HomeMy WebLinkAbout07-11-14 � 1505610143
REV-1500 EX`°Z_„> �
OFFICIAL USE ONLY
PA Department of Revenue pennsylvania County Code Year File Number
Bureau of Mdividual Taxes �PpRTMENTOFREVENUE
PO BOX.280601 INHERITANCE TAX RETURN 21 13 0746
Harrisburg, PA 17128-0601 RESIDENT DECEDENT
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death Date of Birth
06 O1 2013 12 10 1955
DecedenYs Last Name Suffix DecedenYs First Name MI
GRIFFITH JR J�HN W
(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
� 1. Original Return � 2. Supplemental Return � 3. Remainder Return(Date of Death
Prior to 12-13-82)
� 4. Limited Estate � qa. Fu�ure Interes�Compromise � 5. Federal Estate Tax Return Required
(date of death aRer 12-12-82)
� 6 Decedenl Died Testate � � qetacheCopy�of Trust)a Living Trust � 8. Total Number of Safe Deposit Boxes
(Attach Copy of Will)
� 9. Litigation Proceeds Received � �p,Spousal P4vert Credic�(Date�f Deach � 11.Election to tax under Sec.9113(A)
between 1z31�J1 and -1-95 (Attach SChedule O)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.AlL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATtON SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
JAMES D HUGHES ESQ 717 249 6333
REGISTER OF WILLS U3E ONLY
� :=..� �
First Line of Address .�� ,,—i—�- ����:;
354 ALEXANDER SPRING RO �� ' � `" �
< i � � ;_; �
Second Line of Address �� •` � � 3 __�
C�7j C '�� � _ ~i
ETA��FILED -
City or Post Office State ZIP Code � � �" J
CARLI SLE PA 17 015 �- - �;, 4��
Correspondent's e-mail address: jhughes salzmannhuahes 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,correct and complete.Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNAT E F ERSON RESPONSIBLE F R FILING RETURN DATE
nJ , C!� Ro er B. Irwin I� �v I
ADDRESS
354 Alexan ri ad Suite 1 Carlisle PA 17015
SIGNATURE OF EPARER 0 R T REPRESENTATIVE DATE
James D. Hughes Esq. ( Z.n i
ADDRES
354 lexander S ' Road, Suite 1, Carlisle, PA 17015
� Side 1
1505610143 1505610143
J 150561�243
REV-1500 EX
DecedenYs Social Security Number
oe�de�c'SName: G1'Ifflth� JOh�t W. J�.
RECAPITULATION
1. Real Estate(Schedule A).......................................................................................
�. 138 , 000 . 00
2. Stocks and Bonds(Schedule B)............................................................................. 2. 1 , 5 61 , 5 9 9 . 0 9
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. 4 3 9, 52 6 . 3 6
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous lyoq Probate Property
(Schedule G) U Separate Bilimg Requested............ 7.
S. Total Gross Assets(total Lines 1 through 7)........................................................ g. 2 , 13 9, 125 . 45
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 133 , 1�1 . 1�
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule I)............................ 10. 1 ,2 0 6 . 94
11. Total Deductions(total Lines 9 and 10)................................................................ ��. 13 4 ,3�8 . �4
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 2 , 004 , 817 . 41
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)............................................... 13. 1 , 924 , 817 . 41
14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. 8 0 , 0 0 0 . 0�
TAX COMPUTATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116 �5 O . Q Q
(a)(1.2)X.00
16. Amount of Line 14 taxable 0 . �0 16. � . 0�
at lineal rate X .045
17. Amount of Line 14 taxable 10 , 0 0 0 . 0 0 17. 1 ,2 0 0 . 0 0
at sibling rate X.12
18. Amount of Line 14 taxable 10 rJ. �0 . ��
at collateral rate X.15 7� , 0�� . 0 0 18. r
19. TAXDUE................................................................................................................ 19. 11 , 700 . 0�
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT. �
Side 2
L 1505610243 1505610243 �
REV-1500 EX Page 3 File Number 21-13-0746
Decedent's Complete Address:
DECEDENT'S NAME
Griffith,John W.Jr.
STREET ADDRESS
201 Meadow Blvd.
CITY STATE ZIP
Carlisle PA 17013
Tax Payments and Credits:
1. Tax Due(Page 2, Line 19) (1) 11,700.00
2. Credits/Payments
A. Prior Payments 11,115.00
B. Discount 585.00
Total Credits(A +B) (2) 11,700.00
3. Interest �3�
4. If Line 2 is greater than Line 1 +Line 3,enter the difference. This is the OVERPAYMENT. (4)
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. (5) 0.00
Make Check Pa able 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:............................................................................... ❑ ❑X
b. retain the right to designate who shall use the property transferred or its income:.................................. ❑❑ �
c. retain a reversionary interest;or............................................................................................................... x
d. receive the promise for life of either payments,benefits or care?............................................................ ❑ ❑X
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of death without O ❑
receiving adequate consideration?....................................................................................................................
3. Did decedent own an"in trust for" or payable upon death bank account or security at his or her death?....... ❑ �
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
containsa beneficiary designation?.................................................................................................................. ❑ 0
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
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 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 decedenYs lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)].
. The tax rate imposed on the net value of transfers to or for the use of the decedenYs 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-1502 EX+(07-10)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Griffith,John W.Jr. 21-13-0746
All real property owned solely 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 that 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 decedenYs interest if owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Real Estate situate at 201 Meadow Boulevard,Carlisle,Cumberland County, PA 138,000.00
TOTAL(Also enter on Line 1, Recapitulation) 138,000.00
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev.01-10)
Rev-1503 EX+�6-98)
SCHEDULE B
STOCKS 8� BONDS
COMMONWEALTH OF PENNSVLVANIA
INHERITANCE TAX RETURN
RESiDENT DECEDENT
ESTATE OF FILE NUMBER
Griffith,John W.Jr. 21-13-0746
All property jointly-owned with right of survivorship must be disclosed on Schedule F.
ITEM CUSIP VALUE AT DATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
Fidelitv Investments-Individual Account No. 15212�
1 7,633.733 shares of Fidelity Low Priced Stock-FLPSX 45.77 349,395.96
2 6,926.876 shares of Fidelity Strategic Income-FSICX 11.21 77,650.28
3 300 shares of Pfizer Inc.-PFE 27.5975 8,279.25
4 Powershares QQQ Trust Unit Series 1 -QQQ 73.38 889,365.60
5 Vanguard Index Funds Vanguard Total Stock Market-VTI 84.61 236,908.00
TOTAL(Also enter on Line 2, Recapitulation) 1,561,599.09
(If more space is needed,additional pages of the same size)
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule B(Rev.6-98)
Rev-1508 EX+(11-10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, 8� MISC.
