HomeMy WebLinkAbout02-0469
Jan M. Wiley
David J. Lenox
Timothy J. Colgan
Christopher J. Marzzacco
David E. Hershey
Diana Woodside
Bradley A. Winnick
THE WILEY GROUP
Attorneys at La~
Wiley, Lenox, Colgan & Marzzacco, P.c.
February 12,2003
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
In Re: Estate ofFem W. Grove, deceased
File Number 21-02-00469
Dear Register:
Enclosed for filing please find an Inventory, the inheritance tax return in duplicate, and the status
report with regard to the above captioned estate. Also enclosed is a check in the amount of
$869.17 representing the tax due, and a check in the amount of$25.00 representing the filing fee.
Please return the recording receipts to my attention in the enclosed envelope.
Thank you for your cooperation.
Sincerely,
D~fd"'IA"'i'
/dg
encl.
1 South Baltimore Street · Dillsburg, PA 17019 . Phone: (717) 432-9666 · (800) 682-4250 . Fax: (717) 432-0426
Offices in Harrisburg . York. Carbondale
www.wileygrouplaw.com
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of Grove, Fern W.
also known as
, Deceased
No. 21 - 02 - 00469
Date of Death 5/5/2002
Social Security No. 204-03-4342
Robert D. Grove
The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory
include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania
of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the
Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that
which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true
and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa, C. S. Section 4904
relating to unsworn falsification to authorities.
Attorney:
Jan M. Wiley, Esq.
Personal RepresenifMatiV a?1
Signature: _ ~/. _ ~____
Ro e D. Grove
Signature:
I.D. No.:
06298
Signature:
Address:
1 S. Baltimore St.
Dillsburg, P A 17019
Address: 45 AItoona Ave.
Enola, P A 17025
Teiephone: 717/432-9666
Telephone: 717-732-5626
Dated:
~ I"t- \-n..3
Personal Property
Pennsylvania Power and Light
37,430.00
PECD Energy Company:
5,540.00
PNC Brokerage Corp. Blackrock FDS Govt Income Port CLB PNGBX:
12,686.73
American Express Mutual Funds Account Number 01122469684 6 002 + Interest Earned to
date of death:
17,594.30
Loan owed to decedent from Charles A. Grove:
35,387.90
PNC Brokerage Corp. Money Market Account:
1.46
Citizens Bank Account Number 112-422-5218:
77,045.19
PNC Bank Account Number 5140457064:
77,580.64
CNA (Refund Insurance):
3,480.00
(Attach additional sheets if necessary)
Total Personal Property and Real Estate
$266,746.22
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
WILEY JAN M ESQUIRE
1 S BALTIMORE STREET
DILLSBURG, PA 17019
----.--- fold
ESTATE INFORMATION: SSN: 204-03-4342
FILE NUMBER: 2102-0469
DECEDENT NAME: GROVE FERN W
DATE OF PAYMENT: 02/13/2003
POSTMARK DATE: 02/12/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 05/05/2002
NO. CD 002162
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $869.17
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
REMARKS: JAN M WILEY ESQUIRE
CHECK# 0113
SEAL
INITIALS: CW
RECEIVED BY:
REGISTER OF WILLS
$869.17
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
VV
o~
STATUS REPORT UNDER RULE 6.12
Name of Decedent: !err) I AI.
Date of Death: E; IS / ;).Ol')~
I
Will No. d/ -()~ - ()/) '-II, 9
r-; ro \r~
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
State whether administration of the estate is complete:
Yes '/. No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
1.
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal r~presentative file a final
account with the Court? Yes No ~
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
. c. Did the personal representative sXte an
account informally to the parties ~n ~nterest? Yes No
d. Copies of receipts, releases, joinders and
approvals of formal or informal a~,ounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
Date:~.V (7 ) nJ
. (
) .
( type )
()/le- S .13a..1-hW1ore. sl-
Address :/)///.shurg I PIf 17019
(Ill) 4;),.2-9/Ju!t
Tel. No.
Capacity:
Personal Representative
~unsel for personal
representative
(MAH:rmf/AM3)
1-?-6.:3 ~ J?
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
JAN M WILEY ESQ
THE WILEY GROUP
1 S BALTIMORE ST
DILLSBURG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
03-31-2003
GROVE
05-05-2002
21 02-0469
CUMBERLAND
101
'*
REV-1547 EXAFP {Dl-OS>
FERN
W
Allount Rellitted
PA 17019
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REY=is4j-EX-AF'P-coFiiirNciT"icE--OP-YNHEififAifci-YA'irA"PPRA"isEMENT~--ALl-oWANCi-OR------------ -- ---
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF GROVE FERN W FILE NO. 21 02-0469 ACN 101 DATE 03-31-2003
TAX RETURN WAS: I X) ACCEPTED AS FILED
CHANGED
NOTE: I~ an assessment was issued previously, lines 14, IS and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 et Spousel rete (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
.00 X 00 = .00
244,314.96 X 045 = 10,994.17
.00 X 12 = .00
.00 X 15 = .00
119)= 10,994.17
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estete ISchedule A)
2. Stocks and Bonds ISchedule B)
3. Closely Held Stock/Partnership Interest ISchedule C)
4. Mortgages/Notes Receivable ISchedule D)
5. Cash/Bank Deposits/Misc. Personal Property ISchedule E)
6. Jointly Owned Property ISchedule F)
7. Transfers ISchedule G)
8. Total Assets
11)
(2)
(3)
(4)
IS)
(6)
(7)
.00
73.251.03
.00
35.387.90
158.107.29
.00
21.472.37
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Misc. Expenses ISchedule H)
10. Debts/Mortgage Liabilities/Liens ISchedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts ISchedule J)
14. Net Value of Estate Subject to Tax
(9)
110)
42,869.39
1.034.24
Ill)
112)
(13)
114)
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
288,218.59
43.903 63
244,314.96
.00
244,314.96
I''':'''I:~''' 1+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID 1-)
08-01-2002 CDOO1476 506.25 9,618.75
02-12-2003 CD002162 .00 869.17
TOTAL TAX CREDIT 10,994.17
BALANCE OF TAX DUE .00
INTEREST AND PEN. .83
TOTAL DUE .83
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICR), YOU MAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
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July 29, 2002
THE WILEY GROUP
\F ..2 i' :! 1
Wiley. Lenox · Colgan · Marzzacco · P.c.
