HomeMy WebLinkAbout01-18-07
METTE, EVANS & WOODSIDE
A PROFESSIONAL CORPORATION
ATTORNEYS AT LAW
3401 NORTH FRONT STREET
P.O. BOX 5950
HARRISBURG, PA 17110-0950
HOWELL C. ME TIE
IRS NO.
23.1985005
TELEPHONE
(717) 232-5000
FAX
(717) 236-1816
HTTP;l/www.METTE.COM
January 17, 2007
Glenda Farner-Strasbaugh
Register of Wills
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
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He: Estate of Wayland H. Gifford
File No. 21-06-0775
Dear Ms. Strasbaugh:
Enclosed are the following documents:
1. The original and one copy of an Inventory;
2. The original and one copy ofREV-1500, Pennsylvania Inheritance Tax
Return, plus a copy of the cover page of the tax return;
3. A check payable to your office in the amount of $30.00 in payment of
your filing fees; and
4. A self-addressed, postage prepaid envelope for return mail.
Please file the original Inventory and Inheritance Tax Return, and forward a
copy of the Inheritance Tax Return to the Pennsylvania Department of Revenue.
Please return a date-stamped copy of the Inventory and the cover page of the tax
return to my attention in the enclosed envelope.
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Wyomissing Office 11105 Berkshire Boulevard, Suite 3201 Wyomissing, PA 19610 I Telephone (610) 374-11351 Facsimile (610) 371-9510
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January 17,2007
Page 2
Please do not hesitate to call with any questions. Thank you for your
assistance.
Very truly yours,
\L^AoctJ
UK:
Enclosures
cc: Marian J. Trone, Executrix (w/o encs.)
463696vl
owell C. Mette
REV-l500 EX (6-00)
OFFICIAL USE ONLY
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
FILE NUMBER
-.lL
COUNTY CODE
-9L 0775 ___
YEAR NUMBER
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DECEDENTS NAME (LAST, FIRST, AND MIDDLE INITIAL)
Gifford Wa land
DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR)
8/9/2006 9/30/1926
(IF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
Not A licable
[XJ 1. Original Retum
D 4. Limited Estate
[XJ 6. Decedent Died Testate (Attach copy of Will)
D 9. Litigation Proceeds Received
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SOCIAL SECURIlY NUMBER
091-28-1699
'IllIS RETURN MUST BE FILED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
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D 2. Supplemental Retum D 3. Remainder Retum (date of death prior to 12-13-82)
D 4a. Future Interest Compromise (date of death efter 12-12-82) D 5. Federal Estate Tax Retum Required
D 7. Decedent Maintained a Living Trust (Attach copy of Trust) _ 8. Total Number of Safe Deposit Boxes
D 10. Spousal Poverty Credit Idate of death between 12-31-91 and 1-1-9S) D 11. Election to tax under Sec. 9113(A) (Attach Sch 0)
THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDE.NTIALTAX INFORMATION SHOULD BEiiiDIREC'TEDTO:
NAME COMPLETE MAILING ADDRESS
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Howell C. Mette, Es ire
FIRM NAME (If Applicable)
METTE, EVANS & WOODSIDE
TELEPHONE NUMBER
717-232-5000
3401 North Front Street
P.O. Box 5950
Harrisburg, PA 17110-0950
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6. Jointly Owned Property (Schedule F) (6)
o Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
0.00
0.00
0.00
0.00
5,262.81
0.00
~~USE ONLY :::'3
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1. Real Estate (Schedule A)
(1)
(2)
2. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship (3)
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4. Mortgages & Notes Receivable (Schedule D)
5. Cash, Bank Deposits & Miscellaneous Personal Property
(Schedule E)
(4)
(5)
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0.00
8. Total Gross Asseta (total Lines 1-7)
(8)
2,248.15
62,849.33
5,262.81
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) (10)
11. Total Deductions (total Lines 9 & 10)
(13)
65,097.48
(59,834.67)
0.00
(11)
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)
(12)
14. Net Value Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABlE RATES
(14)
(59,834.67)
15. Amount of Line 14 taxable at the spousal tax
z rate, or transfers under Sec. 9116 (a)(1.2)
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~ 16. Amount of Line 14 taxable at lineal rate
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!i 17. Amount of Line 14 taxable at sibling rate
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~ 19. Tax Due
20.0
0.00
0.00
0.00
0.00
x.O L(15)
x .0 45 (16)
x .12 (17)
x .15 (18)
(19)
0.00
0.00
0.00
0.00
0.00
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALL QUESTIONS ON REVERSE SIDE AND RECHECK MATH < <
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3W46451.000
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ece ents omDle e ress:
SlREET ADDRESS
700 Walnut Bottom Road
Cumberland
CllY I STAlE I ZIP
Carlisle PA 17013-
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19)
2. Credits/Payments
A. Spousal Poverty Credit
8. Prior Payments
C. Discount
. (1)
0.00
0.00
0.00
0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Credits (A + 8 + C) (2)
0.00
0.00
0.00
Total Interest/Penalty (D + E) (3)
0.00
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)
0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE.
