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PETITION "'OR PROBATE ond GRANT OF LE'ITERS
J.,1-Q5-732..
Eslale of Darrell II. Miller
also known as
No.
To:
Register of Wills for the
Deceased. County of Cwnllerland In the
SocIal Securlly No. Ib2-36-791O ' Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents thaI:
Your pelltloner(s). who Islare 18 years of age or older an Ihe execul ri"
In the last will of the above decedenl. dated ,111"'. 7Q, lljQd
and codlcll(s) dated
named
, 19_
hl81e relevant circumstances, C.I. rcnunchulon, death or (x<<utor, etc.)
Decedent 11'115 domlcllcd nl death In Cumberland County, Pennsylvania, with
~ is last family or principal residence at 584 Greason Road. Carlisle. PA 17013
W,'at. Pennsborn TOwnship
lIh~t flln....'t. numher, 'I'wp. or IInrn.1
Decedent. Ihcn _ 50 )'cars of nge, dlcd August 3 , 19 95
at IIni versi ty Hospit:a l. H...rshey r PA .
Except as follows, decedent did nOI marry. was not divorced and did not have a child born or adopted
aner execution of the will offered for probate; was nolthe vlcllm of a killing and was never adjudicated
Incompetent:
Decedent at dcath owned properlY with e511mated values as follows:
(If domiciled In Pa.) All personal property $ 3.000.00
(If not domiciled In Pa.) Personal property In Pennsylvania $
(If not domiciled In Pa.) Pcrsonal property In County $
Value of real estste In Pennsylvania $
situated as follows: OWned jointly with wife as
tenants bv the entireties
WHEREFORE, petltloner(s) respectfully r~'l,~~A~~f,yrobate of the last will and codlcll(s)
presented herewith and the grant of letters
theron.
(lcMamentary; admlnblrntlon c.l,a.i admlnluratlon d.b.n.c.l.a.)
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Kath~ M. Miller
~Rd r.rA~qnn Rn~n
Car'~Ql~. D~ J7013
OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA } 88
COUNTY OF rollMRRRT ,MID
The petltloner(s) above-named swear(s) or arnrm(s) that the statements In the foregoing petition are
truc snd correct to the best of the knowledge and belief of petltloner(s) and that as personal represen-
tatlve(s) of the above decedent petltloner(s) will well and truly administer the estate according to law.
Sworn to or affirmed and subscribed { ,:1/7111./>- JI{, >Jkt,f",.. '"
before me this 20th day of Kattirvn M. Miller 0;;'
. r;o E 19---25- ~
RCRlsler ~
No. 21"95"732
Estate of
DARRELL Ii. MU,LER
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW OCTOBER 4 19~,ln consideration of the pelltlon on
the reverse side hereof, satisfactory proof having been presenled before me,
IT IS DECREED that the Instrument(s) dated June 29 , 1994
described therein be admllted to probate and n1ed of record as the last will of
Darrell H. Miller
and Lelters Testarrentary
are hereby granted to Kathryn M. Mil1..r
~'0 Q.. :11,.,,:. t. p'{l~
MARY C. LE lS Real.t" or WI . ~
FEES
Probate, Lelters, Etc. ......... $
Short Certlficates( ).......... $
lfa.r~Ron ................ $
25.00
15.00
9.00
Taylor P. AlTORNEY (Sup. C.. I,D. No.) Andrews IO 15641
7R W PnmFrpt ~trPptr r~r'i~'p, PA 17013
^ODRESS
717-243-0123
"HONE
,1CP $ Ii. 00
TOTAL _ $ 54.00
Flied OC:TQBE.R..4 ,..19.95,.............
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PUT IN ATTORNEYS FILE ON OCT. 1995
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LAST WILL AND TESTAMENT
OF
DARRELL II. MILLER
I, Darrell H. Miller, of West Pennsboro Township, Cumberland County,
Pennsylvania, declare this to be my Last Will and Testament and revoke any and all
wills and codicils heretofore made by me.
ITEM I: My personal representative shall pay from the residue of my
estate the expenses of my last illness, funeral and burial debts duly allowed against my
estate, and estate taxes occasioned by my death and incurred with respect to property
passing by this Will.
ITEM II: I bequeath those articles of my automobiles, personal effects,
household goods, and other tangible personalty of like nature (not including cash or
securities), together with any existing insurance thereon, if any, as may be my individual
property and not the property of my Wife or owned jointly by me with her, as set forth
in a separate memorandum which I shall place with my Will to the persons therein
designated. If I shall leave no separate memorandum, or with regard to my
automobiles, personal effects, household goods, and other tangible personalty of like
nature (not including cash or securities) not referenced by such memorandum, I
bequeath such property to my Wife, Kathryn M. Miller, if she survives me by thirty (30)
days. Should my Wife, Kathryn M. Miller, not be living on the thirty-first day after my
death, I bequeath such tangible personalty and insurance thereon to my children,
Natalie Kay Miller and Nathan Darrell Miller, to be divided among them by my
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Executor with due rcgard for their personal preferences in as nearly equal shares as
practical.
ITEM III: I devise and bequeath the residue of my estate, of every
nature and wherever situate, to my Wife, Kathryn M. Miller, providing she shall survive
me by thirty (30) days. Should my Wife, Kathryn M. Miller, predecease me or die on
or before the thirtieth day following my death, I devise and bequeath the residue of my
estate, of every nature and wherever situate, to my issue, per stirpes, living on the thirty-
first day following my death.
ITEM IV: I appoint my Wife, Kathryn M. Miller, Executrix of this my
Last Will and Testament. Should my Wife fail to qualify or cease to act as Executrix, I
appoint my children Natalie Kay Miller and Nathan Darrell Miller as Co-Executors of
my estate.
ITEM V: I direct that my Executrix and her successors shall !lot be
required to give bond for the faithful performance of their duties in this or any other
jurisdiction.
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IN WITNESS WHEREOl<", I, DARRELL II. MILLER, have hereunto set my hand
and seal to this my Last Will and Testament, consisting of three (3) typewritten pages,
each of which bears my signature, this .5PtH\ day of ."rUIl)t2- ,1994.
CD 0.1./ otp si/ A~ --'(SEAL)
Darrell H. Miller
Signed, sealed, published and declared by the above-named Testator, Darrell H.
Miller, as and for his Last Will and Testament, in the presence of us, who, at his
request, in his sight and presence, and in the sight and presence of eaeh other, have
hereunto subscribed our names as witnesses.
