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Home My WebLink About02-07-07 REV. '500 Ell. CO":, * IIlJI{-'~ REV-150rl/nll~~. INHERITANCE TAX RETURN RESIDENT DECEDENT COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE DEPT. 280601 HARRISBURG, PA 1712~1 DECEDENT'S NAME (LAST, FIRST, AND MIDDLE INITIAL) MILLER, HELENA M. I- Z W o w u w o DATE OF DEATH (MM-DD-YEAR) DATE OF BIRTH (MM-DD-YEAR) OFFICIAL USE ONLY FILE NUMBER 21 06 COUNTY CODE YEAR SOCIAL SECURITY NUMBER 0500 NUMBER 206-38-9753 THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS SOCIAL SECURITY NUMBER ~ 1. Original Return 0 2. Supplemental Return ~ 0 4. Limited Estate 0 4a. Future Interest Compromise (date of death after :.:~lI) ua:::.: 12-12-82) wl!d~ ~ 6. Decedent Died Testate (Attach copy 0 7. Decedent Maintained a Living Trust (Attach Ofiil of Will) copy of Trust) ~ 0 9. Litigation Proceeds Received 0 10. Spousal Poverty Credit (date of death between o 3. Remainder Retum (date of death prior to 12-13-82) o 5. Federal Estate Tax Return Required o 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch 0) OS/25/2006 07/30/1909 ,;,1- l:!ffi ~~ u:r IRM NAME (If applicable) Gingrich, Smith, Klingensmith & Dolan ELEPHONE NUMBER 717/367-1370 222 South Market Street, Suite 201 P.O. Box 267 Elizabethtown, P A 17022 SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES (1 ) (2) (3) (4) (5) (6) (7) -0- 17,740.00 None None None 395,987.12 788,492.44 (IF APPLICABLE) SURVIVING SPOUSE'S NAME ( LAST, FIRST AND MIDDLE INITIAL) (9) (10) 22,968.29 2,871.63 r- OFFICIAL U~NL Y :;3~~ ~ 1. Real Estate (Schedule A) 2. Stocks and Bonds (Schedule B) 3. Closely Held Corporation, Partnership or Sole-Proprietorship z o ~ ..J j:! ~ U w a:: 4. Mortgages & Notes Receivable (Schedule D) 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) 6. Jointly Owned Property (Schedule F) o Separate Billing Requested 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G or L) 8. Total Gross Assets (total Lines 1-7) 9. Funeral Expenses & Administrative Costs (Schedule H) 13. Charitable and Governmental Bequests/Sec 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) -' ?3~? ,~-- -0 :J: 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) . :D :u -'-i }~> r +'" "" (8) 1,202,219.56 (11 ) 25,839.92 1,176,379.64 (12) (13) (14) 1,176,379.64 15.Amountof Line 14 taxable at the spousal tax rate, x .00 (15) or transfers under Sec. 9116(a)(1.2) ! 16. Amount of Line 14 taxable at lineal rate 1,176,379.64 x .045 (16) ~ I- ;:) II. 17. Amount of Line 14 taxable at sibling rate x .12 (17) ~ u ~ 18. Amount of line 14 taxable at collateral rate x .15 (18) I- 19. Tax Due (19) 20.0 CHECK HERE !F vOU ARE REQUESTING A REFUND OF AN OVERPAYMENT 52,937.08 52,937.08 Copyright 2000 form software only The Lackner Group, Inc. Form REV-1500 EX (Rev. 6-00) becedent's Complete Address: STREET ADDRESS 42 Creek Bank Drive CITY I STATE PA I ZIP 17050 Mechanicsburg Tax Payments and Credits: 1. Tax Due (Page 1 Line 19) 2. CreditslPayments A. Spousal Poverty Credit B. Prior Payments C. Discount 50,100.00 2,636.84 Total Credits (A + B + C) 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (D + E) 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 5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. A. Enter the interest on the tax due. B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. Make Check Payable to: REGISTER OF WILLS, AGENT (1 ) 52,937.08 (2) 52,736.84 (3) 0.00 (4) (5) 200.24 (5A) (58) 200.24 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;.................................................................................. ~ I ~: ~:::~ =~e~~:i~~:~:~:~s~~. ~~~~~. ~~~.~~. ~~~.~.~.~.~~~~~~~~~~.~~.i.~.~~~:~~:::::::::::::::::::::::::::::::::::: 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?.. ................... .................... ........... .................................................................. D ~ D 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?........ .... ...... ....... ..... ...... ....... .......................................................................... ~ D ~ IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FilE IT AS PART OF THE RETURN. Under penalties of perjury. I declare that I have examined this retum, 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. SIGNATURE OF PERSON RESPONSIBLE FOR FILING RETURN ADDRESS Helena . Jones 42 Creek Bank: Drive Mechanicsburg, P A 17050 ADDRESS ADDRESS 222 South Market Street, Suite 201 P.O. Box 267 Elizabethtown, P A 17022 DATE DATE z ~P7 For dates of de th 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)]. 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 disdosure of assets and filing a tax retum 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 beneficiaries is 4.5%, except as noted in 72 P.S. 99116 1.2) [72 P.S. 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. COMMONWEALTH OF PENNSYLVANIA .. DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT SMITH JOHN M 222 S MARKET STREET PO BOX 267 ELlZABETHTOWN, PA 17022-2437 __u____ laid ESTATE INFORMATION: SSN: 206-38-9753 FILE NUMBER: 2106-0500 DECEDENT NAME: MILLER HELENA M DA TE OF PAYMENT: 08/18/2006 POSTMARK DATE: 08/17/2006 COUNTY: CUMBERLAND DATE OF DEATH: OS/25/2006 NO. CD 007121 ACN ASSESSMENT CONTROL NUMBER AMOUNT 101 I $50,100.00 I I I I I I I I TOTAL AMOUNT PAID: REMARKS: CH ECK# 003 SEAL INITIALS: JA- RECEIVED BY: TAXPA YER $50,100.00 GLENDA FARNER STRASBAUGH REGISTER OF WILLS '* SCHEDULE A REAL ESTATE COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESDENT DECEDENT ESTATE OF MILLER, HELENA M. I FILE NUMBER 21-06-0500 All real properw 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 which is jointly-owned with right of survivorship must be disclosed on schedule F. ITEM NUMBER 1 , DESCRIPTION VALUE AT DATE OF DEATH See Schedule F for jointly owned property TOTAL (Also enter on Line 1, Recapitulation) * SCHEDULE B STOCKS & BONDS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21-06-0500 ESTATE OF MILLER, HELENA M. All property jointly-owned with right of survivorship must be disclosed on Schedule F. ITEM DESCRIPTION UNIT VALUE VALUE AT DATE OF NUMBER DEATH 1 400 shares Vectren @ $26.68 10,672.00 2 80 shares Bell South @ $32.35 2,588.00 3 XTO Energy, mineral rights deed for oil and gas. The fair market value is 4,480.00 determined by multiplying the annual royalties by 4. The annual royalties for 2006 were estimated to be $1,120.00 x 4 = $4,480.00 I I I TOTAL (Also enter on line 2, Recapitulation) 17,740.00 VECTREN CORPORATION SHARES VECTREN CORPORATION ADORESSITAX IDENTIFICATION CHANGE CARD PLEASE USE THIS CARD TO INFORM US IF YOU HAVE CHANGED YOUR ADDRESS. PLEASE INCLUDE THIS CARD WITH ANY CORRESPONDENCE TO US. 400.000 RATE .3050 RECORD DATE 02/15/2006 PAYABLE DATE 03/01/2006 PLEASE FORWAR[) INFORMATION REGARDING THE COMPANY'S DIVIDEND REINVESTMENT PLAN 0 ACCOUNT NUMBER HR657311511458 NAME HElENA'M MILLER 42 CREEK BANK DRIVE MECHANICSBURG PA17050 GROSS DIVIDEND PAID , /'JL'~.CJ) \....