HomeMy WebLinkAbout03-14-13 (2) 1505610140
REV-1500 EX (01-10)
OFFICIAL USE ONLY
PA Department of Revenue
Bureau of Individual Taxes County Code Year File Number
PO BOX 280601 INHERITANCE TAX RETURN 2 1 1 2 1 2 0 4
Harrisburg,PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
0 9 3 0 2 0 1 2 1 0 2 8 1 9 2 6
Decedent's Last Name Suffix Decedent's First Name MI
G R A Y R I C H A R D R
(If Applicable)Enter Surviving Spouse's Information Below
Spouse's Last Name Suffix Spouse's First Name MI
Spouse's Social Security Number
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
0 1.Original Return 2.Supplemental Return 3.Remainder Return(date of death
prior to 12-13-82)
4.Limited Estate 4a.Future Interest Compromise(date of 5.Federal Estate Tax Return Required
death after 12-12-82)
OX 6.Decedent Died Testate 7.Decedent Maintained a Living Trust 0 8.Total Number of Safe Deposit Boxes
(Attach Copy of Will) (Attach Copy of Trust)
9.Litigation Proceeds Received [J 10.Spousal Poverty Credit(date of death 0 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 TA"FORMATION!§iOULD§J DpfCTED TO:
Name Dayti=Wphone umberM �
H U B E R T X - G I L R 0 Y 7 Na 4 �
4 1
WtdA_rWOF WnS UitiOPWY
?> C> `
First line of address C> ---I
C
1 0 E A S T H I G H S T R E E T. ca err M
Second line of address ,�>
City or Post Office State ZIP Code DATE FILED
C A R L I S L E P A 17 0 1 3
Correspondent's e-mail address: HGILROYAMARTSONLAW.COM
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,co ect and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATUR F PE ON RES IBLE FOR FILI TURN DATE
1
ADDRESS
716 HA D 0 RT CHAMBERSBURG PA 17201
SIG E 29� ER THAN REPRESENTATIVE ATE
T
ADDRESS
10 EAST HIG STREET CARLISLE PA 17013
PLEASE USE ORIGINAL FORM ONLY
Side 1
1505610140 1505610140
Continuation of REV-1500 Inheritance Tax Return Resident Decedent
RICHARD R.GRAY 21 12 1204
Decedent's Name Page 1 File Number
Correspondents
Name Daytime Telephone Number
First line of address
Second line of address
City or Post Office State ZIP Code
Correspondent's e-mail address:
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 representative is based on all information of which preparer has any knowledge.
SIGNW OEX ON ESP SIBLE FOR FILIN TURN DATE
ADDRESS
704 GREEN ACRES STREET MECHANICSBURG PA 17055
J 1505610240
REV-1500 EX Decedent's Social Security Number
Decedent's Name: RICHARD R - GRAY
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 and Notes Receivable(Schedule D) ..... . ........... ..... ... . 4. •
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).. ..... 5. 2 4 2 3 6 5 . 4 2
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested .... . .. 6. 4 2 8 0 2 . 5 4
7. Inter-Vivos Transfers&Miscellaneous N n-Probate Property
(Schedule G) b Separate Billing Requested .... . .. 7. 5 1 5 1 5 0 . 3 3
8. Total Gross Assets(total Lines 1 through 7) .... ....... .. .. ....... .... . 8. 8 0 0 3 1 8 . 2 9
9. Funeral Expenses and Administrative Costs(Schedule H) ............... ... 9• 4 6 8 5 9 . 5 0
10. Debts of Decedent,Mortgage Liabilities,and Liens Schedule I 10. 6 8 8 9 . 1 1
11. Total Deductions(total Lines 9 and 10) ... ... .. ....... .. ...... . ..... .. 11. 5 3 7 4 8 . 6 1
12. Net Value of Estate(Line 8 minus Line 11) .. ... .. ........... .... . . ... . 12. 7 4 6 5 6 9 . 6 8
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. 7 4 6 5 6 9 . 6 8
TAX CALCULATION-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.0 0 . 0 0 15. 0 . 0 0
16. Amount of Line 14 taxable
at lineal rate X.045 7 4 6 5 6 9 . 6 8 16. 3 3 5 9 5 . 6 4
17. Amount of Line 14 taxable
at sibling rate X.12 0 0 0 17. 0 . 0 0
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 0 0 18. 0 . 0 0
19. TAX DUE .... .... . .. ... .. . .. ..... . ... . .... . ............ . .... . .. 19. 3 3 5 9 5 • 6 4
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑
Side 2
1505610240 1505610240
NEW
REV-1500 EX Page 3 File Number
Decedent's Complete Address: 21 12 1204
DECEDENT'S NAME
RICHARD R.GRAY
STREET ADDRESS
704 GREEN ACRES STREET
CITY STATE ZIP
MECHANICSBURG PA 17055
Tax Payments and Credits:
1. Tax Due(Page 2,Line 19) (1) 33,595.64
2. Credits/Payments 25,000.00
A.Prior Payments
B.Discount 1,315.75
Total Credits(A+B) (2) 26,315.75
3. Interest
(3)