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COMMONWEALTH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
WE, DARRELL II. MILLER, TAYLOR P. ANDREWS, and k.4nuy,v )/ ,It IUt.:-e
, the Testator and witnesses, respectively, whose names
are signed to the foregoing or allached instrument, being first duly sworn, do hereby
declare to the undersigned authority that the Testator signed and executed the
instrument as and for his Last Will and Testament and that he signed willingly and that
he executed as his free and voluntary act for the purposes therein expressed, and that
each of the witnesses, in the presence and hearing of the TestRtor, signed the Will as
witnesses and that to the best of their knowledge the Testator was at the time eighteen
(18) or more years of age, of sound mind and under no constraint or undue influence.
~
aylor P. Andrews, Witness
~""_ )}\ 7Jt(.I!/}.'t-J
I , Witness
Subscribed, sworn to and acknowledged before me by DARRELL H. MILLER,
the Testator, and subscribed to and sworn or affirmed to before me by TAYLOR P.
A~EWS and k'cWMzi" '?)J 7/tller , witnesses, this .:n..... day of
...... , 1994.
~""t'_ Y~L;_(SEAL)
Notary Public
NOTAAIAl SEAl.
BRENDA L, SREH". NOTARY FUBUC
CARLISLE oono. CU..BERlAND COUHTY
"Y CO....ISSION EXPIRES JANUARY B, 1VllB
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CERTIFICATION OF NOTICE UNDER RULES 5.6(0\
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Name of Decedent:
Darrell B. Miller
Date of Death:
August 3. 1995
Will No:
1995-00732
To the Register:
I certify that notice of benenclallnterest required by Rule 5.6(8) of the Orphans' Court Rules
was served on or mailed 10 the following benenclarles of the above-captioned estste on November 30,
1995:
Kathryn M. Miller
584 Greason Road
Carlisle, PA 17013
Notice has now been given to all persons entitled thereto d r Rule 5.6(8) except: No exceptlGns.
Date: /2 -( , 1995
'[ r P. Andrews, Esq.
West Pomfret Street
Carlisle, PA 17013
Phone: 717-243-0123
Capacity: Counsel for personal
representatives
.
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NOTICE OF BENEFICIAL INTEREST IN ESTATE
BEFORE THE REGISTER OF WILLS. COUNTY 01' CUMBERLAND. PENNSYLVANIA
IN RE: Estate of Darrell H. Miller. deceased. No. 1995-00732
TO: Kathryn M. Miller
584 Greason Road
Carlisle, PA 17013
Please take notice of the death of decedent and the grant of letters to the personal
representatives named below. You may have a beneficial interest In the estate as follows:
All personal property and entire residue of estate.
Name of decedent:
Last Known Address:
Darrell H. Miller
584 Greason Road
Carlisle, PA 17013
Date of Death:
Place of Death:
August 3. 1995
University Hospital, Hershey, PA
County of Grant of Original Letters:
Cumberland
Decedent died testate.
A copy of the will is attached.
Names, addresses, and telephone numbers of all personal representatives appointed:
Kathryn M. Miller
584 Greason Road
Carlisle, PA 17013
717-249-5712
Names, addresses, and telephone numbers of all counsel:
Taylor P. Andrews
Andrews & Johnson
78 West Pomfret Street
Carlisle. PA 17013
717-243-0123
Additionallnfonnation may be obtained from the undersigned:
Date:
,1995
Taylor P. Andrews, Esq.
78 West Pomfret Street
Carlisle. PA 17013
Phone: 717.243-0123
Capacity: Counsel for personal
representatives
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J fOR DATES Of DIATH AfTER 12/31/91 CHICK HIRI
INHERITANCE TAX RETURN ~o':,::~Ut:~DIT IS CLAIMID 0
RESIDENT DECEDENT fill NUMIlR -
(TO BE FILED IN DUPLICATE 21-95-0732
WITH REGISTER OF WILLS) COUNIY CODE YEAR NUMBER
OleloINt'$ COMPUII ...0011$$
504 Graason Road
CarliSle, PA 17013
COUI'l' C
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COMMONWfAltH Of PINNr.nVANIA
OIPARIM[NJ Of R(VINU[
O!Pl,2I.601
HAUIUORO, PA 11 7',0601
01 (DIN 'i NM.U ItA'. II ,AND MIOOU INIII....I
Miller Darroll"
$OCIAt $((Ulny NUMIU
162-36-7910
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165-38-1812
o 2. Supplemental R.lurn
177 9 5 2
03.
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R.malnder Rllurn
I'or da'e. 0' dealh prior 10 12,I3,S21
Federal ellal. TaJl R.turn Required
_ 8. Tolal Number of Safe D,pollt BOlt..
.....,~fj ........,
o ~a. Futur. Interllt Compromill
I'or da'e. af dealh aller 12.12.B21
o 7. aecedenl Molnlalned 0 lI...lng Trull
(Allach copy of Trull)
~TAX ,TIO JSHO.ULO,BE DIRECTED/, Oi~::;.
COMPUIt MAIliNG AOOIUS
78 W. Pomfret Street
Carlisle, PA 17013
OAU 0' OlA1H
8-3-95
II' "'Pl""IU"UI"'''IHG 'PO,",'''' HoUl'IUII...III"HO "10011 'HIII"'1
Miller Kathr n M
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RRESI'.o.IJIDENC ~D CONFIDENTI
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3.015
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Taylor P. Andrewe, Esq.
243-0123
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1. Real e.la'e (Sch.dul. AI
2. Sloch and Bondi (Sch.dule B)
3. Clallly H.ld Slock/Partnenhlp Inler.1I (Schedule C)
~. Mortgage. and NOtl1 Recel...able (Schedul. 0)
5. Ca,h, Bonk D.pollts & MI.eellan,oul P.nonal Prop.rty
15chedule E)
6. Jolnlly Owned Pr.perty (5chedul. F)
7, Tranlfon 15chedule G) (Schedul. l)
8. Tolal Gron Anell Ilotal line I 1.7)
9. Funeral EkP.n.... Admlnlltralive CO'II, Mbeellaneou.
Eap.n..s (Sch.dul. HI
10. D.bll. Mortgage lIabillllll. lions (Sth.dul. I)
11. Total D.ducllans (tolalllne, 9 & 10)
12. N.I Valu. of e.lal. (lIn. a minus line 11)
13. Charilabl. and Gavernm.ntal aequ'lll (Schedul. JI
1~. N.I Value Sub .ello Talt (line 12 minus line 13)
IS. Spoulal Tranlf.,. lfar dolll of death afl.r 6.30.94)
See In.'ruelianl for Ar,plicable Percentog. on Rev.n.
