ Pryry Yn.etfpatlGrr ^ 1e. ^ No^ IIpp Wa ^ No l^1 1La ^ No ^ 9WCka ^ CdeandWd.Wmiwd ^ M' FIACE OF WURY • N home hart wsel Iadry 0111G . , . , LOCRION IStreer. CN/tel. Slm•1 2aa. 2,, Euad..G ma lSp®tY) C6RIPIEl11C1N J<orrl' on•) ~• ]0f. 'WITMYi N1 PHYSICIAN(Phyec.an ur41Y+4 ~au~ddral ,.Iw.ar.o+w onysr haspman+cae0wn ua compNeo Item 231 ~ TRLE OF ER m w e.q q my a••kdB•. Maeraeeurrad dw r erewaary, aM manne ,q d r r. . ............................... ^ '~qMG AND CBRTMYMG-NYSICIAN (l+hyeinan bath yarrourryq dwn andrwuyr.p ro ws d deae,l NUMBER DRE SIG IMOret D,y, yen •rY An••A•dM daaM ettlerad gtlN lr» d r e h , , . , an p t:., anb dw,e,M ewWal rld mam.rn •Wd .......................... , ~ ]1d . NAME AND ADDRESS DF VEASON W/q COMPLETED CAU OF 'IEDICAL EILAWNER/CORONER (Item 27f Typo r Print SO~ On Mle saa4 q e]a.M ,b ~ Z na n .,r O, MQ n andlor ImaglpaDOn, In my opinion, daatl, oeeumd at Hta,Mra, dq., and gaee, and dw w vie ew !L' rR.nrwruggw ........................ a•la~ara i - ~ ~ ~ ^ h m.. ......................................................... e. s .e, f1e~ ~ e-~-~a/t . i'V ~SvA 8S0 ............... a. REGI 'SSgNRVRE AND NU 1 ~ DATE FlIED fMOM. paY YMn ~. ~~~~i~~ REV:]SOP Ei: r (T•94) 1, COM~IONWEAITH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 17126-0601 INHERITANCE a~?: l~ETURN FOR DATES OF DEATH AFTER14f31/9l CHECI;r}fF~` POVERTY CREDIT IS CLAIMED ^ RE$IDtNT DEfrEGENT FILE NUMBER -'- (TO BE flLED !M. Di~QLlCATE aI~~S-~3aa `^~'- , WITH REGISTEk OF WILLS] ,____ ~=~~~.%. rn~ ss.irv Anne (DECEDENT'S NAME (LAST, fIRST, AND IAIDDIE INITIAL) - T_ tZ E E N v~1 A~ N E i-~ . v . (SOCIAL SECURITY NUM ER DATE Of DEATH DATE Of BIRTH L 18~- 3L~- Co 587 o~i~-95 0°-?7-~3 G, ~l~f A.nic,.uy SuswhNO srousE's NAME pAiT, ANG s,ioaE wrruy SOCIAL SECURITY NUMtlt:R. ~ ~ ~ 1. Original Return Y ~"-`N w~~ ^ 4. Limited l:ztate s°~ ~ ~ m ®b. Decedent Died Testate _ ~ (Attach copy of Will) IOIc~ "DRE>CEt_ f-}1~L5 F3L_~}~, IJEVJ CuMSCRL~Np~ P/~ 1%'rJ~' my Gt~MeERL.ANp ^ 2. Supplemental Return ^ 4a. Future Interest Compramise (for dates of death.ofter 1'.-12-82) ^ 7. Decedent Maintained a Living Trust (Attach copy of Trust) uy', W NAME ~o ~, ~ENNIS C-~(1-EEN EXECt~,~R va TELEPHONE NUMBER t ~~ (I "'1l 8 - 3dZ0 ^ 3. Remainder Return (for dotes of death prior to 12-13-8i ^ 5. Federal E:tots Tax Return Required ~8. Total Number of Safe Depozit Boxes ~O V.)1SGON5f~) /~V1=-, ~SJITE 2S g><TN ESDA , MD,,. z0 g (~{ z 0 5 ~- o. a v W nc z 0 n. 0 a r 1. Real Estate (Schedule A) (1) ~~ Q ~ ~ (~ Q ~ O17 2. Stocks and Bonds (Schedule B) (2) _ - j.1 GiJ k. 3. Closely Held StodJPartnership Interest (Schedule C) (3) ;*; C9 tJ E 4. Mortgages and Notes Receivable (Schedule D) (4) _ N 0 N G 5. Cash, Bank Deposits b Miscellaneous Personal Property (Schedule E) (5) _ _ ) ~ . ~ ~ (. 3 ~ „~"'~ b. Jointly Owned Property (Schedule F) (b) N D N E / , 7. Transfers (Schedule G) (Schedule L) (7) N OtJ ~ 11. Total Deductions (total lines 9 $ 10) 12. Net Value of Estate (Line 8 minus Line 11) 13. Charimbls and Governmental Bequests (Schedule J) 14. Net Value Subject to Tax (Line 12 minus Lins 13) I5. Spousal Transfers (for dates of death ft 6 30 94 8. Total Gross Assets (total Lines 1-7) ).fl) ~ ~'1 8 f ~ ~ •3 Z 9. Fu.:erai ExpPenses, Administrative Costs, Miscellaneous (9) 3 , 12 ~. , O (p / Expenses(Schsduls H)• q 10. Debts, Mortgage liabilities, liens (Schedule I) (10) _~ ~~ ~ ~ 1 (1 1) Q 5 .:Z.~ Jr (12) ~9 f `I 5.7 5 (13) !J ON~ tt41 _ ~~ . boy 5 . ~TS a er - See Instructions for Applicable Percentage on Reverse (15) N f/~ x .