4. If Line 2 is greater than Line 1+Line 3,enter the difference.This is the OVERPAYMENT.
Fill in oval on Page 2,Line 20 to request a refund. (4) 0.00
5. If Line 1+Line 3 is greater than Line 2,enter the difference.This is the TAX DUE. (5) 7,279.89
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; ...................................................................... ❑ Q
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? ....................................................... ❑ Q
2. If death occurred after December 12,1982,did decedent transfer property within one year of death
without receiving adequate consideration? ....................................................................................... R ❑
3. Did decedent own an'in trust for"or payable-upon-death bank account or security at his or her death? ......... ❑ 0
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 RETURN.
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 i;
3 percent[72 P.S.§9116(a)(1.1)(i)].
For dates of death on or after Jan. 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 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 percent[72 P.S.§9116(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 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.
REV-1508 EX+(08-12)
pennsylvania SCHEDULE E
DEPARTMENT OF REVENUE CASH, BANK DEPOSITS & MISC.
INHERITANCE TAX RETURN
RESIDENT DECEDENT PERSONAL PROPERTY
ESTATE OF: FILE NUMBER:
RICHARD R.GRAY 21 12 1204
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly owned with right of survivorship must be disclosed on Schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Sovereign Bank,checking account no. 1681704285($122,999.62+$3.36 accrued interest) 123,002.98
See attached valuation.
2. Sovereign Bank,CD account no. 1685543678($4,000.21 +$1.15 accrued interest) 4,001.36
See attached valuation.
3. Sovereign Bank,CD account no. 1685554246($100,429.90+$82.89 accrued interest) 100,512.79
See attached valuation.
4. PNC Bank,checking account no. 50-7007-9909($13,832.40+$0.04 accrued interest) 13,832.44
See attached valuation.
5. Nationwide Insurance-refund of homeowner's insurance 246.00
6. Simply Thick-refund 121.81
7. Holy Spirit Hospital-refund 118.00
8. Miscellaneous cash receipt 530.04
TOTAL(Also enter on Line 5,Recapitulation) $ 242 365.42
If more space is needed,use additional sheets of paper of the same size.
REV-1509 EX+(01-10)
pennsylvania SCHEDULE F
DEPARTMENT OF REVENUE JOINTLY-OWNED PROPERTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
RICHARD R.GRAY 21 12 1204
If an asset was made jointly owned within one year of the decedent's date of death,it must be reported on Schedule G.
SURVIVING JOINT TENANT(S)NAME(S) ADDRESS RELATIONSHIP TO DECEDENT
A.John R.Gray 716 Orchard Court Son
Chambersburg,PA 17201
B.Michael J.Gray 704 Green Acres Street Son
Mechanicsburg,PA 17055
C.
JOINTLY-OWNED PROPERTY:
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANK ACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECEDENTS VALUE OF
NUMBER TENANT JOINT IDENTIFYING NUMBER.ATTACH DEED FOR JOINTLY-HELD REAL ESTATE. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A./B. 5/2007 Sovereign Bank,CD account no. 1685542464 60,017.75 33.3333 20,005.90
($60,000+$17.75 accrued interest)
See attached valuation.