Side, (Includ. voluel rom Schedule l< or Schedule M.I
16. Amaunl of line 14 10Kable at 6% role
(Includ. va lUll from Sth.dule K or Schedul. M,)
17. Amaunl of lIn. 14 laKabl. at 15% rol.
(Include valuo. from Schedul. K or Sch.dul. M,)
la. PrinclpollaK duelAdd 101t from Un.. IS. 16 and 17.1
19. Credlll Spoulal Po....rty Credll Prior Paymonls
+
(9) 3,784
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20. U lIno 19 h groallr Ihan lIn. 18. .nler th. dlff"enee on lIn. 20. This Is the OVERPAYMENT.
II 0 ."rr:r:I"'IIJII'.I_'I"'."I"I"tl'I~1I' "'I...IIJlIn":'r.-="_',('I'I..I'lo.JIUU'JlIIIII..
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21. If line 1a h g,oaler Ihon lIno 19, enler the dIU".nee an line 21. Thill. the TAX DUE.
A. Enler Ih.lnle'lIl on the balanco due on L1n. 21A.
8. Enlo, Iho 10101 of line 21 and 21A on line 218. This I. the BALANCE DUE.
Male. Checlc Payable tal R.gllter of Will., Agent
i'l.f~,.~ '~, "'BE SUREIlOANSWER ~W.QUESTIONS,ON!REVERSESIDEAND TOiRECHECK MATHI',, ,
Under penallles of perlury, I declare Ihot I ha.... uamln.d Ihl. return, Including accompanying Ichedulo. and 'lol.menh, and 10 Ihe bllt of my knawl.dge and b.lief,
It " tru., correct and compl.t.. I doclare Ihat all real ..Iale hos been repartea allru. ma'-~.' ...alue. Oeclaratian of pr'parer other than th. p'rlanal represenlatlv. i.
balld on alllnfarmalion of which preparer has any knowl.dge.
SIONA UJf 9' PilliON USPO""$lllf fal fllI'~G InUIN ADOIIU, DAlf
L. 584 Greason Road, CarliSle, PA 3 -.;Jo-9~
AD.','il w. Pomfret St., Carlisle, PA 17013 DA1I3_cD_R;
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Act #48 of 1994 provldos for Iho roductlon of Iho talC raloslmposod on Iho nol valuo of Iransfo,. 10 or for
Iho uso of tho spouso. Tho ralos as proscrlbod bV tho slalulo will bel
o 3% (.03) will bo appllcablo for oslalos of docodonll dying on or aftor 7/1/94 and boforo 111/96
o 2% (.02) will bo appllcablo for oslalos of docedonll dying on or aftor 1/1/96 and bofore 1/1/97
o 1% (.01) will bo appllcablo for oslalos of docedonls dying on or aftor 1/1/97 and bsforo 1/1/98
o Spousal transfo,. occurring on or aftor 1/1/98 will bo elCompl from Inhorltanco talC.
PLEASE ANSWER THE FOLLOWING QUESTIONS
BY PLACING A CHECK MARK (.....) IN THE APPROPRIATE BLOCKS.
YES NO
1. Old decedonl moke a transler and:
a. rolaln Iho use or Incomo 01 the property translorred, ...................,...................................
b. retain tho right 10 deslgnats who sholl use the property Iranslerred or Its Income, ...............
x
x
c. retatn a reversionary Interest; or ...................................................................................
x
d. recalve the promise lor Iile 01 either payments, benelits or care' .......,........,......................
2. If daath occurred on or belore Decembsr 12, 1982, did decadent within two years precadlng
death transler property without recalvlng adequote consldaration' II dealh occurred aftsr
Dacember 12, 1982, did decedent Iranslar property within ona year of daoth without receiving
adequato consideration' ........ It..... It..........................................,............................ ...........
x
x
3. Old decedant own an 'In Irust lor' bank account 01 his or her death'...............................,......
x
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
IlY.lSO) U. 1...61
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COMMONWEAltH 0' ,INNSYlYANIA
INHUIfANCE TAX lEfUlN
IUIDENT DECEDENT
SCHEDULE B
STOCKS AND BONDS
FILE NUMBER
21-95-0732
ESTATE OF
Miller, Darroll II.
(All PlOpor1y lolntly-own.d with Right 01 Survlvonhlp mU.1 b. dl.dolld on Sch.dul. F.I
ITEM
NUMBER DESCRIPTION
1. stock option as per employmont benofit to purchaso 375 shares
of stock in employer Corp. - Aogon nv common stock, option is
to purchase at closing prico on October 31, on tho Amsterdam
stock EKchange.
VALUE AT DATE
OF DEI. TIl
option for 125 shares valusd on 10-31-92
option for 125 shares valuod on 10-31-93
option for 125 shares valued on 10-31-94
Value to decedent dotermined by ress1e value and oKchange
rate between guildors and dollars.
Total value of options as per oral report of employer rep-
resentative.
$3,015.00
(Plan description attached)
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TOTAL (Allo enter on line 2. Reea lIuration)
"'.................i........J...J
s
3,015.00
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AEGON nv EMPLOYEE STOCK OPTION PLAN 1992
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AEGON USA, INC.
RULES
1.
Ddinitions
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In this Plan. unless the context otherwise requires, the following words
and expressions shall have the following meaning.
a. Option Plan. this plan,
b. Option Right. the right to acquire one hundred twenty five (125)
AEGON common shares with a nominal value of cne guilder (Dfl 1.001
per share:
c, Reference Date, November 1. 1995, the date as of which the Option
Right is granted;
d. Exercise Price. the final price of AEGON shares at 4.20 p.m. Central
European Time on October 31, 1995 at the Amsterdam Stock Exchange;
e. AEGON. AEGON nv;
f. AEGON USA. AEGON USA, Inc. or any of its subsidiaries in the United
States of America.
2. Participation Criteria
Regular full-time and regular part-time employees of AEGON USA employed
on October 31, 1995, entitled to participate in the Option Plan will be
those whose employment with AEGON USA started on or before November 1,
1992.
3. Participation
3.1 Those who meet the requirement of Section 2 and wish to participate
in the Option Plan must return the Declaration of Acceptance before
the date stated thereon, duly completed and signed.