Attornc)'s at La\V
Register ofWiIls
Cumberland County Courthouse
1 Courthouse Square
Carlisle, P A 17013
,.,\
\.,1,
In Re: Estate of Fern W. Grove
Number 21-02-0469
Dear Register:
Enclosed please find a check from the Estate of Fern W. Grove in the amount of
$ -r c, I ~, "75 for prepayment of inheritance tax. This payment is being made on an
estimated estate as follows: $22..5.000 @ 4.5% for a total tax of$ fCl, I L. S. Qc) , less the
5% discount of $ 50 fc.. '2.5 equals the payment of qb 1$, 7 S-
Please return a receipt to my office in the envelope provided.
Thank you for your assistance.
(-"'Sincerely,
\~'"
c...... . G-J P,
M. WILEY, ESQUIRE
JMW/sdg
encl.
jan M. Wiley. David j. Lenox. Timothy j. Colgan · Christopher j. Marzzacco · Christine j. Taylor
1 South Baltimore Street · Dillsburg, PA 17019 . Phone: (717) 432-9666 · (800) 682-4250 . Fax: (717) 432-0426
Offices in Harrisburg. York . Carbondale
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
WILEY JAN M
1 S BALTIMORE STREET
DILLSBURG, PA 17019
-------- fold
ESTATE INFORMATION: SSN: 204-03-4342
FILE NUMBER: 2102-0469
DECEDENT NAME: GROVE FERN W
DATE OF PAYMENT: 08/02/2002
POSTMARK DATE: 08/01/2002
COUNTY: CUMBERLAND
DATE OF DEATH: 05/05/2002
NO. CD 001476
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $9,618.75
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TOTAL AMOUNT PAID:
$9,618.75
REMARKS: JAN M WILEY ESQUIRE
CHECK# 106
SEAL
INITIALS: AC
RECEIVED BY:
REGISTER OF WILLS
MARY C. LEWIS
REGISTER OF WILLS
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CERTIFICATION OF NOTICE UNDER RULE 5 6 (a)
Name of Decedent: Fern W. Grove
Date of Death: May 5, 2002
Estate Number: ..:t \-0). -o4li? q
To the Register:
I certify that notice of beneficial interest required by Rule 5.6 (a) of the Orphans' Court
Rules was served on or mailed to the following beneficiaries of the above-captioned estate on
May 21 ,2002:
~
Charles A. Grove
Robert D. Grove
Address
12314 Quercus Ln. Wellington, FL 33414
45 Aitoona Ave., Enola, P A 17025
Notice has now been given to all persons entitled t~ under Rule 5.6 (a) except N/ A.
D,t., May ~I ,2002 ~ '^' ,W~
Ig ture
Name: Jan M. Wiley, Esquire
Address: One S. Baltimore St.
Dillsburg, PA 17019
Telephone: (717) 432-9666
::---"J
['-!
Capacity: Counsel for personal Rep.
("",J
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1Lnsl mill nun QIes1nm.ent
21-OZ -lf~q
OF
FERN W. GROVE
BE J:T REMEKBERED, that I, FERN W. GROVE, of 122 West
York
street,
Dillsburg
Borough,
York
County,
Pennsylvania,
being
of
sound
mind,
memory
and
understanding, do make, publish and declare this as and
for my Last will and Testament, hereby revoking and
making null and void any and all wills and Testaments and
writings in the nature thereof by me at any time
heretofore made.
J:TEM 1: I direct that all my just debts and funeral
expenses be paid as soon after my demise as may be
convenient.
J:TEM 2: All the rest, residue and remainder of my
estate, of whatsoever nature and wheresoever situate,
whether it be real, personal or mixed, including property
over which I have a power of appointment, I give, devise
and bequeath unto my two children, CHARLES A. GROVE and
ROBERT D. GROVE, in equal shares, per stirpes.
J:TEM 3:
I appoint MARLENE K. GROVE, as guardian
over any property which passes either under this will or
otherwise to a minor and with respect to which I am
authorized to appoint a guardian and have not otherwise
specifically done so, provided that this appointment of
a guardian shall not supersede the right of any fiduciary
in its discretion to distribute a share where possible to
the minor or to another for the minor's benefit.
Such
WITNESS:
,\...-.4...--,,-.-- t,,'\.......,
, J J-c,
}-J!/'UV -(-do J~",--
FERN W. GROVE
(SEAL)
r~t1fl~ ~~~
-1-
guardian shall have the power to use principal as well as
income from time to time for the minor's support and
education, (including college education, both graduate
and undergraduate), without regard to his or her parent's
ability to provide for such support and education, or to
make payment for these purposes, without further
responsibility to the minor's parent or to any person
taking care of the minor.