-~~ CURRENT .........122.00 YEAR TO DATE $1 ~ 2.00 .' ,~.-L~,{.. NEW ADDRESS (PLEASE TYPE OR PRINT CLEARLY) CURRENT TAX WITHHELD $.00 PLEASE SIGN TO AUTHORIZE CHANGE ADDRESS CITY $.00 STATE PLEASE SIGN TO AUTHORIZE CHANGE To authorize a change, please sign exactly as name appears hereol ZIP CODE Joint Owners should each sign. When signing as attorney. execute Administrator. trustee or guardian. please give lull title as such, YEAR TO DATE Live ~ ~/ VEaREN /" ./' (I, /1 51 f 'f; Iv 1 f~ J lC 1- ' t\.., clo National City Bank Corporale Trust Operations Locator 5352 P. O. Box 94856 Cleveland, ~H 44]41-4~_ + VOTE BY TELEPHONE Have your proxy card available when you call the Toll-Free Number 1-800-542-1160 using a touch-tone phone and follow the simple instructions to record your vote. P0110101192J578 ....AUTO..ALL FOR ADC 170 HELENA M MILLER 595 GENEVA DR APT8 MECHANICSBURG, PA 17055-5450 I" .111. ,,11111111.1..1.1,,1.1..1..1.1.1.11111111111111.1111.1 VOTE BY INTERNET Have your proxy card available when you access the website www.votefast.com and follow the simple instructions presented to record your vote. /Ii;/ 4<-t{}: fJ ~ ~Vud-- ,J:j~ /' ILt :;/; ItJ 5 VOTE BY MAIL Please mark, sign and date your proxy card and return it in the postage-paid envelope provided or return to: National City Bank, P.O. Box 535800, Pittsburgh, PA 15253. Vote by Telephone Call Toll-Free using a Touch-Tone phone: 1-800-542-1160 Vote by Internet Access the website and cast your vote: www.votefast.com Vote by Mail Return your proxy in the postage-paid envelope provided. Vote 24 hours a day, 7 days a week! Your telephone or Internet vote must be received by 11 :59 p.m. Eastern Daylight Time on April 26, 2005, to be counted in the final tabulation. If you vote by telephone or Internet, please do not send your proxy by mail. II ~ 1566 927 9851 II If voting by mail, Proxy must be signed and dated below. ~ Please fold and detach card at perforation before mailing. ~ Historical Quotes: Charting Tools for Looking Up a Security's Exact Closing Price - BigC... Page 1 of2 . This Historical Quotes tool allows you to look up a security's exact closing price. Simply type in the symbol and a historical date to view a quote and mini chart for that security. ill m....J Enter Date: l~!?!9.~. Enter Symbol: lY.Y.'g..... Vectren Corp Monday, June 05,2006 Closing Price: Low: 26.68 26.92 27.06 26.60 277,200 Go To Charting ... ~ No Splits Open: High: Volume: 2-Month Daily Chart of Vectren Corp SPONSORED LINKS Get listed here Rocket Stock Picks Go Up Get in on fast moving, low priced stocks with huge upside potential. Free report. www.J:~G.!sm~tock~~cQm Hedge Your Portfolio Using Commodities! Register for free access now to quotes, charts, news and weather. Silver, copper, sugar, oil and more. Every tool you need to trade, completely free. US and Canada only. Instant access! www..1b_e_G9mmQ.91ty..c._b.gnneL~.m. Buy Stocks Online at Scottrade $7 stock trades at Scottrade. No account inactivity or maintenance fees. Open an account for $500. Apply today. www.scottrade.com The Stockster's Free Hot Stock Picks The Stockster's hot stock picks-sign up on our free e-mail list today and turn your portfolio into a monster performer! ~JhesJoc~~J':,-Corn Free Practice Account Start trading Forex today with afree $50,000 practice account. www.fxcmtr.com G..It_t.9....lI:u~ ne-K..t.l~..'!!:g.l.Q.Unvestl11.e.m: reI;Jt.i!l.r.m http://bigcharts.marketwatch.com/historical/ default.asp?detect= 1 &symbol= VV C&c1ose dat... 6/6/2006 Mellon Investor Services P.O. Box 3333 South Hackensack, NJ 07606 May 18, 2006 @ Mellon HELENA M MILLER ATIN HELENA M JONES 42 CREEK BANK DR MECHANICSBURG P A 17050 i~;~~T.-J~~~~~~J I.. Account Key I~MILLER--- i I HELEMOOOC !__. ~.. ..__.._.J ! Control 1200605180002712 ; !Number I , I ~::,~ne.lO?:631:6~_ ==:-:-] Dear Sir or Madam: Thank you for your inquiry requesting information for this account. --- You will find included an account transcript containing the requested information. This report will show: · Account Profile-general account status · Account Certificate Listing-debit/credit of certificates · Account Payment List-details cumulative dividend payments · Dividend Reinvestment Account Summary-details shares purchased with reinvestment We hope that this information has been helpful. If you have additional questions, please call our Customer Service Center at the number listed above or you may access the account online via Investor ServiceDirect at Vv'vlw.melloninvestoLcom. Sincerely, Mellon Investor Services Shareholder: HELENA M MILLER A TTN HELENA M JONES 42 CREEK BANK DR MECHANICSBURG PA 17050 Our Control Number: 200605180002712 YEAR TO DATE ACCOUNT SUMMARY CERTIFICATE HISTORY (From :1992 To: 2006) BOOK ENTRY HISTORY ( From :1992 To: 2006) PLAN TYPE: IRoo1 01101/2006 Balance Forward 80.0000 .0000000 .00 .00 .00 .00 01/01/2005 Balance Forward 80.0000 .0000000 .00 .00 .00 .00 01/01/2004 Balance Forward 80.0000 .0000000 .00 .00 .00 .00 01101/2003 Balance Forward 80.0000 .0000000 .00 .00, .00 .00 01/01/2002 Balance Forward 80.0000 .0000000 .00 .00 .00 .00 01101/2001 Balance Forward 80.0000 .0000000 .00 .00 .00 .00 01/01/2000 Balance Forward 80.0000 .0000000 .00 .00 .00 .00 01/01/1999 Balance Forward 80.0000 .0000000 .00 .00 .00 .00 12/2411998 Stock DividencllSplit 80.0000 .0000000 .00 .00 .00 .00 01/01/1998 Balance Forward .0000 .0000000 .00 .00 .00 .00 PAYMENT HISTORY (From :1992 To: 2006) 0000000000 Dividend 0000000000 Dividend 11/01/2005 58515179 PAID on 11/07/2005 0000010003304 0000000000 Dividend 08101/2005 57023183 PAID on 08/05/2005 0000010003304 0000000000 Dividend 06/02/2005 56330790 PAID on 07/08/2005 0000010003304 0000000000 Dividend 05/0212005 56195646 PEND 0000010003304 0000000000 Dividend 02101/2005 80195130 PAID on 02109/2005 21.60 0000010003304 0000000000 Dividend 11/01/2004 90799758 PAID on 11/04/2004 21.60 0000010003304 0000000000 *' . SCHEDULE F JOINTLY-OWNED PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MILLER, HELENA M. I FILE NUMBER 21-06-0500 If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. SURVIVING JOINT TENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A Helena M. Jones 42 Creek Bank Drive Mechanicsburg, P A 17050 42 Creek Bank Drive Mechanicsburg, P A 17050 Daughter B A. Richard Jones Son-in-law 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 DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT or similar identifying number. Attach deed for jointly-held real VALUE OF ASSET INTEREST DECEDENT'S INTEREST estate. 