3.2 After accepting the Option Right in accordance with Subsection 3.1,
the participant will receive a Certificate/Exercise Forrr., drawn up in
his/her name. This Form serves as Certificate of participation,
4. Option Rights
4.1 Every participant has an unconditional and irrevocable Option Right
as of the Reference Date,
4.2 As of the Reference Date an Option Right will be immediately and
completely exercisable.
4.3 Option Rights will be exercisable for a period of five /51 years from
the Reference Date. Option Rights not exercised on or before the
earlier of lal a date 2 years after termination of employment except
by reason of death or retirement, or lbl October 31, 2000, lapse
automatically and are null and void, without any right to
compensation.
Page 2
Rules
5. Exercise
5.1 The exercise of an Option Right is to be effected by sending the
Certificate/Exercise Form to the person designated therein, duly
filled in and signed by the participant,
5.2 Exercise Forms received before 3.00 p.m. Iowa (Central) time will be
processed the next business day at the opening of the New York Stock
Exchange, or as soon thereafter as possible.
5.3 An Option Right will only be satisfied through one of the follOWing
two methods, as mentioned on the Exercise Form:
a, transfer of the 125 AEGON shares to the participant;
b. transfer of the 125 AEGON shares to the participant, immediately
followed by the sale of those shares on the New York or other
available stock exchange.
5.4 If the alternative mentioned in Subsection 5.3 a. (transfer only) is
opted for, the AEGON shares shall be issued and transferred on
receipt of the amount due in U.S. dollars (the exercise price
multiplied by 125 and divided by the exchange rate as stated in
Subsection 5.6) in the bank account of AEGON USA, as stipulated in
the Exercise Form.
5,5 If the alternative mentioned in Subsection 5.3 b. (sale) is opted
for, the AEGON shares shall be deemed to be sold by AEGON on the
Amsterdam Stock Exchange at the opening price. If, however, sale at
the opening price is not possible, the shares will be deemed sold at
the price then offered at the Stock Exchange.
In case of the sale of the AEGON shares, the profits of the sale,
reduced by the costs of the sale and withholding taxes, shall be paid
in U. S. dollars to the participant as stated by the participant on
the Exercise Form.
5.6 The exercise price will be converted into U.S.
official exchange rate Dutch guilders/U.S. dollars
day before the date of exercise.
dollars at the
in effect on the
5.7Any taxes or fees arising out of the Option Rights or their exercise
are the responsibility of the participant. AEGON USA is required to
withhold tax on ordinary income recognized by participants in the
Plan in connection with the exercise of options.
Page 3
Ruhs
S.B N81ther, AEGON nor AEGON USA shall bear any responsibility for
differences in price - either resulting from the Stock Exchange price
or from the currency rate of exchange - if any, due to the non-sale
or a delay in the sale of shares; the risk of such dif ferences are
borne by the participant.
5.9 In case of dilution of the share capital of AEGON, e. g. as II result
of recapitalization, the exercise price shall be adjusted if and when
the conversion price of the convertible subordinated bonds, issued by
AEGON in 1992 IUs $600.000, ODD, 4.75\ convertible subordinated bonds
due 2004) is adjusted in case of dilution; adjustment of the
exercise price will be in accordance with the arrangement applicable
to those convertible subordinated bonds,
6. Forbidden Exercise
6.1 The exercise of Option Rights is not permitted at a time when the
participant concerned has insider knowledge.
6.2 In this context insider knOWledge means knOWledge about information
concerning AEGON or the AEGON shares of which the participant knows
or reasonably should know that is non-public knOWledge which cannot
be publicly known without the violation of an obligation to secrecy
by somebody and of which disclosure as can reasonably be expected
shall influence the price of the AEGON shares on any Stock Exchange.
6.3The participant is not permitted to communicate any insider knowledge
to a third party, unless he/she does so to comply with a statutory
obligation or in the performance of hiS/her function; the
participant shall not, on the basis of such information, induce a
third party to deal or not to deal in AEGON shares.
6.4 In any event, the exerC1,;e of Option Rights is not permitted during
the following periods:
a. two (2) calendar months immediately preceding the publication of
the annual report of AEGON;
b. twenty-one (21) days immediately preceding the publication of the
six-month results and the quarterly results or the announcement of
any dividend or interim dividend. as well as on the working days
on which the AEGON shares are not yet quoted ex-dividend on the
Amsterdam Stock Exchange after the announcement of an interim
dividend of AEGON;
c. one (1) month immediately preceding the first publication of a
prospectus for an issue of shares of AEGON,
~.
~
I
Page 4
Rules
6.5 The periods mentioned ln Subsection 6.4 (a) and (b) shall annually be
published.
6.6 The participant must comply with the "Model Code to Prevent Insider
Dealings", which has been attached to this Plan, the principal
provisions of which (relating to option rights) have been embodied in
this Plan.
7. Purther Conditions
7.1The Option Right is strictly personal and cannot be sold, transferred
or assigned in any way except as provided in Subsection 7.4 below.
7.2 The Option Right cannot be pledged or encumbered in any other way.
7.3 Any Option Right which has been transferred, pledged or encumbered in
any other way in contravention of Subsections 7.1 and 7.2 cannot be
exercised.
7.4 On the participant's death, his/her Option Right for the remaining
period shall pass to hiS/her legal representative. The legal
representative shall be required to provide an Affidavit and Letters
of Appointment to be authorized to exercise any option right.
B. Termination
B.1 The Option Right shall terminate on the earlier of 2 years after
termination of employment with AEGON USA, unless such termination is
due to death or retirement of the participant (in such event, the
estate or retiree, as the case may be, shall have until October 31,
2000), or October 31, 2000. This 2 year provision shall apply to
prior years' options not yet exercised.
8.2 All Option Rights which have not been exercised on the date of
expiration, as referred to in Subsection 4.3 shall lapse, without any
right to compensstion.
9. Applicable Law
The Plan is governed by Dutch Civil Law.
-...-".....-,......-
Model Code to Prevent Insider D..ling
P r.&IlIble
The Stock Exchange Association relies upon it that the issuer:
Ii) shall have 1ts own codes for the confidential use of price-
sensitive information:
(ii) shall enforce these codes.
liii) shall take proper care that, as soon as becomes necessary,
information ""h1ch had been confidential up to that moment
shall be announced in such way that everyone can take note
of it at the same time.
Commitment of Issuers
The issuer undertakes towards the Stock Exchange Association to impose
insofar as allowed by law - on the persons to be mentioned hereinafter the
commands and prohibitions to be mentioned hereafter, to enforce the same and
to take adequate measures in the event of infringement of any such
prohibition or non-compliance with any such command.