ITEM 4: I direct my hereinafter named Co-Executors
to pay all inheritance, estate, succession and legacy
taxes of whatsoever nature and kind, to which my estate
or the transfer of any property passing hereunder or
otherwise passing by reason of my demise, may be subject
and to charge such taxes against my residuary estate, it
being my intention that none of the aforesaid taxes,
either federal or state, on any property required to be
included in my gross estate, under the provisions of any
state or federal law now in force or hereafter enacted,
shall be prorated among the persons interested in my
estate to whom such property is or may be transferred or
to whom any benefit accrues.
ITEM 5: I appoint my two children, CHARLES A. GROVE
and ROBERT D. GROVE, as Co-Executors of this my Last will
and Testament.
ITEM 6: I direct that my Co-Executors, Guardian or
their successors shall not be required to give bond for
the faithful performance of their duties in any
W~ESS:
(--"1r~ ~"^- 1 J ~
~& ,!hwJuvf
j~j1-"L) L-LI. /~~
FERN W. GROVE
-2-
(SEAL)
jurisdiction.
seal
IN WITNESS WHEREOF,
l/.+h
this oIu - day of
I have hereunto set my hand and
0/./ j///J:i
, 1995.
hv1J -Cu. ./~
FERN W. GROVE
(SEAL)
-3-
COMMONWEALTH OF PENNSYLVANIA
SS
COUNTY OF YORK
.
.
We, FERN W. GROVE, JAN M. WILEY, ESQUIRE and JANICE
E.
SHAMBAUGH,
the
Testatrix
and
the
witnesses
respectively, whose names are signed to the attached or
foregoing instrument, being first duly sworn, do hereby
declare to the undersigned authority that the Testatrix
signed and executed the instrument as her Last will and
Testament and that she had signed willingly (or willingly
directed another to sign for her), and that she executed
it as her free and voluntary act for the purposes therein
expressed, and that each of the witnesses, in the
presence and hearing of the Testatrix, signed this Last
Will and Testament as witness and that to the best of
their knowledge the Testatrix was at the time eighteen
(18) years of age or older, of sound mind and under no
constraint or undue influence.
~~1!.4J '-WI /~
~. GROVE
~~::;
ITNESS
Sworn to and subscribed
before me this d& -t!J day of
C2u. ~ (ALl :t , 1995.
5-) C ~ ./11 CI-)/ o-f -:L~
NOTARY PUBLIC
MY COMMISSION EXPIRES:
Notarial Seal
S. Dawn Gladfetter, Notary PubflC
Carroll T wp., York County
My Commission Exr.res May 17, 1997
Mi<Tlb&r. PQnnsylvaniaAssociation of Notaries
Register of Wills of Cumberland County, Pennsylvania
PETITION FOR GRANT OF LETTERS
Estate of Fern W. Grove
also known as
No. 2, - 01- 4t.Q
, Deceased
Social Security No. 172 - 32 - 2180
Robert D. Grove
Petitioner(s), who is/are 18 years of age or older, apply{ies) for:
(COMPLETE 'A' or 'B' BELOW:)
m A. Probate and Grant of Letters Testamentary and aver that Petitioner{s) is/are the execut or named in the last Will of
the Decedent, dated 08/26/95 and codicil(s) dated None
Named Co-Executor, Charles A. Grove, renounces his right to serve.
State relevant circumstances, e.g., renunciation, death of executor, etc.
Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the documents
offered for probate; was not the victim of a killing and was never adjudicated incompetent:
o B. Grant of Letters of Administration
(c.I.a.; d.b.n.c.l.a; pendente lite; durante absentia; durante minoritate)
Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and
heirs:
I
Name
RelationshiD
Residence
I
(COMPLETE IN ALL CASES:) Attach additional sheets if necessary.?,--, ^
Decedent was domiciled at death in Cumberland c: ;-7."''l.JI.YV tounty, Pennsylvania with his/her last family
or principal residence at 770 Poplar Church Road
(list street, number, and municipality)
, 19.Q1, at West Shore Health & Rehab Center, PA
(Location)
Decedent, then ~years of age, died 05/05
Decedent at death owned property with estimated values as follows:
(If domiciled in PAl All personal property
(If not domiciled in PAl Personal property in Pennsylvania
(If not domiciled in PAl Personal property in County
Value of real estate in Pennsylvania
250,000.00
$
$
$
$
situated as follows:
Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and CodiciKs) presented with this Petition and the grant of
lellers in the a ro riate form to the undersi ned:
Si
Robert D. Grove
45 Altoona Avenue, Enola PA 17025
Il - LP3~ 'Y
~tepared by the Pennsylvania Bat Association
Copyright (c) 1996 form software only CPSystems, Inc.
Form RW-1 (1991)
Oath of Personal Representative
Commonwealth of Pennsylvania
County of Cumber land
The Petitioner(s) above-named swear(s) or affirrn(s) that the statements in the foregoing Petition are true
and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of
the Decedent, Pet~ioner(s) will well and truly admini..S ter the es~tate ; rding to law. /'
Sworn to or affirmed and subscribed X ~~;fJ L~
/ Ro ert D. Grove U :../ '. .
before me this 14 tflcJay of
:::.
d
i'....:.,
MAY
2002 ~~
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No.
