HomeMy WebLinkAbout03-11-15 1505618403
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REV-1500 OFFICIAL USE ONLY
Bureau of Individual Taxes INHERITANCE TAX RETURN County Code Year File Number
PO BOX 280601
Harrisburg, PA 17128-0601 RESIDENT DECEDENT 21 14 0983
ENTER DECEDENT INFORMATION BELOW
Social Security Number Date of Death MMDDYYYY Date of Birth MMDDYYYY
07 13 2014 08 18 1925
Decedent's Last Name Suffix Decedent's First Name Mi
GROSS ARLENE M
(if Applicable)Enter Surviving Spouse's information Below
Spouse's Last Name Suffix Spouse's First Name MI
GROSS JR . JOHN W
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
FILL IN APPROPRIATE OVALS BELOW
n1. Original Return 2. Supplemental Return 3, Remainder Return(date of death X 1:1 n prior to 12-13-82)
n4. Agricultural Exemption(date of 5. Future Interest Compromise(date of 8. Federal Estate Tax Return Required
death on or after 7-1-2012) death after 12-12-82)
rx] 7. Decedent Died Testate 8. Decedent Maintained a Living Trust a 9. Total Number of Safe Deposit Boxes
(Attach copy of will) (Attach copy of trust.)
F110. Litigation Proceeds Received D 11. Non-Probate Transferee Return 12. Deferral/Election of Spousal Trusts
(Schedule F and G Assets Only)
13. Business Assets 14. Spouse is Sole Beneficiary
(No trust involved)
CORRESPONDENT-THIS SECTION MUST BE COMPLETED.ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO:
Name Daytime Telephone Number
IVO V OTTO 111 717 243 3341
First Line of Address
10 EAST HIGH STREET
Second Line of Address
ry
City or Post Office State ZIP Code
PA 17013
CARLISLE C)
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Correspondent's email address: lottogmartsonla .com 4
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17-1 r
REGISTER OF,WILLS USE ONLY
REGISTER OF WILLS USE ONLY _> _q -11
DATE FILED MMDDYYYY
c-n
DATE FILED STAMP
Side I
111111 IIIII IIIII IIIII IIIII VIII VIII VIII VIII Illli ILII IIII
1505618403 1505618403
J 1505618411
REV-1500 EX
Decedent's Social Security Number
Decedent's Name: Gross, Arlene M.
RECAPITULATION
1. Real Estate(Schedule A)....................................................................................... 1. 227,304 -00
2. Stocks and Bonds(Schedule B)............................................................................. 2. 46,282 - 02
3. Closely Held Corporation, Partnership or Sole-Proprietorship(Schedule C)......... 3.
4. Mortgages and Notes Receivable(Schedule D).................................................... 4.
5. Cash,Bank Deposits and Miscellaneous Personal Property(Schedule E).......... 5.
6. Jointly Owned Property(Schedule F) ❑ Separate Billing Requested............ 6.
7. Inter-Vivos Transfers&Miscellaneous Non-Probate Property
(Schedule G) ❑ Separate Billing Requested............ 7.
8. Total Gross Assets(total Lines 1 through 7)........................................................ 8. 273,586 - 02
9. Funeral Expenses and Administrative Costs(Schedule H).................................... 9. 420 - 50
10. Debts of Decedent,Mortgage Liabilities and Liens(Schedule 1)............................ 10.
11. Total Deductions(total Lines 9 and 10)................................................................ 11. 420 - 50
12. Net Value of Estate(Line 8 minus Line 11).......................................................... 12. 273,165 - 52
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which
an election to tax has not been made(Schedule J)............................................... 13.
14. Net Value Subject to Tax(Line 12 minus Line 13)............................................... 14. 273-,165 - 52
TAX CALCULATION-SEE INSTRUCTIONS FOR APPLICABLE RATES
15. Amount of Line 14 taxable
at the spousal tax rate,or
transfers under Sec.9116
(a)(1.2)X.00 273,165 - 52 15. 0 . 00
16. Amount of Line 14 taxable
at lineal rate X .045 0 -00 16. 0 . 00
17. Amount of Line 14 taxable
at sibling rate X.12 0 .00 17. 0 . 00
18. Amount of Line 14 taxable
at collateral rate X.15 0 . 0 0 18. 11 - 011
19. TAX DUE................................................................................................................ 19. 0 . 00
20. FILL IN THE OVAL IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT ❑
Under penalties of perjury,I declare 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 person responsible for filing the return is based on all information of which preparer has
any knowledge.
