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HomeMy WebLinkAbout09-17-07 .--I 15056041169 REV-1500 EX (06-05) PA Department of Revenue Bureau of Individual Taxes POBox 280601 Harrisburg, PA 17128-0601 ENTER DECEDENT INFORMATION BELOW Social Security Number Date of Death OFFICIAL USE ONLY County Code Year File Number INHERITANCE TAX RETURN '1/ RESIDENT DECEDENT 0< 01 ()LII [) Date of Birth 178-16-6948 02022007 10161923 MILLER LYNN MI B Decedent's Last Name Suffix Decedent's First Name (If Applicable) Enter Surviving Spouse's Information Below Spouse's Last Name Suffix Spouse's First Name MI Spouse's Social Security Number THIS RETURN MUST BE FILED IN DUPLICATE WITH THE REGISTER OF WILLS FILL IN APPROPRIATE BOXES BELOW [Xl 1. Original Return o 4. Lirn~ed Estate o 2. Supplemental Return o 4a. Future Interest Compromise (date of death after 12-12-82) o o 3. Remainder Return (date of death prior to 12-13-82) 5. Federal Estate Tax Return Required [Xl 6. Decedent Died Testate (Attach Copy of Will) o 9. Litigation Proceeds Received [Xl 7. o 10. Decedent Maintained a Living Trust (Attach Copy of Trust) Spousal Poverty Cred~ (date of death between 12-31-91 and 1-1-95) o 8. Total Number of Safe Deposit Boxes o 11. Election to tax under Sec. 9113(A) (Attach Sch. 0) CORRESPONDENT - THIS SECTION MUST BE COMPLETED. ALL CORRESPONDENCE AND CONFIDENTIAL TAX INFORMATION SHOULD BE DIRECTED TO: Name Daytime Telephone Number PHYLLIS J. MARISKOVIC 717-761-1731 Firm Name (If Applicable) REGISTER 0) WILLS USE ONLY .1 ~-, First line of address -. i 5246 DEERFIELD AVENUE Second line of address City or Post Office State ZIP Code DATE FILED (,'? MECHANICSBURG PA 17050 Correspondent's e-mail address: Under pena"ies of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is tr ,oct and com ete. Declaration of preparer other than the personal representative is based on all information of which preparer has any knowledge. RE IBLE fOR LING RETURN DATE {/ --07 PA 17050 DATE (/-2-2--;(.\ 7 7 STREET SHIREMANSTOWW, PA 17011 PLEASE USE ORIGINAL FORM ONLY Side 1 L 15056041169 15056041169 ---I -1 15056042160 REV-1500 EX Decedent's Name: LYNN B MILLER RECAPITULATION 1. Real estate (Schedule A) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 1. 2. Stocks and Bonds (Schedule B). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 2. 3. Closely Held Corporation, Partnership or Sole-Proprietorship (Schedule C) ..... 3. 4. Mortgages & Notes Receivable (Schedule D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. 5. Cash, Bank Deposits & Miscellaneous Personal Property (Schedule E) ....... 5. 6. Jointly Owned Property (Schedule F) 0 Separate Billing Requested . . . . . . . 6. 7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (Schedule G) 0 Separate Billing Requested . . . . . . . 7. 8. Total Gross Assets (total Lines 1 - 7) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. 9. Funeral Expenses & Administrative Costs (Schedule H) . . . . . . . . . . . . . . . . . . . .. 9. 10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule I) . . . . . . . . . . . 10. 11. Total Deductions (total Lines 9 & 10) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. 12. Net Value of Estate (Line 8 minus Line 11) . . . . . . . . . . . . . . . . . . . . . . . . 13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been made (Schedule J) . . . . . . . . . . . . . . . . . 12. 13. 14. Net Value Subject to Tax (Line 12 minus Line 13) . . . . . . . . . . . . . . . . . . . . . .. 14. TAX COMPUTATION - SEE INSTRUCTIONS FOR APPLICABLE RATES 15. Amount of Line 14 taxable at the spousal tax rate, or transfers under Sec. 9116 (a)(1.2) x .0_ 16. Amount of Line 14 taxable at lineal rate x .0 17. Amount of Line 14 taxable at sibling rate X .12 2 92 , 04 2 . 4 1 18. Amount of Line 14 taxable at collatera I rate X .15 15. 16. 17. 18. 19. TAX DUE. . . . . . . . . . . . . . . . . .. . . . . . . . . .. . . . .. . . . . . . . . . . ... . . . . . . . .. 19. 20. FILL IN THE BOX IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT Side 2 L 15056042160 Decedent's Social Security Number 178-16-6948 11,297.50 1,250.00 291,588.37 304,135.87 12,093.46 12,093.46 292,042.41 292,042.41 35,045.09 35,045.09 [Xl 15056042160 -1 REV-1500 EX Page 3 Decedent's Complete Address: File Number 21 0 7 - 04 10 DECEDENT'S NAME LYNN B. MILLER STREET ADDRESS 5246 DEERFIELD AVENUE CITY -1 STATE \ ZIP MECHANICSBURG PA 17050 Tax Payments and Credits: 1. Tax Due (Page 2 Line 19) 2. Credits/Payments A. Spousal Poverty Credit B. Prior Payments C. Discount (1) 35,045.09 36.925.00 1.752.25 Total Credits (A + B + C) (2) 38,677.25 3. Interest/Penalty if applicable D. Interest E. Penalty Total Interest/Penalty (0 + E) (3) 4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT. Fill in box on Page 2, Line 20 to request a refund. (4) 0.00 3,632.16 B. Enter the total of Line 5 + 5A. This is the BALANCE DUE. (5) (5A) (5B) 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. Make Check Payable to: REGISTER OF WILLS, AGENT PLEASE ANSWER THE FOllOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS 1. Did decedent make a transfer and: Yes No a. retain the use or income of the property transferred; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D IX] b. retain the right to designate who shall use the property transferred or its income;. . . D I!J c. retain a reversionary interest; or ......................................... D I!J d. receive the promise for life of either payments, benefits or care? ......... . . . . . D I!J 2. If death occurred after December 12, 1982, did decedent transfer property within one year of death without receiving adequate consideration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D IX] 3. Did decedent own an "in trust for" or payable upon death bank account or security at his or her death? . D [Xl 4. Did decedent own an Individual RetirementAccount, annuity, or other non-probate property which contains a beneficiary designation? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IXl 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. For dates of death on or after July 1, 1994 and before January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is three (3) percent [72 P.S. s9116(a)(1.1.)(i)]. For dates of death on or after January 1, 1995, the tax rate imposed on the net value oftransfers to or for the use of the surviving spouse is zero (0) percent [72 P.S. 99116(a)(1.1 )Qi)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even if the surviving spouse is the only beneficiary. For dates of death on or after July 1, 2000: The tax rate imposed on the net value of transfers from a deceased child 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 zero (0) percent [72 P.S. s9116(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 four and one-half (4.5) percent, except as noted in 72 P.S. S9116(1.2) [72 P.S. s9116(a)(1)]. The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is twelve (12) percent [72 P.S. S9116(a)(1.3)]. A sibling is defined, under Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption. REV-1508 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE E CASH, BANK DEPOSITS, & MISC. PERSONAL PROPERTY FILE NUMBER 2107-0410 Include the proceeds of litigation and the date the proceeds were received by the estate. All property joinlly-owned with right of survivorship must be disclosed on Schedule F. ESTATE OF LYNN B. MILLER ITEM NUMBER 1 2 3 4 5 6 DESCRIPTION ERIE INSURANCE POLICY Q0515007693H INS REFUND CHURCH OF GOD HOME REFUND CHECK 1994 HONDA ACCORD-BLUE BOOK VALUE IRS-2006 US INCOME TAX REFUND DFAS - 2 DAYS PAY PAWC - REFUND VALUEAT DATE OF DEATH 130.00 5,766.64 2,225.00 3,105.00 54.88 15.98 TOTAL (Also enter on line 5, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 11,297.50 REV-1509 EX+ (6-98) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE F JOINTLY-OWNED PROPERTY ESTATE OF LYNN B. MILLER FILE NUMBER 2107-0410 If an asset was made joint within one year of the decedent's date of death, it must be reported on Schedule G. SURVIVING JOINTTENANT(S) NAME ADDRESS RELATIONSHIP TO DECEDENT A. PHYLLIS J. MARISKOVIC 5246 DEERFIELD AVENUE MECHANICSBURG, PA 17050 SISTER B. C. JOINTLY-OWNED PROPERTY: LETTER DATE DESCRIPTION OF PROPERTY %OF DATE OF DEATH ITEM FOR JOINT MADE INCLUDE NAME OF FINANCIAL INSTITUTION AND BANKACCOUNT NUMBER OR SIMILAR DATE OF DEATH DECD'S VALUE OF NUMBER TENANT JOINT IDENTIFYING NUMBER. ATTACH DEED FOR JOINTLY-HELD REAL ESTATE VALU E OF ASSET INTEREST DECEDENT'S INTEREST 1. A. 2001 ING DIRECT ACCOUNT NO 45106253 2,500 50 1,250.00 TOTAL (Also enter on line 6, Recapitulation) $ 1,250.00 (If more space is needed, insert additional sheets of the same size) REV-1510 EX+ (6-98) SCHEDULE G INTER-VIVOS TRANSFERS & MISC. NON-PROBATE PROPERTY COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT ESTATE OF LYNN B. MILLER FILE NUMBER 2107-0410 ITEM NUMBER This schedule must be completed and filed if the answer to any of questions 1 through 4 on the reverse side of the REV-1500 COVER SHEET is yes. DESCRIPTION OF PROPERTY INCLUDE THE NAME OFTHE TRANSFEREE, THEIR RELATlONSHIPTO DECEDENT AND THE DATE OFTRANSFER ATTACH A COPY OFTHE DEED FOR REAL ESTATE 1. ALL ASSETS TRANSFERED VIA A LIVING TRUST DATED NOVEMBER 27, 2001 BY LYNN B. MILLER, GRANTOR 1 97 SHARES METLIFE TAXABLE VALUE DATE OF DEATH % OF DECO'S EXCLUSION VALUE OF ASSET INTEREST (IF APPLICABLE) 6,145.92 8,956.35 94.05 23,719.3 2,913.71 123.30 4.74 7,587.72 183,100 25.31 1,209.44 q,,583.33 8,892.88 1,131.36 2,676.07 8,769.85 17 TRAVELERS LIFE & ANNUITY A/C N0939928031,655.04 2 3 4 5 6 7 PNC INVESTMENTS ACCT NO 6136-0677 794.707 SHARES BLACKROCK MULTI PA CL B 3 SHARES CBS CORP NEW CLASS B 1284.207 SHARES BLACKROCK EQUITY DIV B 210.68 SHARES EV TX-MGD DIVID INCM C 3 SHARES VIACOM INC NEW CLASS B MONEY MARKET INVESTMENT ACCOUNT 8 84 SHARES PRUDENTIAL INSURANCE 9 5246 DEERFIELD AVE, MECHANICSBURG, PA CUMBERLAND COUNTY 10 11 12 13 14 15 16 PNC BANK ACCT NO 50-0398-0326 CKING PNC BANK ACCT NO 50-0402-1899 MNY MKT M&T BANK ACCOUNT NO 33394431 CHECKING M&T BANK ACCT NO 98128981 PREM INT SERIES EE BONDS DEPOSITED TO M&T PREM MEMBERS 1ST FCU ACCT NO 48441 SAVINGS MEMBERS 1ST FCU ACCT NO 48441 CD 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 TOTAL (Also enter on line 7, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 6,145.92 8,956.35 94.05 23,719.30 2,913.71 123.30 4.74 7,587.72 183,100.00 25.31 1,209.44 4,583.33 8,892.88 1,131.36 2,676.07 8,769.85 31,655.04 291,588.37 REV-1511 EX+ (10-06) SCHEDULE H FUNERAL EXPENSES & ADMINISTRATIVE COSTS COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT FILE NUMBER 2107-0410 ESTATE OF LYNN B. MILLER ITEM NUMBER A. 1. 2. 3. Debts of decedent must be reported on Schedule I. DESCRIPTION AMOUNT FUNERAL EXPENSES: MYERS FUNERAL HOME REVEREND LESLIE P. TOWSEY FUNERAL DINNER 8,355.00 200.00 538.2 B. ADMINISTRATIVE COSTS: 1. Personal Representative's Commissions 2. Name of Personal Representative(s) Street Address City State ZIP Year(s) Commission Paid: Attorney Fees 600.00 3. Family Exemption: (If decedent's address is not the same as claimant's, attach explanation) Claimant Street Address City State ZIP Relationship of Claimant to Decedent 4. Probate Fees 5. Accountant's Fees 450.00 6. Tax Return Preparer's Fees 251.00 560.50 49.65 41.41 31.20 396.75 619.75 7. 2 3 4 5 CONTINUING CARE RX-PHARMACY EXPENSE COMCAST-TV CABLE PENNSYLVANIA AMERICAN WATER COMPANY-WATER BILL GIANT FOODS-POSTAGE STAMPS MARIE HUBER, TAC COLLECTOR REAL ESTATE TAXES TOTAL FROM CONTINUATION SCHEDULE TOTAL (Also enter on line 9, Recapitulation) $ (If more space is needed, insert additional sheets of the same size) 12,093.46 Estate of: Lynn B. Miller 178-16-6948 Schedule H Part 7 (Page 2) 6 Moffitt Heart & Vascular Medical bill balance 32.19 7 PP&L Electric Utilities 127.27 8 Myers Funeral Home Four additional death certificates 24.50 9 US Postal Service Stamps & return receipt 13.40 10 PP&L Final bill 264.21 11 Verizon Hospital phone charge 29.68 12 Jack Gaughen Realtor ERA House appraisal 50.00 13 AAA- Transfer Fees & Other Costs 78.50 Total (Carry forward to main schedule) $619.75 REV-1513 EX+ (9-00) COMMONWEALTH OF PENNSYLVANIA INHERITANCE TAX RETURN RESIDENT DECEDENT SCHEDULE J BENEFICIARIES ESTATE OF LYNN B. MILLER FILE NUMBER 2107-0410 RELATIONSHIP TO DECEDENT Do Not List Trustee(s) NUMBER I NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY TAXABLE DISTRIBUTIONS linclude outright spousal distributions, and transfers under Sec. 9116(a)(1.2)] PHYLLIS J. MARISKOVIC 5246 DEERFIELD AVENUE MECHANICSBURG, PA 17050 SISTER 1 AMOUNT OR SHARE OF ESTATE 292,042.41 ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWNABOVE 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 TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-1500 COVER SHEET $ (If more space is needed, insert additional sheets of the same size) LAST WILL AND TEST AMENT OF LYNN B. MILLER Dated:d--. '7/'JOuemt Q b'( ,2001 Prepared by: Martin I. Kleinman, Esquire 1518 Walnut Street 18th Floor Philadelphia, P A 19102 215790-0303 J :",: -LI LAST WILL AND TEST AMENT OF LYNN B. MILLER I, Lynn B. Miller, a resident of and domiciled in the Commonwealth of Pennsylvania, make, publish and declare this to be my Last Will and Testament, revoking all wills and codicils at any time heretofore made by me. FIRST: I direct that the expenses of my last illness and funeral, the expenses of the administration of my estate, and all estate, inheritance and similar taxes payable with respect to property included in my estate, whether or not passing under this will, and any interest or penalties thereon, shall be paid out of my residuary estate, without apportionment and with no right of reimbursement from any recipient of any such property. The provisions of this Article FIRST shall not apply to the extent that contrary provisions concerning the payment or apportionment of any such taxes have been or shall be made in any inter vivos instrument executed by me relating to any insurance, trusts, gifts or other transfers, jointly owned property or accounts, or property subject to power of appointment. SECOND: I give all the rest, residue and remainder of my property and estate, both real and personal, of whatever kind and wherever located, that I own or to which I shall be in any manner entitled at the time of my death (collectively referred to as my "residuary estate"), to the trustee under the following trust to be held and disposed of in accordance with the terms, covenants and conditions of such trust: Lynn B. Miller Living Trust Dated: Even Date Herewith. THIRD: If any property of