Prohibitions imposed on managing directors
1. a. In no capacity whatsoever, whether directly or indirectly, or for his
own account or for account of a third party, shall a managing
director (an individual on Executive Board of AEGON nv) purchase or
sell any of the securities issued by the undertaking of which he is a
managing director (his own undertaking> when he is in possession of
price-sensitive information in relation to such securities.
b. Price sensitive information is understood to mean an unpublished
matter publication of which may in reason be e>tpected to have
considerable effect on the market price of such class of security.
c. A managing director shall not communicate price-sensitive information
to a third party, save if he does so in order to comply with a
statutory obligation or in the performance of his duties as a
managing director nor shall he in the light of such information
induce a third party to deal or not to deal,
d. The prohibitions referred to under a and c shall also apply to a
class of securities issued by another undertaking whose securities
are listed on the Amsterdam Stock Exchange, when by virtue of his
office a managing director has knowledge of a matter as meant under b
in relation to such securities.
2. a. A managing director shall be prohibited from purchasing or selling
directly or indirectly, any of the securities of his own undertaking:
for the period of two months immediately preceding a preliminary
announcement of the undertaking's annual results:
Page 2
Model Code to Prevent Insider Dealing
For the penod of 21 days lmmedlately preceding announcement of
the undertaking's half-yearly or quarterly results or the
announcement of a dividend or lnterim diVidend,
For the period of one month immediately preceding the preliminary
publication of a prospectus for a share issue, unless the issuer
shows that decision making takes less than one month. in which
case such shorter period shall apply.
b.
A managing director shall not sell
securities within six months after he
purchase any securities of his own
after he sold such securities,
any of his own undertaking's
purchased such securities, nor
undertaking wi thin six months
3, In an exceptional case, on special grounds, the issuer may grant
dispensation from a prohibition contained in article 2, if abuse of
unpublished information must be considered out of the question. Both
such request and the grant of dispensation must be in writing.
Restrictions imposed on managing directors
4. When not in possession of price-sensitive information a managing director
shall be free to deal in his undertaking'S securities, but without
prejudice to the provisions laid down in article 2 and subject to the
restrictions to be mentioned hereafter:
a. A managing director shall be prohibited from purchasing or selling,
directly or indirectly, any of his own undertaking's securities
without first notifying in writing his dealing intentions to the
issuer's chairman of the managing board, the chairman of the
supervisory board or another officer appointed for the specific
purpose (the 'central officer') and receiving written acknowledgment
hereof from the issuing undertaking, in his own case the chairman
should inform the (other) managing director Is) or alternatively the
central officer in writing and receive acknowledgment.
b, The issuer shall maintain a written record of the notification and
acknowledgment.
c. Likewise must be promptly reported any effecting of dealings as
stated in a notification referred to under a,
d. Where an intended buying or selling order has not been passed by the
managing director concerned to his bank or stockbroker's house and
carried out the latest on the 20th day after such managing director
received the acknowledgment as referred to under a, the notification
in question shall lose effect, In consequence the procedure set out
under a has to be repeated before any such dealings by the managing
director are allowed.
.i.'"',....',e,.,;
P..ge 3
Model Code to Prevent Insider Dealing
e. Contrary to the provisiona in a. prior notification shall not be
required when a managing director purchases or sells rights, with the
understanding that such dealings shall be promptly reported by him in
the mode as stated under c., save where such purchases or sales are
effected for rounding-up purposes, in which case the managing
director shall be discharged of the obligation to report.
5, For inspection by the members of the managing board a list must be
available, to be compiled annually, showing the dealings effected by
man..ging directors and supervisory directors in securities of their own
undertaking since the effective date of this code or since the previous
list.
Ext.ension of prohibitions and restrictions imposed on managing directors
6. When.. managing director places investment funds under the management of
a third party, he shall make this party subject to the same prohibitions
and restrictions as are applicable to such managing director's own
dealings in the undertaking's securities, unless by virtue of a written
agreement the third party has been given discretion and the managing
director has no influence whatsoever over the management conducted by
such third party,
7. a. A managing director shall not in the name of his own undertsking
grant an option to subscribe for or acquire securities (to be) issued
by the undertaking when he is in possession of price-sensitive
information in relation to that class of securities, nor during the
period referred to in 2.....
b. Any grant by an issuer to a managing director of an option to
subscribe for or acquire securities (to be) issued by the undertaking
shall be regarded as a purchase by such managing director if the
price at which such option may be exercised is fixed at the time of
such grant.
If, however, an option is granted to a director on terms whereby the
striking price is to be fixed at a later time, the purchase is to be
regarded as taking place at the time at which the price is fixed.
c. In the case of an option the six-month-period referred to under 2.b.
shall begin at the time of the grant of such option.
d. Exercising an option other than at time of price fixing shall not be
subject to prohibitions or restrictions.
e. The following exceptions shall apply to options that are grsnted to a
managing director, the issuer being represented by snother person
than such mansging director. or to a managing director or employee of
one or more of cert..in categories in the issuer and/or its subsidiary
within the Netherlands, if the prices at which they may be exercised
Page 4
Model Code to Prevent Insider Dealing
are fixed at the time of the grant. Though they are to be regarded
as purchases effected by such managing director such options shall be
exempted from the prohibitions and restrictions contained in articles
loa.. 2.b. and 4.a. and notwithstanding article 2.b. such managing
director may freely sell the securities thus acquired, irrespective
of the period passed since the time of the grant of such option. on
the condition that the prohibitions set out in articles I.a. and 2.a.
and the restrictions prOVided in article 4.a are duly observed and
subject to the following it shall not be regarded as an infringement
of the prohibitions or as non-observance of the restrictions if a
managing dlrector sells the securities thus acquired within fourteen
Stock Exchange trading days after he exercised the option, provided
such sale is reported in the manner as laid down in article 4.c.
B. The prohibitions and restrictions shall be equally applicable to any
purchase and sale of options on such securities on the European Options
Exchange.
9.
The prohibitions and restrictions shall be
whether a managing director deals directly or
own account or for account of a third party.
a.
applicable
indirectly,
no matter
or for his
b. The prohibitions and restrictions imposed on a managing director
shall remain effective until six months after he has terminated his
office.
prohibitions and restrictions extended to supervisory directors
10. The preceding provisions shall mutatis mutandis apply to a supervisory
director of the issuer and to other persons who by virtue of the law or
the undertaking'S Articles of Association supervise the management
conducted.