2. A.B. 2/2004 Invesco Investment Services,account no.0060014694 68,390.00 33.3333 22,796.64
See attached valuation.
TOTAL(Also enter on Line 6,Recapitulation) $ 42 802.54
If more space is needed,use additional sheets of paper of the same size.
REV-1510 EX+(08-09)
pennsylvania SCHEDULE G
DEPARTMENT OF REVENUE INTER-VIVOS TRANSFERS AND
INHERITANCE TAX RETURN MISC. NON-PROBATE PROPERTY
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
RICHARD R.GRAY 21 12 1204
This schedule must be completed and filed if the answer to any of questions 1 through 4 on page three of the REV-1500 is yes.
DESCRIPTION OF PROPERTY
ITEM INCLUDE THE NAME OF THE TRANSFEREE,THEIR RELATIONSHIP TO DECEDENT AND DATE OF DEATH %OF DECD'S EXCLUSION TAXABLE
NUMBER THE DATE OF TRANSFER.ATTACH A COPY OF THE DEED FOR REAL ESTATE. VALUE OF ASSET INTEREST (IFAPPUCMLE) VALUE
1. Sovereign Bank,IRA CD account no. 1688177524 2,976.52 100.00 2,976.52
Beneficiaries: John R. Gray and Michael J. Gray,sons
See attached valuation.
2. PNC Bank,IRA account no. 75500028506 105,115.90 100.00 105,115.90
Beneficiaries: John R.Gray and Michael J. Gray,sons
See attached valuation.
3. PNC Bank,IRA account no.75100028456 6,661.24 100.00 6,661.24
Beneficiaries: John R. Gray and Michael J. Gray,sons
See attached valuation.
4. Zurich American Life Ins.Co.,annuity contract no.K005385342 142,411.74 100.00 142,411.74
Beneficiaries:John R.Gray and Michael J. Gray,sons
See attached valuation.
5. Lincoln Financial Group,contract no.FQ7109332 78,784.93 100.00 78,784.93
Beneficiaries:John R.Gray and Michael J. Gray,sons
See attached valuation.
6. Real property located at 704 Green Acres Street,Mechanicsburg 179,200.00 100.00 179,200.00
Borough,Cumberland County,PA,known as Tax Parcel No.
20-24-0785-027,being described in Deed dated 01/23/2012 and
recorded in Cumberland County,PA,Deedbook 201202730,being
conveyed to Michael James Gray,decedent's son.
See attached Deed and Tax Assessment.
TOTAL (Also enter on Line 7,Recapitulation) $ 515 150.33
If more space is needed,use additional sheets of paper of the same size.
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX RETURN
RESIDENT DECEDENT ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
RICHARD R. GRAY 21 12 1204
Decedent's debts must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1. Hollinger Funeral Home 11,985.00
2. Reimbursement for funeral expenses 205.00
B. ADMINISTRATIVE COSTS:
1. Personal Representative Commissions:
Name(s)of Personal Representative(s)
Street Address
City State ZIP
Year(s)Commission Paid:
2. Attorney Fees: Martson Law Offices 30,549.00
3. Family Exemption:(If decedent's address is not the same as claimants,attach explanation.) 3,500.00
Claimant Michael J.Gray
Street Address 704 Green Acres Street
City Mechanicsburg State PA ZIP 17055
Relationship of Claimant to Decedent son
4• Probate Fees: Register of Wills,Cumberland County 385.50
5 Accountant Fees:
6. Tax Return Preparer Fees:
7. Register of Wills,filing fee for Inheritance Tax Return 15.00
8. Sovereign Bank,bank fee for date of death value 20.00
9. Miscellaneous filing fees and expenses 200.00
TOTAL(Also enter on Line 9,Recapitulation) $ 46 859.50
If more space is needed,use additional sheets of paper of the same size.