__ Side. (Indude values from Schedule K or Schedule M.) 16. Amount of Line 14 taxable at 696 rate (16) ~ 9 7 ~o ~ , 83 x~ ~ ~ 18 ~ g3 (Include values from Schedule K or Schedule M.) Q 17. Amount of Line 14 taxable et 1596 rote (17) _ ~ S ~ ( ~ ~ X~ I t y ~2 ~1 C~ (Include values from Schedule K or Schedule M.) „{~;y"- d 18, Principal tax due (Add tax from lines 15, 16 and 17.) 19. Credits Spousal Poverty Credit Prior Payments Discount~s`'~'~ Interest + ~ OI + 135,91 __~fR 20. If Line 19 is greater than Lins 18, enter the difference on Line 20. This is the OVERPAYMENT. 21. If Line 18 is greater than Lins 19, enter the difference on line 21. This is the TAX DUF. A. Enter the interest on the balance due on line 21A. B. Enter the total of Line 21 and 2)A on Line 216. This is the BALANCE DUE. Make Check Payable to: Register of Wills, Agent ~naer penalties of perjury, I declare that I have examined this return, it is true, correct and complete. 1 dedare that all real estate has been based on all information of which preparer has env knowledae_ ~~ fi~aH (19) . (20) , 3 0 (21) (21 A) (21 B) accompanying schedules and statements, and to the best of my knowledge and belie at true market value. Declaration of preparer other than the personal representative DATE . ~~W/~~'cors:;, Ae~ Ste .?Sv J2 z7 9~ ~Ca /Lt'~ ZO.9~y DATE Act #48 of 1994 provides for the reduction of the tax rates imposed. on the net value of transfers tc+`7hf'~ls the use of the spouse. The rates as prescribed by the statute will be: • 3% (.03) will be applicable for estates of decedents dying on or after 7/1/94 and before 7/i~9F ' ' • 2% (.02) will be applicable for estates or decedents dying on or after 1/1/96 and before 1/1/9% ' • 1% (.01) will be applicable for estate: of decedents dying on or after 1/1/97 and before 111/9g • Spousal transfers occurring on or after 1/1/98 will be exempt from inheritance tax. PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACIRlG A CHECK F/IARK (,~ j IN THE APPROPRIfi~ITE: BLOCKS. YES NO 1. Did decedent make a transfer and: a. retain the use or income of the property transferred, .... ...........................:........... X b. retain the right to designate who shall use the property transferred or its income, ............... X c. retain a reversionaryt interest; or ................................................................................... X d. receive the promise for life of either payments, benefits or care$ ........................:.. X 2. tf death occurred on or before December 12, 1982, did decedent within two years preceding death transfer property without receiving adequate considerations If death occurred after December 12, 19Fs2 did decedent transfer property within one year of death without recerv ni g a equate consi eration$ ...................................................................... X 3. Did decedent own an 'in trust for'. bank account at his or her death .................. ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN. REV-1502 EX+ (12-85) COMMONWEALTH Of PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTA SCHEDULE A REAL ESTATE ~-`- ` ` l N ~- ~~ . ~~"\ KEt= N rLCe NUMBER ~~11 ~ 2.195322 (Property jointly-owned with Right of Survivors!siya must be disclosed on Schedule F) All real estate should bs reported at'fair mark which is defined ds 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. ITEM NUMBER DESCRIPTION VALUE AT DATE OF DEATH '. SINGLE ~AMtLY DWELLING i tO,OOa. r,v -Located at 1019 Drexel Hills Boulevard, . New Cumberland, PA 17055 - Value based on Actual Sale of Property, approximately ~ months after death of decedent (i.e., 06/16/95) -Value Reflects: Contract Sales Price = $110,000.00 ti _ TOTAL (Also enter on line 1 Recapitulation) $ j \ O p O C~ c.