SIGNA ED E ON RESPONSIBLE FOR FILING RETURN Brian J. Gross 3 //D E
0/5-
ADDR'LtS
9908 S rt(ngkiiII koad, Orrstown, PA 17244
SIGNATU E FP PA E T N REPRESENTATIVE IVO V. Otto III L11
DTE
ADDRESS
10 East High Street, Carlisle, PA
11111111111111111111 II 111111111111 III Side 2
1505618411 1505618411
REV-1500 EX Page 3 File Number 21-14-0983
Decedent's Complete Address:
DECEDENT'S NAME
Gross,Arlene M.
STREET ADDRESS
406 Allendale Way
CITY STATE ZIP
Camp Hill PA 17011
Tax Payments and Credits:
1, Tax Due(Page 2, Line 19) (1) 0.00
2. Credits/Payments
A. Prior Payments
B. Discount 0.00
Total Credits(A +B) (2) 0.00
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
w
Make Check Payable to: REGISTER OF WILLSAGENT.
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;.................................. ❑ ❑x
c. retain a reversionary interest;or............................................................................................................... ❑
d. receive the promise for life of either payments,benefits or care?............................................................ ❑
2. If death occurred after Dec. 12, 1982, did decedent transfer property within one year of 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?....... ❑ 0
4. Did decedent own an individual retirement account,annuity,or other non-probate property which
contains a beneficiary designation?.................................................................................................................. ❑
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 172 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 step-parent of the child is 0 percent[72 P.S.§9116(a)(1.2)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5 percent,except as noted in[72 P.S.§9116(a)(1)].
• The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12 percent[72 P.S.§9116(a)(1.3)]. A sibling is defined,
under Section 9102,as an individual who has at least one parent in common with the decedent,whether by blood or adoption.
Rev-1502 EX+(12.12)
SCHEDULE A
pennsylvania REAL ESTATE
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Gross,Arlene M. 21-14-0983
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 decedent's interest If owned as tenant in common.
ITEM VALUE AT DATE
NUMBER DESCRIPTION OF DEATH
1 Residence-Real estate located at 406 Allendale Way,Lower Allen Township, Cumberland 227,304.00
County,PA, known as Tax Parcel No. 13-24-0807-180 and being described in Deed dated
7/27/1994 and being recorded on 7/27/1994 in Cumberland County Deed Book 109, Page 153,
and being conveyed to Arlene M.Gross, Decedent herein. Value is assessed value of
$229,600.00 x common level ratio of 0.99(see attached).
TOTAL(Also enter on Line 1, Recapitulation) 227,304.00
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group, Inc. Form PA-1500 Schedule A(Rev. 12-12)
Rev-1503 EX+(08-12)
SCHEDULE B
pennsylvania STOCKS & BONDS
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Gross,Arlene M. 21-14-0983
All property jointly-owned with right of survivorship must bedisclosed on Schedule F.
ITEM CUSIP VALUE AT DATE
NUMBER NUMBER DESCRIPTION UNIT VALUE OF DEATH
1 89.46022 shares of Frontier Communications Corp-See 5.7637909 515.63
attached
2 105 shares of Metlife Inc-See attached 55.9250476 5,872.13
3 321.89149 shares of Verizon Communications Inc-See 50.2125111 16,162.98
attached
Accrued dividend on Item 3 through date of death 170.60
4 176 shares of Wells Fargo-See attached 51.3675 9,040.68
5 US Savings Bond,Series EE-Issued 02/1993,Serial No. 14,520.00
X4175511 EE,face value$10,000(see attached)
TOTAL(Also enter on Line 2, Recapitulation) 46,282.02
(If more space is needed,additional pages of the same size)
Copyright(c)2012 form software only The Lackner Group,Inc. Form PA-1500 Schedule B(Rev.08-12)
REV-1511 EX+(08.13)
pennsylvania SCHEDULE H
DEPARTMENT OF REVENUE FUNERAL EXPENSES AND
INHERITANCE TAX
RESIDENT DECEDENT RETURN ADMINISTRATIVE COSTS
ESTATE OF FILE NUMBER
Gross,Arlene M. 21-14-0983
Decedent's debts must be reported on Schedule I.
ITEM DESCRIPTION AMOUNT
NUMBER
A. FUNERAL EXPENSES:
B. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of Personal Representative(s)
Street Address
City State Zip
Year(s)Commission Paid
2. Attorney's Fees
3. Family Exemption: (If decedent's address is not the same as claimant's,attach explanation)
Claimant
Street Address
City State ZiD
Relationship of Claimant to Decedent
4. Probate Fees 420.50
5. Accountant's Fees
6. Tax Return Preparer's Fees
7. Other Administrative Costs
TOTAL(Also enter on line 9, Recapitulation) 420.50
Copyright(c)2013 form software only The Lackner Group, Inc. Form PA-1500 Schedule H(Rev.08-13)
REV-1513 EX+(01.10)
pennsylvania SCHEDULE J
DEPARTMENT OF REVENUE
INHERITANCE TAX RETURN BENEFICIARIES
RESIDENT DECEDENT
ESTATE OF FILE NUMBER
Gross,Arlene M. 21-14-0983
RELATIONSHIP TO
NUMBER NAME AND ADDRESS OF DECEDENT SHARE OF ESTATE AMOUNT OF ESTATE
PERSON(S)RECEIVING PROPERTY (Words) ($$$)
Do Not 'sTrustee(s)
ITAXABLE DISTRIBUTIONS [include outright spousal
distributions,and transfers
under Sec.9116(a)(1.2)]
John W.Gross,Jr. Spouse 100%of residue 273,165.52
406 Allendale Way
Camp Hill, PA 17011
Total 273,165.52
Enter dollar amounts for distributions shown above on lines 15 through 18 on Rev 1500 cover sheet,as appropriate.
NON-TAXABLE DISTRIBUTIONS:
II• A.SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT TAKEN
B.CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
TOTAL OF PART II-ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
Copyright(c)2010 form software only The Lackner Group, Inc. Form PA-1500 Schedule J(Rev.01-10)
FAFILES\Clients\76341.Gross\7634.5.w.will.2011 r
7634.5
p
LAST WILL AND TESTAMENT
1,ARLENE M. GROSS, of Camp Hill, Cumberland County, Pennsylvania,being of sound
and disposing mind and memory, do hereby make,publish and declare this to be my Last Will and
Testament, hereby revoking any and all former Wills or Codicils by me made.
ITEM ONE
I direct that all my legally enforceable debts, funeral expenses, testamentary expenses and
all inheritance taxes shall be paid to the extent possible from the assets held or passing under ITEM
SIX hereof as soon as practicable after my decease and as part of the administration of my estate.
ITEM TWO
In the event my said husband, JOHN W. GROSS, JR., shall predecease or fail to so survive
me by thirty(3 0)days, then I give such items of personalty as are itemized in a certain list attached
hereto to the persons named thereon, which list is signed and dated by me at the end thereof.
ITEM THREE
I give all of my personal and household effects, automobiles, boats and collections, if any,
and any insurance policies thereon,unto my husband,JOHN W. GROSS, JR., if he survives me by
thirty(30) days, otherwise to my children who so survive me to be divided equally among them as
they agree. My Executor(s) shall sell any property as to which there is no such agreement within
sixty (60) days after the admission of this Last Will and Testament to probate and shall add the
proceeds to the residue of my estate.
ITEM FOUR
If my husband,JOHN W. GROSS,JR.,is living thirty(30)days after my death,then I give,
devise and bequeath all of my estate,both real and personal property,unto my said husband,JOHN
W. GROSS, JR., absolutely.
If my said husband does not survive me by thirty(3 0)days,then I give,devise and bequeath
all the rest, residue and remainder of my estate, in the following manner:
A. In light of gifts made by me and my said husband during our lifetimes,I give the sum
of Two Hundred Fifty Thousand Dollars($250,000.00)to my daughter,KAYE L. SENSENIG,and i
the sum of Two Hundred Thousand Dollars($200,000.00)to my daughter,DIANE M. LAROCCA.
f
A.M.G.
Page 1 of 7 Pages
In the event either of my said daughters shall have predeceased or failed to survive me by thirty(30)
days,then such specific bequests shall be disposed of under the terms and conditions of ITEM SIX
(d) of this my Last Will and Testament.
B. I give the sum of Twenty Thousand Dollars ($20,000.00) unto each of my
grandchildren, to wit: CHAD SENSENIG, CARRIE SENSENIG, KYLE SENSENIG, DINA
LAROCCA,NICHOLAS LAROCCA,ZACHARY GROSS and NATHAN GROSS. In the event
any of said beneficiaries is a minor at the time for distribution,then his or her share shall be held by
his or her parent who is my descendent until such beneficiary reaches the age of twenty-one (21)
years,
C. All the rest, residue and remainder of my estate,both real and personal property, I
give unto my Trustees to be held or distributed by such Trustees under ITEM SIX(c) through (d)
hereof.
ITEM FIVE
In the event my said husband shall disclaim all or any portion of any devise or bequest made
to him under the foregoing ITEM FOUR, then the amount otherwise payable shall be held by my
Trustees under ITEM SIX hereof. For purposes of the Trust established under ITEM SIX hereof,
my said husband,JOHN W. GROSS,JR., shall not be deemed to have predeceased me by virtue of
his exercise of the right to disclaim set forth herein.
ITEM SIX
RESIDUARY AND DISCLAIMER TRUST
My Trustees shall hold the assets received under ITEMS FOUR and FIVE hereof,if any,for
the following purposes:
A. To pay the net income,at least quarter-annually,to my husband,JOHN W. GROSS,
JR., for life. In addition, the Trustees in their sole discretion,may invade the principal of the Trust
for the proper and adequate support of my husband.
B. In addition to the above provisions,my said husband shall have the power to direct
my Trustee to pay to him or to apply out of the principal of this Trust in each year,including the year
of my death, an amount not in excess of the greater of Five Thousand ($5,000.00) Dollars or five
1)M&
A.M.G.
Page 2 of 7 Pages
(5%) percent of the then aggregate value of the principal of this Trust. This power shall be
noncumulative and may be exercised only by an instrument in writing signed by him and delivered
to my Trustee within the first thirty(30) days of fiscal year of this Trust.
C. Upon the death of my husband,JOHN W. GROSS,JR.,my Trustees shall distribute
the principal of the Trust to my children,BRIAN J. GROSS,DIANE M. LAROCCA and KAYE L.
SENSENIG, in equal shares, absolutely.
D. In the event that any of my said children shall fail to survive my husband and me,but
shall leave issue surviving, then such deceased child's share shall be held by my Trustees and the
net income therefrom shall be used for the support,maintenance and education of the issue of such
deceased child. My Trustees shall use as much of the principal as they shall deem desirable for said
purposes. My Trustees shall distribute absolutely the principal of such share of such deceased child
to the issue of such deceased child per stirpes as each shall attain the age of thirty(30)years. In the
event that any of my children shall fail to survive my husband and me and not leave issue surviving,
then such deceased child's share shall be added to the shares of my other children as if originally a
part thereof.
ITEM SEVEN
POWERS OF EXECUTOR AND TRUSTEES
In addition to the powers conferred by case law,by statute, and by other provisions hereof,
my Executor and Trustees and their successors, shall have the following discretionary powers
applicable to all property held by them which powers shall be effective without order of any court
and shall exist until final distribution.
A. To retain any property of any nature received by them for whatever period they shall
deem advisable;
B. To invest and reinvest all or any part of said property in such stocks,bonds,securities
or other property, real or personal, as in their discretion they shall deem proper, without regard to
statutes limiting the property which a fiduciary may purchase;
C. To sell,transfer,exchange or otherwise dispose of,any part of said property,for cash
or on terms,publicly or privately,or to lease,even for a term exceeding five(5)years or the duration
of any trust herein, without liability on the purchasers or lessees to see to the application of the
H (y!&
A.M.G.
Page 3 of 7 Pages
proceeds, and to give options for these purchases without the obligation to repudiate them in favor
of a higher offer;
D. To execute and deliver any deeds, leases, assignments or other instruments as may
be necessary to carry out the provisions of any trust hereunder;
E. To borrow money, including the right to borrow money from any bank and to
mortgage or pledge any asset of the estate as security;
F. To assume continuance of the status of any beneficiary with regard to death,marriage,
divorce, illness, incapacity and the like in the absence of information deemed reliable without
liability for disbursements made on such assumption;
G. To pay from the trust,or the income therefrom,all debts or claims against my estate,
or any taxes or similar charges on my estate;
H. To make any distribution hereunder either in kind or in money, or partially in kind
and partially in money. Distribution in kind shall be made at the market value of the property
distributed, and my Trustees, in their absolute discretion, may cause the share distributed to any
distributee to be composed of property similar to or different from that distributed to any other
distributee;
I. To exercise any subscription right in connection with any security held hereunder,to
consent to or participate in any recapitalization, reorganization, consolidation or merger of any
corporation, company or association, the securities of which may be held hereunder, to delegate
authority with respect thereto, to deposit investments under agreements, to pay assessments, and
generally to exercise all rights of investors;
J. To invest in endowment, insurance or annuity policies on the lives of beneficiaries
of any trust hereunder;
K. To continue in any partnership, joint venture, joint ownership or other business
enterprise of which I am a part at the time of my death;
L. To compromise claims;
M. To continue for whatever period of time as they shall deem necessary any ownership
as a tenant in common or as a partner,in real estate or other property and to act as I could have done
had I been living;
A�
A.M.G.
Page 4 of 7 Pages
N. To lend money to my estate or to any trust created hereunder or to purchase from the
estate or from any trust created hereunder, at the market value thereof at the time of purchase, any
securities or other property tendered to them by my estate or any trust created hereunder at any time
and from time to time within a period of nine(9)months after my death;
O. In the event that any amounts are payable hereunder or under any trust created
hereunder to a minor, or to a person otherwise under legal disability, or to a person not adjudicated
incompetent, but who,by reason of illness or mental or physical disability is, in the opinion of the
fiduciary(ies)hereunder,unable to properly administer such amounts,such amounts may be paid by
the fiduciary(ies)hereunder in his,her or their sole discretion in any of the following ways as he,she
or they may deem best:
(1) Directly to such beneficiary;
(2) To a legally appointed guardian of such beneficiary for the benefit of such
beneficiary;
(3) To a person having custody of such beneficiary for the benefit of such
beneficiary;
(4) By the fiduciary(ies)hereunder using such amounts directly to the benefit of
such beneficiary.
Evidence of the application of payment of an amount in such a manner shall be a full and complete
discharge of the fiduciary(ies) hereunder to the extent of such payment or application. This
paragraph shall be applicable to payments of income as well as principal.
P. To do all other acts in their judgment necessary or desirable for the proper
management, investment and distribution of my Estate.
ITEM EIGHT
PROTECTIVE PROVISIONS
All income or principal held for the use and benefit of the beneficiaries of any trust hereunder
shall not be in any way or manner subject to anticipation, assignment, pledge, sale or transfer, nor
shall any such interest,while in the possession of my Trustees,be liable for or subject to the debts,
contracts, obligations, liabilities or torts of any beneficiary, or to attachments, executions or
sequestrations under process of law.
A&6
A.M.G.
Page 5 of 7 Pages
If any beneficiary of any trust shall, in the sole opinion of my Trustees, be or become
mentally or physically incapacitated, by reason of illness, accident, minority or otherwise, my
Trustees may apply either income or principal for the support and welfare of such beneficiary
directly to the person who has the care and control of such beneficiary, without the intervention of
any guardian and without obligation to supervise application of said amounts in any way.
ITEM NINE
APPOINTMENT OF EXECUTOR AND TRUSTEES
I nominate, constitute and appoint my husband, JOHN W. GROSS, JR., as Executor of my
estate. In the event that my said husband shall predecease me or fail to act as Executor, then I
appoint my children, BRIAN J. GROSS, DIANE M. LAROCCA and KAYE L. SENSENIG, as
Executors of my estate. In the event any of my said children shall be unable or unwilling to act as
Executor, then my remaining children shall so act.
I hereby appoint my children, BRIAN J. GROSS, DIANE M. LAROCCA and KAYE L.
SENSENIG, as Trustees of any trust created hereunder. In the event that any of my said children
shall be unable or unwilling to act or continue to act as Trustee, then my remaining children shall
so act.
ITEM TEN
WAIVER OF BOND
I direct that neither my Executor(s)nor my Trustees shall be required to file any bond in any
jurisdiction to secure the faithful performance of their duties,nor shall they be required to obtain any
order or approval of any court for the exercise of any power or discretion set forth in this Will.
IN WITNESS WHEREOF I have hereunto set my hand and seal this 8VJ— day of
2011.
a4,4� )22. L,_o_�jsEAL)
Arlene M. Gross
SIGNED,SEALED,PUBLISHED AND DECLARED by the above-named Testatrix,as and
for her Last Will and Testament,in the presence of us,who at her request,have hereunto subscribed
our names as witnesses thereto, in the presence of the said Testatrix and of each other.
Page 6 of 7 Pages
4 r �
COMMONWEALTH OF PENNSYLVANIA )
SS.
COUNTY OF CUMBERLAND )
We,Arlene M.Gross,Ivo V.Otto III,and ,
the Testatrix and the witnesses, respectively, whose names are signed to the 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 that the Testatrix has signed willingly, and that the
Testatrix 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 the Will as a witness and that
to the best of his/her knowledge the Testatrix was at that time eighteen years of age or older, of
sound mind and under no constraint or undue influence.
Ar ene Gross, Testatrix
Witness
it s
ly
Subscribed, sworn to and acknowledged before by Arlene M. Gross, the Testatrix, and
subscribed and sworn to before my Ivo V.Otto III and _
the witnesses, this qday o 1.
Notary Public
COQ MONATALTH OF PENNSYLVANIA
LCarlisle
OTSEAL
a L.Otto,Notary Public
Boro,Cumberland County
ssion expires December 20,2014
Page 7 of 7 Pages
Property Mapper
Cumberland County, PA
406 ALLENDALF WAY
VIN;13 24,0U01-1bu
Aanao�!0.33
IOALLE�01VC
0u.dmQAsse9sedVd1ue$,169 co
sa e Date Toe Jul 26 L994,, .. ,,
Year OWL 1960
it
40?AA I Pltil,ff.1114Y
esn
Copyright 2011 Esri.All rights reserved.Tue Sep 9 2014 02:37:52 PM.
406 ALLENDALE WAY
PIN: 13-24-0807-180
Deedbook: 00109-00153
Owner: GROSS,ARLENE M
Land Use Code: 101
Property Type:R
Acreage; 0.33
Square Feet: 2203
Taxable Status:T
Clean&Green Status:
Land Assessed Value$: 61600
Building Assessed Value$: 168000
Total Assessed Value$: 229600
Sale Price$: 1
Sale Date:Tue Jul 26 1994 08:00:00 PM
Year Built: 1960
Municipality: LOWER ALLEN TOWNSHIP
Height in Stories:
Type of Dwelling: DETACH
Primary Exterior:Aluminum
Basement Percentage:
Air Conditioning:AC
Total Rooms: 9
Bedrooms:4
Full Bath: 2
Half Bath: 1
V-yam
1
\Jwd176r1-rt.dwWj
¢5� TIJIS DEED Ru CPQ 13—a�-UYiO7-I�
MADE THE o[ 44 day of in the year of our Lord one thousand nine hundred
ninety-four(1994).
BETWEEN JOHN W. GROSS, JR. and ARLENE M. GROSS, his wife, of Lower Allen
Township,Cumberland County,Pennsylvania, hereinafter referred to as:
Grantors,
and ARLENE IV 1. GROSS, of Lower Allen Township, Cumberland County, Pennsylvania,
hereinafter referred to as:
Grantee,
WITNESSETH,that in consideration of ONE AND XX/100($1.00)Dollar in hand paid,
the receipt whereof is hereby acknowledged, the said Grantors do hereby grant and convey to
the said Grantee, her heirs and assigns:
ALL that certain lot or piece of ground with the buildings and improvements
thereon erected situate in Lower Allen Township, Cumberland County,
Commonwbalth of Pennsylvania, bounded and described in accordance with a
Plan of Loris entitled"Section No.30A,Allendale"made by Damon and Foster,
Civil Engineers of Sharon Hill,Pennsylvania,dated July 10, 1959,and recorded
in Plan Bwk No. 10,page 51, Cumberland County records, as follows:
BEGINNING at a point on the westerly side of Allendale Way,at the southern
most extremity of a 29.66 feet radius curve which connects the said side of
Allendale Way and the southerly side of Lantern Lane; thence extending along
the westerly side of Allendale Way in a southerly direction of a curve to the left
having a radius of 630 feet,the arc distance of 99.03 feet to a comer of Lot No.
84 on said plan;thence along the same South 48 degrees 59 minutes,08 seconds
West, 145.52 feet to a point on the southerly side of Lantem Lane;thence along
the same in an easterly direction on a curve to the left having a radius of 698.14
feet,the arc distance of 80.19 feet to a point of reverse curve;thence on a curve
to the right having a radius of 29.66 feet, the arc distance of 49.12 feet to the
point and place of BEGINNING.
BEING Lot No. 85 on the aforesaid plan. House No.406 Allendale Way.
BEING the same premises which Robert D.Kane and Janeen M.Kane,his wife,
by(heir died dated October 30, 1964 and recorded November 2, 1964,in and for
Cumberland County in Deed Book "K", Volume 21, Page 292, granted and
conveyed unto John W. Gross, Jr. and Arlene M. Gross, his wife, Grantors
herein.
130118 109 PAGE 153
M I
1
UNDER AND SUBJECT to certain conditions and building restrictions as of
record.
This conveyance is from husband and wife to wife,and is therefore exempt from
realty transfer taxes.
AND the said Grantors hereby covenant and agree that they will warrant specially the
property hereby conveyed.
IN WITNESS WHEREOF,said Grantors have hereunto set their hands and seals the day
and year first above written.
SIGNED,SEALED AND DELIVERED
IN THE PRESENCE OF
)4"V
-" %'}fes
(SFAL)
ohn W. Gross,Jr.
(SEAL)
Arlene M. Gross
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i�bx 109 racE. 154
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COMMONWEALTH OF PENNSYLVANIA )
COUNTY OF alln&X&110( )
On this, thea?41 day of 1994, before me, the undersigned officer,
personally appoared JOHN W. GROSS, JR. and ARLENE M, GROSS, known to me (or
satisfactorily proven)to be the persons whose names are subscribed to the within instrument,
and acknowledged that they executed the same for the purposes therein contained.
1N WITNESS WHEREOF,i hereunto set my hand and official scat.
l;:et�''.
SEAL)
kkfl"k-`
a ra1T 4. TAda!_.lmel.NWryPd-
I hereby certify that the precise residence and complete post office address of the within
Grantee is 406 fdiendalc Way, Camp Hill, PA 17011
Attorney for Grantee
., ^•c of Pennsylvania SS
^--Wy of Cumberland
octad in the office for the recording of Deeds
.uid for+C mberland County
; i< c, p
i,A9 took Jst Vow Page
11. " ---inns my hand anq seal of offtc of
ef.vl!r,16,PA this..—LL_ ay of 1
R
EOUK V9 PACE 155
Estate Valuation
Date of Death: 07/13/2014 Estate of: Arlene M. Gross Estate
Valuation Date: 07/13/2014 Account: 7634.12
ProcessingDate: 10/30/2014
Report Type: Date of Death
Number of Securities: 3
File ID: 7634.12.Gross
Shares Security Mean and/or Div and Int Security
or Par Description High/Ask Low/Bid Adjustments Accruals value
1) 321.891486 VERIZON COMMUNICATIONS INC (92343V104; VZ)
COM
New York Stock Exchange
07/11/2014 50.43000 49.67000 H/L
07/14/2014 50.60000 50.15000 H/L
50.212500 16,162.98
Div: 0.53 Ex: 07/08/2014 Rec: 07/10/2014 Pay: 08/01/2014 , 170.60
2) 105 METLIFE INC (59156R108; MET)
COM
New York Stock Exchange
07/11/2014 55.93000 55.11000 H/L
07/14/2014 56.74000 55.92000 H/L
55.925000 5,672.13
3) 89.460219 FRONTIER COMMUNICATIONS CORP (35906A108; FTR)
COM
New York Stock Exchange
07/11/2014 5.79500 5.72000 H/L
07/14/2014 5.80000 5.74000 H/L
5.763750 515.63
Total Value: $22,550.74
Total Accrual: $170.60
Total: $22,721.34
To 3
Page 1
This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 7.4.0)
Estate Valuation
Date of Death: 07/13/2014 Estate of: Arlene M. Gross Estate
Valuation Date: 07/13/2014 Account: 7634.12
Processing Date: 02/25/2015 Report Type: Date of Death
Number of Securities: 1
File ID: 7634.12.Gross.2
Shares Security Mean and/or Div and Int Security
or Par Description High/Ask Low/Bid Adjustments Accruals Value
1) 176 WELLS FARGO & CO NEW (949746101; WFC)
COM
New York Stock Exchange
07/11/2014 51.67000 50.82000 H/L
07/14/2014 51.84000 51.14000 H/L
51.367500 9,040.68
Total Value: $9,040.68
Total Accrual: $0.00
Total: $9,040.68
Page 1
This report was produced with EstateVal, a product of Estate Valuations & Pricing Systems, Inc. If you have questions,
please contact EVP Systems at (818) 313-6300 or www.evpsys.com. (Revision 8.0.2)
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