my estate vests in absolute ownership in a minor or incompetent, my Executor, at any time and without court authorization, may: distribute the whole or any part of such property to the beneficiary; or use the whole or any part for the health, education, maintenance and support of the beneficiary; or distribute the whole or any part to a guardian, committee or other legal representative of the beneficiary, or to a custodian for the beneficiary under any gifts to minors or transfers to minors act, or to the person or persons with whom the beneficiary resides. Evidence of any such distribution or the receipt therefor executed by the person to whom the distribution is made sKalt.:be ~fulI discharge of my Executor from any liability with respect thereto, even though my Executor may be such person. If such beneficiary is a minor, my Executor may defer the distribution of the whole or any part of such property until the beneficiary attains the age of twenty-one (21) years, and may hold the same as a separate fund for the beneficiary with all of the powers described in Article FIFTH hereof. If the beneficiary dies before attaining said age, any balance shall be paid and distributed to the estate of the beneficiary. FOURTH: I appoint Phyllis J. Mariskovic to be my Executor. If Phyllis J. Mariskovic shall fail to qualify for any reason as my Executor, or having qualified shall die, resign or cease to act for any reason as my Executor, I appoint Karen I. Stephenson as my Executor. I direct that no Executor shall be required to file or furnish any bond, surety or other security in any jurisdiction. FIFTH: I grant to my Executor all powers conferred on executors under the Pennsylvania Probate, Estates and Fiduciaries Code, as amended, or any successor thereto, and all powers conferred upon executors wherever my Executor may act. I also grant to my Executor power to retain, sell at public or private sale, exchange, grant options on, invest and reinvest, and otherwise deal with any kind of property, real or personal, for cash or on credit; to borrow money and encumber or pledge any property to secure loans; to pay any legacy or distribute, divide or partition property in cash or in kind, or partly in kind, and to allocate different kinds of property, disproportionate amounts of property and undivided interests in property among any parts, funds or shares, and to determine the fair valuation of the property so allocated, with or without regard to tax basis; to exercise all powers of an absolute owner of property; to compromise and release claims with or without consideration; and to employ attorneys, accountants and other persons for services or advice. The term "Executor" wherever used herein shall mean the executors, executor, executrix or administrator in office from time to time. SIXTH: If any beneficiary under this will and I die in a common accident or under circumstances in which it is difficult or impractical to determine who survived the other, such beneficiary shall be deemed to have predeceased me. IN 'WITNESS WHEREOF, I, Lynn B. Miller, sign, seal publish and declare this instrument as my last will and testament this~ 7 day of/l1;9V6?11 ~OO1. I also have affixed my initials on the bottom of each of the preceding pages hereof. The foregoing instrument was signed, sealed, published and declared by Lynn B. Miller, the above-named Testator, to be his last will and testament in our presence, all being present at the same time, and we, at his request and in his presence and in the presence of.:eaeJivther, 'have subscribed our names as witnesses on the date above written. ~ "'7, ) dI-<;1LV ::2 ~~rr- 1.' .uL residing at residing at 5~SO~ - L ~. <U ~OSJ J "}ArC IJ 6'. 6/lfl~t..O J4- v'? jYJ ~C::;( /J ~. . 1 r-rr. J '/ 0 ~ 0 3 ACKNOWLEDGMENT AND AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA, COUNTY OF CUMBERLAND, ss. We, Lynn B. Miller / ~h&cLA Ii ~ k ~ ~ lee/Jf:irt' jt k~ , the Testator and the witnesses respectively, whose names are signed to the attached or foregoing instrument, being first duly sworn, do hereby declare to the undersigned authority that the Testator, Lynn B. Miller, signed and executed said instrument as his last will and testament in the presence and hearing of the witnesses, and that he had signed willingly, and that he executed it as his free and voluntary act and deed for the purposes therein expressed, and that each of the witnesses at the request of the Testator, in the presence and hearing of the Testator and each other, signed the will as witness, and that to the best of his or her knowledge the Testator was at the time at least eighteen years of age, of sound mind and under no constraint, duress, fraud or undue influence. ~I If )~. Lyn . Miller Testator tes~ ~~U7 Witness b-d-{ ~d-R!Jt Notarial Seal Patrick J. McLaughlin, Notary Public Upper MoreJand Twp, Montgomery Cou My CommiSSion Expires June 21. 20~ Member, Pennsylvania Association of Notaries 1. .', , ..t.6-_ ------------------------------------------------ ------------------------------------------------ LIVING TRUST made as of), /7 ,AJ6\)~ \:j ~ ,2001 I by Lynn B. Miller Grantor and Lynn B. Miller Trustee Name Of Trust: Lynn B. Miller Living Trust PREPARED BY: MARTIN I. KLEINMAN, P.C. 1518 WALNUT STREET 18TH FLOOR PHILADELPHIA, PA 19102 ================================================ ;, ." -L..J.. 1. .', J ..2~ T ABLE OF CONTENTS ARTICLE FIRST - Directions of Grantor ARTICLE SECOND - Disability of Grantor ARTICLE THIRD - Successor Beneficiaries ARTICLE FOURTH - Minors or Incompetents ARTICLE FIFTH - Payment of Debts ARTICLE SIXTH - Life Insurance/Death Benefits ARTICLE SEVENTH - Right to Revoke or Amend ARTICLE EIGHTH - Powers of Trustee ARTICLE NINTH - Appointment of Trustee ARTICLE TENTH - Accounts of Trustee ARTICLE ELEVENTH - Trustee Decisions Conclusive ARTICLE TWELFTH - Simultaneous Death ARTICLE THIRTEENTH - Rights Not Assignable ARTICLE FOURTEENTH - Construction ARTICLE FIFTEENTH - Binding Effect ARTICLE SIXTEENTH - Short Name LIVING TRUST LIVING TRUST, made as ofthis a'7 day of ^J&V~ /}~71. 2001, between Lynn B. Miller, having an address at 5246 Deerfield Avenue, Mechanicsburg, P A 17050, as grantor (hereinaft.er referred to as the "Grantor"), and Lynn B. Miller, having an address as aforesaid, as trustee (hereinafter referred to as the "Trustee "). WIT N E SSE T H: WHEREAS, the Grantor desires to create a revocable trust of the life insurance policies and other property described in Schedule A hereto, together with such monies, securities and other assets as the Trustee hereafter may hold or acquire hereunder (said life insurance policies and other property, monies, securities and other assets, together with any additions thereto received pursuant to the Grantor's last will and testament or as the proceeds of insurance on the Grantor's life, or as death benefits or otherwise, being hereinafter referred to as the "trust estate"), for the purposes and upon the terms and conditions hereinafter set forth. NOW, THEREFORE, in consideration of the covenants herein contained and other valuable consideration, the receipt and sufficiency of which hereby are acknowledged, the Grantor hereby transfers, conveys, assigns and delivers to the Trustee as and for the trust estate the property more particularly described in Schedule A hereto, ): :./ -L.1.. . to hold the same, and any other property which the Trustee hereafter may acquire, IN TRUST, for the purposes and upon the terms and conditions hereinafter set forth: ARTICLE FIRST Directions of Grantor The Trustee shall hold, manage, invest and reinvest the trust estate, shall collect the income therefrom, and shall pay any part or all of the income and principal to whomever the Grantor from time to time may direct in writing. Until the Grantor hereafter may direct to the contrary, the net income shall be paid to the Grantor quarter-annually. Any income not so paid or applied shall be accumulated and added to the principal of this trust at least quarter-annually. ARTICLE SECOND Disability of Grantor If at any time the Grantor, in the judgment of the successor Trustee, shall be under any legal disability or shall be unable to manage properly his affairs by reason of illness or mental or physical disability (whether or not a court of competent jurisdiction has declared the Grantor incompetent or mentally ill or has appointed a legal representative for the Grantor), the successor Trustee may payor apply so much or all of the net income and the principal of the trust estate as the successor Trustee deems necessary or advisable for the health, education, maintenance or support of the Grantor, or for the payment of insurance premiums on the life of the Grantor. Any income not so paid or applied shall be accumulated and added to the principal of this trust at least quarter-annually. In making any payment hereunder, the successor Trustee may consider, but shall not be required to consider, the income and other resources of the Grantor. No such paymen.t ~pall.L'pe charged upon a subsequent division of the trust estate against the principal of any share which may be set apart for any beneficiary hereunder. 2 ARTICLE THIRD Successor Beneficiaries Upon the death of the Grantor, the Trustee shall pay and distribute the trust estate at that time remaining to Phyllis J. Mariskovic, if then living, discharged of trust. If Phyllis J. Mariskovic shall not survive Grantor, the balance of this trust at that time remaining shall be paid and distributed to Karen I. Stephenson, if then living, otherwise to her then living issue, per stirpes. The Grantor's principal residence is to be held in trust for the benefit of Karen I. Stephenson, if Phyllis J. Mariskovic is then deceased. The said Karen I. Stephenson shall have the right to reside in the said principle residence for the remainder of her life. If Karen I. Stephenson resides in a home of her own or purchases a principle residence, then the Grantor's principle residence shall be sold and the proceeds distributed to said Karen I. Stephenson or the said residence shall be rented with the rental income paid to Karen I. Stephenson, at her option. ARTICLE FOURTH Distributions To Minors Or Incompetents In any case in which the Trustee is authorized or directed by any provision of this Agreement to payor distribute income or principal to any person who shall be a minor or incompetent, the Trustee, in the absolute discretion of the Trustee and without authorization of any court, may payor distribute the "vhole or any part of such income or principal to such minor or incompetent personally, or may apply the whole or any part thereoLdiJ:-ectb2. to the health, education, maintenance or support of such minor or ~. . t. incompetent, or may payor distribute the whole or any part thereof to the guardian, committee, conservator or other legal representative, wherever appointed, of such minor or incompetent or to the person with whom such minor or incompetent may from time to time 3 reside, or in the case of a minor, may payor distribute the whole or any part thereof to a custodian for such minor under any gifts to minors or transfers to minors act. Evidence of such payment or distribution or the receipt therefor by the person to whom any such payment or distribution is made shall be a full discharge of the Trustee from all liability with respect thereto, even though the Trustee may be such person. The Trustee, in the absolute discretion of the Trustee, may defer payment or distribution of any or all income or principal to which a minor may be entitled until such minor shall attain the age of twenty-one (21) years, or to make such payment or distribution at any time and from time to time, during the minority of such minor, holding the whole or the undistributed portion thereof as a separate fund vested in such minor but subject to the power in trust hereby given to the Trustee to administer and invest such fund and to use the income or principal thereof for the benefit of such minor as if such fund were held in trust hereunder. The Trustee shall pay and distribute any balance of such fund to such minor when such minor shall attain the age of twenty-one (21) years. Except as is herein above provided, if such minor shall die before attaining the age of twenty-one (21) years, the Trustee shall pay and distribute such balance to the executors, administrators or legal representatives of the estate of such minor. The word "minor", wherever used in this Article FOURTH, shall mean any person who has not attained the age of twenty-one (21) years. ARTICLE FIFTH Payment of Debts Upon the death of the Grantor, the Trustee may pay from the principal of the trust. estate..Lthe amount of any estate or death taxes (and any excess accumulation excise tax), by whatever name called, imposed under the laws of any jurisdiction by reason of the Grantor's death, whether in respect of property passing under this Agreement or the Grantor's last will and teSZ:lment or othenvise, and the amount of all of the debts yvhich the 4 Grantor's estate must pay, the expenses of his last illnesses and funeral, and the expenses of administering his estate. The Trustee may rely upon the written certification of the executors, administrators or legal representatives of the Grantor's estate as to the amount of any such tax, debt or expense, without any duty to inquire as to the correctness thereof, and, in its discretion, may make payment thereof either to said executors, administrators or legal representatives or to the taxing authority or person to whom such amount is owed. ARTICLE SIXTH Life Insurance and Death Benefits With respect to any insurance policies or employee death benefits payable to the Trustee, the Trustee, upon being advised that any sum is so payable by reason of the death of the Grantor, shall endeavor to collect the same, and may bring a suit or action therefor, or may compromise, adjust, settle or submit to arbitration any claims therefor. The Trustee shall be entitled to reimbursement from the trust estate for expenses incurred by the Trustee in collecting or attempting to collect any such sum by suit, action or othenvise. The Trustee, however, shall be under no duty to bring a suit or action unless the expenses of the Trustee, including attorneys' fees, shall have been advanced or guaranteed to the satisfaction of the Trustee. The Trustee may repay, out of the trust estate, any advances made by the Trustee or reimburse the Trustee for expenses incurred in collecting or attempting to collect any sum as aforesaid. The Trustee in no case shall be under any duty or