~0 ~ REK1308 EX+ (2-67) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DKEDENT tJIATE OF WA~PNE I-~ . Gr~~~l~ (Ali property jointly-owned with the Righf of Survivorship must be disclosed on schedule F) ITEM NUMBER DESCRIPTION Please Print or Type =1LE NUMBER watt ~ 219 53 2Z ---- VALUE AT DATE OF DEATH 1 2 3 4 5 6 7 Mellon Bank Acct. # 252-109-3977 (Adjusted by subsequent automatic deductions ~ account fees until close-out in Sept. 1995) Mellon Bank Acct. # 1036-01621 (Balance at date of death) Household Goods & Furnishings (Value based on yard. sales 6/95) Office Furnishings (Sold to associate of decedent) Automobile: 1989 Cadillac [Sold 6/95J (l~itle # 41398807402 GR) Automobile: 1979 Chevrolet Van [Sold 6/95J (Title # 32305802002 GR) Monies due to Decedent: - SeweNTrash Refund - Mortgage Settlement Refund - Insurance Refund - NASE - Insurance Refund -State Auto - Insurance Refund - Goodville Mutual Casualty TOTAL TOTAL (Also enter on line 5, Recapi (Attach odditional 8S4" x Il" sheets ii more space is needed.) SCHEDULE E CASH, BANK DEPOSITS AND MISCELLANEOUS PERSONAL PROPERTY $73.69 $6,416.44 $1,185.93 $50.00 $6,450.00 $50.00 $62.31 $12.00 $204.95 $277.00 $109.00 $14, 891.32 s 1~-f , 841 ' REV•ISII EX• (7.881 COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE H FUNERAL EXPENSES, ADMINISTRATIVE COSTS AND MISCELLANEOUS EXPENSES W A`I NE 1~ , C~2E=.EN ITEM DESCRIPTION NUMBER Please Print or T FILE NUMBER L~~11 # ~l9 532Z AMOUNT A Funeral Expenses• B C 1. Pastor - B.R. Rose; Memorial Service 2. Musselmar~ Funeral Home, Inc. 3. Memorial Service Furnishings/Food Administrative Costs 1. Personal Represenative Commissions (paid 1996) For Personal Rep., R. Dennis Green; SSN 181-38-1629 2. Attorney Fees (Andes, Vaughn & Bangs) 3. Family Exemption nla 4. Probate Fees - Register of Wills - Cumberland Law Journal - Patriot News Co. (for Executor Notice) Miscellaneous Expenses n/a Y TOTAL $100.00 ~, $1,462.00 $180.00 $500.00 $721.50 $78.00 $40.00 $44.56 $3,126.06 ~v~r{~ iHlso enter on line 9, Recapitulation) I $ 3 f 12~ ~ ~~ (If more space is needed, insert additional sheets of same size.) ~' ' REK1314 EX+ (t•93~ COMMONWEAUH Of YENNSYlVAN1A INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES AND LIENS ~r W ~~ N E {-1 _ ~~. 2E E IJ Please Print or Type FILE NUMBER Walt ~ ~.1~ 53ZZ. ITEM NUMBER DESCRIPTION A i Mortgage Liabilities 1. First Mortgage Loan -Mellon Bank, N.A. (for property: 1019 Drexel Hills Blvd., New Cumberland) i -Value reflects payoff at time of house sale 6/16/95 ~ 2. Second Mortgage against above property -Also paid off at time of house sale 6/16/95 B I Debts/Liabilities of Decedent 1. Property Sale Expenses I (Per settlement sheet, 6/16/95) I -Include expenses such as : City tax thru 12/95; ~ school tax thru 6/95; "settlement charges" & other ~ 2. Property Sale Expenses -Additional, to Real Estate Agent 3. Auto. Insurance Premium (for coverage thru sale date) 4. Home Insurance Premium (for coverage until sale) ~ 5. MasterCard Acct (Final Payoff) 6. Sears Charge Acct (Final Payoff) 7. Executor Bond (State Farm) 8. Phone Expenses (at Decedent Residence) 9. Utilities (at Decedent Residence) j 10. Other House Expenses (thru sale date) 11. Medical Bills (not covered by insurance) TOTAL TOTAL (Also enter on line 10, Recapitulation) (If more spoce is needed,. insert additional sheets of same size.) AMOUNT $58, .70 $20,782.0 $7,810.49 $210.00 $295.65 $294.00 $98.73 $215.90 $75.00 $122.92 $773.43 $117.44 $2,424.21 $92,119.51 59~.,Ii~1,51 REV.151J EXr 12-67) SCHEDULE .