DEPARTMENT OF REVENUE p E RSO NAL PRO PE RTY
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Griffith,John W.Jr. 21-13-0746
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jointly-owned with the right of survivorship must be disclosed on schedule F.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
Fid li Investments Rollover I A Acco�nt No 207282820-Beneficiarv is decedents estat�
Beneficiary is the decedents estate
1 Fidelity Government Money Market Account No. 207282820 3,647.72
2 Vanguard Index Funds Vanguard Total Stock Market 9,307.10
Fid li Investments Roth I A Acco�nt No 152-151840-Beneficiarv is decedents est?te
Beneficiary is the decedents estate
3 Fidelity Government Money Market Account No. 152151840 4,794.46
4 Powershares QQQ Trust Unit Series 1 9,482.97
5 Cash on hand 288.04
6 Cash on hand 1,140.00
7 General Electric Insurance-check to the estate 1,652.67
8 Fidelity Government Money Market Account No. 152126780 76,633.05
9 GE Capital Invest Direct Account No.93509242247164 6.414.85
10 GE Pension Plan Account 94,894.90
11 Members 1st Federal Credit Union,Account No.208 5.45
12 PNC Bank,Checking Account No.5112072044 25,559.26
Total of Continuation Schedule See attached page
TOTAL(Also enter on Line 5, Recapitulation) 439,526.36
(If more space is needed,additional pages of the same size)
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10)
Rev-1508 EX+���_10)
SCHEDULE E
pennsylvania CASH, BANK DEPOSITS, 8� MISC.
DEPARTMENT OFREVENUE
INHERITANCETAXRETURN PERSONAL PROPERTY
RESIDENT DECEDENT
continued
ESTATE OF FILE NUMBER
Griffith,John W.Jr. 21-13-0746
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
Accrued interest on Item 12 through date of death 0.07
13 2010 Chevrolet Cobalt-VIN1G1AC5F57A7127471 12,000.00
14 Household goods at proceeds of sale 4,196.00
15 Household goods at proceeds of sale 361.00
16 Centurytel, Inc. -refund 11.25
17 Commonwealth of Pennsylvania-2013, PA40 income tax refund 227.00
18 Genworth Life Insurance Co. -refund of unearned premium 45.63
19 Government Employees Insurance Co. -refund 102.06
20 United States Treasury-2013, 1040 income tax refund 364.00
21 Fidelity Investments,Annuity Contract No.410094404-Beneficiary is the decedent's estate 47,651.32
22 GE Retirement Savings Plan(401 K),Account No.03439 126,184.09
23 GE Retirement Savings Plan(401 K),Account No.03439 14,563.47
TOTAL(Also enter on Line 5, Recapitulation) 439,526.36
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule E(Rev. 11-10)
REV-1511 EX+(10-09)
pennsylvania SCHEDULE H
DEPARTMENTOFREVENUE FUNERAL EXPENSES AND
RESIDENTDEC D NTTURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Griffith,John W.Jr. 21-13-0746
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
N MBER
q, FUNERAL EXPENSES:
See continuation schedule(s) attached 2,192.40
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Roger B. Irwin
StreetAddress 354 Alexander Spring Road
city Carlisle state PA zio 17015
Year(s)Commission Paid 55,086.00
2. Attorney's Fees 55,832.52
See continuation schedule(s) attached
3. Family Exemption: (If decedenYs address is not the same as claimanYs,attach explanation)
Claimant
Street Address
City State Zip
Relationshio of Claimant to Decedent
4. Probate Fees 1,348.50
5. AccountanYs Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs 18,641.68
See continuation schedule(s) attached
TOTAL(Also enter on line 9, Recapitulation) 133,101.10
Copyright(c)2009 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev. 10-09)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Griffith,John W.Jr. 21-13-0746
ITEM
NUMBER DESCRIPTION AMOUNT
Funeral Ex eRnses
1 Hoffman-Roth Funeral Home-balance due for funeral expenses 402.32
2 Janda K. Panitiz-reimbursement for funeral expenses 1,790.08
H-A 2,192.40
Attorney Fees
3 Irwin&McKnight, P.C. -Attorney's fees 20,152.52
4 Irwin&McKnight, P.C. -Attorney's fees 4,847.48
5 Salzmann Hughes, P.C. -Attorney's fees 30,832.52
H-B2 55,832.52
Other Administrative Costs
6 Borough of Carlisle-final water and sewer 45.36
7 Cumberland Law Journal-Legal advertising 75.00
8 Duane Otten-lawn care to sell real estate in order to administer the estate 480.00
9 Erie Insurance Group-homeowners insurance 367.00
10 Fidelity Investments-expense to sell security in Fidelity Inherited IRA 224-147441 in order to 63.92
administer the estate
11 Fidelity Investments-commission paid to sell Powershares QQQ in order to administer the 33.12
estate
Copyright(c)2002 form software only The Lackner Group,Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Griffith,John W.Jr. 21-13-0746
ITEM AMOUNT
NUMBER DESCRIPTION
12 Hooke, Hooke 8 Eckman Realtors, LLC-1/2 commission paid to sell real estate in order to 4,140.00
administer the estate
13 Life Changes Realty Group-1/2 commission paid to sell real estate in order to administer 4,140.00
the estate
14 Life Changes Realty Group-transaction paid to sell real estate in order to administer the 200.00
estate
15 Patricia A. Rosendale,CPA-preparation of the 2013, 1040 and PA40 income tax returns 125.00
16 PPL Electric Utilities-electric service 34.52
17 PPL Electric Utilities-electric service 33.70
18 PPL Electric Utilities-electric service 34.44
19 PPL Electric Utilities-electric service 36.13
20 PPL Electric Utilities-electric service 39.36
21 PPL Electric Utilities-electric service 129.83
22 PPL Electric Utilities-electric service 242.45
23 PPL Electric Utilities-electric service,final bill 98.48
24 Recorder of Deeds-1%realty transfer tax paid to sell real estate in order to administer the 1,380.00
estate
25 Register of Wills-short certificate 5.00
26 Register of Wills-short certificate 5.00
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
SCHEDULE H
FUNERAL EXPENSES AND ADMINISTRATIVE COSTS
continued
ESTATE OF FILE NUMBER
Griffith,John W.Jr. 21-13-0746
ITEM AMOUNT
NUMBER DESCRIPTION
27 Register of Wills-2 short certificates 10.00
28 Register of Wills-2 short certificates 10.00
29 Register of Wills-2 short certificates 10.00
30 Rowe's Auction Service-commission paid to sell automobile in order to administer the 2,400.00
estate
31 Rowe's Auction Service-commission paid to sell household goods in order to administer 1,468.60
the estate
32 Rowe's Auction Service-commission paid to sell household goods in order to administer 126.35
the estate