obligation to make any claim against the Grantor's estate, or take any action against the executors, administrators or legal representatives of the Grantor's estate, for reimbursement for any reduction of the sums p~a,Qle .ll}l.on the death of the Grantor by reason of unpaid premiums or for any other cause, including any loans and interest thereto secured by any insurance policies. During the life of the Grantor, the Trustee may, in its discretion, apply the lld income or principal of the trust estate to the payment of premiums on any life 5 insurance policy of which the Trustee or any trust hereunder is beneficiary. If the net income and principal is insufficient to pay such premiums, the Trustee may notify the Grantor and the beneficiaries of the trust of such insufficiency and give them the opportunity to furnish the necessary funds. If neither the Grantor nor any of the bene- ficiaries furnishes the funds necessary to pay the premiums, the Trustee may, but shall not be obligated to, obtain the funds required to pay such premiums by selling a portion of the principal of the trust estate, by borrowing on the security of such principal, by borrowing against the cash surrender value of the policy or by surrendering some policies and using the proceeds to pay the premiums on other policies. The Trustee also is authorized to convert such policies to paid-up or extended term insurance if the trust estate does not have the necessary funds to pay the premiums. If no funds are available for the payment of the premiums of any insurance policy, the Trustee may assign ownership of such policy to the then living income beneficiaries of the trust. The Grantor retains, during his life, all of the rights, options and privileges reserved to or conferred upon him by the terms of said insurance policies or employee death benefit plans, including without limitation the right to borrow upon and pledge the same, to change the beneficiary thereof, to convert the same into other forms of insurance, to collect the cash value thereof, to permit or direct the same to lapse, and to receive dividends and other lifetime benefits of any kind payable to him by the terms thereof. The Grantor may exercise the foregoing rights without the consent of the Trustee or any beneficiary hereunder. The following provisions concern retirement benefits that become distributable to the Trustee (whether directly or through the Grantor's estate) by reason of the deatp ?f,th~.....Grantor. As used herein, "retirement benefits" means amounts held in or payable pursuant to a plan (of 'whatever type) qualified under Section 401 of the Internal Revenue Code, or an individual retirement arrangement under Section 408 or 408A of the Code, or a tax sheltered annuity under Section 403 of the Code, or any other benefit plan 6 subject to the distribution rules of Section 401(a)(9) of the Code, or the corresponding provisions of any subsequent Federal tax law. (a) The Trustee in the absolute discretion of the Trustee may exercise any right to determine the manner and timing of payment of retirement benefits that is available to the recipient of the benefits. (b) The Trustee is authorized to identify and designate the person who, pursuant to the regulations under Section 401(a)(9), is the "designated beneficiary" whose life expectancy may be used to measure payments to any trust. ( c) No retirement benefits shall be used to pay taxes, debts and expenses of the estate of the Grantor. (d) If the Grantor's wife survives the Grantor and retirement benefits are distributable to the Trustee either directly or through the Grantor's estate (other than by reason of disclaimers by the Grantor's wife) the Trustee (other than the Grantor's wife) is authorized, but not directed, in the absolute discretion of the Trustee, to distribute the right to all or part of such benefits outright to the Grantor's wife, or to disclaim all or part of such benefits, and any benefits so disclaimed shall be payable to the Grantor's wife outright, and the Grantor's wife may exercise any right to determine the manner and timing of payment of such distributed or disclaimed benefits that is available to the recipient of the benefits. In exercising this discretionary power, the Trustee may, but need not, consider solely the needs :J.n~"de~i~~s of the Grantor's wife and not those of any other beneficiary. The Grantor hopes that the Trustee will consider distributing or disclaiming if the Grantor's wife wishes to "roll over" the benefits to an individual retirement arrangement and such distribution or disclaimer will help 7 effectuate the rollover, but this precatory expression shall not limit the discretion of the Trustee and it is not meant to direct a distribution or disclaimer even if the Grantor's wife wishes to "roll over" the benefits. ARTICLE SEVENTH Grantor's Right to Revoke or Amend The Grantor reserves the right, at any time during the life of the Grantor and without the consent of any person or notice to any person other than the Trustee, to amend or revoke in whole or in part this Agreement or any trust created hereunder, including the right to change the terms or beneficiaries thereof, by delivering to the Trustee written notice of such amendment or revocation signed by the Grantor. This Agreement shall become irrevocable upon the death of the Grantor. No amendment of this Agreement, however, shall increase the obligations or reduce the commissions of the Trustee without the consent of the Trustee. Upon any such revocation, the Trustee shall deliver to the Grantor all property in the possession or control of the Trustee with respect to any trust which has been revoked and shall execute and deliver any instruments necessary to release any interest of the Trustee in such property. The sale or other disposition by the Grantor of the whole or any part of the trust estate held hereunder shall constitute as to such whole or part a revocation of this Agreement and the trust or trusts affected thereby. The Grantor reserves the power and right during the life of the Grantor to collect any rent, interest or other income which may accrue from the trust estate and, in his sole disfretjon..l.1P accumulate such income as a trust asset or to pay such income to the Grantor individually and not in any fiduciary capacity. The Grantor further reserves the power and right during life of the Grantor to mortgage or pledge all or any part of the trust estate as collateral for any loan. 8 ARTICLE EIGHTH Powers of Trustee In the administration of any property, real or personal, at any time forming a part of the trust estate, including accumulated income, and in the administration of any trust created hereunder, the Trustee, in addition to and without limitation of the powers conferred on trustees under the Pennsylvania Probate, Estates and Fiduciaries Code, as amended or any successor thereto, or otherwise provided by law, shall have the following powers to be exercised in the absolute discretion of the Trustee, except as othenvise expressly provided in this Agreement: (a) To retain such property for any period, whether or not the same is of the character permissible for investments by fiduciaries under any applicable law, and without regard to the effect any such retention may have upon the diversity of investments; (b) To sell, transfer, exchange, convert or othenvise dispose of, or grant options with respect to, such property, at public or private sale, with or without security, in such manner, at such times, for such prices, and upon such terms and conditions as the Trustee may deem advisable; (c) To invest and reinvest in common or preferred stocks, securities, limited liability companies, investment trusts, mutual funds, regulated investment companies, bonds and other property, real or personal, foreign or domestic, including any undivided interest in anyone or more common trust funds, whether or not such investments be of the character permissible for iJlve~tm~llts by fiduciaries under any applicable law, and without regard to the effect any such investment may have upon the diversity of investments; (d) To render liquid the trust estate or any trust created hereunder in whole or in part, at any time and from time to time, and to hold unproductive 9 property, cash or readily marketable securities of little or no yield for such period as the Trustee may deem advisable; (e) To lease any such property beyond the period fixed by statute for leases made by fiduciaries and beyond the duration of any trust created hereunder; (f) To join or become a party to, or to oppose, any reorganization, readjustment, recapitalization, foreclosure, merger, voting trust, dissolution, consolidation or exchange, and to deposit any securities with any committee, depository or trustee, and to pay any fees, expenses and assessments incurred in connection therewith, and to charge the same to principal, and to exercise conversion, subscription or other rights, and to make any necessary payments in connection therewith, or to sell any such privileges; (g) To form one or more corporations or limited liability companies, alone or with any person, in any jurisdiction, and to transfer assets to any new or existing corporation or limited liability company in exchange for stock or membership interests; to form one or more partnerships with any person in any jurisdiction, to have any trust or a nominee be a general or limited partner, and to transfer assets to any new or existing partnership as a capital contribution; to enter into one or more joint ventures or associations with any person in any jurisdiction, and to commit assets to the purposes of those ventures or associations; and to retain as an investment for any period any securities, partnership interests or other assets resulting from any such actions; (h) To vote in person at meetings of stock or security holders and ~j~.JHqIlients thereof, and to vote by general or limited proxy with respect to any stock or securities; (i) To hold stock and securities in the name of a nominee without indicating the trust character of such holding, or unregistered or in such form as will ]0 pass by delivery, or to use a central depository and to permit registration in the name of a nominee; (j) To initiate or defend, at the expense of the trust estate, any litigation relating to this Agreement or any property of the trust estate which the Trustee considers advisable, and to pay, compromise, compound, adjust, submit to arbitration, sell or release any claims or demands of the trust estate or any trust created hereunder against others or of others against the same as the Trustee may deem advisable, including the acceptance of deeds of real property in satisfaction of notes, bonds and mortgages, and to make any payments in connection therewith which the Trustee may deem advisable; (k) To borrow money for any purpose from any source, including any trustee at any time acting hereunder, and to secure the repayment of any and all amounts so borrowed by mortgage or pledge of any property; (I) To possess, manage, develop, subdivide, control, partition, mortgage, lease or othenvise deal with any and all real property; to satisfy and discharge or extend the term of any mortgage thereof; to execute the necessary instruments and covenants to effectuate the foregoing powers, including the giving or granting of options in connection therewith; to make repairs, replacements and improvements, structural or otherwise, or abandon the same if deemed to be worthless or not of sufficient value to warrant keeping or protecting; to abstain from the payment of real estate taxes, assessments, water charges and sewer rents, repairs, maintenance and upkeep of the same; to permit to be lost by tax sale or other proceeding or to ~o~yey jb.e same for a nominal consideration or without consideration; to set up appropriate reserves out of income for repairs, modernization and upkeep of buildings, including reserves for depreciation and obsolescence, and to add such reserves to principal and, if the income from the property , 1 itself should not suffice for such purposes, to advance out of other income any sums needed therefor, and advance any income of the trust for the amor- tization of any mortgage on property held in the trust; (m) To purchase from the legal representatives of the estate of the Grantor or from the trustees of any trust established by the Grantor any property constituting a part of such estate or trust at its fair market value and to make loans for adequate consideration to such legal representatives or trustees, upon such terms and conditions as the Trustee may determine in the absolute discretion of the Trustee; (n) To carry insurance of the kinds and in the amounts which the Trustee considers advisable, at the expense of the trust estate, to protect the trust estate and the Trustee personally against any hazard; (0) To make distribution of the trust estate or of the principal of any trust created hereunder in cash or in kind, or partly in kind, and to cause any distribution to be composed of cash, property or undivided fractional shares in property different in kind from any other distribution, and to determine the fair valuation of the property so allocated, with or without regard to the tax basis; to hold the principal of separate trusts in a consolidated fund and to invest the same as a single fund; to split trusts for purposes of allocating GST exemptions (within the meaning of Section 2642(a) of the Internal Revenue Code); and to merge any trusts which have substantially identical terms and beneficiaries, and to hold them as a single trust; (p) To employ and pay the compensation of accountants, attorneys, experts, ipv~~tm~'p,t counselors, custodians, agents and other persons or firms providing services or advice, irrespective of whether the Trustee may be associated therewith; to delegate discretionary powers to such persons or 1:2 firms; and to rely upon information or advice furnished thereby or to ignore the same, as the Trustee in its discretion may determine; (q) To change the situs and/or governing law of any trust hereunder to any State the Trustee from time to time may deem desirable, and to take such further actions, including without limitation the amendment to the terms of the trust, as may be necessary or advisable to effectuate such change; (r) To execute and deliver any and all instruments or writings which it may deem advisable to carry out any of the foregoing powers; and (s) To exercise all such rights and powers and to do all such acts and enter into all such agreements as persons owning similar property in their own right might lawfully exercise, do or enter into. Except as otherwise provided herein, the Trustee may determine, when there IS reasonable doubt or uncertainty as to the applicable law or the relevant facts, which receipts of money or other assets should be credited to income or principal, and which disbursements, commissions, assessments, fees and other expenses should be charged to income or principal. Any distributions or dividends payable in the stock of a corporation, and rights to subscribe to securities or rights other than cash declared or issued by a corporation, shall be dealt with as principal. The proceeds from the sale, redemption or other disposition, whether at a profit or loss, and regardless of the tax treatment thereof, of any property constituting principal, including mortgages and real estate acquired through foreclosure or otherwise, shall normally be dealt with as principal, but the Trustee may allocate a portion of any such proceeds to income if the property disposed of produced no income or substantially less than the current rate of return on trust investments, or if the Trustee jh~JI d.felm such action advisable for any other reason. The preceding provisions of this paragraph shall not be deemed to authorize any act by the Trustee which may be a violation of any law prohibiting the accumulation of income. 