Now
REV-1512 EX+(12-12)
pennsylvania SCHEDULE
DEPARTMENT OF REVENUE DEBTS OF DECEDENT,
INHERITANCE TAX RETURN MORTGAGE LIABILITIES & LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
RICHARD R.GRAY 21 12 1204
Report debts incurred by the decedent prior to death that remained unpaid at the date of death,including unreimbursed medical expenses.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1. Outstanding checks,PNC Bank checking account no. 5070079909 on date of death 4,313.49
2. Pinnacle Health Medical Services($1,156+$206+$1,137),account payable 2,499.00
3. Veterans Affairs($16+$8),account payable 24.00
4. George Bransaum,M.D.,account payable 24.86
5. Quantum Imaging($2.07+$19.09),account payable 21.16
6. Miscellaneous account payable 6.60
TOTAL(Also enter on Line 10,Recapitulation) $ 6,889.11
If more space is needed,insert additional sheets of the same size.
REV-1513 EX+(0 1-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE BENEFICIARIES
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF: FILE NUMBER:
RICHARD R.GRAY 21 12 1204
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S)RECEIVING PROPERTY Do Not List Trustee(s) OF ESTATE
I TAXABLE DISTRIBUTIONS (Include outright spousal distributions and transfers under
Sec.9116(a)(1.2).]
1. John R.Gray Lineal 283,684.84
716 Orchard Court 1/2 of Sch.E,Sch.F and
Chambersburg,PA 17201 Sch.G,Items 1-5
2. Michael J.Gray Lineal 283,684.84
704 Green Acres Street 1/2 of Sch.E,Sch.F and
Mechanicsburg,PA 17055 Sch.G,Items 1-5
3. Michael J.Gray Lineal 179,200.00
704 Green Acres Street Sch.G,Item 6
Mechanicsburg,PA 17055
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18 OF 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:
1.
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS:
1.
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET. $
If more space is needed,use additional sheets of paper of the same size.
1
LAST WILL AND TESTAMENT OF RICHARD R. GRAY
I, RICHARD R. GRAY, of the Borough of Mechanicsburg, County of
Cumberland and State of Pennsylvania, being of sound and disposing mind,
memory and understanding, do make, publish and declare this my Last Will
and Testament, hereby revoking and making void any and all former Wills
by me at any time heretofore made.
1.
I direct the payment of all my just debts and funeral expenses
as soon after my decease as the same can be conveniently done.
2.
I give, devise and bequeath all the rest, residue and remainder
of my estate, real, personal and mixed, of whatsoever nature and whereso-
ever the same may be situate, to my wife, MARY L. GRAY, absolutely and
unconditionally.
3.
In the event that my said wife, MARY L. GRAY, should prede-
cease me, or should she die at about the same time as I do, such as in
an accident common to both of us, then in such event, I give, devise
and bequeath my entire estate, real, personal and mixed, whatsoever
and wheresoever situate, to my two sons, to wit, JOHN R. GRAY and
-1-
MICHAEL J. GRAY, share and share alike, per stirpes.
A. I nominate, constitute and appoint THE FIRST BANK AND
TRUST COMPANY OF MECHANICSBURG, PA. to be the Guardian and Trustee
of the estate of any minor issue and/or beneficiaries of a de-
ceased child of mine who shall share in my estate hereunder,
for and during the term of their minority, to wit, until such
time as they attain the age of twenty-one (21) years, with the
right and authority in said Trustee, at its sole discretion, to
apply the principal as well as the income of each such minor's
respective estate to insure their comfortable care, support and
education, with particular emphasis to the application of said
funds to their college education or other technical or profes-
sional training after they graduate from High School, without
the necessity on its part of first securing a Decree or Order
of Court before doing so.
4.
LASTLY, I nominate, constitute and appoint my wife, MARY L.
GRAY, to be the Executrix of this, my Last Will and Testament, and in
the event she should predecease me, or should she be unable or unwill-
ing to serve in such capacity for any reason, then I nominate, consti-
tute and appoint my two sons, JOHN R. GRAY and MICHAEL J. GRAY, to be
Co-Executors of this, my Last Will and Testament, in her place and
stead:
IN WITNESS WHEREOF, I have hereunto set my hand and seal this
-2-
•' .3 day of August, A. D. 1989.
_E SEAL)
Richard R. Gray
Signed, sealed, published and declared by the above-named
RICHARD R. GRAY, as and for his Last Will and Testament, in the
presence of us, who, at his request and in his presence, and in the
presence of each other, have hereunto subscribed our names as wit-
nesses.