Prohibitions and restrictions extended to other persons
11. The issuer shall designate the persons who by virtue of their office in
the issuer or its subsidiary operating within the Netherlands have access
to price-sensitive information ('designated persons'), in particular in
the following categories:
executive employees in the issuer;
managing directors, supervisory directors or executive employees
of a subsidiary of the issuer's;
members of a joint consultative committee established by the
issuer and/or of a central joint consultative committee.
Page 5
Model Code to Prevent Insider Dealing
The previously mentioned provisions shall mutatis mutandis also apply to
the designated persons, with the understanding that, contrary to the
provisions in article 4, it shall suffice for each of theae persons to
supply the central officer at least once every three months, at a time
appointed for that purpose, with a written report of the number of the
securities purchased or sold by him, directly or indirectly, in his own
undertaking, as well as the times at which these transactions were
effected. However, if the central officer so requests on good grounds,
which he can do at any time, each of the designated persons shall
promptly report his dealings.
Information to the Stock Exchange Association
12. Whenever in connection with suspected abuse of unpublished information
and investigation is carried out by the Stock Exchange Association into
dealings in certain securi ties, the issuer, if so requested, shall be
obliged to produce the facts collected in virtue of this code for the
inspection of the Compliance Officer (as referred to in article 24 of the
Articles of Association), who shall be a chartered accountant. The
Compliance Officer shall report his findings exclusively to the Chairmsn
of the Stock Exchsnge Association.
"\1.1*... 11"7)
*'
SCHEDULE E
CASH, BANK DEPOSITS AND
MISCELLANEOUS
PERSONAL PROPERTY
Plea.e P,lnt 0' 1 e
FI E UMBER
21-95-0732
COMMONWIAlfH 0' "NNIYIYANIA
INHllnANCI tAX .nUIN
IUIDIHr OlelOINt
STATE F
Miller, Darrell II.
IAII pr.perty 1.lntly.ewned with th. Right .f Survlwrlhlp mUll be dlscl.s.d .n Sch.dule fJ
ITEM DESCRIPTION VALUE AT
NUMBER DATE OF DEATH
1. 1971 Honda 90 motorcycle 500.GO
2. 1973 VW Beetle 1,800.00
3. 15' Starcraft boat/everode Trumph 80 1,000.00
4. 14' v bottom aluminum boat w/8 LP motor 900.00
5. 3 weeke vacation pay 648.83
6. Commissions due from employer 167.28
TOTAL AI.o ente, on line 5, Reca lIulotlon S
5,016.11
IAHDCh Dddlllonal8\ol," )( II" sh.etslf me,.. space II n.eded,t
IIYUIII.. 1'-11,
J:'~'ill
-~~
COMMONW(AltH 0' .(NNSYlVANIA
INHUIfANC( lAX U'URH
IIUIDlNf DlClDlN'
SCHEDULE H
FUNERAL EXPENSES,
ADMINISTRATIVE COSTS AND
MISCELLANEOUS EXPENSES
Plea Ie P,lnl or Type
FILE NUMBER
21-95-0732
ESTATE OF
Millor, Darrell II.
ITEM
NUMBER
A. Funeral Expenlel'
DESCRIPTION
AMOUNT
1.
1I0ffman - Roth Funoral 1I0mo
1,230.00
1.
, Admlnlllrallve COlli'
Perlonal Representative Comml..lonl
Social Security Number of Perlonal Representative:
Vear Cammllllons paid
B.
2.
Attorney Feel
500.00
3.
Family Exemption
Claimant Kathrvn M. Miller
Relationship
wife
2,000.00
Addre.. of Claimant at decedenl's dealh
Stree' Addre.. 584 Greason Road
City Carlisle
4. Probate Feos
C. Mllcellanooul Expensel'
1.
2.
3,
4.
S.
6.
7,
8.
Stale PA Zip Code 17013
54.00
TOTAL (Also enler an IIno 9, Recapitulation)
(If more Ipace II neoded, Inlert additional "hoe'" of lame Ilze.)
S 3,784.00
Rf.V,1649 E'(t (1195)
'*'
SCIIEDULE 0
'I'RANSIIEnS TO SUnVIVING SI'OUSE
~mOf'P'lHlln\lAMA
tltr:lJTAHCSTAJUtWH
--
ESTATEOP
Miller, Darroll II.
tll,Numbcr
21-95-0732
PART A: Enter &be description and value of .1Iln1tmU. both t.uble and non-taxable, rtpdlcu or location. (nd of deductions)
whkh to the dccedmI'Isurvivin I Ie by will. !nttllley, Illon onaw, at othnwilC,
Oescri lion oC items
I Res denco at 584 Groason Road, Carlis1o, PA
deed roferencol 24 B110
tax Assessment 7550 x 13.7 (Common Lovel Ratio)
o\mounl
103,435.00
2. Vehiclos and boats from Schedulo E
4,200.00
3. Commissions and vacation pay from Schodule E
816.11
4. Stock options from Schedulo B
3,015.00
5. 1989 Plymoth Reliant - Jointly owned
2,000.00
6. 1992 Ford Exploror - Jointly owned
8,000.00
7. Joint accounts at York Federel Savings
8. Pension and IRA's
2,669.28
53,779.84
Part A Toll): Enter the amount shown on the rcupitut.don abed in the Dendrnl lnromuUon StdlOIL 1 77 . 91 5 . 23
Election To Subject Property To Till Under Seelion 2113(A) As A Tasable Transfer By This Dccedent.
If IlNII or 11mI1" amnscmcnt meeta the RqIlimncnls .fS<<Iion 1113(^). and:
L The lnIIl or 11mI1" arnnaanent b filled on Schedul. o. and
b. 1be value of the trust or limilar amn&nnentls entered in \\'hole or in put as an as&d on Schedule O.
then the lnnIf...... penonaI repmenl&11"" may .,...u1eally iden,ify the """ (III or I fr.....i...1 pol1lon or perc<nug.)'. be Included In the .1<<Ilon ,. ha""
auch trwt or .imilar property treated as auuble transfer in this ntate. If leu lh&n the mtire value of the IlUIt or similar property ls includtd u.
taxable transfer on Schedule 0. the pcnonal npumlallvc ihall be considered to have made the cltdion only as to. fraction of the trust or IlrnilullTlJ1gcmenl.