2/- ()2 - L./lafl
Estate of Fern W. Grove
Deceased
Social Security No: 172-32-2180
Date of Death: 05/05/02
AND NOW,
MAY 14, 2002
, 19 , in consideration
of the Pet~ion on the reverse side hereon, satisfactory proof having been presented before me,
IT IS DECREED that Letters [R] Testamentary 0 Of Administration
(c.t.a.; d.b.n.c.t.a.; pendente lite; durante absentia; durante minoritate)
are hereby granted to
Robert D. Grove
in the above estate and that the instrument(s) dated
08/26/95
described in the Petition be admitted to probate and filed of record as the last Will of Decedent.
Letters. . . . . . .
FEES
$ ?70 00
$ lR 00
$ <:; 00
~ .~. _ ~~~/1 ~
~ ..(1tCv1~'''c /.l a . I<;!flh' ;r
Y ~ S Register of Wills p
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Attorney:L----:fa.n M. Wiley, EsqUIre
Short Certificate(s).
Renunciation.
Affidavits (
TOTAL.
Prepared by the Pennsylvania Bar Association Copyright (c) 1996 form software only CPSystems, Inc.
$ I.D. No: 06298
The Wiley Group
$ q 00 Address: One S. Baltimore St.
$ Dillsburg, PA 17019
$ <:; 00 Telephone: 717 /432 - 9666
$ filed 5-14-2002
mailed to atty 5-14-02
$
$ 307.00
Extra Pages ( ) .
Codicil. .
JCP Fee.
Inventory.
Other
Form RW-l (1991)
"
RENUNCIATION
21-02.- 4lD'J
In Re Estate of
FERN W. GROVE
deceased.
To the Register of Wills of
Cumberland
County, Pennsylvania.
The undersigned
named co-executor. son
of
the above decedent, hereby renounce(s) the right to administer the estate and respectfully ask(s) that Letters
Testamentary
be issued to
ROBERT D. GROVE
WITNESS
~n\1
I
hand this 1 '5 -t!) day of
f\A frj
,~~.
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""
12314 Quercus Ln. wellington, FL 33414
(Address)
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p
(Signature)
Subscribed and sworn to before me
this J6\:h day of ~ ' 2002.
~()J~ d 1uf I iJ:0
Notary Pub . c
(Address)
(Signature)
(Address)
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17-~3-?
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
I OFFICIAL USE ON"
IALE NUMBER
21 02 00469
I COUNTY CODE YEAR NUMBER
SOCIAL SECURITY NUMBER
COMMONWEALTH OF PENNSYlVAMA
DEPARTMENT Of REVENUE
OEPT.28Oe01
HARRISBURG, PA 17128-OllO1
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Grove, Fern W.
I DATE OF DEATH (MM-DO.YEAR) I DATE OF BIRTH (MM.OO-YEAR)
i 0510512002 I 08/18/1920
(IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL)
t../
204-03-4342
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WillS
SOCIAL SECURITY NUMBER
-~-m,.
l\i~ 104.
~~~ i 181 6.
~..
~ 0
2. Supplemental Return -~-----Cr3~Remainder RetuiTi-(date of death prioi--i012-13-82} ---
4a. Future Interest Compromise (date of death after 0 5. Federal Estate Tax Return Required
12-12-82)
7. Decedent Maintained a Living Trust (Attactl 8. Total Nurnberof Safe Deposit Boxes
copy of Trull)
10. Spousal Poverty Credit (date of d8ll1h between
1 .31.91 and 1-1--95
... .~ "
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Scl1edule J)
14. Net Value SubJectto Tax (Line 12 minus Line 13)
.- -----1 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATis
15 Amount of Line 14 taxable at the spousal tax rate,
I or transfers under Sec. 9116(a)(1.2)
! 16,Amount of Line 14 taxable at lineal rate
I
,
,~
::lz
~~
8~
Original Return
Limited Estate
Decedent Died Testate (Attach copy
"WIll
Litigation Proceeds Received
ME
Jan M. Wiley, Esq.
IRM NAME (I' applicable)
The Wiley Group
LEPHONE NUMBER
7171432-9666
1. Real Estate (Schedule A)
2. Stocks and Bonds (Scl1edule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
z
8
~
"
~
i<
<
u
w
'"
4. Mortgages & Notes Receivable (Scl1edule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Properly (Schedule F)
o Separate Billing Requested
7. Inter-Vivos' Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
g. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
, 11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
z
o
~
~
"
~
~
8
S
17. Amount of Line 14 taxable at sibling rate
i 18. Amount of Line 14 taxable at collateral rate
,
,
I
11g. Tax Due
.20. 0
,
)8*~\L*:;1if~$'~
1 S. Baltimore St.
Dillsburg, PA 17019
(1) None OFFICiAL USE ONLY
(2) 73,251.03
(3) None
(4) 35,387.90
(5) 158,107.29
(6) None
(7) 21,472.37
(8) 288,218.59
-----------.....----
(g) 42,869.39
(10) 1,034.24
(11) 43,903.63
(12) 244,314.96
(13)
(14) 244,314.96
x .00
(15)
244,314.96
(16) 10,994.17
x .045
x .12
(17)
x .15
(18)
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
(19) 10,994.17
Copyright 2000 fom software only The Lackner Group, Inc.