13 No person who deals with any Trustee hereunder shall be bound to see to the application of any asset delivered to such Trustee or to inquire into the authority for, or propriety of, any action taken or not taken by such Trustee. Notwithstanding anything to the contrary contained herein, during such time as any current or possible future beneficiary of any trust created hereunder (other than the Grantor) may be acting as a Trustee hereunder, such person shall be disqualified from exercising any power to make any discretionary distributions of income or principal to himself or herself (unless the discretion to make such distributions is limited by an ascertainable standard \vithin the meaning of Section 2041(b)(l)(A) of the Internal Revenue Code), or to satisfy any of his or her legal obligations, or to make discretionary allocations of receipts or disbursements as between income and principal. No Trustee who is a current or possible future beneficiary of any trust hereunder (other than the Grantor) shall participate in the exercise of any powers of the Trustee which would cause such beneficiary to be treated as the owner of trust assets for tax purposes. ARTICLE NINTH Appointment of Trustee The Grantor appoints himself as Trustee hereunder. The Grantor hereby appoints Phyllis .1. Mariskovic, as successor Trustee hereunder in the event of the death of the Grantor, or his physical or mental incapacity. If Phyllis J. Mariskovic for any reason shall fail or cease to act as Trustee, the Grantor hereby appoints Karen I. Stephenson, as successor Trustee hereunder. The term "Trustee" wherever used herein shall mean the trustee in office from tiI}le:to twt.e. Any such trustee shall have the same rights, powers, duties, authority and privileges, whether or not discretionary, as if originally appointed hereunder. 14 No bond, surety or other security shall be required of any Trustee acting hereunder for the faithful performance of the duties of Trustee, notwithstanding any law of any State or other jurisdiction to the contrary. ARTICLE TENTH Accounts of Trustee The Trustee, at any time and from time to time, may render to the Grantor an account of the acts and transactions of the Trustee with respect to the income and principal of any trust created hereunder, from the date of the creation of such trust or from the date of the last previous account of the Trustee. After the death of the Grantor, the Trustee, at any time and from time to time, may render an account to the living person or persons who are entitled, at the time of such account, to receive all or a portion of the income of the trusts herein created. The approval of any person of full age, or a guardian or parent of a minor or incompetent person, to whom an account is rendered shall, as to all matters stated therein, be final and binding upon him or such minor or incompetent person, or any persons claiming through him or such minor or incompetent person, as the case may be. A person of full age, or a guardian or parent of a minor or incompetent person, to whom an account is rendered shall be deemed to have approved the account if he assents to the account in writing or if he does not communicate to the Trustee his 'written objections to the account within sixty days after the receipt of the account (provided the account was accompanied by a notice of said sixty day period within which to raise objec- tions). The Grantor shall have full power and authority on behalf of all persons interestfd:!n a)1j: trust'hereunder, whether such interest relates to income or principal, to settle any account of the Trustee. Such settlement shall be final and binding upon all persons so interested in such trust. Upon such settlement, the Trustee shall be fully and 15 completely discharged and released from all further liability with respect to acts and transactions set forth in the account so settled. The Trustee shall not be required at any time to file any account in any court, nor shall the Trustee be required to have any account judicially settled. Nothing herein, however, shall be construed as limiting the right of the Trustee to seek a judicial settlement of any account. ARTICLE ELEVENTH Decisions of Trustee Are Conclusive The determination of the Trustee in respect of the amount of any discretionary payment of income or principal from any trust established hereunder, and of the advisability thereof, shall be final and conclusive on all persons, whether or not then in being, having or claiming any interest in such trust, and upon making any such payment, the Trustee shall be released fully from all further liability or accountability therefor. The right of any beneficiary to any payment of income or principal shall in every case be subject to any charge or deduction which the Trustee may make against the same under the authority granted to the Trustee by any law or by this Agreement. ARTICLE TWELFTH Simultaneous Death If any beneficiary under this Agreement shall die simultaneously with the Grantor or any other person upon whose death such beneficiary shall become entitled to receive either income or principal under this Agreement, or in such circumstances as to render it :QiffJ.<:hlt or 'impracticable to determine who predeceased the other, then for purposes of this Agreement such beneficiary shall be deemed to have predeceased the Grantor or such other person. The provisions of this Agreement shall be construed as aforesaid, notwithstanding the provisions of any applicable law establishing a different 16 presumption of order of death or providing for survivorship for a fixed period as a con- dition of inheritance of property. ARTICLE THIRTEENTH Rights of Beneficiaries Are Not Assignable No disposition, charge or encumbrance on the income or principal of any trust established hereunder shall be valid or binding upon the Trustee. No beneficiary shall have any right, power or authority to assign, transfer, encumber or otherwise dispose of such income or principal or any part thereof until the same shall be paid to such beneficiary by the Trustee. No income or principal shall be subject in any manner to any claim of any creditor of any beneficiary or liable to attachment, execution or other process of law prior to its actual receipt by the beneficiary. ARTICLE FOURTEENTH Construction The validity and construction of this Agreement and the trusts created hereunder shall be governed by the laws of the Commonwealth of Pennsylvania. Any provision herein which refers to a statute, rule, regulation or other specific legal reference which is no longer in effect at the time said provision is to be applied shall be deemed to refer to the successor, replacement or amendment to such statute, rule, regulation or other reference, if any, and shall be interpreted in such a manner so as to carry out the original intent of said provision. For purposes of this Agreement, the disability or incapacity of an individual (includi\tg :.the -L Gran tot or any Trustee) shall be conclusively established by a written statement signed by such individual's then attending physician and filed with the records of any trust established hereunder attesting that, in such physician's opinion, such indiyidual is unable to manage his or her affairs. Such written statement shall be conclusive evidence 17 of such fact, and any third party may rely on same in dealing with any trust established hereunder and shall not be obliged to inquire whether such individual is no longer under such disability or incapacity at the time of such dealings. Wherever used in this Agreement and the context so requires, the masculine shall include the feminine and the singular shall include the plural, and vice versa. The captions in this Agreement are for convenience of reference, and they shall not be considered when construing this Agreement. If under any of the provisions of this Agreement any portion of the trust estate would be held in trust beyond a date twenty-one years after the death of the last survivor of the Grantor and the beneficiaries hereunder in being when this Agreement becomes irrevocable, or such later date permitted by the rule against perpetuities applicable in the Commonwealth of Pennsylvania; then, upon such date, the trust of such portion shall terminate and the principal, and any unpaid income thereof, shall be paid and distributed to the person or persons then living who would have been entitled to receive the income therefrom had the trust continued, in the proportions to which they would have been so entitled. ARTICLE FIFTEENTH Binding Effect This Agreement shall extend to and be binding upon the heirs, executors, administrators, successors and assigns of the undersigned Grantor and upon the Trustee acting hereunder. ARTICLE SIXTEENTH Short Name This Agreement and the trusts created hereunder may be referred to, in any other instrument, by the name: "Lynn B. Miller Living Trust". Any transfers to this 1. ..: .L.J.. 18 Agreement or any trust hereunder may refer to the aforesaid name or to "Lynn B. Miller as Trustee under Lynn B. Miller Living Trust", with or without specifying any change in Trustee or any amendment to this Agreement. IN WITNESS WHEREOF, this Agreement has been duly executed as of the date first above written. JenL t5 }~" Lynn Miller Grantor/Trustee ) .', ..LI 19 COMMONWEALTH OF PENNSYL VANIA, COUNTY OF CUMBERLAND, ss. On this;) '7 day of Ne(}-~ [sPJi't , 2001, before me, the undersigned officer, per~nally appeared Lynn B. Miller;-imown to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the urposes therein contained. .-. . ."" ..1.11." uD xpires on (pod{ --0ti9Y Nolanal Seal Patrick J McLe>., uhlln, Notary Public Upper Morelano Tw" Montgomery County My Commission Expires June 21, 2004 Member, Pennsylvania Association at Nolanes DEED (j. ;?!IS INDENTURE, made as of this ~ N day of ~la 5lta.. , 2004, between Lynn B. Miller, as the Grantor hereunder (hereinafter referred to as the "Grantor"), and Lynn B. Miller, Trustee of the Lynn B. Miller Living Trust Dated: ti~JJ&10JU, as the Grantee hereunder (hereinafter referred to as the "Grantee"). WITNESSETH, that Grantor, in consideration of Ten Dollars and other valuable consideration, the receipt and sufficiency of which is hereby acknowledged, does hereby grant, convey and release unto Grantee and the heirs, executors, administrators, successors and assigns of Grantee forever, as joint tenants with right of survivorship, ALL that certain plot, piece or parcel of land, ,-,,'ith the buildings and improvements thereon erected, situate, lying and being in the Township of Hampden, the County of Cumberland and the Commonwealth of Pennsylvania, being more particularly described in Exhibit A attached hereto and made a part hereof, TOGETHER with the appurtenances and all the estate and rights of Grantor in and to said premises, TO HAVE AND TO HOLD the premises herein granted unto Grantee and the heirs, executors, administrators, successors and assigns of Grantee forever. IN 'WITNESS WHEREOF, Grantor has duly executed this Deed on the date first above written. (Seal) V' hh____h.___ i NOT.'-\RIAL SEAL t ,,\ \ 1~0 ~ r:: .I"-,""_".k. ,RcEN Not P bl' ~. ".,'-',L. , ary.u Ie I'll, varnp ~~I,. Cumberland County y Comm,,,,,,on Expires June 6, 2005 1. :'.:' ..L.1.~ .--~ ('t!. () v l""fV I '1\ ~ co ,<.."Dt. !.It-gt<..Drr< 0':- .J)~I:;:>.f CI....11 D~ultVl..x.. -- -:r; ~ ~ ~/1)lp(., COMMONWEAL TH OF PENNSYLVANIA, COUNTY OF CUMBERLAND, ss. On this P day of /J~/~.t/S/ , 2004, before me, the undersigned officer, personally appeared Lynn B. Miller, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within deed, and acknowledged that he executed the same for the uses and purposes therein contained. IN WITNESS WHEREOF I hereunto set my hand and official seal. otary Public My commission expires on NOTARIAL SEAL JAMES E. GREEN, Notary Public Camp Hill, Cumberland County My Commission ExpirF.lS June 6, 20051 1 here~y.ce~ that the Resi' 1. ." ~.JL. ..-. and Post Office of within Grantee. Grantee or Atty. SCHEDULE "A" ALL THAT CERTAIN Cumberland County, follows: lot of land Pennsylvania, situate in Hampden Township, being bounded and described as BEGINNING at a point on the westerly line of Deerfield Avenue at the dividing line between Lots Nos. 18 and 17 of Block "E" on said plan; thence by the westerly line of Deerfield Avenue, South 01 degrees 50 minutes East 100 feet to the dividing line between Lots Nos. 18 and 19 of Block "E"; thence by said dividing line, South 88 degrees 10 minutes West 140 feet to a point; thence North 01 degrees 50 minutes West 100 feet to the dividing line between Lots Nos. 18 and 17; thence by said dividing line, North 88 degrees, 10 minutes East, 140 feet to the Place of BEGINNING. BEING Lot No. 18, Block "E'l of Plan No. 5 of Good Hope Farms, which Plan was on March 29, 1968 duly recorded in the Office of the Recorder of Deeds in and for Cumberland County at Carlisle, Pennsylvania, in Plan Book 19, Page 72. SAID lot of ground is further identified as No. 5246 Deerfield Avenue. BEING a part of the same premises which Eastern Consolidated Land Corporation, by Indenture dated September 11, 1970 and recorded in the Recorder of Deeds' Off ice of Cumber land County, Pennsylvania in Deed Book U23, Page 842, granted and conveyed to LYNN B. MILLER, a single man. ). ..; ..L Ji. c:\docs\miller-l.sch j I (lc).')