~ COMMONWEALTH OF PENNSYLVANIA B E N E F I C IA R T E INHERRANCE TAX RETURN S RESIDENT DKEDENT 3 w~ir~c yr VI~A`~NE --~ . C1~EEN ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY A. Taxable Bequests: 1 BEVERLY B. GREEN 4406 Island Drive North Topsail Beach, NC 28460 i 2 ' RAYMOND H. GREEN 5335 61st Avenue S. St. Petersburg, FL 33715 3 ~ R. Dennis Green [Executor] j ~Jo Han & Associates I+ 7200 Wisconsin Avenue, Suite 250 ~ Bethesda, MD 20814 ti FILE NUMBER '1,.1 ~Il ~ 214 53 zZ RELATIONSHIP ,,,;4MOUNT OR Mother 33 1/3 Father 33 1 /3 Brother 33 1/3 ITEM NUMBER NAME AND ADDRESS OF BENEFICIARY B. Charitable and Governmental Bequests: 1. IJoNG TOTAL CHARITABLE AND GOVERNMENTAL BEQUESTS (Also enter on line 13, Recapitulation) (If more space is needed, insert additional sheets of some size) AMOUNT OR SHARE OF ESTATE S Register of Wills of CUMBERLAND County, Pennsylvania Certificate of Grant of Letters Testamentary No. 1995-00322 PA No. 2195-0322 E5i'ATE OF GREEN WAYNE H , , Late of NEW CUMBERLAND BOROUGH Deceased Social Security No. 181-38-6587 .WHEREAS, on the 28th day of April 1995 an instrument dated April 3rd 1995 was .admitted to probate as .the last will of(GREEN WAYNE H late of NEW CUMBERLAND BOROUGH , CUMBERLAND County, who died on the 22nd day of April 1995 and, WHEREAS, a true copy of the will as probated is annexed hereto. THEREFORE, I, MARY C. LEWIS , Register of Wills in and for the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify that I have this day granted .Letters TESTAMENTARY to R DENNIS GREEN who has duly qualified as Execztor(rix) and has agreed to administer the estate according to law,. all of which fully appears of record ,in my Office at CUMBERLAND COUNTY COURT HOUSE, CARLISLE, PENNSYLVANIA.- IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal. of my Office the 28th day of April 1995. gl e o i **NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE) WILL OF HAYNE H. GREEN ' I, WAYNE H. GRBEN, of ahe Borough of New Cumberland, Cumberland County, Pennsylvania, declare this to be my last will and revoke any will previously made by R ITEM .I. I direct that all my just debts and funeral. expenses, including my gravemarker and .all expenses of my last illness, and .any and all taxes and .assessments imposed by any governmental body as a result of my death, whether on property passing ~ under this will or otherwise, shall be paid from:my residuary estate as soon as practi ( cable after my decease .as a, part of the expense of the administration of my estate. Ii ITEM II.' I give_and bequeath all of my household goods, automobiles,• jewelry, an ~jall other. articles of household and II personal use,., equipment and ornament, together wit 'all insurance thereon and relating thereto, in equal shares to those oft following I, ' ~Ipersons xho survive my.death by thirty (30) days:. m mother ~ y EVERL . ~ GREEN, of :~ ~~North Topsail Beach, North Carolina; my father, 0 GREEN, of St. Petersburq,< {; ~ (Florida; and my brother, R. DENNIS GREEN, of ashington, D.C. l~ `: ITEM