1 A&B 03/0512005 One-third interest in property located at 42 Creek 260,340.00 33.33% 86,771.32 Bank Drive, Mechanicsburg, P A Assessed value $260,340 x 1.00 (common level ratio) = $260,340 2 A 10/31/2007 First State Bank C.D. #0080064146, which includes 12,776.14 50% 6,388.07 accrued interest of $323.54 to date of death 3 I A Bank of America Checking Account #00002274164 16,179.35 50% 8,089.68 which includes accrued interest of$0.75 to date of death (made joint prior to one year of the date of death) 4 A Bank of America MM #000002881010 which 4,238.26 50% 2,119.13 includes accrued interest of $1.04 to date of death (made joint prior to one year of the date of death) 5 A Bank of America C.D. #30000041224621 which 5,017.59 50% 2,508.80 includes accrued interest of$17.59 to date of death (made joint prior to one year of the date of death) 6 A Bank of America C.D. #91000002765200 which 96,870.74 50% 48,435.37 includes accrued interest of $175.64 to date of death (made joint prior to one year of the date of death) 7 A Bank of America C.D. #91000021439494 which 12,745.66 50% 6,372.83 includes accrued interest of $21.65 to date of death (made joint prior to one year of the date of death) 8 A 04/12/2005 Wachovia Bank C.D. #247402052234412 which 18,350.62 50% 9,175.31 includes accrued interest of $27.57 to date of death I Total of Continuation Schedule(s) 226,126.61 I TOTAL (Also enter on line 6, Recapitulation) 395,987.12 * SCHEDULE F JOINTLY-OWNED PROPERTY continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT I FILE NUMBER 21 - 06 - 0500 ESTATE OF MILLER, HELENA M. If an asset was made joint within one year of the decedent's date of death, it must be reported on schedule G. JOINTLY OWNED PROPERTY LETTER DATE DESCRIPTION OF PROPERTY %OF ITEM Include name of financial institution and bank account number DATE OF DEATH DATE OF DEATH NUMBER FOR JOINT MADE or similar identifying number. Attach deed for joinUy-held real VALUE OF ASSET DECO'S VALUE OF TENANT JOINT estate. INTEREST DECEDENT'S INTEREST 9 A 04/12/2005 Wachovia Bank C.D. #247402062249288 which 189,795.71 50% 94,897.86 includes accrued interest of $488.55 to date of death 10 A 05/02/2005 Wachovia Bank C.D. #247402092223994 which 46,141.44 50% 23,070.72 includes accrued interest of $141.44 to date of death 11 A 03/21/2005 Wachovia Bank Checking Account #1010110871930 7,103.91 50% 3,551.96 which includes accrued interest of $0.50 to date of death 12 A 04/12/2005 Wachovia Bank Checking Account #1010110872243 3,978.95 50% 1,989.48 which includes accrued interest of $.46 to date of death 13 A 04/12/2005 Wachovia Bank Certificate of Deposit 190,233.17 50% 95,116.59 #247402052249284 erroneously omitted from the date of death letter 14 A 04/12/20051 Wachovia Bank Certificate of Deposit 15,000.00 50% 7,500.00 #247402052301888 erroneously omitted from the date of death letter I I Page 2 of Schedule F .. ~ First State Bank 08/24/2006 RE: Estate of Helena M. Miller A/k/a Helena M. Miller 42 Creek Bank, Dr. Mechanicsburg, P A 17050 SS# 206-38-9753 To whom it may concern, In response to your letter dated August 14,2006 Ms. Miller had a joint account with Helena Jones which was opened on 10/31/01.The account was closed on 6/22/2006 the balance was 12,776.15 and the interest paid was 366.34 The balance on 5/26/2006 was 12,776.15 with accrued interest of323.54. I hope this information will help in finalizing everything. Should you any further information please call me at 727-898-1000. Thank You ./.~ ~ /~'/" . (.~ '. ~~>.' .~ .( I __________ l - Rosann Traynof First State Bank Customer Service Representative First State Bank 2832 4th Street North · St. Petersburg. FL 33704 · (727) 898-1000 MEMBER FDIC 00 t'rNDER Bank of America ~ ~ September 18,2006 John M. Smith, Esquire Gingrich, Smith, Klingensmith & Dolan 222 South Market Street, Ste. 201 P.O. Box 267 ElizabethTown, P A 17022 Re: Estate of Helena M. Miller [Date of Death May 25,2006] Dear Mr. Smith: Below please find financial information on accounts held in the name of the above-captioned decedent as of date of death: Account Number 000002274164 (Interest Checking) Date of Death Balance: $16,178.60 Accrued Interest: $0.75 Status: Closed (July 5, 2006) Title: Helena M. Miller or Helena Jones (JTWROS) Account Number 000002881010 (Money Market Savings) Date of Death Balance: $4,237.22 Accrued Interest: $1. 04 Status: Closed (July 5, 2006) Helena M. Miller or Helena M. Jones Title: (JTWROS) Account Number 30000041224621 CD 4.28% (due 07/05/06) Date of Death Balance: $5,000.00 Accrued Interest: $17.59 Status: Closed (July 5, 2006) Title: Helena M. Miller or Helena M. Jones Bank of America, FL6-001-02-11 PO BOX 407090, Fort Lauderdale, FL 33340 Recycled Paper .> BankofAmerica ~ ~ John M. Smith, Esquire September 18, 2006 Page 2 Re: Estate of Helena M. Miller [Date of Death May 25,2006] Account Number 91000002765200 CD 4.42% (due 07/05/06) Date of Death Balance: $96,695.10 Accrued Interest: $175.64 Status: Closed (July 5, 2006) Title: I Helena M. Miller or Helena M. Jones Account Number 91000021439494 CD 3.45% (due 07/05/06) Date of Death Balance: $12,724.01 Accrued Interest: $21.65 Status: Closed (July 7,2006) Title: Helena M. Miller or Helena Mary Jones Visa Gold Credit Card Number 4319014902013639 Current Balance due (09/18/06) $456.74 For additional information call 1.888.702.1161 Name(s) ofCardholder(s) Helena M. Miller If you have any questions concerning the information provided, please do not hesitate to contact me. For questions not related to "date of death "values, please call our Sales, Service & Support Center @ 1-800-444-8510. Sincerely, Jackie Miller Legal Order Processing 954.473.7710 op #4 Bank of America, FL6-001-02-11 PO BOX 407090, Fort Lauderdale, FL 33340 Recycled Paper .. ~~ WACHOVIA Reference 10: 1710640 Wachovia Bank N.A. Balance Confirmation Services POBox 40028 Roanoke, VA 24022-7313 August 4, 2006 HELENA W JONES 42 CREEK BNAK DRIVE MECHANICSBURG, PA 17050 SUBJECT: Verification / Confinnation of Account and Balance Infonnation provided for: Customer: HELENA 1\1 MILLER (SSN# 206-38-9753) Date of Death: May 25, 2006 DeDosit Account Information Account Type Account Number Date of Death Balance Average Balance. Date Opened Maturity Interest Accrued YTD Date Date Rate Interest Interest Paid Closed CERTIFICATE OF DEPOSIT 247402062234412 LEGAL TITLE: HELENA M MILLER HELENA W JONES $18,323.05 4/12/2005 10/12/2007 3.92 $27.57 $294.73 CERTIFICATE OF DEPOSIT 247402062249288 LEGAL TITLE: HELENA M MILLER HELENA W JONES $189,307.16 5/2/2005 11/2/2007 3.92 $488.55 $3,045.07 CERTIFICATE OF DEPOSIT 247402092223994 LEGAL TITLE: HELENA M MILLER HELENA W JONES $46,000.00 3130/2005 3/30/2010 4.31 $141.44 $658.38 CHECKING 1010110871930 $7,103.41 3/21/2005 $0.50 $5.73 LEGAL TITLE: HELENA M MILLER HELENA W JONES PAm S POWELL POA CHECKING 1010110872243 LEGAL TITLE: HELENA M MILLER HELENA W JONES $3,978.49 4/12/2005 $0.46 $4.11 · Due to system limitations, we can only provide a twelve month average balance on depository accounts. 0000000614 .. ~~':"'- WACHOVIA Reference ill: 1710640 CAP, BROKERAGE and SELF-DIRECTED IRA ACCOUNTS HAVE BEEN CONVERTED TO W ACHOVIA SECURITIES. YOUR REQUEST HAS BEEN FORWARDED FOR PROCESSING and WILL BE MAILED UNDER SEPARATE COVER. FOR QUESTIONS REGARDING CAP, BROKERAGE, or SELF-DIRECTED IRA ACCOUNTS PLEASE CALL W ACHOVIA SECURITIES at 1-866-874-2717. · Date of death balance does not include accrued interest. · If date of death OCCUITS on a weekend or a holiday, date of death balance does not include any transactions that were , made during;h. time period. . L' Utk, . a0J J ennifer~Straub Servicenter Associate Phone: (540)563-7323 abs; js "'/ .