33 Salzmann Hughes, P.C. -reimbursement for FedEx mailing to Fidelity Investments 20.50
34 Salzmann Hughes, P.C. -closing costs and final fees for income tax preparation, postage 2,000.00
and miscellaneous contingencies in order to administer the estate
35 Shane Bouder-removal of refuse to sell the real estate in order to administer the estate 700.00
36 The Sentinel-Legal advertising 178.92
37 Vital Records-death certificate 9.00
H-67 18,641.68
Copyright(c)2002 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.6-98)
Rev-1512 EX+(12-08)
SCHEDULE 1
pennsylvania DEBTS OF DECEDENT,
DEPARTMENT OFREVENUE
INHERITANCETAXRETURN MORTGAGE LIABILITIES AND LIENS
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Griffith,John W.Jr. 21-13-0746
Report debts incurted 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 Borough of Carlisle-water and sewer service 72.90
2 Borough of Carlisle-water and sewer service 72.90
3 Centurylink-phone service 29.03
4 Centurylink-phone service 29.03
5 Centurylink-phone service 31.12
6 Centurylink-phone service 29•�$
7 Centurylink-phone service 30.72
8 Chase -balance due on credit card 183.73
9 Chase -balance due on credit card 77•74
10 Chase -balance due on credit card 30.62
11 Chase -balance due on credit card 48.41
12 Dental -dental insurance 81.18
13 GE LTC Ltcg Inc. -insurance payment 47.18
14 GEICO-insurance payment 127.10
15 Jean Salinger-cleaning services 225.00
16 PPL Electric Utilities-electric service 40.50
17 Steven L.McCullough-service call 50.00
TOTAL(Also enter on Line 10, Recapitulation) 1,206.94
(If more space is needed,additional pages of the same size)
Copyright(c)2008 form software only The Lackner Group, Inc. Form PA-1500 Schedule I(Rev. 12-08)
REV-1513 EX+(01-10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Griffith,John W.Jr. 21-13-0746
NAME AND ADDRESS OF RELATIONSHIP TO SHARE OF ESTATE AMOUNT OF ESTATE
NUMBER PERSON(Sl RECEIVING PROPERTY DECEDENT (Words) ($$$)
I� TAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116 a 1.2
1 Janda K.Griffith-Panitz Sister Specific 10,000.00
513 Frost Road Bequest,Item 3.
Sandia Park, NM 87047 a.(1)
2 Ernest R.Griffith Uncle Specific 10,000.00
4543 E.Via Estrella Bequest,Item 3.
Phoenix,AZ 85028-4212 a•l2)
3 Joshua K.Griffith Nephew Specific 10,000.00
1813 Hunters Trail Bequest, Item 3.
Round Rock,TX 78681 a.(3)
4 Mary Jeanne DeGroot Cousin Specific 10,000.00
1547 Mission Rd. Bequest,Item 3.
Lancaster, PA 17601 a.(4)
5 Kenneth E. DeGroot Cousin Specific 10,000.00
1 Arrow Lane Bequest, Item 3.
Chadds Ford, PA 19317 a.(5)
See continuation schedule attached Continuation 30,000.00
Total 80,000.00
Enter dollar amounts for distributions shown above on lines 15 throu h 18 on Rev 1500 cover sheet,as a ro riate.
NON-TAXABLE DISTRIBUTIONS:
II. A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1 Carlisle United Methodist Church(previously Grace United Methodist Church) 1,000,000.00
2 Carlisle United Methodist Church (previously Grace United Methodist Church) 924,817.41
TOTAL OF PART II -ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET 1,924,817.41
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10)
SCHEDULE J
BENEFICIARIES
(Part I,Taxable Distributions)
ESTATE OF:
John W. Griffith,Jr. 06/01I2013 168-48-4715
Item Name and Address of Person(s) Share of Estate Amount of Estate
Number Receiving Property Relationship (Words) ($$$)
6 Jean E. DeGroot-Banzhof Cousin Specific Bequest,Item 10,000.00
3209 Caroline Drive 3.a.(6)
East Petersburg, PA 17520
7 Thomas C. DeGroot Cousin Specific Bequest,Item 10,000.00
13 Patchwork Ct. 3.a.(7)
Monkton, MD 21111-1604
8 Neil Wilson Cousin Specific Bequest,Item 10,000.00
14 W. Main St. 3.a.(8)
Ephrata, PA 17522
Total 30.000.00
1
1
C �` ( ...� , . .
`-,� '_ .. ... �.. ....
r° ,
�__
LAST WILL AND TESTA.IV1`E1VT =
I, JOHN W. GRIFFITH, JR., of the Borough of Carlisle, Cumberland County,
Pennsylvania, being of sound mind, disposing memory and full legal age, do hereby make,
publish and declare this to be my Last Will and Testament, hereby revoking all Wills and
Codicils heretofore made by me.
1. I direct my Executor or Substitute Executor, as the case may be,to pay all of my debts,
funeral and administrative expenses as soon as convenient after my decease. Furthermore, I
direct that all state, inheritance, succession and other death taxes imposed or payable by reason of
my death and interest and penalties thereon with respect to all property composing of my gross
estate for death tax purposes, whether or not such property passes under this Will, shall be paid
by the Executor or Substitute Executor from my estate, and that none of the aforesaid taxes shall
be prorated among those persons named herein or are otherwise beneficiaries hereunder.
2. My Executor or Substitute Executor may, at his discretion, compromise claims,
borrow money, retain property for such length of time as he may deem proper; lease and sell
property for such prices, on such terms, at public or private sales, as he may deem proper; and
invest estate property and income without restriction to legal investments unless otherwise
provided hereunder. I authorize and empower my Executor or Substitute Executor to sell any
realty and/or personalty owned by me at my death and not specifically devised or bequeathed
herein, at public or private sale or sales and to give good and sufficient deeds and/or bills of sale
therefor, in fee simple, as I could do if living. My Executor or Substitute Executor is authorized
and empowered to engage in any business in which I may be engaged at my death, for such
period of time after my death as seems expedient to said Executor or Substitute Executor.
� , .
3. I give, devise and bequeath all of my estate of whatever nature and wherever situate as
follow•s:
a. The sum of$10,000.00 to each of the following beneficiaries:
(1) JANDA K. GRIFFITH-PANITZ;
(2) ERNEST R. GRIFFITH;
(3) JOSHUA K. GRIFFITH
(4) MARY JEANNE DeGROOT;
(5) KENNETH E. DeGROOT;
(6) JEAN E. DeGROOT-BANZHOF;
(7) THOMAS C. DeGROOT; and
(8) NEIL WILSON.
Should any of the above-named beneficiaries be deceased at the time of my
death, then that person's share shall be divided equally between the surviving
beneficiaries.
b. All the rest, residue and remainder of my estate of every nature and
wherever situate I give to GRA(.'E UNITED METHODIST CHURCH of
Carlisle, Pennsylvania.