()"iM\ )~FV. (l!(J(\ This is to certifY that this is a true copy of the record which is on file in the Pennsylvania Division of Vital Records 111 accordance with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953. WARNING: It is illegal to duplicate this copy by photostat or photograph. ~cJ-\c If'^~oL No. Frank Yeropoli State Registrar Calvin B. Johnson, M.D., M.P.H. Secretary of Health -' Un /] 4 c::, d ~/' J. ,',....,"_ MAR 1 9 2007 Date H105-143 REV 1112006 TYPE l PRINT IN PERMANENT BLACK INK CORRECTED ITEM(S): 20a COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF HEALTH. VITAL RECORDS PER:FD DATE:03-19-07 bas CERTIFICATE OF DEATH (See instructions and examples on reverse) v, STA fE FILE NUMBER 1 Name of Df-x;oden' (I"irs!. middle. last. suffiX) Lynn B. Miller 178 -16 4. Date 01 Death (Monlh. day, year) February 2, 2007 5. Age (lasI8irthd.1y) 6. Date of Birth (Month. day, yoar) 83 Oct 16 1923 ?vi Cumberland 11, Decedent's Usual Octupalion Kind 01 work dono dunn most of wor1\in Me. Do not state retired) Kind 01 Wort.. Kind of 8usinr.ss/lndustry Chief Master SG US Government Church of God Nursing Home o Inpatient 0 ER! Outpatient 0 DOA [XI Nursing Homo 0 Residence DOther - Spocily' 9. Was Decedont of Hispanic Origin? 00 No 0 Yes 10, Race: Arnerican Indian, Black, 'White. ote (11 yes, specify Cuban (SpocHt1 Mexican, Puerto Rican, etc,) Whl te 14. Marital Status: Married, Never Marrled, Widowed, Divorced (Spcdfyl Divorced 8b Coun!yc! Death Cumberland Did Decedenl Llveina Township? . 16. OocOOonl's Mailing Address (Street. city {town, slale, lip code) 5246 Deerfield Avenue Mechanicsbur PA 17050 12. Was Decedenl evm in Ihe u.s. Armed rOfCCS? lKJyes DNo Decedent's Actual Residence 17a,State 17h. County 17c.1ia Yes, DecodenlU,,",m Hampden 17d, D No, Dooodont Uvod within Actual lirnits 01 TWI' 18. Falhor'sNnme(Firsl,middle,Ia..'>l,suffIX) Earl N. Miller City/Boro 19. Mother's Name (First. middle, maiden surname) Sarah E. Root 2Oa. Intormant's Name (Typo { Print) 20b.lnlormanfs Mailing Address (Street, city / lown, stale, zip code) 5246 Deerfield Avenue 21c. Place of DIsposition (Name of cemetery, cremalory or other p1acel o co ~ "" '" Indiantown Gap National Ce Annvllle PA 17003 PA 17050 . ~ 37 E Main st Mechanicsburg PA 17055 fL+J 55? 2-& '2 I 2c07 23b. Ucensc Number Iterru; 24-26 must bu ccmpleted by person :- who prOOOJflC05 dealh Dyes DNo 3t, Mannorol Death ~ural DHomicida o Acadent 0 Pending Investigation o Suicide 0 Could Not be Determined 26, W85 Case Referred to Medical Examiner {CoronCr lor a Aea.~n Other tha Cremation or Donation' Dyes ~NO Approlirnale interval: Part II: Enter other sionilicant condllio!li.221l~ 28, Did Tobacco Use Contribute to Doath? Onsel10 Death but no! resulting in the underlying cause given il Part I. D Yes 0 Probably D No J>lUnknowo 29. "Female o Nolpregnanlwilhinpastyear o Pregnant aI time of death D Nolpregnant,butprognantwithin42daY5 01 death o Not pregnant, but progMnt 43 days 10 1 year before death o Unknown if pregnanl within tI1e pas1 year 32c. = ~\~~~: ~i;) ~ree!. Factory, CAUSE OF DEATH (See Instructlons and examples) Item 27, Part I: Enlef tI1e dlllin..~.' diseases, injuries, or complications -lhat dirllC1ly caused the dealt1. 00 NOT enler termlnaf events sud'l as cardiac arresl, resplrlllOfY arrest. or venlncular fibrillation wi!houl showing the etiology, list only one cause on each lina. =~~~tn~Si d~~~~I) dise.:;. J;s-:n-~'cJA..i '7:>A1G-u fU.< &vel ~ ;/1 b, DuOlo(",,,'con-;luo"ceo~: C HF r- 000 10 (or as a consequence 00: S 07::::> CA-D Due 10 (or as a consequence 0/): :s ~ ~ SoQuflntiaJly list conditions, ~ any, ~dlnglOthecausellslodonlinea Enter !he UNDERLYING CAUSE ~~~~~~A~rrnt~~~~t~'1r.e d, 3Oa, Was an Aulop!'Y Performed? 3Qb, W6fe Autoplly Rndings Available Prior to Completion 01 Cause 01 Death' Dyes ~o 32d. Time of Injury 32g, localion of Injury 19reet, city Ilown, stale) M --.i 330.1. CartllitJr (chodc only ono) ~:::f:r~~~: =fyi;~= ~~~~~ ~u:~~I~~:r~: ~=-~_ ~~h_a:d _~~ ~e~:~ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~ .... :~n~,.~ =~~.~~=~ :tl==n:~e;I~~~:~~~;~O~hC:~~~~:~ manner 81 stated.- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ D Medical Examiner! Coroner On the ba.l. of e:ramlnatlon and I or Investigation, In my opinIon, death occurred lrl the lime, date, and plaC&, and due (0 the cauae(.) .nd manner as .tIIted- 0 !,; i IcZl ( I~ II I...,), I ~ ~ Disposition Permit No 017~789 1701 J j /\l"h/ CiAUGHEN :ill RE.r1\LTOR E RX' Mechanicsburg Office '101 Old Schoolhouse Lane Mechanicsburg, PA 17055 (717) 697-4673 (717) 697 -0822 FAX February 22, 2007 Ms. Phyllis Mariskovic 5246 Deerfield Avenue Mechanicsburg, P A 17050 Dear Phyllis: Re: Lynn B. Miller Estate 5246 Deerfield Avenue Mechanicsburg, P A 17050 Please find enclosed a comparable market analysis for 5246 Deerfield Avenue for the Estate of Lynn B. Miller. The square footage of the house and the size of the lot are taken from Cumberland County tax records. Based on the comparables available, I estimate a market value of$183,100. Under current market conditions, if the property were offered for sale, I would list higher than the expected $183,100 sale price and anticipate a relatively quick sale in less than 30 days. If I can be of further service, do not hesitate to call me at 717-697-3928. Sincerely, '7 I &utj){t'1-~ Barbara F. Kriebel, GRI Realtor Jack Gaughen Realtor ERA Your Leader for Exceptio0al Reql Estate Service . .., 1) ,rcl/lt'/h'!'';i/ oIjo l;l/," .. Owncd :\nd Opcr~llcd By NRT Ine. \VWVV. Jgr.com Status List P ri ce List$ SqFt Sale Price Sold$ SqFt Contract Date Sold Date DaM City Municipality Acres Year Built Bedrooms Full Baths Half Baths Abv Grd SF Style Exterior Construction Heating Heating Cooling Fireplaces Parking Parking Ext Feat Ext Feat Ext Feat Ext Feat Amenity Amenity Basement Basement Other Room Other Room Comparati~e Market _~1s . .... ) ,~ Jft ".\ .~~." .. < " " "', This analysis has not been performed in accordance with the Uniform Standards of Professional Appraisal Practice which reQuires valuers to act as unbiased. disinterested third parties with impartiali\>,. objectivi\>, and independence and without accomodations of personal interest. It is not to be construed as an appraisal and may not be used as such for any purpose. 5246 Deerfield Avenue Barbara Kriebel Omce:(717) 697-4673 Direct DiJ!.' (717)59 1.0629 flomc Phonc: 697.3928 FJx:(717) 697.0822 [mJi/: barbara.kriebel@jgr.com 205 St Johns Church Ro ~..'?':~ ~~ ~_.-.." .~ ~ '.' L; 10 r L _~_~~ ,"" ", .. ,..::..~'1l,' ; '~1Im ~~~u:",,",_..J ~ S $181,900 $141.01 $181,900 $141.01 06/16/06 07/05/06 8 Camp Hill Hampden 1971 3 2 1290 Aluminum Frame Electric Radiant Wall Units 2 Car Garage Deck Part Finished 411 Lamp Post Lane 4813 Brian Road ~.-~ .. .~~~ ~. , ,'.lMl'l'~.~ <' ~j ~ l.~ ~ """ ....::. ~ ~ rr. t":"d;"; I 4' , ~ " , . . S S $182.500 $182,900 $82.95 $93.51 $182,500 $184,900 $82.95 $94.53 OS/24/06 11/03/06 06/23/06 11/29/06 1 37 Camp Hill Mechanicsb Hampden Hampden 0.26 1972 1970 4 4 2 2 1 2200 1956 Aluminum Brick Stick Built Stick Built Elec Baseboard Forced Air Natural Gas Natural Gas Ceiling Fan Ceiling Fan 1 1 Car Garage 1 Car Garage Integral Deck Deck Hot Tub Gas/Prop Grill Other Outside Lights Patio Park Playground Full Partial Attic Den Family Room Family Room UGHEN m REALTOR ERA Ownce .",.'"Ie] Operated By NRT Incorporated Mal' of~parableP~rties ... .'~;. . , I _ . " 4 " j , , . .:. ~PQ.~I:,;:;'~:: , ~~) ,..- g!~ () i~): :~ ! -"~ii _~ ~, '~ U. r;; '" ~. c. o -- ~ ~~;~!,t'-d.9~9r_, .. ~ ~ .... ira~t~~~ ?,d ,p. ''b. '. \lor \ t1'! i UI s1\~e~.~~P? '_,_ \' ''l} <; \ '; /iray~! g :,1 . ..;-~ sears f'un?! ~. . .. :<a, G~~C~ . . ~\..! , ~<e~ '..j~ ',C\ 'f~1. -<.~~..'. 'l', s~.,~ Dr \~,? ";~. \et~o:l<~d \ rJ",c~~.oL\'t. ,,). !:!O!..- ~~~~\\~~..... ~~~'-;j'\" ~, i.-"~ .~13 '\; " o~" .' .:~ ',0. ","( QC : ; '" h :R . ~/~'~,~ ':xl : ~",(/-",~~'t- .L. ,~o-\ ~~ . ~q".f k..",' ~../, 4 ~,,' ,o~~ . :9/0" .s '" O/' 9, " '0 ,~o-- ''"- .<' 'z' -'l;\ (J.S' ~(':,'cp . ~.) 'f'" ...,?\ 'f..o~".l.-".. Carlisle .E!k~. --~~ c~;:u.tT:~"'!(~ \~ \.~ \ /.~ \~o.-./. .\~ -{~\~~/' ~7 . ,_", co _1~ . \?atl<ft... \\\du"t!\a...... .., 1~ "'~~ '-i$l/ ~ Ref # 1 Address 5246 Deemeld Avenue 205 St Johns Church Road 41 I Lamp Post Lane 481 3 Brian Road 2 Status Subject Property Recently Sold Recently Sold Recently Sold 3 4 Barbara Kriebel Offlce: (717) 697-4673 Direct Dia/: (71 7)59 1-0629 Home Phone: 697.3928 Fax: (717) 697-0822 Emai/."barbara.kriebel@jgr.com JACK GAUGHEN m REALTOR ERA Owned And Operated By NRT incorporated / -:'\ (~ f/ \_--~ ~. 0, PNC1NVESTMENTS - i\kmher N^5D <Ind SIPC February 23, 2007 Phyllis Mariskovic 5246 Deerfield Avenue Mechanicsburg, PA 17050-6841 RE: Lynn B Miller Living Trust Social Security No. 178-16-6948 Date of Death: February 2, 2007 Dear Ms. Mariskovic PNCI Account Number 6136-0677 was the Trust Account which was owned by Lynn B Miller, deceased. The Date of Death Value of the securities held in this account is as follows: 794.707 shares Blackrock Multi PA CI B MGPYX @ $ 11.27 per share 3 shares CBS Corp New Class B CBS @ 31.35 per share 1284.207 shares Blackrock Equity Div B MBDVX @ 18.47 per share 210.680 shares EV TX-MGD Divid Incm C ECDIX @ 13.83 per share 3 shares Viacom Inc New Class B VIA'B @ 41.10 per share - In the Money Market of the investment account there was $4.74 on February 2, 2007. Please do not hesitate to contact me if I can provide you with further service. The information contained herein has been obtained from sources we believe to be reliable but do not guarantee it to be accurate, correct, complete or timely, and shall not be responsible for the results obtained from it's use. Sincerely, (1L ;;/d Charles E Little, CFP Vice President Senior Financial Consultant CEL/DJP A member of The PNC Financial Services Group 2 East Main Street Mechanicsburq Pennsylvania 17055 www.pncinvestmcnts,COr11 Important Investor Information: Se(,llrities and brokerage services are provicled by PNC Investments LLC, l11erntwr NASD and SIPC. Annuities and other insurance products ~Ht' offered by PNC Insurance Services, Inc. a licen<';t'd In<.;ur;lllc\' ;If]f'tH'V II.Mavl.osc Value I ' ;. .010 Bank Guarantee MetLife - Investor Relations - Historical Price Lookup Historical Price Lookup Symbol MET (Common Stock) Select Date February 02 Look Up Price 2007 Results Date Requested 02/02/07 Closing Price $63.36 Volume 2,065,400 Split Adjustment Factor 1: 1 Open $63.40 Day's High $63.53 Day's Low $63.17 Copyright @ 2007 ~ar!<::etWatch,.r[1C. All rights reserved. Please see our IerIDs..of_U..s.e. MarketWatch, the MarketWatch logo, and BigCharts are registered trademarks of MarketWatch, Ine. Intraday data delayed 15 minutes for Nasdaq, and 20 minutes for other exchanges. All quotes are In local exchange time. Intraday data prOVided by Comstock, a division of Interactive Data Corp. and subject to terms .0Lus.e. Historical, current end-of-day data, and splits data provided by EJ..JnteractIYe_D.ata. Copyright 2003-05 Metropolitan Life Insurance Company NY, NY - All Rights Reserved PEANUTS Copyrigbt United Feature Syndicate, Inc. Page 1 of 1 Privacy Policy Le~ Copt Pmdential ~ Financial ----- ~ tomputershare + ~ ~ Computershare Shareholder Services, Inc. PO Box 43033 Providence Rhode Island 02940-3033 Telephone: BOO 305 9404 www.computershare.com - - = LYNN B MILLER TR LYNN B MILLER LIVING TRUST UA 11/27/01 5246 DEERFIELD AVE MECHANICSBURG PA 17050-6841 I1II11I111I1111 ,,11111/11111111111111111111111.111111111111111 Holder Account Number = = = - C 0009263322 FID IIII "U 11111I11111111 " Irrevocable Stock Power =~...............- ~~ t:TaJ'~~~~ --~ '-~ ; ",:~.:,'. . ..~j/:_~_:(~~t,; ";.1' <"-.;:;.:..;'(,,-:::;..~-~:~:~. ~J~ "~ ,~:: '; ;,.....:~: ' . '.;, -, ';~,-:, . . ,'_' :';'i:.'\: :-'(:'_'~':~..,.',.>/"~(C'~;:;~"':. '.._~ . \~;i: ", ", FOR VALUE RECEIVED, the undersigned does (do) hereby sell, assign and transfer to New Owner/CustodianIT rustee/Executor/Olher (First, MI, Last) !PI-I-I'LL3S Street Number I 5;) 'I to Street Name AptJUnit Number I I I I I o 5 0 I J. MA~3 ~KO\JTC . -;nt Owner/Minor/Second Trustee/Other (First, MI, Last) I fOO' Owo"lThtm T..- {Ft.' MI. L"", Name of TnJstJEstate Name I f'{m~~li / 0[; C K 'F1:~ L--D AVe CirflSuburbiTc'Nr I f\'\ ~ C I' A rJ l c S G\J (CG I r.~ A I ro~~, I&<;S~;~ ""mOO' I;"' ;~~~~~~~"o; ""m; I S' Hittle {iff t, u ",,- ik () r- (/ ~I v -y (j 7 %q ~ , '35 f r fL Sf/- tltILt;-- IMPORTANT! YOU MUST COMPLETE AND SIGN THE REVERSE SIDE FOR THE FORM TO BE VALID. . 7USP + + revocable Stock Power(Continued) 11 For stock certificates, complete this portion and submit actual certificates Number of Shares I r""'" N.'I I"'''''''''' N., I f". "'I I j"ri_ "'I f-"'I II~"'I lEI Complete for direct registration shares held in book entry Number of Shares I 8'1 I!I Authorized Signatures. Sign Here. This section must be completed for your instructions to be executed. ,ne undersigned does (do) hereby irrevocably constitute and appoint Computershare as attorney to transfer the $<lid stock, as the case may be, on the books of said Company, with full power of substitution in the premises. Medallion Guarantee Stamp (Notary Public ls Not Acceptable) Note Signature{s) must be stamped with a Medallion Signature Guarantee by a qualified financial If1stitution, such as a commercial bank, savings bank, savings and loan, US. stock broker and secunty dealer, or credit union, that is participating in an approved i\ojedallion Signature Guarantee Program. (A NOTARY SEAL IS NOT ACCEPTABLE) J7g~\ f;;Y The signature{s) to the Stock Power must correspood with !he name{s) as written upon the face of the stock certificates, as the case may be in every particular, without alteration or enlargement or any change whatever, and must be guaranteed by a qualified Medallion Guarantee Member, Signature of current registered owner or legal representative Signature of current registered owner or legal representative Date (mm/ddlyyyy) I IIO)./.<:l /;<007 . q II ~ P 4- (omputershare + Form W.9 Request for Taxpayer Identification Number and Certification ;:- Use a black pen. Print in I CAPITAL letters inside the grey . A areas as shown in this example. B cll1231 0 Computershare .Shareholder Services, Inc. PO Box 43033 Providence Rhode Island 02940-3033 Telephone: BOO 305 9404 www.computershare.com L == - - PI General Information - - --- = == Company Name I Account Number == c --- !!!!!!!!"!! == Name(s) as they appear on account I '? 