-3-
f A
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
it RICHARD R. GRAY the testator
whose name is signed to the attached or foregoing instrument, having
been duly qualified according to 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 volun-
tary act and deed, for the purposes therein contained.
Sworn and affirmed to and acknowledged before me by
RICHARD R. GRAY , the testator , this 23rd
day of August A. D. 1989.
WARM SFAI.
MARY S. USINSih. =.#f OY PUILIC.
COMMONWEALTH OF PENNSYLVANIA ) MECHANICSOURG O RO. COMSEALMD Co.
My Ce issien Expires Sept. 21, 1991
SS.
COUNTY OF CUMBERLAND )
We, the undersigned, J. ROBERT STAUFFER
and MARILYN RAY EAKIN , the witnesses whose names are
signed to the attached or foregoing instrument, being duly qualified
according to law, depose and say that we were present and saw the
testat or 9 RICHARD R. GRAY , sign and exe-
cute the instrument as his Last Will and Testament; that the
said testator , RICHARD R. GRAY , executed it as
his/b= free and voluntary act for the purposes therein expressed;
that each of us, in the hearing and sight of the testator , signed
the Will as witnesses; and that to the best of our knowledge, the
testator was, at the time, eighteen (18) or more years of age,
of sound mind, and under no constraint, duress or undue influence.
Sworn and subscribed to before
me this 23rd day of
August 1989.
IOIARI►L SEAL.
MARY S. R951K,"S t. NSTARY FUILIC
�—` MECHANICSit XG ORO. CUMBERLAND CO.
�J_ �`s-p IV Comissien Expires Sept. 21. 1"1
Sovereign Bank
ESTATE OF Richard R. Gray
SOCIAL SECURITY#: 184-20-5112
DATE OF DEATH: September 30, 2012
Account#: 1681704285 Type: Checking Open date: 9/7/1990
In the name of: Richard R. Gray(Michael J. Gray, POA; John R. Gray, POA)
Date of Death Balance: $122,999.62, E
Int.(YTD) from 1/1/2012 to 9/21/2012 $31.63
Accrued interest to date of death: $3.36
Other Info:
Account#: 1685542464 Type: CD Open date: 5/7/2007
In the name of: Richard R. Gray or Michael J. Gray or John R. Gray
Date of Death Balance: $60,000.00
Int.(YTD) from 1/1/2012 to 9/7/2012 $471.58
Accrued interest to date of death: $17.75
Other Info: Joint since open.
Account#: 1685543678 Type: CD Open date: 8/28/2007
In the name of: Richard R. Gray(Michael J. Gray, POA; John R. Gray, POA)
Date of Death Balance: $4,000.21
Int.(YTD)from 1/1/2012 to 8/31/2012 $13.78Qrr1 c�
Accrued interest to date of death: $1.15
Other Info:
Account#: 1688177524 Type: IRA CD Open date: 1/24/2000
In the name of: Richard R. Gray
Date of Death Balance: $29976.23 r
Int.(YTD) from 1/1/2012 to 8/26/2012 $21.51 � M
Accrued interest to date of death: $0.29
Other Info: Beneficiaries: John R. Gray, 50%; Michael J. Gray, 50%
Account#: 1685554246 Type: CD Open date: 3/28/2012
In the name of: Richard R. Gray(Michael J. Gray, POA; John R. Gray, POA)
Date of Death Balance: $1009429.90
Int.(YTD) from 1/1/2012 to 8/31/2012 $512.79 rn 3
Accrued interest to date of death: $82.89
Other Info:
Page 1 of 1
Mar. 8. 2013 8:25AM PNC Bank No. 9288 P. 1
AE :.