Form REV-1500 EX (Rev. 8-00)
Decedent's Cpmplete Address:
STREET ADDRESS
770 Poplar Church Rd.
CITY
: STATE PA
IZIP l7011
Camp Hill
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. CreditslPayments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
(1)
10,994.17
-..------
9,618.75
506.25
Total Credits (A + 8 + C)
(2)
10,125.00
3. Interest/Penally II applicable
D. Interest
E. Penally
TotallnterestlPenally (D + E)
4. II Line 2 is greaterthan Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a relund
5. "Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
A. Enter the interest on the tax due.
8. Enter the total 01 Line 5 + SA. This is the BALANCE DUE.
(3)
(4)__
(5)
(SA)
(58)
0.00
869.17
869.17
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; .........................m................. ............... ~ I
~.' ~::::~ :h::;:i~On~~s~:~s~~..~.~.~~~.~~~.~~~.:.~~.~.~.~~~~:~.~~~~~..~.~.i~.~~~~~~~:::::..~:::.....
d. . receive the promise for life of either payments, benefits or care?........................................... .........m......
2. II death occurred after December 12, 1982. did decedent transfer property within one year 01 death without
receiving adequate consideration?..................... ....".. ...... ,.. ,.. .... ...................--..................... ................... ...... ...... 0 ~
3. Did decedent own an ~in trust for'" or payable upon death bank account or security at his or her death?.... ~ D
4. Did decedent own an Individual Retirement Account, annuity, or other non.probate property which
contains a beneficiary designation?............. ......... ......................... ..,. ,... .., .,. ..,..... .,...... ..........-....... .... .............. ~ D
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Under penalties of perjury, I declare thall have examined this retum, Including accompanying schedules and stalements, and 10 the best of my knOlMedge and belief, it is true, correct
and complete. Declaration of
preparer 0 than tile personal representative is based on all information of which preparer h8$ any knatot
SIGN U OF PERSON RESPONS1B R FlUNG RETURN ADDRESS
.Gr It
45 Altoons Ave.
Enols, P A 17025
DATE
z..(l'L. J 0 3
-----.- TE -. --
"Z-l~"7._~
ADDRESS
"""
TURE OF PREPARER OTHER THAN REPRESENTATI
M. Wiley, Esq.
ADDRESS
1 S. Baltimore Sl.
Dillsburg, PA 17019
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the
surviving spouse Is 3% [72 P.S. ~9116 (a) (1.1) (i)l.
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%
[72 P.S. ~9116 (a) (1.1) (il)]. The statute does not examot s transler to s surviving spouse Irom tax, and the statutory requiremenls lor disclosure
01 assets and filing a tax return are still applicabie even il the surviving spouse is the only beneficiary.
For dales of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive paronl, or a stepparent 01 the child is 0% [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%, except as noted in 72 P.S. ~9116
1.2) [72 P.S. ~9116 <a) (1)].
The tax rate imposed on the net vaiue oltranslers to or lor the use 01 the decedenl's siblings is 12% [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.
iliCl1l111Iill Clltn Q[.eghntumt
OF
rBRlt .. GROVE
BB IT RBIIBIIllBRBD, that I, FBRIt.. GROVE, of 122 West
York
S't:reet,
Dillsburg
County,
York
Borough,
Pennsylvania,
being of sound mind,
memory and
understanding, do make, publish and declare this as and
for my Last will and Testament, hereby reVOking and
makinq null and void any and all Wills and Testaments and
writings in the nature thereof by me at any time
heretofore made.
ITBK l' I direct that all my just debts and funeral
expenses be paid as soon after my demise as may be
convenient.
ITBH 2. All the rest, residue and remainder of my
estate, of whatsoever nature and wheresoever situate,
whether it be real, personal or mixed, including property
over which I have a_power of appointment, I qive, devise
and bequeath unto my two children, ClUIRLBB A. GROVB and
ROBERT D. GROVE, in equal shares, per stirpes.
ITBII 3' I appoint JIAlILBRB It. GROVB, as guardian
over any property which passes either under this will or
otherwise to a minor and with respect to which I am
authorized to appoint a guardian and have not otherwise
specifically done so, provided that this appointment of
a guardian shall not supersede the right of any fiduciary
in its discretion to distribute a share where possible to
the minor or to another for the minor's benefit. such
. W~TNESS:
I
~~ V'-'
I~ vnJ jJ L
,)~
}--R/tA,)W, ./~
FERN Ii. GROVE
~
_1_
(SEAL)
guardian shall have the power to use principal as well as
income from time to time for the minor's support and
education, (including college education, both graduate
and undergraduate), without regard to his or her parent's
ability to provide for such support and education, or to
make payment for these purposes, without further
responsibility to the minor's parent or to any person
taking care of the minor~
ITBM 4: I direct my hereinafter named Co-Executors
to pay all inheritance, estate, succession and legacy
taxes of whatsoever nature and kind, to which my estate
or the transfer of any property passing hereunder or
otherwise passing by reason of my demise, may be subject
and to charge such taxes against my residuary estate, it
being my intention that none of the aforesaid taxes,
either federal or state, on any property required to be
included in my gross estate, under the provisions of any
state or federal law now in force or hereafter enacted,
shall be prorated among the persons interested in my
estate to whom such property is or may be transferred or
to whom any benefit accrues.
ITEM 5: I appoint my two children, CHARLES A. GROVE
and ROBERT D. GROVE, as Co-Executcrs of this my Last will
and Testament.
ITEM 6: I direct that my Co-Executors, Guardian or
their successors shall not be required to give bond for
the faithful performance of their duties in any
C$ESS:
~ ~~:;
Y--4~' U{ /~
FERN If. GROVE
-2-
(SEAL)
jurisdiction.
seal
III WITllBSS lIHBREOP,
v-m
this du - day of
I have hereunto set my hand and
o /L !11~f:.