1-1 'f L L T. S ::J fV\ I) R TS K 0 \.I 'T e.- If more than one ~der is shown above. enter name of holder whose TIN is listed below I II Taxpayer Identification Enter your TIN for the abcve registeiW name am address in the appo~1E tax, For indMduals, this is your social security number (SSN). For other entities, it is your ell'lJbyer idenlificati::m number (EIN). Social Security Number Employer Identification Number I ? I) ~ b( I 0 I :zl OR I II Legal Entity Check one box only. ~ '"di."", D Corporation D Partnership D Other m Exemption or Notification of Backup Withholding Only check these boxes if they apply to you. D Check this box if you are exempt from backup withholding. For exempt institutions see reverse. Individual or joint ownership accounts are not exempt and should not check this box. D I have been notified by the IRS that I am currently subject to backup withholding as a result of a failure to report all interest and dividends on my tax return. II Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup Withholding because: (a) I am exempt from backup withholding. or (b) I have not been notified by the Internal Revenue SelVlce (IRS) that I am subject to backup withholding, or (c) the IRS has notified me that I am no longer subject to backup Withholding, and 3. I am a US person (including a U.S. resident alien). Note: Item 2 above is not applicable if I have marked the box in section D pertaining to notification of backup withholding. This form must be signed and dated for us to accept as proper certification. Si;)nature of U.S. Person. Please keep signature wtthin the box Date (mm/ddlyyyy) 10:2/).]/:<00JI I ~ J /7 J I Send form to Computershare. Do not send to the IRS. . 11UW9 + AFFIDAVIT OF DOMICILE Note: This Affidavit must be filled In and executed before a Notary Public fft ) )SS: COUNTY OF CJrv\.. ~-k'K-)A-4 P ~ ,Ii ,j STATE OF I j'Vl6.-f; S Ita I.//G- sworn, deposes and says that I reside at S- ~ Lf t Df (! f';; ( /) A J c City (VI (c 0 rt 1\ io h7State of fA; and acting as the Surviving Tenant, Executor, or Administrator for the Estate of (,.1 fl 'f'- (l (Yl, J l~ t' Deceased, who died in the State of f A on the 1-- ~~ day in the month of b II /IJ A"y yr :2 v-J~ " ~ being duly that at the time of his/her death the domicile (legal residence) was at, (V\ tC ~ ^"",I'C) tv) ;' >..2 '1 t:, Deel tl jJ f1v>--' City State of, f P, . : (If the decedent resided in another State within 3 years prior to his or her death, name the State where he or she previously resided ). That all debts, taxes and claims against the decedent's estate have been paid or provided for; that this Affidavit is made for the purposes of securing the transfer or delivery of property owned by the decedent at the time of hislher death to a purchaser or the person or persons legally entitled thereto under the laws of the decedent's domicile; and that any apparent inequality in the distribution has been satisfied or provided for out of other assets of the estate, The above statement can be disregarded if transfer is made to another executor, administrator, surviving joint tenant, or for the purpose of sale. Sworn to and subscribed before me -2-00(7 l:zu~r;;~ COMMONWEALTH OF PENNSYLVANIA Notarial Seal 'bI' [)esmOOCI L ThoffiPSOCl. Nolary Pu IC susqlJElhaM8. Twp., Dauphin COOnty M; CcmmlSSIon Expires Mar, 30, 2009 , Membp.f, Pennsylvaria Association 01 Notanes r~ tal ilanking Statement NC Ihuk PNCBANK For the period 01/13/2007 to 02/09/2007 Primary account number: 50-0398-0326 Page 1 of 3 Number of enclosures: 0 ....."'.- LYNN B MILLER TRT LYNN B MILLER TTEE URTAD 11-27-01 5246 DEERFIELD AVE MECHANICSBURG PA 17050-6841 lQ For 24-hour banking, and transaction or .h.2, interest rate information, sign on to 1!' PNC Bank Online Banking at pnc.com, For customer service call1-888-PNC-BANK between the hOllrs of 6 AM and Midnight ET. Para servicio en espanol, 1-866-HOLA-PNC Moving? Please contact us at 1-888-PNC-BANK ~ Write to: Customer Service PO Box 609 Pittsburgh PA 15230-9738 IQ Visit LIS at pne.com ~ ~ ~ TOO terminal: 1-800-531-1648 For hearing illlpain'd client.s only telationship Overview ank Deposit Accounts ,scription Account Number Ilcl'csl Chccking 'd,mll;l1l('c !\l()ncy 1\bl'kcl. ",..1 Deposits ~,()-()3\l8-0;J26 ~)()-(H02-] 899 Deposit Balance 25.31 1,209.44 1,234.75 our PNC Bank \'isa Chct:k Card orters t:onvenience and rewards. Use your card to set up automatit: hill payments \vithout st,lmps, checks. . trips to thc post ollice. Plus. with your cnrolled card, you'll eam Visa Extms Rewards Points, redeemable Jor exciting gins. It's free to set 1 at W\\'w.plH.;.(;om/payhy(;ard. 'remium Plan I1terest Checking Account Summary ;co lint number: 50-0398-0326 Lynn B Miller Trt Lynn B Miller TTEE URTAD 11-27-01 alance Summary Beginning balance Deposits and other additions Checks and other deductions ~:-).') I .00 .00 Ending t,alance 2:;31 Average monthly balance 2:;.31 Charges and fees .00 lterest Summary Annual Percentage Yield Earned (APYE) Number of days In interest period Average collected balance for APYE Interest Paid thi s period As of 02/09, a total of $.06 in interest was paid this year. 0.00% ~8 2:;.31 .00 ~M&rBank (ij 00 o 06109M NM 017 JAN.12-FEB.09,2007 1 OF 3 STATEMENT PERIOD PAGE 1 I 57569 LYNN B MILLER LIVING TRUST 5246 DEERFIElD AVE MECHANICSBURG PA 17050-6841 SELECTED.ACCOUNT SUMMARY ACCOUNT TYPE ACCOUNT NUMBER INTEREST EARNED YEAR-TO-DATE HATURITY DATE ENDING BALANCE RELATIONSHIP CHECKING WITH INTEREST M&T PREMIUM INTEREST 000000033394431 000000098128981 0.82 1.11 TOTAL DEPOSITS 4,583.33 8,892.88 13,476.21 LYNN B HILLER LIVING TRUST RELATIONSHIP CHECKING WITH INTEREST ACCOUNT NO. 33394431 HAMPDEN ACCOUNT SUMMARY BEGINNING DEPOSITS I- OTHER CURRENT ENDING BALANCE OTHER ADDITIONS . CHECKS PAID SUBTRACTIONS INTEREST PD BALANCE NO. I AHOUNT NO. I AttOUNT NO. I AttOUNT 3,508.59 21 2,771.85 71 1,099.92 7 1 597.46 0.27 4,583.33 POSTING DATE ACTIVITY DEPOSITSjINT.EREST & OTHER ADDITIONS CHECKS.& OTHER SUBTRACTIONS TRANSACTION DESCRIPTION 01-12-07 BEGINNING BALANCE 01-12-07 CHECK NUHBER 4446 01-16-07 CHECK NUMBER 4447 01-16-07 VERIZON ARC CHECK PY"T 000000000004448 01-16-07 THE PATRIOT-NEWS EZ PA717-255-8150 01-17-07 CHECK NUHBER 4449 01-22-07 CHECK NUHBER 4452 01-22-07 CHECK NUMBER 4451 01-25-07 PP ELEC BILL 02-01-07 US TREASURY 312 CIVIL SERV 02-02-07 US TREASURY 303 sac SEC 02-02-07 CHECK NUHBER 4453 '2-06-07 HILLIARD LYONS DEBIT 02-06-07 HETLIFE PAYMENT 02-06-07 AT&T Consumer CHECKPAYKT 000000000004454 VllO.23 \/'26.75 21. 50 . V 54 .80 :.r 400.50 [.._ 258.56 127.27 V 2,219.85 . 'c/552.00 v/Z01.02 ~_.300.00 ---_47.1 ',,/39.56, DAllY BALANCE $3,508.59 3,398.36 3,303.89 3,249.09 2,590.03 2,462.76 4,682.61 5,033.59 ~M&fBank STATEMENT PERIOD PAGE I I JAN.12-FEB.09,2007 2 OF 3 LYNN B MILLER LIVING TRUST POSTING DEPOSITS~INTEREST CHECKS &.OTHER DAILY DATE TRANSACTION DESCRIPTION & OTHER ADDITIoNs SUBTRACTIONS BALANCE 02-06-07 VERIZON ARC CHECK PYHT 000000000004456 35.28 / 4,611.65 02-07-07 CHECK NUHBER 4455 28.59.: 4,583.06 02-09-07 INTEREST PAYHENT 0.27 4,583.33 ENDING BALANCE $4,583.33 ACCOUNT ACTIVITY CHECKS PAID SUHHARY 4446 01-12-07 4451* 01-22-07 4455* 02- 07- 07 110.23 258.56 28.59 4447 01-16-07 4452 01-22-07 46.22 400.50 4449* 01-17-07 4453 02-02-07 54.80 201.02 ANNUAL PERCENTAGE YIELD EARNED 0.09 /. A $1,000 FOR YOUR THOUGHTS? VISIT AN H&T BANK BRANCH BETWEEN JANUARY 16 AND FEBRUARY 16 TO RECEIVE AN INVITATION TO PARTICIPATE IN OUR CUSTOHER SERVICE SATISFACTION SURVEY. COHPLETE THE SURVEY FOR A CHANCE TO WIN A GRAND PRIZE OF $1,000. NO PURCHASE OR TRANSACTION NECESSARY. FOR COHPLETE SWEEPSTAKES RULES VISIT: WWW.~AMnTBAMKSUP.VEY.COM. ACCOUNT I LYNN 8 HILLER LIVING TRUST M&T PREMIUM INTEREST TITLE .. ACCOUNT NO. 98128981 HAHPDEN BEGINNING DEPOSITS & OTHER CURRENT ENDING BALANCE OTHER ADDITIONS CHECKS PAID SUBTRACTIONS INTEREST PO BALANCE NO. I AHOUKT NO. I AHOUNT NO. I AttOUNT 8,225.96 11 666.25 01 0.00 o I 0.00 0.67 8,892.88 ACCOUNT SUMMARY ~M&rBank . ... ... ... . .. !. ... STATEHENT PERIOD PAGE JAN.12-FEB.09,2007 3 OF 3 LYNN B MILLER LIVING TRUST POSTING DEPOSITS,INTEREST CHECKS & OTHER DAILY DATE TRANSACTION DESCRIPTION & OTHER ADDITIONS SUBTRACTIONS BALANCE 01-12-07 BEGINNING BALANCE $8,225.96 02-01-07 DFAS-CLEVELAND RET NET 666.25 8,892.21 02-09-07 INTEREST PAYHENT 0.67 8,892.88 ENDING BALANCE $8,892.88 ACCOUNT ACTIVITY ANNUAL PERCENTAGE YIELD EARNED 0.10 /. ** END OF STATEHENT ** ~ .~ \~ INVOICE T DATE I ?'/U':;!.::UUI ' ! REMITTANCE ADVICE: IF ANY ERRORS ARE FOUND NOTIFY US AT ONCE. DETACH BEFORE DEPOSITING. U~:~~;;()NIU:~::er=[~Sll)t:N'l DEC::~::~NCE j,G~::S. 64 DISCOUNT I I I ! ! NET 4 -~-______L I i i I I I REMITTANCE TOT~1 I I i L.__ 5,766.64 I I I .00 ,5,766.64 ---~_____L_________ THE CHlJRCH OF G~lV~INC~7593 Xlll :". IIY"OVER STREET CARI.ISLE.!'.\ 17111.\ ~ I!IEriEj Insurance ~ Exchange ERIE INSURANCE EXCHANGE P.O. BOX 1699 ERIE, PA 16530 NAMED INSURED COPY CANCELLATION NOTICE @ POLICY NUMBER Q05 1500763 H POLICY EFFECTIVE DATE 05/15/06 PIONEER FAMILY AUTO POLICY CANCELLATION EFFECTIVE 02/02/07 12.01 AM Member . Ene Ins.urance Group 100 Eoe In!:, PI . Erie, PA 16530 --I MAIL DATE 03/05/07 BAL: $130.00 CR L STANDARD TIME NAMED INSURED ESTATE OF LYNN MILLER 5246 DEERFIELD AVE MECHANICSBURG PA 17050 AA7172 WE ARE NOTIFYING YOU THAT THE ABOVE POLICY IS CANCElLED AS OF THE CANCELLATION EFFECTIVE HOUR AND DATE SHOWN ABOVE. IF WE HAVE BEEN ASKED TO PROTECT OTHER INTERESTS, WE ARE REQUIRED TO ADVISE THEM OF THIS CANCEllATION. THE REASON FOR THIS ACTION : INSURED DECEASED ***FORMERLY - MILLER, LYNN PREVIOUS BALANCE UNUSED PREMIUM PRESENT BALANCE $.00 $130.00 CR $130.00 CR REFUND CHECK ENCLOSED 00072 AA7172 CONS CONSOLIDATED INS INC DECEASED FOhn ~1)(0"]O. 6 :....1....../. C!: f7~) 1040 Department of the Treasury - Internal Revenue Service U.S. Individual Income Tax Return 2006 eod In 20 Do not write or sta Ie in this s ace Label Use the IRS label. Otherwise, please print or type Presidential Election Campaign 1 Filing Status 2 Check only 3 one box. Exemptions Ifmore than four dependents, seepage19 Income Attach Form(s) W- 2 here. Also attach Forms W- 2G and 1099- R if tax was withheld. If you did not getaW- 2, see page 23. Enclose, but do notattach,any payment. Also, please use Form 1040- V. Adjusted Gross Income 99 IRS Use 001 OMB No. 1545- 0074 Your social security number 178-16-6948 LYNN B MILLER -DECEASED 2/2/2007 % PHYLLIS MARISKOVIC 5246 DEERFIELD AVENUE MECHANICSBURG, PA 17055 ... Spouse's social security number ... X Single Married filing jointly (even if only one had income) Married fllrng separately. Enter spouse's SSN above & full name below. ~ 5 H the qualifying person is a ch ild but not your depend enl, enter this child's name here" 6a X Yourself. If someone can claim you as a dependent, do not check box 6a b Souse c Dependents: __(1) First name Last name (2) Dependenfs social security numbe (3) Dependent's relationship to ou d Total number of exem tions claimed . 7 Wages, salaries, tips, etc. Attach Form(s) W- 2 __________________________________________ Forll-Ie earJan 1-0ec 31 2006 orothertax earbe mnm 8a Taxable interest Attach Schedule B ifrequired b Tax- exempt interest. Do notincludeon line 8a . 9a Ordinary dividends. Attach Schedule B ifrequired Qualified dividends (see page 23) Taxable refunds, credits, or offsets of state and local income taxes (see page 24) . Alimony received Business income or (loss). Attach Schedule C or C- EZ . Capital gain/(loss). Attach Sch D. If nol required check here Other gains or (losses). Attach Form 4797 . . . _ . . IRA distributions _ _ . 1158.1 I b Taxable amt Pensions and annuities. . f16J b Taxable amt Rental real estate, royalties, partnerships, S corporations, trusts, etc. Attach Schedule E Farm income or (loss). Attach Schedule F . Unemployment compensation . . _ ......... Social security benefits _ ~ 7 , 5 0 6 .1 b Taxable amt Other income. List type and amount (see page 29L_________________________________________ 8b b 10 11 12 13 14 15a 16a 17 18 19 20a 21 I 9b 397. ~'O 22 23 24 Add the amounts in the far ri ht column for lines 7 throu h 21_ This is our total income. Archer MSA deduction_ Attach Form 8853 23 Certain business expenses of reservists, performing artists, and fee- basis government officials. Attach Form 2106 or 2106- EZ 24 Health savings account deduction. Attach Form 8889 25 Moving expenses. Attach Form 3903 26 One- half of self- employment tax. Attach Schedule SE 27 Self- employed SEP, SIMPLE, and qualified plans 28 Self- employed health insurance deduction (see page 29) 29 Penalty on early withdrawal of savings. 30 Alimonypaid b Recipient'sSSN ~ 31a IRA deduction (seepage 31) 32 Student loan interest deduction (see page 33) 33 Jury duty pay you gave to your employer . 34 Domestic production activities deduction. Attach Form 8903 35 Add lines 23 through 31 a and 32 through 35 _ Subtract line 36 from line 22. This is our ad'usted ross income ~ 25 26 27 28 29 30 31a 32 33 34 35 36 37 ~ 36 37 KBA For Disclosure, Privacy Act, and Paperwork Reduction Act Notice, see page 80. 1 edid not live with you due to divorce orseparalion _ Depend ents on 6e not entered above - Ad d numb ers ~~~~n:s ... 1,177. 410. (1,726.) 40,765. 6,380. 47 006. 47 006. Form 1040 (2006) Form 1040 2006 Tax and Credits 40 · People who r checked any 41 boxon line 42 39a or 39b or who can be claimed as a dependent, see page 34 I · All others: I 1M arned f liln9 JOlnttyor ~'::lJalil YI:"lg I ~;e~~;:~iJ. J 1 household, l S7.550__~ Smgl~ or tv! arned f IlIog separa( ely, S5. t 50 Other Taxes Payments r. If you have a qualifying l child, attach Schedule EIC. Refund Direct deposit? See page 61 and fill in 74b, 74c, and 74d, or Form 8888 Amount You Owe Third Party Designee Sign Here Joint return? See page 17. Keep a copy for our records. 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 L 65 LYNN B MILLER 38 39a Amountfrom line37 (adjusted gross income). . . . Check {~ You were born before January2, 1942, if: 0 Spouse was born before January2, 1942, Total boxes checked .. 398 1 7 8 - 1 6 - 6 9 4 8 Pa e 2 38 47,006. 22,179. 24,827. 3,300. 21,527. 2,811. 2,811. tj B;ind: }' D Blind. b If your spouse itemizes on a separate return oryou were a dual- status alien, see pg 34 & check here .. 