- "J '. ) ..... l?h 0000 000614 0002124901 AT 0.30801 30G 65 1...11111.111,,"1.1.11'11...111'11....11.1..1.1..1..1.11"1II HELENA H HILLER HELENA W JONES PB PATTI S POWELL POA lf2 CREEK BANK DR HECHANICSBURG PA 17050 Consolidated Statement 01 1010110871930 752 30 .rIA 3/9/2006 thru 4/10/2006 o 5 67,798 Summary of Accounts Checking & Savings Account number Account ~,1 010110871930 .. \f.4 74020.92223994 ~247402062234412 '\1010110872243 247402052249284 \247402062249288 247402052301888 CROWN CLASSIC BKG . TIMI= nl=l?nSIT 60 MQblTHS TIME DEPOSIT 30 MONTHS HIGH PERFORMANCE MMI TIME DEPOSIT 14 MONTHS TIME DEPOSIT 30 MONTHS TIME DEPOSIT 12 MONTHS Total - = ~ -- Maturity ;;;;;;;;;;;;; - date - - - - 3/30/2010 - 10/12/2007 - ~ !!!!!!!!!!!! 7/02/2006 -- - 11/02/2007 !!!!!!!!!!!! ~ 6/28/2006 iiiiiiiiiiiiiOi ~ ~ ;n :c '- ,..., N ~ 0 ~ ,..., .. <t) ~ 0 .. <.n w w ." ,..., W Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z 0 c 0 c ~ Balance As of Interest rate 10,086.58 46,000.00 18,203.41 3,977.73 190,233.17 188,698.24 15,000.00 . $472,199.13 4/10 4/10 4/10 4/10 4/10 4/10 4/10 3.63% 3.92% 3.73% 4.31 %d 3.92% ~, WACHOVIA BANK, N.A., CARLISLE page 1 of 4 . (C ~q'~ ~ j ,,- 'y' \ J -- THIS DEED Made the L/Jt..... day of /rJ lJrt;h Two Thousand Five (2005). BETWEEN DD & K, INC, a Pennsylvania Business Corporation, with principal place of business at 2300 Bent Creek Boulevard, of the Township of Silver Spring, County of Cumberland and Commonwealth of Pennsylvania, hereinafter called the GRANTOR; AND HELENA M. MILLER, AND A. RICHARD JONES and HELEl'f3 W. <::.:> JONES, Husband and Wife, ofthe County of Cumberland and Commonwealth ofPenns~i~,/ I -- ::, S;;~ 1--:',: ,~) hereinafter called the GRANTEES ~ ,..: t:::. ~;; ~ '.- 1?2: ';' } ...t., ~ ",: ;!~-: N ~ r-1 1-4 :; :~. g C:> ,::, 11'1 WITNESSETH, That in consideration of TWO HUNDRED SIXTY-FIVE THOUSAND NINE' :;:, HUNDRED AND 00/100 ($265,900.00) DOLLARS in hand paid, the receipt whereof is hereby acknowledged, the said Grantor does hereby grant and convey to the said Grantees, their heirs and assigns, holding title as stated below, ALL THAT CERTAIN Unit in the property known as Bent Creek Crossing Condominiums located in the Township of Silver Spring, County of Cumberland and Commonwealth of Pennsylvania, which has heretofore been submitted to the Uniform Condominium Act, Act of July 2, 1980, P.L. 286, No. 82, along with all Amendments thereto, by the recording in the Recorder of Deeds Office in and for Cumberland County, Pennsylvania, of the Declaration creating and establishing Bent Creek Crossing Condominiums, a Condominium, dated October 29, 1998 and recorded October 29, 1998 in said Recorder's Office in Book 593, Page 184 (together with all amendments and supplements thereto recorded on or before the date hereof), and the Plats and Plans which are a part of the aforesaid Declaration recorded April 14, 1998 in said Recorder's Office at Plan Book 76, Page 96 and the Plats and Plans for Phase n recorded at Plan Book 87, Page 3, (together with all amendments and supplements thereto recorded on or before the date hereof) (the aforesaid Declaration, as amended and supplements, and the aforesaid Plats and Plans, as amended and supplement are hereinafter collectively referred to as the "Declaration"), and as described in the First Amendment to the Declaration of Bent Creek Crossing Condominiums, dated June 29, 1999 and recorded in the said Recorder's Office on July 1, 1999 at Book 617, Page 1014, ("The First Amendment") and as described in the Second Amendment to the Declaration of Bent Creek Crossing Condominiums dated January 27,2000 and recorded in the said recorders office on January 31,2000 at Book 636, Page 941, ("The Second Amendment") and as described in the Third Amendment to the Declaration of Bent Creek Crossing Condominiums, dated March 27,2000 and recorded in the said Recorder's Office on April 4, 2000 at Book 641, Page 663, ("The Third Amendment") and as described in the Fourth Amendment to the Declaration of Bent Creek Crossing Condominiums dated May 15, 2000 and recorded in the said Recorder's Office on May 18, 2000 at Book 644, Page 693, ("The Fourth Amendment") and as described in the Fifth Amendment to the Declaration of Bent Creek Crossing Condominiums dated December 28,2000 and recorded in the said Recorder's Office on January 3, 2001 at Book 663, Page 569, ("The Fifth Amendment") and as described in the Sixth Amendment to the Declaration of Bent Creek Crossing Condominiums dated Apri112, 2001 and recorded in said Recorder's Office on April 19, 2001 at Book 672, Page 459, ("The Sixth Amendment") and as described in the Seventh Amendment to the Declaration of Bent Creek Crossing Condominiums dated September 20, 2001 and recorded in the said Recorder's Office on September 24,2001 at Book 681, Page 1202, ("The Seventh Amendment") and as described in the Eighth Amendment to the Declaration of Bent Creek Crossing Condominiums dated September 20,2001 and recorded in the said Recorder's Office on September 24, 2001 at Book 681, Page 1728, ("The Eighth Amendment") and as described in the Ninth Amendment to the Declaration of Bent Creek Crossing Condominiums dated November 30, 2001 and recorded in the said Recorder's Office on December 7, 2001 at Book 682, Page 4704("The Ninth Amendment") and as described in the Tenth Amendment to the Declaration of Bent Creek Crossing Condominiums dated March 12, ~(:'/ :,\~['i450 . 2002 and recorded in the said Recorder's Office on March 14,2002 at Book 685, Page 2501("The Tenth Amendment") and as described in the Eleventh Amendment to the Declaration of Bent Creek Crossing Condominiums dated April 8, 2002 and recorded in the said Recorder's Office on April 8,2002 at Book 686, Page 615 and re-recorded April 24, 2002 at Record Book 686, Page 3437, ("The Eleventh Amendment") and as described in the Twelfth Amendment to the Declaration of Bent Creek Crossing Condominiums dated May 13,2002 and recorded in the said Recorder's Office on May 14, 2002 at Book 687, Page 952 ("The Twelfth Amendment") and as described in the Thirteenth Amendment to the Declaration of Bent Creek Crossing Condominiums dated August 28, 2002 and recorded in the said Recorder's Office on August 29,2002 at Book 689, Page 4052 ("The Thirteenth Amendment") and as described in the Fourteenth Amendment to the Declaration of Bent Creek Crossing Condominiums dated August 28, 2002 and recorded in the said Recorder's Office on August 29, 2002 at Book 689, Page 4074 ("The Fourteenth Amendment") and as described in the Fifteenth Amendment to the Declaration of Bent Creek Crossing Condominiums dated August 28, 2002 and recorded in the said Recorder's Office on August 29,2002 at Book 689, Page 4092 ("The Fifteenth Amendment") and as described in the Sixteenth Amendment to the Declaration of Bent Creek Crossing Condominiums dated August 28, 2002 and recorded