-LE"M
March 8;2013
Melissa A Scholly
Marison Law Offices
10 E High St
Carlisle,PA 17013
RE: Richard R Gray
SSN: 184-20-5112
DOD: 09-30-2012
Dear Ms. Scholly:
In response to your request for Date of Death(DOD)balances for the customer noted above, our
records show the following:
Cheeping Account
Account# 5070079909 Established.: 1225-1973
RICHARD R GRAY
DOD balance: $ 13,932.40+ 0.04 accrued interest
Interest paid 01-01-2012 th;u 09-30-2012 $ 1.44 YTD
IRA Account
Account#75500028506 Established: 03-04-2005
RICHARD R GRAS'"
DOD balance: $ 104,733.33 +382.57 accrued interest _ cSc . Gri sY1
Interest paid 01-01-2012 thru 09-30-2012 $ 3,961.93 YTD
Account# 75100028456 Established: 02-04-2005
RICHARD R GRAY
DOD balance: $6,637.00+2424 accrued interest
Interest paid 01-01-2012 tbru 09-30-2012 $250.97 YTD
For beneficiary information,please call 1-888-762-4727.
Please note that this office provides date of death balances for deposit accounts(IRAs,CDs,Checking and
Savings). We do not process a:oy financial transactions or provide statements. if you need assistance with
any of these items,please call 1-588-PNC-BANK(1-888-762-2265)or stop by your local PNC Bank branch
office.
Sincerely,
National Financial Services Center
PNC Ea-akk,N.A. Member FDIC
Page 1 of 2
��. r n5 `�
_Mar. 8. 2013 8:25AM PNC Bank No- 9288 P. 2
11his message is intended for the use of the individual or entity to which It is addressed and may
contain information thar is privileged, con dential and exempt from disclosure,under-applicable law.
If the.reader of this message is not the intended recipient or the employee or agent responsible,for
delivering this message to the intended recipient,you are hereby notified Char any dissemination,
distribution or copying of this communications is strictly prohibited If you have received this
communication in error,please note me immediately by reply or by telephone at 800-762-177. and
immediately desrroy this faxed document.
Page 2 of 2
02/21/2013 09:46 7172671584 TUCKER FINANCIAL SVS PAGE 02
TUCKER FINANCIAL SERVICES, INC.
Thomas C. Tucker
425 Phoenix Drive
CHA.MEERSBURG, PA 17201
717-267-1426
Richard R, John R & Michael J. Garay JT
Current Position Report
As of September 30,2012
Own Net Amount Market
ID Units Price Invested Value
Mutual Funds
AIM INVESTMENT SERV AMVAM-4927 JT 10,087,076 6.78 68,390
FV
.1
l�
6CK
Page 1,1 Current Position Prepared 02/21/2013
Now
Zurich American Life Insurance Company
P.O. Box 758557
Topeka, KS 66675-8557
December 4,2012
MELISSA A SCHOLLY
MARTSON LAW OFFICES
10 EAST HIGH ST
CARLISLE PA 17013
Re: Contract Number: K005385342
Deceased's Name: Richard R Gray
Type of Annuity: C Zurich Advantage III Non-Qualified
Dear Ms. Scholly:
We are in receipt of Letters Testamentary for the Estate of Richard R. Gray and a copy of the death
certificate for Richard R. Gray. Our records indicate the beneficiary designation for the above referenced
annuity is Michael J Gray and John R Gray. Please have each beneficiary complete and submit a
Claim Form and a certified original death certificate indicating cause and manner of death. The
modes of settlement can be found on the Claim Form. As a death beneficiary must generally start to be
distributed by December 31"of the calendar year following the year in which death occurred.
Your letter dated November 27,2012, requested specific information required for the completion of
inheritance and estate tax returns. As of November 30,2012,the account value and death benefit
payable on the above-referenced account is$142,411.74. Please note that the value of the death benefit
may fluctuate.
If you have any questions, please contact Insurance Services at 800-457-9047. Our service
representatives are available to assist you from 7:30 A.M.to 5:00 P.M. Central Time.
Sincerely,
Zurich American Life Insurance Company
Enclosures
das
Zurich American Life Insurance Company
http://insuranceservices.se2.com
Phone Number 800-457-9047•Fax Number 785-228-4539
4 1-n I�
Dec. 3. 2012 4: 10PM No. 2820 P. 1/1
Lincoln
Financial Group
Fax Cover Shoot
DATE: December 3,2012 TIME: 1:54 P.M.