39b Itemized deductions (from Schedule A) or your standard deduction (see left margin) . Subtract line 40 from line 38 If line 38 is over $112,875, or you provided housing to a person displaced by Hurricane Katrina , see page 36. Otherwise, multiply $3,300 by the total number of exemptions claimed on line 6d Taxable income. Subtract line 42 from Iine41.lfline42 ismore than line41, enter- 0- Tax.Checkifanytaxisfrom: aD Form(s)8814 bD Form4972 . Alternative minimum tax (see page 39). Attach Form 6251 Add lines44 and 45 Foreign tax credit. Attach Form 1116 ifrequired . Credit for child and dependent care expenses. Attach Form 2441 Credit for the elderly or the disabled. Attach Schedule R . Education credits. Attach Form 8863 Retirement savings contributions credit. Attach Form 8880 Residential energy credits. Attach Form 5695 Child tax credit (see page42) AttachForm8901ifrequired . . . Creditsfrom:a 0 Form 8396 b 0 Form 8839 c 0 Form 8859 Other 0-' Form 0 Form 0 credit" a 3800 b 8801 C Form 47 48 49 50 51 52 53 54 55 ,c..dd lmes 47 through 55. These are your total credits Subtract line 56 from line46.lfline 56 ismore than line46 enter- 0- Self- employment tax. Attach Schedule SE Social security and Medicare tax on tip income not reported to employer. Attach Form 4137 . Additional lax on IRAs, other qualified retirement plans, elc. Attach Form 5329 ifrequired Advance earned income credit payments from Form(s) W- 2, box 9 Household employment taxes. Attach Schedule H Add lines57throu h62. This is our total tax . Fed eral income tax withheld from Forms W- 2 and 1099 . 2006 estimated tax payments and amount applied from 2005 return Earned income credit (EIC) Nontaxable combat pay election .. 66b Excess social security and tier 1 RRTA tax withheld (see page 60) Additional child tax credit. Attach Form 8812 64 65 66a Amount paid with request for extension to file[jee page 60) . Payments 0- bD - from. a I r-orm 2439 Form413tl C Form 8885 67 68 69 70 71 ~ .. 56 57 58 59 60 61 62 63 2,811. Cred II f Of f ederallelephone excise tax paid. Attach Form 8913 if required Addlns64 65 66<~ &67throu h71.Theseare ourtolal a ments 2,811. . .. 5,886. 66a b 67 68 69 70 71 72 73 74a .. b ~ d 75 Amountofline 73 lied to our 2007 estimated tax" 75 76 Amount you owe, Subtractline 72 from line 63. For details on how to pay, see page 62 77 Estimated tax enalt see a e 62 77 Do you want to allow another person to discuss this return with the IRS (see page 63)? Yes. Complete the following. No Designee's name Phone no. PersonallD number .. HR BLOCK .. (717) 509 -7 87 6 (PIN)" 13 6 518 Under penalties of perJury. I declare that I have exa~ined thiS return and accompanying s~hedules and statements, and to the best of my knowledge and belief. they are lrl,le, correct, and complete. Declaration 01 preparer (other than taxpayer)Js based on aU Information of whtch preparer has any knowledge ~ Your signature Date Your occupation Daytime phone number RETIRED Spouse's signature. If ajoint return, both must sign. Date Spouse's occupation o 5,916. 3,105, 3,105. Paid Preparer's Use Only Prep arer' s ... signature r Firm'sname(or ~H AND R BLOCK yours tf self- employed), "rlrlrp<:.<; "nrl7IP",nrlp CAMP HILL, PA Preparer's SSN or PTIN POOI03698 I EIN 43 -1862224 Phone no. (717) 761- 5 6Q~ st Send Inquires to: 5000 Louise Drive PO Box 40 Mechanlcsburg, PA 17055 www.members1st.org Statement of Accounts , Dec 25, 2006 thru Mar 24 I 2007 Main Switchboard: (717) 697-1161 or (800) 283-2328 EZ Call: (717) 697-4372 or (800) 283-4372 TOO: (717) 697-5312 or (800) 283-2328 ex!. 5312 TeleBranch: (717) 795-6049 or (800) 237-7288 Account Number: MEMBERS 1st FEDERAL CREDIT UNION Account Balances at a Checking: Savings: Certificates: Loans: Money Management: MILLER LIVING TRUST c/o PHYLLIS J MARISKOVIC 5246 DEERFIELD AVE MECHANICSBURG PA 17050-7236 48441 Glance: 0.00 0.00 0.00 0.00 0.00 Page: 1 of 2 Are you interested in learning more about Identity Theft, Home Buying, Investing for Retirement or Financial Aid? Visit our web site at www.members1st.org or ask an associate for more details about these FREE seminars. SAVINGS ACCOUNTS 00 - REGULAR SAVINGS Date Transaction Description Additions Subtractions Dec 25 Balance Forward Dec 31 Deposit Dividend 1 . 000% 2. 18 Annual Percentage Yield Earned 1. 000% from 12/01/2006 through 12/31/2006 Jan 02 Deposit by Check 100. 00 Jan 31 Deposit Dividend 1.000% 2.27 Annual Percentage Yield Earned 1. 010% from 01/01/2007 through 01/31/2007 Feb 20 Deposit Transfer From Share 40 8,790.44 Feb 20 Deposit Dividend 1 . 39 Annual Percentage Yield Earned 1. 000% from 02/01/2007 through 02/19/2007 Feb 20 Withdrawal 11,467. 90- REGULAR SA VINGS Closed ***This is the final statement presenting information on this product*** *** Please retain this final statement for tax reporting purposes *** Balance 2,571 . 62 2,573. 80 11,466.51 11,467 . 90 0.00 CERTIFICATE ACCOUNTS 40 - 48 MO BUMP. UP CERT Date Transaction Description Additions Dec 25 Balance Forward Dec31 Deposit Dividend 4. 510% 33.34 Annual Percentage Yield Earned 4.600% from 12/01/2006 through 12/31/2006 Jan 31 Deposit Dividend 4. 510% 33.46 Annual Percentage Yield Earned 4.600% from 01/01/2007 through 01/31/2007 Feb 20 Deposit Dividend 20. 59 Annual Percentage Yield Earned 4.610% from 02/01/2007 through 02/19/2007 Feb 20 Withdrawal Transfer To Share 00 48 MO BUMP. UP CERT Closed ***This is the final statement presenting information on this product*** *** Please retain this final statement for tax reporting purposes *** Subtractions Balance 8,703.05 8,736.39 ~9.85:) 8,790.44 8,790.44- 0.00 - - - Continued on following page - -. .. Ii Treasury: Retail Securities Federal Reserve Bank of Cleveland Pittsburgh Branch Fiscal Agent of the United States P.O. Box 299 Pittsburgh, PA 15230-0299 1-800-245-2804 March 7, 2007 MS PHYLLIS MARISKOVIC 5246 DEERFIELD AVE MECHANICSBURG P A 17050 Dear Ms. Mariskovic: Case Reference Number: 725457 - MILLER TR Thank you for your recent savings bond transaction request. Your request is not within the Federal Reserve Bank's authority to process. Your transaction has been forwarded to the Bureau of the Public Debt in Parkersburg, West Virginia. Please allow sufficient time from the date of this letter for processing. If additional information is needed to complete your transaction, a Public Debt representative will contact you. If you have a question about your request once sufficient time has passed, you may call 304-480-7711 for an update. Sincerely, '}v~~Vt.d~ Jerry Vrabel TRS Bond Examiner Federal Reserve Bank of Cleveland / For information about Treasury Retail Securities, go to: .. , ~ M&fBank 5528 Carlisle Pike, Mechanicsburg, PA 17050 7177660507 FAX7177661793 Treasury Retail Securities Site PO Box 299 Pittsburgh,Pa 15230-0299 Dear Sir: Please redeem the following Series EE bonds (R183133562 through R183133566) belonging to Lynn B Miller Living Trust. The social security number is 178166948. Please send the proceeds to Phyllis Mariskovic, successor trustee, at 5246 Deerfield Avenue, Mechanicsburg, Pa 17050. I have enclosed a copy of the trust agreement and the death certificate. Thank you. Yours, 11. ~(li;UWLJ . ?/ifJ ~,,#, -, ~ \YOifJ1l~C/ Margie H Fealtman Banking Officer/Select Banker OJ ~ MetLife MaTch 02.2007 Dane Rasmus 7177371354 Annuitanr. Lynn B. Miller Account: 9399280 Marketing Program: NQual Dear Ms Rasmus: Plea'ic accept our condolences on the receut loss ofLynn B. Miller. /i,JetLlfe Insurance Company a/Connecticut is committed to assisting you in the processing of this claim as promptly as possible. Our records indicate that the de.'lth benefits from the above-referenced annuity account is payable to the beneticiaI)', Phyllis Mariskovic. As )'ou begin the claim process, please review the Annuity Claim Submission Requirements FornI and Settlement Options available to the beneficiary. Beneficiaries are urged to consult with their Registered Representative to review these options as the Death Benefit value may differ su bstantially from the current contract value. After carefully reviewing the options, the beneficiary should complete and return the enclosed Annuity Claim Form along with a certified copy of the death certificate. A self-addressed envelope is enclosed for your convenience. Please be advised that the funds in the annuity contract will remain invested in accordance with the directions on file at the time of death until the ammity is valued according to the contract provisions. In the case of variable funds. these monies may be subject to stock market fluctuations. We realize that this is a very difficult time to make important financial decisions. Beneficiaries should consult with their tax andlor legal ad\isor before making any decisions on how to receive the proceeds of this contract. If you should have any questions, please call Annuity Benefit Services at 1-800-842-5642, r-,.fonday through Friday, 8:00am to 5:00pm, Eastern Time. Sincerely, j) ! f) i/ ftL- t/ ~- j) 3/ (; 5"'5". 0 tj ) Service Consultant MetLife Insurance Company of Connecticut Mtn:L1.Ie ~/LILvvr r:oo:ov AM i-'AUl'. Z I \)Vb Mt::n::L1.Itl Beneficiary Name Last Addltr.s 0fBcncficiory (Street, A IN.)) Z- ~ ~t!;r..cl'(. Relationship to Deceased .:;;~.h~/ U.5. Cilia" ~y ON An ,- l.-S1v.-r Con U1lCI Nu mber q~ ?-~O Name ofDeceastrl L.- Fiest Middle Last . (\"}: l\e r M~~~(p (::~;l'7~ \J Av~ Dale ofDcatl; (Mc.DaylY,) 2--2--01 ~t~:heL~ t'l-s.bL4 Date ofBitth (MC>'Vay/Y ri r b - 16 ~"Z..3 '"fA- lio)O Plelfie Check One: o Asll1lme the Acc:ount/Spwsal Contlnuation (Spousal Option Only - Not available for 401(k) or TSA/Tl Plans) Prllltaryl ,'Ve><' &ufirilrry DesiglUllion: Name SSI Relationship Contingent If additlanal space is needed, please attach separate sheet. ( PriJIJary) o Transfer the Contract Proceeds to a Similar Contract (Spousal Option only tor IRAs and Tax Sheltered Annuitics) Accolt'lt Mmcb..r: "'For TrfIlISjers to '''fOliar compaNY, II Leuu of Acct:pllVlCt: or Tf'tlIfSjU .-tsrtltori;;JUiotl ",ustbe prtnfUJd by~ rer:eivillgcoNfpax.', o Receive It PerimJic Incomel.<\.nnuitization (Minimum ofS2.000) o Inherited Account'Stretcb-Out Deatb Benefit (Non. spousal Option) - Please WiCIlle _ HMfit:ilZr, desiglUUiolt ubow! Ji(Take A Lump Sum Setttemeot" (See witllholding section belo..-} -l~o wiD be withheld ifno tax election is selected Date 0;;11;/#7 '$ 1~ *L19073* Order If L-I9073 I of 4; Rev. 1-06 Myers ~o~~~:':~~,s~~,~e, Inc.@ 37 East Main Street Mechanicsburg, Pennsylvania 17055 (7] 7) 766-3421 Fax (717) 795-7291 -- A standard of excellence in Central Pennsylvania since 1910 Monday, February 19, 2007 Mrs. Phyllis J. Mariskovic 5246 Deerfield Avenue Mechanicsburg, Pa. 17050 Dear Mrs. Mariskovic, Thank you for selecting our funeral home to provide services for your family during your bereavement. I hope that you found our services to be of the highest standards and that they met your needs and those of your family and friends. The following is a summary of the service charges as previously explained and provided in written form on the services for: Lvnn B. Miller $9,950.00 1,595.00 O~O I $8.355.0~ _ (I b- ..ti I f I - .e;.) 2/21 ft.? .___~_'!:..':'i~. (. J -;. AI.. .;J t{l{c,6 - v,.,',f/tJ 7 P ~ 55'S. dO ~ Interest at the rate of 1.5 % per month ( 18 % per annum) will be added to balance after 30 days. If there are any questions or concerns that remain unanswered, please call me. SUMMARY OF EXPENSES TOTAL OF SERVICE RENDERED LESS: Credits granted LESS: Total Payments CURRENT BALANCE Credits Granted: $1,595.0 Package Price Discount Sincerely, /Jy/~ /7/ /,1 j/L:-/?- /J- pt-~ f':;-U /U :t-}(tll..-,,' RED LOBSTER 4711 CARLISLE PI~E MECHANICSBURG, PA 17055 717--163-1760 2007 0195 IME MARISKOVIC/PHYLLIS lHH ** H JHHHH 794 0 040'127 ABBY S 3202 ITH CODE RVER IECK MOUNT $453_65 $64,55 HARGE TIP OTAL CHARGE $518.20 TIP $--~~-d $-~J-t[?~ DD'L INAL TOTAL I Agree to abuve total a~ount as per card issuer a9ree~ent L1 T6 '1:49 PM Please leave a signed coP~ for ~our server. ~"JHP PASfA-LR -r:;1"O SHI1 TRfo-OP I~ED LOBSTER { 2007 4:46 PM 01% 1 62 60018 r ABBY::; lie. ABBY S k . J?02 Ie . '16 STOHED ORDER Gues t No. 1 IIIENtillNG DRAFT 2.99 l::j 'JZ ifRLOT FET7ER-GL 5_50 1DMIRnL'S-OP 16.75 :-SNW eRB lEGS-SR 7.99 -R SI'O PLATTER-oP 12.25 lei; TF:A ~(" I uP INK ,OF T OR INK SOil DRINK SOFT DRINK 3fJF I DRINK SUFT DRINK JCll) fEA fCE:D TEA ::OFFf::E ::OF FEE ICED H:R ))F r DRINi\ > 00 COMBO LeYo-sePI 7 leYO-BROIL SCALLOP lOB BISQUE-B 1. 99 1.99 1. 99 1.99 1.99 1 _ 99 1. 99 1. '99 1,99 1 79 1.79 1. 99 i _ 99 8 99 7 25 :,In SFO pun -Of' .,.FR CHX FING-FB 13.75 5.29 HNYBBQ SHR CKN-LR fmVBBQ SHR CKN-LR 15.50 15.50 GR JUMBO SHRZ-LR 13.99 LOBSIR ROLL AP-SR LOB P j ZZI~.-lhR :iBRKEO TRro X-IJEG OF DAY 7.50 9.25 1.99 1.99 2 99 YI..IF "hi 1 NG mlAFT 1 r; 02. I C[ Cf\[OM UIOCOl ,HE ~JFII/[ -SR uAN BEAN CHlCK-SR 1I0T TEA COFFEE [or' FEE tlR(1[L SFD PI_AT-OP GR CHICKEN-lR L APPL/WALNUT-LR Wi lEY WATER l.JAr ER NY :.;TI\If'110Z LR 1. 99 5 50 5.25 1. 79 1. 79 1.79 13.75 10.99 (5.75 1 G. 7:, 1 Z -(S 17 50 ~AIER JATER JA rER [eu) rEfl ;Fr1SD SHE I R EO-UP 'II[) SHR LING-LR )~1BO '~HR en :-OF T DR INK !ATER CED H A ;OHEF :OfTEE . fR SHRIHP-'SR . SHRIMP PASTA-SR tlWIl SFD PLAT --up OB PUZA-LP 1 .99 17 50 14 99 7 75 1 .99 1 .99 1 .79 1 .79 7 99 8 -?5 13 75 ') 25 1 .79 5 50 5 50 5.25 5.50 5.50 5.50 1.79 2.99 :UF!LF !RNANA FQSTER-SR ;~iNANA f OS TER-SR 'AN BEAN f;fiZCK-SR :HOCOLAT[ WAvE-SR JIOCOL A IE WFiVE-SR JIOCIJLAIF ~JAVE-SR :orTfL UHJGL INE Of~flrT 18 0., Giles I N,). 2 U~ NGI. ] NG DRnFl 1 (j ,Jl f:RLOl FFTZLRGl 'HUn fETZI:.R'-GL 'AlLEYS COFFEE IllER GEN DRAFT EPlOT FETZER-GL 2.99 5.50 5 50 5 50 2.99 5 50 t.ES "TAX 23.28 % t, r- a + '.J it. "'" 6 4 , 5 5 NE IN 518.20 -t U' MODIFT-T.-~ - i::-"tr5 39 -ul 16:24:53 19 FEB 2007 Receipt # 11M-1579-34 AAA CENTRAL PENN SUNDRY RECEIPT Reference # Issued Club# Member# 195-0889577 717-761-1731 Description Product 714750 19 FEB 07 04:24pm PHYLLIS J MARISKOVIC 5246 DEERFIELD AVE MECHANICSBURG, PA 17055-6841 passenger GNN1425 TEMP TAGS - PASSENGER PLATES (TEMPTAGS) MEMBER FEES (MEM) 1 @ 1 @ 0J 10.00 10.00 Payment Due VI Payment Teller Amount --~"'" MG11 Domestic 10.00 10.00 20.00 20.00 {)-f ,t;V -1~F .,.jA ~rv 'DllrI1l6111(; "A~ ~ 5775 Allentown Blvd, Suite 101 Harrisburg, PA 17112 Phone: 717-810-1950 Fax: 717-810-1952 March 5, 2007 ~tif it Of, J- f tJ JItJ-({)7 "2"277 f(, 1 '" "7'/ cft'/..,. 7,1" ~ ~v 'f-",) 7 r ' ,n.tJp-Jr yvll I!