(5)
0.00
A. Enter the interest on the tax due.
(5A)
0.00
8. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (58) 0.00
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
Yes
D
D
D
D
without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . .. D
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 Cla
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 that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and balief, it is true, correcl and complate.
Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge.
SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN
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
No
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Marian J. Trone
ADDRESS
333 Third Street
SIGNATURE OF PREPARER OTHER THAN REPRESENTATIVE
Howell C. Mette, Es ire
ADDRESS
3401 N. Front Street, PO Box 5950
Harrisburg, PA 17110-0950
For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of lransfers to or for lhe use of lhe surviving spouse is 3%
[72 P.S. 99916 (a) (1.1) (i)).
For dales of death on or after January 1, 1995, lhe tax rate imposed on the net value of transfers to or tor the use of the surviving spouse is 0% [72 P.S. 99116 (a) (1.1) (ii))
The slalute does nol exempt a lransfer 10 a surviving spouse from tax, and the statulory requirements for disclosure of assets and filing a tax retum are still applicable even if
the surviving spouse is lhe only beneficiary.
For dales of death on or after July 1, 2000:
The lax rate imposed on the net value of transfers from a deceased child twenly-one years of age or younger at death 10 or for the use of a natural parent, an adoptive parenl,
or a slepparenl oflhe child is 0% [72 P.S. 99116(a)(1.2)).
The lax rale imposed on lhe net value of transfers to or tor lhe use oflhe decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9 9116(1.2) [72 P.S. 99116(a)(1 )].
The lax rale imposed on lhe net value oflransfers to or for the use of the decedent's siblings is 12% (72 P.S. 9 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.
3W4646 1.000
REV-1508 EX + (6-98)
COMMONWEALTH OF PENNSYL VANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
Wayland R. Gifford
FILE NUMBER
21 06 0775
Include the proceeds of litigation and the date the proceeds were received by the estate.
All property jolntly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
DESCRIPTION
VALUE AT DATE
OF DEATH
1
Internal Revenue Service - refund of 2005 personal
income tax
568.00
2
Parthemore Funeral Home & Cremation Services, Inc. -
refund of prepaid funeral arrangements
728.31
3
PNC Bank Money Market Account #5003926557
3,966.50
3W46AD 1.000
TOTAL (Also enter on line 5 Recaoitulationl $
(If more space is needed, insert additional sheets of the same size)
5,262.81
REV-1511 EX + (12-99)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Wayland R. Gifford
ITEM
NUMBER
A.
B.
1.
FUNERAL EXPENSES:
Funeral Luncheon
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
Debts of decedent must be reported on Schedule I.
DESCRIPTION
Total from continuation schedules
Claimant
Street Address
City
Relationship of Claimant to Decedent
4.
Probate Fees
1.
ADMINISTRATIVE COSTS:
Personal Representative's Commissions
Name of Personal Representative(s) Marian J. Trone
5. Accountant's Fees
6. Tax Return Preparer's Fees
7.
1
Marian J. Trone
Postage expenses
Social Security Number(s) I EIN Number of Personal Representative(s)
Street Address 333 Third Street
City New Cumberland
Year(s) Commission Paid: 2006
2.
Attorney Fees
State PA
Zip 17070
3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation)
2
3W46AG 1.000
State
Zip
Sentinel - legal advertisement
Total from continuation schedules
FILE NUMBER
21 06 0775
TOTAL (Also enter on line 9, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
AMOUNT
95.00
61.48
250.00
1,500.00
125.00
4.64
137.03
75.00
2,248.15
Estate of: Wayland R. Gifford
091-28-1699
Schedule H Part 1 (Page 2)
Item
No.
Description
Amount
2
Whylde Thymes Plant Shop
Plant arrangements for funeral
61. 48
Total (Carry forward to main schedule)
61. 48
Estate of: Wayland R. Gifford
091-28-1699
Schedule H Part 7 (Page 2)
3
Cumberland Law Journal - legal advertisement
75.00
Total (Carry forward to main schedule)
75.00
REV-1512 EX + (12-03)
COMMONVVEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
W~land R. Gifford
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES, & LIENS
FILE NUMBER
21 06 0775
Report debts incurred by the decedent prior to death which remained unpaid as of the date of death, including unreimbursed medical expenses.
ITEM
NUMBER DESCRIPTION
1. Forest Park Health Center
Nursing home services
VALUE AT DATE
OF DEATH
2,621.26
2 Claim for restitution of medical assistance to decedent.
Class 6 claim under S3392 of the Decedents, Estates and
Fiduciaries Code, as these expenses were incurred more
than six months prior to decedent's life. See attached
correspondence from the Department of Welfare.
38,708.75
3 Claim for restitution of medical assistance to decedent.
Class 3 claim under S3392 of the Decedents, Estates and
Fiduciaries Code, as these expenses were incurred during
the last six months of decedent's life. See attached
correspondence from the Department of Welfare.
21,519.32
3W46AH 2.000
TOTAL (Also enter on line 10, Recapitulation) $
(If more space is needed, insert additional sheets of the same size)
62 849.33
REV-1513 EX+ (9-00)
SCHEDULE J
BENEFICIARIES
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
Wavland R Gifford
NUMBER
I
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers
under Sec. 9116 (a) (1.2)]
Marian J. Trone
333 Third Street
New Cumberland, PA 17070
1
RELA TlONSHI P TO DECEDENT
Do Not List Trustee(s)
None
FILE NUMBER
21 06 0775
AMOUNT OR SHARE
OF ESTATE
0.00
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 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
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
3W46AI 1.000
TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET
(If more space IS needed, Insert additional sheets of the same size)
$
0.00
METTE, EvANS & WOODSIDE
ATTORNEYS AT LAW
HARRISBURG, PENNSYLVANIA 17110-0950
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11just mill uub (Ucntumcut
OF
WAYLAND ROMAINE GIFFORD
I, WAYLAND ROMAINE GIFFORD, ofFairview Township, York County,
Pennsylvania, do make, publish ''and declare this to be my Last Will and Testament, hereby
revoking all Wills and Codicils by my at any time made.
ITEM I: I direct that all inheritance and estate taxes becoming due by
reason of my death, whether such taxes may be payable by lpy estate or by any recipient of any
propertY, shall be paid by the Executor out of the property passing under ITEM III of this Will,
!
as an expense and cost of administration of my estate. The Executor shall have no duty or
obligation to obtain reimbursement for any such tax so paid, even though on proceeds of
insurance or other property not passing under this Will.
ITEM II: I direct the Executor to pay the expenses of my last illness and
funeral expenses from the property passing under this Will as an expense and cost of
administration of my estate.
ITEM ill: I give, devise and bequeath all the rest, residue and remainder of
my estate, not disposed of in the preceding portions of this Will, to my friend, MARIAN J.
TRONE, of New Cumberland, Pennsylvania, if she survives me. If she does not survive me I
devise and bequeath such rest residue and remainder to her son, JERRY A. TRONE. .
ITEM IV: In addition to powers given by law, the Executor shall have the
following discretionary powers applicable to all real and personal property including property
held for minors, effective without court order and until actual distribution:
(a) To retain any property received by the Executor;
(b) To sell real estate for any purposes, publicly or privately, for such
prices and on such terms as the Executor deems proper, without liability on the
purchasers to see to application of the purchase moneys;
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(c) To compromise corl.troversies;
(d) To distribute in cash or kind or partly in each at valuations fixed by
the Executor;
( e) To hold investments in the name of a nominee; and
(f) To undertake all other acts in the Executor's judgment deemed
necessary for the proper and advantageous administration and settlement of my
estate.
ITEM V: I hereby nominate, constitute and appoint MARIAN
J. TRONE to be the Executor. The Executor is specifically relieved from the duty or
obligation of filing any bond or other security.
IN WITNESS WHEREOF, I have set my hand and seal to this, my Last Will and
Testament, consisting of this and the preceding two (2) pages, at the end of each page of
which I have also set my initials for greater security and better identification this 1;( Aday
of ~~ ,2003.
~'
Mi' ,~
WLROMAlNE G . ORD
(SEAL)
We, the undersigned, hereby certify that the foregoing Will was signed, sealed,
published and declared by the abov~;.named Testator as and for his Last Will and Testament,
in the presence of us; who, at his request and in his presence and in the presence of each
other, have hereunto set our hands and seals the day and year first above written, and we
certify that at the time of the execution thereof, the said Testator was of sound and disposing
mind and memory.
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PARTHEMORE FUNERAL HOME
The Estate of Wayland Gifford
9/7/2006
008392
Overpayment Refund
728.31
Salomon Smith Barne -overpayment refund
728.31
Cashier's Check
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PNC Bank, National Association
No. 00263851
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~ Pay to the Order of EST A TE OF WAYLAND GIFFORD DECD
Date September 21, 2006
$ 3,966.50
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Three Thousand Nine Hundred Sixty-six Dollars And Fifty Cents
Non-Negotiable
Customer Copy
5003926557
Remitter
,-----------.---------------.---------------------.--------------.------------.-.-----.--.---------.-.-------------------------
I 0 PNCBAN< ~127J/JIJ
I PNC Bank, National Association
I Cashier's>Check No ~ 00263851
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DateSepteJllber 21, 2006
Pay to the Order of ESTATE OF WA YI...AND GIFPOR]): DECD
$ '3,966.50
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Three Thousand Nine Hundred. Sixty-six Dollars Arid Fifty Cents
11100 2b ~a 5 ~1I1 1:0 ~ ~ ~ ~ 2? ~al: 5000 ~OOb~ Sill
RESIDENT STATEMENT FROM
FOREST PARK HEALTH CENTER
700 WALNUT BOTTOM ROAD
CARLISLE, PA 17013-3699
717 -243-1032
Statement Date Due Date ACCOUNT NUMBER
10/31/2006 Upon Receipt 22329FP
$2,621.26
AMOUNT PAID $
Please make check payable to FOREST PARK HEALTH CENTER
WAYLAND R GIFFORD
clo MARIAN J TRONE
333 THIRD ST
NEW CUMBERLND, PA ~ 7070
Remit To:
FOREST PARK HEALTH CENTER
POBOX 34308
NEWARK NJ 07189-4308
Please detach and return this portion with your remittance to the address above.
Comments
Business Office Hours: Mon-Thurs.8:00am-4:00pm
Business Office Telephone: (717)960-7702
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Balance Forward
$2,621.26
TOTAL BALANCE DUE:
$2,621.26
FACILITY NAME
I FOREST PARK HEALTH CENTER
RESIDENT NAME
I WAYLAND R GIFFORD
ACCOUNT NUMBER
22329FP
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF PUBLIC WELFARE
BUREAU OF FINANCIAL OPERATIONS
DIVISION OF THIRD PARTY LIABILITY
ESTATE RECOVERY PROGRAM
PO BOX 8486
HARRISBURG. PA 17105-8486
September 22, 2006
METTE EVANS & WOODSIDE PC
HOWELL C METTE ESQUIRE
3401 NORTH FRONT STREET
PO BOX 5950
HARRISBURG PA 17110-0950
Re: WAYLAND GIFFORD
CIS #: 560152406
SSN: 091-28-1699
Date of Death: 08/09/2006
Dear Attorney Mette:
Please be advised that the Department of Public Welfare maintains a
claim in the amount of $60,228.07 against the above-mentioned estate. This
claim is for restitution of medical assistance granted on behalf of the
decedent for which the Probate Estate is now responsible to reimburse the
Department according to Act 49, 62 P.S. 1412, effective August 15, 1994, as
amended by Act 20-95, effective June 30, 1995. Enclosed is the Department's
itemized statement of claim.
A portion of this medical expense, namely $21,519.32, was incurred
during the last six months of the decedent's life; therefore, it is a Class 3
claim pursuant to Section 3392 of the Decedents, Estates, and Fiduciaries
Code, 20 Pa. C.S.A. 3392(3). The balance of the claim, namely $38,708.75, is
to be entered as a priority Class 6 claim against the estate.
Please acknowledge receipt of this letter and advise whether the
Commonwealth's claim is admitted and when payment may be expected. If the
estate accounting is complete, please provide a copy. If the estate contains
real estate, please provide copies of the deed, the latest tax assessment,
and a current appraisal, if available.
Sincerely,
&~~l.~
Elizabeth M. Wilson
TPL Program Investigator
717-214-1868
717-772-6553 FAX
Enclosure
Register of Wills of Cumberland County, Pennsylvania
INVENTORY
Estate of Wayland R. Gifford
No. 2006-0775
also known as
Date of Death August 9, 2006
late of Carlisle Borough, Cumberland County,
Pennsylvania , Deceased
Social Security No. 091-28-1699
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 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
Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the
end of this inventory. IfNe verify that the statements made in this Inventory are true and correct. IfNe understand that false
statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities.
Personal Representative:
Name of
Attorney:
Howell C. Mette, Esquire
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Marian J. Trone, ~cutrix-
1.0. No.:
07217
Telephone: (717) 232-5000
Address 3401 N. Front Street, Harrisburg, PA 17110
Dated:
'\\G \01
DESCRIPTION
VALUE~--.}
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REAL PROPERTY:
PERSONALPROPERT~
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Parthemore Funeral Home - refund of prepaid funeral arrangements
72~1
3,966.50
568.00
PNC Bank Money Market Account #5003926557
Internal Revenue Service - refund of 2005 personal income tax
TOTAL
5,262.81
(Attach Additional Sheets If Necessary)
NOTE: The Memorandum of real estate outside the Commonwealth of Pennsylvania may, at the election of the personal
representative, include the value of each item, but such figures should not be extended into the total of the Inventory:
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