III. I~give, devise, and bequeath all the rest, residue,, and remainder of m ~, ;'possessions and estate of every nature and wherever situate in equal shares. to those o ';the following persons who survive my death by thirty (30) days: my mother, BEVERLY B. ~GREFN, of-North Topsail Beach, North Carolina; my father, RAYMOND H. GREEN, of Wit. :Petersburg, Florida; and my brother, R. DENNIS GREEN, of Washington, D.C. ~r ITEM IV. I appoint~tny brother, R. DENNIS GREEN executor of this my last will. `'~~ Should my said brother predecease me or otherwise fail to qualify or cease to serve as executor of this my last will, I appoint my sister-in-law, HAE R. HAN, of Washington, D.C., executrix of this my last will. - i i~ ~ 1 .. ITEH Y. In addition to the other powers-and authorities granted to mg personal representatives by Pennsylvania-law and by the other terms-and ..provisions of this will, I hereby give to my personal representatives the following powers and authorities effective without court approval and until actual distribution of all~propertys to Ilcompromise any claim or controversy; to make distribution~in cash or in kind; or party 'in cash and partly in kind, and in such manner as my personal representatives may (determine and at valuations finall to i Y be fixed by them, to invest in all forms of (property, including any stock or other securities in any corporate fiducia*y or its ~isuccessor without restriction to investments authorized for Pennsylvania fiduciaries, I~as m ': li y personal representatives deem proper,~without regard to any principle of. risk or ijdiversification; to retain any or all assets of my estate, real or personal, without Ilregard to any principle of risk or diversification; to sell at public .or private sale, ~~ j'to exchange, or~to lease for any period of time, any real or personal property and to ~~ jgive.options for`"sales, exchanges,. or leases, for such prices and upon such terms or ,~ ffconditions as my personal representatives deem proper; and to allocate receipts and expenses to principal or income or partly to each as my personal representatives deem I~ lproper in their sole discretion. ~; ITEH VI. I direct that my personal representatives and fiduciaries shall not be ~requiTed to give bond for the faithful performance of their duties in any jurisdiction. '.~ IN WITNESS WHEREOF, I have hereunto set my hand and seal this. .3 ~1! day of /-~-rOQ;t... 1995. :; WA . E H. GRBEN t: _~ ,~ .. ~'.:.~ The preceding instrument, consisting of this and two other t Ypewritten.pages, eacl identified by the signature of the testator was on1~the.date thereof signed,,published, and declared by WAYNB H. BEEN, the testator therein named, as and for his last :will, in the presence of us, who at his request, in his presence, and in the presence of eacl other, have subscribed our names as witnesses hereto. ~~ -I !I ~I z V II 'I • 1i .~ i i " .. (' 1 .; .:. ` 3 (COMMONWEALTH OF PENNSYLVANIA ) ( SS.: COUNTY OF CUMBERLAND ) The. undersigned, being the testator whose name is signed to the attached or foregoing instrument, having been duly qualified according to law, does hereby acknowledge that I signed and executed the foregoing instrument as my last will, that signed it willingly; and that I signed it as my free and voluntary act for the purpose therein expressed. 1rSworn~ar affirmed to and acknowledged ~before•.me'"•by the to ator named above (this ~ day of ~ 1995. i ~"d ~ 1 .