The numeratorofthb ffattlon b: equal 10 the amount ofthc 11\I11 or .Imllar arr&ngtmmllnduded u .In.ble IUSCt on Schedule O. The dmomWlor I. equal
II) lho lotal value oflhe IIUJt or .imIlar arranstmmL
ELKCI'ION: Do 10U ~lKt WllI~r ScdIon 1 t t3(A) to 'rut &I, "lIble transrer In UW ...tate aU or. portion or. tnut or .lm1lar .rraneem~nt
cruulllorthe 101e UN orthll deudtnt'. .univlnC .pollH durlne tht .un1vlne.powe'. ,nUn Urttimet
YES D NO D Slenatun D.te
Note! lithe tlKtJoa .ppUn to more than one 111111 or .ImUIr .rrancemenl. then I Mp.rale tonn mwl be .Ilnrd and Ned.
Part B: Ent.cr the dc:scriptJon and value of .lIlntercst.J. both taxable and non.taxable, re&udleu of loc.tion, (net of deductions)
which to the deccdcnl"lUrvivin. .pause for which. Section:Z II J (A) e1cdion i. being made.
Dcscri lion of items o\mounl
I
Partii'T...1
LAST WILL AND TESTAMENT
OF
DARRELL II. MILLER
I, Darrell H. Miller, of West Pennsboro Township, Cumberland County,
Pennsylvania, declare this to be my Last Will and Testament and revoke any and all
wills and codicils heretofore made by me.
ITEM I:
My personal representative shall pay from the residue of my
estate the expenses of my last illness, funeral and burial debts duly allowed against my
estate, and estate taxes occasioned by my death and incurred with respect to property
passing by this Will.
ITEM II:
I bequeath those articles of my automobiles, personal effects,
household goods, and other tangible personalty of like nature (not including cash or
securities), together with any existing insurance thereon, if any, as may be my individual
property and not the property of my Wife or owned jointly by me with her, as set forth
in a separate memorandum which I shall place with my Will to the persons therein
designated. If I shall leave no separate memorandum, or with regard to my
au tomobiles, personal effects, household goods, and other tangible personalty of like
nature (not including cash or securities) not referenced by such memorandum, I
bequeath such property to my Wife, Kathryn M. Miller, if she survives me by thirty (30)
days. Should my Wife, Kathryn M. Miller, not be living on the thirty-first day after my
death, I bequeath such tangible personalty and insurance thereon to my children,
Natalie Kay Miller and Nathan Darrell Miller, to be divided among them by my
,
2
Executor with due regard for their personal preferences in as nearly equal shares as
practical.
ITEM III: I devise and bequeath the residue of my estate, of every
nature and wherever situate, to my Wife, Kathryn M. Miller, providing she shall survive
me by thirty (30) days. Should my Wife, Kathryn M. Miller, predecease me or die on
or before the thirtieth day following my death, I devise and bequeath the residue of my
estate, of every nature and wherever situate, to my issue, per stirpes, living on the thirty-
first day following my death.
ITEM IV: I appoint my Wife, Kathryn M. Miller, Executrix of this my
Last Will and Testament. Should my Wife fail to qualify or cease to act as Executrix, I
appoint my children Natalie Kay Miller and Nathan Darrell Miller as Co-Executors of
my estate.
ITEM V: I direct that my Executrix and her successors shall not be
required to give bond for the faithful performance of their duties in this or any other
jurisdiction.
-~---".--_.~.._. .. - - -........----,.'"-,.--...,
",...~>., ~,~~." . . ... ~,
3
IN WITNESS WHEREOF, I, DARRELL H. MILLER, have hereunto set my hand
and seal to this my Last Will and Testament, consisting of three (3) typewritten pages,
each of which bears my signature, this ~ day of , T U /I) lL , 1994,
(D O-lJ P~.fJ d Adfl->(SEAL)
Darrell Ii, Miller
Signed, sealed, published and declared by the above-named Testator, Darrell H.
Miller, as and for his Last Will and Testament, in the presence of us,who, at his
request, in his sight and presence, and in the sight and presence of each other, have
hereunto subscribed our names as witnesses.
~
...~/Q{"",,- )'n )Jtl'(;i:.~.'
I
.
.
COMMONWEALTH OF PENNSYLVANIA )
: SS.
COUNTY OF CUMBERLAND )
WE, DARRELL H. MILLER, TAYLOR 1>. ANDREWS, and ^',;"N.<Y,~' ).f hlLL-eo'"
, the Testator and witnesses, respectively, whose names
are signed to the foregoing or attached instrument, being first duly sworn, do hereby
declare to the undersigned authority that the Testator signed and executed the
instrument as and for his Last Will and Testament and that he signed willingly and that
he executed as his free and voluntary act for the purposes therein expressed, and that
each of the witnesses, in the presence and hearing of the Testator, signed the Will as
witnesses and that to the best of their knowledge the Testator was at the time eighteen
(18) or more years of age, of sound mind and under no constraint or undue influence.
~
~a-:/' "', ._ )}I
I
7J..t:'l:i'.
, Witness
Subscribed, sworn to and acknowledged before me by DARRELL H. MILLER,
the Testator, and subscribed to and sworn or affirmed to before me by TAYLOR P.
ANpEWS and k'aVMv" 'Tn. 71tller . witnesses, this .;;x;-..... day of
...... ,1994. (I
~u.,,,<,,~ Y~'<:-(SEAL)
Notary Public
NOTAIUAl sw.
BRENDA L. BIIDfM. NOTARY FUBUC
CARLISlE sono, CUM8ERLAHO alUlITY
MY COMMISSION EXFlRES JAllUAAY &, I9llll
/
~
/5"-5"K-q
.
REV-1547 EX AFP 112-95*
CDHHOHWEAlTH Of PENNSYLVANIA
DEPAR1Hl:HT or REV[HU(
BUREAU Of IhDlvlDUAl TAMES
DEP'. 210601 .
HARRISBURa, Pi 111'1-0601
, .
C t.-"
ACN
101
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLDWANCE
OF DEDUCTIONS AND ASSESSHEHT OF TAX
DATE
07-08-96
S E GF FILE NO.