4. I nominate and appoint ROGER B. IRWIN to be the Fxecutor of this my Last Will
and Testament. In the event he has predeceased me, failed to qualify or is not able or does not
serve for whatever reason, I then appoint DOUGLAS G. MILLER as Substitute Executor of
2
this my Last Will and Testament with the same powers as are given to the original Executor
hereunder.
5. No person(s) shall benefit hereunder unless such beneficiary shall survive me by sixty
(60) days.
6. No Executor or Substitute Executor acting hereunder shall be required to post bond or
enter security in this or any other jurisdiction.
7. No beneficiary may assign, anticipate or pledge his or her interest in any income or
principal held or distributable hereunder, and no beneficiary's creditors may levy, attach or
otherwise reach any such interest.
8. If any person entitled to share in any distribution under the terms of this my Last Will
and Testament becomes an adverse party in any proceeding to contest the probate of this Last
Will and Testament, such person shall forfeit his or her entire interest inherited hereunder and all
provisions in favor of such person shall be declared void and of no effect. The share of such
person so forfeited shall be distributed as part of the residue pursuant to either Paragraph No. 3.a.
hereof, as the case may be, except that if such person is entitled to share in the said residue, that
interest shall be distributed proportionately to the other residuary beneficiaries.
9. I hereby suggest that my personal representative retain the services of Irwin &
McKnight, P.C. as attorneys in the settlement of my estate.
3
IN WITNESS WHEREOF, I have hereunto set my hand and seal this 6 2 day of July
2012.
.� Lr� � (SEAL)
JOHN W. GRIFF ,JR.
Signed, sealed, published and declared by the above-named Testator, as and for his Last
Will and Testament, in our presence, who, at his request, in his presence and in the presence of
each other have hereunto set our names as subscribing witnesses.
i"i'
�. ��,
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4
ACKNOWLEDGMENT AND AFFIDAVIT
WE, JOHN W. GRIFFITH, JR., MARTHA L. NOEL and SHARON L.
SCHWALM, the Testator and witnesses respectively, whose names are signed to the foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the
Testator signed and executed the instrument as his Last Will and that he had signed willingly,
and that he executed it as his free and voluntary act for the purpose herein expressed, and that
each of the witnesses, in the presence and hearing of the Testator, signed the will as a witness
and that to the best of their knowledge the Testator was, at that time, eighteen years of age or
older, of sound mind and under no constraint or undue influence.
w� �� �J 1�
JOHN W. GRI H, JR.
, �,
'�
MAR A L. NOEL
�h�.�� ��� �' k�-��.� -,-x-���<..�
SHARON L. SCHWALM
COMMONWEALTH OF PENNSYLVANIA :
. SS:
COUNTY OF CUMBERLAND •
Subscribed, sworn to and acknowledged before me by JOHN W. GRIFFITH, JR., the
Testator herein, and subscribed and sworn to before me by MARTHA L. NOEL and SHARON
L. SCHWALM, witiiesses, this (o''� day of July 2012.
�i � ,�_ �-��;
ot ry Public
COMNIC)�I���TH OF P�NNSYLVANIA
Notarial Seal
Roger B.Irwin,Notary Public
Ca�tisle Boro,Cumtreriand Counry
My Commission Expires Uct.3,2012
Member,Pennsylvan�a A�ac'ation of Notaries
�.� OMB Approval No.2502-0265
o'��. •`:� A. Settlement Statement (HUD-1) FINAL
�_i;
.- . ..
1.Q FHA 2.Q RHS 3.Q Conv.Unins. 6.File Number: 7.Loan Number: 8.MoRgage Insurance Case Number:
2013/WELUBHI
4.Q VA 5.Q Conv.Ins.
C.Note:This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agents are shown.Items marked
"(p.o.c)"were paid outside the closing;they are shown here for informational purposes and are not included in the totais.
D.Name&Address of Borrower: E.Name&Address of Seller: F.Name&Address of Lender:
Welubhi Housing Group,LLC Estate of John W.Griffith,Jr. None.
1521 Hemlock Ave.,Carlisle,PA 17013 c/o 60 West Pomfret Street,Carlisle,PA 17013
G.Property Location: H.Settlement Agent: I.Settlement Date:12/20/2013
201 Meadow Boulevard Baric Scherer LLC Disbursement Date: 12/20/2013
Carlisle,PA 17013 19 West South Slreet,Carlisle,PA 17013
Carlisle Borough
Telephone:717-249-6873 Fax:717-249-5755
Place of Settlement: TitleExpress
19 West South Slreet,Carlisle,PA 17013 Printed 12/20/2013 at 11:14 am .
by ALF
. :, . .
100. Gross ArtauM Dw trom Borrowsr 100. Gross Amount Due to Selk►
101. Contract sales price 138,000.00 401. Contract sales price 138,000.00
102. Personal ro ert 402. Personal ro ert
103. Seltlement charges to borrower(line 1400) 2,095.00 403.
�pq, 404.
105. 405.
Ad'ustments for items aid b seller in advance Ad'ustments for items aid b seller in advance
106. City/town taxes to 406. City/town taxes to �
107. County taxes 1 212 0/201 3 to 12/31/2013 30.29 407. County taxes 12/2012013 to 12/31/2013 30.29
108. Assessments to 408. Assessments to
109. Schooltaxes 12I2012013to 06/30/2014 1,060.08 409. Schooltaxes 12/20/2013to 06/30/2014 1,060.08
110. 410.
111. 411.
��z, 412.
120. Gross Amount Due from Borrower 141,185.37 420. Gross Amount Due to Seller 139,090.37
200. AmourKs P�d or Irt BehaH of Borrower 300. Reductlons In Amourrt Due to Seller ,
201. Deposit or eamest money 10,000.00 501. Excess deposit(see instructions)
202. Principal amount of new loan(s) 502. Setflement charges to seller(line 1400) 9,905.36
203. Existin loa s taken sub ect to 503. Existin loa s taken sub ect to
204. 504. Pa off of first mort a e loan
205. 505. Pa off of second mort a e loan
206. 506.
207. 507.
208. Seller Financing 128,000.00 508. Seller Financing 128,000.00
209. 509.
Ad'ustments for items un aid b seller Ad'ustments for items un aid b seller
210. Cityltown taxes to 510. Cityltown taxes to
211. Countytaxes to 511. Countytaxes to
212. Assessments to 512. Assessments to
P13, 513.
214. 514.
215. 515.
216. 516.
217. 517.
218. 518.
219. 519.