, 1995.
~0t,,-.J w. /~
FERN If. GROVE
-3-
(SEAL)
COIDIONWBALTB OJ' PIl1UI8YLVlIllIA
88
COlJllTY OJ' YOU
We, J'BD W. GROVB, JAN II. WILBY, B8QU:IRB and JAN:ICB
B.
SIIAIIIlAUGB,
the Testatrix and the witnesses
respectively, whose names are signed to the attached or
foregoing instrument, being first duly sworn, do hereby
declare to the undersigned'authority that the Testatrix
signed and executed the instrument as her Last will and
Testament and that she had signed willingly (or willingly
directed another to sign for her), and that she executed
it as her free and VOluntary act for the purposes therein
expressed, and that each of the witnesses, in the
presence and hearing of the Testatrix, signed this Last
Will and Testament as witness and that to the best of
their knowledge the Testatrix was at the time eighteen
(18) years of age or older, of sound mind and under no
constraint or undue influence.
J-.u.u '-0, ~
W. GROVE
Sworn to and subscribed
before me this d& -t!i day of
~/ALl:t , ' 1995.
- \:.r~ ~ .ffJv,/ ",O'.&L
NOTARY PUBLIC
MY COMMISSION EXPIRES:
--
s,ea.n_..-,.Plbil
CaroIITwp.,Ytn;.COl.rtty
MyCcmniJOiln_May17,11l1l7
01
.
SCHEDULE B
STOCKS & BONDS
COP.uoNWEALTH OF PENNSYlVANIA
INHERITANCE TAX RETURN
RESIDENT OECEoarr
; FILE NUMBER
21 - 02 - 00469
--,...-----------..--------------------------
ESTATE OF
Grove, Fern W.
All property jolntly-owned with right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1 Pennsylvania Power and Light
DESCRIPTION
UNIT VALUE I VALUE AT DATE OF
I DEATH
37.43 37,430.00
I
55.40' 5,540.00
2 PECO Energy Company:
3
PNC Brokerage Corp. Blaci<rock FDS Govt Income Port CLB PNGBX:
1 American Express Mutual Funds Account Number 01122469684 6 002 + Interest
I Earned to date of death:
10.65
12,686.73
4
4.760
17,594.30
I
I
I i
~~_+I
TOTAL (Also enter on line 2, Recapitulation) I
73,251.03
'*
SCHEDULE D
MORTGAGES & NOTES RECEIVABLE
I
!
I
I FILE NUMBER
,
21 - 02 - 00469
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TM RETURN
RESlOf!NT DECeDENT
ESTATE OF
Grove, Fern W.
All property jolntly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1
DESCRIPTION
VAlUE AT DATE OF
DEATH
..------- --.-- ------~---
35,387.90
Loan owed to decedent from Charles A. Grove:
-~-'-'---_._._---
TOTAL (Also enter on Line 4, Recapitulation) 35,387.90
.
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
C~NlNEAL.THOFF>ENNSYlVAtM
INHERITANCE TAX RETURN
RESIOENT OECEDENT
ESTATE OF
Grove, Fern W.
I FILE NUMBER
I 21 -02-00469
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
NUMBER
1
DESCRIPTION
VALUE AT DATE OF
DEATH
1.46
PNC Brokerage Corp. Money Market Account:
2
Citizens Bank Account Number 112-422-5218:
77,045.19
3
PNC Bank Account Number 5140457064:
77,580.64
4
CNA (Refund Insurance):
3,480.00
TOTAL (Also enter on Line 5, RecapitulatIon)
158,107.29
*'
SCHEDULE G
INTER-VIVOS TRANSFERS &
MISC. NON-PROBATE PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIOENT OECEDENT
ESTATE OF
Grove, Fern W.
I FILE NUMBER
I 21-02-00469
uestlons 1 throu
TAXABLE VALUE
ITEM
NUMBER
This schedule must be com leted and filed If the answer to an of
, DESCRIPTION OF PROPERTY
[I IndlXJe Itl8 nama of the lnlnsfsree, lhw relellonBhip to decedent ancl the dale of transfer.
AttaCh a copy of the deed ftIr real estate.
I
D %OF
DATE OF EATH, " EXCLUSION
VALUE OF ASSETI DECD S ,(IF APPLICABLE)
INTEREST i
~---- ---,
1 American Express Annuity Number 93002389351 2004: 13,908.51 100% I
2 American Express Annuity Number 93005165391 1 004: 6,735.95 100% I
3 Citizens Bank Account Number 00220-448617 Fern W. 827.91 100%
I Grove Cust Miranda K. Grove:
,
i
13,908.51
6,735.95
827.91
TOTAL (Also enter on line 7, Recapitulation)
21,472.37
F~N~
Secur/t/..
. First Union Securities
WF3240
Harrisburg Branch
3401 North Front Street, Suite 110
Harrisburg, P A 17110
Tel 71 7 238-9636
800 254-82]]
Fax 7] 7 238-9789
May 23, 2002
Jan M. Wiley, ESQ
The Wiley Group
1 South Baltimore Street
Dillsburg, PA 17019
RE: Estate of Fern W. Grove
Dear Mr. Wiley:
Per your request dated May 20, 2002, I have provided for you the date of death
values as of May 3,2002 and May 6,2002 for 1000shares of Pennsylvania
Power and Light and 100fshares ofPECO Energy Company.