in the said Recorder's Office on August 29, 2002 at Book 689, Page 4109 ("The Sixteenth Amendment") and as described in the Revisions to the 11'h, 14th, 15th and 16th Amendments to the Declaration dated October 10, 2002 and recorded in the above said Recorder of Deeds Office on October 15,2002 at Record Book 690, Page 4877 ("Revisions to the 12th, 14th, 15th and 16th Amendments") and as described in the Seventeenth Amendment to the Declaration of Bent Creek Crossing Condominiums dated October 23,2002 and recorded in the aforesaid Recorder of Deeds Office on November 1,2002 at Record Book 691, Page 2504 ("The Seventeenth Amendment") and as described in the Eighteenth Amendment to the Declaration of Bent Creek Crossing Condominiums dated March 10, 2003 and recorded in the aforesaid Recorder of Deeds Office on March 12,2003 at Record Book 695, Page 1196, ("The Eighteenth Amendment")and as described in the Nineteenth Amendment to the Declaration of Bent Creek Crossing Condominiums dated June 12,2003 and recorded in the aforesaid Recorder of Deeds Office on June 18, 2003 at Record Book 698, Page 2263, ("The Nineteenth Amendment") and as described in the Twentieth Amendment to the Declaration of Bent Creek Crossing Condominiums dated June 12,2003 and recorded in the aforesaid Recorder of Deeds Office on June 18,2003 at Record Book 698, Page 2267, ("The Twentieth Amendment") and as described in the Twenty-First Amendment to the Declaration of Bent Creek Crossing Condominiums dated September 19, 2003 and recorded in the aforesaid Recorder of Deeds Office on September 23,2003 at Record Book 702, Page 283, ("The Twenty-First Amendment") and as described in the Twenty-Second Amendment to the Declaration of Bent Creek Crossing Condominiums dated November 25,2003 and recorded in the aforesaid Recorder of Deeds Office on December 1, 2003 at Record Book 704, Page 1617, ("The Twenty-Second Amendment") and as described in the Twenty-Third Amendment to the Declaration of Bent Creek Crossing Condominiums dated December 3, 2003 and recorded in the aforesaid Recorder of Deeds Office on December 8, 2003 at Record Book 704, Page 2649, ("The Twenty- Third Amendment") and as described in the Twenty-Fourth Amendment to the Declaration of Bent Creek Crossing Condominiums dated February 9, 2004 and recorded in the aforesaid Recorder of Deeds Office on February 11, 2004 at Record Book 706, Page 455, ("The Twenty- Fourth Amendment") and as described in the Twenty-Fifth Amendment to the Declaration of Bent Creek Crossing Condominiums dated June 2,2004 and recorded in the aforesaid Recorder of Deeds Office on June 7, 2004 at Record Book 708, Page 4050, ("The Twenty-Fifth Amendment") and as described in the Twenty-Sixth Amendment to the Declaration of Bent Creek Crossing Condominiums dated June 24,2004 and recorded in the aforesaid Recorder of Deeds Office on July 1, 2004 at Record Book 709, Page 2478, ("The Twenty-Sixth Amendment") and as described in the Twenty-Seventh Amendment to the Declaration of Bent Creek Crossing Condominiums dated July 12,2004 and recorded in the aforesaid Recorder of Deeds Office on July 14, 2004 at Record Book 709, Page 4281, ("The Twenty-Seventh Amendment") and as described in the Twenty-Eighth Amendment to the Declaration of Bent Creek Crossing Condominiums dated August 13, 2004 and recorded in the aforesaid Recorder of Deeds Office on August 19,2004 at Record Book 710, Page 4459, ("The Twenty-Eighth Amendment") and as described in the Twenty-Ninth Amendment to the Declaration of Bent Creek Crossing Condominiums dated September 1,2004 and recorded in the aforesaid Recorder of Deeds Office on September 3,2004 at Record Book 711, Page 1493, ("The Twenty-Ninth Amendment") and as described in the Thirtieth Amendment to the Declaration of Bent Creek Crossing Condominiums dated November 18, 2004 and recorded in the aforesaid Recorder of Deeds Office on November 23, 2004 at Record Book 713, Page 1447, ("The Thirtieth Amendment") and as described in the Thirty-First Amendment to the Declaration of Bent Creek 2.D:? L'rr~451 ,'w~'j: . . Crossing Condominiums dated December 16,2004 and recorded in the aforesaid Recorder of Deeds Office on December 20, 2004 at Record Book 713, Page 4321, ("The Thirty-First Amendment") and said Unit being designated as Unit No. 112 in said Declaration and Amendments consisting of2,03 7 square feet, as more fully described in the Declaration and Amendments, together with the voting rights, common interest and common expense liability which are subject to diminution by the exercise of certain rights to be found in the Declaration. TOGETHER with all right, title and interest of, in and to the Limited Common Elements designated for each unit in the Declaration and any Amendments made thereto. UNDER AND SUBJECT nevertheless, to the rights and powers of the Association, as created by the Declaration, and under and subject to the provisions of the Declaration, and the easements, agreements, covenants and conditions of record and the provisions, easements, agreements, covenants and restrictions contained in the Declaration. UNDER AND SUBJECT to all other agreements, easements and restrictions of record. BEING a part ofthe same premises which Albert L. Allen, Jr., Barbara A. Hench, William Stuart Hench, III, Barbara J. Allen, Heath L. Allen, n, Melissa A. Smith and Martin R. Allen, as tenants in common, as record owners, and RSM Associates, L.P., a Pennsylvania Limited Partnership, as equitable owner, by deed dated March 23, 1998 and recorded in Cumberland County Deed Book 175, Page 395, granted and conveyed unto DD & K, Inc., a Pennsylvania Business Corporation, one of the grantors herein, which Deed was corrected as to the general partner ofRSM Associates, L.P., a Pennsylvania Limited Partnership, by Corrective Deed from it dated December 15, 1998 and recorded in the Recorder of Deeds Office in and for Cumberland County on December 22, 1998 at Deed Book 191, Page 524. THIS Deed of Conveyance represents the transfer of an interest in the Condominium which is currently defined as 1.0173 % thereof per the above referenced Declaration, the First Amendment thereto, the Second Amendment thereto, the Third Amendment thereto, the Fourth Amendment thereto, the Fifth Amendment thereto, the Sixth Amendment thereto, the Seventh Amendment thereto, the Eighth Amendment thereto, the Ninth Amendment thereto, the Tenth Amendment thereto, the Eleventh Amendment thereto, the Twelfth Amendment thereto, the Thirteenth Amendment thereto, the Fourteenth Amendment thereto, the Fifteenth Amendment thereto and in the Revisions to the Twelfth, Fourteenth, Fifteenth and Sixteenth Amendments, the Seventeenth Amendment thereto, the Eighteenth Amendment thereto, the Nineteenth Amendment, the Twentieth Amendment, the Twenty-First Amendment, the Twenty-Second Amendment, the Twenty-Third Amendment, the Twenty-Fourth Amendment, the Twenty-Fifth Amendment, the Twenty-Sixth Amendment, the Twenty-Seventh Amendment, the Twenty-Eighth Amendment, the Twenty-Ninth Amendment, the Thirtieth Amendment and the Thirty-First Amendment to the Declaration. GRANTEES hold title to the above described property as co-equal joint tenants with the right of survivorship, with Helena M. Miller being one joint tenant, A. Richard Jones being one joint tenant, and his wife, Helena W. Jones, being the other joint tenant. :,: :-',,' :.",,;: /; ~'.::: ~ . ,'j"! I" ..