TO: MELISSA A SCHOLLY PHONE: (717)243-3341
MARTSON LAW OFFICES FAX: {717}243-1650
FROM: KAREN H.BROWN PHONE: 1-800-454-62615,Ext.*8240
LINCOLN FINANCIAL-CLAIMS DEPT. FAX:
RE: CONTRACT#FQ7109332—RICHARD R.GRAY—CLAIM#783165
CC:
Number of pages including cover shoot: 1
MESSAGE:
Thank you for your letter of inquiry dated November 27,2012. The value of this contract as of the
date of death,September 30,2012.was$78,764.93. John R.Gray and Michael J.Gray are the
named beneficiaries on this contract.
Should you have additional questions,please call 1.800454-6265,ext.*8200.
Parcel No. 20-24-0785-027
DEED UYu
MADE THE 43 day of 2012
BETWEEN RICHARD R. GRAY, widower, by his Attorneys-in-Fact, JOHN R. GRAY and
MICHAEL J. GRAY, which Power of Attorney is dated May 13, 1996, and is to
be recorded immediately prior hereto, of Cumberland County, Pennsylvania,
hereinafter referred to as
Grantors,
AND MICHAEL JAMES GRAY, an unmarried person, of Cumberland County,
Pennsylvania, hereinafter referred to as
Grantee
WITNESSETH, that in consideration of ONE DOLLAR and 00/100 ($1.00), the receipt
whereof is hereby acknowledged, the Grantors do hereby grant and convey to the Grantee, his
heirs and assigns:
ALL THAT CERTAIN tract of land, with the improvements thereon erected,
situate on the north side of Green Acres Street in the Borough of Mechanicsburg,
Cumberland County, Pennsylvania, bounded and described as follows:
BEGINNING at a point on the northern line of Green Acres Street, which said
point is on the division line between Lots No. 55 and 56 on the hereinafter
mentioned Plan of Lots; thence in a northerly direction along the division line
between Lots No. 55 and 56, one hundred sixty-nine (169) feet to a point on the
southern line of a proposed alley twelve (12) feet wide; thence in a westerly
direction along said southern line of said proposed alley, sixty-six and five-tenths
(66.5) feet to a point; thence in a southerly direction along the division line
between Lots No. 56 and 57 on the hereinafter mentioned Plan of Lots, one
hundred sixty-nine (169) feet to a point on the northern line of Green Acres
Street; thence along said northern line of Green Acres Street in an easterly
direction, sixty-six and five-tenths (66.5) feet to a point at the place of
BEGINNING.
BEING Lot No. 56 on a Plan of Lots known as Plan No. 2 of Green Acres, which
Plan is recorded in the Recorder's Office in and for Cumberland County,
Pennsylvania, in Plan Book 4, Page 3.
KNOWN and numbered as 704 Green Acres Street, Mechanicsburg, Pennsylvania
17055.
BEING the same premises which Stanley G. Nailor and S. Louise Nailor, by their Deed
dated June 1, 1957, and recorded June 1, 1957, in Deed Book V, Volume 17, Page 376, in the
office of the Recorder of Deeds in and for Cumberland County, Pennsylvania, granted and
conveyed unto Richard R. Gray and Mary L. Gray. The said Mary L. Gray died on April 12,
1990,thereby vesting fee simple title to her surviving spouse, Richard R. Gray, Grantor herein. '
UNDER AND SUBJECT, NEVERTHELESS, to any existing covenants, easements,
encroachments, conditions, restrictions, notations, agreements, amendments and rights of way
affecting the property, visible or of record.
THIS CONVEYANCE IS FROM FATHER TO SON AND IS THEREFORE
EXEMPT FROM PENNSYLVANIA REALTY TRANSFER TAX.
AND the said Grantors do hereby covenant and agree that they will warrant specially the
property hereby conveyed.
IN WITNESS WHEREOF, said Grantors have hereunto set their hands and seals the day
and year first above written.
SIGNED, SEALED AND DELIVERED
IN THE PRESENCE OF:
(rL,_ (Seal)
o . Gray
/Vo-"All- Seal
Michael J. G y
COMMONWEALTH OF PENNSYLVANIA )
) SS
COUNTY OF CUMBERLAND )
On this, the o?3'A day of.-',,r��'W 2012, before me, the undersigned
officer, personally appeared JOHN R. GRAY, known to me or satisfactorily proven to be the
person whose name is subscribed to the within instrument, and acknowledged that he executed
the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
19 4 Seal)
My commission expires: 061g 91QO16 Notat lic-
COMMONMALTH of PENNSYLVANIA
Notarial seal
Margaret Ann Nash,Notary Public
carlme Boro,Cumberland County
My Corn nisslon Bow June 29,2015
M048EP,vBMMANu Assocunai of rarAaIEs
d
COMMONWEALTH OF PENNSYLVANIA )
) SS
COUNTY OF CUMBERLAND )
On this, the aq day of�Q rum- 2012, before me, the undersigned
officer, personally appeared MICHAEL J. GRAY, known to me or satisfactorily proven to be the
person whose name is subscribed to the within instrument, and acknowledged that he executed
the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
l .� (Seal)
My commission expires: ' f4ota ic
MMMOMAM&T l OF PMNMVMIA
Notarial Seal
Manguct Arm Nash,Notary Ptblk
outdo 80m,0XWXW a W cwty
MY C.onxlWM Esph+es June 29,2015
MEMBER,PEtINSY mm Assoami OF NOTARIES
Certification of Residence
I hereby certify that the precise residence and complete post office address of the within
Grantee is: 704 Green Acres Street, Mechanicsburg, PA 17055.
SJr
Date: , 2012
Hubert X. Gilroy,Atto ey for Grantee
The title for this Deed was not searched by the scrivener and all parties hereto are aware
of the same.
MARTSON DEARDORFF WILLIAMS OTTO GILROY&FALLER
MARTSON
LAW OFFICES
10 EAST HIGH STREET
CARLISLE,PENNSYLVANIA 17013
TELEPHONE 717-243-3341
FACSIMILE 717-243-1850
INTERNET WWW.MARTSONLAW.COM
F:\FILES\C1ients\14607 Gray\14607.1.Deed
s �
ROBERT P. ZIEGLER
RECORDER OF DEEDS
CUMBERLAND COUNTY ,
1 COURTHOUSE SQUARE
CARLISLE, PA 17013 =
717-240-6370 -
Instrument Number-201202730
Recorded On 112712012 At 11:35:37 AM *Total Pages-4
*Instrument Type-DEED
Invoice Number-100925 User ID-JM
*Grantor-GRAY,RICHARD R
*Grantee-GRAY,MICHAEL JAMES
*Customer-MARTSON
*FEES
STATE WRIT TAX $0.50 Certification Page
STATE JCS/ACCESS TO $23.50
JUSTICE DO NOT DETACH
RECORDING FEES — $11.50
RECORDER OF DEEDS
PARCEL CERTIFICATION $10.00 This page is now part
FEES of this legal document.
AFFORDABLE HOUSING $11.50
COUNTY ARCHIVES FEE $2.00
ROD ARCHIVES FEE $3.00
MECHANICSBURG SCHOOL $0.00
DISTRICT
MECHANICSBURG BOROUGH $0.00
TOTAL PAID $62.00
I Certify this to be recorded
in Cumberland County PA
r
RECORDER O D EDS
*-Information denoted by an asterisk may change during
the verification process and may not be reflected on this page.
003JYU
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., Tax Ma er
PP
; Cumberland County,, PA
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Copyright 2011 Esri. All rights reserved. Tue Nov 13 2012 03:05:23 PM.
704 GREEN ACRES STREET
PIN: 20-24-0785-027
Deedbook: 201202730
Owner: GRAY, MICHAEL JAMES
Land Use Code: 101
Property Type: R
4creage: 0.26
Square Feet: 1538
Taxable Status: T
;lean & Green Status:
Land Assessed Value $: 40000
Building Assessed Value $: 139200
rota I Assessed Value $: 179200
Sale Price $: 1
Sale Date: Thu ]an 26 2012 07:00:00 PM
Year Built: 1958
Municipality: MECHANICSBURG 5TH WRD
Height in Stories: 1
Type of Dwelling: DETACH
Primary Exterior: Brick +w (�
Basement-Percentage: 100
Air Conditioning: AC
Total Rooms: 5
Bedrooms: 3
Fuli Bath: 1
Half Bath: