HomeMy WebLinkAbout01-0455
PETITION FOR GRANT OF LETTERS OF ADMINISTRATION
Estate of MARGARET C. GRAY
also known as
OL/ - ,,/.
Cf.!r.!J
Social Security No. 188-09-6427
Deceased.
No.
To:
Register of Wills for the
County of Cunberland in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older, appl ies
for letters of administration
on the estate of
(d.b.n.; pendente lite; durante absentia; durante minoritate)
the above decedent.
Decendent was domiciled at death in CUllberland County, Pennsylvania, with
h er last family or principal residence at County Meadows, 4833 Trindle Rd., SUite ~2l,
Mechanicsburg 1 FaWi(l,,:Ill!Rt,Talbship,tuQ)Jllberland County 1 PA
Decendent, then 95 years of age, died March 29 , ~l
at Holy Spirit fl<>fU>itaL East Pennsboro Townshipl CUo'berland CountYI PA
Decendent at death owned property with estimated values as folllows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows: None
12,000.00
$
$
$
$
Petitioner_ after a proper search ha~ ascertained that decedent left no will and was survived by
the following spouse (if any) and heirs:
N R I' h'
ame e atlons Ip I ReSIdence
Charles G. Grav Son 19726 Hillside Drive
Watertown 1 NY 13601
.
THEREFORE, petitioner(s) respectfully request(s) the grant of letters of administration 10 the
appropriate form to the undersigned.
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~3 les G. Gra
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c:: ~ 19726 Hillside Drive
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",': Watertown, NY 13601
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF. PENNSYLVANIA
COUNTY OF CUMBERLAND
} SS c-":'
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The petitioner(s) above-named swear(s) or afflI1Il(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 above decedent petitioner(s) will well d
truly administer the estate according to law.
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Sworn to or affirmed and subscribed f
before me this 3't.L day of
~e. V,,~ I!u ~.bL./~
Register L
No. 21-01-455
Estate of
MARGARET C. GRAY
, Deceased
GRANT OF LETTERS OF ADMINISTRATION
AND NOW MAY 8th 2001 ~~, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that CHARLES G. GRAY
is/are entitled to Letters of Administration, and in accord with such finding, Letters of Administration
are hereby granted to CHARLES G. GRAY
in the estate of MARGARET C. GRAY
~~ J4J~ ~.t7.I1.:JC.~{J~
R(gister of Wills ..
FEES
Letters of Admimstration $ 50.00
Short Certificates( 1) . . . . . . . . .. $ 3 . 00
~ ..~P.l'!I?........ $ 15.00
JCP $ 5.00
TOTAL _ $ 73.00
Filed .~X.?1..,........... A.D. ~ 2001
Arm E. Rhoads, 149631
ATIORNEY (Sup. Ct. I.D. No.)
Cleckner and Fearen
P.O. Box 11847. III Locust. Street
Harrisburg, MDRESS 17108-1847
(717) 238-1731
PHONE
MAILED LETTERS TO ATTORNEY MAY 9, 2001
H105.805 REV 91KG
This is to certify that the information here given is correctly copied from an original certificate of death duly filed with me as
Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing.
WARNING: It is illegal to duplicate this copy by photostat or photograph.
No. Date
1-~</ >:1', i'~
Local Reg~r .
Fee for this certificate, $2.00
p
7152990
AP R Q2.1001
HIOS.143 Rev 211I1 COMMONWEALTH OF PENNSYLVANIA' OEPARTMENT OF HEALTH. VITAL RECORDS
CERTIFICATE OF DEATH
.T
NT
K
NAME OF DECEDENT tflfSl, MICkIte.las}
1.
AGE (LaS! BirtNtayJ
Margaret C. Gray
SEX
2. femal e
STAlE FILE NUMSEA
SOCIA.L SECURlrt NUMBER
uNOER t YEAR
....... Dava
.. 188 - 09
- 6427
Da\,. 'lUll
lAg ~{)l
UNDER 1 OW
ttours MInut..
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95
v...
..
COUNTY OF OEJQ'H
RACE. A~ \ndian. 8lack. WhiCe. *
(S_I
J-l
.... Cumberl and
,..
white
DECEDENT'S USUAL OCCUPRIOH
l~_~.~":::'::::.'&:f
. n., Homemaker ".. own home
DECEDENT'S.......IHG ADOAt!S$ CSk.... CtyIbwn. _. Z",C_' DECEDENT'S
4833 E. Trindle Rd. ~~~
,.. Suite 521 '1~D5BaniCSburg, P ~
FArHER'SNAMEIF,"."iddIe.L"'1 George T. Tallman
11.
INFOAMANT'SHAME(TypeIPtin\\ Charles G. Gray
SURVIVING SPOUSE
\".. gNemalden Nme)
...
Pennsylvania
Cumberland
Old
--
lIYltirU
_? 17d.O :...":".=:..
MOTHER'S NAME iF.,sI. MlddIe. Malden Surname)
tI. Mary E. Beil hartz
INFOllMANT'SWJUNG AOORESSCSk.... c_. _. Z"'~I
~, 19726 Hillside Drive, Watertown, NY 13601
PlACE OF DISPOSITION. N...... Comet.ry, Crematory LOCATION. CiOyI1bwn. _.. Zlp~
..Odloo<......
21c. Montoursv; 11 e Cemetery
NA"EANDADllRESSOFFAClUTY 1 er
..c.P .0.Box 147 733 Broad St.
lICENSE NUM8ER
_.
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....-...
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Io!ETtIOO OF OISPOSIT~
O _I illI C..meliOn 0 Remonf.... 5101.0
~ Od>e< \SPoCoIy)
210.
OATE OF OtSPOSITION
(Month. Day. -,
021., Apr. 3,2001
lICEN"f'fi'''efr 4645 - L
22b.
lOthebe$l of my knowledge, dealh occurred althe time, date MKt place staled
(SiQnatute and Title)
PA
23b. 23c.
WAS CASE REFERRED 10 MEDICAL EXAMINERlCORONEA?
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DUE m (OR AS A CONSEQUENCE Ofj'
..,
I Approximate
: intlllVai' beCw..n
,onMt ~ death
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PART H:
OCher signlftCanf. condl&iona conlribuIing to death, bUt
nocrosuling in the undettving caUM Qiven in. PART I
lb.
..
d.
WERE AU'TOPSV FINDINGS
-.u.81E PRIOR m
COMPlETtON OF CAUSE
OFDEJiI'H?
DUE lO(OAAS ACONSEOUENCE OF):
DUE m(OR ASACONSEOUENCE Ofj,
MANNER OF DEATH
DATE OF INJURY
(Monlh. Day. 'fear)
TIME OF IKJ\JRV
INJURY /(f WOfU<1 DESC~BE HOW INJURY OCCU~O.
Suicide
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HorniC_
Y.. 0
NoD
Could not be delenmnftd
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o ~E OF INJURY - At harM. tarm~;ee1.1ac\orv. attic. ....
buikfing. etc. ,$pecltvl
....
Yes 0 NoD
Halulal
Accident
Pendtng 1n~\9atton
3Oc:.
"MEDICAL EXAMINER/CORONER
on Ute ba.i. of examination and/or invesUgation. in my opinion. deatt! occurred a. the lime, date, and place, and due to the cause(s) and
m.nner as stated.. . . .. . " . . . .. . . ..' .. . . .. .... ." , . .. ". . . ,... .
31a.
REGISTRAA'S SIGNATURE AND NUMBER
1~-I/,JI1.r1
lOCJWION (S1r_. CitylTown. Stale)
.....
E OF CERTifiER
2". 2.b.
CERTifiER cChecfl; only one)
.CERTlfYlHG Pti'lSICI"H (PhYSICI&f1 cerutylf'lg cause d dealh wtlen anolhet ptlVSIC.atI has pl'ooounced dealh and compleled Item 23\
To'" be.. 0' my knowledQ.. de.th occumtd..... d\e "auu(s) and maoner as .'.'ed. .
>t.
:Y>
.PRONOUNCING AND CEATIFVING PHYSICIAN (PhYSIC,"", boIh pfonOUOClng oeath and cettllVlflglo cause 01 dealhl
To ttM bnt of my knowledgft. de.th occurred at the time, date, and pl.ce. and due to the cauu,s) and manner as slilted.. . . .
I
BOND
REGISTER OF WILLS OF Cumberland COUNTY
BOND AND SURETY FOR PERSONAL REPRESENTATIVE
Jeffrey L. Scott
KNOW ALL BY THESE PRESENTS, That Charles G. ..Gray
19726 Hillside Dr., Watertown, NY 13.Rqkincipal(s) and
Selective Insurance Company, 40 Wantage Ave., Branchville, NJ 07890
as surety (sureties) are held and firmly bound unto the Commonwealth of Pennsylvania in the sum of
TWenty-eight '!hR>>JMlSlft 28,000 ) to be paid to the Commonwealth, for which payment we
do bind ourselves, jointly and severally, our heirs, executors, administrators and successors, the
condition of this obligation being that if Charles G. Gray
as (state fiduciary capacity) Executor
of the estate of Margaret C. Gray
, deceased,
or any of them, shall well and truly administer the estate according to law, then this obligation shall
be void as to the personal representative or representatives who shall so administer the estate and his
or their surety or sureties; but otherwise it shall remain in full force.
Signed and sealed this eighth
day of May
, 1~001
, each
(Seal)
(Seal)
(Seal)
_(Seal)
< -) (Seal)
intending to be legally bound hereby.
SdeCWe
Selective Insurance Company of America
40 Wantage Avenue
Branchville, New Jersey 07890
973-948-3000
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS: That the Selective Insurance Company of America, a New Jersey cor-
poration having its principal office in Branchville, State of New Jersey, pursuant to Article VII, Section 13 of the By-
Laws of said Company, to wit:
"The Chairman of the Board, President, any Vice Presidents or the Secretary may, from time to time, appoint attor-
neys in fact, and agents to act for and on behalf of the Company and they may give such appointee such authority, as
his/her certificate of authority may prescribe, to sign with the Company's name and seal with the Company's seal,
bonds, recognizances, contracts of indemnity and other writings obligatory in the nature of a bond, recognizance
conditional undertaking, and any of said Officers may, at any time, remove any such appointee and revoke the
and authority given him/her.
does hereby make, constitute and appoint
PATRICIA K ARBEGAST, DAVID W. HOPCRAFT, JEFFREY L SCOTT
its true and lawful Attorney-in-fact, to make, execute, seal and deliver for and on its behalf, and as its act and deed,
bonds, undertakings, recognizances, contracts of indemnity, or other writings obligatory in the nature of a bond
ject to the following limitations: NO ONE BOND TO EXCEED ONE MILliON DOLLARS (51,000,000.00)
and to bind the Selective Insurance Company of America thereby as fully and to the same extent as if such instruments
were signed by the duly authorized officers of the Selective Insurance Company of America, and all the acts of said
Attorney are hereby ratified and confirmed.
IN WITNESS WHEREOF, the Selective Insurance Company of America has caused these presents to be signed
>- by its Vice President and its corporate seal to the hereto affixed this 13m day of
0..
8 /~TC~~
Cl m ,/ ~ --~~~.f~k4';~ 0:
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u.. BY: :,"""". \~\\
B State of New Jersey EE Gr~, W.: Jr., esidert"
..... , ....', 926 ,!::lQ ,
W County of Sussex \\ ~ '.\ A. \ , 1/ n :/';
U "'CP\~~ ......'i'~1
On this 13m day of DECEMBER 1999 before the subscribe~" Nori.G'Jl<<i,li~te 0 ~ew Jersey in
and for rhe County of Sussex duly commissioned and qualified. came F.F. Greaver, Jr. of the Selective Insurance C an~ me 'onally known
to be the officer described herein. and who executed the preceding instrument. and he acknowledged the execution 0 e sam*d bei y me duly sworn.
deposed and said that he is an officer of said Company aforesaid; that the seal affixed to the preceding instrumenr is the cor aid Company. and the
said corporare seal and his signarure as officer were duly affixed and subscribed ro the said instrument by the authority and direction of the Company; that Article
VII. Section 13 of the By-Laws of said Company is now in force.
DECEMBER
1999
IN WITNESS WHEREOF. I have hereunto set my hand and affixed my offieial seal at Branchville. New Jersey this
day of DECEMBER 1999 . .
JUDITH E. CHAMBfRLAIN ~
NOTARY PUBLIC OF NEW JERSEY
COr~1MISStON eXPIRE.S OCT. 17 2003
The power of attorney is signed and sealed by faCSImile under ana by the authority 0
by the Board of Directors of Selective Insurance Company of America at a meeting
February 1987, to wit:
"RESOLVED, the Board of Directors of Selective Insurance Company of America authorizes and approves the use of
a facsimile corporate seal, facsimile signatures of corporate officers and notarial acknowledgements mereof on powers
of attorney for the execution of bonds, recognizances, contracts of indemnity and other writing:> obligatory in the
nature of a bond, recognizance or conditional undertaking......."
1. Patricia A. Fulkrod. Assistant Secreraty of the Selective Insurance Company of America. do hereby certify that the above ar..:i, for"l;Qit;f;i iSl rrue and corrc:cr copy
of a Power of Attorney executed by said Company which is srill in full force and effect.
IN WIT~SS WHEREOF. I have hereunto set m2~5d and affixed rhe seal of said Company at B~~New Jers~y rhis, e1,',ghth,
day of Y 1 . .. Q '"\ ,(. _ () , ,
~.~"'-"'~
Assist2.nt Sec.ret~ry
The RED border on th~i~c~ ~l ~{292cument has a security VOID background pattern. If it is not RED and the word VOID is visible. this is not a certified copy, Telephone us at Area Code 973-948-3000.
t::
---
CERTIFICATION OF NOTICE UNDER RUl.E 5.6(a)
Name of Decedent:
MARGARET C. GRAY
Date of Death:
March 29, 2001
Admin. No.
2001-00455
WilI No.
To the Register:
I cenify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Coun Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on Mav 11, 2001
Name
Address
Charles G. Gray, 19726 Hillside Drive, Watertown, Ny 13601
Notice has now been given to all persons entitled ~haeto under Rule 5.o( a) except
Date:
5/11/01
~
J::: . ~
Signature
Name
Ann E. Rhoads
Address
P. O. Box 11847
III Locust street
Harrisburg, PA 17108-1847
Tdephone (17) 238-1731
Capacity: _ Personal Representative
-X-Counsel for personal representative
DENNIS J. SHATTO
ANN E. RHOADS
CLECKNER AND FEAREN
ATTORNEYS AT LAW
1 1 1 LOCUST STREET
P.O. BOX 11847
HARRISBURG. PENNSYLVANIA 17108-1847
TELEPHONE: (7171 238-1731
FAX: (717) 238-8481
OF COUNSEL
ROBERT D. HANSON
RETIRED
RICHARD W. CLECKNER
WILLIAM FEAREN
September 19, 2001
Office of the Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013-3387
Re: Estate of Margaret C. Gray
No. 2001-0045
Dear Ladies and Gentlemen:
I enclose the following for filing in the above-referenced
estate:
(1) Original and one (1) copy of Inventory;
(2) Original and two (2) copies of Inheritance Tax Return;
(3) Check in the amount of $25.00 for filing fees.
Please date-stamp the extra copies and return them to me in
the self-addressed, stamped envelope enclosed.
Thank you.
Very truly yours,
CLECKNER AND FEAREN
~'---
Ann E. Rhoads
AER: Inm
Enclosures
cc: Charles G. Gray, Administrator (wjencl.)
C-
bei"9 duly sworn ~ccordin9 to law, deposes and uY' that he is
Executor of the Estate of Margaret C. Gray-
I.te of _Hamp,gen_ ~2~;?.ilip_.._.___. ___ , Cumberland County, P.., decused and thd th.
within il an inventory made by Charles G. Grav ._ _ , the uid Executor
01 the .ntir. esht. 01 uid decedent, consisting of all the penoul prop'..rty and rul utate, except rul eshte ouhid.
the Commonwulth of Pennsylnnia, and that the figures opposite uch item of the Inventory represent it', f.ir nlue
u of the date 01 decedent's death.
~ 2001
and subscribed before me,
Encvfor . Aelmini.t,. or
CHARLES G. GRAY
19726 Hillside Drive
Oat. ol Oeath
. JUDITH A. BARKER
Notary Public, State of New York
No. 01 BA4700260
Qualified In Jefferson CountJv. a
Commission ExpIres August a1.~-Q
29th
O.Y
Watertown, NY '13601
Aelel,...
March
Month
2001
Y..,
INSTRUCTIONS
I. . An inventory must be fjled within three months after appointment of personal representative.
2.- ~. supplement ir:wentory mus! be filed wi~hin t~irty days ~f d1s.covery of additional asseh.
3. Additional sheeh may b. aHached as to personalty or realty
4. See Artide IV, Fiduciaries Ad of 1949.
I
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Inventory or In. r.al and persO(la' estate of
MARGARET C. GRAY
decea~ed
l. Delaware Tax-Free Pennsylvania Fund $12,465 11
B#5570007398
2. -Verizon -credit ~ . 1 77
....1/"'... ".. . ~ - >
-'." countfl' . . ','.- "
3."' Meadows - deposit refund 1,383 67
4. Household Goods 500 00
_._,.~
.- TarAL 14,350 55
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.M:..~
DENNIS J. SHATTO
ANN E. RHOADS
CLECKNER AND FEAREN
ATTORNEYS AT LAW
111 LOCUST STREET
P.O. BOX 11847
HARRISBURG, PENNSYLVANIA 17108-1847
TElEPHONE: 17171238-1731
FAX: (717) 238-8481
OF COUNSEl
ROBERT D. HANSON
RETIRED
RICHARD W. CLECKNER
WILLIAM FEAREN
May 25, 2001
Office of the Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013-3387
Re: Estate of Margaret C. Gray
No. 2001-00455
Dear Ladies and Gentlemen:
I enclose a check payable to "Register of Wills, Agent" in the
amount of $865.00 as an estimated inheritance tax paYment in the
above-referenced estate.
Please forward the receipt to my attention.
Very truly yours,
CLECKNER AND FEAREN
~f..~
Ann E. Rhoads
AER: lnm
Enclosure
cc: Charles G. Gray, Administrator (w/o encl.)
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R.EV-'5,OOEXI6_001
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
OFFICIAL USE ONLY
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FILE NUMBER
INHERITANCE TAX RETURN
RESIDENT DECEDENT
JLJLA.-5..-5..
NUMBER
2..l-.Q.l
COUNTY CODE YEAR
I-
Z
W
C
W
U
W
C
DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
GRAY, MARGARET C.
- 6427
SOCIAL SECURITY NUMBER
188
09
DATE OF DEATH (MM-DD-YEAR)
DATE OF BIRTH (MM-DD-YEAR)
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
03-29-01 04 10-1905
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
None
lKJ 1. Original Return
D 4. Limited Estate
D 6. Decedent Died Testate (Attach copy of Will)
D 9. Litigation Proceeds Received
D 2. Supplemental Return
D 4a. Future Interest Compromise (dale of death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach copyofTrust)
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
D 3. Remainder Return (dale of death prior to 12-13-82)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A} (Attach SGh 0)
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NAME ,
Ann E. Rhoads, Esqu1re
FIRM..NAME Uf Applicable) d
C~eCKner an Fearen
TELEPHONE NUMBER
717-238-1731
COMPLETE MAILING ADDRESS
III Lpcust Street
P. O. Box 11847
Harrisburg, PA 17108-1847
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
(1) 0 OFFICIAL USE ONLY
(2) 0
(3) 0
(4) 0
(5) 14,350.55
(6) 6,679.26
(7) 0
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
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5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non.Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
21.029.81
(8)
(9)
(10)
2,012.84
149.74
9. Funeral Expenses & Administrative Costs (Schedule H)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I)
11. Total Deductions (total Lines 9 & 10)
(11) 2,162.58
(12) 18,867.23
(13) 0
(14) 18,867.23
12. Net Value of Estate (Line 8 minus Line 11)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
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15. Amount of Line 14 taxable at the spousal tax 0
rate, or transfers under Sec. 9116 (a)(1.2) x.O~ (15) 0
16. Amount of Line 14 taxable at lineal rate 18,867.23 xO 42.... (16) 849.03
17. Amount of Line 14 taxable at sibling rate 0 x .12 (17) 0
18. Amount of Line 14 taxable at collateral rate 0 x .15 (18) 0
19. Tax Due (19) 849.03
20. [!g
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
Decedent's Complete Address:
STREET ADDRESS
4833 Trindle Road
Suite 521
CITY Mechanicsburg I STATE PA I ZIP 17055
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
849.03
o
865.00
44.69
Total Credits (A + B + C ) (2)
909.69
3. InteresUPenalty if applicable
D. Interest
E. Penalty
o
o
TotallnteresUPenalty ( D + E ) (3)
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due.
(5A)
(5B)
B. Enter the total of Line 5 + 5A. This is the BALANCE DUE.
o
60.66
o
o
o
Make Check Payable to: REGISTER OF WILLS, AGENT
IIL.I 11.,1 "a..,
PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
No
[1g
IX]
IX]
IX]
1. Did decedent make a transfer and:
a. retain the use or income of the property transferred; ........................................................
b. retain the right to designate who shall use the property transferred or its income;.. .
c. retain a reversionary interest; or... .......................................................
d. receive the promise for life of either payments, benefits or care? .......................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without 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
contains a beneficiary designation? . ................... ....................... ... ...............
Yes
.........0
o
..................... u 0
..................0
.....0
.............0
.. ...........0 IX]
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
IX]
IX]
Ul"lder penalties of perjury, I declare that I have examined this return. includil"lg accompanying schedules and statemel"lts, and to the best of my knowledge and belief, it is true,
correct and complete.
Declaralionofp parer other than the personal representative is based on all information of which preparer has any knowledge.
ADDRESS
19726 Hillside Drive, Watertown, NY
SIGNATURE OF PREPAREB.9TH
,~~.
ADDRESS
III Locust St., P. O. Box 11847, Harrisburg, PA 17108-1847
-. rTlIlllf.U _nJJlIIIIMIJlIIL.llM
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. 99116 (a) (1.1) (i)].
CHARLES G. GRAY
13601
01
ANN E. RHOADS, ESQUIRE
DATE I
q . u)
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. 99116 (a) (1.1) (ii)].
The statute does not exemot 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 twenty-one 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% [72 P.S. 99116(a)(1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficianes is 4.5%, except as noted in 72 P.S. 99116(1.2) [72 P.8. 99116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 99116(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"''''''''~' '*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
EST ATE OF
GRAY, MARGARET C.
FILE NUMBER
21-01-00455
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
1.77
Verizon Credit
2.
Delaware Tax-Free Pennsylvania Fund
B#5570007398
12,465.11
3.
Country Meadows - refund of deposit
1,383.67
4.
Household Goods
500.00
TOTAL (Also enter on line 5, Recapitulation) $ 14,350.55
(If more space is needed, Insert additional sheets of the same size)
",.
",.
SCHEDULE F
JOINTL Y.OWNED PROPERTY
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
GRAY, MARGARET C.
FILE NUMBER
21-01-00455
ESTATE OF
If an asset was made joint within one year of the decedent's date of death, it must be reported on Sthedule G.
SURIJ\V1NG JOINt TENANTlS) NAME
ADDRESS
RELATIONSHIP TO DECEDENT
A. Charles G. Gray
19726 Hillside Drive
Watertown, NY 13601
Son
B.
c
JOINTLY-OWNED PROPERTY,
LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH
ITEM FOR JOINT MADE Include name of financial institution and bank account number or similar identifymg number Attach DATE OF DEATH OECO'S VAlUEGr
NUMBER TENANT JOINT deed for Jointly-held real estate VALUE OF ASSET INTEREST OECEDENT S INTEREST
1. ~. prior
to M & T Bank Savings
1998 Account #15004201342455 11,725.99 50% 5,863.00
2. A. prior M & T Bank Checking
to Account #374-575893 1,632.52 50% 816.26
1998
TOTAL (Also enter on line 6, Recapitulation) $ 6,679.26
(If more space IS needed, Insert addItIonal sheets of the same size)
ESTATE OF
,.
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE T A:t.. RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
FILE NUMBER
21-01-00455
GRAY, MARGARET C.
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A. FUNERAL EXPENSES:
1.
Spitler Funeral Horne, Inc. 137.74
P. O. Box 147
Montoursville, PA 17754
2. Johnson's Cafe - funeral luncheon 347.00
B ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions None
Name of Personal Representative (s)
Social Securrty Numbe~s) I EiN Number of Personal Representative{s}
Street Address
City Stale Zip
Year(s) Commission Paid:
2. Attorney Fees Cleckner and Fearen 750.00
7.
8.
9.
10.
11.
3.
Famliy i..;,.;emption: (If decedent's address IS not the same as c!aimant's. attach ey.~..:anatilj:;) None
Claimant
73.00
75.00
110.10
150.00
70.00
300.00
Street Address
City
Relationship of Claimant to Decedent
State
Zio _~_____
4.
Probate Fees
Register of Wills 5/8/01
Accountant's Fees
5.
6.
Tax Return Preparer's Fe€s
Cumberland Law Journal - legal advertising
Patriot News - legal advertising
Hopcraft Hockley O'Donnell - fiduciary bond
Truck rental
Executor travel expenses
TOTAL (Also enter on line 9. Recapitulation) S
(If more space IS neeced. Insert additional sheets of the same size I
2,012.84
f'fV.1512EX.(1-9l\
'*
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
GRAY, MARGARET C.
FILE NUMBER
21-01-00455
Include unreimbursed medical expenses.
ITEM
NUMBER
1. Cleckner and Fearen -
DESCRIPTION
legal fees prior
to death
AMOUNT
120.00
2.
Health Sout;h
5,30
3.
AT&T
9.81
4.
Verizon
14.63
TOTAL (Also enter on line 10, Recapitulation) S
(If more space IS needed, ;nsert additional sheets of the same size)
149.74
""'''''''''''..
COMMONWEAlTH OF PENNSYLVAWA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE J
BENEFICIARIES
GRAY, MARGARET
FILE NUMBER
21-01-00455
ESTATE OF
RELATIONSHIP TO DECEDENT AMOUNT OR SHARE
NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY Do ~ol List Truslee(s) OF ESTATE
I. T MABLE DISTRIBUTIONS (Indude oulright spousal dislributions)
1. Charles G. Gray Son Entire
19726 Hillside Drive
Watertown, NY 13601
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 17, 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
1.
S. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II . ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV 1500 COVER SHEET $ 0
(It more space is needed, insert edditional sheels at Ihe same size)
RfV.1500 EX (6-001
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:%:00
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l1.
<:(
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
....
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
('Q1
DATE OF DEATH (MM-DD-YEAR)
C9 L( - ? r-; - ;).<9:91 {) 5' - /
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
D,e( n e. . j, 0 fA-
~ 1. Original Return
D 4. Limited Estate
.C8l: 6. Decedent Died Testate (Attach copy of Will)
D 9. Litigation Proceeds Received
t?
DATE OF BIRTH (MM-DD-YEAR)
o
D 2. Supplemental Return
D 4a. Future Interest Compromise (date a/death after 12-12-82)
D 7. Decedent Maintained a Living Trust (Attach ccpy ofTrust)
D 10. Spousal Poverty Credit (date of death between 12-31-91 and 1-1-95)
OFFICiAL USE ONLY
si-
c..,.....---'
FILE NUMBER
.a 1- - (9 -.i
COUNTY CODE YEAR
&,CJ!iIc;
NUMBER
SOCIAL SECURITY NUMBER
Jf<t /d.-
06/5 '
THIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
~ 1- - '-16 - !:J/SS-
D 3. Remainder Return (date of death prior to 12-13-82)
D 5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
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1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
14. Net Value Subject to Tax (Line 12 minus Line 13)
COMPLETE MAILING ADDRESS (\- ---'-:--,(
3'1CJr fI/- rr~ f ?// 5k /O()
!-IQrr'56u71,tJ;4 /'7//0
(1)
(2)
(3)
(4)
(5)
'J:J ?/6. /2-
I
(6)
(7)
(9)
(10)
(8)
I~ ?:~G.t90
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
OFFICIAL USE ONLY
;);), 'FIb ./;<
r
(11)
(12)
(13)
/1~JyI)~...(po
,
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F)
D Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7)
9. 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)
13. Charitable and Governmental Bequests/See 9113 Trusts for which an election to tax has not been
made (Schedule J)
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116 (a)(1.2)
16. Amount of Line 14 taxable at lineal rate
17. Amount of Line 14 taxable at sibling rate
18. Amount of Line 14 taxable at collateral rate
19. Tax Due
!(5), ?r;tfJ./2
(
x .0_ (15)
x .0_ (16)
x .12 (17)
x .15 (18)
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
(14)
(Q - C90
(19)
(Q. ~
Decedent's Complete Address:
STREET ADDRESS
CITY
Tax Payments and Credits:
1. Tax Due (Page 1 line 19)
2. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C. Discount
(1)
0..6)0
Total Credits ( A + B + C ) (2)
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/Penalty ( D + E ) (3)
4. If line 2 is greater than line 1 + line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5. If line 1 + line 3 is greater than line 2, enter the difference. This is the TAX DUE. (5)
A. Enter the interest on the tax due.
(5A)
B. Enter the total of line 5 + 5A. This is the BALANCE DUE. (5B)
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
a. retain the use or income of the property transferred;.......................................................................................... 0
b. retain the right to designate who shall use the property transferred or its income; ............................................ 0
c. retain a reversionary interest; or.......................................................................................................................... 0
d. receive the promise for life of either payments, benefits or care? ...................................................................... 0
2. If death occurred after December 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? ........................................................................................................................ 0
No
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B
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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 pe~ury. 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.
SI~NATU~SON RESPONSIBLE FOR FILING RETURN
~_~. ~___n_
ADDR S
Ce(
DATE I A'7;,-
V-./ -;<c9&/
6/&
DATE
:50 ~C:;P /C~ IIr I' 1'; ~ b.u ~ P,ff- I 7// rJ
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)].
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 PS. ~9116 (a) (1.1) (H)].
The statute does not exemot 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 twenty-one 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% [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 PS. ~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% [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-1511 EX+ (12-99) .
'*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF R. R u S5ei/ DrQ//€-
FILE NUMBER
~e:> 1- (!J(!)<I~6
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER . .c... DESCRIPTION .,..! :.;,',-t;,: AMOUNT
--. ~-- .-. _. .
- --
A. FUNERAL EXPENSES:
1. ~4rn/1?~4T ?~(!).
j-emripl' ~6CJ
t?1 a fA SGJ /-e t(. m '51 t./~?
FIe:) vv-e yo.> ?--t:!JC!J
Ca5Hfl/ - !J.1 ? $'0
11 c/~t"JY
rl.<. n. -e r C( ( '3, :?<1,
Va 5e.. 4CJcJ
B. ADMINISTRATIVE COSTS:
1- Personal Representative's Commissions
Name of Personal Representative(s)
Social Security Number(s)/EIN Number of Personal Representative(s)
Street Address
City State _ Zip
Year(s) Commission Paid:
2. Attorney Fees /'10
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
Claimant
Street Address
City State _ Zip
Relationship of Claimant to Decedent
4. Probate Fees 76
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
TOTAL (Also enter on line 9, Recapitulation) $ / I; -'~~
(If more space Is needed, insert additional sheets of the same size)
COM~NIA
DTA1W OP
.._.____B_~22-e /I
I a&~=-
Dr'? J1 -e.
I
.... ."IIIR
OJ/ (5;>-/ _~c2J::2!I7 h
MY- 'IO..X +('-17)
AI.....,.., JeInI'I ..... wilt....... at..... ..... lie dlaclalld on Sell) lull F.
ITEM . JfALUE AT DATE
~ DESCAIPtlOtl ._._._ _0._______ '" . UNff VALUE
.... ... .. .., 'OF DEATH
.. -
/ (J1a/nS7u I>] '< lrAd (f'u",~ -
(/~/t-<-e ('(I'lcf B ti: '1r:fT 3 '762'6 /9~ ()~'S/~,/
-
toTAL (AIIo __ on.... 2. - ) () ;};7/~, /)
7
I. (............-.ct, ...udcllllollll......CIII..._....)
~tc>> ,..tonn..........,CPSJ 11 w..l_
,_ __'_IX (...... 1-17)
MainStay
II~ I
Investment
Management L LC
MainStay Shareholder Services
P.O. Box 3~0 1
Boston. MA 02266-8~0 1
800 MainStay 300 62~-6782
July 20, 2001
JAMES D DAY
NYLIFE SECURITIES INC
3401 NORTH FRONT ST 1ST FLOOR
HARRISBURG PA 17110-1462
REFERENCE: 01015263
MAINSTAY VALUE FUND B
ACCOUNT NUMBER 79837686 (CLOSED)
R RUSSELL DRANE
Dear Mr. Day:
I am contacting you concerning the request for information about
the above referenced MainStay account registered to R. Russell
Drane.
The information provided in the table below represents the date
of death values as of April 27, 2001.
Account Number
41-7837686
Total Shares
1 154.673
Net Asset Value
$19.50
Total $ Amount
$22 516.12
The value of the account can be determined by multiplying the
total number of shares by the NAV. Fluctuations in the value of
your account will occur based on the fluctuation in the net
asset value of the Fund.
If you have any questions, please contact MainStay Shareholder
Services by calling 1-80Q-MAINSTAY. A representative will be
happy to assist you.
Sincerely,
~~
Nancy Jurgrau
Correspondent
CC: J LOU DRANE
MamStay Sharenolder Services IS a diVision of NYUM ServIce CI)lnpctny, ~l Registered
Transfer Agent and affiliate of New York Life Investment ManilCjflrT1f!nt LLC.
WHEREAS, on the 8th
dated October 6th 1998
was admitted to probate as the last will of DRANE R RUSSELL
(LA.::i'l' , r'l1<.::i'l', M1UUL~)
late of LOWER ALLEN TOWNSHIP CUMBERLAND County, who died on the
27th day of April 2001 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, MARY C. LEWIS , Register of Wills in and for
the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify
that I have this day granted Letters TESTAMENTARY
to J LOU DRANE
who has duly qualified as Executor (rix)
and has agreed to administer the estate according to law, all of which fully
appears of record in my Office at CUMBERLAND COUNTY COURT HOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my Office the 8th day of May 2001.
OPy
Register of Wills of CUMBERLAND County, Pennsylvania
Certificate of Grant of Letters
No. 2001-00456 PA No. 21-01-0456
ESTATE OF DRANE R RUSSELL
(LA.::i'l', r'll<.::il', M1UUL~)
Late of
LOWER ALLEN TOWNSHIP
CUM.tj~l<.LANU CUUN'l'Y,
Deceased
Social Security No. 492-12-6686
day of May
2001 an instrument
* * NOTE * * ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE)
LAST WILL AND TESTAMENT
ill:
R. RUSSELL DRANE
I, R. RUSSELL DRANE, now of Camp Hill, Cumberland County, Pennsylvania,
do hereby declare this to be my Last Will and Testament and hereby revoke all prior Wills and
Codicils made by me.
ITEM I. I direct that all of my just debts and funeral expenses, including the cost
of my gravemarker, if any, shall be paid from my residuary estate as soon as practical after my
decease as a part of the administrative expenses of my estate.
ITEM II. I give and devise all of my estate of every nature and wherever situate
to my wife, J. LOU DRANE.
ITEM III. Should my wife, 1. LOU DRANE, predecease me or die on or before
the thirtieth (30th) day following my death, I give and devise all of my estate as follows:
A. I give three (3%) percent of my net estate, before inheritance and/or estate
taxes, unto the MARKET SQUARE PRESBYTERIAN CHURCH, Harrisburg, Pennsylvania.
B. I give two (2%) percent of my net estate, before inheritance and/or estate
taxes, unto ALPHA GAMMA RHO FRATERNITY, UNIVERSITY OF MISSOURI, Columbia
Missouri.
;1
I) )
..\ . 7),(..vd-~U.f.y 'J:;{LI--;U!
R. Russell Drane
C. I give and devise all of the rest, residue and remainder of my estate of
every nature and wherever situate in equal shares to my brothers and sisters and my wife, 1. Lou
Drane's, brothers and sisters, or their issue, per stirpes.
ITEM IV. GUARDIAN OF MINORS' ESTATE: If any income or principal
shall be payable to any person who shall be under the age of twenty-one (21) or who shall be
incapacitated for any reason, my personal representative, as trustee, shall hold such income and
principal for such beneficiary until the age of twenty-one (21) or during incapacity and shall be
entitled to apply such income and principal to the health, maintenance, support and education of
such person without the appointment of any guardian or committee or any authority of court, and
shall be entitled to make direct application hereunder or to make application by payment thereof
to the parent or other person in charge of such person, or to his or her guardian or to a custodian
under the Uniform Transfers to Minors Act. Any remaining income and principal to which such
person shall be entitled shall be paid and distributed to such person upon attaining the age of
twenty-one (21) or upon the termination of incapacity.
ITEM V. I appoint my wife, 1. LOU DRANE, Executrix of this my Last Will and
Testament. Should she fail to qualify or cease to act in such capacity, I then appoint JAMES D.
DAY, Gardners, Pennsylvania, First Contingent Executor of this my Last Will and Testament.
Should he fail to qualify or cease to act in such capacity, I then appoint DAUPHIN DEPOSIT
BANK AND TRUST COMPANY, Harrisburg, Pennsylvania, Secpnd Contingent Executor of
this my Last will and Testament. No bond shall be required by my personal representative(s) in
any jurisdiction. Should James D. Day be my personal representative, I direct that he be
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2
compensated for his services as such on the same basis as a corporate fiduciary would be
compensated.
ITEM VI. In addition to the powers given by law to my personal representa-
tive(s) and trustee( s) [hereinafter fiduciaries] in the administration of my estate and of any
trust(s) created herein, they shall have the following discretionary powers applicable to all real
and personal property held by them, including property held for minors, effective without court
order until actual distribution.
A. To retain any property owned by me at my death and to invest any funds held
by them in any stocks, bonds, notes or other securities or property, real or personal, including
common trust funds, mutual funds and money market deposit accounts operated or offered by my
corporate trustee, if any, or any affiliate of it.
B. To sell or otherwise dispose of any property, real or personal, at any time
forming a part of my estate or the trust estate, for cash or upon credit, in such manner and on
such terms as they see fit, and no one dealing with the fiduciaries shall be bound to see to the
application of any monies paid.
c. To manage, operate, repair, improve, mortgage or lease for any term [even if
beyond the duration of the trust(s)] any real estate at any time held or owned by them as
fiduciaries.
D. To hold investments in the name of a nominee and exercise and dispose of
warrants.
R ~U4b--ef 0-e.~
R. Ru ell Drane .
3
E. To engage in litigation and compromise, arbitrate or abandon claims and
property .
F. To conduct any business in which I am engaged or in which I have an interest
at the time of my death for such period as the fiduciaries deem advisable, with the power to
borrow money and to pledge the assets of the business and to do all other acts which I, in my
lifetime, could have done, or to delegate such powers to a partner, manager or employee without
liability for any loss occurring therein.
G. To allocate items of receipt or disbursement between principal and income as
the fiduciaries deem equitable regardless of the character given such items by law; to distribute in
cash or kind or partly in each at valuations fixed by the fiduciaries.
H. To borrow money, including the right to borrow from any corporate trustee, if
any, and to mortgage or pledge as security or to hold its own stock if a corporate trustee.
I. To join in any merger, reorganization, voting trust plan or other concerted
action of security holders, and to delegate discr~tionary duties with respect thereto.
J. Should the principal of any trust herein provided for be or become too small in
trustee's opinion so as to make establishment or continuance of the trust inadvisable, my
trustee(s) may make immediate distribution of the then remaining principal and any accumulated
or undistributed income outright to the person or persons and in the proportion they are then
entitled to income. Upon such termination, the rights of all beneficiary(ies) who might otherwise
.
have an interest as succeeding income beneficiary(ies) or in remainder shall cease.
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R)Ru~ell Drane
4
K. In general, to exercise all powers in the management of the assets of my estate
or the trust estate which any individual could exercise in the management of similar property
owned in his own right, upon such terms and conditions as the fiduciaries may deem best, and to
execute and deliver all instruments and to do all acts which the fiduciaries may deem necessary
or proper to carry out the purposes of this will or any trust(s) created herein.
L. To apply income or principal to which any beneficiary is entitled, directly for
his or her comfort, maintenance and support, should the fiduciaries deem such beneficiary
incapable of receiving the same by reason of age, illness, infirmity or incapacity, or to pay the
same to such person or persons as the fiduciaries select to disburse it, whose receipt shall be a
complete acquittance therefore without the intervention of any guardian.
M. To assume continuance of the status of any beneficiary with reference to
death, marriage, divorce, illness, incapacity or other change in the absence of information
deemed reliable without liability for disbursements made on such assumptions.
N. All principal and income shall, until actual distribution to any beneficiary, be
free of the debts, contracts, alienations and anticipations of any beneficiary, and the same may
not be liable for any levy, attachment, execution or sequestration while in the hands of any
fiduciaries. Provided, however, any beneficiary may assign any part or all of the beneficiary's
interest in my estate or the trust(s) to anyone or more of the beneficiaries or my descendants.
~
IN ~ITNESS WHEREOF, I have hereunto set my band and seal this ~ day
of () ~)bvr,J>998.
~~u.WI~~<-<
R. Rus ell Drane
5
The preceding instrument, consisting of this and five other pages, identified by the signature of
the testator, was on the day and date thereof signed, published and declared by R. Russell Drane
the testator therein named, as and for his last Will, in the presence of us, who, at his request, in
his presence, i ~"j'e of each other, subscribed our names as witnesses hereto. , '
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6
ACKNOWLEDGMENT
COMMONWEALTH OF PENNSYLVANIA:
: SS.
COUNTY OF DAUPHIN
I, R. RUSSELL DRANE, testator whose name is signed to the attached or
foregoing instrument, having been duly qualified according to law, do hereby acknowledge that I
signed and executed the instrument as my last Will, that I signed it willingly, and that I signed it
as my free and voluntary act for the purposes therein expressed.
f ~'Aug/ ~)~
R. 'R.tiAsell Drane
, Sworn or afvrmed to and acknowledged before me, by R. Russell Drane, testator,
this C>fn day of ucn1b.v , 1998.
~ Y)kd
I Notary Public
My Comrnissio ,~ .
NOTARIAL SEAL
HOLLY $. KIRK, Notary Public
AFFIDAVIT Harrisburg, Dauphin County
My Commission expires Feb. 15, 1999
COMMONWEALTH OF PENNSYLVANIA:
: SS.
COUNTY OF DAUPHIN
We, fhChQ( d L PI Ii fhJ 6 fI J W, LUCm K W.lJj, hi- , the
witnesses whose names are signed to the attached or foregoing instrument, being' uly qualified
according to law, do depose and say that we were present and saw testator sign and execute the
instrument as his last Will; that he signed willingly and that he executed it as his free and
voluntary act for the purposes therein expressed; that each of us in the hearing and sight of the
testator signed the Will as witnesses; and that to the best of our knowl e the testator was at
that time 18 or more years of age, of sound mind and under no cons nt 0 d~u~nce.
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Sworn to and subscribed before me this
lY-!r,
day of
Oclvlxr'
, 1998.
NOTARIAL SEAL
HOLLY S. KIRK, Notary Public
Harrisburg, Dauphin County
My Commission Exp' ~CommissiOflExplresFeb.15, 1999
\, /6 - ~ 9- C;
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG. PA 171Z8-0601
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
ANN E RHOADS ESQ
CLECKNER & FEAREN
PO BOX 11847
HBG PA Il108
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
11-05-2001
GRAY
03-29-2001
21 01-0455
CUMBERLAND
101
'*
REY-1547 EX AFP 112-DDl
MARGARET
C
Allount Rellitted
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 ~
REV=is47-Ex-AFP-fi'2-=ooY-No'fIcE--oF-YNHERITAifCE-YAx-'A-ppiAISEiiENT~--Ai:.i-owANCE-OR-----------------
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF GRAY MARGARET C FILE NO. 21 01-0455 ACN 101 DATE 11-05-2001
TAX RETURN WAS: (X) ACCEPTED AS FILED
CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Hortgages/Notes Receivable (Schedule D)
5. Cash/Bank Deposits/Misc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
U)
(2)
(3)
(4)
(5)
(6)
(7)
.00
.00
.00
.00
14.350.55
6.679.26
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
UO)
2,012.84
149.74
(11)
(2)
(3)
(4)
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
21,029.81
2.162 'i8
18,867.23
.00
18,867.23
NOTE: I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ~ returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate
16. Allount of Line 14 taxable at Lineal/Class A rate
17. Allount of Line 14 at Sibling rate
18. Allount of Line 14 taxable at Collateral/Class B
19. Principal Tax Due
TAX CREDITS.
US) .00 X 00 = .00
(6) 18,867.23 X 045 = 849.03
(7) .00 X 12 = .00
rate (8) .00 X 15 = .00
(19)= 849.03
.
PAYHENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUtlBER INTEREST/PEN PAID (-)
05-29-2001 AA496653 42.45 865.00
10-29-2001 REFUND .00 58.42-
TOTAL TAX CREDIT 849.03
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
TOTAL DUE .00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS.)
..J.::b9, 7
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
'*
BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-liD7 EX AFP 112-DDl
om NOV 30
\~rllilTE
V'.l tSTATE OF
DATE OF DEATH
P 3~T~UMBER
ACN
11-13-2001
GRAY
03-29-2001
21 01-0455
CUMBERLAND
101
MARGARET
C
RecoroBd
Register
ANN E RHOADS ESQ
CLECKNER 8 FEAREN
PO BOX 11847
HBG
Allount Rellitted
Clerk-C"
PA 17108 Cumbenand Co.. PA
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE. PA 17013
NOTE: To insure proper credit to your account. subllit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV=i6"ifj-E3f-AFP-fi'2:ooY------...--iNHERiTANC'E-TAX-ST'A-fEME-tiT-OF-ACCoUiff--...---------------- -----
ESTATE OF GRAY MARGARET C FILE NO.21 01-0455 ACN 101 DATE 11-13-2001
THIS STATEMENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAMED ESTATE. SHOWN BELOW
IS A SUMMARY OF THE PRINCIPAL TAX DUE. APPLICATION OF ALL PAYMENTS. THE CURRENT BALANCE. AND. IF APPLICABLE.
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 11-05-2001
P R I N C I PAL TAX DUE: ...........,...............................................................................................................................................................................................................
849.03
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
05-29-2001 AA496653 42.45 865.00
10-29-2001 REFUND .00 58.42-
TOTAL TAX CREDIT 849.03
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
It IF PAID AFTER THIS DATE. SEE REVERSE TOTAL DUE .00
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1.
NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR).
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORM FOR INSTRUCTIONS. )
u
STATUS REPORT UNDER RULE 6.12
Name of Decedent: MARGARET C GRAY
Date of D~ath: 03-29-2001
Will No.
Admin. No. 2001-00455
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:
1. State whether administration of'the estate is complete:
Yes X No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. Did the personal representative file a final
account with the Court? Yes No X
b. The separate Orphans' Court No. (if any) for
the personal representative's account is:
c. Did the personal representative state an
account informally to the parties in interest? Yes X No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' ~ourt and may be attached to this report.
Date:
11/13/01
~~I~
Signature
Ann E. Rhoads, Esquire
Name (Please type or print)
119 Locust Street
P ,-0 Box 11847
Address
Harrisburg PA 17108-1847
( 717) 238~1731
Tel. No.
Capacity:
Personal Representative
~__Counsel for personal
representative
(MAH:rmt/AM3)
RW-27