~;: ';';:;i 6', 1':'-1 ,!: :'i.: ~\.: ~:.: ~ ',.; :: ; ~::; \.. ~,;; tLi c.: L'.: .;:. .;.," ,n,,,! /;"'": I .y, jL-: i I ':1::.' .,'j ,'CO;:' ':-V' :1;;-:. ....,.. -:';i :;;::::._j :;:r:;1 ~::r:. ';,"J t::J -.-1 \--.. ""'1 -,1 :,.;;~,. ..:::;: 1;.0 " ...--t .:...-! " i\:~ .:::.:: ~:~; ::~ r-n ':::. ~, l'r ,'.--. :I" " n,t 1P ; ~ Y1 ;:'..,1 :':;1 " . '. ~;;{ ;:~~;:. :.'~~" :.;,1.' :;;,:.' ;;;< ;~;~ _''' , . f'ol t.;. ,....J "rl .~::-.: ~r~ ....J J;';;.' ':..1 I ;:~;i7 r:~:l :y' .. '~1 I q ....., . ;:~,: . ~:::: ;-'1"; ..; .'~'l . " '.'.f r..'; . ."", t::. '.,f.~' . ~ " j' I .. /,. ~ i ': ':..1"1 ,': ':; ,.:'::, <::; ':;..:. ,..,.~. ...1'1 ;, fJ I,:;:> LYl !"rr :'.' <.::' ';::'.' ,,:~:> <:~;, .:'::.... .::';;' ,~:::. 0:::::::' '~:".." .;::::' ")~~:"j "'~r ,4452 ~...u 1 ..llJ~"X ;;'(:, II AND THE said Grantor, does hereby W ARRANT SPECIALLY the property hereby conveyed, IN WITNESS WHEREOF, said Grantor has hereunto set its hand and corporate seal the day and year first above written. SIGNED, SEALED AND DELIVERED IN THE PRESENCE OF DD & K, INC. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND '-I.It day of On this the , 2005, before me, a Notary Public, the undersigned officer, personally appeared David R. Strong, who acknowledged himself to be the President of DD&K, Inc., a Corporation, and that he as such Officer, being authorized to do 50, executed the foregoing instrument for the purposes therein contained by signing the name of the Corporations by himself as President. IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal. My Commission Expires: . MONWEA1.TH Of PflNNSY ,v i NoClIrial SQ\ Stephanie L, Shank, NOllIIy Puhhll Ehzabclbtown Boro, lanwter Count}' My Commission Expires May J. 200S $/114.1-1 ~. >;Jl~;~u Notary Public :3 ~. ..H1 ~. 1... , ..,.~ ....,.,.,...... (i'';''il''i~,;k,1 i n.....(',-'" ' .: ; . ~ .,;" I HEREBY CERTIFY, that the precise address of the Grantees herein is 42 Creek Bank Drive Mechanicsburg, P A 17050 'J;( 2' ..,,-; r,\' c AI 1 t"? '~. . ';:;. 1 h h. 'i 1..1 \)~ . Detailed Results for Parcel 38-06-0011-034.-Ul12 in the 2004 Tax Assessment Database DistrictN 0 38 Parcel_ID 38-06-0011-034.-UI12 MapSuffix HouseNo 42 Direction Street CREEK BANK DRIVE Owner! MILLER, HELENA M C/O & A RICHARD & HELENA W JONES PropType R PropDesc Liv Area 2164 CurLandVal 0 CurImpVal 260340 CurTotVal 260340 CurPretVal Acreage .00 CIGrnStat TaxEx 1 SaleAmt 265900 SaleMo 03 SaleDa 11 SaleCe 20 Sale Y r 05 DeedBkPage 00267-04450 YearBlt 2004 HF File Date 12/28/2005 HF _ Approval_Status A http://taxdb.ccpa.netldetails.asp?id=38-06-0011-034.-Ul12&dbselect=l Page 1 of 1 2/1/2007 *' SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MILLER, HELENA M. FILE NUMBER 21 - 06 - 0500 is sc e ule must e comPI ete an Ie I t e answer to any 0 ' Questions t roual 4 on page ISveS, ITEM DESCRIPTION OF PROPERTY DATE OF DEATH %OF NUMBER Include the name of the transferee. their relationship to decedent and the date of transfer. VALUE OF ASSET DECO'S EXCLUSION TAXABLE VALUE Attach a copy of the deed for real estate. INTEREST (IF APPLICABLE) 1 Wachovia Securities Account #5488-0478 TOD to the decedent's daugher, Helena M. Miller consisting of the following: 2 3500 AGL RES Inc. (001204106) @ $35.32 per share 123,620.00 100% 123,620.00 3 Accrued interest to date of death 1,295.00 100% 1,295.00 4 4600 Gallaher Group PLC (363595109) @ $63.14 per share 290,490.00 100% 290,490.00 5 Accrued interest to date of death 7,922.81 100% 7,922.81 6 40000 Federal Home Ln Bk (31331EKE8) @ $99.078125 39,631.25 100% 39,631.25 ......0... ~h"l"",:lil 7 Accrued interest to date of death 654.86 100% 654.86 8 50000 Federal HOme Ln Bk (31331DOG9) @ $98.593750 49,296.88 100% 49,296.88 per share 9 Accrued interest to date of death 71.18 100% 71.18 10 50000 AMCORE Bk NA Rockford ILL (02341VQB4) @ 49,081.40 100% 49,081.40 $98.1628 per share 11 Accrued interest to date of death 692.71 100% 692.71 12 50000 Mercantile BK Orlando FL (58740WBU5) @ 48,813.80 100% 48,813.80 $97.627600 per share 13 Accrued interest to date of death 826.39 100% 826.39 14 78000 Southside Bk Tyler Tex (84470QALl) @ 76,108.19 100% 76,108.19 $97.574600 per share 15 Accrued interest to date of death 32.50 100% 32.50 16 40392.996 Franklin Custodian FDS Inc. (353496300) @ 98,962.84 100% 98,962.84 $2.450 per share I Total of Continuation Schedule(s) 992.63 TOTAL (Also enter on line 7, Recapitulation) 788,492.44 Th h d b d d fil d 'f h f 1 h h 2' * SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY continued COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MILLER, HELENA M. FILE NUMBER 21-06-0500 Th' h d I tb I t d d fil d'f h t f tl 1 th h4 2' IS sc e u emus e comple e an Ie I t e answer 0 any 0 'Ques ons rougl on page IS yes. I DESCRIPTION OF PROPERTY ITEM DATE OF DEATH %OF NUMBER Indude the name of the transferee, their relationship to decedent and the date of transfer. VALUE OF ASSET DECO'S EXCLUSION TAXABLE VALUE Attach a copy of the deed for real estate. INTEREST (IF APPLICABLE) 17 992.63 Cash 992.63 100% 992.63 i I Page 2 of Schedule G Date of Death: OS/25/2006 Valuation Date: OS/25/2006 Processing Date: 09/08/2006 Shares or Par Security Description 1 ) 3500 AGL RES INC (001204106) COM New York Stock Exchange OS/25/2006 Estate Valuation High/ASk Low/Bid 35.55000 35.09000 H/L 2) Div: 0.37 Ex: 05/17/2006 Rec: 05/19/2006 Pay: 06/01/2006 4600 GALLAHER GROUP PLC (363595109) SPONSORED ADR New York Stock Exchange OS/25/2006 63.59000 62.71000 H/L Div: 1.72235 Ex: 03/15/2006 Rec: 03/17/2006 Pay: 05/30/2006 3) 40000 FEDERAL HOME LN BKS (3133XEKE8) Government/Agency (Dealer Quotations) DTD: 01/30/2006 Mat: 07/28/2009 5.125% OS/25/2006 Int: 01/30/2006 to OS/25/2006 4) tlvvoa rwt:.lV\,", ~t:. LN BKS-13133.<DCI"S) Government/Agency (Dealer Quotations) DTD: 11/15/2005 Mat: 11/15/2010 5.125% OS/25/2006 Int: 05/15/2006 to OS/25/2006 50000 AMCORE BK NA ROCKFORD ILL (02341VQB4) Financial Times Interactive Data DTD: 02/10/2006 Mat: 02/10/2009 4.75% OS/25/2006 5) Int: 02/10/2006 to OS/25/2006 6) 50000 MERCANTILE BK ORLANDO FLA (58740WBU5) Financial Times Interactive Data DTD: 01/26/2006 Mat: 01/26/2011 5% OS/25/2006 Int: 01/26/2006 to OS/25/2006 7 ) 78000 SOUTHSIDE BK TYLER TEX (84470QAL1) Financial Times Interactive Data DTD: 02/22/2006 Mat: 02/22/2011 5% OS/25/2006 Int: OS/22/2006 to OS/25/2006 8) 40392.996 FRANKLIN CUSTODIAN FDS INC (353496300) INCOME FD CL A Mutual Fund (as quoted by NASDAQ) OS/25/2006 9) 992.63 Cash (CASH) Total Value: Total Accrual: Total: $788,492.44 Estate of: Helena M Miller Account: 5488-0478 Report Type: Date of Death Number of Securities: 9 File ID: 54880478 Mean and/or Div and Int Security Adjustments Accruals Value 35.320000 63.150000 1,295.00 7,922.81 99.15625 99.00000 A/B 99.078125 654.86 "----..... 