DATE OF DEATH 08-03-95 CGUNTY CUMBERLAND
NOTE' TO INSURE PROPER CREDIT TO YOUR ACCOUNT, SUBHIT THE UPPER PORTION OF THIS FORH WITH YOUR TAX
PAYHENT TO THE REGISTER OF WILLS. HAKE CHECK PAYASLE TD "REOISTER OF WILLS, AGENT"
REMIT PAVMENT TOI
CUT ALONG THIS LINE .. RETAIN LOWER PORTION FGR YGUR RECORDS .....
iiE'v:is4j-EX-"j:p-n2':9!fj-ilDYicE-iif.-YNHERifANCE-YA'iriippRiiisEHEil'r;-,UrowiiN'cE-oli-----------------
DISALLGWANCE GF DEDUCTIGNS AND ASSESSHENT GF TAX
DARRELL H FILE NO. 21 95-0732 ACN 101
TAX RETURN WAS. ( I ACCEPTED AS FILED ( XI CHANGED SEE
TAYLOR P ANDREWS ESQ
78 W PDMFRET ST
CARLISLE PA 17013
ESTATE OF MILLER
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ONI DRIGINAL RETURN
1. R..l Eat.t. I Schedule A) C 1)
2. stock. and Bondi (Schedul. OJ (2)
5. Clo..ly Hald stock/Partnership Int.r..t (Schedul. C) (31
4. "artaaa../Hot.. Raceivable (Schedule DJ (4)
S. Cash/Bank Deposita/Hilc. Parlonal Property ISchadul. E) (5)
6. Jointly Ownad Property (Schedule F) (6)
7. Tranefar. (Schadul. 01 (7)
8. Tot.1 A...t.
APPRGVED DEDUCTIONS AND EXEMPTIONS:
9. Funaral Expans../Adm. COlt./HIIO. Expan... CSch.dul. H) (9)
10. Oabt./Hortgag. Liabiliti../Li.n. CSchadul. J) CIa)
11. Total Daduction.
12. Hat Valu. of TaM Raturn
13. Charitabl./Govarn.ant.l B.qua.ta CSch.dula 4)
14. Hat V.lu. of E.t.t. Subjaot to TaM
REGISTER OF WILLS
CUMBERLAND CG CGURT HGUSE
CARLISLE, PA 17013
AMount R..itt.d
DATE
ATTACHED
07-08-96
NGTICE
.00
3.015.00
.00
.00
5.016.00
.00
,00
(81
8,031.00
5,284.00
.00
Illl
1121
(151
1141
~.:>R4 nn
2,747.11
.00
2,747.11
NOTE I
14, 15 snd'or 16, 17 snd 18 will
returns assessed to dste.
If an assessment was issued prsviously, linss
rsflect figures that include the total of ALL
ASSESSMENT GF TAXI
15. AMount of Lin. 14 at Spou..l rat.
16. AMount of Lina 14 t.Mabl. .t Lin..l/CI... A rat.
17. AMOunt of Lin. 14 taxabl. at Coll.teraI/Cla.. 8 rat.
18. Prinoipal TaM Dua
1151
1161
1171
TAX CREDITSI
PAYHENT
DATE
RECEIPT
NUHBER
DISCOUNT l+ I
INTEREST (-I
2,747.11 X .00.
,00 X .06.
.00 X .15.
1181
.00
.00
.00
.00
AHOUNT PAID
TGTAL TAX CREDIT
BALANCE GF TAX DUE
INTEREST AND PEN.
TGTAL DUE
.00
.00
.00
.00
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
I IF TOTAL DUE IS LESS THAN Ii, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" ICRI, YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. I
11.,.1470111'-111
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.
INHERITANCE TAX
EXPLANATION
OF CHANGES
COMMONWEAUH OF PENNSYlVANIA
DEPARTMENT OF REVENUE
IIURIAU OP INDIVIDUAL TAXIS
DEPT. 280601
HARRIS8URG. PA 11128.0601
DECEDENT'S NAME
filE NUM8ER
IIHler Durrell
2195-0732
A N
101
SCHIDULE
ITIM IX PLANATION OF CHANGES
NO.
H
B-3 m_r....~._S.'!c,ti!l.L3J2lof.1994 Act, o~fe,ct1v" Januery30, 19,9.5,Jh!JaIllU, IIxlImp,:" ....
tion wall a..ended increasing tho alllOunt of the cldm fro.. $2,000 to $3,500.
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TAX EXAMINER,
Lawrance Szolloay
PAGE
-
JRD/June 30, 1992/17858
REGISTER OF WILLS
Cumberland Counly Courlhouse
One Courlhouse Square
Carlisle, PA 17013
~OTICE PURSUANT TO RULE 6.12
PENNSYLVANIA;SUPREME COURT ORPHANS' COURT RULES
! \~
To: Personal Representative
Counsel: 'l'AYLOR P. ANDREWS, ESQ.,
RE: &tale or DARRELL H. MI~b~ed, Lale or
WEST PENNsBORO TWP
&taleNo.: 21019950732
Date or Decedent's Deathl 803095
Pursuant to Rule 6.12, the above named personal representative or the above na!l1ed attorney, If
applicable, within two (2) years of the decedent's death, and annually thereafter until administrallon Is
compleled, is required to file with the Register of Wills a Slalus Report as required by Rule 6.12, In
substantially the prescribed form, showing the date by which the personal representative, or attorney, as
applicable, reasonably believes administration will be completed. The purpose of this Notice is 10 advise
YGU that unless the requisite Status Report is filed with the Register of Wills or Clerk of the Orphans'
Court, as appropriate, within ten (10) calendar days after the date of this Notice that the Register GfWUls
Is required to notify the Orphans' Court Division, Court of Common Pleas of such delinquency and to
request that said Court conduct a hearing to detennlne whelher sanctions should be Imposed upon the
delinquent personal representative and the delinquent personal representative's counsel, if any.
Accordingly, if the requisite Status Report Is not filed by 10 . B , 1 9 ~7 you are hereby
advised that a request wUl be submitted to the Court in accordance with Rule 6.12.
UJ~
9023.97
Dale:
Distribution to Estate File
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STATUS REPORT UNDER RULE 6.12
Nama of Decedent I DARRELL H. MILLER
Date of Deathl 8/3/95
21-1995-732
Admin. No.
Will No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estatel
1. State whether administration of the estate is complete I
Yes X No
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete I
3. If the answer to No. 1 is Yes, state the followingl
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:
t
c. Did the personal representative state an
account informally to the parties in interest? Yes No X
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d. Copies of receipts, releases, joinders and
approvals of formal or inCormal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this report.
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Sig~t.ure
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Of
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Taylor P. Andrewa
Name (Please type or print)
78 W. Pomfret Street, Carlisle, PA 17013
Address
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( 717 I 2/,3-0123
Tel. No.
CapacitYI
Personal Representative
Counsel for personal
representative
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(MAH I rmf/ AM3)
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