220• Total Paid b Ifor Borrower 138,000.00 520. Total Reduction Amount Due Seller 137,905.36
300. Cash at SNtlement tromlto Borrowar 600. Cash at SdtlsrtKnt toftrom BeNer
3p�, Gross amount due from borrower(line 120) 141,185.37 gp�, Gross amount due to seller(line 420) 139,090.37
302. �ess amounts paid by/for borrower(line 220) 138,000.00 602. Less reductions in amount due seller(line 520) 137,905.36
303. Cash �X From � To Borrower 3,185.37 603. Cash ❑X To ❑ From Seller 1,185.01
epo�ng ur en or rs w e on o in orma ion is e ima a mmu es per response or co e mg.renewmg,an repo i�p e a a. is agency may no co e is m orma ion,an yo�are no repurte o com0 e e
I�is lorm�unless It tllsplays a currenlly veli00MB comrol numGers No conliGenlialily is ess�re0;��is tlisclosure�is manEalory.This rsde5igne0lo proviUe I�e pehles to e RESPp covere0 iransactian vnt��n/ormation Eunng t�e settlement
pmcess
Previous editions are obsolete Page 1 of 4 HUD-1
�, ..��.-,�.��� _ ,�..�_�,...��..� _ ,.,�...�..�.,.� ,.�
7p0.•--T RwIEf�MlroMwF� , _ rqrit al From
Divisiai af mmNe�iaf aetolbYr� : B�tE�w�'s ;Selter's
701. $4,140.00 to Hooke,Hooke 8 Eckman Realtors,LLC FUI"!�l�8t� �: FUIIdS at
702. $4,140.00 to Life Changes Realty Group Sel'�1e1�1eht ' $8l'�1eI1'ie11t
703. Commission paid at serilement 8,280.00
704. Transaction Fee to Life Changes Realty Groups 200.00
800. items ble in ConnecUon wRh Loan
801. Our origination charge (Includes Origination Point 0.000%or$0.00) $ (from GFE#1�
802. Your credit or charge(points)for the specific interest rate chosen $ (from GFE#2)
803. Your adjusted origination charges (from GFE A)
804. A raisal fee to from GFE#3
805. Credit re oR to from GFE#3
806. Tax service to from GFE#3
807. Flood certification to from GFE#3
808. to
900. IE�S ir�d Lender t�M P�Id M AdvmCe
901. Daily interest charges from from 1 2/2012 01 3 to 01/01/2014 @$O.00/day (from GFE#10)
902. Mort a e insurance remium months to from GFE#3
903. Homeowner's insurance months to from GFE#11
904. months to from GFE#11
1000.Reserves wkh Lender
1001. Initial deposit for your escrow account (from�FE#9)
1002. Homeowner's insurance months $ /month
1003. Mort a e insurance months $ Imonth
1004. Pro ert taxes months $ /month
1005. months $ /month
1006.Assessments months $ 0.00/month $
1007.Aggregate Adjustment �
1100.Title Cha
1101. Title services and lender's title insurance from GFE#4
1102. SetUement or closing fee lo $
1103. Owner's title insurance from GFE#5
1 t04. Lender's title insurance $
1105. Lender's title policy limit$0.00
1106. Owner's title policy limit$0.00
1107. Agent's portion of ihe total title insurance premium $
1108. Underwriter's portion of the total title insurance premium $
1109.Attorneys Fees to Baric Scherer LLC 575.00
1200.Govemment R�cord and Transier
1201. Government recording charges $ (from GFE#7) 140.00
1202. Deed$67.00 Mort a e$73.00 Release$
1203. Transfer taxes $ (from GFE#8) 1,380.00
1204. CitylCounty tax/stamps Deed$1,380.00 MoR a e$
1205. State Tax/stamps Deed$1,380.00 Mort a e$ 1,380.00
1206. Deed$ Mort a e$
1300.AdditlonalSeltlementC es
1301.Required services that you can shop for (from GFE#6)
1302. 2013 School Tax to Carlisle Borou h Tax Account $2,205.30 P.O.C.S'
1303. Final Water/Se�ver Acct#013216 to Borou h of Carlisle 45.36
1304. to
1305. to
,�� , , . ,• • . i � . . � � 2,095.00 9,905.36
'Paid outside of closing by(B)orrower,(S)eller,(L)ender,(I)nvestor,Bro(K)er."'Credit by lender shown on page 1."'Credit by seller shown on page 1.
Previous editions are obsolete Page 2 of 4 HUD-1
�i � , , ��.
��-.
o.00 o.00
o.00 o.00
o.00 o.00
� -.�,. c ,, ,* ,�,0 0.00 1,380.00
�pw; - . , _wNf�� z � '.�, a..F ... f n J, ?.���W�����.. �.... �v'�-., �
..�,�`��'� ^.:' A: �# �LV� . \i� 0.0� �4�.���
T setv�es and ineuranoe #'1107 0.00 0.00
ownersn insurance # � o.00 o.00
. #
#
� #
# ,
.�, ., .�.
�
, , 0.00 140.00
� $ 140.00 p� 999.9999%
C es'�tCan' GoodF�Nh'Estlnq�e ` HUD�1'
initial depoeft far your escrow account # 1001 0.00 0.00
Daily interest Ch2ngee f►arn ,. #90'I l 0.00 0.00
Homebwnets insUrence #! 0 00 0.00
�
r; �
� . _
�
Loan Terms
You1'InqNll�1lrt8t#�o�1tM , ;s `� `` , $
y����g years
Yaur ir�t I�iler�wt ri►6a i� `� �'' °�' '° %
.;, ,
Y�utl�iljeilntl�l�}'�g�`dN�tlt}''��t�I�,�:iY�lgqj►hlpl�epe $ includes
kteUtapo9i6'; �Principal
❑Interest
❑Mortgagelnsurance
�yq�p���� X❑No. ❑Yes,it can rise to a maximum of %. The first change
will be on l I and can change again every years afler I I Every change
date,your interest rate can increase or decrease by %. Over the life of the loan,your
interest rate is guaranteed to never be lower than %or higher than %.
,,,,
Ey�,��►���yMBl�,pfXb1Mle,�CBnyoutlpeKi b�lrqltbe? '': ❑X No. ❑Yes,it can rise to a maximum oi$
Eya�N ypu t�lt�p�pt�j`1,�t yqRrtfOnl��f'�rtIF�NltaNedf�pr ! QX No. ❑Yes,the first increase can be on I I and the monthly
pnndpalt,)n19re8t,`�►�ii�g8:ineUlark�a ti�e7` amount owed can rise to$
, ,v;:"= The maximum it can ever rise to is$
poea�qRtpgnhyygap�p�rt�e�ttpe�T' : 's:'f °" s �:' �X No. ❑Yes,yourmaximumprepaymentpenaltyis$
����a y�qq��� QX No. ❑Yes,you have a bal loon payment of$ due in
:'�x . ,°� a �n years on / /
e- .
rpt�l fll0�hl�f gmpldl(`qNb��'�YiIBG�qpltp��BfllB XQ You do not have a monthly escrow payment for items,such as property taxes
and homeowner's insurance. You must pay these items directly yourself.
�You have an additional monthly escrow payment of$
� ` that results in a total initial monthly amounl owed of$ This includes principal,interest,
any mortgage insurance and any items checked below:
�:;�."„
❑Propertytaxes ❑HomeownePsinsurance
"� ' �' 'z ��`� ' �: �Flood insurance ❑
` ., ❑ ❑
Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form,please contact your lender.
Previous editions are obsolete Page 3 of 4 HUD-1
. .�� . .�,��s> . . .�,_., _
. HUD CERTIFICATION OF BUYER AND SELLER
1 have carefully reviewed the HUD-1 Settlement Statement and to the best of my knowledge and belief,it is a true and accurate statement of all receipts and
disbursements made on my account or by me in this transaction.I further certify that I have received a copy of the HUa1 Settlement Statement.
_,,... .
____._- _ '>
�..t�--__..,. . .. .�-^�-----_._
��v/'--" l
Welubhi Housing Group,LLC
i� /,.�vl;' ��'J G�-ct..___ y�-tw%L
Estate of John V�: riffith,Jr.
!
The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction.I have caused or will cause the funds to be
disbursed in accordance with this state t.
1 1 / �
�,��� /Z Zd �l�
S TLEMENT AGENT DA�
WARNING:IT IS A CRIME TO KNOWINGLY MAKE FAISE STATEMENTS TO THE UNITED STATES ON THIS OR ANY SIMILAR FORM.PENALTIES UPON
CONVICTION CAN INCLUDE A FINE AND IMPRISONMENT.FOR DETAILS SEE TITLE 18:U.S.CODE SECTION 1001 AND SECTION 1010.
Previous editions are obsolete Pag°4 of 4 HUD-1
�
� �
��Fid'elit,� ��� �
I i1fVBf T M61�f T8
.'Si.��.l . _. ..... .,i
July 29, 2013
ROGER B IlZWIN
C/O LAW OFFICES IRWIN &MCKNIGHT PC
WEST POMFRET PROFESSIONAL BUII.DING
60 W POMFRET ST
CARLISLE,PA 17013-3222
Dear Roger B Irwin:
As requested, please find the Date of Death Account Valuation for the Estate of John Wesley Griffith Jr
Estate Valuation
Account Number: 152126780 Value Date: 06/01/2013
Share
Symbol Security Description Qty Value Price
FLPSX FIDELITY LOW PRICED STOCK 7633.733 $349,395.96 $45.77
FSICX FIDELITY STRATEGIC �NCOME 6926.876 $77,650.28 $11.21
PFE PFIZER INC 300 $8,279.25 $27.60
QQ� POWERSHARES QQQ TR UNIT SER 1 12120 $889,365.60 $73.38
VTI VANGUARD INDEX FDS VANGUARD TOTAL STK MKT 2800 $236,908.00 $84.61
Total Securities: $1,561,599.09
Cash/Money Markets: $76,633.05 $1.00
Total Value: $1,638,232.14
Estatc�Jaluatian
Account Number: 152151840 Value Date: 06/01/2013
Share
Symbol Security Description �ty Value Price
QQQ POW ERSHARES QQC1 TR UNIT SER 1 129.231 $9,482.97 $73.38
Total Securities: $9,482.97
Cash/Money Markets: $4,794.46 $1.00
Total Value: $14,277.43
DODNEW Brokerage Services provided by Fidelity Brokerage Services LLC Member NYSE,SIPC
Clearing,custody and settlement services by National Financial Services LLC Member NYSE,SIPC
P.O.Box 770001,Cincinnati,OH 45277-0034
�'�,1�'ide/i[y
Estate Valuation
Account Number: 207282820 Value Date: 06/01/2013
, Share
Symbol Security Description Glty Value Price
VTI VANGUARD INDEX FDS VANGUARD TOTAL STK MKT 110 $9,307.10 $84.61
Total Securities: $9,307.10
Cash/Money Markets: $3,647.72 $1.00
Total Value: $12,954.82
All values included represent the Fair Market Value(FMV)of assets held in the account as of the owner's
date of death.The report does not include Limited Partnerships,Precious Metals or Worthless Security
positions held in the account as of the date of death nor any accrued dividends not distributed prior to the
date of death. Values for any accounts that only hold those asset types are therefore, not included.
Fidelity does not warranty the accuracy of this information for any particular purpose nor does Fidelity
provide legal or tax advice. Consult with an attorney or tax professional regarding any specific legal or tax
situation.
We hope this information is helpful. If you have any questions regarding this matter or need instructions
on how to transfer the ownership of the accounts not yet transfened, please call us at 800-544-0003.
Fidelity Inheritor Services Representatives are available Monday through Friday, from 8:00 A.M. to 6:30
P.M. Eastern time,or you may visit our website at www.fidelity.com and search under"change account
registration"for additional information.
Sincerely,
Brannan Pouncy
Brannan Pouncy
Fidelity Investments Operations and Services Group
DODNEW Brokerage Services provided by Fidelity Brokerage Services LLC Member NYSE,SIPC
Clearing,custody and setdement services by National Financial Services LLC Member NYSE,SIPC
P.O.Box 770001,Cincinnati,OH 45277-0034
Prospectus Su lement
GE Capital GE Interest Plus
� r INVESTMENT NUMBER:93509242247164
� invest Direct
PAGE 1 OF 2
�
Under $15,000 to $50,000 to Over
$15,000 $49,999.99 $5 Million $5 Million
02040 SH BG218002 Date Rate Rate Rate Rate'
JOHN W GRIFFITH 08/11/2012 1.00 1.05 1.10 .25
201 MEADOW BOULEVARD
CARLISLE, PA 17013 'The portion of your investment that is>$5 Million will earn a rate of
.25%.
MANAGE YOUR INVESTMENT ONLINE AT WWW.GECAPITALINVESTDIRECT.COM.
LOG IN TO VIEW YOUR BALANCE,ACTNITY AND CHFCK IMAGES,INITIATE TRANSFERS,
OPT-IN FOR E-STATEMENTS,AND UPDATE YOUR PROFILE. NOT REGISTERED FOR
ESERVICE�SIMPLY CLICK ON"REGISTER NOW AND FOLLOW THE INSTRUCTIONS
PROVIDED.
Summary of investments, interest, and Redemptions for the period: MAY 1,Z013 TNROUGH MAY 31,2013
Opening Balance Investments Interest Redemptions Other Charges Closing Balance
$6,409.40 $0.00 a5.45 $0.00 $0.00 $6,414.85 f =
Date Type of Activity Amount Balance Information �
05I31l2013 REF:0000004429000 MTD INT POSTED TRANS 05/312013 $5.45 $6,414.85 Current GE Interest �
Plus Rates and �
Investment �
Information: �
1-800-433-4480 �
24 hours/ 7 days/ �
week �
�
�
Service ��
Representatives: �
1-800-4334480, �
business days, �
8:00 AM to 7:00 PM �
ET.