98.68750 98.50000 A/B 98.593750 71.18 98.16280 Mkt 97.62760 Mkt 97.57460 Mkt 2.45000 Mkt Page 1 98.162800 97.627600 97.574600 2.450000 692.71 826.39 32 .50 $11,495.45 123,620.00 290,490.00 39,631.25 49,296.88 49,081.40 48,813.80 76,108.19 98,962.84 992.63 $776,996.99 - 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 7.0.4) * COMMONWEAlTH OF PENNSYlVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCl-EDULEH RJNERAL EXPENSES & ADMNSTRATIVE COSTS ESTATE OF MILLER, HELENA M. I FILE NUMBER 21 - 06 - 0500 Debts of decedent must be reported on Schedule I. ITEM NUMBER A B. FUNERAL EXPENSES: Funeral expenses 2 Funeral luncheon 3 Obituary in Florida 4 Eric Hollinger, grave marker/lettering 1. ADMINISTRATIVE COSTS: Personal Representative's Commissions DESCRIPTION Social Security Number(s) I EIN Number of Personal Representative(s): Street Address City Year(s) Commission paid Attorney's Fees Gingrich, Smith, Klingensmith & Dolan -- John M. Smith Family Exemption: (If decedenfs address is not the same as c1aimanfs, attach explanation) Claimant Helena M. Jones Street Address 42 Creek Bank Drive City Mecharricsburg Relationship of Claimant to Decedent 2. 3. 4. Letters Testamentary Short Certificates Probate Fees 5. Accountanfs Fees State Zip State P A Daughter Zip 17050 6. Tax Retum Preparer's Fees Sam Thuma, preparation of income taxes 7. 1 Other Administrative Costs Reserve for final closing costs i I TOTAL (Also enter on line 9, Recapitulation) AMOUNT 7,366.00 271.29 125.00 772.00 10,000.00 3,500.00 310.00 24.00 500.00 100.00 22,968.29 * SCHEDULE I DEBTS OF DECEDENT, MORTGAGE LIABILITIES, & LIENS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESDENT DECEDENT ESTATE OF MILLER, HELENA M. I FILE NUMBER 21-06-0500 Include unreimbursed medical expenses. ITEM NUMBER 1 Prescriptions DESCRIPTION AMOUNT 141.26 2 Prescriptions 328.71 3 U.S. Treasury, income tax 41.16 4 P A Dept. of Revenue, income tax 321.00 5 U.s. Treasury, income tax 1,227.00 6 One-third of the real estate taxes (total amount $2,437.50) 812.50 TOTAL (Also enter on Line 10, Recapitulation) 2,871.63 REV.1513 ~+ (~O) * SCHEDULE J BENEFICIARIES . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MILLER, HELENA M. I FILE NUMBER 21-06-0500 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON{S) RECEIVING PROPERTY DECEDENT OF ESTATE nn IIInt I. TAXABLE DISTRIBUTIONS (include outright spousal distributions) 1 A. Richard Jones, Jr. Grandchild $5,000.00 I He 87, Box 114 Pocono Lake, P A 18347 I 2 William Robert Jones Grandchild $5,000.00 546 Appalachian Drive Mechanicsburg, P A 17055 3 Patti Susanne Hartman Grandchild $5,000.00 313 W. Green Street Mechanicsburg, P A 17055 4 Amy Hartman Great- $1,000.00 743 Old Silver Spring Road Grandchild Mechanicsburg, P A 17055 See Continuation Schedule(s) attached 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 I I I I TOTAL OF PART 11- ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET . w J SCHEDULE J BENEFICIARIES continued . COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF MILLER, HELENA M. I FILE NUMBER 21 - 06 - 0500 RELATIONSHIP TO AMOUNT OR SHARE NUMBER NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY DECEDENT Do Not List Trusteels) OF ESTATE I. AXABLE DISTRIBUTIONS [include outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] 5 Kelly Hartman Moore Great- $1,000.00 2929 Denise Road Grandchild East Norriton, PA 19403 6 Megan Hartman Great- $1,000.00 313 W. Green Street Grandchild Mechanicsburg, PA 17055 7 Stephanie Jones Great- $1,000.00 546 Appalachian Drive Grandchild Mechanicsburg, P A 17055 8 Sarah Jones Great- $1,000.00 546 Appalachian Drive Grandchild Mechanicsburg, P A 17055 9 Helena M. Jones Daughter Entire Residue 42 Creek Bank Drive Mechanicsburg, P A 17050 I I Page 2 of Schedule J . ... LAST WILL AND TESTAMENT OF HELENA M. MILLER I, HELENA M. MILLER, also known as HELENA MARY MILLER, a United States citizen and permanent resident of St. Petersburg, Pinellas County, Florida, being of sound mind and disposing memory, do hereby make, publish and declare this my Last Will and Testament, hereby revoking all Wills and Codicils by me heretofore made. ITEM-I It is my wish and direction that I be buried in my lot in Ivy Hill Cemetery, Mt. Pleasant Road, Philadelphia, Pennsylvania, beside my deceased former husband, William Wilson, Jr., and my personal representative hereinafter appointed shall have charge of my funeral and burial and shall cause my name, date of birth and date of death to be inscribed on the marker in place at my grave site. Proceeds of any insurance payable or inuring to the benefit of my estate may be used to pay lawful claims, funeral and burial expenses, costs of administration, taxes, and the remaining proceeds, if any, shall be distributable as part-of my residuary estate. ITEM II With respect to any real or personal property, which I may own at the time of my death, as an estate by the entirety, jointly with right of survivorship with Qnp nr mnre persons, or in the- form of-a certificate of deposit, brokerage account, savings account trust, or similar depository account, I do hereby confirm the same and direct v)..J, . '1.-J.-,. ';It-1 ../ ' 1 . . that such property shall pass to the surviving joint tenant or tenants or beneficiaries, as the case may be, and I give and devise said property accordingly. ITEM III I direct that all estate, inheritance, transfer, legacy or succession taxes, or death duties, which may be assessed or imposed with respect to my estate, or any part thereof, after marital deductions and other allowable credits, shall, unless otherwise provided for, be paid out of my residuary estate. Any apportionment of eseate taxes shall tre---governed-by.the -Flurida Apportionment SLalute then in effect. ITEM IV I give and devise to my daughter, HELENA M. JONES, if she survives me, any automobile I may own at the time of my death and the furniture, furnishings, fixtures and contents of my condominium or dwelling in which I reside at the time of my death, which does not constitute exempt property. In the event my said daughter, HELENA M. JONES, does not survive me, this devise shall lapse and become a part of my residuary estate and be distributed as hereinafter provided. ITEM V I give and devise the sum of Five Thousand ($5,000.00) Dollars each to A. RICHARD JONES, JR., my grandson, WILLIAM ROBERT JONES, my grandson, and PATTI SUSANNE HARTMAN, my granddaughter, or to such of them as -are living at the time of-rny'death. III the event any of the beneficiaries designated in this Item predecease me, the devise to him, her or them shall lapse and become a part of my residuary estate. .-1J/y. ,/.~ ../ t ' 'It'J-'y' / ,"-" P'1 f t 2 . .. designated in this Item predecease me, the devise to him, her or them shall lapse and become a part of my residuary estate. ITEM VII I give and devise the sum of One Thousand ($1,000.00) Dollars each to AMY HARTMAN, my great-granddaughter, KELLY HARTMAN, my great-grand- daughter, MEGAN HARTMAN, my great-granddaughter, STEPHANIE JONES, my great-granddaughter, and SARAH JONES, my great-granddaughter, or to such of them as are living at the time of my death, should any of my said great-grandchildren predecease me. IPEH \rIll I give and devise all the rest, residue and remainder of my estate not hereinabove specifically or generally devised, including real, personal and mixed property of every kind and nature and wherever situated of which I may die seized or possessed or entitled to, insurance payable or inuring to the benefit of my estate, lapsed devises and all prop~rty over which I may have a power of appointment, after payment of lawful claims, taxes and costs of administration, my daughter, HELENA M. JONES, if she survives me, but should my said daughter predecease me, I then give my residuary estate to which my said .daughter would have been entitled had she survived me, in equal shares to my grandson, A. RICHARD JONES, JR., mygrandsori, WILLIAM ROBERT JONES, and my granddaughter,. PATTI SUSANNE HARTMAN, or to such of my said grandchildren as are living at the time of my death. If is my specific intention that my residuary estate shall be distributed to my daughter, HELENA M. JONES, if she survives me, or to such of my said grandchildien as are living at the time of my death and not to any \. ~;~}";J1.y( yr-( 3 - - . descendants of my said grandchildren, should any of my said grand- children also predecease me. ITEM IX I appoint my daughter, HELENA M. JONES, as personal representative of this Will, who shall serve without bond or surety, or minimal bond only if such is required, and I hereby give to her, as personal 'representative, full power and authority at any time or times to sell, - mortgage, pledge, exchange or otherwise deal with or dispose of the real and personal property comprising my estate, upon such terms as she shall deem best, -t:e--se-t-tle-and-compromise--any-and '''all-c1:a-im.3 ~11 favor of or against my estate as she shall deem advisable, and for any of the foregoing purposes to make, execute and deliver any and all deeds, contracts, mortgages, bills of sale, or other instruments necessary or desirable therefor, and to distribute my estate in kind or cash. If my daughter, HELENA M. JONES, does not serve, I then appoint my grand- daughter, PATTI SUSANNE HARTMAN, as personal representative, who shall serve under the same terms and conditions as recited hereinabove. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed my seal to this my Last will and Testament at st. Petersburg, Florida, this / ,-" ,L , ~?'. V.'/1.~.~'. . ,::,~.f. -.--...........,.-. , 1997. day of i' ;(,J t/.(/!e'1U;' 'Ji-.f "-}1'1_".(..J:..~t{./1../ - (S EAL ) HELEN~ M. MILLER 4 . 4 Declared, published, signed and sealed by HELENA M. MILLER, as her Last Will and Testament in the presence of the undersigned as witnesses, she first signing in our presence, and we, then at her special instance and request, signing in her presence and in the presence of each other, this /2 day ,of .)'11~i,.t__..- C/ , 1997. .--." /~ .~ r: i ,/ /)Y"-) I , I /1' :::~./~" ",./ i"/ h~&/tE-'t~n~, /C n- 0' ,', If' .1/'/'-' ~ f ' f/ " residing at St. Petersburg, Florida. ? ff,~., ;,tj,,' ~~...l~ I. y; J ~..(../ c' ""}-:?--' , '1A /L.;a L / ,; .; r/, ."..... ..... ~..."".J- ...4 residing at St. Petersburg, Florida. J '''\'IA, '''YI-'h-- kif fr I 5 . . STATE OF FLORIDA SS SELF PROOF OF WILL COUNTY OF PINELLAS We, HELENA M. MILLER the testator, and W. J. REYNOLDS and GENEVIEVE W. MARSHALL , the witnesses, respectively, whose names are signed to the attached or foregoing instrument, having been sworn, declared to the undersigned officer that the testator, in the presence of the witnesses, signed the instrument as~ his- last'will or codicil, that he signed, or directed another to sign for him, and that each of the witnesses, in the presence of the testator, and in the presence of each other, signed the will as a witness. (The masculine gender used herein shall include the feminine gender as the context requires). L.- r71 a/w.p."c~<:.-,,-I' ~ bU, ''Y7'7~'1-A/hL? L/ / Witness - Subscribed and sworn to before me by HELENA M. MILLER the testator, who is personally known to me or who has produced personally known as identification, and by w. J. REYNOLDS , a witness who is personally known to me or who has produced personatly known as identification and GENEVIEVE W. MARSHALL a witness who is personally known to me or who has produced personally known as identification~ on May I;>.... , 1997. ""~'~"" Julie s. Wood /~~A.."~~~ W COMMtSSION , CC487112 EXPIRES ~:~ .:..~ September 20, 1999 "'-1f&.... .'o"~~ 80NDEO TllRU ~OY FAIN INSURANCE, INC. "t,Rf,,~\.'" ~~ :-AY~ Printed Name: Julie S. Wood NOTARY PUBLIC, STATE OF FLORIDA .r . Register of Wills of Cumberland County, Pennsylvania ORIGINAL INVENTORY , Deceased No. 21 - 06 - 0500 Date of Death 5/25/2006 Social Security No. 206-38-9753 Estate of MILLER, HELENA M. also known as Helena Mary Miller Helena M. Jones The Personal Representative(s) of the above Estate, deceased, verify that the items appearing in the following Inventory include all of the personal assets wherever situate and all of the real estate located in the Commonwealth of Pennsylvania of said Decedent, that the valuation placed opposite each item of said Inventory represents its fair value as of the date of the Decedent's death, and that the Decedent owned no real estate outside of the Commonwealth of Pennsylvania except that which appears in a memorandum at the end of this Inventory. I/We verify that the statements made in this Inventory are true and correct. I/We understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. 1.0. No.: 19520 Personal Representative ~~ Signature: da#.A ~ Helena M. Jones / Signature: Attorney: John M. Smith Signature: Address: 222 South Market Street, Suite 201 P.O. Box 267 Elizabethtown, P A 17022 Telephone: 717/367-1370 Address: 42 Creek Bank Drive Mechanicsburg, P A 17050 Telephone: (717)766-45~ Dated: fe6. ~ u, 7 Personal PrODertv 400 shares Vectren @ $26.68 10,672.00 80 shares Bell South @ $32.35 2,588.00 XTO Energy, mineral rights deed for oil and gas. The fair market value is determined by multiplying the annual royalties by 4. The annual royalties for 2006 were estimated to be $1,120.00 x 4 = $4,480.00 4,480.00 (") ~O -.:; ~J Total Personal Propertyi,] ;:to _.....~ c:';-; ~ ZD;? . C) C) J i;:2 -71 ~ C::l c::> -.l ~:rl , , r T <<1,740f~~ I ..' -.....J -0 :x (-~ -=-=-..:::, --_: ;~;~ '::0 --I .c:-- .:::- 0"\ i./ > (Attach additional sheets if necessary) Total Personal Property and Real Estate $17,740.00 Y' .. .. Register of Wills of Cumberland County, Pennsylvania INVENTORY continued , Deceased No. 21 - 06 - 0500 Date of Death 5/25/2006 Social Security No. 206':'38-9753 Estate of MILLER, HELENA M. also known as Helena Mary Miller Real Estate See Schedule F for jointly owned property Total Real Estate 2