Pennsylvania Power and Light
(name changed to PPL Corporation on February 14, 2000)
, jJ'!P' May 3, 2002 May 6, 2002
\I
Hie:h Low
$37.82 $37.05
Close
$37.06
Hie:h
$37.90
Low
$37.15
Close _.j 31. 4'?P'OO
$37.43
~.
\OJ
PECO Energy Company
(name changed to Exelon Corporation on October 20, 2000)
May 3, 2002
May 6, 2002
Hie:h
$54.99
Low
$54.06
Close
$54.98
Hil!:h
$55.79
Low
$54.99
Close
$55.40
LtO'OC
j:r5", ~
Should you require additional information, please feel welcome to give me a call
at (717) 231-7205 or (800) 254-8211.
Am Union Securities. Inc.
'i
May 29,2002
o PNCBROKERAGECORP
The Wiley Group
Attorneys at Law
1 South Baltimore Street
Dillsburg, PA 17019
Attn: Jao M. Wiley, Esquire
RE: Estate ofFem W. Grove (204-03-43420
Dear Mr. Wiley:
Thank you for your letter dated May 20, 2002. Please find below the requested
information:
1. Title of Account
Fern W. Grove
2. Type of Ownership
Individual
3. Date Established
May 9, 1996
4. Date of Death Value (05/05/2002)
1,191.24200 Shares BLACKROCK FDS GOVT INCOME PORT CL B
PNGBX @$1O.65PERSHARE
$1.46 Money Market Account balaoce
The only security in this account is a Mutual Fund; there is no accrued interest.
Please do not hesitate to contact me if! cao provide you with further information.
Sincerely,
(k ;J-d
Chuck Little
CUdp
A PNC Bank Company
2 East Main Street Mecl1anicsburg Pennsylvania 17055
www.pncbrokerage:.com
Important Invetor Information: Securities brokerage and ot~r products and sr=rvj~ are provided by PNC Brok~ge
Corp, a registeral broker-dealer and member SIPC. PNC Brokerage Corp is a subsidiary of PNC Bank, National
Association, .
which is not a broker-<lealer.
I'May l= \Ill", I
I .No'BankGuarantte
'" "'" ,"WAA'" _,~, "-
AMERICAN EXPRESS FUNDS
AMERICAN EXPRESS CERTIFICATE COMPANY
AMERICAN EXPRESS BROKERAGE
10100 AXP Finlllnclal Center
Minneapolis, MN 55474
May 28, 2002
THE WILEY GROUP
ATTN JAN M WILEY
I SOUTH BALTIMORE ST
DILLSBURG, PA 17019
Re: ESTATE OF FERN GROVE
Dear JAN M WILEY:
We have received notification of FERN W GROVE's death. Please accept our condolences on
your loss. The deceased's name appears on the following accounts. Account values as of
05/0512002 are listed below. At the end of this letter, you will find a list of beneficiaries shown
in our initial review of the accounts.
Account Information
Mutual Funds
Acwunl Number
01122469684 6 002
Ownership
Individual
Annuities - Post 1985
Account Number
93002389351 2004
93005165391 1004
Ownership
Individual
Individual
Mutual Funds
Account Number
OJ 12246%84 6 002
Tota! Value
$17594.3
# of shares
3692.164
Asset Value Per Share
4.760
This value includes accrued interest. Account 01122469684 6 002 was opened on 6/2/1980.
Annuities - Post 1985
Account Number
93002389351 2 004
93005165391 1004
T ota! Value
$13908.51
$6735.95
Cost Basis
$7142.98
$5000.00
Policy Date
1/26/96
1/26/96
The date of death values provided are for estate tax purposes and are not values to be paid.
Accounts may be subject to market fluctuation as governed by each product. Please note that the
values indicated for any Life Insurance product( s) reflect the gross death benefit at date of
death, uot the cash value.
Insurance and annuities are
issued by IDS Ufe Insurance
Company. an American Express
company. American Express
Brokerage is provided by American
Express Financial Advisors Inc.
American Express Financial
Advisors Inc. Member NASa.
American Express Company is
separate from American Express
Financial Advisors Inc. and is not
a broker-dealer.
JUN-18-2002 11:14
PNCBANK CIF DEPARTMENT
412 705 ~~57 P.~I/~l
QPNCBAN<
June 18, 2002
San M. Wiley, Esquire
I South Baltimore Street
DilIsburg, PA 17019
RE: Estate of Fern W. Grove, deceased
SSN: 204-03-4342
DOD: 515/2002
Dear Attorney Wiley:
In response to your request for Date of Death balances for the customer noted above. our
records show the following:
Cheekine AuonDt
Account #5 140457064
Established 03/0111982
FERN W GROVE
DOD balance: 577,554.60" 526.04 accrued interest
4
For Brokerage information, please call J -800.762-6111. IV #42968089
Please notc that this office only provides date of dea1h balances for deposit accounts
(IRAs, CDs, Checking and Savings accounts). We do DO! prouss any f1n.atial
transadioDs or provide statements. If you need assistance with any of these items,
please call1.888-PNC-BANK (1.888. 762-2265). or stop by your local PNC Bank branch
office. .
Sincerely.
~ uj,Ja;J..
Rachelle Wells
1-800-762-1775
P7-PFSC-04-F
500 first Ave.