ACH Transfers:
ABA#043302493
Wire Transfers:
ABA#043000261 g
N
Oniine Services: o
wvvw.GECapitallnvestDire
ct.com S2
S
�,
g��a�y n� Year Interss!this periQd Total Interest Yexr-to-Llate Tax Withheld Tax Withheld YTD �
Ir�terest Invested 2013 $5.45 $26.50 $0.00 $0.00
The investments in the GE Interest Plus Notes identified in this statement were made pursuant to a registered public offering.
.................................................._Cut along this line }�
.............. ... 8
........................................................................................ Additional Investment Form o
i � GE Capital JOHN W GRIFFITH Date: / / �
� InVESt DIreC� Check(s)Enclosed �
Make checks payable to: $ g
GE Tnterest P1us . p
m
0
�
U
Mail check(s)and this form to: piease note that investments g
made by check may not be Total
GE Capi tal Invest Di 1'eCt redeemed for 7 business days.
GE Interest P1 us Checks received aro subjectto
P. 0. Box 534020 collection and to the provisions DO NOT SEND CASH
Pi ttsburgh, PA 15253-4020 ofthe uniform Commercial
Code.
Note:The PO Box and zip is differeM for
deposits than tor correspondence. 9 3 5 0 9 2 4 2 2 4 716 4
3.9yyu��
Ca.,.�ot s: ?�A56
ner�l Electrie as Uisbursing Agent For: JR . ES '� OF JOFN GRIfFITH Pay Begin Oate: 07/OV201
clo Ro Irwin, Exewtor Pay End Oate: 07/311Z014
Contribution Mithdr�wals p�yment Date: 07/Oi12014
0. Box 6024 354 A? r Sprinq Road
henectady, NY 123U1-6024
Carli: 17D15 Check/Advice s: 4102381292
fEDERAL TAX DATA
�rtment:70104-W67 TR Contr Mithdraw�ls Employee ID:585U2799? ���tal Status:Married
r Group:PCW-TR Contribution Withdr�wais Pay Rate: Allovances:003 �� �t�
st 4 di its of SSN:8686 Shift:N Shift Percent: BEFORE-TWC DEDULTIONS
CUHRENi PER_I00 PAYl�NTS PFtIOR PERIOD PAYlENTS
Amount Description Current °YTD
°cription Rate` tburs Amount Oescription �t� ��S 0.00 0.00
'L CUftRENT 0.00 0.00 TOTAL PRIOR 0.00 - 0.00 TOTAL
CURRENT OTtfR PAYlENTS
OTFER INCDlE AFTER TAX DEDUCTIONS
Rate Hours Amount Oescription Amount Oescription Current YTO
�.cription 0.00 TOTAL 0.00 U.00
PenTxbl 0.0000 0.00 26,644.31 TOTAL OTFE R PAITENTS TAXES
• PenNtxb 0.0000 0.00 24,487.96
• <89 Txb 0.0000 O.OU 36,144.41 Description Current YTD
0.0000 0.00 7,618.22 Federal 12,557.74 12,557.74
� c89NTrb TpTp� 12,557.74 12,557.74
4L OfEER PAYlENTS 0.00 94,894.90
i
� � � � � `�i
i
TOTAL GROSS FED TA%ABLE f�t055 SOC SEC GRO55 lEDICARE GROSS TOTAL TAXES TOTAL DEDUCTIONS NET PAY PENSIDN GROSS �
URRENT: 94,894.90 62,788.72 0.00 0.00 12,557.74 D.00 62,337.16
fD: 94 894.90 62 788.72 0.00 0.00 12 557.74 0.00 82 337.i6
EAVE INFORMATION VAC AYG HOURS ELIGIBLE REPORTED TAKEN REMAINING PAY D[STRIBUTION 82,337.16
Check Amount
acation(Days) Diroct Deposit Amount O.OU
Total Net Pa ' 82 337.16
; THE FACE OF;THIS DOCUMENT liAS A G�EETI BACKGROl3ND-NQT A WHfTE$AGKGRQUNR �'
,. �; �_..,
_... . . .
� � . �-- ti
, . = Date Check No.
Gener�l Electric as Disbursinq Agent For: 64-1278/611 GA BANK �F NERICA, N.A. 07/O1/2014 4102381292
TR Contribution Mithdrawals
P.O. Box 6024
Schenectady, NY 12301-6024
Pay Amount
PaY Eighty-Two Thousand Three Hundred Thirty-Seven and 16/100 Dollars 582,337. 16
To The
�(t. . ESTATE Of JOHN GRIFFITH Void after 180 days
Order Of c/o Roger B. Irwin, Executor
354 Alexander Spring Road
Carlisle PA 17015
����j'��,"' {
�
�
�
�
��' 410238LZ92�i' �:�6LLL2788�: 329 976 986L��' �
Jul, 26. 2013 10: 32NN1 PNC Ba,nk No, 0341 P, 1 %1
����
��'���r;a��'
ruly 26, 2013
Roger B �rvvin Esq.
Irwin&McKnight P.C.
60 W Pomfret St
Carlisle,PA 17013-3222
xE= ro�w�ffi�
SSN: 1.68-48-4715
DOD: 06-01-2a13
llear Mr. Yrwin:
In response to your request for Date of Death(DOD) balances foz the customer noted above, our
records show the followzz�g: �
Chec[ring Account
Account# 5112072044 Established= 08-28-2007
70�'W GR7�'FYT�i
DOA balance: $ 25,55926 + 0.07 accrued��terest
Interest paid 01-01-2013 th�u 06-01-2013 � 1.15 YTD
please note that t�is office provides date of death balances for deposit accounts (7RAs, CDs,Chec�.iaag aaad
Sa�rings). We do not process an�financial transactiona or pro�ide statements. lf�rou need assistance with
any of these items,please call 1-888-P1�C-EAN'K(1-588-762-2265)or stop by your aocal PNC Bank branch
office.
5incerely,
l�ational Financial Services Center
. PN'C Bank,NA.
Mezxabez FAZC
1"his message is intended for the use of the individual or entity to which it is addressed and may
contain rriformatzor� that is privileged, confide�tial and exe�npt from disclosure under applicable law.
If the reader of t�izs message is not t�ae intended recipient or the employee or agent responsible for
delivering this message to the intended recipient, you are hereby notified that any dissemination,
distribution or copying of this communications is strictly prohibited. If'you hcrve received thrs
communication in error, please notify me immediately by reply or by telephone at 800-762-1775 and
imrrcediately desrioy this faxed document
, � _.
. :C 7•��.�r.�:i.c:r:�r, .::�;c"s
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AUTHORQED REPpESENTA7NE � OATE ��� _
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BY
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20b MEADOY BLVD �
CARLI�LE PA L7C113 �
pennsytvam� �'
DEPARTMENT OF TRANSPORTATLON����
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RO�VE'S AUCTIO�N SERVICE �RH 79L)
' 2505 Ritner Highway • Carlisle,PA 17015
Bill Rowe (AU 1538L) 249-1978 215-1044 574-1008 Dave Rowe (AU 2295L)
Auction Is Action Call "Rowe" For Satisfaction
�,�t....�.F.r�r �� +��-r � l� �v� '�
SELLERS NAME �b 1t�1� C--�sz��A- DATE
•�
ADDRESS �-1� ��`� �- ��-�L^� PHONE
OTHER AUCTIONEER %
AUCTION DATE/LOCATION CLERK %
DESCRIPTION OF MERCHANDISE
.� ROWE'S AUCTION SERVICE �;�6 rJ 716
SPECIAL ACCOUNT
2505 RITNER HIGHWAY
— CARUSLE,PA 17015 DaTE +4+-�G- �(��'voc3
—i- � PAY TO THE� _ .. ,_,:..
i ORDEftOF eA:16ti� I,.L�. �� 5..�._T�_� T� 1s—"'�p- I $ O°+ -
_ � �s � �667"-/".�
— � ��� T 1�3� �.t�d c�«-rr+s ��t+s�t�A_,r S i b� T;�_t(' l"'— DOLLARS LI ,,,�°"'......_
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— � ORRSTOWNBANK
A����u�
, �-_ MEMO_���c�_S• \ L i- - - �
'� �:0 3 L 3 15 0 3 6�: L 0 6 1 L 0 4 2 0 i�' S 7 16 . Merchandise
IC
to be sold as is t� gi'oupea as necess�y �..���_ .._.-�. - �---_--_� -- 'ize d repres e n-
tative of the merchandise,goods and or property and have good title and the right to sell and that they are free
from all incumbrances. I agree to accept all responsibility for providing merchantable title and for delivery of
title to the purchaser. I agree to hold harmless the Auctioneers against any claims of the nature referred to in
this agreement.
AUCTION SIG ATURE SELLERS SIGNATURE
Total Sales (Clerking 'I�ckets Attached) � � � � 1 '
Less Sale Expense: Q s-
% Commission Auctioneer � 3�� � �`
%Commission Clerks $
4THER: :
TOTAL SALE EXPENSE DEDUCTED $
ar
SELLERS NET � ! �S G�Z-
ROWE'S AUCTIQN SERVICE �RH 79L)
2505 Ritner Highway • Carlisle,PA 17015
Bill Rowe (AU 1538L) 249-1978 215-1044 574-1008 Dave Rowe (AU 2295L)
Auction Is Action Call "Rowe" For Satisfaction
SELLERS NAME ��o�:.•� 1--+ss3 s�-. �-J�-���'`�r` �n- '�g� DATE � ��° �� �
,�
ADDRE SS c-1„ ���'' tl�- �,+Lw t� PHONE
OTHEft AUCTIONEER %
AUCTION DATE/LOCATION CLERK %
DESCRIPTION OF MERCHANDISE
I Commission the Auctioneers to sell the merchandise to the highest bidder by Public Auction. Merchandise
to be sold as is & grouped as necessary to obtain bids. I certify that I am the owner or authorized represen-
tativa of the merchandise,goods and or property and have good title and the right to sell and that they are free
from all incumbrances. I agree to accept all responsibility for providing merchantable title and for delivery of
title to the purchaser. I agree to hold harmless the Auctioneers against any claims of the nature referred to in
thia agreement.
r
AUCTION SIG ATURE SELLERS SIGNATURE
Total Sales (Clerking Tickets Attached) $ � � � 1 '
Less Sale Expense: �S--
%a Commission Auctioneer $ 3�°t `-�
%Commiasion Clerks $
OTHER: :
TOTAL SALE EXPENSE DEDUCTED $
a S"
SELLERS NET $ 1 �..S ta.'2-
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Life lnsuranc� Campany�
Env # 422000052
ESTATE OF JOHN GRIFFITH
ROGER B. IRWIN, EXECUTOR
60 WEST POP�IFRE i STREET
° CARLISLE PA 17013
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C7l12/13 41U094404 Death 6enefit $47,651.32 0.00 0.00 0.00 $47.651.32
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MG 03439 400000030773816
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ot0ooss� Payment type: Death Benefit- non-spousal
ESTATE OF JOHN W GRIFFITH beneficiary
ROGER B IRWJN, EXECUTOR Check Number. 00260403045
C/O SALZMANN HUGHES - Gheck Date: - .1une 16, 2014
354 ALEXANDER SPRING ROAD oescription Current
CARLISLE PA 17015 �ross $�ao,747.56
Taxa bl e $126,184.09
Non-Taxable $14,563.47
Net $140,747.56
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VERIFY THE AUTHENTICITY OF THIS MULTI-TONE SECURITY DOCUMENT. CHECK BACKGROUND AREA CHANGES COLOR GRADUALLY FROM TOP TO BQTTOM
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� Check Numb2r Account Number ! Date of Check
00260403045 ' 03439 ` June 16,2014 �
, , : ; ' � a.....�..140,747.56
One Hundred Forty Thousand Seven Hundred Forty-Seven Dollars And 56 Cents
` Pay to the order of: : , _ vo�d Aner iao oays ,
ESTATE OF JOHN W GRIFFITH Deutsche Bank Trust Company Delaware
ROGER B IRWIN, EXECUTOR
C!O SALZMANN HUGHES : _.,, .,
354 ALEXANDER SPRING ROAD `
CARUSLE PA 17015 .
Authorized Signature
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MG 03439 400000030773816
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ESTATE OF JOHN W GRIFFITH Questions? can s��-�5a �z�i�rnr
ROGER B IRWIN, EXECUTOR �-soo-s�o-4o15),�;business days(except NYSE ''
C/O SALZMANN HUGHES holidays,)from 8:30 a_m;"-8�0 p_m ET or go ta ::':
354 ALEXANDER SPRING ROAD www.netbenefits,com/ge.;;
CARLISLE PA 17015
Distribution Statement
. :
Helpful To Know �
°• Review your transaction for accuracy,and report any discrepancies within 30 days.
•_ Remember to keep�our account address up to ciate �;,, �� � `
• Keep ihis stub(or report)until you receive your tax form next January. �'
• Retirement,plan diskributions may have tax consequences.You may wani to consuk a tax o�finaricial professionat ;;: .
. .this distribution is from an employee benefit ptan intended to be quatified under tntemal Revenue Code section 40i(a)
Distribution Summary
The following is a summary of a death benefit distribution processed from your account.
Beginning Balance $140,747.56
Less Withdrawat ($140,747.56)
Ending Balance $0.00
Tax Information
Tota I
� Total Distribution $140,747.56
Return of After-Tax Contribution $14,563.47
Total Taxable Amount $126,184.09
Ordinary Income Amount $126,184.09