-- p LYNN MILLER PHYLLIS MARISKOVIC 5246 DEERFIELD AVE MECHANICSBURG PA 17055 RE: L YNNMILLER (CHURCH OF GOD) Account #: 100034913 According to our records, you are the designated responsible party for the above named patient. Therefore, this letter serves as your notice of the unpaid pharmacy ba~nd payable for Lynn Miller. This statement indicates a total balance due Of~ Please contact me toll free at 877-372-2279 extension 318 to provide me with the details for the estate of Lynn Miller or if applicable, provide me with any contact information for the attorney who may be involved with the resolution of the final affairs for Lynn Miller. If you are unable to contact me by telephone, please write a note at the bottom of this letter and send it to my attention in the enclosed envelope. Thank you for your prompt attention to this matter. Ke dra Shirey Internal Credit and Coli 'J; H 4&7 ct~ '7/(; 9 i set. ,rV- r' V 'J{oqlo1 / LUJ : 1t{ ''fl.. . ~ IJ'vV- r 'I. 1 ",v , / () 'J "1 S { . / U' (VU /' II ;;, L- . '-/ \ l- I 't e e ---"" " CONTINUING CARE RX #001 28 S 2ND ST /PO BOX 355 NEWPORT PA 17074 * * S TAT E MEN T * * Statement Date: 1/31/07 Page: 2 Account #: 100034913 COG LYNN MILLER PHYLLIS MARISKOVIC 5246 DEERFIELD AVE MECHANICSBURG, PA 17055 ~L{5r tJ;rl?/~ 7 If you have any questions regarding your bill please call (717) 567-2147 or (800) 675-2279. Thank you!! Date 1/16/07 1/19/07 1/22/07 1/24/07 1/24/07 1/06/07 Description Qty Amount -------------------------------------------- ---------- RF 4255733 ELASTO-GEL 4X4 WOUND DRSG 1 21. 32 RX# 4307891 HYDROCODONE/APAP 5/500 TA 60 3.00 COPAY RX# 4313504 AVELOX 400MG TAB 7 9.00 COPAY RX# 4319018 ARGINAID(RESOURCE) ORANGE 1 89.66 RX# 4319022 XENADERM OINT 60GM 1 9.00 COPAY RF 4245650 FLOVENT HFA AER 220MCG 1 9.00 COPAY Ending balance - Pay this amount ---------> Current Past Due 31-60 days Past Due 61-90 days 197.80 203.44 ANY QUESTIONS CALL MIRANDA @ EXT 1443 .00 6) Past Due 90+ days .00 Statement date: 1/31/07 CONTINUING CARE RX #001 28 S 2ND ST /PO BOX 355 NEWPORT PA 17074 Name: LYNN MILLER PHYLLIS MARISKOVIC 5246 DEERFIELD AVE MF.rH~NTr~RTm~ p~ 17n~~ Account #: 100034913 COG (Comcast~ ,--" ,.----, V;s;t us on the web at www.comcast.com @ ACCOUNT NUMBER DATE DUE 09547 197693-01-8 03/07/07 LYNN B. MILLER How to reach us... It - f How to reach us: ..:CJ-' t;4 .s. 4830 Carlisle Pike, Suite 0-14 0 _ / ..;., Mechanicsburg, Pa 17055 ?J I b'f'tJ ~ (717)540-8900 Telephone Customer Service 24 hours a day. seven days a week "-' For service at: 5246 DEERFIELD AVE MECHANICSBURG PA 17050.6841 Summary of Charges Statement Prepared 02/07/07 Billed from 02/24/07 to 03/23/07 Erf?viol,Js Balance ____.__._._. __. _ . __.. -____,_________._4~.:~Q. _,.. E<:!1'.rTlfmts, Q.nclude~pa}'ments rec~,{eQ l:>yO~<!7'{0.!1_,_____________~_9 .65 cr_ 9_a!>lejYideo l ?ervice::; ., ..... __________________________'E..OO __ TCixes, Surcharges. & Fees ________... __ u_. __, gc?2.____. Total Due $49,65 Detail of Charges on back News from Comeas' , "--' The Federal Communications C':lmmission Public Inspection File for this system is maintained at 4601 Smith Street. Harrisburg, Pa 17109. Thank you for your prompt payment. For your convenience, we now accept regular and automatic monthly credit card payments and direct debit, '1I1Q Customer Account Information For Service To: Lynn B Miller 5246 Deerfield Ave Account Number: 24-0657541-1 Premise Number: 24-0388467 Billing Period & Meter Information Billing Date: Jan 31,2007 lIing Period: Dee 28 to Jan 26 (29 days) ,..ext reading on/about: Feb 26, 2007 Rate Type: Residential Meter readings in current billing period: Meter Number N044157936 is a 5/B-inch meter. Present-actual 441000 Last-estimate 438600 Gallons used 2400 Water Usage Comparison Monthly usage in hundred gallons. 1:>5 52 J FMAMJJASONDJ aeapauuuecoea nbrrynl gpt vcn Billing Summary #- L-ILI5 7 dl/-v)tf/ ----Prior Balance------------- €fJ Balance from last biff Payments prior to Jan 31, 2007. Thanks! Total prior balance, Jan 31, 2007 -----Current Water Charges---- Service Charge Water Volume ($.005735 x 2,400) STAS PAWC Water -0.44% DSI- PAWC Charge 5.00% Total water charges, Jan 31,2007 -----Other Current Charges---- H2O-Help To Others Customer Protection Sewer Une Customer Protection Water Une Total other charges, Jan 31,2007 $46.22 -46.22 .00 11.50 13.76 - .11 1.26 26.41 1.00 9.00 5.00 15.00 --AMOUNT DUE --------- f~ / 2 o o 7 Messages to you from Pennsylvania American Water Any portion of the water charges which is not paid as of 2/26/07 will be subject to a 1.50% penalty. . Customers may use their credit card, debit card or pay by electronic check only by calling toll free: 1-866-271-5522. Customers may also pay on-line at www.water.paymybill.com. A service fee will apply. . Approximately 4.72 percent or $1.24, of State taxes are included in your current bill. . Effective January 1, 2007, the Distribution System Improvement Charge (DSIC) has increased from 4.92% to 5%. This charge funds the replacement of water distribution facilities. . Effective January 1,2007, the State Tax Adjustment Surcharge (STAS) decreased from -0.33% to -0.44%. . Effective August 14, 2006, the State Tax Adjustment Surcharge (STA$) decreased from -0.29% to -0.33%. The reading used for this bilt corrects previous estimate reading. 0021901002190 87ER TAVOl 12 Jstomer Service & Emergencies 1-800-565-7292 (24 Hours) For Hearing Impaired Customers TOO 1-800-300-6202 (24 Hours) Visit us on the INTERNET: www.pawc.com RA W100AMW31I A1M 8575 G tf.:.l Quulity.5ele<:tio.... Sc>>vings. Eye..y Day. Visit us on the Internet www.GiantFoodStores.co~ HH goal is to ensure your satisfaction every ti~e HOU shop with us. If there Ie anything more I can do to i~prove your experience please call or write. Dave Rudy, Store Manager Giant Food Store #5 6560 Carlisle Pike Mechanicsbur~, PA 17050 Store Telephone: Phar~acH Telephone: (717) 7%-6555 (717) 796-044" 03/01/07 4:50PM 11If;Ni<- I/o" C If ~ /) J "f- -'.."7/ 1f,t1l5 '1?J 6 I?" /'11 A-Il- ~ P .- .1 @ 7. 8U POSTF1GI S rHW'; r A;': f'n III u**TOTAL CASH CHANGE UP 31 ~.() N .00 31 .20 40.00 8.80 TOT A L IJ U l'i; r H D FIT[ M S SOL lJ 0 0 3/01/n7 ~51 PM 0005 31 0040 3312 :-i--( _~.~ *' *1l n***f-*;.: f.1f **** 1.* ** *********~,*** S top b:, t h'2 [; II ~ t <) '" (. " s (? ,. V lee Des k to 51gn UP 1'0f' ~.IU'Jr O~ln F!DNUSCARD **~*~********~*i.*'******~'**'*****f.*** I'~ glad ~ou shopped here today. Your Cash1er -- JUDI QUALITY. SELECTION. SAVINGS. EVERY DAY. OPEN 24 HOURS EVERY DAY (/59' o () w CJ <( 2 0: 0", ~(') .... 0'" 1-6 o~ 0:. ~2 ~~ LLLL ~-~ 0- o:u.. ou.. (/)0 wYl zO: -0 WI- 0:0 <(W (/)j Wo Xo ~~ !:'::l- (') ~ 8 ~~~~ C\.I 1iir-i";rlo .......... 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C;'" Z g ::> o :E ~ g f'- o CJ) o 01 '<t N 8 o r---wfH cry:g~o ~o,w w 8c;~ 2 o~Ooa: g OcO..JN<( 32 T- ..- W ~ lL -- -oJ OOU:: W ~<( z~a: a. -t=- o "w OW!!!Z wow(/}::r:.cW mZOWO~~O w a. <0 0: 0 I- .- (j) w<(~OOO:gW <( 2 If) <( CL.J a: 0: u CIl W o @ e H&R B10cK CAPn ~L crr''' ~ALL CAMP HILL, PA 1ffice: 36643 (717)161-5602 lrofess1ona1: ~130196 FRANCES DREES :1ient: LYNN ~lLLER iax Preparation 222.00 )eace of mind 29.00 lota1 251.00 Check ~4463 1endered 251.00 Change Due 0.00 EroP 10yee No. 442161 1hank You for choosing ,H&R t\1ocK for your tax services. .' 3/12/2007 3:32:07 P~ 6149063 MI:~A\::iI::S I:;....LAINI:U T Ijt:LUW ~.mI. Service Description Cpt Ox IB!ImI Payment Adjust ~ ~ *** ANY OUESTIONS REGARDING YOUR BILL PLEASE CALL (717) 731-8315 *** *********~************************************************************************* Insurance Charges pending to Prv: 40.00 Ins Pay/Adj against Ins pending 9.14 -30.86 0.00 11/01/06 1 11/30/06 11/30/06 10 F ELECTROCARDIOGRAPHIC MONI 93230 427.1 Medicare Payment Accept Assign Adj. 300.00 128.77 -139.04 32.19* (!J 03\I.d67 ; b\ 1./& ~ F-Your ins did not pay us so it has become your responsibility to pay us. ,KE lEeK Y ABLE TO: 'ATE LAST PAID AMOUNT 00/00/00 0.00 MOFFITT HEART & VASCULAR GROUP 1000 NORTH FRONT STREET WORMLEYSBURG, PA 17043 32.19* PAT# I-LYNN B MILLER PRV# lO-LINE, DENNIS E, MD, FACC Ph: (717)-731-8315 Acctlt: 20669 Date: 03/09/07 Page 1 of 1 PPL Electric Utilities ~lectric Service For: LYNN B MILLER 5246 DEERFIELD AVE MECHANICSBURG PA 17050 Final Bill IJPL Electric Utilities Customer Service 827 Hausman Rd. Allentown, P A 18104-9392 1-800-342-5775 (1-800-DL\L-PPL) www.pplelectric.com , ' , , \ . 1 ' "":.~I::.~.;: ' pp J~~: " ru Page 3 "" :::::::::::)'j'!~~ilJ:~t~::::;::::::::": Tota/from Last Bill Payment Received F'eb 22 - Thank You! Billing Details Balance as of Mar 20, 2007 ':::::::::::U5i:i:~:i"; '".": $ 0.00 Current Charges Char~es for - PPL ELECTRIC UTILITIES Resiclential Rate: R..'i for Jan 4 - Feb 1 Distribution Charge: Customer Charge 200 KWH at 2.18300000t per KWH 600 KWH at 1.97500000~ per KWH 1,043 KWH at 1.8550oo00~ per KWH P A Tax AdiSurcharge at -0.04900000% Tmnsmission Charge: 1,843 KWH at 0-:5680oo00~ per KWH PA Tax Adj Surcharge at 0.12600000% Transition Chan!e: 200 KWH at1.33800000t per KWH 600 KWH at 1.186000oo~ per KWH 1,043 KWH at 1.09500000~ per KWH PA Tax Adj Smcharge at 0.12600000% Generation Cfiarge: Capacity and Enerm' 200 KWH at 5.72800000jt per KWH 600 KWH at 5.0340000016 per KWH 1,043 KWH at 4.61800000~ per KWH P A Tax Adj Surcharge at 0.12600000% Total PPL ELECTRIC UTILITIES Charges Budget Plan as of Last Bill Other Charges for PPL Electric Utilities qperation HELP Donation BUdget Bill Settlement Total of Other Charges 7.96 4.37 11.85 19.35 -0.02 10.47 0.01 2.68 7.12 11.42 0.02 11.46 3020 48.17 0.11 1.00 3.27 $ 165.17 $ 94.77 $4.27 Account Balance $ 264.21 I""'-~..... .n._....1 Postage $ Certified Foe r'I 0 Return Receipt Fee 0 (Endorsement Required) 0 Restricted Delivery Fee 0 (Endorsement Required) ..ll l"'- Total Postage I> Fees $ ru ..ll 0 D l"'- " '0 e Mechanicsburg Main Post Office MECHANICSBURG, Pennsylvania 170553459 4134870055 -0096 03/22/2007 (800)275-8777 04:25:50 PM Sales Receipt Sale Unit Qty Price Final Price Product Description BOYERS PA 16017 First-Class 4.70 oz. Return Rcpt (Green Card) Certified Label #: $1. 35 $1.85 $2.40 70062760000128266427 -------- -------- Issue PVI: $5.60 $7.80 $7.80 Lib/Flag Bk Total: Paid by: Cash Change Due: 1 $7.80 $13.40 $20.00 -$6.60 Order stamps at USPS.com/shop or call 1-800-Stamp24. Go to USPS.com/clicknship to print shipping labels with postage. For other information call 1-800-ASK-USPS. Rill#: 1000401505424 9rk: 18 All sales final on stamps and postage. Refunds for guaranteed services only. Thank you for your business. Customer C.opy , ---- PPL Electric Utilities ~Iectric Service For: LYNN B MILLER 5246 DEERFIELD AVE MECHANICSBURG PA 17050 .Final Bill Questiolls about this bill? Please contact us by Apr 4 at 1-800-342-5775 (1-800-DIAL-PPL) or write to: Customer Service 827 Hausman Rd. Allentown, P A 18104-9392 Vv-ww.pplelectric.com , ' , \ \' I 1 '~~:.~I~:.~*:> pp J~~~ " "\;I Page 1 ::::::X~:~ill::A~~'N~:::::::~::::::: 51240-84005 Summary Page Balance as of Mar 20, 2007 Char~s: TotafPPL ELECTRlC UTILITIES Charges Total Charges $ 0.00 $ 264.21 $ 264.21 dvdP f1 q ~{; 31 '}- 3/ &1/ Electric Use is graph shows . .If electric use 'over the last 13 months. Types of Meter Readings: Actual _ Estimated I'!,Y:I Customer D 90 KWH - Average Per Day 75 r-----.~--+. ------ -~----_. -" ++--- - I-- ,,--- 60 45 30 15 o FMAMJJASONDJF 2006 Months 2007 Meter ReadiDg IDformation \,!eter Feb 1 Ian 4 28 Davs 63161 61318 1m 2007 34F 66 Actual Actual KWH Billed Average - Jt'eb T ~!JY>erature KWH Per Day Yearly Use: Mar 2005 - Fcb 2006 Mar 2006 - Fcb 2007 2006 38F 64 Total Averl!ge Use Monthly 16242 1354 17609 1467 Other important information on back -+ . -'" @ ~~~')"''''~'~~!f~II!TI~,11~'n.~l!I'!iII1r'''''' "-"",, ',,,. ....,..""... ;'1J[!,'\\tI!!iJilJ'i~. ..,.,,',..'" ,., ",,- C,," , . ' Billing D Jte: 03/25/D7 Gage 9 of 10 Telephc.!,e Numbe' 717 7131-1731 Account \jumber: i 17 76! - 1731 529 02Y veri;m11 ~er;70nwireless We never stop working for you~ NEED-TO-KNOW INFORMATION California - Questions ^bout Your Bill? Call Customer Service at 1-877-214-4572. Send written disputes to Verizon Wireless, Customer Service, P.O. Box 96082, Bellevue, \V \ 98009. If you are disputing a charge because you contend it was n, . authorized, and we need time to investigate the complaint, you are at required to pay the disputed amount while our investigation is pendinl;-' If you have a complaint you cannot resolve with us, Wri1l the Cahfornia Public Utilities Commission at Consumer ^fTairs Br:nch, 505 Van Ness ^ve., San l~rancisco, C^ 94102, or at www.CpUC,lgOV, or call 1-800-649-7570 or TTS 1-800-229-6846. ;\lew Mexico Call Customer Service at 1- 877-214-4572 or by dialing >1<611 from our wireless phone. If you are unable to resolve any service problem Ol billing dispute with Verizon Wireless, you may contact the New 1\1 X.ICO public Regulation Commission's Consumer Relations Division at 1-800-663-9782 for assistance. i.Tiene prcguntas sobre su factura? Llame a Servicio al Cliente al 1-877-214-4572 0 marque +611 desde su telCfono inalambrico. Si n puedc resolver su problema de servicio 0 su disputa con Verizon Wireless, pucde contactar a la Division de Relaciones del COnSUnl1!or de la Comision de Regulacibn Publica de Nuevo Mexico, al 1- 800- 663- 9782 para asistencia. Ve/'l2( II WircIes,\ inquir,:; coil /877 2/4-4572 Billing for ES B I OWlr.:m&nrar.: The following charges appear on your Verizon bill as a service to your billing questions to the phone number on the right. [....-..-.....-'-..-----.-.----......---...--...--.....-....--....------'...' L. 13i~lmfii~~...9~e~1~;~t~~~~tr~~~29it~~.2.tt MISCELLANEOlJS CHARGES AND CREDITS SBI. D1n~ct Chargcs and Crcdits for 7 t 7 761- t 731 1 Fel> 1 j-josp Tel Chg 2~- OJ Total $ 2S,411t For questions concerning your bill, call the number listed at the ;,p ofthi~ secti::n. The calls on this page were forwarded by ESBI, the clearinghouse agent for Hospital Services. TAXES AND FEES ON ENHANCED SERVICES BILLING I-',C. 2 State sales tax Total ESBl non-basic service charges 1.c,8 $ 1.68 $ 29.68 Totalfor ESBI'x* $ 29.68 Nonpayment of provider charges will not result in the disconnect ,~n of your 10l:al telephone service; however, collection of unpaid charges may be 'ursued D'I the service provider. . For more informatioll Oil ESBI, please access thdr \Vorld \Vide 'Web Site address at: http://www.hillvicw.com/esbi 33 P063 7177611731 000706 00 PA210'HBRDA1 = .031692 11':;0002(>1:'1': For E,SBI fjllcstions, call toll frcc t 888 295-3724 ~'1c\ G" ~fl\ 01/\\ OU( 01 r ---~ ~ P OF ENVELOPE ~TTED LINE _ _ _ _ _ _ _ ERATTO FOLD AT _ _ __ PLACE STI~FlN AD.2Fl~._ -Mur All --------~~~litiFIEiJ H ~ 4844 6367 50 0003 s '~'I' ...... . I -.., _. If '., 0000 J 7013 RETunN RECeiPT REQUESTED I U.S. POSTAGE PAID MECHANICSBURG.PF 17055 SEP i5. '07 AMOUNT $9.85 ,., 00013630_16 . . 1 i., , ~ ~I Use ~ tJ/1I1IU5KtfV1:- .-//:;1-0 .;/vt:- From //1. ycct' I l<'!>" SJl{b f';J-t 12-7L .~&--u{. /J i?4 15 __ I" (It'. IL . " L rf 1'-' !> . T rft,) uS To ('v,11IJ~7! . (1"l/yt " Iftl tj - Lf/I t..~> J .:7 S 4'JC/ <' r Iji "6 ~ . '" . C ()LI ILl ,~ A- I '7&.)/./ e-)(t-11 -> r i7 Q tl-fl.-L- I S L L; I 2006 228 February Label . --- ------- -- .. ) l