~ i~Notary P . NOTARIAL SEAL i WENDY S. BLAIR, hutzry Public i Lemoyne Baro, Cumbsriand County, Pa. My Commission Expires i1Aay 6, 1995 `COMXiONWEALT OF,~PENNSYLVANIA ) ~' ( SS.: (COUNTY OP CUMBERLAND ) ~~~ WAYNE H. GREEN ~~ WE, GEORGE A. VAUGHN, III, and J. BART DeLONE, the witnesses whose names are ~~sign~ed to the attached or foregoing instrument, being duly qualified according to law, ado.depose and say that we were present and saw the testator sign and execute the instrument as his last will; that he signed it willingly and that he executed it as hi ,~fre~ and voluntary act for the purposes therein expressed;-that each of us in the j!hearing and sight of the testator signed the will.as witnesses; and that to the best o ;:.'our knowledge, the testator was at that time 18 or more ;and under no constraint or undue influence. Years of age, of sound mind, BUREAU OF INDIVIDUAL TAXES INHERITANCE TAX DIVISION DEPT. 280601 HARRISBURG, PA 17128-0601 R DENNIS GREEN STE 250 7200 WISCONSIN AVE BETHESDA MD 20814 DATE 05-12-97 ESTATE OF GREEN WAYNE H DATE OF DEATH 04-22-95 FILE NUMBER 21 95-0322 COUNTY CUMBERLAND ACN 101 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 POR_TION_ FOR YOUR RECORDS ~ ---------------------------------------------- --------------------- REV-1547 EX AFP (03-97) NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX ESTATE OF GREEN WAYNE H FILE N0. 21 95-0322 ACN 101 DATE 05-12-97 TAX RETURN WAS: (X) ACCEPTED AS FILED ( l CHANGED RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN 1. Real Estate (Schedule A) (1) 110.000 00 NOTE: To i 2. Stocks and Bonds (Schedule B) . nsure proper (2) .00 credit to your account 3. Closely Held Stock/Partnership Interest (Schedule C) (3l 00 , 4. Mortgages/Notes Receivable (Schedule Dl . submit the upper portion 5. Cash/Bank Deposits/Misc. Personal Property (Schedule E) (4l (5) .00 14 891 32 of this form with your t 6. Jointly Owned Property (Schedule F) (6) . . .00 ax payment, 7. Transfers (Schedule G) (7) .00 B. Total Assts (g) 124,891.32 APPROVED DEDUCTIONS AND EXEMPTIONS: 9. Funeral Expanses/Adm. Costs/Misc. Expenses (Schedule H) (9) 3,1 26.06 10. Debts/Mortgage Liabilities/Liens (Schedule I) (lOL 92.119 51 11. Total Deductions 12 t (11l -_ 95. 4~ 57 . Ne Value of Tax Return 29 645 75 13. Charitable/Governmental Bequests (Schedule J) (1P1 (1 , . 00 14. Nst Value of Estate Subject to Tax 3) . (14) 29,645.75 NOTE: If an assessment was issued previously, lines reflect figures that incl d t 14, 15 andior 16, 17 and 18 will u e he total of ALL ASSESSMENT OF TAX: returns assessed to date. 15. Amount of Line 14 at Spousal rate (15) . 00 X .00= . 00 16. Amount of Lina 14 taxable at Lineal/Class A rata (16) 19,763.83 X .06. 1 185 83 17. Amount of Lina 14 taxable at Collateral/Class B rate (17) 9,881 .92 X .15. . 1,482 29 18. Principal Tax Due . TAX CR (18) 2,668.12 EDITS: nAVMENT RECEIPT DISCOUNT (+) DATE NUMBER INTEREST/PEN PAID (-) AMOUNT PAID 06-20-95 AA047903 133.41 4,601.51 TOTAL TAX CREDIT 4,734.92 BALANCE OF TAX DUE 2,066.80CR INTEREST AND PEN. .00 TOTAL DUE 2,066.80CR COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE NOTICE OF INHERITANCE TAX APPRAISEMENT, ALLOWANCE OR DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX * IF PAID AFTER DATE INDICATED, SEE REVERSE FOR CALCULATION OF ADDITIONAL INTEREST ( IF TOTAL DUE IS LESS THAN S1, NO PAYMENT IS REQUIRED. . IF TOTAL DUE IS REFLECTED AS A ••CREDIT•• [CR), YOU MAY BE DUE d pFF~INn CFF OFUGDCF CTnC nC TLITC C/\DN CAD TIC TDI II`T T/\-IC \