Pitt&burgh P A 15219
Member rDle
TOTAL P.0t
.: CITIZENS BANK
P.O. Box 7899
Philadelphia;PA 19101-7899
June 10, 2002
The Wiley Group
I South Baltimore Street
Dillsburg, PA 17019
Artn: Jan Wiley
Estate Of Fern W Grove
Date of Death: 05/05/2002
SSN 204-03-4342
Dear Sir/Madam:
In accordance with your request, the attached information sheet has been provided in the
above decedent's name as of his /her date of death.
For IL or LC accounts, contact our Loan Department at 1-800-537-5591. For all other inquiries, please
(215) 553-1585.
.J(Zdo~Juoto/;
Tylisha Tuck1 ' ('
-POiL -.Jf!){',CJt:.C,
Deposit Support Services 199-5355
R.. asS
Page I of 2
.: CITIZENS BANK
11onday, June 10,2002
Account
Number Account Title
112-422-5218
Fern W Grove
Date Opened: 01/01/1962
422-534
Fern W Grove
Principal Balint from Last
as of DOD Posting to DOD
$77,038.41 $6.78
Date Opened: 04/28/1989
Account Type: 00
Account Bal YTD Int to
as of DOD DOD
$77,045.19 $61.05
Account Type: SO
Principal Balint from Last Account Bal
as of DOD Posting to DOD as of DOD
YTD Int to
DOD
00220-448617
Fern W Grove Cust
Miranda K Grove UGMA
Date Opened: 05/02/1988
Principal Balint from Last
as of DOD Posting to DOD
$827.88 $0.03
Account Type: SA
Account Bal YTD Int to
as of DOD DOD
.$827.91 $0.72
Page 2 of 2
.
SCI-EDU.E H
F\.JoERAL EXPENSES &
AD\IINSTRA11VE COSTS
COMMONYtlEALn-I OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT OECEDENT
I FILE NUMBER
i 21-02-00469
ESTATE OF G F W
rove, ern .
Debts of decedent must be reported on Schedule I.
ITEM I DESCRIPTION
~IIIUM~
A. ! FUNERAL EXPENSES:
Cocklin Funeral Home:
AMOUNT
7,745.58
2 Charles A. Grove (Funeral Travel & Lodging):
4,956.29
3 Robert D. Grove (reimbursement for funeral meal):
88.98
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Robert D. Grove
Social SeClJrity Number(s) I EIN Number of Personal Representative(s):
14,500.00
Street Address
Enola
45 Altoona Ave.
State ~ Zip 17025
City
Year(s) Commission paid 2003
Attorney's Fees Wiley, Lenox, Colgan, & Marzzacco, P.C.:
14,500.00
2.
3. Family Exemption: (If decedent's address is nol the same as claimant's, attach explanation)
Claimant
Street Address
City
Relationship of Claimant to Decedent
Stale
Zip
4.
Probate Fees
Register ofWllls:
Register of Wills (add'l short certificates):
307.00
15.00
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
I
Other Administrative Costs
Filing Fee:
25.00
2
Cwnberland Law Journal (advertise):
75.00
Total of Continuation Schedule(s)
656.54
TOTAL (Also enter on line 9, Recapitulation)
.---r---
I
42,869.39
..
Sc:hedlE H
FmeraJ Elcpens 8 S &
AdI,iMdliwCosls conti1ued
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
3 The Sentinel (advertise):
I FILE NUMBER .
21 - 02 - 00469
I
I
100.31
ESTATE OF
Grove, Fern W.
4
Members 1st FCU (Estate account checks):
12.95
5
Miranda K. Grove (reimbursement):
141.00
6
Wachovia Securities (Commission for sale of stock & SEe. Fee):
402.28
._..___~________.____J_.__.____.______._
Page 2 of Schedule H
.
.
SCHEDULE I
DEBTS OF DECEDENT, MORTGAGE
LIABILITIES, & LIENS
Cow.tONWEAl1l-l OF PENNSYlV,r.NIA.
I~ERlTANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Grove, Fern W.
I FILE NUMBE~
i 21-02-00469
Include unreimbursed medical expenses.
ITEM
NUMBER
1 West Shore Health & Rehab:
DESCRIPTION
AMOUNT
-- -..--
456.12
2
West Shore EMS (last illness):
439.24
3
Pharmerica (Prescriptions):
121.40
4
Quantum Imaging (last illness):
17.48
5
6
TOTAL (Also enter on Line 10, Recapitulation)
1,034.24
REV.1m EX' (...., ...
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
.
SCHEDULE J
BENEFICIARIES
NUMBER
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
_._____'__n___..___.. __
I, FILE NUMBER
21 - 02 - 00469
RELATIONSHIP TO I' AMOUNT OR SHARE
DECEDENT i OF ESTATE
i
ESTATE OF
Grove, Fern W.
I.
TAXABLE DISTRIBUTIONS (include outright spousal distributions)
Miranda K. Grove
IGranddaughter
,
827.91
Charles A. Grove
12314 Quercus Ln.
Wellington, FL 33414
Ison
Ison
One-half of residuary
estate.
2
Robert D. Grove
45 A/toone Ave.
Enola, P A 17025
3
One-half of residuary
estate.
I
I
Enter dollar amounts for distributions shown above on Jines 15 through 18, as appropriate, on Rev 1500 cover sheet
II. !NON-TAXABlE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT
BEING MADE
I
I
I
I
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lB. CHARITABLE AND GOVERNMENTAL DISTRiBUTIONS
I
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I I
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I TOTAL OF PART 11_ ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEETI